Residual monomer/additive release and variability in cytotoxicity of light-curing glass-ionomer cements and compomers

Comparative evaluation of the biological response of conventional and resin modified glass ionomer cement on human cells: a systematic review

This review aimed to evaluate and compare the biological response (biocompatibility and cytotoxicity) of resin modified glass ionomer cement (RMGIC) in contrast to conventional glass ionomer cement (GIC) on human cells. Articles reporting parallel and split-mouth clinical trials, randomized controlled trials, non-randomized controlled trials, prospective studies, and in vitro studies on human permanent teeth that assessed the biological response of GIC and RMGIC were included. The following electronic bibliographic databases were searched using the keywords: MEDLINE/PubMed, EBSCO, Cochrane Central Register of Controlled Trials, and Google Scholar. For the risk of bias MINORS tool and the modified scale of Animal Research: Reporting of In Vivo Experiments and Consolidated Standards of Reporting Trials were used. Initial screening identified 552 studies, of which 9 articles met the inclusion criteria and were included in the study. Different parameters such as odontoblastic changes, inflammatory response, tertiary dentin formation, presence of microorganisms, morphological changes, cell viability, number, and metabolism were used to evaluate the biological response of conventional GIC and RMGICs. Conventional GIC shows lower cytotoxicity compared to RMGIC in vital pulp therapy procedures. Further, in vivo studies and long-term clinical trials are needed to compare these observations for pulp therapy using the 2 test materials.

Trial Registration

PROSPERO Identifier: CRD42023426021.

Biological properties versus solubility of endodontic sealers and cements

Endodontic sealers and cements used in root canal treatment have different compositions and properties. Common to all materials is that their primary goal is to fill gaps and voids, making a permanent seal of the root canal system. Furthermore, aspects such as antibacterial properties, cytotoxicity, setting time, solubility and biocompatibility are also crucial and ought to be considered. Over the years, a shift in the view on the importance of these aspects has ocurred. Whereas the antibacterial properties were considered important when the technical factors in endodontics were less developed, the sealing ability and biocompatibility have later been considered the most critical factors. The introduction of tricalcium silicate cements and sealers has led to a renewed interest in material properties, as these cements seem to have good sealing ability and at the same time combine favourable antimicrobial effects with excellent biocompatibility. This review discusses how the various properties of root canal sealers and cements may conflict with the primary aim of providing a permanent seal of the root canal system.

Long-term effect of exposure to triethylene glycol dimethacrylate (TEGDMA) on male mouse reproduction

Our study investigated the impact on male mouse fertility and reproduction of long-term (14 weeks) exposure to triethylene glycol dimethacrylate (TEGDMA), a co-monomer of resin-based compounds, at doses of 0.01, 0.1, 1, and 10 ppm. Test and control mice were then paired with sexually mature untreated female mice and their fertility evaluated. Females paired with males exposed to all TEGDMA doses exhibited a significant decline in pregnancy rates, and significant increases in the total embryonic resorption-to-implantation ratio, except for males exposed to 0.01 ppm TEGDMA. Males in the highest dose group (10 ppm) showed significant increases in seminal vesicle and preputial gland weights. They also had significantly higher serum levels of luteinizing hormone (LH) and follicle stimulating hormone (FSH) than the controls, and the 0.01 ppm dosage group for FSH levels. TEGDMA exposure resulted in notable histopathological alterations in the testis, with detachment of germ cells and shedding of germinal epithelium into the tubule lumen. These results strongly indicate that TEGDMA exposure has detrimental consequences on the reproductive abilities and functions in male mice through disruption of the standard hormonal regulation of the reproductive system, leading to changes in spermatogenesis and ultimately leading to decreased fertility.

Effects of washing agents on the mechanical and biocompatibility properties of water-washable 3D printing crown and bridge resin

Three-dimensional (3D) printing, otherwise known as additive manufacturing in a non-technical context, is becoming increasingly popular in the field of dentistry. As an essential step in the 3D printing process, postwashing with organic solvents can damage the printed resin polymer and possibly pose a risk to human health. The development of water-washable dental resins means that water can be used as a washing agent. However, the effects of washing agents and washing times on the mechanical and biocompatibility properties of water-washable resins remain unclear. This study investigated the impact of different washing agents (water, detergent, and alcohol) and washing time points (5, 10, 20, and 30 min) on the flexural strength, Vickers hardness, surface characterization, degree of conversion, biocompatibility, and monomer elution of 3D printed samples. Using water for long-term washing better preserved the mechanical properties, caused a smooth surface, and improved the degree of conversion, with 20 min of washing with water achieving the same biological performance as organic solvents. Water is an applicable agent option for washing the 3D printing water-washable temporary crown and bridge resin in the postwashing process. This advancement facilitates the development of other water-washable intraoral resins and the optimization of clinical standard washing guidelines.

Residual Monomer Release after the Polymerization of Different-Colored Flowable Compomer

BACKGROUND

Compomers are restorative materials commonly used in pediatric dentistry. It is important to investigate the monomer release of materials used especially in pediatric patients. The aim of this study was to evaluate the residual monomer released from different-colored flowable compomers at five polymerization times.

MATERIALS AND METHODS

Three experimental groups were formed: Group 1: pink flowable compomer (Twinky Star, VOCO, Germany), Group 2: blue flowable compomer (Twinky Star, VOCO), Group 3: white flowable compomer, A2 color of Dyract XP (Dentslpy DeTrey, Konstanz, Germany). For each group, samples were prepared using standard cylindrical Teflon molds (n = 10), and the compomers were cured using a light-emitting diode (LED) source in accordance with the manufacturer's recommendations. During each time period, the number of residual monomers: bisphenol-A glycidyl methacrylate (bis-GMA), urethane dimethacrylate (UDMA), hydroxyethyl methacrylate (HEMA), and triethylene glycol dimethacrylate (TEGDMA) were determined with high-performance liquid chromatography (HPLC). All data were analyzed statistically.

RESULTS

In all groups, the amount of residual monomers increased after 1-h release periods (P < 0.05). For 2 weeks, the total residual monomers released were determined at most in Group 3 and at least in Group 1. However, there was no significant difference between the groups in terms of released amounts of monomers (P > 0.05).

CONCLUSIONS

According to the study, when the total amount of residual monomer released from all groups was compared, no difference was found and it was observed that none of them exceeded the toxic dose. Flowable colored compomers can be used as safely as white compomers in pediatric dentistry.

Toxicity of resin-matrix cements in contact with fibroblast or mesenchymal cells

The main aim of this study was to perform an integrative review on the toxic effects of resin-matrix cements and their products in contact with fibroblasts or mesenchymal cells. A bibliographic search was performed on PubMed using the following search terms: "cytotoxicity" AND "fibroblast" OR "epithelial" OR "mesenchymal" AND "polymerization" OR "degree of conversion" OR "methacrylate" OR "monomer" AND "resin cement" OR "resin-based cement". The initial search in the available database yielded a total of 277 articles of which 21 articles were included in this review. A decrease in the viability of mouse fibroblasts ranged between 13 and 15% that was recorded for different resin-matrix cements after light curing exposure for 20 s. The viability of human fibroblasts was recorded at 83.11% after light curing for 20 s that increased up to 90.9% after light curing exposure for 40 s. Most of the studies linked the highest toxicity levels when the cells were in contact with Bis-GMA followed by UDMA, TEGDMA and HEMA. Resin-matrix cements cause a cytotoxic reaction when in contact with fibroblasts or mesenchymal cells due to the release of monomers from the polymeric matrix. The amount of monomers released from the resin matrix and their cytotoxicity depends on the polymerization parameters.

