pH and calcium ion release evaluation of pure and calcium hydroxide-containing Epiphany for use in retrograde filling

Objective

Hydroxyl (OH^-) and calcium (Ca⁺⁺) ion release was evaluated in six materials: G1) Sealer 26, G2) White mineral trioxide aggregate (MTA), G3) epiphany, G4) epiphany + 10% calcium hydroxide (CH), G5) epiphany + 20% CH, and G6) zinc oxide and eugenol.

Material and Methods

Specimens were placed in polyethylene tubes and immersed in distilled water. After 3, 6, 12, 24, and 48 h, 7, 14, and 28 days, the water was assessed for pH with a pH meter and for Ca⁺⁺ release by atomic absorption spectrophotometry.

Results

G1, G2, G4, and G5 had the highest pH until 14 days (p<0.05). G1 presented the highest Ca⁺⁺ release until 6 h, and G4 and G5, from 12 h through 14 days. Ca⁺⁺ release was greater for G1 and G2 at 28 days. G6 released the least Ca⁺⁺.

Conclusion

MTA, Sealer 26, epiphany, and epiphany + CH release OH ^- and Ca⁺⁺ ions. Epiphany + CH may be an alternative as retrofilling material.     

Evaluation of pH levels and calcium ion release in various calcium hydroxide endodontic dressings

OBJECTIVE: The purpose of this study was to evaluate Ca(2+) release and pH of 3 calcium hydroxide-based products used routinely as intracanal dressings, as well as the new gutta-percha points with calcium hydroxide. STUDY DESIGN: The pH and Ca(2+) release were assessed using Calen with camphorated paramonochlorophenol, saline calcium hydroxide paste, LC paste (Lopes and Costa paste-calcium hydroxide with olive oil), and calcium hydroxide containing gutta-percha points. The materials were inserted in polyethylene tubes and immersed in deionized water. The pH variation and Ca(2+) release were monitored periodically for 4 weeks. RESULTS: After 72 hours, materials 1 and 2 raise the pH from 9.6 and 8.2 to 11.4 and 11.3, respectively, while a small change was observed for materials 3 and 4. The calcium concentration released from materials 1, 2, 3, and 4 after 72 hours was 6.54, 4.98, 1.31, and 1.74 mg/dL, respectively. CONCLUSION: Calen plus camphorated paramonochlorophenol and saline calcium hydroxide paste exhibited the highest calcium release and pH levels.     

Clinical evaluation of gIutaraldehyde with calcium hydroxide and glutaraldehyde with zinc oxide eugenol in pulpotomy of primary molars

Shumayrikh NM, Adenubi JO. Clinical evaluation of glutaraldehyde with calcium hydroxide and glutaraldehyde with zinc oxide eugenol in pulpotomy of primary molars. Endod Dent Traumatol 1999; 15: 259–264. © Munksgaard, 1999.
Abstract — The objectives of this study were to clinically evaluate the effectiveness of 2% buffered glutaraldehyde in pulpotomies of human primary molars and to compare the success rate of glutaraldehyde with calcium hydroxide and glutaraldehyde with zinc oxide eugenol as dressing material on the radicular pulp. Pulpotomies were completed on 61 primary molars in 19 children. The teeth were divided into two groups by random allocation. One group had a dressing of zinc oxide-eugenol base (IRM) incorporated with one drop of 2% buffered glutaraldehyde while the other group had a dressing of calcium hydroxide base incorporated with one drop of 2% buffered glutaraldehyde after the initial placement of 2% buffered glutaraldehyde on cotton pellet for 3 min. All teeth had light-curing compomer (Dyract) placed over the dressing material followed by a stainless steel crown restoration within 1 or 2 weeks after the pulpotomy. Blind clinical and radiographic evaluations of 57 teeth available after 12 months showed a success rate of 92.9% and 73.6% respectively. The clinical and radiographic success rates for glutaraldehyde/zinc oxide eugenol pulpotomies were 96.5% and 75.8% respectively while those for glutaraldehyde-calcium hydroxide were 89.2% and 71.4%. There was no statistically significant difference between the two groups either clinically or radiographi-cally. The overall clinical success rate suggested that 2% buffered glutaraldehyde was an effective agent in the pulpotomy of human primary molars.     

