Calcium sustained release, pH changes and cell viability induced by chitosan-based pastes for apexification

[Abstract] We explored chitosan-based sustained release pastes for apexification. The study aimed to formulate chitosan-based pastes loaded with calcium hydroxide (CH) or with calcium chloride (CC), and to evaluate the sustained release of Ca2+ and pH changes in deionized water as well as the effect of the pastes on cell viability. The pastes were formulated by dissolution of the chitosan in 1% or 2% acetic acid (AAC) plus the addition of CH or CC, then were suspended in deionized water for 50 days ; the released Ca(II) and pH were measured with an electrode probe. The effect of the pastes on viability of human dental pulp cells was evaluated with a MTS assay. The results showed that the pastes prepared with 1% and 2% AAC and loaded with CH released a 74.9% and a 76.1% of the Ca2+ content, respectively, while the pastes prepared with 1% and 2% AAC loaded with CC released a content of Ca2+ of 90.8% and 76.6%, respectively. A control paste (CH and polyethylene glycol) released a 95.4% ; significant statistical differences were found between the percentage of the experimental pastes and the control. The CH-loaded pastes caused an alkaline pH at the starting of the study, but the pH became neutral at the ending. The pH of the CC-loaded pastes was neutral at the starting and was acid at the ending. The pastes no affected on the cell viability. The chitosan-based pastes showed a suitable sustained release profile and cytocompatibility.