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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 201 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
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