Qualitative and Quantitative Evaluation of Cytotoxicity of Five Different One-Step Self-Etching Adhesives

PURPOSE

To qualitatively and quantitatively compare the cytotoxic potentials of five different one-step self-etching adhesives: Prime&Bond One-Select (PB-OS), Optibond All-in-One (OB-AIO), G-Bond (GB), Clearfil Universal Bond (CUB), Single Bond Universal (SBU).

MATERIALS AND METHODS

During the first stage of the study, the cytotoxic activities of the test materials were evaluated qualitatively using the direct contact method. In this method, the test materials were placed directly into a monkey kidney epithelial cell culture medium. Reaction zones which occurred in the culture medium were evaluated, in addition to the density and changes in the morphology of the cells. During the second stage, the cytotoxic potential of four different dilutions (1%, 0.1%, 0.01%, 0.001%) of the test materials on L929 rat fibroblast cells was quantitatively evaluated at three different time periods (24 h, 48 h, 72 h) with the MTT tetrazolium-based assay.

RESULTS

In the first stage, a zone exceeding 1 cm was observed around or below SBU, CUB, GB and OB-AIO. In PB-OS, the zone borders were approximately 1 cm. In the second stage after the MTT assay, CUB was the most cytotoxic after 24 h, GB and SBU after 48 h, and OB-AIO after 72 h.

CONCLUSION

All adhesives tested showed different degrees of cytotoxicity, which statistically significantly increased with dose. Changes were seen related to time.

Preparation and Characterization of Novel Dental Material with High Shear Bond Strength

HPMA (hydroxypropyl methacrylate) and Bis-GMA (bisphenol A glycerolate dimethacrylate), the main ingredients, and styrene, TEGDMA (triethylene glycol dimethacrylate), BPO (benzoyl peroxide) and camphoroquinone, the photo-initiators, and BHT (butylated hydroxytoluene), the photocatalyst were mixed by different ratios and stirred to investigate the compatibility of dental materials with photoinitiators. The degree of polymerization was checked and determination of the most ideal ratio for photopolymerization was followed by establishing the basic combination of styrene, HPMA, Bis-GMA, BHT, TEGDMA and HEMA. The mixture made in accordance to the predetermined ratio was stirred for 24 hours and was polymerized at a wavelength of 440 to 480 nm for 40 secs. The physical properties of each combination were also evaluated to analyze the functionality of the prepared resin cement. And also, the cytotoxicity of the samples was tested, and as a result, the cell lysis rate was 0% in negative control and 100% in positive control and 0% in S-1 combination which indicates that it does not possess cytotoxicity against cultured cells. It is considered suitable for commercializing and will be highly applicable as high quality dental resin cement.

Biological Effects of Provisional Resin Materials on Human Dental Pulp Stem Cells

OBJECTIVES

This study investigated the in vitro cytotoxicity as well as the proinflammatory cytokine expression of provisional resin materials on primary cultured human dental pulp stem cells (hDPSCs).

METHODS

Five commercially available provisional resin materials were chosen (SNAP [SN], Luxatemp [LT], Jet [JE], Revotek LC [RL], and Vipi block [VB]). Eluates that were either polymerizing or already set were added to hDPSCs under serially diluted conditions divided into three different setting times (25% set, 50% set, and 100% set) and incubated for 24 hours with 2× concentrated culture media. Cell cytotoxicity tests were performed by LDH assay and live and dead confocal microscope images. The expression of proinflammatory cytokines in SN and VB was measured using cytokine antibody arrays. Data were analyzed using repeated measures analysis of variance (ANOVA) or ANOVA followed by the Tukey post hoc test at a significance level of p<0.05.

RESULTS

Cytotoxicity greater than 30% was observed in the 50% diluted culture in SN, LT, and JE in the already set stage (p<0.05), while it was detected in SN and LT in early or intermediate stage samples. The cytotoxicity of SN, JE, and LT was greater with eluates from the polymerizing phase compared to that from already set samples (p<0.05), as observed by live and dead images. On the other hand, RL and VB did not exhibit cytotoxicity greater than 30%. Proinflammatory cytokines were not detected in 12.5% diluted culture with eluates from VB and early set stage SN.

CONCLUSIONS

The eluates from chemical-activated provisional resin materials during polymerization (SN, LT, and JE) were cytotoxic to hDPSCs and may adversely affect pulp tissue.

Cytotoxic Effects of One-step Self-etching Dental Adhesives on Human Periodontal Ligament Fibroblasts In Vitro

PURPOSE

To evaluate the potential cytotoxic effects of four one-step self-etching dental adhesives [Adper Easy One (AEO), iBond (IB), Clearfil S³ Bond (CSB), and G-Bond (GB)] on cultured human periodontal ligament fibroblasts.

MATERIALS AND METHODS

Cured adhesives were immersed in complete DMEM or deionized water and maintained at 37°C for 24 h, followed by sterilization. The deionized water-based extract was used for Fourier transform infrared spectroscopy analysis. The DMEM-based extract was diluted into various concentrations for cytotoxicity tests. The viability, integrity, and apoptosis of cultured human periodontal ligament fibroblasts upon treatment with the extracts were determined using the CCK-8 assay, microscopy, and flow cytometry.

RESULTS

All of the four adhesives induced cell viability loss, cell morphology alteration, and cell death. GB showed the greatest cytotoxicity by inducing cell apoptosis and necrosis, while IB had the weakest cytotoxic effect on the cultured cells.

CONCLUSION

All tested dental adhesives have significant adverse effects on cell viability. Therefore, precautions should be taken to protect the periodontal tissues when dental adhesives are applied in the clinic.

Bis-GMA affects craniofacial development in zebrafish embryos (Danio rerio)

Estrogen is a steroid hormone that is vital in vertebrate development and plays a role in a variety of developmental processes including cartilage and craniofacial formation. The effects of estrogen can be mimicked by other compounds found in the environment known as xenoestrogens. Bisphenol-A (BPA) is a known xenoestrogen and is combined with glycidyl methacrylate to make Bisphenol A glycidyl methacrylate (Bis-GMA), a major component in dental resin based composites (RBCs). Bis-GMA based RBCs can release their components into the saliva and bloodstream. Exposure to 1μM and 10μM Bis-GMA in Danio rerio embryos results in increased mortality of approximately 30% and 45% respectively. Changes to gross morphology, specifically craniofacial abnormalities, were seen at concentrations as low as 10nM. While the molecular pathways of Bis-GMA effects have not been studied extensively, more is known about one of the components, BPA. Further research of Bis-GMA could lead to a better understanding of xenoestrogenic activity resulting in improved public and environmental health.

BisGMA-induced cytotoxicity and genotoxicity in macrophages are attenuated by wogonin via reduction of intrinsic caspase pathway activation

Bisphenol-A-glycidyldimethacrylate (BisGMA) is a frequently used monomer in dental restorative resins. However, BisGMA could leach from dental restorative resins after polymerization leading to inflammation in the peripheral environment. Wogonin, a natural flavone derivative, has several benefits, such as antioxidative, anti-inflammatory and neuroprotective properties. Pretreatment of macrophage RAW264.7 cells with wogonin inhibited cytotoxicity which is induced by BisGMA in a concentration-dependent manner. BisGMA induced apoptotic responses, such as redistribution of phosphatidylserine from the internal to the external membrane and DNA fragmentation, were decreased by wogonin in a concentration-dependent manner. In addition, BisGMA-induced genotoxicity, which detected by cytokinesis-blocked micronucleus and single-cell gel electrophoresis assays, were inhibited by wogonin in a concentration-dependent manner. Furthermore, wogonin suppressed BisGMA-induced activation of intrinsic caspase pathways, such as caspases-3 and -8. Parallel trends were observed in inhibition of caspase-3 and -8 activities, apoptosis, and genotoxicity. These results indicate wogonin suppressed the BisGMA-induced apoptosis and genotoxicity mainly via intrinsic caspase pathway in macrophages.

Cytotoxicity of resin composites containing bioactive glass fillers

OBJECTIVE

To determine the in vitro cytotoxicity of dental composites containing bioactive glass fillers.

