Keterangan
There are many methods for filling root canals,we use biochemical material for filling the root canal like gutta percha.The gutta percha is placed along with adhesive cement to ensure proper sealing of the root canals.In most cases temporary filling is placed close to the opening.The basic steps we follow for root canal are using local anesthesia for numbing the area,after the proper placement of dental dam the drilling is done for cavity cut for removing the affected tissue and nerves,then inserting flexible root canal tools.Then once cavity is removed the filling is applied and post is inserted if required.
Today our guest speaker is going to tell us more about the principle to follow for filling the root canal.
Ringkasan
- The speaker emphasized the importance of proper diagnosis and treatment planning in endodontics. Not every tooth requires treatment, and heroic endodontics should be avoided in favor of correct endodontics. They also stressed the significance of effective local anesthesia and rubber dam placement, stating that all steps in root canal treatment are equally important.
- Anesthetic techniques are vital for pain management, especially in acute lesions. Pain management is a key factor, given that patients often seek dental treatment only when experiencing significant pain. Isolation, achieved through rubber dam placement, also plays a major role.
- Updating oneself on the latest techniques and materials is crucial, as traditional knowledge becomes obsolete. Correct rubber dam application can increase treatment efficiency by almost 78-82%. Access cavity preparation involves removing caries and old restorations to access the pulp chamber.
- Conservative preparations are preferred, aiming to conserve tooth structure. In cases of decayed or restored teeth, a pre-endo buildup is necessary for rubber dam clamp support and to prevent irrigant leakage.
- Working length determination is critical for biomechanical preparation, with apex locators increasing in efficiency. Irrigation, typically with sodium hypochlorite, is vital during biomechanical preparation, often complemented by activation techniques.
- Opturation is the second to last step, involving the three-dimensional filling of the root canal system as close to the cemento-dentinal junction as possible. The primary goal is to prevent coronal leakage and bacterial contamination, seal the apex, and seal remaining irritants in the canal.
- The optimal length of obturation is a debated topic, with studies recommending ending at the narrowest constriction of the root (minor diameter), which is usually 0.5 to 2 mm short of the radiographic apex. Overfilling has been shown to have a higher failure rate.
- While a hermetic, fluid-tight seal is desirable, achieving it fully is challenging but possible with modern materials and techniques. Obturation should aim to eliminate bacterial byproducts and provide a stable environment.
- Several obturation materials exist, with gutta-percha being the most common due to its inert nature. Coated cones, coated with medicines like chlorhexidine, can be used for lesions. Resilon, composed of resin-based cones and sealers, forms a "monoblock" for enhanced sealing.
- Several types of sealers are available, including zinc oxide eugenol, calcium hydroxide-based, glass-ionomer-based, resin-based, silicone-based, and bioceramic sealers. The age of bio-ceramic is now because they work on hydroxy apatite crystals.
- The speaker offered advice on creating custom cones and sterilizing gutta-percha cones. They recommended using finger spreaders and hand pluggers for better access and ease of use, while cautioning against using ball burnishers for searing off gutta-percha.
- Techniques for obturation include single cone, lateral compaction, warm vertical condensation, continuous wave, downpack, and thermoplasticized gutta-percha. Warm vertical condensation involves searing off gutta-percha with gentle apical pressure.
- The speaker provided a brief overview of the paste-only root canal fillings with zinc oxide eugenol and calcium hydroxide paste.
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