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Effect of Different Application Modalities on the Bonding Performance of Adhesive Systems to Dentin: A Systematic Review and Meta-Analysis. Cells 2023; 12:cells12010190. [PMID: 36611983 PMCID: PMC9818277 DOI: 10.3390/cells12010190] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/11/2022] [Accepted: 12/30/2022] [Indexed: 01/05/2023] Open
Abstract
Diverse types of dental adhesives exhibit different cytotoxic outcomes on cells in vitro. Currently, no standard adhesive application technique has so far been decisive for clinicians for better durability of resin-dentin bonds of adhesive systems. The purpose of this study was to systematically review the literature to evaluate the bonding performance of adhesive systems to dentin by using different application modalities. The systematic research strategy was conducted by two reviewers among multiple databases: PubMed, Scopus, Web of Science, Embase, and Scielo. In vitro studies reporting the effects of additional steps for the application of adhesive systems on the bond strength to dentin were selected. Meta-analysis was performed using Review Manager Software version 5.3.5 using the random effects model. The methodological quality of each in vitro study was assessed according to the parameters of a previous systematic review. The electronic research through different databases generated a total of 8318 references. After the examination of titles and abstracts, a total of 106 potentially relevant studies accessed the full-text evaluation phase. After full-text examination, 78 publications were included for the qualitative analysis, and 68 studies were included in the meta-analysis. Regarding the etch-and-rinse adhesive systems, the application modalities that improved the overall bond strength were the application of a hydrophobic resin layer (p = 0.005), an extended application time (p < 0.001), an application assisted by an electric current (p < 0.001), a double-layer application (p = 0.05), the agitation technique (p = 0.02), and the active application of the adhesive (p < 0.001). For self-etch adhesive systems, the techniques that improved the overall bond strength were the application of a hydrophobic resin layer (p < 0.001), an extended application time (p = 0.001), an application assisted by an electric current (p < 0.001), a double-layer application (p < 0.001), the agitation technique (p = 0.01), and the active application of the adhesive (p < 0.001). The in vitro evidence suggests that the application of adhesive systems using alternative techniques or additional strategies may be beneficial for improving their bond strength to dentin. The application modalities that favored the overall bond strength to dentin were an extended application time, a double-layer application, an application assisted by an electric current, the active application of the adhesive, and the application of a hydrophobic resin layer. Worth mentioning is that some techniques are intended to increase the degree of the conversion of the materials, and therefore, improvements in the biocompatibility of the materials can be expected.
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Hiers RD, Huebner P, Khajotia SS, Florez FLE. Characterization of Experimental Nanoparticulated Dental Adhesive Resins with Long-Term Antibacterial Properties. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:3732. [PMID: 36364508 PMCID: PMC9656602 DOI: 10.3390/nano12213732] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
Experimental adhesives with functional nitrogen-doped titanium dioxide nanoparticles (N_TiO2) have been shown to display improved properties. However, these materials have not been characterized regarding their degree of conversion (DC), biaxial flexure strength (BFS), surface roughness (SR), elastic modulus (EM), and long-term antibacterial functionalities. Experimental adhesives were synthesized by dispersing N_TiO2 (10%, 20%, or 30%, v/v%) into OptiBond Solo Plus (OPTB, Kerr Corp., USA). Unpolymerized adhesives (volume = 50 μL/drop, n = 3/group) were individually placed onto a heated (37 °C) attenuated total reflectance (ATR) monolithic diamond crystal (Golden Gate, Specac). The spectra of composites were obtained with a Fourier-transform infrared (FTIR) spectrometer (Nicolet IS50; 500-4500 cm-1; resolution = 4 cm-1, 10 internal scans/spectrum) before and after polymerization. Disk-shaped specimens (diameter = 6.0 mm, thickness = 0.5 mm) for BFS (n = 12/group), SR and EM (n = 3/group), and for antibacterial testing (n = 18/group/time-point) were fabricated and photopolymerized (1 min each; 385-515 nm, 1000 mW/cm2; VALO). DC values (%) were calculated from pre- and post-polymerization spectra using the two-frequency method and tangent-baseline technique. BFS was assessed using a universal testing machine (Instron 68TM-5, crosshead speed = 1.27 mm/min, 25 °C). SR and EM were investigated using an atomic force microscope (Multimode 8) with aluminum-coated silicon probes (8 nm pyramidal tip, spring constant 40 N/m, Bruker). Antibacterial testing was performed by growing Streptococcus mutans biofilms (UA159-ldh, 37 °C, microaerophilic) on the surfaces of specimens for 24 h and then measuring the relative luminescence units (RLU) with a Biotek Synergy HT multi-well plate reader. Results demonstrate that experimental materials containing 10%, 20%, and 30% of N_TiO2 displayed higher levels of DC, had better mechanical properties, and were able to exert strong and durable antibacterial properties without visible light irradiation and after extended periods of simulated shelf-life and aging in PBS. The reported experimental materials are expected to increase the service lives of polymer-based bonded restorations by decreasing the incidence of secondary caries.
