Cytotoxic effects of dental cements on two cell culture systems

Impact of bisphenol A and analogues eluted from resin-based dental materials on cellular and molecular processes: An insight on underlying toxicity mechanisms

Dental resin systems, used for artificial replacement of teeth and their surrounding structures, have gained popularity due to the Food and Drug Administration's (FDA) recommendation to reduce dental amalgam use in high-risk populations and medical circumstances. Bisphenol A (BPA), an endocrine-disrupting chemical, is an essential monomer within dental resin in the form of various analogues and derivatives. Leaching of monomers from resins results in toxicity, affecting hormone metabolism and causing long-term health risks. Understanding cellular-level toxicity profiles of bisphenol derivatives is crucial for conducting toxicity studies in in vivo models. This review provides insights into the unique expression patterns of BPA and its analogues among different cell types and their underlying toxicity mechanisms. Lack of a consistent cell line for toxic effects necessitates exploring various cell lines. Among the individual monomers, BisGMA was found to be the most toxic; however, BisDMA and BADGE generates BPA endogenously and found to elicit severe adverse reactions. In correlating in vitro data with in vivo findings, further research is necessary to classify the elutes as human carcinogens or xenoestrogens. Though the basic mechanisms underlying toxicity were believed to be the production of intracellular reactive oxygen species and a corresponding decline in glutathione levels, several underlying mechanisms were identified to stimulate cellular responses at low concentrations. The review calls for further research to assess the synergistic interactions of co-monomers and other components in dental resins. The review emphasizes the clinical relevance of these findings, highlighting the necessity for safer dental materials and underscoring the potential health risks associated with current dental resin systems.

Effect of Potassium Aluminum Sulfate Application on the Viability of Fibroblasts on a CAD-CAM Feldspathic Ceramic before and after Thermocycling

Potassium aluminum sulfate (alum) is a known adjuvant, which has been used as a mordant in textile industry for color fixation. This material has potential to be incorporated into dentistry for color stability, yet its toxicity first needs to be evaluated. The present study aimed to evaluate the cytotoxic potential of potassium aluminum sulfate (alum) on fibroblasts when applied onto feldspathic ceramic before and after thermocycling. Forty-eight feldspathic ceramic specimens were divided into four groups (FC: no alum application or thermocycling; FCT: thermocycling without alum application; FA: alum application without thermocycling; FAT: alum application and thermocycling) (n = 12). Cell viability was assessed by using a tetrazolium salt 3-[4,5-dimethylthiazol-2-yl]-2,5-diphnyltetrazolium bromide assay at 24 and 72 h, and cell cultures without any ceramic specimens served as control (C). One sample from each material group was further analyzed with energy dispersive X-ray spectroscopy (EDX). Cell viability at different time intervals within each group was analyzed with Friedman tests, while Kruskal−Wallis tests were used to compare the test groups within each time interval. Pairwise comparisons were further resolved by using Wilcoxon tests (a = 0.05). C had lower (p = 0.01) and FA had higher (p = 0.019) cell viability after 72 h. After 24 h, the highest cell viability was observed in C (p ≤ 0.036). After 72 h, the differences between C and FA, C and FAT, FC and FA, and FCT and FAT were nonsignificant (p > 0.05). Cell viability was not affected by alum application or thermocycling at any time interval (p ≥ 0.631). EDX analysis showed an increase in potassium concentration in FA and FAT when compared with FC and FCT. Regardless of the time interval, alum application onto feldspathic ceramic and thermocycling did not influence the cell viability.

A critical analysis of research methods and experimental models to study biocompatibility of endodontic materials

Materials used for endodontics and with direct contact to tissues have a wide range of indications, from vital pulpal treatments to root filling materials and those used in endodontic surgery. In principle, interaction with dental materials may result in damage to tissues locally or systemically. Thus, a great variety of test methods are applied to evaluate a materials' potential risk of adverse biological effects to ensure their biocompatibility before commercialization. However, the results of biocompatibility evaluations are dependent on not only the tested materials but also the test methods due to the diversity of these effects and numerous variables involved. In addition, diverse biological effects require equally diverse assessments on a structured and planned approach. Such a structured assessment of the materials consists of four phases: general toxicity, local tissue irritation, pre‐clinical tests and clinical evaluations. Various types of screening assays are available; it is imperative to understand their advantages and limitations to recognize their appropriateness and for an accurate interpretation of their results. Recent scientific advances are rapidly introducing new materials to endodontics including nanomaterials, gene therapy and tissue engineering biomaterials. These new modalities open a new era to restore and regenerate dental tissues; however, all these new technologies can also present new hazards to patients. Before any clinical usage, new materials must be proven to be safe and not hazardous to health. Certain international standards exist for safety evaluation of dental materials (ISO 10993 series, ISO 7405 and ISO 14155‐1), but researchers often fail to follow these standards due to lack of access to standards, limitation of the guidelines and complexity of new experimental methods, which may cause technical errors. Moreover, many laboratories have developed their testing strategy for biocompatibility, which makes any comparison between findings more difficult. The purpose of this review was to discuss the concept of biocompatibility, structured test programmes and international standards for testing the biocompatibility of endodontic material biocompatibility. The text will further detail current test methods for evaluating the biocompatibility of endodontic materials, and their advantages and limitations.

Cytotoxicity of Dental Cements on Soft Tissue Associated with Dental Implants

Purpose

To investigate and compare the cellular host response of human gingival fibroblasts (HGF) on four currently used cements. Methods and Material. 5 cement pellet samples were made for each of the 4 test cements (n = 20). The cements used for this study were zinc phosphate, zinc oxide noneugenol (ZOE), RelyX U200, and glass ionomer cement (GIC). One commercially available cell line was used to investigate the cytotoxicity of peri-implant tissues. Direct contact cell culture testing was conducted following International Organization for Standardization (ISO) methods 10993-5 and 10993-12 (MTT assay test). Cell cultures without dental cement were considered as control. Cells were allowed to grow and confluence over 48 hours after subcultivation according to standard laboratory procedures. The cells were kept in direct contact with the cement samples for 24 hours before being subjected to analysis. All specimens were tested in triplicate to validate the results. Quantitative evaluation of cytotoxicity was done to measure cell death and inhibition of cell growth. Results were analyzed using 1-way ANOVA (a = 0.05) followed by Tukey B post hoc test.

Results

The results of the study showed that HGF was vulnerable to the dental cement test material. GIC, zinc phosphate, ZOE, and resin cement were cytotoxic in decreasing order, respectively, and significantly reduced the cell viability after exposure to HGF (p < 0.001).

Conclusions

Within the limitations of this in vitro cellular study, results indicated that the test dental cements were cytotoxic to HGF. The highest cytotoxicity was observed in GIC followed by zinc phosphate, ZOE, and resin cement.

