This document discusses root canal sealers, including their definition, requirements, functions, and classifications. It describes various common sealers such as zinc oxide eugenol sealers like Kerr Pulp Canal Sealer, Procosol, and Grossman Sealer. It also discusses non-eugenol sealers, medicated sealers, and calcium hydroxide based sealers. The document provides details on the composition, properties, advantages, disadvantages and uses of different sealers.

1. ROOT CANAL SEALERS
D.SAI

2. Introduction
Definition
Requirements of a sealer
Functions
Classification
Various sealers
Sealer extrusion
Controversies
conclusion

3. 
INTRODUCTION

4. Definition
Sealers are the binding agents use to fill up the gap between the root
canal walls and the obturating materials.
It also fill up the irregularities, discrepancies, lateral canals and
accessory canals.
(Or)
Root canal sealer is a radiopaque dental cement used usually in
combination with a solid or semisolid core material, to fill voids and
to seal root canals during obturation.

5. History
1931 – Original ZOE cement by Rickett.
1952 – Biocalex introduced by Bernard.
1955 – Scheufele introduced resin based Diaket sealer.
1956 – Grossman’s non staining ZOE formula appeared as a sealer.
1960 – Witchtelle and Lion introduced plastic material hydron.
1961 – Tubliseal was introduced with a slight modification to Ricket’s
formula.
1965 – Nyborg and Tullin formula of Kloropercha.
1973 – N2 was introduced by Sargenti.

6. 1976 – Pitford recommended endodontic glass ionomer ketac-endo as a
root canal sealer.
1985 – Browne developed calcium phosphate cement.
1990’s – Inorganic agents which have biocompatibility with biological
tissues like the bioceramics have been developed focussed mainly on
apatite type and tricalcium phosphate.
2004 – Epiphany and gutta flow

7. 
REQUIREMENTS OF
IDEAL ROOT CANAL
SEALERS1. Tacky when mixed to provide good adhesion between it and
the canal wall when set.
2. Hermetic seal.
3. Radiopaque.
4. The particles of the powder should be very fine so that they
can mix easily with the liquid.
5. Should not shrink upon setting.
6. Should not stain the tooth structure.
7. Bacteriostatic or atleast not encourage bacterial growth.

8. 8. Should set slowly.
9. Insoluble in tissue fluids.
10. Nonirritating to periradicular tissues.
11. Should be soluble in common solvent if it is necessary to remove
the root canal filling.
12. Should not provoke an immune response in periradicular tissue.
13. Should be neither mutagenic nor carcinogenic.

9. 
FUNCTIONS OF
SEALERS
1. Antimicrobial agent
2. Binding agent
3. A filler
4. A lubricant
5. Radiopacity
6. As canal obturating material

10. 
Classification
Messing Based on
composition
Eugenol
Based
Non Eugenol
Based
medicated
Silver based
Silver free
Diaket resin based
AH 26
Klor & Eucapercha
Non Eugenol, endofil,
GIC
Iodoform Paste
Ca (OH)2 paste

11. Eugenol
a. Silver containing
i.Kerrsealer (Ricket 1931)
ii. Procosol radioopaque Ag cement(Grossman 1936)
b. Silver free cement
1. Procosol non staining cement (Grossman 1958)
2. Grossman sealer (Grossman 1974)
3. Tubliseal (Kerr, 1961)
4. Wach’s paste (Wach 1925)

12. ii) Non Eugenol
Diaket
AH-26
Chloropercha + Eucapercha
Nogenol
Hydron
Endofil
Glass ionomer
Poly carboxylate
CaPO4 cements
Cyanoacrylate

13. iii) Medicated
Diaket – A
N2
Endomethasone
SPAD
Iodoform paste
Riebler’s paste
Mynal cement
Ca(OH)2 paste (Lanes 1962)
Ca(OH)2 paste (Frank, 1962)
(Biocolex)
Endofloss

14. II) According to Grossman
Zinc oxide cements
resin cements
Calcium hydroxide cements.
Paraformaldehyde cements.
Pastes.
III) According to Clarke
Absorbable
Non-absorbable
IV) According to Ingle
Cements
Pastes
Plastic

15. V) According to Harty
Zinc oxide eugenol based.
Tubliseal
Wach’s paste.
Grossman
Resin cement.
AH-26.
Diaket.
Hydron.
Gutta-percha based.
Chloropercha.
Eucapercha.

16. Dentin adhesive materials.
GIC.
Cyanoacrylate.
CaO2
PO2
Composite material.
Polycarboxylate
Materials to which medicaments have been added.
Paraformaldehyde – calcium hydroxide.
Calcibiofic (CRCS).
Sealapex.
Bicalex.

