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INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
 INTRODUCTION
 HISTORY
 OBJECTIVES
 CLASSIFICATION OF OBTURATING TECHNIQUES
GROSSMAN
COHEN
INGLE
MESSING AND STOCK (19...
 RECENT ADVANCES IN
OBTURATING TECHNIQUES
 CLINICAL APPLICATIONS
 REFERENCES AND CONCLUSION
19th
century
Koecker : Red hot wire cauterize pulp
Gold to fill the canal
Various materials used :
Bamboo, waxes, asbestos...
1847: ASA HILL introduced Gutta Percha in the
form of “Hill’s Stopping”
Bleached gutta percha+ carbonate of lime & quartz
...
In 1978, JOHNSON described a unique yet simple method of canal ,
obturation with Thermoplasticized alpha-phase
gutta-perch...
Objectives of obturation
Total debridement, try to get a fluid tight seal
by total obliteration of canal space
• Stops cor...
Methods of obturation
Direction of Compaction :
Lateral
Vertical
Temperature of the gutta percha:
Cold
Warm
Based on need ...
ACC to GROSSMAN:
1. Lateral
2. Vertical
3. Sectional
4. Compaction ( McSpadden technique)
5. Thermoplasticized gutta perch...
Acc to Cohen:
1. Semisolid materials
2. Solid materials
3. Rigid cones
Semisolid materials:
• Chloroform dip technique
• L...
Acc to INGLE
•Lateral condensation
•Vertical condensation
•Sectional condensation
•Chemically plasticized
•Thermo –compact...
Classification according to J.J. Messing and C.J.R. Stock (1988)
1. Sectional
• Silver
• Titanium
• Gutta percha
• Amalgam...
CLASSIFICATION OF OBTURATION TECHNIQUES BY GUTMANN AND
WHITHERSPOON (2002)
I. Solid core Gutta percha with sealants
A. Col...
Lateral / vertical compaction
• Endotec II
Thermo-mechanical compaction
• Microseal System, Engine-Plugger, Maillefer Cond...
II. Apical third filling
– Light speed SimpliFill
– Dentin – chip
– Calcium hydroxide
III. Injection or “Spiral” filling
–...
• RESILON FIBERFILL
RESILON
Resilon is a polymer based thermoplastic resin containing
bioactive glass, bismuth oxychloride, barium sulphate an...
The polymer has an improved flexural strength and, when used in conjunction
with a resin-based sealer, offers improved bon...
Primer.
The primer—a self-etch primer that contains
 Sulfonic acid-terminated functional
monomer,
 2- hydroxyethylmethac...
Sealer in an auto mixing barrel
syringe.
The Resin Sealer—a dual-curing, resin-based composite sealer.
The resin matrix is...
Obtura Gun.Resilon points Resilon Pellet
The Resilon core material a thermoplastic synthetic polymer-based root canal
core...
Mono-Block Concept.
Because Resilon is a synthetic polymer, the resin sealer attaches to it, as
well as to the bonding agent/primer used to pe...
Technique :
Resilon can be softened with heat or dissolved with solvents such as chloroform
for retreatment purposes.
It i...
Advantages :
• Very less microleakage due to ‘Monobloc’ and also ‘Double Seal’
• Resilon is a bonded resin system, it has ...
RealSeal is applied in the same way as gutta percha.
Use the obturation technique of your choice, adding only a
priming st...
USING EPIPHANY WITH SYSTEM B
Set the temperature to 150°C. and the power to 10.
USING EPIPHANY WITH THE OBTURA GUN
• For t...
The Fiberfill Obturator
-Resin and glass fiber post with a terminal gutta
percha tip.
-The gutta percha is available eithe...
Each FibreFill obturator :
 unidirectional fibers in an organic resin matrix.
 gutta percha is attached via a thin, flex...
CANAL WARMED GUTTA PERCHA TECHNIQUE
SYSTEM B COMPACTION
• Also called continuous wave
compaction technique.
• Variation of...
Technique :
• Fit a standardized gutta percha cone in the root canal preparation.
• A Buchanan plugger is chosen that matc...
• System B unit is set to 2000
c at touch mode and plugger is introduced
in the canal and activated to remove excess coron...
1. MASTER CONE CEMENTATION.
The master cone is cemented in the canal with sealer.
2. INITIATION OF DOWN PACK
With the omni...
4. SEPARATION BURST. The heat source
is activated for one second
OBTURA II. This is a thermo plasticized injection-molded ...
“Touch ’n Heat” 5004, battery-powered (rechargeable)heat source.
Heat carrier heats to glowing within seconds to plasticiz...
Lateral/Vertical Compaction of Warm Gutta-percha.
 
