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Statement of the Problem: Endodontic efforts are focused on eliminating intracanal pathogens. Applying intracanal medicament for infected teeth is beneficial for achieving better antibacterial effects in endodontic treatments. Different intracanal medicaments should be assessed and compared for this purpose.Purpose: to assess the antibacterial efficacy of Citrullus colocynthis seed extract comparing to Ca(OH)2 on teeth contaminated with Enterococcus faecalis.Materials and Method: In this in vitro study, a novel strain of Enterococcus faecalis (Enterococcus spp. ATCC 19433) yielded from the root canal treated tooth with persistent apical periodontitis. The canals of 78 human single-rooted extracted teeth were contaminated with mentioned strain and treated with Citrullus colocynthis essential oil and Ca(OH)2 for 1, 7, and 14 days. To determine the chemical composition of the oils, gas chromatography-mass spectrometry (GC–MS) was applied. The percentage reduction from baseline c.f.u./mL values was estimated.Results: Oleic acid, benzoic acid, and gallic acid were the major contents of Citrullus colocynthis essential oil. The c.f.u./mL count decreased considerably as contact duration rose for both medicaments. After 7 days, a statistically significant difference was identified between the medicaments. Citrullus colocynthis showed higher antimicrobial efficacy. However, after 14 days, no substantial difference was found.Conclusion: Citrullus colocynthis essential oil, displayed great antimicrobial efficacy against Enterococcus faecalis higher than Ca(OH)2 over the first week contact period.

Objectives: To evaluate the clinical and radiographic success rate of blood clot and platelet rich fibrin (PRF) as a scaffold system in regenerative endodontic procedure in immature traumatized necrotic teeth.. Materials and methods: This retrospective study examined the records of 28 subjects with necrotic immature open apex due to trauma treated with blood clot or PRF as a scaffold in regenerative endodontic procedure. The disinfection was carried out with calcium hydroxide as an intra-canal medicament. The clinical outcome was recorded using a binary variable of presence or absence of pain and intra-oral swelling. The radiographic outcome was recorded for periapical healing using Ørstavik’s Periapical Index and apical response using Chen and Chen index. Comparison of frequencies of categories of variables with groups was done using the chi-square test. The pairwise comparison of time intervals was done using Wilcoxon Signed Ranks Test. Results: Intra-group comparison of pain and intra-oral swelling had highly significant (p = 0.000) results for both groups over a period of 12 months. Inter-group comparison for clinical outcomes was insignificant. For the radiographic outcome, there was a statistically non-significant difference for periapical healing and apical response for both intra-group and inter-group comparisons. Conclusion: Both PRF and blood clot have a favourable outcome for a regenerative endodontic procedure with a disinfectant protocol using calcium hydroxide as intracanal medicament. Considering the cumbersome procedure involved in procuring PRF scaffold, especially in children, inducing bleeding can be considered a recommended method for a regenerative endodontic procedure.

Objective: To evaluate the effectiveness of ethanol compared to citric acid in the removal of oil-based calcium hydroxide from the apical third of the root canal system using passive ultrasonic irrigation. Method: The in vitro study was conducted from September to October 2021 at the dental clinics of the Aga Khan University Hospital, Karachi, and comprised single-rooted teeth that were selected from institutional bank of extracted teeth. They were randomly divided into group A having 70% ethanol + passive ultrasonic irrigation, group B 10% citric acid + passive ultrasonic irrigation, group C positive controls and group D negative controls. The specimens were sectioned at 1mm and 3mm from the apex and examined under a dental operating microscope. A single examiner scored the specimens on two different occasions. Data was analysed using SPSS 25. Results: Of the 90 teeth, there were 40(44.4%) in each of the 2 experimental groups and 5(5.5%) in each of the 2 control groups. At 3mm apical sections, ethanol was significantly more effective in the removal of oil-based calcium hydroxide (p=0.01). However, at 1mm from the apex, there was no significant difference between the experimental groups (p=0.064). Intragroup comparison showed that for groups A and B, residual medicament at 1mm sections was significantly greater than at 3mm sections (p