Evaluation of residual monomer release after polymerization of different restorative materials used in pediatric dentistry

BACKGROUND

The choice of the restorative resin material to be used in pediatric dentistry is of a great importance due to the cytotoxic effects caused by residual monomers. In this study, it was aimed to investigate the amount of residual monomer released over time from different resin-based restorative materials, which are widely used in pediatric dentistry, by using high performance liquid chromatography with photodiode array detector (HPLC-PDA).

METHODS

The compomers in all colors (Twinky Star and Glasiositte A₂), two composites with different hybrid properties (Arabesk-GrandioSO), and RMGIC (Ionolux) samples with 2 × 5 mm diameters were prepared. The samples were polymerized with an LED light unit (CELALUX 2, VOCO, Cuxhaven, Germany) and then finishing-polishing procedures were applied. A total of 156 samples were obtained, 13 samples in each of the 12 groups. The amount of residual monomer (BIS-GMA; HEMA, TEGDMA, UDMA) (µg/mL) released into the 75% ethanol solution was determined at different times, (1st hour, 1st, 7th, 14th, and 21st day) by using HPLC-PDA.

RESULTS

The residual monomer release continued on day 21 and BIS-GMA was the most released monomer in all groups. HEMA release showed a maximum increase in all the materials at day 7. The highest amount of residual monomer was detected in the gold-colored compomer. HEMA and BIS-GMA release from RMGIC was less than others in all time frames.

CONCLUSIONS

The color and composition of resin-based restorative materials affect the amount of residual monomer. Pediatric dentists should prefer gold-colored compomers less than others as a restorative material, especially in deep cavities. More studies are needed about the subject.

Cytotoxic Evaluation and Determination of Organic and Inorganic Eluates from Restorative Materials

Over the last years, diverse commercial resin-based composites have dominated as dental filling materials. The purpose of the present study was to determine organic and inorganic eluates from five restorative materials using GC/MS and ICP–OES and to compare the effect on cell survival of human gingival fibroblasts of a conventional and a bioactive resin. Five commercially available restorative materials were employed for this study: Activa^TM Bioactive Restorative, ENA HRi, Enamel plus HRi Biofunction, Fuji II LC Capsule, and Fuji IX Capsule. Disks that were polymerized with a curing LED light or left to set were immersed in: 1 mL methanol or artificial saliva for GC/MS analysis, 5mL deionized water for ICP–OES, and 5mL of culture medium for cell viability. Cell viability was investigated with a modified staining sulforhodamine B assay.The following organic substances were detected: ACP, BHT, BPA, 1,4-BDDMA, CQ, DBP, DMABEE, HEMA, MCE, MeHQ, MOPA, MS, TMPTMA, and TPSb and the ions silicon, aluminum, calcium, sodium, and barium. Activa Bioactive Restorative was found to be biocompatible. Elution of organic substances depended on material’s composition, the nature of the solvent and the storage time. Ions’ release depended on material’s composition and storage time. The newly introduced bioactive restorative was found to be more biocompatible.

Cytotoxicity evaluation of eluates from universal adhesives by real-time cell analysis

The aim of this study was to evaluate the cytotoxicity of universal adhesives on L929 mouse fibroblast cell line by using a real-time cell analysis. In order to obtain extract, six different cured dental adhesives were immersed in Dulbecco's Modified Eagle's Medium (DMEM) at 37°C for 24 h. A real-time cell analysis system was used to assess cytotoxicity of the dental adhesives. After seeding 25,000 cells/300 μL/well cell suspensions into the wells of an e-plate, fibroblasts were exposed to extracts of tested adhesives at varying dilutions (1:1, 1:2, and 1:10) and observed at every 30 min intervals for 72 h. Three-way ANOVA one factor repeated measures were used to analyze the results (α=0.05). All tested adhesives induced cell viability loss, cell morphology alteration, and cell death depending on extract concentration and time. Cell viability of L929 cells to between 44 and 10% for 1:1 diluted extracts, at 72 h, when compared to the negative control.

Genotoxic and cytotoxic potential of methacrylate-based orthodontic adhesives

Objectives

The biocompatibility of methacrylate-based adhesives is a topic that is intensively discussed in dentistry. Since only limited evidence concerning the cyto- and genotoxicity of orthodontic adhesives is available, the aim of this study was to measure the genotoxic potential of seven orthodontic methacrylate-based adhesives.

Materials and methods

The XTT assay was utilized to determine the cytotoxicity of Assure Plus, Assure Bonding Resin, ExciTE F, OptiBond Solo Plus, Scotchbond Universal Adhesive, Transbond MIP, and Transbond XT after an incubation period of 24 h on human gingival fibroblasts. We also performed the γH2AX assay to explore the genotoxic potential of the adhesives within cytotoxic dose ranges after an incubation period of 6 h.

Results

The XTT assay showed a concentration-dependent reduction in cell viability. The decrease in cellular viability was in the same dose range most significant for Assure Plus, rendering it the adhesive material with the highest cytotoxicity. Employing the γH2AX assay, a concentration-dependent increase in H2AX phosphorylation was detected, indicating induction of DNA damage.

Conclusions

For most products, a linear correlation between the material concentration and γH2AX foci was observed. The most severe effect on γH2AX focus induction was found for Transbond MIP, which was the only adhesive in the test group containing the co-initiator diphenyliodonium hexafluorophosphate (DPIHP).

Clinical relevance

The data indicate that orthodontic adhesives, notably Transbond MIP, bear a genotoxic potential. Since the study was performed with in vitro cultivated cells, a direct translation of the findings to in vivo exposure conditions should be considered with great diligence.

The influence of a liner on deep bulk-fill restorations: Randomized clinical trial

OBJECTIVE

The aim of this study was to evaluate the influence of a liner on the clinical performance of deep posterior restorations performed with bulk-fill composite.

METHODS

30 subjects received two restorations on deep preparations in posterior teeth, without pulpal exposure, after selective carious-tissue removal in one-stage. The internal walls reached the inner quarter of dentin, but with a radiographically detectable zone of firm dentin remaining. The pulpal protection using a layer of glass ionomer composite liner (Ionoseal, Voco) was applied in just one preparation. The adhesive system Futurabond U (Voco) was applied in all preparations, which were restored with the bulk-fill pure Ormocer nanohybrid composite (Admira Fusion Xtra - Voco), in up to 4 mm thick increments. All restorations were evaluated using the FDI criteria after 7 days, 6, 12 and 24 months postoperatively.

RESULTS

After 24-months, 25 patients attended the recall and 50 restorations were evaluated. The Fisher's statistical analysis (5%) showed no difference between the techniques for the esthetic, functional and biological properties. No postoperative sensitivity was reported for both groups.

