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Dunavári EK, Kőházy A, Vecsernyés M, Szalma J, Lovász BV, Berta G, Lempel E. Does Preheating Influence the Cytotoxic Potential of Dental Resin Composites? Polymers (Basel) 2024; 16:174. [PMID: 38256973 PMCID: PMC10820920 DOI: 10.3390/polym16020174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/01/2024] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
Resin-based dental composites (RBC) release cytotoxic components, however the extent of the elution from preheated RBCs is barely investigated. The aim was therefore to determine the cytotoxic effect of preheated conventional, bulk, and thermoviscous RBCs of clinically relevant sizes using different cell viability methods in a contact-free model. Samples (6 × 4 mm) were prepared from conventional [Estelite Sigma Quick (ESQ), Filtek Z250 (FZ)] and bulk-filled [Filtek One BulkFill Restorative (FOB), SDR Plus Bulk Flow (SDR), VisCalor Bulk (VCB)] RBCs. The pre-polymerization temperature was set to room temperature (RT) and 55/65 °C. Pulp cells were cultured, followed by a 2-day exposure to monomers released from solid RBC specimens suspended in the culture medium. Cytotoxicity was assessed using a WST-1, MTT, and LDH colorimetric viability assays. Data were analyzed using one-way ANOVA, Tukey's post hoc test, multivariate analysis, and independent t-test. The effect size (ƞp2) of material and temperature factors was also assessed. All the RBCs demonstrated cytotoxic effect upon exposure to pulp cells, but to a varying extent (ESQ >> VCB > FZ = FOB = SDR). The effect of pre-polymerization temperature was insignificant (ƞp2 < 0.03), except for the thermoviscous RBC, which showed inconsistent findings when subjected to distinct viability tests. Cell viability was predominantly dependent on the type of material used (p < 0.001) which showed a large effect size (ƞp2 > 0.90). Irrespective of the pre-polymerization temperature, RBC samples in a clinically relevant size can release monomers to such an extent, which can substantially decrease the cytocompatibility.
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Affiliation(s)
- Erika Katalin Dunavári
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Tüzér Street 1, 7624 Pécs, Hungary; (E.K.D.); (A.K.)
| | - Anna Kőházy
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Tüzér Street 1, 7624 Pécs, Hungary; (E.K.D.); (A.K.)
| | - Mónika Vecsernyés
- Department of Medical Biology and Central Electron Microscope Laboratory, University of Pécs Medical School, Szigeti Street 12, 7624 Pécs, Hungary; (M.V.); (G.B.)
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, Tüzér Street 1, 7624 Pécs, Hungary;
| | - Bálint Viktor Lovász
- Oral and Maxillofacial Department, Manchester University Foundation Trust, Manchester Royal Infirmary Hospital, Oxford Rd, Manchester M13 9WL, UK;
| | - Gergely Berta
- Department of Medical Biology and Central Electron Microscope Laboratory, University of Pécs Medical School, Szigeti Street 12, 7624 Pécs, Hungary; (M.V.); (G.B.)
| | - Edina Lempel
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Tüzér Street 1, 7624 Pécs, Hungary; (E.K.D.); (A.K.)
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Wiertelak-Makała K, Szymczak-Pajor I, Bociong K, Śliwińska A. Considerations about Cytotoxicity of Resin-Based Composite Dental Materials: A Systematic Review. Int J Mol Sci 2023; 25:152. [PMID: 38203323 PMCID: PMC10778595 DOI: 10.3390/ijms25010152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/15/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
The dental material industry is rapidly developing resin-based composites (RBCs), which find widespread use in a variety of clinical settings. As such, their biocompatibility has gained increasing interest. This literature review presents a summary of research into the cytotoxicity of methacrylate-based composites published from 2017 to 2023. Subject to analysis were 14 in vitro studies on human and murine cell lines. Cytotoxicity in the included studies was measured via MTT assay, LDH assay, and WST-1 assay. The QUIN Risk of Bias Tool was performed to validate the included studies. Included studies (based entirely on the results of in vitro studies) provide evidence of dose- and time-dependent cytotoxicity of dental resin-based composites. Oxidative stress and the depletion of cellular glutathione (GSH) were suggested as reasons for cytotoxicity. Induction of apoptosis by RBCs was indicated. While composites remain the golden standard of dental restorative materials, their potential cytotoxicity cannot be ignored due to direct long-term exposure. Further in vitro investigations and clinical trials are required to understand the molecular mechanism of cytotoxicity and produce novel materials with improved safety profiles.