The aim of this study is to assess and analyze the intratubular penetration of the intracanal medications nitrofurantoin (Nit), triple antibiotic paste (TAP), and calcium hydroxide (CH). Sixty freshly extracted single-rooted teeth were acquired and decoronated to a standard length of 15 mm. To prepare specimens up to size F3, rotary ProTaper instrumentation was employed. The prepared teeth were divided into three groups, each of which received one of the tested intracanal medicaments: Group I (calcium hydroxide), Group II (triple antibiotic paste), and Group III (nitrofurantoin). Using a size #30 Lentulo spiral, a freshly prepared therapeutic paste was placed into the canals, and the intracanal medicaments were allowed to set in the incubator at 100% humidity. The samples were subsequently sliced perpendicularly to their long axis using a precision saw and assessed under a scanning electron microscope to assess the depth of penetration of intracanal medicaments at the coronal, middle, and apical portions of the root canal dentin. The data were analyzed using one-way ANOVA and Tukey’s post hoc test. The statistical analysis revealed a significant difference between the experimental groups in the quantity and depth of sealer penetration (p < 0.05). In particular, as compared to the Nit group, both the CH and TAP groups had significantly smaller penetration areas (p < 0.05). In conclusion, this ongoing investigation indicates that nitrofurantoin penetrated dentinal tubules better than calcium hydroxide or triple antibiotic paste.

Previous research states that adding propolis to powdered dental materials can increase the mechanical strength of the material. To analyze the differences and correlation of dentin elastic moduli and pH value after the exposure of calcium hydroxide, a mixture of propolis and calcium hydroxide, also a mixture of propylene glycol (PG), calcium hydroxide, and propolis. The dentine of bovine incisors was exposed into various compositions of a mixture of propolis, PG, and calcium hydroxide. The measurement of pH value and dentin elasstic moduli was performed after 7 days. To find difference among groups, one-way ANOVA was used, and Honestly significant difference (HSD) Tukey to compare each groups, followed by Pearson to define the correlation. A statistically meaningful difference was recorded between the groups (P < 0.05), and there was correlation between dentin elastic moduli and pH value. The more alkaline the environment, the more rigid the dentin.

Objective: To find the effect of different combinations of Calcium Hydroxide for the management of post-operative pain in acute apical periodontitis. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Operative Dentistry Armed Forces Institute of Dentistry, Rawalpindi. from Jun to Nov 2019. Methodology: A total of 282 patients presenting with acute apical periodontitis in their mandibular posterior teeth were selected for this study and were randomly divided into three equal groups with the help of scientific random number table. Group-A patients were given intracanal dressing of Calcium Hydroxide mixed with Chlorhexidine, group-B patients were given intracanal dressing of Calcium Hydroxide mixed with Saline and group-C patients were given intracanal dressing of Calcium Hydroxide mixed with Dexamethasone. Endodontic therapy was initiated after application of rubber dam, following pulpectomy and disinfection with frequent irrigation, canals were prepared and intra-canal dressings were placed according to the allotted group and the cavity was restored till the next appointment. Post-operative pain was recorded at 24 hours, 48 hours and one week using the visual analogue scale. Results: The three intra-canal combinations of Calcium Hydroxide used in the study were found to be equally effective in reducing pain. Overall, the result between the three groups after 24 hours proved to be insignificant (p=0.40), after 48 hours (p=0.84) and 1 week (p=0.45) were also insignificant. Conclusion: Calcium Hydroxide mixed with Saline, Chlorhexidine and Dexamethasone are all effective for pain reduction with dexamethasone being the most effective.

Statement of the Problem: A rise in pH and the presence of calcium ions play an important role in prevention or management of external root resorption. Purpose: This study assessed the long-term pH alterations in the periradicular area following the application of calcium hydroxide (CH) and mineral trioxide aggregate (MTA) intracanal medicaments. Materials and Method: This in vitro, experimental study evaluated 45 single-canal extracted human teeth. After decoronation and root canal instrumentation, defects (3×3×1mm) were created in the middle third of the roots. Following smear layer removal, the root surface (except for the defect) was sealed with nail varnish. Five teeth served as negative controls and were filled with distilled water. The remaining 40 teeth were randomly divided into two groups (n=20) for application of MTA and CH as intr-acanal medicaments. Periapical radiographs were obtained to ensure optimal quality of obturation. After coronal sealing with glass ionomer, the teeth were incubated at 37°C, and their pH was measured at 1 and 2 weeks, and 1 and 3 months, using a pH-meter. Data were analyzed using one-way ANOVA, Tukey’s test and Bonferroni adjustment. Results: The mean pH was significantly higher in CH group at 1 and 2 weeks (p< 0.01) but no difference was noted at 1 and 3 months (p= 0.52). The mean pH in both groups was significantly higher at 2 weeks compared with other time points (p< 0.05). Conclusion: CH may be preferred for use in the first weeks following the initiation of root resorption to provide a high pH. MTA can be later applied to maintain the high pH for a longer period of time without the need for medicament exchange.

