RECENT OBTURATION TECHNIQUES

Introduction
The final of endodontic treatment is to fill the entire root canal system and all its complex
anatomic pathways completely and closely with non irritating hermatic sealing agents.
Total obliteration of the canal space, perfect sealing of the apical foramen at the dentin
cementum junction, accessory canals at location other than the root apex with an inert,
dimensionally stable and biologically compatible material are goals for consistently successful endo
treatment.
Obturation of a root canal should result in a complete seal from the coronal aspect to the
apex preventing the entry of microorganisms and fluid About gutta percha:
Gutta percha is the most widely used material for obturation of root canals since it is
relatively inert, non toxic and biocompatible.
Gutta percha (G! exists in two phases α and β. "f the naturally occurring α phase G is
heated above #$%& it becomes amorphous and melts.
&ooling this amorphous material extremely slowly at the rate of $%&'hr will re crystalli(e
the alpha form. )outine cooling of the amorphous melted material results in β form. This form is
commercially used as it is solid, elongatible and compactable.
The α phase gutta percha possess ade*uate rigidity to be placed to length along with a low
melting temperature, low viscosity and increased fluidity to fill the root canal irregularity.
β phase G has a higher melting pt and viscosity that allow it to flow into canal intricacies
when heated.
G harvested from trees is mainly α phase and is used in the latest thermoplastici(ed
techni*ues. β from when heated to +,-+.%& changes to α form.
Old Techniques
/ateral condesation - the most commonly used obturation techni*ue was first advocated by
&allahan in 0.0+.
This method is time consuming difficult in curved or fine canals. "n curved canals the gutta
percha should be compacted by placing the spreader against the inner curve. 1o the more rigid
spread follows the gentler outer curve. 1o that the spreads does not pull out the master G. 2lso the
success is more or less operator dependant.
3ertical condensation 4 manually is also a method commonly used.
5isadvantages of these 4 ressure exerted in these two methods by the spreaders and
pluggers in an attempts to condense the G into a solid mass generates stresses. These stresses can
deform the roots and create microfractures within the dentine.
This deformation may propagate under occlusal load and manifest later as longitudinal root
fractures especially after post preparation.
These techni*ues may produce many irregularities in the mass of G.
0
0. "t does not reproduce canal fins and irregularities.
,. The surface of the material is fre*uently rough and pitted with inade*uate dispersion of the
sealer.
6. The voids that are produced may remain empty or filled with sealer which may resorb in
time, thus decreasing the effectiveness of the obturation.
&hemically plastici(ed G 4 many solvents li7e chloroform, eucalyptol and halothane are
used to dissolve G and obturate the canal.
The main drawbac7 of this method is that once the solvent evaporates the G may shrin7
and a space may be created.
To overcome these disadvantages the thermo plastici(ed gutta percha techni*ues have been
introduced.
,
These techniques are classified by Bhatti & Joshi (1997) as
"ntraradicular 8xtraradicular
"n this the G is heated within the )&
and allowed to flow into the )&.
"n this the G is heated outside the
mouth and then placed in the )&.
The intraradicular techni*ues are
Touch 9n: heat lateral condensation
0. 1childers vertical condensation
,. 1ystem ; (;uchanan!
6. 8ndo tec
+. Thermopact
<8&=2>"&2/
0. Thermo compactor
,. 2utomated plugger
6. ?ltrasonic plasti(ing
+. =igh speed sectional
Extraradicular techniques
0. Terma fill
,. Obturation
6. 1uccess fill
+. ?ltrafil etc.
6
Extraradicular techniques
Endotec: &onsidering the ease and speed of lateral compaction and the superior density gained by
vertical compaction of warm G as stated by 1childer in 0.#@, <artin in developed a device that
appears to achieve the best *ualities of both techni*ues.
This device is called A8ndotecB, endotec is a thermal compacter consists of a cordless
handpiece containing a battery that supplies energy to heat the attached spreader ' plugger tips.
Chen not in use the hand piece sits in a battery charger base. The *uic7 change heated tips
are si(ed e*uivalent to >o. 6D and >o. +DE 0$D files.
Procedure
&anal preparation 4 continuous taper design with definite apical stop.
