Cytotoxicity and genotoxicity of natural resin-based experimental endodontic sealers

Effect of three different root canal sealants on human dental pulp stem cells

The cytotoxic effects of three root canal sealers with different bases on human dental pulp stem cells were assessed in this study using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) test. The cytotoxic effects of three root canal sealers with different bases on human dental pulp stem cells (DPSCs) were assessed in this study using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) test. The cytotoxicity of the sealers was tested after one, 4, and 7 d. Human dental pulp stem cell proliferation was concluded using an MTT assay. Cells not treated with sealer extract were used as controls. The absorption levels were measured using an Eliza spectrophotometer. P was set at 0.05 when the percentage of cell proliferation was matched between groups and observation times using one-way analysis of variance (ANOVA).During the second passage (P2), human dental pulp stem cells displayed a single morphological and phenotypic trait, with fibroblast morphology being the most common. There were no appreciable variations between the four groups after a day. There was a notable variation in the average percentage of cell proliferation between the groups after 4 and 7 days. The control group had the highest percentage, followed by the GuttaFlow Bioseal group, the Well Root St group, and the AH-Plus group, which had the lowest percentage. For every sealing group, after one day, the highest mean percentage of cell proliferation was recorded, followed by day four, and after day seven, the lowest mean percentage. The observation periods showed minimal cytotoxic effects of GuttaFlow Bioseal, whereas AH-Plus was the most cytotoxic to human dental pulp stem cells. The highest mean percentage of cell proliferation for all sealers was recorded on day one.

Cytotoxicity and Genotoxicity of Epoxy Resin-Based Root Canal Sealers before and after Setting Procedures

Epoxy resin-based sealers are commonly used for successful endodontic treatment. This study aimed to evaluate the cytotoxicity and genotoxicity of epoxy resin-based sealers under unset and set conditions. Three epoxy resin-based sealers were used: Adseal, AH Plus, and Dia-Proseal. To test cytotoxicity, an agar overlay test and a 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay were performed using unset and set sealers on L929 mouse fibroblasts. The genotoxicity test of the comet assay was performed using the same cell line. Extract dilutions in the culture media were used as test materials for the MTT and comet assays. The comet tail produced by the damaged DNA was calculated by image analyses. Statistical analyses were performed using one-way analysis of variance and Tukey’s post hoc test. Unset sealers did not show defined decolorized areas. Hardened specimens of resin-based sealers showed circular discolored zones in the agar overlay test. Dia-Proseal was the least cytotoxic after hardening. These results were confirmed in the MTT assay. Cell viability was significantly higher in cells treated with hardened sealers in both groups than that in cells treated with freshly mixed sealers in the MTT assay. Unset AH Plus^® and Dia-Proseal™ significantly increased cell viability with decreasing dilution. Adseal™ was the least cytotoxic. Freshly mixed Adseal™ was more genotoxic when freshly mixed than when set. Unset epoxy resin-based sealers were generally more cytotoxic and genotoxic than set materials. Cytotoxicity does not always match the genotoxicity results; therefore, various test tools are required to test toxicity. It is necessary to properly evaluate the toxic effects to establish a biocompatibility test that mimics clinical conditions.

Genotoxicity of root canal sealers: a literature review

OBJECTIVES

Root canal sealers are widely used worldwide in endodontics to prevent reinfection and growth of surviving microorganisms. Considering the strong correlation between genetic damage and carcinogenesis, evaluation of genotoxicity induced by endodontic sealers is recommended for elucidating the true health risks to patients and professionals. The purpose of this article was to provide a comprehensive review of studies involving genotoxicity analysis of endodontic sealers and the used methodologies.

MATERIALS AND METHODS

A literature search was made in PubMed using the following combination of words "genotoxicity," "mutagenicity," "endodontic sealers," and "root canal sealers." A total of 39 articles with genotoxicity studies were selected for the present study.

RESULTS

Sealers have been ranked in decreasing order of their genotoxicity as: ZOE sealers > GIC sealers > S sealers > ER sealers > MR sealers > Novel sealers > CH sealers > CS sealers.

CONCLUSIONS

All published data showed some evidence of genotoxicity for most of the commercial root canal sealers; however, contradictory results were found, mainly for AH Plus, the most studied sealer.

CLINICAL RELEVANCE

The information provided would direct the endodontists to use the less genotoxic materials in endodontic treatment in a way to reduce DNA damage promoting oral healthcare.

Cytotoxicity and release ions of endodontic sealers incorporated with a silver and vanadium base nanomaterial

The modification of endodontic sealers with nanoparticles to confer antimicrobial activity allow greater effect, with interaction at a molecular level. The nanostructured silver vanadate decorated with silver nanoparticles (AgVO₃) is a nanomaterial unprecedented in dentistry for this application. This study incorporated the AgVO₃ into three endodontic sealers of different compositions and evaluate the cytotoxicity and release of compounds. The groups of commercially available AH Plus, Sealer 26, and Endomethasone N and groups of the same sealers with incorporated AgVO₃ (at concentrations 2.5, 5, 10%) were prepared, and extracts of the specimens were obtained for 24 h. The cell viability (cytotoxicity) of human gingival fibroblasts (HGF) was assessed after 24 h, 7 and 14 days. Silver (Ag⁺) and vanadium (V⁴⁺/V⁵⁺) ion release was quantified after 24 h by ICP-MS. Data were analyzed by Kruskal-Wallis and Dunn's post-hoc (α = 0.05). The cell viability was inversely proportional to treatment time. The Sealer 26 and Endomethasone N groups were cytotoxic for HGF cells, regardless of the incorporation of the AgVO₃ (p > 0.05), and the incorporation reduced cell viability of AH Plus (p < 0.05). The release of ions was proportional to the concentration of AgVO₃. AH Plus released more Ag⁺ ions, and Sealer 26 and Endomethasone N releases more V⁴⁺/V⁵⁺ ions. In conclusion, it was not possible to confirm the influence of AgVO₃ on HGF cell viability to Sealer 26 and Endomethasone N, however, nanomaterial influenced cell-viability to AH Plus, so the commercial sealers can be cytotoxic in synergy with the nanomaterial. The release of Ag⁺ and V⁴⁺/V⁵⁺ was proportional to the AgVO₃ incorporated.

