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Medical Forum / General / Dentistry / March 2005Aestetic fillings, which one is the best
Last ten years we had the gratest restults using XRV Herculite filling for the anterior and posterior teeth, and Esthet-x also.We decided to change filling material ,so we need advice about nanocomposites and sugestions for the great aesthetics,however in anterior and posterior region. Also we need advice about root canal sealer,because we are using AH plus. > Last ten years we had the gratest restults using XRV Herculite filling for >the anterior and posterior teeth, and Esthet-x also.We decided to change >filling material ,so we need advice about nanocomposites and sugestions for >the great aesthetics,however in anterior and posterior region. >Also we need advice about root canal sealer,because we are using AH plus. Stop using AH26 or AH plus immediately. You may as well be using sargenti. Switch to Grossman's sealer. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com I've had excellent results with EndoRez sealer (from Ultradent). Dr. Bonilla I'm using Coltene/Roeko's Guttaflow with a one-cone technique. It takes me 2 minutes to obturate a molar with an excellent fill at a cost of 2.5 quids. I've also heard very good things about EZfill but haven't used it yet. I do believe that cold filling systems are the wave of the future and will become better and better. If you only want a sealer, you might try resilon in one of its various manifestations (realseal etc). WB, out of interest, why are you so negative about AH26? Comparing it to N2 is quite severe in my opinion and not backed up by research. Eugenol-based sealers seem to be a poor choice nowadays. George George wrote: I'm using Coltene/Roeko's Guttaflow with a one-cone technique. It takes me 2 minutes to obturate a molar with an excellent fill at a cost of 2.5 quids. I've also heard very good things about EZfill but haven't used it yet. I do believe that cold filling systems are the wave of the future and will become better and better. If you only want a sealer, you might try resilon in one of its various manifestations (realseal etc). WB, out of interest, why are you so negative about AH26? Comparing it to N2 is quite severe in my opinion and not backed up by research. Eugenol-based sealers seem to be a poor choice nowadays. George Bill's message: What's in AH26? No formaldehyde, I hope! According to this 1991 abstract, at least it does a good job of sealing: A Comparative Study of the Apical Leakage of Four Root Canal Sealers and Laterally Condensed Gutta-percha Sriwalee Limkangwalmongkol, DDS, MDSc, Peter Burscher, PhD, Paul V. Abbott, BDSc, MDS, FRACDS(Endo), Anthony B. Sandler, BDSc, HDDent, and Brian M. Bishop, MDS, MSc, BDS, LDSRCS Previous studies have shown that lateral condensation of gutta-percha and sealer can provide an adequate apical seal. The purpose of this study was to compare the level of apical dye penetration when different sealers were used. One-hundred twenty-five teeth with single root canals were biomechanically prepared using the step-back technique and irrigation with EDTAC and 1% NaOCl solutions. The teeth were divided into five groups of 25 teeth each. The control group root canals were filled with laterally condensed gutta-percha and no sealer and the other four groups were filled with laterally condensed gutta-percha and either Apexit, Sealapex, Tubli-Seal, or AH26 sealer. After storage in 100% humidity at 37°C for 48 h, the root surfaces were coated with nail varnish (except at the apex) and placed in 2% methylene blue dye solution and centrifuged at 3 x g for 3 min. The roots were sectioned transversely at 1-mm intervals to determine the following mean levels of dye penetrations: Apexit, 1.67 mm; Sealapex, 2.28 mm; Tubli-Seal, 1.95 mm; AH26, 0.82 mm; and gutta-percha alone, 8.37 mm. This study demonstrated that a root canal sealer should be used in conjunction with laterally condensed gutta-percha and that AH26 sealer provides a significantly better apical seal than the other sealers. reference: http://tinyurl.com/4dvgr > Bill's message: > What's in AH26? No formaldehyde, I hope! According to this 1991 > abstract, at least it does a good job of sealing: Bill, I think AH26 contains formaldehyde. So does N2. I don't see where's the problem. Formaldehyde is a natural ingredient of many foods, including pork and milk, and the dosage received by one pork chop exceeds the amount in N2 used for a canal. No serious research has ever shown that N2 is toxic; condemning it based on horror stories (where it was used by plonkers who would have caused damage with any material they used) is not dissimilar to condemning amalgam. The fact is that the majority of materials we use could be deemed "unsafe" (amalgam has mercury, guttapercha is cytotoxic and not inert, composites release free radicals and formaldehyde - surprise, surprise), but they work. N2 is still in wide use in Europe since its original conception and no one has died yet! It seems to me that the bad reputation it has received in the US is a result of a political game played by the endodontist specialists and the hordes of no win-no fee lawyers. George And what about aestetic fillings. > And what about aestetic fillings. > > -- > Message posted via http://www.medkb.com Aleksandar, for posterior composites I use SDI's Rok composite. I like its hardness and the way it handles. It provides great value for money. I have heard that it is possible to do invisible restorations time after time by filling up a tooth with a dark shade (say A3.5 or A4) up to 0.5mm before the margin and doing the last layer in translucent shade. This should save you a lot of money from buying all the different shades. I haven't tried that yet, but I think it makes sense (dark shade to mimic dentine, translucent to mimic enamel). WB, I don't think we should be absolute in this. AH26 is definitely not a horrible sealer, considering it's an old one. AH Plus is currently in widespread use even in the States. Since it has approval for use as a dental material, I can't see it being indefensible in court. N2 is indefensible in the US, but not in the rest of the world, and I think this is more because endodontists waged a war against it rather than its actual properties. It is interesting that an improved N2 formula without any lead, arsenic or corticosteroids, but with the formalhedyde still there, has sought approval by the FDA. If it is approved, N2 will be back in business in the US. George >Bill, I think AH26 contains formaldehyde. So does N2. I don't see >where's the problem. Formaldehyde. Yes is does contain formaldehyde. *That* is the problem. It's use is indefensible in court. N2 or AH26. Just asking for trouble, doesn't meet the standards of practice. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >WB, out of interest, why are you so negative about AH26? Comparing it >to N2 is quite severe in my opinion and not backed up by research. >Eugenol-based sealers seem to be a poor choice nowadays. > >George My endodontist buddy informs me that AH26 is a horrible sealer choice and indefensible in court. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com |
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