A+ A A-

Download article


Korenevskaya N.A.
Biocompatibility of composite filling materials
Educational Establishment «Vitebsk State Order of Peoples’ Friendship Medical University», Vitebsk, Republic of Belarus

Vestnik VGMU. 2016;15(3):7-17.

Composite filling materials are widely used in the modern dental practice. Polymerization of composite fillings after their setting and curing is incomplete: the monomers binding percentage for the majority of materials ranges from 55 to 75%. Nonreacted monomers and other substances released from composite filling materials in the presence of oral fluid may exert negative influence on the human body. Numerous studies report about a possible cyto-, geno- , embryotoxic and mutagenic activity of composites, their ability to produce an estrogen-like effect, to cause allergic reactions in patients and dental clinics staff. Besides that, some authors noticed a negative effect of these materials on the tooth pulp, as well as their ability to enhance the cariogenic microorganisms growth and development. The negative influence degree of composites on the body depends on the chemical structure of the latter, their consistency, and compliance with the rules of the restoration making.
Key words: composite filling materials, biocompatibility, toxicity.


1. Tseng WY, Huang CH, Chen RS, Lee MS, Chen YJ, Rueggeberg FA et al. Monomer conversion and cytotoxicity of dental composites irradiated with different modes of photoactivated curing. J Biomed Mater Res B Appl Biomater. 2007 Oct;83(1):85-90.
2. Yoon TH, Lee YK, Lim BS, Kim CW. Degree of polymerization of resin composites by different light sources. J Oral Rehabil. 2002 Dec;29(12):1165-73.
3. Fano V, Shatel M, Tanzi ML. Release phenomena and toxicity in polymer-based dental restorative materials. Acta Biomed. 2007 Dec;78(3):190-7.
4. Bouillaguet S, Shaw L, Gonzalez L, Wataha JC, Krejci I. Long term cytotoxicity of resin-based dental restorative materials. J Oral Rehabil. 2002 Jan;29(1):7-13.
5. Ferracane JL. Hygroscopic and hydrolytic effects in dental polymer networks. Dent Mater. 2006 Mar;22(3):211-22.
6. Geursten W, Spahl W, Muller K, Leyhausen G. Variability of cytotoxicity and leaching of substances from five dentin adhesives. J Biomed Mater Res. 1999;48:772-7.
7. Drummond JL. Degradation, fatigue and failure of resin dental composite materials. J Dent Res. 2008 Aug;87(8):710-9.
8. Willershausen B, Callaway A, Ernst CP, Stender E. The influence of oral bacteria on the surfaces of resin-based dental restorative materials – an in vitro study. Int Dent J. 1999 Aug;49(4):231-9.
9. Stanislawski L, Lefeuvre M, Bourd K, Soheili-Majd E, Goldberg M, Périanin A. TEGDMA-induced toxicity in human fibroblasts is associated with early and drastic glutathione depletion with subsequent production of oxygen reactive species. J Biomed Mater Res. 2003 Sep;66(3):476-82.
10. Lyapina M, Dencheva M, Krasteva A, Tzekova M, Kisselova-Yaneva A. Concomitant contact allergy to formaldehyde and methacrylic monomers in students of dental medicine and dental patients. Int J Occup Med Environ Health. 2014 Oct;27(5):797-807.
11. Schweikl H, Spagnuolo G, Schmalz G. Genetic and cellular toxicology of dental resin monomers. J Dent Res. 2006 Oct;85(10):870-7.
12. Geurtsen W. Biocompatibility of resin-modified filling materials. Crit Rev Oral Biol Med. 2000;11(3):333-55.
13. Bergenholz G. Evidence for bacterial causation of adverse pulpal responses in resin-based dental restorations. Crit Rev Oral Biol Med. 2000;11(4):467-80.
