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Obturation of The Root Canal: Capital Endodontics

The document discusses various methods for obturation of the root canal including lateral compaction, warm vertical compaction, carrier-based techniques like Thermafil, and GuttaCore. It provides details on the GuttaCore technique including indications, clinical steps for shaping, size verification, sealer application, placement and removal of the gutta-percha core.

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105 views

Obturation of The Root Canal: Capital Endodontics

The document discusses various methods for obturation of the root canal including lateral compaction, warm vertical compaction, carrier-based techniques like Thermafil, and GuttaCore. It provides details on the GuttaCore technique including indications, clinical steps for shaping, size verification, sealer application, placement and removal of the gutta-percha core.

Uploaded by

newmexicoomfs
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Obturation of the

Root Canal
David Landwehr D.D.S., M.S.
Capital Endodontics
Madison, Wisconsin
Obturation

Means nothing without a


clean canal
Obturation
Four factors influenced success:
-Absence of a pretreatment periapical
lesion
-Root canal fillings with no voids
-Obturation to within 2.0 mm of the apex
-Adequate coronal restoration

Ng YL, Mann V, Rahbaran S, Lewsey J, Gulabivala K: Outcome of primary root canal


treatment: systematic review of the literature. 2. Influence of clinical factors. Int Endod
J  2008; 41:6.
Methods of Obturation
-little evidence exists to support one
method of obturation as being
superior to another

-prospective Toronto studies have


suggested that warm vertical
compaction may be superior to
lateral compaction; however,
definitive evidence is lacking
Farzaneh et al. 2004
de Chevigny et al. 2008
Peng et al. 2007
Techniques for Obturation
Lateral Compaction and Variations
Vertical Compaction and Variations
Hybrid Techniques
System “B” Obturation System
Obtura II Injectible System
ThermaFil™ Systems
EZ Fill System
Microseal System
SimpliFill™
GuttaFlow®
FibreFill™
EndoREZ™
Epiphany™- Resilon™
Next™
Real Seal™
Characteristics of an
Ideal Root Canal Filling
Gutta Percha
1,4 trans-polyisoprene
Beta
Alpha
Compaction to overcome shrinkage
during cooling
Biocompatible
Warm Vertical
Depth of Heat
deeper heat penetration
increased the quality of
GP adaptation to the
canal walls

thermoplasticized GP
extended 2 to 3 mm
apical to the depth of
heat penetration
Carrier Based
Obturation
Carrier-based obturation was first
described in 1978 and involved the
coating of endodontic files with
thermoplasticized GP

W. B. Johnson, “A new gutta-percha technique,” Journal of


Endodontics, vol. 4, no. 6, pp. 184–188, 1978.
®
Thermafil

• Low viscosity “alpha phase”for


flow
• Vented
• Evidence supports its superior fill
• Great for difficult anatomies
®
Thermafil
Advantage: carrier will compact
thermoplasticized GP and sealer
both laterally and vertically more
rapidly than other techniques

K. Clinton and T. Van Himel, “Comparison of a warm Gutta-


percha obturation technique and lateral condensation,”
Journal of Endodontics, vol. 27, no. 11, pp. 692–695, 2001.
Thermafil®

no evidence was discovered


which would indicate that the
Thermafil Plus obturation
system would result in
damage to the periodontal
ligament and/or the
surrounding attachment
apparatus
®
Thermafil
core techniques produced
higher gutta-percha content
than the Microseal, System B,
and lateral condensation
techniques

The lateral condensation


technique produced the least
gutta-percha content
Carrier based obturation

• Difficult to retreat or remove material


• Difficult to create post space
• Minimal shaping possible
®
Why GuttaCore
• Gutta-percha
• REQUIRES improved shaping, irrigation and shape
verification
• Easy to create post space and retreat
• Take the most scientifically researched filling technique
and make it better
• Solve the problem of gutta-percha melting when heated
®
GuttaCore Crosslinking

Crosslinkers bond the


molecular structure of
gutta-percha together, 
 Crosslinkers bond to the
keeping it from melting gutta-percha to provide
when heated subtle strength and
flexibility
®
GuttaCore
Indications
Long Narrow Canals
Curves
Ledges
Anatomy
GuttaCore Technique
Clinical Technique -
Shaping
• Recommend a minimal shape of 25/.06
• sizes 20-90
• .06 will usually match
• .04 one size smaller than MAF
• waveone primary 25 or 30

Blister Pack
(5 obturators + 1 Size Verifier)
(25 obturators + 5 Size Verifiers)
Clinical Technique – 

Size Verification
1. Irrigate the canal
2. Remove the GuttaCore™ size
verifier from the obturator
package
3. Confirm working length and
passive fit
4. Rotate in the canal 180°
5. Dry the canal with a paper
point
Clinical Technique – 

Working length

Calibration rings:
18, 19, 20, 22, 24

27 and 29
(on the obturator handles)
27

24
20
19
18
Clinical Technique – 

Sealer Application
1. Use a paper point to brush
a very light coating of
ThermaSeal® Plus Ribbon
sealer throughout the
canal
2. Use an additional paper
point to wick up any
excess sealer
1. Not Inflammatory
2. Fills Dentinal Tubules
3. Radiopaque
4. Retreatable
5. Excellent Working Time
6. Easy Use
Clinical Technique –
Placement
Place obturator into canal in one
smooth continuous motion
Do not use excessive force
Pressure should follow obturator
direction into canal

*Place paper point in any unfilled


canals until time for obturation
Slow
Placement

Levitan et al. 2003


J Endod 2003;29:505-08
Locking Pliers
GuttaCore™
HANDLE REMOVAL
– BENDS OFF

Remove the handle by bending


to either side of the canal wall
without affecting the seal
GuttaCore™
POST SPACE AND
RETREATMENT -
SIMPLIFIED

Create post space and


remove the obturation
material with
unprecedented ease
GuttaCore®
Clinical Technique –Removing Material

1. Use rotary file



of same size 

as last file 

taken to 

working length
2. Use solvent 

to soften 

gutta-percha around core

(if needed)
Conclusions: GuttaCore is
removed in less time from
moderately curved canals
with ProTaper files than
either thermoplasticized
gutta-percha or Thermafil
Plus materials.

(J Endod 2013;39:125–128)
How to use the oven
Obturator
Obturator Elevator Arm
Holder

Heating
Power On Chamber
Select Size
Cleaning Mode
(Indicator Light)

Cleaning Mode
(Press Both Buttons)
GuttaCore®
Keys to Success

Great Shape
Size Verify
Minimal Sealer
Slow Placement

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