OBTURATION

•PRESENTED BY :
TEJASWI GUNDAGANI
•IV BDS
•ROLL NO:27
CONTENTS:
• INTRODUCTION
• OBJECTIVES
• MATERIALS USED FOR OBTURATION
• ARMAMENTARIUM FOR OBTURATION
• OBTURATION TECHNIQUES
• REFERENCES
WHAT IS OBTURATION?

OBTURATION means to fill the shaped and disinfected canal

with a temporary or permanent filling material

It can be achieved by using cements ,pastes, plastics ,or solids

 • Microorganisms and their byproducts are
major cause of pulpal and periapical
diseases
• However ,it is difficult to consistently and
WHY TO totally disinfect root canal systems

OBTURATE? • Therefore, the goal of three-dimensional(3-

D OBTURATION is to provide an
impermeable fluid tight seal within the
entire root canal System to prevent oral and
apical Microleakage
WHEN TO OBTURATE?
TOOTH CAN BE OBTURATED
• There is no pain or swelling
• No signs of Sinus ,Abscess and fistula
• The canal is dry and free from necrotic toxins or pus
• In case of vital pulp, OBTURATION can be done in single visit
after cleaning and shaping
OBJECTIVES OF OBTURATION:

Elimination of coronal leakage of microorganisms or potential nutrients

to support their growth in dead space of root canal system

To confine any residual microorganisms that have survived the chemo

mechanical cleaning and shaping to prevent their proliferation and
pathogenicity
To prevent percolation of periapical fluids into the root canal system and
feeding microorganism
GROSSMAN (1982)GROUPED ACCEPTABLE FILLING MATERIALS
INTO PLASTIC, CEMENT, SOLIDS OR PASTES
HE GAVE 10 REQUIREMENTS FOR AN IDEAL ROOT CANAL
FILLING MATERIAL

Bacteriostatic coat
Seal the canal
Easily introduced Not shrink after Impervious to least do not
laterally as well as
into root canal being insertion moisture encourage bacterial
apically
growth

Sterile/easily
Easily removed
Non staining the sterilized
Radiopaque Non irritating from the root canal
tooth structure immediately before
if necessary
OBTURATION
MATERIALS USED FOR
OBTURATION

• Silver cones
• Gutta-percha
• Custom cones
• Resilon
• Root canal sealers
 OBTURATION TECHNIQUES:

• Material of choice for OBTURATION is gutta-percha in conjunction with sealer

• OBTURATION methods vary in directions of compaction(lateral/vertical)
and/or Temperature of gutta-percha used either cold or warm(plasticized
• There are two basic procedures:
1.Lateral compaction of cold Gutta-percha
2.Vertical compaction of warm gutta-percha
3.Other methods-variations of warmed gutta-percha technique .
ARMAMENTARIUM FOR
OBTURATION
• Primary and accessory gutta-percha points
• Spreaders and pluggers for compaction of gutta-percha
• Absorbent paper point for drying the prepared root canal
before applying sealer
• Lentils spirals for placing sealer
• Scissors or Gutta- percha cutter for cutting Gutta-percha
• Endo gauge for measuring size of gutta- percha
 LATERAL COMPACTION TECHNIQUE
• It is one of the common methods used for root canal
obturation
• It involves placement of tapered gutta-percha cones in
canal and then compacting the under pressure against the
canal walls using a spreader
• A canal should have continuous tapered shape with a
definite apical stop,before it is ready to be filled by this
method
TECHNIQUE:
• Select the gutta-percha cone whose diameter is same as that of
master apical file.Feel the tug back with master gutta percha
point
• Check the fit of cone radiographically.If found
satisfactory,remove the cone from the canal and place it in
sodium hypochlorite:
• Select the size of spreader to be used for lateral compaction of
that tooth.It should reach 1-2 mm of true working length
without binding in the canal should occur,there is chance for
tooth fracture with excessive pressures.
• Dry the canal with paper points and apply sealer in canal
• Place master gutta percha cone in the canal
• Coat the premeasured cone with sealer and place into the canal.After master
cone placement ,place spreader into canal along the side of cone.spreader
helps in compaction of gutta-percha.It acts as a wedge to squeeze the gutta
percha laterally under vertical pressure not by pushing it sideways.It should
reach 1-2 mm of the prepared root length.
• Remove the spreader by rotating it back and forth.This the gutta-percha and
creates a space for accessory cones lateral to the master cast
• Place the accessory cones in this space and repeat the above procedure until
spreader no longer penetrates beyond the cervical line.
• Now sever the protruding gutta –percha points at canal orifice with hot
instrument
ADVANTAGES

