Comparison of different irrigation and agitation methods for the removal of two types of calcium hydroxide medicaments from the root canal wall: An in-vitro study

Background and aim: Comparison of different irrigation and agitation methods for the removal of two types of calcium hydroxide medicaments from the root canal walls.Methods: Fifty extracted single rooted teeth were selected for this study. After decoronation, the root canals of these teeth were prepared to the size F3 (30 no.) using rotary ProTaper file system. These samples were randomly divided into four groups. Group 1 (n=20) were filled completely with water based calcium hydroxide (CH), Group 2 (n=20) were filled with oil based CH using lentulo spiral, Group 3 (n=5) - the positive control group received the CH as intracanal medication, but no subsequent removal, Group 4 (n=5) - the negative control did not receive CH placement. Further on, Group 1 and Group 2 were divided into four sub-groups (n=5). In sub-group A we performed conventional syringe irrigation with side-vented needle sub-group B) manual dynamic agitation, sub-group C sonic agitation using endoactivator, sub-group D passive ultrasonic irrigation (PUI). Roots were split longitudinally into mesial and distal halves. Digital images of the root canal walls were acquired by a Dental Operating Microscope (DOM) and assessed by using a scoring criteria at different thirds (coronal, middle and apical) of the root canal as follows: score 1, score 2, score 3, and score 4. Data were analyzed applying one-way analysis of variance (ANOVA) and Tukey’s multiple comparison tests at a 95% confidence interval (P < 0.05).Results: Statistically significant differences were not found between the experimental groups and the negative group in any one third of the root canal (P>0.05). However, a difference did exist between the experimental groups and the positive control group (P<0.05). None of the experimental groups totally removed CH substances from root canal walls.Conclusion: Among all experimental groups, removal of CH was best achieved by sonic agitation using endoactivator followed by passive ultrasonic irrigation (PUI), manual dynamic agitation and conventional syringe irrigation with side-vented needle.

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Passive ultrasonic irrigation in calcium hydroxide removal from root canals: a sem/eds analysis

Journal of Research in Dentistry ◽

10.19177/jrd.v3e32015668-677 ◽

2015 ◽

Vol 3 (3) ◽

pp. 668

Author(s):

Fernanda Hoffmann Busanello ◽

Angela Longo Do Nascimento ◽

Lilian Tietz ◽

Mirela Sangoi Barreto ◽

Ricardo Abreu Da Rosa ◽

...

Keyword(s):

Calcium Hydroxide ◽

Root Canal ◽

Control Group ◽

Passive Ultrasonic Irrigation ◽

Root Canals ◽

Eds Analysis ◽

Ultrasonic Irrigation ◽

Calcium Hydroxide Removal ◽

And Control ◽

Elementary Chemical

AIM: The aim of this study was to evaluate the efficacy of different lengths of time of passive ultrasonic irrigation (PUI) in removing calcium hydroxide (CH) paste from root canal, using scanning electron microscopy and energy dispersive spectrometry (SEM/EDS). MATERIAL AND METHODS: Fifty-four human premolars were used. After coronal access, a size #15 K-file was used to obtain apical patency. Root canal preparation was performed using WaveOne 40.08 instruments. CH paste was placed into the root canal. Specimens were stored in a humid environment, and after seven days, they were divided into five groups (n=12) according to the irrigation protocols: Manual– a size #40 K-file; PUI/1– 1 min; PUI/2– 2 min; PUI/3– 3 min; and Control– without CH paste. An elementary chemical microanalysis (SEM/EDS) was performed to quantify the presence of calcium on the dentinal walls. RESULTS: The percentage of calcium was higher in all experimental groups when compared to the control group (P < 0.05); but no differences among them were found (P > 0.05). CONCLUSION: The amount of calcium hydroxide paste on the dentinal walls was not dependent on length of time of ultrasonic activation. SEM/EDS analysis seems to be a reliable method to assess CH paste removal from the root canals.

