Comparison of calcium and hydroxyl ion release ability and in vivo apatite-forming ability of three bioceramic-containing root canal sealers.

Objective: Bioceramic-containing root canal sealers promote periapical healing via Ca and OH release and apatite formation on the surface. This study aimed to compare Ca and OH release and in vivo apatite formation of three bioceramic-containing root canal sealers: EndoSequence BC sealer (Endo-BC), MTA Fillapex (MTA-F), and Nishika Canal Sealer BG (N-BG).

Materials And Methods: Polytetrafluoroethylene tubes filled with sealers were immersed in distilled water for 6 and 12 h and for 1, 7, 14, and 28 days to measure Ca and OH release. Additionally, tubes filled with sealers were implanted in the backs of rats for 28 days, and in vivo apatite formation was analyzed using an electron probe microanalyzer.

Results: Endo-BC released significantly more Ca than the other sealers at 6 and 12 h and 1 day. Ca release was significantly lower from N-BG than from Endo-BC and MTA-F at 14 and 28 days. OH release was significantly higher from Endo-BC than from the other sealers throughout the experiment, except at 1 day. OH release was lower from N-BG than from MTA-F at 6 h and 7 days. Only Endo-BC implants exhibited apatite-like calcium-, phosphorus-, oxygen-, and carbon-rich spherulites and apatite layer-like calcium- and phosphorus-rich, but radiopaque element-free, surface regions.

Conclusions: Ca and OH release is ranked as follows: Endo-BC > MTA-F > N-BG. Only Endo-BC demonstrated in vivo apatite formation.

Clinical Relevance: Endo-BC could promote faster periapical healing than MTA-F and N-BG.