Pharmacology of drugs

used in Endodontic and

Restorative treatment
Iyad Abou Rabii
DDS. OMFS.MRes.PhD
What Drugs can be applied
restorative and endodontic
treatment ?
• Pulp Capping
• Pulp necrosis generating
• Endodontic retorative materials contains
aiding drugs
• Haemostatic agent
• Antiseptics
• Topical local aneasthesic agents
Pulp Capping

• Pulp dent: Premixed Calcium Hydroxide

Paste For Vital Pulp Therapy and Root
Canal Therapy Bactericidal –
Bacteriostatic (High pH destroyes baterial
cell wall) - Radiopaque Calcium Hydroxide
Pulp Capping

• stimulates consistent dentin bridge

formation.
• The new dentin bridge re-encloses the
pulp in its own natural protective chamber
and is visible clinically after approximately
2-3 months.
Endodontic retorative materials
contains aiding drugs
• Endodontic retorative materials contains
aiding drugs
• Active Points Chlorhexidine ® from
Roeko) that contains Chlohexidine in
order to desinfect route canal.
Endodontic retorative materials
contains aiding drugs
• Tempacanal ®
• Antimicrobial intracanal dressing
between visits in order to desinfect
canal .
• Used for
• large periapical lesions and cysts
• Transverse root fracture
• Avulsed teeth
Different Calcium Hydroxide
Preperations
Pulp necrosis
• (Caustinerf Arsenical ® from
Septodont) that contains Arscenica
Hydrochloride in addition to Lidocaine
and Ephedrine Hydrochloride used to
generate pulb necrosis.
Haemostatic agents
•  Haemostatic agent used to stop
hemorrage from the inflammated pulp,
and injured gengiva they are four types:
• Hemostaic dressings
• Absorbable Gelatin
• Astringents and styptics
• Vasoconstrictors
Haemostatic dressings
• The simpliste way of bleeding control is
to apply sterile gauze with moderate
pressure.
• Collagen dressing may be applied
• In more severe casses (bony bleeding)
Absorbable Gelatin Sponge may be
used  
Absorbable Gelatin Sponge
• Applied on the operated tissues,
controls oozing and seal up the
bleeding tissues immediately. This
prevents blood loss from the deeper
wounds
Example : Surgispon ®
• absorbed biologically within 4-6 weeks
• Not used in Restorative and
Endodontics practice
Thrombin

