Evaluation of Penicillemia After Medication of Root Canals with a Polyantibiotic

A polyantibiotic for the treatment of infected root canals was described by Grossman.' The polyantibiotic consists of a suspension of penicillin, bacitracin, streptomycin, and caprylate sodium in silicone fluid. A small amount of the suspension is ordinarily ejected from a syringe needle into the root canal. In narrow canals of posterior teeth, the suspension is introduced into the pulp chamber and pumped into the root canals with a suitable sterile instrument. An effort is made to limit the polyantibiotic to the confines of the canal. The polyantibiotic has been in use by dentists and in at least one dental school clinic for more than 15 years. Despite this long usage, there have been few accounts of sensitivity reaction. An explanation of this might be that the penicillin contained in the polyantibiotic, to elicit a systemic reaction, would have to reach the blood circulation via the apical foramen and be present in sufficient amount to cause a reaction. The purpose of this study was to determine whether penicillin was present in the blood after sealing the polyantibiotic in the root canal, since sensitivity is reported in 2 to 5 percent of the population.2A