The document discusses various obturation materials and techniques for their removal during root canal retreatment. It describes the different types of gutta percha obturations including single cone, condensed, and overextended, and techniques for removing each using hand files, ultrasonic files, heat, and solvents. For other materials like solid core obturators, paste, Resilon, and silver points, it outlines techniques using rotary files, ultrasonics, solvents, and specialized removal kits. References are provided supporting the various methods described.

1. Removal of Obturation
Materials
Mohamed Ali Alazrag
BDS.Msc
Tripoli Medical center .Libya

2. Obturation Materials
 Guttapercha
 Solid core obturators.
 Paste
 Resilon
 Silver points.

3. Removal of Guttapercha

4. it is depend on the quality of obturation :
 Single cone GP
 Condensed GP

5. Removal of Single cone GP
 H file

6. Removal of Single cone GP
 H file
 Ultrasonic files

7. Over extended GP

8. Removal of Condensed GP
• Removal of gutta percha manually
• Removal of gutta percha using rotary system
• Removal of gutta percha using LASER

9. Removal of gutta percha manually:
1. Probing of the orifice

10. Removal of gutta percha manually:
1. Probing of the orifice
2. Heating endodontic carrier (to remove the
coronal part) avoid over heat.

11. Touch’n, heat device

12. System B

13. Removal of gutta percha manually:
1. Probing of the orifice
2. Heating endodontic carrier (to remove the coronal
part) avoid over heat.
3. Using small Gates gliding drills. (to remove any
remaining coronal material)

15. Removal of gutta percha manually:
1. Probing of the orifice
2. Heating endodontic carrier (to remove the coronal
part) avoid over heat.
3. Using small Gates gliding drills. (to remove any
remaining coronal material)
4. Using gutta percha solvents (to remove the
remaining material in the apica part of the
canal).

17. • Exposure of dental personnel to
chloroform in root-filling procedures.
Allard U, Andersson , Endod Dent
Traumatol 8:155, 1992.
• Chloroform in the endodontic operatory.
McDonald MN, Vire DE, J Endod 18:301,
1992.
• Risk assessment of the toxicity of
solvents of gutta-percha used in
endodontic retreatment.
Chutich MJ et al , J Endod 24:213, 1998.

18. Removal of gutta percha manually:
1. Probing of the orifice
2. Heating endodontic carrier (to remove the
coronal part) avoid over heat.
3. Using small Gates gliding drills. (to remove any
remaining coronal material)
4. Using gutta percha solvents (to remove the
remaining material in the apica part of the canal).
5. Small hand files (#15 C+ file to penetrate the
remaing root filling and enhance it is dissolution
by solvent).

20. Removal of gutta percha manually:
1. Probing of the orifice
2. Heating endodontic carrier (to remove the coronal
part) avoid over heat.
3. Using small Gates gliding drills. (to remove any
remaining coronal material)
4. Using gutta percha solvents (to remove the
remaining material in the apica part of the canal).
5. Small hand files (#15 C+ file to penetrate the
remaing root filling and enhance it is dissolution by
solvent).
6. Radiographic assessment.

21. • An in vivo comparison of two frequency-
based electronic apex locators.
Welk AR, Baumgartner JC, Marshall JG,
J Endod 29:497, 2003.
• Accuracy of two root canal length
measurement devices integrated into
rotary endodontic motors when removing
gutta-percha from root-filled teeth.
Uzun O, Topuz O, Tinaz C, et al, Int
Endod J 41:725, 2008.

23. Removal of gutta percha using rotary system:
• Protaper Universal Retreatment files (DentSply)

24. • Mtwo R (VDW)

25. • GPR (MANI, JAPAN)

27. D-RaCe (FKG)

28. • Recioroc (VDW)
This novel niti reciproc
file created by Dr.Gassn
yard. It is made from
M-Wire® that offers
greater flexibility and
resistance to cyclic
fatigue than traditional
nickel titanium files.

29. Reciprocation

31. Laser

32.  Removal of gutta-percha from root canals using
an Nd:YAG laser. ( In vitro study )
Viducic D, Jukic S, Karlovic Z, et al; Int Endod J,
2003.
N.B: Further investigation required to proving safety and
efficacy of laser during gutta-percha removal .

33. Remove solid core obturators

34. With the increased use of carrier-based systems such
as Thermafill we should understand how to retreat
carriers, and we must be aware of the different types
of carriers
Three Types of solid carriers are found on these
system:
• The first generation: Metal (Stainless steel or
titanium) core and a coating of guttapercha
• The second generation: Plastic core coated with
alpha form of guttapercha e.g. Thermafill
(Dentsplay)
• The last generation: Modified GP core (cross
linked guttapercha ) rather than plastic core e.g.
GuttaCore (Dentsply).

