Cytotoxicity of Epiphany�and Resilon�with a root model

What Are the Chances of Resilon to Dominate the Market Filling Materials for Endodontics?

This paper is a literature review with additional virtual analyses of the authors’ own experimental research results. Knowledge from various areas was synergistically combined, appropriately for concurrent engineering, presenting several possible methodological approaches used in research, optimizing the selection of engineering materials and the conditions of their application with particular application in endodontics. Particular attention was paid to the theoretical aspects of filling material strengths, weaknesses, opportunities, and threats SWOT analysis. Attention was paid to the original concepts of Sustainable Dentistry Development in conjunction with Dentistry 4.0, which includes endodontics as an important element. The dentists’ actions, among others, in conservative dentistry, along with endodontics, requires close cooperation with engineers and the enginering sciences. Methods of root canal preparation were described, together with selected tools, including those made of nitinol. Principles concerning the process of cleaning and shaping the pulp complex are presented. The importance of obturation methods, including the Thermo-Hydraulic-Condensation THC technique, and the selection of filling materials with the necessary sealants for the success of endodontic treatment are discussed. The experimental studies were carried out in vitro on human teeth removed for medical reasons, except for caries, for which two groups of 16 teeth were separated. After the root canal was prepared, it was filled with studs and pellets of a filling material based on polyester materials, which has gained the common trade name of resilon or, less frequently, RealSeal (SybronEndo) with an epiphany sealant. The teeth for the first group were obturated by cold lateral condensation. In the second case the obturation was performed using the Thermo-Hydraulic-Condensation technique using System B and Obtura III. The experimental leakage testing was done using a scanning electron microscope SEM and a light stereoscopic microscope LSM, as typical research tools used in materialography. The research results, in a confrontation with the data taken from the literature studies, do not indicate the domination of resilon in endodontics.

Virtual Approach to the Comparative Analysis of Biomaterials Used in Endodontic Treatment

The importance of endodontics is presented within our own concept of Dentistry Sustainable Development (DSD) consisting of three inseparable elements; i.e., Advanced Interventionist Dentistry 4.0 (AID 4.0), Global Dental Prevention (GDP), and the Dentistry Safety System (DSS) as a polemic, with the hypothesis of the need to abandon interventionist dentistry in favour of the domination of dental prevention. In view of the numerous systemic complications of caries that affect 3−5 billion people globally, endodontic treatment effectively counteracts them. Regardless of this, the prevention of oral diseases should be developed very widely, and in many countries dental care should reach the poorest sections of society. The materials and methods of clinical management in endodontic procedures are characterized. The progress in the field of filling materials and techniques for the development and obturation of root canals is presented. The endodontics market is forecast to reach USD 2.1 billion in 2026, with a CAGR of 4.1%. The most widely used and recognized material for filling root canals is gutta-percha, recognized as the “gold standard”. An alternative is a synthetic thermoplastic filler material based on polyester materials, known mainly under the trade name Resilon. There are still sceptical opinions about the need to replace gutta-percha with this synthetic material, and many dentists still believe that this material cannot compete with gutta-percha. The results of studies carried out so far do not allow for the formulation of a substantively and ethically unambiguous view that gutta-percha should be replaced with another material. There is still insufficient clinical evidence to formulate firm opinions in this regard. In essence, materials and technologies used in endodontics do not differ from other groups of materials, which justifies using material engineering methodology for their research. Therefore, a detailed methodological approach is presented to objectify the assessment of endodontic treatment. Theoretical analysis was carried out using the methods of procedural benchmarking and comparative analysis with the use of contextual matrices to virtually optimize the selection of materials, techniques for the development and obturation of root canals, and methods for assessing the effectiveness of filling, which methods are usually used, e.g., in management science, and especially in foresight research as part of knowledge management. The results of these analyses are presented in the form of appropriate context matrices. The full usefulness of the research on the effectiveness and tightness of root canal filling using scanning electron microscopy is indicated. The analysis results are a practical application of the so-called “digital twins” approach concerning the virtual comparative analysis of biomaterials used in endodontic treatment.

