Endodontics The object of the endodontics are pulpal and periodontal diseases their diagnosis, therapy, prevention Morphology of the root canals > The root canal is not round but almost always oval (long axis mesiodistal) > The root canal does not go straight but it deflects distal > The outfall is not on the top of the root but below (distal or distooral) > The form of the outfall is funnel - shaped > The root canal system has usually more outfalls (ramifications) > The ramifications are situated mostly in apical area (first apical mm) > All outfalls are situated in cementům Basic forms of the root canal system (Weine) Apical morphology Canal shaping terminates in apical constriction ■ Small communication ■ Less risk of periodontal damage ■ Prevention of overfilling ■ Prevention of apical transport of infectious material ■ Possibility of good bacterial decontamination ■ Possibility of good condensation of the root filling Phases of the endodontic treatment ■ Access to the pulp chamber Penetration to the pulp chamber and removal of its roof > Orifices of root canals must be seen clearly > The instrument goes through to the root canal without bending > Walls of the endodontic cavity are divergent Pulpextractor Reamer K- File K file Wire triangl Symbol is a] or sq ways sc uare luare r 1 lenka.roubalikova@tiscali.cz 23 H - file Shaping technique Rotation — K - reamer K- file lenka.roubalikova@tiscali.cz Shaping technique Tiling H- file K - file Risk of peria} Risk of plug 'al infection infection Shaping technique Balanced force K- flexofile K - file 180-270° enka.roubalikova@tiscali.cz Root canal filling Guttapercha + sealer 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 Guttapercha Dried juice of the Taban tree (gutta) 1.4- üolvisoürene Crystallin structure (60%) Brittle, thermoplastic Guttapercha leta phase i Alpha phase 42 - 49 °C - plastic Gamma phase 56 - 62° (amorphous) Coolinp- nrocess very slowly (less than 0,5°C) — alpha phase normal cooling— beta phase Composition of guttapercha materials in endodontic Guttapercha 19%-220/- Zinc oxide 59 - 79% Heavy metal salts 1% - '/7o Wax or resin 1% - 4°/ Calciumhydroxide sealers Base (powder) Calcium hydroxide Zinc oxide Other components and vehicula Catalyst (paste) Zinc stearat i Itanium dioxide Haryum sulphate Euoenol,. Eukalypt Kalciumhydroxide sealers Antibacterial effect Lasy manipulation Resin based sealers Epoxide ^ Polvketone >Metacrylate Epoxide resin ^Base (powder, paste) Bismuth oxid Titanium dioxide Hexametvlentetramine (Silver) ^ Catalyst (liquide, paste) Bisphenoldiglycidylether enka.roubalikova@tiscali.cz Epoxide resins (advantages) time ^Hydrophilic (good penetration) ^ Good adhesion to the root canal walls > Volume stability >No dissolution > Antibacterial Epoxide resins (disadvantac Difficult removal Staining Polyketone > Base Zinc oxide Bismuth phosphate Hexametylentetramine > Liquid Bisphenolglycidylether and Polyketone (Advantages and disadvantages) Advantages Good adhesion No contraction No dissolution Disadvantages High stickness Not removable ts: Diaket Diaket A Í3M ESPE Methacrylate resins Endo ReZ ÍUltradentí - 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 (synthetic polymer - cones or cartridges) .roubalikova@tiscali.cz Glasionomer sealers ^Base (powder) Aluminium silicate glass > Liquid Polyacrylic acid, polymaleic acid, tartaric acid lenka.roubalikova@tiscali.cz 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 Í3M ESPEV Endion fVOCO) .roubalikova@tiscali.cz Silicon based sealers Polyvinylsiloxane (ev. in mixture with powdered guttapercha Biocompatibility Hydro fillic Further invest Silicon based sealers Polyvinylsiloxane guttapercha (ev. in mixture with powdered Biocompatibility Hydro fillic Hrf*«**. desirable. lenka.roubalikova@tiscali.cz 9 Instruments for the root canal filling Instruments ■ Lentulo ■ Compactors ■ Compactors ■ - carriers ■ Others lenka.roubalikova@tiscali.cz 11 Compactors Pointed Vertical introduction Lateral c mdensation technique enka.roubalikova@tiscali.cz Filling techniques