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CALCIUM HYDROXIDE AS INTRACANAL MEDICAMENT PDF

Calcium hydroxide is a multipurpose agent, and there have been an increasing Some of its indications include inter-appointment intracanal medicaments. role of calcium hydroxide in the field of endodontics, focusing on its droxide can be used effectively as intracanal medicament, root canal. Calcium hydroxide (Ca(OH)2) has been widely used as an intracanal medicament for endodontic retreatment, but very few studies used both Ca(OH)2 and 1%.

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The goal of endodontic treatment is the prevention and control of pulpal and periradicular infections.

Since Hermann introduced it in as a pulp-capping agent, calcium hydroxide Ca OH 2 has been widely used in endodontics. Currently, Ca OH 2 is considered the first choice of root canal dressing materials. The purpose of this article is to review the antimicrobial effect of Ca OH 2 as an intracanal medicament in root canal treatment. A PubMed search was performed to identify laboratory and clinical studies that investigated the antimicrobial effect of Ca OH 2 from to and was limited to English-language papers.

Studies that included Ca OH 2 as one of the comparative groups as well as the main subject were all reviewed. The articles were classified and analyzed according to their experimental methods.

The first part of this review will detail the characteristics of Ca OH 2 and ss the results of in vitro studies related to its antimicrobial effect. Calcium hydroxide is a white odorless powder with the formula Ca OH 2. The low solubility is a good clinical characteristic because a az period is necessary for Ca OH 2 to become soluble in tissue fluids when in direct contact with vital tissues.

It dissociates into calcium and hydroxyl ions on contact with an aqueous solution, and the main actions of Ca OH 2 are attributed to the effect of these ions on vital tissues, such as inducing hard tissue deposition and being antibacterial. Most of the pathogens are unable to survive in the highly alkaline environment provided by Ca Caclium 2. The antimicrobial activity of Ca OH 2 is related to the release of hydroxyl ions in contact with aqueous fluids.

Hydroxyl ions are highly oxidant free radicals that show extreme reactivity with biomolecules. A series of studies demonstrated the antimicrobial effect of Ca OH 2 Table 1. Several researchers investigated the effect of root canal medicaments by a direct exposure test, and they found that Ca OH 2 was effective kntracanal killing bacteria.

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Some authors have insisted that E. In the studies of Podbielski et al. On the other hand, some articles have presented results that bring into question the antimicrobial effect of Ca OH 2 Table 2. Metapex, Meta Biomed Co. Several researchers have assessed the influence of vehicles or agents mixed with Ca OH 2 Table 3. The pastes with oily vehicles showed larger zones of inhibition than those with aqueous or viscous vehicles.

In Siqueira and Uzeda’s study, Ca OH 2 mixed with distilled water or glycerin was ineffective against all bacterial strains even after 7 days of incubation. Some studies have reported other factors that could affect the antimicrobial effect of Ca OH 2.

InHaapasalo and Orstavik introduced an in vitro model for a dentinal tubule infection of the root canal. After a certain period, bacterial samples were taken with sterile round burs, and the dentin chips obtained with each bur were immediately collected in separate test tubes.

These tubes were then incubated and inspected. In this study, liquid CMCP rapidly and completely disinfected the dentinal tubules, whereas Ca OH 2 failed to eliminate them even superficially.

Since then, a number of experiments have been performed using this method Table 4.

This model enabled an evaluation meidcament the infection status at different depths of the dentinal tubules. Even though some researchers have modified the details of the model, the main objective of these studies, to evaluate the effect of antimicrobial agents in the calcim canal system with its own structures and components, was the same. Studies on the antimicrobial effect of Ca OH 2 using infected dentin models with bovine teeth.

The results have been controversial. To be effective against the bacteria located inside the dentinal tubules, hydroxyl ions from Ca OH 2 must diffuse through the dentin and reach sufficient levels to be lethal. Dentin has the buffering property of alkaline substances because of the proton donors in the hydrated layer of the hydroxyapatite.

Considerably more studies have been performed with extracted human teeth than with bovine teeth. IKI disinfected dentin effectively, but bacteria remained viable in the dentin after extended periods of Ca OH 2 treatment. This study was followed by several researchers who supported the ineffectiveness of Ca OH 2 as an intracanal medicament.

