Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2017-09-12, 09:26:18 | version 1.38.0
biomaterial for root canal filling technique | Fig. 1 Fig. 2 Fig. 3 visual aids to ensure the best chances of success. As a matter of fact, most of the general practitioners still use the single cone technique, as it is easy and quick to perform. Due to the introduction of nickel-tita- nium tapered instrumentation, gutta-percha cones fitting in taper and apical diameter with the last file used of a given system are now commercialised. The apical sealing ability of a single cone placed inside the root canal is achieved in such condition in the apical third, because of the concordance of the last file used and the gutta cone design. However, because of the non-circular shape of the canal section on the me- dian and coronal thirds, the cone does not perfectly fit into an ovoid canal. Hence, the remaining space is filled with sealer or voids (Angerame et al. 2012, Schäfer et al. 2013, Somma et al. 2011). On this basis, the single cone technique cannot be considered as reliable, since it provides an imperfect sealing. Bioceramic sealers may be considered as an inter- esting solution to make the obturation steps reliable and easier to achieve, potentially replacing the ZnO-eugenol based sealers. In this context, they might provide a tight and durable seal all along the entire length of the root canal without the need of any compaction procedure. Used in combination with an adjusted gutta-percha point and due to its excellent wettability and viscosity, the bioceramic could spread into any root canal irregularity and non-instrumented space. Furthermore, its adhesive properties to dentine and the reduced need of ex- cessive coronal tissue removal would provide an im- proved resistance to root fracture over time. This new class of materials could finally simplify the ob- turation stage, making it reproducible in every prac- titioner’s hands with a reduced learning curve. Above all, such technique could provide equivalent clinical results, if not even better, when compared to the gold standards. Notably among them, BioRoot RCS is one of these new bioceramic materials. The purpose of the present article is to describe its prop- erties and introduce a new way of considering this biomaterial, not as a sealer but as a true root canal filling material. If this material can be considered as reliable, we may assist in a true paradigm shift in the field of endodontics. Description of the technique and case reports From an operational point of view, the procedure is very similar to the single cone technique. How- ever, few indispensable differences justify the reli- ability of BioRoot RCS with such technique. Nota- bly, the single cone technique seals a cone alone. Instead, here the cone is employed as a carrier, which is left in place to allow for material removal in case of retreatement. Indeed, it must not be con- sidered as the core of the filling. The obturation is made by BioRoot RCS itself. Case 1 A pulp necrosis was diagnosed on tooth #16 of a 35-year-old female patient associated with chronic periapical disease (Fig. 1). The patient had experi- enced chronic sinusitis for over two years and received unseccessful medical treatments. After having shaped the root canal and obtained an appropriate tapered preparation, the canal was disinfected with a 3 % sodium hypochlorite solution activated with mechanical agitation (Irrigatys, ITENA). A final rinse with 17 % EDTA and a final flush with sodium hypochlorite were completed before fitting the gutta-percha cones. The canals were dried with paper points. The BioRoot RCS was mixed, following manufacturer recomman- dations and injected into the root canals with a spiral used with a low speed of rotation (800 rpm). Each gutta-percha point was poured into the mixed material to largely cover the surface of the cone. Afterwards, it was gently inserted into the root canal space until reaching the working length. The cone was cut at the entrance of the root canal with a heat carrier, and a slight plug was created with a hand plugger. The second and the third canal were filled in the same way (Fig. 2). The patient was referred to the general practi- tioner who restored the tooth with a bonded Fig. 1: Preoperative radiograph of tooth #16 of a 35-year-old female patient. Fig. 2: Postoperative radiograph after completion of endodontic treatment. Fig. 3: Six-month postoperative recall. roots 3 2017 49