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Effect of Different Irrigation Solutions on the Diffusion of MTA Cement into the Root Canal Dentin

Materials ◽

10.3390/ma13235472 ◽

2020 ◽

Vol 13 (23) ◽

pp. 5472

Author(s):

José Pedro Martinho ◽

Sara França ◽

Siri Paulo ◽

Anabela Baptista Paula ◽

Ana Sofia Coelho ◽

...

Keyword(s):

Root Canal ◽

Ethylenediaminetetraacetic Acid ◽

Treatment Success ◽

Confocal Laser ◽

Control Group ◽

Middle Section ◽

Group 2 ◽

Root Canal Dentin ◽

Group 1

(1) Aim: This study aims to analyze the in vitro infiltration of a silicate root canal sealer into dentinal tubules after using different endodontic irrigating solutions. (2) Methods: Twenty-nine teeth with single roots were separated into three groups according to the final irrigation protocol: G1 n = 10) = 17% EDTA (ethylenediaminetetraacetic acid) + 3.0% sodium hypochlorite (NaOCl), G2 (n = 10) = 17% EDTA + 2.0% chlorhexidine and G3 (Control group, n = 9) = 17% EDTA + saline solution. Root canals were filled using cold lateral compaction technique with MTA Fillapex sealer and gutta-percha. The sealer was labeled with rhodamine B. The teeth were segmented at the middle and third apical sections, which were visualized using 10× confocal laser microscopy to determine the sealer penetration percentage. (3) Results: In the apical section, no statistically significant differences were found between the groups regarding sealer penetration. In the middle section, Group 1 obtained the highest percentage, and Group 2 the lowest (p = 0.004). Group 1 also presented statistically significant differences in the Control Group (p = 0.031) and had close sealer penetration values. Meanwhile, the Control Group (p = 0.023) and Group 2 (p = 0.029) revealed a significant decrease of sealer penetration between the apical and middle sections. (4) Conclusion: The obtained results support that final irrigation with NaOCl promoted similar sealer penetration in the apical and middle sections. On the other hand, a significant decrease in the sealer penetration of the middle section was observed for the chlorhexidine and saline groups. Compared to other irrigant solutions, NaOCl promotes more uniform sealer penetration, which can correlate with better sealing and, consequently, higher endodontic treatment success.

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Effectiveness of NaOCl alone or in combination with EDTA on the diffusion of hydroxyl ions released by calcium hydroxide paste

Journal of Applied Oral Science ◽

10.1590/s1678-77572006000100001 ◽

2006 ◽

Vol 14 (1) ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Mara Cristina Santos Felippe ◽

Wilson Tadeu Felippe ◽

Catherine Schmitz Espezim ◽

Sérgio Fernando Torres de Freitas

Keyword(s):

Calcium Hydroxide ◽

Root Canal ◽

Statistical Significance ◽

Distilled Water ◽

Mechanical Preparation ◽

Group 3 ◽

Group 2 ◽

Water Canals ◽

Group 1

AIM: To evaluate the effect of different irrigant solutions employed during removal and replacement of calcium hydroxide paste on the diffusion of hydroxyl ions through root canal dentine in vitro. METHODOLOGY: Thirty-five maxillary and mandibular human canines with straight and fully developed roots were used. After mechanical preparation up to 1mm short of tooth length, 30 canals were filled with calcium hydroxide paste and 5 canals were left empty; all teeth had their coronal accesses properly sealed. Teeth were placed in plastic containers with distilled water, and pH was read after 30 days when the paste from 20 teeth was renewed. After removal of the paste by endodontic instrumentation and irrigation with distilled water, canals were replenished with newly mixed paste in Group 1 and 2. In these groups, final irrigation was conducted with 5 mL of EDTA followed by 5 mL of NaOCl in specimens in Group 1, and 5 mL of NaOCl only in specimens in Group 2. In 10 teeth the paste was not replenished at 30 days (Group 3). All specimens were returned to the containers with fresh distilled water, and the pH was recorded after another 30 days. The differences between the first (30d) and second (60d) pH readings were calculated and submitted to analysis of variance and individual comparisons using the Scheffeé's test. RESULTS: Results of mean analysis on differences of pH readings showed that greater diffusion had occurred on specimens in Group 3. Individual comparisons using Scheffeé's test showed statistical significance between Groups 2 and 3, and equivalence between all other groups. CONCLUSION: It was concluded that the use of EDTA did not enhance diffusion of hydroxyl ions through root canal dentine.

