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

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

4. 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

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

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

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

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

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

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

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

13. Secondary Functions Root Resorption
After infection and trauma
Several types
CaOH, Ledermix, Calcitonin

14. External Root Resorption

16. Resorption After Bleaching

17. Internal Resorption

18. 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

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

20. Suggested Reading
Harty’s Chapter 7