Seminar Conserve
Seminar Conserve
NAVya binu
FINAL Year part b
DEFINTION
The word obturation means
obturate : to block or to to occlude
Simply means to occlude or fill a cavity.
In endodontics, obturation means a reflection of the cleaning and shaping
and the obturant (obturating material ) must seal the root canal system
three dimensionally as to prevent tissue fluids from percolating in the root
canal and the toxic by products from both the necrotic tissue and micro
organisms regressing to the peri radicular tissues.
CLASSIFICATION OF
Lateral compaction
OBTURATION METHODS
Warm vertical compaction
Continuous wave compaction technique
Warm lateral compaction
Thermoplastic injection techniques
• Obtura II
• Ultrafil 3D
Carrier-Based Gutta Percha
• Thermafil
• Successfil
• Simplifill
Thermomechanical compaction
Solvent techniques
Pastes
Immediate obturation
LATERAL COMPACTION TECHNIQUE
Lateral compaction is a common method for obturation . The technique can be used in most clinical
situations
Technique
• After canal preparation a standard cone is selected that has a diameter consistent with the
prepared canal diameter at the working length. Standard cones generally have less taper when
compared with conventional cones and will permit deeper spreader penetration.
• When the cone extends beyond the prepared length a larger cone must be adapted or
the existing cone shortened until there is resistance to displacement at the corrected
working length. The master cone placement is confirmed with a radiograph. The canal is
irrigated and dried with paper points. Sealer is applied to the canal walls, and a spreader
is prefitted so as to allow it to be inserted to within 1.0 to 2.0 mm from working length.
Appropriate accessory points are also selected to closely match the size of the spreader
• The correlation between spreader size and nonstandard cones is variable and in small curved
canals there does not appear to be a difference in the quality of obturation with nonstandard cones
when compared with standard cones. Finger spreaders provide better tactile sensation and are less
likely to induce fractures in the root when compared with the more traditional D-11T hand spreader.
In addition to the type of spreader, forces applied, and amount of dentin removed, spreader size
may be a factor in root fracture, with large sizes inducing more stress. Spreaders made from nickel–
titanium are available and provide increased flexibility, reduce stress and provide deeper
penetration when compared with stainless steel instruments. The spreader should fit to within 1 to
2 mm of the prepared length, and when introduced into the canal with the master cone in place, it
should be within 2 mm of the working length. There appears to be a correlation between
establishing a seal and spreader penetration.
After placement the spreader is removed by rotating it back and forth as it is withdrawn.
An accessory cone is placed in the space vacated by the instrument. The process is
repeated until the spreader no longer goes beyond the coronal one third of the canal. The
excess gutta-percha is removed with heat and the coronal mass is compacted with an
appropriate plugger. Only light pressure is required during lateral compaction because
the gutta-percha is not compressible, and because as little as 1.5 kg of pressure is
capable of fracturing the root. In addition to the force applied, investigators have noted
that removal of dentin during preparation is a significant factor in root fracture.
Pretreatment radiograph. Coronal access opening, demonstrating
Working length radiograph. the prepared mesiobuccal canal
Standardized master cones Standard master cones fit to length as Master cone radiograph.
they
exhibit minimal taper and permit deeper
Finger spreader Fine-medium Finger spreader
accessory cone placed in preparation, creating Additional cones are
in place space for additional accessory placed until the spreader
placed in the
cones. does not penetrate past
space created by
the spreader the coronal one third of the
canal. The cones are then
removed at the orifice with
heat, and the coronal mass
is vertically compacted
with a
plugger
ADVANTAGES
- Can be used in most clinical situations
- During the compaction of gutta-percha it provides length control, thus decreases the chances
of overfilling
DISADVANTAGES
-may not fill the canal irregularities efficiently
- Does not produce the homogeneous mass
WARM VERTICAL COMPACTION TECHNIQUE
- Schilder266 introduced warm vertical compaction as a method of filling the radicular space in
three dimensions.
