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Endodontic Materials. The main objectives of root canal therapy are: Removal of the pathologic pulp. Cleaning and shaping of the root canal system. Three dimensional obturation to prevent reinfection. Functions of irrigants.

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Endodontic materials

Endodontic Materials

Endodontic materials

  • The main objectives of root canal therapy are:

  • Removal of the pathologic pulp.

  • Cleaning and shaping of the root canal system.

  • Three dimensional obturation to prevent reinfection.

Functions of irrigants

Functions of irrigants

Irrigants are used to clean the root canal and are used in association with the shaping instruments.

Functions of irrigants include:

Lubrication of instruments used to shape the canal.

Flushing out of gross debris.

Dissolution of organic and inorganic tissue.

Antimicrobial effect.



Ideal properties:



Dissolve organic debris




Classification of irrigants

Classification of irrigants

Chemically inactive irrigants



Local anaesthetic solution

Chemically active irrigants

Sodium hypochlorite (NaOCl).

Oxidizing agents as Hydrogen peroxide (H2O2)

Chelating agents as EDTA.




Adequate volume required

Stays within the confines of root canal

Never deliver with excessive force

Apical extrusion results in pain and possible swelling.

Use luer-lok 27 gauge endodontic needle

Efficiency enhanced with ultrasonic, sonic and mechanical instruments

Sodium hypochlorite

Sodium hypochlorite

0.5-5.25 %


Dissolve organic matter


Low toxicity

Apical reaction

Rubber dam

Hydrogen peroxide

Hydrogen peroxide

3% +/- NaOCl

Production of O2 eliminate anaerobes

Bubbles may prevent adequate contact of irrigant with debris

Limited shelf life



Hibisrcub(HIBISCRUB is an antimicrobial preparation for pre-operative surgical hand disinfection, antiseptic handwashing

Usually used in 0.2% concentration

Antibacterial, Substantivity.



Does not dissolve organic debris

Chelating agent

Chelating agent

Ethylene DiamineTetracetic Acid “EDTA” (File-eze, RC Prep)

Remove smear layer allowing

cleaning of tubules

Soften dentine

Not antibacterial

File-eze is water soluble unlike RC Prep which contains carbowax and is difficult to remove



Sterile water

Local anaesthetic

Saline (0.9%)

They only provide lubrication and gross debris removal functions.

Intracanal medicamanets


If root canal treatment can’t be finished in a single visit, root canals are dressed with medicaments.

Functions of intracanal medicaments:

Primary function: antimicrobial activity

Antisepsis(is the destruction or inhibition of (slowing the growth of) microorganisms )

Disinfection(Cleaning an article of some or all of the pathogenic organisms which may cause infection )

Secondary functions

Hard-tissue formation

Pain control

Exudation control

Resorption control

Intracanal medicament

Intracanal medicament

Ideal properties


Penetrates dentinal tubules

Control exudation or bleeding


Eliminates pain

Induce calcific barrier

No effect on temporary


Does not stain tooth

Calcium hydroxide

Calcium hydroxide

Hypocal(contains calcium hydroxide and barium sulfate)

Ca(OH)2, 34-50% Ba SO4,5-15% Methylcellulose.

Antibacterial (pH>12)

Denatures protein

Synergestic with NaOCL

Cytotoxic-local necrosis, calcific barrier


Dries weeping canals



Combination of drugs required to be effective

Resistant strains becoming more difficult to treat




Triamicinolone, prednisolone

Pain relief but no evidence of more effective than Ca(OH)2

?use in root resorption by inhibiting odontoclasts

?depresses the host inflammatory response

Not antibacterial but can be mixed with Ca(OH)2

Ledermix= triamicinolone+ tetracycline

Phenol based agents aldehydes and halidyes

Phenol based agents, Aldehydes and Halidyes

Phenol, parachlorophenol(PCP), camphorated mono PCP, cresol, creosote, formacresol and chlorine.

Antibacterial agents.

Highly toxic agents.

Possible mutagenic and carcinogenic effect.

Obturating materials

Obturating materials

Ideal properties of root canal filling materials:



Good flow

Adhesive in nature

Dimensionally stable

Not affected by moisture


Good handling

Easily removed, post prep or retreat

Does not stain dentine


Gutta percha


Guttapercha “ Isoprene” (C5H8) is one of the oldest and most common root filling material in use today.

