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Endodontic Materials: Root canal obturation materials.

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Presentation on theme: "Endodontic Materials: Root canal obturation materials."— Presentation transcript:

1 Endodontic Materials: Root canal obturation materials

2 Obturating materials After cleaning and shaping of canals, they are filled. After cleaning and shaping of canals, they are filled. Ideal properties of root canal filling materials: Ideal properties of root canal filling materials: Antimicrobial Antimicrobial Biocompatible. Biocompatible. Good flow Good flow Adhesive in nature Adhesive in nature Dimensionally stable Dimensionally stable Not affected by moisture Not affected by moisture Radio-opaque Radio-opaque Good handling Good handling Easily removed, post prep or retreat Easily removed, post prep or retreat Does not stain dentine Does not stain dentine Cheap Cheap

3 Gutta Percha Gutta percha “ Isoprene ” (C 5 H 8 ) is one of the oldest and most common root filling material in use today. A natural latex (rubber) produced from a genus of tropical trees Polymers of isoprene: Polymers of isoprene: Cis-natural rubber Cis-natural rubber Trans-gutta percha. Trans-gutta percha.

4 Gutta percha points used in clinic consists of: Gutta percha 20% Gutta percha 20% Zinc oxide 60-75% Zinc oxide 60-75% Metal sulphides, waxes, resin, opacifiers Metal sulphides, waxes, resin, opacifiers Gutta percha is available in 2 phases; Alpha and Beta.

5 Gutta percha taken from trees is the Alpha phase. Gutta percha taken from trees is the Alpha phase. Gutta percha in points used in the clinic is the Beta phase. Gutta percha in points used in the clinic is the Beta phase. Both phases differ in Melting temperature, volumetric changes and flow characteristics when molten. Both phases differ in Melting temperature, volumetric changes and flow characteristics when molten.

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7 Gutta percha Advantages of gutta percha: Biocompatible Biocompatible Dimensionally stable Dimensionally stable Compactable Compactable Easily removed Easily removed Cheap Cheap Disadvantages of gutta percha: Does not adhere to dentine Does not adhere to dentine Lacks rigidity Lacks rigidity

8 Metal points Silver (gold, tin, lead and titanium have been used) Silver (gold, tin, lead and titanium have been used) Introduced in 1930 ’ s Introduced in 1930 ’ s Silver preferred due to antibacterial effect Silver preferred due to antibacterial effect Rigid, unyielding Rigid, unyielding Impossible to adapt to canals Impossible to adapt to canals Poor seal as canal not commonly circular in shape Poor seal as canal not commonly circular in shape Corrosion Corrosion Difficult to remove for post Difficult to remove for post Titanium- biocompatible and avoids corrosion Titanium- biocompatible and avoids corrosion

9 Silver Point Failure

10 Sealers Sealers are used in association with Gutta percha. Sealers are used in association with Gutta percha. Functions of sealer Functions of sealer Cementing (luting, binding) the core material (gutta percha) into the canal. Cementing (luting, binding) the core material (gutta percha) into the canal. Filling the discrepancies between the canal walls and core material Filling the discrepancies between the canal walls and core material Acting as a lubricant to enhance the positioning of the core filling material Acting as a lubricant to enhance the positioning of the core filling material Acting as a bactericidal agent Acting as a bactericidal agent

11 Root canal sealers Most sealers are toxic when freshly mixed Most sealers are toxic when freshly mixed Toxicity substantially reduced when set Toxicity substantially reduced when set Most sealers are absorbable to some extent when exposed to tissue fluid Most sealers are absorbable to some extent when exposed to tissue fluid Ideally sealer should flow backwards out of the canal Ideally sealer should flow backwards out of the canal However, no evidence that apical extrusion reduces success rate providing preparation and obturation are meticulous However, no evidence that apical extrusion reduces success rate providing preparation and obturation are meticulous

12 Zinc-oxide eugenol Grossmans, Tubliseal Grossmans, Tubliseal Antibacterial Antibacterial Radio-opaque Radio-opaque Slightly toxic when freshly mixed. Slightly toxic when freshly mixed. Good flow and working time Good flow and working time Does not adhere Does not adhere soluble soluble

