Hello. I'm Dr. Manor Haas. I'm a certified endodontist from Toronto, Canada.
In this segment, I would like to review the management of large or ovoid
canals, canals with no apical constriction, post space preparations,
and retreatment of Guttacore®.
First I'll speak about obturation of ovoid canals.
As shown in the video, in ovoid or large canals I personally like
to place a single master gutta-percha point corresponding to your master file
at one side of the canal and in turn leaving space for the Guttacore that
will be inserted alongside of it. To improve visibility and reduce
interference with the warm Guttacore that will be inserted, I suggest cutting
the cold gutta-percha at or below occlusal table. This is the same as when
I recommended doing with the paper points meant to block out adjacent
canals. This is optional, but in large canals and as you may see in this clip, I
like to down pack the warm Guttacore gutta-percha around the cold gutta-percha in
order to provide an even better obturation.
Second, I'll speak about canals
with no apical constriction. These include but are not limited to cases with apical
pathology or canals you know have been instrumented large beyond the apex. In
such cases, I recommended that you obturate at least one millimeter short of
your working length and remember to use very little sealer in these canals. This
will help reduce extrusion of sealer and/or gutta-percha. This case of mine of
the maxillary central with an apical lesion demonstrates how using too much
sealer and/or not filling short of the working length could result in
unintentional extrusion.
Third I'll speak about post preparation. Preparing a post
space in canals obturated with Guttacore is quite easy. Simply wait maybe about 30
seconds or so to allow the Guttacore to set and then you may use nearly any
drill you wish to make your post space. This could be done the same way as you
would with plain gutta-percha obturations. I found that you don't necessarily need
special post space drills for Guttacore. I can't say the same with other carrier-
based obturations, however. Now I'll speak about retreatment.
In the unlikely event you need to remove your Guttacore,
I recommend using a Hedstrom file for engaging and removing the Guttacore.
As seen in this video, turn the Hedstrom file in a clockwise direction to engage into
the Guttacore and pull the file coronally. This is very easy to perform,
especially before the Guttacore has fully set. If, or once the sealer is fully
set, you may retreat the Guttacore the same way you would any other
gutta-percha based obturations. Now I'd like to discuss accessibility into
difficult-to-reach sites. Now, most root canal treatments are
performed on posterior teeth which are often more challenging to reach because
of the opposing arch or the patient's limited opening. With that in mind, I
would like to mention that from a practical and clinical perspective, it's
not just about getting warm 3D obturation of the root canal system.
But it's just as important to evaluate if your warm obturation system can enable
you to obturate with ease in difficult-to-access areas. In this video, you can see
how accessibility to posterior teeth is amongst various obturation systems on the market.
As you can see in the clinical demonstration, only the Guttacore
obturators can make warm 3D obturations so easy in difficult-to-reach sites.
The ability to break off the Guttacore handle and turn the obturator into a
shorter and easily maneuverable gutta-percha separates this from other
warm obturation systems on the market. Many obturation systems may enable you to
obturate with warm gutta-percha, but please ask yourself if they can be used
easily, predictably, comfortably, and in more difficult-to-reach sites?
So to recap, I've shown how you can obturate large ovoid canals, how to manage
canals with no apical constriction, how to easily prepare post spaces, and
retreat canals obturated with Guttacore. Finally, I demonstrated how Guttacore
stands out and above other warm obturations by enabling you to obturate so
easily in difficult-to-reach sites. I hope you found this useful. Good luck and
thank you for your time.