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Calcium hydroxide ameliorates tobramycin toxicity in cultured chick tibiae.

Results from this laboratory have shown that bone metabolism is directly related to extracellular pH and that high concentrations of tobramycin released from impregnated polymethylmethacryrate (PMMA) beads has pH-dependent toxic effects on bone. In the present study, beneficial effects of calcium hydroxide-impregnated PMMA were investigated regarding tobramycin toxicity and bone metabolism in chick embryo tibiae in vitro. Also using Ca(OH)2 as a pH regulator, the antibiotic efficacy of tobramycin-impregnated PMMA was evaluated with respect to inhibition of Staphylococcus aureus growth. When Ca(OH)2 was added to PMMA beads containing tobramycin, the beads released hydroxyl and calcium ions into the culture medium and released more antibiotic than beads containing only tobramycin. Bone metabolism (glycolysis, total protein synthesis, and collagen synthesis) was enhanced by Ca(OH)2-impregnated beads with or without tobramycin. Additionally, bacterial growth was inhibited more strongly when S. aureus was incubated with tobramycin- and Ca(OH)2-impregnated PMMA disks than with disks containing only tobramycin. This study demonstrates the feasibility of adding Ca(OH)2 to tobramycin-impregnated PMMA beads as a regulator of local pH and a promoter of bone metabolism for protection of bone when high concentrations of tobramycin are used to treat osteomyelitis. It also suggests that lower concentrations of antibiotic may be effective if Ca(OH)2 and tobramycin are administered simultaneously.

Animals↗

Remineralization of carious dentin. II: In vivo microradiographic and chemical studies in human permanent teeth capped with calcium hydroxide.

The main aim of this in vivo study was to evaluate a possible remineralization of human carious dentin by means of chemical and microradiographic studies. Eighty-six samples of carious dentin were removed from 36 permanent teeth of 24 patients. These were divided into untreated (control) and chemically pure calcium hydroxide-capped (experimental) samples and analyzed at intervals varying from 10 to 120 days. They were classified according to depth of caries and degree of dentin softening and evaluated in relation to weight, phosphorus concentration, qualitative and quantitative microradiography and absolute values of total mineral content. One of two halves of each sample was selected for chemical studies and the other for total content of mineral salts. Experimental samples were examined with a light microscope and the results obtained showed a qualitative increase in radiopacity. Quantitatively, it was observed that, in the case of samples analyzed for phosphorus concentration, the average mean of differences in percentage increase after treatment was 9.6%, while for the samples evaluated microradiographically for total mineral content, it was 22.29%. In both cases, the differences were statistically significant.

Adolescent↗

Neurotoxic effect of two root canal sealers with calcium hydroxide on rat phrenic nerve in vitro.

Root canal sealers placed into contact with the inferior alveolar nerve can cause paraesthesia in the area innervated by this nerve. The paraesthesia is due to neurotoxic effects of the sealers. In this study we examined the effect on nerve conduction in vitro of two calcium hydroxide-containing root canal sealers, Sealapex and CRCS. An isolated rat phrenic nerve was placed between two suction electrodes in a bath containing Tyrode solution. The sealers were brought into contact with the nerve, and the evoked compound action potentials (cAP) were recorded before and after contact with the materials. Both Sealapex and CRCS induced a fast and complete inhibition of the cAP in this model. The degree of reversibility of the inhibition varied from experiment to experiment. Both materials exhibited reversible and irreversible block of the nerve conduction after 90s and 5 min exposure. However, after 30 min of contact, the conduction of the cAP was irreversibly blocked for both materials.

Action Potentials↗