Best method to obturate canal
by Barry Musikant on Mon May 8, 2011
Source:  www.endomailmessageboard.com

Ketty on Sun May 08, 2011 8:55 pm

what is the best way to obturate canals?
- ordinary gutta percha with lateral condesation(which is more time consuming)
- thermafil obturator(over filling)
- gutta percha gun (need to to vertical condensation then fill with gun)

Ketty,

My opinion is to depend as much on the cement as possible. The purpose of gutta percha is to leave
a material that is easily removable if a post or retreatment is necessary. No one argues that the
cement is the material sealing the tooth. If that cement is epoxy resin you are placing a sealer
that bonds to dentin and gutta percha both chemically and physically, does not shrink upon
polymerization and is highly resistant to hydrolytic degradation. It has a history of working well
for over 65 years. Furthermore, the epoxy resins I prefer will be digested by the macrophage if
inadvertently expressed over the apex.

Thermoplastic obturation shrinks about 4-5% when cooling to body temperature from its insertional
temperature of 201º C. The ligament is also potentially exposed to excessive heat when the heating
devices are inserted into the tooth to plasticize the dentin. It is worth keeping in mind that
the epoxy resin at room temperature is far more flowable than thermoplasticized gutta percha and
warms to body temperature, doesn't cool and contract like thermoplastic gutta percha. Common sense
tells us that if we have the means to flood the canal with epoxy resin cement from the get go,
that along with often nothing more than a well coated single gutta percha point will produce a
superior seal than expensive and highly technical thermoplastic techniques.

If I have an oval canal, I will use a spreader with minimal apical pressure to create a space for
a second well coated gutta percha point, but that is as far as I go. I never use more force than
the weight of my hand because that would cause deformation of the gutta percha point causing it
to rebound with the production of a void and potentially excessive stress to the walls of the canal.

Now all these points could be argued and I only wish that those who disagree with these viewpoints
would give solid arguments why the approaches I advocate are incorrect. I think it would be good for
the members to hear both sides of what could be a contentious issue.

Regards, Barry