Contemporary Endodontic Sealers

Abstract

Endodontic treatment over goes multiple phases to ensure long term successful outcome. Starting with an accurate diagnosis and treatment planning, through proper debridement and disinfection of the root canal system. Finally maintaining a sterile environment of the pulpal space, by filing its root’s with an inert biocompatible material and securing it with a final restoration, a process known as obturation. Accordingly, quality of the seal was shown to be an influencing factor in the long term success of an endodontic treatment, as root canal obturation act as a barrier isolating both periapical tissue and radicular space from ingress of microbial contaminant, and promotes healing as it entombs any remaining pulpal or microbial irritants. (1)(2)

Traditionally, root canal obturation consist of a core material most typically gutta-percha (GP), and some sort of an endodontic sealant to produce a homogenous filling. (3) These Sealers play a major role in obturation by overcoming the physical limitation of the core material, they help to seal minor anomalies, accessory canals and foramina, and fill any voids between root canal walls and core material. (4)  Sealers also facilitate placement of core material. (5)(6) While the broader objective of these sealers is to ban microbial ingress, some sort of micro leakage does occur in almost all types of sealant used. (7)

Apart from antimicrobial activities, ideal properties desired in an endodontic sealer were outlined by Grossman. These sealers must be biocompatible or at least non-toxic, insoluble in tissue fluids but dissolve in retreatment solvent, and must display excellent sealing ability. Other include; appropriate adhesion to dentinal walls, bacteriostatic, dimensionally stable, provide adequate working time, radiopaque, and must not stain the tooth. (8) Unfortunately, no available sealer displays all of these properties yet. (9) In light of this, selection of any type of an endodontic sealer could therefore affect treatment outcome. (10-13)

Root canal sealers are available in various quantities and have been grouped in a number of arrangement according to either their chemical composition, usage, or tissue absorbance (14) This paper will touch upon conventional ones and will attempt to introduce contemporary and new ones.