Effects of long-term sub-lethal concentrations of dental monomers on THP-1 human monocytes

Biocompatibility of Root Canal Filling Materials: Differences between Vitality and Functionality Tests

Biocompatibility of root canal filling materials is of great interest because they can come into permanent contact with the living periapical tissue, and induce mild or severe inflammatory responses. Usually biocompatibility tests only determine non-cytotoxic effects of dental materials, even if their functional interactions with cells also play a role in the host responses. The purpose of this study is to evaluate peripheral blood monocyte (PBM) vitality and functionality after contact with 5 different root canal filling materials: Thermafil (gutta-percha), Real Seal and Real Seal 1 (methacrylic resins), AureoSeal (MTA) and SuperSeal (EBA). Cellular vitality was determined by MTT test and cellular functionality by Chemiluminescence (CL) technique. Dishes of the materials were covered with cell culture medium (0.5 cm2/mL) and incubated for 24 h. The extracts were added to PBMs and the latter, after 2 h of incubation, were analysed by MTT and by Chemiluminescence (CL). All results are expressed as mean ± SEM. The group means were compared by analysis of variance. Results showed that SuperSeal and AuroSeal exhibited a moderate cytotoxic effect, while the toxicity induced by RealSeal, RealSeal 1 and Thermafil was lower. SuperSeal and AuroSeal induced a significant decrease of both oxidative burst and basal reactive oxygen species (ROS) production. RealSeal 1 caused a doubling of basal ROS production in respect to control. The results demonstrate that a low cytotoxic effect does not guarantee a total integrity of cellular functionality and more differences among biocompatibility of root canal materials can be detected when a functionality test is used.

Osteoblast response to dimethacrylate composites varying in composition, conversion and roughness using a combinatorial approach

Dimethacrylate polymers and composites are seeing increased usage in orthopedics. As these applications require the material to integrate with the surrounding tissues, direct contact cytotoxicity assays should be used to assess the biocompatibility. This study utilized a combinatorial testing platform to evaluate the cell response to dimethacrylate composites with a variety of properties on a single sample. MC3T3-E1 pre-osteoblasts were cultured directly on composites with varying filler content, filler type, degree of conversion (DC), and surface topography. Cell viability, density, and area depended on an interplay of the material properties, with low DC causing a reduction in cell area but having minimal effect on cell viability, high filler content causing an increase in cell density, and filler content/type altering the surface roughness as a function of DC. The combinatorial testing platform successfully quantified the effects of numerous material properties on several aspects of the osteoblast response.

A natural component as coinitiator for unfilled dental resin composites

A natural component, 1,3-benzodioxole (BDO), was used for the purpose of replacing the conventional amine for dental composite. Camphorquinone (CQ)/BDO was used to initiate the photopolymerization of urethane dimethacrylate (UDMA)/triethylene glycol dimethacrylate (TEGDMA) (70/30 wt %). The kinetics was recorded by real-time Fourier transformation infrared spectroscopy (FTIR). The mechanical properties were measured by dynamic mechanical analyzer (DMA), and CQ/ethyl 4-N,N-dimethylaminobenzoate (EDMAB) mixture was used as control in the same photocuring condition. The results indicated that, the addition of BDO as coinitiator greatly improved the rate of polymerization and final double bond conversion (DC), when compared with the system initiated by CQ alone. BDO and EDMAB were found to reach almost the same final DC (75%), though the kinetics of two systems was different. Comparing with EDMAB, BDO brought approximately the same glass transition temperature (Tg), but slightly higher storage modulus around 37 degrees C. The water sorption and solubility for two mixtures were almost the same and within the range of the ISO 4049's standards. These results suggested that BDO was an effective alternative to conventional amine for coinitiator. And the human diet characteristics of BDO made it more promising than amine in the dental resin formulations.

Histo-blood group antigen expression and proliferative activity of fibroblasts treated with dental monomers

The present work is focused on examining the effect of the structurally similar dental monomers bis-GA and bis-GMA on the expression of histo-blood group antigens (HBGAs) in comparison with fibroblast vitality and proliferation. The fibroblast cell line McCoy-Plovdiv was cultivated in a serum-free medium and was treated with both monomers. Cell vitality was measured by the crystal violet test. Mitotic index and cell morphology were assessed. An immunocytochemical technique was applied to follow the expression of proliferative antigens PCNA and Ki-67 and of HBGA. The expression level of HBGA was measured by an improved pixel selection algorithm with proprietary software. The lowest concentration of 2.5 micromol/L did not significantly affect morphology, vitality, or proliferation activity. Interestingly, the quantitative analysis revealed augmented expression of HBGA B at 2.5 micromol/L. The higher concentrations of the dental monomers reduced cell vitality and mitotic indices and altered proliferative antigen expression. Bis-GA proved to be more toxic than bis-GMA and caused more prominent alterations including greater enhancement of HBGA B expression. We present novel evidence for altered expression of proliferative antigens and enhanced expression of HBGA B in fibroblasts treated with dental monomers bis-GA and bis-GMA suggesting that these substances affect cell morphology, proliferative activity, and antigenic profile.

