Earlier in domestic dentistry, filling of tooth canals with a special paste was practiced. The method was very unified and quite cheap. However, not every paste has the necessary fluidity to completely cover all the smallest channel holes. In addition, pastes contribute to the formation of voids, are subject to strong shrinkage and resorption, which causes the opening of channels and the development of an inflammatory process.
Also, substances can cause an allergic reaction. Due to all the negative properties, this method has not been practiced for a long time. It was replaced by innovative methods with a high level of efficiency.
Features of filling
Timely filling of the canals of the tooth at a professional level in the elimination of periodontitis and pulpitis is the key to the absence of complications in the future. The main requirement at this stage of therapy is a high degree of sealing reliability, which excludes the possibility of penetration of pathogens and the combination of the canal with the tooth.cavity and periodontium.
Since the root canals are narrow, an important step in preparing for filling is their expansion, as well as the improvement of the patency along the entire length.
It is difficult for a person who does not understand all the nuances of the dental profession to make a choice. Doctors do not always have enough time to tell the patient about all the advantages and disadvantages of this or that method. Therefore, the patient chooses the most suitable option in terms of duration and price, the use of which is not always advisable.
The article will discuss the filling methods existing in modern dental practice, the materials used, as well as the pros and cons of all methods.
Filling materials
Filling the root canals of teeth is the filling of the cleaned cavity with a special material. Since the root canals go deep into the gum, the filling material is in constant contact with the periodontium. Thus, canal filling is an operation to replace damaged tissues with artificial content.
Materials for filling the root canals of teeth must meet a number of requirements:
- They must have absolute tightness, protect the channel from infection.
- An important component is the absence of an allergic reaction, dissolution and decomposition in contact with periodontium and tissue fluid.
- Substances must have X-ray contrast. They should show up on the picture.clearly. Otherwise, it will be very difficult for the dentist to understand how well the filling procedure was carried out.
- If the manipulation fails, the filling should be easily removed from the root canal. In addition, when solidifying, the substance should shrink, while cavities filled with air should not form inside.
Over the years, root canal filling has undergone some changes. Many different methods have been tried. However, a universal material that would meet all of the above criteria has never been invented. That is why it is customary in modern dentistry to use combined formulations.
The main stages of preparation for the filling process
Filling the root canal involves a number of steps:
- All carious tissue must be removed. The dentist can also remove unaffected parts of the tooth to open free access to all channels.
- The nerve of the tooth is being removed. And filling the canals after that is possible. The pulp from the root canals and crown is also removed.
- The doctor determines the length of each canal.
- Using a special tool, the dentist goes along the entire length of the canals to the root tip, and also expands the diameter to the required value.
- A direct filling process is being carried out.
Determining the lengthroot canals
Quality filling of tooth canals involves filling the canal with material up to the top of the root. If the treatment is carried out poorly, then the infection penetrates into the gaps. Over time, the inflammatory process can spread to the very top of the root.
Most often, the cause of poor-quality tooth filling is the incorrect measurement of the length of the canal by the dentist. As a result, the doctor does not process its entire length.
If this parameter was determined incorrectly, periodontitis or a cyst may develop. As a result, the tooth will have to be removed. If the sealing is done again, the patient may begin to complain that after filling the canals, the tooth hurts when pressed. The development of an inflammatory process is not excluded. Therefore, the measurement of the root canal is an important part of the treatment. The dentist performs the procedure using special thin instruments. After the manipulation, a picture should be taken. This will allow the clinician to determine if the tip of the instrument has reached the root end.
Machining
It involves the process of expanding the root canal. Channels that have not undergone such processing remain narrow. They are inconvenient to fill with filling material.
Machining contributes to the expansion of the channel and the elimination of all irregularities and convolutions in it. The channel expands to the desired size.
There are two types of processing: manual and mechanical. The last wayinvolves the use of a special tip. Titanium pro-files are inserted into it. With the help of the tip, the pro-files are rotated in the canal, which contributes to the removal of chips from its walls and expansion. After such a manipulation, the process of canal filling is carried out.
Method of root canal filling with gutta-percha
How is root canal filling performed? Materials, as noted, are used differently. One of them is gutta-percha. It is firm and elastic.
Substance has excellent characteristics:
- low toxicity;
- biological compatibility;
- ability to completely fill the root canals when heated;
- easy to remove when needed.
There are a number of ways to fill canals with this material.
One Paste Method
In this case, the canal is closed with an elastic gutta-percha paste, which then hardens. This method causes complications in the vast majority of cases, so its use is inappropriate.
Single pin method
Tooth canal filling methods involve the use of a pin. After the root canal has been filled with paste, a similar gutta-percha device is inserted into it. This method is also fraught with complications.
Side condensation method
This is the most commonly used filling method, during which a sealer (sealant) is applied. The effectiveness of this method is directly dependent on how wellcleaned surface for manipulation.
Steps of side condensation
The main stages of the process are:
- Placing the center pin. Before this process, its selection is carried out depending on how much the channel is expanded.
- The filling area is thoroughly dried with paper pins.
- Next, the introduction of the sealer is carried out.
- The main pin is being inserted.
- The pin is pushed to the tooth wall.
