Chong B S, Pitt Ford T R
United Medical and Dental Schools, Guy's Hospital, London, UK.
Int Endod J. 1992 Mar;25(2):97-106. doi: 10.1111/j.1365-2591.1992.tb00743.x.
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.
对根管内用药作为根管充填材料的作用进行了重新审视。在牙髓摘除术和一些根管治疗中，当根管内含有活髓组织时，是否需要常规的根管内用药值得怀疑。在感染根管中，根管内用药被提倡用于多种目的。根管内用药用于：（i）在根管预备后消除任何残留细菌；（ii）减轻根尖周组织和牙髓残余的炎症；（iii）使根管内容物失去活性并中和组织碎片；（iv）作为防止临时充填物渗漏的屏障；（v）帮助干燥持续潮湿的根管。然而，大多数根管内用药的适应证都值得怀疑。根管内用药仅应用于感染根管的消毒，作为控制无菌操作的一部分，其作用次于根管的清理和成形。彻底的根管清创和充分的根管预备更为重要，并强调了它们的重要性。如果牙齿对治疗无反应，可能需要进行细菌学采样，以帮助选择根管内用药。
