Basic Hydraulic Condensation Technique

[@serenaleigh8418]

I am not endotologist but have a great interest since I have started to see your videos I learned a lot and deeply thankful. You explain the details very well and clear.

[@AANasseh]

I would not recommend a lentulo spiral for the same reason direct injection is not recommended any more. Forgetting the potential for overfill, you can pack too much sealer using a lentulo as well. When you use the master file (or one file size smaller) you force all the excess sealer against the walls as the size of the file and the ensuing GP are the same. Any additional sealer will get pushed against the walls and if there's more sealer than needed the sealer will go into the file flutes. :)

[@AANasseh]

Thanks for your feedback. I'm glad it's working for you.

[@TheMinishKid]

Tried this modified sealer placement technique the other day on a 4 canalled molar. Worked like a charm, thank you!

[@oussamateiar8563]

Really good tutorial ... simple clear and concise... thank you very much

[@drcune8]

Great technique, finally all obturation material shrinkage related compromises are history. Do we have to disinfect and dry BC-coated GP points with the same protocol as before? What happens with the BC coating when it comes in contact with NaOCl? Doesn‘t it affects the chemistry of BC Coating? I would very much appreciate your answer. Thanks for great Videos, and best regards from Vienna, Austria

[@moderndentalclinic1144]

Nice question

[@ronyeahright9536]

This is the technique I was taught 30 years ago in dental school. Use cement on final file to coat the walls; coat the master cone and seat. No cement necessary on any accessory gp points, if used.

[@AANasseh]

Hi Tasos! I will do another video about vertical condensation with BC Sealer next. But to answer your question, oval canals are best treated by putting additional cones next to the main cone. Then sear off with heat. If you have large spaces left laterally, either use the putty or use thermoplastic gutta percha backfill with Obtura. The manufacturer of the BC Sealer has now made BC gutta percha pellets for use with Obtura for vertical. I will do that demo video next. Thanks for watching! :)

[@michaellupu2080]

Thank you for this video! I do have a question: At 10:02 you show a case in which you apply the technique, specifically, you describe how you dip the master file in the sealer and place it in the canal with some counter-clockwise rotations and you mention that one should "repeat as needed". You yourself apply a coated master file a second time. My question is: what am looking for to determine if I should repeat the application of the sealer or not? Said differently, how do I know if I have enough sealer when using this technique? Thank you once again, Dr. Nasseh!

[@medzoklife]

Each time I learn something practical. 👍👍👌✌️

[@marygracevidor5576]

So beautiful obturation

[@tasoskoursoumis6866]

Dr. Nasseh hi, One quick question, is bioceramic sealer affected by heat. For instance if you have an oval shaped canal can you downpack with a thermo device and fill up the canal with root repair material or gutta percha? thanks a lot

[@TheMinishKid]

Thank you for the reply, that makes sense! I love your videos Dr. Nesseh, please keep them coming! :-)

[@TheMinishKid]

Thanks for posting this video! I was having that same exact problem with master cones not seating to working length after injecting the BC sealer. I will give this technique a try. Also, what about using a lentulo spiral instead of the last Endosequence file?

[@faymansouri]

hello, Thank you for all your video. I was wondering why you didn't suggest washing the extra sealer with an air-water syringe .after obturation and condensing instead of ultrasonic water or wet cotton pellet.

[@AANasseh]

fay mansouri Thanks. The ultrasonic and water is the fastest way to clean this hydrophilic sealer; but if you don’t have one cotton pellet and water will do too.

[@AbsoluteXero]

Hi, does this mean that you don't vertically compact because that would spread the sealer thin? By just putting the cone in and pumping it a little bit is enough to hydraulically condense the sealer into the canal system? Vertical compaction can sometimes cause trouble because of the canal anatomy since you can't always get a clean downpack and might end up getting a void with your backfill.

[@babakziari908]

very interesting idea about this new GP since it was the weak link. I have a question, can we use Lentulo-Spirals to introduce the sealer in the canals instead of MAF? Thanks for all the info provided.Cheers. Babak

[@iraxican]

Lentulo-Spirals have no place in modern endo.

[@eyadmassalha8484]

Thank you❤❤❤❤❤

[@hawraaabd6055]

thank u

[@ksdharmareddy1043]

Hii ...I'm wondering sir..way u fill ur lateral canalss ...can please give some techinques to fill lateral Canals.. please sir.

[@Muwahideen4Ever]

Thanks for the video. Two questions: 1. Can I use Vortex Blue and Wave One Gold master comes with BC sealer and expect good results despite not using BC gutta percha points? 2. Can I use the master gutta percha point instead of the rotary file to coat the walls? I find that allows me to place a more even application than the rotary. I will order BC Sealer next week. However I won't be able to change our rotary system. Hence my first question

[@AANasseh]

No specific studies have given an answer to that guest but U.Penn showed (through their internal research) that you get a less effective seal for the first 60 days with non-bc coated GP but then the seal becomes the same after 60 days, presumably because sealer expansion over time. So, if you have to use that combination then you'll likely be ok as long as you've done the right job of cleaning and shaping.

