Chronic exposure to lipopolysaccharides as an in vitro model to simulate the impaired odontogenic potential of dental pulp cells under pulpitis conditions

Abstract Simulating a bacterial-induced pulpitis environment in vitro may contribute to exploring mechanisms and bioactive molecules to counteract these adverse effects. Objective To investigate the chronic exposure of human dental pulp cells (HDPCs) to lipopolysaccharides (LPS) aiming to establish a cell culture protocol to simulate the impaired odontogenic potential under pulpitis conditions. Methodology HDPCs were isolated from four healthy molars of different donors and seeded in culture plates in a growth medium. After 24 h, the medium was changed to an odontogenic differentiation medium (DM) supplemented or not with E. coli LPS (0 - control, 0.1, 1, or 10 µg/mL) (n=8). The medium was renewed every two days for up to seven days, then replaced with LPS-free DM for up to 21 days. The activation of NF-κB and F-actin expression were assessed (immunofluorescence) after one and seven days. On day 7, cells were evaluated for both the gene expression (RT-qPCR) of odontogenic markers (COL1A1, ALPL, DSPP, and DMP1) and cytokines (TNF, IL1B, IL8, and IL6) and the production of reactive nitrogen (Griess) and oxygen species (Carboxy-H2DCFDA). Cell viability (alamarBlue) was evaluated weekly, and mineralization was assessed (Alizarin Red) at 14 and 21 days. Data were analyzed with ANOVA and post-hoc tests (α=5%). Results After one and seven days of exposure to LPS, NF-κB was activated in a dose-dependent fashion. LPS at 1 and 10 µg/mL concentrations down-regulated the gene expression of odontogenic markers and up-regulated cytokines. LPS at 10 µg/mL increased both the production of reactive nitrogen and oxygen species. LPS decreased cell viability seven days after the end of exposure. LPS at 1 and 10 µg/mL decreased hDPCs mineralization in a dose-dependent fashion. Conclusion The exposure to 10 µg/mL LPS for seven days creates an inflammatory environment that is able to impair by more than half the odontogenic potential of HDPCs in vitro, simulating a pulpitis-like condition.

Assessment of the regenerative potential of macro-porous chitosan-calcium simvastatin scaffolds on bone cells

Abstract This study evaluated the bioactive potential of a macro-porous chitosan scaffold incorporated with calcium hydroxide (CH-Ca) and functionalized with bioactive doses of simvastatin (SV) for bone tissue regeneration. Initially, the bioactive dose of SV in osteoblastic cells (SAOS-2) was determined. For the direct contact experiment, SAOS-2 cells were plated on scaffolds to assess cell viability and osteogenic differentiation. The second assay was performed at a distance using extracts from scaffolds incubated in culture medium to assess the effect of conditioned medium on viability and osteogenic differentiation. The initial screening showed that 1 μM SV presented the best biostimulating effects, and this dose was selected for incorporation into the CH-Ca and pure chitosan (CH) scaffolds. The cells remained viable throughout the direct contact experiment, with the greatest cell density in the CH-Ca and CH-Ca-SV scaffolds because of their higher porosity. The CH-Ca-SV scaffold showed the most intense bio-stimulating effect in assays in the presence and absence of osteogenic medium, leading to an increased deposition of mineralized matrix. There was an increase in the viability of cells exposed to the extracts for CH-Ca, CH-SV, and CH-Ca-SV during the one-day period. There was an increase in ALP activity in the CH-Ca and CH-Ca-SV; however, the CH-Ca-SV scaffold resulted in an intense increase in the deposition of mineralized nodules, approximately 56.4% at 7 days and 117% at 14 days, compared with CH (control). In conclusion, functionalization of the CH-Ca scaffold with SV promoted an increase in bioactivity, presenting a promising option for bone tissue regeneration.

Pro-inflammatory mediators expression by pulp cells following tooth whitening on restored enamel surface

Abstract This paper aimed to assess the influence of adhesive restoration interface on the diffusion of hydrogen peroxide (H2O2), indirect toxicity, and pro-inflammatory mediators expression by odontoblast-like cells, after in-office tooth whitening. Dental cavities prepared in bovine enamel/dentin discs were adhesively restored and subjected or not to hydrolytic degradation (HD). A whitening gel with 35% H2O2 (WG) was applied for 45 min onto restored and non-restored specimens adapted to artificial pulp chambers giving rise to the groups: SD- intact discs (control); SD/HP- whitened intact discs; RT/HP- restored and whitened discs; and RT/HD/HP- restored and whitened discs subjected to HD. The extracts (culture medium + WG components diffused through enamel/dentin/restoration interface) were collected and applied to odontoblast-like MDPC-23 cells. The study evaluated the amount of H2O2 in the extracts, as well as the cell viability (CV), cell morphology (CM), and gene expression of inflammatory mediators (TNF-α and COX-2) by the pulp cells exposed to the extracts (ANOVA and Tukey tests; 5% significance). All whitened groups presented lower CV than SD (control; p<0.05). The highest CV reduction and gene expression of TNF-α and COX-2 was observed in the RT/HD/HP group in comparison with SD/HP and RT/HP (control; p<0.05). CM alterations occurred in all whitened groups. The intensity of these cell side effects was directly related with the amount of H2O2 in the extracts. We concluded that adhesive restoration of dental cavity increases the H2O2 diffusion after in-office whitening, enhancing the indirect toxicity of this therapy and trigger pro-inflammatory overexpression by MDPC-23 cells.

