 Hello everyone, I am Dr. Rancida. Today I will be talking about Obturation techniques. The success of anaerotic treatment depends on three factors, that is the debridement of the canal, disinfection of the canal and Obturation of the canal. Debridement falls into your biomechanical preparation, disinfection comes under your irrigation and Obturation is where you fill your root canals so that you are obtaining 3D hermetic seed. According to the word Obturation, the word Obturation means to obstruct or to occlude. It is defined as a method used to fill and seal a clean and shaped root canal using a root canal spreader and a core filling material. Basically you are filling the canal and sealing it using a core filling material and also with the help of the spreader. Now you might wonder why is Obturation required we have already debrided the infection and disinfected the canal. It is to reduce the coronal leakage and the bacterial contamination and also to seal the apex from the periapical tissue fluids. And Obturation also entombs the remaining irritants in the canal. What does this word entombs mean? Imagine the canal after biomechanical preparation and irrigation there will be some amount of bacteria that might be present within the dentinal tubules or in the lateral tubules or accessory canals. But once the main canal is sealed the bacteria gets entombed inside the canals so that their virility will be reduced. Coming to the objectives of the Obturation technique it should be fluid impervious, fluid tight and bacteria tight sealed. These are the objectives of the Obturation technique. Now coming to the Grossman's requirements for an ideal root canal filling material. What all should be the ideal qualities that a root canal filling material should have? It should be easy to introduce into the canal. It should seal laterally as well as apically. The root canal filling material should fill laterally and apically canal. It should not shrink after being inserted. It should set slowly. It should be impervious to moisture. It should be bactericidal, radiopic and should not stain the tooth. It should not irritate the periratical tissues. It should also be sterile and easy to sterile. And it should be easy to remove also in case of necessary. Among all the root canal filling materials, Ghatapacha is the one which meets most of the requirements and is still considered a better choice for the Obturation. Coming to the classification of Obturation techniques. According to Grossman, the Obturation techniques can be cold lateral condensation, warm compaction. Under warm compaction it can be either through vertical or lateral. Then comes continuous wave compaction technique, thermoplasticized Ghatapacha injection technique, carrier-based obturation technique. Under carrier-based you have thermo-fill, simply-fill. You also then you have mixed pattern thermo-mechanical compaction, chemically plasticized Ghatapacha and custom-cool. These are the different types of obturation technique. According to Cohen, the Obturation techniques are classified as lateral compaction, warm vertical compaction, continuous wave compaction, warm lateral compaction, thermoplastic injection techniques. So basically there are two basic procedures for the Obturation. That is either you obtrude the canals using lateral compaction of cold Ghatapacha or vertical compaction of your warmed Ghatapacha. So either you're laterally condensing your cold Ghatapacha or vertically condensing your warm Ghatapacha. All the other methods are variation of the warmed Ghatapacha technique. The first one is the lateral compaction of the cold Ghatapacha technique. This is the most commonly used technique especially in case of your anteriors also. What exactly do we do in this lateral compaction technique is that see before obturation the first the important things that you should check is you should isolate the tooth and dry the canals with the paper points before obturating. After the biomechanical preparation you should select a master cone and you should check for the apical tug back. Once you place your master cone into the canal there should be a tug back for the Ghatapacha point and after you place master cone you should take an IOPI always. If in case the Ghatapacha is beyond the apex you can either cut if it is very little beyond then cut the tip and reinsert the cone and take a working length again x-ray again if not insert in larger size Ghatapacha and then verify it. In case it is short of the apex then either place a primary GP and then smaller size GP and verify or increase the size of the canal. If it is at the working length then you can after you confirm it with the radiograph you can go ahead to obturate with it. So now you've done the BMP you've selected the master cone now what you should do you should coat the canal with the sealer. Sealer using lentilow spiral or master cone you can take the sealer either in lentilow spiral or in master cone and coat it all over the canal then you can insert the master cone until the working length. After you insert the master cone a spreader can be inserted alongside the master cone this spreader has to be inserted up to 1 mm short of the working length for 10 to 60 seconds it's like almost a minute then after that you can disengage the spreader. So what happens when you place the spreader and you have to push it lateral side so there will be a place formed for the placement of the accessory cones by lateral compaction. See this is how you can do it. See master cone is placed up to the working length after that a spreader is inserted up to 1 mm short of the working length and laterally compacted so that the space you know that accessory canals are placed into the space that is formed between the canal wall and the master cone. The same method is repeated again and again till there is no space for the spreader to be placed the entire canal is filled with the master cone and the accessory can or Gattaparcha. After that the excess Gattaparcha should be removed from the crown. See the level till where the Gattaparcha is removed it is removed below the free gym level almost it should be below your CEJ so that you can do the access filling. This is a very clear picture the canal is prepared you placing a master file and then