ROOT CANAL SEALERS

INTRODUCTION
SEALERS : These are Cements / Resins / Semiliquid / Plastic-which are
used as binding agents to fill up the gap between root canal and
obturating material.
- It also fills up the irregularities, discrepancies, lateral canals and
accessor canals.
- It helps to achie!e a proper apical seal.
IDEAL REQUIREMENTS
- The requirements of a suitable sealers used for filling the dr
canal in con"unction with gutta-percha / sil!er cone are as
follows#
$% It should be T&C'(, when mi)ed to pro!ide good adhesion
between the filling material and canal wall when set.
*% It should pro!ide a +,R-,TIC S,&. /an e)cellent seal apicall
and laterall%.
0% Should be R&1I2-2P&34,, so that it can be !isuali5ed in a
radiograph.
6% Should not shrin7 upon setting /1I-,8SI28&..( ST&9.,%.
$
:% Should not ST&I8 tooth structure.
;% Should be I8S2.49., in tissue fluids.
<% Should be TISS4, T2.,R&8T i.e. non-irritating to peri-apical
tissues.
=% Should be 9&CT,RI2ST&TIC / atleast not encourage bacterial
growth.
>% Should not PR2?2', an immune response in peri-apical region
/should be absorbable when e)truded%.
$@%It should be neither mutagenic nor carcinogenic.
$$%Should be easil mi)ed and introduced into the root canal.
$*%Should S,T S.2A.( to ensure sufficient A2R'I8B TI-,.
$0%Cilm thic7ness should be as minimum as possible.
$6%It should be S2.49., I8 common sol!ents if it is necessar to
remo!e the root canal filling.
FUNCTIONS
$% The e)ert B,R-ICI1&. / &8TI9&CT,RI&. acti!it after
the placement.
*% The form a 9281 between the filling material and the dentinal
walls /acts as 9I81I8B &B,8T%.
*
0% The act as .49RIC&8TS when used in con"unction with
semisolid material.
6% The e)hibit R&1I2-2P&CIT( as it ma disclose the presence
of accessor canals, resorpti!e areas, root fractures and the shape
of apical foramen.
CLASSIFICATION
There are a number of classifications of root canal sealers which
can be discussed as#
I ACCORDING TO THEIR COMPOSITION [MESSING]
a) EUGENOL
b) NON-EUGENOL c) MEDICATED
i) Silver co!aii" ii) Silver Free
$% Ric7ettDs
formula 'errDs
Sealer /$>0$%
*% Procosol
Radio-opaque
sil!er cement
/Brossman-
$>0;%
$% Procos
ol 8on-
staining B
cement
/Brossman-
$>:=%
*% Brossm
anDs sealer
/Brossman-
$><6%
0% Tublise
al /'err-
$>;$%
6% AachDs
Paste /Aach
$>*:-::%
$% 1I&',T
/$>:$%
*% &+ *; /$>:<%
0% Chloropercha
,ucapercha
6% 8ogenol
:% +dron
;% ,ndofil
<% Blass Ionomer
=% Polcarbo)lat
e
>% Ca P2
6
cements
$@% Canoacrlate
$. 1I&',T-
&
*. 8* /$><@%
0. ,ndometha
sone
6. Spad
:. Iodoform
paste
;. RieblerDs
paste
<. -nol
cement
=. Ca /2+%
*
paste /.anes, $>;*%
>. Ca /2+%
*
/Crant, $>;*%
E9iocale)-
Ca/2+%
*
%F
0
6
II ACCORDING TO GROSSMAN#
$% Ginc-o)ide resin cements.
*% Ca/2+%
*
cements.
0% Paraformaldehde cements.
6% Pastes.
III ACCORDING TO COHEN
Specification number :< classifies endodontic filling materials as
follows#
Tpe I H Cl $, Cl *
Tpe II H Cl $, Cl *, Cl 0
Tpe III H Cl $, Cl *, Cl 0, Cl 6
Type I : C2R, /Standardi5ed% au)iliar /con!entional% points to be used
with sealer cements.
Class $ H -etallic.
Class * H Polmeric.
Type II # Sealer cements to be used with core materials.
Class $ H Powder and liquid nonpolmeri5ing.
Class * H Paste and non-polmeri5ing.
Class 0 H Polmer resin sstems.
:
Type III # Cilling materials to be used without either use materials /
sealer cements.
Class $ H Powder and liquid non-polmeri5ing.
Class * H Paste and paste non-polmeri5ing.
Class 0 H -etal amalgams.
Class 6 H Polmers.
$ ACCORDING TO INGLE
- Cements.
- Pastes.
- Plastic.
$I ACCORDING TO CLAR%
- &bsorbable.
- 8on-absorbable
$II ACCORDING TO HART& F'(
1. Pastes and cements may be d!ded nt" # $%"&ps.
$% Ginc-o)ide eugenol based.
*% Resin based.
0% BP based.
6% 1entin adhesi!e materials.
:% -aterials to which medicaments ha!e been added.
,)amples of Gn2, are alread mentioned.
;
'. Resn based: Consists of an epo) resin base which sets upon mi)ing
with an acti!ator. ,)amples H &+ H*;
- 1ia7et
- +dron.
(. )&ttape%c*a based # Pastes and cements based on gutta-percha
consists of solutions of gutta-percha in organic sol!ents well 7nown
products are#
- Chloropercha.
