The Changing Face of Endodontic Treatment: Vital Pulp Therapy

The Changing Face of Endodontic Treatment: Vital Pulp Therapy

Innovative, 2nd-generation MTA-type materials headline Brasseler’s newest contribution to Vital Pulp Therapy techniques 

They say experience and knowledge are the engine of innovation and this has never been more true than in the world of endodontics. Here, a root canal of a decade ago looks nothing like one today. Following this evolving science, many dentists are embracing Vital Pulp Therapy (VPT) as a potential alternative to standard root canal treatment.

New treatment approaches in endodontics naturally demand cutting-edge materials and equipment, and at the forefront of this trend is the EndoSequence line of bioceramic products from Brasseler, a leader in bioceramics and restorative dentistry.

Dr. Martin Trope—clinical professor at the University of Pennsylvania, owner of Next Level Endodontics (a private teaching institute), and well-known teacher of VPT techniques and its core position in overall tooth preservation and survivability— reaches for the EndoSequence line of products for his VPT procedures.

“If we can keep the tooth vital, we won’t have apical periodontitis,” he explained, “And, really, the key is vital pulp therapy because a healthy pulp means there’s a 90% rate of successful outcomes.”

“Really, the key is vital pulp therapy because a healthy pulp means there’s a 90% rate of successful outcomes.”

- Martin Trope, DMD

Preserving Healthy Pulp

Healthy pulp can defend itself against microbial challenges, so a patient’s chances of long-term successful outcomes after root canal procedures are increased if the tooth is more vital than necrotic or infected. As part of his VPT, Dr. Trope has relied on a series of 3 secondgeneration mineral trioxide aggregate (MTA) products in Brasseler’s EndoSequence line, finding that all 3 forms are similar biologically with different particle sizes, resulting in different handling properties. He starts with the EndoSequence BC Root Repair Material, a radiopaque, hydrophilic material whose relatively small particle size allows ideal flow properties, ultimately providing a bond to dentin and superior healing properties. The moisture present in the dentin initiates setting and its highly alkaline pH allows it to be antibacterial.

Paired with the BC Root Repair Material, and unlike similar sealers, the EndoSequence BC Sealer uses moisture naturally present in the dentinal tubules to initiate a setting reaction. Highly radiopaque, antibacterial, and hydrophilic, EndoSequence BC Sealer chemically bonds to dentin, has zero shrinkage, and forms hydroxyapatite upon setting. It is the only pure medical-grade bioceramic product available for endodontic obturation.

A core advantage with EndoSequence BC Sealer is that it adheres to the tooth and expands slightly at final setting, which means it’s no longer necessary to remove unnecessary tooth structure before placing the material, thereby reducing the chance of fracture.

To be used along with BC Sealer and BC Root Repair Material, Brasseler’s EndoSequence BC Liner chemically bonds to dentin without needing a bonding agent. In addition, its moisture-friendly chemistry seals teeth against micro leakage. The material continuously releases and recharges calcium, phosphate, and fluoride ions.

No More Discoloration

Remembering past experiences with calcium hydroxide materials that eventually wash out, and a coronal restoration with amalgam, which can leak, Dr. Trope reports overall success with the EndoSequence line of bioceramics. Two noteworthy issues with previous formulations of bioceramics have been a tendency to discolor, and many dentists found it was difficult to prevent excessive waste while using them.

Premixed For Zero Waste

“This latest material from Brasseler is a premixed bioceramic,” Dr. Trope explained, “These materials are well-researched, have the same properties as the original MTA, and since it is premixed, you only use what you need—the dentin provides the water. An additional advantage is that it won’t discolor.” “Overall, bioceramics have been shown to be outstanding sealing materials that are biologically active in endodontics and operative dentistry,” Dr. Trope concluded.