Skip to main content

Advertisement

SpringerLink
Log in

Cytocompatibility, bioactivity potential, and ion release of three premixed calcium silicate-based sealers

  • Original Article
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objective

Compositional modifications may alter the biological and physicochemical characteristics of calcium silicate-based sealers (CSBS) and, ultimately, their bioactivity. The main objective of this study was to evaluate the biological properties of three CSBS: EndoSequence BC Sealer, Ceraseal, and Endoseal mineral trioxide aggregate.

Materials and methods

Human periodontal ligament stem cells (hPDLSCs) were exposed to several eluates of CSBS. The ion release profile and pH were determined, and metabolic activity and cell migration were assessed using the MTT and wound healing assays. hPDLSCs were cultured in direct contact with the surface of each material, and cell morphology and attachment were analyzed by scanning electron microscopy (SEM). Bioactivity potential was assessed by RT-qPCR and mineralization assays. Statistical differences between biomaterials were assessed using one- or two-way ANOVA (α < 0.05).

Results

All materials showed an alkaline pH, although Endoseal exhibited a significantly higher pH compared with the other CSBS (p < 0.05). Ceraseal released significantly more Ca2+ (p < 0.05) than EndoSequence BC Sealer and Endoseal. Interestingly, Endoseal induced a significant reduction in cell viability and cell migration compared with the control (p < 0.001). Moreover, SEM showed abundant cells adhering to EndoSequence BC Sealer and Ceraseal surfaces, whereas very few round cells were detected on the surface of Endoseal. Finally, Ceraseal and EndoSequence induced ALP, CAP, and CEMP-1 expression and a significantly higher mineralization capacity than Endoseal (***p < 0.001).

Conclusions

The eluates from EndoSequence BC Sealer and Ceraseal displayed higher cell viability, cell attachment, cell migration rates, and ion release rates than Endoseal. Ceraseal and EndoSequence BC Sealer exhibited significantly more gene expression and mineralization capacity than Endoseal.

Clinical relevance

The results obtained in the present work suggest that EndoSequence BC Sealer and Ceraseal possess biological properties that make them suitable materials for root canal treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Khalil I, Naaman A, Camilleri J (2016) Properties of tricalcium silicate sealers. J Endod 42:1529–1535. https://doi.org/10.1016/j.joen.2016.06.002

    Article  PubMed  Google Scholar 

  2. Donnermeyer D, Burklein S, Dammaschke T, Schafer E (2018) Endodontic sealers based on calcium silicates: a systematic review. Odontology. https://doi.org/10.1007/s10266-018-0400-3

    Article  PubMed  Google Scholar 

  3. Marciano MA, Duarte MA, Camilleri J (2016) Calcium silicate-based sealers: assessment of physicochemical properties, porosity and hydration. Dent Mater 32(2):e30–e40. https://doi.org/10.1016/j.dental.2015.11.008

    Article  PubMed  Google Scholar 

  4. Silva Almeida LH, Moraes RR, Morgental RD, Pappen FG (2017) Are premixed calcium silicate-based endodontic sealers comparable to conventional materials? A systematic review of in vitro studies. J Endod 43(4):527–535. https://doi.org/10.1016/j.joen.2016.11.019

    Article  PubMed  Google Scholar 

  5. Dubey N, Rajan SS, Bello YD, Min KS, Rosa V (2017) Graphene nanosheets to improve physico-mechanical properties of bioactive calcium silicate cements. Materials (Basel) 10(6). https://doi.org/10.3390/ma10060606

    Article  PubMed Central  Google Scholar 

  6. Jimenez-Sanchez MDC, Segura-Egea JJ, Diaz-Cuenca A (2019) Higher hydration performance and bioactive response of the new endodontic bioactive cement MTA HP repair compared with ProRoot MTA white and NeoMTA plus. J Biomed Mater Res B Appl Biomater 107:2109–2120. https://doi.org/10.1002/jbm.b.34304

    Article  PubMed  Google Scholar 

  7. Benetti F, Gomes-Filho JE, de Araujo Lopes JM, Barbosa JG, Jacinto RC, Cintra LTA (2018) In vivo biocompatibility and biomineralization of calcium silicate cements. Eur J Oral Sci 126(4):326–333. https://doi.org/10.1111/eos.12539

