obturation techniques

1. Obturation Techniques

2.  Classification
 Single cone technique
 Cold lateral compaction
 Chemically plasticized gutta percha technique
 System b technique
 Touch n’ heat
 Endotec
 Sectional compaction / sectional gutta percha technique
 Thermomechanical compaction
 Thermal lateral compactor
 Microseal system
 Microflow system
 J.S. Quick-fill.
 Automated plugger
 Ultrasonic plasticizing
 Thermoplasticized gutta- percha techniques
 Core carrier gutta percha techniques

3. Classification according to J.J. Messing and C.J.R. Stock (1988)
 Sectional
 Silver
 Titanium
 Gutta percha
 Amalgam
 Single Cone
 Gutta percha
 Silver
 Titanium point
 Multiple cone
 Cold lateral condensation
 Warm lateral condensation
 Hot vertical condensation
 Custom made
 Gutta percha with solvents
 Thermal compaction
 Injection molded thermoplasticized pastes alone

4. CLASSIFICATION OF OBTURATION TECHNIQUES
BY GUTMANN AND WHITHERSPOON (2002)
I. Solid core Gutta percha with sealants
A. Cold Gutta percha points
 Lateral compaction
 Variations of lateral compaction
B. Chemically plasticized cold gutta percha
 Essential oils and solvents
 Eucalyptol
 Chloroform
 Halothane

5. C. Canal warmed gutta percha
 Vertical compaction
 System B compaction
 Sectional Compaction
 Lateral / vertical compaction
 Endotec II
 Thermomechanical compaction
 Microseal System, TLC, Engine-Plugger, Maillefer Condenser
 Hybrid technique
 J.S. Quick-Fill
 Ultrasonic plasticizing

6. D. Thermoplasticized gutta percha
 Syringe insertion
 Obtura
 Inject R-fill, backfill
 Solid – core carrier insertion
 Thermafil and densfil
 Soft core and three Dee GP
 Silver points

7. II. Apical third filling
 Light speed SimpliFill
 Dentin – chip
 Calcium hydroxide
III. Injection or “Spiral” filling
 Cements
 Pastes
 Plastics
 Calcium phosphate

8. CLASSIFICATTION OF OBTURATION TECHNIQUES
 Based on number of core materials used
 Single cone technique
 Multiple cone technique
 Based on direction of compaction
 Lateral
 Vertical
 Based on temperature of core material used.
 Cold
 Warm

9.  Based on need of sealer
 With sealer
 Without sealer (Paste fills)
 Based on instrumentation of canal
 Requiring instrumentation
 Not requiring Instrumentation
 (Vaccum obturation technique – Portmann , Lussi 1994)

10. Single cone technique
 Basically involves the use of a single core filing material and use of sealer
 Earliest – diffusion technique
 Popularized – Silver cones
 Sealer weak interface
 Adhesive sealers
 E.g. Ketac Endo
 Sealer / gutta percha weak interface
 Abandoned
 Potential resurgence – Greater taper gutta percha cones
 Disadvantages
 does not totally obliterate the canal
 large gaps partially filled with sealer.

11. SECTIONALTECHNIQUE or SPLIT-CONE METHOD
 For teeth requiring post and core
 Materials used
 Silver
 Titanium
 Amalgam
 Gutta percha

12. SILVER, TITANIUM
 Used in 2 techniques
 Sectional silver or titanium technique
 Notching of snuggly fitting cone 6mm from the apical
tip
 Cementing the cone in root canal
 Rotating cemented cones to break

13. Messing precision apical silver or titanium points
 Tips – 3mm / 5 mm length
 In 12 ISO sizes
 Tips contain screw thread projections which engage the end of
the shaft
 Handle of the shaft rotated anti clockwise.
 Disadvantages
 No allowances are made for lateral canals in middle or
coronal third of root.
 Difficult to produce a hermetic seal with any of these
materials.

14. AMALGAM
 Small size amalgam carriers
 P.D.Messing spring loaded
root canal ‘gun’
 3 interchangeable tips
 Hill’s Endodontic amalgam
carrier
 Dimashkieh amalgam carrier

15. Dimashkieh carrier
 Flexible spring loaded
amalgam carrier with outer
diameter of 45, 60 or 80
corresponding to ISO sizes.
 With matching condensers
 Apical 3mm filled in several
increments
 Remaining space – filled
with laterally condensed
gutta percha

16. COLD LATERAL COMPACTION

17. CHEMICALLYPLASTICIZED GUTTA
PERCHATECHNIQUE

18. CANALWARMED GUTTA PERCHATECHNIQUES
WARM
VERTICAL
COMPACTION
LATERAL
/VERTICAL
COMPACTION
SECTIONAL
COMPACTION
THERMO
MECHANICAL
COMPACTION
LASERS
Traditional
heat carrier Electric heat carrier
Schilder’s Boston
technique
System B
Touch n’ Heat

