Restorative Dentistry & Endodontics

Review Article

Success rate of direct pulp capping on permanent teeth using bioactive materials: a systematic review and meta-analysis of randomized clinical trials: Karem Paula Pinto, Gabriela Ribeiro da Silva, Cláudio Malizia Alves Ferreira, Luciana Moura Sassone, Emmanuel João Nogueira Leal da Silva; Restor Dent Endod 2024;49(4):e34. Published online September 6, 2024; DOI: https://doi.org/10.5395/rde.2024.49.e34

Abstract PDF Supplementary Material PubReader ePub: This systematic review and meta-analysis aimed to evaluate the success rate of direct pulp capping (DPC) on permanent teeth, comparing the use of MTA with calcium hydroxide and calcium silicate-based cements. A systematic search was carried out in 4 databases until July 2023. The selection was based on PICOS criteria and only randomized clinical trials were included. The risk of bias was assessed using RoB-2 tool, and meta-analyses were performed using RevMan 5.3 software. The overall quality of evidence was determined using the GRADE tool. Thirteen studies were included. Meta-analyses indicated significantly higher success rate for DPC using MTA compared to calcium hydroxide, while no significant difference was observed between MTA and Biodentine, showing a success rate from 80% to 100% even after 3 years of follow-up. Five studies were classified as having high risk of bias and the GRADE assessment revealed low certainty of evidence. DPC is highly effective for permanent teeth when using MTA or Biodentine. There is a need for future well-designed randomized clinical trials to evaluate the efficacy of DPC using newer bioceramic materials.

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Case Report

Garre’s osteomyelitis of the mandible managed by nonsurgical re-endodontic treatment: Heegyun Kim, Jiyoung Kwon, Hyun-Jung Kim, Soram Oh, Duck-Su Kim, Ji-Hyun Jang; Restor Dent Endod 2024;49(2):e13. Published online March 18, 2024; DOI: https://doi.org/10.5395/rde.2024.49.e13

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Chronic osteomyelitis with proliferative periostitis, known as Garre’s osteomyelitis, is a type of osteomyelitis characterized by a distinctive gross thickening of the periosteum of bones. Peripheral reactive bone formation can be caused by mild irritation or infection. Garre’s osteomyelitis is usually diagnosed in children and young adults, and the mandible is more affected than the maxilla. The following is a case report of a 12-year-old female patient with Garre’s osteomyelitis of the mandible due to an infection of a root canal-treated tooth. Without surgical intervention, the patient’s symptoms were relieved through nonsurgical root canal re-treatment with long-term calcium hydroxide placement. A cone-beam computed tomography image obtained 6 months after treatment completion displayed complete healing of the periapical lesion and resolution of the peripheral reactive buccal bone. Due to the clinical features of Garre's osteomyelitis, which is characterized by thickening of the periosteum, it can be mistaken for other diseases such as fibrous dysplasia. It is important to correctly diagnose Garre's osteomyelitis based on its distinctive clinical features to avoid unnecessary surgical intervention, and it can lead to minimally invasive treatment options.

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Focal osteomyelitis with proliferative periostitis
Zarah Yakoob
South African Dental Journal.2025; 79(09): 508. CrossRef

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Research Article

Influence of access cavity design on calcium hydroxide removal using different cleaning protocols: a confocal laser scanning microscopy study: Seda Falakaloğlu, Merve Yeniçeri Özata, Betül Güneş, Emmanuel João Nogueira Leal Silva, Mustafa Gündoğar, Burcu Güçyetmez Topal; Restor Dent Endod 2023;48(3):e25. Published online July 24, 2023; DOI: https://doi.org/10.5395/rde.2023.48.e25

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Objectives

The purpose of this study was to evaluate the influence of endodontic access cavities design on the removal of calcium hydroxide medication of the apical third of mandibular incisor root canal walls and dentinal tubules with different cleaning protocols: EDDY sonic activation, Er,Cr:YSGG laser-activated irrigation, or conventional irrigation with IrriFlex.

Materials and Methods

Seventy-eight extracted human mandibular incisors were assigned to 6 experimental groups (n = 13) according to the endodontic access cavity and cleaning protocol for calcium hydroxide removal: traditional access cavity (TradAC)/EDDY; ultraconservative access cavity performed in the incisal edge (UltraAC.Inc)/EDDY; TradAC/Er,Cr:YSGG; UltraAC.Inc/Er,Cr:YSGG; TradAC/IrriFlex; or UltraAC.Inc/IrriFlex. Confocal laser scanning microscopy images were used to measure the non-penetration percentage, maximum residual calcium hydroxide penetration depth, and penetration area at 2 and 4 mm from the apex. Data were statistically analyzed using Shapiro-Wilk and WRS2 package for 2-way comparison of non-normally distributed parameters (depth of penetration, area of penetration, and percentage of non-penetration) according to cavity and cleaning protocol with the significance level set at 5%.

Results

The effect of cavity and cleaning protocol interactions on penetration depth, penetration area and non-penetration percentage was not found statistically significant at 2 and 4 mm levels (p > 0.05).

Conclusions

The present study demonstrated that TradAC or UltraAC.Inc preparations with different cleaning protocols in extracted mandibular incisors did not influence the remaining calcium hydroxide at 2 and 4 mm from the apex.

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Effect of Apical Preparation Size and Preparation Taper on Smear Layer Removal Using Two Different Irrigation Needles: A Scanning Electron Microscopy Study
Rania Lebbos, Naji Kharouf, Deepak Mehta, Jamal Jabr, Cynthia Kamel, Roula El Hachem, Youssef Haikel, Marc Krikor Kaloustian
European Journal of Dentistry.2024;[Epub] CrossRef

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Case Report

Successful nonsurgical treatment of type II dens invaginatus with 5 root canals using a self-adjusting file: a case report: George Táccio de Miranda Candeiro, Antônio Sérgio Teixeira de Menezes, Ana Carolina Saldanha de Oliveira, Flávio Rodrigues Ferreira Alves; Restor Dent Endod 2023;48(2):e17. Published online April 27, 2023; DOI: https://doi.org/10.5395/rde.2023.48.e17

Abstract PDF PubReader ePub: The present report describes the endodontic treatment of an Oehlers type II dens invaginatus in a maxillary lateral incisor with 5 root canals, an extremely rare condition. Apical periodontitis and related symptoms were noted. Cone-beam computed tomography was used to aid the diagnosis, reveal tooth morphology, and assist in canal location. The pulp chamber was carefully accessed, and the root canals were explored under magnification. All root canals were prepared with an R25 Reciproc Blue system and sodium hypochlorite (NaOCl) irrigation. After initial preparation, a self-adjusting file (SAF) with NaOCl and ethylenediaminetetraacetic acid was used to complement the disinfection. Additionally, calcium hydroxide medication was applied. Vertical compaction was used to fill the canals with a calcium silicate-based endodontic sealer and gutta-percha. After 12 months, the patient exhibited healing of the periapical region, absence of symptoms, and normal dental function. In conclusion, this nonsurgical treatment protocol was successful in promoting the cure of apical periodontitis. Both complementary disinfection with an SAF and use of calcium hydroxide medication should be considered when choosing the best treatment approach for dens invaginatus with very complex anatomy.

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Research Articles

Calcium-doped zinc oxide nanocrystals as an innovative intracanal medicament: a pilot study: Gabriela Leite de Souza, Thamara Eduarda Alves Magalhães, Gabrielle Alves Nunes Freitas, Nelly Xiomara Alvarado Lemus, Gabriella Lopes de Rezende Barbosa, Anielle Christine Almeida Silva, Camilla Christian Gomes Moura; Restor Dent Endod 2022;47(4):e38. Published online October 4, 2022; DOI: https://doi.org/10.5395/rde.2022.47.e38

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Objectives

This study investigated the cytotoxicity, radiopacity, pH, and dentinal tubule penetration of a paste of 1.0% calcium-doped zinc oxide nanocrystals (ZnO:1.0Ca) combined with propylene glycol (PRG) or polyethylene glycol and propylene glycol (PEG-PRG).

Materials and Methods

The pastes were prepared by mixing calcium hydroxide [Ca(OH)₂] or ZnO:1.0Ca with PRG or a PEG-PRG mixture. The pH was evaluated after 24 and 96 hours of storage in deionized water. Digital radiographs were acquired for radiopacity analysis and bubble counting of each material. The materials were labeled with 0.1% fluorescein and applied to root canals, and images of their dentinal tubule penetration were obtained using confocal laser scanning microscopy. RAW264.7 macrophages were placed in different dilutions of culture media previously exposed to the materials for 24 and 96 hours and tested for cell viability using the MTT assay. Analysis of variance and the Tukey test (α = 0.05) were performed.

Results

ZnO:1.0Ca materials showed lower viability at 1:1 and 1:2 dilutions than Ca(OH)₂ materials (p < 0.0001). Ca(OH)₂ had higher pH values than ZnO:1.0Ca at 24 and 96 hours, regardless of the vehicle (p < 0.05). ZnO:1.0Ca pastes showed higher radiopacity than Ca(OH)₂ pastes (p < 0.01). No between-material differences were found in bubble counting (p = 0.0902). The ZnO:1.0Ca pastes had a greater penetration depth than Ca(OH)₂ in the apical third (p < 0.0001).

Conclusions

ZnO:1.0Ca medicaments presented higher penetrability, cell viability, and radiopacity than Ca(OH)₂. Higher values of cell viability and pH were present in Ca(OH)₂ than in ZnO:1.0Ca.

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Nano calcium zincate-assisted synthesis of benzo[ d ]thiazol-2-yl phenylisoxazoles: quantum computational, in silico molecular docking simulations and DNA interaction
A. K. Smitha, V. Srinivasa Murthy, B. Vinay Kumar, M. Sennappan, A. H. Shridhar, Lohit Naik, K. Yogendra, N. Madhusudhana
Nucleosides, Nucleotides & Nucleic Acids.2025; : 1. CrossRef

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Calcium hydroxide intracanal medication effects on pain and flare-up: a systematic review and meta-analysis: Ahmed Mohamed Ibrahim, Siza Yacoub Zakhary, Suzan Abdul Wanees Amin; Restor Dent Endod 2020;45(3):e26. Published online May 22, 2020; DOI: https://doi.org/10.5395/rde.2020.45.e26

Abstract PDF Supplementary Material PubReader ePub

Objectives

This study aimed to systematically review the pain and flare-up effects of calcium hydroxide (CH) as intracanal medication (ICM) in non-vital mature teeth.

