„Sealing the Deal: Understanding the optimum sealer choice for root canal therapy“

Root canal therapy is based on a dichotomy of procedures being the adequate cleaning and shaping of the dental pulp space. Three-dimensional sealing is crucial to prevent the ingress of micro-organisms from the oral cavity to the apical tissues by allowing the optimum environment for apical tissue healing and creating a favourable biological environment for healing to take place. The ultimate purpose of root canal treatment is to retain teeth in function with optimum aesthetic outcomes by eliminating any pulpal or periapical pathosis for life. This phenomenon still remains challenging to achieve on long-term basis when considering the varying factors involved in sustaining successful endodontic therapy. Nearly 60% of endodontic failures have been attributed to incomplete or inadequate obturation of the root space despite innovative techniques and materials. In this respect, sealers are the essential element of obturation materials. Therefore, an ideal root canal sealer would require specific properties such as tissue tolerance, minimal/no shrinkage with setting, slow setting time, ability to bond, radiopacity, bacteriostatic, absence of staining, solubility in solvents, insolubility to oral and tissue fluids and retriviability. There are still limitations of gutta percha and different types of sealers with respect to microleakage which may cause failure via clinically undetectable passage of micro-organisms, fluids, molecules or ions between the tooth and restorative material. Innovative materials such as bio-ceramic based sealers are promising. This talk aims to provide an evidence-based approach for the optimum sealer choice as part of root canal therapy.