Physicochemical performance and biological response of ready-to-use bioceramic endodontic sealers.

This study evaluated the physicochemical and biological properties of three ready-to-use bioceramic sealers, BioRoot® Flow (BRF), ZenSeal™ (ZS) and EndoCeramic™ (EC), in comparison with an epoxy resin-based sealer, AH Plus Jet® (AHP). Setting time, solubility, pH, radiopacity, and flow were assessed following ISO standards. Biological response was evaluated by cell viability using the XTT assay, and gene expression of osteogenic and inflammatory markers was analyzed by quantitative PCR. Data were analyzed at a 5% significance level. EC showed the shortest initial setting time, followed by ZS, BRF, and AH (P < 0.05). EC also had the shortest final setting time, followed by ZS, AHP, and BRF, with significant differences among groups except between AHP and BRF (P > 0.05). EC exhibited the lowest flow (P < 0.01), whereas no differences were observed among the other sealers (P > 0.05). Radiopacity was lowest for BRF, followed by EC, ZS, and AHP, with no difference between EC and ZS (P > 0.05). AHP showed the lowest solubility, followed by EC, ZS, and BRF (P < 0.001). All sealers demonstrated an alkaline pH, which decreased over time. ZS showed the highest cell viability, followed by EC, BRF, and AHP (P < 0.05). BRF showed significant upregulation of IL10, ALPL, TNF, TGFB1, and TNFSF11 expression with 24 h of exposure (P < 0.05), whereas at 48 h, TNFSF11 was significantly upregulated with AHP exposure (P < 0.05). AHP demonstrated superior physicochemical properties but unfavorable biological properties. Although bioceramic sealers displayed favorable biological properties, their higher solubility may compromise long-term stability and clinical outcome. Ready-to-use bioceramic sealers may present favorable cytocompatibility, but their increased solubility highlights the need for cautious interpretation, particularly regarding long-term sealing stability.