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Abstract
OBJECTIVE: External inflammatory root resorption (EIRR) may occur after trauma due to root damage and pulpal infection, resulting in hard tissue loss. Standard treatment involves root canal therapy using calcium hydroxide (CH) as an intracanal medicament to elevate pH in peripheral dentin. The high pH can arrest the root resorption process and promote hard tissue formation. This study compared the effectiveness of CH and a new bioceramic intracanal medicament in raising and maintaining pH in a simulated EIRR model.
MATERIALS AND METHODS: Fifty-four extracted human teeth were decoronated to a standard length and grouped by similar dentin thickness using Cone Beam Computed Tomography (CBCT). The teeth were divided into three groups (n=18/group). Following root canal preparation with a standardized protocol, external root surface defects were created with a #6 round bur, and the canals were filled according to their respective group: saline (control), CH (Ultracal XS), and bioceramic (EndoSequence BC Temp). pH levels at the defect site were measured after 5 hours (0.2 days), 1, 7, 14, 21, 28, 49, and 84 days. Data were analyzed using ANOVA and Tukey’s test (P<0.05).
RESULTS: The pH of simulated external root surface defects of teeth filled with CH tended to rise, peaking at day 7, after which it gradually decreased over time. The pH of saline and bioceramic significantly decreased over time (P<0.001). At the 5-hour and 1-day time points, both CH and bioceramic treated teeth had higher pH than teeth filled with saline (P<0.001), but there was no significant difference among CH and bioceramic groups. After 7, 14, 21, 28, 49, and 84 days, CH treated teeth had higher pHs than teeth treated with bioceramic (P<0.05), but there was no significant difference between saline and bioceramic groups.
CONCLUSIONS: Time-dependent pH changes occurred both within and between the experimental and control groups. Compared to bioceramic and saline, calcium hydroxide was the most effective in maintaining a basic pH over time.
