Endodontics

Lecture 7

Root canal filling materials

By
Abdullah Mohammed Al Jawher
B.D.S. M.Sc. (conservative)
 Sealers:
• Root canal sealers are necessary to seal the space between the dentinal wall and
the obturating core material.

• Sealers also fill voids and irregularities in the root canal, lateral and accessory
canals, and spaces between gutta-percha points used in lateral condensation.

• Sealers also serve as lubricants during the obturation process.

 Properties of an Ideal Sealer:
Grossman outlined the properties of an ideal sealer. At present no sealer satisfies all the
criteria.
♦ Exhibits tackiness when mixed to provide good adhesion with the canal wall when set
♦ Establishes a hermetic seal
♦ Radiopaque, so that it can be seen on a radiograph
♦ Very fine powder, so that it can mix easily with liquid
♦ No shrinkage on setting
♦ No staining of tooth structure
♦ Bacteriostatic, or at least does not encourage bacterial growth
♦ Exhibits a slow set
♦ Insoluble in tissue fluids
♦ Tissue tolerant; that is, nonirritating to periradicular tissue
♦ Soluble in a common solvent if it is necessary to remove the root canal filling
Types of root canal sealers:

The four major types of sealers are:

1) zinc oxide–eugenol based,
2) resin based (epoxy resin or methacrylate resin) sealers,
3) glass ionomer based .
4) calcium hydrox­ide based.

 Regardless of the sealer selected, all exhibit toxicity until they

have set. For this reason, extrusion of sealers into the
periradicular tissues should be avoided.
Zinc oxide–eugenol sealers
• Zinc oxide–eugenol (ZnOE) sealers have been used for many years and ample clinical
experience exists with these materials.
• sealing ability and biological properties are, in general, inferior compared with other root
canal sealers.
• Because of its tendency for disintegration ZnOE is still recommended as a root canal filling
material for deciduous teeth.
• Formaldehyde-releasing ZnOE root canal sealers should not be used any more because of
their inherent toxic potential. The European Society of Endodontology discourages the use of
these materials.
 Epoxy resin sealers
• Epoxy resin sealers have comparatively good mechanical and sealing properties.
• No effects on general health are expected and allergic reactions are apparently rare.
• Antimicrobial properties are good, especially in a freshly mixed state.
• Cytotoxicity is moderate to low (set state).
• Mutagenicity is mainly observed shortly after mixing and no unacceptable risk is expected
for the patient.
• For dental personnel, a “no touch technique” is recommended.
Glass Ionomer based sealer

• This material has the advantage of bonding to dentin, seems to

provide an adequate apical and coronal seal, and is biocompatible.
• However, its hardness and insolubility make retreatment and post
space preparation more difficult
 Calcium hydroxide sealers
• Calcium hydroxide sealers have inferior technical properties compared with epoxy resin
preparations.
• poorer sealing quality compared with other sealers.
• From a biological point of view, calcium hydroxide sealers are very favorable materials
and they exhibit considerable antimicrobial activity.
• Furthermore, they belong to the few materials that apparently support apical healing and
hard-tissue formation (root-end closure).
 Mineral trioxide aggregate (MTA)
• A new category of root canal sealers based on MTA has recently been commercially
available.
• This type of root canal sealer is attractive because of the bioactivity of MTA, which are also
known for being hydrophilic.
 Silicone Sealers
• RoekoSeal (Coltène/Whaledent) is a polydimethylsiloxane that has been reported to
expand slightly on setting.
• GuttaFlow and GuttaFlow2 (Coltène/Whaledent) consist of gutta-percha in particulate
form (less than 30 μm) added to RoekoSeal.
• The technique involves injection of the material into the canal, followed by placement of
a single master cone.
• Evidence suggests that the material fills canal irregularities with consistency and is
biocompatible
Ceramic-Based Sealer
• Ceramic-based sealer is a recently introduced root canal sealer.
• The sealer has been reported as insoluble, radiopaque, and nonshrinking; it requires moisture
to harden (hydrophilic).
• Studies have shown that bioceramic sealer has minor cyto­toxicity.
• However, further studies are necessary to determine the long-term effect of this sealer on the
success of the treatment.
 SEALER
PLACEMENT
The sealer may be placed with:
• paper points,
• files,
• ultrasonic activation of files,
• special drills (lentulo),
• as a coating on the primary cone,
• or by injecting with special syringes.
Core obturating materials:
 Properties of an Ideal Obturation Material:
♦ Easily manipulated and provides ample working time
♦ Dimensionally stable with no shrinkage once inserted
♦ Seals the canal laterally and apically, conforming to its complex
internal anatomy
♦ Nonirritating to the periapical tissues
♦ Impervious to moisture and nonporous
♦ Unaffected by tissue fluids—no corrosion or oxidization
♦ Inhibits bacterial growth
♦ Radiopaque
♦ Does not discolor tooth structure
♦ Sterile
♦ Easily removed from the canal if necessary
 Silver Cones

The use of silver cones today is considered to

be below the standard of care in contemporary
endodontic practice.
 Gutta-Percha
• Gutta-percha is the most popular core material used for obturation.
• Major advantages of gutta-percha are its plasticity, ease of manipulation, minimal toxicity,
radiopacity, and ease of removal with heat or solvents.
• Disadvantages include its lack of adhesion to dentin and, when heated, shrinkage upon
cooling.
Costume cones
customized gutta-percha point can be created by rolling
several warmed gutta-percha points together between two
glass slabs or with a cement spatula on a glass slab. The point
is cooled with water and the size is tested in the canal and
rerolled until an approximate fit is achieved.
 Resilon:
• Resilon is a high-performance industrial
polyester that has been adapted for dental use.
• The resin sealer bonds to a Resilon core, and
attaches to the etched root surface.
• The manufacturer claims that this forms a
“monoblock” .
THANK YOU