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1 Root canal filling Root canal filling.

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Prezentace na téma: "1 Root canal filling Root canal filling."— Transkript prezentace:

1 1 Root canal filling Root canal filling

2 2 Root canal filling Root canal filling Good coronal, Middle Apical seal Quality guidelines for endodontic treatment, European Society of of Endodontology (ESE), 1994

3 3 Root canal fillings Root canal fillings

4 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

5 5 Classification of root canal fillings  Solid  Semisolid  Pastes

6 6 Guttapercha Dried juice of the Taban tree (Isonandra percha) (gutta) 1,4 - polyisoprene Crystallin structure (60%) Brittle

7 7 Guttapercha Beta phase Beta phase Alpha phase 42 – 49 °C Alpha phase 42 – 49 °C - plastic - Gamma phase 56 – 62° (amorphous) Cooling process very slowly (less than 0,5°C) – alpha phase very slowly (less than 0,5°C) – alpha phase normal cooling– beta phase normal cooling– beta phase

8 8 Sealers Chemically curing plastic materiáls Good adhesion to root canal walls as well as solid cones X- ray contrast Biocompatibility

9 9 Sealers Zinc Oxide-Eugenol ChloroperchaCalciumhydroxideResinsGlasionomerSilicone

10 10 Sealers Importance Filling of the spaces between the solid cones Seal of the root canal filling Seal of the root canal filling

11 11 Zinc - Oxid Eugenol Powder: Powder: Zinc oxide Liquid:Eugenol Acidic resins Good adhesivity, antimikrobial effect, cytotoxic. resorbable)

12 12 Zink Oxid Eugenol sealers Pulp Canal Sealer (Kerr, USA)) Pulp Canal Sealer (Kerr, USA)) Tubuli- Seal (Kerr, USA) Caryosan (Spofa Dental, ČR)

13 13 Chloropercha Powder Powder Canadian balsam ResinsGuttapercha Zinc oxide Liquid:ChloroformResins

14 14 Chloropercha Vlastnosti: Vlastnosti: Good adhesivity ShrinkageToxicity

15 15 Calciumhydroxide sealers Base ( powder) Calcium hydroxide Zinc oxide Other components and vehicula

16 16 Kalciumhydroxidové sealery Catalystr (paste) Zinc stearat Titanium dioxide Baryum sulphate or Eugenol,. Eukalypt others

17 17 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

18 18 Resins  Rezorcin formaldehyd  Epoxide  Polyketone  Metacrylate

19 19 Rezorcin – formaldehyd resins Toxicity N2, Endomethason, Riebler´s paste, Foredent

20 20 Epoxide resin  Base (powder, paste) Bismuth oxid Titanium dioxide Hexametylentetramine(Silver)  Catalyst (liquide, paste) Bisphenoldiglycidylether

21 21 Epoxid resin (advantages)  Long working time  Hydrophilic (good penetration)  Good adhesion to the root canal walls  Volume stability  No dissolution  Antibacterial

22 22 Epoxidové pryskyřice (disadvantages)  Difficult removal  Staining  Initiatiory roxicity No suitable for the single cone technique ! No suitable for the single cone technique !

23 23 Polyketone  Base Zinc oxide Bismuth phosphate Hexametylentetramine  Liquid Bisphenolglycidylether and other components

24 24 Polyketon resins Advantages Good adhesion No contraction No dissolution Disadvantages High stickness Not removable Products: Diaket, Diaket A (3M ESPE)

25 25 Methacrylate resins 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

26 26 Glasionomer sealers Glasionomer sealers  Base (powder) Aluminium silicate glass Aluminium silicate glass  Liquid Polyacrylic acid, polymaleic acid, tartaric acid

27 27 Glasionomer sealers (Advantages and disadvantages) Glasionomer sealers (Advantages and disadvantages) Advantages: Curing under wett conditions, chemical bonding to hard dental tissues, no staining Disadvantages Short working time, difficult removal, porousProducts Ketac Endo (3M ESPE), Endion (VOCO)

28 28 Silicon based sealers Polyvinylsiloxane (ev. in mixture with powdered guttaperchaBiocompatibilityHydrofillic Further investigation desirable.

29 29 Root canal filling Root canal filling A cone inside the sealer – core material A cone inside the sealer – core materialGuttaperchaResilon Silver cones Custom cones

30 30 Root canal filling 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

31 31 Root canal filling Root canal filling Guttapercha 20% gutta-percha 65% zink oxide 10% radioopacifiers 5% plasticizers

32 32 Root canal filling 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.

33 33 Root canal fillings - forms Root canal fillings - forms  Points (Cones)  Materials for injection  Plastic materials

34 34 Instruments Instruments Lentulo Lentulo Compactors Compactors Compactors - carriers Compactors - carriers Others Others

35 35 Lentulo  delivers pastes  1,5 – 2 mm ahead  at most for Ca (OH) 2

36 36 Spreader Compactors Pointed Vertical introduction Lateral condensation technique

37 37 Plugger Not pointed Vertical introduction Vertical condensatuion - compaction Compactors

38 38 Filling techniques Cold ColdWarm

39 39 Single cone technique Single cone technique Easy Easy Fast Fast Good control of WL Good control of WL Standard round preparation – risk of leakage Standard round preparation – risk of leakage Wesselink, P.: Root filling techniques, Textbook of Endodontology; p , Blackwell Munksgaard 2003, Oxford

40 40 Shrinkage, difficult removal Paste only

41 41

42 42 Standard cold technique Standard cold technique Wesselink, P.: Root filling techniques, Textbook of Endodontology; p , Blackwell Munksgaard 2003, Oxford Lateral condensation Lateral compaction

43 43 Warm lateral condensation Warm lateral condensation

44 44

45 45

46 46

47 47 Vertical condensation

48 48

49 49 Injection Injection Rychlá technika Rychlá technika Možná extruze sealeru Možná extruze sealeru Teplo Teplo

50 50 Perfektní hermetický uzávěr i u kanálků s nepravidelným tvarem

51 51 Fáze plnění 2. BackfillBeeFillem hermeticky uzavřeme a zaplníme zbývající část kanálku kulatého i oválného a uzavřeme postranní ramifikace ve vrchních částech kanálku.