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Affiliation(s)
- Rochelle Denise Hiers
- Division of Dental Biomaterials, Department of Restorative Sciences, College of Dentistry, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA
| | - Pedro Huebner
- Department of Mechanical Engineering, University of Utah, Salt Lake City, UT 84112, USA
| | - Sharukh Soli Khajotia
- Division of Dental Biomaterials, Department of Restorative Sciences, College of Dentistry, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA
| | - Fernando Luis Esteban Florez
- Division of Dental Biomaterials, Department of Restorative Sciences, College of Dentistry, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA
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Caldas IP, da Silva EM, Lourenço ES, Martins do Nascimento JC, Leite PEC, Leão MP, Alves G, Scelza MZ. The influence of methodology on the comparison of cytotoxicity of total-etch and self-etch adhesive systems. J Dent 2022; 122:104158. [PMID: 35550400 DOI: 10.1016/j.jdent.2022.104158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 05/03/2022] [Accepted: 05/08/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES The present study aimed to compare the in vitro cytocompatibility of two etch-and-rinse (Adper Scothbond, Optibond) and two self-etch (Clearfill SE Bond and Single Bond Universal) dental adhesives through a dentin-barrier model with human pulp fibroblasts. METHODS Human fibroblasts were placed on a plastic device containing 500μm human dentin discs treated with each adhesive or without treatment (control). Other groups were directly exposed to media conditioned with adhesive samples according to ISO 10993-5:2009. After 24h exposure, cell viability was assessed by XTT, and released inflammatory mediators were detected with a multiparametric immunoassay. RESULTS The standardized test without barrier indicated both etch-and-rinse adhesives and self-etch as cytotoxic, promoting viabilities under 70% of the control group (p<0.05). The dentin-barrier model identified increased cell viability for self-etch adhesives, with Clearfill SE Bond identified as non-cytotoxic. The immunoassay evidenced high rates of cytokines by cells exposed to the conditioned media of Adper Scotchbond, Optibond S, and Single Bond Universal. CONCLUSIONS The use of a dentin-barrier in vitro model detected a better biocompatibility for self-etching adhesives and, in the case of Clearfill SE Bond, with a reversion from cytotoxic to biocompatible when compared to the indirect standardized test. CLINICAL SIGNIFICANCE The use of a dentin-barrier in vitro model was able to detect a better biocompatibility for self-etching adhesives when compared to the indirect standardized test and presents itself as a predictive in vitro method for assessing the cytotoxicity of dental restorative materials that may simulate the clinical condition more accurately.
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Affiliation(s)
- Isleine Portal Caldas
- Geriatric Dentistry Department, School of Dentistry, Fluminense Federal University (UFF), Niterói, RJ, Brazil
| | - Eduardo Moreira da Silva
- Analytical Laboratory of Restorative Biomaterials - LABiom-R, School of Dentistry, Fluminense Federal University, Niterói, RJ, Brazil
| | | | | | - Paulo Emilio Correa Leite
- Clinical Research Unit of the Antonio Pedro Hospital, Fluminense Federal University, Niteroi, RJ, Brazil
| | | | - Gutemberg Alves
- Clinical Research Unit of the Antonio Pedro Hospital, Fluminense Federal University, Niteroi, RJ, Brazil; Cell and Molecular Biology Department, Institute of Biology, Fluminense Federal University, Niteroi, Brazil
| | - Miriam Zaccaro Scelza
- Laboratory of Experimental Culture Cell (LECCel), School of Dentistry, Fluminense Federal University (UFF), Niteroi, RJ, Brazil; Endodontics Department, School of Dentistry, Fluminense Federal University (UFF), Niteroi, RJ, Brazil.
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Wawrzynkiewicz A, Rozpedek-Kaminska W, Galita G, Lukomska-Szymanska M, Lapinska B, Sokolowski J, Majsterek I. The Toxicity of Universal Dental Adhesives: An In Vitro Study. Polymers (Basel) 2021; 13:polym13162653. [PMID: 34451192 PMCID: PMC8400476 DOI: 10.3390/polym13162653] [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: 07/09/2021] [Revised: 08/01/2021] [Accepted: 08/04/2021] [Indexed: 01/23/2023] Open
Abstract
There is no consensus in the literature regarding the potential toxicity of universal dental adhesives (UDA). Being used in close proximity to the pulp, their biocompatibility should be an important factor in dental research. The aim of the present study was to evaluate the biocompatibility of UDA in an in vitro model. The study was performed using a monocyte/macrophage peripheral blood SC cell line (ATCC CRL-9855) on four specific UDA, namely: All-Bond Universal (Bisco); CLEARFIL Universal Bond Quick (Kuraray); G-Premio BOND (GC); Single Bond Universal (3M ESPE). The cytotoxicity of the investigated UDA was measured using the XTT colorimetric assay. The genotoxicity of the analyzed compounds was evaluated using an alkaline version of the comet assay. Furthermore, flow cytometry (FC) apoptosis detection was performed using the FITC Annexin V Apoptosis Detection Kit I. FC cell-cycle arrest assessment was performed using propidium iodide staining. The study observed significant differences in the toxicity of the UDA that were tested, as G-Premio BOND showed significant in vitro toxicity in all of the tests performed, while All-Bond Universal, CLEARFIL Universal Bond Quick and Single Bond Universal did not present any significant toxic effects toward SC cell line. The in vitro toxicity of UDA should be taken into consideration prior to in vivo and clinical studies. The flow cytometry could improve the accuracy of dental materials research and should be incorporated into the standardization criteria.
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Affiliation(s)
- Adam Wawrzynkiewicz
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, 90-419 Lodz, Poland; (A.W.); (W.R.-K.); (G.G.)
| | - Wioletta Rozpedek-Kaminska
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, 90-419 Lodz, Poland; (A.W.); (W.R.-K.); (G.G.)
| | - Grzegorz Galita
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, 90-419 Lodz, Poland; (A.W.); (W.R.-K.); (G.G.)
| | - Monika Lukomska-Szymanska
- Department of General Dentistry, Medical University of Lodz, 92-213 Lodz, Poland; (M.L.-S.); (B.L.); (J.S.)
| | - Barbara Lapinska
- Department of General Dentistry, Medical University of Lodz, 92-213 Lodz, Poland; (M.L.-S.); (B.L.); (J.S.)
| | - Jerzy Sokolowski
- Department of General Dentistry, Medical University of Lodz, 92-213 Lodz, Poland; (M.L.-S.); (B.L.); (J.S.)
| | - Ireneusz Majsterek
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, 90-419 Lodz, Poland; (A.W.); (W.R.-K.); (G.G.)
