Calcium hydroxide induced apexification with apical root development: a clinical case report

Abstract

* In young patients, dental trauma may cause pulp necrosis and arrest of root formation. * Under certain circumstances, chemo-mechanical debridement, including the use of a calcium hydroxide paste, is a valid alternative to mineral trioxide aggregate and or surgery for root-end closure. * In teeth with incompletely formed roots associated with periapical lesions, calcium hydroxide can induce periapical repair through the closure of the foramen and apical root development.

Farkli Api̇kal Açikliğa Sahi̇p Di̇şlerde İnternal Matri̇x İle Bi̇rli̇kte Kullanilan Mta’nin Api̇kal Sizintisinin Değerlendi̇ri̇lmesi̇

“…1,2 Bu tip dişlerin, kök kanal duvarlarının kalınlığı azalmış olduğundan az miktarda dentin uzaklaştırıl-makta bu durum da biyomekanik preparasyonu sınır-lamaktadır. 3 Ayrıca, apikalde bir sert doku engeli oluş-madığı için, kök kanallarının apikal ve lateral yönde sız-dırmaz bir şekilde doldurulması oldukça zordur. 4 Bakteriyel enfeksiyonu sınırlandırmak ve kök kanal dolgu maddelerinin taşmasını engellemek için sert doku benzeri apikal tıkacın oluşması için apeksifikasyon tedavisi uygulanmaktadır.…”

A Comparison of Selected Regenerative Materials Used in the Management of Pulp Diseases – Review of the Literature

“…It also demonstrates long term anti-inflammatory properties through inhibition of enzyme phospholipase, activation of Ca canals and hygroscopic action [6,9,10,12]. Other significant advantages of this material are low toxicity and allergenic potential and resorbability of the material inadvertently deposited behind the apex during endodontic treatment [6,8,11]. The relatively low costs, flexible consistency and availability of various formulations are not without significance.…”

“…They frequently include so-called tunnels (gaps), which may predispose the patient to infection of the pulp. Materials based on calcium hydroxide are not indicated for the treatment of immature permanent teeth if there are remnants of vital pulp within the canal, due to the risk of formation of a layer of highly mineralized tissue which obstructs the root canal leading to the inhibition of regenerative processes [8,9,12]. Calcium hydroxide may also harm Hertwig sheat cells resulting in the loss of their capability to stimulate the transformation of undifferentiated cells into odontoblasts [15,16].…”

“…The extremely high pH provides an alkaline environment triggering bacteriocidic and bacteriostatic properties of the preparations. The intracellular action leads to irreversible damage of DNA, proteins, enzymes and lipids within bacterial cells and hydrolysis of the lipopolysaccharides in their cytoplasmatic membranes [6,[8][9][10][11]. Absorption of carbon dioxide from the environment potentiates the bactericidal effects of this material, additionally exerting its negative impact on anaerobe microorganisms [9,12].…”

“…It was introduced into dentistry in the 19 th century and since that time it has been commonly used in various indications, especially due to its strong alkalizing, antibacterial, antinflammatory potential as well as its capacity to stimulate pulpal regenerative processes [5][6][7][8][9][10]. The mechanism of action of calcium hydroxide products is based on its ability to dissociate in aqueous solutions into free Ca 2+ ions and hydroxyl ions which activate many chemical reactions in contact with vital tissue as well as provide a highly alkaline environment with pH of approximately 12.5 [5][6][7][8][9][10]. Free hydroxyl ions show enormous reactivity with many various biomolecules.…”