Irrigants & Intracanal Medicaments: Bioceramic Paste, EDTA Gels & More

Dental Avenue

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Rs. 100 Rs. 175

Avue Cal - Premixed Calcium Hydroxide

Avue Cal is a ready-to-use paste with a calcium hydroxide formulation. It is a radiopaque, extremely alkaline water-soluble paste that can be readily cleansed and removed from the canal. Highly indicative in weeping canals, temporary root canal filling material.

Calcium hydroxide (Ca(OH)₂) has been widely used in endodontics as an intracanal medicament to eliminate the remaining microorganisms after chemomechanical preparation.

Dentists have used calcium hydroxide in clinical practice for over a century. In 1920, Herman introduced calcium hydroxide to dentistry as a pulp-capping material but today it is used widely in endodontics.

Avuecal is widely used due to its advantages such as:

• Initially bactericidal effect then bacteriostatic.

• Promotes healing and repair.

• High pH stimulates fibroblasts.

• Stops internal resorption.

• Neutralizes low pH of acids.

• Inexpensive and easy to used

Antimicrobial Effect of AvueCal

The release of hydroxyl ions in an aqueous environment is essential for the activation of calcium hydroxide against microbes. These ions reacted intensively with several biomolecules due to their highly oxidant free radicals.

As this reactivity is unspecified, the free radicals most likely gathered at the sites of generation. Hydroxyl ions have fatal effects on bacterial cells. They may damage the cytoplasmic membrane of bacteria, denature their proteins, or damage the DNA.

Used as disinfecting dressing

The application of calcium hydroxide paste at intervals of at least 7 days is able to eliminate and/or reduce the total number of bacteria surviving even after biomechanical preparation.

The Effect of calcium hydroxide on pro-Inflammatory cytokines was studied and concluded that it leads to denaturation of these pro-inflammatory mediators such as interleukin-1 α (IL-1α), tumor necrosis factor α(TNF α) and calcitonin gene-related peptide (CGRP) that is a potential mechanism by which calcium hydroxide contributes to the resolution of periradicular periodontitis.

Intracanal medicament in Weeping Canal

Weeping canal is a canal from which constant clear or reddish exudation is appeared.

This exudate is associated with a large apical radiolucency. The tooth is difficult to treat as when opened, exudate stops but it again reappears in next appointment.

Signs and symptoms varies from symptomless to tenderness to percussion and palpation. Obturation of canals with exudates is contraindicated.

For such teeth, application of calcium hydroxide in the canal after drying with sterile

absorbent paper points is helpful. This is because of its high alkalinity, which changes

the acidic pH of periapical tissues to a more basic environment.

Two other mechanisms have also been proposed:

1) Build up bone in the lesion due to the calcifying potential of calcium hydroxide and

2) The residual chronically inflamed tissue is cauterized by the caustic action of calcium hydroxide.

Perforation Management

It has many advantages in this treatment modality such as stimulation of hard tissue formation, easy preparation, rapid resorption when extruded into the periodontium and healing enhancement of damaged periodontal tissues, we can use Avuecal or Avuepex or MTA/Bioceramics for the perforation management

Role in Root Resorption

Root resorption can be classified into internal, external or root-ended resorption based.

on the site of origin, and can affect the cementum and/or dentine of the root. Since calcium hydroxide has alkaline pH, it actively influences the local environment around a resorptive area by reducing osteoclast activity and stimulating repair.

The alkaline calcium hydroxide neutralizes the acidic environment which exists in the region of resorption, reversing the reaction and thus stimulating hard tissue formation. The diffusion of hydroxyl ions released by calcium hydroxide through the dentinal tubules that directly communicate with periodontal space would increase the pH of periodontal space from 6.0 to 7.4 - 9.6. To treat an internal resorption, the canal and resorption lacuna are filled with calcium hydroxide paste.

The resorptive defect should be filled with calcium hydroxide at 3-month intervals until it reveals hard tissue formation, confirmed by both direct examination through the access cavity and radiograph. After establishment of physical barrier, the defect can be compacted with Gutta-percha.

Composition

AvueCal is made up of Calcium Hydroxide, Barium Sulphate & Excipients.

Advantages

Premixed paste
Syringe type for easy delivery of the paste into the canal
Excellent antibacterial property
Excellent radiopacity
can be used as Cavity liner under the restoration
High pH making it bactericidal to disinfect the canal efficiently

In stock

Avue Prep - EDTA Gel (15% w/w) with Carbamide Peroxide (10%w/w)

Dental Avenue

Avue Prep - EDTA Gel (15% w/w) with Carbamide Peroxide (10%w/w)

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From Rs. 100 Rs. 175

Avue Prep is a water soluble Ethylenediaminetetraacetic acid (EDTA) gel for root canal cleaning

Avueprep works by reacting with the mineral components of the hard tissues of the tooth. The chelating agent Avueprep softens the tissues, decalcifying the canal walls. It facilitates the mechanical preparation of the root canal and further removal of the smear layer, which opens dentin tubules

EDTA is a polyaminocarboxylic acid and a colorless, water-soluble solid. It is widely used to dissolve lime scale. Its usefulness arises because of its role as a hexadentate ligand and chelating agent, i.e. its ability to sequester metal ions such as Ca²⁺ and Fe³⁺.