 5ry the canal
 1ealer application
 rimary adaptation with hand or finger spreader
 2dditional G placed to reduce the possibility of warm plugger loosening the patient when
the tip is retracted.
 8ndotec placed in canal to full depth
 2ctivator button pressed and plugger ' spreader moved in cloc7wise direction.
 2ngle button is released and plugger cods immediately
 >ow remove in counter / wise direction
 This motion has now formed a space for an attributed point to be added
 rocedure is repeated
 >ow the plugger can be used cold to compact the softened G
 <otion for using endotec plugger
 3ertical sweeping lat pressure
"n this manner the canal is completely obtained. To complete the procedure a cold hand
plugger can be used to firmly condensed the fused G bolus.
2n 2ir Force Group in 0..6 also found that they could improve compaction in a molar with
& shaped canal by using the endotec with a Gap and tap method.
Tap & Tap
Procedure
 reheat the endotec for +-$ secs before insertion (Gap!.
 <ove the instrument in and out in short continuous stro7es 0D-0$ times. (Tap!
 The plugger was removed while still hot.
+
 Told spreader is used and accessory points are placed.
The two causes for concern with this treatment may be 4 over heating, development of
stresses.
&astelli in 0..0 stated that there was no heat related damage to periodontium from endo tec.
2 ?1 army group showed that heat produced by endotec 4 <ax $DD%& is less than that of other heat
devices li7e the touch > and unit.
They stated that even though the internal temperature may reach upto 0D,%& G and dentin
are poor conductors of heat so this temperature may not cause damage to periodontium.
<artin in 0..D showed that endotec creates less stresses than cold lateral condensation.
Touch ‘n’ heat unit
The main disadvantage with schilders 93: compaction is the need to warm the G with an
instrument heated over the flame. To over come these disadvantages analytic technologies develop
of the first G heating units the Touch > heat model $DD0. 2lso models $DD,, $DD+ are available
with different tips.
The touch > heat $DD6 is an electronic device specially developed for the warm vertical
compaction of gutta percha. ;attery '2& models are available.
"t exhibits the same thermal properties as the original heat carried used by schilder in 0.#@
but has the advantage of generating heat automatically at the tip of the instrument.
This instrument is capable of providing a range of high temperatures instantly ranging from
D%-@DD%&.
Procedure
- <aster cone is fitted
- 1childers pluggers are prefitted
&oronal 0'6 4 wide
<iddle 0'6 4 narrow
2pical 0'6 4 narrows
- <aster cone is placed
- Touch > heat unit is carried into the canal and left there for ,-6 seconds to allow the
heat to transfer.
- "t is then withdrawn with slightly circular ' wiping motion.
- 1ome of the G gets fro(en on the carrier.
- "mmediately vertical compaction follows.
recautions with this system are that the operator should restrict the use of system at the
lower power setting >o. ,+6 and increase the amount of the time the heated tip is activated.
Hurcate H.H. et al in 0.., said that if it is used at the >o. # setting the temperature might rise
upto 00+-$0% which is a potentially damaging temperature.
$
Advantaes of this !ethod are
0. >o need for an open flame.
,. 1ome amount of control over temperature generated.
System B (;uchanan 0..#!
)ecently 2nalytic technology introduced the system ; heat source model 0DD$. this
instrument has a digital temperature display and a variable resistor control that allows the user to
use the desired temperature.
These heat carriers are designed as pluggers that concentrate the heat at the tip of the carrier.
The system ; is based on the schilder techni*ue. The tapered pluggers the system ; heat
upto ,DD%& at the tip at the touch of a button. This softens the G in I seconds.
2 wave of heat (,$D%-6DD%&! is produced as the plugger is forced through the already fitted
cone is used to drive the G into the canal.
2s the plugger approaches the apex the heat button released and apical pressure is
maintained with the plugger for a 0D second. 1ustained push to ta7e up the shrin7age that occurs on
cooling.
The heat button is pushed again while maintaining pressure. 2 surge of heat is produced
6DD%& 4 $ seconds. That immediately separates the plugger from the apical mass of gutta percha.
Thus it can be rapidly with drawn. The canal is then bac7filled with the same techni*ue or
obturation.
Disadvantages
0. ;rea7age and 7in7ing of spreader.
dvantages
- 3oid elimination created during normal lateral condensation of warm G.
