A critical review of the material properties guiding the clinician’s choice of root canal sealers

Abstract

Objectives The introduction of hydraulic cement sealers has increased the popularity of single cone obturation where the chemistry and properties of hydraulic cement sealers are crucial. This article has investigated the materials present on the market by reviewing the chemistry aiming at understanding whether these materials are optimized or have been tested appropriately. Methodology A market search on materials called bioceramic and hydraulic sealers was undertaken. The safety data sheet and manufacturer details for every material were searched and the components were checked. The literature was searched for information about the properties of these materials based on their composition. Results The safety data sheets and manufacturer details were imprecise with some manufacturers providing little detail on composition. From the publications reviewed, it is apparent that the materials used clinically are not optimized, and there is little evidence that the material chemistry and presentation aid the clinical technique in any way. Conclusions There has been a rapid increase in materials identifying as bioceramics on the market. These materials have diverse chemistries, and some of the constituents are not declared. This may affect the clinical performance of these materials. Clinical significance Smart materials developed on the clinical need which are appropriately tested are necessary for a paradigm shift in root canal obturation. It is important to use reputable materials that have been adequately researched in clinical practice.

Epoxy vs. Calcium Silicate-Based Root Canal Sealers for Different Clinical Scenarios: A Narrative Review

“…A CSS is recommended for vital or non-vital cases over multiple visits, teeth with internal root resorption with perforation or internal approach for external cervical resorption, teeth with open apices, and teeth with iatrogenic aberrations. Moreover, the clinician should also take into account the existence of various CSS materials with diverse chemistries, including different percentages of calcium silicate, which can potentially impact their clinical performance [86,87].…”

Physicochemical properties of two commercially available bioceramic sealers: An in vitro study

“…These studies have also shown significant differences amongst currently available bioceramic sealers (17)(18)(19)(20)(21)(22)(23)(24). In a recent review, authors showed that in the last years, endodontists faced a rapid increase in materials identified as bioceramics on the market, but these materials have different chemistries, and some of the constituents are not declared (11). The authors conclude that this may affect the clinical performance of these materials and highlighted the importance of using reputable materials that have been adequately researched both in vitro and in clinical practice (11).…”

“…New operative techniques have been developed, focusing on making chemomechanical preparation more rapid and efficient, and ideally increasing quality by providing more predictable cleaning and shaping results (7)(8)(9)(10). As a consequence, there has been a similar interest in improving the simplicity and quality of root canal obturation, with a continuous request for alternative sealers that are more biocompatible, more bioactive, and more capable of bonding to the root canal wall when compared to traditional resin-based or eugenol-based sealers (11)(12)(13)(14)(15)(16). Therefore, the criteria for the ideal material for use in endodontic obturations must be comprehensive Physicochemical properties of two commercially available bioceramic sealers: An in vitro study and include the following characteristics: non-toxic, insoluble in tissue fluids, dimensionally stable, antibacterial, hard tissue conductive, biocompatible, radiopaque and easy to handle (3).…”

“…However, the various bioceramic sealers commercially available nowadays show a great diversity in their biological, chemical, and physical properties: most of them are mainly related to their chemical composition, but also to the manufacturing process. Such differences can also significantly affect clinical performance, and consequently, new commercially available products must be carefully investigated to assess quality and check differences with existing products (11)(12)(13). It has been shown that the safety data sheets and manufacturer details of currently available bioceramic sealers were imprecise.…”

“…It has been shown that the safety data sheets and manufacturer details of currently available bioceramic sealers were imprecise. Moreover, little detail on composition was provided by manufacturers (11). The current in vitro study investigated five physicochemical properties (setting time, solubility, pH analysis, radiopacity and film thickness) of two commercially available bioceramic sealers: a new one and the one which has been most extensively evaluated in the last decade.…”