A description of the monobloc concept/ principle in endodontics including a detailed introduction and meaning of concept, classification of monoblocs in endodontics, various examples in monoblocs and a review of various studies undertaken using different monobloc systems and root canal filling materials

1. MONOBLOC IN ENDODONTICS

2. DEEPA JINAN
BAPUJI DENTAL COLLEGE & HOSPITAL

3. CONTENTS
• Introduction
• Role of monobloc in Endodontics
• Classification of monoblocs
• Clinical significance
• Characteristics of monblocs
• Sealability
• Reinforcement
• Primary monobloc
• Secondary monobloc
• Tertiary monobloc

4. CONTENTS
• Controversies
• Conclusion
• References

5. INTRODUCTION
‘Monobloc’
‘Single unit’
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398.
DEFINITION
A forging or casting made in a single piece, rather than being
fabricated from components
In orthodontics, introduced in 1902 by Dr. Pierre Robin -
united upper and lower acrylic removable appliances
To treat Class II division 1malocclusion & forms forerunner of
functional appliances by uniting two functional matrices (i.e.,
maxilla & mandible) into single unit
1

6. ROLE IN ENDODONTICS
‘Monobloc’Recent interest in the application of dentin adhesive technology to
endodontics
Improve the quality of seal in
root fillings
Strengthen roots
1 2
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398.
Scenario - canal space perfectly filled with a gap-free, solid mass that
consist of different materials & interfaces
Post systemsRoot canal filling materials
Generated controversial discussionsPotential of adhesive sealers & adhesive post systems to create
‘MONOBLOCS
‘Single units – reinforce tooth structure’
2

7. CLASSIFICATION
Replacement monoblocks created in root canal spaces classified as
Primary Monobloc
Secondary monobloc
1
2
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398.
Tertiary monobloc
3
interfaces present
between
the bonding substrate
and the bulk material
core
Root canal filling
material
Post & core systems
May be applied to
3

8. CLINICAL SIGNIFICANCE
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398.
Diseased pulps to be replaced by sealing
restorative materials – prevent reinfection
Rigidity of the root weakened by
endodontic & restorative instrumentation
Sealing quality & tooth strengthening
potential of monoblocks -important
Long term prognosis of endodontic treatment
4

9. CHARACHTERISTICS OF MONOBLOC
Ona M1, Wakabayashi N, Yamazaki T, Takaichi A, Igarashi Y. The influence of elastic modulus mismatch between tooth and post and core
restorationson root fracture. Int Endod J. 2013 Jan;46(1):47-52.
Sealing quality
Improoving degree of
bonding/adhesion of root filling
material
Strengthening
Similarity of Elastic modulus of
root filling materials to dentin
1 2
5

10. SEALABILITY
Schwartz RS. Adhesive dentistry and endodontics. Part 2: bonding in the root canal system-the promise and the problems: a review. J Endod. 2006 Dec;32(12):1125-34.
Reason for microgaps
Poor adhesion &
wetting
1
Successful RCT - achieve & maintain tight seal, chemically / mechanically, along
canal system
Prevent microleakage - passage of bacteria, fluids, molecules or ions
between a cavity wall and the restorative material
Polymerization
shrinkage
Thermal stresses, occlusal
loading /water sorption
2 3
6

11. SEALABILITY
Belli S, Eraslan O, Eskitascioglu G, Karbhari V. Monoblocks in root canals: a finite elemental stress analysis study. Int Endod J. 2011 Sep;44(9):817-26.
4 generations of methacrylate resin–based sealers have been introduced
HYDRON use
of poly[2-
hydroxyethyl
methacrylate] as
major ingredient
1 Recent trends in endodontics - development of bonded
obturating materials, - attempt provide more effective seal
coronally & apically
Low viscosity methacrylate resin–based root canal sealers
New root filling material that claims to adhere to methacrylate resins
Non etching
& hydrophilic, no
adjunctive use of
a dentin adhesive
ENDOREZ
Self-etching
primer & dual-
cured resin
composite canal
Sealer
RESILON/EPIPH
ANY
2
3
Combination
etchant, primer,
& sealer into an
all-in-one self
etching,
self-adhesive
sealer
METASEAL
4
7
Since fibre posts are passively retained into the root canal, an adhesive
cement important for good seal
Due to their ability to bond to tooth structure, resin cements have potential to
exhibit less microleakage than other cementsTotal-Etch Resin
Cements
Self-Etch Resin
Cements
Self-Adhesive Resin
Cements
To achieve a monoblock, high bond strengths necessary between dentin &
sealer, as well as between the sealer and obturating material

