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Dentinal pH changes following electrophoretically activated calcium hydroxide ions in the root canal space of bovine teeth.

The aim of the study was to evaluate pH changes of external root dentin surface at different depths following electrophoretic activation of calcium hydroxide (CH) in the root canals. For the study, 60 cavities were drilled on three external root surfaces of 20 bovine teeth specimens to obtain remaining dentin thickness (RDT) of 0.3, 0.7 and 1.0 mm. CH paste was inserted in the lumens. In the experimental group (10 specimens) CH paste was electrophoretically activated. Microelectrode was used to measure pH changes in the cavities immediately after placement of CH, following electrophoretical activation, and after 30 days storage. A significant (P < 0.05) increase in pH following electrophoresis was found in all specimens in the experimental group. Cavities with 0.4 mm RDT showed a maximal pH increase to the value of 11.3 +/- 0.4. In the control group no change in pH was observed after 3 min. A similar increase in pH was observed in both groups after 30 days. The pH changes were significantly depended on the RDT (P < 0.05) in all groups. Electrophoretically activated CH could significantly increase dentinal pH of external root surface within minutes up to 30 days.

Analysis of Variance↗

Coronal leakage of two root canal sealers containing calcium hydroxide after exposure to human saliva.

This in vitro study evaluated the coronal leakage of human saliva into root canals filled by lateral condensation of gutta-percha using two root canal sealers containing calcium hydroxide. Obturated canals with gutta-percha and either Sealapex of Sealer 26 were mounted in an apparatus and then exposed to saliva. The number of days required for total recontamination of the root canal was recorded. Evaluation was conducted for 60 days. Thirty-five percent of the specimens of the Sealer 26 group showed entire recontamination at 60 days. Eighty percent of the root canals obturated with Sealapex showed complete recontamination at 60 days. Sealer 26 presented significantly less leakage than Sealapex (p < 0.01).

Bismuth↗

Recontamination of coronally unsealed root canals medicated with camphorated paramonochlorophenol or calcium hydroxide pastes after saliva challenge.

This in vitro study evaluated the ability of some medications to prevent recontamination of coronally unsealed root canals by bacteria from saliva. The medications tested were camphorated paramonochlorophenol (CPMC) applied in cotton pellets in the pulp chamber; calcium hydroxide/saline solution paste filling the root canal; and calcium hydroxide/CPMC/glycerin paste also filling the root canal. Medicated canals were exposed to saliva, and the number of days required for total recontamination to occur was recorded. Canals medicated with CPMC in cotton pellets were thoroughly recontaminated within an average of 6.9 days. Canals filled with calcium hydroxide/saline solution and calcium hydroxide/CPMC/glycerin showed entire recontamination within an average of 14.7 and 16.5 days, respectively. Calcium hydroxide pastes were significantly more effective than CPMC (p < 0.05).

Bacteria↗

Effect of an oily calcium hydroxide suspension (Osteoinductal) on healing of intrabony periodontal defects. A pilot study in dogs.

The aim of the present study was to evaluate histologically in dogs the effect of treating intrabony defects with an oily calcium hydroxide suspension (OCHS). Intrabony defects were surgically created bilaterally at the distal aspects of the maxillary first premolars and at the mesial aspects of the third premolars in two mongrel dogs. Subsequently, the defects were randomly treated with (a) access flap surgery followed by the application of an OCHS or (b) access flap surgery alone. After 8 weeks of healing, the animals were killed. Dissected blocks containing the experimental specimens were fixed in formalin, decalcified in EDTA, and embedded in paraffin. The formation of new cementum and bone was assessed histomorphometrically. In the control group, healing was predominantly characterized by the formation of a long junctional epithelium along the root surface and limited periodontal regeneration at the most apical part of the defect. The OCHS-treated defects consistently revealed periodontal regeneration (i.e., new periodontal ligament, new cementum with inserting collagen fibers, and new bone). Within the limits of the present study, it can be concluded that OCHS may favor periodontal regeneration in acute-type intrabony periodontal defects.

Alveolar Bone Loss↗

Comparison of using calcium hydroxide or a dentine primer for reducing dentinal pain following crown preparation: a randomized clinical trial with an observation time up to 30 months.

The purpose of this study was to evaluate effect of a calcium hydroxide suspension [Ca(OH)2] or glutaraldehyde based dentine primer (GDP) to reduce tooth sensitivity after full crown preparation. Thirty-six patients were treated with Ca(OH)(2) on one tooth and with GDP on another. Patients completed a questionnaire regarding sensitivity during crown preparation, when the not-anaesthetized abutments were irritated [cotton pellet (20 degrees C)]. The teeth were tested before (T(0)) and after using the desensitizer (T(1)), again after 7 days (T(2)), 6 months (T(3)) and 30 months (T(4)). The results were registered on a visual analogue scale [0 (no pain)-100 (severe pain)]. The changes of tooth sensitivity between different testing times were analysed. The median and the (interquartile range) for the different time intervals for Ca(OH)(2) were DeltaT(0)-T(1): 5 (6-17), DeltaT(0)-T(2): 17 (14-32), and for GDP, DeltaT(0)-T(1): 9 (7-18) DeltaT(0)-T(2): 18 (16-33), the decreases in sensitivity were lower for DeltaT(0)-T(1) than for DeltaT(0)-T(2) for both desensitizers (P < 0.001). There was no statistical difference (P > 0.05) between the agents (DeltaT(0)-T(1), DeltaT(0)-T(2), DeltaT(3)-T(4)). Both substances might be useful in reducing tooth sensitivity after crown preparation, but no differences in the efficacy were found when comparing the materials.

