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Research Article
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
AbstractAbstract PDFSupplementary MaterialPubReaderePub
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
  • 420 View
  • 15 Download
  • 8 Crossref
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Case Report
Surgical management with intentional replantation on a tooth with palato-radicular groove
Jorge Forero-López, Luis Gamboa-Martínez, Laura Pico-Porras, Javier Laureano Niño-Barrera
Restor Dent Endod 2015;40(2):166-171.   Published online December 22, 2014
DOI: https://doi.org/10.5395/rde.2015.40.2.166
AbstractAbstract PDFPubReaderePub

A palato-radicular groove (PRG) is a developmental anomaly primarily found in the maxillary lateral incisors. It is a potential communication path between the root canal and the periodontium that decreases the survival prognosis of the affected tooth, therefore compromising the stability of the dental structure in the oral cavity. The aim of this case report is to present an original technique where a PRG was treated by means of intracanal disinfection, PRG sealing with glass ionomer, replantation with intentional horizontal 180 degree rotation of the tooth, and an aesthetic veneer placed to provide adequate tooth morphology. The clinical and biological benefits of this novel technique are presented and discussed.

Citations

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  • Diagnostic Approaches of Palatogingival Groove: A Systematic Review
    Greta Venskutė
    Journal of Dental Health and Oral Research.2024; : 1.     CrossRef
  • Palatogingival Groove: A Plaque Trap Leading to Bone Loss in a Maxillary Lateral Incisor – A Rare Case Report
    Gayathri Priyadharshini Elangovan, Indra Kumar Periyasamy, Saravana Kumar R, Gopinath Vivekanandhan
    Dental Journal of Indira Gandhi Institute of Medical Sciences.2024; 3: 104.     CrossRef
  • Palatogingival Groove: The Known–unknown Devourer
    Sandeep Tandon, Rinku Mathur, Ambika S Rathore, Tripti S Rai, Kanchan Kumari Dhaker, Sumedha Gupta
    International Journal of Clinical Pediatric Dentistry.2024; 17(S1): S95.     CrossRef
  • Palatal groove associated with periodontal lesions: a systematic review illustrated by a decisional tree for management
    Yvan Gaudex, Vianney Gandillot, Isabelle Fontanille, Philippe Bouchard, Stephane Kerner, Maria Clotilde Carra
    BMC Oral Health.2024;[Epub]     CrossRef
  • Prevalence of palatogingival groove affecting maxillary anterior teeth in Saudi subpopulation: A cone-beam computed tomographic study with literature review
    Ali Ibrahim Aljuailan, Roqayah Aljuailan, Rahul N. Gaikwad, Shaul Hameed Kolarkodi, Nasser Rufaydan Alamri
    The Saudi Dental Journal.2023; 35(8): 1039.     CrossRef
  • Interdisciplinary approach for diagnosis and management of the tooth with type III palatogingival groove
    Harakh Chand Baranwal, Jyoti Yadav
    Saudi Endodontic Journal.2023; 13(2): 211.     CrossRef
  • Management of Palatogingival Groove in Maxillary Lateral Incisor: A Report of a Rare Case With a Brief Review of Literature
    Irfan Ansari, Sanjay Miglani, Vijay Yadav, Shamimul Hasan
    Cureus.2023;[Epub]     CrossRef
  • Intentional replantation combined root resection therapy for the treatment of type III radicular groove with two roots: A case report
    Dan Tan, Shi-Ting Li, Hao Feng, Zhong-Chao Wang, Cai Wen, Min-Hai Nie
    World Journal of Clinical Cases.2022; 10(20): 6991.     CrossRef
  • The incidence of radicular groove on maxillary lateral incisors of Saudi population: CBCT evaluation
    Sarah M. Alkahtany, Fatemah Alrwais, Asma Altamimi, Sundus M. Bukhary, Amani Mirdad
    BMC Oral Health.2022;[Epub]     CrossRef
  • Retrospective Study of Intentional Replantation for Type IIIb Dens Invaginatus with Periapical Lesions
    Na Li, Huihui Xu, Cunhui Kan, Jing Zhang, Song Li
    Journal of Endodontics.2022; 48(3): 329.     CrossRef
  • Combined Periodontal and Endodontic Management of Palatal Radicular Groove with Platelet‐Rich Fibrin and Biodentine®
    Arjun Hari Rijal, Bhageshwar Dhami, Pratistha Ghimire, Konstantinos Michalakis
    Case Reports in Dentistry.2022;[Epub]     CrossRef
  • Intentional Replantation of Single-Rooted and Multi-Rooted Teeth: A Systematic Review
    Massimo Pisano, Federica Di Spirito, Stefano Martina, Giuseppe Sangiovanni, Francesco D’Ambrosio, Alfredo Iandolo
    Healthcare.2022; 11(1): 11.     CrossRef
  • Management of the palato-radicular groove with a periodontal regenerative procedure and prosthodontic treatment: A case report
    Dan-Hua Ling, Wei-Ping Shi, Yan-Hong Wang, Dan-Ping Lai, Yan-Zhen Zhang
    World Journal of Clinical Cases.2022; 10(17): 5732.     CrossRef
  • Prevalence and Periodontal Conditions of Developmental Grooves in an Italian School of Dentistry and Dental Hygiene: A Cross-Sectional Study
    Giovanna Laura Di Domenico, Simone Fabrizi, Paolo Capparè, Maria Teresa Sberna, Massimo de Sanctis
    International Journal of Environmental Research and Public Health.2022; 19(7): 4047.     CrossRef
  • Clinical Observation and Research Progress of Comprehensive Treatment of Palatogingival Groove
    华姣 胡
    Advances in Clinical Medicine.2021; 11(03): 846.     CrossRef
  • Palato-gingival groove: A silent nidus. Recognition and an innovative management approach: A report of 3 cases
    Purushothama Rangaswamy, Sri Harsha Tummala, Samrat R Magarvalli, Sujith Ramachandra, Kavitha Govindappa, Shwetha E
    IP Indian Journal of Conservative and Endodontics.2021; 6(2): 114.     CrossRef
  • Periodontal Regenerative Treatment of Intrabony Defects Associated with Palatal Grooves: A Report of Two Cases
    Stefano Corbella, Alice Alberti, Beatrice Zotti, Luca Francetti
    Case Reports in Dentistry.2019; 2019: 1.     CrossRef
  • Recognition and management of palatogingival groove for tooth survival: a literature review
    Hee-Jin Kim, Yoorina Choi, Mi-Kyung Yu, Kwang-Won Lee, Kyung-San Min
    Restorative Dentistry & Endodontics.2017; 42(2): 77.     CrossRef
  • The use of Intentional Replantation to Repair an External Cervical Resorptive Lesion not am Enable to Conventional Surgical Repair
    Kreena Pa Tel, Federico Foschi, Ioana Pop, Shanon Patel, Francesco Mannocci
    Primary Dental Journal.2016; 5(2): 78.     CrossRef
  • Management of apicomarginal defect in esthetic region associated with a tooth with anomalies
    Vinayak Venkoosa Meharwade, Dipali Yogesh Shah, Pradyna Prabhakar Mali, Vidya Vinayak Meharwade
    Restorative Dentistry & Endodontics.2015; 40(4): 314.     CrossRef
  • 289 View
  • 4 Download
  • 20 Crossref
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Original Article
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
AbstractAbstract PDFPubReaderePub

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
  • 204 View
  • 3 Download
  • 3 Crossref
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