Antimicrobial Activity of Calcium Hydroxide in Endodontics: A Review

Studies reporting Ca OH 2 to be ineffective using infected dentin models with human teeth. Nevertheless, the opposite results have also been exhibited Table 6. The study of Stuart et al. Studies reporting antimicrobial effect of Ca OH 2 using infected dentin models with human teeth.

Lastly, there were authors who reported the limited antimicrobial effect of Ca OH 2 that could partially reduce the number of bacteria Table 7. Similar results were exhibited in other studies. Studies reporting limited effect of Ca OH 2 using infected dentin models with human teeth. Some have compared the effect of Ca OH 2 with different vehicles Table 8. Studies on the effect of Ca OH 2 mixed with vehicles or other agents using infected dentin models with human teeth.

One study applied molecular techniques to the infected dentin model. However, PCR results showed a positive result on most of the experimental groups. These molecular techniques have been actively used for in vivo studies, which we shall discuss in the next part of this article. Studies on the antimicrobial effect of Ca OH 2 have differed with regard to methodology, inoculum size and age, culture medium, and bacterial strains used. Furthermore, experimental conditions completely equivalent to the root canal environment could not be ensured.

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Therefore, the studies showed varied, even conflicting, results. Although some studies have supported the antimicrobial effect of Ca OH 2others have questioned its efficacy. In summary of the first part of this review, the antimicrobial effect of Ca OH 2 is related to the hydroxyl ions released in an aqueous environment, which affects cytoplasmic membranes, proteins, and the DNA of microorganisms.

Ca OH 2 has a wide range of antimicrobial effects against common endodontic pathogens, but it is less effective against specific species such as E. No potential conflict of interest relevant to this article was reported.

National Center for Biotechnology InformationU. Journal List Restor Dent Endod v. Published online Aug Dohyun Kim and Euiseong Kim. Find articles by Dohyun Kim. Find articles by Euiseong Kim. Author information Article notes Copyright and License information Disclaimer.

Received Apr 8; Accepted Jun The Korean Academy of Conservative Dentistry. This article has been cited by other articles in PMC. Abstract The goal of endodontic treatment is the prevention and control of pulpal and periradicular infections.

Antimicrobial effect, Calcium hydroxide, Endodontics, Intracanal medicament, Microorganism. Introduction Microorganisms are the cause of apical inflammatory lesions, and the goal of endodontic treatment is the prevention and control of pulpal and periradicular infections. Review Chemical characteristics of calcium hydroxide and mechanisms of antimicrobial effect Calcium hydroxide is a white odorless powder with the formula Ca OH 2. Antimicrobial susceptibility tests A series of studies demonstrated the antimicrobial effect of Ca OH 2 Table 1.

Open in a separate window. Table 2 Studies reporting Ca OH 2 to be ineffective. Table 3 Studies on the effect of Ca OH 2 mixed with vehicles or other agents.

Antimicrobial Activity of Calcium Hydroxide in Endodontics: A Review

Infected dentin models – bovine teeth InHaapasalo and Orstavik introduced an in vitro model for a dentinal tubule infection of the root canal. Table 4 Studies on the antimicrobial effect of Ca OH 2 using infected dentin models with bovine teeth. Infected dentin models – human teeth Considerably more studies have been performed with extracted human teeth than with bovine teeth.

Table 6 Studies reporting antimicrobial effect of Ca OH 2 using infected dentin models with human teeth. Table 7 Studies reporting limited effect of Ca OH 2 using infected dentin models with human teeth.

Table 8 Studies on the effect of Ca OH 2 mixed with vehicles or other agents using infected dentin models with human teeth. Conclusions Studies on the antimicrobial effect of Ca OH 2 have differed with regard to methodology, inoculum size and age, culture medium, and bacterial strains used. Footnotes No potential conflict of interest relevant to this article was reported. The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats.

Bacteriologic evaluation of the effect of 0. The antibacterial effect of camphorated paramonochlorophenol, camphorated phenol and calcium hydroxide in the treatment of infected root canals. The antibacterial action of sodium hypochlorite and EDTA in 60 cases of endodontic therapy. Bacteriologic evaluation of ultrasonic root canal instrumentation.

Reduction of intracanal bacteria using nickel-titanium rotary instrumentation and various medications. Bacteriologic evaluation of the efficacy of mechanical root canal instrumentation in endodontic therapy. Scand J Dent Res.

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