Success in Endodontics was originally based on the triad of debridement, thorough disinfection and obturation with all the aspects equally important. At present, successful root canal treatment is based on broader principles, these includes Diagnosis and treatment planning Knowledge of anatomy and morphology Concepts of thorough debridement Obturation of the root canal space Finally the coronal seal / restoration. A meta- analysis of factors influencing the root canal treatment found that the following four factors influenced success: Absence of pre-treatment periapical lesion / Co-existing pathology Root canal fillings with minimal or no voids Obturation to within 2.0mm / or as close as possible to the radiographic apex An adequate coronal restoration.

1. V I O L A S O L O M O N
Panineeya Institute of Dental
Sciences and Research Center
Hyderabad – INDIA

2. V I O L A S O L O M O N
OBTURATION OF THE
ROOT CANAL SPACE
Part - 4
Dr. Raji Viola Solomon., MDS., MFDS., RCPS (Glasgow)
Department Of Conservative Dentistry & Endodontics
Panineeya Institute Of Dental Sciences And Research Center
Hyderabad
INDIA

3. V I O L A S O L O M O N
Classification of obturation
techniques
Individual obturation techniques

4. V I O L A S O L O M O N
• Negotiating curved roots with pluggers
can be difficult because of varied degree
of curvature and mismatch between
canal diameter and plugger diameter at
various levels of root canal.
• In these situations, contemporary
techniques like gutta-percha carrier-
based obturation and thermoplasticized
injection technique alone or along with
warm vertical compaction in apical 3
mm of root canal can be performed to
enhance gutta-percha flow while
maintaining the predictability and ease
of use of traditional lateral compaction.
4Dr. Raji Viola Solomon

5. V I O L A S O L O M O N
Currently 2 types of flowable gutta-percha obturating systems are
popular in Endodontics.
1. Injectable obturating systems like
• Obtura II
• Ultrafil
• Calamus obturating system
• Elements obturating unit (SybronEndo).
2. Carrier based gutta percha systems like
• Thermafil
• Successfil
5Dr. Raji Viola Solomon

6. V I O L A S O L O M O N
COMPONENTS
• The Obtura system consists of a
handle-held “gun” that contains a
chamber surrounded by heating
element into which the pellets of
gutta-percha are loaded
• Electrical control unit
• Digital read out temperature control
ranging from 160°C to 200°C
• Flexible silver needle is used for
delivery of plasticized gutta percha
into the canal.(20 guage -60 file and
23 gauge -40 file)
6Dr. Raji Viola Solomon

7. V I O L A S O L O M O N
Obtura ii
• Martin introduced obtura
and later modified to
presently available obtura
II
• Obtura II, introduced by
Yee et al in 1977 to
improve the homogenicity
and surface adaptation of
the gutta percha and have
been proved to
significantly better than
lateral condensation in
replicating root canal
7Dr. Raji Viola Solomon

8. V I O L A S O L O M O N
8Dr. Raji Viola Solomon

9. V I O L A S O L O M O N
• Regular Beta phase gutta
percha is used with this system
• Heated to approximately 160
to 200 °C.
• Thermoplastic gutta percha
extrudes from the needle tip
with a temperature ranging
from 62- 65°c
9Dr. Raji Viola Solomon

10. V I O L A S O L O M O N
INDICATIONS
• Curved canals
• Canal irregularities such as
Root canal webbings/cul de sacs
Internal resorptions
C shaped canals
Accessory/ lateral canals
• Back filling of gutta percha
10Dr. Raji Viola Solomon

11. V I O L A S O L O M O N
Prerequisites• “Continuously tapering funnel from the apical foramen to the
canal orifice.”
• A definitive apical matrix is also important. This constriction
prevents the extrusion of filling material into the periapex.
• Preparations to size 25 or 30 files at the apical terminus,
tapered to a size 60 file at the coronal orifice
• Warn against the development of the “coke-bottle” canals so
frequently seen following Gates-Glidden canal preparations
• The tapered preparation enhances the flow of the plasticized
material, whereas the coke-bottle preparation negates the
flow
11Dr. Raji Viola Solomon

12. V I O L A S O L O M O N
Technique
12
Gutta percha preheated in the gun
Needle is positioned in the canal within 3 to 5 mm of apical preparation
Gutta percha is passively injected without any apical pressure
Needle backs out of the canal as the apical portion is filled.
Plugger is used to compact the gutta percha.
Compaction should continue until the gutta percha cools and solidifies
to compensate contraction
Dr. Raji Viola Solomon

