Is Hydraulic Condensation with BC Sealer a single Cone Technique (Friday Questions)
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- Опубліковано 20 сер 2024
- In this video Dr. Nasseh explains why Hydraulic Condensation using BC Sealer is different from the original Single Cone Technique.
You can watch this video on the RWE Website here: bit.ly/1UynL0i
This is by far the best endo Channel on UA-cam. I wish I had the option of whatching your videos 10 years ago when I graduated. It would have made my life a whole lot easier. I struggled with protaper Universal because everyone was using it back then. Never worked for me. My life got easier when I discovered biorace. Today I use hyflex files for apical part and biorace for upper parts of root canal. Anyway thank you for letting me steal some of your experience and knowledge. After over 8000 endos that i have completed I still learn from whatching your Channel. I am sorry for this rather lengthy comment
Thank you Petar for the kind words. Happy to hear about your success with your instrumentation! Best wishes!
I just had a rep from a major dental supply company tell me that bioceramics were bad, but everything you say in this video is what I have heard in residency and throughout my career. Glad to get confirmation that what I have heard up to now is correct. I love my BC sealer
You should have asked him where did he/she get their endo certificate from? LOL! Of course, not all bioceramics are created equal and there's a lot of poor materials; but there are good ones that work and are time proven. Cheers!
I just did 3 root canals today with this technique using BioRace Rotary with Endosequence GP cones. this technique is simple, and very good.
Dr. Nasseh i've been using this technique now for a little while (bc sealer and treated gutta percha cone) and I have to say I love it much appreciated and I love your channel thank you so much Greg
Hunter333444 happy to hear it's helping you. I've now done well over 5K cases of it since 2008 and can say unequivocally that it works! Remember that it's not a short cut to great cleaning and disinfection, just a shortcut to quick and easy obturation! Spend more time cleaning and disinfecting and less time filling! That's the idea. :) Cheers!
Was very curious about this topic but you addressed my concerns. Thank you Dr Nasseh!!
the only factor is BIOCERAMIC IS TOO EXPENSIVE! 2 gr of endosequence 153euros + IVA, total near 190 euros. Absolutely crazy, they MUST get down the price
I am so grateful I found your channel. ❤️🥰 keep doing the good work doctor!!
Thank you! Will do! :)
Dr. there are two technique for using Bioceramic sealer that i have come across, the conventional one where we only "coat the walls" using guttapercha similar to use of resin based sealers, and the other technique where we fill the entire canal with B.C sealer and then insert the guttapercha.
is the first technique a valid one ,"it's used mainly for economic reasons". Thank you.
Thank you Dr Nasseh!!
Many many thanks for your videos
Grazie delle informazioni.
Thanks Dr Jimmy Fallon
uh, I prefer Steven Colbert! ;)
@@AANasseh ok doc, i like your channel, best regards 👍🏼
Good day dr.Nasseh,, thank you so much for all the info. you present in this channel. I'm Endo resident R2, and I have assignment to talk about ( new trends in Endo), can you help me by some ideas.
Try Three Dimensional Instrumentation or Anatomic Shaping (shaping oval canals with round instruments.. etc.) There will be content added very soon to our website in this area. Good luck!
@@AANasseh reading this made me smile ..humour in endodontic preparation must be sustained...it's humorphilic!🌷
thank you
I am a dentist from india. I want to change to bc sealers seeing your tutorials. But I could not find it. Could u plz guide me as to where to get bc sealer and bc putty in india.
HS Dental systems
09867506060
Great , but would it seal the accessory or lateral canals ?
Thanks sir
Theorectically couldn't you use a GI like Fuji IX as your cement and wouldn't it function similarly to the biceramics?
using BC sealer you can leave cone 2mm short of apex?
Shahnam Amini No. We do not recommend that. We recommend that you take your BC Gutta percha cone to full length. This is the only way to make it retreatable!
awesome video
The price of these types of sealers makes them hard to use outside the US. In america people pay 1000$ for a root canal ...
I agree. The price is a barrier. Hopefully less expensive pure bioceramics will be in the horizon. Cheers.
