smartseal FAQ’s

What is smartseal?

smartseal is a root canal obturating system that utilizes hydrophilic polymer technology. It is a single point and paste system that makes obturating prepared canals easy, quick and predictable. propoints contain a hydrophilic polymer coating around a central core. This coating can absorb water from the root canal and swell laterally only in to any open space to self-seal. Similarly, smartpaste is a resin-based sealer containing an active polymer powder that ensures it can also swell to fill and seal any lateral canals, irregularities or tubules in the dentine. smartpaste bio is a bioceramic sealer that is very biocompatible and also hydrophilic, so expands slightly on setting.

Hydrophilic polymers

What does ‘hydrophilic’ and ‘hydrophobic’ mean and why is it important?

The literal meaning of ‘hydrophilic’ is water-loving. In general, hydrophilic materials have a structure that includes sites that undergo hydrogen bonding. With hydrogen bonding, a molecule has a temporary negative charge (sometimes called a dipole) that attracts the temporary positive charge on the hydrogen atoms in water. Hence, hydrophilic materials like to gather water molecules around the hydrogen bonding sites if they can. Hydrophilic materials can be synthesised such as contact lens materials or natural. Many body tissues are hydrophilic (e.g. cartilage).
Hydrophobic materials do not have any dipoles or hydrogen bonding (sometime they are called non-polar) and hence tend to repel rather than attract water. Oil is an example of a hydrophobic material.
Hydrophobic materials and hydrophilic materials do not mix readily. An example is oil and water. This behaviour is why many hydrophobic dental sealer materials, such as gutta percha, cannot ‘wet and bond’ to dentine which is hydrophilic.

Is smartseal safe?

Yes. smartseal has been assessed (standard ISO 13485 for medical devices) and has been CE marked.
The hydrophilic polymer used in smartseal is similar to those used in soft contact lenses and intraocular lenses used for cataract treatment. These materials have been used for over 25 years, with millions of lenses produced and used per annum.
The sealers used in smartpaste have a history of use in Europe, USA and other territories.

Preparation and Cleaning

Is smartseal compatible with all preparation and cleaning agents?

The use of smartseal with undiluted sodium hypochlorite is not recommended. The canal should be rinsed with EDTA or water before smartseal is used.

What irrigation regime is recommended?

Copious irrigation with sodium hypochlorite solution is recommended followed by rinsing and drying with paper points

Can Sodium Hypochlorite (bleach, Milton’s solution) be left in the tooth for several days to treat a reoccurring infection?

No. Sodium hypochlorite may be used during instrumentation, cleaning and shaping but is not intended for treatment or as a medicament. Any sodium hypochlorite solution should be removed by a final rinse using EDTA or bacteria free water.

What files do you recommend?

propoints come match fit to most of the available file systems. If you use constant taper files, we recommend our constant taper points (.04 and .06) at tip size 25. A smartgauge is available to trim the tip to whichever apical size is required, allowing one point to fit any size required. Pre-cut tip sizes are also available if preferred.

Can smartseal be used with the Sendoline S5* file system

Yes. The propointS range is designed to precisely fit the variable taper profiles generated by the Sendoline S5* file system to ensure that an effective seal is achieved. propointS are available in sizes S2 through to S4 to match the final file taken to full working length.

Can smartseal be used with the ProTaper* file system

Yes. The propointPT range is designed to precisely fit the complex canal profiles generated by the ProTaper* file system and ensures that an effective seal is achieved when the correct ProTaper* file sequence is used. propointPT are available in sizes F1 through to F5 to match the final finishing file taken to full working length.

Obturating with smartseal

Can smartseal be used with thermal or mechanical compaction techniques?

smartseal is designed to swell once in the root canal to create an excellent mechanical seal, there is no need to use either mechanical or thermal compaction. A simple single master cone technique is recommended for the majority of cases, which ensures a good seal is readily achieved and saves time. In very oval canals, two propoints may be used together.

What is the waiting time after using smartseal before placing a post?

Post prep can be conducted immediately after insertion of smartseal provided you get good tug back and initial fit.

Is smartseal compatible with the various post systems?

Yes

Why do you have two sealers, and what are the advantages of each?

Simply because different practitioners have different personal preferences with regards to sealants. Our resin sealer (smartpaste) has a shorter working time, and because you can control the amount of hydrophilic powder you add to it, you can control its expansion and rheology. It’s great if you want to do a post prep in the same session. The bioceramic sealer (smartpaste bio) is hydrophilic and expands slightly on setting. It releases calcium hydroxide and hydroxyapatite while setting so creates a very antimicrobial environment during this time, but is very biocompatible afterwards. It is also pre-mixed and injectable so much less messy.

How many canals can be treated using a pack of smartpaste or smartpaste bio?

