Effect of thickness on the degree of conversion, monomer elution, depth of cure and cytotoxicity of bulk-fill composites.

PURPOSE: Today, bulk-fill composites are used as a single layer with a thickness of up to 4-5 mm. However, is proper polymerization achieved with this increased thickness? METHODS: This study was designed to investigate the effect of thickness on the degree of conversion (DC) (n = 6), the elution of monomers (n = 6), depth of cure (DoC) (n = 10) and cytotoxicity (n = 6) of the bulk-fill composites SDR Flow Plus (SDR), SonicFill2 SingleFill (SF) and ACTIVA Bioactive Restorative (ACT) in comparison to the conventional G-aenial Posterior (GC). Two-way analysis of variance (ANOVA) was used to assess the interaction between materials and surfaces, and one-way ANOVA and Tukey tests were used to compare the degree of conversion, monomer elution and cytotoxicity values (P < 0.05). RESULTS: The highest DC was found at the top surface of SDR, while the lowest DC was found at SF. The V2 mm/V0 mm DoC ratios of the composites except ACTs were appropriate according to the threshold. None of the composites were cytotoxic on day 1. CONCLUSION: In bulk-fill composites, DC decreased and monomer elution increased with increasing depth. The V4 mm/V0 mm ratios of all bulk-fill groups were not appropriate. Additionally, only ACTs had a cell viability of <70% on day 7.

Cytotoxicity and reactive oxygen species production induced by different co-monomer eluted from nanohybrid dental composites.

BACKGROUND: Safety issues for dental restorative composites are critical to material selection, but, limited information is available to dental practitioners. This study aimed to compare the chemical and biological characteristics of three nanohybrid dental composites by assessing filler particle analysis, monomer degree of conversion (DC), the composition of eluates, and cytotoxicity and reactive oxygen species (ROS) production in fibroblasts. METHODS: Three nanohybrid composites (TN, Tetric N-Ceram; CX, Ceram X Sphere Tec One; and DN, DenFil NX) were used. The size distribution and morphology of the filler particles were analysed using scanning electron microscopy (n = 5). The DC was measured via micro-Raman spectroscopy (n = 5). For the component analysis, methanol eluates from the light-polymerised composites were evaluated by gas chromatography/mass spectrometry (n = 3). The eluates were prepared from the polymerised composites after 24 h in a cell culture medium. A live/dead assay (n = 9) and Water-Soluble Tetrazolium-1 assay (n = 9) were performed and compared with negative and positive controls. The ROS in composites were compared with NC. Statistical significance in differences was assessed using a t-test and ANOVA (α = 0.05). RESULTS: Morphological variations in different-sized fillers were observed in the composites. The DC values were not significantly different among the composites. The amounts of 2-hydroxyethyl methacrylate (HEMA) were higher in TN than DN (p = 0.0022) and triethylene glycol dimethacrylate (TEGDMA) in CX was higher than in others (p < 0.0001). The lowest cell viability was shown in CX (p < 0.0001) and the highest ROS formation was detected in TN (p < 0.0001). CONCLUSIONS: Three nanohybrid dental composites exhibited various compositions of filler sizes and resin components, resulting in different levels of cytotoxicity and ROS production. Chemical compositions of dental composites can be considered with their biological impact on safety issues in the intraoral use of dental restorative composites. CX with the highest TEGDMA showed the highest cytotoxicity induced by ROS accumulation. DN with lower TEGDMA and HEMA presented the highest cell viability.

Effects of nanohybrid flowable resin-based composites on fibroblast viability using different light-curing units.