- Correspondence: ; Tel.: +48-42-272-5300
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Klein-Junior CA, Sobieray K, Zimmer R, Portella FF, Reston EG, Marinowic D, Hosaka K. Effect of heat treatment on cytotoxicity and polymerization of universal adhesives. Dent Mater J 2020; 39:970-975. [PMID: 32611987 DOI: 10.4012/dmj.2019-103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
To assess, in vitro, the influence of heat air treatment on cytotoxicity and degree of conversion (DC) of universal self-etch adhesives (Ambar Universal APS, Scotchbond Universal Adhesive, and Tetric N-Bond Universal) in an NIH/3T3 fibroblast cell culture. Samples were divided into three groups: 1) no heat treatment (control), 2) 37°C and 3) 60°C heat treatment before photopolymerization. Cytotoxicity was analyzed by MTT assay and the DC by FTIR. All adhesives heated at 60°C showed reduced cytotoxicity levels when compared with those heated at 37°C. In general, DC of Ambar Universal APS presented the highest DC than Scotchbond Universal Adhesive and Tetric N-Bond Universal, and the hot air treatment do not influence the conversion. Heat treatment at 60°C was able to reduce the cytotoxicity of universal self-etch adhesives, even, the heat treatment does not enhances the DC.
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Affiliation(s)
| | - Kathleen Sobieray
- Department of Operative Dentistry, School of Dentistry, Universidade Luterana do Brasil (ULBRA)
| | - Roberto Zimmer
- Department of Operative Dentistry, School of Dentistry, Universidade Luterana do Brasil (ULBRA)
| | | | - Eduardo Galia Reston
- Department of Operative Dentistry, School of Dentistry, Universidade Luterana do Brasil (ULBRA)
| | - Daniel Marinowic
- Brain Institute, Neuroscience laboratory, Pontificia Universidade Católica do Rio Grande do Sul (PUC)
| | - Keiichi Hosaka
- Department of Oral Health Science, School of Medical and Dental Science, Tokyo Medical and Dental University
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ATILAN YAVUZ S, SURMELİOGLU D. EVALUATION OF CYTOTOXICITY OF DIFFERENT UNIVERSAL BONDS USING THE XCELLIGENCE SYSTEM. CUMHURIYET DENTAL JOURNAL 2020. [DOI: 10.7126/cumudj.792699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Esteban Florez FL, Kraemer H, Hiers RD, Sacramento CM, Rondinone AJ, Silvério KG, Khajotia SS. Sorption, solubility and cytotoxicity of novel antibacterial nanofilled dental adhesive resins. Sci Rep 2020; 10:13503. [PMID: 32782299 PMCID: PMC7421579 DOI: 10.1038/s41598-020-70487-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 07/20/2020] [Indexed: 02/05/2023] Open
Abstract
Dental adhesives hydrolyze in the mouth. This study investigated the water sorption (SOR), solubility (SOL) and cytotoxicity (CYTO) of experimental adhesives containing nitrogen-doped titanium dioxide nanoparticles (N_TiO2). Specimens (n = 15/group [SOR, SOL]; n = 10/group [CYTO]) of unaltered Clearfil SE Protect (CSP), OptiBond Solo Plus (OSP), Adper Scotchbond (ASB) and experimental adhesives (OSP + 25% or 30% of N_TiO2) were fabricated, desiccated (37 °C) and tested for SOR and SOL according to ISO Specification 4049 (2009). CYTO specimens were UV-sterilized (8 J/cm2) and monomer extracted in growth medium (1, 3 or 7 days). Human pulp cells were isolated and seeded (0.5 × 104) for MTT assay. SOR and SOL data was analyzed using GLM and SNK (α = 0.05) and CYTO data was analyzed with Kruskal–Wallis and SNK tests (α = 0.05). SOR and SOL values ranged from 25.80 μg/mm3 (30% N_TiO2) to 28.01 μg/mm3 (OSP) and 23.88 μg/mm3 (30% N_TiO2) to 25.39 μg/mm3 (25% N_TiO2). CYTO results indicated that pulp cells exposed to experimental materials displayed comparable viabilities (p > 0.05) to those of OSP. Experimental materials displayed comparable SOR, SOL and CYTO values (p > 0.05) when compared to unaltered materials. N_TiO2 incorporation have not adversely impacted SOR, SOL and CYTO properties of unaltered adhesives.