17. According to Stock
a) Zinc oxide eugenol sealers
b) Calcium hydroxide based sealers
c) Combination of zinc oxide and calcium hydroxide
material
d) Glass ionomer sealer
e) Resin based sealer
f) Silicon based sealer

18. ACCORDING TO COHEN
Specification number 57 classifies endodontic filling materials as
follows:
Type I – Cl 1, Cl 2
Type II – Cl 1, Cl 2, Cl 3

19. Type I : Sealer cements to be used with core materials.
Class 1 – Powder and liquid nonpolymerizing.
Class 2 – Paste and non-polymerizing.
Class 3 – Polymer resin systems.
Type II : materials to be used with or without core materials /
sealer cements.
Class 1 – Powder and liquid non-polymerizing.
Class 2 – Paste and paste non-polymerizing.
Class 3 – Polymers
Class 4 –Metal amalgams.

20. Nicholus – according to alphabetical order
AH-26
Diaket
Endomethasone
Grossman’s cement
Kerr Root canal sealer
Kerr Tubliseal
Klorpercha
N2

21. Factors to be considered in selection of sealers
These are determined by the need for each case
►Amount of lubrication that is needed
►Working time anticipated
►Temperature of core materials
►Irritating potential of sealer, if it escapes into periapical tissues
►Choice of intra canal irrigants and medicaments
►Antimicrobial action
►Biocompatibility

22. 
ZINC OXIDE SEALERS

23. Kerr pulp canal sealer
Based on cement described by Dixon and Ricket in 1931
Powder Liquid
Zinc oxide 34-41.2% Oil of cloves 78-80%
Precipitated silver 25-30% Canada balsam 20-22%
Oleo resins 30-16%
Thymol iodide 11-12%

24. 
Advantages
 Excellent lubricating properties.
 Germicidal and biocompatibility.
 Greater bulk than any sealer
 Prostaglandin inhibition property
Disadvantages
 Stains dentinal tubules.
 Rapid setting time
Indication
 Warm gutta-percha technique where lateral canals are present.
PCS-EWT - setting time 6 hrs

25. Manipulation
Powder contained in a pellet and liquid in a dropper bottle.
1 drop of liquid is added to one pellet of powder
Sets and is inert within 15-30 min.

26. Procosol radiopaque – silver cement
Introduced by Grossman – 1936
Composition
Powder Liquid
Zn Oxide USP 45% Eugenol 90%
Precipitated silver 17% Canada balsam 10%
Hydrogenalid resin 36%
Magnesium oxide 2%
Powder Liquid
Zno 40% Eugenol 80%
Staybelite resin 27% Sweet oil of almond 20%
Bismuth subcarbonate 15%
Barium sulphate 16%
Procosol non staining cement Grossman 1958

27. Grossman Sealer – ROTH’S 801
Revised in 1974
Composition
Powder Liquid
Zinc oxide 40 parts Eugenol 5 parts
Staybelite resin 30 parts
Bismuth subnitrate
15 parts
Barium sulfate 15 parts
Sodium borate anhydrous 1 part

28. 
Properties
 Plasticity and low setting time.
 Good sealing potential and small volumetric change on setting.
 Zinc eugenolate in decomposed by water through continuous
loss of eugenol – thus a weak unstable compound.
 Setting time 2 hours at 37°C but in root canals it begins to set
within 10-30 mins.

29. 
Disadvantage
 Resin is of coarse particle size, and may lodge on the walls of
the canal and prevent the root canal filling from seating at
correct level.
Manipulation
 Root canal cement is mixed on sterile glass slab with spatula.
 Two or 3 drops of liquid is used and slowly small increments of
cement powder is added to the liquid and spatulated to a smooth
creamy consistency.

30. 
Wach’s Sealer
Was developed by Dr. Edward Wach of the University of Illinois.
 Introduced in 1925
 Reintroduced in 1955
Composition:
Powder Liquid
Zinc oxide 10g Canada balsam 20ml
Tricalcium phosphate 2g Oil of cloves 6 ml
Bismuth subnitrate 3.5g
Bismuth subiodide 0.3g
Heavy magnesium
oxide 0.5g

31. 
Properties :
 Medium working time.
 Minimum lubricating quality.
 Minimal periapical irritation.
 Sticky, due to the presence of Canada balsam.
 Increasing the thickness of the sealer lessens its lubricating
effect, so this sealer is indicated when there is a possibility of
over extension beyond the confines of the root canal.
Indications :
Small curved canals.
In all lateral condensation methods.
Contraindication:
Heavy lubrications is needed as with short master cone.

32. 
Advantages
 It is germicidal.
 Less periapical irritation.
 It has light body, thus does not defect small G.P. cones.
Disadvantages
 Odour of liquid

33. 
Base Catalyst
ZnO 57-59% Eugenol
Bismuth trioxide 18.5-21.25% Polymerised resin
Thymol iodide 3.75-5% Annidalin
Oil + waxes 10-10%
Barium sulphate
Tubliseal
Introduced in 1961
Two paste system
Base
Catalyst

34. 
Advantages:
 Easy to mix
 Extremely lubricating
 Does not stain tooth structure
Disadvantages :
 Irritant to periapical tissues.
Setting time – 20 min on glass slab. 5 min in the root canal.
Working time - <30 min & shorter in presence of moisture.