PURPOSE: To investigate the in vitro cytotoxic effects of Bis-GMA-containing and Bis-GMA-free flowable resin-based composites (RBCs) on primary human gingival fibroblast cells (hGFc) using direct and indirect curing methods and three different light-curing units (LCUs). MATERIALS AND METHODS: Cells were isolated and cultured in vitro in 24-well plates. The plates were divided into treatment (cells with RBC), control (cells only), and blank (media only) groups. In the treatment groups, two types of nanohybrid flowable RBCs were used: Bis-GMA-free and Bis-GMA groups. Each treatment group was subdivided according to the curing method, i.e., direct curing (RBC was injected into the wells and cured directly on the attached cells) and indirect curing (the samples were pre-cured outside of the well plate and then added to the well plate with cells). To vary the LCU, the subgroups were further divided into three groups: multiple-emission peak light-emitting diode, single-emission peak light-emitting diode, and quartz-tungsten-halogen units. Curing was conducted for 20 seconds. The hGFc cytotoxicity was evaluated via 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay after 24, 48, and 72 hours of culturing. RESULTS: The MTT assay results showed that both RBCs were significantly cytotoxic toward hGFc compared to the control group (p < 0.0001). The Bis-GMA group was significantly more cytotoxic to the cells compared to the Bis-GMA-free group. In addition, the curing method and time interval affected cell viability regardless of the LCU used. CONCLUSION: The Bis-GMA flowable RBC and direct curing method had the highest cytotoxic effects on hGFc regardless of the LCU used. Careful selection of flowable RBCs and proper curing techniques are required to decrease the cytotoxic effects on hGFc and improve the clinical handling of oral tissues.

Considerations about Cytotoxicity of Resin-Based Composite Dental Materials: A Systematic Review.

The dental material industry is rapidly developing resin-based composites (RBCs), which find widespread use in a variety of clinical settings. As such, their biocompatibility has gained increasing interest. This literature review presents a summary of research into the cytotoxicity of methacrylate-based composites published from 2017 to 2023. Subject to analysis were 14 in vitro studies on human and murine cell lines. Cytotoxicity in the included studies was measured via MTT assay, LDH assay, and WST-1 assay. The QUIN Risk of Bias Tool was performed to validate the included studies. Included studies (based entirely on the results of in vitro studies) provide evidence of dose- and time-dependent cytotoxicity of dental resin-based composites. Oxidative stress and the depletion of cellular glutathione (GSH) were suggested as reasons for cytotoxicity. Induction of apoptosis by RBCs was indicated. While composites remain the golden standard of dental restorative materials, their potential cytotoxicity cannot be ignored due to direct long-term exposure. Further in vitro investigations and clinical trials are required to understand the molecular mechanism of cytotoxicity and produce novel materials with improved safety profiles.

Human osteoblasts response to different dental implant abutment materials: An in-vitro study.

OBJECTIVES: This study aimed to investigate human osteoblasts (HOB) response towards different dental implant abutment materials. METHODS: Five dental implant abutment materials were investigated: (1) titanium (Ti), (2) titanium coated nitride (TiN), (3) cobalt chromium (CoCr), (4) zirconia (ZrO2), and (5) modified polyether ether ketone (m-PEEK). HOBs were cultured, expanded, and seeded according to the supplier's protocol (PromoCell, UK). Cell proliferation and cytotoxicity were evaluated at days 1, 3, 5, and 10 using Alamar Blue (alamarBlue) and lactate dehydrogenase (LDH) colorimetric assays. Data were analysed via two-way ANOVA, one-way ANOVA and Tukey's post hoc test (significance was determined as p < 0.05 for all tests). RESULTS: All the investigated materials showed high and comparable initial proliferation activities apart from ZrO2 (46.92%), with P% of 79.91%, 68.77%, 73.20%, and 65.46% for Ti, TiN, CoCr, and m-PEEK, respectively. At day 10, all materials exhibited comparable and lower P% than day 1 apart from TiN (70.90%) with P% of 30.22%, 40.64%, 37.27%, and 50.65% for Ti, CoCr, ZrO2, and m-PEEK, respectively. The cytotoxic effect of the investigated materials was generally low throughout the whole experiment. At day 10, the cytotoxicity % was 7.63%, 0.21%, 13.30%, 5.32%, 8.60% for Ti, TiN, CoCr, ZrO2, and m-PEEK. The Two-way ANOVA and Tukey's Multiple Comparison Method highlighted significant material and time effects on cell proliferation and cytotoxicity, and a significant interaction (p < 0.0001) between the tested materials. Notably, TiN and m-PEEK showed improved HOB proliferation activity and cytotoxic levels than the other investigated materials. In addition, a non-significant negative correlation between viability and cytotoxicity was found for all tested materials. Ti (p = 0.07), TiN (p = 0.28), CoCr (p = 0.15), ZrO2 (p = 0.17), and m-PEEK (p = 0.12). SIGNIFICANCE: All the investigated materials showed excellent biocompatibility properties with more promising results for the newly introduced TiN and m-PEEK as alternatives to the traditionally used dental implant and abutment materials.

