lenka.roubalikova@tiscali.cz 1 P1010030 lenka.roubalikova@tiscali.cz 2 Root canal filling n P1010030 lenka.roubalikova@tiscali.cz 3 bednarskorozhojen Kopie bednarvychozi bednarpoplrez Kopie bednarsehoji Kopie bednarzhojen1 lenka.roubalikova@tiscali.cz 4 rosicky zuzkapoplneni wilhelm lenka.roubalikova@tiscali.cz 5 fialova1 fialovaplneni smutny vecht kachyn lenka.roubalikova@tiscali.cz 6 chalabalova chalabalova1 lenka.roubalikova@tiscali.cz 7 tomandlovavych tomandlova po para tomandlovapo6 tomandlovapoendo lenka.roubalikova@tiscali.cz 8 sedlakova rytychova pickova lenka.roubalikova@tiscali.cz 9 okacvych1 n Bez názvu 1 kopie capovova1 lenka.roubalikova@tiscali.cz 10 lentule Lentulo spread Spreader lenka.roubalikova@tiscali.cz 11 plug Plugger - compactor lenka.roubalikova@tiscali.cz 12 Root canal filling nGuttapercha n nSealer lenka.roubalikova@tiscali.cz 13 Root canal filling lenka.roubalikova@tiscali.cz 14 Root canal filling n nGood coronal, nMiddle nApical seal. 1 Auswahl-2 2 Core-Concept Auswahl-3 3 Auswahl-3 Auswahl-3 Quality guidelines for endodontic treatment, European Society of of Endodontology (ESE), 1994 lenka.roubalikova@tiscali.cz 15 Root canal fillings lenka.roubalikova@tiscali.cz 16 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 12. 12. 12. 12. lenka.roubalikova@tiscali.cz 17 Classification of root canal fillings Ø Solid Ø ØSemisolid Ø ØPastes lenka.roubalikova@tiscali.cz 18 Guttapercha n nDried juice of the Taban tree (Isonandra percha) n(gutta) n n1,4 - polyisoprene n nCrystallin structure (60%) n nBrittle n n lenka.roubalikova@tiscali.cz 19 Guttapercha nBeta phase n nAlpha phase 42 – 49 °C -plastic -Gamma phase 56 – 62° (amorfní) nCooling process n very slowly (less than 0,5°C) – alpha phase n normal cooling– beta phase lenka.roubalikova@tiscali.cz 20 Composition of guttapercha materials in endodontic nGuttapercha 19% – 22% n nZinc oxide 59 - 79% n nHeavy metal salts 1% - 7% n nWax or resin 1% - 4% n lenka.roubalikova@tiscali.cz 21 Resilon (Pentron) Ø Thermoplastic synthetic polymer Ø Ø Points or material for injection n nComposition: nPolyester polymers nBioactive glass nRadioopaque fillers (bismuthum oxichlorid a and nbaryum sulphate) n n n lenka.roubalikova@tiscali.cz 22 Silver or titanium cones Ø Ø ØNo good seal Ø ØSilver cones - corrosion lenka.roubalikova@tiscali.cz 23 Sealery nChemically curing plastic materiáls n n nGood adhesion to root canal walls as well as solid cones nX- ray contrast nBiocompatibility n n lenka.roubalikova@tiscali.cz 24 Sealers n nZinc Oxide-Eugenol nChloropercha nCalciumhydroxide nResins nGlasionomer nSilicone lenka.roubalikova@tiscali.cz 25 Sealers nImportance n n nFilling of the spaces between the solid cones n n Seal of the root canal filling n n n lenka.roubalikova@tiscali.cz 26 Zinc - Oxid Eugenol n Powder: nZinc oxide n nLiquid: nEugenol nAcidic resins nGood adhesivity, antimikrobial effect, cytotoxic. resorbable) lenka.roubalikova@tiscali.cz 27 Zink Oxid Eugenol sealers n Pulp Canal Sealer (Kerr, USA)) n nTubuli- Seal (Kerr, USA) n nCaryosan (Spofa Dental, ČR) lenka.roubalikova@tiscali.cz 28 Chloropercha n Powder nCanadian balsam nResins nGuttapercha nZinc oxide n nLiquid: nChloroform nResins lenka.roubalikova@tiscali.cz 29 Chloroperča n Vlastnosti: n nGood adhesivity nShrinkage nToxicity n lenka.roubalikova@tiscali.cz 30 Calciumhydroxide sealers nBase ( powder) nCalcium hydroxide nZinc oxide nOther components and vehicula lenka.roubalikova@tiscali.cz 31 Kalciumhydroxidové sealery nCatalystr (paste) nZinc stearat nTitanium dioxide nBaryum sulphate nor nEugenol,. Eukalypt n nothers lenka.roubalikova@tiscali.cz 32 Kalciumhydroxide sealers ØIncrease of the healig potential of periapical tissues Ø ØAntibacterial effect Ø ØEasy manipulation nBut! nResorbable if not homogeneus nNot suitable for the single cone technique Ø lenka.roubalikova@tiscali.cz 33 Resins ØRezorcin formaldehyd n ØEpoxide Ø ØPolyketone n ØMetacrylate lenka.roubalikova@tiscali.cz 34 Rezorcin – formaldehyd resins nToxicity n nN2, Endomethason, Riebler´s paste, Foredent lenka.roubalikova@tiscali.cz 35 Epoxide resin ØBase (powder, paste) nBismuth oxid nTitanium dioxide nHexametylentetramine n(Silver) ØCatalyst (liquide, paste) nBisphenoldiglycidylether n n lenka.roubalikova@tiscali.cz 36 Epoxid resin (advantages) Ø Long working time ØHydrophilic (good penetration) ØGood adhesion to the root canal walls