Frequently asked questions
Q1. How do you mix and apply Odontocem?
Every dentist is familiar with mixing plaster. The best way to describe the mixing of Odontocem, is to think of it as doing the same – mixing plaster. Do not try to mix and apply Odontocem as you would Ledermix Cement. The two are very different in the way they behave during mixing. Odontocem cannot be mixed to a runny consistency and applied in thin sections. It will never set. Odontocem must be mixed into a dough and applied as a portion of the dough.
Q2. What makes Odontocem different to MTA?
Odontocem was designed as a calmative liner for deep cavities, a pulp capping agent and for use in deciduous pulpotomies. It contains calcium silicate which is a component of MTA along with various calcium cements based on “bone cement” formulations. The additional calcium salts utilised ensure that calcium is readily available. This means that there is an abundance of calcium present at the site where it is needed the most – at the pulp exposure.
Q3. Why does Odontocem contain a steroid?
The steroid in Odontocem is used to reduce pain following pulp capping procedures. It achieves this by reducing inflammation. The steroid present is in low amounts for two reasons. The first is that a low concentration of steroid means that the effect of the steroid is short-lived. This reduces the chance of a possible masking of a negative result due to prolonged steroid activity. Secondly, steroids inhibit healing hence a reduced amount of steroid has a reduced effect regarding the delay of healing. This is important in pulp capping where a dentinal bridge needs to be formed.
Q4. How long does it take for Odontocem to set?
Initial set is within 3-5 mins with a full set within 24 hrs.
Q1. Does Odontocide clinically stain teeth?
No, you do not have to bleach afterwards.
Q2. What is the difference between Odontocide and Odontopaste?
Both Odontocide and Odontopaste have antibacterial and anti-inflammatory properties. Odontopaste achieves this through an antibiotic/steroid combination and Odontocide through calcium hydroxide/NSAID combination. Odontocide has superior antibacterial properties compared to Odontopaste. Odontopaste has superior anti-inflammatory properties.
Q3. Why does Odontocide have 20% calcium hydroxide whilst other formulations have higher percentages of up to 40%?
Odontocide contains 20% calcium hydroxide. The level (%) of calcium hydroxide is commonly used as an indicator of the effectiveness of the paste. This is an incorrect assumption. The effectiveness of the calcium hydroxide-based paste is better correlated to the pH of calcium hydroxide in solution. pH is determined by the solubility of calcium hydroxide in water and by the dissociation constant of calcium hydroxide. Calcium hydroxide has a high dissociation constant meaning that most of the calcium hydroxide which dissolves converts to free hydroxyl ions and calcium ions. The hydroxyl ions are responsible for the antibacterial properties of the paste. However, with only 1.73 grams of calcium hydroxide dissolving in one litre of solution, the concentration of hydroxyl ions is low and this is why calcium hydroxide achieves a pH of approx. 12.4-12.6 whilst other similar compounds such as sodium hydroxide and potassium hydroxide, which are far more soluble, achieve a pH of 14.
Theoretically, if more than 0.173% calcium hydroxide is present, then the pH will always be the same as anything more than 0.173% cannot dissolve into solution and is effectively inert. So a 0.173%, 5%, 10%, 20% 40% calcium hydroxide paste wiill all have the same pH. The only advantage of the higher % calcium hydroxide paste is that it lasts longer within the canal. As the calcium and hydroxyl ions are lost through disolution then more calcium hydroxide dissolves to replace the amount lost. Therefore the higher percentage pastes will last longer. How long? Well that remains unknown. However, there are several calcium hydroxide pastes on the market, other than Odontocide, which have only 20% calcium hydroxide present, and they have been used for many decades. eg. Calcipulpe and Calxyl (slightly more than 20%).
Odontocide is therefore not compromised in terms of its antibacterial properties because of its lower calcium hydroxide percentage.
Q4. How does Odontocide “achieve” a pH of 12.5?