35. 
Indications :
 When apical surgery is to be performed immediately after
filling.
 Because of greater lubricating property, it’s a good choice for
use when it becomes difficult for a master cone to reach last
millimeter of preparation.

36. 
Setting reaction of ZnO eugenol cement
Advantages:
 Sufficiently plastic
 Ease of manipulation
 Adhesion to the dentinal walls.
 Radio-opaque with some germicidal properties.
 Minimal staining.
 Ample working time.
Disadvantages :
 Irritant to periapex.
 Not easily absorbed from apical tissue.

37. Biocompatibility:
Cytotoxic
Undergo dissolution – release irritants
Inflammation in periapical area persists for years

38. CHLOROPERCHA
[chloroform + gutta percha]
Not adhesive
Increased shrinkage
Decreased radiopacity
Chloroform – potential carcinogen
EUCAPERCHA
eucalyptol
gutta percha
CALLAHAN-
JOHNSTON TECHNIQUE
[DIFFUSION TECHNIQUE]
Chloroform + rosin
gutta percha
KLOROPERKA N- Ø
chloroform + resin + zinc
oxide
gutta percha

39. 
This is a mixture of gutta-percha and chloroform.
Made by mixing white gutta-percha with chloroform.
Gutta – percha – 9.0
Chloroform – 91.0
The chloropercha paste has been used by some clinicians as the
sole canal filling material
Allows gutta – percha to fit better in the canal
Chlorpercha

40. Indications :
This technique is useful in perforations and unusually curved canals or
canals with ledge formations.
It is used in conjunction with well fitted primary cone. Chlorpercha can
fill accessory canals and root canals space.
Disadvantages:
Has no adhesive properties
1mm of chloropercha has radiodensity of 1.2 – 2.7mm of
Aluminium
Shrinkage because of evaporation of chloroform
Technique is very sensitive to proper manipulations
Chloroform
Concerns about toxicity and carcinogenicity
Known hepatotoxin

41. Modified chlorpercha methods :
Johnson – Callahan and Nygaard – Ostby
Johnston-Callahan method:
•The canal is repeatedly flooded with 95% alcohol.
•Then dried with absorbent points.
•It is then flooded with Callahan resin, chloroform solution for 2-3 minutes
(more chloroform is added if the paste becomes too thick by diffusion /
evaporation.
•A suitable gutta-percha is inserted and compressed laterally and apically
with a string motion of the plugger until the gutta-percha is dissolved
completely in the chloroform solution in the root canal.

42. •Additional points are added one at a time and dissolved in the same way.
•Extrusion should be prevented because freshly prepared chloroform is
toxic before evaporation of chloroform (as chloroform evaporates – it
shrinks and apical seal is lost).
NYGAARD OSTBY
•The canal walls are coated with kloroperka the primary cone dipped in
sealer is inserted apically.
•Pushing partially dissolved tip of the cone to its apical seal.
•Addition cones dipped in sealer are packed into the canal to obtain
satisfactory filling.
•FDA has banned the use of chloroform since it has a carcinogenic
potential.

43. This formula was suggested by Nyborg and Tullin in 1965.
Kloroperka N-O sealer
Powder Liquid
Canada balsam 19.6% Chloroform
Resin 11.8%
Gutta-percha 19.6%
Zinc oxide 49%
The powder is mixed with liquid chloroform, after insertion chloroform
evaporates leaving voids. It has been shown to be associated with a greater
degree of leakage than other materials.
NON-EUGENOL CEMENT

44. EUCAPERCHA:
•By Buckley
•Eucalyptol does not dissolve gutta percha rapidly as does chloroform
•Replaced chloropercha because chloroform considered a potential carcinogen
•Is a paste made by softening surface of gutta –percha in warm oil of
eucalyptus (eucalyptol)
•The softened gutta – percha used to coat the canal wall with a thin film of
eucapercha
•Same cone inserted and compressed with pluggers to the apical juncture
•Disadvantages
Difficult to avoid overfilling the canal
If extruded, acts as an irritant initially

45. Nogenol:
To overcome the properties of Eugenol
Base Accelerators
ZnO Hydrogenated rosin methyl acetate
Barium sulfate lauric acid
Salicylic acid
Chloethymol
Cytotoxic in cell culture
Neurotoxic – total inhibition of the action potential

46. 
CALCIUM HYDROXIDE
SEALERS

47. Calcium hydroxide has been used in endodontics as a root-canal
filling material, intra canal medicaments or as a sealant in conjunction
with solid core materials, such as gutta-percha.
The use of Ca(OH)2 paste as a root-canal filling material is based
on the assumption that there is formation or hard structures or
tissues at the apical foramen.
The alkalinity of Ca(oH)2 stimulates the induction of mineralized
tissue.

48. Calcium hydroxide and/or calcium hydroxide sealers can:
• Induce mineralization
• Induce apical closure via cementogencsis
•Inhibit root resorption subsequent to trauma
•Inhibit osteoclast activity via an alkaline pH
• Seal or prevent leakage as good as or better than ZOE sealers
• Less toxic than ZOE sealer.
An endodontic sealer based on calcium hydroxide must dissolve and
the solid consequently lose content. Thus one major concern is that
the calcium hydroxide content may dissolve, leaving obturation void.