- Additional pins are introduced, which are pre-lubricated with sealer.
- The gap is filled with material until it is completely sealed.
- Excess material being removed.
- Condensation of gutta-percha occurs at the mouth of the canal.
- Therapeutic procedures are performed in the oral cavity.
Varieties of pastes for canal filling
- Pastes containing zinc and eugenol. They are used to close the channels of all types of teeth. Their minus lies in the rapid washing out of the root. Also, such substances can cause irritation of dental tissue.
- Resorcinol. It has been used in dentistry for many years and has the ability to discolor the tooth.
- Forfenan. During the polymerization period, it heats up in the channel, facilitating the release of a substance penetrating into the tubules on the sides. The pulp becomes insoluble.
- Endomethasone - non-resorbable and irritating.
Key requirements for filling materials
KThe materials used for filling are subject to a number of requirements. Their presence ensures the reliability, durability and safety of the manipulations. Undoubtedly, it is difficult to foresee all the norms, but they should not be neglected when choosing a material for filling.
The main requirements include:
- sealing reliability
- no toxic substances;
- high biocompatibility;
- low shrinkage;
- easy way to sterilize;
- optimum level of sensitivity to x-rays;
- easy removal;
- no effect on tooth enamel color.
Filling canals with heated gutta-percha
Methods for filling tooth canals with gutta-percha are different:
- injection of gutta-percha in liquid form;
- continuous wave method;
- vertical condensation;
- introduction of gutta-percha through a syringe.
Thermophile filling method
The Thermofil system involves filling the canals of the tooth with hot gutta-percha. As the channel fills, the material cools down and becomes solid. This method has a high level of efficiency, but requires professional training of a doctor and a lot of money.
When warmed up, gutta-percha becomes elastic, which ensures tight closure of the dental canal system.
The tightness of the material reduces the likelihoodpenetration into the tooth infection. This system was invented after the tools appeared, through which it became possible to effectively process the channels.
Plastic pins together with hot gutta-percha are introduced slowly into the canal. Under pressure, the material fills all channels and branches. This method is called "bulk filling", as the entire root canal system is sealed.
The main advantages of the Thermofil system include:
- high level of tightness;
- minimal risk of infection entering the canal;
- low toxicity;
- no pain after filling;
- speed of the therapeutic procedure.
Use of depophoresis
This method makes it possible to treat teeth that have crooked and hard-to-reach canals, as well as to treat teeth that have already been filled. Also, the method makes it possible to seal the unit, in the channel of which there is a fragment of a dental instrument.
After the manipulation, the patient usually does not experience any pain.
Application of the silver pin
Metals have been used to seal channels for many years. Gold, silver and lead are widely used, as these substances have elasticity.
Silver posts have been used in dentistry since the 1920s. Silver was chosen for its antibacterial properties. Other than that, that's enoughsoft metal, which makes it possible to install the pin directly into curved channels.
To date, the antibacterial effect of silver has been scientifically proven. Pure silver is non-toxic and non-irritating. However, with prolonged contact of the argentum with tissue fluids, as happens when the pin is in the root canal, the metal is oxidized. Corrosion releases silver sulfate, which is toxic. This can provoke the occurrence of an inflammatory process in nearby tissues. In this regard, silver pins are practically not used in dentistry.
As for the physical characteristics of the mentioned metal, the pins from it are easily inserted into the root canal of the tooth, have a high level of contrast to x-rays. However, the devices do not provide high-quality sealing. They are recommended to be used in conjunction with root sealants.
If secondary treatment is required, these pins can be removed from the canal with ease. There are cases when manipulation is associated with a number of difficulties or cannot be performed at all.
What should I do if my tooth hurts after filling?
Many are interested: how long can a tooth hurt after canal filling? If for 1-2 days the tooth aches a little, then this is considered the norm.
If the patient experiences intense pain, this may indicate complications:
- presence of perforation of root walls;
- not good enough filling;
- findingtool fragment in the channel;
- failed antiseptic treatment;
- removal of filling material beyond the top of the root.
Therapy in case of complications
What to do if a tooth hurts after canal filling? When perforations occur, treatment begins with diagnosis using x-rays. This method makes it possible to visualize the state of the root lumen. If perforation has occurred, then the instrument, when pressed on the tooth, begins to fail, the gums bleed, and the patient complains of pain. In this case, therapy involves sealing the perforation with a filling material.
If a tooth hurts after filling the canals due to the presence of the remnant of the instrument in it, then in this case the tooth will lie down to be removed.
It happens that the filling was performed poorly. Therapy involves repeated cleaning and sealing.
If there are gaps in the root that do not contain filling material, then an inflammatory process may occur. In this case, you should not hesitate to contact a specialist.
When removing the material to the root apex, the treatment depends on the severity of the case.
Filling canals of milk teeth
Filling the canals of temporary teeth (milk) in children differs from the manipulation performed with an adult patient due to the peculiarity of the structure of the child's teeth.
When a temporary tooth shouldto be replaced by a permanent one, its roots begin to dissolve, only the upper part remains. Therefore, the root canals are subject to sealing with a special paste, which is also subject to resorption. It is this method that makes the eruption of permanent teeth unimpeded.
