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Whether a canal was missed during a previous procedure or new decay has exposed the root canal, or one of a number of other scenarios—retreatments are just part of the territory when you’re doing root canals. That means that removing gutta percha also comes with the territory. And that’s worth doing right!
This can be a frustrating proposition. But you know what’s really frustrating? When you hate the look of your obturation (either you have a void, or you’re shot), and you want to start all over again.
And this is honestly a common conundrum. One of the most frequent questions I get from dentists is, “Sonia, how do you get your gutta percha out of teeth when you’re doing a retreatment???”
Luckily, I’ve come up with a formula that knocks out this part of any retreatment quickly and will get on to phase two in no time.
Allow me to show you how simple it can be.
How to Remove Gutta Percha: Step One, the File
There are lots of fancy files out there. I know, because I own a TON of them.
On a side note, if you want to learn about some of my all time fave files, head over to this blog when you’re done here!
But when it comes to removing gutta percha and how to get it done quickly and efficiently, welllllll, there’s one file that stands head and shoulders above the rest. And that’s my 25/.06. The kind I work with is one of Dentsply Sirona’s ProFiles that is just so dang good for this purpose. I really like how it lifts the gutta percha coronally.
Why this file? You might be thinking.
I like it because it is pretty short and I find that the shorter files have a little bit more strength, which comes in handy when removing gutta percha. You totally can use a 25mm – it will get the job done – but I feel that the 21mm file is a bit safer, so that’s what I recommend.
Let’s Talk Process!
Once I’ve got my preferred file on my rotary, I begin.
How I remove gutta percha is a process I’ve refined over the last decade. I’m a huge fan of repeated processes that make life easier, so once I got this one down to a science, I don’t diverge too much. That helps me feel prepared for every retreatment and means I don’t have to reinvent the wheel every time I do one.
Pro tip: document the processes that you do all the time! This way you won’t have to figure out every time what file it is that you used last time OR someone else can fill your shoes if need be!
My strategy is to remove a small amount of gutta percha from each canal, creating a little well in the tooth to house your chloroform. I let the gutta percha soak it in the chloroform about five minutes to help soften it. Pro tip: Be efficient with your time! This is a great opportunity to slip out of the operatory to do a hygiene check!
That’s when the real work begins!
Getting a Clean Result
After the gutta percha has softened up, I then take my 25/.06 ProFile and turn the speed up to about 1000 RPMs. I then get into each canal, buzzing out the gutta percha.
I’m not gonna lie—it doesn’t always come out cleanly right away. If only it did, that would make our jobs a lot easier!
I usually end up taking about half of the gutta percha out from the canal, but if the file is binding a lot, I back off. Knowing when to back off is crucial, which also means being super familiar with your instrumentation systems.
I’ve got a free instrumentation workflow that can help with that if you’re interested!
If I need to, I’ll add a bit more C-solution to the canal and get back in there with my hand file to make a glide path through the gutta percha before going back and forth with my 25/.06 again. You have to be smart here and FEEL your file! Go back to your hand file if you feel things getting tight!
It might take some time, patience, and perseverance, but through this simple process, you’ll remove all the gutta percha, so you can get on to the treatment.
Simple Processes, Big Results
It’s sometimes the simple stuff that has the most impact, don’t ya think?
When it comes to questions like how to remove gutta percha, establishing a sound, repetitive routine that works for you is my best advice.
I hope you can use the instructions I’ve laid out to remove that gutta percha like a boss—but also integrate the changes that work for you as a badass endo practitioner! You’ve got this!
And when it comes to processes and workflows, gosh, they make such a huge difference in your business. Seriously, I can’t recommend integrating them enough.
If you’re interested in upping your business know-how when it comes to running your practice, you’re gonna want to know more about my new program on practice efficiency. Subscribe to the wait list here, so you can be the first to know all the deets!
What have you systematized within your practice? Let me know in the comments!
– Sonia
15 Comments
Hi Sonia
How about removing gutta core which has a plastic carrier inside ? also do u use a different technique for post space creation in the canals filled with obturators with plastic carriers?
Hi there!! I typically use retreatment files to remove the plastic carrier or I wind two hedstrom files together to engage the carrier and then pull it out. This is definitely one of the more trickier things to do in endo. I am not really sure of the most efficient way to create a post space with the carrier in place since I don’t use that form of obturation.
-Sonia
Thank you
Hi Dr. Chopra,
I was wondering if you have any modifications in your recommendations for GP removal in curved canals.
Thanks so much!
Maria,
I take the bulk of the GP out and then I will do the curvy portion removal with a hand file and paper points and rely heavily on my solvent. Hope this helps!
-Sonia
Hello Maria, i see that the GT profile is not offered any more with a 25 tip size. What to do!? 20 or 30? Thanks!
Zachary, I like the 25/.06 Profile the best. Try that file.
-Sonia
Hey Sonia
I have noticed that chloroform does not dissolve the GP that efficiently . I have used endosolve in the past and it worked really well. is there anything similar that we can use as it has been discontinued . i soaked a cotton pellet with Chloroform and placed it into the canal for 5 minutes 4 times with an time interval of 10 minutes each . but the GP still does not budge.
Juweria,
I have used chloroform with tremendous success that I have not needed to use anything else. Sorry, I wish I was of more help.
-Sonia
Hello Mam,
How can i remove the over-extruted gutta percha (which is pin point)?
Without any invasive procedure!
Please suggest any technique if you know!
Jency, I am going to answer you with another blog here https://drsoniachopra.com/blog/tooth-story-4-give-teeth-a-chance/
I hope this helps.
-Sonia
Hello Dr Sonia! just read your great post! For Rotary file at 1000RPM to remove GP, is the setting in reverse?
Nope, it’s forward.
-Sonia
Hello Dt Sonia Chopra , my wife has been suffering with pain for over 1 1/2 years from an over extended guttapercha we feel like nobody in California wants to help, possibly because we have medical, but at this point we are willing to do whatever it takes to get it fixed, how can you help us ?
Hi Ernesto, thanks for reaching out to me about your wife’s case. I really care about patients, and I want to make sure you get the best care you can. I’m not able to give any clinical advice without seeing your tooth or scans. The easiest option for me to assist you is for you to make an appointment to come see me at my practice in Charlotte, NC. Or you can book a consultation with me here: https://soniachopradds.thrivecart.com/patient-dental-consult/ – and I can give you more insight on her case then! I’d be happy to help.