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![GUTTA PERCHA BASED SEALERS
CHLOROPERCHA
[chloroform + gutta percha]
Not adhesive
Increased shrinkage
Decreased radiopacity
Chloroform – potential carcinogen
EUCAPERCHA
eucalyptol
gutta percha
CALLAHAN-
JOHNSTON TECHNIQUE
[DIFFUSION TECHNIQUE]
Chloroform + rosin
gutta percha
KLOROPERKA N- Ø
chloroform + resin + zinc oxide
gutta percha](https://image.slidesharecdn.com/obturationtechniques-240915182709-90e99e12/85/OBTURATION-TECHNIQUES-methods-types-and-uses-32-320.jpg)
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OBTURATION TECHNIQUES ,methods, types and uses
- 1.
- 2. DEFINITION: Obturation is definedas three-dimensional filling of the entire root canal system as close to the cemento-dentinal junction as possible.
- 3. HISTORICAL PERSPECTIVES : Alarge variety of filling materials have been used through the years. Some of the materials used in the early days were: ► Pigeon droppings ► Plaster of Paris ► Asbestos ► Bamboo ► Wooden pegs ► Feathers
- 4. Before 1800 rootcanal filling was limited to gold. Subsequent obturation with various metals, oxychloride of zinc paraffin and amalgam resulted in varying degrees of success and satisfaction. Dental history also indicates the use of iridoplatinum as filling materials. History of solid core filling materials: The first solid core filling materials were used unintentionally. They were the endodontic instruments that separated within the canal.
- 5. Gutta-percha had beenused to fill canals as early 1830. In 1847 Hill developed the first Gutta-percha root canal filling material known as “Hills stopping”. Bowman popularized Gutta-percha in 1867. Silver points were introduced in endodontics in 1930’s. Later, they fell to disuse because of their corrosion potential.
- 6. OBJECTIVES OF OBTURATION: Substitution of an inert filling in the space previously occupied by the pulp tissue. To eliminate all avenues of leakage from the oral cavity or the periradicular tissues into the root canal system (i.e. to attain a three dimensional fluid impervious seal apically, laterally and coronally within the confines of the root canal system).
- 7. To sealwithin the system any irritants that cannot be fully removed during canal cleaning and shaping procedures. To adequately seal iatrogenic causes such as perforations, ledges and zipped apices.
- 8. To attaina radiographic appearance of a dense three dimensional filling which extends as close as possible to the cemento dentinal junction without gross over extension or under filling in the presence of a patent canal. Radiographically:
- 9. Obturated rootcanal should reflect a shape that is approximately the same shape as the root morphology. Shape of the obturated canal should reflect a continuously tapering funnel preparation without excess removal of tooth structure at any level of the canal system.
- 10. Importance: To achieve a3-D seal of root canal system, but it is dependent on the quality of the canal cleaning and shaping and skill of the clinician.
- 11. OBTURATING MATERIALS: CLASSIFICATION OFROOT CANAL FILLING MATERIALS: (by Grossman) Plastics Solids Cements Pastes
- 12. Requirements for anideal root canal filling material: Requirements for an ideal root canal filling material: GROSSMAN 1940: GROSSMAN 1940: Easily introduced Easily introduced ♦ Seal laterally as well as apically Seal laterally as well as apically ♦ Not shrink after being inserted Not shrink after being inserted ♦ Impervious to moisture Impervious to moisture ♦ Bacteriostatic or at least not encourage bacterial growth Bacteriostatic or at least not encourage bacterial growth ♦ Radiopaque Radiopaque ♦ Not stain tooth Not stain tooth ♦ Not irritate periradicular tissues Not irritate periradicular tissues ♦ Sterile or sterilizable Sterile or sterilizable ♦ Easily removed Easily removed
- 13. SOLID - COREMATERIALS : METAL CORE MATERIALS: SILVER CONES: Silver point Technique: These have been used to fill root canals since 1930. Pure silver molded into a conical shape. They are round in cross section.
- 14. STAINLESS STEEL FILES: Originallysuggested by Sampeck in 1961. Used to fill fine, tortuous canals. Heavily calcified dilacerated narrow canals. Used instead of silver cones.
- 15. OTHER METAL COREMATERIALS: Gold (by Grove) Iridioplatinum Tantalum Titanium (by Messing) Amalgam
- 16. SEMI SOLID-CORE MATERIALS: PLASTICCORE MATERIALS: GUTTA PERCHA: The word ‘Gutta Percha’ is an English derived word from the Malay origin “Getah Pertja” meaning ‘strings of sticky plant juices’. • Getah – sap • Pertja – strips of cloth
- 17. SOURCE: Trees indigenousto the Malay archipelago Scientifically called ‘PALAQUIUM GUTTA BAIL’ Belongs to the SAPODILLA FAMILY
- 18. NATURAL GUTTA PERCHA: isthe Alpha phase crystalline form which is- • More linear in structure • More stable • This is subjected to a boiling process and then cooled. • The rate at which it is cooled determines the phase formed. • When cooled at a slower rate of 0.5 C the low molecular weight alpha phase is formed. • When cooled at room temperature the higher molecular weight beta phase is formed.
