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In Vitro Biocompatibility of Contemporary Bulk-fill Composites.

W S Toh, A U J Yap, S Y Lim

    Operative Dentistry
    |August 4, 2015
    PubMed
    Summary

    Biocompatibility testing of bulk-fill resin-based composites (RBCs) revealed that pre-reacted glass ionomer (PRG) materials showed the lowest cell viability. Composite thickness significantly impacts cytotoxicity, with some non-PRG bulk-fill RBCs performing better than standard composites at 4mm.

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    Area of Science:

    • Biomaterials Science
    • Dental Materials Science
    • Toxicology

    Background:

    • Bulk-fill resin-based composites (RBCs) are increasingly used in dental restorations.
    • Evaluating their biocompatibility, especially concerning International Organization for Standardization (ISO) 10993 standards, is crucial.
    • The influence of material thickness on cytotoxicity requires further investigation.

    Purpose of the Study:

    • To assess the biocompatibility of contemporary bulk-fill RBCs, including pre-reacted glass ionomer (PRG) types.
    • To determine the effect of composite thickness (2mm and 4mm) on the cytotoxicity of these materials.
    • To compare the cytotoxicity of bulk-fill RBCs with standard composites.

    Main Methods:

    • Investigated two standard composites, two bulk-fill PRG RBCs, and three bulk-fill non-PRG RBCs.
    • Prepared specimens of 2mm and 4mm thickness, cured using a light-emitting diode (LED) light (700 mW/cm², 20s).
    • Exposed L929 mouse fibroblasts to material extracts at varying dilutions (1:1, 1:2, 1:10) for 24 hours, assessing cytotoxicity via cell viability and morphology.

    Main Results:

    • PRG-containing bulk-fill RBC extracts exhibited the lowest cell viability among bulk-fill materials.
    • At 4mm thickness, undiluted extracts of bulk-fill non-PRG RBCs showed significantly higher cell viability than standard composites.
    • Cytotoxicity was influenced by chemical composition, specimen thickness, and extract concentration, correlating with observed morphologic changes in cells.

    Conclusions:

    • Not all bulk-fill RBCs meet high cell viability (>70%) at 4mm thickness, challenging manufacturer recommendations for bulk placement.
    • PRG materials may present a higher cytotoxic risk compared to non-PRG bulk-fill composites.
    • Material thickness is a critical factor influencing the biocompatibility assessment of bulk-fill RBCs.