221706863 Root Canal Sealers Orthodontic Courses by Indian Dental Academy

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Transcript of 221706863 Root Canal Sealers Orthodontic Courses by Indian Dental Academy

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    ROOT CANAL SEALERS

    INTRODUCTION

    SEALERS :These are Cements / Resins / Semiliquid / Plastic-which are

    used as binding agents to fill up the gap between root canal and

    obturating material.

    - It also fills up the irregularities, discrepancies, lateral canals and

    accessor canals.

    - It helps to achie!e a proper apical seal.

    IDEAL REQUIREMENTS

    - The requirements of a suitable sealers used for filling the dr

    canal in con"unction with gutta-percha / sil!er cone are as

    follows#

    $% It should be T&C'(, when mi)ed to pro!ide good adhesion

    between the filling material and canal wall when set.

    *% It should pro!ide a +RTIC S& an e)cellent seal apicall

    and laterall%.

    0% Should be R&1I2-2P&34, so that it can be !isuali5ed in a

    radiograph.

    6% Should not shrin7 upon setting 1I8SI28&( ST&9%.

    $

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    :% Should not ST&I8 tooth structure.

    ;% Should be I8S249 in tissue fluids.

    % Should not PR2?2' an immune response in peri-apical region

    should be absorbable when e)truded%.

    $@%It should be neither mutagenic nor carcinogenic.

    $$%Should be easil mi)ed and introduced into the root canal.

    $*%Should ST S2A( to ensure sufficient A2R'I8B TI.

    $0%ilm thic7ness should be as minimum as possible.

    $6%It should be S249 I8 common sol!ents if it is necessar to

    remo!e the root canal filling.

    FUNCTIONS

    $% The e)ert BRICI1& / &8TI9&CTRI& acti!it after

    the placement.

    *% The form a 9281 between the filling material and the dentinal

    walls acts as 9I81I8B &B8T%.

    *

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    0% The act as 49RIC&8TS when used in con"unction with

    semisolid material.

    6% The e)hibit R&1I2-2P&CIT( as it ma disclose the presence

    of accessor canals, resorpti!e areas, root fractures and the shape

    of apical foramen.

    CLASSIFICATION

    There are a number of classifications of root canal sealers which

    can be discussed as#

    I ACCORDING TO THEIR COMPOSITION [MESSING]

    a) EUGENOL

    b) NON-EUGENOL c) MEDICATED

    i) Silver co!aii" ii) Silver Free

    $% Ric7ettDsformula 'errDs

    Sealer $>0$%

    *% Procosol

    Radio-opaque

    sil!er cement

    Brossman-

    $>0;%

    $% Procosol 8on-

    staining B

    cement

    Brossman-

    $>:=%

    *% Brossm

    anDs sealer

    Brossman-

    $>:$%

    *% &+ *; $>:

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    6

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    II ACCORDING TO GROSSMAN#

    $% Ginc-o)ide resin cements.

    *% Ca2+%*cements.

    0% Paraformaldehde cements.

    6% Pastes.

    III ACCORDING TO COHEN

    Specification number :< classifies endodontic filling materials as

    follows#

    Tpe I H Cl $, Cl *

    Tpe II H Cl $, Cl *, Cl 0

    Tpe III H Cl $, Cl *, Cl 0, Cl 6

    Type I :C2R Standardi5ed% au)iliar con!entional% points to be used

    with sealer cements.

    Class $ H etallic.

    Class * H Polmeric.

    Type II# Sealer cements to be used with core materials.

    Class $ H Powder and liquid nonpolmeri5ing.

    Class * H Paste and non-polmeri5ing.

    Class 0 H Polmer resin sstems.

    :

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    Type III # illing materials to be used without either use materials /

    sealer cements.

    Class $ H Powder and liquid non-polmeri5ing.

    Class * H Paste and paste non-polmeri5ing.

    Class 0 H etal amalgams.

    Class 6 H Polmers.

    $ ACCORDING TO INGLE

    - Cements.

    - Pastes.

    - Plastic.

    $I ACCORDING TO CLAR%

    - &bsorbable.

