Fabricio B. Teixeira

Several factors can contribute to the clinician's ability to achieve success in endodontic therapy. The importance of the coronal seal to positive endodontic outcomes has been established in numerous studies; fracture strength also has a significant influence on the prognosis of an endodontically treated tooth. This presentation discusses the role of these two factors in contemporary endodontic therapy and demonstrates how the utilization of an adhesively bonded, synthetic root-filling system can support the practitioner's management of nonvital teeth.

Several factors can contribute to the achievement of success with endodontic therapy. After an effective microbial‐control phase, an adequate canal and coronal filling will guarantee a high probability of success. Gutta‐percha has for many years been widely used as a solid material in root fillings associated with different types of sealers. Even associated with a sealer, this material it is not capable of preventing leakage, as has been shown in many studies. In fact, because of gutta‐percha's limitations, the seal of a coronal restoration may be as important as the guttapercha fill in preventing reinfection of the root canal. Although sealers can form close adhesion to the root canal wall, none is able to bond to the gutta‐percha core material. Upon setting, the sealer pulls away from the gutta‐percha core, leaving a gap through which bacteria may pass. This article describes a new thermoplastic, synthetic root canal filling material, whose design is based on polyester chemistry, that looks and handles like gutta‐percha. It is used in the same manner as most bonding systems. After the usual preparation of the root canal, a self‐etch primer is used to condition the canal walls and prepare them for bonding to the resin. The resin sealant is introduced in the root canal. It bonds to the primer and to the resin core material; thus, a “monoblock” is formed without the gaps typical in gutta‐percha fillings. Studies have shown that leakage of bacteria with this material is significantly reduced compared with gutta‐percha.