a slideshow presentation lectured and presented in Al-Sadr Specialized dental center in the continuing dental learning weekly lectures. Rusafa medical institute- Baghdad- Iraq lecturer: Dr. Rami Ahmed Jumaah (BDS) Supervisor: Dr. Iman J. Ahmed (BDS: MSc)

2. Introduction
• After the root canal system has been appropriately
prepared, it must be obturated with a material capable
of completely preventing communication between the
oral cavity and the periapical tissue.

3. Introduction
• The materials commonly used for root canal fillings can
be divided into gutta-percha core filling material and
sealer.

4. Introduction
Root canal sealers are necessary to:
• Seal the space between the core
material and dental walls.
• Fill all the discrepancies between the
cone and the canal walls (lateral and
accessory canals).
• Serve as lubricant during obturation
process.

5. Several types of root canal sealers are used in endodontic practice

6. Grossman’s Ideal requirements
of Root Canal Sealer
• Tacky which helps for good adhesion between it and the canal wall when
set.
• Provide an excellent seal apically and laterally.
• Produce adequate adhesion when it sets.
• Radiopaque.
• Non staining.
• Dimensionally stable.
• Easily mixed and introduced in the canal.
• Soluble in a common solvent.
• Insoluble in tissue fluids.
• Bacteriostatic.
• Biocompatible.
• Set slowly.
• Neither mutagenic nor carcinogenic.
• Not provoke an immune response in periradicular tissue.

7. Types of endodontic sealers
• Zinc oxide and eugenol sealer.
• Non eugenol sealers.
• Medicated sealers (containing formaldehyde).
• Solvent based sealer (Chloropercha).
• Calcium hydroxide sealers.
• Glass ionomer sealers.
• Resin based (epoxy resin or methacrylate resin)
sealers.
• Silicone sealers.
• Calcium silicate based sealers.

8. Zinc oxide Eugenol sealer
• For many years zinc oxide containing
sealers have been the most popular and
widely used sealer.
• There are many formulations and brands
of sealers that have zinc oxide as the
primary ingredient, differing only by other
components added to the sealer.

9. Conventional zinc oxide sealers are
generally based on the formulas of
Grossman or Rickert.

10. GROSSMAN’S SEALER (Original
formula)
POWDER LIQUID
Zinc oxide 40% Eugenol
Staybelite resin 30%
Bismuth sub-
carbonate 15%
Barium sulfate 15%
Sodium borate <1%

11. PROCOSOL NON-STAINING CEMENT
(GROSSMAN, 1958)
POWDER LIQUID
Zinc oxide 40% Eugenol 80%
Staybelite resin 27%
Sweet oil of
almond 20%
Bismuth subcarbonate 15%
Barium sulfate 15%

12. Roth’s sealer
• It is the same as
Grossman’s original
formulation with the
substitution of bismuth
sub nitrate for bismuth
sub-corbonate .
• Roth’s 801 is an modern-
day Grossman formula and
its newer version is Roth’s
811

13. • Rickerts’s formula (Dixon and Rickert 1931).
POWDER LIQUID
Zinc oxide
Oil of cloves
(Eugenol)
Silver
Canada
balsam
Resins
Thymol iodide
Rickerts’s formula marketed as Kerr’s pulp canal sealer. Major disadvantage
is rapid setting time especially in regions with high temp. and high
humidity. To over come this disadvantage, the researchers formulated
pulp canal sealer EWT (6 hours).

14. PCS/PCS EWT
Advantages:
1. excellent lubricating properties
2. working time more than 30 mints
ratio 1:1 Completely set and
become inert within 15-30min
thus reducing the inflammatory
responses compared to other
That take 24-36hours to set (EWT
6 hour working time).
3. Germicidal.
4. greater bulk than any sealer –this
is ideal for condensation
techniques.
Disadvantages:
• Staining of the tooth
• Rapid setting time in high
heat/humidity region

15. Tubli-Seal
Base paste Catalyst paste
Zinc oxide Eugenol
Barium sulfate Polypale resin
Mineral oil
Thymol iodideCorn starch
Lecithin
Setting time: glass slab (20 minutes)
root canal (5 minutes)

16. Tubliseal
Advantages:
• Quick and Easy mix and
manipulation
• Provides High lubrication
(Due to its lubrication
property can be used when it
is difficult for the master
cone to Reach the last
millimeter of preparation)
• Does not stain teeth
• Expands after setting
Disadvantages:
• Irritate periapical tissues
• very low viscosity easy
extrusion through apical
foramen
• short working time, rapid set
especially in the presence of
moisture (used when apical
surgery is to Be performed
immediately after filling)
The company has reformulated the sealer to extend
working time, it now available in auto-mix tube
Tubliseal Express

