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Updated: May 7, 2026
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Accessing the Cytotoxicity and Cell Response to Biomaterials
Published on: July 8, 2021
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Cytocompatibility of Three Calcium Silicate-Based Biomaterials: A Systematic Review and Meta-Analysis
Sahar Shabani Panbeh Choleh1,2, Mahmoud Heidari3, Ezatolah Kazeminejad2
1Cellular and Molecular Biology, Department of Biology, Go.C., Islamic Azad University, Gorgan, Iran.
Iranian Endodontic Journal
|May 6, 2026
Summary
Mineral Trioxide Aggregate (MTA), Biodentine, and Calcium Enriched Mixture (CEM) cement show similar in vitro cytotoxicity. CEM cement demonstrated consistent biocompatibility, while MTA and Biodentine showed reduced cell viability at specific concentrations and durations in vital pulp therapy.
Area of Science:
- Dental Materials Science
- Biocompatibility Testing
- Regenerative Endodontics
Background:
- Vital pulp therapy (VPT) relies on biocompatible materials to preserve pulp vitality.
- Calcium silicate-based cements are widely used in VPT.
- Comparative cytotoxicity data is crucial for material selection.
Purpose of the Study:
- To systematically evaluate and compare the in vitro cytotoxic effects of three calcium silicate-based cements: Mineral Trioxide Aggregate (MTA), Biodentine, and Calcium Enriched Mixture (CEM) Cement.
- To assess their biocompatibility with human dental pulp cells in the context of VPT.
Main Methods:
- A comprehensive literature search was performed across multiple databases up to February 2023.
- Included studies focused on in vitro cytotoxicity evaluations using cell viability assays (e.g., MTT).
- A meta-analysis was conducted on 11 selected studies out of 32 meeting inclusion criteria.
Main Results:
- No significant overall differences in cytotoxicity were found among MTA, Biodentine, and CEM cement.
- Undiluted MTA and Biodentine (1:4 dilution) showed significant cytotoxicity at 48 hours (P<0.05).
- CEM cement consistently exhibited favorable biocompatibility across studies.
Conclusions:
- MTA, Biodentine, and CEM cement generally possess acceptable in vitro biocompatibility for VPT.
- Material concentration and exposure duration can influence biological responses.
- Careful clinical application is essential for optimal outcomes in vital pulp therapy.