Resumo Este trabalho teve como objetivo avaliar a influência da interface de uma restauração adesiva na difusão do peróxido de hidrogênio (H2O2), toxicidade indireta e expressão de mediadores pró-inflamatórios por células odontoblastóides, após clareamento dental em consultório. Cavidades dentárias preparadas em discos de esmalte / dentina foram restauradas com adesivo e submetidas ou não à degradação hidrolítica (HD). Um gel clareador com 35% H2O2 (WG) foi aplicado por 45 min em discos restaurados e não restaurados adaptados às câmaras pulpares artificiais dando origem aos grupos: SD- discos intactos (controle); SD / HP - Discos intactos clareados; RT / HP - discos restaurados e clareados; e RT / HD / HP - discos restaurados, clareados e submetidos a HD. Os extratos (meio de cultura + componentes WG difundidos através da interface esmalte/dentina/restauração) foram coletados e aplicados em células odontoblastóides MDPC-23. Foi avaliada a quantidade de H2O2 nos extratos, bem como a viabilidade (CV), morfologia (CM) e expressão gênica de mediadores inflamatórios (TNF-α e COX-2) pelas células pulpares expostas aos extratos (ANOVA e testes de Tukey; 5% de significância). Todos os grupos clareados apresentaram menor CV do que SD (controle; p <0,05). A maior redução CV e expressão gênica de TNF-α e COX-2 foi observada no grupo RT / HD / HP em comparação com SD / HP e RT / HP (controle; p <0,05). Alterações na CM ocorreram em todos os grupos clareados. A intensidade desses efeitos celulares teve relação direta com a quantidade de H2O2 nos extratos. Concluímos que a presença de uma cavidade contendo restauração adesiva aumenta a difusão de H2O2 após o clareamento em consultório, o que, por sua vez, aumenta a toxicidade indireta dessa terapia e desencadeia a expressão de mediadores pró-inflamatórios pelas células pulpares MDPC-23.

Bioactivity effects of extracellular matrix proteins on apical papilla cells

Abstract Potent signaling agents stimulate and guide pulp tissue regeneration, especially in endodontic treatment of teeth with incomplete root formation. Objective This study evaluated the bioactive properties of low concentrations of extracellular matrix proteins on human apical papilla cells (hAPCs). Methodology Different concentrations (1, 5, and 10 µg/mL) of fibronectin (FN), laminin (LM), and type I collagen (COL) were applied to the bottom of non-treated wells of sterilized 96-well plates. Non-treated and pre-treated wells were used as negative (NC) and positive (PC) controls. After seeding the hAPCs (5×103 cells/well) on the different substrates, we assessed the following parameters: adhesion, proliferation, spreading, total collagen/type I collagen synthesis and gene expression (ITGA5, ITGAV, COL1A1, COL3A1) (ANOVA/Tukey; α=0.05). Results We observed greater attachment potential for cells on the FN substrate, with the effect depending on concentration. Concentrations of 5 and 10 µg/mL of FN yielded the highest cell proliferation, spreading and collagen synthesis values with 10 µg/mL concentration increasing the ITGA5, ITGAV, and COL1A1 expression compared with PC. LM (5 and 10 µg/mL) showed higher bioactivity values than NC, but those were lower than PC, and COL showed no bioactivity at all. Conclusion We conclude that FN at 10 µg/mL concentration exerted the most intense bioactive effects on hAPCs.

