P3-ENDO-CHAPTER 10 PPT

Necessity of obturation

Sealing the root canal system

Entombing residual irrigants

Preventing periapical pathology

Promoting periapical healing

Ideal root canal filling are

Complete sealing

Non-resorbable

Radiopacity

Non-toxic and biocompatible

Easily retrievable

Timing of obturation depends either

Single-visit obturation

Multiple-visit obturation

Recommended for cases with vital pulps, no signs of infection, and well dried canals

Single-visit obturation

Multiple-visit obturation os indicated when

There is persistent periapical inflammation

The canal exhibits exudation or it not completely dr

A necrotic pulp with infection is present

Length of obturation is

0.5-1mm short of the radiographic apex

Extrusion beyond apex is

Overfilling

Short of the working length is

Underfilling

Overfilling may cause

Periapical irritation

Underfilling can leave

Unsealed spaces that can harbor bacteria

Preparation for obturation steps are

Removal of the smear layer

Final irrigation

Drying the canal

The layer of dentinal debris and bacteria is eliminated using

EDTA

citric acid

NaOCl

Final irrigation is combination of

EDTA and NaOCl

combination of NaOCl and EDTA ensures

Thorough decontamination and allows better adaptation of sealers

Used to eliminate residual moisture before obturation

Paper points

Instruments for obturation

Paper points

Lentulo spiral

Spreaders

Pluggers

Gutta percha

Sealers

Deliver sealer in the canal

Lentulo spiral

Lentulo spiral usage is

Clockwise

For lateral compaction

Spreaders

For vertical compaction

Plugger

Sealants can be introduced into the canal using various methods are

Coating the master cone

Using lentulo spirals

Applying with files and reamers

Utilizing ultrasonic devices

Ideal root canal sealer are

Hermetic seal

Adhesion to dentin and core material

Dimensional stability

Flowability

Types of Sealers

Zoe sealers

Calcium hydroxide sealers

Glass ionomer sealers

Resin-based sealers

Silicone-based sealers

Bioceramic sealers

Composition of zoe sealers

Zinc oxide, eugenol, and additives for setting control

Mechanism of zoe sealers

Forms a chelating reaction with dentin, creating a mechanical seal

Properties of zoe sealers

Antimicrobial due to eugenol

Long setting time can take 24 hrs

Good working time and flow

Disadvantages of zoe sealers

Can shrink over time, leading the leakage

Eugenol may cause cytotoxic effects on periapical tissues

Soluble in tissue fluids, reducing long-term stability

Still widely used but have been largely replaced by more advanced materials

Zoe sealers

Examples of sealers

Tubi-seal

Grossman sealer

Roth rcc

Composition of calcium hydroxide sealer

Calcium hydroxide, resins and fillers

Mechanism of calcium hydroxide sealers

Releases hydroxyl ions, promoting antibacterial activity and hard tissue formation

Properties of calcium hydroxide sealers

Bactericidal effect due to high pH

Stimulates apical barrier formation

Disadvantages of calcium hydroxide sealers

Soluble over time, leading to microleakage

Weak adhesion to dentin

Calcium hydroxide sealers is best suited for cases requiring

Apexification and regenrative endodontics

Calcium hydroxide sealers examples

Sealapex

Calciobiotic root canal sealer

Apexit plus

Composition of glass ionomer sealers

GIC with fluoride release

Mechanism of glass ionomer based sealers

Forms chemical bonds to dentin, improving adhesion

Properties of GI sealers

High radiopacity

Fluoride release may enhance remineralization

Disadvantages of GI sealers

Brittle and difficult to remove in retreatment

Can undergo dimensional changes over time

Used in cases requiring string adhesion but less preferred due to difficulty in retreatment

Glass ionomer based sealers

Examples of glass-ionomer based sealers

Ketac Molar

Composition of resin-based sealers

Epoxy resin and methacrylate-based formulation

Mechanism of resin-based sealers

Adhesive bonding to dentin, providing excellent sealing ability

Properties of resin-based sealers

Minimal shrinkage

High radiopacity

Long setting time 8 hrs.