A comparative study on cytotoxicity and genotoxicity of the hydroxyapatite-bioactive glass and fluorapatite-bioactive glass nanocomposite foams as tissue scaffold for bone repair

Considering to the possibility of cellular and genetic damage by the implant materials in the patient and the clinician, the safety of the biomaterials should be evaluated. The purpose of this study was to compare the cytotoxicity and genotoxicity induced by two nanocomposites, hydroxyapatite/bioactive glass (HA/BG) and fluorapatite/bioactive glass (FA/BG) in vitro. Biomaterial extracts (BMEX, 100%) were prepared by incubating 100 mg/mL of each biomaterial powder in complete culture medium (RPMI1640 + 10% FBS) for 72 h. Saos-II cells were exposed to different concentrations of BMEXs for different periods of time and evaluated at the end of each period. According to 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay results, both BMEXs at low concentrations (<25%) has no inhibitory effects on the cells growth. After 24 h of exposure, only HA/BG BMEX at 100% concentration showed significant cytotoxic effect. After 48 and 72 h, both HA/BG and FA/BG BMEXs showed similar cytotoxic effect at concentration higher than 75 and 50%, respectively. The results of the comet assay showed that the tail elongation, and proportionally DNA damage, increased in a dose/time dependently fashion with BMEXs exposure. Based on low and similar cytotoxicity and genotoxicity profiles on the Saos-II cell line, it could be concluded that FA/BG, like HA/BG, could be a good candidate for further in vivo biocompatibility studies to be used in bone tissue repair. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 2605-2612, 2018.

Cytotoxicity Evaluation of Root Canal Sealers Using an In Vitro Experimental Model with Roots

The aim of the present study was to evaluate the cytotoxicity of root canal sealers under conditions closely resembling a clinical reality. A primary human fibroblast cell line was seeded in 24-well acrylic plates with Dulbecco's modified Eagle's medium supplemented with 10% serum fetal bovine (SFB) and incubated for 24 h. Root canals from premolars were filled and individually attached to nylon devices to be stabilized in the wells with the already seeded cells. Specimens were divided into groups as follows: Control: gutta-percha cones (GPC); AH Plus+GPC; Sealapex+GPC; MTA Fillapex+GPC and Endofill+GPC. After 24 and 48 h, cell viability and morphology were evaluated by MTT assay and scanning electron microscopy (SEM), respectively. Statistical analysis was performed by Mann-Whitney test, complemented by Kruskal Wallis test (p<0.05). Only Endofill presented cytotoxicity after 24 h. MTA Fillapex and Endofill reduced the production of succinic desidrogenase after 48 h. AH Plus was non-toxic at any time point. SEM showed that the AH Plus and MTA Fillapex groups presented fibroblasts with morphology close to the control group, while the Endofill group presented few cells with thin extensions cells. The present study showed that good results were present in AH Plus and Sealapex, but not the Endofill group after 48 h. The method used enabled evaluation of the cytotoxicity of the studied sealers that diffused through the root apex.

Bioactivity of a Calcium Silicate-based Endodontic Cement (BioRoot RCS): Interactions with Human Periodontal Ligament Cells In Vitro

INTRODUCTION

Tricalcium silicate-based materials are recognized as bioactive materials through their capacity to induce hard tissue formation both in the dental pulp and bone. Sealing the apex implies that the root canal filling materials interact with the periapical tissues. This work was designed to study the interactions of newly developed tricalcium silicate cement (BioRoot RCS; Septodont, Saint Maur Des Fosses, France) with apical tissue compared with a standard zinc oxide-eugenol sealer (Pulp Canal Sealer [PCS]; SybronEndo, Orange, CA).