Effects of calcium hydroxide addition on the physical and chemical properties of a calcium silicate-based sealer

Recently, various calcium silicate-based sealers have been introduced for use in root canal filling. The MTA Fillapex is one of these sealers, but some of its physicochemical properties are not in accordance with the ISO requirements.

Objective

The aim of this study was to evaluate the flowability, pH level and calcium release of pure MTA Fillapex (MTAF) or containing 5% (MTAF5) or 10% (MTAF10) calcium hydroxide (CH), in weight, in comparison with AH Plus sealer.

Material and Methods

The flowability test was performed according to the ISO 6876:2001 requirements. For the pH level and calcium ion release analyses, the sealers were placed individually (n=10) in plastic tubes and immersed in deionized water. After 24 hours, 7 and 14 days, the water in which each specimen had been immersed was evaluated to determine the pH level changes and calcium released. Flowability, pH level and calcium release data were analyzed statistically by the ANOVA test (α=5%).

Results

In relation to flowability: MTAF>AH Plus>MTAF5>MTAF10. In relation to the pH level, for 24 h: MTAF5=MTAF10=MTAF>AH Plus; for 7 and 14 days: MTAF5=MTAF10>MTAF>AH Plus. For the calcium release, for all periods: MTAF>MTAF5=MTAF10>AH Plus.

Conclusions

The addition of 5% CH to the MTA Fillapex (in weight) is an alternative to reduce the high flowability presented by the sealer, without interfering in its alkalization potential.     

Comparison of zinc oxide and eugenol, and Vitapex for root canal treatment of necrotic primary teeth

OBJECTIVES: The aims of this study were to evaluate iodoform base materials for root canal treatment of necrotic primary teeth, and to compare them with traditionally used zinc oxide and eugenol (ZOE). SAMPLE AND METHODS: Zinc oxide and eugenol and Vitapex (a premixed calcium hydroxide and iodoform paste) were compared for root canal treatment in 52 necrotic primary teeth in two groups of children with a mean age of 5 years and 8.4 months. All the patients were followed-up clinically and radiographically 3 months and 10-16 months postoperatively. RESULTS: The overall success rates of Vitapex and ZOE were 100% and 78.5%, respectively. Using Fisher's Exact Test, the difference was statistically significant (P < 0.05). CONCLUSION: Both ZOE and Vitapex gave encouraging results. Vitapex, however, can be used more safely whenever there is a doubt about the patient's return for follow-up.     

3种剂型氢氧化钙药物根尖周扩散的体外研究

目的:观察不同剂型氢氧化钙通过模拟根管向根尖周扩散的效果。方法:用吸液管尖、BHI琼脂及5ml塑料注射针筒制备成模拟根尖周模型。120个模型分为3组,每组40个,按根尖孔径不同(15#、25#、40#、80#),每组又分为4个亚组,每亚组10个。第1组模拟根管内封入20%氢氧化钙悬浊液100μl;第2组封入90%氢氧化钙糊剂100μl;第3组封入氢氧化钙药尖并加入100μl蒸馏水。另备12支模拟模型,封入100μl蒸馏水作为对照。用pH分析仪和钙离子分析仪分别测定pH值和Ca2 浓度。将所得数据建立数据库,采用SPSS13.0软件包进行随机区组设计的方差分析。结果:pH分析发现,第1、2、3组的平均pH值分别为8.26、7.96和7.83,第1组与2、3组之间有显著性差异(P<0.05),第2、3组之间平均pH值无显著差异;Ca2 测定结果,第1、2、3组平均Ca2 浓度分别为29.87、24.62和16.42ppm,3组间均有显著性差异(P<0.05)。分析结果还表明,不同根尖孔径平均pH值和平均Ca2 浓度组间均有显著性差异(P<0.05),依次为80#>40#>25#>15#。结论:氢氧化钙悬浊液在模拟根尖周模型内的扩散效果好于氢氧化钙糊剂和氢氧化钙药尖;根尖孔径越大,药物扩散效果越好。     