CONCLUSION

The application of a liner did not influence the clinical performance of deep restorations with bulk-fill Ormocer composite.

CLINICAL RELEVANCE

The application of a liner with a GIC-based material did not have a significant effect on the clinical performance of bulk-fill restorations and seems to be unnecessary for the material tested.

Influence of the degree of conversion and Bis-GMA residues of bulk fill resins on tissue toxicity in an subcutaneous model in rats

AIM

To analyse the influence of the degree of conversion (DC) and light curing residues of different bulk fills (BFs) composites on the inflammatory profile in the subcutaneous tissue of rats.

MATERIALS AND METHODS

Resin disks of BF-resins and their active conventional resins (CR; 3M®, Ivoclar®, and Kerr®) were light-cured at 2 mm (BF-superficial) and 4 mm (BF-deep) thicknesses and analyzed by infrared spectroscopy (FTIR; n = 3/group; DC and light curing residues). Then, the disks were implanted in four quadrants in the subcutaneous tissue of Wistar rats (sham, CR, BF-superficial and RF-deep), and after 7, 14, and 28 days, the animals (n = 6/day) were euthanized for histological analysis of the intensity of the inflammatory process (scores 0-3). Kruskal-Wallis/Dunn and ANOVA/Bonferroni tests were used (p < 0.05, Graph Pad Prism 5.0).

RESULTS

The DC of CR 3M® did not differ significantly compared to BF-superficial and BF-deep resins (p = 0.235). The Ivoclar® and Kerr® resins showed a higher DC with CR and BF-superficial compared to the BF-deep (p = 0.005 and p = 0.011, rctively). Kerr® resins showed a higher Bis-GMA/UDMA ratio, especially in BF-deep resin (p < 0.05). 3M® and Ivoclar resins did not show high inflammation scores, but for Kerr® BF resins (superficial and deep), the inflammatory process was significantly higher than that in the CR and sham quadrants (p = 0.031).

CONCLUSION

The tissue inflammatory response after resin inoculation depends on the DC and light curing residues of Bis-GMA.

Human pulp response to conventional and resin-modified glass ionomer cements applied in very deep cavities

OBJECTIVES

This study assessed the human pulp response after adhesive restoration of cavities by indirect pulp capping with a conventional or a resin-modified glass ionomer cement.

MATERIALS AND METHODS

Deep cavities prepared in 26 human premolars were lined with Riva Light Cure (Riva LC), Riva Self Cure (Riva SC), or Dycal, and then restored with composite resin. Four teeth were used as intact control. After time intervals of 7 or 30 days, the teeth were extracted, processed for histological evaluation of the pulp, and the remaining dentin thickness (RDT) between the cavity floor and the pulp was measured.

RESULTS

At 7 days, a slight pulp inflammation associated with discrete tissue disorganization was observed in most of t the teeth lined with Riva LC and Riva SC. Moderate pulp inflammation occurred in one tooth lined with Riva LC. Bacteria were identified in one specimen of the same group that exhibited no pulp damage. At 30 days, slight pulp inflammation and discrete tissue disorganization persisted in two specimens treated with Riva LC, in which a thin layer of tertiary dentin was deposited. Mean RDTs ranged from 383.0 to 447.8 μm.

CONCLUSIONS

Riva LC produced more damage to the pulp than Riva SC. However, the initial pulp damage decreased over time and after 30 days both GICs were labeled as biocompatible.

CLINICAL RELEVANCE

In this study conducted with human teeth, the conventional and the resin-modified glass ionomer cements investigated were shown not to cause post-operative sensitivity or persistent pulp damage when applied as liners in very deep cavities, thereby indicating their biocompatibility.

Cytotoxicity of universal dental adhesive systems: Assessment in vitro assays on human gingival fibroblasts

Universal adhesives are the most important innovation in restorative dentistry. They are composed of different monomers, solvents and fillers. The potential cytotoxic effect of these materials is an important scientific aspect in recent literature. The aim of this study was to determine, using different in vitro techniques, the cytotoxicity evaluation of seven universal enamel-dental adhesives on human gingival fibroblasts. For this purpose, seven universal dental enamel adhesives have been evaluated by in vitro cytotoxicity tests using direct contact tests (an unpolymerized and a polymerized method) and an indirect contact test: preparation of extracts. The polymerized method showed a cytotoxicity range from 36% (G-PremioBond, GPB) to 79% (FuturaBond M+, FB). With the unpolymerized direct methods the range was from 4% (Prime&Bond Active, PBA) to 40% (Ibond Universal, IB) for undiluted adhesives; generally passing to the major dilutions the test showed a strong inhibitory activity by all the adhesives. Whereas with the indirect method by diluting the extracts of all dental adhesives the cell viability increased. The data obtained from the work has shown a lower cytotoxic effect of Optibond Solo Plus (OB) and Adhesive Universal (AU) with more reliable results with the extracts technique. The choice of reliable in vitro cytotoxic technique could represent, in dental practice, an important aid for clinical procedures in the use of adhesive systems.

Polymerization characteristics of colored compomers cured with different LED units

Aim:

Incomplete polymerization of a resin material used for dental restoration affects the properties of the restoration. We evaluated the structural and mechanical properties of three different colored compomers cured with three different LED units to observe the characteristic changes occurring in different matches.

Methods:

Polytetrafluoroethylene molds (5 mm in diameter and 2 mm in thickness) were used to prepare disk-shaped sample specimens. Nine sample groups (each of five specimens) were prepared, three each of different compomer resin colors (gold, berry, and silver). Samples were cured using three different LED units (Optima, VALO, and Demi Ultra), according to the manufacturers’ instructions. Microstructural properties of samples were characterized by determining the degree of curing using Fourier-transform infrared spectroscopy and by analyzing sample morphology under a scanning electron microscope. The Vickers hardness, compressive strength, and elastic modulus of the samples were measured to investigate their mechanical properties.

Results:

The degrees of curing decreased in the order of silver > berry > gold for all curing units. Conversely, gold compomers exhibited poorer mechanical values than the berry and silver counterparts. The Optima 10 unit yielded slightly higher degrees of curing than the other devices, followed by Demi Ultra and VALO light-curing units, respectively.

Conclusion:

The resin color affected the structural and mechanical properties of the compomers, possibly as a result of the complex interactions and relationships between the irradiation light and resin material, such as light absorbance and reflectance; thus, depending on the color as well as the curing protocol.

Modification of glass ionomer cements on their physical-mechanical and antimicrobial properties

OBJECTIVE

The aim of this review was to provide an insight about the factors affecting the properties of glass ionomer cements and provides a review regarding studies that are related to modification of glass ionomer cements to improve their properties, particularly on physical-mechanical and antimicrobial activity.

METHODS

PubMed and Science Direct were searched for papers published between the years 1974 and 2018. The search was restricted to articles written in English related to modification of glass ionomer cements. Only articles published in peer-reviewed journals were included. The search included literature reviews, in vitro, and in vivo studies. Articles written in other languages, without available abstracts and those related to other field were excluded. About 198 peer-review articles in the English language were reviewed.

