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Pulp response to a novel adhesive calcium hydroxide based cement.

This study compares pulp responses to 3 formulations of calcium hydroxide, namely: a) An experimental adhesive calcium hydroxide cement containing polyacrylic acid, b) Dycal (L.D> Caulk Co, Milford, Delaware) Batch Nos 176970/176990, c) "Analar" calcium hydroxide mixed with sterile distilled water. After 28 days dentine bridges were present in 77% of teeth capped with the test material, 64% of teeth treated with Dycal and in 62% of teeth capped with calcium hydroxide and water. Inflammatory infiltrates were observed in a number of teeth remote from the bridges. Bacteria were detected in these specimens. Exposed rat molar pulp responses to an experimental adhesive calcium hydroxide cement were similar to to those observed with 2 other calcium hydroxide formulations.

Animals↗

The rate of OH- ion release from lining materials containing calcium hydroxide.

Four light-cured calcium hydroxide and three chemically cured resin-based lining materials were compared for hydoxil ion (OH-) release. Results indicated that the chemically cured calcium hydroxide cements were capable of OH- release for a longer period than the light-cured resin bases. Alkaliner (a chemically cured liner) produced and maintained the highest alkaline environment in the long-term, whereas calcium fluoride liner and Basic-L (both resin-based) showed the lowest values of OH- ion release.

Analysis of Variance↗

Surface properties of kaolin and illite suspensions in concentrated calcium hydroxide medium.

The adsorption behaviour of calcium hydroxide onto illite and kaolin clay minerals was investigated by monitoring with atomic emission spectroscopy and pH measurements the amounts of ions left in solution after exposing clay minerals to calcium hydroxide solutions of various concentrations. Both clay minerals can adsorb calcium and hydroxyl ions. Rather than just considering proton exchanges at the clay mineral surfaces, the adsorption is explained by an approach based on Lewis description of molecules. With this approach, a mechanism for calcium hydroxide adsorption not only at the edges of the clay particles but also onto the faces is proposed. In order to gain a better insight onto the active groups at the surface of the studied clay minerals, adsorption of pyridine and ammonia on illite and kaolin was followed by FTIR spectroscopy. These measurements gave the signature of edges, which are marginally involved in interactions with calcium ions.

Journal Article↗

The comparative antimicrobial effect of calcium hydroxide.

The antimicrobial effectiveness of calcium hydroxide, camphorated paramonochlorophenol, and formocresol in root canals of extracted human teeth was compared. Canals in single-rooted teeth were enlarged and inoculated with Streptococcus mutans, Actinomyces viscosus, and Bacteroides gingivalis or Bacteroides fragilis. After treatment with a test agent and sealing and incubation for 1 hour, the canal contents were analyzed for the number of viable test bacteria and compared with that of inoculated teeth not treated with test agents. All test agents exhibited antimicrobial activity against all bacteria, with percent reductions in viable bacteria ranging from 64.3% to 100%. The combined data for Pulpdent paste and calcium hydroxide showed significantly higher antimicrobial activity than the combined data for camphorated paramonochlorophenol and formocresol for S. mutans and B. gingivalis or B. fragilis but showed no difference for A. viscosus.

Actinomyces↗

Two methods to evaluate the antimicrobial action of calcium hydroxide paste.

The objective of this study was to analyze two methods for determining the antimicrobial effectiveness of (i) calcium hydroxide plus saline, (ii) calcium hydroxide plus polyethylene glycol, and (iii) calcium hydroxide plus camphorated paramonochlorophenol. Four microorganisms (Staphylococcus aureus (ATCC 6538), Enterococcus faecalis (ATCC 29212), Pseudomonas aeruginosa (ATCC 27853), and Bacillus subtilis (ATCC 6633)), one yeast (Candida albicans (ICB/USP-562)), and one mixture of these organisms were used. The strains were inoculated in Brain Heart Infusion (BHI) and incubated at 37 degrees C for 24 h. Two methods, the direct exposure test and the agar diffusion test were used to evaluate antimicrobial effects. For the direct exposure test (DET) 288 paper points were contaminated with the standard microbial suspensions and exposed to the intracanal dressings for 1, 24, 48, and 72 h. The points were immersed in Letheen Broth, followed by incubation at 37 degrees C for 48 h. An inoculum of 0.1 ml obtained from Letheen Broth was then transferred to 7 ml of BHI under identical incubation conditions, and microbial growth was evaluated. Pastes showed activity between 1 and 72 h, depending on the microorganism/mixture tested. For the agar diffusion test 36 Petri plates with 20 ml of BHI agar were inoculated with 0.1 ml of the same microbial suspension used for the DET, using sterile swabs that were spread on the medium. Five cavities were made in each of two agar plates (total = 10) and completely filled with one of the calcium hydroxide pastes. The plates were preincubated for 1 h at environmental temperature and then incubated at 37 degrees C for 24 to 48 h. The inhibition zone around each well was recorded in millimeters, and the results were submitted to ANOVA and Tukey test (alpha = 0.05). All intracanal dressings induced inhibition zones (range 5.0-10.0 mm). Data obtained showed that both the DET and agar diffusion test are useful in establishing the calcium hydroxide antimicrobial spectrum, thus improving infection control protocols. The direct exposure method is independent of other variables and is a practical laboratory procedure. A complete antimicrobial effect was observed after 48 h on indicator microorganisms, in both tests, irrespective of the calcium hydroxide paste vehicle.