The synergistic effects of SrF2 nanoparticles, YSZ nanoparticles, and poly-ε-l-lysin on physicomechanical, ion release, and antibacterial-cellular behavior of the flowable dental composites

Resin-based pit-and-fissure sealants (flowable resin composites) were formulated using bisphenol-A-glycerolatedimethacrylate (Bis-GMA)-triethylene glycol dimethacrylate-(TEGDMA)-diurethanedimethacrylate (UDMA) mixed monomers and multiple fillers, including synthetic strontium fluoride (SrF₂) nanoparticles as a fluoride-releasing and antibacterial agent, yttria-stabilized zirconia (YSZ) nanoparticles as an auxiliary filler, and poly-ε-l-lysin (ε-PL) as an auxiliary antibacterial agent. Based on the physical, mechanical and initial antibacterial properties, the formulated nano-sealant containing 5 wt% SrF₂, 5 wt% YSZ and 0.5 wt% ε-PL was selected as the optimal specimen and examined for ion release and cytotoxicity. The results showed an average release rate of 0.87 μg·cm^-2·day^-1 in the aqueous medium (pH 6.9) and 1.58 μg·cm^-2·day^-1 in acidic medium (pH 4.0). The maximum cytotoxicity of 20% toward human bone marrow mesenchymal stem cells (hMSCs) was observed according to the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) cytotoxicity assay and acridine orange staining test. A synergy between SrF₂ nanoparticles and ε-PL exhibited a better antibacterial activity in terms of colony reduction compared to the other samples. However, the inclusion of SrF₂ and ε-PL caused mechanically weakening of the sealants that was partly compensated by incorporation of YSZ nanoparticles (up to 10 wt%).

Cytotoxicity of Different Nano Composite Resins on Human Gingival and Periodontal Ligament Fibroblast Cell Lines: An In Vitro Study

The aim of this study is to determine the cytotoxicity of three different nano composite resins (CRs) on human gingival fibroblast (hGF) and periodontal ligament fibroblast (hPDLF) cell lines. These CRs selected were nanohybrid organic monomer-based Admira Fusion (AF), nanohybrid Bis-(acryloyloxymethyl) tricyclo [5.2.1.0.sup.2,6] decane-based Charisma Topaz (CT), and supra nano filled resin-based Estelite Quick Sigma (EQS). MTT assay was performed to assess the cytotoxicity of CRs at 24 h and one week. AF and EQS applied on hGF cells at 24 h and one week demonstrated similar cytotoxic outcomes. Cytotoxicity of CT on hGF cells at one week was higher than 24 h (p = 0.04). Cytotoxicity of CT on hGF cells was higher at 24 h (p = 0.002) and one week (p = 0.009) compared to control. All composites showed higher cytotoxicity on hPDLF cells at one week than the 24 h (AF; p = 0.02, CT; p = 0.02, EQS; p = 0.04). AF and EQS demonstrated lower cytotoxicity on hPDLF cells than the control group at 24 h (AF; p = 0.01, EQS; p = 0.001). CT was found more cytotoxic on hPDLF cells than the control (p = 0.01) and EQS group (p = 0.008) at one week. The cytotoxicity of CRs on hGF and hPDLF cells vary, according to the type of composites, cell types, and exposure time.

In Vitro Cytotoxicity Evaluation of Novel Nano-Hydroxyapatite-Silica Incorporated Glass Ionomer Cement

INTRODUCTION

Glass Ionomer Cements (GIC) are among the most popular restorative materials, but their use in dentistry is limited due to their physical properties. The hardness of GIC was improved by incorporation of nano-hydroxyapatite-silica into GIC, to expand its applicability.

AIM

To evaluate the cytotoxic effects of nano-hydroxyapatite-silica incorporated glass ionomer cement (HA-SiO₂-GIC) on human Dental Pulp Stem Cells (DPSC) and compare it with conventional GIC and resin modified GIC.

MATERIALS AND METHODS

Material extracts of Fuji IX, Fuji II LC and HA-SiO₂-GIC were prepared into seven serial concentrations and applied to 96-well-plates seeded with DPSC. The 96-well-plates were incubated for 24 and 72 hours. The morphology of DPSC was observed under the inverted phase contrast microscope, and the cell viability was determined using MTT assay at both time intervals. Kruskal-Wallis test was performed for statistical analysis.

RESULTS

At maximum concentration, DPSC appeared fewer in number, but the normal spindle morphology was maintained in all groups except for Fuji II LC. At lower concentrations, DPSC appeared normal and more confluent in all groups. The cytotoxic effects of all groups were dose dependent. Fuji IX demonstrated the lowest cytotoxicity, followed by HA-SiO₂-GIC. Fuji II LC demonstrated the highest cytotoxicity. The difference was significant between all groups at 200 mg/ml concentration (p<0.05). At concentration <100 mg/ml, cytotoxicity of HA-SiO₂-GIC was comparable to that of Fuji IX and lower than that of Fuji II LC.

CONCLUSION

HA-SiO₂-GIC showed a favourable cytotoxicity response and thus holds promise as a future potential restorative material in clinical dentistry.

Elution study of unreacted TEGDMA from bulk-fill composite (SDR™ Dentsply) using HPLC

PURPOSE

The study evaluates the dynamics of unreacted TEGDMA monomer elution from new generation of flowable bulk fill composite resin (SDR™ Dentsply).

MATERIAL AND METHODS

Polymerised specimens of SDR™ composite (7mm diameter and 4mm thick) were placed in four solutions: 100% ethanol, 75% ethanol, distilled water and 100% methanol. The concentration of the eluted TEGDMA was measured using the HLPC method after 0.5, 1, 2 and 3h as well as after 1, 3, 7, 14, 21 and 31 days.

RESULTS

During the first 24h of storage in each medium, a significant elution of TEGDMA was observed (100% ethanol - 12.5μg/g, 75% ethanol - 8.4μg/g, distilled water - 5.4μg/g and 100% methanol - 7μg/g). The elution time of the TEGDMA into 100% ethanol, 75% ethanol, distilled water and 100% methanol was 14, 7, 3 and 1 day, respectively. After 31 days, total concentrations of TEGDMA were as follows: 100% ethanol - 16μg/g, 75% ethanol - 9.4μg/g, distilled water - 6μg/g and 100% methanol - 7μg/g.

CONCLUSIONS

The TEGDMA was released from the SDR™ composite into each solution used. The TEGDMA concentration and the time of its elution depend on the type of the solvent. In an aqueous environment, the SDR™ composite exhibits a high chemical stability compared to other solutions. The direct toxicity towards to the dental pulp is established during the first hours after the placement of resin.

Evaluation of salivary total oxidant-antioxidant status and DNA damage of children undergoing fixed orthodontic therapy

OBJECTIVE

To determine the total oxidant status (TOS), total antioxidant status (TAS), and the 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels and their interrelationship in the saliva of children undergoing fixed orthodontic therapy.

MATERIALS AND METHODS

Thirty children were randomly divided into three groups. The attachments were bonded to all of the teeth using three different orthodontic composites: Transbond XT, Kurasper F, and GrenGloo. The salivary levels of TOS, TAS, and 8-OHdG were determined three times, as follows: before treatment (T1) and at 1 month (T2) and 3 months (T3) following appliance placement. All data were statistically analyzed.

