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18 "Cytotoxicity"
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Review Article
Comparative evaluation of the biological response of conventional and resin modified glass ionomer cement on human cells: a systematic review
Shishir Singh, Gaurav Kulkarni, R S Mohan Kumar, Romi Jain, Ameya M Lokhande, Teena K Sitlaney, Musharraf H F Ansari, Navin S Agarwal
Restor Dent Endod 2024;49(4):e41.   Published online November 1, 2024
DOI: https://doi.org/10.5395/rde.2024.49.e41
AbstractAbstract PDFPubReaderePub

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

Trial Registration

PROSPERO Identifier: CRD42023426021

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Research Articles
Evaluation of mineral induction ability and cytotoxicity of carbonated hydroxyapatite for pulp tissue regeneration: an in vitro study
S. Swathi Priyadharshini, Chinnasamy Ragavendran, Anand Sherwood, J. Ramana Ramya, Jogikalmat Krithikadatta
Restor Dent Endod 2024;49(4):e40.   Published online October 29, 2024
DOI: https://doi.org/10.5395/rde.2024.49.e40
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to evaluate carbonated hydroxyapatite (CHA)’s ability for mineral induction and its in vitro cytotoxicity with human dental pulp cells.

Materials and Methods

Precursors for the study include di-ammonium hydrogen phosphate and calcium nitrate tetrahydrate, with sodium hydrogen carbonate added to achieve different levels of carbonate substitution. The synthesized CHA samples are characterized using X-ray diffraction, Fourier transform infrared spectroscopy, and Raman spectroscopy. Scanning electron microscopy (SEM) was used to observe morphology. For 14 days at 37°C, samples were submerged in simulated body fluid to assess their mineral induction capabilities. SEM was used to confirm apatite formation on sample surfaces. The cytotoxicity assay was used to assess the vitality of the cells following their exposure to various concentrations of CHA.

Results

The Joint Committee on Powder Diffraction Standards data for HA aligned well with the results from X-ray diffraction analysis of CHA across 3 different concentrations, indicating strong agreement. Fourier transform infrared spectra indicated the presence of phosphate, hydroxyl, and carbonate groups within the samples. SEM and Energy-dispersive X-ray analysis show agglomerated and flaky nanoparticles. All the samples are bioactive, but the formation of apatite differs from one another. In vitro cytotoxicity assay showed that over 70% of cells maintain viability.

Conclusions

The results of this study may provide insight into the potential use of carbonated HA as a dental pulp-capping material for vital pulp therapy.

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Cytotoxicity of two self-adhesive resin cements and their interference in the phagocytic activity of murine macrophages
Danilo Couto da Silva, Leonardo Gomes Vaz, Warley Luciano Fonseca Tavares, Leda Quercia Vieira, Ricardo Reis de Oliveira, Antônio Paulino Ribeiro Sobrinho
Restor Dent Endod 2022;47(3):e31.   Published online July 14, 2022
DOI: https://doi.org/10.5395/rde.2022.47.e31
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to evaluate in vitro the effects of the self-adhesive resin cements RelyX U200 (3M ESPE) and seT PP (SDI Limited) on murine macrophages and the interference of the photoactivation.

Materials and Methods

Cell viability assays, cell adherence, yeast phagocytosis of Saccharomyces boulardii and production of reactive oxygen species (ROS) were performed in the presence of capillaries containing the respective self-adhesive cement when photoactivated or not.

Results

After long periods of contact, both types of cements, when not photoactivated, are more cytotoxic for macrophages. The seT PP cement when only chemically activated seems to interfere more negatively in the process of phagocytosis of yeasts S. boulardii. Both types of cements interfere in the cell adhesion process, independent of photoactivation. None of the types of cements tested was able to induce the production of ROS.

Conclusions

Our results highlight the great importance of the photoactivation of self-adhesive resin cements in the dental clinic, since RelyX U200, when photoactivated, presented the best results within the evaluated parameters.