METHODS

Cell viability was assessed by direct contact between human periodontal ligament (PDL) cells and BioRoot RCS or PCS. In addition, an in vitro tooth model was used to study the interactions between these materials and PDL cells. For this purpose, human extracted incisors were sectioned at the enamel-cementum junction; root canals were prepared, sterilized, and filled with lateral condensation with both materials. The root apices were dipped in the culture medium for 24 hours. These conditioned media were used to investigate their effects on human PDL cells. Cell proliferation was investigated with the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, and the secretion of angiogenic and osteogenic growth factors was quantified using an enzyme-linked immunosorbent assay.

RESULTS

BioRoot RCS has less toxic effects on PDL cells than PCS and induced a higher secretion of angiogenic and osteogenic growth factors than PCS.

CONCLUSIONS

Taken together, these preclinical results suggest that the calcium silicate cement (BioRoot RCS) has a higher bioactivity than the zinc oxide-eugenol sealer (PCS) on human PDL cells.

Biotoxicity of commonly used root canal sealers: A meta-analysis

INTRODUCTION

The main objective of a root canal sealer is to provide a fluid tight seal. The purpose of this systematic meta-analysis was to determine the relative toxicity of commonly used root canal sealers like zinc oxide eugenol, calcium hydroxide, and resin-based sealers.

MATERIALS AND METHODS

An online search was conducted in peer-reviewed journals listed in PubMed, Cochrane, EBSCO, and IndMed databases between 2000 and 2012). Statistical analysis was carried out by using analysis of variance (ANOVA) followed by post-hoc comparison by Bonferroni method. The comparison between toxicity at 24 h and between 3 and 7 days was done by using paired t-test for each sealer.

RESULTS

At 24 h, the relative biotoxicity of the three sealers reported was insignificant (P- value 0.29), but the difference in toxicity was found significant (P < 0.001) after 3 days.

CONCLUSION

Calcium hydroxide sealer and zinc oxide eugenol were found to be significantly biotoxic as compared to resin-based sealers after 3 days.

Resilon: a comprehensive literature review

Background and aims. An ideal root canal filling material should completely seal the entire root canal space and block communication between the root canal system and its surrounding tissues; it should also be nontoxic, noncarcinogenic, non-genotoxic, biocompatible, insoluble in tissue fluids and dimensionally stable. Bonding to dentin is a promising property, which can prevent leakage and improve the sealing ability of root canal filling materials. Resilon was developed and rec-ommended initially because the existing rootcanal filling materials did not bond to root canal dentin. Since its introduction in 2004, numerous reports have been published regarding various aspects of this material. The aim of this literature review is to present investigations regarding Resilon's physical and chemical properties and leakage studies. Materials and methods. A review of the literature was performed by using electronic and hand searching methods for Resilon from May 2004 to April 2012. Results. There are many published reports regarding Resilon. The searchshowed that Resilon is composed of a parent polymer, polycaprolactone or Tone, which is a biodegradable aliphatic polyester, with filler particles consisting of bioactive glass, bismuth oxychloride and barium sulfate. It possesses some antibacterial and antifungal properties. It is a promising material for root canal filling. Despite the presence of numerous case reports and case series regarding these applications, there are few designed research studies on clinical applications of this material. Resilon has some drawbacks such as high cost. Conclusion. Resilon seals well and is a biocompatible material. However, more clinical studies are needed to confirm its efficacy compared with other materials.

Effect of time of extraction on the biocompatibility of endodontic sealers with primary human fibroblasts

The aim of this work was to evaluate the effects of different times of extraction on the cytotoxicity of six representatives of different root canal sealer groups-Real Seal SE, AH Plus, GuttaFlow, Sealapex, Roth 801, and ThermaSeal Plus-with human gingival fibroblasts. The materials were prepared according to manufacturers' specifications, and were incubated in culture medium (DMEM) at 37ºC for 1, 7, 14, 21, and 28 days, with daily washing, to simulate periodontal ligament clearance. Human fibroblasts were exposed to the final extracts at 24 hours, and cell viability was determined by MTT assay, with exposure to unconditioned DMEM as a negative control. Statistical analysis comparing cytotoxicities at each exposure time was performed by ANOVA with Scheffé adjustment for multiple comparisons at a 95% confidence level. Results indicated that GuttaFlow was significantly less cytotoxic than all other sealers (p < 0.05) at 1 day of extraction. After 7 days of extraction, cell viability for GuttaFlow was significantly increased as compared with that of all groups except sealer AH Plus. At day 14, cytotoxicity of Sealapex was significantly higher than that of all other sealers (p < 0.05). At days 21 and 28, there were no significant differences in cytotoxicity among sealer groups. All materials presented some level of cytotoxicity to fibroblasts, while GuttaFlow was the least cytotoxic sealer tested. However, the cytotoxicity of all materials seemed to decrease similarly in a time-dependent manner.