RESULTS

There were no significant differences in TOS, TAS, and 8-OHdG within the same time periods among the three different orthodontic composites (P > .05). TAS in all composite groups decreased over time. These decreases were found to be significant for Kurasper F and GrenGloo at the T1-T3 and T2-T3 time periods (P < .05). In all composite groups 8-OHdG decreased between T1 and T2 (P < .05). However, 8-OHdG in all composite groups increased from T2 to T3. These differences in 8-OHdG were significant in Kurasper F and GrenGloo (P < .05).

CONCLUSIONS

Fixed orthodontic appliances bonded with the tested composites did not increase the cytotoxicity markers in saliva.

Effect of extraction media and storage time on the elution of monomers from four contemporary resin composite materials

Introduction:

The purpose of this study was to examine the effect of different extraction media, including culture media, as well as storage times on the elution of monomers from modern dental composites.

Materials and Methods:

Four contemporary composite materials were tested: (a) Clearfil Majesty Esthetic (Kuraray), (b) Esthet X (DENTSPLY), (c) Filtek Silorane (3M ESPE), and (d) Admira (Voco). Forty-eight specimens were made. The specimens were stored in 1 ml of (a) artificial saliva, (b) Dulbecco's Modified Eagle Medium (DMEM), (c) DMEM plus 10% fetal bovine serum (FBS), and (d) ethanol 75%. The specimens were analyzed after 24 hours and after 1 week of storage. HPLC Liquid Chromatography was performed to analyze the extracted solutions. The statistical package SPSS 18 was used for the statistical analysis of the results.

Results:

All the materials tested released monomers that were consistent with the base composition of their resin matrix. Bisphenol-A (BPA) was detected in Clearfil Esthetic and EsthetX when ethanol 75% was used for storage. TEGDMA was released at a faster rate compared to the other monomers with most of the monomer eluted in the first 24 hours. The effect of storage solution and storage time on the elution of the same monomers varied between materials.

Conclusions:

There was a significant effect of time, storage solution, and material on the elution of the detectable unbound monomers. Unbound monomers were detected in culture media, which may lead to false-negative results in cytotoxicity tests of resin composite materials. BPA was detected in two of the tested materials.

Quantitation and human monocyte cytotoxicity of the polymerization agent 1-hydroxycyclohexyl phenyl ketone (Irgacure 184) from three brands of aqueous injection solution

In this study, levels of the photoinitiator 1-hydroxycyclohexyl phenyl ketone (1-HCHPK) in aqueous injection solutions were analyzed by GC-MS. In our previous studies, photoinitiators such as 2-methyl-4'-(methylthio)-2-morpholinopropiophenone (MTMP) were detected in intravenous (i.v.) injection bag solution, and they were found to be cytotoxic to human monocytes. Therefore, we hypothesized that 1-HCHPK might display similarly cytotoxicity. The purpose of this study was to quantitate the amount of contaminants from plastic containers such as those used for peripheral parenteral nutrition and to determine the cytotoxicity of such extracts on human monocytes. The sample extraction procedure for GC-MS analysis involved a liquid-phase extraction. The solvent was evaporated under a stream of nitrogen at 50°C to yield a residue, which was dissolved in n-hexane and injected into a GC-MS. Normal human peripheral blood mononuclear cells (PBMC), isolated from the buffy coat by centrifugation, were suspended in RPMI 1640 medium supplemented with 10% (v/v) heat-inactivated fetal calf serum. In the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) cell viability assay, cells (1×10(4)) were treated with 1-HCHPK for 24 h or 48 h at 37°C. From the GC-MS analysis, 6.13-8.32 µg/mL of 1-HCHPK was found in 20 mL vials of water for injection solution. In the MTT assay, 1-HCHPK decreased cell viability for both the 24 h and 48 h incubation periods. In conclusion, our findings suggest that 1-HCHPK could promote adverse events in patients. Future studies will clarify the possible health risks of photoinitiator accumulation in human cells.

Preparation, physical-chemical characterization, and cytocompatibility of polymeric calcium phosphate cements

Aim. Physicochemical mechanical and in vitro biological properties of novel formulations of polymeric calcium phosphate cements (CPCs) were investigated. Methods. Monocalcium phosphate, calcium oxide, and synthetic hydroxyapatite were combined with either modified polyacrylic acid, light activated polyalkenoic acid, or polymethyl vinyl ether maleic acid to obtain Types I, II, and III CPCs. Setting time, compressive and diametral strength of CPCs was compared with zinc polycarboxylate cement (control). Specimens were characterized using X-ray diffraction, scanning electron microscopy, and infrared spectroscopy. In vitro cytotoxicity of CPCs and control was assessed. Results. X-ray diffraction analysis showed hydroxyapatite, monetite, and brushite. Acid-base reaction was confirmed by the appearance of stretching peaks in IR spectra of set cements. SEM revealed rod-like crystals and platy crystals. Setting time of cements was 5–12 min. Type III showed significantly higher strength values compared to control. Type III yielded high biocompatibility. Conclusions. Type III CPCs show promise for dental applications.

Fate of Extruded Sealer: A Matter of Concern

The most important objective of successful root canal treatment is thorough biomechanical preparation of root canal. Elimination of infected pulp and dentine, adequate root canal preparation and three dimensional obturation constitute the basic principle of root canal treatment. Ideally, the filling material along with sealer should be confined to the root canal without extending to periapical tissue or other neighboring structures. Endodontic filling material and sealer, beyond the apical foramen may give rise to clinical manifestations as a result of the toxicity of the product. When the extruded material is either close to or in intimate contact with nerve structures, anesthesia, hypoaesthia, paraesthasia, or dysaesthesia may occur. The purpose of this paper is to discuss few cases of apical extrusion of sealer during obturation and its effects on periapical tissue and the success of treatment.

Biocompatibility of Resin-based Dental Materials

Oral and mucosal adverse reactions to resin-based dental materials have been reported. Numerous studies have examined the biocompatibility of restorative dental materials and their components, and a wide range of test systems for the evaluation of the biological effects of these materials have been developed. This article reviews the biological aspects of resin-based dental materials and discusses the conventional as well as the new techniques used for biocompatibility assessment of dental materials.

Degree of conversion and color stability of the light curing resin with new photoinitiator systems

OBJECTIVES

This study investigated p-octyloxy-phenyl-phenyl iodonium hexafluoroantimonate (OPPI) as a photoinitiator, in combination with camphorquinone/amine photoinitiation systems, for use with di(meth)acrylate-based composite resins. The investigation determined if the inclusion of OPPI improved degree and rate of conversion, initial color and color stability of a representative composite resin dental material.

