Endodontics

By Dr. Alison Qualtrough

Obturation Tip

It is well known that students struggle with obturation and the use of the classic ‘cold lateral condensation’ technique.

Here is a step by step guide on how to perfect your obturation from Dr Alison Qualtrough – Consultant Restorative Dentist and a Specialist Endodontist here at Manchester.

  1. The tooth should be asymptomatic and the canals dry.
  2. In a multi-rooted tooth, place a paper point in the other canals whilst you are filling one, this will prevent GP points and sealer from being misdirected.
  3. In multi-rooted teeth, fill the largest canals first.
  4. When the canal(s) have been filled, cut the GP back to just below the level of the cemento-enamel junction and cover with a thin layer of flowable glass ionomer.
  5. A cone fit radiograph is not essential if you have a reliable working length radiograph.
  6. A cone fit radiograph is recommended if you only have an apex locator reading for working length.
  7. If the main gutta percha point will not go to length, check that you have sufficient coronal opening.
  8. If the main gutta percha point will not go to length, try another of the same size; there is only a 10% fit accuracy between points of the same size!
  9. If you cannot get “tug back”, cut 1mm from the tip of the point and try again.
  10. Only use a thin smear of sealant on the GP points.
  11. Make sure that you measure the length of the lateral spreader at 3mm short of the working length. Use a stop to mark the length, otherwise there is a risk of extruding points beyond the apical foramen.
  12. Use a gentle twisting movement when removing the lateral spreader when you are condensing; preventing points from sticking to the spreader.
  13. Take the final radiograph on the day of obturation.
  14. The next radiograph should be taken in 12 months.