METHODS

Dental composites (50:50 Bis-GMA/TEGDMA resin: 72.5wt% filler, 67.5%Sr-glass and 5% OX50) containing different concentrations (0, 5, 10 and 15wt%) of two sol-gel bioactive glasses, BAG65 (65mole% SiO2, 31mole% CaO, 4mole% P2O5) and BAG61 (3mole% F added) were evaluated for cytotoxicity using Alamar Blue assay. First, composite extracts were obtained from 7 day incubations of composites in cell culture medium at 37°C. Undifferentiated pulp cells (OD-21) were exposed to dilutions of the original extracts for 3, 5, and 7 days. Then freshly cured composite disks were incubated with OD-21 cells (n=5) for 2 days. Subsequently, fresh composite disks were incubated in culture medium at 37°C for 7 days, and then the extracted disks were incubated with OD-21 cells for 2 days. Finally, fresh composites disks were light cured for 3, 5, and 20s and incubated with OD-21 cells (n=5) for 1, 3, 5, and 7 days. To verify that the three different curing modes produced different levels of degree of conversion (DC), the DC of each composite was determined by FTIR. Groups (n=5) were compared with ANOVA/Tukey's (α≤0.05).

RESULTS

Extracts from all composites significantly reduced cell viability until a dilution of 1:8 or lower, where the extract became equal to the control. All freshly-cured composites showed significantly reduced cell viability at two days. However, no reduction in cell viability was observed for any composite that had been previously soaked in media before exposure to the cells. Composites with reduced DC (3s vs. 20s cure), as verified by FTIR, showed significantly reduced cell viability.

SIGNIFICANCE

The results show that the composites, independent of composition, had equivalent potency in terms of reducing the viability of the cells in culture. Soaking the composites for 7 days before exposing them to the cells suggested that the "toxic" components had been extracted and the materials were no longer cytotoxic. The results demonstrate that the cytotoxicity of composites with and without BAG must predominantly be attributed to the release of residual monomers, and not to the presence of the BAG.

In vitro detection of DNA damage in human leukocytes induced by combined effect of resin composites and adhesive systems

PURPOSE

To simultaneously evaluate the genotoxicity of dental composites and adhesive systems in vitro using a cytogenetic assay, with respect to the influence of composite shade.

METHODS

Genotoxicity assessment was carried out in human peripheral blood leukocytes using the comet assay. Three resin composite materials, two microhybrids and one nano-hybrid, in shade A1 and A3.5 were used with manufacturer-recommended four adhesive systems. Cultures were treated for 48 hours with samples after elusion for 1 hour, 1 day, 7 days or 30 days, in two different concentrations (4.16 mg/mL, 8.33 mg/mL). Kruskall-Wallis test was used for the statistical analysis (alpha = 0.05).

RESULTS

For combinations of micro-hybrid composite (A3.5) with two self-etch adhesives (16.1 +/- 5.50 and 16.2 +/- 9.52) after exposure to samples eluted for 1 day, the incidence of primary DNA damage was significantly higher than for the corresponding negative control (14.7 +/- 2.85). Genotoxicity was also higher after treatment with samples eluted for 1 hour (15.3 +/- 4.70) and 1 day (15.3 +/- 9.10), comprised of nano-hybrid composite (A1) with self-etch adhesive in relation to the control (13.1 +/- 1.70). There was no clear trend of increased DNA damage in material combinations with darker shades of composites. Material composition and higher material concentrations showed greater influence on the genotoxicity.

Influence of different photo-activation distances on cytotoxicity of a dental adhesive model resin

AIM

This study evaluated the cytotoxicity of a dental bonding model resin (DBMR) submitted to different photo-activation distances.

METHODS

A monomer mixture based on Bis-GMA and HEMA was used to assess the cytotoxicity in a mouse fibroblast-cell line. To promote different photo-activation distances glass slides were interposed between DBMR surface and halogen light curing unit (LCU) tip. Afterwards, the specimens were immersed in RPMI culture medium for 24 h to obtain extracts. The extracts were incubated in contact with the cells for 24 h. Finally, an MTT colorimetric assay was used to assess the cytotoxicity. The cell viability data (absorbance) were analyzed by one way ANOVA followed by Tukey's test (P<0.05).

RESULTS

The light output decreased according to the increase in the number of glass slides between the halogen LCU tip and DBMR surface. Yet, the distance between the tip of the curing light system and the specimens had significant influence on the cytotoxicity. All extracts produced by groups submitted to different photo-activation distances showed cytotoxic effect after 24h of incubation.

CONCLUSION

The photo-activation distance and the interposition of glass slides between LCU tip and DBMR was shown to play an important role in the cytotoxic effect.

Current status of potential bisphenol toxicity in dentistry

Bisphenols are chemical components found in dental composites and sealants. Similar compounds also can be found in baby bottles, food can liners, and even drinking water. Bisphenols have gained attention recently because they, like other natural and synthetic compounds, including hormone-based drugs and soybean products, have the capacity to mimic the actions of the hormone estrogen in living cells and animals. Such estrogenic activity has been linked to a variety of health problems, including breast and prostate cancer, metabolic disorders, and reproductive dysfunction. In early 2010, the FDA issued a report stating that there are some concerns about the safety of bisphenols in food products and called for more research on bisphenol toxicity. At present, no regulatory or professional organization has expressed concern about health effects of bisphenols in dental materials.

Oxidative stress and cytotoxicity generated by dental composites in human pulp cells

Dental composites are a source of residual monomers that are released into the oral environment. Since monomers act on cultured cells through reactive oxygen species (ROS), we hypothesized that composites generate ROS associated with cytotoxicity. Human pulp-derived cells were exposed to extracts of methacrylate-based materials including triethylene glycol dimethacrylate and 2-hydroxyethyl methacrylate-free composites (Tetric Ceram, Tetric EvoCeram, els, els flow, Solitaire 2) and a silorane-based composite (Hermes III). The materials were polymerized in the presence and absence of a polyester film and then extracted in culture medium. The generation of ROS was measured by flow cytometry, and cytotoxicity was determined as well. Methacrylate-based composites reduced cell survival but varied in efficiency. Undiluted extracts of Solitaire 2 specimens prepared in the absence of a polyester film reduced cell survival to 26% compared with untreated cultures. Cytotoxicity was reduced when specimens were covered with a polyester film during preparation. Cytotoxicity of the composites was ranked as follows: Solitaire 2 >> els flow > Tetric Ceram = Tetric EvoCeram = els > Hermes III. The generation of ROS followed the same pattern as detected with cytotoxic effects. A positive correlation was found between ROS production and cell survival caused by extracts made from materials not covered with a polyester film. These findings suggest that components released from composites affect cellular signaling networks through ROS formation. Regenerative and reparative capacities of the dentine-pulp complex may be impaired by biologically active resin monomers released from composite restorations.

Bisphenol A-glycidyl methacrylate induces a broad spectrum of DNA damage in human lymphocytes

Bisphenol A-glycidyl methacrylate (BisGMA) is monomer of dental filling composites, which can be released from these materials and cause adverse biologic effects in human cells. In the present work, we investigated genotoxic effect of BisGMA on human lymphocytes and human acute lymphoblastic leukemia cell line (CCRF-CEM) cells. Our results indicate that BisGMA is genotoxic for human lymphocytes. The compound induced DNA damage evaluated by the alkaline, neutral, and pH 12.1 version of the comet assay. This damage included oxidative modifications of the DNA bases, as checked by DNA repair enzymes EndoIII and Fpg, alkali-labile sites and DNA double-strand breaks. BisGMA induced DNA-strand breaks in the isolated plasmid. Lymphocytes incubated with BisGMA at 1 mM were able to remove about 50% of DNA damage during 120-min repair incubation. The monomer at 1 mM evoked a delay of the cell cycle in the S phase in CCRF-CEM cells. The experiment with spin trap—DMPO demonstrated that BisGMA induced reactive oxygen species, which were able to damage DNA. BisGMA is able to induce a broad spectrum of DNA damage including severe DNA double-strand breaks, which can be responsible for a delay of the cell cycle in the S phase.

Effect of dual-cured adhesive resin cements on cell proliferation of pulp and human fibroblasts

PURPOSE

To comparatively evaluate the effects of three dual activated adhesive resin cements on cell proliferation of rat pulp cells (RPC-C2A) and human lung fibroblasts (MRC5).

METHODS

The cements tested were RelyX ARC, RelyX Unicem and Panavia F. The cements were prepared according to manufacturers' instructions and placed in contact with the cells. Cell survival was estimated by the sulphorhodamine-B staining assay after 24 and 72 hours and cellular changes in morphology were examined under microscope.

RESULTS

All resin cements decreased cell proliferation. The decrease observed was material- and time-dependent. Panavia F was found more potent in decreasing cell proliferation. Differences were found in the effect on cell proliferation among the materials tested, that might be associated to their clinical behavior.

