Effects of citric acid treatment on autogenous free graft coverage of localized recession

Citric acid root conditioning prior to free gingival autograft (FGA) coverage of denuded roots may increase the likelihood of reattachment, but controlled studies to determine the value of the procedure have not been done on human subjects. This investigation was done to compare the effects of FGA root coverage with and without citric acid pretreatment. Nineteen patients with 30 affected teeth participated in the study. Fifteen teeth received FGAs without citric acid pretreatment and 15 teeth received FGAs with citric acid pretreatment. Measurements of gingival recession and sulcus depth were made preoperatively and 30, 60 and 90 days following the surgical procedure. Free gingival autografts with and without citric acid pretreatment each significantly reduced the amount of exposed root, but no differences between groups were found. Except for the 90-day single tooth control group, mean sulcus depths were significantly decreased at 30, 60 and 90 days, but there were no differences noted between single tooth citric acid and control groups or multiple tooth citric acid and control groups. Citric acid treatment of affected roots prior to FGA coverage does not appear to be justifiable.