The How's and Why's of Root Filling Techniques Flashcards
Why are root canal’s filled?
The outcome of endodontic treatment depends on how well the canals have been cleaned and disinfected
How do RCFs help prevent future infection?
They fill the canal space making conditions less favourable for bacterial colonisation. This is due to less space and less nutrients present
What do radiographs tell us about RCFs?
Clinically we base our assessment on the radiographic appearance
However, limited:
Radiographs do not indicate the degree of filling of the root canal SYSTEM
What is the aim of a root canal filling?
Apical seal to keep tissue fluids out of the canal (To prevent nutrient supply)
Apical seal blocks bacteria and/or endotoxins from reaching the periapical region apically.
Coronal seal keeps bacteria out of the canal (Stops reinfection)
Coronal seal keeps nutrients out of the canal (so bacteria cannot survive)
What does apical dye penetration tell us about the importance of technical quality of RCFs?
They are not important for creating a seal at the apex of the root of the tooth.
The quality of the coronal restoration is more important than the quality of the RCF for apical periodontal healing.
If quality of RCF isn’t so important for the outcome why do we put so much effort on them?
They fill most of the space
Create an unfavourable environment for bacteria to survive in
Slow down the process of further infection and apical periodontitis
Give an indication of the overall technical standard of the endodontic treatment.
Do RCFs slow down the onset of apical periodontitis?
Yes, however the seal of the coronal restoration is the most critical factor for the prevention of apical periodontitis.
When should the canal be filled?
When all of the following have occurred:
Canal preparation and cleaning completed
There are no symptoms associated with the tooth
The canals can be dried
Mobility, percussion and palpation are normal
The draining sinus has healed (if presented pre-oply)
Swelling has resolved (if present pre-oply)
Evidence of healing (if large lesion pre-op’ly)
Which technique/materials can be used for RCFs?
Single cone
Lateral compaction/condensation
Vertical compaction/condensation
Solvent techniques
Thermomechanical compaction
Thermoplastic injection techniques
Carrier-based techniques
Hybrid techniques
How is RCF technique chosen?
Must suit the canal prep technique
Must suit the instruments/materials available
Materials and techniques must suit each other
Must have alternatives for unusual cases
This is not critical for success so can be a personal choice.
What are the features of the ideal root filling material?
Must be easily introduced into the canal
Seal laterally and apically
Not shrink
Be impervious to moisture
Be bacteriostatic
Be sterile or able to be disinfected
Be radiopaque
Not stain tooth structure
Not irritate periapical tissues
Be easily removed
What material is used universally for RCFs?
Gutta Percha
What do GP points contain?
Gutta percha: 19 - 22%
ZnO: 60 - 75%
Waxes and resins: 1 - 5%
Metal sulphates: 1 - 17%
What is used for lateral compaction of GP?
Spreaders (D11T and D11)
Pluggers for vertical condensation
Hand instruments
Finger instruments
Which cements are used for RCFs?
Resin based: ZnO - eugenol, Ca(OH)2, Glass Ionomer based, Medicated cements
