Are Premixed Calcium Silicate-based Endodontic Sealers Comparable to Conventional Materials? A Systematic Review of In Vitro Studies.

INTRODUCTION: This study aimed to compare the physicochemical and biological properties of premixed calcium silicate-based endodontic sealers with other conventional root canal filling materials by systematically reviewing laboratory studies.

METHODS: The search was conducted in 3 databases (Medline via PubMed, Scopus, and Web of Science) following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Two reviewers independently selected the studies and extracted the data. The properties of interest were bond strength, radiopacity, pH, solubility, setting and working time, dimensional change, flow, calcium ion release, antimicrobial activity, biocompatibility, and cytotoxicity.

RESULTS: From 2636 potentially eligible studies, 31 were selected for full-text analysis, and 27 were included in the review. Premixed calcium silicate-based endodontic sealers followed the ISO 6876:2012 requirements for most physicochemical properties except for solubility. The target sealers also presented favorable biological findings when compared with conventional sealers.

CONCLUSIONS: Despite the lack of well-designed long-term clinical trials, the target premixed calcium silicate-based sealers show good physicochemical and biological properties in vitro. In general, the results were similar or better than conventional endodontic sealers as observed in in vitro and in vivo animal studies.