- ,ncapercha.
+. Dentn ad*es!e mate%a,s: &dhesi!e cements ha!e been tested in an
attempt to impro!e the qualit of sealers.
,)amples# Canoacrlate cements.
- Blass ionomer cements.
- Polcarbo)late cement.
- Calcium phosphate.
- Composite materials.
#. Mate%a,s t" -*c* medcaments *a!e been added.
- These ma be di!ided into * groups#
i. Those in which strong disinfectants and antiphlogistics
ha!e been added in order to supports possible post-
operati!e pain.
<
ii. Those in which Ca/2+%
*
has been added with the
purpose of inducing cementogenesis and dentino-
genesis at the foramen, thus creating a permanent
biological seal. ,)amples#
- Paraformaldehde.
- Calcium hdro)ide.
In the first group of pastes, the supplemented disinfectant is
paraformaldehde and corticosteriod preparation is used as an
antiphlogistic.
The most popular commercial Ca/2+%
*
containing cements are#
- Calcibiotic root canal sealer /CRCS%.
- Sealape).
- 9iocale).
Antp*,"$sts : &gents which counteract inflammation.
INDI$IDUAL SEALERS
A. SIL/ER CONTAININ)
)) %err roo! *caal +ealer , Ric-er!.+ For/0la#
Co/1o+i!io#
P"-de%:
Gn2 06-6$.*I.
Precipitated sil!er *:-0@.@I
2leo resins 0@-$;I
=
Thmol iodide $$-$*I
>
L0&d
2il of clo!es <=-=@I
Canal balsam *@-**I
Ad!anta$es:
i. ,)cellent lubricating properties.
ii. It allows a wor7ing time of more than 0@ minutes when
mi)ed in $#$ ratio.
iii. Bermicidal action and biocompatibilit.
i!. Breater bul7 than an sealer and hence fills !oids,
au)illar canals and irregularities present lateral to gutta-percha
cones.
!. Prostaglanding inhibition propert /Gn ,ugenolate%.
Dsad!anta$es:
i. Stains dentin to dar7 gre colar.
Indcat"n:
i. This is indicated to warm gutta-percha technique where
lateral canals are present.
Mai10la!io#
$. 2ne drop of liquid J $ pellet of powder.
$@
*. Branular appearance remains e!en after
spatulation is completed because of precipitated sil!er.
0. It completel sets and is inert within $:-0@
minutes, so BrossmanDs formula appeared in $>0;K with the
purpose of de!eloping a sealer that afforded more wor7ing time.
2) Proco+ol Ra3io1a40e * Silver Ce/e!
P"-de%:
Gn2 4SP 6:I
Ppt sil!er $<I
+drogenated resin 0;I
-agnesium o)ide *I
L0&d:
,ugenol >@I
Canada balsam $@I
To get rid of stain H use )lol to wash the pulp chamber after
condensation.
I3ica!io+#
$. -aterial of choice for lateral canals.
*. Cor sil!er points.
0. ?ertical condensation of warm gutta-percha when
bul7 of material is required as a sealer.
$$
Pac-a"i"#
- .iquid in bottle /dropper%.
- Premeasured powder in pellet form.
Mi5i"#
- $ pellet to $ drop /$#$%.
&% S,!e% F%ee # BrossmanDs formula was re!ised to
e)clude &g.
)) Proco+ol No-+!aii" Ce/e! , Gro++/a.+ E0"eol Ce/e!
6)789)#
This sealer is re!ised b Brossman again in $><6K b the addition
of 8a borate to the powder component and b the elimination of all
ingredients e)cept eugenol from the liquid.
Proco+ol No-+!aii" 6)789) Gro++/a.+ Sealer 6)7:;)
Co/1o+i!io# Co/1o+i!io#
Po<3er# Po<3er#
Gno /reagent% H 6@I
Sta)belite resin H *<I
9ismuth subcarbonate H $:I
9a sulfate H $:I
L0&d:
,ugenol H =@I
Sweet oil of almond H *@I
Gno /reagent% H 6@I
Stabelite resin H 0@I
9ismuth subcarbonate H $:I
9a sulfate H $:I
8a anhdrous H $I
L0&d:
,ugenol H : parts.
$*
BrossmanDs sealer is used widel because it pro!ides good seal.
Co//ercial a/e+#
- Procosol non-staining sealer.
- RothDs sol.
- ,ndoseal.
Pro1er!ie+#
i% It has plasticit.
ii% It has slow setting time in the absence of
moisture and due to the presence of 8a borate anhdrate.
iii% It has good sealing potential and small
!olumetric change upon setting.
i!% Ginc ,ugenate is decomposed b +
*
2
through continuous loss of eugenol which ma7es Gn2,K a wea7
unstable compound.
9ecause the use of BrossmanDs sealer in bul7 for retrofillings and
surgical root end repair is questionable.
This sealer if e)truded apicall gets absorped.
Di+a3va!a"e+#
$% Resin is of coarse particle si5e and unless the material in
spatulated !igorousl during mi)ing, an increased piece of resin
$0
ma lodge on the walls of the canal and pre!ent the root-canal
filling from sealing at correct le!el.
Se!!i" Ti/e#
- This cement hardens in appro)imate * hours at 0<LC.
