Effect of layer thickness on the elution of bulk-fill composite components

Evaluation of Color Stability and Translucency of Different Composite Resins Exposed to Alcohol

BACKGROUND

As there is evidence showing the effects of alcohol on the surface properties of composite resins, it is of great importance to understand the effects of commonly consumed beverages on the discoloration of composite restorations in people who consume alcohol.

AIM

The aim of this study was to investigate the changes in the color and translucency of composite resins immersed in different beverages after exposure to alcohol.

METHODS

Disk-shaped samples from each composite resin (Filtek Z250 (Z250), Clearfil Majesty Esthetic (CME), and Esthelite Bulk Fill Flow (EBF), were prepared (n = 60) and randomly divided into two groups (exposed or unexposed to alcohol). The samples were immersed in distilled water, black tea, and coffee. The color parameter (∆E00) and translucency parameter (∆TP) were calculated after 24 h, 1 week, and 3 weeks. Four-way ANOVA and Tukey's post-hoc analysis were used for the statistical analysis (α = 0.05).

RESULTS

Alcohol significantly increased the discoloration of Z250 and EBF in black tea. The discoloration of CME was not affected by alcohol exposure. Z250 and EBF showed clinically unacceptable discoloration (ΔE00 > 2.25) after immersion in black tea and coffee, whereas CME showed clinically unacceptable discoloration after immersion in black tea. Black tea caused the greatest color change in all composite materials regardless of alcohol exposure. EBF showed the lowest ΔTP values (∆TP = -1.82) at 3 weeks of immersion in black tea.

CONCLUSIONS

The effect of alcohol on discoloration depended on the composite type used. The translucency of bulk-fill flowable composite decreased with alcohol exposure.

Leaching components and initial biocompatibility of novel bioactive restorative materials

OBJECTIVES

Bioactive restorative materials were developed on the premise that direct restorations should not only serve the purpose of reconstructing dental hard tissue defects but also exhibit biological features that prevent secondary caries development, without having adverse effects on the host cells. This study focuses on assessing the in vitro biocompatibility of two novel bioactive restorative materials.

METHODS

Specimens of the bioactive restorative materials, Cention Forte (CF) and ACTIVA BioACTIVE RESTORATIVE (AB), a glass ionomer cement/glass hybrid (EQUIA Forte HT, EF) and an established nanohybrid composite (Venus Diamond, VD) were produced and finished. The specimens were eluted in water and methanol and the resulting eluates were analyzed via gas chromatography-mass spectrometry. hGF-1 cells were exposed to eluates prepared in cell culture medium. Cellular ATP levels, oxidized glutathione concentration, caspase-3/7 activity and the inflammatory response (IL-6 and PGE₂ levels) were determined. Microscopic images were taken to examine the cell morphology.

RESULTS

Methyl methacrylate and 2-Hydroxyethyl methacrylate were the main monomers detected in CF and AB eluates. All materials inhibited cell proliferation and led to significantly reduced ATP-levels. The cells exhibited a healthy morphology in the presence of CF and AB. Cells exposed to VD showed increased oxidized glutathione levels. Only EF led to enhanced caspase-3/7 activity. CF and AB caused IL-6 levels to increase, while EF and AB led to enhanced PGE₂ levels.

SIGNIFICANCE

CF and AB are promising materials from a biological point of view and seem to have improved bioactive properties compared to glass ionomer cements.

Detection of Leachable Components from Conventional and Dental Bulk-Fill Resin Composites (High and Low Viscosity) Using Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) Method

The aim of this study was to investigate leachable components (monomers) in high and low viscosity dental bulk-fill resin composites and conventional resin composite materials after polymerization. Six bulk-fill and six conventional dental resin composite materials were used in this study. The samples of each material (three sets of triplicates) were cured for 20 s with irradiance of 1200 mW/cm² with a LED curing unit and immersed in a 75% ethanol solution at 37 °C. The eluates from each triplicate set were analyzed after 24 h, 7 days or 28 days using liquid chromatography coupled with triple quadrupole tandem mass spectrometry (LC-MS/MS). Detectable amounts of 2-Hydroxyethyl methacrylate (HEMA) were found in both Gradia materials and the amount observed across different time points was statistically different (p ˂ 0.05), with the amount in solution increasing for Gradia and decreasing for Gradia Direct flo. Bisphenol A diglycidildimethacrylate (BIS GMA) was found in Filtek and Tetric materials. Triethylene glycol dimethacrylate (TEGDMA) was detected in all materials. On the other hand, there were no statistically significant differences in the amounts of TEGDMA detected across different time points in either of the tested materials. Monomers HEMA, TEGDMA, 4-dimethylaminobenzoic acid ethyl ester (DMA BEE) and BIS GMA in bulk-fill and conventional composites (high and low viscosity) can be eluted after polymerization. The good selection of composite material and proper handling, the following of the manufacturer's instructions for polymerization and the use of finishing and polishing procedures may reduce the elution of the unpolymerized monomers> responsible for the possible allergic and genotoxic potential of dental resin composites.

