The document discusses various root canal sealers, highlighting their advantages, disadvantages, compositions, and applications in endodontics. Different types of sealers such as polycarboxylate cement, cyanoacrylic cements, and calcium hydroxide sealers are analyzed for their bonding properties and biocompatibility. Additionally, newer sealers, including Endofloss and appetite root canal sealer, are introduced, emphasizing their settings, potential irritations, and effects on periapical tissues.

1. Advantages
1. Good physical properties.
2. Good bonding to dentin.
3. Good flow properties.
4. Few voids.
5. Less cytotoxic
Disadvantages:
It cannot be removed in the even of re-treatment. However recent
studies shown that GIC can effectively removed by chloroform solvent
followed by 1 minute ultrasonic instrumentation.
Polycarboxylate cement:
Consists of modified zinc-oxide powder and an aqueous solution of
polyacrylic acid. The cement has chelating action bonding to both enamel
and dentin. Because of its adhesive property and antibacterial action of this
cement has be tested as root canal sealer. However apical seal is found to
be inferior to other materials. It exhibits an inflammatory response when
extruded into periapical tissue.

2. Cyanoacrylic Cements:
These are composite type polymers that can be polymerized to hard
products by the use of basic inorganic material that also serves as filled.
They have been reported to be bio-compatible but not in much use.
Medicated cement:
The medicated sealers consists of paraformaldehyde, iodoform,
calcium hydroxide or other powerful antiseptics. They fail to provide a
compact root canal filling, but prolonged therapeutic effect.
Riebler’s paste : Paraformaldehyde based.
Powder / Liquid formulations:
Powder :
Zinc oxide.
Formaldehyde
Barium sulphate.
Phenol.
Liquid:
Formaldehyde
Sulphuric acid.
Ammonia
Glycerine.

3. Mynol cement: Iodoform based
Powder:
Zinc oxide
Iodoform
Rosin
Bismuth Subnitrate
Liquid
Eugenol
Cresol
Thymol
These materials are used without core materials and are introduced
into root canal by lentulospiral or some type of infection device.
Paraformaldehyde containing paste exhibits severe inflammatory reaction
and tissue necrosis. Hence it is used as a sealer is restricted.
Paraformaldehyde
N2 : Was introduced by Sargenti and Ritcher in 1961. Two type of N2
sealers were available initially i.e.:
N2, Normally for root filling and
N2, Apical as antiseptic medication.

4. Recently N universal a cement containing the feature of both N2
normal and N2 apical has been developed for endodontic use.
Composition:
Powder:
Zinc oxide
Lead tetraoxide
Paraformaldehyde
Bismuth subcarbonate
Titanium dioxide
Bismuth subnitrate
Phenyl mercuric borate
68.51 gms
12 gms
4.70 gms-Antiseptic
2.60gms – Opacifier
8.40gms- Adhesion
3.70gms – Opacifier
0.05 gms - Antiseptic
Liquid:
Eugenol
Oleum Roae
Olum Lavandulae
Corticosteroids are now added separately as hydrocortisone powder.
Severe irritation is its major drawback of N2. Increased blood lead level
absorbed after N2 insertion.

5. Endometasone : Powder / Liquid
Powder:
Zinc oxide
Bismuth subnitrate
Dexamethasone
Thymol iodide
Paraformaldehyde
100gms
100gms
0.019gms
25 gms
2.20gms
Liquid
Eugenol
The powder is pink coloured and mixed with eugenol to thick
consistency. It exhibits severe irritation and masks the inflammatory
reaction. Therefore sometimes gives rise to pain after 6 to 8 hours of
insertion.
Spad :
This material is advertised as a one visit non-irritant, radiopaque
filler and sealer. It is a resorbinol formaldehyde resin supplied as a powder
and 2 liquid.
Powder :
Zinc oxide 72.9gms
Barium sulphate

6. Titanium dioxide
Paraformaldehyde
Hydrocortizone acetate
Calcium hydroxide
Phenyl mercuric borate
Liquid L : (Clear liquid)
Formaldehyde 87.00 gms
Glygerin 13.00gms
Liquid LD : (Red colour)
Glycerine 55gms
Resorcinol 25 gms
Hydrochloric acid 20 gms
Equal parts of the 2 liquids are mixed with powder. The essential
reaction to form the resin is between the resorcinol and the formaldehyde.
To take place this reaction and pH is essential which is provided by Hcl.
The role of zinc oxide is to control the pH and to prolong the setting time.
The setting time of SPAD is 24 hours, during which small quantities of
formaldehyde gas is released.

7. Indications:
1. Pulpotomies in both deciduous and permanent teeth.
2. For the treatment of acute endodontic infections.
3. Teeth with periapical infections.
When SPAD is used in the treatment of periapical infection, a small
amount is intentionally introduced beyond the apex with the belief that the
sterilizing effect helps healing.
Calcium Hydroxide has been used in endodontics as a root canal
filling material, in intracanal medicament or as a sealant in conjugation
with solid core materials. Pure Ca(OH)2 can be used or can be mixed with
saline solution, methylecellulose or anesthetic solution. However pH of all
these mixtures has found to be between 12.5 to 14.5.
The use of Ca(OH)2 paste, as a root canal filling material is based
on the assumption that, there is formation of hard structure or tissue at the
apical foramen. Ca(OH)2 neutralizes the acids produced by bacteria and
thereby decreasing the osteoclastic activity. The activity of Ca(OH)2
stimulates the induction of alkaline phosphate thus forming the hard tissue.
Ca(OH)2 sealers may contain soley of Ca(OH)2 or it is combined
with zinc oxide. E.g., Sealapex, Apexit, CRCS. Procalex. Life Sealer 26.

