Types of Sealers and Their Importance
Endodontic sealers are essential for root canal treatment (RCT) and endodontic practice. Different types of sealers are used during the obturation procedure, the final step in RCT.
An endodontic filling consists of two materials primarily:
- Gutta-percha (core)
- Endodontic sealers
To give a 3-dimensional seal, the correct application of sealer along with gutta-percha is equally important.
This article explains the different types of sealers and their importance in endodontic treatments.
What are endodontic sealers?
Endodontic sealers are filling materials that fill the space between gutta-percha, dentin walls, and root canal space.
Sealers are dental cement that forms a tight seal and covers all the gaps and irregularities during the obturation process.
What is the importance of endodontic sealers?
Root canal sealers provide fluid tight seal in the root canal space as it fills the empty space between prepared dentinal walls and core filling material.
Key functions of endodontic sealers are:
Binding
Apart from gutta-percha, obturation needs a filling material or a sealer to close the open canal spaces and irregularities. A sealer acts as a binding agent that fills in these spaces. It binds the materials and prevents leakages.
Lubrication
Sealers have lubricating properties. Gutta-percha is a solid material and does not flow or lubricate the dentin walls. It helps the solid gutta-percha to penetrate the narrow areas within the canals and facilitate proper placement of the core filling material.
Adhesive agents
Sealers chemically bond and attach to the core materials and the dentin and prevent micro-leakage of fluids.
Antibacterial components
Sealers may have antimicrobial properties that remove residual bacteria and microorganisms from the root canal and prevent further infections. This enhances the longevity of the root canal treatment.
Biocompatibility
Root canal sealers are biocompatible which means they bond well with the surrounding tissues and do not cause adverse reactions like allergies, infections, or inflammations.
What are the types of endodontic sealers?
A good sealer should provide a tight seal, are non-toxic, and are well-absorbed by the soft tissues present in the root canal.
Ideal properties include:
- Opacity (visible on radiographs)
- Provides a hermetic or air-tight seal
- Allows good chemical binding
- Fine powder that mixes well with other solvents
- Nontoxic, non-irritating, and non-staining
- Tissue-tolerant
- Antibacterial
- Does not shrink after setting
Types of sealers:
Zinc oxide eugenol-based (ZOE) sealers –ZOE is widely used for endodontic and root canal treatments. It is one of the oldest sealers developed in 1931 by Rickert and Dixon, which came to be known as the Kerr sealer. Later in 1936, Grossman developed a formula known as Proco-Sol. ZOE consists of zinc oxide and liquid eugenol, an oil extracted from cloves. Some drawbacks of ZOE are slow setting time, high solubility, and weak in nature.
Calcium hydroxide-based (CH) sealers–It is highly alkaline and is believed to help in remineralisation procedures. It has antimicrobial properties. Studies show that CH has mild cytotoxicity compared to other sealers.
Epoxy resin-based sealer – Epoxy resin sealers like AH Plus have less solubility and take approximately 8 hours to set. Other epoxy sealers like AH 26 have good flow, high adhesivity, and low solubility but a comparative study shows that it is more toxic compared to AH Plus.
Glass ionomer-based sealer–These sealers have good adhesion qualities and bond well with the dentin. Disadvantages are that they have minimal microbial activity and need to be removed during retreatment.
Final words
Dentists should choose endodontic sealers that are leakage-free, offer tight sealing, and protect the root canal and dentin from long-term bacterial infections.
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