Effect of topical fluoride applications on residual monomer release from resin-based restorative materials

BACKGROUND

The effects of topical fluoride applications on the release of monomer ingredients from resin-based dental materials by immersion in various extraction solutions are unclear. The aim of this study was to determine the effect of topical fluorides (APF and NaF) on the elution of residual monomers (Bis-GMA, TEGDMA, UDMA, and HEMA) from resin-based materials.

METHODS

Ninety specimens were prepared, 30 bulk-fill composite resin, 30 nanohybrid universal composite resin, and 30 polyacid-modified composite resin (compomer). These were randomly divided into three groups based on fluoride application procedures. Each specimen was kept in 75% ethanol solution, and residual monomers released from materials were analyzed using high-performance liquid chromatography (HPLC) after 10 min, 1 h, 24 h, and 30 days. The groups were compared using the Mann Whitney U and Kruskal Wallis tests. Measurements were analyzed using the Friedman and Wilcoxon signed-rank tests.

RESULTS

Fluoride applications generally had no considerable effect on the amount of residual monomer released from resin-based restorative materials. The amount of monomer release after topical APF application was similar to the release in the control group and was lower than the release in the NaF group. The release of monomers from the resin-based material used in the study did not approach toxic levels at the applied time intervals. The compomer released lower amounts of monomer than other resin-based materials.

CONCLUSIONS

Fluoride applications do not increase monomer release from resin-based restorative materials. However, compomers should be employed by clinicians due to their lower monomer release compared to other resin restorative materials. The release of monomers from all the resin-based materials did not approach toxic levels at the applied time intervals.

Analysis of Monomer Release from Different Composite Resins after Bleaching by HPLC

(1) Background: This study aimed to examine the effect of bleaching agents on the release of triethylenae glycol dimethacrylate, 2-hydroxyethyl methacrylate, bisphenol A, urethane dimethacrylate, and bisphenol A-glycidyl methacrylate monomers, which are released from different composite resins, using the high-performance liquid chromatography (HPLC) method. (2) Methods: Ninety disc-shaped specimens were produced and immersed in artificial saliva. After different bleaching applications [office type bleaching (OB) and home type bleaching (HB)], the specimens were immersed in a 75 wt% ethanol/water solution, and the released monomers were analyzed by HPLC at predefined time intervals: 1, 7, and 28 days. The Kruskal−Wallis and Mann−Whitney U tests were conducted for statistical analysis (p = 0.05). (3) Results: The monomers were released at all times from all composite specimens. The monomer release was increased over time. The highest monomer release was detected on day 28. Bleaching applications affected monomer release. No statistical difference was found between OB and HB applications (p > 0.05). The most released monomer was Bisphenol-A in all composites. (4) Conclusion: Given that a residual monomer release from composite resins has a toxic effect and that bleaching treatments increase this release, a treatment protocol should be made in accordance with the manufacturer’s instructions.

Renewal MI Dental Composite Etch and Seal Properties

This study's aim was to assess whether the Renewal MI composite can self-etch enamel, seal sound cavities, and stabilize demineralized dentine. Etching was assessed using scanning electron microscopy (SEM). Cavity sealing was quantified using the ISO-11405 dye microleakage test. Demineralized dentine stabilization was evaluated by visualizing resin tag formation, enzyme activity and mineral precipitation at the adhesion interface. Renewal MI provided a mild etching of sound enamel in comparison with 37% phosphoric acid. It provided a comparable seal of sound cavities to Z250/Scotchbond Universal adhesive and a superior seal to Activa, Fuji IX and Fuji II LC. With demineralized dentine, Renewal MI formed 300-400 µm resin tags covering 63% of the adhesion interface compared with 55 and 39% for Z250/Scotchbond and Activa. Fuji IX and Fuji II LC formed no resin tags. A higher tag percentage correlated with lower surface enzyme activity. Unlike Activa and Fuji II LC, Renewal MI promoted mineral precipitation from simulated body fluid, occluding adjacent dentinal tubules within 6 months. These novel etching and sealing properties may facilitate Renewal MI's application in minimally invasive dentistry.

