Filling Root Canal Systems and obturation devices

recent advancements of obturation devices

1. GOOD MORNING..

2. Name of Presenter- DR KUSUM MEENA TOPIC- FILLING ROOT CANAL SYSTEMS:THE CALAMUS 3D OBTURATION TECHNIQUE Department: CONSERVATIVE DENTISTRY & ENDOODNTICS MAHATMA GANDHI DENTAL COLLEGE & HOSPITAL A unit of Mahatma Gandhi University of Medical Sciences & Technology

3. Filling Root Canal Systems: The Calamus 3D Obturation Technique

4. CONTENTS INTRODUCTION HISTORY OF ROOT CANAL OBTURATION PURPOSE OF OBTURATION DIFFERENT OBTURATION TECHNIQUES CALAMUS RECENT ADVANCEMENTS CONCLUSION REFRENCES

5. INTRODUCTION “Obturation is the three-dimensional filling of the entire root canal system as close to the cementodentinal junction as possible, using an inert core material along with a sealer, to prevent reinfection.” -GROSSMAN Obturation is the method of filling and sealing a cleaned and shaped root canal system with a non-irritating, biocompatible material to establish a complete seal against the ingress of bacteria and tissue fluids.” -INGLE’S “The objective of obturation is to fill the entire root canal space with a stable, biocompatible, and impervious material that prevents communication between the periapical tissues and the oral cavity.” -COHEN

6. History of Root Canal Obturation Techniques Early Era (1800s – early 1900s) 1800s – First root fillings attempted with gold foil, silver points, lead, wood, and asbestos (biologically unacceptable). 1847 – Hill’s stopping (gutta-percha, resin, CaSO ₄) introduced → considered the first endodontic filling material. 1867 – Bowman introduced gutta-percha cones as a root canal filling material → still the gold standard.

7. Mid-1900s Cold lateral condensation (Grossman, 1950s) – Most widely taught/used technique. Involves placing a master cone + accessory cones using spreader pressure. Advantages: simplicity, control. Limitations: voids, poor adaptation in irregular canals. Silver points (1950s–60s) – Easy insertion but prone to corrosion, leakage, and failures.

8. Thermoplastic Era (1960s–1980s) McSpadden compactor (1967) – Mechanical compaction of heated gutta-percha → risk of extrusion. Vertical compaction of warm gutta-percha (Schilder, 1967) – Landmark technique introducing 3D obturation with heat and condensation.

9. Modern Era (1990s – Present) Continuous Wave of Condensation (Buchanan, 1990s) – Modified Schilder’s technique with System B. Thermafil carriers (1991, Johnson) – Plastic/metal carriers coated with gutta-percha, inserted into canal. Obtura II (1990s) – Injectable thermoplasticized gutta-percha. Calamus® 3D Obturation System (2007, Dentsply) – Combination of System B downpack + Obtura backfill in one device.

10. Current Trends (2010s – 2025) Bioceramic sealers + single-cone obturation gaining popularity → easier, less technique-sensitive. Debate continues: Warm vertical compaction vs. Bioceramic single cone

11. Purpose of Root Canal Obturation Prevent Reinfection Maintain Periapical Health Seal Lateral and Accessory Canals Ensure 3D adaptation to main canal, lateral canals, fins, and isthmuses. Provide Coronal and Apical Seal Prevent microleakage from both ends of the canal system. Maintain Tooth Integrity Prevent collapse or fracture by supporting internal tooth structure. Stability of Filling Material Ensure permanent, biocompatible, and dimensionally stable filling. Facilitate Future Restorations Proper obturation provides a solid foundation for post, core, or crown restoration.

12. Different obturation techniques 1. Cold Lateral Compaction 2. Warm Compaction (warm GP) A. Vertical B. Lateral 3. Continuous wave Compaction technique 4. Thermoplasticized GP injection 5. Carrier- based GP A. Thermafil thermoplasticized B. SimpliFill sectional obturation 6. McSpadden thermomechanical compaction 7. Chemically plasticized GP 8. Custom cone

13. COLD LATERAL COMPATION

14. STEPS Select and fit a master gutta-percha cone to working length with tug-back. Coat the canal walls and cone with sealer . Insert the cone, then use a finger or hand spreader alongside it to laterally compact. Add accessory cones into the space created by the spreader and continue compaction until the canal is filled. Cut off excess gutta-percha at the canal orifice

15. Warm vertical compaction is an obturation technique where thermoplasticized gutta-percha is compacted vertically inside the root canal system in increments to achieve a dense 3D fill.

