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Reviewing Intercanal Medicaments

Learning Objectives:

After hearing this podcast, the listener should: 
  • Understand the advantages and disadvantages of several intercanal medicaments
  • Be able to name at least 3 intercanal medicaments

Advances in technology have improved the use and quality of tooth-canal instrumentation. Available irrigants (ie, NaOCl, chlorhexidine, EDTA, and MTAD) provide antibacterial tissue solvent and smear-removing capabilities that aid in cleaning the root canal system of tissue remnants, bacteria, bacterial products, and dentinal debris. In spite of this, root canals with nonvital pulp often retain viable bacteria after instrumentation. The complexity of the root canal system and the inability of instruments or irrigants to eradicate all bacteria contribute to this result. To decrease the bacterial count of a tooth canal in patients whose treatment plans include a series of appointments, a wide range of materials have been sealed in the tooth between appointments as intercanal medicaments.

*Associate Professor and Chairman, Department of Endodontics, University of Mississippi School of Dentistry, Jackson, MS 

Related Reading:

  1. Byström A, Sundqvist G. The antibacterial action of sodium hypochlorite and EDTA in 60 cases of endodontic therapy. Int Endod J 1985;18(1):35-40.
  2. McGurkin-Smith R, Trope M, Caplan D, et al. Reduction of intracanal bacteria using GT rotary instrumentation, 5.25% NaOCl, EDTA, and Ca(OH)2. J Endod 2005;31(5):359-363.
  3. Messer H, Shepard C, Chen RS. The duration of effectiveness of root canal medicaments. J Endod 1984;10(6):240-245.
  4. Hata G, Nishikawa I, Kawazoe S, Toda T. Systemic distribution of 14C-labeled formaldehyde applied in the root canal following pulpectomy. J Endod 1989;15(11):539-543.
  5. Fager FK, Messer HH. Systemic distribution of camphorated monochlorophenol from cotton pellets sealed in pulp chambers. J Endod 1986;12(6):225-230.
  6. Stamos DG, Haasch GC, Gerstein H. The pH of local anesthetic/calcium hydroxide solutions. J Endod 1985;11(6):264-265.
  7. Shuping GB, Orstavik D, Sigurdsson A, et al. Reduction of intracanal bacteria using nickel-titanium rotary instrumentation and various medications. J Endod 2000;26(12):751-755.
  8. Safavi KE, Nichols FC. Effect of calcium hydroxide on bacterial lipopolysaccharide. J Endod 1993;19(2):76-78.
  9. Wadachi R, Araki K, Suda H. Effect of calcium hydroxide on the dissolution of soft tissue on the root canal wall. J Endod 1998;24(5):326-330.
  10. Manzur A, González AM, Pozos A, et al. Bacterial quantification in teeth with apical periodontitis related to instrumentation and different intracanal medications: A randomized clinical trial. J Endod 2007;33(2):114-118.
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