    Article  PubMed  Google Scholar 

  8. Natu VP, Dubey N, Loke GC, Tan TS, Ng WH, Yong CW, Cao T, Rosa V (2015) Bioactivity, physical and chemical properties of MTA mixed with propylene glycol. J Appl Oral Sci 23(4):405–411. https://doi.org/10.1590/1678-775720150084

    Article  PubMed  PubMed Central  Google Scholar 

  9. Vouzara T, Dimosiari G, Koulaouzidou EA, Economides N (2018) Cytotoxicity of a new calcium silicate endodontic sealer. J Endod 44(5):849–852. https://doi.org/10.1016/j.joen.2018.01.015

    Article  PubMed  Google Scholar 

  10. Cintra LTA, Benetti F, de Azevedo Queiroz IO, de Araujo Lopes JM, Penha de Oliveira SH, Sivieri Araujo G, Gomes-Filho JE (2017) Cytotoxicity, biocompatibility, and biomineralization of the new high-plasticity MTA material. J Endod 43(5):774–778. https://doi.org/10.1016/j.joen.2016.12.018

    Article  PubMed  Google Scholar 

  11. Sequeira DB, Seabra CM, Palma PJ, Cardoso AL, Peca J, Santos JM (2018) Effects of a new bioceramic material on human apical papilla cells. J Funct Biomater 9(4). https://doi.org/10.3390/jfb9040074

    Article  PubMed Central  Google Scholar 

  12. Taraslia V, Anastasiadou E, Lignou C, Keratiotis G, Agrafioti A, Kontakiotis EG (2018) Assessment of cell viability in four novel endodontic sealers. Eur J Dent 12(2):287–291. https://doi.org/10.4103/ejd.ejd_9_18

    Article  PubMed  PubMed Central  Google Scholar 

  13. Seo BM, Miura M, Gronthos S, Bartold PM, Batouli S, Brahim J, Young M, Robey PG, Wang CY, Shi S (2004) Investigation of multipotent postnatal stem cells from human periodontal ligament. Lancet 364(9429):149–155. https://doi.org/10.1016/S0140-6736(04)16627-0

    Article  PubMed  Google Scholar 

  14. Souza GL, Rosatto CMP, Silva MJB, Silva MV, Rocha Rodrigues DB, Moura CCG (2018) Evaluation of apoptosis/necrosis and cytokine release provoked by three root canal sealers in human polymorphonuclears and monocytes. Int Endod J 52:629–638. https://doi.org/10.1111/iej.13036

    Article  PubMed  Google Scholar 

  15. Giacomino CM, Wealleans JA, Kuhn N, Diogenes A (2019) Comparative biocompatibility and osteogenic potential of two bioceramic sealers. J Endod 45(1):51–56. https://doi.org/10.1016/j.joen.2018.08.007

    Article  PubMed  Google Scholar 

  16. Kebudi Benezra M, Schembri Wismayer P, Camilleri J (2018) Interfacial characteristics and cytocompatibility of hydraulic sealer cements. J Endod 44(6):1007–1017. https://doi.org/10.1016/j.joen.2017.11.011

    Article  PubMed  Google Scholar 

  17. Collado-Gonzalez M, Garcia-Bernal D, Onate-Sanchez RE, Ortolani-Seltenerich PS, Lozano A, Forner L, Llena C, Rodriguez-Lozano FJ (2017) Biocompatibility of three new calcium silicate-based endodontic sealers on human periodontal ligament stem cells. Int Endod J 50(9):875–884. https://doi.org/10.1111/iej.12703

    Article  PubMed  Google Scholar 

  18. Collado-Gonzalez M, Tomas-Catala CJ, Onate-Sanchez RE, Moraleda JM, Rodriguez-Lozano FJ (2017) Cytotoxicity of GuttaFlow Bioseal, GuttaFlow2, MTA Fillapex, and AH Plus on human periodontal ligament stem cells. J Endod 43(5):816–822. https://doi.org/10.1016/j.joen.2017.01.001

    Article  PubMed  Google Scholar 

  19. Rodriguez-Lozano FJ, Collado-Gonzalez M, Tomas-Catala CJ, Garcia-Bernal D, Lopez S, Onate-Sanchez RE, Moraleda JM, Murcia L (2019) GuttaFlow Bioseal promotes spontaneous differentiation of human periodontal ligament stem cells into cementoblast-like cells. Dent Mater 35(1):114–124. https://doi.org/10.1016/j.dental.2018.11.003

