CC BY-NC-ND 4.0 · Eur J Dent 2018; 12(03): 386-392
DOI: 10.4103/ejd.ejd_77_18
Original Article
Dental Investigation Society

Diffusion of calcium hydroxide through dentinal tubules of retreated root canals: An in vitro study

Mohammed Mustafa
1   Department of Conservative Dental Sciences, Division of Endodontics, College of Dentistry, Prince Sattam bin Abdulaziz University, AlKharj, Saudi Arabia
,
Wafa Hassan Alaajam
2   Department of Conservative Dental Sciences, Division of Endodontics, College of Dentistry, King Khalid University, Abha, Saudi Arabia
,
Ahmed Abdul Azeim
2   Department of Conservative Dental Sciences, Division of Endodontics, College of Dentistry, King Khalid University, Abha, Saudi Arabia
,
Najla Aedh Alfayi
3   General Dentist, Abha, Saudi Arabia
,
Rahaif Misfer Alqobty
3   General Dentist, Abha, Saudi Arabia
,
Shahad Alghannam
4   General Dentist,College of Dentistry and Hospital, Prince Sattam bin Abdulaziz University, AlKharj, Saudi Arabia
› Author Affiliations
Further Information

Publication History

Publication Date:
15 October 2019 (online)

ABSTRACT

Objective: Studies about the dispersion of hydroxyl ions through dentin of endodontically retreated teeth are scarce. The present study aims at examining the diffusion of calcium hydroxide in vitro by recording the pH changes of retreated root canal using two types of calcium hydroxide preparations. Materials and Methods: A total of 45 recently extracted single-rooted mandibular first premolars were collected and cleaned from calculus and remains of periodontal tissue. The teeth so collected were stored in thymol 10% solution till use. During collection, teeth with cracks, open apices, and restorations were excluded. Root canal preparations were performed using Protaper rotary system files, till #F3 file. All canals were obturated using cold lateral condensation and zinc oxide-based sealer. After 7 days, all gutta-percha were removed and the canals were irrigated with normal saline. The teeth were then randomly distributed into three groups. Canals in Group I were kept empty without any dressing to serve as a negative control group, Canals in Group II were filled with a freshly prepared mixture of calcium hydroxide powder with normal saline solution, and Group III was filled with Metapex. Periodically, the calcium hydroxide material was removed and the pH was measured using pH meter at 7, 10, 14, and 30 days. Results: The pH values of Group II and III ranged between 9.2 and 11.2. This was found to be highly significant against the negative control group. After 7 and 10 days, freshly mixed Ca(OH)2 showed the higher pH than the creamy Metapex, and statistically the difference was highly significant after 10 days (P<0.001). After 14 days, Metapex group pH was higher than freshly mixed Ca(OH)2, but it was not statistically significant as they reached nearly the same pH after 30 days (P>0.05). Conclusion: All Ca(OH)2 preparations had high pH around the roots after 7 and 10 days. Metapex continued to have higher pH after 14 days.

