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PubMed2003

Calcium hydroxide as an intracanal medication: effect on posttreatment pain.

Calcium hydroxide is advocated as an intracanal medication for various purposes, including prevention of posttreatment symptoms. This study assessed whether calcium hydroxide had a pain-controlling effect at different times when compared with no intracanal medication. One hundred forty patients participated. Conditions diagnosed were pulp/periapical pathosis with or without symptoms. At least partial cleaning and shaping was completed. At random, either Ca(OH)2 plus H2O paste or a dry cotton pellet was placed in the canals of half the teeth, respectively. All teeth were temporized with Intermediate Restorative Material. Patients assessed posttreatment pain up to 48 h as none, mild, moderate, or severe. The pain levels in each test group [Ca(OH)2 versus cotton pellet] at each time period were compared statistically with a multiple-regression analysis. There was no significant difference in posttreatment pain between the two groups at any time period or with any diagnosis or symptom. The use of calcium hydroxide as an intracanal medication was unrelated to the incidence and/or severity of posttreatment pain.

Adult↗
PubMed1989

[Calcium hydroxide in the treatment of traumatized teeth].

Calcium hydroxide is used in the treatment of different traumatized teeth. New concepts about the effects of calcium hydroxide on vital pulps and immature non vital teeth are developed. Some clinical techniques and their results are described.

Calcium Hydroxide↗
PubMed2003

Effectiveness of stannous fluoride and calcium hydroxide against Enterococcus faecalis.

The objective of this study was to evaluate the antimicrobial activity of stannous fluoride, calcium hydroxide, or the two in combination against Enterococcus faecalis. Fifteen Mueller-Hinton agar plates were used to conduct a disc diffusion susceptibility test. The plates were inoculated with E. faecalis. The groups tested were: (a) stannous fluoride (Stanimax); (b) calcium hydroxide; and (c) a combination of stannous fluoride and calcium hydroxide. Three filter paper discs, each soaked with one of the groups, were placed along with an antibiotic control (ampicillin) on each agar plate. The plates were then incubated at 37 degrees C. The zones of inhibition were measured at 24 and 48 h. One-way ANOVA revealed a statistically significant difference (p < 0.05) between the three groups. Stannous fluoride displayed the widest zone (1.7 mm), followed by the combination of stannous fluoride and calcium hydroxide (1.1 mm), whereas calcium hydroxide by itself displayed a minimal zone of inhibition (0.05 mm).

Analysis of Variance↗
PubMed2001

Calcium hydroxide retention in wide root canals with flaring apices.

Calcium hydroxide (CH) is used to induce apexification in immature, pulpless teeth with wide root canals and flaring apices. Three placement methods of CH were compared in vitro, for their ability to enhance CH retention in the canal. Barium sulfate (BS), added as radiopacifier, was studied for its effects on the radiographic follow up of CH retention, as well as on the ability to detect voids in the CH. Calcium hydroxide filled teeth were kept in phosphate buffered saline-containing tubes in a shaker water bath. Radiographs were taken weekly to follow the retention or loss of the material; they were scanned and stored as digitized images. Quantitative evaluations were done on these images, using a computerized gray scale. Condensed CH was better retained in root canals than either lentulo-placed paste or commercial injected paste. Barium sulfate in the CH paste enabled better detection of voids in the paste filling the canal, however, it obscured the disappearance of CH from the canal, due to a residual radiopacity effect. The results supported (a) condensation of calcium hydroxide as a preferred method that improves its retention in wide root canals, and (b) discontinuing the use of barium sulfate as a radiopacifier in apexification procedures.

Analysis of Variance↗
PubMed2001

PH changes at the surface of root dentin after intracanal dressing with calcium oxide and calcium hydroxide.

This study was designed to compare pH changes at the cervical and apical surfaces of root dentin after canal obturation with calcium oxide or calcium hydroxide pastes. The effect of the exposure to CO2 on the pH at the root surface also was assessed for both materials. Thirty-six extracted human canines were selected and instrumented. Wells 1 mm deep x 1.5 mm in diameter were drilled in the cervical and apical regions of the buccal root surface. The teeth were randomly divided into two groups and obturated with either calcium hydroxide or calcium oxide. pH was measured in the cervical and apical wells at varying time intervals until 48 days posttreatment. After pH measurement on day 48 the vials were flushed with CO2 and the pH measured again at days 53 and 68. The results indicated a similar pattern of pH increase after treatment with either calcium oxide or calcium hydroxide. pH dropped significantly after exposure to CO2 in both groups. This study demonstrated that hydroxyl ions produced when calcium oxide reacts with water diffuse through the dentinal tubules to the surface of the root in a manner similar to hydroxyl ions from calcium hydroxide.