Considering the ease and speed of lateral compaction as well as the su...
Motion for using Endotec II- plugger/spreader—
Vertical pressure with sweeping lateral pressure.
Endotec II- plugger
Gutta...
Martin and Fischer have shown, in a photo elastic stress test, that “warm lateral
condensation (Endotec) created less stre...
SECTIONAL COMPACTION
• Modifications of the vertical compaction.
• Known as the “Chicago” technique
since it was widely pr...
CANAL WARMED GUTTA PERCHA TECHNIQUE
CANAL WARMED GUTTA PERCHA TECHNIQUE
THERMOMECHANICAL COMPACTION
• By McSpadden in 1979. Initially called the ‘McSpadden Compactor’.
• Device resembled a rever...
• A well adapted master cone is
placed in the canal with a
suitable sealer.
• A mechanically activated
rotating compactor ...
• Thermocompactors available –
Maillefer Gutta-condenser, McSpadden Ni-Ti thermocompactor,
Zipperer thermocompactor and Qu...
                                                                                                              
MicroSeal S...
                                                       
Developed by Dr. John McSpadden
 
 
Includes the following feature...
Micro-Seal Gutta-percha Condenser is operated at slow speed.
• Run at a speed of 1000 to 4000 rpm.
Microseal Condensers
Th...
Microseal Spreaders
Nickel-titanium finger or engine spreaders enable even distribution of
condensation forces against the...
Microseal Heater
MicroSeal Heater efficiently heats gutta percha to full working temperature in less
than 45 seconds. The ...
1. MicroFlow master
cone and sealer are
placed in the canal.
2. Warm MicroFlow Gutta
percha is introduced and
condensed in...
 
One other innovation using the thermo mechanical principle to compact gutta-percha in
the root canal has been introduced...
D. Thermoplasticized gutta percha.
Syringe insertion ( Pressure syringe).
a. Obtura II, Elements obturation
b. Inject R Fi...
THERMOMECHANICAL COMPACTION
Ultrasonic Plasticizing.
First suggested by Moreno from Mexico
Used a Cavitron ultrasonic scal...
THERMOPLASTICIZED
INJECTABLE GUTTA-
PERCHA OBTURATION.
-SYRINGE INSERTION
Obtura II System
THERMOPLASTICIZED INJECTABLE GUTTA-PERCHA OBTURATION.
THERMOPLASTICIZED INJECTABLE GUTTA-PERCHA OBTURATION.
Introduced to the profession in 1977
Developed by a group at Harvard...
Obtura II: ( High Heat )
• was introduced by Yee et al in 1977
• Consists of hand held ‘gun’ that contains a chamber surro...
Technique :
• Canal is prepared, dried and the walls are coated with sealers.
• GP is preheated in the gun and the needle ...
Advantages :
Best adaptation to the root canal walls
Better bacterial seal
Flows in areas of root resorption, accessory ca...
Disadvantages :
lack of length control (overextension or underextension )
THERMOPLASTICIZED INJECTABLE GUTTA-PERCHA OBTURA...
Elements Obturation System
THERMOPLASTICIZED INJECTABLE GUTTA-PERCHA OBTURATION.
Inject-R Fill–Backfilling Technique.
 
Method of backfilling has been developed by Roane at the University of Oklahoma
Moy...
Inject-R Fill,
miniature-sized metal tube +
conventional gutta-percha
plunger,
used for backfilling process.
allows for de...
The Inject-R Fill
• Heated in a flame or an electronic heater
• Coronal surface of the gutta-percha -canal should be warme...
Ultrafill 3D ( low heat tech)
• 1984 by Michanowicz and Czonstokowsky
• System uses Ampules that contain GP of different v...
THERMOPLASTICIZED INJECTABLE GUTTA-PERCHA OBTURATION.
Advantages :
• Simple, fast, predictable filling of root canals.
• Especially useful for small or very curved canals.
• Mo...
SOLID-CORE
CARRIER:
MANUAL
INSERTION
 
SOLID-CORE CARRIER: MANUAL INSERTION
 
In 1978, Johnson described a unique yet simple method of canal obturation with
ther...
Original handmade gutta-percha
obturator mounted on regular
endodontic file.
Modern manufactured Thermafil
Obturators—alph...
Contemporary carriers are made of radiopaque plastic
While the gutta-percha covering the original carriers was heated in a...
Efficacy of ThermaFil Obturation.
 
 Weller et al. at Georgia used a split-tooth model to assess gutta-percha adaptation
u...
COLD PLASTICIZED GP
COLD PLASTICIZED GP
GuttaFlowGuttaFlow®®
Cold Flowable Gutta PerchaCold Flowable Gutta Percha
COLD PLASTICIZED GP
COLD PLASTICIZED GP
GuttaFlow®
is the first Non-Heated Flowable Obturation Material for
root canals which combines Gutta-P...
COLD PLASTICIZED GP
GuttaFlow®
Step-by-Step / Application
• Activation
• Mixing
GuttaFlow®
Step-by-Step / Application
• Dispensing
COLD PLASTICIZED GP
GuttaFlow®
Step-by-Step Application
Root canals filled with master points
and GuttaFlow®
AH Plus-8 hours curing
time
COLD ...
• Light speed Simplifill.
• MTA
Apical third filling
APICAL THIRD FILLING
 SimpliFill Obturation Technique
SimpliFill was originally developed by Senia at Light Speed Technolo...
•LIGHTSPEED's very short cutting blade provides more accurate
tactile feedback which helps determine when the canal has be...
 
