Residual monomer/additive release and variability in cytotoxicity of light-curing glass-ionomer cements and compomers

Inorganic elemental analysis and identification of residual monomers released from different glass ionomer cements in cell culture medium

INTRODUCTION: Glass ionomer cements (GICs) release inorganic elements and organic residual monomers with the potential for deleterious effects on pulp cells. OBJECTIVE: To identify and quantify inorganic elements present in different GICs and released components from these materials in cell culture medium. MATERIAL AND METHOD: Samples of two resin-modified GICs for base/liner (Vitrebond and Fuji Lining LC), two resin-modified restorative GICs (Vitremer and Fuji II LC) and two conventional restorative GICs (Ketac Fil Plus and Ketac Molar Easymix) were prepared and analyzed by Energy-Dispersive X-Ray Fluorescence Spectrometry (EDXRF). Extracts of these materials were obtained by immersion of each sample in separate containers of DMEM for 24 h (total surface-liquid ratio = 45.7 mm²/mL). The extracts were analyzed by EDXRF and Gas Chromatography-Mass Spectrometry (GC-MS). RESULT: Higher percentages of strontium, silicon and aluminum were identified in Vitrebond, Vitremer, Fuji Lining LC, Fuji II LC, and Ketac Fil Plus, while zinc was detected only in Vitrebond. Ketac Molar Easymix presented a greater atomic composition of lanthanum, calcium, aluminum and silicon. Strontium was detected in the extracts from all materials except Ketac Molar Easymix; calcium was present in extracts from Ketac Fil Plus; zinc only in Vitrebond; and silicon in Fuji II LC extract. The analysis by GC-MS detected 2-hydroxyethyl-methacrylate (HEMA) in the extracts from all resin-modified GICs, and iodine benzene was detected only in the Vitrebond extract. CONCLUSION: Of the GICs sampled, Vitrebond released the highest number of components with cytotoxic potential.

Toxicity evaluation of two dental composites: three-dimensional confocal laser scanning microscopy time-lapse imaging of cell behavior

The purpose of this study was to investigate the in vitro biocompatibility of two dental composites (namely A and B) with similar chemical composition used for direct restoration using three-dimensional confocal laser scanning microscopy (CLSM) time-lapse imaging. Time-lapse imaging was performed on cultured human HGF-1 fibroblast-like cells after staining using Live/Dead®. Image analysis showed a higher mortality rate in the presence of composite A than composite B. The viability rate decreased in a time-dependent manner during the 5 h of exposure. Morphological alterations were associated with toxic effects; cells were enlarged and more rounded in the presence of composite A as shown by F-actin and cell nuclei staining. Resazurin assay was used to confirm the active potential of composites in cell metabolism; results showed severe cytotoxic effects in the presence of both no light-curing composites after 24 h of direct contact. However, extracts of polymerized composites induced a moderate decrease in cell metabolism after the same incubation period. Composite B was significantly better tolerated than composite A at all investigated end points and all time points. The finding confirmed that the used CLSM method was sufficiently sensitive to differentiate the biocompatibility behavior of two composites based on similar methacrylate monomers.

Effect of 2-hydroxyethyl methacrylate on antioxidant responsive element-mediated transcription: a possible indication of its cytotoxicity

BACKGROUND

The resin monomer 2-hydroxyethyl methacrylate (HEMA) is known to be more cytotoxic than methyl methacrylate (MMA). Using a luciferase reporter assay system, we previously showed that MMA activates the glutathione S-transferase alpha 1 gene (Gsta1) promoter through the anti-oxidant responsive element (ARE). However, it is not known whether HEMA induces ARE-mediated transcription.

METHODOLOGY/PRINCIPAL FINDINGS

We further developed the reporter system and studied the concentration-dependent effect of HEMA on ARE enhancer activity. The revised system employed HepG2 cells stably transfected with a destabilized luciferase reporter vector carrying 2 copies of the 41-bp ARE region of Gsta1. In this system, MMA increased ARE activity by 244-fold at 30 mM; HEMA augmented ARE activity at 3 mM more intensely than MMA (36-fold versus 11-fold) and was equipotent as MMA at 10 mM (56-fold activation); however, HEMA failed to increase ARE activity at 30 mM. In HepG2 cells, HEMA detectably lowered the cellular glutathione levels at 10 mM and cell viability at 30 mM, but MMA did not.

CONCLUSIONS

These results suggest that the low-concentration effect of HEMA on ARE activity reflects its cytotoxicity. Our reporter system used to examine ARE activity may be useful for evaluating cytotoxicities of resin monomers at concentrations lower than those for which cell viabilities are reduced.

