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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 ·



Abstract

• Purpose: Clinical and laboratory assessment of a

new root canal filling material – Resilon-Epiphany

system.




REALSEAL (RESILON/EPIPHANY)

• The core

• The sealer is a dual-cure sealer.

• In addition the system comes with a self-etching primer.


Resilon can be placed as single cones, warm verticalcompaction thermoplastic injection, or lateral

compaction.



#35, 0.04 tapered cone bent to show the

flexibility of the conesResilon cones

Resilon Pellet

Thermoplastic ResilonMaterial through anObtura gun (150°C)



Primer and Sealer



• 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.



Mono block



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?



Clinical and laboratory evaluation of

Resilon system



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)

dvances in Medical Sciences · Vol. 51 · 2006 · Suppl. 1 ·



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



• 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.



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.



• 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



Results

Clinical evaluation

• Treatment results have been presented



One year after the treatmentImmediately after the treatment



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



• 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



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



Discussion

• Mono-block with root canal walls – the sealer

adheres to Resilon points and root dentine,

properly prepared by means of the primer.




• 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.



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




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.



Micrograph demonstrating intimate

contact of sealer and Resilon.



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)



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.

dvances in Medical Sciences · Vol. 51 · 2006 · Suppl. 1



• In this study, some gaps had contours corresponding

in shape and size to the filler particles that were

probably pulled out during root cutting




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

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