U Orthograde Obturation Technique
This page describes an endodontic obturation technique using a hydraulic grafting material like OrthoMTA.
The method involves:

● Minimum MAF(Master Apical File) is at least #30 file.
● Minimum taper is at least 0.04.
● Use 0.04/#25 tapered Nitinol finger spreader to create apical space.
● The speed of Compacter is 60~120 rpm.
● The use of an OrthoMTA Compacter dramatically improves the success rate of orthograde
   grafting treatments.
● The OrthoMTA Compacter, an .02 tapered engine driven Compacter, can simultaneously
   introduce and condense hydraulic OrthoMTA paste into the canal system.
● OrthoMTA Compacters have a taper that increases the diameter by .02 mm for each
   millimeter of the distance measured from the tip of the instrument to the handle.
   Having a working portion of the shaft of 16 mm, it follows that the diameter toward the
   handle is .32 mm larger than the tip (ie 16 x .02). The OrthoMTA Compacter with its
   .02 taper and size #25 at the apical tip will therefore have a diameter .57mm at the
   end of the working portion (.25 + [.02 x 16]).
1. Prepare the canal for obturation. Successful root canal treatment depends on thoroughly cleaning the canal. After thorough irrigation the canal is dried and is ready for obturation.

2. Dry the canal for an effective grafting procedure. Remove the excessive water with paper points.

3. The interface of OrthoMTA is more complete and effective in the presence of moisture. This is unique and excellent property of OrthoMTA as a root canal grafting material.
4. Open the cap of a vial and add enough distilled water.
5. Centrifuge for 15 seconds
6. Remove any excess water.
7. Load the OrthoMTA paste into the needle of the OrthoMTA Carrier with gentle pushing motion.
8. pre-mixed OrthoMTA paste is introduced into canal system by the OrthoMTA Carrier.
9. Gently plug the OrthoMTA paste into the canal system.
10. Spread the paste against the canal wall, making space for the OrthoMTA Compacter by the OrthoMTA Spreader with a reciprocating motion.
11. Ensure that a 0.02 tapered size 25 OrthoMTA Spreader fits loosely the full length of the working length.
12. A sterile OrthoMTA Compacter is selected. If a standard .02 taper Compacter is selected it should be at least one size smaller than the size of the largest file taken for the working length.
13. Withdraw the Compacter 0.5 mm from the working length if you were able to insert to this level, this is to avoid any threat of extrusion past the apical constriction.
14. Resist the 'kick-back' force that is felt, and then retract the rotating Compacter whilst applying gentle force along the canal wall.
15. Apply apical pressure gently but resisting back and forth motion with the 16:1 gear reduction contra-angle to rotate at approximately 150-300 rpm. Slowly withdraw the Compacter while applying gentle pressure on one side of the canal to help feed the OrthoMTA paste into the canal. Holding it in one position too long causes over-heating and black discoloration of the grafting material.
16. Placing a plugger at the canal orifice level.
17. After finishing the canal obturation, Post preparation is available immediately.
Orthograde grafting
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