In Vitro Examination of The Cytotoxicity of Alkasite Restorative Material on Dental Pulp Stem Cells

Abstract Background: The clinical suitability of restorative dental materials is also determined by their biocompatibility, in addition to their physical and chemical properties. The present study aimed to examine the cytotoxic effects of three dental restorative materials on human dental pulp stem cells (DPSCs). Methods: This study examined the cytotoxic properties of a composite (Gradia Direct,GC Europe), a high-viscosity glass ionomer cement (HVGIC; Equia Forte,GC Europe), and an alkasite restorative material (Cention N,Ivoclar Vivadent). In total, 12 samples of each material were prepared for cytotoxicity assays; the cytotoxic effects were determined by taking biomaterial releases into consideration. Cell viability and proliferation were observed and analyzed at intervals of 24- and 72-hours using both the methyl-thiazole-diphenyl-tetrazolium (MTT,Sigma Aldrich) and xCELLigence (RTCA-DP,ACE) cytotoxicity assays. Data were calculated using the RTCA-DP integrated software of the xCELLigence system and the GraphPad Prism 9.1.1 (GraphPad Software, Inc) program. Data from the proliferation experiments were statistically evaluated using the two-way ANOVA test. Results: Alkasite exhibited the highest cytotoxicity, whereas HVGIC and composite did not exhibit any significant difference compared with the control. No difference in the cytotoxicity of the alkasite and composite was noted between the two time points in the MTT assay; however, the cytotoxicity of HVGIC was higher at 72-hours than that at 24-hours. Similar results were obtained with both assays. Conclusions: Although alkasite exhibited higher cytotoxicity compared to composite and HVGIC, all materials exerted slightly cytotoxic effects (60%–90% cell viability) on DPSCs. Considering its cytotoxic, aesthetic and mechanical properties, alkasite can be clinically preferred instead other materials in cavities that are not close to the dental pulp.