Carrier-Based Technique: Step-by-Step Sequence: Advanced Endodontics Dr. Cliff Ruddle

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Carrier-based obturators deliver warm gutta percha to the working length and especially are indicated in longer, more curved and smaller diameter canals.
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the carrier-based operation method has become very very popular in recent years and increasing over the last decade and Johnson's disciples giuseppe canto Tory and I might add Stephen Nemzek and bill Henson have kind of led the way internationally helping colleagues better appreciate the completeness of this method of operation carrier based operation methods are specifically relevant in longer routes smaller diameter canals and more curved routes many times if we notice a curve on a preoperative film that's about in mid route it may be impossible to get our pluggers within 5 millimetres of the full working length as such carrier-based obturation offers the opportunity to move warm gutta-percha 100% of the time to the radiographic terminus I'm going to speak about carrier based operation in the context that we shape the canals with ProTaper but suffice it to say most shaping systems have their own individualized carrier based operators there are 5 Pro Taper finishing files and each one has its own correspondingly sized carrier based obturator x' once the canal has been shaped we can confirm which obturator to use by using a size verifier the size verifier needs to fit the full working length and be able to be rotated clockwise or counter clockwise so it is loose at the desired length as an example once we have shaped the canal with a pro tape or f1 the yellow band on the handle we would choose the corresponding yellow handled size verifier and adjust the stop to the working length correspondingly we would adjust the stop on the carrier base operator to the same length the method to introduce sealer utilizing a carrier-based obturation method has varied considerably from clinician to clinician in this example sealer can be placed on a paper point but I importantly want to mention we do not need much sealer at all and so it would be useful to use dry paper points to mop out surplus sealer until the paper points come out virtually clean this will prevent the needless expression of sealer beyond the foramen the selected carrier base top trader is placed in the Pro Taper heating oven and press down into the chamber once the carrier base top traders gone through its heating cycle the Alpha gutta-percha has been sufficiently thermal softened and we can sometimes break the handle off just to improve visibility and place the carrier base table trader with a hemostat or a locking cotton plier as an example the insertion rate is methodical deliberate but in around 2 or 3 seconds you should have a carrier seated to its full working length after the carrier has been seated we can use the preppy burr or ultrasonic instrument as an example to sear off the nonuseful handle and shaft portion of the carrier giuseppe canto torre showed in clear section analysis the completeness of the observation in the mesial root of a mandibular molar notice all the inner communications the apical bifida T's and the completeness of the fill again looking at Giuseppe's beautiful work you can see the carrier-based obturation is appropriate and longer smaller diameter and more curved canals notice the beautiful shapes that are picked up perfectly radiographically by the post-operative fill again notice the recurvature of the mesial root of this mandibular molar notice that shapes are very conservative over their length and there is a great balance between a well shaped canal and maximising remaining dentin you've probably noticed in this show that I have shown other people's post-operative I recently began teaching this method of operation because my belief system is such that I can now say that this technique is as effective as any method currently available so if one is looking at how to fill root canal systems using a warm gutta-percha technique cliff runnel completely endorses the carrier-based method and you will have a lot of post-operative films to demonstrate exciting anatomy let's review the carrier-based technique first of all we need to understand that there are specific cases that could benefit from this method of operation choose the correct carrier based on the final finishing file that was carried to length the sealer can be introduced either on a paper point or on a tip of Explorer just wiped at the orifice level after the carrier has come out of the oven immediately place it in a deliberate methodical manner taking no more