Sealapex Xpress and RealSeal XT Feature Tissue Compatibility In Vivo

Objective: This study evaluated the response of apical and periapical tissues of dogs' teeth with pulp vitality after root canal filling with the endodontic sealers Sealapex Xpress and Real Seal XT. Methods: Thirty-eight root canals with vital pulp from dogs' premolars were used. After instrumentation, the canals were filled with Sealapex Xpress and gutta-percha (group SX/GP, n = 16) or Real Seal XT and Resilon cones (group RS/R, n = 22). The animals were killed after 90 days, and the teeth with surrounding tissues were subjected to histotechnical processing. Hematoxylin-eosin-stained sections were examined by conventional light microscopy for a quantitative histopathologic analysis (sealing of apical opening by newly formed mineralized tissue [biological sealing], inflammatory cell infiltrate, root and bone tissue resorption), according to a scoring system. The subsequent sections were evaluated by immunohistochemistry for identification of mineralization markers (osteopontin, alkaline phosphatase, and RUNX2). Data were analyzed by nonparametric Mann-Whitney U test (alpha = 0.05). Results: Complete biological sealing was observed in 50% and 22.7% of the specimens of groups SX/GP and RS/R, respectively. Partial biological sealing was observed in 25% and 54.6% and absence of sealing in 25% and 22.7% of the specimens of groups SX/GP and RS/R, respectively. There were no significant differences (P > .05) between the groups for the scores attributed to the histopathologic parameters. Positive staining for osteopontin, alkaline phosphatase, and RUNX2 was observed in both groups, especially in the periodontal ligament. Conclusions: Sealapex Xpress and Real Seal XT feature tissue compatibility in vivo and allow for sealing of apical opening by deposition of mineralized tissue.