Yu-Lin Lai

In vitro color stability, stain resistance, and water sorption of four removable gingival flange materials

STATEMENT OF PROBLEM Evaluation of the color stability of materials used for removable gingival flange prostheses may provide information on their serviceability. PURPOSE This in vitro study compared the color stability, stain resistance, and water sorption of 4 materials commonly used for gingival flange prostheses. MATERIAL AND METHODS Forty-five cylindrical disks (15 mm in diameter and 10 mm thick) were fabricated out of 1 silicone (Gingivamoll), 1 copolyamide (Flexite Supreme), and 2 heat-polymerized acrylic resins (QC-20 and Vertex). Ten specimens of each material were evaluated by a spectrophotometer after 7, 14, 30, 60, 120, and 180 days of immersion in staining solutions of coffee and tea, whereas specimens placed in water and exposed to air, served as controls. Color differences before staining and after storage periods were assessed. Another 5 specimens of each material were tested for water sorption after 56 days. Data for color change (DeltaE) and weight difference (DeltaW) were analyzed by use of a repeated measures analysis of variance and Scheffes multiple comparisons (alpha=.05). RESULTS The coffee solution produced the highest discoloration value in the silicone material (DeltaE=7.31 +/- 0.57, P<.001), followed by the copolyamide (DeltaE=4.22 +/- 0.40, P<.001), and 2 acrylic resins. In the tea solution, the copolyamide had the greatest staining (DeltaE=2.74 +/- 0.56), whereas the other materials had smaller color changes (P<.001). All investigated materials were relatively color stable (DeltaE < 2) when stored in air and water for 6 months. The copolyamide material showed the greatest water uptake, whereas silicone adsorbed the least water (P<.001). CONCLUSIONS All flange materials tested demonstrated color stability in air and water. However, the color changes of silicone and copolyamide materials stored in coffee solution for 180 days were greater than 3 NBS (National Bureau of Standards) units, which would be characterized as appreciable and considered clinically unacceptable.

Contributing factors of mandibular deformation during mouth opening

OBJECTIVES A decrease in mandibular arch width during forced opening has been documented. However, the contributing factors of mandibular deformations are still unclear. This study investigated the mandibular deformation during mouth opening, and searched for contributing factors related to this phenomenon. METHODS Sixty-two dental students volunteered for this study. A linear variable differential transducer (LVDT) was cemented on the mandibular first molars to record mandibular deformation during mouth opening. Proposed factors including geometric factors of the mandible such as lower gonial angle, mandibular length, symphyseal width and height were measured from cephalometric analysis. Densitometric analysis was performed to detect symphyseal area and bone density. RESULTS The changes in width between the mandibular first molars ranged from 20 to 437 microm, which was negatively correlated to the symphyseal width, area, and bone density. Where the lower gonial angle had a positive influence, the arch width changed during mouth opening. A multifactorial model showed a significant correlation between the set of predictor variables (symphyseal area, bone density, and mandibular length) and mandibular deformation. CONCLUSIONS Mandibular arch width narrowed during forced opening. Subjects with smaller symphysis, lower bone density and longer mandible tend to have larger arch width changes.

Areca nut extracts increased expression of inflammatory cytokines, tumor necrosis factor-α, interleukin-1β, interleukin-6 and interleukin-8, in peripheral blood mononuclear cells

