Retreatment of endodontically treated lower second molar

Preoperative RVG

Postoperative RVG

Upper third molar root canal treatment

Upper third molar root canal treatment 

Patient came with third molar deep carious lesion with pain and patient does not want remove third molar , so we have started root canal with upper right third molar and here is the master cone x rvg with same tooth.

Patient is doing well after treatment.

Post Obturation RVG with upper third molar (wisdom tooth)

Post Obturation RVG with upper third molar (wisdom tooth)

Proerties and uses of MTA

Properties

Ø  ph initial 10.2 & rises to 12.5 when set

Ø  Highly alkaline

Ø  Setting Time is 2 hrs 45min

Ø  Compressive strength 40 mpa immediately

   & 70 mpa after 21days

Ø  MTA has calcium oxide which reacts with water to form calcium hydroxide

Ø  This causes formation of calcite crystals & & fibronectin

Ø  These act as initiating step for hard tissue barrier formation

Ø  Fibronectin promotes cellular adhesion & differentiation

Uses

Ø  Repair of perforation

Ø  Root end filling material

Ø  Pulp capping agent

Ø  Apexification

Ø  Apical third filling material

Ø  Obturating material 

Advances in material aspect MTA

Advances in material aspect

MTA

Ø  Mineral Trioxide Aggregate

Ø  Developed at Loma Linda University

Ø  By Dr. Mohammed Torabinejad

Ø  Initially developed as perforation repair & root end filling material .

Ø  Now finds wide application in endodontics

Material is
FDA approved & commercially available as
Pro Root MTA

Composition

Ø  Main molecules are calcium & phosphorous ions

Ø  Derived from components

   --tricalcium silicate ,

   --tricalcium aluminate ,

   --tricalcium oxide &

   --silicate oxide

Ø    Bismuth oxide imparts radio-opacity

Portland cements & MTA

Ø  Portland cements contain the same components as MTA except that MTA also contains bismuth oxide for radio-opacity 

APICAL THIRD FILLING , Calcium Hydroxide Apical Filling

APICAL THIRD FILLING

                                                               SimpliFill Obturation

Calcium Hydroxide Apical Filling.

Ø  Mainly used where the apexification is desired

Ø  It is thought to provoke the cementogenesis

Calcium-Phosphate Cement Obturation.

Ø  More recently, Harbert has suggested using tricalcium phosphate as an apical plug,much like dentin shavings and calcium hydroxide have been used

Ø  In testing the sealing ability of CPC when used as a root canal sealer-filler, the Paffenbarger group reported that in most of the specimens there was “no dye penetration into the filler-canal wall interface”

Ø  Two calcium phosphate compounds, one acidic and one basic, are unique in that when mixed with water they set into a hardened mass”—hydroxyapatite—the principal mineral in teeth and bones

Ø  Another possibility of using hydroxyapatite relates to the laser. A cross-linked collagen-hydroxyapatite mixture has been placed in the root canal and “melted” to place with a laser beam through a fiber optic.

Ø  Another possibility of using hydroxyapatite relates to the laser. A cross-linked collagen-hydroxyapatite mixture has been placed in the root canal and “melted” to place with a laser beam through a fiber optic.

Thermoplasticized Injectable Gutta-percha Obturation

Thermoplasticized Injectable Gutta-percha Obturation

SOLID-CORE CARRIER: MANUAL INSERTION THERMAFIL