Ideal requirements, core materials (Solid, semisolid and paste), and sealers

1. Dr. Deepthi P.R.
3rdYear MDS
Dept. of Conservative Dentistry & Endodontics

2.  Amalgam
 Asbestos
 Balsam
 Bamboo
 Cement
 Cu, Fe, ZnOCl, Au or Sn foil, Ag points
 Pastes
 PoP
 Resin
 Rubber

3. Obturation of Root canal systems- Endodontics : Colleagues of Excellence, Fall 2009

4.  2 basic groups
 Core filling materials
 Sealers

5.  Solid core : Ag points
 Semisolid core: Gutta percha
 Paste : ZnO containing pastes

6.  Jasper- 1933
 1930s- 1960s
 Advantages
 Drawbacks
 Seltzer et al.
 Brady & Del Rio
 Goldberg
 Guttirez
 Kehoe

7.  Polycaprolactone core material

8.  Bioactive glass
 Bi, Ba salts: fillers
 Pigments
 Resin sealer

9.  “Monoblock”

10.  Primer
 Sealer
 Synthetic polymer points/ pellets
 Lower temperatures than GP
 Miner et al.
 Nielsen & Baumgartner
 Shipper et al.

11.  Susceptibility to degradation- Tay et al.
 Interfacial strength analysis: Gesi et al.
 Stratton et al,Von Fraunhofer et al.
 Wang et al.
 Epley et al.
 Williams et al.
 Karr et al.
J Endod 2007; 33: 749-752

12.  Gutta percha
 C- points

13.  “GETAH”: gum
 “PERTJA”: name of the tree in Malay
language
 JohnTradescant: 1656- ‘ MazerWood’
 Dr. William Montgomerie: Gold medal in
1843
 Ernst Werner von Siemans: 1848
Prakash et al. Gutta- percha: An untold story- ENDODONTOLOGY

14.  Alexander Cabriol & Duclos: first GP patent
 Hamock & Bewley: 1845
 James Paterson: 1845- hand moulded golf
balls ‘Gutties’
 Field of Medicine
Prakash et al. Gutta- percha: An untold story- ENDODONTOLOGY

15.  EdwinTruman: Temporary filling material
 Hill’s stopping: 1847
 Bowman: 1867- root canal filling material
 Perry: 1883
 S.S. White company: 1887
 Rollins: 1893
Prakash et al. Gutta- percha: An untold story- ENDODONTOLOGY

16.  Callahan: 1914
 Ingle & Levine: 1959
 Standardized GP: 2nd International
Conference at Philadelphia – 1959
 ISO: 1976
 ADA # 78
Prakash et al. Gutta- percha: An untold story- ENDODONTOLOGY

17.  Rubber trees :Malaysia, Borneo, Indonesia,
Brazil
 Mimusops globsa, Manilkara bidentata,
Blanco genus
 Palaqium gutta, Isonanadra gutta,
Dichopis gutta
Prakash et al. Gutta- percha: An untold story- ENDODONTOLOGY

18.  Palaquium obavatum
 Palaquium polyanthum
 Palaquium ellipticum
 Palaquium gutta
Prakash et al. Gutta- percha: An untold story- ENDODONTOLOGY

19.  Surinam Gutta-percha
 Butyrospermum park
 Dyera costulata
 Maytenus phyllanthoides
 Calatropis giganlea
 Manilkara species
 Synthetic trans- poly isoprene
Prakash et al. Gutta- percha: An untold story- ENDODONTOLOGY

20. BUNN: 1942

21. Crude form
Gutta : 75- 82 %
Alban: 14- 16%
Fluavil: 4-6 %
Tannin, salts, saccharine substances
Prakash et al. Gutta- percha: An untold story- ENDODONTOLOGY

22.  19% to 22% Balata
 59% to 75% zinc oxide
 Waxes
 Coloring agents
 Antioxidants
 Metallic salts
J.L. Gutmann. Root Canal Obturation: An Update. www.ineedce.com

