endodontics

1. MORNING

2. SEALER AND OBTURATING
MATERIALS
GUIDED BY-
DR.ARUN VERMA
DR.SWAPAN RAI
DR.ASHUTOSH PRATAP SINGH
PRESENTED BY
NANDLAL(INTERN)
2015-16 BATCH
CHANDRA DENTAL COLLEGE &
HOSPITAL

3. POINTS SHOULD BE CONSIDERS BEFORE CHOOSING THE ROOT
CANAL FILLING MATERIALS-
Easy to
introduced in
root canal.
Seal the canal
laterally and
apically
Should not
shrink after
insertion
Set slowly
Impervious
to moisture
Bactericidal
Radiopaque
Should not
affect the
tooth
structure
Sterile &
easily
removable

4. HISTORICAL SOLID CORE FILLING
MATERIALS-
• For the past 50 years SILVER CONES have
been used.
• Stiffer than GP.
• It corrod with saliva & become toxic.
• Dificult to remove for retreatment.
• Hence, these are no longer in use.

5. CURRENTLY USED SOLID CORE
FILLING MATERIALS-
These are of three types
Gutta percha
Resilon
MTA

6. (1) Gutta-percha-
• Most often used in dentistry.
• Introduced by Bowman in 1867.
COMPOSITION
20%
66%
11%
3%
GUTTA PERCHA
(MATRIX)
ZINC OXIDE
(FILLER)
HEAVY METAL
SULFATE
(RADIOPACIFIER)
WAXES OR RESINS
(PLASTICIZER)
20%
66%
11%
3%

7. CHARACTERSTICS
Rigid natural latex.
Produce by the tree of genus PALAGUIUM
GUTTA.
Exits in Alpha & Beta crystalline forms.
Beta solid become Alpha tacky after heat.
BETA used in lateral condensation techniques.
Alpha used in thermoplasticized techniques.
Can be sterilize by 5.25% NaOcl for 1 minute.

8. PROPERTIES
Dose not shrink after insertion until
plasticized.
Radiopaque.
Easily removable.
Least toxic & irritating.

9. SIZE & TAPER
Conventional size
• Extra fine
• Fine
• Medium fine
• Fine medium
• Medium
• Large
• Extra large
Standardized size
• ISO 2% from size
no. 15-140
• 4 or 6% tapered
• Protaper F1,F2 &
F3

10. (2) RESILON-
High performance polyurethane.
Alternative to GP.
Always used with resin sealers.
COMPOSITION
POLYCAPROLACT
ONE CORE
MATERIAL
BIOACTIVE
GLASS
DIFUNCTIONAL
METHACRYLATE
RESIN
BISMITH &
BARIUM
SALT(FILLERS &
PIGMENTS)

11. * This system can be placed using
Lateral compaction
Warm vertical compaction
Thermoplastic injection
• Available in ISO-Sized points &
pallets for use with obtura-III
• Long term clinical traits required to
recomned at the place of GP.

12. (3) MTA(Mineral Trioxide Aggregate)-
* Used because of its superior physiochemical
& bioactive properties.
INDICATIONS
Teeth with open apices.
Retreatment with MTA obturation.
Internal resorption.
Dens in dente.
CONTRAINDICATIONS
Difficulty in retreatment in curved canals.
Potential for discoloration especially when used in
anterior esthetic zone.

13. ROOT CANAL SEALERS-
Used in conjunction with biologically acceptable semisolid or solid
obturating material to establish an adequate seal.
CRITERIA TO CHOOSE-
~ Excellent seal when set
~ Adequate adhesion
~ Radiopaque
~ Non-staining
~ Stable
~ Easily mixed & introduced
~ Easily removable
~ Bactercidal
~ Slow setting to ensure ~sufficent working time

14. Zinc oxide
eugenol based
sealers-
(A) Gross man’s
formula
(B) Roth’s 801
(C) Tubliseal
Calcium
hydroxide based
sealers
(A) Sealapex
(B) Apexit
Glass ionomer
based sealers
Resin based
sealers
(A) AH plus
(B) AH26
(C) Epiphany
(D) Diaket
CLASSIFICATION

