Endodontics

BioRoot™ RCSSucceed.

Long term success

Easy & fast technique

What if you didn’t need to compromise between long term clinical success AND easy & fast technique?

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Endodontic obturation implies facing a number of requirements.

Clinical requirements

Procedural requirements

Current techniques all have compromises

EASY TO IMPLEMENT TIME EFFECTIVE

COST EFFECTIVE EASY TO RE-TREAT IF NECESSARY

Sealer Gutta-Percha

Sealer Gutta-Percha

Sealer Gutta-Percha

LATERAL AND APICAL SEAL

1

4

6

5

7

ANTIMICROBIAL

2NO SHRINKAGE

3

5

Long term clinical success

Optimisedpatient chair time

4

Single Cone Technique

Lateral Condensation

Warm Vertical Condensation

Drawbacks

Drawbacks

Drawbacks

Lateral and apical seal limited to sealer penetration.

Time consuming to: - learn the technique - compact each GP cone individually.

Implementation requires additional finger spreaders.

Sealers’ shrinkage leads to gaps and voids.

Implementation: need for a highly tapered canal.

Time consuming to: - learn the technique - implement the technique properly Heat may modify properties of sealers.

Cost: Purchase of additional equipment.

Benefits

Benefits

Benefits

Lateral and apical seal achieved by “pushing” the sealer inside the tubules & lateral canals.

Cost effective need for Gutta-Percha and sealer.

Tight lateral and apical seal through melting and compaction of Gutta-Percha.

Lateral and apical seal limited to sealer penetration, i.e. relatively low seal.

Sealers’ shrinkage leads to gaps and voids.

Easy to implement no learning curve.

Time effective a fast procedure in only 3 steps.

Cost effective need for Gutta-Percha and sealer only.

TIGHT LATERAL AND APICAL SEAL

3-dimensional seal achieved without compaction.

FAST IMPLEMENTATION

TIME

through placement of a single cone.

SIMPLE & EASY OBTURATION TECHNIQUE

no learning curve.

NO SHRINKAGEresin-free material, maintains the

seal quality over time.

EASY RETREATMENTdissolve gutta-percha with eucalyptol and

remove obturation with endo instruments.

LIMIT BACTERIAL GROWTH

superior calcium ion release leading to pH increase (>11).

HIGHLY COST EFFECTIVE

no need to purchase additional equipment,

reduced cost per obturation.

No More Compromise!BioRoot™ RCS is easy to use and brings long term clinical success.

New Concept: Hydraulic Filling

Clinical requirements

Procedural requirements

BioRoot™ RCS introduces the concept of Hydraulic Filling, which releases the achievement of a tight endodontic seal from technique dependence. Both the lateral and apical seal are obtained with a simple cold technique.

The procedure is simple and fast while, at the same time, BioRoot™ RCS ensures long-term clinical success.

BioRoot™ RCS Gutta-Percha

BioRoot™ RCS is hydrophilic: it flows into the dentinal tubules & lateral canals

Crystallisation while setting: chemical bonding with dentine and tight seal

Gutta-percha: soft core in case a retreatment is needed

Bioactivity: It supports peri-apical healing

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Obturation with BioRoot™ RCS, note the obliteration of the lateral canal in the apical third. Courtesy Dr Ambu, Italy.

BioRoot™ RCS: only benefits

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54

3

7

2

6

8 9

1 Day 2 Days 3 Days 4 Days

5

6

7

8

9

10

11

12

mm

+/-

sta

ndar

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viat

ion

0

1

2

3

0,5

7 Days 30 Days

1,5

2,5

3,5

BioRoot™ RCS

AH Plus Jet

Pulp Canal Sealer (PCS)

Pulp Canal Sealer (PCS) + warm compaction

BioRoot™ RCS + cold technique

74%

78%

82%

86%

76%

CBCT images Periapical radiographs

80%

84%

88%

90%

92%

AH Plus Warm vertical condensation group (51 tooth)

BioRoot™ RCS single cone group (53 thooth)

84% 80% 90% 89%

Zavattini A, Knight A, Foschi F, Mannocci F, Outcome of Root Canal Treatments Using a New Calcium Silicate Root Canal Sealer: A Non-Randomized Clinical Trial, J Clin Med., 2020 Mar 13;9(3).