Materials and Methods

Electronic-databases searching for published and grey literature and manual searching were conducted. Only randomized clinical trials (RCTs) were included comparing CH to other ICMs in non-vital mature teeth. The risk of bias was assessed using the RoB 2.0 Cochrane tool. The main outcomes were pain and flare-up. Qualitative and quantitative analysis, wherever applicable, was performed. The certainty of evidence (CoE) was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE).

Results

Sixteen articles were included in 6 comparisons at different time points for different outcomes. CH reduced pain risk than no ICM within the 1–14-days interval (p < 0.05) and than triple-antibiotic paste within the first day (p < 0.05) and was similar to corticosteroid/antibiotics combination (p > 0.05). Chlorhexidine (CHX) or CH/CHX, however, reduced pain levels than CH alone (p < 0.05). CH showed higher flare-up risk than CHX (p < 0.05). CoE, however, ranged from very low to moderate.

Conclusion

Most comparisons for different outcomes are based on very few studies, mostly low-powered, with an overall low CoE. Thus, the available evidence is considered insufficient to either support or refute CH effectiveness or to recommend one ICM over another. Therefore, further well-designed, larger RCTs are required.

Trial Registration

PROSPERO database Identifier: CRD42016041953

Citations

Citations to this article as recorded by

Garre’s osteomyelitis of the mandible managed by nonsurgical re-endodontic treatment
Heegyun Kim, Jiyoung Kwon, Hyun-Jung Kim, Soram Oh, Duck-Su Kim, Ji-Hyun Jang
Restorative Dentistry & Endodontics.2024;[Epub] CrossRef
Interpretation by literature review of the use of calcium hydroxide as an intra-ductal medication
María Belén Muñoz Padilla, Verónica Alicia Vega Martínez, Camila Alejandra Villafuerte Moya
Salud, Ciencia y Tecnología.2024; 4: 924. CrossRef
ProTaper Ultimate: The Evolution of Rotary Systems and Their Clinical Applicability
Mateo-Castillo JF, Siqueira-Sandrin VDS, Moreira RA, Brandelero Junior S, Olano-Dextre TL, Claudia R Pinheiro
Journal of Operative Dentistry & Endodontics.2024; 9(1): 16. CrossRef
Comparative Evaluation of Bacterial Reduction by Laser-Activated Irrigation Technique (LAI) With Conventional Needle Irrigation (CNI) in Single-Rooted Teeth With Pulpal Necrosis: A Single-Blinded Randomized Controlled Trial
Keerthika Rajamanickam, Sandhya Raghu, J Vijayashree Priyadharsini, Delphine Priscilla Antony, Nivedhitha Malli Sureshbabu
Cureus.2023;[Epub] CrossRef
Post-Operative Endodontic Pain Management: An Overview of Systematic Reviews on Post-Operatively Administered Oral Medications and Integrated Evidence-Based Clinical Recommendations
Federica Di Spirito, Giuseppe Scelza, Roberto Fornara, Francesco Giordano, Donato Rosa, Alessandra Amato
Healthcare.2022; 10(5): 760. CrossRef
Management of External Inflammatory Root Resorption following Tooth Autotransplantation Using a Modified Combination of Triple Antibiotics
Saeed Asgary, Ardavan Parhizkar, Paulo J. Palma
Case Reports in Dentistry.2022; 2022: 1. CrossRef
Calcium hydroxide as an intracanal medication for postoperative pain during primary root canal therapy: A systematic review and meta-analysis with trial sequential analysis of randomised controlled trials
Muhammad Zubair Ahmad, Durre Sadaf, Khalid A Merdad, Amani Almohaimeed, Igho J. Onakpoya
Journal of Evidence-Based Dental Practice.2022; 22(1): 101680. CrossRef
Post-operative Pain and Antibacterial Efficacy of Silver Nanoparticles Formulations Intracanal Medication: A Randomized Controlled Clinical Study
Nermine Hassan, Alaa Diab, Geraldine Ahmed
Open Access Macedonian Journal of Medical Sciences.2021; 9(D): 248. CrossRef

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Review Article

Effect of calcium hydroxide on inflammatory root resorption and ankylosis in replanted teeth compared with other intracanal materials: a review: Maryam Zare Jahromi, Mahmood Reza Kalantar Motamedi; Restor Dent Endod 2019;44(3):e32. Published online August 1, 2019; DOI: https://doi.org/10.5395/rde.2019.44.e32

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Calcium hydroxide (CH) is the gold-standard intracanal dressing for teeth subjected to traumatic avulsion. A common complication after the replantation of avulsed teeth is root resorption (RR). The current review was conducted to compare the effect of CH with that of other intracanal medications and filling materials on inflammatory RR and replacement RR (ankylosis) in replanted teeth. The PubMed and Scopus databases were searched through June 2018 using specific keywords related to the title of the present article. The materials that were compared to CH were in 2 categories: 1) mineral trioxide aggregate (MTA) and endodontic sealers as permanent filling materials for single-visit treatment, and 2) Ledermix, bisphosphonates, acetazolamide, indomethacin, gallium nitrate, and enamel matrix-derived protein (Emdogain) as intracanal medicaments for multiple-visit management of avulsed teeth prior to the final obturation. MTA can be used as a single-visit root filling material; however, there are limited data on its efficacy due to a lack of clinical trials. Ledermix and acetazolamide were comparable to CH in reducing RR. Emdogain seems to be an interesting material, but the data supporting its use as an intracanal medication remain very limited. The conclusions drawn in this study were limited by the insufficiency of clinical trials.

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Efficacy of Simvastatin in Inhibiting Bone Resorption and Promoting Healing in Delayed Tooth Avulsion: A Case Series
Rajesh Kumar, Supraja N Atluri, Alekhya Achanta, Chittaranjan Bogishetty, Tejaswini R Chunduri, Tejaswini PSS, Ramakrishna Ravi
Cureus.2025;[Epub] CrossRef
Bioactive potential of Bio-C Temp demonstrated by systemic mineralization markers and immunoexpression of bone proteins in the rat connective tissue
Camila Soares Lopes, Mateus Machado Delfino, Mário Tanomaru-Filho, Estela Sasso-Cerri, Juliane Maria Guerreiro-Tanomaru, Paulo Sérgio Cerri
Journal of Materials Science: Materials in Medicine.2024;[Epub] CrossRef
The use of mineral trioxide aggregate for treatment of children with complications of dental trauma
L.Yu. Kharkova, M.V. Korolenkova
Stomatology.2024; 103(4): 59. CrossRef
Instant Re-Implantation of Avulsed Teeth
Smita Paul, Sambarta Das, Nirmal Debbarma, Barun Dasgupta, Bidyut Seal, Ayesha Satapathy
Journal of Pharmacy and Bioallied Sciences.2024; 16(Suppl 4): S3461. CrossRef
Interpretation by literature review of the use of calcium hydroxide as an intra-ductal medication
María Belén Muñoz Padilla, Verónica Alicia Vega Martínez, Camila Alejandra Villafuerte Moya
Salud, Ciencia y Tecnología.2024; 4: 924. CrossRef
Evaluation of the physicochemical properties of intracanal medications used in traumatized teeth
Patricia Almeida da Silva de Macedo, Walbert de Andrade Vieira, Paulo Henrique Gabriel, Karla de Faria Vasconcelos, Francisco Haiter Neto, Ana Carolina Correia Laurindo de Cerqueira Neto, Brenda Paula Figueiredo de Almeida Gomes, Marcos Roberto dos Santo
Brazilian Journal of Oral Sciences.2024; 23: e242997. CrossRef
Treatment of Teeth with Root Resorptions: A Case Report and Systematic Review
Damla Erkal, Abdullah Başoğlu, Damla Kırıcı, Nezahat Arzu Kayar, Simay Koç, Kürşat Er
Galician Medical Journal.2023;[Epub] CrossRef
Successful outcome of permanent maxillary incisor reimplanted after 30 hours of extra‐oral time—a case report with 5‐year follow‐up
Ibadat Preet Kaur, Ashok Kumar, Mukul Kumar, Kanistika Jha
Clinical Case Reports.2023;[Epub] CrossRef
Replantation of an Avulsed Tooth: A Case Report
Nishad Kadulkar, Rubi Kataki, Adrija Deka, Salouno Thonai
Cureus.2023;[Epub] CrossRef
Avulsion of Permanent Mandibular Incisors: A Report of Two Cases with Pertinent Literature
Ibadat Preet Kaur, Jitendra Sharan, Pallawi Sinha, Ashok Kumar, Anand Marya, Leandro Napier de Souza
Case Reports in Dentistry.2023; 2023: 1. CrossRef
The Impact of Autologous Platelet Concentrates on the Periapical Tissues and Root Development of Replanted Teeth: A Systematic Review
Zohaib Khurshid, Faris Yahya I. Asiri, Shariq Najeeb, Jithendra Ratnayake
Materials.2022; 15(8): 2776. CrossRef

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Research Articles

Effect of intracanal medications on the interfacial properties of reparative cements: Andrea Cardoso Pereira, Mariana Valerio Pallone, Marina Angélica Marciano, Karine Laura Cortellazzi, Marcos Frozoni, Brenda P. F. A. Gomes, José Flávio Affonso de Almeida, Adriana de Jesus Soares; Restor Dent Endod 2019;44(2):e21. Published online May 9, 2019; DOI: https://doi.org/10.5395/rde.2019.44.e21

Abstract PDF PubReader ePub

Objectives

The purpose of the present study was to evaluate the effect of calcium hydroxide with 2% chlorhexidine gel (HCX) or distilled water (HCA) compared to triple antibiotic paste (TAP) on push-out bond strength and the cement/dentin interface in canals sealed with White MTA Angelus (WMTA) or Biodentine (BD).

Materials and Methods

A total of 70 extracted human lower premolars were endodontically prepared and randomly divided into 4 groups according to the intracanal medication, as follows: group 1, HCX; group 2, TAP; group 3, HCA; and group 4, control (without intracanal medication). After 7 days, the medications were removed and the cervical third of the specimens was sectioned into five 1-mm sections. The sections were then sealed with WMTA or BD as a reparative material. After 7 days in 100% humidity, a push-out bond strength test was performed. Elemental analysis was performed at the interface, using energy-dispersive spectroscopy. The data were statistically analyzed using analysis of variance and the Tukey test (p < 0.05).

Results

BD presented a higher bond strength than WMTA (p < 0.05). BD or WMTA in canals treated with calcium hydroxide intracanal medications had the highest bond strength values, with a statistically significant difference compared to TAP in the WMTA group (p < 0.05). There were small amounts of phosphorus in samples exposed to triple antibiotic paste, regardless of the coronal sealing.

