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.
2006 J.Bringas, DMD, DDS, MS

Medium Fine Finger Spreader

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Gutta Percha Master Cones

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Iris Scissors

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Gutta Percha Accessory Cones

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Medium Fine Accessory Cones

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Paper Points (absorbent points)

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Endodontic Cotton Pliers

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Mirror and Handle

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Handle with mm Ruler

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Spatula and Mixing Pad

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Endodontic Sealer

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Glick #1 Instrument

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Endodontic Pluggers (5/7 & 9/11)

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

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

Example: FWL=23mm
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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.

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

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

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

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Check Master Cone (MC) Length

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Master Cone Fit

23

If MC is at FWL, you are ready to obturate.

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Master Cone is Long

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

Cleaning and shaping is rechecked.

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

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

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

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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.

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Mark the Master Cone to FWL

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Mark the Master Cone to FWL

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Place MC in the canal system.

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Mark should correspond to reference point.

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

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Mix the Sealer

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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

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Mix the Sealer

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Sealer Placement

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Sealer Placement

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Sealer Placement

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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.

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

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

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

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

2006 J.Bringas, DMD, DDS, MS

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

2006 J.Bringas, DMD, DDS, MS

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

2006 J.Bringas, DMD, DDS, MS

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

2006 J.Bringas, DMD, DDS, MS

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

2006 J.Bringas, DMD, DDS, MS

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.
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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.

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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.
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