[@Muwahideen4Ever]

@@AANasseh Thank you for the quick response. I understand the importance of a good seal, especially in the apical third. However, assuming proper cleaning and shaping, are we to assume that a non-effective seal can allow recontamination of the tooth from the remnant of bacterial matter beyond the tooth apex in the PDL and bone space? Just want to ensure the correct understanding. I currently do lots of my endo with cold lateral condensation using Dentsply Ribbon sealer. Many times my master single cone fits snugly enough to where I cannot pack any lateral cones. I use mostly vortex blue 0.06 taper and wave one gold. I realize that single cone obturation should ideally be done with a ceramic based sealer. I would imagine with my single cone obturation using a non ceramic based sealer, I'm getting a good seal in the apical third but not so much towards the coronal area

[@esnaosmanagaj3472]

Thank you!

[@san5a89]

hello Dr Ali Nasseh. please can you tell me which brand sells brasseler's products in Europe. I'm a but confused since a few years ago FKG was the brand but now I can see the bc sealer is sold by BUSA. thanks a lot for your help

[@AANasseh]

Currently, Brasseler does not sell in Europe. They are distributors primarily in North America. FKG was private labeling some of the BrasselerUSA Products such as BC Sealer and Putty but that's about it. Cheers.

[@san5a89]

@@AANasseh I guess they divided their product into two distributors... I'll try to contact both. Cheers

[@AANasseh]

@@san5a89 Schein also sells BC Sealer. I forgot to mention.

[@san5a89]

@@AANasseh OK. what I really need is the right cone for the bc sealer based obturation. do you think a gutta cone of the dentsply system would warp with the bioceramic sealer? I actually had a lot of problems with conventional cones but I never used dentsply or vdw cones

[@varunmonga23]

hello sir i am using bioroot sealer from septodont from last 1.5 year and i find difficulty in lateral fills do u feel same with bioceramic sealer from bressler ?

[@dr.omarmontaser5080]

So I shouldn’t use BC sealer if I’m not using BC cones?

[@siumingyeoh6583]

Hi cn i use scaler tip to remove excess sealer? Or i must use only specific endodontic ultrasonic? Tq

[@AANasseh]

If the scaler tip can reach deep on the furcation it should work (should be used with water!)

[@shazuish]

What if we leave a sealer in the acess preparation after obturation

[@afsanashaikh5571]

What treatment have to be done sir on the first visit of patient with a swelling ...? Access opening?

[@AANasseh]

Access, Cleaning & Shaping. Ca(OH)2. If you're not experienced, please refer to a specialist.

[@dr.shrutikalia3370]

Sir...m not able to push the sealer out of canal..

[@dimplegurnani5160]

Thank ya doctor I have noticed that while checking my master cone gp and taking the x ray it comes pretty good but after putting sealer ( MTA- Fillapex) I use , the cone ends up being short most of the times . Please advice me to improve my obturation

[@AANasseh]

First of all, you shouldn't be using MTA FillApex with this technique. MTA FillApex is a primarily a resin based material that much like Ribbon or AH Plus is resorbable. It's not a bad sealer but you need to use the usual lateral or vertical condensation with that sealer. Only pure bioceramics can be used with Hydraulic Condensation since they a non-resorbable after they set.

[@dimplegurnani5160]

Real World Endo Thank you sir !!!

[@moderndentalclinic1144]

After dispensing mta fillapex and ready to use, use it within 10 secs for each canal... Don't coat the Canals with sealer before obturating the canal with GP... Instead coat(thin coat) the master GP with sealer and insert it in the canal... Definitely this will solve your problem... Cheers!

[@ricebowl3]

thanks I'm a dentist and this helps alot

[@phzar]

Dr, cleaning the excess sealer with scaler and water,... wouldn' t that dissolve or remove the sealer?

[@AANasseh]

Good question. It would if you use the ultrasonic to touch the Gutta Percha. You should direct the tip of the ultrasonic only on the dentinal walls near the gutta percha and never directly on the gutta percha or sealer interface. That's an important detail. Cheers!

[@gabes2095]

This was extremely interesting, and I was looking for something that had to do with Astronomy. Dang, maybe I should be a dentist instead. that was COOL!

