• Restorative Dentistry and Endodontics
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• v.48 no.3
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• pp.31.1-31.11
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• 2023

Objectives: This retrospective cohort study examined the incidence of interappointment emergencies during multiple-visit molar root canal treatments conducted by undergraduate students. Treatments performed without the use of intracanal medicament were compared to treatments that incorporated calcium hydroxide as an intracanal medicament. Materials and Methods: Interappointment emergencies, defined as instances of pain or swelling that required the patient to make an unscheduled follow-up visit, were recorded for up to 2 months after the intervention. To avoid the influence of obturation on the observed incidence of emergency visits, only unscheduled visits occurring between the start and end of the root canal treatment were included. Results: Of the 719 patients included in this study, 77 (10.7%) were recorded as experiencing interappointment emergencies. Of these emergencies, 62% occurred within 2 weeks following the most recent intervention. In the group of patients who did not receive intracanal medicament, the incidence of interappointment emergencies was 11.9% (46 of 385 patients). In comparison, this rate was 9.3% (31 of 334 patients) among those who received calcium hydroxide as an intracanal medicament (odds ratio, 1.33; 95% confidence interval, 0.82-2.15; p = 0.249). Conclusions: Interappointment emergencies may arise at any point during root canal treatment, but they most commonly occur within the first 2 weeks following intervention. The omission of intracanal medicament in multiple-visit molar root canal treatments, performed by undergraduate students, did not significantly increase the incidence of these emergencies.

• Restorative Dentistry and Endodontics
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• v.16 no.2
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• pp.182-188
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• 1991

The purpose of this study was to clarify the effect of intracana1 medication on the clinical symptoms and the number of visits before canal filling in endodontic treatment The experimental teeth was divided into three groups. The teeth of group 1 was irrigated with saline solution and the teeth of group 2 was irrigated with sodium hypochlorite during biomechanical preparation. The intracanal medicament was not applied in the canals of group 1 and group 2. The teeth of group 3 was irrigated with sodium hypochlorite and hydrogen peroxide during canal enlargement and applied formocresol as intracanal medicament after drying the root canals with paper points. The incidence of interappintment pain and percussion pain after 1 st visit and the number of appointments before canal filling was examined, and the results was statistically compared. The following results were obtained. 1. The incidence of interappointment pain and percussion pain and the number of visits before canal filling was not effected by the types of irrigant and the use of the intracanal medicament 2. There was no significant difference in the incidence of interappintment pain arid percussion pain and the number of appointement before canal filling between vital teeth and non vital teeth, and also between single rooted teeth and multirooted teeth. 3. The use of formocresol as intracanal medicament was not able to aid the elimination of clinical symptoms and to decrease the number of appointment before canal filling.

• Restorative Dentistry and Endodontics
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• v.39 no.4
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• pp.241-252
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• 2014

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 $Ca(OH)_2$.

• The Journal of the Korean dental association
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• v.53 no.10
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• pp.743-750
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• 2015

Objectives: This study compared the mechanical efficacy of sonic activated and passive ultrasonic irrigation for removing intracanal medicament from a simulated root canal under controlled conditions. Materials and Methods: Thirty simulated root canal in resin blocks were randomly divided into 3-groups. The canals were enlarged using ProTaper files and K3XF (#30/0.06). After cleaning and drying, canals were filled with Calcipex. Overfilled materials were wiped out and measured their weight to the unit of 1/10mg. After one week storage in 100% humidity $37^{\circ}C$ temperature, canals were irrigated using 20mL of saline with one of following methods according to the designated groups (n = 10). For group-NI, 30-gauge nickel-titanium irrigation needle was used. During irrigation with every 5mL, needle was moved in-and-out with 4-mm amplitudes. EndoActivator and ultrasonic tip were used for group-EA and group-UT respectively for 20 seconds after every 5mL irrigation using needle. Then the weight was measured again to calculate the weight of residual remnants. The data were analyzed by one-way ANOVA and Duncan's post-hoc test at a significance level of 95%. Results: The weight of the residual medicaments were $3.62{\pm}0.81mg$, $2.84{\pm}0.28mg$, and $2.73{\pm}0.90mg$ for group-NI, -EA, and -UT, respectively. Group-EA and group-UT had no significant differences to remove intracanal medicament and left significantly less amount of paste than group-NI (p < 0.05). Conclusions: Under the controlled conditions of this study, the sonic activation and PUI have similar mechanical efficacy for removing intracanal medicament.

• Restorative Dentistry and Endodontics
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• v.40 no.2
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• pp.97-103
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• 2015

The first part of this study reviewed the characteristics of calcium hydroxide ($Ca(OH)_2$) and summarized the results of in vitro studies related to its antimicrobial effects. The second part of this review covers in vivo studies including human clinical studies and animal studies. The use of $Ca(OH)_2$ as an intracanal medicament represented better histological results in animal studies. However, human clinical studies showed limited antimicrobial effects that microorganisms were reduced but not eliminated through the treatment, and that some species had resistance to $Ca(OH)_2$. Most of clinical outcome studies supported that there is no improvement in healing of periapical lesions when $Ca(OH)_2$ was applied between appointments. Further studies are required for the antimicrobial effects of $Ca(OH)_2$, and search for the ideal material and technique to completely clean infected root canals should be continued.