49. 
CRCS:
 Introduced in 1982
 Termed the calcibiotic root canal sealer was the first
of the calcium hydroxide based sealer.
 Is a zinc oxide eugenol eucalyptol sealer to which
calcium hydroxide has been added for its osteogenic
effect.
Composition
Powder Liquid
Zinc oxide Eugenol
Hydrogenated rosin Eucalyptol
Barium sulfate
Calcium hydroxide
Bismuth dioxide

50.  It is mixed like any other powder:liquid sealer sets both in dry
and wet canals.
 Ca(OH)2 + Eucalyptol  osteogenic effect
 It takes 3 days to set fully in either dry or humid environment,
shows little water sorption which makes it stable and improves
its seal and quality.

51. 
Sealapex : (Kerr)
 Non eugenol calcium hydroxide polymeric resin root canal sealer.
 It is delivered as paste to paste formulation.
Composition :
BASE
 ZnO with Ca(OH)2,
 Butyl benzene,
 Sulfonamide and
CATALYST
 Barium sulfate,
 Titanium dioxide as radioopacifiers with proprietary resin
 Isobutyl salicylate and
 Acrocil R 972.
 Zinc stearate

52. PROPERTIES:
Has poor cohesive strength
Easily disintegrate in the tissue and causes chronic inflammation
Claims of therapeutic effect
Takes a long time to set
Absorbs more water (may be due to its porosity) and expands while
setting

53. 
Biocalex :
Developed and introduced by Bernard in
1952.
Composition
Powder Liquid
Heavy calcium oxide Glycol
Zinc oxide Water

54. 
 Powder and liquid are mixed to form a paste.
 Progressively expands to more than 6 times its original volume.
 So it is not necessary to prepare the root canal prior to root
canal filling.
 Calcium oxide and water react within the tooth to form the
calcium hydroxide which ionizes to release OH ions.
 These OH ions decomposes necrotic pulpal tissue to form water
and carbondioxide.

55. 
Life
 Calcium hydroxide liner and pulp capping material similar in
formulation to seal apex.
Vitapex
 Introduced by Japanese researcher
 Calcium hydroxide sealer containing 40% iodoform, also
contain silicon oil.
Advantage
 Iodoform a known bactericide is released from the sealer to
suppress any lingering bacteria in the canal or periapex.

56. 
Concerns over calcium
hydroxide sealers
Based on current information in the literature, it can be concluded
that in terms of leakage, calcium hydroxide–based sealers are not
superior to other groups of sealers
Calcium hydroxide–based sealers had a statistically insignificant
association to the rapid healing of apical periodontitis
The limited antibacterial activity of calcium hydroxide sealer might be
attributed to a lack of sufficient pH elevation, limited solubility, and
diffusibility of calcium hydroxide into dentinal tubules - possibly
buffering ions present in the tubules

57. 
Resin based sealers

58. POLYKETONE BASED SEALER
DIAKET:
Diaket is a polyvinyl resin (Polyketone), a reinforced chelate formed
between zinc oxide and diketone.
It was introduced in Europe by Scheufele in 1952.
It’s a Modified zinc oxide cement widely used in Europe either with gutta
percha or alone as a paste fill material.

59. COMPOSITION
►POWDER
Zinc oxide
Bismuth phosphate.
►LIQUID
►Propionylacetophenone (B-diketone)
►Copolymers of vinylacetate, vinyl chloride and vinyl isobutyl ether
►Triethanolamine
►Caproic acid
►Dichlorophen
Diaket consists of a fine, pure white powder and a viscous, honey colored
liquid. Two drops of liquid are mixed with one scoop or powder.

60. PROPERTIES
►Powder: Liquid ratio – 1:2
►Very tacky material- difficult to manipulate
►Good adhesion
►Sets quickly in the root canal at room temperature (3-4 min)
►Good volume stability
►Low solubility
►Superior tensile strength
►Is highly toxic and causes extensive tissue necrosis
►Irritation is long lasting.
►Has a greater tendency towards fibrous encapsulation if extruded.
DIAKET A:
Diaket A is a polyvinyl resin in a polyketone vehicle.
Chemically this sealer is similar to diaket but it also contains the disinfectant
hexachlorophene.
Diaket is one of the few medicated cements, which does not contain
paraformaldehyde.

61. EPOXY BASED SEALERS
AH - 26: (Dentsply/ deTrey, Zurich):
This is an epoxy resin recommended by Shroeder in 1957.
Epoxy resin based sealers are characterized by the reactive epoxide ring
and are polymerized by the breaking of this ring.
Feldman and Nyborg gave the following composition.
Powder:
Bismuth oxide 60%
Hexamethylene tetramine 25%
Silver powder 10%
Titanium Oxide 5%
Liquid:
Bisphenol A diglycidyl ether.(BADGE)

62. Derives its name from
A- Aethoxylinharz (German) for ethoxyline base
H- Hexamethylene tetramine
26- Was the test number
Properties:
1. It has good adhesive property.
2. It has good flow
3. Antibacterial
4. It contracts slightly while hardening
5. Low toxicity and well tolerated by periapical tissue.
6. Has good handling characteristics
7. Can be warmed on a glass slab over an alcohol flame to decrease
viscosity.