12. STRENGTHENING ROOTS
Belli S, Eraslan O, Eskitascioglu G, Karbhari V. Monoblocks in root canals: a finite elemental stress analysis study. Int Endod J. 2011 Sep;44(9):817-26.
Root filled teeth more prone to biomechanical failure
Loss of tooth structure
Clinical failure attributed to physiologic masticatory forces / parafunctional forces
repeated over long periods
Fatigue stress
8

13. STRENGTHENING ROOTS
Belli S, Eraslan O, Eskitascioglu G, Karbhari V. Monoblocks in root canals: a finite elemental stress analysis study. Int Endod J. 2011 Sep;44(9):817-26.
In biomechanical aspect -restoration of root filled teeth with materials
having similar MOE to dentin can save remaining tooth structure
Allowing some slight
flex
Favorable dissipation
of stress
Reducing the
likelihood of damage
to the root
Popularity of fibre posts with Resin
cements
9
Adhesive composite cements whose elastic modulus is in the same range of
that of both the
post and dentin have the potential to reinforce the root

14. PRIMARY MONOBLOC
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398
Cementum
Dentin
Root filling
material
One interface that extends circumferentially between the material and the root
canal wall
Hydron
MTA
1
2
Polyethylene fibre post-
core sys Ribbond
3
10

15. PRIMARY MONOBLOC
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398.
In the late 1970s, Poly HEMA containing root filling material (Hydron; Hydron
Technologies) marketed
HYDRON
Interest as a potential successor for sealer-dependent lateral and vertical gutta-
percha obturation
En masse filling of roots
Easy to use
Nonirritating
Adaptable to walls
Nonsupport bacteria
Calcify - extrusion
11

16. Became obsolete in the 1980s because discrepancies between manufacturer’s
claims and laboratory/clinical findings
HYDRON
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398.
SEALABILITY ?
Residual moisture within root
canals – Polymerisation hampered
Polymerisation in situ ??
Presence of water form soft
hydrogels - permeable &
leachable
Studies demonstrated - Hydron-
filled root canals exhibited
extensive leakages
Injectible
12

17. Manufacturer of Hydron did not infer that filling root canals with Hydron helps to
strengthen roots and prevent root fractures
HYDRON
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398.
STRENGTH ?
Modulus of elasticity of porous poly (HEMA) hydrogels
such as Hydron ranges from 180 to 250 MPa
To reinforce roots, the modulus of elasticity of a root filling
material would need to approximate that of dentin (i.e., 14,000
MPa)
13

18. PRIMARY MONOBLOC
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398.
Calcium silicate based material , distributed as ProRoot MTA, Dentsply from
1998
MTA
Orthograde obturation with mineral trioxide aggregate - as an apexification
material represents a primary monoblock
Apexification material
Biocompatible
Antimicrobial
Retreatment not possible
14

19. These alkaline biomaterials have gained wide acceptance in endodontic
community - good physico-chemical & biological properties
MTA
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398.
SEALABILITY & BOND STRENGTH
Hydrophilic , sets in the presence
of moisture
Setting in situ ??
Adhere to root dentine by forming a
crystalline bond by
biomineralization
Formation of gap-filling apatite
deposits
accounts for the seal
Syringed - carrier
Plugged columns
Lee MTA block &
plugger
15