17. Practically all ZOE Sealer Cements are cytotoxic and invoke an inflammatory
response in connective tissues.

18. NOGENOL
• This product is developed to over come the
irritating effects of eugenol.
• It is an outgrowth of a non-eugenol
periodontal pack.
• has a long working time on the mixing pad.
Setting time in the mouth is 7 minutes.
Base paste Catalyst paste
Zinc oxide Hydrogenated rosin
Barium sulfate Methyl abietate
Bismuth oxychloride Lauric acid
Vegetable oil
Chlorothymol
(disinfectant)
Salicylic acid

19. Medicated Sealers

20. N2
Powder Liquid
Zinc oxide Eugenol
Zinc stearate Rose oil
Paraformaldehyde
5.710%
Lavender
oil
Titanium oxide Peanut oil
Bismuth carbonate
Bismuth nitrate
Ferric oxide
Hydrocortisone
TOXICITY
Degree of irritation is severe with
over filling , persisting paresthesia.
Endomethasone
Powder Liquid
Zinc oxide Eugenol
Dexamethasone
Paraformaldehyde
Bismuth subnitrate
Thymol iodide
Hydrocortisone
Sometimes endomethazone gives pain or
discomfort after 6-8 weeks of insertion.

21. Cholorpercha
Chloropercha is obtained
by mixing gutta percha
with chloroform.
POWDER LIQUID
Canada balsam 19.6%
Chloroform
Rosin 11.8%
Gutta percha 19.6%
Zinc oxide 49%

22. Chloropercha is no longer used as an
obturation material in root canal therapy due
to:
• Has no adhesive properties.
• Chloro percha products undergo shrinkage of
during the evaporation of chloroform which
result in greater degree of leakage.
• Irritant to the periapical tissues.
• Carcinogenic.

23. Ca(OH)2 sealers

24. Calcium hydroxide based sealers
Sealapex
Base
Calcium hydroxide
Zinc oxide
Calcium oxide
Butyl benzene
Silicon dioxide
Catalyst
Barium sulfate 18.6%
Titanium dioxide 5.1%
Zinc stearate 1%
Isobutyl salicylate
Disalicylate
Trisalicylate
Bismuth trioxide
Calcibiotic
Powder
Calcium Hydroxide
Zinc Oxide
Bismuth dioxide
Barium Sulfate
Liquid
Eugenol
Eucalyptol
Apexit
Base
Calcium hydroxide
Zinc oxide
Calcium Oxide
Silicon dioxide
Zinc stearate
Hydrogenised colophony
Tricalcium phosphate
Poly dimethyl siloxane
Activator
Trimethyl hexanedioldisalicylate
Bismuth carbonate basic
Bismuth oxide
Silicon dioxide
1,3 Butanediol di Salicylates
Hydrogenised colophony
Tricalcium phosphate
Zinc stearate
Vitapex Calcium hydroxide, iodoform, mineral oil.

25. Apexit plus
Advantages:
• Excellent tissue tolerance
• Durable sealing of the root canal
due to the slight setting
expansion
• Its easy flowing composition
allows the material to adapt well
even to morphologically
complicated canals
• Convenient application (automix
syringe and Intra Canal Tip
enable easy direct application)
• Long working time (mixed
Apexit Plus can be used over 3
hours at room temperature)
Disadvantages:
Contraindicated in Retrograde
obturation

26. • Ca (OH)2 sealers were developed for therapeutic activity.
• Ca(OH)2 sealers have antimicrobial effect due to release of
hydroxyl ions and by having a high pH.
• In addition to the therapeutic effect, Ca(OH)2 sealers are
biocompatible.
• The antibacterial effects of calcium hydroxide in sealers are variable.
Cytotoxicity appears to be milder than for other groups of sealers.
Has the potential for the formation of calcific repair tissues in the
vicinity of the materials.
Sealapex and Apexit are well known brand names of this type of material. The setting
reaction of these materials is complex and quite inhomogenous; through contact with
moisture, a hard surface is produced, but the deeper part of the mix may remain in a
dough-like consistency. Products of this kind stand up remarkably well in laboratory
leakage, biological, animal as well as clinical tests in humans (24), but their lack of
physical sturdiness has given rise to concern. Thorough condensation of gutta-percha is
especially important to minimize the risk of the root filling loosening during post space
preparation.

27. KETAC ENDO
Adhesive quality
Powder
• Calcium aluminium lanthanum fluorosilicate glass.
• Calcium volframate.
• Silicic acid.
• Pigments.
Liquid
• Polyethylene polycarbonic acid/maleic acid.
• Copolymer.
• Tartaric acid.
• water.

