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Endodontics II > Lecture 3: Obturation > Flashcards

Lecture 3: Obturation Flashcards

1
Q

The goal of obturation is to eliminate ____ 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 eliminate all avenues of leakage from the oral cavity _____ the RC system or ___ of the RC system and into the ___ or ___

A

INTO; OUT OF; periodontal & oral tissues

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3
Q

For obturation, seal ___ the RC system any irritants that cannot be fully removed during canal cleaning & shaping and ___ their ___ out to the peri-radicular tissues of leakage of saliva or other contaminates into pulp system.

A

within; prevent; leakage

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4
Q

RCT success depends upon thoroughness of _____ and ____ of the canal system including ____.

A

removal of irritants; quality of seal; coronal restoration

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5
Q

The 3 primary functions of a root canal filling include:

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

The qualities of Gutta Perccha:

A
  1. can be softened by heat & solvents
  2. if heated sufficiently, will change phases
  3. SHRINKS following softening
  4. by ITSELF does not seal
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7
Q

Gutta percha can be softened by:

A

heat & solvents

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8
Q

If gutta percha is heated sufficiently, it will:

A

change phases

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9
Q

Following heating & softening of gutta percha, it will:

A

shrink

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10
Q

T/F: Gutta percha by itself is an ideal sealer

A

False- by itself it does NOT seal; must consider sealers

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11
Q

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

A
  1. alpha phase
  2. beta phase
  3. amorphous melt
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12
Q

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

A

42-44

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13
Q

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

A

below 42

CLC-GP!!!

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14
Q

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

A

56-64

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15
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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16
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. easily introduced
  2. laterally & apically
  3. shrink
  4. moisture
  5. bacteriostatic; bacterial growth
  6. radiopaque
  7. stain
  8. periapical tissue
  9. sterile; sterilized
  10. removed
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17
Q

Until ____ & _____ sealers came into play, no sealer was ideal due to shrink and dissolving

A

Bio-ceramic & Bio-active

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18
Q

Until bio-ceramic & bio-active sealers came into play, no sealer was ideal and all sealers: (2)

A
  1. shrank upon setting
  2. dissolved in body fluids over time
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19
Q

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

A

dimensionally stable

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20
Q

Bio-ceramic sealers characteristics: (3)

A
  1. Do NOT shrink
  2. Do NOT dissolve
  3. Are Bio active
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21
Q

Bio-ceramic sealers provide viability to the ____.

A

Hydraulic (“single cone”) technique

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22
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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23
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-fillings; patent canal

24
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 ISOLATED
  5. comfortable & master cone fitted + XR
  6. RC is dry
  7. DST is healed
25
Q

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

A

true

26
Q

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

A
  1. if patient is still in pain
  2. if original symptoms have not ceased
27
Q

List 3 acceptable obturation techniques:

A
  1. cold lateral compaction of gutta percha
  2. hydraulic obturation technique
  3. warm vertical compaction
28
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

29
Q

CLC-GP:

A

Cold Lateral Compaction of Gutta Percha

30
Q

Acceptable obturation techniques at UMKC:

A
  1. cold lateral compaction of gutta percha
  2. hydraulic obturation technique
  3. warm vertical compaction
31
Q

What GP cone is used with cold lateral compaction?

A

0.25 GP cone (Red)

Quiz said 0.2??

32
Q

____ 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

A

Finger spreaders

33
Q

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

A

space for more gutta percha accessory cones

34
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
35
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

36
Q

What two components does hydraulic obturation use?

A
  1. BC sealer
  2. 0.4 GP cones
37
Q

What size of cone is used with hydraulic obturation?

A

0.4 GP cone

38
Q

List the steps for hydraulic technique:

A
  1. select an 0.4 GP Cone and fit to WL
  2. Radiograph (to make sure its at WL)
  3. Dry canal following EDT & NaOCl
39
Q

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

A

false- insert into wet canal

39
Q

How should you evaluate the fit of the MC?

A

radiograph

40
Q

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

A

mark exactly your point of reference

41
Q

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

A

cone will distort (crinkle) near apex

42
Q

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

A

Intimate fit at WL with no spaces and no crinkling

43
Q

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

A

true

44
Q

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

A

CLC-GP

45
Q

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

A

True

46
Q

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

A

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

47
Q

Take home messages:

A
  1. Use GP with a biocerampic sealer
  2. Obturate when the canal is dry and patient has remained asymptomatic
  3. Lateral compaction needs blue finger spreaders (COMPACTION)
  4. Hydraulic obturation technique uses a 0.4 GP cone and BC sealer
  5. Sear GP below the CEJ, clean the pulp chamber and seal the canal with GI
48
Q

What is gutta percha?

A

Trans-polyisoprene (an isomer of latex)

49
Q

What size of GP cone for CLC?

A

0.2 taper (#20 &#50)

50
Q

What phase of GP do we use?

A

Beta phase (below 42 degrees Celsius) CLC-GP

51
Q

List the composition of GP: (4)

A
  1. Gutta percha
  2. Zinc oxide (59-76%)
  3. waxes/ resins/ coloring agents
  4. metal sulfates
52
Q

Silver points are considered:

A

beneath the standard of care

53
Q

Paraformaldehyde-containing pastes are considered:

A

beneath the standard of care

54
Q

GP requires:

A

sealer (dimensionally stable)

55
Q
A

Endodontics II (9 decks)

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