Obturation CLC-GP & Hydraulic Flashcards
(46 cards)
Goals of Obturation
Eliminate ALL AVENUES OF LEAKAGE from the oral cavity INTO the
ROOT CANAL SYSTEM or OUT OF the ROOT CANAL SYSTEM INTO the
PERIODONTAL or ORAL TISSUES
Seal within the RC system any irritants that cannot be fully
removed during canal cleaning & shaping and prevent their
leakage out to the peri-radicular tissues or leakage of saliva
or other contaminates into pulp system.
RCT Success depends upon thoroughness of
removal
of irritants and quality of seal of the canal system
including coronal restoration***
Gutta Percha:
–Can be softened by
–If heated sufficiently, will change
–Following softening
–GP by itself
–Must consider
heat and solvents
phases
SHRINKS
DOES NOT SEAL
SEALERS
GP can exist in different isomeric forms: (3)
alpha phase
beta phase
amorphous melt at 56-64
Standard of Care: RC Obturation
* Avoidance of
* Minimal Sealer beyond
* No under-fillings in the presence of
a
gross overextension
into the peri-apical tissues (GP and
Sealer)
apical constriction
patent canal
- GP positioned — short of the
canal exit - Totally filled with
- Radiographic appearance of a
1 mm.
gutta percha and
sealer (no VOIDS)
dense filling
Acceptable Obturation Techniques:
(3)
- Cold Lateral Compaction of Gutta Percha
- Hydraulic Obt Technique
- Warm vertical compaction
- Carrier-based techniques (Thermafil ®) ??
(5)
- Carrier-based thermoplasticized
– Carrier-based sectional thermoplasticized
– RETX and posts a problem - Chemoplasticized (Chloropercha) NO
- Custom Cones/Solvents NO
— is the secret to CLC-GP
obturation success (Fill Must be dense and
free of voids and have a — sealer layer to
be effective.
COMPACTION
THIN
skipped
WHEN ARE WE READY TO OBTURATE?
Comfortable
& Master
Cone Fitted
+ XR
Root canal is
dry DST is healed
Tooth is Cleaned &
Shaped to facilitate
obturation
Tooth isolated to prevent
contamination during
obturation
Free of all signs &
symptoms of
infection/inflammation
If the patient is still in pain or the original symptoms have
not abated, obturation of the RC system will
NOT resolve
the patient’s symptoms
GP: Master Cone Fitment
select proper size — GP cone (size MAF)
gently insert in — canal until resistance is felt near apex (NaOCL stimulates the lubricity of sealer)
0.04
wet
Make sure the “mark” on the GP
cone goes EXACTLY to your
reference point
If it doesn’t,
DON’T TAKE A
RADIOGRAPH
Master Cone too small
.
–Cone is too small in diameter and
distorts (crinkles) near apex
Properly fitted cone has
an intimate fit
at WL with NO SPACES and no crinkling.
MC should not extend past working length
-When Master-Cone is inserted, it should STOP at
-MC must NOT be able to be pushed beyond
WL
WL, tap on it to check
If the MC is NOT TIGHT at WL or pushes longer;
GET A BIGGER MASTER CONE
skipped
Master Cone too large (short)
(3)
–Cone is too large coronally or canal taper is insufficient and will not seat at WL Black Arrow indicates level of binding (MC should bind only at WL)Red arrows indicates space along side of cone at apical end*Fit should be INTIMATE at WL
the Master Cone Radiograph is our last chance to
correct a problem easily (without re-treatment)
Until Bio-Ceramic, Bio-Active Sealers came into play,
NO SEALER was ideal and ALL SEALERS:
(2)
DISSOLVED
In body fluids over
time
SHRANK
upon setting
DIMENTIONALLY STABLE SEALER
which allows
a
more efficient technique.
BIO-CERAMIC SEALERS:
(3)
*Do NOT shrink
*Do NOT dissolve
*Are BIO active
BC SEALER
Provides viability to the Hydraulic (“single
cone”) techniquewhich will be taught in
addition to Cold Lateral Compaction.
Gutta Percha is only necessary here primarily as
a source of
hydraulic sealer compression/flow
and a route to retreatment or post should
either become necessary
cementation of master cone
the master cone is then coated with sealer and placed slowly and carefully to WL in the canal, then the master cone is removed from the root canal, coated again with sealer and gently repositioned to WL without any pumping motion