20. MTA
SEALABILITY & BOND STRENGTH
16
MTA Lateral
condensed GP
Thermoplasticiz
ed GP

21. MTA
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398
STRENGTH ?
The compressive EM of Portland cement
increases
after 14 days to 15,000 Mpa with a w/P ratio of
0.6
MTA theoretically able to strengthen roots EM 14,000 –18,600 MPa
Recent study - examined fracture resistance of MTA applied to
immature sheep roots - no difference filled with saline versus those
filled with MTA
17

22. MTA
Andreasen JO1, Munksgaard EC, Bakland LKComparison of fracture resistance in root canals of immature sheep teeth after filling with calcium hydroxide
or MTA.. Dent Traumatol. 2006 Jun;22(3):154-6.
STRENGTH ?
18
Saline Calcium
hydroxide
MTA

23. PRIMARY MONOBLOC
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398
Ultra-high molecular weight polyethylene fibres coated with a dentine bonding
agent are used to build-up endodontic posts and cores.
POLYETHYLENE FIBRE POST-CORE
19
Woven fibres have a modulus of
elasticity similar to that of dentine
Fibres adapt to root canal, canal
enlargement is not required
Polyethylene fibers conditioned with bonding
agent, placed in the slot of the root canal,
Braided polyethylene
fibers

24. POLYETHYLENE FIBRE POST-CORE
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398
STRENGTH
In clinical conditions MOE of polyethylene fibre
reinforced material with an adhesive material like
flowable composite has a MOE of 23GPa
High MOE and low flexural modulus of polyethylene fibre have a
modifying effect on interfacial stresses developed along resin dentin
boundary
20

25. POLYETHYLENE FIBRE POST-CORE
BONDING
21
Reforpost RibbondParapost- metal

26. POLYETHYLENE FIBRE POST-CORE
BONDING & SEALABILITY
22
Zirconia Stainless steel Glass fibre Polyethylene
fibre

27. POLYETHYLENE FIBRE POST-CORE STRENGTHENING ROOTS
23
Glass fibre post Ribbond fibre
post

28. PRIMARY MONOBLOC
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398.
Commercial product was containing bioactive glass of the 45S5 type
incorporated into polyisoprene, the matrix polymer of gutta-percha
BIOGUTTA
Formation of CaP crystals on the material’s surface in a wet environment
Self adhesive
Good sealing
Preliminary studies –
push out bond strength
24

29. SECONDARY MONOBLOC
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398.
Cementum
Dentin
Root filling
material
Resin cement/
root canal sealer
Resilon based systems
Fibre re-inforced posts
1
2
2 circumferential interfaces, one between cement & dentin & other between the cement
& core material.
25

30. SECONDARY MONOBLOC
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398.
By definition, conventional root canal obturations may be regarded as secondary
monoblock systems
Sealer does not bond to dentin or gutta percha
MOE 175–230 times lower than dentin
26

31. SECONDARYMONOBLOC
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398.
Monoblock concept rekindled in 2004 -Advent of bondable root filling materials
RESILON
Material looks and handles like conventional gutta percha. Unlike gutta percha ,
Resilon obturators bond to its associated sealer – Epiphany Sealer.
Primer & a dual cure sealer
(Epiphany)
Resilon - polycaprolactone-based,
dimethacrylate resin– contains Bioactive
glass
27

32. Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398.
SEALABILITY ?
Fill the root canal space with Resilon Points &
light cure – 40 secs
Apply self etch primer to the level of the apex with a
well fitting paper point
Express a small amount of the dual cure sealer –
place in
canal
RESILON
Only bondable root filling material works effectively with vertical condensation
and lateral
condensation techniques and includes pellets for the Obtura* gun system
Resilon material only shrinks 0.5%, unlike Gutta
Percha, it is physically bonded to the sealer by
polymerization - no gaps are present due to
shrinkage.
Coronal 2 mm of canal filling polymerized with a
curing light, - enhancing coronal seal
28

