Ayala Stabholz

Histochemical analysis of dental hard tissues following bleaching.

The effect of commonly used bleaching materials on the dental hard tissues was tested in extracted human premolars. In each tooth, the apical two-thirds of the root was removed, and the remaining tooth stump was cut longitudinally into two equal segments. The segments were cleaned, dried, and divided into six experimental groups. Each group was treated with one of the following bleaching materials: 30% hydrogen peroxide (HP), 10% carbamide peroxide (CP), sodium perborate (SP), Nu-Smile (NS), Opalescence (Op), and DentlBright (DB). Treatment consisted of immersing the specimens in the respective test material followed by incubation at 37 degrees C for 7 days. The levels of calcium, phosphorus, sulfur, and potassium were measured in the enamel, dentin, and cementum. In the enamel, a significant reduction in the calcium/phosphorus (Ca/P) ratio was found following treatment with HP. In the dentin, a significant reduction in Ca/P ratio was found following treatment with HP,CP, DB, and Op. In the cementum, a significant reduction in the Ca/P ratio was found following treatment with HP, CP, NS, and Op. Changes in sulfur and potassium levels also occurred, but were usually not statistically significant. Significant reduction in sulfur levels occurred only in the cementum following treatment with CP and SP. Sulfur levels increased significantly following treatment with NS. Significant reduction in potassium levels occurred only in the dentin following treatment with CP. It is concluded that bleaching materials may adversely affect the dental hard tissues and should be used with caution.

Haim-Munk syndrome and Papillon-Lefèvre syndrome are allelic mutations in cathepsin C

Of the many palmoplantar keratoderma (PPK) conditions, only Papillon-Lefèvre syndrome (PLS) and Haim-Munk syndrome (HMS) are associated with premature periodontal destruction. Although both PLS and HMS share the cardinal features of PPK and severe periodontitis, a number of additional findings are reported in HMS including arachnodactyly, acro-osteolysis, atrophic changes of the nails, and a radiographic deformity of the fingers. While PLS cases have been identified throughout the world, HMS has only been described among descendants of a religious isolate originally from Cochin, India. Parental consanguinity is a characteristic of many cases of both conditions. Although autosomal recessive transmission of PLS is evident, a more “complex” autosomal recessive pattern of inheritance with phenotypic influences from a closely linked modifying locus has been hypothesised for HMS. Recently, mutations of the cathepsin C gene have been identified as the underlying genetic defect in PLS. To determine if a cathepsin C mutation is also responsible for HMS, we sequenced the gene in affected and unaffected subjects from the Cochin isolate in which both the PLS and HMS phenotypes appear. Here we report identification of a mutation of cathepsin C (exon 6, 2127A→ G) that changes a highly conserved amino acid in the cathepsin C peptide. This mutation segregates with HMS in four nuclear families. Additionally, the existence of a shared common haplotype for genetic loci flanking the cathepsin C gene suggests that affected subjects descended from the Cochin isolate are homozygous for a mutation inherited “identical by descent” from a common ancestor. This finding supports simple autosomal recessive inheritance for HMS in these families. We also report a mutation of the same exon 6CTSC codon (2126C→T) in a Turkish family with classical PLS. These findings provide evidence that PLS and HMS are allelic variants of cathepsin C gene mutations.

Marginal adaptation of retrograde fillings and its correlation with sealability

Marginal adaptation of retrograde fillings with Restodent, zinc phosphate cement, Cavit-W, Duralon, and amalgam was evaluated in vitro by scanning electron microscopy. The results were compared with those of a previous in vitro study which used an innovative radionuclidic model for comparing sealability of the same five retrograde fillings. A correlation was established between marginal adaptation and sealing ability. Restodent sealed significantly better than the other four materials and demonstrated the best adaptation to cavity walls, while amalgam was significantly inferior to the four other materials in both marginal adaptation and seal.