    - 8on-absorbable

    $II ACCORDING TO HART& F'(

    1. Pastes and cements may be d!ded nt" # $%"&ps.

    $% Ginc-o)ide eugenol based.

    *% Resin based.

    0% BP based.

    6% 1entin adhesi!e materials.

    :% aterials to which medicaments ha!e been added.

    )amples of Gn2 are alread mentioned.

    ;

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    '. Resn based:Consists of an epo) resin base which sets upon mi)ing

    with an acti!ator. )amples H &+ H*;

    - 1ia7et

    - +dron.

    (. )&ttape%c*a based # Pastes and cements based on gutta-percha

    consists of solutions of gutta-percha in organic sol!ents well 7nown

    products are#

    - Chloropercha.

    - ncapercha.

    +. Dentn ad*es!e mate%a,s:&dhesi!e cements ha!e been tested in an

    attempt to impro!e the qualit of sealers.

    )amples# Canoacrlate cements.

    - Blass ionomer cements.

    - Polcarbo)late cement.

    - Calcium phosphate.

    - Composite materials.

    #. Mate%a,s t" -*c* medcaments *a!e been added.

    - These ma be di!ided into * groups#

    i. Those in which strong disinfectants and antiphlogistics

    ha!e been added in order to supports possible post-

    operati!e pain.

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    ii. Those in which Ca2+%* has been added with the

    purpose of inducing cementogenesis and dentino-

    genesis at the foramen, thus creating a permanent

    biological seal. )amples#

    - Paraformaldehde.

    - Calcium hdro)ide.

    In the first group of pastes, the supplemented disinfectant is

    paraformaldehde and corticosteriod preparation is used as an

    antiphlogistic.

    The most popular commercial Ca2+%*containing cements are#

    - Calcibiotic root canal sealer CRCS%.

    - Sealape).

    - 9iocale).

    Antp*,"$sts :&gents which counteract inflammation.

    INDI$IDUAL SEALERS

    A SIL/ER CONTAININ)

    ) %err roo! *caal +ealer , Ricer!.+ For/0la#

    Co/1o+i!io#

    P"-de%:

    Gn2 06-6$.*.

    Precipitated sil!er *:-0@.@

    2leo resins 0@-$;

    =

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    Thmol iodide $$-$*

    >

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    L0&d

    2il of clo!es

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    *. Branular appearance remains e!en after

    spatulation is completed because of precipitated sil!er.

    0. It completel sets and is inert within $:-0@

    minutes, so BrossmanDs formula appeared in $>0;K with the

    purpose of de!eloping a sealer that afforded more wor7ing time.

    2) Proco+ol Ra3io1a40e * Silver Ce/e!

    P"-de%:

    Gn2 4SP 6:

    Ppt sil!er $@

    Canada balsam $@

    To get rid of stain H use )lol to wash the pulp chamber after

    condensation.

    I3ica!io+#

    $. aterial of choice for lateral canals.

    *. or sil!er points.

    0. ?ertical condensation of warm gutta-percha when

    bul7 of material is required as a sealer.

    $$

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    Paca"i"#

    - iquid in bottle dropper%.

    - Premeasured powder in pellet form.

    Mi5i"#

    - $ pellet to $ drop $#$%.

    &% S,!e% F%ee # BrossmanDs formula was re!ised to

    e)clude &g.

    ) Proco+ol No-+!aii" Ce/e! , Gro++/a.+ E0"eol Ce/e!

    6789)#

    This sealer is re!ised b Brossman again in $>

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    BrossmanDs sealer is used widel because it pro!ides good seal.

    Co//ercial a/e+#

    - Procosol non-staining sealer.

    - RothDs sol.

    - ndoseal.

    Pro1er!ie+#

    i% It has plasticit.

    ii% It has slow setting time in the absence of

    moisture and due to the presence of 8a borate anhdrate.

    iii% It has good sealing potential and small

    !olumetric change upon setting.

    i!% Ginc ugenate is decomposed b +*2

    through continuous loss of eugenol which ma7es Gn2K a wea7

    unstable compound.

    9ecause the use of BrossmanDs sealer in bul7 for retrofillings and

    surgical root end repair is questionable.

    This sealer if e)truded apicall gets absorped.

