• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.1
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• pp.123-130
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• 2018

In the root fracture, pulp necrosis tends to involve only the coronal fragment, while the pulp in the apical fragment remains vital. The prognosis of endodontic treatment of the apical fragment is poor due to the possibility of overfilling of the space between the fragments and difficulty in removing necrotic tissue. In the present cases, endodontic treatment of the apical fragment of root fracture was performed. However, in reendodontic treatment, resistance was felt at the fracture site and access to the root canal in the apical fragment was difficult. Therefore, the calcium hydroxide was periodically exchanged only in the coronal fragment without further treatment in the apical fragment and the canal of the coronal fragment was finally filled with Gutta-percha. Regular observation revealed no radiologic complications in the apical fragment. In some cases, we can observe good healing pattern such as absorption of calcium hydroxide and pulp canal obliteration of apical fragment in the long term.

• Korean journal of applied entomology
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• v.7
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• pp.77-81
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• 1969

The effects of submerged method. Zentmyer's drench method. pot test and field test with materials such as Carbamisol (ammonium methyldithiocarbamic acid $30\%$), NCS (ammonium N-methyldithiocarbamate$50\%$, Similuton(ethyl phenethynylmeroury $3.3\%$), Soill(N-ethylmercuric p-toluensulfonanilide $4\%$, Captan (N-trichloromethylthio-1, 2, 3, 6-tetra-hydrophthalimide $80\%$), Difolatan(N-tetrachloroet-hylthio 4cyelohexeno-1,2-dicarboximide $80\%$, Grand(2, 3-dibromepropionitryl $20\%$, trichloronitroethylene $20\%$) and Calcium hydroxide upon occurrence of Fusarium wilt of cucumber were studied. The results are summarized as follows. 1. According to submerged method, all the compounds tested were highly inhibitory to mycelial growth of Fusarium oxysporum f. cucumerinum except calcium hydroxide. But several compounds were no inhibitory to the causal fungus except Grand and Similuton, with Zentmyer's drench method. 2. Grand was the most effective fungicide for the control of cocumber Fusarium wilt in the pot test, and followed by Similuton and calcium hydroxide. The population of Fusarium oxysporm was markedly reduced when soil was treat with Grand compared with other chemicals. 3. Fungicidal effects upon occurrence of Fusarium wilt of cucumber under the field experiment varied with the fungicides. Of the fungicides tested. Grand gave the best control, and followed by Difolatan.

• Restorative Dentistry and Endodontics
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• v.3 no.1
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• pp.17-21
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• 1977

After a vital pulpotomy in dogs' teeth, the responses of the remaining pulp tissue under calcium hydroxide and formocresol were studied histologically. The class I and V cavities were prepared on the teeth and the pulp was amputated. Calcium hydroxide and formocresol were placed over the amputated tissue and the cavities were sealed with zine oxide eugenol cement and zinc phosphate cement. Animals. were sacrifice after 1, 2, and 3 weeks following the operation. The teeth were decalcfied, sectioned and stained with hematoxylin and eosin. Microscopic examination reveals as follows; 1. Healing of the pulp at the amputation site did not occur in the pulps treated with formocresol. 2. At one week, a thin layer of darker staining tissues just below the necrotic zone was presented in the pulps treated with formocresol. In this stage the tissues beneath the darker staining layer were normal. 3. At two weeks, the cells of the palest staining layer were showed indistinct nucleus which suggested the karyolysis and the karyorrhexis in the pulps treated with formocoresol. As reached to the middle third of the pulp, the odontoblasts were scarcely evident or missed in this stage. 4. At three weeks, the necrotic zone was reached to the middle third of the pulp canal. The cells beneath the zone showed massive infiltration of inflammatory cells in the pulps treated with formocresol. 5. Dentin bridge in the control group was deposited below the necrotic zone from the two. weeks later. 6. Normal tissues were observed ill the apical third of all. the dental pulps in all case of calcium hydroxide and formocresol.