METHODS

Camphorquinone (CQ) and OPPI were combined in various proportions with the amine co-initiator 2-dimethylaminoethyl methacrylate (DMAEMA) and used at two levels in which CQ + OPPI + DMAEMA = 1 wt.% or 3 wt.% to photoinitiate a BisGMA/BisEMA/TEGDMA (37.5:37.5:25 wt.%) monomer blend.A total of eight groups (four groups for each level of total photoinitiator, 1% and 3%) were tested according to the following proportion of components in the photoinitiator system: Group C: CQ only. Group CO: CQ + OPPI (1:2). Group CA: CQ + DMAEMA (1:2). Group COA: CQ + OPPI + DMAEMA (1:1:1). Each monomer was polymerized using a quartz-halogen curing unit (Demetron 400, Demetron Research Corp., Danbury, CT) with an intensity of 400 mW/cm2 for 5 s, 20 s, 40 s, 60 s, 300 s and their conversion levels (DC) were determined at each exposure time using a Fourier transform infrared spectrophotometer (FTIR).To examine color stability, experimental composite resins were made by mixing 3.2% silanated barium glass (78 wt.%, average filler size; 1 microm) with each monomer system, except both CQ only group and 1% CO group, which were found to cure insufficiently to be able to prepare useful specimens. Disk-shaped samples (10 mm in diameter and 1.5 mm in thickness) were made and stored under the conditions of dry or saline solution at room temperature (25 degrees C) or 60 degrees C water bath. Each CIELAB scale was determined with a colorimeter (CHROMA METER CR-400) at the time of baseline (day after curing), 1 week, 2 weeks, and 4 weeks later.

RESULTS

The high level (3%) photoinitiated groups exhibited greater DC than the low level (1%) groups. In the 3% group, the COA group showed the fastest and the highest DC, while in the 1% group the CA and COA groups showed the greatest DC.In the color stability test, both CA groups were darker and more yellow than the CO and COA groups. Color was more stable in composite resins containing OPPI than those containing only the CQ and amine components. The least color change (greatest color stability) was found using 25 degrees C saline solution aging, and the most change (least color stability) occurred using 60 degrees C dry air aging.

SIGNIFICANCE

This study suggests that OPPI can be used to replace the amine in a given CQ/amine photoinitiator system to accelerate cure rate, increase conversion, reduce initial color and increase color stability.

Orthodontic adhesives induce human gingival fibroblast toxicity and inflammation

OBJECTIVE

To test the null hypothesis that the resin base and the resin hybrid glass ionomer base adhesives do not cause inflammation after contacting primary human gingival fibroblasts in vitro.

MATERIALS AND METHODS

The resin base and resin hybrid glass ionomer base adhesives were used to treat human gingival fibroblasts to evaluate the survival rate using MTT colorimetric assay to detect the level of cyclooxygenase-2 (COX-2) mRNA by reverse transcription polymerase chain reaction (RT-PCR) technique and COX-2 protein expression using Western blot analysis. The results were analyzed using one-way analysis of variance (ANOVA). Tests of differences of the treatments were analyzed using the Tukey test and a value of P < .05 was considered statistically significant.

RESULTS

The paste and primer of the resin base adhesive and the liquid of glass ionomer adhesive showed decreasing survival rates after 24 hours of treatment (P < .05). All orthodontic adhesives induced COX-2 protein expression in human gingival fibroblasts. The exposure of quiescent human gingival fibroblasts to adhesives resulted in the induction of COX-2 mRNA expression. The investigations of the time-dependent COX-2 mRNA expression in adhesive-treated human gingival fibroblasts revealed different patterns.

CONCLUSIONS

The hypothesis is rejected. For orthodontic patients with gingival inflammation, except for those with oral hygiene problems, the activation of COX-2 expression by orthodontic adhesive may be one of the potential mechanisms.

HPLC analysis of components released from dental composites with different resin compositions using different extraction media

Components released from dental composite resins are essential factors in the assessment of biocompatibility of these materials. The effect of different extraction media on monomer release from composite resins based on different monomer types was evaluated. Three types of visible light cured composite resins were formulated based on the following monomers: triethylene glycol dimethacrylate (TEGDMA), bisphenol A glycerolate dimethacrylate (BisGMA), and urethane dimethacrylate (UDMA). Seventy-five composite resin discs were fabricated and light cured for 1 min in the absence of oxygen. Extraction media used were: distilled water, saline solution, artificial saliva, serum-free culture medium, and culture medium with 10% fetal calf serum. The analysis of extracts from the composite resins was carried out by High Performance Liquid Chromatography (HPLC). Quantifiable amounts of TEGDMA were released into the aqueous media. However, BisGMA and UDMA were not detectable in any of the extracts from the composite resins. Statistical analysis by one-way ANOVA followed by Tukey's test showed that there was a significant difference in TEGDMA release between culture media and other media (p < 0.05). From the results of this experiment it can be concluded that TEGDMA-based composite resins can release a high quantity of monomer into aqueous environments. The type of extraction medium may have a significant effect on monomer release from composite resins.

Cytotoxicity of a calcium aluminate cement in comparison with other dental cements and resin-based materials

The objective of this study was to compare the cytotoxic effects of a calcium aluminate cement with several currently used direct restorative materials. Specimens of three composites (QuiXfil, Tetric Ceram, Filtek Supreme), one zinc phosphate cement (Harvard Cement), one glass ionomer cement (Ketac Molar), and one calcium aluminate cement (DoxaDent), were used fresh or after 7-days' preincubation in cell culture medium at 37 degrees C, pH 7.2. PVC strips for ISO 10993-5 cytotoxicity test were used as positive control and glass specimens as negative control. L-929 fibroblasts (5-ml aliquots, containing 3 x 10(4) cells/ml), cultivated in DMEM with 10% FCS, 1% glutamine, and 1% penicillin/streptomycin at 37 degrees C/5% CO2 and trypsinized, were exposed to the specimens for 72 h. The cells were harvested, centrifuged, and resuspended in 500 microl DMEM and then counted in 500 microl DMEM for 30 s with a flow cytometer at 488 nm. The analysis of variance comparing the six materials showed different influences on L-929 fibroblast cytotoxicity (p <0.0001). The cytotoxicity of all specimens diminished with increasing preincubation time (p <0.0001). Fresh DoxaDent exhibited the lowest cytotoxicity, followed by QuiXfil. Ketac Molar showed the highest cytotoxicity. After 7 days of preincubation, Harvard Cement and Filtek Supreme demonstrated more cytotoxicity than the other materials (p <0.005).

Use of a light-polymerized composite removable partial denture base for a patient hypersensitive to poly(methyl methacrylate), polysulfone, and polycarbonate: a clinical report

This article describes a light-polymerized composite denture base used for a patient with hypersensitivity to poly(methyl methacrylate) (PMMA), polysulfone (PSF), and polycarbonate (PC). A urethane-dimethacrylate (UDMA) composite was used as an alternative to fabricate both the denture base and the custom artificial teeth. Immediately after placing the new prosthesis, allergic symptoms disappeared from the patient's mucous membrane. The denture has functioned satisfactorily for more than 2.5 years without recurrence of the hypersensitivity.

Cytotoxicity of composite resins polymerized with different curing methods

AIM

To compare the relative cytotoxicity of resin-based composite materials polymerized with three different curing methods on L 929 cells over a period of 1 week.

METHODOLOGY

Ten discs of each material (Flowline, P 60 and Z 250) were cured from one side with either standard cure (Optilux 401), soft-start cure (Elipar Free Light) or fast cure (Hilux Ultra Plus). Then the samples were aged for 1, 2, 3, 5 and 7 days in Dulbecco's Modified Eagle Medium/Ham's F12 (DMEM/F12). After each ageing interval, cytotoxicity of the extracts to cultured fibroblasts (L 929) was measured by MTT assay. The degree of cytotoxicity for each sample was determined according to the reference value represented by the cells with a pure culture medium. Statistical significance was determined by one-way analysis of variance (anova), followed by the Student's Newman-Keuls test.

