Cytotoxicity evaluation of dental resin composites and their flowable derivatives.
TL;DR: The flowable derivatives are more cytotoxic than the traditional composites whereas the ormocer Admira Flow is less cytotoxicity than the AdMira composite.
Abstract: 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.
Citations
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TL;DR: The aim of this article is to systematically review the ingredients commonly used in current dental adhesives as well as the properties of these ingredients.
1,218 citations
TL;DR: A meta-analytical study on the short and long-term release of components from resin-based dental materials, and how much (order of magnitude) of those components may leach out in the oral cavity is presented in this paper.
323 citations
01 Jan 2013
TL;DR: This meta-analytical study reviewed the literature on the short- and long-term release of components from resin-based dental materials, and to determine how much of those components may leach out in the oral cavity.
Abstract: OBJECTIVES
Resin-based dental materials are not inert in the oral environment, and may release components, initially due to incomplete polymerization, and later due to degradation. Since there are concerns regarding potential toxicity, more precise knowledge of the actual quantity of released eluates is necessary. However, due to a great variety in analytical methodology employed in different studies and in the presentation of the results, it is still unclear to which quantities of components a patient may be exposed. The objective of this meta-analytical study was to review the literature on the short- and long-term release of components from resin-based dental materials, and to determine how much (order of magnitude) of those components may leach out in the oral cavity.
METHODS
Out of an initial set of 71 studies, 22 were included. In spite of the large statistical incertitude due to the great variety in methodology and lack of complete information (detection limits were seldom mentioned), a meta-analytical mean for the evaluated eluates was calculated. To relate the amount of potentially released material components with the size of restorations, the mean size of standard composite restorations was estimated using a 3D graphical program.
RESULTS
While the release of monomers was analyzed in many studies, that of additives, such as initiators, inhibitors and stabilizers, was seldom investigated. Significantly more components were found to be released in organic than in water-based media. Resin-based dental materials might account for the total burden of orally ingested bisphenol A, but they may release even higher amounts of monomers, such as HEMA, TEGDMA, BisGMA and UDMA. Compared to these monomers, similar or even higher amounts of additives may elute, even though composites generally only contain very small amounts of additives. A positive correlation was found between the total quantity of released eluates and the volume of extraction solution.
SIGNIFICANCE
There is a clear need for more accurate and standardized analytical research to determine the long-term release from resin-based materials. Several guidelines for standardization are proposed.
317 citations
Cites background from "Cytotoxicity evaluation of dental r..."
...There ere also differences regarding the moment of immersion of he sample; some authors preferred to wait for 24 h to allow or a post-irradiation cure [95]....
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...[95] Al Hiyasat AS, Darmani H, Milhem MM....
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...1 Al-Hiyasat AS, Darmani H, Milhem MM [95] Cytotoxicity evaluation of dental resin composites and their flowable derivatives Clin Oral Investig 2005;9:21–5 Composite filling material HPLC g/ml Bis-EMA BisGMA BPA TEGDMA UDMA Culture medium without serum...
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...Some researchers advocated a post-irradation cure, signifying that they waited for a period (usually 24-h) before immersing their samples [76,95]....
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TL;DR: This article reviews the literature regarding the biocompatibility, marginal adaptation, color matching, patient selection, technique sensitivity, and mode and rate of failure of tooth-colored restorations.
Abstract: Controversy persists regarding the treatment planning criteria for esthetic restorations. This article reviews the literature regarding the biocompatibility, marginal adaptation, color matching, patient selection, technique sensitivity, and mode and rate of failure of tooth-colored restorations. A Medline search was completed for the period from 1986 to 2006, along with a manual search, to identify pertinent English peer-reviewed articles and textbooks. The key words used were amalgam, posterior composite resin, ceramic inlays/onlays, CEREC, porcelain laminate veneers, all-ceramic crowns, and all-ceramic fixed partial dentures.
244 citations
Cites background from "Cytotoxicity evaluation of dental r..."
