Biocompatibility and bioactivity of bioceramic endodontic sealer: NeoSealer Flo

OBJECTIVE: Bioceramic materials are developed based on their biological properties and bioactive potential. NeoSealer Flo (NeoFlo, NuSmile, Houston) is a ready-to-use bioceramic endodontic sealer. The aim of this study was to evaluate the biocompatibility and bioactivity of NeoFlo compared to Bio-C Sealer (BC, Angelus) and AH Plus (AHP, Dentsply). METHODOLOGY: The tissue reaction induced by materials in rat subcutaneous tissues was assessed at seven, 15-, 30-, and 60-days post-implantation (n=6/group). The number of inflammatory cells (ICs), fibroblasts, and osteocalcin (OCN)-labelled cells were recorded. Amorphous calcite was identified using the von Kossa method and polarized light. The data were evaluated using two-way ANOVA followed by Tukey's test, with a 5% significance level. OCN data were submitted to the Kruskal-Wallis test, with Dunn, Friedman, and Nemenyi post-hoc tests. RESULTS: NeoFlo capsules showed higher number of IC than BC and AHP (p<0.05) in all periods, with a reduction over time, and was considered moderate at 60 days. Moreover, significant reduction in the number of IC and an increase in the fibroblasts was accompanied by an increase in the amount of collagen in the capsules around all materials over time. Immunoexpression of OCN was only observed in the capsules of NeoFlo and BC, but the capsules of BC showed the highest values in all periods (p<0.05). CONCLUSION: In the present study, NeoFlo showed lower biocompatibility than BC, however, NeoFlo shows bioactivity in connective tissue.