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Intracanal Medication

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

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Intracanal Medication

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  1. Intracanal Medication Dr syed Abrar Ali Assistant Professor Operative Dentistry

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

  3. 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

  4. Primary functionDisinfectionAntimicrobial Agents • Antibiotics • Sulpha preparations • Penicillins • Metronidazole • Terracycline • Clindamycin

  5. Antimicrobial Agents • Disinfectants • Aldehydes • Halogens • Phenols • Chlorhexdine • Calcium Hydroxide • CaOH with antimicrobial additives

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

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

  8. Secondary FunctionsInduction Of Hard Tissue Formation • Also called root end closure or apexification • Calcium hydroxide, MTA • Barrier allows mechanical compression of root filling

  9. Secondary FunctionsPain Of Endodontic Origin • Interappointment dressing to combat infection • Ledermix • Corticosteroids • NSAIDS

  10. Secondary FunctionsExudation And Bleeding • Exudation • Sign of infection • Large apical formen • Over-instrumented canal • Bleeding • Calcium Hydroxide • Formacresol

  11. Secondary FunctionsRoot Resorption • After infection and trauma • Several types • CaOH, Ledermix, Calcitonin

  12. External Root Resorption

  13. Resorption After Bleaching

  14. Internal Resorption

  15. 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

  16. Suggested Clinical Procedure • Mechanical reduction of bacteria • Application of medicament • Irrigation • Dressing • Temporary filling

  17. Suggested Reading • Harty’s Chapter 7

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