The role of intracanal medication as a root canal dressing is re-examined. In pulpectomy and some root canal treatments, where the root canal contains vital pulp tissue, it is doubtful whether a routine intracanal medicament is needed. In infected root canals, intracanal medication has been advocated for many purposes. An intracanal medicament is used to: (i) eliminate any remaining bacteria after canal instrumentation; (ii) reduce inflammation of periapical tissues and pulp remnants; (iii) render canal contents inert and neutralize tissue debris; (iv) act as a barrier against leakage from the temporary filling; (v) help to dry persistently wet canals. However, most of the indications for intracanal medicaments are questionable. Intracanal medicaments should only be used for root canal disinfection as part of controlled asepsis in infected root canals, and their role is secondary to cleaning and shaping of the root canal. Thorough canal debridement and adequate canal preparation are more pertinent, and their importance is emphasized. Bacteriological sampling may be necessary if a tooth does not respond to treatment, to help in the choice of intracanal medicament.

The role of intracanal medication in root canal treatment.

Gingival crevicular fluid is regarded as a promising medium for the detection of markers of periodontal diseases activity. The collection protocols are straight forward and non-invasive and can be performed at specific sites of interest in the periodontium. Because the fluid accumulates at the gingival margin, it will contain potential markers derived not only from the host tissues and serum but also the subgingival microbial plaque, and thus an extremely broad range of candidate molecules may be investigated. However, the ability to successfully describe indicators of current disease activity and predictors of future disease is dependent not only upon the choice of the biochemical marker but also on the accurate description of the health status of the sample sites using currently available clinical and radiographic methods. Areas of study which currently show the most promise involve the analysis of host enzyme activities directed against components of the extracellular matrix, the nature of the glycosaminoglycans released into the sulcus and the concentration in gingival crevicular fluid of certain mediators of the inflammatory process, most notably prostaglandin E2.

Detection of high‐risk groups and individuals for periodontal diseases:

Chemistry and Pharmacology of Heparin

Proteoglycans of the periodontium: structure, role and function.

Glycosaminoglycans in human gingival crevicular fluid as indicators of active periodontal disease.

Investigation of homologous antibodies to an extract of rabbit dental pulp.

Isolation and characterization of acid mucopolysaccharides of bovine periodontal membrane.

Adjuvant effects of oral microorganisms on the immunological responses

Cellular hypersensitivity in guinea pigs immunized with BCG vaccine through the gingival crevice

Induction of cellular hypersensitivity to oral microorganisms in guinea-pigs.

M. Aono

Papers

Investigation of homologous antibodies to an extract of rabbit dental pulp.

Isolation and characterization of acid mucopolysaccharides of bovine periodontal membrane.

Adjuvant effects of oral microorganisms on the immunological responses

Cellular hypersensitivity in guinea pigs immunized with BCG vaccine through the gingival crevice

Induction of cellular hypersensitivity to oral microorganisms in guinea-pigs.