Intracanal Medication Dr syed Abrar Ali Assistant Professor

Intracanal Medication Dr syed Abrar Ali Assistant Professor Operative Dentistry

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

Functions of Intracanal Medicaments n Primary function n n Disinfection Secondary Functions n n Induction of hard tissue formation Pain control Control of exudation or bleeding Control of inflammatory root resorption

Primary function Disinfection Antimicrobial Agents n Antibiotics n n n Sulpha preparations Penicillins Metronidazole Terracycline Clindamycin

Antimicrobial Agents n Disinfectants n n n Aldehydes Halogens Phenols Chlorhexdine Calcium Hydroxide Ca. OH with antimicrobial additives

Concept Of Predictable Disinfection In Endodontics n Mechanical instrumentation n Antibacterial effect of irrigation n Effect of antibacterial dressing n Single visit issue

Microbes Of The Pulp n With apical periodontitis n n Retreatment cases n n Fusobacterium, prevotella, pophyromonas, peptostreptococcus, veillonella, spirochetes Enterococci esp. E. Fecalis, Yeasts Actinomyces

Secondary Functions Induction Of Hard Tissue Formation n Also called root end closure or apexification Calcium hydroxide, MTA Barrier allows mechanical compression of root filling

Secondary Functions Pain Of Endodontic Origin n Interappointment dressing to combat infection n Ledermix n Corticosteroids n NSAIDS

Secondary Functions Exudation And Bleeding n Exudation n n Sign of infection Large apical formen Over-instrumented canal Bleeding n n Calcium Hydroxide Formacresol

Secondary Functions Root Resorption n After infection and trauma n Several types n Ca. OH, Ledermix, Calcitonin

External Root Resorption

Resorption After Bleaching

Internal Resorption

Tissue Toxicity and Biological Considerations n Aldehydes and phenols n Tissue damage n Interfere with healing or serve as locus for bacterial colonization to creat a lesion that never existed

Suggested Clinical Procedure n Mechanical reduction of bacteria n Application of medicament n n n Irrigation Dressing Temporary filling