CS3-6. Techniques and Materials used for Root Canal Filling - Assoc. Prof. Dr. Umut Aksoy.pdf

Techniques and Materials used for Root Canal Filling Assoc.Prof.Dr.Umut Aksoy LEARNING OBJECTIVES At the end of this course, students 1. Will be able to explain the reasons for filling root canals 2. Will be able to list the criteria for root canal filling 3. Will be able to define the properties...

Techniques and Materials used for Root Canal Filling Assoc.Prof.Dr.Umut Aksoy LEARNING OBJECTIVES At the end of this course, students 1. Will be able to explain the reasons for filling root canals 2. Will be able to list the criteria for root canal filling 3. Will be able to define the properties of the ideal root canal filling material. 4. Will be able to choose the appropriate technique for the case by explaining different root canal filling techniques ROOT CANAL OBTURATION TECNIQUES SUCCESS IN ENDODONTIC THERAPY DEPENDS ON THE MAIN 3 FACTORS: •ACCURATE DIAGNOSIS •COMPLETE CHEMO-MECHANICAL PREPARATION •3 DIMENSIONAL OBTURATION OF ROOT CANALS FROM THE CORONAL PORTION OF THE CANAL TO THE APICAL FORAMEN ROOT CANAL OBTURATION TECNIQUES After disinfection, the obturation stage: Fill the root canal- hermetic (fluid tight) seal from the coronal orifice of the canal to the apical foramen at the CDJ The responsibility does not end here Coronal seal- an integral part of endodontic treatment & important role in the treatment’s success ROOT CANAL OBTURATION TECNIQUES After disinfection, the obturation stage: Fill the root canal- hermetic (fluid tight) seal from the coronal orifice of the canal to the apical foramen at the CDJ The responsibility does not end here Coronal seal- an integral part of endodontic treatment & vital role in the treatment’s success ROOT CANAL OBTURATION TECNIQUES OBJECTIVES OF ROOT CANAL OBTURATION 1-To prevent leakage of bacterial organisms, bacterial elements and nutritional elements from the oral environment to the root canal (coronal leakage) 2-To inhibit growth of any surviving bacteria in dentinal tubules and uninstrumented parts of the root canal space 3-To prevent release of bacterial elements in the other direction, i.e. from the root canal to the apical environment (apical leakage) 4-To prevent leakage of nutritional elements from the periapical tissue to the canal space. 5-To allow proper healing of the periapical tissues ROOT CANAL OBTURATION TECNIQUES 3 MAIN FUNCTIONS OF ROOT CANAL FILLING KÖK KANAL DOLGUSUNUN 3 ANA GÖREVİ: 1.KORONAL SIZINTIYI DURDURUR 2.CANLI KALABİLMİŞ BAKTERİLERİ ELİMİNE EDER 3.PERİAPİKAL DOKU KAYNAKLI SIVILARIN KÖK KANALINA ULAŞMASINA ENGEL TEŞGİL EDER ROOT CANAL OBTURATION TECNIQUES Effective obturation of the root canal space and coronal restoration prevents apical and coronal leakage and eliminates the pulp cavity as a reservoir of infection. ROOT CANAL OBTURATION TECNIQUES Obturation of the radicular space: 1.Eliminates leakage 2.Reduces coronal leakage & bacterial contamination 3.Seals the apex from the periapical tissue fluids 4.Entombs the remaining irritants in the canal ROOT CANAL OBTURATION TECNIQUES Inadequate obturation of the root canal invites failure and requirement for surgical procedures such as: periapical surgery or extraction ROOT CANAL OBTURATION TECNIQUES Criterias for Root Canal Obturation The root canal can be obturated when: • • • • • • • There is an absence of pain and swelling. There is no tenderness to percussion and palpation. There is no patent sinus tract. The canal is dry. The canal is odour-free. Temporary filling material is intact. Negative culture is obtained (not required in clinic). ROOT CANAL OBTURATION TECNIQUES ROOT CANAL OBTURATION TECNIQUES Ideal Properties of Root Canal Obturation Materials ★ It should be easily introduced into the root canal system ★ It should seal the canal laterally as well as apically. ★ It should not shrink after being inserted. ★ It should be impervious to moisture. ★ It should be bacteriostatic or at least not encourage bacterial growth. ★ It should be radiopaque ★ It should not stain tooth structure. ★ It should not irritate periapical tissue. (Biocompatibility) ★ It should exhibit a slow set. ★ It should be easily removed from the root canal if necessary. _________________________________________ ROOT CANAL OBTURATION TECNIQUES __________________________________ •SILVER CONE  •GUTTA-PERCHA ☺ ☺ •RESILON ☺ ☺ •COATED CONES ☺ ☺ __________________________________ ROOT CANAL OBTURATION TECNIQUES Today, the most recommended material for filling the root canals is gutta percha with a root canal sealer. ROOT CANAL OBTURATION TECNIQUES Gutta-percha→→→ • The concrete juice of Isonandra gutta, Palaquium gutta and Dichopsis gutta are the main trees from where, we obtain Gutta-percha material. • Gutta-percha has been used in Endodontics for over 100 years and is currently the most frequently used core material for permanent obturation of root canals. ROOT CANAL OBTURATION TECNIQUES ROOT CANAL OBTURATION TECNIQUES ROOT CANAL OBTURATION TECNIQUES ROOT CANAL OBTURATION TECNIQUES Composition and mechanical properties of gutta-percha endodontic points Material % Function Gutta percha Zinc oxide Wax/Resin Metal sulfates 18-22 59-76 1-4 1-18 Matrix Filler Plasticizer Radiopacifier ROOT CANAL OBTURATION TECNIQUES Major advantages of gutta-percha • 1- Compactible • 2- Minimal toxicity • 3- Dimensional stability • 4- Radioopacity • 5- Inert (not resorbable) • 6- Plasticity • 7- Ease of removal with heat or solvents ROOT CANAL OBTURATION TECNIQUES Disadvantages of gutta-percha • 1- Lack of rigidity • 2- Lack of adhesion to dentin ROOT CANAL OBTURATION TECNIQUES ROOT CANAL OBTURATION TECNIQUES WITH GUTTA PERCHA: I.SOLID CORE TECHNIQUES 1) SINGLE CONE TECHNIQUE 2) COLD LATERAL COMPACTION II.SOFTENED CORE TECHNIQUES 1) 2) 3) 4) 5) 6) WARM LATERAL COMPACTION WARM VERTİCAL COMPACTİON THERMOMECHANICAL COMPACTİON INJECTION-MOLDED GUTTA PERCHA CORE CARRIER TECHNIQUE CHLOROPERCHA TECNIQUE ROOT CANAL OBTURATION TECNIQUES COLD LATERAL COMPACTION TECHNIQUE: KANAL DOLDURMA SİSTEMLERİ COLD LATERAL COMPACTION TECHNIQUE: The objective is to fill the canal with gutta-percha cones by compacting them laterally against the sides of the canal walls. ROOT CANAL OBTURATION TECNIQUES Master cone selection • After root canal system preparation, a standard cone should be selected that has a diameter consistent with the prepared canal diameter at the working length. This is “master cone”. • For exp. If we used file no: 40 at the working length Master cone should be no: 40 ROOT CANAL OBTURATION TECNIQUES Master Cone How to fit that master gutta-percha cone? • Clinical examination • Radiographic examination ROOT CANAL OBTURATION TECNIQUES 1- Clinical Examination • This “master cone” is measured and grasped with cotton plier so that the distance from the tip of the cone to the reference point on the plier is equal to the prepared length. A reference point on the cone can be made by pinching the cone. • The cone is placed in the canal, and if an appropriate size is selected, there will be resistance to displacement: “tug-back”. ROOT CANAL OBTURATION TECNIQUES Clinical Examination • If there is no tug-back and the cone is loose it can be adapted by removing small increments from the tip until a good fit is obtained. • If the master cone fails to go to the prepared length, a smaller cone can be selected. Or make the preparation again. • When the cone extends beyond the prepared length a larger cone must be adapted or the existing cone shortened until there is resistance to displacement at the corrected working length. ROOT CANAL OBTURATION TECNIQUES Ideal Master Cone Features • 1- Should be fitted at working length • 2- Master cone should be fitted laterally at the apical portion of tooth and there must a well tug-back feeling • 3- Master cone should be at the point of cementodentinal junction and 0,5 - 1 mm short from the radiographic apex. • 4- Never extend beyond the apical foramen ROOT CANAL OBTURATION TECNIQUES 2- Radiographic Examination • After adaptation and clinical examination of master cone, a radiograph should be taken to make sure that the master cone is at the working length. It must be 0.5 - 1 mm short of the radiographic apex. ROOT CANAL OBTURATION TECNIQUES 2- Radiographic Examination ROOT CANAL OBTURATION TECNIQUES KANAL DOLDURMA SİSTEMLERİ ROOT CANAL OBTURATION TECNIQUES ROOT CANAL OBTURATION TECNIQUES ROOT CANAL OBTURATION TECNIQUES ROOT CANAL OBTURATION TECNIQUES COLD LATERAL COMPACTION TECHNIQUE: ROOT CANAL OBTURATION TECNIQUES ROOT CANAL OBTURATION TECNIQUES ROOT CANAL OBTURATION TECNIQUES ROOT CANAL OBTURATION TECNIQUES ROOT CANAL OBTURATION TECNIQUES SOĞUK LATERAL KOMPAKSİYON YÖNTEMİ: •that's all for now • to be continued… • love endo…