Obturation 1

What to fill root

canal space

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 Gutta-Percha
Well tolerated by the periapical
tissue, adapts to the canal walls,
stable, non resorbable,
radioopaque, sterilizable,…etc.

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 Semi-Solid Materils
Gutta-Percha

• Gutta-Percha 19-22%
• Lack rigidity
• ZNO 59-75%
• Not adhere to dentine
• Wax
• Can be stretched
• Coloring Agents
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Sealers

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 Root canal sealers are
necessary to seal the space
between the dentinal wall and
the Gutta percha

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 Sealers are used in
absolutely minimal amount
(a few microns in thickness) to
fill the space between gutta
percha and the canal walls.

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For this reason, at least 90%
of the filling in every
obturated root canal should
be gutta-percha

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 Remember….

minimal amount

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 The use of sealers
containing
paraformaldehyde,
endomethasone are
unacceptable and must be
viewed as obsolete
(European Society of Endodontology, 2006).
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Paraformaldehyde (e.g., N2)

are considered neurotoxic,

cytotoxic, genotoxic and also
have significant allergenic
potential.
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 Endomethasone

often leads to an uncontrolled

local colonization of
microorganisms, which further
leads to enhancement of any pre-
existing periapical inflammation

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SEALER PLACEMENT

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 Investigators compared sealer
placement using a file rotated
counterclockwise, the lentulo
spiral , an ultrasonic file, and
coating the master gutta-percha
cone. Placement did not differ
with the various techniques
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Where is the ideal
endpoint for filling

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 instrumentation and
obturation should not
extend beyond the apical
foramen

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 no one can ensure sterility in any
given root canal space, the surest
chance of clinical success is gained
when root canal systems, in all of
their complexities, are filled to
their full apical and lateral
extents
Sjogren U, et al. Int Endod J. 1997;30:297-306.
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When to fill

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 You can fill when…

the canal can be dried and

the patient is not experiencing
swelling.

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 When patients present with
acute symptoms caused by
pulp necrosis and acute
periradicular abscess,
obturation is generally delayed
until the patient is
asymptomatic.
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How to fill ?
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 Continuous Wave
Compaction Technique

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 The continuous wave of
compaction technique was
developed by Dr Stephen
Buchanan in 1987 to
simplify the warmed gutta-
percha down-packing
technique.
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 It was developed by Dr
Stephen Buchanan in 1987

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  The  core  of  this  technique  
is  placing  Gutta  –  Percha  
cones  with  sealer  in  the  
canal  and  then  
compacting  them  using  
heated  pluggurs..
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26
 The adjusted gutta-
percha cone should
exhibit strong “tug back”
…

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 Tug-back
(resistance to displacement)
very important to
guarantee apical
seal
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Without Tug-back…
you could not
control apical seal
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 If you are not
confident of your
tug-back…change
the technique
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 After  the  adaptation  of  
the  master  cone…    

 
 

   
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 Gutta-Percha Cone
should be cut to a length
0.5 mm from the full
length

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 Take post
operative X-
ray..
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 In order for the method
to be most effective…
Gutta-percha Cones-taper
4% is used…. 34
 Limiting the tug back to
the apical extent prevents
premature coronal binding
of the gutta-percha

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Obturation Device
EQ-V
(META)

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Down-­‐Pack Back-­‐Pack

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 META

Continuous(wave(
Technique 38
 The largest tapered
plugger that fits to within 5
mm of the working length

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 The suggested heat
setting for the down
packing process is 230
degrees Celsius.

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Canal is dried with Paper
Points

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 Sealers are used in
absolutely minimal amount
(a few microns in thickness) to
fill the space between gutta
percha and the canal walls.

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 hand plugger is used to
condense the softened gutta
percha at the orifice level.

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The heat plugger is placed
against the master cone,
the switch is depressed,
beginning the down
pack…

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 The plugger
immediately heats at its
tip and starts moving
through the canal.

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when you reach
to reference
point…remove
your finger from
switch…

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the plugger is removed with
the gutta percha that was
displaced along its sides

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 Immediately following the
down pack of gutta percha…..

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 a hand plugger is used to
further condense the apical
plug of gutta-percha…

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After completion of down-
packing…..

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 a gutta-percha gun
should be used for the
back-packing procedure

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 EQ#V%FILL
The “gun”
contains a
chamber pellets
of gutta-percha
are loaded

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The canal walls are
coated with
sealer…
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Heat of gutta-percha in
the gun…

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Insert the heated tip to the
level of the down-pack… 55
 Wait 5-6 seconds after
inserting the needle into
the canal before pulling
the trigger

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 Gutta-percha is then gradually,
injected by squeezing the trigger
of the “gun.” 57
 Pause for 5 seconds…remove
the needle gently..use a plugger
in a very firm, sustained
condensation 58
 compaction should
continue until the gutta-
percha cools and
solidifies …
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60
You have
another
option….
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post 62