@@AANasseh as demand increases I would hope the price goes down. I would certainly like to experiment with BC sealer when I graduate
Bioceramic sealers are extremely soluble with solubility extending over 10pc for every brand out there on weekly basis.There are plenty of anecdotal reports of teeth needing retreatments,unset cement seen at apex during periapical surgery ...I feel BC is more hype than anything else.Only sealers which have really low solubility are epoxy ones and maybe Roekoseal from Coltene.
Current solubility testing standards for self setting hydrophilic cements are incorrect. As a result, most studies using the current 6876 ISO standard and 57 ANSI Standards are invalid. I'm on the ADA materials and cements committee and everyone on the committee knows these standards have to be corrected since they were not designed for accurate measurement of this new generation of cements. The current ANSI and ISO solubility testing is designed for a different class of compounds and why it's unable to measure the solubility of these products accurately, especially the self setting bioceramics. This is a long conversation and not something for a UA-cam comment but essentially, the testing using stainless steel rings prevents these self setting materials to set and solubility testing is therefore done on unset cement, which is why it exhibits higher solubility. The self setting bioceramics (BC Sealer/TotalFill, etc.) were designed to use in Vivo and do not set in Vitro. This is why stainless steel rings are not the right vehicle to test the material as it won't allow water to get to the cement. It's basically the same environment as inside the syringe before injection and a vastly different environment than you find in the tooth.
I hope it make sense.
@@AANasseh hope its insoluble in vivo. Assure me please. I have recently started using it and while its the sweetest sealer to use I was wondering whether to retreat all the cases I have completed.
@@narad8165 I have completed more than 10,000 cases over the past 11 years and I'm more concerned about it than anyone else. So far, and I think a decade is a pretty good measure of time with many 10 year recalls, that hasn't happened. Over 20million cases have been done using this cement over past 11 years and there has been no report of pandemic problems (like there was with Resilon!) I think it's pretty safe to say if the correct technique is used that the sealer is not a problem.
Lastly, keep in mind cases fail not because of a sealer type but because of inadequate cleaning and shaping and removal of the biofilm. That's an important point to keep in mind.
Cheers.
@@AANasseh thank you for your prompt reply.
Thank you very much for such a great video, but does that mean the rule of "as minimum as possible" for sealers not applied for bc sealer?
yes doc you're right on spot. Bioceramic obturation is a "sealer based obturation" which means that almost everything has to do with the sealer, the gutta percha is just a carrier there..
Thank you doctor for the great scientific inform...
My question is since we depend merely on the sealer
Do we need tug back in the gutta percha as we did in the old ways of zinc oxide eugenol
Or just full working length tug back is not a mandatory?
Thanx
the way it was explained to me is that tug back is not so important as having a well-fitting cone. Tug back can be indicative of an appropriately sized/shaped canal/cone, but if you want to know how it is fitting, make a cone fit xray to see
Hello dr.Nasseh, perhaps the hydraulic condensation method pressented here as commercial to BC sealer and very much compared to thermoplastic gutta-percha obturation ,could you please give your own clinical indications for using hydraulic
?condensation as obturation method compared to the traditional lateral and vertical condensation methods
Thank you for attention
Hi Lior. The point of the Hydraulic Condensation is that it's Universal. You can use it instead of Lateral and Vertical Condensation. It's not a commercial technique. Yes, if you use the BC Cones it's better but it also works with regular GP Cones as long as you have the right amount of sealer in the canal. So, in my practice, I use HC in all the cases that I treat. I do 50-60 RCTs per month (used to do 100-120 but had to cut down due to time limitations for managing educational and academic obligations.) So, to be clear, I use HC on all my clinical cases! It does the same thing WWC and LC did. The point of the technique is that bioceramics have released us from the old thinking that you have to condense GP vertical and lateral to get rid of the sealer and those techniques are now replaced by Sealer Based Techniques with HC being the first technique of its kind. So, I hope it makes more sense now. :)
Cheers!
If we don't use normal go not bioceramic coated gp along with BC sealer will it affect the success of Rct specially when good coronal seal is established
Won't be as ideal since your sealer is not going to bond to your GP Cone. But it's still better than the lesser alternatives. You may still need to condense a little to pack the GP. Unfortunately no specific studies on that I can quote.
