Abstract

Adhesive resin-cements are increasingly used in modern dentistry. Nevertheless, released substances from resin materials have been shown to cause cellular toxic effects. Disc-shaped specimens from 12 different resin cements and one conventional zinc phosphate cement were prepared and used for direct stimulation of five different human cell lines via transwell cell culture system or in an indirect way using conditioned cell culture media. Cytotoxicity was determined using LDH and BCA assays. All tested cements led to a decrease of cell viability but to a distinct extent depending on cell type, luting material, and cytotoxicity assay. In general, cements exhibited a more pronounced cytotoxicity in direct stimulation experiments compared to stimulations using conditioned media. Interestingly, the conventional zinc phosphate cement showed the lowest impact on cell viability. On cellular level, highest cytotoxic effects were detected in osteoblastic cell lines. All resin cements reduced cell viability of human cells with significant differences depending on cell type and cement material. Especially, osteoblastic cells demonstrated a tremendous increase of cytotoxicity after cement exposure. Although the results of this in vitro study cannot be transferred directly to a clinical setting, it shows that eluted substances from resin cements may disturb osteoblastic homeostasis that in turn could lead to conditions favoring peri-implant bone destruction. Thus, the wide use of resin cements in every clinical situation should be scrutinized. A correct use with complete removal of all cement residues and a sufficient polymerization should be given the utmost attention in clinical usage.

Highlights

  • In reconstructive dentistry, cementation of indirect restorations is a crucial step in the treatment protocol and generally defines the finish of dental rehabilitation

  • The organic matrix predominantly consists of cross-linking methacrylates, the so called “heavy” base monomer systems like 2,2-bis[4-(2hydroxy-3-methacryloxypropoxy)phenyl]propane (BisGMA) and urethane dimethacrylate (UDMA) as well as different comonomers like triethyleneglycol dimethacrylate (TEGDMA) and 2-hydroxyethyl methacrylate (HEMA), which show a lower degree of viscosity [9,10,11]

  • The strongest cytotoxic effect was demonstrated in transwell experiments for the cements SmartCem2, BeautiCem SA, PermaCem 2.0, and Bifix SE with values of 100% and more in Saos-2 cells after 24 h

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Summary

Introduction

Cementation of indirect restorations is a crucial step in the treatment protocol and generally defines the finish of dental rehabilitation. Especially powder–liquid based cements such as zinc phosphate cements were used for fixation of restorations, in modern dentistry a numerous number of resin-based luting materials are utilized [1]. Due to their minimally invasive, preservative, and esthetic qualities, resin-based compounds have become the most important material group in modern dentistry [2]. The mechanical qualities of resin-based compounds, their viscosity, polymerization shrinkage, absorption of water, and their degree of conversion are predominantly determined by the composition of the monomers [12, 13]. Negative biological consequences such as local or systemic toxicity, allergic and estrogenic effects are possible [10, 14,15,16,17]

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