...Elutable substances such as TEGDMA and formaldehyde may be released in the oral cavity and have demonstrated cytotoxic effects causing lichenoid or allergic reactions, questioning their universal biocompatibility.(35) Additionally, a direct relationship between fluoride releasing composite resin materials and caries inhibition has not been demonstrated in vivo....
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TL;DR: In this paper, femtosecond laser two photon polymerization (2PP) of organically modified ceramic (Ormocer®) hybrid materials was used to create three-dimensional microneedle devices for transdermal drug delivery.
Abstract: Three-dimensional microneedle devices were created by femtosecond laser two photon polymerization (2PP) of organically modified ceramic (Ormocer®) hybrid materials Arrays of in-plane and out-of-plane hollow microneedles (microneedle length=800 μm, microneedle base diameter=150–300 μm) with various aspect ratios were fabricated The fracture and penetration properties of the microneedle arrays were examined using compression load testing In these studies, the microneedle arrays penetrated cadaveric porcine adipose tissue without fracture Human epidermal keratinocyte viability on the Ormocer® surfaces polymerized using 2PP was similar to that on control surfaces These results suggest that 2PP is able to create microneedle structures for transdermal drug delivery with a larger range of geometries than conventional microfabrication techniques
212 citations
References
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TL;DR: The results of these studies suggest that elution of leachable components from composites is rapid, with the majority being released within a matter of hours.
Abstract: A significant amount of residual monomer or short chain polymers remain unbound in set composite material. Due to its potential impact on both the biocompatibility and the structural stability of the restoration, many investigators have studied the elution of these unbound molecules into aqueous media. The results of these studies suggest that elution of leachable components from composites is rapid, with the majority being released within a matter of hours. Weight losses of up to 2% of the mass of the composite have been reported under certain conditions. The studies have also shown that the extent and rate of elution of components from composites is dependent upon several factors. The quantity of leachables has been correlated to the degree of cure of the polymer network. The composition and solubility characteristics of the extraction solvent influence the kinetics and mechanism of the elution process. Elution is generally thought to occur via diffusion of molecules through the resin matrix, and is therefore dependent upon the size and chemical characteristics of the leachable species.
635 citations
"Cytotoxicity evaluation of dental r..." refers background in this paper
...Previous studies have reported that residual (co)monomers, additives, or polymerization products may be released from set resin composite fillings into the adjacent tissues and oral cavity [4, 5, 15, 18]....
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TL;DR: The leakage of filler elements from four composites after storage in water was investigated by use of atomic absorption spectrophotometry and confirmed previous findings that leaching of silicon from different composites is strongly dependent on filler composition.
Abstract: The leakage of filler elements from four composites after storage in water was investigated by use of atomic absorption spectrophotometry. The results confirmed previous findings that leaching of silicon from different composites is strongly dependent on filler composition. Consideration of the total filler surface of each composite material indicated that quartz as well as pyrolytic silica-containing composites leached less silicon than did composites containing fillers of strontium and/or barium glasses. A correlation between leakage and crack formation in the matrix appeared to exist for all composites except for the microfilled resin. These cracks were explained as a result of osmotic pressure built up at the matrix-filler interface due to hydrolytic degradation of the filler. Of the investigated materials, the microfilled resin was found to be the most stable material in a wet environment with respect to crack formation. This finding was explained by filler composition, filler form, and the specific structure of the microfilled resin.
496 citations
"Cytotoxicity evaluation of dental r..." refers background in this paper
...Previous studies have reported that residual (co)monomers, additives, or polymerization products may be released from set resin composite fillings into the adjacent tissues and oral cavity [4, 5, 15, 18]....
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TL;DR: There was no cell type identified which was consistently less or more sensitive to the toxic effects of the tested compounds than the others, and for several of the highly cytotoxic composite components, less cytot toxic alternatives are available.
