UltraCal XS Research Articles

Effectiveness of Artocarpus lakoocha extract, poloxamer 407, on Enterococcus faecalis in vitro

The antiviral activities of Artocarpus lakoocha (A.lakoocha) extract have been reported in a number of studies; however, data regarding its antibacterial capability are limited. The aim of the present study was to examine the effectiveness of A.lakoocha extract, poloxamer 407, on Enterococcus faecalis (E.faecalis). The effect of the antimicrobial activity of A.lakoocha extract and A.lakoocha extract, poloxamer 407, against E.faecalis was investigated. The antibacterial efficacy of A.lakoocha extract, poloxamer 407, against E.faecalis was compared to calcium hydroxide in a tooth model. The minimal inhibitory concentration and minimal bactericidal concentration (MBC) of A.lakoocha extract against E.faecalis were 0.39±0mg/mL and 3.12±0mg/mL, respectively; the MBC of calcium hydroxide against E.faecalis was 31.25±0mg/mL. In the tooth model, the E.faecalis count in all groups significantly decreased as the depth into the dentin increased compared to the control. There were no significant differences between 4% A.lakoocha extract poloxamer and UltraCal XS at any time period (P>0.05) with one exception: at a depth of 0.6mm on day 5, UltraCal XS had a significantly greater colonization than 4% A.lakoocha extract poloxamer. A.lakoocha extract, poloxamer 407, might be a useful alternative for antimicrobial medication in endodontic treatment. However, controlled clinical studies to evaluate its efficacy are needed.

Biocompatibility of Intracanal Medications Based on Calcium Hydroxide

Objective. The aim of this study was to evaluate the rat subcutaneous tissue reaction to calcium hydroxide-based intracanal medicaments, UltraCal XS (calcium hydroxide, barium sulphate, aqueous matrix), Hydropast (calcium hydroxide, barium sulphate, and propyleneglycol), and Calen (Calcium hydroxide, zinc oxide, colophony, and polyethyleneglycol), used as a control. Methods. Forty-eight rats (Rattus Norvegicus Holtzman) were distributed in three groups: Calen, UltraCal XS, and Hydropast. Polyethylene tubes filled with one of the medicaments were implanted in the dorsal subcutaneous. After 7 and 30 days, the implants were removed and the specimens were fixed and embedded in paraffin. Morphological and quantitative analyses were carried out in the HE-stained sections. The numerical density of inflammatory cells in the capsule was evaluated and statistical analyses were performed (P ≤ 0.05). Results. At 7 days, all materials induced an inflammatory reaction in the subcutaneous tissue adjacent to the implants. In all groups, a significant reduction in the number of inflammatory cells and giant cells was verified in the period of 30 days. Conclusion. These results indicate that the calcium hydroxide-based medicaments evaluated present biocompatibility similar to Calen.

Tooth discoloration induced by endodontic materials: a laboratory study

To investigate the discoloration potential of endodontic materials using a bovine tooth model. Two hundred and 10 dentine-enamel cuboid blocks (10 × 10 × 3.5 mm) were prepared out of the middle thirds of bovine tooth crowns. Standardized cavities were prepared in the walls of the pulp chamber leaving 2 mm of enamel and dentine on the labial wall of the crown. The specimens were randomly assigned to 14 groups (n = 15). Endodontic materials were placed into the cavities as follows: group A: empty, group B: blood, group C: calcium hydroxide, group D: ApexCal, group E: Ultracal XS, group F: Ledermix, group G: triple antibiotic paste (3Mix), group H: grey MTA(GMTA), group I: GMTA + blood, group J: white MTA (WMTA), group K: WMTA + blood, group L: Portland cement (PC), group M: PC + blood and group N: AH Plus. The cavities were sealed with composite and stored in water. Standardized colour measurement (VITA Easyshade compact) was performed at the following intervals: prior to (T0) and after placement of the filling (T1), 1 week (T2), 1 month (T3), 3 months (T4), 6 months (T5) and after 1 year (T6). Colour change (ΔE) values were calculated. A two-way analysis of variance was used to assess significant differences between the endodontic materials. The mean values of all groups were compared using the Tukey multiple comparison test (α = 0.05). Significant differences were detected amongst the experimental groups after 12 months (P < 0.0001). The lowest colour change values were observed in the groups N (AH Plus, 3.2 ± 1.5), A (empty, 3.8 ± 1.4), L (PC, 4.1 ± 1.7), C (calcium hydroxide, 4.7 ± 1.5), E (Ultracal XS, 5.1 ± 1.9) and J (WMTA, 7.9 ± 6.7). The most discoloration was measured in groups G (3Mix, 66.2 ± 9.9) and F (Ledermix, 46.2 ± 11.6). PC showed the best colour stability amongst the Portland cement-based materials; however, when contaminated with blood (group M), a significantly higher ΔE value (13.6 ± 4.2) was detected (P = 0.032). Materials used in endodontics may stain teeth. Therefore, the choice of material should not rely solely on biological and functional criteria, but also take aesthetic considerations into account.