33. Bodrumlu E1, Tunga U. The apical sealing ability of a new root canal filling material. Am J Dent. 2007 Oct;20(5):295-8.
SEALABILITY ?RESILON
29

34. Bodrumlu E1, Tunga U. The apical sealing ability of a new root canal filling material. Am J Dent. 2007 Oct;20(5):295-8.
ROOT REINFORCEMENT?RESILON
30

35. SECONDARYMONOBLOC
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398.
First implied existence of a mechanically homogeneous monoblock in
reported in 1996 with the bonding of epoxy resin– based, carbon fiber–
reinforced posts to root dentin
FIBRE POSTS
Authors claim -carbon fiber posts, having MOE similar to that of dentin, could
achieve a
tooth–post– core monoblock
C fibers made to bond to
epoxy resins oxidative
process
Strongest carbon fibers
have a tensile modulus 500
–1000 GPa
Fibres no longer surface active once post exposed by
roughening /with bur
Stiffness of carbon fiber lowered by presence of epoxy
resin
Epoxy resin not bondable to methacrylates under
physiological temperatures
Beneficial claims of carbon fiber post–root dentin monoblock could not be validated in
independent
in vitro and retrospective in vivo studies
31

36. SECONDARYMONOBLOC
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398
Over the years, carbon fibers in this type of first-generation fiber post replaced
glass
FIBRE POSTS
The epoxy resin embedding matrix replaced with highly cross-linked,
methacrylate resin matrices have the potential to bond to methacrylate-based
resin cements
Different modalities of surface treatments of posts
are also available
More conducive to bonding to methacrylate-based
resins
Similarity in the modulus of
Elasticity between fiber posts and root dentin
32

37. Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–39Schwartz RS. Adhesive dentistry and
endodontics. Part 2: bonding in the root canal system-the promise and the problems: a review. J Endod. 2006 Dec;32(12):1125-34.
SEALABILITY & BOND ?
Remove obturation with drill
FIBRE POST + RESIN
Problems with bonding in root canals
33
Etch & rinse
Prepare dual cure/self cure primer, coat canal
Apply self/dual cure resin cement in canal
Place post, remove excess and cure

38. TERTIARY MONOBLOC
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398
Cementum
Dentin
Bondable coating on
fiber post/root filling
material
Resin cement/
Root canal sealr
Endorez
Fibre posts + external
silane
Third circumferential interface is introduced between the bonding substrate and the
abutment
material
34

39. TERTIARY MONOBLOC
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398.
EndoREZ (Ultradent Products Inc, is a dualcured radiopaque methacrylate
sealer
ENDOREZ
Hydrophilic and self-priming resin sealer, does not require the adjunctive use of
a dentin adhesive
EndoREZ points
resin-coated gutta-percha
Used - wet environment of canal
Effective penetration of dentinal
tubules & adapting walls
GP resin coating bondable
resin sealer
35

40. ENDOREZ
Tay FR1, Loushine RJ, Monticelli F, Weller RN, Breschi L, Ferrari M, Pashley D. Effectiveness of resin-coated gutta-percha cones and a dual-cured, hydrophilic
methacrylate resin-based sealer in obturating root canals. J Endod. 2005 Sep;31(9):659-64.
SEALABILITY ?
Mixed material deposited
into canal by passive
injection
Use of resin
coated GP cones
passively
Syringed – Navi tip
Leakage & morphologic studies showed - seal of the EndoRez system is mediocre
SEALER
RESIN TAGS
DENTIN
Long resin tags could be identified within dentinal tubules
May be attributed to
Polymerization shrinkage of sealer
Weak bond of sealer to prepolymerized coating
Inconsistency of resin coating
Uneven circumferential thickness or
partial detachment
Lack of FR for bonding - removal of
OI layer - Packing
1
2
3
Tensile B.S Apical seal
Improoved
Dual-cured self-etching
primer/adhesive
Problem - rapid
polymerization of adhesive in
environ with reduced oxygen
36

