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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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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.
slide24
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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