Obturation Flashcards
3 principle functions of the root canal filing
- Entombment of most surviving bacteria
- Stopping influx of periapical tissue-derived fluid from reaching surviving bacteria in the root canal system
- Acting as a barrier thereby preventing re-infection of the root canal
Sundqvist & Figdor 1998
Grossman’s requirements an ideal root canal material
- Introduce easily in the root canal
- Should be impervious to moisture
- Should seal the canal laterally as well as apically
- Should not shrink after being inserted
- Should be bacteriostatic, or at least, should discourage growth
- Should be radiopaque
- Should not stain tooth structure
- Should not irritate periapical tissue
- Should be easily removed if necessary
- Should be sterile or easily and quickly sterilized immediately before insertion
Gutta-percha is a ……. isomer of ………
Gutta-percha is a trans isomer of polyisoprene
Friedman et al. 1975
Rubber is a ……. isomer of ………
Rubber is a cis isomer of polyisoprene
Friedman et al. 1975
GP is 60% crystalline, while rubber is amorphous
Friedman et al. 1975
No difference in healing of apical lesions between the instrumented and obturated and instrumented and non-obturated root canal systems. (in dogs)
Sabeti et al. 2006
Gutta-percha alpha heated beyond ?°C becomes …. and ….
GP alpha heated beyond 65°C becomes amorphous and melts
Routine rapid cooling of amorphous gutta-percha will recrystillaze….
beta GP, which upon heating will melt at 56°C (whereas slow cooling 0.5°C per hour will recrystallize in alpha GP)
Gutta-percha beta heated beyond ?°C becomes …. and ….
Gutta-percha beta heated beyond 56°C becomes amorphous and melts.
The obturation technique had little impact on the quality of obturation in the apical third
Ozawa et al. 2009
Basic constituents of bioceramic sealer
- Calcium Oxide (CaO)
- Silicon Dioxide (SiO2)
- Calcium Aluminate (CaOAl2O3)
Coronal seal is important ?
Yes : Ray & Trope 1995
Tronstad 2000
Homez 2002
retrieve smear layer before obturation is necessary
Ng et al. 2011
Time-dependant effects of EDTA
çalt & Seper 2002
Why AH+ has replaced AH26 ?
Because AH26 released formaldehyde
Setting time of AH+
4 hours
Which component of MTA stain the tooth ?
the radiopacifer bismuth oxide (it was replaced in new bioceramic sealers by zirconia dioxide or tantalum oxide
No difference in healing of apical periodontitis between the instrumented and obturated and instrumented and non-obturated root canal systems.
Sabeti et al. 2006 (The success of RCT ultimately depends on : - The elimination of microorganisms - Host response - Coronal seal
Prevalence of overextension in the warm GP group was significantly higher than CLC group.
No statistical difference between the 2 obturation techniques in the:
a- Log-term outcome
b- Post-op pain
c- Obturation quality
Outcome of root canal obturation by Warm Gutta-percha versus Cold Lateral Condensation: A meta-analysis
Peng et al. 2007
Outcome of root canal obturation by Warm Gutta-percha versus Cold Lateral Condensation: A meta-analysis
Peng et al. 2007
Prevalence of overextension in the warm GP group was significantly higher than LC group. No statistical difference between the 2 obturation techniques in the :
- Long-term outcome
- Post-op pain
- Obturation quality
Continuous deeper heat penetration during WVCof GP improves the 3D fill of the root canal space.
Effect of varying the depth of heat application on the adaptibility of the gutta-percha during warm vertical compaction
Smith et al. 2000
Clinical outcome of NS-RCT using single-cone technique with Endosequence Bioceramic sealer: A retrospective analysis
Chybowski et al. 2018
- Single cone technique with BC sealer has success rate of 90,9%
- Lesion size was determined to be a prognostic factor with lesion <5mm having a higher success rate.
- Although sealer extrusion was found in almost half of the cases, it did not appear to affect the outcome
Not all extruded sealers were predictably removed from periradicular tissues (Study)
Ricucci (JOE) 2016
Treatment outcome was not significantly affected by the type of extruded sealer
Ricucci (JOE) 2016
A significantly better outcome was observed for teeth with no lesion in comparison with teeth with apical periodontitis
Ricucci (JOE) 2016
– Ca(OH)2 disinfection before obturation of infected root canals results in significantly less periapical inflammation than obturation alone.
– Obturation alone significantly reduces inflammation, compared with an empty canal.
- RC filling is not a good seal and entombing method.
Histological periapical repair after obturation of infected root canals in dogs
Katebzadeh et al. 1999
- Microorganisms occured in all cases of root-filled teeth associated with periradicular lesions.
- If bacteria were entombed, they were expected to enhanced healing teeth with PA lesions.
PCR-based analysis of microorganisms associated with failed endodontic treatment
Siqueira & Roças 2004
PCR-based analysis of microorganisms associated with failed endodontic treatment
Siqueira & Roças 2004
- Microorganisms occured in all cases of root-filled teeth associated with periradicular lesions.
- If bacteria were entombed, they were expected to enhanced healing teeth with PA lesions.
Histological periapical repair after obturation of infected root canals in dogs
Katebzadeh et al. 1999
– Ca(OH)2 disinfection before obturation of infected root canals results in significantly less periapical inflammation than obturation alone.
– Obturation alone significantly reduces inflammation, compared with an empty canal.
- RC filling is not a good seal and entombing method.
Healing of apical periodontitis after endodontic treatment with and without obturation in dogs.