28. Advantages:
• Optimal physical qualities.
• Shows bonding to dentin.
• Shows minimum number of voids.
• Low surface tension (surface tension results
from the greater attraction of liquid molecules to
each other (due to cohesion) than to the molecules
in the air (due to adhesion)) leading to
penetration of pores and lateral defects.
• Optimal flow property.
No longer marketed, these
were considered to be
biocompatible and to show some
adhesion to dentin, both of
which are seen as desirable
properties in a root filling. Since
their introduction some 20 years
ago, they have been used widely
despite laboratory findings of
leakage and disintegration.
Disadvantages
• Cannot be removed in the event of retreatment – No solvent
• Toronto/Osract group – chloroform and ultrasonic no.25 file

29. Resin sealers
They are two major categories:
 Epoxy resin based sealers.
 Methacylate resin based sealers

30. AH 26 AH PLUS
Powder
Bismuth oxide
Hexamethylene teramine
Silver powder
Titanium oxide
Liquid
Bisphenol diglycidyl
ether
Paste A
Calcium tungstate
Zirconium oxide
Silica
Iron oxide
Paste B
Adamantiameamine
N,N- dibenzyl-5-Oxanonane-
diamine-1,9,TCD-diamine
Zirconium oxide
Silica
Silicone oil
Slow Setting time:24- 36 hours Short Setting time: 8 hours.
Releases small amount of formaldehyde
on mixing, making it toxic in nature.
Not release formaldehyde upon setting
(biocompatible).
Tooth staining from silver. No staining.
Less soluble. Half solubility when compared to AH 26.
Epoxy resin sealers

31. AH Plus
• Dentsply retained the epoxy resin "glue” of AH26 but added new amines to maintain the
natural color of the tooth. Its shade and color stability make it Material of choice where
aesthetic demands are high.
• Advantages:
• Tendency of discoloration and
formaldehyde release are eliminated.
• AH Plus has relatively long working
time about 4 hrs.
• It is highly radiopaque, even in thin
layers (13.6mm/mmAl)
• Has low solubility irrespective of
medium (appro.0.31%)
• Very low shrinkage (appro.1.76%) and
low linear expansion (appro.0.129 ±
0.08).Thus it‘s dimensional stability is
good.
• AH Plus has a film thickness of 26µm,
which is in the range specified by ISO
standards for root canal materials
(should be below 50µm).
• AH Plus has good adhesion to dentin
and to gutta percha (about 4Mpa),
which increases if EDTA is applied
before sealing the canal and further
increases to about 7Mpa after Er:YAG
laser treatment of root canal.
• Being slightly thixotropic, AH Plus has
improved handling properties. AH Plus
has flow of 36mm as per the ISO
standards (>25mm).
• It is a very biocompatible material
without showing any toxicity
(Formaldehyde eliminated).

32. Methacrylate resin sealers
Four generations of methacrylate resin–
based root canal sealers have been
marketed for commercial use.

33. HYDRON
• First generation of hydrophilic methacrylate
resin based sealer.
• Appeared in the mid 1970s.
•The major component is Polymer of hydroxy
ethyl methacrylate.
•It is available as an injectable root canal
sealer without the use of a core.
• Hydron became obsolete in the 1980s since it
cause irritation to the periapical tissues.

34. Endo REZ
• Second generation of hydrophilic
methacrylate resin based sealer.
• Contain UDMA (Urethane
DiMethAcrylate).
• Hydrophilic properties. It is designed to
flow into accessory canals and D.tubules
to facilitate resin tag formation for
retention and seal after smear layer
removal with NaOCl and EDTA.
• Seal best when applied to moist
interradicular dentin.
• Used with either conventional GP or
specific EndoREZ points (resin coated
GP).

36. EPIPHANY
• Third generation of methacrlylate resin based sealer.
• This system involve:
• Self etch primer before placement of sealer.
• Dual curable resin composite sealer composed of:
 BisGMA (bisphenol A and Glycidyl MethAcrylate).
 Ethoxylated BisGMA.
 UDMA.
 Hydrophilic difunctional methacrylates
 Fillers of: Ca(OH)2, barium sulfate, barium glass and
silica.
• Used with RESILON points [(thermoplastic synthetic polymer
based root canal points) which contain bioactive glass, bismuth
and barium sulfate] to achieve excellent seal by creating a
MONOBLOCK.

37. EPIPHANY
Prior to the application of primer:
 17% EDTA- smear layer removal.
 Rinsing with saline or 2% CHX.
 Primer with paper points.
 Sealer mixed (dual syringe mixed with auto mixing tip).
 Applied into the canal using lentulo spiral or Master Cone.
PROPERTIES
• Highly radiopaque.
• Easy to remove.
• Dual curing, hydrophilic.
• Biocompatible, non-mutagenic and non-cytotoxic.
• Improves the fracture resistance of the roots.

