European Journal of Molecular & Clinical Medicine

Endodontic therapy of a tooth with open apex and necrotic pulp presents multiple challenges during treatment. Microbial elimination from chronic lesions makes treatment all the more difficult. Apexification and pulp revascularization are the treatment options available. Apexification with calcium hydroxide has certain disadvantages and mineral trioxide aggregate (MTA) may be considered as a promising alternative.

The success of root canal treatment depends on thorough disinfection of the root canal system, and to provide fluid impervious seal which in turn halt the progress of the periapical infection. The oral microorganisms from the degenerated pulp tissue are responsible directly or indirectly for most of the periapical lesions. For the treatment of these lesions there are surgical and non-surgical methods. Surgical removal of the periapical lesion without proper root canal disinfection and obturation will result in improper healing of lesions whereas in non-surgical root canal therapy the lesions heal if proper cleaning, shaping and obturation of root canal are done. This clinical case series highlights the follow-up results of three cases demonstrating the resolution of periapical lesion through nonsurgical approach and confirms that periapical lesions respond favorably to non-surgical treatment

Aim: To investigate the antimicrobial properties of calcium hydroxide when mixed with three vehicles namely Zamzam water, Normal saline and 2% Chlorhexidine.
Materials & Method: 6 plates of nutrient broth and S. aureus culture were prepared. 2 (5*3 mm) wells were prepared in one plate and is used as control. 3 wells each were prepared in the remaining 5 plates and filled with freshly prepared mix of calcium hydroxide with the three vehicles (5 wells were filled with each mix). The same process was repeated using 6 plates containing nutrient broth and B. subtilis culture. The plates were then incubated for 24 hours and the Zone of inhibition (ZOI) was measured. The pH of each mixture was also measured by using a pH meter. The data was analyzed by ANNOVA test and compared by using Tukey HSD test.
Result: The mean value of ZOI for Ca(OH2) and Zamzam was statistically significant when tested against both the bacteria. The pH of 12.26, 11.90 and 12.10 was achieved for Ca(OH2) and Zamzam, Ca(OH2) and Normal saline and 2% Chlorhexidine and Ca(OH2).
Conclusion: Calcium hydroxide powder mixed with Zamzam water exhibited the highest pH of 12.26 and showed statistical significant antimicrobial difference when compared to other medicaments. However further in depth scientific investigations regarding the properties and safety of Zamzam water and World health organization (WHO) approval would be required before considering its clinical use.