This study aimed to use intact mineral trioxide aggregate (MTA) as a root canal sealer by hydrophilizing the gutta-percha (GP) surface. The GP specimens were treated with atmospheric air plasma, cetylpyridinium chloride (CPC), or a combination of both. The wettability and surface chemical properties were evaluated using contact angle measurements and X-ray photoelectron spectroscopy (XPS). The physicochemical properties of MTA mixed with water or 100 mM of CPC solution were evaluated using setting time, flowability, compressive strength, and X-ray diffraction (XRD) analyses. Sealing ability was assessed by evaluating the dye penetration in obturated single-rooted teeth. Combined plasma and CPC treatment significantly decreased the contact angle of GP compared to that of the untreated group (p < 0.05) and showed the least hydrophobic recovery after 8 weeks. The XPS analysis confirmed the adsorption of CPC onto the GP surface. The XRD and compressive strength results indicated that the CPC did not interfere with the setting reaction of intact MTA, although the setting time was prolonged (p < 0.05). Dye penetration was significantly reduced in the plasma- and CPC-treated GP groups compared to the untreated GP group (p < 0.05), with a sealing ability comparable to that of the zinc oxide-based sealer.

The biological aging of titanium implants, marked by increased surface hydrophobicity and organic contamination, reduces bioactivity and delays osseointegration. A major challenge in implant dentistry is determining how to preserve surface hydrophilicity during storage, as conventional atmospheric conditions accelerate surface degradation. This pilot in vivo study aimed to evaluate ozone nanobubble water (NBW3) as a storage medium to prevent biological aging and enhance the early-stage osseointegration of glow discharge-treated titanium implants. Screw-type implants were stored in either NBW3 or atmospheric conditions and then implanted into femoral bone defects in Sprague Dawley rats. Removal torque testing, scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and histological analysis of bone-to-implant contact (BIC) were performed 14 and 28 days post-implantation. At 14 days, the NBW3-stored implants demonstrated significantly higher removal torque (2.08 ± 0.12 vs. 1.37 ± 0.20 N·cm), BIC (65.74 ± 12.65% vs. 44.04 ± 14.25%), and Ca/P atomic ratio (1.20 ± 0.32 vs. 1.00 ± 0.22) than the controls. These differences were not observed at 28 days, indicating NBW3’s primary role in accelerating early osseointegration. The findings suggest that using NBW3 is a simple, effective approach to maintain implant surface bioactivity during storage, potentially improving clinical outcomes under early or immediate loading protocols.