    Di+a3va!a"e+#

    $% Resin is of coarse particle si5e and unless the material in

    spatulated !igorousl during mi)ing, an increased piece of resin

    $0

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    ma lodge on the walls of the canal and pre!ent the root-canal

    filling from sealing at correct le!el.

    Se!!i" Ti/e#

    - This cement hardens in appro)imate * hours at 0

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    Co/1o+i!io#

    ase:

    Gn2 H :

    2leo resins H $=.: H *$.*:

    9ismuth trio)ide H

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    *% ?er low !iscosit e)trusion through apical foramen because

    shorter spatulation time is recommended.

    0% A.T. is less than 0@ minutes and e!en less in the presence of

    moisture.

    I3ica!io+#

    i. In apical surger cases immediatel after filling. The

    canal is o!erfilled intentionall with hea! condensation and the

    e)cess remo!ed b curettage.

    ii. or filling the last millimeter of the prepared canal

    where the master cone ma not reach because of its great

    lubricating propert.

    >) Giac?.+ Sealer 6788@ ac? e! al)

    Co/1o+i!io#

    P"-de%:

    Gno $@g

    Tricalcium phosphate *g

    9ismuth subnitrate 0.:g

    9ismuth subiodide @.0g

    agnesium o)ide hea!% @.:g

    L0&d:

    Canada balsam *@ml

    2il of clo!es ;ml.

    $;

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    Pro1er!ie+#

    a% edium AT.

    b% inimum lubricating qualit.

    c% inimum periapical irritation.

    d% It is stic7 due to the presence of Canada balsam.

    e% It should be mi)ed to smooth cream consistenc and

    should string out at least one inch when spatula is raised

    from the glass slab.

    f% Increasing the thic7ness of the sealer lessens its lubricating

    effect so this sealer is introduced when there is a

    possibilit of o!er e)tension beond the confines of the

    root canal.

    g% It is pac7aged as powder and liquid in separate bottles.

    A3va!a"e+#

    a% It is germicidal.

    b% ess peri-apical irritation.

    c% It has light bod and thus does not defect the

    small gutta-percha cones.

    $

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    d% It stas in position due to the tac7iness at the tip

    of the cone.

    Di+a3va!a"e#

    a% 2dour of liquid.

    I3ica!io+#

    a% &ll lateral condensation methods especiall

    when chance of o!erfilling is present.

    b% Small cur!ed canals of minimum caliber

    because of its light bod does not defect the small master

    gutta-percha cone used in such canals.

    Co!rai3ica!io+#

    a% Ahen hea! lubrication is needed as with

    short master cone.

    Paca"i"#

    Powder and liquid in separate bottles.

    Mi5i"#

    - i)ed to cream consistenc, mass drawn/ $ inch from raised

    spatula.

    - Thic7er for larger canals and for o!erfilling.

    $=

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    Summar of Gn2 based cements# 9asicall Gn2 based

    cements ha!e an ad!antage of#

    - ase of manipulation.

    - &dhesion to dentinal walls and limited dimensional changes.

    - Radioopaque, germicidal action, ample AT and minimal staining

    e)cept &g containing PR2C2S2.

    Di+a3va!a"e+#Pa irritation and not absorped easil from apical tissues.

    Se!!i" Reac!io#It reacts because of a combination of phsical and

    chemical reaction ielding a hardened mass of Gn2 embedded in a

    matri) of long sheath li7e crstal of Gn eugenolate. an factors is

    moistureK particle si5eK p+ etc. are factors that influence the setting

    reaction.

    - Tissue culture stud of Gn2 formulation are ctoto)ic.

    - Inflammation at Pa region persists for ears.

    - 4ntil e)cess Gn2 cement is phagoctosed.

    NON-EUGENOL

    1 DIA2ET

    - It is a pol!inl resin Pol7etone%, a reinforced chelate formed

    between Gn2 and 1i7etone.

    $>

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    - 1ia7et consists of a fine, pure white powder and a !iscous hone

    coloured liquid.

    - * drops of liquid J $ scoop of powder changing the ratio of

    powder to liquid effects the hardness of the final set and

    radioopacit%.

