Real‐time evaluation of the biocompatibility of calcium silicate‐based endodontic cements: An in vitro study

Abstract

Introduction An ideal filling material should hermetically seal the communication pathways between the canal system and surrounding tissues. Therefore, during the last few years, the development of obturation materials and techniques to create optimal conditions for the proper healing of apical tissues has been a focus of interest. The effects of calcium silicate‐based cements (CSCs) on periodontal ligament cells have been investigated, and promising results have been obtained. To date, there are no reports in the literature that have evaluated the biocompatibility of CSCs using a real‐time live cell system. Therefore, this study aimed to evaluate the real‐time biocompatibility of CSCs with human periodontal ligament cells (hPDLCs). Methodology hPDLC were cultured with testing media of endodontic cements for 5 days: TotalFill‐BC Sealer, BioRoot RCS, Tubli‐Seal, AH Plus, MTA ProRoot, Biodentine, and TotalFill‐BC RRM Fast Set Putty. Cell proliferation, viability, and morphology were quantified using real‐time live cell microscopy with the IncuCyte S3 system. Data were analyzed using the one‐way repeated measures (RM) analysis of variance multiple comparison test ( p < .05). Results Compared to the control group, cell proliferation in the presence of all cements was significantly affected at 24 h ( p < .05). ProRoot MTA and Biodentine lead to an increase in cell proliferation; there were no significant differences with the control group at 120 h. In contrast, Tubli‐Seal and TotalFill‐BC Sealer inhibited cell growth in real‐time and significantly increased cell death compared to all groups. hPDLC co‐cultured with sealer and repair cements showed a spindle‐shaped morphology except with cements Tubli‐Seal and TotalFill‐BC Sealer where smaller and rounder cells were obtained. Conclusions The biocompatibility of the endodontic repair cements performed better than the sealer cements, highlighting the cell proliferation of the ProRoot MTA and Biodentine in real‐time. However, the calcium silicate‐based TotalFill‐BC Sealer presented a high percentage of cell death throughout the experiment similar to that obtained.

Antibacterial Activity and Sustained Effectiveness of Calcium Silicate-Based Cement as a Root-End Filling Material against Enterococcus faecalis

“…Although dental pulp stem cells and PDLSCs belong to the same mesenchymal stem cell lineage, they show differences in proteomics under osteogenic conditions [ 35 ]; they exhibit differences in the orientation of the sheet and stem cell markers as well [ 36 ]. CSCs used for root-end filling stimulate growth and proliferation of the PDLSCs, leading to improved healing and better tooth prognosis [ 37 ].…”

Importance of radiological examination in the evaluation of canal fillings performed with bioceramic sealers

“…Biodentine is an endodontic sealer composed of calcium silicate, primarily tricalcium silicate, with certain additives and a zirconium oxide radiopacifier. It is specifically designed to be utilized as a dentine replacement material and has undergone extensive scientific engineering (15).…”

Specimen Shape and Elution Time Affect the Mineralization and Differentiation Potential of Dental Pulp Stem Cells to Biodentine

“…Eluents of cements obtained from powder (20 mg/mL, three days) decreased cell proliferation [4,22], while other studies observed no changes in the growth rates when cells were treated with eluent from discs [0.14 mg/mL, four days]. Furthermore, cell proliferation rates exhibited distinct patterns when exposed to different dimensions of the material; for instance, a 4 × 3 mm disc led to decreased cell proliferation on the fifth day [19], whereas a 5 × 3 mm disc resulted in increased cell proliferation on the seventh day [9]. Another study reported increased proliferation when cells were grown directly on the surface of the material [29].…”

“…In this method, there are no specifications governing the variables involved in production of the eluents. The material can be shaped as discs [11,18,19] or crushed into powder [6,[20][21][22]. Likewise, the elution period varied across studies.…”