1ilver GJ et al in 0... conducted a study on Acompression of , vertical condensation
obturation techni*ues 4 touch and heat and system ;.
They concluded that system ; may produce an acceptable obturation and produces less heat
than touch and heat. The heat produced by system ; is accurate upto K0D%&.
"t is generally accepted that a 0D%& evaluation temperature on the root surface can
irreversibility damage the periodontium silver status that the system ; techni*ues 7ept the
temperature normal not exceeding 0D%&. also the obturation by this method was faster.
Thermopact
&onsists of a unit containing a transformer and an electronically controlled circuit for heat
generation. "t also has a hand piece adapted with different si(ed spreaders and heat carriers.
The temperature can be selected regulated and maintained at any desired level from +D%& to
@D%&. 1auveur suggested that thermopact must be ideally set and maintained at +,%& for warm
lateral condensation at about $.%& for warm vertical condensation.
#
The main advantage of the system ; over the touch > angle is that when silver tested the
temperature produced by T L angle and system ; system ; produced less angle.
Termomechanical !ompactors
The <cspadden compactor was introduced in 0.@M. "t resembles a reverse hadstrom file
fitted into a handpiece and spins in the canal at speeds between MDDD and ,DDDD rpm. The heat
generated softens the already fitted G and the design of the blades forces the gutta percha apically.
@
The disadvantaes of this technique "ere
0. Fragility of the instruments as the compactor rotates at 6#D%& at full speed therefore leads to
fatigue failure.
,. &annot be used in narrow canals.
<aillefer modified the =edstreem type instrument as the gutta condenser and (ipper called
its modification the engine plugger. The (ipper thermo compactor resembles an inverted J file.
<c 1padden modified his original patent and introduced the >T condenser. "t is supplied as an
engine driven or hand powered >ic7el titanium instrument. "t advantages is flexibility. The >T
condensor is use with heat softened α phase G, >ormal G.
Procedure
- lace primary G
- 2ppropriate si(e condense coate with gutta percha (angle softned! G" and G "".
- The condenseris then spin in the canal at 0DDD-+DDD rpm which flings the G
laterally and vertically.
- The speed is controlled by >T matic hand piece.
"y#rid Technique
This was put fourth by Tagger of Tel 2viv in 0.M+. "n this techni*ue first a primary cone is
fitted followed by an accessory point.
2n engine plugger is places and rotated at 0$DDD rpm after 0 second it is advanced into the
canal until resistance is meet.
"t is then slowly bac7ed out while still rotating. This whole procedure ta7es just ,-6 seconds.
The hybrid techni*ue is *uic7er to complete and easy to master. 2lso overfilling is less li7ely.
$S %uic& 'ill
This system is designed to be a thermomechanical solid core G obturation techni*ue.
This system has titanium core devices resembling latch type drills. These are coated with
alpha phase gutta percha.
These are then fitted to the prepared root canal and then, following sealer are spin in the
canal with regular low speed latch type hand piece.
Frictional heat plastici(es the gutta percha and it is compacted to place by the design of the
*uic7 fill core. 2fter compactor either the compactor may be removed and final compaction dov
with hand plugger or the titanium core may be left in place and separated by an inverted cone bur.
utomated Plugger
The canal finder plugger is a stepwise flexible plugger sloped li7e a telescope. "t is used in a
canal finder handpiece which delives a rapid vertical stro7e that varies between 6 and 0mm.
M
Procedure
- 1ealer placement
- <aster cone placement
- >ext, the vertical vituating plugger is 7ept.
- The edges of the plugger blades catch in the gutta percha.
- G gets compacted vertically and laterally.
This method may have some discrepancies.
(ltrasonic Plastici)ing
1uggested by <oreno in 0.@@, he used a cavitron scaler with a ) 6D inert can be used only
in anterior (cavitron!.
Procedures
- rimary patient is placed
- ?nit is placed beside G, the ?1 unit with the rheostat set at 0 activated for 6-+ sec.
- The ultrasound thermal energy released by vibratory motion of the ultrasonically file
plastisi(es the G.
- The file is removed and the spreader is immediately inserted to ma7e space for new
cone.