Effect of Adhesive Resin as a Modeling Liquid on Elution of Resin Composite Restorations

Background

Adhesive resin is increasingly used as a modeling liquid for composite. Based on previous studies, elution of some components from the composite mass negatively affects the oral tissues. Since few studies have focused on the effect of adhesive resin on composite mass, this study aimed to investigate the effect of dental adhesion factors as modeling liquid on the elution of substances from composite restorations.

Materials and Methods

Sixty-four composite specimens (6 × 2 mm diameter × height) were prepared in four groups (n = 16) by using a Teflon ring. Composite mass was incrementally applied in four layers (0.5 mm). The control group contained no material between the layers, but other groups had one of the single bond, SE bond, and wetting resin adhesives between the layers. Specimens were immersed in distilled water and methanol. The amount of released triethylene glycol dimethacrylate (TEGDMA), urethane dimethacrylate (UDMA), and camphorquinone (CQ) was monitored by gas chromatography after 24 hours and 7 days. Data were analyzed with SPSS software through Kruskal–Wallis and Mann–Whitney U tests (α = 0.05).

Results

The highest rate of released TEGDMA comonomer was seen in the wetting resin group in the water medium. The highest rate of released UDMA monomer was seen in SE bond and wetting resin groups in the methanol medium after 24 hours. The highest amount of released CQ in the methanol medium was observed in the SE bond group after 7 days.

Conclusion

Single bond adhesive can be used as modeling liquid since it has no significant effect on the elution of components from composite mass. Whereas, wetting resin and SE bond adhesives are not suitable to be used as modeling liquid due to the high amounts of released TEGDMA and UDMA.

Meta-analytical analysis on components released from resin-based dental materials

OBJECTIVES

Resin-based materials are applied in every branch of dentistry. Due to their tendency to release substances in the oral environment, doubts have been raised about their actual safety. This review aims to provide a comprehensive analysis of the last decade literature regarding the concentrations of elutable substances released from dental resin-based materials in different type of solvents.

MATERIALS AND METHODS

All the literature published on dental journals between January 2010 and April 2022 was searched using international databases (PubMed, Scopus, Web of Science). Due to strict inclusion criteria, only 23 papers out of 877 were considered eligible. The concentration of eluted substances related to surface and volume of the sample was analyzed, considering data at 24 h as a reference. The total cumulative release was examined as well.

RESULTS

The most eluted substances were HEMA, TEGDMA, and BPA, while the less eluted were Bis-GMA and UDMA. Organic solvents caused significantly higher release of substances than water-based ones. A statistically significant inverse correlation between the release of molecules and their molecular mass was observed. A statistically significant positive correlation between the amount of released molecule and the specimen surface area was detected, as well as a weak positive correlation between the release and the specimen volume.

CONCLUSIONS

Type of solvent, molecular mass of eluates, and specimen surface and volume affect substances release from materials.

CLINICAL RELEVANCE

It could be advisable to rely on materials based on monomers with a reduced elution tendency for clinical procedures.

The effects of polymerization mode and layer thickness on monomer released from bulk fill composite resins

Background

Residual monomers released from composite resins have cytotoxic, mutagenic, and estrogenic effects. Mode of polymerization and application thickness are important for monomer release.

Aims

The aim of this study was to investigate the effects of different modes of a third-generation light-curing unit (LCU) and layer thickness on residual monomer released from two different bulk-fill composite resins. A total of 80 samples were prepared for each bulk-fill composite using a mold. Each bulk-fill composite was divided into four groups according to polymerization mode (standard and extra power) and layer thickness (2 and 4 mm). In addition, four groups were divided into four subgroups according to time periods (1 h, 24 h, 3 days, and 7 days).

Methods and Material

The samples were polymerized with VALO LED device. The amount of residual monomer was measured with High-Performance Liquid Chromatography (HPLC). All statistical analyses were processed using SPSS Version 23.0. The normal distribution of data was confirmed using Kolmogorov-Smirnov Normal Distribution Test and Shapiro-Wilk Normal Distribution Test. When the distribution was normal, parametric tests, Student's t test and one-way ANOVA, were used. When the distribution was not normal, non-parametric tests, Mann-Whitney U test, and Kruskal-Wallis testwere used.

