Genetic and cellular toxicology of dental resin monomers

N-acetyl cysteine alleviates inflammatory reaction of oral epithelial cells to poly (methyl methacrylate) extract

OBJECTIVES

The purpose of this in vitro study was to determine whether the cytotoxicity of self-curing polymethyl methacrylate (PMMA) dental resin to oral epithelial cells was eliminated by mixing the antioxidant amino acid derivative, N-acetyl cysteine (NAC) with the material.

MATERIALS AND METHODS

Rat and human oral epithelial cells cultured on polystyrene were incubated in culture medium with or without extract from self-curing PMMA dental resin, with or without pre-mixing with NAC. On day 1, the cultures were evaluated for cellular damage, intracellular formaldehyde invasion, cellular redox status and pro-inflammatory cytokine production. Formaldehyde content and the amount of released NAC in the extract were evaluated.

RESULTS

Rat epithelial cells cultured with PMMA extract showed marked increases in lactate dehydrogenase (LDH) release, intracellular formaldehyde and lysosomal levels and reductions in attached cell number and the amount of E-cadherin compared with those in the culture without the extract; these adverse biological effects were alleviated or prevented by pre-mixing the resin with NAC. In human oral epithelial cells cultured with PMMA extract, the addition of NAC into the resin prevented the intracellular elevation of reactive oxygen species and the reduction in cellular glutathione levels. Human cell cultures with the extract produced higher levels of various pro-inflammatory cytokines than cultures without the extract; this was prevented by mixing the resin with NAC. The extract from PMMA pre-mixed with NAC contained a lower concentration of formaldehyde and a substantial amount of antioxidants.

CONCLUSION

The cytotoxicity of self-curing PMMA dental resin to oral epithelial cells was eliminated by mixing the resin with NAC.

The influences of N-acetyl cysteine (NAC) on the cytotoxicity and mechanical properties of Poly-methylmethacrylate (PMMA)-based dental resin

Objectives. This study aimed to investigate the influences of N-acetyl cysteine (NAC) on cytotoxicity and mechanical properties of Poly-methylmethacrylate (PMMA) dental resins.

Methods. Experimental PMMA resin was prepared by incorporating various concentrations of NAC (0, 0.15, 0.3, 0.6 and 0.9 wt.%). MTT assay was performed to investigate viability of human dental pulp cells after exposure to extract of PMMA resin with or without NAC. Cell adhesion on resin specimens was examined with scanning electron microscopy. Degree of conversion was studied with Fourier Transform Infrared Spectroscopy (FTIR). Flexural strength, microhardness and surface roughness was evaluated using a universal testing machine, microhardness tester and optical profilometer, respectively.

Results. Incorporation of NAC into PMMA resin significantly reduced its cytotoxicity and enhanced cell adhesion on its surface. NAC induced negative influences on the mechanical and physical properties of PMMA resin in a dose-dependent manner. The degree of conversion for all experimental PMMA resins reached as high as 72% after 24 h of polymerization. All the tested properties were maintained when the concentration of incorporated NAC was 0.15 wt.%.

Conclusion. The addition of 0.15 wt.% NAC remarkably improved biocompatibility of PMMA resin without exerting significant negative influence on its mechanical and physical properties.

Effect of the Acidic Dental Resin Monomer 10-methacryloyloxydecyl Dihydrogen Phosphate on Odontoblastic Differentiation of Human Dental Pulp Cells

Although 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) is frequently used as an acidic resin monomer in dental adhesives, its effect on dental pulp cells (DPCs) has been rarely reported. The purpose of this study was to examine the effects of 10-MDP on the inflammatory response and odontoblastic differentiation of DPCs at minimally toxic concentrations. We found that 10-MDP caused the release of inflammatory cytokines including NO, PGE2, iNOS, COX-2, TNF-α, IL-1β, IL-6 and IL-8 in a concentration-dependent manner. In addition, 10-MDP reduced alkaline phosphatase activity, mineralization nodule formation and mRNA expression of odontoblastic differentiation markers such as dentin sialophosphoprotein, dentin matrix protein-1, osterix and Runx2 in a concentration-dependent manner with low toxicity. In addition, 10-MDP induced activation of nuclear factor-E2-related factor 2 (Nrf2) and its target gene, haeme oxygenase-1 (HO-1). We evaluated whether the effect of 10-MDP was related to the induction of HO-1 and found that treatment with a selective inhibitor of HO-1 reversed the production of 10-MDP-mediated pro-inflammatory cytokines and the inhibition of differentiation markers. Pre-treatment with either a GSH synthesis inhibitor or antioxidants blocked 10-MDP-induced mitogen-activated protein kinases (MAPKs), Nrf2 and NF-κB pathways. Taken together, the results of this study showed that minimally toxic concentrations of 10-MDP promoted an inflammatory response and suppressed odontoblastic differentiation of DPCs by activating Nrf2-mediated HO-1 induction through MAPK and NF-κB signalling.