    Article  PubMed  Google Scholar 

  20. Torabinejad M, Parirokh M, Dummer PMH (2018) Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part II: other clinical applications and complications. Int Endod J 51(3):284–317. https://doi.org/10.1111/iej.12843

    Article  PubMed  Google Scholar 

  21. Parirokh M, Torabinejad M, Dummer PMH (2018) Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part I: vital pulp therapy. Int Endod J 51(2):177–205. https://doi.org/10.1111/iej.12841

    Article  PubMed  Google Scholar 

  22. Willershausen I, Wolf T, Kasaj A, Weyer V, Willershausen B, Marroquin BB (2013) Influence of a bioceramic root end material and mineral trioxide aggregates on fibroblasts and osteoblasts. Arch Oral Biol 58(9):1232–1237. https://doi.org/10.1016/j.archoralbio.2013.04.002

    Article  PubMed  Google Scholar 

  23. Poggio C, Riva P, Chiesa M, Colombo M, Pietrocola G (2017) Comparative cytotoxicity evaluation of eight root canal sealers. J Clin Exp Dent 9(4):e574–e578. https://doi.org/10.4317/jced.53724

    Article  PubMed  PubMed Central  Google Scholar 

  24. Li X, Yoshihara K, De Munck J, Cokic S, Pongprueksa P, Putzeys E, Pedano M, Chen Z, Van Landuyt K, Van Meerbeek B (2017) Modified tricalcium silicate cement formulations with added zirconium oxide. Clin Oral Investig 21(3):895–905. https://doi.org/10.1007/s00784-016-1843-y

    Article  PubMed  Google Scholar 

  25. Rajasekharan S, Vercruysse C, Martens L, Verbeeck R (2018) Effect of exposed surface area, volume and environmental pH on the calcium ion release of three commercially available tricalcium silicate based dental cements. Materials (Basel) 11(1). https://doi.org/10.3390/ma11010123

    Article  PubMed Central  Google Scholar 

  26. Candeiro GT, Correia FC, Duarte MA, Ribeiro-Siqueira DC, Gavini G (2012) Evaluation of radiopacity, pH, release of calcium ions, and flow of a bioceramic root canal sealer. J Endod 38(6):842–845. https://doi.org/10.1016/j.joen.2012.02.029

    Article  PubMed  Google Scholar 

  27. Ha JH, Kim HC, Kim YK, Kwon TY (2018) An evaluation of wetting and adhesion of three bioceramic root canal sealers to intraradicular human dentin. Materials (Basel) 11(8). https://doi.org/10.3390/ma11081286

    Article  PubMed Central  Google Scholar 

  28. Silva GF, Guerreiro-Tanomaru JM, da Fonseca TS, Bernardi MIB, Sasso-Cerri E, Tanomaru-Filho M, Cerri PS (2017) Zirconium oxide and niobium oxide used as radiopacifiers in a calcium silicate-based material stimulate fibroblast proliferation and collagen formation. Int Endod J 50(Suppl 2):e95–e108. https://doi.org/10.1111/iej.12789

    Article  PubMed  Google Scholar 

  29. Chiang TY, Ding SJ (2010) Comparative physicochemical and biocompatible properties of radiopaque dicalcium silicate cement and mineral trioxide aggregate. J Endod 36(10):1683–1687. https://doi.org/10.1016/j.joen.2010.07.003

    Article  PubMed  Google Scholar 

  30. Min KS, Chang HS, Bae JM, Park SH, Hong CU, Kim EC (2007) The induction of heme oxygenase-1 modulates bismuth oxide-induced cytotoxicity in human dental pulp cells. J Endod 33(11):1342–1346. https://doi.org/10.1016/j.joen.2007.07.012

    Article  PubMed  Google Scholar 

  31. Moon HJ, Lee JH, Kim JH, Knowles JC, Cho YB, Shin DH, Lee HH, Kim HW (2018) Reformulated mineral trioxide aggregate components and the assessments for use as future dental regenerative cements. J Tissue Eng 9:2041731418807396. https://doi.org/10.1177/2041731418807396

    Article  PubMed  PubMed Central  Google Scholar 

  32. da Silva EJ, Zaia AA, Peters OA (2016) Cytocompatibility of calcium silicate-based sealers in a three-dimensional cell culture model. Clin Oral Investig 21:1531–1536. https://doi.org/10.1007/s00784-016-1918-9