19. WARM VERTICAL COMPACTION

21. SYSTEM B TECHNIQUE (Analytical
Technology, Santa Barbara , CA)
 by Stephen Buchanan in 1996.
 Also called the “Continuous wave of obturation
Technique”
 Variation of warm gutta percha vertical
compaction techniques using an electrical heart
carrier

22. Consists of
 System B Heat
source:
 Thermostatically
controlled
 Electric device that
supplies heat.
 It has continuous
/touch mode
 Temperature: 200C
 Period of time -
determined by the
operator.
Handpiece
holds the tips
connected to the heat
source by a cord
has a ring switch “which is
pressed to activate the
handpiece

23.  Pluggers /Tips
 available in
standardized sizes as
well as non
standardized sizes
 medium system B tip
0.06 taper
 medium /fine system B
tip 0.04 taper

24. Technique: done in 3 stages
 Cone fit + plugger fit in
 Down pack technique
 Backfill technique
 Cone fit:
 Appropriate sized gutta percha cone selected
 Must fit in last 1 mm and to full length
 Minimal outback 0f 0.5 mm of apical tip of
gutta percha cone

25.  Plugger fit in
 Plugger must stop at about 5-7 mm short of working
length (binding point)
 Stop attachment adjusted at coronal reference points
 Plugger removed and attached to heat sources .
 Requirements
 a smooth tapering funnel
 a apical construction
 appropriate master cone adaptaion

26.  Down pack technique:
 Primary point coated with sealer and pushed to
place.
 Heat source preset at 200C (power dial at 10)
 The tip is activated by pressing the ring switch
on the hand piece
 Cone is seared off at orifice
 Preheated plugger driven smoothly through
gutta percha to within 3-4 mm of binding point
in 2 sec
 Heat switch is released.
 Plugger continues to more apically
 Cold plugger held for additional 10 seconds under
sustained pressure
 To remove plugger
 Heat switch activated for 1 second followed by 1 second
pause.
 Cold pluger then quickly withdrawn.
 Radiographic confirmation

27.  Back fill technique:
 same gutta percha cone coated with sealer
and positioned in back fill space
 system B with the same plugger inset at
100C for ¼ second only
 cut heat
 immediately plunge plugger into backfill
cone and hold in place for 3-5 seconds
 another cone placed and procedure
repeated.
 Final plugging with a large cold regular
plugger.

28.  Advantages:
 Clinician can control the amount of heat in the heat
carrier by use of thermostat
 Heat once activated is constant and is concentrated at
the tip.
 Hence can soften gutta percha and apply vertical
pressure in one continue one motion (continuous wave
of condensation)
 Faster than traditional warm vertical candisation
 More accurate
 Temperature at the tip of heat carrier plugger is
monitered
 Disadvantages:
 Potential for extrusion
 Potential for thermal damage to periodontal
ligament and supporting alveolar bone.

29. System-B/Elements Obturation
Unit
(SybronEndo)
 coupled with a revolutionary
motorized extruder that makes
the backfill easy
 Buchanan Pluggers are available
in tapers of .04, .06, .08, .10 and
.12, to correspond with the
shapes created by GT Files.

30. Bee Fill 2in1

31. Touch n’ Heat
(Sybron Endo)
 an electronic device specially
developed for the warm gutta -
percha technique
 Battery or AC models are available
 Consist of
 Control unit
 Heat Carrier
 connected to the unit by a cord
 tips are interchangeable with those
of system B
 Uses:
 heat carrier
 sear off excess gutta percha
 preparation of post space
 pulp testing tool for a response to
heat

32. Touch n’ Heat
 Half the cost of System B
 Same basic set up but
without thermostat and
power control knob
 temperature is not
controlled
System B
 Relatively expensive
 Thermostatically controlled

33.  Disadvantages:
 Might lead to overheating the gutta percha
 Excessive heat may damage periodontal ligament in
teeth with narrow roots such as mandibular anterior
 Connected to the unit by a cord

34. Endotec(L.D Caulk / DentsplyMilford DE)
Developed by Howard Martin and Fisher
 Was engineered principally to compensate for the voids
created during the “cold welding” of cones during normal
lateral condensation
 Cordless handpiece with a specially designed battery
powered heat carrier used for both lateral and vertical
compaction , It consists of
 Endotec handpiece
 Cordless handpiece with an activator button
 Battery operated