Non randomised clinical trial CBCT and PA radiographs were made at baseline and at 12 months recall.

The increase or decrease in the size of preoperative periapical radiolucencies and development of new radiolucencies were assessed by a consensus panel consisting of two pre-calibrated examiners.

At 1 year recall 104 teeth were assessed.

BioRoot™ RCS obturation with apical healing

Success rate criteria

Vert. Cond.

Vert. Cond.

BioRoot™ RCS

BioRoot™ RCS

BioRoot™ RCS obturation after retreatement procedure

Pre-op X-ray. Note the periapical lesion.

Pre-operative X ray of tooth #36 of a 31 years old female patient.

Instrumented canal. Gutta-percha master cone fitted to length.

Post-operative X ray after completion of endodontic treatment.

Master cone coated with BioRoot™ RCS, cemented and finished with plugger at orifice.

Decentred post operative X-Ray showing the slight extrusion of material in the inter-radicular area.

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One-year post-op Xray showing complete periapical healing.

6 months post-operative recall.

2 techniques compared

VSWarm vertical condensation of gutta-percha and AH Plus**

Single cone technique

and BioRoot™ RCS*

What if you could reach a newparadigm?

*Septodont **Dentsply Sirona

Clinically provenBioRoot™ RCS: similar clinical success as vertical condensation.

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1 Day 2 Days 3 Days 4 Days

5

6

7

8

9

10

11

12

mm

+/-

sta

ndar

d de

viat

ion

0

1

2

3

0,5

7 Days 30 Days

1,5

2,5

3,5

BioRoot™ RCS

AH Plus Jet

Pulp Canal Sealer (PCS)

Pulp Canal Sealer (PCS) + warm compaction

BioRoot™ RCS + cold technique

74%

78%

82%

86%

76%

CBCT images Periapical radiographs

80%

84%

88%

90%

92%

AH Plus Warm vertical condensation group (51 tooth)

BioRoot™ RCS single cone group (53 thooth)

84% 80% 90% 89%

• Hydraulic infiltration of dentinal tubules and lateral canals• Creates a mineral interaction zone in the dentine tubules along with

biomineralisation and phosphate deposition at the dentine interface (1,2)• The bonding of BioRoot™ RCS is chemical in nature, as opposed to resin

based sealer (2) and provides tight 3D seal. (Resin-free)

• No shrinkage, less than 0.1% dimensional change maintaining seal quality over time• Obliteration of lateral canals• Stronger seal at short times than warm technique (BioRoot™ RCS Science File)

Hydraulic filling for stable chemical bonding

Tight lateral and apical seal

Apical penetration length after teeth immersion at 37°C and 100% relative humidity for 7 or 30 days.Source: Internal Scientific file.

Obturation with BioRoot™ RCS, note the obliteration of the lateral canal in the apical third. Courtesy Dr Ambu, Italy.

Bioactivity* to support peri-apical healing• Crystallises as biological apatite inducing

osteogenic** properties (5)• Stimulates periodontal ligament (PDL)

cells proliferation (5,6)

BioRoot™ RCS (cold technique) shows less microleakage than warm technique

Post-operative X ray after completion of endodontic treatment.

6 months post-operative recall.

*bioactivity: any effect on, interaction with or response from a living tissue.**properties of a material to bring proper conditions for bone cells to form bone.

Technical Insights Technical Insights

• Easy coating of root canal walls• Rapid insertion of the Gutta-Percha point• Optimised working and setting times:

• Working time: > 10 minutes• Setting time: < 4 hours

Fast placement

Take mixed BioRoot™ RCS. Coat the root canal walls with BioRoot™ RCS.

Coat the apically adjusted cone with BioRoot™ RCS.

Insert the cone gently into the root canal.

Immediate post-operative radiograph.