• Restorative Dentistry and Endodontics
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• v.45 no.3
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• pp.26.1-26.18
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• 2020

Objectives: This study aimed to systematically review the pain and flare-up effects of calcium hydroxide (CH) as intracanal medication (ICM) in non-vital mature teeth. Materials and Methods: Electronic-databases searching for published and grey literature and manual searching were conducted. Only randomized clinical trials (RCTs) were included comparing CH to other ICMs in non-vital mature teeth. The risk of bias was assessed using the RoB 2.0 Cochrane tool. The main outcomes were pain and flare-up. Qualitative and quantitative analysis, wherever applicable, was performed. The certainty of evidence (CoE) was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: Sixteen articles were included in 6 comparisons at different time points for different outcomes. CH reduced pain risk than no ICM within the 1-14-days interval (p < 0.05) and than triple-antibiotic paste within the first day (p < 0.05) and was similar to corticosteroid/antibiotics combination (p > 0.05). Chlorhexidine (CHX) or CH/CHX, however, reduced pain levels than CH alone (p < 0.05). CH showed higher flare-up risk than CHX (p < 0.05). CoE, however, ranged from very low to moderate. Conclusion: Most comparisons for different outcomes are based on very few studies, mostly low-powered, with an overall low CoE. Thus, the available evidence is considered insufficient to either support or refute CH effectiveness or to recommend one ICM over another. Therefore, further well-designed, larger RCTs are required.

• Restorative Dentistry and Endodontics
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• v.19 no.1
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• pp.205-216
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• 1994

The purpose of this study is to evaluate of apical plug materials for the contral of extrusion and sealing ability of high-temperature thermoplasticized gutta-percha in plastic root canal blocks. Seventy seven plastic blocks with canal preformed were instrumented with # 50K file 1 mm beyond apical foramen. Blocks were randomly divided into 5 groups of 15 blocks each. Group 1 was filled by high-temperature thermoplasticized gutta-percha only. The another 4 groups were placed with apical plug materials each other and then remaining space was back filled with high temperature thermoplasticized gutta-percha Apical plug materials were used as follows; Group 2: Thermoplasticized gutta-percha (Thermoplasticized gutta-percha group) Group 3 :. Calcium hydroxide powder (Calcium hydroxide group) Group 4 : Silver point (Silver point group) Group 5 : Gutta-percha cone softened by chloroform (Gutta-percha cone group) All the blocks were stored in 100 % relative humidor at room temperature for 14 days. Filling material extruded was removed carefully and then weighed in analytic balance. Each block was placed in centrifuge tube filled with India ink, and then centrifuged for 20 minutes at 3,000 rpm. Apical leakage was measured from the apical foramen to the most coronal level of dye leakage in millimeter by two examiners under a stereoscope. The data were analysed statistically by Student's t-test The obtained results were as follows; 1. The amounts of material extruded through the foramen decreased in all of groups used apical plug materials (P<0.01). 2. Silver point group and gutta-percha cone group were similar linear leakage to high-temperature thermoplasticised gutta-percha technique only (P>0..5). 3. Calcium hydroxide group and thermoplasticized gutta-percha group showed more liner leakage than high-temperature thermoplasticized gutta-percha only (P<0.01, P<0.05). 4. High-temperature thermoplasticized gutta-percha technique with silver point and gutta-percha cone as apical plugs showed less linear leakage and less extrusion of filling material.

• Restorative Dentistry and Endodontics
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• v.40 no.1
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• pp.44-49
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• 2015

Objectives: This study compared the ability of several techniques to remove calcium hydroxide (CH) from the root canal and determined the influence of CH residues on the accuracy of the electronic apex locator. Materials and Methods: Root canals of 90 human maxillary lateral incisors with confirmed true working length (TWL) were prepared and filled with CH. The teeth were randomly assigned to one of the experimental groups according to the CH removal technique (n = 14): 0.9% saline; 0.9% saline + master apical file (MAF); 17% ethylenediamine tetraacetic acid (EDTA); 17% EDTA + MAF; 5.25% sodium hypochlorite (NaOCl); 5.25% NaOCl + MAF. Six teeth were used as negative control. After CH removal, the electronic working length was measured using Root-ZX (Morita Corp.) and compared with TWL to evaluate Root-ZX accuracy. All specimens were sectioned longitudinally, and the area of remaining CH (CH) and total canal area were measured using imaging software. Results: The EDTA + MAF and NaOCl + MAF groups showed better CH removal than other groups (p < 0.05). Root-ZX reliability to prevent overestimated working length to be > 85% within a tolerance of ${\pm}1.0mm$ (p < 0.05). There was strong negative correlation between amount of CH residues and EAL accuracy (r = -0.800 for ${\pm}0.5mm$; r = -0.940 for ${\pm}1.0mm$). Conclusions: The mechanical instrumentation improves the CH removal of irrigation solutions although none of the techniques removed the dressing completely. Residues of CH medication in root canals affected the accuracy of Root-ZX adversely.

