Mutagenicity of dentin bonding agents

The lower alkyl methacrylates: Genotoxic profile of non-carcinogenic compounds

All of the lower alkyl methacrylates are high production chemicals with potential for human exposure. The genotoxicity of seven mono-functional alkyl esters of methacrylic acid, i.e. methyl methacrylate, ethyl methacrylate, hydroxyethyl methacrylate, n-, i- and t-butyl methacrylate and 2 ethyl hexyl methacrylate, as well as methacrylic acid itself, the acyl component common to all, is reviewed and compared with the lack of carcinogenicity of methyl methacrylate, the representative member of the series so evaluated. Also reviewed are the similarity of structure, chemical and biological reactivity, metabolism and common metabolic products of this group of compounds which allows a category approach for assessing genotoxicity. As a class, the lower alkyl methacrylates are universally negative for gene mutations in prokaryotes but do exhibit high dose clastogenicity in mammalian cells in vitro. There is no convincing evidence that these compounds induce genotoxic effects in vivo in either sub-mammalian or mammalian species. This dichotomy of effects can be explained by the potential genotoxic intermediates generated in vitro. This genotoxic profile of the lower alkyl methacrylates is consistent with the lack of carcinogenicity of methyl methacrylate.

Biocompatibility of Resin-based Dental Materials

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

Biocompatibility of glass?ionomer cements using mouse lymphoma cells in vitro

Glass-ionomer cements are widely used in dentistry as restorative materials and adhesives for composite restorations. A number of genotoxicity studies have been conducted using these materials with results conflicting so far. Thus, the approach was aimed to look at the genotoxic and cytotoxic potential of three different glass-ionomer cements available commercially (Ketac Cem, Ketac Molar and Vitrebond) by the single cell gel (comet) assay and trypan blue exclusion test, respectively. For this, such materials were exposed to mouse lymphoma cells in vitro for 1 h at 37 degrees C. Data were assessed by Kruskall-Wallis non-parametric test. The results showed that all powders assayed did not show genotoxic effects. On the other hand, the liquid from Vitrebond at 0.1% dilution caused an increase of DNA injury. Significant statistically differences (P < 0.05) in cytotoxicity provoked by all powders tested were observed for exposure at 1,000 micro g mL(-1) concentration and 100 micro g mL(-1) for Ketac Molar. With respect to liquids of glass-ionomer cements evaluated, the major toxic effect on cell viability was produced at 1%, beginning at the dilution of 0.5% for Vitrebond. Taken together, these results support the notion that some components of glass-ionomer cements show both genotoxic and cytotoxic effects in higher concentrations.

Final report of the safety assessment of methacrylate ester monomers used in nail enhancement products

Methacrylate ester monomers are used in as artificial nail builders in nail enhancement products. They undergo rapid polymerization to form a hard material on the nail that is then shaped. While Ethyl Methacrylate is the primary monomer used in nail enhancement products, other methacrylate esters are also used. This safety assessment addresses 22 other methacrylate esters reported by industry to be present in small percentages as artificial nail builders in cosmetic products. They function to speed up polymerization and/or form cross-links. Only Tetrahydrofurfuryl Methacrylate was reported to the FDA to be in current use. The polymerization rates of these methacrylate esters are within the same range as Ethyl Methacrylate. While data are not available on all of these methacrylate esters, the available data demonstrated little acute oral, dermal, or i.p. toxicity. In a 28-day inhalation study on rats, Butyl Methacrylate caused upper airway irritation; the NOAEL was 1801 mg/m3. In a 28-day oral toxicity study on rats, t-Butyl Methacrylate had a NOAEL of 20 mg/kg/day. Beagle dogs dosed with 0.2 to 2.0 g/kg/day of C12 to C18 methacrylate monomers for 13 weeks exhibited effects only in the highest dose group: weight loss, emesis, diarrhea, mucoid feces, or salivation were observed. Butyl Methacrylate (0.1 M) and Isobutyl Methacrylate (0.1 M) are mildly irritating to the rabbit eye. HEMA is corrosive when instilled in the rabbit eye, while PEG-4 Dimethacrylate and Trimethylolpropane Trimethacrylate are minimally irritating to the eye. Dermal irritation caused by methacrylates is documented in guinea pigs and rabbits. In guinea pigs, HEMA, Isopropylidenediphenyl Bisglycidyl Methacrylate, Lauryl Methacrylate, and Trimethylolpropane Trimethacrylate are strong sensitizers; Butyl Methacrylate, Cyclohexyl Methacrylate, Hexyl Methacrylate, and Urethane Methacrylate are moderate sensitizers; Hydroxypropyl Methacrylate is a weak sensitizer; and PEG-4 Dimethacrylate and Triethylene Glycol Dimethacrylate are not sensitizers. Ethylene Glycol Dimethacrylate was not a sensitizer in one guinea pig study, but was a strong sensitizer in another. There is cross-reactivity between various methacrylate esters in some sensitization tests. Inhaled Butyl Methacrylate, HEMA, Hydroxypropyl Methacrylate, and Trimethylolpropane Trimethacrylate can be developmental toxicants at high exposure levels (1000 mg/kg/day). None of the methacrylate ester monomers that were tested were shown to have any endocrine disrupting activity. These methacrylate esters are mostly non-mutagenic in bacterial test systems, but weak mutagenic responses were seen in mammalian cell test systems. Chronic dermal exposure of mice to PEG-4 Dimethacrylate (25 mg, 2 x weekly for 80 weeks) or Trimethylolpropane Trimethacrylate (25 mg, 2 x weekly for 80 weeks) did not result in increased incidence of skin or visceral tumors. The carcinogenicity of Triethylene Glycol Dimethacrylate (5, 25, or 50%) was assessed in a mouse skin painting study (50 microl for 5 days/week for 78 weeks), but was not carcinogenic at any dose level tested. The Expert Panel was concerned about the strong sensitization and crossor co-reactivity potential of the methacrylate esters reviewed in this report. However, data demonstrated the rates of polymerization of these Methacrylates were similar to that of Ethyl Methacrylate and there would be little monomer available exposure to the skin. In consideration of the animal toxicity data, the CIR Expert Panel decided that these methacrylate esters should be restricted to the nail and must not be in contact with the skin. Accordingly, these methacrylate esters are safe as used in nail enhancement products when skin contact is avoided.

