• 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.1 no.1
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• pp.50-53
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• 1975

• Restorative Dentistry and Endodontics
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• v.45 no.3
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• pp.29.1-29.9
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• 2020

This study describes the clinical steps taken in the treatment of a patient who had an avulsed right upper central incisor that presented with incomplete root development and chronic apical periodontitis. A 7-year-old boy was referred from a private dentist to a dental office specializing in endodontics. The tooth had remained in a dry environment for 20 minutes, and tooth replantation was performed at an emergency appointment. After clinical and radiographic examinations, root canal decontamination was performed, followed by several changes in intracanal calcium hydroxide medication. Blood clot formation was attempted, but bleeding within the root canal was insufficient; therefore, we opted for an intracanal medication change to stimulate mineralized tissue formation in the apical region. Root obturation was performed 45 days after the last change of intracanal medication, and clinical, radiographic, and tomographic follow-up examinations were performed at 3, 6, 18, and 40 months after the endodontic intervention. The increase in thickness and length of the root structure and the absence of root resorption were verified through follow-up examinations. Therefore, it was concluded that the procedures used were successful for tooth replantation.

• Restorative Dentistry and Endodontics
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• v.31 no.2
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• pp.86-95
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• 2006

The purpose of this clinical study is to assess whether calcium hydroxide as an intracanal medication affects post-treatment pain in teeth especially odontogenic pain which comes from inflammation of the pulp and periradicular tissues when compared with no intracanal medication. From 213 patients who has been treated 237 root canals due to significant pain (moderate-to-severe) we recorded their age, sex, treated tooth, degree of pain, pre-operative states of the tooth. We classified patients into 2 test group; Group 1 (not gain intracanal $Ca(OH)_2$), Group 2 (gain intracanal $Ca(OH)_2$). Through the survey from the patients, we let them write down the occurrence and degree of post-treatment pain in 4hours, 2days, 7days after treatment as none, mild, moderate or severe. The followings were evaluated ; the overall incidence of flare-ups, the overall incidence of post-treatment pain in each group at each time period , the incidence of post-treatment pain in each group at each time period as related to pre-operative states of the teeth These were compared statistically with Chi-square analysis (p < 0.05). Under the condition of this investigation, no difference was observed in the incidence of post-treat-ment pain between the two groups. Therefore, $Ca(OH)_2$ as intracanal medication had no effect on preventing or decreasing the post-treatment pain.

• 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.

• 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.

• 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.

• The Journal of the Korean dental association
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• v.56 no.5
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• pp.254-262
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• 2018

Objectives: This study aimed to compare the postoperative pain and clinical performance after applying three different intracanal medicaments and root canal sealers. Materials and Methods: Sixty-five patients requiring root canal treatment due to symptomatic apical periodontitis were included in this study. After a glide path preparation by using PathFile, each canal was shaped with ProTaper Next file system. After the canal cleaning and shaping procedure, the canal was dried and each intracanal medicaments were adjusted (Calcipex II, TRC-paste, Metapaste). At the next visit, the patients were requested to answer the absence of the pain after the procedure. Once the patients showed no symptom, the canal was obturated with each corresponded root canal sealers (AH plus, Radic-sealer, ADseal). The patients were recalled after 1 week, 1, 3, and 6 months to check the postoperative pain or unexpected clinical signs. One-way ANOVA and Duncan's post hoc comparison, and Chi-square test were used for statistical analysis to evaluate any differences among tested materials. Results: The average number of visits for intracanal medication was 2.69, 2.65, and 2.61 for Calcipex II, TRC-paste, and Metapaste. There were no statistically differences in post-obturation pain among three groups obturated with different root canal sealers (P > 0.05). Conclusions: Under the limitations of this study, three tested intracanal medicaments and epoxy resin root canal sealers showed clinically acceptable similar results.

• Restorative Dentistry and Endodontics
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• v.40 no.2
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• pp.166-171
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• 2015

A palato-radicular groove (PRG) is a developmental anomaly primarily found in the maxillary lateral incisors. It is a potential communication path between the root canal and the periodontium that decreases the survival prognosis of the affected tooth, therefore compromising the stability of the dental structure in the oral cavity. The aim of this case report is to present an original technique where a PRG was treated by means of intracanal disinfection, PRG sealing with glass ionomer, replantation with intentional horizontal 180 degree rotation of the tooth, and an aesthetic veneer placed to provide adequate tooth morphology. The clinical and biological benefits of this novel technique are presented and discussed.

• 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?