• Restorative Dentistry and Endodontics
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• v.44 no.2
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• pp.21.1-21.8
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• 2019

Objectives: The purpose of the present study was to evaluate the effect of calcium hydroxide with 2% chlorhexidine gel (HCX) or distilled water (HCA) compared to triple antibiotic paste (TAP) on push-out bond strength and the cement/dentin interface in canals sealed with White MTA Angelus (WMTA) or Biodentine (BD). Materials and Methods: A total of 70 extracted human lower premolars were endodontically prepared and randomly divided into 4 groups according to the intracanal medication, as follows: group 1, HCX; group 2, TAP; group 3, HCA; and group 4, control (without intracanal medication). After 7 days, the medications were removed and the cervical third of the specimens was sectioned into five 1-mm sections. The sections were then sealed with WMTA or BD as a reparative material. After 7 days in 100% humidity, a push-out bond strength test was performed. Elemental analysis was performed at the interface, using energy-dispersive spectroscopy. The data were statistically analyzed using analysis of variance and the Tukey test (p < 0.05). Results: BD presented a higher bond strength than WMTA (p < 0.05). BD or WMTA in canals treated with calcium hydroxide intracanal medications had the highest bond strength values, with a statistically significant difference compared to TAP in the WMTA group (p < 0.05). There were small amounts of phosphorus in samples exposed to triple antibiotic paste, regardless of the coronal sealing. Conclusions: The use of intracanal medications did not affect the bond strength of WMTA and BD, except when TAP was used with WMTA.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.2
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• pp.75-86
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• 2022

This review aims to identify the influence of the vehicle and its concentration used to carry calcium hydroxide (Ca(OH)₂) medicament on postoperative pain. The protocol for this review was registered in the open science framework (Registration DOI-10.17605/OSF.IO/4Y8A9) and followed the guidelines provided by the Joanna Briggs Institute. Reporting was based on the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR). Literature screening and searches were performed on PubMed/Medline, Scopus, and EBSCO hosts. Furthermore, additional records were manually analyzed using various sources. The selected studies were published in English and included the use of any vehicle adjunct to Ca(OH)₂ to evaluate postoperative pain using qualitative and quantitative pain assessment tools. Descriptive analysis was conducted to review the study design, vehicle elements, and their effects. A preliminary search yielded 7584 studies, of which 10 were included. According to the data collected, the most commonly used Ca(OH)₂ vehicles were chlorhexidine (CHX), normal saline, and camphorated paramonochlorophenol/glycerine (CPMC/glycerine), which had a significant effect on postoperative pain. Among the included studies, six evaluated the effect of CHX as a vehicle. It was observed that a higher concentration of the vehicle (2%) showed a favorable response in reducing postoperative pain. A majority of studies have validated a positive consequence of using a vehicle on postoperative pain. Although higher vehicle concentrations were found to alter postoperative pain levels, the data were insufficient to draw a firm conclusion. Our scoping review indicates that further clinical studies should focus on using different vehicles at various concentrations and application times to check for feasible and safe exposure in addition to providing pain relief.

