Physicochemical properties and biological interaction of calcium silicate-based sealers - in vivo model.

OBJECTIVES

To investigate volumetric changes, in vivo biocompatibility, and systemic migration from eight commercial endodontic sealer materials in paste/paste, powder/liquid, and pre-mixed forms.

MATERIALS AND METHODS

The sealers AH Plus Bioceramic, AH Plus Jet, BioRoot RCS, MTApex, Bio-C Sealer, Bio-C Sealer Ion+, EndoSequence BC Sealer and NeoSEALER Flo were studied. After characterisation by scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS), Raman spectroscopy and X-ray diffractometry (XRD), tubes were implanted in Wistar rats' alveolar bone and subcutaneous tissues. Micro-CT evaluated volumetric changes pre/post 30 days of implantation. Histological and immunohistochemistry analyses assessed biocompatibility. Kidney samples underwent spectrometry (ICP-MS) for tantalum, tungsten and zirconium. Statistical analysis determined normality and significance (udp < 0.05).

RESULTS

Characterisation revealed calcium, silicon, and radiopacifiers in the materials. Volumetric changes showed greater alteration in subcutaneous tissues than alveolar bone; BioRoot RCS and MTApex (powder/liquid) were most stable. Histological analysis indicated intense inflammation for AH Plus Jet, moderate for others; IL-10 was marked positively for all materials. AH Plus Jet had an 18-fold higher tungsten and a 37-fold higher zirconium mass fraction in kidneys versus controls, while tantalum showed lower accumulation patterns.

CONCLUSION

Root canal filling materials' responses varied by implantation site and form, demonstrating acceptable biocompatibility. Tantalum and zirconium oxide radiopacifiers appear systemically safe; tungsten-based radiopacifiers are unsuitable due to metal accumulation risks.

CLINICAL RELEVANCE

This study highlights the need for further in vivo studies on endodontic sealers' chemical, biological, and physical behaviors and their systemic migration.