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Biological assessment of a new ready-to-use hydraulic sealer
Francine Benetti, João Eduardo Gomes-Filho, India Olinta de Azevedo-Queiroz, Marina Carminatti, Letícia Citelli Conti, Alexandre Henrique dos Reis-Prado, Sandra Helena Penha de Oliveira, Edilson Ervolino, Elói Dezan-Júnior, Luciano Tavares Angelo Cintra
Restor Dent Endod 2021;46(2):e21.   Published online March 24, 2021
DOI: https://doi.org/10.5395/rde.2021.46.e21
AbstractAbstract PDFPubReaderePub
Objectives

This study compared the cytotoxicity, biocompatibility, and tenascin immunolabeling of a new ready-to-use hydraulic sealer (Bio-C Sealer) with MTA-Fillapex and white MTA-Angelus.

Materials and Methods

L929 fibroblasts were cultivated and exposed to undiluted and diluted material extracts. Polyethylene tubes with or without (the control) the materials were implanted into the dorsa of rats. At 7 days and 30 days, the rats were euthanized, and the specimens were prepared for analysis; inflammation and immunolabeling were measured, and statistical analysis was performed (p < 0.05).

Results

MTA-Fillapex exhibited greater cytotoxicity than the other materials at all time points (p < 0.05). The undiluted Bio-C Sealer exhibited greater cytocompatibility at 6 and 48 hours than white MTA-Angelus, with higher cell viability than in the control (p < 0.05). White MTA-Angelus displayed higher cell viability than the control at 24 hours, and the one-half dilution displayed similar results at both 6 and 48 hours (p < 0.05). At 7 days and 30 days, the groups exhibited moderate inflammation with thick fibrous capsules and mild inflammation with thin fibrous capsules, respectively (p > 0.05). At 7 days, moderate to strong immunolabeling was observed (p > 0.05). After 30 days, the control and MTA-Fillapex groups exhibited strong immunolabeling, the white MTA-Angelus group exhibited moderate immunolabeling (p > 0.05), and the Bio-C Sealer group exhibited low-to-moderate immunolabeling, differing significantly from the control (p < 0.05).

Conclusions

Bio-C Sealer and white MTA-Angelus exhibited greater cytocompatibility than MTA-Fillapex; all materials displayed adequate biocompatibility and induced tenascin immunolabeling.

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Effects of four novel root-end filling materials on the viability of periodontal ligament fibroblasts
Makbule Bilge Akbulut, Pembegul Uyar Arpaci, Ayce Unverdi Eldeniz
Restor Dent Endod 2018;43(3):e24.   Published online May 25, 2018
DOI: https://doi.org/10.5395/rde.2018.43.e24
AbstractAbstract PDFPubReaderePub
Objectives

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

Materials and Methods

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

Results

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

Conclusions

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

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Removal efficacy and cytotoxicity of a calcium hydroxide paste using N-2-methyl-pyrrolidone as a vehicle
Myung-Jin Lim, Hyun-Jin Jang, Mi-Kyung Yu, Kwang-Won Lee, Kyung-San Min
Restor Dent Endod 2017;42(4):290-300.   Published online October 20, 2017
DOI: https://doi.org/10.5395/rde.2017.42.4.290
AbstractAbstract PDFPubReaderePub
Objectives

This study investigated the removal efficacy and cytotoxicity of a newly developed calcium hydroxide paste (cleaniCal, Maruchi) using N-2-methyl-pyrrolidone (NMP) as a vehicle in comparison with ApexCal (Ivoclar Vivadent) and Calcipex II (Nishika), which use different vehicles such as polyethylene glycol and propylene glycol, respectively.

Materials and Methods

Thirty maxillary premolars with oval-shaped canals were divided into 3 groups and the teeth were filled with one of the pastes. After removal of the paste, micro-computed tomographic (μ-CT) imaging was obtained to assess the volume of residual paste in the root canal of each tooth. The teeth were then split longitudinally and the area of the paste-coated surface was evaluated by stereomicroscopy. The cytotoxicity of each product was assessed using an agar overlay assay. The effect of each vehicle on cell viability was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The data were analyzed using one-way analysis of variance and Tukey's tests to detect any significance (p < 0.05).