BACKGROUND AND OBJECTIVE Cytokines represent a central role in inflammatory tissue destruction and regulate the immune responses that may govern the progression of periodontal diseases. This study investigated the effects of areca nut extracts on the expression of inflammatory cytokines, tumor necrosis factor-alpha, interleukin-1beta, interleukin-6 and interleukin-8 in peripheral blood mononuclear cells. The role of oxidative stress of areca nut extracts was also examined using curcumin. MATERIAL AND METHODS The expression of cytokines in peripheral blood mononuclear cells treated with extracts of ripe areca nut or extracts of tender areca nut was analyzed using enzyme-linked immunosorbent assay and reverse transcription-polymerase chain reaction. RESULTS Both extracts of ripe areca nut (< or = 40 microg/mL) and extracts of tender areca nut significantly enhanced the production of tumor necrosis factor-alpha and interleukin-1beta in peripheral blood mononuclear cells in a dose-dependent and time-dependent manner. The kinetics of mRNA expression of both cytokines was also enhanced by areca nut extracts. The stimulatory effects of areca nut extracts on the secretion of tumor necrosis factor-alpha, interleukin-1beta, interleukin-6 and interleukin-8 and on the mRNA expression of tumor necrosis factor-alpha, interleukin-1beta and interleukin-6 at 4 h of incubation were reduced by curcumin (20-50 microm). However, the level of interleukin-8 transcripts was not affected by curcumin. Moreover, interleukin-1beta induction by extracts of tender areca nut, but not by extracts of ripe areca nut, was weakened by 10 microm curcumin. The inhibitory effects of curcumin may vary with different cytokines and with different areca nut extract treatments. CONCLUSION The complex cytokine profile induced by areca nut extracts-treated peripheral blood mononuclear cells implied the possibility of enhanced local inflammation and altered immune functions by the areca chewing habit. The inhibitory effects of curcumin on cytokine expression suggested that oxidative stress might be involved in areca nut extracts-associated immune alteration.

PI3K/Akt signaling mediated apoptosis blockage and viral gene expression in oral epithelial cells during herpes simplex virus infection

Phosphatidylinositol 3-kinases (PI3Ks) function in the anti-apoptotic pathway, and are commonly exploited by various viruses to accomplish the viral life cycle. This study examined the role of the PI3K pathway in human oral epithelial cells following herpes simplex virus type 1 (HSV-1) infection. The results showed that HSV-1 induced the phosphorylation of Akt and glycogen synthase kinase 3 (GSK-3). Phosphorylation of Akt, but not GSK-3, induced by HSV-1 was PI3K-dependent. The expression of HSV-1 immediate-early genes may be involved in the initial phosphorylation of Akt and GSK-3. Inhibition of HSV-1-induced PI3K activity increased DNA fragmentation and cleavage of poly ADP-ribose polymerase (PARP), caspase 3 and caspase 7 compared with infected alone. Inhibition of PI3K attenuated the expression of HSV-1-infected cell protein 0 (ICP0), but not thymidine kinase (TK) and viral replication. Collectively, these data suggested that, in oral epithelial cells, the HSV-1-induced PI3K/Akt activation was involved in the regulation of apoptosis blockage and viral gene expression.

Retentive and compressive strengths of modified zinc oxide–eugenol cements

OBJECTIVES This investigation sought to improve the handling and physical properties of a commonly used temporary zinc oxide-eugenol cement by changing the base/accelerator (B/A) ratio or combining it with a petroleum jelly or fluoride varnish. METHODS Twelve modifications of a temporary cement were evaluated in terms of retentive strength, compressive strength at 24 h, film thickness and by scanning electron microscopy. RESULTS Decreasing the B/A mixing ratio increased the retentive and compressive strengths, but reduced the film thickness of the cement. By increasing the percentage of incorporated petroleum jelly or fluoride varnish in the cement, there was a progressive decrease in the retentive and compressive strengths and in film thickness. CONCLUSIONS Modifications of a zinc oxide-eugenol temporary cement to change the B/A ratio or to incorporate additives resulted in variations in physical properties. All modified forms of the cement had a film thickness less than 25 microns and a compressive strength below 35 MPa. With a wide range of retentive strength, modified forms of zinc oxide-eugenol cement may be found to have diverse clinical applications.

Kinetics of fluoride release from and reuptake by orthodontic cements.