SimpliFill is a relatively new
two-phased obturation method
use of a stainless steel carrier to place
compact a 5 mm seg...
                                                    Obturators
BETTER
Virtually no leakage occurred through SimpliFill's A...
     
•Conserves Dentin
•Simple to use
•Requires no expensive equipment
•Requires no heat
•Leaves no carrier in canal
•Is ...
Trial Fitting
The purpose of trial fitting is to check that
the SimpliFill GP Plug fits the apical
preparation correctly.*...
Step 1
Place Apical GP Plug™ to WL
Apical third filling
Step 2
Release GP Plug
from Carrier
Apical third filling
Step 3
Fill Remainder of
Canal with Sealer
SimpliFill syringe
Apical third filling
MINERAL TRIOXIDE AGGREGATES
• It is used as an apical obturation material before complete obturation
of the canal.
• Follo...
Apical third filling
NON INSTRUMENTATION TECHNIQUE OF OBTURATION
Fully automatic method:
• Mechanism of root canal preparation: Rapid pressure ...
ENDODONTICS – INGLE
PATHWAYS OF PULP—COHEN.
ENDODONTIC THERAY – FRANKLIN WEINE
www.pubmed.com
www.google.com
ENDODONTOLOGY...
Recent advances in obturation techniques/ dental implant courses
Recent advances in obturation techniques/ dental implant courses
Recent advances in obturation techniques/ dental implant courses
Recent advances in obturation techniques/ dental implant courses
Recent advances in obturation techniques/ dental implant courses
Recent advances in obturation techniques/ dental implant courses
Recent advances in obturation techniques/ dental implant courses
Recent advances in obturation techniques/ dental implant courses
Recent advances in obturation techniques/ dental implant courses
Recent advances in obturation techniques/ dental implant courses
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Recent advances in obturation techniques/ dental implant courses

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.

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Recent advances in obturation techniques/ dental implant courses

