Eman SALMAN, Abeer H MAHRAN, Ahmed KHALAF, Tarek ELSEWIFY
European Endodontic Journal - 2026;11(7):340-347
Objective: To assess the effect of blood contamination and acidic pH on the bioactive surface changes of 2 calcium silicate-based materials used for furcation perforation repair. Methods: Furcation perforation was created in 36 extracted mandibular molars, randomised and equally divided into 3 groups according to the medium used to set the repair material: blood, butyric acid and Hank's balanced salt solution (HBSS). Each group was subdivided into 2 equal subgroups according to the repair material used: mineral trioxide aggregate (MTA) and EndoSeal MTA. Scanning electron microscopic examination was performed at x1500 and x1600 to evaluate the crystalline structure, gap measurements and energy-dispersive X-ray analysis. Data were statistically analysed at a significance level of 0.05. Results: Morphological analysis revealed that blood contamination induced rounded, globular crystal formation in both materials, while acid and HBSS contamination resulted in apatite-like deposits along the cement-dentin interface. For gap measurement in blood, both materials achieved superior sealing with no detectable gaps. In acid and HBSS, EndoSeal MTA exhibited significantly smaller gaps compared to MTA in both acidic and HBSS conditions. Elemental analysis indicated that while both materials performed similarly in blood and HBSS, EndoSeal MTA maintained a significantly higher calcium-to-phosphorus ratio than MTA under acidic conditions, suggesting better chemical stability in low-pH environments. Conclusion: Under the tested ex vivo conditions, EndoSeal MTA demonstrated superior marginal adaptation and surface elemental stability compared to MTA when exposed to acidic and HBSS environments, although both materials provided a comparable interfacial adaptation in the presence of blood. These laboratory findings highlight material differences under stress but cannot be directly extrapolated to definitive clinical success or healing potential.
