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Viruses in sewage: effect of phosphate removal with calcium hydroxide (lime).

During calcium hydroxide (lime) treatment (pH 9.6 to 10.5) of wastewaters for phosphate removal there was also a two-log removal of added poliovirus (type I, Sabin) from effluents. A similar virus reduction was seen in the sludge generated in these experiments. However, in view of the limitations of techniques for virus recovery from sludge, only a small portion of the infectious virus present in lime sludge may have been detected. Storage of lime sludge at 28 degrees C for up to 48 h produced no appreciable reduction in the virus titre. Five sets of field samples of sewage, effluents, and sludge from a sewage treatment plant (Kemptville, Ont.) which utilizes lime for phosphate removal were also examined for indigenous viruses being BS-C-1 cells. All of the sample of lime sludge and 80% of the samples of both sewage and lime-treated effluent revealed virus; after chlorination only 20% of the lime-treated effluent samples were positive for virus. In contrast, in an earlier study with essentially the same experimental set up, 76% of the sample of chlorinated primary effluent were found to contain virus. Because of the easily detectable quantities of infectious virus in lime sludge and due to the lack of virus inactivation during storage of such sludge, caution must be exercised in its handling and disposal.

Antiviral Agents

Intracanal calcium hydroxide therapy--the Webber technique.

Calcium hydroxide powder has been used as a treatment medication for different pathologies of the teeth. This article describes the physiological effects and general principles involved in using calcium hydroxide. The indications for its use and the contraindications are described. Filling and refilling the root canal with calcium hydroxide using the Webber technique induces a calcified tissue barrier and stimulates osteogenic healing. A case report using the Webber technique is included.

Animals

Histopathologic evaluation of the effects of four calcium hydroxide liners on monkey pulps.

Pulpal response of four calcium hydroxide liners, MPC 10, MPC 12, Dycal and Pulpdent were tested on primary and permanent teeth with zinc oxide and eugenol (ZOE) and silicate as controls. Responses of the pulps were evaluatedi in Rhesus monkeys, utilizing Class V cavity preparations at 3 days, 5 and 8 weeks. An equivalent number of anterior and posterior teeth were studied for all compounds. The Ca(OH)2 liners, zinc oxide and eugenol (ZOE) and silicate controls were placed in 80 primary and 80 permanent teeth. Following perfusions the teeth were prepared utilizing routine histological procedures. The 3 day response of the calcium hydroxides was moderate with some disruption in the odontoblasts, vacuolization and mild inflammation underlying the cavity except Pulpdent which was more severe. At 5 weeks a decrease in inflammatory response and the formation of reparative dentin was similar for all calcium hydroxides tested at this time period. At 8 weeks more reparative dentin was noted with slight to moderate pulpal responses. At all time periods ZOE produced the least pulpal response while silicate produced the most severe response at 5 and 8 weeks. This study reports the biological responses of four calcium hydroxide compounds used as cavity liners in non-exposures in a series of primary and permanent teeth of monkeys using ZOE and silicate as controls. Responses to the four Ca(OH)2 compounds were moderate for all the experimental compounds except Pulpdent which was more severe at the early time period tested. ZOE produced a milder and silicate a severe response at all periods. All of these compounds were placed by random selection in anterior and posterior teeth of both arches and five teeth were evaluated in both primary and permanent teeth at 3 days, 5 and 8 weeks.

Animals

Reaction of the human dental pulp to silver amalgam restorations. The modifying effect of treatment with calcium hydroxide.

Cavities were prepared in 43 bicuspid teeth using two general categories of cavity depth. In the "deep" cavities the bottom was placed in the inner third of the dentin. In the "intermediate depth" cavities the bottom was positioned in the middle third of the dentin. The bottom of the cavities was either rubbed with calcium hydroxide, covered with calcium hydroxide, or left unlined before filling according to the wet amalgam technique. The teeth were extracted after 1 week and examined histologically. All cases, except 2 with deep and 1 with intermediate depth rubbed cavities, showed local vascular dilatation in the pulp underneath the cavity. In addition, all teeth with deep unlined cavities showed inflammatory cells as did 1 with an intermediate depth unlined cavity. There were fewer displaced odontoblast nuclei in the dentin in the calcium hydroxide-treated groups. The milder reactions in the rubbed or covered groups are probably due to the restrictive effect by calcium hydroxide on penetration of amalgam components. In the teeth with deep cavities there were only minor differences between the ones which had been rubbed and those which had been covered with calcium hydroxide.

Calcium Hydroxide

Calcium hydroxide and potassium nitrate as desensitizing agents for hypersensitive root surfaces.

