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

The effect of N-acetyl-l-cysteine and ascorbic acid on visible-light-irradiated camphorquinone/N,N-dimethyl-p-toluidine-induced oxidative stress in two immortalized cell lines

Recent studies have revealed that visible-light (VL)-irradiated camphorquinone (CQ), in the presence of a tertiary amine (e.g., N,N-dimethyl-p-toluidine, DMT), generates initiating radicals that may indiscriminately react with molecular oxygen forming reactive oxygen species (ROS). In this study, the ability of the antioxidants N-acetyl-l-cysteine (NAC) and ascorbic acid (AA) to reduce intracellular oxidative stress induced by VL-irradiated CQ/DMT or VL-irradiated hydrogen peroxide (H(2)O(2)) was assessed in an immortalized Murine cementoblast cell line (OCCM.30) and an immortalized Murine fibroblast cell line, 3T3-Swiss albino (3T3). Intracellular oxidative stress was measured with the membrane permeable dye, 2',7'-dichlorodihydrofluorescein diacetate (H(2)DCF-DA). VL-irradiated CQ/DMT and VL-irradiated H(2)O(2) each produced significantly (p<0.001) elevated intracellular oxidative levels in both cell types compared to intracellular ROS levels in VL-irradiated untreated cells. OCCM.30 cementoblasts were found to be almost twice as sensitive to VL-irradiated CQ/DMT and VL-irradiated H(2)O(2) treatment compared to 3T3 fibroblasts. Furthermore, 10mm NAC and 10mm AA each eliminated oxidative stress induced by VL-irradiated CQ/DMT and VL-irradiated H(2)O(2) in both cell types. Our results suggest that NAC and AA may effectively reduce or eliminate oxidative stress in cells exposed to VL-irradiated CQ/DMT following polymerization.

Induction of cyclooxygenase-2 expression in human pulp cells stimulated by dentin bonding agents

OBJECTIVES

Histological investigations have demonstrated that dentin bonding agents can induce pulpal inflammation. However, there is little information on the precise mechanisms about dentin bonding agent-induced pulpal inflammation. Cyclooxygenase-2 (COX-2) is an inducible enzyme believed to be responsible for prostaglandin synthesis at the site of inflammation. The aim of this study was to investigate the effects of dentin bonding agents on the expression of COX-2 in human pulp cells.

STUDY DESIGN

Human pulp cells were cultured from extracted impacted third molars using an explant technique. Patients gave informed consent. The reverse-transcriptase polymerase chain reaction and Western blot assays were used to investigate the effects of cultured human pulp cells exposed to dentin bonding agents. In addition, NS-398 (a selective COX-2 inhibitor) was added to test how it modulated the cytotoxic effects of dentin bonding agents.

RESULTS

The exposure of quiescent human pulp cells to dentin bonding agents resulted in the induction of COX-2 mRNA and protein expression. The expression of COX-2 signals depended on the materials tested. In addition, NS-398 at noncytotoxic dose was not able to prevent dentin bonding agent-induced cytotoxicity (P > .05).

CONCLUSION

The activation of COX-2 expression may be one of the pathogenesis of dentin bonding agent-induced pulpal inflammation. In addition, dentin bonding agent-induced cytotoxicity is not directly via the induction of COX-2 expression.

Antibacterial activity of glass-ionomer cements, compomers and resin composites: relationship between acidity and material setting phase

Agar diffusion testing was used with four different media to evaluate the antibacterial activity of six products (one conventional glass-ionomer cement (GIC), two light-activated glass-ionomers, two polyacid-modified resin composites and one resin composite) on Streptoccoccus mutans. Their respective antibacterial activities were also compared during and after setting. The relationship between product acidity and antibacterial activity was evaluated. All the GICs demonstrated antibacterial properties in contrast to the polyacid-modified resin composites and resin composite which did not shown any antibacterial effects. Vitrebond GIC exhibited higher antibacterial action, probably because of a cytotoxic photo-initiator diphenyliodoniumchloride. A direct relationship between material acidity and growth inhibition of S. mutans was observed.

Comparison of different test models for the assessment of cytotoxicity of composite resins

This study compared the use of different test models to assess the cytotoxicity of a dental composite. The cytotoxicity of a composite polymerized using two halogen-based light-curing units (LCUs) (Max LC and Astralis) and two light-emitting diode LCUs (E-light and Freelight) served as the basis of comparison. Disk-shaped specimens (7 mm diameter, 2 mm high) were fabricated using the four different light sources. The specimens were used in several cytotoxicity test models: direct and indirect contact tests as well as an extract test with an established cell line L-929. The cells were stained with neutral red after cell-material contact for 48 h. Neutral red-stained areas (in mm2, for direct and indirect tests) and absorbance readings (for extract tests) were analysed statistically using ANOVA and the Tukey post hoc test, with P < 0.05 considered to be significantly different. Good correlation between direct and indirect contact tests (r = 0.903) was found. The extract test was the least correlated among the three tests. It was found that the E-light + Freelight-cured composite elicited cytotoxicity from the correlated studies. Uncured specimens were most detrimental to the cells in all tests. Our data demonstrated that composite cured with light-emitting diode LCUs were cytotoxic to L-929 cells. Different test models were found to give rise to different findings. Thus, a good cell-material contact method would replicate more closely the physiological situation in vivo. This in turn would give more clinically relevant results.

Adverse effects of human pulps after direct pulp capping with the different components from a total-etch, three-step adhesive system

OBJECTIVES

The objective was to evaluate the response of human pulps capped with different components from a total-etch three-step adhesive system.

METHODS

Direct pulp capping was performed in 25 caries-free human premolars scheduled for extraction due to orthodontic treatment. The teeth were randomly divided in five groups, and capped with the following materials: Group 1-acid+primer+adhesive were used as recommended; Group 2-only primer was applied; Group 3-only bonding resin (light-cured for 10s); Group 4-only composite resin (light-cured for 40s); Group 5-calcium hydroxide. After capping, all teeth were restored with ScotchBond Multi Purpose Plus and Z-100 was placed incrementally. After 60 days, the teeth were extracted and processed for light microscopic examination (H/E) according to a histological score system. These were subjected to non-parametric tests (alpha<0.05).

RESULTS

Overall, the histological features showed that groups 1-4 were quite similar and inferior to group 5. In groups 1-4 the pulp response varied from acute inflammatory cell infiltrate with varying degrees to necrosis. The groups 3 and 4 showed a trend towards better pulp response, since a normal connective tissue could be observed in more than half of the sample. All teeth from group 5 showed normal connective tissue below an amorphous dentin bridge.

SIGNIFICANCE

Adhesive components (primer or adhesive) as well as a composite should be avoided for pulp capping. Ca(OH)(2) should be the first choice for pulp capping.