38. MetaSEAL
Fourth generation self-adhesive dual-cure sealer, available in the
powder-liquid form. It is an insoluble, radiopaque material that
can be used either with resilon or Gutta-percha.
Powder Liquid
Zirconia oxide
filler, silicon
dioxide filler and
polymerization
initiators
4-META, mono-
functional methacrylate
monomers and photo-
initiators

39. (4-META/liquid primer) is able to promote monomer
diffusion into the acid-conditioned and underlying intact
dentin and produces functional hybridized dentin with
polymerization. The formation of the hybrid dentin is the
major mechanism of bonding and also the high quality
hybridized dentin resists acidic challenges.

40. • Fourth generation of methacrylate resin
based sealer.
• Acidic resin monomers that are originally
present in primers are now incorporated into
the resin-based sealer to render them self-
adhesive to dentin substrates.
• The RealSeal endodontic obturation system
now offers an additional choice of resin-
based sealers RealSeal SE self-etch sealer.
This new self-etch sealer eliminates the
priming step without hindering the sealer's
performance.
• RealSeal SE provides all the benefits of the
original RealSeal resin sealer and gives the
same superior seal. And when switching from
guttapercha to the RealSeal SE system,
there's absolutely no change in technique
needed.
RealSeal SE

41. Advantages:
• Biocompatible
• Nontoxic and Nonmutagenic
• Leak-Resistant. Unlike gutta
percha, RealSeal leaves no
gap for leakage. Coronal and
apical leakage are
substantially reduced.
• Strengthening. Gives the root
significant toughness.
• Technique-Compatible. Works
with your current filling
method. Retreatable. With
chloroform and/or heat.
• Radiopaque.
RealSeal resin tags (electron
microscopy 1500X)
Sodium hypochlorite may
negatively affect bond
strength.the last irrigation should
be EDTA & Sterile water or
chlorhexidine.

42. Silicone sealers

43. ROEKOSEAL
• Composition – poly dimethyl siloxane, silicone oil, paraffin base
oil, hexachloroplatinic acid, zirconium dioxide.
Properties
• Biocompatible.
• Excellent flow.
• Insolubility.
• Expands slightly on setting(0.2%).
• Highly radiopaque.
• Hydrophobic

44. Guttaflow
• Prepared by mixing gutta percha powder (to a low grain size) into the
components of silicone sealer.
• Unidose capsule, injected after mixing for 30 seconds in a standard triturator
followed by placement of single master cone.
• Working time: 15min.
• Setting time: 25-30min.
• The material fills canal irregularities with consistency.
• Biocompatible.

45. GUTTA FLOW2
Advantages:
• No heat – no shrinkage
• Sealer and Gutta-percha in
one material.
• Exceptional flow plus
expansion no condensation
required.
• Adheres to Gutta-percha and
dentin.
• Solubility of 0.0%
• contains micro-silver that
provides optimum
protection against re-
infection of the root canal.
The chemical form and
concentration of the silver
does not lead to any
corrosion or discoloration

46. Calcium silicate sealers
These sealers are an outgrowth of the
popularity of MTA materials, which are
based on tricalcium silicate, a hydraulic
(water setting) powder used for various
surgical and vital pulp therapy treatments.

49. • Presence of MTA in the formula: allows the formation of new tissue, including root cementum
• Biocompatibility: rapid recovery of tissues without causing inflammatory reaction
• High Radiopacity: perfect radiographic visualization
• Excellent Flow: the flowable consistency of MTA Fillapex is engineered to penetrate and also to
fill lateral canals
• Setting expansion: provides excellent sealing of the root canal, avoiding the penetration of tissue
fluids and/or bacterial recontamination
• Calcium ion release: induces rapid tissue regeneration in sites with bone lesion and microbial
activity
• Easy removal: allows easy removal for retreatment, particularly when used with GP points.
Calcium silicate sealers (MTA
Fillapex)

50. Conclusion
• Among the multiple brands
and variety of sealant types, a
clinician’s sound knowledge
with proper manipulation
should guide the way to
correctly choosing the type
that fulfills the obturation
needs…

51. References
• Endodontic sealers a presentation by Dr. A.M.Badraldin published at G.V.Black Dental Center
Khartoum-Sudan Jully-2009.
• Endodontic sealers a presentation by Dr. JAGADEESH K. on www.Slideshare.com
• https://www.ncbi.nlm.nih.gov
• https://pubchem.ncbi.nlm.nih.gov (Information about certain chemical components)
• Materials used for root canal obturation: technical, biological and clinical testing by DAG ØRSTAVIK
(Article)
• Calcium Hydroxide–Based Root Canal Sealers: A Review (Article) By Shalin Desai, BDS, and
Nicholas Chandler, BDS, MSc, PhD
• Ingle’s Endodontics 6th edition (general information)
• Cohen’s Pathways of the pulp 11th edition (general information)