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Affiliation(s)
- Kacper Wiertelak-Makała
- Student Scientific Society of Civilization Diseases, Medical University of Lodz, 251 Pomorska Str., 92-213 Lodz, Poland
| | - Izabela Szymczak-Pajor
- Department of Nucleic Acid Biochemistry, Medical University of Lodz, 251 Pomorska Str., 92-213 Lodz, Poland
| | - Kinga Bociong
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska Str., 92-213 Lodz, Poland
| | - Agnieszka Śliwińska
- Department of Nucleic Acid Biochemistry, Medical University of Lodz, 251 Pomorska Str., 92-213 Lodz, Poland
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Human Primary Odontoblast-like Cell Cultures—A Focused Review Regarding Cell Characterization. J Clin Med 2022; 11:jcm11185296. [PMID: 36142943 PMCID: PMC9501234 DOI: 10.3390/jcm11185296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 11/17/2022] Open
Abstract
Cell cultures can provide useful in vitro models. Since odontoblasts are postmitotic cells, they cannot be expanded in cell cultures. Due to their extension into the dentin, injuries are inevitable during isolation. Therefore, “odontoblast-like” cell culture models have been established. Nowadays, there is no accepted definition of odontoblast-like cell cultures, i.e., isolation, induction, and characterization of cells are not standardized. Furthermore, no quality-control procedures are defined yet. Thus, the aim of this review was to evaluate both the methods used for establishment of cell cultures and the validity of molecular methods used for their characterization. An electronic search was performed in February 2022 using the Medline, Scopus, and Web of Science database identifying publications that used human primary odontoblast-like cell cultures as models and were published between 2016 and 2022. Data related to (I) cell culture conditions, (II) stem cell screening, (III) induction media, (IV) mineralization, and (V) cell characterization were analyzed. The included publications were not able to confirm an odontoblast-like nature of their cell cultures. For their characterization, not only a similarity to dentin but also a distinction from bone must be demonstrated. This is challenging, due to the developmental and evolutionary proximity of these two tissue types.
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Lovász BV, Lempel E, Szalma J, Sétáló G, Vecsernyés M, Berta G. Influence of TEGDMA monomer on MMP-2, MMP-8, and MMP-9 production and collagenase activity in pulp cells. Clin Oral Investig 2021; 25:2269-2279. [PMID: 32845470 PMCID: PMC7966645 DOI: 10.1007/s00784-020-03545-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 08/20/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Resin-based composites may leach monomers such as triethylene-glycol dimethacrylate (TEGDMA), which could contribute to intrapulpal inflammation. The aim of this investigation was to examine whether various concentrations of TEGDMA are able to influence dentally relevant Matrix metalloproteinase (MMP)-2, MMP-8, and MMP-9 production, total collagenase/gelatinase activity in pulp cells, and suggest possible signaling mechanisms. MATERIALS AND METHODS Pulp cells were cultured, followed by a 1-day exposure to sublethal TEGDMA concentrations (0.1, 0.2, and 0.75 mM). Total MMP activity was measured by an EnzCheck total collagenase/gelatinase assay, while the production of specific MMPs and the relative changes of phosphorylated, i.e., activated signaling protein levels of extracellular signal-regulated kinase (ERK)1/2, p38, c-Jun N-terminal kinase (JNK) were identified by western blot. Immunocytochemistry image data was also plotted and analyzed to see whether TEGDMA could possibly alter MMP production. RESULTS An increase in activated MMP-2, MMP-8, and MMP-9 production as well as total collagenase activity was seen after a 24-h exposure to the abovementioned TEGDMA concentrations. Increase was most substantial at 0.1 (P = 0.002) and 0.2 mM (P = 0.0381). Concurrent p-ERK, p-p38, and p-JNK elevations were also detected. CONCLUSIONS Results suggest that monomers such as TEGDMA, leached from resin-based restorative materials, activate and induce the production of dentally relevant MMPs in pulp cells. Activation of ERK1/2, p38, or JNK and MMP increase may play a role in and/or can be part of a broader stress response. Clinical relevance Induction of MMP production and activity may further be components in the mechanisms of intrapulpal monomer toxicity.