A syringe of smartpaste can treat approximately 60 canals. The precise figure depends on the nature of the canals and the technique of the practitioner. The active polymer supplied with smartpaste is sufficient for in excess of 20 treatments.smartpaste bio can treat approximately 45 canals and is supplied with 15 intracanal tips.

How do you remove the excess at the base of the propoint once it’s in the canal?

There are several ways you can do this:1. Simply use a high-speed flame bur to remove the excess and then push down on the top with a round diamond bur until the propoint is flush with the orifice. The smarttrim trimming kit contains two types of bur that are perfect for this. You may keep the water on if you choose to do so since the system is hydrophilic, although only when using the resin sealer (smartpaste). If using smartpaste bio, keep the burs dry or else you may find the water washes much of the sealer away.

2. Alternatively, dry ultrasonics (not cavitron) with an endo diamond tip works well to remove the excess at the base of the point while in situ.

3. Another method is to place a coloured endo stop onto the base of the propoint. Place the point into the canal and use the stop to mark the working length you require the point to be. Remove the propoint and trim to size using sharp scissors before seating back into the canal.

Where does the water come from when I dry the canal thoroughly with paper points?

Dentine contains thousands of tubules, where water can diffuse in and out of the tooth environment (hence why sealers resorb over time). Even if the canal is dried thoroughly, the water will diffuse back through to the surface within a matter of seconds. We recommend removing any excess irrigant from the canal, but you don’t need to worry about drying the canal as with gutta percha.

Are propoints bactericidal, and if the polymer coating on the propoint absorbs water, why can’t bacteria and other microorganisms can’t get in?

propoints aren’t inherently antimicrobial because they are so biocompatible; however the structure of the polymer coating is such that although water can enter the polymer matrix, it is too small for micro organisms to get in. This is indicated on our dye studies, where you can see that although the dye has reached the outside of the polymer cone, it is unable to penetrate though it, or even up around the outside of it. The hydrophilic polymer has created an excellent seal. As it is non-biodegradable, this seal will not break down over time.

Why won’t the swelling of the propoint crack the tooth?

The expansion of the polymer on the propoint is controlled so that once it reaches a barrier it stops expanding. We’ve placed points into thousands of teeth, some of which were sterilised and desiccated for our dye leakage studies, and none of these have ever fractured. I know people are cautious about expanding points after a material called Hydron caused a lot of problems some time ago, but our material is completely different.

Will the propoint go into the tubules?

No, but the paste will. If the polymer alone comes up against a tubule, it will create an excellent mechanic seal but will not expand into it. We have excellent dye study images that show this.

What if it goes through the apex?

propoints are biocompatible so there will be no inflammatory response if they go through the apex. As with all resin sealers, if smartpaste goes through the apex, the resin will resorb over time. The hydrophilic polymer powder is completely biocompatible so will not cause any discomfort. smartpaste bio is non-resorbable however it is also extremely biocompatible so again there should be no issues. However, we do not recommend exerting anything through the apex.

How would you remove smartseal in the case of re-treatment?

Use retreatment burs to remove the propoint. It will cut out very easily. If the polymer has not fully hydrated for whatever reason, warmed water will soften it very quickly.

Are there any issues with bits of the propoint polymer left in the canal after removal?

If you look at SEM pictures of the surface of dentine, the notion that you can clean gutta percha, polymer, old paste etc. from the canal is flawed, which is why re-treatments do not carry the same success rate as first time treatments. However, in the case that a re-treatment is needed, the main concern should be cleaning the canal of infection effectively rather than worrying about any polymer.

Can you use chloroform to dissolve it?

No. No solvents can be used with the smartseal system. Simply remove with burs.

Does smartseal contain Latex?

No, there are no latex components in the smartseal system.

Does smartseal contain gutta percha?

No, there is no gutta percha in the smartseal system.

Warm Gutta percha is known to shrink on cooling. How does smartseal compare?

No shrinkage is one of the advantages of smartseal. With hot gutta percha, the shrinkage on cooling is estimated at approximately 6-7% which can leave significant voids that can potentially lead to infection. Similarly, with lateral condensation gaps are believed to be introduced due to the difficulty in ensuring and maintaining intimate contact between the gutta percha, which is hydrophobic, and the dentine which is hydrophilic.smartseal (both propoint and smartpaste) can swell to fill any cavities in the canal and thereby achieve and maintain a good seal.

Are there any restrictions on the use of smartseal?

smartseal is an epoxy –amine based resin material and should not be used on patients who are known to be sensitised to amines. smartseal should not be used on children under the age of 10.

Why are propoints more expensive than GP?

It may seem that a pack of points is expensive, however you need to take into consideration the time saving achieved by using smartseal (plus we have excellent offers on all the time too!). A single point only is needed, and because you can be reassured that you are creating an excellent seal, there is less chance of a retreatment being needed. Check out our cost comparison between using smartseal against other obturation techniques which shows that it is actually very cost effective.