SP-6 Calcium Hydroxide Controversies in Apexification

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CE Hours: 0.75

Description: Calcium hydroxide has a long history of applications in endodontics and dental traumatology.  The material has strong disinfectant and osseo-inductive properties. With regard to dental traumatology, the use of calcium hydroxide has applications in vital pulp therapy of complicated crown fractures, pulp necrosis following trauma, avulsions with extended dry time, apexification, MTA barrier techniques and regenerative endodontics.  However, the use of calcium hydroxide in apexification has become controversial.   Cvek identified a high incidence of transverse root fractures for immature teeth treated with long-term calcium hydroxide dressings. In vitro studies have reported calcium hydroxide has decreased the fracture strength of root dentine over time. However, this finding is also controversial with inconsistent and conflicting observations reported. Calcium hydroxide has been used for 50 years and now some authors and organizations advocate for the use of MTA barrier techniques rather than calcium hydroxide.  The purpose of this presentation is to discuss the science around calcium hydroxide, its use of and concerns with calcium hydroxide in dental traumatology.

Learning Objectives:  

  • Critically appraise the calcium hydroxide literature.
  • Follow fracture mechanics principles of root fracture mechanics.
  • Appraise the different approaches to treat immature permanent teeth with pulp necrosis and infection.
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