Evaluation of stemness properties of cells derived from granulation tissue of peri-implantitis lesions

Objectives

Peri‐implantitis (PI) is an inflammatory disease associated with peri‐implant bone loss and impaired healing potential. There is limited evidence about the presence of mesenchymal stromal cells (MSCs) and their regenerative properties within the granulation tissue (GT) of infrabony peri‐implantitis defects. The aim of the present study was to characterize the cells derived from the GT of infrabony PI lesions (peri‐implantitis derived mesenchymal stromal cells—PIMSCs).

Material and Methods

PIMSC cultures were established from GT harvested from PI lesions with a pocket probing depth ≥6 mm, bleeding on probing/suppuration, and radiographic evidence of an infrabony component from four systemically healthy individuals. Cultures were analyzed for embryonic (SSEA4, NANOG, SOX2, OCT4A), mesenchymal (CD90, CD73, CD105, CD146, STRO1) and hematopoietic (CD34, CD45) stem cell markers using flow cytometry. PIMSC cultures were induced for neurogenic, angiogenic and osteogenic differentiation by respective media. Cultures were analyzed for morphological changes and mineralization potential (Alizarin Red S method). Gene expression of neurogenic (NEFL, NCAM1, TUBB3, ENO2), angiogenic (VEGFR1, VEGFR2, PECAM1) and osteogenic (ALPL, BGLAP, BMP2, RUNX2) markers was determined by quantitative RT‐PCR.

Results

PIMSC cultures demonstrated high expression of embryonic and mesenchymal stem cell markers with inter‐individual variability. After exposure to neurogenic, angiogenic and osteogenic conditions, PIMSCs showed pronounced tri‐lineage differentiation potential, as evidenced by their morphology and expression of respective markers. High mineralization potential was observed.

Conclusions

This study provides evidence that MSC‐like populations reside within the GT of PI lesions and exhibit a multilineage differentiation potential. Further studies are needed to specify the biological role of these cells in the healing processes of inflamed PI tissues and to provide indications for their potential use in regenerative therapies.

Impaired angiogenic differentiation of dental pulp stem cells during exposure to the resinous monomer triethylene glycol dimethacrylate

OBJECTIVE

Dental pulp stem cells (DPSCs) can differentiate into tissue specific lineages to support dental pulp regeneration after injuries. Triethylene glycol dimethacrylate (TEGDMA) is a widely used co-monomer in restorative dentistry with adverse effects on cellular metabolism. Aim of this study was to analyze the impact of TEGDMA on the angiogenic differentiation potential of DPSCs.

METHODS

DPSCs were characterized by flow cytometry. Short-term (max. 72h) cytotoxicity of TEGDMA was assessed by MTT assay. To evaluate TEGDMA effects on angiogenic differentiation, DPSCs were cultivated in angiogenic differentiation medium (ADM) in the presence or absence of short-term non-toxic TEGDMA concentrations (0.1mM and 0.25mM). Subsequently, angiogenic differentiation was analyzed by qRT-PCR analysis of mRNA markers and in vitro spheroid sprouting assays.

RESULTS

DPSCs treated with 0.25mM TEGDMA revealed downregulation of angiogenesis-related marker genes PECAM1 (max. 3.8-fold), VEGF-A (max. 2.4-fold) and FLT1 (max. 2.9-fold) compared to respective untreated control. In addition, a reduction of the sprouting potential of DPSCs cultured in the presence of 0.25mM TEGDMA was detectable. Larger spheroidal structures were detectable in the untreated control in comparison to cells treated with 0.25mM TEGDMA. In contrast, TEGDMA at 0.1mM was not affecting angiogenic potential in the investigated time period (up to 28 days).

SIGNIFICANCE

The results of the present study show that TEGDMA concentration dependently impair the angiogenic differentiation potential of DPSCs and may affect wound healing and the formation of granulation tissue.

Genotoxic and mutagenic potential of camphorquinone in L5178/TK+/- mouse lymphoma cells

OBJECTIVES

Camphorquinone (CQ) is the most important photoinitiator used in dental composite resins. Sparse data indicate a mutagenic potential of CQ. Therefore, it was aim of this study to evaluate the cytotoxicity, genotoxicity, and mutagenicity of CQ in L5178Y TK^+/- mouse lymphoma cells.

METHODS

L5178Y/TK^+/- cells were exposed to different concentrations of non-irradiated CQ (0.25-2.5mM). Cytotoxicity was evaluated by propidium iodide assay, determination of suspension growth rate, relative total growth and the mitotic index. Intracellular levels of reactive oxygen/nitrogen species (ROS/RNS) were quantified by 2',7'-dichlorofluoresceine diacetate (DCFH-DA). Early induction of DNA strand breaks and oxidative DNA base lesions was assessed using the 8-hydroxyguanine DNA-glycosylase 1 (hOGG1)-modified alkaline comet assay, whereas mutagenicity of CQ was determined in the mouse lymphoma TK assay (MLA), according to OECD Guideline No. 490.

RESULTS

CQ (0.5-2.5mM) induced concentration- and time-dependent inhibition of cell growth associated with increased ROS/RNS production, amounting to 2342%±1108% of controls after 90min at 2.5mM. Additionally, CQ concentration-dependently caused direct DNA-damage, i.e. formation of DNA strand breaks and 8-hydroxy-2'-deoxyguanosine. Whereas the MLA indicated lack of mutagenicity of CQ after a 4h of treatment, CQ concentration-dependently increased total mutant frequency (MF) after 24h (about 2-fold at 2.5mM). But, based on the global evaluation factor concept, increase in MF did not reach biologically relevance.

SIGNIFICANCE

CQ induced concentration-dependent, cytotoxic and genotoxic effects in L5178Y/TK^+/- cells, most likely due to oxidative stress, but without mediating obvious biological relevant mutagenicity.

Isolation and prolonged expansion of oral mesenchymal stem cells under clinical-grade, GMP-compliant conditions differentially affects "stemness" properties

Background

Development of clinical-grade cell preparations is central to meeting the regulatory requirements for cellular therapies under good manufacturing practice-compliant (cGMP) conditions. Since addition of animal serum in culture media may compromise safe and efficient expansion of mesenchymal stem cells (MSCs) for clinical use, this study aimed to investigate the potential of two serum/xeno-free, cGMP culture systems to maintain long-term “stemness” of oral MSCs (dental pulp stem cells (DPSCs) and alveolar bone marrow MSCs (aBMMSCs)), compared to conventional serum-based expansion.

Methods

DPSC and aBMMSC cultures (n = 6/cell type) were established from pulp and alveolar osseous biopsies respectively. Three culture systems were used: StemPro_MSC/SFM_XenoFree (Life Technologies); StemMacs_MSC/XF (Miltenyi Biotek); and α-MEM (Life Technologies) with 15% fetal bovine serum. Growth (population doublings (PDs)), immunophenotypic (flow cytometric analysis of MSC markers) and senescence (β-galactosidase (SA-β-gal) activity; telomere length) characteristics were determined during prolonged expansion. Gene expression patterns of osteogenic (ALP, BMP-2), adipogenic (LPL, PPAR-γ) and chondrogenic (ACAN, SOX-9) markers and maintenance of multilineage differentiation potential were determined by real-time PCR.

Results

Similar isolation efficiency and stable growth dynamics up to passage 10 were observed for DPSCs under all expansion conditions. aBMMSCs showed lower cumulative PDs compared to DPSCs, and when StemMacs was used substantial delays in cell proliferation were noted after passages 6–7. Serum/xeno-free expansion produced cultures with homogeneous spindle-shaped phenotypes, while serum-based expansion preserved differential heterogeneous characteristics of each MSC population. Prolonged expansion of both MSC types but in particular the serum/xeno-free-expanded aBMMSCs was associated with downregulation of CD146, CD105, Stro-1, SSEA-1 and SSEA-4, but not CD90, CD73 and CD49f, in parallel with an increase of SA-gal-positive cells, cell size and granularity and a decrease in telomere length. Expansion under both serum-free systems resulted in “osteogenic pre-disposition”, evidenced by upregulation of osteogenic markers and elimination of chondrogenic and adipogenic markers, while serum-based expansion produced only minor changes. DPSCs retained a diminishing (CCM, StemPro) or increasing (StemMacs) mineralization potential with passaging, while aBMMSCs lost this potential after passages 6–7 under all expansion conditions.

Conclusions

These findings indicate there is still a vacant role for development of qualified protocols for clinical-grade expansion of oral MSCs; a key milestone achievement for translation of research from the bench to clinics.