- Its setting time in canal is less# $@-0@ minute because of the
moisture present in dentin. The S.T. is influenced b#
a% 3ualit of the Gn2 and p+ of the resin used.
b% Technique used in mi)ing the cement.
c% &mount of humidit in the temperature.
d% Temperature and drness of the mi)ing slab and spatula.
Mai10la!io#
- Two / 0 drops of liquid# small increments of powder.
- Spatulation time depends on number of liquids drops.
- Spatulated to a smooth cream consistenc on a sterili5edK dried,
cool glass slab.
a% 1rop test b% String out teeth
- $@-$* seconds - $ inch without brea7ing.
2) T0bli+eal# )7=))
- &!ailable in paste sstem containing base and catalst.
$6
Co/1o+i!io#
1ase:
Gn2 H :<-:>I
2leo resins H $=.: H *$.*:I
9ismuth trio)ide H <.:I
Thmol iodide H 0.<:I - :I
2il and wa)es H $@-$@.$I
9arium sulphate
Cata,yst:
,ugenol
Polmeri5ed resin
&mmidalin.
It differs from Ric7ertDs cement in that the Gn2 base paste also
contains barium sulphate as a radiopacifier and mineral oil, corn, startch
and lethin, catalst is made up of polpale resin eugenol and thermol
iodide.
A3va!a"e+#
$% ,as to mi).
*% ,)tensi!el lubricated.
0% 1oes not stain the tooth structure.
6% It e)pands after setting.
Di+a3va!a"e+#
$% Irritant to peri apical tissue.
$:
*% ?er low !iscosit e)trusion through apical foramen because
shorter spatulation time is recommended.
0% A.T. is less than 0@ minutes and e!en less in the presence of
moisture.
I3ica!io+#
i. In apical surger cases immediatel after filling. The
canal is o!erfilled intentionall with hea! condensation and the
e)cess remo!ed b curettage.
ii. Cor filling the last millimeter of the prepared canal
where the master cone ma not reach because of its great
lubricating propert.
>) Giac?.+ Sealer 6)788@ Aac? e! al)
Co/1o+i!io#
P"-de%:
Gno $@g
Tricalcium phosphate *g
9ismuth subnitrate 0.:g
9ismuth subiodide @.0g
-agnesium o)ide /hea!% @.:g
L0&d:
Canada balsam *@ml
2il of clo!es ;ml.
$;
Pro1er!ie+#
a% -edium AT.
b% -inimum lubricating qualit.
c% -inimum periapical irritation.
d% It is stic7 due to the presence of Canada balsam.
e% It should be mi)ed to smooth cream consistenc and
should string out at least one inch when spatula is raised
from the glass slab.
f% Increasing the thic7ness of the sealer lessens its lubricating
effect /so this sealer is introduced when there is a
possibilit of o!er e)tension beond the confines of the
root canal.
g% It is pac7aged as powder and liquid in separate bottles.
A3va!a"e+#
a% It is germicidal.
b% .ess peri-apical irritation.
c% It has light bod and thus does not defect the
small gutta-percha cones.
$<
d% It stas in position due to the tac7iness at the tip
of the cone.
Di+a3va!a"e#
a% 2dour of liquid.
I3ica!io+#
a% &ll lateral condensation methods especiall
when chance of o!erfilling is present.
b% Small cur!ed canals of minimum caliber
because of its light bod does not defect the small master
gutta-percha cone used in such canals.
Co!rai3ica!io+#
a% Ahen hea! lubrication is needed as with
short master cone.
Pac-a"i"#
Powder and liquid in separate bottles.
Mi5i"#
- -i)ed to cream consistenc, mass drawn/ $ inch from raised
spatula.
- Thic7er for larger canals and for o!erfilling.
$=
Summar of Gn2, based cements# 9asicall Gn2, based
cements ha!e an ad!antage of#
- ,ase of manipulation.
- &dhesion to dentinal walls and limited dimensional changes.
- Radioopaque, germicidal action, ample AT and minimal staining
e)cept &g containing PR2C2S2..
Di+a3va!a"e+# Pa irritation and not absorped easil from apical tissues.
Se!!i" Reac!io# It reacts because of a combination of phsical and
chemical reaction ielding a hardened mass of Gn2 embedded in a
matri) of long sheath li7e crstal of Gn eugenolate. -an factors is
moistureK particle si5eK p+ etc. are factors that influence the setting
reaction.
- Tissue culture stud of Gn2, formulation are ctoto)ic.
- Inflammation at Pa region persists for ears.
- 4ntil e)cess , Gn2, cement is phagoctosed.
NON-EUGENOL
1. DIA2ET
- It is a pol!inl resin /Pol7etone%, a reinforced chelate formed
between Gn2 and 1i7etone.
$>
- 1ia7et consists of a fine, pure white powder and a !iscous hone
coloured liquid.
- * drops of liquid J $ scoop of powder /changing the ratio of
powder to liquid effects the hardness of the final set and
radioopacit%.
- 1ia7et hardens rapidl.
- S.T. is ;-= minutes on glass slab and faster in the root canal.
- 1ia7et is 7nown for its resistance to absorption.
- It is a superior to other sealers in tensile strength and resistance to
permeabilit.
- -odification of apical cementum and al!eolar bone occurred
with glass o!erfilling.
- This cement is usuall used for ,812SS,24S I-P.&8T.
- 1ia7et showed a greater tendenc towards fibrous encapsulation
where as &+-*; tends to disintegrate into fine granules which
were phagoctosed.