    - 1ia7et hardens rapidl.

    - S.T. is ;-= minutes on glass slab and faster in the root canal.

    - 1ia7et is 7nown for its resistance to absorption.

    - It is a superior to other sealers in tensile strength and resistance to

    permeabilit.

    - odification of apical cementum and al!eolar bone occurred

    with glass o!erfilling.

    - This cement is usuall used for 812SS24S IP&8T.

    - 1ia7et showed a greater tendenc towards fibrous encapsulation

    where as &+-*; tends to disintegrate into fine granules which

    were phagoctosed.

    ' A34'5

    This is an epo) resin recommended b S+R21R in $>:6.

    P"-de%:

    9ismuth o)ide H ;@

    *@

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    le)amethlene tetramine H *:

    &g powder H $@

    Titanium o)ide H :

    L0&d:

    9isphenol diglcidl ether

    The formulation has been altered recentl with the remo!al of

    sil!er as one of the constituents to pre!ent tooth discolouration.

    PROPERTIES , AD$ANTAGES#

    $. It has good adhesi!e propert.

    *. &ntibacterial.

    0. It contracts slightl while hardening.

    6. ow to)icit and well tolerated b Pa tissues.

    DISAD$ANTAGES#

    $. Parasthesia ma occur following the use of

    &+-*;, but partial reco!er occurs within $-* ears.

    *. Inhibits leu7octe migration.

    PAC%AGING

    (ellow powder and !iscous resin, liquid and is mi)ed to a thic7

    cream consistenc.

    Its setting time# 0;-6= hours at bod temperature.

    : to < das at room temperature.

    *$

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    TISSUE CULTURE STUDIES#

    - The material was moderatel to se!ere to)ic when tested on

    human epithelial cellsK blood, monoctes and lmphoctes etc.

    H0/a +!03ie+#

    - Aell tolerated b Pa tissue.

    - )cess material in the P1 tends to become encapsulated.

    - andibular parasthesia ma occur following filling.

    EFFECTI$ENESS OF SEALER#

    - It is an effecti!e sealing agent.

    >) %LOROPER%A N'O' SEALER#

    This formula is gi!en b 8borg and Inllin in $>;:.

    Co/1o+i!io#

    P"-de%:

    Canada balsam H $>.;

    Resin H $$.=Buttapercha H $>.;

    Ginc o)ide H 6>

    L0&d:

    Chloroform

    - It was first introduced in $>0>.

    **

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    - The powder is mi)ed with liquid chloroform.

    - &fter insertion the chloroform e!aporates, lea!ing !oids.

    - It is associated with a greater degree of lea7age than other

    materials.

    CHLOROPERCHA

    - This is a mi)ture of gutta-percha and chloroform.

    - This chloroform paste has been used b some clinicians as the

    sole canal filling material.

    - &s such the technique is improper because of the e)cessi!e

    shrin7age of the filling after e!aporation of the chloroform.

    INDICATIONS#

    - Perforations.

    - 4nusuall cur!ed canals.

    - Canals with ledge formation.

    - In con"unction with well fitted primar cone chloropercha can fill

    accessor canals and root canal space.

    MODIFIED CHLOROPERCHA METHODS

    There are * modifications#

    $. Mohnston H Callahan.

    *. 8gaard H 2stb.

    *0

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    (o?+!o-Calla?a /e!?o3#

    - The canal is repeatedl flooded with >: alcohol.

    - Then dried with absorbent points.

    - It is then flooded with Callahan resin, chloroform solution for *-0

    minutes more chloroform is added if the paste becomes too thic7

    b diffusion / e!aporation.

    - & suitable gutta-percha is inserted and compressed laterall and

    apicall with a string motion of the plugger until the gutta-percha

    is dissol!ed completel in the chloroform solution in the root

    canal.

    - &dditional points are added one at a time and dissol!ed in the

    same wa.

    - )trusion should be pre!ented because freshl prepared

    chloroform is to)ic before e!aporation of chloroform as

    chloroform e!aporates H it shrin7s and apical seal is lost%.

    N&GAARD OSTB&

    - The canal walls are coated with 7loroper7a the primar cone

    dipped in sealer is inserted apicall.

