In cases with significant bone loss and lesions due to infection at the root tip, completing root canal treatment in a single session often results in failure. In multi-session treatment, after cleaning the canals, a high pH (approximately 12.5) medical paste called “Calcium Hydroxide” is placed inside, and the tooth is left in this solution for 15-30 days. The fundamental aim of this philosophy is to completely eliminate stubborn bacteria (such as Enterococcus faecalis) that thrive in the deepest parts of the dentin tubules and love acidic environments, even those that traditional disinfectants cannot kill, using the immense alkaline power of calcium hydroxide. Calcium hydroxide both breaks down the cell wall of bacteria and neutralizes the acidic lesion environment, providing the alkaline environment and calcium ions necessary for the regeneration of the jawbone at the root tip.
