note on different techniques of obturation

1. 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

2. 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

3. DIFFERENT TECHNIQUES
1. Cold Lateral Compaction
2. Warm Compaction (warm GP)
A. Vertical
B. Lateral
3. Continuous wave Compaction technique
4. Thermoplasticized GP injection
5. Carrier- based GP
A. Thermafil thermoplasticized
B. SimpliFill sectional obturation
6. McSpadden thermomechanical compaction
7. Chemically plasticized GP
8. Custom cone

4. COLD LATERAL COMPACTION
• Most widely taught & practised
• Sealer considerations
• Spreader considerations
• Master cone considerations
• Radiographs

5. TECHNIQUE
Isolation &
drying the
canals with
paper points
Selection of
master cone
Checking for
apical “TUG
BACK”

6. 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

7. 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

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

9. 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 2006
Endodontic Topics 2005, 12, 2–24

10. 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
Endodontic Topics 2005, 12, 2–24

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

12. WARM VERTICAL COMPACTION
• Herbert Schilder
• Berg
• Heated pluggers
• Objectives defined: preparation for obturation with
this technique
• Indications

13. TECHNIQUE
•
Primary non std. or
greater taper GP
cone
corresponding to
the last instrument
Canal coated
with thin layer of
RC sealer
Primary GP cone
inserted to WL

14. 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

15. TECHNIQUE
Vertical pressure
with condenser/
plugger of
suitable size
Forces the
plasticized
material apically
Alternate
application of
heat carrier &
condenser: 3D FIll

16. WARM VERTICAL COMPACTION

17. WARM VERTICAL COMPACTION
Pulp Canal Sealer, Kerr
Endodontic Topics 2005, 12, 2–24

18. WARM VERTICAL COMPACTION
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

19. 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

20. 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

21. CONTINUOUS WAVE COMPACTION
TECHNIQUE
• Buchanan
• Greater hydraulic forces
• Tapered pluggers: System B

22. CONTINUOUS WAVE COMPACTION
TECHNIQUE
Master cone
selected &
plugger prefitted:
5-7mm from WL
System set in
Touch mode:
200oC
Cold plugger
initillay placed
against GP; firm
pressure

23. CONTINUOUS WAVE COMPACTION
TECHNIQUE
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

24. ppdentistry.com

25. ppdentistry.com

26. ppdentistry.com

27. CONTINUOUS WAVE COMPACTION
TECHNIQUE
• Mean temperature change near CEJ: 4.1oC
• Silver et al. Elevation > 10oC
• Flore et al. temperature setting > 250oC- hazardous

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

29. OBTURA III
• Hand-held gun
• Ag needles
• Control unit

30. 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

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

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

33. ULTRAFIL- 3D
• GP cannulas
• Heating unit
• Injection syringe
• 3 types of Cannulas: Regular set, Firm set & Endoset

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

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

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

37. CARRIER- BASED GP
• Thermafil
• Profile GT obturators
• GT Series X Obturators
• ProTaper Universal Obturators
• Successfil
• SimpliFill
• JS Quick-Fill

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

39. THERMAFIL
Canal dried;
light coat of
sealer applied.
Carrier set to
predetermined
length
disinfected
Paced on
heating device
Retrieved &
inserted into
canal : 10 sec
Rapid insertion:
enhances
obturation
Position verified
radiographically
2-4 minutes:
cooling
Resection of
carrier

40. THERMAFIL

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

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

43. 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.

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

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

46. THERMOMECHANICAL COMPACTION
• McSpadden compactor
• H- file in reverse
• Slow speed handpiece
• Advantage
• Disadvantages
• Microseal condensers

47. 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

48. 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.
JOE — Volume 32, Number 4, April 2006

49. • 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.
JOE — Volume 32, Number 4, April 2006

50. 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
Endodontic Topics 2005, 12, 2–24

52. CONCLUSION
• Wide array of options and materials
• Wisely chosen & applied depending on the clinical
situation

53. Thank you!!