CALCIUM HYDROXIDE CEMENT

Herman (1930) introduced calcium hydroxide for pulp capping.

1. Two paste system containing base

1. Light cured system Two paste system
2. Single paste in syringe form

1. Powder form

• Glycol salicylate; 40% – reacts with Ca (OH)2 and ZnO
• Calcium sulphate
• Titanium dioxide – inert fillers, pigments
• Calcium tungstate or barium sulphate – provides radiopacity

• Calcium hydroxide 50% – principle reactive ingredient
• Zinc oxide – 10%
• Zinc stearate; – 0.5% – accelerator
• Ethylene toluene
• Sulfonamide – 39.5% – oily compound, acts as carrier

Calcium hydroxide cements have poor mechanical properties.

• The solubility in water is high (0.4 – 7.8%).

Light activated calcium hydroxide cement

Calcium hydroxide root canal sealing pastes

• Effective antibacterial property without irritation

USES OF CALCIUM HYDROXIDE:-

• Direct and indirect pulp capping.
• Apexification and apexogenesis.
• An intracanal medicament.
• Treatment of avulsed teeth.
• Treating root fractures.
• Treatment of perforations.
• Treatment of intraoral external resorption.
• Root canal filling material for primary molars.

• No tenderness to percussion.
• No abnormal mobility.

• History of spontaneous pain.
• Tenderness to percussion.
• Abnormal mobility.
• Root resorption.

• After drying the cavity calcium hydroxide is placed.
• The cavity is sealed with an interim restoration

• Small pulp exposure produced during cavity

• Large pulp exposure.
• In teeth with history of spontaneous pain.
• Rubber dam application keeps the pulp free from contamination
• Complete caries should be excavated
• The exposure site is dried and calcium hydroxide is placed over the exposure.
• The tooth is restored with on interim restoration
• Preservation of vitality of the radicular pulp
• Relief of pain in patients with acute pulpalgia
• Vital tooth with healthy periodontium
• A restorable tooth
• Absence of spontaneous pain
• Atleaast 2/3 of root length should be present
• Irreversible pulpitis
• Swelling
• Presence of fistula
• External root resorption
• Internal root resorption
• Periapical abscess
• Presence of pulp calcification
• Rubber dam is applied
• Access is gained into the pulp chamber
• The coronal portion of pulp is removed with a sharp spoon excavator
• Calcium hydroxide paste is applied to the pulp stump.
• A zinc phosphate cement base is applied

Calcium hydroxide pulpotomy outcomes in primary teeth

• Calcium hydroxide pulpotomies in primary teeth only a 31% success.
• Administration of local anesthesia
• Dry the canal with absorbent points-
• Recall every six weeks.
• Usually the calcium hydroxide dressing is changed every 2-3 months.
• Calcium hydroxide + methylcellulose
• Calcium hydroxide + sterile water
• Calcium hydroxide + CMCP
• Calcium hydroxide + cresatin
• Calcium hydroxide in RCT:-

  Calcium hydroxide as a cavity liner

  Calcium hydroxide as a base-