23. Dental GP- not mostly GP
 ZnO: 50-79%
 Heavy metal salts: 1- 17 %
 Wax or resin: 1- 14%
 Actual GP: 19- 22%
Obturation of Root Canal Systems- Endodontics: Colleagues for Excellence- Fall 2009

24. Ingle’s Endodontics: 6th Edition

25.  ZnO: filler, mild antibacterial
 Waxes & resins: Plasticizers
 Metal sulfates:BaSO4-radiopacifier

26.  Iodoform
 Free iodine
 Protection
 No difference: regular GP points & MGP-
ability to delay microleakage of E. faecalis
Martin et al. 1999

27.  Ca(OH)2: (40–60%)
(Roeko/Coltene/Whaledent, Langenau,
Germany)
 Ca(OH)2 containingGP point: improvement
in the apical sealing quality Holland et al.

28.  Activ Point (Roeko/Coltene/Whaledent): CHX
 Better antibacterial than Ca(OH)2 containing
GP: Lin et al.
 Podbielski et al.
 GP + tetracycline

29.  Alpha
 Beta
Prakash et al. Gutta- percha: An untold story- ENDODONTOLOGY

30.  Coagulation
 Obach’s technique
 Aging: rejuvenation
Prakash et al. Gutta- percha: An untold story- ENDODONTOLOGY

31.  ISO sizes
 0.04 & 0.06 taper
 Traditional sizes
 Pellets

32.  Low humidity
 Effects of high
humidity
 Senia et al.- 5.25%
NaOCl – 1 minute
 Short et al.
 Valois et al.
 Gomes et al.

33.  Solid core Gutta-percha points
- Standardized
- Non standardized
 Thermo mechanical compactibleGP
 Thermo plasticizedGP
- Solid core system
- Injectable form
 MedicatedGutta-percha
Prakash et al. Gutta- percha: An untold story- ENDODONTOLOGY

34.  Toxicity
 Sjogren et al.
 Serene et al.
 Cross reactivity
 Costa et al. , Hamann et al.
 Solubility

35.  Plasticity at relatively low temperatures
 Heat cycling
 Shrinkage: 1-2 %
 Relative inability to transmit heat for
softening and 3D molding
SimonsW. Revolutionary Advances, Part 3: Pursuit of the 3-D cork. DentistryToday. 2015
Obturation of Root Canal Systems- Endodontics: Colleagues for Excellence- Fall 2009

36.  Natural
 Inert
 High biocompatibility
 Dimensionally stable
 Thermoplastic
 Compactable
 Radiopaque
 Dissolvable
 Antibacterial activity
SimonsW. Revolutionary Advances, Part 3: Pursuit of the 3-D cork. DentistryToday. 2015

37.  Distorted by pressure
 Forced through the apical foramen if too
much pressure is used
 Not rigid
 A sealer is necessary
Carrotte P. Endodontics: Part 8. Filling the Root Canal System. British Dental Journal 197, 667- 672
(2004)

38. Smart materials-
Designed materials that have one or more properties
that can be significantly changed
in a controlled fashion by external stimuli, such as
stress, temperature, moisture, pH, and electric or
magnetic fields
Badamill & Ahuja. Biosmart Materials: Braeaking New Ground in Dentistry. Hindawi Publications.
Vol. 2014

39. EndoTechnologies, LLC

40.  Lateral expansion
 Non isotropic
 Smart Paste Bio Sealer
 Bioceramics
 Ca (OH)2 & HAP
 Setting time
Badamill & Ahuja. Biosmart Materials: Braeaking New Ground in Dentistry. Hindawi Publications.
Vol. 2014

41.  Economides et al.
 Eid et al.
 Didato et al.
 25 to 45 sizes:
 0.04 % & 0.06% taper
Badamill & Ahuja. Biosmart Materials: Braeaking New Ground in Dentistry. Hindawi Publications.
Vol. 2014

