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Presented by:Josef Ma. Karlos S. Bringas, D.M.D., D.D.S., M.S.Department of Endodontics
Obturation: Lateral Compaction
2006 J.Bringas, DMD, DDS, MS
Objectives of Obturation
• Create a complete seal of the entire root canal system by eliminating all avenues of leakage from the oral cavity or the periradicular tissues into the root canal system.
• To seal within the system any irritants that cannot be fully removed during canal cleaning and shaping procedures.
2006 J.Bringas, DMD, DDS, MS
Medium Fine Finger Spreader
2006 J.Bringas, DMD, DDS, MS
Gutta Percha – Master Cones
2006 J.Bringas, DMD, DDS, MS
Iris Scissors
2006 J.Bringas, DMD, DDS, MS
Gutta Percha – Accessory Cones
2006 J.Bringas, DMD, DDS, MS
Medium Fine Accessory Cones
2006 J.Bringas, DMD, DDS, MS
Paper Points (absorbent points)
2006 J.Bringas, DMD, DDS, MS
Endodontic Cotton Pliers
2006 J.Bringas, DMD, DDS, MS
Mirror and Handle
2006 J.Bringas, DMD, DDS, MS
Handle with mm Ruler
2006 J.Bringas, DMD, DDS, MS
Spatula and Mixing Pad
2006 J.Bringas, DMD, DDS, MS
Endodontic Sealer
2006 J.Bringas, DMD, DDS, MS
Glick #1 Instrument
2006 J.Bringas, DMD, DDS, MS
Endodontic Pluggers (5/7 & 9/11)
2006 J.Bringas, DMD, DDS, MS
Completed C&S
• The canal system should be properly tapered in a continuous funnel shape allowing debridement, irrigation and obturation.
2006 J.Bringas, DMD, DDS, MS
Completed C&S
Note your FWL.
*FWL is 1mm short of patency length.
Example:• FWL=23mm
2006 J.Bringas, DMD, DDS, MS
Obturation
• The canal is obturated to Final Working Length.
• Obturation Length = FWL
2006 J.Bringas, DMD, DDS, MS
Obturation
• The canal is obturated to Final Working Length.
• Obturation Length = FWL
2006 J.Bringas, DMD, DDS, MS
Spreader Fit
• To check satisfactory apical cleaning and shaping before obturation.
• To see if there is enough room for compaction with the selected finger spreader. (size: medium fine MF)
• Set rubber stop 1-2mm short of FWL.
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
Spreader fit
• Fit within 1-2mm of FWL.
• If not, more shaping is required because apical size and taper is inadequate.
2006 J.Bringas, DMD, DDS, MS
• Select Master Cone size that corresponds to your MAF size.
• Ex. MAF size 30
• MC size should also be size 30.
Master Cone Fit
2006 J.Bringas, DMD, DDS, MS
• The Master Cone should seat to final working length.
• Obturation length= FWL
Master Cone Fit
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
Check Master Cone (MC) Length
2006 J.Bringas, DMD, DDS, MS
Master Cone Fit
• If MC is at FWL, you are ready to obturate.
23
2006 J.Bringas, DMD, DDS, MS
Master Cone is Long
• Cut the Gutta Percha tip to correct the discrepancy to avoid overextension.
2006 J.Bringas, DMD, DDS, MS
Master Cone is Short
• Cleaning and shaping is rechecked.
2006 J.Bringas, DMD, DDS, MS
MC is short
• Reinsert MAF file.
• Sometimes, dentin filings prevents it from seating to FWL.
2006 J.Bringas, DMD, DDS, MS
Reshape
• Check to see if MAF goes to FWL.
• Go through hand filing procedure.
• Sometimes, repeating C&S with rotaries is necessary.
2006 J.Bringas, DMD, DDS, MS
Refit MC
• After filing with the MAF to FWL, the selected Master Cone should fit to proper FWL also.
2006 J.Bringas, DMD, DDS, MS
Master Cone Fit
• The MC should have a definite apical resistance when MC is placed to FWL.
• The MC should exhibit “tugback” or resistance to removal.
2006 J.Bringas, DMD, DDS, MS
Mark the Master Cone to FWL
2006 J.Bringas, DMD, DDS, MS
Mark the Master Cone to FWL
2006 J.Bringas, DMD, DDS, MS
Place MC in the canal system.
2006 J.Bringas, DMD, DDS, MS
Mark should correspond to reference point.
2006 J.Bringas, DMD, DDS, MS
Take a Radiograph
• Master Cone 4th of 6
• Show radiograph to instructor.
• Dry the canal and you are now ready to obturate.
2006 J.Bringas, DMD, DDS, MS
Mix the Sealer
2006 J.Bringas, DMD, DDS, MS
Mix the Sealer
2006 J.Bringas, DMD, DDS, MS
Mix the Sealer
2006 J.Bringas, DMD, DDS, MS
Mix the Sealer
2006 J.Bringas, DMD, DDS, MS
Mix the Sealer
2006 J.Bringas, DMD, DDS, MS
Mix the Sealer
2006 J.Bringas, DMD, DDS, MS
Sealer Placement
2006 J.Bringas, DMD, DDS, MS
Sealer Placement
2006 J.Bringas, DMD, DDS, MS
Sealer Placement
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
Lateral Compaction
• Advance the spreader with a watch winding motion as pressure is applied in an apical direction.
2006 J.Bringas, DMD, DDS, MS
Lateral Compaction
• Advance the spreader with a watch winding motion as pressure is applied in an apical direction.
2006 J.Bringas, DMD, DDS, MS
Lateral Compaction
• Advance the spreader with a watch winding motion as pressure is applied in an apical direction.
2006 J.Bringas, DMD, DDS, MS
Lateral Compaction
• Remove the spreader with the same watch winding motion.
2006 J.Bringas, DMD, DDS, MS
Lateral Compaction
• Immediately insert a premeasured and coated MF accessory cone into the space created by the spreader.
2006 J.Bringas, DMD, DDS, MS
Lateral Compaction
• Insert to resistance.
• This should be done as quickly as possible to prevent voids.
2006 J.Bringas, DMD, DDS, MS
• Repeat this procedure of finger spreader insertion alternated with accessory cone placement.
Lateral Compaction
2006 J.Bringas, DMD, DDS, MS
• Repeat this procedure of finger spreader insertion alternated with accessory cone placement.
Lateral Compaction
2006 J.Bringas, DMD, DDS, MS
• Repeat this procedure of finger spreader insertion alternated with accessory cone placement.
Lateral Compaction
2006 J.Bringas, DMD, DDS, MS
• Repeat this procedure of finger spreader insertion alternated with accessory cone placement.
Lateral Compaction
2006 J.Bringas, DMD, DDS, MS
• Repeat this procedure of finger spreader insertion alternated with accessory cone placement.
Lateral Compaction
2006 J.Bringas, DMD, DDS, MS
• Do this until the canal is obturated to the cervical line.
• Take a radiograph at this time and evaluate fill.
• This confirms adequacy of the obturation.
Lateral Compaction
2006 J.Bringas, DMD, DDS, MS
Lateral Compaction
• If the obturation is satisfactory, the excess gutta percha should be cut to the CEJ level (bucco-lingual).
• If obturation is not dense, or if voids are present, remove all the cones and redo the obturation process.
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
2006 J.Bringas, DMD, DDS, MS
Final Radiograph• Remove the
rubber dam clamp and rubber dam material and take the radiograph.
*In a real patient, a temporary restoration is placed before rubber dam is removed.