Hoiner in 0.M. found that the heat produced was #.6$%& into 6 sec by this method. =e thus
concluded that the heat produced by the cavitron would not be harmful.
The "nac ultrasonic unit has also been used with a certain degree of success by ;aumgardner
in 0..@. "n this unit a spreader is attached. "n this method the G was not plastici(ed.
They felt that the spreader more easily penetrated the cross of G than did the finger
spreaders and that in the end the energi(ed spreading led to a more hamogenous mass with less
stress and less apical microlea7age.
The heat generated with the enac ultrasonic unit was found to be more i.e. 0.0%& rise in
temperature to obdurate. This system is inferior to the cavitron
6D
unit.
*ight Speed Sectional +ethod
2 two phase obturation techni*ue has been proposed by light speed technology 4 Texas.
This techni*ue advocates the use of a stainless steel carrier to place and condense a $mm
section of gutta-percha into the apical portion of the canal.
Once placed the carrier is termed and removed leaving a gutta percha plug. The second
phase uses a rotary instrument to bac7 fill the remainder of the canal with the Jetac 8ndo and a
single G cone. The techni*ue was first studied met by 1antos 5< et al in 0....
.
+ethod
2 G plug the same si(e as the master apical rotary was selected. <2) 4 is the final apical
si(e of the instrument which is used to prepare the canal last.
- The canal and plug were coated with sealer.
- The plug was inserted and vertically condensed to C/
- ;y using moderate apical pressure.
- The carrier is removed by tuning its handle counter cloc7 wise until the plug was
released and the carrier could be removed and easily detached from the G.
- The second phase, a light speed bac7fill instrument was used to carry the Jeta endo
sealer into the canal orifice.
- This was rotated at 0DDD-,DDD )< and advanced apically till the apical Gp plug
was reached.
- The instrument was then removed while wiping against one wall.
- This was repeated till the canal was filled with sealer.
- The master cone was then coated with sealer and placed till the apical plug.
- The excess G was then removed at the level of canal orifice.
The =1 techni*ues is similar to the sectional method described by grossman and &oolidge.
The difference with this techni*ue is that slight apical force seates the tapered plug into a parallel
apical preparation whereas in the sectional techni*ue the master cone is passively seated to wor7ing
length. ;ecause of this modification a right apical seal should be produced. 2lthough not
specifically measured the time involved in this method is lesser than the conventional techni*ue.
E,tra radicular techniques
Thermo plastici(ed gutta percha, in these techni*ues the gutta percha is heated outside the
mouth and is already softened before insertion.
These can be classified as
0. "njectable systems
- Obturation
- ?F
- 2& 0DD
,. 1olid core carried insertion systems
- Termofil
- 5ensfil
- 1uccess fil
6. <ultiphase techni*ues
- <icroseal
0D
- 2lphaseal
- Trifecta
-
- "njectable systems
This techni*ue involves injecting molten G into the root canal system. "mportant points to
remember regarding these methods.
0. The delivery middle should be 6-$ mm within wor7ing
,. "nade*uate temperature control leads to poor results.
6. 2s the G cools it shrin7s condensation pressure is needs
+. Over extension may result
"ntroduced 0
st
in 0.@@ by Nee called gutta gun, obturation is a convenient delivery system.
)elatively flexible silver needles of different si(es 0M, ,D, ,$ gauge are used to introduce the
plastici(ed G into the canal. The injection 4 averages less than ,D seconds.
?pon completion of the injection the G remains sufficiently plastici(ed for upto , minutes
which is enough time for manual condensation. extruted G has a temperature of #,-#$%& and may
remain soft for 6 minutes.
To counter balance the effect of dimensional change continuous condensation force must be
exceeded during cooling.
Today, through further improvements this system is mar7eted obturation "" heated G
system (exceed!.
Temperature range  0#D%-,DD%
>eedle si(e  ,D gauge #D file
,6 gauge +D file
β phase -P is used.
#re$aration  continuously tapering funnel from apex to canal orifice. This ehances the
flow the plastici(ed material.
dvantages
0. iston grip syringe is more resistant to higher temperature.
,. &ontrol is e*uipped with digital read out of the temperature
6. silver needle is disposable and better designed for added advantages and infection control.
