Effect of heat treatment on cytotoxicity of self-adhesive resin cements: Cell viability analysis

Shelf life effects on the bond strength and microhardness of self-adhesive resin cements

Background

Among the main advantages of self-adhesive resin cements comprise good aesthetics, strong restoration-tooth bond and biocompatibility. However, some disadvantages, such as high viscosity level, color limitation and short shelf life should be mentioned. Thus, the aim of the current study was to assess bond strength between fiberglass post and root dentin in teeth subjected to self-adhesive resin cements with expired shelf life and hardness.

Material and Methods

Sixty (60) single-rooted human teeth were sectioned and divided into 2 groups of different cements: U200 3M and MaxCem Elite Kerr. Each group was divided into 3 subgroups, based on self-adhesive resin cements' shelf life, namely: Within the use-time recommended by the manufacturer or no expiration date; 6 months after opening the aluminum blister; 12 months after opening the aluminum blister. Bond strength was measured through push-out test conducted in universal testing machine; fracture pattern was analyzed, and microhardness was investigated through Knoop test, based on hardness readings. Data were subjected to Shapiro-Wilk normality test; nonparametric test was applied to hardness data, whereas parametric test was applied to bond strength data. Hardness data were subjected to Kruskal-Wallis test, whereas bond strength data were subjected to analysis of variance, which was followed by Tukey test; both tests were conducted at 5% significance level (α = 0.05).

Results

There was no statistically significant difference in knoop hardness values recorded for the material / time / root thirds combination (p=0.483). There was no statistically significant difference in bond strength values recorded for the Material / Time / Thirds combination (p=0.237).

Conclusions

It was possible concluding that shelf life did not influence material's hardness and bond strength. Key words:Dental cements, Resin Cements, Shelf Life of Products.

Various ways of pre-heating a bulk-fill thermoviscous composite in restoration in non-carious cervical lesions: 12-month randomized clinical trial

OBJECTIVE

The objective of the study is to evaluate through a randomized clinical trial the best method to preheat a composite resin, if using a Caps dispenser device associated with Caps Warmer (CD) or with a VisCalor Caps dispenser/warmer (VD) for restorations in non-carious cervical lesions (NCCLs).

MATERIAL AND METHODS

One hundred and twenty restorations were distributed to two groups (n = 60) according to the pre-heating way of thermoviscous bulk-fill composite resin. For the CD group, pre-heating was carried at 68 °C using a heating bench for 3 min. For the VD group, pre-heating was performed at 68 °C using a heating gun for 30 s. After that, pre-heated bulk-fill composites were directly inserted in the NCCLs. The total working time was recorded. The restorations were evaluated after 6 and 12 months of clinical performance according to the FDI criteria. Statistical analysis was performed using the Student's t test for unpaired samples for working time, and the Chi-square test for restoration clinical performance (α = 0.05).

RESULTS

Working time was shorter for VD with a statistically significant difference compared to CD (p = 0.01). Few restorations were lost or fractured after 12 months of clinical evaluation (p > 0.05). The retention rates were 96.7% (CI 95 %: 88.6-99.1%) for CD and 98.3% (CI 95 %: 91.1-99.7%) for VD. The other FDI parameters were considered clinically acceptable.

CONCLUSIONS

The different pre-heating ways did not influence the clinical performance of thermoviscous bulk-fill composite restorations in NCCLs after 12 months.

CLINICAL RELEVANCE

Regardless of the bulk-fill thermoviscous composite resin pre-heating ways, the restorations are clinically acceptable after 12 months.

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.

Comparative chemical properties, bioactivity, and cytotoxicity of resin-modified calcium silicate-based pulp capping materials on human dental pulp stem cells

OBJECTIVES

This study investigated the cytotoxicity, the residual monomer release, degree of conversion (DC), calcium ion (Ca²⁺) release, and crystal structure of TheraCal PT (ThPT) by comparison with TheraCal LC (ThLC) and mineral trioxide aggregate (MTA).

MATERIALS AND METHODS

The cytotoxicity of the cured materials was evaluated on human dental pulp stem cells (hDPSCs) isolated from third molars by the water-soluble tetrazolium salt (WST-1) method. The monomer release and DC of the resin-containing materials were analyzed by high-performance liquid chromatography (HPLC) and Fourier transform infrared (FTIR), respectively. The chemical composition and Ca²⁺ release of the materials were determined by scanning electronic microscopy-energy-dispersive spectroscopy (SEM-EDS), X-ray diffractometry (XRD), and inductively coupled plasma-optical emission spectroscopy (ICP-OES), respectively. Statistical differences were evaluated with one-way ANOVA, repeated measure ANOVA, and the Tukey test (p < 0.05).

RESULTS

MTA showed significantly lower cytotoxicity than either ThLC or ThPT after 1, 3, and 7 days (p < 0.05). TEGDMA release of ThPT is significantly higher than ThLC (p < 0.05). All materials showed calcium Ca²⁺ release, with MTA significantly higher than the others (p < 0.05).

