Advances in obturation systemin Endodontics         INDIAN DENTAL ACADEMY      Leader in Continuing Dental Education      ...
contentsIntroductionDefinitionHistory of obturationRequirements of obturation materialsClassification of obturation materi...
Advances in obturation systems    System B technique    Therma fil technique    UltraFil 3D    Obtura technique    Simplef...
INTRODUCTION       Obturation is the substitution of an inert filling inthe space previously occupied by the pulp tissues,...
HISTORYBefore – 1800 – Gold,bronze,silver.1867 - Bowman Claimed first use of gutta  percha.1883 – Perry used gold wire wra...
1914 – Challahan used chemicallyplasticized gutta percha.1977 – Thermoplasticizing device wasintroduced by yee et .1978 – ...
Obturation – “The three dimensional filling ofthe entire root canal system as close to thecementodentinal junction as poss...
3-D OBTURATION          Quality of cleaning and shaping                Skill of the clinician                  Materials u...
PURPOSE(1) To eliminate all avenues of leakage from the oral  cavity or the periradicular tissues into the root  canal sys...
WHEN TO OBTURATE ?Historically – Negative culture/cessation of signsand symptoms• Tooth is asymptomatic• Canal is dry• No ...
REQUIREMENTS FOR AN IDEAL ROOT CANAL         FILLING MATERIAL• Easily introduced• Liquid or semisolid and become solid• Se...
OBTURATION MATERIALS• Plaster of paris, asbestos, bamboo, precious metals  Contemporary material can be classified as• Pas...
• Semisolid, solid core materials      Gutta-percha      Silver points      Gold, Iridoplatinum, tantalum      Titanium – ...
GUTTA-PERCHA• Introduced by Bowman (1867)• Sapodilla family, genera payena• Trans isomer of 1,4 – poly isoprene           ...
β Phase             α phase              Amorphous  melt37° C               42 – 44°C            56 – 62°C• 1% - 2% expans...
Composition :• Gutta-percha - 20% - MATRIX• Zinc oxide - 66% - is the filler• Heavy metal sulfates - 11% - acts as the  Ra...
PROPERTIES: Compactable, adaptable Can be softened (heat / solvents) Inert Does not stain Easily removed Lacks rigid...
SILVER POINTSIndications :• Mature teeth, small well calcified round taperedcanals• Tight fitting canals / curved canalsCo...
Various obturation techniques       www.indiandentalacademy.com
OBTURATION TECHNIQUELateral compactionVertical compaction (Warmgutta-percha)Compactionmethod (McSpadden technique)Chemical...
Thermoplasticized gutta-percha       Technique’s        www.indiandentalacademy.com
OBTURA II TECHNIQUE“High heat technique”•    Requires tapering funnel preparation withdefinite apical matrixDevice (obtura...
Method of useNeedle / pluggers or prefit (3-5mm from apex)Minimum sealer placedGutta-percha injected passively (2-5sec)Imm...
Variations Regular flow gutta-percha (homogenized, superior flow) Easy flow gutta-percha (Lower temp., more workingtime)...
System B obturation • Introduced in 1987 by Dr.L.Stephen   Buchanan. • He retained the principles of vertical   compaction...
Down pack technique• A Corresponding size plugger is selected  and should stop at its binding point at 4-  5mm from the wo...
Back fill technique• Accessory cones are added , condensed with the  preheated pluggers and obturation is completed.• Obtu...
UltraFil 3D• Its is a thermoplastic guttapercha technique injection  technique• Consists of cannuals , Heating unit , inje...
• Method of use :• Obturation is done similarly to that of obtura II system.• Each cannula has a 22 guage stainless steel ...
SIMPLIFILL•Uses stainless steel carrier to place and compact5mm segment of GP.•Rubber stopper is set 2mm short of the W/L•...
Therma Fil Obturation• The Thermafill technique was introduced in an  attempt to bridge the "silver cone - gutta  percha v...
Method of use:• After the canal preparation,Removal of the smear  layer is recommended.• Light sealer coat is applied  on ...
•   Carrier is placed in the heating device for 10-15 sec.•   The carrier is carried and nserted into the canal.•   Gutta-...
