Biomimetics and the restoration of the endodontically treated tooth / Biomimética e a restauração do dente tratado endodonticamente

Although much progress has been obtained in terms of the Endodontic treatment, the literature shows that true success can be only achieved with adequate coronal seal to avoid bacterial contamination, and protect the tooth structure from fracture. There are many options available to the clinician to restore the endodontically treated tooth; however, there is not much evidence available on what alternative is better than another. This review will critically present the current knowledge on restorative choices, including posts and endocrowns, showing advantages and disadvantages of different treatment forms. With this knowledge, we will also introduce the concept of biomimetics to endodontically treated teeth, and how the nature of their remaining tooth structure can benefit from this approach. This concept entails the use of mechanisms and biologically produced materials to restore a tooth in a way that would mimic its natural structure, with the purpose of achieving better long-term prognosis (AU)

Embora tenha se obtido progresso em relação ao tratamento endodôntico, a literatura mostra que o sucesso real só pode ser atingido com o selamento coronal adequado, para evitar-se a contaminação bacteriana e proteger-se a estrutura dental de fraturas. Há muitas opções disponíveis para o clínico para a restauração do dente tratado endodonticamente; entretanto, não há muita evidência disponível sobre qual alternativa é melhor que a outra. Esta revisão apresentará criticamente o conhecimento atual sobre opções restauradoras, incluindo retentores intraradiculares e endocrowns, mostrando vantagens e desvantagens das diferentes formas de tratamento. Com esse conhecimento, também introduziremos o conceito de biomimética, uma vez que dentes tratados endodonticamente, devido a natureza de sua estrutura dental remanescente, podem se beneficiar desta abordagem. Esse conceito envolve o uso de mecanismos e materiais produzidos biologicamente para restaurar um dente de forma a imitar a estrutura natural, com o objetivo de alcançar melhor prognóstico de longo-prazo.(AU)

Granuloma Central de Células Gigantes: Relato de Caso Clínico / Central giant cell granuloma: a case report

O presente caso relata uma lesão central de células gigantes, apresentando, ainda, uma revisão da literatura com vistas ao diagnóstico e tratamento da lesão. Paciente do gênero masculino, leucoderma, 25 anos de idade procurou o serviço de cirurgia Buco-Maxilo-Facial da Universidade de Taubaté, apresentando uma lesão de grandes proporções em corpo mandibular esquerdo. Foram solicitados exames radiográficos e tomográficos, evidenciando uma área radiolúcida de aspecto unilocular, sugerindo as hipóteses diagnósticas de ameloblastoma, granuloma central de células gigantes e cisto ósseo aneurismático. Foi realizada a biópsia incisional, na qual se notou a presença de células gigantes multinucleadas e grupos de fibras colágenas com áreas de extravasamento de eritrócitos e depósitos de hemossiderina. Foram solicitados, também, exames bioquímicos do sangue para verificação dos níveis da fosfatase alcalina, os níveis de cálcio e fósforo e a dosagem de paratormônio, evidenciando-se valores normais para todos. O tratamento eleito foi curetagem cirúrgica da lesão com preservação dos dentes envolvidos no processo. A proservação do caso é de 24 (vinte e quatro) meses e demonstra franca recuperação, com evidente neoformação óssea, conforme análise clínica e radiográfica.

This study reports a case of central giant cell granuloma and also presents a review of the literature, focusing on the diagnosis and management of this lesion. A 25-year-old caucasian male, came to the Maxillofacial Surgery Outpatient Clinic of the University of Taubaté presenting a large lesion in the left mandibular body. Radiographic and computed tomography (CT) examinations revealed a unilocular radiolucent area suggesting the diagnoses of ameloblastoma, central giant cell granuloma and aneurysmal bone cyst. We performed an incisional biopsy, which revealed the presence of multinucleated giant cells embedded in a collagenous stroma with areas of extravasation of erythrocytes and hemosiderin deposits. Complementary biochemical examinations of the serum, demonstrated normal levels of alkaline phosphatase, calcium, phosphorus and parathyroid hormone. The treatment was surgical curettage of the lesion with preservation of the teeth involved. After twenty-four months of follow-up the patient shows a full recovery with no signs of recurrence and clear new bone formation, as evidenced by clinical and radiographic analyses.