Electronic supplementary material

The online version of this article (doi:10.1186/s13287-017-0705-0) contains supplementary material, which is available to authorized users.

TEGDMA Causes Apoptosis in Primary Human Gingival Fibroblasts

Previous in vivo studies have revealed that resins may generate a persistent inflammation of oral tissues and cell death as well. Apoptosis is an important regulated process that results in rapid cell death. This study tested the hypothesis that the comonomer triethyleneglycol-dimethacrylate (TEGDMA) causes apoptosis. The effects of TEGDMA on proliferation and apoptosis in primary oral fibroblasts were analyzed by light microscopy and flow cytometry (FACS; Annexin V-assay). TEGDMA at 5 and 7.5 mM inhibited proliferation after 24 hrs. No increased frequency of apoptosis or necrosis was observed with 1 mM or 2.5 mM TEGDMA after 24 hrs. Apoptosis and Annexin V-positive cells were observed with 5 mM and 7.5 mM TEGDMA by light microscopy after 24 hrs. A dramatic increase in apoptotic cells was detected by FACS after 24 hrs with 7.5 mM TEGDMA. Thus, TEGDMA was cytotoxic and “apoptotic” in a dose- and time-dependent manner.

Angiogenic Potential and Secretome of Human Apical Papilla Mesenchymal Stem Cells in Various Stress Microenvironments

Stem cells from the apical papilla (SCAP) of human adult teeth are considered an accessible source of cells with angiogenic properties. The aims of this study were to investigate the endothelial transdifferentiation of SCAP, the secretion of pro- and antiangiogenic factors from SCAP, and the paracrine effects of SCAP when exposed to environmental stress to stimulate tissue damage. SCAP were exposed to serum deprivation (SD), glucose deprivation (GD), and oxygen deprivation/hypoxia (OD) conditions, individually or in combination. Endothelial transdifferentiation was evaluated by in vitro capillary-like formation assays, real-time polymerase chain reaction, western blot, and flow cytometric analyses of angiogenesis-related markers; secretome by antibody arrays and enzyme-linked immunosorbent assays (ELISA); and paracrine impact on human umbilical vein endothelial cells (HUVECs) by in vitro transwell migration and capillary-like formation assays. The short-term exposure of SCAP to glucose/oxygen deprivation (GOD) in the presence, but mainly in deprivation, of serum (SGOD) elicited a proangiogenesis effect indicated by expression of angiogenesis-related genes involved in vascular endothelial growth factor (VEGF)/VEGFR and angiopoietins/Tie pathways. This effect was unachievable under SD in normoxia, suggesting that the critical microenvironmental condition inducing rapid endothelial shift of SCAP is the combination of SGOD. Interestingly, SCAP showed high adaptability to these adverse conditions, retaining cell viability and acquiring a capillary-forming phenotype. SCAP secreted higher numbers and amounts of pro- (angiogenin, IGFBP-3, VEGF) and lower amounts of antiangiogenic factors (serpin-E1, TIMP-1, TSP-1) under SGOD compared with SOD or SD alone. Finally, secretome obtained under SGOD was most effective in inducing migration and capillary-like formation by HUVECs. These data provide new evidence on the microenvironmental factors favoring endothelial transdifferentiation of SCAP, uncovering the molecular mechanisms regulating their fate. They also validate the angiogenic properties of their secretome giving insights into preconditioning strategies enhancing their therapeutic potential.

Genotoxic effects of camphorquinone and DMT on human oral and intestinal cells

OBJECTIVE

Released components of oral biomaterials can leach into the oral cavity and may subsequently reach the gastrointestinal tract. Camphorquinone (CQ) is the most common used photoinitiator in resinous restorative materials and is often combined with the co-initiator N,N-dimethyl-p-toluidine (DMT). It has been shown that CQ exerts cytotoxic effects, at least partially due to the generation of reactive oxygen species (ROS). Objective of this study was to examine the cytotoxic and genotoxic potential of CQ in human oral keratinocytes (OKF6/TERT2) and immortalized epithelial colorectal adenocarcinoma cells (Caco-2). Furthermore, the effects of visible-light irradiation and the co-initiator DMT were investigated as well as the generation of ROS, the potential protective effect of glutathione (GSH) and a recovery period of CQ-treated Caco-2 cells.

METHODS

The alkaline comet assay was used to determine DNA damage. Additionally, an enzyme modified comet assay was applied, which detects 7,8-dihydro-8-oxoguanine (8-oxoguanine), a reliable marker for oxidative stress.

RESULTS

Our data revealed that high concentrations of CQ induced DNA lesions in OKF6/TERT2 cells. This DNA damage is at least partly caused by the generation of 8-oxoguanine. In addition, CQ and DMT increased ROS formation and induced DNA damage in Caco-2 cells. CQ-treatment resulted in generation of 8-oxoguanine. The antioxidant GSH efficiently prevented CQ-associated DNA damage. Furthermore, a recovery following CQ-treatment significantly reduced DNA damage.

SIGNIFICANCE

We conclude that CQ-induced DNA damage is caused by oxidative stress in oral and intestinal cells. These lesions can be prevented and possibly repaired by GSH-treatment and recovery of cells after the photoinitiator is removed from cultures.

Wnt/β-catenin signaling regulates Dental Pulp Stem Cells' responses to pulp injury by resinous monomers

OBJECTIVES

Aim of this study was to investigate whether Dental Pulp Stem Cells-DPSCs responses to pulp injury caused by resinous monomers is be mediated through activation of Wnt/β-catenin signaling.

METHODS

DPSCs cultures were established from third molars of healthy donors and characterized for stem cell markers with flow cytometry. Cells were exposed to TEGDMA (T: 0.5-2mM) with or without presence of the Wnt-1 ligand (W:25-100ng/ml) or the GSK3β inhibitor Lithium (L:1-10mM), used both as activators of Wnt/β-catenin signaling. Cell viability was evaluated by MTT assay, cell cycle profiles by flow cytometry and expression of key molecules of Wnt/β-catenin signaling by Real-time PCR and Western Blot.

RESULTS

DPSC exposure to TEGDMA caused a concentration-dependent cytotoxicity, accompanied by G1 arrest at lower and G2/M arrest at higher concentrations or after prolonged exposure. Lithium caused a dual effect, by stimulating/inhibiting cell proliferation at lower/higher concentrations respectively and causing a G2/M arrest in a concentration-dependent manner. Wnt signaling could be activated in DPSCs after Lithium or Wnt-1 treatment, as shown by accumulation of β-catenin, its translocation into the nucleus and enhanced expression of key pathway players, like LEF1 and Cyclin D1. Importantly, exposure to TEGDMA caused a more pronounced activation of the pathway, whereas cumulative effects were observed after T/L or T/W co-treatment, indicating a very strong activation of Wnt signaling after treatment of already "activated" (by Lithium or Wnt-1) cells with TEGDMA.

SIGNIFICANCE

These findings highlight the important role of Wnt canonical signaling in pulp repair responses to common injuries.

Effects of alendronate on osteoclast formation and activity in vitro

INTRODUCTION

Root resorption is a common complication after replantation following traumatic dental avulsion. Endodontic therapy combined with local and intracanal medications aims to avoid osteoclastic activity. In such cases, the application of alendronate (ALN), a bisphosphonate widely used for the treatment of bone disorders, could be of clinical relevance. This study evaluated alendronate biocompatibility on periodontal ligament cells as well as its effects on an in vitro osteoclastogenesis model.

METHODS

Alendronate cytotoxicity (10(-3) to 10(-9) mol/L) in human periodontal ligament fibroblasts, human osteogenic sarcoma cells, and murine osteoclastic precursors (RAW 264.7) was analyzed using cell number determination, cell viability, and proliferation assays. ALN (10(-6) to 10(-12) mol/L) effects on RANKL-induced osteoclastogenesis of RAW cells were assessed by tartrate-resistant acid phosphatase (TRAP) staining and activity and real-time polymerase chain reaction.

RESULTS

ALN at higher concentrations was cytotoxic for all cell types, inhibiting significantly the proliferation of human osteogenic sarcoma cells and human periodontal ligament fibroblasts (≥10(-5) mol/L). TRAP activity and expression of the osteoclast markers TRAP and cathepsin K by RAW-derived osteoclasts decreased significantly with ALN at low concentrations, reaching the maximum effect at 10(-10) mol/L.

CONCLUSIONS

We showed that ALN at very low concentrations is an effective inhibitor of RANKL-generated osteoclasts, without causing cytotoxic effects on their precursors or periapical cells. ALN at such concentrations might be useful to prevent replacement resorption in avulsed teeth.