Successfil• Its is also a carrier based obturation system.• Carrier is made of Titanium or Radiopaque  plastic.• Gutta-per...
• Method of use:• Sealer is placed on the canal walls.• The carrier with the gutta-percha is   placed into the canal to th...
Newer systems Each system component is resin based resulting in a solid resin monoblock in the root that effectively seals...
Resin based obturations     www.indiandentalacademy.com
Resilon obturating system• Resilon research ltd,LLC.• Resilon (Trade name "Epiphany"-  Manufactured By Pentron ) - This is...
Core material : thermoplastic,syntheticpolymer based (polyester).Resilon points – available in ISO sizes in0.02,0.04,0.06 ...
Composition :•   Polycaprolactone (50%) has low glass    transition temperature (-62ºC). the glass    transition temperatu...
• PROPERTIES :• CYTOTOXICITY : Resilon is same as  biocompatible as G.P.• MELTING POINT : 60.50*C• REMOVAL FOR RETREATMENT...
• Resin sealer :• Epiphany root canal sealer is a dual cured methacrylate  resin based sealer containing a new redox catal...
METHOD OF USE :• After the canal preparation is done, irrigation  is done with 5.25% sodium hypo chloride  solution and fi...
Air Displaced ObturationConsists of:• A Reciprocating handpiece• 7 Stainless steel files (3 shaping files used in hand  pi...
The sealer comes as a dual cure material in a skinnisyringe.The 29G navitip cannula helps in delivary of the sealer inthe ...
• Sealer is placed in the apical third of the root  canal and the remaining canal is filled using  gutta-percha which are ...
Fiberfil system• Fiber fill (jeneric pentron,walling’sford,CT,USA.• It simplifies sealing of a root canal both apically  a...
• The Fiberfill root canal sealer (RCS) is a  radiopaque dual cure resin sealer.,• Contains : UDMA, PEGDMA, HDDMA, and  BI...
• Once mixed it provides a working time of  10-12 minutes and a self cure setting  time of approximately 25 minutes. It  p...
Method of use :•   An obturator is selected that matches the final diameter of the    canal.•   The yellow Peeso reamer (i...
• An automix tip is placed on the Fiberfill RCS  syringe and the sealer is introduced into the canal  with a lentulo or ot...
•   Advantages:•   Obturation and post placement – same visit•   80 % root strengthening•   Immediate coronal seal•   High...
EZ Fill Obturation systemEpoxy resin sealer with bidirectionallentulo spiral system.Advantages:•The cements works synergis...
• A Pre-fitted gutta-percha point is selected.• Place the spiral in a slow-speed hand piece  (the 300 rpm hand piece desig...
• Conclusion :• With the newer endodontic obturation systems ,  obturation has become easy , quick and accurate ,  But eve...
Thank you  www.indiandentalacademy.com
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Advances in obturation system in endodontics /certified fixed orthodontic courses by Indian dental academy

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Advances in obturation system in endodontics /certified fixed orthodontic courses by Indian dental academy

  1. 1. Advances in obturation systemin Endodontics INDIAN DENTAL ACADEMY Leader in Continuing Dental Education www.indiandentalacademy.com
  2. 2. contentsIntroductionDefinitionHistory of obturationRequirements of obturation materialsClassification of obturation materialsVarious obturation techniques www.indiandentalacademy.com
  3. 3. Advances in obturation systems System B technique Therma fil technique UltraFil 3D Obtura technique Simplefil technique Successfil techniqueResin based obturation techiniques Resilon system Endo rez technique Fiber fil technique EZ Fil Obturation system www.indiandentalacademy.com
  4. 4. INTRODUCTION Obturation is the substitution of an inert filling inthe space previously occupied by the pulp tissues, toprevent recurrent infection by way of circulation orthrough a break in the integrity of the crown of the tooth. www.indiandentalacademy.com
  5. 5. HISTORYBefore – 1800 – Gold,bronze,silver.1867 - Bowman Claimed first use of gutta percha.1883 – Perry used gold wire wrapped with gutta percha.1887 – S.S. white manufacturers GP points.1893 – Rollins introduced gutta percha with vermilion. www.indiandentalacademy.com
