The effect of alternatives to formocresol on antigenicity of proteins

As part of an overall evaluation of possible substitutes for the pulpotomy agent formocresol, this study was initiated to compare the antigenicity of the reaction products of protein with formaldehyde, glutaraldehyde, or dimethylsuberimidate (DMS). Rabbits were injected with rabbit serum albumin (RSA) which had been treated with one of the following solutions: phosphate-buffered saline, 2% glutaraldehyde, 4% formaldehyde, or 2% DMS. The antisera from the rabbits were analyzed for elicited antibodies by the enzyme-linked immunosorbent assay (ELISA) and in a horseradish peroxidase (HRP) assay using a spot technique on nitrocellulose paper. These assays demonstrated that DMS-treated RSA was the most antigenic of the reaction products tested. The least provocative was the glutaraldehyde-treated RSA; the reaction product of formaldehyde was intermediate. Our findings suggest that if non-immunogenicity of a pulpotomy agent is a desirable property, then DMS does not meet the criteria of an alternative pulp fixative. In contrast, the relatively low antigenicity of glutaraldehyde reinforces other favorable findings which support its use clinically.