CONCLUSION

Based on the finding, most of the modification has improved physical-mechanical properties of glass ionomer cements. Recently, researchers have attempted to improve their antimicrobial properties. However, the attempts were reported to compromise the physical-mechanical properties of modified glass ionomer cements.

CLINICAL SIGNIFICANCE

As the modification of glass ionomer cement with different material improved the physical-mechanical and antimicrobial properties, it could be used as restorative material for wider application in dentistry.

In vitro cytotoxic evaluation of novel fast-setting calcium silicate cement compositions and dental materials using colorimetric methyl-thiazolyl-tetrazolium assay

A novel fast-setting calcium silicate cement with fluoride (CSC) has been developed for potential application in tooth crowns. This study compared the cytotoxicity of CSC compositions and a variety of dental materials. We tested CSC compositions (Protooth), MTA, Biodentine, Ketac Molar, Fuji II LC, Vitrebond, DeTrey Zinc, Dycal, and IRM, DMEM (negative control) and 1% NaOCl (positive control). After setting of cements for 24 h, specimens were immersed in DMEM for 24 h to obtain material elutes. The elutes were serially diluted in serum-free DMEM to obtain three dilutions. L929 mouse fibroblast cells (1 × 10⁴ cells per well) were treated for 24 h with elute dilutions (n = 3). Cytotoxicity was determined using methyl-thiazolyl-tetrazolium assay in triplicate. CSC compositions, MTA, and Biodentine showed no significant reduction in cell viability compared to DMEM. There was no significant difference in cell viability, at any of three dilutions, between CSC compositions and either MTA or Biodentine. Cytotoxicity was significantly lower for CSC compositions than for Vitrebond, DeTrey Zinc, Dycal, IRM, and 1% NaOCl, at all three dilutions, and undiluted Fuji II LC elute. In contrast to resin-modified glass ionomers, zinc phosphate cements, Dycal, and IRM, the CSC compositions showed no cytotoxic potential.

Biological, thermal and mechanical characterization of modified glass ionomer cements: The role of nanohydroxyapatite, ciprofloxacin and zinc l-carnosine

The study evaluated the effects of 4 wt% nanohydroxyapatite (HA), 6 wt% zinc l-carnosine (MDA) and 1.5 wt% Ciprofloxacin (AB) on the mechanical, thermal and biological properties of glass ionomer cements (GIC). Filler and additive concentrations were selected after a previous study had tested single components and different percentages. Specimens included five silicon molds of each GIC cement for all tests. They were stored at room temperature for 24 h from specimen collection to analysis. Mechanical tests, calorimetric analysis, morphological investigation, antibacterial and cell viability assays were conducted. One-way analysis of variance (ANOVA) was used for data analysis with significance set at p < 0.05. Adding HA, MDA and AB to GICs modified their thermal, mechanical and microbiological properties. Polymerization increased. A slight decrease in the compressive strength of modified GICs was observed in dry condition (p < 0.05). Cement extracts affected cell viability in relation to extract dilution. Mechanical behavior improved in modified glass ionomer cements, especially with the powder formulated antibiotic. Overall cytotoxicity was reduced. Therefore adding nanohydroxyapatite, antibiotic and a mucosal defensive agent to conventional glass ionomer cement in special need patients could improve the clinical, preventive and therapeutic performance of the cements, without altering their mechanical properties.

Comparative evaluation of microleakage of mineral trioxide aggregate and Geristore root-end filling materials in different environments: An in vitro study

Aim:

The aim of this in vitro study was to evaluate and compare the microleakage of mineral trioxide aggregate (MTA) and Geristore root-end filling materials in different environments.

Materials and Methods:

After removing the anatomical crowns of ninety extracted human maxillary central incisors, their root canals were instrumented and obturated. The apical 3 mm of each root was resected, and a standardized root-end cavity was prepared using an ultrasonic tip. The roots were alienated into three equal subgroups for each material and the root-end filling was performed in different environments namely dry, saliva contaminated, and blood contaminated. Samples were immersed in 0.2% Rhodamine B dye for 48 h. Roots were sectioned longitudinally and examined under a fluorescent microscope to measure the linear dye penetration. The results were statistically analyzed using analysis of variance and Tukey's honestly significant difference post hoc test.

Results:

The Geristore dry group illustrated the lowest linear leakage, while the MTA saliva-contaminated group illustrated the highest leakage. In dry environment, linear dye penetration of both MTA and Geristore groups did not show any significant difference. However, statistically significant difference was observed between MTA and Geristore groups in blood- and saliva-contaminated environments.

Conclusion:

Geristore showed better results in saliva- and blood-contaminated environments; hence, Geristore may be used as an alternative to MTA for root-end filling.

Effects of four novel root-end filling materials on the viability of periodontal ligament fibroblasts

Objectives

The aim of this in vitro study was to evaluate the biocompatibility of newly proposed root-end filling materials, Biodentine, Micro-Mega mineral trioxide aggregate (MM-MTA), polymethylmethacrylate (PMMA) bone cement, and Smart Dentin Replacement (SDR), in comparison with contemporary root-end filling materials, intermediate restorative material (IRM), Dyract compomer, ProRoot MTA (PMTA), and Vitrebond, using human periodontal ligament (hPDL) fibroblasts.

Materials and Methods

Ten discs from each material were fabricated in sterile Teflon molds and 24-hour eluates were obtained from each root-end filling material in cell culture media after 1- or 3-day setting. hPDL fibroblasts were plated at a density of 5 × 10³/well, and were incubated for 24 hours with 1:1, 1:2, 1:4, and 1:8 dilutions of eluates. Cell viability was evaluated by XTT assay. Data was statistically analysed. Apoptotic/necrotic activity of PDL cells exposed to material eluates was established by flow cytometry.

Results

The Vitrebond and IRM were significantly more cytotoxic than the other root-end filling materials (p < 0.05). Those cells exposed to the Biodentine and Dyract compomer eluates showed the highest survival rates (p < 0.05), while the PMTA, MM-MTA, SDR, and PMMA groups exhibited similar cell viabilities. Three-day samples were more cytotoxic than 1-day samples (p < 0.05). Eluates from the cements at 1:1 dilution were significantly more cytotoxic (p < 0.05). Vitrebond induced cell necrosis as indicated by flow cytometry.

Conclusions

This in vitro study demonstrated that Biodentine and Compomer were more biocompatible than the other root-end filling materials. Vitrebond eluate caused necrotic cell death.

Biological evaluation of subgingivally placed direct resin composite materials

Placement of composite resin restorations in deep subgingival cavities can damage surrounding soft tissues. In addition, commonly used resin-based composites (RBCs) might interfere with wound healing and periodontal health. To clarify cellular interactions with RBCs, we used an MTT assay to investigate adhesion of primary human gingival fibroblasts and human osteoblasts (hFOB 1.19) on five RBC materials with and without surface modifications (alumina blasting with 50- or 110-μm Al₂O₃). In addition, high-performance liquid chromatography (HPLC) was used to determine release of resin monomers from RBCs after 1 h, 1 day, and 7 days. As compared with tissue culture plastics (the control), cellular adhesion was significantly lower (P < 0.001) for human gingival fibroblasts and osteoblasts. Only minor, nonsignificant differences between individual RBCs were identified. HPLC analyses identified the release of three bifunctional methacrylates bisphenol A glycerolate dimethacrylate, triethylene glycol dimethacrylate, and diurethane dimethacrylate from RBCs and showed that monomer release increased between 1 h and 1 day but remained low. The present findings suggest that surface adhesion in the subgingival area is limited for the tested RBCs. Although residual monomer release was low for all tested RBCs, it might be sufficient to adversely affect cell adhesion.

