Obturation

In this sixth and final part of the series, which explains the basic principles of root canal treatment for a single-rooted tooth with simple root morphology, the focus is on the process of obturating (filling) the root canal system. The following steps are outlined:

1. Materials Needed:
   • Master apical cone
   • Sterile paper points
   • Sealer
   • Accessory gutta-percha cones
   • Finger spreader
   • Flat plastic or endodontic plugger
   • Mole pledgets
   • Resin-modified glass ionomer
   • Endodontic kit
2. Obturation Process:
   • Take a master apical cone that corresponds to the size of the finishing file used and seat it into the wet canal following the removal of the intra-appointment medicament.
   • Take a trial point fit radiograph to confirm that the master cone sits within one millimeter of the radiographic apex. Adjust cone size if necessary.
   • Once the correct position of the master apical cone is confirmed, remove the gutta-percha cone, and dry the canal with sterile paper points.
   • Pre-coat the accessory gutta-percha cones and paste in preparation for cold lateral compaction.
   • Measure the master apical cone to working length, lightly cover with sealer, and gently place it into the canal to working length until a definitive stop is felt.
   • Insert the finger spreader, hold while applying apical and lateral pressure for 10 seconds, and then remove the finger spreader with a gentle rotation.
   • Lightly coat an accessory cone in sealer, place it into the canal, and repeat cold lateral compaction until no more cones fit into the canal.
   • Remove excess gutta-percha with a warm flat plastic or a spoon excavator, and compact the remaining gutta-percha vertically using an endodontic plugger.
   • Take an obturation verification radiograph to confirm the correct length of the root filling.
   • Clean the inside of the access cavity with an alcohol-soaked piece of cotton wool or a microbrush up to the cemento-enamel junction to avoid staining the crown.
   • Use a long-shanked rose head bur in a slow-speed handpiece to remove excess gutta-percha from the crown over the cemento-enamel junction.
   • Once the definitive restoration is placed, remove the rubber dam, check for occlusion interference, and take a final post-treatment radiograph.
   • Provide post-operative instructions to the patient.

This concludes the six-part series covering the basic principles of root canal treatment for a single-rooted tooth with simple root morphology.