Background. The choice of sealant is an important dentist’s decision with a long-term influence on treatment. Knowledge of the properties and characters of each material is key to the optimal endosealer selection on individual basis.Objectives. A comparison of endodontic sealants based on epoxy resins, calcium hydroxide, zinc oxide eugenol and bioceramics.Methods. Publications were mined in the PubMed and Google Scholar electronic databases to cover the four sealer groups (epoxy, calcium hydroxide, zinc oxide eugenol and bioceramics) over years 2014-2021, including selected relevant sources within 2002-2013; 73 articles were considered for review, regardless of the study design or language. Content and descriptive analyses were used as research tools. Meta-analysis was not used due to a high evidence heterogeneity.Results. The dental market currently offers a variety of sealant groups. Endodontic sealants based on epoxy resins, zinc oxide eugenol, calcium hydroxide and bioceramics are the most common. The review identifies no ideal material for the root canal filling.Conclusion. Manifold studies demonstrate the pros and cons in each endodontic sealant group with respect to variant criteria. Depending on clinical situation, the practitioner can opt for the material property to identify the endosealer.

Previous research states that adding propolis to powdered dental materials can increase the mechanical strength of the material. To analyze the differences and correlation of dentin elastic moduli and pH value after the exposure of calcium hydroxide, a mixture of propolis and calcium hydroxide, also a mixture of propylene glycol (PG), calcium hydroxide, and propolis. The dentine of bovine incisors was exposed into various compositions of a mixture of propolis, PG, and calcium hydroxide. The measurement of pH value and dentin elasstic moduli was performed after 7 days. To find difference among groups, one-way ANOVA was used, and Honestly significant difference (HSD) Tukey to compare each groups, followed by Pearson to define the correlation. A statistically meaningful difference was recorded between the groups (P < 0.05), and there was correlation between dentin elastic moduli and pH value. The more alkaline the environment, the more rigid the dentin. [ABSTRACT FROM AUTHOR]

Amongst all the types of external resorption, External Cervical Resorption (ECR) is the least understood. ECR usually encompasses the cervical region of the tooth and is located immediately below the epithelial attachment. The diagnosis and management of ECR defects is usually difficult. However, a comprehensive knowledge pertaining to the true nature and exact location of the defect helps achieve effective management and render appropriate treatment. Advancements in digital imaging like Cone Beam Computed Tomography (CBCT) have made possible, the diagnosis of pathological lesions like ECR with greater precision. Here we report a case of 21-years old male patient, treated with the successful retreatment of maxillary central incisor along with the non invasive management of ECR associated with the tooth. The patient presented with a history of spontaneous pain in respect to maxillary left central incisor and punched out radiolucent lesion was evident on the disto-cervical aspect radiographically. It also revealed an incomplete endodontic treatment. As the patient was not willing for any surgical intervention, conservative non-surgical endodontic re-treatment was performed which involved long term calcium-hydroxide therapy. At two years follow-up, the patient remained asymptomatic demonstrating radiographic evidence of bone-like tissue filling the resorptive defect. The clinical implications of this paper aim at an appropriate diagnosis of the resorptive lesion using three dimensional (3D) imaging techniques and a conservative non surgical long term calcium-hydroxide therapy for the management of ECR. The endodontic treatment was further followed by aesthetic rehabilitation for the asymmetric smile correction using minimally invasive technique of EMax crowns.

