intraorifice barrier and temporization

what is an intraorifice barrier

restorative material placed directly over canal orifices after a RCT is completed before placing a permanent restoration

types of intraorifice barrier materials

• BC liner (blue or white)

• vitrebond (RMGI)

• flowable

• permaflo purple

why place an intraorifice barrier

• when gutta percha is exposed to saliva or other contaminants, bacterial contamination can occur very quickly

• without a barrier, 60% of RCT teeth leak after 60 days, but with barrier, NONE of the teeth experience leakage

• furcation canals in molars

endo tx teeth exposed to saliva leak after ___ days and the saliva will travel down over ___% of the root in that time

3 days ; 79%

endo tx teeth showed to have total bacterial penetration of the root canal obturation in about ___ days when gutta percha was in direct contact w bacteria

24 days

molars have an occurence of accessory canal in the duration of ___%

28.4%

importance of furcation canals in relation to intraorifice barriers

• these canals can communicate w the furcation and can lead to furcal radioluciencies

• intraorifice barriers seal these since these canal are NOT filled w sealer or gutta percha

in the pre-doc clinic, we use ____ as an intraorifice barrier

permaflo purple

qualities of permaflo purple

• sealbility

• color indications

• flowability

• abillity to bond to dentin w or w/o etching

• ease of handeling

when to temporize

when a case cannot be completed same day and needs to be temporarily sealed for future access

qualities of temporizing between apts

• good seal → minimize bacterial leakage adn dislodgement

• easy to visualize and remove → no etch/bond

types of temporary material

• cavity

• IRM

• GI

properties of cavity

• easy to place and remove

• strong

• hydrophilic

• superior sealing ability

cavit needs at least ___mm to prevent leakage

3.5 mm

______ temp material should NOT be used for vital cases, ____ or ___ should be used for cital cases to avoid desiccating the pulp tissue

cavit; IRM or GI

basic workflow if finishing RCT

1. clean chamber and orifices w alcohol microbrush

2. place intraorifice barrier (etch, adhesive, flowable comp)

3. place teflon/cotton pellet/sponge for spacer

4. place temp material

5. bring pt back for build up and crown

basic workflow if NOT finishing RCT

1. place calcium hydroxide

2. place teflon/cotton pellet/sponge for spacer

3. place temp material