Effects of gamma irradiation on the measurement of hepatitis B virus DNA in dentin harvested from chronically infected patients

Background: The manufacturing of the demineralized dentin matrix (DDM) has been proven to extensively reduce the presence of human hepatitis B viral DNA (HBV DNA). This study measured and compared HBV DNA in fresh dentin to that in gamma radiation (GR)-sterilized dentin extracted from HBV-infected patients. The application of GR as a means of terminal sterilization is hypothesized to inactivate or eliminate HBV within the dentin matrix.

Methods: Dentin from 18 HBV-infected patients was collected and divided into three fragments. The first fragment was unaltered and used as the control group; the remaining two fragments were sterilized with gamma radiation doses of 15 or 25 kGy. DNA was extracted and purified from each fresh (control), and the GR-sterilized (experimental) dentin specimen and HBV DNA copy numbers were evaluated on the basis of the real-time polymerase chain reaction. The copy numbers were used to assess GR efficacy as a means of terminal sterilization for HBV inactivation or elimination.

Results: HBV DNA was detected in 66.67% of the fresh dentin specimens. The differences in HBV DNA levels between the fresh dentin and the GR-sterilized dentin were confirmed by the Wilcoxon signed-rank test for the doses of 15 and 25 kGy with P value of 0.012 and 0.010, respectively. Among the twelve HBV-DNA-positive fresh dentin samples, HBV DNA persisted in eleven after GR sterilization, yet the copy number was reduced to <10 (except for a single sample within each experimental group).

Conclusions: The results suggest that 15 and 25 kGy of GR significantly reduced the HBV DNA levels in the fresh dentin matrix. Expansion of the possible clinical applications of allogenic grafts with the irradiated DDM will require additional studies, including validation of viral load inactivation to prevent infectious transmission and examination of GR exposure effects on the osteoinductivity of the matrix.