35.  Endotec tips
 quick changes tips
 21mm long
 2 sizes
 larger tip (No.45)
 small tip (No.30)
 Autoclavable
 May be adjusted to any access
angulation
 Silicone stops can be placed
on tips for length control
 Temperature
 1700 C along the apical 16mm of
the tip in 5 seconds
 Takes 2 sec to cool down

36. Endotec
(L.D. Caulk / Dentsply)
 Powered by rechargeable
batteries
 Would sit in a battery
changing between use
Endotec II
(Medidenta Inc, Woodside
NY)
 Powered by 2 A.A size
batteries that will last for 8
weeks

37.  TECHNIQUE
 Heated plugger moved in a
clock wise motion with
activator button pressed
 Activator button is them
released
 Plugger is allowed to cool
 Removed from the gutta
percha with a counter
clockwise motion

38.  USES
 Warm lateral condensation
 Gutta percha removal during retreatment or post preparation
 Elimination of voids created during normal lateral condensation
 Zap and tap technique
 For obturating mandibular molars with C –shaped canals.
 Technique
 Preheating Endotec plugger for 4-5 seconds
 Insertion (Zap)
 Then moving the hot instrument in and out in short continuous
strokes (Taps) 10-15 times
 Plugger removed while still hot
 Followed by insertion of a cold spreader
 Insertion of additional accessory points

39.  ADVANTAGES:-
 Combines the best of the 2 techniques
 Lateral compaction – relative simplicity (ease and speed)
 Vertical compaction – superior density
 Tip can be used as both a plugger or spreader
 Heated tip is able to advance apically with minimum
exertion because of softening of master cone and mass
of gutta percha
 Creates less stress on root structure than does cold
lateral condensation
 DISADVANTAGES:-
 Increased time needed for obturation
 Spreader breakage and kinking
 Heaviness of the handpiece

40. Sectionalcompaction / sectionalguttaperchatechnique
 By Coolidge 1946
 Also called “Chicago
technique”
 (as it was promoted by
Coolidge, Blayney and
Lundquist – Chicago dentist)
 One of the earliest
modification of vertical
compaction method

41.  Technique:
 Plugger should fit the prepared tapered canal loosely and extend
to within 3 mm of the working length
 Primary gutta percha point is blunted and carried to place, to fit 1
mm short of working length
 3 mm of the tip of the point is clearly excised with a scalpel
 This small piece is then luted to the end of the warmed plugger
 Canal lined with sealer
 Gutta percha tip is warmed by passing through alcohol flame and
then carried to place
 Vertical compaction
 Variation
 Soften in chloroform or halothane
 Backfilling – using thermoplastized gutta percha

42. THERMOMECHANICALCOMPACTION
 introduced by McSpadden in 1979
 Principle
 heat generated by friction softened the gutta-percha
 design of the blades forced the material apically
 McSpadden Compactor
 resembled a reverse Hedstroem file, or a reverse screw
design
 made of stainless steel
 fit into a latch-type handpiece
 speeds between 8,000 and 20,000 rpm
 Used with regular beta phase gutta percha cones

44.  Advantages
 Canals could be filled in seconds
 Ability to fill very irregular spaces and teeth with resorptive defects
 Gave a dense fill
 Conservative use of gutta percha
 Disadvantages
 Fragility and fracture of the instruments
 In canals less than size 50
 Curved canals
 Overfilling
 Difficulty in mastering the technique
 Void formation
 ‘popcorn appearance’ of gutta percha
 Poor seal
 Use of speeds higher than recommended

45.  Gutta-Condenser
(Maillefer)
 Blunt tipped
 Flute depth reduced
 Less likely to fracture
 Engine Plugger (Zipperer)
 more closely resembles an
inverted K-file
 K file design with a reverse
twist

46. TLC / THERMAL LATERAL COMPACTOR
(Brasseler,Savannah,Georgia)
 Less aggressive
 Less prone to fracture
 Reduce the possibility of
extrusion through the apex

47. Disadvantages
 Cutting / gouging of dentin
 Breakage of compactors
 Potential for generation of excessive heat levels on external
root surfaces
 Overfilling extrusion of filling material
 Hybrid technique
 by Tagger et al. of Tel Aviv in 1984
 “backfilling” after the initial vertical or lateral compaction
is complete
 Technique
 first coat regular primary point with sealer and place
 spread it aside with a finger spreader
 followed by an accessory point

48.  then place an Engine Plugger
 size 45 or 50
 4 or 5 mm into the canal
 rotate it at 15,000 rpm
 After 1 second, it is advanced into the canal until
resistance is met and then slowly backed out while
still rotating
 Advantages
 Only 2 or 3 seconds are involved to completely fill
the canal
 Significantly less apical leakage with the hybrid
technique than with lateral condensation (Tagger
et al)
 Overfilling is also less likely (Saunders)
 Disadvantages
 Intracanal heat generated