63. AH 26 consists of a yellow powder and viscous resin liquid and is mixed
to a thick creamy consistency.
The setting time is 36 to 48 hours at body temperature and 5-7 days at
room temperature
The long setting time and material fluidity results in no cracking or rapid
separation from dentinal walls.
AH26 produces greater adhesion to, dentin especially when smear layer is
removed. Smear layer removal exposes the dentinal tubules creating an
irregular surface thus enhancing adhesion.

64. AH Plus:
AH Plus is a two-component paste: root canal sealer based on epoxy- amine
resin chemistry.
This easy-to-mix sealer adapts closely to the walls of the prepared root canal
and provides minimal shrinkage upon setting as well as outstanding long-
term dimensional stability and sealing properties.
Composition:
AH Plus Paste A:
BADGE
Calcium tungstate
Zirconium oxide
Silica
Iron oxide pigments
AH Plus Paste B:
Adamantane amine
(N,N-dibenzoyl-5-oxanonane-diamine-I.9-
TCD-diamine)
Silica
Silicone oil

65. The working time is at minimum 4 hours at 23 0c
The setting time is at minimum 8 hours at 37 °c
Advantages:
Excellent biocompatibility
User-friendly handling and application
Optimal working time and easier removal
Outstanding physical properties
Excellent radiopacity
Suitable for all root canal obturation techniques.

66. Adverse reactions:
With sealers containing epoxy resins, the following adverse
reactions were reported:
•Reversible acute inflammation of the oral mucosa after contact
with the unset paste.
•In individual cases, local and systemic allergic reactions have been
reported.

67. AH-26
 Powder-liquid system
 When freshly prepared releases small
amounts of formaldehyde
 Antibacterial
 Toxic
► Staining
► Film thickness-39µ
good flow
► Sets slowly in 24-36 hours
► Is not sensitive to moisture and has low
solubility
AH-PLUS
 Paste –paste system
Less toxic
New amines added to maintain the natural
colour of the tooth
Half the film thickness
Better flow
► Shorter setting time of 8 hours
► Has half the solubility of AH-26

68. 
Methacylate resins added to the sealers.
4 generations:
1st generation – Hydron
2nd generation – Endorez
3rd generation – Fiberfil, Epiphany
4th generation - Metaseal
Methacrylate based
sealers
J Endod 2010

69. Creation of a solid, bonded, continuous material from one dentinal wall of the
canal to the other such that it perfectly seals without forming any gaps or
voids

70. 
Hydron :
 Introduced by Wichterle and Lim in 1960
 Rapid setting hydrophilic, plastic material used as a root
canal sealer without the use of a core.
 Hydron is a polymer of hydroxy ethyl methacrylate.
 It is available as air injectable root canal filling material.
Require the use of special syringe and needle.
 Working time is 6-8 minutes.
 Setting time is 10 minutes.
Advantages:
 Biocompatible material that confirms to the shape of the
root canal because of its plasticity.

71. 
Disadvantages:
 Syringe method makes it difficult to control placement of gel
accurately.
 Radiopacity is very low, this complicates the radiographic
observation of an overfill.
 Several investigators have indicated that overfilling with hydron
causes long-term periapical inflammation so tissue tolerance of
hydron is controversial.
 It cannot be removed from the canal, retreatment is difficult.
 Pyner reported a case of Parasthesia from overfilling of lower
molar.

72. ENDO REZ (Ultradent Products, South Jordan, UT)
Hydrophilic, non etching dual cure radiopaque sealer
Supplied in a Two-Spense mixing and delivery syringe
COMPOSITION
►Zinc oxide
►Barium sulfate
►Resins
►Pigments
In a matrix of urethane dimethacrylate resin

73. PROPERTIES
Has radiopacity similar to gutta percha cones
Does not compromise the use of dentin bonding agents
Preliminary observations
Excellent sealing properties
Good adaptation to the root canal walls in the presence of moisture
Effective penetration of material into the dentinal tubules
Stayed soft and plastic for a long period of time.

74. EPIPHANY ROOT CANAL SEALER (Pentron Clinical Technologies)
•Is a dual-curing, hydrophilic resin sealer
•Used with Resilon core materials
•Dispensed from a double barrel, auto-mix syringe
►for greater ease of use .
►accurate mixing

75. Composition
Resin matrix
►Mixture of Bis GMA
►Ethoxylated Bis GMA
►UDMA
►Hydrophilic difunctional methacrylates
Fillers
►Calcium hydroxide
►Barium sulfate
►Barium glass
►Silica
Total filler content
►70% by weight
Epiphany Primer/adhesive
Self-etch primer
Contains
sulfonic acid terminated
functional monomer
HEMA
Water
polymerization initiator