• Restorative Dentistry and Endodontics
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• v.35 no.1
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• pp.5-12
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• 2010

The purpose of this study was to evaluate the pulp tissue reaction to direct pulp capping of mechanically exposed beagle dogs' pulp with several capping materials. A total of 36 teeth of 2 healthy beagle dongs were used. The mechanically exposed pulps were capped with one of the followings: (1) Mineral Trioxide Aggregate (MTA: $ProRoot^{(R)}$ MTA. Dentsply, Tulsa, USA), (2) Clearfil SE Bond (Dentin adhesive system: Kuraray, Osaka, Japan), (3) Ultra-Blend (Photo-polymerized Calcium hydroxide: Ultradent, South Jordan, USA), (4) Dycal (Quick setting Calcium hydroxide: LD Caulk Co., Milford, USA) at 7, 30, and 90 days before sacrificing. The cavities were restored with Z350 flowable composite resin (3M ESPE, St. Paul. MN, USA). After the beagle dogs were sacrificed, the extracted teeth were fixed, decalcified, prepared for histological examination and stained with HE stain. The pulpal tissue responses to direct pulp capping materials were assessed. In MTA calcium hydroxide, and photo-polymerized calcium hydroxide groups, initial mild inflammatory cell infiltration, newly formed odontoblast-like cell layer and hard tissue bridge formation were observed. Compared with dentin adhesive system, these materials were biocompatible and good for pulp tissue regeneration. In dentin adhesive system group, severe inflammatory cell infiltration, pulp tissue degeneration and pulp tissue necrosis were observed. It seemed evident that application of dentin adhesive system in direct pulp capping of beagle dog teeth cannot lead to acceptable repair of the pulp tissue with dentine bridge formation.

• Restorative Dentistry and Endodontics
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• v.27 no.5
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• pp.463-472
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• 2002

Bacterial lipopolysaccharide (LPS) plays a major role in stimulating the synthesis and release of the principal osteoclast-activating cytokines, namely, interleukin 1 and tumor necrosis factor-$\alpha$ from immune cells. Although rnonocytes/macrophages are the main producers of these cytokines, recent evidence has indicated that polymorphonuclear leukocytes (PMN) have the ability to release IL-1 and TNF-$\alpha$. Calcium hydroxide has been shown to be an effective medicament in root canal infections, reducing the microbial titre within the canal. It has been proposed that the therapeutic effect of Ca(OH)$_2$ may also be the result of direct inactivation of LPS. The purpose of this study was to investigate whether treatment of Porphyromonas endodontalis LPS with calcium hydroxide alters its biological action as measured by human PMN secretion of IL-1 and TNF-$\alpha$, and it was compared with Escherichia coli LPS. P. endodontalis ATCC 35406 was cultured in anaerobic condition, and LPS was extracted using the hot-phenol water extraction method and purified. Purchased E. coli LPS was also purified. 100 $\mu\textrm{g}$/ml of each LPS in pyrogen free water were incubated with 25mg/ml Ca(OH)$_2$ at 37$^{\circ}C$ for 7 days. The supernatants were subjected to ultrafiltration, and the isolates were lyophilized and weighed. PMNs were obtained from peripheral blood by centrifugation layered over Lymphoprep. The cells were resuspended (4$\times$10$^6$ cells/ml) in RPMI 1640 followed by treatment with various concentrations of LPS (0, 0.1, 1, 10$\mu\textrm{g}$/ml) for 24 hours at 37$^{\circ}C$ in 5% $CO_2$ incubator. The supernatants of cells were collected and the levels of IL-1$\alpha$, IL=1$\beta$ and TNF-$\alpha$ were measured by enzyme-linked immunosorbent assay. The results were as follows ; 1. The levels of IL-1$\alpha$, IL-1$\beta$, TNF-$\alpha$ from PMN treated with each LPS were significantly higher than those released from unstimulated PMN of the control group (p<0.05). 2. The levels of all three cytokines released from PMN stimulated with each calcium hydroxide treated LPS were significantly lower than those released from PMN stimulated with each untreated LPS (p<0.05), while they were not significantly different from those released from unstimulated PMN of the control group (p>0.05) 3. The levels of secretion for all three cytokines were affected in a dose-dependent manner in PMN stimulated with each LPS (p<0.05), but not in PMN stimulated with each calcium hydroxide treated LPS (p>0.05). 4. The levels of all three cytokines released from PMN stimulated with p. endodontalis LPS were significantly lower than those released from PMN stimulated with E coli LPS (p<0.05).