Cytotoxicity of components of resins and other dental restorative materials.

Cytotoxicity testing of dental restorative materials must be viewed as an assessment of hazards, that is the potential of the material to cause pulpal problems. In this context, composites, glass ionomers, amalgams, zinc-based cements and peroxide bleaching agents are all possible hazards to the pulp. The risks that these materials will cause pulpal toxicity in vivo can be partly estimated by assessing the cytotoxicity of the substances which are released from these materials in vitro and comparing these cytotoxic concentrations with those concentrations that are present in vivo. The resin components of composites, metal ions and hydrogen peroxide, all of which are released from dental restorative materials, have been shown to be cytotoxic in vitro in sufficient concentrations. The potencies of these substances are quite diverse. However, the cytotoxicity of these substances in usage tests, and therefore the risks of pulpal toxicity, depends on their ability to diffuse through the dentine and accumulate in the pulp.

Permeability of biological and synthetic molecules through dentine.

The diffusion through dentine by a number of biological and synthetic molecules, including resins and dyes, is reported. In vitro measurements were derived by experiments with a modified 'split-chamber device'. Diffusion was found to be indirectly proportional to dentine thickness for all molecules. Permeability of water-soluble molecules and ethanol-soluble molecules was proportional to the molecular weights, except for fluorescein, hydrogen peroxide (H2O2) and urethane dimethacrylate. The resin components tested are not soluble enough in an aqueous medium to diffuse through 0.5 mm dentine at sufficient concentrations to cause cytotoxicity to pulpal cells.

Cytotoxicity and dentin permeability of carbamide peroxide and hydrogen peroxide vital bleaching materials, in vitro.

There has been recent concern about the inadvertent exposure of dentin with patent tubules as well as gingiva to bleaching systems containing 10-15% carbamide peroxide or 2-10% hydrogen peroxide for more than a few minutes. The aims of the present study were: (1) to determine the cytotoxicity of dilutions of hydrogen peroxide in cell culture; (2) to measure hydrogen peroxide diffusion from bleaching agents through dentin in vitro; and (3) to determine the risk of hydrogen peroxide-induced cytotoxicity from exposure of dentin to these vital bleaching agents. The 50% inhibitory dose (ID50) of hydrogen peroxide to succinyl dehydrogenase activity in cultured cells was found to be 0.58 mmol/L after 1 h. All bleaching materials demonstrated diffusion of hydrogen peroxide through dentin in an "in vitro pulp chamber" device. The one- and six-hour diffusates of all bleaching agents through 0.5-mm dentin exceeded the ID50 in monolayer cultures. Inhibition of succinyl dehydrogenase activity corresponded to the amount of hydrogen peroxide that can rapidly diffuse through dentin in vitro and reach concentrations which are toxic to cultured cells in less than 1 h.