A root canal treatment (RCT) is one of the most common dental procedures today. Filling in the empty canal from where the pulp has been extracted, is a crucial part of the intervention. Traditionally, the filling material that was used in case of a RCT was called ‘gutta percha’. it is a material of rubbery texture (both in room temperature and while consuming too hot or chilled cold beverages). Gutta percha is the the coagulated sap of certain tropical trees.
Over the decades, there has been extensive research in lieu of filling material used in the root canal procedure. Ideally, the filling material that will be used, has to be essentially inert and with the least complications. Therefore, the findings on different compounds, over the years, have been interesting enough.
Obsolete Methods: The Sargenti Formula:
For instance, the ‘Sargenti formula’ worked for many years. Sometime back in the 1950s a Swiss dentist named Angelo Sargenti used paraformaldehyde as filling material in root canals. This was indeed easier and faster to place inside the empty canal, as compared to gutta percha. However, when paraformaldehyde cones in contact with water, it forms formaldehyde (a preservative used in embalming fluids.)
Why did the Sargenti Paste become Obsolete? Cons of its use…
As we already know, the Sargenti paste uses paraformaldehyde. If this paraformaldehyde extrudes beyond the root tip, formaldehyde will be emitted. This erodes the surrounding bone, destroys nearby connective tissues, thus leading to numbness, jaw pain or infection of the maxillary sinus!
Evidently, the Sargenti method only adds to the risks involved. It has no advantages over standard endodontic procedures whatsoever. Its proponents have had more than 40 years to prove the safety elements of using this paste to the FDA, but have failed to do so! Therefore, although this filling material works well in most cases, yet, when things go wrong, the results can be devastating.
According to an article by,Stephen Barrett, M.D. “the Sargenti Opposition Society was formed in 2008 to campaign against the use of paraformaldehyde-containing paste and to help patients identify and avoid the dentists who use it.”
The Need for Alternative Root Canal Filling Material
A significant factor in the RCT is that, a lot of pressure is needed to reach the tip of the root. This exerted thrust may force the paste into surrounding tissues. There, it can even cause serious injuries if the paste further comes in contact with the jaw nerves or worse still, the maxillary sinuses above the upper jaw!
One of the latest research outcomes is promoting the use of blood clots as a canal filling material. The composition of the blood clots cannot be controlled. The procedure has been mostly successful but there were negative effects too.
So, how can the blood-clot filling material affect you dental health?
- It may cause discoloration or fractures of the tooth.
- The procedure may damage the tooth’s stem cells, which are needed for tissue regeneration.
An Alternative to the Blood Clot Method: Biomimetic Nanomatrix Gel
Most of the time a blood clot filling goes well. However, a biodegradable material that would provide both healing and tooth regeneration would can be a better alternative. Researchers from across the globe, have developed a gel filling to be used during a root canal treatment. This new gel releases nitric oxide and antibiotics inside tooth treated tooth. According to the findings of the pilot study, this new canal filling material has potential for boosting the regeneration of your impaired tooth!
Pros of Using the Nanomatrix Gel:
In a root canal treatment, after the successful removal of necrotic and infected debris, it is essential to create an aseptic environment. This is done by means of irrigation, applying medications within the canal, inserting filling material and so on.
Its Antibacterial Properties…
The nitric oxide-releasing gel has exhibited antibacterial effects. Also, nitric oxide helps wound healing. It prevents the death of blood vessel cells (vascular endothelial cells) thus regulating the vascular endothelial growth factor. This allows the the treated tooth to regenerate internally.
Findings from the pilot study concerned with Effects of the nitric oxide
Over the decades, there has been extensive research in lieu of filling material used in the root canal procedure.
releasing biomimetic nanomatrix gel on pulp-dentin regeneration has confirmed the notion that:
Antibiotics and NO were released from the nanomatrix gel by enzymatic degradation, demonstrate compatible antibacterial effects with optimal concentrations. NO does not interfere with the antibacterial effect of the antibiotics however.
Cited: Moon C-Y, Nam OH, Kim M, Lee H-S, Kaushik SN, Cruz Walma DA, et al. (2018) Effects of the nitric oxide releasing biomimetic nanomatrix gel on pulp-dentin regeneration: Pilot study. PLoS ONE 13(10): e0205534.
Fights Antibiotic resistance…
Secondly, antibiotic resistance within the body is curtailed. The application of antibiotics through a gel inside the tooth happens to be a totally localized affair. Being so it is preferable as it is capable in fighting antibiotic resistance. Local release would expose only a small number of bacteria to antibiotics. Whereas, oral antibiotics face a much larger number of bacteria that are present in the whole body. Since antibiotic resistance is only applicable to bacteria that are exposed to antibiotics, its probability of occurrence is now much lesser! Releasing antibiotics directly in the tooth therefore helps to limit the spread of antibiotic resistance.
This new gel would probably be subjected to more research in the coming days for some significant reasons. Since, for optimal tooth regeneration the required components are in fact being supplied by it. What is required for tissue growth after a successful RCT include a biodegradable scaffold, dental mesenchymal stem cells (tooth stem cells) and some growth factors. The new gel already provides the biodegradable scaffold and the nitric oxide has no adverse affects on the stem cells.