Comparative characterization of STRO-1(neg)/CD146(pos) and STRO-1(pos)/CD146(pos) apical papilla stem cells enriched with flow cytometry

OBJECTIVE

Stem Cells residing in the Apical Papilla (SCAP) of human permanent teeth represent a promising cell source for dental tissue regeneration. Therefore, the functional and molecular properties of specific subpopulations existing within heterogeneous cultures should be further investigated to give insight whether their selection could be beneficial for targeted therapeutic applications.

DESIGN

In this study we extensively characterized SCAP cultures established from 10 healthy subjects, as well as their STRO-1(pos/)CD146(pos) and STRO-1(neg/)CD146(pos) subpopulations isolated with fluorescence-activated cell sorting. SCAP were analyzed for embryonic (Nanog, Oct3/4, SSEA-3, TRA-1-60), mesenchymal (STRO-1, CD146/MUC18, CD105/endoglin, CD24, CD90/Thy-1, CD81-TAPA, CD34, CD49f/a6-integrin), neural (CD271/NGFR, nestin) and hematopoietic (CD117/c-kit, CD45) stem cell (SC) markers using flow cytometry. Multipotentiality was evaluated with culture specific staining (Alizarin-Red-S, Oil- Red-O) and RT-PCR analysis for osteo/odontogenic (DSPP, BSP, ALP, osteocalcin, osteonectin, BMP-2, Runx2), adipogenic (lipoprotein-lipase-LPL) and neurogenic (Neurofilament/NFL-L, nestin, β-tubulin-III, NCAM) markers.

RESULTS

Our results showed that the STRO-1(pos)/CD146(pos) subpopulation demonstrated higher CFU efficiency and much higher expression of several embryonic and mesenchymal SC markers compared to the non-sorted SCAP. They also showed enhanced odontogenic differentiation potential, as evidenced by higher mineralization capacity and expression of osteo/odontogenic markers. By contrast, absence of STRO-1 in the STRO-1(neg)/CD146(pos) subpopulation yielded the opposite results and was associated with significant downgrading of the above-mentioned properties.

CONCLUSIONS

These results suggest that STRO-1(pos)/CD146(pos) SCAP cells represent a very promising adult MSCs source with enhanced multipotent SC properties that could be easily isolated with simple flow cytometric methods to be used for tissue engineering applications.

Glutathione level and genotoxicity in human oral keratinocytes exposed to TEGDMA

Triethylene-glycol dimethacrylate (TEGDMA) is an important matrix comonomer used in many resin-modified dental materials. As the monomer-polymer conversion of these biomaterials is up to 80% at best, TEGDMA may leach into the oral cavity and the pulp in millimolar concentrations. Objective of this study was to evaluate whether TEGDMA is genotoxic in immortalized human oral keratinocytes (OKF6/TERT2), for example, due to formation of oxidative DNA-lesions. OKF6-TERT2 cells were exposed to TEGDMA at concentrations ranging from 0.5 mM to 5.0 mM. Cell viability was analyzed by the fluorescent probe propidium iodide (PI), intracellular levels of reactive oxygen species (ROS) were measured by 2',7'-dichlorofluorescein diacetate, whereas glutathione concentrations (GSH) were read using monobromobimane. Genotoxicity was determined quantitatively by the alkaline comet assay. To explore the presence of oxidized bases that could be produced by oxidative events during short-term treatment with TEGDMA, the 8-hydroxyguanine DNA-glycosylase 1 (hOGG1)-modified comet assay was used. TEGDMA induced an early and rapid GSH-depletion in a concentration-dependent manner (p < 0.05). A total of 5 mM TEGDMA reduced GSH to 57.8% ± 8.6% of control values already after 30 min. There was no significant reduction in cell viability during 6 h of incubation, and only moderate ROS-formation was detected after 4 h of treatment with TEGDMA. But after 24 h, TEGDMA-concentrations of ≥2.5 mM induced a significant reduction of total cell numbers and cells' viability. Furthermore, TEGDMA caused a concentration-dependent DNA damage in OKF6/TERT2 cultures, which was not associated with a detectable formation of 8-hydroxy-2'-deoxyguanosine (8-OHdG) in the cellular genome. In conclusion, our results show that TEGDMA influences the intracellular redox metabolism and may exhibit pronounced cyto- and genotoxic effects in human immortalized oral keratinocytes. However, it may be concluded that oxidative stress is not causative for TEGDMA-dependent genotoxicity in these cells.

Assessment of the impact of two different isolation methods on the osteo/odontogenic differentiation potential of human dental stem cells derived from deciduous teeth

Human deciduous teeth have been proposed as a promising source of mesenchymal stem cells for application in bone and dental tissue engineering. We established cultures of mesenchymal stem cells from the pulp of human deciduous teeth (deciduous teeth stem cells, DTSCs) and analyzed their morphologic, growth, immunophenotypic, and osteo/odontogenic differentiation characteristics using different isolation methods and culturing environments. We compared the biologic behavior of DTSCs isolated either by enzymatic dissociation (DTSCs-ED) or by direct outgrowth from pulp tissue explants (DTSCs-OG). We found that different isolation methods give rise to different populations/lineages of cells with respect to their phenotypic and differentiation characteristics. DTSCs-ED cultures comprised heterogeneous cell populations, whereas DTSCs-OG comprised more homogenous spindle-shaped cells. We have characterized DTSCs as STRO-1(+)/CD146(+)/CD34(+)/CD45(-) cells. However, the percentage of STRO-1(+) and CD34(+) cells was higher in DTSCs-ED (STRO-1, 17.01 ± 5.04%; CD34, 19.79 ± 4.66%) compared to DTSCs-OG cultures (STRO-1, 5.18 ± 2.39%; CD34, 9.94 ± 3.41%), probably as a result of a higher release of stem/progenitor cells from the perivascular niche during enzymatic dissociation. DTSCs isolated using either method displayed an active potential for cellular migration and biomineralization, giving rise to 3D mineralized structures when challenged with dexamethasone, monopotassium phosphate, and β-glycerophosphate. These cellular aggregates progressively expressed differentiation markers of functional odontoblasts, including dentin sialophosphoprotein, bone sialoprotein, osteocalcin, and alkaline phosphatase, having the characteristics of osteodentin. However, in DTSCs-ED, the mineralization rate and the amount of mineralized matrix produced was higher compared to DTSCs-OG cultures. Therefore, DTSCs-ED cells display enhanced biomineralization potential, which might be of advantage for application in clinical therapy.

Comparative analysis of in vitro osteo/odontogenic differentiation potential of human dental pulp stem cells (DPSCs) and stem cells from the apical papilla (SCAP)

OBJECTIVE

The aim of this study was to compare the in vitro osteo/odontogenic differentiation potential of mesenchymal stem cells (MSCs) derived from the dental pulp (dental pulp stem cells - DPSCs) or the apical papilla (stem cells from the apical papilla - SCAP) of permanent developing teeth.

DESIGN

DPSCs and SCAP cultures were established from impacted third molars of young healthy donors at the stage of root development. Cultures were analysed for stem cell markers, including STRO-1, CD146, CD34 and CD45 using flow cytometry. Cells were then induced for osteo/odontogenic differentiation by media containing dexamethasone, KH(2)PO(4) and β-glycerophosphate. Cultures were analysed for morphology, growth characteristics, mineralization potential (Alizarin Red method) and differentiation markers (dentine sialophosphoprotein-DSPP, bone sialoprotein-BSP, osteocalcin-OCN, alkaline phosphatase-ALP), using immunocytochemistry and reverse transcriptase-polymerase chain reaction.

RESULTS

All DPSCs and SCAP cultures were positive for STRO-1, CD146 and CD34, in percentages varying according to cell type and donor, but negative for CD45. Both types of MSCs displayed an active potential for cellular migration, organization and mineralization, producing 3D mineralized structures. These structures progressively expressed differentiation markers, including DSPP, BSP, OCN, ALP, having the characteristics of osteodentin. SCAP, however, showed a significantly higher proliferation rate and mineralization potential, which might be of significance for their use in bone/dental tissue engineering.

CONCLUSIONS

This study provides evidence that different types of dental MSCs can be used in tissue engineering/regeneration protocols as an approachable stem cell source for osteo/odontogenic differentiation and biomineralization that could be further applied for stem cell-based clinical therapies.

