Department of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway.
Department of Operative Dentistry and Periodontology, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Swiss Dent J. 2022 Sep 5;132(9):586-597. doi: 10.61872/sdj-2022-09-01. Epub 2022 May 9.
Periapical tissue may be exposed to root canal filling materials in consequence of root canal therapy. There is scant scientific data about the biocompatibility of root canal filling materials of various chemistry on the periapical area. This study aimed to investigate the effects of different root canal sealers and their eluates on human alveolar osteoblasts in terms of cell proliferation, adhesion, morphology and gene expression in vitro. Five endodontic sealers (AH Plus®, Apexit®, Tubli-Seal®, Real Seal SE®, EndoRez®) and one gutta-percha obturation material (BeeFill®) were tested. Human alveolar osteoblasts derived from 3 different donors following incubation with sealer eluates after 24 h and 72 h were investigated by means of qPCR (gene expression). Morphological reactions of the alveolar osteoblasts were measured by culturing the cells for 3 d, and 7 d and 14 d, respectively, followed by scanning electron microscopy (morphology, adhesion) and fluorescence imaging of the actin cytoskeleton (morphology, proliferation). A repeated measures analysis was performed and p-values were adjusted by Tukey. While all sealers influenced the cell morphology and the expression of genes associated with apoptosis (Casp3), proliferation (histone H3), and inflammation (interleukin-6 and matrix metalloproteinases 1 and 3), mainly AH Plus® and Apexit® yielded a regular actin cytoskeleton and beneficial gene expression patterns. Regarding cell adhesion, only AH Plus® supported proper anchorage for alveolar osteoblasts. Our results provide evidence for the biocompatibility of epoxy resin-based endodontic sealers, i.e. AH Plus®, while other sealers proved cytotoxic for alveolar osteoblasts. Further studies are needed for understanding the bone cell reactions after endodontic treatment and the clinical decision-making regarding the sealer of choice for root canal fillings.
根尖周组织可能会因根管治疗而暴露于根管充填材料中。关于各种化学成分的根管充填材料在根尖区域的生物相容性，科学数据很少。本研究旨在体外研究不同根管封闭剂及其浸提液对人牙槽骨成骨细胞的细胞增殖、黏附、形态和基因表达的影响。测试了 5 种根管封闭剂（AH Plus®、Apexit®、Tubli-Seal®、Real Seal SE®、EndoRez®）和 1 种牙胶根管封闭材料（BeeFill®）。通过 qPCR（基因表达）研究了与封闭剂浸提液孵育 24 小时和 72 小时后，来自 3 个不同供体的人牙槽骨成骨细胞的形态反应。通过分别培养细胞 3 天、7 天和 14 天，然后进行扫描电子显微镜（形态、黏附）和肌动蛋白细胞骨架荧光成像（形态、增殖）来测量牙槽骨成骨细胞的形态反应。采用重复测量分析，并通过 Tukey 调整 p 值。虽然所有封闭剂都影响细胞形态以及与细胞凋亡（Casp3）、增殖（组蛋白 H3）和炎症（白细胞介素-6 和基质金属蛋白酶 1 和 3）相关的基因的表达，但主要是 AH Plus®和 Apexit®产生了规则的肌动蛋白细胞骨架和有益的基因表达模式。关于细胞黏附，只有 AH Plus®支持牙槽骨成骨细胞的适当锚定。我们的结果为基于环氧树脂的根管封闭剂（即 AH Plus®）的生物相容性提供了证据，而其他封闭剂则被证明对牙槽骨成骨细胞具有细胞毒性。需要进一步的研究来了解根管治疗后的骨细胞反应以及选择根管充填封闭剂的临床决策。