52 52 Root canal filling Methods Root canal filling Methods

53 53 Filling Always combination Plastic material – sealer Plastic material – sealer Guttapercha Guttapercha

54 54 Paste only No good seal, today only temporary filling using calcium hydroxide

55 55 Cold techniques Cold techniques Single cone technique Single cone technique Lateral condensation Lateral condensation Guttapercha cone (cones) and sealer

56 56 Single cone Lateral condensation

57 57 Compactor for lateral condensation Spreader

58 58

59 59 gutaperča sealer Vertical compaction (condensation)

60 60 guttapercha sealer Injection

61 61 guttapercha sealer Vertical compaction

62 62 Compactor - plugger Warm techniques – using heated guttapercha

63 63 Paste carrier -Lentulo  Delivers the plastic material forward  1,5 – 2 mm before the front  Most often for Ca (OH) 2

64 64 Kořenové cpátko - spreader Kompaktory Hladký povrch, špička Zasunutí do kořenového kanálku vertikálně Laterální kondenzace gutaperčových čepů

65 65 Kořenové cpátko - plugger Hladký povrch, rovné čelo Zasunutí do kořenového kanálku vertikálně Vertikální kondenzace kondenzace gutaperči Kompaktory

66 66 Technika jednoho čepu Jednoduchá Jednoduchá Rychlá Rychlá Dobrá kontrola délky Dobrá kontrola délky Standardní,okrouhlá preparace, riziko netěsnosti u oválných kanálků Standardní,okrouhlá preparace, riziko netěsnosti u oválných kanálků Wesselink, P.: Root filling techniques, Textbook of Endodontology; p , Blackwell Munksgaard 2003, Oxford

67 67 Technika jednoho čepu Jednoduchá Jednoduchá Rychlá Rychlá Dobrá kontrola délky Dobrá kontrola délky Standardní,okrouhlá preparace, riziko netěsnosti u oválných kanálků Standardní,okrouhlá preparace, riziko netěsnosti u oválných kanálků Wesselink, P.: Root filling techniques, Textbook of Endodontology; p , Blackwell Munksgaard 2003, Oxford

68 68 Dobrá kontrola pracovní délky Dobrá kontrola pracovní délky Masa gutaperči není kompaktní Masa gutaperči není kompaktní Časově náročnější Časově náročnější Možné riziko fraktury kořene Možné riziko fraktury kořene Wesselink, P.: Root filling techniques, Textbook of Endodontology; p , Blackwell Munksgaard 2003, Oxford Laterální kondenzace

69 69 Teplá laterální kondenzace Horší kontrola pracovní délky Horší kontrola pracovní délky Časová náročnost Časová náročnost Teplo Teplo

70 70 Vertikální kondenzace Obtížnější kontrola pracovní délky Obtížnější kontrola pracovní délky Možná extruze sealeru Možná extruze sealeru Teplo Teplo

71 71

72 72 Injekční aplikace rozehřáté gutaperči Injekční aplikace rozehřáté gutaperči Rychlá technika Rychlá technika Možná extruze sealeru Možná extruze sealeru Teplo Teplo

73 73 Root canal filling Methods Root canal filling Methods

74 74 Filling Plastic material – sealer Plastic material – sealer Guttapercha Guttapercha

75 75 Paste only

76 76

77 77 Cold techniques Cold techniques Single cone technique Single cone technique Lateral condensation Lateral condensation

78 78 Single cone technique Wesselink, P.: Root filling techniques, Textbook of Endodontology; p , Blackwell Munksgaard 2003, Oxford

79 79 Wesselink, P.: Root filling techniques, Textbook of Endodontology; p , Blackwell Munksgaard 2003, Oxford Lateral condensation Lateral condensation

80 80

81 81 Compactor Sperader

82 82 Warm techniques Vertical condensation Vertical condensation Injection Injection Thermafil Thermafil Thermomechanical condensation – Mc Spadden Thermomechanical condensation – Mc Spadden

83 83

84 84 guttapercha sealer Vertical compaction (condensation)

85 85 guttapercha sealer Injection

86 86 guttapercha sealer Vertical compaction after injection

87 87 Warm lateral condensation Warm lateral condensation

88 88 Vertical condensation Vertical condensation

89 89

90 90 Injection of heated guttapercha Injection of heated guttapercha

91 91 Thermomechanical condensation Guttapercha is heated using a special compactor Wesselink, P.: Root filling techniques, Textbook of Endodontology; p , Blackwell Munksgaard 2003, Oxford

92 92 Thermafil Guttapercha on plastic carrier is heated ina special oven and put into the root canal. Guttapercha on plastic carrier is heated ina special oven and put into the root canal.

93 93 Compactor for vertical condensation - plugger

94 94 Power driven filling - lentulo  Delivers the paste forward  1,5 – 2 mm before the front  Mostly for Ca (OH) 2

95 95 Spreader Compactors Pointed instrument Lateral condensation

96 96 Plugger Straight front Vertical action - condensation Compactors


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