16. STEPS Fit a master cone with sealer to full working length. Use a heated plugger to soften and compact the coronal portion of the gutta-percha. Incrementally add and heat gutta-percha, packing it vertically deeper into the canal. Continue until the entire canal system (including irregularities, fins, and lateral canals) is densely filled

17. THERMOPLASTISIZED GP INJECTION

18. Gutta-percha is gradually injected by squeezing the trigger of the gun, and the needle is gradually withdrawn as the canal gets filled apically. The gutta-percha is then compacted using pluggers of appropriate size. The rest of the canal can be filled in one to two increments in the same way.

19. Carrier-based Gutta-Percha Obturation Technique (a) Thermafil Thermoplasticized  – The Thermafil is a carrier-based gutta-percha obturation system comprising a plastic core carrier coated with alpha phase gutta-percha. These Thermafils are available in ISO standardized sizes as well as tapered sizes for canals prepared with NiTi tapered instruments. After the canal is prepared, the size is verified with a Thermafil verifier instrument, which helps in the selection of the appropriately sized obturator.

20. Drying of the canal followed by sealant application is done as in any other technique. The silicon stopper on the carrier is adjusted to the working length, and the carrier is loaded into the Thermaprep plus Oven device for approximately 10 seconds. The carrier is then inserted into the canal and placed up to the working length with firm, uniform apical pressure without rotating. The position of the carrier is verified radiographically, and the gutta-percha is allowed to cool for 2–4 minutes before resecting the carrier at the level of the canal orifice

21. (b) SimpliFill Sectional Obturation It is a carrier-based sectional gutta-percha obturation system used in conjunction with light-speed rotary instruments. The SimpliFill carrier has an apical 5 mm plug of gutta-percha, which performs cold sectional obturation of the root canal. After the usual drying and sealant application in the canal, the carrier is selected depending on the master apical file and introduced up to the working length. The handle of the carrier is rotated quickly in the counterclockwise direction three to four times to disengage the apical plug of gutta-percha from the carrier. The remaining coronal space can be filled with lateral compaction or thermoplasticized gutta-percha methods

22.  McSpadden Thermomechanical Compaction Obturation Technique Introduced by McSpadden, this technique uses heat to decrease the viscosity of gutta-percha and increase its plasticity. The heat is created by rotating a compacting instrument in a slow-speed contra-angle handpiece at 8,000–10,000 RPM alongside gutta-percha cones inside the root canal. The stop on the compactor blade helps guide the rotating tip of the blade to within 1.5 mm of the root apex, helping prevent gutta-percha from flowing beyond the apex. The compactor, whose spiraled 90° flutes are similar to the flutes on a Hedstroem file but in reverse, forces the softened gutta-percha apically and laterally.

23. Disadvantages:   Cannot be used in narrow canals  Compactor blades often break in the canal  Frequent  overfilling  of the canal  Shrinkage of the cooled or set filling 

24. Chemically Plasticized Gutta-Percha Obturation Technique This technique is no longer recommended. It involves gutta-percha being plasticized with chemical solvents like chloroform, eucalyptol, or xylol. The disadvantage of using a chemical-solvent filling material is its inability to control overfilling, often leading to periapical tissue reaction and shrinkage of the filling after setting, resulting in a poor apical and lateral seal. 

25. Custom Cone Obturation Technique It is a chair-side procedure wherein the dentist customizes the cone for adequate tug-back in a canal. The technique involves softening the gutta-percha with one or more accessory cones using heat or rolling between two glass slabs to achieve a single master cone of the required size. Another method is softening the master gutta-percha with chloroform, eucalyptol, or halothane for a few seconds and gently placing it to the working length with a locking plier. Upon removal, the softened gutta-percha has the impression of the canal, and this process is repeated until a snug fit is achieved. 

26. CALAMUS The Calamus obturation technique is  a warm vertical compaction method using a Dentsply Sirona Calamus system to fill root canals three-dimensionally.  It involves heating  gutta-percha  with a  Calamus unit   and using the heat plugger to push it deep into the canal, followed by a backfill technique to fill the coronal portion.  The technique aims to create a dense, void-free filling by heating and compacting the gutta-percha, promoting better adaptation to the root canal's complex anatomy. 

