Restor Dent Endod.  2017 Nov;42(4):290-300. 10.5395/rde.2017.42.4.290.

Removal efficacy and cytotoxicity of a calcium hydroxide paste using N-2-methyl-pyrrolidone as a vehicle

• Lim MJ
• Jang HJ
• Yu MK
• Lee KW
• Min KS

• KMID: 2403070
• DOI: http://doi.org/10.5395/rde.2017.42.4.290

Abstract

OBJECTIVES
This study investigated the removal efficacy and cytotoxicity of a newly developed calcium hydroxide paste (cleaniCal, Maruchi) using N-2-methyl-pyrrolidone (NMP) as a vehicle in comparison with ApexCal (Ivoclar Vivadent) and Calcipex II (Nishika), which use different vehicles such as polyethylene glycol and propylene glycol, respectively.
MATERIALS AND METHODS
Thirty maxillary premolars with oval-shaped canals were divided into 3 groups and the teeth were filled with one of the pastes. After removal of the paste, micro-computed tomographic (μ-CT) imaging was obtained to assess the volume of residual paste in the root canal of each tooth. The teeth were then split longitudinally and the area of the paste-coated surface was evaluated by stereomicroscopy. The cytotoxicity of each product was assessed using an agar overlay assay. The effect of each vehicle on cell viability was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The data were analyzed using one-way analysis of variance and Tukey's tests to detect any significance (p < 0.05).
RESULTS
In the μ-CT and stereomicroscopic analysis, cleaniCal exhibited less remnants of medicament than ApexCal and Calcipex. cleaniCal showed a higher cytotoxicity than the other pastes in the agar overlay assay. Furthermore, NMP exhibited lower cell viability compared to the other vehicles.
CONCLUSIONS
cleaniCal showed better removal efficacy compared to the other products. However, clinicians should be aware of the higher cytotoxicity of the NMP-based material and consider its possible adverse effects on periradicular tissue when it is overfilled.

Keyword

Calcium hydroxide; Cytotoxicity; N-methylpyrrolidone; Removal

MeSH Terms

Agar
Bicuspid
Calcium Hydroxide*
Calcium*
Cell Survival
Dental Pulp Cavity
Ointments
Polyethylene Glycols
Propylene Glycol
Tooth
Agar
Calcium
Calcium Hydroxide
Ointments
Polyethylene Glycols
Propylene Glycol

Figure

• 

  Figure 1 (A) Representative micro-computed tomographic (μ-CT) images show the radiopaque remnants of each material. (B) A stereomicroscopic image shows the coated surface (indicated as the green area) with the remaining material in a split root canal system.

• 

  Figure 2 Removal efficacy and radiopacity of the tested materials. Mean percentage and standard deviation of the remaining volume (A) and remaining area (B) of the remnants in micro-computed tomographic (μ-CT) and stereomicroscopic assessments, respectively. *A significant difference was determined at p < 0.05. CL, cleaniCal; AC, ApexCal; CP, Calcipex II.

• 

  Figure 3 (A) A radiograph showing the radiopacity of each material and its equivalence to that of the aluminum step wedge. (B) Relative radiographic density of each material in comparison with that of a 10-step aluminum step wedge. (C) An image showing the turbidity of the suspension in which the pastes were dissolved. Note that white precipitate formed after sedimentation. *A significant difference was determined at p < 0.05. CL, cleaniCal; AC, ApexCal; CP, Calcipex II.

• 

  Figure 4 (A) A representative image showing the inhibition zone of each material in the agar overlay assay. (B) Mean and standard deviation of the inhibition zone of each material. (C) Cell viability of the vehicle for each product. *A significant difference was determined at p < 0.05. CON, control; CL, cleaniCal; AC, ApexCal; CP, Calcipex II; NMP, N-2-methyl-pyrrolidone; PEG, polyethylene glycol; PG, propylene glycol.

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