TOYO CHEMICAL LABORATORIES.,INC.

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1 Obturation System Warm Gutta Percha Technique Method Director :Otani Endodontic Insitute PAT. U.S.A. &JAPAN TOYO CHEMICAL LABORATORIES.,INC.

2 Injection method for root canal filling Obturation System The purpose of root canal filling is to completely fill aroot canal, from the orifice to the foramen apices, with amaterial of sufficient physical-chemical stability that it will allow no remaining dead space. The Obturation System shuts off any communication between the apical foramen and the periodontal tissues and prevents bacteria and injurious substances from acting into the canal. Conventional root canal fillings, however, require much time and arefined technique. Therefore, perfect fillings have been difficult to achieve. The "OTANI Obturation System" is an epoch-making new development which can solve the problems of conventional endodontic treatment. In the Obturation System, athermoplastic dental guttapercha materialthe Obturation Gutta Percha- is injected with aspecific injector directly into the root canal to completely fill it. More nearly perfect root canal fillings are obtained with ease in ashort time. United States Patents &Japan Patents are aquired. Reference : U.S.FDA. dental device I.D.Registration No TOYO CHEMICAL LABORATORIES.,INC. Features of the Obturation System 1. The root canal filling is similarto conventional gutta percha root canals. 2. Curved canals and those requiring inverted gutta percha points are easily filled as the Obturation Gutta Percha is injected. 3. This is one of the best methods for filling root canals. 4. Due toitsabsorption properties, Obturation Gutta Percha can be applied to milk teeth. 5. Due to the low softening point of 45 C(113 F), Obturation Gutta Percha causes little irritation when injected. 6. The Obturation Gutta Percha can be injected within 20 seconds. 7. It is not necessary to use the root canal sealer together. 8. It is not necessary to try the gutta percha master cone. 9. The Obturation Gutta Percha causes little irritation to periapical tissue, and can be abosorbed unlike theother gutta percha materials. 10.The root canal is easily re-entered after Obturation Gutta Percha treatment. 11.The Obturation Gutta Percha root canal fillings are easily seen on X-rays.

3 Root Canal Preparation 1. Measure the working length of the canal, file the canal into agenerally flared shape to aminimum. 2. It is best to make atapered apical seat in the foramen apices with a relatively larger angle than the usual spear-shaped angle. This tapered shape is made by making steps of about 1mm and grinding the steps to asmooth surfaceas shown by the dotted in the figure. In particular, it is necessary to make tapered apical seat under I.S.O#30 sized foramen apices. Standard file : Posterior #30 Anterior mandibular #20 3. Root canal filling is done after cleaning, smoothing and dehydrating the root canal with the heat-carrier or absorbent paper points. Filling Procedure Materials and Instruments Obturation Heater(Device for warming gutta percha Obturation Gutta Percha(Root canal filling material) Obturation Injector(Injector for Obturarion Gutta Percha) Obturation Injection Nozzle(6sizes) Obturation Plugger(Equipment for vertical condensation) Heat Carrier(Equipment for re-softening gutta percha) EucalySoft(Solvent for gutta-percha,cleaner for endodontic instruments) Set Up 1. Select an injection nozzle from six sizes offered. Choose one slightly smaller than the diameter of root canal orifice. Attach the nozzle to the injector. If the threaded portion of the nozzle will notturn,slightly heat it directly over the flame. Not tighten the nozzle too much, that causes the crush of O-ring and leak of guttapercha. 2. Put the Obturation Gutta Percha into the injector. If the gutta percha tip is too long, break and reduce it in the half.every time of the supplement, be sure to test to inject outside of the mouse. Because the air remained inside of the injector may spatterthe warmed gutta percha. Warming and softening Slide the black protector in the direction of handle. Warmwith the Obturation Heater Set the Obturation Injector on the Obturation Heater. It takes 3minutes for softening the Obturation Gutta Percha at the begininng (when the power turned on). After a softening temperature is reached once, the Obturation Gutta Percha is kept in the softening and injectable condition. After injection, set on the heater again,and re-soften within 5to10 seconds. Warmin ahot water After putting the material in to the injector, dip the heat portion into a hotwater bath ( F), about 30 seconds to soften the material for injection.

4 Warmwith the flame Heat the nozzle alittle by putting the mouse of the injector directly over the flame. DO NOT OVERHEAT. Because the softening temperature of the Obturation Gutta Percha is as lowas 45 (113 F), over heating causes the carbonization of gutta percha and cannot get rid of it anymore. Injection and Condensation 1. Slide the protector in the direction of the nozzle to prevent a burn of the lip. 2. Insert the nozzle as deeply as possible into the root canal and gradually inject the Obturation Gutta Percha. When about one third of the canal has been filled and the surface of the material has hardened, push the material with the pluggers to forcibly press it against the apical part. The first plugger used should be one size larger than that of the last reamer or file used to prepare the root canal,and set a rubber stopper at the 3mm short of the working length. 3. Check with roentgenographs whether the filling to the apex is achieved or not. If not, push again with the plugger. If the guttapercha in the canal has hardened, re-soften with the heat carrier and condense again. 4. Use premeasured pluggers of larger sizes in turn, repeatedly pushing the Obturation Gutta Percha to the bottom of the canal. Pluggers must be premeasured with a rubber stopper to avoid fracturing the root. 5. Re-inject Obturation Gutta Percha into the root canal up to alevel of overflowat the floor of pulp chamber. Push the material down by pressing it against the floor of the pulp chamber. 6. Fill the pulp chamber with cement. 1.Soften 2.Injection 3.Condense 4.Condense 5.Re-injection 6.Filling 7.X-ray 8.Cement thecavity projection filling

