Doug Kase
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event you may have encountered at one time or another in your endodontic
past or may yet encounter in your endodontic future is an overfill during
obturation of the canal either with gutta-percha or sealer. Employing
techniques that utilize lateral and or apical pressure with or without
thermoplastics increase the possibility of an overfill.
Over-extended gutta-percha or extruded sealer of
various types such as ZOE-based sealers can act as chronic irritants, preventing
the healing of periapical pathology or even causing apical breakdown that
did not have pathology to begin with. Thus, it is important to choose
the correct system of obturation that is consistent with a low probability
of overfill.
A single-cone technique utilizing AH-26 or its derivatives,
such as EZ-Fill cement, will minimize your exposure to an overfill.
Placing a single gutta-percha cone to a pre-measured length without apical
pressure as in the Simplified Endodontic Technique (S.E.T.), will eliminate
gutta-percha overfills and decrease the probability of apical sealer extrusion.
Since AH-26 and its derivative EZ-Fill cement are biocompatible, the minimum
amount of cement that may be extruded is well tolerated.
As illustrated by the series of radiographs at the
right, which show a maxillary molar obturated with EZ-Fill and a single-cone
technique, the body will resorb sealer extrusion. The one-month and
six-month recall films further indicate that the healing process is unimpeded.
03/20/2000
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FIGURE 1
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FIGURE 3
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