26 Intracanal Dressings
A temporary intracanal dressing is necessary when an endodontic treatment cannot be completed in a single visit because an empty root canal system will be recolonized by bacteria within a short time. In infected cases with pulpal necrosis, the application of an intracanal medication in addition to chemo-mechanical preparation is recommended in order to reduce the number of remaining microorganisms.
However, the extent to which the application of calcium hydroxide might increase the rate of clinical success remains unclear (Sathorn et al., 2007). The current standard medication is an aqueous solution of calcium hydroxide (Rödig and Hülsmann, 2005), but the use of chlorhexidine (CHX) gel or a combination of calcium hydroxide and CHX has been discussed (Rödig, 2006, Turk et al., 2009).
For patients with acute pain, the application of Ledermix (Riemser, Greifswald, Germany) has been suggested, primarily in Europe (this combination of antibiotics and corticosteroids is not available worldwide). The use of chlorphenol-containing dressings is not recommended because these substances have severe cytotoxic effects and exhibit questionable antimicrobial activity.