The purpose of this investigation was to evaluate calcium hydroxide and potassium nitrate individually as densensitizing agents for hypersensitive root surfaces. The apparatus used in the experiment to measure hypersensitivity was (a) a thermo-electric stimulating device to measure hot and cold stimulation quantitatively and (b) a mechanical stimulating device to measure scratch stimulation quantitatively. The conclusions drawn from the study were: 1. Calcium hydroxide was more consistently effective in decreasing sensitivity then was potassium nitrate or the control. 2. Calcium hydroxide as compared to the control was statistically (99% level of significance) more effective in reducing sensitivity to mechanical, hot and cold stimulation immediately and at the conclusion of the experiment (3 months). 3. It appears that calcium hydroxide could be used as a desensitizing agent initially following periodontal surgery to reduce pain from hypersensitive roots in order that proper oral hygiene could be reestablished.

Adult

A 2-year follow-up of primary molars, pulpotomized with a gentle technique and capped with calcium hydroxide.

The prognosis for pulpotomy of primary molars with calcium hydroxide as wound dressing was evaluated clinically and radiographically. Thirty-three primary mandibular molars were amputated under the following conditions: (1) chronic coronal pulpitis, (2) the amputation was done with diamond instruments and a high-speed machine under aseptic conditions, and (3) application of calcium hydroxide in contact with the wound surface. After 1 year the treatment was regarded as successful for 22 of the teeth (67%); 11 teeth showed internal dentin resorption. After 2 years the frequency of success, allowing for drop-out, was 59%. Internal dentin resorption was seen in 14 root canals; in 10 of them within the first 6 months. A histologic study of nine root pulps with internal dentin resorption revealed an extra-pulpal blood clot on the wound surface in five.

Blood Coagulation

The clinical and histological evaluation of cresatin with calcium hydroxide on the human dental pulp.

Metacresylacetate with calcium hydroxide in a methylcellulose base produces clinically and radiographically successful pulpotomies, when performed on sound primary teeth. Under sterile conditions, with proper surgical and restorative technique, pulp tissue will heal with metacresylacetate with calcium hydroxide-methylcellulose. The dental pulp will form on osteodentin bridge and the pulp adjoining the bridge will remain histologically viable and free of inflammation. Methylcellulose with sterile distilled water does not produce as favorable a histological reaction as metacresylacetate with calcium hydroxide-methylcellulose. No dentinal bridging was in evidence and there were present in the radicular pulp varying degrees of inflammation.

Calcium Hydroxide

In vitro solubility of human pulp tissue in calcium hydroxide and sodium hypochlorite.

The tissue solvent capacity of a 2% stabilized sodium hypochlorite solution (Milton) and a commercial calcium hydroxide solution (Calasept) was examined under in vitro conditions where autolyzed human pulp fragments weighing approximately 0.0065 g were immersed in these solutions at 37 degrees C for periods of up to 10 days. It appeared that sodium hypochlorite was able to dissolve half the volume of pulp tissue within 1 h and the remaining tissue after 2-2 1/2 h. Calcium hydroxide dissolved half the pulp volume within 2 h, whereas it took 1 week for the remaining tissue to dissolve. These findings support the use of sodium hypochlorite as an irrigation solution during canal preparation and calcium hydroxide as a canal dressing for the purpose of creating a canal free of pulp remnants before root filling.

Calcium Hydroxide

Root canal treatment with calcium hydroxide. I. Effect of overfilling and refilling.

Root canals of dog premolar teeth were negotiated and overfilled with calcium hydroxide paste. After 30 days, half of the treated teeth were refilled up to the apical limit. Root canals not filled were considered as the control group. Ninety days after the first treatment, histologic analysis showed more favorable results in the refilled root canals. The overfilling elicits calcium hydroxide resorption and the ingrowth of periapical connective tissue into the root canal.

Animals

Prognosis of luxated non-vital maxillary incisors treated with calcium hydroxide and filled with gutta-percha. A retrospective clinical study.

A material of 885 luxated, non-vital incisors was evaluated radiographically with respect to healing of periodontal tissues including inflammatory root resorption and occurrence of ankylosis and cervical root fractures. The results were assessed after completion of calcium hydroxide treatment and 4 years after filling of the root canal with gutta-percha. After treatment with calcium hydroxide, periapical healing occurred in 95% of the teeth. Four years after filling with gutta-percha, periapical healing was present in 91% of the teeth. In the remaining teeth, recurrent or persistent periapical radiolucency was more frequent in overfilled than adequately filled teeth (P = 0.0001). There was no difference between immature and mature teeth. Inflammatory root resorption healed in 192 of 197 teeth (97%); in 5 teeth it developed into ankylosis. Ankylosis occurred in 13 teeth, all of which were intruded into the alveolar bone at the time of injury. The frequency of cervical root fractures was markedly higher in immature than mature teeth (P greater than 0.0001). Among immature teeth, the frequency of fractures was dependent on the stage of root development (chi 2 = 31.6) and ranged from 77% in teeth with the least to 28% in teeth with the most developed roots. The frequency of fractures was also related to the defects after healing of inflammatory root resorption in the cervical area of the root, significant at P less than 0.0001.

