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An in vitro comparison of pH changes in root dentine following canal dressing with calcium hydroxide points and a conventional calcium hydroxide paste.

AIM: This study aimed to measure and compare pH changes at apical and cervical sites on the external root surface of extracted teeth dressed with calcium hydroxide in two different formulations. METHODOLOGY: Root canals of 45 single-rooted extracted human teeth were accessed and shaped using a step-down technique with rotary instrumentation. Standard cavities were prepared on the external root surface at specific apical and cervical sites. The teeth were randomly allocated to three groups. Teeth in group A were dressed with calcium hydroxide points, those in group B were dressed with an aqueous calcium hydroxide paste and teeth in group C were left unfilled. Following storage in humid conditions, the pH of the dentine at apical and cervical sites was measured at baseline and then at 24 h, 72 h, 1 week, 10 days, 2 weeks and 3 weeks. RESULTS: The pH of the root dentine at both apical and cervical sites was significantly greater (P < 0.001) in teeth dressed with aqueous calcium hydroxide paste compared with those dressed with calcium hydroxide points, when averaged out across all time periods. For all groups, there was a significant difference between the mean apical and cervical pH values for each tooth with lower values for the apical sites (P < 0.001). CONCLUSION: The results of this study indicate that an aqueous calcium hydroxide paste was more effective than calcium hydroxide points at raising the pH on the external root surface of extracted teeth.

Analysis of Variance↗

Evaluation of antacid suspensions containing aluminum hydroxide and magnesium hydroxide.

Liquid antacid suspensions containing aluminum hydroxide and magnesium hydroxide were evaluated for composition, antacid properties, and product quality. The equivalent aluminum oxide and magnesium hydroxide content was determined by chelatometric titration, and sodium content was determined by flame photometry. Antacid properties measured were acid-consuming capacity, antacid effectiveness (preliminary antacid test, acid-neutralizing capacity test), and pH-stat titration. Content uniformity, consistency of the antacid properties, and microbiological content were examined for each product. Data are presented for 36 products for which samples from four or more lots were obtained. The ratio of percentage of equivalent aluminum oxide to percentage of magnesium hydroxide ranged from 1:0.6 to 1:3.5; this range allows for selection of the desired balance between the laxative effect of magnesium hydroxide and the constipating effect of aluminum hydroxide. Based on a daily dose of 280 meq of antacid, the sodium content of the products tested ranged from less than 2% to approximately 45% of the 500 mg per day of sodium allowed in a sodium-restricted diet. The concept of bioavailability was related to the amount of the antacid reacting at pH 3, 37 degrees C during the estimated gastric residence time of 15 minutes. Antacid suspensions are available which will react almost completely (neutralizing greater than 90% of the theoretical quantity of acid) during the estimated gastric residence time. Approximately 4% of the samples contained unacceptable numbers of bacteria. An antacid suspension cannot be adequately evaluated by a single test; choice of a product should be based on an evaluation that integrates several characteristics including sodium content, time and volume required to neutralize a given amount of acid, and uniformity of content.

Aluminum Hydroxide↗

Use of magnesium hydroxide and low magnesium dialysate does not permit reduction of aluminum hydroxide during continuous ambulatory peritoneal dialysis.

In an effort to reduce the ingestion of aluminum in phosphate-binding antacids, we treated seven patients on continuous ambulatory peritoneal dialysis (CAPD) with low magnesium dialysate and phosphate binders containing both aluminum and magnesium hydroxide. The total amount of phosphate binders prescribed was adjusted to maintain the serum phosphorus at normal levels. The dose of magnesium hydroxide was limited by intolerable gastrointestinal side effects in six of the seven patients. One patient also developed symptomatic hypermagnesemia. When magnesium hydroxide was prescribed in tolerable doses, the mean aluminum dose was not significantly decreased compared with the dose when taking aluminum hydroxide alone. We conclude that substitution of magnesium hydroxide for aluminum hydroxide as a phosphate binder fails to reduce the dose of aluminum in most patients on CAPD.

Adult↗

Action of hydrochloric acid on aluminum hydroxide-magnesium hydroxide gels and magaldrate: 27Al NMR and pH-stat studies.