76. Properties
Bonds to both the Epiphany Primer and Resilon obturating material
can be light cured for an immediate coronal seal
self cures apically in 25 minutes
shrinks 2-3% on polymerization
highly radiopaque
easy to remove
Resorbable
less irritating than epoxy resin or ZOE sealers

77. Advantages
Adheres to the sealer
Excellent sealing capability due to creation of a “monobloc” which
adheres to the dentin walls
Provides an immediate coronal seal
Shrinks only 0.5% even heated
DISADVANTAGES:
Polymerization shrinkage
Cytotoxic when extruded
Water sorption leads to disruption of bonds
Bond strength lesser than conventional GP/sealer

78. 
Glass Ionomer Sealer
 Recommended by Pittford in 1970.
reintroduced by Ray and seltzer in 1991
 Marketed as Ketac Endo.
 During setting they form a hard
polysalt gel which adhere tightly to
dentine, because of their adhesive
qualities, they can potentially be used
as root canal sealers.
 It can be triturated and injected in the
root canal.

79. 
Advantages :
 It has good physical properties.
 Initial good bonding to dentin.
 Few voids.
 Low toxicity.
Disadvantages :
 Difficult to remove.
 Retreatment is difficult

80. 
Poly carboxylate cement:
Composition
 Powder Liquid
 Zinc oxide Polyacrylic acid

Properties
 Chelating action, bonding to both enamel and dentin.
Because of its adhesive and antibacterial properties, the
cement has been tested as a root canal sealer.

81. 
Advantages :
 It bonds well to dentin.
 Antibacterial property.
 Compounds like fluoride and calcium hydroxide can be added.
Disavantages :
 Special plastic plugger is required for insertion since it has great
adhesiveness to steel instruments.
 Apical seal is found to be inferior to other sealers.
 Exhibits inflammatory response when extruded out of the apex.

82. 
Riebler’s paste
Powder Liquid
Zn oxide Formaldehyde
Formaldehyde Sulfuric acid
Barium sulfate Ammonia
Phenol Glycerine
MEDICATED CEMENTS
Paraformaldehyde based
Composition:

83. 
Mynol cement
Powder Liquid
Zn oxide Eugenol
Iodoform Creosol
Resin Thymol
Bismuth subnitrates
Used without core materials,
Introduced into the root canal by means of either a lentulospiral or some
type of injection device.
Iodoform based
Composition:

84. 
N2
 Introduced by Sargenti in 1961
 N2 refers to the so called second nerve.
Initially 2 different types of N2 sealers were available :
 N2-Normal – Used for root filling.
 N2-Apical – Used for antiseptic medication of canal.
 Recently N2-‘Universal’ a cement containing the features of
both N2-Normal and N2-Apical has been introduced. The
formula has been altered by removing hydrocortizone,
prednisolone and barium sulfate

85. 
Composition of N2-Universal
Powder Liquid
Zinc oxide 68.51g Eugenol
Lead tetroxide 12g Cleum Rosea
Paraformaldehyde 4.7 Cleum Lavandular
Bismuth subcarbonate 2.60g
Bismuth subnitrate 3.7g
Titanium dioxide 8.4g
Phenyl mercuric
borate
0.09 g

86. Coagulation necrosis
reaches max. in 3 days
tissue is unable to undergo repair for months due to formaldehyde
impregnation
with time formaldehyde washes away
bacteria re-establishes or repair
if blood supply is good
seen as localized inflammatory reaction

87. 
Toxicity :
 Degree of irritation is severe when overfilling with N2 is
forced into the maxillary sinus or mandibular canal
persisting paraesthesia was observed.
 Blood lead level is increased after the insertion of root
filling.
Effectiveness of sealers :
 Apical seal with N2 is better when compared to procosol,
nogenol, tubliseal and diaket.

88. 
Endomethasone :
 The formulation of this sealer is very similar to N2 composite.
 Pink antiseptic powder
Composition
Endomethasone root canal sealers give rise to pain or discomfort
after 6-8 weeks of insertion. This occurs because corticosteroids
masks any inflammatory reaction until it is removed from the
area.
Powder Liquid
Zinc oxide 100g Eugenol
Bismuth subnitrate 100g
Dexamethasone 0.019g
Hydrocortisone 1.6g
Thymol iodide 25.0g
Paraformaldehyde 2.20g

89. 
SPAD :
One visit non irritant radioopaque filler and sealer.
 It is a resorcinal formaldehyde resin supplied as a powder
and two liquids.
Composition
Powder Liquid (Clear)
ZnO 72.9g Formaldehyde 57.0g
Barium sulfate 13.0g Glycerine 13.0g
Titanium dioxide 6.30g
Paraformaldehyde 4.70 Liquid (Red)
Hydrocortizone acetate 2.00g Glycerine 55g
Calcium hydroxide 0.44g Resorcinal 25g
Phenyl mercuric borate 0.16g Hydrocloric acid 20g

90. 
Manipulation
 Equal parts of the 2 liquids are mixed with the powder. The
essential reaction to form the resin is between the resorcinal and
the formaldehyde.
 Setting time of SPAD is 24 hrs.
Indications :
 Pulpotomies in both deciduous and permanent teeth.
 For treatment of acute endo infection.
 Teeth with periapical areas.
 When SPAD is used in treatment of periapical infection a small
amount is intentionally introduced beyond the apex with the
belief that sterilization helps healing.