Conclusions

The use of intracanal medications did not affect the bond strength of WMTA and BD, except when TAP was used with WMTA.

Citations

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Effects of calcium hydroxide intracanal medicament on push‐out bond strength of endodontic sealers: A systematic review and meta‐analysis
Mohammed Nasser Alhajj, Fadhilah Daud, Sadeq Ali Al‐Maweri, Yanti Johari, Zuryati Ab‐Ghani, Mariatti Jaafar, Yoshihito Naito, Widyasri Prananingrum, Zaihan Ariffin
Journal of Esthetic and Restorative Dentistry.2022; 34(8): 1166. CrossRef
Evaluation of a Novel Tool for Apical Plug Formation during Apexification of Immature Teeth
Yasser Alsayed Tolibah, Line Droubi, Saleh Alkurdi, Mohammad Tamer Abbara, Nada Bshara, Thuraya Lazkani, Chaza Kouchaji, Ibrahim Ali Ahmad, Ziad D. Baghdadi
International Journal of Environmental Research and Public Health.2022; 19(9): 5304. CrossRef
Spectrophotometric analysis of internal bleaching of traumatized teeth with coronal discoloration following regenerative endodontic procedures
Jaqueline Lazzari, Walbert Vieira, Vanessa Pecorari, Brenda Paula Figueiredo de Almeida Gomes, José Flávio Affonso de Almeida, Adriana De-Jesus-Soares
Brazilian Journal of Oral Sciences.2021;[Epub] CrossRef
Do intracanal medications used in regenerative endodontics affect the bond strength of powder-to-liquid and ready-to-use cervical sealing materials?
MarinaCarvalho Prado, Kevillin Martiniano, AndreaCardoso Pereira, KarineL Cortellazzi, MarinaA Marciano, Gabriel Abuna, Adriana de-Jesus-Soares
Journal of Conservative Dentistry.2021; 24(5): 464. CrossRef

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Discoloration of teeth due to different intracanal medicaments: Farzaneh Afkhami, Sadaf Elahy, Alireza Mahmoudi Nahavandi, Mohamad Javad Kharazifard, Aidin Sooratgar; Restor Dent Endod 2019;44(1):e10. Published online February 12, 2019; DOI: https://doi.org/10.5395/rde.2019.44.e10

Abstract PDF PubReader ePub

Objectives

The objective of this study was to assess coronal discoloration induced by the following intracanal medicaments: calcium hydroxide (CH), a mixture of CH paste and chlorhexidine gel (CH/CHX), and triple antibiotic paste (3Mix).

Materials and Methods

Seventy extracted single-canal teeth were selected. Access cavities were prepared and each canal was instrumented with a rotary ProTaper system. The specimens were randomly assigned to CH, CH/CHX, and 3Mix paste experimental groups (n = 20 each) or a control group (n = 10). Each experimental group was randomly divided into 2 subgroups (A and B). In subgroup A, medicaments were only applied to the root canals, while in subgroup B, the root canals were completely filled with medicaments and a cotton pellet dipped in medicament was also placed in the pulp chamber. Spectrophotometric readings were obtained from the mid-buccal surface of the tooth crowns immediately after placing the medicaments (T1) and at 1 week (T2), 1 month (T3), and 3 months (T4) after filling. The ∆E was then calculated. Data were analyzed using 2-way analysis of variance (ANOVA), 3-way ANOVA, and the Scheffé post hoc test.

Results

The greatest color change (ΔE) was observed at 3 months (p < 0.0001) and in 3Mix subgroup B (p = 0.0057). No significant color change occurred in the CH (p = 0.7865) or CH/CHX (p = 0.1367) groups over time, but the 3Mix group showed a significant ΔE (p = 0.0164).

Conclusion

Intracanal medicaments may induce tooth discoloration. Use of 3Mix must be short and it must be carefully applied only to the root canals; the access cavity should be thoroughly cleaned afterwards.

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Effects of Intra-canal Medicaments on Infrared Light Energy Transmission Through Enamel and Dentin During Photobiomodulation: An In Vitro Study
Sachin Kulkarni, Laurence J. Walsh, Yash Bhurani, Roy George
Journal of Endodontics.2025;[Epub] CrossRef
Effect of Calcium Hydroxide Versus Double Antibiotic Paste on Endodontic Treatment Outcomes in Teeth With Large Periapical Lesions: A Triple‐Blind Randomized Clinical Trial
Afsaneh Rahmati, Farshad Seyedein, Omid Dianat, Sara Saedi, Golriz Rostami, Alireza Akbarzadeh Baghban, Shima Sabertahan, Majid Kazem, Kee Y. Kum
International Journal of Dentistry.2024;[Epub] CrossRef
The effect of different intracanal irrigants on the push-out bond strength of dentin in damaged anterior primary teeth
Leila Bassir, Shirin Taravati, Farzad Nouri, Saeide Rahimi
Journal of Medicine and Life.2024; 17(5): 536. CrossRef
In Vıtro Evaluatıon of Dıscoloratıon Caused by Root Canal Sealers and Color Changes after Bleachıng
Emre Bodrumlu, Esma Dinger
Annals of Dental Specialty.2024; 12(1): 77. CrossRef
The effect of four different intracanal medicaments on the push-out bond strength of root canal sealers
Shalu Maan, Vijaya Dhar Bhatt, Rohit Singh, Sayak Gupta, Syed Alay Noorain, Aashna Gill, Pradeep Kumar, Sushil Yadav, Preeti Sharma
Journal of Medicine and Life.2022; 15(4): 448. CrossRef
Effect of hydrogel-based antibiotic intracanal medicaments on crown discoloration
Rayan B. Yaghmoor, Jeffrey A. Platt, Kenneth J. Spolnik, Tien Min Gabriel Chu, Ghaeth H. Yassen
Restorative Dentistry & Endodontics.2021;[Epub] CrossRef

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Retention of BioAggregate and MTA as coronal plugs after intracanal medication for regenerative endodontic procedures: an ex vivo study: Suzan Abdul Wanees Amin, Shaimaa Ismail Gawdat; Restor Dent Endod 2018;43(3):e18. Published online April 26, 2018; DOI: https://doi.org/10.5395/rde.2018.43.e18

Abstract PDF PubReader ePub

Objectives

This study compared the retention of BioAggregate (BA; Innovative BioCeramix) and mineral trioxide aggregate (MTA; Angelus) as coronal plugs after applying different intracanal medications (ICMs) used in regenerative endodontics.

Materials and Methods

One-hundred human maxillary central incisors were used. The canals were enlarged to a diameter of 1.7 mm. Specimens were divided into 5 groups (n = 20) according to the ICM used: calcium hydroxide (CH), 2% chlorhexidine (CHX), triple-antibiotic paste (TAP), double-antibiotic paste (DAP), and no ICM (control; CON). After 3 weeks of application, ICMs were removed and BA or MTA were placed as the plug material (n = 10). The push-out bond strength and the mode of failure were assessed. The data were analyzed using 2-way analysis of variance, the Tukey's test, and the χ² test; p values < 0.05 indicated statistical significance.

Results

The type of ICM and the type of plug material significantly affected bond strength (p < 0.01). Regardless of the type of ICM, BA showed a lower bond strength than MTA (p < 0.05). For MTA, CH showed a higher bond strength than CON, TAP and DAP; CHX showed a higher bond strength than DAP (p < 0.01). For BA, CH showed a higher bond strength than DAP (p < 0.05). The mode of failure was predominantly cohesive for BA (p < 0.05).

Conclusions

MTA may show better retention than BA. The mode of bond failure with BA can be predominantly cohesive. BA retention may be less affected by ICM type than MTA retention.

Citations

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An in vitro comparative evaluation of the effect of three intracanal medicaments – chlorhexidine gel, triple antibiotic paste, and calcium hydroxide paste on the push-out bond strength of MTA Plus, Biodentine, and calcium-enriched mixture
Gouthami Datta, Ramya Raghu, Ashish Shetty, Gautham P Manjunath, Dishant Patel, Subhashini Rajasekhara
Endodontology.2023; 35(1): 60. CrossRef
Effects of calcium hydroxide intracanal medicament on push‐out bond strength of endodontic sealers: A systematic review and meta‐analysis
Mohammed Nasser Alhajj, Fadhilah Daud, Sadeq Ali Al‐Maweri, Yanti Johari, Zuryati Ab‐Ghani, Mariatti Jaafar, Yoshihito Naito, Widyasri Prananingrum, Zaihan Ariffin
Journal of Esthetic and Restorative Dentistry.2022; 34(8): 1166. CrossRef
A Breakthrough in the Era of Calcium Silicate-Based Cements: A Critical Review
Payal S Chaudhari, Manoj G Chandak, Akshay A Jaiswal, Nikhil P Mankar, Priyanka Paul
Cureus.2022;[Epub] CrossRef
Modern Medicaments for Endodontic Treatment in Children
Н.В. Шаковец, О.С. Романова
Стоматология. Эстетика. Инновации.2021; (4): 408. CrossRef
Do intracanal medications used in regenerative endodontics affect the bond strength of powder-to-liquid and ready-to-use cervical sealing materials?
MarinaCarvalho Prado, Kevillin Martiniano, AndreaCardoso Pereira, KarineL Cortellazzi, MarinaA Marciano, Gabriel Abuna, Adriana de-Jesus-Soares
Journal of Conservative Dentistry.2021; 24(5): 464. CrossRef
In vivo Biocompatibility and Bioactivity of Calcium Silicate-Based Bioceramics in Endodontics
Wencheng Song, Wei Sun, Lili Chen, Zhenglin Yuan
Frontiers in Bioengineering and Biotechnology.2020;[Epub] CrossRef
Effect of Hydrogel-Based Antibiotic Intracanal Medicaments on Push-Out Bond Strength
Rayan B. Yaghmoor, Jeffrey A. Platt, Kenneth J. Spolnik, Tien Min Gabriel Chu, Ghaeth H. Yassen
European Journal of Dentistry.2020; 14(04): 575. CrossRef
Regenerative Endodontic Procedures, Disinfectants and Outcomes: A Systematic Review
Adam S. Kharchi, Nara Tagiyeva-Milne, Shalini Kanagasingam
Primary Dental Journal.2020; 9(4): 65. CrossRef

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Removal efficacy and cytotoxicity of a calcium hydroxide paste using N-2-methyl-pyrrolidone as a vehicle: Myung-Jin Lim, Hyun-Jin Jang, Mi-Kyung Yu, Kwang-Won Lee, Kyung-San Min; Restor Dent Endod 2017;42(4):290-300. Published online October 20, 2017; DOI: https://doi.org/10.5395/rde.2017.42.4.290

Abstract PDF PubReader ePub

Objectives

This study investigated the removal efficacy and cytotoxicity of a newly developed calcium hydroxide paste (cleaniCal, Maruchi) using N-2-methyl-pyrrolidone (NMP) as a vehicle in comparison with ApexCal (Ivoclar Vivadent) and Calcipex II (Nishika), which use different vehicles such as polyethylene glycol and propylene glycol, respectively.

