Citation Information :
Shetty R, Jagtap P, Agarwalla A, Wani P, Bhargava K, Martande S. Comparative Evaluation of Cytotoxicity of Root Canal Sealers on Cultured Human Periodontal Fibroblasts: In vitro Study. J Contemp Dent Pract 2018; 19 (7):847-852.
Aim: To evaluate and compare the cytotoxic effects of different types of root canal.
Materials and methods: The sealers were eluted with culture medium for 1 hour, 7 days, and 14 days. Cell viability was estimated by 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay and trypan blue exclusion method on human periodontal ligament (PDL) fibroblast cells. Sealers used are mineral trioxide aggregate (MTA)-based sealer (MTA Fillapex, Angelus), calcium hydroxide-based sealer (Apexit Plus, Ivoclar Vivadent), resin-based sealer (AH Plus, Dentsply), and zinc oxide eugenol-based sealer (Tubli Seal, SybronEndo).
Results: The order of cytotoxicity through MTT assay, at the end of the second week, was observed as MTA Fillapex> Tubli Seal> Apexit Plus > AH Plus. The percentage cell viability obtained after trypan blue exclusion method decreased in the order of Apexit Plus> Tubli Seal> AH Plus> MTA Fillapex, which was similar to the reported cytotoxicity from the MTT assay after 1 hour.
Conclusion: Each type of sealer showed moderate-to-severe cytotoxic response when compared with the control. The MTA Fillapex was found to be the most cytotoxic sealer. Use of resin-based material as a root canal sealer may result in a more favorable response to PDL fibroblasts.
Clinical significance: Having knowledge of the cytotoxicity of various sealers will help in increasing patient\'s comfort.
Hülsmann M, Peters OA DP. Mechanical preparation of root canals: shaping goals, techniques and means. Endod Top 2005;10:30-76.
Grossman LI. Endodontics 1776-1976: a bicentennial history against the background of general dentistry. J Am Dent Assoc 1976 Jul;93(1):78-87.
Eldeniz AU, Mustafa K, Ørstavik D, Dahl JE. Cytotoxicity of new resin-, calcium hydroxide- and silicone-based root canal sealers on fibroblasts derived from human gingiva and L929 cell lines. Int Endod J 2007 May;40(5):329-337.
Schmalz G. Use of cell cultures for toxicity testing of dental materials--advantages and limitations. J Dent 1994;22 (Suppl 2): S6-S11.
Camp MA, Jeansonne BG, Lallier T. Adhesion of human fibroblasts to root-end-filling materials. J Endod 2003 Sep;29(9):602-607.
Souza NJA, Justo GZ, Oliveira CR, Haun M, Bincoletto C. Cytotoxicity of materials used in perforation repair tested using the V79 fibroblast cell line and the granulocyte-macrophage progenitor cells. Int Endod J 2006 Jan;39(1):40-47.
De-Deus G, Canabarro A, Alves GG, Marins JR, Linhares ABR, Granjeiro JM. Cytocompatibility of the ready-to-use bioceramic putty repair cement iRoot BP Plus with primary human osteoblasts. Int Endod J 2012 Jun;45(6):508-513.
Johnson WT, Kulild JC. Obturation of the cleaned and shaped root canal system. In: Cohen S HK, ed. Pathways of the pulp. 10th ed. St Louis, MO: Mosby; 2011. pp. 349-388.
Heil J, Reifferscheid G, Waldmann P, Leyhausen G, Geurtsen W. Genotoxicity of dental materials. Mutat Res 1996 Jul;368(3-4): 181-194.
Yoshino P, Nishiyama CK, Modena KC da S, Santos CF, Sipert CR. In vitro cytotoxicity of white MTA, MTA Fillapex® and Portland cement on human periodontal ligament fibroblasts. Braz Dent J 2013;24(2):111-116.
Rodrigues JC, Hegde MN, Kumari S. A comparative evaluation of root canal sealers on human gingival fibroblasts—a cell culture study. Endodontology 2011;23 (Suppl.):48-55.
Al-Hiyasat AS, Tayyar M, Darmani H. Cytotoxicity evaluation of various resin based root canal sealers. Int Endod J 2010 Feb;43(2):148-153.
Mosmann T. Rapid colorimetric assay for cellular growth and survival: application to proliferation and cytotoxicity assays. J Immunol Methods 1983 Dec;65(1-2):55-63.
Correa GT, Veranio GA, Silva LE, Hirata Junior R, Coil JM, Scelza MF. Cytotoxicity evaluation of two root canal sealers and a commercial calcium hydroxide paste on THP1 cell line by Trypan Blue assay. J Appl Oral Sci 2009 Sep-Oct;17 (Suppl 5): 457-461.
Browne RM. The in vitro assessment of the cytotoxicity of dental materials--does it have a role? Int Endod J 1988 Mar;21(2):50-58.
Al-Nazhan S, Spangberg L. Cytotoxicity study of AH26 and Amalgam, in vitro, using human periodontal ligament fibroblasts. Saudi Dent J 1990 Jan;2(2):48-51.
Karapýnar-Kazandað M, Bayrak OF, Yalvaç ME, Ersev H, Tanalp J, Sahin F, Bayýrlý G. Cytotoxicity of 5 endodontic sealers on L929 cell line and human dental pulp cells. Int Endod J 2011 Jul;44(7):626-634.
Huang T-H, Ding S-J, Hsu T-Z, Lee Z-D, Kao C-T. Root canal sealers induce cytotoxicity and necrosis. J Mater Sci Mater Med 2004 Jul;15(7):767-771.
Mittal M, Chandra S, Chandra S. Comparative tissue toxicity evaluation of four endodontic sealers. J Endod 1995 Dec;21(12):622-624.
Ersev H, Schmalz G, Bayirli G, Schweikl H. Cytotoxic and mutagenic potencies of various root canal filling materials in eukaryotic and prokaryotic cells in vitro. J Endod 1999 May;25(5):359-363.
Chang MC, Lin LD, Chen YJ, Tsai YL, Cheng YA, Kuo CS, Chang HH, Tai TF, Lin HJ, Jeng JH. Comparative cytotoxicity of five root canal sealers on cultured human periodontal ligament fibroblasts. Int Endod J 2010 Mar;43(3): 251-257.