• Restorative Dentistry and Endodontics
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• v.44 no.3
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• pp.32.1-32.13
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• 2019

Calcium hydroxide (CH) is the gold-standard intracanal dressing for teeth subjected to traumatic avulsion. A common complication after the replantation of avulsed teeth is root resorption (RR). The current review was conducted to compare the effect of CH with that of other intracanal medications and filling materials on inflammatory RR and replacement RR (ankylosis) in replanted teeth. The PubMed and Scopus databases were searched through June 2018 using specific keywords related to the title of the present article. The materials that were compared to CH were in 2 categories: 1) mineral trioxide aggregate (MTA) and endodontic sealers as permanent filling materials for single-visit treatment, and 2) Ledermix, bisphosphonates, acetazolamide, indomethacin, gallium nitrate, and enamel matrix-derived protein (Emdogain) as intracanal medicaments for multiple-visit management of avulsed teeth prior to the final obturation. MTA can be used as a single-visit root filling material; however, there are limited data on its efficacy due to a lack of clinical trials. Ledermix and acetazolamide were comparable to CH in reducing RR. Emdogain seems to be an interesting material, but the data supporting its use as an intracanal medication remain very limited. The conclusions drawn in this study were limited by the insufficiency of clinical trials.

• Proceedings of the KACD Conference
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• 2003.11a
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• pp.608-608
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• 2003

The main objectives of root canal therapy are cleaning and shaping and then obturating the root canal system in 3 dimensions to prevent reinfection. Many instrumentation techniques and devices, supported by an irrigation system capable of removing pulp tissue remnants and dentin debris, have been proposed to shape root canals. But current regimens in chemomechanical debridement using instrumentation and irrigation with NaOCl are not predictably effective in root canal disinfection. These findings are not surprising because the root canal system is complex and contains numerous ramifications and anatomical irregularities. The microorganisms in root canals not only invade the anatomic irregularities of the root canal system but also are present in the dentinal tubules. Therefore further disinfection with an effective antimicrobial agent may be necessary and it well1mown that use of intracanal medication will lower bacterial count in infected root canals. Calcium hydroxide has a long history of use in endodontics, and more attention has been given to the use of calcium hydroxide as intracanal dressing for the treatment of infected pulp. However, when treatment is completed in one visit, no intracanal medications other than intracanal irrigants are used. Recently, a mixture of a tetracycline isomer, an acid, and a detergent(MTAD), has been introduced as a final rinse for disinfuction of the root canal system. It has been shown that MTAD is able to remove the smear layer with minimal erosive changes on the surface of dentin, and is effective against Enterococcus faecalis, a microorganism resistant to the action of other antimicrobial medications. In another study, the ability of MTAD was investigated to disinfect contaminated root canals with whole saliva and compared its efficacy to that of NaOCl Based on the results, it seems that MTAD is significantly more effective than 5.25% NaOCl in eradicating bacteria from infected root canals. In the cytotoxicity evaluation, MTAD is less cytotoxic than engenol, 3% $H20_2,\;Ca(OH)_2$ paste, 5.25% NaGCl, Peridex, and EDTA and more cytotoxic than 2.63%,1.31% and 0.66% NaOCl. Is it promising or transient?

• Restorative Dentistry and Endodontics
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• v.26 no.1
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• pp.77-85
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• 2001

The purpose of this in vitro study was to compare the apical leakage in extracted teeth filled with gutta-percha subsequent to dressing with one of three different calcium hydroxide preparations. Thirty six extracted teeth with single canal were used in this study. After working length determination, canals were prepared with K flexo files to a #40 at the working length. Step-back flaring was produced by using #45, #50 K flexo files and #2, #3, #4 Gates Glidden burs. The teeth were randomly divided into 3 groups of 10 each : the remaining six teeth were used for negative and positive leakage control: Group 1, dressed with pure calcium hydroxide powder (Sigma, USA) mixed with distilled water; Group 2, dressed with Metapaste (Metadent, Korea) ; Group 3, dressed with Vitapex (Neo Dental, Japan). Teeth were sealed with Caviton (GC, Japan) and incubated in 100% humidity, at 37$^{\circ}C$ for 1 wk. All kinds of calcium hydroxide were removed from the canal with a MAF and 5% NaOCl. The canals were filled with AH-26$^{\circledR}$ sealer and gutta-percha using lateral condensation technique, incubated in 100% humidity, at 37$^{\circ}C$ for 2 days for the sealer to be set. The teeth were coated twice with nail varnish except for an area of approximately 2mm surrounding the apical foramen. All specimens were placed in 2% methylene blue solution for 2 days. The root were sectioned longitudinally, the amount of apical leakage was measured to the most coronal part of the root canal to which the dye had penetrated. The independent measurements were made for each root using a stereomicroscope ($\times$40 magnification) and the average was recorded for statistical analysis. The results were as follows ; 1. The mean of apical leakage in group of pure calcium hydroxide ranged 0.102$\pm$0.156mm, in Metapaste$^{\circledR}$ ranged 0.062$\pm$0.069mm, and in Vitapex$^{\circledR}$ ranged 0.067$\pm$0.072mm. 2. Group of pure calcium hydroxide exhibited more leakage than those of 2 manufactured calcium hydroxide preparations, but it was not statistically significant. 3. Group of water-based Metapaste$^{\circledR}$ showed lesser leakage than that of oil-based Vitapex$^{\circledR}$, but it was not statistically significant.