SP-16 Enhancing Root Canal Obturation: A Negative Pressure Sealer Application Technique for Improved Seal and Reduced Voids

CE Hours: 0.75

Description: The primary objective of root canal obturation is to create a thorough three-dimensional seal of the canal space following chemomechanical debridement to prevent microleakage and bacterial re-contamination. Voids within the root canal fillings act as reservoirs for microorganisms, significantly impacting the effectiveness of the treatment. Tricalcium silicate sealers are known for their excellent biocompatibility, chemical stability, flowability, and  radiopacity. Recent clinical observations have shown a success rate of 90.9% when using a premixed tricalcium silicate sealer with the single-cone technique over a period of 30.1 months. Despite these advantages, in vitro studies reveal that this method may lead to the formation of voids, occupying up to 6.29% of the canal volume in round or slightly oval canals, and as much as 15.39% in more elongated canals.This presentation introduces a refined obturation technique that involves the application of a mild apical negative pressure during the insertion of the tricalcium silicate sealer. This method facilitates the sealer's movement from the canal orifice to the apex, effectively reaching full working length. The technique, when combined with the single-cone method, significantly reduces void formation in elongated root canals to just 0.42%, compared to 15.39% with the traditional method alone. This approach enhances the quality of root canal fillings by minimizing voids and avoids complications such as sealer extrusion by using smaller taper and size gutta-percha points. Unlike the vacuum obturation method proposed by Dr. Adrian Lussi, this negative pressure technique simplifies the procedure, offering a practical and efficient solution for practitioners.

Learning Objectives:  

• Describe the limitations of traditional root canal obturation, including the formation of voids.
• Utilize the principle behind the negative pressure obturation technique, to minimize void formation and improve the quality of seal in the root canal.
• Compare the performance of the negative pressure obturation technique with conventional singlecone and other obturation methods.