Analysis of Variance↗
PubMed1999

Effect of vehicle on antimicrobial properties of calcium hydroxide pastes.

The current discussion about the importance of intracanal dressings and the effect of vehicles on calcium hydroxide pastes is justified by controversy concerning the achievement of complete disinfection after preparation of infected root canals and the real antimicrobial effect of these vehicles. The aim of this study is to investigate the role of vehicles in the antimicrobial effect of calcium hydroxide pastes. Well-conducted research about the characteristics of calcium hydroxide, such as antimicrobial potential, physico-chemical aspects and histocompatibility, gives credibility to the choice of this medication in several clinical situations. Different vehicles have been added to calcium hydroxide in an attempt to enhance its properties. Scientific reasoning indicates the use of hydrosoluble vehicles (distilled water, saline) associated with calcium hydroxide because of their chemical characteristics of dissociation, diffusibility and filling capability which are decisive for the biological behavior, i.e., antimicrobial qualities and induction of tissue repair.

Anti-Infective Agents, Local↗
PubMed1994

Alteration of biological properties of bacterial lipopolysaccharide by calcium hydroxide treatment.

Bacterial lipopolysaccharide (LPS) plays a major role in the development of periapical bone resorption. Although the chemical properties of LPS are altered by treatment with an alkali such as calcium hydroxide, the effects of calcium hydroxide on the biological properties of LPS are not known. The purpose of this study was to investigate whether treatment of LPS with calcium hydroxide alters its biological action as measured by human monocyte secretion of prostaglandin E2. Monocyte cell cultures were stimulated with LPS or calcium hydroxide-treated LPS and culture supernatants were analyzed for prostaglandin E2 content using gas chromatography-mass spectrometry. Prostaglandin E2 was identified in supernatants of LPS-stimulated monocytes but not in those stimulated with calcium hydroxide-treated LPS. It was concluded that the treatment with calcium hydroxide may alter biological properties of bacterial LPS.

Calcium Hydroxide↗
PubMed1999

Mechanisms of antimicrobial activity of calcium hydroxide: a critical review.

Literature review The primary function of calcium hydroxide as a routine intracanal medicament is to provide antimicrobial activity. However, the mechanisms of antimicrobial activity of calcium hydroxide are not well known. Physicochemical properties of this substance may limit its effectiveness in disinfecting the entire root canal system. In addition, calcium hydroxide is not effective against all bacterial species found in root canal infections. Association with other medicaments may enhance the efficacy of the intracanal medication in eliminating residual bacteria in the root canal system.

Anti-Infective Agents, Local↗
PubMed1996

Apical leakage after root canal filling with an experimental calcium hydroxide gutta-percha point.

This study was an in vitro analysis of the apical seal of root canals filled with an experimental calcium hydroxide gutta-percha point. One hundred and ten recently extracted human permanent teeth with a single root were used. The root canals were biomechanically prepared, and some received a dressing of calcium hydroxide for 7 days. Root canals not dressed were filled by the lateral condensation technique with either regular gutta-percha or calcium hydroxide gutta-percha points. The dressed root canals were filled with the same sealers and regular gutta-percha points. The specimens were placed into a 2% methylene blue dye solution under vacuum, and the apical leakage was linearly evaluated. The experimental groups with calcium hydroxide dressing and the one with calcium hydroxide gutta-percha points exhibited significantly (p < 0.05) less leakage than the groups filled with regular gutta-percha points. The results obtained indicated that calcium hydroxide gutta-percha points produced an improvement in the apical sealing quality of the root canal filling.

Analysis of Variance↗
PubMed1997

A histological and quantitative histomorphometric study of apexification of nonvital permanent incisors of vervet monkeys after repeated root filling with a calcium hydroxide paste.