RESULTS

Exposure of L 929 cells to the test materials resulted in a high survival fraction at 1 and 7 days. Flowline specimens, either cured with Optilux 401 or Elipar Free Light, had no toxic effect on the cells, whereas the other groups were moderately toxic on the 2-day interval. All experimental groups presented lower cell viability than the control at the 3- and 5-day intervals.

CONCLUSIONS

The composite resins used in this study were cytotoxic after 48 h pre-incubation, but this toxicity disappeared after pre-incubation in a biological medium for 7 days. Curing did not have a significant effect on the cytotoxicity of the composite materials tested.

An evaluation of the cytotoxic effects of orthodontic bonding adhesives upon a primary human oral gingival fibroblast culture and a permanent, human oral cancer-cell line

The purpose of this investigation was to determine the cytotoxic effects of three different kinds of orthodontic adhesive on a human primary gingival fibroblast culture (GF) and a human oral cancer-cell line (OC2). The adhesives comprised a self-cure bonding resin, a light-cure bonding resin, and a hybrid glass ionomer. Any differences between the cytotoxic potencies of eluates of the orthodontic materials on GF and OC2 cells were quantified colorimetrically (MTT test). The results are as follows: For the hybrid glass ionomer, the survival rate of GF cells exposed to the liquid component revealed a significant dose-dependent decrease (p < 0.05). The liquid component and the mixed hybrid glass-ionomer material reflected a significant dose-dependent decrease (p < 0.05) in exposed OC2 cell survival. Associated with an increase in the cell exposure concentration of Resin A, Resin B, Paste A, Paste B, Resin A + B, Paste A + B and the set material of the self-cure resin adhesive, was a significant decrease in survival rate for cultured GF and OC2 cells (p < 0.05). Associated with an increase in the concentration of the primer, paste, and mixed material of the light-cure resin adhesive to which test cells were exposed, the survival rate reflected a decrease for GF cells (p < 0.05). The survival rate of cells exposed to light-cure resin paste reflected no difference for OC2 cells. It is concluded that the liquid of the hybrid glass-ionomer cement, Resin A and Resin B and Resin A + B of the self-cure resin and the primer of the light-cure resin are toxic agents to the GF and OC2 cell lines. Primary human gingival fibroblasts were found to be more sensitive than the tested human oral carcinoma cell line from most of the substances.

In vitro biological response to core and flowable dental restorative materials

OBJECTIVES

In vitro cytotoxicities of commercially available core and flowable dental restorative materials were assessed and compared to traditional resin composites. Our hypothesis was that the increased resin diluents added to achieve higher flow in flowables would increase cytotoxicities, whereas the higher filler content of core materials would decrease cytotoxicities relative to traditional resin composites.

METHODS

Specimens were made under aseptic conditions, then extracted into an artificial saliva solution for 0-4 weeks, to assess the effect of aging on cytotoxicity. After extraction, specimens were tested for cytotoxicity in vitro using Balb/c fibroblasts in direct contact format. Cells were exposed to the materials for 48h, after which the mitochondrial activity of the cells was measured (MTT method). Cellular activity was normalized to Teflon negative controls.

RESULTS

Core materials were uniformly and severely (<50% of Teflon cellular activity) cytotoxic initially, but several materials (Corepaste, Definite core) improved somewhat with aging in artificial saliva. Flowable materials were uniformly and severely cytotoxic with no trend toward improvement with aging. The Definite-flow was the least cytotoxic of the flowable materials, but it too was severely cytotoxic.

SIGNIFICANCE

Commercially available core and flowable restorative materials showed severe in vitro cytotoxicities that are worse than some traditional composites and most dental casting alloys and amalgams used today. Of particular note was the persistent cytotoxicity of these materials after 4 weeks of extraction with artificial saliva. These cytotoxicities indicate a continuing release of mass from these materials at levels that have biological relevance in vitro. In vivo relevance of these cytotoxicities is less clear, but these results indicate a higher biological risk for these materials compared to traditional materials that exhibit less initial toxicity and improve with aging time.

Influence of hyperbranched multi-methacrylates for dental neat resins on proliferation of human gingival fibroblasts

We have previously shown that hyperbranched multi-methacrylate (H-MMA)-modified dental resins have VLC activities, lower polymerization shrinkage, and improved mechanical properties, compared to the 2,2-bis[4-(2-hydroxy-3-methacryloyolxypropoxy)phenyl]propane/triethyleneglycol dimethacrylate (BisGMA/TEGDMA) neat resin. The results are due to the unique molecular structure and high molecular weight of H-MMA intermediates. The purpose of this study was to evaluate the biocompatibility of H-MMA-modified dental neat resins. The cell proliferation of three human gingival fibroblast strains on either H-MMA, BisGMA/TEGDMA, or a polystyrene disk was examined. Following 10 days of cell proliferation, there was no statistical difference in cell number between H-MMA-modified and unmodified resin disks. H-MMA-modified resins had less free monomer leaching than the unmodified resin but showed similar properties in water sorption and contact angle values. All these results suggest that the biocompatibility of H-MMA-modified dental neat resins is as good as that of commercially used BisGMA/TEGDMA resin and H-MMA has potential applications in dental composites.

Enzymatic responses of human deciduous pulpal fibroblasts to dental restorative materials

The purpose of this study was to evaluate the responses of succinic dehydrogenase (SDH) and alkaline phosphatase (ALP) activities of human deciduous teeth pulpal fibroblasts (HDPF) to dental restorative materials. Tested materials included Z100 (3M), Dyract (Dentsply), FujiII (GC), and FujiIILC (GC). IRM (Dentsply) and culture medium (MD) alone were used as positive and negative controls, respectively. Specimens 6 mm (diameter) x 3 mm were prepared in accordance with manufacturers' instructions. For light-cured materials, specimens were light cured for 40 s on both sides under a celluloid strip. For chemical-cured materials, specimens were allowed to set at room temperature for 15 min. The specimens were immersed in 1 mL of culture medium without serum for 24 h at room temperature. The extracts were filtered through 0.22-mm filters. HDPF (10,000 cells/well) was incubated with 100 microL of extract and 20 % FBS in a 96-well plate for 24 h in a 37 degrees, 5 % CO(2) incubator. Six wells per material were prepared. Optical density (OD) of SDH and ALP of HDPF were measured by a spectrophotometer. The means were analyzed by ANOVA and then a Duncan Test. The ranking of OD of SDH was IRM < FujiIILC < FujiII = Z100 < Dyract < MD (p < 0.05). The ranking of OD of ALP was IRM < Z100 = Dyract < FujiII < FujiIILC < MD (p < 0.05). The result showed that all of the tested restorative materials were cytotoxic to human deciduous pulpal fibroblasts. The cytotoxicity of resin-modified glass ionomer cements (FujiIILC) was stronger than that of traditional glass ionomer cements (FujiII) and composite resin (Z100), and that of compomer (Dyract) was the weakest. On the contrary, ALP activities of resin-modified glass ionomer cements (FujiIILC) and composite resin (Z100) were higher than those of traditional glass ionomer cements (FujiII), while those of compomer (Dyract) were the lowest. It is concluded that, in this study, FujiIILC was the most cytotoxic material and the least inhibitive of ALP activities, Dyract was the weakest cytotoxic material and had the highest inhibition of ALP activities. The rankings of the MTT assay and the ALP assay were not consistent.

