title: In vitro biocompatibility, inflammatory response, and osteogenic potential of 4 root canal sealers: Sealapex, Sankin apatite root sealer, MTA Fillapex, and iRoot SP root canal sealer.
abstract: BACKGROUND
  The objective of this study was to compare the cytotoxicity, inflammatory response, osteogenic effect, and the signaling mechanism of these biologic activities of 4 calcium compound-based root canal sealers (ie, Sealapex [Sybron Kerr, WA], apatite root sealer [ARS; Dentsply Sankin, Tokyo, Japan], MTA Fillapex [Angelus Indústria de Produtos Odontológicos S/A, Londrina, PR, Brazil], and iRoot SP [Innovative BioCreamix Inc, Vancouver, Canada]) in human periodontal ligament cells.
  
  
  METHODS
  Cytotoxicity was assessed using the 3-(4,5-dimethylthiazolyl-2-yl)-2,5-diphenyltetrazolium bromide assay. Levels of inflammatory mediators were measured by enzyme-linked immunosorbent assay, reverse-transcription polymerase chain reaction, and Western blot analysis. Osteogenic potential was evaluated by alkaline phosphatase activity, alizarin red staining, and marker genes by reverse-transcription polymerase chain reaction. The signal transduction pathways were examined by Western blotting.
  
  
  RESULTS
  None of the sealers were cytotoxic. ARS, MTA Fillapex, and iRoot SP induced a lower expression of proinflammatory mediators than Sealapex. All sealers increased ALP activity and the formation of mineralized nodules and up-regulated the expression of osteoblastic marker messenger RNA. ARS, MTA Fillapex, and iRoot SP showed superior osteogenic potential compared with Sealapex. The expression and/or activation of integrin receptors and downstream signaling molecules, including focal adhesion kinase, paxillin, Akt, mitogen-activated protein kinase, and nuclear factor κB, was induced by ARS, MTA Fillapex, and iRoot SP treatment but not by Sealapex treatment.
  
  
  CONCLUSIONS
  We show for the first time that ARS, MTA Fillapex, and iRoot SP induce a lower expression of inflammatory mediators and enhance osteoblastic differentiation of PDLCs via the integrin-mediated signaling pathway compared with Sealapex.
authors.affiliation: Department of Conservative Dentistry, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Seok-Woo
authors.initials: SW
authors.lastname: Chang
authors.affiliation: Department of Oral and Maxillofacial Pathology and Research Center for Tooth and Periodontal Regeneration (MRC), School of Dentistry, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: So-Youn
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Oral Medicine, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Soo-Kyung
authors.initials: SK
authors.lastname: Kang
authors.affiliation: Department of Conservative Dentistry, Dental Research Institute and BK 21 Program, School of Dentistry, Seoul National University, Seoul, Republic of Korea.
authors.forename: Kee-Yeon
authors.initials: KY
authors.lastname: Kum
authors.affiliation: Department of Oral and Maxillofacial Pathology and Research Center for Tooth and Periodontal Regeneration (MRC), School of Dentistry, Kyung Hee University, Seoul, Republic of Korea. Electronic address: eckim@khu.ac.kr.
authors.forename: Eun-Cheol
authors.initials: EC
authors.lastname: Kim
mesh_terms: D000469:Alkaline Phosphatase / Q000032:analysis / Q000187:drug effects; D017607:Aluminum Compounds / Q000494:pharmacology / Q000633:toxicity; D000880:Anthraquinones; D001672:Biocompatible Materials / Q000494:pharmacology* / Q000633:toxicity; D017610:Calcium Compounds / Q000494:pharmacology / Q000633:toxicity; D002126:Calcium Hydroxide / Q000494:pharmacology / Q000633:toxicity; D002454:Cell Differentiation / Q000187:drug effects; D002460:Cell Line; D002470:Cell Survival / Q000187:drug effects; D004396:Coloring Agents; D004338:Drug Combinations; D017886:Durapatite / Q000494:pharmacology / Q000633:toxicity; D051417:Focal Adhesion Kinase 1 / Q000187:drug effects; D006801:Humans; D018836:Inflammation Mediators / Q000494:pharmacology* / Q000633:toxicity; D008422:Materials Testing; D020928:Mitogen-Activated Protein Kinases / Q000187:drug effects; D016328:NF-kappa B / Q000187:drug effects; D053758:Nanoparticles; D010006:Osteoblasts / Q000187:drug effects; D010012:Osteogenesis / Q000187:drug effects*; D010087:Oxides / Q000494:pharmacology / Q000633:toxicity; D051419:Paxillin / Q000187:drug effects; D010513:Periodontal Ligament / Q000166:cytology / Q000187:drug effects; D051057:Proto-Oncogene Proteins c-akt / Q000187:drug effects; D012387:Root Canal Filling Materials / Q000494:pharmacology* / Q000633:toxicity; D012459:Salicylates / Q000494:pharmacology / Q000633:toxicity; D015398:Signal Transduction / Q000187:drug effects; D017640:Silicates / Q000494:pharmacology / Q000633:toxicity; D013778:Tetrazolium Salts; D013844:Thiazoles
chemical_list: D017607:Aluminum Compounds; D000880:Anthraquinones; D001672:Biocompatible Materials; D017610:Calcium Compounds; D004396:Coloring Agents; D004338:Drug Combinations; D018836:Inflammation Mediators; D016328:NF-kappa B; D010087:Oxides; C496061:PXN protein, human; D051419:Paxillin; D012387:Root Canal Filling Materials; D012459:Salicylates; C106819:Sankin apatite; D017640:Silicates; D013778:Tetrazolium Salts; D013844:Thiazoles; C086631:mineral trioxide aggregate; C055601:Sealapex; C010078:alizarin; D017886:Durapatite; D051417:Focal Adhesion Kinase 1; C496050:PTK2 protein, human; D051057:Proto-Oncogene Proteins c-akt; D020928:Mitogen-Activated Protein Kinases; D000469:Alkaline Phosphatase; C022616:thiazolyl blue; D002126:Calcium Hydroxide; C031293:calcium silicate
keywords: Apatite root sealer; MTA Fillapex; Sealapex; iRoot SP; inflammatory response; osteogenic differentiation; periodontal ligament cells; root canal sealer