Research Article

Impact of vehicle and insertion method on intratubular penetration of calcium hydroxide pastes: an in vitro confocal laser microscopy analysis

Volume: 60 Number: 1 September 7, 2026
  • Mirela Barros *
  • Daiara Da Silva Franco
  • Lidiane De Castro Pinto
  • Flaviana Bombarda De Andrade
  • Luciana Vitti Betti

Impact of vehicle and insertion method on intratubular penetration of calcium hydroxide pastes: an in vitro confocal laser microscopy analysis

Abstract

Purpose

This study aimed to evaluate the effect of different vehicles and insertion/agitation methods on the penetration of calcium hydroxide (CH) paste into dentinal tubules.

Materials and methods

Eighty single-rooted premolars were standardized to 12 mm, prepared using the ProDesign 40.05 instrument, and randomly assigned to eight experimental groups (n = 10): CH–propylene glycol/camphorated paramonochlorophenol (PG/CPMC) + K-file (KF), CH–PG/CPMC + XP Clean (XP), CH–PG/CPMC + Easy Clean (EC), CH–PG/CPMC + ultrasonic activation (UA); Ultracal XS (UC) + KF, UC + XP, UC + EC, and UC + UA. The CH paste was mixed with 0.1% Rhodamine dye and inserted into the specimens. Two 1-mm-thick sections were obtained at 2 mm and 5 mm from the apex, scanned using confocal microscopy, and analyzed with ImageJ software to calculate the percentage penetration and maximum penetration depth (MPD). Student’s t-test, one-way ANOVA, and Tukey’s post hoc tests were used for statistical analysis (P < .05).

Results

The penetration of the PG/CPMC paste differed significantly between KF and EC, as well as between KF and UA, at both 5 mm (p< .05) and 2 mm (p < .05). UC showed enhanced penetration with UA, while EC outperformed KF at 2 mm. For MPD, no significant differences were observed at 5 mm.

Conclusion

Both the insertion/agitation methods and paste formulations influenced the percentage penetration of the paste into the root canal lumen and dentinal tubules. At 2 mm, aqueous and viscous vehicles optimized MPD, particularly when combined with UA and EC.

Keywords

Supporting Institution

Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo

Ethical Statement

CAEE 41963020.4.0000.5441

References

  1. Herrera H, Herrera H, Silva FW, Leonardo MR, Silva LA. Large apical periodontitis following root canal dressing with calcium hydroxide: a case report. Rev Odonto Ciênc. 2011;26:172–5. google scholar
  2. Leonardo RT, Leonardo MR. Current aspects of root canal system infection’s therapy. Rev Assoc Paul Cir Dent. 2012;66:174–80. google scholar
  3. Javidi M, Zarei M, Afkhami F. Antibacterial effect of calcium hydroxide on intraluminal and intratubular enterococcus faecalis. Iran Endod J. 2011;6:103–6. -2746 google scholar
  4. Chong BS, Pitt Ford TR. The role of intracanal medication in root canal treatment. Int Endod J. 1992;25:97–106. [CrossRef ] google scholar
  5. Penesis VA, Fitzgerald PI, Fayad MI, Wenckus CS, BeGole EA, Johnson BR. Outcome of one-visit and two-visit endodontic treatment of necrotic teeth with apical periodontitis:a randomized controlled trial with one-year evaluation. J Endod. 2008;34:251– 7. [CrossRef ] google scholar
  6. Ordinola-Zapata R, Noblett WC, Perez-Ron A, Ye Z, Vera J. Present status and future directions of intracanal medicaments. Int Endod J. 2022;55(Suppl 3 Suppl 3):613–36. [CrossRef ] google scholar
  7. Kumar A, Tamanna S, Iftekhar H. Intracanal medicaments – Their use in modern endodontics:A narrative review. J Oral Res Rev. 2019;11:94–9. [CrossRef ] google scholar
  8. Siqueira JF Jr, Guimarães-Pinto T, Rôças IN. Effects of chemomechanical preparation with 2. 5% sodium hypochlorite and intracanal medication with calcium hydroxide on cultivable bacteria in infected root canals. J Endod. 2007;33:800–5. [CrossRef ] google scholar

