The effect of calcium hydroxide on the steroid component of Ledermix® and Odontopaste®

Athanassiadis M, Jacobsen N, Parashos P. The effect of calcium hydroxide on the steroid component of Ledermix (R) and Odontopaste (R). International Endodontic Journal, 44, 1162-1169, 2011. Aim To investigate the chemical interaction of calcium hydroxide with the corticosteroid triamcinolone acetonide in Ledermix (R) Paste and in Odontopaste (R), a new steroid/antibiotic paste. Methodology Validated methods were developed to analyse the interaction of calcium hydroxide in two forms, Pulpdent (R) Paste and calcium hydroxide powder, with triamcinolone acetonide within Odontopaste (R) and Ledermix (R) Paste. High-performance liquid chromatography (HPLC) was used to analyse the mixed samples of the pastes and calcium hydroxide. The concentration of triamcinolone acetonide within the pastes was determined over 0, 2, 6, 24 and 72-h time-points. All tests with the HPLC involved the testing of the standard with triplicate injections alongside the samples. All samples were tested in duplicate with each injected twice; therefore, four tests were performed for each investigation. Linearity, precision and specificity of the testing procedures and apparatus were validated. Descriptive statistics are provided. Results In both pastes, there was a marked rapid destruction of the triamcinolone acetonide steroid upon mixing with calcium hydroxide. Odontopaste (R) suffered a lower rate of destruction of the triamcinolone acetonide component than Ledermix (R) Paste, but both pastes showed very similar degrees of steroid destruction after 72 h. When using calcium hydroxide powder with Ledermix (R) Paste, the triamcinolone was destroyed entirely and immediately. Conclusion The addition of calcium hydroxide to Odontopaste (R) or Ledermix (R) Paste results in the rapid destruction of the steroid.