| Agent used | Method of use | Advantages | Limitations |
|---|---|---|---|
| Citric Acid | pH 1.0. Topical application on root surface for 2-3 minutes after scaling and root planing. | Removal of smear layer [9]. | No predictable regeneration [12]. pH acidic and can be unfavorable for cell attachment [13]. |
| Tetracycline | 100mg/ml solution. Topical application on root surface for 5 minutes after scaling and root planing. | Anti-collagenase and anti-microbial activity [14]. Smear layer removal [15]. |
No significant gain in attachment reported [12]. |
| Fibronectin | 0.38mg/ml solution- topical application. | Promotes cell adhesion to root surface and chemotactic effect on periodontal fibroblasts [16]. | Ineffective when used alone. When combined with citric acid, better clinical attachment level gain [17]. |
| EDTA | 2 concentrations have been used (8% and 24%). The 24% concentration had neutral ph (7.0-7.2). Topical application on root surface for 2-3 minutes after scaling and root planing | Effective smear layer removal [18]. Neutral pH favors cell migration and attachment [19]. |
Ineffective when used alone. When used with Emdogain, periodontal regeneration has been demonstrated [20]. |
| EMDOGAIN | A combination of enamel matrix proteins. Bio-mimetic concept. Used along with 24% EDTA. |
Acellular cementum formation has been demonstrated [21]. | Cost is prohibitive |