Biocompatibility of 4-META/MMA-TBB resin used as a dental luting agent

STATEMENT OF PROBLEM

The bonding and biological properties of currently used luting/cementing materials need to be improved. 4-Acryloyloxyethyl trimellitate anhydride/methyl methacrylate-tri-n-butylborane (4-META/MMA-TBB) resin is primarily used for splinting mobile teeth or treating fractured teeth. It undergoes moisture-resistant polymerization and bonds strongly to dentin and metals.

PURPOSE

The purpose of this in vitro study was to compare the biological and biochemical properties META/MMA-TBB resin with those of conventional polymethyl methacrylate (PMMA)-MMA resin and other currently used luting materials in order to determine whether it may be a viable dental luting agent.

MATERIAL AND METHODS

The degree of polymerization of 4-META/MMA-TBB resin, PMMA-MMA autopolymerizing resin, 10-methacryloyloxydecyl dihydrogen phosphate-dimethacrylate (MDP-DMA) adhesive resin, and a glass ionomer cement was measured by Fourier-transformed infrared spectroscopy. Free radical production during setting was evaluated by electron spin resonance (ESR) spectroscopy. Rat dental pulp cells cultured on these materials were examined for cell viability, attachment, proliferation, and functional phenotype.

RESULTS

The degree of polymerization of 4-META/MMA-TBB resin was 82% thirty minutes after preparation, compared to 66% for PMMA-MMA autopolymerizing resin. ESR spectroscopy revealed free radical production from 4-META/MMA-TBB resin and glass ionomer cement was equivalent 24 hours after preparation, with no spike in radical generation observed. In contrast, free radical production from PMMA-MMA and MDP-DMA adhesive resins was rapid and sustained and 10 to 20 times greater than that from 4-META/MMA-TBB. The percentage of viable dental pulp cells 24 hours after seeding was considerably higher on MDP-DMA and 4-META/MMA-TBB resin than on glass ionomer cement. Cell number, proliferation, and alkaline phosphatase activity were highest on 4-META/MMA-TBB resin and lowest on the glass ionomer cement.

CONCLUSIONS

4-META/MMA-TBB resin is at least as biocompatible, and perhaps even more biocompatible, than other current luting materials, with fast, favorable, and nontoxic polymerization properties. Further in vivo and human studies of 4-META/MMA-TBB resin as a dental luting agent are warranted.

Synthesis and evaluation of a novel co-initiator for dentin adhesives: polymerization kinetics and leachables study

A new tertiary amine co-initiator (TUMA) containing three methacrylate-urethane groups was synthesized for application in dentin adhesives. The photopolymerization kinetics and leaching of unreacted components from methacrylate-based dental polymers formulated with this new co-initiator were determined. The newly synthesize co-initiator showed good chemical stability and decreased amine release from the initiator system. This study provides important information for the future development of biocompatible dentin adhesives/composites.

Laser phototherapy enhances mesenchymal stem cells survival in response to the dental adhesives

Background. We investigated the influence of laser phototherapy (LPT) on the survival of human mesenchymal stem cells (MSCs) submitted to substances leached from dental adhesives. Method. MSCs were isolated and characterized. Oral mucosa fibroblasts and osteoblast-like cells were used as comparative controls. Cultured medium conditioned with two adhesive systems was applied to the cultures. Cell monolayers were exposed or not to LPT. Laser irradiations were performed using a red laser (GaAlAs, 780 nm, 0.04 cm², 40 mW, 1 W/cm², 0.4 J, 10 seconds, 1 point, 10 J/cm²). After 24 h, cell viability was assessed by the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide reduction assay. Data were statistically compared by ANOVA followed by Tukey's test (P < 0.05). Results. Different cell types showed different viabilities in response to the same materials. Substances leached from adhesives were less cytotoxic to MSCs than to other cell types. Substances leached from Clearfil SE Bond were highly cytotoxic to all cell types tested, except to the MSCs when applied polymerized and in association with LPT. LPT was unable to significantly increase the cell viability of fibroblasts and osteoblast-like cells submitted to the dental adhesives. Conclusion. LPT enhances mesenchymal stem cells survival in response to substances leached from dental adhesives.

Evaluation of Cytotoxicity of Silorane and Methacrylate based Dental Composites using Human Gingival Fibroblasts

AIM

The effects of leached substances from the restorative dental materials may induce local and systemic adverse effects. Thus the biological and toxic properties of the restorative dental materials must be compatible with the oral tissues or with general health. Therefore, the need for biocompatible restorative dental material implies the necessity of toxicity testing. It was the purpose of this investigation to determine and compare the possible toxic effect of silorane based composite (Filtek P90) on human gingival fibroblast (HGF) in vitro using cytotoxicity measuring parameters (MTT assay) in comparison with its methacrylate counterpart (Z100) for their viability, proliferation rate.

MATERIALS AND METHODS

Fresh healthy biopsy specimens of human gingival tissue of patients were obtained. For HGF, cells were cultured in Dulbecco's modified Eagle medium and grown to sub confluent monolayers. After attaining confluence, cells were treated with different doses of the Filtek P90 or Z 100 for different time point. HGF cells were observed for their proliferation, viability by MTT assay.

