A Novel Polyurethane Expandable Root Canal Sealer

  • Mohammad Ali Saghiri
    Address requests for reprints to Dr Mohammad Ali Saghiri, Biomaterial and Prosthodontics Laboratory, Department of Restorative Dentistry, Office: MSB C639A, Rutgers Biomedical and Health Sciences, 185 South Orange Avenue, Newark, NJ 07103.
    Biomaterial and Prosthodontics Laboratory, Rutgers School of Dental Medicine, Newark, New Jersey

    Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, New Jersey

    Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, California
    Search for articles by this author
  • Kasra Karamifar
    Sector of Angiogenesis Regenerative Medicine, Dr. Hajar Afsar Lajevardi Research Cluster, Hackensack, New Jersey
    Search for articles by this author
  • Devyani Nath
    Biomaterial and Prosthodontics Laboratory, Rutgers School of Dental Medicine, Newark, New Jersey

    Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, New Jersey
    Search for articles by this author
  • James L. Gutmann
    Department of Endodontics, Nova Southeastern University, College of Dental Medicine, Fort Lauderdale, Florida
    Search for articles by this author
  • Nader Sheibani
    McPherson Eye Research Institute, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

    Department of Cell and Regenerative Biology, University of Wisconsin, Madison, Wisconsin

    Department of Biomedical Engineering, University of Wisconsin, Madison, Wisconsin
    Search for articles by this author
Published:December 22, 2020DOI:



      Endodontic sealers play a vital role in the obturation of root canal space. The aim of this study was to evaluate the utility of a recently developed polyurethane expandable sealer (PES), along with its cytotoxicity and dimensional changes.


      L929 fibroblasts and an cell viability assay (MTS assay) were used to determine the cytotoxicity of dental sealers (AH Plus [Dentsply Maillefer, Ballaigues, Switzerland], Sure-Seal Root [Sure Dent Corporation, Gyeonggi-do, South Korea], and the PES) at 24, 48, 72, and 96 hours. An advanced choroidal neovascularization model was used to assess the effect of these sealers on angiogenesis. Thirty-six extracted single-rooted human teeth were prepared and randomly divided into 3 groups (n = 12). Obturation was performed with gutta-percha and a sealer using lateral compaction as follows: group 1, AH Plus; group 2, Sure-Seal; and group 3, PES. The average depth of sealer penetration into dentinal tubules was measured with a scanning electron microscope. Data were analyzed using 1-way analysis of variance and post hoc Tukey tests (level of significance, P < .05).


      The values of MTS, choroidal neovascularization, and the penetration depth of PES were significantly higher than in other experimental groups (P < .05). The lowest values were noted in specimens of AH Plus, whereas the highest were detected in the PES group.


      PES showed promising results in terms of biocompatibility and dentinal tubule adaptation and penetration.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Endodontics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Siqueira Jr., J.F.
        • Rôças I.N.
        • Lopes H.P.
        • et al.
        Coronal leakage of two root canal sealers containing calcium hydroxide after exposure to human saliva.
        J Endod. 1999; 25: 14-16
        • Shipper G.
        • Teixeira F.B.
        • Arnold R.R.
        • et al.
        Periapical inflammation after coronal microbial inoculation of dog roots filled with gutta-percha or resilon.
        J Endod. 2005; 31: 91-96
        • De-Deus G.
        • Brandão M.
        • Fidel R.
        • et al.
        The sealing ability of GuttaFlow in oval-shaped canals: an ex vivo study using a polymicrobial leakage model.
        Int Endod J. 2007; 40: 794-799
        • Mamootil K.
        • Messer H.
        Penetration of dentinal tubules by endodontic sealer cements in extracted teeth and in vivo.
        Int Endod J. 2007; 40: 873-881
        • Barborka B.J.
        • Woodmansey K.F.
        • Glickman G.N.
        • et al.
        Long-term clinical outcome of teeth obturated with Resilon.
        J Endod. 2017; 43: 556-560
        • Nair P.R.
        • Sjögren U.
        • Krey G.
        • et al.
        Therapy-resistant foreign body giant cell granuloma at the periapex of a root-filled human tooth.
        J Endod. 1990; 16: 589-595
        • Sousa C.
        • Loyola A.
        • Versiani M.
        • et al.
        A comparative histological evaluation of the biocompatibility of materials used in apical surgery.
        Int Endod J. 2004; 37: 738-748
        • Hoskinson S.E.
        • Ng Y.-L.
        • Hoskinson A.E.
        • et al.
        A retrospective comparison of outcome of root canal treatment using two different protocols.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002; 93: 705-715
        • Costa F.
        • Gomes P.S.
        • Fernandes M.H.
        Osteogenic and angiogenic response to calcium silicate–based endodontic sealers.
        J Endod. 2016; 42: 113-119
      1. Saghiri MA. 2020. Composition and Method for Root CANAL filling. PCT/US20/53925.