Results

In the μ-CT and stereomicroscopic analysis, cleaniCal exhibited less remnants of medicament than ApexCal and Calcipex. cleaniCal showed a higher cytotoxicity than the other pastes in the agar overlay assay. Furthermore, NMP exhibited lower cell viability compared to the other vehicles.

Conclusions

cleaniCal showed better removal efficacy compared to the other products. However, clinicians should be aware of the higher cytotoxicity of the NMP-based material and consider its possible adverse effects on periradicular tissue when it is overfilled.

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White mineral trioxide aggregate mixed with calcium chloride dihydrate: chemical analysis and biological properties
Hany Mohamed Aly Ahmed, Norhayati Luddin, Thirumulu Ponnuraj Kannan, Khairani Idah Mokhtar, Azlina Ahmad
Restor Dent Endod 2017;42(3):176-187.   Published online April 17, 2017
DOI: https://doi.org/10.5395/rde.2017.42.3.176
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to evaluate the chemical and biological properties of fast-set white mineral trioxide aggregate (FS WMTA), which was WMTA combined with calcium chloride dihydrate (CaCl2·2H2O), compared to that of WMTA.

Materials and Methods

Surface morphology, elemental, and phase analysis were examined using scanning electron microscope (SEM), energy dispersive X-ray microanalysis (EDX), and X-ray diffraction (XRD), respectively. The cytotoxicity and cell attachment properties were evaluated on human periodontal ligament fibroblasts (HPLFs) using methyl-thiazol-diphenyltetrazolium (MTT) assay and under SEM after 24 and 72 hours, respectively.

Results

Results showed that the addition of CaCl2·2H2O to WMTA affected the surface morphology and chemical composition. Although FS WMTA exhibited a non-cytotoxic profile, the cell viability values of this combination were lesser than WMTA, and the difference was significant in 7 out of 10 concentrations at the 2 time intervals (p < 0.05). HPLFs adhered over the surface of WMTA and at the interface, after 24 hours of incubation. After 72 hours, there were increased numbers of HPLFs with prominent cytoplasmic processes. Similar findings were observed with FS WMTA, but the cells were not as confluent as with WMTA.

Conclusions

The addition of CaCl2·2H2O to WMTA affected its chemical properties. The favorable biological profile of FS WMTA towards HPLFs may have a potential impact on its clinical application for repair of perforation defects.

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Cytotoxicity and biocompatibility of Zirconia (Y-TZP) posts with various dental cements
Hyeongsoon Shin, Hyunjung Ko, Miri Kim
Restor Dent Endod 2016;41(3):167-175.   Published online May 30, 2016
DOI: https://doi.org/10.5395/rde.2016.41.3.167
AbstractAbstract PDFPubReaderePub
Objectives

Endodontically treated teeth with insufficient tooth structure are often restored with esthetic restorations. This study evaluated the cytotoxicity and biological effects of yttria partially stabilized zirconia (Y-TZP) blocks in combination with several dental cements.

Materials and Methods

Pairs of zirconia cylinders with medium alone or cemented with three types of dental cement including RelyX U200 (3M ESPE), FujiCEM 2 (GC), and Panavia F 2.0 (Kuraray) were incubated in medium for 14 days. The cytotoxicity of each supernatant was determined using 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays on L929 fibroblasts and MC3T3-E1 osteoblasts. The levels of interleukin-6 (IL-6) mRNA were evaluated by reverse transcription polymerase chain reaction (RT-PCR), and IL-6 protein was evaluated by enzyme-linked immunosorbent assays (ELISA). The data were analyzed using one-way ANOVA and Tukey post-hoc tests. A p < 0.05 was considered statistically significant.

