Periapical lesions accidentally filled with calcium hydroxide

Moor, R. J. G. De; Witte, A. M. J. C. De

doi:10.1046/j.1365-2591.2002.00597.x

Cited by 43 publications

(36 citation statements)

References 16 publications

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“…It could be noticed that the CHG was always one experimental period behind the IG and this group was one experimental period behind the control wound, which means that repair in the IG was faster than in the CHG. The results found for the quantitative analysis could relate the histological and clinical findings (10,12,13,15,18). The presence of inflammatory cells (macrophages, lymphocytes and neutrophils) was higher in the control wound after three days and similar after five days.…”

Section: • 3 Daysmentioning

confidence: 72%

“…On the other hand, iodoform shows a slow and continuous release of iodine, and an interaction with bacteria, which leads to the stimulation of the inflammatory reaction because of its antigenicity, i.e., iodoform acts as a foreign body and develops an immunological reaction (11,12). So iodoform showed higher efficiency with an inevitable, but shorter delay in the repair, according to clinical findings (10,18). Clinically, the type of lesion and consequently its physical characteristics should be considered to confirm these results.…”

Section: Discussionmentioning

confidence: 99%

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Tissue inflammatory response to implantation of calcium hydroxide and iodoform in the back of rats

Pallotta¹,

Machado²,

Reis³

et al. 2010

Rev. odonto ciênc. (Online)

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Purpose: This study evaluated the inflammatory reaction caused by the implantation of iodoform and calcium hydroxide in the back of rats. These drugs may be used as intracanal dressings to eliminate residual bacteria of the root canal system. Methods: Twenty albinic rats (Rattus norvegicus, var Wistar) were divided into four groups: control group 1 (CG1) had normal skin; control group 2 (CG2) had wounded tissue without drugs; in groups 3 and 4, iodoform (IG) and calcium hydroxide (CHG) were inserted into the wounds, respectively. After 3, 5 and 11 days, slices of the implanted areas were macroscopically and microscopically observed regarding to their qualitative and quantitative aspects.Results: In the macroscopical analysis, the CHG showed a large area of necrosis and swelling, which progressively decreased; in the IG the presence of iodoform surrounded by normal tissue was observed. The qualitative and quantitative histological analysis showed that IG promoted a shorter delay in the inflammatory response than the CHG.Conclusion: The inflammatory reaction for iodoform had a peak period five days after the drug insertion. By comparison, calcium hydroxide showed a very large area of necrosis that could only be partially eliminated after eleven days.Key words: Calcium hydroxide; Endodontics; inflammation; iodoform ResumoObjetivo: O objetivo deste estudo foi avaliar a resposta inflamatória causada pela implantação do iodofórmio ou hidróxido de cálcio em dorso de ratos. Estas drogas podem ser usadas como curativo intracanal para eliminar bactérias residuais do sistema de canal radicular.Metodologia: Foram utilizados 20 ratos albinos (Rattus norvegicus, var Wistar) e divididos em 4 grupos: grupo controle 1 (CG1) representado por tecido normal íntegro; grupo controle 2 (CG2) com ferida e sem medicação; nos grupos 3 e 4, Iodofórmio (IG) e hidróxido de cálcio (CHG) foram, respectivamente, inseridos nas feridas. Após três, cinco e onze dias, cortes microscópicos das áreas implantadas foram observados macroscópica e microscopicamente quanto a seus aspectos qualitativos e quantitativos.Resultados: Na análise macroscópica, o CHG mostrou uma grande área de necrose e edema, o que diminuiu progressivamente, no GI, a presença de iodofórmio rodeada por tecido normal foi observado. A análise qualitativa e quantitativa histológica mostrou que IG promoveu um prazo mais curto na resposta inflamatória do que o CHG.Conclusão: A reação inflamatória de iodofórmio teve um período de pico de cinco dias após a inserção de drogas. Em comparação, o hidróxido de cálcio mostrou uma grande área de necrose que só poderia ser parcialmente eliminada após onze dias.

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Section: • 3 Daysmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Tissue inflammatory response to implantation of calcium hydroxide and iodoform in the back of rats

Pallotta¹,

Machado²,

Reis³

et al. 2010

Rev. odonto ciênc. (Online)

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show abstract

“…As 100 ml of water can dissolve only 0.02 g of BaSO 4 it has been proposed to use resorbable iodine compounds like diatrizoate or iothalamate instead of BaSO 4 due to the fact that these do not have a significant effect on the length of the healing period [12]. In a study conducted on the effect of accidental and voluminous Ca(OH) 2 overextrusion into periradicular lesions and tissues on the prognosis of periapical healing by De Moor and De Witte [14] reported that in cases of extensive Ca(OH) 2 overextrusion, repair took more than six months and observed that complete resorption of the paste including BaSO 4 did not occur, eventhough the periradicular radiolucency disappeared. The time taken for periradicular radiolucency to disappear was approximately 24 months in the presented case which is in line with the findings of other researchers.…”