Influence of thicknesses of smear layer on the transdentinal cytotoxicity and bond strength of a resin-modified glass-ionomer cement

This study evaluated the transdentinal cytotoxicity (TC) and the bond strength (BS) of a resin-modified glass-ionomer cement (RMGIC) applied to dentin covered with smear layer (SL) of different thicknesses. Forty dentin discs had thick (TSL) or thin (THSL) smear layer created on their occlusal side. In artificial pulp chambers, MDPC-23 cells were seeded on the pulpal side of the dentin discs and divided into five groups: G1TC: no treatment (control); G2TC: TSL + RMGIC; G3TC: THSL + RMGIC; G4TC: TSL removal + RMGIC; G5TC: THSL removal + RMGIC. After 24 h, cell metabolism and morphology were evaluated by the methyltetrazolium (MTT) assay and by scanning electron microscopy (SEM), respectively. For BS, the following groups were determined: G1BS: TSL removal + RMGIC; G2BS: THSL removal + RMGIC; G3BS: TSL + RMGIC; G4BS: THSL + RMGIC. Shear bond strength was tested to failure in a mechanical testing machine MTS (0.5 mm/min). Statistically significant difference was observed only between the control and experimental groups (Kruskal-Wallis, p<0.05). The metabolic activity of the viable MDPC-23 cells in G2TC, G3TC, G4TC and G5TC decreased by 54.85%, 60.79%, 64.12% and 62.51%, respectively. Mean shear bond strength values for G1BS, G2BS, G3BS and G4BS were 7.5, 7.4, 6.4 and 6.7 MPa, respectively, without significant difference among them (ANOVA, p>0.05). RMGIC presented moderate transdentinal cytotoxic effects. Maintenance or removal of smear layer did not affect the bond strength of RMGIC to dentin substrate.

Histological evaluation of rat tissue response to GMTA, Retroplast, and Geristore retrograde filling materials

The aim of the study was to compare the short-term biocompatibility of grey mineral trioxide aggregate (GMTA), Retroplast and Geristore. Silicon tubes filled with the materials and empty control tubes were implanted in the dorsal connective tissue of 30 Wistar albino rats. The tubes and surrounding tissues were excised and prepared for histological examination at 1 week, 1 month and 2 months after implantation. Inflammatory cell counts and the presence or absence of necrosis adjacent to the materials and control tubes were recorded. Data were statistically analysed using one-way anova and Tukey's multiple comparisons tests. The empty control tubes were well tolerated. All tested materials showed a more severe initial reaction than the control group. With time, the reaction became chronic, with variable increase in the numbers of inflammatory cells. Retroplast recorded the most statistically significant increase in the sum of inflammatory cells. Although the increase in the sum of inflammatory cells was statistically significant for Geristore but not for GMTA, the inflammatory cell counts for both were comparable. It was concluded that the three materials continued to irritate tissues throughout the evaluation period. Retroplast was the least biocompatible of the three tested materials at 2 months, followed by Geristore then GMTA.

Influence of light curing units on failure of directcomposite restorations

Light polymerizable tooth colored restorative materials are most widely preferred for advantages such as esthetics, improved physical properties and operator's control over the working time. Since the introduction of these light polymerizable restorative materials, there has been a concern about the depth of appropriate cure throughout the restoration. Photopolymerization of the composite is of fundamental importance because adequate polymerization is a crucial factor for optimization of the physical and mechanical properties and clinical results of the composite material. Inadequate polymerization results in greater deterioration at the margins of the restoration, decreased bond strength between the tooth and the restoration, greater cytotoxicity, and reduced hardness. Therefore, the dentist must use a light curing unit that delivers adequate and sufficient energy to optimize composite polymerization. Varying light intensity affects the degree of conversion of monomer to polymer and depth of cure.

HEMA down-regulates procollagen alpha1 type I in human gingival fibroblasts

2-Hydroxyethyl methacrylate (HEMA) can be released from restorative materials and diffused into the tooth pulp over long periods of time. Although cytotoxicity due to high concentrations of monomers has been well studied, little is known about the risk of chronic toxicity resulting from low concentrations. The purpose of the study was to evaluate the effects of a minor toxic concentration of HEMA in the synthesis and expression of procollagen alpha1 type I produced by human gingival fibroblasts (HGF). HGF were exposed to 3 mM HEMA from 24 to 96 h. An MTT assay was performed to evaluate cell viability while reverse-transcriptase polymerase chain reaction (RT-PCR), real-time polymerase chain reaction (real-time PCR), and Western-blot analysis were carried out to evaluate the variability in the expression and synthesis of procollagen alpha1. Immunofluorescence was performed to detect the protein inside the cells. The results showed that there was a strong reduction of procollagen alpha 1 type I expression at 72 and 96 h. These findings demonstrate that, even if it does not reduce cell viability, 3 mM HEMA interferes both with the synthesis of the procollagen alpha 1 type I protein and its mRNA expression, suggesting that normal cell production and activity are modified by HEMA at concentrations below those which cause acute cytotoxicity.

Biocompatibility of Resin-based Dental Materials

Oral and mucosal adverse reactions to resin-based dental materials have been reported. Numerous studies have examined the biocompatibility of restorative dental materials and their components, and a wide range of test systems for the evaluation of the biological effects of these materials have been developed. This article reviews the biological aspects of resin-based dental materials and discusses the conventional as well as the new techniques used for biocompatibility assessment of dental materials.

Cytotoxic effects of halogen- and light-emitting diode-cured compomers on human pulp fibroblasts

OBJECTIVE

The aim of this study was to determine the cytotoxic effects of three different compomers (Dyract AP, Compoglass, and Hytac) cured using a halogen light-curing unit (LCU) and a light-emitting diode (LED) LCU on human pulp fibroblasts.

METHODS

Specimens of three compomers were added to human pulp fibroblast cultures. Cytotoxicity was evaluated over 96 h using the agar overlay method.