Additive effects of TEGDMA and hydrogenperoxide on the cellular glutathione content of human gingival fibroblasts

OBJECTIVES

Only few data are available about cytotoxic effects of leachable dental resin compounds in combination with hydrogen peroxide (H(2)O(2)) segregated from dental bleaching agents. Therefore, the purpose of this study was to evaluate the effects of various concentrations of triethylene-glycol dimethacrylate (TEGDMA) and H(2)O(2) on intracellular glutathione levels (GSH) and viability of human gingival fibroblasts (HGF) that are primary target cells of cytotoxic actions of these substances.

METHODS

HGF were grown in 96-well plates for 24h, treated with various concentrations of TEGDMA (0.5-5.0mM) for 24h and subsequently for 90min with 0.2mM H(2)O(2) or culture medium (control). The relative intracellular GSH concentration was determined using a fluorescence assay with monobromobimane. Readings were normalized to cell numbers, which were determined by a propidium iodide assay. Data were statistically analyzed by t-test and ANOVA with Tukey's post test. A significance level of p<0.05 was used.

RESULTS

Exposure to TEGDMA reduced the viability of HGF at concentrations > or =1.0mM. TEGDMA induced a decrease of the GSH pool in a concentration-dependent manner (p<0.05). The depletion of GSH was correlated with a reduction of viability (p<0.05) and the total cell number. Furthermore, a significant decrease of the intracellular GSH content was found when cells were exposed to TEGDMA in combination with H(2)O(2), compared to experiments without H(2)O(2).

SIGNIFICANCE

We conclude from our findings that TEGDMA and H(2)O(2) have additive adverse effects on GSH metabolism and cell viability.

Effects of three resin monomers on the cellular glutathione concentration of cultured human gingival fibroblasts

OBJECTIVES

Oral and systemic cells are permanently exposed to various types of xenobiotics, such as dental restorative materials, which may subsequently cause adverse effects. Objective of the present investigation was to analyze the effects of three important resin monomers on the glutathione metabolism of human gingival fibroblasts after an incubation period of 4h.

METHODS

Cells were exposed to various concentrations of 2-hydroxyethyl methacrylate (HEMA; 0.1-10 mM), triethylene-glycol dimethacrylate (TEGDMA; 0.05-2.5 mM), and urethane dimethacrylate (UDMA; 0.005-0.25 mM). Subsequently, cellular glutathione (GSH) concentrations were determined after a treatment period of 4h using the monobromobimane assay. Data were statistically evaluated using Tukey ANOVA with p<0.05.

RESULTS

GSH depletion was dependent on the type of the resin monomer: UDMA>TEGDMA>HEMA. The concentrations for a 50%-reduction of cellular GSH varied between 0.1 mM (0.05 mM) (UDMA), 0.33 mM (0.09 mM) (TEGDMA), and 1.6 mM (0.8 mM) (HEMA). Simultaneously, no decrease of cell numbers was found at any tested concentration.

SIGNIFICANCE

These data indicate that the investigated resins may cause cell damage due to depletion of intracellular GSH level even at low concentrations within a short period of time. The decrease of GSH is an early reaction, which is triggered prior to other cytotoxic alterations.

ROS formation and glutathione levels in human oral fibroblasts exposed to TEGDMA and camphorquinone

Glutathione (GSH) is important for the self-protection of cells against oxidative stress and toxic xenobiotics, whereas reactive oxygen species (ROS) at elevated concentrations may cause detrimental alterations of cell membranes, DNA, and other cellular structures. The present investigation addressed the effects of triethylene-glycoldimethacrylate (TEGDMA) and camphorquinone (CQ) on glutathione metabolism and the formation of ROS in oral cells. Primary human pulp fibroblasts were exposed to various concentrations of TEGDMA and CQ (0.1-5 mM). Subsequently, GSH concentration and ROS formation were analyzed with the use of the monobromobimane assay (GSH) and 2',7'-dichlorofluorescein diacetate (DCFH-DA) (ROS). The endogenous ROS hydrogen peroxide (H2O2) was used as a positive control (0.02-2 mM). TEGDMA significantly decreased GSH at concentrations between 0.5 and 5 mM (p<0.05), but did not elevate ROS levels. Contrary, CQ increased ROS formation at concentrations>or=1 mM, but had only a moderate effect on GSH at the highest test concentration. Hydrogen peroxide increased ROS and simultaneously decreased GSH at concentrations of >or=0.2 mM. These data show that the investigated substances may cause cell damage due to various mechanisms, GSH decrease and/or ROS increase. As a consequence, TEGDMA and CQ released into an aqueous environment from resinous materials might interact, thus generating significant cytotoxic effects even at low concentrations.

Effects of BisGMA on glutathione metabolism and apoptosis in human gingival fibroblasts in vitro

Aim of this study was to investigate the effects of the resin monomer BisGMA on the glutathione concentration (monobromobimane assay) and apoptosis (Annexin V/PI-assay) of cultured primary human gingival fibroblasts. Cells were treated for up to 24h with 0.001-0.25 mM BisGMA to determine growth curves using the DNA stain H33342. Subsequent Annexin V/PI-assays revealed that fibroblasts exposed to concentrations of 0.005-0.01 mM (non-cytotoxic) and 0.05 mM (ED(10)-concentration) showed no increase of the share of apoptotic cells compared to non-treated controls (5-8%), while 0.1 mM BisGMA (approximately ED(50)-concentration) caused a significant increase of the percentage of apoptotic cells (50%). Simultaneously to the induction of apoptosis, 0.1 and 0.25 mM of BisGMA caused a significant depletion of the intracellular GSH content after 18 h of incubation. Our results indicate that BisGMA at concentrations >0.1 mM causes an extreme depletion of the intracellular GSH pool as well as apoptosis.

Effects of low-concentrated chlorhexidine on growth of Streptococcus sobrinus and primary human gingival fibroblasts

The aim of this study was to investigate the in vitro effects of low concentrations of chlorhexidine (CHX) on the proliferation of Streptococcus sobrinus (ATCC 33478) and primary human gingival fibroblasts (HGF). Liquid cultures of bacteria or human gingival fibroblasts were exposed to CHX concentrations ranging from 0.07 to 40 microM in microtiter plates at 37 degrees C for 24 h. Bacteria or cells grown without CHX served as controls. The effects of CHX were determined either by measurements of the optical density (OD) of bacterial cultures or by evaluation of cell growth with the DNA-intercalating fluorescent stain H33342 in comparison to untreated controls. Results were evaluated calculating means and standard deviations. Data were statistically analyzed by an ANOVA using Post Hoc tests ( p<0.005). No growth inhibition of S. sobrinus was found at concentrations between 0.07 and 0.15 microM CHX, whereas 0.3 microM CHX led to an elongated (2 h more) lag phase and 0.6 microM CHX induced a lag phase of 4 h more and a minor inclination of the curve in the log phase. Concentrations of CHX>/=1.25 microM completely inhibited growth of S. sobrinus. On the contrary, CHX showed no significant effect on growth of HGF at concentrations </=5 microM. A slight growth inhibition was only observed at a concentration of 5 microM. CHX-concentrations of 10 and 20 microM reduced cell growth to 88 or 75% of control assays. Data analysis showed that overall treatment effects were highly significant ( p<0.005). Our data reveal that chlorhexidine inhibits proliferation of S. sobrinus even at very low concentrations while concentrations of CHX</=5 microM are not cytotoxic to human gingival fibroblasts.

Cytotoxicity of precious and nonprecious alloys--experimental comparison of in vitro data from two laboratories

The aim of this investigation was to evaluate and compare the reproducibility of cytotoxicity data generated in two different laboratories using the same testing protocols. A series of dental alloys that are widely used in both countries were chosen. These alloys (five precious, two nonprecious) were wet ground up to 1200 grit SiC, sterilized in 70% ethanol, and extracted in sterile culture medium for 7 days. Pure copper was used as a positive control and Teflonreg and media only were used as negative controls. Test and control samples were randomized and blinded to each laboratory. Cells, primary human gingival fibroblasts, and immortalized 3T3 fibroblasts, were exposed to the extracts for 24 h. Extract cytotoxicity was evaluated spectrophotometrically with the use of a mitochondrial enzyme activity assay. Data were collected from both laboratories, combined, and subjected to a mixed-model analysis of variance. No statistical difference was obtained for the immortalized 3T3 cells, except for two extracts in which differences between the two labs were significant but were still not cytotoxic. Furthermore, no statistical differences were found for the primary cells. These data strongly suggest that cytotoxicity tests performed in different laboratories with the use of the same test materials may lead to comparable results if sample preparation, cells, test procedures, and data analyses are carefully considered.