Periodontal healing following avulsion and replantation of teeth: a multi‐centre randomized controlled trial to compare two root canal medicaments

Non-setting calcium hydroxide (Ultracal XS(®) ) is recommended by the International Association of Dental Traumatology as the initial medicament following avulsion and replantation for mature teeth. There is experimental evidence to suggest Ledermix(®) , placed as an alternative inter-visit dressing may improve periodontal healing. This study investigated, using a multi-centre randomized controlled trial, the effect of two root canal medicaments, Ledermix(®) and Ultracal XS(®) , on periodontal healing of avulsed and replanted teeth. Children were recruited if they fulfilled all inclusion criteria. Treatment followed a standardized protocol. Assessment of periodontal healing or ankylosis was made clinically and radiographically by an experienced, 'blinded', clinician at 12months. Over 200 patients were assessed for eligibility at five centres. Twenty-nine patients were eligible for inclusion. Final analysis involved 22 patients with 27 teeth. Ankylosis was detected in four of the 12 teeth in the Ledermix(®) group and nine of 15 in the Ultracal XS(®) group. No significant difference between medicaments was found in the proportion of teeth or patients showing periodontal healing. There was no significant difference in periodontal healing between the two medicaments at either a tooth or patient level. The numbers recruited fell short of an estimated power calculation. For patients meeting the inclusion criteria and completing the trial, periodontal healing was seen in 52% of teeth at the 12-month assessment between both groups. The only factor found to significantly influence the periodontal outcome was dry time.

Discoloration of Teeth after Avulsion and Replantation: Results from a Multicenter Randomized Controlled Trial

Introduction There is evidence to suggest that Ledermix, placed as an intervisit root canal dressing, might improve periodontal healing after replantation of avulsed teeth. As a part of a multicenter randomized controlled trial, we aimed to compare the effect of 2 root canal medicaments, Ledermix and Ultracal XS, on the discoloration of replanted teeth. Methods Discoloration was investigated by using 3 methods: patient satisfaction with the color of replanted teeth, clinical photographs taken at baseline and 12-month reviews, and estimation of color change by using CIELAB scores for baseline and 12-month photographs. Results Twenty-two patients (27 teeth) were recruited. Ten patients (12 teeth) were randomized to the Ledermix group and 12 patients (15 teeth) to the Ultracal XS group. At 12 months, 8 patients were concerned with the discoloration of their teeth. Seven came from the Ledermix group and 1 from the Ultracal XS group. This difference was significant (Fisher exact test, P = .009). Standardized photographs were taken for the patients recruited at one center only (17 patients). There was significant discoloration of teeth from baseline with Ledermix, causing a darkening and gray-brown discoloration (mean change from baseline to 12 months, L∗ = –5.1, a∗ = 0.3, b∗ = –1.2, and ΔE = 8.1) and Ultracal XS, causing a yellowing and lightening of teeth (L∗ = 1.9, a∗ = 0.3, b∗ = 3.3, and ΔE = 5.4). There was a significant difference for the L∗ and b∗ variables (independent t test) between the 2 groups. Conclusions Both root canal medicaments cause discoloration, with Ledermix proving less acceptable to patients.