RESULTS

All three compomers tested were found to be moderately cytotoxic to human pulp fibroblasts, regardless of whether they were cured using halogen or LED LCUs. The decolorization zone of Hytac was significantly larger than those of the other compomers tested (P < 0.05). Dyract AP and Compoglass specimens showed greater decolorization when cured with LED than with halogen LCUs (P < 0.05).

CONCLUSION

Compomers are potentially toxic to human pulp fibroblasts, and the type of curing unit may affect compomer toxicity.

Preparation and evaluation of a high-strength biocompatible glass-ionomer cement for improved dental restoratives

We have developed a high-strength light-cured glass-ionomer cement (LCGIC). The polymer in the cement was composed of the 6-arm star-shape poly(acrylic acid) (PAA), which was synthesized using atom-transfer radical polymerization. The polymer was used to formulate with water and Fuji II LC filler to form LCGIC. Compressive strength (CS) was used as a screening tool for evaluation. Commercial glass-ionomer cement Fuji II LC was used as control. The results show that the 6-arm PAA polymer exhibited a lower viscosity in water as compared to its linear counterpart that was synthesized via conventional free-radical polymerization. This new LCGIC system was 48% in CS, 77% in diametral tensile strength, 95% in flexural strength and 59% in fracture toughness higher but 93.6% in shrinkage lower than Fuji II LC. An increasing polymer content significantly increased CS, whereas an increasing glass filler content increased neither yield strength nor ultimate CS except for modulus. During aging, the experimental cement showed a significant and continuous increase in yield strength, modulus and ultimate CS, but Fuji II LC only showed a significant increase in strength within 24 h. The experimental cement was very biocompatible in vivo to bone and showed little in vitro cytotoxicity. It appears that this novel LCGIC cement will be a better dental restorative because it demonstrated significantly improved mechanical strengths and better in vitro and in vivo biocompatibilities as compared to the current commercial LCGIC system.

Lipid vesicles as membrane models for toxicological assessment of xenobiotics

Traditionally animals and cell cultures have been used to assess the toxic potential of xenobiotics on cell membranes. In search for more reproducible, quantitative, cost- and time-effective assays, toxicologists have recently become interested in biomimetic lipid vesicle-based test systems. Lipid vesicles (liposomes) have long been appreciated as simple cell membrane models in biochemical and biophysical studies providing a good understanding of the physicochemical properties of liposome systems. More recently a number of reports have been published on the interactions of toxic substances with vesicles. Literature reports on liposome assays have appeared for widely different classes of xenobiotics, such as dental materials, antibiotics, detergents, and peptides. In this review we focus on those reports that contain a quantitative and significant correlation with more established toxicological tests like cell culture assays. We provide an introduction to the structure and main characteristics of vesicles and related lipid aggregates. The two main assays presented are leakage of fluorescence dyes and differential scanning calorimetry (DSC) measurements of the solid-ordered/liquid-disordered main phase transition temperature (Tm).

Protective effects of antioxidants on micronuclei induced by camphorquinone/N,N-dimethyl-p-toluidine employing in vitro mammalian test system

Camphorquinone (CQ) is widely used as an initiator in modern visible-light (VL) cured resin systems. CQ is also characterized as a potential allergenic compound. To date, there is growing concern that CQ may produce genetic damage by inducing mutation. In this study, CQ in the presence of reducing agent N,N-dimethyl-p-toluidine (DMT) with or without VL irradiation was analyzed for the induction of chromosomal aberrations indicated by micronuclei (MN) induced in CHO cells. Our data demonstrated that an increase in the numbers of MN was observed with CQ/DMT with or without VL irradiation (p < 0.05). Significant prolongation of cell cycles was observed by the treatment with CQ/DMT with or without VL irradiation (p < 0.05). In addition, VL irradiated CQ/DMT was found to exhibit significantly genotoxic and cytotoxic effects as compared with CQ/DMT alone (p < 0.05). Furthermore, to determine whether oxidative stress could modulate the MN induced by CQ/DMT with or without VL irradiation in CHO cells, cells were pre-treated with various antioxidants 10 mM N-acetyl-L-cysteine (NAC), 2 mM ascorbic acid, and 2 mM alpha-tocopherol. The pre-treatment with antioxidants could antagonize not only the increased MN cells but also the prolonged cell cycle induced by CQ/DMT with or without VL irradiation in CHO cells (p < 0.05). Our findings provide the evidences for the induction of MN by CQ/DMT employing mammalian test system, indicating clastogenic activity of CQ/DMT with or without VL irradiation in vitro. In addition, VL irradiated CQ/DMT exhibits higher genotoxic and cytotoxic effects than CQ/DMT alone. Moreover, NAC, ascorbic acid, and alpha-tocopherol act as the antagonists against the genotoxicity and cytotoxicity of CQ/DMT with or without VL irradiation.

Cytotoxic effects of hard-setting cements applied on the odontoblast cell line MDPC-23

OBJECTIVE

The present study evaluated the cytotoxic effects of hard setting applied on the odontoblastlike cells MDPC-23.

