[Medications for endodontic use]

Area of Science:

• Endodontics
• Dental Therapeutics
• Microbiology

Context:

• Root canal treatment outcomes are critically dependent on effective intracanal disinfection.
• Traditional endodontic medications like Rocklès 4, antiseptics, anti-inflammatory agents, and antibiotics exhibit significant toxicity or inefficacy in vivo.
• There is a need for safer and more effective intracanal agents in endodontic practice.

Purpose:

• To evaluate the efficacy and safety of commonly used endodontic medications.
• To propose a revised armamentarium for endodontic treatment based on scientific evidence.
• To highlight the limitations of certain medicaments in achieving successful root canal disinfection.

Summary:

• Successful endodontic treatment hinges on mechanical preparation, as medications alone cannot disinfect inadequately shaped canals.
• Rocklès 4, despite in vitro antibacterial properties, should be avoided due to toxicity, mutagenicity, antigenicity, and in vivo inefficacy.
• Other commonly used antiseptics, anti-inflammatory agents, and antibiotics are also deemed unsuitable for endodontic use due to adverse effects or lack of efficacy against endodontic flora.

Impact:

• Recommends a restricted endodontic medication list comprising 2.5% sodium hypochlorite (NaOCl) for irrigation and calcium hydroxide for inter-appointment medication.
• Advocates for the removal of toxic and ineffective agents from endodontic practice.
• Emphasizes the importance of evidence-based selection of intracanal medicaments for improved patient safety and treatment success.