  6. 6. 1914 – Challahan used chemicallyplasticized gutta percha.1977 – Thermoplasticizing device wasintroduced by yee et .1978 – Johnson introduced solid core carriertechnique.1979 – Mc Spadden introducedthermomechanical compaction .1982 – Touch ‘n’ heat device was introducedby john masreillez.1987- System B obturation technique wasinrtroduced by Dr.L.Buchanan.. www.indiandentalacademy.com
  7. 7. Obturation – “The three dimensional filling ofthe entire root canal system as close to thecementodentinal junction as possible. Minimalamounts of root canal sealers which have beendemonstrated to be biologically compatible are usedin conjunction with the core filling material toestablish an adequate seal”. www.indiandentalacademy.com
  8. 8. 3-D OBTURATION Quality of cleaning and shaping Skill of the clinician Materials used Coronal seal Health of the supporting periodontium Periradicular tissue regeneration The clinicians must choose a path oftreatment that will result in best possible cleaningand shaping of the root canal system coupled withan obturation technique that provides a 3D sealapically, laterally and coronally WITHIN the www.indiandentalacademy.comconfines of the root canal system.
  9. 9. PURPOSE(1) To eliminate all avenues of leakage from the oral cavity or the periradicular tissues into the root canal system.(2) To seal within the system any irritants that cannot be fully removed.RATIONALE “ Microbial irritants and products of pulp tissue degeneration are the prime causes for pulpal demise and it subsequent extension into the periradicular tissue”. www.indiandentalacademy.com
  10. 10. WHEN TO OBTURATE ?Historically – Negative culture/cessation of signsand symptoms• Tooth is asymptomatic• Canal is dry• No sinus tract• Intact temporary filling www.indiandentalacademy.com
  11. 11. REQUIREMENTS FOR AN IDEAL ROOT CANAL FILLING MATERIAL• Easily introduced• Liquid or semisolid and become solid• Seal laterally and apically• Not shrink• Impervious to moisture• Bacteriostatic• Not stain• Not irritate periapical tissues• Easily removed• Sterile or sterilizable• Radiopaque www.indiandentalacademy.com
  12. 12. OBTURATION MATERIALS• Plaster of paris, asbestos, bamboo, precious metals Contemporary material can be classified as• Pastes : Zincoxide eugenol cements andmodifications• Synthetic resins : Epoxy, acrylic, poly etheylene ,polyvinyl resins, Poly carboxylate, glass ionomercements ,Silicone rubber www.indiandentalacademy.com
  13. 13. • Semisolid, solid core materials Gutta-percha Silver points Gold, Iridoplatinum, tantalum Titanium – advocated by Messing www.indiandentalacademy.com
  14. 14. GUTTA-PERCHA• Introduced by Bowman (1867)• Sapodilla family, genera payena• Trans isomer of 1,4 – poly isoprene Two crystalline formsAlpha (α) Beta (β)• Direct form • Commercial form• Brittle • Flexible• Low melting point• Adhesive• Good flow characteristics www.indiandentalacademy.com
  15. 15. β Phase α phase Amorphous melt37° C 42 – 44°C 56 – 62°C• 1% - 2% expansion occurs but % shrinkage is greater when cooled• Slow cooling forms α chains, rapid cooling forms β chainsCommercially supplied asCones - ISO standardized / Non standardizedPellets / Cannulas (Injectable thermoplastictechniques)Heatable syringes (Thermomechanicaltechniques)Coated over cores (Plastic / metal) www.indiandentalacademy.com
  16. 16. Composition :• Gutta-percha - 20% - MATRIX• Zinc oxide - 66% - is the filler• Heavy metal sulfates - 11% - acts as the Radiopacifier.• Waxes or Resins - 3% - they make the points more pliable or compactable.• Varies slightly with each manufacturers www.indiandentalacademy.com
  17. 17. PROPERTIES: Compactable, adaptable Can be softened (heat / solvents) Inert Does not stain Easily removed Lacks rigidity No adhesive quality Easily displaced by pressure www.indiandentalacademy.com
  18. 18. SILVER POINTSIndications :• Mature teeth, small well calcified round taperedcanals• Tight fitting canals / curved canalsContraindications:• Large canals / Oval canalsDisadvantages :• Corrosion (Sulfur/chlorides) www.indiandentalacademy.com