Objective: To compare the effect of Ledermix paste and Calcium hydroxide as intracanal medicament on the mean postoperative pain after instrumentation of the root canals. Study Design: Comparative prospective study. Place and Duration of Study: Department of Operative Dentistry, Armed Forces Institute of Dentistry, Rawalpindi, from Sep 2017 to Mar 2018. Methodology: A total of 256 patients (128 patients in each group) were included in the study. Cases were divided into two groups i.e., group-A and group-B randomly based on lottery method dressed with Ledermix paste and Calcium hydroxide respectively. Access cavity was sealed with cavit, each patient was given an evaluation sheet and visual analogue pain scale was explained. Results: Mean age of the patients was 27.45 ± 7.52 and 26.77 ± 7.32 years in group-A and B, respectively. In group-A 80 patients (62.5%) and in group-B 63 patients (49.2%) were males while 48 patients (37.5%) from group-A and 65 patients (50.8%) from group-B were females. Comparison of mean pain score after 72 hours shown statistically significant difference between group-A and group-B (1.90 ± 1.52 vs. 3.47 ± 2.16) with p-value

Introduction/Objective. We aimed to investigate the effects of diabetes mellitus (DM) on rat dental pulp repair by measuring time-dependent changes in expressions of vascular endothelial growth factor (VEGF) and bone morphogenetic protein 2 (BMP 2) following direct pulp capping. Methods. Two groups, each of 20 Wistar rats, received either streptozotocin (for DM induction) or the same volume of sterile saline. A week later, the pulp of maxillary and mandibular right incisors in diabetic and non-diabetic groups were exposed and capped with calcium hydroxide in order to provoke reparative response. The levels of VEGF and BMP 2 were determined in the pulp tissue lysates one and seven days after the pulp capping, using enzyme-linked immunosorbent assays. Results. Diabetic state per se increased VEGF level, with a peak at first day after the pulp capping (19.3 ± 0.9 pg/mg, p < 0.001), but did not affect BMP 2 levels. Significant increase of BMP 2 expression was noticed on the seventh day in capped pulp, but only in diabetic rats (16.7 ± 1 pg/mg, p = 0.001). Positive correlation between VEGF and BMP 2 was found on the seventh day following capping, only in diabetic pulp (r = 0.905, p = 0.003). Conclusion. Diabetes-induced increase in VEGF expression reflects changes in the inflammatory phase of pulp repair in DM. Increase in BMP 2 expression suggest that stimulating effect of calcium hydroxide appears seven days after diabetic pulp capping.

Background Control over microbial growth is a crucial factor in determining the success of endodontic therapy. Enterococcus faecalis is the most resistant biofilm-forming species leading to endodontic failure. Hence, the current researches are directed towards discovering materials with superior disinfection properties and lesser cytotoxicity. This study aimed to synthesize and characterize biogenically produced Selenium Nanoparticles, and to evaluate the antimicrobial and antibiofilm efficacy, against Enterococcus Faecalis, for the following test groups: Group I: Distilled water (control), Group II: SeNPs (1 mg/ml), Group III: Calcium hydroxide (1 mg/ml), Group IV: 2% Chlorhexidine gluconate (CHX), Group V: 5.25% Sodium hypochlorite (NaOCl). Materials and Methods Selenium nanoparticles were derived using fresh guava leaves (Psidium guajava) and were characterized. The antibacterial efficacy against E. faecalis was evaluated by agar well diffusion method. The antibiofilm efficacy of the test groups was observed by viable cell count, antibiofilm assay, and Anthrone and Bradford’s tests. The morphology of the biofilms was analysed using the Scanning Electron Microscope and Fourier Transform Infrared spectroscopy. Results Antibacterial and antibiofilm efficacy of all tested solutions showed superior antibacterial and antibiofilm efficacy when compared to the control group. Overall, SeNPs (Group II) was the most effective against E. faecalis biofilm, followed by NaOCl (Group V), CHX (Group IV), and Ca(OH)2 (Group III). Conclusion Biogenically produced SeNPs emerged as a novel antibacterial and antibiofilm agent against E. faecalis. This nano-formulation demonstrates the potential to be developed as a root canal disinfectant combating bacterial biofilm in endodontics after the results have been clinically extrapolated.