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Comparison of Anti-Bacterial Efficacy between Passive Ultrasonic Irrigation and 980 nm-GaAlAs Laser Application in Two Root Types

Medicina ◽

10.3390/medicina57060537 ◽

2021 ◽

Vol 57 (6) ◽

pp. 537

Author(s):

Sung-Eun Yang ◽

Yong-Min Kim

Keyword(s):

Root Canal ◽

Qpcr Assay ◽

Control Group ◽

Laser Application ◽

Passive Ultrasonic Irrigation ◽

Single Root ◽

Bonferroni Adjustment ◽

Canal Surfaces ◽

Ultrasonic Irrigation ◽

Group 1

Background and Objectives: The purpose of the present study was to investigate the anti-bacterial efficacy of passive ultrasonic irrigation (PUI) and a 980-nm-gallium-aluminum-arsenide (GaAlAs) laser using a real-time DNA-based quantitative polymerase chain reaction (qPCR) assay and scanning electron microscopy (SEM). Materials and Methods: Eighty-six extracted single- and double-rooted human teeth were used in the experiment. The following four experimental groups were evaluated, as well as a control group: group 1: single root + PUI (n = 20); group 2: single root + laser application (n = 20); group 3: double roots + PUI (n = 20); group 4: double roots + laser application (n =20); control group (n = 6): 3 single roots, 3 double roots. The qPCR assay was performed in three stages to evaluate the efficacy of the adjunctive method against Enterococcus faecalis. SEM analysis was also used to examine the microstructure of root canal surfaces. The data were statistically analyzed using the Friedman test and the Kruskal–Wallis test with Bonferroni adjustment. Results: The decrease in the DNA levels from S1 (before preparation) to S2 (just after preparation) was highly significant in all groups, and decreases in DNA levels from S2 to S3 (after incubation for 1 week) were found in all experimental groups except group 1. An inter-group analysis showed that PUI was significantly more effective in terms of antibacterial efficacy than GaAlAs laser irradiation in single root (p < 0.05). However, in double roots, experimental groups did not show significantly lower DNA levels than the control group (p > 0.05). SEM images showed that cleaning of the root canal surface and reduction of dentin debris were achieved only in single-rooted teeth when using PUI application. Conclusions: Two adjunctive methods were effective in reducing E. faecalis in single rooted tooth.

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Comparison of ratios combination calcium hydroxide Ca(OH)2 with red pine (Pinus densiflora) of viscosity

Conservative Dentistry Journal ◽

10.20473/cdj.v11i2.2021.50-55 ◽

2021 ◽

Vol 11 (2) ◽

pp. 50

Author(s):

Latief Mooduto ◽

Ari Subiyanto ◽

Shafa Prasita

Keyword(s):

