Hydraulic Condensation/ Single Cone with new bioceramic Sealers from Tulum Mexico
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- čas přidán 28. 04. 2023
- During his vacation Dr. Nasseh takes a moment to describe the potential problems with the newer generation of bioceramic sealers when used with Hydraulic Condensation or the Single Cone Technique. It's important to read the MSDS of the materials and look at the composition of the materials. Cements with hydrophilic polymers may have less stability in the long run in areas where pooling may occur.
Thanks Dr Allen this is an eye opener video for many. Since there are so many brands of Bioceramic sealer in the market today. If possible a list or detailed video on “true Bioceramic sealers” v/s “others” would be helpful. And some reasoning why the “others Bioceramic sealers” are not ideal for single cone/hydraulic condensation technique would also help
Thanks for sharing and look forward to more videos from you
thanks alot dear Dr ❤this is a very needed video as the market nowadays is filled with cheap BC sealers that contain lots of resins
Very interesting and makes a lot of sense with my experience of using various BC sealers
Thanks for sharing this video with us bc knowledge never ends 🤞Happy Holiday 😊
The bc sealer I use the most contains 50-60% calcium silicate & doesn't contain polymer in its composition,So I think it will fulfill the characteria of an ideal bc sealer 🤞
Хорошего отдыха доктор!
I want my surface area/volume ratio to be as high as possible, correct? Ideally, as few molecules of BC sealer as possible will exist between the surface of my canal space and my filler (gutta percha) - because a single molecule will have total volumetric shrinkage of zero.
In other words, the role of gutta percha is a space filler. It applies hydraulic pressure to the intricate canal space.
Thanks dr . Allen for the great info, i was wondering , if i had a good tug back (apical seal) and a good coronal seal, following an efficient irrigation protocol ,using single cone with polymer based cements , where would infection originate from even if it shrinked over time?
If you had what you described reliably on every case then you could really fill with any technique and within any cement since you had sterilized the canal and sealed it coronally. The problem is that this is not achievable clinically in a reliable way. More exactly, it’s nearly impossible to achieve at the Ultrastructural level!
But this is a great question I should make a video for others to share! 👍
Is there a list of "true" bioceramics or how would we know when product shopping?
Original MTA, EndoSequence line of BC products, TotalFill, Edge BC, and Septodon's Biodentine and their sealer. These are the real, original ones. The Endosequence has the longest track record. The newer ones, such as Avalon neoflow is also a true bioceramic, but it contains Aluminum, which some people object to. So, it depends if you are a fan of aluminum or not. I probably should compile a list and share. But I'll have a non-commercial academic material scientist other than myself talk about it since I am considered biased as I have helped develop the BC line and it would be inappropriate for me to comment on others. Cheers!
@@AANasseh Thanks Doc. According to the published MSDS the original endosequence bc sealer contains 50% by volume of calcium trisilicate and calcium disilicate while ah plus bioceramic sealer contains about 5-15 % by volume of tricalcium silcate, with 30% dimethyl sulfoxide. Is it ratios or compositions that account for the differences in solubility?
@@mnnh3317 In the case of AHPlus BC it's the setting reaction that's the problem. They tried to solve the setting reaction by going to the use of water soluble polymer instead of the hydration/precipitation reaction that's the hallmark of pure bioceramics. As you can imagine a water soluble polymer is no the right material to use in an environment that's submerged in water! The downside of the BC Sealer's Hydration/Precipitation is its long setting time (4hours). The downside of the other is the fact that it dissolves in water over time!
Thank you Dr. nice to know you are having a great time in Mexico, hope you come to lecture some day in the future too! Do the brands inform if their BC contains polymers? Could you name some brands using this type of BC? Thank you very much.
Itt's important to read the Material Safety Data Sheet of the sealers to look at the compositions and also attend courses by non-biased material scientists to see what the properties of various sealers are. There are substantial difference between sealers, primarily because there are patents and newer sealers need to circumvent patents and must therefore be substantially different. As a result, even though many call themselves bioceramic the composition can be very different and therefore the material properties and stability will be different in the long run. Consumers must be were and do their own research. Maybe at some point I will make a video distinguishing these sealers or interview a material scientists talking about them. Cheers! :)
@@AANasseh I have access to Bio-C and CeraSeal, according to their data sheet these sealers don't contain polymers. A couple of years ago I attended to a lecture where they were addressing this issue too, definitely this is an important aspect of bioceramic sealers to take into consideration.
@@trickjacko8482 Look at the calcium silicate concentration. You want it to be 30% or above when possible for more reactivity. You also want to check out for aluminum content. Other things to look at is the Calcium Phosphate concentration. It's a little more complex than any other white cement. But all of them should work if used with vertical and lateral condensation. But Hydraulic Condensation requires stable cements due to cement film thickness being much larger.
@@AANasseh Dr. Nasseh thank you for your video and also for very interesting comments. Since I started to look into bc sealers I try to get to know composition of almost each bc sealer available in my country . What I did not find out how it is clinically relevant. For example many sealers which are most common used contains 30% and more calcium aluminate but only 0-5% calcium silicate. I am trying to find out if that low percentage of CS matters if there is such a huge percentage of CA. Do you have any comment on this?
Also sorry for my long message . Since you mentioned setting of BC sealers in acidic enviroment is worse, do you prefer to go for single visit anyway? I just had a follow up of my case obturated 2 years ago with full length bc sealer (piston technique without any cone, only warm guttapercha in orrifice as a piston) and after 1 month everything was looking the same as at the post op, after 2 years there is almos 4 mm washout of the sealer in apical part . I know it is hard to answer if you do not know my whole protocol but I am wondering what could be wrong in this case - low contain of CS or acidic enviroment?
Once again sorry for long reply and thanks in advance for your comment
@@michalpolivka6066 Great question Michal. The composition should be written on the MSDS Sheet inside each sealer package. The manufacturers must by law divulge their components (at least in the US). You can also read the compositions from the FDA 510 application the companies send. Aluminate is used by some manufacturers as a replacement for calcium silicate in order to facilitate setting; however, some people frown upon the permanent implantation of aluminum in the body since it has been found in Alzeimer's Plaque and other types of toxicity. But that's the same kind of controversy as with the Hg in amalgam. The bc you used and found the washout may be something that contains some of the washout prone components or have a water soluble (miscible) polymer as its basis (Marucci'/AHPlus BC). These are prone to this washout based on their chemistry. However, these sealers, as I mentioned in the video, would be perfectly fine if you follow the Minimize the Sealer Interface protocol by doing either Lateral/Vertical compaction as we did with ZOE and Epoxy resins. I just wouldn't recommend them for Hydraulic Condensation since maximizing the sealer interface or large areas of pooling will very likely washout in time. Therefore, the problem is to undrestand that term bioceramic sealer is somewhat abused nowadays for marketing reasons. You need to know the composition and use the correct technique for the material you use. Cheers! :)
Dr. is it possible to retreat root canal with BC sealer?
If you use Hydraulic Condensation correctly yes. But if you fill the canal mostly with bioceramic then it’s very difficult if not impossible to retreat. This is why we developed Hydraulic Condensation: to harness the power of bioceramics without the potential side effects of a bioceramic fill.
Cheers!
@@AANasseh Thanks.