Aim: To investigate chemical changes in calcium hydroxide introduced into human root canals as a medicament using Fourier transform-(FT) Raman spectroscopy.
Methodology: Ten necrotic maxillary anterior teeth were selected in 10 patients. The teeth were divided into five treatment groups, according to the survey time. Root canal instrumentation was performed with hand instruments until the master apical file was size 40. Calcium hydroxide paste, in a 1 : 1.25 mixture by weight of powder and distilled water, was introduced directly into the root canal with a lentulo-spiral filler and then condensed with a finger plugger. The access cavity was sealed with a temporary dressing. After 2 and 4 days, then 2, 4 and 6 weeks, the calcium hydroxide paste was sampled with a K-file and then analysed using FT-Raman spectroscopy. The excitation source was an Nd : YAG laser with an excitation wavelength of 1064 nm. All spectra were taken with a laser power of 200 mW, 275-1185 scans, and 4 cm(-1) resolution. The conversion of calcium hydroxide to calcium carbonate was calculated on the basis of the spectral data obtained from the mixtures of both compounds.
Results: The calcium hydroxide paste in the apical region showed weak bands at 1088 and 284 cm(-1), in addition to bands associated with calcium hydroxide. The weak bands, assigned to calcium carbonate, became stronger with time. Calcium carbonate content increased rapidly in the first 2 days and then tended to increase slowly. Approximately 11% of the calcium hydroxide at the apical portion of the canal was converted to calcium carbonate after 6 weeks. However, little alteration of the paste was noticed in the samples from the middle portion of the canal.
Conclusions: Calcium hydroxide medicament in root canals became transformed into calcium carbonate in the apical region within 2 days. Although the transformation continued with time, approximately 90% of the calcium hydroxide remained unchanged after 6 weeks.