Intracanal Medication

Dr syed Abrar AliAssistant ProfessorOperative Dentistry

Introduction

An agent used as an adjunt to cleaning and shaping for prevention or treatment of apical periodontitis.

Functions of Intracanal Medicaments

Primary function Disinfection

Secondary Functions

Induction of hard tissue formation Pain control Control of exudation or bleeding Control of inflammatory root resorption

Primary functionDisinfectionAntimicrobial Agents Antibiotics

Sulpha preparations Penicillins Metronidazole Terracycline Clindamycin

Antimicrobial Agents

Disinfectants

Aldehydes Halogens Phenols Chlorhexdine Calcium Hydroxide CaOH with antimicrobial additives

Concept Of Predictable Disinfection In Endodontics Mechanical instrumentation

Antibacterial effect of irrigation

Effect of antibacterial dressing

Single visit issue

Microbes Of The Pulp With apical periodontitis

Fusobacterium, prevotella, pophyromonas, peptostreptococcus, veillonella, spirochetes

Retreatment cases Enterococci esp. E. Fecalis, Yeasts

Actinomyces

Secondary FunctionsInduction Of Hard Tissue Formation Also called root end closure or

apexification

Calcium hydroxide, MTA

Barrier allows mechanical compression of root filling

Secondary Functions

Pain Of Endodontic Origin Interappointment dressing to

combat infection

Ledermix

Corticosteroids

NSAIDS

Secondary FunctionsExudation And Bleeding

Exudation Sign of infection Large apical formen Over-instrumented canal

Bleeding Calcium Hydroxide Formacresol

Secondary FunctionsRoot Resorption

After infection and trauma

Several types

CaOH, Ledermix, Calcitonin

External Root Resorption

Resorption After Bleaching

Internal Resorption

Tissue Toxicity and Biological Considerations

Aldehydes and phenols

Tissue damage

Interfere with healing or serve as locus for bacterial colonization to creat a lesion that never existed

Suggested Clinical Procedure

Mechanical reduction of bacteria

Application of medicament Irrigation Dressing

Temporary filling

Suggested Reading

Harty’s Chapter 7