Neutralization of mixtures of aluminum hydroxide-magnesium hydroxide gels and of magaldrate by hydrochloric acid were studied by 27Al NMR under conditions of both equilibrium and kinetic control. Under conditions where equilibrium has been attained, an aluminum NMR signal is detectable for suspensions of the mixed gels and magaldrate only after enough acid has been added to exhaust the acid-neutralizing capacity of the magnesium hydroxide. Mixed gels seem to form several soluble aluminum-containing species as neutralization proceeds. Under the conditions of the modified Beekman neutralization procedure, in which the species concentrations reflect neutralization kinetics, mixed gels show a sharp burst of the hexaaquoaluminum cation as acid is added followed by a slow loss of that cation from solution and an accompanying slow rise in pH. Magaldrate shows a steady increase in the hexaaquoaluminum cation with added acid. Differences between magaldrate and mixed gels are also apparent in pH-stat titrations in which magaldrate displays a biphasic response, contrasting to the two burst phases with an intervening lag phase observed for mixed gels. The results of the 27Al NMR and pH-stat titrations are consistent with the hypotheses that magaldrate is a homogeneous substance with a hydrotalcite-like structure and that mixed gels consist of a magnesium hydroxide core surrounded by aluminum hydroxide.

Aluminum↗

Action of hydrochloric acid on aluminum hydroxide-magnesium hydroxide gels and magaldrate: quasi-elastic light scattering studies.

The effects of hydrochloric acid on mixed gels of aluminum and magnesium hydroxide and on magaldrate have been examined using quasi-elastic light scattering. Particles of magaldrate and mixed gels behave differently. The magaldrate particles initially decrease in size in response to increasing amounts of hydrochloric acid up to that sufficient to neutralize all the magnesium hydroxide present, then increase in size to approximately 2 microns. The composition of the mixed gels appears to be particularly important in determining the reaction with limited amounts of acid. For these particles, which are thought to consist of a magnesium hydroxide core surrounded by an aluminum hydroxide sheath, slow erosion of the aluminum hydroxide was apparently followed by complete disintegration of the particles. Particles which remain grow in size to approximately 3 microns.

Aluminum Hydroxide↗

Gastric prostaglandin E2 release induced by aluminium hydroxide and aluminium hydroxide-containing antacids in rats. Effect of low doses and citric acid.

Suspensions of aluminium hydroxide or a commercial antacid containing aluminium hydroxide (Trigastril) was instilled intragastrically in rats in doses comparable to high and low human therapeutic doses (aluminium hydroxide, 125 mg and 12.5 mg/kg, respectively). Corresponding experiments were carried out with 0.6% citric acid added to the antacid suspensions. Prostaglandin E2 (PGE2) in the gastric content was analysed by radioimmunoassay 6 h after drug administration. Both high and low doses of aluminium hydroxide and Trigastril increased the concentration of PGE2 significantly. Citric acid did not significantly affect the antacid-induced PGE2 release except in combination with a low dose of aluminium hydroxide, with which a significant increase was seen. Release of PGE2 by low doses of antacids implies the possibility that enhanced cytoprotection may be involved in the mechanism by which antacids promote the healing of peptic ulcers.

Aluminum Hydroxide↗

Domperidone plus magnesium hydroxide and aluminum hydroxide: a valid therapy in children with gastroesophageal reflux. A double-blind randomized study versus placebo.

To evaluate the efficacy of different drug combinations in treating severe gastroesophageal reflux (GER), we studied 80 children with GER. The patients were randomly divided into four groups: group A was treated with domperidone plus magnesium hydroxide and aluminum hydroxide, group B with domperidone plus alginate, group C with domperidone alone, and group D received placebo. At the time of diagnosis and 8 weeks after treatment the patients were clinically evaluated and underwent 24-h continuous esophageal pH monitoring. After treatment a complete regression of symptoms was observed in 16 of 20 patients in group A, in 8 of 20 in group B (A versus B, p < 0.018), in 9 of 20 in group C (A versus C, p < 0.034), and in 7 of 20 in group D (A versus D, p < 0.001). Moreover, there was a statistically significant improvement in several pH-metric variables studied in all treatment groups; in addition, a comparison of the pH-metric data of the four groups after treatment indicated that reflux variables were significantly lower in group A than in the other groups. We conclude that the domperidone plus magnesium hydroxide and aluminum hydroxide combination was more effective than the other drugs we used in treating GER and in modifying the objective pH-metric variables in pediatric patients.