Introduction. Successful endodontic treatment is affected by a number of factors associated with the disinfection and filling of the root canal. The chemical-mechanical root canal preparation consists in a thorough removal of any content from the pulp space, including inflamed pulp, bacteria, as well as canal filling materials. Aim. The aim of the study was to analyse the efficacy of the XP-endo Finisher and the Brush-Finisher on the removal of a calcium hydroxide dressing. Material and Methods. The study was conducted using extracted single-rooted human teeth prepared according to sample standardization. Calcium hydroxide with iodoform was inserted into the canals. After two weeks, canal cleaning was performed with the use of 2% sodium hypochlorite solution and both finisher files. A conventional endodontic needle and syringe (SNI) were used in the control group. Following rinsing activation, two projection radiographs were performed and uploaded to software developed specifically for the study. The graphic files were evaluated in terms of the remaining amount of dressing. In order to analyse whether the percentage of the canal area that remained untreated was statistically significant, the Kruskal-Wallis ANOVA test with Dunn’s post-hoc test were employed. Results. The intracanal dressing was most effectively removed in the XP-endo Finisher group (in both projections 96.32% and 91.35%), and its removal was considerably better than that in the control group (p

Background: Deep carious lesions cause pulpal inflammation, if not managed, they may result in pulp necrosis and involvement of the periradicular tissues, with possible pain requiring, endodontic treatment or extraction. Material and methods: This study included 35 patients with deep dental caries, 14 males and 21 females with the age range 25-37. The patients are divided into 2 groups. First group – with deep caries treated by capping material “Trioxident” based on mineral trioxide aggregate (MTA), and second group – with deep caries treated using calcium hydroxide. Results: In our work for the treatment of deep caries, we used the preparations: “Trioxident” based on MTA and “Ultra Blend Plus” based on calcium hydroxide. Applications by material “Ultra Blend Plus” for 3-6 weeks on dentin surface show good results because sterile environment, significant alkaline reaction and calcification of the dentinal tubules. In this regard, it should be noted that the material “Trioxident” does not have porosity in the formed “dentin bridge” and is free from this disadvantage. The use of medical pads with MTA and calcium hydroxide with direct and indirect pulp capping methods did not reveal negative results (complicated caries). Conclusions: Theoretical data is important for setting correct diagnosis and most suitable protocol of treatment. The described in the article materials – “Trioxident” and “Ultra Blend Plus” provide anti-inflammatory, analgesic and plastic effect. They stimulate the formation of a new secondary dentin layer. The first material – “Trioxident” (based on MTA), in our opinion, is more preferable because it has a number of useful advantages.

Background and aim: Residues may remain in canal extensions and irregularities after removing the medication from root canals with a file. These residues can only be removed with irrigation. The present systematic review and meta-analysis investigate the effect of various irrigation methods on the elimination of calcium hydroxide from root canals. Material and methods: A preliminary analysis included 225 articles. Two reviewers investigated all the available abstracts and titles and determined whether they were associated with the cleaning effectiveness of a variety of irrigation systems in removing calcium hydroxide. The conducted search involved the years between 2013-18. Results: The studies investigated lacked any standardization concerning the irrigation method used or the measurement of outcomes; for instance, the volume or the concentration of the irrigation solution. Conclusion: Although none of the methods examined could completely eliminate the calcium hydroxide dressing, activation methods resulted in better calcium hydroxide dressing removal compared to using master apical file or syringe irrigation only.

Background: Stem cells play an important role in the success of regenerative endodontic procedures. They are affected by the presence of medicaments that are used before the induction of bleeding or the creation of a scaffold for endodontic regeneration. This study examines the effects of different intracanal medicaments on the viability and survival of dental pulp stem cells at different doses and over different exposure times. Methods: Dental pulp stem cells were cultured from healthy third molar teeth using the long-term explant culture method and characterized using flow cytometry and exposed to different concentrations of calcium hydroxide, doxycycline, potassium iodide, triamcinolone, and glutaraldehyde, each ranging from 0 (control) to 1000 µg/mL. Exposure times were 6, 24, and 48 h. Cell viability was measured using the MTT assay, and apoptosis was measured using the Annexin V-binding assay. Results: All medicaments significantly reduced cell viability at different concentrations over different exposure times. Calcium hydroxide and triamcinolone favored cell viability at higher concentrations during all exposure times compared to other medicaments. The apoptosis assay showed a significant increase in cell death on exposure to doxycycline, potassium iodide, and glutaraldehyde. Conclusion: The intracanal medicaments examined in our study affected the viability of dental pulp stem cells in a time and dose-dependent manner. They also adversely affected the survival of dental pulp stem cells. Further studies are needed to better understand the effect of prolonged exposure to medicaments according to clinical protocols and their effect on the stemness of dental pulp stem cells.

