In vitro: Biocompatibility evaluation of Grey MTA Plus and Master-Dent MTA mixed with anti-washout gel compared to Proroot MTA
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Introduction: Iatrogenic defects during endodontic treatment can negatively influence the treatment outcome, and for healing to occur a biocompatible material must be used. High degrees of clinical success in dealing with such cases were associated with the use of Gray ProRoot ® MTA. However, evolving drawbacks, such as poor anti-washout properties, have led manufacturers to compensate for deficiencies. MTA Plus ® (Avalon Biomed Inc. Bradenton, FL, USA) and Master-Dent ® MTA (Pearson Dental, Sylmar, CA, USA) are FDA-approved products similar to ProRoot ® MTA, but are claimed to have superior anti-washout properties when mixed with the gel provided with materials. Aim of Study: To evaluate the early biocompatible effects of completely set MTA Plus ® and Master-Dent ® MTA mixed with anti-washout gel compared to completely set gray ProRoot ® MTA on normal human osteoblastic cells from alveolar bone and to evaluate if time is a factor affecting the cells’ reaction to these materials. Materials and Methods: MTT (3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyltetrazolium bromide), ALP (alkaline phosphatase), and IL-1β (interleukin-1 beta) assays were conducted on cells incubated with materials for 3, 5, and 7 days. All materials were mixed according to manufacturers’ instructions, were molded, and were allowed to set at 37C in 100% relative humidity for 2 days. Primary human osteoblastic cells were first cultured with set materials before being assayed according to the time and condition needed for each assay. Readings were taken with a Bio-Rad ® micro plate spectrophotometer (Bio-Rad laboratories, NY, USA), and data were analyzed using a One-way ANOVA at a 5% level of significance, followed by the Tukey HSD method. Results: There was a statistically significant induction in cell differentiation measured by the ALP assay in all three tested groups compared to control group with no material added (p < 0.05). However, all materials show evidence of reduction in cell activity compared to controls measured by the MTT assay in all tested groups at 3 and 5 days (p 0.05). No statistical significant differences were found between MTA Plus and Master-Dent MTA when compared to Proroot MTA. For the IL-1β assay, all the absorbance values in the cell samples were lower than the 0 standard. Therefore, it appears that there were no detectable levels of IL-1β in any of our samples tested. Conclusion: When MTA Plus and Master-Dent MTA are placed in direct contact with human osteoblastic cells, there are possible initial negative metabolic effects. Longer periods of incubation, however, indicated a reversal from negative effects of both materials on the cellular behavior without differences between them. Both MTA Plus and Master-Dent MTA cements are biocompatible and appear to have osetoconductive effects on osteoblastic cells as indicated by their enhanced cell activity over time and by their levels of ALP, an early marker of osteoblastic cell differentiation.