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  1. 1. Root canal sealers A device or substance which is used to seal something specially with a hermetic or an impervious seal…… Hermetic = air tight / fluid tight
  2. 2. Functions act as a binding agent, to the dentin and to the core material helps to fill irregularities and minor discrepancies discloses the presence of accessory canals, resorptive areas, root fractures, shape of the apical foramen (high flow rate)  Acts as lubricant Antimicrobial agent Provide radiopacity
  3. 3. REQUIREMENTS FOR AN IDEAL ROOT CANAL SEALER  Tacky when mixed -to provide good adhesion between it and the canal when set  Make a fluid tight seal  Radiopaque – so that it can e visualized in the radiograph  Should have ample setting time  Particles of powder should be very fine  Not shrink upon setting  Not stain tooth structure  Bacteriostatic, or at least not encourage bacterial growth.
  4. 4.  Insoluble in tissue fluids  Tissue tolerant that is non-irritating to periradicular tissue.  Soluble in a common solvent if it is necessary to remove ADDITIONAL REQUIREMENTS  Not provoke an immune response in periradicular tissue. Neither mutagenic nor carcinogenic.
  5. 5. KERR’S SEALER (Rickert’s formula) Rickert’s formula (1931) was an early ZnO containing sealer.  because GP based sealers (choloropercha and europercha) lacked dimensional stability after setting so, Rickert’s formula was developed to eliminate this problem.
  6. 6. COMPOSITION Powder contains  Zinc Oxide 41.2 parts  Precipitated silver 30.0 parts  White resin 16.0 parts  Thymol iodide 12.8 parts Liquid  Oil of clove 78 parts  Canada balsam 22 parts Setting time Half an hour
  7. 7. Advantages:  Germicidal action and biocompatibilty  Excellent lubricating Greater bulk than any sealer Working time more than 30 min (1:1 ratio) Disadvantages: Staining of tooth structure due to presence of silver. Any Surplus of the cement in the crown of an anterior tooth should be removed immediately after root fillings. Prolonged spatulation during mixing is needed to break up particles and reduce viscosity due to large particle size.
  8. 8. INDICATIONS It can be used as sealer during obturation with silver points. Warm vertical condensation of gutta percha when lateral canals are anticipated. Since the silver present in the powder is radio opaque, the lateral canal with the sealer is the silver rather than the mass of sealer mix or any softened gutta percha. Weine has observed that lateral canals demonstrated with Kerr’s sealer remained noticeable radiographically for longer than do such canals with Wach’s paste.
  9. 9. CONTRAINDICATIONS Sealer not advised in anterior. If used, the pulp chamber should be washed out with xylol after condensation of gutta percha to ensure removal of sealer. (cause staining) MANIPULATION Supplied as pellets or bulk (powder) and the liquid in a dropper bottle. One drop of liquid to one pellet of powder (1:1 ratio) is taken and mixed with a heavy spatulation until relative homogeneity is obtained. Because of the precipitated silver, some granular appearance remains even when the spatula is completed.
  10. 10. GROSSMAN’S SEALER Due to the relatively rapid setting time of Rickert’s sealer, Grossman’s formula appeared in 1936, with the purpose of developing a sealer that allowed more working time . PROCOSOL RADIOPAQUE SILVER CEMENT Powder contains  Zinc oxide - 45.0%  Silver (precipitated) - 17.0%  Hydrogenated resin - 36.0%  Magnesium oxide - 2.0% Liquid contains  Eugenol - 90.0%  Canada Balsam - 10.0% causes staining of tooth due to silver. So it was revised in 1958 by elimination of silver content.
  11. 11. PROCOSOL NON STAINING ROOT CANAL CEMENT (Grossman 1958) Powder contains  Zinc oxide (reagent) - 40.0%  Stabelite resin - 27.0%  Bismuth sub-carbonate - 15.0%  Barium sulfate - 15.0% Liquid contains  Eugenol - 80.0%  Sweet oil of Almond - 20.0% Again it was revised by the addition of sodium borate to the powder component and by the elimination of all in ingredient except eugenol from the liquid component.
