The Structural, Physical, and In Vitro Biological Performance of Freshly Mixed and Set Endodontic Sealers

The objective of this study was to evaluate the in vitro performance of endodontic sealers in their freshly mixed and set forms.

The commercially used endodontic sealers (AH Plus, Dia-ProSeal, GuttaFlow 2, and Pulpdent Root Canal Sealer) were investigated and the chemical structure of freshly mixed and set sealers were assessed with Fourier transform infrared spectroscopy (FTIR). The surface morphology and elemental analysis were assessed with a scanning electron microscope (SEM) equipped with energy-dispersive X-ray spectroscopy. The pH and solubility analysis were performed and the cytotoxicity was done on extracts of freshly mixed and set materials using Alamar blue assay. One way ANOVA and Post Hoc Tukey analysis was used to do multiple comparison analysis of the mean values and standard deviation results through SPSS version 20 (IBM Software, NY, USA) for pH, solubility, and cytotoxicity analysis.

FTIR analysis revealed the structural pattern and the difference in freshly mixed and set samples was observed with the change in intensities of the peaks. The morphological pattern revealed the presence of micro/nano-particles with pores distributed throughout their structure. The sealer with the least solubility was AH Plus (0.10±0.01) followed by Dia-ProSeal (0.77±0.25), GuttaFlow 2 (1.88±0.82) and Pulpdent Root Canal Sealer (3.03±0.18). The solubility of AH plus was significantly lower (P<0.05) in comparison to GuttaFlow 2 and Pulpdent Root Canal Sealer. The highest pH (10.09±0.034) in the freshly mixed state and highest cytotoxicity in the freshly mixed (70.08±5.852) and set sealers (83.87±5.409) (P<0.05) at day 7 was observed in Dia-ProSeal. GuttaFlow 2 was the most biocompatible sealer in the set state and AH Plus was the most biocompatible sealer in the freshly mixed state at day 7.

Clinically, the sealer is applied in fresh state, whereby this study signifies that which material is more biocompatible in fresh state and provides insight information to clinicians. AH Plus showed least solubility and cytocompatibility in fresh state compared to other groups.