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Affiliation(s)
- Fernando Luis Esteban Florez
- Division of Dental Biomaterials, Department of Restorative Sciences, College of Dentistry, The University of Oklahoma Health Sciences Center, 1201 North Stonewall Avenue, Oklahoma City, OK, 73117, USA.
| | - Hannah Kraemer
- Division of Dental Biomaterials, Department of Restorative Sciences, College of Dentistry, The University of Oklahoma Health Sciences Center, 1201 North Stonewall Avenue, Oklahoma City, OK, 73117, USA
| | - Rochelle Denise Hiers
- Division of Dental Biomaterials, Department of Restorative Sciences, College of Dentistry, The University of Oklahoma Health Sciences Center, 1201 North Stonewall Avenue, Oklahoma City, OK, 73117, USA
| | - Catharina Marques Sacramento
- Department of Physiological Sciences, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901-Bairro Areião, Piracicaba, São Paulo, 13414-903, Brazil.,Department of Prosthodontics and Periodontics, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901-Bairro Areião, Piracicaba, São Paulo, 13414-903, Brazil
| | - Adam Justin Rondinone
- Oak Ridge National Laboratory, Center for Nanophase Materials Sciences, Oak Ridge, TN, 37831, USA
| | - Karina Gonzales Silvério
- Department of Physiological Sciences, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901-Bairro Areião, Piracicaba, São Paulo, 13414-903, Brazil.,Department of Prosthodontics and Periodontics, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901-Bairro Areião, Piracicaba, São Paulo, 13414-903, Brazil
| | - Sharukh S Khajotia
- Division of Dental Biomaterials, Department of Restorative Sciences, College of Dentistry, The University of Oklahoma Health Sciences Center, 1201 North Stonewall Avenue, Oklahoma City, OK, 73117, USA
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Wawrzynkiewicz A, Rozpedek-Kaminska W, Galita G, Lukomska-Szymanska M, Lapinska B, Sokolowski J, Majsterek I. The Cytotoxicity and Genotoxicity of Three Dental Universal Adhesives-An In Vitro Study. Int J Mol Sci 2020; 21:ijms21113950. [PMID: 32486393 PMCID: PMC7312029 DOI: 10.3390/ijms21113950] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/23/2020] [Accepted: 05/29/2020] [Indexed: 12/16/2022] Open
Abstract
Dental universal adhesives are considered an useful tool in modern dentistry as they can be used in different etching techniques, allow for simplified protocol and provide sufficient bond strength. However, there is still no consensus as to their toxicity towards pulp. Thus, the present study aimed to evaluate the cytotoxicity and genotoxicity of three universal adhesives: OptiBond Universal, Prime&Bond Universal and Adhese in an in vitro experimental model, monocyte/macrophage cell line SC (ATCC CRL-9855). The cytotoxicity was measured by means of XTT assay, whereas the genotoxicity (comet assay) was evaluated based on the percentage of DNA present in the comet tail. Furthermore, the ability of the adhesives to induce apoptosis was analyzed using flow cytometry (FC) with the FITC annexin V/propidium iodide (PI) double staining. The analysis of the cell cycle progression was performed with FC using PI staining. OptiBond Universal presented significant, while Prime&Bond Universal and Adhese Universal had minimal cytotoxicity and genotoxicity towards human SC cells. Moreover, only OptiBond Universal increased the level of apoptosis in SC cell line. None of the adhesives showed significant cell cycle arrest, as revealed by FC analysis. Due to substantial differences in toxicity in in vitro studies of dental adhesives, there is a great need for further research in order to establish more reliable test protocols allowing for standardized methodology.
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Affiliation(s)
- Adam Wawrzynkiewicz
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, 90-419 Lodz, Poland; (A.W.); (W.R.-K.); (G.G.)
| | - Wioletta Rozpedek-Kaminska
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, 90-419 Lodz, Poland; (A.W.); (W.R.-K.); (G.G.)
| | - Grzegorz Galita
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, 90-419 Lodz, Poland; (A.W.); (W.R.-K.); (G.G.)
| | - Monika Lukomska-Szymanska
- Department of General Dentistry, Medical University of Lodz, 90-419 Lodz, Poland; (M.L.-S.); (B.L.); (J.S.)
| | - Barbara Lapinska
- Department of General Dentistry, Medical University of Lodz, 90-419 Lodz, Poland; (M.L.-S.); (B.L.); (J.S.)
| | - Jerzy Sokolowski
- Department of General Dentistry, Medical University of Lodz, 90-419 Lodz, Poland; (M.L.-S.); (B.L.); (J.S.)
| | - Ireneusz Majsterek
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, 90-419 Lodz, Poland; (A.W.); (W.R.-K.); (G.G.)
- Correspondence: ; Tel.: +48-42-272-53-00
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Cytotoxicity of Self-Etch Versus Etch-and-Rinse Dentin Adhesives: A Screening Study. MATERIALS 2020; 13:ma13020452. [PMID: 31963535 PMCID: PMC7013582 DOI: 10.3390/ma13020452] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/13/2020] [Accepted: 01/15/2020] [Indexed: 11/17/2022]
Abstract
Six dentin adhesives were tested in vitro regarding their cytotoxicity on human fibroblasts. The adhesives Hybrid Bond, One-up Bond F Plus, AdheSE, Clearfil SE Bond, Optibond Solo Plus and Syntac were eluted with culture medium as single or sequentially applied adhesive part for 24 h. 75 Petri dishes were produced per group. They were evaluated triangulated, comprising the quantitative evaluation (105 ones) to determine “viable”, “dead” and “debris” cells with the use of a cell-counter and the reactivity index was also identified based on the qualitative assessment (420 ones). One-up Bond F Plus, AdheSE and Clearfil SE Bond showed a statistical difference of viable cells to the cell control. For One-up Bond F Plus, statistically, differences compared to hybrid bond and Syntac were also found. All the adhesives except One-up Bond F Plus showed significant differences between single and sequentially applied adhesive part regarding the quantitative evaluation. The test material showed a moderate grade of cytotoxicity. As a result, a statistically significant difference of the cytotoxicity between the self-etch and etch-and-rinse adhesives cannot be demonstrated regarding the qualitative evaluation and the reactivity index, but the differences between sequentially applied and single applied components can be proved.
