Under filled root canal

ENDO-surgery seminarMorteza Parmis - DDM

Nouri EsmaeilNouri Amin

Esmaeili MortezaRazon Arlhie

Presented by:

GOALS of obturation

• TO FILL THE ENTIRE CANAL SYSTEM AND ITS COMPLEX ANATOMIC PATHWAYS COMPLETELY WITH NONIRRITATING HERMATIC SEALINGAGENTS.

OBJECTIVES OF CANAL OBTURATION

• Prevents percolation and microleakage of periradicular exudate into the root canal space.

• ) ) Prevents reinfection through good sealing of the apical foramina.

• ) ) Creates a favorable biologic environment for the process of tissue healing to take place.

Ideal root canal filling material requirments :

. ) ) Easily introduced

•) ) Seals laterally and apically

•) ) No shrinkage

•) ) Impervious to moisture

•) ) Bacteriostatic

•) ) Does not stain tooth

• ) ) Non irritating to periapical tissues

• ) ) Easily removed

• ) ) Sterilizable

• ) ) Radiopaque

STEPS OF ROOT CANAL OBTURATION

• Rubber dam application

• Verify completion of the canal preparation.

• Check your working length, irrigate & DRY the canal.

• Fit the master cone (TUG- -BACK). BACK).

• Take radiograph. Take radiograph.

• Introduce the sealer cement.

• Condense the MC and accessory guttapercha.

• Take intermediate radiograph.

• Add more G.P points and remove access.

• Temporize the access and take final radiograph.

Master Cone

• (1) fit tightly laterally in the apical third of the canal (have good " canal),

• (2) fit to the full length of the canal (i.e., to the dentin- cementum junction or about 1 mm from the cementum junction or about 1 mm from the radiographic apex),

• (3) be impossible to force farther beyond the apical foramen.

LATERAL CONDENSATION

• Involves the compaction of the primary master cone and sealer against the apical foramen

• Condensing additional accessory gutta percha cones alongside the the master cone fills the remainder of the canal

Finishing

• GP to level with the CEJ

• Using cool end of plugger to vertically condense gutta percha at orifice

• Clean pulp chamber with cotton pellets soaked in alcohol

• Place temporary or final restoration

• Preferable to take radiograph before removing rubber dam

Radiographic evaluation of obturation

• Radiolucencies: Are there voids, indicating incomplete obturation?,

• Density: Is there uniform density from coronal to apical?

• Length: Does material extend to WL?

• Shape: Does fill reflect shape of the canal, tapered from coronal to apical?

Underfill

• An incomplete obturation of the root canal space with resultant voids

• Inadequate taper in preparation

• Improper spreader/cone placement

• Cannot be corrected by increased force

• An ideal root canal filling three-dimensionally fills the entire root canal system as close to the cemento-dentinal junction as possible

• •Teeth filled more than 2mm short of apex has poor prognosis underfillings with necrotic pulps

Causes

• o Dentin chips

• o Ledged canal

• o Curved canal

• o Master cone too large

• o Improper 3D shaping of canal in apical to middle third

Dentin chip

Ledged canal

Curved canal

Too large master cone

Improper shaping of canal

• Inadequate taper in preparation

Non-Surgical Retreatment

• Gain access to canal system and reach apical foramen via removal/bypass of obturation materials from canal

• - Patient usually has high outcome expectations - Requires greater clinical skill than original NSRCT treatment

• - Canal Obstructions – posts, separated instruments

Non-Surgical Retreatment. GP removal

. Quality of condensation

Shape of root canal

Length of obturation material – short fill, overextension, etc

Gates Gliddens, ProFiles, GPX

Removes GP t

Provides reservoir for solvent

Heat and hedstrom removal technique

Non-Surgical Retreatment

• Solvents.

• Chloroform

• Methylchloroform, Eucalyptol, Halothane, Xylene, Rectified white turpentine

Thank you for your listening