41. TERTIARY MONOBLOC
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398.
In ActiV GP (Brasseler USA), the root filling system is marketed as a
monoblock system
ACTIV GP
Stiffer GP cone - function as both the tapered filling cone and as its own carrier
core
Silanated glass ionomer particles at % - not affect the properties of GP
Capability of wet bonding
Creates an ionic bond to the dentinGP cones-surface coated with GI
fillers
37

42. As this system is new, limited information is available
ACTIV GP
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398
SEALABILITY ?
Apical seals to fluid filtration -
comparable to GP & AH Plus
Being single-cone technique, coronal
leakage to fluid filtration was worse than GP &AH
Plus
Hand file coated with Activ GP sealer & taken to
WL
Activ GP cone is coated with sealer & slowly
inserted into the canal to its working length
38

43. ENDOREZ & ACTIV GP
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398.
STRENGTH ?
Bulk of the material inside still consists of
thermoplastic GP
Unrealistic to expect establishment of a mechanically homogenous unit
within root canal with the EndoRez system & Activ GP
Elastomeric polymer - flows when stressed
39

44. TERTIARY MONOBLOC
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398
Conditioning of post is commonly done chairside, which makes the treatment
longer and increases the risk of failure
FIBRE POSTS + EXTERNAL SILANE
DT Light®SL
Coating made of silane and silicate is applied to the
post
In order to protect its activation before its use in dental
practice, an additional protective layer made of MMA is
applied
Fibre post conditioned with the latest coating technologies in an industrial process, The
practitioner no longer needs to condition post as the post is pre-conditioned
40

45. FIBRE POSTS + EXTERNAL SILANE
Goracci C1, Raffaelli O, Monticelli F, Balleri B, Bertelli E, Ferrari M. The adhesion between prefabricated FRC posts and composite resin cores: microtensile bond strength
with and without post-silanization. Dent Mater. 2005 May;21(5):437-44.
BONDING ?
41

46. TERTIARY MONOBLOC
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398.
Further improvement in post adaptation and retention attempted with
‘ANATOMIC POST’
ANATOMIC POSTS
Translucent fibre post – covered by a layer of light curing resin, which allows for
individual anatomic shaping of post
Individualized posts – appearance
after light curing outside of patients
oral cavity
Better fit than prefabricated posts
Precise fit – thin uniform layer of cement ideal for post
retention
42

47. TERTIARY MONOBLOC
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or a tangible goal. J Endod. Apr 2007; 33(4): 391–398.
Post adapted to lubricated post space & photoactivated to partially polymerize
composite
ANATOMIC POSTS
Efficacy of system not throughly investigated
43
Relined assembly,
removed & optimally
polymerized
Resin cement layer significantly reduced
Reduction in resin cement layer – reduction in volumetric
shrinkage
Reduction of polymerisation shrinkage in low compliance
environment ??
Gaps b/t post & relining composite – act as stress raisers
result in adhesive failure

48. TERTIARY MONOBLOC
Belli S, Eraslan O, Eskitascioglu G, Karbhari V. Monoblocks in root canals: a finite elemental stress analysis study. Int Endod J. 2011 Sep;44(9):817-26.
ROOT REINFORCEMENT?
44
Secondary
monobloc
Tertiary
monobloc
Primary
monobloc

49. CONTROVERSIES
Belli S, Eraslan O, Eskitascioglu G, Karbhari V. Monoblocks in root canals: a finite elemental stress analysis study. Int Endod J. 2011 Sep;44(9):817-26.
Root canal filling available today have MOE far less
compared to
dentin
Monoblocks aim at achieving a single unit – most root filling
materials require additional interfaces
46
Good bond strength of adhesive materials may not
imply good sealing

50. CONTROVERSIES
MBRS + RESIN POINT APICAL
FILLING
DENTI
N
FIBRE
POST
COMPOSITE
CORE
CERAMIC
CROWN
RESIN
CEMENT
Concept of single unit Monobloc
hypothetical ??
47