Results

It was found that the standard mode of LCU produced lower amounts of TEGDMA, Bis-GMA, and UDMA in both composite materials. In addition, when the layer thickness increased, TEGDMA, Bis-GMA, and UDMA releases increased, too.

Conclusions

This study revealed that the amount of residual monomers released from bulk-fill composites was affected by layer thickness and polymerization time.

Elution behavior of a 3D-printed, milled and conventional resin-based occlusal splint material

OBJECTIVE

The elution of unpolymerized (co-)monomers and additives from methacrylic resin-based materials like polymethyl methacrylate (PMMA) can cause adverse side effects, such as mutagenicity, teratogenicity, genotoxicity, cytotoxicity and estrogenic activity. The aim of this study was to quantify the release and the cytotoxicity of residual (co-)monomers and additives from PMMA-based splint materials under consideration of real splint sizes. Three different materials used for additive (3D printing), subtractive (milling) and conventional (powder and liquid) manufacturing were examined.

METHODS

The splint materials SHERAprint-ortho plus (additive), SHERAeco-disc PM20 (subtractive) and SHERAORTHOMER (conventional) were analysed. 16 (n = 4) sample discs of each material (6 mm diameter and 2 mm height) were polished on the circular and one cross-section area and then eluted in both distilled water and methanol. The discs were incubated at 37 °C for 24 h or 72 h and subsequently analysed by gas chromatography/mass spectrometry (GC/MS) for specifying and quantifying released compounds. XTT-based cell viability assays with human gingival fibroblasts (HGFs) were performed for Tetrahydrofurfuryl methacrylate (THFMA), 1,4-Butylene glycol dimethacrylate (BDDMA) and Tripropylenglycol diacrylate (TPGDA). In order to project the disc size to actual splint sizes in a worst-case scenario, lower and upper jaw occlusal splints were designed and volumes and surfaces were measured.

RESULTS

For SHERAeco-disc PM20 and for SHERAORTHOMER no elution was determined in water. SHERAprint-ortho plus eluted the highest THFMA concentration of 7.47 μmol/l ±2,77 μmol/l after 72 h in water. Six (co-)monomers and five additives were detected in the methanol eluates of all three materials tested. The XTT-based cell viability assays resulted in a EC₅₀ of 3006 ± 408 μmol/l for THFMA, 2569.5 ± 308 μmol/l for BDDMA and 596.7 ± 88 μmol/l for TPGDA.

SIGNIFICANCE

With the solvent methanol, released components from the investigated splint materials exceeded cytotoxic concentrations in HGFs calculated for a worst-case scenario in splint size. In the water eluates only the methacrylate THFMA could be determined from SHERAprint-ortho plus in concentrations below cytotoxic levels in HGFs.

The polymerization efficiency of a bulk-fill composite based on matrix-modification technology

Objectives

To evaluate the polymerization efficiency of a matrix-modified bulk-fill composite, and compare it to a conventional composite which has a similar filler system. The degree of conversion (DC%) and monomer elution were measured over different storage periods. Additionally, fillers' content was examined.

Materials and Methods

Cylindrical specimens were prepared, in bulk and incrementally, from Filtek Bulk Fill (B) and Filtek Supreme XTE (S) composites using a Teflon mold, for each test (n = 6). Using attenuated total reflection method of Fourier transformation infrared spectroscopy, DC% was measured after 24 hours, 7 days, and 30 days. Using high-performance liquid chromatography, elution of hydroxyethyl methacrylate, triethylene glycol dimethacrylate, urethane dimethacrylate, and bisphenol-A glycidyl dimethacrylate was measured after 24 hours, 7 days and 30 days. Filler content was examined by scanning electron microscopy (SEM). Data were analyzed using 2-way mixed-model analysis of variance (α = 0.05).

Results

There was no significant difference in DC% over different storage periods between B-bulk and S-incremental. Higher monomer elution was detected significantly from S than B. The elution quantity and rate varied significantly over storage periods and between different monomers. SEM images showed differences in fillers' sizes and agglomeration between both materials.

Conclusions

Matrix-modified bulk-fill composites could be packed and cured in bulk with polymerization efficiency similar to conventional composites.

[Factors influencing clinical application of bulk-fill composite resin]

Bulk-fill composite resin are simple to operate, and they reduce polymerization shrinkage and microleakage compare to traditional resin-based composites. However, their clinical application could be affected by numerous factors, such as the material itself, light curing, placement techniques, storage condition, and preheating. This review aimed to summarize the definitions, classifications, indications, clinical properties, and influencing factors of the clinical application of bulk-fill resin-based composites and discuss the ways to improve their clinical effectiveness.