The effect of camphorquinone (CQ) and CQ-related photosensitizers on the generation of reactive oxygen species and the production of oxidative DNA damage

Recent evidence suggests that following visible-light (VL) irradiation, CQ and the CQ-related photosensitizers benzil (BZ), benzophenone (BP), and 9-fluorenone (9-F) generate initiating radicals that may indiscriminately react with molecular oxygen forming reactive oxygen species (ROS). The purpose of this investigation was to determine whether VL-irradiated CQ, BZ, BP, and 9-F cause DNA damage due to the generation of ROS in vitro. ROS formation by CQ and CQ-related photosensitizers+/-dimethyl-p-toluidine (DMT) was investigated in a cell-free system with VL irradiation. DNA damage was determined using PhiX-174 RF I supercoiled double-stranded plasmid DNA and ROS quantified with 4-((9-acridinecarbonyl)amino)-2,2,6,6-tetramethylpiperidin-1-oxyl (TEMPO-9-AC), a fluorogenic ROS-sensitive probe. VL-irradiated CQ, BZ, BP, and 9-F (+/-DMT) produced significant DNA damage at 0.1, 0.5, and 1.0 mM and in a concentration-dependent manner (p<0.05). TEMPO-9-AC revealed that all investigated VL-irradiated photosensitizers produced significant amounts of ROS with BZ in the presence of DMT generating the most ROS after 30, 60, and 90 min. VL-irradiated CQ, BZ, BP, and 9-F +/-DMT continued to generate significant amounts of ROS 90 min after VL irradiation. As a result, future investigations should evaluate the effect of VL-irradiated photosensitizers in cells and possible protective effects provided by antioxidants.

Selective Influence of Dentin Thickness upon Cytotoxicity of Dentin Contacting Materials

The effect of three dentin contacting materials on three-dimensional cultures of pulp-derived cells was evaluated in a dentin barrier test device. The test materials (Syntac Classic, Prompt L-Pop, Vitrebond) were applied on dentin disks of different thicknesses ranging from 100 to 500 microm. After 24 h of exposure with and without perfusion of the test chamber, cell survival was evaluated using the MTT assay and related to a nontoxic control material. Syntac Classic decreased cell activity significantly (p </= 0.0003), independently of the dentin thickness. For Prompt L-Pop and Vitrebond a significant influence of dentin thickness was found on the cell reaction. After exposure of the control material, photometric readings showed no dependency of the cellular reaction on dentin thickness (p > 0.05). It could be demonstrated that dentin acts as a barrier, decreasing the elicited cytotoxicity with increasing thickness. This effect is material related, showing little influence for the nontoxic or the glutaraldehyde containing material.

Development of highly reactive mono-(meth)acrylates as reactive diluents for dimethacrylate-based dental resin systems

Reactive diluents such as triethyleneglycol-dimethacrylate (TEGDMA) have been widely used with bisphenol-A-glycidyl-dimethacrylate (Bis-GMA) to achieve restorative resins with appropriate viscosity and higher conversion. However, additional water sorption and polymerization shrinkage were also introduced. The aim of this work is to investigate whether the cure and material properties can be improved in dental resins containing novel mono-(meth)acrylates as reactive diluents so that these Bis-GMA-based copolymers have reduced polymerization shrinkage but higher overall double bond conversion. Several ultra-high-reactivity mono-(meth)acrylates that contain secondary functionalities have been synthesized and investigated. The polymerization rate and double bond conversion were monitored using photo-FTIR. Polymerization shrinkage, dynamic mechanical analysis, and flexural strength were characterized. Compared with the Bis-GMA/TEGDMA control, the Bis-GMA/mono-methacrylate systems studied showed higher final conversions, faster curing rates, and decreased polymerization shrinkage. Our optimum system Bis-GMA/morpholine carbamate methacrylate achieved 86% final conversion (vs. 65%), a polymerization rate 3.5 times faster, and a 30% reduction in polymerization volumetric shrinkage. These results indicate that certain highly reactive, novel mono-(meth)acrylates possess very promising potential to replace TEGDMA as reactive diluents and can readily be applied to develop superior dental resins.

Influence of pH and time on organic substance release from a model dental composite: a fluorescence spectrophotometry and gas chromatography/mass spectrometry analysis

In this study we assessed the influence of pH and time on the degradation and elution of organic substances from the composite resin material, Z-100. To accomplish this, fluorescence spectrophotometry was evaluated as an appropriate technique for the identification of six organic substances (methacrylic acid, methyl methacrylate, hydroquinone, ethylene glycol dimethacrylate, triethylene glycol dimethacrylate and 4,4'-isopropylidenediphenol) that were eluted from resin composite material stored for 24 h or 6 months at pH 4.0, 6.0 or 8.0. In addition, complementary analyses (solid-phase microextraction/gas chromatography/mass spectrometry) were carried out to identify and quantify the substances. The main substances leached from the resin composite were methacrylic acid, triethylene glycol dimethacrylate and hydroquinone. It was concluded that fluorescence spectrophotometry seems to be a suitable, non-destructive technique for the qualitative analysis of eluted organic components. Critical combinations of time and pH allowed the elution of several organic substances, predominantly methacrylic acid, triethylene glycol dimethacrylate and hydroquinone, from the model resin composite, Z-100.

The effectiveness of compomer as a root-end filling: a clinical investigation

OBJECTIVE

This study investigates the treatment outcome of a root-end filling technique that uses a light-cured compomer combined with a light-cured dental adhesive.

STUDY DESIGN

The study used 34 single-rooted teeth restored with post, core, and crowns. A shallow concave apical preparation was filled with a light-cured compomer with a light-cured dental adhesive. As a control, a chemically cured glass ionomer was used with a conventional root-end preparation. A follow-up clinical and radiographic evaluation of the treatment result was conducted after 1 year.

RESULTS

A significantly higher success rate (P<.015) was observed in the treatment group that used a compomer (89% complete healing) compared to glass ionomer (44% complete healing).

CONCLUSIONS

When used as a retrograde root filling in a shallow concave preparation, a light-cured compomer and a dental adhesive improves healing regardless of the quality of the remaining root filling.

Separation of ethoxylated bisphenol A dimethacrylates in dental composite after derivatisation to ionisable amines by capillary zone electrophoresis

Bisphenol A ethoxylate dimethacrylates (Bis-EMA) are transformed into ionisable amines by derivatisation in order to make the analytes applicable to capillary electrophoresis. For this goal, piperidine was added onto the C=C double bond of the alpha,beta-unsaturated ester group forming a tertiary amine with pKa values between 9 and 10. Formation of the derivatives was confirmed by electrospray ionisation MS. Commercial Bis-EMA is a mixture of homologues with different number of ethoxy groups; it is characterised by the average number of the ethoxy groups in the chains. These homologues were resolved by capillary zone electrophoresis at pH 4. It is shown for the product with an average of four ethoxy groups per Bis-EMA molecule that about seven homologues can be baseline separated when differing by only one ethoxy group. For Bis-EMA with 30 ethoxy groups in average, about 23 homologues could be differentiated. The high resolution power of capillary zone electrophoresis enables characterisation of commercial dental composite material concerning the Bis-EMA constituents.