RESULTS

The results of the cytotoxicity assay showed that, the percentage of viable cells was very good in the first 24h and marginally decreased in the next 48h period in all groups. However, the proliferation rate was never below 84% in all the groups, at any given concentration. Filtek P90 and Z100 treated cells exhibited insignificant decrease in the cell proliferation both in 24h and 48h exposure when compared to significant decrease in the cell survival rate in the positive control (Mitomycin C 250 μg/ml).) Comparison of the toxicity between Filtek P90 and Z100 in 24h & 48h separately showed that there was no significant difference (p<0.05) between these two composites in 24h and 48h' time period at all concentrations of the composites.

CONCLUSION

To conclude, the new silorane based restorative composite showed comparable cytotoxic characteristics to clinically successful dimethacrylate composites suggesting the non-toxic nature in the oral environment and hence contributing to clinical success of these new restorative materials.

Human oral cells' response to different endodontic restorative materials: an in vitro study

Introduction

The aim of this study was to compare the biological interaction of human osteoblasts and cells of the human periodontal ligament (PDL) with different endodontic restorative material as Mineral Trioxide Aggregate (MTA), Biodentine, amalgam and composite over a time period of 20 days.

Materials and methods

Human PDL cells and osteoblasts were harvested, cultured and according to standardized protocols. The cell populations were characterized with the corresponding surface markers following standardized procedures. The specimens were produced with special regard to constant dimensions and volume in the different groups. Cell attachment and proliferation were evaluated morphologically after Richardson staining and cell count was performed after 1d, 8d, 13d and 20d. All experiments were performed in triplets. The results were statistically analyzed using the ANOVA- and Tukey-test (p < 0.05).

Results

Morphological analysis proved good proliferation and cell attachment in both cements. A remarkable result was the organized spreading and parallel alignment of the PDL cells in contact with MTA and especially Biodentine (cells maturing in a second cell layer crossway to the first one). From 8d onward Biodentine showed the highest quantity of PDL cells (p < 0.05). Biodentine and MTA resulted in a significantly higher cell density in osteoblast and PDL cell culture. The other groups showed a lower PDL cell density from 8d and a lower osteoblast cell density from 13d when compared to control and cement samples (p < 0.05).

Conclusions

MTA and Biodentine showed a good biocompatibility in contact with the human osteoblasts and cells of the periodontal ligament. Regarding cell survival and proliferation particularly of PDL cells Biodentine showed good results and can be considered as a well-tolerated bioactive endodontic material.

Electronic supplementary material

The online version of this article (doi:10.1186/s13005-014-0055-4) contains supplementary material, which is available to authorized users.

A dual role for β1 integrin in an in vitro Streptococcus mitis/human gingival fibroblasts co-culture model in response to TEGDMA

AIM

To evaluate the effect of TEGDMA on human gingival fibroblasts (HGFs) in vitro co-cultured with Streptococcus mitis, focusing on the signalling pathways underlying cell tissue remodelling and inflammatory response processes.

METHODOLOGY

β1 integrin expression was evaluated by means of imaging flow cytometry. The Western blot technique was used to investigate the expression of protein kinase C (PKC), extracellular signal-regulated kinase (ERK), matrix metalloproteinase 9 (MMP9) and 3 (MMP3). RT-PCR was performed to quantify nuclear factor-kb subunits (Nf-kb1, ReLa), IkB kinase β (IkBkB), cyclooxygenase II (COX-2) and tumour necrosis factor-α (TNF-α) mRNA levels. Statistical analysis was performed using the analysis of variance (anova).

RESULTS

When HGFs are co-cultured with S. mitis, β1 integrin intensity, phosphorylated PKC (p-PKC), activated ERK (p-ERK), IkBkB mRNA level and MMP9 expression increased (for all molecules P < 0.05 HGFs versus HGFs co-cultured with S. mitis). A higher level of MMP3 in HGFs treated with TEGDMA was recorded (P < 0.05 HGFs versus HGFs exposed to TEGDMA). COX-2 inflammatory factor mRNA level appeared higher in HGFs exposed to 1 mmol L(-1) TEGDMA (P < 0.01 HGFs versus HGFs exposed to TEGDMA), whereas TNF-α gene expression was higher in HGFs co-cultured with S. mitis (P < 0.05 HGFs versus HGFs co-cultured with S. mitis).

CONCLUSIONS

β1 integrin triggered the signalling pathway, transduced by p-PKCα and involving ERK 1 and 2 and MMPs. This pathway resulted in an unbalanced equilibrium in tissue remodelling process, along with inflammatory response when HGFs are exposed to bacteria or biomaterial alone. On the contrary, the TEGDMA/S. mitis combination restored the balance between extracellular matrix deposition and degradation and prevented an inflammatory response.

Cytotoxicity of low-shrink composites with new monomer technology on bovine dental pulp-derived cells

Objectives:

The aim of this study was to evaluate the cytotoxicity of four low-shrink composites with new monomer technology on the bovine dental pulp-derived cells (bDPCs).

