Lecture 3: Obturation

Question 1

The goal of obturation is to eliminates ______ from the oral cavity INTO the root canal system or OUT OF the root canal system into the periodontal or oral tissues

Answer 1

all avenues of leakage

Question 2

The goal of obturation is to eliminates all avenues of leakage from the oral cavity _____ the root canal system or ____ the root canal system into the ______

Answer 2

INTO; OUT OF; periodontal & oral tissues

Question 3

The goal of obturation is to seal _____ the RC system any irritants that cannot be fully remove during canal cleaning & shaping and ____ their _____ out to the peri-radicular tissues or leakage of saliva or other contaminates into the pulp system:

Answer 3

within; precent; leakage

Question 4

RCT success depend upon thoroughness of _______ & _______ of the canal system including _____.

Answer 4

removable of irritants; quality of seal; coronal restoration

Question 5

Primary functions of a root canal filling: (3)

Answer 5

1. stop coronal leakage
2. entomb surviving microorganisms
3. prevent accumulation of stagnant fluid

Question 6

The following qualities of gutta percha make it an ideal obturation material:

1. can be softened by ____ & ___
2. if heated sufficiently, will ______
3. following softening ______
4. GP by itself ______
5. must consider ____

Answer 6

1. heat & solvents
2. will change phases
3. shrinks
4. does not seal
5. sealers

Question 7

GP can exist in different isometric forms including: (3)

Answer 7

1. alpha phase
2. beta phase
3. amorphous melt

Question 8

The “alpha phase” of gutta percha occurs at what degrees Celsius?

Answer 8

42-44

Question 9

The “beta phase” of gutta percha occurs at what degrees Celsius?

Answer 9

below 42

CLC-GP!!!

Question 10

The “amorphous melt” of gutta percha occurs at what degrees Celsius?

Answer 10

56-64

Question 11

What isomeric form of GP is considered CLC-GP? What temp does this occur at?

Answer 11

Beta phase (below 42 degrees)

Question 12

The requirements for an ideal root filling cement (obturation sealer)

1. it should be _____ into the canal
2. It should seal the canal ___ as well as ____
3. It should not ____ after insertion
4. It should be impervious to _____
5. It should be _____ or at least not encourage ____
6. It should be ____ (on x-ray)
7. It should NOT ___ tooth structure
8. It should NOT irritate ____
9. It should be ____ or quickly and easily ____ before insertion
10. It should be easily ____ from the root canal if necessary

Answer 12

1. introduced
2. laterally; apically
3. shrink
4. moisture
5. bacteriostatic; bacterial growth
6. radiopaque
7. stain
8. periapical tissue
9. sterile; sterilized

Question 13

Until _____ & ______ came into play no sealer was ideal due to shrink & dissolving

Answer 13

bio-ceramic; bio-active sealers

Question 14

Until bio-ceramic & bio-active sealers came into play, no sealer was ideal and all sealers:

Answer 14

1. shrank upon setting
2. dissolved in body fluids over time

Question 15

Bio-Ceramic & Bio-Active Sealers are considered ______ which allows a more efficient technique

Answer 15

dimensionally stable

Question 16

Bio-Ceramic Sealers characteristics: (3)

Answer 16

1. do NOT shrink
2. do NOT dissolve
3. are BIO active

Question 17

Bio-ceramics provide viability to the ______.

Answer 17

Hydraulic (“single cone”) technique

Question 18

With a bio-ceramic sealer, gutta percha is only necessary as a source of ____ and a route to retreatment or post should either become necessary

Answer 18

hydraulic sealer compression/flow

Question 19

Standard of care: RC Obturation-

1. GP is positioned ____ of the canal exit
2. ____ with gutta percha and sealer with ____
3. Radiographic appearance of a ____
4. _____ into the peri-apical tissues (GP & Sealer)
5. ____ beyond apical constriction
6. No ____ in the presence of a _____

Answer 19

1) 1mm short
2) totally filled; NO voids
3) dense filling
4) Avoidance of gross overextension
5) Minimal sealer
6) under-filings; patent canal

Question 20

When are we ready to obturate?