- 19. COMPOSITION OF COMMERCIALLY AVAILABLEGUTTA- PERCHA: COMPOSITION COMPOSITION PERCENTAGE PERCENTAGE VARIATION VARIATION FUNCTION FUNCTION Gutta- percha Gutta- percha 19-22% 19-22% Matrix Matrix Zinc oxide Zinc oxide 59-79% 59-79% Filler Filler Heavy metal Heavy metal sulfates sulfates 1-17% 1-17% Radiopacifier Radiopacifier Waxes / Resins Waxes / Resins 1-4% 1-4% Plasticizer Plasticizer
- 20. PROPERTIES: • Softens ata temperature above 64C. • Easily dissolved in chloroform and halothane. • Heat or solvent plasticized gutta percha, results in shrinkage of 1% -2%.
- 21. Sterilization of guttapercha cones: 5.25% or 5% NaOCl for 1 min. Disinfected by- 1% NaOCl – 1min 0.5% NaOCl – 5min After disinfection, gutta percha cones must be rinsed in ethyl alcohol to remove crystallized NaOCl before obturation.
- 22. Core points: Sizingbased on similar size and taper as standardized endodontic files. Used as master cones.
- 25. ADVANTAGES OF GUTTAPERCHA: COMPACTIBILITY Adapts to the root canal walls BIOLOGICALLY INERT least reactive minimal toxicity minimal tissue irritability least allergenic well tolerated by periradicular tissues DIMENSIONAL STABILITY BECOMES PLASTIC WHEN WARMED HAS KNOWN SOLVENTS Chloroform Xylol DOES NOT DISCOLOUR THE TOOTH IT IS RADIOPAQUE
- 26. DISADVANTAGES OF GUTTAPERCHA Undergoes shrinkage when plasticized. Does not possess adhesive qualities. Lack of rigidity. Undergoes vertical distortion during compaction. Needs a definite apical constriction / stop.
- 27. ENDODONTIC SEALERS REQUIREMENTS FORAN IDEAL ROOT CANAL SEALER GROSSMAN’S REQUIREMENTS (1958) • Tacky when mixed – to provide good adhesion between it and the canal when set • Make a hermetic seal • Radiopaque – so that it can be visualized in the radiograph
- 28. ADDITIONAL REQUIREMENTS • Notprovoke an immune response in periradicular tissue • Neither mutagenic nor carcinogenic Functions of sealers • Serves as a filler for canal irregularities and minor discrepancies between the root canal wall and core filling material • To obturate the lateral canals • Acts as lubricant • Enhances the possible attainment of an impervious seal • Can assist in microbial control of root canal walls or in tubules • For radiopacity
- 29. CLASSIFICATION BASED ON COMPOSITION ZINCOXIDE CONTAINING NON-ZINC OXIDE CONTAINING EUGENOL CONTAINING NON- EUGENOL CONTAINING Rickert’s sealer Kerr’s Pulp Canal Sealer Procosol Tubliseal Wach’s paste (Sealex Extra) Nogenol FORMALDEHYDE BASED N2 / RC2B Endomethasone Riebler’s paste IODOFORM BASED MCS (Medicated Canal Sealer) Dentalis
- 30. CALCIUM HYDROXIDE BASED CRCS (Calcibiotic Root Canal Sealer) Sealapex Apexit RESINBASED epoxy AH – 26, AH- Plus diketone Diaket EndoRez methacrylate Fibrefill Epiphany root canal sealant CALCIUM PHOSPHATE BASED Bioseal Apatite Root Canal Sealer I & II G – 5, G – 6 CAPSEAL I & II
- 31. BASED ON ABSORBABILITY: Absorbable- Kerr Sealer (Rickert) Grossman's Sealer Roth Root Canal Cement Tubliseal , Tubliseal EWT Sealapex Nonabsorbable - Diaket (polyvinyl resin) AH-26 (epoxy type resin) Ketac Endo
- 32. GUTTA PERCHA BASEDSEALERS CHLOROPERCHA [chloroform + gutta percha] Not adhesive Increased shrinkage Decreased radiopacity Chloroform – potential carcinogen EUCAPERCHA eucalyptol gutta percha CALLAHAN- JOHNSTON TECHNIQUE [DIFFUSION TECHNIQUE] Chloroform + rosin gutta percha KLOROPERKA N- Ø chloroform + resin + zinc oxide gutta percha
- 33. GUTTA PERCHA OBTURATION TECHNIQUES 1.Cold lateral compaction 2. Warm compaction (warm gutta-percha) (a) Vertical (b) Lateral 3. Continuous 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
- 34. COLD LATERAL COMPACTION RalphSommer provided the essentials of this technique 1946 Is the technique most commonly taught in and used by practitioners and has long been the standard against which other methods of canal obturation have been judged. This technique encompasses first placing a sealer lining in the canal, followed by a measured primary point, that in turn is compacted laterally by a plugger-like tapering spreader used with vertical pressure, to make room for additional accessory points An apical stop must be created to resist apically directed condensation
- 35. Spreader Size Determination. fitthe spreader to reach to within 1.0 to 2.0 mm of the true working length and to match the taper of the preparation. Therefore, a spreader of the same apical instrument size or one size larger is chosen so that it reaches to within 1.0 to 2.0 mm but will not penetrate the apical orifice.