36. Thermafill plus with vent
N.B: Obturator with groove for better backflow and retreatment.

37. GuttaCore (Dentsply)
Modified GP core (cross linked guttapercha )

40. Techniques for removal of metal core
obturators:
1st Heat application to the carrier to soft GP
surrounding it to facilitate its removal with with plier
or Steiglitz forceps.
 Endodontic retreatment of Thermafil versus
laterally condensed gutta-percha.
Wilcox LR, Juhlin JJ. J Endod. 1994

42. 2nd : Use of solvent and removal of surrounding
GP with small hand instrument ,followed by
ultrasonic toughing around the carrier and
remove it like separated instrument.
 Problem solving in endodontics. Prevention,
identification, and management.
Editors: Gutmann JL, Dumsha TC, Lovdahl PE,
Hovland EJ, ed 3, St. Louis, 1997, Mosby.

44. Techniques for removal of plastic core
obturators:
1st technique: Use of solvent and Hand files to
remove the GP surrounding the carrier then a
large Hedstrom file used to remove the carrier.
 Removal of Thermafil root canal filling material.
Bertrand MF, Pellegrino JC, Rocca JP ; J Endod
1997

46. 2nd technique: The manufacture recommended
the Use of rotary System e.g. Profile 0.04 taper
 Efficiency of the 0.04 taper ProFile during the
re-treatment of gutta-percha-filled root canals.
Baratto Filho F, Ferreira EL, Fariniuk LF, Int
Endod J, 2002.

47.  Efficacy of Reciproc® and Profile® Instruments
in the Removal of Gutta-Percha from Straight
and Curved Root Canals ex Vivo. Journal of
Oral & Maxillofacial Research.
Marfisi K et al. (Sep)
2015

49. 3rd technique: Using of System B heat source
 Thermafil retreatment using a new “System B”
technique or a solvent.
Wolcott JF, Himel VT, Hicks ML, J Endod ,1999.

51. Removal of Modified GP core carrier.
(GuttaCore,DentSply)
Rotary System e.g. Protaper universal
Retreatment system
 Time required to remove GuttaCore, Thermafil Plus,
and Thermoplasticized gutta-percha from moderately
curved root canals with ProTaper files.
Beasley RT et al ; J Endod 2013

52. Protaper universal Retreatment

53. Paste removal
Various types of paste have been used as a root
canal obturation materials they are used for many
years but due to paste toxicity and poor quality of
filling it is not used now in modern endodontics.

54. Removal of Non sitting or Soft paste
• Solvent
• Hand or rotary instrument (copious Naocl
irrigation ).
• Ultrasonically activated and irrigated files.
 Problem solving in endodontics. Prevention,
identification, and management.
Editors: Gutmann JL, Lovdahl PE, ed 5, ELSEVIER,
2011 Mosby.

55. Hard Sitting Paste

56. • Resorcinol-formaldehyde resin ‘‘Russian Red’’
endodontic therapy.
Schwandt NW, Gound TG. J Endod
2003

57. Removal of Hard sitting pastes:
 Burs , Ultrasonic tips ( accessible straight
portion of the canal )
 Precurved small hand files (apical area)
 Use of Solvent (Endosolve – R, Septodent )
The effect of endodontic solutions on resorcinol-
formalin paste in teeth.
Gambrel MG et al; J Endod 2005.

58. (Endosolve – R, Septodent
)

59. Removal of Resilone
Resilon system compsed of :
• Primer (self etching)
• Resilon sealer
• Riselon core material
The removal of Resilon root filling is
normally attempted in a manner
similar to the removal of condensed
gutta-percha with heat, solvent and
mechanichal instrumentation.

62.  The complete removal of Resilon may be
challenging since the resin sealer can
penetrate into the dentinal tubules. This is why
Guttapercha still the 1st choice for filling of root
canals.

63. Removal of Silver Point
It is apart of history, it has been used in the past
because of their ease of handling and placement.
Not used now days as it corrode with time ,loss of
the apical seal and the the corrosion products are
toxic and irritate to apical tissue.

64. 1st technique :
 is to establish a proper access.
 Carefully remove core material around the sliver
cone by use of ultrasonic
 Solvent to dissolve the sealer around the cone
 Grasp the exposed end of the silver point with
plier.

69. 2nd technique : The Hedstrom file technique:
 The sealer around the silver cone is dissolved
by use of solvent.
 Small file are negotiated as far apically as
possibly in two to three areas around the silver
point.
 The spaces surrounding the silver point are
carefully instrumented to size 15, and then small
Hedstrom files are gently screwed in as far as
possible apically.
 The files then twisted together and pulled out
through the access.

70. The Hedstrom file technique

72. 3rd technique: Use Instrument removal kits

73. Thank You

74. References
 Cohen’s Pathway of the pulp 11th edition
 Endodontic Principles and Practice 4th Edition
 Problem solving in endodontics. Prevention,
identification, and management. Editors: Gutmann
JL, Lovdahl PE, ed 5, ELSEVIER, 2011,Mosby.
 Removal of root filling materials." Duncan, Henry
Fergus, and BUN SAN CHONG. ,Endodontic topics
19 (2011): 33-57.