To sum up, the risk/benefit ratio should be always weighed before prescribing antibiotics.
Appropriately selected patients will benefit from systemically administered antibiotics.
A restrictive and conservative use of antibiotics is highly recommended in endodontic practice, but indiscriminate use is contrary to sound clinical practice
Future generations will thank us for today’s conscientious and judicious use of antibiotics
Bioceramics are materials which include Alumina, Zirconia, Bioactive glass, Glass ceramics, Hydroxyapatite, resorbable Calcium phosphates.
Used in dentistry for
Filling up bony defects
Root repair materials
Apical fill materials
Aids in regeneration etc.
Bioinert: non-interactive with biological systems (Alumina, zirconia)
Bioactive: durable tissues that can undergo interfacial interactions with surrounding tissue (bioactive glasses, bioactive glass ceramics, hydroxyapatite, calcium silicates)
Biodegradable: soluble or resorbable, eventually replaced or incorporated into tissue (Tricalcium phosphate, Bioactive glasses).
An inlay may cap none, or may cap all but one cusp.
Sturdevant’s 4th ed. page579
Inlays may be used as single-tooth restorations for proximo-occlusal or gingival lesions with minimal to moderate extensions
Shillingburg page 1
An inlay may be defined as a restoration which has been constructed out of mouth from gold, porcelain, or other material & then cemented into the prepared cavity of a tooth.
William McGehee pg410
a detailed account of the principles of tooth preparation with main reference from Shillingburg
The presentation is available on request. Mail me at apurvathampi@gmail.com
Bioceramics are materials which include Alumina, Zirconia, Bioactive glass, Glass ceramics, Hydroxyapatite, resorbable Calcium phosphates.
Used in dentistry for
Filling up bony defects
Root repair materials
Apical fill materials
Aids in regeneration etc.
Bioinert: non-interactive with biological systems (Alumina, zirconia)
Bioactive: durable tissues that can undergo interfacial interactions with surrounding tissue (bioactive glasses, bioactive glass ceramics, hydroxyapatite, calcium silicates)
Biodegradable: soluble or resorbable, eventually replaced or incorporated into tissue (Tricalcium phosphate, Bioactive glasses).
An inlay may cap none, or may cap all but one cusp.
Sturdevant’s 4th ed. page579
Inlays may be used as single-tooth restorations for proximo-occlusal or gingival lesions with minimal to moderate extensions
Shillingburg page 1
An inlay may be defined as a restoration which has been constructed out of mouth from gold, porcelain, or other material & then cemented into the prepared cavity of a tooth.
William McGehee pg410
a detailed account of the principles of tooth preparation with main reference from Shillingburg
The presentation is available on request. Mail me at apurvathampi@gmail.com
There have been several changes since inception in the field of dental ceramics. Need for newer materials with improved aesthetics, flexural strength and optical properties made it necessary for introduction of advanced technology in fabrication of dental ceramics.
The ultimate goal of endodontic treatment is to remove as many micro-organisms and their byproducts from the root canal space by using various antimicrobial agents to provide a environment free of micro-organisms . Antibiotics have revolutionized the entire health care system including both medicine and dentistry.
major advantages and unique features as well as its ability to overcome the disadvantages of other materials, biodentine has great potential to revolutionize the different aspects of managing both primary and permanent in endodontics as well as operative dentistry.
After reading this chapter, the student should be able to:
1. Understand the microbial etiology of apical
periodontitis.
2. Describe the routes of entry of microorganisms to the
pulp and periradicular tissues.
3. Recognize the different types of endodontic infections
and the main microbial species involved in each one.
4. Understand the bacterial diversity within infected root
canals.
5. Describe the factors involved with symptomatic
endodontic infections.
6. Understand the ecology of the endodontic microbiota
and the features of the endodontic ecosystem.
7. Discuss the role of microorganisms in the outcome of
endodontic treatment.
8. Understand the development and implications of
extraradicular infections.
Smear layer is a controversial topic in the field of operative dentistry and endodontics. This presentation includes composition, concepts, structure, advantages, disadvantages, and removal methods of smear layer.
There have been several changes since inception in the field of dental ceramics. Need for newer materials with improved aesthetics, flexural strength and optical properties made it necessary for introduction of advanced technology in fabrication of dental ceramics.
