IN T R A C A N A L
ME D IC A T IO N
A IM:
W h en treatm ent cannot b e com p leted in one
ap p ointm ent th e su rviving intracanal b acteria p roliferate
b etw een ap p ointm ents.
T h erefore, an intracanal m edication th at w ill restrict
b acterial reg row th , su p p ly continu ed disinfection and
create a p h ysical b arrier can b e advantag eou s.
C A LC IU M H Y D R O X ID E
T h e m ost p op u lar intracanal m edication in u se. It is introdu ced in
1 9 2 0 s.
C a(O H )2 :
slow -acting antisep tic
2 4 -h ou r contact p eriod is req u ired for com p lete killing of
enterococci
u se as a b road-sp ectru m antim icrob ial ag ent
O T H E R U S E S O F C A (O H )2
1 . A p exification of th e im m atu re tooth w ith p u lp al necrosis b efore
p lacing an ob tu ration m aterial.
2 . In cases w h ere revascu larization is desired, C a(O H )2 can b e u sed
instead of antib iotic p astes.
C L IN IC A L P R O T O C O L
•C alciu m h ydroxide sh ou ld b e in contact w ith th e tissu e to act.
•C a(O H )2 p ow der m ay b e m ixed w ith sterile w ater or saline and p laced
into th e canal w ith u sing a lentu lo p aste filler.
•For m axim u m effectiveness, th e root canal sh ou ld be filled
h om og eneou sly to th e w orking leng th .
L IMIT A T IO N S O F C A LC IU M H Y D R O X ID E
T h e h andling and p rop er p lacem ent of C a(O H )2 p resent a ch alleng e to
th e averag e clinician.
T h e rem oval of C a(O H )2 is freq u ently incom p lete.
D entin can inactivate th e antib acterial activity of C a(O H )2
P H E N O L IC
P R E P A R A T IO N S
B ecau se of th eir volatile p rop erties, th ey cou ld p enetrate dentinal tu b u les
and anatom ic irreg u larities.
H ow ever, th ese com p ou nds h ave a sh ort life sp an, and th eir volatility can
diffu se th rou g h th e tem p orary filling s and also th rou g h th e p eriap ical
tissu e cau s ing toxicity. !!!!!
F O R MA LD E H Y D E
u sed as form ocresol, is h ig h ly toxic, m u tag enic,and carcinog enic
volatile and releases antim icrob ial vap ors w h en ap p lied to a
cotton p ellet for p u lp ch am b er disinfection.
T h ere is no clinical reason to u se form ocresol as an
antim icrob ial ag ent for endodontic treatm ent
T R IP L E -A N T IB IO T IC P A S T E
Mixtu re of antib iotics is su fficiently p otent to eradicate th e
b acteria.
O ne p otential concern of u sing an intracanal antib iotic p aste is
th at it m ay cau se b acterial resistance.
Metronidazole,cip rofloxacin,m inocycline
1 :1 :1
D IS IN F E C T IO N D E V IC E S
A N D T E C H N IQ U E S
S Y R IN G E D E L IV E R Y
A p p lication of an irrig ant into a canal b y m eans of a syring e and
needle allow s exact p lacem ent.
b oth th e diam eter and p osition of th e needle ou tlet determ ine
su ccessfu l ch em om ech anical deb ridem ent
T ip desig n
D iam eter
P osition
T Y P E S O F IR R IG A T IO N
TManu
E CallyHA Nctivated
IQ UIrriEg ation
S
S onically A ctivated Irrig ation
P assive U ltrasonic Irrig ation
N eg ative A p ical P ressu re
G entle W ave S ystem
Laser-A ctivated Irrig ation
P h otoactivation D isinfection
S onic-u ltrasonic activation
T ip of th e needle m u st b e 2 m m
sh orter th an th e w orking leng h t to
avoid extru sion
