Obturation materials

OBTURATION MATERIALS

PRESENTED BY: R.MANTHRU NAIK

PURPOSE OF OBTURATION To achieve three-dimensional fluid tight seal of root canal

system

To achieve total obliteration of root canal space so as to prevent ingress of bacterias and body fliuds into root canal space as well as egress of bacterias which are left in root canal.

To prevent bacterial microleakage.

To replace the empty root canal space with an inert filling material so as to prevent recurrent infection.

TIMING OF OBTURATION

The canal should be reasonably dry with no weeping of fluids in the form of bleeding or serous fluids.

When patient is without sensitivity on percussion.

After optimal cleaning and shaping is achieved.

Teeth with no periradicular radiolucency.

REQUIREMENTS OF AN IDEAL ROOT CANAL FILLING MATERIAL BY GROSSMAN

The material should be easily introduced into the root canal.

It should seal the canal laterally as well as apically.

It should not shrink after being inserted. It should be impervious to moisture. It should be bactericidal, or at

least ,should discourage growth.

It should be radioopaque. It should not stain tooth structure. It should not irritate periradicular tissue

or affect tooth structure. It should be sterile, or easily and quickly

sterilized immediately before insertion. It should be easily removable from the

root canal if necessary.

MATERIALS USED FOR OBTURATION

Plastics: Gutta-percha Resilon Solids or metal cores: Silver points Gold Stainless steel Titanium Irridio-platinum Cements and pastes: Hydron MTA Calcium phosphate Gutta flow

GUTTA - PERCHA

Most commonly used solid – core filling material.

Gutta – percha is derived from two words. GEETAH –meaning gum PERTJA –name of the tree Gutta – percha is a dried coagulated extract

derived from BRAZILLIAN trees(PALAQUIUM) belonging to SAPOTACEAE family.

Gutta – percha was earlier used As restorative material As splints for holding fractured joints To control hemorrhage in extracted sockets In skin diseases like psoriasis, eczema In manufacturing of golf balls

Historical background Edwin truman:introduced gutta percha as temporary filling material. Bowman: first to use gutta percha as root filling material CompositionIn crude form:gutta-75-82%Alban-14-16%Fluavil-4-6%Also contains tannins,salts,saccharine

Different forms of GP

Alpha form Pliable and tachy at 56-64 degree avaialable in form of bars and pellets Comes directly from trees Used in thermoplastized obturation technique

Beta form Most of the commercially avaialable products are in beta form Rigid and solid 42-44 degree Used for manufacturing GP points and sticksAmorphous form Exists in molten stage

Phases of Gutta perchaPhases are inter-convertible-Alpha-runny,tacky and sticky(lower viscosity)-Beta-solid,compactable and elongatable(higher viscosity)-gamma-unstable form.

Manipulation -On heating GP expands which acounts for increased volume of material which can be compacted into root canal

- GP shrinks as it reaches normal temperature

- Vertical pressure should be applied in all warm GP technique to compensate for volume change in cooling occurs.- GP should always be used with sealer and cement to seal root canal space at GP lacks adhering qualities

Rejuvenation technique for GP by Sorien and Oliet Aging of GP causes brittleness because of

the oxidation process Storage under artificial light also speeds

up the deterioration In this technique GP is immersed in hot

water(55 degree) for 1 or 2 sec then immediately immersed in cold water for few seconds

Sterilization of GP GP cannot be heat sterilized For dis-infection of GP they should be

immersed in 5.25% NaOCl for 1 min.then GP should be rinsed in hydrogen peroxide or ethyl alcohol.

The aim of rinsing is to remove crsytalized NaOCl before obturation as these crystalized particles impaired the obturation

GP is soluble in in certain solvents like chloroform eucalyptus oil.this property can be used to plastisize GP by treating with the solvent for bettar filling in the canal , but It has shown that GP shrinks when solidifies .

