Considerations about Cytotoxicity of Resin-Based Composite Dental Materials: A Systematic Review

Abstract

The dental material industry is rapidly developing resin-based composites (RBCs), which find widespread use in a variety of clinical settings. As such, their biocompatibility has gained increasing interest. This literature review presents a summary of research into the cytotoxicity of methacrylate-based composites published from 2017 to 2023. Subject to analysis were 14 in vitro studies on human and murine cell lines. Cytotoxicity in the included studies was measured via MTT assay, LDH assay, and WST-1 assay. The QUIN Risk of Bias Tool was performed to validate the included studies. Included studies (based entirely on the results of in vitro studies) provide evidence of dose- and time-dependent cytotoxicity of dental resin-based composites. Oxidative stress and the depletion of cellular glutathione (GSH) were suggested as reasons for cytotoxicity. Induction of apoptosis by RBCs was indicated. While composites remain the golden standard of dental restorative materials, their potential cytotoxicity cannot be ignored due to direct long-term exposure. Further in vitro investigations and clinical trials are required to understand the molecular mechanism of cytotoxicity and produce novel materials with improved safety profiles.

Keywords: apoptosis; biocompatibility; cytotoxicity; dental materials; oxidative stress; resin-based composite.

Figure 1

Most common resin monomers: EGDMA—ethylene glycol dimethacrylate; BisGMA—bisphenol A-glycidyl methacrylate; TEGDMA—triethylene glycol dimethacrylate.

Figure 2

PRISMA flow chart of the study selection process.