13. V I O L A S O L O M O N
13Dr. Raji Viola Solomon

14. V I O L A S O L O M O N
SECOND METHOD
• Another popular obturation method used by many
endodontists is to initially place a fitted master point to the
apical terminus and follow this with the Obtura needle-tip,
depositing a bolus of warm gutta-percha around the point.
• This is immediately compacted vertically and laterally.
• More thermo plasticized gutta-percha is then added and
compacted.
• This technique will better ensure apical closure without
overfilling.
14Dr. Raji Viola Solomon

15. V I O L A S O L O M O N
SEGMENTAL FILLING OR
COMPLETE FILLING
• Research by Johnson and Bond at Louisiana State University
showed no difference in dye penetration in canals that were
backfilled with 1 mm, 4 to 5 mm, or 10 mm increments.
• However, the clinician probably has better control of moving
and compacting guttapercha when segmental filling is done.
15Dr. Raji Viola Solomon

16. V I O L A S O L O M O N
ADVANTAGES
• Significantly better than
lateral compaction method
• Less microleakage around
filled root canals – better
adaptation
• If smear layer is removed
properly this system may
push gutta percha and
sealer into the dentinal
tubules
DISADVANTAGES
• Potential for extrusion of
gutta percha and
• Prolonged heat may damage
the periodontium
• More difficult to remove in
cases of retreatment
16Dr. Raji Viola Solomon

17. V I O L A S O L O M O N
Calamus flow
• The Calamus Flow Obturation Delivery
System has a hand piece and activation
cuff to enable control of the flow and
temperature of the gutta-percha into the
canal.
• The temperature of the thermoplasticized
gutta-percha as it is extruded through the
needle tip ranges from 38°C to 44°C.
• The gutta-percha remains able to flow
for 45 to 60 seconds.
17Dr. Raji Viola Solomon

18. V I O L A S O L O M O N
The Hotshot Delivery System
(Discus Dental) is a cordless
thermoplastic device that has a
heating range from 150ºC to
230ºC.
The unit is cordless and can be
used with Resilon or Gutta
Percha.
Needles are available in 20, 23,
25 gauges
18
HOT SHOT
Dr. Raji Viola Solomon

19. V I O L A S O L O M O N
Ultra fil system
• Alpha phase gutta percha is prepackaged in
cannulas with attached 22 gauge needle.
• It softens at a temperature of approximately 70-
90°c in a special heater.
• Gutta percha is available in three consistencies
19
Regular(low viscosity) White cannula
Firm set (Moderately
viscosity)
Blue cannula
Endoset (High
viscosity)
Green cannula
Dr. Raji Viola Solomon

20. V I O L A S O L O M O N
Technique
• Placement of needle and sealer are similar to obtura II
technique
• Needle placement is usually far from apical matrix(8-10mm)
20
Regular set Syringe trigger is squeezed
and released and after a wait
period of 3 seconds it is
squeezed and released again.
Needle is not withdrawn but
left in place until softened
GP is felt to lift the needle
from canal
Endo set Less flow and can be
compacted with plugger and
spreaderDr. Raji Viola Solomon

21. V I O L A S O L O M O N
DISADVANTAGES
• As good as lateral
condensation
• Broken instruments can be
bypassed
• Internal resorption defects
can be filled
• Low viscosity –material
may extrude
21
ADVANTAGES
Dr. Raji Viola Solomon

22. V I O L A S O L O M O N
E & Q MASTER:
• Manufactured by Meta Dental Corporation.
Consists of PEN SET and GUN SET.
• It is a cordless system of obturation.
Thermoplasticized obturation technique of
obturation.
• Consists of special length master cones which
can be used as apical third filling and later back
filling can be carried out.
22Dr. Raji Viola Solomon

23. V I O L A S O L O M O N
Pac-160-Precision apical control at 160°c
Definite apical constriction is preferred
Advantages
Fill accessory/lateral canals
Irregular configurations of root canal can be obturated
Temperature is not more than 160°c
23Dr. Raji Viola Solomon

24. V I O L A S O L O M O N
Solid core carrier obturating systems
• Successfil
• Thermafil
• Trifecta
24Dr. Raji Viola Solomon

25. V I O L A S O L O M O N
Successfil
• Solid core carrier (titanium or radio opaque plastic) coated with alpha gutta
percha just before it is inserted in the canal
• High viscosity gutta percha that sets in two minutes
25
Successfil core same as diameter of the last apical file is selected and
placed upto the working length without binding
Core coated with GP is immediately inserted to full depth
withou twisting
With plugger dipped in alcohol the gutta percha is compacted
around the carrier
Core is severed 2 mm above the orifice with bur
Radiograph for confirmation
Dr. Raji Viola Solomon