Effect of TEGDMA on the intracellular glutathione concentration of human gingival fibroblasts

Previous studies revealed that primarily small and relatively hydrophilic comonomers, such as TEGDMA, leach out of resin-based restorative materials into aqueous media. Subsequently, these compounds may cause detrimental reactions with intracellular metabolic systems. The present experiments attempted to elucidate the interactions of TEGDMA with the important intracellular reducing agent glutathione (GSH). The influence of various concentrations of TEGDMA (0.5-7.5 mM) on viability and intracellular GSH concentration of primary human gingival fibroblasts was determined by means of a fluorescence assay (monobromobimane) performed in microtiter plates. Cells were treated with TEDGMA between 2 and 24 h. The incubation of fibroblasts with TEGDMA even at subtoxic concentrations quickly decreased the intracellular glutathione level to 30-50% of controls within the first 2-6 hours. However, no simultaneous adverse effect on cell viability was found. Longer incubation periods up to 24 h caused a regulatory reincrease at TEGDMA concentrations <or= 2.5 mM, whereas higher concentrations resulted in a continuous depletion of glutathione concentration concomitant with a significant decrease of cell viability. Because glutathione plays an important role in protection and detoxification processes as well in the regulation of cell death, the early and extensive depletion of the intracellular glutathione pool due to TEGDMA may significantly contribute to the cytotoxic potency of this compound.

Long-term cytocompatibility of various endodontic sealers using a new root canal model

It was the purpose of our study to determine the cytotoxicity of several types of root canal sealers in vitro over the period of 1 yr by using a new test model. Roots of extracted human teeth were filled with N2, Apexit, Roekoseal, AH Plus, Ketac Endo, Endomethasone, and one gutta-percha point. In addition, roots filled with laterally condensed gutta-percha/N2. Teeth filled with one gutta-percha point only were controls. All specimens were consecutively extracted with distilled water for a total period of 1 yr. Extracts were investigated for cytotoxicity by using immortalized 3T3 fibroblasts and primary human periodontal ligament fibroblasts. Results were statistically analyzed with Dunnett's t tests (p < 0.05). Pronounced cytotoxic effects were only caused by N2-extracts in both cell cultures (p < 0.05). Furthermore, statistically significant cytotoxic alterations were also induced by 10-week eluates of Endomethasone (p < 0.05). All other investigated materials did not significantly alter cell metabolism.

The cellular compatibility of five endodontic sealers during the setting period

The purpose of this study was to evaluate the cellular compatibility of five endodontic sealers in the first 24 h after mixing. Specimens of N2, Endomethasone, Apexit, AH Plus, and Ketac Endo were extracted with cell culture medium 0, 1, 5, and 24 h after mixing. Eluates were tested for cytotoxicity with immortal 3T3 cells and primary human periodontal ligament fibroblasts using XTT-assays. Data were analyzed for statistically significant differences by means of Dunnett's t tests (p < 0.05). All extracts of N2 completely inhibited cell metabolism (p < 0.05). Similar effects were provoked by the first three eluates of Endomethasone, but the 24-h extract irritated cells significantly less (p < 0.05). Severe cytotoxicity was also observed with all Ketac Endo extracts (p < 0.05). A significant inhibition of mitochondrial activity was induced by the first (3T3) or the first and second eluate (periodontal ligament fibroblasts) of AH Plus (p < 0.05). The subsequent eluates of this sealer and all extracts of Apexit did not reveal any cytotoxic potency.

Chemical-biological interactions of NaF with three different cell lines and the caries pathogen Streptococcus sobrinus

Fluoride is used in dentistry as a prophylactic agent to reduce caries rates due to the demineralization/remineralization effect and its influence on the metabolism of cariogenic bacteria. The purpose of this study was to evaluate the cytotoxic effects of sodium fluoride (NaF) on three different cell lines and the antibacterial potency on Streptococcus sobrinus. Cell lines were treated with various concentrations of NaF ranging from 0.039 mM to 10 mM for 24 h. For microbial assays, concentrations of NaF between 0.03 mM and 10 mM were added to liquid cultures of bacteria. Our results showed that immortalized human keratinocytes (HaCaT) and human osteogenic sarcoma cells (SAOS-2) were similarly affected by concentrations up to 2.5 mM. However, cell growth of HaCaT was slightly more inhibited at 2.5 mM of NaF than SAOS-2. At concentrations between 0.62 mM and 10 mM, 3T3 mouse fibroblast cells reacted more sensitively than HaCaT and SAOS-2 to NaF. The 3T3 cells did not survive in the presence of 10 mM NaF. NaF caused no significant effect on all tested cells at concentrations of < or = 0.31 mM. NaF at 0.039 mM and 0.06 mM did not affect growth of S. sobrinus. At concentrations of 0.125 mM and 0.5 mM, growth was slightly reduced. The proliferation of S. sobrinus significantly decreased at 1 mM and 2 mM NaF. S. sobrinus survived at 4 mM, revealing a delayed log phase with a decreased proliferation. No viable S. sobrinus cells were detected at concentrations of > or = 8 mM NaF. Data analysis revealed that overall treatment effects were highly significant (P<0.05, analysis of variance, Tukey's difference test). This study indicates that cytotoxic effects due to NaF significantly vary in dependence upon the applied cell line. The toxicity of NaF approached 50% (TC50) at concentrations of 6 mM for HaCaT, 2.3 mM for 3T3 cells, and 7.5 mM for SAOS-2. Additionally, NaF revealed antimicrobial effects only at concentrations that are significantly higher than oral fluoride concentrations.

Chemical-Biological Interactions of the resin monomer triethyleneglycol-dimethacrylate (TEGDMA)

Most dental resinous materials contain high quantities of the diluent monomer triethyleneglycol-dimethacrylate (TEGDMA). Due to its 'hydrophilic' nature, significant amounts of this substance leach into an aqueous environment, such as the oral cavity. Therefore, it is hypothesized that TEGDMA frequently interferes with oral and/or systemic tissues. In vitro studies revealed that TEGDMA is considerably cytotoxic in various cell cultures. It has also been observed that TEGDMA can easily penetrate membranes and subsequently may react with intracellular molecules. The formation of glutathione-TEGDMA adducts is of specific interest, since the nearly complete exhaustion of this molecule significantly reduces its cellular detoxifying potency. Large deletions of DNA sequences were caused by TEGDMA, resulting in high mutation frequency. In addition, TEGDMA has been identified as an important resinous sensitizer in patients and professionals. Taken together, available in vitro information, in vivo studies with animals, and clinical data as well indicate that TEGDMA may contribute considerably to local and systemic adverse effects caused by dental resins.

Effects of mechanical force on primary human fibroblasts derived from the gingiva and the periodontal ligament

Previous experiments have shown that mechanical stress may alter the interactions between cells and extracellular matrix (ECM). The purpose of our study was to investigate the effects of mechanical load on metabolism and ECM expression of primary human periodontal cells. The influence of gravitational force on proliferation, lactate dehydrogenase (LDH) release, and tenascin expression of gingival (HGF) and periodontal ligament fibroblasts (HPDL), as well as their adhesion to various extracellular matrix (ECM) components, was determined. Cells were centrifuged in microplates or flat tubes for 16 hrs at 217 g. Neither an enhanced release of LDH nor an alteration of cell proliferation could be detected after centrifugation. However, the attachment of loaded gingival and periodontal ligament fibroblasts to all tested ECM components significantly decreased in comparison with controls (Wilcoxon-Mann-Whitney test; HGF, p < 0.05; HPDL, p < 0.01). Tenascin expression of mechanically stressed fibroblasts significantly increased in comparison with controls (p < 0.01).

