Page 39 - The Beauty and Sorrow in Endodontics-Chapter 1

5. Fig 20H (Cone Fit Plus Sealer) – This radiograph assesses the placement

of the master GP cone dipped in sealer in the canal. The purpose of this
x-ray is to reconfirm the GP placement prior to obturation. Operators
should check whether the cone has been placed to the ideal depth and if

the sealer has evenly coated the canal walls or if there are voids. This
allows the operator to determine which area requires special attention
during warm vertical compaction.

6. Fig 20I (Down-pack) – This radiograph assesses the down-pack result of
the GP cone to 5~7mm from RT. Take the time to check if the obturation

density and flow is adequate; if the down-pack is apical enough or if
more needs to be removed; if the coronal walls are clean of sealer and
GP, etc. If there are residues of sealer or GP on the walls, backfill quality

will inevitably be affected. At this point, the operator can either proceed
with backfill the coronal space with warmed GP or leave it as post space.

7. Fig 20J (Final) – This radiograph is the final record of the entire root

canal treatment. Operators should compare this with the pre-op film and
future recall/post-op films. One should make sure that the coronal seal is
appropriate, even a temporary restoration should exhibit adequate

thickness and marginal seal. Post-operative instructions and recall
schedules should be discussed with the patient at this point as well.

1
Note In the past, silverpoints were often used as the obturation material, however,
since most canals are not symmetrically circular, cases that were obturated with
silverpoints often failed due to inadequate fill (Fig 20C; Image not from this

case).
2 For retrieval of separated instruments, see “Chapter 6”
3 Clinicians should take in mind that most x-ray images are slightly enlarged.
4 For more information on determining RT, see “Working Length”.

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