Evaluation of cytotoxicity and adaptability of a novel bioceramic root canal sealer: An in vitro and scanning electron microscope study

Cytotoxicity and adaptability are among the highly imperative tests that should be performed on a novel endodontic material to ensure its successful implementation in endodontic treatment. Assess a recently introduced bioceramic root canal sealer CeramoSeal with TotalFill BC and AH plus sealers regarding the cytotoxicity and adaptability. Five sealer discs were prepared for each sealer and their extracts were cultured in 96-well plates containing human fibroblasts for 24 h. After their incubation, MTT solution was added to each well plate using an enzyme-linked immunosorbent assay plate reader was implemented to calculate the percentage of viable cells. Thirty mandibular single-rooted premolars were prepared using the Edge Endo rotary system, teeth were divided into three groups (n = 10) based on the sealer type: Group 1 CeramoSeal, Group 2 Totalfill, and Group 3 AH plus sealer. Teeth were sectioned longitudinally and viewed under a scanning electron microscope where the region with the gaps was identified and quantified as a percentage of the root canal’s overall area. One-way ANOVA test was used for cytotoxicity, while Kruskal–Wallis and Friedman’s tests were used for adaptability. Ceramoseal statistically significantly showed the lowest viability, at high concentrations AH plus showed the highest cell viability, while at lower concentration Totalfill BC sealer showed the highest cell viability percentage. The gap percentages were statistically significantly higher in Ceramoseal group, there was no statistically significant difference between AH Plus and Totalfill groups. Ceramoseal sealer exhibited the lowest viability and highest gap percentage compared to the other sealers.