        • Marín-Bauza G.A.
        • Silva-Sousa Y.T.
        • da Cunha S.A.
        • et al.
        Physicochemical properties of endodontic sealers of different bases.
        J Appl Oral Sci. 2012; 20: 455-461
        • Denka
        Sure-Seal Bioceramic Root Canal Sealer 1 X 2G Syringe & 20 Tips.
        (Available at:) (Accessed December 5, 2020)
        • Saghiri M.A.
        • Asatourian A.
        • Nguyen E.H.
        • et al.
        Hydrogel arrays and choroidal neovascularization models for evaluation of angiogenic activity of vital pulp therapy biomaterials.
        J Endod. 2018; 44: 773-779
        • Saghiri M.A.
        • Asatourian A.
        • Morgano S.M.
        • et al.
        Moderately acidic pH promotes angiogenesis: an in vitro and in vivo study.
        J Endod. 2020; 46: 1113-1119
        • Wang S.
        • Sorenson C.M.
        • Sheibani N.
        Lack of thrombospondin 1 and exacerbation of choroidal neovascularization.
        Arch Ophthalmol. 2012; 130: 615-620
        • Massi S.
        • Tanomaru-Filho M.
        • Silva G.F.
        • et al.
        pH, calcium ion release, and setting time of an experimental mineral trioxide aggregate–based root canal sealer.
        J Endod. 2011; 37: 844-846
        • Patel D.
        • Sherriff M.
        • Ford T.
        • et al.
        The penetration of RealSeal primer and Tubliseal into root canal dentinal tubules: a confocal microscopic study.
        Int Endod J. 2007; 40: 67-71
        • Shokouhinejad N.
        • Sabeti M.
        • Gorjestani H.
        • et al.
        Penetration of Epiphany, Epiphany self-etch, and AH Plus into dentinal tubules: a scanning electron microscopy study.
        J Endod. 2011; 37: 1316-1319
        • Schäfer E.
        • Bering N.
        • Bürklein S.
        Selected physicochemical properties of AH Plus, EndoREZ and RealSeal SE root canal sealers.
        Odontology. 2015; 103: 61-65
        • Topçuoğlu H.S.
        • Tuncay Ö.
        • Karataş E.
        • et al.
        In vitro fracture resistance of roots obturated with epoxy resin-based, mineral trioxide aggregate-based, and bioceramic root canal sealers.
        J Endod. 2013; 39: 1630-1633
        • Warriner Z.
        • Lam L.
        • Matsushima K.
        • et al.
        Initial evaluation of the efficacy and safety of in-hospital expandable hemostatic minisponge use in penetrating trauma.
        J Trauma Acute Care Surg. 2019; 86: 424-430
        • Schmalz G.
        Use of cell cultures for toxicity testing of dental materials—advantages and limitations.
        J Dent. 1994; 22: S6-S11
        • Huang T.-H.
        • Kao C.-T.
        • Huang M.-F.
        • et al.
        Cytotoxicity of AH 26 and AH plus root canal sealers on oral cancer cell line OC∼ 2.
        Chin Dent J. 1999; 18: 101-108
        • Huang T.-H.
        • Yang J.-J.
        • Li H.
        • et al.
        The biocompatibility evaluation of epoxy resin-based root canal sealers in vitro.
        Biomaterials. 2002; 23: 77-83
        • Spångberg L.
        Biological effects of root canal filling materials. 7. Reaction of bony tissue to implanted root canal filling material in guineapigs.
        Odontol Tidskr. 1969; 77: 133-159
        • Chandra S.
        • Krishna G.
        Obturation of the radicular space.
        in: Chandra S. Krishna G. Grossman's Endodontic Practice. 13th ed. Wolters Kluwer Health, India2014: 343-373
        • Granchi D.
        • Stea S.
        • Ciapetti G.
