Ca(OH)2 removal

Wheaton cosmetic dentist Bryan Bauer

Ca(OH)2 removal in endodontics

Ca(OH)2 removal depends on several factors including type of CaOH2 that one uses, file systems, and solutions. Root canal therapy still relies on Ca(OH)2 for case so this topic is of importance.

CaOH2 we use that we later remove in root canal teeth.
Ca(OH)2 paste for endodontics

Ca(OH)2 removal of oil or water Ca(OH)2

Important distinction is if water based or oil based.  Water based can be removed easily with PUI, oil based is tougher.

Oil-based Calcium Hydroxide Paste.
(But actually it is classified as Iodoform oil based paste)

  1. Diapex in Canada is same formula as Vitapex.
  2. Metapex
  3. Wellpex
  4. Forendo, etc..

After mechanically removing as much as possible citric acid is the method of choice in removing the remainder of calcium hydroxide on the walls.

Ca(OH)2 removal research

PUI = passive ultrasonic irrigation = ESI, Irri-safe, ss #15 k file in ultrasonic for 1 minute 1 mm short length
CUI = continuous ultrasonic irrigation = irrigant continually replenished = VPro StreamClean System 30g = ProUltra PiezoFlow .5mm
Negative apical pressure NAP= Endovac and VPro Endosafe
*Modified negative apical pressure = Used for canals with isthmus solution in one endovac in other
Sonic irrigation = Endoactivator
SNI = standard needle irrigation
LAI = laser activated irrigation
PIPS=photon-induced photoacoustic streaming

Ca(OH)2 removal studies

Finising file and PUI>SNI but nothing got it all. Neelakantan AGD 2017

Systemic review UI>SNI and NAP.  Unclear about Sonic irrigation.  Yaylali JOE 2015 Oct

1% PAA beat EDTA/NaOCl in apical portion only rest about same

10% citric acid beat EDTA for oil based

PUI beats SNI

SI>CUI=NAP in every third of canal JOE 2015 Alturaiki