42.  Self sealing; dentin derived moisture
 Less dentin removal
 Avoids compaction forces
EndoTechnologies, LLC

43.  ZnO
 Russian Red
 Trailement SPAD
 MTA
 Paraformaldehyde

44.  Eastern Europe, Asian & Pacific rim nations
 Orstavik
http://www.dentstal.com
Powder:
Dexamethazone 20mg
Resorcin 11g
Zinc oxide 50 g
BaSO4 29g
Liquid:
Formaldehyde solution 10 ml
Catalyst:
Resorcin 20g
HCl 2 ml
Aqua destillata about 1000m

45.  Conventional core filling materials cannot be
used
 Drawbacks: Somewhat difficult handling
characteristics
 Extended setting time of at least 3 hours or
more

46.  Sealing ability
 Marginal adaptation
 Leakage
 Cytotoxicity
 Repair & Regeneration
 Use of moist cotton
 Solubility

47. Whitworth J. Methods of Filling Root canls: Principles & Practices. EndoTopics. 2005, 12, 2- 24

48.  Angelo Sargenti- Early 1950s
 Sargenti Paste
 N2
 N2 Normal
 N2 Medical
 N2 Universal
 N2 Apical
 RC-2B
 RC-2W
 TCM
 White One-Step Endodontic Formula
 Endodilato
Barrett S. BeWary of Sargenti Paste. Dental Watch. 09. 01. 2014

49.  Easier and faster to place
 Release HCHO
 Serious injuries to surrounding tissues

50.  Brewer D.L.
 SchwartzeT.
 Position statement by AAE in 1991
 No FDA approval
 Proponents: 1969- American Endodontic
Society
 Sargenti Opposition Society: 2008

51. Endomethasone:
 Powder: dexamethasone, hydrocortisone
acetate, thymol iodide, paraformaldehyde, &
a radiopaque excipient
 Liquid: eugenol, peppermint oil & Anise oil
Riebler’s paste
Trailement SPAD

52. ‘A radiopaque dental cement used, usually in
combination with a solid or semi-solid core
material, to fill voids and to seal root canals
during obturation’
- Glossary of EndodonticTerms

53.  Impervious seal
 Filler
 Antimicrobial
 Lubricant
 Adhesive properties
J.L. Gutmann. Root Canal Obturation: An Update. www.ineedce.com

54. 1. It should be tacky when mixed to provide
good adhesion between it and the canal wall
when set.
2. It should make a hermetic seal.
3. It should be radiopaque so it can be
visualized in the radiograph.
4.The particles of powder should be very fine
so they can mix easily with the liquid.
5. It should not shrink upon setting.
6. It should not stain tooth structure.

55. 7. It should be bacteriostatic or at least not
encourage bacterial growth.
8. It should set slowly.
9. It should be insoluble in tissue fluids.
10. It should be tissue tolerant, that is,
nonirritating to periradicular tissues.
11. It should be soluble in a common solvent, if
it is necessary to remove the root canal
filling

56. 12. It should not provoke an immune response
in periradicular tissues. ( Block et al.)
13. It should be neither mutagenic nor
carcinogenic. ( Harnden & Lewis)

57. The sealer should adhere to the obturating
material, usually gutta percha, when placed in
the canal, and should adhere to the canal wall
with its irregularities to completely fill the canal
space.
Gatewood R.S. Endodontic Materials. Dent Clin N Am 51 (2007) 695–712

58. The core material itself does not provide an
adhesive seal to the canal wall.To create
and maintain a fluid-tight seal of the
canal is a prime requirement of a sealer
Gatewood R.S. Endodontic Materials. Dent Clin N Am 51 (2007) 695–712

59. The sealer should contribute to the
radiopacity of the root filling for
visualization on radiographs and
evaluation of obturation of lateral canals
and apical ramifications.
Gatewood R.S. Endodontic Materials. Dent Clin N Am 51 (2007) 695–712

60. Any shrinkage of the sealer would tend to
create gaps at the dentin interface or
within the core material, compromising
the seal.
Components of sealer should not leach into
dentin leading to coronal or cervical
discoloration of the crown
Gatewood R.S. Endodontic Materials. Dent Clin N Am 51 (2007) 695–712