STUDY DESIGN

Eighty round-shaped samples were prepared with the following experimental materials: calcium hydroxide, Vitrebond, RelyX Luting, and RelyX Unicem. The samples were placed in serum-free culture medium and incubated for 24 hours or 7 days at 37 degrees C with 5% CO2 and 95% air. The odontoblast cells were plated in the wells and incubated for 72 hours. After this period, the complete culture medium was replaced by the extracts obtained from every sample, and the methyltetrazolium assay was carried out to evaluate the cell metabolism.

RESULTS

For the 24-hour period, the experimental materials calcium hydroxide, Vitrebond, RelyX Luting, and RelyX Unicem decreased the cell metabolic activity by 91.52%, 81.14%, 78.17%, and 2.64%, respectively. For the 7-day period, calcium hydroxide, Vitrebond, RelyX Luting, and RelyX Unicem decreased the metabolic activity of the MDPC-23 cells by 91.13%, 87.27%, 79.04%, and 10.51%, respectively.

CONCLUSION

RelyX Unicem presented the lowest cytopathic effects to the cultured odontoblast cell line.

Quantitative analysis of TEGDMA and HEMA eluted into saliva from two dental composites by use of GC/MS and tailor-made internal standards

OBJECTIVES

The use of resin-based dental restorative materials is rapidly increasing, concurrently the biocompatibility of the materials is under investigation. Attention has been placed on studies addressing the cytotoxic, genotoxic and estrogenic potential of these materials. Therefore, the degree of exposure to eluted compounds from the dental materials is of high interest. The aim of this study was to assess the amounts of 2-hydroxyethyl methacrylate (HEMA) and triethyleneglycol dimethacrylate (TEGDMA), released from two composites, eluting into human saliva. To improve the method of quantification, three tailor-made internal standards were synthesized.

METHODS

Specimens made from two composites (Tetric EvoCeram and Filtek Z250) were polymerized and immersed in human saliva for 24h. Eluted TEGDMA and HEMA were identified and quantified. The quantitative analyses were performed by use of combined gas chromatography-mass spectrometry (GC/MS) with tailor-made internal standards synthesized by dissolving HEMA or TEGDMA in methanol and reducing the double bond of the methacrylate group by hydrogenation with 1H2 and 2H2 (D2) gas.

RESULTS

HEMA was released from both materials, whereas TEGDMA eluted from Filtek Z250 only. Full scan GC-MS analysis of each tailor-made internal standard demonstrated one peak only, which was well separated from the corresponding analyte's peak and with no traces of HEMA or TEGDMA.

SIGNIFICANCE

The quantification method seems well suited for in vivo analysis, and the three standards synthesized represent an improved tool for quantification of the eluted monomers. The synthesis may be applied to other methacrylate monomers to produce tailor-made standards for quantification.

A novel comonomer-free light-cured glass-ionomer cement for reduced cytotoxicity and enhanced mechanical strength

OBJECTIVE

The objective of this study was to develop a novel comonomer-free light-cured glass-ionomer system based on the 4-arm star-shape poly(acrylic acid). The mechanical strengths and in vitro cytotoxicity of the formed system were evaluated and compared with those of several representative commercial glass-ionomer cements.

MATERIALS AND METHODS

The 4-arm poly(acrylic acid) was synthesized using ATRP and tethered with glycidyl methacrylate (GM). The GM-tethered polymer was formulated with water, photo-initiators, and Fuji II LC filler. Fuji II, Fuji II LC and Vitremer were used for comparison. Compressive strength (CS) and MTT assay were used as tools to evaluate the mechanical strengths and in vitro cytotoxicity of the cements, respectively.

RESULTS

The experimental cement exhibited significantly high compressive, diametral tensile and flexural strengths as compared to commercial glass-ionomer cements, Fuji II, Fuji II LC and Vitremer. The effects of polymer/water (P/W) ratio, GM-grafting ratio, glass powder/polymer liquid (P/L) ratio and aging in water on strengths were significant. Similar to conventional glass-ionomer cement Fuji II, the eluates from the experimental cement showed little in vitro cytotoxicity to Balb/c mouse fibroblast cells, as compared to Fuji II LC and Vitremer that contain HEMA as a comonomer.

CONCLUSIONS

It appears that this novel comonomer-free light-cured glass-ionomer cement will be a promising dental restorative because it demonstrated significantly improved mechanical strengths and almost no in vitro cytotoxicity as compared to current commercial light-cured glass-ionomer cements.

Apoptosis induced by the monomers HEMA and TEGDMA involves formation of ROS and differential activation of the MAP-kinases p38, JNK and ERK

OBJECTIVES

Cytotoxic methacrylate monomers have been identified in aqueous extracts of freshly cured compomers. Some of these compounds, including HEMA and TEGDMA, induce apoptosis and necrosis in vitro. The aim of the present study was to elucidate possible signaling pathways involved in apoptosis following exposure to HEMA or TEGDMA in a salivary gland cell line.

METHODS

The cells were exposed to various concentrations of HEMA or TEGDMA. ROS formation was determined by dichlorofluorescein assay. Phosphorylated MAP-kinases ERK1/2, p38 and JNK, as well as specific caspases were identified by Western blotting. Apoptosis was assayed by fluorescence microscopy.

RESULTS

HEMA or TEGDMA exposure resulted in ROS formation and concentration-dependent apoptosis as well as phosphorylation of ERK. Phosphorylation of JNK and p38 was induced by HEMA. Selective inhibitors of ERK and JNK modified the apoptotic response after HEMA and TEGDMA exposure, whereas p38 inhibition modified the apoptotic response only after HEMA exposure. Vitamin C reduced HEMA-induced apoptosis.

