The Age of Bioceramics
Improving endodontic care with innovative products
Allen Ali Nasseh, DDS, MMSc
Figure 1 | Eight years ago, a new endodontic sealer was introduced to the profession that promised to make possible a new era of adhesive endodontics. EndoSequence® BC Sealer™ is a pure, nano-particulate bioceramic root canal sealer formulated from a family of compounds that migrated from orthopedic medicine into endodontics and promised to change the use of endodontic cements. Since its introduction, this premixed sealer was developed into a root repair material, putty, and now fast-set putty, which have transformed endodontic obturation and root repair through the use of a universal compound to address all endodontic cement needs for both nonsurgical and surgical use.
On the nonsurgical side, the material properties of the bioceramic sealer have made endodontists re-engineer the old endodontic shaping concepts that have historically produced the expected radiographic look of our cases. For example, since the bioceramic material bonds to the hydroxyapatite in the root canal walls, the resulting chemical bond has been shown to increase the tooth’s fracture resistance. Because the material is dimensionally stable and wash-out resistant in the root canal after setting, a simpler obturation technique such as hydraulic condensation using a single synchronized cone has become possible. By eliminating the need for the thermoplastic techniques, this has resulted into more coronally conservative root canal preparations, saving important tooth structure during preparation.
On the surgical front, bioceramics were originally introduced to endodontics more than 2 decades ago with mineral trioxide aggregate (MTA), which had difficult clinical handling properties in spite of its excellent biocompatibility. As a result, clinicians often resorted to less optimal materials because MTA was too technique-sensitive. The unique formulation of EndoSequence BC RRM-Fast Set Putty allows clinicians to roll the material into cones before the surgery begins, and apply to the surgical site with unprecedented speed because of the unique setting properties of the material, where the setting reaction begins only after exposure to the oral cavity and not outside the mouth. Furthermore, the hydrophilic qualities of the material allow better adaptation during surgery and its biocompatibility reduces any surgical inflammation due to the material chemistry. Lastly, the basic nature of the material allows a welcome quality of bone induction during the healing phase of the bone.
Today, as a result of improvements in material science and particularly in the field of pure, nano-particulate bioceramic cements, we have begun to change the way we view endodontics.
About the Author
Allen Ali Nasseh, DDS, MMSc, is an endodontist practicing in Boston, Massachusetts. Dr. Nasseh holds a part-time staff position at Harvard School of Dental Medicine in the post-doctoral endodontic program, and is the editor of the Harvard Dental Bulletin. In addition to serving as the clinical director of Real World Endo, Dr. Nasseh lectures extensively and is both an Editorial Board Member and theEndodontics Section Editor for Inside Dentistry.
• Moldable, condensable putty consistency that is even more resistant to wash out than the market-leading EndoSequence® BC RRM-Putty™
• Sanidose™ syringe means no mixing, no waste, no cross-contamination, and a consistently perfect unit-dose putty plug with every application
• Highly biocompatible and osteogenic, the formulation is nonstaining and antibacterial, with a pH of +12
• New fast-set chemistry means the set time is reduced to only 20 minutes
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