Evaluation of new bioceramic endodontic sealers: An in vitro study

The biophysical properties of root canal sealers (RCSs) positively affect the success of endodontic treatment. It is important to ensure an impermeable apical seal after the thorough eradication of the infection. Since bioceramic sealers release bioactive and concomitantly biocompatible products after setting, chemical bonding to dentin and favorable healing is achieved.

This study evaluated the chemical composition and elemental distribution of 4 RCSs (1 resinbased and 3 bioceramic-based) by using energy dispersive X-ray spectroscopy (EDX), field emission scanning electron microscopy (FE-SEM) and elemental mapping after root canal obturation, both coronally and apically.

Forty extracted single-rooted teeth were shaped, cleaned and randomly divided into 4 groups according to the type of sealer used for obturation. After the sealer set, the teeth were sectioned horizontally to obtain coronal and apical standardized sections. The sections were qualitatively and quantitatively assessed in terms of chemical composition of the tested sealers, using SEM images and elemental mapping as well as the EDX analysis.

All of the calcium silicate sealers showed significantly higher peaks of calcium at the periphery of the root canals, contacting dentinal moisture, and high peaks of zirconium, while tungsten was significantly high in AH Plus™. TotalFill® BC™ and BioRoot™ RCS showed higher calcium, oxygen and silicon content coronally than apically, while phosphorus was only detected more apically, which was different for EndoSeal® MTA. All sealers revealed small amounts of different heavy metals, not described by their manufacturers, and a uniform particle distribution with almost regular surfaces.

All of the tested sealers except AH Plus revealed high calcium/phosphorus ratio peaks, suggesting regenerative potential in vivo, with acceptable purity and surface texture, and supporting their biocompatibility, with chemical bonding to root dentin.