Resin composite monomers alter MTT and LDH activity of human gingival fibroblasts in vitro

OBJECTIVES

Substances such as monomers may be released from composite resin systems and may induce adverse effects in biological tissues. The aim of this study is to investigate the cytotoxic concentrations of resin composite monomers on cultures of human gingival fibroblasts.

METHODS

A range of dilutions of five resin composite monomers (HEMA, HPMA, DMAEMA, TEGDMA, and Bis-GMA) were added to the culture medium of human gingival fibroblasts for 24 h. Their cytotoxic effects were measured by using two colorimetric functional assays, mitochondrial dehydrogenase activity (MTT) and lactate dehydrogenase activity (LDH) assay. The logP values (water/octanol partition) of test monomers were also calculated computationally.

RESULTS

Mitochondrial reducing activity assessed with the MTT test was inhibited by all monomers and all the monomers increased the LDH release in a reproducible dose dependent manner. A wide range of TC 50 values (concentrations altering MTT and LDH activity by 50%) (0.32-5.8 mM by MTT assay and 0.36-6.7 mM by LDH assay) was observed. Ranking of composite resin monomer cytotoxicities (TC 50) were similar for both the MTT and LDH assays, (Bis-GMA>TEGDMA>DMAEMA>HPMA >HEMA). However, the MTT assay was found to be more sensitive than the LDH assay, particularly when lower doses of the tested monomers were determined. The ranking of TC 50 concentrations correlated with the calculated logP values.

SIGNIFICANCE

Monomers used in dental restorative materials show a variety of toxic effects on gingival fibroblasts. A combination approach using MTT and LDH assays provides valuable information about their toxic effects.

The use of glass ionomer cements in both conventional and surgical endodontics

The capacity to bond to dental tissues, especially to dentine, their long-term fluoride release and their biocompatibility make glass ionomer cements (GICs) advantageous for use in endodontics, as well as in restorative dentistry. This review provides information on the basic properties of GICs, such as adhesion, antimicrobial effects and biocompatibility, particularly as they relate to use in endodontics. Indications for the use of GICs in endodontics are orthograde root canal sealing, root-end filling, repair of perforations and root resorption defects, treatment of vertical fractures and maintenance of the coronal seal. The paper includes a review on each of these indications. It is concluded that in spite of the critical handling characteristics and the inconclusive findings regarding sealing ability and antimicrobial activity, there is substantial evidence to confirm their satisfactory clinical performance. Both soft tissue and bone compatibility make them suitable for use during endodontic surgery.

Biocompatibility of resin-based materials used as pulp-capping agents

AIM

To evaluate and compare the response of pulps of rats capped with resin-modified glass-ionomer cement (RMGIC) or self-etching adhesive system.

METHODOLOGY

Class I cavities were prepared on the occlusal surface of 54 maxillary first molars of 27 rats. Pulp exposure was performed on the cavity floor. The following resin-based materials were applied as pulp-capping agents: G1, Clearfil Liner Bond 2V (CLB 2V; Kuraray Co., Japan); G2, Vitrebond (VIT; 3M/ESPE, USA). In group 3 (control group), a calcium hydroxide/saline paste (CH; Labsynth, Brazil) was used. The cavities were restored with amalgam. After 7, 30 and 60 days, the animals were sacrificed and the jaws were processed for microscopic evaluation.

RESULTS

Despite the inflammatory response caused by the experimental and the control materials at 7 days, pulpal healing associated with calcified barrier formation was observed at 60 days following the pulp therapy. Both resin-based materials promoted a large zone of cell-rich fibrodentine matrix deposition on the pulp horn related to the pulp exposure site, which was larger to VIT than to CLB 2V specimens. Tertiary dentine underneath the fibrodentine matrix was deposited by a layer of elongated pulpal cells. The remaining pulpal tissue exhibited normal histological characteristics. In the control group, healing and dentine-bridge formation was observed at 30 days. Pulpal breakdown occurred only when bacterial infection occurred.

CONCLUSION

Both experimental pulp-capping agents allowed pulpal healing characterized by cell-rich fibrodentine and tertiary dentine deposition as well as calcified barrier formation.

Short-term evaluation of the pulpo-dentin complex response to a resin-modified glass-ionomer cement and a bonding agent applied in deep cavities

OBJECTIVES

To evaluate the response of the pulpo-dentin complex following application of a resin-modified glass-ionomer cement or an adhesive system in deep cavities performed in human teeth.

METHODS

Deep class V cavities were prepared on the buccal surface of 26 premolars. In Group 1 the cavity walls (dentin) and enamel were conditioned with 32% phosphoric acid and the dentin adhesive system One Step (Bisco, Inc., Itasca, IL, USA) was applied. In Groups 2 and 3, before total etching and application of bonding agent, the cavity floor was lined with the resin-modified glass-ionomer cement-Vitrebond (3M ESPE Dental Products Division, St. Paul, MN, USA) or the calcium hydroxide cement-Dycal (control group, Dentsply, Mildford, DE, USA), respectively. The cavities were restored using light-cured Z-100 composite resin (3M ESPE). The teeth were extracted between 5 and 30 days and prepared for microscopic assessment. Serial sections were stained with H/E, Masson's trichrome and Brown and Brenn techniques.

RESULTS

In Group 1, the inflammatory response was more evident than in Groups 2 and 3. Diffusion of dental material components across dentinal tubules was observed only in Group 1, in which the intensity of the pulp response increased as the remaining dentin thickness decreased. Bacteria were evidenced in the lateral walls of two samples (Group 2) which exhibited no inflammatory response or tissue disorganization.

CONCLUSIONS

Based on the experimental conditions, it was concluded total acid etching followed by application of One Step bonding agent cannot be recommended as adequate procedures. In this clinical condition the cavity walls should be lined with a biocompatible dental material, such as Vitrebond or Dycal.

Induction of cyclooxygenase-2 mRNA and protein expression by dentin bonding agents in human gingival fibroblasts

An ideal dentin bonding agent should be nonirritating to surrounding tissues. Unfortunately, all histological investigations have demonstrated that dentin bonding agents can induce mild to severe inflammatory alterations. However, there is little information on the precise mechanisms about dentin bonding agents-induced inflammatory reaction. Cyclooxygenase-2 (COX-2) is an inducible enzyme believed to be responsible for prostaglandin synthesis at the site of inflammation. The aim of the present study was to investigate the effects of three dentin bonding agents, Clearfil SE Bond, Prime & Bond NT, and Single Bond on the expression of COX-2 mRNA gene and protein in cultured human gingival fibroblasts. The exposure of quiescent human gingival fibroblasts to dentin bonding agents resulted in the induction of COX-2 mRNA expression. The investigations of the time-dependent on COX-2 mRNA expression in dentin bonding agent-treated human gingival fibroblasts revealed different patterns. The influence of COX-2 mRNA depended on the tested materials. In addition, all dentin bonding agents also induced COX-2 protein expression in human gingival fibroblasts. Taken together, the activation of COX-2 expression may be one of the potential mechanisms of dentin bonding agent-induced gingival inflammation.

