This study aimed to investigate the impact of different viscosities of silicone oil on the physicochemical, pre-clinical usability, and biological properties of a sodium iodide paste. Six different paste groups were created by mixing therapeutic molecules, sodium iodide (D30) and iodoform (I30), with calcium hydroxide and one of the three different viscosities of silicone oil (high (H), medium (M), and low (L)). The study evaluated the performance of these groups, including I30H, I30M, I30L, D30H, D30M, and D30L, using multiple parameters such as flow, film thickness, pH, viscosity, and injectability, with statistical analysis (p < 0.05). Remarkably, the D30L group demonstrated superior outcomes compared to the conventional iodoform counterpart, including a significant reduction in osteoclast formation, as examined through TRAP, c-FOS, NFATc1, and Cathepsin K (p < 0.05). Additionally, mRNA sequencing showed that the I30L group exhibited increased expression of inflammatory genes with upregulated cytokines compared to the D30L group. These findings suggest that the optimized viscosity of the sodium iodide paste (D30L) may lead to clinically favorable outcomes, such as slower root resorption, when used in primary teeth. Overall, the results of this study suggest that the D30L group shows the most satisfactory outcomes, which may be a promising root-filling material that could replace conventional iodoform-based pastes.

Objectives: This study aimed to compare the physical properties and antibacterial effectiveness of iodoform based root filling pastes, Vitapex® and Metapex®, with sodium iodide root filling paste (NaI paste) for primary teeth. Materials and Methods: The physical properties (flowability, film thickness, radiopacity) of the pastes were evaluated according to ISO 6876:2012. The antibacterial activity against Enterococcus faecalis strain (ATCC 6538) was evaluated using a direct contact test. Results: There was no significant statistical difference (<i>p</i> > 0.05) observed in the flow and film thickness of NaI paste when compared to the currently available root canal filling materials. The average flow capacities for Vitapex®, Metapex®, and NaI paste were 15.40 mm, 21.25 mm, and 20.01 mm, respectively. The average film thickness for Vitapex®, Metapex®, and NaI paste were 33.3 μl, 22.6 μl, and 25.0 μl, respectively. However, NaI paste showed lower radiopacity than the existing materials, and this difference was statistically significant (<i>p</i> < 0.05) NaI paste demonstrated higher antimicrobial activity than the available materials, and this difference was also statistically significant (<i>p</i> < 0.05). Conclusion: Compared to the existing commercialized root canal filling materials, NaI paste exhibited similar performance in terms of flow and film thickness, and superior antimicrobial activity against E. faecalis . Hence, NaI paste could be a promising root filling material for primary teeth and may be a potential alternative to existing materials.