1. Endodontic Filling Materials Qiang Zhu, DDS, PhD

2. The purpose of root canal filling: * Fill pulp space *Prevent microorganisms leakage and invasion *Protect exposed connective tissue wound surface *For the placement of post retention 1

3. Endodontic Filling Material Requirements Handling: * Easy to use and remove * Setting in an adequate time, allowing sufficient time for obturation and x-ray control Biological: * Antimicrobial * Sterile * No general health problems or allergies. * No irritation and stimulation of the apical healing process. 2

4. Technical: * No shrinkage * No solubility in tissue fluids, no water absorption. * Good adhesion/adaptation to dentine or combining materials * No tooth discoloration * Radiopaque Textbook of Endodontology, Bergenholtz, et al. 2003 3

5. Endodontic Filling Material I. Solid Materials 1. Gutta Percha 2. Silver Cone 3. Resilon 4. Coated Cones II. Sealers (Cements) III. Materials for Root-End Filling 4

6. 1. Gutta Percha  phase: nature form; from the Taban tree when cool slowly (1F o /Hr) from melting phase; has better flow.  phase: most gutta percha cones; when cool normally from melting phase; less brittle than the  -form From  to  when heated ~ 46 0 C (115 0 C) Melt at 65 0 C (147 0 C). Dissolved in Chloroform I. Solid Materials 5

7. Gutta Percha Cone 70% Zinc Oxide 20% Gutta Percha 10% Metal sulfates, pigments, wax, and resins 6

8. Gutta Percha Cone *Standardized Cores: Used as master cone. #25, #30, etc. Taper 0.02mm/mm. ANSI/ADA Spec.#57: tolerance +/- 0.05 mm !!! *Accessory Cones: Used as accessory points in lateral condensation. Such as Fine-fine, Medium-fine. Taper various. 7

9. *Greater taper cones: 4% or 6% used with special engine-driven rotary instruments. 8 0.06 0.04 0.02

10. Carrier-Based (Thermafil): Plastic or Titanium core coated with gutta percha 9

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12. Obtura II: Thermoplasticized gutta-percha injection. Heat segment of gutta percha to 160 o C. 11

13. MicroSeal: Solid master cone and thermoplasticized gutta-percha injection. 12

14. 2. Silver Cone (you may see) Before After Re-treatment1.5 years later Removed Siler Cone 13

15. 3. Resilon *A new synthetic resin-based polycaprolactone polymer. *Developed as a gutta-percha substitute to be used with a new resin sealer, Ephiphany. *Attempt to form an adhesive bond at the interface of the synthetic polymer-based core, the canal wall, and the sealer. 14

16. 4. Coated Cones Gutta percha cones coated with a resin, used with resin sealer Gutta percha coated with glass ionomer, used with glass ionomer sealer. Regular GPActive GP Activ GP Active GP Sealer Dentin 15

17. II Endodontic Sealers * Bond gutta percha to root canal wall * Fill space between gutta percha cones, and between cones and root canal wall * Facilitate the seating gutta percha into the canal Classification: *ZOE Sealers *Polymers *Calcium Hydroxide Sealers *Glassionomer cement *Others 16

18. Function of Endodontic Sealer Sealer Gutta percha Master Cone Accessory Cone Canal wall Lateral canal 17

19. ZOE Sealers Zinc Oxide, Eugenol, Resins etc. Harding is due to zinc eugenolate formation Reasonable seal, antimicrobial, and long-lasting cytotoxicity. High humidity increases setting time. * Rochert’s Sealer (Kerr Pulp Canal Sealer) * Tubliseal * Grossman’s Sealer * Procosol Cement * Wach’s Paste 18

20. Polymers Best sealing; Freshly mixed cytotoxicity; once set, biocompatible; Antimicrobial effect decreased with increased setting time * AH26 – Epoxyresin, ~34 hours (AHPlus ~ 8 hours) * Diaket - Polyvinyl resin, ~ 7 min * EndoFill - Silicone 19

21. Calcium Hydroxide Sealers Release calcium hydroxide, may result in disintegration; Once set, no calcium hydroxide released; initial antibacterial effect. * Sealapex - two paste, resin based * CRCS Cement - power, liquid, Zinc oxide-eugenol based * Apexit - power, liquid combination 20

22. Glassionomer Cement Good biocompatibility, set too fast and hard to remove * Ketec-Endo – Polycarboxylate working time in mouth ~ 7 min 21

23. III. Materials for Root-end Filling *Amalgam, old material, easy to use *Modified ZnOE cements: IRM *Mineral Trioxide Aggregate (MTA) *Composite (Gluma-Retroplast) 22

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25. Evaluation of Biocompatibility of Root Canal Filling Materials 1. In vitro study on cell and tissue culture. 2. In vivo implantation in experimental animals- soft tissue or bone. 3. Usage evaluation when the material is used as intended - on experimental animals or humans. 24

26. In this lecture you should know: *What is the most important requirement for root canal filling material? *What is the composite of GP point (cone)? *What is the tolerance of GP point? *Which sealer belongs to which group? *What is the two most used root-end filling materials?

27. Endodontic Lab Schedule Group A Group B Group C Group D Tue 4/03/13 Access and preparation of anterior teeth 1:00–5:00 PM Wed 4/10/13 Obturation of anterior teeth 1:00–5:00 AM Tue 4/23/13 Access and preparation of maxillary premolar 1:00–5:00 PM Wed 4/24/13 Obturation of maxillary premolar 1:00–5:00 PM Tue 4/30/13 Rotary Instruments Access and prep. of max. molar 1:00–5:00 PM (A, B) (C, D) Wed 5/01/13 Access and prep. of max. molar Rotary Instruments 1:00–5:00 PM (A, B) (C, D) Mon 5/20/13 Obturation of max molar (A, B, C, D) 8:00–12:00 AM Tue 5/21/13 Makeup 1:00–5:00 PM Wed 5/22/13 PRACTICAL EXAMINATION 1:00–5:00 PM

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