49. NT Condenser (NT Co.
U.S)
 By McSpadden
 Principle
 slower-speed, lower-temperature
plasticized gutta-percha
 can be placed with less stress to the
tooth
 yet provide optimal obturation
 Modification of the original
McSpadden compactor
 Made of Ni-Ti
 Flexibility
 Can be used in curved canals
 Blunted blades and tip
 Prevents gouging

50.  Supplied as
 Engine driven
 Hand powered
 Used in a Ni-Ti
Matic handpiece
 slower speed
 1000 – 4000 rpm

51.  Used in a ‘Multiphase
Technique’
 Regular gutta percha
points
 Alpha phase gutta percha
syringes
 Phase I
 Low heat gutta percha
 Phase II
 High heat gutta percha
 Heated in a Phase II
gutta percha heater

52.  Technique
 Coat canal with sealer
 Primary gutta percha cone
placed
 Place condenser coated with
heat softened Phase I and
Phase II gutta percha
 Condenser rotated
 Flings gutta percha laterally
and vertically

53. MICROSEAL SYSTEM
(SybronEndo)
 By J.T. McSpadden, 1996
 Consists of
 MicroSeal condenser
 MicroSeal spreader
 MicroSeal gutta percha
heater
 gutta percha syringe
 Special formulation of gutta
percha
 Low-fusing gutta percha – as
cones
 Ultra low-fusing gutta percha –
in cartridges

54. Microseal Condensers
 engine-driven nickel-
titanium condensers
 reverse-helix design
 Avialable in
 0.02 taper
 Sizes 25 – 60
 0.04 taper
 Size 25
 Designed to be used in a 1:1
electric handpiece
 5000 – 7000 rpm
Advantages
 Made of nickel titanium
 Highly flexible
 Can reach apical 2-3 mm
During rotation
 Creates heat by friction
 Creates centrifuge forces
 simultaneously introduces
and condenses gutta
percha into the intricacies
of the canal system

55.  Angle between blades and
axis
 Varies from 600 to 300
 Decreases in amplitude from
handle to tip
More open in the coronal part
 Forces directed apically
 Acts as a plugger
 More closed in the apical part
 Forces directed apically
 Acts as a spreader

56. Microseal Spreaders
 Nickel-titanium
 enable even distribution of condensation
forces against the master cone, even
around curvatures
 Finger spreader
 0.02 taper
 Size 20, 25, 30
 0.04 taper
 Size 25
 Used with continuous rotational motion
 Engine spreader
 1:16 reduction handpiece
 300 rpm
MicroSeal gutta percha cones
 Low – fusing (alpha phase) gutta
percha

57. Microflow cartridges
 Ultra low – fusing (alpha phase)
gutta percha
 Single use cartridges
 allow for even heat distribution
 designed to unify with master cone
to form one, homogenous mass of
gutta percha
 tacky consistency
 allows for thorough adhesion to canal
walls

58. Microflow Syringe
 Autoclavable heavy-duty metal construction
 with large finger supports for easy extrusion of Microflow
Cartridges
MicroSeal gutta percha heater
 To warm gutta percha in cartridge
 Working temperature is reached within 45 seconds
 is thermostatically controlled
 maintain ideal working temperature of cartridges
throughout treatment

59. J.S. Quick-Fill (J.S. Dental Co.,
Sweden/USA)
 Uses precoated compactors
 titanium core devices
 resemble latch-type endodontic
drills
 in ISO sizes 15 to 60
 coated with alpha-phase
gutta-percha
 Advantages
 Does not need to be heated
 Easy to use
 Disadvantages
 Tendency for voids

60.  Technique
 fitted to the prepared root canal
 sealer placement
 spun in the canal with a regular low-speed, latch-
type handpiece
 friction heat plasti-cizes the gutta-percha
 compacted to place by the design of the Quick-
Fill core
 After compaction two choices
 the compactor may be removed and final
compaction completed with a hand plugger
 the titanium solid core left in place and
separated in the coronal cavity with an inverted
cone bur

61. AUTOMATED PLUGGER
Canal Finder Plugger (Laser Medical technology Inc. U.S.)
 Stepwise flexible plugger shaped much like a telescope
 Used in a Canal Finder Handpiece
 Delivers a rapid vertical stroke that varies between 0.3mm and 1.0mm
 Telescopic design catches in gutta percha and compacts it apically
 Accessory points are added in lateral voids produced

