11. Obturation and Coronal Seal Flashcards
what are the elements to success in endodontics?
- diagnosis and treatment planning
- knowledge of anatomy and morphology
- cleaning and shaping
- obturation
- coronal seal
What are common procedural errors when preparing for opturation?
- loss of length (ledging - into dentinal wall)
- canal transportation
- perforation
- loss of coronal seal
- vertical root fracture
- all of these adversely affect the apical seal and lead to failure
what is the purpose of obturation?
- a root canal system cannot be completely cleaned and disinfected. Therefore the purpose of obturation is:
- to achieve a complete seal (apically, laterally, and coronally) which seals any bacteria remaining in the root system, preventing further infection and aids healing of any periapical disease
(- reduce coronal leakage and bacterial contamination.
- seals the apex from periapical tissue fluid.
- entombs remaining irritants in the canal)
What type of seal are we aiming for:
historically named a hermatic seal (sealed against the escape and entry of air)
but we are looking more for a fluid/bacterial tight seal.
This is a more appropriate term as root canals are evaluated for leakage of fluid
What are the guidelines for single visit root canal treatments?
- no significant symptoms
- no significant clinical signs (not TTP)
- Canal must be clean and dry (no blood, exudate, pus)
- appointment time must be a sufficient time
example for: - asymptomatic periapical periodontitis (a periapical radiolucency on the radiograph)
- condensing osteitis
- a necrotic pulp (elective RCT, irreversible pulpitis)
When would a multiple visit root canal treatment be recommended?
- presence of acute signs, symptoms or swelling
- persistent exudate in root canal
- anatomical difficulties
- technical difficulties
- patient or dentist is tired or lost patients
What are the “advantages” of multiple visit appointments?
- allows medication with an antibacterial dressing
- calcium hydroxide paste with reduce the number of bacteria remaining following cleaning and shaping
What would we use as an inter-appointment disinfection dressing?
calcium- hydroxide paste
- non-setting
- dressing for 1 week is sufficient to disinfect the canals
- canal should completely fill the canal
What factors are we looking at when considering radiographic criteria?
- length
- taper
- density - especially apical 1/3rd (lack of voids)
- adequate provisional or definitive restoration
what do we use to seal the canal
- maximum gutta percha and minimum sealer
- sealer ensure a fluid tight seal
what are the technical properties of an ideal obturating material?
- no shrinkage on setting
- insoluble in tissue fluid
- good adaptation/adhesion to dentine
- no water absorption
- no tooth discolouration
what are the biological properties of an ideal obturating material?
- no allergy
- no irritation to local tissues
- sterile
- antimicrobial
- stimulate periapical healing
what are the handling properties of an ideal obturating material?
- radioapaque
- adequate setting time
- easy to remove
What obturation technique will we be most familiair with by the end of our endodontic course?
cold lateral compaction
What makes up the composition of gutta percha?
gutta percha
zinc oxide
radiopacifiers
plasticisers