The ultimate goal of endodontic treatment is to remove as many micro-organisms and their byproducts from the root canal space by using various antimicrobial agents to provide a environment free of micro-organisms . Antibiotics have revolutionized the entire health care system including both medicine and dentistry.
major advantages and unique features as well as its ability to overcome the disadvantages of other materials, biodentine has great potential to revolutionize the different aspects of managing both primary and permanent in endodontics as well as operative dentistry.
After reading this chapter, the student should be able to:
1. Understand the microbial etiology of apical
periodontitis.
2. Describe the routes of entry of microorganisms to the
pulp and periradicular tissues.
3. Recognize the different types of endodontic infections
and the main microbial species involved in each one.
4. Understand the bacterial diversity within infected root
canals.
5. Describe the factors involved with symptomatic
endodontic infections.
6. Understand the ecology of the endodontic microbiota
and the features of the endodontic ecosystem.
7. Discuss the role of microorganisms in the outcome of
endodontic treatment.
8. Understand the development and implications of
extraradicular infections.
Smear layer is a controversial topic in the field of operative dentistry and endodontics. This presentation includes composition, concepts, structure, advantages, disadvantages, and removal methods of smear layer.
This simplified lecture will present to you the basic concept of intracanal medicaments, their indication, classification, and their appropriate selection.
Presented to you by Iraqi Dental Academy.
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or Twitter:
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Intracanal medicaments /certified fixed orthodontic courses by Indian dental...Indian dental academy
Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
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12 PRINCIPLES OF ANTIBIOTIC THERAPY seminar 12.pptxsneha
This PowerPoint presentation offers a concise yet technical overview of antibiotic therapy. Dive into antibiotic mechanisms, classifications, indications, and prudent use. Master essential aspects of antibiotic therapy for informed clinical decision-making.
Antibiotic selection /certified fixed orthodontic courses by Indian dental ac...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
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this slides includes overview of antimicrobial drugs, their classifications, antimicrobial resistance, adverse effects and toxicity, choice of antimicrobial drugs and its uses
Pharmacological Classfication of Drugs
Drugs Acting on Autonomic Nervous System
Autacoids and Related Drugs
Drugs for Respiratory Disorders
Hormones and Related Drugs
Drugs Acting on Peripheral (somatic) Nervous System
Drugs Acting on Central Nervous System
Cardiovascular Drugs
Drugs Acting on Kidney
Drugs Affecting Blood
Gastrointestinal Drugs
Antibacterial Drugs
Antifungal, Antiviral, Antiprotozoal and Anthelmintic Drugs
Anticancer Drugs (Antineoplastic Drugs)
Miscellaneous Drugs
CEMENTATION OF INLAY AND VARIOUS TECHNIQUE FOR TEMPORIZATIONms khatib
A provisional or temporary restoration is necessary when using indirect systems that require two appointments. it is important that the patient be comfortable and the tooth be protected and stabilized with an adequate temporary restoration. The temporary restoration should satisfy the following requirements: it should -
When properly made, the custom temporary restoration can satisfy these requirements and is the preferred temporary restoration.
Temporaries can be fabricated intraorally directly on the prepared teeth (direct technique) or outside of the mouth using a post-operative cast of the prepared teeth (indirect technique).
The indirect technique is not as popular as the direct technique because of the increased number of steps and complexity ; however, it is useful when making temporaries that might become “locked on” (e.g., intracoronal inlays) when using the direct technique
Investment materials developed in the first half of the twentieth century, to give clinically acceptable dental castings. But
Wrongly, many assume that dental casting investment materials have reached a level of development that makes them completely fit for purpose and that the technology is stable.
This is not the case. Casting titanium and it’s requirement for increased precision have given new challenges
Silica exists in 22 different condensed phases. Five of these are amorphous, and 17 are crystalline; the latter are the polymorphs of silica.
Of this group, only one phase, low-temperature quartz, is thermodynamically stable at normal temperature and pressure. Two more, tridymite and low-temperature cristobalite, exist under normal atmospheric conditions as metastable (but actually long-lived) phases
In the investment powder, the binder is calcium sulfate hemihydrate. When the investment sets, the silica is unaffected; the hemihydrate binder combines with water to form dihydrate (gypsum).The set investment consists of fine particles of silica embedded in gypsum crystals.