62. Ultrasonicplasticizing
 first suggested by Moreno from Mexico
 Cavitron ultrasonic scaler
(Dentsply/Caulk;Milford, Dela.) with a PR30
insert
 it could be used only in the anterior mouth
 place gutta-percha points to virtually fill the
canal
 then insert the attached endodontic instrument
into the mass
 activate the ultrasonic instrument (without the
liquid coolant)
 the gutta-percha is plasticized by friction and
advanced it to the measured root length
 final vertical compacton with hand or finger
pluggers

63. Concerns about the heat generated by this technique
 Cavitron PR30
 very little heat rise: 6.35°C in 6.3 seconds
 Enac ultrasonic unit (Osada Co.; Los Angeles, Calif.
and Japan)
 a 19.1°C rise in temperature
 took 141 seconds to plasticize the mass

64. LASERS
 To warm gutta percha by laser heat energy
 Argon
 Nd:YAG
 Carbon dioxide

 Anic and Matsumoto (1995)
 sectioned gutta percha segements
 pulsed Nd: YA G laser
 vertical condensation
 disadvantages
 required to much time
 Significant temperature increases on the external rot
surfaces

65. THERMOPLASTICIZED GUTTA- PERCHA
TECHNIQUES
OBTURA II- (Obtura/Sparton ; Fenton , MO).
 Also called the “ High heat technique”
 The principle used in this system was developed by a Yee
et al in 1977 at Harvard Forsyth
 Original prototype - Pressue Syringe
 Warmed in a hot glycerin bath to 160C
 Expressed through an 18 guauge needle
 Disadvantage:
 was clumsy to use
 not efficient

66.  Jay Marlin - Injection Molding
Device
 a) an injection molding
syringe
 b) electrical control unit
 The injection molding
syringe consisted of
 needle (18, 20 and 25 gauge)
 heating element
 barrel
 Plunger
 The syringe was fully
insulated
 Conventional gutta percha
cones were used to load the
syringe.
This was later
patented and
made
commercially
available as
Obtura (Unitek
Corp U.S)

67.  It consisted of
 obtura gun
 control unit
 Obtura gun: Also called
“gutta gun”
 It used a pistol grip syringe
 It used silver needles which
were more flexible and
retained heat to keep the
gutta percha soft.
 It used pellets of gutta
percha which were loaded in
a chamber of the obtura
gun.

68.  later modified and
commercialized as
Obtura II (Texceed
Corp. U.S)

69. Obtura (Unitek Corp.U.S)
 warmed at 160 C
 no digital display
 needle size-18 gauge
 uses gutta percha pellets
Obtura II (Texceed Corp U.S)
 digitally controlled
temperature 160-200oC
 digital display of
temperature reading
 disposable silver needles
reduced to
 20 gauge (approach 60 size
file)
 23 guage (approx 40 size file)
 25 gauge
 availability of gutta percha
pellets that can flow at
lower temperature.

70. Temperature
 160C- 200C
 depends on the gauge of the needle (smaller the
gauge of the needle higher the temperature
needed)
 extruded gutta percha has temperature of 62 o - 65
oC and remains soft for 3 min.

71. Technique :
 requires a minimum, size 40 preparation in body
of canal and continuously tapering funnel from
the apical matrix to the canal orifice
 needle and pluggers should reach within 3.5 to
5mm of the terminus (binding point) and fit
loosely at that point.
 compaction necessary – to close space and gaps
 compensates for shrinkage as gutta percha cools

72. USES:
 Complete or primary obturation
 Total
 Segmental (system S technique)
 Backfilling (sectional techniques)
 Managing canal irregularities
 fins
 webs
 cul de - sacs
 internal resorption
 accessory /lateral canals
 arborized foramina
 Combination techniques
 Master cone + Obtura injection around the point

73. ULTRAFIL 3D (Hygenic, Akron, OH, U.S)
 Is a ‘low heat’ injectable
gutta percha system
 Introduced by Michanowicz
and Czonstokowsky is 1984
 Consists of
 heating unit
 Metal syringe
 Cannules prefilled with gutta
percha

74. CANNULES
 Prefilled with GP
 Has attached needles
of 22 gauge (0.7 mm
diameter)
 Disposable
 Contains enough GP
to fill at least one molar

75. Available in 3 colours
 WHITE (Regular set)
 Setting time – 30 min
 Low viscosity, compaction not required
 BLUE – (Firm set)
 Setting time – 4 min
 Condensation possible but not required
 GREEN – (Endoset)
 Setting time – 2min
 Highest viscosity
 Must be condensed

