In today's post we talk about one of the most important aspects in endodontics: the obturation process. It is, without a doubt, one of the keys to the success of any endodontic treatment.

What is the obturation process?

The obturation process consists of filling the canal with specific materials after extracting the pulp. For a successful obturation it is essential to get a homogeneous fill to prevent reinfection.

The goal is to eliminate leaks from the oral cavity or periapical tissues and to seal off the system from all irritants that cannot be completely eliminated.

¿Con qué material se realiza una buena obturación?

The most popular material for root canal filling is gutta-percha. The particularity of this material is that it can be applied cold, as a solid mass, or hot, since it becomes flexible, sticky and can flow under pressure. Thanks to these properties, it is the ideal material for filling narrow and delicate root canals.

What are the most common obturation techniques?

There are countless techniques to perform obturation of root canals. Some of the most popular are:

• Single cone seal. A cone of gutta-percha is inserted into the canal and sealed with filling cement.

• Lateral condensation. Through a lateral opening, several cones of gutta-percha are inserted accompanied by a small amount of sealing cement until the canal is completely filled.

• Vertical condensation. The technique is based on heating a cone of gutta-percha inside the canal and its subsequent compaction with successive applications.

• Injectable thermoplastic gutta-percha. Hot gutta-percha is injected into the canal.

• Thermomechanical compaction or thermocompaction of gutta-percha. A file-like instrument is inserted into the canal rotating at 8,000 to 10,000 rpm. At this speed of rotation, the heat generated by the friction itself compacts the gutta-percha apically, while the condenser is propelled coronally. 

• Solid core or centre conductors, surrounded by a coating of alpha gutta-percha. It uses carriers for the application of soft gutta-percha. This system makes it possible to distribute the material with reasonable apical control and uniform density.

The most complete obturation systems on the market

The following are three of the most complete systems on the market. They combine vertical and thermoplastic condensation techniques to offer the specialist a system capable of solving all types of obturations in the most complex canals. 

• B&L Superendo

 It is an obturation system made up of 2 parts:

1. Alpha II handpiece for vertical condensation. With an ergonomic design, helps distribute weight to reduce fatigue on the specialist during treatment. It has 6 keyholes that connect the plugger securely and prevent it from rotating during use. It has a battery life of 4 hours of continuous use.

2. Beta Mini cordless device for thermoplastic condensation. It has needles that rotate 360º and perfect ergonomics to offer the greatest comfort to the endodontist. It incorporates a safety measure to avoid small accidental burns to the dentist with the hot needle or gutta-percha.

• Z-Down + Z-Up from Zarc

The Zarc Z-Down + Z-Up obturation system is made up of 2 parts: 

1. Z Down. It is an ergonomic and extraordinarily light vertical condensing system that generates a continuous wave heat transfer. Its use is really simple: it can be turned on and off in any position and it offers a very comfortable and secure grip. It has a temperature range from 90 to 250º and can memorise up to 5 customisable programs (temperature and time). It heats up and cools down in just a few seconds to offer maximum safety to the patient and specialist. In addition, only 4-6mm of the tip is heated to prevent soft tissue burns. Z-Down includes a lithium battery that allows the system to be used while charging.

2. Z-Up. Zarc's three-dimensional thermoplastic obturation system achieves an impeccable filling of the canal. It is able to maintain the thermoplastic temperature of the gutta-percha allowing for a smooth flow withing the root canal. This allows a homogeneous and gap-free sealing. In addition, it rotates 360º to facilitate optimal filling from any position.

It also has a temperature range that ranges between 90 and 250º, and, like Z-Down, it can memorise up to 5 customisable programs. This device is equipped with a display to adjust temperature and exclusion speed, as well as an indicator of the level of gutta-percha remaining. Can be used while charging.

• Dentsply Sirona Gutta-Smart

Gutta-Smart is the latest vertical and thermoplastic filling system from Dentsply Sirona. It is a completely cordless system that incorporates a long-lasting battery.

It offers an ergonomic design to make the dentist's work easier. It is made up of two handpieces that have 360º activating rings, making it a really comfortable and easy-to-use system. It has an indicator of the level of gutta-percha remaining so that endodontists have all the necessary information at their disposal at all times.

Gutta-percha temperature, volume and flow are adjustable on its charging base.

Advantages of working with these obturation systems

Working with a top-quality obturation system is essential when it comes to achieving truly effective results for patients. Any error in the process can cause impacting consequences for patients’ oral health, so it is essential to carry out safe and long-lasting treatments.

With the latest obturation technology you can:

- Avoid leaks due to increased density of gutta-percha.

- Improve lateral canal filling due to the greater fluidity of the hot material.

- Improve adaptation to the original dentin of the canal.

- Be less aggressive with the anatomy of the root canal.

- Increase efficiency compared to traditional lateral condensation systems.

- Make treatments easier and faster.

Welcome to endodontics of the future!