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PubMed2004

Remineralization of carious dentin. I: in vitro microradiographic study in human teeth capped with calcium hydroxide.

The objective of this in vitro study was to evaluate a possible remineralization of human carious dentin by calcium hydroxide. Thirty-nine freshly extracted human permanent and deciduous carious teeth were split into two halves. One half was used as control and the other as experimental. In the latter, a cavity was prepared and the remaining bottom layer of demineralized dentin capped with chemically pure calcium hydroxide. The experimental samples were stored at 37 masculine C. Time intervals were 2, 4, 6, 8, 10 and 12 weeks. All tooth halves were sawed and ground to plano-parallel sections with a thickness varying from 75 to 117 microm. Qualitative microradiographs showed a qualitative increase in radiopacity of the calcium hydroxide treated samples. Quantitative microradiography showed a statistically significant increase in total mineral content in the experimental samples compared to the control samples. These results indicate an in vitro remineralization of carious dentin by calcium hydroxide.

Calcium Hydroxide↗
PubMed1977

Calcium hydroxide and potassium nitrate as desensitizing agents for hypersensitive root surfaces.

The purpose of this investigation was to evaluate calcium hydroxide and potassium nitrate individually as densensitizing agents for hypersensitive root surfaces. The apparatus used in the experiment to measure hypersensitivity was (a) a thermo-electric stimulating device to measure hot and cold stimulation quantitatively and (b) a mechanical stimulating device to measure scratch stimulation quantitatively. The conclusions drawn from the study were: 1. Calcium hydroxide was more consistently effective in decreasing sensitivity then was potassium nitrate or the control. 2. Calcium hydroxide as compared to the control was statistically (99% level of significance) more effective in reducing sensitivity to mechanical, hot and cold stimulation immediately and at the conclusion of the experiment (3 months). 3. It appears that calcium hydroxide could be used as a desensitizing agent initially following periodontal surgery to reduce pain from hypersensitive roots in order that proper oral hygiene could be reestablished.

Adult↗
PubMed2003

Influence of age on the behavior of dental pulp of dog teeth after capping with an adhesive system or calcium hydroxide.

This study evaluated histomorphologically the influence of chronological age of the dog on the dental pulp-healing process after capping with the All Bond 2 system or with calcium hydroxide paste. The animals were divided according to age into young and adult groups. Class 5-type cavities were prepared, and the pulp was submitted to an exposure of a diameter of 0.5 mm. The pulp of the teeth was then protected with the adhesive system or with a calcium hydroxide paste. Sixty days after treatment, the results obtained with the adhesive system in the young group were significantly better than those in the adult group. With calcium hydroxide, the results were similar for both groups. The pulp treated with calcium hydroxide exhibited a complete hard tissue bridge and a pulp without inflammatory reaction, a fact not observed when the adhesive system was used. In conclusion, the chronological age of the pulp influenced the comparative results only for the adhesive system (P = 0.1), and the total results were better with calcium hydroxide than with the All Bond 2 system (P = 0.01).

Age Factors↗
PubMed1991

Calcium hydroxide in restorative dentistry.

This paper reviews the various calcium hydroxide preparations available for use in restorative dentistry and their constituents. The significance of individual constituents in relation to the properties of such materials and their mode of therapeutic action with respect to the dentine pulpal response and antibacterial activity is discussed. Applications of calcium hydroxide in restorative dentistry are also reviewed.

Calcium Hydroxide↗
PubMed2001

Response of the pulp of dogs to capping with mineral trioxide aggregate or a calcium hydroxide cement.

This study was conducted to observe the response of dogs' dental pulp to mineral trioxide aggregate (MTA) and a calcium hydroxide cement when used as pulp capping materials. After the pulps of 30 teeth were exposed, they were capped with either MTA or a calcium hydroxide cement. Histological analysis was performed 2 months after treatment. Results showed a healing process with complete tubular dentin bridge formation and no inflammation in any of the pulps capped with MTA. On the other hand, only five specimens from the calcium hydroxide cement group formed a complete dentin bridge. In this experimental group, pulp inflammation was observed in all but three cases. In conclusion, MTA exhibited better results than the calcium hydroxide cement for the capping of the pulp in dogs.