?sed in
- "rregular shaped wide canals.
- "nternal resorption defects.
- "ncompletely formed roots with induced apical barriers.
00
- )etrofilling after surgery.
%!$ortant $atient to be re!e!bered
- 2 denitive apical matrix is very important.
- ?se only the G which is made for the system which has a high molecular weight.
- Once it is heated it should be used within 0$ minutes.
- 2 slow setting sealer should be used which is not affectably heat.
Procedure
T"o !ethods !ay be used&
". 1ealer placement (I drops!
- 2n increment of G with obturation.
- &ompacted (for segmental filling! apically and laterally.
- Then bac7 fill with obturation GO>
"". The second method is to place a master gutta percha cone.
- Then the obturation needle tip deposites the G all around the master cone.
- /ateral and vertical compaction is done.
- 2pical 0'6 to middle 0'6 is the most critical area of preparation.
Gutta percha is heated in a prototype pressure syringe which warms it to the re*uired
temperature.
This second method is better as less chances for G extrusion are seen. The main
disadvantage of this method is that it is operator dependent and it ta7es time to master this
techni*ue.
E//icacy o/ O#tura II
One doubt that arises is about the intracanal temperatures rise at the time of injector.
<ean and temperature in vitro studies was #6.@%&. the temperature rise on the overlying
bone was 0.0%& ' #D seconds. This is said to be as after temperature level according to Gutt man
0.M@. ;one injury occurs with a temperature rise of 0D%& if maintained for 0 minutes.
Cilson 0.M@, 1tavos 0.M#, <artin in 0.M# this system fills fins, euldesacs internal
resorbtion cavities, & shaped canal, accessory canals and carori(ed foramina.
2& 4 0#D (Chale dent "nt '>N!
"n 0.M0 1choeffel designed and built a prototype delivery system to operate indefinitely and
accurately at 0#D%&. This unit uses standardi(ed gutta percha. This device is called 2&-0#D as it
gives precision apical control at 0#D%&.
&avity preparation: 1light flare coronally definite apical constriction.
dvantages
0,
- Fills multiple formina
- "rregular configurations of the root canal
- Temperature is not more than 0#D%&.
(ltra/il System
)ather than using traditional b phase G this method depends upon a patented alpha phase
G supplied in disposable cannules with ,, gauge middles attached.
The G becomes plastici(ed when warmed to @D%& in a special heater. The warmed
cannulas are then placed in a special piston grip syringe for injecting into the canal.
The cannules are supplied in 6 different viscosities.
)egular 1et 4 doesn:t re*uire condensation, (Chite cannule!.
8ndo set 4 must be condensed (Green &annule!.
Firm set 4 &ondensation possible but not re*uired (;lue cannule!.
The α phase gutta percha is made by plastici(ed the β phase G under advancing heat. "t
ta7es 0$ minutes to come to a flowable state in the special heater.
reparation 4 &ontinuous taper at M-0D mm from apex at least upto $D files definite apical stop is
very important or the G will extrude into the tissues limitlessly.
#rocedure by 'ichano"ic( in 19)*
". &hec7 for needle fil surgery M 40Dmm from apex.
- CT #-O@D seconds
- &annules are heated 0$ minutes
- laced into the injector
- lace in the canal
- 1*uee(e ' release the triggel
- Cait for 6 seconds
- 1*uee(e ' release
- This sends a bolus of G towards apex.
The needle is not moved till a 9lift: is felt. 2s the material flows to the apex and bac7flow
tends to displace the needle. ressureless injection is continued as the G flows and pushes the
cannules out of the canal.
"". <aster cone placement <ich in 0.., =and spreader creates space
- >eedle positioned beside the point
- , increments of s*uee(e ' release are made.
- 2fter this material sets a little.
- The canal is bac7filled allowing the needle to be gradually displaced by the deposit.
06
The regular set: cannot be compacted because of its soft consistency. 2lso it does not reach
a full set for 6D minutes.
8ndoset 4 the high viscosity G that has less flow can be compacted hence either vertical '
lateral compaction can be done.
Procedure 0ith Endoset
1ealer application 4 two s*uee(es of the endoset are injected M-0D mm from apex and
immediately compacted apically and laterally with prefilled plugges. &oafirm apical seal
radiographical.