Analysis of Variance↗

Influence of different vehicles on the pH of calcium hydroxide pastes.

The main known benefit of calcium hydroxide as an intracanal medicament lies in the bactericidal effect conferred by its pH. The objective of this work was to determine the influence of the vehicle on the pH of calcium hydroxide pastes after usage in patients and in vitro. The incisor root canals of 180 patients were instrumented and filled with calcium hydroxide pastes containing distilled water, chlorhexidine, propylene glycol, anesthetic solution, camphorated p-monochlorophenol and camphorated p-monochlorophenol-propylene glycol. The pH of the paste in the patients' root canals was measured at 7, 14 and 21 days. Similarly, pH was measured in vitro up to 21 days. The pH of all the pastes remained constant throughout the time periods assessed. The calcium hydroxide-water combination showed significantly higher pH values than the other pastes in clinical use. Comparative analysis showed that the pH values of the anesthetic solution, camphorated p-monochlorophenol and camphorated p-monochlorophenol-propylene glycol were significantly higher in vitro. The type of vehicle was shown to influence the final pH of the pastes. However, the alkalinity of all pastes was maintained over time under the experimental conditions.

Adult↗

[Investigation of chemical reaction and isolation of calcium hydroxide and Zn-phosphate cement in vitro conditions].

An important question in conservative dentistry is whether in direct contact of calcium hydroxide paste and phosphate cement the neutralization of pH calcium hydroxide occurs and how it can be prevented. Chemical investigations performed in vitro conditions (in the test tube) concerned 3 groups, each of which had 12 samples. In the A group (control group) calcium hydroxide paste was put at the bottom of the test tube and ZOOK paste and phosphate cement layer were put over it; in the B group, Tubulitec base in 2 layers was applied over calcium hydroxide cement and then the phosphate cement; and in the C group, the calcium hydroxide paste and phosphate cement were put in the test tube in direct contact. Within 12 weeks, after 7 days, the 3 samples were investigated (1 in each group). Contrary to expectations the results showed that in direct contact of calcium hydroxide paste and phosphate cement no change occurred in pH calcium hydroxide, and that its average value was 12.70. Further were there was no statistically significant difference in values of pH calcium hydroxide paste among the A, B and C groups. On the basis of these studies and in the opinion of other authors, it may be concluded that, although there was no decrease in pH calcium hydroxide in direct contact of calcium hydroxide paste and phosphate cement, it should be necessary to make the mutual isolation of these materials; in practice this is most efficiently done on two-layer Tubulitec base.

Calcium Hydroxide↗

A laboratory study evaluating the release of hydroxyl ions from various calcium hydroxide products in narrow root canal-like tubes.

AIM: The aim of the present study was to describe pH changes in a variety of buffering solutions within a narrow test tube containing either a gutta-percha point with incorporate calcium hydroxide, a commercial calcium hydroxide paste (Calcicur) or a freshly mixed paste of calcium hydroxide in distilled water. METHODOLOGY: The test material was placed centrally in a test tube of 2 mm inner diameter. Saline (1%) was placed at one end, whilst the buffering solutions were introduced at the other. The pH of the buffering solutions was monitored using electrodes placed at each end of the test tube. RESULTS: It was found that the pH 4.01 buffer strongly resisted pH changes at levels below 6.0, whilst saliva and bovine serum was buffered less and more evenly in the whole range up to pH 11.5. The calcium hydroxide containing gutta-percha points caused the pH to increase quickly in the sodium chloride solution to levels above 11.5. However, in bovine serum, in saliva and in the pH 4.01 buffer the pH remained below 8.5, 8.0 and 6.0, respectively, 1 mm from the point. In contrast, the release of hydroxyl ions from the two calcium hydroxide pastes brought pH above pH 11.5 irrespective of the buffering of the solutions 5 mm from the paste. CONCLUSION: It is concluded that Calcicur and the calcium hydroxide-water mixture contained substantially more available calcium hydroxide than did the calcium hydroxide containing gutta-percha points, with the result that the release of hydroxyl ions from the points was limited in comparison to that from the pastes.

