Comparative study of hyperpure chlorine dioxide with two other irrigants regarding the viability of periodontal ligament
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ORIGINAL ARTICLE
Comparative study of hyperpure chlorine dioxide with two other irrigants regarding the viability of periodontal ligament stem cells Orsolya Láng 1 & Krisztina S. Nagy 2,3 & Julia Láng 1 & Katalin Perczel-Kovách 2,4 & Anna Herczegh 5 & Zsolt Lohinai 5 & Gábor Varga 2 & László Kőhidai 1 Received: 16 June 2020 / Accepted: 1 October 2020 # The Author(s) 2020
Abstract Objectives Periodontal ligament stem cells (PDLSCs) have an underlined significance as their high proliferative capacity and multipotent differentiation provide an important therapeutic potential. The integrity of these cells is frequently disturbed by the routinely used irrigative compounds applied as periodontal or endodontic disinfectants (e.g., hydrogen peroxide (H2O2) and chlorhexidine (CHX)). Our objectives were (i) to monitor the cytotoxic effect of a novel dental irrigative compound, chlorine dioxide (ClO2), compared to two traditional agents (H2O2, CHX) on PDLSCs and (ii) to test whether the aging factor of PDLSC cultures determines cellular responsiveness to the chemicals tested. Methods Impedimetry (concentration-response study), WST-1 assays (WST = water soluble tetrazolium salt), and morphology analysis were performed to measure changes in cell viability induced by the 3 disinfectants; immunocytochemistry of stem cell markers (STRO-1, CD90, and CD105) measured the induced mesenchymal characteristics. Results Cell viability experiments demonstrated that the application of ClO2 does not lead to a significant decrease in viability of PLDSCs in concentrations used to kill microbes. On the contrary, traditional irrigants, H2O2, and CHX are highly toxic on PDLSCs. Aging of PLDSC cultures (passages 3 vs. 7) has characteristic effects on their responsiveness to these agents as the increased expression of mesenchymal stem cell markers turns to decreased. Conclusions and clinical relevance While the active ingredients of mouthwash (H2O2, CHX) applied in endodontic or periodontitis management have a serious toxic effect on PDLSCs, the novel hyperpure ClO2 is less toxic providing an environment favoring dental structure regenerations during disinfectant interventions. Keywords Chlorine dioxide . Dental stem cells . PDLSC . Viability . Toxicity . Hydrogen peroxide . Chlorhexidine
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00784-020-03618-5) contains supplementary material, which is available to authorized users. * László Kőhidai [email protected] 1
Department of Genetics, Cell- and Immunobiology, Semmelweis University, Budapest, Hungary
2
Department of Oral Biology, Semmelweis University, Budapest, Hungary
3
Laboratory of Nanochemistry, Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
4
Department in Community Dentistry, Semmelweis University, Budapest, Hungary
5
Department of Conservative Dentistry, Semmelweis University, Budapest, Hungary
For the last two decades, the discovery of the dental stem cells (DSCs) has opened
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