Cytotoxicity of Root Perforation Repair Biomaterials Using Periodontal Stem Cells

Objective. This study was intended to evaluate in vitro cytotoxicity of six common types of root perforation repair biomaterials on human periodontal stem cells (hPSCs). Background. An endodontic perforation is as an artificial communication between the root canal system and the external tooth surface, there are new materials that show better biocompatibility and results in direct contact with periodontal tissues. Methods. HPSCs (NIDCR, Bethesda, MD) were grown to confluence. Materials were packed into tubing to create 1mm by 1mm samples. The test biomaterials (n = 60 samples) were; A MTA (White ProRoot MTA, Dentsply, Tulsa, OK.); a calcium hydroxide material (USP, Henry Schein, Melville, NY.); a Zinc oxide-eugenol cement (IRM, Dentsply, Milford, DE.); a glass ionomer (Geristore, DenMat, St Maria, CA.); a composite (Resilon, Pentron, CT.), and amalgam (Dispersalloy, Dentsply Milford, DE.). The biomaterials were set for 48 hours in a 37oC incubator. The biomaterials were placed in contact with hPSCs for 24 hours. The cytotoxicity of the biomaterials was measured using a lactate dehydrogenase membrane integrity assay (CytoTox-ONE, Promega, Medison, WI). Results. The most to the least cytotoxic biomaterials were; Zinc oxide eugenol (96%), glass ionomer (49%), Amalgam (35%), mineral trioxide aggregate (30%), Composite (17%) and calcium hydroxide (8%). Conclusion. Root perforations should be repaired with calcium hydroxide, composite or MTA to limit the death of adjacent periodontal cells. Grants. This study was supported by the AAE Foundation and NSU HPD grants.