Monomers are released from dental resin materials, and thus cause adverse biological effects in mammalian cells. Cytotoxicity and genotoxicity of some of these methacrylates have been identified in a vast number of investigations during the last decade. It has been well-established that the co-monomer triethylene glycol dimethacrylate (TEGDMA) causes gene mutations in vitro. The formation of micronuclei is indicative of chromosomal damage and the induction of DNA strand breaks detected with monomers like TEGDMA and 2-hydroxyethyl methacrylate (HEMA). As a consequence of DNA damage, the mammalian cell cycle was delayed in both G1 and G2/M phases, depending on the concentrations of the monomers. Yet, the mechanisms underlying the genetic and cellular toxicology of resin monomers have remained obscure until recently. New findings indicate that increased oxidative stress results in an impairment of the cellular pro- and anti-oxidant redox balance caused by monomers. It has been demonstrated that monomers reduced the levels of the natural radical scavenger glutathione (GSH), which protects cell structures from damage caused by reactive oxygen species (ROS). Depletion of the intracellular GSH pool may then significantly contribute to cytotoxicity, because a related increase in ROS levels can activate pathways leading to apoptosis. Complementary, cytotoxic, and genotoxic effects of TEGDMA and HEMA are inhibited in the presence of ROS scavengers like N-acetylcysteine (NAC), ascorbate, and Trolox (vitamin E). Elevated intracellular levels of ROS can also activate a complex network of redox-responsive macromolecules, including redox-sensitive transcription factors like nuclear factor kappaB (NF-kappaB). It has been shown that NF-kappaB is activated probably to counteract HEMA-induced apoptosis. The induction of apoptosis by TEGDMA in human pulp cells has been associated with an inhibition of the phosphatidylinositol 3-kinase (PI3-K) cell-survival signaling pathway. Although the details of the mechanisms leading to cell death, genotoxicity, and cell-cycle delay are not completely understood, resin monomers may be able to alter the functions of the cells of the oral cavity. Pathways regulating cellular homeostasis, dentinogenesis, or tissue repair may be modified by monomers at concentrations well below those which cause acute cytotoxicity.

http://journals.sagepub.com/doi/pdf/10.1177/154405910608501001

Genetic and Cellular Toxicology of Dental Resin Monomers

http://faculty.fortlewis.edu/blake_d/Publications%20PDFs/Harvey2008.pdf

Nrf2-regulated glutathione recycling independent of biosynthesis is critical for cell survival during oxidative stress

In vitro and in vivo studies have clearly identified that some components of restorative composite resins, adhesives, and resin-modified glass ionomer cements are toxic. The mechanisms of cytotoxicity are related firstly to the short-term release of free monomers occurring during the monomer–polymer conversion. Secondly, long-term release of leachable substances is generated by erosion and degradation over time. In addition, ion release and proliferation of bacteria located at the interface between the restorative material and dental tissues are also implicated in the tissue response. Molecular mechanisms involve glutathione depletion and reactive oxygen species (ROS) production as key factors leading to pulp or gingival cell apoptosis. Experimental animal approaches substantiate the occurrence of allergic reactions. There is a large gap between the results published by research laboratories and clinical reports.

In vitro and in vivo studies on the toxicity of dental resin components: a review

Prolonged high secretion of glucocorticoids normally reflects a state of chronic stress, which has been associated with an increase in disease susceptibility and reduction in Darwinian fitness. Here, we hypothesize that an increase in oxidative stress accounts for the detrimental effects of prolonged high secretion of glucocorticoids. We performed a meta-analysis on studies where physiological stress was induced by administration of glucocorticoids to evaluate the magnitude of their effects on oxidative stress. Glucocorticoids have a significant effect on oxidative stress (Pearson r = 0.552), although this effect depends on the duration of treatment, and is larger in long-term experiments. Importantly, there was a significant effect on tissue, with brain and heart being the most and the least susceptible to GC-induced oxidative stress, respectively. Furthermore, effect size was larger (1) in studies using both sexes compared to males only, (2) when corticosterone rather than dexamethasone was administered and (3) in juveniles than in adults. These effects were not confounded by species, biochemical biomarker, or whether wild or laboratory animals were studied. In conclusion, our meta-analysis suggests that GC-induced oxidative stress could be a further mechanism underlying increases in disease susceptibility and decreases in Darwinian fitness observed under chronic stress.

A meta-analysis of glucocorticoids as modulators of oxidative stress in vertebrates.

How much do resin-based dental materials release? A meta-analytical approach

In vitro embryotoxicity assessment with dental restorative materials.

Antioxidative vitamins decrease cytotoxicity of HEMA and TEGDMA in cultured cell lines.

1 Dimercaprol (BAL), 2,3-dimercaptopropanesulpho nate sodium (DMPS) and meso-2,3-dimercaptosucci nic acid (DMSA) are effective arsenic antidotes, but the question which one is preferable for optimal therapy of arsenic poisoning is still open to discussion. Major drawbacks of BAL include (a) its low therapeutic index, (b) its tendency to redistribute arsenic to brain and testes, for example, (c) the need for (painful) intramuscular injection and (d) its unpleasant odour.2 The newer antidotes DMPS and DMSA feature low toxicity and high therapeutic index. They can be given orally or intravenously due to their high water solubility. While these advantages make it likely that DMPS and DMSA will replace BAL for the treatment of chronic arsenic poisoning, acute intoxication - espe cially with lipophilic organoarsenicals - may pose a problem for the hydrophilic antidotes, because their ionic nature can adversely affect intracellular avail ability.3 This article focuses on aspects dealing with the power of BAL, DM...

U. I. Walther

Papers

In vitro embryotoxicity assessment with dental restorative materials.

Antioxidative vitamins decrease cytotoxicity of HEMA and TEGDMA in cultured cell lines.

Are we ready to replace dimercaprol (BAL) as an arsenic antidote

Cytotoxicity of dental composite components and mercury compounds in lung cells.

Cytotoxicity of dental composite components and mercury compounds in pulmonary cells.