A method of adapting gutta-percha master cones for obturation of open apex cases using heat

CLINICAL TECHNIQUE: It is generally accepted that the success of root-canal treatment is mainly dependent on the proper cleaning, shaping and hermetic obturation of root canals. Obturation of the root canal is of importance as 60% of endodontic failures are attributable to incomplete obliteration of the root-canal system. The clinical application of many obturation techniques used today demands the preservation of the natural apical construction or the preparation of an artificial equivalent during chemo-mechanical preparation. However, in clinical practice there are cases where the apical foramen is wide because of over-instrumentation, root-end resection during periradicular surgery, root resorption or because the apex of the root is incompletely formed. Thus the preparation of an artificial apical stop is very difficult to achieve. It is a common experience that performing usual gutta-percha condensation techniques in such canals often results in overfilling and therefore special obturation techniques are needed. Some clinical cases of teeth with wide apical foramen treated by a special obturation method are presented in this paper. In this method the end point of the primary gutta-percha cone is elasticized with a heated instrument and inserted into the root canal to record the internal morphology of the apical portion.