In vitro cytotoxicity of five glass-ionomer cements

To evaluate the cytotoxic effects of five glass-ionomer cements (GICs) on an odontoblast cell line (MDPC-23), disks of every material were prepared and divided into Group 1: Vitrebond, Group 2: Vitremer, Group 3: Fuji II LC, Group 4: Fuji IX GP, Group 5: Ketac-Molar, Group 6: Z-100 (positive control). In Group 7, phosphate-buffered saline solution (negative control) was applied on filter paper. After placing the samples in the bottom of wells, the cells (30,000cells/cm(2)) were plated and incubated for 72h. The cell number was counted, the cell morphology was assessed by scanning electron microscopy and the cell metabolism was evaluated using methyltetrazolium assay. The statistical analysis of Kruskal-Wallis was used to determine if the scores obtained for the cell metabolism and number of cells were different at the 95% confidence level. In groups 1, 2, 3, 4, 5, and 6 the materials decreased the cell number by 74.5%, 75.5%, 45.5%, 29.5%, 32.5%, and 88.5%, respectively. In groups 1, 2, 3, 4, and 5, the experimental GICs reduced the cell metabolism by 79%, 84%, 54%, 40%, and 42.5%, respectively. Despite the fact that all experimental materials were cytotoxic to the MDPC-23 cells, the GICs were the least cytotoxic. On the other hand, the RMGICs caused the highest cytophatic effects.

Toughness, bonding and fluoride-release properties of hydroxyapatite-added glass ionomer cement

Improving the mechanical strength of glass ionomer cement while preserving its favorable clinical properties such as fluoride release, bonding to tooth structure and biocompatibility is desirable. In this study, hydroxyapatite was incorporated into chemically setting glass ionomer cement and its effect on the fracture toughness, bonding to dentin and fluoride release was identified. Commercial glass ionomer cement (Fuji IX GP((R)) ) was the control and base material. Eight weight percent of hydroxyapatite was added into the glass ionomer powder. Specimens were fabricated and the fracture toughness, shear bond strength and eluted fluoride ion concentration were measured. Adding hydroxyapatite into the glass ionomer cement led to significantly higher fracture toughness after 15min and 24h from mixing. The hydroxyapatite-added cement also exhibited bond strength to dentin similar to that of the control from 15min to 56 days and consistent fluoride release for 13 weeks. SEM findings showed a cohesive type of fracture in the material for all specimens in both groups. These results indicate that hydroxyapatite-added glass ionomer cement has a potential as a reliable restorative material with improved fracture toughness, long-term bonding to dentin and unimpeded ability of sustained fluoride release.

Identification of organic eluates from four polymer-based dental filling materials

Elution from polymer-based dental filling materials may have a potential impact on the biocompatibility of the materials. Since information from the manufacturers about ingredients in the materials often is incomplete, analyses of eluates from the materials are necessary for a better knowledge about possible harmful compounds. The aim of this study was to identify organic eluates from polymerized samples of two composites, one compomer and one resin-reinforced glass ionomer cement. Samples were immersed in ethanol or Ringer's solution. Organic leachables were analyzed by gas chromatography-mass spectrometry. Identification was confirmed with reference substances, if available. Among components detected were monomers, co-monomers, initiators, stabilizers, decomposition products and contaminants. Thirty-two substances were identified and 17 were confirmed with reference substances. From elution in Ringer's we identified 13 eluates from Tetric Ceram, 10 from Z250, 21 from Dyract and six from Fuji II LC; HEMA, HC and CQ were found in all samples. From elution in ethanol 12 eluates from Tetric Ceram, 18 eluates from Z250, 19 from Dyract and 10 from Fuji II LC were identified. The diversity of eluates from the four materials under study is demonstrated. Owing to variation between the materials, the biocompatibility including the allergenic potential may be different.

Effect of bleaching agents on the fluoride release and microhardness of dental materials

The use of bleaching agents has become a popular procedure for whitening teeth. Recently introduced polyacid-modified composite resins (compomers) have several favorable features, such as improved physical properties and fluoride release. Because these two materials have many possibilities to interact in the oral cavity during dental treatment, it is necessary to understand such interaction. To evaluate the effect of a bleaching agent on dental restoratives, three compomers were photopolymerized and then bleached for 1, 2, 3 and 5 days with the use of 30% hydrogen peroxide. Fluoride release, surface microhardness, and surface modifications were evaluated. It was found that the cumulative fluoride release was found to be linearly correlated to the tested periods of bleaching in all compomers. Among the tested compomers, F2000 showed the highest cumulative fluoride release. Bleached compomers became soft because of surface degradation, so the surface microhardness decreased. F2000 showed an apparent crack formation that was not observed in other compomers. The nearly linear correlation between the filler content and microhardness was found in the control samples. However, the same correlation was not observed after the compomers were stored in a bleaching agent or distilled water.

Dentin bonding agents induce c-fos and c-jun protooncogenes expression in human gingival fibroblasts

An important requirement for a dentin bonding agent is biologic compatibility; the bonding agent usually remains in close contact with living dental tissues over a long period of time. Information on the genotoxicity/mutagenicity and cacinogenicity potentials of dentin bonding agents is rare. It has been shown that c-fos and c-jun are induced rapidly by a variety of chemical and physical stimuli. Little is known about the induction of cellular signaling events and specific gene expression after cell exposure to dentin bonding agents. Therefore, we used primary human gingival fibroblasts to examine the effect of six dentin bonding agents on the expression of c-fos and c-jun protooncogenes to evaluate the genotoxicity/mutagenicity and cacinogenicity potential of the dentin bonding agents. The levels of mRNA were measured by the quantitative RT-PCR analysis. c-fos and c-jun mRNA expression in dentin bonding agents-treated cells revealed a rapid accumulation of the transcript, a significant signal first was detectable after 1h of exposure. Persistent induction of c-jun and c-fos protooncogenes by dentine bonding agents may distribute systemically to cause some unexpected adverse effects on human beings. It would be necessary to identify the severely toxic compounds and replace these substances by better biocompatible components. Otherwise, leaching of those genotoxicity/mutagenicity and cacinogenicity components must be minimized or prevented.

Response of human pulps following acid conditioning and application of a bonding agent in deep cavities

OBJECTIVES

The aim of this in vivo study was to evaluate the human dental pulp response when a one-bottle adhesive system was applied on etched or unetched deep dentine.

METHODS

Eighteen class V deep cavity preparations were divided in three groups: group 1-total etching + two coats of single bond (SB) + composite resin (Z-100); group 2-enamel etching + two coats of SB + Z-100; group 3-cavity floor lined with a calcium hydroxide liner (Dycal) + acid-etching of enamel and lateral walls + two coats of SB + Z-100. Two teeth were used as intact control group. After 30 days the teeth were extracted and processed through H and E, Masson's trichrome and Brown and Brenn staining techniques.

