Obturation Flashcards
Steps to endo:
diagnose, pretreat, access, clean and shape, obturate, restore
Define obturation:
fill and seal cleaned and shaped canal w sealer and core material
Obturation tech we use at SDM:
Warm Vertical condensation
Other methods of obturation:
Lateral, Warm Lateral, continuos Wave, Carrier-based, single cone
Do sealer and/or gutta purcha klll bac?
no
TF? Obturation greatly affects the success rate of endo tx:
F. getting all bac out is most imp
Which tech(s) fill(s) the canal the bast?
warm
He invented warm vertical condensation:
Herbert
Tech’s we use and lab and clinic:
lab: traditional Shilder, clinic: continuous wave of condensation (Buchanan)
How to cut gutta percha:
to size of MAF (Master Cone)
Sealer we use:
Kerr EWT, which is a ZOE
EWT sf:
extended working time, ZOE
Fxn of sealer:
interface bw gutta-percha and canal walls, fills voids, seals canals,
TF/ Type of sealer doesn’t change success rate.
T
TF? Ensure that no sealer extrudes past the apex, this coul lead to serious issues.
F. resorbs over time, doens’t matter if we get a little out of the apex
Fxn of heat carriers:
to heat gutta-percha
Sizes of pluggers:
8-11
Fxn of plugers:
condense gutta-percha
Obturation technique:
cone fit, cone fit rg, prefit plugger, mix sealer & seat cone w sealer, add accessory cones IF necessary, downpack, downpack rg (working obturation), backfill
Cone fit should hav tug-back here:
apical 3rd of canal
What does tugback indicate?
a relative degree of adaptation, at least in2 dimensions, not necessarily 3, though
Getting tugback indicates that you may potentially have achieved this form.
resistance form
Use this to trim gutta-percha to MAF:
gutta-percha gauge
What might it mena if the gp cone will not fit properly?
MAF was not determined properly
His recommendation for gp to use:
Hygienic ADA Size Fine-Medium
TF? Gp resorbs over time.
F
What is false tugback?
Gp binding coronally due to not having straight line access to root
What to do if you are having problems fitting multiple cones:
reassess canal prep, most likely not tapered properly and/or incorrect MAF
How close to the WL must hte cone be on rg?
w/in 1mm of WL
What may happen if you are binding on canal wall?
you may crack tooth
Which pluggers are expected to o about 1/2 the WL?
the larger pluggers: 10,11
The smaller plugges are expected to go w/in how many mm of the WL?
5-7mmm size 8,9 pluggers
How to choose the correct plugger:
Shouldn’t bind walls
These should be prefit in canal:
one small plugger, 1 large plugger, 1 heat carrier (to 5-7mm of WL)
Which is the limiting instrument?
heat carrier, you won’t be ablet o downpack if this doesnt reach 5-7mm
Sealer we use:
ZOE
What are the powder and liquid portions of ZOE?
powder: zinc oxide and silver
liquid: eugenol
Mix sealer on:
glass slab
Powder to liquid ratio for sealer:
1:1
How to know if sealer is proper consistency:
should string up 1 inch
Why do you need to measure paper points before placing in canal?
otherwise they may go past foramen
What to do before placing gp with sealer:
dry canal w paper points
TF? Paper point are used to place sealer.
F
GP cut to MAF:
cone
How to apply sealer to canal walls:
use cone as brush, 2 coats, seat firmly to WL
.What is a “bulk of gp?”
addition of accessory cones IF there is a lot of space bw the cone and canal walls
To create space for accessory cones:
endo explorer used as a spreader
How to insert accessory cone:
twisting motion, won’t got o WL
2 phases of obturation;
Downpack, Backfil
Downpack;
compaction of incremental segments of heat-softened gp, to create apical plug
Purpose of downpacking:
create an apical plug, 3d seal in apical 3rd
Instrument to sear off gp at orifice:
glick #2 (endo spoon excavator)
What should happen w the placement of heat plugger in canal?
Gp should stick to heat carrier and be removed from canal
Plugger to use for condensing gp after searing gp:
larger plugger
How far to sink heat carrier into canal:
2mm, remove, condense again
Heat carrier is to plugger as:
remove is to recondense
To determine if downpack was successful:
Rg from at least 2 angles
When to switch from larger plugger to smaller:
once you reach 1/2 WL
When to take downpack rg:
small plugger reaches 5-7mm from WL and walls are clean of gp
What to assess of downpack rg:
if you reached 5-7mm and if apical 3rd is well filled
Defne backfill:
injecting and/or compaction of gp into canal after creating an apical seal
Backfill tech:
Cut gp into 2-3mm segments, warm gp in canal, grab a segment of precut gp w heat carrier, heat in flame, place in canal, condense with small plugger
Plugger size to use for Backfilling:
small, then large
When to switch from small to large plugger in backilling:
once you reach 1/2 WL
How to clean gp out of coronal area:
small cotton pellet
Why do we stop backfilling when we do?
prevent gp color from effecting tooth esthetic, create an ideal seal of canal
Backfill to here for anteriors:
Facial CEJ (or just below)
Backfill to here for posteriors:
pulpal floor, which is always at CEJ
Take RG’s in these 2 views to assess backfilling and downpacking:
clinical and proximal
