Abstract

Over the last two decades, calcium silicate-based materials have grown in popularity. As root canal sealers, these formulations have been extensively investigated and compared with conventional sealers, such as zinc oxide–eugenol and epoxy resin-based sealers, in in vitro studies that showed their promising properties, especially their biocompatibility, antimicrobial properties, and certain bioactivity. However, the consequence of their higher solubility is a matter of debate and still needs to be clarified, because it may affect their long-term sealing ability. Unlike conventional sealers, those sealers are hydraulic, and their setting is conditioned by the presence of humidity. Current evidence reveals that the properties of calcium silicate-based sealers vary depending on their formulation. To date, only a few short-term investigations addressed the clinical outcome of calcium silicate-based root canal sealers. Their use has been showed to be mainly based on practitioners’ clinical habits rather than manufacturers’ recommendations or available evidence. However, their particular behavior implies modifications of the clinical protocol used for conventional sealers. This narrative review aimed to discuss the properties of calcium silicate-based sealers and their clinical implications, and to propose rational indications for these sealers based on the current knowledge.

Highlights

  • Despite numerous technological leaps, the purpose of root canal treatment is still prevention and healing of apical periodontitis by achieving proper disinfection and threedimensional filling of the root canal space [1]

  • The current review aimed to discuss the properties of calcium silicate-based sealers (CSBS) and their clinical implications, and to propose rational indications based on the current knowledge and

  • Rheological properties of calcium silicate-based materials such as ProRoot® Mineral trioxide aggregate (MTA) (Denstply Sirona, Ballaigues, Switzerland) or Biodentine (Septodont, Saint-Maur-des-Fossés, France) were not appropriate to be used as a root canal sealer in association with gutta-percha for obturation

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Summary

Introduction

The purpose of root canal treatment is still prevention and healing of apical periodontitis by achieving proper disinfection and threedimensional filling of the root canal space [1]. A recent survey demonstrated that the methods of using CSBS in clinical practice were variable and based on practitioners’ habits rather than manufacturers’ recommendations or available evidence on these sealers [22]. This highlights the possible inappropriate use of CSBS, which may negatively impact the obturation, and the outcome of the root canal treatment. This exposes a knowledge gap between the fundamental research on CSBS and their clinical application, justifying the need to better connect these two aspects. The current review aimed to discuss the properties of CSBS and their clinical implications, and to propose rational indications based on the current knowledge and CSBS specificities

Literature Search Methodology
Terminology
Setting Reaction and Setting Time
Setting reaction reaction of of CSBS
Flowability
Wettability
Film Thickness
Dimensional Stability
Solubility of CSBS
Adhesion–Interaction with Dentin Walls
Adhesion between the Gutta-Percha and the Sealer
Microhardness
2.1.10. Radiopacity
Biological Properties
Genotoxicity and Cytotoxicity
Antimicrobial Activity
Bioactivity
Obturation Quality
Retreatability
Root Canal Anatomy
Operative Accessibility
Can CSBS Be Used with Any Type of Gutta-Percha?
How to Reduce Voids Occurrence When Using CSBS with CHC?
Can CSBS Be Used with Thermoplasticized Gutta-Percha Obturation Techniques?
Does Use of CSBS Make Non-Surgical Retreatment More Difficult?
Findings
Conclusions
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