The cytotoxic effects of a new epoxy resin-based root canal sealer (AH-plus), together with those of two other commonly used endodontic sealers (AH26 and zinc oxide-eugenol), have been studied in vitro on a culture of human gingival fibroblasts. Cytotoxicity was assessed by direct incubation of sealers' extracts with the cultured fibroblasts at different time intervals. Morphological and cytotoxic effects of the sealers were evaluated microscopically and spectrophotometrically using the neutral red cytotoxicity assay. Our results demonstrated that the cytotoxic effects induced by zinc oxide-eugenol were detectable as early as 1 hr after mixing and remained at a high level until completion of the experiment (5 wk). AH26, however, induced early cytotoxic effects that lasted for 1 wk, followed by a substantial reduction in cytotoxicity. Cytotoxicity of the AH-plus was confined to the early period of experiment and was no longer detectable after 4 hr of mixing. Comparison between the results obtained for each sealer revealed significant differences at particular time intervals. Our findings suggest the potential advantage of this sealer over the other two sealers.

Radiotherapy has a key role in cancer treatment in more than half of patients with cancer. The management of severe side effects of this treatment modality is a limiting factor to appropriate treatment. Immune system responses play a pivotal role in many of the early and late side effects of radiation. Moreover, immune cells have a significant role in tumor response to radiotherapy, such as angiogenesis and tumor growth. Melatonin as a potent antioxidant has shown appropriate immune regulatory properties that may ameliorate toxicity induced by radiation in various organs. These effects are mediated through various modulatory effects of melatonin in different levels of tissue reaction to ionizing radiation. The effects on the DNA repair system, antioxidant enzymes, immune cells, cytokines secretion, transcription factors, and protein kinases are most important. Moreover, anti-cancer properties of melatonin may increase the therapeutic ratio of radiotherapy. Clinical applications of this agent for the management of malignancies such as breast cancer have shown promising results. It seems anti-proliferative, anti-angiogenesis, and stimulation or suppression of some immune cell responses are the main anti-tumor effects of melatonin that may help to improve response of the tumor to radiotherapy. In this review, the effects of melatonin on the modulation of immune responses in both normal and tumor tissues will be discussed.

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