26. V I O L A S O L O M O N
Thermafil
Patented endodontic obturator consisting of flexible
steel/titanium/plastic central carrier sized and tapered to
match standard endodontic files coated with alpha gutta
percha
• Heated at 115°c for 3-7 min depending on size ranging
from 20-140 – Thermaprep oven
• Gutta percha coating extending beyond the carrier by 1-
2mm
• Markings at 18, 19, and 20mm, gutta percha covers 1st
mark
26Dr. Raji Viola Solomon

27. V I O L A S O L O M O N
27Dr. Raji Viola Solomon

28. V I O L A S O L O M O N
Technique
Step back technique is preffered
Thermofil obturator is selectedwhich corresponds to master
apical file
Canal is coated with suitable sealer
Thermafil obturators are heated over flame or oven
Once GP attains surface shine firm pressure is till the established
working length
After radiographic verification the carrier shaft is severed
28Dr. Raji Viola Solomon

29. V I O L A S O L O M O N
ADVANTAGES
• Quick and easy
• They can be curved to fill
curved canals
• Flexible carriers pre curving
is not required
• Can be used in open apices
• Less stresses in the root canal
because of minimal
condensation forces
DISADVANTAGES
• Chances of extrusion
• Post space preparation
difficult
• Retreatment difficult
29Dr. Raji Viola Solomon

30. V I O L A S O L O M O N
Gutta flow-cold flowable gutta percha
A great disadvantage of the warm filling systems is the
fact that warmed gutta-percha shrinks during the cooling
process, which leads to leakage in the root filling.
GuttaFlow is the first flowable, non-heated gutta-
percha that does not shrink but expands slightly
(0.2%), resulting in an excellent seal of the root canal
30Dr. Raji Viola Solomon

31. V I O L A S O L O M O N
s
31Dr. Raji Viola Solomon

32. V I O L A S O L O M O N
32
capsule Gutta percha powder (30µm)
Polymethlsiloxane silicon oil
Paraffin oil
Platinum catalyst
Zirconium dioxide
Nano silver(preservative)
Coloring agent
The capsule is mixed for 30 seconds in a triturator.
Canal Tip The GuttaFlow Canal Tip(flexible) was developed for a
fast, easy and safe application. It uses a luer lock design
which is screwed onto the capsule after the mixing
process.
Dispenser: The dispenser has an elongated design to facilitate
application..
Dr. Raji Viola Solomon

33. V I O L A S O L O M O N
Properties
• Excellent flow - better seal-The material is
thixotropic, the viscosity diminishes under
pressure so GuttaFlow flows into the smallest
canals
• Solubility-According to ISO 6876:2001 show a
solubility of 0,0%. This results in a
dimensionally stable and impervious root canal
filling.
• Extremely biocompatible.
• Working time is up to 15 minutes
33Dr. Raji Viola Solomon

34. V I O L A S O L O M O N
ADVANTAGES
• Ease of handling, simple to use (condensation is
not required)
• Allows for excellent post preparation (no plastic
carrier to remove)
• Easily removed during retreatment
• Ensures a very tight seal of the root canal
• Radiopaque for excellent x-ray evaluation
• No heater necessary
34Dr. Raji Viola Solomon

35. V I O L A S O L O M O N
EZ-FILL OBTURATION SYSTEM
The EZ-Fill technique overcomes the shortcomings of
thermoplastic gutta-percha techniques by using a bi-directional
spiral filler to place epoxy resin sealer
35Dr. Raji Viola Solomon

36. V I O L A S O L O M O N
Technique
36
Spiral at the coronal end
spin the cement down the
shaft towards the apices
Spirals at apical end spin
the cement toward the
coronal end where they
meet(3-4mm) from apical
end
Cement is thrown out
laterally
Dr. Raji Viola Solomon

37. V I O L A S O L O M O N
Technique
• A pre-fitted single gutta percha point is placed is to the apices
• Tapered shape of the canal let the excess cement escape coronally
• The cement seal the apex and lateral and accessory canals
• Excess GP seared off
37Dr. Raji Viola Solomon