Results

The MTT assays showed that MC3T3-E1 osteoblasts were more susceptible to dental cements than L929 fibroblasts. The resin based dental cements increased IL-6 expression in L929 cells, but reduced IL-6 expression in MC3T3-E1 cells.

Conclusions

Zirconia alone or blocks cemented with dental cement showed acceptable biocompatibilities. The results showed resin-modified glass-ionomer based cement less produced inflammatory cytokines than other self-adhesive resin-based cements. Furthermore, osteoblasts were more susceptible than fibroblasts to the biological effects of dental cement.

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In vitro cytotoxicity of four calcium silicate-based endodontic cements on human monocytes, a colorimetric MTT assay
Sedigheh Khedmat, Somayyeh Dehghan, Jamshid Hadjati, Farimah Masoumi, Mohammad Hossein Nekoofar, Paul Michael Howell Dummer
Restor Dent Endod 2014;39(3):149-154.   Published online April 30, 2014
DOI: https://doi.org/10.5395/rde.2014.39.3.149
AbstractAbstract PDFPubReaderePub
Objectives

This study was performed to evaluate the cytotoxicity of four calcium silicate-based endodontic cements at different storage times after mixing.

Materials and Methods

Capillary tubes were filled with Biodentine (Septodont), Calcium Enriched Mixture (CEM cement, BioniqueDent), Tech Biosealer Endo (Tech Biosealer) and ProRoot MTA (Dentsply Tulsa Dental). Empty tubes and tubes containing Dycal were used as negative and positive control groups respectively. Filled capillary tubes were kept in 0.2 mL microtubes and incubated at 37℃. Each material was divided into 3 groups for testing at intervals of 24 hr, 7 day and 28 day after mixing. Human monocytes were isolated from peripheral blood mononuclear cells and cocultered with 24 hr, 7 day and 28 day samples of different materials for 24 and 48 hr. Cell viability was evaluated using an MTT assay.

Results

In all groups, the viability of monocytes significantly improved with increasing storage time regardless of the incubation time (p < 0.001). After 24 hr of incubation, there was no significant difference between the materials regarding monocyte viability. However, at 48 hr of incubation, ProRoot MTA and Biodentine were less cytotoxic than CEM cement and Biosealer (p < 0.01).

Conclusions

Biodentine and ProRoot MTA had similar biocompatibility. Mixing ProRoot MTA with PBS in place of distilled water had no effect on its biocompatibility. Biosealer and CEM cement after 48 hr of incubation were significantly more cytotoxic to on monocyte cells compared to ProRoot MTA and Biodentine.

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Cytotoxicity and physical properties of tricalcium silicate-based endodontic materials
Young-Eun Jang, Bin-Na Lee, Jeong-Tae Koh, Yeong-Joon Park, Nam-Eok Joo, Hoon-Sang Chang, In-Nam Hwang, Won-Mann Oh, Yun-Chan Hwang
Restor Dent Endod 2014;39(2):89-94.   Published online March 21, 2014
DOI: https://doi.org/10.5395/rde.2014.39.2.89
AbstractAbstract PDFPubReaderePub
Objectives

The aim of this study was to evaluate the cytotoxicity, setting time and compressive strength of MTA and two novel tricalcium silicate-based endodontic materials, Bioaggregate (BA) and Biodentine (BD).

Materials and Methods

Cytotoxicity was evaluated by using a 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-5-((phenylamino)carbonyl)-2H-tetrazolium hydroxide (XTT) assay. Measurements of 9 heavy metals (arsenic, cadmium, chromium, copper, iron, lead, manganese, nickel, and zinc) were performed by inductively coupled plasma-mass spectrometry (ICP-MS) of leachates obtained by soaking the materials in distilled water. Setting time and compressive strength tests were performed following ISO requirements.

