Composite Root End Fillings Important and Non Important

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Composite Root End Fillings

Composite Root End Fillings

Important and Non Important ® Bond strength measurements are probably not important ® Tendency

Important and Non Important ® Bond strength measurements are probably not important ® Tendency to develop gaps is probably very important

Cytotoxicity Rakich, D. R. , J. C. Wataha, et al. (1998). "Effects of dentin

Cytotoxicity Rakich, D. R. , J. C. Wataha, et al. (1998). "Effects of dentin bonding agents on macrophage mitochondrial activity. " J Endod 24(8): 528 -33. ® Peltola, M. , T. Salo, et al. (1992). "Toxic effects of various retrograde root filling materials on gingival fibroblasts and rat sarcoma cells. " Endod Dent Traumatol 8(3): 120 -4. ® Osorio, R. M. , A. Hefti, et al. (1998). "Cytotoxicity of endodontic materials. " J Endod 24(2): 91 -6. ®

Biocompatibility ® Ozbas, H. , M. Yaltirik, et al. (2003). "Reactions of connective tissue

Biocompatibility ® Ozbas, H. , M. Yaltirik, et al. (2003). "Reactions of connective tissue to compomers, composite and amalgam root-end filling materials. " Int Endod J 36(4): 281 -7. Valux Plus composite (3 M), Dyract and F 2000 compomers and Oralloy amalgam were equally biocompatible.

Biocompatibility ® Zhu, Q. , R. Haglund, et al. (2000). "Adhesion of human osteoblasts

Biocompatibility ® Zhu, Q. , R. Haglund, et al. (2000). "Adhesion of human osteoblasts on root-end filling materials. " J Endod 26(7): 404 -6. Adhesion of osteoblasts to composite same as MTA.

Microleakage ® Fogel, H. M. and M. D. Peikoff (2001). "Microleakage of root-end filling

Microleakage ® Fogel, H. M. and M. D. Peikoff (2001). "Microleakage of root-end filling materials. " J Endod 27(7): 456 -8. There was no significant difference of microleakage between a dentin-bonded resin, Super-EBA, and mineral trioxide aggregate.

Retroplast ® Retroplast is a Bis-Gma (Bisphenol AGlycidyl Methacrylate) composite.

Retroplast ® Retroplast is a Bis-Gma (Bisphenol AGlycidyl Methacrylate) composite.

Retroplast Jensen SS, Nattestad A, Egdø P, Sewerin I, Munksgaard EC, Schou S: A

Retroplast Jensen SS, Nattestad A, Egdø P, Sewerin I, Munksgaard EC, Schou S: A prospective, randomized, comparative clinical study of resin composite and glass ionomer cement for retrograde root filling. Clin Oral Invest 2002; 6: 236 -243 Seems to hold up over time much better than GI’s

Ultrablend ® Ultrablend is a Urethane dimethacrylate Bis-Acrylic Resin (UDMA) Composite Resin combined with

Ultrablend ® Ultrablend is a Urethane dimethacrylate Bis-Acrylic Resin (UDMA) Composite Resin combined with Calcium Hydroxide.

Hemostasis with Viscostat ® With Dento Infusor and rubbing

Hemostasis with Viscostat ® With Dento Infusor and rubbing

Extraneous coagulum is removed ® So that almost all the coagulum is within just

Extraneous coagulum is removed ® So that almost all the coagulum is within just the blood vessel orifices; not large clumps throughout the crypt.

Make apical preparation ® Using Carr Retrotips

Make apical preparation ® Using Carr Retrotips

Apical Preparations

Apical Preparations

Retroplast ® Rud J, Munksgaard EC, Andreasen JO, Rud V, Asmussen E: Retrograde root

Retroplast ® Rud J, Munksgaard EC, Andreasen JO, Rud V, Asmussen E: Retrograde root filling with composite and a dentin bonding agent I. Endod Dent Traumatol 1991; 7: 118 -125 They used monkeys in Copenhagen and showed that the histologic response to a retrograde root filling procedure using composite and a dentin bonding agent (Gluma) was favorable.

Ultra-Etch ® With a Nano tip (either 30 or 31 gauge). ® Deliver to

Ultra-Etch ® With a Nano tip (either 30 or 31 gauge). ® Deliver to the preparation slightly beyond preparation margin. * ® This also prevents finishing abrasives from contaminating the crypt. ® Etch for 15 -20 seconds. * (This assures flash of resin is bonded to the root as it is first choice to not disturb the finished restoration with mechanical finishing. )

Surgi Tip ® Use Luer Vacuum Adapter with Surgi. Tip at first only to

Surgi Tip ® Use Luer Vacuum Adapter with Surgi. Tip at first only to vacuum the etch from the preparation. Then wash out the preparation and end of root. The Tri. Away or Stopko with a Black Mini tip works well for this.

PQ 1 or PQ Clear ® With a Nano tip 31 gauge (orange). ®

PQ 1 or PQ Clear ® With a Nano tip 31 gauge (orange). ® Deliver a moderately thick layer of the adhesive to the preparation and slightly beyond the margin.

Suck excess resin out ® Including from the depth of the preparation. ® Luer

Suck excess resin out ® Including from the depth of the preparation. ® Luer Vacum Adapter wit surgi tip ® Hold Surgi. Tip vacuum near root end for 15 -20 seconds so to facilitate drying of solvent from bonding resin. ® Careful with light (orange filter in scope)

Or blow Gently with Stropko

Or blow Gently with Stropko

Cure the bond resin ® 20 seconds ® With Endo. Guide attached to Ultra.

Cure the bond resin ® 20 seconds ® With Endo. Guide attached to Ultra. Lume II

Ultra-Blend with 30 gauge Nano ® totally coat the inside of the preparation ®

Ultra-Blend with 30 gauge Nano ® totally coat the inside of the preparation ® just beyond the margin ® Light cure using Endo. Guide for 10 seconds.

Add increments of Ultra-Blend ® One or Two as needed. ® Polymerize each layer

Add increments of Ultra-Blend ® One or Two as needed. ® Polymerize each layer 10 seconds.

Scrape to remove any residual coagulum ® Small quantities within capillaries are not a

Scrape to remove any residual coagulum ® Small quantities within capillaries are not a problem. ® Do scrape to initiate some moderate bleeding however ® Suture as usual.

De. Ox ®. With a Nano tip on the De. Ox syringe ® coat

De. Ox ®. With a Nano tip on the De. Ox syringe ® coat the outer surface of Ultra-Blend with a moderately thick layer of De. Ox. ® Set the Endo. Guide tip end into the De. Ox and polymerize for 10 -20 more seconds.