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Eskandarizadeh A, Nasseri E. Comparative study of different cytotoxicity of bonding systems with different dentin thickness on L929 cell line: An experimental study. Dent Res J (Isfahan) 2020. [DOI: 10.4103/1735-3327.302890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Caldas IP, Alves GG, Barbosa IB, Scelza P, de Noronha F, Scelza MZ. In vitro cytotoxicity of dental adhesives: A systematic review. Dent Mater 2018; 35:195-205. [PMID: 30527507 DOI: 10.1016/j.dental.2018.11.028] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/11/2018] [Accepted: 11/23/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The increased demand for esthetics and minimally invasive tooth restorations resulted in a rapid development of adhesive dentistry. However, much controversy remains about the safe use and cytotoxic effects of different groups of dental adhesives. The present study performed a systematic review to identify the answer to the following question: are self-etch adhesives more cytotoxic than those employing the etch-and-rinse system? METHODS This systematic review was performed in accordance with the PRISMA statement; a quality assessment for in vitro studies was conducted using the ToxRTool. Specific search strategies were developed and performed in the electronic databases MEDLINE via PubMed, Cochrane Library, Scopus, Web of Science, and LILACS/BBO. After removal of duplicated studies and application of the exclusion criteria, ten eligible articles were selected and submitted to a qualitative descriptive analysis comparing both groups of dental adhesives. Most in vitro test systems employed pulp cells or gingival fibroblasts. RESULTS The methodologies presented great variability regarding the exposure to the test materials. Only four studies assessed the role of the degree of conversion of the materials in their toxicity, with conflicting results. SIGNIFICANCE While the lack of methodological standardization among the studies still hinders the establishment of a relationship between type of dental adhesive and toxicity, studies employing dentin barrier systems indicate greater cytotoxicity for etch-and-rinse adhesives.
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Affiliation(s)
- Isleine Portal Caldas
- Doctoral Program in Dentistry of University Federal Fluminense (UFF), Niteroi, RJ, Brazil
| | - Gutemberg Gomes Alves
- Professor, Molecular and Cell Biology Department, Institute of Biology, University Federal Fluminense (UFF), Niteroi, RJ, Brazil
| | - Igor Bastos Barbosa
- Geriatric Dentistry Department, Faculty of Dentistry of University Federal Fluminense (UFF), Niteroi, RJ, Brazil
| | - Pantaleo Scelza
- Geriatric Dentistry Department, Faculty of Dentistry of University Federal Fluminense (UFF), Niteroi, RJ, Brazil
| | - Fernando de Noronha
- Geriatric Dentistry Department, Faculty of Dentistry of University Federal Fluminense (UFF), Niteroi, RJ, Brazil
| | - Miriam Zaccaro Scelza
- Full Professor, Endodontics and Geriatric Dentistry Department, Laboratory Experimental of Culture Cell (LECCel), Faculty of Dentistry, University Federal Fluminense (UFF), Niteroi, RJ, Brazil.
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Silva EJNL, Carvalho NKD, Ronconi CT, De-Deus G, Zuolo ML, Zaia AA. Cytotoxicity Profile of Endodontic Sealers Provided by 3D Cell Culture Experimental Model. Braz Dent J 2016; 27:652-656. [DOI: 10.1590/0103-6440201600792] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 08/25/2016] [Indexed: 11/22/2022] Open
Abstract
Abstract The aim of the present study was to evaluate the cytotoxic effects of five endodontic sealers (AH Plus, Endomethasone N, EndoSequence BC, MTA Fillapex and Pulp Canal Sealer EWT) using a three-dimensional (3D) cell culture model. A conventional bi-dimensional (2D) cell culture model was used as reference technique for comparison. Balb/c 3T3 fibroblasts were cultured in conventional bi-dimensional cell culture and in rat-tail collagen type I three-dimensional cell culture models. Then, both cell cultures were incubated with elutes of freshly mixed endodontic sealers for 24 h. Cell viability was measured by the methyl-thiazol-diphenyltetrazolium assay (MTT). Data were statistically analyzed using ANOVA and the Tukey test at a significance level of p<0.05. All tested sealers exhibited cytotoxic effects; however, cytotoxic effect was culture model- and sealer-dependent. Sealers showed higher cytotoxicity in 2D than in 3D cell culture model (p<0.05). In both conditions, EndoSequence BC showed the lowest cytotoxicity (p<0.05). MTA Fillapex was much more cytotoxic than the other tested endodontic sealers (p<0.05), with the exception of AH Plus in the 2D cell culture model (p>0.05). Endomethasone N and Pulp Canal Sealer EWT showed lower cytotoxic effects than AH Plus in 2D cell culture model (p<0.05); however no statistical differences was observed among these sealers in 3D cell culture model. It may be concluded that cytotoxicity was higher in 2D cell culture compared to 3D cell culture. EndoSequence BC sealer exhibited the highest cytocompatibility and MTA Fillapex the lowest cytocompatibility.