Effect of Finishing-Polishing Procedures on Cytotoxicity of Resin-Based Restorative Materials via Real-Time Cell Analysis.

OBJECTIVE: The aim of this study was to evaluate the effect of finishing and polishing procedures of compomer and bulk-fill composite resins on cytotoxicity against human gingival fibroblasts by xCELLigence analysis. STUDY DESIGN: Filtek™ Bulk Fill composite and Dyract XP compomer were used. After curing, the specimens were randomly divided into two groups and finishing-polishing procedures were applied to one group; no finishing-polishing procedures were applied to the other group. For the first time in this study, pure gold samples were prepared with the same weight and base area as the test specimens and the wells containing the pure gold samples were determined as the control group. xCELLigence system was used to assess the response of the human gingival fibroblasts after exposure to test specimens. Measurements were recorded for 72 hours after adding specimens. RESULTS: Finishing and polishing procedures caused a significant increase in cell viability of Dyract XP compomer samples at all time periods; the percentage of cell viability reached above 70% after finishing and polishing procedures. However, significant effects were not observed in Filtek™ Bulk Fill composite samples at any time period. CONCLUSION: Finishing and polishing procedures play an essential role in increasing the biocompatibility of Dyract XP compomer. It is recommended to apply finishing and polishing procedures even though a smooth surface may be obtained in restorations with matrix strips.

Characterization of universal chromatic resin-based composites in terms of cell toxicity and viscoelastic behavior.

OBJECTIVES: A current trend to simplify dental restorative procedures is toward using universal chromatic light-cured resin-based composites (RBCs) designed to adapt esthetically to various clinical situations. This study offers a comparative characterization of the mechanical and cytotoxic behavior of such materials that use different techniques to adjust their optical properties (e.g., structural color instead of pigment addition), have different filler systems but are based on a comparable organic matrix. METHODS: The structural appearance of the filler systems was assessed by scanning electron microscopy. Various quasi-static and viscoelastic parameters were evaluated at clinically relevant frequencies (0.5-5 Hz) using an instrumented indentation test with a Dynamic Mechanical Analysis (DMA) module. Cytotoxicity on human gingival fibroblasts (HGF-1), when exposed to eluates from tested RBCs specimens (up to one month), was assessed using a WST-1 colorimetric proliferation assay. Multifactor analysis of variance was applied to compare the parameters of interest (Martens, Vickers, and indentation hardness; elastic and total indentation work; creep, indentation depth; storage, loss, and indentation moduli; loss factor; cell viability) between analyzed RBCs, loading frequencies, and eluate age. RESULTS: Structural particularities of the filler systems are directly reflected in the mechanical behavior of the analyzed materials. Changes in the filler system, necessary to achieve structural color, generally resulted in lower mechanical properties but a better ability to absorb shock. In contrast, the cytotoxicity was comparable. SIGNIFICANCE: Based on the performed characterization, universal chromatic RBCs fits in the conventional RBCs class to expect comparable clinical behavior.

Boron nitride nanoplatelets as reinforcement material for dental ceramics.

