Techniques of Root Canal Obturation

D E E P T H I P . R .I I I Y E A R M D S

D E P T . O F C O N S S E R V A T I V E D E N T I S T R Y & E N D O D O N T I C S

TECHNIQUES OF OBTURATION

INTRODUCTION

• Many methods: old & new• Plasticity/ flow of GP• Flow into the RC• Compress against the walls• Fill fine tortuous canals• Seal various exits• Compact into a solid core filling

DIFFERENT TECHNIQUES

1. Cold Lateral Compaction2. Warm Compaction (warm GP)A. VerticalB. Lateral3. Continuous wave Compaction technique4. Thermoplasticized GP injection5. Carrier- based GPA. Thermafil thermoplasticizedB. SimpliFill sectional obturation6. McSpadden thermomechanical compaction7. Chemically plasticized GP8. Custom cone

COLD LATERAL COMPACTION

• Most widely taught & practised• Sealer considerations• Spreader considerations• Master cone considerations• Radiographs

TECHNIQUE

Isolation & drying the canals with

paper pointsSelection of master cone

Checking for apical “TUG

BACK”

TECHNIQUE

Inadequate fit- beyond the apex• Tip cut off: reinserted primary cone fits snugly at the WL• Next larger size GP inserted & verified

Inadequate fit- short of the apex• Patency established to the corrected length• Another primary GP inserted & verified

At working length

TECHNIQUE

• Sealer manipulation• Canal coated

• Master cone inserted till WL• Spreader inserted alongside: level 1mm short of the WL- 10 to 60

sec

• Spreader disengaged• Placement of sequential accessory cones by lateral compaction

Endodontic Topics 2005, 12, 2–24

• Butt end of the GP: cut off with heated instrument• Warm vertical compaction: coronal GP• Chamber cleaned• Restoration placed

COLD LATERAL COMPACTION

Advantages • “ Deep spreader

penetration”: minimize apical leakage/ percolation• Positive dimensional

stability of the root canal filling • Less likelihood of

carrying filling material beyond the root apex

Limitations • Presence of voids• Increased sealer : GP

ratio• Less able to seal

intracanal defects & lateral canals• Less homogeneous

mass• Time consuming

JOE—Volume 32, Number 4, April 2006Endodontic Topics 2005, 12, 2–24

VARIANTS ON COLD LATERAL COMPACTION

• Warming spreaders before each use in a hot bead sterilizer

• Softening gutta percha with heat before insertion of the cold spreader

• Mechanical activation of finger spreaders in an endodontic reciprocating handpiece

• Application of an ultrasonically energized spreader• Application of an engine-driven thermomechanical

compactor which creates frictional heat and advances the material apically within the canal


STUDIES

• Bal et al. • Hembrough et al.• Wilson & Baumgartner• Better results with warm techniques: Collins et

al.• Da Silva et al.

WARM VERTICAL COMPACTION

• Herbert Schilder• Berg • Heated pluggers• Objectives defined: preparation for obturation

with this technique• Indications

TECHNIQUE

•

Primary non std. or greater taper

GP cone corresponding to

the last instrument

Canal coated with thin layer of RC

sealerPrimary GP cone inserted to WL

TECHNIQUE

•

Coronal end of the cone – cut off

wih a heated instrument

“ Heat carrier”: plugger, electric

heat carriers: orced into the

coronal 3rd of GP

Coronal GP seared off by the plugger as it is

removed from the canal

TECHNIQUE

Vertical pressure with condenser/

plugger of suitable size

Forces the plasticized

material apically

Alternate application of heat carrier &

condenser: 3D FIll



Pulp Canal Sealer, Kerr



Advantges • Irregularities &

accessory canals better filled• Excellent seal of the

canal laterally & apically

Disadvantages • Time consuming• Risk of vertical fracture

from undue force• Less length control• Overfiling with GP or

sealer that cannot be retrieved from periradicular tissues

• Difficult in curved canals

WARM LATERAL COMPACTION

• Warm GP hybrid technique; Martin• Master cone placed• Lateral compaction: heat carriers • Unheated spreader & accessory cones• Endotec II, Endo Twinn, EI DownPak

WARM LATERAL COMPACTION

Endo Tec II:• Liewehr et al. Increased weight of GP: 14.63%• Kersten et al. • Collins et al.

Endo Twinn:• Kulid et al.

