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PubMed1997

Periapical repair and apical closure of a pulpless tooth using calcium hydroxide.

A case with a wide-open apex and a large cystlike periapical lesion in an adult is presented. The lesion formed as a result of necrosis from trauma to a maxillary central incisor 12 years ago. After nonsurgical endodontic treatment with calcium hydroxide paste and a calcium hydroxide-containing root canal sealer, apical closure and significant healing of the periapical lesion within 15 months were observed. This report suggests that even large periapical lesions (likely cystic) could respond favorably to nonsurgical treatment.

Adult↗
PubMed1996

Disinfection by calcium hydroxide pastes of dentinal tubules infected with two obligate and one facultative anaerobic bacteria.

Bovine dentine cylinders were experimentally infected with Actinomyces israelii, Fusobacterium nucleatum, or Enterococcus faecalis. The latter is a facultative anaerobic bacteria and the others are obligate anaerobes commonly found in endodontic infections. The infected specimens were exposed to pastes of calcium hydroxide mixed with saline solution or camphorated paramonochlorophenol for periods of 1 h, 1 day, and 1 week. The viability of bacteria after these exposure times was evaluated by specimen incubation in culture medium to compare the effectiveness of the pastes in disinfecting dentinal tubules. The calcium hydroxide/camphorated paramonochlorophenol paste effectively killed bacteria in the tubules after a 1-h period of exposure, except for E. faecalis that required one day of exposure. In contrast, the calcium hydroxide/saline paste was ineffective against E. faecalis and F. nucleatum even after 1 week of exposure. The results showed that camphorated paramonochlorophenol increased the antibacterial effects of calcium hydroxide.

Actinomyces↗
PubMed1991

The antimicrobial effect of calcium hydroxide as a short-term intracanal dressing.

The antibacterial effect of calcium hydroxide as a short-term intracanal dressing was clinically evaluated by applying the medicament for 10 minutes or 7 days in root canals of teeth with periapical lesions. The results showed that the 7-day dressing efficiently eliminated bacteria which survived biomechanical instrumentation of the canal, while the 10-minute application was ineffective.

Bacteria, Anaerobic↗
PubMed1998

Effect of calcium hydroxide on the dissolution of soft tissue on the root canal wall.

Calcium hydroxide [Ca(OH)2] paste can aid in the cleaning of a root canal because of its soft tissue-dissolving potential. In this study, we examined with a scanning electron microscope the dissolution by Ca(OH)2 paste of pulpal tissue attached to uninstrumented bovine root canal walls. Extracted bovine anterior teeth were divided into small specimens at the middle portion of the roots. The experimental groups were treated with sodium hypochlorite (NaOCl), Ca(OH)2, or a combination of Ca(OH)2 + NaOCl. The control group was given no treatment. The root canal walls were observed with a scanning electron microscope, and the amount of remaining pulp tissue was compared. The amount of debris was reduced remarkably in the groups treated with NaOCl for > 30 s, or Ca(OH)2 for 7 days. The combination of Ca(OH)2 + NaOCl was more effective than the separate treatments. The results suggest that Ca(OH)2 as a root canal medicine serves as an effective agent in removing tissue debris remaining on the root canal walls.

Animals↗
PubMed1989

[The effect of calcium hydroxide eugenol agents on pulp of primary teeth of young dogs. The view of early stages].