Biocompatibility of RealSeal, its primer and AH Plus implanted in subcutaneous connective tissue of rats

OBJECTIVE

This study tested rat connective tissue response to RealSeal, RealSeal primer or AH Plus after 7, 15, 30, 60 and 90 days of implantation.

MATERIAL AND METHODS

Thirty Wistar rats had subcutaneous sockets created on their back and received four implants each of polyethylene tubes containing one of the materials tested according to the groups: AH (AH Plus Sealer); RS (RealSeal Sealer); RP (RealSeal Primer); CG (control group - empty tube). After histological processing, sections were analyzed to identify the presence of neutrophils, lymphocytes and plasma cells, eosinophils, macrophages and giant cells, as well as fibrous capsule and abscesses, by an examiner using light microscope. Kruskal-Wallis and multiple-comparisons test were used for statistical analysis. Significance level was set at 5%.

RESULTS

Lymphoplasmacytic infiltrate scores significantly higher than those of the control group were observed at 14 and 60 days in AH group, and at 90 days in RS group (p<0.05). There were no differences in terms of presence of macrophages, giant cells, eosinophils, neutrophils or fibrosis. AH Plus group scored higher for abscesses at 7 days than after any other period (p=0.031). RP group scored higher for lymphoplasmacytic infiltrate at 14 days than at 90 days (p=0.04).

CONCLUSION

The main contribution of this study was to demonstrate that issues involved with tissue tolerance of a Resilon-containing sealer, RealSeal Sealer, cannot be attributed to its primer content.

An in vitro evaluation of the growth of human periodontal ligament fibroblasts after exposure to a 4-META-containing methacrylate-based endodontic sealer

INTRODUCTION

In this study we evaluated the cytotoxic effects of MetaSEAL, a 4-META-containing meth-acrylate-based endodontic sealer, on human periodontal ligament (HPDL) fibroblasts. There are a limited number of studies on the cytotoxic effects of MetaSEAL, and there are no studies on the cytotoxic effects of MetaSEAL on cells it might come into contact with in vivo.

METHODS

MetaSEAL concentrations of 25, 50, 100, 200, 400, and 800 μg/mL were exposed to HPDL fibroblast cultures and evaluated at 1, 3, 7, 14, and 21 days. Controls included untreated cells and cells treated with ethanol, the vehicle for MetaSEAL suspension. Crystal violet staining in 24-well plates and the fluorescence-based CyQUANT Cell Proliferation Assay in 96-well plates assessed fibroblast viability.

RESULTS

Significant cytotoxicity against HPDL growth by MetaSEAL was both time- and concentration-dependent. At day 1 there were no significant cytotoxic effects, whereas by day 3, 800 μg/mL concentration, by day 7, 200, 400, and 800 μg/mL concentrations, and by day 14, 50, 100, 200, 400, and 800 μg/mL concentrations were significantly cytotoxic. By day 21, all concentrations were significantly cytotoxic. These findings were confirmed by both the crystal violet and CyQUANT assays.

CONCLUSIONS

MetaSEAL endodontic sealer has increasing HPDL cytotoxicity with both concentration and time exposure.

In vitro Evaluation of the Cytotoxicity of Different Root Canal Filling Materials

OBJECTIVE

Aim of the present study was to evaluate the cytotoxicity of Real Seal 1 compared to other commercially available endodontic filling materials: Real Seal (SybronEndo, Orange, CA, USA) and Thermafil (Tulsa Dental, Tulsa, OK, USA).

