Although periapical healing starts after Root canal cleaning, shaping and disinfection is done, it is an accepted scientific fact that good obturation is needed for it to stay healed over the years.An Obturation should :-
Proper root canal filling should achieve three dimensional obturation of the endodontics space to prevent micro organisms from entering and reinfecting the root canal system and to prevent tissue fluids from percolating back into the root canal system to provide a culture medium for any residual bacteria. It should seal all “portals of exit” to impede any sort of communication or exchan- ge between the endodontium and periodontium.
It is clear from the objectives that the most critical area is the apical terminus of the root canal. While attempting to provide a hermetic seal in this region, we have to keep in mind that when heated gutta percha cools, always there is contraction. Even though thermo plasticized gutta percha techniques are fast and good enough for obturating the body of the root canal, it cannot give a hermetic seal in the apical third.
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Another important consideration is that if a post space is to be prepared or in the event of a re- root canal treatment, we should be able to remove the obturation without jeopardizing the integrity of the remaining tooth structure. So it is preferable to use a technique that doesn’t leave a ‘difficult to remove’ carrier in the root canal.
Lateral condensation is a good technique where it is indicated, and it has withstood the test of time.
Root canal spreaders for lateral condensation:
SimpliFill is the only carrier system where the carrier is not left in the canal. We all know that removal of carrier is not a pleasant job if we have to go for a post or a retreatment has to be done. It is the best hermetic seal you can obtain for your well prepared canal. When you push a 5mm of .02 tapered gutta percha into a 4mm of parallel apical preparation, you can understand that we are providing a cork like tight seal for the apical third.
To me the best advantage of SimpliFill is the opportunity to finish the post cementation in the same sitting. Because of the tight apical seal, I don’t have to worry that the vibration during the post space preparation may dislodge the gutta percha or compromise the apical seal. Equally important are cases with severely curved root canals and canals with curvatures in two planes. LightSpeed LSX system makes possible cleaning and enlarging the canal and it is only SimpliFill that can make sure the gutta percha reaches to the apical extent and a hermetic seal is provided. We can’t push a gutta percha point into such canals because they will buckle and won’t reach till the full working length
Resilon is a thermoplastic synthetic polymer based root canal filling material. Based on polymers of polyester, Resilon Material contains bioactive glass and radiopaque fillers. It performs like gutta-percha, has the same handling properties, and for retreatment purposes may be softened with heat, or dissolved with solvents like chloroform. Similar to gutta-percha, there are master cones in all ISO sizes and accessory cones in different sizes available. It can be bonded with tooth. There is still not enough evidence that Resilon performs better than Guttapercha. GP with lateral condensation continues to be GOLD standard for Endo obturation.
The Thermafil obturator consists of two parts, the carrier and the gutta-percha. The carrier is similar to a manual endodontic instrument without the blades, made from a special radio-opaque plastic. Carrier is coated with GP. Thermafil obturators have a taper of .04 and are available in various tip sizes starting from size 20 to 140. The chosen size is placed in a special oven and this warm cone is then pushed into canal giving a 3D filling. However cooling does lead to some shrinkage.
This technique leaves a plastic carrier in the canal which poses a problem should you have to place post or retreat the case.
Special oven (therma prep plus oven) is required to heat thermafil cones.
In curved canals carrier usually gets stripped of GP in curvature.
You needs special technique and time to remove nasty carrier in cases which need post core or retreatment.
Many companies have copied this product, "Stay away from Thermafil and its likes"
Thermaflo is similar to Thermafil, CLICK HERE TO SEESmartSeal- Obturation system with claim that on contact with canal fluids the obturation point will expand and seal the canal. MORE HERE
Example technique (use common sense)Insert ultrasonic spreader (F 88 009 –S04, Satelec by Acteon Group, Mérignac Cedex, France)alongside the master cone and activated with an ultrasonic unit (P-MAX, Satelec) for 3 seconds, push apically, and activate again for 3 seconds. Repeat until the spreader reaches 3mm short of the working length. Briefly activate (setting 3-5) and remove spreder and put a size 35 standardized gutta-percha cone, coated with sealer.Continue condensation until the canal is filled. Excess gutta-percha is seared off and the heated gutta-percha vertically condensed with an ultrasonic plugger (F 00 250-5, Satelec). LINK HERE
Sealers may contain different medicaments for antibacterial activity etc. KeyPOINT: Canal has to be cleaned well, dirty apex can not be healed by sealer.Tweet