When this material is heated to the temperatures required for complete dehydration and sufficiently high to ensure complete castings, it shrinks
considerably and occasionally fractures.
The thermal expansion curves of the three common forms of gypsum products are shown in Figure. All forms shrink considerably after dehydration between 200" C and 400" C . A slight expansion takes place between 400" C and approximately 700, and a large contraction then occurs This shrinkage is most likely caused by decomposition and the release of sulfur gases, such as sulfur dioxide. This decomposition not only causes shrinkage but also contaminates the castings with the sulfides of the non-noble alloying elements, such as silver and copper.
Thus it is imperative that gypsum investments not be heated above 700" C (1292" F). However, for gypsum products containing carbon, the maximum temperature should be 650" C (1202" F). In this way, proper fit and uncontaminated alloys are obtained.
vertical root fracture and it's management .....ms khatib
it's always difficult to understand any vrf and it's more difficult to handle it's managment
heres are some tips and advice about it how to manage it referred by various article
i hope u appreciate it
crossbite management in restorative dentistryms khatib
Restorative management of crossbite
its a dilemma to all of us that how to restore the teeth with crossbite cases
and most difficult is its maintaining occlusal stability.......
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
3. CONTENTS
• INTODUCTION
• HISTORY
• CLASSIFICATION OF
ANTIBIOTICS
• SELECTION OF
ANTIMICROBIALAGENTS
• BACETRIOLOGY
• ODONTOGENIC INFECTION
• COMMONLY USE ANTIIBIOTIC
IN ORAL INFECTION
• COMPLICATION OF ANTIBIOTIC
THERAPY
• FASCIAL SPACE INFECTION
• MANAGEMENT OF ABSSCESS
AND CELLULITIS
• ANTIBIOTIC PROPHYLAXIS
• RESISTANCE
• ANTIBIOTIC DOSAGE
• USE OF ANTIBIOTIC AS AN INTRA
CANAL MEDICAMENT
• MYTHS
• CONCLUSION
• REFRENCES
3
4. • Antibiotics-These are substances produced by
microorganisms, which selectively suppress the growth of or
kill other microorganisms at very low concentrations
• Antimicrobial agent (AMA)-synthetic as well as naturally
obtained drugs that attenuate microorganisms
• Chemotherapy-Treatment of systemic infections with specific
drugs that selectively suppress the infecting microorganism
without significantly affecting the host
4
6. Empirical phase
• Mouldy curd by Chinese on boils
• Chaulmoogra oil for leprosy,
• Chenopodium by Aztecs for intestinal worms,
• Mercury by Paracelsus (16th century) for syphilis,
• Cinchona bark (17th century) for fevers.
6
7. Ehrlich's phase (1890-1935)
• Ehrlich given the idea that if certain dyes could selectively stain microbes,
they could also be selectively toxic to these organisms. He tried
methyleneblue, trypan red, etc
• He developed arsphenamine in 1906 and neoarsphenamine in 1909 for
syphilis.
• He coined the term 'chemotherapy'
7
8. Modern era
• Domagk (1935) - The therapeutic effect of Prontosil.
• Pasteur (1877) - Demonstrated the phenomenon of antibiosis :
growth of anthrax bacilli in urine was inhibited by air-borne
bacteria.
8
9. • Fleming (1929) - Discovered penicillin .
• Chain and Florey (1941)- Clinical use of penicillin .
• Waksman and his colleagues (1944)- Discovered
streptomycin
9
11. CLASSIFICATION OF ANTIBIOTIC
11
• Based on
A. Chemical structure
B. Mechanism of action
C. Type of organism against which primarily active
D. Spectrum of activity
E. Type of action
TRIPATHI 6TH EDITION
16. SELECTION OF ANTIMICROBIALAGENTS
The organism’s identity
Patient factors
The site of the infection
The organism’s susceptibility to a particular agent
The safety of the agent
The cost of therapy
16
Lippincotts pharmacology 5th edition
18. • The pulpodentin complex is sterile.
• Bacterial invasion of dentinal tubules occurs more
rapidly in nonvital teeth than in vital ones.