Materials and Methods

Thirty maxillary premolars with oval-shaped canals were divided into 3 groups and the teeth were filled with one of the pastes. After removal of the paste, micro-computed tomographic (μ-CT) imaging was obtained to assess the volume of residual paste in the root canal of each tooth. The teeth were then split longitudinally and the area of the paste-coated surface was evaluated by stereomicroscopy. The cytotoxicity of each product was assessed using an agar overlay assay. The effect of each vehicle on cell viability was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The data were analyzed using one-way analysis of variance and Tukey's tests to detect any significance (p < 0.05).

Results

In the μ-CT and stereomicroscopic analysis, cleaniCal exhibited less remnants of medicament than ApexCal and Calcipex. cleaniCal showed a higher cytotoxicity than the other pastes in the agar overlay assay. Furthermore, NMP exhibited lower cell viability compared to the other vehicles.

Conclusions

cleaniCal showed better removal efficacy compared to the other products. However, clinicians should be aware of the higher cytotoxicity of the NMP-based material and consider its possible adverse effects on periradicular tissue when it is overfilled.

Citations

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Mi-Ah Kim, Min-Kyeong Kim, Eun-Sook Kang, Kyung-San Min
Journal of Oral Science.2025; 67(1): 35. CrossRef
Lipoteichoic Acid from Lacticaseibacillus rhamnosus GG as a Novel Intracanal Medicament Targeting Enterococcus faecalis Biofilm Formation
Ji-Young Yoon, Somin Park, Dongwook Lee, Ok-Jin Park, WooCheol Lee, Seung Hyun Han
Journal of Microbiology.2024; 62(10): 897. CrossRef
Rheological properties and handling characteristics of four injectable calcium hydroxide pastes
Min-Jung KIM, In-Bog LEE
Dental Materials Journal.2024; 43(6): 796. CrossRef
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Dikshya Purohit, Shronika, Pradyumna Misra, Gaurav Jain, Preeti Shukla
Asian Journal of Oral Health and Allied Sciences.2023; 13: 9. CrossRef
Removal of Calcium Hydroxide Paste Leaked Into the Maxillary Sinus
Dohee Kim, Young Kim, Jeong Joon Han
Ear, Nose & Throat Journal.2023;[Epub] CrossRef
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Sahili Mungekar-Markandey, Ashwin Jawdekar
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Sonic irrigation for removal of calcium hydroxide in the apical root canal: A micro-CT and light-coupled tracking analysis
Wonjoon Moon, Shin Hye Chung, Juhea Chang, Zhaoqiang Zhang
PLOS ONE.2022; 17(6): e0268791. CrossRef
Effect of N-2-methyl-pyrrolidone on Enterococcus faecalis biofilms
Mi-Ah KIM, Prasanna NEELAKANTAN, Kyung-San MIN
Dental Materials Journal.2022; 41(5): 774. CrossRef
Characterization, Antimicrobial Effects, and Cytocompatibility of a Root Canal Sealer Produced by Pozzolan Reaction between Calcium Hydroxide and Silica
Mi-Ah Kim, Vinicius Rosa, Prasanna Neelakantan, Yun-Chan Hwang, Kyung-San Min
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Ray J. Butcher, Andrew P. Purdy, Paul A. Brown, Daniel Gunlycke
Acta Crystallographica Section E Crystallographic Communications.2021; 77(1): 70. CrossRef
Effect of a calcium hydroxide-based intracanal medicament containing N-2-methyl pyrrolidone as a vehicle against Enterococcus faecalis biofilm
Taegun KIM, Mi-Ah KIM, Yun-Chan HWANG, Vinicius ROSA, Massimo DEL FABBRO, Kyung-San MIN
Journal of Applied Oral Science.2020;[Epub] CrossRef

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Case Report

Accidental injury of the inferior alveolar nerve due to the extrusion of calcium hydroxide in endodontic treatment: a case report: Yooseok Shin, Byoung-Duck Roh, Yemi Kim, Taehyeon Kim, Hyungjun Kim; Restor Dent Endod 2016;41(1):63-67. Published online January 6, 2016; DOI: https://doi.org/10.5395/rde.2016.41.1.63

Abstract PDF PubReader ePub

During clinical endodontic treatment, we often find radiopaque filling material beyond the root apex. Accidental extrusion of calcium hydroxide could cause the injury of inferior alveolar nerve, such as paresthesia or continuous inflammatory response. This case report presents the extrusion of calcium hydroxide and treatment procedures including surgical intervention. A 48 yr old female patient experienced Calcipex II extrusion in to the inferior alveolar canal on left mandibular area during endodontic treatment. After completion of endodontic treatment on left mandibular first molar, surgical intervention was planned under general anesthesia. After cortical bone osteotomy and debridement, neuroma resection and neurorrhaphy was performed, and prognosis was observed. But no improvement in sensory nerve was seen following surgical intervention after 20 mon. A clinician should be aware of extrusion of intracanal medicaments and the possibility of damage on inferior alveolar canal. Injectable type of calcium hydroxide should be applied with care for preventing nerve injury. The alternative delivery method such as lentulo spiral was suggested on the posterior mandibular molar.

Citations

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Uma Maheswari Pandyan, Banumathi Arumugam, Ulaganathan Gurunathan, Shahul Hameed Kopuli Ashkar Ali
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Inferior alveolar nerve injury due to the extrusion of calcium hydroxide during endodontic treatment: A case report
Metin Berk Kasapoğlu, Gülce Ecem Doğancalı
Australian Endodontic Journal.2022; 48(2): 342. CrossRef
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P. Uma Maheswari, A. Banumathi, G. Ulaganathan, R. Yoganandha
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Keith A. Sonneveld, Kristopher L. Hasstedt, Roger A. Meyer, Shahrokh C. Bagheri
Journal of Oral and Maxillofacial Surgery.2021; 79(7): 1434. CrossRef
The significance of diagnosis and treatment planning in periapical lesion overfilled with calcium hydroxide paste
Kyoung-Hwa Jung, Eun-Young Kwon, Youn-Kyung Choi, So-Yeun Kim, Hye-Mi Jeon, Jeong-Kil Park
Journal of Dental Rehabilitation and Applied Science.2021; 37(2): 95. CrossRef
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Michał Puciło, Mariusz Lipski, Magdalena Sroczyk-Jaszczyńska, Aleksandra Puciło, Alicja Nowicka
Surgical and Radiologic Anatomy.2020; 42(5): 529. CrossRef
Massive extrusion of calcium hydroxide paste containing barium sulphate during endodontic treatment
Jéssica Montenegro Fonsêca, Natália Rangel Palmier, Gleyson Kleber Amaral‐Silva, Lady Paola Aristizabal Arboleda, José Flávio Affonso Almeida, Mario Fernando de Goes, Pablo Agustin Vargas, Marcio Ajudarte Lopes, Alan Roger Santos‐Silva
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Alan H. Gluskin, Gordon Lai, Christine I. Peters, Ove A. Peters
The Journal of the American Dental Association.2020; 151(5): 317. CrossRef
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R. Castro, M. Guivarc'h, J.M. Foletti, J.H. Catherine, C. Chossegros, L. Guyot
Journal of Stomatology, Oral and Maxillofacial Surgery.2018; 119(5): 412. CrossRef
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Alex Lvovsky, Shir Bachrach, Hyeon-Cheol Kim, Ajinkya Pawar, Oleg Levinzon, Joe Ben Itzhak, Michael Solomonov
Journal of Endodontics.2018; 44(4): 555. CrossRef
A case of high density abnormality in x-ray findings of mandible caused by leakage of root canal filling paste
Haruko Kashiwamura, Kyoko Oka, Yoko Tuchihashi, Hanako Yoshioka, Mayumi Kato, Atsuko Baba, Toyohiro Kagawa, Kazuhiko Okamura, Masao Ozaki
Pediatric Dental Journal.2017; 27(3): 162. CrossRef
Oral dysesthesia
Christopher J. Spencer, Gary D. Klasser
The Journal of the American Dental Association.2017; 148(12): 941. CrossRef
Microsurgical Decompression of Inferior Alveolar Nerve After Endodontic Treatment Complications
Bernardo Bianchi, Andrea Ferri, Andrea Varazzani, Michela Bergonzani, Enrico Sesenna
Journal of Craniofacial Surgery.2017; 28(5): 1365. CrossRef

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Research Articles

Effect of dentin treatment on proliferation and differentiation of human dental pulp stem cells: Minjeong Park, Nan-Sim Pang, Il-Young Jung; Restor Dent Endod 2015;40(4):290-298. Published online September 23, 2015; DOI: https://doi.org/10.5395/rde.2015.40.4.290

Abstract PDF PubReader ePub

Objectives

Sodium hypochlorite (NaOCl) is an excellent bactericidal agent, but it is detrimental to stem cell survival, whereas intracanal medicaments such as calcium hydroxide (Ca[OH]₂) promote the survival and proliferation of stem cells. This study evaluated the effect of sequential NaOCl and Ca[OH]₂ application on the attachment and differentiation of dental pulp stem cells (DPSCs).

Materials and Methods

DPSCs were obtained from human third molars. All dentin specimens were treated with 5.25% NaOCl for 30 min. DPSCs were seeded on the dentin specimens and processed with additional 1 mg/mL Ca[OH]₂, 17% ethylenediaminetetraacetic acid (EDTA) treatment, file instrumentation, or a combination of these methods. After 7 day of culture, we examined DPSC morphology using scanning electron microscopy and determined the cell survival rate with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. We measured cell adhesion gene expression levels after 4 day of culture and odontogenic differentiation gene expression levels after 4 wk using quantitative real-time polymerase chain reaction.

Results

DPSCs did not attach to the dentin in the NaOCl-treated group. The gene expression levels of fibronectin-1 and secreted phosphoprotein-1 gene in both the Ca[OH]₂- and the EDTA-treated groups were significantly higher than those in the other groups. All Ca[OH]₂-treated groups showed higher expression levels of dentin matrix protein-1 than that of the control. The dentin sialophosphoprotein level was significantly higher in the groups treated with both Ca[OH]₂ and EDTA.

