The Effect of the Combination of Calcium Hydroxide, Carbonate Apatite, and Ellagic Acid on the Viability and Proliferation of Fibroblast Cells

The failure rate of calcium hydroxide [Ca(OH)2] as a pulp protection material is 13.64% one year after treatment. Carbonate apatite (CO3Ap) is a biocompatible material that has the ability to carry and release drugs in a phosphate-buffered saline (PBS) solution that functions to regulate the pH and osmolarity balance of cells. Ellagic acid (EA) is a natural, bioactive phenolic and flavonoid compound. 12.5% EA has been shown to inhibit the growth of Enterococcus faecalis. This research not only aims to develop a formula for Ca(OH)2 combined with CO3Ap, and ellagic acid (EA) solvent, but also investigates their effect on the cytotoxicity and proliferation of fibroblasts. Material samples were prepared by mixing various proportions of Ca(OH)2 with CO3Ap dissolved in 12.5% EA solvent. Baby hamster kidney-21 cells were prepared and incubated in a 96-well microplate for 24 h and 72 h with media containing the material samples. Cell viability was monitored by measuring the absorbance of each microplate using an ELISA reader. After 24 h, group 3 (50% CO3Ap wt%) showed the highest percentage of viable cells; after 72 h, the highest percentage was found in group 3 (50% CO3Ap wt%). Group 5 (87.5% CO3Ap) had the lowest percentage value of living cells after 24 and 72 h treatment. The difference between groups 3 and 5 at 24 hours was significant (p<0.05). The combinations in groups 1, 2, 3, and 4 were nontoxic and able to stimulate the proliferation of fibroblast cells and thus have ideal characteristics as a new candidate material for pulp capping.