Root canal sealers.pptx definition and properties
- 2. ROOT CANAL SEALERS MARVA MADALA BDS PART 2
- 3. CONTENTS • Definition • Ideal requirements • Functions • Classification • Materials 1. Zinc oxide sealers 2. Calcium hydroxide based sealer 3. Glass ionomer based sealers 4. Resin based sealers 5. Medicated sealers 6. Resilon • Monoblock concept • Method of sealer placement • Conclusion
- 4. DEFINITION: A radiopaque dental cement used , usually in combination with a solid or semisolid core material , to fill voids & to seal root canals during obturation.
- 5. IDEAL REQUIREMENTS: According to Grossman an ideal root canal sealer should: • Provide an excellent seal when set • Produce adequate adhesion among it, the canal walls, and the Filling material 0 Be radiopaque • Be nonstaining • Be dimensionally stable • Be easily mixed and introduced into the canals • Be easily removed if necessary • Be insoluble in tissue fluids • Be bactericidal or discourage bacterial growth • Be non-irritating to periradicular tissues • Be slow setting to ensure sufficient working Additional requirements: 1. It should not provoke an immune response in periradicular tissue. 2. It should be neither mutagenic or carcinogenic.
- 6. FUNCTIONS: • Antimicrobial Agent • Fill in the discrepancies between the obturating material & dentin walls • Binding Agent • As Lubricant • Radiopaque : visible on radiograph. • Certain techniques dictate use of particular sealer : for example chloropercha technique use material as sealant as well as a solvent of master cone.
- 7. CLASSIFICATIONS: 1. According to their composition: • Eugenol • Noneugenol • Medicated. EUGENOL -Silver containing cements: i. Kerr sealer(Rickert, 1931) ii. Procosol radai -Silver free cements: i. Procosol nonstaining cement (Grossman,1958) ii. Grossman’s sealer(Grossman,1 974) iii. Tubliseal (Kerr),1961) iv. Wach’spaste(Wach)
- 8. NONEUGENOL These sealers do not contain eugenol and consist of wide variety of chemicals. For examples: • Diaket • -AH-26 • Chloropercha and eucapercha • Nogenol Hydron -Endofil • Glass ionomer • Polycarboxylate • Calcium phosphate cement MEDICATED These include the group of root canal sealers which have therapeutic properties. These materials are usually used without core materials. For examples: -Diaket-A -N2 -Endomethasone -SPAD -iodoform paste -Riebler's paste -Ca(OH)2 paste
- 9. • According to grossman 1.Zinc oxide resin cement 2.Calcium hydroxide resin cement 3.Paraformaldehyde cements 4.Pastes • According to ingle 1.Cements 2.Pastes 3.Plastics • According to cohen ADA specification no.57 classify endodontic filling material as; Type 1: material intended to be used with core material Type 2.: materials intended to be used with or without core material or sealer
- 10. ZINC OXIDE EUGENOL (ZOE) SEALERS Most of the sealer in common use contain zinc oxide resin as a base Ingredient of the powder. Included ln thls group are Grossman‘s cement, Roth‘s Sealer(Roth International), ThblI-Seal , and Wachs Sealer (Balas Dental). The liquid usually consists of eugenol anne or In combination with other liquids suchstaining cement that meets most of the ideal requirements for a root canal cement. The formula is as follows: GROSSMANS FORMULA FOR NONSTAINING SEALER: Powder Parts • Zinc oxide, reagent 42 • Staybelite resin. 27 • Bismuth subcarbonate. 15 • Barium sulfate. 15 • Sodium borate,anhydrous. 1 Liquid • Eugenol
- 11. • Grossman,’s cement hardens on approximately 2hours at 37degree Celsius and 100% relative humidity. Its setting time in a canal is less. It begins to set in the root canal within 10-30 minutes because of the moisture present in dentin. The setting time is also influenced by the quality of the zinc oxide and the pH of the resin used, the care and technique in mixingthe cement to its proper consistency, the amount of humidity in the atmosphere, and the temperature and dryness of the mixing slab and spatula. • The sealer is mixed on a sterile glass slab with a sterile spatula. Depending on the number of canals to be filled, one uses two or three drops of root canal cement liquid. Slowly, small increments of cement powder are added to the liquid while one spatulates it to a smooth, creamy mix. The spatulation time depends on the number of drops of liquid used, a minute per drop. • The completed mix. can be tested for proper consistency by raising the flat blade of the spatula up from the mixed mass. The cement should "string out" for at least an inch before breaking. Another test for consistency is that the suspended mix should cling to the inverted spatula blade for 10-15 seconds before dropping from the spatula. The cement is now coated into the dried root canal. {a) Proper consistency of sealer (b) Increased liquid content in sealer makes the sealer thin (c) Grainy mix due to excessive powder. • Because moisture accelerates the set of the cement, the pulp chamber and canals should be thoroughly dried before inserting the cement. Small amount of cement is carried into the canal using a lentulospiralor the master cone. This procedure prevents air bubbles from becoming trapped in the cement. Coat the walls of the canal with a thin layer of cement by means of a lateral or rotary motion. Avoid forcing any cement into the periradicular tissues. Tissue tolerance of this sealer is satisfactory, with little inflammation and no inhibition of repair. Langeland and coworkers have stated that all root canal cements are irritating in their freshly mixed state, but on setting, most become relatively inert.
