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Genotoxicity of root canal sealers: a literature review

Clinical Oral Investigations volume 24, pages 3347–3362 (2020)Cite this article

Abstract

Objectives

Root canal sealers are widely used worldwide in endodontics to prevent reinfection and growth of surviving microorganisms. Considering the strong correlation between genetic damage and carcinogenesis, evaluation of genotoxicity induced by endodontic sealers is recommended for elucidating the true health risks to patients and professionals. The purpose of this article was to provide a comprehensive review of studies involving genotoxicity analysis of endodontic sealers and the used methodologies.

Materials and methods

A literature search was made in PubMed using the following combination of words “genotoxicity,” “mutagenicity,” “endodontic sealers,” and “root canal sealers.” A total of 39 articles with genotoxicity studies were selected for the present study.

Results

Sealers have been ranked in decreasing order of their genotoxicity as: ZOE sealers > GIC sealers > S sealers > ER sealers > MR sealers > Novel sealers > CH sealers > CS sealers.

Conclusions

All published data showed some evidence of genotoxicity for most of the commercial root canal sealers; however, contradictory results were found, mainly for AH Plus, the most studied sealer.

Clinical relevance

The information provided would direct the endodontists to use the less genotoxic materials in endodontic treatment in a way to reduce DNA damage promoting oral healthcare.

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Fig. 1
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Abbreviations

BisDMA:

Bisphenol-A dimethacrylate

BisEMA:

Ethoxylated bisphenol-A dimethacrylate

BisGMA:

Bisphenol-A-glycidylmethacrylate

CH:

Calcium hydroxide

CS:

Calcium silicate

DSB:

Double-strand breaks

GIC:

Glass ionomer cements

ER:

Epoxy resin

hDPF:

Human dental pulp fibroblast

hDPSC:

human dental pulp stem cells

HEMA:

Hydroxyethylene methacrylate

hGF:

Human gingival fibroblast

hPB:

Human peripheral blood

MR:

Methacrylate resin

MN:

Micronucleus

MTA:

Mineral trioxide aggregate

PBMC:

Peripheral blood mononuclear cells

PDL:

Periodontal ligament cells

PEGDMA:

Polyethylene glycol dimethacrylate

PR:

Polyvinyl resin

RCS:

Root canal sealer

ROS:

Reactive oxygen species

S:

Silicone

SHE:

Syrian hamster embryo

TEGDMA:

Triethyleneglycoldimethacrylate

UDMA:

Urethanedimethacrylate

ZOE:

Zinc oxide-eugenol

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Acknowledgments

The authors would like to thank the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq - MCT), process n. 304845/2015-9, and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), process n. PVE1232013-UFRN-123/2013, for the financial support provided.

Funding

The work was supported by the Conselho Nacional de Desenvolvimento Científico e Tecnológico, CNPq, proc.n.442329/2014-8, and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) proc.n. PVE1232013, from Brazil.

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Affiliations

  1. Department of Cell Biology and Genetics, Biosciences Center, Federal University of Rio Grande do Norte, Natal, Brazil

    Fábio Miguel dos Santos Costa & Silvia Regina Batistuzzo de Medeiros

  2. Faculty of Dental Medicine, U. Porto, Porto, Portugal

    Maria Helena Fernandes

  3. LAQV/REQUIMTE, U. Porto, Porto, Portugal

    Maria Helena Fernandes

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  1. Fábio Miguel dos Santos Costa
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  2. Maria Helena Fernandes
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  3. Silvia Regina Batistuzzo de Medeiros
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Correspondence to Silvia Regina Batistuzzo de Medeiros.

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dos Santos Costa, F., Fernandes, M. & Batistuzzo de Medeiros, S.R. Genotoxicity of root canal sealers: a literature review. Clin Oral Invest 24, 3347–3362 (2020). https://doi.org/10.1007/s00784-020-03478-z

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Keywords

  • Endodontic sealers
  • Comet assay
  • Micronucleus test
  • Mutagenicity