Conclusions

The application of Ca[OH]₂ and additional treatment such as EDTA or instrumentation promoted the attachment and differentiation of DPSCs after NaOCl treatment.

Citations

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Effect of erbium yttrium aluminium garnet laser dentin conditioning on dental pulp stem cells viability
Aryan Jafari, Mehdi Vatanpour, Nooshin Barikrow, Pouyan Razavi, Sohrab Tour Savadkouhi
Heliyon.2024; 10(5): e26954. CrossRef
Comparison of the effect of NaOCL, curcumin, and EDTA on differentiation, proliferation, and adhesion of dental pulp stem cells
Vahid Zand, Amin Salem Milani, Carolyn Primus, Marzie Aghazade, Hadi Mokhtari, Sabete Bagheri Sabzevar, Pardis Tehranchi
Journal of Oral Biology and Craniofacial Research.2023; 13(2): 347. CrossRef
Differential Effects of Extracellular Matrix Glycoproteins Fibronectin and Laminin-5 on Dental Pulp Stem Cell Phenotypes and Responsiveness
Hyungbin Lee, Allen Bae, John Kim, Karl Kingsley
Journal of Functional Biomaterials.2023; 14(2): 91. CrossRef
Assessment of the Influence of Various Concentrations of Sodium Hypochlorite on Stem Cell Derived From Human Exfoliated Deciduous Teeth (SHED) Proliferation and Differentiation
Viral Maru, Ashwini KB, Manisha Madkaikar, R K Sarada Devi, Ashita Gada, Salil Bapat
Cureus.2022;[Epub] CrossRef
Effects of sodium hypochlorite and ethylenediaminetetraacetic acid on proliferation, osteogenic/odontogenic differentiation, and mechanosensitive gene expression of human dental pulp stem cells
Yuejun Li, Changlong Jin, Shouliang Zhao, Han Xie
Tissue and Cell.2022; 79: 101955. CrossRef
Influence of ethylenediaminetetraacetic acid on regenerative endodontics: A systematic review
Alexandre H. dos Reis‐Prado, Lucas G. Abreu, Rogéria R. Fagundes, Sabrina de C. Oliveira, Marco C. Bottino, Antônio P. Ribeiro‐Sobrinho, Francine Benetti
International Endodontic Journal.2022; 55(6): 579. CrossRef
An in-vitro Comparative Evaluation of Quantitative Release of Transforming Growth Factor β-1 from Dentin upon the Action of Endodontic Irrigants, Medicaments, Ultrasonic Activation, and Low-Level Laser Irradiation
Anilkumar Akhila, V. P. Prabath Singh, Kerala R. Varma, Senthil V. Vasudevan, V. Sukhithasri, Salu Sasikumar
Amrita Journal of Medicine.2021; 17(2): 34. CrossRef
Non-Thermal Atmospheric Pressure Plasma-Conditioned Root Dentin Promotes Attraction and Attachment of Primary Human Dental Pulp Stem Cells in Real-Time Ex Vivo
Yeon-Jee Yoo, Min-Ji Kang, Hiran Perinpanayagam, Joo-Cheol Park, Seung-Ho Baek, Kee-Yeon Kum
Applied Sciences.2021; 11(15): 6836. CrossRef
The Effects of Intracanal Irrigants and Medicaments on Dental-Derived Stem Cells Fate in Regenerative Endodontics: An update
Sara Ayoub, Ali Cheayto, Sanaa Bassam, Mehdi Najar, Antoine Berbéri, Mohammad Fayyad-Kazan
Stem Cell Reviews and Reports.2020; 16(4): 650. CrossRef
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Jeen Nee Lui, Wen Yi Lim, Domenico Ricucci
Journal of Endodontics.2020; 46(5): 627. CrossRef
Dynamic Irrigation Promotes Apical Papilla Cell Attachment in an Ex Vivo Immature Root Canal Model
Sanupong Prompreecha, Thanapat Sastraruji, Phumisak Louwakul, Tanida Srisuwan
Journal of Endodontics.2018; 44(5): 744. CrossRef
Odontoblast-like differentiation and mineral formation of pulpsphere derived cells on human root canal dentin in vitro
Jörg Neunzehn, Sandra Pötschke, Christian Hannig, Hans-Peter Wiesmann, Marie-Theres Weber
Head & Face Medicine.2017;[Epub] CrossRef
Effects of Epigallocatechin Gallate, an Antibacterial Cross-linking Agent, on Proliferation and Differentiation of Human Dental Pulp Cells Cultured in Collagen Scaffolds
Young-Sun Kwon, Hee-Jin Kim, Yun-Chan Hwang, Vinicius Rosa, Mi-Kyung Yu, Kyung-San Min
Journal of Endodontics.2017; 43(2): 289. CrossRef

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Effect of intracanal medicaments used in endodontic regeneration procedures on microhardness and chemical structure of dentin: Ghaeth Hamdon Yassen, George Joseph Eckert, Jeffrey Allen Platt; Restor Dent Endod 2015;40(2):104-112. Published online December 24, 2014; DOI: https://doi.org/10.5395/rde.2015.40.2.104

Abstract PDF PubReader ePub

Objectives

This study was performed to investigate the effects of different intracanal medicaments on chemical structure and microhardness of dentin.

Materials and Methods

Fifty human dentin discs were obtained from intact third molars and randomly assigned into two control groups and three treatment groups. The first control group received no treatment. The second control group (no medicament group) was irrigated with sodium hypochlorite (NaOCl), stored in humid environment for four weeks and then irrigated with ethylenediaminetetraacetic acid (EDTA). The three treatment groups were irrigated with NaOCl, treated for four weeks with either 1 g/mL triple antibiotic paste (TAP), 1 mg/mL methylcellulose-based triple antibiotic paste (DTAP), or calcium hydroxide [Ca(OH)₂] and finally irrigated with EDTA. After treatment, one half of each dentin disc was subjected to Vickers microhardness (n = 10 per group) and the other half was used to evaluate the chemical structure (phosphate/amide I ratio) of treated dentin utilizing attenuated total reflection Fourier transform infrared spectroscopy (n = 5 per group). One-way ANOVA followed by Fisher's least significant difference were used for statistical analyses.

Results

Dentin discs treated with different intracanal medicaments and those treated with NaOCl + EDTA showed significant reduction in microhardness (p < 0.0001) and phosphate/amide I ratio (p < 0.05) compared to no treatment control dentin. Furthermore, dentin discs treated with TAP had significantly lower microhardness (p < 0.0001) and phosphate/amide I ratio (p < 0.0001) compared to all other groups.

Conclusions

The use of DTAP or Ca(OH)₂ medicaments during endodontic regeneration may cause significantly less microhardness reduction and superficial demineralization of dentin compared to the use of TAP.

Citations

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Aparna Palekar, Piyush Mantri, Minal Awinashe, Basawaraj Biradar, Mukund Singh
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Adriana Katunarić, Sandra Flinčec Grgac, Dragana Gabrić, Božidar Pavelić, Ivona Bago
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Rasoul Sahebalam, Marzie Boskabady, Maryam Naghavi, Samira Dehghanitafti
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Review Article

Antimicrobial effect of calcium hydroxide as an intracanal medicament in root canal treatment: a literature review - Part II. in vivo studies: Dohyun Kim, Euiseong Kim; Restor Dent Endod 2015;40(2):97-103. Published online December 9, 2014; DOI: https://doi.org/10.5395/rde.2015.40.2.97

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The first part of this study reviewed the characteristics of calcium hydroxide (Ca(OH)₂) and summarized the results of in vitro studies related to its antimicrobial effects. The second part of this review covers in vivo studies including human clinical studies and animal studies. The use of Ca(OH)₂ as an intracanal medicament represented better histological results in animal studies. However, human clinical studies showed limited antimicrobial effects that microorganisms were reduced but not eliminated through the treatment, and that some species had resistance to Ca(OH)₂. Most of clinical outcome studies supported that there is no improvement in healing of periapical lesions when Ca(OH)₂ was applied between appointments. Further studies are required for the antimicrobial effects of Ca(OH)₂, and search for the ideal material and technique to completely clean infected root canals should be continued.

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Research Article

Calcium hydroxide dressing residues after different removal techniques affect the accuracy of Root-ZX apex locator: Emel Uzunoglu, Ayhan Eymirli, Mehmet Özgür Uyanik, Semra Çalt, Emre Nagas; Restor Dent Endod 2015;40(1):44-49. Published online November 5, 2014; DOI: https://doi.org/10.5395/rde.2015.40.1.44

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Objectives

This study compared the ability of several techniques to remove calcium hydroxide (CH) from the root canal and determined the influence of CH residues on the accuracy of the electronic apex locator.

Materials and Methods

Root canals of 90 human maxillary lateral incisors with confirmed true working length (TWL) were prepared and filled with CH. The teeth were randomly assigned to one of the experimental groups according to the CH removal technique (n = 14): 0.9% saline; 0.9% saline + master apical file (MAF); 17% ethylenediamine tetraacetic acid (EDTA); 17% EDTA + MAF; 5.25% sodium hypochlorite (NaOCl); 5.25% NaOCl + MAF. Six teeth were used as negative control. After CH removal, the electronic working length was measured using Root-ZX (Morita Corp.) and compared with TWL to evaluate Root-ZX accuracy. All specimens were sectioned longitudinally, and the area of remaining CH (CH) and total canal area were measured using imaging software.

Results

The EDTA + MAF and NaOCl + MAF groups showed better CH removal than other groups (p < 0.05). Root-ZX reliability to prevent overestimated working length to be > 85% within a tolerance of ± 1.0 mm (p < 0.05). There was strong negative correlation between amount of CH residues and EAL accuracy (r = -0.800 for ± 0.5 mm; r = -0.940 for ± 1.0 mm).

Conclusions

The mechanical instrumentation improves the CH removal of irrigation solutions although none of the techniques removed the dressing completely. Residues of CH medication in root canals affected the accuracy of Root-ZX adversely.

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Review Article

Antimicrobial effect of calcium hydroxide as an intracanal medicament in root canal treatment: a literature review - Part I. In vitro studies: Dohyun Kim, Euiseong Kim; Restor Dent Endod 2014;39(4):241-252. Published online August 20, 2014; DOI: https://doi.org/10.5395/rde.2014.39.4.241

Abstract PDF PubReader ePub

The goal of endodontic treatment is the prevention and control of pulpal and periradicular infections. Calcium hydroxide (Ca(OH)₂) has been widely used in endodontics as an intracanal medicament to eliminate the remaining microorganisms after chemomechanical preparation. The purpose of this article is to review the antimicrobial properties of Ca(OH)₂ as an intracanal medicament in root canal treatment. The first part of this review details the characteristics of Ca(OH)₂ and summarizes the results of in vitro studies related to its antimicrobial effect. The antimicrobial effect of Ca(OH)₂ results from the release of hydroxyl ions when it comes into contact with aqueous fluids. Ca(OH)₂ has a wide range of antimicrobial effects against common endodontic pathogens, but is less effective against Enterococcus faecalis and Candida albicans. The addition of vehicles or other agents might contribute to the antimicrobial effect of Ca(OH)₂.