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing Dental Education
  2. 2.  INTRODUCTION  HISTORY  OBJECTIVES  CLASSIFICATION OF OBTURATING TECHNIQUES GROSSMAN COHEN INGLE MESSING AND STOCK (1988) GUTMANN AND WITHERSPOON (2002)  METHODS OF OBTURATION
  3. 3.  RECENT ADVANCES IN OBTURATING TECHNIQUES  CLINICAL APPLICATIONS  REFERENCES AND CONCLUSION
  4. 4. 19th century Koecker : Red hot wire cauterize pulp Gold to fill the canal Various materials used : Bamboo, waxes, asbestos, POP, cotton, ivory, wood , rubber . Metals , zinc , amalgam. 1847--- Hill’s Stopping.- Gutta Percha: 1867--- BOWNMAN first root canal filling using gutta-percha in extracted tooth.
  5. 5. 1847: ASA HILL introduced Gutta Percha in the form of “Hill’s Stopping” Bleached gutta percha+ carbonate of lime & quartz 1883: PERRY –used gold wire wrapped with GP RICHMOND used orange wood coated with gutta-percha 1887: SS White company first began to manufacture GP 1914: CALLAHAN: Used various metals for Obturation …….. Silver was the most common. 1977 : Thermoplasticized Injectable Gutta-percha Obturation was introduced
  6. 6. In 1978, JOHNSON described a unique yet simple method of canal , obturation with Thermoplasticized alpha-phase gutta-percha carried into the canal on an endodontic file. A Totally new concept of heat softening and compacting gutta-percha was introduced by MCSPADDEN in 1979. GUTTA-PERCHA has been known to dentistry for over 100 years, and is by far the most universally used solid-core root canal filling material.
  7. 7. Objectives of obturation Total debridement, try to get a fluid tight seal by total obliteration of canal space • Stops coronal leakage • Entombs surviving bacteria • Stops influx of periapical tissues and release of bacterial elements . The commonly used term “hermetic seal” is not accurate. “Hermetic” is defined as “airtight by fusion or sealing.” Air is not the problem at the periapex—fluid is the problem. “Impermeable” is a more accurate term. Fluid Impervious, Fluid Tight , Bacteria Tight Seal – appropriate to use .
  8. 8. Methods of obturation Direction of Compaction : Lateral Vertical Temperature of the gutta percha: Cold Warm Based on need of sealer : With sealer Without sealer (Paste fills) Based on number of cone used : Single cone technique Multiple cone technique
  9. 9. ACC to GROSSMAN: 1. Lateral 2. Vertical 3. Sectional 4. Compaction ( McSpadden technique) 5. Thermoplasticized gutta percha 6. Chemically plasticized gutta percha
  10. 10. Acc to Cohen: 1. Semisolid materials 2. Solid materials 3. Rigid cones Semisolid materials: • Chloroform dip technique • Lateral • Lateral and vertical • Sectional • Thermoplasticized materials • Thermo-mechanical condensation • Chemically plasticized gutta percha • Pressure syringe technique • Pastes Solid materials: • Silver cones • Stainless steel points Rigid cones • Vitallium • Cr-Co implant points
  11. 11. Acc to INGLE •Lateral condensation •Vertical condensation •Sectional condensation •Chemically plasticized •Thermo –compaction •Thermoplasticized GP technique •Ultrasonic plasticizing technique •Light speed sectional technique •Solid core material technique •Hybrid technique •Others
  12. 12. Classification according to J.J. Messing and C.J.R. Stock (1988) 1. Sectional • Silver • Titanium • Gutta percha • Amalgam 2. Single Cone • Gutta percha • Silver • Titanium point 3. Multiple cone • Cold lateral condensation • Warm lateral condensation • Hot vertical condensation • Custom made 4. Gutta percha with solvents 5. Thermal compaction 6. Injection molded thermo-plasticized pastes alone
  13. 13. 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 C. Canal warmed gutta percha Vertical compaction System B compaction Sectional Compaction
  14. 14. Lateral / vertical compaction • Endotec II Thermo-mechanical compaction • Microseal System, Engine-Plugger, Maillefer Condenser • Hybrid technique • J.S. Quick-Fill • Ultrasonic plasticizing D. Thermoplasticized gutta percha Syringe insertion Obtura Inject R-fill, backfill Solid – core carrier insertion Thermafil and Densfil Soft core and Three Dee GP Ultrafil
  15. 15. II. Apical third filling – Light speed SimpliFill – Dentin – chip – Calcium hydroxide III. Injection or “Spiral” filling – Cements – Pastes – Plastics – Calcium phosphate
  16. 16. • RESILON FIBERFILL
  17. 17. RESILON Resilon is a polymer based thermoplastic resin containing bioactive glass, bismuth oxychloride, barium sulphate and additional radiopaque fillers Resilon is a industrial polyurethane Adapted for dental use .
  18. 18. The polymer has an improved flexural strength and, when used in conjunction with a resin-based sealer, offers improved bonding potential compared with gutta- percha. Resilon is non mutagenic, non toxic , and biocompatible. Sizes: ISO #15 - # 40,Cone tapers: S1, S2, S3. Resilon is the central component of the Epiphany™ Soft Resin Endodontic Obturation System (Pentron Clinical Technologies, LLC), and RealSeal™ (SybronEndo). These systems include three primary components:  Resilon core material  Resin sealer  Primer
  19. 19. Primer. The primer—a self-etch primer that contains  Sulfonic acid-terminated functional monomer,  2- hydroxyethylmethacrylate (HEMA),  water  Polymerization initiator. HEMA enhances the bonding of resin to dentin.