    - Pushing partiall dissol!ed tip of the cone to its apical seal.

    *6

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    - &ddition cones dipped in sealer are pac7ed into the canal to

    obtain satisfactor filling.

    - 1& has banned the use of chloroform since it has a carcinogenic

    potential.

    ) NEL& DE$ELOPED CaPO; T&PE SEALERS ARE#

    $. Tetra calcium phosphate TeCP%.

    *. 1iacalcium phosphate dihdrate 1CP1%.

    0. If modified C II !ains and buffer solution

    T1%.

    6. T1-S-9uffer solution J *.; chondrotin

    sulphate.

    Co/1o+i!io#T1-S

    P"-de%:

    a. Tetracalcium phosphate.

    b. 1ibasic Ca phosphate.

    L0&d:

    a. Citric acid.

    b. 1ibasic 8aP26.

    c. Chondrotin sulphate.

    d. 1istilled +*2.

    $. 9iocompatible.

    *:

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    - ow radioopacit.

    - ow wetting abilit.

    $% ENDOFLOSS # O ba+e3 /e3ica!e3 ce/e!.

    Po

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    H&DRON # ie?!erle a3 Li/ 67=)#

    - It is a rapid setting hdrophilic, plastic material used as a root

    canal sealers without the use of core.

    - Boldman-&dron is a polmer of hdro)-ethl methacrlate

    +&%.

    - It is a!ailable as an in"ectable root-canal filling material.

    - 9iocompatible and it conforms to the shape of the canal because

    of its plasticit.

    - Ahen it comes in contact with moisture, the gel absorbs +*2 and

    swells.

    - A.T. is ; to = minutes.

    - ess radioopaque than gutta-percha.

    - The sringe method ma7es it difficult to control the placement of

    plastic gel accuratel and to control the formation of !oids within

    its structure.

    - ong-term studies showed that it causes Pa irritation and

    inflammation with the acti!ation of macrophages.

    - +dron is thi)otropic i.e. before polmeri5ation occurs it changes

    from a gel to liquid for short-time.

    *=

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    - It can be remo!ed onl b burs i.e. peeso reamer.

    ENDOFIL#

    - & recentl introduced in"ectable silicone resin endodontic sealant

    is 7nown as ee ndo-fill.

    - It can be used with gutta-percha as the core material or H as a sole

    sealant and filling material to be in"ected in the canal with a

    pressure sringe.

    End"6,,:a silicone elastomer H silicone monomer.

    Cata,ystH silicone based radioopacifier H bismuth subnitrate.

    &cti!e ingredients.

    - +dro)l terminated dimethl polsilo)ane.

    - 4ndeclenic acid.

    - 9en5l alcohol.

    - +drophobic amorphous silica $@-0@N particle si5e%.

    Cata,ystH Tetra ethlorthosilicate poldimethl silo)ane#

    - The mi)ed silicone has low wor7ing !iscosit with good

    adaptation to the tooth structure.

    - Bood penetration of accessor canals.

    *>

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    - It cures to a pale pin7 rubber solid resembling gutta-percha in

    properties.

    - ST H = to >@ minutes depending on the catalst amount O

    catalst, faster setting, O shrin7age.

    - The !oids can be detected on a radiograph and can be repac7ed.

    - & moist cotton pellet is used for !ertical condensation and the

    e)cess is remo!ed.

    - +*2 accelerates the S.T.

    AD$ANTAGES#

    $. ase of preparation.

    *. &d"ustable A.T.

    0. ow wor7ing !iscosit.

    6. Rubber consistenc.

    :. It is not a resorbable material.

    DISAD$ANTAGES#

    $. Cannot be used in the presence of +*2*.

    *. Canal must be absolutel dr.

    0. Shrin7s upon setting but has an affinit for flowing into

    open tubuli.

    6. ndo-fills bonding abilit to the canal walls decreases if it

    is not used within about *@ minutes of mi)ing.

    0@

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    BIOCOMPATIBILIT

    - Silicon elastomers are low in to)icit and inert to tissues.

    GLASS IONOMER CEMENT 6%ETAC-ENDO)

    - Saito introduced the endodontic glass ionomer.

