Evolução e aplicabilidade do hidróxido de cálcio como medicação intracanal na endodontia: revisão de literatura

Intraradicular infections remain the main challenge in endodontic treatment, requiring the use of intracanal medications as adjuncts to chemomechanical preparation for complete disinfection of the root canal system. Among these medications, calcium hydroxide stands out as the gold standard. Accordingly, the aim of this study was to carry out a literature review to analyze the applicability and evolution of calcium hydroxide used as an intracanal medication in Endodontics, and to compare it with other medications. The search was conducted in the PubMed and Virtual Health Library (BVS) databases, including articles published between 2020 and 2025. The MeSH/DeCS descriptors “Endodontics”, “Calcium Hydroxide” and “Root Canal Therapy” were used, combined with the Boolean operator “AND”, focusing on studies that addressed the antimicrobial action of these substances. Calcium hydroxide (Ca(OH)2), although it is the first-choice medication owing to its broad beneficial and antimicrobial properties, showed limited efficacy when used alone against resistant microorganisms, notably Enterococcus faecalis. It is concluded that success in eliminating periradicular infection requires integrating traditional resources, often enhanced through associations and vehicles, with the exploration of new formulations, such as nanoparticles, bioceramics and natural compounds, which represent the promising path toward greater clinical predictability in Endodontics.