RealSeal™

Frequently Asked Questions

Q: What are the exact chemical compositions of both RealSeal cones and the sealer?
RealSeal Points
Compound of Polyester
Difunctional Methacrylate Resin
Bioactive Glass
Pigments

RealSeal Sealer
UDMA, PEGDMA, EBPADMA & BISGMA Resins
Silane Treated Bariumborosilicate Glass
Barium Sulfate
Silica
Calcium Hydroxide
Bismuth Oxychloride with Amines
Peroxide
Photo Initiator
Pigments

Q: Does the canal have to be perfectly dry to get a correct bond, like on a tooth structure?
NO. Like tooth structure, if the dentin is dry the bond will fail. The canal cannot have standing fluids in it but it should be moist/damp.

Q: What does the primer consist of? Why can’t a doctor use his current bonding agent to etch and prime the canal?
The primer consists of HEMA (a methacrylate resin), sulfonic acid and water. This formulation has an acidic pH which allows it to self etch the tooth, opening the tubules for the sealer.

We don’t know how well a doctor’s current bonding agent will etch and prime the canal and therefore, we can’t guarantee the same level of success as with our component. In addition, we don’t know if the sealer will bond well with their bonding agent. Lastly, there is no research to support the use of any primer other than our own.

Q: Does this primer have to be in the canal for a specific amount of time?
30 seconds

Q: What are possible issues if the primer has pooled in the canal?
Excess will be expressed into the PDL space possibly causing discomfort postoperatively

Q: How is the doctor assured that the primer is getting down the canal? Micro brushes are too big for a lot of canals and paper points absorb a lot of the product?
Using a paper point soaked in primer first will insure that primer is carried down the canal. Alternatively placing an abundant amount of primer at the orifice of the canal with the brush and then carrying it down the canal with paper points also works quite well.

Another technique is to place a dry paper point in the canal and place 2 drops of primer on it. The primer will run down the surface of the point towards the apex. Since the primer contains a large amount of water, it will travel along the surface of the root quite well.

Q: What makes Resilon sealer different than AH26? A lot of patients complain about post-op sensitivity with AH26. Aren’t these both resin based sealers?
AH26 is an Epoxy based sealer that contains certain amounts of formaldehyde. This is what causes the sensitivity not the resin formulation itself.

Q: Does the sealer resorb?
Yes

Q: How do you remove sealer from the walls of the canal during retreatment?
The same way you remove any conventional sealer; files, chloroform and alcohol.

Q: What happens when sealer goes beyond the apex and has self cured? Does this pose a problem to the patient? How is retreated.
It is treated the same as any other sealer that goes beyond the apex.

Q: How long does it take for the sealer to completely cure in the canal?
Setting is initiated with a curing light and will completely cure in the canal within approximately 45 minutes. Please remind the Dr. that these are in-vivo figures and that the sealer sets in an anaerobic environment; as a result, the sealer will not completely set on a pad or table top where it is exposed to oxygen.

Q: What is the depth of cure coronally when cured with a curing light? Does it make a difference if you use LED or Halogen curing lights?
The depth of cure will be 1 to 2mm, due to the opacity of the sealer. To be safe, double the cure time with an LED light.

Q: When backfilling, does the canal need to be precoated with the sealer? Does the sealer need to applied coronally to the final backfill so that there is a ball of sealer to light cure?
The canal does need to be pre-coated with sealer before the backfill is done. A ball of sealer does not need to be at the canal orifice for curing, but it is important that the sealer stays in place on the canal walls during backfilling.

Q: If the sealer and cone fit so well, why would the doctor need to heat in with warm vertical condensation?
We feel that maximum Resilon which has very little potential for contraction and minimum sealer (which has about 1% potential for shrinkage on setting) will give the best fill of the canal. A sealer layer that is too thick may shrink more than the bonding of the sealer to the core material. Only the warming and condensing of material will result in the maximum density of Resilon material in the cleaned and shaped root canal system. In addition, it is easier to retreat a canal filled with Resilon than a canal mostly filled with resin sealer.

Q: Prior to filling with Resilon, what should be the final rinse and why?
Anything except sodium hypochlorite can be the final rinse. Sodium hypochlorite cannot be the final rinse because it will interfere with the bonding. EDTA, (Smear Clear), or chlorhexidine (0.12 or 2%) are recommended.

Q: What is the longest study to date on Resilon and what are the current results of that study?
There is an outcome study in excess of 1 year at the University of North Carolina which is currently being tabulated. It was a double blind study conducted at their clinic. The results show excellent results for Resilon. Dr. Debelian has a study of 18 months in his private practice showing over 90% success for teeth even with apical periodontitis.