Endodontics
Course Review
Enoch Ng, DDS 2014
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GP Points
Standardized – same tip diameter and taper as files
Master cone should be same as MAF
Conventional – tip has one size, body a different size (FM – fine tip, medium body)
Fairly large tolerance in manufacture (size 40 point ranges from 35-45)
Sealer
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Essential for success
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Enhances seal and serves as filler for canal irregularities
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May serve as lubricating agent
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All types exhibit some toxicity – decreases after setting
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Ideal properties
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Tissue tolerant, soluble in solvents but not oral fluids, bacteriostatic
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Slow setting, adhesive, non-staining, radiopaque
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Types of Sealer
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ZOE (gold standard) – Roth’s sealer, tubliseal, kerr pulp canal sealer
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CaOH – CRCS, sealapex
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Glass Ionomer – Ketac-endo
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Resin – diaket, AH26, AH-plus, epiphany, RealSeal
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MTA – iRoot Sp
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Sealer placement
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Hand file
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Ultrasonic file
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Lentulo spiral
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Master cone
Obturation techniques
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Pure lateral or vertical techniques rarely used
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No clinical difference in normal canals
Warm technique – better canal adaptation but higher incidence of extrusion beyond apex
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Increased compaction pressure does NOT significantly decrease apical leakage
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No obturation material/technique will be successful without proper cleaning and shaping
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Other Obturation Systems
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Gutta-percha carrier system
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Warm vertical compaction
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Continuous wave
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Hybrid technique