91. SILICONE-BASED ROOT
CANAL SEALERS
Silicone is inert and biocompatible and has been widely used in medicine as
an implant material. Silicone-based root canal sealers are now available.

92. Endofill ( Lee Endofill ):
Injectible silicon resin sealer
Used with / without core material
Least non toxic – least irritating sealer
Base Catalyst
Bi subnitrate Tetraethylorthosilicate
Hydroxly dimethyl poly siloxane
Benzyl alcohol
Polydimethylsiloxane
Sets to a rubbery solid similar to gutta percha

93. Adv:
Ease of preparation
Adjustable WT- Setting time can be adjusted from 10-60 min
Low working viscosity
Easy to remove - due to rubbery consistency
Disadv:
Cannot be used with H2O2 – canal should be dried
Shrinks on setting – but has affinity to flow in open tubules
Endo-fill's bonding ability to the canal walls decreases if it is not used
within about 20 min of mixing.

94. ROEKOSEAL:
•Is a polydimethyl siloxane based root canal sealer
Composition:
Polydimethylsiloxane
Silicone oil
Paraffin-base oil
Hexachloroplatinic acid
Zirconium dioxide
Properties:
Flow properties: RoekoSeal has excellent flow properties. RoekoSeal easily
spreads throughout the canal, sealing all areas.
Insolubility: Most standard toot canal sealers are soluble to varying degrees.
RoekoSeal provides an insoluble sealer for long lasting, reliable root canal
obturation.

95. Dimensional stability: RoekoSeal does not shrink but actually expands
slightily (0.2%). provides excellent seal against bacteria.
Biocompatibility: Standard sealers show toxicity ranging from “slight"
through "medium" to "severe". Cell tests, tests for mutagenic effects and
sensibilisation tests all showed negative results with RoekoSeal. RoekoSeal
is extremely biocompatible.
►Less cytotoxic than Kerr’s pulp canal sealer
Al – Awadhi et al 2004

96. Does not contain eugenol
It is highly radiopaque for an excellent x-ray evaluation.
No antibacterial activity
Cobankara et al 2004
RoekoSeal is available
►Automix syringe
one double-barrel syringe
12 flexible mixing tips
►Single Dose package

97. 
It is the first sealer guttapercha combination that is flowable at room temperature.
The guttapercha powder is extremely fine with particle size <30µ.
Nanosilver provides a preservative effect.
Composition:
 Polydimethylsiloxane
 Silicone oil
 Paraffin oil
 Platinum catalyst
 Zirconium dioxide
 Nano-silver
 Gutta-percha powder
It is packaged in inidividual use capsules that provides a safe, simple and hygienic
delivery procedures
Gutta Flow

98. 
MTA based sealers
Endo-CPM-Sealer, MTA Obtura and ProRoot Endo Sealer
The composition of CPM sealer is reported
to be
50% MTA (SiO2, K2O, Al2O3, SO3 , CaO and Bi2O3), 7% SiO2,
10% CaCO3,
10% Bi2O3,
10% BaSO4,
1% propylene glycol alginate,
1% propylene glycol, 1%sodium citrate and
10% calcium chloride

99. Sealers based on MTA have been reported to be biocompatible, stimulate
mineralization (Gomes-Filho et al. 2009), and encourage apatite-like
crystalline deposits along the apical and middle thirds of canal walls
(Weller et al. 2008)
These materials exhibited higher push-out strengths than Pulp Canal
Sealer (PCS) particularly after storage in simulated body fluid
(Huffman et al. 2009)
Similar sealing properties to epoxy resin-based sealer when evaluated
using the fluid filtration system (Weller et al. 2008).

100. 1. Apatite rot canal sealers
2. Root canal sealer containing tetra calcium – dicalcium
phosphate & 1%Chondroitin sulphate
3. Unfilled Bis-GMA resin sealers

101. 
Appetite Root Canal Sealer
 Composed of hydroxyapatite and tricalcium phosphate.
 3 types.
Type I
 Powder
 Tricalcium phosphate – 80%.
 Hydroxy apatite – 20%.
 Liquid
 Polyacrylic acid – 25%.
 Water – 75%.
This is used for vital pulpectomy.
Tricalcium based Sankin apatite root canal
sealer

102. 
Type II
 Powder:
 Tricalcium phosphate – 52%.
 Hydroxyapatite – 14%
 Iodoform – 30%.
 Liquid
 Polyacrylic acid – 25%
 Water – 75%
Used in infected canals

103. 
Type III:
 Powder
 Tricalcium phosphate – 80%.
 Hydroxyapatite – 14%
 Iodoform – 5%
 Bismuth subcarbonate – 1%
 Liquid:
 Polyacrylic acid – 25%
 Water – 75%
 Used in cases of accidental perforation and retrograde
filling material.