Radicals produced by blue-light–resin interactions alter the redox status of THP1 human monocytes

Resin composites are widely used in dentistry, and are polymerized in situ using a blue-light activated, free-radical polymerization mechanism. Blue light (400-500nm) is used to activate camphoroquinone (CQ), which decomposes to form free radicals that are stabilized by dimethyl-p-toludine (DMPT). CQ and DMPT are applied near tooth pulpal tissues and are irradiated during restorative procedures, suggesting that pulpal cells are exposed to free radicals. Because glutathione is a major component of the cellular redox management system, we tested the hypothesis that blue light irradiation would shift cellular glutathione redox balance of cells exposed to CQ and DMPT. We also measured NFkappaB activation, a redox-sensitive transcription factor that regulates inflammatory responses and glutathione synthetic enzyme levels. THP1 human monocytes were exposed to sublethal levels of CQ (0.4 mM) or DMPT (1.0 mM), with or without blue light exposure (25 J/cm(2)) from a quartz-tungsten-halogen source. The ratio of reduced to oxidized glutathione was measured using as assay based on 5,5'-dithio-bis(2-nitrobenszoic acid). NFkappaB transactivation was measured by transfection of an NFkappaB-containing plasmid linked to a luciferase reporter. Our results showed that blue light, CQ, or DMPT alone had no significant effect on cellular glutathione redox balance, but that the combination of these agents induced a marked oxidative bias, and reduced total glutathione levels up to 50%. On the other hand, light, CQ, and DMPT alone or in combination suppressed NFkappaB transactivation by >70%. Our results suggest that CQ and DMPT pose risks to pulpal tissues with or without blue light irradiation, and that multiple, interacting mechanisms shape the response to these agents.

Alteration of monocytic cell oxidative burst caused by methacrylic monomers present in dental materials: a chemiluminescence study

Methacrylates are present in dental composite resins used in clinical practice. Methacrylates are photo-polymerized, but this reaction is never complete, so release of uncured monomers in the periapical tissues and in biological fluids may happen and, potentially, alter the repair of pulpal and of periapical lesions by interfering with local phagocytes. The aim of this study was the evaluation of the functional activity of the monocyte-macrophage system after incubation with methacrylic monomers. The oxidative burst of two cellular systems was analysed using the chemiluminescence technique. Data were collected and statistically analysed. Monomers were found to reduce the in vitro oxidative burst of phagocytes independently from their cytotoxicity. These findings demand further evaluation of the effects of oxidative burst alteration in monocyte-macrophage function and may prompt the inclusion of the described chemiluminescence test in biocompatibility preliminary studies of dental materials.

Dental adhesive compounds alter glutathione levels but not glutathione redox balance in human THP-1 monocytic cells

The use of hydrophilic dental monomers in dentin bonding agents has vastly improved resin-dentin bond strengths, but incomplete polymerization of these monomers and their leaching into adjacent (pulpal) oral tissues has raised concerns about their biocompatibility. The sublethal effects of these resins are virtually unknown, but their electrophilic nature led to the hypothesis that they may alter cellular oxidative stress pathways. Glutathione balance between reduced (GSH) and oxidized (GSSG) is a major mechanism by which cells maintain redox balance and was therefore the focus of the current investigation. THP-1 human monocytic cells were exposed to hydroxyethyl methacrylate (HEMA), benzoyl peroxide (BPO), camphorquinone (CQ), or triethyelene glycol dimethacrylate (TEGDMA) for 24 h at sublethal doses, then GSH and GSSG levels were measured by means of Ellman's method adapted for cell culture. The results indicate that these dental resin compounds act at least partly via oxidative stress by increasing GSH levels at sublethal concentrations. However, the GSH-GSSG ratio was relatively unaffected. Only BPO altered the GSH-GSSG ratio at 24 h, again at sublethal levels (7.5-15 micromol/L). The results support the hypothesis that resin monomers act, at least in part, via oxidative stress, and that oxidative-stress pathways should be one focus of future investigations of monomer biocompatibility.

Effects of cured dentin bonding materials on human monocyte viability

OBJECTIVES

Dentin Bonding Agents (DBAs) have been proposed as root-end filling materials. This study examined the effect of polymerized DBAs on human monocyte viability.

STUDY DESIGN

Monocytes were directly isolated from peripheral blood and being exposed to cured Scotch bond I (Single Bond) and Prime & Bond in different time intervals (36 and 72 hours). The viability of monocytes was determined by MTT assay.