Eugenol has such effective anti-corrosion and pain-killing properties that it is widely used for dentistry clinically. We focused our attention on eugenol and made agents for pulpotomy which were mixtures of calcium hydroxide, eugenol and polyethylene glycol 4000 for a base. We attempted to use them for the pulpotomy of primary teeth of young dogs and observed the healing progress of the treated teeth during the early stages. The experiment utilized four young dogs whose primary teeth were pulpotomized by the usual method. Agents of the pulpotomy were mixed calcium hydroxide (1.0 g), eugenol (0.8 ml) and polyethylene glycol 4000 (1.2 ml). After 3 days and 7 days, these teeth were taken out to be made into histopathological specimens. We inspected them microscopically. The results obtained were as follows. 1) After 3 days, the amputated pulp which was in contact with the agents turned into necrotic layers. Degenerative, necrotic, and non-structural states were widely observed. Under the necrotic layers, there were hematoxyline dark stained layers. Also the hematoxyline dark stained layers separated from the proper pulp. In the proper pulp, there were no abnormalities. 2) After 7 days, the necrotic layers were atrophied. In the dark stained layers, the stained areas were darker than that of after 3 days and increased in degeneration. In the proper pulp, round cells appeared and with a chronic inflammatory appearance along with vacuole, atrophy and degeneration. It seemed to be affected by eugenol. Dentin bridges still has not yet formed.

Animals↗
PubMed2002

The use of amalgam powder and calcium hydroxide to recreate a radiopaque image of a lost dental restoration.

Radiographs of dental restorations are highly reliable when used to identify postmortem dental remains. A problem exists if key dental restorations are missing or defective, which results in the loss of a comparative radiographic image. This article describes a simple method allowing the odontologist to quickly recreate a temporary radiopaque restoration. This article presents a method of using amalgam powder (radiopaque material) and calcium hydroxide (radiopaque material and transport medium for the amalgam powder) to recreate a radiopaque image on a tooth that has lost a dental restoration. Amalgam powder and calcium hydroxide is easily obtained (in any dental office), fairly clean, easy to manipulate, inexpensive, inert, stable, and able to be removed without damaging the dental remains. The amalgam powder/calcium hydroxide mixture can easily be re-shaped or modified to reflect the radiopaque image of the original restoration. Radiographic comparison of the "restored" dental remains to the antemortem radiographs is now possible. The use of this technique is presented in a case report.

Calcium Hydroxide↗
PubMed1993

In vitro release of calcium and hydroxyl ions from two types of calcium hydroxide preparation.

Non-setting and setting pastes are the most common forms of calcium hydroxide, used in endodontics. The aim of this study was to investigate the differences in the availability of calcium and hydroxyl ions from some commercial preparations of both types. In vitro released calcium and hydroxyl ions were determined by a potentiometric method, after diffusion through sintered glass. The non-setting pastes evaluated were Calcipulpe, Calxyl Red, Calxyl Blue and Cinacal; while setting base materials were represented by Dycal, Nu-Cap and Reolit. The data obtained showed significantly higher availability of calcium and hydroxyl ions from non-setting pastes, compared with 'alkaline cements' (P < 0.05). Great variations in the amount of released ions were also found among samples of the same material.

Analysis of Variance↗
PubMedDate not supplied

A comparison of the pulpal response to freeze-dried bone, calcium hydroxide, and zinc oxide-eugenol in primary teeth in two cynomolgus monkeys.

This study assessed the pulp healing response to human freeze-dried bone (FDB) in two cynomolgus monkeys using 36 noncarious primary teeth pulpotomized and randomly assigned to three medicaments. FDB was applied on the pulp stumps and covered with sterile tin foil as experimental group. The two other groups received either calcium hydroxide [Ca(OH)2], or IRM (reinforced ZOE). All teeth were restored with amalgam. One animal was sacrificed at 6 weeks and the other 6 months after treatment. Teeth were extracted and placed in 10% formalin. Histological evaluation indicated that 100% of teeth treated with FDB had vital pulps compared with 75% of the Ca(OH)2 group after 6 weeks. Dentin bridges were present in 87.5% of FDB versus 75% of Ca(OH)2 group. Inflammatory cells were absent or mild in 100% of FDB-treated versus 75% of the Ca(OH)2 group. After 6 months, 83.3% of FDB-treated teeth had vital pulps compared with the Ca(OH)2 group, which showed 100% pulpal necrosis. In FDB-treated pulps, 100% of teeth showed dentin bridges versus 50% of teeth treated with Ca(OH)2. Inflammatory cells were absent or mildly present in 83.3% of FDB-treated teeth while 100% of Ca(OH)2 showed moderate to severe inflammation. IRM-treated teeth all showed pulpal necrosis after 6 months. We concluded that FDB was superior to calcium hydroxide in treating primary pulp dentition in cynomolgus monkeys.