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Research Articles

Comparative efficacy of photo-activated disinfection and calcium hydroxide for disinfection of remaining carious dentin in deep cavities: a clinical study: Sidhartha Sharma, Ajay Logani, Naseem Shah; Restor Dent Endod 2014;39(3):195-200. Published online June 26, 2014; DOI: https://doi.org/10.5395/rde.2014.39.3.195

Abstract PDF PubReader ePub

Objectives

To comparatively evaluate the efficacy of photo-activated disinfection (PAD), calcium hydroxide (CH) and their combination on the treatment outcome of indirect pulp treatment (IPT).

Materials and Methods

Institutional ethical clearance and informed consent of the patients were taken. The study was also registered with clinical registry of India. Sixty permanent molars exhibiting deep occlusal carious lesion in patients with the age range of 18 - 22 yr were included. Clinical and radiographic evaluation and set inclusion and exclusion criteria's were followed. Gross caries excavation was accomplished. In group I (n = 20) PAD was applied for sixty seconds. In group II (n = 20), CH was applied to the remaining carious dentin, while in group III (n = 20), PAD application was followed by CH placement. The teeth were permanently restored. They were clinically and radiographically followed-up at 45 day, 6 mon and 12 mon. Relative density of the remaining affected dentin was measured by 'Radiovisiography (RVG) densitometric' analysis.

Results

Successful outcome with an increase in radiographic grey values were observed in all three groups. However, on inter-group comparison, this change was not significant (p > 0.05).

Conclusions

PAD and CH both have equal disinfection efficacy in the treatment of deep carious dentin. PAD alone is as effective for treatment of deep carious lesion as calcium hydroxide and hence can be used as an alternative to CH. They can be used independently in IPT, since combining both does not offer any additional therapeutic benefits.

Citations

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Clinical and Radiographic Evaluation between Conventional Mineral Trioxide Aggregate and Gel-based Mineral Trioxide Aggregate in Indirect Pulp Therapy: A Randomized Clinical Trial
Yusuf Chunawala, BK Vanishree, Supriya S Dighe, Rooposhi Saha
International Journal of Clinical Pediatric Dentistry.2025; 17(12): 1383. CrossRef
Potentialities of photoactivated disinfection in dentistry
E.I. Utkina, M.A. Gorbatova, A.M. Grjibovski, L.N. Gorbatova, A.A. Simakova
Stomatologiya.2023; 102(2): 84. CrossRef
Clinical and radiographic evaluation of diode laser and chemical disinfection in comparison to selective caries removal in management of patients with deep carious lesions
Mohamed Bahgat AbdelHamid, Ahmed Fawzy Abo Elezz, Ola M. Ibrahim Fahmy
Lasers in Dental Science.2022; 6(4): 219. CrossRef
Commercially Available Ion-Releasing Dental Materials and Cavitated Carious Lesions: Clinical Treatment Options
Amel Slimani, Salvatore Sauro, Patricia Gatón Hernández, Sevil Gurgan, Lezize Sebnem Turkun, Ivana Miletic, Avijit Banerjee, Hervé Tassery
Materials.2021; 14(21): 6272. CrossRef
Radiological Appraisal of Biodentine and Pulpotec Individually or in Combination with Photo-activated Disinfection as Pulp-capping Cements in Mature Teeth
Pratik Agrawal, Gaurav Patri, Surabhi Soumya, Prasanti K Pradhan, Vijeta Patri
The Journal of Contemporary Dental Practice.2021; 22(9): 1014. CrossRef
Clinical and radiographic evaluation of indirect pulp treatment of young permanent molars using photo-activated oral disinfection versus calcium hydroxide: a randomized controlled pilot trial
Marwa Aly Elchaghaby, Dalia Mohamed Moheb, Osama Ibrahim El Shahawy, Ahmed Mohamed Abd Alsamad, Mervat Abdel Moniem Rashed
BDJ Open.2020;[Epub] CrossRef
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A preliminary report on histological outcome of pulpotomy with endodontic biomaterials vs calcium hydroxide: Ali Nosrat, Ali Peimani, Saeed Asgary; Restor Dent Endod 2013;38(4):227-233. Published online November 12, 2013; DOI: https://doi.org/10.5395/rde.2013.38.4.227

Abstract PDF PubReader ePub

Objectives

The purpose of the study was to evaluate human dental pulp response to pulpotomy with calcium hydroxide (CH), mineral trioxide aggregate (MTA), and calcium enriched mixture (CEM) cement.

Materials and Methods

A total of nine erupted third molars were randomly assigned to each pulpotomy group. The same clinician performed full pulpotomies and coronal restorations. The patients were followed clinically for six months; the teeth were then extracted and prepared for histological assessments. The samples were blindly assessed by an independent observer for pulp vitality, pulp inflammation, and calcified bridge formation.

Results

All patients were free of clinical signs/symptoms of pulpal/periradicular diseases during the follow up period. In CH group, one tooth had necrotic radicular pulp; other two teeth in this group had vital uninflamed pulps with complete dentinal bridge formation. In CEM cement and MTA groups all teeth had vital uninflamed radicular pulps. A complete dentinal bridge was formed beneath CEM cement and MTA in all roots. Odontoblast-like cells were present beneath CEM cement and MTA in all samples.

Conclusions

This study revealed that CEM cement and MTA were reliable endodontic biomaterials in full pulpotomy treatment. In contrast, the human dental pulp response to CH might be unpredictable.

Citations

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Review Article

Chemical characteristics of mineral trioxide aggregate and its hydration reaction: Seok-Woo Chang; Restor Dent Endod 2012;37(4):188-193. Published online November 21, 2012; DOI: https://doi.org/10.5395/rde.2012.37.4.188

Abstract PDF PubReader ePub

Mineral trioxide aggregate (MTA) was developed in early 1990s and has been successfully used for root perforation repair, root end filling, and one-visit apexification. MTA is composed mainly of tricalcium silicate and dicalcium silicate. When MTA is hydrated, calcium silicate hydrate (CSH) and calcium hydroxide is formed. Formed calcium hydroxide interacts with the phosphate ion in body fluid and form amorphous calcium phosphate (ACP) which finally transforms into calcium deficient hydroxyapatite (CDHA). These mineral precipitate were reported to form the MTA-dentin interfacial layer which enhances the sealing ability of MTA. Clinically, the use of zinc oxide euginol (ZOE) based materials may retard the setting of MTA. Also, the use of acids or contact with excessive blood should be avoided before complete set of MTA, because these conditions could adversely affect the hydration reaction of MTA. Further studies on the chemical nature of MTA hydration reaction are needed.

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Basic Researchs

The effects of short-term application of calcium hydroxide on dentin fracture strength: Eun-Jung Shin, Yeong-Joon Park, Bin-Na Lee, Ji-Hyun Jang, Hoon-Sang Chang, In-Nam Hwang, Won-Mann Oh, Yun-Chan Hwang; J Korean Acad Conserv Dent 2011;36(5):425-430. Published online September 30, 2011; DOI: https://doi.org/10.5395/JKACD.2011.36.5.425

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Objectives

This in vitro study investigated whether short-term application of calcium hydroxide in the root canal system for 1 and 4 wk affects the fracture strength of human permanent teeth.

Materials and Methods

Thirty two mature human single rooted mandibular premolars in similar size and dentin thickness without decay or restorations were hand and rotary instrumented and 16 teeth vertically packed with calcium hydroxide paste and sealed coronally with caviton to imitate the endodontic procedure and the other 16 teeth was left empty as a control group. The apicies of all the samples were sealed with resin, submerged in normal saline and put in a storage box at 37℃ to mimic the oral environment. After 1 and 4 wk, 8 samples out of 16 samples from each group were removed from the storage box and fracture strength test was performed. The maximum load required to fracture the samples was recorded and data were analysed statistically by the two way ANOVA test at 5% significance level.

Results

The mean fracture strengths of two groups after 1 wk and 4 wk were similar. The intracanal placement of calcium hydroxide weakened the fracture strength of teeth by 8.2% after 4 wk: an average of 39.23 MPa for no treatment group and 36.01 MPa for CH group. However there was no statistically significant difference between experimental groups and between time intervals.

Conclusions

These results suggest that short term calcium hydroxide application is available during endodontic treatment.

Citations

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Effect of Calcium Hydroxide as an Intracanal Medication on Dentine Fracture Resistance: A Systematic Review and Network Meta-Analysis
Chayanit Sunlakawit, Chitpol Chaimanakarn, Natchalee Srimaneekarn, Sittichoke Osiri
Journal of Endodontics.2024; 50(12): 1714. CrossRef

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Comparison of gene expression profiles of human dental pulp cells treated with mineral trioxide aggregate and calcium hydroxide: Yong-Beom Kim, Won-Jun Shon, Woocheol Lee, Kee-Yeon Kum, Seung-Ho Baek, Kwang-Shik Bae; J Korean Acad Conserv Dent 2011;36(5):397-408. Published online September 14, 2011; DOI: https://doi.org/10.5395/JKACD.2011.36.5.397

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Abstract Objectives:

This study investigated changes in gene expressions concerning of differentiation, proliferation, mineralization and inflammation using Human-8 expression bead arrays when white Mineral Trioxide Aggregate and calcium hydroxide-containing cement were applied in vitro to human dental pulp cells (HDPCs).

Materials and Methods:

wMTA (white ProRoot MTA, Dentsply) and Dycal (Dentsply Caulk) in a Teflon tube (inner diameter 10 mm, height 1 mm) were applied to HDPCs. Empty tube-applied HDPCs were used as negative control. Total RNA was extracted at 3, 6, 9 and 24 hr after wMTA and Dycal application. The results of microarray were confirmed by reverse transcriptase polymerase chain reaction.

Results:

Out of the 24,546 genes, 43 genes (e.g., BMP2, FOSB, THBS1, EDN1, IL11, COL10A1, TUFT1, HMOX1) were up-regulated greater than two-fold and 25 genes (e.g., SMAD6, TIMP2, DCN, SOCS2, CEBPD, KIAA1199) were down-regulated below 50% by wMTA. Two hundred thirty nine genes (e.g., BMP2, BMP6, SMAD6, IL11, FOS, VEGFA, PlGF, HMOX1, SOCS2, CEBPD, KIAA1199) were up-regulated greater than two-fold and 358 genes (e.g., EDN1, FGF) were down-regulated below 50% by Dycal.