master cone check the fit of it then after you place the master cone place your spreader up to 1 mm short then compact it laterally after you compact it laterally you add an accessory cone repeat the procedure till you fill the entire canal with accessory Gattaparcha and master cone then seal the canal and condense it. See this is the picture in case of your molars. See lateral compaction is not only done in case of your anteris it is done it can be done in all the tooth especially in cases of the oval route oval shaped canals it is very useful. The Gattaparcha should be cut at the level of CEJ in case of anterior tooth in case of posterior tooth it should be at the orifice are approximately 1 mm below the orifice. The other method of obturation is worm vertical compaction technique. This method was introduced by Schilder with the objective of filling the main root canal as well as the lateral and accessory canals here not only the main root canal but lateral and accessory canals are also filled with this technique. How exactly this technique is done is here heated pluggers are used and pressure is applied in a vertical direction on heat softened Gattaparcha. Basically softened Gattaparcha is condensed vertically by applying pressure using heated pluggers therefore what happens they'll be flow of your Gattaparcha which will fill the entire numen of the canal. See the master cone is placed in the canal a condenser is placed wood and the pressure is applied so the Gattaparcha is compacted at the apical third first then the middle third then the cornel third. So coming to the steps involved in this worm vertical compaction first and foremost the fit of your master cone should be verified your master cone should be 0.5 mm short of the apex the reason being short of the apex space when you apply pressure using the heated pluggers what happens your Gattaparcha will flow if your master cone is exactly at the tip of the apex there are chances that it might overflow out of the canal so you have to always be careful that your pressure that you're applying is controlled and your master cone is short of the apex there are different type of pluggers there are pluggers which prefit the coronal third pluggers with fit the middle third and the coronal third according to the thirds of the canal first and foremost a sealer is deposited with a handy lentilow spiral basically you have to coat the canal with the sealers then a largest pluggush be used to compact the worm Gattaparcha into the bolus so what happens when you're using the largest plugger the lateral canals in the mid route will get obturated then after this you can remove the excess GP that is there from the canal then again you can take a mid-sized plugger and try compacting it from packing the Gattaparcha this will causes the Gattaparcha to flow into the lateral and accessory canals in the apical third after that you can then change the plugger into the apical size plugger when you condense it the Gattaparcha will flow into the lateral and accessory canals at the apical third so basically you're sealing the apical third first and the lateral and accessory canals at the mid route and the apical third after your apical third is filled then the canal is filled back in your middle and coronal third will be obturated up to the level of your CG that is all about the worm vertical compaction technique coming to the worm lateral compaction technique this provides the advantages of both the thermoplastic technique as well as the lateral compaction technique what are the advantages is see this involves placement of master cone and laterally compacting as I told in warm vertical compaction technique there are chances that your Gattaparcha might overflow out of the canal so that risk is avoided in case of your worm lateral compaction where here we are not compacting the Gattaparcha vertically instead we are compacting the Gattaparcha laterally is using heat carrier such as Endotech 2 tips or Endotwin 2 tips basically instead of vertical compaction your lateral compaction is done this is the different types of heat carriers touch now heat is a heat carrier that has been designed by Schilder it's an electronic device specially developed for the worm Gattaparcha technique next method is the system be continuous wave of obturation the system be technique is a variation of warm vertical compaction technique introduced by Buckman this technique employs the use of Gattaparcha cones and pluggers that mimics the tapered preparation thereby permitting the application of greater hydraulic force during the worm compaction basically they're telling that the force that we applied during the condensation can be much more because of the tapered cones which fit exactly into the prepared canals this is the system be technique so coming to the steps involved in non- standardized Gattaparcha cone is chosen for its adaptation into the shape of the root canal space then you also place the plugger of your system be and select the pre-fit to its binding point you can check whether the Gattaparcha is fitting perfectly in Gattaparcha and your plugger is fitting into the canal perfectly a pickle 4 mm of the master cone is coated with the sealer and using gentle pressure the cone is seated into the place the system be heat source is turned to use and touch mode basically after you place your Gattaparcha you place your system be plugger and turn it on so that it gets heated then you turn it off you condense the Gattaparcha as the heated plugger approaches the binding point the rings which is released which allows the plugger to continue its apical movement because the Gattaparcha is softened so what happens the you can move your plugger in the apical direction the apical pressure is maintained on the apical plug of Gattaparcha for a 10 second sustained push to prevent cooling shrinkage while maintaining the apical pressure the rings which is activated again for one full second and the switch is released and the plugger quickly withdrawn so that you don't retract any of the Gattaparcha coronal flash of the Gattaparcha is then removed and a clean interface homogeneous mass of Gattaparcha sealing is obtained in the apical third after this sealer can be applied to the remaining canal length of the canal and the canal