Animals↗
PubMed1989

Antimicrobial activity of calcium hydroxide liners on Streptococcus sanguis and S. mutans.

The antimicrobial activity of 10 calcium hydroxide liners on Streptococcus sanguis and S. mutans was studied. One hundred plates of tryticose soy agar-sheep red blood cells (10%), each with four distinct 3 mm diameter wells, were divided into two groups of 50. One group was inoculated with S. sanguis and the second group with S. mutans. A 4 mg liner was placed in each of three wells; the fourth well was left empty as a control. Plates were incubated at 37 degrees C and observed at 24 hours, 48 hours, and 7 days. All liners inhibited growth of both organisms. The inhibitory zones for S. mutans were larger than inhibitory zones for S. sanguis for all tested liners. Life Fast Set material had significantly less inhibitory effect on S. mutans. VLC Dycal, Life, and Life Fast Set materials had significantly less inhibitory effect on S. sanguis at p = 0.05.

Bacterial Infections↗
PubMed2005

Microleakage of glass-ionomer cement placed in association with non-setting calcium hydroxide.

The purpose of this investigation was to determine whether non-setting calcium hydroxide [Ca (OH)2] cement placed in the root canal system of premolar teeth would affect the subsequent microleakage of a glass-ionomer restoration (GIC). Following selection, 62 human premolar teeth extracted for orthodontic reasons were accessed and root canals prepared according to a standardized procedure. The specimens were then allocated randomly into two major groups each of 30 teeth. Two other teeth were used as a positive and a negative control. The control group was restored with glass-ionomer cement following drying of the canal and placement of a cotton wool pledget. The test group had all canals dressed with non-setting Ca(OH)2 and then was subdivided, one set (n = 22) being restored following conditioning of the access cavity margins, the other (n = 8) having the margins cleaned with a hand excavator. Samples were assessed for microleakage using a two-point scoring system (leakage or no leakage) in conjunction with a clearing technique using AgNO3. Using Fisher's exact test, a statistically significant difference was found between the control and test groups (P < 0.05) but there was no significant difference between the excavated and conditioned cavities (P=0.55). It is concluded that contamination of access cavity margins with Ca(OH)2 during medication of a root canal interferes with the bond of GIC, resulting in increased microleakage in vitro.

Algorithms↗
PubMed2004

[Calcium hydroxide and treatment of inflammatory inter-radicular bone resorption of non-vital deciduous molars].

On non-vital deciduous molars, inter-radicular bone resorption is often an indication of extraction. The endodontic treatment of these teeth by means of zinc oxide-eugenol (ZOE) paste also showed its limits. To mitigate the deficiencies of this material, we suggested a preliminary treatment by means of calcium hydroxide (Ca(OH)2) for its anti-inflammatory and antiseptic properties as well as its ability to stimulate calcified tissues apposition or remineralisation. This study concerns 21 non-vital deciduous molars. X-rays excluded any lesion of the underlying permanent bony crypt (bone tissue) as well as any inflammation of the dental follicle. After preparation, root canals were filled by means of Pulpdent. An initial X-ray check was made 15 days and then every 3 months. After disappearance of the inflammatory resorption, root canal fillings were performed with ZOE paste. The remineralisation of the inter-radicular alveolar bone was observed for 14 deciduous molars, which were then filled using ZOE. The remineralisation period varies from 3 to 18 months depending on the scale of the lesion. Of the 7 failed treatments, 3 failed following downfall of the crown filling material, and 2 due to failure to keep appointments and late replacement of resorbed Ca(OH)2. On 2 teeth, the treatment did not stop the lesion forming. Calcium hydroxide (Ca(OH)2) give encouraging results in the treatment of inter-radicular alveolar bone resorption of non-vital deciduous tooth. Its fast resorption requires rigorous controls, frequent refills, and thus strong motivation on the part of the child and parents. It cannot, on any account, be considered as permanent filling material.

