Tag Archives: thermafil

One Cone Fits All, or Does It?

“After about ten years of first appearing on the market, currently Thermafil obturators are completely modified and form an integral part of a complete and sophisticated system of root canal obturation that, when used correctly, can give optimal results.   — W. Ben Johnson”

The reported advantages of Thermafil include: shortness of learning curve, speed of clinical application, apical control of fill, conservative enlargement of root canal (when compared to other warm gutta percha compaction techniques), three-dimensional obturation and apical sealing ability, etc.

In my opinion, shorter treatments do not allow for adequate disinfection of the canal system, speed compromises the quality, apical control of fill is nonexistent with this technique, and conservative enlargement of root canal is not always beneficial since some degree of apical enlargement is necessary to allow for proper disinfection by irrigants.

If used correctly (proper size obturator in a single, adequately-instrumented canal and following the manufacturer’s recommendations), 3-D obturation and apical sealing ability are the major advantages of this obturation technique.

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Inappropriate case selection for the use of Thermafil obturation technique is demonstrated above.  This case shows how Thermafil would give us a false sense of achieving an “optimal” obturation in challenging cases such as this.  There was only one obturator used in the canal system that splits into three apically.

As I mentioned in my previous post I Love Sealer Puffs!, extrusion of obturation material into the uncleaned and unshaped portion of the canal system (lateral canals, fins, isthmus, irregular areas, etc.) does not translate into success.  The prerequisite for any obturation technique is adequate shaping and cleaning of the entire system, and the only reason for endodontic failure is the presence of micro-organisms.


Alcohol Will Set Things Straight!

During re-treatment procedures, removing the gutta-percha dry (if possible) is preferred.  Simply because it is less messy.  But I often find myself use a bit of C-form (what we call chloroform in the office) specially when I have to negotiate the very last part of the gutta-percha close to the apex.  I also use it quite often when I re-treat cases with carrier-based obturation material.  And, what a mess that creates!

softened gutta-percha by chloroform

To get rid of this “soup” of gutta-percha from the access cavity and to continue working in a very clean and controlled environment, alcohol should be used as the next irrigant.  It clumps up all the softened gutta-percha to the point that it can easily be rinsed off by water spray or picked off by instruments.

Once the gross removal of gutta-percha from the canals is complete with alternating use of C-form and alcohol, I usually use EDTA as it will continue to clean the remaining of the softened gutta-percha from the canal system.