'. A34'5
This is an epo) resin recommended b S+R2,1,R in $>:6.
P"-de%:
9ismuth o)ide H ;@I
*@
Cle)amethlene tetramine H *:I
&g powder H $@I
Titanium o)ide H :I
L0&d:
9isphenol diglcidl ether
The formulation has been altered recentl with the remo!al of
sil!er as one of the constituents to pre!ent tooth discolouration.
PROPERTIES , AD$ANTAGES#
$. It has good adhesi!e propert.
*. &ntibacterial.
0. It contracts slightl while hardening.
6. .ow to)icit and well tolerated b Pa tissues.
DISAD$ANTAGES#
$. Parasthesia ma occur following the use of
&+-*;, but partial reco!er occurs within $-* ears.
*. Inhibits leu7octe migration.
PAC%AGING
(ellow powder and !iscous resin, liquid and is mi)ed to a thic7
cream consistenc.
Its setting time# 0;-6= hours at bod temperature.
: to < das at room temperature.
*$
TISSUE CULTURE STUDIES#
- The material was moderatel to se!ere to)ic when tested on
human epithelial cellsK blood, monoctes and lmphoctes etc.
H0/a +!03ie+#
- Aell tolerated b Pa tissue.
- ,)cess material in the P1. tends to become encapsulated.
- -andibular parasthesia ma occur following filling.
EFFECTI$ENESS OF SEALER#
- It is an effecti!e sealing agent.
>) %LOROPER%A N'O' SEALER#
This formula is gi!en b 8borg and Inllin in $>;:.
Co/1o+i!io#
P"-de%:
Canada balsam H $>.;I
Resin H $$.=I
Buttapercha H $>.;I
Ginc o)ide H 6>I
L0&d:
Chloroform
- It was first introduced in $>0>.
**
- The powder is mi)ed with liquid chloroform.
- &fter insertion the chloroform e!aporates, lea!ing !oids.
- It is associated with a greater degree of lea7age than other
materials.
CHLOROPERCHA
- This is a mi)ture of gutta-percha and chloroform.
- This chloroform paste has been used b some clinicians as the
sole canal filling material.
- &s such the technique is improper because of the e)cessi!e
shrin7age of the filling after e!aporation of the chloroform.
INDICATIONS#
- Perforations.
- 4nusuall cur!ed canals.
- Canals with ledge formation.
- In con"unction with well fitted primar cone chloropercha can fill
accessor canals and root canal space.
MODIFIED CHLOROPERCHA METHODS
There are * modifications#
$. Mohnston H Callahan.
*. 8gaard H 2stb.
*0
(o?+!o-Calla?a /e!?o3#
- The canal is repeatedl flooded with >:I alcohol.
- Then dried with absorbent points.
- It is then flooded with Callahan resin, chloroform solution for *-0
minutes /more chloroform is added if the paste becomes too thic7
b diffusion / e!aporation.
- & suitable gutta-percha is inserted and compressed laterall and
apicall with a string motion of the plugger until the gutta-percha
is dissol!ed completel in the chloroform solution in the root
canal.
- &dditional points are added one at a time and dissol!ed in the
same wa.
- ,)trusion should be pre!ented because freshl prepared
chloroform is to)ic before e!aporation of chloroform /as
chloroform e!aporates H it shrin7s and apical seal is lost%.
N&GAARD OSTB&
- The canal walls are coated with 7loroper7a the primar cone
dipped in sealer is inserted apicall.
- Pushing partiall dissol!ed tip of the cone to its apical seal.
*6
- &ddition cones dipped in sealer are pac7ed into the canal to
obtain satisfactor filling.
- C1& has banned the use of chloroform since it has a carcinogenic
potential.
)) NEAL& DE$ELOPED CaPO; T&PE SEALERS ARE#
$. Tetra calcium phosphate /TeCP%.
*. 1iacalcium phosphate dihdrate /1CP1%.
0. If modified -C II !ains and buffer solution
/T1-%.
6. T1--S-9uffer solution J *.;I chondrotin
sulphate.
Co/1o+i!io# T1--S
P"-de%:
a. Tetracalcium phosphate.
b. 1ibasic Ca phosphate.
L0&d:
a. Citric acid.
b. 1ibasic 8aP2
6
.
c. Chondrotin sulphate.
d. 1istilled +
*
2.
$. 9iocompatible.
*:
*. 8o peri-apical inflammator reaction.
0. Chondrotin and other ingredients said to promote wound
healing.
2) APPATITE ROOT CANAL SEALER * HC3ro5
Po<3er Li40i3
- -tricalcium phosphate
- +dro)l appatite.
- Iodoform.
- 9ismuth subcarbonate.
- Polacrlic acid.
- 1istilled +
*
2.
Tpe I H &RS used for ?IT&. P4.P,CT2-(
Tpe II H 0@I iodoform used in I8C,CT,1 C&8&.S has
radioopacit.
9actericidal
9one in!igoration effects.
Tpe III H :I iodoform.
Treatment of accidental perforations.
2rthograde filling after apicectom.
AD$ANTAGES#
- 9iocompatible.
- 2steogenic potential.
- .ow tissue to)icit.
DISAD$ANTAGES#
- Sets quic7l, hence multiple mi) essential.
*;
- .ow radioopacit.
- .ow wetting abilit.
$% ENDOFLOSS # DO ba+e3 /e3ica!e3 ce/e! .
