Chris S. Ivanoff

Renal enzyme activities in experimental ochratoxin A‐induced porcine nephropathy: Diagnostic potential of phosphoenolpyruvate carboxykinase and gamma‐glutamyl transpeptidase activity

Enzyme activities have been measured in needle biopsies from kidneys of pigs fed 1 ppm or 0.2 ppm of ochratoxin A for 1-5 wks. After feeding 1 ppm toxin for 1 wk, the activity of cytosolic phosphoenolpyruvate carboxykinase (PEPCK) was decreased by 40% and remained inhibited until the termination of the experiment (5 wk). The activity of gamma-glutamyl transpeptidase, a brush-border enzyme found in the proximal tubules, was reduced to a similar degree and remained inhibited. The activities of hexokinase, a cytosolic enzyme of general distribution in the nephron, and phosphate-dependent glutaminase, a distal tubule enzyme, were not affected. The biopsy results were confirmed by measurements in renal slices taken at the termination of the experiment, except that biopsy samples showed more variation in enzyme activity and a lower PEPCK activity. A guinea pig antibody against the cytosolic form of PEPCK was used to demonstrate that the mitochondrial form of the enzyme, which accounts for a considerable part of the total cellular activity, was not affected by ochratoxin A. When mitochondrial PEPCK activity present in the cytosolic fraction was accounted for, ochratoxin A was found to reduce PEPCK activity by 70-80%. The increase of ochratoxin A exposure from zero through 0.2 ppm to 1 ppm, which resulted in dose-dependent activity decrease of PEPCK and gamma-glutamyl transpeptidase, was accompanied by dose-dependent decrease of renal function, as measured by a reduction of maximal tubular excretion of para-aminohippurate per clearance of inulin (TmPAH/CIn) and an increase in glucose excretion. This suggest that these enzymes are sensitive indicators of ochratoxin A-induced porcine nephropathy. Assuming that porcine nephropathy represents a valid model of endemic (Balkan) nephropathy in humans, the measurement of cytosolic PEPCK and gamma-glutamyl transpeptidase activity in the kidney could be a sensitive test for ochratoxin A-induced disease in humans.

Gallium poisoning: A rare case report

The authors present a case of a college student who suffered acute gallium poisoning as a result of accidental exposure to gallium halide complexes. This is extremely rare and has never been reported in the literature. Acute symptoms after the incident, which initially presented as dermatitis and appeared relatively not life-threatening, rapidly progressed to dangerous episodes of tachycardia, tremors, dyspnea, vertigo, and unexpected black-outs. Had there been effective emergency medical care protocols, diagnostic testing, treatment and antidotes, the latent manifestations of irreversible cardiomyopathy may have been prevented. Given how quickly exposure led to morbidity, this article aims to raise an awareness of the toxic potential of gallium. This has particular relevance for workers involved in the production of semiconductors where there is a potential for accidental exposure to gallium by-products during device processing. It may also have implications for dentists who use gallium alloys to replace mercury containing amalgam. In the absence of threshold limit values and exposure limits for humans, as well as emergency medical guidelines for treatment of poisoning, the case calls on the National Institute for Occupational Safety and Health and the Occupational Safety and Health Administration to establish guidelines and medical management protocols specific for gallium.

Dielectrophoresis: A model to transport drugs directly into teeth

The article describes an innovative delivery system based on the principles of dielectrophoresis to transport drugs directly into site‐specific intraoral targets. The hypothesis that a drug can be driven into tooth enamel during the application of an applied electrical potential difference was tested by the authors in in vitro studies comparing dielectrophoresis to diffusion to transport carbamide peroxide and fluoride. The studies showed that these agents can be transported directly into teeth using an alternating current (AC) electric field more effectively than diffusion. It was found that a 20‐min bleaching treatment on human teeth with dielectrophoresis increased carbamide peroxide absorption by 104% and, on average, improved the change in shade guide unit 14 times from 0.6 SGU to 9 SGU. After applying a 1.23% acidulated phosphate fluoride gel to bovine incisors for 20 min by dielectrophoresis or diffusion, analysis with wavelength dispersive spectrometry determined that dielectrophoresis doubled fluoride uptake in the superficial layers compared to diffusion, and drove the fluoride significantly deeper into enamel with an uptake 600% higher than diffusion at 50 μm depth. Finally, dielectrophoresis promises to be a viable model that can potentially be used clinically to deliver other targeted drugs of variable molecular weight and structure.