OBJECTIVE: The main goal of this research was to demonstrate the potential value of boron nitride nanoplatelets (BNNPs), which have excellent mechanical properties and biocompatibility, as a suitable reinforcement for dental materials. METHODS: The BNNPs were prepared by exfoliating h-BN via high-energy ball-milling and dispersion on a zirconia matrix. Then the composite powder was consolidated using spark plasma sintering. Fracture toughness, flexural strength and wear resistance were the mechanical properties explored. Agar diffusion-based biocompatibility testing was carried out. Low temperature degradation tests were also performed in a steam environment in an autoclave. RESULTS: The BNNPs dispersed zirconia exhibited improved strength (up to 27.3%), and fracture toughness was also increased (up to 37.5%) with the addition of 1-1.5 vol.% BNNPs. Tribological properties were also enhanced by the addition of BNNPs. The cytotoxicity tests confirmed that the BNNPs do not have obvious toxicity. The accelerated low-temperature degradation experiment revealed the barrier properties of the BNNPs, whose addition almost fully inhibited the degradation of the zirconia matrix in a humid environment. SIGNIFICANCE: The main contribution of this study is the introduction of an advanced material, BNNP, which can be used as a biocompatible reinforcement for dental materials, resulting in enhanced mechanical properties of the system due to its unique structure and extraordinary properties.

In vitro and in silico evaluations of resin-based dental restorative material toxicity.

OBJECTIVES: This study aims to evaluate the cytocompatibility of three provisional restoration materials and predict neurotoxic potential of their monomers. These materials are Tab 2000® (methyl methacrylate based), ProTemp 4™ (bis-acrylic based) and Structur 3® (urethane dimethacrylate based). MATERIALS AND METHODS: Resin samples were incubated in a cell culture medium and the cytotoxic effects of these extracts were studied in 3T3 fibroblast cells through MTT and crystal violet assays as well as ROS assessment. The presence of relevant leached monomers was determined by HPLC. Additionally, the blood-brain barrier (BBB) permeability to these resin-based monomers was predicted using ACD/Labs algorithms model. RESULTS: Cell survival rates were compared with the resin extracts, and Structur 3® was statistically significant different from the others (p < 0.001) at all-time incubation periods. All materials induced a dose-dependent loss of cell viability; however, only Structur 3 extracts were cytotoxic against 3T3 fibroblasts. The highest cytotoxic effect (77%, p < 0.001) was observed at 24 h incubation period, which may be associated with the presence of urethane dimethacrylate (UDMA) leached monomers. Furthermore, the computational model showed that most monomers under study are expectedly capable of crossing the BBB. CONCLUSIONS: Our results showed that Structur 3® is not cytocompatible with our cell model and UDMA is a potential neurotoxic compound. CLINICAL RELEVANCE: These results indicate that only ProTemp 4™ and Tab 2000® are safe for provisional restorations.

Zebrafish; an emerging model organism for studying toxicity and biocompatibility of dental materials.

Zebrafish (danio rerio) is a small, tropical freshwater teleost fish that belongs to the Cyprinidae family and lives in natural waters and rice fields in South Asia, North India, and Pakistan. Zebrafish has become a popular vertebrate model organism for biomedical research due to its numerous advantages such as their small size, short life cycle, accessibility in large numbers and inexpensive maintenance. In addition, fertilization happens externally in zebrafish and allows zebrafish to be manipulated directly. As another important advantage, the embryos are transparent thus the stages of development can be easily identified. Zebrafish can have multiple co-orthologs for human genes. In the 1930s, the zebrafish was first used as a model for developmental and embryological studies and in 1981, was introduced as a genetic model by Streisinger by force of developed genetic techniques in zebrafish such as cloning, mutagenesis and transgenesis. In the 1990s, various genetic manipulations were introduced. These improvements have contributed to the popularity of zebrafish. After that zebrafish was used in various research areas including genetics, biomedicine, neurobiology, toxicology, pharmacology as well as in human disease models. Zebrafish is also becoming a popular model organism in dental research. It is preferred in dental material toxicity studies and in research related to the genetic and molecular factors in tooth formation and craniofacial development. This review provides information on the use of zebrafish in dental research, focusing on tooth formation and dentition (pharyngeal dentition) of zebrafish and the dental research performed using zebrafish.

Cytotoxicity Evaluation of Endodontic Pins on L929 Cell Line.