Clinical evaluation of glutaraldehyde with calcium hydroxide and glutaraldehyde with zinc oxide eugenol in pulpotomy of primary molars

The objectives of this study were to clinically evaluate the effectiveness of 2% buffered glutaraldehyde in pulpotomies of human primary molars and to compare the success rate of glutaraldehyde with calcium hydroxide and glutaraldehyde with zinc oxide eugenol as dressing material on the radicular pulp. Pulpotomies were completed on 61 primary molars in 19 children. The teeth were divided into two groups by random allocation. One group had a dressing of zinc oxide-eugenol base (IRM) incorporated with one drop of 2% buffered glutaraldehyde while the other group had a dressing of calcium hydroxide base incorporated with one drop of 2% buffered glutaraldehyde after the initial placement of 2% buffered glutaraldehyde on cotton pellet for 3 min. All teeth had light-curing compomer (Dyract) placed over the dressing material followed by a stainless steel crown restoration within 1 or 2 weeks after the pulpotomy. Blind clinical and radiographic evaluations of 57 teeth available after 12 months showed a success rate of 92.9% and 73.6% respectively. The clinical and radiographic success rates for glutaraldehyde/zinc oxide eugenol pulpotomies were 96.5% and 75.8% respectively while those for glutaraldehyde-calcium hydroxide were 89.2% and 71.4%. There was no statistically significant difference between the two groups either clinically or radiographically. The overall clinical success rate suggested that 2% buffered glutaraldehyde was an effective agent in the pulpotomy of human primary molars.     

Calcium release and pH-characteristics of calcium hydroxide plus points

AIM: To evaluate calcium ion release and pH-characteristics of calcium hydroxide plus points (CHPP), conventional calcium hydroxide points (CHP, both Coltène/Whaledent, Langenau, Germany) and aqueous calcium hydroxide suspension (CHS) (Calxyl, OCO, Dirmstein, Germany). METHODOLOGY: Ten CHPP or CHP of size 50 were immersed into 5 mL isotonic sodium chloride solution. Conventional Ca(OH)2-free gutta-percha points served as negative control. Calcium release was measured up to 44 days by means of complexometric titration. Time dependent pH behaviour of all points in comparison with CHS was determined immersing 30 points of size 50 into 2.3 mL 0.9% wt NaCl-solution at time intervals of 0.5-72 h by a microelectrode measuring chain and a pH-meter. The surface morphologies of new and used gutta-percha points were evaluated qualitatively under a scanning electron microscope. Statistical evaluation was carried out using Kolmogorov-Smirnov-tests, Mann-Whitney-tests and multifactorial anova. RESULTS: For CHPP, a threefold greater calcium release was measured compared with CHP. Both types of points as well as CHS showed a maximum pH of approximately 12. Differences between groups were statistically significant for calcium release and pH (multifactorial anova; P < 0.001). Both types of points showed porous surfaces after usage, with a rougher surface for CHPP. CONCLUSIONS: CHPP and CHP increased the pH of isotonic sodium chloride >11 within 3 min. CHPP had a greater release of Ca2+ compared with CHP.     