Section: Discussionmentioning

confidence: 99%

Effect of Unintentional Periapical Extrusion of Metapex in Immature Teeth- A Case Report

Galhotra

Singla

Jindal

et al. 2015

JCDR

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A 14-year-old boy was referred to the Department of Pedodontics and Preventive dentistry with complain of pain in right mandibular posterior teeth since three weeks. Careful intraoral examination revealed a sinus tract found on the buccal gingiva of the right lower second premolar. Hard tissue examination revealed the presence of a deep pit in right mandibular second premolar. Radiographic examination revealed deep pit communicating with the pulp space, presence of blunderbuss canal and the presence of large irregular radiolucency suggestive of chronic abscess with bone resorption associated with mandibular right premolar teeth [Table/ Fig-1]. The presence of sinus tract with periapical radiolucency indicative of chronic periapical abscess confirmed the necrosis of pulp. Nonsurgical endodontic treatment with apexification was considered keeping in view the age and amount of trauma expected during surgical treatment. Pulpal necrosis confirmed the non vitality of the tooth. Hence, the need of giving local anesthesia was excluded. The informed written consent was taken from the parents. Access opening was done under rubber dam isolation. Due to exudation of pus from the canal, the access cavity was left open. In next appointment the biomechanical preparation was done using circumferential filling till size 80K file. Sodium hypochlorite 1% solution was used as root canal irrigant throughout the procedure. In the same sitting calcium hydroxide and iodoform combination (Metapexô, META Biomed Co. Ltd., Korea) was placed in the canal which was accidentally extruded into the periapical lesion [Table/ Fig-2]. The patient was then recalled after two weeks. The healing of sinus and history of no pain was evident in the recall appointment.Patient was followed for 3, 6 & 12 months. During these appointments, the follow up radiograph revealed, metapex that had aBstRaCt The paper discusses a case of an immature premolar tooth with a large periapical lesion, in which Metapex (calcium hydroxide paste containing iodoform and barium sulphate as a radiopacifier) was used. There was an un-intentional extrusion of calcium hydroxide during application. The patient was evaluated for periapical healing at 12 and 24 months. The follow up revealed that the accidental extrusion of metapex did not have any detrimental effect on periapical healing. However, delayed resorption of Metapex as well as healing of the periapical lesion may be attributed to the presence of BaSO 4 and iodoform as compared to plain Calcium hydroxide. extruded in the periradicular region has not resorbed; in addition, the periapical lesion was seen to have decreased in size [Table/ Fig-3]. At the end of 12 months apical barrier was formed. A file was used that can easily reach the apex to gently probe for a stop at the apex. At that time, the medicament was removed from the canal using H-file followed by irrigation with 1.25% sodium hypochlorite. After confirming dryness of canal, the root canal was finally obturated after 12 months with Gutta-percha by using the cold ...

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“…When calcium hydroxide paste is used as a root canal medication, the anticipated effects include long-acting antimicrobial activity, analgesia, hemostasis, exudate control, cleansing of the root canal wall, and the induction of hard tissue 7,12) . However, the effects on soft tissue have not been clarified 5) . Calcipex ® is strongly alkaline, with a pH of 12.4, and chemical burns of the mucosa have been reported 3,4,14,15) .…”

Section: Discussionmentioning

confidence: 99%

Two Patients Requiring Surgical Management for Leakage of Calcium Hydroxide Paste from Root Canal into Infraorbital Space

Ikawa

Takeyasu

Ukichi

et al. 2012

Bull. Tokyo Dent. Coll.

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Two patients requiring surgical management for leakage of calcium hydroxide paste from a root canal into the infraorbital space are reported. A paste root canal treatment material used at the time of maxillary root canal treatment had leaked out of the root canal in both patients. Computed tomography confirmed displacement of the root canal treatment material into the soft tissue, with extension into the infraorbital space. In both cases, foreign body removal was performed. Root canal treatment using a calcium hydroxide paste should be performed carefully without strong pressure.

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Periapical lesions accidentally filled with calcium hydroxide

Abstract: Extensive extrusion of calcium hydroxide into the periapical tissues does not appear to comprise periapical healing. Despite this finding, the deliberate extrusion of dental materials into the apical tissues is not advocated.

Cited by 43 publications

References 16 publications

Tissue inflammatory response to implantation of calcium hydroxide and iodoform in the back of rats

Tissue inflammatory response to implantation of calcium hydroxide and iodoform in the back of rats

Effect of Unintentional Periapical Extrusion of Metapex in Immature Teeth- A Case Report

Two Patients Requiring Surgical Management for Leakage of Calcium Hydroxide Paste from Root Canal into Infraorbital Space

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