Inter-appointment Medication with Calcium Hydroxide in Routine Cases of Root Canal Therapy

  • Gunnar BergenholtzEmail author
  • Calvin Torneck
  • Anil Kishen
Part of the Springer Series on Biofilms book series (BIOFILMS, volume 9)


This chapter discusses the use of an inter-appointment application of calcium hydroxide in the endodontic treatment of teeth with apical periodontitis, from a historic and evidence-based perspective. Despite a long history of clinical use and the publication of numerous in vitro, in vivo, and treatment outcome studies, strong scientific evidence in support of its use in this capacity is still not available. Today’s “best scientific evidence” is based primarily on a just a small number of studies that by today’s standard are not considered “strong.” However, given that elimination of bacteria from the root canal before placement of a root canal filling appears to enhance the treatment outcome, inter-appointment placement of calcium hydroxide could be an easy and appropriate way of promoting it. Any perceived advantage of its use, however, must be balanced by the risk of altering the physical properties of the root dentin due to its caustic action, particularly when it is present in the root canal for a long period of time. While clinical confirmation of an increased risk of root fracture in calcium hydroxide-treated fully developed teeth is still not verifiable, prudence dictates that caution should be exercised when calcium hydroxide is used in this manner in permanent teeth that are not completely developed.


Root Canal Cone Beam Compute Tomography Calcium Hydroxide Mineral Trioxide Aggregate Dentinal Tubule 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Gunnar Bergenholtz
    • 1
    Email author
  • Calvin Torneck
    • 2
  • Anil Kishen
    • 2
  1. 1.Department of Endodontics, The Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
  2. 2.Department of EndodonticsUniversity of TorontoTorontoCanada

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