    Article  PubMed  Google Scholar 

  33. Leprince JG, Zeitlin BD, Tolar M, Peters OA (2012) Interactions between immune system and mesenchymal stem cells in dental pulp and periapical tissues. Int Endod J 45(8):689–701. https://doi.org/10.1111/j.1365-2591.2012.02028.x

    Article  PubMed  Google Scholar 

  34. Agrafioti A, Taraslia V, Chrepa V, Lymperi S, Panopoulos P, Anastasiadou E, Kontakiotis EG (2016) Interaction of dental pulp stem cells with Biodentine and MTA after exposure to different environments. J Appl Oral Sci 24(5):481–486. https://doi.org/10.1590/1678-775720160099

    Article  PubMed  PubMed Central  Google Scholar 

  35. Zhu Y, Shang L, Chen X, Kong X, Liu N, Bai Y, Fang J, Dang J, Wang X, Jin Y (2013) Deciduous dental pulp stem cells are involved in osteoclastogenesis during physiologic root resorption. J Cell Physiol 228(1):207–215. https://doi.org/10.1002/jcp.24122

    Article  PubMed  Google Scholar 

  36. Zhu L, Yang J, Zhang J, Peng B (2014) A comparative study of BioAggregate and ProRoot MTA on adhesion, migration, and attachment of human dental pulp cells. J Endod 40(8):1118–1123. https://doi.org/10.1016/j.joen.2013.12.028

    Article  PubMed  Google Scholar 

  37. Zhou HM, Du TF, Shen Y, Wang ZJ, Zheng YF, Haapasalo M (2015) In vitro cytotoxicity of calcium silicate-containing endodontic sealers. J Endod 41(1):56–61. https://doi.org/10.1016/j.joen.2014.09.012

    Article  PubMed  Google Scholar 

  38. Alsubait SA, Al Ajlan R, Mitwalli H, Aburaisi N, Mahmood A, Muthurangan M, Almadhri R, Alfayez M, Anil S (2018) Cytotoxicity of different concentrations of three root canal sealers on human mesenchymal stem cells. Biomolecules 8(3). https://doi.org/10.3390/biom8030068

    Article  PubMed Central  Google Scholar 

Download references

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, and project “RD16/0011/0001” funded by the Instituto de Salud Carlos III to JMM and co-funded by the European Regional Development Fund.

Author information

Authors and Affiliations

  1. Cellular Therapy and Hematopoietic Transplant Unit, Hematology Department, Virgen de la Arrixaca Clinical University Hospital, IMIB-Arrixaca, University of Murcia, Murcia, Spain

    S. López-García, D. García-Bernal & F. J. Rodríguez-Lozano

  2. Department of Genetics and Microbiology, Faculty of Biology, University of Murcia, Murcia, Spain

    S. López-García & L. Murcia

  3. R&D Institute, Meta Biomed Co. Ltd., Cheongju, South Korea

    Baek Myong-Hyun

  4. Department of Stomatology, University de Valencia, Valencia, Spain

    A. Lozano, L. Forner & C. Llena

  5. Department of Internal Medicine, University of Murcia, Murcia, Spain

    D. García-Bernal

  6. School of Dentistry, Faculty of Medicine, University of Murcia, Hospital Morales Meseguer 2pl., Av. Marqués de los Vélez s/n, 30008, Murcia, Spain

    J. Guerrero-Gironés & F. J. Rodríguez-Lozano

Authors
  1. S. López-García
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Baek Myong-Hyun
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Lozano
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. D. García-Bernal
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. L. Forner
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. C. Llena
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. J. Guerrero-Gironés
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. L. Murcia
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. F. J. Rodríguez-Lozano
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to F. J. Rodríguez-Lozano.

Ethics declarations

Conflict of interest

Baek Myong-Hyun has a commercial interest in one of the tested products. The other 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 University of Murcia (procedure number: 1528/2017). 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 personal data protection.

Informed consent

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

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

López-García, S., Myong-Hyun, B., Lozano, A. et al. Cytocompatibility, bioactivity potential, and ion release of three premixed calcium silicate-based sealers. Clin Oral Invest 24, 1749–1759 (2020). https://doi.org/10.1007/s00784-019-03036-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-019-03036-2

Keywords

Search

Navigation