Effects of Antiseptic Solutions Commonly Used in Dentistry on Bone Viability, Bone Morphology, and Release of Growth Factors.
OBJECTIVE
Antiseptic solutions are commonly used in dentistry for a number of sterilization procedures, including harvesting of bone chips, irrigation of extraction sockets, and sterilization of osteonecrotic bone. Despite its widespread use, little information is available regarding the effects of various antiseptic solutions on bone cell viability, morphology, and the release of growth factors.


METHODS
The antiseptic solutions included 1) 0.5% povidone iodine (PI), 2) 0.2% chlorhexidine diguluconate (CHX), 3) 1% hydrogen peroxide (H2O2), and 4) 0.25% sodium hypochlorite (HYP). Bone samples collected from porcine mandibular cortical bone were rinsed in the antiseptic solutions for 10 minutes and assessed for cell viability using an MTS assay and protein release of transforming growth factor (TGF-β1), bone morphogenetic protein 2 (BMP2), vascular endothelial growth factor (VEGF), interleukin (IL)-1β, and receptor activator of nuclear factor κB ligand (RANKL) using an enzyme-linked immunosorbent assay at 15 minutes and 4 hours after rinsing.


RESULTS
After antiseptic rinsing, changes to the surface protein content showed marked alterations, with an abundant protein layer remaining on CHX-rinsed bone samples. The amount of surface protein content gradually decreased in the following order: CHX, H2O2, PI, and HYP. A similar trend was also observed for the relative cell viability from within bone samples after rinsing, with up to 6 times more viable cells found in the CHX-rinsed bone samples than in the HYP- and PI-rinsed samples. An analysis of the growth factors found that both HYP and PI had significantly lower VEGF and TGF-β1 protein release from bone samples at 15 minutes and 4 hours after rinsing compared with CHX and H2O2. A similar trend was observed for RANKL and IL-1β protein release, although no change was observed for BMP2.


CONCLUSIONS
The results from the present study have demonstrated that antiseptic solutions present with very different effects on bone samples after 10 minutes of rinsing. Rinsing with CHX maintained significantly higher cell viability and protein release of growth factors potent to the bone remodeling cycle.
Resident, Department of Cranio Maxillofacial Surgery, Inselspital, University of Bern, Bern, Switzerland; and Nippon Dental University, School of Life Dentistry at Niigata, Advanced Research Center, Niigata, Japan.
Kosaku
K
Sawada
Resident, Department of Cranio Maxillofacial Surgery, Inselspital, University of Bern, Bern, Switzerland.
Masako
M
Fujioka-Kobayashi
Resident, Department of Cranio Maxillofacial Surgery, Inselspital, University of Bern, Bern, Switzerland.
Eizaburo
E
Kobayashi
Professor, Department of Cranio Maxillofacial Surgery, Inselspital, University of Bern, Bern, Switzerland.
Benoit
B
Schaller
Head, Department of Oral Surgery and Stomatology, Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland. Electronic address: richard.miron@zmk.unibe.ch.
Richard J
RJ
Miron
D000818:Animals; D000891:Anti-Infective Agents, Local / Q000494:pharmacology*; D055396:Bone Morphogenetic Protein 2 / Q000187:drug effects; D018929:Cell Culture Techniques; D048430:Cell Shape / Q000187:drug effects; D002470:Cell Survival / Q000187:drug effects; D002478:Cells, Cultured; D002710:Chlorhexidine / Q000031:analogs & derivatives / Q000494:pharmacology; D006861:Hydrogen Peroxide / Q000494:pharmacology; D036341:Intercellular Signaling Peptides and Proteins / Q000032:analysis* / Q000378:metabolism; D053583:Interleukin-1beta / Q000187:drug effects; D008334:Mandible / Q000166:cytology / Q000187:drug effects* / Q000378:metabolism; D008565:Membrane Proteins / Q000187:drug effects; D008855:Microscopy, Electron, Scanning; D011206:Povidone-Iodine / Q000494:pharmacology; D053245:RANK Ligand / Q000187:drug effects; D012973:Sodium Hypochlorite / Q000494:pharmacology; D013552:Swine; D013997:Time Factors; D053773:Transforming Growth Factor beta1 / Q000187:drug effects; D042461:Vascular Endothelial Growth Factor A / Q000187:drug effects
D000891:Anti-Infective Agents, Local; D055396:Bone Morphogenetic Protein 2; D036341:Intercellular Signaling Peptides and Proteins; D053583:Interleukin-1beta; D008565:Membrane Proteins; D053245:RANK Ligand; D053773:Transforming Growth Factor beta1; D042461:Vascular Endothelial Growth Factor A; D011206:Povidone-Iodine; D006861:Hydrogen Peroxide; D012973:Sodium Hypochlorite; C010882:chlorhexidine gluconate; D002710:Chlorhexidine