Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2017-09-12, 09:26:18 | version 1.38.0
| technique biomaterial for root canal filling BioRoot RCS a new bio- material for root canal filling Author: Prof. Stéphane Simon, France Introduction Due to progresses in scientific knowledge, endo- dontic treatments now provide highly predictable re- sults. However, such results are closely tied to the re- spect of a number of steps that are nowadays clearly identified as key elements for endodontic treatment success. Notably, the filling of root canals is one of them. In clinical applications, it requires both knowl- edge and thoroughness (Ray and Trope 1995). Sterilising and obtaining a root canal free of bac- teria, following disinfection, is, so far, impossible to obtain (Siqueira et al. 1997). Apart from disinfect- ing, obturation is responsible for trapping residual bacteria, filling the predisinfected space and ulti- mately sealing it, in order to avoid any bacterial leak- age into the periapical area. Modern techniques for filling root canals are based on the association of gutta-percha (the core of the fill- ing) and a sealer. The latter acts as a sealing material and, because of its fluidity, it is able to spread into any free space, notably those which were not en- larged during the mechanical root canal preparation. Depending on the technique used by the practi- tioner, the gutta-percha is compacted differently: lat- erally when used with cold lateral condensation or ver- tically when used with a warm vertical compaction. Both techniques provide good long-term results, as the root canal is filled with a high proportion of gutta- percha with a small volume of sealer. The quantity of the latter needs to be minimal, as being degradable, it may lead to canal bacterial contamination over time. The single cone technique is still very popular among practitioners, being quick and easy to perform. This technique consists in by employing a single cone with a large amount of sealer, which acts as a filling material. Unfortunately, the currently used sealers are prone to dissolution. As a consequence, with time, the canal is again contaminated with bacteria, leading to treatment failure and the growth of an apical lesion. Thereby, although being easy to accomplish, the single cone technique is not recommended for root canal filling (Beatty 1987, Pommel et Camps 2001). However, the single cone technique may be re- opened and provided new reliability with new pro- posed biomaterials based on bioceramics, devel- oped in the last few decades and launched on the market as root canal sealers. Bioceramics properties Bioceramics are specifically designed for medical and dental use with the prefix ‘bio,’ referring to their biocompatibility. In the orthopaedic field, inert bioce- ramics are used for prosthetic devices, while the active and re-absorbable ones are applied in endodontics. Bioceramics are composed of alumina, zirconia, bioactive glass, glass ceramics, coatings, compos- ites, hydroxyapatite, resorbable calcium phosphates and radiotherapy glasses (Dubock 2000, Best et al. 2008). Among them, calcium phosphate–based ma- terials are used for filling bone defects. Calcium sil- icates and bio-aggregates (Mineral Trioxide Aggre- gate for example) were introduced for apical plug-in apexification procedures, but also for coronal/root repair in case of perforations (Trope and Debelian 2014, Koch and Brave 2009). Three basic types of bi- oceramics must be distinguished: (1) bio-inert high strength ceramics (alumina, zirconia and carbon); (2) bioactive ceramics which form direct chemical bonds with the bones or soft tissues of a living or- ganism (bioglass and glass ceramics); and (3) biode- gradable/soluble/re-absorbable ceramics (calcium phosphate based ceramics) that actively participate in the metabolic processes of an organism. According to the manufacturers, such sealers could be used alone or combined with a gutta-percha point using a single cone technique in the context of an endodontic treatment or retreatment (Koch and Brave 2009). These sealers are mainly composed of tricalcic silicate, calcium phosphate monobasic, cal- 46 roots 3 2017