Intracanal Medication Dr syed Abrar Ali Assistant Professor Operative 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 function Disinfection Antimicrobial 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 Retreatment cases Fusobacterium, prevotella, pophyromonas, peptostreptococcus, veillonella, spirochetes Retreatment cases Enterococci esp. E. Fecalis, Yeasts Actinomyces

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

Secondary Functions Root 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