INTRODUCTION The purposes of this in-vitro study were to compare the fluoride-release profiles and the fluoride release, reuptake, and rerelease characteristics of orthodontic cements before and after topical fluoride treatment. METHODS The orthodontic cements tested were 2 resin-modified glass ionomers (Vitremer [3M Dental Products, St Paul, Minn] and Fuji Ortho LC [GC Dental, Tokyo, Japan]), a glass ionomer (Ketac-Cem [Espe-Premier Dental Products, Norristown, Pa]), and a composite (Concise [3M Dental Products]). Fifteen specimens of each material were stored in plastic vials containing deionized water at 37 degrees C. Fluoride release was measured daily for the first 15 days and then weekly for a 57-day period. After initial elusion, specimens were exposed to 1.23% acidulated phosphate fluoride gel, and the fluoride release was monitored daily for 7 consecutive days. The fluoridation/elution procedure was repeated once, and the specimen surfaces were then examined with a scannning electron microscope. RESULTS Kinetic release profiles of the test materials were deduced. All materials except Concise had similar fluoride-release profiles. Vitremer demonstrated the highest fluoride release, followed by Fuji Ortho LC and then Ketac-Cem in the time period of the study (P <.01). All glass-ionomer cements, but especially Fuji Ortho LC, showed enhanced uptake and release on repeated exposure to the topical fluoride treatment. Nevertheless, Vitremer showed the greatest surface degradation after refluoridation. CONCLUSIONS All resin-modified and conventional glass ionomers studied exhibited the capacity for fluoride release and reuptake after fluoridation, but the subsequent fluoride release was transitory. Thus, the benefit from fluoride reuptake in these orthodontic cements should be balanced with the risk of weakening them after repeated fluoridation.

Effects of Sonic and Ultrasonic Scaling on the Surface Roughness of Tooth-colored Restorative Materials for Cervical Lesions

This study investigated the effects of sonic and ultrasonic scaling on the surface roughness of five commonly used tooth-colored restorative materials for Class V cavities, including a flowable resin composite (Tetric Flow), a compomer (Compoglass F), a glass ionomer (Fuji II), a resin-modified glass ionomer (Fuji II LC Imp) and a resin composite (Z100). Twenty rectangular block specimens (16 x 6 x 1.5 mm) of each material were cured against matrix strips, then stored in artificial saliva for two months before performing the periodontal instrumentation. Each specimen was divided into two experimental zones, and both scaling treatments were performed on each sample. The surface roughness (Ra) of these materials was determined before and after the different instrumentations, and differences were evaluated with the use of a profilometer. Data were statistically analyzed using repeated measures of ANOVA with Tukeys multiple comparisons and paired t-tests at a significance level of 0.05. Significant increases in surface roughness of all test materials were recorded from both scaling treatments. With the exception of Tetric Flow, ultrasonic scaling had more adverse effects on the surface roughness of all test materials compared to sonic scaling. For the test materials Z100 and Tetric Flow, resin composites showed the least surface changes in both scaling treatments, while Fuji II glass ionomer demonstrated the greatest roughness after instrumentation. More importantly, the mean surface roughness values of several materials after instrumentation were above the critical threshold roughness of 0.2 microm.

Stimulatory effects of glucose and Porphyromonas gingivalis lipopolysaccharide on the secretion of inflammatory mediators from human macrophages.