Enhanced penetration of fluoride particles into bovine enamel by combining dielectrophoresis with AC electroosmosis

Fluoride deposition into the pores of enamel is necessary at high concentrations to reduce enamel demineralization and with a high degree of penetration to account for loss by ingestion. Current diffusion and electrochemical methods are inadequate for effectively transporting fluoride greater than 20 μm into enamel. The study explores the coupling of dielectrophoresis (DEP) and AC electroosmosis (ACEO) to selectively concentrate fluoride particles from fluoride gel excipients and enhance their penetration into enamel. By measuring the frequency response of approximately 10‐μm‐sized sodium fluoride particles in an aqueous gel media, appropriate frequencies for positive DEP, negative DEP, and ACEO are identified. An assembly composed of two cross‐planar interdigitated electrode (IDE) arrays with open slots is driven successively by fields at appropriate frequencies to drive fluoride particles through the slots of the IDE and into the enamel pores using a combination of DEP and ACEO methods. Fluoride uptake and penetration of 1.23% acidulated phosphate fluoride gel into bovine tooth enamel at various depths is measured using wavelength dispersive spectrometry to compare deposition by diffusion, DEP, and DEP plus ACEO. Fluoride levels in all DEP groups were significantly higher than diffusion groups at depths 10 and 20 μm. The highest fluoride concentrations at 10, 20, 50, and 100 μm depths occur under deposition conditions combining DEP with ACEO. Fluoride levels at 50 μm were equivalent to long‐term prophylactic exposure. These methods may potentially benefit populations at high risk for development of caries and periodontal disease, including underserved children and disparate groups.

Perceptions of Saudi dental students on cultural competency

Objectives: To probe dental students’ perceptions on their cultural competency and international student exchange programs as a way of improving cultural competency training. Methods: A cross-sectional survey (n=460) was distributed to predoctoral students at the College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia in May 2014 at the male and female university campuses. Descriptive statistics were carried out using Statistical Package for Social Sciences (p=0.05). Results: It was found that 79.6% of students think that teaching them regarding cultural diversity is important. Only 41% of students thought their dental education teaches them on the importance of volunteerism and philanthropy. Most students (89.8%) think that international student exchanges can enhance their cultural competence. Conclusion: In this study, it was found that students believe that cultural competence is important and participation in international student exchange programs can enhance their training.

Testiranje spojnog smicanja dubokih okluzalnih kompozitnih restauracija postavljenih preko podloge od Dycal, Dycal LC, konvencionalnog ili smolom modifikovanog glas-jonomer cementa

Background/Aim. The longevity of a dental restoration may be predicted to some degree by its adhesive ability, and this, in turn, can be measured by bond strength testing between restorative materials and tooth structure. The aim of this study was to test an innovative joggle lap shearing jig that integrates the tooth and the entire biomechanical unit into testing, to compare the shear bond strengths of Class I occlusal composite restorations in deep cavity preparations lined with Dycal, Dycal LC, conventional glass ionomer or resinmodified glass ionomer. The mode of failure (adhesive, cohesive, mixed) after debonding was determined by stereomicroscopy. Methods. A total of 150 standardized occlusal cavities were prepared and divided into five groups. The group I cavities (n = 30) were coated with adhesive (ExciTE®F) and filled directly with composite (TetricEvoCeram). The group II and III cavities were lined with Dycal (n = 30) or Dycal LC (n = 30) before placing composite. The groups IV and V specimens were based with Fuji IX (n = 30) or Fuji II LC (n = 30). Shear bond strengths were determined with a universal testing machine and fractured bonding sites were analyzed under stereomicroscope. The mean bond strengths were analyzed using one-way ANOVA test (p < 0.05) and the means between the groups were analyzed with Student’s t-test. Results. The shear bond strength (MPa) of composite restorations in cavities without base (23.91 ± 4.54) was higher than cavities lined with Fuji II LC (17.45 ± 2.74), Fuji IX (8.76 ± 2.57), Dycal LC (13.07 ± 1.84) or Dycal (6.12 ± 1.28). The results using the jogged lap shearing jig were consistent with the literature. Conclusion. The shear bond strength of occlusal composite restorations in deep cavities without liners was greater than cavities lined with Fuji II LC > Fuji IX > Dycal LC > Dycal.