Calcium Hydroxide

Treatment of non-vital permanent incisors with calcium hydroxide. VI. A clinical, microbiological and radiological evaluation of treatment in one sitting of teeth with mature or immature root.

The purpose of the investigation was clinically, microbiologically and radiologically to assess the effect of calcium hydroxide as a temporary root-filling inserted in the same sitting as root canal debridement in non-vital permanent incisors with mature and immature root, infected or uninfected root canal and with or without radiologically demonstrated periapical bone changes. The material consisted of 141 teeth divided in 3 groups in which mechanical cleansing was accompanied by flushing with sterile saline and sodium hypochlorite solutions giving 0.5% or 5.0% active chlorine, respectively. Microbiological samples were taken from root canals after extirpation of necrotic pulp tissue, after completed cleansing of the root canal and 3 and 6 month after treatment. Results of treatment were evaluated from the radiographs taken before treatment and at the 3 and 6 month follow-ups. Complication, pain and an abscess, occurred in 2 cases, 2 and 5 days, respectively, after treatment. No statistical correlation between occurrence of samples that gave growth, taken from the root canals at 3 (8%) or 6-month control (9%) and 1) bacteriological status of the root canal prior to filling with calcium hydroxide, 2) the development of the root or 3) periapical healing at 3 or 6 month follow-up could be ascertained. Periapical bone healing at the end of 6-months observation period was noted in 61 teeth (46%), regression of periapical bone lesions in 64 (49%) and no periapical healing in 6 (5%). The only difference in healing pattern, statistically significant on 0.1% level, was found in the group of teeth flushed with 5.0% sodium hypochlorite. At 3 month control they showed percentually less cases with regression and more cases with no healing of periapical bone lesions than the teeth in the other two groups. It was concluded that treatment in one sitting can be done routinely, irrespective of the initial status, in all those cases where no other treatment is possible. If the periodontium or the periapical bone are injured during cleansing procedures or if necrotic rests are not pressed out through the apical foramen, no complications after treatment need to be feared.

Adolescent

Calcium hydroxide: the ultimate medicament?

There has been a trend to the promiscuous use of calcium hydroxide in clinical endodontics. It can be concluded that this medicament is not the principal factor in success following its use. It is reasonable to state that endodontic success is related to the obliteration of the canal system with a solid core root canal filling such as gutta percha.

Calcium Hydroxide

Stability constants of Ca-alkyl salicylate complexes and their effect on the dissolution of calcium hydroxide dental cements.

The proton-ligand stability constants (pKa) and Ca-ligand stability constants (log beta) of the five types of alkyl salicylate were determined and the dissolution of the calcium hydroxide cements prepared from those salicylates was examined in water. The dissolution of the cements containing monoesters decreased with the increase in their pKa and log beta values. The cement containing diester showed lower dissolution than that estimated from those values. This seems to be related to the polymeric structure of the cement matrix consisting of the complex of the diester with calcium.

Calcium Hydroxide

Changes in vitamin A conditioned hamster cheek pouch epithelium on exposure to commercial shell lime (calcium hydroxide) and tobacco. I-Optical histopathology.

Epidemiologically a high incidence of oral cancer and addiction to tobacco, singly or in combination with other ingredients of the betel quid, are closely correlated. Attempts at the induction of malignancy in laboratory animals on exposure to these ingredients have hitherto failed. Studies are reported on cheek pouch epithelium of 152 Syrian golden hamsters exposed to commercial shell lime (calcium hydroxide) and tobacco, singly and in combination, with parallel conditioning by Vitamin A palmitate. The abnormal changes found especially in lime and lime-plus-tobacco treated epithelia are massive hyperplasia, keratinization anomalies, marked edema and dysplasia. The most significant findings are (1) greater epithelial alteration caused by lime, lime plus vitamin A, tobacco plus vitamin A, lime plus tobacco and lime plus tobacco and vitamin A, than by tobacco alone; (2) increasing epithelial dysplasia in response to longer periods of exposure to the test substances; and (3) enhancement of tissue changes in the presence of vitamin A.

Animals