Abstract
Background and aims. The aim of this study was to compare the biocompatibility of calcium-enriched mixture cement
(CEM), composite resin and nano-particled mineral trioxide aggregate (NP-MTA) using human gingival fibroblasts.
Materials and methods. A comparative in vitro cell culture study was carried out using 60 single-rooted teeth which
were assigned to the following four groups: 1) untreated healthy group (control); 2) restored with composite resin; 3) CEM
cement; 4) NP-MTA. The MTT assay was used to measure the viability of fibroblasts attached to each specimen and scanning
electron microscopy (SEM) was used for describing cell morphology.
Results. After 24 hours of incubation, the survival rates for composite resin and NP-MTA were 74.1% and 76.9%, respectively,
which were significantly lower than the value in the control group, while both were equally biocompatible. No statistically
significant difference was found between the control group and CEM cement samples (94.3%). After 3 days of
incubation, some increases in the viability of fibroblasts were detected in the composite resin and NP-MTA groups, with
their survival rates being 89% and 93%, respectively. Conversely, in the CEM cement group, the survival rate decreased to
80.7%, which was significantly lower than that in the control group (P = 0.0001).
Conclusion. The results of in vitro tests indicated that on days 1, 3 and 5 after incubation, composite resin, CEM cement
and NP-MTA exhibited acceptable biocompatibility, provided they were allowed to set for 24 hours before exposure to the
cells.