Kazragul Histological periapical repair after obturation of infected root canals in dogs. An in vitro comparative study on the antimicrobial effects of bioglass 45S5 vs. Retrievabilty of calcium hydroxide intracanal medicament with chitosan from root canals: It is possible that deeper in hydroxire outside the main root canalCa OH 2 is present as a saturated solution or at concentrations even below that level. Table 7 Studies reporting limited effect of Ca OH 2 using infected dentin models with human teeth. Review of ultrasonic irrigation in endodontics: Find articles by Dohyun Kim. Biofilm, Calcium hydroxide, Candida albicans, Endotoxin.

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Corresponding author. 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. Calcium hydroxide Ca OH 2 has been widely used in endodontics as an intracanal medicament to eliminate the remaining microorganisms after chemomechanical preparation.

The purpose of this article is to review the antimicrobial properties of Ca OH 2 as an intracanal medicament in root canal treatment. The first part of this review details the characteristics of Ca OH 2 and summarizes the results of in vitro studies related to its antimicrobial effect.

The antimicrobial effect of Ca OH 2 results from the release of hydroxyl ions when it comes into contact with aqueous fluids. Ca OH 2 has a wide range of antimicrobial effects against common endodontic pathogens, but is less effective against Enterococcus faecalis and Candida albicans.

The addition of vehicles or other agents might contribute to the antimicrobial effect of Ca OH 2. Keywords: 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. Intracanal medicaments may perform these roles by remaining in the root canal between treatment appointments.

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 summarize the results of in vitro studies related to its antimicrobial effect.

Review Chemical characteristics of calcium hydroxide and mechanisms of 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 long 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 OH 2. Hydroxyl ions are highly oxidant free radicals that show extreme reactivity with biomolecules. Antimicrobial susceptibility tests 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 in killing bacteria. Leonardo et al. Vitapex, Neo-Dental Int.

Some authors have insisted that E. Pavelic et al. In the studies of Podbielski et al. Ohara et al. Metapex, Meta Biomed Co. Several researchers have assessed the influence of vehicles or agents mixed with Ca OH 2 Table 3. Estrela et al. The pastes with oily vehicles showed larger zones of inhibition than those with aqueous or viscous vehicles.

Basrani et al. Portenier et al. Infected dentin models - bovine teeth In , Haapasalo 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 of 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 root canal system with its own structures and components, was the same. 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. Infected dentin models - human teeth Considerably more studies have been performed with extracted human teeth than with bovine teeth.

Safavi et al. 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. Nevertheless, the opposite results have also been exhibited Table 6. The study of Stuart et al.



The purpose of this literature review is to focus on the role of calcium hydroxide in the field of endodontics including a brief explanation of its mechanism of action, antimicrobial effects, different applications, cytotoxicity or biocompatibility, and finally removal of calcium hydroxide from the root canals. Materials and Methods 3. Antimicrobial Effect of Calcium Hydroxide Endodontic infections occur as a result of microbial mixtures containing bacteria represented by Enterococcus faecalis [6] and fungi which are especially represented by Candida Albicans [7]. Anaerobic bacteria with their endotoxins on their cell walls also predominant in this microbial diversity and can be detected especially gram negative [8].


Calcium Hydroxide as Intracanal Medicament in Pulp Necrosis with Periapical Lesion : A Case Report

Abstract Intracanal medication is adjunct to cleaning and shaping in reducing postoperative pain and tenderness in symptomatic teeth. The present clinical study aimed to investigate the effectiveness of Ledermix paste as intracanal medicament in symptomatic teeth using the eugenol as control. Access cavity was prepared for 30 symptomatic teeth,Intracanal medicament was placed. Incidence of post access pain and tenderness were evaluated. Ledermix showed faster action than eugenol in reducing symptoms i. Clinical Relevance To Interdisciplinary Dentistry Intracanal medicament is very important to control the infection and symptoms even after the root canal therapy for better prognosis With good longacting intracanal medication ,prognosis of post-endo restoration will be better and it helps in clinical success of the cases.

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