L3 Obturation CLC-GP and Hydraulic Flashcards
what are the goals of obturation
eliminate all avenues of leakage from the oral cavity into the root canal system or out of the root canal system into the periodontal or oral tissues
you want to seal within the RC system:
any irritants that cannot be fully removed during canal cleaning and shaping and prevent their leakage out to the peri-radicular tissues or leakage of saliva or other contaminants into pulp system
RCT success depends upon thoroughness of:
removal of irritants and quality of seal of the canal system including coronal restoration
what are the qualities of gutta percha
- can be softened by heat and solvents
- if heated sufficiently will change phases
- following softening it shrinks
- GP by itself does not seal
- must consider sealers
what are the different isometric forms in which gutta percha exists
- alpha phase
- beta phase - CLC-GP
- amorphous melt
what temperature is GP at the beta phase
98.6 F or 37 C
what are the requirements for an ideal root filling cement
- should be easily introduced into the canal
- should seal the canal laterally and apically
- should not shrink after being inserted
- should be impervious to moisture
- should be bacteriostatic or at least not encourage bacterial growth
- should be radiopaque
- should not stain tooth structure
- should not irritate periapical tissue
- should be sterile, or quickly and easily sterilized before insertion
- should be easily removed from canal if necessary
what are the types of sealers
-Zn-O eugenol
- resin
- glass ionomer
- silicone
- calcium hydroxide
until bio-ceramic, bio-active sealers came into play:
no sealer was ideal and all sealers shrank upon setting and/or dissolved in body fluids over time
bio-ceramic sealers:
-do not shrink
- do not dissolve
- are bio active
BC sealer provides:
viability to the hydraulic technique
when is GP necessary with bio ceramic sealers
as a source of hydraulic sealer compression/flow and a route to retreatment or post
what is the standard of care for RC obturation
- GP positioned 1mm short of the canal exit
- totally filled with GP and sealer- no voids
- radiographic appearance of a dense filling
- avoidance of gross overextension into PA tissues
- minimal sealer beyond apical constriction
- no under fillings in the presence of a patent canal
when are we ready to obturate
- asymptomatic
- free of signs and symptoms of infection and inflammation
- tooth is cleaned and shaped to facilitate obturation
- tooth isolated to prevent contamination during obturation
- comfortable and master cone fitted and XR
- root canal is dry
- DST is healed
what are the acceptable obturation techniquea
- cold lateral compaction of GP
- hydraulic obt technique
- warm vertical compaction
which obturation techniqeus do we not use
carrier based techniques with thermafil
- chemoplasticized (chloropercha)
- custom cones/solvents
what is the secret to CLC-GP obturation success
compaction
what does compaction in obturation mean
fill must be dense and free of voids and have a thin sealer layer
describe cold lateral compaction
finger spreaders are used to compact the MC gutta percha in the canal to create space for more gutta percha accessory cones to accomplish a dense fill and thin film of sealer on the canal
- use .25 GP cone (red)
what are the steps to lateral compaction
- master cone is fitted
- a finger spreader or plugger is inserted ideally to 6-2mm of the prepared length
- the spreader is rotated and removed and an accessory cone is placed in the space created
- repeat
what is used with hydraulic obturation
BC sealer and .04 GP cones
what is the size of the gutta percha cone the same as
the size of MAF
how do you test the fit of the gutta percha master cone
gently insert in WET canal until resistance is felt near apex
- mark on the GP cone exactly to your reference point
what happens in the radiograph if the GP master cone is too small
- distorts/crinkles near apex
- will have spaces