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Wegehaupt FJ, Lunghi N, Belibasakis GN, Attin T. Influence of light-curing distance on degree of conversion and cytotoxicity of etch-and-rinse and self-etch adhesives. BMC Oral Health 2016; 17:12. [PMID: 27430972 PMCID: PMC4948104 DOI: 10.1186/s12903-016-0239-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 06/24/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The degree of conversion (DC) of resin based materials depends, beside other factors, on the light-intensity applied during light curing. A lower DC might be correlated with an increased cytotoxicity of the respective materials. Therefore, aim of the present study was to investigate the influence of the distance between light-curing tip and adhesives on their cytotoxicity and degree of conversion (DC). METHODS For the cytotoxicity assay, a total of 98 bovine dentine samples were prepared, distributed to seven groups (G1-G7; n = 14) and treated as follows: G1: untreated; G2-G4: OptiBond FL; G5-G7: OptiBond All-In-One. Adhesives were light-cured (1200 mW/cm(2)) at 1 mm (G2;G5), 4 mm (G3;G6) or 7 mm (G4;G7) distance. Samples were stored in culture media for 24 h and extracts were added to cell cultures (dental pulp cells and gingival fibroblasts) for a further 24 h. Finally, released lactate dehydrogenase activity (LDH) was photometrically determined, as measure for the cytotoxic effects of the extracts. The cytotoxicity assay was performed three times. Additionally, the DC of the adhesives was determined by FTIR spectroscopy. DC measurements were performed five times. RESULTS For both cell types, no significant difference of LDH release was observed between untreated control group (G1) and treated groups G2-G7 (p > 0.05, respectively), between the groups treated with same adhesive and light-cured at different distance (p > 0.05, respectively), as well as between groups treated with different adhesives and light-cured at the same distance (p > 0.05, respectively). Within the respective adhesive, no significant difference in the DC was observed when light-cured at different distance (p > 0.05, respectively), while OptiBond FL showed significantly higher DCs compared to OptiBond All-In-One when light-cured at same distances (p < 0.05, respectively). CONCLUSIONS The distance between light-curing tip and adhesive surface does not significantly influence either the cytotoxicity or the DC of the tested adhesives.
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Affiliation(s)
- Florian J Wegehaupt
- Clinic for Preventive Dentistry, Periodontology and Cariology, University of Zurich, Plattenstrasse 11, 8032, Zürich, Switzerland.
| | - Nancy Lunghi
- Clinic for Preventive Dentistry, Periodontology and Cariology, University of Zurich, Plattenstrasse 11, 8032, Zürich, Switzerland
| | - Georgios N Belibasakis
- Section of Oral Microbiology and Immunology, Institute of Oral Biology, University of Zürich, Plattenstrasse 11, 8032, Zürich, Switzerland
| | - Thomas Attin
- Clinic for Preventive Dentistry, Periodontology and Cariology, University of Zurich, Plattenstrasse 11, 8032, Zürich, Switzerland
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Banava S, Najibfard K, Garcia-Godoy F, Saghiri MA, Ghahremani MH, Ostad N. Impact of Dilution and Polymerization on Cytotoxicity of Dentin Adhesives to Human Gingival Fibroblasts: Early Exposure Time. J Dent Res Dent Clin Dent Prospects 2015; 9:151-8. [PMID: 26697147 PMCID: PMC4682011 DOI: 10.15171/joddd.2015.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Accepted: 05/23/2015] [Indexed: 01/12/2023] Open
Abstract
Background and aims. The aim of this study was to evaluate the effect of dilution and curing methods of an etch-and-rinse adhesive and a self-etching primer from the same manufacturer at early exposure time on cytotoxicity of primary human gingival fibroblasts. Materials and methods. Primary human gingival fibroblasts were exposed to different dilutions of Adper Single Bond (ASB) and Adper Prompt L-Pop (APL) (3M ESPE, USA). They were evaluated in unpolymerized mode for 20 s, 5 min and 24 h and in polymerized mode for 24 h and 48 h. Cytotoxicity was evaluated using three cytotoxic tests (MTT, cell counting and DNA condensation). Data was analyzed by a one-way ANOVA and Post Hoc Tukey HSD test. Results. Cytotoxicity tests revealed that unpolymerized APL was more cytotoxic compared to ASB after 20 s (P<0.05). By increasing the time to 5 min and 24 h, ASB was more cytotoxic than APL with lower dilutions. Polymerized ASB was more toxic than APL. Conclusion. Both adhesives were cytotoxic in different dilutions, times and curing modes. Cytotoxicity of the unpolymerized self-etching primer (APL) was more than etch-and-rinse adhesive (ASB) in 20 s, which is important clinically and dentists should be aware of the harmful effects and try to minimize it by curing and rinsing soon after composite resin insertion. ASB was more cytotoxic at 5 min and 24h.
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Affiliation(s)
- Sepideh Banava
- Assistant Professor, Department of Dental Materials, Azad University, Dental Branch, Tehran, Iran
| | | | - Franklin Garcia-Godoy
- Bioscience Research Center, College of Dentistry, the University of Tennessee Health Science Center, Memphis, TN, USA
| | - Mohammad Ali Saghiri
- Department of Ophthalmology & Visual Sciences, University of Wisconsin School of Medicine and Public health, Madison, WI, USA
| | - Mohammad Hossein Ghahremani
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, and Pharmaceutical Sciences Research Centre, Tehran University of Medical Sciences, Tehran
| | - Naser Ostad
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, and Pharmaceutical Sciences Research Centre, Tehran University of Medical Sciences, Tehran
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15
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Cytotoxicity evaluation of three light-cured dentin adhesive materials on human gingival fibroblasts, ex vivo. Adv Med Sci 2013; 57:385-90. [PMID: 23154426 DOI: 10.2478/v10039-012-0038-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE To evaluate the cytotoxic effects of three current light-cured dentin adhesives, in both uncured and post-cured conditions, on human gingival fibroblasts. MATERIAL AND METHODS The materials tested were Heliobond, Adper Single Bond 2 and Xeno V, which are characterized by various compositions and application procedures. Each agent, in volumes of 5 and 10 μL, was tested after polymerization, and those unpolymerized were diluted in DMEM to 10-3 and 10-5. The cytotoxicity of the adhesives was assessed on the basis of a test of cell viability in a culture of human gingival fibroblasts, with the use of tetrazolic salt (MTT assay). RESULTS The results showed that, among the adhesive/bonding systems tested, Xeno V was the least cytotoxic. There were statistically significant differences in cell survival between polymerized Xeno V, Adper Single Bond 2 and Heliobond in the amount of 5 μL as well as between the Xeno V and Adper Single Bond 2 in 10-5 dilutions. The tested adhesives were more toxic in the polymerized form than in the dilutions. Samples of 10 μL resulted in a lower survival percentage of fibroblasts compared to 5 μL. CONCLUSION All the tested adhesives demonstrated cytopathic effects towards human gingival fibroblasts, but varied in their cytotoxicity. This has clinical implications. Dentists should follow the rules of adhesive application, precisely dose them and not allow direct contact with the gums as, even after polymerization, adhesive agents exhibit potential cytotoxic activity.
