R oot canal obturati on classification : single cone and lateral compaction

1. Root canalobturationclassification: singlecone and lateralcompaction 3rdyear 2nd semester

2. Specific Objectives • In root canal therapy the root filling has two additional objectives: • 1. To prevent nutritional elements from accessing the pulpal space along any entrance to the root canal space, including apical foramina, accessory canals and the oral access cavity. • 2. To eliminate space for further growth of microorganisms that may have survived the biomechanical preparation.

3. The necrotic pulp

4. The objectives of obturation

5. Working length estimation

6. Diagrammatical representation of the apical region

7. Properties of root canal filling materials I. • Requirements of root filling material are: • abilty to adapt to the shape of the canal • need to fill the canal's irregularities • lenght control • filling material should allow a technique that keeps the entire material within the canal space • safety • biocompatibility

8. Properties of root canal filling materials II. • insoluble • in both saliva and tissue fluid • removable • easily to remove from the canal if necessary • radiopaque • bacteriostatic

9. Outline of techniques to fill root canals with gutta-percha

10. Gutta-perchafillingtechniques I. The root canal to be filled should be assessed before choosing a technique: • Is the apical foramen wide open? • Is it long, narrow, and curved? • Has an apical perforation or zipping taken place? • Is the canal blocked apically, or does it end in a delta (multiple canal exits)? • Are lateral canals with associated lesions visible on the radiograph?

11. Gutta-perchafillingtechniques II. If there is any question regarding the operator’s ability to control obturation materials within the canal space, the canal should be obturated and compacted with cold lateral condensation. A thermoplastic obturation or controlled injectable technique may allow a more three-dimensional fill.

12. Lateral compaction of gutta-percha I. • The objective is to fill the canal with gutta-percha points by compacting them laterally against the sides of the canal walls. • Requires:selection of a master point, one size larger than the MAF ,which should seat about 0.5 mm short of the working length, if lhe poin is loose at working length , then either 1 mm should be cut from the tip and the point refitted to the canal or a larger size point selected.

13. Lateral compaction II. • Once the master point is fitted to length and demonstrates a slight resistance to withdrawal, accessory points are then inserted alongside the master point. • Instruments: long handed spreaders, finger spreaders. • Advantage: length control is good, no filling material is extruded beyond the foramen. • Disadvantages: not one compact mass of gutta-percha, time consuming technique, risk of root fracture.

14. Lateral compaction procedure I. • canal should be irrigated cleaned and dried • master point is selected and fitted, mark the working length • the master point is coated with sealer and used to pace the canal walls with sealer before setting the point at full working length

15. Lateral compaction procedure II. • leave the spreader alongside the master point, only apical finger pressure in situ for 30 seconds • result: deformed gutta-percha point • select an accessory point, dip its tip into sealer with tweezers • place the accessory point, reinsert the spreader and laterally compact both points • repeat the sequence using smaller spreaders and points until the canal is filled • Remove excess gutta-percha from the canal orifice with a heated plugger and firmly compact the remaining gutta-percha • cement base • periapical RTG

16. Singleconetechnique I. The single-cone technique consists of matching a cone to the prepared canal. The size of the cone and the shape of the preparation are closely matched. The techniquecannot be considered as one that seals canals completely. In vitro research has shown that the single-cone technique permitted significantly more dye penetration than other techniques. Advantage of the technique: it is simple Disadventages: The single-cone technique, at best, only seals theapicalportion.

17. Singleconetechnique II. Single canal (round) preparations seem to be especially adaptive to matched tapered cones. The goal of a single-cone obturation technique is to adapt a cone of gutta-percha or Resilon (Resilon Research) to the root canal preparation in such a way that the dimensions of the canal preparation and the cone in the last few millimeters of the most apical portion of the prepared canal space are same.

18. Singlegutta-perchaconewithsealerFacts: • Single-cone obturation has become increasingly popular with some clinicians since the introduction of nikkel-titanium root canal instruments. • Preparations have become better centered, and instrument errors have minimized. • As such, it has become easier to match the size and taper of the master cone with that of the last rotary instrument taken to working length.

19. Singlegutta-perchaconetechniquewithsealer I. • The point is seated to WL, you will feel a slight resistance (often referred to as „tug back”) when removing the test point from the canal. • The cone is slightly coated with sealer and placed to WL. • If procedural errors such as apical edging and canal transportation have altered the apical canal configuration, it will be virtually impossible to place a close-fitting single cone into the apical preparation. • In this situation, a single cone should be fitted to WL, and a warm gutta-percha filling technique should be used to increase the flow characteristics of the gutta-percha.

20. Singlegutta-perchaconetechniquewithsealer II. • The condensation forces (lateral or vertical) will help condense the softened gutta-percha into the apical aberrations, and sealer will fill any remaining space. • Because of the shrinkage problem with sealers, you must rely more an the efficiency of your condensation technique to fill the canal space and depend less on the sealer. • The safest approach is to keep the sealer layer at a minimum thickness and thus as dimensionally stable as possible.

21. Lateral compaction of warm gutta-percha • Simple modification to the cold lateral compaction technique is to apply heat to the gutta-percha • Easier to compact • Denser root filling • Instrument: sharp tip for lateral, blunt plugger tip for limited vertical compaction, electrically heated spreaders

22. Thermafil I. • Uses standardized plastic points coated with alpha-gp. • Gutta-percha is softened by heating • Root canal can that be obturated in one step • Rigid carriers are now plastic • Carrier remains in the canal as a central core • advantages:quick • disadvantages:overfilling,plastic carrier point comes into direct contact with the periapical tissue • instruments:special oven for warming Termafil point

23. Thermafil II. • procedures: • Instrumentation of the straight root canal with hand-held instuments through size 70 • Working length is checked with rtg • Root canal preparation is evaluated with a carrier point

24. Thermafil III. • Sealer is conveyed with k-file counterwise rotation • Thermafil point is heated in the oven immediately before it is used • The thermafil point is inserted in the canal to the depth marked by the rubber stop • The plastic carrier is then cut off at the level of the canal entrance with diamond stone • RTG

25. Characteristics of guttafusion techniquesThe innovation • The obturator consists entirely of gutta-percha. • On the inside, crosslinked polymer chains give stability to the carrier. • On the outside, the carrier is coated with flowable gutta-percha. • The carrier helps to condense the heated, flowable gutta-percha in the whole root canal system. • The beneficial characteristics of gutta-percha are maintained.

26. Characteristics of guttafusion techniquesWarm 3D Obturation – Without Compromise • Homogeneous filling of the whole root canal system due to excellent condensation of the warm gutta-percha in ramifications and isthmi • Precise placement of the obturator possible even in molars, thanks to the specially developed handle for tweezers • Easy separation of the handle without additional instruments • Easy removal of gutta-percha for post space preparation • Fast retreatment thanks to the gutta-percha carrier