OBJECTIVE: The aim of this study was to evaluate the cytotoxic potential of a type of endodontic pin on L929 cell line according to the UNI EN ISO 10993/2009 rule. METHODS: L929 cells were used for the assays; extracts were prepared from three different-diameter endodontic pins, made of epoxy resin and fiberglass matrix and from Reference Materials (ZDEC, ZDBC, and HDP films). MTS assay was performed after 24 h, 48 h, and 72 h of exposure of L929 cells to pin and Reference Material extracts, 5% phenol solution, and control reagent. Cells cultured with different media containing extracts were monitored for up to 72 h and stained with haematoxylin/eosin. RESULTS: Pins of different diameters had no cytotoxic effects on L929 cells at 24 h, 48 h, and 72 h (all values >70%). Cells cultured in medium containing pin extracts grew without any differences compared to the control cells. CONCLUSION: The endodontic pins tested showed no cytotoxic effects and did not induce changes in morphology for up to 72 h.

Contact sensitization to ingredients of dental materials and cosmetics in dental students: a pilot study.

OBJECTIVE: The aim of this study was to evaluate the rate of contact sensitization to selected cosmetic allergens, i.e. ingredients of dental materials, in students of dental medicine and dental patients. METHODS: A total of 50 participants were included in the study: 40 students of dental medicine exposed to the studied allergens during the course of practical education; and 10 randomly selected dental patients without occupational exposure to the investigated substances served as a control group. All of them were patch-tested with colophonium, myroxylon pereirae resin, paraben mix, fragrance mix I, isopropyl myristate, triclosan, polysorbate 80, compositae mix II, and hydroperoxides of limonene. RESULTS: The sensitization rates for colophonium and polysorbate 80 were the highest. For the group of dental students, we established significantly higher sensitization rate for colophonium compared to the ones for myroxylon pereirae resin and hydroperoxides of limonene (χ2 = 4.93; p = 0.026), paraben mix (χ2 = 3.6; p = 0.05), isopropyl myristate (χ2 = 6.56; p = 0.01), and triclosan (χ2 = 8.5; p < 0.001); and to polysorbate 80 compared to the ones for myroxylon pereirae resin and hydroperoxides of limonene (χ2 = 3.97; p = 0.046), isopropyl myristate (χ2 = 5.47; p = 0.02) and triclosan (χ2 = 7.34; p = 0.007). Significantly increased concomitant sensitization rate to compositae mix and to hydroperoxides of limonene was established (χ2 = 12.55; p < 0.001). Generally, the incidence of concomitant sensitization to the studied allergens in the whole studied population was high. CONCLUSIONS: Colophonium and polysorbate 80 could be outlined as sensitizers of paramount importance for both dental students and dental patients. We consider the major importance of exposure to colophonium during the course of practical education in dentistry for the onset of the sensitization. Sensitization to compositae mix was observed only among dental students. We consider the leading role of consumer exposure for the onset of the sensitization to triclosan and to hydroperoxides of limonene. Unexpected and unreported reactions of concomitant sensitization were observed.

Comparison of Various Implant Provisional Resin Materials for Cytotoxicity and Attachment to Human Gingival Fibroblasts.

PURPOSE: The aim of this study was to evaluate the responses of human gingival fibroblast (HGF-1) in contact with provisional materials with various chemical compositions and fabricated using different methods. MATERIALS AND METHODS: A total of 210 specimens in eight experimental groups were used. Groups were divided by chemical compositions (poly[ethyl methacrylate], poly[methyl methacrylate], bis-acryl, and hybrid ceramic) and fabricating methods (direct, indirect, and computer-aided design/computer-aided manufacturing [CAD/CAM]). To evaluate the surface characteristics of each group, roughness, water contact angle, and degree of conversion were measured. The responses of HGF-1 to provisional materials were evaluated with cytotoxicity and cell attachment assay. The roughness, surface energy, degree of conversion, level of cytotoxicity, and cell attachment were compared between groups using one-way analysis of variance (ANOVA) and Tukey's multiple comparison (α = .05). RESULTS: The poly(ethyl methacrylate)-direct/indirect and poly(methyl methacrylate)-direct/indirect groups showed higher roughness than the bis-acryl-direct/indirect, poly(methyl methacrylate)-CAD/CAM, and hybrid ceramic-CAD/CAM groups with statistical significance (P < .05). The poly(ethyl methacrylate)-direct group showed the significantly highest water contact angle, and the hybrid ceramic-CAD/CAM group showed the lowest water contact angle (P < .05). The groups that used indirect fabrication methods showed a higher degree of conversion than those that used direct fabrication methods, regardless of chemical composition (P < .05). The poly(ethyl methacrylate) groups showed significantly lower cell viability than the other groups regardless of fabricating methods (P < .05). The poly(ethyl methacrylate)-direct method group showed the lowest cell attachment, and the hybrid ceramic-CAD/CAM method group showed the highest cell attachment (P < .05). CONCLUSION: Poly(methyl methacrylate) and bis-acryl have lower cytotoxicity to HGF-1 than poly(ethyl methacrylate). Indirect fabrication and CAD/CAM are recommended to prevent residual monomer and achieve high cell attachment. To use direct fabrication methods, the auto-mix system is beneficial for the favorable cell response, as it derives a smooth surface.

