Cytotoxicity and osteogenic potential of silicate calcium cements as potential protective materials for pulpal revascularization

Abstract

Objectives In pulpal revascularization, a protective material is placed coronal to the blood clot to prevent recontamination and to facilitate osteogenic differentiation of mesenchynal stem cells to produce new dental tissues. Although mineral trioxide aggregate (MTA) has been the material of choice for clot protection, it is easily displaced into the clot during condensation. The present study evaluated the effects of recently-introduced calcium silicate cements (Biodentine and TheraCal LC) on the viability and osteogenic differentiation of human dental pulp stem cells (hDPSCs) by comparing with MTA Angelus. Methods Cell viability was assessed using XTT assay and flow cytometry. The osteogenic potential of hDPSCs exposed to calcium silicate cements was examined using qRT-PCR for osteogeic gene expressions, alkaline phosphatase enzyme activity, Alizarin red S staining and transmission electron microscopy of extracellular calcium deposits. Parametric statistical methods were employed for analyses of significant difference among groups, with α=0.05. Results The cytotoxic effects of Biodentine and TheraCal LC on hDPSCs were time- and concentration-dependent. Osteogenic differentiation of hDPSCs was enhanced after exposure to Biodentine that was depleted of its cytotoxic components. This effect was less readily observed in hDPSCs exposed to TheraCal LC, although both cements supported extracelluar mineralization better than the positive control (zinc oxide-eugenol–based cement). Significance A favorable tissue response is anticipated to occur with the use of Biodentine as a blood clot-protecting material for pulpal revascularizaiton. Further investigations with the use of in vivo animal models are required to validate the potential adverse biological effects of TheraCal LC on hDPSCs.

Cytocompatibility of Biodentine and iRoot FS with human periodontal ligament cells: an in vitro study

“…It was also noticed that ALP gene expression was lower in the Biodentine group compared to the control group, which is inconsistent with most other studies (Bortoluzzi et al . , Margunato et al . ).…”

Clinical and radiographic evaluation of Biodentine and Mineral Trioxide Aggregate in revascularization of non‐vital immature permanent anterior teeth (randomized clinical study)

“…Biodentine has the same mechanical properties as human dentine, very low cytotoxicity, and overcomes clinical drawbacks of white MTA . It had better consistency and allowed its condensation without any apical displacement . Biodentine sets within 12 minutes, which allowed the placement of composite restoration in the same appointment.…”

Cytotoxicity and biocompatibility of resin-free and resin-modified direct pulp capping materials: A state-of-the-art review

“…The hydrophilic matrix allows higher calcium and hydroxide release, which are very important in protecting pulp their ability to stimulate dentin formation and provide antibacterial action (high alkalinity), respectively 6,31,33) . Both TheraCal LC and resin-modified calcium hydroxide were shown to be more cytotoxic to murine odontoblasts cells and human dental pulp stem cells than resin-free calcium silicates, such as Biodentine, MTA Angelus, and ProRoot MTA, but they showed similar or lower cytotoxicity than Dycal (vitality with MTT test after 72 h: resin-modified materials: 14-15%, resin-free MTA 28-35%, Dycal 9%; number of vital cells with Alamar blue tests after 72 h: resin-modified materials: 33000-35000, resin-free MTA 333000-533000, Dycal 30000) 8,34) . However, this cytotoxicity might be due to the uncured monomers in the oxygen inhibition layer on the surface of TheraCal LC test samples during sample preparation in the laboratory (exposure to air/oxygen).…”