Root canal filling
lenka.roubalikova@tiscali.cz
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Root canal filling
lenka.roubalikova@tiscali.cz
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lenka.roubalikova@tiscali.cz
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Ideal root canal filling (Grossman 1988)
1. Easy mixing
2. Sufficient working time
3. Good seal
4. X- ray contrast
5. Easy removal
6. No shrinkage
7. Long term volume stability
8. No bacterial growing
9. No permeability for fluids
10. Biocompatibility
11. No staining
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Classification of root canal fillings
> Solid >Semisolid >Pastes
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Guttapercha
Dried juice of the Taban tree (Isonandra percha) (gutta)
1,4- polyisoprene Crystallin structure (60%) Brittle
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Guttapercha
9 Beta phase
•Alpha phase 42-49 °C - plastic
• Gamma phase 56 - 62° (amorphous) Cooling process
very slowly (less than 0,5°C) - alpha phase normal cooling- beta phase
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Sealers
Chemically curing materials
Good adhesion to root canal walls as well as solid cones
X- ray contrast
Biocompatibility
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Sealers
Zinc Oxide-Eugenol Chloropercha Calciumhydroxide Resins
Glasionomer Silicone
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Sealers
Importance
Filling of the spaces between the solid cones Seal of the root canal filling
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Zinc - Oxid Eugenol
Powder: Zinc oxide
Liquid: Eugenol Acidic resins
Good adhesivity, antimikrobial effect, cytotoxic, resorbable)
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Zink Oxid Eugenol sealers
Pulp Canal Sealer (Kerr, USA)) Tubuli- Seal (Kerr, USA) Caryosan (Spofa Dental, CR)
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Chloropercha
Powder
Canadian balsam Resins
Guttapercha Zinc oxide
Liquid:
Chloroform
Resins
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Chloroperchí
Vlastnosti:
Good adhes
Shrinkage
Toxicity
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Calciumhydroxide sealers
Base ( powder) Calcium hydroxide Zinc oxide
Other components and vehicula
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Kalciumhydroxidove sealery
Catalystr (paste) Zinc stearat Titanium dioxide Baryum sulphate or
Eugenol,. Eukalypt
others
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Kalciumhydroxide sealers
>lncrease of the healig potential of periapical tissues
>Antibacterial effect
>Easy manipulation But!
Resorbable if not homogeneus
Not suitable for the single cone technique
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Resins
>Rezorcin formaldehyd >Epoxide >Polyketone >Metacrylate
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Rezorcin -formaldehyd resins
Toxicity
N2, Endomethason, Riebler's paste, Foredent
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Epoxide resin
>Base (powder, paste) Bismuth oxid Titanium dioxide Hexametylentetramine (Silver)
>Catalyst (liquide, paste) Bisphenoldiglycidylether
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Epoxid resin (advantages)
> Long working time
>Hydrophilic (good penetration)
>Good adhesion to the root canal walls
>Volume stability
>No dissolution
>Antibacterial
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Epoxidové pryskyřice (disadvantages)
> Difficult removal
> Staining
> Initiatiory roxicity
No suitable for the single cone technique !
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Polyketone
> Base Zinc oxide Bismuth phosphate Hexametylentetramine
> Liquid
Bisphenolglycidylether and other components
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Polyketon resins
Advantages Good adhesion No contraction No dissolution
Disadvantages High stickness Not removable
Products: Diaket, Diaket A (3M ESPE)
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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 Resilon
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Glasionomer sealers
>Base (powder) Aluminium silicate glass
> Liquid
Polyacrylic acid, polymaleic acid, tartaric acid
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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)
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Silicon based sealers
Polyvinylsiloxane (ev. in mixture with powdered guttapercha
Biocompatibility Hydrofillic
Further investigation desirable.
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Root canal filling
• A cone inside the sealer - core material
Guttapercha
Resilon
Silver cones
Custom cones
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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
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Root canal filling
Guttapercha 20% gutta-percha 65% zink oxide 10% radioopacifiers 5% plasticizers
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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.
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Root canal fillings - forms
> Points (Cones)
>Materials for injection
>Plastic materials
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Instruments
• Lentulo
• Compactors
• Compactors - carriers
• Others
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Lentulo
lenka.roubalikova@tiscali.cz
> delivers pastes
> 1,5 — 2 mm ahead
> at most for Ca (OH)2
Compactors
Spreader
Pointed
Vertical introduction
II
Lateral condensation (lateral compatction) technique
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Compactors
Plugger
Not pointed
Vertical introduction
Vertical condensatuion - compaction
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Root canal filling Methods
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Filling
Always combination
• Plastic material - sealer
• Guttapercha
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Root canal filling methods
Cold Warm
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Cold methods
Paste only
Shrinkage, difficult removal
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Single cone technique
Easy Fast
Good control of WL
Standard round preparation - risk of leakage
Lentulo
lenka.rou
Single cone technique
Lateral condensation Lateral compaction
• Standard cold technique
lenka.roubalikova@tiscali.cz
»vcoociu ir\, I .. I .......y icij.....i_ju^v
Blackwell Munksgaard 2003, Oxford
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Warm lateral condensation
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Vertical condensation
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Injection
• Fast
• Possible extrusion of the sealer
• Hot guttapercha - risk of damage od the periodontal membrane
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lenka.roubaliko'
Cold techniques
• Single cone technique
• Lateral condensation
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lenka.roubalikova@tiscali.cz
Wesselink, P.: Root filling techniques, Textbook of Endodontology; p. 286-299, Blackwell Munksgaard 2003, Oxford
lenka.roubalikova@tiscali.cz
Compactor Sperader
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Warm techniques
• Vertical condensation
• Injection
• Thermafil
• Thermomechanical condensation - Mc Spadden
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\7
Vertical compaction
(condensation)
lenka.roubalikova@tiscali.cz
guttapercha
sealer
\7
Vertical compaction after injection
lenka.roubalikova@tiscali.cz
guttapercha
sealer