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16
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Cytotoxicity test of dentin bonding agents using millipore filters as dentin substitutes in a dentin barrier test. Clin Oral Investig 2012; 17:1489-96. [PMID: 23011524 DOI: 10.1007/s00784-012-0840-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Accepted: 09/04/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The purpose of this study was to find proper dentin substitute for standardized dentin barrier test and perform the cytotoxicity test of commercial bonding agents with the proper substitute. MATERIALS AND METHODS The three-dimensional cells attached to dentin disc or millipore filters as the dentin substitute were tested in a dentin barrier test by perfusion. MTT assay was performed as an evaluation method for the cell survival rate. The cytotoxicity test of serial phenol dilution by bovine dentin disc was done to determine a standard toxic material, and the test of this proper phenol by using various millipore combinations was performed to find the suitable dentin substitute. Also, the cytotoxicity test of bonding agents was performed by this standardized substitute. The cell viability was expressed as percentages of untreated group. RESULTS Phenol concentration of 0.05 % was selected as the standard toxic material. The different combinations of millipore filters--two sheets of 0.45 μm, two sheets of 0.22 μm, and the combination of 0.65, 0.45, and 0.22 μm--showed similar cytotoxicity to natural dentin discs by 0.05 % phenol (p > 0.05). The millipore combination of 0.65, 0.45, and 0.22 μm that had structural similarity to natural dentin discs was used as the substitute for cytotoxicity test of bonding agents. The toxic level of Adper Prompt L-Pop using the selected substitute was significantly the highest among four kinds of dentin bonding agents (p < 0.05). Also, the dentin barrier test by the substitute showed constant results compared with the one by the natural dentin disc. CONCLUSIONS The millipore filter combination of 0.65, 0.45, and 0.22 μm could be used as the substitute for the cytotoxicity test of materials applied to dentin. CLINICAL RELEVANCE Dentin barrier test by standardized substitutes would be helpful for considering the potential toxicity of dentin bonding agents prior to clinical adaptations and reducing the variations of natural bovine dentin that has individually different characteristics.
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17
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Reaction of rat subcutaneous connective tissue to resin composites polymerized with different light curing units and different lightening methods. Int J Dent 2012; 2012:156352. [PMID: 22761617 PMCID: PMC3384911 DOI: 10.1155/2012/156352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Revised: 03/24/2012] [Accepted: 04/24/2012] [Indexed: 11/17/2022] Open
Abstract
The aim of the study was to determine and compare the reaction of rat subcutaneous connective tissue to resin composites polymerized with different lights curing and lightening methods. In this in vivo study, 20 mature Wister Albino rats were used. The composite discs, 4 mm in diameter and 2 mm thick, were cured by QTH or LED light curing units with 4 different lightning methods (full power QTH, full power LED, pulse LED, and ramp LED). Five resin composite discs were implanted in each rat, so that 4 of 5 discs for implantation of cured composite discs differently and central one as control without implantation. After sacrificing at 7, 14, 30, and 60 days the inflammatory grade, fibrosis, and necrosis were determined. Freedman and Cochran tests were used to analyze the data using SPSS software ver. 15. The results of the study showed significant differences in inflammation grade and fibrosis among control group and 4 experimental groups at day 14 (P < 0.05). In necrosis, there was no significant difference among 4 groups in different times (P > 0.05). In conclusion, neither the type of light curing units (LED or QTH) nor the lightening methods can affect the grade of inflammatory reaction.
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Ergun G, Egilmez F, Yilmaz S. Effect of reduced exposure times on the cytotoxicity of resin luting cements cured by high-power led. J Appl Oral Sci 2011; 19:286-92. [PMID: 21625748 PMCID: PMC4234344 DOI: 10.1590/s1678-77572011000300019] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2009] [Accepted: 04/29/2010] [Indexed: 12/03/2022] Open
Abstract
Objective Applications of resin luting agents and high-power light-emitting diodes (LED)
light-curing units (LCUs) have increased considerably over the last few years.