• Proceedings of the KACD Conference
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• 2003.11a
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• pp.560-560
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• 2003

I. Objectives Intracanal medicament with antibacterial action is required to maximize the disinfection of the root canal system. The purpose of this study was to evaluate the efficacy of 2% chlorhexidine digluconate(CHX) and controlled release device(CRD) containing 20% CHX and chitosan coating, compared to calcium hydroxide as intracanal medicament against E. faecalis. II. Materials and Methods One hundred and twenty intact freshly extracted bovine incisors were used and were 0.5% NaOCl. Middle 1/3 portion of roots were sliced into 4mm thick section and cementum was removed using diamond burs and external diameter was approximally 6mm.(omitted)

• Restorative Dentistry and Endodontics
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• v.46 no.4
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• pp.52.1-52.11
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• 2021

Objectives: This study evaluated the effects of low and moderate concentrations of triple antibiotic paste (TAP) and double antibiotic paste (DAP) loaded into a hydrogel system on crown discoloration and explored whether application of an adhesive bonding agent prevented crown discoloration. Materials and Methods: Intact human molars (n = 160) were horizontally sectioned 1 mm apical to the cementoenamel junction. The crowns were randomized into 8 experimental groups (calcium hydroxide, Ca[OH]₂; 1, 10, and 1,000 mg/mL TAP and DAP; and no medicament. The pulp chambers in half of the samples were coated with an adhesive bonding agent before receiving the intracanal medicament. Color changes (ΔE) were detected by spectrophotometry after 1 day, 1 week, and 4 weeks, and after 5,000 thermal cycles, with ΔE = 3.7 as a perceptible threshold. The 1-sample t-test was used to determine the significance of color changes relative to 3.7. Analysis of variance was used to evaluate the effects of treatment, adhesive, and time on color change, and the level of significance was p < 0.05. Results: Ca(OH)₂ and 1 and 10 mg/mL DAP did not cause clinically perceivable tooth discoloration. Adhesive agent use significantly decreased tooth discoloration in the 1,000 mg/mL TAP group up to 4 weeks. However, adhesive use did not significantly improve coronal discoloration after thermocycling when 1,000 mg/mL TAP was used. Conclusions: Ca(OH)₂ and 1 and 10 mg/mL DAP showed no clinical discoloration. Using an adhesive significantly improved coronal discoloration up to 4 weeks with 1,000 mg/mL TAP.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.4
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• pp.455-463
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• 2018

The purpose of this study was to evaluate the effect of the intracanal medicaments on the push-out bond strength of the calcium silicate-based materials. Forty extracted single-root human mandibular premolars were sectioned below cementoenamel junction. Standardized root canal dimension was obtained with a parallel post drill. The specimens were randomly divided into a control group (no medicament), and experimental groups received medicaments with either CH (calcium hydroxide), DAP (double antibiotic paste; a mixture of ciprofloxacin and metronidazole), or TAP (triple antibiotic paste; a mixture of minocycline, ciprofloxacin and metronidazole). Following removal of medicaments with irrigation, roots were cut into sections with 1-mm-thickness. Thereafter, calcium silicate-based materials are applied to the specimens : (i) ProRoot MTA$^{(R)}$ and (ii) Biodentine$^{(R)}$. A push-out bond strength was measured and each specimen was examined to evaluate failure mode. Intracanal medication using CH significantly increased the bond strength to the root dentin. But there are no significant differences on the bond strength of ProRoot MTA$^{(R)}$ or Biodentine$^{(R)}$ among TAP, DAP and control groups. The dislodgement resistance of Biodentine$^{(R)}$ from root dentin was significantly higher than that of ProRoot MTA$^{(R)}$ regardless of the type of intracanal medicaments.

• Proceedings of the KACD Conference
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• 2001.11a
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• pp.565.2-565
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• 2001

Calcium hydroxide is unavoidably left on the root canal wall when used as an intracanal medicament, and is assumed to have some undesirable influence on the canal sealers. The purpose of this study was to determine whether the $Ca(OH)_2$ change physical properties (Exp. I) and sealing ability (Exp. II) of root canal sealers. Exp. I: As calcium hydroxide agents, $Calcipex^{\circledR}, {\;}Vitapex^{\circledR}, {\;}Calxyl^{\circledR}, {\;}and{\;}Ca(OH)_2$ were used.(omitted)

• Restorative Dentistry and Endodontics
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• v.44 no.3
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• pp.25.1-25.10
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• 2019

Objective: The aim of this study was to evaluate discoloration of teeth undergoing regenerative endodontic procedures (REPs) using blood clot or platelet-rich fibrin (PRF) as the scaffolds and different calcium silicate-based materials as the intracanal coronal barriers in an ex vivo model. Materials and Methods: Forty-eight bovine incisors were prepared and disinfected using 1 mg/mL double antibiotic paste (DAP). The specimens were then randomly divided into 2 groups (n = 24) according to the scaffolds (blood or PRF). After placement of scaffolds each group was divided into 2 subgroups (n = 12) according to the intracanal coronal barriers (ProRoot MTA or Biodentine). The pulp chamber walls were sealed with dentin bonding agent before placement of DAP and before placement of scaffolds. The color changes (${\Delta}E$) were measured at different steps. The data were analyzed using 2-way analysis of variance. Results: Coronal discoloration induced by DAP was not clinically perceptible (${\Delta}E{\leq}3.3$). Regarding the type of the scaffold, coronal discoloration was significantly higher in blood groups compared with PRF groups at the end of REP and after 1 month (p < 0.05). However, no significant difference was found between PRF and blood clot after 6 months (p > 0.05). Considering the type of intracanal coronal barrier, no significant difference existed between ProRoot MTA and Biodentine (p > 0.05). Conclusions: With sealing the dentinal tubules of pulp chamber with a dentin bonding agent and application of DAP as an intracanal medicament, coronal color change of the teeth following the use of PRF and blood sealed with either ProRoot MTA or Biodentine was not different at 6-month follow-up.