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Affiliation(s)
- Bálint Viktor Lovász
- Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, 5 Dischka Gy. St, Pécs, 7621, Hungary.
| | - Edina Lempel
- Department of Conservative Dentistry and Periodontology, University of Pécs Medical School, 5 Dischka Gy. St, Pécs, 7621, Hungary
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, 5 Dischka Gy. St, Pécs, 7621, Hungary
| | - György Sétáló
- Department of Medical Biology and Central Electron Microscope Laboratory, University of Pécs Medical School, 12 Szigeti St, Pécs, 7624, Hungary
| | - Mónika Vecsernyés
- Department of Medical Biology and Central Electron Microscope Laboratory, University of Pécs Medical School, 12 Szigeti St, Pécs, 7624, Hungary
| | - Gergely Berta
- Department of Medical Biology and Central Electron Microscope Laboratory, University of Pécs Medical School, 12 Szigeti St, Pécs, 7624, Hungary
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Lovász BV, Berta G, Lempel E, Sétáló G, Vecsernyés M, Szalma J. TEGDMA (Triethylene Glycol Dimethacrylate) Induces Both Caspase-Dependent and Caspase-Independent Apoptotic Pathways in Pulp Cells. Polymers (Basel) 2021; 13:polym13050699. [PMID: 33669057 PMCID: PMC7956203 DOI: 10.3390/polym13050699] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/18/2021] [Accepted: 02/20/2021] [Indexed: 12/13/2022] Open
Abstract
Monomers leached from resin-based composites (RBCs) may reach intrapulpal concentrations of the millimolar (mM) range, which could contribute to inflammation. The aim of this investigation was to assess the cytotoxicity of triethylene glycol dimethacrylate (TEGDMA) monomers on pulp cells as well as to identify molecular mechanisms leading to apoptosis. Pulp cells were harvested from molars extracted for orthodontic reasons and cultured through an explant method. To assess cytotoxicity, cells underwent a 5-day exposure to 0.75, 1.5, and 3 mM TEGDMA and were subject to cell counting and WST-1 staining. Based on the findings, cells were subsequently exposed to 0.1, 0.2, 0.75, 1.5, and 3 mM TEGDMA for 24 h to uncover the details of apoptosis. Changes in the production or cleavage of the apoptosis-specific proteins caspase-8, caspase-9, caspase-3, caspase-12, and Apoptosis-Inducing Factor (AIF) were measured by Western blot. The 5-day study showed concentration- and time-dependent cytotoxicity. Significant cell death was detected after 24 h with TEGDMA concentrations of 1.5 and 3 mM. One-day exposure to TEGDMA led to the activation of caspase-8, -9, -3, and -12 and an increased AIF production. Results suggest that relevant concentrations of TEGDMA monomers, leached from RBCs, induce apoptosis in pulp cells through both caspase-dependent as well as caspase-independent mechanisms. Endoplasmic reticulum stress and the activation of caspase-independent apoptotic pathways may be further mechanisms by which monomers induce apoptosis in pulp cells.
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Affiliation(s)
- Bálint Viktor Lovász
- Department of Oral and Maxillofacial Surgery, University of Pécs, Medical School, 5. Dischka St., 7621 Pécs, Hungary;
- Correspondence: ; Tel.: +4-479-8860-0193
| | - Gergely Berta
- Department of Medical Biology and Central Electron Microscope Laboratory, University of Pécs Medical School, 12. Szigeti St., 7624 Pécs, Hungary; (G.B.); (G.S.J.); (M.V.)
- Szentágothai Research Centre, University of Pécs, Ifjúság Street 20, 7624 Pécs, Hungary
| | - Edina Lempel
- Department of Restorative Dentistry, University of Pécs, Medical School, 5. Dischka St., 7621 Pécs, Hungary;
| | - György Sétáló
- Department of Medical Biology and Central Electron Microscope Laboratory, University of Pécs Medical School, 12. Szigeti St., 7624 Pécs, Hungary; (G.B.); (G.S.J.); (M.V.)
- Szentágothai Research Centre, University of Pécs, Ifjúság Street 20, 7624 Pécs, Hungary
| | - Mónika Vecsernyés
- Department of Medical Biology and Central Electron Microscope Laboratory, University of Pécs Medical School, 12. Szigeti St., 7624 Pécs, Hungary; (G.B.); (G.S.J.); (M.V.)
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs, Medical School, 5. Dischka St., 7621 Pécs, Hungary;
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Jochums A, Volk J, Perduns R, Plum M, Schertl P, Bakopoulou A, Geurtsen W. Influence of 2-hydroxyethyl methacrylate (HEMA) exposure on angiogenic differentiation of dental pulp stem cells (DPSCs). Dent Mater 2021; 37:534-546. [PMID: 33579530 DOI: 10.1016/j.dental.2020.12.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/13/2020] [Accepted: 12/30/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The angiogenic differentiation of dental pulp stem cells (DPSCs) is important for tissue homeostasis and wound healing. In this study the influence of 2-hydroxyethyl methacrylate (HEMA) on angiogenic differentiation was investigated. METHODS To evaluate HEMA effects on angiogenic differentiation, DPSCs were cultivated in angiogenic differentiation medium (ADM) in the presence or absence of non-toxic HEMA concentrations (0.1 mM and 0.5 mM). Subsequently, angiogenic differentiation was analyzed on the molecular level by qRT-PCR and protein profiler analyzes of angiogenic markers and flow cytometry of PECAM1. The influence of HEMA on angiogenic phenotypes was analyzed by cell migration and sprouting assays. RESULTS Treatment with 0.5 mM HEMA during differentiation can lead to a slight reduction of angiogenic markers on mRNA level. HEMA also seems to slightly reduce the quantity of angiogenic cytokines (not significant). However, these HEMA concentrations have no detectable influence on cell migration, the abundance of PECAM1 and the formation of capillaries. Higher concentrations caused primary cytotoxic effects in angiogenic differentiation experiments conducted for longer periods than 72 h. SIGNIFICANCE Non-cytotoxic HEMA concentrations seem to have a minor impact on the expression of angiogenic markers, essentially on the mRNA level, without affecting the angiogenic differentiation process itself on a detectable level.
