Step 10 – Master Cone Selection
02 or 04 tapered gutta percha cones are used. A Gutta-Percha gauge is a helpful tool cut the cone to the proper size using a #15 scalpel blade. The gutta-percha gauge has brass gauges that correspond file sizes. Simply take the cone and place it in the appropriate brass gauge and cut off any excess from the bottom a #15 blade. The cone be pinched with cotton pliers to mark the working length and should fit snugly in the canal with "tug-back."
Clinic Tip: Always fit gutta percha cones in a wet canal.
Take a Master Cone radiograph to confirm your cone fit.
Finally, prior to final obturation and irrigate the canals and dry using paper points that have been measured to the working length.
Step 11 – Mixing Cement
Automix Ribbon is the sealer used at Pacific. To mix the sealer, simply dispense the appropriate amount of the expressed ribbon on a mixing pad. Mix the cement with a spatula and then clean the spatula immediately with an alcohol gauze.
Step 12 – Lateral Condensation / Obturation
Using a measured paper point, apply sealer to the canal walls. Coat the master cone with sealer and insert it slowly into the canal to allow excess sealer to escape in the coronal direction. Next, insert the finger spreader in a watch winding motion to 2mm of working length into the canal to condense the master cone laterally and vertically. The next accessory cone is inserted in the space created by the finger spreader. If you remove the spreader too soon the void will fill in with sealer before you have have a chance to place the accessory point. Remove the spreader by watch winding to dislodge it from the canal. Repeat this until you have about 2 accessory points in each canal and take a Mid Obturation radiograph.
If you have a good apical fill continue to add cones, until the spreader can only be inserted to 3mm from the CEJ or canal orifice. At this point, use a hot spoon to sear the cones and condense with a cold condenser.
Clinic Tip: Make sure that your plugger is hot enough to sear off the gutta percha and work quickly before it cools. If the instrument isn’t hot enough, or you leave it in place and let it cool, there is a risk of pulling out all of the gutta percha cones.
Clean the access cavity and chamber using cotton pellets dipped in alcohol to remove any excess sealer. You can place a buildup or place a spacer (cotton pellet or sponge) and temporize with Fuji 9 or CAVIT (with a small cl. I cavity only).
Step 13 – Final Post-Operative Radiograph
After placing the temporary remove the rubber dam and clamp and take a final raiograph.
Create a radiograph template in axiUm and label it with the tooth number.
Page Updated: April 17, 2019