medicaments Flashcards
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
Bystrom et al. 1985, Bystrom et al. 1987, Siqueira 2001
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
Siqueira et al. 1998
Use of Intracanal medicaments:
- 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)
against ledermix
- 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.
pro ledermix
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.
abbott 1990
Diffussion of ledermix
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.
Mixing these two medicaments (Ledermix +CAOH) alters the release and diffusion of the active components of the Ledermix paste
Abbott et al. 1989
Ledermix was shown to give the greatest pain relief
Matthews et al. 1994
The action of the triamcinolone component of Ledermix can biologically inactivate clastic cells associated with root resorption.
Heithersay 1994
The corticosteroid directly inhibits the spreading of dentinoclasts, suggesting that it acts by detaching resorption dentinoclasts from the root surface .
Pierce et al. 1988
replanted teeth after extraction followed by mechanical instrumentation and medicated with Ledermix inhibited inflammatory root resorption or inflammation of the periodontal membrane
Pierce & Lindskog 1987
Ledermix treated roots had significantly more healing and less resorption than the roots treated with calcium hydroxide
Bryson et al 2002
Immediate intracanal placement of Ledermix paste was therefore recommended at the emergency visit after an avulsion injury to decrease resorption and increase favourable healing
Abbott 1990
RCT medicated with ledermix, septomixine and caoh
• Similar microbiological outcomes
Chu et a 2006
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
Kim et al. 2000