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Clinical implementation

• BioRoot RCS releases twice as much calcium as Endosequence BC sealer and ten times more than MTA Fillapex (1)

• Based on proprietary Active Biosilicate Technology• Maintains high pH (7) to limit bacterial growth (3,4)• Reduces the risk of bacterial reinfection

Limit bacterial growth for obturation success

Simpler & better retreatment

Easy follow-up

1 Day 2 Days 3 Days 4 Days

5

6

7

8

9

10

11

12

mm

+/-

sta

ndar

d de

viat

ion

0

1

2

3

0,5

7 Days 30 Days

1,5

2,5

3,5

BioRoot™ RCS

AH Plus Jet

Pulp Canal Sealer (PCS)

Pulp Canal Sealer (PCS) + warm compaction

BioRoot™ RCS + cold technique

74%

78%

82%

86%

76%

CBCT images Periapical radiographs

80%

84%

88%

90%

92%

AH Plus Warm vertical condensation group (51 tooth)

BioRoot™ RCS single cone group (53 thooth)

84% 80% 90% 89%

Comparative pH evolution of 3 root canal sealers: BioRoot™ RCS, AH Plus Jet (Epoxy resin matrix) and Pulp Canal Sealer (Zinc Oxide Eugenol).Source: Internal Scientific file

pH Evolution (Set Material)

• Shorter retreatment times (8)• Less sealer remnants observed (8)

• 5 mm Al radiopacity for easy follow-up on the radiograph

What if you could obturate beyond cold compaction boundaries?

Presentation

35-application pack- 15 g powder bottle- 35 single dose containers

References

Septodont - Units R & S - Orchard Business Centre - St Barnabas Close - Maidstone - Kent - ME16 0JZTél. : +44 (0)1622 695520 - Fax : +44 (0)1622 695521

Please visit our website for more information: www.septodont.co.uk

Xuereb, Vella, Damidot,Sammut, Camilleri

In situ assessment of the setting of tricalcium silicate-based sealers suing a dentin pressure model

J Endond 2015 1

Viapiana, Moinzadeh, Camilleri, Wesselink, Tanomaru Filho,Camilleri

Porosity and sealing ability of root fillings with gutta-percha and BioRoot™ RCS or AH Plus sealers.Evaluation by three ex vivo methods.

Int Endod J 2016 2

Arias-Moliz, CamilleriEffect of the final irrigant on the antimicrobial

activity of root canal sealersJ Dent 2016 3

Urban, Neuhaus, Donnermeyer, Schäfer, Dammaschke

Solubility and pH values of 3 different root canalsealers : a long term investigation

J Endod 2018 4

Camps, Jeanneau, El Ayachi, Laurent, About

Bioactivity of a calcium silicate based endodontic cement (BioRoot™ RCS) : interactions with human periodontal

ligament cells in vitroJ Endod 2015 5

Dimitrova-Nakov, Uzunoglu,Ardila-Osorio, Baudry, Richard,

Kellerman, Goldberg

In vitro bioactivity of BioRoot RCS via A4 mouse pulpal stem cells

Int Endod J 2015 6

Siboni, Taddei, Zamparini, Prati, Gandolfi

Properties of BioRoot™ RCS, a tricalcium silicate endodontic sealer modified with povidone and polycarboxylate

Int Endod J 2017 7

Donnermeyer, Bunne, Schäfer, Dammaschke

Retreatability of three calcium silicate-containing sealers and one epoxy resin-based root canal sealer

with four different root canal instrumentsClin Oral Investig 2018 8

Jeanneau, Giraud, Laurent, About

BioRoot™ RCS extracts modulate the early mechanisms of periodontal inflammation and regeneration

J Endod 2019

Authors Title Journal Year Ref.

All registered trademarks and copyrighted product names are the property of their companies and affiliates

BioRoot ™ RCS

Biodentine™

800+

15 years of research and development and partnership with dental schools

worldwide have led to one of the latest Septodont proprietary innovations in

the field of dental materials: tricalcium silicate based products (C3S).

Active Biosilicate Technology:

innovative bioactive dental materials