Is there a risk of harm or toxicity in the placement of pit and fissure sealant materials? A systematic review

BACKGROUND

Recently, there has been increased interest in the in vivo release of dental sealant components, such as bisphenol A (BPA), which has the potential to bind the estrogen receptors of relevant cells at subtoxic concentrations in vitro, impairing the development, health and reproductive systems of wildlife. The purpose of this systematic review was to investigate whether the placement of pit and fissure sealant materials causes toxicity, and thus harms patients.

METHODS

The literature search (from the earliest record up to March 2007) for relevant articles was done with Ovid MEDLINE, CINAHL and other bibliographic databases.

RESULTS

A total of 377 articles were identified by the literature search; relevance was determined by examining the title and abstract of the articles. Eleven original studies met the inclusion criteria. These articles were read in full and scored independently by 2 reviewers.

RECOMMENDATIONS

The evidence suggests that patients are not at risk for exposure to BPA from the use of dental sealants. To reduce the potential, if any, for BPA toxicity from sealants, dental providers should use a mild abrasive, such as pumice, either on a cotton applicator or in a prophy cup; have older children and adolescents gargle with tepid water for 30 seconds; or wash the sealant surface for 30 seconds with an air-water syringe while suctioning fluids and debris from a child"s mouth.

[Biocompatibility study of some adhesive systems for tooth pulp indirect and direct capping]

Microcolorimetric method was used for study of toxic and antiproliferous properties of 3 adhesive systems acting by adhesive upon fibroblast cell culture. It was established that I Bond adhesive system was most biocompatible and that it can be used for direct and indirect capping of injured tooth pulp.

Cytotoxicity of resin monomers on human gingival fibroblasts and HaCaT keratinocytes

OBJECTIVES

The aim of this study was to evaluate and compare the biological effects of three resin monomers on three human gingival fibroblast (HGF) cell lines and immortalised human keratinocytes.

METHODS

Primary HGFs and HaCaT keratinocytes were cultured for 24h and grown to sub-confluent monolayers. Resin monomers were dissolved in dimethyl sulphoxide (DMSO) and diluted with culture medium. Cultures were exposed to different concentrations of monomers (10(-2) to 10mM) for 24h. Cell viability measured by Alamar Blue assay, and cell culture supernatant was examined for the presence of human interlukin-1beta (IL-1beta) using sandwich enzyme-linked immunosorbant assay (ELISA). TC50 values were calculated from fitted dose-response curves.

RESULTS

All monomers showed toxic effects on the HGFs and HaCaT cells and inhibited chemical reduction of Alamar Blue in high concentrations. Statistical analysis of TC50 values by one-way ANOVA followed by Tukey's analysis showed that there is a significant difference in TC50 values between the cell lines (p<0.05), although the rank order of monomer toxicity remained the same for different cell lines. None of these monomers-induced IL-1beta release from HGFs and HaCaT cells.

SIGNIFICANCE

Dental resin monomers are toxic to human gingival fibroblasts and HaCaT keratinocytes. However, they cannot induce IL-1beta release from these cells by themselves. Alamar Blue assay is a sensitive method for the evaluation of cytotoxicity and it can detect different sensitivities of different cell lines to the resin monomers.

In vivo evaluation of the biocompatibility of three current bonding agents

The aim of this in vivo study was to evaluate the biocompatibility of three current bonding agents and calcium hydroxide cement. Sixty polyethylene tubes filled with the following materials: Group 1: Prime & Bond NT (PB-Dentsply, US; Group 2: Bond 1 (BO-Jeneric/Pentron, US); Group 3: Optibond Solo (OP-Kerr, US); and Group 4 (control): calcium hydroxide cement - Dycal (CH-Dentsply, US) were implanted into the connective tissue of 30 rats. After 15, 30 and 60 days, the implants were excised and the animals sacrificed. The biopsies were immersed in Karnovsky (pH, 7.2) fixative solution for 48 hours, and processed using routine histological technique. Six-micron-thick sections were cut and stained with hematoxilin and eosin and Masson's trichome technique. Microscopic evaluation was used to compare the connective tissue reactions caused by the experimental and control materials adjacent to the tube opening. At 15 days, the experimental and control materials triggered a moderate to intense inflammatory response which gave rise to a thick capsule adjacent to the tube opening. With time, the inflammatory reaction decreased. At 60 days, the connective tissue adjacent to the bonding agents exhibited a persistent inflammatory response mediated by macrophages and giant cells which were engulfing displaced resin components. On the other hand, for the control group (calcium hydroxide) no inflammatory response associated with a thin capsule adjacent to the material was observed even at the 30-day period. The hard-setting calcium hydroxide cement allowed complete healing and was considered more biocompatible than the bonding agents.

Adhesive resin and the hydrophilic monomer HEMA induce VEGF expression on dental pulp cells and macrophages

Vascular endothelial growth factor (VEGF) plays an important role in angiogenesis by inducing endothelial cell proliferation, migration and survival. Direct pulp capping with an adhesive resin system was shown to induce local increase in blood vessel density and lack of dentin bridging. However, the mechanisms involved in the increase in blood vessel density observed near the pulp exposures capped with an adhesive resin are largely unknown. OBJECTIVES.: To investigate the effect of an adhesive resin or one of its hydrophilic monomers (HEMA), in the expression of VEGF by pulp cells. METHODS.: Mouse odontoblast-like cells (MDPC-23), undifferentiated pulp cells (OD-21), gingival fibroblasts, and macrophages were exposed to SingleBond (3M) or to 0-1000nM HEMA. VEGF expression was evaluated by ELISA and semi-quantitative RT-PCR. RESULTS AND SIGNIFICANCE.: VEGF expression was upregulated in MDPC-23 cells exposed to HEMA (p<0.001) or to SingleBond (p<0.018), and in macrophages exposed to HEMA (p<0.001) or SingleBond (p=0.001). In contrast, VEGF expression remained unchanged in undifferentiated pulp cells (OD-21), or fibroblasts exposed to either HEMA or Single Bond (p>0.05). Treatment with SingleBond or HEMA did not affect VEGF expression at the mRNA level of any cell type evaluated here, suggesting that the induction of VEGF expression in these cells is regulated primarily at the post-transcriptional level. These findings suggest that VEGF is involved in the regulation of pulp neovascularization observed in response to the application of adhesive resins at site of pulp exposure.

In vitro cytotoxicity of a remineralizing resin-based calcium phosphate cement

Recently, a resin-based calcium phosphate cement (RCPC) has been reported as a remineralizing pulp-capping or lining cement. RCPC consists mainly of tetracalcium and dicalcium phosphates, ethoxylated bisphenol A dimethacrylate and pyromellitic glycerol dimethacrylate monomers and photo- and chemical initiators.

OBJECTIVES

Here, the cytotoxic effects of RCPC were evaluated. The hypothesis was that RCPC induced only minor cytotoxic response in immortalized murine odontoblast and pulp cells, comparable to that produced by similar dimethacrylates due to unpolymerized dimethacrylate monomer present after curing.

METHODS

Cytotoxicity was determined following the changes in cell succinate dehydrogenase activity after 24 h exposure to the cement components and after a 24 h recovery period. A fourfold range of concentrations was tested of the monomers, the eluate of cured RCPC leached in Dulbecco's modified Eagle's medium, and crushed cured cement in dimethyl sulfoxide.

RESULTS

The monomers themselves had cytotoxicities similar to those reported for other dimethacrylates, although they are significantly less toxic than Bis-GMA. Differential cell sensitivity was demonstrated, with the pulp cells having greater sensitivity to the unpolymerized monomer than the odontoblast-like cells. The leached components have cytotoxicity similar to that of the free monomers. The crushed material demonstrated no apparent cytotoxicity at the dilutions tested.

SIGNIFICANCE

These data demonstrate that RCPC has an in vitro cytotoxicity that is comparable to other materials containing dimethacrylate monomers and suggest that the material may be suitable for use in dental restorations. The data also indicate that the pulp cells appear more sensitive to dimethacrylates than the odontoblasts.

Cytotoxicity of substances leached or dissolved from pulp capping materials

AIM

To evaluate the cytotoxic effects of substances leached or dissolved from pulp capping materials on human pulp fibroblasts.