38. V I O L A S O L O M O N
Advantages
• Single gutta percha cone technique – No lateral stressses on
the root
• Obturation at room temperature-No shrinkage upon cooling
• Radioopaque
• Flow of the cement into the lateral canals is superior to
thermoplastic GP
• Bonds chemically and physically to dentine and gutta percha
• The time required for thorough obturation is minimal.
38Dr. Raji Viola Solomon

39. V I O L A S O L O M O N
MONOBLOCK
Definition
Creation of solid, bonded, continuous material from
one dentine wall of the canal to the other.
A monoblock obturation system is the unit in which
the core material, sealer and the root canal dentin
for a single cohesive unit.
With the advent of adhesive technology the term
MONOBLOCK has popularized.
According to various studies it strengthens the root
by approximately 20%
Classification
• Primary –MTA
• Secondary- Resilon based system
• Tertiary-EndoREZ and Active GP
39Dr. Raji Viola Solomon

40. V I O L A S O L O M O N
40Dr. Raji Viola Solomon

41. V I O L A S O L O M O N
Hydron
Rapid setting hydrophillic polymer plastic material
Polymer of hydroxylethylmethacrylate (HEMA)
Biocompatible
Comes in contact with moisture, gel swells up
Working time is 6-8 min
Low radiopacity
41Dr. Raji Viola Solomon

42. V I O L A S O L O M O N
Mineral trioxide aggregate
• Portland cement (75%)
Dicalcium silicate(55%)
Tricalcium silicate(20%)
Tricalcium aluminate(10%)
Tetracalcium aluminoferrite(10%)
• Bismuth oxide (20%)
• Gypsum (5%)( To delay the setting time)
• Trace amounts of SiO2, CaO, MgO, K2SO4,
and Na2SO4
42Dr. Raji Viola Solomon

43. V I O L A S O L O M O N
TECHNIQUE
Smear layer is not removed as it acts as a coupling agent that
might enhance MTA bonding to root canal dentine
MTA is mixed with 0.12% CHX to increase antimicrobial
properties
Mixed MTA is placed in the canal with carrier gun and advanced
apically with endodontic plugger
Radiograph is taken to assess the presence of voids
When requisite compaction density is achieved , compaction
continued from apical to coronal area with larger pluggers
43Dr. Raji Viola Solomon

44. V I O L A S O L O M O N
Advantages
• Superior physicochemical and bioactive properties
• Radio opaque
• Non shrinkage
• Not sensitive to moisture and blood contamination
• Bacteriostatic
• Provides effective seal against dentin and cementum
• Promotes biologic repair and regeneration of PDL
(HIGH pH)
• Stimulates mechanisms responsible for the bio re-
mineralization and resolution of periapical disease
• superior sealability against bacterial micro leakage
44Dr. Raji Viola Solomon

45. V I O L A S O L O M O N
Disadvantages:
• Long setting time
• Difficult to manipulate
• Expensive
45Dr. Raji Viola Solomon

46. V I O L A S O L O M O N
Resilon
• Resilon looks and can be handled like Gutta
percha- RESIN PERCHA
• Available as standardized points, accessory
points and pellets
• Various techniques like single cone, cold lateral
condensation and thermoplastic techniques can
be used
46Dr. Raji Viola Solomon

47. V I O L A S O L O M O N
47Dr. Raji Viola Solomon

48. V I O L A S O L O M O N
Resilon Thermoplastic synthetic root filling material-major component
• Polyester
• Methacrylate co-polymer (10%) helps in bonding chemically
with methacrylate based sealers.
• Bioactive glass
• Radioopaque fillers(bismuthoxychloride and barium
sulfate)-65%
• Softened by heat +chloroform-compatible with various
treatment techniques
Epiphany
sealer
Resin based composite that bonds to dentine wall
• BISGMA
• Ethoxylated BISGMA
• UDMA
• Difunctional methacrylates
• Fillers(70%) – calcium hydroxide,barium sulfate,barium
glass,bismuth oxychloride and silica
Primer Prepares the canal
Sulfonic acid terminated functional monomer, HEMA, water, and
polymerization initiator
48Dr. Raji Viola Solomon

49. V I O L A S O L O M O N
METHODOLGY
Cleaning and shaping procedures an appropriate cone is fit and a
radiograph obtained to verify the apical position
Smear layer removal -Since NaOCl may affect the bond strength of the
primer, EDTA should be the last irrigant used before rinsing the canal with
sterile water, saline, or chlorhexidine
Placement of primer-self etch primer is used to condition the canal
walls,increase surface area for bonding and prepare them for bonding to the
resin sealant
Placement of sealer- The sealer is applied using a paper point, Resilon
point, or lentulo spiral.
Obturation- The canal is then obturated using lateral compaction, warm
vertical compaction or thermoplastic injection
Immediate care-The sealer takes approximately 25minutes to set, so it is
recommended that the coronal surface of the material be light cured for 40
seconds.
49Dr. Raji Viola Solomon