Responses of L929 mouse fibroblasts, primary and immortalized bovine dental papilla-derived cell lines to dental resin components

OBJECTIVE

The use of adequate target cells for cytotoxicity testing of dental restorative materials has often been experimentally assessed with respect to the clinical relevance of the test results. In the present study, the responses in primary bovine dental papilla-derived cells (pulp cells) were compared with those in transformed dental papilla-derived cell lines and L929 mouse fibroblasts after exposure to various dental resin compounds.

METHODS

Primary bovine dental papilla-derived cells (CPC), tCPC B (CPC cells transformed with SV40 T-antigen), tCPC E (CPC cells transformed with E6/E7 oncogen), and L929 mouse fibroblast cells were exposed to various compounds of dental resin materials for 24 h, and cytotoxicity was determined using the MTT assay. Bis-GMA, UDMA, 1,6 hexane diol dimethacrylate (HDDM), TEGDMA, HEMA, MMA, camphorquinone (CQ), bisphenol A (BPA), and glycidyl methacrylate (GMA) were tested. Concentrations leading to 50% cell survival (TC50 values) were calculated from fitted dose-response curves.

RESULTS

The simple ranking of the cytotoxic effects of the dental resin compounds in the four cell types was identical, and TC50 values determined in L929 cells here were consistent with findings by other authors using continuous cell lines. However, the concentrations of the resin compounds necessary for eliciting cytotoxic responses in the various cells were clearly different. The analyses of TC50 values of the resin compounds revealed a linear correlation between cell lines, and the overall sensitivities increased as follows: CPC=tCPC B<tCPC E<L929.

SIGNIFICANCE

The low sensitivities of primary cells and transformed tCPC B cells compared with the continuous L929 cell line and the transformed tCPC E cells indicates the presence of specific structural and functional properties relevant in vivo. The differences between the transformed tCPC B and tCPC E cells may indicate modifications of cellular functions caused by the different transformation processes.

The effects of dentin permeability on restorative dentistry

The permeability properties of dentin determine its sensitivity and the degree of pulpal response to restorative procedure materials and microleakage. Most pulpal reactions are due to bacteria or bacterial products that permeate across dentin. These reactions can be prevented if dentin is sealed with resins as soon as it is exposed. In the future, restorative dentists may employ topical application of biologic growth factors to permeate across dentin to modify the formation of reactionary or reparative dentin, thereby lowering dentin permeability and protecting the pulp.

Cytotoxicity of fluoride on human pulp cell cultures in vitro

OBJECTIVES

Numerous studies have revealed that conventional glass-ionomer cements might release fluoride into an aqueous environment. The objective of this study was to examine the effects of fluoride on human pulp cells in vitro.

STUDY DESIGN

H33258 fluorescence, cell proliferation, protein synthesis, and mitochondrial activity assay were used to investigate the pathobiological effects of fluoride on cultured human pulp cells.

RESULTS

Fluoride was found to be a cytotoxic agent to cultured human pulp cells by inhibiting cell growth, proliferation, mitochondrial activity, and protein synthesis.

CONCLUSIONS

Fluoride release has significant potential for pulpal toxicity.

Cytotoxicity evaluation of perforation repair materials on human periodontal ligament cells in vitro

Perforation of a tooth structure resulting in communication of the pulp space with periodontium occasionally occurs during endodontic therapy. For the best prognosis, the perforation area must be sealed as soon as possible. Because these materials will be in direct contact with periodontal tissues, their cytotoxic potential must be evaluated before clinical use. The purpose of this study was to determine the cytocompatibility of three perforation repair materials (amalgam, resin, and glass ionomer). Cultured human periodontal ligament (PDL) cells were used to evaluate the cellular response resulting from these materials by cell viability and proliferation assays. Twenty-seven 5 x 4 mm cylinders of each material were fabricated for this study. All tested materials were cytotoxic to human PDL cells. Both types of material and time affected cell viability and proliferation. Resin exhibited the most cytotoxic effects followed by glass ionomer and amalgam during a 14-day incubation period. Amalgam and glass ionomer slightly inhibited cell viability and growth in the first 24 hr, compared with the control. Amalgam or glass ionomer may initially react more favorably to PDL cells than resin. The present model of cultured human PDL cells is simple, relatively cheap, and easily established and propagated under standardized conditions in any laboratory. Furthermore, this method allows long-term observation of human cellular reactions and thus might be a preliminary screening test for initial biocompatibility of dental materials.

In vitro cytotoxicity of solid epoxy-based dental resins and their components

OBJECTIVE

The objective of this study was to evaluate the effect of adding a spiroorthocarbonate (SOC) or a polyol on the cytotoxicity of epoxy-based dental resins.

METHODS

Resins contained one of the epoxies: diglycidyl ether Bisphenol A (GY-6004); 3,4-epoxycyclohexanemethyl-3,4-epoxycyclohexane carboxylate (UVR-6105); vinyl cyclohexane dioxide (ERL-4206) or the three-epoxy mixture (Epoxy-M). The SOC was t/t-2,3,8,9-di(tetramethylene)-1,5,7,11-tetraoxaspiro[5.5]undecane (SOC). The polyols were polytetrahydrofuran (p-THF-250) and polycaprolactone triol (TONE-301). The photoinitiator (4-octylphenyl)phenyliodonium hexafluoroantimonate and camphorquinone were used for light curing the resins. Four types of resins (epoxy, SOC/epoxy, polyol/epoxy and SOC/polyol/epoxy) were evaluated for cytotoxicity as solids in the agar diffusion assay and as aqueous extracts in the MTT assay using L929 cells.

RESULTS

In agar diffusion analysis, ERL-4206 and UVR-6105 resins were severely cytotoxic (+3), but the addition of SOC changed them to non-cytotoxic (-). Addition of 1-3% SOC changed Epoxy-M from mild (+) to non-cytotoxic. Adding SOC changed GY-6004 from moderate (+2) to mild (-) cytotoxicity. Generally, addition of SOC did not change cytotoxicity when added to polyol/epoxy combinations. Either polyol produced resins with reduced cytotoxicity when added to UVR-6105, but the opposite occurred when added to Epoxy-M resins. In MTT analysis, percent cell survival from 100 microliters resin extracts were statistically compared (ANOVA, p < 0.05). Epoxy-M and GY-6004 resin extracts were significantly less cytotoxic than UVR-6105 and ERL-4206 resin extracts were. Overall, the SOC component reduced the cytotoxicity of all SOC/epoxy combinations, except SOC/ERL-4206, which was significantly more cytotoxic than ERL-4206 resin extract. This may be the result of cell fixative effects observed for SOC/ERL-4206 in agar diffusion analysis. Addition of SOC produced significantly less cytotoxic SOC/polyol/Epoxy-M resins when compared to its non-SOC counterpart. The contrary result was obtained with SOC/polyol/UVR-6105 resin combinations. Consistent with agar diffusion results, adding polyol significantly decreased cytotoxicity of UVR-6105 resins. The cytotoxicity of these resins may be related to the 50% cytotoxicity (TC50) of their components as leachates. The TC50 values of the individual components were compared to BISGMA. Polyols, epoxy monomers, SOC monomer and camphorquinone were significantly (p < 0.05) less cytotoxic than BISGMA.