Adult↗

Newly developed resinous direct pulp capping agent containing calcium hydroxide (MTYA1-Ca).

AIM: The aim of this study was to evaluate a newly developed resin (MTYA1-Ca) for direct pulp capping. METHODOLOGY: The powder of MTY1-Ca is composed of 89.0% microfiller, 10.0% calcium hydroxide and 1.0% benzoyl peroxide and was mixed with liquid (67.5% triethyleneglycol dimethacrylate, 30.0% glyceryl methacrylate, 1.0% o-methacryloyl tyrosine amide, 1.0% dimethylaminoethylmethacrylate, and 0.5% camphorquinone). The shear bond, diametral tensile, bending and compressive strengths were measured. The alkaline activity of the elute dissolved from MTYA1-Ca was calculated. Cell viability by MTT assay and alkaline phosphatase (ALPase) activity were evaluated from dental pulp fibroblast reaction to the eluate dissolved from MTYA1-Ca. Histopathological studies of the response to exposed dental pulp of beagle dogs were completed with Dycal as a control. RESULTS: The physical properties of MTYA1-Ca were significantly superior to those of Dycal. It was impossible to measure these properties with Dycal because of poor physical properties. Both MTYA1-Ca and Dycal maintained high levels of alkaline activity (pH 10.96-12.20) over the 168-h duration of the study. Cell viability by MTT assay in the intact eluate of MTYA1-Ca was significantly higher than that of Dycal, whilst ALPase showed no difference between MTYA1-Ca and Dycal. A dentine bridge formed more slowly under MTYA1-Ca than under Dycal, but similar amounts had formed at 90 days. CONCLUSIONS: MTYA1-Ca has the potential to be used as a direct pulp capping material.

Analysis of Variance↗

The strength and fracture toughness of calcium hydroxide preparations.

The strength of a brittle material depends upon the toughness of the material itself and the degree of perfection with which it can be placed. This study shows that both the compressive and tensile strength of calcium hydroxide lining materials is dependent on the fracture toughness at unstable crack propagation, KIC, and the size, number and distribution of pores (which are the defects that nucleate fracture). Of the products tested here, Dycal possesses the greatest actual strength due to a higher than average KIC value and relatively few isolated small pores. However, the greatest potential for strength exists in Reocap which has a KIC value a factor of 2.4 greater than its nearest rival (Dycal). Unfortunately its strength, as determinedhere, is less than Dycal due to the large number of pores in close proximity to each other.

Calcium Hydroxide↗

Histological comparison of alendronate, calcium hydroxide and formocresol in amputated rat molar.

The purpose of this study was to evaluate the potential of alendronate sodium (ALN), a biphosohonate to stimulate hard tissue formation in pulpotomized (amputated) rat molars. Two commonly used pulpotomy materials, calcium hydroxide (CH) and formocresol (FC) were utilized for comparisons. Histological evaluations were performed by observers blinded to treatment allocation on days 7, 15, 30 and 60, followed by statistical analysis of selected histological criteria. In all evaluation periods, hard tissue deposition was evident along the radicular dentin in ALN and CH groups. In days 30 and 60, the latter two groups showed no differences in inflammatory cell response and hard tissue deposition scores (P > 0.05). ALN appears to be capable of maintaining pulpal vitality, while promoting hard tissue formation, similar to CH.

Alendronate↗

The comparison of a dentin adhesive with calcium hydroxide as a pulp-capping agent on the exposed pulps of human and sheep teeth.

OBJECTIVE: This study evaluated the biocompatibility of a one-step dentin bonding agent (Prime&Bond 2.1) in pulp capping compared with calcium hydroxide [Ca(OH)2]. METHOD AND MATERIALS: Thirty sheep teeth and 20 intact human premolars were used. After cavity preparation, pulp exposure was achieved with a bur (#390). Adhesive pulp capping was performed in 25 teeth (15 sheep and 10 human). In the control group (12 sheep and 10 human teeth), pulps were capped with Ca(OH)2 and all of the cavities in both groups were sealed with resin composite. Three of the sheep teeth were used as intact controls. Teeth were extracted 7 or 90 days following treatment and prepared for histological examination and bacterial detection. RESULTS: At 7 days, severe inflammatory responses underlying the bonding agent and in the coronal pulp were observed with soft tissue disorganization in both human and sheep teeth capped with Prime&Bond 2.1. All of the teeth capped with Ca(OH)2 exhibited mild inflammatory reactions limited with the perforation area. After 90 days with the bonding agent, in 3 of 9 sheep teeth, chronic inflammatory reactions were significant, while slight pulpal reactions were observed in the others and dentin bridge formation in all of the sheep teeth was found. However, in human pulps, persistent, unresolved inflammation with the lack of dentin bridge formation was observed. In the Ca(OH)2 group, pulp repair with dentin bridging was found in all of the teeth, both sheep and human. No correlation was found between the presence of inflammation and bacterial staining using Spearman rank correlation test (P > .05). CONCLUSION: Prime&Bond 2.1 facilitates enhanced pulp healing and bridge formation in sheep teeth, but in human teeth it was not as successful as Ca(OH)2 as a pulp capping agent.