A review on potential toxicity of dental material and screening their biocompatibility.

OBJECTIVES: A wide range of compounds are utilized in dentistry such as dental composites, resins, and implants. The successful clinical use of dental materials relies on theirm physiochemical properties as well as biological and toxicological reliability. Different local and systemic toxicities of dental materials have been reported. Placement of these materials in oral cavity for a long time period might yield unwanted reactions. An extensive variety of materials is used in dentistry including filling materials, restorative materials, intracanal medicines, prosthetic materials, different types of implants, liners, and irrigants. The increasing rate in development of the novel materials with applications in the dental field has led to an increased consciousness of the biological risks and tempting restrictions of these materials. The biocompatibility of a biomaterial used for the replacement or filling of biological tissue such as teeth always had a high concern within the health care disciplines for patients. MATERIALS AND METHODS: Any material used in humans should be tested before clinical application. There are many tests evaluating biocompatibility of these materials at the point of in vitro, in vivo, and clinical investigations. RESULTS: The current review discusses the potential toxicity of dental material and screening of their biocompatibility. CLINICAL RELEVANCE: It is essential to use healthy and safe materials medical approaches. In dentistry, application of different materials in long-term oral usage demands low or nontoxic agents gains importance for both patients and the staff. Furthermore, screening tests should evaluate any potential toxicity before clinical application.

Cytotoxic effects to mouse and human gingival fibroblasts of a nanohybrid ormocer versus dimethacrylate-based composites.

OBJECTIVES: Tooth-colored composites have emerged as a standard restorative material in caries therapy and have largely replaced materials such as silver amalgam or glass ionomer cements. In addition to their superior esthetics and desirable mechanical properties, composites also comprise negative characteristics, such as wear, shrinkage, and an adverse biocompatibility. Modifications of classic resin-based dental composites have been developed to overcome these shortcomings. For example, ormocers are innovative inorganic-organic hybrid polymers that form a siloxane network modified by the incorporation of organic groups. Recently, a new ormocer, Admira Fusion (VOCO), was introduced to composite technology. The absence of cytotoxic matrix monomers leads to the hypothesis that ormocers have improved biocompatibility compared to resin-based dental restorative materials. MATERIALS AND METHODS: The aim of this study was to compare the cytotoxic effects of Admira Fusion to a nanohybrid composite (GrandioSO, VOCO) and a nanofiller composite (Filtek Supreme XTE, 3M Espe) on the standard dermal mouse fibroblasts (L929) and human gingival fibroblasts (GF-1) via a Cell Counting Kit-8 (CCK-8) assay. RESULTS: Admira Fusion was significantly less cytotoxic than GrandioSO and Filtek Supreme XTE to both the standard mouse dermal fibroblasts (L929) and human gingival fibroblasts. CONCLUSIONS: Compared to other resin-based dental restorative materials, the ormocer (Admira Fusion) possesses a superior biocompatibility in vitro. Future research studies are needed to confirm our results. CLINICAL SIGNIFICANCE: Clinically, dental practitioners and their patients might benefit from Admira Fusion in terms of reduced adverse biologic reactions compared to resin-based dental restorative materials.

In Vitro Analysis of the Cytotoxicity of Indirect Restorative Materials.