Metabolic effects of dental resin components in vitro detected by NMR spectroscopy

Earlier studies have shown that the comonomer triethyleneglycol-dimethacrylate (TEGDMA) and the photostabilizer 2-hydroxy-4-methoxybenzophenone (HMBP) are cytotoxic and inhibit cell growth. It was the aim of this study to elucidate the underlying metabolic effects of TEGDMA and HMBP on immortal contact-inhibited Swiss albino mouse embryo cells (3T3 fibroblasts) by nuclear magnetic resonance (NMR) spectroscopy. Cell extracts and culture media were analyzed by NMR spectroscopy for metabolic changes after incubation for 24 hours with ED20-concentrations of TEGDMA and HMBP. TEGDMA could be detected in all fractions (cytosol, lipid fractions, and culture media) of 3T3 cells, while HMBP was found only in the lipid fraction accumulated at a maximum rate (51 nmol/mg DNA) compared with TEGDMA (27 nmol/mg DNA). TEGDMA increased the concentration of phosphomonoesters to 180+/-36% and decreased the phosphodiesters to 65+/-5% of controls (control = 100%). Thus, the turnover of phospholipids was enhanced, whereas content and composition of phospholipids of membranes did not alter markedly. Additionally, TEGDMA changed the metabolic state of cells, indicated by slight decreases of nucleoside triphosphates and an increase in the ratio of nucleoside diphosphates to nucleoside triphosphates, while HMBP had no effect. The most remarkable effect of TEGDMA was a nearly complete decline of the intracellular glutathione levels. Analysis of our data shows that NMR spectroscopy of cell-material interactions may reveal metabolic effects of organic test substances which are not detectable by standard in vitro assays. The comonomer TEGDMA affected the metabolism of the cells on different levels, while HMBP accumulated in the lipid fraction and induced significantly fewer effects on cell metabolism.

Effects of BisGMA and TEGDMA on proliferation, migration, and tenascin expression of human fibroblasts and keratinocytes

Previous studies have documented a marked cytotoxic potency of BisGMA and TEGDMA. The purpose of this investigation was to determine if these substances also affect proliferation, migration, and tenascin expression of primary human gingival fibroblasts (HGF) and immortalized human keratinocytes (HaCaT). These parameters play an important role in healing wounds. HGF and HaCaT cultures were incubated with TEGDMA and BisGMA. Cell proliferation (BrdU-assay) and migration (Boyden method) were determined 24 h after incubation. Tenascin expression was investigated four and seven days after treatment. Results were statistically evaluated by ANOVA using the Wilcoxon-Mann-Whitney test (p < 0.05). Proliferation of both cell types was significantly inhibited at concentrations > or = 0.25 mM (TEGDMA) or > or = 0.01 mM (BisGMA). Migration of HaCaT was significantly increased after incubation with BisGMA for 24 h. TEGDMA did not alter migration of HGF and HaCaT. In addition, TEGDMA had no effect on tenascin expression of both cell cultures. After 4 days of incubation, BisGMA (at a concentration of 0.01 mM) significantly reduced tenascin production of HaCaT cultures related to cell number. However, 7 days after treatment, BisGMA significantly increased tenascin expression of HGF and HaCaT cultures. Altogether, our results indicate that BisGMA can affect migration of keratinocytes and alters the expression of the extracellular matrix component tenascin. Thus, BisGMA may significantly influence the healing of injured oral tissues.

Compatibility of resorbable and nonresorbable guided tissue regeneration membranes in cultures of primary human periodontal ligament fibroblasts and human osteoblast-like cells

The purpose of this study was (a) to evaluate the cytocompatibility of three resorbable and nonresorbable membranes in fibroblast and osteoblast-like cell cultures and (b) to observe the growth of those cells on the various barriers by scanning electron microscopy (SEM). Primary human periodontal ligament fibroblasts (HPLF) and human osteoblast-like cells (SAOS-2) were incubated with nonresorbable polytetrafluoroethylene (ePTFE) barriers and resorbable polylactic acid as well as collagen membranes. Cytotoxic effects were determined by XTT (mitochondrial metabolic activity) and sulforhodamine B assays (cellular protein content). In addition, HPLF and SAOS-2 grown for 21 days on the investigated barriers were evaluated by SEM. Data were analyzed statistically by ANOVA using the Wilcoxon-Mann-Whitney test (P < 0.05). No changes were established in the periodontal ligament fibroblasts and human osteoblast-like cells after incubation with the collagen membrane. Cytotoxic effects, however, were induced by the polylactic acid barrier which slightly inhibited cell metabolism of the periodontal fibroblasts (XTT: 90.1% +/- 3.6 of control value). Moderate cytotoxic reactions were caused by the nonresorbable ePTFE membrane in HPLF-cultures (XTT: 82.7% +/- 3.5) and osteoblast-like cell monolayers (XTT: 80.0% +/- 0.6%). Mitochondrial activity in both cell cultures was significantly reduced by ePTFE barriers in comparison to non-incubated control cells (P = 0.028). SEM analysis of cell behavior on barriers demonstrated the differences between these materials: collagen barriers were densely populated with HPLF and SAOS-2, whereas only few or no cells were seen to adhere to the ePTFE and polylactic acid membranes. Our findings indicate that the collagen barrier investigated is very cytocompatible and may be integrated into connective tissue well. On the contrary, the ePTFE and polylactic acid membranes induced slight to moderate cytotoxic reactions which may reduce cellular adhesion. Thus, gap formation between the barrier surface and the connective tissue may be promoted which may facilitate epithelial downgrowth and microbial accumulation. Consequently, these effects may reduce the potential gain in periodontal attachment.

Aqueous extracts from dentin adhesives contain cytotoxic chemicals

It was the aim of our study to investigate the composition and cytotoxicity of aqueous elutes from five dentin adhesives currently used in clinical practice: Solobond Plustrade mark, Solisttrade mark, Scotchbond Multipurposetrade mark, Syntac SCtrade mark, and Prime & Bondtrade mark 2.1. Water extracts were analyzed by gas chromatography/mass spectrometry (GC/MS) and relative quantities of identified compounds were compared by means of an internal caffeine standard [%CF]. The in vitro cytotoxic effects of substances released into DMEM were determined using immortalized 3T3-fibroblast cultures. In addition, the cytotoxicity of ethylene glycol (EG), which was identified in the extracts of Syntac SC, was evaluated. All dentin adhesives tested released various chemical components, like comonomers (mainly ethylene glycol compounds), HEMA, and initiating substances (e.g., camphorquinone). Elutes of Solobond Plus, which contained very high amounts of TEGDMA, were extremely cytotoxic. Two bonding agents (Scotchbond Multi-purpose, Syntac SC), which released significant quantities of HEMA, induced severe cytotoxic effects. In contrast, extracts from Solist and Prime & Bond 2.1 had very small effects on cell proliferation; these elutes contained small amounts of released chemical compounds. EG, a product of HEMA hydrolysis, in concentrations ranging from 0.025-25 mM was not cytotoxic. In summary, these results provide evidence that all dentin adhesives tested in the present study release in aqueous media chemical compounds some of which (for example, TEGDMA and HEMA) are cytotoxic.

Effect of storage media on the fluoride release and surface microhardness of four polyacid-modified composite resins ("compomers")

OBJECTIVES

The aims of this investigation were to measure the surface microhardness (Vickers) as well as the release of fluoride from four polyacid-modified composite resins (PMC) ("compomers") (Compoglass F, F 2000, Dyract AP, experimental compomer) after storage in various artificial saliva (buffers) including one esterase-buffer.

METHODS

Samples were stored for 6 days in de-ionized water, acidic buffer I (pH 4.2), neutral buffer II (pH 7.0), or neutral buffer III (pH 7.0) containing porcine esterase. The specimens were transferred into fresh media every 48 h. Fluoride release was measured every 48 h. Vickers hardness of each five samples of every group was determined before storing the samples in media (baseline) as well as after storage for 24, 48, and 144 h in the various solutions. Dry-stored specimens served as control.

RESULTS

The surface microhardness of all PMCs significantly decreased after storage in the various media. No significant differences, however, were found between samples of the same material stored in the various media for 6 days. In general, the highest fluoride quantity was released into the acidic buffer I except for Dyract AP, which segregated similar quantities of fluoride into buffer I and into de-ionized water. More fluoride was released into de-ionized water than into neutral buffers. Further, esterase treatment increased fluoride release from three PMCs.

SIGNIFICANCE

Our results suggest that the action of salivary esterases may weaken the surface of polyacid-modified composite resin restorations. As a clinical consequence, wear may be enhanced and load resistance may be reduced. In addition, fluoride release from PMCs may be increased by hydrolytic enzymes in saliva and under acidic conditions.

Cytocompatibility of periodontal dressing materials in fibroblast and primary human osteoblast-like cultures

Purpose of this investigation was to determine the cytocompatibility of various periodontal dressing materials by means of human primary gingival fibroblasts (HGF), human osteoblast-like cells (HObl) derived from the alveolar bone, and permanent 3T3 mouse fibroblasts (3T3). Cell culture medium extracts (time periods of extraction: day 1 and between day 2 and day 8 after setting) as well as solid specimens of the following materials were investigated: Coe-pak, Voco pac, Peripac, and Barricaid. Responses of cultures exposed for 24 h and 48 h to these materials were monitored by the fluorescent dyes H33342 and sulforhodamin 101 as well as by light microscopy. It was found that most extracts of Voco pac, Peripac, and Barricaid did not inhibit growth of HGF. Coe-Pak, however, clearly reduced the proliferation of HGF compared to untreated controls. Peripac decreased growth of HObl whereas Coe-Pak, Voco pac, and Barricaid caused no cytotoxic alterations in any of the test assays. Contrary to HGF and HObl, 3T3 cells were much more irritated by the test materials. But the light-curing resinous material Barricaid reduced proliferation of 3T3-fibroblasts only slightly. Our data indicate that Barricaid is exceedingly cytocompatible, whereas all other materials revealed moderate or severe cytotoxic effects according to the cell type.