  12. 12. GROSSMAN’S SEALER (Grossman, 1974) Power contains  Zinc Oxide - 42%  Stabelite resin - 27%  Bismuth subcarbonate - 15%  Barium sulfate - 15%  Sodium borate (anhydrous) - 1% Liquid contains  Engenol - 100% Setting time: 2hrs at 37° C
  13. 13. MANIPULATION Not more than 3 drops of liquid should be used at a time, because excessive time and effort would be required to spatulate a large amount. Small increments of powder is added to liquid and mixed to a creamy consistency.  Spatulation time – 1 minute/drop  The cement will not harden for 6-8 hrs if left on the glass slab.
  14. 14. ADVANTAGES  The use of Grossman’s sealer reduced leakage nearly 50% Good plasticity and slow setting time. There is small volumetric change upon setting. The sealer has the ability to be absorbed in case of apical extrusion of the sealer during canal obturation Possess minimal level of irritation and high level of antimicrobial activity.
  15. 15. DISADVANTAGES Zinc eugenolate can be decomposed by water through a continuous loss of eugenol making zinc oxide eugenol a weak, unstable material. Toxicity studies have shown that a small amount when extruded may first cause an inflammatory reaction, nevertheless it is well tolerated by the periapical tissues.
  16. 16. WACH’S PASTE Wach’s paste, a variant of zinc oxide eugenol. Formula was originally formulated in 1925, but did not receive widespread adoption until its publication and reintroduction in 1955. It first became popular in Chicago. Creosote is added as a medical component. It is highly desirable sealer for use with gutta-percha.
  17. 17. The powder contains Zinc Oxide - 61.0 – 61.4% Calcium phosphate tribasic - 12.0 – 12.2% Bismuth sub-nitrate - 21.0 – 21.4% Bismuth sub-iodide - 1.9 – 2% Magnesium oxide - 3.1 – 4.0% Liquid contains:  Canada balsam - 74 .0 – 76.9% Oil of cloves - 22.0 – 23.1% Eucalyptol - 2.0% Beechwood creosote - 2.0%
  18. 18. Indication : All lateral condensation methods , when chance of overfilling is present Contraindication: When heavy lubrication is needed. Properties Medium working time Medium lubricating quality Minimal periapical irritation
  19. 19. Should be mixed to smooth creamy consistency , should string out at least 1 inch when spatula raised from glass slab Increasing thickness of sealer lessens lubricating effects , so indicated when there is possibility of over extension . Available as powder and liquid in separate bottles
  20. 20. ADVANTAGES Wach’s paste has a smooth consistency, useful in small curved canals of minimal calibre as this light body does not deflect the small gutta percha used to fill these canals. It is very sticky and tacky due to the presence of Canada balsam as it remains on the reamer during placement until it is spun off good germicidal ,relatively low tissue irritant The sealer is biocompatible to the periapical tissue. It has a good setting time.
  21. 21. DISADVANTAGES Odor of liquid Less lubricating quality
  22. 22. TUBLISEAL This sealer was introduced by Kerr manufacturing company in 1961, as an alternative to Rickert’s formula. Tubliseal is a two paste system as opposed to the powder liquid system of other zinc oxide types.
  23. 23. Base paste contains Zinc Oxide - 57.4 - 59.0% Oleo resins - 18.5 - 21.25% Bismuth Inoxide - 7.5% Thymol Iodine - 3.5% - 5% Oils and Waxes - 10.0 - 10.1% The catalyst contains Eugenol Polymerised resin Annidalin
  24. 24. MANIPULATION Tubliseal sealer is contained in two collapsible tubes containing a base and accelerator which when mixed together to about half an inch (which is sufficient in most cases) forms a creamy mix. ADVANTAGES The sealer does not stain the tooth structures.  It is extremely lubricating has a high rate of flow giving a thinner film. It allows maximal condensation in packing. Since the sealer is white in colour it provides a good contrast to the flapped tissue during surgical procedures.
  25. 25. DISADVANTAGES has a very low viscosity it makes extrusion through the apical foramen more likely Short working time Irritant to periapical tissue INDICATIONS  Tubliseal sealer is used in instance when shorter setting time is required (eg) where a root filling is to be followed immediately by apicectomy.  This sealer is used in cases where master cone becomes difficult to reach last millimeter of the preparation, due to its lubricating property.
