Caution: The caps of Endoseal MTA are single-use only. Never reuse it! Do not remove the needle tip after use. Be sure to place the tip cover, and replace the needle tip with a new one when you use it next time. See additional precautions
ENDOSEAL MTA is a paste-type root canal sealer and filler based on pozzolan cement that has excellent physical and biological properties of MTA. It is part of the family of products known as calcium silicate-based endodontic sealers. Endoseal is premixed and pre-loaded in a syringe that allows direct application of the sealer into the root canal without requiring powder/liquid mixing, unlike other products. The product has outstanding flowability and maneuverability, which makes it possible to completely fill the root canal system including accessory and lateral canals. It is eugenol-free and will not impede adhesion inside the root canal.
Endoseal MTA Indications ENDOSEAL MTA is developed for root canal filling and root perforation repair, effectively preventing periapical tissue irritation as well as secondary infection.
Premixed and pre-loaded in a syringe: No powder/liquid mixing required!
Endoseal MTA Science and Technology
The inside of the root canal system has high humidity due to residual moisture in the dentinal tubules. MTA solidifies into a hard structure by absorbing the moisture from the surrounding tissue and has outstanding sealing capacity and biocompatibility. Therefore, it is appropriate for root canal treatment. Endoseal MTA solidifies by absorbing the moisture from the surrounding tissue and producing calcium hydroxide during the process that penetrates into the dentinal tubules, and it creates hydroxyapatite extensively. In addition, it induces regeneration of the surrounding damaged hard tissue.
Endoseal MTA Biocompatibility
Since Endoseal MTA is a root-end filling material based on MTA, it has superior biocompatibility and little inflammation. These characteristics of Endoseal MTA have been verified by many researchers and published at SCI journals.
Endoseal MTA Antibacterial effect
Endoseal MTA has a high PH and excellent antibacterial effects. E. faecalis, which is most commonly observed in teeth where endodontic treatment has failed, is very difficult to control with conventional intracanal instruments and cleansing, and is resistant to intracanal medicament. If a root canal sealer has antibacterial effects against E. faecalis, the root canal treatment will have higher predictability.
Endoseal MTA Hermetic sealing
2% dimensional change of Endoseal MTA occurs only during the setting process. Afterward, it rarely expands as shown in the table. In addition, Endoseal MTA is naturally penetrated even into unreachable spaces, where a dentist could not fill, during complete hardening time (12 hours).
Endoseal MTA Hard Tissue formation
Endoseal MTA not only has excellent sealing ability, but it also promotes hard tissue formation around the infected tooth. The superior ability of the hard tissue formation can be seen by various genetic tests.
Directions for Storage and Precautions
Endoseal MTA starts to harden when it is exposed to moisture in the air, and in the root canal. If you leave the tip in place, the front part of the tip will harden, which will result in sealing. The plastic or needle tip, however, does not guarantee complete long-term sealing. Therefore, after unpacking and using the product the first time, regular reuse at least once a week is recommended to avoid the gelation of the front end of the product. If the product has not been used for a long time remove the inserted tip, squeeze a little, and insert a new tip.
Pulling back the plunger will cause the moisture in the air to come inside the syringe, which will cause the product to harden. Thus, never pull back the plunger.
Overfill may occur if the plastic or needle tip is stuck in the canal. Inject the product with the tip loose in the root canal.
Use the product without the master cone for primary and permanent teeth under orthodontic treatment.
Recap the needle tip after use for storage.
Before reuse, check if the product can be smoothly squeezed out at the tip like a waterdrop and insert it in the root canal.
Completely dry the root canal before obturation.
Moisture in the root canal will greatly accelerate the gelation of the product.
Filling with Endoseal without gutta-percha will also ensure good outcomes.
Yes, there have been several studies published on Endoseal. Please see some of them below. Click on the title of the article for more information.
Root Canal Filling Quality of a Premixed Calcium Silicate Endodontic Sealer Applied Using Gutta-percha Cone-mediated Ultrasonic Activation. J Endod. 2018 Jan;44(1):133-138. Kim JA, et al. INTRODUCTION: The aim of this study was to investigate the filling quality of a recently developed premixed calcium silicate-based endodontic sealer (Endoseal MTA) with a single gutta-percha (GP) cone technique compared with a resin-based sealer (AH plus) with warm vertical compaction. We also explored the effect of GP cone-mediated ultrasonic activation on the filling quality of Endoseal MTA. CONCLUSION: Endoseal MTA performs best when used with GP cone-mediated ultrasonic activation. Furthermore, stereomicroscopic observation of sections of the specimens should be performed when evaluating root canal filling quality.
OBJECTIVES: The aim of this study was to evaluate tooth discoloration caused by contact with a novel injectable mineral trioxide aggregate (MTA)-based root canal sealer (Endoseal; Maruchi, Wonju, Korea) compared with a widely used resin-based root canal sealer (AHplus; Dentsply De Trey, Konstanz, Germany) and conventional MTA (ProRoot; Dentsply, Tulsa, OK, USA).
CONCLUSIONS: Within the limitations of this study, our data indicate that the MTA-based sealer, Endoseal, produces a similar amount of tooth discoloration as AHplus which is considered to be acceptable.
BACKGROUND: The aim of this study was to investigate the physical properties and biological effects of an experimentally developed injectable premixed calcium-silicate root canal sealer (Endoseal) in comparison with mineral trioxide aggregate (MTA) and a resin-based sealer (AHplus).