  20. 20. Sealer in an auto mixing barrel syringe. The Resin Sealer—a dual-curing, resin-based composite sealer. The resin matrix is composed of bisphenol-A-glycidyldimethacrylate (BisGMA) ethoxylated BisGMA, urethanedimethacrylate (UDMA) and hydrophilic difunctional methacrylates. It contains fillers of calcium hydroxide, barium sulfate, barium glass, and silica total filler content is approximately 70% by weight.
  21. 21. Obtura Gun.Resilon points Resilon Pellet The Resilon core material a thermoplastic synthetic polymer-based root canal core material : bioactive glass, bismuth oxychloride and barium sulfate. The filler content is approximately 65% by weight.
  22. 22. Mono-Block Concept.
  23. 23. Because Resilon is a synthetic polymer, the resin sealer attaches to it, as well as to the bonding agent/primer used to penetrate into the dentin tubules. As a result, a ‘monoblock’ is formed, consisting of filling material resin sealer-bonding agent/primer-dentin. Sealer used for resilon is called ‘Epiphany’ or ‘Real seal’
  24. 24. Technique : Resilon can be softened with heat or dissolved with solvents such as chloroform for retreatment purposes. It is available as master cones and accessory cones in different sizes, and as Resilon pellets. Flushing the root canals : with 17% ethylenediaminetetraacetic acid (EDTA) and/or 2% chlorhexidine removes this smear layer and residual sodium hypochlorite
  25. 25. Advantages : • Very less microleakage due to ‘Monobloc’ and also ‘Double Seal’ • Resilon is a bonded resin system, it has the potential to strengthen the root. • Resilon is highly radiopaque and handles well with both cold and heated root canal filling techniques. • Healing in a short period of time.
  26. 26. RealSeal is applied in the same way as gutta percha. Use the obturation technique of your choice, adding only a priming step before filling. Has excellent handling, working time and flow characteristics. RealSeal flows easily into the accessible lateral anatomy of the root canal system. RealSeal EndoREZ EndoREZ Points are unique, resin-coated gutta percha cones. The resin coating bonds with EndoREZ during obturation resulting in more complete "monoblock"-type seal. EndoREZ Points can be used with all obturation techniques, including warm GP and lateral condensation.
  27. 27. USING EPIPHANY WITH SYSTEM B Set the temperature to 150°C. and the power to 10. USING EPIPHANY WITH THE OBTURA GUN • For the 25 gauge needle tips, set the temperature to 160°C. • For the 23 gauge needle tips, set the temperature to 140°C. • For the 20 gauge needle tips, set the temperature to 120-130°C.
  28. 28. The Fiberfill Obturator -Resin and glass fiber post with a terminal gutta percha tip. -The gutta percha is available either in 5 or 8mm lengths. -The diameter of the post : 30, 40, 50, 60, 70 ,80. apical gutta percha is retreatable, -removal of the bonded fiber post has proven to be difficult. -resin-based system can actually increase the strength of roots.
  29. 29. Each FibreFill obturator :  unidirectional fibers in an organic resin matrix.  gutta percha is attached via a thin, flexible filament The FibreFill obturator bonded to the tooth, The obturator not only fills the canal but also serves as a post FibreFill Root Canal Sealant, provides a more effective apical and coronal seal
  30. 30. CANAL WARMED GUTTA PERCHA TECHNIQUE SYSTEM B COMPACTION • Also called continuous wave compaction technique. • Variation of warm vertical compaction. • Heating element is contained within specifically designed pluggers ( Buchanan pluggers), • tips of which are 0.5 mm in diameter. • Pluggers are tapered and made up of stainless steel and come in sizes; 0.06,0.08, 0.10, 0.12.
  31. 31. Technique : • Fit a standardized gutta percha cone in the root canal preparation. • A Buchanan plugger is chosen that matches the taper of the selected gutta percha cone and a rubber stopper is placed on the plugger 5 mm short of WL. • Buchanan plugger is fitted to its binding point in the canal. Stop is adjusted and the plugger is removed. • Canal is dried and the cone is cemented. CANAL WARMED GUTTA PERCHA TECHNIQUE
  32. 32. • System B unit is set to 2000 c at touch mode and plugger is introduced in the canal and activated to remove excess coronal material. • Preheated plugger is driven smoothly through the GP until it stops. Procedure is repeated until the plugger is within 0.5 – 1 mm of the binding point. • Apical pressure without heat is maintained for 10 seconds to take up any shrinkage that might occur upon cooling. • Since the Buchanan pluggers heat from their tips back, heat burst in this portion can lead to coronal surplus of GP from the already condensed mass. • The canal is now ready for “obtura backfill”. CANAL WARMED GUTTA PERCHA TECHNIQUE
  33. 33. 1. MASTER CONE CEMENTATION. The master cone is cemented in the canal with sealer. 2. INITIATION OF DOWN PACK With the omni directional "trigger" switch activated 3. SUSTAINED APICAL CONDENSATION. The omni directional "trigger" switch should be released once within 3-4 mm of the apical constriction. CANAL WARMED GUTTA PERCHA TECHNIQUE
  34. 34. 4. SEPARATION BURST. The heat source is activated for one second OBTURA II. This is a thermo plasticized injection-molded delivery system 5. Remainder of the canal is ready for backfill. CANAL WARMED GUTTA PERCHA TECHNIQUE
  35. 35. “Touch ’n Heat” 5004, battery-powered (rechargeable)heat source. Heat carrier heats to glowing within seconds to plasticize gutta-percha in canal. Also used in removal of gutta-percha CANAL WARMED GUTTA PERCHA TECHNIQUE Advantages and Disadvantages