    - +e suggested using u"i Tpe I luting cement to fill entire root-

    canal.

    - ater Pittford and Stewart wor7ed on this material to impro!e the

    properties.

    - Blass-ionomer cements are reaction product of an ion-leachable

    glass powder and a polanion in aqueous solution.

    - 2n setting the form a hard polsalt gel which adhere tightl to

    enamel and dentin.

    - 9ecause of their adhesi!e propert the are used as root-canal

    sealers, pro!ided the are not ctoto)ic. It can be triturated and

    in"ected onto root-canal.

    AD$ANTAGES#

    - It has best phsical qualities.

    - It has best binding to dentin.

    - ewest !oids.

    - owest surface tension.

    - 9est flow propert.

    0$

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    - ess ctoto)ic.

    DISAD$ANTAGES#

    - It cannot be remo!ed in case of re-treatment no 7nown sol!ent

    for BI%.

    - +owe!er Toronto / 2sract group has reported that 7etac-endo

    sealer can be effecti!el remo!ed b H hand instruments, -

    chloroform sol!ent followed b $ minute with an ultrasonic no.

    *: file.

    NOGENOL#

    - This was de!eloped to o!ercome the irritating qualit of ugenol.

    - The product is an outgrowth of non-eugenol periodontal pac7.

    - This Gn2 non-eugenol cement nogenol ha!e been ad!ocated as it

    considered to be less irritating sealer.

    - It was found that after *6 hours all sealers showed considerable

    inflammation.

    - &+-*; hours nogenol was considerabl less irritating than the

    other sealers.

    - )pands on setting and impro!e its sealing efficac with time.

    9ase is Gn2 with barium sulfate and !egetable oil.

    - &ccelerator H hdrogenated rosin.

    0*

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    - ethl abietable.

    - auric acid.

    - Chlorothmol.

    - Saliclic acid.

    POL&CARBO&LATE CEMENTS#

    - It consists of modified Gn2 powder and aqueous solution of

    polacrlic acid.

    - The cement has chelating action.

    - 9inds to both enamel and dentin.

    - 9ecause of its adhesi!e and antibacterial properties, the cement

    has been tested as a root canal sealer.

    - i7e an other sealer, this material also produces an

    inflammator response when it is e)truded into Pa tissues.

    - &pical seal is found to be inferior to other sealers.

    AD$ANTAGES#

    $. It bonds well to dentine.

    *. &ntibacterial propert.

    0. Compounds li7e fluoride and Ca2+%* can be added.

    DISAD$ANTAGES#

    00

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    $. Special plastic plugger is required for insertion since it has great

    adhesi!eness to steel instruments.

    CALCIUM PHOSPHATE CEMENT#

    - It has been de!eloped for use on e)posed root surfaces of

    sensiti!e teeth.

    - 9rowne $>=0% showed that this cement penetrated and occluded

    the radicular dentinal tubules and enhanced hdro)apatite

    formation.

    - Aefel $>=6% found that it effecti!el plugged the apical foramen

    and penetrated the dentinal tubules upto $@mm.

    - The biocompatibilit of this cement in ndo-therap has not et

    been established

    C&ANOACR&LATE CEMENTS#

    - These are composite tpe polmers that can be polmeri5ed to

    hard products b the use of basic inorganic material that also

    ser!e as fillers.

    - & number of homologues including methl, ethlK n-butl,

    isobutl and isopropl ha!e been formulated in dental cements.

    - The ha!e been reported to be biocompatible.

    MEDICATED CEMENTS#

    06

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    )amples#

    Da7et A:

    - Chemicall this sealer is similar to dia7et but it also contains the

    disinfectant +&C+2R2P+8.

    - It is one of the few medicated cements which does not contain

    paraformaldehde.

    TISSUE CULTURE STUDIES#

    - 1ia7et is moderatel to)ic to cells.

    - It has a strong ctoto)ic effect upto 6= hours after insertion.

    HUMAN STUDIES#

    - aterial is well tolerated b the Pa tissues o!erfillings with

    1ia7et-& causes no inflammator reaction and are encapsulated

    b fibrous connecti!e tissue%.

