Abstract
Background: The development of materials with bioregenerative properties is critically important for vital pulp therapies and regenerative endodontic procedures. The aim of this study was to evaluate the cytocompatibility and cytotoxicity of a new endodontic biomaterial, PulpGuard, in comparison with two other biomaterials widely used in endodontic procedures, ProRoot Mineral Trioxide Aggregate (MTA) and Biodentine. Methods: Apical papilla cells (APCs) were isolated from third molars with incomplete rhizogenesis from patients with orthodontic indication for dental extraction. Cultured APCs were incubated for 24, 48, or 72 h with different dilutions of eluates prepared from the three materials. Cellular viability, mobility, and proliferation were assessed in vitro using the Alamar Blue assay and a wound-healing test. The cells were also cultured in direct contact with the surface of each material. These were then analyzed via Scanning Electron Microscopy (SEM), and the surface chemical composition was determined by Energy-Dispersive Spectroscopy (EDS). Results: Cells incubated in the presence of eluates extracted from ProRoot MTA and PulpGuard presented rates of viability comparable to those of control cells; in contrast, undiluted Biodentine eluates induced a significant reduction of cellular viability. The wound-healing assay revealed that eluates from ProRoot MTA and PulpGuard allowed for unhindered cellular migration and proliferation. Cellular adhesion was observed on the surface of all materials tested. Consistent with their disclosed composition, EDS analysis found high relative abundance of calcium in Biodentine and ProRoot MTA and high abundance of silicon in PulpGuard. Significant amounts of zinc and calcium were also present in PulpGuard discs. Concerning solubility, Biodentine and ProRoot MTA presented mild weight loss after eluate extraction, while PulpGuard discs showed significant water uptake. Conclusions: PulpGuard displayed a good in vitro cytocompatibility profile and did not significantly affect the proliferation and migration rates of APCs. Cells cultured in the presence of PulpGuard eluates displayed a similar profile to those cultured with eluates from the widely used endodontic cement ProRoot MTA.
Highlights
IntroductionThe development of new materials with bioregenerative properties has been a major goal in biomaterial engineering
The development of new materials with bioregenerative properties has been a major goal in biomaterial engineering. The use of these products on vital pulp therapies and regenerative endodontic procedures must provide a barrier for blood clot and microorganisms and simultaneously possess adequate biocompatibility and bioactive properties to induce tissue repair or stimulate stem cell differentiation and regeneration [1,2]
Our results indicate that when comparing only the most concentrated eluates across time and between different biomaterials, only Biodentine shows a significant reduction in cellular viability compared to the control conditions or to other endodontic cements (Two-way ANOVA: Effect of compound p < 0.001) (Figure 1J and Table 1)
Summary
The development of new materials with bioregenerative properties has been a major goal in biomaterial engineering. MTA is the most common biomaterial used in endodontic treatment and is primarily composed of tricalcium and dicalcium silicate with bismuth oxide (Table S1—Composition and setting time of the tested materials) [4] Hydration of this powder results in the formation of calcium hydroxide and a calcium silicate hydrate gel which, after a period of time, transforms into a poorly crystallized and porous solid [5]. Several studies have revealed that ProRoot MTA can induce cell attachment, proliferation, and differentiation of dental pulp stem cells and apical papilla stem cells into cells that are able to produce mineralized tissue [10].
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