Aluminum Hydroxide↗

Absence of in vivo and in vitro interactions of an aluminum hydroxide, magnesium hydroxide containing antacid with cimetidine in patients with peptic ulcer.

In view of contradictory reports on the bioavailability of cimetidine in the presence of concomitantly administered antacids we studied the areas under the plasma concentration time curves (AUC) of cimetidine, the maximal concentrations (cmax) and the time, at which cmax was reached (tmax) in eight patients (five patients with duodenal ulcer, three patients with gastric ulcer) with and without the administration of an aluminum hydroxide magnesium hydroxide containing antacid (Maaloxan). No significant effects of the antacid on AUC, cmax and tmax of cimetidine were found. In vitro studies also showed no adsorption of cimetidine to aluminum hydroxide, magnesium hydroxide or the antacid.

Adult↗

The bio-availability of beta-acetyldigoxine alone and combined with aluminum hydroxide and magnesium hydroxide (Alucol).

The bio-availability of Novodigal (beta-acetyldigoxine) alone and applied together with Alucol (aluminum hydroxide, magnesium hydroxide) was studied in six healthy probands. Bio-availability parameters were calculated from the areas under the plasma concentration curves and from the comparison of the blood levels after absorption during steady state. There was no significant difference between the bio-availability of beta-acetyldigoxine alone and that of the combination with Alucol. Thus, beta-acetyldigoxine combined with antacids of the aluminum hydroxide and magnesium hydroxide type can be applied in the same dosage as usual since no decrease of effect has to be apprehended.

Adult↗

Protonation and reactivity towards carbon dioxide of the mononuclear tetrahedral zinc and cobalt hydroxide complexes, [Tp(Bu)t(,Me)]ZnOH and [Tp(Bu)t(,Me)]CoOH: comparison of the reactivity of the metal hydroxide function in synthetic analogues of carbonic anhydrase.

The tris(3-tert-butyl-5-methylpyrazolyl)hydroborato zinc hydroxide complex [Tp(Bu)t(,Me)]ZnOH is protonated by (C(6)F(5))(3)B(OH(2)) to yield the aqua derivative [[Tp(Bu)t(,Me)]Zn(OH(2))][HOB(C(6)F(5))(3)], which has been structurally characterized by X-ray diffraction, thereby demonstrating that protonation results in a lengthening of the Zn-O bond by ca. 0.1 A. The protonation is reversible, and treatment of [[Tp(Bu)t(,Me)]Zn(OH(2))](+) with Et(3)N regenerates [Tp(Bu)t(,Me)]ZnOH. Consistent with the notion that the catalytic hydration of CO(2) by carbonic anhydrase requires deprotonation of the coordinated water molecule, [[Tp(Bu)t(,Me)]Zn(OH(2))](+) is inert towards CO(2), whereas [Tp(Bu)t(,Me)]ZnOH is in rapid equilibrium with the bicarbonate complex [Tp(Bu)t(,Me)]ZnOC(O)OH under comparable conditions. The cobalt hydroxide complex [Tp(Bu)t(,Me)]CoOH is likewise protonated by (C(6)F(5))(3)B(OH(2)) to yield the aqua derivative [[Tp(Bu)t(,Me)]Co(OH(2))][HOB(C(6)F(5))(3)], which is isostructural with the zinc complex. The aqua complexes [[Tp(Bu)t(,Me)]M(OH(2))][HOB(C(6)F(5))(3)] (M = Zn, Co) exhibit a hydrogen bonding interaction between the metal aqua and boron hydroxide moieties. This hydrogen bonding interaction may be viewed as analogous to that between the aqua ligand and Thr-199 at the active site of carbonic anhydrase. In addition to the structural similarities between the zinc and cobalt complexes, [Tp(Bu)t(,Me)ZnOH] and [Tp(Bu)()t(,Me)]CoOH, and between [[Tp(Bu)t(,Me)]Zn(OH(2))](+) and [[Tp(Bu)t(,Me)]Co(OH(2))](+), DFT (B3LYP) calculations demonstrate that the pK(a) value of [[Tp]Zn(OH(2))](+) is similar to that of [[Tp]Co(OH(2))](+). These similarities are in accord with the observation that Co(II) is a successful substitute for Zn(II) in carbonic anhydrase. The cobalt hydroxide [Tp(Bu)()t(,Me)]CoOH reacts with CO(2) to give the bridging carbonate complex [[Tp(Bu)t(,Me)]Co](2)(mu-eta(1),eta(2)-CO(3)). The coordination mode of the carbonate ligand in this complex, which is bidentate to one cobalt center and unidentate to the other, is in contrast to that in the zinc counterpart [[Tp(Bu)t(,Me)]Zn](2)(mu-eta(1),eta(1)-CO(3)), which bridges in a unidentate manner to both zinc centers. This difference in coordination modes concurs with the suggestion that a possible reason for the lower activity of Co(II)-carbonic anhydrase is associated with enhanced bidentate coordination of bicarbonate inhibiting its displacement.

