Comparative In Vitro Analysis of Root Cementum Surface Alterations Following Various Mechanical and Chemical Treatment Protocols in Gingival Surgery

<b>Background/Objectives:</b> Gingival recession poses significant challenges in periodontal therapy, particularly in procedures aimed at achieving predictable root coverage and long-term stability of grafts. Conditioning of the root surface plays a crucial role in improving biomaterial adhesion and facilitating periodontal regeneration. This in vitro study aimed to evaluate the morphological and microroughness alterations of root cementum following different mechanical and chemical conditioning protocols commonly used in mucogingival surgery. <b>Methods:</b> Forty extracted human single-rooted teeth were randomly allocated into eight groups: untreated control, mechanical scaling alone, and scaling combined with ethylenediaminetetraacetic acid (EDTA), citric acid, phosphoric acid, tetracycline, doxycycline, or saline. Surface roughness was measured using contact profilometry, while structural modifications were analyzed via scanning electron microscopy. <b>Results:</b> Statistically significant intergroup differences (<i>p</i> < 0.05) were observed. Baneocin treatment produced the most conservative changes, with limited surface roughness and minimal structural alteration, whereas phosphoric acid, tetracycline, and EDTA caused pronounced demineralization and surface porosity. Citric acid and doxycycline induced moderate alterations, with partial preservation of cementum integrity. The null hypothesis assuming no surface or morphological changes was rejected. <b>Conclusions:</b> These findings indicate that low-aggressiveness agents may achieve an optimal balance between surface decontamination and cementum preservation, which is critical for enhancing graft integration and improving clinical outcomes in root coverage surgery.