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Endodontics II > Lecture 3: Obturation > Flashcards

Lecture 3: Obturation Flashcards

1
Q

The goal of obturation is to eliminates ______ from the oral cavity INTO the root canal system or OUT OF the root canal system into the periodontal or oral tissues

A

all avenues of leakage

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2
Q

The goal of obturation is to eliminates all avenues of leakage from the oral cavity _____ the root canal system or ____ the root canal system into the ______

A

INTO; OUT OF; periodontal & oral tissues

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3
Q

The goal of obturation is to seal _____ the RC system any irritants that cannot be fully remove during canal cleaning & shaping and ____ their _____ out to the peri-radicular tissues or leakage of saliva or other contaminates into the pulp system:

A

within; precent; leakage

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4
Q

RCT success depend upon thoroughness of _______ & _______ of the canal system including _____.

A

removable of irritants; quality of seal; coronal restoration

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5
Q

Primary functions of a root canal filling: (3)

A
  1. stop coronal leakage
  2. entomb surviving microorganisms
  3. prevent accumulation of stagnant fluid
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6
Q

The following qualities of gutta percha make it an ideal obturation material:

  1. can be softened by ____ & ___
  2. if heated sufficiently, will ______
  3. following softening ______
  4. GP by itself ______
  5. must consider ____
A
  1. heat & solvents
  2. will change phases
  3. shrinks
  4. does not seal
  5. sealers
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7
Q

GP can exist in different isometric forms including: (3)

A
  1. alpha phase
  2. beta phase
  3. amorphous melt
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8
Q

The “alpha phase” of gutta percha occurs at what degrees Celsius?

A

42-44

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9
Q

The “beta phase” of gutta percha occurs at what degrees Celsius?

A

below 42

CLC-GP!!!

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10
Q

The “amorphous melt” of gutta percha occurs at what degrees Celsius?

A

56-64

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11
Q

What isomeric form of GP is considered CLC-GP? What temp does this occur at?

A

Beta phase (below 42 degrees)

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12
Q

The requirements for an ideal root filling cement (obturation sealer)

  1. it should be _____ into the canal
  2. It should seal the canal ___ as well as ____
  3. It should not ____ after insertion
  4. It should be impervious to _____
  5. It should be _____ or at least not encourage ____
  6. It should be ____ (on x-ray)
  7. It should NOT ___ tooth structure
  8. It should NOT irritate ____
  9. It should be ____ or quickly and easily ____ before insertion
  10. It should be easily ____ from the root canal if necessary
A
  1. introduced
  2. laterally; apically
  3. shrink
  4. moisture
  5. bacteriostatic; bacterial growth
  6. radiopaque
  7. stain
  8. periapical tissue
  9. sterile; sterilized
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13
Q

Until _____ & ______ came into play no sealer was ideal due to shrink & dissolving

A

bio-ceramic; bio-active sealers

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14
Q

Until bio-ceramic & bio-active sealers came into play, no sealer was ideal and all sealers:

A
  1. shrank upon setting
  2. dissolved in body fluids over time
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15
Q

Bio-Ceramic & Bio-Active Sealers are considered ______ which allows a more efficient technique

A

dimensionally stable

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16
Q

Bio-Ceramic Sealers characteristics: (3)

A
  1. do NOT shrink
  2. do NOT dissolve
  3. are BIO active
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17
Q

Bio-ceramics provide viability to the ______.

A

Hydraulic (“single cone”) technique

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18
Q

With a bio-ceramic sealer, gutta percha is only necessary as a source of ____ and a route to retreatment or post should either become necessary

A

hydraulic sealer compression/flow

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19
Q

Standard of care: RC Obturation-

  1. GP is positioned ____ of the canal exit
  2. ____ with gutta percha and sealer with ____
  3. Radiographic appearance of a ____
  4. _____ into the peri-apical tissues (GP & Sealer)
  5. ____ beyond apical constriction
  6. No ____ in the presence of a _____
A

1) 1mm short
2) totally filled; NO voids
3) dense filling
4) Avoidance of gross overextension
5) Minimal sealer
6) under-filings; patent canal

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20
Q

When are we ready to obturate?