Cytotoxicity of Two Experimental Epoxy Resin-Based Sealers

INTRODUCTION

Many endodontic sealers are available, but search for the ideal sealer continues. This study aimed to assess the cytotoxicity of two experimental endodontic sealers in comparison with AH-26 resin sealer.

METHODS AND MATERIALS

This in vitro study was conducted on conventional and experimental root canal sealers: AH-26, an epoxy resin experimental sealer A (ES-A) composed of calcium tungstate, zirconium oxide, aerosil, bismuth oxide, titanium oxide, hexamine and an epoxy resin and experimental sealer B (ES-B) with compositions similar to ES-A except for the presence of imidazoline as a catalyst. The experimental sealers containing nano-particles were mixed with 37.5% of an epoxy resin. The extraction of five samples of each experimental sealer (A, B) and AH-26 sealer were subjected to MTT assay in the form of set and fresh at 1, 24 and 72 h with 1, 10, 100% dilution according to the International Standard ISO:10993-2012. Data were analyzed using the one-way ANOVA.

RESULTS

The set ES-A had the least cytotoxicity from the first hour but the cytotoxicity of ES-B and AH-26 extraction decreased over time. In fresh form, except for 100% concentration, ES-A showed the least cytotoxicity compared to the other two sealers.

CONCLUSION

All three sealers had high cytotoxicity in 100% concentration but had low cytotoxicity in 10% and 1% concentrations.

Effect of root canal sealers on human periodontal ligament fibroblast viability: ex vivo study

The aim of the study was to compare ex vivo the toxic effects of six root canal sealers immediately after mixing or setting on human periodontal ligament fibroblasts (HPdLF). Freshly mixed (I group) or set (allowed to dry for 24 h) (II group) specimens of AH Plus Jet (AH), Apexit Plus (AP), MTA Fillapex (FL), GuttaFlow (GF), MetaSEAL Soft (META), and Tubli-Seal (TS) were prepared. HPdLF were exposed for 24 h to the specimens. 3-(4,5-dimethylthiazolo-2-yl)-2,5-diphenyltetrazolium bromide assay was used to examine the effect of the root canal sealers on mitochondrial metabolic activity. Fluorescein isothiocyanate (FITC)-annexin V (AnV) and propidium iodide staining followed by flow cytometry was used to identify the effects of the materials on cell apoptosis/necrosis. Statistical analyses were performed by one-way ANOVA followed by post hoc tests, and significance was determined at P < 0.05. Most materials from the two groups reduced the viability of the cultured cells compared with the control group (P < 0.05). Statistical analysis showed significant differences in HPdLF viability between the individual materials in each group (P < 0.001). AH and AP induced a significant increase in the percentage of apoptotic cells, while TS, FL, and META elevated the proportion of necrotic cells compared with other materials and the controls (p < 0.05). The cytotoxic effects of the tested root canal sealers (both fresh and set) on HPdLF varied. Both forms of sealers were able to cause toxic effects by inducing apoptosis and necrosis in HPdLF. The cytotoxicity of FL, META, TS was mainly associated with necrosis, while AH and AP with apoptosis.

Biocompatibility of New Pulp-capping Materials NeoMTA Plus, MTA Repair HP, and Biodentine on Human Dental Pulp Stem Cells

INTRODUCTION

The aim of the present study was to evaluate the in vitro cytotoxicity of MTA Repair HP, NeoMTA Plus, and Biodentine, new bioactive materials used for dental pulp capping, on human dental pulp stem cells (hDPSCs).

METHODS

Biological testing was carried out in vitro on hDPSCs. Cell viability and cell migration assays were performed using eluates of each capping material. To evaluate cell morphology and cell attachment to the different materials, hDPSCs were directly seeded onto the material surfaces and analyzed by scanning electron microscopy. The chemical composition of the pulp-capping materials was determined by energy-dispersive X-ray and eluates were analyzed by inductively coupled plasma-mass spectrometry. Statistical differences were assessed by analysis of variance and Tukey test (P < .05).

RESULTS

Cell viability was moderate after 24 and 48 hours in the presence of MTA Repair HP and NeoMTA Plus, whereas at 48 and 72 hours, Biodentine showed higher rates of cell viability than MTA Repair HP and NeoMTA Plus (P < .001). A cell migration assay revealed adequate cell migration rates for MTA Repair HP and NeoMTA Plus, both similar to the control group rates, meanwhile the highest cell migration rate was observed in the presence of Biodentine (P < .001). Scanning electron microscope studies showed a high degree of cell proliferation and adhesion on Biodentine disks but moderate rates on MTA Repair HP and NeoMTA Plus disks. Energy-dispersive X-ray pointed to similar weight percentages of C, O, and Ca in all 3 materials, whereas other elements such as Al, Si, and S were also found.

CONCLUSIONS

The new pulp-capping materials MTA Repair HP, NeoMTA Plus, and Biodentine showed a suitable degree of cytocompatibility with hDPSCs, and good cell migration rates, although Biodentine showed higher rates of proliferation time-dependent.