27. CALAMUS Calamus Pack Handpiece Heats Electric Heat Pluggers (EHPs) to thermos soften and condense gutta-percha during the downpacking phase. Features : Ergonomic design with a 360° activation cuff for precise control and minimal hand movement. Calamus Flow Handpiece Heats and extrudes thermoplasticized gutta-percha into the root canal system during the backfill phase. Features : Utilizes single-use gutta-percha cartridges available in 20- and 23-gauge sizes, ensuring a clean and efficient backfill process. Bending Tool Purpose : Allows clinicians to shape the canula of the Flow handpiece to navigate complex canal anatomies, ensuring optimal delivery of gutta-percha. US$3,950.50

28. 🔹 Clinical Advantages Seamless Integration : The dual-handpiece design streamlines the obturation process, reducing the need for multiple devices and enhancing workflow efficiency. Ergonomic Design : Both handpieces are crafted for comfort, reducing hand strain during extended procedures. Consistent Performance : The system's heating capabilities ensure uniform thermoplasticization of gutta-percha, resulting in improved adaptation and sealing of the root canal system. Space-Saving : The compact design occupies minimal counter space, making it suitable for various clinical settings.

29. Advantages Has efficient 3D filling system facilitates warm vertical compaction and backfill techniques, ensuring a well-adapted and dense root canal filling. It allows controlled extrusion of gutta-percha, improving adaptation to canal irregularities. The lightweight and user-friendly design reduces hand fatigue during procedures. Fast Heating. The system provides stable and adjustable temperature settings for optimal gutta-percha flow. It helps achieve a hermetic seal, reducing the risk of microleakage and reinfection. Compatibility with Various Techniques.

30. Disadvantages 1. High Cost. 2. Proper training is required to master the system and achieve optimal results. 3.Potential Overfilling Risk. Excessive gutta-percha flow can lead to overextrusion beyond the apex if not controlled properly. 4. Unlike cordless systems, the Calamus 3D requires a power connection, which may restrict mobility in clinical settings.

31. THE DOWNPACK TECHNIQUE Technique involves adapting a master cone in the same manner as with lateral compaction. A 0.04 taper gutta-percha cone is fitted in the root canal to working length. The 0.02 taper spreader of the battery-powered DownPak is activated and heated for 2 seconds in vibration mode and placed between the master cone and the dentin. It is advanced until the tip reaches within 2 mm of working length. The spreader is removed and spreader is placed to within 1 mm of the working length in order to condense the filling material. A fine-medium accessory gutta-percha point is then placed. This procedure is repeated until no more than 2 mm of the spreader can be advanced into the canal.

32. BACKFILL Backfill is the second stage of warm obturation , where the coronal and middle thirds of the root canal are filled with thermoplasticized gutta-percha , after the apical seal has been established (usually by downpack ). Steps: After downpack /continuous wave , the apical 3–5 mm is densely sealed. A thermoplasticized GP delivery system (e.g., Obtura , Calamus Flow, BeeFill ) is used to inject heated gutta-percha into the remaining canal space. A plugger is used incrementally to condense and adapt the material. The process is repeated until the canal is completely filled up to the orifice.

33. The 3D obturation was best with Calamus as compared to Thermafill and lateral condensation. Best results with Calamus could be explained on the basis of the maximum inert core material, minimum amount of sealer and a higher degree of homogeneity associated with the calamus Voids were seen in all the root fillings • Calamus obturating technique showed the least spaces or voids • Lateral compaction produced the maximum spaces or voids • Warm vertical compaction exhibited least voids than cold lateral compaction

34. Feature Calamus 3D Warm Vertical Compaction (System B etc.) Lateral Condensation Single Cone Carrier-based / Thermafil Filling Area / Void Volume Very high / minimal voids High / low voids More voids / lower fill area Variable / more voids Moderate to good, some voids Apical Seal Quality Excellent Excellent Moderate Lower Good apical but issues elsewhere Adaptation to Canal Walls Very good, especially irregularities Good Less good Poor in irregular anatomy Good if properly fitted Time / Ease Moderate-High (complex setup) Moderate Lower (simple) Fastest Fast but technique-sensitive Retreatment Complexity More difficult Moderate Easier Easiest Carrier removal issues

35. SMARTSEAL Since Schilder introduced thermoplastic obturation techniques in 1967, various devices and systems using thermoplasticized gutta-percha as a root canal filling material have been developed. The advancement in endodontic obturation materials involves the use of a hydrophilic polymer within the root canal, exemplified by the SmartSeal system ( Prosmart - DRFP Ltd., Stamford, UK)

36. This system includes obturation points ( ProPoints ) made of a polyamide core coated with a bonded hydrophilic polymer, along with a specialized sealer containing polymer powder that is incorporated during its preparation It is available in following sizes: 6% taper - ISO tip sizes 25 to 45 4% taper - ISO tip sizes 25 to 45 ProTaper™ - F1, F2, F3, F4 & F5 Sendoline™ S5 - S2, S3, S4 The hydrophilic layer, featuring a hydrogel coating, enables the points to swell and adapt to the complexities of the root canal system