• Can be used in most clinical situations

• Positive dimensional stability of root filling
• During compaction of gutta-percha, it
provides length control, thus ,decreases the
chances of overfilling
DISADVANTAGES

• Presence of voids
• Increased sealer:GP ratio
• Does not produce homogenous mass
• Space may exist between accessory and master cones
• Time consuming
• Less able to seal lateral canals and intracanal defects
WARM VERTICAL COMPACTION TECHNIQUE:

Introduced by Schiller with an

objective of filling all the
portals of exist with maximum
amount of gutta-percha and
minimum amount of
sealer.This is also known as
schilder’s technique of
obturation
In this technique using heated
pluggers,pressure is applied in
vertical direction to heat
softened gutta-percha which
causes it to flow and fill the
canal space
BASIC REQUIREMENTS OF A PREPARED CANAL TO BE
FILLED BY VERTICAL COMPACTION TECHNIQUE ARE

Continuous tapering funnel shape from orifice to apex

Apical opening to be as small as possible so as to prevent

extrusion of obturating material

Decreasing the cross-sectional diameter at every point apically and

increasing at each point as canal is approached coronally
TECHNIQUE
• Select a master cone according to shape and size of the preparedcanal.Cone
should fit in 1-2 mm of apical stop because when softened material moves
apically into prepared canal,it adapts better to the canal walls
• Confirm the fit of cone radiographically,if found satisfactory,remove it from the
canal and place in sodium hypochlorite
• Irrigate the canal and then dry by rinsing it with alcohol and latter using the
paper point
• Select the heat transferring instrument and pluggers according to canal shape
and size
• Pluggers are predicted at 5mm intervals so as to capture maximum cross-
section area of the softened gutta-percha
• Cut the coronal end of selected gutta-percha at Incisal or occlusal
reference point
• Now use heated pluggers to force the gutta-percha into the
canal.Blunt end of pluggers created a deep depression in the center
of master cone.The outer walls of softened gutta-percha are then
folded inward to fill the central void.At the same time,mass of
softened gutta-percha is moved apically and laterally.This
procedure also removes 2-3 mm of coronal part of gutta-percha
• Once apical filling is done,complete obturation by doing
backfilling.oturate the remaining canal by heating small segments
of gutta-percha,carrying them into the canal and then compacting
them using heated pluggers.
THERMOPLASTISIZED INJECTABLE
GUTTA-PERCHA OBTURATION
• Obtura II Heated Gutta-percha System/High-Heat system
• This technique was introduced in 1977 at Harvard institute
• It consists of an electric control unit with pistol grip syringe and
specially designed Gutta-percha pellets which are heated to
approximately 365-390 (185-200 C) for obturation
• In this ,refusal Beta phase of gutta-percha is used
• Prerequisites for Canal to be filled by Obturate II:
• Continuous tapering funnel shaped for unrestricted flow of
softened gutta-percha
• A definite apical stop to prevent overfilling
INDICATIONS FOR USING
OBTURA II

• Roots with straight or slightly curved canal

• For backfilling of canals
• For obturation of roots with internal
resorption,perforations,etc .
 TECHNIQUE:
• Before starting the obturation,applicator needle and
pluggers are selected.Needle tip should reach ideally 3-5
mm of the Apical terminus passively
• Apply sealer along the dentinal walls to fill the interface
between Gutta-percha and dentinal walls
• Place Obturate needle loosely 3-5 mm short of apex,as
warm Gutta-percha flows and fills the canal,back pressure
pushes the needle out of the canal
• Now use pluggers to compact the Gutta-percha;pluggers are
dipped in isopropyl alcohol or sealer to prevent sticking of
the Gutta-percha
 VARIATIONS IN THERMOPLASTICIZING
TECHNIQUE OF GUTTA-PERCHA

