Obturation: Lateral Compaction Presented by: Josef Ma. Karlos S. Bringas, D.M.D., D.D.S., M.S. Department of Endodontics

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.

Medium Fine Finger Spreader

Gutta Percha – Master Cones

Iris Scissors

Gutta Percha – Accessory Cones

Medium Fine Accessory Cones

Paper Points (absorbent points)

Endodontic Cotton Pliers

Mirror and Handle

Handle with mm Ruler

Spatula and Mixing Pad

Endodontic Sealer

Glick #1 Instrument

Endodontic Pluggers (5/7 & 9/11)

Completed C&S The canal system should be properly tapered in a continuous funnel shape allowing debridement, irrigation and obturation.

Completed C&S Note your FWL. Example: FWL=23mm *FWL is 1mm short of patency length. Example: FWL=23mm

Obturation The canal is obturated to Final Working Length. Obturation Length = FWL

Obturation The canal is obturated to Final Working Length. Obturation Length = FWL

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.

Spreader fit Fit within 1-2mm of FWL. If not, more shaping is required because apical size and taper is inadequate.

Master Cone Fit Select Master Cone size that corresponds to your MAF size. Ex. MAF size 30 MC size should also be size 30.

Master Cone Fit The Master Cone should seat to final working length. Obturation length= FWL

Check Master Cone (MC) Length

Master Cone Fit 23 If MC is at FWL, you are ready to obturate.

Master Cone is Long Cut the Gutta Percha tip to correct the discrepancy to avoid overextension.

Master Cone is Short Cleaning and shaping is rechecked.

MC is short Reinsert MAF file. Sometimes, dentin filings prevents it from seating to FWL.

Reshape Check to see if MAF goes to FWL. Go through hand filing procedure. Sometimes, repeating C&S with rotaries is necessary.

Refit MC After filing with the MAF to FWL, the selected Master Cone should fit to proper FWL also.

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.

Mark the Master Cone to FWL

Mark the Master Cone to FWL

Place MC in the canal system.

Mark should correspond to reference point.

Take a Radiograph Master Cone 4th of 6 Show radiograph to instructor. Dry the canal and you are now ready to obturate.

Mix the Sealer

Mix the Sealer

Mix the Sealer

Mix the Sealer

Mix the Sealer

Mix the Sealer

Sealer Placement

Sealer Placement

Sealer Placement

Lateral Compaction Advance the spreader with a watch winding motion as pressure is applied in an apical direction.

Lateral Compaction Advance the spreader with a watch winding motion as pressure is applied in an apical direction.

Lateral Compaction Advance the spreader with a watch winding motion as pressure is applied in an apical direction.

Lateral Compaction Remove the spreader with the same watch winding motion.

Lateral Compaction Immediately insert a premeasured and coated MF accessory cone into the space created by the spreader.

Lateral Compaction Insert to resistance. This should be done as quickly as possible to prevent voids.

Lateral Compaction Repeat this procedure of finger spreader insertion alternated with accessory cone placement.

Lateral Compaction Repeat this procedure of finger spreader insertion alternated with accessory cone placement.

Lateral Compaction Repeat this procedure of finger spreader insertion alternated with accessory cone placement.

Lateral Compaction Repeat this procedure of finger spreader insertion alternated with accessory cone placement.

Lateral Compaction Repeat this procedure of finger spreader insertion alternated with accessory cone placement.

Lateral Compaction 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 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.

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.