    Pb tet%"8deH is to)ic to human organism and is of little benefit to the

    properties of cement.

    Pa%a6"%ma,de*ydeH hereb irritating and destructi!e to tissue.

    C"%tc"ste%"dH are supposed to reduce post-operati!e pain.

    0:

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    L0&d:

    ugenol.

    2leum Rosae

    2leum a!andulal

    - The corticosteroids are now added to the cement separatel as

    hdrocortisone powder / terra-cortil.

    - The ob"ect of introducing formaldehde within the root-filling is

    to obtain a continued release of formaldehde gas H which brings

    prolonged fi)ation and antiseptic action.

    TOICIT

    - 9ecause of irritation is se!ere if forced into ma)illar sinus

    mandibular canal-caused persisting, paresthesia.

    - &PIC& S& H is better when compared to procosol, nongenol

    and tubliseal and dia7et.

    ENDOMETHASONE#

    - The formation of this sealer is similar to 8*composition#

    P"-de%:

    Gn2 - $@@.@gm

    9ismuth subnitrate H $@@.@g

    1e)amethasone H @.@$>g

    +drocortisone H $.;g

    0

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    Thmol iodide H *:.@g

    Paraformaldehde H *.*@g

    L0&d:

    ugenol

    - & pin7 antiseptic powder is mi)ed with eugenol.

    - Sometimes endomehasone RC sealers gi!es rise to pain /

    discomfort after ; to = wee7s of insertion.

    - This occurs because the corticosteroid mas7s an inflammator

    reaction until it is remo!ed from the area.

    - Paraformaldehde is not resorbed equall, quic7l and the

    smptom of the inflammator reaction becomes apparent.

    SPAD#

    - 'nown for one !isit non-irritant radioopaque filler and sealer.

    - It is a resorcinol formaldehde resin supplied as a powder and *

    liquids.

    Co/1o+i!io#

    P"-de%:

    Gn2 H g

    9a Sulphate H$0.@@g

    Titanium dio)ide H ;.0@g

    Paraformaldehde H 6.

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    Ca2+%* H @.>6g

    Phenl mercuric borate H @.$;g

    L0&d:

    Clear% ormaldehde solution H =

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    - Pa within Pa infections H because it is thought that sterili5ing

    affect accelerates healing.

    - )trusion H bone necrosis.

    IODOFORM PASTE#

    - If alone / in combination with ether substances has been used as a

    cement / as sealer with core materials.

    - Aal7hoff $>*=%.

    - It is a resorbable paste.

    Consists of# ;@ parts of iodoform.

    6@ parts of solution H 6: parachlorphenol,

    &ntiseptic H 6> of camphor

    ; menthol.

    COMMERCIALL& aa %RI * 1a+!e'

    - Ahen the pulp is necrotic, the apical foramen is intentionall

    widened during preparation and paste is deliberatel filled into

    the region during filling.

    - If a sinus is present, paste is pushed beond the canal until it

    e)trudes through the sinus.

    - arge Pa lesions, paste is used to fill the Rl and also as antiseptic

    dressing.

    6@

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    - It is not necessar to insert a guttpercha/sil!er points as core

    filling, if it is used, it should not touch the ape).

    - It stimulates the Pa tissues and e!en accelerates bone formation.

    - The filling material in the peri ape) is remo!ed b the action of

    phagoctosis and direct drainage to the associated lmphnodes.

    DISAD$ANTAGE#

    $% Pa irritation during construction of post crown so call has

    to be filled with non-absorbable material according to

    aws $>:>% H apical quarter of the canal with a section of

    gutta-percha J paste and the remaining with non-

    resorbable material.

    *% 1iscoloration.

    0% Cannot be used in patients who ha!e sensiti!it to iodine.

    RIEBLER.S PASTE#

    P"-de%:

    Gn2ormaldehde

    9a sulphate.

    Phenol.

    6$

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    L0&d:

    ormaldehde.

    Sulphuric acid.

    &mmonia.

    Blcerine.

    M&NOL CEMENT#

    P"-de%:

    Gn2.

    Iodoform.

    Rosin.

    9ismuth subnitrate.

