Journal of Conservative Dentistry

EDITORIAL
Year
: 2020  |  Volume : 23  |  Issue : 6  |  Page : 543-

From the Desk of the Editor......The Vehicle for Calcium Hydroxide


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 Vehicle for Calcium Hydroxide.J Conserv Dent 2020;23:543-543


How to cite this URL:
Singh S. From the Desk of the Editor......The Vehicle for Calcium Hydroxide. J Conserv Dent [serial online] 2020 [cited 2021 Apr 17 ];23:543-543
Available from: https://www.jcd.org.in/text.asp?2020/23/6/543/309150


Full Text

Dear Readers,

The use of calcium hydroxide as a root canal medicament is common place, especially with its many advantages. One important fact that is overlooked is its mode of administration.

Although available as a plain powder, the commercial products may be aqueous, viscous, or oil based; fast setting, slow setting, or controlled setting. While the pastes are used as intracanal medicaments, setting formulations are used as cavity liners or endodontic sealers.[1] Besides the antimicrobial activity, it is important to understand the benefit of using a particular formulation.[2],[3]

The aqueous versions consist of calcium hydroxide mixed with either water, saline, anesthetic solution, Ringer's solution, an aqueous suspension of methyl cellulose, or carboxy methyl cellulose or anionic detergent solutions. The aqueous combinations release calcium and hydroxyl ions rapidly and have a high degree of solubility. As a result, the root canal dressing needs to be changed several times increasing the number of appointments.[4]

In a viscous preparation, the vehicles used are glycerin, polyethylene glycol, or propylene glycol with the calcium hydroxide. These mixtures release calcium and hydroxyl ions slowly, have a low solubility, and remain in the root canal for a longer time interval, hence reducing the number of sittings.[5] This results in better antimicrobial actions with better performance and biocompatibility.

The oil-based blends have calcium hydroxide in combination with olive oil, silicone oil, camphorated monochlorophenol CMCP, fatty acids, eugenol, or metacresylacetate. These mixes have a low solubility and remain in the root canal for a prolonged time.[6]

In summary, the indications of calcium hydroxide as per vehicle types can be:

For clinical situations that require a rapid ionic liberation at the beginning of the treatment, an aqueous vehicle containing calcium hydroxide paste is indicatedWhile in clinical situations that require a gradual and uniform ionic liberation, a viscous vehicle containing calcium hydroxide pastes is usedPastes containing oily vehicles have restricted use and are only employed in those clinical situations that require a very slow ionic dissociation.

Thus, it is of utmost importance that the clinician understands the chemistry and clinical outcomes related with the use of various vehicles for calcium hydroxide in intracanal medication.

References

1Fava LR, Saunders WP. Calcium hydroxide pastes: Classification and clinical indications. Int Endod J 1999;32:257-82.
2Siqueira JF Jr, Lopes HP. Mechanisms of antimicrobial activity of calcium hydroxide: A critical review. Int Endod J 1999;32:361-9.
3de Almeida Barbosa M, de Oliveira KV, Dos Santos VR, da Silva WJ, Tomazinho FSF, Baratto-Filho F, et al. Effect of vehicle and agitation methods on the penetration of calcium hydroxide paste in the dentinal tubules. J Endod 2020;46:980-6.
4Deonizio MD, da Silva WJ, Batista A, Sydney GB, do Nascimento FC, Goncalves LM, et al. Efficacy of calcium hydroxide paste prepared with different vehicles against salivary microbial infiltration of root canals. Gen Dent 2014;62:e22-5.
5Athanassiadis B, Walsh LJ. Aspects of solvent chemistry for calcium hydroxide medicaments. Materials (Basel) 2017;10.
6Pacios MG, Silva C, López ME, Cecilia M. Antibacterial action of calcium hydroxide vehicles and calcium hydroxide pastes. J Investig Clin Dent 2012;3:264-70.