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New technology in endodontics
– the Resilon-Epiphany systemfor obturation of root canals
1 Department of Conservative Dentistry, Medical University of
Białystok,Poland,2 Department of Dentistry Propaedeutics,
Medical,University of Białystok, Poland,3 Department of
Paedodontics,Medical University of Białystok, Poland
Pawińska M1*, Kierklo A2, Marczuk -Kolada G3
Advances in Medical Sciences · Vol. 51 · 2006 · Suppl. 1 ·
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Abstract
• Purpose: Clinical and laboratory assessment of a
new root canal filling material – Resilon-Epiphany
system.
Advances in Medical Sciences · Vol. 51 · 2006 · Suppl. 1 ·
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REALSEAL (RESILON/EPIPHANY)
• The core
• The sealer is a dual-cure sealer.
• In addition the system comes with a self-etching primer.
Advances in Medical Sciences · Vol. 51 · 2006 · Suppl. 1 ·
Resilon can be placed as single cones, warm verticalcompaction thermoplastic injection, or lateral
compaction.
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#35, 0.04 tapered cone bent to show the
flexibility of the conesResilon cones
Resilon Pellet
Thermoplastic ResilonMaterial through anObtura gun (150°C)
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Primer and Sealer
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• During the cleaning and shaping procedures,alternating rinses of EDTA and sodiumhypochlorite remove the smear layer and open
the dental tubules for penetration of the resinoussealer. Because resins will not set in the presenceof oxygen, the oxygenating agent sodiumhypochlorite should not be the last irrigant before
the resin sealer is introduced into the canal. Thelast irrigant should be EDTA, followed by sterilewater or 2% chlorhexidine solution.
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Mono block
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BIOCOMPATIBILITY•
Several early publications (2001 and 2003) havereported on the biocompatibility and adhesiveness of EndoREZ.
• Testing different MBRS formulations and using a varietyof techniques, which to a large extent have caused more
controversy and confusion than answering the followingbasic questions:
• 1. Are resin-based sealers safe?
• 2. Can they be used successfully in patients?
• 3. Will they ultimately replace gutta-percha andconventional sealers?
• 4. Will they last as long as conventional materials?
• 5. Are they easier to use than conventional materials?
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Clinical and laboratory evaluation of
Resilon system
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Material and methods
5 men 16 women
Aged 14-55,
(5 incisors, 1 canine, 6 premolars and 12
molars)
Endodontically treated 48 root canals(24teeth)
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Irreversiblepulpitis
Acute apical
periodontitis
Chronic apicalperiodontitisgranulous - 4
suppurative- 1
Exacerbated
apical
periodontitiswith sub
mucous abscess
vital pulp were
treated for
periodontal
reasons
11 2 5
42
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• Pulpectomy was performed in 15 teeth
• In local anaesthesia -8
• After intentional devitalization - 7
• In the remaining cases, antiseptic root canal
treatment was instituted with the use of calciumhydroxide nonsetting paste – Biopulp, placed inthe canal with a Lentulo spiral for 7-21 days.
• In two patients with submucous abscess, abscess
was incised, and the patients were given Dalacin Cat a dose of 0.15 g every 6 hours andMetronidasol at a dose of 0.25 g every 8 hours.
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Results
• Four cases with radiologically confirmed root
canal overfilling, they observed pain on biting
and positive reaction of periapical tissues to
vertical percussion. The symptoms subsided
after 2-3 days.
• In the remaining cases, the canals were
properly filled (0-2 mm filling distance from the
radiographic apex) and no pain was reportedeither after the fillings were inserted or 6-12
months after treatment termination.
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• No clinical crown discolouration was noted
throughout the observation period. All the
follow-up radiographs showed normal picture
of the periapical structures.
• Bone regeneration at the site of bone loss was
observed in teeth with chronic and
exacerbated apical periodontitis
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Results
Clinical evaluation
• Treatment results have been presented
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One year after the treatmentImmediately after the treatment
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Laboratory evaluation – 4 extracted tooth
Transverse cross-section of the root canal obturated with Resilon-Epiphany system. Sealer (U)
adheres tightly to dentine (Z) and Resilon (R), sealer tags are visible in dentine
tubules (arrow). Magnification 3000x
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• Transverse cross-section of the root canal obturated with Resilon-Epiphany
system: a) A 1,2 m wide gap visible between sealer (U) and Resilon (R)
(arrow). Magnification 2 500x
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Visible is the sealer (U) adhering to dentine (Z) as well as gaps between the sealer
and Resilon (R) (arrows), a likely result of root cutting. Magnification 3 000x
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Discussion
• Mono-block with root canal walls – the sealer
adheres to Resilon points and root dentine,
properly prepared by means of the primer.
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• Resilon to bond to methacrylate-based root canal
sealers has also been questioned because the amount
of dimethacrylate in the thermoplastic composite
may not be optimum for chemical coupling.17
• However, when surface roughness was established,
the micromechanical interlocking increased the
mean bond strength significantly.
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Conti
• Shipper et al. evaluated the efficacy of Resilonand Epiphany in comparison to gutta-percha
and AH 26 pasta in the prevention of apical
periodontitis.• They created conditions for reinfection of the
previously filled root canal system and found a
significantly lower rate of apical periodontitisin resin-percha filled teeth.
• R_E is better when compared to gutta-percha
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RealSeal (Resilon™) fills seamlessly
and smoothly, eliminating leakage
Traditional gutta percha shows fissures and
gaps between its surface and the dentin – justthe place for harmful bacteria to multiply.
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Micrograph demonstrating intimate
contact of sealer and Resilon.
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SEM demonstrating intimate contact with
methacrylic sealer and Resilon, and dentinal
tubula penetration of the sealer. (RS -
methacrylic sealer; D - dentin)
SEM demonstrating microgap formation with
AH 26 epoxy sealer due to polymerization
shrinkage. (ES - epoxy sealer; D - dentin)
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Conti..
• SEM compared the tightness of root canal obturation
with the Resilon-Epiphany system and gutta-percha
and AH Plus pasta, using System B and Obtura II.
• In both groups, the authors observed both gap-freeand gap-containing regions.
Reported by Tay et al.
It is assumed that these gaps are probably created by rapidpolymerization contraction, promoted by heat generated
during material condensation with a hot plugger.
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• In this study, some gaps had contours corresponding
in shape and size to the filler particles that were
probably pulled out during root cutting
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Conclusion
Resilon-Epiphany system has yielded positive
outcome both in clinical and microscopicexaminations.
d i M di l S i V l 51 2006 S l 1