Influence of Different Concentration and Ratio of a Photoinitiator System on the Properties of Experimental Resin Composites

Abstract The aim in this study was to evaluate the influence of different ratio of camphorquinone/tertiary amine concentration on the flexural strength (FS), elastic modulus (EM), degree of conversion (DC), yellowing (YL), water sorption (WS) and water solubility (WSL) of experimental composites. Thus, acrylate blends were prepared with different camphorquinone (CQ) and amine (DABE) concentrations and ratios by weight: (CQ/DABE%): 0.4/0.4% (C1), 0.4/0.8% (C2), 0.6/0.6% (C3), 0.6/1.2% (C4), 0.8/0.8% (C5), 0.8/1.6% (C6), 1.0/1.0% (C7), 1.0/2.0% (C8), 1.5/1.5% (C9), 1.5/3.0% (C10). For the FS and EM, rectangular specimens (7x2x1 mm, n=10) were photo-activated by single-peak LED for 20 s and tested at Instron (0.5 mm/min). Then, the same specimens were evaluated by FTIR for DC measurement. For YL, disks (5x2 mm, n=10) were prepared, light-cured for 20 s and evaluated in spectrophotometer using the b aspect of the CIEL*a*b* system. For WS and WSL, the volume of the samples was calculated (mm³). For WS and WSL, composites disks (5x0.5 mm, n=5) were prepared. After desiccation, the specimens were stored in distilled water for 7 days and again desiccated, in order to measure the WS and WSL. Data were submitted to one-way ANOVA and Tukey’s test (5%). The groups C8, C9 and C10 showed higher DC, EM and YL means, compared to other composites. Therefore, the FS and WS values were similar among all groups. Also, C1, C2 and C3 presented higher WSL in 7 days, compared to other composites. In general, higher concentrations of camphorquinone promoted higher physical-mechanical properties; however, inducing higher yellowing effect for the experimental composites

Generation and Role of Reactive Oxygen and Nitrogen Species Induced by Plasma, Lasers, Chemical Agents, and Other Systems in Dentistry

The generation of reactive oxygen and nitrogen species (RONS) has been found to occur during inflammatory procedures, during cell ischemia, and in various crucial developmental processes such as cell differentiation and along cell signaling pathways. The most common sources of intracellular RONS are the mitochondrial electron transport system, NADH oxidase, and cytochrome P450. In this review, we analyzed the extracellular and intracellular sources of reactive species, their cell signaling pathways, the mechanisms of action, and their positive and negative effects in the dental field. In dentistry, ROS can be found—in lasers, photosensitizers, bleaching agents, cold plasma, and even resin cements, all of which contribute to the generation and prevalence of ROS. Nonthermal plasma has been used as a source of ROS for biomedical applications and has the potential for use with dental stem cells as well. There are different types of dental stem cells, but their therapeutic use remains largely untapped, with the focus currently on only periodontal ligament stem cells. More research is necessary in this area, including studies about ROS mechanisms with dental cells, along with the utilization of reactive species in redox medicine. Such studies will help to provide successful treatment modalities for various diseases.

Cytotoxicity and DNA double-strand breaks in human gingival fibroblasts exposed to eluates of dental composites

OBJECTIVE

Previously, single composite components were used to study cytotoxicity and induction of DNA double-strand breaks (DNA-DSBs) of dental composite resins. In the present study, cytotoxicity and induction of DNA-DSBs in human gingival fibroblasts (HGFs) were investigated with dental composite eluates consisting of multiple components. The eluates were qualified and quantified.

METHODS

The composites Esthet.X^® HD, Venus^®, X-tra fil^®, CLEARFIL™ AP-X, Admira^® Fusion and QuiXfil^® were polymerized and immersed into Dulbecco's modified Eagle's medium (DMEM) for 72h. Subsequently, HGFs were incubated with the corresponding composite eluates. The cell viability of HGFs was obtained from an XTT assay. DNA-DSBs were determined using a γ-H2AX assay. The qualification and quantification of eluates were performed by gas chromatography/mass spectrometry (GC/MS).

RESULTS

HGFs exposed to the eluates of all investigated composites showed no significant loss of cell viability, compared to negative control. Significant DNA-DSBs induction could be found in HGFs exposed to the eluates of Esthet.X^® HD (0.43±0.05 foci/cell) and Venus^® (0.39±0.04 foci/cell), compared to control (0.22±0.03 foci/cell). A total of 12 substances were detected from the investigated composite eluates. Five of them were methacrylates: tetraethyleneglycol dimethacrylate (TEGDMA), 2-hydroxyethyl methacrylate (HEMA), hydroxypropyl methacrylate (HPMA), ethyleneglycol dimethacrylate (EGDMA) and trimethylolpropane trimethacrylate (TMPTMA). The highest concentration of HEMA (110.5μM), HPMA (86.08μM) and TMPTMA (4.50μM) was detected in the eluates of QuiXfil^®. The highest concentration of TEGDMA was 1080μM in Venus^® eluates and the highest concentration of EGDMA was 3.18μM in Esthet.X^® HD eluates.

SIGNIFICANCE

Significant DNA-DSBs induction can be found in HGFs exposed to the eluates of Esthet.X^® HD and Venus^®. The interactive effects among released (co)monomers and additives may influence the cytotoxicity and induction of DNA-DSBs, compared to exposure with single composite component.

Biocompatibility Evaluation of Four Dentin Adhesives Used as Indirect Pulp Capping Materials

BACKGROUND

In many cases, the indirect pulp treatment (IPT) is an acceptable treatment for deciduous teeth with reversible pulp inflammation. Various medicaments have been used for IPT, ranging from calcium hydroxide and glass ionomers to dentin adhesives.

OBJECTIVE

This in vitro trial aimed to measure cytotoxicity in a cell culture, comparing the following four adhesives: Xeno® V (XE), Excite® F DSC (EX), Adhese® OneF (AD) and Prime & Bond NT (PB).

MATERIALS AND METHODS

The adhesives were prepared according to the manufacturer's instructions. After 24 hours of exposure, the cell viability was evaluated using a photometrical test (MTT test). Data were subjected to analysis of variance (ANOVA).

RESULTS

Adhesives, the main component of which was 2-hydroxyethyl methacrylate (HEMA), were found to be less cytotoxic, while those that included the monomer urethane dimethacrylate (UDMA were the most cytotoxic) in their composition. The effects on cell viability assay varied between the adhesives assayed with statistically significant differences.

CONCLUSIONS

The results may support the argument that Adhese® OneF is the least cytotoxic of the adhesives assayed, and may be considered as an adhesive agent for indirect pulp treatment. However, Prime and Bond NT showed a reduced biocompatibility under the same conditions.