Introduction/Objective. The purpose of this study was to assess effectiveness of endodontic root canal procedures in traumatized permanent teeth with necrotic pulps and chronic periapical lesions after definitive obturation with mineral trioxide aggregate (MTA) products. Adobe Photoshop CS (San Jose, CA, USA) image-analysis software was used for healing assessment. Methods. Twenty-seven traumatized single-rooted permanent teeth diagnosed with necrotic pulps and chronic periapical lesions were treated with non-surgical procedure using a tri-antibiotic paste and calcium hydroxide as intra-canal medication. Definitive obturation was performed with ProRoot MTA (Dentsply Tulsa Dental Specialties, Tulsa, OK, USA) or MTA+ Cerkamed (Cerkamed, Stalowa Wola, Poland). Control follow-ups were done three, six, 12, and 24 months following the completion of treatment. Results. The positive clinical outcome was recorded in 24 (88.9%) cases, while radiographic success was present in 26 (96.3%) cases. A statistically significant decrease in the sizes of periapical lesions was consistently observed at follow-up periods (p < 0.001). There was no statistically significant difference between the two tested MTA materials (p > 0.05). Conclusion. The MTA products were effective for the root canal obturation and appeared to contribute to the significant reduction or complete regression of periapical lesions in teeth treated. The presented procedure may be proposed for everyday clinical practice. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 172026]

Endodontic treatment of immature non-vital teeth poses a considerable challenge. Its goals should include the control of intracanal infection and the promotion of continuous root development. This case report describes an apexification as an alternative strategy for the maintenance of a tooth with incomplete root formation. An 11-year-old female presented with a history of pain and discomfort on the left side of the mandibular region. Intraoral examination revealed the presence of a draining sinus tract located in the buccal mucosa, next to tooth 35, for which a cold test was negative. Periapical radiographs revealed a single-rooted tooth with incomplete root formation and a periapical lesion. A diagnosis of periapical abscess with fistula was made, and a root canal treatment in conjunction with apexification was planned. Cone Beam Computed Tomography (CBCT) imaging was performed which revealed resorption on the buccal side of the root and the destruction of the buccal cortical bone. After six appointments, the intraoral sinus tract had healed, no purulent discharge was observed, and the root apex was closed. The root canal was filled, and the tooth was restored. The three years follow-up examination showed adequate bone repair and the absence of periapical lesion. Apexification shows favourable results for the management of immature non-vital teeth.

Statement of the Problem: A great challenge in periodontal therapy is the regeneration enhancement of osseous defects through applying osteoinductive materials. Demineralized freeze-dried bone allograft (DFDBA) has already been introduced as an allograft with osteoconductive and variable osteoinductive properties. Calcium hydroxide [Ca(OH)2] is an available well-known material in dentistry, which induces hard tissue formation. Purpose: This study evaluated the efficiency of combination of DFDBA and Ca(OH)2 in improving the quality of osteoinduction of DFDBA. Materials and Method: Human bone marrow-derived mesenchymal stem cells were taken from volunteers’ iliac crest. Cell proliferation was determined by MTT test at 18, 24 and 48 hours post-culture in 10 groups. The employed material were 0.5, 1.0 mg/ml Ca(OH)2 in two forms of suspension and pH-adjusted solution, 10mg/ml DFDBA per se and in combination with 0.5 and 1.0 mg/ml Ca(OH)2. Mineralization was assessed by Alizarin red staining in 10 mg/ml DFDBA, DFDBA+ 0.5 and 1 mg/ml Ca(OH)2 in solution and suspension forms. The data were statistically analyzed by using one-way ANOVA and Tukey’s post-hoc test (p< 0.05). Results: The pH-adjusted solutions exhibited better cell proliferation compared with the suspension groups. The combination of 0.5mg/ml Ca(OH)2 solution and DFDBA increased the cell proliferation and mineralization compared with DFDBA per se (p= 0.033). Conclusion: The combination of Ca(OH)2 with DFDBA improved the osteoinductivity of DFDBA.

