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Submitted: 16 Sep 2025
Revision: 18 Nov 2025
Accepted: 11 Dec 2025
ePublished: 30 Jun 2026
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Avicenna J Dent Res. 2026;18(2): 65-72.
doi: 10.34172/ajdr.4569
  PDF Download: 1

Original Article

In Vitro Comparison of the Cytotoxicity of Different Endodontic Sealers: AH Plus, AdSeal, Endoseal MTA, and GuttaFlow Bioseal

Mehdi Dastorani 1* ORCID logo, Muhammad Javad Aliee 2, Raheleh Halabian 3, Mostafa Solati 4, Mohammadsadegh Alemrajabi 5

1 Department of Endodontics, School of Dentistry, AJA University of Medical Sciences, Tehran, Iran
2 Research Center, School of Dentistry, AJA University of Medical Sciences, Tehran, Iran
3 Microbiology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
4 Department of Periodontics, School of Dentistry, AJA University of Medical Sciences, Tehran, Iran
5 Department of Oral Medicine, School of Dentistry, AJA University of Medical Sciences, Tehran, Iran
*Corresponding Author: Mehdi Dastorani, Email: dastorani88@gmail.com

Abstract

Introduction: Endodontic sealers are essential components of root canal treatment and contribute to the sealing of the root canal system. Their cytotoxicity is an important factor in evaluating their biocompatibility. This study aimed to assess the cytotoxicity of four commonly used endodontic sealers, namely, AH Plus, AdSeal, Endoseal MTA, and GuttaFlow Bioseal against human gingival fibroblasts (HGFs).

Methods: HGFs were exposed to the respective sealers in set form and in five different weights after sterilization. Then, the cytotoxicity of the sealers was evaluated after 1 day, 3 days, and 7 days using the methyl thiazolyl tetrazolium (MTT) assay. Ultimately, data were analyzed by repeated measures ANOVA followed by Tukey’s post hoc test.

Results: After 24 hours, all sealers showed low cytotoxicity. However, sealers in 0.25 g and 0.5 g weights exhibited a marked reduction in cell viability (<30%) at 3 days and 7 days, indicating high cytotoxicity, while lighter weights (0.125 g, 0.1 g, and 0.08 g) demonstrated moderate-to-low cytotoxicity (30–70%). Moreover, AdSeal consistently displayed the highest cell viability, particularly at 0.08 g (around 70%), whereas AH Plus illustrated the lowest viability (approximately 5%) across all weights and time points.

Conclusion: Among the tested sealers, AdSeal had the lowest cytotoxicity and the highest biocompatibility. Therefore, its use may promote faster periapical healing while reducing the risk of inflammatory complications compared with AH Plus.



Please cite this article as follows: Dastorani M, Aliee MJ, Halabian R, Solati M, Alemrajabi M. In vitro comparison of the cytotoxicity of different endodontic sealers: AH Plus, AdSeal, Endoseal MTA, and GuttaFlow Bioseal. Avicenna J Dent Res 2026;18(2): 65-72. doi:10.34172/ajdr.4569
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