Durability of a low shrinkage TEGDMA/HEMA-free resin composite system in Class II restorations. A 6-year follow up

OBJECTIVE

The objective of this randomized controlled prospective trial was to evaluate the durability of a low shrinkage and TEGDMA/HEMA-free resin composite system in posterior restorations in a 6-year follow up.

METHODS

139 Class II restorations were placed in 67 patients with a mean age of 53 years (range 29-82). Each participant received at random two, as similar as possible, Class II restorations. In the first cavity of each pair the TEGDMA/HEMA-free resin composite system was placed with its 3-step etch-and-rinse adhesive (cmf-els). In the second cavity a 1-step HEMA-free self-etch adhesive was used (AdheSe One F). The restorations were evaluated using slightly modified USPHS criteria at baseline and then yearly during 6 years. Caries risk and parafunctional habits of the participants were estimated.

RESULTS

Three molar teeth showed mild post-operative sensitivity during 3 weeks for temperature changes and occlusal forces. After 6 years, 134 Class II restorations were evaluated. Twenty-one restorations, 8 cmf-els (11.4%) and 13 ASE-els (20%) failed during the 6 years (p<0.0001). The annual failure rates were 1.9% and 3.3%, respectively. The main reasons for failure were fracture followed by recurrent caries. Most fractures and all caries lesions were found in high risk participants.

SIGNIFICANCE

The Class II resin composite restorations performed with the new TEGDMA/HEMA-free low shrinkage resin composite system showed good durability over six years.

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.

In Vitro Comparison of Biological Effects of Coe-Pak and Reso-Pac Periodontal Dressings

Objectives

The purpose of the present study was to compare the cytotoxicity of Reso-Pac and Coe-Pak periodontal dressing.

Material and Methods

According to ISO-10993-12:2012, 1-, 3- and 7-day extracts of the two periodontal dressings were prepared in cell culture medium and exposed to the two cultured cell lines. Cell viability and proliferation at 24 h and 72 h following exposure were evaluated using quantitative MTT assay.

Results

The results showed a significant (P < 0.05) reduction in the viability of cells exposed to the 3- and 7-day Coe-Pak extracts at 24 h and 72 h compared to the control group (no exposure to the extract). Reso-Pac extracts slightly decreased cell viability compared to the control group. Understudy materials showed greater cytotoxicity against human osteoblast-like compared to the human gingival fibroblast cells. No significant (P > 0.05) difference was found in the viability of cells exposed to undiluted (100%) one-day extract and diluted (50%) extract of both understudy materials at 24 h and 72 h after exposure.

Conclusions

Based on the results, Reso-Pac periodontal dressing has less cytotoxicity than Coe-Pak.

Setting kinetics and mechanical properties of flax fibre reinforced glass ionomer restorative materials

Regardless of the excellent properties of glass ionomer cements, their poor mechanical properties limit their applications to non-load bearing areas. This study aimed to investigate the effect of incorporated short, chopped and randomly distributed flax fibers (0, 0.5, 1, 2.5, 5 and 25 wt%) on setting reaction kinetics, and mechanical and morphological properties of glass ionomer cements. Addition of flax fibers did not significantly affect the setting reaction extent. According to their content, flax fibers increased the compressive (from 148 to 250 MPa) and flexure strength (from 20 to 42 MPa). They also changed the brittle behavior of glass ionomer cements to a plastic one. They significantly reduced the compressive (from 3 to 1.3 GPa) and flexure modulus (from 19 to 14 GPa). Accordingly, flax fiber-modified glass ionomer cements could be potentially used in high-stress bearing areas.

In vitro dentin barrier cytotoxicity testing of some dental restorative materials

OBJECTIVES

To investigate the cytotoxicity of four dental restorative materials in three-dimensional (3D) L929 cell cultures using a dentin barrier test.

METHODS

The cytotoxicities of light-cured glass ionomer cement (Vitrebond), total-etching adhesive (GLUMA Bond5), and two self-etching adhesives (GLUMA Self Etch and Single Bond Universal) were evaluated. The permeabilities of human dentin disks with thicknesses of 300, 500, and 1000μm were standardized using a hydraulic device. Test materials and controls were applied to the occlusal side of human dentin disks. The 3D-cell scaffolds were placed beneath the dentin disks. After a 24-h contact with the dentin barrier test device, cell viabilities were measured by performing MTT assays. Statistical analysis was performed using the Mann-Whitney U test.

RESULTS

The mean (SD) permeabilities of the 300-μm, 500-μm, and 1000-μm dentin disks were 0.626 (0.214), 0.219 (0.0387) and 0.089 (0.028) μlmin^-1cm^-2cm H₂O^-1. Vitrebond was severely cytotoxic, reducing the cell viability to 10% (300-μm disk), 17% (500μm), and 18% (1000μm). GLUMA Bond5 reduced the cell viability to 40% (300μm), 83% (500μm), and 86% (1000μm), showing moderate cytotoxicity (300-μm) and non-cytotoxicity (500-μm and 1000-μm). Single Bond Universal and GLUMA Self Etch did not significantly reduce cell viability, regardless of the dentin thicknesses, which characterized them as non-cytotoxic.

CONCLUSIONS

Cytotoxicity varied with the materials tested and the thicknesses of the dentin disks.

CLINICAL SIGNIFICANCE

The tested cytotoxicity of materials applied on 300-, 500-, and 1000-μm dentin disks indicates that the clinical use of the test materials (excepting self-etching adhesives) in deep cavities poses a potential risk of damage to the pulp tissues to an extent, depending on the thickness of the remaining dentin.

Cytotoxicity of Two-step Self-etching Primer/Adhesives on L929 Cells

The cytotoxicity of four self-etching primer/adhesive systems (Clearfil® SE Bond, Clearfil® Protect Bond, Mac Bond® II and FL® Bond) was tested against L929 fibroblasts. The primer or adhesive component of each adhesive system was diluted serially with the culture medium at a ratio of 1:1,000 and 1:4,000 (v/v). Cytotoxicity was identified by adding L929 cells in 24-well culture plates at an initial density of 35,000 cells mL 1. The cells were maintained for 5 days; every 24h, the medium was changed with fresh medium containing specific dilutions of the primer or adhesive components of the test materials. Cytotoxicity was assessed quantitatively at 24, 48, 72, 96 and 120h. Physiological and pathological cellular changes as well as reactions and growth of the cell cultures were examined under an inverted microscope. All self-etching systems were found to be cytotoxic to varying degrees; more pronounced toxic effects were observed at lower dilution (1:1,000 [v/v]). The adhesive components of Mac Bond® II and FL® Bond showed the highest cytotoxicity at 1:1,000 (v/v). The primer and adhesive of Clearfil® SE Bond, the primer of Mac Bond® II and the antibacterial monomer (MDPB)-containing Clearfil® Protect Bond (at 1:4,000 [v/v]) were relatively less cytotoxic.

Influence of light-curing distance on degree of conversion and cytotoxicity of etch-and-rinse and self-etch adhesives

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.