Materials and methods:

Ten samples were prepared for each group composites, and the samples were immersed in 7 mL of culture medium for 72 h at 37°C to extract residual monomer or cytotoxic substances. The culture medium containing the material extracts was sterile filtered for use on the cell cultures. Materials were incubated in medium with serum for 72 h. bDPCs were maintained in a medium with serum. A real-time cell analyzer was used to evaluate cell survival. After seeding 200 mL of the cell suspensions into the wells (10,000 cells/well) of the E-plate 96, bDPCs were treated with bioactive components released by the composite materials (1:1 and 1:2 dilutions) and monitored every 15 min for 50 h.

Results:

According to analysis of variance, there were significant differences between the cell indexes of the control and GC kalore ( p < 0.05) and Bisco Reflexions ( p < 0.001) groups for the 1:1 dilutions at 25 h. When evaluated at 50 h, 1:1 dilutions of GC Kalore ( p < 0.01) and Bisco Reflexions ( p < 0.001) reduced cell survival significantly.

Conclusions:

Although composites resins are being advanced, their cytotoxic effects have been proceeding till this time. However, two of the four materials tested significantly reduced cell viability when compared with control.

Clinical relevance:

Research should focus on the cytotoxicity of composites in addition to their mechanical properties.

Dental sealants and composite restorations and longitudinal changes in immune function markers in children

OBJECTIVE

Resins used in dental composites, derived from bisphenol-A (BPA), have been shown to alter immune cells. The objective of this study was to explore children's immune function changes in relation to resin composite treatment.

DESIGN

We conducted secondary data analysis of the New England Children's Amalgam Trial immune function substudy (N = 59). Immune function was measured pre-treatment and up to five times post-treatment through 5-year follow-up. Multivariable generalized linear regression models were used to estimate the association between three classes of resin composites (bisphenol-A-diglycidyl-dimethacrylate [BisGMA]-based flowables used for preventive sealants; urethane dimethacrylate [UDMA]-based compomer restorations; bisGMA-based restorations) and changes in immune function markers measured annually.

RESULTS

Total white blood cell counts and responsiveness of T cells or neutrophils were not appreciably altered by composite treatment levels. Changes in B cell responsiveness were greater throughout follow-up among children with more bisGMA-based composite restorations, which opposed findings for amalgam treatment levels. Monocyte responsiveness changes were decreased at 6 months with greater treatment, but not over longer follow-up.

CONCLUSIONS

Results of this analysis showed no overt immune function alterations associated with resin composites. Additional research regarding lymphocyte activation may be warranted given the consistency of results within these analyses and with a prior study showing increased B cell activation.

Effects of dental methacrylates on oxygen consumption and redox status of human pulp cells

Several studies have already demonstrated that the incomplete polymerization of resin-based dental materials causes the release of monomers which might affect cell metabolism. The aim of this study was to investigate the effects of triethylene glycol dimethacrylate, 1,4-butanediol dimethacrylate, urethane dimethacrylate, and 2-hydroxyethyl methacrylate on (1) cellular energy metabolism, evaluating oxygen consumption rate, glucose consumption, glucose 6-phosphate dehydrogenase activity, and lactate production, and (2) cellular redox status, through the evaluation of glutathione concentration and of the activities of enzymes regulating glutathione metabolism. Methods. Human pulp cells were used and oxygen consumption was measured by means of a Clark electrode. Moreover, reactive oxygen species production was quantified. Enzymatic activity and glucose and lactate concentrations were determined through a specific kit. Results. Triethylene glycol dimethacrylate, 1,4-butanediol dimethacrylate, and 2-hydroxyethyl methacrylate induced a decrease in oxygen consumption rate, an enhancement of glucose consumption, and lactate production, whilst glucose 6-phosphate dehydrogenase and glutathione reductase activity were not significantly modified. Moreover, the monomers induced an increase of reactive oxygen species production with a consequent increase of superoxide dismutase and catalase enzymatic activities. A depletion of both reduced and total glutathione was also observed. Conclusion. The obtained results indicate that dental monomers might alter energy metabolism and glutathione redox balance in human pulp cells.

Urethane dimethacrylate induces cytotoxicity and regulates cyclooxygenase-2, hemeoxygenase and carboxylesterase expression in human dental pulp cells

The toxic effect of urethane dimethacrylate (UDMA), a major dental resin monomer, on human dental pulp is not fully clear. In this study, we investigated the influence of UDMA on the cytotoxicity, cell cycle distribution, apoptosis and related gene expression of dental pulp cells. The role of reactive oxygen species, hemeoxygenase-1 (HO-1) and carboxylesterase (CES) in UDMA cytotoxicity, was evaluated. UDMA induced morphological changes of pulp cells and decreased cell viability by 29-49% at concentrations of 0.1-0.35 mM. UDMA induced G0/G1, G2/M cell cycle arrest and apoptosis. The expression of cdc2, cyclinB1 and cdc25C was inhibited by UDMA. Moreover, UDMA stimulated COX-2, HO-1 and CES2 mRNA expression of pulp cells. The cytotoxicity of UDMA was attenuated by N-acetyl-l-cysteine, catalase and esterase, but was enhanced by Zn-protoporphyrin (HO-1 inhibitor), BNPP (CES inhibitor) and loperamide (CES2 inhibitor). Exposure of UDMA may potentially induce the inflammation and toxicity of dental pulp. These findings are important for understanding the clinical response of human pulp to resin monomers after operative restoration and pulp capping, and also provide clues for improvement of dental materials.

