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Year : 2020  |  Volume : 23  |  Issue : 5  |  Page : 429
From the Desk of the Editor......the Endodontic Elixir

Department of Conservative Dentistry and Endodontics, Terna Dental College, Navi Mumbai, Maharashtra, India

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Date of Submission20-Jan-2021
Date of Acceptance20-Jan-2021
Date of Web Publication10-Feb-2021

How to cite this article:
Singh S. From the Desk of the Editor......the Endodontic Elixir. J Conserv Dent 2020;23:429

How to cite this URL:
Singh S. From the Desk of the Editor......the Endodontic Elixir. J Conserv Dent [serial online] 2020 [cited 2023 Jun 4];23:429. Available from:
The Science of Endodontics has progressed rapidly bringing to us a variety of choices as far as treatment choices go. One of the main objectives of endodontic treatment is the elimination of microorganisms, for which an array of medicaments and antibacterials have been proposed.[1] Strangely, so the endodontic textbooks and literature are replete with a long list of endodontic medicaments, but there is just one that has stood the test of time which is calcium hydroxide. This white alkaline powder with a pH of 12 was introduced to dentistry by B.W. Hermann a century ago in 1920 and till date is the most preferred medicament by endodontists worldwide.

Its indications and uses are many:[2]

  1. As a root canal medicament in endodontic therapy
  2. In treating weeping canals with a lot of pus discharge
  3. For direct and indirect pulp capping treatments
  4. In pulpotomy treatments as a medicament
  5. For apexification and apexogenesis cases
  6. As a medicament in treatment of internal resorptions, external resorptions, and apical resorptions
  7. As a medicament for treatment of horizontal root fractures
  8. As a root canal sealer ingredient
  9. As a medicament for perforation treatments
  10. As a cavity liner.

Calcium hydroxide forms a physical barrier preventing bacterial ingress and destroys the remaining bacteria. Its antibacterial action is due to a high pH and leaching action on necrotic pulp tissue.[3] This antibacterial activity is due to its ability to damage the bacterial cytoplasmic membrane and cause protein denaturation and DNA damage. Ability to induce hard tissue formation, good tissue-dissolving properties, minimal side effects, and a high healing potential makes it a preferred medicament. Interestingly, it has been proven that, when used for a prolonged period in treating necrotic pulps and apical periodontitis, there is a high healing rate.[4],[5]

When used singly or in combination with other materials and irrigants, it performs very well without much harmful effects.[6],[7],[8] On the other hand, a lot of evidence exists with materials showing similar or even better properties in the endodontic literature.[9] On a concluding note, one must weigh each individual case treatment modalities properly, the pros and cons associated with the use of a specific material, its costs, patient affordability, and finally prognosis and outcomes.

   References Top

Gulabivala K, Patel B, Evans G, Ng YL. Effects of mechanical and chemical procedures on root canal surfaces. Endod Topics 2005;10:103-22.  Back to cited text no. 1
Mohammadi Z, Dummer PM. Properties and applications of calcium hydroxide in endodontics and dental traumatology. Int Endod J 2011;44:697-730.  Back to cited text no. 2
Siqueira JF Jr., Lopes HP. Mechanisms of antimicrobial activity of calcium hydroxide: A critical review. Int Endod J 1999;32:361-9.  Back to cited text no. 3
Best S, Ammons CL, Karunanayake GA, Saemundsson SR, Tawil PZ. Outcome assessment of teeth with necrotic pulps and apical periodontitis treated with long-term calcium hydroxide. J Endod 2021;47:11-8.  Back to cited text no. 4
Mohammadi Z, Jafarzadeh H, Shalavi S, Sahebalam R, Kinoshita JI. Additive and reducing effects between calcium hydroxide and current irrigating solutions. J Contemp Dent Pract 2017;18:246-9.  Back to cited text no. 5
Sharma G, Ahmed HMA, Zilm PS, Rossi-Fedele G. Antimicrobial properties of calcium hydroxide dressing when used for long-term application: A systematic review. Aust Endod J 2018;44:60-5.  Back to cited text no. 6
Silva S, Alves N, Silva P, Vieira T, Maciel P, Castellano LR, et al. Antibacterial activity of Rosmarinus officinalis, Zingiber officinale, Citrus aurantium bergamia, and Copaifera officinalis alone and in combination with calcium hydroxide against Enterococcus faecalis. Biomed Res Int 2019;2019:8129439.  Back to cited text no. 7
Asnaashari M, Ashraf H, Rahmati A, Amini N. A comparison between effect of photodynamic therapy by LED and calcium hydroxide therapy for root canal disinfection against Enterococcus faecalis: A randomized controlled trial. Photodiagnosis Photodyn Ther 2017;17:226-32.  Back to cited text no. 8
Suhag K, Duhan J, Tewari S, Sangwan P. Success of direct pulp capping using mineral trioxide aggregate and calcium hydroxide in mature permanent molars with pulps exposed during carious tissue removal: 1-year follow-up. J Endod 2019;45:840-7.  Back to cited text no. 9

Correspondence Address:
Dr. Shishir Singh
Department of Conservative Dentistry and Endodontics, Terna Dental College, Nerul, Navi Mumbai, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JCD.JCD_37_21

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