Pulp capping calcium hydroxide

As well as being used for direct and indirect pulp capping, calcium hydroxide materials are recommended for nse in deep cavities. This is similar to their use in indirect pulp capping, but implies that all of the carious dentine has been removed, leaving behind a thin layer of sonnd caries-free dentine. Even in this circumstance, the high alkalinity of calcinm hydroxide materials is able to stimulate further dentine formation [41,43,44]. Their application where remaining sonnd dentine is thin will ensure that it does not remain thin. Instead, it will thicken in sitn nnder the influence of the calcium hydroxide to form an improved layer of dentine that is better able to protect the pulp from diffusion of monomers from repair materials or from the effects of bacterial penetration. This process takes time, with typically approximately 2 months time being need to form 0.1 mm of reparative dentine. 

Visible light activated resin compositions containing calcium hydroxide have been made available as cavity lining materials (99) for pulp capping and pulpotomy, and may offer in other appHcations an alternative to the calcium sahcylate type cements. 

Pastes of calcium hydroxide with water have been used as pulp-capping materials for many years and it is the material of choice for this application (Granath, 1982). Its favourable tissue responses have been known for many years (Zander, 1939). It has a healing effect, for it induces the formation of hard tissues of reparative dentine when pulp has been exposed (Eidelman, Finn Koulourides, 1965). This action seems to be associated with its high alkalinity (pH 12-5) and consequent bactericidal and proteinlysing effect (Fisher, 1977). 

U. Schroder, Effects of calcium hydroxide-containing pulp-capping agents on pulp cell migration, prohferation, and differentiation, J. Dent Res. 64 (1985) 541-548. 

T.R. Pitt Eord, G.J. Roberts, Immediate and delayed direet pulp capping with the use of a new visible hght cured calcium hydroxide preparation. Oral Surg. Oral Med. Oral Pathol. 71 (1991)338-342. 

Calcium hydroxide materials of various kinds are used to cap pulps, both exposed and when still covered by a thin layer of dentine. In carrying out this procedure, it is important that the exposed tissue should be cleaned thoroughly and any bleeding arrested by irrigation with sterile saline [41]. The calcium hydroxide should be placed gently straight onto the pulp, with care being taken to ensure that there is no blood or debris in the way [34]. 

A.H. Schuurs, R.J. Gruythuysen, P.R. Wesselink, Pulp capping with adhesive resin-based composite vs calcium hydroxide a review. Ended. Dent. Traumatol. 16 (2000) 240-250. J. Ward, Vital pulp therapy in cariously exposed permanent teeth and its limitations, Aust. Endod. J. 28 (2002) 29-37. 

J. Mente, B. Geletneky, M. Ohle, M.J. Koch, P.G.F. Ding, D. Wolff, J. Dreyhaupt, N. Martin, H.J. Staehle, T. Pfefferle, Mineral trioxide aggregate or calcium hydroxide direct pulp capping an analysis of the chnical treatment outcome, J. Endod. 36 (2010)... 

M. Aeinehchi, B. Eslami, M. Ghanbariha, A.S. Saffar, Mineral tiioxide aggregate (MTA) and calcium hydroxide as pulp-capping agents in human teeth a preliminary report, Int. Endod. J. 36 (2003) 225-231. 

As described in Chapter 9, the main use of calcium hydroxide is as a pulp capping material. It is also used as a medicament for intra-canal treatment and in some apexification procedures [30], In addition, following pioneering studies in the late 1970s [31], it has also become used as the main active component of a group of proprietary root canal sealers. 

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