- Preparation requirements for the technique include preparing a canal with a continuously
tapering funnel and keeping the apical foramen as small as possible. The armamentarium
includes a variety of pluggers and a heat source. Schilder pluggers come in a variety of sizes (#8
= 0.4 mm, # 8.5 = 0.5 mm, etc., for sizes #9, # 9.5 , #10, #10.5, #11, #11.5, #12) with
increasing diameter. The instruments are marked vertically at 5-mm intervals.
- The technique involves fitting a master cone short of the corrected working length (0.5 to 2
mm) with resistance to displacement . This ensures that the cone diameter is larger than the
prepared canal.
- Nonstandard cones that closely replicate the canal taper are best because they permit the
development of hydraulic pressure during compaction.
After the adaptation of the master cone it is removed and sealer is applied. The cone is placed
in the canal and the coronal portion is removed with heat. A heated spreader or plugger is used
to remove portions of the coronal gutta-percha and soften the remaining material in the canal.
The Touch ’n Heat (SybronEndo) , EI DownPak (EI/Hu-Friedy, Chicago, IL), and System B
(SybronEndo) are alternatives to applying heat with a flame-heated instrument because they
permit temperature control. A plugger is inserted into the canal and the gutta-percha is
compacted, forcing the plasticized material apically. The process is repeated until the apical
portion has been filled. The coronal canal space is backfilled, using small pieces of gutta-percha.
The sectional method consists of placing 3- to 4-mm sections of gutta-percha approximating the
size of the canal into the root, applying heat, and compacting the mass with a plugger
Nonstandard Heated pluggers or A room temperature Apical compaction is
cones are spreaders are used plugger is used to complete
selected and fit to apply heat to the compact the heated
short master cone and gutta-percha.
of the prepared remove the excess
length because coronal material.
they more
closely replicate
the prepared
canal.
The process is repeated for
A gutta-percha Heated segment is the coronal portion of the
segment is placed compacted . canal by placing and heating
in the canal, and a segment of gutta-percha.
heat is applied.
Completed
A plugger is again used to obturation
compact
the heated material.
The forces developed appear to be equal to lateral compaction. Investigators compared warm vertical
compaction and lateral compaction as a function of time. Results indicated that the forces developed
with the two techniques were not significantly different.
ADVANTAGES
• producing movement of the plasticized gutta-percha
• filling irregularities and accessory canals better than lateral compaction
DISADVANTAGES
• Slight risk of vertical root fracture because of compaction forces
• Less length control than with lateral compaction,
• The potential for extrusion of material into the periradicular tissues.
• Warm vertical compaction is difficult in curved canals, where the rigid pluggers are unable to
penetrate to the necessary depth. To allow the rigid carriers to penetrate within 4 to 5 mm of the
apex, the canals must be enlarged and tapered more, in comparison with the lateral compaction
technique; however, excessive removal of tooth structure weakens the root.
WARM LATERAL COMPACTION
The use of warm lateral compaction with the Endotec demonstrated an increased weight of mass,
by 14.63%, when compared with traditional lateral compaction.
Using the Endotec II, one investigation reported a statistically significantly better ability of warm
vertical and warm lateral compaction techniques versus cold lateral compaction to reproduce
artificially produced canal irregularities.
Another group EndoTwinn (Hu-Friedy), an instrument for warm lateral
compaction, in a similar experiment. The EndoTwinn instrument also
possesses the ability to vibrate the electronically heated tip.
They reported that warm lateral compaction, using both heat and vibration,
and warm vertical compaction of gutta-percha provided statistically better
replication of defects than cold lateral compaction.
The warm lateral compaction technique involves adapting a master cone in the same manner as
with traditional lateral compaction.
An appropriate-size Endotec II tip is selected. Endotec II tips are available in various taper and tip
diameters. The sizes consist of #.02/20 and #.02/40.
The device is activated and the tip is inserted beside the master cone to within 2 to 4 mm of the
apex, using light pressure. The tip is rotated for 5 to 8 seconds and removed.
An unheated spreader can be placed in the channel created to ensure adaptation and then an
accessory cone is placed. The process is continued until the canal is filled.
Endotec II device (Medidenta, Woodside, NY)