The survival role of peroxisome proliferator-activated receptor gamma induces odontoblast differentiation against oxidative stress in human dental pulp cells

INTRODUCTION

Peroxisome proliferator-activated receptor gamma (PPARγ) has well-known anti-inflammatory action in human dental pulp cells (HDPCs). The purpose of this study was to investigate whether the anti-inflammatory action of PPARγ involves in cellular cytoprotection and supports odontoblast differentiation under oxidative stress in HDPCs.

METHODS

To simulate long-term oxidative stress, pulp cells were treated with 150 μmol hydrogen peroxide (H(2)O(2)) for 12 days. The replication deficiency adenovirus (adenovirus PPARγ) was introduced for PPARγ overexpression in pulp cells. The cellular cytotoxicity and reactive oxygen species formation by H(2)O(2) were determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and 2',7'-dichlorodihydrofluorescein diacetate with fluorescence-activated cell sorting assay. To determine the roles of PPARγ, several molecules of odontogenic/osteogenic and signal pathway were analyzed by reverse-transcription polymerase chain reaction and Western hybridization. Dentin mineralization was determined by alizarin red stain and alkaline phosphatase activity assay.

RESULTS

Pulp cells treated with long-term H(2)O(2) showed high reactive oxygen species formation, low cell viability, down-expression of antioxidant molecules (Cu/Zn and Mn superoxide dismutase), and odontogenic/osteogenic markers (eg, dentin sialophosphoprotein, dentin matrix protein-1, osteopontin, bone sialoprotein, Runx-2, and bone morphogenetic protein 2 and 7). In addition, pulp cells with oxidative stress underwent the activation of ERK1/2, activator protein-1, and nuclear factor-κB translocation to the nucleus. However, the PPARγ-overexpressed cells gave opposite results although under oxidative stress. Furthermore, PPARγ and its agonist rosiglitazone exhibited an induction of dentin mineralization under oxidative stress.

CONCLUSIONS

PPARγ in pulp cells increases cell viability, odontoblastic differentiation, and dentin mineralization under oxidative stress. These results offer new insights into the potential antioxidative activity of PPARγ and its agonist for therapeutic agents for pulp vitality in HDPCs.

Triethylene Glycol Dimethacrylate Induction of Apoptotic Proteins in Pulp Fibroblasts

Objective

Monomers such as triethylene glycol dimethacrylate (TEGDMA) can leach from dental composites. TEGDMA-induced apoptosis in human pulp has been reported. However, the apoptotic (pro or anti) proteins involved in this process remain unclear. Therefore, the purpose of this study was to determine which apoptotic proteins are enhanced or suppressed during TEGDMA-induced apoptosis.

Materials and Methods

Human pulp fibroblasts (HPFs) were incubated with different TEGDMA concentrations (0.125-1.0 mM) and cytotoxicity was determined. TEGDMA was shown to be cell cytotoxic at concentrations of 0.50 mM and higher. The highest concentration with no significant cytotoxicity was then incubated (0.25 mM TEGDMA) with the HPFs. Cell lysates were then prepared and the protein concentrations determined. Human Apoptosis Array kits were utilized to detect the relative levels of 43 apoptotic proteins.

Results

HPFs exposed to TEGDMA showed significant increases in multiple pro-apoptotic proteins such as Bid, Bim, Caspase 3, Caspase 8, and Cytochrome c at 24 hours. Some anti-apoptotic proteins were also altered.

Conclusions

The results indicated that TEGDMA activates both the extrinsic and intrinsic apoptotic pathways.

Human and bovine pulp-derived cell reactions to dental resin cements

OBJECTIVES

The objective of this study was to evaluate the cytotoxic reaction of transfected human pulp derived cells (tHPDC) and transfected bovine pulp derived cells (tBPDC) after exposure to resin cements [RelyX UnicemClicker (RX), MaxCem (MC), Panavia F 2.0 (PF), BisCem (BC), and Bistite II DC (BII)] and to compare it to the generation of reactive oxygen species (ROS).

MATERIALS AND METHODS

Set materials were extracted in culture medium, cell survival as a measure of cytotoxicity was determined photometrically using crystal violet after cells were exposed to the extracts for 24 h. The generation of ROS was detected by flow cytometry after cells were exposed to extract dilutions for 1 h.

RESULTS

The ranking of the least to the most cytotoxic material was: RX < BII < PF < BC < MC for both cell lines, but for tHPDC, only MC and PF eluates were different from untreated controls. Generally, tBPDC were more susceptible to materials than tHPDC, but only for RX and BC was this difference statistically significant. All undiluted extracts increased ROS production in both cell lines but to a higher amount in tHPDC than in tBPDC.