Aluminum Compounds↗
PubMed2006

A comparative study on the disinfection potentials of bioactive glass S53P4 and calcium hydroxide in contra-lateral human premolars ex vivo.

AIM: To evaluate the effects of bioactive glass S53P4 versus calcium hydroxide when used as dressings in contra-lateral human premolars infected with Enterococcus faecalis ATCC 29212. METHODOLOGY: Pairs of contra-lateral premolar teeth plus single control premolars were obtained from 23 individuals aged 10-26 years undergoing orthodontic treatment. Root canals of teeth with fully formed apices (nine contra-lateral pairs, seven controls) were instrumented using a size 60 FlexoFiles 2 mm short of canal length. Canals with open apices (six contra-lateral pairs, four controls) were circumferentially instrumented using a FlexoFile. Root canals were rinsed with 1% sodium hypochlorite and 10% citric acid. Teeth were then suspended in tryptic soy broth (TSB) and autoclaved. Positive controls and study teeth were infected with E. faecalis ATCC 29212 for 2 weeks in TSB, while negative controls were kept in sterile TSB. Subsequently, contra-lateral premolars were dressed with bioactive glass S53P4 (BAG) or calcium hydroxide suspensions for 10 days. Dentine samples were obtained from teeth with fully formed apices using ISO-size 70, 80 and 90 FlexoFiles to working length and cultured. Teeth with open apices were fixed, fractured and examined using scanning electron microscopy (SEM). RESULTS: Calcium hydroxide had a strong antibacterial effect and was significantly more effective than BAG in preventing residual bacterial growth (P < 0.01). SEM analysis revealed apparent substance-specific modes of action. CONCLUSIONS: Calcium hydroxide was an effective disinfectant in human teeth.

Adolescent↗
PubMed1989

Physical properties of calcium hydroxide and glass-ionomer base and lining materials.

Compressive, diametral tensile and flexural strengths, moduli of elasticity, pH, and acid solubility values were compared for six calcium hydroxide cements, seven glass-ionomer cements, and one calcium aluminate cement. Results indicated that the glass-ionomer materials were generally stronger than the calcium hydroxide liners. Prisma VLC Dycal showed the lowest value for modulus of elasticity and the least acid solubility. The glass-ionomer materials were initially acidic, reaching a final pH between 5.4 and 7.3, whereas the calcium hydroxide and calcium aluminate cements were strongly alkaline at all time intervals.

Calcium Hydroxide↗
PubMed1997

Comparative in vitro investigation of different methods for temporary root canal filling with aqueous suspensions of calcium hydroxide.

Three methods for temporarily filling root canals with calcium hydroxide pastes were compared. Each of 20 root canals of extracted, human, single-rooted teeth was shaped with hand instruments under standardized conditions up to ISO size 50 and filled using a syringe system, a lentulo spiral or an endodontic reamer. Quality of fillings was assessed radiographically and by inspecting ground preparations. Ridit (relative to an identified distribution) analysis was employed to confirm differences in frequencies of certain quality criteria obtained with various application methods. With regard to degree of obturation and occurrence of porosities, application of temporary fillings with a lentulo spiral or syringe system revealed significantly better results than application with hand instruments (reamer). No differences with regard to degree of obturation were detected when comparing results obtained with syringe or lentulo. Fewer porosities in the apical part of the root canal were seen, both on radiographs and ground sections, with the syringe system compared with the lentulo spiral. In the presence of some contradictory reports found in the literature, the present study suggests that, after straight or slightly curved root canals have been shaped up to at least ISO size 50, high quality temporary root canal fillings may be obtained by application of an aqueous suspension of calcium hydroxide with a syringe system.

