Root canal sealants

1. ROOT CANAL S E A L E R S

2. What is ROOT CANAL SEALERS? The objectives of endodontic therapy are the complete removal of pathogenic organisms and stimuli that cause irreversible damage the tooth and three- dimensional filling of the root canal system. Gutta percha is the most commonly employed primary obturating material. However, gutta percha alone cannot result in a hermetic seal of the root canal. For this reason, low viscosity materials known as root canal sealers are used in conjunction with the primary obturating material to ensure a hermetic seal of the root canal. Dental root canal sealing materials along with the solid core material play an important role in achieving a fluid tight seal.

3. ROOT CANAL SEALERS CLASSIFICATION: Root canal sealers have been classified by eminent dentists such as Ingle and Clark. Ingle’s Classification of Root Canal Sealers: • Zinc oxide eugenol based sealers • Calcium hydroxide containing sealers • Resin based sealers • Glass Ionomer based sealers • Experimental Sealers Clark’s Classification of Root Canal Sealers: • Absorbable • Non-absorbable

4. What are the ideal requirements of a root canal sealer? Grossman put forth the ideal requirements of root canal sealants as follows: • They should be tacky which enhances adhesion with the canal wall when set • Provide a hermetic seal • Must be radiopaque for identification in the radiograph • Must have bacteriostatic properties • Should set slowly allowing a long working time • Should shrink when set • Should not stain the tooth structure • Must be insoluble in tissue fluids • Must be biocompatible • Should be soluble in a common solvent • Must not be mutagenic or carcinogenic • Should not provoke an immune response in periradicular tissue

5. What are the different types of Root Canal Sealers? Zinc oxide eugenol based sealers: The following are the different types of ZOE based root canals sealers: • Rickert Sealer :- o Silver added for radiopacity o Might cause staining of teeth o Removal of all cement from access cavity can reduce chances of staining • Roth’s Sealer :- o Developed by Grossman in 1958 o Non staining o Meets most of Grosssmans requirements for sealers • TubliSeal :- o 2 pastes system o Non-staining 

6. • Watch’s Cement :- o Smooth mix o Non staining Medicated versions of zinc oxide eugenol sealers are also present. They are: • Sealers containing formaldehyde as an antibacterial agent – Eg.            Endomethasone root canal sealer • Non eugenol sealers – Eg. Nogenol root canal sealer Calcium hydroxide containing sealers: • CRCS (Calciobiotic Root Canal Sealer) : o CaOH + ZOE o Osteogenic effect o Takes up to 3 days to set fully • SealApex: o 2 paste system o 3 weeks to reach final set of material

7. • Apexit: o A high quality root canal sealer • Vitapex II: o Contains 40% iodoform o Iodoform has bactericidal properties • MCS (Medicated Canal Sealer): o An iodoform containing root canal sealer EPOXY RESIN BASED ROOT CANAL SEALERS: • Diaket: o First introduced in 1951 o Resin reinforced chelate o Very tacky • AH-26: o Epoxy resin based sealer o Low solubility, slight shrinkage and biocompatible o Also sold as Therma Seal

8. • AH-Plus: o 2 paste systems o Less chances of tooth staining o Less toxicity o Highly biocompatible Glass Ionomer based sealers: • Ketac Endo: o Modified GIC o Introduced in 1991 o Favourable biological, chemical and physical properties Experimental Sealers: • Bis GMA Unfilled resin: o Tested as a sealer o Biocompatible o Impossible to remove from the canal 

9. • Pit & Fissure sealants (low viscosity):  o Low viscosity resins have been tried as root canal filing materials o Removal of the smear layer is important  • Isopropyl Cyanoacrylate: o Has been adequate in sealing the canals o Not approved by the FDA • Dentin Bonding Agents: o The efficacy of DBAs as root canal sealers were tested at the University of Minnesota o It was seen that they might play a major role in achieving an endodontic seal • Polyamide Varnish o Less effective than ZOE