Endodontic Filling Materials

Qiang Zhu, DDS, PhD

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

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Endodontic Filling Material RequirementsHandling:

* 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.

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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

Endodontic Filling MaterialI. Solid Materials

1. Gutta Percha2. Silver Cone3. Resilon4. Coated Cones

II. Sealers (Cements)

III. Materials for Root-End Filling

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1. Gutta Percha phase: nature form; from the Taban tree

when cool slowly (1Fo/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 0C (115 0C)

Melt at 650C (1470C). Dissolved in Chloroform

I. Solid Materials

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Gutta Percha Cone

70% Zinc Oxide20% Gutta Percha10% Metal sulfates, pigments,

wax, and resins

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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 lateralcondensation. Such as Fine-fine, Medium-fine. Taper various.

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*Greater taper cones: 4% or 6% used with special engine-driven rotary

instruments.

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0.06 0.04 0.02

Carrier-Based (Thermafil):

Plastic or Titanium core coated with gutta percha

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Obtura II:Thermoplasticized gutta-percha injection.Heat segment of gutta percha to 160 oC.

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

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2. Silver Cone (you may see)

Before After Re-treatment 1.5 years later

Removed Siler Cone 13

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.

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4. Coated ConesGutta percha cones coated with a resin, used with resin sealer

Gutta percha coated with glass ionomer, used with glass ionomer sealer.

Regular GP Active GP

ActivGP

Active GP Sealer

Dentin

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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

Function of Endodontic Sealer

Sealer

Gutta perchaMasterCone

AccessoryCone

Canalwall Lateral

canal

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ZOE SealersZinc 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

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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

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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

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Glassionomer Cement

Good biocompatibility, set too fast and hard to remove

* Ketec-Endo – Polycarboxylate working time in mouth ~ 7 min

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III. Materials for Root-end Filling

*Amalgam, old material, easy to use

*Modified ZnOE cements: IRM

*Mineral Trioxide Aggregate (MTA)

*Composite (Gluma-Retroplast)

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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.

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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?

Endodontic Lab Schedule Group A Group B Group C Group D

Tue 4/03/13 Access and preparation of anterior teeth1:00–5:00 PM

Wed 4/10/13 Obturation of anterior teeth1:00–5:00 AM

Tue 4/23/13 Access and preparation of maxillary premolar1:00–5:00 PM

Wed 4/24/13 Obturation of maxillary premolar1:00–5:00 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 EXAMINATION1:00–5:00 PM

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