104. Adv:
Biocompatible
Osteogenic potential
Low tissue toxicity
Disadv:
Sets quickly
Low radiopacity
Low wetting ability

105. Newly Developed Calcium Phosphate type Sealers:
1. Tetracalcium Phosphate (TeCP)
2. Dicalcium Phosphate Dihydrate (DCPD)
3. TD Modified MC Ivain’s & Buffer Solution (TDM)
4. TDM – S – Buffer Solution + 2.5% Chondroitin Sulphate

106. Powder Liquid
Tetracalcium Phosphate Citric Acid
Dibasic Calcium Phosphate Dibasic sodium Phosphate
Chondroitin Sulphate
Distilled water
Excellent biocompatibility – no periapical reaction seen
Chondroitin – promotes wound healing
TDM –S

107. 
SEALER PLACEMENT
1. Coating the master cone and placing the sealer in the canal with a
pumping action.
2. Placing the sealer on the final file used at the corrected working
length and turning the file counterclockwise.
3. Placing the sealer in the canal with a lentulo-spiral drill.
4. Injecting the sealer with special syringes.

108. ROTARY OR SPIRAL PASTE FILLERS
Used for
placing initial sealer with solid core materials
Completely filling the canal with paste filling
Designed
►To be used in slow speed contra angle headpiece
►Can also be turned clockwise between fingers
Basically 2 designs in use

109. 
Coiled wire
 Have long been used to
place final cements and
pastes
 High risk of fracture
 Should only be used for
inserting provisional
dressing
Twisted blade
 Stronger rectangular
blade
 Has more metal in cross
section
 Less prone to fracture

110. Lentulo spirals available for hand use - More chances of sealer extrusion
OTHER DEVICES:
Used in a rotary motion:
GUTTA CONDENSER (Maillefer)
ULTRASONIC FILE (without coolant)
K-FILE rotated counterclockwise
Used in a non-rotary motion:
SYRINGES
VACCUM (Lussi et al 1994)

111. Anatomic considerations – open apex, resorbed ape
Techniques of BMP – disruption of Apical constriction ?
Misfit of GP master cone
Pressure applied while Obturation
Consistency of Root Canal Sealer
Setting time of the Sealer

112. Resorbability of the Sealer
Amount of Sealer extruded
Individual patient response
Blood supply of the area
Extent of Pathology present at the Local site
Corrective / Surgical corrective measures employed

113. 
Controversies in sealer
Removal of smear layer is necessary
Monobloc effect??
Technique of placement of sealer

114. 
 Acceptable root canal sealer -- producing a seal while being well
tolerated by periapical tissues.
 All the sealers -- good sealing abilities but none of them produce a
leak proof seal.
 All of them produce some degree of periapical inflammation,
ranging from mild to severe, in the initial few days after obturation.
 Most root canal sealers --of zinc oxide eugenol cement or resin
 Many of the other sealers like glass ionomer, AH-26, life, diaket,
hydron etc have tested for their sealing efficiency but none of them
have showed cent percent results.

115. 
 Fortunately, the inflammatory process does appear to resolve
completely and healing follows.
 Adhesive obturating materials are in the early stages of
development.
 Current research on inorganic agents, which have the compatibility
with biological tissue, the bioceramics i.e. hydroxyapatite sealers
have been encouraging results
 Although none of the current materials appear to offer a big
advantage over traditional obturating materials, none are likely to
come to a disastrous end.
 However, continued research and development is likely to result in
improvements and in new, more effective materials.

116. 
Conclusion
With so many Sealers available to the dentists these days, it
becomes a part of clinical judgement as to use which Sealer
in a particular clinical situation.

117. 
 Endodontics: Ingle, obturation of radicular space. 5th and 6th edition
 Pathways of pulp: Cohen, 10th edition
 Endodontic therapy: Weine, canal filling with semisolid materials.
 Grossman’s Endodontic practice, obturation of the root canal, 12th
edition
 Restorative dental materials: Craig, cements.
 Richard S. Schwartz: adhesive dentistry and endodontics- a review, JOE,
December 2006, 1125-1133.
 Ashraf El Ayouti et al.: homogeneity and adaptation of a new gutta
percha paste to the root canals, JOE, September 2005,687-690.
REFRENCES

118.  Critical review on methacrlate resin based root canal sealers. Y K KIM
et al..J Endod vol 36,no.3 pg 383-399
 Adhesive dentistry and endodontics. Schwartz RS. J Endod
2005;31:151-65
 Dynamic sealing ability of MTA root canal sealer
J. Camilleri. International Endodontic Journal, 44, 9–20, 2011
 Monoblocks in Root Canals: A Hypothetical or a Tangible Goal
.Franklin R. Tay. J Endod 2007;33:391–398
 A review of a resin-based root canal filling material Cora Hiu-Wan Ko
, Hong Kong Dental Journal 2008;5:38-44
 Calcium Hydroxide–Based Root Canal Sealers: A Review
Shalin Desai. (J Endod 2009,1–6)

119. 