• Can be apply locally, especially with

patent having oral anti-coagulant drugs
• thrombin can regulate the growth, cell
cycle progression, and functional
reorganization of the pulp tissue during
pulp healing and inflammatory
processes (Mei-Chi Chang,1999)
Astringents and styptics
• An astringent (also spelled
adstringent) substance is a chemical
compound that tends to shrink or
constrict body tissues
• Styptics (also spelled stiptics) are a
specific type of antihemorrhagic agent
that work by contracting tissue to seal
injured blood vessels
• Zinc, iron, and aluminum salts are the
best Astringents and styptics
substances used in dentistry
Vasoconstrictors
• Applied locally and for a very short
time.
• Can be injected, but it is better to avoid
to do this
• adrenalin dipped gauze are available in
the market
Examples
• Astrigedent X ® from Ultradent
• Dental TD Zett ® from J.Morita
• Quick Stat FS ® from Vista
Astrigedent X ® from Ultradent
• Astrigedent X is an aqueous 12.7% iron
solution containing equivalent ferric
sulfate and ferric subsulfate for difficult-
to-stop, problem bleeding
• Less acidic than competitive iron
subsulfate solutions
Dental TD Zett ® from J.Morita
• It is a fast-acting intraoral topical
hemostatic agent.
• It combines aluminum chloride, which has
an astringent action, with Cetylpyridinium
chloride and also lidocaine.
• Indications - For hemostasis in the
following cases:
1) Subgingival abutment tooth or cavity
preparation
2) Gingival retraction during Gingivoplasty
Quick Stat FS from Vista
• 15.5% Ferric Sulfate Haemostatic Gel
• Provides effective tissue management
when completing impressions,
restorations, crown & amp; bridge, and
Pedodontic pulp treatment
• Doesn`t flow onto surrounding tissue
Oral Rinses
Rinses are generally classified by the
U.S. Food and Drug Administration
(FDA) as either :
• cosmetic 
• therapeutic
• a combination of the two. 
Cosmetic rinses
• Cosmetic rinses are commercial over-the-
counter (OTC) products that help remove
oral debris before or after brushing,
temporarily suppress bad breath, diminish
bacteria in the mouth and refresh the
mouth with a pleasant taste. 
Therapeutic rinses
•  Antiplaque/antigingivitis rinses containing
an active bacteria- fighting ingredient such
as quaternary ammonium compounds,
boric and benzoic acid phenolic
compounds.
• Anticavity fluoride rinses.
• Topical antibiotic rinses
• Enzyme rinses
• Artificial saliva rinses
• Rinses that control calculus formation
Natural/Herbal Oral Rinses
• Natural oral rinses do not contain alcohol,
harsh chemicals, dyes or preservatives.
They often contain herbs with beneficial
properties and alternative ingredients
• For instance, Xylitol, a natural sweetener
derived from the fibrous parts of plants,
helps reduce the risk of tooth decay and
promotes oral health. Recently several
chewing gums have entered the
marketplace that contain Xylitol and are
promoted as reducing decay.
Examples :
• Phenol products: Listerine ®
• Chlorhexidine products: Peridex ®
• Herbal Sanguinaria products: Viadent ®
• Therapeutic Anticavity Fluoride Rinses :
Oral-B ® Anticavity Rinse
• Cosmetic Breath Freshening Mouth
Rinses: Signal ®
Side effects
• ulcers
• sodium retention
• stains
• soreness
• numbness
• changes in taste
• painful mucosal erosions. 
Symptoms of an oral rinse
overdose include:
When swallowing especially by children
1. Breathing problems, such as deep
breathing, rapid shallow breathing,
slowed breathing or breathing stoppage
2. Gastrointestinal problems, such as
abdominal pain, diarrhea, nausea and
vomiting
3. Nervous system problems, such as coma,
dizziness or drowsiness
Symptoms of an oral rinse
overdose include:
4. Bluish skin, particularly lips and
fingernails
5. Collapse
6. Convulsions
7. Decreased blood pressure (hypotension)
8. Less-frequent urination
9. Excessive sweating and thirstiness
10. Trouble walking normally
11. Slurred speech
topical anesthetic for oral
mucosal application.
Examples
• Comfort caine ® (Harry Basworth)
• Cainetips ® (J. Morita)
• Pharmaethyl ® (Septodent)
• Anaestho Gel ® (Voco)
Comfort Caine ®
• Comfort Caine is a topical anesthetic for oral
mucosal application.
• Comfort Caine contains the active ingredient ethyl
4-amino benzoate 20% Benzocaine, in a flavored
polyethylene glycol base sweetened with
saccharin.
• Comfort Caine combines fast onset (15-20
seconds) and short duration (12-15 minutes) with
virtually no systemic absorption.
Cainetips
• Individually wrapped, disposable swabs
pre-filled with a 20% Benzocaine solution,
CaineTips oral pain relievers are designed
for intraoral applications
Cainetips ®
• The single dose packaging allows for
direct and precise application with no
mess or drips and delivers quick pain relief
onset. 
• Recommended for pre-injection,
periodontal curettage, deep scaling, and
post-care treatment, they also help prevent
cross-contamination. Available in a cherry
flavored solution
Pharmaethyl ®
• Topical freezing agent with natural mint
flavor.
• Pharmaethyl is used for local applications
on the mucous membrane of the oral
cavity and its adnexa: lancing of
abscesses, extractions of deciduous teeth,
extraction of pyorrheal teeth, vitality tests.
• Do not spray close to an open flame or
any incandescent sources.
Anaestho Gel ®
• Contains the active ingredient of
Lidocaine.
• Useful in case of aphtous ulcerations
• Gag reflex inhibition
Thank You

Iyad Abou Rabii

DDS.OMFS.MRes.PhD