CONCLUSIONS

MTA showed low cytotoxicity and high Ca²⁺ release compared to ThLC and ThPT.

CLINICAL RELEVANCE

The cytotoxicity and residual monomer release of ThLC and ThPT may raise concerns about the viability of hDPSCs. Further investigations with the use of in vivo research models are required to validate in vitro bioactivity properties and the potential adverse biological effects of ThLC and ThPT on hDPSCs.

Cytotoxicity assessment of Bio-C Repair Íon+: A new calcium silicate-based cement

Background. Direct pulp capping is a method designed to preserve the exposed dental pulp. Due to good biological, physical, and mechanical properties, new versions of calcium silicate-based materials have been developed as pulp capping materials. The present study aimed to evaluate the cytotoxic effects of four calcium silicate-based pulp capping materials, of which the Bio-C Repair Íon+ is still in an experimental phase.

Methods. Biodentine, MTA Repair HP, Bio-C Repair, and Bio-C Repair Íon+ cements were dispensed in a metallic matrix to produce 125-mm³ specimens, which were immersed in Dulbecco’s Modified Eagle Medium (DMEM) to obtain extracts. NIH 3T3 cells were cultured and exposed to the extracts for 24 hours and seven days. Cell viability was assessed by the methyl tetrazolium test (MTT). The mean values for the experimental and control groups (without treatment) were compared by analysis of variance (ANOVA) and post hoc Tukey tests, considering a significance level of 5%.

Results. All the tested materials demonstrated a reduction in cell viability (P < 0.05). According to ISO 10993-5: 2009 (E), Bio-C Repair Íon+ exhibited mild and moderate cytotoxicity in the 24- hour and 7-day analyses, respectively. Bio-C Repair and Biodentine showed mild cytotoxicity, and MTA Repair HP exhibited moderate cytotoxicity at both intervals.

Conclusion. The highest cell viability was demonstrated by Biodentine, MTA, and Repair HP, in descending order. Bio-C Repair and Bio-C Repair Íon+ showed moderate cytotoxicity, similar to MTA Repair HP in the 7-day analysis.

Effect of Time and Temperature of Air Jet on the Mechanical and Biological Behavior of a Universal Adhesive System

OBJECTIVES

To evaluate the influence of heat application on the degree of conversion (DC) of the 3M Single Bond Universal Adhesive System, as well as its transdentinal cytotoxicity and microtensile bond strength to dentin.

METHODS

Experimental groups were established according to the time and temperature of the air jet: G1: 5 seconds-25°C; G2: 10 seconds-25°C; G3: 20 seconds-25°C; G4: 5 seconds-50°C; G5: 10 seconds-50°C; G6: 20 seconds-50°C. In control group (G7), no treatment was performed. The DC was assessed using the Fourier transform infrared spectroscopy-attenuated total reflectance (FTIR-ATR) technique. For the transdentinal cytotoxicity test, dentin discs fitted in artificial pulp chambers (APC) received the application of the adhesive system and the air jets. For the microtensile bond strength, healthy molars were restored and submitted to the microtensile test after 24 hours and 6 months, respectively.

RESULTS

Significant reduction in viability of Mouse Dental Papilla Cell-23 (MDPC-23), which exhibited morphological changes, was observed in all experimental groups compared to control (p<0.05). Although all tested protocols resulted in transdentinal diffusion of 2-hydroxyethyl methacrylate (HEMA), the group G6 presented the highest degree of monomeric conversion and the lowest cytotoxic effect, with higher dentin bond strength values in comparison to group G1 (p<0.05).

CONCLUSIONS

Applying an air blast at 50°C for 20 seconds increases the DC and microtensile bond strength of the 3M Single Bond Universal Adhesive System to dentin, as well as reduces the transdentinal cytotoxicity of the material to pulp cells.

Effect of heat treatment on cytotoxicity and polymerization of universal adhesives

To assess, in vitro, the influence of heat air treatment on cytotoxicity and degree of conversion (DC) of universal self-etch adhesives (Ambar Universal APS, Scotchbond Universal Adhesive, and Tetric N-Bond Universal) in an NIH/3T3 fibroblast cell culture. Samples were divided into three groups: 1) no heat treatment (control), 2) 37°C and 3) 60°C heat treatment before photopolymerization. Cytotoxicity was analyzed by MTT assay and the DC by FTIR. All adhesives heated at 60°C showed reduced cytotoxicity levels when compared with those heated at 37°C. In general, DC of Ambar Universal APS presented the highest DC than Scotchbond Universal Adhesive and Tetric N-Bond Universal, and the hot air treatment do not influence the conversion. Heat treatment at 60°C was able to reduce the cytotoxicity of universal self-etch adhesives, even, the heat treatment does not enhances the DC.