MATERIAL AND METHODS

Periodontal ligament cells from healthy patients were cultured. The eluate of Real Seal 1(TM) (RS1), Real Seal (RS) and Thermafil (TF) samples was used for the cells viability tests, both diluted (50%) or undiluted (100%). Incubation of the specimens was performed in culture medium for 24 h, 48 h and 72 h at 37 °C under sterile conditions. The cellular mortality was evaluated by MTT test. Results were statistically analysed and the statistical significance was set at p< 0.05.

RESULTS

None of the studied materials showed toxic effects during the period of observation (0 -72 h) when compared to the control group. Only RS induced a very modest increase in cell mortality (about 3% at both concentrations used, during the first 24 hours), when increasing the incubation time, however, only the lower concentration continued to show modest toxicity.

CONCLUSIONS

Results of the present study showed that all tested materials did not exhibit cytotoxic effects when compared to the control group.

Cytotoxicity of 5 endodontic sealers on L929 cell line and human dental pulp cells

AIM

To investigate the cytotoxicity of five root canal sealers on L929 mouse fibroblasts and primary human dental pulp cells.

METHODOLOGY

Cylindrical specimens of AH Plus (Dentsply De Trey GmbH, Konstanz, Germany), RoekoSeal (Coltène Whaledent, Langenau, Germany), EndoREZ (Ultradent Products Inc., South Jordan, UT, USA), Epiphany (Pentron Clinical Technologies, LLCC, Wallingford, CT, USA) and Activ GP (Brasseller Inc., USA, Savannah, GA, USA) were kept at 37 °C in a humidified atmosphere of 5% CO(2) for thrice the length of the setting time given by the manufacturer. Extraction of specimens was performed after setting in cell growth medium for 1, 4 and 7 days. Undiluted, 50% and 25% diluted eluates were incubated with cultured cells for 24 and 72 h. Cytotoxicity was assessed using MTS colorimetric bioassay. Kruskal-Wallis test and post hoc Dunn's multiple comparison test were used to compare the sealers and diluted/undiluted eluates in terms of cell viability (% of control). Friedman test and post hoc Dunn's multiple comparison test were performed to compare extraction periods. Wilcoxon test was utilized in comparing 24- and 72-h readings.

RESULTS

Undiluted 1-day eluate of Activ GP was significantly more cytotoxic than all other sealers (P < 0.0001). Undiluted 4- and 7-day eluates of Epiphany and Activ GP were significantly more cytotoxic than the other three sealers (P < 0.0001). Diluted eluates of Activ GP and Epiphany were generally less toxic than the undiluted ones. The cytotoxicity of Epiphany significantly increased as the extraction period increased (P < 0.0001). Epiphany became more toxic with time of exposure to cells. No or minimal cytotoxicity was observed with RoekoSeal, AH Plus and EndoREZ.

CONCLUSIONS

The sealers exhibited varying degrees of cytotoxicity dependent on their chemical composition.

Physicochemical properties, sealing ability, bond strength and cytotoxicity of a new dimethacrylate-based root canal sealer

BACKGROUND/PURPOSE

Resin-based root canal sealer can bond to dentin and establish a hermetic seal. The aim of this study was to evaluate the physicochemical properties, sealing ability, cytotoxicity and bond strength of a new resin-based root canal sealer (NRCS).

METHODS

The physicochemical properties were assessed by the flow, setting time, solubility, film thickness, radiopacity and dimensional changes. Sixty premolar root samples were filled with either Resilon/NRCS or Resilon/Epiphany and sectioned perpendicularly at the long axis at 2 mm below the cemento-enamel junction into 1-mm serial slices. The bond strength was tested by a universal testing machine. The glucose microleakage model was used to test the sealing ability. Elutes of NRCS and Epiphany were co-cultured with human periodontal ligament cells to test the cytotoxicity.

