Literature review uncovers physicochemical limitations and bacterial resistance to calcium hydroxide in root canal infections, highlighting the need for combined medicaments.
Literature review The primary function of calcium hydroxide as a routine intracanal medicament is to provide antimicrobial activity. However, the mechanisms of antimicrobial activity of calcium hydroxide are not well known. Physicochemical properties of this substance may limit its effectiveness in disinfecting the entire root canal system. In addition, calcium hydroxide is not effective against all bacterial species found in root canal infections. Association with other medicaments may enhance the efficacy of the intracanal medication in eliminating residual bacteria in the root canal system.
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Siqueira et al. (1999) studied this question.
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