- 36. Advantages Simplicity & ease Speed Disadvantage Doesnot achieve a dense homogenous mass Filling of lateral and accessory canals not achieved Cannot adapt to canal wall irregularities Chances of stress development and fracture 1.5kg – 5kg
- 38. If gutta-percha gun(Obtura II) is used for backfill, the needle is inserted to the apical segment and then backed out, leaving deposit. Plasticized gutta-percha is compacted to complete obturation to canal orifice. - Final compaction of backpack done with largest plugger. - Gutta-percha and sealer are removed to below free gingival level, crown is thoroughly cleansed, and final restoration is placed in the coronal cavity.
- 39. CANAL WARMED GUTTAPERCHA TECHNIQUES 1) WARM VERTICAL COMPACTION USING TRADITIONAL HEAT CARRIER SCHILDER’S BOSTON TECHNIQUE ►Three dimensional technique Herbert Schilder, 1967 Technique of warm gutta-percha/vertical compaction: - Master gutta-percha cone fits tightly to radiographic apex. Marked at incisal edge to establish length reference. - Master cone cut back 0.5 to 1.0 mm at tip and retried in canal. Trimmed incisal reference remains same.
- 41. CHEMICALLY PLASTICIZED GUTTAPERCHA TECHNIQUE The principal solvent used in this technique is chloroform. It is preferred because it is more volatile than other solvents, and no solvent adhering to the cone is desired during condensation. Other solvents such as eucalyptol, halothane, xylene, methylchloroform and rectified white turpentine have been evaluated as substitutes for chloroform.
- 42. II. Warm COMPACTIONMethod II. Warm COMPACTION Method (Warm Gutta-Percha) (Warm Gutta-Percha) A. Warm Vertical Compaction A. Warm Vertical Compaction Principle Principle The warm vertical condensation or “warm The warm vertical condensation or “warm guttapercha” guttapercha” technique of filling root canals was introduced technique of filling root canals was introduced by by Schilder Schilder with the objective of filling the with the objective of filling the main root canal as well as lateral and main root canal as well as lateral and accessory accessory
- 43. Using heatedpluggers, one applies pressure Using heated pluggers, one applies pressure in a vertical direction to the heat-softened in a vertical direction to the heat-softened guttapercha guttapercha and thereby causes it to flow and to fill the and thereby causes it to flow and to fill the entire lumen of the canal entire lumen of the canal
- 44. Warm verticalcompaction technique: Warm vertical compaction technique: Master cone adaptation in the prepared root Master cone adaptation in the prepared root canal. canal. Severing of the coronal portion of the master Severing of the coronal portion of the master cone with a heated instrument. cone with a heated instrument. Compaction of the master cone. Compaction of the master cone. Sequential segments removed with the heat Sequential segments removed with the heat carrier followed by compaction. (f)–(h) Once carrier followed by compaction. (f)–(h) Once the apical third is reached, the canal is the apical third is reached, the canal is backfilled with heated segments of gutta-percha backfilled with heated segments of gutta-percha followed by compaction with suitable pluggers. followed by compaction with suitable pluggers.
- 46. B. Warm LateralCompaction B. Warm Lateral Compaction This technique provides the advantages inherent to thermoplastic This technique provides the advantages inherent to thermoplastic techniques as well as length control during obturation techniques as well as length control during obturation The technique involves The technique involves placement of the master cone and lateral compaction using heat placement of the master cone and lateral compaction using heat carriers such as carriers such as Endotec II tips Endotec II tips(Medidenta) and (Medidenta) and EndoTwinn tips EndoTwinn tips (Hu-Friedy). (Hu-Friedy). The device is placed beside the master coneand activated The device is placed beside the master coneand activated followed by placement of an followed by placement of an unheated spreader in the space previously occupied unheated spreader in the space previously occupied by the heat carrier. Accessory cones are then by the heat carrier. Accessory cones are then placed and the process repeated until the canal. placed and the process repeated until the canal.
- 47. unheated spreader inthe space previously occupied by the heat carrier. Accessory cones are then placed and the process repeated until the canal is filled.
- 48. Continuous wave compaction Continuouswave compaction technique technique
- 49. V. Carrier-Based V. Carrier-Based Gutta-Percha Gutta-Percha Techniques Techniques Thermafil Thermoplasticized Thermafil Thermoplasticized
- 50. CONCLUSION: The quality ofobturation has a great role to play in the success of endodontics.Percolation of periradicular exudate into the incompletely filled canal can be attributed to the major cause for root canal failure. It has been recognised for decades that the ideal end result in root canal therapy would be closure of apical and lateral foramina with reparative cementum. This permits re-establishment of a complete attachment apparatus and precludes future failure caused by pulpo-periodontal fluid exchange and invasion of bacteria.