OBJECTIVES This systematic review aimed to compare the cytotoxicity of root canal filling materials (RCFMs) assessed using tetrazolium salt-based tests (TSBT), including the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay, with those obtained using other cell viability assays. METHODS A search was performed on PubMed, Scopus, Web of Science and OpenGrey up to March 2019, followed by a manual search. According to the Participants, Exposure, Comparator and Outcomes (PECO) criteria, in vitro studies that evaluated the cytotoxic effect of RCFMss on animal and/or human cells through TSBT and at least one other viability assay were compared. The methodological quality of selected papers was assessed using ToxRTool® and SciRAP® . Data were analysed using Wilcoxon's signed-rank test for paired samples and linear weighting kappa. RESULTS A total of 230 non-duplicated records were identified. After applying the eligibility criteria, 55 studies were selected for methodological evaluation, seven were selected by manual searching, 22 were excluded for methodological reasons, and 40 were included. A total of 410 comparisons were performed between TSBT and distinct cell viability tests (DCVT). MTT had moderate concordance with DCVT using human cells (n = 138 samples) (P = 0.507; k = 0.4225) and animal cells (n = 122 samples) (P = 0.124; k = 0.5775). XTT had good concordance using human (n = 110 samples) (P = 0.507; k = 0.6336) and animal cells (n = 12 samples) (P = 0.564; k = 0.6604). MTT, XTT, WST and MTS assays showed moderate concordance with DCVT (n = 410 samples) (P = 0.375; k = 0.5138) and complete agreement in 226 samples. DISCUSSION The included studies had methodological heterogeneity that was minimized by the systematic review methodology. CONCLUSIONS MTT and XTT do not cause over- or underestimation of cell viability during cytotoxicity screening of root canal filling materials, implying that these assays can be considered reliable for this purpose. Nonetheless, the development of protocols for the cytotoxic screening of these materials on 3D tissue-like cultures aiming to improve their predictability in the clinical scenario is suggested.

中文翻译：

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MTT 与其他细胞活力测定相比，用于评估根管填充材料的生物相容性：系统评价。

目的 本系统评价旨在比较使用基于四唑盐的测试 (TSBT) 评估的根管填充材料 (RCFM) 的细胞毒性，包括 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium溴化物 (MTT) 测定，以及使用其他细胞活力测定获得的测定。方法 在 PubMed、Scopus、Web of Science 和 OpenGrey 上进行搜索，直至 2019 年 3 月，然后进行手动搜索。根据参与者、暴露、比较者和结果 (PECO) 标准，比较了通过 TSBT 和至少一种其他活力测定评估 RCFMss 对动物和/或人类细胞的细胞毒性作用的体外研究。使用 ToxRTool® 和 SciRAP® 评估所选论文的方法学质量。使用 Wilcoxon' 分析数据 s 配对样本的符号秩检验和线性加权 kappa。结果 共识别出 230 条非重复记录。应用纳入标准后，选择55项研究进行方法学评价，7项通过人工检索选择，22项因方法学原因被排除，40项被纳入。在 TSBT 和不同细胞活力测试 (DCVT) 之间进行了总共 410 次比较。MTT 与使用人类细胞（n = 138 个样本）（P = 0.507；k = 0.4225）和动物细胞（n = 122 个样本）（P = 0.124；k = 0.5775）的 DCVT 具有中等一致性。XTT 使用人类（n = 110 个样本）（P = 0.507；k = 0.6336）和动物细胞（n = 12 个样本）（P = 0.564；k = 0.6604）具有良好的一致性。MTT、XTT、WST 和 MTS 检测显示与 DCVT（n = 410 个样本）的中等一致性（P = 0.375；k = 0。5138) 并在 226 个样本中完全一致。讨论 纳入研究的方法异质性被系统评价方法最小化。结论 MTT 和 XTT 在根管充填材料的细胞毒性筛选过程中不会导致细胞活力的高估或低估，这意味着这些测定可被认为是可靠的。尽管如此，还是建议开发在 3D 组织样培养物上对这些材料进行细胞毒性筛选的方案，以提高它们在临床场景中的可预测性。这意味着这些分析可以被认为是可靠的。尽管如此，还是建议开发在 3D 组织样培养物上对这些材料进行细胞毒性筛选的方案，以提高它们在临床场景中的可预测性。这意味着这些分析可以被认为是可靠的。尽管如此，还是建议开发在 3D 组织样培养物上对这些材料进行细胞毒性筛选的方案，以提高它们在临床场景中的可预测性。