Endodontic sealer types

Leakage around calcium hydroxide sealers has been studied experimentally, and findings have generally been satisfactory [34-36]. However, there have been some adverse reports [37], and these variations have been attributed to crucial differences in experimental methods [38]. Leakage appears to be related to both the solubility of the material and the questionable adhesion to both the dentine walls and the gutta percha points. The calcium hydroxide sealer Apexit, for example, was found to have a high solubility when set compared with other types of endodontic sealer [39] and, in some studies, sealer particles have been found to occur with the tissues at a considerable distance from the sample [40,41],... 

The epoxy sealer AH26 Plus has been shown to have reasonable anti-bacterial properties [43]. In a comparative study of several different types of endodontic sealer, it was found to be as effective as Grossman s sealer in reducing the number of cultivable cells of Enterococcus faecalis. By contrast, the calcium hydroxide sealers Apexit and Sealapex were not effective at aU in reducing the number of these cells. 

Over the years, a number of brands of this type of endodontic sealer have become available [75]. In recent years, there has been considerable interest in two brands, which have been widely studied. These are EndoREZ (Ultradent Products, Utah) and Epiphany (Penton Clinical, Connecticut), though other materials of this type are also discussed in recent publications [76]. The brand Epiphany has been designed specifically to be used in conjunction with the polycaprolactone endodontic points marketed under the brand name Resilon. The good adhesion obtained between the resin and these points has led to the suggestion that this system may be capable of behaving effectively as a monoblock [75], though experimental results do not really support this concept. 

There have been several smdies of the biological effects of resin-based endodontic sealers [82-85]. As with other types of endodontic sealer, adverse reactions are... 

These biological findings suggest that these resin-based endodontic sealers are acceptable for clinical use, a result that has been confirmed by clinical evaluations [86-88]. In one 5-year smdy involving 129 patients, results showed that root canals were adequately filled in 76.66% of cases (92) and were short in 10.83% (13) of cases. In 15 cases (12.50%), there was evidence of slight resorption of the sealer at the apex within the lumen of the root canal. These clinical results show that resin-based sealers compare well with sealers based on other types of material, and that they are satisfactory for use in endodontics [48,89],... 

Materials employed as points are usually fabricated from gutta percha, though other materials have been considered (see Sections 10.2 and 10.3). Materials for sealers may be cements, including acid-base cements, or methacrylate monomer-based materials of the type used in composite resins. However, more commonly in modem endodontics, cements based on tricalcium silicate systems that set by hydration processes are used. This chapter discusses the wide variety of possible materials that can be used for this purpose, with some indication of the clinical effectiveness. 

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