The Obturation Revolution
EndoSequence BC Sealer, Root Repair Material (RRM), and Putty (Brasseler USA) are 3 formulations of the same set of bioceramic-based cement and obturation materials that have revolutionized endodontic obturation during the past 5 years.
The case demonstrated here showcases the clinical application of the BC Sealer for nonsurgical obturation of a standard necrotic molar tooth with 4 canals. Here, the Hydraulic Condensation Technique using the EndoSequence bioceramic-coated gutta percha cones was used instead of lateral or vertical condensation. This very efficient technique requires less than 5 minutes to obturate all 4 canals in this molar from, start to finish!
The patient presented with a necrotic tooth No. 19 with large distal periapical radiolucency, which necessitated a root canal. Following cleaning and shaping with the EndoSequence .04 NiTi rotary instruments to large apical diameters and irrigation with sodium hypochloride, the canals are dried simply by paper points and the premixed BC Sealer is injected into each canal. Only enough sealer is injected so that the top half of the canal is filled.
A file is then used to safely push the sealer down to the full working length in each canal. Each corresponding EndoSequence BC coated gutta percha cone is then seated to full working length in each canal. Cones are seared off at the orifice level using a heat source such as the EndoPro 270 (Brasseler USA).
Following condensation of the gutta percha at the orifice level, the excess sealer is washed out using ultrasonics and water (or a wet cotton pellet). Some additional sealer can be placed on the chamber floor to seal the orifices. The immediate postoperative radiograph and 1-year follow up shows acceptable fill and complete healing of the periapical lesion.
This case demonstrates the results you can expect with the Hydraulic Condensation Technique in conjunction with adequate cleaning and shaping procedures. It's important to realize that the BC Sealer can also be used in conjunction with either lateral or vertical condensation technique in the traditional way. However, given the superior material properties of this sealer, a simpler obturation option such as the Hydraulic Condensation is now available to endodontic practitioners.