  36. 36. Lateral/Vertical Compaction of Warm Gutta-percha.   Considering the ease and speed of lateral compaction as well as the superior density gained by vertical compaction of warm gutta-percha, Martin developed a device that appears to achieve the best qualities of both techniques that was called Endotec II (Medidenta Inc; Woodside, N.Y.) Endotec II handpiece contains battery power pack. CANAL WARMED GUTTA PERCHA TECHNIQUE
  37. 37. Motion for using Endotec II- plugger/spreader— Vertical pressure with sweeping lateral pressure. Endotec II- plugger Gutta-percha. CANAL WARMED GUTTA PERCHA TECHNIQUE Pluggers 02/30, 02/40, 04/40, 04/70 06/70, 06/100
  38. 38. Martin and Fischer have shown, in a photo elastic stress test, that “warm lateral condensation (Endotec) created less stress during obturation than did cold lateral condensation.” Martin pointed out that the Schilder compaction method leads to 0.45% shrinkage, and since Endotec temperatures are lower than with the other technique, shrinkage following Endotec usage should be lower as well CANAL WARMED GUTTA PERCHA TECHNIQUE
  39. 39. SECTIONAL COMPACTION • Modifications of the vertical compaction. • Known as the “Chicago” technique since it was widely promoted by Coolidge,Blayney, and Lundquist, all from Chicago. CANAL WARMED GUTTA PERCHA TECHNIQUE
  40. 40. CANAL WARMED GUTTA PERCHA TECHNIQUE
  41. 41. CANAL WARMED GUTTA PERCHA TECHNIQUE
  42. 42. THERMOMECHANICAL COMPACTION • By McSpadden in 1979. Initially called the ‘McSpadden Compactor’. • Device resembled a reverse Hedstroem file. • latch-type handpiece • 8,000 and 20,000 rpm. • In Europe, Maillefer modified the Hedstroem- ‘Gutta-Condenser’, • Zipperer (Germany) called ‘Engine Plugger’. • McSpadden modified it • made of nickel titanium • Microseal System (Analytic/Quantec, USA). • This technique describes plasticity generated within GP by heat developed during mechanical activity
  43. 43. • A well adapted master cone is placed in the canal with a suitable sealer. • A mechanically activated rotating compactor similar to reverse Hedstroem file is introduced in the canal which heats up the GP and thermoplasticizes it. THERMOMECHANICAL COMPACTION
  44. 44. • Thermocompactors available – Maillefer Gutta-condenser, McSpadden Ni-Ti thermocompactor, Zipperer thermocompactor and Quickfill compactor. THERMOMECHANICAL COMPACTION
  45. 45.                                                                                                                MicroSeal System Microseal Heater Microflow Syringe Microflow Cartridge. MicroFlow master cone MicroSeal absorbent points. THERMOMECHANICAL COMPACTION
  46. 46.                                                         Developed by Dr. John McSpadden     Includes the following features: • Low-fusing gutta percha specifically designed to flow with pressure, heat or both. • Condensers are stiff enough to go full length, flexible enough to slide around curvatures and easy to custom-fit without distortion. THERMOMECHANICAL COMPACTION
  47. 47. Micro-Seal Gutta-percha Condenser is operated at slow speed. • Run at a speed of 1000 to 4000 rpm. Microseal Condensers The engine-driven nickel-titanium condensers utilize a reverse-helix design that simultaneously introduces and condenses gutta percha into the intricacies of the canal system THERMOMECHANICAL COMPACTION
  48. 48. Microseal Spreaders Nickel-titanium finger or engine spreaders enable even distribution of condensation forces against the master cone, even around curvatures Technique THERMOMECHANICAL COMPACTION
  49. 49. Microseal Heater MicroSeal Heater efficiently heats gutta percha to full working temperature in less than 45 seconds. The device is thermostatically controlled to maintain ideal working temperature of cartridges throughout treatment. Microflow Syringe Autoclavable heavy-duty metal construction with large finger supports for easy extrusion of Microflow Cartridges.   THERMOMECHANICAL COMPACTION
  50. 50. 1. MicroFlow master cone and sealer are placed in the canal. 2. Warm MicroFlow Gutta percha is introduced and condensed in the canal. 3. A root canal that is filled in all its dimensions. T E C H N I Q U E THERMOMECHANICAL COMPACTION
  51. 51.   One other innovation using the thermo mechanical principle to compact gutta-percha in the root canal has been introduced as the J.S. Quick-Fill (J.S. Dental Co., Sweden/USA). This system consists of titanium core devices that come in ISO sizes 15 to 60, resemble latch-type endodontic drills, coated with alpha-phase gutta-percha. Thermo mechanical Solid-Core Gutta-percha Obturation. J.S. Quick-Fill titanium carriers coated with alpha-phase gutta percha comes in sizes and operates in regular slow-speed handpiece. Friction plasticizes gutta-percha. Titanium core may be severed and left or removed while still spinning. THERMOMECHANICAL COMPACTION
  52. 52. D. Thermoplasticized gutta percha. Syringe insertion ( Pressure syringe). a. Obtura II, Elements obturation b. Inject R Fill c. Ultrafil Solid core carrier insertion. a. Thermafill and Soft core and Three Dee GP. E.Cold plasticized Gutta percha technique a. Gutta flow F.Apical 3rd filling a. Simplifil b. MTA G. Non Instrument Technology
  53. 53. THERMOMECHANICAL COMPACTION Ultrasonic Plasticizing. First suggested by Moreno from Mexico Used a Cavitron ultrasonic scaler with a PR30 insert, Used only in the anterior mouth. Moreno placed gutta-percha points to virtually fill the canal. Insert the attached endodontic instrument into the mass, activated the ultrasonic instrument -plasticized the gutta-percha by friction Final vertical compaction could be done with hand or finger pluggers.
