The influence of dentine permeability on cytotoxicity of four dentine bonding systems, in vitro.

Dentine adhesives are often placed directly on dentine from which the smear layer has been removed, the thickness of the dentine is minimal and the potential for diffusion of adhesive components into the pulp is greatest. The permeability of the dentine is one factor that should be critical to whether sufficient diffusion of adhesive components occurs to cause damage to pulpal cells. Dentine discs were prepared and divided into those with low-, medium-, and high-permeability. They were then treated with four different dentine adhesives, after which the pulpal side of the dentine was placed in contact with 1 mL of cell-culture medium. The medium was collected at 24 h intervals for 168 h, and was then placed on monolayers of human pulpal fibroblasts for 24 h. The response of the cells was assessed by succinic dehydrogenase activity (MTT method). The results showed that four dentine adhesive systems released sufficient components to cause suppression of cellular metabolism through dentine. High-permeability dentine generally allowed more diffusion of these components, but the effect of dentine permeability depended on the material. On the other hand, the time interval between the application of the bonding agent and collection of the eluant was consistently important for all materials. Materials were most cytotoxic at early intervals, and were generally less cytotoxic at later intervals, although there were exceptions and there was persistent (> 15%) suppression of cellular metabolism even at late (168 h) intervals. The results suggest that application of these materials to dentine, and particularly dentine with high permeability, poses a potential risk to the health of pulpal tissues.