The purpose of this study was to compare the effect of a monthly refilling of the root canals with calcium hydroxide paste with a single packing or replacement of the paste at 3 months on the apexification of nonvital maxillary incisors of vervet monkeys. Forty-eight maxillary incisors from 12 monkeys were used following radiographic determination that root development was incomplete. The pulps were extirpated under general anesthesia and the root canals filed and cleaned. The root canals were filled with a commercial calcium hydroxide paste, Calxyl, and a temporary cavity filling placed. Twelve teeth were left without further treatment. The calcium hydroxide paste was replaced in 12 teeth after a 3-month interval, and in the remaining 24 teeth the calcium hydroxide root filling was replaced five times at monthly intervals. The monkeys were killed after 6 months, and blocks of the teeth and surrounding tissues were embedded, decalcified and 6 microns serial sections prepared and stained. The sections were studied histologically to evaluate 11 parameters. Significant differences were found in the amount of calcium hydroxide at the apices, the presence of new cementum on the roots and the degree of inflammation, all of which were better in the monthly refill group. Histomorphometric measurements to evaluate the obturation of the open apices and the volume of new primary osteocementum showed no significant difference between the three groups. It was suggested that after the initial root filling with calcium hydroxide there was nothing to be gained by repeated root filling either monthly or after 3 months, for at least 6 months.

Analysis of Variance↗
PubMed2002

Electrocoagulation extends the indication of calcium hydroxide pulpotomy in the primary dentition.

The primary molars received calcium hydroxide pulpotomy with or without the electrocoagulation procedure. Teeth were evaluated clinically and radiographically at 6, 12, and 24 months after treatment. There was no statistically significant difference in success rate between calcium hydroxide pulpotomies, with and without the electrocoagulation procedure, either clinically or radiographically. These results indicate that a pulpotomy with calcium hydroxide is an effective treatment for cariously exposed pulp in primary molars and electrocoagulation can extend its indication.

Calcium Hydroxide↗
PubMed1991

Oral administration of calcium hydroxide stimulates bone metabolism in the femoral diaphysis of rats with skeletal unloading.

The preventive effect of calcium hydroxide on the disorder of bone metabolism caused by skeletal unloading was investigated. Skeletal unloading was designed using the model of hindlimb hang in rats. Skeletal unloading for 7 d caused a significant decrease of inorganic phosphorus concentration in the serum and of alkaline phosphatase activity and deoxyribonucleic acid (DNA) content in the femoral diaphysis of rats. Oral administration of calcium hydroxide (16 and 24 mg Ca/kg) caused a significant increase in serum inorganic phosphorus concentration and femoral-diaphyseal calcium content and alkaline phosphatase activity of rats with skeletal unloading. Bone DNA content was significantly increased by the dose of 24 mg Ca/kg. These results clearly indicate that skeletal unloading-induced disorder of bone metabolism is partly prevented by oral administration of calcium hydroxide. Calcium ingestion may be useful as a therapeutic tool in the disorder of bone metabolism caused by skeletal unloading.

Animals↗
PubMed1991

Analysis of pH variation of various calcium hydroxide compounds in vitro.

Among the reasons for the use of calcium hydroxide products, there is their alkalinity. Variations in the alkalinity of six commonly used calcium hydroxide compounds were studied in vitro at different time intervals. All these compounds rendered the saline solution strongly alkaline. Dycal, Life, Nucap and Reocap, had a weaker effect as compared with Contrasil and to Pulpdent paste. Such differences in the pH values were accompanied by differences in calcium loss, as revealed by scanning electron microscopy. Differences in the alkaline pH values and calcium losses among these calcium hydroxide compounds may account for their different clinical effectiveness in vivo.

Calcium Hydroxide↗
PubMed2004

Lack of genotoxicity of formocresol, paramonochlorophenol, and calcium hydroxide on mammalian cells by comet assay.

Formocresol, paramonochlorophenol, and calcium hydroxide are widely used in dentistry because of their antibacterial activities in root canal disinfection. However, the results of genotoxicity studies using these materials are inconsistent in literature. The goal of this study was to examine the genotoxic potential of formocresol, paramonochlorophenol, and calcium hydroxide using mouse lymphoma cells and human fibroblasts cells in vitro by the comet assay. Data were assessed by Kruskal-Wallis nonparametric test. The results showed that all compounds tested did not cause DNA damage for the tail moment or tail intensity parameters. These findings suggest that formocresol, paramonochlorophenol, and calcium hydroxide do not promote DNA damage in mammalian cells and that the comet assay is a suitable tool to investigate genotoxicity.

Analysis of Variance↗
PubMed1980

Effect of calcium hydroxide in powder or in paste form on pulp-capping procedures: histopathologic and radiographic analysis in dog's pulp.