SIGNIFICANCE

Addition of SOCs and polyols in the formulation of epoxy-based resins may contribute to development of biocompatible dental composites.

Cytotoxic effects of dental composites, adhesive substances, compomers and cements

OBJECTIVES

Although research interest in biocompatibility of dental materials has been increasing, findings are frequently controversial and non-harmonized experimental approaches often lead to the production of contradictory results. The aim of this study was to compare the cytotoxic effects of six different light-cured dental composites, one compomer, one advanced glass-ionomer, two glass-ionomer cements, two zinc phosphate cements, one calcium hydroxide liner, one composite cement and one carboxylate cement with the same standardized cell-culture system. Two composites, one compomer and one advanced glass-ionomer were also tested in combination with the appropriate bonding substances and surface primers.

METHODS

Specimens were added to the cultures immediately after production or after preincubation for 1, 2 or 7 days or 6 weeks under cell-culture conditions. Specimens were incubated with L-929 fibroblasts for 72 h and cell numbers determined by flow cytometry.

RESULTS

All freshly prepared composite materials were cytotoxic. These effects diminished with increased preincubation times and were not significant after 7 days. Combinations of composites and bonding substances were still cytotoxic after preincubation for 7 days, but not after 6 weeks. Combinations of compomers and bonding substances demonstrated stronger toxicity than composites, although these effects were reduced earlier during preincubation. Glass-ionomer and phosphate cements showed similar effects to the composites with the exception of carboxylate cement, which demonstrated severe and persistent effects even after 6 weeks' preincubation. Together, our data provide evidence that all dental materials tested are cytotoxic immediately after production and that these effects are reduced after different preincubation periods in most cases.

SIGNIFICANCE

Tested with a standardized cell-culture system, differences in toxicological potency between various commonly used dental materials were observed. Cytotoxicity data from standardized protocols should form the basis of screening the cytotoxic effects of new materials.

Cytotoxicity of urethane dimethacrylate composites before and after aging and leaching

The in vitro cytotoxicity of urethane dimethacrylate composites cured at different times by visible light and after different aging times and extraction treatments was evaluated using succinic dehydrogenase activity in the mitochondria of a fibroblastic cell line to reflect cell viability. In addition, extractable chemicals associated with cell response were identified. The composite samples were tested untreated, polished, or extracted with water or 75% ethanol-water. Balb/c 3T3 fibroblasts were used as the cell culture system while MTT-formazan production was used as the toxicity parameter. Cell viability was calculated as a percentage of Teflon controls. Identification of the chemicals was measured by extracting the composites with 75% ethanol-water, separating the extract by HPLC, and identifying the fractions with mass spectroscopy. In general, cell viability increased continuously with curing time for differently treated samples at high aging times (288 h) while it decreased when the composites were not aged (0 h). In addition, for 75% ethanol or water-extracted composites, cell viability increased within the first 24 h of aging and reached a plateau after 72 h. Lowest cytotoxicity occurred when the samples were extracted with the 75% ethanol solution. The highest cytotoxic effects were found when the samples were untreated. Slightly reduced cytotoxic effects were seen with polished composites. The results suggest that curing the light-activated composites for a minimum of 150 s and post-curing for 24 h is required to attain comparable biocompatibility with the Teflon control. Removing the oxygen-inhibited layer from these composites decreased the cytotoxicity by 33% while extracting the composites with 75% ethanol-water decreased it by 77%. Chemicals released from the surface accounted for approximately 40% of cellular response while about 60% of the response was due to chemical components released from the bulk. The primary leachable component from the composites was UDMA monomer. Small quantities of 1,6 hexane diol methacrylate, camphoroquinone, and 2,4,6-tritertiarybutyl phenol also were found.

Inhibition by glass-ionomer cements of protein synthesis by human gingival fibroblasts in continuous culture

The effects of several glass-ionomer cements (Baseline and Chem Fil of De Trey; Ketac Fil and Ketac Bond of ESPE; Vitrebond and Vitremer of 3 M) on the protein synthesis of cultured gingival fibroblasts were studied. The presence of cements in the culture medium inhibited protein synthesis, although the relative effectiveness varied significantly. The cements tested have been ranked in three groups, group A (Chem Fil and Ketac Fil), group B (Ketac Bond and Baseline) and group C (Vitrebond and Vitremer), showing 50, 75 and 100% reduction in protein synthesis, respectively. Incubation of cells with medium previously conditioned by Baseline and Ketac Fil caused only transient inhibition of protein synthesis followed by almost complete recovery. This recovery was not observed when the medium was conditioned with Vitrebond. A characterization of the factors determining the inhibitory effect of one cement in each group was attempted. The cements, irrespective of the type, produced small but reproducible decreases in the pH of the medium but released fluoride ions to a different extent. Both changes in the pH of the medium and in the fluoride concentration inhibited protein synthesis by cultured gingival fibroblasts. The different action of cements can be explained, at least in part, by a differing release of fluoride ions.

Cytotoxicity of Ketac Silver cement

The aim of this experiment was to investigate the effect of a glass ionomer cement with silver particles (Ketac Silver) on pulp tissue. Class V cavities were prepared in 60 healthy teeth scheduled for extraction for orthodontic reasons. A base of Dycal was placed in each cavity. Thirty teeth were filled with Ketac Silver and 30 with ZOE. Ten teeth of each group were extracted 15, 30, and 60 days later. At 15 days, the pulps in the Ketac group showed vacuolization and disruption of the odontoblastic layer, edema, vasodilation, chronic inflammatory infiltrate (CII), and necrosis. At 30 days, a necrotic odontoblastic layer, severe CII, and extensive areas of necrosis were seen. At 60 days, pulp tissue was almost completely necrotic. The ZOE control group showed a slight CII at 15 days. Our results suggest that under these experimental conditions, this cement is highly toxic and induces irreversible pulpal damage.

