Root canal sealers

What root canal sealers are available today?

Root canal sealers come in a wide variety of different categories. Farther down I go into all the categories.  Here I just list the two I have most frequently used.

AH Plus

  1. Epoxy paste – diepoxy, calcium tungstate, zirconium oxide, silica=aerosol, dye
  2. Amine paste – 1-adamantane amine, N.N’dibenzyl-5oxanonandiamine-1,9, TCD-diamine, calcium tungstate, zirconium oxide, aerosol, silicon oil
  3. Adding CHX AND CTR increases antibacterial effect  Bailón-Sánchez 2014

Endosequence BC Sealer

  1. Zirconium oxide, calcium silicates, tantalum oxide, calcium phosphate monobasic, calcium hydroxide, filler, thickening agents

Radiopacifying agents in order

  1. Bismuth oxide
  2. Zirconium oxide
  3. Calcium tungstate
  4. Barium sulfate
  5. Zinc oxide

General categories of dental sealers

ZOE and ZON-E

  • Roth sealer, Grossman’s, Pulp Canal Sealer by Kerr, Root Canal Sealer by Pulpdent, Tubli-Seal Xpress by Kerr
  • Non-eugenol – Nogenol by GC America

Epoxy Resins

  • AH26, AH Plus, Diket, Endofil, Epiphany
  • TopSeal
  • 2-seal
  • EZ-Fill Xpress by Essential Dental Systems
  • SimpliSeal by Kerr
  • Sealer Plus has calcium hydroxide and is less cytotoxic than other resins. Cintra JOE 2017

Methacrylate Resins

  • Real Seal=UDMA, PEGDM
  • EndoREZ=UDMA, zinc oxide, barium sulfate, resins, pigments A, Bis-EMA, BisGMA, silane heated barium borosilicate glasses, barium sulfate, silica, calcium hydroxide, bismuth oxychloride with amines, peroxide, photoinitiator, stabilizers, pigment
  • Smartseal
  • Epiphany
  • MetaSeal by Parkell

CaOH (Bioactive)

  • Sealapex, Apexit Plus
  • Calcicur=45%CaOH2, radio-opaquer, thickeners

Calcium phosphate

  • CapSeal

GIs

  • Ketac-Endo, ActivGP

MTA

calcium silicate-based (Bioactive) but based on salicylate resin and other resins (at least Fillapex anyway Almeida 2017 JOE)

  • MTA Obtura
  • MTA fillapex
  • ProRoot MTA
  • Endo-CPM-Sealer
  • MTA Plus?
  • Biodentine?

Bioceramics “chemically bonded ceramic” (Bioactive)

  • EndoSequence BC Sealer – Calcium Silicate bioceramic (aluminum-free, not portland cement composition)
  • Iroot SP
  • Bio aggregate

Silicone

  • RoekoSeal
  • GuttaFlow 2 by Coltene

Full and awesome list of root canal sealer options.  It’s from Eur J Gen Dent Tyagi 2013.

What are some root canal sealer options?

What do root canal sealers cost?

Research on different root canal sealers

MTA Fillapex stimulates HA formation – duh but can likely never retreat??

AH Plus (epoxy resin based) beats MTA and iRoot SP (both calcium silicate based) push out test
Also CaOH no effect

Lit review of CaOH sealer = nothing special

BC sealer beating AH Plus June 12 BUT can not retreat once BC is set? look next study below this says yes can

BC Sealer and AH Plus dentin penetration and RETREATMENT efficacy similar Kim JOE 2015

BC beats AH+ and MTA+ push out test DeLong JOE 2015

Lateral and constant tapered cones beat variable taper cones in apical areas

Don’t finish with NaOCl or AH Plus (and likely all resins) don’t bond Neelakantan 2015 JOE July

Retreatment issues?

PCS much easier to clean out than BCS Zuolo JOE 2016

Resorption of extruded root canal sealer

ZOE then CaOH both much better than Resin Ricucci JOE 2016

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