An In-vitro Evaluation of the pH Change Through Root Dentin Using Different Calcium Hydroxide Preparations as an Intracanal Medicament

Comparative evaluation of antimicrobial efficacy of different combinations of calcium hydroxide against Enterococcus faecalis

BACKGROUND

The study aims to compare the synergistic antibacterial efficacy of different combinations of calcium hydroxide as an intracanal medicament against E. faecalis.

MATERIAL AND METHODS

The current study included four hundred extracted human permanent mandibular premolar teeth. After complete chemo-mechanical preparation, the middle third of the root was sectioned using a rotary diamond disc and a total of 400 samples were obtained. The specimens were inoculated with E. faecalis for 21 days. After that, specimens were divided into five groups (n = 80) based on materials used for the disinfection of samples: Group I, calcium hydroxide alone; Group II, calcium hydroxide + 2% chlorhexidine gel; Group III, calcium hydroxide + 2% chitosan gel; Group IV, calcium hydroxide + 0.02% silver nanoparticle gel; Group V, calcium hydroxide + Bioactive glass S53P4. Dentin shavings from the apical third were obtained from the inner third of dentin were obtained using gates glidden no.1 to the apical depth, followed by no.2, 3, 4 and 5 analyzed for E. faecalis using the culture method. One-way analysis of variance (ANOVA) was used for data analysis, followed by post-hoc Tukey's test for multiple comparisons of means to check the difference in bacterial inhibition between the groups.

RESULTS

ANOVA results revealed a significant reduction of bacterial counts in all the groups compared (p < 0.001). Intergroup comparison showed maximum bacterial reduction (p < 0.001) with calcium hydroxide + bioactive glass S53P4 compared with other groups.

CONCLUSION

Synergistic effect of calcium hydroxide showed better bacterial reduction compared to calcium hydroxide alone. Among the combinations evaluated, calcium hydroxide with bioactive glass, found to be most effective compared to other groups.

New and Efficient Bioactive Glass Compositions for Controlling Endodontic Pathogens

Endodontic treatment aims to conserve teeth through removing infected tissue, disinfecting, and filling/sealing the root canal. One of the most important treatment steps is the removal of microorganisms to avoid reinfection and consequent tooth loss. Due to increased resistance to intracanal medications, new alternative procedures are needed. Thus, an intracanal medication is suggested using three bioactive glass (BG) compositions (BG1, BG2, and BG3) produced by the sol–gel method, with different molar contents of bactericidal oxides. The BGs were morphologically and physically characterized. Their ability to inhibit the growth of two oral pathogens responsible for the failure of endodontic treatments (E. faecalis and C. albicans) was also studied. The results suggest that BG2 and BG3 can inhibit the growth of E. faecalis after 48 h of incubation, and all BG samples have a significant effect on C. albicans survival.

Effect of nanoparticle based intra-canal medicaments on root dentin micro-hardness

Complete eradication of bacterial infection from the root canal with minimum or no effect on the microhardness of the dentin is desirable for the success of endodontic treatment. The effect of nanoparticle based intracanal medicaments on the root dentine microhardness was assessed. The medicaments used were combination of calcium hydroxide - silver nanoparticles, Combination of graphene oxide - silver nanoparticles, Calcium hydroxide and a control group. Vickers hardness value were evaluated and compared at coronal, middle and apical third level. Graphene oxide - silver nanoparticles based intracanal medicament showed least effect on the microhardness of the root dentin compared to calcium hydroxide and calcium hydroxide combined with silver nanoparticle based intracanal medicaments.

Calcium Silicate-Based Cements as Root Canal Medicament

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.

Retention of BioAggregate and MTA as coronal plugs after intracanal medication for regenerative endodontic procedures: an ex vivo study

Objectives

This study compared the retention of BioAggregate (BA; Innovative BioCeramix) and mineral trioxide aggregate (MTA; Angelus) as coronal plugs after applying different intracanal medications (ICMs) used in regenerative endodontics.

Materials and Methods

One-hundred human maxillary central incisors were used. The canals were enlarged to a diameter of 1.7 mm. Specimens were divided into 5 groups (n = 20) according to the ICM used: calcium hydroxide (CH), 2% chlorhexidine (CHX), triple-antibiotic paste (TAP), double-antibiotic paste (DAP), and no ICM (control; CON). After 3 weeks of application, ICMs were removed and BA or MTA were placed as the plug material (n = 10). The push-out bond strength and the mode of failure were assessed. The data were analyzed using 2-way analysis of variance, the Tukey's test, and the χ² test; p values < 0.05 indicated statistical significance.

Results

The type of ICM and the type of plug material significantly affected bond strength (p < 0.01). Regardless of the type of ICM, BA showed a lower bond strength than MTA (p < 0.05). For MTA, CH showed a higher bond strength than CON, TAP and DAP; CHX showed a higher bond strength than DAP (p < 0.01). For BA, CH showed a higher bond strength than DAP (p < 0.05). The mode of failure was predominantly cohesive for BA (p < 0.05).

Conclusions

MTA may show better retention than BA. The mode of bond failure with BA can be predominantly cohesive. BA retention may be less affected by ICM type than MTA retention.

Propolis: A Smart Supplement for an Intracanal Medicament

Introduction

One of the most important factors for successful endodontic therapy is root canal cleaning. The difficulty involved in eliminating microorganisms, as well as their residual presence, warrants the use of root canal dressings after bio-mechanical preparation.

Aim

The aim of the study was to compare the diffusion ability between nonalcoholic calcium hydroxide-propolis paste, calcium hydroxide-saline paste, and calcium hydroxide-propylene glycol paste.

Materials and methods

For this proposed study, single-rooted extracted permanent teeth were randomly divided into three groups to fill the canals: group I: Calcium hydroxide-propylene glycol paste, group II: Calcium hydroxide-saline paste, and group III: Calcium hydroxide-propolis paste. After complete filing of the root canal, the pH values of the solutions in the flasks are measured at an interval of 3, 24, 72, 168 hours.

Results

After 168-hour interval, it was noticed that the mean pH obtained by calcium hydroxide-propolis paste was 10.54 (± 0.38), which was greater than calcium hydroxide-propylene glycol paste 9.70 (± 0.45) and calcium hydroxide-saline paste 9.16 (± 0.30) consecutively.

Conclusion

The nonalcoholic calcium hydroxide-propolis paste used during the study was able to diffuse through the dentinal tubules. Thus, it can be used as a vehicle for calcium hydroxide.

How to cite this article: Baranwal R, Duggi V, Avinash A, Dubey A, Pagaria S, Munot H. Propolis: A Smart Supplement for an Intracanal Medicament. Int J Clin Pediatr Dent 2017; 10(4):324-329.