This study aimed to compare the cytotoxicity of the Vita AC12, Lava Ultimate, Vita Enamic and InSync indirect restorative materials. Extracts of each material were prepared by incubation for 1, 7 and 40 days, with daily washing. Human gingival fibroblasts were exposed to the extracts, and cell viability was evaluated by sequential assessment of mitochondrial activity (XTT), membrane integrity (NRU) and cell density (CVDE). Extracts of polystyrene beads and latex fragments were used as negative and positive controls, respectively. Differences between groups and experimental times were evaluated by analysis of variance. At the 24 h extraction, significant differences between the control and both Vita AC-12 and InSync were observed in the XTT assay (p<0.05), and between the control and both Enamic and Lava Ultimate, in the CVDE assay (p<0.05). AC12, Lava Ultimate, and InSync presented significantly lower cell viability than Enamic and the control group, in the NRU assay (p<0.05). The Vita Enamic and Lava Ultimate hybrid ceramic-like materials presented better biocompatibility at the 24 h extraction time point than the AC12 and InSync ceramic materials. However, a simulation of the removal of toxic components by biological fluids, conducted by using longer extraction times and daily washing, led to the absence of cytotoxicity in all the tested restorative materials. These findings can be viewed as positive for the clinical indication of these restorative materials, considering their contact with adjacent soft tissues for extended periods of time.

Cytotoxicity and Genotoxicity of Resin Based Dental Materials in Human Lymphocytes In Vitro.

The aim of this in vitro study was to evaluate cytotoxicity and genotoxicity of six different dental nanocomposite materials, three conventional ones and three flowable composite resin materials, in human lymphocytes. The following materials were tested: Tetric EvoCeram, Tetric EvoFlow, Filtek Ultimate, Filtek Ultimate Flow, G-aenial and G-aenial Flo. Cytotoxicity was evaluated for two mass concentrations (0.007 g/mL and 0.013 g/mL) of each material, non-cured and cured, after 4 hours and 24 hours. Genotoxicity was evaluated using micronucleus assay under the same conditions as applied during the investigation of cytotoxicity. Uncured forms of Tetric EvoCeram, Tetric EvoFlow and Filtek Ultimate Flow in higher mass concentration caused genotoxic effect. Uncured G-aenial Flo in higher mass concentration induced apoptosis and necrosis. Uncured Tetric EvoFlow and uncured Filtek Ultimate Flow in higher mass concentration induced early apoptosis after both test periods. None of the conventional composite resin materials tested showed cytotoxicity except for uncured G-aenial, which induced apoptosis in higher mass concentration in both test periods. In conclusion, under the conditions of this in vitro study, cured conventional composites did not show cytotoxic or genotoxic effect, which is important for clinical application of these materials, whereas uncured forms exhibited certain level of cytotoxicity and genotoxicity, mainly because of monomers in their composition.

[EVALUATION OF THE COMPARATIVE TOXICITY OF VARIOUS MATERIALS FOR DENTAL PROSTHETICS ON CELL CULTURE MODELS].

Difficulties in repairing the defects of the teeth are related with allergic-inflammatory, traumatic and dystrophic complications arising from the interaction of the foreign body with the mucous tissues of the oral cavity after the patient's prosthesis is established. The aim of our study was to establish the toxic pro-inflammatory activity of materials used for the manufacturing of bases of removable dentures - plastics based on polymethylmethacrylate prosthetic complexes Prothyl Hot, Ftorax and Perflex Flexi Nylon on the model of human leukemia transformed T cells (Jurkat cells) and MDCK cells. For the cells simulation Jurkat and MDCK cells was incubated with the components of prosthetic materials, Prothyl Hot, Ftorax and Perflex Flexi Nylon/ Prosthetic materials were added to the incubation medium at the doses used in practice (calculated at 106 cells); duration of incubation was 24 hours. A comparative assessment of the toxicity of prosthetic materials was determined by the MTT test (activity of mitochondrial dehydrogenases). Statistical analysis was carried out using the package (SPSS version 11.0). The statistical reliability of the difference between the indices was evaluated by the Student t test (the P <0.05 level was considered reliable). The results of the conducted studies testify to the absence of toxicity of the complexes Prothyl Hot, Ftorax and Perflex Flexi Nylon, used as a basis of circuit prostheses, on intact Jurkat and MDCK cells, as evidenced by the stability of their mitochondrial dehydrogenases. Based on the analysis of the conducted studies, it can be concluded, that as Jurkat and MDCK cells are used as models of immune and epithelial cells, the materials used for manufacturing of removable prostheses, the polymethylmethacrylate-based plastics (Prothyl Hot and Ftorax) and elastic thermoplastic polymer material Perflex Flexi Nylon, are not toxic. Studied materials, with the high probability, are not capable to cause massive death of immune cells, development of allergic or inflammatory damages, which in turn can stat cause the development of stomatitis and gingivitis, the destruction of the paradental tissue.