Conclusions:

Both wMTA and Dycal induced changes in gene expressions related with differentiation and proliferation of pulp cells. wMTA induced changes in gene expressions related with mineralization, and Dycal induced those related with angiogenesis. The genes related with inflammation were more expressed by Dycal than by wMTA. It was confirmed that both wMTA and Dycal were able to induce gene expression changes concerned with the pulp repair in different ways.

Citations

Citations to this article as recorded by

Analysis of gene expression during odontogenic differentiation of cultured human dental pulp cells
Min-Seock Seo, Kyung-Gyun Hwang, Hyongbum Kim, Seung-Ho Baek
Restorative Dentistry & Endodontics.2012; 37(3): 142. CrossRef

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Original Articles

A COMPARISON OF THE IRRIGATION SYSTEMS IN CALCIUM HYDROXIDE REMOVAL: Jae-Seung Eun, Se-Hee Park, Kyung-Mo Cho, Jin-Woo Kim; J Korean Acad Conserv Dent 2009;34(6):508-514. Published online January 14, 2009; DOI: https://doi.org/10.5395/JKACD.2009.34.6.508

Abstract PDF PubReader ePub: Abstract
The purposes of this study were to compare the efficacy of irrigation systems by removing a calcium hydroxide (Ca(OH)₂) paste from the apical third of the root canal and the effect of the patency file. Sixty single rooted human teeth were used in this study. The canals were instrumented by a crown-down manner with .04 taper ProFile to ISO #35. Ca(OH)2 and distilled water were mixed and placed inside the root canals. The teeth were divided into 6 groups according to the root canal irrigation system and the use of patency file as follows: group 1 - conventional method; group 2 - EndoActivator^®; group 3 - EndoVac^®; group 4 - conventional method, patency; group 4 - EndoActivator^®, patency; group 6 - EndoVac^®, patency. All teeth were irrigated with sodium hypochlorite. After the root canal irrigation, the teeth were split in bucco-lingual aspect. Percentage of the root canal surface coverage with residual Ca(OH)2 until 3 mm from working length was analyzed using Image Pro Plus ver. 4.0. Statistical analysis was performed using the One-way ANOVA, t-test and Scheffe's post-hoc test. Conventional groups had significantly more Ca(OH)2 debris than EndoActivator^®, EndoVac^® groups. There was no significant difference between EndoActivator^® and EndoVac^® groups. Groups with patency file showed more effective in removing Ca(OH)₂ paste than no patency groups, but, it was no significant difference. This study showed that EndoActivator^® and EndoVac^® systems were more effective in removing Ca(OH)2 paste from the apical third of the root canal than conventional method.

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Histological evaluation of direct pulp capping with DSP-derived synthetic peptide in beagle dog: Jae-Hoon Kim, Jun-Bae Hong, Bum-Soon Lim, Byeong-Hoon Cho; J Korean Acad Conserv Dent 2009;34(2):120-129. Published online January 14, 2009; DOI: https://doi.org/10.5395/JKACD.2009.34.2.120

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Abstract

The purpose of this study was to investigate the pulpal response to direct pulp capping with dentin sialo-protein (DSP) -derived synthetic peptide in teeth of dogs, and to compare its efficacy to capping substances Ca(OH)₂ and white mineral trioxide aggregate (WMTA). A total of 72 teeth of 6 healthy male beagle dogs were used. The mechanically exposed pulps were capped with one of the following: (1) DSP-derived synthetic peptide (PEP group); (2) Ca(OH)₂ (CH group); (3) a mixture paste of peptide and Ca(OH)₂ (PEP+CH group); or (4) white MTA (WMTA group). The access cavity was restored with a reinforced glass ionomer cement. Two dogs were sacrificed at each pre-determined intervals (2 weeks, 1 month, and 3 months). After the specimens were prepared for standard histological processing, sections were stained with hematoxylin and eosin. Under a light microscope, inflammatory response and hard tissue formation were evaluated in a blind manner by 2 observers. In the PEP group, only 3 of 17 specimens showed hard tissue formation, indication that the DSP-derived synthetic peptide did not induce proper healing of the pulp. Compared with the CH group, the PEP group demonstrated an increased inflammatory response and poor hard tissue formation. The CH and WMTA groups showed similar results for direct pulp capping in mechanically exposed teeth of dogs.

Citations

Citations to this article as recorded by

Tubular Dentin Regeneration Using a CPNE7-Derived Functional Peptide
Yoon Lee, Yeoung-Hyun Park, Dong-Seol Lee, You-Mi Seo, Ji-Hyun Lee, Joo-Hwang Park, Han-Wool Choung, So-Hyun Park, Won Shon, Joo-Cheol Park
Materials.2020; 13(20): 4618. CrossRef
Pulp response of beagle dog to direct pulp capping materials: Histological study
Ji-Hyun Bae, Young-Gyun Kim, Pil-Young Yoon, Byeong-Hoon Cho, Yong-Hoon Choi
Journal of Korean Academy of Conservative Dentistry.2010; 35(1): 5. CrossRef

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Effect of calcium hydroxide on bond strength of dentin bonding systems: No-Hoon Park, Sang-Hyuk Park, Gi-Woon Choi, Sang-Jin Park; J Korean Acad Conserv Dent 2007;32(3):198-207. Published online May 31, 2007; DOI: https://doi.org/10.5395/JKACD.2007.32.3.198

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The purpose of this study was to investigate the effect of calcium hydroxide on dentin bonding strength of various dentin bonding systems as a function of time in composite resin restoration.

Dentin adhesives used in this study were Scotchbond Multipurpose, Single Bond, SE Bond and Prompt L-Pop. Flat dentin surfaces adjacent to pulp chamber were created, then Ca(OH)₂ and saline were mixed and applied on dentin surface of experimental group, then IRM was used to cover the mixture on dentin surface and the specimens were stored at 36.5℃ for experiment period (7 days, 30 days). After removing IRM and Ca(OH)₂, each dentin adhesives were treated on dentin surfaces.

Composite resin (Z-250, 3M) was placed with 5 mm height and was light-cured for 20 seconds. After stored in distilled water for 24 hours, each dentin-composite bonded spicemen was embedded in epoxy resin and sectioned into 1.0 × 1.0 mm² cross section composite-dentin beams. Specimen was mounted on zig of Universal testing machine and µTBS test was performed. SEM analysis was performed to examine the fractured surfaces.

The results suggested that applying calcium hydroxide did not show significant difference in dentin bonding strength.

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Pulp response of mineral trioxide aggregate, calcium sulfate or calcium hydroxide: Young-Ran Yun, In-Seok Yang, Yun-Chan Hwang, In-Nam Hwang, Hong-Ran Choi, Suk-Ja Yoon, Sun-Hun Kim, Won-Mann Oh; J Korean Acad Conserv Dent 2007;32(2):95-101. Published online March 31, 2007; DOI: https://doi.org/10.5395/JKACD.2007.32.2.095

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This study was performed to verify the possibility of MTA and calcium sulfate as a pulp capping agent through comparing the dental pulp response in dogs after capping with MTA, calcium sulfate, and calcium hydroxide.

24 teeth of 2 dogs, 8 month old, were used in this study.

Under general anesthesia, cervical cavities were prepared and pulp was exposed with sterilized #2 round bur in a high speed handpiece.

MTA, calcium hydroxide, and calcium sulfate were applied on the exposed pulp. Then the coronal openings were sealed with IRM and light-cured composite.

Two months after treatment, the animals were sacrificed. The extracted teeth were fixed in 10% neutral-buffered formalin solution and were decalcified in formic acid-sodium citrate. They were prepared for histological examination in the usual manner. The sections were stained with haematoxylin and eosin.

In MTA group, a hard tissue bridges formation and newly formed odontoblasts layer was observed. There was no sign of pulp inflammatory reaction in pulp tissue.

In calcium hydroxide group, there was no odontoblast layer below the dentin bridge. In pulpal tissue, chronic inflammatory reaction with variable intensity and extension occurred in all samples.

In calcium sulfate group, newly formed odontoblast layer was observed below the bridge. Mild chronic inflammation with a few neutrophil infiltrations was observed on pulp tissue.

These results suggest that MTA is more biocompatible on pulp tissue than calcium hydroxide or calcium sulfate.

Citations

Citations to this article as recorded by

Effects of the exposure site on histological pulpal responses after direct capping with 2 calcium-silicate based cements in a rat model
Panruethai Trongkij, Supachai Sutimuntanakul, Puangwan Lapthanasupkul, Chitpol Chaimanakarn, Rebecca Wong, Danuchit Banomyong
Restorative Dentistry & Endodontics.2018;[Epub] CrossRef
Conservative approach of a symptomatic carious immature permanent tooth using a tricalcium silicate cement (Biodentine): a case report
Cyril Villat, Brigitte Grosgogeat, Dominique Seux, Pierre Farge
Restorative Dentistry & Endodontics.2013; 38(4): 258. CrossRef
Comparison of gene expression profiles of human dental pulp cells treated with mineral trioxide aggregate and calcium hydroxide
Yong-Beom Kim, Won-Jun Shon, Woocheol Lee, Kee-Yeon Kum, Seung-Ho Baek, Kwang-Shik Bae
Journal of Korean Academy of Conservative Dentistry.2011; 36(5): 397. CrossRef
Pulp response of beagle dog to direct pulp capping materials: Histological study
Ji-Hyun Bae, Young-Gyun Kim, Pil-Young Yoon, Byeong-Hoon Cho, Yong-Hoon Choi
Journal of Korean Academy of Conservative Dentistry.2010; 35(1): 5. CrossRef
Gene expression profiling in human dental pulp cells treated with mineral trioxide aggregate
Yong-Beom Kim, Won-Jun Shon, WooCheol Lee, Kee-Yeon Kum, Seung-Ho Baek, Kwang-Shik Bae
Journal of Korean Academy of Conservative Dentistry.2010; 35(3): 152. CrossRef
Biocompatibility of experimental mixture of mineral trioxide aggregate and glass ionomer cement
Min-Jae Oh, Yu-Na Jeong, In-Ho Bae, So-Young Yang, Bum-Jun Park, Jeong-Tae Koh, Yun-Chan Hwang, In-Nam Hwang, Won-Mann Oh
Journal of Korean Academy of Conservative Dentistry.2010; 35(5): 359. CrossRef
Biocompatibility of bioaggregate cement on human pulp and periodontal ligament (PDL) derived cells
Choo-Ryung Chung, Euiseong Kim, Su-Jung Shin
Journal of Korean Academy of Conservative Dentistry.2010; 35(6): 473. CrossRef
Physical and chemical properties of experimental mixture of mineral trioxide aggregate and glass ionomer cement
Yu-Na Jeong, So-Young Yang, Bum-Jun Park, Yeong-Joon Park, Yun-Chan Hwang, In-Nam Hwang, Won-Mann Oh
Journal of Korean Academy of Conservative Dentistry.2010; 35(5): 344. CrossRef
The effect of several root-end filling materials on MG63 osteoblast-like cells
Jeong-Ho Lee, Won-Jun Shon, WooCheol Lee, Seung-Ho Baek
Journal of Korean Academy of Conservative Dentistry.2010; 35(3): 222. CrossRef
Effects of condensation techniques and canal sizes on the microleakage of orthograde MTA apical plug in simulated canals
Deuk-Lim Nam, Jeong-Kil Park, Bock Hur, Hyeon-Cheol Kim
Journal of Korean Academy of Conservative Dentistry.2009; 34(3): 208. CrossRef
Comparison of biocompatibility of four root perforation repair materials
Min-Kyung Kang, In-Ho Bae, Jeong-Tae Koh, Yun-Chan Hwang, In-Nam Hwang, Won-Mann Oh
Journal of Korean Academy of Conservative Dentistry.2009; 34(3): 192. CrossRef
A bioactivity study of Portland cement mixed with β-glycerophosphosphate on human pulp cell
Young-Hwan Oh, Young-Joo Jang, Yong-Bum Cho
Journal of Korean Academy of Conservative Dentistry.2009; 34(5): 415. CrossRef