[@AANasseh]

From Astronomy to Dentistry is a fairly large gap! Although many dentists, including myself, are very interested in Astrophysics. :)

[@gabes2095]

The condensation sequence has to do with how the solar system formed. It is much the same as differentiation on Earth, which states that the heavier elements will sink closer to the core before the lighter elements. In other words, it has to do with density. Pretty interesting. I have watched your video a couple of times. I am mesmerized by it, although I don't see med school in my future : - )

[@AANasseh]

Gabe S LOL! Yes. As quantum flapdoodle in the movie Interstellar would have us believe, the answer to everything is Gravity!! ;)

[@gabrielsteiger5465]

RealWorld Endo Actually, if you go by Hitchhikers Guide to the Galaxy, the answer to everything is 42. If you go by my Astronomy teacher, however, the answer to everything is hydrogen : - )

[@gabrielsteiger5465]

RealWorld Endo And of course, if you are talking to your wife, the answer to everything is "Yes." We can't leave that one out : - )

[@nmda9578]

Game changer.

[@afsanashaikh5571]

Do we need to dry it after rinsing Gutta percha points with sodium hypochlorite

[@AANasseh]

Yes. Dry with alcohol.

[@minamoheb9793]

In this tutorial , said that leakage occurs between gutta-percha and sealer so we should use bc coated cones ...is leakage occurs actually between gutta-percha and sealer or between sealer and dentin walls along the canals ?? Or both ??

[@AANasseh]

Technically, leakage happens between GP and sealer in all sealers. The idea of using BC Cones is to help reduce this leakage by bonding to the surface of the GP. They've done studies at U.Penn showing that there's more leakage with regular GP than coated cones for the first 60 Days. There's then expansion of the sealer and the effect is negligible. That's why we recommend the BC cones unless they are not available were you are. Cheers!

[@minamoheb9793]

@@AANasseh okay, regardless of using bc coated Gp ...,as leakage occurs between gutta-percha and sealer in all sealers why we don't use for example resin sealer wz single cone as leakage occurs in any case??

[@AANasseh]

Leakage is only one factor. Resin and ZOE sealers will wash out of the canal in whole when pooled in one are. Historically, that’s the basis of our Condensation techniques.

[@minamoheb9793]

@@AANasseh thank you sir, but if single cone is used wz resin sealer , how much time will it take to get washed out ?? Range ??

[@AANasseh]

If you extrude a bunch of AH Plus out the root end you can see it resorb within a few months. Inside the tooth it will take longer but if it's pooling it will happen. Again, this is a matter of preventing the odds. It's not like every time you don't wear a seat belt you will get into an accident. But if you're not wearing it when you get into an accident then you're in trouble! This is the analogy for making decisions the enhance your outcome based on principles. Cheers!

[@cliffordvillas6185]

Is the hydraulic condensation technique another name for the single cone technique?

[@afsanashaikh5571]

Can this method be followed usin zoe sealer

[@AANasseh]

Of course not. ZOE Shrinks and washes out. This is why the Single Cone technique in the 1950's was abandoned.

[@f35bhore]

Ultrasonic and sterile water, right? And I just cannot see the problem with too much sealer/filler. The GP will not seat properly, well, as long as everything is sealed with the BC-filler, why should that be a problem? And why not cut the GP-cone further down than to the orifice of the canal? Why not 2-3 mm down the canal from the orifice, and then use a new layer of sealer/filler of bioceramic up to the level of the orifice? Since the GP will not bond to the dentin, but the sealer/filler will, it will be completely sealed. So the GP will be completely surrounded with sealer/filler.

[@AANasseh]

All great points. Yes, Sterile water (or same water you use in your high speed handpiece.) Regarding the other points, we teach Hydraulic Condensation to make sure the GP goes to the apex so the case is retreatable if it needed down the line. If there's a long segment of cement without a GP center it would be difficult. Regarding the use of a canal cap, one can do that, but having sealer on the orifice makes it difficult to place a restoration immediately since the cement will not set immediately and the wet cement prevent the application of a bonding agent if you want to bond a core.

[@babakziari908]

I apologize, this question was answered before. Thank you

[@afsanashaikh5571]

Sir...most of the times even after giving inferior alveolar nerve block while performing root canal on vital tooth lower molars ,the tooth doesnt get anesthesized only the soft anaesthesises ..in such cases how to perform painless rcts?

[@sria8163]

I suggest that you can infiltration on buccal side of the tooth approximately the length of the root. Additionally you may allow NaoCl to stay into the chamber for 10 minutes .U may think L.A gel into the chamber.

[@sria8163]

Or intrapulpal L.A inject

[@vedansh]

I don't like single cone obturatiion..

[@AANasseh]

That’s fine but Keep in mind, this is not the Single Cone technique. This is called Hydraulic Condensation. It’s people from other companies who are trying to discredit this technique that call it a single cone technique, because the original single cone technique in the 1950’s using ZOE failed. This is a different and non resolvable cement. Also, In wide, ribbon shaped canals you will need to use 2 or 3 cones adjacent to the main cone to fill in the gaps. That’s why it’s not a single cone technique. Cheers.

[@akhilendrasengar8759]

Boring