METHODOLOGY

The substances were applied to cell cultures in conditioned media. The experimental groups were: GI (control; n = 24)--cultures treated with fresh medium; GII (n = 24)--cultures treated with calcium hydroxide cement; GIII (n = 24)--cultures treated with adhesive resin and GIV (n = 24)--cultures treated with 37% orthophosphoric acid. The media were conditioned by placing the crude materials in contact with fresh culture medium for 1 h. The cytotoxicity analysis was performed using the Trypan blue dye exclusion assay at times of 0, 6, 12 and 24 h for cell viability assay, and at 1, 3, 5 and 7 days for survival assay. Data were treated by anova (P < 0.05) and Tukey's test (P < 0.05).

RESULTS

GI and II presented similar cell viability and cell growth. GIII and IV exhibited statistically significant lower percentages of cell viability: GIV only at the 0 h experimental time, whereas in GIII this viability markedly diminished reaching values of 10% by 12 h. Cell growth was impaired only in cultures of GIII.

CONCLUSIONS

Substances dissolved from the adhesive system tested were cytotoxic for human dental pulp fibroblasts in culture, whilst substances leached from calcium hydroxide were biocompatible.

Vasorelaxant effect of resin-based, single-bottle dentin bonding systems

Single-bottle dentin bonding systems are currently in wide use. Because these materials are sometimes inadvertently placed on microscopic pulp exposures while at other times deliberately on frank exposures, their effects on pulpal soft tissues need to be evaluated. The present study assessed the vascular effects of 3M Single Bond (3MSB) and Prime & Bond NT (PBNT), using rat aortic ring preparations. It is hypothesized that these bonding agents induce relaxation of these preparations. Both 3MSB and PBNT caused endothelium-dependent and -independent relaxations in a concentration-dependent manner. The endothelium-dependent relaxation was associated with the release of nitric oxide. However, the responses to both agents did not involve the generation of prostanoids or KATP channel activation. At relatively low concentrations, the responses of endothelium-denuded tissues to 3MSB were greater than those to PBNT, indicating certain differences in the vascular action between these products. The data suggest that 3MSB and PBNT interfere with vascular function by causing vasorelaxation via mechanisms occurring in the smooth muscle and endothelium, including the release of nitric oxide. Among others, this effect may promote bleeding if these adhesives are placed on pulp exposures.

In vitro embryotoxicity assessment with dental restorative materials

OBJECTIVES

Resin (co)monomers may be released from restorative dental materials and can diffuse into the tooth pulp or the gingiva, and can reach the saliva and the circulating blood. Genotoxic potential of some dental composite components has been clearly documented. The genotoxic effects of xenobiotics can represent a possible step in tumor initiation and/or embryotoxicity/teratogenesis. A modified fluorescent mouse embryonic stem cell test (R.E.Tox) was used to test the embryotoxic potential of following dental restorative materials: Bisphenol A glycidylmethacrylate (BisGMA), urethanedimethacrylate (UDMA), hydroxyethylmethacrylate (HEMA), and triethyleneglycoldimethacrylate (TEGDMA), as well as some of their metabolic intermediates 2,3-epoxy-2-methyl-propionicacid-methylester (EMPME), methacrylic acid (MA), and 2,3-epoxy-2-methylpropionic acid (EMPA).

METHODS

Mouse embryonic stem (ES) cells stably transfected with a vector containing the gene for the green fluorescent protein under control of the cardiac alpha-myosin heavy chain promoter were differentiated in the presence of various concentrations of the test compounds for 12 days. Fluorescence was measured using the TECAN Safire and values were expressed as percent of control values. To distinguish between cytotoxic and embryotoxic effects, all compounds were tested in a standard MTT assay.

RESULTS

HEMA, TEGDMA and EMPME did not influence the differentiation process of ES cells towards cardiac myocytes. No cytotoxic effects were observed at any of the concentration levels tested. Exposure to BisGMA resulted in a 50% decrease in cell survival and a very strong inhibition of cell differentiation at 10(-5)M (p<0.01). Embryotoxic effects were also present at 10(-6) and 10(-7)M (p<0.05). EMPA induced a decrease in ES cell differentiation at 10(-5)M (p<0.01) without cytotoxic effects. No embryotoxic effects were induced at lower concentrations. Exposure to UDMA resulted in a slight decrease of cell differentiation at 10(-5)M (p<0.05). Exposure of cells to MA resulted in an increase of cardiac differentiation up to 150% (p<0.05) at 10(-5)M without cytotoxic effects.

CONCLUSIONS

BisGMA induced a significant high embryotoxic/teratogenic effect over a large range of concentration. Therefore attention should be focused on this dental monomer, which should be investigated further by in vivo experiments.

Leached components from dental composites and their effects on fertility of female mice

This study investigated the effects of leached components from a resin-based dental composite (Z-100) and bisphenol A (BPA) on female mouse fertility. Leached components or BPA (5, 25 and 100 microg kg(-1)) were administered intragastrically daily to the test and distilled water to the control groups for 28 d. Female mice were then mated with sexually mature untreated males and their fertility was assessed. The results revealed a significant reduction in the number of pregnancies--54.5% vs. 100% (control)--in mice treated with the leached components from the dental composite, which also showed an increase of 142% in relative ovary weights. Exposure to 25 and 100 microg kg(-1) BPA resulted in significant increases in the total number of resorptions out of the total number of implantations and significant increases in relative uterine weights. Relative ovarian weights were significantly increased at the highest dose. High performance liquid chromatography analysis showed that tri-(ethylene glycol)-dimethacrylate (TEG-DMA) was the major leached component (total: 5945 microg ml(-1)) from the composite, followed by bisphenol A glycerolate dimethacrylate (BIS-GMA) (total: 2097 microg ml(-1)) and BPA (total: 78 microg ml(-1)). The results suggest that leached components from the dental composite used and commercially purchased BPA have adverse effects on the fertility and reproductive system of female mice.

Dipalmitoylphosphatidylcholine (DPPC) and DPPC/Cholesterol Liposomes as Predictors of the Cytotoxicity ofBis‐GMA Related Compounds

In light of recent development, dental materials such as 2, 2-bis [4-2(-hydroxy-3-methacryloyloxypropoxy)phenyl] propane, ( bis-GMA); 2, 2-bis [4-(1-hydroxymethyl-2-methacryloxy)phenyl] propane, (iso-bis-GMA); and triethyleneglycol dimethacrylate, (TEGDMA) were investigated to determine whether their phase transition properties (phase transition temperature, temperature width, cooperativity) could be induced in samples of DPPC or DPPC/cholesterol (CHOL) liposomes using differential scanning calorimetry (DSC). The changes in phase transition properties of DPPC liposomes caused by addition of TEGDMA were greater than those caused by addition of bis-GMA or iso-bis-GMA, but the extent of changes in the properties of DPPC/CHOL (10:1 or 4:1) liposomes declined in the order of bis-GMA > iso-bis-GMA > TEGDMA. The degree of alteration was related to the cytotoxicity of these compounds. DPPC/CHOL liposomes were found to be better predictors of cytotoxicity than DPPC liposomes. Whether the computational approach to studying the molecular mechanism of alteration is applicable using descriptors such as reactivity of energy of the highest occupied molecular orbital (HOMO) and/or lowest unoccupied molecular orbital (LUMO) was investigated, and the data suggested that these descriptors are useful for studying the interactive roles of dental materials.

Genotoxicity and cytotoxicity of dental materials in human lymphocytes as assessed by the single cell microgel electrophoresis (comet) assay

OBJECTIVES

Resin monomers may be released from restorative dental materials and can diffuse into the tooth pulp or the gingiva, and can reach the saliva and the circulating blood. Whereas the cytotoxic potential of some components has been clearly documented, possible genotoxicity in human target cells demands further investigation.

METHODS

The Comet assay was used to quantify DNA single strand breaks, alkali labile and incomplete excision repair sites in lymphocytes of 10 volunteers. The xenobiotics investigated were 2-hydroxyethylmethacrylate (HEMA), triethyleneglycoldimethacrylate (TEGDMA), urethane dimethacrylate (UDMA), and bisphenol A-glycidyl methacrylate (Bis-GMA) with N-methyl-N'-nitro-N-nitrosoguanidine and dimethyl sulfoxide as controls. DNA migration was quantified using the tail moment according to Olive (OTM) and DNA migration was considered to be elevated at OTM levels above 2. Cytotoxicity was monitored using trypan blue.

RESULTS

In the negative controls, OTM ranged between 1.0 and 1.2. With HEMA concentrations above 10(-6)M, TEGDMA 10(-3)M, Bis-GMA 10(-4)M, and UDMA above 10(-6)M relevant enhancements of DNA migration (OTM>2) were achieved. At higher concentrations of up to 2.5x10(-2) induced DNA migration was expressed by OTM of 3.3 for HEMA, 4.5 for TEGDMA, 7.4 for Bis-GMA, and 2.8 for UDMA. Relevant cytotoxic effects were also seen but vitality levels were at a critical range of 71% for Bis-GMA and 73% for TEGDMA, only.