BACKGROUND Hyperglycemia is widely considered to be the causal link between diabetes mellitus (DM) and diabetic complications. The purpose of this study is to determine the effects of high glucose in the presence of lipopolysaccharide (LPS) purified from the periodontal pathogen Porphyromonas gingivalis on human macrophages. METHODS Macrophages (U937) were treated with various concentrations of P. gingivalis-LPS under normal (5.5 mM) or high (25 mM) glucose conditions. Mitochondrial dehydrogenase activity was determined using the 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyltetrazolium bromide assay. The levels of inflammatory mediators secreted were determined using the enzyme-linked immunosorbent assay and the competitive enzyme immunoassay. The intracellular calcium chelator was used to examine whether the intracellular calcium was involved. Statistical differences were assessed using a one-way analysis of variance and Tukey multiple-comparison intervals with α = 0.05. RESULTS High glucose condition enhanced the mitochondrial dehydrogenase activity in macrophages. P. gingivalis-LPS induced the secretion of interleukin (IL)-6, tumor necrosis factor (TNF)-α, and prostaglandin E(2) (PGE(2)) in a dose-dependent manner both in normal and high glucose conditions. The stimulatory effects by P. gingivalis-LPS were more evident when cells were cultured under high glucose conditions. Changes of intracellular calcium concentration were involved not only in high glucose-induced mitochondrial dehydrogenase activity but also in P. gingivalis-LPS-induced production of IL-6, TNF-α, or PGE(2), especially under the high glucose conditions. CONCLUSIONS High glucose appeared to enhance the inflammatory response induced by the periodontal pathogen. The information generated may help to delineate the possible mechanisms by which hyperglycemia compromises the periodontal health of patients with DM.

Areca nut extracts increased the expression of cyclooxygenase-2, prostaglandin E2 and interleukin-1α in human immune cells via oxidative stress.

BACKGROUND AND OBJECTIVES Areca nut has been identified as a carcinogen. Inflammation reveals a strong link with tumourigenesis. The aim of this study was to investigate the effects of areca nut on the expression of the key pro-inflammatory mediators involved in malignancy, cyclooxygenase-2 (COX-2), prostaglandin E2 (PGE2), interleukin (IL)-1α and nuclear factor-κB (NF-κB), by human immune cells. The role of oxidative stress was also examined. MATERIALS AND METHODS Human peripheral blood mononuclear cells (PBMCs) were treated with extracts of ripe areca nut (rANE) or tender areca nut (tANE). Expression of pro-inflammatory mediators was assayed using Western blotting, reverse transcription-polymerase chain reaction, competitive enzyme immunoassay or enzyme-linked immunosorbent assay (ELISA). Activity of NF-κB was evaluated using an ELISA-based method. RESULTS Both rANE and tANE enhanced the expression of COX-2, PGE2 and IL-1α by PBMCs. The secretion of PGE2 was induced by rANE (≤20-40μgml(-1)) and tANE (≤160μgml(-1)) significantly in a dose- and time-dependent manner. However, the above enhancing effects of ANEs could be attenuated by antioxidants. ANEs also increased the nuclear expression of the redox-sensitive factor NF-κB. CONCLUSIONS The results demonstrate that ANEs induced the expression of pro-inflammatory mediators mainly through the induction of oxidative stress and implicate the possibility of using antioxidants for disease prevention.

Development of digital shade guides for color assessment using a digital camera with ring flashes

Digital photographs taken with cameras and ring flashes are commonly used for dental documentation. We hypothesized that different illuminants and camera’s white balance setups shall influence color rendering of digital images and affect the effectiveness of color matching using digital images. Fifteen ceramic disks of different shades were fabricated and photographed with a digital camera in both automatic white balance (AWB) and custom white balance (CWB) under either light-emitting diode (LED) or electronic ring flash. The Commission Internationale d’Éclairage L*a*b* parameters of the captured images were derived from Photoshop software and served as digital shade guides. We found significantly high correlation coefficients (r2 > 0.96) between the respective spectrophotometer standards and those shade guides generated in CWB setups. Moreover, the accuracy of color matching of another set of ceramic disks using digital shade guides, which was verified by ten operators, improved from 67% in AWB to 93% in CWB under LED illuminants. Probably, because of the inconsistent performance of the flashlight and specular reflection, the digital images captured under electronic ring flash in both white balance setups revealed less reliable and relative low-matching ability. In conclusion, the reliability of color matching with digital images is much influenced by the illuminants and camera’s white balance setups, while digital shade guides derived under LED illuminants with CWB demonstrate applicable potential in the fields of color assessments.