Calcium Hydroxide↗
PubMed2001

Effect on the healing of periapical perforations in dogs of the addition of growth factors to calcium hydroxide.

The purpose of this study was to investigate the effect of the addition of platelet-derived growth factor-BB and insulin-like growth factor-I to calcium hydroxide in the repair of apical perforations in dogs. Fifty-one premolar teeth of four beagle dogs were used. After developing periapical lesions root apices were artificially perforated. The teeth were divided into the three groups: group 1, the apical perforations were not sealed; group 2, the perforated areas were obturated with calcium hydroxide; and group 3, calcium hydroxide plus growth factors was applied to the sites of perforation. All canals were filled by a lateral condensation technique. Animals were killed 12 wk later, and sections were hematoxylin & eosin-stained and immunostained for osteonectin. The amount of inflammation was evaluated histomorphologically. The one-way ANOVA test demonstrated that the three groups were significantly different from one another. In group 3 there was no inflammatory reaction of apical tissue, and the connective tissue adjacent to the newly formed hard tissue was strongly immunostained for osteonectin. Most sections in group 1 showed no apical healing. Moderate healing was found in group 2. In conclusion the combination of platelet-derived growth factor-BB and insulin-like growth factor-I with calcium hydroxide improved healing of apical perforation in dogs.

Alveolar Bone Loss↗
PubMed2006

The influence of haemostatic agents on healing of healthy human dental pulp tissue capped with calcium hydroxide.

AIM: To investigate the hypothesis that different haemostatic agents could impair the histological response of human pulps capped with calcium hydroxide. METHODOLOGY: Forty-five third molars scheduled for extraction were selected. Class I cavities with pulp exposures were prepared. Three agents were used to control bleeding: 0.9% saline solution (control, n = 14), 5.25% sodium hypochlorite (n = 16) and 2% chlorhexidine digluconate (n = 15). The pulps were dressed with hard-setting calcium hydroxide cement. After 7, 30 or 90 days, teeth were extracted, formalin-fixed and prepared for histochemical techniques. The biological response was categorized using the following criteria: inflammatory response, soft tissue organization, reactionary dentine and reparative dentine. Data were submitted to statistical analysis, using nonparametric Kruskal-Wallis one-way analysis of variance on ranks. Differences amongst groups were detected using Dunn's method. RESULTS: The statistical analysis disclosed that whilst inflammatory response decreased over time, reactionary dentine deposition and reparative dentine formation increased in the latter periods of evaluation (P < 0.05). The three agents had similar performances for all criteria evaluated. The conventional pulp response to calcium hydroxide was observed over time, and complete pulp healing was observed in 88% of the specimens after 90 days. CONCLUSION: The three haemostatic agents did not impair the healing process following pulp exposure and capping with calcium hydroxide at different time intervals investigated.

Adult↗
PubMed1978

A 2-year follow-up of primary molars, pulpotomized with a gentle technique and capped with calcium hydroxide.

The prognosis for pulpotomy of primary molars with calcium hydroxide as wound dressing was evaluated clinically and radiographically. Thirty-three primary mandibular molars were amputated under the following conditions: (1) chronic coronal pulpitis, (2) the amputation was done with diamond instruments and a high-speed machine under aseptic conditions, and (3) application of calcium hydroxide in contact with the wound surface. After 1 year the treatment was regarded as successful for 22 of the teeth (67%); 11 teeth showed internal dentin resorption. After 2 years the frequency of success, allowing for drop-out, was 59%. Internal dentin resorption was seen in 14 root canals; in 10 of them within the first 6 months. A histologic study of nine root pulps with internal dentin resorption revealed an extra-pulpal blood clot on the wound surface in five.

Blood Coagulation↗
PubMed2003

Release of hydroxyl ions from calcium hydroxide preparations used in endodontic treatment.

