Abstract
The aim of the present study was to evaluate the cytotoxic effects of five endodontic sealers (AH Plus, Endomethasone N, EndoSequence BC, MTA Fillapex and Pulp Canal Sealer EWT) using a three-dimensional (3D) cell culture model. A conventional bi-dimensional (2D) cell culture model was used as reference technique for comparison. Balb/c 3T3 fibroblasts were cultured in conventional bi-dimensional cell culture and in rat-tail collagen type I three-dimensional cell culture models. Then, both cell cultures were incubated with elutes of freshly mixed endodontic sealers for 24 h. Cell viability was measured by the methyl-thiazol-diphenyltetrazolium assay (MTT). Data were statistically analyzed using ANOVA and the Tukey test at a significance level of p<0.05. All tested sealers exhibited cytotoxic effects; however, cytotoxic effect was culture model- and sealer-dependent. Sealers showed higher cytotoxicity in 2D than in 3D cell culture model (p<0.05). In both conditions, EndoSequence BC showed the lowest cytotoxicity (p<0.05). MTA Fillapex was much more cytotoxic than the other tested endodontic sealers (p<0.05), with the exception of AH Plus in the 2D cell culture model (p>0.05). Endomethasone N and Pulp Canal Sealer EWT showed lower cytotoxic effects than AH Plus in 2D cell culture model (p<0.05); however no statistical differences was observed among these sealers in 3D cell culture model. It may be concluded that cytotoxicity was higher in 2D cell culture compared to 3D cell culture. EndoSequence BC sealer exhibited the highest cytocompatibility and MTA Fillapex the lowest cytocompatibility.
Highlights
IntroductionFor safety reasons, each sealer must have its biological properties comprehensively and independently screened by in vitro and in vivo tests before its unlimited clinical use, in order to minimize incidence of local and/or systemic adverse effects [4,5,6]
Root canal sealers may come in intimate contact with the periapical tissues for an extended period because of extrusion from the apex and/or when restricted to the root canal because of degradation products that may leach through a lateral and accessory canal or apical foramina, reaching the surrounding tissues [1,2,3].for safety reasons, each sealer must have its biological properties comprehensively and independently screened by in vitro and in vivo tests before its unlimited clinical use, in order to minimize incidence of local and/or systemic adverse effects [4,5,6]
Endomethasone N and Pulp Canal Sealer EWT showed lower cytotoxic effects than AH Plus in 2D cell culture model (p
Summary
For safety reasons, each sealer must have its biological properties comprehensively and independently screened by in vitro and in vivo tests before its unlimited clinical use, in order to minimize incidence of local and/or systemic adverse effects [4,5,6]. Cytotoxicity tests are evaluated using traditional bi-dimensional (2D) culture systems. It may be argued that some sealers have a significant toxic behavior in vitro, it does not occur in the clinical real-life situation mostly because of the difference between in vitro and in vivo conditions. Bi-dimensional culture systems form a monolayer that may have inhibition contacts among cells and change the original characteristic of cell morphology and functionality [8]. Three-dimensional (3D) cell models, on the other hand, can mimic in vivo cellular conditions in a better way because the 3D scaffold supports cell growth and cell functions, including morphogenesis, cell metabolism and cell-to-cell interactions [9]
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