51. “The future of endodontics is bonded”
“The goal of being able to bond a canal from the minor constriction to the
canal orifice to the occlusal surface is a desirable one.’’
CONCLUSION
Review of the available data Contradicting ex vivo and in
vivo tests
Resin based materials are
here to stay
Replace conventional
materials
In parallel - alternative choice
48

52. REFERENCES
Goracci C1, Raffaelli O, Monticelli F, Balleri B, Bertelli E, Ferrari M. The adhesion
between prefabricated FRC posts and composite resin cores: microtensile bond
strength with and without post-silanization. Dent Mater. 2005 May;21(5):437-44.
Pitout E, Oberholzer TG, Blignaut E, Molepo J. Coronal leakage of teeth root-filled
with gutta-percha or Resilon root canal filling material. J Endod 2006; 32: 879–81.
Pameijer CH, Zmener O. Resin materials for root canal obturation. Dental Clinic N
America 2010; 325-44.
Radovic I, Monticelli F, Goracci C, Vulicevic ZR, Ferrari M. Self- adhesive resin
cements: A literature review. J Adhes Dent 2008; 10: 251–8.
Marending M1, Bubenhofer SB, Sener B, De-Deus G. Primary assessment of a self-
adhesive gutta-percha material. Int Endod J. 2013 Apr;46(4):317-22.
Schwartz RS. Adhesive dentistry and endodontics. Part 2: bonding in the root canal
system-the promise and the problems: a review. J Endod. 2006 Dec;32(12):1125-34.

53. REFERENCES
Franklin R. Tay and David H. Pashley. Monoblocks in root canals - a hypothetical or
a tangible goal. J Endod. Apr 2007; 33(4): 391–398
Kim YK, Grandini S, Ames JM, Gu LS, Kim SK, Pashley DH, Gutmann JL, Tay FR.
Critical review on methacrylate resin-based root canal sealers. J Endod. 2010
Mar;36(3):383-99.
Belli S, Eraslan O, Eskitascioglu G, Karbhari V. Monoblocks in root canals: a finite
elemental stress analysis study. Int Endod J. 2011 Sep;44(9):817-26.
Tay FR1, Loushine RJ, Monticelli F, Weller RN, Breschi L, Ferrari M, Pashley D.
Effectiveness of resin-coated gutta-percha cones and a dual-cured, hydrophilic
methacrylate resin-based sealer in obturating root canals. J Endod. 2005
Sep;31(9):659-64.
Ona M1, Wakabayashi N, Yamazaki T, Takaichi A, Igarashi Y. The influence of
elastic modulus mismatch between tooth and post and core
restorationson root fracture. Int Endod J. 2013 Jan;46(1):47-52

54. REFERENCES
Andreasen JO1, Munksgaard EC, Bakland LKComparison of fracture resistance in
root canals of immature sheep teeth after filling with calcium hydroxide
or MTA.. Dent Traumatol. 2006 Jun;22(3):154-6.
Pitout E, Oberholzer TG, Blignaut E, Molepo J. Coronal leakage of teeth root-filled
with gutta-percha or Resilon root canal filling material. J Endod 2006; 32: 879–81.
Pameijer CH, Zmener O. Resin materials for root canal obturation. Dental Clinic N
America 2010; 325-44.
Radovic I, Monticelli F, Goracci C, Vulicevic ZR, Ferrari M. Self- adhesive resin
cements: A literature review. J Adhes Dent 2008; 10: 251–8.
Marending M1, Bubenhofer SB, Sener B, De-Deus G. Primary assessment of a self-
adhesive gutta-percha material. Int Endod J. 2013 Apr;46(4):317-22.
Schwartz RS. Adhesive dentistry and endodontics. Part 2: bonding in the root canal
system-the promise and the problems: a review. J Endod. 2006 Dec;32(12):1125-34.

55. MONOBLOC IN ENDODONTICS