Cytotoxic effects of different self-adhesive resin cements: Cell viability and induction of apoptosis

PURPOSE

The effects of four different self-adhesive resin cement materials on cell viability and apoptosis after direct and indirect exposure were evaluated using different cell culture techniques.

MATERIALS AND METHODS

Self-adhesive cements were applied to NIH/3T3 mouse fibroblasts by the extract test method, cell culture inserts, and dentin barrier test method. After exposure periods of 24 h and 72 h, the cytotoxicity of these self-adhesive materials was evaluated using the MTT assay (viability) and the Annexin-V-FITC/PI staining (apoptosis).

RESULTS

The lowest cell viability was found in cells exposed to BeautiCem SA for 24 h in the extract test method. Cell viability was reduced to 70.6% compared to negative controls. After the 72 h exposure period, viability rate of cell cultures exposed to BeautiCem SA decreased more than 2- fold (29.5%) while cells exposed to RelyX U200 showed the highest viability rate of 71.4%. In the dentin barrier test method, BeautiCem SA induced the highest number of cells in apoptosis after a 24 h exposure (4.1%). Panavia SA Cement Plus was the material that caused the lowest number of cells in apoptosis (1.5%).

CONCLUSION

The used self-adhesive cements have showed different cytotoxic effects based on the evaluation method. As exposure time increased, the materials showed more cytotoxic and apoptotic effects. BeautiCem SA caused significantly more severe cytotoxic and apoptotic effects than other cements tested. Moreover, cements other than BeautiCem SA have caused necrotic cell death rather than apoptotic cell death.

Hot air stream reduces cytotoxicity of light-cured calcium hydroxide based cements

Background

The light-cured calcium hydroxide based cements have incomplete polymerization and unconverted monomers can cause pulp cell damage. The aim of this study was to evaluate the influence of a warm and hot air stream on the cytotoxicity of light-cured calcium hydroxide based cements.

Material and Methods

The materials Dycal (conventional cement), Biocal, Hidrox-Cal, and Ultra-Blend Plus (light-cured calcium hydroxide cements) were submitted to cytotoxicity analysis after polymerization, without vs. with previous heat treatment with a warm (37°C) and a hot (60°C) air stream. Following polymerization, cements were maintained in culture medium for 24 hours and 7 days, and subjected to the MTT test. Data were analyzed using analysis of variance (ANOVA) followed by post-hoc Student-Newman-Keuls (<0.05).

Results

The results indicated significant differences between the materials according to their composition, i.e., light-cured cements treated with a jet of warm air showed similar cytotoxicity levels to those observed for conventional cement, suggesting that they may be considered alternatives in cases requiring pulp-capping treatment.

Conclusions

Application of a hot air stream reduced cytotoxicity of materials tested.

Key words:Dental pulp capping, dental cements, calcium hydroxide, cell survival.

Effect of various polymerization protocols on the cytotoxicity of conventional and self-adhesive resin-based luting cements

OBJECTIVES

This study evaluated the cytotoxicity of resin-based luting cements on fibroblast cells using different polymerization protocols.

MATERIALS AND METHODS

Two conventional dual-polymerized (RelyX ARC, VariolinkN) and two self-adhesive resin cements (RelyX Unicem, Multilink Speed) specimens were polymerized using four different polymerization protocols: (a) photo-polymerization with direct light application, (b) photo-polymerization over ceramic and (c) resin nano-ceramic discs and (d) auto-polymerization. The specimens were then assigned to four groups to test cytotoxicity at 0, 1, 2 and 7 preincubation days (n = 5). MTT test was performed using NIH/3T3 fibroblast cells. Data were analysed using three- and one-way ANOVA. Multiple comparisons were made using Bonferroni post hoc test (p < 0.05).

RESULTS

The highest cytotoxic values were recorded at day 2 for conventional resin cements and at day 0 for self-adhesive resin cements. Self-adhesive resin cements showed the most cytotoxic effect at the second day, while conventional resin cements presented immediate cytotoxicity. Auto-polymerized resin specimens and especially Multilink Speed demonstrated the most cytotoxic effect regardless of the preincubation time. Cytotoxicity of cements tested reached the lowest level at day 7. Interposition of ceramic or nano-ceramic restorative material did not significantly affect the cytotoxicity of tested luting cements (p > 0.05).

CONCLUSIONS

Cytotoxicity of dual-polymerized resin cements was material-dependent and decreased gradually up to 7 days. Photo-polymerization plays an important role in reducing the cytotoxic effects.

CLINICAL RELEVANCE

When luting ceramic or resin nano-ceramic restorations of which thickness does not exceed 2 mm, the level of cytotoxicity with the tested materials is not significant. Luting of restorative materials that do not allow for light transmission such as metal-fused porcelain, clinicians should be cautious in the use of dual-polymerized conventional resin cements as only auto-polymerization of resin cements takes place under such materials.