Otturazione del sistema dei canali radicolari con guttaperca termoplasticizzata: principi, materiali e tecniche

Abstract

Objectives As described and shown by Schilder, the success of the endodontic treatment depends on the ability of the operator to shape the main canal and to cleanse and fill the whole endodontic space three-dimensionally; since after shaping and cleaning it is very difficult, if not impossible, to reach the complete sterilization of the canal, the filling is still a conclusive phase for the success of the whole treatment. Today, the only technique that allows to get a reliable and predictable seal of all the “exit doors” of the canal is based on the use of warm gutta-percha vertically compacted. Materials and methods Thanks to technological evolution, currently a complete range of tools is available to the clinician, suitable to different variations of compaction of the thermoplastic gutta-percha. The article considers the technique of filling described by Schilder, analyzing its biological motivations and mechanics, deepening the knowledge of the physical features of gutta-percha and clinically describing in details the most feasible methods, such as the continuous wave of condensation, devoleped by Steve Buchanan, and the thermo-hydraulic condensation described by Joseph Nahmyas. Results and conclusions The vertical gutta-percha obturation technique is based on the assumption that the root canal system, once cleaned, can be effectively sealed in all its ramifications provided that we succeed in giving a correct “shape of resistance” to the main canal. Assimilating the guidelines outlined in this article and understanding the importance of an adequate three-dimensional filling of the root canal system in relation to the established biological principles of modern Endodontics will let us achieve consistently excellent root canal treatments and produce satisfactory results for both the clinician and the patient.