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 cium hydroxide, and zirconium oxide that closely resemble the composition of MTA (Tyagi et al., 2013). The premixed form facilitates their use in good con- ditions, with decreased risk of heterogeneity in the preparation (Yang and Lu 2008). Bioceramics have shown remarkable properties in terms of biocompatibility and antimicrobial activity with an excellent bioactivity, capable to induce min- eralisation of periapical tissues (Zhang et al. 2009, Zhang et al. 2010). Indeed, the bioceramics specific physicochemical properties are what make them so interesting for the endodontic field. Firstly, because of their hydrophilic profile, they can set in a humid environment, such as dentine, which is made of almost 20 % water (Koch and Brave 2010). Second, due to their wettability, a decreased viscosity and a higher quality sealing is present in bioceramics when compared with all the current sealers on the market. BioRoot RCS specific properties and composition BioRoot RCS is the newest endodontic sealer based on tricalcic silicate materials, benefiting from both Active Biosilicate Technology and Biodentine. The first provides a medical grade level of purity and, unlike ‘Portland cement’-based materials, it en- sures the purity of the calcium silicate content with the absence of any aluminate and calcium sulfate. BioRoot RCS is a mineral-based root canal sealer us- ing a tricalcium silicate setting system. The powder part additionally contains zirconium oxide as a bio- compatible radiopacifyier and a hydrophilic bio- compatible polymer for adhesion enhancing. The liquid part contains mainly water, calcium chloride as a setting modifyier and a water reducing agent. BioRoot RCS is bioactive by stimulating bone physiological process and mineralisation of the den- tinal structure (Camps 2015, Dimitrova-Nakov 2015). Therefore, it creates a favourable environment for periapical healing and bioactive properties, including biocompatibility (Reichl 2015), hydroxyapatite for- mation, mineralisation of dentinal structure, alkaline pH and sealing properties. BioRoot RCS is indicated for the permanent root canal filling in combination with gutta-percha points and is suitable for use in single cone technique or cold lateral condensation (Camilleri 2015). BioRoot RCS was designed to be used by mixing the powder part with the liquid part by simple spatulation: there is no need for a mixing machine. The working time is around 15 minutes and the setting time is less than 4 hours in the root canal. In addition, BioRoot RCS dis- played a tight seal with the dentine and the gut- ta-percha (Xuereb 2014) and an appropriate radi- opacity. The paste is of smooth consistency with good flow and adequate adhesion to instruments in order to enable an optimal placement in the root canal. Thanks to the use of Active BioSilicate Technology, which is monomer free, there is no shrinkage of BioRoot RCS during setting for reaching a tight seal of the root canal. Despite the similar composition in terms of vis- cosity and texture with a sealer, BioRoot RCS must be considered as an adhesive root filling material. A fitted gutta-percha point is used as a plugger-like carrier to facilitate the flow of BioRoot RCS into the canal space. Indeed, BioRoot RCS is also recom- mended for facilitating the obturation removal in case of retreatment. A new concept of obturation To achieve root canal filling and prevent any bac- terial or fluid leakage, practitioners were always told to associate a core material with a sealer in or- der to fill the canal space. So far, gutta-percha is the most used material because it is a non-resorbable and well biotolerated. Unfortunately, gutta-percha has no intrinsic adhesive properties to dentine. Thereby, in order to ensure the seal of the final fill- ing, the use of a sealer is required. The latter is also used for filling voids, flowing into anatomical irreg- ularities, notably the ones that were not enlarged by mechanical preparation (i.e. isthmus, lateral/ac- cessory canals). Nevertheless, sealers are subjected to shrinkage, degradation over time and have no chemical sealing ability to dentine. As a consequence, the use of a large amount of core material with the thinnest layer of sealer is recommended to improve the qual- ity of the filling. Among the obturation techniques, cold lateral and warm vertical compaction are the best ones. Indeed, they are both capable of pushing the sealer into the non-instrumented spaces, where residual bacteria may persist. However, the first technique leaves excessive cold sealer inside the canal irregu- larities (instead of leaving gutta-percha) and the second one requires the placement of a plugger within 4 mm of the apex. Furthermore, with the warm lateral compaction, a large volume of coro- nal dentine needs to be removed, causing concerns among practitioners as it may possibly weaken the tooth structure (Trope and Debelian 2014). Moreover, these techniques are time consuming, highly operator-dependent and require the use of 48 roots 3 2017