lenka.roubalikova@tiscali.cz 1 Root canal filling lenka.roubalikova@tiscali.cz 4 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 5 Classification of root canal fillings  Solid  Semisolid  Pastes lenka.roubalikova@tiscali.cz 6 Guttapercha Dried juice of the Taban tree (Isonandra percha) (gutta) 1,4 - polyisoprene Crystallin structure (60%) Brittle lenka.roubalikova@tiscali.cz 7 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 lenka.roubalikova@tiscali.cz 8 Composition of guttapercha materials in endodontic Guttapercha 19% – 22% Zinc oxide 59 - 79% Heavy metal salts 1% - 7% Wax or resin 1% - 4% lenka.roubalikova@tiscali.cz 9 Resilon (Pentron)  Thermoplastic synthetic polymer  Points or material for injection Composition: Polyester polymers Bioactive glass Radioopaque fillers (bismuthum oxichlorid a and baryum sulphate) lenka.roubalikova@tiscali.cz 10 Silver or titanium cones  No good seal  Silver cones - corrosion lenka.roubalikova@tiscali.cz 11 Sealery Chemically curing plastic materiáls Good adhesion to root canal walls as well as solid cones X- ray contrast Biocompatibility lenka.roubalikova@tiscali.cz 12 Sealers Zinc Oxide-Eugenol Chloropercha Calciumhydroxide Resins Glasionomer Silicone lenka.roubalikova@tiscali.cz 13 Sealers Importance Filling of the spaces between the solid cones Seal of the root canal filling lenka.roubalikova@tiscali.cz 14 Zinc - Oxid Eugenol Powder: Zinc oxide Liquid: Eugenol Acidic resins Good adhesivity, antimikrobial effect, cytotoxic. resorbable) lenka.roubalikova@tiscali.cz 15 Zink Oxid Eugenol sealers Pulp Canal Sealer (Kerr, USA)) Tubuli- Seal (Kerr, USA) Caryosan (Spofa Dental, ČR) lenka.roubalikova@tiscali.cz 16 Chloropercha Powder Canadian balsam Resins Guttapercha Zinc oxide Liquid: Chloroform Resins lenka.roubalikova@tiscali.cz 17 Chloroperča Vlastnosti: Good adhesivity Shrinkage Toxicity lenka.roubalikova@tiscali.cz 18 Calcium hydroxide sealers Catalystr (paste) Zinc stearat Titanium dioxide Baryum sulphate or Eugenol,. Eukalypt others lenka.roubalikova@tiscali.cz 19 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 lenka.roubalikova@tiscali.cz 20 Resins Rezorcin formaldehyd Epoxide Polyketone Metacrylate lenka.roubalikova@tiscali.cz 21 Epoxide resin Base (powder, paste) Bismuth oxid Titanium dioxide Hexametylentetramine (Silver) Catalyst (liquide, paste) Bisphenoldiglycidylether lenka.roubalikova@tiscali.cz 22 Epoxide resins (advantages)  Long working time Hydrophilic (good penetration) Good adhesion to the root canal walls Volume stability No dissolution Antibacterial lenka.roubalikova@tiscali.cz 23 Epoxide resins (disadvantages)  Difficult removal  Staining  Initiatiory roxicity No suitable for the single cone technique ! lenka.roubalikova@tiscali.cz 24 Polyketone  Base Zinc oxide Bismuth phosphate Hexametylentetramine  Lequid Bisphenolglycidylether and other components lenka.roubalikova@tiscali.cz 25 Polyketon resins ( advantages and disadvantages) Advantages Good adhesion No contraction No dissolution Disadvantages High stickness Not removable Products: Diaket, Diaket A (3M ESPE) lenka.roubalikova@tiscali.cz 26 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 lenka.roubalikova@tiscali.cz 27 Glasionomer sealers Base (powder) Aluminium silicate glass Liquid Polyacrylic acid, polymaleic acid, tartaric acid lenka.roubalikova@tiscali.cz 28 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 29 Silicon based sealers Polyvinylsiloxane (ev. in mixture with powdered guttapercha Biocompatibility Hydrofillic Further investigation desirable. lenka.roubalikova@tiscali.cz 30 Root canal fillings - forms  Points (Cones) Materials for injection Plastic materials lenka.roubalikova@tiscali.cz 31 Instruments  Lentulo  Compactors  Compactors - carriers  Others lenka.roubalikova@tiscali.cz 32 Lentulo delivers pastes 1,5 – 2 mm ahead at most for Ca (OH)2 lenka.roubalikova@tiscali.cz 33 Spreader Compactors Pointed Vertical introduction Lateral condensation technique lenka.roubalikova@tiscali.cz 34 Plugger Not pointed Vertical insertion Vertical condensatuion - compaction Compactors Filling techniques Cold Warm lenka.roubalikova@tiscali.cz 37 Shrinkage, difficult removal Paste only lenka.roubalikova@tiscali.cz 38 lenka.roubalikova@tiscali.cz 40 Warm lateral condensation lenka.roubalikova@tiscali.cz 41 lenka.roubalikova@tiscali.cz 42 lenka.roubalikova@tiscali.cz 43 lenka.roubalikova@tiscali.cz 44 Vertical condensation  Risk of overfilling  Warm lenka.roubalikova@tiscali.cz 45 lenka.roubalikova@tiscali.cz 46 Injection of heated guttapercha  Fast  Risk of ovefilling  Warm lenka.roubalikova@tiscali.cz 47 lenka.roubalikova@tiscali.cz 48 gutapercha sealer Down pack lenka.roubalikova@tiscali.cz 49 gutaperha sealer Backfill lenka.roubalikova@tiscali.cz 50 gutapercha sealer Condensation with cold plugger lenka.roubalikova@tiscali.cz 51 lenka.roubalikova@tiscali.cz 52 lenka.roubalikova@tiscali.cz 53 lenka.roubalikova@tiscali.cz 54 lenka.roubalikova@tiscali.cz 55 lenka.roubalikova@tiscali.cz 56 BeeFill lenka.roubalikova@tiscali.cz 57 Pluggery ISO 40/.03 standard ISO 60/.06 soft ISO 50/.05 soft lenka.roubalikova@tiscali.cz 58 lenka.roubalikova@tiscali.cz 59 lenka.roubalikova@tiscali.cz 60 LR lenka.roubalikova@tiscali.cz 61 LR lenka.roubalikova@tiscali.cz 62 LR lenka.roubalikova@tiscali.cz 63 1,3 min. VIDEO UKÁZKA Široké oválné rovné kanálky lenka.roubalikova@tiscali.cz 64 VIDEO UKÁZKA Rezorbované, nebo nepravidelně opracované kanálky granulom lenka.roubalikova@tiscali.cz 65 Netěsnosti při plnění centrálním čepem, nebo při nedokonalé laterální kondenzaci. V nezaplněných místech kanálku hrozí vznik a množení bakterií a mikroorganizmů což vede k zánětům atd. lenka.roubalikova@tiscali.cz 66 Perfektní hermetický uzávěr i u kanálků s nepravidelným tvarem lenka.roubalikova@tiscali.cz 68 Gutaperča na nosiči  Rychlá technika  Riziko extruze  Možnost sesmeknutí gutaperči z nosiče  Teplo  Obtížné odstranění lenka.roubalikova@tiscali.cz 69 gutaperča nosič sealer