Additive and reducing Effects between Calcium Hydroxide and Current Irrigation Solutions

Abstract

Introduction: Microorganisms should be considered to have the major role in starting and perpetuation of pulpo-periapical diseases. Using intracanal medicaments is necessary to gain a bacteria-free environment in the canal system. Calcium hydroxide (abbreviated as Ca(OH) 2), which is the most commonly used medicament in endodontic therapy, has been shown to be effective against primary sources of infection; however, its effectiveness against some microorganisms, such as Candida albicans and Enterococcus faecalis has not been proved. On the other hand, sodium hypochlorite (NaOCl), chlorhexidine (CHX), and iodine potassium iodide (IKI) have been shown to be the potent medicaments against these microorganisms. Because of this fact, combination of Ca(OH) 2 and some irrigants of the root canal has been suggested as potential intracanal medicaments. The aim of this literature review is to identify and address the efficacy of Ca(OH) 2 in combined with some of these irrigating solutions.

The Effect of Different Combinations of Calcium Hydroxide for Management of Post-Operative Pain in Acute Apical Periodontitis

“…11 Results of a systemic review concluded that the major effects of steroids on pain reduction occur during 24-72 hours and this coincides with our study. 4 Another study by Mohammed Saadi Alarbeed et al, 14 comparing use of Calcium Hydroxide alone and in combination with chlorhexidine concluded that the mixture was more effective in reducing pain in necrotic teeth. The use of chlorhexidine as a potential intracanal medicament has proven to be effective because of its broad antimicrobial spectrum including enterococcus faecalis, and its ability to maintain its antibacterial action for a prolonged period of almost three months.…”

“…Different vehicles can be used for its delivery into the root canals including distilled water, normal saline, chlorhexidine and different corticosteroid solutions. 3,4 Several studies have reported using Calcium Hydroxide in combination with Chlorhexidine as an intracanal dressing for post treatment pain. Chlorhexidine is an antibacterial that is effective against many gram positive and negative bacteria.…”

Therapeutic Potential of Chlorhexidine-Loaded Calcium Hydroxide-Based Intracanal Medications in Endo-Periodontal Lesions: An Ex Vivo and In Vitro Study

“…Other biological effects attributed to CH include an anti-inflammatory and a pro-mineralizing potential [ 24 , 25 ]. Chlorhexidine (CHX) has also been proposed as an intracanal medication because of its strong antimicrobial properties and its affinity for dental tissues that allows for prolonged drug release [ 26 , 27 ]. Our group recently confirmed that a mixture of CH and CHX is effective against microorganisms such as E. faecalis , which is frequently considered as non-susceptible to CH alone [ 28 ].…”