SIGNIFICANCE

In higher concentration levels, all tested substances induced significant but minor enhancement of DNA migration in the Comet assay as a possible sign for limited genotoxic effects. However, with the highest levels of DNA migration being combined with elevated cytotoxic effects, a low in vivo genotoxic strain appears to be posed by the resin components.

Cytotoxicity and oxidative stress caused by dental adhesive systems cured with halogen and LED lights

The aim of the present study was to investigate the cytotoxicity of two "one bottle" adhesive systems after polymerization with a conventional halogen or a light emitting diode (LED) lamp. We hypothesized that different polymerization sources might enhance the intracellular production of reactive oxygen species (ROS), leading to reduced cell survival. Two "one bottle" adhesive systems (Optibond Solo and Scotchbond One) were cured with a commercial halogen (Optilux 500) and an LED source (Elipar Freelight, 3 M). The specimens were extracted for 24 h in complete cell culture medium or in phosphate-buffered saline (PBS). Endothelial cells (ECV 304) were exposed to the extracts for 24 h and survival rates were evaluated by the MTT assay. Then, ROS generation was monitored by the oxidation-sensitive fluorescent probe 2'7'-dichlorofluorescin diacetate (DCFH-DA). Extracts from all materials except for Optibond Solo polymerized with the halogen lamp were rated significantly cytotoxic. Scotchbond One cured with LED was the most toxic material, which reduced cell survival to about 23% compared with control cultures. Significantly higher amounts of ROS were produced in cell cultures treated with adhesives polymerized with the LED lamp compared with the materials cured with the commercial halogen light source. We demonstrated that the production of intracellular ROS by extracts of the adhesive systems depended on the light sources used for curing of the materials. These results suggested a possible link between ROS production and cytotoxic activity.

Cytotoxicity evaluation of single component dentin bonding agents

This study evaluated the cytotoxicity of four single component dentin bonding agents: Syntac Single Component, Prime & Bond 2.1, Single Bond and One Up Bond F. The test materials were applied on dentin discs of dentin barrier models in the same way as in the clinical procedures recommended by each manufacturer. Cell viability of L 929 after exposure with the bonding agents was determined by MTT assay. The results revealed that cell survival of the first three bonding agents was 60%, while the fourth was an impressive 93%. This study showed that a total-etching bonding system is more cytotoxic than a self-etching bonding system.

Biocompatibility of hydroxylated metabolites of BISGMA and BFDGE

Unpolymerized dental monomers can leach out into the oral biophase and are bioavailable for metabolism. We hypothesize that metabolites would be less toxic than parent monomers. We first identified the formation of metabolites from bisphenol F diglycidyl ether (BFDGE) and Bisphenol A glycidyl methacrylate (BISGMA) after their exposure to liver S9 fractions. Then, the metabolites and parent compounds were subjected to in vitro cytotoxicity, mutagenicity, and estrogenicity studies. Bisphenol A bis(2,3-dihydroxypropyl) ether and bisphenol F bis(2,3-dihydroxypropyl) ether were the hydroxylated metabolites of BISGMA and BFDGE, respectively. Cytotoxicity against L929 cells showed that the metabolites were significantly (p < 0.05) less cytotoxic than the parent monomers. Only BFDGE was mutagenic in the Ames assay with strain TA100 of Salmonella typhimurium. Parent and metabolite compounds did not stimulate estrogen-dependent MCF-7 cell proliferation above solvent controls. These results indicated that the hydroxylated metabolites were non-mutagenic, non-estrogenic, and less cytotoxic than their parent monomers.

Cytotoxicity of bisphenol A glycidyl methacrylate on cytochrome P450-producing cells

Of the cytochrome P450 (CYP) family of carcinogen-activating enzymes, CYP3A is the major form found in human livers. The purpose of this study was to investigate the cytotoxic effects of dental resin monomers after being metabolized by CYP3A4 and CYP3A7, using a colony formation assay and a neutral red assay. Specimen wells were plated with transfected cells derived from the Chinese hamster lung at 100 cells well(-1). The experimental group consisted of CYP-producing 3A4-10 and 3A7-40 cells, while the control group consisted of non-CYP-producing CR-119 cells. Bisphenol A (BPA) and bisphenol A glycidyl methacrylate (Bis-GMA) and a positive control (Aflatoxine Bl) were added separately to each well and cultured for 7 days. After cultivation, the number of the colonies was counted and IC50 values were determined. The data were statistically analysed by a Student's t-test. The resultant of IC50 values indicated that the monomers were not metabolically activated by CYP3A4 or CYP3A7 as compared with the control (P < 0.05). We also confirmed that these monomers act neither as activators nor as inhibitors of CYP3A4 and CYP3A7.

Cytotoxicity of three dentin bonding agents on human dental pulp cells

OBJECTIVES

Dentin bonding agents (DBA) have been widely used in operative restoration to prevent leakage and promote bonding strength in the resin-dentin interface. However, DBA may exert potentially harmful effects to the dental pulp. In the present study, differential cytotoxicity of three DBA (Syntac Sprint, SP; Prime and Bond 2.1, PB; and Single Bond, SB) on the pulp cells was tested.

METHODS

Three DBA were diluted with the culture medium by a ratio of 1:1000, 1:2000 and 1:4000 (v/v). Pulp cells (5 x 10(4) cells/well) were then exposed to culture medium containing different diluents of three DBA for 12, 24h and 3 days. Cytotoxicity was measured with a modified 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay.

RESULTS

A 12h experiment revealed that SP was the strongest cytotoxic agent, followed sequentially by SB and PB. Exposure of pulp cells to 1:4000 (v/v) dilution of SP, PB and SB for 24h reduced the cell number by 23, 6 and 45%, respectively. A 1:2000 (v/v) of DBA diluents reduced the cell number for 32, 13 and 65%, respectively, by SP, PB and SB. Dilution of DBA by 1000-fold of culture medium further enhanced the cytotoxic response. Cell number decreased by 89, 65 and 72%, respectively, by SP, PB and SB. Similar to the 12h-cytotoxicity data, SB is more toxic at high dilution condition, whereas, at low dilution condition, SP is the most toxic agent to pulp cells. Similar cytotoxicity was noted when pulp cells were exposed to DBA for 3 days. Toxicity of DBA was concomitant with marked retraction and rounding of dental pulp cells.

SIGNIFICANCE

These results indicate that DBA exerts potential harmful effects to the pulp. Differential toxic effects of DBA on the pulp cells should be considered during selection of a suitable DBA for operative restoration.

Cytotoxicity of dentine-bonding agents on human pulp cells in vitro

AIM

To investigate the cytotoxicity of five different dentine-bonding agents on human pulp cells in vitro.

METHODOLOGY

Set specimens from Clearfil SE Bond (CB), Heliobond (HB), Prime & Bond NT (PB), Single Bond (SB), and Syntac Single Component (SC) were eluted with culture medium for 2 and 5 days. Cytotoxicity was judged using tetrazolium bromide reduction assay on human primary pulp cells.

RESULTS

Elutes from five dentine-bonding agents were cytotoxic to primary human pulp cells (P < 0.05). CB was the least toxic sealer amongst the chemicals tested. The cytotoxic response decreased in an order of SB > PB > SC > HB > CB.

CONCLUSIONS

The influence of the cytotoxicity depended on the materials tested. Dentine-bonding agents have significant potential for pulpal toxicity.

Short- and long-term clinical evaluation of post-operative sensitivity of a new resin-based restorative material and self-etching primer

This study evaluated the post-operative sensitivity of posterior restorations restored with a resin-based restorative material and a self-etching primer. Forty-six restorations, 28 Class I and 18 Class II were placed by two clinicians in 25 patients. After cavity preparations were completed under rubber dam isolation, they were restored using a self-etching primer (Fluorobond, Shofu Inc, Kyoto, Japan) and a resin-based restorative material (Beautifil, Shofu Inc, Kyoto, Japan). Patients were contacted on days 2 and 7 post-operatively and questioned regarding the presence of sensitivity, the stimuli that created sensitivity, the length of time the sensitivity lasted and its intensity using a rating scale from slight to severe. If sensitivity was experienced on day 7, patients were also contacted on days 14, 30 and 90 to assess the degree of sensitivity. All patients were recalled after 6-, 12- and 24-months for further evaluation of any sensitivity experienced. Chi-Square and Fisher's Exact Test were used for statistical analysis. At day 2, six restorations were sensitive to cold with no statistical difference (p > 0.05) from the restorations that were not sensitive. At day 7, only two restorations were sensitive. No sensitivity was present after day 14, which was also confirmed at the six-month recall. No correlation could be established among the duration of the sensitivity, the degree of pain and the causes that initiated sensitivity (p > 0.05). At one-year recall, one restoration was replaced due to post-operative sensitivity that started after the six-month recall. No sensitivity was noted at the 24-month recall. No correlation (p > 0.05) was found between sensitive restorations and those with a normal response throughout the study. The study showed that Fluorobond self-etching primer and Beautifil resin-based restorative material, when placed in posterior restorations, do not result in long-term post-operative sensitivity.