RESULTS

All the physicochemical properties of NRCS conformed to ISO 6876:2001(E). The root samples filled with Resilon/NRCS had significantly less leakage (p < 0.01) and greater bond strength (p < 0.001) than the Resilon/Epiphany group had. Environmental scanning electron microscopy showed that Resilon/NRCS filling material was intimately bonded to the root dentin. Although NRCS was slightly toxic to human periodontal ligament cells, its cytotoxicity was significantly less than that of Epiphany (p < 0.01)

CONCLUSION

NRCS has better physicochemical and sealing properties, as well as lower cytotoxicity and microleakage than Epiphany has.

Periapical repair in dog teeth: root canal adhesive filling by using the Resilon System

INTRODUCTION

New filling biomaterials with better physicochemical properties would create a favorable biologic environment for the healing of periapical tissues. The aim of this study was to evaluate periapical repair after biomechanical preparation and root filling with an adhesive system compared with the gold standard material (gutta-percha+sealer) in dog teeth.

METHODS

The pulp of 25 root canals was removed. The apical cementum layer was perforated, and the root canals were prepared up to size #60 K-file followed by step-back shaping with the #90 K-file and filled by the lateral condensation technique. In the experimental group (n=15), the Resilon System (Pentron Clinical Technologies, Wallingford, CT) was used. As a control material (n=10), gutta-percha cones and pulp canal sealer were used. After 60 days, the animals were killed, and 10 histologic parameters were evaluated. Differences among the groups were analyzed by using the Mann-Whitney and Fisher exact tests.

RESULTS

In radiographic and histologic evaluations, most fillings were slightly short of the apex. Progressive regenerative stages were observed; however, there was a reduced prevalence of biologic foraminal closure. No significant differences were observed between the 2 biomaterials with regard to any of the parameters evaluated (P>.05).

CONCLUSIONS

The Resilon System shows periapical biocompatibility equivalent to the gold standard material.

Comparative analysis of leakage in root canal fillings performed with gutta-percha and Resilon cones with AH Plus and Epiphany sealers

OBJECTIVE

The aim of this study was to compare the leakage of root canal fillings of gutta-percha or Resilon cones in association with AH Plus or Epiphany sealer.

STUDY DESIGN

Four groups of premolars (n = 64) were instrumented to size 45/.04 ProFile and filled with laterally compacted gutta-percha cones or Resilon cones in association with AH Plus or Epiphany sealer. The specimens were stored for 2 weeks at 37 degrees C and 100% humidity. After that, leakage was measured using the fluid filtration method and determined as microL/min.10 psi.

RESULTS

Homogeneity of variance and multiple comparisons tests were performed and indicated that root fillings with the combination of gutta-percha cones and AH Plus sealer showed lower leakage values (P < .05) than the other groups.

CONCLUSION

Considering the experimental conditions and the results obtained, it was concluded that fillings made with gutta-percha cones in combination with AH Plus sealer had the best performance.

The induction of cytotoxicity, oxidative stress, and genotoxicity by root canal sealers in mammalian cells

OBJECTIVE

Toxicologic aspects of the root canal sealers Acroseal, Epiphany, AH Plus, and castor oil polymer (COP) were analyzed using cell culture techniques.

STUDY DESIGN

Set materials were extracted in culture medium, and cytotoxicity and the generation of reactive oxygen species (ROS) were determined in human pulp cells. The formation of micronuclei (MN), indicative of genotoxicity and changes of the cell cycle, were analyzed in V79 cells.

RESULTS

The ranking of the most to the least toxic material was: Acroseal > Epiphany = AH Plus >> COP. The production of ROS was increased by Epiphany, Acroseal, and AH Plus about 4-7-fold, but enhanced ROS production was not detected with COP. Acroseal, Epiphany, and AH Plus increased the numbers of MN, and Acroseal delayed the cell cycle in G2 phase.

CONCLUSION

The materials which tested cytotoxic in the present study may be able to alter oral tissue-specific functions and cause inflammation.

Cytotoxicity evaluation of Activ GP and Resilon cones in vitro

OBJECTIVE

This study was done to evaluate the cytotoxicity of Activ GP and Resilon cones in an in vitro cell culture system.

