Scanning electron microscopy study to analyze the morphological characteristics of root surfaces after application of Carisolv gel in association with scaling and root planing: In vitro study

CONTEXT: There has been considerable interest in the use of chemical-assisted root detoxification. Chemical agents have been proposed to facilitate calculus removal. AIMS: A study was carried out to analyze the morphological characteristics of the root surfaces after application of Carisolv gel in association with scaling and root planing under scanning electron microscopy (SEM). SETTINGS AND DESIGN: The Department of Periodontics of the K. M. Shah Dental College and Hospital, Vadodara, (Gujarat, India). MATERIALS AND METHODS: Sixty periodontally compromised extracted human teeth were randomly assigned to four groups: (1) scaling and root planning (SRP) alone; (2) passive topical application of Carisolv + SRP; (3) active topical application of Carisolv + SRP; (4) multiple applications of Carisolv + SRP. Carisolv gel was applied to the root surfaces for 30 seconds, followed by scaling and root planing, consisting of 30 strokes, with Gracey curettes in an apical-coronal direction, parallel to the long axis of the tooth. The only exception was group 4, where the roots were instrumented until a smooth, hard, and glass-like surface was achieved. All specimens were further analyzed by SEM. STATISTICAL ANALYSIS: The Analysis of Variance (ANOVA) method was used. RESULTS: Active application of Carisolv gel produced more extensive morphological changes than passive application and SRP alone. When multiple applications of Carisolv with SRP were performed, there was a significant decrease in the smear layer compared to a single application of the gel, either passively or actively. CONCLUSIONS: The Carisolv gel failed to remove the smear layer completely, especially with a single application, independently of the method of application. This study documented that the Carisolv gel produced changes in the root morphology of periodontally compromised teeth, only when it was applied actively and multiple times.