Sealers for Root Canal Treatment - A Review
Sharma Y and Toor SK
Published on: 2019-10-16
Abstract
The purpose of obturation is to prevent reoccurrences of periapical pathology after root canal endodontic treatment. Recent advancements in endodontic sealers are main topic of discussion.
Keywords
Biocalex; Plus root canal sealer; ApexitIntroduction
The golden rule in the practice of Endodontology is to debride and complete obturation of pulp space as efficiently and three dimensionally as possible is considered to be an important part of root canal treatment [1].
History
Eugenol sealer cements
The original zinc oxide-eugenol cement was developed by Rickert this is based on the cement described by Dixon and Rickert in 1931. Both Rickert’s and Grossman's formulas were not accepted for including precipitated silver for radiopacity. Grossman's formula was modified again in 1947, by the addition of Sodiumborate to the powder component and by the elimination of all ingredients except eugenol from the liquid. Wach's paste, a varient of a zinc oxide-eugenol formula, was originally compounded in 1925 but did not recieve wide spread adoption until its publication and reintroduction in 1955. It is now marketed under several commercial brand names with minor variations in formulation. Tubliseal, introduced two-paste system as opposed to the powder- Liquid systems of the other zinc oxide types.
Noneugenol sealer cements
- Chloropercha (Moyco) is in use for more than a century.
- Kloropercha N-O was introduced in 1939 from Norway.
- Diaket is an organic polyketone compound introduced in Europe by Schmitt in1951.
- AH-26, introduced in Europe by Schroeder in 1957 for use in endodontic therapy is an epoxy-type resin, used commercially as an industrial adhesive and insulator [2].
Medicated root canal cements
- Iodoform has been used as cement or as sealer with core materials. It was described by Walkhoff in 1928.
- Biocalex originally developed and introduced by Bernard in 1952 under the name of Ocalex was a calcium oxide based sealer.
- Calcium hydroxide pastes were introduced by Laws and Frank in 1962.
Functions of Root Canal Sealers
Root canal sealers are used in conjunction with filling materials for the following purposes:
- Antimicrobial agent: All the popularly used sealers contain some antimicrobial agent, and so a germicidal quality is excreted in the period of time immediately after its placement.
- Sealers are needed to fill in the discrepancies between the fit material and the dentin walls, penetrate into irregularities, isthmus, fins and ramifications, and to obturate the lateral canals.
- Binding agent: Since the sealers are in the plastic or semi liquid state, they are able to form a bond between the filling material and the dentin walls.
- A lubricant: With the use of semisolid materials, the most important function for the sealer to perform is its action of lubrication. Having little rigidity, gutta-percha must have considerable lubrication when it is placed to reach in the apical portion of the preparation.
- Radiopacity: All sealers shows radiopacity property; therefore their presence can be demonstrated on a radiograph [3] (Table 1).
Classification
According to Grossman: (Eleventh Edition)
- Zinc-oxide resin cements
- Calcium hydroxide cements
- Paraformaldehyde cements
- Pastes
Table 1: Categorisation of Endodontic sealers according to their composition.
S. No |
Root Canal Sealers |
Brand Name |
1 |
Zinc Oxide Eugenol based sealers |
Roth sealer Kerr PCS Procoseal Endomethasone |
2 |
Epoxy resin based sealers |
AH Plus AH 26 Top Seal 2-Seal |
3 |
Silicon based sealers |
RoekoSeal Gutta flow |
4 |
MTA based sealers |
Endo-CPM-Sealer MTA Obtura proRoot Endo Sealer MTA fillapex |
5 |
Calcium-silicate-Phos-phate based biocer-amic sealers |
Endosequence/iRoot SP iRoot BP Bioaggregate |
6 |
Methaacrylate resin based sealer |
First generation-Hydron Second generation-EndoREZ, Realseal Third generation-Epiphany,Fibrefill Fourth generation-Realseal SE, Metaseal SE. Smartseal |
7 |
Calcium-phosphate based sealers |
Capseal I Capseal II |
Recent Endodontic Sealers
ProRoot endo sealer
It is a calcium silicate-based root canal sealer .It is used in the cold lateral, warm vertical or carrier based filling techniques.
