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Best method to obturate canal
by Barry Musikant on Mon May 8, 2011
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)
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.