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Why do we obturate?
Fidgor (2002) stated 3 functions of root canal obturation: 1- Prevent coronal leakage of bacteria. 2- Entombing remaining bacteria. 3- Prevent the influx of apical tissue-derived fluids and accumulation of stagnant fluids.
Functions of Obturation
Cohen et. al. stated that a 3D obturating material is essential to: 1- Prevents percolation and microleakage of periapical exudate. 2- Prevents reinfection. 3- Creates a favorable biologic environment for the process of tissue healing.
When to obturate?
After the completion of root canal cleaning and shaping, the root canal is ready to be filled when: 1- Tooth is asymptomatic. 2- The canal is dry. 3- There is no sinus tract. 4- There is no foul odor. 5- No swelling 6- Temporary filling is intact.
Core Materials:
Ideal Requirements of Core materials:
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. It should be easily manipulated. It should be dimensionally stable. It should seal the canal laterally and apically. It should not irritate the periapical tissues. It should be impervious to moisture. It should be unaffected by tissue fluids. It should not support bacterial growth. It should be radiopaque. I t should not discolor tooth structure. It should be sterile. It should be easily removed from the canal if necessary.
Core Materials:
1- Pastes:
Zinc oxide-eugenol cements with various additives Epoxy resins (AH-26) Acrylic, polyethylene, and polyvinyl resins polycarboxylate cements
2- Semisolid Materials:
Gutta Percha Resin based core filling Materials Combinations
3- Solid Materials:
Silver Points Titanium points
Core Materials:
Materials of choice: 1- Silver Points. 2- Gutta Percha 3- Resin based core filling materials 4- Combinations.
Silver Points
Introduced by Jasper in 1940. Rigid so, easily introduced into canals, especially in narrow curved canals, but impossible to adapt to canal irregularities. When leakage occurs and the points contact tissue fluids, they corrodes, further increasing leakage. Corrosion products are toxic which impede healing.
Gutta Percha
Derived from dried juices from trees of the family Sapotaceae. Crystalline gutta-percha may occur in - or phase. Popularized by Bowman in 1867.
Gutta Percha
The gutta percha filling material was discovered by Bomann 1867 could be one of the most accepted obturation materials for Root Canals because it fulfill previous criteria of good condensed inside the root canal either by lateral or vertical condensation techniques & either if it is cold or warm.
Gutta Percha
Supplied as standardized or non-standardized forms. Standardized forms are used as a primary cones, Non-standardized forms are used as auxiliary cones , because they have greater taper, thus being more rigid and more controllable.
Gutta Percha
In their final form, gutta-percha points consist of some 20% gutta-percha and up to 65% zinc oxide. A dye and metal salts are added for color and radiographic contrast. Some manufacturers add antimicrobials. o e.g. calcium hydroxide Chlorhexidine iodoform
Gutta Percha
Advantages of gutta percha: 1.Adapts excellently to the irregularities. 2.Can be softened and made plastic by heat or organic solvents. 3.Inert. 4.Dimensional stability. 5.Tissue tolerant. 6.will not discolor the tooth structure. 7.Radiopaque. 8.Easily removed from the canal when necessary.
Gutta Percha
Disadvantages of gutta percha: 1.lacks rigidity. 2.lacks adhesive quality. 3.It can be easily displaced by pressure.
1. Sealing off of the root canal system, 2. Entombment of remaining bacteria 3. Filling of irregularities in the prepared canal.
A sealer is what should meet hard and soft tissues; the percha is merely a piston.
Solvent-based sealers
Rosin-chloroform (Johnston-Callahan technique) Chloropercha techniques
Kloroperka
Solvent-based sealers
Pros 1. Biocompatible 2. Clinical documentation? Cons 1. Leakage 2. Shrinkage
Zinc-oxide-eugenol-based sealers
Rickerts sealer Kerr PCS (Silver) Grossmans sealer Roths, ProcoSol (bismuth, barium salts)
Zinc-oxide-eugenol-based sealers
Pros Used for a century Clinical documentation Good seal Cons Local toxicity Allergen Poor stability
Ketac-Endo
BisGMA, UDMA and hydrophilic methacrylates Epiphany. UDMA EndoREZ. (hydrophilic, doesnt need primer) Epoxy-bis-phenol resin, metheneamine, enoxolone, calcium hydroxide Acroseal