Introduction/Objective. This study determined the 12 months clinical and radiographic periapical healing of teeth with apical periodontitis treating with different formulations of calcium hydroxide (CH): paste (CHpaste) and gutta-percha points (CH-GP), and chlorhexidine (CHX): gel (CHX-gel) and gutta-percha points (CHX-GP). Methods. Eighty patients with chronic apical periodontitis were randomly allocated to 4 different treatment groups according to the intracanal medicament used: CH-paste, CH-GP, CHX-gel and CHX-GP group. Seventy eight patients were analyzed clinically and radiographically 12-month postoperatively. The Periapical index (PAI) was used for radiographic evaluation of treatment success. Results. Overall outcome was classified according to radiographic evaluation only, because in all patients clinical success was observed. In all groups significant reduction in PAI scores were observed (p < 0.001). The proportions of healed teeth (PAI ≤ 2) were 73.7%, 60.0%, 68.4% and 65.0% in CH-paste, CH-GP, CHXgel and CHX-GP group, respectively, with no significant differences between the groups. Conclusion. The results suggested that there are no differences between investigated CH- and CHXdelivery systems regarding treatment outcome of teeth with apical periodontitis.

Introduction: The aim of this in vitro study was to evaluate the effect of calcium hydroxide mixed with different vehicles on the push-out bond strength of mineral trioxide aggregate. Materials and Methods: The study was conducted on 80 extracted single-rooted human maxillary incisor teeth who secrowns had been removed. The root canals were instrumented and divided into 4 groups according to the vehicle of the calcium hydroxide paste: Group I – distilled water; Group II – propylene glycol; Group III – 0.2% chlorhexidine; Group IV – control. After placement ofthe root canal dressings, the teeth were washed with EDTA and sodium hypochlorite and sealed with MTA. After 7 days, the push-out test was carried out using a universal testing machine. Data were analyzed with one-way ANOVA and gomes-howell tests. Results: The maximum and minimum bond strength values were recorded in the propylene glycol and distilled water groups, respectively. There was significant differences in push out bond strength between chlorhexidine and propylene glycol groups (P=0.015). There were significant differences in resistance to dislodgement between group control - propylene glycol (P=0.032) and group control-chlorhexidine (P=0.012). Conclusion: Placement of propylene glycol before placement of MTA in root canal improves the push-out bond strength of this material.

Objective To investigate the feasibility of using UV curable calcium hydroxide as temporary crown binder. Methods 242 patients with temporary crown were selected and randomly divided into three groups according the order of registration week each month, and respectively underwent temporary crown cement with TempoCemNE (n = 78), Provicol (n = 80) and Calcimol LC (n = 84) for each tooth. The retention effect and the status of the gum and the pulp were observed at one week after operation. Results There was no significant difference between the three groups in the retention effect and the status of the gum and the pulp (c1 2 = 5.553, P1 = 0.062 > 0.05; c2 2 = 4.783, P2 = 0.091 > 0.05; c3 2 = 3.290, P3 = 0.193 > 0.05). Conclusion There was a good effect of temporary crown cement in three groups of TempoCemNE, Provicol and Calcimol LC. Calcimol LC can be used as a new type of temporary crown cement with good bonding performance and the protection to gums and pulp, and simple operation.

Calcium hydroxide is widely used as disinfectant of root canals recently. The vehicle is a substance which is added into calcium hydroxide to form a paste. It can be classified into water soluble, viscous and oily. Different vehicles for calcium hydroxide may produce different disinfectant effects. Searching for an ideal vehicle for calcium hy⁃ droxide is a hot research topic in recent years. This article will make a review on progress in the study of calcium hy⁃ droxide in different vehicles.

