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Choice of common calcium hydroxide preparations for various clinical scenarios based on calcium ion release and pH changes
Saba Waqar Quresh
Statement of the Problem: Calcium hydroxide is available in many forms and compositions for dentistry, often making it difficult for the clinician to make the correct choice in a clinical scenario. There was a need to outline a scientific comparison of the available forms in terms of effectiveness. Calcium ion elution and pH changes have been proved to be the basis for the benefits of calcium hydroxide in dentistry. The objective herein was to outline the best clinical applications of each of four different commercially available calcium hydroxide preparations by quantifying pH variation and Ca2+ release patterns of each.
Methodology & Theoretical Orientation: Samples of four preparations, including a light cure paste, LC; a two-paste system, TP; a methylcellulose-based cavity liner, CL; and a generic preparation, CP were immersed in deionized water. Using a pH/ISE meter, Ca2+ release was monitored every thirty minutes for two hours; whereas both parameters were recorded daily for 15 days, and by 1st, 3rd and 6th month. Data was analyzed using two-way ANOVA (SPSS v. 22).
Findings: CL showed the highest pH (13.1); LC, the lowest (9.6). As for calcium release, CP exhibited the highest initial Ca2+ burst (1.94 X 10-2 ppm after 120 min); LC, the lowest (6.8 X 10-4 ppm after 120 min); whereas LC and TP continued to release Ca2+ even after 6 months. Difference between the groups was significant (p<0.05).
Conclusion & Significance: This study signifies that calcium hydroxide formulations may be categorized as to those which should be used initially and those for long-term management. Formulations similar to CP and CL may be used in situations requiring high alkalinity for immediate infection inhibition, whereas those similar to TP and LC for long-term Ca2 release is required, for example, long- term management of perforated root canal, where they can cause mineralization.