  54. 54. THERMOPLASTICIZED INJECTABLE GUTTA- PERCHA OBTURATION. -SYRINGE INSERTION
  55. 55. Obtura II System THERMOPLASTICIZED INJECTABLE GUTTA-PERCHA OBTURATION.
  56. 56. THERMOPLASTICIZED INJECTABLE GUTTA-PERCHA OBTURATION. Introduced to the profession in 1977 Developed by a group at Harvard/Forsyth Institute, Gutta-percha was ejected out of a prototype pressure syringe that had warmed it to 160°C. -- 18 gauge Today marketed as the Obtura II Heated Gutta-Percha System Digitally controlled temperatures --160°C to 200°C Needle size -- 20 gauge (equal to a size 60 file) 23 gauge (equal to a size 40 file). Although regular beta-phase gutta-percha is still used, Now -less viscous, higher flow form of gutta-percha known as Easy Flow .
  57. 57. Obtura II: ( High Heat ) • was introduced by Yee et al in 1977 • Consists of hand held ‘gun’ that contains a chamber surrounded by heating element into which pellets of GP are loaded. • Silver needles are used to deliver the material into the canal. • Control unit allows the adjustment of temperature and thus viscosity of GP. • Temp of GP from needle – 600 to 700 c THERMOPLASTICIZED INJECTABLE GUTTA-PERCHA OBTURATION.
  58. 58. Technique : • Canal is prepared, dried and the walls are coated with sealers. • GP is preheated in the gun and the needle is positioned in the canal so that it reaches within 3-5 mm of the apical preparation. • GP is passively injected by squeezing the trigger of the gun.Needle backs out of the canal as the apical portion is filled. • Pluggers dipped in alcohol are used to compact the GP when it gets cooled. • GP is heated at 160-2000 c THERMOPLASTICIZED INJECTABLE GUTTA-PERCHA OBTURATION. 3 Techniques of Using OBtura II
  59. 59. Advantages : Best adaptation to the root canal walls Better bacterial seal Flows in areas of root resorption, accessory canals and other irregularities Clinical considerations : “COKE BOTTLE EFFECT” THERMOPLASTICIZED INJECTABLE GUTTA-PERCHA OBTURATION.
  60. 60. Disadvantages : lack of length control (overextension or underextension ) THERMOPLASTICIZED INJECTABLE GUTTA-PERCHA OBTURATION.
  61. 61. Elements Obturation System THERMOPLASTICIZED INJECTABLE GUTTA-PERCHA OBTURATION.
  62. 62. Inject-R Fill–Backfilling Technique.   Method of backfilling has been developed by Roane at the University of Oklahoma Moyco-Union Broach; Bethpage, N.Y THERMOPLASTICIZED INJECTABLE GUTTA-PERCHA OBTURATION.
  63. 63. Inject-R Fill, miniature-sized metal tube + conventional gutta-percha plunger, used for backfilling process. allows for delivery of a single backfill injection of gutta-percha THERMOPLASTICIZED INJECTABLE GUTTA-PERCHA OBTURATION.
  64. 64. The Inject-R Fill • Heated in a flame or an electronic heater • Coronal surface of the gutta-percha -canal should be warmed • Burner is used -- sleeve is waved through the flame until gutta-percha begins to extrude from the open end. warmed unit -placed into the orifice canal orifice must be at least 2 mm in diameter. handle pushed - injects the heated gutta-percha into the canal. Pre-fitted hand or finger pluggers used to compact the gutta-percha. THERMOPLASTICIZED INJECTABLE GUTTA-PERCHA OBTURATION.
  65. 65. Ultrafill 3D ( low heat tech) • 1984 by Michanowicz and Czonstokowsky • System uses Ampules that contain GP of different viscosities. • GP formulations : Regular set, Endoset and Firm set. • Ampules are heated for 15 minutes to plasticize the GP. • A cannula with diameter of 0.7 mm is attached to each ampule and the GP is injected with a modified ‘ PERIPRESS SYRINGE’. • Excessive pressure is avoided to prevent extrusion of material. THERMOPLASTICIZED INJECTABLE GUTTA-PERCHA OBTURATION.
  66. 66. THERMOPLASTICIZED INJECTABLE GUTTA-PERCHA OBTURATION.
  67. 67. Advantages : • Simple, fast, predictable filling of root canals. • Especially useful for small or very curved canals. • More dense and well adapted root canal fillings compared to the conventional technique. Disadvantages : Overextension. THERMOPLASTICIZED INJECTABLE GUTTA-PERCHA OBTURATION.
  68. 68. SOLID-CORE CARRIER: MANUAL INSERTION  
  69. 69. SOLID-CORE CARRIER: MANUAL INSERTION   In 1978, Johnson described a unique yet simple method of canal obturation with thermoplasticized alpha-phase gutta-percha carried into the canal on an endodontic file. ThermaFil is considered the major core-carrier technique, Two similar products : Soft-Core, and its European version, Three Dee GP. The central carrier is uniformly coated with a layer of refined and tested alpha-phase gutta-percha ThermaFil ThermaFil
  70. 70. Original handmade gutta-percha obturator mounted on regular endodontic file. Modern manufactured Thermafil Obturators—alpha-phase gutta-percha mounted on radiopaque, flexible, plastic carriers. SOLID-CORE CARRIER: MANUAL INSERTION  
  71. 71. Contemporary carriers are made of radiopaque plastic While the gutta-percha covering the original carriers was heated in a flame, New plastic core carriers are heated in a controlled oven environment called the ThermaPrep Plus heating system Dentsply/Tulsa. Method of Use. The sealer is applied, the warmed obturator is removed from the ThermaPrep Plus heater and carried slowly to full working length in the canal. ThermaPrep Plus heater SOLID-CORE CARRIER: MANUAL INSERTION  
