Multilayer and monolayer cell cultures in a cytotoxicity assay of root canal sealers

Cytotoxicity evaluation of zinc oxide-eugenol and non-eugenol cements using different fibroblast cell lines

OBJECTIVES

Despite being commonly used as temporary cements in dentistry, there is a lack of studies regarding the cytotoxicity of zinc oxide-eugenol (ZOE) and zinc oxide non-eugenol (ZONE) cements. In addition, cytotoxicity evaluation of the materials often involves animal-based cells. Therefore, in this study, a cytotoxicity evaluation of commercially available ZOE and ZONE cements was carried out using both animal and human-based cells.

MATERIALS AND METHODS

The extraction or dilution of the extraction from four commercially available cements (two zinc oxide-eugenol and two zinc oxide non-eugenol) was tested for cytotoxicity, using three different cells and a water-soluble treatzolium salt assay. The results were confirmed using a confocal laser microscope following calcein AM and ethidium homodimer-1 staining.

RESULTS

The results showed that there was a significant difference in cell viability depending on which cell was used, even when the same material was tested. Generally, L929 showed relatively low cell viability with a low EC50 (effective concentration of extracts that caused 50% of cell viability compared to the control) value compared to both HGF-1 and hTERT-hNOF. Such results were also confirmed by a confocal laser microscope.

CONCLUSIONS

Careful consideration on interpreting the results for cytotoxicity evaluation of ZOE and ZONE cements is needed when different cells are used.

Cytotoxicity Test of One-Step Self-Etching Bonding Agents by Standardized Dentin Barrier Test Using Polyurethane Discs

This study was performed to standardize a dentin barrier test with the substitute and evaluate the cytotoxicity of one-step self-etching bonding agents. Each of the natural bovine dentin and polyurethane discs were 500-μm thick and were tested using a perfusion device. Following the treatment with 0.05% phenol on the natural bovine disc or three kinds of polyurethane discs—30, 40, and 50 pcf (pounds per cubic foot)—cell viability of L-929 was measured by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and expressed as percentages of non-treated group, respectively. A substitute showing permeability similar to that of bovine dentin was determined based on this result. Cytotoxicity test of bonding agents was performed by the selected substitute, the results of which were expressed as percentages of the control. In addition, SEM images were taken after the tests. The cell viability by 40-pcf polyurethane disc was not statistically different from that by bovine dentin disc (P > 0.05). Futurabond DC resulted in the highest cell viability and Bond force the lowest by the 40-pcf polyurethane disc (P < 0.05). The adhesives on the 40-pcf polyurethane disc changed cellular morphology with different degrees on the SEM images. This standardized test might be useful for assessing the cytotoxicity of dental materials applied to dentin before clinical applications.

Calcium hydroxide-based root canal sealers: a review

The aim of this review was to consider laboratory experiments and clinical studies of calcium hydroxide-based root canal sealers. An extensive search of the endodontic literature was made to identify publications related to calcium hydroxide-based root canal sealers. The articles were assessed for the outcome of laboratory and clinical studies on their biological properties and physical characteristics. Comparative studies with other sealers were also considered. Several studies were evaluated covering different properties of calcium hydroxide-based sealers including physical properties, biocompatibility, leakage, adhesion, solubility, antibacterial properties, and periapical healing effect. Calcium hydroxide-based root canal sealers have a variety of physical and biological properties. Comparative studies reveal their mild cytotoxicity, but their antibacterial effects are variable. Further research is required to establish the tissue healing properties of calcium hydroxide in root canal sealers.

In vivo comparison of the biocompatibility of two root canal sealers implanted into the subcutaneous connective tissue of rats

OBJECTIVE

To evaluate the subcutaneous biocompatibility of 2 root canal sealers.

STUDY DESIGN

The subcutaneous implant technique recommended by the Fédération Dentaire International (FDI) was used to test Endométhasone and EndoREZ root canal sealers. These materials were placed in Teflon tubes, 1 mm in diameter and 10 mm in length, and implanted into 2 pockets created in the back of 40 Calomys callosus rodents, 20 for each material. Tissue biopsies were collected and histologically examined 15, 30, 60, and 90 days after the implantation procedure. The overall level of the inflammatory tissue response was graded as none, slight, moderate, or severe on the sealer-connective tissue interface at the opening ends of the tubes. The connective tissue response along the lateral wall outside of each tube served as a negative control.

RESULTS

The tissue reaction to the Endométhasone diminished with time. The EndoREZ sealer was highly toxic during all experimental periods.

CONCLUSION

Endométhasone root canal sealer presented biocompatibility within the analyzed periods, whereas EndoREZ showed no biocompatible behavior and caused late hypersensitive reaction.