18
COHEN 10TH EDITION
22. When do you need the drugs to kill the bugs?
• Fever > 100° F
• Malaise
• Lymphadenopathy
• Trismus
• Increased Swelling
• Cellulitis
• Osteomyelitis
• Persistent Infection
22
American Association of Endodontists, 2006
23. Just say NO! Kill the bugs without the drugs
Irreversible pulpitis,
Acute apical periodontitis,
Draining sinus tracts,
After endodontic surgery,
To prevent flare-ups,
After incision for drainage of a localized swelling
(without cellulitis, fever, or lymphadenopathy)
23
COHEN 10th edition
26. DOSAGE
26
Antibiotic Dosage Duration
Penicllin V 250mg/500mg Every4-6hours/5-7days
Amoxicillin /
Amoxicillin with clavulanate
250mg/500 mg Every 8 hours/5-7 days
Clindamycin 300 mg/600mg Every 6 hours/5-7 days.
Metronidazole 200mg/400 mg Every 8 hours/5-7 days.
Azithromycin 250mg/500mg Once a day /5-7 days.
American Association of Endodontists 2006
28. COMPLICATIONS OF ANTIBIOTIC THERAPY
• Hypersensitivity
• Direct toxicity
• Superinfections
28
lippincotts pharmacology 5th edition
29. THE FASCIAL SPACES
The mandible and
below
The buccal
vestibule
Body of the
mandible
The mental space
The submental
space
The sublingual
space
Submandibular
space
The cheek and
lateral face
The buccal
vestibule of the
maxilla
The buccal space
The submasseteric
space
The temporal space
The pharyngeal and
cervical areas
The pterygo-
mandibular space
The para-
pharyngeal
spaces
The cervical
spaces
The
midface
The palate
The base of
the upper
lip
The canine
spaces
The
periorbital
spaces
29
30. Management of Abscesses and Cellulitis
• Correct diagnosis
• Removal of the cause
• Incision for drainage is indicated for any infection marked
by cellulitis. It is important to provide a pathway of
drainage to prevent further spread of the abscess and/or
cellulitis.
30
COHEN 10th edition
31. Systemic Antibiotics for Endodontic Infections
• Selection of antibiotics-
– Empirical
– based on the results of microbial susceptibility tests.
• For diseases with known microbial causes, empirical
therapy may be used.
• Most of the bacterial species involved with endodontic
infections, including abscesses, are susceptible to
penicillins .
31
COHEN 10TH EDITION
33. 33
• Managment
Amoxicillin (500 mg, orally) at
intervals of 8 h for 7 days and
dexamethasone (4 mg, intramuscularly)
at intervals of 24 h for 3 days
2% chlorhexidine gel applied with a 5-
ml syringe
34. TOOTH AVULSION
• Systemic administration of antibiotics is generally
recommended in order to prevent the harmful effects of
bacterial contamination.
• Antibiotics decrease the incidence of inflammatory root
resorption but have a limited, or no, effect on the pulp
34
Australian Dental Journal Endodontic Supplement 2007
35. • Gram-negative obligate anaerobic rods
– Porphyromonas spp.
– Prevotella spp.
• Prophylactic use of antibiotic to decrease incidence of
flare up Controversy.
Flare-Up’s
Cohen pathways of pulp : 10 th edition 35
37. Infective Endocarditis (IE)
• A life threatening disease with substantial morbidity and
mortality which affects individuals with underlying
structural cardiac defects who develop bacteremia.
37
41. • The French agency for Health Product Health Safety
advices against or contraindicates
– Dental facial surgery,
– Bone surgery,
– Periodontal surgery,
– Root canal treatment in these patients except under emergency
situations,
As these patients are prone to high risk of infection.
41
Asian Pac J Trop Biomed 2012; 2(9): 749-754
43. PREGNANCY
• Any drug used during pregnancy should be taken
only under the supervision of the patient’s
physician.