13 Calcium hydroxide based sealers Sealapex, Apexit Sealapex, Apexit Radio-opaque Radio-opaque Soluble Soluble Biocompatible Biocompatible Antimicrobial Antimicrobial Does not adhere Does not adhere

14 Resin based sealers AH26, AH Plus, Endorez, Epiphany, RealSeal. AH26, AH Plus, Endorez, Epiphany, RealSeal. Adhesive Adhesive Antibacterial Antibacterial Toxic when freshly mixed Toxic when freshly mixed Show setting shrinkage when set Show setting shrinkage when set

15 Glass-ionomer based sealers Ketac Endo and ActiV GP sealer. Ketac Endo and ActiV GP sealer. Mildly antibacterial Mildly antibacterial Adheres to dentine Adheres to dentine Slightly soluble Slightly soluble Unset GIC is cytotoxic but when set this reduces with time Unset GIC is cytotoxic but when set this reduces with time Very difficult to be removed Very difficult to be removed

16 Silicone based sealers Roekoseal sealer. Roekoseal sealer. Slightly expands when set. Slightly expands when set. Addition type silicone. Addition type silicone. GuttaFlow is Roekoseal sealer with added gutta percha particles. GuttaFlow is Roekoseal sealer with added gutta percha particles. Does not adhere to root canal. Does not adhere to root canal.

17 New root canal filling materials Resilon: resin-based cones. Similar in appearance and handling to gutta percha cones. Used with any resin- based sealer. Resilon: resin-based cones. Similar in appearance and handling to gutta percha cones. Used with any resin- based sealer. Endorez cones: resin-coated gutta percha. Used with endorez sealer or any other resin-based sealer. Endorez cones: resin-coated gutta percha. Used with endorez sealer or any other resin-based sealer. ActiV GP: glass ionomer coated gutta percha. Used with glass ionomer based sealers. ActiV GP: glass ionomer coated gutta percha. Used with glass ionomer based sealers.

18 Retrograde root filling materials Ideal properties Ideal properties Seals apex Seals apex Biocompatible Biocompatible Ease of handling Ease of handling Moisture and blood tolerant Moisture and blood tolerant Low solubility Low solubility Radio-opaque Radio-opaque Good tissue response Good tissue response Bonds to dentine Bonds to dentine

19 Amalgam Corrosion Corrosion Apical inflammation Apical inflammation Poor sealing ability Poor sealing ability Mercury toxicity Mercury toxicity

20 IRM Modified zinc oxide-eugenol Modified zinc oxide-eugenol Seals better than amalgam Seals better than amalgam Need high powder to liquid ratio to decrease toxicity and solubility Need high powder to liquid ratio to decrease toxicity and solubility Short working time Short working time

21 Super EBA Modified zinc oxide-eugenol Modified zinc oxide-eugenol High compressive and tensile strength High compressive and tensile strength Neutral pH Neutral pH Low solubility Low solubility Not affected by blood Not affected by blood Good tissue response Good tissue response

22 Composite Problems with moisture control Problems with moisture control Some good results in sealing ability but further work required Some good results in sealing ability but further work required

23 Glass Ionomer Cements Bonds to tooth substance Bonds to tooth substance Biocompatibilty (Toxicity reduces when set) Biocompatibilty (Toxicity reduces when set) Some antibacterial properties Some antibacterial properties Seal superior to amalgam Seal superior to amalgam

24 New materials Diaket (Tricalcium phosphate paste) Diaket (Tricalcium phosphate paste) Polyvinyl resin Polyvinyl resin Good tissue response Good tissue response ?cementum forming ?cementum forming Mineral Trioxide aggregates (MTA) Mineral Trioxide aggregates (MTA) Seals better than amalgam or super EPA Seals better than amalgam or super EPA Not adversly affected by blood Not adversly affected by blood Marginal adaptation better than amalgam, IRM or super EBA Marginal adaptation better than amalgam, IRM or super EBA ?cytotoxicity ?cytotoxicity Laser Laser Hydroxyapatite Hydroxyapatite

25 MTA Mineral trioxide aggregate: Mineral trioxide aggregate: Pulp capping Pulp capping Pulpotomy and partial Pulpotomy and partialPulpotomy. Perforation repair Perforation repair Internal and external resorption. Internal and external resorption. Nonsurgical apical closure Nonsurgical apical closure Surgical root end filling Surgical root end filling


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