76. METHOD
 Cannule is chosen and needle may be bent on the
barrel of the syringe
 Cannule is placed in the preset heater at 90 0C for
15min
 Cannule is placed in injection syringe during which
time it loses heat rapidly and drops to 70 0C – ready for
injection
 Has a 1 minute working time
 If required the cannule with the gun can be returned to
the heater for further softening
 May be reheated if unused at one sitting
 If left in the heater for more than 4 hours should be
discarded
 Injection procedure is technique sensitive trigger
should be squeezed slowly and steadily

77.  Material is injected into the
preparation at 420 – 450C
 Excessive pressure can
 Fracture the cannule
 Extrude gutta percha
through back of the
cannule

78.  Number of techniques
 Injection of entire canal
 With regular set / firm set
 Lateral and accessory canals
 Narrow and curved canals
 Around separated instruments
 Internal resorption
 Master cone and injection
 When an apical barrier is not present
 Master cone acts as barrier
 Either regular set / firm set used
 Injection and vertical compaction
 When apical stop is present
 Internal resorption
 Large canals and apexification

79.  Injection and lateral compaction
 When apical stop is present
 Trifecta technique
 Utilizes two viscosities of gutta percha to provide
flow with apical control
 Apical 1/ 3 – higher viscosity – SuccessFil
 Remaining portion- lower viscosity – Ultrafil
portion
 Retrograde filling
 firm set / endoset

80. INJECT – R FILL
(Moyco– Union Broach, Bethpage N.Y)
 By James B. Roane at the
University of Oklahoma in
1994
 Method of backfilling
 Consists of
 A miniature – sized
metal tube containing
gutta percha
 Plunger

81.  Heated in a
 Flame
 Electric heater (Heat R- Oven)
until gutta percha extrudes from the open
end
 Plunger is pushed forward which allows
for a single back fill injection
 The technique is rapid
 The canal orifice must be at least 2mm
in diameter
 Produces results similar to warm vertical
compaction

82. CORE CARRIER GUTTA PERCHATECHNIQUES
-PRINCIPLE
Gutta percha
Superior to silver
cores for sealing
Better tolerated
by the body
Silver cones
Ability to traverse
through small canals
more easily
Better length control
W. Ben Johnson
1978
(Baylor University)
Original hand made gutta-percha obturator
Thermoplasticized alpha-phase gutta percha on an endodontic file

83.  Very little interest was paid to this technique
 Then in 1989 it was commercialized in the form of
THERMAFIL
Thermafil
 A patented endodontic obturator
 Consisting of a flexible central carrier uniformly
coated with a layer of refined and tested alpha-
phase gutta percha

84. Carriers
 Made of
 Stainless steel (initially)
 Titanium (later)
 Plastic
 Have ISO standard dimension
with matching color coding
 Comes in sizes of 20-140
 Plastic carrier
 Made of special synthetic
resin
 Liquid plastic crystal
 Polysulphone polymer

85.  Liquid plastic crystal
 To make sizes 25-40
 Resistant to solvents
 Stiffer material
 Polysulphone polymer
 To make sizes 45 and above
 Can be dissolved in most
organic solvents
 Both plastics are
 Non toxic
 Highly stable polymer
 Well tolerated by the body

86.  The small plastic carriers (no 25,
30, 35) have an incrementally
greater taper
 Advantages of plastic core
 Allows post space to be made more
easily
 Retreatment of larger sizes performed
more easily
 Plastic carrier is cut off
 Heated instrument
 Long shank diamond stone
 Inverted stainless steel bur
 Prepi bur

87.  The gutta percha normally covers
the first two or three graduation
marks at 18, 19, 20mm and must be
cut away if required
 The gutta percha coating extends
beyond the length of the carrier by
1-2mm
 Previously the gutta percha was
moulded into a non standardized
thick parallel sided point
 More recently the gutta percha is
shaped into a tapering cone to
avoid wastage

88. Disadvantage of thermafil
oburators
 Cannot check by radiograph to
test if master cone fits properly
Size verification kit
 Collection of plastic obturators
only without the gutta percha
portion
 Size verifier of same as the
master apical file is chosen
 But if cannot verify the presence
of apical dentin matrix

89.  Initially metal obturators
 Heated over a Bunsen burner
 Rotated in the blue zone of the flame
 Until a shiny coat developed on the gutta percha
 Disadvantages
 The exact amount of heat; not easy to obtain (heat is not
controlled)
 If not heated sufficiently
 obturator did not go to place
 metal would push through the gutta percha
 made the entire unit unusable
 If overheated
 Causes gutta percha to conflagrate
 Becomes unusable