SIGNIFICANCE

ROS formation and differential MAP kinase activation appear to be involved in the apoptotic response following exposure to HEMA and TEGDMA.

Effects of combinations of ROS scavengers on oxidative DNA damage caused by visible-light-activated camphorquinone/N,N-dimethyl-p-toluidine

The objective of this investigation was to analyze whether various combinations of the ROS scavengers glutathione (GSH), N-acetyl-cysteine (NAC), and vitamins C and E decrease DNA damage due to visible-light-irradiated (VL-irradiated) camphorquinone/N,N-dimethyl-p-toluidine (CQ/DMT) compared with individual vitamin C or E. PhiX-174 RF plasmid DNA was used to determine single and double strand breaks as parameters of DNA damage. Individual ROS scavengers and combinations of the antioxidants were added to plasmid DNA treated with VL-irradiated CQ/DMT/Cu (II). After incubation, DNA was loaded into a 1% agarose gel. Following electrophoresis, gels stained with 0.5 microg/mL ethidium bromide were photographed under ultraviolet illumination and analyzed with NIH ImageJ software. Results were evaluated between groups for statistical significance using Student's paired t-test (p < 0.05). Glutathione significantly reduced oxidative DNA damage at all test concentrations when combined with vitamin C or vitamin E. The concentration of damaged DNA observed in the presence of combinations of GSH with vitamin C or vitamin E was significantly lower compared with all other combinations of antioxidants investigated in our study (p < 0.05). In contrast to GSH, NAC was not able to compensate the pro-oxidative effects of vitamin C and vitamin E. Only at a concentration of 2 mM, NAC combined with vitamin C efficiently prevented CQ/DMT/Cu (II)-associated DNA damage. Our data indicate that solely the combinations of GSH with vitamin C or vitamin E significantly reduce the severity of oxidative DNA damage caused by CQ/DMT, whereas NAC may even increase the pro-oxidant activity of vitamin C and vitamin E.

Cytotoxicity evaluation of an antibacterial dentin adhesive system on established cell lines

Clearfil Protect Bond is a new dental bonding agent recently introduced into clinical practice. It contains an antibacterial monomer that contributes to its antibacterial profile. The aim of the present study was to evaluate cytotoxic effect of Clearfil Protect Bond against three established fibroblastic cell lines, in comparison with four commonly used adhesive materials (Adper Scotchbond 1, Excite, Tyrian SPE, and One Step plus). The experiments were performed using RPC-C2A, BHK21/C13, and MRC5 cell lines. Test specimens, either cured or uncured, were placed in a culture medium and the extraction media were used as experimental material. The effect of the bonding materials was assessed by a modified sulforhodamine-B assay after 24 and 48 h of exposure. All tested agents exhibited an antiproliferative effect on cells, the effect on RPC-C2A being the most marked. Extraction media from the uncured materials were without exception highly cytotoxic. In the experiments performed using extraction medium from cured material, Clearfil Protect Bond appeared to be the least toxic material, followed by Tyrian SPE and One Step plus. Adper Scotchbond 1 and Excite exhibited the strongest cytotoxic effect. The cell survival percentage ranged between 66 and 97% for Clearfil Protect bond, 15 and 82% for Tyrian SPE, 28 and 58% for One Step plus, 2 and 28% for Excite, and 1 and 6% for Adper Scotchbond 1. Taking into consideration the limitations of an in vitro study, our results indicate that the new antibacterial dental adhesive system is suitable for clinical application.

Biocompatibility of resin-based dental materials applied as liners in deep cavities prepared in human teeth

BACKGROUND

Since only a few data have been published concerning the effects of resinous dental materials on the pulp-dentin complex, the aim of this study was to evaluate the biocompatibility of resin-based materials applied as liners in deep cavities prepared in human teeth.

METHODS

After preparing class V cavities, the following dental materials were applied on the axial walls: group 1, Vitrebond (VIT; 3M ESPE); group 2, Ultra-Blend Plus (UBP; Untradent); and group 3, Clearfil SE Bond (CSEB; Kuraray). In group 4 (control), the hard-setting calcium hydroxide cement Dycal (CH; Caulk/Dentsply) was used. The teeth extracted at 7 days or between 30 and 85 days after the clinical procedures were processed for histological evaluation.

RESULTS

For all the experimental and control groups, most of specimens exhibited no pulpal response or slight inflammatory reaction associated with slight tissue disorganization at 7-day period. Moderate inflammatory pulpal response occurred only in one tooth (RDT = 262 microm) of group 3 in which transdentinal diffusion of resin components was observed.

CONCLUSION

The resin-based dental cements VIT and UBP as well as the bonding agent CSEB presented acceptable biocompatibility when applied in deep cavities prepared in sound human teeth.