61. This property is desirable, but increasing
the antibacterial qualities of a sealer also
increases its toxicity to host tissues.
Should set slowly. A sealer must have ample
working time to
allow for placement during obturation
and adjustment in the case of immediate
post-space preparation.
Gatewood R.S. Endodontic Materials. Dent Clin N Am 51 (2007) 695–712

62. Stability of sealer when set is a prime factor
in maintaining a hermetic seal over time.
This is compromised if fluid contact
causes dissolution of the sealer.
Biocompatibility of the sealer promotes
periradicular repair. Most sealers tend to
be more tissue-toxic in the unset state
and considerably less toxic when fully
set.
Gatewood R.S. Endodontic Materials. Dent Clin N Am 51 (2007) 695–712

63. To allow for retreatment or post-space
preparation, the sealer and the core
material should be removable.This can
be facilitated by using a solvent.
Gatewood R.S. Endodontic Materials. Dent Clin N Am 51 (2007) 695–712

64.  Zinc oxide-eugenol
 Polyketone
 Epoxy
 Ca(OH)2
 Silicone
 Resin
 Glass ionomer
 Resin-modified glass ionomer
J.L. Gutmann. Root Canal Obturation: An Update. www.ineedce.com

65.  Eugenol
- Rickert’s formula
- Grossman’s formula
Carrotte P. Endodntics- Part 5. British Dental Journnal 2004; 197: 455- 464

66.  Non- eugenol
 Medicated : Corticosteroid +
paraformaldehyde

67.  Paraformaldehyde, Rosin, Canada balsam
 Procosol sealer

68. Roth’s 801 Sealer
 Bismuth subnitrate
Rickert’s formula
 Kerr’s Pulp Canal Sealer
 Pulp Canal Sealer EWT- 6 hours

69. Tubli-Seal
ZnO base paste:
 BaSO4
 Mineral oil
 Cornstarch
 Lecithin
Catalyst tube:
 Polypale resin
 Eugenol
 Thymol iodide

70. Wach’s Paste
Powder:
 ZnO
 Bi subnitrate
 Bi subiodide
 MgO, Ca3(PO4)2
Liquid:
 Oil of cloves
 Eucalyptol
 Canada balsam
 Beechwood creosote

71. Nogenol
Base:
 ZnO
 BaSO4
 Bi oxychloride
 Vegetable oil
Catalyst
 Hydrogenated rosin
 Methyl abietate
 Lauric acid
 Chlorothymol
 Salicylic acid

72. MedicatedCanal Sealer
 Martin
 Iodoform
 MGP GP- 10% CHI3

73. Sealapex
Base:
 ZnO
 Ca(OH)2
 Butyl benzene
 Sulfonamide
 Zn stearate
Catalyst:
 BaSO4
 TiO2
 Proprietary resin
 Isobutyl salicylate
 Aerocil
Holland & De Souza

74. Apexit
www.ivoclarvivadent.in

75. Calcibiotic Root Canal Sealer
Slow setting- 3 days
Stable

76. Vitapex
 40% iodoform
 Silicone oil
 Beltes et al.
 Siquiera et al.

77. RESIN SEALERS
 AH 26
 HCHO
 Advantages
 Disadvantages
 AH Plus & Thermaseal Plus
 Advantages of AH 26
 Epoxy- bisphenol resin:
adamantine
 WT & ST
 Other improvements

78. EPIPHANY/ REAL SEAL
 UDMA, PEGDMA, EPGADMA, Bis- GMA
 Silane-treated Ba borosilicate
 Glass, BaSO4, Silica, Ca(OH)2
 Bi oxychloride with amines, peroxide
 Photo inhibitor, pigments
 Self- etch primer
 NaOCl & peroxide lubricants
 EDTA & sterile water

79. EPIPHANY/ REAL SEAL
 Sousa et al.
 Versiani et al.
 Solubility
 Dimensional stability
 ANSI/ ADA standards
 Ungor et al.