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Effect of two different calcium hydroxide paste removal techniques on apical leakage: an electrochemical study: Chan-Je Park, Kyung-A Jeon, Ho-Beom Kwon; J Korean Acad Conserv Dent 2006;31(3):186-191. Published online May 31, 2006; DOI: https://doi.org/10.5395/JKACD.2006.31.3.186

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This study evaluated the effect of two different calcium hydroxide (Ca(OH)₂) paste removal techniques on the apical leakage of canals obturated with gutta percha cones and sealer after removing a Ca(OH)₂ dressing using an electrochemical method.

Seventy extracted single-rooted teeth were instrumented on with Profile rotary files under NaOCl irrigation. Fifty-eight canals were filled with calcium hydroxide paste, which was then removed using one of the following two techniques. In group A, calcium hydroxide was removed using only NaOCl irrigation, and in group B, the canals were re-prepared with a Profile rotary files-one size larger than the previous instrument and were irrigated with NaOCl. In both groups, the root surfaces were coated twice with nail varnish from CEJ to an area 4 mm away from the apex after canal obturation. Apical leakage was measured using an electrochemical method for 24 days.

All the specimens showed leakage that increased markedly in the first three days. There was no significant difference between the two groups (p > 0.05). The effect of two calcium hydroxide paste removal techniques on the apical leakage was not different during a short period.

Citations

Citations to this article as recorded by

A Comparison of the irrigation systems in calcium hydroxide removal
Jae-Seung Eun, Se-Hee Park, Kyung-Mo Cho, Jin-Woo Kim
Journal of Korean Academy of Conservative Dentistry.2009; 34(6): 508. CrossRef

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The effect of calcium hydroxide on post-treatment pain: Wook Nam, Sang-Hyuk Park, Gi-Woon Choi; J Korean Acad Conserv Dent 2006;31(2):86-95. Published online March 31, 2006; DOI: https://doi.org/10.5395/JKACD.2006.31.2.086

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The purpose of this clinical study is to assess whether calcium hydroxide as an intracanal medication affects post-treatment pain in teeth especially odontogenic pain which comes from inflammation of the pulp and periradicular tissues when compared with no intracanal medication.

From 213 patients who has been treated 237 root canals due to significant pain (moderate-to-severe), we recorded their age, sex, treated tooth, degree of pain, pre-operative states of the tooth. We classified patients into 2 test group; Group 1 (not gain intracanal Ca(OH)₂), Group 2 (gain intracanal Ca(OH)₂). Through the survey from the patients, we let them write down the occurrence and degree of post-treatment pain in 4hours, 2days, 7days after treatment as none, mild, moderate or severe. The followings were evaluated; the overall incidence of flare-ups, the overall incidence of post-treatment pain in each group at each time period, the incidence of post-treatment pain in each group at each time period as related to pre-operative states of the teeth. These were compared statistically with Chi-square analysis (p < 0.05).

Under the condition of this investigation, no difference was observed in the incidence of post-treatment pain between the two groups. Therefore, Ca(OH)₂ as intracanal medication had no effect on preventing or decreasing the post-treatment pain.

Citations

Citations to this article as recorded by

Calcium hydroxide intracanal medication effects on pain and flare-up: a systematic review and meta-analysis
Ahmed Mohamed Ibrahim, Siza Yacoub Zakhary, Suzan Abdul Wanees Amin
Restorative Dentistry & Endodontics.2020;[Epub] CrossRef
Intra-canal medication containing silver nanoparticle versus calcium hydroxide in reducing postoperative pain: A randomized clinical trial
Fatma El Zahraa El Abbasy, Salsabyl Ibrahim, Olfat Shaker, Geraldine Ahmed
F1000Research.2018; 7: 1949. CrossRef
A Comparison of the irrigation systems in calcium hydroxide removal
Jae-Seung Eun, Se-Hee Park, Kyung-Mo Cho, Jin-Woo Kim
Journal of Korean Academy of Conservative Dentistry.2009; 34(6): 508. CrossRef

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Effect of sonicated extracts of Enterococcus faecalis on the production of matrix metalloproteinase-8 by human polymorphonuclear neutrophils: Sung-Kyung Park, Won-Jun Shon, Sung-Sam Lim; J Korean Acad Conserv Dent 2005;30(2):138-144. Published online March 31, 2005; DOI: https://doi.org/10.5395/JKACD.2005.30.2.138

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This in vitro study monitored MMP-8 production on PMN by stimulated with the following three groups; Sonicated extracts of E. faecalis (SEF), SEF treated with Ca(OH)₂ (12.5mg/ml) for 7 days, and lipopolysaccharides (LPS) of E. coli. The level of MMP-8 in each group was immediately measured by ELISA. The data were analyzed with Kruskal-Wallis test and Mann-Whitney U test.

In the SEF group, the level of production of MMP-8 was higher than the negative control group in low concentration (0.05µg/ml) of SEF (p < 0.05), but it decreased with an increase in the concentration of SEF (p < 0.05). In the case of SEF treated with Ca(OH)₂, all of the MMP levels were higher than negative control group (p < 0.05), but no statistical difference was found among the different SEF concentrations (p > 0.05). All of the levels in E. coli LPS were increased with increasing concentrations (p < 0.05).

According to this study we could summarize as follows:

1. MMP-8 was expressed at low level in untreated PMN group and the levels of MMP-8 were upregulated in PMN stimulated by E. coli LPS groups.

2. In the SEF groups, the level of production of MMP-8 decreased with an increase in the concentration of SEF (p < 0.05). So E. faecalis may have suppressive effect on the production of MMP-8 by PMN.

3. In the case of SEF treated with Ca(OH)₂, all of the MMP levels at different SEF concentrations were higher than untreated PMN group (p < 0.05), but no statistical difference was found among the different SEF concentrations (p > 0.05).

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Anti-inflammatory effects of PPARγ on human dental pulp cells
Jeong-Hee Kim
Journal of Korean Academy of Conservative Dentistry.2006; 31(3): 203. CrossRef

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A study of ionic dissociation on various calcium hydroxide pastes using molecular sieving model: Kyoung-Sun Lee, Seung-Jong Lee; J Korean Acad Conserv Dent 2002;27(6):632-643. Published online November 30, 2002; DOI: https://doi.org/10.5395/JKACD.2002.27.6.632

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The purpose of this study was two-fold. First was to evaluate whether the molecular sieving model was appropriate for ionic dissociation experiment. Second was to compare the dissociation of calcium and hydroxyl ions from five types of calcium hydroxide pastes (Pure calcium hydroxide paste, DT temporary dressing®, Metapaste®, Chidopex®, Metapex®) in three vehicles (aqueous, viscous and oily) and the antibacterial effect.

Each calcium hydroxide pastes was placed into 0.65ml tube with cap and then 15% polyacrylamide gel was placed onto calcium hydroxide pastes. After the gel was hardened, the tubes were filled with tridistilled water (pH 7.14) and closed with cap. The tubes were stored in 37℃, 100% incubator. The pH reading and the concentration of calcium ions were taken at 1, 4, 7, 10, and 14 days. The brain heart infusion agar plates with S. mutans and A. actinomycetemcomitans were used for antibacterial activity test. Middle of agar plate was filled with the calcium hydroxide pastes. The plates were incubated at 37℃ and observations were made to detect the zones of inhibition. These data were evaluated statistically by use of the analysis of variance and duncan test.

The results were as follows.

1. In fresh mixing state, the pH of five types of calcium hydroxide pastes were measured between 12.5 and 12.8.

2. The pH was increased in all five types of calcium hydroxide pastes compared with control group. In 14 days, Pure calcium hydroxide paste (11.45) and DT temporary dressing® (11.33) showed highest pH, followed by Metapaste® (9.49), Chidopex® (8.37) and Metapex® (7.59).

3. Calcium was higher in all five types of calcium hydroxide pastes compared with control group. In 14 days, Pure calcium hydroxide paste (137.29 mg%) and DT temporary dressing® (124.6 mg%) showed highest value, followed by Metapaste® (116.74 mg%), Chidopex® (111.84 mg%) and Metapex® (60.22 mg%).

4. The zones of bacterial inhibition were seen around all five types of calcium hydroxide pastes. Chidopex® and Metapex® groups which include iodoform were observed significantly larger zone of inhibition in A. actinomycetemcomitans compared with the other calcium hydroxide groups (p<0.05). However, Metapex® showed the least antibacterial effect on S. mutans compared with other groups (p<0.05).

The molecular sieving model was found to be acceptable in dissociation experiment of hydroxyl and calcium ions when compared with the previous tooth model study. But this model was not appropriate for the antibacterial test.

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A Comparison of the irrigation systems in calcium hydroxide removal
Jae-Seung Eun, Se-Hee Park, Kyung-Mo Cho, Jin-Woo Kim
Journal of Korean Academy of Conservative Dentistry.2009; 34(6): 508. CrossRef

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