RESULTS

Moderate inflammatory response, disorganization of pulp tissue, as well as, deposition of thin layer of reactionary dentin were observed in group 1 teeth in which the remaining dentin thickness (RDT) was less than 300 microm. These histological findings appear to be related to long resin tags formation and bonding agent diffusion through dentinal tubules. In group 2, slight inflammatory response was observed only in one tooth in which the RDT was 162 microm. In group 3, all the teeth showed normal histological characteristics which were similar to the intact control group. Presence of bacteria was not correlated with the intensity of pulpal response. The patients reported no symptoms during the experiment. Radiographic evaluation showed no periapical pathology for any of the teeth.

SIGNIFICANCE AND CONCLUSIONS

Acid-etched deep dentin (RDT less than 300 microm) lined with SB causes more intense pulpal response than unetched deep dentin. Based on the results observed in the present study and the conditions in which it was carried out, we recommend the application of a biocompatible liner before etching deep dentin and applying SB.

Cytotoxicity of resin-based restorative materials on human pulp cell cultures

OBJECTIVE

The objective of this study was to determine the cytocompatibility of 5 different extracts of resin-based restorative materials (2 resin-modified glass ionomer cements, 1 compomer, and 2 composite resins) on human pulp cells.

STUDY DESIGN

Set specimens from 2 resin-modified glass-ionomer cements (Fuji II LC and Fuji IX), 1 compomer (Dyract), and 2 composite resins (Tetric and Superfil) were eluted with culture medium for 2 and 5 days. The effects of resin-based restorative materials on human pulp cells were evaluated with cytotoxicity and mitochondrial activity assays.

RESULTS

The results showed that the eluates from resin-modified glass-ionomer, compomer, and composite resins were cytotoxic to primary human pulp cells. In addition, Superfil, Fuji IX, and Tetric demonstrated an inhibitory effect on mitochondrial activity of human pulp cells. It was found that composite resin Superfil was the most toxic restorative material among the chemicals tested.

CONCLUSION

The influence of the cytotoxicity depended on the materials tested. Compomer or light-curing resin-modified glass ionomer may initially react more favorably to pulp cells.

Influence of polymerization conditions on monomer elution and microhardness of autopolymerized polymethyl methacrylate resin

Residual monomer contents and surface hardness are important factors in determining the serviceability of provisional restorations. The intent of this study was to systemically evaluate the effects of curing conditions on provisional polymethyl methacrylate (PMMA) resins which utilize a free-radical polymerization reaction. Combinations of the three curing factors of temperature, pressure, curing environment (water/air) were adjusted during the fabrication of autopolymerized specimen disks. The initial hardness of tested materials was measured with a microhardness tester 1 h after disc fabrication, and the amounts of residual methyl methacrylate (MMA) released into water were analyzed by reverse-phase HPLC after 7 d of water immersion. Results from multiple regressions showed that curing temperature was the dominant factor in improving resin surface hardness, whereas curing in water was the key factor for reducing the quantity of residual monomer. The pressure factor, which was thought to be critical for managing autopolymerized resins, showed no significant influences on the properties tested. ANOVA results showed that provisional PMMA resins cured in hot water, with or without pressure, significantly reduced the amount of residual MMA elution (up to 80%) and increased the microhardness values (up to 50%).

Resinous perforation-repair materials inhibit the growth, attachment, and proliferation of human gingival fibroblasts

The choice of repair material is one of the important factors in the prognosis of the endodontically treated tooth with a perforation defect. The cytotoxicity of perforation-repair materials must be investigated to ensure a safe biological response. The aim of this in vitro study was to evaluate the effect of resin-modified, glass-ionomer cement, compomer, and resin on human-gingival fibroblasts. Human gingival fibroblasts from crown lengthening surgery were cultured by using an explant technique with the consent of the patient. Cytotoxicity was judged by using an assay of tetrazolium bromide reduction. The results showed that resin-modified, glass-ionomer cement Fuji II LC, compomer Compoglass, and resin SpectrumTPH (TPH) were cytotoxic to primary human gingival fibroblast cultures by inhibiting cell growth and proliferation. TPH alone had an effect on cell attachment. It was found that TPH was the most cytotoxic repair material among those tested in all cultures. The toxicity decreased in the order of TPH>FLC>CG.

Long-term effects of four extraction media on the fluoride release from four polyacid-modified composite resins (compomers) and one resin-modified glass-ionomer cement

It was the aim of the present experiments to evaluate the fluoride leaching of four compomers and one resin-modified glass-ionomer cement (gic) into aqueous media over a 1-year period. Various extraction/equilibrium solutions were applied to simulate important intraoral parameters. Specimens of Dyract, Compoglass F, F2000, one experimental compomer, and the resin-modified gic Fuji II LC were stored for 366 days in distilled water (I), acidic medium (pH 4.2) (II), neutral medium (pH 7.0) (III), or solution III supplemented with 1.6 u/mL porcine liver esterase (IV). Equilibrium media were changed and fluoride concentration was measured every 48 h (first 30 d), thereafter each week (twice), then every 14 d (three times), and finally every 28 d up to a total period of 1 year. Data were statistically analyzed for significant differences by means of Scheffe' tests (p < 0.05). The gic and the compomers leached significantly more fluoride into the acidic solution in the initial phase compared to the other media (p < 0.05). Cumulative fluoride release from all materials (except experimental compomer) was elevated because of esterase activity (p <0.05). Measurable but low quantities of fluoride were segregated into all media during the 1-year period. But no significantly different long-term fluoride release into the various media from the investigated materials was found. The data indicate that plaque-associated organic acids or salivary hydrolases may increase initial fluoride release from resin-modified gics or compomers in the oral cavity. Because long-term fluoride release from all materials decreased to low concentrations within a 30-day period, their caries preventive effect remains questionable.

The effect of dental restorative materials on dental biofilm

To investigate the arrangement of biofilms formed in vivo, volunteers wore splints with slabs of six different dental materials inserted to collect smooth surface plaque. After 5 d of undisturbed plaque accumulation, the specimens were vital stained and analyzed by the confocal laser scanning microscopy (CLSM) to evaluate the percentage of vital biofilm microflora (VF percentage). Further parameters were the area of the specimens covered by plaque (surface coating; SC, %) and the height of the biofilms (BH, pm). The metals amalgam and gold, the compomer, as well as the glass-ionomer cement harboured an almost entirely dead biofilm (VF <8%). Resin composite led to vitality values between 4 and 21%, while a very thin biofilm on ceramic revealed the highest vitality values (34-86%). SC varied from 6% on glass-ionomer cement to 100% on amalgam. BH reached its highest value on amalgam and gold of 17 and 11 microm, respectively, while heights of between 1 and 6 microm were found on the ceramic, resin composite, compomer and the glass-ionomer cement. Within their limits, the present findings indicate that amalgam, gold, compomer and glass-ionomer cement exert an influence against the adhering biofilm. No general relationship could be established between the different parameters VF percentage, SC percentage and BH (microm).