43
lippincotts pharmacology 5th edition
44. 44
CATEGORY DESCRIPTION DRUS
A No human fetal risk or
remote possibility of fetal
harm
B No controlled studies show
human risk;
animal studies Suggest
potential Toxicity
β-Lactams,β-Lactams with inhibitors,
Cephalosporins, Aztreonam , Clindamycin,
Erythromycin, Azithromycin, Metronidazole
Nitrofurantoin. Sulfonamides
C Animal fetal toxicity
demonstrated; human risk
Undefined
Chloramphenicol, Fluoroquinolones,
Clarithromycin, Trimethoprim, Vancomycin
Gentamicin, Trimethoprim-sulfamethoxazole
D Human fetal risk present,
but benefits
Mayoutweigh Risks
Tetracyclines, Aminoglycosides
(except gentamicin)
X Human fetal risk present
but does not
Outweigh benets;
contraindicated in
pregnancy
United States FDA categories of antimicrobials and fetal risk.
lippincotts pharmacology 5th edition
45. Partial List of Drugs Usually Compatible With Both
Pregnancy and Breast-Feeding
• Local anesthetics including lidocaine , etidocaine , and
prilocaine
• Penicillins- 250mg/500mg(Every 8 hours)
• Clindamycin- 300/600mg(6 hrs)
• Azithromycin- 250/500mg(OD)
• Acyclovir
• Prednisone
45
COHEN 10TH EDITION
55. LOCAL DRUG DELIVERY
• Bacteria located inside dentinal tubules are protected from
host defence cells, systemic antibiotics and
chemomechanical preparation.
• Therefore, endodontic medicaments must be able to
penetrate into dentinal tubules and kill bacteria within
them.
55
Australian Dental Journal Endodontic Supplement 2007;52:1.
57. Grossmann Poly Antibiotic Paste
• The first reported local use of an antibiotic in endodontic treatment
was in 1951
• When Grossman used a polyantibiotic paste known as PBSC
(penicillin, bacitracin, streptomycin, and caprylate sodium).
Australian Dental Journal Endodontic supplement :2007
57
58. • All compounds were all suspended in a silicone vehicle.
• The composition was ineffective against anaerobic species
58
Australian Dental Journal Endodontic Supplement 2007;52:1.
Penicillin Gram-positive organisms
Bacitracin For penicillin-resistant strains
Streptomycin Gram-negative organisms
Caprylate sodium Yeasts
59. Septomixine Forte
• Contains two antibiotics –
Neomycin
Polymixin B sulphate
59
Gram-negative bacilli Neomycin X Bacteroides , fungi
Gram-positive bacteria Polymyxin B sulphate
International Journal of Pharmacy and Pharmaceutical Sciences Vol 6, Issue 3, 2014
60. Ledermix paste
TRIAMCINOLONE
• Anti-inflammatory action
• Concentration of 1.0%
• Inhibits clastic cells
(osteoclasts, cementoclasts and
dentinoclasts)
DEMECLOCYCLINE
• Anti microbial action
• concentration of 3.21%
60
Australian Dental Journal Endodontic supplement :2007
61. • Ledermix:
Effective in preventing inflammatory resorption in
avulsed teeth
Pain management
Australian Dental Journal Endodontic supplement :2007
61
62. Ledermix paste + Calcium hydroxide
An intracanal dressing
Pulp necrosis and infection with incomplete root formation
Perforations
Inflammatory root resorption
Inflammatory periapical bone resorption
The treatment of large periapical radiolucent lesions
62
Australian Dental Journal Endodontic supplement :2007
63. TRIPLE ANTIBIOTIC PASTE
• Metronidazole + Ciprofloxacin + Minocycline.
• Used in - The revitalization regeneration procedures
63
COHEN 10TH EDITION
66. DISADVANTAGES
It may cause bacterial resistance.
Use of minocycline can cause tooth discoloration
66
COHEN 10TH EDITION
67. TETRACYCLINES
To remove the smear layer from instrumented root canal walls
Irrigation of apical root-end cavities during periapical surgical
procedures
As intracanal medicaments
Mohammadi etal: An update on the antibiotic-based root canal irrigation solutions:IEJ 2008
69. • MTAD is capable of
Removing the smear layer
Disinfecting the root canal system.
• Commercially available as BioPure MTAD
69
COHEN 10TH EDITION
70. • Tetraclean is another combination product similar to
MTAD.
• The use of tetraclean was able to reduce 90%
bacteric load after 5 minutes and 99.9% after 30
minutes of application.
70
MTAD TETRACLEAN
DOXYCYCLINE 150mg/5ml 50mg/5ml
Tween 80 Polypropylene glycol
JOE-2007
COHEN 10TH EDITION
71. MTAD has best antibacterial efficiency against E faecalis
when compared to 2.5% Sodium Hypochlorite and 2%
Chlorhexidine.