In vitro evaluation of different dental materials used for the treatment of extensive cervical root defects using human periodontal cells

INTRODUCTION

Repair materials for extensive cervical root defects may come in direct contact with periodontal tissues. This in vitro study compared the effects of four calcium silicate cements (CSC), one resin-modified glass ionomer cement, and one glass carbomer cement on primary human gingival fibroblasts (HGF), alveolar osteoblasts (HAO), and a human osteoblast cell line (hFOB 1.19).

METHODS

HGF, HAO, and hFOB were seeded on discoid test specimens. Relative numbers of viable cells were quantitatively assessed after 1 and 24 h for cytotoxicity/adhesion assays and after 4, 24, 48, and 72 h for proliferation assays. Data were statistically analyzed using non-parametric tests (α = 0.05).

RESULTS

Relative to the control (100 %), CSC allowed for mean numbers of 71-81 % viable HGF and 80-82 % viable HAO. Then, 64 % of HGF and 56 % of HAO were assessed on GC Fuji II LC. Mean numbers of viable cells were 59-64 % HGF and 67-68 % HAO for GCP Glass Fill specimens. Cells exposed to CSC over 24 h remained viable and even increased in number. Both cell types adhered almost equally well to CSC and GC Fuji II LC. GCP Glass Fill continued to decrease cell viability and adhesion. CSC-based materials and GC Fuji II LC allowed for HGF and hFOB proliferation; however, none of the tested materials specifically stimulated cell proliferation.

CONCLUSIONS

CSC characterized by low cytotoxicity. GC Fuji II LC shows moderate cytotoxic effects. ProRoot MTA, Harvard MTA, Biodentine, EndoSequence putty, and GC Fuji II LC allow HGF and HAO to adhere and HGF and hFOB to proliferate. GCP Glass Fill decreases cell viability, adhesion, and proliferation.

CLINICAL RELEVANCE

CSC remain the paramount biologic choice for the repair of extensive cervical root defects. GC Fuji II LC might be considered in addition to CSC when the defect comprises supracrestal areas and the restoration requires superior aesthetic and mechanical characteristics.

The role of poly(acrylic acid) in conventional glass polyalkenoate cements

Glass polyalkenoate cements (GPCs) have been used in dentistry for over 40 years. These novel bioactive materials are the result of a reaction between a finely ground glass (base) and a polymer (acid), usually poly(acrylic acid) (PAA), in the presence of water. This article reviews the types of PAA used as reagents (including how they vary by molar mass, molecular weight, concentration, polydispersity and content) and the way that they control the properties of the conventional GPCs (CGPCs) formulated from them. The article also considers the effect of PAA on the clinical performance of CGPCs, including biocompatibility, rheological and mechanical properties, adhesion, ion release, acid erosion and clinical durability. The review has critically evaluated the literature and clarified the role that the polyacid component of CGPCs plays in setting and maturation. This review will lead to an improved understanding of the chemistry and properties of the PAA phase which will lead to further innovation in the glass-based cements field.

Photo-irradiation paradigm: Mapping a remarkable facile technique used for advanced drug, gene and cell delivery

Undoubtedly, the progression of photo-irradiation technique has provided a smart engineering tool for the state-of-the-art biomaterials that guide the biomedical and therapeutic domains for promoting the modern pharmaceutical industry. Many investigators had exploited such a potential technique to create/ameliorate numerous pharmaceutical carriers. These carriers show promising applications that vary from small drug to therapeutic protein delivery and from gene to living cell encapsulation design. Harmony between the properties of precisely engineered precursors and the formed network structure broadens the investigator's intellect for both brilliant creations and effective applications. As well, controlling photo-curing at the formulation level, through manipulating the absorption of light stimuli, photoinitiator system and photo-responsive precursor, facilitates the exploration of novel distinctive biomaterials. Discussion of utilizing different photo-curing procedures in designing/formulation of different pharmaceutical carriers is the main emphasis of this review. In addition, recent applications of these intelligent techniques in targeted, controlled, and sustained drug delivery with understanding of photo-irradiation concept and mechanism are illustrated.

Inhibition of odontogenic differentiation of human dental pulp cells by dental resin monomers

Background

Dental resin monomers that are leached from the resin matrix due to incomplete polymerization can affect the viability and various functions of oral tissues and cells. In this study, the effects of triethylene glycol dimethacrylate (TEGDMA) and 2-hydroxyethyl methacrylate (HEMA) on odontogenic differentiation of human dental pulp cells (HDPCs) were examined. To mimic clinical situations, dental pulp cells were treated with resin monomers for 24 h prior to the analysis of alkaline phosphatase (ALP) activity and mRNA expression of genes related to pulp cell differentiation. To elucidate the underlying signaling pathways, regulation of mitogen-activated protein (MAP) kinases by resin monomers was also investigated.

Results

The ALP activity of HDPCs was reduced by TEGDMA and HEMA at noncytotoxic concentrations. The mRNA expression of dentin sialophosphoprotein (DSPP), osteocalcin (OCN), and osteopontin (OPN) was also downregulated by resin monomers. However, DSPP expression was not affected by hydrogen peroxide (H₂O₂). Among the MAP kinases examined, ERK activation (ERK phosphorylation) was not affected by either resin monomers or H₂O₂, whereas JNK was phosphorylated by TEGDMA and HEMA. Phospho-p38 was upregulated by HEMA, while TEGDMA and H₂O₂ suppressed p38 phosphorylation.

Conclusions

Exposure to TEGDMA and HEMA for a limited period suppresses differentiation of HDPCs via different signaling pathways.

Cytotoxicity of coated and uncoated fibre-reinforced composites

OBJECTIVE

Currently, there are many fibre-reinforced composites (FRCs) available which differ in the type and volume fraction of fibres, pre-treatment of fibres and matrix composition. The aims of this in vitro investigation were to determine whether there is a difference in biocompatibility of FRCs and if coating FRCs with resin composites influences their cytotoxic potential.

MATERIALS AND METHODS

Five different FRC materials were tested which were either uncoated or coated with flowable or viscous resin composite. Artificial saliva extracts were prepared according to USP-XXIII and ISO-10993 to determine cytotoxicity by testing cell viability and growth of primary human gingival fibroblasts (HGF) using MTT assay, LIVE/DEAD(®) assay and cell proliferation assay. The influence of eluates on fibres of the cytoskeleton was investigated by vimentin, tubulin and actinin immunostainings. A two-way ANOVA followed by Scheffe's post-hoc test, which included the factors FRC material and coating procedure, was performed to assess cytotoxicity.

RESULTS

All extracts of FRC materials displayed minor cytotoxic potential on HGF cell viability, cell proliferation and integrity of the cytoskeleton. The type of FRC material significantly influenced cell viability (MTT assay) (p < 0.0001), whereas neither the presence of a coating nor the type of coating material resulted in altered cell viability. Distribution and organization of cytosolic fibres was not affected after HGF exposure to eluates.

CONCLUSIONS

There is a lack of knowledge about the leaching behaviour of commonly available fully pre-impregnated FRCs and their interactions with coating materials. The coating of FRCs with resin composite materials did not impact biocompatibility.

Cytotoxicity of low-shrink composites with new monomer technology on bovine dental pulp-derived cells

Objectives:

The aim of this study was to evaluate the cytotoxicity of four low-shrink composites with new monomer technology on the bovine dental pulp-derived cells (bDPCs).

