Intra canal medicaments
Transcript of Intra canal medicaments
IntroductionAn agent used as an adjunct to cleaning
and shaping for prevention or treatment
of apical periodontitis.
FunctionsPrimary
Antisepsis
Disinfection
SecondaryHard tissue formation
Pain control exudation
Resorption control
Secondary functionsPain during and after treatment can occur and
associated tissue reaction include:
Exudation
Transudation
swelling
resorption
Pain control• Pain is mostly associated with infection and the
primary means of pain control is infection control
Control of exudation or bleeding
• Persistant exudation in the root canal may
oocur.Exudation reflects inflammation.
• Therefore treatment is aimed at dealing with
potential infection as well as drying or coagulation
the site
Controlling inflammatory root resorption
• Inflammatory root resorption is most aggressive and
destructive
• It is associated with infection of root canal
combined with physical damage to the cementum,
so again a primary function of treatment is to
eliminate infection in root canal system
Induction of hard tissue formation
• It is often desirable to allow hard tissue to form to
continue apical root development to close wide
foramen or to create a mechanical barrier at a
fracture line
Micobes of pulp• With apical periodontitis
o Fusobacterium, prevotella, pophyromonas, veillonella, spirochetes
• Retreatment caseso Enterococci esp. E. Fecalis, Yeasts
• Actinomyces
Antimicrobial agents
• Sulpha preparations
• Effective against gram-negative and gram positive
microorganism
3.Tetracycline
• It shows affinity for hard tissues and may be retained
on tooth surface.
• There might resistance to tetracycline occurs and
spectrum is quite narrow
Disinfectants
• They act by direct toxicity to microbes
• They have a broader antibacterial spectrum than
antibiotics
Aldehydes• Formaldehdye, paraformaldehyde and
glutaraldehyde have been widely used.
• They are water soluble and protein denaturing
agents and are most potent disinfectants
• Formocresol is an aqueous solution contaning
cresol,formaldehyde and glycerine,used for
pulpotomy procedures,but its toxic and mutagenic
properties are concerned
Halogens• Includes chlorine and iodine which are used in
various formulations
• They are potent oxidizing agents with rapid
bactericidal effects
• Sodium hypochlorite is currently the irrigating
solution of choice
• Necrotic tissue and debris are dissolved
• Effective conc 0.5-5.25%
Phenol derivative• No longer used because of its high toxicity
• Includes paramonochlorophenol,thymol and
eugenol
• But has high toxicity and limited antimicrobial effect
Chlorhexidine• Broad spectrum activity and less toxicity
• Effective conc is 0.2-2% range
• Innovative attempts to utilize the disinfecting
properties of it include its inclusion in gutta purcha
points for root canal filling
Calcium hydroxide• Antibacterial agents with high pH
• Physically restricts bacterial colonization of the
canal space
• It is applied as a thick creamy suspension
Antibacterial effect of irrigation and
dressing• Addition of sodium hypochlorite increases the
number of bacteria free canal substantially
• The number of bacteria free canal may be further
increase when a dressing of calcium hydroxide is
place
Disadvantages• Tissue toxicity
• Carcinogenic
• May stain the teeth
• Allergic reactions
• Induction of inflammatory response