Mutagenic potentials of dental cements as detected by the Salmonella/microsome test

The potential mutagenicity of a zinc phosphate (Poscal), a polycarboxylate (Aqualox) and glass ionomer cements with (Argion) and without (Meron) silver reinforcement were characterized by employing the Ames Salmonella/microsome test. The materials were eluted in dimethyl sulphoxide or physiologic saline and the aliquots were used either immediately or after an incubation period of 24h at 37 degrees C. Mutagenic effects of the materials were tested on Salmonella typhimurium strains TA 98, TA 100, TA 102 and TA 1535 using the standard plate incorporation assay, and in the presence or absence of S9 fraction from rat liver. Poscal and Aqualox elicited mutagenic effects on S. typhimurium TA 98 and TA 1535, whereas Meron exhibited mutagenic effects on S. typhimurium TA 98. No mutagenic effects were detected for Argion. The type of solvent, dose of the material and incubation as well as the interactions between these factors exhibited varying degrees of influences on the mutagenic activities of the cements (P<0.05 and P<0.1). We conclude that zinc phosphate, polycarboxylate, and glass ionomer cements may have possible mutagenic activities.

Leachability of plasticizer and residual monomer from commercial temporary restorative resins

OBJECTIVES

This study was performed to determine the compositions of commercial temporary restorative resins and to evaluate the leachability of plasticizer and residual monomer from them.

METHODS

The chemicals in four commercial temporary restorative resins (Dura Seal, Fit Seal, Plast Seal Quick, and Poly Seal) were detected by GCMS and HPLC. The amounts of plasticizers and residual monomers that leached from cured resin samples immersed in ethanol for 1 h to 14 d were determined by HPLC.

RESULTS

Phthalate esters used as plasticizers contained 40-55 wt% either di-n-butyl phthalate (DBP) or butyl phthalyl butyl glycolate. The resin monomer included methyl methacrylate (MMA) or a mixture of MMA and 2-hydroxyethyl methacrylate (HEMA); 1,3-butanediol dimethacrylate was added as a cross-linking agent. Each resin contained 40-60 wt% monomer. The amounts of phthalate esters leached increased with immersion time up to 7 d, reaching 120-190 microg/mg, and did not change subsequently. The residual monomers leached gradually for up to 3d and did not change subsequently. The amount of leached residual monomer (MMA, HEMA) was 20-90 microg/mg after 3d storage. More than 50% of the leachable plasticizers and monomers were eluted from the cured resins within 24 and 3 h, respectively.

CONCLUSIONS

The amounts of leached plasticizers and residual monomers were extremely large compared with the concentrations of endocrine disrupters and their potentially genotoxic effects. Therefore, it is very important to evaluate the leachability of these compounds from temporary restorative resins.

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.

