Abstract
Aim: This study aimed to evaluate the pH, Ca2+ release, solubility, and antimicrobial activity of calcium hydroxide (Ca(OH)2) pastes in association with different substances. Methods: Sixty acrylic teeth (n=10) were filled with pastes that associated Ca(OH)2 with the following substances: benzalkonium chloride 5% (G1) and 50% (G2) both in propylene glycol, arnica glycolic extract (G3), green tea glycolic extract (G4), Calen/PMCC™ (G5), and Calen™ (G6). In the group G1 to G4 were used 1g of Ca(OH)2 powder with 0,8g of vehicle. pH and Ca2+ release was measured after 7, 15, and 30 days. For solubility, micro-CT was used immediately and at the periods of 7, 15, and 30 days. For the antimicrobial analysis, a biofilm of E. faecalis was induced in vitro on bovine dentin discs. Live/dead viability dye and confocal scanning microscopy were used. Results: The highest pH values occurred on the first 7 days, and the G6, G1, G3, and G5 presented the highest pH values at this period (P <0.05). Ca2+ release was higher in all groups at 7 days, with the highest values observed in G1, G5, and G6. The volume of all pastes showed no significant difference in the intragroup analysis at 7 and 15 days (P <0.05). G1 and G2 showed the highest antimicrobial action (P <0.05). For the biovolume, there was difference between the G6 and the other groups (P >0.05) with G1 presenting the lowest values. Conclusion: Benzalkonium chloride 5% increases the antimicrobial action of the Ca(OH2), without impairs physicochemical properties.
Highlights
The aim of endodontic treatment of teeth with apical periodontitis is to eliminate microorganisms from the root canal system[1]
Different substances with phytotherapeutic and antiseptic properties were associated with the Ca(OH)[2] paste to evaluate their effects against E. faecalis biofilms
The results obtained with regard to pH, after 7 days, reinforce that the association with viscous vehicles, such as propylene glycol, is related to a greater diffusion of hydroxyl and calcium ions through dentinal tubules, and the penetration into the bacterial cell membrane[16,17,18]
Summary
The aim of endodontic treatment of teeth with apical periodontitis is to eliminate microorganisms from the root canal system[1]. Root canal preparation, due to its anatomical complexity, is not totally effective in complete disinfection, requiring the use of intracanal dressing[2]. Calcium hydroxide (Ca(OH)2) paste has been the most widely used intracanal medication for this purpose[3]. Its mechanism of action involves the dissociation in calcium (Ca2+) and hydroxyl (OH-) ions, showing biological properties such as antimicrobial activity, tissue dissolution capacity and inhibition of osteoclast activity[4,5]. The association of Ca(OH)[2] with inert vehicles has demonstrated limited antimicrobial effectiveness, especially against Enterococcus Faecalis[3]. The association with antiseptic substances to potentiate the antimicrobial activity of the paste has been recommended[6]
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