STUDY DESIGN

Gutta-percha (GP), Activ GP, and Resilon cones were tested in this study. L929 cells were seeded into 96-well plates at 3 x 10(4) cells/well. In one set of experiments, 2-mm segments cut from the tip of GP and Resilon cones were placed into the cell culture wells and incubated for 1, 2, and 3 days. In another set of experiments, 2 20-mm segments of GP, Activ GP, and Resilon cones were incubated in 2 mL cell culture medium for 1 week. Then 100 microL elutes were tested for 24 and 48 h. Cell viability was evaluated by MTT assay. Data were analyzed using 1-way analysis of variance.

RESULTS

When GP, Activ GP, and Resilon segments were placed into cell cultures, cell viability in the Resilon group was significantly greater than in the GP and Activ GP groups at any test time. There was no cell viability difference between the Activ GP and GP groups. When the elutes of GP, Activ GP, and Resilon was placed into cell cultures, the results were the same as using segments of the tested material. The cytotoxicity of GP and Activ GP is greater than that of the Resilon cone. There was no cell viability difference between Activ GP and regular GP.

CONCLUSION

Resilon has better biocompatibility than regular GP and Activ GP cones. The cytotoxicity of Activ GP is similar to that of regular GP.

Comparative study of the cytotoxic effect of resilon against two cell lines

Resilon is a new material that is a candidate to replace gutta-percha as a root filling material. This study evaluated the antiproliferative effect of Resilon and two commercially available gutta-percha points (Roeko, Dentsply). Two established cell lines (L929 and RPC-C2A) were used for the experiment. Cell survival fraction was estimated by the sulforhodamine-B assay, in reference to controls after 48-h exposure. Non-parametric tests (Kruskal-Wallis followed by Dunn's multiple comparisons) were used to evaluate the statistical significance of the results (α=0.05). Cytotoxicity in a descending order was: Resilon > Roeko gutta-percha > Dentsply gutta-percha. At 24-h exposure, no statistically significant differences (p>0.05) were observed between tested materials in both cell lines. At 48-h exposure, statistically significant differences (p<0.05) were found between Resilon and the other materials in the L929 cell line. In the RPC-C2A cell line Resilon was significantly more cytotoxic than Dentsply gutta-percha (p<0.05), but no statistically significant differences (p>0.05) were found between Resilon and Roeko gutta-percha. The cytotoxicity of Resilon increased significantly from 24 h to 48 h in both cell lines. Resilon points were more cytotoxic than gutta-percha points. The cytotoxicity was time dependent and increased after 48 h.

Toxicity evaluation of root canal sealers in vitro

AIM

To compare the toxicity of methacrylate resin-based root canal sealers with sealers based on epoxy resin and silicone by two-well established cell culture methods.

METHODOLOGY

Specimens of AH Plus, EndoREZ, RoekoSeal and Epiphany were prepared for direct contact in the Millipore filter diffusion test and as extracts in the MTT assay. Mouse fibroblasts (L929) were used as toxicity targets. Differences in cytotoxicity between fresh and set specimens and between the extracts of root canal sealers were determined by t-test (P < 0.05).

RESULTS

In the filter diffusion test, freshly mixed Epiphany and AH Plus were rated severely toxic and RoekoSeal and EndoREZ nontoxic. When set, Epiphany was moderately toxic, whereas AH Plus, RoekoSeal and EndoREZ were nontoxic. Epiphany was significantly more toxic than RoekoSeal and EndoREZ (P < 0.05). In the MTT assay with set specimens, Epiphany was rated severely toxic; AH Plus and RoekoSeal slightly toxic; and EndoREZ nontoxic. Epiphany was significantly more toxic than the other three materials in this test (P < 0.001).

CONCLUSION

The multi-methacrylate resin-based (Epiphany) root canal sealer was significantly more toxic to L-929 cells than the silicone-based Roeko Seal and the single methacrylate-based EndoREZ root canal sealers. AH Plus showed intermediate toxicity.