Endodontic Sealers

A presentation by:
Dr. Batool Makki
Dr. Mohammed Hilal
Dr. Debaj Ahmed

Supervised by:
Dr. Safa
 Introduction
• After the root canal system has been
appropriately prepared, it must be obturated
with a material capable of completely
preventing communication between the oral
cavity and the periapical tissue.
 Introduction
• The materials commonly used for root canal
fillings can be divided into gutta-percha core
filling material and sealer.
 Introduction
Root canal sealers are necessary
to:

• Seal the space between the core

material and dental walls.
• Fill all the discrepancies between
the cone and the canal walls
(lateral and accessory canals).
• Serve as lubricant during
obturation process.
Several types of root canal sealers are used in endodontic
practice
 Grossman’s Ideal requirements
of Root Canal Sealer
• Tacky which helps for good adhesion between it and the canal
wall when set.
• Provide an excellent seal apically and laterally.
• Produce adequate adhesion when it sets.
• Radiopaque.
• Non staining.
• Dimensionally stable.
• Easily mixed and introduced in the canal.
• Soluble in a common solvent.
• Insoluble in tissue fluids.
• Bacteriostatic.
• Biocompatible.
• Set slowly.
• Neither mutagenic nor carcinogenic.
• Not provoke an immune response in periradicular tissue.
 Types of endodontic sealers

• Zinc oxide and eugenol sealer.

• Non eugenol sealers.
• Medicated sealers (containing formaldehyde).
• Solvent based sealer (Chloropercha).
• Calcium hydroxide sealers.
• Glass ionomer sealers.
• Resin based (epoxy resin or methacrylate resin)
sealers.
• Silicone sealers.
• Calcium silicate based sealers.
 Zinc oxide Eugenol sealer
• For many years zinc oxide containing
sealers have been the most popular
and widely used sealer.
• There are many formulations and
brands of sealers that have zinc
oxide as the primary ingredient,
differing only by other components
added to the sealer.
Conventional zinc oxide sealers
are generally based on the
formulas of
Grossman or Rickert.
GROSSMAN’S SEALER (Original formula)

POWDER LIQUID

Zinc oxide 40% Eugenol

Staybelite resin
30%
Bismuth sub-
carbonate 15%
Barium sulfate
15%
Sodium borate
<1%
 PROCOSOL NON-STAINING CEMENT
(GROSSMAN, 1958)
POWDER LIQUID

Zinc oxide 40% Eugenol 80%

Staybelite resin 27%

Sweet oil of
Bismuth subcarbonate 15%
almond 20%

Barium sulfate 15%

 Roth’s sealer
• It is the same as
Grossman’s original
formulation with the
substitution of bismuth
sub nitrate for bismuth
sub-corbonate .

• Roth’s 801 is an
modern-day Grossman
formula and its newer
version is Roth’s 811
• Rickerts’s formula (Dixon and Rickert 1931).

Rickerts’s formula marketed as Kerr’s pulp canal sealer. Major

disadvantage is rapid setting time especially in regions with high
temp. and high humidity. To over come this disadvantage, the
researchers formulated pulp canal sealer EWT (6 hours).

LIQUID
POWDER
Oil of cloves
Zinc oxide
(Eugenol)
Silver

Resins Canada
balsam
Thymol
iodide
 Tubli-Seal
Catalyst
Base paste
paste
Zinc oxide Eugenol

Barium sulfate Polypale resin

Mineral oil

Corn starch Thymol iodide

Lecithin
Setting time: glass slab (20 minutes)
root canal (5 minutes)
Tubliseal
Advantages: Disadvantages:
• Irritate periapical tissues
• Quick and Easy mix and
• very low viscosity easy
manipulation
extrusion through apical
• Provides High lubrication foramen
(Due to its lubrication • short working time, rapid
property can be used set especially in the
when it is difficult for the presence of
master cone to Reach moisture (used when apical
the last millimeter of surgery is to Be performed
preparation) immediately after filling)
• Does not stain teeth
• Expands after setting
The company has reformulated the sealer to extend
working time, it now available in auto-mix tube
Tubliseal Express
Practically all ZOE Sealer Cements are cytotoxic and invoke an
inflammatory response in connective tissues.
 NOGENOL
• This product is developed to over come
the irritating effects of eugenol.
• It is an outgrowth of a non-eugenol
periodontal pack.
• has a long working time on the mixing
pad. Setting time in the mouth is 7
minutes.
Base paste Catalyst paste
Zinc oxide Hydrogenated rosin
Barium sulfate Methyl abietate
Bismuth Lauric acid
oxychloride
Chlorothymol
(disinfectant)
Vegetable oil
Salicylic acid
Medicated Sealers
 Cholorpercha

Chloropercha is
obtained by mixing
gutta percha with
chloroform.

