The effect of retreatment procedure on the pH changes at the surface of root dentin using two different calcium hydroxide pastes

J Conserv Dent. 2012 Oct;15(4):346-50. doi: 10.4103/0972-0707.101899.

Abstract

Aim: To compare pH changes at the cervical, middle and apical surfaces of root dentin in retreated and non- retreated teeth, after canal obturation with two different calcium hydroxide pastes.

Materials and methods: After instrumentation of 55 extracted teeth, three cavities with 0.75 mm depth and 1.5 mm in diameter were drilled at buccal root surface. The teeth were randomly divided into five groups. Canals in the first two groups were filled with either mixture of calcium hydroxide and saline solution and calcium hydroxide and 2% chlorhexidine (CHX). In the third and fourth groups canals were first obturated with gutta-percha and AH26 sealer, and then materials were removed. After 2 days canals were filled with two different calcium hydroxide pastes similar to the first and the second groups. The pH was measured in the prepared cavities at 1, 3, 7 and 14 days.

Results: In the non-retreated groups, pH at the surface of the roots was significantly higher in comparison to the retreated ones (P value < 0.001). pH values were significantly higher in the non-retreated teeth filling with calcium hydroxide and saline solution (P value < 0.001).

Conclusion: Regarding to the little pH changes at the surface of dentin in retreated teeth, the hydroxyl ions cannot penetrate into the dentinal tubules. Thus, to achieve higher pH at the root surface in retreated teeth, it is clinically advisable to remove more dentin from the inner walls and to use normal saline as a vehicle for calcium hydroxide rather than acidic pH materials.

Keywords: Calcium hydroxide; pH; retreatment; root dentin.