14. Unemori M, Matsuya Y, Akashi A, Goto Y, Akamine A. Composite resin restoration and postoperative sensitivity: clinical follow-up in an undergraduate program. J Dent. 2001 Jan;29(1):7-13.
15. Chandwani ND, Pawar MG, Tupkari JV, Yuwanati M. Histological evaluation to study the effects of dental amalgam and composite restoration on human dental pulp: an in vivo study. Med Princ Pract. 2014;23(1):40-4.
16. Krifka S, Spagnuolo G, Schmalz G, Schweikl H. A review of adaptive mechanisms in cell responses towards oxidative stress caused by dental resin monomers. Biomaterials. 2013 Jun;34(19):4555-63.
17. Krifka S, Petzel C, Hiller KA, Frank EM, Bosl C, Spagnuolo G et al. Resin monomer-induced differential activation of MAP kinases and apoptosis in mouse macrophages and human pulp cells. Biomaterials. 2010 Apr;31(11):2964-75.
18. Geurtsen W, Spahl W, Müller K, Leyhausen G. Aqueous extracts from dentin adhesives contain cytotoxic chemicals. J Biomed Mater Res. 1999;48(6):772-7.
19. Chang MC, Lin LD, Chan CP, Chang HH, Chen LI, Lin HJ te al. The effect of BisGMA on cyclooxygenase-2 expression, PGE2 production and cytotoxicity via reactive oxygen species- and MEK/ERK-dependent and -independent pathways. Biomaterials. 2009 Sep;30(25):4070-7.
20. Kleinsasser NH, Schmid K, Sassen AW, Harréus UA, Staudenmaier R, Folwaczny M et al. Cytotoxic and genotoxic effects of resin monomers in human salivary gland tissue and lymphocytes as assessed by the single cell microgel electrophoresis (Comet) assay. Biomaterials. 2006 Mar;27(9):1762-70.
21. Samuelsen JT, Dahl JE, Karlsson S, Morisbak E, Becher R. Apoptosis induced by the monomers HEMA and TEGDMA involves formation of ROS and differential activation of the MAP-kinases p38, JNK and ERK. Dent Mater. 2007 Jan;23(1):34-9.
22. Schwengberg S, Bohlen H, Kleinsasser N, Kehe K, Seiss M, Walther UI et al. In vitro embryotoxicity assessment with dental restorative materials. J Dent. 2005 Jan;33(1):49-55.
23. Wisniewska-Jarosinska M, Poplawski T, Chojnacki CJ, Pawlowska E, Krupa R, Szczepanska J et al. Independent and combined cytotoxicity and genotoxicity of triethylene glycol dimethacrylate and urethane dimethacrylate. Mol Biol Rep. 2011 Oct;38(7):4603-11.
24. Kleinsasser NH, Wallner BC, Harréus UA, Kleinjung T, Folwaczny M, Hickel R et al. Genotoxicity and cytotoxicity of dental materials in human lymphocytes as assessed by the single cell microgel electrophoresis (comet) assay. J Dent. 2004 Mar;32(3):229-34.
25. Martins CA, Leyhausen G, Geurtsen W, Volk J. Intracellular glutathione: a main factor in TEGDMA-induced cytotoxicity? Dent Mater. 2012 Apr;28(4):442-8.
26. Pettini F, Savino M, Corsalini M, Cantore S, Ballini A. Cytogenetic genotoxic investigation in peripheral blood lymphocytes of subjects with dental composite restorative filling materials. J Biol Regul Homeost Agents. 2015 Jan-Mar;29(1):229-33.
27. Fleisch AF, Sheffield PE, Chinn C, Edelstein BL, Landrigan PJ. Bisphenol A and related compounds in dental materials. Pediatric. 2010 Sep;126(4):760-8.
28. Darmani H, Al-Hiyasat AS. The effect of Bis-GMA and TEG-DMA on female mouse fertility. Dent Mater. 2006 Apr;22(4):353-8.
29. Schafer TE, Lapp CA, Hanes CM, Lewis JB. What parents should know about estrogen-like compounds in dental materials. Pediatr Dent. 2000 Jan-Feb;22(1):75-6.
30. Rathee M, Malik P, Singh J. Bisphenol A in dental sealants and its estrogen like effect. Indian J Endocrinol Metab. 2012 May;16(3):339-42.
31. Goon AT, Isaksson M, Zimerson E, Goh CL, Bruze M. Contact allergy to (meth)acrylates in the dental series in southern Sweden: simultaneous positive patch test reaction patterns and possible screening allergens. Contact Dermatitis. 2006 Oct;55(4):219-26.