Results

BA had comparable cell viability to MTA, whereas the cell viability of BD was significantly lower than that of MTA. The ICP-MS analysis revealed that BD released significantly higher amount of 5 heavy metals (arsenic, copper, iron, manganese, and zinc) than MTA and BA. The setting time of BD was significantly shorter than that of MTA and BA, and the compressive strength of BA was significantly lower than that of MTA and BD.

Conclusions

BA and BD were biocompatible, and they did not show any cytotoxic effects on human periodontal ligament fibroblasts. BA showed comparable cytotoxicity to MTA but inferior physical properties. BD had somewhat higher cytotoxicity but superior physical properties than MTA.

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Cytotoxicity of newly developed pozzolan cement and other root-end filling materials on human periodontal ligament cell
Minju Song, Tae-Sun Yoon, Sue-Youn Kim, Euiseong Kim
Restor Dent Endod 2014;39(1):39-44.   Published online January 20, 2014
DOI: https://doi.org/10.5395/rde.2014.39.1.39
AbstractAbstract PDFPubReaderePub
Objectives

The purpose of this study was to evaluate in vitro cytotoxicity of the pozzolan cement and other root-end filling materials using human periodontal ligament cell.

Materials and Methods

Endocem (Maruchi), white ProRoot MTA (Dentsply), white Angelus MTA (Angelus), and Super EBA (Bosworth Co.) were tested after set completely in an incubator at 37℃ for 7 days, Endocem was tested in two ways: 1) immediately after mixing (fresh specimens) and 2) after setting completely like other experimental materials. The methods for assessment included light microscopic examination, cell counting and WST-1 assay on human periodontal ligament cell.

Results

In the results of microscopic examination and cell counting, Super EBA showed significantly lower viable cell than any other groups (p < 0.05). As the results of WST-1 assay, compared with untreated control group, there was no significant cell viability of the Endocem group. However, the fresh mixed Endocem group had significantly less cell viability. The cells exposed to ProRoot MTA and Angelus MTA showed the highest viability, whereas the cells exposed to Super EBA displayed the lowest viability (p < 0.05).

Conclusions

The cytotoxicity of the pozzolan cement (Endocem) was comparable with ProRoot MTA and Angelus MTA. Considering the difficult manipulation and long setting time of ProRoot MTA and Angelus MTA, Endocem can be used as the alternative of retrofilling material.

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A comparative evaluation of cytotoxicity of root canal sealers: an in vitro study
Gautam Pyarelal Badole, Manjusha Madhukar Warhadpande, Ganesh Kothiramji Meshram, Rakesh Namdeoraoji Bahadure, Shubha Gopal Tawani, Gopal Tawani, Shital Gautam Badole
Restor Dent Endod 2013;38(4):204-209.   Published online November 12, 2013
DOI: https://doi.org/10.5395/rde.2013.38.4.204
AbstractAbstract PDFPubReaderePub
Objectives

The objective of this in vitro study was to evaluate and compare the cytotoxicity of four different root canal sealers i.e. Apexit Plus (Ivoclar Vivadent), Endomethasone N (Septodont), AH-26 (Dentsply) and Pulpdent Root Canal Sealer (Pulpdent), on a mouse fibroblast cell line (L929).

Materials and Methods

Thirty two discs for each sealer (5 mm in diameter and 2 mm in height) were fabricated in Teflon mould. The sealer extraction was made in cell culture medium (Dulbecco's Modified Eagle's Medium, DMEM) using the ratio 1.25 cm2/mL between the surface of the sealer samples and the volume of medium in a shaker incubator. Extraction of each sealer was obtained at 24 hr, 7th day, 14th day, and one month of interval. These extracts were incubated with L929 cell line and 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyltetrazolium bromide (MTT) assay was done. Two-way ANOVA for interaction effects between sealer and time and Post-hoc multiple comparison using Tukey's test across all the 16 different groups were used for statistical analysis.

Results

Apexit Plus root canal sealer was significantly less toxic than other sealers (p < 0.05) and showed higher cellular growth than control. Endomethasone N showed mild cytotoxicity. AH-26 showed severe toxicity which became mild after one month while Pulpdent Root Canal Sealer showed severe to moderate toxicity.

