This document discusses various intracanal medicaments used to disinfect the root canal system and destroy remaining bacteria between appointments. It describes common medicaments like calcium hydroxide, formocresol, eugenol, and caustinerf. Calcium hydroxide is effective due to its high pH, which suppresses bacterial growth through its physical barrier and chemical properties. Formocresol is a bactericidal agent used for vital pulpotomies but has toxicity concerns. Eugenol is an antiseptic constituent of root canal sealers. Ideal intracanal medicaments must be effective antimicrobials, non-irritating to tissues, and stable in solution.

1. INTRACANAL
MEDICAMENTS

2. Submitted by:
Dr. Md. Nazmul H Bin Khair
BDS (DU)

3. INTRACANAL MEDICAMENTS
INTRODUCTION:
Intracanal medicaments are agent used to
disinfect the total root canal system by destroy
the remaining bacteria and limit the growth of
the bacteria.

4. TYPES OF INTRA CANAL MEDICAMENTS:
Essential Oil: Eugenol
Phenolic compound:
 Phenol
 Para mono chloro phenol
 Camphorated phenol
Aldehydes
 Formocresol
 Para formaldehyde
 Glutaraldehyde

5. Caustinerf
Calcium hydroxide
Halogens
 Iodine potassium iodide
Heavy metal salt
Antibiotics

6. IDEAL REQUIREMENTS:
 It should be effective germicide and fungicide.
 it should not irritate the periapical tissue.
 It should have prolonged antimicrobial effect.
 it should remain stable in solution.
It should have low surface tension.
 It should not stain the tooth structure.
 It should not induce a cell mediated immune
response.
 It should be easy to handle.

7. INDICATION:
 Destroy the remaining bacteria and limit the growth of the
bacteria.
To disinfect the root canal system.
 Prevention or control of post treatment pain.
 To neutralize the tissue debris
To act as a barrier against leakage form in intra appointment
dressing.

8. LIMITATION:
 The therapeutic action of these medicaments
depends on direct contact on the tissue but this
substances probably do not reach all the areas
where bacteria or tissue are present and are
limited to surface action only.

9. CALCIUM HYDROXIDE

10. The use of Calcium hydroxide in endodontics
was introduced by Hermann in 1920
 Calcium hydroxide is effective in inhibiting
microbial growth.
 Calcium hydroxide available in two form:
 Powder form.
 Paste form.

11. FORM AND APPLICATION:
 Can be placed as a dry powder, A powder
mixed with a liquid such as Local Anaesthetic
solution, saline, water or glycerine to form a
thick paste.
 A lentulo spiral is effective and efficient for
placement.

12. MECHANISM:
 Physical
 As it act as a physical barrier so it
limit entry of the bacteria and destroy
the remaining bacteria by limiting
space for multification.

13. CHEMICAL:
 It show antiseptic action because of High PH.
 Suppress enzymatic activity and disrupts cell
membrane.
 Inhibit DNA replication.
 It hydrolyses the lipid part of bacterial
lipopolysaccharide and inactivate the activity.

14. INDICATION:
 In weeping canal.
 In resorption cases
 For apexification
During pulpotomy
 Non surgical treatment of periapical lesion.
 As a sealer for obturation.
 Reduce post operative pain after over
instruments.

15. ADVANTAGE
 Form physical barrier for ingress of bacteria.
 High PH (11-12)
 Leaching action on necrotic pulp tissue.
 Increase PH of circumpulpal dentine.
 Suppress enzymatic activity.
 Disrupt cell membrane.

16. LIMITATIONS
Difficult to remove from the canal.
 Residual Ca(OH)2 can shortened the setting
time of zinc oxide eugenol based endodontic
sealer.
 Ca(OH)2 is not totally effective against E.
Faecalis and Candida Albicans.

17. FORMOCRESOL

18. Formocresol is a non specific bacterial
medicament effective against aerobic and
anaerobic organism found in root canal.
 COMPOSITION:
Formaldehyde (19 %)
Cresol (35%)
Water and glycerine (46%)

19. MECHANISM OF ACTION:
 It prevents tissue autolysis by binding to
protein. This is reversible process accomplished
without changing the basic overall structure of
the protein molecule

20. PROPERTIES
It has anodyne effect.
It act as a strong bactericidal agent.
Kills bacteria at the pulp protection side.
It promote the fixation of radicular pulp.
It may interfere with the process of physiologic root
resorption.

21. INDICATION
Vital pulpotomy in deciduous teeth.
Intracanal medicaments in endodontic
treatment.

22. CONTRAINDICATION
Sensitivity to formaldehyde or cresol.
Should not be used with individual who are
pregnant without physician consultation

23. TOXICITY
Local toxicity includes tissue burn and damage
to the succedaneous teeth
Systemic toxicity includes carcinogenicity and
mutagenicity

24. CAUSTINERF

25.  Medicaments for the devitalization of
dental pulp.
 Composition:
Paraformaldehyde ( 46%)
Lidocaine ( 37%)
Phenol (6%)

26. PROPERTIES:
 It coagulates the albumins
 Reduce pain
 Because of hardening effect of para
formaldehyde, it increases the antiseptic
effect of preparation.

27. APPLICATION:
 After removing carious dentine and expose the
pulp and apply 10 mg of paste with the cotton
pellet.
 Seal with the cement and open after 7-10 days.
 If necessary repeat the procedure.
 But this product is to be used only twice in the
treatment of any tooth.

28. LIMITATION:
 It should not be used in a patient with history
of allergic reaction.
 It should not be used after 12 months of its
opening.

29. EUGENOL

30. This is the chemical essence of oil of clove. It
is both antiseptic and an anodyne. It is a
constitute of most root canal sealer.
COMPOSITION : Eugenol (85%)
Clove oil (15%)

31. INDICATION
Intracanal medicament.
Root canal sealer.
Temporary sealing agent.

32. PLACEMENT OF INTRA CANAL
MEDICAMENTS:
Copiously irrigate the canal to remove debris
present if any.
Place the master apical file in the canal.
Dry the canal using paper points.
 In case of formocresol place the medicament on
a sterile cotton pellet and place it into the pulp
chamber.
Place another cotton and seal with temporary

33. REFERENCES:
• Nisha garg & Amit garg [ Textbook of Endodontics]
• Harty’s Endodontics
• Kennedy’s paediatric operative dentistry
• Wikipedia