Genotoxicity and cytotoxicity of the epoxy resin-based root canal sealer AH plus

Previous studies with four rapid in vitro and in vivo test systems have shown that the epoxy resin-based root canal sealer AH26 may be genotoxic and cytotoxic (9). The purpose of this study was to determine the cytotoxic and genotoxic effects of the new resinous root canal sealer AH Plus by means of the growth inhibition test with primary human periodontal ligament fibroblasts and permanent 3T3 monolayers, the procaryotic umu test, the eucaryotic DNA synthesis inhibition test, and the in vivo alkaline filter elution test. In addition, Ames tests were performed with extracts from AH Plus. AH Plus caused only slight or no cellular injuries. Furthermore, no genotoxicity and mutagenicity were revealed by AH Plus. These data should be taken into consideration when deciding about a root canal sealer.

Variability of cytotoxicity and leaching of substances from four light-curing pit and fissure sealants

It was the aim of our study to investigate the composition and cytotoxicity of aqueous extracts of four light-curing pit and fissure sealants. Water extracts were analyzed by gas chromatography/mass spectrometry (GC/MS), and relative quantities of identified compounds were compared by means of an internal caffeine standard [%CF]. Cytotoxic effects due to medium extracts were determined by means of permanent 3T3 fibroblasts. All light-curing pit and fissure sealants segregated different ingredients into water, such as co-monomers (mainly ethylene glycol compounds) and initiating substances (e.g., camphorquinone). Bisphenol-A, however, which is easily detected by GC/MS, was not found in any of the analyzed eluates. The extracts of three sealants inhibited monolayer growth only moderately whereas the eluate of one product inhibited cell proliferation significantly. In the extracts of this sealant high quantities [%CF] of the co-monomer TEGDMA were detected. Our results indicate that light-curing pit and fissure sealants release substances into aqueous media that may induce cytotoxic effects. However, no concerns about potential estrogenic effects of Bisphenol-A are supported by our results.

Residual monomer/additive release and variability in cytotoxicity of light-curing glass-ionomer cements and compomers

In previous studies, light-cured glass-ionomer cements have been shown to evoke cytotoxic reactions. It was the purpose of this investigation (a) to determine the nature of the ingredients released into an aqueous medium from 2 light-cured glass-ionomer cements (GICs) and 3 compomers; (b) to evaluate the cytotoxicity of these extracts; and (c) to correlate the extent of the cytotoxic effects with eluted substances. Specimens of 2 light-cured GICs and 3 compomers were prepared and extracted in distilled water or cell culture medium for 24 hrs (surface-liquid ratio 42.4 mm2/mL). The aqueous eluates were analyzed by gas chromatography/mass spectrometry (GC/MS). The relative amounts of the components released from various products were compared by means of an internal caffeine standard [%CF]. For evaluation of cytotoxic effects, permanent 3T3 fibroblasts were incubated with medium extracts for 24 hrs. In addition, the ED50 concentration of the photoinitiator diphenyliodoniumchloride (DPICl) was determined. In all extracts, several water-elutable organic substances were found: (Co)monomers (especially HEMA and ethylene glycol compounds), additives (e.g., camphorquinone and diphenyliodoniumchloride), and decomposition products. The extracts of 3 products inhibited cell growth only moderately, whereas the light-cured GIC Vitrebond and the compomer Dyract Cem revealed severe cytotoxic effects. Vitrebond liberated the initiator DPICl, whereas Dyract Cem segregated a relatively high quantity [2966 %CF] of the comonomer TEGDMA in comparison with the other products. The present data show that TEGDMA and DPICl may be regarded as the prime causes for cytotoxic reactions evoked by the investigated light-cured glass-ionomer cements or compomers. Therefore, leaching of these substances should be minimized or prevented.

Cytotoxicity of 35 dental resin composite monomers/additives in permanent 3T3 and three human primary fibroblast cultures

It was the purpose of this investigation to determine the cytotoxic effects (ED50 concentrations) of 35 monomers or additives identified in commercial dental resin composites. Monolayers of permanent 3T3 cells and three primary human fibroblast types derived from oral tissues (gingiva, pulp, and periodontal ligament) were used as test systems. All substances were tested in concentrations ranging from 0.01 to 5.0 mM. In general, ED50 values varied from 0.06 to > 5 mM. Within the groups of co(monomers), initiators, and cointiators, severe (e.g., Bis-GMA, UDMA, DMBZ, and DMDTA) or moderate (HEMA, BEMA, CQ, DMPT, and DMAPE) cytotoxic effects could be evaluated. Within the group of reaction/decomposition products, only moderate or slight effects were found (ED50: 0.7 to > 5 mM). The inhibitor BHT, the contaminant TPSb, and the photostabilizer HMBP, however, were highly cytotoxic in all cell cultures. In addition, the ED50 values of DBPO and HMBP significantly varied (0.43-3.8 mM, respectively, and 0.44-3.07 mM) with the applied cell culture. Our comprehensive screening shows that for several of the highly cytotoxic composite components, less cytotoxic alternatives are available. Furthermore, there was no cell type identified which was consistently less or more sensitive to the toxic effects of the tested compounds than the others. Primary human periodontal ligament and pulp fibroblasts, however, were found to be more sensitive than 3T3 and gingival fibroblasts to alterations from most tested substances.

Effects of extraction media upon fluoride release from a resin-modified glass-ionomer cement

Previous studies have shown that various factors such as ionic composition or pH of the extraction medium may significantly influence leaching of components from restorative materials. Therefore, it was the aim of this investigation to determine the release of fluoride from a resin-modified glass-ionomer cement (GIC) following storage in various extraction media, including an esterase buffer. Specimens of the resin-modified GIC, Fuji II LC, were stored for 144 h in deionized water, acidic buffer (pH 4.2), neutral buffer (pH 7.0), and neutral buffer supplemented with porcine liver esterase. Fluoride release into the various media was measured every 48 h over a 6-day period. In addition, activity of porcine esterase in neutral buffer (artificial saliva) was measured for up to 144 h. The data were statistically evaluated by three-way ANOVA using the Student-Newman-Keuls test (P < 0.05). It was found that esterase activity in neutral artificial saliva decreased during the first 24 h to approximately 40% of the baseline value and then remained constant for up to 6 days. Fluoride release into the various storage media varied significantly (P < 0.05). The highest amounts of fluoride were released into deionized water (30.9 ppm +/- 1.1) and acidic buffer (26.9 ppm +/- 0.7) after 48 h. In addition, significantly more fluoride leached into esterase-containing neutral artificial saliva (6.9 ppm +/- 0.2) than into neutral buffer without enzyme (6.3 ppm +/- 0.2) after 96 h. Our data indicate that fluoride release from the resin-modified GIC investigated may be increased under acidic conditions and by hydrolysis in saliva.

Cytotoxicity of four root canal sealers in permanent 3T3 cells and primary human periodontal ligament fibroblast cultures

OBJECTIVES

The purposes of this study were to determine the cytocompatibility of four endodontic sealers and gutta-percha using various extracts and to compare the cellular injuries resulting from these materials in permanent 3T3 monolayers and primary human periodontal ligament fibroblasts.

STUDY DESIGN

Set specimens from four sealers (AH26, Apexit, Sealapex, N2) as well as gutta-percha were eluted with cell culture medium for 24 hours, 5 days, 5 days, and 24 hours, respectively. Cytotoxic effects due to these extracts were evaluated by determining proliferation of permanent 3T3 cells and primary human periodontal ligament fibroblasts by means of the fluorochrome propidiumiodide.

RESULTS

No statistically significant cellular alterations were induced by gutta-percha and Apexit, whereas various extracts of AH26 and Sealapex caused significant moderate or severe growth inhibition. Severe cellular damage was documented for all extracts of N2, which was statistically significantly different from the other materials in both cell lines (p < 0.05).

