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Fast-Setting Calcium Silicate-Based Pulp Capping Cements-Integrated Antibacterial, Irritation and Cytocompatibility
Gabriel Kato1,2, Pedro Sousa Gomes1,2, Karin Hermana Neppelenbroek3
1Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal.
Materials (Basel, Switzerland)
|January 8, 2023
Summary
Three fast-setting calcium silicate-based cements (CSCs) show significant antibacterial activity. Biodentine demonstrated no toxicity, while TotalFill and Theracal LC exhibited varying degrees of cytotoxicity, with Theracal LC raising safety concerns.
Area of Science:
- Endodontics
- Biomaterials Science
- Dental Materials
Background:
- Calcium silicate-based cements (CSCs) are crucial for vital pulp capping, with fast setting times and pre-mixed formulations enhancing clinical efficiency and asepsis.
- Clinical success hinges on the biological performance of endodontic materials interacting with vital pulp tissue.
Purpose of the Study:
- To conduct an integrative biological characterization of three fast-setting CSCs: Biodentine™, TotalFill® BC RRM™ Fast Putty, and Theracal LC®.
- To evaluate their antibacterial, irritation, and cytocompatibility profiles.
Main Methods:
- Scanning electron microscopy (SEM) with Energy Dispersive Spectroscopy (EDS) for material characterization.
- Direct contact assay for antibiofilm activity against *S. mutans*.
- Standardized Chorioallantoic Membrane (CAM) assay for irritation and fibroblast cell culture for cytotoxicity assessment.
Main Results:
- All tested CSCs exhibited expected topography and elemental composition post-setting.
- Significant and comparable antibiofilm activity against *S. mutans* was observed for all three cements.
- Eluates were non-irritant in the CAM assay, but cytotoxicity varied: Biodentine showed no toxicity, TotalFill had transient mild toxicity, and Theracal LC was toxic at high concentrations.
- Compared to ProRoot MTA, Biodentine showed similar biological performance, while TotalFill and Theracal LC had poorer antibiofilm/cytocompatibility profiles, with Theracal LC indicating potential safety concerns.
Conclusions:
- Fast-setting CSCs offer promising antibacterial properties for vital pulp capping.
- Biodentine exhibits a favorable biological profile, comparable to traditional MTA.
- TotalFill and Theracal LC present a less favorable balance of antibiofilm activity and cytocompatibility, with Theracal LC warranting caution due to potential safety issues.
