10 March 2020

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CAD/CAM materials might reduce gingival inflammation during provisional phase in prosthodontics rehabilitation

Massimo Gagliani

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Several prosthodontics rehabilitation processes are needed to recreate a correct masticatory function. The provisional stage is quite important and materials employed in this phase are not completely satisfactory, not only for resistance but also for the interaction with dental plaque and soft tissues.
A very interesting study was published on one of the most important journal in dental research.
The aim of this study was to evaluate the cytotoxicity and inflammatory response of different types of provisional restorative traditional and CAD/CAM materials to mice gingival fibroblasts.

The Authors choose to investigate cytotoxicity of provisional material discs :
-thermal-polymerized acrylic resin
-auto-polymerized acrylic resin
-bisacrylic resin
-nano-ceramic resin for CAD/CAM
-prefabricated polymer block for CAD/CAM

All these disks were tested to Mice (Balb/c) gingival cell both in direct and indirect contact (extracts) at 24, 48 and 72 h, using the MTT and Alamar blue assays. Materials extracts (24 h) were applied to the cell culture (indirect contact) or cells were seeded on discs of provisional materials, and the cytotoxicity and production of IL-6, IL-1β and TNF-α after 24, 48 and 72 h were analyzed through MTT, Alamar Blue® and ELISA. Culture medium was used as control for indirect contact assay (extract) and the surfaces of the wells without discs of provisional materials were used as control for direct contact assay. 

Results
The results were quite clear: Auto-polymerized and bisacrylic resins (direct contact) reduced cell viability after 24, 48 and 72 h compared to control (P < .05). In addition, Auto-polymerized and bisacrylic resins increased IL-6, IL-1β and TNF-α levels mainly at 24 h when compared to the other materials (P < .001). Indirect contact (extract) was not cytotoxic to cells at all periods compared to control (P > .05).

Conclusion
Auto-polymerized and bisacrylic resins were more cytotoxic to mice gingival fibroblasts. CAD/CAM nano ceramic resin and prefabricated polymer blocks are more predictable materials to preserve the periodontal soft tissues during the provisional phase of a prosthodontics rehabilitation.

For additional informations: Cytotoxicity and inflammatory response of different types of provisional restorative materials.