    L0&d:

    ugenol.

    Creosol.

    Thmol.

    - These cements are used, without core materials and are

    introduced b means of lentulospiral / in"ection de!ice.

    APPLICATION OF A SEALER

    - Sealer can be placed b #

    - Reamer.

    - entulo-spiral.

    6*

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    - &s a sealant in con"unction gutta-percha.

    - &s a root canal filling material.

    - Pure Ca2+%* can be used / J saline solution.

    - p+$*.0 to $*.:.

    - Its use is based on the assumption that there is formation of hard

    structures / tissues at the apical foramen.

    - The al7alinit of Ca2+%*, stimulates the induction of

    minerali5ed tissue.

    - Ca2+%* ma be effecti!e as an I8TRI treatment but should

    ser!e as a permanent RC filling material because it ma

    disintegrate if lea7age occurs.

    - Some Gn2 cements ha!e been modified b incorporating

    Ca2+%*.

    - Ca2+%* sealers are considered superior to Gn2 cements.

    9A SEALAPE ; 2ERR COMPAN

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    Co/1o+i!io#

    - 9ase consists of Gn2 with Ca2+%*.

    9utl ben5ene

    Sulfonamide.

    Gn stearate.

    - Cata,yst 9a sulphate.

    Titanium dio)ide H radioopaque.

    Resin.

    Isobutl saliclate and &crocil R>

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    L0&d:

    ugenol

    ucalptol.

    - CRCS is a Gn2 eucalstol sealers to which Ca2+%* has been

    added for its osteogenic effect.

    - CRCS H is powder # iquid combination.

    - CRCS H 0 das to set full in either dr / humid en!ironment.

    It shows ma little +*2 sorption i.e. quite stable.

    - The setting time, solubilitK compressi!e strength and other

    properties of these and Ca2+%* sealers were compared with

    PR2C2S2.

    - The found that sealape) showed a tpical beha!iour on its

    pronounced !olume e)pansion water absorption and change in

    radioopacit with time.

    6B) LIFE

    - & Ca2+%* liner and pulp capping material and sealer.

    - Similar composition to sealape).

    6C) $ITAPE

    - Mapanese ha!e introduced.

    - Components are iodoform and silicone oil.

    6;

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    NEER SEALERS

    $. ndofloss.

    *. &ppetite root canal sealer.

    0. RCS containing tetra-calcium dicalcium phosphate and $

    chondrotin sulphate.

    1 ENDOFLOSS:

    - Recentl introduced sealer consisting of P# formulation.

    P"-de%:

    Gn2.

    Iodoform.

    Ca2+%*

    9aS26

    L0&d:

    ugenol.

    Parachlorophenol.

    - It is 5inc o)ide based medicated cement.

    - i)ing is similar to procosol Gn2 sealer%.

    - S.T. H 0@-6: minutes.

    - 9iocompatible.

    6=

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    - Induces se!ere inflammator reaction in 6= hours and graduall

    reduced after 0 months.

    - Se!ere to)icit along with coagulation necrosis was obser!ed

    which is attributed to the presence of iodoform parachlorophenol.

    ' APPETITE RCS: 3

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    BIOSEAL#

    Sealing abilit of a new-hdro)apatite containing endodontic

    sealer using lateral condensation and thermatic composition of gutta-

    percha in !itro M2, ?ol. **K 8o. 6# &pril >;.

    H3ro5#

    $. Is assumed to influence the apical healing.

    *. It ma effect the sealing abilit of the cement because of its

    composite structure additi!e did not effect the sealing abilit.

    BIOSEAL # PCS'

    IM ># Ca2+%* RCS # e!aluation of p+ Ca ion

    concentration and conducti!it.

    Sealape) +ighest p+K ionic Ca and total Ca !alues.

    +gienic CRCS IInd.

    1entspl - Sealer *;IInd

    ?i!adent &pe)it IIIrd.

    ffect of sealer thic7ness on long-term sealing abilit # a *-ear

    follow up stud.

    Gn2Roth Thic7 laers O lea7age than thin laers.

    PCS H 8T

    &+-*;K 'etac ndoK Sealape)Thic7 and thin laers.