Intradental corticosteroids used in dentistry

Intradental corticosteroid and antibiotic combinations can be used to manage pulp and periapical diseases, which are caused by bacteria and inflammation. Dental treatment is also required.

Two forms of corticosteroid and antibiotic combinations are commercially available for intradental use—a water-soluble paste and a hard-setting cement. The form used depends on the condition being treated and where the compound is to be placed.

Combination corticosteroid and antibiotic pastes (eg triamcinolone with clindamycin or demeclocycline) can be used within the root canal system of a tooth (intracanal application). Pastes can be used:

during endodontic treatment
to reduce periapical inflammation and pain associated with irreversible pulpitis or an infected root canal system
to prevent and manage several forms of inflammatory root resorption (eg internal inflammatory resorption, external apical inflammatory resorption, external lateral inflammatory resorption)
to reduce external replacement resorption following tooth avulsion and intrusive luxation injuries.

Combination corticosteroid and antibiotic cements typically contain other substances (eg calcium hydroxide, zinc oxide, eugenol). To prepare the cement, a powder and liquid are mixed to form a paste. The paste is placed on the dentine or exposed pulp, and sets to form a hard cement. Cements can be used:

within the crown of a tooth as part of a cavity lining or base
as an indirect pulp cap
as a direct pulp cap
as a pulpotomy agent before restoring cavities in teeth that have reversible pulpitis.