Po<3er# Li40i3#
- Gn2.
- Iodoform.
- Ca/2+%
*
- 9aS2
6
- ,ugenol.
- Parachlorophenol.
- -i)ing is similar to PR2C2S2. /Gn2 sealer%.
- S.T. 0@-6: minutes.
- 9iocompatible.
- Induces se!ere inflammator reaction in 6= hours and graduall
reduces after 0 months.
- Se!ere ctoto)icit along with coagulation necrosis was obser!ed
H which is attributed to the presence of iodoform and
parachlorphenol.
2) TS-=E
Po<3er Li40i3
- Gn2.
- Rosin.
- -agnesium o)ide
- Catt acids.
- 2rtho etho) ben5oic acid.
- Blcol.
*<
H&DRON # Aie?!erle a3 Li/ 6)7=E)#
- It is a rapid setting hdrophilic, plastic material used as a root
canal sealers without the use of core.
- Boldman-&dron is a polmer of hdro)-ethl methacrlate
/+,-&%.
- It is a!ailable as an in"ectable root-canal filling material.
- 9iocompatible and it conforms to the shape of the canal because
of its plasticit.
- Ahen it comes in contact with moisture, the gel absorbs +
*
2 and
swells.
- A.T. is ; to = minutes.
- .ess radioopaque than gutta-percha.
- The sringe method ma7es it difficult to control the placement of
plastic gel accuratel and to control the formation of !oids within
its structure.
- .ong-term studies showed that it causes Pa irritation and
inflammation with the acti!ation of macrophages.
- +dron is thi)otropic i.e. before polmeri5ation occurs it changes
from a gel to liquid for short-time.
*=
- It can be remo!ed onl b burs i.e. peeso reamer.
ENDOFIL#
- & recentl introduced in"ectable silicone resin endodontic sealant
is 7nown as .ee ,ndo-fill.
- It can be used with gutta-percha as the core material or H as a sole
sealant and filling material to be in"ected in the canal with a
pressure sringe.
End"6,,: a silicone elastomer H silicone monomer.
Cata,yst H silicone based radioopacifier H bismuth subnitrate.
&cti!e ingredients.
- +dro)l terminated dimethl polsilo)ane.
- 4ndeclenic acid.
- 9en5l alcohol.
- +drophobic amorphous silica /$@-0@N particle si5e%.
Cata,yst H Tetra ethlorthosilicate poldimethl silo)ane#
- The mi)ed silicone has low wor7ing !iscosit with good
adaptation to the tooth structure.
- Bood penetration of accessor canals.
*>
- It cures to a pale pin7 rubber solid resembling gutta-percha in
properties.
- ST H = to >@ minutes /depending on the catalst amount O
catalst, faster setting, O shrin7age.
- The !oids can be detected on a radiograph and can be repac7ed.
- & moist cotton pellet is used for !ertical condensation and the
e)cess is remo!ed.
- +
*
2 accelerates the S.T.
AD$ANTAGES#
$. ,ase of preparation.
*. &d"ustable A.T.
0. .ow wor7ing !iscosit.
6. Rubber consistenc.
:. It is not a resorbable material.
DISAD$ANTAGES#
$. Cannot be used in the presence of +
*
2
*
.
*. Canal must be absolutel dr.
0. Shrin7s upon setting but has an affinit for flowing into
open tubuli.
6. ,ndo-fills bonding abilit to the canal walls decreases if it
is not used within about *@ minutes of mi)ing.
0@
BIOCOMPATIBILIT&#
- Silicon elastomers are low in to)icit and inert to tissues.
GLASS IONOMER CEMENT 6%ETAC-ENDO)
- Saito introduced the endodontic glass ionomer.
- +e suggested using Cu"i Tpe I luting cement to fill entire root-
canal.
- .ater Pittford and Stewart wor7ed on this material to impro!e the
properties.
- Blass-ionomer cements are reaction product of an ion-leachable
glass powder and a polanion in aqueous solution.
- 2n setting the form a hard polsalt gel which adhere tightl to
enamel and dentin.
- 9ecause of their adhesi!e propert the are used as root-canal
sealers, pro!ided the are not ctoto)ic. It can be triturated and
in"ected onto root-canal.
AD$ANTAGES#
- It has best phsical qualities.
- It has best binding to dentin.
- Cewest !oids.
- .owest surface tension.
- 9est flow propert.
0$
- .ess ctoto)ic.
DISAD$ANTAGES#
- It cannot be remo!ed in case of re-treatment /no 7nown sol!ent
for BI%.
- +owe!er Toronto / 2sract group has reported that 7etac-endo
sealer can be effecti!el remo!ed b H hand instruments, -
chloroform sol!ent followed b $ minute with an ultrasonic no.
*: file.
NOGENOL#
- This was de!eloped to o!ercome the irritating qualit of ,ugenol.
- The product is an outgrowth of non-eugenol periodontal pac7.
- This Gn2 non-eugenol cement nogenol ha!e been ad!ocated as it
considered to be less irritating sealer.
- It was found that after *6 hours all sealers showed considerable
inflammation.
- &+-*; hours nogenol was considerabl less irritating than the
other sealers.
- ,)pands on setting and impro!e its sealing efficac with time.
9ase is Gn2 with barium sulfate and !egetable oil.
- &ccelerator H hdrogenated rosin.