15. (1) ZINC OXIDE BASED SEALERS-
COMPOSITION
POWDER PARTS
Zinc oxide,reagent 42
Staybelite resin 27
Bismuth subcarbonate 15
Barium Sulfate 15
Sodium borate,anhydrous 1
LIQUID
Eugenol

16. Gross man’s cement –
 Harden in 2 hrs at 37c .
 Set in root canal within 10-30 min because of
moisture in dentin.
 The spatulation time depends on the no of drops
of liquid used a minute per drop.
 Proper consistency test should be done by “string
out” 1 inch without breaking or dropping in 10-15
sec from spatula.
 Inserted with lentulo spiral or master cone.

17. (2) CALCIUM HYDROXIDE BASED
SEALERS-
These are developed for the their anti-microbial & osteogenic-
cementogenic potential.
SEALAPEX-
* Non-eugenol
* Calcium hydroxide polymeric resin root canal sealer available in base
catalyst system
COMPOSITION
BASE CONTAINS
1- Zinc oxide
2- Calcium hydroxide
3- Butyl benzene
4- Sulftonamide
5- Zinc stearate
CATALYST CONTAINS
1- Resin
2- Isobutyl salicylate
3- Barium sulfate
4- Titanium dioxide
5- Aerosol

18. (3) GLASS IONOMER BASED
SEALERS-
Applied because of their dentin
bonding ability.
Eg- RETAC Endo( 3M ESPE).
Not used because difficulty in
removing the sealer in retreatment.

19. (4) RESIN BASED SEALES-
AH plus modified formulation of AH26 & does
not release formaldehyde.
COMPOSITION
Paste A
- Epoxy resin
- Calcium tungstate
- Zirconium oxide
- Silica
- Iron oxide
Paste B
- Adamantaneamine-N
- Calcium tungstate
- Zirconium oxide
- Silica-silicone oil

20. Advantages-
Good sealing ability.
Biocompatibility to periapical tissue.
Moderate antimicrobial activity.
Dentinal adhesion.
Long working time & ease of
manipulation.

21. GUTTA PERCHA OBTURATION
TECHNIQUES-
There are 8 techniques we use in obturation
(1) Cold lateral compaction
(2) Warm compaction(warm gutta percha)
(a) Vertical
(b) lateral
(3) Continous wave compaction technique
(4) Thermoplasticized gutta percha injection
(5) Carrier based gutta percha
(a) Thermafil thermoplasticized
(b) Simplifill sectional obturation
(6) McSpadden thermomechanical compaction
(7) Chemically plasticized gutta percha
(8) Custom cone

22. (1) Cold lateral compaction-
-Clinical consideration-
1- Sealer consideration-
Sealer application can be performed using a LENTULO
SPIRAL or with master cone gutta percha itself.
2- Spreader consideration-
The greater the space b/w the canal wall and the butt end of
the gutta percha, the larger(wider) the spreader used.
3- Master cone consideration-
Should be same as master apical file size. Minimum force
should be applied to avoid root fracture.
Additional secondary cones are inserted confirm that the canal
is fully compacted laterally.
4- Several radiograph must taken to check the accuracy of the
procedure.
5- After the verification the butt end of the gutta percha is cutt
of with the help of hot instruments.

37. Techniques of the cold lateral compaction
Isolation and drying
the canal with paper
points
Selection of master
cone (same as master
apical file)
Checking for apical
“TUG BACK”
Radiographic
verification of
master cone fit
Short of the apex
Working length
Beyond the apex
If master cone goes
beyond the apex the
tip should be cut off
so that the reinserted
primary cone fit
snugly at the working
length.
Sealer manipulation
Master cone inserted till
working length 1 mm
shorter
The spreader is
disengaged
Post obturation
radiograph
Irrigation,recapit
ulation, &
shaping of canal,
Another primary
GP is fitted

38. Limitations
* Presence of voids in b/w the filling.
* Increased sealer:GP ratio compare to
thermoplasticized technique.
* Warm compaction technique have better
ability to seal intracanal defects and lateral
canal than cold lateral compaction.

