How to properly place GuttaCore

GuttaCore obturators are said to be the first cross-linked Gutta-Percha core obturators to deliver warm Gutta-Percha throughout the canal system. GuttaCore is designed to create a dense, 3D fill in minutes, and the cross-linked Gutta-Percha core removes easily.

In the video below, Dr. Manor Haas, a certified endodontist from Toronto, Canada, walks users through delivering GuttaCore into canals, a process he says is easier than you may think.

Watch the video below to learn more about the process, then follow our step-by-step guide:

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Continue to Page 2 for step-by-step instructions ...

Step 1. By now, you've used a size verifier and lined canal walls with a bit of sealer, which means you're ready to obturate. If you're new to GuttaCore, Dr. Haas strongly recommends that prior to warming GuttaCore, you practice placement into and removal from the oven. He also recommends using enhanced illumination and magnification. The video shows a trial run with the oven off.

Step 2. Place the rubber stopper to your desired working length as per the markers on GuttaCore. Ensure the oven is set properly, then place the cold GuttaCore into the oven's GuttaCore holder and press down. Wait until it blinks, indicating the GuttaCore is sufficiently warmed and ready for insertion into the canal. To remove GuttaCore from the oven, press down on the holder and, with one hand, grab the GuttaCore handle. With cotton pliers in the other hand, grab GuttaCore just above the rubber stopper and break off the handle. You are now ready to carry GuttaCore obturator into the canal.

The ability to break off the GuttaCore handle and turn the obturator into a shorter and more maneuverable Gutta-Percha is designed to separate GuttaCore from other warm obturation systems on the market. It is said to be a huge advantage, especially with teeth that are difficult to access, such as posteriors. If you wish to keep the handle in place, Dr. Haas says you may do so, but you will have much better control using cotton pliers than your fingers.

Step 3. Don't take too long to carry the warm obturator into the canal. The delivery of the warm GuttaCore from the oven into the tooth should be done in less than 10 seconds to maintain the desired Gutta-Percha characteristics. Spending any more time will allow GuttaCore to cool down, which will affect insertion flow of GuttaCore into the canal and final obturation.

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Step 4. As for setting GuttaCore obturation length, do not do so with a ruler. Only use the markers on the obturator. These markers coincide with the markers on the files. They are 18 mm, 19 mm, 20 mm, 22 mm, 24 mm and, on the handle, 27 mm and 29 mm.

Step 5:  While obturating, do not turn the obturator as if you are placing a file into the canal. it should simply be placed in an inward direction into the canal. Dr. Haas says something you may want to consider is cutting the rubber stopper off the cold GuttaCore obturator prior to placing it in the oven, as shown in the video. Removing it reportedly makes visibility even easier.

Step 6: The placement of GuttaCore from orifice to apex should be done in about seven seconds. Do not touch the pulp chamber walls. Some dentists do it too quickly-Dr. Haas recommends you or your assistant count as you insert GuttaCore into the canal. This process is very similar to drying canals with paper points so while conducting that procedure, practice doing so in seven seconds. Inserting GuttaCore too slowly or too quickly will not obtain a good obturation. 

Step 7: At times, GuttaCore may break or buckle during insertion if it is:

• Not warmed enough or cooled down before insertion into the canal

• Inserted too quickly or with too much pressure

• Pressed through a constriction

This is often seen in cases with apically convergent canals. Once one mesial canal is obturated, the apical third of the second mesial canal is also obturated.

This is actually an advantage of the system, Haas says. Using other carrier-based obturations may allow the dentist to continue inserting by forcing the stiff plastic carrier to working length. But with the apical and convergent part of the root canal already obturated, doing so could lead to apical extrusion of the sealer and Gutta-Percha. With GuttaCore, this is extremely unlikely to happen as added pressure will simply result in the coronal and not apical flow of excess Gutta-Percha.

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