BioRoot Flow Pediatric & Warm Technique Cases by Julianna Bair, DMD

The ease of use of the pre-mixed syringe makes BioRoot Flow great for pediatric cases.

12-year-old male, trauma to front teeth at school. Tooth #8 was intruded. Teeth #8,9 pulp exposures. Tooth #7 was non-responsive to cold test and EPT. Oral surgery surgically repositioned #8 and splinted the teeth. I treated teeth #7,8,9 with 2-visit root canal therapy with 1-month calcium hydroxide. I obturated the teeth with gutta-percha and BioRoot Flow Sealer. The ease of use of the pre-mixed syringe really helped in this case because the patient had a bad experience with the splinting and was really anxious in my chair. The pre-mixed syringe saved treatment time.

Warm Vertical Obturation Technique

Tooth #15 Retreatment with interim calcium hydroxide. RCT #15 was initially completed 2 years ago in another office. The patient presented to me symptomatic, with a throbbing ache in the upper left quadrant. Tooth #15 was +++percussion, +++palpation, and ++bite, mobility and probings were WNL. On the preop CBCT, there is an apical lucency associated with #15 and mucositis of the maxillary sinus. Prior root canal fills were short and inadequate. I initiated retreatment and achieved patencies on all canals. At the second visit 2 weeks later, the patient was asymptomatic and I obturated with gutta-percha and BioRoot Flow Sealer, with the warm vertical technique.

Advantages Warm Vertical Technique

I prefer the warm vertical technique because canals are not circular, hollow tubes. I like to sear down the gutta-percha with heat, compact the gutta-percha to fit the canal shape as best as I can, pushing the biocompatible and bioactive sealer into all the spaces within. I like the BioRoot Flow for my technique because it is not as radiodense as other sealers I have used, allowing me to differentiate between gutta-percha and sealer. This is illustrated in the case I shared above, the sealer puff of the palatal canal is less dense than the gutta-percha.

Here is another case I completed with BioRoot Flow. Tooth #31 RCT. The patient presents symptomatic +++percussion and +++cold test lingering. There was a crack across the mesial marginal ridge and buccal, but did not extend to the orifices. I completed the RCT and obturated with gutta-percha and BioRoot Flow Sealer, with the warm vertical technique. Again, I like how I can differentiate the sealer from the gutta percha at the apex of the distal root.