Journal of Dental Medicine

Statement of Problem: The pulp may be exposed during remove of caries or by traumatic and iatrogenic injuries. The material used to DPC, must be biocompatible, scalable and prevent bacterial leakage.Furthermore, it is better to stimulate dentinogenesis. Calcium hydroxide is most usual material for DPC. But it cannot provide a suitablcbiologic seal. Mineral irioxide aggregate (MTA) is also a suitable material for DPC.
Purpose: The aim of this study was to compare the clinical success of DPC done with MTA or calcium hydroxide cement.

Materials and Methods: In this study eighteen posterior teeth without previous spontaneous pain that involved mechanicaly exposure was randomly selected and capped with MTA or calcium hydroxide. These teeth were evaluated by clinical vitality test and radiograph after 3 and 12 months, and patients were questioned about irritative or spontancus pain in this period. Statistical analysis was carried out by Usher exact
test (a-0.05).
Results: This study showed that in calcium hydroxid groud three had irreversible pulpitis and two teeth had symptom and signs of reversible pulpitis. While, In MTA group all cases were normaL and no clinical sign was evident.
Conclusion: MTA exhibited better results than calcium hydroxide cement for the capping of the pulp in human

Background and Aim: During root canal therapy, it is necessary to remove as many bacteria as possible from the root canal. The use of medicaments is recommended to reduce the microbial population prior to root filling. Calcium hydroxide pastes have been used because of their antibacterial effects and the ability of tissue dissolving. The aim of this study was to evaluate the effect of calcium hydroxide/glycerine mixture, calcium hydroxide/normal saline mixture and calcium hydroxide/distilled water mixture on root dentin microhardness in storage times of 7 and 14 days.

Materials and Methods: In this in vitro study, fifteen extracted maxillary canines and central incisors were selected. The crowns of the teeth were removed and the canals were prepared. Teeth were sectioned transversally to produce a total of 30 dentin discs from the middle third of the roots. Specimens were divided into three groups of 10 discs each. Dentin samples were subjected to calcium hydroxide/glycerine, calcium hydroxide/normal saline and calcium hydroxide/distilled water mixtures for 7 and 14 days. Dentin microhardness was measured by a Vickers indenter with a load of 200 g for 15 seconds. Data were analyzed using ANOVA, Paired t-test and LSD with p<0.05 as the level of significance.

Results: Statistical analysis showed that all three mixtures decreased dentin microhardness. After 7 days, reduction in dentin microhardness by calcium hydroxide/glycerine combination was significantly higher than calcium hydroxide/normal saline and calcium hydroxide/distilled water combinations. After 14 days, reduction in dentin microhardness by calcium hydroxide/distilled water combination was significantly higher than the other two groups.

Conclusion: Based on the results of this study, the use of calcium hydroxide combinations for intracanal dressing reduces dentin microhardness. After 7 days calcium hydroxide/glycerine combination and after 14 days calcium hydroxide/distilled water combination are the most effective combinations.

Background and Aim: Researches have shown that bacteria play the main role in development of pulpal and periapical diseases. Chemo-mechanical cleaning of infected root-canal system can not remove all of the microorganisms. Thus interappointment medicaments are necessary to aid this goal. Calcium hydroxide is one of the most useful medicaments in root canal therapy, but this medicament can not eliminated all of the bacteria in root canal system. Carvacrol is an edible plant extract that has antimicrobial and anti-inflammatory effects. If this extract is effective against endodontic bacteria, it can be used as an root canal medicament.

Materials and Methods: In this experimental study, Initially, MIC and MBC of carvacrol detected with Macro broth dilution method and determined as 0.3% and 0.6%, respectively. After that, 30 single root and single canal extracted human teeth were used in this study. The number of specimens determined in a pilot study on 4 extracted teeth. After preparation to apical size # 30 with hand and rotary instruments, teeth were randomly divided into two experimental and two control groups. After culturing Enterococcus faecalis in prepared canals, we used emulsion of 0.6% carvacrol and calcium hydroxide in two A and B experimental groups for 7 days as the intracanal medicament. Microbial samples obtained before and after experiment. Then, canals with negative culture selected to obtain dentinal shaving to culture. Data obtained from microbiological samples analyzed with kruskal-wallis and Bonferroni tests.

Results: Results of this study showed that emulsion of 0.6% carvacrol has no significant difference with calcium hydroxide in elimination enterococcus faecalis after 7 days dressing (p>0.05).

Conclusion: Carvacrol can be used as an intrappointment intracanal medicament.