Toxicity parameters for cytotoxicity testing of dental materials in two different mammalian cell lines

The present study compares three specific toxicity parameters for cytotoxicity testing of chemically different dental materials. Two glass ionomer cements, a zinc phosphate cement, and a composite material were used to evaluate the sensitivity of three assays: two viability assays, the MTT assay and the quantifiable neutral red assay, and a proliferation assay based on the determination of the total protein content of a cell culture. The colorimetric assays were carried out using transformed mouse fibroblasts (L-929 cells) and fibroblasts derived from biopsies of normal human gingiva. In most cases, all colorimetric assays detected much weaker cytotoxic responses, if any, in gingival fibroblasts than in L-929 cells. The viability assays indicated cytotoxicity of the extracts to two glass ionomer cements in L-929 cells when the materials were set at 0% relatively humidity for 24 h. The severe cytotoxicity of the zinc-phosphate cement in both viability assays was less influenced by the setting conditions. The cytotoxicity of the composite material was most pronounced in the neutral red assay. In general, both the MTT assay and the neutral red assay were more sensitive than the colorimetric proliferation assay. These assays can be performed very effectively; only few cells are needed for rapid, reliable and inexpensive screening purposes of a large number of samples in a short time. Automated processing with a microplate reader after non-radioactive labeling of the cells and subsequent automated analyses of original data, with no need for sophisticated and expensive equipment, are additional advantages of the systems.

Bioavailability of components of resin-based materials which are applied to teeth

Chemical components of many materials used in dental practice can move into the local biophase, where they can have beneficial or adverse effects. The strongest indirect evidence that components of resin-based materials used in dentistry can move into the biophase are the many reports of allergic dermatitis in dental personnel. Direct measurement of component release has shown that triethylene glycol dimethacrylate (TEGDMA), hydroxyethyl methacrylate (HEMA), and, in the case of some orthodontic cements, bis-glycidyl methacrylate and benzoyl peroxide can move into an aqueous medium from a range of resin-based materials which are applied to teeth as part of oral care. In the case of resin composite restorations, HEMA and TEGDMA are available in microgram quantities via the salivary surface in the minutes and hours after clinical placement and via dentin and pulp in the hours and days after placement. Fortunately, moderate thickness of dentin protects pulp tissue against local toxicity. There are no data which suggest that systemic toxicity is a risk with any of these materials. There are some case reports of allergic responses to the monomers in patients, but the incidence of such responses appears at present to be much lower than that in dental personnel.

Cytotoxicity evaluation of six root canal sealers

Cell cultures of human gingival fibroblasts obtained from healthy patients were used to evaluate the toxicity of six different endodontic cements: AH-26, Pulp Canal Sealer, Rocanal-R2, Rocanal-R3, Bioseal, and Endomethasone. The toxicity was determined by measuring spectrophotometrically at 405 nm the colorimetric reaction of N-acetyl-beta-hexosaminidase, an endogenous enzyme, with the chromogenic substrate [p-nitrophenol-N-acetyl-beta-D-glucosamide (NAG)]. Severe cytotoxicity was observed in the 1- and 2-wk test solutions of AH-26. Pulp Canal Sealer and Endomethasone showed low cytotoxicity in the 1- and 2-wk test solutions at 24, 48, and 72 h. Moderate cytotoxicity was observed in the 1- and 2-wk test solutions of Bioseal, except at 48 and 72 h of 1-wk test solutions. Rocanal-R2 showed severe cytotoxicity in the 1-wk test solutions at 48 and 72 h, and in the 2-wk test solutions at 24, 48, and 72 h. Moderate cytotoxicity was seen in the 1- and 2-wk test solutions of Rocanal-R3 only at 24 h.

Cytotoxicity of eluates from light-polymerized denture base resins

This study examined the metabolic effects of eluates from four light-polymerized denture base resins and one heat-polymerized denture base resin on oral epithelial cells in vitro. The eluate was cell culture medium that contained either or both of apparently nonpolymerized components and reaction products that diffused out of the resin samples. Eluates were prepared by daily transfer of sample disks in a cell culture medium over 10 days. Toxicity of eluates was tested immediately after transfer (fresh) and after storage for 30 days (aged) by use of radioisotope incorporation and cell viability studies. The fresh eluates inhibited cell metabolism, whereas the aged eluates stimulated then inhibited the responses. Results suggest that the components that leach out of the tested materials do so at different rates and have prolonged toxic effects on cells. Thus soaking prosthesis in water before insertion may be beneficial.

Cytotoxicity of components of resins and other dental restorative materials

Cytotoxicity testing of dental restorative materials must be viewed as an assessment of hazards, that is the potential of the material to cause pulpal problems. In this context, composites, glass ionomers, amalgams, zinc-based cements and peroxide bleaching agents are all possible hazards to the pulp. The risks that these materials will cause pulpal toxicity in vivo can be partly estimated by assessing the cytotoxicity of the substances which are released from these materials in vitro and comparing these cytotoxic concentrations with those concentrations that are present in vivo. The resin components of composites, metal ions and hydrogen peroxide, all of which are released from dental restorative materials, have been shown to be cytotoxic in vitro in sufficient concentrations. The potencies of these substances are quite diverse. However, the cytotoxicity of these substances in usage tests, and therefore the risks of pulpal toxicity, depends on their ability to diffuse through the dentine and accumulate in the pulp.

Cytotoxicity of potential retrograde root-filling materials

The cytotoxicity of potential retrograde root-filling materials was assessed using the Millipore filter method. A light-cured glass ionomer cement, Vitrebond (VB), and three reinforced zinc oxide-eugenol cements, Kalzinol, IRM and ethoxybenzoic acid (EBA) cement, were compared with amalgam. Twenty standardized pellets of each material, 10 fresh and 10 aged by storage in sterile distilled water for 72 h were produced. Ten filters were included as controls: five filters with a cell monolayer, but without test specimens, and another five without cells but with test specimens. Fresh IRM exhibited the most pronounced cytotoxic effect and the difference was statistically significant compared with all the other materials. There was no statistically significant difference between fresh VB, Kalzinol, EBA cement and amalgam. When aged, Kalzinol was the most cytotoxic and the difference was statistically significant compared with the other materials. Aged IRM was the second most cytotoxic material and this too was statistically different. The cytotoxicity of VB, EBA, and amalgam did not differ significantly from one another.

Effect of cell line on in vitro metal ion cytotoxicity

OBJECTIVES

The choice of cell line for in vitro biological tests which assess the cytotoxicity of dental materials remains controversial, yet this issue is important because these tests are widely used to rate the biocompatibility of new and existing materials, and many different cell lines are commonly used. The purpose of the current study was to quantify the responses of four cell lines (Balb/c 3T3, L929, ROS 17/2.8 and WI-38) to 14 metal ions which are released from dental materials, and relate these responses to the metabolic activity and population doubling times of these cells.

METHODS

Succinic dehydrogenase (SDH) activity was used to monitor metabolic activity and cytotoxic response.

RESULTS

The cell lines responded differently to most metal ions. In general, the Balb/c 3T3 line was the most sensitive, and the WI-38 line was the least sensitive. However, there were many exceptions depending on the metal ion. The passage number of the cells also affected the cytotoxic response. It was concluded that the cytotoxicity of materials which release metal ions will be significantly different depending on which cell line is selected and its passage number.

SIGNIFICANCE

Based on the findings that cell lines ranked the toxicities of the metal ions similarly, it seems reasonable to use these types of in vitro tests to rank the cytotoxicities of materials. However, if these types of tests are used to predict in vivo cytotoxicity, care should be taken to choose conditions and cells which are relevant.