Calcium Hydroxide ◽

Pinus Densiflora ◽

Antibacterial Properties ◽

Positive Control ◽

Red Pine ◽

Control Group ◽

Liquid Form ◽

Group 3 ◽

Group 2 ◽

Group 1

Background: Calcium hydroxide is a gold standard for root canal sealing material. However, there are many defects in calcium hydroxide that have prompted many researchers to look for alternative materials, including natural origin ingredients. Red pine (Pinus densiflora) is often used in dentistry for its antioxidant and antibacterial properties. The mixture of calcium hydroxide and red pine has never been achieved before. One of the criteria for material sealing is that the channel should be fully sealed with high flow ability and low viscosity. Therefore, this research is performed to analyze the viscosity value of the mixture of calcium hydroxide and red pine (Pinus densiflora). Purpose: Knowing the difference in viscosity of the combination of calcium hydroxide and red pine with a ratio of 1:1, 1:1.5, and 1:2. Methods: This study used four treatment groups, with each group consisting of 8 replications. Group 1 was a combination of calcium hydroxide and red pine with a 1: 1, group 2 the ratio was 1: 1.5, group 3 had the ratio 1: 2, and the positive control group used calcium hydroxide and a sterile aquadest. Calcium hydroxide in powder form and an extract of red pine in liquid form are mixed according to the ratio. The viscosity value is measured using a viscosity tester, namely the Brookfield Viscometer. Results: The control group had a lower viscosity than group 3, group 3, and group 2 than group 1. Conclusion: Combination of calcium hydroxide and red pine with a ratio of 1:2, the lowest viscosity was obtained compared to the ratio of 1: 1 and 1: 1.5

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Alkalizing potential and calcium release of residues from intracanal dressing containing calcium hydroxide

Revista de Odontologia da UNESP ◽

10.1590/1807-2577.11018 ◽

2018 ◽

Vol 47 (6) ◽

pp. 383-387

Author(s):

Mariana Pires CRESPO ◽

Kamila de Figueiredo PEREIRA ◽

Milton Carlos KUGA ◽

Thiago Soares PORTO ◽

Luciana ARMADA

Keyword(s):

Calcium Hydroxide ◽

Calcium Ions ◽

Root Canal ◽

Calcium Release ◽

Ph Value ◽

Positive Control ◽

Positive Control Group ◽

Control Group ◽

Distilled Water ◽

Significant Difference

Abstract Introduction If the restoration, that seal the root canal from oral environment, failed or solubilize, the intracanal dressing could be partially removed, decreasing the efficiency of calcium hydroxide (CH). Objective To evaluate the alkalizing potential and calcium ions release of intracanal residues from different medications, in different periods. Materials and method Human incisors were endodontically instrumented and randomly divided (n=10). The root canals were filled with: G1⎯Calcium hydroxide (CH); G2⎯CH with 0.4% chlorhexidine digluconate (CHC); G3⎯CH with camphorated paramonochlorophenol and glycerin (HPG); G4⎯CH was maintained during all experiment, as positive control group (PC) and G5⎯ No medication was performed in the negative control group (NC). The specimens were immersed in distilled water for 7 days. The intracanal dressing was removed from the experimental groups using F1 instrument (Protaper). The teeth were stored in distilled water for 24 hours, 7, 14 and 28 days. pH value and calcium ions released were evaluated and the data were submitted to ANOVA one-way and Tukey tests. Result All experimental groups presented lower alkalizing potential and calcium ions release than PC (P<0.05). No significant difference was found among the experimental groups, regardless of the period (P>0.05). Conclusion The alkalizing potential and calcium ions release of residues from different intracanal dressing, in different periods, were similar and lower than the positive control group, that the medication was maintained inside the root canal, encouraging the replacement of intracanal dressing when the restoration fail.

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Compressive Strength Test on Calcium Hydroxide with Propolis Combination

Conservative Dentistry Journal ◽

10.20473/cdj.v9i1.2019.28-32 ◽

2019 ◽

Vol 9 (1) ◽

pp. 28

Author(s):

Ira Widjiastuti ◽

S. Setyabudi ◽

M. Mudjiono ◽

Erika Setyowati

Keyword(s):