Alveolar Bone Loss↗
PubMed1979

Calcium hydroxide: the ultimate medicament?

There has been a trend to the promiscuous use of calcium hydroxide in clinical endodontics. It can be concluded that this medicament is not the principal factor in success following its use. It is reasonable to state that endodontic success is related to the obliteration of the canal system with a solid core root canal filling such as gutta percha.

Calcium Hydroxide↗
PubMed1989

Calcium hydroxide in the treatment of external root resorption.

A case is presented in which calcium hydroxide was used in endodontic treatment of external root resorption in a tooth with a necrotic pulp, during active orthodontic movement. A calcified deposit formed, filling a defect, and the tooth was subsequently obturated with gutta-percha. Thus, both types of therapy--endodontic and orthodontic--were performed simultaneously.

Adolescent↗
PubMed2006

In vitro assessment of the effectiveness of chlorhexidine gel and calcium hydroxide paste with chlorhexidine against Enterococcus faecalis and Candida albicans.

OBJECTIVE: The purpose of this study was to compare the effectiveness of various medicaments, including Ca(OH)2/2% chlorhexidine, 2% chlorhexidine gel, and Ca(OH)2 alone, against Enterococcus faecalis and Candid albicans in vitro. STUDY DESIGN: Eighty extracted single-rooted human maxillary teeth were used. After removing the crown, each root was instrumented up to size 50 by using a conventional technique. The root canal was irrigated with ethylenediamine tetra-acetic acid (EDTA) solution to remove smear layer. Then, roots were infected with E faecalis and C albicans. Subsequently, the roots were divided into 4 treatment groups: group 1 was treated with calcium powder hydroxide in distilled water, group 2 was treated with calcium hydroxide powder in 2% chlorhexidine, group 3 was treated with 2% chlorhexidine gel, and group 4 was treated with 0.9% sterile saline serving as negative control. Microbial samples were taken after 7, 15, and 30 days. After incubation, dentine chips were obtained form each root canal and examined microbiologically. The microbiological samples were plated to count colony-forming units in per milligram of dentin. RESULTS: The results showed that the 2% chlorhexidine gel was significantly more effective than calcium hydroxide with 2% chlorhexidine, calcium hydroxide, and control saline solution (P < .05). CONCLUSION: Under the conditions of this study, 2% chlorhexidine gel is effective in the elimination of E faecalis and C albicans from the root canal system. However, to support this in vitro observation, further in vivo studies are needed.

Anti-Infective Agents, Local↗
PubMed2004

In vitro effects of calcium hydroxide and polymyxin B on endotoxins in root canals.