HOXB5 expression in oral squamous cell carcinoma

Human HOX genes encode transcription factors that act as master regulators of embryonic development. They are important in several processes such as cellular morphogenesis and differentiation. The HOXB5 gene in particular has been reported in some types of neoplasm, but not in oral cancer. OBJECTIVE: The present study investigated the expression of HOXB5 in oral squamous cell carcinoma (SCC) and in non-tumoral adjacent tissues, focusing on verifying its possible role as a broad tumor-associated gene and its association with histopathological and clinical (TNM) characteristics. MATERIAL AND METHODS: RT-PCR was performed to amplify HOXB5 mRNA in 15 OSCCs and adjacent non-tumoral epithelium. A possible association with TNM and histopathologic data was verifed by the chi-square and post-hoc t-test. RESULTS: HOXB5 was amplifed in 60 percent non-tumoral epithelium and in 93.3 percent carcinomas. No statistically signifcant differences were found regarding the HOXB5 mRNA expression and TNM or histological grade. CONCLUSION: HOXB5 is expressed in OSCCs and its role in cancer progression should be further investigated.

Time- and concentration-dependent cytotoxicity of antibiotics used in endodontic therapy

OBJECTIVE: New drugs have to be assessed in endodontic therapy due to the presence of microorganisms resistant to therapeutic procedures. Thus, this study evaluated the time- and concentration-dependent cytotoxicity of different antibiotics used in endodontic therapy. MATERIAL AND METHODS: Human gingival fibroblasts were treated and divided into the following experimental groups: Group I - control; Group II - ciprofoxacin hydrochloride; Group III - clyndamicin hydrochloride; and Group IV - metronidazole. Each drug was used at concentrations of 5, 50, 150, and 300 mg/L for 24, 48, 72, and 96 h. Cytotoxicity was evaluated by the MTT assay [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] and spectrophotometric reading of ELISA plates. The results were analyzed by BioEstat 4.0 software using Kruskal-Wallis and Dunn's tests at a signifcance level of 5 percent. Cell viability was assessed for the different concentrations and times. RESULTS: All drugs presented dose-dependent cytotoxicity. Concentrations of 5 and 50 mgjL produced viable fibroblasts at all experimental times in all groups. CONCLUSIONS: Cell viability at 24 h was greater than in the other experimental times. Comparison between the same concentrations of antibiotics at different times showed that metronidazole presented the highest cell viability at 72 and 96 h compared to the other antibiotics, whereas clyndamicin hydrochloride showed higher cell viability at 72 h than ciprofoxacin hydrochloride.

Interleukin-1 beta and interleukin-8 in healthy and inflamed dental pulps

After aggression to the dental pulp, some cells produce cytokines in order to start and control the inflammatory process. Among these cytokines, interleukin-1 beta (IL-1β) and interleukin-8 (IL-8) emerge as important ones. OBJECTIVE: The purpose of this study was to analyze the location, distribution and concentration of these cytokines in healthy and inflamed dental pulps. MATERIAL AND METHODS: Twenty pulps, obtained from healthy third molars (n=10) and from pulpectomies (n=10) were used for the study, with half of each group used for immunohistochemistry and half for protein extraction and ELISA assays. Fibroblasts obtained from healthy dental pulps, stimulated or not by Escherichia coli lipopolysaccharide (LPS), in order to simulate aggression on the cell cultures, were also used and analyzed by ELISA for IL-1β and IL-8 as complementary information. Data obtained from immunohistochemistry were qualitatively analyzed. Data obtained from ELISA assays (tissue and cells) were statistically treated by the t-test (p<0.05). RESULTS: Immunohistochemically, it was observed that inflamed pulps were strongly stained for both cytokines in inflammatory cells, while healthy pulps were not immunolabeled. ELISA from tissues quantitatively confirmed the higher presence of both cytokines. Additionally, cultured pulp fibroblasts stimulated by LPS also produce more cytokines than the control cells. CONCLUSIONS: It may be concluded that inflamed pulps present higher amounts of IL-1β and IL-8 than healthy pulps and that pulp fibroblasts stimulated by bacterial LPS produce higher levels of IL-1β and IL-8 than the control group.

Expressão do RNA mensageiro de genes HOX em linhagens celulares de carcinomas epidermoides de cabeça e pescoço / HOX genes mRNA expression in head and neck squamous cell carcinoma cell lineages