90. Therma prep oven
 Was needed with introduction of
plastic carrier
 Advantages
 Enables operator to have a consistently
reliable temperature of the obturator
 Better chance for smooth complete
placement
 Heating temperature -1150 C (constant)
 Heating time
 3-7 min depending on size of carriers
 Time was operator controlled
 Gutta percha sets in 2-4 minutes

91. Thermafil System Plus
 Itt is s the second generation
obturation technology
Thermafil plus obturators
 Redesigned with a slight
groove along 600 of the
circumference
 Allows for the backflow of
excess gutta percha
 Provides a pilot point / space
for carrier retrieval if
retreatment is necessary

92. Thermafil Plus size
verifiers
 Available in nickel titanium
 Can be heat-sterilized for
reuse
 Redesigned with flutes,
making them excellent for
minor apical shaping

93.  ThermaPrep Plus Oven
 uniform, predictable
 in less time
 from up to seven minutes
down to as little as 17 seconds
 The heating time varies
 depending on obturator size
 from 17 to 45 seconds
 regulated automatically
Gutta master

94. For post space preparation
 If a metal carrier is used
 Scored at the break - off point 4 or
5 mm from the apex
 Then twisted off
counterclockwise after obturation
 Prepost Preparation Instrument
(Prepi burs)

95. ONE –STEP
OBTURATORS
SOFT-CORE
OBTURATORS

96. Alpha Seal
 Provides -phase percha in
a syringe which is heated in
a special oven
 This system uses
conventional K files or
similarly sized carriers as
the carrier
 Similar in concept to the
thermafil system but in
contrast the clinician does
the “coating” of the carrier

97.  Advantages
 Use of master apical file or similarly sized titanium
carrier is more effective in resisting slippage and
displacement of the gutta-percha than pre-coated
carriers
 Ability to try in the carrier prior to obturation
 Ability to precurve the carrier prior to coating

98. SuccessFil (Hygenic corp,
Akron, OH)
 Consists of
 SuccessFil solid-core carriers
 Titanium cores
 Radiopaque plastics
 SuccessFil syringes
 Contain high viscosity alpha phase
gutta percha
 Heated in special heater owen
 It sets in 2 minutes
 SuccessFil heater

99. Technique
 The gutta percha syringe is warmed
 The carriers are inserted to the
measured depth into the gutta-
percha in the syringe and then
extruded by forcing the plunger
 Rapid withdrawl
 Creates a tapered shape
 Slower withdrawl
 creates a cylinder shape
 Inserted into the canal
 Core is separated by holding the
handle and severing the core shaft
2mm above the orifice

100. Trifecta system
 A method to block the apex
and prevent extrusion
 A plug of gutta percha at t
 he apical foramen
 SuccessFil
 remainder of canal
 Ultrafil
 Technique
 2-3mm of warm, plasticized gutta-percha is retrieved from
a SuccessFil syringe on the tip of a sterile endodontic file
one size smaller than the last enlarging file used at the apex
 File rotated counterclockwise and retrieved
 Plugger is used to compact
 Sectional injections of Ultrafil is used to fill the rest of the
canal and compacted

101. APICALTHIRD FILLING
WITH GUTTA PERCHA WITHOUT GUTTA PERCHA
- Lightspeed Simplifill obturator
- Fibrefill obturator
- Dentin chips
- Calcium hydroxide
- Mineral Trioxide aggregate

102. SIMPLIFILL
 Trial fit an Apical GP Plug™,
without sealer, to ensure a correct
apical fit.
 Use a GP Plug the same size as the
LIGHTSPEED Master Apical
Rotary (MAR).
 Set the rubber stop 2 mm short of
working length (WL) and slowly
advance the GP Plug apically
without rotating the handle
 The Plug should advance without
resistance until just reaching the
length at which the rubber stop is
set (WL minus 2 mm).

103.  Place Sealer in the apical 1/3 of the canal using a LIGHTSPEED
instrument smaller than the MAR, or a paper point.
 Re-set the rubber stop on the Carrier to the WL and coat the GP
Plug with sealer.
 Slowly advance the GP Plug until resistance is felt. Then,
condense (push) it vertically to WL without rotating the handle!
 After the Apical GP Plug™ is in place, release the plug from the
Carrier using a Counter Clockwise rotation.
 Do not push or pull while rotating the handle!
 Obturation is now complete if a post will be used.
 Load syringe with sealer.
 Insert the tip of the needle as far as possible into the canal to
eliminate air bubbles in the backfill.
 Slowly withdraw syringe while injecting sealer until the canal is
filled to the orifice.

104.  For the Backfill Cone, select a standardized
(ISO/ADA) cone the same size as the Apical GP
Plug™.
 Advance the Backfill Cone apically until it
contacts the Apical GP Plug™.
 Fill any remaining space with an accessory
cone(s).
 Remove excess gutta percha to the level of the
canal orifice.

