Abstract Bioactive endodontic sealers play a crucial role in restorative dentistry due to their ability to promote tissue repair and inhibit microbial proliferation. Given the high cost of commercial materials such as mineral trioxide aggregate (MTA), this study aimed to develop and characterize experimental bioactive endodontic cements composed of low-cost constituents—including fine Portland cement, ground metallurgical slag, and cellulose—while maintaining physicochemical and antimicrobial properties comparable to MTA (Angelus®). The materials were subjected to comprehensive characterization using X-ray diffraction (XRD), thermogravimetric analysis (TG/DTG), scanning electron microscopy (SEM), hydrogenionic potential (pH) analysis, inductively coupled plasma optical emission spectrometry (ICP-OES), and antimicrobial testing against Enterococcus faecalis using the agar diffusion method. Additionally, a complementary environmental assessment was performed to quantify potential CO₂ savings from clinker substitution with metallurgical slag, expressed as kg CO₂-eq per kilogram of cement. Statistical analyses were performed via ANOVA with Tukey’s post-hoc test. The experimental formulations revealed the presence of key bioactive phases, including calcium hydroxide, dicalcium and tricalcium silicates, tricalcium aluminate, and calcium carbonate. The materials exhibited a stable alkaline pH and effective antibacterial activity, confirming their biological potential. SEM imaging showed morphological differences between the experimental groups and commercial MTA, particularly regarding particle homogeneity. Nonetheless, overall physicochemical similarities were evident, especially for the slag-containing formulation (Group 2), which most closely mirrored the reference material. The environmental analysis indicated that slag incorporation led to a reduction of approximately 0.08 kg CO₂-eq per kilogram of cement (≈80 kg CO₂-eq per ton), highlighting the dual advantage of functional performance and environmental responsibility. These findings suggest the feasibility of producing alternative bioactive cements by reusing industrial by-products, offering a sustainable and economically viable option for endodontic applications without compromising clinical efficacy. Graphical Abstract
Duarte et al. (Thu,) studied this question.