Root canal filling lenka.roubalikova@tiscali.cz 1 Ideal root canal filling (Grossman 1988) Easy mixing Sufficient working time Good seal X- ray contrast Easy removal No shrinkage Long term volume stability No bacterial growing No permeability for fluids Biocompatibility No staining lenka.roubalikova@tiscali.cz Classification of root canal fillings > Solid > Semisolid > Pastes lenka.roubalikova@tiscali.cz Guttapercha Dried juice of the Taban tree (Isonandra percha) (gutta) 1,4 - polyisoprene Crystallin structure (60% Britde lenka.roubalikova@tiscali.cz Guttapercha Beta phase Alpha phase 42 - 49 °C - plastic Gamma phase 56 - 62° Cooling- process amorphous^ very slowly (less than 0,5°C) — alpha phase normal cooling— beta phase lenka.roubalikova@tiscali.cz 7 Sealers Chemically curing olastic materials Good adhesion to root canal walls as well as solid cones lenka.roubalikova@tiscali.cz Sealers Zinc Oxide-Eugenol Chloropercha C alciumhydr oxide Glasionomer Silicone lenka.roubalikova@tiscali.cz 9 Importance Sealers Filling of the spaces between the solid cones Seal of the root canal filling lenka.roubalikova@tiscali.cz Zinc - Oxid Eugenol Good adhesivity, antimikrobial effect, cytotoxic, resorbable) lenka.roubalikova@tiscali.cz 11 Zink Oxid Eugenol sealers Pulp Canal Sealer (Kerr, USA)) Tubuli- Seal (Kerr, USA) v Caryosan (Spofa Dental, CR) lenka.roubalikova@tiscali.cz Chloropercha Powder Canadian balsam Resins Guttapercha Zinc oxide Liquid: Chloroform Resins lenka.roubalikova@tiscali.cz 13 Chloropercha Good adhesivity Shrinkage Toxicity lenka.roubalikova@tiscali.cz 14 Calciumhydroxide sealers Base (powder) Calcium hydroxide Zinc oxide Other components and vehicula lenka.roubalikova@tiscali.cz 15 Kalciumhydroxidové sealery Catalystr (paste) Zinc s tear at Titanium dioxide Baryum sulphate or Eugenol,. Eukalypt others lenka.roubalikova@tiscali.cz 16 Kalciumhydroxide sealers > Increase of the healig potential of periapical tissues > Antibacterial effect > Easy manipulation But! resorbable if not homogeneus Not suitable for the single cone technique lenka.roubalikova@tiscali.cz 17 Resins ^Rezorcin formaldehyd > Epoxide ^Polyketone ^ Metacrylate lenka.roubalikova@tiscali.cz Rezorcin — formaldehyd resins N2, Endomethason, Riebler's paste, Foredent lenka.roubalikova@tiscali.cz Epoxide resin ^Base (powder, paste) Bismuth oxid Titanium dioxide Hexametylentetramine (Silver) ^ Catalyst (liquide, paste) Bisphenoldiglycidylether lenka.roubalikova@tiscali.cz Epoxid resin (advantages) Long working time ^ Hydrophilic (good penetration) ^ Good adhesion to the root canal walls ^Volume stability ^No dissolution ^Antibacterial lenka.roubalikova@tiscali.cz Epoxidové pryskyřice ^ Difficult removal ^ Staining ^ Initiatiory toxicity No suitable for the single cone technique lenka.roubalikova@tiscali.cz Polyketone ^ Base Zinc oxide Bismuth phosphate Hexametylentetramine > Liquid Bisphenolglycidylether and other components lenka.roubalikova@tiscali.cz 23 Polyketon resins Advantages Good adhesion No contraction No dissolution Disadvantages High stickness Not removable Products: Diaket, Diaket A (3M ESPE) lenka.roubalikova@tiscali.cz Methacrylate resins Endo ReZ (Ultradent) - UDMA For injection — single cone technique Epiphany (Pentron) Bis- GMA, etoxy bif- GMA, hydrophilic bifunctional methacrylates Calcium hydroxide, baryum sulphate, baryum glass silica. Sealer in combination with Res Hon lenka.roubalikova@tiscali.cz 25 Glasionomer sealers ^Base (powder) Aluminium silicate glass > Liquid Poly acrylic acid, polymaleic acid, tartaric acid lenka.roubalikova@tiscali.cz 26 Glasionomer sealers (Advantages and disadvantages) Advantages: Curing under wett conditions, chemical bonding to hard dental tissues, no staining Disadvantages Short working time, difficult removal, porous Products Ketac Endo (3M ESPE), Endion (VOCO) lenka.roubalikova@tiscali.cz 27 Silicon based sealers Polyvinylsiloxane (ev. in mixture with powdered guttapercha Biocompatibility Hydro fillic Further investigation desirable. lenka.roubalikova@tiscali.cz Root canal filling ■ A cone inside the sealer — core material Guttapercha Resilon Silver cones Custom cones lenka.roubalikova@tiscali.cz 29 Root canal filling Guttapercha Trans isomer of polyisoprene 2 crystalline forms (alpha, beta) Beta — room temperature Alpha after heating Various process of cooling Extremly slow cooling: Aplha phase recrystalize. 