8. Sealapex:
Is a product of Kerr manufacturing company has been described as
non eugenol Ca(OH)2 polymer resin root canal sealer.
Composition : It is a 2 paste formulation.
Base paste:
Zno with Ca(OH)2
Butyl Benzine.
Sulfonamide
Zinc Stearite and sumicron silica.
Catalyst
Barium sulphate
Titanium dioxide
Isobutyl salysilate
Acrocil R 972
Two pastes are dispensed equally on mixing pad and mixed to a
smooth, uniform consistency. It never sets on dry atmosphere which makes
the presence of moisture essential for setting of sealapex. In 100% it takes
3 weeks to reach a final set. Sealapex expands while setting. It is
biocompatible and shows good osteogenic potential.

9. CRCS (Calcibiotic Root Canal Sealers):
It is the first sealer of the Ca(OH)2 group. It is basically a zinc oxide
eugenol eucolyptol sealer to which Ca(OH)2 has been added for its
osteogenic effect.
Composition : Powder / Liquid system).
Powder :
Zinc oxide
Hydrogenated Rosin.
Barium sulphate
Calcium hydroxide
Bismuth subcarbonate
Liquid L :
Eugenol
Eucalyptol
CRCS is mixed like any other powder-liquid sealers. It sets both in
dry as well as wet conditions. It shows very negligible water sorption,
hence more stable, when compared to sealapex and other resin based
sealers.
Biocalex : Is another Ca(OH)2 based sealer consists of :

10. Powder:
Calcium hydroxide
Zinc oxide
Liquid :
Glycol
Water
Powder and liquid when mixed to form a paste acts as both
intracanal medicament and as a sealer. After placement in the prepared
cavity, it expands to more than 6 times is original volume, penetrating into
all parts of root canal system.
Iodoform pastes :
Is a resorbable paste used alone or in combination with other core
materials. It consists of:
1. 60 parts of iodoform.
2. 40 parts of solution of Parachlorophenol
3. 49% Camphor (antiseptic solution).
4. 6% menthol (antiseptic solution).
Iodoform paste is intentionally placed beyond the apex to stimulate
the inflammatory reaction, the end result of which is repair. It also

11. accelerates the bone formation. The paste in periapical region is removed
by phagocytic action and slowly disappears with time.
The disadvantage of iodoform paste is that it induces severe
inflammatory reaction and with time discoloration, the tooth if not
removed from the pulp chambers. The introduction of iodoform paste into
the root canal may lead to rise in the iodine level in blood, hence
contraindicated in patients who are sensitivity to iodine.
Newer sealers:
1. Endofloss.
2. Appetite Root canal sealer.
3. Root canal sealers containing Tetra-calcium – Dicalcium phosphate
and 1% chondrotin sulphate.
Endofloss:
Endofloss is a sealer consisting of powder liquid formulation.
Powder:
Zinc oxide.
Iodoform
Calcium hydroxide.
Barium sulphate.

12. Liquid:
Eugenol
Parachlorophenol
It is a zinc oxide based medicated cement. Mixing is similar to that
of procosol (zinc oxide sealer). Setting time is approximately 30-45
minutes. Relatively biocompatible. It also a absorbable sealer.
It induces severe inflammatory reaction in 48 hours and gradually
reduced after 3 months. Cytotoxicity was observed along with coagulation
necrosis which is attributed in the presence of iodoform parachlorophenol.
Appetite root canal sealer
One of the recently introduced sealers.
Powder and Liquid Combination
Powder:
α-tricalcium phosphate.
Hydroxyl apatite
Iodoform
Bismuth subcarbonate
Liquid:
Polyacrylic acid.

13. Distilled water.
3 types – Type I, Type II and Type III
1) Type I : AR used for vital pulpectomy. Type II –30% iodoform used
in infected canals that has radiopacity, bactericide and bone
invigoration effects. Type III – in between cases which contains a
5% of iodoform. It can be also used in the treatment of accident
perforation, as a retrograde filling material.
Advantages Disadvantages
1. Biocompatible Sets quickly, hence multiple mix essential.
2. Osteogenic potential Low radiopacity
3. Low tissue toxicity Low wetting ability.
Newly Developed Calcium Phosphate type Sealers are:
a. Tetracalcium phospate (TeCP)
b. Dicalcium Phosphate Dihydrate (DCPD).
c. A modified McIIvain’s and Buffer solution (TDM).
d. TDM-S-Buffer solution + 2.5% Chondroitin sulphate.

14. Composition : Powder and liquid systems
TDM-S TDM
Powder
Tetracalcium phosphate
Dibasic Calcium phosphate
Liquid
Citric acid
Dibasic sodium phosphate
Chondroitin sulphate.
Distilled water
Tetracalicum phosphate
Diabasic calcium phosphate
Citric acid
Diabasic sodium phosphate
Chondroitin sulphate
Distilled water
Studies have shown excellent biocompatibility.
No periapical inflammatory reaction seen.
Chondrotin and other ingredients said to promote wound healing.
Application of a Root canal sealer
RCS may be placed in the canals either by lentulospirals or by
Reamers and files. Lentulospiral is made up of fine wire spiraled into the
shape of a reverse spiral. It can be used by finger or attached to hand piece.
When spiral turned clockwise it carries cement apically. It should not be
used in narrow canal for the reason that if binds result in breakage. It tend

15. to push cement outside the canal when used with handpiece and may set
too rapidly as a result of its whipping action.
Whatever may be the means of application it should be coated
uniformly along the canal walls (Coating the mater cone and accessory
cones with sealers is recommended as it reduces the voids and irregularities
within the canals.