39. (2) WARM COMPACTION METHOD
(WARM GUTTA PERCHA)-
A. Warm vertical compaction B.Warm lateral compaction
 Introduced by Schilder with
objective of filling the Main root
canal as well as lateral and accessory
canals using heated
pluggers,pressure applied in vertical
direction to heat softened gutta
percha thereby cause it to flow and
to fill the entire lumen of canal.
Advantage-
Excellent seal
Obturation of large lateral &
accessory canals
Disadvantage-
Time taking , risk of vertical root
fracture
 It involves placement of master
cone & lateral compaction using
heat carriers such as Endotec II
tips9Medidenta) & Endotwinn
tips(Hu-friedy).
 The device is placed beside the
master cone.
 Accessory cones are then placed
and the process repeated unit the
canal is filledS.

41. (3)CONTINOUS WAVE
COMPACTION TECHNIQUE-
 Variation of warm vertical compaction technique
Introduced by Buchanan.
 Uses tapered nickel titanium system to prepare the canal.
Pluggers are selected in consistence with the size of the
shaping instruments used.
 Tapered pluggers #.06, #.08, #.10, #.12 with the tip diameter
similar to tapered gutta percha point , respectively are
employed.
 The procedure is carried out with a heat carrier
system(system B , sybronEndo).

42. (4)THERMOPLASTICIZED GUTTA PERCHA
INJECTION TECHNIQUE-
 This technique comprises a pressure of an insulated
electrically heated syringe barrel & a selection of needle
ranging from 18-25 gauge size.
 The plunger is designed to prevent backward flow of the GP.
 The degree of heat is regulated to provide proper extraction
of the GP according to the size of needle.
 Eg-Obtura III (it heats the GP
 The needle selection will be 3-5mm short then the working
length.
LIMITATION-
 Lack of precision in delivering the GP near the apical
foramen & the beyond.

44. (5)CARRIER BASED GUTTA PERCHA
TECHNIQUES-
Thermafil
Thermoplasticize
d Technique
Thermafil
obturation
Technique
Next slide
Simplifill sectional
obturation
technique(lightspeed
technology Inc.)
=It is carrier based sectional
gutta percha obturation system.
-The simplifill carrier has an
apical 5mmplug of gutta percha
which perform cold sectional
obturation of the root canal.
-The carrier size is choosen
according to the diameter of the
master apical file(MAF)
-The handle of the carrier is
roatated quickly in the
counterclock wise direction
three to four times to disengage
the apical plug of GP from
carrier
-carrier based GP
obturation system
-a plastic core carrier coated
with alpha phase GP.
-The obturation are used in
conjucation with a heating
device known as the
Thermaprep plus oven(for
10 sec the carrier is put in
the oven)

46. (6)McSPADDEN
THERMOMECHANICAL
COMPACTION METHOD-
-Introduced by McSpadden.
-uses heat to decrease gutta percha viscosity & increase its plasticity.
-the heat is created by rotating a compacting instrument in a slow speed
contra angle handpiece at 8000-10,000 RPM alongside GP cone inside the
root canal.
-This method used only to fill the straight canals.
ADVANTAGE
-Ease of selection and
insertion of GP cones.
-Economy of time.
-Rapid filling of canals.
DISADVANTAGE
-inability to use the technique in
narrow canals.
-frequent breakage of compactor
blades.
-overfilling of canal.

47. McSpadden compactor

48. (7)CHEMICALLY PLASTICIZED GUTTA PERCHA
TECHNIQUE(EUCAPERCHA,CHLOROPERCHA
-GP can be plasticized by chemical solvents such
as chloroform,eucalyptol or xylol.
-Disadvantage is its ability to control
overfilling,with resultant periapical tissue
reaction and shrinkage of the filling after
setting,resulting in poor apical and lateral seal.
-this technique is no longer recommended.

49. (8) CUSTOM CONE TECHNIQUE-
Soften the tip of the master cone with chloroform for few second
and gently place it to the working length with a locking plier.