Evaluation of pH and Calcium Ion Release of Root-end Filling Materials Containing Calcium Hydroxide or Mineral Trioxide Aggregate

IntroductionTo evaluate calcium ion release and pH of Sealer 26 (S26) (Dentsply, Rio de Janeiro, RJ, Brazil), white mineral trioxide aggregate (MTA), Endo CPM Sealer (CPM1) (EGEO SRL Bajo licencia MTM Argentina SA, Buenos Aires, Argentina), Endo CPM Sealer in a thicker consistency (CPM 2), and zinc oxide and eugenol cement (ZOE).MethodsMaterial samples (n = 10) were placed in polyethylene tubes and immersed in 10 mL of distilled water. After 3, 6, 12, 24, and 48 hours and 7, 14, and 28 days, the water pH was determined with a pH meter, and calcium release was assessed by atomic absorption spectrophotometry. An empty tube was used as the control group.ResultsThe control group presented a pH value of 6.9 at all studied periods and did not show the presence of calcium ion. S26 presented greater hydroxyl ion release up to 12 hours (p < 0.05). From 24 hours until 28 days, S26, MTA, CPM1, and CPM2 had similar results. In all periods, ZOE presented the lowest hydroxyl ion release. CPM1, followed by CPM2, released the most calcium ions until 24 hours (p < 0.05). Between 48 hours and 7 days, CPM1 and CPM2 had the highest release. A greater calcium ion release was observed for CPM2, followed by CPM1 at 14 days and for S26, CPM1, and CPM2 at 28 days. ZOE released the least calcium ions in all periods.ConclusionSealer 26, MTA, and Endo CPM sealer at normal or thicker consistency release hydroxyl and calcium ions. Endo CPM sealer may be an alternative as root-end filling material.     

Evaluation of pH and Calcium Ion Release of Calcium Hydroxide Pastes Containing Different Substances

IntroductionThe objective of this study was to evaluate the pH and calcium ion release of calcium hydroxide pastes associated with different substances.MethodsForty acrylic teeth with simulated root canals were divided into 4 groups according to the substance associated to the calcium hydroxide paste: chlorhexidine (CHX) in 2 formulations (1% solution and 2% gel), Casearia sylvestris Sw extract, and propylene glycol (control). The teeth with pastes and sealed coronal accesses were immersed in 10 mL deionized water. After 10 minutes, 24 hours, 48 hours, and 7, 15, and 30 days, the teeth were removed to another container, and the liquid was analyzed. Calcium ion release was measured by atomic absorption spectrophotometry, and pH readings were made with a pH meter. Data were analyzed statistically by analysis of variance and Tukey test (α = 0.05).ResultsCalcium analysis revealed significant differences (P < .05) for 1% CHX solution and 2% CHX gel at 10 minutes. After 24 hours, 2% CHX gel × Control and 2% CHX gel × 1% CHX solution differed significantly (P < .05). After 48 hours, there were significant differences (P < .05) for 2% CHX gel × Control and Extract × Control. No differences (P > .05) were observed among groups in the other periods. Regarding the pH, there were significant differences (P < .05) for 2% CHX gel × Control and 2% CHX gel × 1% CHX solution after 48 hours and for 2% CHX gel × Control after 15 days. In the other periods, no differences (P > .05) were observed among groups.ConclusionsAll pastes behaved similarly in terms of pH and calcium ion release in the studied periods.     

Evaluation of sealing ability, pH and flow rate of three calcium hydroxide-based sealers

Abstract Three endodontic sealers containing calcium hydroxide (Sealapex, Sealer 26 and Apexit) and a zinc oxide-eugenol cement (Grossman's sealer) were examined for sealing ability, release of hydroxyl ions and flow rate. Dye penetration test was used to assess the sealing ability of the endodontic sealers. The pH test was accomplished to evaluate the release of hydroxyl ions from sealers and the pH readings were done at intervals of 30 min, 60 min and 7 days. In the flow test the sealers were placed between two glass slabs and a weight of 500 g was placed on the top of the glass. The diameters of the formed discs were recorded. The results revealed no statistically significant difference between apical seal provided by the four sealers. All of the calcium hydroxide based sealers alkalinized the surrounding medium. Sealer 26 cement presented significantly superior flow rate when compared with the other cements. These findings indicated that endodontic sealers containing calcium hydroxide presented satisfactory physicochemical properties when compared with a zinc oxide-eugenol sealer commonly used in endodontics.     

