Hardened exogenous material after extrusion of calcium hydroxide with barium sulfate: Case study and histopathologic and laboratory analyses.

Title Hardened exogenous material after extrusion of calcium hydroxide with barium sulfate: Case study and histopathologic and laboratory analyses.
Authors G. Nevares; G.Queiroz de Monteiro; A.Paula Vera Sobral; S.Lemos de Campello; M.Cristiny F. da Silva; A. Bezerra; F.Xavier Bez da Silva; C.Musso Scheneider; D.Santana Albuquerque
Journal J Am Dent Assoc
DOI 10.1016/j.adaj.2017.07.031
Abstract

BACKGROUND AND OVERVIEW: Although calcium hydroxide (Ca[OH]2) paste associated with barium sulfate (BaSO4) is considered a safe agent, there is a lack of clinical research on its effects on periodontal and submucosal tissues. The aim of the authors was to report the effects of extrusion of Ultracal XS paste (Ultradent Products) in 2 cases. The authors also analyzed the paste constituents and compared them with the proportion reported by the manufacturer and the material extruded.

CASE DESCRIPTION: The authors present 2 cases in which root canals were restored with Ultracal XS paste after cleaning and shaping, and there was unintentional overextension of the paste into periradicular tissues, with a hardened exogenous material observed associated with inflammatory signs and symptoms. A biopsy was performed, and the material was subjected to histopathologic analysis and characterization through scanning electron microscopy, energy dispersive x-ray spectroscopy, Fourier transform infrared spectroscopy, and x-ray diffraction.

CONCLUSIONS: BaSO4 and calcium carbonate (CaCO3) were associated with a hardened material after Ultracal XS paste extrusion. The Ca(OH)2 percentage on the Ultracal XS paste was approximately 2 times greater than the proportion reported by the manufacturer.

PRACTICAL IMPLICATIONS: Ca(OH)2 with BaSO4 paste application should be performed carefully, and its extrusion to periradicular and submucosal tissues should not occur. Its extrusion may result in the formation of a persistent exogenous material of hardened consistency associated with inflammatory signs and symptoms.

Citation G. Nevares; G.Queiroz de Monteiro; A.Paula Vera Sobral; S.Lemos de Campello; M.Cristiny F. da Silva; A. Bezerra; F.Xavier Bez da Silva; C.Musso Scheneider; D.Santana Albuquerque.Hardened exogenous material after extrusion of calcium hydroxide with barium sulfate: Case study and histopathologic and laboratory analyses.. J Am Dent Assoc. 2018;149(1):5966. doi:10.1016/j.adaj.2017.07.031

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Barium

See more Barium products. Barium (atomic symbol: Ba, atomic number: 56) is a Block S, Group 2, Period 6 element with an atomic weight of 137.27. The number of electrons in each of barium's shells is [2, 8, 18, 18, 8, 2] and its electron configuration is [Xe] 6s2. Barium Bohr ModelBarium is a member of the alkaline-earth metals. The barium atom has a radius of 222 pm and a Van der Waals radius of 268 pm. Barium was discovered by Carl Wilhelm Scheele in 1772 and first isolated by Humphry Davy in 1808. Elemental BariumIn its elemental form, barium is a soft, silvery-gray metal. Industrial applications for barium include acting as a "getter," or unwanted gas remover, for vacuum tubes, and as an additive to steel and cast iron. Barium is also alloyed with silicon and aluminum in load-bearing alloys. The main commercial source of barium is the mineral barite (BaSO4); it does not occur naturally as a free element . The name barium is derived from the Greek word "barys," meaning heavy.

Calcium

See more Calcium products. Calcium (atomic symbol: Ca, atomic number: 20) is a Block S, Group 2, Period 4 element with an atomic weight of 40.078. The number of electrons in each of Calcium's shells is [2, 8, 8, 2] and its electron configuration is [Ar]4s2. Calcium Bohr ModelThe calcium atom has a radius of 197 pm and a Van der Waals radius of 231 pm. Calcium was discovered and first isolated by Sir Humphrey Davy in 1808. It is the fifth most abundant element in the earth's crust and can be found in minerals such as dolomite, gypsum, plagioclases, amphiboles, pyroxenes and garnets. In its elemental form, calcium has a dull gray-silver appearance. Calcium is a reactive, soft metal that is a member of the alkaline earth elements. Elemental CalciumIt frequently serves as an alloying agent for other metals like aluminum and beryllium, and industrial materials like cement and mortar are composed of calcium compounds like calcium carbonate. It is also an biologically essential substance found in teeth, bones, and shells. The name "calcium" originates from the Latin word "calics," meaning lime.

Sulfur

See more Sulfur products. Sulfur (or Sulphur) (atomic symbol: S, atomic number: 16) is a Block P, Group 16, Period 3 element with an atomic radius of 32.066. Sulfur Bohr ModelThe number of electrons in each of Sulfur's shells is 2, 8, 6 and its electron configuration is [Ne] 3s2 3p4. In its elemental form, sulfur has a light yellow appearance. The sulfur atom has a covalent radius of 105 pm and a Van der Waals radius of 180 pm. In nature, sulfur can be found in hot springs, meteorites, volcanoes, and as galena, gypsum, and epsom salts. Sulfur has been known since ancient times but was not accepted as an element until 1777, when Antoine Lavoisier helped to convince the scientific community that it was an element and not a compound.

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