  19. 19. Various obturation techniques www.indiandentalacademy.com
  20. 20. OBTURATION TECHNIQUELateral compactionVertical compaction (Warmgutta-percha)Compactionmethod (McSpadden technique)Chemically plasticized gutta-percha www.indiandentalacademy.com
  21. 21. Thermoplasticized gutta-percha Technique’s www.indiandentalacademy.com
  22. 22. OBTURA II TECHNIQUE“High heat technique”• Requires tapering funnel preparation withdefinite apical matrixDevice (obtura II)• Heated delivery system (Pistol shape)• GP heated to 185 – 200°C• Needle gauge 20 (#60 file), 23 (#40 file)Best used in presence of canal irregularities (fins,webs, cul-de-sacs, internal resorption, C-shapecanals, accessory and lateral canals). www.indiandentalacademy.com
  23. 23. Method of useNeedle / pluggers or prefit (3-5mm from apex)Minimum sealer placedGutta-percha injected passively (2-5sec)Immediately cold compacted (within 1minute) orCompletely filled. www.indiandentalacademy.com
  24. 24. Variations Regular flow gutta-percha (homogenized, superior flow) Easy flow gutta-percha (Lower temp., more workingtime) Apical closure using fitted master cone + injected gutta- percha www.indiandentalacademy.com
  25. 25. System B obturation • Introduced in 1987 by Dr.L.Stephen Buchanan. • He retained the principles of vertical compaction and improved the methodology. • Obturation is completed • in 2 phases. • Down pack technique. • Back fill technique www.indiandentalacademy.com
  26. 26. Down pack technique• A Corresponding size plugger is selected and should stop at its binding point at 4- 5mm from the working length.• Primary cone is coated with the sealer and is placed in the canal. • The heat device is activated and the temperature is set at 200*c. •The pre heated plugger is then driven smoothly through the gutta-percha to within 3-4mm of its binding point. • The softened gutta percha flows to the apical matrix and the accessory canals. www.indiandentalacademy.com
  27. 27. Back fill technique• Accessory cones are added , condensed with the preheated pluggers and obturation is completed.• Obturation can be also completed using obtura II gutta- percha gun. www.indiandentalacademy.com
  28. 28. UltraFil 3D• Its is a thermoplastic guttapercha technique injection technique• Consists of cannuals , Heating unit , injection suringe.• Cannuals come in 3 types :• Regular set - low viscosity - 30 min• Firm set - low viscosity - 4 min• Endo set - High viscosity - 2 min www.indiandentalacademy.com
  29. 29. • Method of use :• Obturation is done similarly to that of obtura II system.• Each cannula has a 22 guage stainless steel needle that can be pre curved.• Cannula is placed in the warm heater for about 3 min.• Sealer is applied to the canal walls• Gutta percha is displaced into the canal with the pre curved 22 guage needle• Manufacturers recommend compaction using both Regular set and Firm set followed by the Endo set www.indiandentalacademy.com
  30. 30. SIMPLIFILL•Uses stainless steel carrier to place and compact5mm segment of GP.•Rubber stopper is set 2mm short of the W/L•Carrier must not be rotated during insertion•GP vertically compacted to full W/L•GP plug is released by rotating the handle CCW www.indiandentalacademy.com
  31. 31. Therma Fil Obturation• The Thermafill technique was introduced in an attempt to bridge the "silver cone - gutta percha void". It involved the heating of gutta percha on a "carrier" system, first made of metal and then later on - in plastic. When used correctly it was also very successful. www.indiandentalacademy.com
  32. 32. Method of use:• After the canal preparation,Removal of the smear layer is recommended.• Light sealer coat is applied on the canal walls.• Carrier is marked,set to pre determined length.• Millimeter calibration markings are provided on the carrier at18,19,20,22,24,27,29. www.indiandentalacademy.com
  33. 33. • Carrier is placed in the heating device for 10-15 sec.• The carrier is carried and nserted into the canal.• Gutta-percha is alowed to cool for 2-4 min.• Excess is removed using a Round Bur. www.indiandentalacademy.com