Os genes HOX são importantes para o controle do desenvolvimento embrionário e regulam aspectos da morfogênese e diferenciação celular. A associação entre os genes HOX e o processo da oncogênese tem sido verificada em casos de carcinomas de cólon, pele, rim, pulmão, mama, leucemias e outros tipos de câncer. O objetivo deste trabalho foi verificar a expressão de genes HOX em linhagens celulares de carcinomas epidermoides de cabeça e pescoço. Para tanto, utilizamos a técnica RT-PCR para analisar a expressão de três grupos de genes HOX em linhagens celulares de carcinomas epidermoides de cabeça e pescoço: HN-6, HN-19, HN-30 e HN-31, utilizando-se os primeiros degenerados HOX1, HOX2 e HOX3 e coamplificação com o gene constitutivo da β-actina. Material de gengiva humana e embrião de camundongo foram utilizados como controle de expressão do gene HOX. Os resultados obtidos mostraram que a expressão dos genes HOX apresentou padrão semelhante aos controles utilizados. Houve, porém, subexpressão do grupo HOX1 nas linhagens HN-6 e HN-19 e superexpressão do grupo HOX-2 na linhagem HN-31. Esses achados nos permitem levantar a hipótese de que os genes HOX podem participar das alterações moleculares observadas em carcinomas epidermoides de cabeça e pescoço.

Expressão de genes homeobox em células de carcinoma epidermóide de boca estimuladas com EGF e TGF-B / Expression of homeobox genes in oral squamous cell carcinoma cell lines, stimulated with EGF and TGF-B

Genes homeobox, vitais para muitos aspectos relacionados com crescimento e diferenciação celular, têm sido descritos desregulados em alguns cânceres. Seu papel na carcinogênese, principalmente de carcinomas epidermóides de boca permanece pouco claro e pobremente caracterizado. Desse modo, esse estudo objetivou avaliar, em cultura de células, o perfil de expressão de seis genes homeobox (ASH2L, HOXA7, HHEX, PKNOX1, PITX1, TGIF) selecionados dentre aqueles previamente identificados no Projeto Genoma Câncer de Cabeça e Pescoço (2001) sob estímulo de EGF e TGF-β1. Para tal, linhagens celulares de carcinoma epidermóide de cabeça e pescoço primário (HN6) e metastático (HN31) e uma linhagem não-tumoral (HaCat) foram cultivadas sob condições-padrão. Após a confecção do cDNAs de cada linhagem, por meio de RT-PCR, os transcritos foram amplificados e quantificados pela técnica de PCR em tempo real. Os dados foram normalizados com o gene HPRT e a quantificação relativa foi realizada seguindo o método do ΔCt. De acordo com os resultados foi possível verificar que o EGF produziu uma modulação variável da expressão dos genes avaliados em todas as linhagens celulares, enquanto que, em geral, o TGF-β1 foi capaz de aumentar significantemente (ANOVA, p<0,05) a expressão dos transcritos de 5 genes homeobox (HOXA7, HHEX, PKNOX1, PITX1, TGIF). Particularmente transcritos dos genes PITX1 e TGIF foram signicantemente mais expressos nas linhagens tumorais (HN6 e HN31) frente à linhagem não-tumoral quando tratados com TGF-β1. Desse modo, sugere-se que os genes homeobox estudados desempenhem diferentes funções na carcinoma epidermóide de boca, e que, especialmente PITX1 e TGIF atuem como oncogenes inibindo a resposta anti-proliferativa dependente de TGF-β elevando a progressão tumoral...

Homeobox genes, vital to many aspects related with cellular growth and differentiation, had been described as deregulated in some cancers. Their role in carcinogenesis, mainly oral squamous cell carcinomas, remains unclear and poorly characterized. Thus, this study had the purpose to evaluate, in cell cultures, the expression profile of six homeobox genes (ASH2L, HOXA7, HHEX, PKNOX1, PITX1,TGIF) selected among genes previously identified in the Head and Neck Cancer Genoma Project (2001), under stimulation with EGF and TGF-β1. Oral squamous cell carcinoma cell lines from primary tumour (HN6) and from methastasis (HN31), and anon-tumoral cell line (HaCat) were cultured under standard procedures. CDNAs were obtained by RT-PCR and the transcripts were amplified and quantified by real-time PCR. Data were normalized by HPRT gene and the relative quantification was madeby the ΔCt method. According to the results, it was possible to observe that EGF produced a variable modulation of the analyzed genes, in all cell lines. Generally, TGF-β1 was able to significantly increase (ANOVA, p<0,05) the expression of the transcripts of 5 homeobox genes (HOXA7, HHEX, PKNOX1, PITX1, TGIF). Transcripts of PITX1 and TGIF genes were particularly more expressed in the tumoral cell lines (HN6 e HN31), when compared to the non-tumoral cell line, when treated with TGF-β1. It is suggested that the studied homeobox genes play different roles in oral squamous cell carcinoma and that, especially the PITX1 and TGIF act as oncogenes, inhibitting the TGF-dependent anti-proliferative response, leading totumour progression...