Conclusions

Apexit Plus was relatively biocompatible sealer as compared to other three sealers which were cytotoxic at their initial stages, however, they became biocompatible with time.

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Basic Research
Biocompatibility of experimental mixture of mineral trioxide aggregate and glass ionomer cement
Min-Jae Oh, Yu-Na Jeong, In-Ho Bae, So-Young Yang, Bum-Jun Park, Jeong-Tae Koh, Yun-Chan Hwang, In-Nam Hwang, Won-Mann Oh
J Korean Acad Conserv Dent 2010;35(5):359-367.   Published online September 30, 2010
DOI: https://doi.org/10.5395/JKACD.2010.35.5.359
AbstractAbstract PDFPubReaderePub
Objectives

The purpose of the present in vitro study was to evaluate the biocompatibility of mineral trioxide aggregate (MTA) mixed with glass ionomer cement (GIC), and to compare it with that of MTA, GIC, IRM and SuperEBA.

Materials and Methods

Experimental groups were divided into 3 groups such as 1 : 1, 2 : 1, and 1 : 2 groups depending on the mixing ratios of MTA powder and GIC powder. Instead of distilled water, GIC liquid was mixed with the powder. This study was carried out using MG-63 cells derived from human osteosarcoma. They were incubated for 1 day on the surfaces of disc samples and examined by scanning electron microscopy. To evaluate the cytotoxicity of test materials quantitatively, XTT assay was used. The cells were exposed to the extracts and incubated. Cell viability was recorded by measuring the optical density of each test well in reference to controls.

Results

The SEM revealed that elongated, dense, and almost confluent cells were observed in the cultures of MTA mixed with GIC, MTA and GIC. On the contrary, cells on the surface of IRM or SuperEBA were round in shape. In XTT assay, cell viability of MTA mixed with GIC group was similar to that of MTA or GIC at all time points. IRM and SuperEBA showed significantly lower cell viability than other groups at all time points (p < 0.05).

Conclusions

In this research MTA mixed with GIC showed similar cellular responses as MTA and GIC. It suggests that MTA mixed with GIC has good biocompatibility like MTA and GIC.

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Original Articles
Comparison of biocompatibility of four root perforation repair materials
Min-Kyung Kang, In-Ho Bae, Jeong-Tae Koh, Yun-Chan Hwang, In-Nam Hwang, Won-Mann Oh
J Korean Acad Conserv Dent 2009;34(3):192-198.   Published online May 31, 2009
DOI: https://doi.org/10.5395/JKACD.2009.34.3.192
AbstractAbstract PDFPubReaderePub

This study was carried out in order to determine in vitro biocompatibility of white mineral trioxide aggregate (MTA), and to compare it with that of the commonly used materials, i. e. calcium hydroxide liner (Dycal), glass ionomer cement (GIC), and Portland cement which has a similar composition of MTA. To assess the biocompatibility of each material, cytotoxicity was examined using MG-63 cells. The degree of cytotoxicity was evaluated by scanning electron microscopy (SEM) and a colorimetric method, based on reduction of the tetrazolium salt 2,3 bis {2methoxy 4nitro 5[(sulfenylamino) carbonyl] 2H tetrazolium hydroxide} (XTT) assay.

The results of SEM revealed the cells in contact with GIC, MTA, and Portland cement at 1 and 3 days were apparently healthy. In contrast, cells in the presence of Dycal appeared rounded and detached. In XTT assay, the cellular activities of the cells incubated with all the test materials except Dycal were similar, which corresponded with the SEM observation. The present study supports the view that MTA is a very biocompatible root perforation repair material. It also suggests that cellular response of Portland cement and GIC are very similar to that of MTA.

