The in vitro cytotoxic response to endodontic sealers was assessed for one year. AH-Plus (AHP), Epiphany (EPH), EndoRez (ER), Guttaflow (GF), InnoEndo (IN), and Pulp Canal Sealer (PCS) were exposed to mouse osteoblasts and human monocytes after curing, 52 weeks of aging, and after resurfacing post-aging; cellular response was estimated by succinate dehydrogenase (SDH) activity. The effect of materials on TNFα secretion from activated (LPS) and inactivated monocytes also was measured. Cell responses were compared with ANOVA and Tukey post hoc analysis (α = 0.05). Initially, all materials except GF suppressed osteoblastic SDH activity compared with Teflon (Tf) controls. SDH activity in cells exposed to some aged sealers improved significantly; but IN and ER remained cytotoxic. When aged materials were resurfaced then tested, AHP, ER, GF, and IN did not change. EPH and PCS were more toxic. Monocytes responded similarly to the osteoblasts. No endodontic sealer activated monocytic TNFα secretion (p > 0.05 vs. -LPS Tf-controls). LPS-activated monocytes exposed to unresurfaced AHP and IN significantly suppressed TNFα secretion. When activated monocytes were exposed to the resurfaced sealers, differential suppression of TNFα secretion was observed for three of the four sealers tested (EPH, IN, and PCS). The results suggest that long-term aging may be a useful adjunct to in vitro assessment of these materials.
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