50. V I O L A S O L O M O N
Push-out bond strengths: the Epiphany–Resilon endodontic
obturation system compared with different pairings of Epiphany,
Resilon, AH Plus and gutta-percha
• group1, AH Plus + gutta-percha;
• group 2, AH Plus + Resilon
• group 3, Epiphany +Resilon
• group 4, Epiphany + gutta-percha
• group 5 (control), gutta-percha only.
(Epiphany + gutta-percha) had significantly (P < 0.001) greater
bonding strength than all the other groups.The Epiphany–Resilon
combination (group 3) was not superior to that of the AH Plus
gutta percha combination.
50Dr. Raji Viola Solomon

51. V I O L A S O L O M O N
Advantages
• The Resilon core bonds to the resin sealer, which attaches to
the etched root surface forming a “monoblock” better than
gutta percha sealer interface and dentin sealer interface.
• This bonding of Resilon appears to provide a better seal and
may strengthen the root.
• Biocompatible
• Good coronal seal
52Dr. Raji Viola Solomon

52. V I O L A S O L O M O N
Tertiary monoblock
• ENDOREZ
• ACTIVE GP
53Dr. Raji Viola Solomon

53. V I O L A S O L O M O N
Tertiary Monoblock
EndoRez
• Endorez points are
standardized GP points
coated with a thin resin
coating, which bonds
chemically to a resin
sealer.
• They are the first GP
points to achieve a
chemical bond with the
sealer, providing a more
efficient seal than
traditional GP.
Activ GP
• Gutta percha points
manufactured in a
traditional design and
impregnated with glass
ionomer and also coated
with the same glass
ionomer
• Single cone obturation
technique
54Dr. Raji Viola Solomon

54. V I O L A S O L O M O N
Endo REZ system
Endo REZ is a two part, dual cure set endodontic sealer and
filler based on UDMA resin
Consists of:
• A Reciprocating handpiece
• 7 Stainless steel files (3 shaping files used in hand piece and 4
hand files for apical 3 mm)
• Irrigants and Lubricants
• Delivery tips
• EndoRez Sealer -Methacrlylate based resin sealer consists of
30% UDMA
• EndoRez points
55Dr. Raji Viola Solomon

55. V I O L A S O L O M O N
Express a very small amount of EndoREZ from the syringe to
verify flow before placing it in the canal
Keep the end of the Navi Tip 2mm to 3mm away from the
apex, and not wedged tight, to prevent extruding material
beyond the apex.
Fill the canal completely with EndoREZ, stopping at the canal
orifice then place the EndoREZ points will bond chemically
with EndoREZ to create a tight canal seal
To eliminate resin oxygen inhibition, place a flowable resin
over the orifice.
56Dr. Raji Viola Solomon

56. V I O L A S O L O M O N
SINGLE CONE TECHNIQUE
This technique uses larger master cones that best match the
geometry of the nickel-titanium rotary files.
The use of these gutta-percha points does not require either
accessory points or the lateral condensation.
When the root canal is enlarged with rotary instruments. the use
of a single gutta-percha point at environment temperature, with a
variable cement thickness depending on the adaptation of the
point to the root canal walls.
57Dr. Raji Viola Solomon

57. V I O L A S O L O M O N
ADVANTAGE
• The technique speeds the root canal filling
• No need to add additional points or cones
• Minimizes the pressure applied to the root canal walls
58Dr. Raji Viola Solomon

58. V I O L A S O L O M O N
DISADVANTAGES
This technique has been considered less effective in sealing root
canal because of the
• Greater volume of cement that can be expected in the absence of
condensation
• Possible anatomic variations of the root canal, which cannot
always be filled with larger master cones.
• Porosities in large volumes
• Cement dissolution
• Lower adaptation of the single cone in the middle and coronal
thirds of the canal with irregular shape are the main
disadvantages of this technique
59Dr. Raji Viola Solomon

59. V I O L A S O L O M O N
Challenges to Monobock concept
• C factor
• Polymerizing shrinkage forces are high
• Residual dentin moisture
• Infiltrating smear layer challenges
• Ability to cure, bond, air-dry
60Dr. Raji Viola Solomon

