The gutta-percha cones can be manipulated into the root canal with either cold lateral

condensation, or through a method which involves softening the core filling material
with the application of heat, which was introduced more than 40 years ago by Dr.
Schilder. The gutta-percha and sealer filling material has been the most popular and
1

most tested filling material throughout the history of nonsurgical endodontic

procedures.

Despite significant advances in materials science over the past 50 years, it was just
recently that an alternative filling material for root canal obturation was introduced
and studied in an attempt to improve upon the successful history of gutta-percha. A
new a polycaprolactone resin-based thermoplastic filling material (Resilon [Resilon
Research LLC]) has been introduced that differs from gutta-percha—the rubber in the
gutta-percha material has been replaced with a urethane-based resin. A dual-cured
methacrylate resin sealer cement (Epiphany [Pentron Clinical Technologies]) was
developed to be utilized with a self-etching primer in association with Resilon in an
attempt to create a root filling material that is of a single, solid, bonded material. This
system differs from the gutta-percha sealer-based obturation material because it has
the ability, through dentin adhesive resin-bonding technology, to bond the root canal
walls to the sealer cement, which in turn bonds to the core filling material. This has
the potential to strengthen roots and to improve the leakage resistance of the obturated
root, hopefully improving nonsurgical endodontic outcome success over the long
term. The Resilon and Epiphany obturation material is available under different
names: Resilon/Epiphany (Pentron Clinical Technologies), Resinate (Obtura Spartan),
and RealSeal (SybronEndo).

In the past 4 years, sponsored and independent research has been busy determining if
the new Resilon material is an acceptable alternative to the time-tested gutta-percha
and sealer. Factors that have been tested include the cement’s cellular toxicity,
bacterial leakage in filled roots, fluid filtration leakage comparisons, microscopic
bonding visual analyses, bond strength to root dentin studies, periapical inflammation
evaluations, and clinical outcome comparisons. Based on the majority of the current
research through 2008 covering the various aspects of the new material, studies show
that the new filling material is a viable alternative to the gutta-percha-sealer technique
for filling roots in nonsurgical endodontic treatment. Furthermore, future research and
development may eventually reveal that it has the potential to be a better material than
gutta-percha

The Resilon core-filling material has less body stiffness and cohesion when compared
to a standard gutta-percha cone. This translates into a cone that is softer (less stiff) and
can be pulled apart easier. For example, if a master cone does not match the
instrumentation size precisely, a cone that fits 0.5 mm short of the desired length
cannot be “pushed” that extra distance with pressure on the cone itself. This is
because the softer cone will buckle under pressure and will not slide apically like a
gutta-percha cone might have a tendency to do. Additionally, if a Resilon cone is
placed into a canal where it has very firm “tug-back,” if the cone is pulled on to
withdraw it, there is a risk that the cone can be pulled apart upon withdrawal leaving
the firm-fitting apical fragment in place. Of course, the flipside of this situation is that
less tugback is required to successfully perform various obturation procedures. For
example, when using a single master cone warm vertical obturation technique and
there is inadequate tug-back present, the master cone could be withdrawn attached to
the heated plugger. This is more difficult to do with a softer Resilon cone. Although
the cone feels different in this subtle way, its flow characteristics and adaptability to
the root canal walls have been studied and found to perform comparably to heated
gutta-percha with sealer techniques in replicating anatomic depressions and filling
lateral canals. In lateral condensation filling techniques, the softer cone does lead to
2-4

an increased spreader-depth penetration versus gutta-percha cones. As a result, this

5

permits further spreader penetration, which is essential for better master cone
adaptation.6

The largest and potentially negative issues are as follows: the presence of intracanal
moisture and its effect on bonding agents; the unfavorable bonding surface
configuration of the root canals; the microscopic root surface characteristics; and the
flexing during tooth function that potentially leads to root filling debonding. Despite
these issues, Resilon has performed favorably in various leakage comparisons when
compared to other filling materials. Current studies show that the Resilon/Epiphany
root filling material performs favorably in the presence of intracanal moisture, even
when residual calcium hydroxide is left behind in the canals. Clinically, outcome
15

studies show that the success rate between gutta-percha filled cases and Resilon filled
cases are comparable. Even though the type of material that fills the roots of
16,17

endodontically-treated teeth is not an essential factor to permit the healing of apical

periodontitis in the absence of coronal leakage, recurrent caries and restorative
18

failures do occur. Therefore, a root canal filling that seals totally is needed.
It is well known that when a gutta-percha and sealer is in contact with saliva in the
oral cavity, complete reinfection of the root canal can occur in a short amount of
time.19 This is an indication that the current popular choice of root filling materials
does not always perform as expected, and a newer filling material is needed that can
perform with even better results.

CONCLUSION

In the past 4 years, Resilon, and its other brand names Resinate (Figure 4) and
RealSeal, have been shown to be an effective alternative to gutta-percha for filling the
roots of endodontically treated teeth. With further studies, research, and development,
this material may evolve to eventually retire gutta-percha as the endodontic root
filling of choice.