80. DIAKET
 Polyketone compound
 Vinyl polymers + ZnO & Bi3(PO4)2
 PVC
 B- diketone
 Biocompatibility
 Eldeniz et al. Shear bond strength

81. SILICONE BASED SEALERS
 Lee Endo-Fill, RoekoSeal
 Wu et al.
 Gutta Flow:
- Silicone oil
- Paraffin oil
- Platin catalyst
- ZrO2
-Nano-Ag: preservative, coloring agent

82. URETHANE METHACRYLATE SEALERS
 EndoREZ
 2- part: chemical set
 Sealer, Resin- coated Gutta Percha, Accelerators
 Hydrophilic characteristics
 Tay et al.
 Hirashi et al.
 Zmener et al.

83. ahrendental.com

84.  EZ Fill
 Single GP; Bidirectional spiral

85.  MetaSEAL
 Thinner version of
4- META
 Belli et al.
 Self- etching

86.  Ketac- Endo
 Good biocompatibility
 Seal
 Solubility

87.  Johnston & Callahan
 GP particles + CHCl3
 Shrinkage & voids
 Chlorosin
 Chloropercha
 Kloropercha N- 

88.  Orstavik
 ANSI/ADA & ISO
 Flow,WT, ST
 Radiopacity
 Solubility & disintegration
 Dimensional change following setting
 Biologic tests, Usage tests , Antibacterial
testing
 Clinical test

89.  Juhasz et al.-Sealapex allowed more leakage
than Pulp Canal Sealer
 Cobankara et al.- Sealapex
 Orucoglu et al. Diaket + cold lateral
compaction
 Saleh et al.
 Pommel et al.
 Lee et al.
 Tagger et al.

90.  Miletic et al.
 Spangberg & Pascon
 Economides et al.
 Huumonen et al.

91.  Orstavik
 Lacey et al.
 McMichen et al
 Tagger et al.
Orstavik. EndodonticTopics 2005, 12, 25–38

92.  Nielsen et al.
 Anaerobic: Ketac-Endo
& Resilon
 Aerobic: KerrTubli Seal
& Ketac Endo
 Roth’s 801 & 811-
slowest
 Kazemi et al:
- ZOE: 4 hours
- Endomethasone: 9 hrs
- Endo-Fill: 2.5 hrs
- AH-26: 12 hrs
 Orstavik et al.
 Flow as a function of
time
 ZOE sealers

93.  ZOE & Ca(OH)2
 Schafer & Zandbiglari
 AH plus
 Kazemi et al.
 ZOE sealers
 Endo- Fill : least
 Endo- Fill & AH- 26-
lower rates

94.  Minimum: 3mm Al
 Std. GP points: 6mmAl
Orstavik. EndodonticTopics 2005, 12, 25–38

95.  Concern for untoward reaction
 Extreme situations
 Delay / prevent resolution
Orstavik. EndodonticTopics 2005, 12, 25–38

96.  Expt. Animals
 Uninfected teeth
 Katebzadeh et al. Induced apical
periodontitis
Orstavik. EndodonticTopics 2005, 12, 25–38

97.  Sipert et al.
 Pizzo et al.
 Williamson et al.
 Siqueira and Goncalves
 Leonardo et al.
 Kayaoglu et al.
 Aravind et al.
JCD. Iss. 9(1): 2006

98.  Composite resins
 Glass ionomers
 Cavit
 IRM
 Super EBA
 Dentin bonding agent

99. Cavit:
 ZnO
 CaSO4
 ZnSO4
 Glycoacetate
 Polyvinylacetate resin
 PVC acetate
 Triethanolamine
 Red pigment

100. IRM:
Polymer-resin-reinforced ZOE
TERM:
 UDMA polymers
 Inorganic radiopaque filler
 Pigments
 Initiators

101.  Grossman’s requirements
 Long term RCTs
 Tissue regeneration