Improved sample preparation of biomaterials for in vitro genotoxicity testing using reference materials

New biomaterial related reference materials with known genotoxic properties were produced in order to study the sample preparation and in vitro genotoxicity testing of biomaterials. We incorporated genotoxic substances like benzo[a]pyrene into the biomaterial Tecoflex, a polyurethane frequently used for catheters and other applications. We demonstrated that the model compound benzo[a]pyrene is sufficiently extracted by organic solvents, whereas cell culture medium only extracts very limited quantities. By changing the medium several times during extraction the extracted amount was augmented. Using higher amounts of organic solvent in relation to the reference material's surface led to a higher recovery of extracted benzo[a]pyrene. For the in vitro genotoxicity testing using the Mammalian Cell Gene Mutation Test (HPRT test), Mammalian Chromosome Aberration Test, and bacterial umu- and SOS-tests, concentration of extracts is a prerequisite because of the low sensitivity of the test systems. Often cytotoxicity interferes with the evaluation of genotoxic effects. We demonstrated that some recommendations of the ISO 10993-Part 3 and 12,(1),(2) dealing with the biological evaluation of medical devices, seem to be insufficient, and new rules for the in vitro genotoxicity testing of biomaterials have to be established.

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.

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.

Cytotoxicity of 35 dental resin composite monomers/additives in permanent 3T3 and three human primary fibroblast cultures

It was the purpose of this investigation to determine the cytotoxic effects (ED50 concentrations) of 35 monomers or additives identified in commercial dental resin composites. Monolayers of permanent 3T3 cells and three primary human fibroblast types derived from oral tissues (gingiva, pulp, and periodontal ligament) were used as test systems. All substances were tested in concentrations ranging from 0.01 to 5.0 mM. In general, ED50 values varied from 0.06 to > 5 mM. Within the groups of co(monomers), initiators, and cointiators, severe (e.g., Bis-GMA, UDMA, DMBZ, and DMDTA) or moderate (HEMA, BEMA, CQ, DMPT, and DMAPE) cytotoxic effects could be evaluated. Within the group of reaction/decomposition products, only moderate or slight effects were found (ED50: 0.7 to > 5 mM). The inhibitor BHT, the contaminant TPSb, and the photostabilizer HMBP, however, were highly cytotoxic in all cell cultures. In addition, the ED50 values of DBPO and HMBP significantly varied (0.43-3.8 mM, respectively, and 0.44-3.07 mM) with the applied cell culture. Our comprehensive screening shows that for several of the highly cytotoxic composite components, less cytotoxic alternatives are available. Furthermore, there was no cell type identified which was consistently less or more sensitive to the toxic effects of the tested compounds than the others. Primary human periodontal ligament and pulp fibroblasts, however, were found to be more sensitive than 3T3 and gingival fibroblasts to alterations from most tested substances.

The mutagenic activity of unpolymerized resin monomers in Salmonella typhimurium and V79 cells

Dimethacrylate derivatives are used as monomers to polymerize dental composite materials and for a great variety of other industrial resins. Occupational exposure is likely in various ways because of the many areas of methacrylate application. Here, the mutagenicity of the monomers, bisphenol A-diglycidyl dimethacrylate (Bis-GMA), urethane dimethacrylate (UDMA), triethylene glycol dimethacrylate (TEGDMA), Bisphenol A (BPA), glycidyl methacrylate (GMA), methyl methacrylate (MMA), and 2-hydroxyethyl methacrylate (HEMA) was studied in a bacterial (Ames test) and a mammalian gene mutation assay (V79/HPRT assay). Mutagenicity was determined in different Salmonella typhimurium strains (TA97a, TA98, TA100, TA102) and in V79 cells in the presence and in the absence of a metabolically active microsomal fraction from rat liver (S9). No mutagenic effects were observed with Bis-GMA and UDMA, methyl methacrylate, 2-hydroxyethyl methacrylate and bisphenol A. Glycidyl methacrylate (GMA) was mutagenic in a dose-dependent manner in three Salmonella tester strains. The number of mutants was increased by a factor of 2 to 3 with strains TA97a and TA102 in the absence of S9. Moreover, the numbers of mutants induced in S. typhimurium TA100 were about 8-fold higher than in solvent controls. GMA also induced an increase of mutants in V79 cells in the absence of S9. However, GMA was inactivated by microsomal enzymes. Triethylenglycol dimethacrylate (TEGDMA) was not mutagenic in any S. typhimurium. In contrast, the compound induced a dose-dependent rise in mutant frequencies in V79 cell cultures. It is concluded that TEGDMA acted through a clastogenic mechanism which is not detected by Ames tester strains.

