Study of calcium hydroxide as an intra-canal medicament in endodontic treatment in chronic apical periodontitis (original) (raw)
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In Vivo Study of Calcium Hydroxide Endodontic Treatment in Chronic Apical Periodontitis
ARS Medica Tomitana, 2018
The aim of this study was to evaluate the in vivo efficiency of endodontic treatment with calcium hydroxide in chronic apical periodontitis by determining the microbial load from the endodontic space in different stages of treatment. The microbiological determinations that have been made have led to the conclusion that calcium hydroxide possesses a redoubltable antimicrobial activity, but only with the condition of long-lasting contact with the root canals. Another important result is the essential role of the rigorous biomechanical treatment of the root canals, intracanal medication with calcium hydroxide is addresses mostly to microorganisms located in root canal ramifications.
International Endodontic Journal, 2020
Aim To evaluate the antimicrobial effectiveness of Ca(OH) 2 paste combined with ibuprofen or ciprofloxacin in infected root canals of teeth with asymptomatic apical periodontitis. Methodology Forty-five patients were randomly divided into three groups using a web program according to the medication selected: Ca(OH) 2 : 1 g Ca(OH) 2 powder with 1 mL propylene glycol, Ca(OH) 2 + Ibuprofen: 50 mg of ibuprofen was added into 950 mg Ca(OH) 2 powder and mixed with 1 mL propylene glycol, Ca(OH) 2 + Ciprofloxacin: 50 mg of Ciprofloxacin was added into 950 mg Ca(OH) 2 powder and mixed with 1 mL propylene glycol. Root canal bacteriological samples were collected before root canal treatment (S1) and after chemo-mechanical procedures (S2). After root canal preparation, the intracanal medicaments were placed into the root canals to a level approximately 1 mm short of the working length using K-files and access cavities were filled temporarily. The participants were scheduled for a second visit 7 days later when the medication was removed mechanically and after irrigation of the root canals, the final samples (S3) were collected. Samples were subjected to quantitative real-time polymerase chain reaction to evaluate the numbers of total bacteria, Enterococcus faecalis and Streptococcus species. For intragroup analysis, a Friedman test was used to compare reduction of counts of total bacteria, Streptococci and E. faecalis among the three samples (S1, S2 and S3). The chi-square test was used to compare the number of root canals positive for bacteria in S1, S2 and S3 among the groups. Results Intragroup analysis revealed a significant reduction in the number of intracanal bacterial cells from S1 to S2 and from S2 to S3 in all medication groups (P < 0.01). Although there was no significant difference among the groups when comparing quantitative S1 or S2 data, there were significantly lower bacterial counts in the Ca(OH) 2 + Ciprofloxacin group (0.49 × 10 2) than the pure Ca(OH) 2 (1.25 × 10 2) and Ca(OH) 2 + Ibuprofen groups (0.76 × 10 2) at S3. The percentage of reduction from S1 to S3 and from S2 to S3 was significantly greater in the Ca(OH)2 + Ciprofloxacin than the pure Ca(OH)2 and Ca(OH)2 + Ibuprofen groups. (P < 0.05). In the Ca(OH) 2 + Ciprofloxacin group there were significantly fewer positive cases (8/15) than the pure Ca(OH) 2 (13/15) and Ca(OH) 2 + Ibuprofen (13/15) groups (P < 0.05). Conclusion The addition of ciprofloxacin to Ca(OH) 2 provided further antibacterial effectiveness when used as an intracanal medicament in vivo during root canal treatment.
Antimicrobial activity of calcium hydroxide in endodontics: a review
Chonnam medical journal, 2012
The purpose of endodontic therapy is to preserve the patient's natural teeth without compromising the patient's local or systemic health. Calcium hydroxide has been included in several materials and antimicrobial formulations that are used in several treatment modalities in endodontics, such as inter-appointment intracanal medicaments. The purpose of this article was to review the antimicrobial properties of calcium hydroxide in endodontics. Calcium hydroxide has a high pH (approximately 12.5-12.8) and is classified chemically as a strong base. The lethal effects of calcium hydroxide on bacterial cells are probably due to protein denaturation and damage to DNA and cytoplasmic membranes. Calcium hydroxide has a wide range of antimicrobial activity against common endodontic pathogens but is less effective against Enterococcus faecalis and Candida albicans. Calcium hydroxide is also a valuable anti-endotoxin agent. However, its effect on microbial biofilms is controversial.