5 Caution Besure that the nozzle never come off falls. Besure to test to inject outside of the mouse. Because the air remained inside of the injector mayspatter the warmed gutta percha, and causes burn. Becareful not to touch the face or lip of patient with the injector. Don't condense forcely,it causes root fracture. Re-soften with heat carrier and condense again. Usage of the Heat Carrier (ToyoHeat Carrier is not deteriorated due to heating.) 1.Re-softening of the gutta percha in the root canal. Heatwith the flame, and soon insert into the canal and soften the gutta percha within 1second. 2.Dehydration of root canal. In the dehydration, take special care to heat irritation to periodontal tissue. Questions &Answers 1. What is the differece between the Obturation Gutta Percha SOFT and the HARD ANS. The Obturation Gutta Percha SOFT has softening point of 45,and the HARD 49.So the SOFT has more flow-time in the filling than the HARD. 2. Why does the Obturation Gutta Percha stick to the plugger, in the condensation ANS-1. Because the dehydration of root canal is imcomplete.if the canal is kept moist, the gutta percha does not stick to the canal wall. ANS-2. Because the timing of condensation is so fast that the gutta percha is still soft. 3. How large is it best to prepare the root canal ANS. It is best to enlarge, at least, #15 in apices, and #80 in orifice. 4. Why can the Obturation Gutta Percha be absorebed unlike the other gutta percha materials ANS. Ordinally, conventional gutta percha root canal fillings combine gutta-percha rubber, aclylic resin,zincoxide, and etc.guttapercha rubber has charasteristics of absorption to tissue, then Obturation Gutta Percha iscombined without aclylic resin and other non-absorbed properties. Therefore the overfilled gutta percha will be absorbed. However, because it takes long time for absorption of 3to5years,over filling should be avoided if possible. 5. Is it better to use the rootcanal sealer together ANS. It is able to use the root canal sealer together. However,the root canal sealer can be made to overfill by the vertical condensation, and causes irritation if it should be overfilled. Particularly, there is the possibility of remaining dead space withthe calcium hydroxide based cement-sealers, because it is also absorbed in side of the root canal.

6 CLINICAL STUDIES (Courtesy Dr.Mitsuru Otani, Dr.Tatsuhiro Kami) CLINIC- Before the treatmen 6 months later There is above #140 in apical foraman,fill with Obturation Gutta Percha in the symptom which is impossible to prepare the apical seat.compared with the before, It appears that the symptom is well healing, Radiopacity reduces in half 6months after the treatment. CLINIC- 5measuring working length of cana immediately after filling the canal (itwasfilledinthelateralbranch) CLINIC- 6months later 11 months later PAD is reduced in compared with the time of filling 7 the gutta shaped root Easily filled by the Obturation System difficult to fill by lateral condensation

7 CLINIC- 2before the treatmen 9months later 14months later CLINIC- CLINIC- 2immediately after filling 6months later 14months later The lesion heals radially, The trace of lesion still remains, filled in lateral branches over filled gutta percha is gradually absorbed. 6 Soft apical periodontit is 12 years and 5months later immediately after filling

8 Sterilization of The Obturation Injector The ObturationInjector can be sterilized by following methods. 1.Autoclave 2.Chemical sterilization 3.Dry heat sterilization Cleaning of The Obturation Injector The Obturation Injector is able to taken in pieces. Syringe barrel : Dip in a hot water bath( F)for afew minutes, and stuffcotton pellets into the syringe barrel, and push it with injection-bar, and wipe the sticked gutta percha. Injection nozzle: Put the Eucalysoft(TOYOCHEMICAL) or chloroforminasuitable glass container or adappen dish,and dip the nozzle for more than 15 minutes. Scratch and get rid of the gutta percha with the files.if it can be got rid of anymore, exchange it for newone. (Injection nozzles are cheap expendable supply.) protector syringe barrel handle nozzle bar screw Handle By putting ascrew conversely, ahandle becomes movable. Fixed Handle Movable Handle

9 Details of the materials and instruments Obturation Plugger No.3 4 5L 6L Size number means the diameter of tip.(ex.no.3 0.3mm;I.S.O.#30) InjectionNozzle L M S1 S2 S3 S4 Diameter mm Obturation Injector Heat Carrier Eucaly Soft Obturation Gutta Obturation Heater SOFT HARD

10 PRODUCT INFORMATION Manufacturedby TOYO CHEMICAL LABORATORIES.,INC. Itabashi ,Itabashi-Ku,Tokyo JAPAN

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