 
  • REFERENCES

  • 1 Endo MS, Ferraz CC, Zaia AA, Almeida JF, Gomes BP. Quantitative and qualitative analysis of microorganisms in root-filled teeth with persistent infection: Monitoring of the endodontic retreatment. Eur J Dent 2013; 7: 302-9
  • 2 Bystrom A, Claesson R, Sundqvist G. The antibacterial effect of camphorated paramonochlorophenol, camphorated phenol and calcium hydroxide in the treatment of infected root canals. Endod Dent Traumatol 1985; 1: 170-5
  • 3 Mohammadi Z, Shalavi S, Yazdizadeh M. Antimicrobial activity of calcium hydroxide in endodontics: A review. Chonnam Med J 2012; 48: 133-40
  • 4 Teoh YY, Athanassiadis B, Walsh LJ. Comparison of commercial calcium hydroxide pastes for prolonged antibacterial effect using a colourimetric assessment. Materials (Basel) 2018; 11: pii E348
  • 5 Mustafa M, Saujanya KP, Jain D, Sajjanshetty S, Arun A, Uppin L. et al. Role of calcium hydroxide in endodontics: A review. Glob J Med Public Health 2012; 1: 66-70
  • 6 Poggio C, Beltrami R, Colombo M, Ceci M, Dagna A, Chiesa M. et al. In vitro antibacterial activity of different pulp capping materials. J Clin Exp Dent 2015; 7: e584-8
  • 7 Sireesha A, Jayasree R, Vidhya S, Mahalaxmi S, Sujatha V, Kumar TS. et al. Comparative evaluation of micron-and nano-sized intracanal medicaments on penetration and fracture resistance of root dentin – An in vitro study. Int J Biol Macromol 2017; 104: 1866-73
  • 8 Ndiaye D, Diongue K, Bane K, Seck A, Niang SO, Lèye Benoist F. et al Efficacy of sodium hydroxide at 2.5 %, chlorhexidine gluconate at 0.5 % and calcium hydroxide against Candida albicans. J Mycol Med 2016; 26: 317-22
  • 9 de Souza CA, Teles RP, Souto R, Chaves MA, Colombo AP. Endodontic therapy associated with calcium hydroxide as an intracanal dressing: Microbiologic evaluation by the checkerboard DNA-DNA hybridization technique. J Endod 2005; 31: 79-83
  • 10 Trope M, Moshonov J, Nissan R, Buxt P, Yesilsoy C. Short vs. long-term calcium hydroxide treatment of established inflammatory root resorption in replanted dog teeth. Endod Dent Traumatol 1995; 11: 124-8
  • 11 Kazemipoor M, Tabrizizadeh M, Dastani M, Hakimian R. The effect of retreatment procedure on the pH changes at the surface of root dentin using two different calcium hydroxide pastes. J Conserv Dent 2012; 15: 346-50
  • 12 Pashley DH, Livingston MJ. Effect of molecular size on permeability coefficients in human dentine. Arch Oral Biol 1978; 23: 391-5
  • 13 Saber SE, El-Hady SA. Development of an intracanal mature Enterococcus faecalis biofilm and its susceptibility to some antimicrobial intra-canal medications: An in vitro study. Eur J Dent 2012; 6: 43-50
  • 14 Cai M, Abbott P, Castro Salgado J. Hydroxyl ion diffusion through radicular dentine when calcium hydroxide is used under different conditions. Materials (Basel) 2018; 11: pii E152
  • 15 Ba-Hattab R, Al-Jamie M, Aldreib H, Alessa L, Alonazi M. Calcium hydroxide in endodontics: An overview. Open J Stomatol 2016; 6: 274-89
  • 16 Siqueira Jr JF, Fraga RC, Garcia PF. Evaluation of sealing ability, pH and flow rate of three calcium hydroxide-based sealers. Endod Dent Traumatol 1995; 11: 225-8
  • 17 Kontakiotis EG, Tzanetakis GN, Loizides AL. A comparative study of contact angles of four different root canal sealers. J Endod 2007; 33: 299-302
  • 18 Madarati AA, Zafar MS, Sammani AMN, Mandorah AO, Bani-Younes HA. Preference and usage of intracanal medications during endodontic treatment. Saudi Med J 2017; 38: 755-63
  • 19 Rizvi A, Zafar MA, Farid WM, Gazal G. Assessment of antimicrobial efficacy of MTAD, sodium hypochlorite, EDTA and chlorhexidine for endodontic applications: An in vitro study. Middle East J Sci Res 2014; 21: 353-7
  • 20 Yücel AC, Aksoy A, Ertaş E, Güvenç D. The pH changes of calcium hydroxide mixed with six different vehicles. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 103: 712-7
  • 21 Dausage P, Dhirawani RB, Marya J, Dhirawani V, Kumar V. A comparative study of ion diffusion from calcium hydroxide with various herbal pastes through dentin. Int J Clin Pediatr Dent 2017; 10: 41-4
  • 22 Gomes BP, Souza SF, Ferraz CC, Teixeira FB, Zaia AA, Valdrighi L. et al. Effectiveness of 2% chlorhexidine gel and calcium hydroxide against Enterococcus faecalis in bovine root dentine in vitro . Int Endod J 2003; 36: 267-75
  • 23 Komabayashi T, D'souza RN, Dechow PC, Safavi KE, Spångberg LS. Particle size and shape of calcium hydroxide. J Endod 2009; 35: 284-7
  • 24 Eftekhar B, Moghimipour E, Eini E, Jafarzadeh M, Behrooz N. Evaluation of hydroxyl ion diffusion in dentin and injectable forms and a simple powder-water calcium hydroxide paste: An in vitro study. Jundishapur J Nat Pharm Prod 2014; 9: e14029
  • 25 Sáez MDM, López GL, Atlas D, de la Casa ML. Evaluation of pH and calcium ion diffusion from calcium hydroxide pastes and MTA. Acta Odontol Latinoam 2017; 30: 26-32
  • 26 Lage Marques JL, Conti R, Antoniazzi JH, Guth I. In vitro assessment of the ionic dissociation velocity of calcium hydroxide to different vehicles. Rev Odontol Univ São Paulo 1994; 8: 81-7
  • 27 Komabayashi T, Ahn C, Spears R, Zhu Q. Comparison of particle morphology between commercial- and research-grade calcium hydroxide in endodontics. J Oral Sci 2014; 56: 195-9
  • 28 Larsen MJ, Horsted-Bindslev P. A laboratory study evaluating the release of hydroxyl ions from various calcium hydroxide products in narrow canal-like tubes. Int Endod J 2000; 33: 238