Gutta-percha in dentistry: technology sealing
Gutta-percha found a good use to the dentists and has established itself as a reliable endosealers is, because the technology of root canal filling allows you to tightly close polyarnoy cavity, which reduces the likelihood of infection from pathogenic microorganisms.
Dentists regularly use gutta-percha pins at work since the seventies of the last century. And today his popularity among physicians and patients has not diminished. Naturally, when working with this material may cause complications, but most are due to the peculiarities of the structure of the canal system and not properties of gutta-percha.
What is it?
Substance is used in dentistry in the form of tapered pins which are color-coded on the tail denoting the size, in accordance with the ISO standards. Each pin consists of several components:
- beta-gutta — percha- is the fifth part of the total mass of the substances. Provides plasticity and flexibility;
- zinc oxide is the main structural mass, in certain species, its concentration reaches 75%;
- a radio-opaque substance – provides a clear visualization on the snapshot, its mass fraction does not exceed 1%;
- additional components – the dye, a plasticizer, an antioxidant.
The pins produce the standard that have a specific set taper and length, as well as custom with the thicker body and smaller size.
Why use gutta-percha in dentistry?
The material copes with the task of ensuring the tightness of the root canal, which is why it is used in endodontics. Reasons why gutta-percha pins have found wide application.
- Convenience and ease of operation.
- Accessibility for concert halls channel if necessary re-treatment.
- No allergic reactions to the material.
- Elasticity and pliability.
- The contrast on the radiographic images.
- Does not absorb liquid.
- Low cost.
Related article: removed the nerve and filled the channels, and the tooth hurts.
Advantages and disadvantages
The advantages of the gutta-percha cannot be ignored, because it is considered the most popular material for the qualitative and hermetic obturation of the lumen of the root canal. Gutta-percha pins have significant advantages in comparison with other tools for root canal filling, for the reason that they:
- provide reliable filling of the entire depth and width of the tooth cavity, and also to create the necessary density of root fillings;
- have the ability to compression, and therefore provide good conditions for adaptation to the walls in the condensation of the filler;
- inert, indicating that their inability to react chemically to the tooth tissues and spreads to fill the lumen polyarnoi camera;
- indifference – percha does not cause irritation or allergic reactions when fading in periapical region;
- under the influence of the tissue fluid does not occur the dissolution or destruction of the structure of the pins;
- contrast x-rays;
- ease of use in the sealing channel.
Of the downsides are few features of the material:
- gutta-percha has antibacterial and bacteriostatic effect, as it is a neutral substance that is not able to allocate in the cavity in any of the active elements;
- the risk of deformation, so it is not possible to control the insertion depth;
- the lack of rigidity, this material can’t fix in the narrow channels;
- you cannot apply without a root sealant, as the pins are not characteristic of adhesion to the channel walls;
- if the equipment violation and lack the dense condensation in the process of filling may dislodge filler at the stage of excision of the free part of the post.
The properties of this substance in comparison with other endodontic materials made gutta-percha one of the leading and reliable means for filling the cavity of the tooth. Such negative features as lack of adhesion to dentin and the ability to influence the microflora of kompensiruet used cements and pastes for canal filling.
When carrying out filling the root canal with warm gutta-percha, you must comply with two main conditions.
- High-quality preparation of the tooth cavity – a sufficient level of expansion and passage to the full depth.
- The preservation of the natural configuration of the channel when it is processed – if you have thin walls you should not remove all the defects, not to get perforated.
Before closing polyarnoy camera dental cement with the use of gutta-percha, performed certain actions, without which it is impossible to conduct high-quality endodontic treatment regardless of the chosen methodology.
- the imposition of a cofferdam, which eliminates the ingress of oral fluid into the tooth;
- preparation caries removal with defective seals;
- opening and widening mouths;
- definition of working length;
- machining the walls of the channel throughout;
- antiseptic lavage and drying of the pulp chamber.
After the canal is prepared, start filling materials. There are several techniques use of pins for endodontic purposes.
- The method of lateral condensation.
- The method of one pin.
- Method of vertical condensation.
- Thermoplastic obturation system Termafil.
Consider in more detail each of the methods.
Video: filling with gutta-percha.
Technique lateral condensation
Based on the gradual filling of the lumen of the root canal material. The procedure begins by setting the master pin and continues with the application of additional fillers, while the cavity of the tooth is not sealed all over.
- selection of the main pin – percha is selected one size smaller than the last root needle, which could pass the channel system to the full depth. The filler to freely enter and displayed without deformation;
- kneading pasta – obtaining a solution of a creamy consistency and its introduction into the channel in a small amount to fill the apical third;
- commit master-pin – tip of the gutta-percha smeared with cement and put it in the full depth of the tooth cavity;
- condensation is a special tool of appropriate caliber to fulfill the pressing pin and the wall of the channel;
- filling – phased introduction of the filler is smaller with a repetition of 3 and 4 points until then, until there is free space;
- x-ray control – using the picture to determine at what level is the tip of the pin;
- removal of excess free edge of the plastic material is cut with a heated tool or an ultrasonic scaler.
At the end of the procedure, the tooth is closed a temporary filling material, then in the next visit you can restore the crown part with composite materials or stump inserts.
The technique of vertical condensation
The method is based on the maximum filling of the canal with heated gutta-percha with minimal application of sealer. The technique involves special tools in various sizes – plagiary, which produces a seal at different levels of the pulp chamber.
The procedure is as follows:
- fit pin on the working length and mark with a tweezers on the surface of the gutta-percha;
- extraction from the channel and cutting off 1 mm from the apical part, and then re-fitting;
- preparation of plageron and application of a mark of the depth of the required introduction;
- introduction endodontic cement;
- dip the tip of the pin in Siler and subsequent installation in the canal of the tooth;
- removal of the excess gutta-percha from the mouth of a heated trowel and condensation playroom the largest size and then use smaller tools;
- the remaining space in the canal is filled with gutta-percha fragments of pins and re-compaction of hot plaginami as long as the cavity is not hermetically sealed.
The method of one pin
This is the first proposed uses of gutta-percha in dentistry. The quality of endodontic treatment depends on the properties of the material. Performed earlier technique of filling the channel with only one paste over time has shown to be ineffective due to the fact that the solutions were dissolved, forming voids where the breeding of pathogenic bacteria. Method one pin possible to avoid this problem.
The sequence of manipulations similar to the lateral technique, however, has its own characteristics.
- The fitting of the pin with the selection of taper and thickness of the tail part.
- Making pasta in the root canal over its entire length.
- Immersion of gutta-percha to the working length.
- Removal of excess material.
For reliability of such sealing is necessary to firmly seal the apical hole, in addition, requires a thicker layer of liquid material between the canal wall and the gutta-percha, which worsens Hermeticism. The only disadvantage is the existence of a large risk of removing the tip of the pin up at the root tip, which is fraught with complications in the future.
Is a flexible rod of plastic or metal, equipped with a handle, and the applied rubber coating. Each obturator notches are present, which indicate the distance to the tip. The tool simultaneously performs two functions: it contains the filler and helps it to condense.
The technique is fairly simple but requires special equipment and skills:
- the verifier (a tool to check) specify the size of the processed channel and select the desired obturator;
- tip with material placed in an oven for reheating, and then contribute to the channel;
- gutta-percha becomes fluid and fills in all the branches the pulp chamber, draining the core;
- the handle of the obturator is cut at the desired depth and compacted filler in the channel.
Each filling has its own characteristics and advantages and disadvantages, but the use of gutta-percha in dentistry has allowed us to provide a high level of quality of the filling of the lumen of the root canal without the risk of resorption of the material.