CONCLUSIONS

Our results confirm that various root canal sealers constantly segregate substances after being exposed to an aqueous environment for extended periods, possibly causing moderate or severe cytotoxic reactions and possibly contributing to failure.

Inorganic polyphosphate in human osteoblast-like cells

Significant amounts of inorganic polyphosphates and of polyphosphate-degrading exopolyphosphatase activity were detected in human mandibular-derived osteoblast-like cells. The amount of both soluble and insoluble long-chain polyphosphate in unstimulated osteoblast-like cells was higher than in human gingival cells, erythrocytes, peripheral blood mononuclear cells, and human blood plasma. The cellular content of polyphosphate in osteoblast-like cells strongly decreased after a combined treatment of the cells with the stimulators of osteoblast proliferation and differentiation, dexamethasone, beta-glycerophosphate, epidermal growth factor, and ascorbic acid. The amount of soluble long-chain polyphosphate, but not the amount of insoluble long-chain polyphosphate, further decreased after an additional treatment with 1alpha,25-dihydroxyvitamin D3 (1,25(OH)2D3). The decrease in polyphosphate content during treatment with dexamethasone, beta-glycerophosphate, epidermal growth factor, and ascorbic acid was accompanied by a decrease in exopolyphosphatase, pyrophosphatase, and alkaline phosphatase activity. However, additional treatment with 1,25(OH)2D3 resulted in an increase in these enzyme activities. Osteoblast-like cell exopolyphosphatase activity and exopolyphosphatase activity in yeast, rat tissues, and human leukemia cell line HL60 were inhibited by the bisphosphonates etidronate and, to a lesser extent, clodronate and pamidronate. From our results, we assume that inorganic polyphosphate may be involved in modulation of the mineralization process in bone tissue.

Biocompatibility of various light-curing and one conventional glass-ionomer cement

The purpose of this study was to determine and to compare the cellular compatibility of modern light-curing (lc) glass-ionomer cements (GICs) to one conventional (co) GIC. The following materials were investigated: Ionoseal (IS, lc) (VOCO, Germany), Vitrebond (VB, lc) (3M, USA), Compoglass (CG, lc) (Vivadent, FL) and Ketac Fil Applicap (KF, co) (ESPE, Germany). From all GICs, equally sized specimens (height 2 mm, diameter 5 mm) were polymerized or set according to the instructions of the manufacturers. Various extracts of all specimens were obtained by subsequent elutions. Human primary fibroblasts of the attached gingiva (HGF) and permanent mouse fibroblasts (3T3) were used for the experiments. HGF and 3T3 cells were exposed to the extracts of all materials for 48 h. Growth inhibition due to cytotoxic effects was determined by staining the cultures with Hoechst 33342 (determination of DNA and cell vitality). It was found that the material CG induced no growth inhibition in any of the assays. Proliferation of HGF was not, or only slightly, inhibited by the extracts of the materials IS and KF, whereas severe alterations were caused by the extracts of the material VB. Growth of 3T3 cells was only moderately or slightly reduced by the extracts of materials IS and KF respectively, but was severely or totally inhibited by all extracts of VB. From our results we conclude that the GIC VB is very cytotoxic and therefore may also induce alterations in vivo. All other investigated GICs revealed excellent (CG), or good (IS, KF) cellular compatibility.

Nicotine-induced alterations in human primary periodontal ligament and gingiva fibroblast cultures

Various in vivo and in vitro investigations have indicated that tobacco smoking as well as the use of smokeless tobacco products may be important risk factors for the development and severity of inflammatory periodontal disease. The purpose of this study was to determine the cytotoxicity of nicotine by means of human primary oral fibroblast cultures and a permanent cell line. The cytotoxicity of nicotine was evaluated by determination of cell growth, cell membrane integrity, protein content, and alterations of the cytoskeleton. Furthermore, recovery following nicotine exposure was assessed by vital staining (trypan blue). Dose-dependent toxic effects of nicotine were measured within a range of 0.48 mM to 62 mM. Growth of fibroblasts was decreased by nicotine concentrations higher than 7.8 mM. Additionally, the protein content was significantly decreased and cell membranes were damaged. Morphological alterations of microtubules and vimentin filaments were observed at concentrations higher than 3.9 mM. Nicotine-exposed cells revealed atypical shapes and vacuoles. The toxic effects of nicotine became irreversible in the range between 10.5 and 15.5 mM, whereas at lower concentrations cells recovered after the withdrawal of nicotine. Our results confirm clinical oberservations regarding the important role of nicotine as a risk factor in the etiology and progression of periodontal disease.

Effects of various resin composite (co)monomers and extracts on two caries-associated micro-organisms in vitro

Previous studies have shown that extracts of various filling materials, e.g., resin composites, may influence the growth of cariogenic micro-organisms. The purpose of this study was to examine the effects of important resin composite (co)monomers (Bis-GMA, UDMA, TEGDMA, EGDMA) and extracts of two commercial dental composites with similar composition (composite A, Arabesk; composite S, Superlux) on the growth of the two cariogenic bacterial pathogens Streptococcus sobrinus and Lactobacillus acidophilus. It was found that neither the monomers Bis-GMA and UDMA, nor the comonomer EGDMA, nor the extract of composite A influenced the growth of S. sobrinus in the log phase. The comonomer TEGDMA and the extract of composite S were found to stimulate growth in the log phase, but this stimulation was not statistically significant. However, EGDMA, TEGDMA, and the extract of composite S did stimulate the total growth of S. sobrinus. In the assays with L. acidophilus, Bis-GMA, UDMA, and the extract of composite A inhibited the growth in the log phase, whereas TEGDMA stimulated it. Furthermore, EGDMA, TEGDMA, and the extract of composite S stimulated the biomass production of L. acidophilus. We conclude from our results that a release of EGDMA and TEGDMA from resin composites should be avoided due to their growth-stimulating effects on the caries-associated micro-organisms S. sobrinus and L. acidophilus.

Biological aspects of root canal filling materials--histocompatibility,cytotoxicity, and mutagenicity

In order to minimize the incidence of local and/or systemic side effects, the biocompatibility of all endodontic materials should be investigated by various in vitro and in vivo tests prior to clinical application. The battery of in vitro tests includes determinations of mutagenicity, cytotoxicity, and antibacterial effects. Several reports have shown that paraformaldehyde-containing ZnO-eugenol cements in particular, such as Endomethasone and N2, are antibacterial. On the other hand, it has been found that endodontic materials with strong antimicrobial activity are frequently mutagenic, i.e., primarily those which release formaldehyde. Cell culture tests clearly show significantly different cytocompatibility of the various types of endodontic sealers: in general, formaldehyde-containing ZnO-eugenol cements are classified as highly/extremely cytotoxic, whereas most Ca(OH)2-based sealers are rated as possessing good or excellent cytocompatibility. These results were confirmed by numerous histological studies in vivo. Sealers with inferior biocompatibility, such as formaldehyde-releasing materials, should no longer be applied in practice because safer alternatives are available.

Genotoxicity of dental materials

This study was performed to characterize the (possible) DNA-damaging properties of dental materials and to identify specific compounds that contribute to this genotoxicity. For screening, three tests that assay for different aspects of genotoxicity (i) the bacterial umu-test; (ii) the eucaryotic DNA synthesis inhibition test; and (iii) the in vivo alkaline filter elution technique were chosen. This investigation gives several lines of evidence that most dental materials tested (14 chemical monosubstances present in dental devices and 7 extracts of dental materials) yield 'positive' results in at least one of the genotoxicity tests, however, with effects ranging from 'borderline' to 'strong positive'. The extracts of the widely used dental materials Vitrebond and AH26 elicited clear concentration-related genotoxic responses in all test systems. On the basis of these data and public concern, more attention has to be given to local or systemic complications which may be associated with the use of dental materials.

New principle for large-scale preparation of purified human pancreas islets

Because successful human islet transplantation requires large quantities of viable islets that must be separated from the highly immunogenic exocrine tissue and because handpicking is too time-consuming and laborious to be clinically relevant, a new approach for solving this problem has been established in rat models. It is based on the principle that magnetic microspheres (MMSs) coupled to lectins with binding specificity for the exocrine tissue portion are trapped in an electromagnetic field, thus providing effluent islets of a high degree of purity. In this study our aim was to adapt this principle to human islet preparations. In this context our prime interest was focused on a lectin suitable for human pancreatic tissue. Of 19 different lectins tested, only 1, Wisteria floribunda agglutinin (WFA), is suitable, as shown by immunofluorescence, MMS-lectin binding, and magnetic separation.