Cytotoxicity and Genotoxicity of Epoxy Resin-Based Root Canal Sealers before and after Setting Procedures

Abstract

Epoxy resin-based sealers are commonly used for successful endodontic treatment. This study aimed to evaluate the cytotoxicity and genotoxicity of epoxy resin-based sealers under unset and set conditions. Three epoxy resin-based sealers were used: Adseal, AH Plus, and Dia-Proseal. To test cytotoxicity, an agar overlay test and a 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay were performed using unset and set sealers on L929 mouse fibroblasts. The genotoxicity test of the comet assay was performed using the same cell line. Extract dilutions in the culture media were used as test materials for the MTT and comet assays. The comet tail produced by the damaged DNA was calculated by image analyses. Statistical analyses were performed using one-way analysis of variance and Tukey’s post hoc test. Unset sealers did not show defined decolorized areas. Hardened specimens of resin-based sealers showed circular discolored zones in the agar overlay test. Dia-Proseal was the least cytotoxic after hardening. These results were confirmed in the MTT assay. Cell viability was significantly higher in cells treated with hardened sealers in both groups than that in cells treated with freshly mixed sealers in the MTT assay. Unset AH Plus® and Dia-Proseal™ significantly increased cell viability with decreasing dilution. Adseal™ was the least cytotoxic. Freshly mixed Adseal™ was more genotoxic when freshly mixed than when set. Unset epoxy resin-based sealers were generally more cytotoxic and genotoxic than set materials. Cytotoxicity does not always match the genotoxicity results; therefore, various test tools are required to test toxicity. It is necessary to properly evaluate the toxic effects to establish a biocompatibility test that mimics clinical conditions.

Surgical Site-Released Tissue Is Potent to Generate Bone onto TCP and PCL-TCP Scaffolds In Vitro

“…In accordance, epoxy resin-based root canal sealers are in clinical application in dentistry for years [41]. Although some data document dose-dependent cytotoxicity and genotoxicity for epoxy resins in vitro [42], other results confirm a relative good cytocompatibility for the most products in its polymerized stage [43]. In our study, we showed that the cultivated cells from SSRT migrated into the 3D micropores of both scaffolds and found qualitative differences in SEM.…”

Cytotoxicity and genotoxicity of bioceramic root canal sealers compared to conventional resin-based sealer

“…AH Plus was the most widely studied in cytotoxicity assessment, thus in our study was considered as the reference sealer 19 , 33 – 38 . In the present study, set AH Plus exhibited above 90% of viable hGF and SC cells after both incubation periods.…”

“…Among the many desirable features of sealants, one is biocompatibility. According to the International Organization for Standardization (ISO) 1942, the biocompatible material used in dentistry does not cause any adverse local or systemic effects when contact with vital tissue, but provides the most beneficial host response 19 , 20 . The toxicity of root canal sealers can be related directly to their components such as eugenol, bisphenol A, resin monomers; substances that are released during the setting reaction (e.g., formaldehyde) or after due to their solubility (e.g., calcium hydroxide).…”

“…The substances formed due to the degradation of sealants may be in long-term contact with periapical tissues and thus induce cytotoxic and genotoxic effects 23 , 24 . They can temporarily or permanently enter the bloodstream or come into contact with other tissue fluids, causing irritation, inflammation and possibly delayed healing after endodontic procedures 19 , 25 .…”

Effect of Different Sealers on the Cytocompatibility and Osteogenic Potential of Human Periodontal Ligament Stem Cells: An In Vitro Study

“…Additionally, the polymerization reaction of AH Plus is associated with a minor release of formaldehyde [ 36 ], which might explain why AH-Plus has been shown to be cytotoxic when freshly mixed but not when set [ 37 , 38 ]. Additionally, another study reported that ADSeal was more biocompatible than AH Plus in an MTT assay on L929 mouse fibroblasts, regardless of being set or unset [ 39 ].…”