Cytotoxic effects of contemporary bulk-fill dental composites: A real-time cell analysis

The aim of this study was to evaluate the cytotoxicity of contemporary flowable and paste-like bulk-fill dental composites by using a real-time cell analysis. In the present paper, cytotoxicity levels of five flowable, five paste-like bulk-fill composite materials and one conventional flowable, one conventional paste-like resin composite were examined on L929 mouse fibroblast cell line. After seeding 25,000 cells/300 μL/well cell suspensions into the wells of an E-plate, test materials were added and observed at every 30 min intervals for 72 h. Kruskal Wallis H and Mann Whitney U multiple comparison tests were used to analyze the results. Pre-reacted glass-ionomer (PRG) containing bulk-fill composites were severely toxic at all time points (24, 48 and 72 h, p<0.05). None of the tested composites demonstrated high cell viability (>70%) at 48 and 72 h. Flowable and paste-like composites of the same brand exhibited similar cytotoxic properties (p>0.05).

Curing Depth and Degree of Conversion of Five Bulk-Fill Composite Resins Compared to a Conventional Composite

Background:

Limited curing depth and its effect on the degree of conversion are among the challenges of working with light-cure composite resins. The use of bulk-fill composites is one strategy to overcome these limitations.

Methods:

Ever X Posterior (EXP), Filtek Bulk-Fill Posterior (FBP), Sonic Fill 2 (SF2), Tetric N-Ceram Bulk-Fill (TNB), and X-tra Fil (XF) bulk-fill and Filtek Z250 conventional composite were evaluated in this in vitro experimental study. Six samples for the assessment of microhardness and three samples for the evaluation of DC were fabricated of each composite. After light curing and polishing, the samples were incubated at 37°C for 24 hours. Microhardness was measured by a Vickers hardness tester three times and the mean value was calculated. DC of the top and bottom surfaces was determined using Fourier-Transform Infrared Spectroscopy (FTIR). Data were analyzed using one-way ANOVA and Tukey’s test.

Results:

Microhardness and DC were significantly different among the groups (P<0.001). XF and Z250 equally showed the highest bottom-to-top surface microhardness ratio (0.97 ± 0.01) and significantly higher DC in the top (P<0.001) and bottom (P<0.005) surfaces compared to other groups. TNB showed the lowest microhardness ratio (0.88 ± 0.04) and DC (68.66 ± 1.52 and 61.00 ± 2.00); the difference in DC of the bottom surface was statistically significant (P<0.003).

Conclusion:

It appears that bulk-fill composites evaluated in this study are adequately polymerized at 4 mm depth. Their DC was optimal and within the range of conventional composites.

Evaluation of Isobornyl Acrylate Content in Medical Devices for Diabetes Treatment

Background: Along with increased usage of continuous glucose monitors, flash glucose monitors, and patch pumps by patients with diabetes, the frequency of skin reactions has also increased. Skin irritation and itching can be annoying to users. However, more serious contact allergies to one or more components of the adhesives or plastic material of the housing of the devices can become lifelong. Redness and itchiness are so strong that patients can no longer use a particular system. In August 2017, a major culprit allergen, isobornyl acrylate (IBOA), was identified for these more serious reactions. Objectives: Our objective was to evaluate IBOA content in different medical products. Methods: The plastic material used for the housing of the Freestyle Libre (n = 3), Dexcom G6 (n = 3), and Enlite (n = 4) was analyzed for IBOA content by gas chromatography-mass spectrometry. Adhesives of the different systems were also analyzed. Results: IBOA was found in the housings of Freestyle Libre and Enlite sensor, but not in the Dexcom G6. Conclusions: Patients with an IBOA allergy should consider switching to a medical product without IBOA. Furthermore, removal of IBOA from devices that contact the skin is encouraged.

Antioxidants as a novel dental resin-composite component: Effect on elution and degree of conversion

OBJECTIVE

Ascorbic acid (Asc) and N-acetylcysteine (NAC) were reported to reduce genotoxicity induced by dental (co)monomers and their epoxy metabolites. The aim of the present study was to investigate Asc or NAC as novel components in light-curable methacrylate based dental composites regarding their effects on degree of conversion (DC) and elution of composite components. Additionally, the release of Asc or NAC was determined.

