Dental Glass Ionomer Cement for Root Perforation Management: Physicochemical Characteristics and In Vitro Cell Response

Background/Objectives: Root perforation treatment is essential for restoring the tightness of the root system, preventing periradicular inflammation and tooth loss. The present study aimed to evaluate the biocompatibility of Ketac™ Molar EasyMix as well as conduct a thorough morphological and structural characterization of the material, considering its potential use in managing root perforations. Methods: Morpho-structural characterization was performed by scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX), Fourier-transform infrared spectroscopy (FT–IR), and X-ray diffraction (XRD). Biocompatibility tests were performed on osteosarcoma cell line (ATCC—G 292 CRL-1423), monitoring metabolic activity and cell viability (MTT, n = 3), as well as the inflammatory response (nitric oxide—NO, n = 6), after 24 and 48 h of incubation. The control group consisted of cells unexposed to the material. Results: Microstructurally, the material exhibits a heterogeneous structure, along with pores and cracks. The specific bonds of the material, including both organic acid (COO−, O-H) and the glass components (Si-O-Al, Ca-O, C-F), were identified by FT-IR, while the crystalline phase composed of calcium fluorolanthanate was determined by XRD. Moreover, in vitro metabolic activity and viability test (MTT) showed a decrease of ~28% (p = 0.029) and ~30% (p = 0.150) after 24 and 48 h for samples incubated with Ketac™ Molar EasyMix. The statistically significantly increased levels of NO (p = 0.002, p = 0.004) suggest that the cells are trying to adapt to the environment that they have been exposed to. Conclusions: Within the limitations of the present study, under the tested conditions, our results suggest that Ketac™ Molar EasyMix maintained cell viability close to the 70% threshold defined by ISO 10993-5:2009, indicating a borderline biological response, a feature that may be influenced by the composition and behavior of the material.