Intracanal Medication

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Intracanal Medication

• Dr syed Abrar Ali
• Assistant Professor
• Operative Dentistry

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Introduction

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

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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

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Primary functionDisinfectionAntimicrobial Agents

• Antibiotics
• Sulpha preparations
• Penicillins
• Metronidazole
• Terracycline
• Clindamycin

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Antimicrobial Agents

• Disinfectants
• Aldehydes
• Halogens
• Phenols
• Chlorhexdine
• Calcium Hydroxide
• CaOH with antimicrobial additives

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Concept Of Predictable Disinfection In Endodontics

• Mechanical instrumentation
• Antibacterial effect of irrigation
• Effect of antibacterial dressing
• Single visit issue

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Microbes Of The Pulp

• With apical periodontitis
• Fusobacterium, prevotella, pophyromonas,
  peptostreptococcus, veillonella, spirochetes
• Retreatment cases
• Enterococci esp. E. Fecalis, Yeasts
• Actinomyces

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Secondary FunctionsInduction Of Hard Tissue
Formation

• Also called root end closure or apexification
• Calcium hydroxide, MTA
• Barrier allows mechanical compression of root
  filling

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Secondary FunctionsPain Of Endodontic
Origin

• Interappointment dressing to combat infection
• Ledermix
• Corticosteroids
• NSAIDS

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Secondary FunctionsExudation And Bleeding

• Exudation
• Sign of infection
• Large apical formen
• Over-instrumented canal
• Bleeding
• Calcium Hydroxide
• Formacresol

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Secondary FunctionsRoot Resorption

• After infection and trauma
• Several types
• CaOH, Ledermix, Calcitonin

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External Root Resorption
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Resorption After Bleaching
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Internal Resorption
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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

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Suggested Clinical Procedure

• Mechanical reduction of bacteria
• Application of medicament
• Irrigation
• Dressing
• Temporary filling

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Suggested Reading

• Hartys Chapter 7

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