Medicaments in endodontics
• Disinfectants and antiseptics
• Antibiotics and corticoids
• Others
• Local
• Systemic
Irrigation
 Removal of debris
 Decontamination
Irrigants
• Debridment
• Antimicrobial effect
• Dissolution of rests of dentapl pulp
• Removal smear layer
• Decalcification
• Lubrication
Irrigants
• Sodium hypochlorite (1,5 – 5,5%)
• Chlorhexidin (0,12% - 0,2%)
• EDTA – etyléndiaminotetraacetic acid 17%
Irrigants
• Sodiumhypochlorite
2 – 6%
- Oxidation a chloration
- Dissolving efect
- Bad smell, irritant.
Syringe and cannula
• Blunt, side apertures,smallest ISO 35
• No pressure
Activation of irrigation
• Increased effectivity
Vibration
Increasing of temperature
Decomposition of irrigants - dissociation
Calcium hydroxide
Alcaline
Antibacterial
Stimulation of hard tissue formation
Haemostatic and antiphlogictic
Calcium hydroxide
Alcaline
Antibacterial
Stimulation of hard tissue formation
Haemostatic and antiphlogictic
Calcium hydroxide
Temporary root canal filling
Subbase
Component of sealers
Mode of action
 Realease of hydroxyl ions
 Long term alkalinization
 Stimulation of hard tissues formation
Koçkapan, C.:Curriculum Endodontie, p. 377-385, Quintessenz, Berlin 2003
Dressing
Calcium hydroxide
• Short term action
1 – 2 weeks
Desinfection, haemostasis
Calcium hydroxide
• Midle term action
2 – 3 months
Apexification
Chronic form of apical periodontitis
MTA composition
• Dicalcium silicate
• Trikalcium silicate
• Tricalcium aluminate
• Tetrakalcium aluminate
• Cuprum sulphate
• Bismuth trioxide
= portland cement with Bi2O3
MTA
• Direct pulp capping
• Pulpotomy – treatment of the pulp
• Apexifikation
• Internal and external resorption
• Apical surgery
Disinfectants and antiseptics
• Sodiuk hypochloride
• Chloramine
• Chlorhexidine
• Hydrogenium peroxide
• Phenolic based
• Formalin
Phenolic based antiseptics
• Phenol
• Camphor
• Ethanol
Dezinficiencia a antiseptika
• Chlumského roztok
• Trikresolformalin
Antibiotika a kortikoidy
Bacitracin, Neomycin.
Dexametason, Triamcinolon.
• Septomyxin
• Ledermix
Devitalization - pastes
• Based on paraphormaldehyd,
Anaesthetics, vehiculum.
10 – 14 days.
Antibiotics and corticoids
• Combination – pastes
Antimicrobial effect
Decreased inflammation and imunologic
response