  72. 72. Efficacy of ThermaFil Obturation.    Weller et al. at Georgia used a split-tooth model to assess gutta-percha adaptation using Obtura, three types of ThermaFil core carriers, and lateral compaction. No root canal sealer was used. The best adaptation was with Obtura obturations, followed by ThermaFil plastic, ThermaFil titanium, ThermaFil stainless steel, and lateral compaction SOLID-CORE CARRIER: MANUAL INSERTION  
  73. 73. COLD PLASTICIZED GP
  74. 74. COLD PLASTICIZED GP GuttaFlowGuttaFlow®® Cold Flowable Gutta PerchaCold Flowable Gutta Percha
  75. 75. COLD PLASTICIZED GP
  76. 76. COLD PLASTICIZED GP GuttaFlow® is the first Non-Heated Flowable Obturation Material for root canals which combines Gutta-Percha and Sealer in One product • Works at room temperature • Easier and Faster – Gutta-Percha and Sealer in One – No condensation needed + = GP Powder Sealer GuttaFlow • Excellent Seal No Heat - No Shrinkage Expands slightly by 0.2% percen • Insoluble and dimensionally stable
  77. 77. COLD PLASTICIZED GP GuttaFlow® Step-by-Step / Application • Activation • Mixing
  78. 78. GuttaFlow® Step-by-Step / Application • Dispensing
  79. 79. COLD PLASTICIZED GP
  80. 80. GuttaFlow® Step-by-Step Application Root canals filled with master points and GuttaFlow® AH Plus-8 hours curing time COLD PLASTICIZED GP
  81. 81. • Light speed Simplifill. • MTA Apical third filling
  82. 82. APICAL THIRD FILLING  SimpliFill Obturation Technique SimpliFill was originally developed by Senia at Light Speed Technology to complement the canal shape created using Light Speed instruments. The Apical GP Plug size is the same ISO size as the LightSpeed “Master Apical Rotary” (MAR) Apical third filling
  83. 83. •LIGHTSPEED's very short cutting blade provides more accurate tactile feedback which helps determine when the canal has been properly cleaned. •LIGHTSPEED's taper less shaft gives it more flexibility than others.   This flexibility keeps it centered, virtually eliminating ledging, zipping and perforating the canal.   •LIGHTSPEED instrumentation is conservative.  It removes sufficient dentin to clean and shape without over-enlarging the canal and weakening the root.  This approach reduces the risk of future root fracture. Apical third filling
  84. 84.   SimpliFill is a relatively new two-phased obturation method use of a stainless steel carrier to place compact a 5 mm segment of gutta-percha into the apical portion Once placed, the carrier is removed, leaving a plug of gutta-percha. If a post is not desired, The Second Phase backfill canal with Ketac-Endo sealer along with accessory cones of gutta-percha. Backfill Syringe Apical third filling
  85. 85.                                                     Obturators BETTER Virtually no leakage occurred through SimpliFill's Apical Plug FASTER ... Complete obturation with SimpliFill® was accomplished in less than half the time of lateral condensation "Maria D. Santos, William A. Walker, and David L. Carnes.. J Endodon 1999; 25: 609-12. Abstract " Apical third filling
  86. 86.       •Conserves Dentin •Simple to use •Requires no expensive equipment •Requires no heat •Leaves no carrier in canal •Is kind to the root • Saves time when post space is required •Simplifies cleaning and shaping Apical Plug Rubber stop Shaft Apical GP Plug ( length 5mm). Apical third filling
  87. 87. Trial Fitting The purpose of trial fitting is to check that the SimpliFill GP Plug fits the apical preparation correctly.*Trial fit a GP Plug the same size as the MAR. Set the stop at WL. Do not use sealer. S I M P L I F I L L ® Apical third filling
  88. 88. Step 1 Place Apical GP Plug™ to WL Apical third filling
  89. 89. Step 2 Release GP Plug from Carrier Apical third filling
  90. 90. Step 3 Fill Remainder of Canal with Sealer SimpliFill syringe Apical third filling
  91. 91. MINERAL TRIOXIDE AGGREGATES • It is used as an apical obturation material before complete obturation of the canal. • Following cleaning and shaping, canal is dried and MTA is placed. • The material is compacted into the apical portion of the root to form a barrier. • After the material sets,GP can then be compacted without extrusion Advantages : • sterile, biocompatible • Induces hard tissue formation at the apical region. • Rapid, eliminating the need for numerous visits. Apical third filling
  92. 92. Apical third filling
  93. 93. NON INSTRUMENTATION TECHNIQUE OF OBTURATION Fully automatic method: • Mechanism of root canal preparation: Rapid pressure changes under partial vaccum cause bubble formation which then implode (cavitations). This process takes place at least 250 times per second and produces an intense exchange of sodium hypochlorite within the canals. • Strong tissue dissolving action of NaOCl removes pulp tissue within 10-15 minutes. • Mechanism of root canal obturation: The device consists of a multistage vaccum pump which when fitted to the tooth creates vaccum in prepared canals. The root canal filling paste is then sucked in the canal. • The pump contains a ball inside, which prevents air entry in the reservoir.
  94. 94. ENDODONTICS – INGLE PATHWAYS OF PULP—COHEN. ENDODONTIC THERAY – FRANKLIN WEINE www.pubmed.com www.google.com ENDODONTOLOGY -BEER , KIM COMPANY CATALOGUES –GUTTA FLOW MAGNIFICATION IN ENDODONTICS: THE USE OF THE OPERATING MICROSCOPE INTERNATIONAL DENTISTRY SA – AUSTRALASIAN EDITION VOL. 1, NO. 2

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