Intra-Canal Medication, Temporization and Non-Vital Bleaching Flashcards
Many studies show no statistical difference in
outcomes between RCT completed in
a single
visit vs. RCT completed in multiple visits.
Single visit RCT is acceptable as a
modern evidenced-based standard
in general ; most predictable with
vital teeth and no P/R pathoses.
Other respected studies show that cases with primary apical
periodontitis completed in multiple visits with — as an
interim intra-canal medication improved the microbiological
status of the root canal system.
CaOH
One of the primary goals of RCT is to
reduce
the microbiological status of the root canal
system to the extent at which P/R healing can
occur.***
Therefore the — visit protocol RCT is acceptable and
may be superior (in terms of reduction of micro-organisms in
the canal system in teeth with P/R pathosis) as a modern
evidenced-based standard in general.
2 or even 3
AT UMKC-SoD, Teeth with
Peri-Radicular Pathosis or
Necrotic Pulp will be treated
at least
one week with intra-
canal medication with
Ca(OH)2 before Obturation.
DST should heal.
Between RCT visits or at any time the canal is not
protected by adequate rubber dam isolation, the
canal must be protected from
salivary contamination
(micro-organisms) by some type of temporary filling.
Anytime obturation is
not yet accomplished,
this is an indication for
intra-canal medication.
Any Time that a Temporary
Restoration is placed, it is a
good idea to
Medicate &
Seal with Proper Interim
Temporization
— is currently the singular most popular
intra-canal medication to use for disinfection of
canal between RCT visits*
CaOH
Calcium Hydroxide
– Far less — than previous intra-canal medications
– — environment for most micro-organisms (pH –)
– — encouraged in a basic vs. acidic environment
– — activity extends over extended periods (up to 3 mos.)
– Helps to — a “weepy” canal
– Safe & easily removed by — at subsequent appointment
– DO NOT CONFUSE WITH —
toxic
Unfavorable, 12.4
Bone healing
Antimicrobial
dry
irrigation
BC SEALER
– (You will never get set BC SEALER OUT of the canal(s)
CaOH tip is placed about — short of WL (do NOT allow to BIND)
and the CaOH is expressed as the syringe is retracted from the canal.
Objective: fill the canal in its entirety to
2mm
Cervical Line
USE CARE! If you have a
mandibular PM or Molar with
open apices, it is possible to
force CaOH out the apex & into
the Mandibular Canal possibly
causing Paresthesia
and Severe and lasting Pain to
the jaw and Face.
Clear excess CaOH from –
chamber
Place sterile cotton pellet in chamber to prevent clogging of the canal with
temporary filling material ***
Temporary filling is placed following the
cotton pellet
Temporization Between Visits
(2)
- Sterile cotton in chamber over CaOH
- Place Cavit, IRM, Amalgam or
Composite over cotton
skipped
Place Cavit, IRM, Amalgam or
Composite over cotton:
(3)
– Cavit:
– IRM:
– Composite, Amalgam, Temporary Crown:
– Cavit:
Comes from the tube or jar ready to place in the
tooth. No mixing. (1-2 week duration of seal – seals better
than IRM but deteriorates rapidly)
Best used only for 1 surface access
– IRM:
(1-4 week duration of seal = stronger = use when 2
surfaces or more are missing)
– Composite, Amalgam, Temporary Crown:
(when
considerable tooth structure is compromised or a greater
delay to next treatment visit is anticipated
Temporary Filling
Material:
3-4 mm
Temporization following Obturation
* “—” (resin modified glass ionomer) is
recommended to seal the obturated canal (G.P.)
against leakage following successful RCT completion
while awaiting permanent restoration
Vitrebond