MTAD was effective in killing E. faecalis up to 200 x
dilution whereas NaOCl ceased to exert its antibacterial
activity beyond 32 x dilution
Torabinejad et al. (2003)
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Journal of Dental and Medical SciencesVolume 5, Issue 3 (Mar.- Apr. 2013), PP 47-53
73. Odontopaste is the most effective against Enterococcus
faecalis.
Propolis is partially effective against Candida albicans.
73
Journal of International Dental and Medical Research Volume ∙ 5 ∙ Number ∙ 1 ∙ 2012
74. BioPure (MTAD) is effective in removing the smear layer.
Ledermix help to reduce the periapical inflammatory reaction
including clastic-cell mediated resorption.
Clindamycin alone or in an ethylene vinyl acetate (EVA)
vehicle can reduce the bacterial load inside the root canal
system
74
International Endodontic Journal 2009
75. • The local application of antibiotics may be a more effective
than systemic routes.
• Tetracyclines –
remove the smear layer from instrumented root canal walls
for irrigation of apical root-end cavities during periapical surgical
procedures
intracanal medicament
• Substantivity of tetracyclines has been shown for up to at
least 12 weeks.
• BioPure (MTAD) is effective in removing the smear layer.
• Substantivity of MTAD has been shown to last for up to 4
weeks.
75
International Endodontic Journal 2009
77. Acquired resistance to PENICILLIN
• Resistance to penicillin is usually by three
mechanisms.
Decreased bacterial cell wall penetration,
Inability to bind to the penicillin binding proteins,
Production of ß-lactamase.
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JOURNAL OF ENDODONTICS, JANUARY 2003
78. Beta-lactamase production
78
• Black-pigmented Prevotella
• Nonpigmented Prevotella species
• F. nucleatum,
• P. acnes,
• Actinomyces species,
• Peptostreptococcus species
• Capnocytophaga
• Neisseria species
COHEN 10TH EDITION
79. • Amoxicillin’s broad spectrum is more than is required for
endodontic needs, and its use in a healthy individual may contribute
to the global antibiotic resistance problem.
79
JAC 2013
Resistance Drugs
F. nucleatum Penicillin, amoxicillin, and metronidazole
P. intermedia Tetracycline and amoxicillin
A. actinomycetemcomitans Amoxicillin and azithromycin
Fusobacterium and nonpigmented Prevotella
species
Macrolides (erythromycin and azithromycin)
81. MYTHS
Antibiotics cure patients.
Antibiotics are substitutes for surgical intervention.
The most important decision is which antibiotic to
use.
Antibiotics increase the host’s defense to infection.
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American Association of Endodontists, 2012
82. Multiple antibiotics are superior to a single antibiotic.
Bactericidal agents are always superior to
bacteriostatic agents.
Antibiotic dosages, dosing intervals and duration of
therapy are established for most infections.
Bacterial infections require a “complete course” of
antibiotic therapy.
82
MYTHS
American Association of Endodontists, 2012
83. CONCLUSION
• To sum up, the risk/benefit ratio should be always weighed
before prescribing antibiotics.
• Appropriately selected patients will benefit from
systemically administered antibiotics.
• A restrictive and conservative use of antibiotics is highly
recommended in endodontic practice, but indiscriminate
use is contrary to sound clinical practice
• Future generations will thank us for today’s conscientious
and judicious use of antibiotics.
83
84. REFERENCES
• Cohen 10th edition
• Tripathi 6TH EDITION
• Lippincotts pharmacology 5th edition
• Ingles endodontics - 6th ed.
• Siquiera jr et al : update endodontic microbiology 2008
• Asian pac J trop biomed 2012; 2(9): 749-754
• J antimicrob chemother 2014
• American association of endodontists 2006
• International endodontic journal 2009
84
85. • JADA, vol. 131, march 2000
• American heart association, 2007; 116: 1736-1754
• Australian dental journal endodontic supplement 2007;52:1
• American association of endodontics 2012
• Journal of International Dental and Medical Research Volume
5 Number 2012
• ADA council 1997
• Journal of dental and medical sciencesvolume 5, issue 3 (mar.-
Apr. 2013), pp 47-53
• Journal of endodontics, january 2003
• International Journal of Pharmacy and Pharmaceutical
Sciences Vol 6, Issue 3, 2014
85
REFERENCES