Cytotoxicity and genotoxicity of calcium silicate-based cements on an osteoblast lineage

Vital Pulp Therapy in Aesthetic Zone-Identifying the Biomaterial That Reduces the Risk of Tooth Discolouration

Calcium silicate-based cements are biocompatible materials for vital pulp therapy. However, they discolour the tooth tissue, which is important for the aesthetics of the anterior teeth. The aim of this study was to investigate the effect of calcium silicate-based cements on tooth discolouration. The study included 70 extracted bovine incisors. The crown of the tooth was cut off from the root, 2 mm below the cement-enamel junction. The pulp tissue was removed via a cervical cut with a barbed broach. The teeth were randomly divided into five experimental, one positive, and one negative control groups. The evaluated materials included Biodentine, Ortho MTA, Retro MTA, MTA Plus, MTA Repair HP, and in the positive group, ProRoot MTA. A VITA Easyshade Compact 5.0 spectrophotometer was used before the application, after 1 week, 1 month, 3 months, and 6 months. The significance levels were set at p < 0.05. All materials significantly changed the teeth colour (p < 0.05). However, Ortho MTA, ProRoot MTA, MTA Plus, and Biodentine (ΔE > 6) caused maximum colour change after 6 months. While the ProRoot MTA, Ortho MTA, and MTA Plus caused grey discolouration, Biodentine darkened the shade of the base colour. Thus, Retro MTA and MTA Repair HP can be safely used in the aesthetic dentition zone. According to these clinical results, the possibility of using Biodentine, due to its lack of gray discoloration, can be considered.

Genotoxicity of root canal sealers: a literature review

OBJECTIVES

Root canal sealers are widely used worldwide in endodontics to prevent reinfection and growth of surviving microorganisms. Considering the strong correlation between genetic damage and carcinogenesis, evaluation of genotoxicity induced by endodontic sealers is recommended for elucidating the true health risks to patients and professionals. The purpose of this article was to provide a comprehensive review of studies involving genotoxicity analysis of endodontic sealers and the used methodologies.

MATERIALS AND METHODS

A literature search was made in PubMed using the following combination of words "genotoxicity," "mutagenicity," "endodontic sealers," and "root canal sealers." A total of 39 articles with genotoxicity studies were selected for the present study.

RESULTS

Sealers have been ranked in decreasing order of their genotoxicity as: ZOE sealers > GIC sealers > S sealers > ER sealers > MR sealers > Novel sealers > CH sealers > CS sealers.

CONCLUSIONS

All published data showed some evidence of genotoxicity for most of the commercial root canal sealers; however, contradictory results were found, mainly for AH Plus, the most studied sealer.

CLINICAL RELEVANCE

The information provided would direct the endodontists to use the less genotoxic materials in endodontic treatment in a way to reduce DNA damage promoting oral healthcare.