Sustained Release Device Containing Metronidazole for Periodontal Use

The purpose of this study was to develop a sustained release device containing metronidazole for insertion within periodontal pockets and to examine the release kinetics in vitro and in vivo. Cast films of ethyl cellulose with or without polyethylene glycol, containing metronidazole, were prepared and exhibited sustained release. Release rate of metronidazole from the film was measured by means of a UV spectrophotometer, and kinetics of release in vitro was found to conform to Higuchis diffusional model. The microbiological results proved that embedding metronidazole in ethyl cellulose film does not inhibit the biological activity. The release kinetics in vivo correlated with in vitro results, exhibiting a sustained release of metronidazole over a period of three days from 30% metronidazole with polyethylene glycol or 40% metronidazole in ethyl cellulose chloroform cast. This study demonstrates that, by embedding metronidazole in ethyl cellulose, it is possible to obtain sustained release of the drug within the periodontal pocket for three days.

Salivary LL-37 Secretion in Individuals with Down Syndrome is Normal

Antimicrobial peptides play an important role in the innate immune response. Deficiency in salivary LL-37 antimicrobial peptide has been implicated in periodontitis in patients with morbus Kostman syndrome. Down syndrome is associated with periodontitis, diminished salivary flow, and salivary immunoglobulin deficiency. In the present study, levels of LL-37 and its hCAP18 precursor were measured in saliva samples from young individuals with Down syndrome and compared with levels in those from age-matched healthy controls. LL-37 and human cathelicidin antimicrobial protein (hCAP18) were detected in whole but not in parotid saliva. hCAP18 was more abundant than LL-37. The concentrations of salivary hCAP18 and LL-37 were found to be higher in individuals with Down syndrome than in healthy controls, but their secretion rates were similar. We concluded that, while the adaptive immunity of individuals with Down syndrome is impaired at the oral mucosa, the secretion rate of the LL-37 component of the innate immune system is normal.

Sealing of human dentinal tubules by XeCl 308-nm excimer laser

Root hypersensitivity occurs as a result of exposed dentinal tubules. Various methods and materials have been tried in an attempt to occlude these tubules. The purpose of this investigation was to study by scanning electron microscope the effects of XeCl excimer laser on exposed dentinal tubules of human extracted teeth. Fifteen 3-mm-thick slices were cut at the cementoenamel junction from 15 extracted human teeth by an electric saw. By using a diamond bur to remove the cementum layer the dentinal tubules were exposed. Each slice was scored by a permanent marker into four equal quadrants. Three of the quadrants were lased for 4 s by XeCl excimer laser with fluences ranging from 0.5 to 7.0 J/cm2 and pulse repetition of 25 Hz. The unlased quadrant served as control. The specimens were mounted on a stub, sputter coated by gold, and examined by scanning electron microscope. Nonlased surfaces showed numerous exposed dentinal tubules. In contrast, all specimens lased at fluences of up to 1 J/cm2 showed the presence of melted dentin which closed the dentinal tubules. At fluences of 4 J/cm2 and higher, rupture of molten materials and exposure of dentinal tubules were noted. The results indicate the application of XeCl excimer laser at specific fluences can cause melting of dentin and closure of exposed dentinal tubules.

Sustained release device containing minocycline for local treatment of periodontal disease

Abstract This study reports the development of a system for the sustained release of minocycline for use in the treatment of periodontal diseases. Films of ethylcellulose containing 30% (w/w) minocycline cast from ethanol, chloroform, or chloroform with polyethylene glycol were prepared as sustained release delivery devices. The release rate and the antibacterial activity of minocycline were measured in vitro and in vivo. The results indicate that each formulation studied releases the minocycline at a rate that decreases with time. The release kinetics of minocycline in vivo correlate with the in vitro results. The results of the short-term clinical study indicate that use of the device in periodontal pockets may cause complete eradication of the pathogenic bacteria from the pocket.