It is not accurate to refer to a pH of a paste which is not aqueous-based when drawing comparisions to calcium hydroxide-based pastes in different solvents such as water. However, due to criticisms from our competitors regarding ADM not providing a pH we decided to phrase it as “it achieves a pH”. It only does this when the solvent used in Odontocide, polyethylene glycol, is displaced by significant amounts of water. The pH of a paste in a non-aqueous solvent cannot be compared to a pH in an aqueous solvent. This is a well known fact in electrochemistry, however, of which dentists are not aware. It is best to think of pH mesures in two different solvents as two temperature scales, Celsius and Fahrenheit. You can measure temperatures using either scale but you cannot compare their direct measures unless you convert the scales. pH is even more complex as no conversion exists between different pH measures in different solvents. It is simply impossible to compare pH of aqueous to pH of non-aqueous such as polyethylene glycol. Unfortunately most dentists do not understand electrochemistry and are unaware of this fact. Odontocide therefore “acheives” a pH of 12.5 but only when placed within the root canal and where the solvent has been displaced with water. It is the only way of making a statement regarding pH which is accurate in terms of the science and chemsitry involved. It is unfortunate that some companies attempt to mislead the dental profession by stating that they have a paste with a pH of greater than 14 in a calcium hydroxide/polyethylene glycol mixture. This is simply not possible.
Q1. Does Odontopaste clinically stain teeth?
No, you do not have to bleach afterwards.
Q2. Can Odontopaste be used 50:50 with calcium hydroxide?
No. Odontopaste already has 0.5% calcium hydroxide. Any further addition of calcium hydroxide will degrade the steroid and antibiotic components of the paste. For a better antibacterial paste, try Odontocide. Odontocide has 20% calcium hydroxide and ibuprofen at 7% premixed.
Q3. Can Ledermix Paste be used 50:50 with calcium hydroxide.
Please refer to published research on this topic. The article is free to download.
Q4. Why has the tube changed?
Odontopaste is now supplied in a plastic laminate tube. This allows for heat sealing of the tube and improves the tamper evidence measures. There is still 8 grams of paste in the tube even though the tube is smaller in size.
Q5. What is the difference between Odontocide and Odontopaste?
Both Odontocide and Odontopaste have antibacterial and anti-inflammatory properties. Odontopaste achieves this through an antibiotic/steroid and Odontocide through calcium hydroxide/NSAID. Odontocide has superior antibacterial properties compared to Odontopaste. Odontopaste has superior anti-inflammatory properties.
Q6. Why does Odontopaste have an extra nozzle and how do I use it?
The Odontopaste nozzle provides a finer application for easier lentulo spiral pickup. It is not essential to use the Odontopaste nozzle for application. We recommend using only figure pressure when squeezing paste through the nozzle. Excessive pressure to the neck of the tube may damage the tube/nozzle.
Q1. When do I use Odontopaste and when do I use Odontocide?
Odontopaste is the preferred dressing for patients who present in pain. The steroid within Odontopaste is far more effective than the ibuprofen in Odontocide in controlling inflammation and pain. Odontopaste is also ideal in cases where teeth have been avulsed. The steroid reduces inflammation and Odontopaste is less cytotoxic than Odontocide thereby providing a better environment for the recovery of the compromised periodontal ligament. Odontocide is the preferred endodontic dressing for most routine endodontic cases. The calcium hydroxide provides a better antibacterial effect than clindamycin hydrochloride in Odontopaste and the ibuprofen assists in pain relief caused by the alkalinity of the calcium hydroxide in Odontocide.
Patients presents in pain:
The Parashos Validated Protocol for the cleaning of endodontic files is a simple process which if followed correctly cleans files in a manner allowing them to be resterilised and reused. The protocol was devised by Prof. Peter Parashos who is the head of Endodontics at the University of Melbourne.
The summary of his protocol is as follows:
Step 1: 10 vigorous strokes in a scouring sponge soaked in 0.2% chlorhexidine solution.
Step 2: 30 minutes pre-soaking in an enzymatic cleaning solution.
Step 3: 15 minutes ultrasonication in an enzymatic cleaning solution.
Step 4: 20 Second rinse in running tap water.
From the graph above you can see a comparison between different cold sprays on the market. Frostbite 248 uses a gas system which has been specifically formulated to produced the lowest possible temperature without the need for exotic and expensive ingredients. When you compare Frostbites ability to achieve a temperature of -55C against the other competitors on the market you can see the superiority of Frostbite 248. Carbon dioxide cold sticks, or dry ice, approach -60C but cost over a thousand dollars to setup and then there are the additional maintenance costs. Frostbite 248, on the other hand, is inexpensvie, has no maintenance costs, and is far easier to use. Carbon dioxide sticks also tend to cause a cold burn on the patient’s cheeks. With Frostbite 248 this is far less likely due to the way it is used.
If you would like to do a simple comparison between the available cold sprays on the market then simply spray the back of your hand which each coldspray for a short time. You will quickly realize that Frostbite is by far colder.