Comparative evaluation of calcium hydroxide and zinc oxide eugenol as root canal filling materials for primary molars: a clinical and radiographic study

Calcium hydroxide, a material widely used for the treatment of permanent teeth has not been used frequently for pulpectomy in primary teeth. A comparative evaluation of calcium hydroxide and zinc oxide eugenol used as root canal filling materials in primary molars is presented.     

pH and calcium ion release of 2 root-end filling materials

OBJECTIVE: The purpose of this study was to evaluate the pH and calcium ion release of 2 materials used for root-end fillings and perforation repair. STUDY DESIGN: ProRoot and MTA-Angelus were placed in plastic tubes and immersed in glass flasks containing deionized water. After 3, 24, 72, and 168 hours, the water in which each had been immersed was tested to determine the pH changes and released calcium. RESULTS: The values for pH and calcium ion release were slightly higher for MTA-Angelus than ProRoot. The calcium release and pH of both materials were initially higher. CONCLUSION: The results suggest that both materials release calcium and promote alkaline pH.     

In vitro release of hydroxyl ions from calcium hydroxide gutta-percha points

In endodontic practice, calcium hydroxide is widely used for a number of reasons associated with its high pH. The purpose of the present study was to determine in vitro the alkalizing potential of newly introduced calcium hydroxide gutta-percha points that are proposed for temporary filling of root canals. The materials tested were: calcium hydroxide gutta-percha points; chemical pure calcium hydroxide powder mixed with distilled water; and Reogan rapid, a nonsetting calcium hydroxide preparation. The materials were placed into dialysis tubing and transferred into plastic vials containing bidistilled water. Measurements were taken by a digital pH meter after 10, 20, and 30 s; 1, 15, and 30 min; and 1, 2, 3, 24, 48, 72, 96, and 120 h. The calcium hydroxide containing gutta-percha points showed a significantly lower alkalizing potential than Reogan rapid and calcium hydroxide mixed with distilled water (p < 0.05).     

Pulp reaction to a temporary zinc oxide/eugenol cement.

The pulpal irritation, such as inflammatory reaction and aspiration of pulpal cells, demonstrated after insertion of the zinc oxide/eugenol cement (Nobetec) seems to warrant the following recommendations: (1) A temporary restoration with a zinc oxide/eugenol base should not be inserted in deep cavities without a protective liner or a calcium hydroxide base covering the exposed dentinal tubules. (2) Before the temporary cementing of inlays and crowns with a zinc oxide/eugenol cement, not only should the dentin be properly cleaned and debris removed, but the prepared surfaces should be covered with a calcium hydroxide liner.     

Bacterial growth inhibition produced by root canal sealer cements with a calcium hydroxide base

Inhibition of growth of six bacterial strains produced by two root canal sealers with a calcium hydroxide base, CRCS and Sealapex sealers, is studied. The results are compared with those obtained with two zinc oxide eugenol sealers and one epoxy resin. The inhibition produced with the calcium hydroxide sealers is similar to that obtained with the other sealers. The component of paraformaldehyde in a sealer increases the inhibition significantly.     

3种根充糊剂微渗漏的实验研究

目的评价3种根充糊剂的根管封闭性能。方法收集新鲜拔除的人前牙100颗,随机分为A、B、C 3个实验组（每组30颗牙齿）和D、E 2个对照组（每组5颗牙齿）,A、B、C组分别采用Vitapex糊剂、AH- plus糊剂、氧化锌丁香油（ZOE）糊剂加牙胶尖侧压充填根管,D组为阳性对照组,E组为阴性对照组。牙齿用2%甲基兰溶液浸泡,脱矿使牙齿透明,在根管显微镜下测量染料渗入根管的长度。结果A、B、C组染料渗入长度分别为（0.57±0.56）mm、（0.79±0.96）mm、（1.07±1.12）mm,阳性对照组染料渗入根管全长,阴性对照组无染料渗入。A组与B、C组间染料渗入长度有显著性差异（P<0.01）,B组与C组间染料渗入长度无显著性差异（P>0.05）。结论Vitapex糊剂根尖封闭性优于AH- plus糊剂与ZOE糊剂。     

