Root canal filling 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 Classification of root canal fillings  Solid  Semisolid  Pastes Guttapercha Dried juice of the Taban tree (Isonandra percha) (gutta) 1,4 - polyisoprene Crystallin structure (60%) Brittle Guttapercha  Beta phase  Alpha phase 42 – 49 °C - plastic - Gamma phase 56 – 62° (amorfní) Cooling process very slowly (less than 0,5°C) – alpha phase normal cooling– beta phase Composition of guttapercha materials in endodontic Guttapercha 19% – 22% Zinc oxide 59 - 79% Heavy metal salts 1% - 7% Wax or resin 1% - 4% Resilon (Pentron)  Thermoplastic synthetic polymer  Points or material for injection Composition: Polyester polymers Bioactive glass Radioopaque fillers (bismuthum oxichlorid a and baryum sulphate) Silver or titanium cones  No good seal  Silver cones - corrosion Sealers Chemically curing plastic materiáls Good adhesion to root canal walls as well as solid cones X- ray contrast Biocompatibility Sealers Zinc Oxide-Eugenol Chloropercha Calciumhydroxide Resins Glasionomer Silicone Sealers Importance Filling of the spaces between the solid cones Seal of the root canal filling Zinc - Oxid Eugenol Powder: Zinc oxide Liquid: Eugenol Acidic resins Good adhesivity, antimikrobial effect, cytotoxic. resorbable) Zink Oxid Eugenol sealers Pulp Canal Sealer (Kerr, USA)) Tubuli- Seal (Kerr, USA) Caryosan (Spofa Dental, ČR) Chloropercha Powder Canadian balsam Resins Guttapercha Zinc oxide Liquid: Chloroform Resins Chloroperca Properties: Good adhesivity Shrinkage Toxicity Calciumhydroxide sealers Base ( powder) Calcium hydroxide Zinc oxide Other components and vehicula Calcium hydroxide sealers Catalyst (paste) Zinc stearat Titanium dioxide Baryum sulphate or Eugenol,. Eukalypt others Calciumhydroxide 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 Resins Resorcin phormaldehyd Epoxide Polyketone Metacrylate lenka.roubalikova@tiscali.cz 22 Epoxide resin Base (powder, paste) Bismuth oxid Titanium dioxide Hexametylentetramine (Silver) Catalyst (liquide, paste) Bisphenoldiglycidylether lenka.roubalikova@tiscali.cz 23 Epoxi resins (advantages)  Long working time Hydrophilic (good penetration) Good adhesion to the root canal walls Volume stability No dissolution Antibacterial lenka.roubalikova@tiscali.cz 24 Epoxi resin (disadvantages)  Difficult removal  Staining  Initiatiory toxicity No suitable for the single cone technique ! lenka.roubalikova@tiscali.cz 25 Polyketone  Base Zinc oxide Bismuth phosphate Hexametylentetramine  Liquid Bisphenolglycidylether and other components lenka.roubalikova@tiscali.cz 26 Polyketon resins Advantages Good adhesion No contraction No dissolution Disadvantages High stickness Not removable Products: Diaket, Diaket A (3M ESPE) lenka.roubalikova@tiscali.cz 27 Methacrylate resins Endo ReZ (Ultradent) – UDMA For injection – single cone technique Epiphany (Pentron) Bis- GMA, etoxy bis- GMA, hydrophilic bifunctional methacrylates Calcium hydroxide, baryum sulphate, baryum glass silica. Sealer in combination with Resilon lenka.roubalikova@tiscali.cz 28 Glasionomer sealers Base (powder) Aluminium silicate glass Liquid Polyacrylic acid, polymaleic acid, tartaric acid lenka.roubalikova@tiscali.cz 29 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 30 Silicon based sealers Polyvinylsiloxane (ev. in mixture with powdered guttapercha Biocompatibility Hydrofillic Further investigation desirable. lenka.roubalikova@tiscali.cz 31 Root canal fillings - forms  Points (Cones) Materials for injection Plastic materials lenka.roubalikova@tiscali.cz 32 Instruments  Lentulo  Compactors  Compactors - carriers  Others lenka.roubalikova@tiscali.cz 33 Root canal filling Methods lenka.roubalikova@tiscali.cz 34 Filling Always combination  Plastic material – sealer  Guttapercha lenka.roubalikova@tiscali.cz 35 Paste only No good seal, today only temporary filling using calcium hydroxide lenka.roubalikova@tiscali.cz 36 Cold techniques  Single cone technique  Lateral condensation Guttapercha cone (cones) and sealer lenka.roubalikova@tiscali.cz 37 Single cone Lateral condensation lenka.roubalikova@tiscali.cz 38 Compactor for lateral condensation Spreader lenka.roubalikova@tiscali.cz 39 lenka.roubalikova@tiscali.cz 40 gutaperča sealer Vertical compaction (condensation) lenka.roubalikova@tiscali.cz 41 guttapercha sealer Injection lenka.roubalikova@tiscali.cz 42 guttapercha sealer Vertical compaction lenka.roubalikova@tiscali.cz 43 Compactor - plugger Warm techniques – using heated guttapercha lenka.roubalikova@tiscali.cz 44 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 45 Kořenové cpátko - spreader Compactors Hladký povrch, špička Zasunutí do kořenového kanálku vertikálně Laterální kondenzace gutaperčových čepů lenka.roubalikova@tiscali.cz 46 Kořenové cpátko - plugger Hladký povrch, rovné čelo Zasunutí do kořenového kanálku vertikálně Vertikální kondenzace kondenzace gutaperči Compactors lenka.roubalikova@tiscali.cz 47 Root canal filling Methods lenka.roubalikova@tiscali.cz 48 Filling  Plastic material – sealer  Guttapercha lenka.roubalikova@tiscali.cz 49 Paste only lenka.roubalikova@tiscali.cz 50 lenka.roubalikova@tiscali.cz 51 Cold techniques  Single cone technique  Lateral compaction (lateral condensation) lenka.roubalikova@tiscali.cz 54 lenka.roubalikova@tiscali.cz 55 Compactor Spearader lenka.roubalikova@tiscali.cz 56 Warm techniques  Vertical condensation  Injection  Thermafil  Thermomechanical condensation – Mc Spadden lenka.roubalikova@tiscali.cz 57 lenka.roubalikova@tiscali.cz 58 guttapercha sealer Vertical compaction (condensation) lenka.roubalikova@tiscali.cz 59 guttapercha sealer Injection lenka.roubalikova@tiscali.cz 60 guttapercha sealer Vertical compaction after injection lenka.roubalikova@tiscali.cz 61 Warm lateral condensation lenka.roubalikova@tiscali.cz 62 Vertical condensation lenka.roubalikova@tiscali.cz 63 lenka.roubalikova@tiscali.cz 64 Injection of heated guttapercha lenka.roubalikova@tiscali.cz 66 Thermafil  Guttapercha on plastic carrier is heated ina special oven and put into the root canal. lenka.roubalikova@tiscali.cz 67 Compactor for vertical condensation - plugger lenka.roubalikova@tiscali.cz 68 Power driven filling - lentulo Delivers the paste forward 1,5 – 2 mm before the front Mostly for Ca (OH)2 lenka.roubalikova@tiscali.cz 69 Spreader Compactors Pointed instrument Lateral condensation lenka.roubalikova@tiscali.cz 70 Plugger Straight front Vertical action - condensation Compactors