Root canal sealer cytotoxicity with human gingival Fibroblasts. III. Calcium hydroxide-based sealers

The cytotoxicity of four different calcium hydroxide-based root canal sealers (Sealapex, Apexit, CRCS, and Endoflas FS) was tested using human gingiva fibroblasts. The fibroblasts were acquired from the attached gingiva of apparently healthy patients. The sealers were allowed to set for 24 and 48 h before being covered with a fibroblastic suspension. The estimation of the incorporation rate of L-[14C]leucine in the fibroblasts after being in contact with the sealers was utilized to designate the fibroblasts' protein synthesis potential. The research was conducted over a period of 21 days. Endoflas FS induced a dramatic reduction in the protein synthesis potential of the fibroblasts in the 24-h group. In the 48-h group, Endoflas FS showed a slightly better response. Endoflas FS, however, showed a significantly higher cytotoxicity with respect to other sealers in both trials (p < 0.05). Sealapex demonstrated a relatively low cytotoxicity after 3 days of culturing. Although CRCS showed a slightly higher cytotoxicity during the initial phase of the experiments, a declining level of toxicity could be measured after 3 days of culturing. Apexit had a relatively high cytotoxicity in the beginning phase, but an ascending incorporation rate of L-[14C]leucine in the fibroblasts could be distinguished after 3 days of culturing.