(PR12) Calcium Hydroxide Application Methods: A Systematic Review

Introduction: Calcium hydroxide (Ca(OH)2) is widely used in endodontics as an intracanal medicament to provide antimicrobial activity or as a physical barrier. Calcium hydroxide exerts its mechanism of action through the release of hydroxyl ions, which are highly oxidant free radicals and result in damage to the bacterial cytoplasmic membrane, damage to bacterial DNA, and bacterial protein denaturation. Several methods have been described in the literature for intracanal placement. The objective of this systematic review is to synthesize the available literature on calcium hydroxide placement techniques used for successful intracanal delivery. Materials and Methodology: This systematic review was conducted per the PRISMA (Preferred Reporting Items for Systematic Review and Meta‐analyses) guidelines. We searched PubMed, Web of Science, and the Cochrane Library for experimental and observational studies on calcium hydroxide placement using a standardized search strategy and extracted relevant articles using our predefined inclusion and exclusion criteria.

Results: The initial search strategy yielded 457 results. After eliminating duplicates and applying our criteria, 13 relevant articles were included and 8 methods were identified. The lentulo spiral method for calcium hydroxide delivery appears to be effective and safe, however K-files tend to be the safest. Nanoparticles combined with Ca(OH)2 show potential to increase penetration in dentinal tubules. Canal size and preparation can significantly affect calcium hydroxide delivery.

Conclusion: Calcium hydroxide presents many benefits as an intracanal medicament. However, proper application and care must be employed to implement it safely and effectively in endodontic practice.