The pulps of seventy dog teeth were evaluated histopathologically and radiographically following intentional exposure and treatment with either a calcium hydroxide powder or a calcium hydroxide paste prepared with distilled water. The results were recorded after periods of 2, 30, 70, and 120 days. No differences were detected in the pulpal responses to direct pulp capping achieved with a calcium hydroxide paste and with a calcium hydroxide powder.

Animals↗
PubMed2007

The effect of calcium hydroxide root filling on dentin fracture strength.

This in vitro study measured the effect of calcium hydroxide root filling on the microtensile fracture strength (MTFS) of teeth. A total of 40 extracted human disease-free permanent maxillary incisors were hand and rotary instrumented and vertically compacted with United States Pharmacopeia (USP) calcium hydroxide. The teeth were stored in a moist environment for 7, 28, and 84 days. As a control group, 10 teeth were vertically compacted with gutta percha and sealer. The MTFS of the teeth was measured (Mpa) using an Instron machine. Data were assessed statistically using an unpaired t-test (P value). The intracanal placement of calcium hydroxide weakened the MTFS of teeth by 13.9 Mpa per 77 days: an average of 0.157 MPa day-1. Between 7 and 84 days, the MTFS of the dentin was reduced by 43.9%. This difference was statistically significant (P < 0.05). A statistical difference (P < 0.05) was observed between the mean MTFS of the calcium hydroxide-filled dentin between 7 days (45.7 MPa) and 28 days (35.6 MPa) and also between 7 and 84 days (31.8 MPa). There was also a significant difference (P < 0.05) between the MTFS of the calcium hydroxide-filled dentin after 84 days (31.8 MPa) and the gutta percha-filled dentin (41.3 MPa) when used as a control root filling material. The weakening of the dentin by 23-43.9% following root canal filling with calcium hydroxide provides compelling evidence to re-evaluate the daily usage of this material in endodontic therapy.

Calcium Hydroxide↗
PubMed1995

Effect of root canal filling materials containing calcium hydroxide on the alkalinity of root dentin.

The effect of root canal filling pastes containing calcium oxide resp. calcium hydroxide on the alkalinity of extracted human teeth was investigated using a colour indicator (cresol red). An aqueous suspension of calcium hydroxide (Pulpdent), which is normally used for temporary root canal filling, most consistently produced alkalinity. Removal of the smear layer following instrumentation of the root canal led to increased proportion of alkaline-positive spots in dentinal locations distant from the canal. A clearly smaller effect was found with a calcium salicylate cement (Sealapex) and an oil-paste (Gangraena Merz), both of which are available for definite root canal fillings. Following removal of the smear layer, these hard-setting preparations caused moderate alkalinity in dentin adjacent to the canal but no effect was observed in locations more distant from the canal. Neither at locations adjacent to nor distant from the root canal was alkalinity found when another calcium salicylate cement (Apexit) was used. Apparently the release of hydroxyl ions into root dentin from calcium hydroxide containing root canal filling materials is not solely influenced by the absolute amount of calcium hydroxide, but also depends on other ingredients which variably inhibit the release of these ions.

Binomial Distribution↗
PubMed1975

Reaction of the human dental pulp to silver amalgam restorations. The modifying effect of treatment with calcium hydroxide.

Cavities were prepared in 43 bicuspid teeth using two general categories of cavity depth. In the "deep" cavities the bottom was placed in the inner third of the dentin. In the "intermediate depth" cavities the bottom was positioned in the middle third of the dentin. The bottom of the cavities was either rubbed with calcium hydroxide, covered with calcium hydroxide, or left unlined before filling according to the wet amalgam technique. The teeth were extracted after 1 week and examined histologically. All cases, except 2 with deep and 1 with intermediate depth rubbed cavities, showed local vascular dilatation in the pulp underneath the cavity. In addition, all teeth with deep unlined cavities showed inflammatory cells as did 1 with an intermediate depth unlined cavity. There were fewer displaced odontoblast nuclei in the dentin in the calcium hydroxide-treated groups. The milder reactions in the rubbed or covered groups are probably due to the restrictive effect by calcium hydroxide on penetration of amalgam components. In the teeth with deep cavities there were only minor differences between the ones which had been rubbed and those which had been covered with calcium hydroxide.

Calcium Hydroxide↗