37. SMARTPASTE SmartPaste is a resin-based sealer containing an active polymer that expands to fill any gaps or voids within the root canal system. It is supplied in a syringe to ensure consistent and precise ratios of sealer components with each use, and mixing or dispensing trays are included to facilitate application

38. Smartpaste Bio This resin-based sealer is designed to swell with the addition of ground polymer. The inclusion of bioceramics provides exceptional dimensional stability, making the sealer nonresorbable within the root canal. During the setting reaction of the bio-paste, calcium hydroxide and hydroxyapatite are produced as byproducts, rendering the material antibacterial during setting and highly biocompatible once set

39. Advantages 1. The hydrophilic nature of the obturating points allows them to absorb surrounding moisture and expand, effectively filling voids and spaces within the root canal system. 2. Has versatile nature, allows for the creation of points compatible with various file systems, enhancing its adaptability in clinical practice. 3. The Smart Seal system's properties enable a simplified obturation process, potentially reducing chair time compared to traditional methods. Disadvantages 1. Limited Retreatment Options. The polymer-based material can be challenging to remove. 2. Higher Cost 3. Technique Sensitive 4. Uncontrolled expansion in some cases may lead to overfilling or extrusion beyond the apex, potentially causing complications.

40. Woodpecker obturation pen system Rs.38,995 The Woodpecker Obturation Pen System is designed to heat the working tip, cut the gutta-percha point, and soften and pressurize the gutta-percha. The Woodpecker Obturation Pen System is utilized during root canal treatments to achieve warm vertical compaction The device is cordless and ergonomically designed, providing clinicians with comfortable handling and precise control during procedures.

41. Advantages 1. Reaches operating temperature in approximately 0.2 seconds, allowing for efficient workflow. 2. Offers four preset temperatures (150°C, 180°C, 200°C, 230°C) for better adaptability to different obturation needs. 3. Provides ease of use, reducing hand fatigue during procedures. 4. Ensures proper softening and sealing of the root canal system. 5. Long Battery Life 6. Precision and Control Disadvantages There is a lack of extensive research evaluating its long-term performance and effectiveness. 2. Higher Cost 3. If not handled properly, excessive heat may damage periapical tissues. 4. Technique Sensitivity 5. Device Maintenance: Regular care is needed to ensure consistent performance

42. Bee fill obturation system The BeeFill 2in1 Obturation System, developed by VDW, is a comprehensive device designed for three-dimensional root canal obturation. It combines downpack and backfill capabilities, enabling efficient and reliable filling of the entire root canal system.

43. Clinical application It is utilized for warm vertical condensation, achieving a homogeneous and dense filling of the root canal system, including oval canals, isthmi , ramifications, and lateral canals. The BeeFill 2in1 Obturation System offers a versatile and efficient solution for endodontic obturation, combining advanced technology with user-friendly features to enhance clinical outcomes in root canal treatments. €3,286.50

44. found that, after two weeks, the BeeFill group exhibited greater leakage compared to single-cone and cold lateral compaction methods. However, all test groups showed a significant decrease in fluid conductance over time, indicating improved sealing with prolonged use

45. NeoSEALER Flo obturation system It is a bioactive bioceramic sealer developed by Avalon Biomed. It is specifically designed to enhance the obturation process during root canal treatments by providing an effective seal that promotes healing and reduces bacterial contamination US$190

46. CLINICAL APPLICATIONS Ideal for use in obturating complex canal systems, including those with lateral canals or isthmi . Works well with the provided Flex Flo Tips™, allowing accurate application with minimal waste. Effective for primary endodontic treatments and retreatment procedures

47. Elements IC obturation system The Elements™ IC Obturation System by Kerr Endodontics is a cordless, comprehensive solution designed to enhance the efficiency and effectiveness of root canal obturation procedures. Combining a Downpack heat source with a Backfill extruder, it facilitates the Continuous Wave warm vertical condensation technique, ensuring precise and predictable results US$3,335 – US$4,089.99

48. CONCLUSION Successful root canal therapy depends on thorough cleaning, shaping, and three-dimensional obturation . Traditional techniques (cold lateral, warm vertical) have limitations in sealing complex canal systems. The Calamus 3D obturation system combines continuous wave downpack with thermoplasticized backfill , offering: Recent advances such as bioceramic sealers, sealer-based techniques, and thermoplastic injection devices are reshaping the philosophy of obturation. Ultimately, the goal remains the same: achieving a fluid-tight, durable seal that promotes long-term periapical healing.

49. REFRENCES