Answer 20

1. asymptomatic
2. free of all signs of infection/inflammation
3. tooth is cleaned & shaped to facilitate obturation
4. tooth is ISOLATIED
5. comfortable & master cone fitter + XR
6. RC is dry
7. DST is healed

Question 21

T/F: If the patient is still in pain or the original symptoms have not abated, obturation of the RC system will NOT resolve the patients symptoms

Answer 21

True

Question 22

In what cases will obturation of the RC system NOT resolve the patients symptoms? (2)

Answer 22

1. if patient is still in pain
2. if original symptoms have not ceased

Question 23

List 3 acceptable obturation techniques:

Answer 23

1. cold lateral compaction of gutta percha
2. hydraulic obturation technique
3. warm vertical compaction

Question 24

______ is the secret to CLC-GP obturation success (Fill must be dense and free of voids and have a ___ sealer layer to be effective)

Answer 24

Compaction; thin

Question 25

CLC-GP:

Answer 25

Cold lateral compaction of Gutta percha

Question 26

Acceptable obturation techniques at UMKC:

Answer 26

1. Cold lateral compaction of gutta percha 2. Hydraulic obturation technique 3. Warm vertical compaction

Question 27

What GP cone is used with cold lateral compaction?

Answer 27

0.25 GP cone (RED) Quiz said 0.2???

Question 28

Used to compact the MC gutta percha in the canal to create space for more gutta percha accessory cones to accomplish a dense fill and thin film of sealer on the canal:

Answer 28

finger spreaders

Question 29

Finger spreaders are used to compact the MC gutta percha in the canal to create:

Answer 29

space for more gutta percha accessory cones

Question 30

List the steps of lateral compaction:

Answer 30

1. the master cone is fitted 2. a finger spreader or plugger is inserted, ideally to 6-2mm of the prepared length 3. the spreader is rotated and removed, and an accessory cone is placed in the space created 4. the process is repeated

Question 31

In lateral compaction, after the master cone is fitted, a finger spreader or plugger is inserted ideally:

Answer 31

6-2mm of the prepared length

Question 32

What two components does hydraulic obturation use?

Answer 32

1. BC sealer 2. .04 GP cones

Question 33

What size of cone is used with hydraulic obturation?

Answer 33

.04 GP cone

Question 34

List the steps of hydraulic technique obturation:

Answer 34

1. select a .04 GP cone & fit to WL 2. Radiograph 3. Dry canal following ETDA & NaOCl

Question 35

T/F: The canal should be completely dry when the GP master cone is inserted

Answer 35

False- insert into wet canal

Question 36

What is a VERY important step when inserting the gutta percha cone?

Answer 36

Mark exactly your point of reference

Question 37

How should you evaluate the fit of the MC?

Answer 37

radiograph

Question 38

On a radiograph, how can you determine if the master cone is too small?

Answer 38

Cone will distort (crinkle) near apex

Question 39

Describe how a properly fitted cone will appear on a radiograph:

Answer 39

Properly fitted cone has an intimate fit at WL with NO SPACES and no crinkling

Question 40

T/F: You should NEVER go beyond WL with ANY shaping instruments

Answer 40

True

Question 41

For an open apex, you should use _____ instead of "single cone"

Answer 41

CLC-GP

Question 42

T/F: Premolars and molar require crowns in ALL cases to prevent VRF

Answer 42

True

Question 43

T/F: Anterior teeth with minimal loss of tooth structure require a crown

Answer 43

False- may only need a composite restoration to restore RCT access

Question 44

Take home messages:

Answer 44

1. Use GP with a bioceramic sealer 2. Obturate when the canal is dry and the patient has remained asymptomatic 3. Lateral compaction needs blue finger spreaders (COMPACTION) 4. Hydraulic obturation technique uses a .04 GP cone and BC sealer 5. Sear GP below the CEJ, clean the pulp chamber and seal the canal with GI

Question 45

What is gutta percha?

Answer 45

Trans-polyisoprene (an isomer of latex)

Question 46

What size of GP cone is used in cold lateral compaction?

Answer 46

.02 taper GP (sizes #20 & #50_

Question 47

What phases of GP do we use?

Answer 47

Beta phase (below 42 degrees Celsius) CLC-GP

Question 48

List the composition of GP: (4)

Answer 48

1. Gutta percha 2. zinc oxide (59-76%) 3. waxes/resins/coloring agents 4. metal sulfates

Question 49

Silver points are considered:

Answer 49

BENEATH the standard of care

Question 50

Paraformaldehyde-contain pastes are considered:

Answer 50

BENEATH the standard of care

Question 51

GP requiires:

Answer 51

Sealer (dimensionally stable)