Materials for disinfection of the pulp space



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Dr.BiLaL ArJuManD

MIHS


  • Desired Irrigant Actions

  • Have a broad antimicrobial spectrum and high efficacy against an aerobic and facultative microorganisms organized in biofilms.

  • Dissolve necrotic pulp tissue remnants

  • Inactivate endotoxin

  • Prevent the formation of a smear layer during instrumentation

  • Irrigation Materials

Proteolytic Materials

  • NaOCI

Detergents

  • Quaternary ammonium compounds

  • Zephiran Chloride

  • Iodophores

Decalcifying Materials

  • Carbamide peroxide

  • Salvizol

  • EDTA

  • Proteolytic Materials

  • Dissolves Necrotic tissue and debris

  • The amount of free chlorine is important for this breakdown of the proteins into amino groups

  • In dentistry conc of 0.5% - 1% -5.25% concentration, provides sufficient tissue dissolution and antimicrobial effect

  • Solution NaOCI is replenished frequently

  • Stored in dark place in tight seal

  • Smell is objectionable

  • Severe symptom if injected beyond apex

  • Detergents

  • Effective in removing fatty tissue residues that are by-products of tissue necrosis

  • Quaternary ammonium antiseptics are normally used in water solution at 0.1% to 1%.

  • toxicity comparable with other irrigation solutions and a rather narrow bactericidal spectrum

  • Iodophores are organic iodine products are not allergenic and are effective at low concentrations.

  • They are antimicrobially effective at an iodine concentration

of 0.05% (volume/volume)

  • Decalcifying Materials

  • During preparation of the root canal a smear layer is formed. There is no clear scientifically based understanding if this smear layer must be removed or can be left

  • EDTA chelate and remove the mineralized portion of smear layers.

  • It decalcify up to a 50-mm thin layer of the root canal wall

  • EDTA is used in a concentration of 17%.

  • The smear layer consists of both an organic and an inorganic

component. To remove this smear layer effectively, it is

normally insufficient to use EDTA only. A proteolytic component



(e.g., NaOCI) must also be added for removal of the organic components of the smear layer

  • EndoDilator is a combination of EDTA and a NaOCl

  • Chlorhexidine

  • Cationic agent and binds with positively charged bacterial cell wall

  • It has a property of substantivety

  • binds effectively to hydroxyapatite, and this provides a lasting reservoir of chlorhexidine after the completion of treatment.

  • Intracanal Disinfection/Medicaments

Phenolic Preparations

  • Paramonochlorphenol

  • Thymol

  • Cresol

Formaldehyde

  • formocresol

Halogens

  • Chlorine Chloramine-T

  • Iodine potassium iodide

Calcium Hydroxide

LEDERMIX

  • Biomechanic instrumentation and irrigation with an antimicrobial solution is essential for the disinfection of the pulp

  • In recent years more attention has been given to the use of calcium hydroxide as intracanal dressing of choice for the treatment of infected pulp necrosis.

  • Phenolic Preparations

  • Severe toxicity, derivatives of phenol, such as paramonochlorphenol, thymol, and cresol, are still in common use for endodontic treatment

  • Phenol is a nonspecific protoplasm poison, having optimal antibacterial effect at 1 % to 2%

  • Highly toxic and induce inflamatory changes

  • Formaldehyde

  • Its high toxicity, carcinogenic and mutagenic potential

  • Contain formaldehyde above the 10% normally used for fixation of pathologic specimens

  • Tricresol formalin is another formaldehyde preparation cont

formaldehyde preparations are potent toxins with an antimicrobial effectiveness much lower than their toxicity. containing 10% tricresol and 90% formaldehyde

  • Halogens

  • Chlorine has been used for irrigation as well as intracanal

dressing in the form of Chloramine-T

  • Iodine, in the form of iodine potassium iodide, is a very

  • effective antiseptic solution 175,113 with a low tissue toxicity

  • Iodine potassium iodide releases

  • vapors that have a strong antimicrobial effect

  • Calcium Hydroxide

  • Used as slurry of calcium hydroxide in a water base

  • Direct contact experiments in vitro require a 24-hour contact period for complete kill of enterococci

  • One week of intracanal dressing has been shown to safely disinfect a root canal system

  • Ability to hydrolyze the lipid moiety of bacterial lipopolysaccharides,

thereby inactivating the biologic activity of the lipopolysaccharide

filled homogeneously to the working length.

  • Alternative Concepts

Use of laser high induce lethal photosensitization on canal microbiots. Irrigantion using electrochemically activated water ozone gas information into the endodontic system. In the future, other ways to fill root canal systems may evolve and/or be established, such as the sue of resin bonded systems , bioactive materials or even the attempt to regenerate pulp tissue in necrotic cases.

  • ROOT CANAL-FILLING MATERIALS

Solid Materials

  • Gutta-Percha

  • Silver Cones

Sealers and Cements

Endodontic Sealers

  • Zinc Oxide-Eugenol Cements

  • Chloropercha

  • Calcium Hydroxide Sealers

  • Polymers

  • Glass lonomer Cement

  • Formaldehyde-Containing Sealers


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