Flame spray synthesis has opened the possibility to add additional elements to complex materials such as bioactive glasseswhile maintaining nanoparticulate properties. In this study, it was investigated whether a flamesprayed bismuth oxide doped nanometric 45S5 bioactive glass could be incorporated into a commercially available epoxy-resin root canal sealer, and how this compared to a conventional, pure 45S5 micrometric bioactive glass. Effects on radiopacity, microhardness, pH and mineral induction in phosphate buffered saline and simulated body fluid were studied. It was revealed that the radiopaque nanometric bismuth-containing 45S5 bioactive glass reduced radiopacity of the root canal sealer less than a conventional micrometric counterpart. In addition, pH induction and calcium phosphate precipitation were quicker with the nanometric compared to the micrometric material, whilst the micrometric glass displayed a higher alkaline capacity. Both materials apparently bound to the epoxy resin matrix, thus increasing its microhardness after polymerization reaction. Effects were dose-dependent. The investigated radiopaque bioactive glass containing bismuth oxide could be a valuable add-on for current root canal sealers.