Effect of ArF-193 nm excimer laser on human dentinal tubules: A scanning electron microscopic study

The purpose of this study was to evaluate the effects of the ArF-193 nm excimer laser on the dentinal tubules of extracted human teeth under a scanning electron microscope. Fifteen 3 mm thick slices were cut with an electric saw at the cementoenamel junction from 15 extracted human teeth. A diamond bur was used to remove the cementum layer and expose the dentinal tubules. Each slice was scored by a permanent marker into four equal quadrants. The ArF excimer laser was applied for 5 seconds on three of the quadrants with fluences that ranged from 0.2 J/cm2 to 15 J/cm2 and pulse repetition of 25 Hz. The untouched quadrant served as a control. The specimens were mounted on stubs, sputter coated by gold, and examined by a scanning electron microscope. The effects of the ArF excimer laser irradiation varied. Laser fluences of 0.2, 0.5, and 1.0 J/cm2 had no effect. Although fluence of 15 J/cm2 caused significant removal of peritubular dentin, melting and resolidification of the dentinal smear layer was also observed under the scanning electron microscope with a laser fluence of 5 J/cm2.

EFFECTS OF TETRACYCLINES ON THE PATHOLOGIC ACTIVITY OF ENDOTOXIN: IN VITRO AND IN VIVO STUDIES

Lipopolysaccharide (LPS) is considered to be one of the major virulence factors of Gram-negative bacteria. Recently, tetracyclines (TTCs) were found to prevent the patho-physiological changes associated with LPS in vivo and the secretion of inflammatory mediators in vitro. However, the mechanism by which TTCs prevents LPS-induced pathology in vivo is still unclear. In order to shed light on that problem, we carried out in vitro and in vivo experiments. TTC inhibited the secretion of nitric oxide (NO) and TNFa from LPSstimulated macrophages and inhibited macrophage-induced thymocyte proliferation. However, TTC inhibited NO secretion with use of concentrations five-fold lower than those that inhibited TNFα secretion and thymocyte proliferation. The secretion of NO was inhibited by the addition of TTC to the cultures up to 6 hrs post-LPS stimulation. TTC inhibition of LPS-induced NO secretion was not reversed by the addition of recombinant TNFa, and TTC inhibition of LPS-induced TNFa secretion was not reversed by the addition of NO donor. These results suggest that the inhibition of TNFa by TTC is not the result of the inhibition of LPS-induced NO secretion or vice versa. In vivo experiments had shown that TTC prevented mortality in LPS-treated mice, but not in mice pre-sensitized with galactosamine prior to the LPS challenge. These results suggest that TTC activity in vivo is due not to the suppression of synthesis of inflammatory mediators but rather to the induction of acute phase-like response, which antagonizes the LPS-induced activity.

Assessing the levels of immunoglobulins in the saliva of diabetic individuals with periodontitis using checkerboard immunodetection

BACKGROUND Current methods for determining salivary antibodies are cumbersome for large-scale screenings. OBJECTIVES To test checkerboard immunodetection for monitoring salivary antibodies and to profile them in diabetic individuals with periodontitis. METHODS Salivary anti-Porphyromonas gingivalis, anti-Actinobacillus actinomycetemcomitans and total IgA levels of 10 individuals were compared using checkerboard immunoblotting and enzyme-linked immunosorbent assay (ELISA). RESULTS Close correlation between both methods was found in anti-P. gingivalis IgA and total IgA, but not in anti-A. actinomycetemcomitans IgA, because of high background levels in ELISA. Thereafter, checkerboard immunodetection was used to compare salivary antibodies of 20 adult type II diabetic with 32 non-diabetic individuals with (n=22) or without (n=10) periodontitis. Patients with periodontitis (regardless of their diabetic condition) expressed increased levels of total IgA in both whole and parotid saliva, but reduced levels of anti-A. actinomycetemcomitans IgA in whole saliva. Consequently, the proportion of anti-A. actinomycetemcomitans IgA in the total IgA was lower in saliva of patients with periodontitis compared with healthy controls. CONCLUSIONS Checkerboard immunodetection was reliable and economical for screening saliva samples for multiple antibody reactions. Our results support previous reports which suggested that patients with periodontitis are able to secrete high levels of salivary Ig, but are hampered in targeting their salivary response toward A. actinomycetemcomitans.