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Obturation

FINAL WORKING LENGTH CHECK

OBTURATION
Cleaning and Shaping More Important Than Obturation (taking out more important than putting in) If Problems with Obturation, Work on Cleaning and Shaping!!!

Objective is to create a seal from the coronal to the apical (FINAL RESTORATION MOST IMPORTANT)

Ideal Requirements No material has all


Easily introduced Liquid or semisolid and become solid Seal laterally and apically Not shrink Impervious to moisture Bacteriostatic/cidal Not stain tooth Not irritate periapical tissues Easily removed Sterile or sterilizable Radiopaque (SEXY)!!

WHEN NOT TO OBTURATE?


Continued purulence or exudate in the canals Significant swelling/infection Unable to complete treatment same day (complicated case, pain problems) You cant get them numb, or came late, you just relief the pain.

TYPES OF OBTURATION MATERIALS

Solid Materials
Gutta PerchaBEST Silver Points Carrier-Based Systems

Semisolids(NOT RECOMMANDED)
Pastes

TYPES OF OBTURATION MATERIALS

Pastes
1- Difficult to control length (easy to overfill) 2- Poor seal (inconsistent seal) 3- May shrink 4- May contain toxic materials Do not use paraformaldehyde containing materials (AAE Position Statement)

TYPES OF OBTURATION MATERIALS

Silver Points
No longer recommended for use because of problems with corrosion by-products Do NOT need to be retreated unless pathosis or if needed for restoration (e.g. needs post space)

TYPES OF OBTURATION MATERIALS

Carrier-Based Systems
Gutta Percha Lollipop (plastic carrier coated with gutta percha) Requires oven heating

Problems arise from forcing to length without adequate cleaning and shaping (and difficult to retreat)

CARRIER-BASED SYSTEMS

TYPES OF OBTURATION MATERIALS

Gutta Percha
Mostly Zinc-Oxide (approx 75%) Gutta Percha (20%) Filling material (5%) Standardized and Conventional Cones Variability in gutta percha cone sizing (not all #30 cones are the same size)**

Made from the sap of a Malaysian rubber tree, the gutty replaced feathery balls leather pouches stuffed with goose down. Old Tom Morris smacked gutties with glee, but his boss, Allan Robertson, the first full-time golf pro, called them "the filth" and paid caddies a penny apiece for gutties, which Robertson burned in his St. Andrews fireplace.
http://www.golf.com/photos/equipment-game-changers/1850s-gutta-percha-ball

GUTTA PERCHA

Accessory cones

Regular 0.2

TYPES OF OBTURATION MATERIALS

Sealers
Grossmans Ideal Characteristics

Tissue tolerance No shrinkage with setting Slow setting time Adhesiveness (create a bond) They bond to the tooth not to gutta percha Radiopaque--SEXY No staining Soluble (in a specific solvent) Not soluble in oral fluids Antibacterial Creates a good seal

TYPES OF OBTURATION MATERIALS

Sealers
4 major types: ZOE (zinc oxide eugenol)* Plastics Glass Ionomer Calcium Hydroxide Containing (CaOH is an antibacterial which dr will put inside the tooth.

OBTURATION TECHNIQUES

Cold lateral condensation* - gold standard, safest and easiest technique

Other techniques in book

LAB OBTURATION VIDEO


See lab/clinic handout for written basic steps

MASTER CONE CHECK


Instruments/Materials Needed: Paper Points Endodontic Files Sealer Gutta Percha Spreaders Pluggers Master Cone Radiograph Hemostats

MASTER CONE CHECK

OBTURATION
Instruments/Materials Needed: Sealer Gutta Percha Spreaders Pluggers Glick Electronic Heat Instrument Alcohol Pellets

OBTURATION

SUPERENDO ALPHA2 (B&L BIOTECH)

DIAPEN (DIADENT)

DIAPEN

TOUCH N HEAT (SYBRON ENDO)

SYSTEM B (SYBRON ENDO)

TEMPORARY OR FINAL RESTORATION


Instruments/Materials Needed: Final Radiograph (double-pack) Temporary restoration material (Cavit or IRM) OR Permanent restoration Glick Mirror Explorer Floss

TEMPORARY OR FINAL RESTORATION