Cytotoxicity of Ketac Silver cement

The aim of this experiment was to investigate the effect of a glass ionomer cement with silver particles (Ketac Silver) on pulp tissue. Class V cavities were prepared in 60 healthy teeth scheduled for extraction for orthodontic reasons. A base of Dycal was placed in each cavity. Thirty teeth were filled with Ketac Silver and 30 with ZOE. Ten teeth of each group were extracted 15, 30, and 60 days later. At 15 days, the pulps in the Ketac group showed vacuolization and disruption of the odontoblastic layer, edema, vasodilation, chronic inflammatory infiltrate (CII), and necrosis. At 30 days, a necrotic odontoblastic layer, severe CII, and extensive areas of necrosis were seen. At 60 days, pulp tissue was almost completely necrotic. The ZOE control group showed a slight CII at 15 days. Our results suggest that under these experimental conditions, this cement is highly toxic and induces irreversible pulpal damage.