POWDER LIQUID

Canada balsam 19.6%

Rosin 11.8%
Chloroform
Gutta percha 19.6%
Zinc oxide 49%
Chloropercha is no longer used as an
obturation material in root canal therapy due
to:

• Has no adhesive properties.

• Chloro percha products undergo shrinkage
of during the evaporation of chloroform
which result in greater degree of leakage.
• Irritant to the periapical tissues.
• Carcinogenic.
Ca(OH)2 sealers
• Ca (OH)2 sealers were developed for therapeutic activity.
• Ca(OH)2 sealers have antimicrobial effect due to release of
hydroxyl ions and by having a high pH.
• In addition to the therapeutic effect, Ca(OH)2 sealers are
biocompatible.
• The antibacterial effects of calcium hydroxide in sealers are
variable. Cytotoxicity appears to be milder than for other
groups of sealers. Has the potential for the formation of
calcific repair tissues in the vicinity of the materials.
Powder
• Calcium aluminium lanthanum fluorosilicate glass.
• Calcium volframate.
• Silicic acid.
• Pigments.
Liquid
• Polyethylene polycarbonic acid/maleic acid.
• Copolymer.
• Tartaric acid.
• water.
Advantages: No longer marketed,
• Optimal physical qualities. these were considered to be
biocompatible and to show
• Shows bonding to dentin. some adhesion to dentin,
• Shows minimum number of voids. both of which are seen as
desirable properties in a root
• Low surface tension filling. Since their
• Optimal flow property. introduction some 20 years
ago, they have been used
widely despite laboratory
findings of leakage and
disintegration.

Disadvantages
• Cannot be removed in the event of retreatment – No solvent
• Toronto/Osract group – chloroform and ultrasonic no.25 file
 Resin sealers
They are two major categories:

 Epoxy resin based sealers.

 Methacylate resin based sealers

 Epoxy resin sealers
AH 26 AH PLUS
Powder Liquid Paste A Paste B
Bismuth oxide Bisphenol diglycidyl Calcium tungstate Adamantiameamine
Hexamethylene ether Zirconium oxide N,N- dibenzyl-5-Oxanonane-
teramine Silica diamine-1,9,TCD-diamine
Silver powder Iron oxide Zirconium oxide
Titanium oxide Silica
Silicone oil

Slow Setting time:24- 36 hours Short Setting time: 8 hours.

Releases small amount of

formaldehyde on mixing, making it Not release formaldehyde upon setting
toxic in nature. (biocompatible).

Tooth staining from silver. No staining.

Less soluble. Half solubility when compared to AH 26.
 Methacrylate resin
sealers
Four generations of methacrylate
resin–based root canal sealers have
been marketed for commercial use.
HYDRON
• First generation of hydrophilic methacrylate
resin based sealer.
• Appeared in the mid 1970s.
•The major component is Polymer of hydroxy
ethyl methacrylate.
•It is available as an injectable root canal
sealer without the use of a core.
• Hydron became obsolete in the 1980s since it
cause irritation to the periapical tissues.
 Endo REZ
• Second generation of hydrophilic
methacrylate resin based sealer.
• Contain UDMA (Urethane
DiMethAcrylate).
• Hydrophilic properties. It is designed to
flow into accessory canals and D.tubules
to facilitate resin tag formation for
retention and seal after smear layer
removal with NaOCl and EDTA.
• Seal best when applied to moist
interradicular dentin.
• Used with either conventional GP or
specific EndoREZ points (resin coated
GP).
 EPIPHANY
• Third generation of methacrlylate resin based
sealer.
• This system involve:
• Self etch primer before placement of sealer.
• Dual curable resin composite sealer composed of:
 BisGMA (bisphenol A and Glycidyl
MethAcrylate).
 Ethoxylated BisGMA.
 UDMA.
 Hydrophilic difunctional methacrylates
 Fillers of: Ca(OH)2, barium sulfate, barium
glass and silica.
• Used with RESILON points [(thermoplastic synthetic
polymer based root canal points) which contain bioactive
glass, bismuth and barium sulfate] to achieve excellent seal by
creating a MONOBLOCK.
 EPIPHANY
Prior to the application of primer:
 17% EDTA- smear layer removal.
 Rinsing with saline or 2% CHX.
 Primer with paper points.
 Sealer mixed (dual syringe mixed with auto mixing tip).
 Applied into the canal using lentulo spiral or Master
Cone.
PROPERTIES
• Highly radiopaque.
• Easy to remove.
• Dual curing, hydrophilic.
• Biocompatible, non-mutagenic and non-cytotoxic.
• Improves the fracture resistance of the roots.
 MetaSEAL