Polymer-based dental filling materials placed during pregnancy and risk to the foetus.

BACKGROUND: Tooth-coloured polymer-based dental filling materials are currently the first choice for dental restorative treatment in many countries. However, there are some concerns about their safety. It has been shown that substances known as endocrine disrupters, which might pass through the placental barrier, are released from these materials within the first hours after curing. Thus, the placement of polymer-based dental fillings in pregnant women may put the vulnerable foetus at risk. Large epidemiological studies exploring the risk of having polymer-based dental materials placed during pregnancy are lacking. The aim of this study was to investigate the association between the placement of polymer-based dental fillings during pregnancy and adverse birth outcomes. METHODS: This study is based on data from the large Norwegian Mother and Child Cohort Study (MoBa). The information about dental treatment during pregnancy was obtained from questionnaires sent to the participating women during weeks 17 and 30 of pregnancy. Reported placement of "white fillings" was used as exposure marker for having received polymer-based dental filling materials. Only singleton births were included in the present study. Data were linked to the Medical Birth Registry of Norway. Logistic regression models that included the mother's age, level of education, body mass index, parity, and smoking and alcohol consumption during pregnancy were used to estimate the odds ratio (OR) and 95% confidence interval (CI). Different adverse birth outcomes were of interest in the present study. RESULTS: Valid data were available from 90,886 pregnancies. Dentist consultation during pregnancy was reported by 33,727 women, 10,972 of whom had white fillings placed. The adjusted logistic regression models showed no statistically significant association between having white dental fillings placed during pregnancy and stillbirth, malformations, preterm births, and low or high birth weight. CONCLUSIONS: In this study, women who reported white fillings placed during pregnancy had no increased risk for adverse birth outcomes compared with women who did not consult a dentist during pregnancy. Thus, our findings do not support the hypothesis of an association between placement of polymer-based fillings during pregnancy and adverse birth outcomes.

Ethylene glycol dimethacrylate and diethylene glycol dimethacrylate exhibits cytotoxic and genotoxic effect on human gingival fibroblasts via induction of reactive oxygen species.

Although methacrylic acid derivatives in their polymeric form are considered to be safe, insufficient polymerization and the release of monomers due to either mechanical or enzymatical factors can lead to their reaching millimolar concentrations in local tissue. The present study evaluates the effect of two methacrylate monomers - ethylene glycol dimethacrylate (EGDMA) and diethylene glycol dimethacrylate (DEGDMA) - on human gingival fibroblasts (HGFs). Both monomers were found to reduce cells viability in MTT assay, increase apoptosis and cause cell cycle arrest in G1/G0 phase. They also increased intracellular reactive oxygen species (ROS) production as measured by DCFH-DA and DHE probes and increased expression of GPx4 and SOD2. Both monomers increased DNA damage in comet assay. Moreover, HGFs were not able to repair those lesions within 120min of repair incubation. However, the monomers were not found to have any effect on the integrity of isolated plasmids. We postulate that EGDMA and DEGDMA exhibit their cytotoxic and genotoxic properties via increased production of ROS, which cause DNA damage, affect apoptosis, viability and cell cycle. Further studies are needed to better understand the properties of methacrylic acid monomers and to evaluate the risk that they cause for patients, dentists and dental technicians.