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Intracanal Medicaments

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Dabbor Gml

on 21 January 2014

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Transcript of Intracanal Medicaments

Calcium hydroxide
Bio-active glass


Phenol Agents
Intracanal Medicaments
Primary function
Antimicrobial activity
Secondary function
Hard tissue formation
Pain control
Exudation control
Resorption control
Recommended in cases with endodontic symptoms
Inhibit root resorption
The release of triamcinolone after 24 hours 30% , and 70% after 14 weeks
Disadvantges :
-Reach to systemic circulation via diffusion through dentinal tubules , lateral canals and apical foramen

Metronidazole + Criprofloxacin + Minocycline

Very strong bacteriocidal
-Bacterial resistance
- Discoloration ( minocycline)

A drug used in the root canal system during the course of therapy.
Little effective in E.Faecalis – Candida Albicans
Difficult to remove it(
2 theories
)even by EDTA or (NAOCL-SALINE) as
which affect the zinc oxide eugenol sealer

The potential problems that canbe associated with calciumhydroxide may be
Calcium Hydroxide
Chlorine, an active ingredient of NaOCl and iodine

Iodine-potassium iodine
(2% iodine plus 4% potassium iodide and 94% distilled water)

Excellent Antibacterial
Decrease cytotoxicity
May act as sever A
and dentine D

Antibacterial but very strong toxic

There's no clinical reasons to use formocresol

Cytotoxic, Mutagenic , and Carcinogenic
Very strong antibacterial but have severe toxicity
Phenol derivatives:
-increase antibacterial
-increase toxicity
Phenolic compound available as a camphorated solutions so decrease the toxic phenolic compound because Of the decrease of the released toxins

The use of intracanal medicaments is basically to prevent or treat apical periodontitis which may develop from failure of endodontic treatment.

Thus their primary function is to prevent canal infection or to inactivate bacteria already infecting the root canal. Intracanal medicaments are antimicrobial in nature.

Form all the medicaments reviewed, there were two materials that exhibited theses properties effectively and had features that would be considered nearly ideal properties after evaluating the ratio of risk to advantage. The materials are Calcium hydroxide , Ledermix paste.
(between appointments)
Ultimately no single agents fulfill these criteria.
Germicide , Fungicide and prolonged Antimicrobial effect.
Not irritating to the periapical tissue.
Stable in solution.
Low surface tension and easily diffusible.
Not interfere with repair of periapical tissues.
Not stain the tooth structure.
Capable of inactivation in a culture medium.
No immune response.
Easy to handle
Cheap .

High alkaline nature.
Strong Antibacterial
some studies show:
NAOCL as irrigation only in RCT lead to bacterial reduction 61.9%
NAOCL+CA(OH) as ICM in RCT lead to bacterial reduction by 92.5%
-hydrolyze (LPS) which are reminants of cell wall of killed bacteria which lead to bacterial reduction
-the mix CA(OH) powder +saline applied by lentulo spiral to the working length

Added to some new sealers

0.12% – 2%
Increase conc. Make it bacteriocidal
Decrease conc. Make it bacteriostatic
-low cytotoxicity
-disadv.: May lead to discoloration
Substantivity :
Chlorhexidene bind with albumin in tooth pellicle and hydroxyapitite of the tooth.
Decrease conc. Bind decrease bacteria
Increase conc. Bind and produce multilayers decrease more bacteria

7 days ttt with chx lead to 12 weeks reduce in bacterial no.

limitations of intracanal medicaments :
Intracanal environments the therapeutic action of these medicaments depends on the direct contact on the tissues
But these substances probably do not reach all the areas where bacteria or tissues are present and are limited to the surface action only.

Thank You
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