Cultured Primary Osteoblast Viability and Apoptosis in the Presence of Root Canal Sealers

This study was designed to test the hypothesis that Roekoseal is less cytotoxic than eugenol-based Sealapex or calcium hydroxide-based Kerr's Pulp Canal Sealer. Embryonic, day-19, rat calvarial osteoblasts were cultured at 4 x 10(5) cells/well. The concentration of conditioned medium from each sealer producing 50% surviving cells (ED50) was determined and long-term viability and apoptosis of cells assessed after exposure to the ED50 of each sealer. Low concentrations of Kerr's Pulp Canal Sealer (190 mm(2)/1 ml) and high concentrations of Sealapex and Roekoseal (190 mm(2)/300 microl) produced the ED50. ED50 challenged osteoblasts had fewer viable cells at 72 h than at 24 h, with significantly more viable cells in the Roekoseal group. There was significantly less apoptotic activity in cells exposed to Roekoseal ED50 than in cells exposed to Kerr's Pulp Canal Sealer (p < 0.05) ED50. Roekoseal may be less cytotoxic than Kerr's Pulp Canal Sealer, but further studies of this new sealer are required.

Tissue reaction initiated by different sealers

AIMS

To analyse the type and degree of inflammatory reaction initiated by four sealers.

METHODOLOGY

Twenty-four root canals of Macaca mulatta monkeys were filled within the canal and eight were overfilled with AH26, Apexit, Endomethasone or Grossman's sealers. The result of the treatment was evaluated after 6 months by histological assessment of the periapical tissues.

RESULTS

In the group of root canals filled within the root, no inflammatory reaction was detected in specimens of Apexit and Grossman's sealers, but the other two sealers initiated different degrees of lymphocytic/plasmocytic tissue reactions. Endomethasone initiated a mild lymphocytic/plasmocytic reaction in three of the nine cases and AH26 caused mild lymphocytic/plasmocytic infiltration in two of the seven cases. In the group of overfilled root canals, all four sealers initiated inflammatory reactions. The periapical tissue reactions of overfilled root canals were similar to reactions detected in cases filled within the canal. However, additional histological features developed in specimens of Endomethasone and AH26: Endomethasone initiated a foreign body-type granulomatous reaction around the sealer particles and AH26 particles were engulfed by macrophages. The overfilled root canals of Apexit and Grossman's sealers initiated only lymphocytic/plasmocytic reactions.

CONCLUSIONS

This study suggests that sealers with different chemical compositions initiate different histological reactions. It also emphasizes the importance of confining root filling to the canal system because all sealers initiate inflammatory reactions when they are present in the apical tissues

A comparison of the in vitro cytotoxicity of two root canal sealers

The purpose of this study was to compare the cytotoxicity of an epoxy resin-based sealer (AH Plus) and a silicone-based sealer (Roeko Seal Automix, RSA). Cytotoxicity was assessed using the MTT assay for mitochondrial enzyme activity and haemocytometer viable cell counting after 24, 48 and 72-h exposure to L929 cells. AH Plus and RSA showed no statistically significant difference in the degree of toxicity. Both sealers had a low toxic influence on the cells during the experimental period. This study indicates that epoxy resin-based sealer AH Plus and the silicone-based sealer RSA have similar levels of cytotoxicity to mouse fibroblasts.

Biocompatibility of dental materials used in contemporary endodontic therapy: a review. Part 2. Root-canal-filling materials

Root-canal-filling materials are either placed directly onto vital periapical tissues or may leach through dentine. The tissue response to these materials therefore becomes important and may influence the outcome of endodontic treatment. This paper is a review of the biocompatibility of contemporary orthograde and retrograde root-canal-filling materials.

Biocompatibility of root canal filling materials

Results of in vitro and in vivo studies clearly indicate that some endodontic sealers may cause local and systemic adverse effects. Though occasionally contradictory data has been reported from various authors, it may be concluded that zinc-oxide-eugenol sealers possess a marked cytotoxic and tissue-irritating potency. Most Ca(OH)2-based materials, however, were biocompatible. Genotoxic effects have been observed with sealers releasing paraformaldehyde or containing mutagenic substances, such as bisphenol-A-diglycidyl-ether or its derivatives. It cannot be excluded that these materials may pose a systemic risk because formaldehyde is rapidly distributed systemically following its application into the pulp cavity. Furthermore an increasing number of cases with an aspergillosis of the maxillary sinus have been observed which were mainly caused by zinc-releasing endodontic sealers. Overall, it is recommended that for endodontic practice, sealers that have been found to be biocompatible in a "mixed bag" of various in vitro and in vivo tests, be selected. From this point of view, ZnOE-sealers should no longer be used for root canal fillings. This recommendation applies also to sealers containing paraformaldehyde or generating this substance during their setting reaction. More experimental and clinical studies are necessary to elucidate whether new materials, such as mineral trioxide aggregate (MTA) or calcium phosphate cement, will be biocompatible alternatives in the future.

Dental materials: 1997 literature review

This review of the published literature on dental materials for the year 1997 has been compiled by the Dental Materials Panel of UK. It continues a series of annual reviews started in 1973. Emphasis has been placed upon publications, which report upon the materials science or clinical performance of the materials. The review has been divided by accepted materials classifications (fissure sealants, glass polyalkenoate cements, dentine bonding, dental amalgam, endodontic materials, casting alloys, ceramometallic restorations and resin-bonded bridges, ceramics, denture base resins and soft lining materials, impression materials, dental implant materials, orthodontic materials, biomechanics and image processing, resin composites, and casting investment materials and waxes). Three hundred and thirty three articles have been reviewed.