Composite root end fillings
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Composite Root End Fillings. Bond strength measurements are probably not important. Tendency to develop gaps is probably very important. Important and Non Important. Cytotoxicity.

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Important and non important

Bond strength measurements are probably not important

Tendency to develop gaps is probably very important

Important and Non Important


Cytotoxicity
Cytotoxicity

  • Rakich, D. R., J. C. Wataha, et al. (1998). "Effects of dentin bonding agents on macrophage mitochondrial activity." J Endod24(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 Traumatol8(3): 120-4.

  • Osorio, R. M., A. Hefti, et al. (1998). "Cytotoxicity of endodontic materials." J Endod24(2): 91-6.


Biocompatibility
Biocompatibility

  • Ozbas, H., M. Yaltirik, et al. (2003). "Reactions of connective tissue to compomers, composite and amalgam root-end filling materials." Int Endod J36(4): 281-7.

    Valux Plus composite (3M), Dyract and F2000 compomers and Oralloy amalgam were equally biocompatible.


Biocompatibility1
Biocompatibility

  • Zhu, Q., R. Haglund, et al. (2000). "Adhesion of human osteoblasts on root-end filling materials." J Endod26(7): 404-6.

    Adhesion of osteoblasts to composite same as MTA.


Microleakage
Microleakage

  • Fogel, H. M. and M. D. Peikoff (2001). "Microleakage of root-end filling materials." J Endod27(7): 456-8.

    There was no significant difference of microleakage between a dentin-bonded resin, Super-EBA, and mineral trioxide aggregate.


Retroplast
Retroplast

  • Retroplast is a Bis-Gma (Bisphenol A-Glycidyl Methacrylate) composite.


Retroplast1
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

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


Hemostasis with viscostat
Hemostasis with Viscostat

  • With Dento Infusor and rubbing


Extraneous coagulum is removed
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
Make apical preparation

  • Using Carr Retrotips



Retroplast2
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;7:118-125They 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
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
Surgi Tip

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


Pq1 or pq clear
PQ1 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
Suck excess resin out

  • Including from the depth of the preparation.

  • Luer Vacum Adapter wit surgi tip

  • Hold SurgiTip vacuum near root end for 15-20 seconds so to facilitate drying of solvent from bonding resin.

  • Careful with light (orange filter in scope)



Cure the bond resin
Cure the bond resin

  • 20 seconds

  • With EndoGuide attached to UltraLume II


Ultra blend with 30 gauge nano
Ultra-Blend with 30 gauge Nano

  • totally coat the inside of the preparation

  • just beyond the margin

  • Light cure using EndoGuide for 10 seconds.


Add increments of ultra blend
Add increments of Ultra-Blend

  • One or Two as needed.

  • Polymerize each layer 10 seconds.


Scrape to remove any residual coagulum
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.


DeOx

  • . With a Nano tip on the DeOx syringe

  • coat the outer surface of Ultra-Blend with a moderately thick layer of DeOx.

  • Set the EndoGuide tip end into the DeOx and polymerize for 10-20 more seconds.


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