Intracanal Medicaments

Intracanal medicaments can be used in different endodontic conditions including multiple visit endodontic treatment after trauma or in regenerative endodontics. These endodontic medicaments should be removed from the root canal before the placement of the filling or repair material.

Types Of Intracanal Medicaments #

Multiple Antibiotic Pastes #

• Should be used per gram per body weight and intracanal medicament does not give precise dose

• Should not be used in endodontic treatment since it can create mutans or resistant infections.

• Double antibiotic paste is a root canal medicament used in regenerative endodontics and its long-term exposure to dental hard tissues was shown to reduce its mechanical properties.

• The amoxicillin-clavulanate paste is a medicament effective against endodontic pathogens and is effective in endodontic regeneration.

Eugenol #

• Acts as sedative but no strong antibacterial action

• Eugenol is a nonspecific intracanal medicaments commonly used in endodontic practice

• Eugenol as an endodontic medicament have high tissue irritation potential when used in conventional strength

Formocresol #

• It is carcinogenic and toxic, so it should be mostly avoided

• Formocresol is a nonspecific intracanal medicaments commonly used in endodontic practice

• It has high tissue irritation potential when used in conventional strength

Chloromono Camphorated Phenols #

• It gives severe post operative pain if pushed into periapical region

• It is effective in reducing or eliminating the endodontic microbiota, as demonstrated by the incidence of negative cultures

Calcium Hydroxide Paste #

• It is safe, biocompatible, strong irritant if extruded periapically

• It is the best endodontic intracanal medicament

• It inhibits the growth of bacteria by neutralizing acidic environment

• It is alkaline, highly recomended due to antibacterial action

• It is recomended to put calcium hydroxide in vital teeth without lesion upto half working length

Triple Antibiotic Paste #

• It is a mixture of Ciprofloxacin, Metronidazole and Minocycline

• Ciprofloxacin is a synthetic fluoroquinolone and has a bactericidal mode of action

• Nitroimidazole compound that exhibits a broad spectrum of activity against protozoa and anaerobic bacteria.

• Minocycline is a semi-synthetic derivative of tetracycline with a similar spectrum of activity

• It also contains propyelene glycol.

• Triple antibiotic paste is mixed with normal saline or 2% chlorhexidine, produced the largest zone of inhibition against, Enterococcus faecalis (E.Faecalis).

• Propyelene glycol acts as a vehicle for antimicrobial compound by their penetrating ability to control the infection as far as it extend.

• This material has been used to promote periapical healing in non-vital teeth associated with periapical lesion.

• Combination of drugs can kill any bacterium in carious lesions, necrotic pulp, infected root dentin and periapical lesions.