Biomimetic Materials↗

A five-year comparative study of calcium hydroxide-glutaraldehyde pulpotomies versus calcium hydroxide pulpotomies in young permanent molars.

Twenty children with twenty cariously exposed first permanent molars treated with either calcium hydroxide-glutaraldehyde or calcium hydroxide pulpotomies, were followed up clinically and radiographically for a period of five years. Overall success rates obtained at the end of the follow up period were higher with calcium hydroxide-glutaraldehyde pulpotomies (100%) than with calcium hydroxide pulpotomies (80%).

Calcium Hydroxide↗

Benzyltrimethylammonium hydroxide trihydrate containing hydroxide--water layers.

In the title compound, C(10)H(16)N(+) x OH(-) x 3H(2)O, two-dimensional bilayer-like arrays of organic cations and corrugated anionic hydroxide-water layers are stacked alternately along the c axis. All hydroxide and water H atoms are in ordered positions, giving rise to a network of hydrogen bonds [O...O 2.639 (2)--2.927 (2) A for water donors and O...O 3.323 (2) A for hydroxide donors] with four- and six-membered rings.

Journal Article↗

Effect of an orally administered antacid agent containing aluminum hydroxide and magnesium hydroxide on abomasal luminal pH in clinically normal milk-fed calves.

OBJECTIVE: To determine the effects of a commercially available orally administered antacid agent containing aluminum hydroxide and magnesium hydroxide on abomasal luminal pH in clinically normal milk-fed calves. DESIGN: Randomized trial. ANIMALS: 5 male dairy calves. PROCEDURE: Throughout the study, calves were fed milk replacer at 7:30 AM and 7:30 PM. Cannulae for pH electrodes were placed in the abomasal body and pyloric antrum. Treatments consisted of oral administration of a high (50 ml) or low (25 ml) dose of the antacid agent and oral administration of milk replacer alone (control). Antacid was given at 7:30 AM, 3:30 PM, and 11:30 PM, and luminal pH was monitored continuously for 24 hours, beginning 15 minutes before administration of the first dose of antacid. RESULTS: Administration of the first dose of antacid at the time of the morning feeding resulted in an increase in mean abomasal body luminal pH of < 1 pH unit, whereas administration of the second and third doses of the antacid caused transient (< 3 hours) increases in mean luminal pH of approximately 1.5 (low dose) and 2.5 (high dose) pH units. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that clinically normal milk-fed calves given a commercially available antacid agent, PO, will have a transient increase in abomasal luminal pH. Such agents may, therefore, have a role in the treatment of abomasal ulceration in calves; however, the long-term effects of orally administered antacid agents in milk-fed calves and the clinical efficacy of such agents in treating abomasal ulceration remain to be determined.

Abomasum↗

[Magnesium hydroxide and aluminum hydroxide in the treatment of gastroesophageal reflux].