CONCLUSIONS: The present study indicates that Endoseal has favorable physical properties and biocompatibility. Therefore, we suggest that Endoseal has the potential to be used as a predictable root canal sealer.
Pz-MTA (Endoseal) cement can be used as a promising bioactive root canal sealer to enhance biomineralization of dentinal tubules under controlled environment.
For the convenience of obturation, the single cone technique can provide sufficient sealing effects. In case of the root canal with excessive enlargement or wide shape, accessory cones can be additionally inserted in order to reduce bubble formation. Vertical pressurization increases the viscosity of Endoseal MTA, reduces bubble formation, and helps Endoseal MTA to penetrate deeper into the dentinal tubules. The ultrasonic condensation technique is the most delicate technique as stated in the IFU and it has less bubble formation.
Endoseal MTA Steps (click on the image for a full view)
It is recommended to use a beveled 24-gauge metal tip. Since Endoseal MTA is pushed to the side, there is little possibility of an excessive injection beyond the root apex. Therefore, it is safe to use. For root canal filling of deciduous teeth, a plastic tip, such as Vitapex, should be used. If there are obstacles (e.g. broken file in the root), insert the plastic tip directly above the obstacle, and then fill with strong pressure.
You do not need to insert the tip deeply into the root canal length. Since Endoseal MTA has a low contact angle and its viscosity increases when pressurized, it can be easily dispensed into the root apex even in the case of elongated root canals. Hence, after injecting the Endoseal MTA into the center of the root canal, it is sufficient to just insert the master cone slowly so the Endoseal MTA penetrates into the root apex. If the tip is tightly fitted in the root canal, you must pay special attention to dispense the Endoseal MTA because a large amount of paste may overflow beyond the root canal.
A: In case of the root canal without apical stop or with lesions, you must smoothly insert the master cone by neither applying vibration or pumping. Although, Endoseal MTA goes beyond the root apex, it does not irritate the root apex or cause lesions. Because, even though time passes, Endoseal MTA is usually not absorbed, due to hard tissue formed around the overflowed Endoseal MTA. If nerves run beneath the root apex, special attention should be taken not to pass beyond the root apex.
A: To create a core for the one-day treatment, cut the master cone at the orifice of the root canal and then compress it with a condenser to seal it. Afterward, thoroughly clean with water and perform conventional etching and bonding. To create a post for the one-day treatment, cut the master cone as much as you want by using the ultrasonic tip or vertical compaction instrument, compress it, and then seal with a GP cone. After that proceed with conventional etching and bonding. If you need to build up a post at the next appointment, follow conventional methods.
Rapidly increased viscosity makes Endoseal MTA diffused into not only the root apex, but also the complex anatomical structures (e.g. accessory canal and dentinal tubule), so it helps to produce better sealing and healing performance. For the master cone, non-standard GP cone is recommended to use. And it is better to feel the tug-back in the middle third of the root canal than the apical third.
Endoseal MTA uses the pozzolanic reaction that is internationally patented. Therefore, it does not discolor the tooth. Since the free silica ingredient forms hydrous calcium silicate by reacting with calcium hydroxide created during the process of solidification, it prevents tooth discoloration.
In case of deciduous teeth, Endoseal MTA must be used only by itself, in order to be naturally absorbed as the root of deciduous tooth. It must never be used with GP Cone. In the case of an endondontic treatment for the deciduous teeth, if sealing the accessory canal by applying Endoseal MTA onto the bottom of the pulp chamber as at least 2mm thickness, it can yield more predictable results. If there is a furcation defect, a permanent tooth eruption is faster than an alveolar bone regeneration resulting from effects of MTA. Therefore, you must inform the guardian of the possibility of an early eruption.
Case 2:
In case of root perforation having lesions, Endocem MTA, which has a faster setting time, was used instead of Endoseal MTA, however a deciduous canine adjacent to the surrounding was filled with Endoseal MTA. After a year, the natural eruption of the permanent tooth and absorption of Endoseal MTA were observed.
Case 3.
This is a common case of pulpectomy by Endoseal MTA and pulpotomy by Endocem MTA. In case of a deciduous tooth with a furcation defect, the eruption of the follow-up permanent tooth occurs earlier than the alveolar bone regeneration, even after a complete healing. A naturally absorbed Endoseal MTA has been observed.
Since Endoseal MTA contains enough zirconia, Endoseal MTA can be removed any time, even after solidification. If treatment is required, Endoseal MTA can be removed using a general hand file or Ni-Ti file.
Endoseal MTA has the exact same advantages of MTA. Hence, applications for booth root perforation and immature permanent teeth yield predictable results. In case of immature permanent teeth in which the inside of the root canal is filled with blood, it is recommended to use Endocem MTA.
A: Endoseal MTA has a strong hygroscopic property. You must never reuse the plunger cap of the syringe. Instead of it, the tip,
which you used for the treatment, must be kept without removal. In this case, it is safer to reinstall the used tip's cap.
Just prior to the next application, you replace the unremoved tip with a new one.
The inside of the root canal system has high humidity due to residual moisture in the dentinal tubules. MTA solidifies into a hard structure by absorbing the moisture from the surrounding tissue and has outstanding sealing capacity and biocompatibility. Therefore, it is appropriate for root canal treatment. Endoseal MTA solidifies by absorbing the moisture from the surrounding tissue and producing calcium hydroxide during the process that penetrates into the dentinal tubules, and it creates hydroxyapatite extensively. In addition, it induces regeneration of the surrounding damaged hard tissue.
