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Microstructural composition, ion release, and bioactive potential of new premixed calcium silicate–based endodontic sealers indicated for warm vertical compaction technique

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Abstract

Objective

The aim of this study was to evaluate the microstructural composition, ion release, cytocompatibility, and mineralization potential of Bio-C Sealer ION+ (BCI) and EndoSequence BC Sealer HiFlow (BCHiF), compared with AH Plus (AHP), in contact with human periodontal ligament cells (hPDLCs).

Materials and methods

The sealers’ ionic composition and release were assessed using energy-dispersive spectroscopy (EDS) and inductively coupled plasma mass spectrometry (ICP-MS), respectively. For the biological assays, hPDLCs were isolated from third molars, and sealer extracts were prepared (undiluted, 1:2, and 1:4 ratios). An MTT assay, wound-healing assay, and cell morphology and adhesion analysis were performed. Activity-related gene expression was determined using RT-qPCR, and mineralization potential was assessed using Alizarin Red staining (ARS). Statistical analyses were performed using one-way ANOVA and Tukey’s post hoc test (α < 0.05).

Results

The three sealers exhibited variable levels of silicon, calcium, zirconium, and tungsten release and in their composition. Both BCI and BCHiF groups showed positive results in cytocompatibility assays, unlike AHP. The BCHiF group showed an upregulation of CAP (p < 0.01), CEMP1, ALP, and RUNX2 (p < 0.001) compared with the negative control, while the BCI group showed an upregulation of CEMP1 (p < 0.01), CAP, and RUNX2 (p < 0.001). Both groups also exhibited a greater mineralization potential than the negative and positive controls (p < 0.001).

Conclusions

The calcium silicate–based sealers considered in the present in vitro study exhibited a high calcium ion release, adequate cytocompatibility, upregulated osteo/cementogenic gene expression, and increased mineralized nodule formation in contact with hPDLCs.

Clinical relevance

From a biological perspective, BCI and BCHiF could be clinically suitable for root canal filling.

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Funding

This work was supported by the Spanish Network of Cell Therapy (TerCel), RETICS subprograms of the I+D+I 2013–2016 Spanish National Plan, project “RD16/0011/0001” funded by the Instituto de Salud Carlos III to JMM and co-funded by the European Regional Development Fund.

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Authors and Affiliations

  1. Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, 46010, Valencia, Spain

    J. L. Sanz, A. Lozano, C. Llena & L. Forner

  2. Cellular Therapy and Hematopoietic Transplant Research Group, Biomedical Research Institute, Virgen de la Arrixaca Clinical University Hospital, IMIB-Arrixaca, University of Murcia, 30120, Murcia, Spain

    S. López-García & F. J. Rodríguez-Lozano

  3. Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, 30100, Murcia, Spain

    S. López-García, M. P. Pecci-Lloret, J. Guerrero-Gironés & F. J. Rodríguez-Lozano

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  1. J. L. Sanz
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  2. S. López-García
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Contributions

Investigation and methodology: Sergio López-García, Francisco Javier Rodríguez Lozano, and José Luis Sanz; supervision, visualization, conceptualization, and data curation: Adrián Lozano and Julia Guerrero-Gironés; investigation, methodology, and writing—original draft: José Luis Sanz and Francisco Javier Rodríguez-Lozano; conceptualization, formal analysis, project administration, supervision, validation, and writing—review and editing: Leopoldo Forner, Carmen Llena, and Maria Pilar Pecci-Lloret; investigation, methodology, project administration, resources, writing—original draft, and writing—review and editing: José Luis Sanz, Francisco Javier Rodríguez-Lozano, and Leopoldo Forner. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to F. J. Rodríguez-Lozano.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

The study protocol was approved by the Clinical Research Ethics Committee of the Universidad de Murcia (ID: 2199/2018). Likewise, permission was obtained from the Health Department authorities to use the information contained in the CDHs, previously anonymized by one of the investigators belonging to the medical staff of the Health Department in order to protect patient confidentiality. All the information was processed in abidance with the confidentiality regulations defined under Act 15/1999 referred to as personal data protection.

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Informed consent was obtained from the parents of all individual participants included in the study.

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Sanz, J.L., López-García, S., Lozano, A. et al. Microstructural composition, ion release, and bioactive potential of new premixed calcium silicate–based endodontic sealers indicated for warm vertical compaction technique. Clin Oral Invest 25, 1451–1462 (2021). https://doi.org/10.1007/s00784-020-03453-8

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