Acetone↗

Calcium hydroxide and a corticosteroid-antibiotic association as dressings in cases of biopulpectomy. A comparative study in dogs' teeth.

The subject of this paper was to study the behavior of the periapical tissues of dogs' teeth after biopulpectomy and dressing with calcium hydroxide or a corticosteroid-antibiotic association, before root canal filling with zinc oxide eugenol (ZOE) or Sealapex sealers. The teeth were overinstrumented and dressed for 7 days before the root canal filling. The animals were sacrificed 180 days after treatment and the specimens were prepared for morphological analysis. Specimens treated with Sealapex presented a higher number of cases with biological closure than ZOE. When the root canals were filled with ZOE, better results were observed with the use of the Ca(OH)2 dressing.

Animals↗

Anaerobic tissue-dissolving abilities of calcium hydroxide and sodium hypochlorite.

Closed root canals likely have an oxygen-free environment; most bacteria in canals are anaerobic. These bacteria and other debris are difficult to remove. Unknown is tissue dissolution with chemicals under these anaerobic conditions. This study evaluated and compared dissolving properties of calcium hydroxide (Ca(OH)2) and sodium hypochlorite (NaOCl) on bovine pulp tissue in aerobic and anaerobic environments. Sixty bovine pulp specimens were dried, then randomly divided into six groups. Groups A and B were immersed in Ca(OH)2 + water solution, whereas group C and D were in 2.5% NaOCl. Groups E and F (controls) specimens were placed in distilled water. Groups A, C, and E were incubated anaerobically, and groups B, D, and F were incubated under regular atmospheric conditions, all for 7 days. Percentages of weight loss were compared between groups. Results showed the following: (a) both chemicals partially dissolved pulp tissue, (b) anaerobic environment did not alter tissue-dissolving properties of Ca(OH)2 or NaOCl, and (c) Ca(OH)2 and NaOCl were equal and more effective than water.

Anaerobiosis↗

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

A case with a open apex and a large periapical lesion in a 10 year old boy is presented. The lesion formed as a result of necrosis from trauma to a maxillary right central incisor 1 year ago. Apical closure and complete healing of periapical lesion was observed after non-surgical endodontic treatment using calcium hydroxide paste. This report suggests that even large periapical lesions could respond favourably to non-surgical treatment.

Calcium Hydroxide↗

[Histological evaluation of direct pulp capping with a self-etching adhesive and calcium hydroxide].

OBJECTIVE: To evaluate the beagles' pulp response following direct pulp capping with Clearfil SE BOND (SB). METHODS: 130 sound teeth were used. 120 had their pulps mechanically exposed and were divided in two groups. In group A, teeth were capped with SB. In group B, teeth were capped with calcium hydroxide (CH). The left 10 teeth were used as control. After 7, 30 and 90 days, the teeth were extracted and processed for light microscopical examination. RESULTS: In 7 day observation period, inflammatory reaction in SB group was slighter than that of CH group, but the difference was statistical insignificant. In the 30 day and 90 day observation period, inflammatory reaction was slight in both groups, but specimens with dentin bridge formation was significantly less in SB group than in CH group (P < 0.05). CONCLUSION: SB showed acceptable biocompatibility with pulp, but its ability to induce hard tissue barrier on pulp exposure is weaker than CH.

Adhesives↗

Reparative hard tissue formation following calcium hydroxide application after partial pulpotomy in cariously exposed pulps of permanent teeth.

In a prospective study, partial pulpotomy was performed on six permanent molars with deep carious lesions and pulpal involvement. The bleeding pulp was irrigated with normal tap water until bleeding had stopped and the exposed pulp was covered with calcium hydroxide followed by zinc oxide eugenol, and finally covered with a semipermanent restoration. All teeth showed hard tissue barrier formation, both clinically and radiographically, within three months and were free from subjective and objective symptoms through the observation period (average observation period was 26 months). The patients also experienced the therapy positively. These findings and those of others have helped gain more recognition for partial pulpotomy as a strong possible alternative therapy when pulps are exposed by deep carious lesions and a bleeding pulp is exposed during the excavation process. The rationale for this therapy is to remove the infected and/or inflamed pulpal areas beneath the carious lesion and disintegrated tissue. A rapid and simplified procedure would allow the general practitioner to perform this procedure when necessary at dental clinics, without specialist facilities under conditions that avoid unnecessary contamination of the pulp.

Adolescent↗