In vitro cytotoxicity of a composite resin and compomer

AIM

This work was designed to investigate the potential cytotoxicity of two of the newer dental restorative materials. Spectrum composite resin and Dyract AP compomer.

METHODOLOGY

Cultured human endothelial cells (ECV-304) were exposed to each of the restorative materials through a 70-microm dentine barrier to simulate the in vivo clinical situation. Cell viability was measured by the MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyltetrazolium bromide) assay and lactate dehydrogenase release assay. The effects of different extents of light-curing were also examined by microscopic examination of stained human promyelocytic leukemia cells (HL-60). Caspase-3 activation was determined as a measure of apoptotic cell death.

RESULTS

Assessment of cellular viability indicated that both materials cause cell death, with Spectrum being the more toxic. The cytotoxicity was considerably increased in the absence of the dentine barrier. Direct exposure to Spectrum for 12 h resulted in the death of 69% of the cells after full light-curing (78% of total death was by apoptosis) and 96% after partial light-curing (73% of total death was by necrosis). Assessment of caspase activation, in the absence of the dentine barrier, showed that longer curing-times resulted in an increase in the proportion of the cells dying through apoptosis, rather than necrosis, for both materials tested.

CONCLUSIONS

These results indicate the restorative materials to be potentially toxic, particularly if the degree of light-cure is inadequate.

Hygroscopic expansion of a compomer and a composite on artificial gap reduction

OBJECTIVE

This study compared the effect of water sorption on the extent of marginal gap reduction in a compomer (Dyract AP, Dentsply) and a composite (Spectrum, Dentsply) over a 12-week storage period.

MATERIALS AND METHODS

Artificial gaps were created in 40 borosilicate glass cylinders, each 5mm deep and with an internal diameter of 5.5mm. Half of the internal bonding surface of each cylinder was sandblasted, silanised and coated with a dentine adhesive (Prime&Bond NT, Dentsply). Twenty partially bonded cylinders were incrementally filled with Dyract AP (AP) and the rest with Spectrum (S). For each material, 10 specimens were stored in de-ionised water (W), and 10 (control) in non-aqueous silicone fluid (O) at 37 degrees C. The dimension of the same maximum gap created in each specimen was repeatedly measured at 0, 1, 2, 4, 6, 8, 10 and 12 weeks, using a light microscope under incident light at 570x magnification. Gap widths in each of the four groups (n=10) were statistically compared. Correlations between mean gap width reduction and storage time were also examined.

RESULTS

Friedman repeated measures ANOVA on ranks revealed significant differences (p<0.001) among the gap widths measured at different time intervals in groups AP-W and S-W. No significant differences (p>0.05) were found in groups AP-O and S-O. Tukey's multiple comparison test indicated that no significant differences (p>0.05) were detectable beyond the sixth week in AP-W and the fourth week in S-W. Linear regression analyses showed that mean gap widths decreased exponentially with time for AP-W (r=0.97) and S-W (r=0.90). From the slopes of the regression lines, the rate of marginal gap reduction in AP-W was 4.6 times faster than S-W.

CONCLUSION

Marginal gap reduction in both the materials are directly attributed to water sorption and that the reduction is larger and more rapid in Dyract AP.

Chemical-Biological Interactions of the resin monomer triethyleneglycol-dimethacrylate (TEGDMA)

Most dental resinous materials contain high quantities of the diluent monomer triethyleneglycol-dimethacrylate (TEGDMA). Due to its 'hydrophilic' nature, significant amounts of this substance leach into an aqueous environment, such as the oral cavity. Therefore, it is hypothesized that TEGDMA frequently interferes with oral and/or systemic tissues. In vitro studies revealed that TEGDMA is considerably cytotoxic in various cell cultures. It has also been observed that TEGDMA can easily penetrate membranes and subsequently may react with intracellular molecules. The formation of glutathione-TEGDMA adducts is of specific interest, since the nearly complete exhaustion of this molecule significantly reduces its cellular detoxifying potency. Large deletions of DNA sequences were caused by TEGDMA, resulting in high mutation frequency. In addition, TEGDMA has been identified as an important resinous sensitizer in patients and professionals. Taken together, available in vitro information, in vivo studies with animals, and clinical data as well indicate that TEGDMA may contribute considerably to local and systemic adverse effects caused by dental resins.

The production of reactive oxygen species by irradiated camphorquinone-related photosensitizers and their effect on cytotoxicity

Camphorquinone (CQ) is widely used as an initiator in modern light-cured resin systems but there are few reports about its effects on living cells. To clarify the mechanism of photosensitizer-induced cytotoxicity, the production of initiator radicals and subsequent reactive oxygen species (ROS) by CQ, benzil (BZ), benzophenone (BP), 9-fluorenone (9-F) in the presence of the reducing agent (2-dimethylaminoethyl methacrylate or N,N-dimethyl-p-toluidine, DMT) with visible-light irradiation was examined in a cell or cell-free system. Initiator radical production was estimated by the reduction rate of 1,1-diphenyl-2-picrylhydrazyl and by the conversion of poly-triethyleneglycol dimethacrylate; the results indicated that CQ/DMT had the highest activity among them. The cytotoxic effects of the photosensitizers on both human submandibular gland (HSG) adenocarcinoma cell line and primary human gingival fibroblast (HGF) showed that the 50% toxic concentration (TC(50)) declined in the order: CQ>BP>9-F>BZ. ROS produced in HSG or HGF cells by elicited, irradiated photosensitizers were evaluated in two different assays, one using adherent cell analysis and sorting cytometry against adherent cells and the other, flow cytometry against floating cells, with fluorescent probes. ROS production was dose- and time- dependent, and declined in the order: BZ>9-F>BP>CQ. Cytotoxic activity was correlated with the amount of ROS. Cytotoxicity and ROS generation in HGF cells was significantly lower than in HSG cells. ROS induced by aliphatic ketones (CQ) were efficiently scavenged by hydroquinone and vitamin E, whereas those by aromatic ketones (9-F) were diminished by mannitol and catalase, suggesting that OH radicals were involved in ROS derived from 9-F. A possible link between the cytotoxic activity and ROS is suggested.

Cytotoxicity testing with three-dimensional cultures of transfected pulp-derived cells

SV40 large T-antigen-transfected bovine pulp-derived cells were grown three-dimensionally on polyamide meshes. For optimal cell growth, various cell numbers and mesh coatings were tested. Next the three-dimensional cultures were used in a dentin barrier test device, and the system was evaluated by testing a set of dental filling materials. After 24 hr exposure with or without perfusion of the pulpal part of the test device, cell survival was evaluated using an MTT assay. In all experiments pulp-derived cells transfected with SV40 large T-antigen grew three-dimensionally on polyamide meshes and showed growth kinetics similar to those on cell culture plates with lag, log, and plateau phases (reached after about 14 days of incubation). Cross-sections of the three-dimensional cell cultures revealed about 15 to 20 cell layers. In vitro cytotoxicity tests resulted in cell survival rates which are in good agreement with in vivo data and with results obtained from cytotoxicity tests with three-dimensional cultures of human foreskin fibroblasts.