ØVolume stability ØNo dissolution ØAntibacterial Ø lenka.roubalikova@tiscali.cz 37 Epoxidové pryskyřice (disadvantages) Ø Difficult removal Ø Ø Staining n Ø Initiatiory roxicity n n No suitable for the single cone technique ! n lenka.roubalikova@tiscali.cz 38 Polyketone Ø Base nZinc oxide nBismuth phosphate nHexametylentetramine n Ø Liquid nBisphenolglycidylether and other components n lenka.roubalikova@tiscali.cz 39 Polyketon resins nAdvantages nGood adhesion nNo contraction nNo dissolution n nDisadvantages nHigh stickness nNot removable nProducts: Diaket, Diaket A (3M ESPE) n lenka.roubalikova@tiscali.cz 40 Methacrylate resins nEndo ReZ (Ultradent) – UDMA nFor injection – single cone technique nEpiphany (Pentron) nBis- GMA, etoxy bif- GMA, hydrophilic bifunctional nmethacrylates nCalcium hydroxide, baryum sulphate, baryum glass nsilica. nSealer in combination with Resilon lenka.roubalikova@tiscali.cz 41 Glasionomer sealers ØBase (powder) n Aluminium silicate glass n ØLiquid nPolyacrylic acid, polymaleic acid, tartaric acid n lenka.roubalikova@tiscali.cz 42 Glasionomer sealers (Advantages and disadvantages) nAdvantages: nCuring under wett conditions, chemical bonding to hard ndental tissues, no staining n nDisadvantages nShort working time, difficult removal, nporous nProducts nKetac Endo (3M ESPE), Endion (VOCO) n lenka.roubalikova@tiscali.cz 43 Silicon based sealers nPolyvinylsiloxane (ev. in mixture with powdered nguttapercha n nBiocompatibility nHydrofillic n nFurther investigation desirable. n n lenka.roubalikova@tiscali.cz 44 Root canal filling nA cone inside the sealer – core material nGuttapercha nResilon nSilver cones nCustom cones n n n lenka.roubalikova@tiscali.cz 45 Root canal filling nGuttapercha nTrans isomer of polyisoprene n2 crystalline forms (alpha, beta) nBeta – room temperature nAlpha after heating nVarious process of cooling nExtremly slow cooling: Aplha phase recrystalize. n65°. nLess shrinkage, more dimensionally stable n lenka.roubalikova@tiscali.cz 46 Root canal filling nGuttapercha n20% gutta-percha n65% zink oxide n10% radioopacifiers n5% plasticizers n lenka.roubalikova@tiscali.cz 47 Root canal filling nGuttapercha nCones: conventional and standardized sizes n nConventional: dimension of the tip and body n nStandardized cones are designed to match the ntaper of the instrument. n lenka.roubalikova@tiscali.cz 48 Root canal fillings - forms Ø Ø Ø Points (Cones) ØMaterials for injection ØPlastic materials lenka.roubalikova@tiscali.cz 49 Instruments n Lentulo n nCompactors n n Compactors - carriers n n Others lenka.roubalikova@tiscali.cz 50 lentule Lentulo Ø delivers pastes Ø Ø1,5 – 2 mm ahead Ø Ø at most for Ca (OH)2 Ø lenka.roubalikova@tiscali.cz 51 spread Spreader Compactors Pointed Vertical introduction Lateral condensation technique lenka.roubalikova@tiscali.cz 52 plug Plugger Not pointed Vertical introduction Vertical condensatuion - compaction Compactors pluggery Filling techniques Cold Warm lenka.roubalikova@tiscali.cz 54 Single cone technique n Easy n Fast n Good control of WL n Standard round preparation – risk of leakage Wesselink, P.: Root filling techniques, Textbook of Endodontology; p. 286-299, Blackwell Munksgaard 2003, Oxford P1010011 lenka.roubalikova@tiscali.cz 55 Shrinkage, difficult removal Paste only lenka.roubalikova@tiscali.cz 56 08_Apexcal_Lentulopr 09_Guttaeinprobepr lenka.roubalikova@tiscali.cz 57 n nStandard cold technique n Wesselink, P.: Root filling techniques, Textbook of Endodontology; p. 286-299, Blackwell Munksgaard 2003, Oxford Lateral condensation Lateral compaction lenka.roubalikova@tiscali.cz 58 14_Kavum_gereinigtpr 13_Lat_Kondensationpr lenka.roubalikova@tiscali.cz 59 Warm lateral condensation n n n lenka.roubalikova@tiscali.cz 60 n laterální kondenzace lenka.roubalikova@tiscali.cz 61 lenka.roubalikova@tiscali.cz 62 Vertical condensation n lenka.roubalikova@tiscali.cz 63 n vertikalni kondenzace pluggery lenka.roubalikova@tiscali.cz 64 Injection nRychlá technika nMožná extruze sealeru n Teplo n lenka.roubalikova@tiscali.cz 65 výřez zubu studie poslední twinn Perfektní hermetický uzávěr i u kanálků s nepravidelným tvarem lenka.roubalikova@tiscali.cz 66 Bez názvu 1 kopie výřez zubu studie poslední twinn Fáze plnění 2. Backfill BeeFillem hermeticky uzavřeme a zaplníme zbývající část kanálku kulatého i oválného a uzavřeme postranní ramifikace ve vrchních částech kanálku.