Radicals produced by blue-light–resin interactions alter the redox status of THP1 human monocytes

Resin composites are widely used in dentistry, and are polymerized in situ using a blue-light activated, free-radical polymerization mechanism. Blue light (400-500nm) is used to activate camphoroquinone (CQ), which decomposes to form free radicals that are stabilized by dimethyl-p-toludine (DMPT). CQ and DMPT are applied near tooth pulpal tissues and are irradiated during restorative procedures, suggesting that pulpal cells are exposed to free radicals. Because glutathione is a major component of the cellular redox management system, we tested the hypothesis that blue light irradiation would shift cellular glutathione redox balance of cells exposed to CQ and DMPT. We also measured NFkappaB activation, a redox-sensitive transcription factor that regulates inflammatory responses and glutathione synthetic enzyme levels. THP1 human monocytes were exposed to sublethal levels of CQ (0.4 mM) or DMPT (1.0 mM), with or without blue light exposure (25 J/cm(2)) from a quartz-tungsten-halogen source. The ratio of reduced to oxidized glutathione was measured using as assay based on 5,5'-dithio-bis(2-nitrobenszoic acid). NFkappaB transactivation was measured by transfection of an NFkappaB-containing plasmid linked to a luciferase reporter. Our results showed that blue light, CQ, or DMPT alone had no significant effect on cellular glutathione redox balance, but that the combination of these agents induced a marked oxidative bias, and reduced total glutathione levels up to 50%. On the other hand, light, CQ, and DMPT alone or in combination suppressed NFkappaB transactivation by >70%. Our results suggest that CQ and DMPT pose risks to pulpal tissues with or without blue light irradiation, and that multiple, interacting mechanisms shape the response to these agents.

Cytotoxicity of resin monomers on human gingival fibroblasts and HaCaT keratinocytes

OBJECTIVES

The aim of this study was to evaluate and compare the biological effects of three resin monomers on three human gingival fibroblast (HGF) cell lines and immortalised human keratinocytes.

METHODS

Primary HGFs and HaCaT keratinocytes were cultured for 24h and grown to sub-confluent monolayers. Resin monomers were dissolved in dimethyl sulphoxide (DMSO) and diluted with culture medium. Cultures were exposed to different concentrations of monomers (10(-2) to 10mM) for 24h. Cell viability measured by Alamar Blue assay, and cell culture supernatant was examined for the presence of human interlukin-1beta (IL-1beta) using sandwich enzyme-linked immunosorbant assay (ELISA). TC50 values were calculated from fitted dose-response curves.

RESULTS

All monomers showed toxic effects on the HGFs and HaCaT cells and inhibited chemical reduction of Alamar Blue in high concentrations. Statistical analysis of TC50 values by one-way ANOVA followed by Tukey's analysis showed that there is a significant difference in TC50 values between the cell lines (p<0.05), although the rank order of monomer toxicity remained the same for different cell lines. None of these monomers-induced IL-1beta release from HGFs and HaCaT cells.

SIGNIFICANCE

Dental resin monomers are toxic to human gingival fibroblasts and HaCaT keratinocytes. However, they cannot induce IL-1beta release from these cells by themselves. Alamar Blue assay is a sensitive method for the evaluation of cytotoxicity and it can detect different sensitivities of different cell lines to the resin monomers.

In vitro biological response to a light-cured composite when used for cementation of composite inlays

OBJECTIVE

To define the cytotoxicity of a photo-cured composite when used as a bonding system under a composite inlay.

METHODS

Composite specimens were photo-cured with or without a 2 mm composite inlay interposed between them and the light source. Samples were extracted in complete cell culture medium and the obtained eluates applied to primary cultures of human pulp and gingival fibroblasts. After 72 h of incubation, cell viability was evaluated by MTT assay. Survival rates were calculated with respect to negative controls.

RESULTS

Both shielded and unshielded composite samples were cytotoxic to pulp and gingival cells. The inlay shielded composite samples reached a significantly higher level of cytotoxicity compared to the unshielded ones.

SIGNIFICANCE

The results suggested that the cytotoxicity of a light-cured composite resin used as a bonding system for indirect composite restorations may be significantly increased as a result of an inlay light-shielding effect.

Quantification of organic eluates from polymerized resin-based dental restorative materials by use of GC/MS

Residual monomers, additives and degradation products from resin-based dental restorative materials eluted into the oral cavity may influence the biocompatibility of these materials. Emphasis has been placed on studies addressing cytotoxic, genotoxic and estrogenic potential of these substances. A prerequisite for analyzing the potential of exposure to eluted compounds from dental materials is reliable quantification methods, both real time and accelerated measurements. The purpose of the present study was to quantify nine eluates; 2-hydroxyethyl methacrylate (HEMA), hydroquinone monomethyl ether (MEHQ), camphorquinone (CQ), butylated hydroxytoluene (BHT), ethyl 4-(dimethylamino)benzoate (DMABEE), triethylene glycoldimethacrylate (TEGDMA), trimethylolpropane trimethacrylate (TMPTMA), oxybenzone (HMBP) and drometrizole (TIN P) leaching from specimens of four commonly used resin-based dental materials in ethanol and an aqueous solution. All analyses were performed by use of GC/MS, each component was quantified separately and the results presented in microg mm(-2). This study has shown that elution from various materials differs significantly, not only in the types of eluates, but also regarding amounts of total and of single components. A high amount of HMBP, a UV stabilizer with potential estrogenic activity, was detected from one material in both solutions.

