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5th ICP - Endo > Thermal GP Obturation > Flashcards

Thermal GP Obturation Flashcards

1
Q

Aim obturation?

A

A fluid tight barrier that protect the periradicular tissues from microorganisms

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2
Q

Where should obturation provide the seal?

A

Coronal orifice of canal as ACJ

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3
Q

Functions of obturation?

A

Prevent coronal leakage - micro-organisms
Prevent periapical/periodontal fluid entering canal
Entomb residual micro-organisms - prevent proliferation/ pathogenicity

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4
Q

Ideal properties root filling?

A 
Easy handle
Seal canal apical and laterally 
Conform internal anatomy
Non-irritant 
Anti-microbial 
Non-porous
Unaffected tissue fluid
Radiopaque
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5
Q

Why do root fillings need to be non-irritant?

A

Close contact w/ PA tissue

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6
Q

What is GP?

A

Gutta percha - naturally occurring rubber

Produced in variety of cone size

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7
Q

What are two phases of GP?

A

Has two crystalline forms - alpha and beta phase

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8
Q

Difference between alpha and beta phase?

A

Alpha - 42-49 degree C

Beta - below 42 degree C

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9
Q

What happens to GP above 49 degree?

A

Becomes amorphous

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10
Q

Role of Endodontics sealers?

A
  1. Seal space between obdurating core and internal root surface
  2. Seal space between core and accessory filling material
  3. Seal irregularities of complex canal anatomy
  4. Lubricate and facilitate seating filling
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11
Q

6 types of Endodontics sealers?

A 
Zinc oxide/ eugenol 
Calcium hydroxide based
Glass ionomer based
Resin-based
Calcium silicate based 
Sillicone based
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12
Q

Most commonly used sealer?

A

Zinc oxide/eugenol - Tubliseal

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13
Q

Adv of calcium hydroxide based sealer?

A

Less toxic

But less antimicrobial

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14
Q

Disadv glass ionomer based sealers?

A

Difficult to remove

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15
Q

What are different ways to obtrude?

A 
Lateral compaction
Single cone
Thermo-mechanical compaction 
Warm vertical compaction
Carrier based
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16
Q

How carry out cold lateral compaction?

A 
Master GP file - fits snug w/ tug back
Coat sealer and place WL
Place finger spreader 1mm from WL
Place accessory 1mm from WL
Continue w/ accessory 
Continue until accessory just below canal orifice
Sear cones 
Compact vertically
17
Q

What is warm lateral compaction?

A

Uses energised spreading
K file inserted into piezoelectrical ultrasonic unit
File activated and introduced into GP to soften it
Finger spreader placed followed by accessory

18
Q

Adv of warm lateral compaction > cold?

A

Thermoplastic GP may flow into accessory anatomy

19
Q

Why is single cone obturation not recommended?

A

Doesn’t provide good 3D seal

20
Q

What is thermo-mechanical compaction?

A

Heat generated from reverse H file which is driven w/ slow handpick
Master point placed w/ sealer and instrument 3-4mm from WL
GP driven apical and lateraly

21
Q

Disadv thermo-mechanical compaction?

A

Extrusion from apex

Instrument fracture

22
Q

What is warm vertical compaction otherwise known as?

A

Continuous wave compaction

23
Q

Aim of warm vertical compaction?

A

Create apical plug of GP which seal and fills apical 3-4mm canal

24
Q

How to do warm vertical compaction

A
  1. Create apical plug GP - seal apical 3-4mm

2. Backfill - using molten GP

25
Q

Step by step warm vertical compaction?

A
  1. Select GP fits apical prep and has tug back
  2. Choose plugger extend 4mm from apex
  3. Turn heat source on and plunge plugger through GP
  4. Apply pressure to pre-determined binding point
  5. Stop heat source and maintain apical pressure to prevent shrinkage
  6. Place tip injectable GP gun against apical plug and extrude 3-4mm burst
  7. Use condenser to compact GP
26
Q

Adv of warm vertical compaction?

A

Improved 3D obturation
Homogenous mass GP
Good internal resorption defect

27
Q

Disadv of warm vertical compaction?

A

Technique sensitive

Expensive

28
Q

What is carrier based obturation?

A

Carrier coated in GP

Plastic carrier surrounded heated GP - inserted into canal - carrier cut at orificce

29
Q

Adv of carrier based obturation?

A

Improved 3D obturation

Quick and easy learn

30
Q

Disadv of carrier based obturation?

A

Length control
Increased post-op pain
Carrier issue remove if re-tx/ need endo post

31
Q

What obturation technique should be used if immature apex?

A

Apical barrier

32
Q

When should apical plug be considered?

A

If apical size >0.7mm (ISO 70)

33
Q

Material of choice for apical plug?

A

MTA

34
Q

What is placed next MTA help it set?

A

Damp cotton wool pledget - then next appt MTA will have set

35
Q

How to assess obturation?

A

Judge taper, condensation and length

36
Q

Ideal assessment of obturation?

A

Want well condense filling, coronal to apical foramen, no extrusion of GP into apical tissue

5th ICP - Endo (7 decks)

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