Glutaraldehyde-containing dentin bonding agents are mutagens in mammalian cells in vitro

The mutagenic potential of glutaraldehyde-containing dentin bonding agents was shown in previous studies using a bacterial gene mutation assay, the Ames test. However, current strategies of genotoxicity testing and regulatory requirements for the biological evaluation of medical devices recommend a battery of tests that indicate induced mutations in prokaryotic and eukaryotic cells. Accordingly, the mutagenicity of three glutaraldehyde-containing bonding agents (Syntac adhesive, Prisma Universal Bond 3 adhesive, and Gluma 3) was investigated using a quantitative mammalian cell gene mutation assay (V79/HPRT test) in the present investigation. The materials were extracted in dimethyl sulfoxide (0.1 g/2 mL) for 24 h and original extracts were then serially diluted in cell culture medium before exposure to V79 cells. Cytotoxic and mutagenic effects were observed with identical concentrations of extracts of the different test materials. There was a moderate decrease of the number of surviving cells immediately after the end of exposure. Mutagenicity at the hprt locus in V79 cells was found with all materials tested, and the increases in the absolute numbers of mutants were dose dependent. The mutant frequencies were about 15- (Syntac adhesive and Gluma 3) to 20-fold (Prisma UB3 adhesive) higher than solvent control values. Since other substances than glutaraldehyde may be responsible for the mutagenic effects in mammalian cells in this study, work is currently in progress to identify the individual mutagenic compounds of dentin adhesives and related composite materials.

Validation of the SOS/umu test using test results of 486 chemicals and comparison with the Ames test and carcinogenicity data

The present study gives a comprehensive update of all umu genotoxicity assay results published so far. The available data of 486 chemicals investigated with the umu test are compared with the Ames test (274 compounds) as well as rodent carcinogenicity data (179 compounds). On the whole, there is good agreement between the umu test and the Ames test results, with a concordance of about 90%. The umu test was able to detect 86% of the Ames mutagens, while the Ames test (using at least 5 strains) detected 97% of the umu positive compounds. The elimination of TA102 from the set of Ames tester strains reduced the percentage of detectable umu genotoxins from 97 to 86%. The agreement between carcinogenesis and umu response was 65%, which is comparable to earlier studies concerning rodent carcinogenesis and Salmonella mutagenesis. The present compilation of umu results provides a database that can be used for the comparison of the SOS-inducing activity of chemicals and their mutagenicity, respectively, carcinogenicity. The results presented here clearly demonstrate that a chemical which induces the expression of the umu operon can be regarded a rodent carcinogen with a high degree of certainty (93%).

Genotoxicity of dental materials

This study was performed to characterize the (possible) DNA-damaging properties of dental materials and to identify specific compounds that contribute to this genotoxicity. For screening, three tests that assay for different aspects of genotoxicity (i) the bacterial umu-test; (ii) the eucaryotic DNA synthesis inhibition test; and (iii) the in vivo alkaline filter elution technique were chosen. This investigation gives several lines of evidence that most dental materials tested (14 chemical monosubstances present in dental devices and 7 extracts of dental materials) yield 'positive' results in at least one of the genotoxicity tests, however, with effects ranging from 'borderline' to 'strong positive'. The extracts of the widely used dental materials Vitrebond and AH26 elicited clear concentration-related genotoxic responses in all test systems. On the basis of these data and public concern, more attention has to be given to local or systemic complications which may be associated with the use of dental materials.

Mutagenic activity of various dentine bonding agents

The potential mutagenicity of bonding agents of the new generation was characterised by employing an in vitro gene mutation assay. Eight different components of three dentine bonding systems (Scotchbond Multi Purpose, Prisma Universal Bond 3 and C&B Metabond) were tested in the Ames test using four different Salmonella strains (TA97a, TA98, TA100 and TA102). The materials were eluted in dimethyl sulphoxide and physiological saline; aliquots of the serially diluted eluates were then used in the standard plate incorporation assay. No mutagenic effects were found with Scotchbond Multi Purpose primer and adhesive, Prisma Universal Bond 3 primer, and C&B Metabond base, powder and activator. However, the glutaraldehyde-containing Prisma Universal Bond 3 adhesive elicited a strong mutagenic effect in S. typhimurium strain TA102. Mutation rates caused by dimethyl sulphoxide eluates as well as physiological saline eluates were about five times higher than solvent control values. A mutagenic effect was also observed with C&B Metabond catalyst, especially in strain TA97a when the material was eluted in physiological saline. Both mutagenic responses were not influenced by a metabolically active microsomal fraction from rat liver. We consider the results observed in the Ames test as a first indication of possible mutagenic activity in higher organisms. Therefore, the materials are currently under further investigation using a quantitative in vitro mammalian cell mutation assay.

Biological Evaluation of Medical Devices: A Review of EU Regulations, with Emphasis on In Vitro Screening for Biocompatibility

— The quality of medical devices (including their biocompatibility) is regulated throughout the European Economic Area by Directive 93/42/EEC, which came into effect on 1 January 1995. The CE (conformity assessment) mark placed on the device shows conformity with the essential requirements, which guarantee the desired level of quality. Standards can be used to prove this conformity with the essential requirements. Scientific input is needed to produce and update relevant standards.