Wednesday, December 9, 2009

Calcium Hydroxide as Intercanal Medicament

Ca(OH)2 pastes are used in endodontics as a temporary canal filling material for multiple purposes including:
1. Stimulate continue root development
2. Control exudate/disinfect the canal system
3. Prevention of external root resorption following traumatic injuries
4. Create an apical barrier following over instrumentation

Occasionally, I will use calcium hydroxide as a intracanal medicament to look for signs of initial healing prior to obturation. On this particular retreatment case, the distal canal was long and wide. I was concerned there may have been some resorption or possible an apical crack that I could not visualize.

Pre-Operative Radiograph


Calcium Hydroxide paste was placed (and extruded) in the canals.

3 month recall shows remarkable resorption of the extruded Ca(OH)2 and healing of the apical lesion.

Tooth was re-obturated and another tooth has been saved!


Source:
Cohen & Burns. Pathways of Pulp 6th ed. p.406-407.

6 comments:

Anonymous said...

thanks a lot for this nice presentation.
this will help me a lot in my dental practice.

thanks
dr ali hossaint talukder
bangladesh

James Portelli said...

Did that extrusion cause any significant pain ? Whenever I extrude calcium hydroxide past the apex patients usually experience significant pain. Anyone had similar problems ? Is it necessary to wait 3 months for cases like this ? Isn't 1 month enough ?

nancyhsing said...

What kind of solution do you mixed with Ca(OH)2? Thanks!

Jason J. Hales D.D.S., M.S. said...

I used UltraCal from Ultradent. Easy to place, no mess.

It can also be placed as a powder, paste made with anesthetic, saline, water, or glycerine.

Jason J. Hales D.D.S., M.S. said...

James,

In this case, the patient had no symptoms. I have had patients have some discomfort, but that is a minority of the time. While I don't intentionally extrude the Ca(OH)2, I would rather completely fill the canal than have it short.

I don't think it's necessary to wait 3 months either. I usually wait 2-3 months because I expect to see more healing of the bone at that point.

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