- 12. CALCIUM HYDROXIDE BASED SEALERS • Some zinc oxide Eugenol cements have been modified by incorporating calcium hydroxide. Calcium hydroxide sealers were developed for their antimicrobial and osteogenic-cementogenic potential; however, these actions have not been clinically demonstrated. • Sealapex has been described as noneugenol, calcium hydroxide polymericresin root canal sealer available in a base catalyst system. The base contains zinc oxide, calcium hydroxide, butyi benzene, sulfonamide, and zinc stearate. The catalyst contains resin, isobutyl salicylate, barium sulfate, titanium dioxide, and aerosoL • Hovland and Dumsha reported approximately the same amount of microleakage of Sealapex, Procosol, and Tthi-Seal when these materials were used in filling root canals. Cox and associates reported healing at the root apices of teeth of monkeys 6 months after sealing of the canals with Sealapex. • When these investigators compared postoperative results with AH26, Rickert's sealer, and Sealapex, healing was more advanced with Sealapex. Another zinc oxide-type cement containing calcium hydroxide is CRCS(calcibiotic root canal sealer). Set CRCS contains 14% by weight by calcium hydroxide.
- 13. GLASS IONOMER BASED SEALERS: Glass ionomers have been advocated as root canal sealers for their dentin bonding ability. Ketac Endo (3M ESPE) is an example of a glass ionomer sealer. They are not popular because of the difficulty in removing the sealer from root canal walls during retreatment. Solvents are ineffective against them.
- 14. RESIN BASED SEALERS: AH26 (Denstply Detrey) is an epoxy resin containing a nontoxic hardener. Radiopacity is imparted to it by bismuth oxide. It has strong adhesive properties and contracts slightly while hardening. However, it was found to release formaldehyde during setting. AH Plus is a modified formulation of AH26 and does not release formaldehyde. ADVANTAGES • sealing ability • Biocompatibility to periapical tissues • Moderate antimicrobial activity • Dentinal adhesion • Long working time and ease of manipulation
- 15. MEDICATED SEALERS: • The basic ingredient of the medicated sealer is zinc oxide, but usually they contain other contraindicated ingredients, including paraformaldehyde. • Sargenti advocated the use of a sealer containing 6.5% paraformaldehyde and lead that was marketed as N2 and later as RCZB. Lead is toxic to the humans and adds little benefit to the property of the cement. • Paraformaldehyde is highly irritating and destructive to tissues. Other paraformaldehyde sealers include SPAD and Reibler's paste. Endomethasone (Septodent) contains a corticosteroid. Corticosteroids reduce postoperative pain, but the claim is still unproved. • The role of medicated sealer in endodontics ls controversial and Is not clinically recommended.
- 16. RESILON: It is developed to overcome the problems of gutta percha viz; 1.Shrinkage of gutta percha on cooling. 2.Gutta percha do not bind to sealer, result in gap formation. COMPONENTS OF RESILON SYSTEM: PRIMER: it is a self etch primer, which contain sulphuric acid terminated functional monomer, , HEMA, water and a polymerisation initiator. RESILON SEALER: it is a dual cure, resin based sealer. RESILON CORE MATERIAL: it is thermoplastic synthetic polymer based core material. METHOD OF USE: 1. Smear layer removal: use 17%EDTA or 2% chlorhexidine as final rinse. 2. Placement of primer: after drying canal using paper point primer is applied to apex.use dry paper to wick out excess primer from canal. 3. Placement of sealer: sealent is placed to canal using lentulo spiral or by coating master cone. 4. Obturation: obturate canal by lateral or warm compaction. 5. Curing : it is cured with halogen curing light for 40s. 6. Coronal restoration: a coronal restoration is done to seal access cavity.
- 17. ADVANTAGE OF EPIPHANY: • Biocompatible • Good coronal seal • Nontoxic • Nonmutagenic • Forms monoblock • Increase resistance to fracture. DISADVANTAGE: Does not retain its softness after heating.
- 18. MONOBLOCK CONCEPT: It means the creation of solid, bonded, continuous material from one dentin wall of canal to the other . monoblock phenomena strengthen the root by approx. 20%. Classification based on number of interfaces present between core filling material and substrate: Primary: obturation is done completely with core material.eg; hydron, mta, biogutta. Secondary: two circumferetial interface. One between sealer and dentin and other between sealer and core material.eg; resilon based system. Teritary : conventional gutta precha coated with resin which bond with sealer which further bond to canal.eg; endorez, active GP system. Two prerequisite for a monoblock to function as mechanically homogenous unit : 1.Material should be able to bond strongly and mutually to each other and substrate used for monoblock. 2.Monoblock material should have same modulus of elasticity as that of substrate.
- 19. METHOD OF SEALER PLACEMENT: • PIacing the sealer in the canal with a lentulo spiral • Coating the master cone and placing the sealer in the canal with a pumping action. Placing the sealer on the final file used at the corrected working length and turning the file counterclockwise. • Injecting the sealer with special syringes. Sealer placement techniques vary with the status of apical foramen. • If apex is open, only apical one-third of master cone is coated with sealer to prevent its extrusion into periapical tissue • If apex is closed , any of above techniques can be used.
- 21. CONCLUSION: Most techniques of obturation employ a core material and a sealer. Regardless of the core material, a sealer is essential to every technique and provides the fluid impervious seal .....