Thermal GP Obturation Flashcards
Aim obturation?
A fluid tight barrier that protect the periradicular tissues from microorganisms
Where should obturation provide the seal?
Coronal orifice of canal as ACJ
Functions of obturation?
Prevent coronal leakage - micro-organisms
Prevent periapical/periodontal fluid entering canal
Entomb residual micro-organisms - prevent proliferation/ pathogenicity
Ideal properties root filling?
Easy handle Seal canal apical and laterally Conform internal anatomy Non-irritant Anti-microbial Non-porous Unaffected tissue fluid Radiopaque
Why do root fillings need to be non-irritant?
Close contact w/ PA tissue
What is GP?
Gutta percha - naturally occurring rubber
Produced in variety of cone size
What are two phases of GP?
Has two crystalline forms - alpha and beta phase
Difference between alpha and beta phase?
Alpha - 42-49 degree C
Beta - below 42 degree C
What happens to GP above 49 degree?
Becomes amorphous
Role of Endodontics sealers?
- Seal space between obdurating core and internal root surface
- Seal space between core and accessory filling material
- Seal irregularities of complex canal anatomy
- Lubricate and facilitate seating filling
6 types of Endodontics sealers?
Zinc oxide/ eugenol Calcium hydroxide based Glass ionomer based Resin-based Calcium silicate based Sillicone based
Most commonly used sealer?
Zinc oxide/eugenol - Tubliseal
Adv of calcium hydroxide based sealer?
Less toxic
But less antimicrobial
Disadv glass ionomer based sealers?
Difficult to remove
What are different ways to obtrude?
Lateral compaction Single cone Thermo-mechanical compaction Warm vertical compaction Carrier based
How carry out cold lateral compaction?
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
What is warm lateral compaction?
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
Adv of warm lateral compaction > cold?
Thermoplastic GP may flow into accessory anatomy
Why is single cone obturation not recommended?
Doesn’t provide good 3D seal
What is thermo-mechanical compaction?
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
Disadv thermo-mechanical compaction?
Extrusion from apex
Instrument fracture
What is warm vertical compaction otherwise known as?
Continuous wave compaction
Aim of warm vertical compaction?
Create apical plug of GP which seal and fills apical 3-4mm canal
How to do warm vertical compaction
- Create apical plug GP - seal apical 3-4mm
2. Backfill - using molten GP
Step by step warm vertical compaction?
- Select GP fits apical prep and has tug back
- Choose plugger extend 4mm from apex
- Turn heat source on and plunge plugger through GP
- Apply pressure to pre-determined binding point
- Stop heat source and maintain apical pressure to prevent shrinkage
- Place tip injectable GP gun against apical plug and extrude 3-4mm burst
- Use condenser to compact GP
Adv of warm vertical compaction?
Improved 3D obturation
Homogenous mass GP
Good internal resorption defect
Disadv of warm vertical compaction?
Technique sensitive
Expensive
What is carrier based obturation?
Carrier coated in GP
Plastic carrier surrounded heated GP - inserted into canal - carrier cut at orificce
Adv of carrier based obturation?
Improved 3D obturation
Quick and easy learn
Disadv of carrier based obturation?
Length control
Increased post-op pain
Carrier issue remove if re-tx/ need endo post
What obturation technique should be used if immature apex?
Apical barrier
When should apical plug be considered?
If apical size >0.7mm (ISO 70)
Material of choice for apical plug?
MTA
What is placed next MTA help it set?
Damp cotton wool pledget - then next appt MTA will have set
How to assess obturation?
Judge taper, condensation and length
Ideal assessment of obturation?
Want well condense filling, coronal to apical foramen, no extrusion of GP into apical tissue
