medicaments

Question 1

Evidence indicates that intracanal medicaments are required for maximum microbial elimination in the root canal system and for killing microorganisms not reached by the instruments and irrigants

Answer 1

Bystrom et al. 1985, Bystrom et al. 1987, Siqueira 2001

Question 2

Intracanal medicaments that temporarily seals the root canal, such as calcium hydroxide pastes, deny space for microbial proliferation between visits, and can play an important role in pre- venting the recontamination of the root canal between appointments

Answer 2

Siqueira et al. 1998

Question 3

Use of Intracanal medicaments:

Answer 3

• Eliminate remaining m/o after chemo-mechanical preparation
• Reduce inflammation of pulp remnant
• Prevent recontamination in between appointments
• Inducing healing in calcified tissues
• Render canal contents inert and neutralise tissue debris
• Act as barrier against leakage from temporary resto
• Control inflammatory root resorption
• Help to dry persistently wet canals (Abbott 1990)

Question 4

against ledermix

Answer 4

• De Deus & Han (1967) reported that hydrocortisone applied directly to the dental pulp in hamsters could be detected in other organs within 2 minutes.
• Hargreaves (2002) and Seltzer (2000) state that the intracanal use of corticosteroids reduces the inflammatory response, suppresses vasodilation and limits neutrophil migration. They also interfere with phagocytosis and protein synthesis. As a result, infections became rampant and tissue repair was delayed.

Question 5

pro ledermix

Answer 5

Abbott (1992) calculated that the highest possible amount of Ledermix paste can be used as an intracanal dressing, and analysed the release and diffusion characteristics, making comparisons with known endogenous levels of corticosteroids. He suggested that the intracanal use of Ledermix paste is unlikely to result in any systemic side effects.

Question 6

abbott 1990

Diffussion of ledermix

Answer 6

The rate of release of demeclocycline at day one was about 10 times more than the rate after one week. Demeclocycline might be effective against bacteria within the first few days after Ledermix placement, but would not be suitable as a long term dressing.

Question 7

Mixing these two medicaments (Ledermix +CAOH) alters the release and diffusion of the active components of the Ledermix paste

Answer 7

Abbott et al. 1989

Question 8

Ledermix was shown to give the greatest pain relief

Answer 8

Matthews et al. 1994

Question 9

The action of the triamcinolone component of Ledermix can biologically inactivate clastic cells associated with root resorption.

Answer 9

Heithersay 1994

Question 10

The corticosteroid directly inhibits the spreading of dentinoclasts, suggesting that it acts by detaching resorption dentinoclasts from the root surface .

Answer 10

Pierce et al. 1988

Question 11

replanted teeth after extraction followed by mechanical instrumentation and medicated with Ledermix inhibited inflammatory root resorption or inflammation of the periodontal membrane

Answer 11

Pierce & Lindskog 1987

Question 12

Ledermix treated roots had significantly more healing and less resorption than the roots treated with calcium hydroxide

Answer 12

Bryson et al 2002

Question 13

Immediate intracanal placement of Ledermix paste was therefore recommended at the emergency visit after an avulsion injury to decrease resorption and increase favourable healing

Answer 13

Abbott 1990

Question 14

RCT medicated with ledermix, septomixine and caoh

• Similar microbiological outcomes

Answer 14

Chu et a 2006

Question 15

Ledermix paste used as an intracanal medicament may cause discolouration of both mature and immature teeth after it had been in the canals for more than 4 weeks

Answer 15

Kim et al. 2000

Question 16

efficacy of calcium hydroxide in endodontic therapy is from its of caoh

Answer 16

• bactericidal effects (Hermann 1930; Bystrom & Sundqvist 1985),
• its destructive effect on bacterial cell membranes and protein structures (Gordon et al. 1985; Safavi & Nichols 1993),
• inhibition of tooth resorption (Tronstad 1988)
• induction of repair by hard tissue formation (Foreman & Barnes 1990).
• Tissue dissolution (Nerwich 1993)

Question 17

Introduced caoh

Answer 17

Hermann 1920

Question 18

Meta-analysis on caoh as intracanal medicament: the difference in pre and post medicament had no statistical significance

Answer 18

Sathorn 2007

Question 19

Calcium hydroxide needs to diffuse through tissues and the hydroxyl concentration is decreased because of the dentine hydroxyapatite buffering property

Answer 19

Nerwich et al. 1993

Question 20

hydroxyl ions derived from a calcium hydroxide intracanal dressing diffuse in a matter of hours into the inner root dentin but require 1 to 7 days to reach the outer root dentin and 2 to 3 wk to reach peak levels.

Answer 20

Nerwich et al. 1993

Question 21

calcium hydroxide is an effective physical barrier, which can kill remaining microorganisms by withholding substrates for growth and by limiting space for multiplication

Answer 21

Dahlen & Haapasalo 1998