Journal of Conservative Dentistry

EDITORIAL
Year
: 2020  |  Volume : 23  |  Issue : 5  |  Page : 429-

From the Desk of the Editor......the Endodontic Elixir


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

Correspondence Address:
Dr. Shishir Singh
Department of Conservative Dentistry and Endodontics, Terna Dental College, Nerul, Navi Mumbai, Maharashtra
India




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


How to cite this URL:
Singh S. From the Desk of the Editor......the Endodontic Elixir. J Conserv Dent [serial online] 2020 [cited 2022 Oct 1 ];23:429-429
Available from: https://www.jcd.org.in/text.asp?2020/23/5/429/309017


Full Text

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]

As a root canal medicament in endodontic therapyIn treating weeping canals with a lot of pus dischargeFor direct and indirect pulp capping treatmentsIn pulpotomy treatments as a medicamentFor apexification and apexogenesis casesAs a medicament in treatment of internal resorptions, external resorptions, and apical resorptionsAs a medicament for treatment of horizontal root fracturesAs a root canal sealer ingredientAs a medicament for perforation treatmentsAs 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

1Gulabivala K, Patel B, Evans G, Ng YL. Effects of mechanical and chemical procedures on root canal surfaces. Endod Topics 2005;10:103-22.
2Mohammadi Z, Dummer PM. Properties and applications of calcium hydroxide in endodontics and dental traumatology. Int Endod J 2011;44:697-730.
3Siqueira JF Jr., Lopes HP. Mechanisms of antimicrobial activity of calcium hydroxide: A critical review. Int Endod J 1999;32:361-9.
4Best 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.
5Mohammadi 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.
6Sharma 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.
7Silva 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.
8Asnaashari 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.
9Suhag 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.