Root canal filling lenka.roubalikova@tiscali.cz 1 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 lenka.roubalikova@tiscali.cz 4 Classification of root canal fillings > Solid > Semisolid > Pastes lenka.roubalikova@tiscali.cz 5 Guttapercha Dried juice of the Taban tree (Isonandra percha) (gutta) 1,4- polyisoprene Crystallin structure (60%) Brittle lenka.roubalikova@tiscali.cz 6 Guttapercha ■ 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 lenka.roubalikova@tiscali.cz Sealers Chemically curing olastic materials Good adhesion to root canal walls as well as solid cones X- ray contrast ISio compatibility lenka.roubalikova@tiscali.cz 8 Sealers Zinc Oxide-Eugenol Chloropercha C alciumhy droxide Resins Glasionomer Silicone lenka.roubalikova@tiscali.cz Sealers Importance Filling of the spaces between the solid cones Seal of the root canalfilling lenka.roubalikova@tiscali.cz Zinc - Oxid Eugenol Powder: Zinc oxide Liquid: Eugenol Acidic resins 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 12 Chloropercha Powder Canadian balsam Resins Guttapercha Zinc oxide Liquid: Chloroform Resins lenka.roubalikova@tiscali.cz 13 Chloropercha Vlastnosti: Good adhesivity Shrinkage Toxicity lenka.roubalikova@tiscali.cz 14 Calciumhydfoxide sealers Base (powder) Calcium hydroxide Zinc oxide Other components and vehicula lenka.roubalikova@tiscali.cz 15 Kalciumhydroxidove sealery Catalystr (paste) Zinc stearat 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 18 Rezorcin — formaldehyd resins Toxicity N2, Endomethason, Riebler's paste, Foredent lenka.roubalikova@tiscali.cz 19 Epoxide resin ^Base (powder, paste) Bismuth oxid Titanium dioxide Hexametylentetramine (Silver) ^ Catalyst (liquide, paste) Bisphenoldiglycidylether lenka.roubalikova@tiscali.cz 20 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 21 Epoxidové pryskyřice ^ Difficult removal ^ Staining ^ Initiatiory roxicity 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 24 Methacrylate resins Endo ReZ (Ultradent) - UDMA For injection — single cone technique Epiphany (Pentron) Bis- GM A, etoxy bif- GM A, hydrophilic bifunctional methacrylate s Calcium hydroxide, baryum sulphate, baryum glass silica. Sealer in combination with Resilon lenka.roubalikova@tiscali.cz 25 Glasionomer sealers ^Base (powder) Aluminium silicate glass > Liquid Polyacrylic 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 Hydrofillic Further investigation desirable. lenka.roubalikova@tiscali.cz Root canal filling ■ A cone inside the sealer — core material Guttapercha 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% radioopacifiers 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 32 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) lenka.roubalikova@tiscali.cz 35 Compactors Spreader Pointed Vertical introduction Lateral c mdensation technique lenka.roubalikova@tiscali.cz 36 Compactors Plugger Not pointed Vertical introduction Vertical condensatuion - compaction lenka.roubalikova@tiscali.cz 37 Filling techniques Cold Warm lenka.roubalikova@tiscali.cz 38 Paste only / I Shrinkage, difficult | / I removal lenka.roubalikova@tiscali.cz 40 Warm lateral condensation lenka.roubalikova@tiscali.cz 43 Vertical condensation lenka.roubalikova@tiscali.cz 47 lenka.roubalikova@tiscali.cz 48 Injection ■ Rychla technika ■ Mozna extruze sealeru ■ Teplo lenka.roubalikova@tiscali.cz 49 s nepravidelným tvarem lenka.roubalikova@tiscali.cz Fáze plnění 2. Backfill BeeFillem hermeticky uzavřeme a zaplníme zbývající část kanálku kulatého i oválného a uzavřeme postranní ramifikace ve vrchních částech k Root canal filling Methods lenka.roubalikova@tiscali.cz 52 Filling Always combination ■ Plastic material — sealer ■ Guttapercha lenka.roubalikova@tiscali.cz 53 Cold techniques ■ Single cone technique ■ Lateral condensation Guttapercha cone (cones) and sealer lenka.roubalikova@tiscali.cz 55 Single cone Lateral condensation Compactor for lateral condensation Spreader Vertical compaction (condensation) gutaperca sealer lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz 60 Vertical compaction Warm techniques - using heated guttapercha Compactor - plugger lenka.roubalikova@tiscali.cz 62 Paste carrier -Lentulo ^Delivers the plastic material forward >1,5 - 2 mm before the front >Most often for Ca (OH) lenka.roubalikova@tiscali.cz 63 Kompaktory Kořenové cpátko - spreader Hladký povrch, špička Zasunutí do kořenového kanálku vertikálně Later ální kondenzace gutaperčových čepů lenka.roubalikova@tiscali.cz 64 Kompaktory Kořenové cpátko - plugger Hladký povrch, rovné čelo Zasunutí do kořenového kanálku vertikálně Vertikální kondenzace kondenzace gutaperči lenka.roubalikova@tiscali.cz 65 Teplá laterální kondenzace ■ Horší kontrola pracovní délky v ■ Časová náročnost ■ Teplo lenka.roubalikova@tiscali.cz 69 Vertikální kondenzace Obtížnější kontrola pracovní délky Možná extruze sealeru Teplo lenka.roubalikova@tiscali.cz 1 j 1 i lenka.roubalikova@tiscali.cz 71 Injekční aplikace rozehřáté gutaperči ■ Rychlá technika ■ Možná exttruze sealeru ■ Teplo lenka.roubalikova@tiscali.cz 72 Root canal filling Methods lenka.roubalikova@tiscali.cz 73 Filling ■ Plastic material — sealer Guttapercha lenka.roubalikova@tiscali.cz 74 Cold techniques ■ Single cone technique ■ Lateral condensation lenka.roubalikova@tiscali.cz 77 Compactor Sperader Warm techniques ■ Vertical condensation ■ Injection ■ Thermafil ■ Thermomechanical condensation — Mc Spadden lenka.roubalikova@tiscali.cz 82 Vertical compaction (condensation) guttapercha sealer lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz 85 Vertical compaction after inj ection guttapercha sealer lenka.roubalikova@tiscali.cz Warm lateral condensation lenka.roubalikova@tiscali.cz 87 Vertical condensation lenka.roubalikova@tiscali.cz 88 lenka.roubalikova@tiscali.cz 89 Injection of heated guttapercha lenka.roubalikova@tiscali.cz 90 Thermafil ■ Guttapercha on plastic carrier is heated ina special 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 lenka.roubalikova@tiscali.cz 96