Animals↗

[Chemical change of calcium hydroxide contained in root canal filling materials in serum].

In the previous report we showed the conversion of calcium hydroxide contained in root canal filling materials to calcium carbonate by means of 4 weeks of subcutaneous implantation in rats. The purpose of this study was to discover if this reaction would take place in vitro as a chemical reaction and also to find out the rate of the conversion. The alteration of three materials. Vitapex, Calvital, calcium hydroxide, when in serum, was checked and the alteration of the latter two, when in the air, was checked. The solubility of calcium hydroxide in serum or distilled water was also determined. The results showed that calcium hydroxide was neutralized to calcium carbonate after several weeks in the serum. The conversion in the air was much slower than that in the serum. This means that calcium hydroxide will not change while in storage and when it has no contact with the tissue fluid. Calcium hydroxide was dissolved in both the serum and distilled water, but calcium carbonate was not. This fact suggests that calcium hydroxide neutralized to calcium carbonate by serum will cause little or no chemical irritation.

Animals↗

Calcium hydroxide root canal sealers: evaluation of pH, calcium ion concentration and conductivity.

The calcium hydroxide ionization of four root canal sealers (Sealapex, CRCS, Sealer 26, and Apexit) was studied by measuring conductivity and pH and by conducting atomic absorption spectrophotometry. Samples 6 mm in diameter and 15 mm long were prepared from these sealers. After setting and 48 h storage in a desiccator, five samples of each material were placed in 50 mL distilled water and analysed after 0,1,2,4,6 and 24 h and 5, 15 and 30 days. The results showed that Sealapex was the root canal sealer showing the highest pH, ionic calcium and total calcium values (P < 0.05) throughout the experimental period, followed by CRCS, Apexit and Sealer 26.

Bismuth↗

[Removal of two calcium hydroxide preparations: S.E.M. study].

Calcium hydroxide is one of the most often medication used for temporary treatment in endodontics. Different forms of preparation are available. The aim of this study is to evaluate in vitro the elimination of the pharmaceutical and the commercial forms of presentation. The aspect of the dentinal walls were analysed using SEM and X-ray microanalysis. The results show that Ca(OH)2 removal is difficult but there is no significant difference of elimination between the two forms.

Calcium Hydroxide↗

The effects of calcium hydroxide on dentin permeability.

Calcium hydroxide paste was applied to human dentin in vitro to determine its effects on dentin permeability. Discs of dentin were acid-etched on both sides to permit determination of their maximum permeability. Smear layers were then applied to the enamel sides of the discs, thereby reducing dentin permeability 99%. Topical application of Ca(OH)2 paste to the smear layer reduced dentin permeability further, to levels 48% below that of untreated smear layers. When the Ca(OH)2-treated smear layers were exposed to 6% citric acid for two min, dentin permeability returned to the initial acid-etched value, demonstrating that Ca(OH)2 offers little protection to acid challenge. Treatment of acid-etched dentin with Ca(OH)2 produced a similar reduction in dentin permeability, which was restored to normal following acid challenge. Thus, Ca(OH)2 is effective at reducing the permeability of both the smear layer and of acid-etched dentin, in vitro.

Acid Etching, Dental↗

Effect of calcium hydroxide on bacterial lipopolysaccharide.

Apical periodontitis and its concomitant periapical osteolysis is caused by pulpal infection, and bacterial lipopolysaccharide (LPS) is known to play a major role in the bone resorption process. Little is known concerning the effect of root canal intervisit dressings on residual LPS in root canals after bacterial cell lysis. The purpose of this study was to evaluate the effects of calcium hydroxide on bacterial LPS. Free hydroxy fatty acids were quantified in samples of LPS treated with calcium hydroxide. Calcium hydroxide treatment of LPS was shown to release elevated quantities of hydroxy fatty acids. It was concluded that calcium hydroxide hydrolyzed the lipid moiety of bacterial LPS, resulting in the release of free hydroxy fatty acids. This result suggests that calcium hydroxide-mediated degradation of LPS may be an important reason for the beneficial effects obtained with calcium hydroxide use in clinical endodontics.

Calcium Hydroxide↗

Histologic evaluation of periradicular tissues in dogs treated with calcium hydroxide in combination with HCT20 and camphorated P-chlorophenol.

