Cytotoxicity evaluation of a new radiopaque resin additive--triphenyl bismuth

Triphenyl bismuth (Ph3Bi) is a promising new additive for making biomedical resins visible on x-ray images. We evaluated the cytotoxicity of Ph3Bi, both alone and as a component of a denture resin, as an initial step in determining its biocompatibility. These experimental materials were compared with several types of dental materials that are in current clinical use (PMMA denture acrylic resin, two photo-cured sealants, and two glass-ionomer cements). Human embryonic lung fibroblast tissue cultures (WI-38 cells) were exposed to 24-hour aqueous extracts of the materials. Changes in cell growth, cell viability, and the visual appearance of cells were used for the assessment of toxic response. Only a slight degree of cytotoxicity was observed for Ph3Bi, both alone and in combination with self-cured PMMA. All clinical materials showed a higher level of cytotoxicity than did Ph3Bi. The sealants and cements exhibited the most cytotoxicity and PMMA acrylic the least. The cytotoxicity of PMMA was elevated slightly by inclusion of Ph3Bi, probably due to decreased monomer conversion. When stored in water, the already low levels of cytotoxicity of both PMMA and PMMA with added Ph3Bi were reduced even further. From these results, we can predict a high level of safety for Ph3Bi as a radiopaque additive for biomedical resins. Any toxicity associated with Ph3Bi-containing resins can be reduced or avoided by prior extraction. Alternatively, curing conditions can be selected that would drive the polymerization reaction to a higher level of conversion.