Does heat affect the performance of bioceramic sealers? A systematic review of warm obturation

BACKGROUND: The use of bioceramic sealers in endodontic treatment has gained traction due to their bioactivity, biocompatibility, and ability to promote mineralization. However, their integration with warm obturation techniques presents challenges, particularly concerning their thermal stability and adhesive properties. This review evaluates the compatibility of bioceramic sealers with warm obturation methods, focusing on the effects of heat on bond strength, physicochemical properties, and clinical outcomes. METHODS: A systematic search of the literature identified 12 relevant studies, with results showing that controlled heat can enhance sealer flow and adaptation but excessive temperatures compromise bond strength and material stability. RESULTS: Clinical studies demonstrate favorable outcomes for warm obturation techniques, provided that thermal thresholds are maintained. Advancements in bioceramic formulations may improve resilience to thermal challenges, highlighting the need for optimized obturation protocols and clear clinical guidelines. CONCLUSIONS: This review underscores the importance of balancing thermal enhancement with material preservation to achieve successful endodontic outcomes.