Physicochemical and biological properties of four calcium silicate-based endodontic cements

BACKGROUND/PURPOSE: Several brands of calcium silicate-based cements (CSBCs) are currently marketed. Here we compared physicochemical and biological properties of new products Ortho MTA (BioMTA), Retro MTA (BioMTA), and EZ-Seal (Ezekiel) to widely used ProRoot MTA (Dentsply Tulsa). MATERIALS AND METHODS: CSBCs were analyzed by X-ray diffractometry and examined by scanning electron microscopy. Elemental composition was determined by energy dispersive spectroscopy. Particle size was measured by particle size analyzer. Human stem cells from apical papilla (SCAPs) were incubated with eluates from CSBCs. Survival of SCAP cells was evaluated with MTT assay. The Alizarin red S stain was used to identify calcified nodules formed in SCAP cultures. The effects of CSBC eluates on SCAP proliferation and migration were examined using an in-vitro scratch “wound-healing” assay. RESULTS: All CSBC specimens showed similar X-ray diffraction patterns. The average particle size of EZ-Seal was smaller than ProRoot MTA, Ortho MTA, and Retro MTA (P < 0.001). The least cytotoxicity of eluates was found for EZ-Seal. In the Alizarin red S staining test, calcified nodules were observed in cultures with ProRoot MTA, Ortho MTA, and Retro MTA, however, no calcified nodules were observed in cultures with EZ-Seal. SCAP proliferation and migration capacity in presence of EZ-Seal was higher than with ProRoot MTA, Ortho MTA, and Retro MTA (P < 0.001). CONCLUSION: EZ-Seal has a smaller average particle size and a better cytocompatibility than all other examined CSBCs.