2010 Volume 53 Issue 3 Pages 330-338
The purpose of this study was to evaluate the clinical healing effects of the calcium hydroxide preparation "Calvital®" on refractory apical periodontitis. Refractory apical periodontitis cases can be divided into apical periodontitis associated with procedural accidents and true apical periodontitis caused by a bacterial biofilm. In this study, we describe interesting results obtained when using the calcium hydroxide preparation "Calvital®" for root canal treatment in patients diagnosed with refractory apical periodontitis. A total of 100 patients diagnosed with refractory apical periodontitis by local dentists were referred to the General Dentistry Department of Tokyo Dental College, Suidobashi Hospital. In these patients, Calvital® was applied for root canal treatment at 1-month intervals starting at week 2 and the course was observed. Symptoms disappeared in 91 of the 100 subjects, while the symptoms were alleviated but did not disappear in 9 patients. Of these, 3 patients underwent surgical treatment, and 6 patients were diagnosed with neurogenic pain. The symptoms disappeared or were alleviated in 91% of patients. The action of calcium hydroxide seemed to be effective for healing the wound and bacterial biofilm on the outside of the root apex. A change in the root canal environment by long-term application of a potent alkaline agent in patients with true refractory disease could be responsible for the observed pharmacological effects. From these findings, it is suggested that the application of Calvital® in patients with refractory apical periodontitis is useful in refractory root canal treatment.
