Calcium Silicate-Based Root Canal Sealers: A Narrative Review and Clinical Perspectives
Abstract
:1. Introduction
1.1. Literature Search Methodology
1.2. Terminology
2. Review
2.1. Physico-Chemical Properties
2.1.1. Setting Reaction and Setting Time
2.1.2. Flowability
2.1.3. Wettability
2.1.4. Film Thickness
2.1.5. Dimensional Stability
2.1.6. Solubility of CSBS
2.1.7. Adhesion–Interaction with Dentin Walls
2.1.8. Adhesion between the Gutta-Percha and the Sealer
2.1.9. Microhardness
2.1.10. Radiopacity
2.2. Biological Properties
2.2.1. Genotoxicity and Cytotoxicity
2.2.2. Antimicrobial Activity
2.2.3. Bioactivity
2.3. Obturation Quality
2.4. Retreatability
3. A Proposal for Clinical Perspectives on CSBS with Cold Hydraulic Condensation
3.1. Root Canal Anatomy
3.2. Operative Accessibility
3.3. Biological Aspects
- Connection between the roots and the maxillary sinus, especially for immunocompromised patients for whom zinc oxide–eugenol-based and formaldehyde-based sealers are not recommended [22].
- Connection between the roots and inferior alveolar nerve: CSBS are more biocompatible, and their use with CHC avoids thermal nerve injuries.
- Middle or apical root canal perforations, consequences of a false canal: the use of CSBS with CHC allows the filling of the root canal and the perforation at the same time while also taking advantage of their biological properties.
- Patients with high risks of osteonecrosis connected to treatments such as radiotherapy or anti-resorptive drugs such as bisphosphonates, because it is suitable to reduce bone aggression factors in these situations.
4. Clinical Application of CSBS
4.1. Can CSBS Be Used with Any Type of Gutta-Percha?
4.2. Do CSBS Usage Impact the Final Irrigation Protocol and the Root Canal Drying Technique?
4.3. How to Reduce Voids Occurrence When Using CSBS with CHC?
- Coating the master cone with CSBS followed by its slow insertion to the full working length. This technique might be insufficient when dealing with oval or wide canals. Accessory cones can also be used to complete the sealer distribution.
- Lentulo spiral usage at low speed (around 700–800 rpm) or flexible injection tip before master cone insertion.
4.4. Can CSBS Be Used with Thermoplasticized Gutta-Percha Obturation Techniques?
4.5. Does Use of CSBS Make Non-Surgical Retreatment More Difficult?
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Sfeir, G.; Zogheib, C.; Patel, S.; Giraud, T.; Nagendrababu, V.; Bukiet, F. Calcium Silicate-Based Root Canal Sealers: A Narrative Review and Clinical Perspectives. Materials 2021, 14, 3965. https://doi.org/10.3390/ma14143965
Sfeir G, Zogheib C, Patel S, Giraud T, Nagendrababu V, Bukiet F. Calcium Silicate-Based Root Canal Sealers: A Narrative Review and Clinical Perspectives. Materials. 2021; 14(14):3965. https://doi.org/10.3390/ma14143965
Chicago/Turabian StyleSfeir, Germain, Carla Zogheib, Shanon Patel, Thomas Giraud, Venkateshbabu Nagendrababu, and Frédéric Bukiet. 2021. "Calcium Silicate-Based Root Canal Sealers: A Narrative Review and Clinical Perspectives" Materials 14, no. 14: 3965. https://doi.org/10.3390/ma14143965