CONCLUSIONS

tHPDC reacted less sensitive than tBPDC in the cytotoxicity test but with the same rank order of materials. In contrast, the cellular oxidative stress reaction was more pronounced in tHPDC than in tBPDC.

CLINICAL RELEVANCE

Depending on the residual dentine layer in deep cavities, biologically active resin monomers or additives released from resin cements may influence the dentine–pulp complex, for instance, its regenerative and reparative capacities.

Sensitization potential of dental resins: 2-hydroxyethyl methacrylate and its water-soluble oligomers have immunostimulatory effects

The immunostimulatory effects of the representative dental resin monomer 2-hydroxyethyl methacrylate (HEMA), a HEMA derivative that does not contain a double bond (2-hydroxyethyl isobutyrate, HEIB), and polymerized water-soluble oligomers of HEMA (PHEMA) were investigated. It is known that expression levels of either or both of CD54 and CD86 in THP-1 cells are increased by exposure to sensitizing substances. In this study, the expression levels of CD54 and CD86, the production of reactive oxygen species (ROS), and the viability of the cells were measured after 24 h of incubation with these materials at different concentrations. The concentrations of the materials that induced the expression of both CD54 and CD86 were low in the following order: NiSO₄, HEMA, and methyl methacrylate (MMA). These results indicate that these dental resin monomers have lower sensitizing potentials than NiSO₄. Although HEIB, which lacks a double bond, resulted in negligible ROS production and reduced cytotoxicity than HEMA, it induced the expression of CD54 and CD86. Comparison of the results for HEMA and HEIB indicates that dental resin monomer-induced sensitization may be related not only to the oxidative stress related to the methacryloyl group but also to the structures of these compounds. Of particular interest is the result that a water-soluble PHEMA oligomer with a relatively high-molecular weight also exhibited negligible cytotoxicity, whereas the expression level of CD54 increased after exposure to PHEMA at a high concentration. This result serves as a warning that polymerized substances also have the potential to induce sensitization. This study provides insight into the nature of allergic responses to dental resin materials in clinical use and may facilitate the development of more biocompatible restorative materials in the future.

Effects of a dental adhesive on cell cycle regulatory proteins

Dental bonding agents may affect the cell cycle patterns and induce cell cycle arrest by blocking its progression. This study tested the cell cycle effects through cyclin-dependent kinase (cdc2) and Rb phosphorylation. Human lung fibroblasts (MRC5) were used for the experiments. The bonding agent tested was the total-etch XP bond. Extracts of the bonding agent were prepared and serial dilutions were tested. The effects of the bonding agent on cell survival, proliferation and DNA synthesis were tested by the SRB and BrdU assays. Analysis of cell cycle distribution was performed by flow cytometry. XP bond exhibited strong inhibition of DNA synthesis and after 48 h of exposure cells were accumulated in the G2/M phase. Cells exposed to the half maximal cell growth inhibitory concentration (IC50) showed an increase in cdc2 kinase and Rb phosphorylation. The results most likely indicate mutagenic effect of the tested agent.

The Challenge for Innovation in Direct Restorative Materials

During the past 50 years, a series of key UN conferences have established a framework to minimize human health risks from environmental exposures to key chemicals. In January 2013, more than 140 countries agreed to the text of new treaty to minimize Hg effects on the environment (the Minamata Convention). Dental caries is omnipresent around the globe, affecting 60% to 90% of school children and most adults, and producing discomfort that affects quality of life. Dental amalgam is frequently used to treat carious lesions and its use releases mercury into the environment. The best way to avoid the use of dental amalgam is to emphasize caries prevention. Alternatives to amalgam are suitable in some applications, but no replacement for amalgam has been found for large posterior restorations. For any restorative material, safety and environmental impacts are part of clinical risk assessment. Safety is freedom from unacceptable risks. Risk is a combination of probability of exposure and severity of harm. Best management practices are crucial to manage dental amalgam, but these impose additional that are disproportionately more for developing countries. The Minamata Convention seeks a phase-out of all mercury-based products except dental amalgam, where a phase-down is the present goal. For dentistry, the most important focus is the promotion of caries prevention and research on new materials.

Mechanism of detoxification of the cationic antibacterial monomer 12-methacryloyloxydodecylpyridiniumbromide (MDPB) by N-acetyl cysteine

OBJECTIVES

The protective effects of N-acetyl cysteine (NAC) against cytotoxicity induced by conventional dental resin monomers have been widely documented. However, its effectiveness to detoxify cationic antibacterial monomers has not yet been elucidated. The aim of the present study was to investigate the possible protective effects of NAC against the cytotoxicity of 12-methacryloyloxydodecylpyridiniumbromide (MDPB) and explore the role of adduct formation in NAC-directed detoxification.

METHODS

The influences of NAC on the cytotoxicity of MDPB were studied in mouse osteoblast-like MC3T3-E1 cells using the MTT assay. Ultra-performance liquid chromatography (UPLC) and liquid chromatography-mass spectrometry (LC-MS) analysis were performed to investigate the possible chemical reaction between NAC and MDPB.