• Ultrasonic plasticizing of Gutta-Percha

• It has been seen that ultrasonics can be used to fill the canals by plasticizing
the gutta –percha
• Earliet ,Cavitrob US scaler was used for this purpose but its design limited
it’s use only in anterior teeth
• Recently,ENAC ultrasonic unit comes with an attached spreader which has
shown to produce homogenous compaction of gutta -percha
• Ultrafil System
• This system uses low temperature,
(90C)plasticized alpha-phase gutta-percha
• Here gutta –percha is available in 3 different
viscosities for use in different situations
• Regular set and the firm set with highest flow
properties primarily used for injection and
need not be compacted manually.Endoser is
more viscous and can be condensed
immediately after injection
 TECHNIQUE:
• Cannula needle is checked in canal for fitting
• It should be 6-7 mm from the apex
• After confirming the fit,it is placed in heater which has a preset
temperature of 90 C
• Apply sealer in the canal and passively insert the needle into the
canal. AS the warm Gutta-percha fills the canal it’s back pressure
pushes the needle out of the canal
• Once needle is removed,predicted plugger dipped in alcohol is
used for manual compaction of Gutta-Percha
 • Thermafil Endodontic Obturators
• Thermafil endodontic Obturators are specially
designed of flexible steel, titanium,or plastic carriers
coated with alpha phase Gutta-percha
• Thermafil Obturation was devised by W.Ben Johnson
SOLID CORE in 1978

CARRIER • In this,carriers are made up of stainless

steel,titanium,or plastic
TECHNIQUE • They have ISO standard dimension with matching
color coding in sizes 20-140
• Plastic carriers is made up of special synthetic resin
which can be liquid plastic crystal or polysulfone
polymer
• The Carrier is not primary cone for obturation
• It acts as carrier and condenser for thermally
plasticized gutta-percha
• Plastic cores allow post space to be made
easily and they can be cut off by heated
instruments, stainless steel bur,diamond
stone,or therma cut bur
TECHNIQUE
Select a thermafil Obturators of the size and shape which fits passively at the working
length. Verify the length of verifier by taking a radiograph

Now disinfect the obturator in 5.25% of sodium hypochlorite for 1 min and then rinse it in
70% alcohol

Preheat the obturator in Themaprep oven for sometime.Offers a stable heat source with
more control and uniformity for plasticizing the gutta –percha

Dry the canal and lightly coat it with sealer.aplace the heated obturator into the canal with
firm apical Pressure to the marked working length

Working time is 8-10 s after removal of obturator from oven If more Obturators are
required,insert them immediately
 When found accurate ,while stabilizing the carrier with index
While finger,sever the shaft level with the orifice using a prepi bur on an
inverted cone but in high-speed hand piece
Do not use flame heated instrument to sever the plastic shaft because
Do not use instrument cools too rapidly and thus may cause inadvertent
obturator displacement from the canal

Now use a small condenser coated with Vaseline or dipped alcohol,to

Use condense Gutta-percha vertically around the shaft

When post is indicated,sever the obturator with fissure bur at

Sever selected length and give counterclockwise rotation of shaft following
insertion to disengage the instrument
 ADVANTAGES
• Requires less chair-side time
• Provides dense 3-D obturation as gutta-percha flows into canal
irregularities such as fins,anastomoses,and lateral canals
• No need to precurve Obturators because of flexible carriers
• Since this technique requires minimum compaction,so less strain
while obturation with this technique
CHICAGO TECHNIQUE

• In this technique ,small pieces of gutta percha cones are used to

fill the sections of the canal .
• It is also known as Chicago technique because it was widely
promoted by Coolidge,Lundquist,blayney, all from Chicago
TECHNIQUE

• A gutta-percha cone of same size of the prepared root canal is selected and
cut into sections of 3-4 mm long
• Select a plugger which loosely fits within 3 mm of working length
• Apply sealer in the canal
• One end of gutta percha is mounted to heat plugger and is then carries into
the canal and apical pressure is given
• After this, disengage the plugger from gutta percha by rotating it.
• Then confirm its fit by radiograph
ADVANTAGES
• It seals the canal apically
and laterally
• In case of post and core
cases,only apical section of
canal is filled.
DISADVANTAGES
• Time –consuming
• If canal gets
overfilled ,difficult to remove
sections of gutta percha
REFERENC
ES:
TEXTBOOK OF
ENDODONTICS NISHA
GARG AMIT GARG