Complicated pneumonia with empyema caused by streptococcus anginosus in a child / Complicated pneumonia with empyema caused by streptococcus anginosus in a child

ABSTRACT Objective: To highlight the pathogenicity of Streptococcus anginosus, which is rare in pediatric patients, but can cause severe infections that are known to have a better outcome when treated early with interventional procedures and prolonged antibiotic therapy. Case description: The patient is a 6-year-old boy with global developmental delay, examined in the emergency room due to fever and respiratory distress. The physical examination and diagnostic workout revealed complicated pneumonia with empyema of the left hemithorax; he started antibiotic therapy and underwent thoracic drainage. Pleural fluid cultures grew Streptococcus anginosus. On day 11, the child had a clinical deterioration with recurrence of fever, hypoxia, and respiratory distress. At this point, considering the causative agent, he was submitted to video-assisted thoracoscopic decortication, with good progress thereafter. Comments: Streptococcus anginosus is a commensal bacterium of the human oral cavity capable of causing severe systemic infections. Although reports of complicated thoracic infections with this agent are rare in the pediatric population, they have been increasing in adults. Streptococcus anginosus has a high capacity to form abscess and empyema, requiring different therapeutic approaches when compared to complicated pneumonia caused by other agents.

RESUMO Objetivo: Alertar para a patogenicidade do Streptococcus anginosus que, apesar de raro em pediatria, pode causar infeções graves que necessitam de tratamento invasivo e antibioterapia de longo curso para obter um melhor prognóstico. Descrição do caso: Criança de seis anos, com atraso do desenvolvimento psicomotor, avaliado no serviço de urgência por febre e dificuldade respiratória. O exame físico, juntamente com os exames complementares, revelou uma pneumonia complicada com empiema no hemitórax esquerdo, tendo iniciado antibioterapia e sido submetido à drenagem do líquido pleural. Foi identificado Streptococcus anginosus nesse líquido. No 11º dia de doença, a criança agravou o seu estado clínico, com recidiva da febre, hipoxemia e dificuldade respiratória. Considerando-se o microrganismo identificado, o paciente foi submetido à decorticação pulmonar por videotoracoscopia, com boa evolução clínica posterior. Comentários: Streptococcus anginosus é uma bactéria comensal da cavidade oral humana, que pode causar infecções sistêmicas graves. Apesar de serem raros os casos descritos em pediatria, têm sido cada vez mais descritas infecções torácicas complicadas em adultos. Esse microrganismo também tem a capacidade de formar abcessos e empiemas, que precisam de intervenções terapêuticas diferentes, quando comparados a pneumonias complicadas causadas por outros agentes.

Increased whitening efficacy and reduced cytotoxicity are achieved by the chemical activation of a highly concentrated hydrogen peroxide bleaching gel

Abstract Objective This study was designed for the chemical activation of a 35% hydrogen peroxide (H2O2) bleaching gel to increase its whitening effectiveness and reduce its toxicity. Methodology First, the bleaching gel - associated or not with ferrous sulfate (FS), manganese chloride (MC), peroxidase (PR), or catalase (CT) - was applied (3x 15 min) to enamel/dentin discs adapted to artificial pulp chambers. Then, odontoblast-like MDPC-23 cells were exposed for 1 h to the extracts (culture medium + components released from the product), for the assessment of viability (MTT assay) and oxidative stress (H2DCFDA). Residual H2O2 and bleaching effectiveness (DE) were also evaluated. Data were analyzed with one-way ANOVA complemented with Tukey's test (n=8. p<0.05). Results All chemically activated groups minimized MDPC-23 oxidative stress generation; however, significantly higher cell viability was detected for MC, PR, and CT than for plain 35% H2O2 gel. Nevertheless, FS, MC, PR, and CT reduced the amount of residual H2O2 and increased bleaching effectiveness. Conclusion Chemical activation of 35% H2O2 gel with MC, PR, and CT minimized residual H2O2 and pulp cell toxicity; but PR duplicated the whitening potential of the bleaching gel after a single 45-minute session.

Bond Strength and Cytotoxicity of a Universal Adhesive According to the Hybridization Strategies to Dentin

Abstract This study evaluated application protocol (etch-and-rinse/ER and self-etching/SE) and dentin wettability (wet and dry) on microtensile bond strength (μTBS) and transdentinal cytotoxicity of ScotchbondTM Universal (SU) adhesive system. The μTBS values and fracture mode were registered 24 h after adhesive system application and resin composite block build-up (n=5). For analysis of transdentinal cytotoxicity, odontoblast-like MDPC-23 cells were seeded on pulpal surface of dentin discs (0.4 mm thick) adapted to artificial pulp chambers (n=8). The adhesive system was applied to occlusal surface, followed by 24-h incubation time. Cell viability (Alamar Blue) and morphology (SEM) were assessed. Adper Single Bond 2 and Clearfil SE Bond were used as positive controls of the ER and SE application protocols, respectively. No treatment was performed on negative control (NC) group. Data were analyzed by ANOVA and Tukey's tests (α=5%). Higher μTBS values were found for ER mode in comparison with SE protocol (p<0.05). Dentin wettability had no effect on bond strength of SU in both the ER and SE techniques (p>0.05). Most fractures involved hybrid layer and/or adhesive layer. Neither variable prevented the intense toxic effects of adhesive systems on MDPC-23 cultured cells, since intense reduction in cell viability (±88%) and severe alterations in cell morphology were observed for all groups compared to NC, with no differences among them (p>0.05). Therefore, it was concluded that application of SU following the ER protocol had better adhesive performance. However, this adhesive system featured intense transdentinal cytotoxicity to pulp cells, regardless of application protocol and dentin wettability.