Effects of two multi-step self-etch primer/adhesives on apoptosis in human gingival fibroblastsin vitro

Various in vitro studies have shown induction of apoptosis by monomers incorporated to dental restorative materials and adhesive resins, while information regarding the effect of monomer combinations as commercially available products on apoptosis is limited. The aim of this study was to investigate the effects of two multi-step self-etch primer/adhesive systems on apoptosis of cultured primary human gingival fibroblasts. Cells were treated up to 48 h with Clearfil SE Bond (Kuraray, Japan) and FL Bond (Shofu, Japan) at 1:1000 v:v ratio to determine cell proliferation, using 0.02 mM staurosporine as positive control. Apoptosis was assessed using propidium iodide/acridine orange (PI/AO) staining, compared to nontreated controls. When compared to FL Bond, exposure of gingival fibroblasts to Clearfil SE Primer and Clearfil SE Bond resulted in a higher degree of cell proliferation. PI/AO staining revealed typical morphological features of apoptosis in FL Bond and Staurosporine groups, while some cells cultured in the presence of primer and adhesive components of Clearfil SE Bond showed nuclear fragmentation, indicative of early apoptosis. Our results indicate that apoptotic potential of the multi-step self-etch adhesives were material-dependent within the 48 h test period.

In vivo evaluation of the biocompatibility of three current bonding agents

The aim of this in vivo study was to evaluate the biocompatibility of three current bonding agents and calcium hydroxide cement. Sixty polyethylene tubes filled with the following materials: Group 1: Prime & Bond NT (PB-Dentsply, US; Group 2: Bond 1 (BO-Jeneric/Pentron, US); Group 3: Optibond Solo (OP-Kerr, US); and Group 4 (control): calcium hydroxide cement - Dycal (CH-Dentsply, US) were implanted into the connective tissue of 30 rats. After 15, 30 and 60 days, the implants were excised and the animals sacrificed. The biopsies were immersed in Karnovsky (pH, 7.2) fixative solution for 48 hours, and processed using routine histological technique. Six-micron-thick sections were cut and stained with hematoxilin and eosin and Masson's trichome technique. Microscopic evaluation was used to compare the connective tissue reactions caused by the experimental and control materials adjacent to the tube opening. At 15 days, the experimental and control materials triggered a moderate to intense inflammatory response which gave rise to a thick capsule adjacent to the tube opening. With time, the inflammatory reaction decreased. At 60 days, the connective tissue adjacent to the bonding agents exhibited a persistent inflammatory response mediated by macrophages and giant cells which were engulfing displaced resin components. On the other hand, for the control group (calcium hydroxide) no inflammatory response associated with a thin capsule adjacent to the material was observed even at the 30-day period. The hard-setting calcium hydroxide cement allowed complete healing and was considered more biocompatible than the bonding agents.

Antibacterial Effect of Selected Root-End Filling Materials

The purpose of this study was to evaluate the antibacterial activity of leachable components of selected root-end filling materials: amalgam, ProRoot MTA (mineral trioxide aggregate), Intermediate Restorative Material (IRM), Super Bond C&B, Geristore, Dyract, Clearfil APX composite with SE Bond, or Protect Bond. The direct contact test (DCT) with Staphylococcus aureus, Enterococcus faecalis, and Pseudomonas aeruginosa, was used. The materials were tested immediately after application to the microtiter wells (fresh samples) and after setting for 3 days (set samples). Ten microliters of bacterial suspension was added to each well for direct contact with each material for 1 h at 37 degrees C. Growth of surviving bacteria was then measured in a microplate spectrophotometer hourly at 620 nm for 15 h. Twelve uncoated wells using identical inoculum size served as positive controls. The data obtained at the end of 15 h was subjected to one-way ANOVA and post hoc comparisons were done using Tamhane's T2 test. Fresh samples of all materials showed a 3-h delay in exponential growth of both E. faecalis and S. aureus, and a 5-h delay in growth of P. aeruginosa. Set samples of IRM and ProRoot MTA cements showed generally greater antibacterial activity than the other materials: both completely inhibited P. aeruginosa, and both delayed or limited growth of E. faecalis. The DCT, by being quantitative and virtually independent of solubility and diffusion, was found suitable to assay solid root-end filling materials. IRM and ProRoot MTA were generally more potent inhibitors of bacterial-growth than the other tested materials.

Effect of N-acetyl-l-cysteine on ROS production and cell death caused by HEMA in human primary gingival fibroblasts

Previous investigations have shown that 2-hydroxyethyl methacrylate (HEMA) causes reactive oxygen species (ROS) production, which in turn affects cell survival and cell death. The purpose of this study was to evaluate the effects of the antioxidant N-acetyl-L-cysteine (NAC) on HEMA-induced toxicity in human primary gingival fibroblasts (HGF). HGF were treated with various concentrations of HEMA (0-12 mm) in the absence and presence of NAC (1, 5, and 10 mm). The 3-(4,5 dimethyiazol-2-1)-2-5-diphenyl tetrazolium bromide (MTT) assay was used to evaluate the mitochondrial dehydrogenase activity after HEMA exposure. Viability and cell death were determined by flow cytometry using Annexin V and PI staining. ROS production was detected by the increasing fluorescence of the oxidation-sensitive dye 2',7'-dichlorofluorescein diacetate (DCFH-DA) after HEMA treatment. After a 24h incubation period, HEMA concentrations higher then 10mm caused a decrease of cell viability, mitochondrial activity, and an increase of cell death. HEMA concentrations of 4-12 mm markedly increased ROS levels in a dose-dependent manner. High NAC concentrations (5 and 10 mm) significantly reduced cell death, and restored the mitochondrial activity after a 24 h co-treatment, but 1 mm NAC increased HEMA toxicity (p<0.05). All NAC concentrations significantly reduced ROS levels induced by HEMA after a 2 h exposure (p<0.05), but no such reduction was observed after a 4 h treatment. Furthermore, treatment with 10 mm HEMA and 1 mm NAC for 6h caused an increase in ROS levels compared to 10 mm HEMA alone (p<0.05). In conclusion, our results suggest that high NAC concentrations protect HGF against HEMA cytotoxicity by reducing the induced ROS levels.

