Gutta percha root fillings with a poor seal may be removed by rotating one, two or if possible three small Hedström files around the root canal filling and pulling it out. If this is not successful, softening of the gutta percha using chloroform, xylene, oil of cajaput or heat may be employed to aid mechanical removal with hand instruments. Alternatively, rotary instruments, for example Gates-Glidden drills, may be used in the straight part of the canal. These are available in a range of sizes and have a safe cutting tip that reduces the risk of perforation. Care should be taken during their use, as considerable heat is produced which can damage the periodontal structures. This can be minimized by using the drills intermittently.
Ultrasonically activated files have been suggested as being useful for the removal of gutta percha, but in our experience this has proved to be a messy and innefective procedure as these files tend to produce softening rather than removal of the material.
See also the clinical sequence.