60. V I O L A S O L O M O N
Apical 1/3 root canal obturation
• Dentin chips
• Sectional obturation
• Carrier based apical filling
• New McSpadden NiTi
• Maillefer Gutta Condenser
• Zipperer
• JS Quickfil
• Microseal System
• Continuous wave compaction methods
• Fibrefil system etc.
61Dr. Raji Viola Solomon

61. V I O L A S O L O M O N
Dentine chips
• Dentine chips are used as
apical plug against which
other materials are
compacted.
• There is a biological seal
rather than mechanical-
chemical seal
• Dentine chips stimulate
osteogenesis or
cementogenesis
62Dr. Raji Viola Solomon

62. V I O L A S O L O M O N
STUDIES
63
Gottlieb and
Orban
Noted cementum forming around dentin
chips in the PDL as early as 1921
Mayer and
Ketterl
Filled 1,300 canals with apical dentin chips and
reported 91% success
Ketterl later reported 95% success with cementum-like
closure at the apex
Waechter and
Pritz
Reported “osteocementum” apical closing in 20
human cases.
Baume et al. “osteodentin” closings but incomplete
calcification across all of their histologic serial
sections
Dr. Raji Viola Solomon

63. V I O L A S O L O M O N
Oswald et al Dentin chips lead to
quicker healing,
minimal inflammation,
and apical cementum
deposition, even when
the apex is perforated
Holland et al Dentin chips, if
infected, are a serious
deterrent to healing,
Torneck et al. Some dentin chips
may actually irritate
and hinder repair.
64Dr. Raji Viola Solomon

64. V I O L A S O L O M O N
Technique
Cleaning and shaping
Gates glidden drill or head strom file used to produce dentine powder in central
portion of the canal
Dentine chips so produced are pushed apically with butt end and blunted tip of
paper point
1-2mm of chips should block the foramen-checked with small file
Apical leakage can be reduced by injecting small amount of dentine adhesive into
coronal half of dentinal apical plug
Rest of the canal is filled with routine gutta percha
65Dr. Raji Viola Solomon

65. V I O L A S O L O M O N
66Dr. Raji Viola Solomon

66. V I O L A S O L O M O N
SECTIONAL OBTURATION
• Small pieces of gutta percha are packed into apical area to
achieve apical obturation
• Widely promoted by COOLIDGE, LUNDQUIST,
BLAYNEY – all from Chicago
• Also called CHICAGO technique
67Dr. Raji Viola Solomon

67. V I O L A S O L O M O N
Technique
Plugger is selected which loosely in the canal
Stopper is placed to mark the length
Primary GP is blunted and carried to place 1mm short of working
length-confirmed radiographically
Upon removal 3mm tip is excised with scalpel
Sealer is placed in the canal and GP is warmed by passing through
alchohol flame and carrier in the canal.
Plugger pressed apically and packed thoroughly in place+radiograph
Post space+back filled with thermoplastic GP
68Dr. Raji Viola Solomon

68. V I O L A S O L O M O N
CALCIUM HYDROXIDE APICAL FILLING
• Cementogenesis, which is stimulated by
dentin filings, appears to be replicated by
calcium hydroxide as well
• When condensed properly it acts as apical
barrier and promotes cemental growth
• However calcium hydroxide resorbs away from
the apex faster than dentine chips.
69Dr. Raji Viola Solomon

69. V I O L A S O L O M O N
Method
• 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 and 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.
70Dr. Raji Viola Solomon

70. V I O L A S O L O M O N
Moist calcium hydroxide can be placed in a
number of ways:
Amalgam carrier
Plugger
 Lentulo spiral
Injection from one of the commercial
syringes loaded with calcium hydroxide:
Calasept or TempCanal
In the latter method, the calcium hydroxide paste
is deposited directly at the apical foramen from a
27-gauge needle and is then “tamped” to place
with a premeasured plugger.
71Dr. Raji Viola Solomon

71. V I O L A S O L O M O N
• Apexification of pulpless
incisor with periradicular
lesion.
• A, Preoperative film.
• B, Calcium hydroxide
and camphorated
monochlorophenol
filling canal and
extruding through apex.
• C, Nine months later,
canal filled with sealer,
softened gutta-percha,
and heavy vertical
compaction. No
overfilling.
• D, Two-year recall
72Dr. Raji Viola Solomon

72. V I O L A S O L O M O N
Carrier based apical filling
• Simplifill obturation system
• Fiberfill obturation system
• EZ Fill system
73Dr. Raji Viola Solomon