Identification of 2,3-epoxymethacrylic acid as an intermediate in the metabolism of dental materials in human liver microsomes

OBJECTIVES

In previous studies it could be demonstrated that methacrylic acid (MA) is an intermediate in the metabolism of unpolymerized dental comonomers, released from dental restorative materials. This study was performed to identify the possible dental material intermediate 2,3-epoxymethacrylic acid (2,3-EMA) from MA in human liver microsomes. Most epoxy compounds are regarded as highly toxic substances.

METHODS

The formation and hydrolysis were studied in defined systems containing only MA and human liver microsomes at 37 degrees C. Hydrolysis was inhibited by cyclohexene oxide, a competitive inhibitor of epoxide hydrolase. The reaction product 2,3-EMA was analyzed by the headspace gas chromatography-mass spectrometry. After 5, 30, and 60 min samples were taken and analyzed.

RESULTS

For the reaction of MA to 2,3-EMA the average conversion rate was about 5% within 1h. It was found that without cyclohexene oxide the rate constant of enzymatic hydrolysis at pH 7.4 was about 10 times higher than the rate constant of the formation from MA in combination with cyclohexene oxide (k=8.3 versus 0.83 micromol/l min), indicating an instability and thus a high reactivity of 2,3-EMA. The formation of the MA intermediate 2,3-EMA was not observed when heat-inactivated liver microsomes were used (controls).

SIGNIFICANCE

It could be clearly demonstrated that 2,3-EMA is a product of dental material metabolisms in biological systems. Therefore, increased toxicity might occur on dental restorative materials which are able to release (co)monomers which can be metabolized to MA.

Identification of organic extractables from commercial resin-modified glass-ionomers using HPLC-MS

Elution of organic compounds from resin-based dental fillings during their application in the human mouth environment may have a potential impact on the human health. Ethanol, water and other solvents very often present in the human mouth have the ability to penetrate dental fillings placed in the human tooth. Penetration of liquids into the tooth may lead to the liberation of unreacted dental filling ingredients or their degradation products. Determination of these compounds is necessary for better knowledge from possible harmful effects caused by dental fillings. The aim of this study was the isolation and identification of compounds released from resin-modified glass-ionomer cements (RMGICs), resin-based dental materials applied in dentistry. Compounds were extracted from fillings by using four solvents (40% ethanol, water, 1% acetic acid and artificial saliva). Liquid samples containing eluted compounds were then extracted, evaporated and analyzed by using of HPLC-MS (high-performance liquid chromatography-mass spectrometry) and HPLC-DAD (high-performance liquid chromatography-diode array detection) techniques. Almost thirty components (monomers and additives) of RMGICs were identified. The main identified extractables were: Bis-GMA (bisphenol A glycidyl dimethacrylate), Bis-EMA (ethoxylated bisphenol A dimethacrylate), UDMA (urethane dimethacrylate), TEGDMA (triethylene glycol dimethacrylate), HEMA (2-hydroxyethyl methacrylate) as monomers and diphenyliodonium chloride, camphorquinone (initiators), BHA (inhibitor), 4-(dimethylamino) ethyl benzoate (co-initiator) as additives.

Application of HS-SPME in the determination of potentially toxic organic compounds emitted from resin-based dental materials

Leaching of volatile substances from resin-based dental materials may have a potential impact on the biocompatibility as well as safety of these materials. Information from manufacturers on ingredients in the materials is very often incomplete. Patients and dentists may be in contact with components emitted from cured dental fillings or from substrates applied in their preparation. Therefore, determination of the components of these materials is necessary for better prevention from possible harmful effects caused by dental fillings. The aim of this work was the isolation and identification of organic compounds evolved from four commercial resin-modified glass-ionomer cements (resin-based dental materials applied in dentistry) by using an alternative method of volatile compounds analysis-HS-SPME (headspace-solid phase microextraction). Dental materials were heated in closed vial at various temperatures and volatile substances released into the headspace phase above the sample were isolated on a thin polymeric fibre placed in SPME syringe. Identification was performed by using the GC-MS (gas chromatography-mass spectrometry) technique. Almost 50 RMGIC (resin-modified glass-ionomer cement) components (monomers and additives) were identified. The main identified leachables were: iodobenzene (DPICls-diphenyliodonium chloride degradation product), camphorquinone (photo-initiator), tert-butyl-p-hydroxyanisole (inhibitor), 4-(dimethylamino)ethyl benzoate (co-initiator), ethylene glycol dimethacrylate (monomer).