Biological effects of acid-eroded MTA Repair HP and ProRoot MTA on human periodontal ligament stem cells

  • Mar Collado-González
  • Sergio López-García
  • David García-Bernal
  • Ricardo E. Oñate-Sánchez
  • Christopher J. Tomás-Catalá
  • Jose M. Moraleda
  • Adrián Lozano
  • Leopoldo Forner
  • Francisco J. Rodríguez-LozanoEmail author
Original Article



The aim of this study was to analyze the biological effects of MTA Repair HP and ProRoot MTA on human periodontal ligament stem cells (hPDLSCs) after exposure to acidic and neutral environments.

Materials and methods

Discs of each material (n = 30) were exposed to phosphate buffered saline (pH = 7.4) or butyric acid (pH = 5.2) for 7 days, and biological testing was carried out in vitro on hPDLSCs. Cell viability and apoptosis assays were performed using eluates of each root-end filling material. To evaluate cell attachment to the different materials, hPDLSCs were directly seeded onto the material surfaces and analyzed by scanning electron microscopy. The chemical composition of the root-end filling materials was determined by energy-dispersive x-ray and eluates were analyzed by inductively coupled plasma-mass spectrometry. Statistical differences were assessed by ANOVA and Tukey test (p < 0.05).


Under an acidic environment, both materials displayed similar ion release abilities, with the increased release of Si and Ca ions. Substantial changes in microstructure were observed for both materials after exposure to acidic pH. In addition, material exposure to an acidic environment showed a similar degree of cell adherence, and, surprisingly, MTA Repair HP exhibited higher cell viability rates at pH 5.2 than ProRoot MTA.


Exposure to an acidic environment promoted Si and Ca ion release from ProRoot MTA and MTA Repair HP. Moreover, we observed optimal biological properties of ProRoot MTA and MTA Repair HP in terms of cell viability, cell death, and cell attachment in both environments.

Clinical relevance

These results may suggest that MTA Repair HP and ProRoot exhibited optimal biological properties in terms of cell viability, cell death and cell attachment in acidic environment, being considered as materials for root-end filling and perforations.


Acidic environment Cytotoxicity MTA Repair HP Mineral trioxide aggregate 



This work was supported by the Spanish Network of Cell Therapy (TerCel), RETICS subprograms of the I+D+I 2013–2016 Spanish National Plan, and projects “RD12/0019/0001” and “RD16/0011/0001” funded by the Instituto de Salud Carlos III to JMM and co-funded by the European Regional Development Fund.

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study protocol was approved by the Clinical Research Ethics Committee of the University of Murcia (procedure number: 1528/2017). Likewise, permission was obtained from the Health Department authorities to use the information contained in the CDHs, previously anonymized by one of the investigators belonging to the medical staff of the Health Department in order to protect patient confidentiality. All the information was processed in abidance with the confidentiality regulations defined under Act 15/1999 referred to personal data protection.

Informed consent

Informed consent was obtained from the parents of all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Mar Collado-González
    • 1
    • 2
  • Sergio López-García
    • 1
  • David García-Bernal
    • 1
    • 3
  • Ricardo E. Oñate-Sánchez
    • 2
  • Christopher J. Tomás-Catalá
    • 1
    • 2
  • Jose M. Moraleda
    • 1
    • 3
  • Adrián Lozano
    • 4
  • Leopoldo Forner
    • 4
  • Francisco J. Rodríguez-Lozano
    • 1
    • 2
    Email author
  1. 1.Cellular Therapy and Hematopoietic Transplant Unit, Hematology Department, Virgen de la Arrixaca Clinical University Hospital, IMIB-ArrixacaUniversity of MurciaMurciaSpain
  2. 2.School of Dentistry, Faculty of MedicineUniversity of MurciaMurciaSpain
  3. 3.Department of Internal MedicineUniversity of MurciaMurciaSpain
  4. 4.Department of StomatologyUniversity de ValenciaValenciaSpain

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