RESULTS

While only slight reduction in the cytotoxicity of MDPB by NAC was observed immediately after mixing with MDPB, remarkable protection against MDPB-induced cell death was detected when the mixture was tested after 24h of pre-incubation. UPLC and LC-MS analysis revealed that chemical binding of MDPB and NAC occurred under neutral conditions after 24h of pre-incubation.

SIGNIFICANCE

Our findings suggest that NAC reduces the toxicity of the cationic antibacterial monomer MDPB, and adduct formation is partially responsible for the detoxification ability of NAC against MDPB-induced cell damage.

A comparison of the in vitro cytotoxicity of conventional and resin modified glass ionomer cements

To evaluate cytotoxicity of experimental conventional and resin modified glass-ionomer cements on UMR-106 osteoblast cell cultures and cell cultures of NIH(3)T(3) mouse fibroblasts specimens were prepared for every experimental material and divided into: group 1.Conventional glass-ionomer cements: GC Fuji IX GP Fast, GC Fuji Triage and Ketac Silver; group 2. Resin modified glass-ionomer cements: GC Fuji II LC, GC Fuji Plus and Vitrebond; group 3. Positive control was presented by specimens of composite Vit-l-ecence® and negative control-group 4. was presented by α-minimum essential medium for UMR-106 - osteoblast-like cells and Dulbecco's Modified Eagle's Medium for NIH(3)T(3) mouse fibroblast cells. Both cell cultures were exposed to 10% of eluate of each single specimen of each experimental material. Experimental dishes were incubated for 24 h. Cell metabolism was evaluated using methyltetrazolium assay. Kruskal-Wallis test and Tukey-Kramer post hoc test for the materials evaluated on NIH(3)T(3) mouse fibroblast cells, as well as UMR-106 osteoblast-like cells showed significantly more cytotoxicity of RMGICs, predominantly Vitrebond to both GICs and composite- Vit-l-ecence®.The lowest influence on cell's metabolism on UMR-106 osteoblas-like cells was shown by Ketac Silver and the lowest influence on cell's metabolism on NIH(3)T(3) mouse fibroblast cells was shown by Fuji IX GP Fast. Statistical evaluation of sensitivity of cell lines UMR-106 osteoblast-like cells and NIH(3)T(3) mouse fibroblast cells, using Mann-Whitney test, showed that NIH(3)T(3) mouse fibroblast cells were more sensitive for the evaluation of cytotoxicity of dental materials.

Ethanol postpolymerization treatment for improving the biocompatibility of acrylic reline resins

Objective. To evaluate the effect of postpolymerization treatment based on ethanol-aqueous solutions on the residual monomer (RM) content, flexural strength, microhardness, and cytotoxicity of hard chairside reline resins (Kooliner, Ufi Gel Hard). Methods. After polymerization, specimens were immersed in water, 20%, 50%, or 70% ethanol solutions at 23°C or 55°C for 10 minutes. Controls were left untreated. HPLC was used for the determination of RM content. Specimens were submitted to Vickers microhardness and 3-point loading flexural strength tests. Cytotoxicity of resin eluates was determined on human fibroblasts by assessing cellular mitochondrial function and lactate dehydrogenase release. Results. Higher concentrations of ethanol promoted lower RM content at 55°C in both materials. The mechanical properties were maintained after 50% and 20% ethanol treatments in Kooliner and Ufi Gel Hard, respectively. Specimens submitted to those treatments showed significant reduction on cytotoxicity compared to immersion in hot water, the treatment of choice in the recent literature. Significance. Immersion of relined dentures in specific ethanol solutions at 55°C for 10 minutes can be considered an effective postpolymerization treatment contributing to increase materials biocompatibility. The proposed protocol is expeditious and easy to achieve with simple equipment in a dental office.

Transdentinal cytotoxicity of experimental adhesive systems of different hydrophilicity applied to ethanol-saturated dentin

The aim of this study was to evaluate the transdentinal cytotoxicity of experimental adhesive systems (EASs) with different hydrophilicity and dentin saturation solutions on odontoblast-like cells. One hundred 0.4-mm-thick dentin discs were mounted in in vitro pulp chambers and assigned to 10 groups. MDPC-23 cells were seeded onto the pulpal side of the discs, incubated for 48h. The EASs with increasing hydrophilicity (R1, R2, R3 and R4) were applied to the occlusal side after etching and saturation of etched dentin with water or ethanol. R0 (no adhesive) served as controls. R1 is a non-solvated hydrophobic blend, R2 is similar to a simplified etch-and-rinse adhesive system and R3 and R4 are similar to self-etching adhesives. After 24h, cell metabolism was evaluated by MTT assay (n=8 discs) and cell morphology was examined by SEM (n=2 discs). Type of cell death was identified by flow cytometry and the degree of monomer conversion (%DC) was determined by infrared spectroscopy (FTIR) after 10s or 20s of photoactivation. Data were analyzed by the Kruskal-Wallis and Mann-Whitney tests (α=0.05). Dentin saturation with ethanol resulted in higher necrotic cell death ratios for R2, R3 and R4 compared with water saturation, although R2 and R3 induced higher SDH production. Photoactivation for 20s significantly improved the %DC of all EASs compared with 10s. A significant positive correlation was observed between the degree of hydrophilicity and %DC. In conclusion, except for R1, dentin saturation with ethanol increased the cytotoxicity of EASs, as expressed by the induction of necrotic cell death.