;ac7 fill with increments of endoset condensed with increasingly large pluggers. 8ndoset is
completely set in two minutes.
Firmset 4 light bodied and good flow properties.
<ay be used to dypars the bro7en instruments is loose in the canal or fill resorbtive defects.
"n 0.MM )itchie G.< et al found a method to control the apical extrusion of this system. The apical
foramen is first bloc7ed with sealer.
2 section of silver point is left behind as the remainder of the point is twisted off where it
was scored with a bur followed by warm G.
The <ichano Cic( group reported that the low temperature G will flow into the dentinal
tubules thus improving the apical seal.
recautions to be ta7e with this method.
0. The trigger should be s*uee(ed slowly and steadily under haste may cause excessive
pressure which may fracture the cannula.
E//icacy o/ ultra/il
There have been repeated warmings of warm G shrin7ing as it cools. ?ltrafil regular and
firmest are thus *uestionable as the shrin7 ,.,P yet all too fluid and cant even be compacted.
ossibly the fact that they flow into the dentinal tubules is their saving geace. Thus to use
these systems smear layer removal is very important.
Tragic and Frightening cases of over extrusion beyond the apex have been reported by Gatot
in 0.M., haconebe reported significantly more over extension with low temperature G than lateral
compaction. Thus with this method the apical stop becomes crucial.
Solid core carrier section
Thermo/il1 "n 0.@M Hohnson described a uni*ue yet simple method of canal obturation with
thermoplastici(ed alpha phase gutta percha carried on an endodontic file.
"n 0.MM this system finally got recognition and was introduced as Thermofil. Thermofil is
patented endodontic obturator consisting of a flexible central carrier, si(ed and tapered to match
standard endodontic files that are uniformly coated with refined and tested alpha phase gutta percha.
"nitially stainless steel carriers were introduced. here they may be heated in flame and then
introduced into the canal. /ater the carriers were made of titanium radio opa*ue plastic.
0+
"t is recommended that all three types should preferrebly be heated in the thermapreparation
over at 00$%& for 6-@ minutes depending on the si(e which ranges from ,D-0+D. The G coating
extends beyond the carriers by 0-,mm.
reparation continues taper preparation. The coronal portion of the carrier has mar7ings
with a rubber stop. The G normally cools the 0
st
,'6 graduation meter at 0M, 0. ' ,Dmm.
lastic carries are used nowadays
- These are relatively flexible.
- 1mall si(es ,$, 6D, 6$ have a incrementally greater taper than the normal ,$, 6D ' 6$
si(ed files.
- 1i(es below +D are made of a li*uid plastic crystal and are not soluble.
- 1i(es above +$ are made from a polysulfone polymer and may be dissolved in
organic solvents.
- 5ry canal
- 2pply thin coal of sealer, thermoseal, 2= ,#, 1elabex, GnO8 &en this acts as an
adhesive Q lubricant.
- Carm the oburator and carry it slowly to full wor7ing length.
- )adiographically confirm the position of the oburator
- 1ever the shaft in the coronal cavity, with a =O 6@ no cone beel.
;lan7 plastic carries are available to gauge the appropriate si(e for a canal
The obturator may be heated in a
Flame Thermopeepove
Obturator must be passed in the blue (one if passed thru the hotlest yellow (one they may
ignite. The obturator is ready when it ta7es on a sheer and expands.
Hohnson suggested that final compaction can be completed and improved if a +-$mm piece
of regular G is then inserted into the softened G. 2 large plugger can also be used to apically
compresses the gutta percha all around the central carrier. Final set is reached in ,-+ minutes. Chen
the G reaches the apical stop the metal or plastic carrier still continues apically more compaction
apically and laterally.
Important Point
0. "n teeth with multiple canals the other orifices must be sealed with damp cotton wool or the
G may bac7 the other orifices.
,. The coronal excess may also be pretrimmed to avoid bloc7age of other canals.
Potential pro#lems
0. 8xtrusion
,. ost space creation
0$
6. )etreatment
Prepi
These are strongly recommended if a post is to be placed. The latest device to melt the gutta
percha and plastic carries is the prepost preparation instrument 9repi: that is used in a latch type
handpiece.