  34. 34. Successfil• Its is also a carrier based obturation system.• Carrier is made of Titanium or Radiopaque plastic.• Gutta-percha comes in a syringe. www.indiandentalacademy.com
  35. 35. • Method of use:• Sealer is placed on the canal walls.• The carrier with the gutta-percha is placed into the canal to the predetermined length.• The gutta-percha is then compacted around the carried with various pluggers.• Severing of the carrier is done with a round bur above the orifices. www.indiandentalacademy.com
  36. 36. Newer systems Each system component is resin based resulting in a solid resin monoblock in the root that effectively seals to the dentinal walls. www.indiandentalacademy.com
  37. 37. Resin based obturations www.indiandentalacademy.com
  38. 38. Resilon obturating system• Resilon research ltd,LLC.• Resilon (Trade name "Epiphany"- Manufactured By Pentron ) - This is the most promising material for replacement of Gutta Percha. The Epiphany obturation system has been shown to resist leakage significantly better than gutta percha based obturation.• Resilon was introduced to bond with methacrylate sealers and produce a monoblock with the tooth.• Resilon system is supplied as core + primer + resin sealer www.indiandentalacademy.com
  39. 39. Core material : thermoplastic,syntheticpolymer based (polyester).Resilon points – available in ISO sizes in0.02,0.04,0.06 tapers. www.indiandentalacademy.com
  40. 40. Composition :• Polycaprolactone (50%) has low glass transition temperature (-62ºC). the glass transition temperature dictate whether the Polymer is hard and brittle or soft and flexible.• Methacrylate co-polymer(10%)helps in bonding chemically with methacrylate based sealers.• Glass fillers(40%)• Bismuth oxychloride is the radiopaque filler. www.indiandentalacademy.com
  41. 41. • PROPERTIES :• CYTOTOXICITY : Resilon is same as biocompatible as G.P.• MELTING POINT : 60.50*C• REMOVAL FOR RETREATMENT : heat or solvents like chloroform can be used for removal of the resilon points.• DEGRADABILITY : degrades slowely in water and can be accelerated by the enzymes.• REINFORCEMENT OF TOOTH STRUCTURE : it can provide 20% more that of the G.P points provide.• Resilon has low melting point than G.P• Resilon has higher molecular weight that G.P so when subjected to heat resilon exhibits higher flowability than G.P www.indiandentalacademy.com
  42. 42. • Resin sealer :• Epiphany root canal sealer is a dual cured methacrylate resin based sealer containing a new redox catalyst that enables optimal auto polymerisation under acidic environment.• Composition:• BISGMA• Ethoxylated BISGMA• UDMA• Difunctional methacrylates• Fillers(70%) – calcium hydroxide,barium sulfate,barium glass,bismuth oxychloride and silica www.indiandentalacademy.com
  43. 43. METHOD OF USE :• After the canal preparation is done, irrigation is done with 5.25% sodium hypo chloride solution and final rinse is done with 17% EDTA• Canal is dried with the paper points.• Self-etch primer is brought into the canal by insertion of a saturated fitted paper point.• Excess is removed with a dry paper point.• Epiphany resin sealer is then express into the canal using a auto mix syringe.• The fitted master cone was coated with the sealer and is placed into the canal.• Obturation is completed using Downpack and Back fill technique. www.indiandentalacademy.com
  44. 44. Air Displaced ObturationConsists of:• A Reciprocating handpiece• 7 Stainless steel files (3 shaping files used in hand piece and 4 hand files for apical 3 mm)• Irrigants and Lubricants• Delivery tips• EndoRez Sealer and EndoRez points www.indiandentalacademy.com
  45. 45. The sealer comes as a dual cure material in a skinnisyringe.The 29G navitip cannula helps in delivary of the sealer inthe apical third region without air trapment. www.indiandentalacademy.com
