Bioceramic sealers represent an advancement in dental materials, particularly for sealing root canals. These materials are used in endodontic procedures to fill the internal space of a tooth after it has been cleaned, preventing bacterial leakage and promoting long-term tooth preservation. They offer enhanced sealing capabilities and biological compatibility compared to traditional options.
Understanding Bioceramic Sealers
Bioceramic sealers are a class of dental materials for dental applications, known for their high biocompatibility. These sealers are predominantly composed of calcium silicate-based materials, often including dicalcium silicate and tricalcium silicate. Their development emerged from the broader field of bioceramic technology, with the first-generation material, mineral trioxide aggregate (MTA), introduced in the 1990s.
They are often supplied as a powder and liquid that mix to form a hydrated calcium silicate gel, which then hardens into a strong structure. Some formulations are available as pre-mixed pastes or putties.
How Bioceramic Sealers Function
Bioceramic sealers function through a chemical reaction that allows them to interact with tooth structure and bodily fluids. Their hydrophilicity means they readily react with moisture in the dentinal tubules, crucial for their hydration setting process.
As the sealer sets, it produces calcium silicate hydrate and calcium hydroxide. The calcium hydroxide then reacts with calcium and phosphate ions in the surrounding tissue fluid, leading to the formation of hydroxyapatite. This newly formed hydroxyapatite is a mineral similar in composition to the natural hard tissues, facilitating a strong chemical bond with the dentin. The slight expansion upon setting contributes to their sealing ability by filling microscopic gaps and preventing leakage.
Advantages of Bioceramic Sealers
Bioceramic sealers offer advantages over traditional dental sealers. Their strong sealing ability, creating a robust barrier within the root canal system, prevents bacterial infiltration, reinfection, and treatment failure.
The biocompatibility of bioceramic materials reduces the risk of inflammation, irritation, or allergic reactions in surrounding tissues. Additionally, some bioceramic sealers exhibit self-sterilizing properties due to the release of calcium hydroxide, which provides antibacterial effects and promotes healing.
Bioceramic sealers also demonstrate dimensional stability, meaning they do not undergo shrinkage upon setting. This maintains the integrity of the seal over time, preventing gaps. Their ability to form a chemical bond with dentin, through the generation of hydroxyapatite, results in a more stable and durable seal compared to traditional materials that rely on mechanical retention.
Primary Dental Applications
Bioceramic sealers are primarily used in endodontic procedures, especially root canal treatments. After the cleaning and shaping of the root canal system, these sealers are used in conjunction with a core filling material, such as gutta-percha, to create a hermetic seal. This application is beneficial due to the sealer’s ability to fill the complex anatomy of the root canal, including tiny irregularities and accessory canals.
The hydrophilic nature of bioceramic sealers allows them to set even in the presence of moisture, simplifying application compared to traditional sealers requiring a dry environment. Beyond root canal obturation, bioceramic materials in various forms (sealer, paste, putty) are also employed in other endodontic scenarios, such as pulp capping, repair of root perforations, and apical barrier formation. Their ability to promote tissue healing and regeneration makes them a choice for these applications.
Patient Considerations
Bioceramic sealers contribute to the long-term stability of the root canal filling, offering a durable seal that resists degradation over time. The material’s radiopacity allows dentists to clearly visualize the filled canal on X-rays, aiding in post-treatment assessment and verification of complete sealing.
While pain after root canal treatment can occur regardless of the sealer used, studies have indicated that bioceramic sealers are associated with a low incidence of postoperative pain. Patients might experience slight discomfort initially, which typically resolves. Following the procedure, adherence to follow-up care instructions is important to ensure the continued success of the treatment and overall oral health.