<p>Calcium Silicate-Based Cements as Root Canal Medicament</p>

Abstract

Purpose: This study aims to retard the setting reaction of CSC by mixing it with 2% chlorhexidine gel (CHX) which will be used as an intracanal medicament, and to evaluate the removal of the experimental medicaments from the root canal. Materials and Methods: White Portland cement, white ProRoot MTA and Biodentine were mixed with 2% CHX. The setting time, flowability and film thickness of the CSC/CHX mixture (experimental medicaments) were assessed and measured following the standards of ISO specification. Calcium ion release was measured using ICP-OES, while pH was tested using a pH meter. Moreover, twenty single-rooted teeth were filled with the experimental medicaments for seven days, then the medicaments were removed and the samples analyzed using SEM. Calcium hydroxide paste was used as a control. Results: The setting time of the experimental medicaments was inhibited until 84 days. The calcium ion release of the experimental medicaments was significantly higher compared to the control over the period of 14 days (P<0.001). The mean pH value was above 11.45 for all tested materials over a period of 14 days, with no significant difference between them (P<0.05). There was no significant difference in film thickness of the experimental medicaments compared to the control (P> 0.05). However, the flowability of the experimental medicaments was significantly higher than the control (P<0.05). SEM showed no significant differences in the removal of the intracanal medicaments between all the tested groups. Conclusion: The addition of 2% CHX to CSCs retarded or inhibited its setting reaction over a period of 84 days. The calcium ion release and flowability of these experimental medicaments was found to be better than calcium hydroxide. Removal of the intracanal medicaments from the root canal was successfully achieved in all groups. Therefore, these experimental medicaments have the potential to be used as an enhanced root canal medicament.

Comparison of Cytotoxicity between Mineral Trioxide Aggregate Mixed with Chlorhexidine and Common Endodontic Regeneration Medicaments on Periodontal Ligament Stem Cells: an in Vitro Study

“…Most studies in the field of endodontic regeneration have been limited to case reports or case series and the best intracanal medicament with the lowest cytotoxicity and highest antimicrobial property is yet to be determined. An in vitro study by Mahmoud et al [ 17 ] showed the possibility of using MTA as an intracanal medication by mixing it with 2% CHX to slow down its setting time. The calcium ion release and flowability of this mixture was shown to exceed that of CH.…”

“…The original goal of this study was to investigate the potential cytotoxicity of retro-MTA mixed with CHX as an intracanal medicament and our results showed that its cytotoxicity increased significantly over time. This may be due to the fact that MTA has strong alkalizing activity [ 17 ] which can have an adverse effect on cell viability [ 28 ]. According to the result of the current investigation, viability percentage in the MTA+CHX group after 7 days was less than 30%, indicating that the mixture was highly cytotoxic.…”

“…Bidar et al [ 16 ] indicated that chlorhexidine (CHX) mixed with MTA, and CEM cement confers antimicrobial effects against Enterococcus faecalis ( E. faecalis ), while MTA and CEM cement alone do not have such activity. Mahmoud et al [ 17 ] showed that the addition of 2% CHX to calcium silicate-based cements prevents its setting reaction in an 84-day period. Calcium ion release and flowability was superior to CH paste and it was successfully removed from the root canals.…”

Portland Cement: An Overview as a Root Repair Material: Applications and Various Modifications

“…The intracanal application of calcium silicate-based cement (white Portland cement, white ProRoot MTA and Biodentine) with chlorhexidine as a vehicle showed higher calcium ion release compared to calcium hydroxide during the 14 days period. The addition of 2% chlorhexidine extended the setting time up to 84 days and consequently facilitated the removal of medicament [36].…”

Comparative evaluation of the antibacterial efficacy of two experimental calcium silicate-based intracanal medicaments: An in-vitro study

“…[ 1 ] Merely shaping the canal is insufficient for thorough bacteria elimination, prompting the recommendation of a combined approach involving irrigation, instrumentation, and intracanal medication. [ 2 ] Studies have shown that a significant proportion, ranging from 40% to 60%, of cultivable bacteria remains present in the root canals, even after undergoing irrigation with sodium hypochlorite. [ 3 ]…”