CLINICAL To this end, each GuttaCore blister pack, besides five obturators, has a verifier of corresponding size and taper (Figures 7 and 8). This is a manual instrument that is passively inserted to the working length of the root canal. If the verifier does not passively fit to working length, it can be used as a finishing file for apical enlargement. 4. When using GuttaCore obturators, a thin layer of sealer is applied to the coronal or, in case of long root canals, the coronal and middle thirds of the canal. To apply the sealer, a paper point, a probe, or in case of using AH Plus Jet sealant, a special mixing tip can be employed (Figure 9). The preheated obturator, in the process of insertion into the root canal, evenly distributes the sealer along its walls. If there is excess sealer, or it was applied to the full working length, there is a very high risk of sealer extrusion into the periapical tissues. 5. The working length is set on the oburator, after which it is placed into a holder of one of the ThermaPrepŽ 2 (Dentsply Tulsa Dental Specialties) oven’s heating elements (Figures 10 and 11). The distinguishing characteristics of the ThermaPrep 2 oven are rapid three-dimensional heating of obturators, while maintaining the properties of the gutta percha carrier, as well as the option of having both heating elements operating simultaneously. When working with the GuttaCore system, unlike obturators with a plastic carrier, a minimum heating level of 20-25 is set on the operating panel of the oven, regardless of the obturator size (Figure 12). The obturator is placed into the ThermaPrep 2 heating element by gently pressing down the holder. Immediately, the operating cycle is automatically activated, and an indicator light is switched on. The option of having both heating elements operating simultaneously makes it possible to heat up two obturators at the same time, if necessary. When the heating is complete, the oven makes a sound signal, and the indicator
light starts blinking. Pressing on the holder releases it; the obturator is removed (Figure 13), and slowly, without rotation, inserted into the root canal to the working length. With cases that have difficult access to root canals, especially in posterior teeth in a patient with limited oral opening, the GuttaCore obturator carrier may be inserted with pliers (Figure 14), after the obturator
handle has been removed by bending it from side to side (Figures 15 and 16). 6. After the obturator is inserted into the root canal, the heated gutta percha can be condensed with a plugger in the coronal part of the root canal. This generates additional hydrodynamic pressure, enabling the gutta percha to fill the ramifications of the main canal, such as
Figure 9: AH Plus Jet sealer with mixing tip for inserting material directly into root canals
Figure 8: Canal size verifier
Figure 10
Figures 11-13: Heating an obturator in a ThermaPrep 2 oven
Figures 12
Figures 13
Figures 14-16: Application of GuttaCore obturators in hard-to-access root canals 20 Endodontic practice
Volume 7 Number 4