Metabolic effects of dental resin components in vitro detected by NMR spectroscopy

Earlier studies have shown that the comonomer triethyleneglycol-dimethacrylate (TEGDMA) and the photostabilizer 2-hydroxy-4-methoxybenzophenone (HMBP) are cytotoxic and inhibit cell growth. It was the aim of this study to elucidate the underlying metabolic effects of TEGDMA and HMBP on immortal contact-inhibited Swiss albino mouse embryo cells (3T3 fibroblasts) by nuclear magnetic resonance (NMR) spectroscopy. Cell extracts and culture media were analyzed by NMR spectroscopy for metabolic changes after incubation for 24 hours with ED20-concentrations of TEGDMA and HMBP. TEGDMA could be detected in all fractions (cytosol, lipid fractions, and culture media) of 3T3 cells, while HMBP was found only in the lipid fraction accumulated at a maximum rate (51 nmol/mg DNA) compared with TEGDMA (27 nmol/mg DNA). TEGDMA increased the concentration of phosphomonoesters to 180+/-36% and decreased the phosphodiesters to 65+/-5% of controls (control = 100%). Thus, the turnover of phospholipids was enhanced, whereas content and composition of phospholipids of membranes did not alter markedly. Additionally, TEGDMA changed the metabolic state of cells, indicated by slight decreases of nucleoside triphosphates and an increase in the ratio of nucleoside diphosphates to nucleoside triphosphates, while HMBP had no effect. The most remarkable effect of TEGDMA was a nearly complete decline of the intracellular glutathione levels. Analysis of our data shows that NMR spectroscopy of cell-material interactions may reveal metabolic effects of organic test substances which are not detectable by standard in vitro assays. The comonomer TEGDMA affected the metabolism of the cells on different levels, while HMBP accumulated in the lipid fraction and induced significantly fewer effects on cell metabolism.

Effects of BisGMA and TEGDMA on proliferation, migration, and tenascin expression of human fibroblasts and keratinocytes

Previous studies have documented a marked cytotoxic potency of BisGMA and TEGDMA. The purpose of this investigation was to determine if these substances also affect proliferation, migration, and tenascin expression of primary human gingival fibroblasts (HGF) and immortalized human keratinocytes (HaCaT). These parameters play an important role in healing wounds. HGF and HaCaT cultures were incubated with TEGDMA and BisGMA. Cell proliferation (BrdU-assay) and migration (Boyden method) were determined 24 h after incubation. Tenascin expression was investigated four and seven days after treatment. Results were statistically evaluated by ANOVA using the Wilcoxon-Mann-Whitney test (p < 0.05). Proliferation of both cell types was significantly inhibited at concentrations > or = 0.25 mM (TEGDMA) or > or = 0.01 mM (BisGMA). Migration of HaCaT was significantly increased after incubation with BisGMA for 24 h. TEGDMA did not alter migration of HGF and HaCaT. In addition, TEGDMA had no effect on tenascin expression of both cell cultures. After 4 days of incubation, BisGMA (at a concentration of 0.01 mM) significantly reduced tenascin production of HaCaT cultures related to cell number. However, 7 days after treatment, BisGMA significantly increased tenascin expression of HGF and HaCaT cultures. Altogether, our results indicate that BisGMA can affect migration of keratinocytes and alters the expression of the extracellular matrix component tenascin. Thus, BisGMA may significantly influence the healing of injured oral tissues.

Biocompatibility of resin-modified filling materials

Increasing numbers of resin-based dental restorations have been placed over the past decade. During this same period, the public interest in the local and especially systemic adverse effects caused by dental materials has increased significantly. It has been found that each resin-based material releases several components into the oral environment. In particular, the comonomer, triethyleneglycol di-methacrylate (TEGDMA), and the 'hydrophilic' monomer, 2-hydroxy-ethyl-methacrylate (HEMA), are leached out from various composite resins and 'adhesive' materials (e.g., resin-modified glass-ionomer cements [GICs] and dentin adhesives) in considerable amounts during the first 24 hours after polymerization. Numerous unbound resin components may leach into saliva during the initial phase after polymerization, and later, due to degradation or erosion of the resinous restoration. Those substances may be systemically distributed and could potentially cause adverse systemic effects in patients. In addition, absorption of organic substances from unpolymerized material, through unprotected skin, due to manual contact may pose a special risk for dental personnel. This is borne out by the increasing numbers of dental nurses, technicians, and dentists who present with allergic reactions to one or more resin components, like HEMA, glutaraldehyde, ethyleneglycol di-methacrylate (EGDMA), and dibenzoyl peroxide (DPO). However, it must be emphasized that, except for conventional composite resins, data reported on the release of substances from resin-based materials are scarce. There is very little reliable information with respect to the biological interactions between resin components and various tissues. Those interactions may be either protective, like absorption to dentin, or detrimental, e.g., inflammatory reactions of soft tissues. Microbial effects have also been observed which may contribute indirectly to caries and irritation of the pulp. Therefore, it is critical, both for our patients and for the profession, that the biological effects of resin-based filling materials be clarified in the near future.

In vitro investigation of aluminum and fluoride release from compomers, conventional and resin-modified glass-ionomer cements: a standardized approach

The amount of fluoride release from dental cements necessary for an anticariogenic effect is not established: moreover, the possible toxic effects due to high fluoride and aluminum release are not well known and the results are still controversial. The aim of our study was to evaluate fluoride (F) and aluminum (Al) release from dental cements using a 'standardized approach' according to the end-use of the materials, i.e. biocompatibility testing. Two polyacid-modified resin composites of recent application, commonly called compomers (Dyract and Dyract Cem), were compared with two conventional acid-based (Fuji I, Ketac-Cem) and two resin-modified (Vitremer, Vitrebond) glass-ionomer cements (GICs). All types of cement are used in dentistry and are commercially available. Extracts of the cements into minimum essential medium, after setting over a 1-h (group A) and 1-week (group B) period, were performed. The extraction conditions were rigorously standardized. Mean values +/- standard deviation of F- and Al-levels in such extracts were measured and were expressed as microg g(-1) (micrograms of ions per gram of cement). A great difference in the amount of ion release, both F and Al, was shown among the tested materials. The GICs, as well as Ketac-Cem, released more F and Al than the compomers. All of the materials released the greatest proportion of ions when the extraction was performed in the first hour after mixing (group A). Al- and F-values showed a highly significant positive correlation, independently from the curing time. We conclude that the biological assessment of dental cements can be performed only if a pre-evaluation of the leachables is obtained by applying a standardized protocol which allows a useful comparison between the different materials.