Sabeti et al. 2006
No difference in healing of apical periodontitis between the instrumented and obturated and instrumented and non-obturated root canal systems.
The success of RCT ultimatley depends on:
a- The elimination of microorganims
b- Host response
c- Coronal seal
No difference in healing of apical periodontitis between the instrumented and obturated and instrumented and non-obturated root canal systems.
The success of RCT ultimatley depends on:
a- The elimination of microorganims
b- Host response
c- Coronal seal
Healing of apical periodontitis after endodontic treatment with and without obturation in dogs.
Sabeti et al. 2006
An evaluation of coronal microleakage in endodontically treated teeth. Part I. Time periods
Swanson & Madison 1987
– Significant amount of coronal microleakage is evident after 3 days of exposure to artificial saliva.
– The amount of coronal microleakage that can occur in a short time should be considered a potential etiological factor for root canal failure.
– Significant amount of coronal microleakage is evident after 3 days of exposure to artificial saliva.
– The amount of coronal microleakage that can occur in a short time should be considered a potential etiological factor for root canal failure.
An evaluation of coronal microleakage in endodontically treated teeth. Part I. Time periods
Swanson & Madison 1987
An evaluation of coronal microleakage in endodontically treated teeth. Part II. Sealer types
Madison et al. 1987
- More coronal microleakage can be expected when root canals obturated with GP and AH26 sealer are exposed to saliva.
- AH26 demonstrated significantly more coronal microleakage than sealapex and Roth’s sealer.
- More coronal microleakage can be expected when root canals obturated with GP and AH26 sealer are exposed to saliva.
- AH26 demonstrated significantly more coronal microleakage than sealapex and Roth’s sealer.
An evaluation of coronal microleakage in endodontically treated teeth. Part II. Sealer types
Madison et al. 1987
Human saliva penetration of coronally unsealed obturated root canals
Khayat et al. 1993
No statistically difference was found between lateral and vertical condensation techniques.
All root canals were recontaminated in less than 30 days
No statistically difference was found between lateral and vertical condensation techniques.
Human saliva penetration of coronally unsealed obturated root canals
Khayat et al. 1993
Effect of varying the depth of heat application on the adaptibility of the gutta-percha during warm vertical compaction
Smith et al. 2000
Continuous deeper heat penetration during WVC of GP improves the 3D fill of the root canal space.
In vitro microbial leakage of endodontically treated teeth using new and standard obturation techniques.
Shipper & Trope 2004
Microbial leakage occured more quickly in lateral and vertical condensation techniques compared to SimpliFill and FibreFill techniques.
Combination of an apical plug of GP with SimpliFill and a FibreFill coronal seal was the best obturation technique used.
Microbial leakage occured more quickly in lateral and vertical condensation techniques compared to SimpliFill and FibreFill techniques.
Combination of an apical plug of GP with SimpliFill and a FibreFill coronal seal was the best obturation technique used.
In vitro microbial leakage of endodontically treated teeth using new and standard obturation techniques.
Shipper & Trope 2004
Periapical inflammation after coronal microbial inoculation of dog roots filled with GP or Resilon
Shipper et al. 2005
- The Resilon monoblock system was associated with less apical periodontitis wich may be because of its superior resistance to coronal microleakage.
- The Resilon monoblock system was associated with less apical periodontitis wich may be because of its superior resistance to coronal microleakage.
Periapical inflammation after coronal microbial inoculation of dog roots filled with GP or Resilon
Shipper et al. 2005
A comparison of three Gutta-percha obturation techniques to replicate canal irregularities.
Collins et al. 2006
The warm techniques were significantly better at replicating defects than cold lateral condensation
No significant difference between the two thermoplastic obturation techniques (WVC and WLC)
The warm techniques were significantly better at replicating defects than cold lateral condensation
No significant difference between the two thermoplastic obturation techniques (WVC and WLC)
A comparison of three Gutta-percha obturation techniques to replicate canal irregularities.
Collins et al. 2006
- Single cone technique with BC sealer has success rate of 90,9%
- Lesion size was determined to be a prognostic factor with lesion <5mm having a higher success rate.
- Although sealer extrusion was found in almost half of the cases, it did not appear to affect the outcome
Clinical outcome of NS-RCT using single-cone technique with Endosequence Bioceramic sealer: A retrospective analysis
Chybowski et al. 2018
Radiographic evaluation of extruded obturation materials
Augsburger & Peters 1990
- Healing will occur if canal are well obturated, even if some obturation material is extruded into the periradicular tissues.
- ZOE-based sealers, extruded into periradicular tissues during root canal filing, disappear from successive recall radiographs.
- There is evidence that, given enough time postoperately, all extruded sealer will be removed.
- There is evidence that GP is more resistant to removal than the ZOE-based sealer.
- Healing will occur if canal are well obturated, even if some obturation material is extruded into the periradicular tissues.
- ZOE-based sealers, extruded into perIradicular tissues during root canal filing, disappear from successive recall radiographs.
- There is evidence that, given enough time postoperately, all extruded sealer will be removed.
- There is evidence that GP is more resistant to removal than the ZOE-based sealer.
Radiographic evaluation of extruded obturation materials
Augsburger & Peters 1990
In vitro endotoxin penetration of coronally unsealed endodontically treated teeth
Trope, Chow, Nissan 1995
Endotoxin may move through obturated root canals.
20 days
Endotoxin may move through obturated root canals.
20 days
In vitro endotoxin penetration of coronally unsealed endodontically treated teeth
Trope, Chow, Nissan 1995
