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Title: Biocompatibility of Root Canal Sealers: A Systematic Review of In Vitro and In Vivo Studies
Authors: Fonseca, Diogo Afonso 
Paula, Anabela Baptista 
Marto, Carlos Miguel 
Coelho, Ana 
Paulo, Siri 
Martinho, José Pedro 
Carrilho, Eunice 
Ferreira, Manuel Marques 
Keywords: endodontics; root canal sealer; root canal filling materials; cell death; biocompatibility; systematic review
Issue Date: 9-Dec-2019
Publisher: MDPI
Serial title, monograph or event: Materials
Volume: 12
Issue: 24
Abstract: (1) Aim: To perform a systematic review of the literature on the biocompatibility of root canal sealers that encompasses the various types of sealers that are commercially available as well as both in vitro and in vivo evidence. (2) Methods: This systematic review has been registered in PROSPERO (ID 140445) and was carried out according to PRISMA guidelines using the following databases: PubMed, Cochrane Library,, Science Direct, and Web of Science Core Collection. Studies published between 2000 and 11 June 2019 that evaluated cytotoxicity (cell viability/proliferation) and biocompatibility (tissue response) of root canal sealers were included. (3) Results: From a total of 1249 studies, 73 in vitro and 21 in vivo studies were included. In general, studies suggest that root canal sealers elicit mild to severe toxic effects and that several factors may influence biocompatibility, e.g., material setting condition and time, material concentration, and type of exposure. Bioactive endodontic sealers seem to exhibit a lower toxic potential in vitro. (4) Conclusions: The available evidence shows that root canal sealers exhibit variable toxic potential at the cellular and tissue level. However, the methodological heterogeneity among studies included in this systematic review and the somewhat conflicting results do not allow a conclusion on which type of sealer presents higher biocompatibility. Further research is crucial to achieve a better understanding of the biological effects of root canal sealers.
ISSN: 1996-1944
DOI: 10.3390/ma12244113
Rights: openAccess
Appears in Collections:I&D IBILI - Artigos em Revistas Internacionais
I&D CIBB - Artigos em Revistas Internacionais
I&D ICBR - Artigos em Revistas Internacionais

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