Fig. 1

This is a typical examples of uncontrolled  extrusion. The clinician was expecting a feedback from the canal during sealer application made with syringe, but unfortunately only the final X-ray highlighted the clinical matter. In terms of symptoms both cases were completely asymptomatic during the following days. 

Fig. 2

Due to this uncertain situation, some clinician suggested to come back to the origin with paper points or lentulo models, but honestly the concept is like unaccepting the evolution and in any case both concepts still leave risks for the clinician, like dehydration of sealer made by paper points and lentulo breakage. 

Fig. 3

This is the reason why a new application technique has been designed basing on two different models:

  1. Plastic carrier as applicator
  2. Modified Irriflex Needle 

Plastic carrier applicator

This techniques is the easiest:

  1. Extrude just coronally 3mm of sealer with the needle that comes in the box
  2. Distribute on the walls the sealer moving plastic carrier close to the WL.
  3. Introduce GP cone inside the canal
  4. Make the desired GP technique, Warm or Cold. 

Modified Irriflex needle Technique

This technique requires a bit more training made by the operator and it is made in this way:

1) Apply irriflex to the Bioceramic sealer needle

2) Place a rubber stop on Irriflex

3) Cut last 2/3 mm of the needle

4) Adjust the rubber stop 1mm shorter than wl

5) check sealer extrusion on rubber dam

6) extrude sealer in the first 4 mm of the canal

7) stop extrusion when sealer appears at orifice level

8) introduce irriflex inside the canal without further material extrusion and move the needle by side in order to distribute sealer on the walls (NO UP AND DOWN MOVEMENTS)

9) before introducing GP cone make sure that no more sealer is in the middle of the coronal third. It must look like a black hole with white circumference.

10) introduce GP cone and make your preferred technique


In case of carrier based technique, the operator can use both techniques, but it’s suggested to distribute the sealer just in the coronal /mid part of the canal. Also here the canal must be empty in the central part in order to avoid GP blockage at the coronal level


A new material can become a fast trend in dentistry, but even if it’s a promising one, the operator should carefully evaluate also the operative technique. It’s not fair pretend that all operators will be able tu use it since the beginning in proper way. The two techniques here suggested has been developed with hundreds trials until good outcomes has been obtained


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