Department of Conservative Dentistry, Dental Institute, King's College, London, London, UK.
Int Endod J. 2013 Jan;46(1):88-97. doi: 10.1111/j.1365-2591.2012.02115.x. Epub 2012 Nov 9.
To describe a technique for the placement of apical Mineral trioxide aggregate (MTA) plugs in canals with wide apices.
A novel technique to fill root canals with an apical diameter larger than 0.4 mm is presented. The technique includes three main stages; three Thermafil carriers of increasing size, previously de-sheathed by removing the Gutta-percha coating, are selected to engage 1, 2 and 3 mm short of the apex. Their use allows the negotiation of acute curvatures and ledged canals. Subsequently, an MTA plug matching the apical gauge is pre-formed with a pellet block, placed and condensed using the modified carriers in sequence. The presented protocol for the management of teeth with apices of a diameter greater than 0.4 mm allows a favourable apical control of the MTA. Clinical cases completed using this methodology are presented.
MTA placement in teeth with wide apices was facilitated by using de-sheathed Thermafil carriers, to create an appropriate seal and stable platform for Gutta-percha backfilling or subsequent fibre post placement. The use of de-sheathed Thermafil carriers of different sizes allows predictable placement of pre-formed MTA plugs. Gauging of Thermafil carriers enhances control of the condensation phase to limit the extrusion of MTA.
描述一种在根尖宽大的根管中放置根尖矿化三氧化物聚合体（MTA）塞的技术。
本文介绍了一种用于填充根尖直径大于 0.4mm 的根管的新技术。该技术包括三个主要阶段；选择三个尺寸逐渐增大的Thermafil 载体，这些载体在去除牙胶涂层后预先去鞘，以进入根尖 1、2 和 3mm 处。它们的使用允许通过锐角和肩台进行协商。随后，用牙胶粒预成型与根尖直径匹配的 MTA 塞，使用改良的载体依次放置和压缩。该方法用于管理根尖直径大于 0.4mm 的牙齿，有利于 MTA 的根尖控制。本文介绍了使用这种方法完成的临床病例。
使用去鞘 Thermafil 载体来处理根尖宽大的牙齿，为牙胶的回填或随后的纤维桩放置创造合适的密封和稳定的平台，从而促进了 MTA 在根尖宽大的牙齿中的放置。使用不同尺寸的去鞘 Thermafil 载体可实现预成型 MTA 塞的可预测放置。Thermafil 载体的测量增强了对压缩阶段的控制，以限制 MTA 的挤出。