Details

Primary Language

English

Subjects

Endodontics

Journal Section

Research Article

Authors

Daiara Da Silva Franco This is me
0009-0008-8212-7430
Brazil

Lidiane De Castro Pinto This is me
0000-0001-9764-0327
Brazil

Flaviana Bombarda De Andrade This is me
0000-0002-1238-2160
Brazil

Luciana Vitti Betti This is me
0009-0005-6888-4732
Brazil

Publication Date

September 7, 2026

Submission Date

April 10, 2025

Acceptance Date

September 8, 2025

Published in Issue

Year 2026 Volume: 60 Number: 1

APA
Barros, M., Da Silva Franco, D., De Castro Pinto, L., Bombarda De Andrade, F., & Vitti Betti, L. (2026). Impact of vehicle and insertion method on intratubular penetration of calcium hydroxide pastes: an in vitro confocal laser microscopy analysis. European Oral Research, 60(1), 202-210. https://doi.org/10.26650/eor.20261667260
AMA
1.Barros M, Da Silva Franco D, De Castro Pinto L, Bombarda De Andrade F, Vitti Betti L. Impact of vehicle and insertion method on intratubular penetration of calcium hydroxide pastes: an in vitro confocal laser microscopy analysis. EOR. 2026;60(1):202-210. doi:10.26650/eor.20261667260
Chicago
Barros, Mirela, Daiara Da Silva Franco, Lidiane De Castro Pinto, Flaviana Bombarda De Andrade, and Luciana Vitti Betti. 2026. “Impact of Vehicle and Insertion Method on Intratubular Penetration of Calcium Hydroxide Pastes: An in Vitro Confocal Laser Microscopy Analysis”. European Oral Research 60 (1): 202-10. https://doi.org/10.26650/eor.20261667260.
EndNote
Barros M, Da Silva Franco D, De Castro Pinto L, Bombarda De Andrade F, Vitti Betti L (September 1, 2026) Impact of vehicle and insertion method on intratubular penetration of calcium hydroxide pastes: an in vitro confocal laser microscopy analysis. European Oral Research 60 1 202–210.
IEEE
[1]M. Barros, D. Da Silva Franco, L. De Castro Pinto, F. Bombarda De Andrade, and L. Vitti Betti, “Impact of vehicle and insertion method on intratubular penetration of calcium hydroxide pastes: an in vitro confocal laser microscopy analysis”, EOR, vol. 60, no. 1, pp. 202–210, Sept. 2026, doi: 10.26650/eor.20261667260.
ISNAD
Barros, Mirela - Da Silva Franco, Daiara - De Castro Pinto, Lidiane - Bombarda De Andrade, Flaviana - Vitti Betti, Luciana. “Impact of Vehicle and Insertion Method on Intratubular Penetration of Calcium Hydroxide Pastes: An in Vitro Confocal Laser Microscopy Analysis”. European Oral Research 60/1 (September 1, 2026): 202-210. https://doi.org/10.26650/eor.20261667260.
JAMA
1.Barros M, Da Silva Franco D, De Castro Pinto L, Bombarda De Andrade F, Vitti Betti L. Impact of vehicle and insertion method on intratubular penetration of calcium hydroxide pastes: an in vitro confocal laser microscopy analysis. EOR. 2026;60:202–210.
MLA
Barros, Mirela, et al. “Impact of Vehicle and Insertion Method on Intratubular Penetration of Calcium Hydroxide Pastes: An in Vitro Confocal Laser Microscopy Analysis”. European Oral Research, vol. 60, no. 1, Sept. 2026, pp. 202-10, doi:10.26650/eor.20261667260.
Vancouver
1.Mirela Barros, Daiara Da Silva Franco, Lidiane De Castro Pinto, Flaviana Bombarda De Andrade, Luciana Vitti Betti. Impact of vehicle and insertion method on intratubular penetration of calcium hydroxide pastes: an in vitro confocal laser microscopy analysis. EOR. 2026 Sep. 1;60(1):202-10. doi:10.26650/eor.20261667260