Gutta percha is handy. What would we do without the ability to put gutta percha in a tooth to seal everything up during the root canal?
I love closing out a root canal and after everything is nice and clean and disinfected, finishing up a job well done by filling and sealing with this naturally-derived permanent filling.
But you know what I don’t love? When your gutta percha are shorter than your canal. Major facepalm moment.
How can we troubleshoot something like that? 🤔
Issues with Gutta Percha in the Tooth
This scenario is mostly common when you’re working on a canine tooth, where, sure, you only have one canal, so treatment is typically a little easier, but this canal tends to be the longest in someone’s mouth.
But the bottom line is that you still run into issues. In this case, a common problem is that sometimes you are trying to work with a tooth that is way longer than your instruments and the gutta percha in that tooth.
This is where most of us run into some major frustration.
Getting Your Tools Right for Greater Success
We all know that hand files and rotary files are essential tools (click here to get the rundown on my favorite files of all-time) to clean and shape our root canals and create a shape that we can more easily work with.
Files tend to come in the following sizes:
And if you’re like me, you invest in getting all of the lengths of every file type out there. From working with curvy canals to adding length quickly, I keep a whole lot of files handy so that I can get the job done successfully.
When it comes to working with a canine, though, I tend to reach for one length in particular—the 31mm length file. Because in this case, that length is going to make your life easier.
So, What’s the Strategy?
OK, you’re probably wondering though… “But how do I work with gutta percha in a tooth that is too long?” Let’s talk through it.
Say you don’t have that length file or your gutta percha is just too darn short for that oh-so-tricky canine canal. I mean, I’ve even run into the issue where my file is long enough, but my gutta percha isn’t.
The good news: there are things you can do to compensate for that length discrepancy. Let’s get into it.
1. I reduce the occlusion. As long as it’s not in the esthetic zone, you’re good. This will not only decrease the length of your canal, but it will also decrease your patients’ postoperative pain. That’s as much of a win-win as you can ask for. This should be standard operating procedure, if you ask me. It’s better for everyone. And, if you want my two cents: you should do this on every case before you even put the rubber dam on.
2. OK, up next, I change the location that I grab my gutta percha from and reorient my locking plier. Instead of holding it horizontally and below the tip of the point like this:
I grab the point vertically and as close to the tip of the point as I can like this:
That approach makes the canal easier to fill at its complete length. A simple tweak, but a huge difference!
3. Last but not least, I simply change my reference point. Does that sound too simple? Hear me out. Let’s say, for example, it’s the maxillary canine. Yes, it is easier just to use the cusp tip as your reference, but you can also use the cavosurface margin instead. If you just grab the gutta percha point right where it exits the tooth and use that new spot as your reference, you’ll shrink your working length instantly by a few millimeters! Goodbye struggle! Whatever you do, just make sure that your reference point is repeatable.
Getting the gutta percha in the tooth might seem like such a small detail that you don’t have to give it much thought. But it can have a tremendous impact on the outcome of your case. And that, my friends, is worth giving some thought to. Remember, endo is all about the tiny little details.
So don’t overlook this one!
As always, tell me what you think and leave a comment. I really hope this little tip saves you time and money.
Hungry for more tips and tricks from an endo pro? Check out E-School, a one-of-a-kind endo academy designed to support dentists like you in creating better outcomes for their patients and their practice.