Genotoxic biomonitoring of flowable and non-flowable composite resins in peripheral blood leukocytes

OBJECTIVE

Composite restorative materials represent one of the most important groups of materials in contemporary dental practice. However, their incomplete polymerization may lead to monomer-induced genotoxicity. The objective of this study was to evaluate the genotoxicity of three flowable (Filtek Supreme XT Flow, Tetric EvoFlow, Gradia Direct Flo) and three non-flowable dental composite materials (Filtek Z250, Tetric EvoCeram, Gradia Direct Posterior).

MATERIALS AND METHODS

Genotoxicity assessment of composite materials was carried out in vitro in human peripheral blood leukocytes using the alkaline single-cell gel electrophoresis technique (comet assay). Prepared materials were eluted in saline solution for 1 h, 1 day and 5 days. Thereafter leukocyte cultures were treated with different concentrations of eluates obtained from each of the tested dental composite materials. Kruskall-Wallis non-parametric test was used for statistical analysis (p < 0.05).

RESULTS

The tested materials did not show genotoxic effects after exposure of leucocytes to 1 h eluates. Culture treated with 1 day eluates of all tested materials, only at a highest concentration (10(-2)), affected the measured cytogenetic parameters. Of all tested materials, only Filtek Z250 and Filtek Supreme XT Flow did not exhibit a genotoxic effect in cultures that were under the influence of 5 day eluates.

CONCLUSION

Tested materials exhibited limited genotoxic activity in peripheral blood leukocytes. Since the effect was observed only in leukocyte cultures treated by 1-day eluates at the highest concentration (10(-2)) and it decreases in cultures exposed to 5 day eluates, it should not pose a significant risk to the human genome.

Infrared spectroscopic analysis of restorative composite materials' surfaces and their saline extracts

This study aims at finding out if multiple attenuated internal reflection-infrared (MAIR-IR) spectroscopic analysis can be used as a tool to differentiate commercial resin composite brands and to find out if different resin composites will have different abilities of leaching materials that are cytotoxic to human gingival fibroblasts (HGFs) Tooth-colored resin fillings have become increasingly popular as restorative materials, which make it important to differentiate the commercial brands for forensic and biological purposes. Fourteen resin composite brands were used in the study. MAIR-IR spectroscopic analysis was used for surface characterization of the organic and inorganic parts of the resin composite samples which were studied as is and after 2 weeks of saline incubation. IR spectroscopy was also done on the saline extracts to find out if different resin composite materials would have different leaching abilities. The saline extracts were also used for the viability testing of HGF cell cultures. One-way analysis of variance test statistics was used to analyze the results. It was found that the resin composite brands have different spectra after saline soaking. It was also found that these resin composite brands possess different leaching abilities with regard to the amount and type of materials and different cytotoxic effects, which were found to be threshold dependent, meaning there is a critical or threshold value of leaching material at or above which the toxic effect will be significant and below which there is no toxic effect. Therefore, IR spectroscopy might be considered as a useful tool for dental resin composite characterization. However, more oral simulating environmental testing methods, different surface characterization methods, and more cell viability testing methods and assays must be considered for more specific results which relate more to the behavior of these dental resin composites in the oral environment.

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.

Risk aspects of dental restoratives: From amalgam to tooth-colored materials

Dental materials’ choice of patients has considerably changed. Whereas cast gold and amalgam have been the predominant biomaterials for decades, today tooth-colored materials like resin-based composites and ceramics are more and more successful. However, are we going to replace a good but biologically questionable material (amalgam) with an equal material (resin composite) being more esthetic but also biologically questionable For amalgam, long-term clinical studies reported some significant hints that in single cases amalgam may be a health hazard for patients, finally Norway banned amalgam completely. The main advantage of a resin-based composite over amalgam is its tooth-like appearance and more or less absence of extensive preparation rules. For many years it was believed that resin-based composites may cause pulpal injury. However, pulpal injury associated with the use of resin-based composites is not correlated with their cytotoxic properties. Nevertheless, resin-based composites and other dental materials require rigorous safety evaluation and continuous monitoring to prevent adverse events similar like with amalgam. Because of non-biocompatible pulp responses to resin-based composites and amalgam, they should not be placed in direct contact with the dental pulp. The less dentin remaining in the floor of preparations between resin-based composites or other dental materials is more likely to cause pulpitis. Percentage of patients and dental practitioners who display allergic reactions is between 0.7% and 2%. The release of cytotoxic monomers from resin-based materials is highest after polymerization and much lower after 1 wk. Substances released from resin-based composites have been shown to be toxic in cytotoxicity tests. Nevertheless, in vitro cytotoxicity assays have shown that amalgam has greater toxic effects than resin-based composites, sometime 100-700-fold higher. Altogether, the risk of side-effects is low, but not zero, especially for dental personnel.