Microparticulated and nanoparticulated zirconium oxide added to calcium silicate cement: Evaluation of physicochemical and biological properties.

The physicochemical and biological properties of calcium silicate-based cement (CS) associated to microparticulated (micro) or nanoparticulated (nano) zirconium oxide (ZrO2 ) were compared with CS and bismuth oxide (BO) with CS. The pH, release of calcium ions, radiopacity, setting time, and compression strength of the materials were evaluated. The tissue reaction promoted by these materials in the subcutaneous was also investigated by morphological, immunohistochemical, and quantitative analyses. For this purpose, polyethylene tubes filled with materials were implanted into rat subcutaneous. After 7, 15, 30, and 60 days, the tubes surrounded by capsules were fixed and embedded in paraffin. In the H&E-stained sections, the number of inflammatory cells (ICs) in the capsule was obtained. Moreover, detection of interleukin-6 (IL-6) by immunohistochemistry and number of IL-6 immunolabeled cells were carried out. von Kossa method was also performed. The differences among the groups were subjected to Tukey test (p ≤ 0.05). The solutions containing the materials presented an alkaline pH and released calcium ions. The addition of radiopacifiers increased setting time and radiopacity of CS. A higher compressive strength in the CS + ZrO2 (micro and nano) was found compared with CS + BO. The number of IC and IL-6 positive cells in the materials with ZrO2 was significantly reduced in comparison with CS + BO. von Kossa-positive structures were observed adjacent to implanted materials. The ZrO2 associated to the CS provides satisfactory physicochemical properties and better biological response than BO. Thus, ZrO2 may be a good alternative for use as radiopacifying agent in substitution to BO.