PURPOSE: The purpose of our study was to compare the in vitro release of hydroxyl ions from several calcium hydroxide preparations used in endodontic treatment. MATERIAL AND METHODS: Equal quantities of the materials--nonsetting (pure calcium hydroxide, Biopulp, Calcicure), setting--canal sealers (Sealapex, Apexit) and points were placed in dialysis tubes which were then immersed in deionized water. The release of hydroxyl ions from the preparations was measured by the median pH of the deionized water used for dialysis, by means of a pH-meter. The results of our study were analyzed by means of Tukey's reasonable correlation. Significance difference (one-way variance analysis ANOVA) and Pearson's linear correlation coefficient (r2). RESULTS: Nonsetting preparations of calcium hydroxide have a significantly higher capability of hydroxyl ions release in comparison with sealers and points, irrespective of time (p < 0.05). Sealapex and "plus" points released hydroxyl ions to a much greater extent than both Apexit and "regular" points at most periods of the experiment (p < 0.05). Apexit released significantly more of hydroxyl ions than "regular" points, and Sealapex more than "plus" points in the later periods of the experiment (p < 0.05). The pH values of dialysis samples of all materials correlated positively with time and the pH. Almost all materials reached a maximum on the 8-th day of the experiment. CONCLUSIONS: To achieve maximum concentration of hydroxyl ions in tissues: for temporary root fillings nonsetting preparations of calcium hydroxide should be chosen rather than points and they should be placed for at least one week, for permanent root fillings it is more recommended to use Sealapex than Apexit as a sealer.

Calcium Hydroxide↗
PubMed1997

Use of calcium hydroxide for apical barrier formation and healing in non-vital immature permanent teeth: a review.

OBJECTIVE: To review the use of calcium hydroxide for induction of apical barrier formation and healing in immature permanent teeth. INTRODUCTION: Pulp necrosis is a frequent complication of dental trauma in immature permanent teeth. Endodontic treatment of these teeth is often complicated. The walls of the root canals are frequently divergent and the apices immature, making debridement and obturation difficult. The aim of treatment is induction of apical healing which may be defined as apical closure through formation of mineralised tissue and repair of the periapical tissues. Calcium hydroxide is the material of choice for apical barrier formation and healing. RESULTS: The use of calcium hydroxide for apical barrier formation is successful in 74-100% of cases irrespective of the proprietary brand used. The average length of time for apical barrier formation is approximately 5 to 20 months. Control of infection and adequate cleaning of the root canal are very important for apical healing. CONCLUSIONS: While the success rate of apical barrier formation using calcium hydroxide is high, long-term follow-up of these teeth is necessary. Problems such as failure to control infection, recurrence of infection and cervical root fracture may occur. The latter is more frequent in immature luxated teeth with the least root development.

Bacterial Infections↗
PubMed1995

Short vs. long-term calcium hydroxide treatment of established inflammatory root resorption in replanted dog teeth.

This study examined, histologically, the healing of intentionally produced inflammatory root resorption of replanted teeth in beagle dogs, treated with short- or long-term placement of calcium hydroxide. Thirty beagle dog incisors were randomly divided into four groups. In group 1 (negative control), uninfected incisors were extracted, the roots were longitudinally grooved and the teeth were replanted within 2 min. In group 2 the root canals were artificially infected followed by extraction, longitudinal grooving, and replantation as in group 1. Radiographs were taken biweekly and at the first signs of inflammatory root resorption or at 4 weeks, the root canals were fully instrumented and medicated with calcium hydroxide. In group 2, the root canals were permanently obturated with gutta-percha and sealer after 1 week of calcium hydroxide. The teeth in group 3 were treated as described in group 2 but after 1 wk the calcium hydroxide dressing was repacked for the duration of the study. In group 4 (positive control) the teeth were treated as described in groups 2 and 3 but no endodontic treatment was performed. Twelve weeks after the initiation of the endodontic treatment, sacrifice and histological preparation were carried out. In group 1, complete cemental repair was seen in all teeth. In group 2, five of ten teeth showed complete cemental repair whereas in group 3 complete cemental repair was seen in nine of ten teeth. None of the teeth in group 4 showed cemental repair. It was concluded that long-term may be more effective than short-term calcium hydroxide treatment of established inflammatory root resorption.