Compressive Strength ◽

Calcium Hydroxide ◽

Positive Control ◽

Control Group ◽

Propolis Extract ◽

Pulp Capping ◽

Alternative Ingredients ◽

Group 3 ◽

Group 2 ◽

Group 1

Background: Calcium hydroxide is a dental material used as a gold standard for pulp capping materials. However, calcium hydroxide has several weaknesses which cause many researchers to look for alternative ingredients that come from nature. Propolis in the field of dentistry has long been used because of its ability as an anti-inflammatory, anti-microbial, anti-fungal, and can cure scars. The combination of calcium hydroxide and propolis is proven to have good biocompatibility and anti-bacterial properties. One of the requirements of pulp capping material is to have sufficient compressive strength. Therefore, a research to test the compressive strength value of the combination of calcium hydroxide with propolis is needed. Purpose: To find out the difference in compressive strength of the combination of calcium hydroxide-propolis with a ratio of 1: 1, 1: 1.5, and 1: 2. Methods: The study used 4 treatment groups with each group consisting of 6 replications. Group 1 is a combination of calcium hydroxide-propolis with a ratio of 1: 1, group 2 with a ratio of 1: 1.5, group 3 with a ratio of 1: 2, and a positive control group using calcium hydroxide - sterile aquadest. Calcium hydroxide powder and propolis extract liquid is mixed according to comparison and printed on a cylindrical mold with the size of 4 mm x 6 mm. Then, the compressive strength was tested using an Autograph test instrument. Result: Compressive strength was smaller in group 3 compared to group 2, group 2 compared to group 1, and group 1 compared to the control group. Conclusion: In calcium hydroxide-propolis combination, the more propolis extract used in the combination the lower the compressive strength of the combination will be.

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Antibacterial power effectiveness of calcium hydroxide and propolis mixture on Fusobacterium nucleatum bacteria

Conservative Dentistry Journal ◽

10.20473/cdj.v9i1.2019.1-4 ◽

2019 ◽

Vol 9 (1) ◽

pp. 1

Author(s):

Ira Widjiastuti ◽

S. Sukaton ◽

Agnes Melinda Wong ◽

Nanik Zubaidah

Keyword(s):

Calcium Hydroxide ◽

Root Canal ◽

Fusobacterium Nucleatum ◽

Positive Control ◽

Test Tube ◽

Control Group ◽

Natural Material ◽

Hard Tissue ◽

Alternative Ingredients ◽

Group 2

Background: Calcium hydroxide is a root canal dressing material that is widely used in dentistry because of its ability to regenerate hard tissue and eliminate bacteria. According to Ferreira et al. (2015), Fusobacterium nucleatum was found in 90% of teeth that had a root canal treatment done using calcium hydroxide as an intracanal medication. Due to this shortcoming of the antibacterial power of calcium hydroxide, additional research on alternative ingredients that can be combined with calcium hydroxide to improve its antibacterial power is necessary. Propolis is a natural material that has high antibacterial power and has long been used in dentistry. The addition of propolis to calcium hydroxide is expected to improve the antibacterial power of calcium hydroxide without eliminating its function in terms of regenerating hard tissue. Purpose: To find out how effective is the antibacterial power of a combination of calcium hydroxide and propolis against Fusobacterium nucleatum. Methods: The research was carried out using 4 treatment groups consisting of 6 samples for each group. Group 1 is given a combination of calcium hydroxide and propolis with a ratio of 1:1, group 2 with a ratio of 1:1.5, group 3 with a ratio of 1:2, and group 4 is a positive control of calcium hydroxide and sterile aquadest suspension. Each sample was put into a test tube containing BHIB and a suspension of Fusobacterium nucleatum, incubated at 37ºC for 24 hours, and vortexed for 1 minute. A total of 0.1 ml of bacterial inoculum was taken from each sample and then put into the MHA and grown for 24 hours. The number of Fusobacterium nucleatum colonies grown on MHA was calculated and expressed using the Colony Forming Unit (CFU). Results: There were fewer colonies of Fusobacterium nucleatum in the treatment group compared to the control group. Conclusion: The combination of calcium hydroxide and propolis has an effective antibacterial power against Fusobacterium nucleatum which the ratio of 1:2 is more effective than ratio of 1:1,5 and 1:1.