Response of human pulps following acid conditioning and application of a bonding agent in deep cavities

OBJECTIVES

The aim of this in vivo study was to evaluate the human dental pulp response when a one-bottle adhesive system was applied on etched or unetched deep dentine.

METHODS

Eighteen class V deep cavity preparations were divided in three groups: group 1-total etching + two coats of single bond (SB) + composite resin (Z-100); group 2-enamel etching + two coats of SB + Z-100; group 3-cavity floor lined with a calcium hydroxide liner (Dycal) + acid-etching of enamel and lateral walls + two coats of SB + Z-100. Two teeth were used as intact control group. After 30 days the teeth were extracted and processed through H and E, Masson's trichrome and Brown and Brenn staining techniques.

RESULTS

Moderate inflammatory response, disorganization of pulp tissue, as well as, deposition of thin layer of reactionary dentin were observed in group 1 teeth in which the remaining dentin thickness (RDT) was less than 300 microm. These histological findings appear to be related to long resin tags formation and bonding agent diffusion through dentinal tubules. In group 2, slight inflammatory response was observed only in one tooth in which the RDT was 162 microm. In group 3, all the teeth showed normal histological characteristics which were similar to the intact control group. Presence of bacteria was not correlated with the intensity of pulpal response. The patients reported no symptoms during the experiment. Radiographic evaluation showed no periapical pathology for any of the teeth.

SIGNIFICANCE AND CONCLUSIONS

Acid-etched deep dentin (RDT less than 300 microm) lined with SB causes more intense pulpal response than unetched deep dentin. Based on the results observed in the present study and the conditions in which it was carried out, we recommend the application of a biocompatible liner before etching deep dentin and applying SB.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

SIGNIFICANCE

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

Cytotoxicity of modern dentin adhesives--in vitro testing on gingival fibroblasts

The present investigation was designed to test cellular toxicity of modern dentin adhesives. With the use of the products Ariston Liner, Etch & Prime 3.0, Optibond Solo, Prime & Bond NT, Scotchbond 1, and Syntac Sprint, test specimens were prepared according to the manufacturers' instructions and transferred into a culture medium. Eluates were obtained and pipetted onto fibroblast cultures, incubated, and subsequently stained. The respective cell densities and the numbers of normal, altered, and dead cells were determined and compared with control cell cultures. Statistical analysis of the data showed that all materials caused cytotoxic effects. Scotchbond 1 displayed the highest number of dead cells. The difference was statistically significant compared to Etch" 3.0, Optibond Solo, Prime&Bond NT, and the control. The lowest cell density was found for Scotchbond 1 and Ariston Liner. The difference was also statistically significant in comparison with Etch" 3.0, Optibond Solo, Prime&Bond NT, and the control. To conclude, all tested dentin adhesives caused cytotoxic reactions. Taking the limitations of an in vitro experiment into consideration, Prime&Bond NT, Optibond Solo, and Etch" 3.0 appear to be the most recommendable products, and Scotchbond 1 and Ariston Liner the least.

Human peripheral blood monocytes versus THP-1 monocytes for in vitro biocompatibility testing of dental material components

Monocytes play a central role in the response of tissues to biomaterials. Monocytic cell lines such as the THP-1 cell line have been used extensively as models for primary monocytes (directly from blood) in biocompatibility research. However, little information exists about the appropriateness of these cell lines as models. Thus, the current study compared the biological response of both primary peripheral blood monocytes (PBMs) and the THP-1 cell line to four common components of dental materials known to be released into the oral environment: nickel ions, 2-hydroxyethyl methacrylate (HEMA), triethylene glycol dimethacrylate (TEGDMA), and 2,2-bis[4(2-hydroxy-3-methacryloloxy)-phenyl]propane (Bis-GMA). Comparisons were made by constructing dose-response curves for each type of monocyte and the four components. The 50% cytotoxicity values (TC50 values) were then statistically compared. In addition, the response of the monocytes to the materials with and without lipopolysaccharide (LPS) stimulation were assessed by measuring TNF-alpha secretion from the monocytes. The results showed that the PBMs were 5-10 times less sensitive than the THP-1 monocytes to these dental components, but that both cell lines ranked the components identically. TNF-alpha secretion from both types of monocytes often showed similar trends, although some inconsistent results were noted. The current study supports the use of THP-1s as a model for ranking the cytotoxicity of components of dental biomaterials. Furthermore, the secretory activity of PBMs appears to be generally well represented by the THP-1s. However, sufficient differences between these cell types exist to recommend confirmation of any critical results obtained with THP-1s using PBMs.

Neurotoxic effects of fifth-generation dentin adhesives on rat sciatic nerve

This study evaluated the effect of the fifth-generation dentin adhesives, Single Bond (SB), Excite (EX), Prime & Bond NT (PB), and Optibond Solo (OS) on nerve conduction. Isolated rat sciatic nerves were placed between two suction electrodes in a bath containing tyrode solution. The bonding agents were brought into contact with the nerves and the evoked compound action potentials (cAPs) were recorded before and after contact with the materials. SB, EX, and PB caused total inhibition of the cAPs, with PB being the fastest (73 +/- 5.8 min). All cAPs except one in the PB group were irreversibly inhibited in the SB, EX, and PB groups. As for OS the reduction in cAP was not 50% after an application time of 200 min. Recovery of the cAPs in this group was recorded in an average time of 35 min.

Effects of dental resins on TNF-alpha-induced ICAM-1 expression in endothelial cells

Many reports have demonstrated inflammation after the placement of dental restorations. To explain this side-effect, we studied a biomarker in the inflammatory response. The intercellular adhesion molecule-1 (ICAM-1) is a key mediator for recruitment of leukocytes to the site of inflammation. Therefore, we investigated whether methacrylates (a BISGMA-based dental resin, BISGMA, and MAA) and Cyracure UVR 6105, an epoxy monomer, could alter ICAM-1 expression in unstimulated and TNF-alpha-stimulated endothelial cells. Six-well plates with monolayers of human umbilical vein cells, ECV 304 (ATCC CRL 1998), were exposed to TNF-alpha (1 ng/mL) in the presence and absence of subtoxic and TC50 doses of chemicals for 24 hrs at 37 degrees C/5% CO2. Several doses of TNF-alpha (0.5-2 ng/mL) were coincubated with 100 microL of undiluted aqueous dental resin extracts. Cells were harvested and stained with mAB FITC-conjugated anti-human ICAM-1 (CD54). ICAM-1 expression was measured by flow cytometry. Cells expressed basal levels of ICAM-1, which was up-regulated by TNF-alpha but was not changed by all samples studied. Except for UVR 6105, the methacrylates significantly decreased ICAM-1 expression in TNF-alpha-stimulated cells. These findings suggest that methacrylates may decrease the recruitment of leukocytes to sites of inflammation.

The induction of micronuclei in vitro by unpolymerized resin monomers

Components of resin materials may damage DNA, leading to genetic alterations in mammalian cells. Here, monomers were analyzed for the induction of chromosomal aberrations indicated by micronuclei induced in V79 cells. A dose-related increase in the numbers of micronuclei was observed with triethyleneglycol dimethacrylate (TEGDMA), 2-hydroxyethyl methacrylate (HEMA), and glycidyl methacrylate (GMA). These effects were reduced, however, by a metabolically active microsomal fraction from rat liver. The very low activity of Bis-GMA and UDMA and the elevated numbers of micronuclei caused by high concentrations of methyl methacrylate and bisphenol A were associated with cytotoxicity. Our findings provide evidence for the induction of micronuclei by TEGDMA, HEMA, and GMA under physiological conditions, indicating clastogenic activity of these chemicals in vitro. Since it has been shown that TEGDMA also caused gene mutations and DNA sequence deletions in mammalian cells, the activity of this substance should be analyzed in vivo.