  26. 26. CHLOROPERCHA introduced in 1939 in Norway obtained by mixing gutta percha with chloroform. sealers appear vague on radiograph. radio-density is low. NON-EUGENOL SEALER CEMENTSNON-EUGENOL SEALER CEMENTS
  27. 27. KLOROPERCHA N – φ (NYGARD – OSTBY 1939) Powder contains Canada Balsam - 19.6 % Rosin - 11.8 % Gutta percha - 19.6 % Zinc oxide - 49.0 % Liquid contains Chloroform - 100 %
  28. 28. DISADVANTAGES Chloro percha is carcinogenic Chloro percha products undergo shrinkage of during the evaporation of chloroform. It acts as an irritant to the periapical tissues. Chloro percha has been shown to be associated with a greater degree of leakage than other materials.
  29. 29. INDICATIONS  Produces excellent result in the filling of unusual curvatures or where the apical part of root canal is inaccessible and also in cases of perforation and ledge formation. It is used in case of canals, which divide in the apical part of the root into two major branches.
  30. 30. NOGENOL This was developed to overcome the irritating quality of eugenol. The product is an outgrowth of a non- eugenol periodontal pack Base Zinc oxide , barium sulfate as a raiopacifer along with vegetable oil. Catalyst hydrogenated rosin, methyl abeitate, lauric acid, chlorothymol and salicylic acid ADVANTAGES Nogenol is a less irritating sealer The sealer expands on setting and may improve its sealing efficacy with time
  31. 31. Polycarboxylate cement Modified zinc oxide powder nad aqueous solution of polyacrylic acid Chelating action , bonding to both enamel and dentin . Because of its adhesive and antibacterial properties tested as sealer. Inflammatory response , when axtruded into periapical tissues Apical seal inferior to other sealers
  32. 32. Advantages : Bonds well to dnetine , antibacteral property Fluoride and calcuim hydroxide can be added. Disadvantages: Special plastic plugger required for insertion since great adhesiveness too steel instruments.
  33. 33. Calcium phosphate cement Browne ( 1983) showed this cement penetrated on occluded radicular dentinal tubules and enhanced hydroxyapatite formation . wefel (1984) found it effectively plugged apical foramen and penetrated dentinal tubules upto 10 mm
  34. 34. CALCIUM HYDROXIDE SEALERS CALCIBIOTIC ROOT CANAL SEALERS (CRCS)  It is essentially a zinc oxide eugenol/eucalyptol sealer to which calcium hydroxide has been added for its so-called osteogenic effect. It represents the first of the calcium hydroxide based sealers. Contains 14% by weight of calcium hydroxide.  It takes 3 days to set
  35. 35. Powder contains  Calcium Hydroxide  Zinc Oxide  Bismuth dioxide  Balsom Sulfate Liquid contains  Eugenol  Eucalyptol
  36. 36. SEAL APEX Delivered as paste to paste in collapsible tubes Base Contains  Zinc Oxide 6.5 %  Calcium hydroxide 25.0 %  Butyl benzene  Sulfonamide  Zinc stearate Catalyst contains  Barium sulfate 18.6 %  Titanium dioxide 51 %  Proprietary resin  Isobutyl salicylate  Aerocil R 972.
  37. 37. LIFE  It is a calcium hydroxide liner and pulp capping material similar in formulation to Sealapex, has also been suggested as a sealer. APEXIT  (developed by vivadent, Liechtenstein)  It is a calcium hydroxide sealer with salicylates also incoprated into formula.
  38. 38. Base  Calcium hydroxide 31.9 %  Zinc oxide 5.5 %  Calcium Oxide 5.6 %  Silicon dioxide 8.1 %  Zinc stearate 2.3 %  Hydrogenised colophony 31.5 %  Tricalcium phosphate 4.1 %  Poly dimethyl siloxane 2.5 % ACTIVATOR  Trimethyl hexanedioldisalicylate 25.0 %  Bismuth carbonate basic 18.2 %  Bismuth oxide 18.2 %  Silicon dioxide 15.0 %  1,3 Butanediol di Salicylates 11.4 %  Hydrogenised colophony 5.4 %  Tricalcium phosphate 5.0 %  Zinc stearate 1.4%
  39. 39. vitapex It is a sealer which was developed in japan. It contain not only calcium hydroxide but also 40 percentage idoform and silicone oil among other ingredients.
  40. 40. RESINS based sealers New sealers are mostly polymers or resin based.  The more common brands are Diaket, Endofill, AH- 26, AH- Plus.
  41. 41. DIAKET first reported in 1951,  It is a resin reinforced chelate formed between zinc oxide and a liquid, β-di-ketone.  A very tacky material,  It contracts slightly while setting, which is subsequently negated by uptake of water.