65°. Less shrinkage, more dimensionally stable lenka.roubalikova@tiscali.cz 30 Root canal filling Guttapercha 20% gutta-percha 65% zink oxide 10% radio op acifiers 5% plasticizers lenka.roubalikova@tiscali.cz 31 Root canal filling Guttapercha Cones: conventional and standardized sizes Conventional: dimension of the tip and body Standardized cones are designed to match the taper of the instrument. lenka.roubalikova@tiscali.cz Root canal fillings - forms > Points (Cones) > Materials for injection ^Plastic materials lenka.roubalikova@tiscali.cz 33 Instruments Lentulo Compactors Compactors - carriers Others lenka.roubalikova@tiscali.cz Lentulo > delivers pastes > 1,5 - 2 mm ahead > at most for Ca (OH)2 lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz 36 Compactors Plugger Not pointed Vertical introduction Vertical condensatuion - compaction lenka.roubalikova@tiscali.cz Filling techniques Cold Warm lenka.roubalikova@tiscali.cz 38 Paste only Shrinkage, difficult removal lenka.roubalikova@tiscali.cz 40 Warm lateral condensation lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz 44 lenka.roubalikova@tiscali.cz 47 Injection Rychlá technika Možná exttruze sealeru Teplo li lín m lenka.roubalikova@tiscali.cz 49 Fáze plnění 2. Backfill BeeFillem hermeticky uzavřeme a zaplníme zbývající část kanálku kulatého i oválného a uzavřeme postranní ramifikace ve vrchních částech k lenka.roubalikova@tiscali.cz Root canal filling Methods lenka.roubalikova@tiscali.cz 52 Filling Always combination Plastic material — sealer Guttapercha lenka.roubalikova@tiscali.cz Paste only lenka.roubalikova@tiscali.cz 54 Cold techniques Single cone technique Lateral condensation Guttapercha cone (cones) and sealer lenka.roubalikova@tiscali.cz Compactor for lateral condensation Spreader lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz 58 Vertical compaction (condensation) gutaperca sealer lenka.roubalikova@tiscali.cz 59 lenka.roubalikova@tiscali.cz 60 Vertical compaction Warm techniques - using heated guttapercha Compactor - plugger lenka.roubalikova@tiscali.cz Paste carrier -Lentulo >Delivers the plastic material forward > 1,5 - 2 mm before the front >Most often for Ca (OH)2 lenka.roubalikova@tiscali.cz Kompaktory Kořenové cpátko - spreader Hladký povrch, špička Zasunutí do kořenového kanálku vertikálně Later ální kondenzace gutaperčových čepů lenka.roubalikova@tiscali.cz Kompaktory Kořenové cpátko - Dlugger Hladký povrch, rovné čelo Zasunutí do kořenového kanálku vertikálně Vertikální kondenzace kondenzace gutaperči lenka.roubalikova@tiscali.cz Teplá laterální kondenzace Horší kontrola pracovní délky v Časová náročnost Teplo lenka.roubalikova@tiscali.cz Vertikální kondenzace Obtížnější kontrola pracovní délky Možná extruze sealeru Teplo 1 lenka.roubalikova@tiscali.cz njekční aplikace rozehřáté gutaperči Rychlá technika MožnjLextruze sealeru Teplo m m iia lenka.roubalikova@tiscali.cz Root canal filling Methods lenka.roubalikova@tiscali.cz 73 Filling Plastic material — sealer Guttapercha lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz 75 Cold techniques Single cone technique Lateral condensation lenka.roubalikova@tiscali.cz Compactor Sperader lenka.roubalikova@tiscali.cz Warm techniques Vertical condensation Injection Thermafil Thermomechanical condensation — Mc Spadden lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz 83 Vertical compaction (condensation) guttapercha sealer lenka.roubalikova@tiscali.cz 84 lenka.roubalikova@tiscali.cz 85 Vertical compaction after injection guttapercha sealer lenka.roubalikova@tiscali.cz 86 Warm lateral condensation lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz 88 Injection of heated guttapercha lenka.roubalikova@tiscali.cz Thermafil ■ Guttapercha on plastic carrier is heated ina pecial oven and put into the root canal. - Compactor for vertical condensation - plugger lenka.roubalikova@tiscali.cz 93 Power driven filling - lentulo > Delivers the paste forward > 1,5 - 2 mm before the front > Mostly for Ca (OH)2 lenka.roubalikova@tiscali.cz 94 Compactors lenka.roubalikova@tiscali.cz 95 Compactors Plugger Straight front Vertical action - condensation lenka.roubalikova@tiscali.cz