32. Aalto-Korte K, Alanko K, Kuuliala O, Jolanki R. Methacrylate and acrylate allergy in dental personnel. Contact Dermatitis. 2007 Nov;57(5):324-30.
33. Syed M, Chopra R, Sachdev V. Allergic Reactions to Dental Materials-A Systematic Review. J Clin Diagn Res. 2015 Oct;9(10):ZE04-9.
34. Dawson VS, Amjad S, Fransson H. Endodontic complications in teeth with vital pulps restored with composite resins: a systematic review. Int Endod J. 2015 Jul;48(7):627-38.
35. Murray PE, Windsor LJ, Smyth TW, Hafez AA, Cox CF. Analysis of pulpal reactions to restorative procedures, materials, pulp capping, and future therapies. Crit Rev Oral Biol Med. 2002;13(6):509-20.
36. Kawai K, Tsuchitani Y. Effects of resin composite components on glucosyltransferase of cariogenic bacterium. J Biomed Mater Res. 2000 Jul;51(1):123-7.
37. Imazato S, Tarumi H, Ebi N, Ebisu S. Cytotoxic effects of composite restorations employing self-etching primers or experimental antibacterial primers. J Dent. 2000 Jan;28(1):61-7.
38. Bakopoulou A, Papadopoulos T, Garefis P. Molecular toxicology of substances released from resin-based dental restorative materials. Int J Mol Sci. 2009 Sep;10(9):3861-99.
39. Falconi M, Teti G, Zago M, Pelotti S, Breschi L, Mazzotti G. Effects of HEMA on type I collagen protein in human gingival fibroblasts. Cell Biol Toxicol. 2007 Sep;23(5):313-22.
40. About I, Camps J, Mitsiadis TA, Bottero MJ, Butler W, Franquin JC. Influence of resinous monomers on the differentiation in vitro of human pulp cells into odontoblasts. J Biomed Mater Res. 2002;63(4):418-23.
41. Engelmann J, Janke V, Volk J, Leyhausen G, von Neuhoff N, Schlegelberger B et al. Effects of BisGMA on glutathione metabolism and apoptosis in human gingival fibroblasts in vitro. Biomaterials. 2004 Aug;25(19):4573-80.
42. Moharamzadeh K, Van Noort R, Brook IM, Scutt AM. Cytotoxicity of resin monomers on human gingival fibroblasts and HaCaT keratinocytes. Dent Mater. 2007 Jan;23(1):40-4.
43. Wataha JC, Lockwood PE, Bouillaguet S, Noda M. In vitro biological response to core and flowable dental restorative materials. Dent Mater. 2003 Jan;19(1):25-31.
44. Aranha AMF, Giro EMA, Hebling J, Lessa FCR, de Souza Costa CA. Effects of light-curing time on the cytotoxicity of a restorative composite resin on odontoblast-like cells. J Appl Oral Sci. 2010;18(5):461-6.
45. Ergun G, Egilmez F, Cekic-Nagas I. The cytotoxicity of resin composites cured with three light curing units at different curing distances. Med Oral Patol Oral Cir Bucal. 2011 Mar;16(2):e252-9.
46. Ponce-Bravo S, Ledesma-Montes C, Martínez-Rivera JL, Garcés-Ortíz M. Toxicity test of a dental commercial composite. J Clin Exp Dent. 2015 Apr;7(2):e289-92.
47. Moilanen LH, Dahms JK, Hoberman AM. Reproductive toxicity evaluation of the dental resin monomer triethylene glycol dimethacrylate (CASRN 109-16-0) in mice. Int J Toxicol. 2014 Mar-Apr;33(2):106-15.
48. Kwon HJ, Oh YJ, Jang JH, Park JE, Hwang KS, Park YD. The effect of polymerization conditions on the amounts of unreacted monomer and bisphenol A in dental composite resins. Dent Mater J. 2015;34(3):327-35.

Information about authors:
Korenevskaya N.A. – Candidate of Medical Sciences, associate professor of the Chair of Preventive Dentistry, Educational Establishment «Vitebsk State Order of Peoples’ Friendship Medical University».

Correspondence address: Republic of Belarus, 210023, Vitebsk, 27 Frunze ave., Educational Establishment «Vitebsk State Order of Peoples’ Friendship Medical University», Chair of Preventive Dentistry. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Korenevskaya N.A.

Поиск по сайту