0*
- -ethl abietable.
- .auric acid.
- Chlorothmol.
- Saliclic acid.
POL&CARBOF&LATE CEMENTS#
- It consists of modified Gn2 powder and aqueous solution of
polacrlic acid.
- The cement has chelating action.
- 9inds to both enamel and dentin.
- 9ecause of its adhesi!e and antibacterial properties, the cement
has been tested as a root canal sealer.
- .i7e an other sealer, this material also produces an
inflammator response when it is e)truded into Pa tissues.
- &pical seal is found to be inferior to other sealers.
AD$ANTAGES#
$. It bonds well to dentine.
*. &ntibacterial propert.
0. Compounds li7e fluoride and Ca/2+%
*
can be added.
DISAD$ANTAGES#
00
$. Special plastic plugger is required for insertion since it has great
adhesi!eness to steel instruments.
CALCIUM PHOSPHATE CEMENT#
- It has been de!eloped for use on e)posed root surfaces of
sensiti!e teeth.
- 9rowne /$>=0% showed that this cement penetrated and occluded
the radicular dentinal tubules and enhanced hdro)apatite
formation.
- Aefel /$>=6% found that it effecti!el plugged the apical foramen
and penetrated the dentinal tubules upto $@mm.
- The biocompatibilit of this cement in ,ndo-therap has not et
been established
C&ANOACR&LATE CEMENTS#
- These are composite tpe polmers that can be polmeri5ed to
hard products b the use of basic inorganic material that also
ser!e as fillers.
- & number of homologues including methl, ethlK n-butl,
isobutl and isopropl ha!e been formulated in dental cements.
- The ha!e been reported to be biocompatible.
MEDICATED CEMENTS#
06
,)amples#
Da7et A:
- Chemicall this sealer is similar to dia7et but it also contains the
disinfectant +,P&C+.2R2P+,8,.
- It is one of the few medicated cements which does not contain
paraformaldehde.
TISSUE CULTURE STUDIES#
- 1ia7et is moderatel to)ic to cells.
- It has a strong ctoto)ic effect upto 6= hours after insertion.
HUMAN STUDIES#
- -aterial is well tolerated b the Pa tissues /o!erfillings with
1ia7et-& causes no inflammator reaction and are encapsulated
b fibrous connecti!e tissue%.
Pb tet%"8de H is to)ic to human organism and is of little benefit to the
properties of cement.
Pa%a6"%ma,de*yde H hereb irritating and destructi!e to tissue.
C"%tc"ste%"d H are supposed to reduce post-operati!e pain.
0:
N
2
#
- It was introduced b S&RB,8T and RITC+,R /$>;$/<$%.
- 8
*
refers to the *
nd
ner!e /pulp is referred to as first ner!e%.
- * different tpes of 8
*
were a!ailable pre!iousl.
8
*
normal 8
*
apical
- 4sed for root filling. - 4sed for antiseptic medication of
the canal.
- Recentl 8
*
4ni!ersal has been introduced.
- The formula has been cultured b remo!ing hdrocortisone,
prednisolone and barium sulfate.
Co/1o+i!io#
P"-de%
Gn2 H ;=.:$g
Pb tetro)ide - $*.@@g
Radiopaquers - Paraformaldehde H 6.<@g
9ismuth subcarbonate *.;@g
9ismuth subnitrate 0.<@g
&ntiseptic H Titanium dio)ide =.6@
Phenl mercuric borate H @.@6g
0;
L0&d:
,ugenol.
2leum Rosae
2leum .a!andulal
- The corticosteroids are now added to the cement separatel as
hdrocortisone powder / terra-cortil.
- The ob"ect of introducing formaldehde within the root-filling is
to obtain a continued release of formaldehde gas H which brings
prolonged fi)ation and antiseptic action.
TOFICIT&#
- 9ecause of irritation is se!ere if forced into ma)illar sinus
mandibular canal-caused persisting, paresthesia.
- &PIC&. S,&. H is better when compared to procosol, nongenol
and tubliseal and dia7et.
ENDOMETHASONE#
- The formation of this sealer is similar to 8
*
composition#
P"-de%:
Gn2 - $@@.@gm
9ismuth subnitrate H $@@.@g
1e)amethasone H @.@$>g
+drocortisone H $.;g
0<
Thmol iodide H *:.@g
Paraformaldehde H *.*@g
L0&d:
,ugenol
- & pin7 antiseptic powder is mi)ed with eugenol.
- Sometimes endomehasone RC sealers gi!es rise to pain /
discomfort after ; to = wee7s of insertion.
- This occurs because the corticosteroid mas7s an inflammator
reaction until it is remo!ed from the area.
- Paraformaldehde is not resorbed equall, quic7l and the
smptom of the inflammator reaction becomes apparent.
SPAD#
- 'nown for one !isit non-irritant radioopaque filler and sealer.
- It is a resorcinol formaldehde resin supplied as a powder and *
liquids.
Co/1o+i!io#
P"-de%:
Gn2 H <*.>g
9a Sulphate H$0.@@g
Titanium dio)ide H ;.0@g
Paraformaldehde H 6.<@g
+drocortisone acetate H *.@@g
0=
Ca/2+%
*
H @.>6g
Phenl mercuric borate H @.$;g
L0&d:
/Clear% Cormaldehde solution H =<.@@g
Blcerine H $0.@@g
L0&d 9LD.
