Enhancing Apexification with Bioceramic Putty and the Zemurg Shavit Pellet Former

 

Introduction

Apexification aims to create an apical plug that seals the open apex and improves the likelihood of a successful root canal treatment. One innovative technique for achieving this is the use of a pellet former, in this case, the Zemurg Shavit Pellet Former, in combination with One-Fil bioceramic putty. This article explores the procedure to create a stable apical plug for apexification.

The Role of Bioceramic Putty

Bioceramic putty is a cutting-edge endodontic material with remarkable biocompatibility and sealing properties. It is used to create a stable apical plug to seal the open apex of a tooth effectively. The success of this technique depends not only on the properties of the bioceramic putty but also on the precision of placement.

The Zemurg Shavit Pellet Former

The Zemurg Shavit Pellet Former is a remarkable instrument designed to facilitate the precise placement of bioceramic putty in apexification procedures. To use this instrument correctly, follow these steps:

Step 1: Preparing the GP Point

  1. Cut a GP (Gutta-Percha) point to the relevant apical diameter 

  2. Note that the width of the pellet former is 3.5 millimeters.

  3. Cut 3.5 millimeters off the end of the custom GP point. This measurement ensures that the bioceramic plug and GP point are the working length of the tooth.

Step 2: Loading the Pellet Former

  1. Load the pellet former with your bioceramic putty of choice. A good option is One-Fil PT

  2. The pellet former is loaded to the desired diameter, which, in this case, is also 90.

Step 3: Placing the Initial Pellet

  1. Use a GP point to pick up the pellet former. The precision of this process is crucial for success.

  2. The result is a GP point with 3.5 millimeters of the pellet on its end. This GP point serves as a guide for placing the pellet to the correct working length of the tooth.

Step 4: Verifying Placement

  1. After the initial pellet is placed, take a radiograph to confirm whether it is at the correct working length and if the volume is sufficient. Ideally, there should be approximately 5 millimeters from the apex.

  2. In cases where the initial pellet does not provide the desired volume, further obturation with bioceramic is required. The pellet former can also be used to create generic-sized pellets to aid in placement.

Step 5: Compaction and Final Placement

  1. Once the bioceramic putty is packed into the pellet former, these pellets can be easily picked up with a plugger and placed within the apical third of the tooth.

  2. Remember, gentle compaction is essential to ensure a proper seal and the success of the apexification procedure.

Conclusion

This technique  is a valuable approach to achieving a stable apical plug for apexification. It offers precision, excellent sealing properties, and the potential for customized placement. This method ultimately contributes to better infection prevention and a higher success rate for root canal treatments. Dentists and endodontists who utilize these innovative tools and techniques can provide their patients with optimal outcomes in apexification procedures.

 

This video is made by an excellent Endodontist Dr Samuel Johnson, You can follow his channel for more videos like this on (13) I Love The Pulp - YouTube

Shalini and Maneshs visit have got me on to getting as many Onefil sealer cases back in for review as I can.

If anyone can share review cases with me too comment below and that would be really appreciated. I’ll try to build a library of cases that we can share and publish some data.

I rarely get cbct reviews of cases but this was a fortuitous case today as referred for another assessment.

Nice osseous healing.

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Bills case here is a lovely example of the biocompatibility of the material and ability of the body to heal and to form bone around and with the material. It doesn’t resorb like some other sealers, it’s sets hard and has a nice flow.

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Nice case from David

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Another beautiful case from the superbly talented Mitra. 6 months and excellent healing with onefil

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Previously accessed teeth resulted in significant loss of coronal dentine.
Excellent healing with Onefil. The sealer doesn’t resorb like some sealers and small excess while not aimed for shouldn’t affect healing as material is so biocompatible. Time for cores to be done asap!!

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Lovely Result from Anand

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Lesion on palatal root with small extrusion

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