RESULTS

Viability of the cells was time dependent. There was no significant difference between the effect of 2 DBAs on monocytes.

CONCLUSION

Results indicate that DBAs in polymerized form can alter the viability of monocytes and decrease it within time.

Future directions in bonding resins to the dentine-pulp complex

Resin-based materials are rapidly becoming the primary restorative material to replace tooth structure and the low percentage of biological problems reported for resin-based restorations is testimony to their relative biocompatibility. Despite considerable advances in the understanding of the mechanisms, which govern the integration of resin composite materials with the dentine-pulp complex, considerable potential for improvement remains. Most of these improvements centre around a better understanding of the biological and microbiological risks of resin materials and will only be possible with improved in vitro and in vivo models. There are also a number of possible future developments in materials, clinical techniques and diagnostic methods that may improve the long-term success and reliability of resin-based restorations. The remainder of this paper describes the most likely avenues for future improvements.

Antioxidative vitamins decrease cytotoxicity of HEMA and TEGDMA in cultured cell lines

OBJECTIVES AND METHODS

In a previous study it was postulated that toxicity of 2-hydroxyethylmethacrylate (HEMA) and triethleneglycoldimethacrylate (TEGDMA) is based on oxidative metabolites. In this study the influence of antioxidative vitamins (including uric acid) on the toxicity of HEMA or TEGDMA was tested. Toxicity of HEMA and TEGDMA was determined in rat alveolar epithelial L2, human malignant A549, and human fibroblast-like 11Lu cells by inhibition of methionine incorporation (as a marker of protein synthesis inhibition) and by determination of glutathione depletion, as well as by measurement of GSSG increase.

RESULTS

Toxicity of the composite components HEMA and TEGDMA was demonstrated by GSH depletion as the most sensitive method. Five hundred micromoles per litre Vitamin C or 250 micromol/l Vitamin E were mostly able to decrease toxicity of HEMA and TEGDMA in the cell lines tested. In addition, 250 micromol/l Vitamin A was only effective in L2 cells impairing HEMA toxicity and 250 micromol/l uric acid impairing TEGDMA toxicity as assessed by decreased GSH depletion. In A549 cells only methionine incorporation inhibition but not GSH depletion was significantly affected. By contrast, in 11Lu cells methionine incorporation inhibition was not significantly changed, but GSH depletion was.

CONCLUSIONS

The postulated mechanism of HEMA or TEGDMA toxicity based on radical metabolites is supported by the effectivity of the antioxidative substances tested in mitigating toxicity and by the greater susceptibility of the glutathione redox system as compared to protein synthesis inhibition in assessing toxicity.

BIOLOGICAL RISKS OF RESIN-BASED MATERIALS TO THE DENTIN-PULP COMPLEX

Over the past 30 years, restorative dentistry has seen a revolution in materials, restorative techniques, and patient priorities. This revolution has been made possible with the development of new resin-based materials which can be bonded to the tooth structure. Not all of these changes have been without controversy or concern, and some have raised questions about the biological safety of these new materials and techniques. It is the purpose of this review to present recent and relevant information about the biological risks and consequences of resin-tooth bonding and how these risks are affected by the material, its clinical properties, and its manipulation by the practitioner. These biological risks are complex and interactive, and are still incompletely defined. In broad terms, these risks can be divided into those stemming from the toxicological properties of the materials themselves (direct biological risks) and those stemming from microbiological leakage (indirect biological risks).

Cytotoxicity of ingredients of various dental materials and related compounds in L2- and A549 cells

Various ingredients of dental materials and related compounds were tested for cytotoxicity in two alveolar epithelial cell lines (L2 and A549 cells). Release of lactate dehydrogenase (LDH) from cells was measured after incubation with the test substances for time intervals up to 48 h and expressed as percentage of total LDH content of lysed cells. Furthermore, the glutathione content of cells was determined in the nonmalignant L2 cells. Additionally, cell viability was assessed by microscopic examination. The highest cytotoxicity was observed with mercury compounds (methylmercuric chloride and mercury dichloride) in the range of 5-20 micromol/l. The composite components 2-hydroxyethylmethacrylate (HEMA) and triethleneglycoldimethacrylate (TEGDMA) showed time- and concentration-dependent effects of cytotoxicity at high concentrations (about 1-5 mmol/l). A time dependence for GSH decrease was mainly found for the composite components up to 12 h of cellular exposure. L2 cells were more sensitive to both mercury and composite compounds than A549 cells. Gold compounds (sodiumaurothiomalate and gold particles < 1.5 microm) did not produce any sign of toxic reactions. A time-dependent increased toxicity in pulmonary cell lines was found for the composite components HEMA and TEGDMA, but not for mercury and gold compounds.