GP also shows some tissue irritation which is due to high content of ZnO

CURRENT AVAILABLE FORMS OF GUTTA PERCHA

i)GP points standard cones are of same size and shape as that of ISO endodontic instruments(2% taper from size nos. 15 to 140)ii)Auxiliary points Non-standardised cones perceive form of root canals.The conventional sizesw include:

Extra fine Fine fine Fine Medium fine

Fine medium Medium Large Extra largeiii)Greater taper guttapercha points Available in 4% , 6% , 8% , 10% taper iv) Variable taper gutta percha points suiting the taper of variable taper shaping instruments like the Protaper F1,F2,and F3.

v) Gutta percha pellets or bars these are used in thermoplastisized guttapercha obturation ex: Obtura systemvi) Precoated core carrier guttapercha In these stainless steel , titanium / plastic carriers are precoated with alpha phase guttapercha ex: Therma fil

vii)Syringe systems They use low viscosity guttapercha ex: Successful & Alpha sealviii) Gutta flow In this guttapercha powder is incorporated into resin based sealer ix) Guttapercha sealers like Chloropersha & Eucopercha , In these guttapercha is dissolved in Chloroform/eucalyptol x) Medicated guttapercha – Calcium hydroxide Iodoform or chlorhexidine diacetate containing GP points

ADVANTAGES OF GUTTA - PERCHA

Compactability-adaptation to canal walls It is easily sterilized prior to insertion and

does not encourage bacterial growth. It is nonstaining and impervious to

moisture. Inertness-makes it non-reactive material Dimensionally stable

Tissue tolerance Radioopacity-easily recognisable on

radiograph Plasticity-becomes plastic when heated Dissolve in some solvents-like chloroform,

eucalyptus oil etc.This property makes it more versatile as canal filling material.

It is probably least toxic and least irritating root canal filling material.

DISADVANTAGES Lack of rigidity-Bending of gutta percha is

seen when lateral pressure is applied. So, difficult to use in small canals.

Easily displaced by pressure. Lacks adhesive quality.

MEDICATED GUTTA – PERCHA Calcium hydroxide containing gutta

percha: Ca(OH)2 POINTS Made by combining 58% of calcium hydroxide in matrix of 42% gutta percha.They are available in ISO size of 15-140.Advantages: Ease of insertion and removal Minimal or no residual fit Firm for easy insertion

Disadvantages: Short – lived action Radiolucent Lack of sustained release Calcium hydroxide plus points:Along with Ca(OH)2 they contain TENSIDE which reduces the surface tension.These are more reactive.

Iodoform containing gutta percha: Remains inert untill it comes in contact with tissue fluids.On coming in contact with tissue fluids, free iodine is released, which is antibacterial in nature. Chlorhexidine diacetate containg gutta

percha:In this gutta percha matrix is embedded in 5% chlorhexidine diacetate. This material is used as an intracanal medicament.

RESILON Resilon is a high performance

polyurethane.It is a polycaprolactone core material with difunctional methacrylate resin , bioactive glass, bismuth and barium salts as fillers and pigments.A resin sealer is always employed with core filling material for obturation.

Available in the form of ISO sized points and pellets for use with obtura III(Obtura spartan)

This system can be placed using lateral compaction, warm vertical compaction and thermoplastic injection.Resilon requires 150 degree centigrade temperature for thermoplasticized techniques.

Resilon also reinforces root canal due to adhesive properties.

There exist doubt in susceptibility of this material to hydrolytic enzymes.Further clinical trials are required to recommend this material as an alternative to gutta percha.

Ex:Epiphany Real seal

SILVER CONES Silver cones contain traces of metal like

copper, nickel which add up the corrosion of the silver points when they come in contact with saliva or body fluids.The corrosion products are toxic and leads to endodontic treatment failure.

A silver cone is stiffer than gutta percha and can be easily inserted in a fine, tortuous canal.

They cannot confirm with the shape of root canal because they lack plasticity.