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Root canal filling instruments and materials
The document discusses root canal filling materials and techniques. It describes various instruments used for root canal filling like Lentulo spirals and spreaders. It discusses different obturation materials like gutta percha points, sealers based on zinc oxide-eugenol, calcium hydroxide, glass ionomers and resins. It also describes different root canal filling techniques like single cone, lateral condensation, warm lateral/vertical condensation and thermoplasticized techniques.
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Root canal filling instruments and materials
- 1. Root canal filling materials. Rootfilling techniques. Lecturer: Levkiv Mariana Department of Therapeutic Dentistry TSMU
- 2. Purpose of rootcanal filling To prevent bacteria and bacterial elements from spreading from (or through) the canal system to the periapical area, the fully instrumented root canal has to be provided with a tight and long-lasting obturation. A root canal filling material should, therefore, prevent infection/reinfection of treated root canals. Together with an acceptable level of biocompatibility (inert material) this will provide the basis for promoting healing of the periodontal tissues and for maintaining healthy periapical conditions.
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- 4. Instruments for rootcanal filling Lentulo spiral filler/rotary paste filler Function and features • Small flexible instrument used to place materials into the canal • Fits into the conventional handpiece • Use with caution as it can be easily broken • Different sizes available
- 5. Finger spreader Function, featuresand precaution • Used to condense gutta percha into the canal during obturation • Finger instrument with a smooth, pointed, tapered working end • Disposed of in the sharps’ container Varieties Can be of the hand instrument type (lateral condenser)
- 6. Endodontic plugger Function Working endis flat to facilitate plugging or condensing the gutta percha after the excess has been removed by melting off with a heated instrument Varieties • Different sizes of working ends are available •Available as hand or finger instruments
- 7. Gutta perchapoints Function and features •Non-soluble, non-irritant points that are condensed into the pulp chamber during obturation • Standardised type: follows same ISO classification as endodontic files • Non-standardised: have a greater taper than the standard ISO type Varieties • Can be packaged in single dose or bulk packages • Different sizes with different tapers available
- 8. OBTURATING MATERIALS Core ObturationMaterials Historically, a variety of materials have been employed to obturate the root canal, falling into three broad categories: pastes(sealers) semisolids solids
- 9. Sealers Sealers fillthe space between the canal wall and core obturation material and may fill lateral and accessory canals, isthmuses, and irregularities in the root canal system.
- 10. Obturating materials Idealproperties of root canal filling materials:Ideal properties of root canal filling materials: AntimicrobialAntimicrobial Biocompatible.Biocompatible. Good flowGood flow Adhesive in natureAdhesive in nature Dimensionally stableDimensionally stable Not affected by moistureNot affected by moisture Radio-opaqueRadio-opaque Good handlingGood handling Easily removed, post prep or retreatEasily removed, post prep or retreat Does not stain dentineDoes not stain dentine CheapCheap
- 11. The most popularsealers are grouped by type: Zinc oxide-eugenol formulations Calcium hydroxide sealers Glass- ionomers Resins Regardless of the sealer selected, all are toxic until they set. For this reason, extrusion of sealers into the periradicular tissues should be avoided.
- 12. Sealers based on calciumhydroxide An easy, effective method of sealer application. The file covered with sealer will be inserted and spun counterclockwise to coat the canal walls.
- 13. Indications for theuse of calcium hydroxide include:
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- 15. Acceptable methods ofplacing the sealer in the canal include the following: Placing the sealer on the master cone and pumping the cone up and down in the canal Placing the sealer on a file and spinning it counter clockwise Placing the sealer with a lentulo spiral Using a syringe Activating an ultrasonic instrument The clinician should use care when placing sealer in a canal with an open apex to avoid extrusion.
- 16. Solid materials Silver conesmet many of the criteria for filling materials but suffered from several deficiencies. When leakage occurred and the points contacted tissue fluids, they corroded, further increasing leakage.
- 17. Semisolid material Gutta-percha, asemisolid material, is the most widely used and accepted obturating material. Typical composition of gutta- perchacones.
- 18. Resin Resin-based obturation system containsprimer, sealer, and cones. The cones resemble gutta- percha and can be placed using lateral or warm vertical compaction. Pellets are available for thermoplastic injection.
- 19. Single cone Warm lateral compaction Warmvertical compaction Lateral compaction Thermomec- hanical compaction Injection- molded gutta- percha Core carrier Root filling techniques Solid core techniques Softened core techniques
- 20. Root canal fillingtechnique. Solid core technique Single cone The single-cone technique consists of matching a cone to the prepared canal. For this technique a type of canal preparation is advocated so that the size of the cone and the shape of the preparation are closely matched.
- 21. Cold lateralcondensation This is a commonly taught method of obturation and is the gold standard by which others are judged. The technique involves placement of a master point chosen to fit the apical section of the canal. Obturation of the remainder is achieved by condensation of smaller accessory points. The steps involved are:
- 22. 1. Selecta GP master point to correspond with the master apical file instrument. This should fit the apical region snugly at the working length so that on removal a degree of resistance or 'tug-back' is felt. If there is no tug-back select a larger point or cut 1 mm at a time off the tip of the point until a good fit is obtained. The point should be notched at the correct working length to guide its placement to the apical constriction. 2 . Take a radiograph to confirm that the point is in correct position if you are in any doubt. 3. Coat walls of canal with sealer using a small file. 4. Insert the master point, covered in cement. 5 . Condense the GP laterally with a finger spreader to provide space into which accessory points can be inserted until the canal is full. 6. Excess GP is cut off with a hot instrument and the remainder packed vertically into the canal with a cold plugger.
- 23. Sketch showing across-sectional cut through a root canal filled with a master cone and multiple accessory cones
- 24. Warm lateralcondensation As above, but uses a warm spreader after the initial cold lateral condensation. Finger spreaders can be heated in a flame or a special electronically heated device (Touch of heat) can be used.
- 25. Diagram ofthe warm vertical condensation technique. A, After a heated spreader is used to remove the coronal segment of the master cone, a cold plugger is used to apply vertical pressure to the softened master cone. B, Obturation of the coronal portion of the canal is accomplished by adding a gutta -percha segment. C, A heated spreader is used to soften the material. D, A cold plugger is then used to apply pressure to the softened gutta-percha.
- 26. Thermoplasticized injectable GP(e.g. Obtura, Ultrafil) Thermomechanical compactio
- 27. Coated carriers(e.g. Thermafil) These are cores of metal or plastic coated with GP. They are heated in an oven and then simply pushed into the root canal to the correct length. The core is then severed with a bur. A dense filling results, but again apical control is poor and extrusions common. They are expensive and difficult to remove.
- 28. GuttaFlow is acold flowable injection system that combines a silicone-based matrix with finely ground gutta-percha. It is used in conjunction with a master gutta-percha point without the need for compaction.
- 29. Glass ionomer–coated gutta- perchapoints (A) are used in conjunction with a glass ionomer sealer (B) to attempt to create a monoblock within the canal system.
- 30. A, Resin composite core buildup,with a ferrule incorporated into the preparation. B, Full crown as the definitive restoration. A cast post and core provides the best foundation for restoring maxillary premolars.
- 31. THE CORONAL SEAL Regardless of the technique used to obturate the canals, coronal microleakage can occur through seemingly well- obturated canals within a short time, potentially causing infection of the periapical area. A method to protect the canals in case of failure of the coronal restoration is to cover the floor of the pulp chamber with a lining of glass ionomer cement after the excess gutta- percha and sealer have been cleaned from the canal.