Disadvantages of resin-based sealers

Requires complete canal dryness for bonding

Some formulations contain cytotoxic components

Difficult to remove in retreatment

One of the most commonly used sealers due to its superior sealing properties and low solubility

AH plus(epoxy resin)

Examples of resin-based sealers

Epiphany

AH plus

Composition of silicone based sealers

Silicone based materials with gutta percha particles

Mechanism of silicone based sealers

Expansion during setting, ensuring a tight seal

Properties of silicone based sealers

Biocompatible and tissue friendly

Dimensional stability, does not shrink

Disadvantages of silicone based sealers

Expensive compared to other sealers

Weaker adhesion to dentin

Easy to use material are

GuttaFlow

Example of silicone based sealers

Automix

GuttaFlow

Composition of bioceramic sealers

Calcium silicates, calcium phosphate, and zirconium oxide

Mechanism of bioceramic sealers

Forms hydroxyapatite upon setting, chemically bonding to dentin

Properties of bioceramic sealers

Excellent biocompatibility and bioactivity

Strong antimicrobial processes due to high pH

Hydrophilic works well in moist environment

Disadvantages of bioceramic sealers

Long setting time 12-24 hrs

Expensive compared to traditional sealers

Gold standard due to their superior sealing ability, biocompatibility, and dimensional stability

Bioceramic sealers

Examples of Bioceramic sealers

Root SP

Endosequence

Bioroot RCS

Core filling materials examples are

Gutta-percha

Resilon

Silver cones

Gold standard in root canal obturation

Gutta Percha

Gutta percha is composed of

20% gutta-percha

65% zinc oxide

10% radiopacifiers

5% plasticizers

Gutta percha is available in

Standardized and non-standardized cones

A synthetic polymer-based alternative to gutta percha

Resilon

Methods of obturation

Lateral compaction

Warm vertical compaction

Continuous wave compaction

Thermoplastic injection technique

Carrier-based gutta-percha

Thermomechanical compaction

Most commonly taught technique for obturation

Cold lateral compaction

Uses master gutta-percha cone and additional accessory cones compacted laterally using a spreader and sealer

Cold lateral compaction

Advantages of cold lateral compaction

Simple, cost-effective, and provides good control

Disadvantages of cold lateral compaction

May leave voids and does not adapt well to irregular canal anatomy

Involves softening gutta-percha using heat and compacting it vertically with a plugger

Warm vertical compaction

Advantages of warm vertical compaction

Provides better adaptation to canal walls and irregularities

Disadvantages of warm vertical compaction

More techniques sensitive and requires specialized equipment

A variation of warm vertical compaction using a heated plugger to down pack gutta percha in one continuous motion

Continuous wave compaction

Advantages of continuous wave compaction

More efficient than traditional warm vertical compaction

Disadvantages of continuous wave compaction

Requires a learning curve and specialized instruments

Uses injected thermoplasticized gutta-percha via a deliver system

Thermoplastic injection techniques

Advantages of thermoplastic injection technique

Provides a homogenous fill and excellent adaptability to canal irregularities

Disadvantages of thermoplastic injection techniques

Expensive and may lead to overfilling if not controlled properly

Uses a central plastic or cross linked gutta-percha carrier coated with flowable gutta-percha

Carrier-based gutta-percha

Carrier-based gutta-percha advantages

Quick and easy placement, good adaptation

Carrier-based gutta-percha disadvantages

Difficult to retreat if necessary

Materials for coronal orifice sealing are

Cavit and resin-modified glass ionomer cements

Temporary restorations are

Cavit, IRM, and glass ionomer

Permanent restoration are

Composite, crown

Calcium hydroxide sealer is manufactured as

Powder

Paste

Powder form is based?

Water based

Paste form based?

Oil based

White form of calcium hydroxide is

Powder

Paste form of calcium hydroxide is

Yellow