4.5 Review

Present status and future directions of intracanal medicaments

Journal

INTERNATIONAL ENDODONTIC JOURNAL
Volume 55, Issue -, Pages 613-636

Publisher

WILEY
DOI: 10.1111/iej.13731

Keywords

antimicrobial peptides; apical periodontitis; biofilms; calcium hydroxide

Funding

  1. National Center for Advancing Translational Sciences [UL1TR002494]

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The outcome of root canal treatment is influenced by various factors, including intraoperative factors, host, and microbial factors. It is important for clinicians to analyze these variables and incorporate them into the disinfection strategy to maximize the chances of healing.
Two fundamental goals of endodontic treatment are to prevent or treat apical periodontitis. From a predictive perspective, several variables can affect the outcome of root canal treatment. Some of these variables depend on intraoperative factors, which include irrigation technique, size of the apical preparation, use of intracanal medicaments or the number of appointments necessary to complete the treatment. However, the outcome may also be affected by host and microbial factors. The intensity of periradicular bone loss or tissue damage, the presence of preoperative pain and associated conditions such as mechanical allodynia and central sensitization, the anatomical complexity of the apical portion of the canal, and the virulence and longevity of the bacterial infection can all have a profound influence on the outcome. Furthermore, numerous medical conditions have been reported to decrease the capability of the immune system to heal the periapical tissues. It is the clinician's responsibility to analyse these variables and incorporate them into the disinfection strategy to maximize the chances of healing. This narrative review will focus on the present status of intracanal medicaments, the clinical indications for their use and future directions for research.

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