Graphene oxide-enhanced bioceramic sealers: Evaluation of antimicrobial activity, sealing ability, and biocompatibility

Abstract

Graphene oxide-enhanced bioceramic sealers have emerged as a promising advancement in endodontic materials
due to their potential to improve the biological and functional properties of conventional root canal sealers. The
incorporation of graphene oxide into calcium silicate-based bioceramic sealers aims to enhance antimicrobial
activity against persistent endodontic pathogens, improve adaptation to dentinal walls, reduce microleakage, and
promote favorable interactions with periapical tissues. This review summarizes the current evidence regarding
the physicochemical characteristics, antimicrobial mechanisms, sealing ability, and biocompatibility of graphene
oxide-enhanced bioceramic sealers. Available laboratory and preclinical studies suggest that graphene oxide
contributes to superior antibacterial performance through membrane disruption, oxidative stress induction,
and inhibition of biofilm formation while maintaining or improving the bioactivity and cytocompatibility of
the sealer matrix. In addition, these modified materials demonstrate promising sealing properties owing to
improved flow characteristics and interfacial adaptation. Despite encouraging findings, variations in graphene
oxide concentration, testing methodologies, and limited long-term clinical evidence highlight the need for
standardized research protocols and well-designed clinical investigations. Overall, graphene oxide-enhanced
bioceramic sealers represent a promising biomaterial with the potential to improve the predictability and longterm
success of root canal treatment.