JOE—Volume 32, Number 8, August 2006

CONTINUOUS WAVE COMPACTION TECHNIQUE

• Buchanan• Greater hydraulic forces• Tapered pluggers: System B


Master cone selected &

plugger prefitted: 5-

7mm from WL

System set in Touch mode:

200oC

Cold plugger initillay placed

against GP; firm pressure


Plugger rapidly moved: 1-2 sec within 3mm o binding point

Heat inactivated; firm

pressure maintained: 5-

10 sec

Cooled; 1 sec heat application

separates plugger

ppdentistry.com

ppdentistry.com

ppdentistry.com


• Mean temperature change near CEJ: 4.1oC• Silver et al. Elevation > 10oC• Flore et al. temperature setting > 250oC-

hazardous

THERMOPLASTIC INJECTION TECHNIQUES

• Harvard/ Forsythe Institute: 1977• Obtura III• Calamus• Elements• HotShot• Ultrafil 3D- 90oC• Obtura II- 160oC

OBTURA III

• Hand-held gun• Ag needles• Control unit

OBTURA III

Canal dried, coated with sealer

GP preheated: needle within 3-5 mm of apical prepaartion

Gradually & passively injected; compacted with pluggers dipped in alcohol

OBTURA III

• Length control: Hybrid technique• Tani- Ishii et al.• Weller et al.• Jacobsen et al.

CALAMUS

• Cartridge system : 20 & 23 G needles• Control of temperature• Flow rate• Pluggers• 360 degree activation switch

ULTRAFIL- 3D

• GP cannulas• Heating unit• Injection syringe• 3 types of Cannulas: Regular set, Firm set &

Endoset

ELEMENTS

• System B heat source & plugger• Extruder • 20, 23 , 25 gauge needles: GP• 20, 23 gauge: Real Seal

HOTSHOT

• Cordless thermoplastic device• 150oC to 230o C• GP or Resilon• 20, 23, 25 gauge needles

GUTTAFLOW

• Polydimethyl siloxane with finely ground GP• Capsules• WT: 15’; curing: 25- 30’

CARRIER- BASED GP

• Thermafil• Profile GT obturators• GT Series X Obturators• ProTaper Universal Obturators• Successfil• SimpliFill• JS Quick-Fill

THERMAFIL

• GP with a solid core• Metal core & coating of GP• Advantages• Disadvantages• Obturators: correspond to file systems• Sealer: required

THERMAFIL

Canal dried; light coat of sealer applied.Carrier set to predetermined lengthdisinfected

Paced on heating deviceRetrieved & inserted into canal : 10 secRapid insertion: enhances obturation

Position verified radiographically2-4 minutes: coolingResection of carrier

THERMAFIL

THERMAFIL

• Advantage• Disadvantage • Pro Post drills• Retreatment• Plastic carriers- non toxic material

SUCCESSFIL

• Associated with Ultrafil 3D• GP: syringe• Carrier inserted into syringe• Sealer coated on canal walls: carrier with GP

paced

TRIFECTA TECHNIQUE

• Hygenic Corporation• Succesfil GP injected onto sterile K-file tip• Carried into most apical part: turned counter-

clockwise• Soft GP condensed• Remainder: Ultrafil GP• Modified Trifecta: rest with lateral condensation

Chandra & Shetty. Endodontology.

SIMPIFILL

• LightSpeed Instruments• Apical 5mm GP plug• Carrier: MAF• Seated & carrier removed• Lateral compaction/ thermoplastic

JS QUICKFIL

• Alpha phase GP coated Ti cores• ISO: 15 to 60• Spun into the canal at low speed• Maybe left behind or removed

THERMOMECHANICAL COMPACTION

• McSpadden compactor• H- file in reverse• Slow speed handpiece• Advantage• Disadvantages• Microseal condensers

SOLVENT TECHNIQUES

• CHCl3 , Eucalyptol, xylol.• Disadvantages • Callahan- Johnson technique• 95% ethyl alcohol solution, chlorosin solution• Nygard- Ostby technnique

JOE — Volume 32, Number 4, April 2006

SOLVENT TECHNIQUES

• A small amount of chloropercha is streaked onto the walls of the dry root canal with a fine root canal spreader or other suitable instrument.• The apical third of the master cone is dipped into

the chloropercha paste, and the entire master cone is gently repositioned into the canal. • The material in the canal is now forced laterally

with root canal spreaders, making room for additional GP cones which are added repeatedly in sufficient number to provide a dense root canal filling.


• Each piece of GP blends with the GP & chloropercha already in the canal to form a homogeneous mass which conforms quite adequately to the configuration of the root canal system.• The lateral pressure on the plastic GP–

chloropercha mixture automatically imparts a small vertical component of pressure, owing to the shape of most prepared canals. • The entire mass moves apically during lateral

condensation with any solvent technique.


SINGLE- CONE OBTURATIONS

• 1960s: ISO standardization• Circular, stop preparation in the apical 2mmof the

canal: single GP, Ag, sectional Ag or Ti• Cemented in place: thin & uniform layer of

traditional sealer• Ergonomic matched file & cone


CONCLUSION

• Wide array of options and materials• Wisely chosen & applied depending on the clinical

situation

Thank you!!

Techniques of Root Canal Obturation

Health & Medicine