A
  1. asymptomatic
  2. free of all signs of infection/inflammation
  3. tooth is cleaned & shaped to facilitate obturation
  4. tooth is ISOLATIED
  5. comfortable & master cone fitter + XR
  6. RC is dry
  7. DST is healed
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21
Q

T/F: If the patient is still in pain or the original symptoms have not abated, obturation of the RC system will NOT resolve the patients symptoms

A

True

22
Q

In what cases will obturation of the RC system NOT resolve the patients symptoms? (2)

A
  1. if patient is still in pain
  2. if original symptoms have not ceased
23
Q

List 3 acceptable obturation techniques:

A
  1. cold lateral compaction of gutta percha
  2. hydraulic obturation technique
  3. warm vertical compaction
24
Q

______ is the secret to CLC-GP obturation success (Fill must be dense and free of voids and have a ___ sealer layer to be effective)

A

Compaction; thin

25
Q

CLC-GP:

A

Cold lateral compaction of Gutta percha

26
Q

Acceptable obturation techniques at UMKC:

A
  1. Cold lateral compaction of gutta percha
  2. Hydraulic obturation technique
  3. Warm vertical compaction
27
Q

What GP cone is used with cold lateral compaction?

A

0.25 GP cone (RED)

Quiz said 0.2???

28
Q

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:

A

finger spreaders

29
Q

Finger spreaders are used to compact the MC gutta percha in the canal to create:

A

space for more gutta percha accessory cones

30
Q

List the steps of lateral compaction:

A
  1. the master cone is fitted
  2. a finger spreader or plugger is inserted, ideally to 6-2mm of the prepared length
  3. the spreader is rotated and removed, and an accessory cone is placed in the space created
  4. the process is repeated
31
Q

In lateral compaction, after the master cone is fitted, a finger spreader or plugger is inserted ideally:

A

6-2mm of the prepared length

32
Q

What two components does hydraulic obturation use?

A
  1. BC sealer
  2. .04 GP cones
33
Q

What size of cone is used with hydraulic obturation?

A

.04 GP cone

34
Q

List the steps of hydraulic technique obturation:

A
  1. select a .04 GP cone & fit to WL
  2. Radiograph
  3. Dry canal following ETDA & NaOCl
35
Q

T/F: The canal should be completely dry when the GP master cone is inserted

A

False- insert into wet canal

36
Q

What is a VERY important step when inserting the gutta percha cone?

A

Mark exactly your point of reference

37
Q

How should you evaluate the fit of the MC?

A

radiograph

38
Q

On a radiograph, how can you determine if the master cone is too small?

A

Cone will distort (crinkle) near apex

39
Q

Describe how a properly fitted cone will appear on a radiograph:

A

Properly fitted cone has an intimate fit at WL with NO SPACES and no crinkling

40
Q

T/F: You should NEVER go beyond WL with ANY shaping instruments

A

True

41
Q

For an open apex, you should use _____ instead of “single cone”

A

CLC-GP

42
Q

T/F: Premolars and molar require crowns in ALL cases to prevent VRF

A

True

43
Q

T/F: Anterior teeth with minimal loss of tooth structure require a crown

A

False- may only need a composite restoration to restore RCT access

44
Q

Take home messages:

A
  1. Use GP with a bioceramic sealer
  2. Obturate when the canal is dry and the patient has remained asymptomatic
  3. Lateral compaction needs blue finger spreaders (COMPACTION)
  4. Hydraulic obturation technique uses a .04 GP cone and BC sealer
  5. Sear GP below the CEJ, clean the pulp chamber and seal the canal with GI
45
Q

What is gutta percha?

A

Trans-polyisoprene (an isomer of latex)

46
Q

What size of GP cone is used in cold lateral compaction?

A

.02 taper GP (sizes #20 & #50_

47
Q

What phases of GP do we use?

A

Beta phase (below 42 degrees Celsius) CLC-GP

48
Q

List the composition of GP: (4)

A
  1. Gutta percha
  2. zinc oxide (59-76%)
  3. waxes/resins/coloring agents
  4. metal sulfates
49
Q

Silver points are considered:

A

BENEATH the standard of care

50
Q

Paraformaldehyde-contain pastes are considered:

A

BENEATH the standard of care

51
Q

GP requiires:

A

Sealer (dimensionally stable)

52
Q
A

Endodontics II (10 decks)

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