Indications of Avueprep EDTA with carbamide peroxide:

Chelating (calcium binding) agent react with minerlized component of tooth.
Removal of the smear layer which is produced during instrumentation.
For chemical and mechanical cleaning of the root canal.
Shaping of the root canal via using rotary or hand files.
To be used with sodium hypochlorite as carbamide peroxide helps to produce nascent oxygen molecules when used with sodium hypochlorite

Smear layer removal:

The use of 15% -17%EDTA resulted in the greatest concentration of calcium ions compared with other chelating agents. Avueprep/Avueprep+ were the most efficient solution for removal of smear layer.

Antimicrobial activity

The antibacterial activity of Avueprep is due to the chelation of cations from the outer membrane of bacteria.

Effects on Dentin microhardness:

it reduce the root dentine microhardness, whereby the greatest differences are to be found in dentine immediately adjacent to the root canal lumen. After 3 min, Avueprep produced a greater reduction in microhardness.

Positively affect adhesion of root canal sealer:

Treating dentine with a combination of NaOCl and EDTA produced stronger adhesion of resin based sealer compared to NaOCl alone.

Avueprep is Biocompatible

It has been proven that even if EDTA is forced through the apical foramen into the periapical tissues, no periapical tissue damage could be detected after 14 months. Furthermore, that placement of EDTA for 28 days after pulpotomy produced no pulpal tissue necrosis. However, changes in macrophage activity can cause the inflammatory reaction to be more easily initiated, but reduced capacity of phagocytosis can result. Furthermore, EDTA improves plasma extravasation and mediator action.

Can remove calcium hydroxide while using Avueprep

It has been revealed that using Avueprep or NaOCl alone as irrigants did not remove calcium hydroxide from the root canal, but combining these two irrigants with hand instrumentation improved the effectiveness of the removal.

Composition of Avueprep

EDTA Disodium Salt – 15% w/w
Carbamide Peroxide – 10% w/w
Lubricants and Excipients

In stock

AvuePex - Premixed Calcium Hydroxide with Iodoform

Dental Avenue

AvuePex - Premixed Calcium Hydroxide with Iodoform

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Rs. 425 Rs. 700

AvuePex - Premixed Calcium Hydroxide with Iodoform

Premixed Calcium Hydroxide with Iodoform. The addition of Iodoform to the Calcium Hydroxide improve it’s radiopacity and adds an antibacterial agent to the paste.

Composition

25-35%-calcium hydroxide -To stimulate hard tissue formation, as well as to exert antimicrobial actions. Released calcium ions play important roles in cell stimulation, migration and proliferation, as well as in mineralization and hard tissue repair
15-25%-Iodoform –Radiopacifier and Bacteristatic agent
30-40%-Silicone Oil-using a more viscous solvent could improve the clinical handling and slow the rate of hydroxyl ion release, allowing for less frequent re-dressing of the root canal system

Ideal for temporay filling of root canal

Calcium hydroxide has ionic effect observed by chemical dissociation into calcium and hydroxyl ions. Calcium and hydroxyl ions have antimicrobial effects and induce mineralization. Calcium hydroxide stimulates “blast” cells aiding apexogenesis and its high pH neutralizes endotoxins produced by anaerobic bacteria.

Iodoform has bacteriostatic property by releasing free iodine. Thereby, iodine eliminates the infection of root canal and periapical tissue by precipitating protein and oxidizes essential enzymes. Iodoform also enhances radiopacity for better visualization.

Root canal filling material after pulpectomy in deciduous/ primary teeth

The primary advantage is that it resorbs from periapical tissue in one to two months, is apparently harmless to permanent tooth germ, is radioopaque, does not set to hard mass, and is easily inserted and removed.

Avuepex has osteoinductive action

Hydroxyl ions act on the cytoplasmic membrane of bacteria and it enhances tissue enzymes activity such as alkaline phosphatase which plays a role of extending roots and apical closure.

Regenerate bone around the roots of avulsed tooth posttrauma.

Healing of periapical lesion within 2 months with mild to moderate pain indication is crucial properties when comparing AVUEPEX to conventional treatment.

Advantages of AvuePex

-Excellent antibacterial and bacteriostatic properties

-Saves time! Pre-mixed and pre-filled

-Superior Radiopacity-easy to check the presence of residue

-Quick and Simple Application Pre-bent tip ensures accessibility to apex

-Does not harden, so Ca(OH)2 remains active

-Disinfects Canal Promotes

-Hard tissue formation

-Treats Traumatic Injuries

In stock