The release of components from dental composite into surrounding tissue may cause an adverse tissue reaction. Thus, this study investigated the cytotoxicity of three types of dental composites with their flowable derivatives and determined the compounds released from these materials by high-performance liquid chromatography (HPLC) analysis. Fifteen specimens from each composite (Admira, Z250, Tetric Ceram) with fifteen of their flowables (Admira Flow, Tetric Flow, Feltik Flow) were prepared in the form of discs and divided into two groups of 10 and 5 for each material. The first group (10 discs) was used to evaluate the cytotoxicity of the material on balb/c 3T3 fibroblasts by measuring cellular metabolic activity (3{4,5-dimethylthiazol-2-yl}-2,5-diphenyltetrazolium bromide [MTT] assay) relative to Teflon controls, while the second group (5 discs) was used to determine the leached components from each material into culture medium by HPLC analysis. The results revealed that Z250 and Tetric Ceram were less cytotoxic than their flowable derivatives. However, the ormocer, Admira, was significantly more cytotoxic than Admira Flow. Among the standard composites, Tetric Ceram was the least cytotoxic and Admira the most. Furthermore, Tetric flow was the most cytotoxic and Admira flow was significantly the least cytotoxic among the flowable materials tested. HPLC analysis revealed bisphenol A glycerolate dimethacrylate (bis-GMA) and triethylene glycol dimethacrylate (TEGDMA) in the eluates of all the materials, while urethane dimethacrylate (UDMA) was present in all eluates except that of Feltik Flow. In conclusion, the flowable derivatives are more cytotoxic than the traditional composites whereas the ormocer Admira Flow is less cytotoxic than the Admira composite.

This study investigated the effect of extracts of different composites, glass ionomer cement (GIC)s and compomers on the viability of brine shrimp larvae. Ethanolic extracts of four dental composites (Z-100; Solitaire 2; Filtek P60 and Synergy), a conventional GIC (Ketac-Fil), a resin-modified glass ionomer cement (Vitremer), two compomers (F2000; Dyract AP), and a flowable compomer (Dyract Flow) were prepared from each material. Following evaporation of the ethanol, the extracts were resuspended in distilled water, which was then used to test the effects on the viability of brine shrimp larvae. For the composites, the extract of Synergy was the least toxic (88% viability) followed by the extracts of Solitaire 2, Z100 and P60 (75%, 67.5% and 50% viability, respectively). One-way ANOVA revealed highly significant differences between the resin composite materials (p<0.001). Follow-up comparison between the composite groups by Tukey's pairwise multiple-comparison test (α =0.05) showed that the extract of Synergy was significantly less toxic than the extracts of all the other materials except that of Solitaire 2. The compomers showed 100% lethality, while the percentage of viable larvae for the extracts of Ketac-Fil, and Vitremer were 32.3%, and 37.0%, respectively. One-way ANOVA revealed highly significant differences between the groups of materials (p<0.001). Follow-up comparison between the groups by Tukey's test (α = 0.05) showed that the toxic effect of the extracts of the compomers were significantly greater than that of Ketac-Fil, and Vitremer. The differences in the toxic effects of Vitremer and Ketac-Fil were not statistically significant. In conclusion, the toxicity of composite materials varied according to their chemical composition. Compomers were the most lethal materials to brine shrimp larvae followed by GICs and then composites.