/R,1% Blcerine H ::g
Resorcinol H *:g
+Cl acid H *@g
- ,qual parts of the * liquids are mi)ed with powder.
- Reaction in between the resorcinol and formaldehde.
- Cor this reaction, an acid p+ is needed and this is pro!ided b the
+Cl acid.
- The large amount of Gn2 in the powder is to control the p+ and
so prolong the S.T.
- Setting time of spad is *6 hours during which small amounts of
unreacted formaldehde gas released.
INDICATIONS#
- Pulpotomies in 1e!i and permanent teeth.
- Treatment of acute endo infections.
0>
- Pa within Pa infections H because it is thought that sterili5ing
affect accelerates healing.
- ,)trusion H bone necrosis.
IODOFORM PASTE#
- If alone / in combination with ether substances has been used as a
cement / as sealer with core materials.
- Aal7hoff /$>*=%.
- It is a resorbable paste.
Consists of# ;@ parts of iodoform.
6@ parts of solution H 6:I parachlorphenol,
&ntiseptic H 6>I of camphor
;I menthol.
COMMERCIALL& a-a %RI * ) 1a+!e'
- Ahen the pulp is necrotic, the apical foramen is intentionall
widened during preparation and paste is deliberatel filled into
the region during filling.
- If a sinus is present, paste is pushed beond the canal until it
e)trudes through the sinus.
- .arge Pa lesions, paste is used to fill the Rl and also as antiseptic
dressing.
6@
- It is not necessar to insert a guttpercha/sil!er points as core
filling, if it is used, it should not touch the ape).
- It stimulates the Pa tissues and e!en accelerates bone formation.
- The filling material in the peri ape) is remo!ed b the action of
phagoctosis and direct drainage to the associated lmphnodes.
DISAD$ANTAGE#
$% Pa irritation during construction of post crown /so call has
to be filled with non-absorbable material according to
.aws /$>:>% H apical quarter of the canal with a section of
gutta-percha J paste and the remaining with non-
resorbable material.
*% 1iscoloration.
0% Cannot be used in patients who ha!e sensiti!it to iodine.
RIEBLER.S PASTE#
P"-de%:
Gn2
Cormaldehde
9a sulphate.
Phenol.
6$
L0&d:
Cormaldehde.
Sulphuric acid.
&mmonia.
Blcerine.
M&NOL CEMENT#
P"-de%:
Gn2.
Iodoform.
Rosin.
9ismuth subnitrate.
L0&d:
,ugenol.
Creosol.
Thmol.
- These cements are used, without core materials and are
introduced b means of lentulospiral / in"ection de!ice.
APPLICATION OF A SEALER
- Sealer can be placed b #
- Reamer.
- .entulo-spiral.
6*
Reame%:
- To carr the cement apicall H a counter cloc7wise turn is gi!en
to the reamer.
- 2ne si5e less than the last instruction is selected.
- The safest is to use with a stopper to the appro)imate A...
- & small amount of cement is gathered on the blade and is carried
into the canal and is rotated in counter cloc7wise as it is
withdrawn.
- Spinning the sealer into the canal slow gentle pumping action J
helps a lateral rotar motion of the instrument H helps to caat the
walls thoroughl and dispersal air trapped in the canal.
Lent&,"sp%a,:
- It is turned cloc7wise either b fingers / handpiece.
- It carries cement apicall.
- 8ot effecti!e in marrow canals, eas brea7age.
- Causes e)trusion of the cement when used with handpiece.
- Causes cement to set rapidl as a result of its whipping action.
CALCIUM H&DROFIDE CEMENT#
- Ca/2+%
*
has been used H as intra-canal medicaments.
60
- &s a sealant in con"unction gutta-percha.
- &s a root canal filling material.
- Pure Ca/2+%
*
can be used / J saline solution.
- p+ $*.0 to $*.:.
- Its use is based on the assumption that there is formation of hard
structures / tissues at the apical foramen.
- The al7alinit of Ca/2+%
*
, stimulates the induction of
minerali5ed tissue.
- Ca/2+%
*
ma be effecti!e as an I8T,RI- treatment but should
ser!e as a permanent RC filling material because it ma
disintegrate if lea7age occurs.
- Some Gn2, cements ha!e been modified b incorporating
Ca/2+%
*
.
- Ca/2+%
*
sealers are considered superior to Gn2, cements.
9A. SEALAPE: ; 2ERR COMPAN<:
- 8on-eugenol Ca/2+%
*
polmeri5e resin RC sealer.
- It is deli!ered in paste form.
66
Co/1o+i!io#
- 9ase consists of Gn2 with Ca/2+%
*
.
9utl ben5ene
Sulfonamide.
Gn stearate.
- Cata,yst 9a sulphate.
Titanium dio)ide H radioopaque.
Resin.
Isobutl saliclate and &crocil R><*.
- It ne!er sets in dr atmosphere.
- It $@@I humidit H it ta7es 0 wee7s to reach final set.
- It e)pands while setting.
- +ealing is better with sealape) than other sealers.
CRCS 6H&GEINIC) # )792
- Aas first of the Ca/2+%
*
based sealers.
- Seale) was introduced later.
Co/1o+i!io#
P"-de%:
Gn2
+drogenated rosin.
9a S2
6
Ca/2+%
*
H $6I
9ismuth subcarbonate.
6:
L0&d:
,ugenol
,ucalptol.