  46. 46. • Sealer is placed in the apical third of the root canal and the remaining canal is filled using gutta-percha which are ovelayed with a thin resin coat.• The resin coat allows the Endo Rez points to bond chemically with Endo Rez sealer.• The coronal portion of the sealer is then light cured and the sealer sets in 15 min time and final set – 2hrs. www.indiandentalacademy.com
  47. 47. Fiberfil system• Fiber fill (jeneric pentron,walling’sford,CT,USA.• It simplifies sealing of a root canal both apically and coronally.• The Fiberfill system consists of an adhesive bonding agent, a light-curable CaOH based resin sealer and a fiber post with an apical terminus of gutta percha .• Primer included in the system is a self etching two bottle liquid that allows the sealer to chemically bond to the canal dentin. The primer is a self curing adhesive. www.indiandentalacademy.com
  48. 48. • The Fiberfill root canal sealer (RCS) is a radiopaque dual cure resin sealer.,• Contains : UDMA, PEGDMA, HDDMA, and BISGMA resins with silane treated bariumborosilcate glasses, barium sulfate, calcium hydroxide with initiators.• The material comes in a two barrel automix syringe. www.indiandentalacademy.com
  49. 49. • Once mixed it provides a working time of 10-12 minutes and a self cure setting time of approximately 25 minutes. It provides a depth of light cure of 1.7mm .• The Fiberfill obturator is a resin and glass fiber post with a terminal gutta percha tip.• The gutta percha is available either in 5 or 8mm lengths .• The diameter of the post is available in sizes 30, 40, 50, 60, 70 and 80. www.indiandentalacademy.com
  50. 50. Method of use :• An obturator is selected that matches the final diameter of the canal.• The yellow Peeso reamer (included in the kit) is introduced into the canal set either to 5 or 8mm from the working length.• Then the blue Peeso reamer (also in the kit) is taken to the same depth as the previous reamer.• The canal is irrigated, disinfected and dried.• A drop of primer A and B are mixed in a dish and applied in the canal with the kits spiral brush.• The brush tip is introduced to the depth made by the Peeso reamers. www.indiandentalacademy.com
  51. 51. • An automix tip is placed on the Fiberfill RCS syringe and the sealer is introduced into the canal with a lentulo or other sealer applicator.• The obturator is gently seated to working length allowing excess sealer to be expressed coronally.• The dual cure Fiberfill RCS is light cured to stabilizer the coronal portion.• The result is a durable restoration with a resin/fiber reinforced root that is optimally sealed apically and coronally www.indiandentalacademy.com
  52. 52. • Advantages:• Obturation and post placement – same visit• 80 % root strengthening• Immediate coronal seal• Highly radiopaque sealer www.indiandentalacademy.com
  53. 53. EZ Fill Obturation systemEpoxy resin sealer with bidirectionallentulo spiral system.Advantages:•The cements works synergisticallywith gutta-percha to assure acomplete seal.•Lateral and vertical condensationnot needed.•Bonds chemically and physically withdentin and gutta-percha.•Hydrophobic in nature.•No shrinkage.•Mild Expansion of the sealerprovided tightwww.indiandentalacademy.com seal.
  54. 54. • A Pre-fitted gutta-percha point is selected.• Place the spiral in a slow-speed hand piece (the 300 rpm hand piece designed for Endo Magic files is perfect), and coat it with the resin cement. Insert the coated spiral into the canal and advance slowly to working length.• Apply two or three applications of the sealer with a smooth in-and-out motion to coat the canal walls and fill the canal with cement.• Coat the apical 4mm of your pre-fitted gutta- percha point with the resin cement, and slowly insert it to length in the canal.• Using a heated instrument (or an electric device such as the Touch N Heat), sear off the excess gutta-percha. www.indiandentalacademy.com
  55. 55. • Conclusion :• With the newer endodontic obturation systems , obturation has become easy , quick and accurate , But even having so many obturation systems the quest for the hermetic seal remains as a myth . www.indiandentalacademy.com
  56. 56. Thank you www.indiandentalacademy.com

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