A natural latex produced from a genus of tropical trees

Polymers of isoprene:

Cis-natural rubber


Endodontic materials

Guttapercha points used in clinic consists of:

Guttapercha 20%

Zinc oxide 60-75%

Metal sulphides, waxes, resin, opacifiers

Guttapercha is available in 2 phases; Alpha and Beta.

Endodontic materials

Guttapercha taken from trees is in Alpha phase.

Guttapercha in points used in the clinic is in Beta phase.

Both phases differ in Melting temperature, volumetric changes and flow characteristics when molten.

Gutta percha1


Advantages of guttapercha:


Dimensionally stable


Easily removed


Disadvantages of guttapercha:

Does not adhere to dentine

Lacks rigidity

Metal points

Metal points

  • Silver (gold, tin, lead and titanium have been used)

  • Introduced in 1930’s

  • Silver preferred due to antibacterial effect

  • Rigid, unyielding

  • Impossible to adapt to canals

  • Poor seal as canal not commonly circular in shape

  • Corrosion

  • Difficult to remove for post

  • Titanium- biocompatible and avoids corrosion

Silver point failure

Silver Point Failure



Sealers are used in association with Guttapercha.

Functions of sealer

Cementing (luting, binding) the core material (guttapercha) into the canal.

Filling the discrepancies between the canal walls and core material

Acting as a lubricant to enhance the positioning of the core filling material

Acting as a bactericidal agent

Root canal sealers

Root canal sealers

Most sealers are toxic when freshly mixed

Toxicity substantially reduced when set

Most sealers are absorbable to some extent when exposed to tissue fluid

Ideally sealer should flow backwards out of the canal

However, no evidence that apical extrusion reduces success rate providing preparation and obturation are meticulous

Zinc oxide eugenol

Zinc-oxide eugenol

Grossmans, Tubliseal



Slightly toxic when freshly mixed.

Good flow and working time

Does not adhere


Calcium hydroxide based sealers

Calcium hydroxide based sealers

Sealapex, Apexit




Preserve vitality of pulp stump and promote healing

Does not adhere

Resin based sealers

Resin based sealers

AH26, AH Plus, Endorez, Epiphany, RealSeal.



Toxic when freshly mixed

Show setting shrinkage when set

Glass ionomer based sealers

Glass-ionomer based sealers

Ketac Endo and ActiV GP.

Mildly antibacterial

Adheres to dentine

Slightly soluble

Unset GIC is cytotoxic but when set this reduces with time

Very difficult to be removed

Silicone based sealers

Silicone based sealers

Roekoseal sealer.

Slightly expands when set.

Addition type silicone.

GuttaFlow is Roekoseal sealer with added guttapercha particles.

Does not adhere to root canal.

New root canal filling materials

New root canal filling materials

Resilon: resin-based cones. Similar in appearance and handling to guttapercha cones. Used with any resin-based sealer.

Endorez cones: resin-coated guttapercha. Used with endorez sealer or any other resin-based sealer.

ActiV GP: glass ionomer coated guttapercha. Used with glass ionomer based sealers.

Retrograde root filling materials

Retrograde root filling materials

Ideal properties

Seals apex


Ease of handling

Moisture and blood tolerant

Low solubility


Good tissue response

Bonds to dentine




Apical inflammation

Poor sealing ability

Mercury toxicity

Endodontic materials


Modified zinc oxide-eugenol

Seals better than amalgam

Need high powder to liquid ratio to decrease toxicity and solubility

Short working time

Super eba

Super EBA

Modified zinc oxide-eugenol

High compressive and tensile strength

Neutral pH

Low solubilty

Not affected by blood

Good tissue response



Problems with moisture control

Some good results in sealing ability but further work required

Glass ionomer cements

Glass Ionomer Cements

Bonds to tooth substance

Biocompatibilty (Toxicity reduces when set)

Some antibacterial properties

Seal superior to amalgam

New materials

New materials

Diaket (Tricalcium phosphate paste)

Polyvinyl resin

Good tissue response

?cementum forming

Mineral Trioxide aggregates (MTA)

Seals better than amalgam or super EPA

Not adversly affected by blood

Marginal adaptation better than amalgam, IRM or super EBA




Endodontic materials


Mineral trioxide aggregate:

Pulp capping

Nonsurgical apical closure

Perforation repair

Surgical root end filling

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