| Doug Kase, D.D.S.
Tales from the Chamber
Inventing a Better Mousetrap: A Product Review |
Doug Kase
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 HOSE OF US who practice the EZ-Fill® technique for obturating canals in a predictable and complete method, creating a replicable three-dimensional seal, are all now very familiar with our sealer of choice: EZ-Fill cement. This sealer is an epoxy resin root-canal cement derived from the old standard of AH-26 sealer with modifications that make it easier to use and more radio-opaque while decreasing formaldehyde levels by half and ensuring that once the cement is set there will be no formaldehyde release. In addition, the cement’s decreased hardness makes for easy post-hole preparation with a Gates Glidden or Peeso. Also, it becomes less viscous when heated. I certainly by now do not have to repeat the technique when obturating with EZ-Fill, but I will again review its advantages over traditional root canal sealers. Its epoxy-based chemistry has no double bonds; as a result, it sets slowly, generating no heat, and it does not shrink or expand. It also has excellent flow due to its adjustable viscosity. It is also not clinically irritating to the periapical tissues and does not degrade over time. EZ-Fill adheres to tooth structure and gutta percha chemically and mechanically. OK; enough of its advantages.
The only disadvantage to the system—and believe me it is only a small one—has been the way it is dispensed. A powder-and-liquid system of delivery for any cement can lead to inaccurate mixing. The dentist may mix too much or too little cement for what needs to be accomplished. Additionally, using too much powder or too much liquid can lead to inconsistencies and to altering the physical properties of any cement. When it comes to EZ-Fill, inaccurate mixing can alter setting time and radio-opacity, which we can compensate for by additional powder or by heating the mix to increase flow by decreasing viscosity. Wouldn’t it be nice if there were something that would standardize the process?
Well, hello EZ-Fill Xpress (Figure 1), a new product coming soon from Essential Dental Systems, which I had the pleasure to test drive. The material, EZ-Fill cement, is basically the same animal as before except now it is a liquid-and-liquid mix in a dispensing syringe with a mixing tip (Figure 2). Let me tell you that this makes endodontic life easier and more predictable, at least with regard to root canal sealer. When you are an endodontist, what more can you ask for? Dispensing the cement in this manner has many advantages. First of all, you can dispense the appropriate amount. Usually in a powder-and-liquid mix we mix too much or too little. Too much equates to waste which eventually means wasting money. Even in an endodontic office where we do multiple cases, we ultimately end up throwing out a percentage of the mix. Also, there is consistent consistency (no pun intended) and viscosity. Using the EZ-Fill bi-directional spiral, the cement can be dispersed in the canal right out of the syringe without having to modify its viscosity. It is interesting to see that in a traditional powder-and-liquid mix the consistency can change from mix to mix. Also equally as important the radio-opacity can also change as well. Too much liquid equates to less radio-opacity. Too much powder creates a very thick and viscous mix that sets quickly and has to be heated on a frequent basis to thin it out. Thus this method for dispensing EZ-Fill also gives a consistent radio-opacity to the final product and to your final single-cone fill. My rating is six out of five stars, so keep a close watch for this future product.
January - March 2008
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FIGURE 1: EZ-Fill Xpress, coming soon from Essential Dental Systems.
FIGURE 2: EZ-Fill Xpress is a liquid-and-liquid mix in a dispensing syringe with a mixing tip.
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© Copyright 2008 by Musikant, Deutsch,
Kase, Dukoff, Bui, & Lipner. All rights reserved.
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