METHODS

Asc or NAC (1, 0.1, 0.01 or 0 wt%) was experimentally incorporated into the composites Venus^®, Grandio^® and Filtek^TM Supreme XTE and polymerized according to the instruction of manufacturers. The samples were elussted in methanol and water. For each composite-antioxidant mixture and elution medium four samples (n = 4) were prepared. The eluates were analyzed by gas chromatography/mass spectrometry (GC/MS), high-performance liquid chromatography/ultraviolett/diode array detection (HPLC/UV/DAD) and high-performance liquid chromatography/fluorescence detection (HPLC/FLD). DC of composite-antioxidant mixtures was measured in real-time with Fourier transform infrared spectroscopy (FTIR).

RESULTS

The highest concentrations of eluted Asc were 313.98 μM (Venus^®-1 wt% Asc; 1 day; methanol) and 245.34 μM (Filtek^TM Supreme XTE-1 wt% Asc; 5 min; water). The highest concentrations of eluted NAC were 42.99 μM (1 day; Filtek^™ Supreme XTE-1 wt% NAC; 1 day; methanol) and 108.11 μM (Filtek^™ Supreme XTE-1 wt% NAC; 7 day; water). Triethylene glycol dimethacrylate (TEGDMA) elution was significantly increased in Venus^®-1 wt% Asc and Grandio^®-1 wt% Asc (1 day and 7 day methanol/water), compared to control. No significant difference was found for TEGDMA elution in Filtek^™ Supreme XTE-1 wt% Asc/NAC. DC was significantly decreased compared to control (= composite without antioxidant) in Grandio^® and Filtek^™ Supreme XTE after 1, 0.1 and 0.01 wt% Asc incorporation and in Venus^® after 1 and 0.1 wt% Asc incorporation. For composite-NAC mixtures, only DC of Grandio^®-1 wt% NAC was significantly reduced.

SIGNIFICANCE

Incorporation of NAC (1 wt%), as a novel composite component, into Filtek^™ Supreme XTE, had no effect on DC and composite component elution, and supplies sufficient amount of antioxidant which may reduce toxicity. Therefore, it represents a beneficial mixture.

Cytotoxicity and DNA double-strand breaks in human gingival fibroblasts exposed to eluates of dental composites

OBJECTIVE

Previously, single composite components were used to study cytotoxicity and induction of DNA double-strand breaks (DNA-DSBs) of dental composite resins. In the present study, cytotoxicity and induction of DNA-DSBs in human gingival fibroblasts (HGFs) were investigated with dental composite eluates consisting of multiple components. The eluates were qualified and quantified.

METHODS

The composites Esthet.X^® HD, Venus^®, X-tra fil^®, CLEARFIL™ AP-X, Admira^® Fusion and QuiXfil^® were polymerized and immersed into Dulbecco's modified Eagle's medium (DMEM) for 72h. Subsequently, HGFs were incubated with the corresponding composite eluates. The cell viability of HGFs was obtained from an XTT assay. DNA-DSBs were determined using a γ-H2AX assay. The qualification and quantification of eluates were performed by gas chromatography/mass spectrometry (GC/MS).

RESULTS

HGFs exposed to the eluates of all investigated composites showed no significant loss of cell viability, compared to negative control. Significant DNA-DSBs induction could be found in HGFs exposed to the eluates of Esthet.X^® HD (0.43±0.05 foci/cell) and Venus^® (0.39±0.04 foci/cell), compared to control (0.22±0.03 foci/cell). A total of 12 substances were detected from the investigated composite eluates. Five of them were methacrylates: tetraethyleneglycol dimethacrylate (TEGDMA), 2-hydroxyethyl methacrylate (HEMA), hydroxypropyl methacrylate (HPMA), ethyleneglycol dimethacrylate (EGDMA) and trimethylolpropane trimethacrylate (TMPTMA). The highest concentration of HEMA (110.5μM), HPMA (86.08μM) and TMPTMA (4.50μM) was detected in the eluates of QuiXfil^®. The highest concentration of TEGDMA was 1080μM in Venus^® eluates and the highest concentration of EGDMA was 3.18μM in Esthet.X^® HD eluates.

SIGNIFICANCE

Significant DNA-DSBs induction can be found in HGFs exposed to the eluates of Esthet.X^® HD and Venus^®. The interactive effects among released (co)monomers and additives may influence the cytotoxicity and induction of DNA-DSBs, compared to exposure with single composite component.