73. V I O L A S O L O M O N
Simplifill obturation system
• It is designed to be compatible with light speed
instrumentation system for cleaning and shaping
74Dr. Raji Viola Solomon

74. V I O L A S O L O M O N
• Uses apical plug(ISO sized)-5mm in length with 2% taper
• Carrier for apical gutta percha plug is made from stainless steel
which is flexible enough to negotiate curves enough to push
the tight fitting plug to the working length
• 1mm threaded tip holds the gutta percha plug on the carrier
• Carrier has plugger like surface which pushes the plug to WL
75Dr. Raji Viola Solomon

75. V I O L A S O L O M O N
TECHNIQUE
• Check the fit of apical gutta percha plug to the working
length
• Place sealer in apical part of the canal
• After inserting the plug into canal, slowly advance it
apically without rotating the handle
• With the plug at working length leave it there by turning
the carrier handle counterclockwise and removing the
carrier from the canal
• Placement of post or backfilling.
76Dr. Raji Viola Solomon

76. V I O L A S O L O M O N
Advantages
• Quick and easy
• Does not leave metal or plastic carrier in the canal
that makes post space or retreatment difficult
• Simple technique
• Does not require special treatment
• Does not require heat (No GP shrinkage on cooling)
77Dr. Raji Viola Solomon

77. V I O L A S O L O M O N
Fiber fill obturation system
• A Fiber Reinforced Adhesively Bonded Endodontic Obturator and Post System
• Resin and glass fiber post +Terminal GP
• Lengths-5mm and 8 mm
• Diameter -30,40,50,60,70,80
78Dr. Raji Viola Solomon

78. V I O L A S O L O M O N
Technique
The obturator has to be selected based on the diameter of the canal
Drop of primer A and B are mixed and applied with kits spiral brush
Sealer is introduced into canal with fiberfill syringe
Obturator is gently seated to the working length allowing excess sealer to
escape out coronally
Dual cure sealer is light cured to stabilize obturator
Additional primer is appiled on the protuding portion of obturator post
,dentin and enamel to be contacted by core build up material.
79Dr. Raji Viola Solomon

79. V I O L A S O L O M O N
Cements and pastes as filling material
• MTA
• Calcium hydroxide
• Calcium phosphate cement
• N2- Sargenti technique
• Hydron
80Dr. Raji Viola Solomon

80. V I O L A S O L O M O N
N2
Introduced by Sargenti and Ritcher (1961)
Previously known as Bakelite / Russian Red
Modification Of Mummification Technique ( Europe);
US-RC2B
Consists of:
Zn OE
Paraformaldehyde ( 6.5%)
Lead oxide
Corticosteroids
Phenylmercuric borate
81Dr. Raji Viola Solomon

81. V I O L A S O L O M O N
 Available As-
 N2 – Normal: For root filling
 N2 – Apical: For antiseptic medication
 N2 – Universal: Root filling and antiseptic medication
82Dr. Raji Viola Solomon

82. V I O L A S O L O M O N
Method
• No irrigation is done
• Filled with N2
• Whole treatment is performed in single visit
• Artificial fistulation is required sometimes without raising flap-apical fenestration
83Dr. Raji Viola Solomon

83. V I O L A S O L O M O N
ADVANTAGES:
• Pastes involve the use of a single material.
• No sealer required.
DISADVANTAGES
• Paraformaldehye causes toxicity, severe periapical
inflammation
• May lead to over extension, under extension and voids
• Persistent paraesthesia of nerve
• Difficult to obtain a dense non porous filling
• Cannot fill accessory canals.
84Dr. Raji Viola Solomon

84. V I O L A S O L O M O N
CALCIUM – PHOSPHATE CEMENT
• By W. E Brown and L. C Chow
• Developed and patented at the American Dental Association (ADA)
COMPONENTS
• Acidic – Dicalcium phosphate dihydrate / anhydrous dicalcium
phosphate
• Basic – Tetracalcium phosphate
• When mixed with water sets into a hardened mass
• Sets within 5 minutes
• By adding glycerin to the mixture
• Setting time can be extended
• Can be extruded from a 19 gauge needle
85Dr. Raji Viola Solomon

85. V I O L A S O L O M O N
Mild irritant for some time but promotes cementogenisis and
osteogenisis
Final set cement
• Nearly all-crystalline material
• As radio paque as bone
• Nearly insoluble in water, saliva and blood
• Readily soluble in strong acids
• Has a porosity that is in direct ratio to the amount of solvent
(water) used
86Dr. Raji Viola Solomon