Introduction/Objective. The success of endodontic treatment depends on the effective removal of root content, the elimination of infection, and the hermetical sealing of the root system using a compatible material. The objective of this paper was to evaluate the tissue response to the implant of endodontic material based on calcium hydroxide into the bone in the artificially prepared defect in a rat mandible. Methods. The research was carried out on 40 Wistar rats. The artificial defect was made between the midline and the mental foramen on the left side of the mandible. The prepared defect was left to heal spontaneously in animals of the control group, while among the animals of the experimental group the sealer Apexit (Ivoclar Vivadent, Schaan, Lichtenstein) was implanted into the experimental defect. The tissue samples consisting of the experimental field and the surrounding bone were microscopically analyzed with a light microscope. Results. During the initial phase, 15 days after the implantation, signs of chronic inflammation were noted and expansion of the Volkmann’s and Haversian canals. On the 30th day after the implantation, osteosynthetic activity and filling with newly-formed bone were noted. Changes were also noted in cement lines in the wider region of the experimental defect. Sixty days following the implantation, the bone was gradually remodeled. Ninety days after the implantation, a restitutio ad integrum was noted. Conclusion. Apexit does not lead to any disruptions in normal reparation processes nor in morphofunctional relations in bone tissue during the remodeling phase. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 175061: The antioxidant protection and potentials for differentiation and regeneration of mesenchymal stem cells from different tissues during the aging process]

For several decades, the "gold standard" of direct pulp capping material is Calcium Hydroxide (CaOH). Because of its low success rate (36.70% out of 30 cases), many researchers are looking for another material derived from nature to replace CaOH. Because of its ability to act as an anti-inflammatory, anti-microbial, anti-fungal and cure scars, a material called Propolis has been used for long in dentistry. Due to this reason, addition ofpropolis extract to improve the function of CaOH is expected. The aim of this study is to analyze the effectiveness of CaOH-Propolis combination against Lactobacillus Acidophilus colonization. This research consists of 4 groups treatment of CaOH and Propolis Extract combination. Group 1 was a 1:1 combination ratio, Group 2 was a 1:1.5 combination ratio, Group 3 was a 1:2 combination ratio and group 4 was positive control group consist of combination of CaOH and Sterile Aquades. Each sample was then immersed in the saliva for 1 hour, and continued to be washed using PBS. All of the samples were then inserted into suspension of Lactobacillus Acidophilus, grown for 24 hours, after that the samples was taken and put into BHIB medium and vortex for 1 minute. A total of 0.1 ml of Lactobacilus Acidophilus Suspension of each group was put in to MHA, grown for 24 hours. The number of colonies was then calculated. The least amount of bacterial colonization was found in group 3, the group with the highest amount of Propolis Extract, continued with Group 2, Group 1, and Positive Control Group. The combination of calcium hydroxide and propolis with 1:2 ratio is the most effective on inhibit L. acidophilus colonization. [ABSTRACT FROM AUTHOR]

As the gold standard, pulp inflammation can be treated with pulp capping by calcium hydroxide. Tissue necrosis accompanied by inflammation could be caused by calcium hydroxide pulp capping. Calcium hydroxide combined with propolis which have anti-inflammatory effects through inhibition of the NF-kB pathway and pro-inflammatory cytokines. The increase in vascular permeability and neutrophil chemotaxis will be inhibited by that method. By regulating the quantity of neutrophil cells as an acute phase marker, the inflammatory process will speed up, so the healing process happens more quickly. The quantity of neutrophil cells in the pulp perforation of Wistar rats after calcium hydroxide-propolis combination application must therefore be examined. The aim of this study is to analyze the differencenumber of neutrophil cells onthe Wistar rats pulp perforation after applicated by calcium hydroxide-propolis combination compared with calcium hydroxide-aquadest. M1 tooth perforated for all groups with three types tratment: no medication (control group), calcium hydroxide-aquadest 1: 1 (P-1 group), and calcium hydroxide-propolis 1: 1.5 (P-2 group) and closed with cention. Observations were made on the 1st and 3rd day with HE staining. One Way ANOVA shown a significant difference (p <0.05) of the average amount of neutrophil cells between all treatment groups on 1st day (p = 0.000) and 3rd day (p = 0.000). In the calcium hydroxide-propolis (P-2) combination group, the number of neutrophil cells was lower than in the control group and in the calcium hydroxide-aquadest (P-1) group on days 1 and 3. The quantity of neutrophil cells after calcium hydroxide-propolis is added is smaller than that of calcium hydroxide-aquadest. [ABSTRACT FROM AUTHOR]