Root Canal Sealers

Dr Aaron Sarwal
Root Canal Sealers
 Root canal sealers are used in conjunction with
biologically acceptable semi-solid or solid obturating
materials to establish an adequate seal of the root
canal system.
(Grossman)
Root Canal Sealers
 Sealers are the binding agents use to fill up the gap between
the root canal walls and the obturating materials.

 They also fill up the irregularities, discrepancies, lateral canals

and accessory canals.
 Grossman’s Criteria for an Ideal
Root Canal Sealer
 Should form a hermetic seal
 Provide good adhesion between itself, and the canal walls,
and the filling material.
 Be radio opaque
 Should not stain the tooth structure.
 Should be dimensionally stable.
 Be easily mixed and introduced into the canals.
 Should be easy to remove if necessary.
 Be insoluble in tissue fluids.
 Bactericidal or bacteriostatic.
 Nonirritating to periradicular tissues.
 Should set slowly to provide working time.
What does a Sealer do?
 Antimicrobial Agent
 Binding Agent
 A filler
 A lubricant
 Provides radiopacity
 As canal obturating material
Grossman’s Classification Of Currently
Employed Root Canal Sealers

Zinc Oxide Calcium Glass Resin

Eugenol Hydroxide Ionomer Based
Based Based Based Sealers
Sealers Sealers Sealers
• Grossman’s • SealApex • ZiCal • AH Plus
Formula • ApexIt • Ketac Endo • AH26
• Roth’s 801 • Epiphany
• TubliSeal • Diaket
A. Zinc Oxide Eugenol Based Sealers
 Most common sealers use ZnO
as a base ingredient for the
powder.

 The liquid usually contains

eugenol either alone or in
combination with other liquids.

 Grossman’s Non-staining
cement was developed to meet
most of his criteria for an ideal
RC sealer.
 Non Staining Cement (Grossman 1958)

POWDER LIQUID

ZnO 42% Eugenol

Staybelite Resin 27%

Bismuth Subcarbonate 15%

Barium Sulphate 15%

Sodium borate, anhydrous 1%

Non Staining Cement (Grossman 1958)
 Setting time: 2 hours (37°C @
100% humidity)
 Sets in the root canal within
10-30 mins due to the moisture
of dentin.
 Quality of ZnO and pH
influence setting.
 Plasticity and low setting time.
 Good sealing potential and
small volumetric change on
setting.
Grossman’s Sealer
 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.
 Consistency is tested by raising the spatula from the slab and
checking for a “string out” about 1 inch long.
Correct consistency of mixed sealer
 Mix should coat the GP
cone well.

 It should not be too thick

and neither too thin.

 A thick sealer will not

allow the GP cone to seal
the apex.

 A thin sealer will not be

able to coat the walls
properly and may be
pushed periapically.
B. Calcium Hydroxide Based Sealers
 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.
Advantages Of Ca(OH)2 Based Sealers
 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.
Sealapex by Kerr
 Non eugenol calcium hydroxide polymeric resin root
canal sealer.

 It is delivered as paste to paste formulation.

Sealapex by Kerr
 BASE
 ZnO with Ca(OH)2
 Butyl benzene
 Sulfonamide

 CATALYST
 Barium sulfate,
 Titanium dioxide as radioopacifiers
with proprietary resin
 Isobutyl salicylate and
 Acrocil R 972.
 Zinc stearate
Calcium Hydroxide Based Sealers
 Howland and Dumsha reported the same amount of
microleakage in Sealapex, Proscol and Tubliseal.

 Cox et al reported better healing at 6 months with

Sealapex as compared to AH26 and Rickert’s Sealer.

 Another calcium hydroxide based sealer is CRCS

(calcibiotic root canal sealer) which when set contains
14% by wt of calcium Hydroxide.
 C. Glass Ionomer Based Sealers
 Advocated as root canal
sealers due to their ability
to bind with dentin.

 Ketac Endo by 3M ESPE is

an example.

 Not popular as they are

difficult to remove during
retreatment.

 Solvents are ineffective

against them.
 D. Resin Based Sealers
 AH26 (Dentsply DeTrey) is an
epoxy resin containing a
nontoxic hardener.

 Radio-opacity is imparted by
bismuth oxide.

 Strong adhesive properties and

contracts slightly while
hardening.
AH26 vs. AH Plus
 AH26 was found to  AH Plus Paste A:
release formaldehyde  BADGE
during setting.  Calcium tungstate
 Zirconium oxide
 AH Plus is a modified  Silica
formulation of AH26  Iron oxide pigments
and doesn’t release
formaldehyde.  AH Plus Paste B:
 Adamantane amine
 Silica
 Silicone oil
 AH Plus
 Advantages:
 Good sealing ability
 Biocompatibility to periapical
tissues
 Moderate antimicrobial
activity
 Dentinal Adhesion
 Long working time and ease
of manipulation.
 Conclusion
 No root canal filling material is
entirely innocuous.
 Any extrusion reduces the chance
of healing by as much as 25%.
 ZoE cements are irritating due to
eugenol.
 Epoxy resin sealers are more bio-
compatibile.
 Irritation caused by overfilling is,
fotunately, generally mild for
most materials.
 Confining filling to the canal is
the best.