Background and Aims: It is important to use intracanal medicaments in teeth with necrotic pulp. Calcium hydroxide is the intracanal medicament of choice in such cases. Also, Mineral Trioxide Aggregate (MTA) is a suitable root canal filling material because of its favorable characteristics. MTA can be used in some cases where calcium hydroxide is used. The purpose of this study was to evaluate the Ca++ and OH ˉ diffusion through root dentin using calcium hydroxide paste and two different brands of MTA as root canal filling materials.
Materials and Methods: In this in vitro study, the root canals of 52 single-rooted teeth were instrumented and shaped. External defects were created on the middle one-third of the root surface. 17% EDTA and 5% NaOCl were used to remove the smear layer. All surfaces except the external defects were sealed and the teeth were placed in normal saline. Ten teeth were selected as the control group. Forty-two remaining teeth were divided into three groups of 14 teeth each (A,B, and C groups). ProRoot MTA was placed in group A. Angelus MTA was placed in group B and Calcium hydroxide paste was placed in group C. After sealing the coronal access, all specimens were placed in normal saline solution. Ca++ concentration and pH were determined after 24 hours, 48 hours and one week in all groups. The data were analyzed with Repeated Measure ANOVA and Pair T- tests.
Results: Ca++ release and pH in group C was significantly higher than those in groups A and B in all time periods (P<0.001). The difference between groups A and B was not significant (P>0.05).
Conclusion: The results of this study indicate that in necrotic cases with lesion which MTA is indicated (open apex and perforation), calcium hydroxide might be better used as an intracanal dressing before using MTA as a permanent filling material.

Background and Aims: Nowadays, calcium hydroxide is used as a dressing for canal sterilization and repair progression of apical lesions. The aim of this study was to investigate the effect of calcium hydroxide as an intracanal medicament on the apical microleakage of root filling.
Materials and Methods: In this experimental study, 46 extracted single-rooted human teeth were instrumented with step-back technique to master apical file (MAF) size 35. Specimens were randomly divided into 2 groups (n = 20). In group 1, the specimens were treated with calcium hydroxide intracanal medication and in group 2, the samples did not receive any medication. The teeth were incubated in 100% humidity at 37°C for one week. After that, calcium hydroxide was removed using irrigation with normal saline and reaming with MAF. The root canals were obturated with gutta- percha and AH26 sealer using lateral compaction technique. Specimens were incubated in 100% humility at 37°C for 72 hours and then immersed in India ink for 1 week. Finally, the teeth were cleared and the maximum linear dye penetration was measured under a stereomicroscope at 4X magnification. The data were analyzed by T-test and Chi-square.
Results: There was no significant difference between the two experimental groups (P=0.068).
Conclusion: The findings of this study indicated that using calcium hydroxide as an intracanal medicament did not influence the apical microleakage after final obturation of the root canal system.

Background and Aims: Calcium hydroxide has a pronounced antimicrobial activity against most of the bacterial species found in infected root canals and endodontic infections. It is one of the most frequently used intracanal medications in endodontic therapy. The objective of this study was to determine the antimicrobial efficacy of six calcium hydroxide formulations (mixed with saline, lidocaine 2%, chlorhexidine 2%, chlorhexidine 0.2%, Iodine Potassium iodide (IKI) 2%, and glycerin) on Enterococcus faecalis using agar diffusion test.
Materials and Methods: Twelve culture plates were incubated with Enterococcus faecalis. Five cavities were made in each plate with 5 mm diameter and 4 mm depth. Two plates were randomly considered for each calcium hydroxide formulation and filled completely with creamy mixture of tested materials. The plates were incubated at 37ºC for 48 hours. The diameter of inhibition zone around each well was recorded in millimetres and data were submitted to ANOVA and Tukey tests.
Results: The results of this study showed that all tested calcium hydroxide pastes had good antimicrobial activity. The antimicrobial activity of calcium hydroxide mixed with lidocaine, chlorhexidine 2% and IKI 2% were significantly greater than that of calcium hydroxide mixed with saline (P<0.001). No significant differences in the antimicrobial  were found between the other groups (P>0.01).
Conclusion: Considering the results of this study, lidocaine 2%, chlorhexidine 2% and IKI 2% are suggested to be used for preparation of calcium hydroxide paste. Further studies with different methods are needed for confirming these results.

  Background and Aims: The purpose of this study was to evaluate the tissue responses to octacalcium phosphate (OCP) and calcium hydroxide (CH) used as direct pulp capping (DPC) materials in cat teeth.

  Materials and Methods: 72 premolar teeth of 9 cats were selected and divided into 3 groups (Two experimental and one control group). After the cats had been anesthetized, the pulp were exposed and capped directly with OCP, CH or no capping material as control group. The cavities of all three groups were filled with Glass ionomer cement (GI). Histological evaluations were performed at two, four and eight weeks after pulp capping. After tissue preparation procedures, paraffin blocks were prepared. After preparation and staining of the sections, the relevant variables were measured by optical microscope. The results were analyzed using Mann-Whitney U and Chi-square tests ( α =0.05).

  Results: Two weeks after pulp capping, all specimens in three groups showed mild to sever inflammation. The formation of hard tissue (dentinal bridge) at in the exposed areas of the experimental groups was more noticeable for calcium hydroxide than that of octacalcium phosphate group. These differences were statistically significant (P<0.001). At four weeks, hard tissues were observed in both groups which were more evident for the CH group and there were statistically significant difference between two experimental groups (p<0.003). At eight weeks, continuous hard tissues were observed in both groups and there were no statistically significant difference between them (P>0.05), but hard tissues continuity were better for in the OCP than that of the CH.

  Conclusion: It seems that the formation of hard tissue in CH because of its porosities had a worse percentage in sealing of the pulp than the OCP .