  42. 42. Powder: Zinc oxide 98.0% Bismuth phosphate 2.0% Liquid: 2,2-Dihydroxy 5.5’dichlorodiphenylmethane Proplonylacetaphenone Triethanolamine Caproic acid Copolymer of vinyl acetate,  Vinyl chloride, vinyl Isobutyl ether
  43. 43. AH-26 Shroeder in 1957 Powder Silver Powder 10% Bismuth oxide 60% Hexamethylenetetramine 25% Titanium oxide 5% Liquid Bisphenol-di-glycidyl ether 100%
  44. 44. AH-26 is not sensitive to moisture, and will even set under water.  It will not set, however if hydrogen peroxide is present.  It sets slowly in 24 to 36 hours. Releases formaldehyde
  45. 45. AH-PLUS A new formulation of AH-26 is now available called AH plus.  This is a paste and paste mixing system that assures a better mixture.  It has an increasing radiopacity  shorter setting time,  It has better flow compared with AH-26.
  46. 46. Epoxy paste (A) Epoxy resin Calcium tungstate Zirconium oxide Aerosil Iron oxide Amine paste (B) Adamantane amine N,N – Di benzyl –5- oxanonanediamine Calcium tungstate Zirconium oxide Aerosil Silicon oil
  47. 47. ENDOFILL The least irritating sealer Endofill is virtually nontoxic  rubbery consistency COMPOSITION Base Bismuth sub nitrate as radio opacifier. Dimethyl poly-siloxane, Undecylenic acid benzyl alcohol  hydrophobic amorphous silica (10 -30 milli microns).
  48. 48. Catalysts ethyl ortho silicate, poly dimethyl siloxane
  49. 49. ADVANTAGES It is easy to prepare, It has a adjustable working time, low viscosity and rubbery in consistency. DISADVANTAGES The endofill cannot be used in the presence of hydrogen peroxide and the canal must be absolutely dry. It also shrinks upon setting.
  50. 50. GLASS IONOMER CEMENT (Ketac-Endo) cause less tissue irritation low toxicity in vitro Little biological data are available relative to its use as an endodontic sealer safety and efficacy not been established. quality of the seal - not good adhesive failures - common
  51. 51. Advantages Ease of preparation , adjustable working time , low working viscosity , rubbery consistency , non resorbable material Disadvantages Canal must be absolutely dry , shrinks upon setting , bonding ability decreses not used within 20 min of mixing
  52. 52. FORMALDEHYDE CONTAINING SEALERS Endomethasone, Kri paste, Reblers paste and N2 N2 has been the material most commonly focused on. Strong tissue coagulating property - toxic material
  53. 53. N2 SERGENTI nad RITCHER ( 1961) N2 refers to second nerve ( pulp is referred first nerve )| Two different types were available N2 normal – root filling N2 apical – medication of canal Recently N2 universal – features of both N2 normal and apical
  54. 54. COMPOSITION N2 is basically a zinc oxide eugenol sealer. The significant content of lead oxide and smaller amount of organic mercury arethe major toxic components of N2 ( often missing in recent formulas.)  However this material still contains large amount of formaldehyde. It seals well in combination with a core.
  55. 55. The tissue reaction normally is observed as a coagulation necrosis within a very short time, reaching its maximum in less than 3 days. The coagulated tissue is altered to such an extent that it cannot undergo any repair for months because it is formaldehyde impregnated.
  56. 56. Endomethasone powder liquid Zinc oxide 100 g Bismuth subnitrate 100 g Dexamethasone 0.019 g Hydrocortisone 1.6 g Thymoliodide 25 g Paraformaldehyde 2.2 g eugenol
  57. 57. Sometimes it gives pain or discomfort after 6 -8 weeks of insertion.
  58. 58. Iodoform paste Walkhoff ( 1928) Alone or in combination with other substances used as sealer with core materials Resorbable paste Idoform 60 parts , 40 parts of solution containing 45 % parachlorophenol , 49 %camphor and 6% menthol Commercial prepaartion -Kri-1 paste Stimulates periapical tissue and accelerate bone formation
  59. 59. disadvantages Periapical irritation Discoloration Rise in blood level of iodine
  60. 60. NEW SEALER Epiphany, to be used with Resilon System consists of Self etching primer Dual cure resin based composite sealer Resilon core-thermoplastic,synthetic polymer
  61. 61. THANKYOU