OBJECTIVE: The aim of this study was to evaluate the biocompatibility of calcium hydroxide suspended in HTC20 or calcium hydroxide plus CMCP and their effects on the healing of periapical lesions in dogs. STUDY DESIGN: Experimental apical periodontitis was induced by opening the pulp chamber of 36 mandibular premolars in 6 3-year old dogs. The teeth were left opened for 1 week and then closed with IRM for 60 days in order to induce periapical lesions. The teeth were divided into 1 control and 2 experimental groups. Both experimental groups received intracanal dressings with a calcium hydroxide slurry. In the first experimental group calcium hydroxide was mixed with a detergent vehicle and in the second group with camphorated parachlorophenol. The medications were kept in the root canal for 2 periods of 30 days each. Afterwards, the dogs were killed and the periapical areas were studied histologically. RESULTS: Based on biocompatibility and tissue remodeling in the periapical area, the best results were observed when calcium hydroxide was mixed with the detergent. The difference was statistically significant (P < .05). CONCLUSION: Calcium hydroxide plus CMCP intracanal dressing was the most irritating to the periapical region, and the group of calcium hydroxide plus HCT 20 showed the best results whenever biocompatibility and the capacity of new bone formation was considered.

Animals↗

Calcium hydroxide and apexogenesis.

This case report describes the effect of calcium hydroxide in the treatment of traumatized immature tooth. Calcium hydroxide is used to fill the root canal after complete chemomechanical debridement has been performed. The result demonstrated the successful use of calcium hydroxide in stimulating the epithelial cells of Hertwig's sheath and the surrounding undifferentiated progenitor cells to continue formation of the apical portion of the root. Thus, the use of calcium hydroxide stimulated apical bridge formation, as well as inducing apexogenesis.

Calcium Hydroxide↗

Changes in pH at the dentin surface in roots obturated with calcium hydroxide pastes.

The purpose of this study was to determine the pH, after defined periods of time, in cavities prepared in the facial surface of the cervical, middle, and apical regions of roots obturated with calcium hydroxide pastes. Root canal instrumentation was performed on 40 recently extracted, single-rooted human teeth. Cavities 1.5 mm in diameter and 0.75 mm in depth were prepared in the cervical, middle, and apical regions of the facial surface of each root. Teeth were randomly divided into four groups. One group was left unobturated and served as a control. The three remaining groups were obturated with either aqueous calcium hydroxide, calcium hydroxide mixed with camphorated monochlorophenol. or Pulpdent pastes. Access cavities and apical foramina were closed with Cavit. Each tooth was stored individually in a vial containing unbuffered isotonic saline. pH at the surface was measured in the cervical, middle, and apical cavities at 0 and 3, 7, 14, 21, 28, 45, 60, 90, and 120 days. Results indicate that hydroxyl ions derived from calcium hydroxide pastes diffused through root dentin at all regions over the experimental period of 120 days. The pattern of pH change at the tooth surface was similar in all regions of the root, regardless of the type of calcium hydroxide paste used. This was a rapid rise in pH from a control value of pH 7.6, to greater than pH 9.5 by 3 days, followed by a small decline to pH 9.0 over the next 18 days, before finally rising and remaining at, or above pH 10.0 for the remainder of the experimental period. Pulpdent paste in the apical region was the only exception in this pattern, producing a pH rise nearly one full unit below the other pastes, pH 9.3. These results indicate that, for all pastes tested, a high pH is maintained at the root surface for at least 120 days.

Analysis of Variance↗

Root canal filling with calcium hydroxide using different techniques.

Several different techniques for placing calcium hydroxide into root canals have been proposed, such as amalgam carriers, vertical pluggers, McSpadden compactors, Lentulo drills, files and special syringes. Because correct filling of the root canal is necessary for calcium hydroxide paste to act effectively, the aim of this research was to study different techniques of root canal filling with calcium hydroxide pastes in dog teeth. The placement of calcium hydroxide with a file, absorbent paper points and vertical pluggers presented the lowest number of empty spaces in the three thirds of the root canal, followed by the Lentulo drill and the McSpadden compactor.

Animals↗

[Development of a visible light-curing calcium hydroxide cement].

A visible light-curing calcium hydroxide cement is presented here and the effects of its resin matrix on the Ca2+ releasing, compressive strength of set material and the pH value of water in which set materials immersed are evaluated. Experimental results show that the effects of the selected resin matrix on Ca2+ releasing, compressive strength and pH value are significant. The calcium hydroxide cement containing BEMA or EMA and HEMA as resin matrix has good properties. The pulp capping test showed that an excellent dentin bridge appeared in dogs capped teeth at 70 days. pulp, pulp capping, calcium hydroxide, visible light-curing, dental materials

Animals↗