The Complete Guide to Dental Gutta-Percha: It's use in Endodontics

Posted by webtiger 06/09/2022 0 Comment(s)

Have you visited the dentist's office? Have wondered what all the terminology in the dentist world means? Some common terms may include fillings, root canals, and crowns. But have you ever heard about gutta-percha? We'll help you understand what gutta-percha is used for and also consider it before heading to your root canal procedure.

Introduction

There is ongoing research for newer endodontic obturating materials to obtain better materials than the existing ones to fulfill the biological requisites along with predictable long-term treatment outcomes. Various materials have been tried and tested for filling the root canal.

The results were variable,  at times, and not fully satisfying. Of all the tested materials, Gutta-Percha (GP) has been the best way and the test of time for years. It is consistent clinical performance in various clinical situations across the world. As of now, no other materials can be considered for a replacement for GP in its various forms.

What Is Gutta-Percha?

Gutta-percha is a type of material used to fill a tooth after a root canal procedure. It is a plastic substance from a Malaysian tree called a Percha tree and is used as a permanent filling in root canals. During the root canal procedure, the tooth's damaged area, called the pulp, is removed, and the tooth's canals are cleaned out and disinfected before being filled and sealed. Gutta-percha is the thermoplastic filling material heated and compressed into our tooth's canal. It is sealed with adhesive cement.

What is the composition of Gutta-percha?

Gutta-percha is a trans-isomer of polyisoprene. If we see its chemical structure it is of 1, 4, trans–polyisoprene. The molecular structure of Gutta-Percha is close to that of natural rubber from Hevea brasiliensis, which is a cis-isomer of polyisoprene. Both have high-molecular weight with structured forms. The same basic building unit or iso-prenemer.

What is the manufacturing of Gutta-percha?

There is a series of “V” shaped or concentric cuts that are made on the bark for the collection of milky juice in Areca palm conic receptacles. The juice is just put into a pot and boiled with a little water. Juice is used to prevent its hardening on exposure to air.  And then boiled and kneaded under running water to remove its particles of wood and bark rolled into sheets to expel the air enabling it to dry quickly. Placed in a revolving masticator and heated until it is fit for every use. The chemical method of coagulation is the addition of a creosote mixture, alcohol, ammonia,  caustic soda, and limewater.

What are the techniques of gutta-percha obturation?

Gutta-percha is used for endodontic obturation purposes. It is used in both, alpha and beta forms, b form of gutta-percha was used for improved stability, hardness, and reduced stickiness. But the phase gutta-percha with low viscosity will flow with less stress, creating a more homogenous filling.

There are different forms of gutta-percha available:

Solid core gutta-percha points with standardized and non-standardized points called Beta form. Cold lateral condensation is used with warm vertical compaction. Thermoplasticized gutta-percha is usually available in an injectable form alpha phase.

Thermoplaticized gutta-percha systems provide special heaters used to heat the gutta-percha till the temperature when it flows.  Cold lateral compaction of gutta-percha is still the most widely popular for its work.

Lateral compaction of gutta-percha

In this technique, the objective is to fill the canal with gutta-percha points by compacting them laterally against the sides of the canal walls.

  • Lateral compaction of warm gutta-percha:

It is a simple modification to the cold lateral compaction technique to apply heat to the gutta-percha.

  • Single gutta-percha point and sealer:

The tendency to preparation techniques of greater taper, its points of matching taper may be used. The positive point of this technique is its simplicity.

  • Thematic compaction of gutta-percha: 

The frictional heat from the compactor plasticizes the gutta-percha and the blades drive the softened material into the root canal under pressure.

  • Heated gutta-percha carriers:

Alpha-phase gutta-percha is attached to get the rigid carrier. Most carriers are now made with plastic.

  • Vertical compaction of warm gutta-percha:

It is particularly useful in every situation such as internal resorption, and C-shaped canals.

What are the chemical phases of Gutta-Percha?

Gutta-percha polymer could exist in two distinctly different crystalline forms, which are termed “alpha” and “beta” modifications. These forms were “trans” isomers, with differences only in single bond configuration and molecular repeat distance, and hence could be converted into each other.

What are the physical forms of Gutta-percha?

Some of the physical forms of Gutta-percha are:-

  • Solid core GP points

  • Thermo plasticized GP

  • Cold flowable GP

  • Thermomechanical compactable GP

What are the physical and thermo-mechanical properties?

Gutta-Percha is a thermoplastic and viscoelastic material which is temperature sensitive. At different ranges of ambient room temperature, it exists in a stiff as well as solid state. It becomes brittle on long-duration exposure to light and air due to oxidation. It becomes soft at 60°C and then it melts around 95°C–100°C with partial degradation.

A decrease in temperature increases the strength and resilience and vice versa, especially when the temperature exceeds 30°C. The physical properties of tensile stiffness, strength, brittleness, and radiopacity depend on the organic (GP polymer and wax/resins) and inorganic components (zinc oxide and metal sulfates).

Zinc oxide increases brittleness, and decreases percentage elongation and ultimate tensile strength. An account of the tensile strength of GP gives a more reliable measure of its properties than compressive tests. Materials with the predominant property of ductility do not exhibit repeatable values for compression on account of resulting in complicated stress different patterns.

What are the Biological properties and tissue interaction?

  • Cross-reactivity

  • Connective tissue reaction

  • The reaction of the dental pulp

  • Scaffolds

  • gingival fibroblast and epithelial tumor cells reaction

Conclusion

The lateral condensation technique fills using one vital point and a number of accessory points placed in the root canal space with a sealer. It has been widely accepted and used clinically for a long time. A number of techniques for root canal filling using GP have been developed. Most of them make use of its properties of thermoplasticity and solubility with an organic solvent. There was a great surge in the development of root canal therapy as a specialty. Although various cleaning and shaping methods have since been introduced, gutta-percha remains to be the vital core material used for root canal fillings.

Related Product: TheDentalDealer Gutta Percha

 Note: The blog is just for educational purposes only

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