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Affiliation(s)
- André Jochums
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, D-30625 Hannover, Germany.
| | - Joachim Volk
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, D-30625 Hannover, Germany.
| | - Renke Perduns
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, D-30625 Hannover, Germany.
| | - Melanie Plum
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, D-30625 Hannover, Germany.
| | - Peter Schertl
- Department of Cell Biology and Biophysics, Leibniz University Hannover, D-30419 Hannover, Germany
| | - Athina Bakopoulou
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Greece.
| | - Werner Geurtsen
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, D-30625 Hannover, Germany.
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Perduns R, Volk J, Schertl P, Leyhausen G, Geurtsen W. HEMA modulates the transcription of genes related to oxidative defense, inflammatory response and organization of the ECM in human oral cells. Dent Mater 2019; 35:501-510. [DOI: 10.1016/j.dental.2019.01.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 10/19/2018] [Accepted: 01/11/2019] [Indexed: 12/21/2022]
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Inchingolo R, Faletti R, Grazioli L, Tricarico E, Gatti M, Pecorelli A, Ippolito D. MR with Gd-EOB-DTPA in assessment of liver nodules in cirrhotic patients. World J Hepatol 2018; 10:462-473. [PMID: 30079132 PMCID: PMC6068846 DOI: 10.4254/wjh.v10.i7.462] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 04/25/2018] [Accepted: 05/30/2018] [Indexed: 02/06/2023] Open
Abstract
To date the imaging diagnosis of liver lesions is based mainly on the identification of vascular features, which are typical of overt hepatocellular carcinoma (HCC), but the hepatocarcinogenesis is a complex and multistep event during which, a spectrum of nodules develop within the liver parenchyma, including benign small and large regenerative nodule (RN), low-grade dysplastic nodule (LGDN), high-grade dysplastic nodule (HGDN), early HCC, and well differentiated HCC. These nodules may be characterised not only on the basis of their respective different blood supplies, but also on their different hepatocyte function. Recently, in liver imaging the introduction of hepatobiliary magnetic resonance imaging contrast agent offered the clinicians the possibility to obtain, at once, information not only related to the vascular changes of liver nodules but also information on hepatocyte function. For this reasons this new approach becomes the most relevant diagnostic clue for differentiating low-risk nodules (LGDN-RN) from high-risk nodules (HGDN/early HCC or overt HCC) and consequently new diagnostic algorithms for HCC have been proposed. The use of hepatobiliary contrast agents is constantly increasing and gradually changing the standard of diagnosis of HCC. The main purpose of this review is to underline the added value of Gd-EOB-DTPA in early-stage diagnoses of HCC. We also analyse the guidelines for the diagnosis and management of HCC, the key concepts of HCC development, growth and spread and the imaging appearance of precursor nodules that eventually may transform into overt HCC.
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Affiliation(s)
- Riccardo Inchingolo
- Division of Interventional Radiology, Department of Radiology, Madonna delle Grazie Hospital, Matera 75100, Italy
| | - Riccardo Faletti
- Department of Surgical Sciences, Radiology Unit, University of Turin, Turin 10126, Italy
| | - Luigi Grazioli
- Department of Radiology, University of Brescia “Spedali Civili”, Brescia 25123, Italy
| | - Eleonora Tricarico
- Division of Interventional Radiology, Department of Radiology, Madonna delle Grazie Hospital, Matera 75100, Italy
| | - Marco Gatti
- Department of Surgical Sciences, Radiology Unit, University of Turin, Turin 10126, Italy
| | - Anna Pecorelli
- Department of Diagnostic Radiology, School of Medicine, University of Milano-Bicocca, Monza 20900, Italy
| | - Davide Ippolito
- Department of Diagnostic Radiology, School of Medicine, University of Milano-Bicocca, Monza 20900, Italy
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