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ANTIBACTERICAL POTENCY OF CALCIUM HYDROXIDE AND PROPOLIS MIXTURE ON MIXED BACTERIA OF CARIOUS DENTIN

Conservative Dentistry Journal ◽

10.20473/cdj.v9i1.2019.5-12 ◽

2019 ◽

Vol 9 (1) ◽

pp. 5

Author(s):

Ruslan Effendy ◽

Vita Ariesta ◽

Widya Saraswati

Keyword(s):

Calcium Hydroxide ◽

Antibacterial Properties ◽

Positive Control ◽

Positive Control Group ◽

Control Group ◽

Group I ◽

Carious Dentine ◽

Group 3 ◽

Mixed Bacteria ◽

Group 2

Background: Calcium hydroxide has been known as the gold standard of pulp capping process, but still has some weaknesses such as a pH that is too high to be potentially toxic, resistant to certain bacteria, causing necrosis of the pulp, and causing a tunnel defect. This weakness causes researchers to look for alternative ingredients that have antibacterical properties that can be combined with calcium hydroxide. Propolis has antibacterial properties such as flavonoids, tannins, saponins, and terpenoids which can work as the best carrier that allows dissociation of ions from calcium hydroxide so the combination of both that has antibacterial power is expected to have an effective antibacterial potency against the number of bacterial colonization with mixed dentine carious. Aims: This study aims to determine the antibacterial potency produced by a combination of calcium hydroxide and propolis against mixed bacteria of carious dentine. Methods: The research was carried out using 4 treatment groups with each of 7 samples. Group I is a combination of calcium hydroxide and propolis with a ratio of 1: 1, group 2 with a ratio of 1: 1.5, group 3 with a ratio of 1: 2, and a positive control group. Each sample was put into a suspense of mixed bacteria of carious dentine, grown for 24 hours. Suspense is vortexed for 1 minute so the solution becomes homogeneous. Put 0.1 ml of suspended mixed bacteria of dentine carious from BHIB media, grown for 24 hours on MHA media and counted the number of colonies. Results: The highest number of colonies in the positive control group, then group 1, group 2, and the least number of colonies in group 3 with the most extract of propolis. Conclusion: The combination of calcium hydroxide and propolis with a ratio of 1: 2 has the best antibacterial power in inhibiting colonization of mixed bacteria of carious dentine.

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Effect of Various Irrigating Devices on the Removal of Two Different Forms of Calcium Hydroxide from Internal Resorption Cavities

International Journal of Dentistry ◽

10.1155/2020/8881177 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Nima Mousavi Nasab Mobarakeh ◽

Afsaneh Taheri ◽

Hadi Rahmanian ◽

Dana Jafarpour ◽

Sareh Rahmanian

Keyword(s):

Calcium Hydroxide ◽

Root Resorption ◽

Positive Control ◽

Negative Control ◽

Passive Ultrasonic Irrigation ◽

Root Canals ◽

Significant Difference ◽

Ultrasonic Irrigation ◽

Analyze Data

The present study aimed to investigate the efficiency of passive ultrasonic irrigation (PUI), EndoActivator (EA), standard needle irrigation (SNI), and XP-endo Finisher files in removing pure calcium hydroxide (pCH) and injectable CH from in vitro root resorption cavities. Using a rotary system, the root canals of 116 extracted single rooted teeth were prepared. Imitated internal resorption cavities were then created in root halves. The specimens were divided into two groups according to the form of CH (n = 58): (I) pCH; (II) injectable CH. The teeth of each group were randomly divided into six subgroups: negative control (n = 5), positive control (n = 5), PUI (n = 12), XP-endo Finisher (n = 12), EA (n = 12), and SNI (n = 12). The root canals were irrigated using NaOCl and EDTA and split longitudinally, and both halves were evaluated with a stereomicroscope. Kruskal–Wallis and Mann–Whitney U tests were used to analyze data. The present results revealed that PUI completely removed pCH in 79% and injectable CH in 70.8% of the internal resorption cavities which was significantly higher than other methods (p<0.05). There was no statically significant difference between different forms of CH in terms of CH removal (p=0.918). The PUI technique was observed as the most efficient method of P-CH and injectable CH removal from a replicated internal resorption cavity. Finally, according to the findings, different forms of CH were comparable in terms of CH removal.

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