- CRCS is a Gn2, eucalstol sealers to which Ca/2+%
*
has been
added for its osteogenic effect.
- CRCS H is powder # .iquid combination.
- CRCS H 0 das to set full in either dr / humid en!ironment.
It shows ma little +
*
2 sorption i.e. quite stable.
- The setting time, solubilitK compressi!e strength and other
properties of these and Ca/2+%
*
sealers were compared with
PR2C2S2..
- The found that sealape) showed a tpical beha!iour on its
pronounced !olume e)pansion water absorption and change in
radioopacit with time.
6B) LIFE
- & Ca/2+%
*
liner and pulp capping material and sealer.
- Similar composition to sealape).
6C) $ITAPEF
- Mapanese ha!e introduced.
- Components are iodoform and silicone oil.
6;
6D) BIOCALEF
- 9ernard /$>:* as H 2cale).
- Powder# .iquid sstem.
- Powder# +ea! Ca o)ide, Gn o)ide
- .iquid# Blcol, +
*
2
- The powder and liquid are mi)ed to a paste.
- &cts as H RC medicament and RC filler.
- &fter being sealed in the canal He)pands ; times its original
!olume.
- Ca2J+
*
2 react within the tooth to form the Ca/2+%
*
which
ioni5es to release 2+ ions.
- 1ecompose necrotic pulp tissue to form +
*
2 and C2
*
.
- The +*2 b combining with residual Ca2 H leads to further
Ca/2+%
*
formation while C2
*
reacts with Ca/2+%
*
to form
carbonate which is deposited in the RC walls.
- The end result is that H the contents of the canals are sub"ected to
chemical incineration with sterili5ation occurring b the action of
2+ ions and sealing of the canal b decomposition of Ca/C2
0
%.
- ,fficac of sealing the root canal with 9iocale) is a contro!ers.
6<
NEAER SEALERS
$. ,ndofloss.
*. &ppetite root canal sealer.
0. RCS containing tetra-calcium dicalcium phosphate and $I
chondrotin sulphate.
1. ENDOFLOSS:
- Recentl introduced sealer consisting of P#. formulation.
P"-de%:
Gn2.
Iodoform.
Ca/2+%
*
9aS2
6
L0&d:
,ugenol.
Parachlorophenol.
- It is 5inc o)ide based medicated cement.
- -i)ing is similar to procosol /Gn2 sealer%.
- S.T. H 0@-6: minutes.
- 9iocompatible.
6=
- Induces se!ere inflammator reaction in 6= hours and graduall
reduced after 0 months.
- Se!ere to)icit along with coagulation necrosis was obser!ed
which is attributed to the presence of iodoform parachlorophenol.
'. APPETITE RCS: 3<DRO: 4 P:L C"mbnat"n
P"-de%: L0&d:
-trica P2
6
Polacrlic acid.
+dro)l appetite. 1istilled +
*
2
Iodoform.
9ismuth subcarbonate.
3 types: - Type I; II and III:
$. Tpe I # &RS used for !ital pulpectom.
Tpe II # 0@I iodoform used in infected canals that has
radioopacitK bactericide and bone in!igoration effects.
Tpe III # in between cases which contains :I iodoform.
*. Treatment of accidental perforations.
0. 2rthograde filling.
Ad!anta$es: Dsad!anta$es:
$. 9iocompatible. $. Sets quic7lK hence multiple mi)
essential.
*. 2steogenic potential.*. .ow radioopacit.
0. .ow tissue to)icit. 0. .ow wetting abilit.
6>
Ne-,y de!e,"ped CaPO+ type sea,e%s a%e:
$. Tetraca phosphate /TeCP%.
*. 1icalcium phosphate dihdrate /1CP1%.
0. & modified -cII !ains and buffer solution /M1-%.
6. T1--S buffer solution J *:I chondrotin sulphate.
Co/1o+i!io#
T1--S T1-
P"-de%:
Tetracalcium P2
6
Tetraca phosphate
1ibasic Ca P2
6
1ibasic Ca phosphate
L0&d:
Citric acid Q
1ibasic 8aP2
6
Q
Chondrotin sulphate Q
1istilled +
*
2 Q
- Studies ha!e shown e)cellent biocompatibilit.
- 8o Pa inflammator reaction seen.
- Chondrotin and other ingredients said to promote wound healing.
:@
BIOSEAL#
Sealing abilit of a new-hdro)apatite containing endodontic
sealer using lateral condensation and thermatic composition of gutta-
percha in !itro M2,, ?ol. **K 8o. 6# &pril >;.
HC3ro5#
$. Is assumed to influence the apical healing.
*. It ma effect the sealing abilit of the cement because of its
composite structure additi!e did not effect the sealing abilit.
BIOSEAL # PCS'
I,M /><% 0@K *@:-*@># Ca/2+%
*
RCS # e!aluation of p+ Ca ion
concentration and conducti!it.
Sealape) +ighest p+K ionic Ca and total Ca !alues.
+gienic CRCS II
nd
.
1entspl - Sealer *; II
nd
?i!adent &pe)it III
rd
.
,ffect of sealer thic7ness on long-term sealing abilit # a *-ear
follow up stud.
Gn2, Roth Thic7 laers O lea7age than thin laers.
PCS H ,8T
&+-*;K 'etac ,ndoK Sealape) Thic7 and thin laers.
:$