Frictional heat generated by this hot cutting bladeless metal ball melts the material.
+etal carries
G is removed at the re*uired level using here. The carries is noteched with a diamond bur.
&ross sectional diameter of the carries is reduced to D.#mm.
The heated carries is reached to C/ without rotation. Once fully separated the coronal part
of the carries is separated by applying apical pressure and turning the handle cloc7wise.
"f post space preparation has to be delayed then the rubber stopper is slid towards the orifice
and only the carrier is removed. 3ertical compaction is then done with a moist cotton pledge.
For metal carries they are scored at the brea7age point +-$mm from the apex and then
twisted off counter cloc7wise after the obturator fully reaches the apex.
dvantages
- Ruic7 L easy
- They can be curved to fill curved canals.
- To fill internal resorbtive defects.
- Open apices.
8fficacy of thermofil in 0.M. christensen stated that thermal allows simple fast predictable
filling of root canals. 8specially useful for small or curved canals, techni*ue sensitive.
1hoen )oc7 in found that the plastic carriers provided the most complete system. "n 0..@
Celler >.). studied adaptation to the canal walls of these techni*ues and found that the order of
perfect adaptation was
- lastic
- Titanium
- 1tainless steel
)etreatment of canals may prove difficult because carriers jammed in the canals all very
difficult to remove.
Success 'ill System
"n completion with thermal the hygienic corporation introduced success fill. The only
difference between these two systems is that here the G in a warm plastici(ed shape is added to the
carrier just before it is inserted into the canal. These syringes contain high viscosity G that sets in
two mintues.
0#
!arriers 2 titanium r’op plastic
They are inserted to the measured depth in the syringe and are then extended by forcing the
plunger. )apid withdrawal tapering shape.
1low with drawal  cylindrical shape
Procedure
- &ore section full to length without binding
- Then carrier is coated with G and inserted to full depth.
- 2 plugger is used to compact the G around the core.
- The core is separated by holding the handle and severing the core shaft , mm above
the orifice.
To date no reports have been published regarding this techni*ue.
+ultiphase -P
The multiphase G obtained tech uses , different 7ind of G tooth --- the canal.
α phase  rigid enough to place in the canal and low in point, low viscosity and more fluidity to
fill the )& irregularities.
β phase  high < point and viscosity to flow into canal intricacies when heated.
These techni*ues involve the use of both α and β phases of gutta percha. They may also be a
combination of the above techni*ues.
Tri/ecta system
This method uses the combination the success fill and ultra fill.
Procedure
,-6 mm of warm G is retrieved from the success fill syringe on the tip of an endo file.
Chich is one si(e smaller than the last file used. This plug of G is then carried down the sealer
coated canal. Chen it reaches C/ the file is twisted counter cloc7wise and retrieved.
&ompaction is done with a pleages. 2fter confirming the placement with radiograph. ?ltra
fill may be used to bac7 fill the canal.
2F 5ewani > et al conducted an evaluation of the trifecta obturation techni*ue. They
concluded that under laboratory conditions bifecta has more sealability but poorer radio graphic
*uality than lateral condensation.
lphaseal
2lphaseal is one of the systems which attempts to overcome the cooling shrin7age of
α phase gutta percha. "n this system nic7el titanium condensers are coated with β phase G
followed by α phase G. The dimensionally stable b phase forms the coll and the low viscosity of
alpha permits it to flow into the irregularities of the root canal. The gutta percha is speen into the
0@
canal by rotating the condenser at speeds of between 0DDD and +DDD rpm. "t is then withdrawn as
the canal fill from the apex to the coronal aspect.
dvantage !anals can #e prepared 0ith 3i'i /iles and then o#turated 0ith the condensor.
Disadvantage !ontrol o/ material 0ithin the canal is di//icult.
"n 0... 5avalou et al studied the +icroseal Endodontic o#turation technique. "n this
techni*ue a master G cone is first compacted laterally with a spreader an then thermoplastici(ed
G is delivered and compacted with an electric stainless steel compactor in order to unite with the
master cone and fill the canal (stainless steel!.
Procedures
- 1ealers
- <aster &one
- 1preader inserted
- &ompacted and removed
The appropriate composite is inserted into a G cartridge and coated with G. &ompactor
inserted carefully, rotates at #DDD rpm slowly bac7ed out till canal is filled. 1urplus is condensed
with hand plugges.