Effects of Intracanal Mineral Trioxide Aggregate and Calcium Hydroxide During Four Weeks on pH Changes in Simulated Root Surface Resorption Defects: An In Vitro Study Using Matched Pairs of Human Teeth

Introduction Diffusion of hydroxyl ions from intracanal calcium hydroxide (CH) through dentin is used to arrest external inflammatory root resorption. However, long-term and short-term CH placement has been associated with an increased risk of root fracture. Intracanal mineral trioxide aggregate (MTA) might provide an alternative to CH as a source of hydroxyl ions. This in vitro study compared the effects of intracanal MTA and CH on hydroxyl ion diffusion through dentin by measuring pH changes over time in simulated root surface resorption defects prepared in matched pairs of teeth; the null hypothesis tested was that there is no difference. Methods Root surface cavities were prepared 5 mm from the apex in extracted human permanent anterior teeth (21 matched pairs) and 7 additional teeth (controls). Root canals were instrumented to size 50/.04 and filled with either tooth-colored MTA (ProRoot) or CH (UltraCal XS); control teeth were filled with saline. The pH in root surface cavities was measured at 3 hours, 24 hours, 1 week, 2 weeks, 3 weeks, and 4 weeks. Results In controls, pH readings did not differ significantly during the 4 weeks ( P > .05, repeated-measures analysis of variance [ANOVA]). For the experimental intragroup effects, significant pH changes occurred over time in the MTA group ( P = .005, repeated-measures ANOVA) and the CH group ( P < .0001). For the experimental intergroup effects, the overall mean pH was higher in the MTA group (8.66; standard error [SE], 0.07) compared with the CH group (8.46; SE, 0.07) ( P = .014, paired t test). At 4 weeks pH was higher in the MTA group (8.30; SE, 0.16) compared with the CH group (7.90; SE, 0.11) ( P = .011); at all other time points intergroup differences were insignificant. The null hypothesis was rejected. Conclusions Intracanal MTA and CH groups differed in their overall effect on pH measured in simulated root surface resorption defects. At 4 weeks intracanal placement of MTA compared with CH resulted in a small but significantly higher pH.

An Agar Diffusion Comparison of the Antimicrobial Effect of Calcium Hydroxide at Five Different Concentrations with Three Different Vehicles

The purpose of this study was to determine if varying the percent (by weight) of aqueous calcium hydroxide or using different vehicles had an effect on its antibacterial efficacy against common endodontic pathogens in a pour plate/traditional streak agar diffusion model. Mixtures of calcium hydroxide powder and sterile saline in 40, 50 and 60 percent concentrations and the commercial preparations UltraCal XS and Vitapex were tested against six known endodontic pathogens with an agar diffusion method. Each medicament was placed in one of five wells, in each of 10 agar plates (n = 10), for cultures of each bacterial species. Zones of inhibition were measured after 48 hours incubation for aerobes and 96 hours incubation for anaerobes. Multiple one-way analyses of variance and post-hoc Student Neuman Keuls evaluated the data at α = 0.05. Larger zones of inhibition were consistently observed for higher concentrations of calcium hydroxide with statistical significance among the bacteria, particularly between 40% and 60%. Vitapex had significantly smaller zones of inhibition than all other medicaments and 35% Ultracal XS with methylcellulose was nearly as effective as 50% Ca(OH) 2 in inhibitory activity. Formulations containing 50–60% Ca(OH) 2 or 35% Ca(OH) 2 with aqueous methylcellulose are recommended as endodontic interappointment medicaments.

An in vitro study of the pH of three calcium hydroxide dressing materials

Calcium hydroxide is widely used as a root canal dressing material because of its favorable alkalinizing effect. It has been suggested that the action comes from diffusion of hydroxyl ions through the apical foramen. The purpose of this in vitro study was to test the pH changes that occurred over a period of 30 days using a mixture of calcium hydroxide and distilled water and two commercial calcium hydroxide products in a simulated periapical environment. The materials were inserted in glass tubes closed at one end, which were placed in individual vials containing distilled water at a pH 7.4. Unfilled glass tubes were used as controls. Alkalinity changes of the medium were measured at 1 and 24 h and 15 and 30 days. The alkalinizing properties of all materials showed a rapid increase at 1 and 24 h followed by a continuous but more gradual increase from 15 to 30 days. The control tubes did not cause a change in pH of the medium, which remained at pH 7.4. At the end of the observation period, the alkalinizing properties of Calasept and Ultracal XS were significantly higher (P < 0.05) than the calcium hydroxide/distilled water paste.