105. Dentin Chip Apical Filling
 Based on premise
 dentin fillings will stimulate osteo or cementogenesis
 Advantages
 Prevents overfilling and confining the irrigating solutions and
filling materials to the canal space (El Deeb et al)
 lead to quicker healing, minimal inflammation, and apical
cementum deposition, even when the apex is perforated (Oswald et
al)
 Disadvantage
 dentin chips, if infected, are a serious deterrent to healing (Holland
et al)

106.  Dentin Chip Technique
 the canal is totally debrided and shaped
 Gates-Glidden drill or Hedstroem file is
used to produce dentin powder in the
central position of the canal
 These dentin chips may then be pushed
apically with the butt end of a paper point
and then the blunted tip of a paper point
 They are finally packed into place at the
apex using a premeasured file one size
larger than the last apical enlarging
instrument

107.  One to 2mm of chips should
block the foramen
 Completeness of density is
tested by resistance to
perforation by a No. 15 or 20
file
 The final gutta-percha
obturation is then compacted
against the plug

108. Calcium Hydroxide Apical Filling
 Cementogenesis, which is stimulated by dentin filings, appears to be
replicated by calcium hydroxide as well
 calcium hydroxide resorbs away from the apex faster than do dentin
chips
 Method of Use
 Calcium hydroxide can be placed as an apical plug in either a dry or
moist state
 Dry calcium hydroxide powder
 May be deposited in the coronal orifice from a sterilized amalgam
carrier
 The bolus may then be forced apically with a premeasured plugger
 Tapped to place with the last size apical file that was used
 One to 2 mm must be well condensed to block the foramen
 Blockage should be tested with a file that is one size smaller

109. Moist calcium hydroxide
 can be placed in a number of ways
 amalgam carrier and plugger
 Lentulo spiral
 injection from one of the commercial syringes loaded with
calcium hydroxide
 Calasept (J.S. Dental Prod., Sweden/USA)
 TempCanal (Pulpdent Corp.; Boston Mass.)
 calcium hydroxide deposit should be thick enough and well
condensed
 serve not only as a stimulant to cemental growth but also as a
barrier to extrusion of well compacted gutta-percha
obturation

110. Methods of gutta percha removal
 the adhesion of the gutta-percha is tested with a fine Hedstroem
file.
 file made to pass alongside the filling to the apical stop
 If the filling is really defective
 it may be lifted out by blades of the file
 with two fine files, one on either side of the gutta-percha
 If the gutta-percha is solid
 a flame-heated endodontic plugger
 an electrically heated Touch ’n Heat spreader
 repeatedly plunged into the mass, bringing out gutta-percha each time
 Peeso reamers, Gates-Glidden drills, and round burs should not
be used because they are easily diverted

111.  GPX burs (Brasseler; Savannah,
Ga.)
 designed specifically to remove
gutta-percha and will not engage the
dentin walls
 used in a low-speed handpiece
 features spiraled vents through
which gutta-percha extrudes
coronally as it is plasticized by
frictional heat

112.  Gutta-percha solvents
 The solvents commonly used are
 chloroform
 xylol
 eucalyptol
 Halothane
 a “well’’ is made in the center of the defective filling
 one or two drops of solvent are introduced from a
syringe or the beaks of cotton pliers

113. GuttaFlow
 is a new self-curing filling
system for root canals that
combines two products in one
capsule
 gutta-percha in particle form (less
than 30 µm)
 Sealer
 Injectable system
 time-saving obturation

114.  The capsule
 is activated by compression
 mixed for only 30 seconds in a
standard triturator.
 is designed for single use
mixing
 (one capsule can fill up to 3-4
canals)
 No contamination can occur

115.  Advantages
 Easier and faster to use
 no condensation required
 Radiopaque
 Dimensionally stable
 No heat – No shrinkage
 Better seal
 Biocompatible
 Easily removed for retreatment or post preparation,
no plastic carriers
 Economical
 no heating unit required

116. References
 Stephen Cohen 8 th and 9th edition
 Grossman 11th edition
 John I Ingle 5th 6edition
 John I Ingle 6th 6edition
 Franklin S Weine 6th edition
 www.sybronendo.com
 www.vdw.co.zam
 www.endoweb.com
 www.youtube.com


117.  Evaluation of Root Canal Obturation: A Three-
dimensional, In Vitro Study. joe 2009
 Filling Root Canals in Three Dimensions, Herbert
Schilder, JOE — Volume 32, Number 4, April 2006.
 Obturation of the Root Canal System- ARNALDO
CASTELLUCCI

118. Thank u