86. V I O L A S O L O M O N
Obturation with Non Instrumentation
Technology
87
Int Endod J. 1999
Jan;32(1):17-23.
Obturation of root canals
with different sealers using
non-instrumentation
technology.
Lussi A1, Imwinkelried S,
Stich H.
Dr. Raji Viola Solomon

87. V I O L A S O L O M O N
Obturation of the root canals is performed using a vacuum
pump, which produces a vacuum of at least 11.4mmHg.
Reservoir valve containing the freshly mixed sealer is
opened and the obturation paste is sucked into the canals.
Only one sealer, AH-26 has been tested scientifically with
the new device.
88Dr. Raji Viola Solomon

88. V I O L A S O L O M O N
ADVANTAGES:
Roots are not weakened by the removal of tooth tissue.
Reaches accessory canals
Reduced working stress and reduced treatment time.
Not dependent on anatomical criteria or flexibility and
fracture resistance of the instruments.
89Dr. Raji Viola Solomon

89. V I O L A S O L O M O N
In vivo performance of the new non-instrumentation technology
(NIT) for root canal obturation.
Aim :compare the radiographic quality of root fillings performed by
the NIT-obturation method versus conventional mechanical obturation.
Conclusion: Root canals filled by the reduced-pressure-method using
sealer combined with gutta-percha cones exhibited equivalent
radiographic quality compared to conventionally filled canals.
Int Endod J. 2002 Apr;35(4):352-8
90Dr. Raji Viola Solomon

90. V I O L A S O L O M O N
PLACEMENT AND FINISHING OF ROOT-
END FILLINGS
• Amalgam carried to root-end preparation - K-G carrier - sized
for root-end preparations.
• Deeper apices - reached by Messing gun.
• IRM & Super-EBA attached to back side of a spoon
excavator / tip of a plastic instrument / Hollenback carver.
• IRM does not adhere well to itself and should thus be inserted
as a single mass and condensed rather than placed
incrementally
• Root-end preparations using ultrasonic tips smaller in
diameter -extend deeper into root specially designed root-end
filling condensers
• Condenser - small enough in diameter - not bind wall of the
root-end preparation. 91Dr. Raji Viola Solomon

91. V I O L A S O L O M O N
CONCLUSION
Root canal obturation, plays a crucial role deciding the
success of endodontic therapy.
Due to increasing technological advancements in every field
of Endodontics, knowledge about the various improvements
in root canal obturation will help every clinician to render
precise endodontic treatment.
These advances in obturation systems have greatly enhanced
the standards of endodontic treatment by improving
operator’s precision.
92Dr. Raji Viola Solomon

92. V I O L A S O L O M O N
References
• Ingle 5th and 6th edition
• Cohen
• Walton and torabinajad
• Stock
• Wein
• Vimal sikri
• Int Endod J. 2002 Apr;35(4):352-8.In vivo performance of the new non-
instrumentation technology (NIT) for root canal obturation.Lussi A1, Suter B,
Fritzsche A, Gygax M, Portmann P.
93Dr. Raji Viola Solomon

93. V I O L A S O L O M O N
• Gilhooly RM Hayes SJ et al. comparison of lateral
condensation and thermomechanically compacted warm
alpha gutta- percha with a single cone for obturating curved
root canals. OOOE; 91;89; 2001
• Wu MK, Wesselink et al. a preliminary study of percentage of
gutta percha filled area in apical canal filled with warm
vertical compaction. IEJ 26; 37;1993
• Perez Heredia et al. apical seal comparison of low
temperature thermoplasticized technique and lateral
condensation with two master- cones Med Oral Patol Oral Cir
Bucal 12.E; 175; 2007
• Schilder H. Filling root canals in three dimensions. DCNA. Nov.
723; 1967
94Dr. Raji Viola Solomon

94. V I O L A S O L O M O N
• DuLac KA. Neilsen et al. comparison of obturation of lateralcanals with six
obturation techniques. JOE 25; 376; 1999
• Wu MK, Wesselink et al. quality of cold and warmgutta percha filling in oval
canals in mandibular premolars. IEJ; 34; 485; 2001
• Blum JY et al .Warm vertical compaction sequences in relation to gutta percha
temperature. JOE 23;307; 1997
• Simpson TH, Natkin E. Gutta-percha techniques for filling canals of younger
permanent teeth after induction of apical root formation. J Br Endod Soc
1972;3:59.
95Dr. Raji Viola Solomon

95. V I O L A S O L O M O N
T H E E N D