Materials and methods:

Ten samples were prepared for each group composites, and the samples were immersed in 7 mL of culture medium for 72 h at 37°C to extract residual monomer or cytotoxic substances. The culture medium containing the material extracts was sterile filtered for use on the cell cultures. Materials were incubated in medium with serum for 72 h. bDPCs were maintained in a medium with serum. A real-time cell analyzer was used to evaluate cell survival. After seeding 200 mL of the cell suspensions into the wells (10,000 cells/well) of the E-plate 96, bDPCs were treated with bioactive components released by the composite materials (1:1 and 1:2 dilutions) and monitored every 15 min for 50 h.

Results:

According to analysis of variance, there were significant differences between the cell indexes of the control and GC kalore ( p < 0.05) and Bisco Reflexions ( p < 0.001) groups for the 1:1 dilutions at 25 h. When evaluated at 50 h, 1:1 dilutions of GC Kalore ( p < 0.01) and Bisco Reflexions ( p < 0.001) reduced cell survival significantly.

Conclusions:

Although composites resins are being advanced, their cytotoxic effects have been proceeding till this time. However, two of the four materials tested significantly reduced cell viability when compared with control.

Clinical relevance:

Research should focus on the cytotoxicity of composites in addition to their mechanical properties.

Residual HEMA and TEGDMA release and cytotoxicity evaluation of resin-modified glass ionomer cement and compomers cured with different light sources

The purpose of this study was first to evaluate the elution of 2-hydroxyethyl methacrylate (HEMA) and triethylene glycol dimethacrylate (TEGDMA) monomers from resin-modified glass ionomer cement (RMGIC) and compomers cured with halogen and light-emitting diode (LED) light-curing units (LCUs). The effect of cured materials on the viability of L929 fibroblast cells was also evaluated. One RMGIC (Ketac N100) and two compomers (Dyract Extra and Twinkystar) were tested. Materials were prepared in teflon disks and light-cured with LED or halogen LCUs. The residual monomers of resin materials in solution were identified using high-performance liquid chromatography. The fibroblast cells' viability was analyzed using MTT assay. The type of LCU did not have a significant effect on the elution of HEMA and TEGDMA. A greater amount of HEMA than TEGMDA was eluted. The amount of TEGDMA eluted from Twinkystar was greater than Dyract Extra (P < 0.05) when cured with a halogen LCU. All material-LCU combinations decreased the fibroblast cells' viability more than the control group (P < 0.01), except for Dyract Extra cured with a halogen LCU (P > 0.05). Curing with the LED LCU decreased the cells' viability more than curing with the halogen LCU for compomers. For Ketac N100, the halogen LCU decreased the cells' viability more than the LED LCU.

A comparative study on root canal repair materials: a cytocompatibility assessment in L929 and MG63 cells

Cytocompatibility of repair materials plays a significant role in the success of root canal repair. We conducted a comparative study on the cytocompatibility among iRoot BP Plus, iRoot FS, ProRoot MTA, and Super-EBA in L929 cells and MG63 cells. The results revealed that iRoot FS was able to completely solidify within 1 hour. iRoot BP Plus required 7-day incubation, which was much longer than expected (2 hours), to completely set. ProRoot MTA and Super-EBA exhibited a similar setting duration of 12 hours. All the materials except Super-EBA possessed negligible in vitro cytotoxicity. iRoot FS had the best cell adhesion capacity in both L929 and MG63 cells. With rapid setting, negligible cytotoxicity, and enhanced cell adhesion capacity, iRoot FS demonstrated great potential in clinical applications. Future work should focus on longer-term in vitro cytocompatibility and an in vivo assessment.

Reproductive toxicity evaluation of the dental resin monomer triethylene glycol dimethacrylate (CASRN 109-16-0) in mice

The reproductive toxicity potential of the resin monomer triethylene glycol dimethacrylate (TEGDMA; Chemical Abstracts Service Registry Number 109-16-0) was investigated in male and female Crl:CD1(ICR) mice, 4 dosage groups, 25 mice/sex/group. Formulations of TEGDMA (0, 0.01, 0.1, or 1.0 mg/kg/d) in reverse osmosis-processed deionized water were intubated once daily beginning 28 days before cohabitation and continuing through mating (males) or through gestation day 17 (females). The following parameters were evaluated: viability, clinical signs, body weights, estrous cyclicity, necropsy observations, organ weights, sperm concentration/motility/morphology, cesarean-sectioning and litter observations, and histopathological evaluation of select tissues. No deaths or clinical signs related to TEGDMA occurred. No significant changes in male and female body weights and body weight gains were recorded for any of the administered dosages of TEGMDA. All mating and fertility parameters and all litter and fetal data were considered to be unaffected by dosages of TEGMDA as high as 1 mg/kg/d. Gross or histopathologic tissue changes attributable to the test article were not observed. Reproductive and developmental no observed adverse effect levels (NOAELs) for TEGMDA were 1.0 mg/kg/d, the highest dose tested. Comparison of conservatively estimated TEGDMA exposures from dental treatments to the NOAEL of 1.0 mg/kg/d identified in this study indicates margins of exposure of at least 120- to 3000-fold depending on the exposure scenario. The results of this study support the continued safe use of TEGDMA in polymeric dental products applied according to the manufacturers' instructions.

A comparison of the in vitro cytotoxicity of conventional and resin modified glass ionomer cements

To evaluate cytotoxicity of experimental conventional and resin modified glass-ionomer cements on UMR-106 osteoblast cell cultures and cell cultures of NIH(3)T(3) mouse fibroblasts specimens were prepared for every experimental material and divided into: group 1.Conventional glass-ionomer cements: GC Fuji IX GP Fast, GC Fuji Triage and Ketac Silver; group 2. Resin modified glass-ionomer cements: GC Fuji II LC, GC Fuji Plus and Vitrebond; group 3. Positive control was presented by specimens of composite Vit-l-ecence® and negative control-group 4. was presented by α-minimum essential medium for UMR-106 - osteoblast-like cells and Dulbecco's Modified Eagle's Medium for NIH(3)T(3) mouse fibroblast cells. Both cell cultures were exposed to 10% of eluate of each single specimen of each experimental material. Experimental dishes were incubated for 24 h. Cell metabolism was evaluated using methyltetrazolium assay. Kruskal-Wallis test and Tukey-Kramer post hoc test for the materials evaluated on NIH(3)T(3) mouse fibroblast cells, as well as UMR-106 osteoblast-like cells showed significantly more cytotoxicity of RMGICs, predominantly Vitrebond to both GICs and composite- Vit-l-ecence®.The lowest influence on cell's metabolism on UMR-106 osteoblas-like cells was shown by Ketac Silver and the lowest influence on cell's metabolism on NIH(3)T(3) mouse fibroblast cells was shown by Fuji IX GP Fast. Statistical evaluation of sensitivity of cell lines UMR-106 osteoblast-like cells and NIH(3)T(3) mouse fibroblast cells, using Mann-Whitney test, showed that NIH(3)T(3) mouse fibroblast cells were more sensitive for the evaluation of cytotoxicity of dental materials.