Tissue response to anodyne medicaments

Endodontic Treatment In The Primary Dentition

A number of factors are involved in the development of pulp and periapical disease in primary and permanent teeth, with dental caries being the main factor. Although these factors are similar, the clinical management of a primary or permanent tooth with pulp or periapical disease may be quite different. This is based mainly on the differences between the two types of teeth, with primary tooth longevity, coronal structural integrity, root canal morphology, and root anatomy being important features to be taken into account when treatment planning. This paper reviews some aspects of primary teeth and the various treatment options for the management of pulp and periapical disease.

The role of intracanal medication in root canal treatment

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.

Effects of eugenol on polymorphonuclear cell migration and chemiluminescence

In this study, the effects of eugenol on human polymorphonuclear (PMN) cell migration and chemiluminescence were examined in vitro. Utilizing zymosan-activated serum or crude Bacteroides sonicate fractions as chemotractants, we found that eugenol inhibits PMN migration at 6.6 X 10(-2) to 6.6 X 10(-5) mol/L (P less than 0.05). Also, similar effects were observed in PMNs pre-incubated in eugenol. Regardless of concentration, eugenol was not found to induce chemotaxis of PMNs. An examination of PMN membrane activation through chemiluminescence gave results consistent with the chemotaxis data, demonstrating a decrease in light emission at concentrations as low as 6.6 X 10(-6) mol/L (P less than 0.05). In view of these data, the potential effect of eugenol on in vivo (sulcular or periapical) PMN function deserves further study.

Evaluation of eugenol for mutagenicity by the mouse micronucleus test

Mutagenicity of eugenol (2-methoxy-4-allylphenol) was evaluated by an in vivo eukaryotic assay in mice. A 50% lethal dose (LD50) for intraperitoneal (IP) delivery of eugenol was found to be 1109.6 mg/kg body weight (7.5% eugenol-in-saline). Oral (PO) delivery via stainless-steel, esophageal cannulation was not lethal to 14,794 mg/kg body weight (100%) eugenol. Based upon recommended procedure, 80 and 25% LD50 doses were administered IP in 250 microliter volumes. Undiluted eugenol was administered PO in 100 microliter volumes. Delivery of eugenol by both regimes to male mice induced anaphase mutations in polychromatic erythrocytes as measured by the bone marrow micronucleus test. IP delivery of both doses induced the formation of micronuclei to significant levels (P less than 0.001) compared to saline controls. PO delivery of eugenol induced a much reduced frequency of micronuclei when compared to the IP route. However, a significant increase in micronuclei was evident when this test population was compared to its control group (P less than 0.003). These results suggest that eugenol presents some mutagenic capacity in eukaryotic hosts and should be evaluated for further toxicological effects.