Herbal sealer biosealer
It is a root canal sealer based on Copaifera multijuga oil-resin. Its powder is composed of zinc oxide, calcium hydroxide, bismuth subcarbonate, natural resin (rosin) and borax, and the liquid is purified Copaifera multijuga oil-resin.
Nanoseal plus root canal sealer
It is made up of calcium phosphate hydroxyapitite nanoparticles range from 40-60 nm. The rod shaped active nanoparticles can penetrate the dentinal tubules & enter accessory canals to ensure that all the spaces are effectively sealed [4].
Hybrid root seal
It is fourth generation selfadhesive dual-cure sealer with an insoluble, radiopaque material property. The liquid consist of 4-META, monofunctional methacrylate monomers and photo-initiators, while the powder contain a mixture of zirconia oxide filler, silicon dioxide filler and polymerization initiators.
Gutta flow 2 sealer
It is a cartridge form gutta percha sealer. The flow able property of material made it the sealer of choice. The larger armamentarium was main setback.
Root SP/EndoSequence BC sealer
It has an ability to form hydroxyappetite while the setting process and form strong bonding between dentinal wall and the sealer. It has insoluble, radio opaque and aluminium free material based properties. Tubli-Seal Sybron Endo/Kerr is a two-paste system contained in two separate tubes with nonstaining property, it contain zinc oxide-base paste with barium sulfate for radiopacity, and mineral oil, cornstarch,and lecithin.
Wach’s cement Roth International Inc., Chicago, IL
Contain powder of zinc oxide, bismuth subnitrate,bismuth subiodide etc. The liquid contains oil of cloves, eucalyptol etc. The liquid gives Wach’s cement a rather distinctive odor of an old-time dental office. It has the advantage of having a smooth consistency, and the Canada balsam makes the sealer tacky.
Sealapex Sybron Endo/Kerr
Is a calcium hydroxidecontaining noneugenol polymeric sealer that contain zinc oxide in the base along with calcium hydroxide and also contains butyl benzene, sulfonamide, and zinc stearate.
Apexit Ivoclar Vivadent, Schaan, Liechtenstein
Is a calcium hydroxide sealer with combination of salicylates?
CRCS Calciobiotic Root Canal Sealer; Coltene/ Whaledent/Hygenic, Mahwah,NJ
Is a calcium hydroxide containing sealer with a zinc oxide–eugenol–eucalyptol base? It is a slow setting sealer, especially in dry or in humid climates.
Diaket 3M/ESPE, Minneapolis, MN
It is a polyketone compound containing vinyl polymers mixed with zinc oxide and bismuth phosphate [5].
Conclusion
The sealer acts as a binding agent between the gutta-percha and the canal wall, enhance the impervious seal by serving as filler for root canal irregularities and minor spaces between the root canal and the core material. Root canal sealers used as main materials in the obturation of root canal systems, shows positive root canal treatment.
References
- Hauman CH, Love RM. Biocompatability of dental materials used in contemporary endodontic therapy: a review. Part 2: Root canal filling materials. Int Endod J. 2003; 36: 147-160.
- Huang FM, Tai KW, Chou MY, Chang YC. Cytotoxicity of resin-, zinc oxide-eugenol, and calcium hydroxide-based root canal sealers on human periodontal ligament cells and permanent V79 cells. Int Endod J. 2002; 35: 153-158.
- Koch MJ. Formaldehyde release from root-canal sealers: Influence of method. Int Endod J. 1999; 32: 10-16.
- Olsen BEM, Orstavik D, Eriksen HM. Radiographic voids and leakage along root fillings in vitro. Int Endod J. 1983; 16: 51-58.
- Juhasz A, Verdes E, Tokes L, Kobor A, Nagy DC. The influence of root canal shape on the sealing ability of two root canal sealers. Int Endod J. 2006; 39: 282-286.