Animals↗
PubMed1982

Characterization and aqueous extraction of calcium hydroxide materials.

Analysis of two single and eight dual product systems showed the former to be calcium hydroxide dispersed in an aqueous gel in methyl ethyl ketone solution of an acrylic polymer and the latter were cements based on the polymerization occurring when mixing salicylate esters with calcium hydroxide. Using water as an extractant under controlled conditions, specimens of the prepared materials produced marked differences in pH values over 24 hours and conductivity over 72 hours; also cumulative extractions over 26 weeks showed substantial variation in the amount of calcium hydroxide and other solubles.

Calcium Hydroxide↗
PubMedDate not supplied

The clinical and histological evaluation of cresatin with calcium hydroxide on the human dental pulp.

Metacresylacetate with calcium hydroxide in a methylcellulose base produces clinically and radiographically successful pulpotomies, when performed on sound primary teeth. Under sterile conditions, with proper surgical and restorative technique, pulp tissue will heal with metacresylacetate with calcium hydroxide-methylcellulose. The dental pulp will form on osteodentin bridge and the pulp adjoining the bridge will remain histologically viable and free of inflammation. Methylcellulose with sterile distilled water does not produce as favorable a histological reaction as metacresylacetate with calcium hydroxide-methylcellulose. No dentinal bridging was in evidence and there were present in the radicular pulp varying degrees of inflammation.

Calcium Hydroxide↗
PubMed2002

Effects of instrumentation, irrigation and dressing with calcium hydroxide on infection in pulpless teeth with periapical bone lesions.

AIM: The aim of this study was to evaluate the fate of microorganisms in root canals of teeth with infected pulps and periapical bone lesions with and without the use of calcium hydroxide medication. METHODOLOGY: Endodontic samples were cultured and microorganisms were counted and identified in 43 teeth before (sample 1) and after (sample 2) treatment during the first visit and before (sample 3) and after (sample 4) treatment during the second visit. In the first visit teeth were instrumented and half of the teeth were filled with a thick slurry of calcium hydroxide in sterile saline. The other teeth were obturated with gutta-percha and AH-2 6 sealer. After 4 weeks the teeth with calcium-hydroxide were accessed again and after microbiological sampling they were obturated with gutta-percha and AH-26 sealer. RESULTS: The mean total colony forming unit (CFU) counts of positive samples dropped significantly as a result of canal preparation during the first visit from 1.0 x 10(6) to 1.8 x 10(3) (between samples 1 and 2) but increased to 9.3 x 10(3) in the period between the two visits (sample 2 and 3). There was no difference in mean total CFU counts of positive samples between the end of the first (sample 2) and the end of the second visit (sample 4). The most frequently isolated species were Prevotella intermedia, Capnocytophaga spp.. Actinomyces odontolyticus. Propionibacterium acnes and Peptostreptococcus micros. CONCLUSIONS: Although a calcium hydroxide paste was placed in the prepared canals, the number of positive canals had increased in the period between visits. However, the number of microorganisms had only increased to 0.93% of the original number of CFU (sample 1). It is concluded that a calcium hydroxide and sterile saline slurry limits but does not totally prevent regrowth of endodontic bacteria.

Actinomyces↗
PubMed1985

Pulpal response to a calcium hydroxide material for capping exposures.

Two calcium hydroxide cements, Dycal and Life, were compared as direct pulp-capping agents in forty teeth of two beagle dogs. Both materials produced similar responses after observation periods of 4 and 12 weeks. It was noted that the response in one animal were less favorable, but the reason could not be demonstrated.

Animals↗