Fifteen children with gastro-esophageal reflux took part in a treatment trial with a regimen of magnesium hydroxide and aluminium hydroxide for 8 weeks period (700 mmol/1.73 mq/die). All children were evaluated clinically and underwent a 24-hour continuous esophageal pH-monitoring both at diagnosis and after 8 weeks of treatment. After therapy 12/15 children were cured and 3/15 improved. Moreover the total percentage of time during which pH was less than 4, the number of reflux episodes and the number of refluxes lasting than 5' recorded during 24-hour continuous esophageal pH-monitoring were significantly reduced after treatment. The Authors conclude that antacids in large quantities are effective in medical treatment of gastro-esophageal reflux.

Aluminum Hydroxide↗

Layered double hydroxide stability. 2. Formation of Cr(III)-containing layered double hydroxides directly from solution.

Solutions containing divalent metal [M(II) = Mg2+, Zn2+, Co2+, Ni2+, Mn2+] chlorides and CrCl3 6H2O were titrated with NaOH to yield, for M(II) = Zn, Co, and Ni, hydrotalcite-like layered double hydroxides (LDHs), [[M(II)]1-z[Cr(III)]z(OH)2][Cl]z yH2O, in a single step, without intermediate formation of chromium hydroxide. Analysis of the resultant titration curves yields solubility constants for these compounds. These are in the order Zn < Ni approximately Co, with a clear preference for formation of the phase with z = 1/3. With Mg2+ as chloride, titration gives a mixture of Cr(OH)3 and Mg(OH)2, but the metal sulfates give Mg2Cr(OH)6 1/2(SO4) by a two-step process. Titrimetric and spectroscopic evidence suggests short-range cation order in the one-step LDH systems.

Anions↗

[Dynamic comparative study of the intraalveolar cell population after intratracheal injection of beryllium hydroxide and aluminum hydroxide in the rat].

A sequential quantitative analysis of free alveolar cells was performed on S.P.F. rats after intratracheal injection of Be (OH)2 and Al (OH)3. The induced lesions were entirely restored 20 days after the initial injection. Beryllium hydroxide inhibited DNA synthesis in the free alveolar macrophages and the transeptal cellular flow could be evidenced. Aluminium hydroxide increased the number of free cells without inhibiting DNA synthesis. Quantitative variations of polymorphonuclears, lymphocytes and macrophages were correlated with changes in the alveolar environment. A strong direct correlation between the number of lymphocytes and DNA synthetizing macrophages was shown out. This reaction was not observed in beryllium treated rats.

Aluminum↗

Effect of calcium hydroxide and combinations of Ledermix and calcium hydroxide on inflamed pulp in dog teeth.

The effects of Ledermix+calcium hydroxide (Ca(OH)2) or Ca(OH)2 alone on inflamed pulp tissues of dogs were studied. Fifty-nine upper incisor teeth of 10 dogs were used. Class V cavities were prepared and filled with amalgam after placement of decayed dentin particles. After 7 days, the decayed dentin and alloy were removed, and the pulps of the teeth were exposed. Ledermix and Ca(OH)2 mixtures or Ca(OH)2 alone were applied to the cavities. At the end of 7, 30, and 90 days, the teeth were extracted and examined histopathologically. Inflammation was found to be more prevalent in the 7- and 30-day groups that were treated with the Ledermix+Ca(OH)2 combination, whereas fibrosis and necrosis were nearly similar in both groups. In the 90-day groups, no inflammation was seen. No difference between the two 90-day groups with regard to reparative dentin was found.

Animals↗

Layered double hydroxide stability. 1. Relative stabilities of layered double hydroxides and their simple counterparts.

Solutions containing di- and trivalent metal chlorides [M(II) = Mg2+, Zn2+, Co2+, Ni2+, Mn2+; M(III) = Al3+, Fe3+] were titrated with NaOH to yield hydrotalcite-like layered double hydroxides (LDH), [[M(II)]1-x[M(III)]x(OH)2][Cl]x yH2O, by way of M(III) hydroxide/hydrous oxide intermediates. Analysis of the resultant titration curves yields nominal solubility constants for the LDH. The corresponding LDH stabilities are in the order Mg < Mn < Co approximately Ni < Zn for M(II) and Al < Fe for M(III). The stability of LDH relative to the separate metal hydroxides/hydrous oxides is discussed.

Aluminum↗