The main advantages with this techni*ue is that since the gutta percha has been already
thermoplastici(ed and it unifies with the master G cone to an even mass.
+ther Ex$eri!ental Techniques
0. 3acuum pressure techni*ue
,. >ew method for open apex
6. =ydron
+. &alcium O
+
cement
4acuum pressure
)ussi, 1uter and Grosrey in 0..@ published an article about obturation of root canal in vivo
with a new vacuum techni*ue. 2 no((le was fitted on the tooth and the root canals were dried by
applying vacuum from a + stage vacuum pump.
2s soon as the re*uired absolute pressure reached a stable value of 0D m bar O @.$mm =g
the pulp was stopped. Filling paste was then mixed and evaluated by the same pump.
- )eservoir fill with obturating material
- 1teel ball placed on the filling material.
- 3. pump was turned on
- The desired vacuum was reached again
- 2 top connects the reservoir with the root canal this was opened.
- The material was suc7ed into the canal by the vacuum.
0M
- 1urprisingly this method did not produce any discomfort to the patient on whom it
was tried.
- 2n internal resorbtion cavity in the apical 0'6 which is difficult to fill had been
filled.
- )adiographs show that the fillings seen to be dense.
This method appears to have promise as a daily office procedure producing radiographically
dense root fillings.
!aPO
5
o#turation
)ecently calcium phosphate cement has been suggested as a total root canal filling material.
252 4 affen barger 5ental research center have developed a simple mixture of calcium
phosphates that sets to become hydroxyapatite.
They state that , &aO
+
&ompounds
2cidic ;asic
Chen mixed with water set into a hardened mass 4 hydroxyapatite.
;ase 4 Tetracalcium phosphate
2cid 4 5icalcium O+ dihydrate dihydrous dicalcium O+.
Cater is a vehicle for the dissolution of the reactants. Glycerin may be added to extend
setting time. <ild phosphoric acid 4 speeds the dissolution of the components.
This cement >ot soluble 4 water
>o soluble 4 blood and saliva
<ay be soluble in strong acids
Glycerin may also help to ma7e the mixture to a consistency where it can be extruded from
a syringe 0. gauge. 2 funnel shaped needle is also being considered. Tissue reaction studies have
shown new bone formation adjacent to the filling and no signs of 2 tissue irritation. 2s a sealer it
seems to adhere well to the canal wall.
"f a delivery system can be found this may be the sealer filler for further endodontics.
Firstly 4 =.2. is a naturally occurring product bone grows into it and replaces extruded
material.
- "t is very biocompatible
- "t may replace &aO= in treating open apex and S root cases.
*asers
)ecently, a theory has bee part forth relating lasers to =2. 2 cross lin7ed collagen =2 has
bee placed in the )& and melted into place with a laser beam through a fiber optic. There is no
published data about this techni*ue.
=ydron 4 2 hydrophilic plastic )& filling material.
0.
=ydron is an injectable )& filling material. "t is get passed on the alcoholic reesterification
of methylmethacrlate with ethelene glycol.
roperties
CT 4 #-M mins. ):op 4 lower than that of G some authors have reported exceller bio
compatibility while others have shown long term inflammation, material absorption and have
*uestions hydrons ability to effect a permanent seal.
1ome investigates have shown that overfillings with hydron cause longteen severe 2
inflammatory response and activates a large number of macrophages containing particles of hydron.
;ut hydron is said to replace fins, irregulation etc excellently. "n view of the foregoing
controversies further evaluation of hydron as an )& filling is need.
+ethod /or open ape,
)are(oudis et al in 0... put forth a new method of adapting gutta percha master cones for
obturation of open apex cases using heat. "n this method the end point of the primary G cone is
elastici(ed with a heated instrument and inserted into the root canal to record the internal
morphology of the apical portion.
?sually ,'6 attempts are needed to obtain satisfaction adaptation. Then the cone sealed in
place with a sealer and obturation is complete with lateral condensation.
This method was also mentioned by stoc7 and gulabivala. The efficacy, advantages and
disadvantages of this method have not been studied yet.
,D

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