Cytotoxicity of calcium enriched mixture cement compared with mineral trioxide aggregate and intermediate restorative material

Abstract

Calcium enriched mixture (CEM) cement has been recently invented by the last author. It is composed of calcium oxide, calcium phosphate, calcium silicate and calcium sulphate; however, it has a different chemical composition to mineral trioxide aggregate (MTA). The purpose of this ex vivo study was to investigate the cytotoxicity of CEM cement, and compare it with intermediate restorative material (IRM) and MTA. The materials were tested in fresh and set states on L929 fibroblasts to assess their cytotoxicity. The cell viability responses were evaluated with methyl-tetrazolium bromide assay and Elisa reader at 1, 24 and 168 h (7 days). The tested materials were eluted with L929 culture medium according to international standard organisation 109935 standard. Distilled water and culture medium served as positive and negative controls, respectively. Differences in cytotoxicity were evaluated by one-way anova and t-tests. The cytotoxicity of the materials was statistically different at the three time intervals (P < 0.01). The lowest cytotoxic values recorded were expressed by MTA subgroups followed by CEM cement; IRM subgroups were the most cytotoxic root-end/dental material (P < 0.001). CEM cement and MTA are reasonable alternatives to IRM because of lower cytotoxicity. CEM cement also has good biocompatibility as well as lower estimated cost to MTA and seems to be a promising dental material.

Regenerative Endodontic Treatment (Revascularization) for Necrotic Immature Permanent Molars: A Review and Report of Two Cases with a New Biomaterial

“…Sealing ability, cytotoxicity, and biocompatibility of CEM cement are comparable to MTA (35)(36)(37)(38), and unlike MTA, the surface characteristics of set CEM cement are similar to human dentin, which has the ability to promote hydroxyapatite formation even in normal saline solution and might promote the process of differentiation in stem cells and induce hard tissue formation (34,39).…”

Shear bond strength of a novel light cured calcium silicate based-cement to resin composite using different adhesive systems

“…Biomaterials that are advocated for use in VPT procedures should possess certain characteristics such as biocompatibility, the ability to maintain pulp vitality, adhere to dentine and the restorative material, and also to resist forces during restoration placement and function 6) . Mineral trioxide aggregate has been used for this purpose due to its numerous advantages such as biocompatibility 7,8) , low solubility 9) , prevention of bacterial leakage 10) , and its ability to release calcium hydroxide 11) . However, it has certain shortcomings such as difficulty in handling and a long setting time which might lead to leakage, and loss of marginal adaptation 12) .…”

Revascularization of Necrotic Immature Permanent Anterior Tooth (Case Report)

“…CEM biocompatibility and sealing abilityare comparable to that of MTA [11][12][13][14]. CEM promote hydroxyapatite formation and may encourage the process of differentiation in stem cells and hard tissue formation [10,15].…”