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Evaluation of the radiopacity and cytotoxicity of resinous root canal sealers
Chang-Kyu Kim, Hyun-Wook Ryu, Hoon-Sang Chang, Byung-Do Lee, Kyung-San Min, Chan-Ui Hong
J Korean Acad Conserv Dent 2007;32(5):419-425.   Published online September 30, 2007
DOI: https://doi.org/10.5395/JKACD.2007.32.5.419
AbstractAbstract PDFPubReaderePub

The aim of this study was to evaluate the radiopacity and cytotoxicity of three resin-based (AH 26, EZ fill and AD Seal), a zinc oxide-eugenol-based (ZOB Seal), and a calcium hydroxide-based (Sealapex) root canal sealers. Specimens, 10 mm in diameter and 1 mm in thickness, were radiographed simultaneously with an aluminum step wedge using occlusal films, according to ISO 6876/2001 standards. Radiographs were digitized, and the radiopacity of sealers was compared to the different thicknesses of the aluminum step wedge, using the Scion image software. Using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, the cytotoxicity of each material was determined in immortalized human periodontal ligament (IPDL) cells.

The results demonstrated that EZ fill was the most radiopaque sealer, while Sealapex was the least radiopaque (p < 0.05). AH 26, AD Seal and ZOB Seal presented intermediate radiopacity values. All the materials evaluated, except for Sealapex, presented the minimum radiopacity required by ISO standards. The cell viabilities of resin-based root canal sealers were statistically higher than that of other type of root canal sealers through the all experimental time. Further, EZ fill showed statistically lower cell viability in 24 and 48 hours compared to AD Seal and in 72 hours compared to all other resin-based root canal sealers. However, there was no correlation between the radiopacity and cytotoxicity of three resin-based root canals sealers (p > 0.05).

These results indicate that resin-based root canal sealer is more biocompatible and has advantage in terms of radiopacity.

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Cytotoxicity and genotoxicity of newly developed calcium phosphate-based root canal sealers
Hee-Jung Kim, Seung-Ho Baek, Kwang-Shik Bae
J Korean Acad Conserv Dent 2006;31(1):36-49.   Published online January 31, 2006
DOI: https://doi.org/10.5395/JKACD.2006.31.1.036
AbstractAbstract PDFPubReaderePub

The purpose of this study was to compare the cytotoxicity by MTT test and genotoxicity by Ames test of new calcium phosphate-based root canal sealers (CAPSEAL I, CAPSEAL II) with commercially available resin-based sealers (AH 26, AH Plus), zinc oxide eugenol-based sealers (Tubliseal EWT, Pulp Canal Sealer EWT), calcium hydroxide-based sealer (Sealapex), and tricalcium phosphate based sealers (Sankin Apatite Root Canal Sealer I, II, III).

According to this study, the results were as follows:

The extracts of freshly mixed group showed higher toxicity than those of 24 h set group in MTT assay (p < 0.001).

CAPSEAL I and CAPSEAL II were less cytotoxic than AH 26, AH Plus, Tubliseal EWT, Pulp Canal Sealer EWT, Sealapex and SARCS II in freshly mixed group (p < 0.01).

AH 26 in freshly mixed group showed mutagenicity to TA98 and TA100 with and without S9 mix and AH Plus extracts also were mutagenic to TA100 with and without S9 mix.

Tubliseal EWT, Pulp Canal Sealer EWT and Sealapex in freshly mixed group were mutagenic to TA100 with S9 mix.

Among those of 24 h set groups, the extracts of SARCS II were mutagenic to TA98 with and without S9 mix and AH 26 showed mutagenic effects to TA98 with S9 mix.

No mutagenic effect of CAPSEAL I and CAPSEAL II was detected.

There is no statistically significant difference between CAPSEAL I and CAPSEAL II at MTT assay and Ames test in both freshly mixed group and 24 h set group.

