Under filled root canal

1. Under filled root canal
ENDO-surgery seminar

3. Nouri Esmaeil
Nouri Amin
Esmaeili Morteza
Razon Arlhie
Presented by:

4. GOALS of obturation
• TO FILL THE ENTIRE CANAL SYSTEM AND
ITS COMPLEX ANATOMIC PATHWAYS
COMPLETELY WITH NONIRRITATING
HERMATIC SEALINGAGENTS.

5. OBJECTIVES OF CANAL OBTURATION
• Prevents percolation and microleakage of
periradicular exudate into the root canal
space.
• ) ) Prevents reinfection through good
sealing of the apical foramina.
• ) ) Creates a favorable biologic
environment for the process of tissue
healing to take place.

6. Ideal root canal filling material requirments :
. ) ) Easily introduced
•) ) Seals laterally and apically
•) ) No shrinkage
•) ) Impervious to moisture
•) ) Bacteriostatic
•) ) Does not stain tooth

7. • ) ) Non irritating to periapical tissues
• ) ) Easily removed
• ) ) Sterilizable
• ) ) Radiopaque

9. STEPS OF ROOT CANAL OBTURATION
• Rubber dam application
• Verify completion of the canal preparation.
• Check your working length, irrigate & DRY the canal.
• Fit the master cone (TUG- -BACK). BACK).
• Take radiograph. Take radiograph.
• Introduce the sealer cement.
• Condense the MC and accessory guttapercha.
• Take intermediate radiograph.
• Add more G.P points and remove access.
• Temporize the access and take final radiograph.

11. Master Cone
• (1) fit tightly laterally in the apical third of the canal
(have good " canal),
• (2) fit to the full length of the canal (i.e., to the dentin-
cementum junction or about 1 mm from the cementum
junction or about 1 mm from the radiographic apex),
• (3) be impossible to force farther beyond the apical
foramen.

12. LATERAL CONDENSATION
• Involves the compaction of the primary master cone and sealer
against the apical foramen
• Condensing additional accessory gutta percha cones alongside the
the master cone fills the remainder of the canal

14. Finishing
• GP to level with the CEJ
• Using cool end of plugger to vertically condense
gutta percha at orifice
• Clean pulp chamber with cotton pellets soaked in
alcohol
• Place temporary or final restoration
• Preferable to take radiograph before removing
rubber dam

15. Radiographic evaluation of obturation
• Radiolucencies: Are there voids, indicating incomplete
obturation?,
• Density: Is there uniform density from coronal to apical?
• Length: Does material extend to WL?
• Shape: Does fill reflect shape of the canal, tapered from
coronal to apical?

16. Underfill
• An incomplete obturation of the root canal space with resultant voids
• Inadequate taper in preparation
• Improper spreader/cone placement
• Cannot be corrected by increased force

18. • An ideal root canal filling three-dimensionally fills the entire root
canal system as close to the cemento-dentinal junction as
possible
• •Teeth filled more than 2mm short of apex has poor prognosis
underfillings with necrotic pulps

19. Causes
• o Dentin chips
• o Ledged canal
• o Curved canal
• o Master cone too large
• o Improper 3D shaping of canal in apical to middle third

20. Dentin chip

21. Ledged canal

22. Curved canal

23. Too large master cone

24. Improper shaping of canal

25. • Inadequate taper in preparation

26. Non-Surgical Retreatment
• Gain access to canal system and reach apical
foramen via removal/bypass of obturation
materials from canal
• - Patient usually has high outcome
expectations - Requires greater clinical skill
than original NSRCT treatment
• - Canal Obstructions – posts, separated
instruments

27. Non-Surgical Retreatment
. GP removal
. Quality of condensation
Shape of root canal
Length of obturation material – short fill, overextension, etc
Gates Gliddens, ProFiles, GPX
Removes GP t
Provides reservoir for solvent
Heat and hedstrom removal technique

28. Non-Surgical Retreatment
• Solvents.
• Chloroform
• Methylchloroform, Eucalyptol, Halothane, Xylene, Rectified white
turpentine

29. Thank you for your
listening