Hardened exogenous material after extrusion of calcium hydroxide with barium sulfate

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.

Autor: Giselle Nevares Currículo Lattes
Co-autor: Gabriela Monteiro Currículo Lattes
Co-autor: Ana Paula Sobral Currículo Lattes
Co-autor: Sérgio Campello Currículo Lattes
Co-autor: Marcely Cassimiro Currículo Lattes
Co-autor: Aldo Bezerra Currículo Lattes
Co-autor: Felipe Xavier Currículo Lattes
Co-autor: Cristina Musso Currículo Lattes
Co-autor: Diana Albuquerque Currículo Lattes

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