Calcium Silicate-Based Cements as Root Canal Medicament

PURPOSE: This study aims to retard the setting reaction of CSC by mixing it with 2% chlorhexidine gel (CHX) which will be used as an intracanal medicament, and to evaluate the removal of the experimental medicaments from the root canal. MATERIALS AND METHODS: White Portland cement, white ProRoot MTA and Biodentine were mixed with 2% CHX. The setting time, flowability and film thickness of the CSC/CHX mixture (experimental medicaments) were assessed and measured following the standards of ISO specification. Calcium ion release was measured using ICP-OES, while pH was tested using a pH meter. Moreover, twenty single-rooted teeth were filled with the experimental medicaments for seven days, then the medicaments were removed and the samples analyzed using SEM. Calcium hydroxide paste was used as a control. RESULTS: The setting time of the experimental medicaments was inhibited until 84 days. The calcium ion release of the experimental medicaments was significantly higher compared to the control over the period of 14 days (P<0.001). The mean pH value was above 11.45 for all tested materials over a period of 14 days, with no significant difference between them (P<0.05). There was no significant difference in film thickness of the experimental medicaments compared to the control (P> 0.05). However, the flowability of the experimental medicaments was significantly higher than the control (P<0.05). SEM showed no significant differences in the removal of the intracanal medicaments between all the tested groups. CONCLUSION: The addition of 2% CHX to CSCs retarded or inhibited its setting reaction over a period of 84 days. The calcium ion release and flowability of these experimental medicaments was found to be better than calcium hydroxide. Removal of the intracanal medicaments from the root canal was successfully achieved in all groups. Therefore, these experimental medicaments have the potential to be used as an enhanced root canal medicament.