OBJECTIVES: To evaluate the effects of intracanal medicaments on endotoxins in root canals. METHODS: Seventy-five freshly extracted maxillary incisors were used in this study. The crowns of teeth were sectioned near the CEJ in order to standardize the root length to 14 mm. The root canals were instrumented to an apical size #50 file and irrigated with 1% sodium hypochlorite solution and sterilized with 60Co gamma irradiation. Standardized suspension containing Escherichia coli endotoxin was inoculated into the 60 root canals. The specimens were randomly assigned to 5 groups (n=15), according to the intracanal medicament used: (G1) calcium hydroxide; (G2) polymyxin B; (G3) combination neomycin-polymyxin B-hydrocortisone; (G4) positive control (no intracanal medicament); (G5) negative control (no endotoxin and no intracanal medicament). After 7 days, the detoxification of endotoxin was evaluated by Limulus lysate assay and antibody production in B-lymphocytes culture. RESULTS: Groups 1, 2 and 5 presented the best results by Limulus lysate and were significantly different to groups 3 and 4 (p<0.05). Stimulation of antibodies production in cell culture by groups 1 and 6 was smaller and statistically different than groups 2, 3, 4 and 5 (p<0.05). Groups 2 and 5 induced a small increase in the antibodies production in relation to the groups 1 and 6. Groups 3 and 4 induced a significant increase of antibodies production (p<0.05). CONCLUSIONS: The calcium hydroxide and polymyxin B intracanal medicaments detoxified endotoxin in root canals and altered the properties of LPS to stimulate the antibody production by B-lymphocytes. The combination neomycin-polymyxin B-hydrocortisone did not detoxified endotoxin.

Anti-Bacterial Agents↗
PubMed2005

Fracture resistance of human root dentin exposed to intracanal calcium hydroxide.

The purpose of the present study was to determine if exposure to intracanal calcium hydroxide [Ca(OH2)] alters the fracture resistance of human root dentin. One hundred and two freshly extracted single rooted human teeth divided into three groups of 34 teeth each. Coronal access and endodontic instrumentation using round burs, stainless steel files, and Profile GT rotary files were completed for each tooth. The prepared root canal system of each tooth was filled with saline solution (group 1), USP Ca(OH)2 (group 2), or Metapaste (group 3). The apicies and access openings were sealed with composite resin and the teeth were immersed in saline. After 30 days, the roots of 17 teeth from each group were sectioned horizontally into 1-mm thick disks and each disk was loaded to fracture at 2.5 mm/min with a SATEC universal-testing machine. After 180 days the same procedure was performed on the remaining 17 teeth in each of the 3 groups. The peak load at fracture was measured for each dentin disk. Data were analyzed using one-way ANOVA and a post hoc Student-Newman-Keuls test. After 30 days exposure to the test solution, there was no difference in the peak load at fracture for the three groups of teeth. However, after 180 days, the roots of the teeth exposed to USP Ca(OH)2 showed a significant decrease in peak load at fracture when compared to the 30-day groups and the 180-day groups exposed to saline or Metapaste.

Calcium Hydroxide↗
PubMed2001

Microleakage in endodontically treated teeth: influence of calcium hydroxide dressing following bleaching.

AIM: The purpose of the present study was to evaluate microleakage of a fourth generation dentine-bonding agent and composite restoration during a walking bleach treatment. METHODOLOGY: Thirty extracted non-carious incisors were selected and conventional root canal treatment was performed. Teeth were randomly divided into 3 groups (n = 10): group A (control), access cavities were restored with a fourth generation dentine-bonding agent, and incrementally restored with composite resin; group B, a paste composed of sodium perborate and hydrogen peroxide was placed into the pulp chamber and sealed with glass ionomer cement for 7 days, teeth were then restored in the same manner as group A; group C, a paste of sodium perborate and hydrogen peroxide was placed in the pulp chamber for 7 days and then after removal of the bleaching mixture, pulp chambers were filled with a calcium hydroxide paste and cavities sealed with glass ionomer for 1 week. The cavities were then restored with bonded restorations as in groups A and B. Teeth were subjected to thermal cycling and immersed in methylene blue for 8 h. Teeth were sectioned from buccal to lingual, through the centre of the restoration, using a diamond disk. Leakage was assessed using a standard scheme, under magnification (x20). Data were submitted to statistical analysis using nonparametric Kruskal-Wallis test. RESULTS: Groups A and C exhibited similar leakage patterns, and both demonstrated less leakage values than group B (P < 0.05). CONCLUSIONS: It was concluded that bleaching with sodium perborate and hydrogen peroxide increases microleakage; short-term use of a calcium hydroxide medicament did not increase microleakage.

Borates↗