Research, Society and Development, 2021
The aim of this systematic review was to compare the clinical performance of calcium hydroxide (Ca(OH)2) as an intracanal medicament alone or combined with other antimicrobial agents. The PICO question was “Is the antibacterial effectiveness of calcium hydroxide paste as an intracanal medication combined with other drugs greater than that of calcium hydroxide paste alone in apical periodontitis?” The study was carried out according PRISMA guidelines and is registered in PROSPERO (CRD42020205741). Searches were performed in the PubMed/MEDLINE, Web of Science and Cochrane databases without publication date restrictions. Inclusion: randomized clinical trials, non-randomized intervention studies, studies including a minimum of 10 patients, studies comparing the use of Ca(OH)2 alone and in combination with other compounds, studies evaluating primary and permanent teeth with apical periodontitis, and studies including teeth not submitted to retreatment. The Cochrane risk-of-bias tool for...
The use of calcium hydroxide, antibiotics and biocides as antimicrobial medicaments in endodontics
Australian Dental Journal, 2007
Bacteria have been implicated in the pathogenesis and progression of pulp and periapical diseases. The primary aim of endodontic treatment is to remove as many bacteria as possible from the root canal system and then to create an environment in which any remaining organisms cannot survive. This can only be achieved through the use of a combination of aseptic treatment techniques, chemomechanical preparation of the root canal, antimicrobial irrigating solutions and intracanal medicaments. The choice of which intracanal medicament to use is dependent on having an accurate diagnosis of the condition being treated, as well as a thorough knowledge of the type of organisms likely to be involved and their mechanisms of growth and survival. Since the disease is likely to have been caused by the presence of bacteria within the root canal, the use of an antimicrobial agent is essential. Many medicaments have been used in an attempt to achieve the above aims but no single preparation has been found to be completely predictable or effective. Commonly used medicaments include calcium hydroxide, antibiotics, non-phenolic biocides, phenolic biocides and iodine compounds. Each has advantages and disadvantages, and further research is required to determine which is best suited for root canal infections.
Antimicrobial Activity of Ca(OH) 2 Dental Cements: An In Vitro Study
Journal of Endodontics, 2003
The effect of five commercial calcium hydroxide root canal medications (XR-SPAD, Calcicur, Hycal, Root-cal, Hypo-cal) and two calcium hydroxide mixtures (with water or glycerin) on the growth of (a) three anaerobic bacteria associated with endodontic infections; and (b) saliva bacterial strains was determined using the agar diffusion inhibitory test. Statistically significant zones of bacterial growth inhibition for all the bacteria tested were observed. Calcium hydroxide mixed with glycerin showed the largest zones of bacterial inhibition, whereas Root-cal was the least active. These results underline the necessity to evaluate the antibacterial potential of endodontic medications against the different bacterial strains commonly isolated from infected root canals.
Brazilian Dental Journal, 2005
The aim of this study was to investigate in vitro the antimicrobial activity of calcium hydroxide [Ca(OH)2] in combination with different vehicles against endodontic pathogens. For such purpose, a broth dilution test was performed. Pastes were prepared with Ca(OH)2 powder and the following vehicles: sterile water, glycerin, camphorated monochlorophenol (CMCP), CMCP + glycerin, polyethyleneglycol and CMCP + polyethyleneglycol. The time required for the pastes to produce negative cultures against the tested microorganisms was recorded and analyzed statistically using the Kruskal Wallis test at 5% significance level. Timing for pastes to eliminate the aerobic and facultative anaerobic microorganisms ranged from 6 to 24 h, while strict anaerobic microorganisms were inhibited within 30 s to 5 min. Microbial susceptibility, ranked from weakest to strongest, can be presented as follows: Enterococcus faecalis (the most resistant microorganism), Candida albicans, Staphylococcus aureus, Porph...
Brazilian Dental Journal
This clinical study reports on the antibacterial effects and outcome of endodontic treatment using either a single-file or a multifile system, associated with calcium hydroxide interappointment medication. The root canals of single-rooted teeth with apical periodontitis were treated by using either Reciproc or BioRaCe instrument systems, 2.5% NaOCl irrigation, and calcium hydroxide medication. Bacteriological samples taken before preparation and immediately before obturation were evaluated for total bacterial counts by quantitative real-time polymerase chain reaction (qPCR). Patients were followed up and the treatment outcome was assessed by clinical and radiographic criteria. Decreasing lesions were classified as success in a lenient criterion or failure in a rigid one. Bacteria were detected in all initial samples (47 cases) and were significantly reduced after treatment in both groups (p<0.001). In the Reciproc and BioRaCe groups, 7/25 (28%) and 11/22 (50%) root canals yielded...