Vertical Condensation Technique - Mandibular Molar: Case I: Advanced Endodontics

All content has been transcribed from original audio recordings. As a result, transcribed text may contain certain grammatical, spelling, or other language artifacts which don’t reflect the original audio recording. Please refer to the audio for the most accurate information and messaging. Any reproduction of the video content, audio, or transcribed text is strictly forbidden. Condensation Technique Mandibular Molar Case I The objective of this obturation technique is to continuously and progressively carry a wave of warm gutta percha along the length of the master cone starting coronally and ending in apical corkage. Once the downpack is complete, reverse waves of condensation are performed as necessary to complete the backpack. In this Just-In-Time segment, Dr. Ruddle will clinically present the Vertical Condensation Technique by packing merging systems, the MB and ML canals, in a mandibular molar. Topics include: Fitting the master cone Selecting the pluggers Paperpoint drying technique Choosing & placing sealer Downpacking Backpacking * let’s look at the warm gutta-percha with vertical condensation technique and one of the mesial systems of this mandibular first molar the clinical crown was removed with the metal lift instrument looking at the isolated tooth you can see that we have shaped all the systems and another just in time show we showed how ProTaper can shape most of our posterior teeth with just three instruments well shaped canals are conducive to fitting a cone so in this instance we’re fitting a pro taper matching gutta-percha master cone the cone is set at the correct length and the cone is teased into a fluid-filled canal I typically have sodium hypochlorite in at this time I’m checking the cone for short crisp Tugg back when I remove the cone I can further look at the cone to evaluate where the scratches striations or rub marks are if they’re up in the body of the canal it means you have faults tug back so ideally we would like to see this marking right at the terminal one or two millimeters of the cone after fitting the cones and laying them aside in preparation for operation it is wise to pre-fit pluggers pre fit the largest plugger that will fit passively in the coronal one-third then you can choose a smaller diameter plugger that can fit deeper into the middle one-third the goal is to fit a smallest plugger that will work within five millimeters of working length the pluggers have convenient lines at five ten fifteen and twenty millimeter intervals so we always know where we are we can further be oriented by placing a rubber stop on the plugger if so desired we can use an irrigating syringe to vacuum out the bulk of the reagent that’s inside the mesial systems paper points are used to do the final drawing and to length that the paper points it Carolee in the canal so that they can wick up surplus moisture the paper point can be set a little bit longer just to see if the drawing point can be extended remember when we’re doing endodontics were off-course about 90% of the time so all these little steps help us refocus and readjust our course that part of the paper point that accordions a little bit represents that part of the paper point that is potentially beyond the foramen we can even set the coin at another half millimeter longer than we just showed and sometimes this will move through the foramen and it’ll come out with a little bit of a hemorrhagic exudate on its terminal extent that part of the paper point that is completely dry consistently represents that part of the paper point that is confined to the root canal space the master cone could then be trimmed and adjusted accordingly the trim master cone is then placed with its apical extent against the last file that was snug at length this is kind of a smell test to make sure that the world we see is the world that is in this technique I use curved pulp canal sealer extended working time the sealer is picked up on the master cone and the cone is slid to place once the cone is seated remove the cone and inspect it if the cone is still lubricated with sealer simply Ricci’s it back to place go slowly so the cement can reflux and move back in a coronal direction since we’re going to pack the mesial systems together we would lubricate the MB and tease it to place by pumping the cone to the length or by using a vigorous motion we can needlessly extrude sealer through the foramen now remove the cone like we showed in the ml re-inspect it if it’s denuded we simply rebut er the cone and tease it back to place the master cones can be seared off with the heat transfer device and again once the cones are seared off you’ll have a five millimeter heat wave through the Quran most part of that master cone thermos often gutta-percha has compaction potential this wave of condensation is showing sealing the canal laterally and vertically over a range of few milliliters the sealer becomes