Development and evaluation of radiopaque light cure composite

After the development of a two-paste chemical cure composite, evaluation of its physicochemical properties, toxicological evaluation and in-vivo experiments in dogs teeth with histopathological study of dental tissues, a clinical trial was carried out and commercial production recommended. As the shelf life of the material was not enough, a light cure composite was developed, its material characteristics, toxiclological study, in-vivo experiments in dogs with histopathological evaluation and clinical trials carried out. However, the material was radiolucent, and could not be seen in an x-ray and differentiated from a cavity after filling was done. This led to the development of radiopaque light cure composite. Compressive strength, diametral strength, and microhardness were tested with 200-250 phr range of incorporated radiopaque glass particle filler of the size 0.7 to 1.0 micron this improved the properties when compared to conventional composites. The composite was non-toxic and suitable for animal studies. In vivo studies are underway in dogs with histopathological studied of the pulp and dentin. The material awaits clinical trials prior to commercial production.

Biocompatibility of resin-modified filling materials

Increasing numbers of resin-based dental restorations have been placed over the past decade. During this same period, the public interest in the local and especially systemic adverse effects caused by dental materials has increased significantly. It has been found that each resin-based material releases several components into the oral environment. In particular, the comonomer, triethyleneglycol di-methacrylate (TEGDMA), and the 'hydrophilic' monomer, 2-hydroxy-ethyl-methacrylate (HEMA), are leached out from various composite resins and 'adhesive' materials (e.g., resin-modified glass-ionomer cements [GICs] and dentin adhesives) in considerable amounts during the first 24 hours after polymerization. Numerous unbound resin components may leach into saliva during the initial phase after polymerization, and later, due to degradation or erosion of the resinous restoration. Those substances may be systemically distributed and could potentially cause adverse systemic effects in patients. In addition, absorption of organic substances from unpolymerized material, through unprotected skin, due to manual contact may pose a special risk for dental personnel. This is borne out by the increasing numbers of dental nurses, technicians, and dentists who present with allergic reactions to one or more resin components, like HEMA, glutaraldehyde, ethyleneglycol di-methacrylate (EGDMA), and dibenzoyl peroxide (DPO). However, it must be emphasized that, except for conventional composite resins, data reported on the release of substances from resin-based materials are scarce. There is very little reliable information with respect to the biological interactions between resin components and various tissues. Those interactions may be either protective, like absorption to dentin, or detrimental, e.g., inflammatory reactions of soft tissues. Microbial effects have also been observed which may contribute indirectly to caries and irritation of the pulp. Therefore, it is critical, both for our patients and for the profession, that the biological effects of resin-based filling materials be clarified in the near future.

Biocompatibility of two current adhesive resins

The purpose of the study was to evaluate the biocompatibility of two current adhesive resins and a calcium hydroxide cement. Fifty-four polyethylene tubes were filled with these dental materials, which were hand-mixed or light-cured according to the manufacturer's directions: group 1--Clearfill Liner Bond 2 (Kuraray); group 2--Single Bond (3 M); and group 3--calcium hydroxide cement (Dycal-Dentsply). The materials were implanted into dorsal connective tissue of rats, which were killed 7, 30, and 60 days after the implantation procedure. The implant sites were excised, immersed in buffered Karnovsky's fixative, and processed using routine histological techniques. Sections of 6 microns thickness were stained with hematoxylin and eosin and assessed under light microscopy. Both adhesive resins at 7 days elicited a moderate/intense inflammatory reaction that decreased over time. Fibrous capsules surrounding the tubes were observed at 30 days. Half of the samples in groups 1 and 2 showed thin fibrous capsule formation containing macrophages, capillaries, lymphocytes, fibroblasts, and collagen fibers. Connective tissue healing was observed even though many specimens exhibited a persistent inflammatory reaction mediated by macrophages and giant cells at the 60-day evaluation. Dycal allowed complete healing at 30 days with only a thin fibrous capsule. In conclusion, all experimental materials were successfully walled off by the connective tissue of the rat. However the adhesive resins may release particulates that may, in turn, induce a persistent local inflammatory reaction. Consequently, in this specific condition, these materials cannot be regarded as biocompatible. Dycal was less irritating than the adhesive resins and was better tolerated by the connective tissue.

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

Studies have shown that monomers from dental resins are acutely cytotoxic, but little is known of their long-term effects at sub-lethal concentrations. The current study determined the long-term effects of sub-lethal concentrations of TEGDMA (triethyleneglycol dimethacrylate) and Bis-GMA (bisphenol-glycidylinethacrylate), two common dental monomers, on the in vitro cellular proliferation, succinic dehydrogenase activity, and total cellular protein production of monocytes. Human THP-1 monocytes were exposed to concentrations of 100, 200, and 400 micromol l(-1) of TEGDMA or 1, 5, and 25 micromol l(-1) Bis-GMA for 5 weeks. Controls received only vehicle solutions of ethanol. Each week cellular proliferation (hemocytometer), succinic dehydrogenase (SDH) activity (MTT) and total cellular protein (bicinchoninic acid) were assessed. The results were compared with ANOVA and Tukey intervals (alpha = 0.05). TEDGMA had no proliferative or cellular protein effects, but increased SDH activity 20-60% in week 1 (p < 0.05). SDH activity then decreased 40% in week 2, followed by a gradual increase of 30-40% over week 3-5 (p < 0.05). Bis-GMA reduced proliferation by 40-60% from 1-5 weeks exposure (p < 0.05). However, SDH activity and total protein per cell were not affected. There was some indication of increased SDH activity after 5 weeks (20-30%, p < 0.05). Sub-lethal concentrations of TEGDMA and Bis-GMA have significant long-term effects on monocytes at low-dose 5-week exposures in vitro. Each monomer acted differently.

Cytotoxic effects of current dental adhesive systems on immortalized odontoblast cell line MDPC-23

OBJECTIVES

Evaluate the cytotoxic effect of the three dental adhesive systems.

METHODS

The immortalized mouse odontoblast cell line (MDPC-23) was plated (30,000 cell/cm2) in 24 well dishes, allowed to grow for 72 h, and counted under inverted light microscopy. Uncured fresh adhesives were added to culture medium to simulate effects of unset adhesive. Three adhesives systems were applied for 120 min to cells in six wells for each group: Group 1) Single Bond (3M), Group 2) Prime & Bond 2.1 (Dentsply), and Group 3) Syntac Sprint (Vivadent). In the control group, PBS was added to fresh medium. The cell number was counted again and the cell morphology was assessed under SEM. In addition, the adhesive systems were applied to circles of filter paper, light-cured for 20 s, and placed in the bottom of 24 wells (six wells for each experimental materials and control group). MDPC-23 cells were plated (30,000 cell/cm2) in the wells and allowed to incubate for 72 h. The zone of inhibition around the filter papers was measured under inverted light microscopy; cell morphology was evaluated under SEM; and the MTT assay was performed for mitochondrial respiration.

RESULTS

The fresh adhesives exhibited more toxic (cytopathic effects) to MDPC-23 cells than polymerized adhesives on filter papers, and as compared to the control group. The cytopathic effect of the adhesive systems occurred in the inhibition zone around the filter papers, which was confirmed by the MTT assay and statistical analysis (ANOVA) combined with Fisher's PLSD test. In the control group, MDPC-23 cells were dense on the plastic substrate and were in contact with the filter paper. In the experimental groups, when acid in the adhesive systems was removed by changing the culture medium, or when the adhesives were light-cured, some cells grew in the wells in spite of the persistent cytotoxic effect.

SIGNIFICANCE

All dentin adhesive systems were cytotoxic odontoblast-like cells. Both acidity and non-acidic components of these systems were responsible for the high cytopathic effect of those dental materials.

