Nonsurgical management of persistent periapical lesions in the anterior region - A systematic review

The basic objective of endodontic therapy is to prevent or arrest the pulpal or periradicular infection. Widely used intracanal medicament calcium hydroxide (Ca[OH]2) introduced by Hermann in 1920 has numerous biological properties such as antimicrobial activity, tissue dissolving ability, inhibition of resorption, and bone formation associated with periradicular healing nonsurgically with less adverse reactions. A systematic search was conducted using MEDLINE PubMed, EBSCOhost, Scopus, Google Scholar, and manual search library resources from January 1, 2008, to July 31, 2019, in order to identify relevant studies. All cross-reference lists of the selected studies were also screened. The inclusion criteria were articles in English or those having detailed summary in English, published between January 2008 and July 2019. Case reports and case series providing information about Calcium Hydroxide as an effective intracanal medicament in persistent periapical infections. Review, abstracts, letters to editors, and editorials were excluded. Data extraction was performed independently by two reviewers. A total of 73 case report articles were identified through the database searching. A total of 20 articles were qualified and were selected. Most of the articles concluded that Ca (OH)2 in any form of vehicle promoted periapical healing with less adverse effects in persistent periapical infections.