can be back filled the same steps used to fill the apical canal that checking the prefit of your pluggers then condensing the Gattaparcha is carried out for both the middle third and the coronal third of the canal once the canal operation is completed you can access do the access film thermoplasticized Gattaparcha injection techniques thermoplasticized Gattaparcha injection techniques this technique comprises of a pressure operator consisting of an insulated electrically heated syringe barrel and a selection of needles ranging from 18 to 25 God size you can select the needles depending on the size of the canal basically the plugger is designed so as to prevent the backflow of the Gattaparcha and the degree of the heat that is applied will be regulated so that there is no extrusion of the Gattaparcha in outside the canal example for such types of technique is optura 3 basically thermoplasticized Gattaparcha is a technique wherein you deliver the heated Gattaparcha in syringe and you can compact it using the plugger next one is the solid core carriers under solid core carriers there are various varieties of solid core carriers one among them is thermo fill the other one that i'll be talking about will be simply fill thermo fill is a carrier based Gattaparcha operation technique in which the core carrier is a plastic material to a plastic core the alpha phase Gattaparcha is coated onto it which will be placed inside the canal they are available in various taper sizes also they are available in ISO standard sizes also these operators are used in conjugation with the heating device basically you need a heating device so that the alpha phase Gattaparcha can be heated and placed inside the canal such heating device is called as thermo prep plus oven so how exactly is this done is after your biomechanical preparation you can verify the thermo fill various instrument you can place the instrument then check what size material do you require after selecting the appropriate sized obturator you can dry the canal and coat the canal with a layer of sealants then you can place the carrier into thermo plus oven first for approximately 10 seconds then you can place the carrier into the canal up to the working length with a firm uniform apical pressure you shouldn't rotate it the position of the carrier is then verified radiographically and the Gattaparcha is allowed to cool for 2 to 4 minutes before selecting the carrier at the level of the canal orifice the carrier is introduced into the canal placed up to the working length then it is cut off at the level of your orifice the other type of solid core carrier is simply filled sectional obturation technique this is also a carrier based technique in which the carrier it is it is also a carrier based technique which is used along with the light speed rotary instrument in thermo fill the entire canal was filled with one single obturator but in case of simply fill only the apical 5 mm of the canal will be filled with the simply fill technique here the apical 5 mm of the simply fill carrier is coated with the Gattaparcha and then it will be placed inside the canal after choosing the appropriate carrier size you have to follow the basic steps like drying the canal applying the sealant and then you can introduce the carrier up to the working length after introducing it into the canal you can rotate the handle of the carrier in a counter clockwise direction once you rotate this in a counter clockwise direction what happens it disengages the apical plug of the Gattaparcha from the carrier so what happens your apical 5 mm will be filled the remaining coronal space can be filled using the lateral compaction or thermoplastic size Gattaparcha methods the next method is the max python thermo mechanical compaction method this method uses the heat to decrease Gattaparcha viscosity and increase its plasticity how exactly is this heat generated in this technique is heat is created by rotating a compacting instrument here they are using a compacting instrument and rotating it at a slow speed contra angle and piece of 8000 to 10000 rpm alongside the Gattaparcha cones after placing the Gattaparcha inside the canal they're placing this compacting instrument and rotating at a speed of 8000 to 10000 rpm what happens this compactor forces the softened Gattaparcha apically and laterally that's how it fills both apically and the lateral canals what exactly happens in this case is after the step back method the canal can be verified the Gattaparcha cones can be inserted and you can verify the whether it is going up to the apex or whether it is short then you can also select the compacter blade according to the width and the length of your prepared canal by inserting it between the Gattaparcha and the canal wall next one is the chemically plasticized Gattaparcha technique this is nothing but you're using chemical solvents to soften your Gattaparcha so that you can condense and adapt it and fill your canals but the greatest disadvantages of this technique is the inability to control the overfilling what happens when the Gattaparcha gets dissolved there are chances that it might overflow beyond the canal with so there are chances of periapical tissue reaction and also there are chances that the material might shrink after setting resulting in a poor apical and lateral shape this is the reason this technique is not so commonly used these days the last technique will be the custom cone technique it is a chair side procedure employed for customizing the Gattaparcha in case of wide canals where the traditional cones cannot be used to adapt the canals in this technique a few Gattaparcha cones or softens along with the help of the eat and roll together between the glass laps or a spatula might be used to roll the Gattaparcha so that we can create larger size master cone is created which can fit into the size of the canal you can see in this picture smaller size Gattaparcha cones are taken and rolled together after eating and between glass caps and a larger size Gattaparcha cones is made to fit into the wide canals so these are the types of obturation techniques based on the size of the canal length of the canal you can decide the obturation techniques that is required and obtain a 3d hermetic seal of the canal thank you