Abstract: It was the purpose of this investigation to determine the cytotoxic effects (ED50 concentrations) of 35 monomers or additives identified in commercial dental resin composites. Monolayers of permanent 3T3 cells and three primary human fibroblast types derived from oral tissues (gingiva, pulp, and periodontal ligament) were used as test systems. All substances were tested in concentrations ranging from 0.01 to 5.0 mM. In general, ED50 values varied from 0.06 to > 5 mM. Within the groups of co(monomers), initiators, and cointiators, severe (e.g., Bis-GMA, UDMA, DMBZ, and DMDTA) or moderate (HEMA, BEMA, CQ, DMPT, and DMAPE) cytotoxic effects could be evaluated. Within the group of reaction/decomposition products, only moderate or slight effects were found (ED50: 0.7 to > 5 mM). The inhibitor BHT, the contaminant TPSb, and the photostabilizer HMBP, however, were highly cytotoxic in all cell cultures. In addition, the ED50 values of DBPO and HMBP significantly varied (0.43-3.8 mM, respectively, and 0.44-3.07 mM) with the applied cell culture. Our comprehensive screening shows that for several of the highly cytotoxic composite components, less cytotoxic alternatives are available. Furthermore, there was no cell type identified which was consistently less or more sensitive to the toxic effects of the tested compounds than the others. Primary human periodontal ligament and pulp fibroblasts, however, were found to be more sensitive than 3T3 and gingival fibroblasts to alterations from most tested substances.
463 citations
"Cytotoxicity evaluation of dental r..." refers background in this paper
...The composition of dental composites is chemically complex since they contain a great variety of different monomers and additives [6, 19, 20]....
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...Since bis-GMA is reported to exert greater toxicity than TEGDMA, this could be the underlying reason for the greater cytotoxicity observed in Admira compared with its flowable derivative [6, 27]....
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...Indeed, TEGDMA has been reported to be toxic in different cell lines [6, 10, 22, 27]....
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...did not reach the reported ED50 values for these cells [6]....
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TL;DR: In acrylates, methacrylate, and ethylmethacrylate with either substituents, the lipophilicity of substituent affected their cytotoxicity, and an inverse correlation between IC50 and logP was observed.
Abstract: Thirty-nine acrylates and methacrylates that had been used in dental resin materials were evaluated by a cytotoxicity test, and the relationships between their structures and cytotoxicity were studied to predict cytotoxic levels of dental resin materials in order to develop new low-toxic resin materials All the acrylates evaluated were more toxic than corresponding methacrylates In both the acrylates and methacrylates, a hydroxyl group seemed to enhance cytotoxicity Dimethacrylates with 14 or fewer oxyethylene chains showed similar cytotoxicity while dimethacrylates with 23 oxyethylene chains showed lower cytotoxicity The cytotoxicity ranking of monomers widely used in dental resin materials was bisphenol A bis 2-hydroxypropyl methacrylate (bisGMA) > urethane dimethacrylate (UDMA) > triethyleneglycol dimethacrylate (3G) > 2-hydroxyethyl methacrylate (HEMA) > methyl methacrylate (MMA) In acrylates, methacrylates, and ethylmethacrylates with either substituents, the lipophilicity of substituents affected their cytotoxicity, and an inverse correlation between IC50 and logP was observed These results will be useful in developing new resin materials with low toxic monomer compositions
384 citations
"Cytotoxicity evaluation of dental r..." refers background in this paper
...Since bis-GMA is reported to exert greater toxicity than TEGDMA, this could be the underlying reason for the greater cytotoxicity observed in Admira compared with its flowable derivative [6, 27]....
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...Indeed, TEGDMA has been reported to be toxic in different cell lines [6, 10, 22, 27]....
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TL;DR: The study lends support to the view that dental composites do not provide a chronic source of unreacted monomer to the pulp or other oral tissues, due to a rapid and complete elution of the molecules.
342 citations
"Cytotoxicity evaluation of dental r..." refers background in this paper
...Previous studies have reported that residual (co)monomers, additives, or polymerization products may be released from set resin composite fillings into the adjacent tissues and oral cavity [4, 5, 15, 18]....
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