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Cytotoxicity of resin-based root canal sealer, adseal
Hee-Jung Kim, Seung-Ho Baek, Woo-Cheol Lee, Han-Soo Park, Kwang-Shik Bae
J Korean Acad Conserv Dent 2004;29(6):498-503.   Published online November 30, 2004
DOI: https://doi.org/10.5395/JKACD.2004.29.6.498
AbstractAbstract PDFPubReaderePub

The properties of ideal root canal sealers include the ability of sealing the total root canal system and no toxic effects to periradicular tissues. Cytotoxicity test using cell culture is a common screening method for evaluation of the biocompatibility of root canal sealers. The purpose of this study was to investigate the cytotoxic effect of newly developed resin-based sealer (Adseal 1, 2, and 3) comparing with those commercial resin-based sealers (AH26 and AH Plus), ZOE-based sealers (Tubliseal EWT, Pulp Canal Sealer EWT) and calcium hydroxide based sealer (Sealapex). An indirect contact test of cytotoxicity by agar diffusion was performed according to the international standard ISO 10993-5. L929 fibroblast cells were incubated at 37℃ in humidified 5% CO2-containing air atmosphere. The freshly mixed test materials were inserted into glass rings of internal diameter 5 mm and height 5 mm placed on the agar. After the 24 hrs incubation period, the decolorization zones around the test materials were assessed using an inverted microscope with a calibrated screen. A Decolorization Index was determined for each specimen. Adseal 1, 2, and 3 did not exert any cytotoxic effects, whereas AH26, AH Plus, Tubliseal EWT, Pulp Canal Sealer EWT, and Sealapex produced mild cytotoxicity.

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Evaluation of Sodium Dichloroisocyanurate as a root canal irrigation solution; Cl- concentration, pH, Cytotoxicity and Antimicrobial effect in vitro
Woo-Cheol Lee, Bong-Sun Kang, Cheol-Ho Kim, Ho-Hyun Son
J Korean Acad Conserv Dent 2003;28(5):425-430.   Published online September 30, 2003
DOI: https://doi.org/10.5395/JKACD.2003.28.5.425
AbstractAbstract PDFPubReaderePub

The purpose of this study was to evaluate the clinical applications of the Sodium Dichloroisocyanurate effervescent tablet as a routine root canal irrigant by performing several in vitro tests such as Cl- content, cytotoxicity, antimicrobial effect as well as its pH level compared to the equivalent concentration of sodium hypochlorite solution.

Sodium Dichloroisocyanurate demonstrated lower level of Cl- concentation than each dilution of sodium hypochlorite solution. Both solution has increased level of Cl- as the concentration of each solution increased. There was no significant change of Cl- concentration in sodium hypochlorite as time goes by. However, Cl- concentration in Sodium Dichloroisocyanurate was increased.

The antimicrobial effects of both solutions were increased when their concentrations were increased. One day after dilution, antimicrobial effect of Sodium Dichloroisocyanurate was slightly higher than sodium hypochlorite, however, there was no difference in 1 week dilution solution. One month dilution solution of sodium hypochlorite still retain its activity, but antimicrobial effect of Sodium Dichloroisocyanurate was drastically decreased 1 month after dilution.

The cytotoxicity of Sodium Dichloroisocyanurate was rather higher than same concentration of sodium hypochlorite solution until 1 week after dilution. Then in 1 month, cytotoxicity of Sodium Dichloroisocyanurate was decreased than that of 1 week dilution solution, especially 4% Sodium Dichloroisocyanurate solution has almost no toxicity. However, 1% and 2% sodium hypochlorite solution has unchanged moderate degree of cytotoxicity after the dilution. Furthermore, 4% sodium hypochlorite solution showed high level of toxicity.

The pH level of Sodium Dichloroisocyanurate showed that the solution was weak acid (pH5). On the other hand, sodium hypochlorite was revealed as a strong alkaline solution (pH12). There was no change in pH following the dilution of each solution.

As results, Sodium Dichloroisocyanurate solution fully satisfy the basic requirements as a root canal irrigation solution. However, we strongly recommend to use this solution clinically in low concentration and try to apply into the root canal within 1 week after dilution.

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