In vitro cytotoxicity of orthodontic bonding resins on human oral fibroblasts

Polymerization of bonding resins is compromised by atmospheric oxygen, giving rise to a layer of low molecular weight chemical species commonly known as the oxygen inhibited layer. The aim of this study was to evaluate the cytotoxic effect of this layer on primary cultures of human oral fibroblast. The cytotoxic effect related to the modes of polymerization of seven commercially available orthodontic bonding resins was also evaluated statistically. Each material was polymerized into 12 resin disks of standardized dimensions. Half of them were washed with 99% acetone to remove the oxygen inhibited layer. In duplicates, human oral fibroblasts were exposed to the intact and washed resin disks in tissue culture inserts. Cell viability was assessed by tetrazolium bromide reduction assay (MTT) 1, 3, and 6 days after exposure. Glass disks served as controls. ANOVA was used to test for statistical significance. Overall, the presence of an oxygen inhibited layer renders bonding resins 33% more cytotoxic (P <.01, F = 11.83, DF = 1). Light-cured and chemically cured 2-pastes materials had their mean cytotoxicities approximating their inert controls over 6 days. In chemically cured liquid-paste materials, the viability of human oral fibroblasts was only 37% (P <.001, F = 26.4, DF = 2) comparing to the control, 64% on day 1, 30% on day 3 and 14% on day 6. This suggested that the oxygen inhibited layer formed on the surface of bonding resins is an important cytotoxic source in vitro. Chemically cured liquid-paste materials were more cytotoxic than light-cured and chemically cured 2-paste materials. Further investigation into the influence of the modes of polymerization on materials' toxicodynamic effect is warranted to verify its clinical implication.

Cytotoxicity of dental resin monomers in the presence of S9 mix enzymes

The purpose of the this study was to evaluate the cytotoxicity of dental resin monomers in the presence of a rat liver S9 mix containing cytochrome P 450 enzymes. JTC-12 cells derived from a monkey kidney were seeded on a 96-well multi-well-plate at 9 x 10(3) cells per well. After cultivation, the S9 mix was added to the wells as an S9 mix group (+S9), and PBS- was added to the other wells as a none-S9 mix group (-S9), then 7 different concentrations of various monomers were added to each well. All the specimens were cultured for another 24 hrs. The cell survival ratios (CSR) were calculated by using a neutral red cytotoxicity assay. CSR for 50 micrograms/mL of Bis-GMA/S9 mix was 92.6% while for none-S9 mix it was 6.6%. The values of CSR for UDMA, Bis-MPEPP, EGDMA, TEGDMA, DMAEM, 4-META and HEMA exhibited a reduction in cytotoxicity in the presence of the S9 mix. There were significant differences between +S9 and -S9 for respective monomers (p < 0.05). However, there were no significant differences between +S9 and -S9 for MMA (p < 0.05).

BIS-GMA--based resins in dentistry: are they safe?

BACKGROUND

The authors critically surveyed research dealing with the release of resin components from dental composites and the potential of these agents to mimic or disrupt estrogenic cell responses.

TYPES OF STUDIES REVIEWED

The studies reviewed included those on synthetic methods used to make bisphenol A glycidyl methacrylate, or BIS-GMA, and the biological effects of this resin in cell culture and animals. The estrogenic effect of bisphenol A was targeted because bisphenol A is present as an impurity in some resins (BIS-GMA) and as a degradation product from other resins (bisphenol A dimethacrylate, or BIS-DMA).

RESULTS

The outcomes of this review revealed that short-term administration of BIS-GMA and/or bisphenol A in animals or cell cultures can induce changes in estrogen-sensitive organs or cells. However, considering the dosages and routes of administration and the modest response of estrogen-sensitive target organs, the authors conclude that the short-term risk of estrogenic effects from treatments using bisphenol A-based resins is insignificant. Long-term effects need to be investigated further.

CLINICAL IMPLICATIONS

Commonly used dental resins should not be of concern to the general public; however, pharmacological evaluation of dental materials is needed to ensure biologically safe and therapeutically effective substances.

In vitro cytotoxicity of dental adhesive systems under simulated pulpal pressure

OBJECTIVES

Most of the devices used to evaluate the cytotoxicity of resin-based composites in vitro use a dentin barrier test. However, it is difficult to obtain the number of freshly extracted teeth, all on the same day, that is necessary for powerful statistical analysis. Tooth cryopreservation provides a way to build up a supply of teeth. This in vitro study compared cryopreserved teeth and freshly extracted teeth in an evaluation of the cytotoxicity of resin-based composites. In addition, this study also evaluated the effects of pulsatile pressure and the importance of dentin permeability on the cytotoxic response to bonding resins.

METHODS

Forty freshly extracted and forty cryopreserved third molars were used. A standardized Class I cavity was prepared within the dentin. The hydraulic conductance of each tooth was recorded. The cavities were filled either with Scotchbond Multi-Purpose Plus and Z 100 (3M Dental Products) or with Optibond and Herculite (Kerr). A plexiglas device was designed to permit 24 h long contact between culture medium and the roof of the pulp chamber while a pulsatile pulpal pressure was simulated. The viability of L 929 cells cultured with a control medium and evaluated by an MTT assay was compared to that of L 929 cells cultured with medium which remained for 24 h in contact with the pulp chamber of restored teeth. A three-way ANOVA was used to compare the cytotoxicity among the different groups. A simple least-squares linear regression was used to seek a relationship between the hydraulic conductance of dentin and the cytotoxicity of composite restorative materials.

RESULTS

No significant differences in cytotoxicity were found between the freshly extracted teeth and the cryopreserved teeth (p = 0.53). The cytotoxicity of the resin adhesives was statistically higher when a pulsatile pulpal pressure was simulated (p = 0.04). A significant relationship was found between the hydraulic conductance of dentin and the cytotoxicity of resin-based composites (p = 0.02).

SIGNIFICANCE

Cryopreserved teeth can be used for in vitro evaluation of the cytotoxicity of resin adhesives. Pulsatile pulpal pressure simulations increased the in vitro cytotoxicity of the tested materials.

Cytotoxic interactive effects of dentin bonding components on mouse fibroblasts

Previous studies have shown a wide range of pulpal reactions to dentin bonding systems and a poor correlation between in vitro and in vivo toxicity of dentin bonding agents. Because dentin bonding agents are composed of multiple components which may diffuse through dentin, we hypothesized that these components may cause cytotoxicity through interactive (synergistic) effects. We investigated the cytotoxicities of four dentin bonding components--HEMA, Bis-GMA, TEGDMA, and UDMA--and interactive effects for three binary combinations of the dentin bonding components--HEMA and Bis-GMA, Bis-GMA and TEGDMA, and TEGDMA and UDMA. Cytotoxicities to Balb/c 3T3 mouse fibroblasts were measured by the MTT assay. Concentrations which caused 50% toxicity compared with controls (TC50 values) were compared, and the interactive effects were determined by evaluation of the differences between observed and expected MTT activities of the cells. The ranks of toxicity of the dentin bonding components in terms of TC50 values were as follows: Bis-GMA > UDMA > TEGDMA >>> HEMA (least toxic) after 24- and 72-hour exposures. As binary combinations, the three combinations of dentin bonding components interacted in three ways--synergism, additivism, and antagonism--which were influenced by the concentrations of both components. The longer period of exposure resulted in a significant increase in the cytotoxicity of the dentin bonding components and combinations. The findings indicate that both exposure time and the interactions between the dentin bonding components may be important parameters in determining the cytotoxicity of dentin bonding agents in vivo.

Effects of unpolymerized resin components on the function of accessory cells derived from the rat incisor pulp

Monomeric resin components from dental composites are toxic to fibroblasts in culture and thus may interfere with the local immune system of the pulp, reducing its effective defense potential, either by cytotoxicity or by a more specific immune mechanism. Therefore, the present study was undertaken to observe the cytotoxic effects elicited by certain unpolymerized components of resin composites upon the function of accessory pulp cells in mitogen-induced proliferation of T-lymphocytes. Accessory cells from the rat incisor pulp were released following enzymatic digestion with collagenase. The assay included incubation of these cells with purified T-lymphocytes from cervical lymph nodes for 72 h in the presence of different concentrations of the resin components. The proliferative T-lymphocyte response was monitored by 3H-thymidine incorporation. Initially, we conducted experiments on spleen cells to determine the proper concentration intervals for suitable testing of the resin components. To assess the individual susceptibility of accessory cells and T-lymphocytes, we pre-treated each of these cells with some of the test materials prior to assay. At low concentrations, urethane dimethacrylate (UDMA), bisglycidyl methacrylate (bis-GMA), triethylene glycol dimethacrylate (TEGDMA), and bis-phenol A (BPA) increased spleen cell proliferation to concanavalin A (con A). Purified T-lymphocytes stimulated by pulpal cells did not show enhanced responses to UDMA, bis-GMA, glycidyl mehtacrylate (GMA), or N,N,-dihydroxyethyl-p-toluidine (DHEpT). At higher concentrations, all substances except camphoroquinone (CAMP) showed inhibitory effects in both test systems. The in vitro study shows that resin components can evoke either immunosuppression or immunostimulation on mitogen-driven proliferation of purified T-lyumphocytes and spleen cells.