However, it is not clear whether the effect of reduced exposure time on
cytotoxicity of such products have adequate biocompatibility to meet clinical
success. This study aimed at assessing the effect of reduced curing time of five
resin luting cements (RLCs) polymerized by high-power LED curing unit on the
viability of a cell of L-929 fibroblast cells. Material and Methods Disc-shaped samples were prepared in polytetrafluoroethylene moulds with
cylindrical cavities. The samples were irradiated from the top through the ceramic
discs and acetate strips using LED LCU for 20 s (50% of the manufacturer's
recommended exposure time) and 40 s (100% exposure time). After curing, the
samples were transferred into a culture medium for 24 h. The eluates were obtained
and pipetted onto L-929 fibroblast cultures (3x104 per well) and
incubated for evaluating after 24 h. Measurements were performed by
dimethylthiazol diphenyltetrazolium assay. Statistical significance was determined
by two-way ANOVA and two independent samples were compared by t-test. Results Results showed that eluates of most of the materials polymerized for 20 s (except
Rely X Unicem and Illusion) reduced to a higher extent cell viability compared to
samples of the same materials polymerized for 40 s. Illusion exhibited the least
cytotoxicity for 20 s exposure time compared to the control (culture without
samples) followed by Rely X Unicem and Rely X ARC (90.81%, 88.90%, and 83.11%,
respectively). For Rely X ARC, Duolink and Lute-It 40 s exposure time was better
(t=-1.262 p=0,276; t=-9.399 p=0.001; and t=-20.418 p<0.001, respectively). Conclusion The results of this study suggest that reduction of curing time significantly
enhances the cytotoxicity of the studied resin cement materials, therefore
compromising their clinical performance.
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Affiliation(s)
- Gulfem Ergun
- Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey.
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19
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Sengün A, Yalçın M, Ülker HE, Öztürk B, Hakkı SS. Cytotoxicity evaluation of dentin bonding agents by dentin barrier test on 3-dimensional pulp cells. ACTA ACUST UNITED AC 2011; 112:e83-8. [PMID: 21546285 DOI: 10.1016/j.tripleo.2011.02.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 02/11/2011] [Accepted: 02/14/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effects of 4 dentin-bonding agents on the cell viability of bovine derived cells. STUDY DESIGN Cytotoxicity of dentin-bonding agents (G-Bond [GB], Adper Prompt Self-Etch [APSE], Clearfil DC Bond System [CDCB], and Quadrant University-1-Bond [UB]) was analyzed with a dentin barrier test device using 3-dimensional (3D) pulp cell cultures. A commercially available cell culture perfusion chamber was separated into 2 compartments using a 500 μm dentin disk. The 3D cultures were placed on a dentin disk and held in place with a special biocompatible stainless steel holder. Test materials were introduced into the upper compartment in direct contact with the cavity side of the dentin disks according to the manufacturer's instructions. Subsequently, the pulpal part of the perfusion chamber containing the cell cultures was perfused with a medium (2 mL/h). After an exposure period of 24 hours, cell survival was determined by using the MTT assay. Statistical analyses were performed using the Mann-Whitney U test. RESULTS In the dentin barrier test, cell survival rates of UB and CDCB were similar to the control group (P > .05). However, all other tested materials were cytotoxic for the 3D pulp-derived cell cultures (P < .05). CONCLUSIONS Dentin-bonding agents include biologically active ingredients and may modify pulp cell metabolism when the materials are used in deep cavities in spite of a dentin barrier. If these adhesive agents are used in deep cavities, a biocompatible cavity liner should be used.
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Affiliation(s)
- Abdülkadir Sengün
- Department of Conservative Dentistry, School of Dentistry, University of Kırıkkale, Kırıkkale, Turkey
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20
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Monteiro GQM, Souza FB, Pedrosa RF, Sales GCF, Castro CMMB, Fraga SN, Galvão BHA, Braz R. In vitro biological response to a self-adhesive resin cement under different curing strategies. J Biomed Mater Res B Appl Biomater 2009; 92:317-21. [PMID: 19927333 DOI: 10.1002/jbm.b.31517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Self-adhesive resin cements represents a new approach in indirect restorative dentistry, although little is known about its biological properties. The influence of the curing strategy on the biological response of a self-adhesive resin cement (Rely-X Unicem/3M ESPE) was evaluated through methyltetrazolium (MTT) and nitric oxide (NOx) assays. Cylindrical specimens (n = 48) were prepared and cured according to the following strategies: photoactivation with halogen light-curing unit (LCU) Demetron/Kerr, LED LCU Radii/SDI, and chemical activation. A control group with culture medium and a group with lipopolysaccharide, employed for cells stimulation, were used for comparisons (n = 8). After 24 h of direct contact between specimens and rat alveolar macrophages, the biological response was evaluated. Statistical evaluation of the data was performed with Kruskal-Wallis and Dunn's test (p = 0.05). The MTT test showed that the specimens cured by halogen light and chemical activation provided higher alterations on cell metabolism. For LED-cured specimens, cell viability was compatible to the results observed in the control group. For the NOx assay, all curing methods were cytotoxic to rat macrophages. Rely-X Unicem demonstrated different cytotoxic effects according to the curing strategy employed.
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Affiliation(s)
- Gabriela Q M Monteiro
- Department of Restorative Dentistry, Dental School of the University of Pernambuco-FOP/UPE, Camaragibe-PE, Brazil.
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Schmid-Schwap M, Franz A, König F, Bristela M, Lucas T, Piehslinger E, Watts DC, Schedle A. Cytotoxicity of four categories of dental cements. Dent Mater 2009; 25:360-8. [DOI: 10.1016/j.dental.2008.08.002] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2008] [Revised: 07/15/2008] [Accepted: 08/13/2008] [Indexed: 11/16/2022]
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22
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Transdentinal diffusion and cytotoxicity of self-etching adhesive systems. Cell Biol Toxicol 2008; 25:533-43. [DOI: 10.1007/s10565-008-9110-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2008] [Accepted: 10/27/2008] [Indexed: 12/30/2022]
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