Abstract
(1) Background: The EndoSequence BC Sealer HiFlow (Brasseler, Savannah, GA, USA) has recently been introduced in clinical applications. Thus, the aims of the present study are to determine its biocompatibility in vivo and to examine its ability to drive macrophage polarization in vitro and in vivo. (2) Methods: HiFlow was implanted into rat connective tissue for 7, 30 and 150 days. The microstructures and elemental compositions were determined by scanning electron microscopy-energy-dispersive X-ray spectroscopy (SEM-EDX). Hematoxylin–eosin, immunofluorescence, RT–qPCR and flow cytometry were used to elucidate the effects on inflammatory responses and macrophage polarization. (3) Results: SEM-EDX revealed the formation of surface hydroxyapatite crystal layers. Histological evaluation showed that HiFlow exhibited long-term biocompatibility because it decreased inflammatory responses and reduced the number of macrophages over time; however, tissue necrosis was observed in all the groups. RT–qPCR verified that HiFlow regulated the expression of inflammatory factors to inhibit the inflammatory response. Immunofluorescence analysis performed on in vivo samples revealed that HiFlow promoted M2-like macrophage polarization, and these results were confirmed by flow cytometry in vitro. (4) Conclusion: After 150 days of investigation, HiFlow was considered biologically acceptable, and the formation of apatite crystal layers and the promotion of M2-like macrophage polarization may contribute to its favorable biocompatibility.
Highlights
Macrophages, the main cells that infiltrate the interface between implanted materials and tissues, secrete proinflammatory and anti-inflammatory cytokines to regulate the foreign body reaction, and we studied the effects of iRoot SP and BC Sealer HiFlow on macrophage polarization [17]
We found that the mean fluorescence intensities of CD163 and CD206 expression in Bone-Marrow-Derived Macrophages (BMDMs) increased after 12 h of treatment with BC Sealer HiFlow or iRoot SP regardless of whether LPS was present
SP and mineral trioxide aggregate cement (MTA) are biocompatible with subcutaneous tissues, have a satisfactory ability to form similar ultrastructural bone-like apatite layers and promote M2-like macrophage polarization in vivo
Summary
The calcium silicate-based bioceramic root canal sealer iRoot. Sealer (Brasseler, Savannah, GA, USA), was introduced to the field of endodontics, and it has attracted considerable attention due to its ease of use. This material is a premixed, injectable, and ready-to-use white cement paste that is mainly composed of calcium silicate, calcium phosphate, calcium hydroxide, zirconium oxide, filler, and thickening agents [1]. This sealer exhibits favorable flowability, excellent sealing abilities, and good biocompatibility, and it exerts good osteoconductive effects [2–5]. The manufacturer recommends using the single-cone (SC) technique, which has been suggested to be a viable option for root canal obturation
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