Hi! Can single cone obturation with BC sealer be used if instrumentation was performed with hand files?
Didn't you watch the video?! You still call it "Single Cone?!!" :(
HC can be used with hand instrumentation. But use additional confirmation cones on the side or just use lateral condensation with it.
Is single cone GP with BC sealer can be Retreated if its short of apex ? Can we remove it even if the GP cone is short ? What about remaining BC sealer ?
Thanks
Depends how long beyond the cone and what type of canal. If it's a few millimeters and past a curve it will be very difficult to remove. If it's a straight canal ultrasonic can remove it easily. The key here is to implement the technique properly and make sure you fit the cone to the apex and seat it to the end. It's the same thing with cementing a crown with resin cement. If one doesn't fully seat the crown and screw up the technique it's difficult to remove that crown after it has set! Like anything else, poor technique can ruin a good material! :)
can we mix bc sealer with another types of sealer?
+Ayman Mahfouth Absolutely Not!!
Is it expected that the hydraulic pressure will cause post operative pain when biting or touching the tooth?
No. That's mostly due to inflammation or infection. You first check the bite to make sure the tooth is not in hyperocclusion. Then if the tooth is sore beyond 6 weeks, it means there's some microscopic amount of microbes left at the root end. The options are either to redo or do a surgical approach, or monitor for up to six months, where some teeth may remains just "different" before the revert back to normal. Radiographs and CBCT will also help know if potential anatomy was missed or root canal therapy was done adequately.
@@AANasseh thanks a lot, I appreciate your quick response doctor
Thanks for the clear explanation. I watched a video where it stated that BC sealer will work the best when it is used in conjunction with BC coated cones. Can I use any type of cones to still get the benefits of the sealer? Would this still be considered hydraulic condensation?
Thanks
You can use it but you'll get only 50% of the benefits of bonding since it won't bond to the GP surface and will only bind to the dentinal walls. So, ideally and for the best benefits it should be used with the BC Cones.
+Real World Endo
Thanks for the quick reply. That leaves me with one more question. Would you recommend vertical condensation with a different sealer (AH plus) or hydraulic (single cone) with BC sealer without using the BC coated cone. The reason I ask this is because I have just switched to protaper next (ordered a lot) but I still want to try BC sealer. thanks
Jay Choi We obviously prefer HC; but Brasseler may make BC cones for other File Systems.
Thanks a lot, I will look into it!
It would be considered hydraulic condensation but you obviously won't get the best results. Is it still better than traditional sealers that way, yes. According to internal studies at Penn you get better initial sealing with the BC Cones. Down the line the sealer expands and that may help. It's the same idea as slanting your post vs. not slanting your post. Which is better? Obviously slanting it? Are there clinical studies that show a difference in success? Who knows! :) So, unless you have no access to BC Cones why take a chance? They are not expensive.
How do you cut back the single cone? I find when I use a heated instrument to cut back, as in cold lateral condensation, because the GP isn't as tightly packed sometimes the heated excavator sticks to the GP and tugs it out. Also I am finding that the Protaper matched cones are much wider than the files so they don't go to length as they should. I understand they have redesigned them because of this and I have yet to try the new ones. But which files and matched cone system do you recommend?
I've seen this as well. I go down a size and use a little more sealer. I always do a point fit first and trim the excess if necessary, but that's worked for me.
By having a strong tugback and a well heated instrument usually gp stays
Good morning, dr. Nasseh!
Thank you very much for your enlightenment !!
How do you think which technic is more advisable ,vertical condensation of guttapercha by injection (only by injection ) or BC sealer + single cone ?
Thank you again for your great job !!
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Good day. Can I use this single cone technique if I’m using reciprocation stainless steel files shaping up to a 40 and using a calcium hydroxide sealer (Sealapex)? Thanks.
hydraulic condenstaion is limited to non shrinkable and non-resorbable, washout resistant bioceramic cements. So, no, not with seal apex as it will shrink and washout over time. You need conventional complication techniques (vertical or lateral) with conventional cements.
Real World Endo thank you