The pulpal response to topically applied citric acid

Citric acid is currently being used to aid in the reattachment of periodontal tissues to tooth roots which have become separated as a result of periodontitis. The present study examines the effect of topically applied citric acid on the dental pulp. Citric acid, pH 1, was applied for 3 minutes on instrumented premolar teeth in six dogs. As a control, saline solution was applied on similarly instrumented premolars. The teeth were removed 1, 6, 24, 48, 72, and 144 hours after citric acid application. After histologic preparation, the pulps were examined for inflammatory cell infiltrates, odontoblast displacement into the dentinal tubules, hyperemic capillaries in the odontoblast layer, hemorrhage, abscess formation, irregular dentin, and the thickness of the dentin remaining beneath the treated area. There was no statistically significant response to the citric acid over the saline controls. Nor was the pulpal response, as examined above, correlated to the thickness of the remaining dentin. The results suggest that citric acid, pH 1, when applied to tooth roots during surgical reattachment therapy, does not adversely affect the pulp.