Effects of long-term sub-lethal concentrations of dental monomers on THP-1 human monocytes

Studies have shown that monomers from dental resins are acutely cytotoxic, but little is known of their long-term effects at sub-lethal concentrations. The current study determined the long-term effects of sub-lethal concentrations of TEGDMA (triethyleneglycol dimethacrylate) and Bis-GMA (bisphenol-glycidylinethacrylate), two common dental monomers, on the in vitro cellular proliferation, succinic dehydrogenase activity, and total cellular protein production of monocytes. Human THP-1 monocytes were exposed to concentrations of 100, 200, and 400 micromol l(-1) of TEGDMA or 1, 5, and 25 micromol l(-1) Bis-GMA for 5 weeks. Controls received only vehicle solutions of ethanol. Each week cellular proliferation (hemocytometer), succinic dehydrogenase (SDH) activity (MTT) and total cellular protein (bicinchoninic acid) were assessed. The results were compared with ANOVA and Tukey intervals (alpha = 0.05). TEDGMA had no proliferative or cellular protein effects, but increased SDH activity 20-60% in week 1 (p < 0.05). SDH activity then decreased 40% in week 2, followed by a gradual increase of 30-40% over week 3-5 (p < 0.05). Bis-GMA reduced proliferation by 40-60% from 1-5 weeks exposure (p < 0.05). However, SDH activity and total protein per cell were not affected. There was some indication of increased SDH activity after 5 weeks (20-30%, p < 0.05). Sub-lethal concentrations of TEGDMA and Bis-GMA have significant long-term effects on monocytes at low-dose 5-week exposures in vitro. Each monomer acted differently.

Aqueous extracts from dentin adhesives contain cytotoxic chemicals

It was the aim of our study to investigate the composition and cytotoxicity of aqueous elutes from five dentin adhesives currently used in clinical practice: Solobond Plustrade mark, Solisttrade mark, Scotchbond Multipurposetrade mark, Syntac SCtrade mark, and Prime & Bondtrade mark 2.1. Water extracts were analyzed by gas chromatography/mass spectrometry (GC/MS) and relative quantities of identified compounds were compared by means of an internal caffeine standard [%CF]. The in vitro cytotoxic effects of substances released into DMEM were determined using immortalized 3T3-fibroblast cultures. In addition, the cytotoxicity of ethylene glycol (EG), which was identified in the extracts of Syntac SC, was evaluated. All dentin adhesives tested released various chemical components, like comonomers (mainly ethylene glycol compounds), HEMA, and initiating substances (e.g., camphorquinone). Elutes of Solobond Plus, which contained very high amounts of TEGDMA, were extremely cytotoxic. Two bonding agents (Scotchbond Multi-purpose, Syntac SC), which released significant quantities of HEMA, induced severe cytotoxic effects. In contrast, extracts from Solist and Prime & Bond 2.1 had very small effects on cell proliferation; these elutes contained small amounts of released chemical compounds. EG, a product of HEMA hydrolysis, in concentrations ranging from 0.025-25 mM was not cytotoxic. In summary, these results provide evidence that all dentin adhesives tested in the present study release in aqueous media chemical compounds some of which (for example, TEGDMA and HEMA) are cytotoxic.

Cytotoxic effects of current dental adhesive systems on immortalized odontoblast cell line MDPC-23

OBJECTIVES

Evaluate the cytotoxic effect of the three dental adhesive systems.

METHODS

The immortalized mouse odontoblast cell line (MDPC-23) was plated (30,000 cell/cm2) in 24 well dishes, allowed to grow for 72 h, and counted under inverted light microscopy. Uncured fresh adhesives were added to culture medium to simulate effects of unset adhesive. Three adhesives systems were applied for 120 min to cells in six wells for each group: Group 1) Single Bond (3M), Group 2) Prime & Bond 2.1 (Dentsply), and Group 3) Syntac Sprint (Vivadent). In the control group, PBS was added to fresh medium. The cell number was counted again and the cell morphology was assessed under SEM. In addition, the adhesive systems were applied to circles of filter paper, light-cured for 20 s, and placed in the bottom of 24 wells (six wells for each experimental materials and control group). MDPC-23 cells were plated (30,000 cell/cm2) in the wells and allowed to incubate for 72 h. The zone of inhibition around the filter papers was measured under inverted light microscopy; cell morphology was evaluated under SEM; and the MTT assay was performed for mitochondrial respiration.

RESULTS

The fresh adhesives exhibited more toxic (cytopathic effects) to MDPC-23 cells than polymerized adhesives on filter papers, and as compared to the control group. The cytopathic effect of the adhesive systems occurred in the inhibition zone around the filter papers, which was confirmed by the MTT assay and statistical analysis (ANOVA) combined with Fisher's PLSD test. In the control group, MDPC-23 cells were dense on the plastic substrate and were in contact with the filter paper. In the experimental groups, when acid in the adhesive systems was removed by changing the culture medium, or when the adhesives were light-cured, some cells grew in the wells in spite of the persistent cytotoxic effect.

SIGNIFICANCE

All dentin adhesive systems were cytotoxic odontoblast-like cells. Both acidity and non-acidic components of these systems were responsible for the high cytopathic effect of those dental materials.

Effect of storage media on the fluoride release and surface microhardness of four polyacid-modified composite resins ("compomers")

OBJECTIVES

The aims of this investigation were to measure the surface microhardness (Vickers) as well as the release of fluoride from four polyacid-modified composite resins (PMC) ("compomers") (Compoglass F, F 2000, Dyract AP, experimental compomer) after storage in various artificial saliva (buffers) including one esterase-buffer.

METHODS

Samples were stored for 6 days in de-ionized water, acidic buffer I (pH 4.2), neutral buffer II (pH 7.0), or neutral buffer III (pH 7.0) containing porcine esterase. The specimens were transferred into fresh media every 48 h. Fluoride release was measured every 48 h. Vickers hardness of each five samples of every group was determined before storing the samples in media (baseline) as well as after storage for 24, 48, and 144 h in the various solutions. Dry-stored specimens served as control.

RESULTS

The surface microhardness of all PMCs significantly decreased after storage in the various media. No significant differences, however, were found between samples of the same material stored in the various media for 6 days. In general, the highest fluoride quantity was released into the acidic buffer I except for Dyract AP, which segregated similar quantities of fluoride into buffer I and into de-ionized water. More fluoride was released into de-ionized water than into neutral buffers. Further, esterase treatment increased fluoride release from three PMCs.

SIGNIFICANCE

Our results suggest that the action of salivary esterases may weaken the surface of polyacid-modified composite resin restorations. As a clinical consequence, wear may be enhanced and load resistance may be reduced. In addition, fluoride release from PMCs may be increased by hydrolytic enzymes in saliva and under acidic conditions.