The effect of calcium ion concentration on the bone response to oxidized titanium implants

Aim: To investigate the effect of calcium concentration on the bone tissue response to Ca‐incorporated titanium implants Materials and methods: Two titanium surfaces containing 4.2% and 6.6% calcium were prepared using the micro‐arc oxidation process. The implants were inserted in the tibia of nine New Zealand White rabbits. After 6 weeks of healing, the bone response to the implants was quantitatively compared by biomechanical and histomorphometrical measurements. Results: Ca 4.2% and Ca 6.6% containing implants revealed no distinctive differences in their qualitative surface chemistry; chemical bonding state of Ca in titanium oxide was mainly calcium titanates. No significant differences were observed between two implants in peak removal torque and shear strength comparisons (P>0.05). Histomorphometrical analyses presented no significant differences in bone–metal contact, bone area and newly formed bone measurements between two implants (P>0.05). Conclusions: From biomechanical and histomorphometrical measurements, the two calcium concentrations in this study did not differ significantly with respect to their influence on the bone tissue response. This similar bone response in rabbit tibiae may be explained by the similarity of the qualitative Ca chemistry in titanium surfaces.     

Histopathologic evaluation of the effects of four calcium hydroxide liners on monkey pulps

Pulpal response of four calcium hydroxide liners, MPC 10®, MPC 12®, Dycal® and Pulpdent® were tested on primary and permanent teeth with zinc oxide and eugenol (ZOE) and silicate as controls. Responses of the pulps were evaluated in Rhesus monkeys, utilizing Class V cavity preparations at 3 days, 5 and 8 weeks. An equivalent number of anterior and posterior teeth were studied for all compounds. The Ca(OH)₂ liners, zinc oxide and eugenol (ZOE) and silicate controls were placed in 80 primary and 80 permanent teeth. Following perfusions the teeth were prepared utilizing routine histological procedures. The 3 day response of the calcium hydroxides was moderate with some disruption in the odontoblasts, vacuolization and mild inflammation underlying the cavity except Pulpdent which was more severe. At 5 weeks a decrease in inflammatory response and the formation of reparative dentin was similar for all calcium hydroxides tested at this time period. At 8 weeks more reparative dentin was noted with slight to moderate pulpal responses. At all time periods ZOE produced the least pulpal response while silicate produced the most severe response at 5 and 8 weeks. This study reports the biological responses of four calcium hydroxide compounds used as cavity liners in non-exposures in a series of primary and permanent teeth of monkeys using ZOE and silicate as controls. Responses to the four Ca(OH)₂ compounds were moderate for all the experimental compounds except Pulpdent which was more severe at the early time period tested. ZOE produced a milder and silicate a severe response at all periods. All of these compounds were placed by random selection in anterior and posterior teeth of both arches and five teeth were evaluated in both primary and permanent teeth at 3 days, 5 and 8 weeks.     

Evaluation of pH and calcium ion release of three root canal sealers

The pH and calcium ion release of three root canal sealers--Sealapex, Sealer 26, and Apexit--were assessed at 24 and 48 hr, and at 7 and 30 days after spatulation. After manipulation, the sealers were placed in 1-cm-long tubes measuring 4 mm in diameter and immersed in a glass flask containing 10 ml of deionized water, which was hermetically sealed and stored at 37 degrees C. The tubes were removed at the scheduled times and the water in which they were immersed was tested for pH with a pHmeter and for released calcium by atomic absorption spectrophotometry. Starting 48 hr after immersion, Selapex produced an alklaine pH and released significantly higher calcium amounts compared with the other two sealers, with even more pronounced results after 30 days. On the basis of the results obtained, we conclude that Sealapex presented the highest calcium and hydroxyl release, especially after longer time intervals, whereas Sealer 26 showed highest release during the initial periods (i.e. during its setting time). Apexit presented the least satisfactory results.