        • Cavedagna D.
        • et al.
        Endodontic cements induce alterations in the cell cycle of in vitro cultured osteoblasts.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995; 79: 359-366
        • Geurtsen W.
        Biocompatibility of root canal filling materials.
        Aust Endod J. 2001; 27: 12-21
        • Tepel J.
        • el Sawaf M.D.
        • Hoppe W.
        Reaction of inflamed periapical tissue to intracanal medicaments and root canal sealers.
        Dent Traumatol. 1994; 10: 233-238
        • Zhang J.-Y.
        • Beckman E.J.
        • Hu J.
        • et al.
        Synthesis, biodegradability, and biocompatibility of lysine diisocyanate–glucose polymers.
        Tissue Eng. 2002; 8: 771-785
        • Hao H.
        • Shao J.
        • Deng Y.
        • et al.
        Synthesis and characterization of biodegradable lysine-based waterborne polyurethane for soft tissue engineering applications.
        Biomater Sci. 2016; 4: 1682-1690
        • Bjugstad K.
        • Lampe K.
        • Kern D.
        • et al.
        Biocompatibility of poly (ethylene glycol)-based hydrogels in the brain: an analysis of the glial response across space and time.
        J Biomed Mater Res A. 2010; 95: 79-91
        • Liu X.Y.
        • Nothias J.-M.
        • Scavone A.
        • et al.
        Biocompatibility investigation of polyethylene glycol and alginate-poly-L-lysine for islet encapsulation.
        ASAIO J. 2010; 56: 241-245
        • Gandolfi M.G.
        A new method for evaluating the diffusion of Ca2+ and OH-Ions through coronal dentin into the pulp.
        Iran Endod J. 2012; 7: 189-197
        • Kontakiotis E.
        • Nakou M.
        • Georgopoulou M.
        In vitro study of the indirect action of calcium hydroxide on the anaerobic flora of the root canal.
        Int Endod J. 1995; 28: 285-289
        • Moradi S.
        • Ghoddusi J.
        • Forghani M.
        Evaluation of dentinal tubule penetration after the use of dentin bonding agent as a root canal sealer.
        J Endod. 2009; 35: 1563-1566
        • Weis M.V.
        • Parashos P.
        • Messer H.
        Effect of obturation technique on sealer cement thickness and dentinal tubule penetration.
        Int Endod J. 2004; 37: 653-663
        • Şen B.
        • Pişkin B.
        • Baran N.
        The effect of tubular penetration of root canal sealers on dye microleakage.
        Int Endod J. 1996; 29: 23-28
        • Vassiliadis L.P.
        • Sklavounos S.A.
        • Stavrianos C.K.
        Depth of penetration and appearance of Grossman sealer in the dentinal tubules: an in vivo study.
        J Endod. 1994; 20: 373-376
        • White R.R.
        • Goldman M.
        • Lin P.S.
        The influence of the smeared layer upon dentinal tubule penetration by plastic filling materials.
        J Endod. 1984; 10: 558-562
        • Toursavadkohi S.
        • Zameni F.
        • Afkar M.
        Comparison of tubular penetration of AH26, EasySeal, and SureSeal root canal sealers in single-rooted teeth using scanning electron microscopy.
        J Res Dent Maxillofac Sci. 2018; 3: 27-32
        • Versluis A.
        • Tantbirojn D.
        • Lee M.S.
        • et al.
        Can hygroscopic expansion compensate polymerization shrinkage? Part I. Deformation of restored teeth.
        Dent Mater. 2011; 27: 126-133
        • Saghiri M.A.
        • Saghiri A.M.
        In memoriam: Dr. Hajar Afsar Lajevardi MD, MSc, MS (1955-2015).
        Iran J Pediatr. 2017; 27: 1