Fourth generation self-adhesive dual-cure sealer, available in the

powder-liquid form. It is an insoluble, radiopaque material that
can be used either with resilon or Gutta-percha.

Powder Liquid
Zirconia oxide 4-META, mono-
filler, silicon functional
dioxide filler and methacrylate
polymerization monomers and photo-
initiators initiators
 RealSeal SE

• Fourth generation of methacrylate

resin based sealer.
• Acidic resin monomers that are
originally present in primers are now
incorporated into the resin-based
sealer to render them self-adhesive to
dentin substrates.
Advantages:
• Biocompatible
• Nontoxic and
Nonmutagenic
• Leak-Resistant. Unlike
gutta percha, RealSeal
leaves no gap for leakage.
Coronal and apical leakage
are substantially reduced.
• Strengthening. Gives the
root significant toughness.
• Technique-Compatible.
Works with your current
filling method.
Retreatable. With
chloroform and/or heat.
Sodium hypochlorite may
•negatively
Radiopaque.
affect bond
strength.the last irrigation
should be EDTA & Sterile
water or chlorhexidine. RealSeal resin tags (electron
microscopy 1500X)
Silicone sealers
ROEKOSEAL
• Composition – poly dimethyl siloxane, silicone oil, paraffin base
oil, hexachloroplatinic acid, zirconium dioxide.
Properties
• Biocompatible.
• Excellent flow.
• Insolubility.
• Expands slightly on setting(0.2%).
• Highly radiopaque.
• Hydrophobic
 Guttaflow
• Prepared by mixing gutta percha powder (to a low grain size) into the
components of silicone sealer.
• Unidose capsule, injected after mixing for 30 seconds in a standard triturator
followed by placement of single master cone.
• Working time: 15min.
• Setting time: 25-30min.
• The material fills canal irregularities with consistency.
• Biocompatible.
 GUTTA FLOW2

Advantages:
• No heat – no shrinkage
• Sealer and Gutta-percha
in one material.
• Exceptional flow plus
expansion no
condensation required.
• Adheres to Gutta-percha
and dentin.
• Solubility of 0.0%
• contains micro-silver
that provides optimum
protection against re-
infection of the root
canal. The chemical form
and concentration of the
silver does not lead to
any corrosion or
discoloration
 Calcium silicate sealers
These sealers are an outgrowth of the
popularity of MTA materials, which are
based on tricalcium silicate, a
hydraulic (water setting) powder used
for various surgical and vital pulp
therapy treatments.
 Conclusion
• Among the multiple brands
and variety of sealant
types, a clinician’s sound
knowledge with proper
manipulation should guide
the way to correctly
choosing the type that
fulfills the obturation
needs…
 References
• Endodontic sealers a presentation by Dr. A.M.Badraldin published at G.V.Black
Dental Center Khartoum-Sudan Jully-2009.
• Endodontic sealers a presentation by Dr. JAGADEESH K. on www.Slideshare.com
• https://www.ncbi.nlm.nih.gov
• https://pubchem.ncbi.nlm.nih.gov (Information about certain chemical components)
• Materials used for root canal obturation: technical, biological and clinical testing by
DAG ØRSTAVIK (Article)
• Calcium Hydroxide–Based Root Canal Sealers: A Review (Article) By Shalin Desai,
BDS, and Nicholas Chandler, BDS, MSc, PhD
• Ingle’s Endodontics 6th edition (general information)
• Cohen’s Pathways of the pulp 11th edition (general information)