Resumo Este estudo avaliou o protocolo de aplicação (convencional/ER e autocondicionante/SE) e o grau de umidade da dentina (úmida e seca) sobre a resistência de união à microtração (μTBS) e a citotoxicidade transdentinária do sistema adesivo ScotchbondTM Universal (SU). Os valores de μTBS e o modo de fratura foram registrados 24 h após aplicação do sistema adesivo e restauração com resina composta pela técnica incremental. Para avaliação da citotoxicidade transdentinária, células odontoblastóides MDPC-23 foram semeadas na face pulpar de discos de dentina (0,4 mm de espessura) adaptados a câmaras pulpares artificiais (n = 8). O sistema adesivo foi aplicado na superfície oclusal, seguido de incubação por 24 h. A viabilidade e morfologia celular foram avaliadas pelo teste de Alamar Blue e MEV, respectivamente. Adper Single Bond 2 e Clearfil SE Bond foram utilizados como controle positivo do protocolo de aplicação ER e SE, respectivamente. Nenhum tratamento foi realizado no grupo controle negativo (NC). Os dados foram analisados pelos testes de ANOVA e Tukey (α = 5%). Maiores valores de μTBS foram encontrados para o modo ER em comparação com o protocolo SE (p < 0,05). O grau de umidade da dentina não apresentou efeito na resistência de união do SU em ambos os protocolos ER e SE (p > 0.05). A maioria das fraturas envolveu a camada híbrida e / ou camada adesiva. Ambas as variáveis não preveniram o intenso efeito citotóxico dos sistemas adesivos sobre as células MDPC-23 em cultura, uma vez que redução intensa na viabilidade celular (± 88%) e alterações severas na morfologia celular foram observadas para todos os grupos quando comparados ao NC, sem diferenças entre eles (p > 0.05). Desta forma, foi concluído que a aplicação do SU seguindo o protocolo ER apresentou melhor performance adesiva. No entanto, esse sistema adesivo promoveu intensa citotoxicidade transdentinária sobre células pulpares, independente do protocolo de aplicação e grau de umidade dentinária.

Análise da citotoxicidade de um gel clareador com 10% de peróxido de hidrogênio sobre células odontoblastóides de acordo com a espessura do substrato dental / Analysis of the cytotoxicity of a 10% hydrogen peroxide bleaching gel to odontoblast-like cells according to the thickness of dental substrate

Objetivo: Avaliar a citotoxicidade de um gel clareador contendo 10% de peróxido de hidrogênio (H2O2), aplicado sobre discos de esmalte/dentina simulando diferentes espessuras dentais. Material e método: Discos com 2,3; 3,5; e 4,0 mm de espessura foram obtidos para simular incisivos centrais inferiores, incisivos centrais superiores e segundos pré-molares superiores, respectivamente. Para cada espessura, o gel com 10% de H2O2 foi aplicado sobre o esmalte por 3x 15 min, 1x 15 min ou 1x 5 min. O protocolo 35% H2O2 3x 15 min foi empregado como controle positivo (CP), e nenhum tratamento foi realizado no controle negativo (CN). Células odontoblastóides MDPC-23 foram expostas por 1 h aos componentes da difusão trans-amelodentinária coletados imediatamente após o clareamento, sendo realizada análise da viabilidade celular, estresse oxidativo, deposição de nódulos de mineralização, bem como a quantificação da difusão de H2O2 pelos discos. Resultados: O gel com 10% de H2O2 não promoveu redução significativa da viabilidade celular em relação ao CN para todos os protocolos e espessuras testadas, resultando em valores de difusão de H2O2 significativamente inferiores ao CP. Apenas o protocolo 10% 3x 15 min aplicado sobre os discos simulando incisivos promoveu aumento no estresse oxidativo e reduziu a deposição de nódulos de mineralização em relação ao CN; porém, estes efeitos foram significativamente inferiores ao CP. Conclusão: De acordo com a metodologia usada neste estudo, foi possível concluir que, independente da espessura dental, a aplicação de um gel clareador com 10% de H2O2 por 5-45 min sobre o esmalte causa limitado efeito citotóxico sobre células pulpares.

Objective: To evaluate the cytotoxicity of a bleaching gel with 10% hydrogen peroxide (H2O2) applied onto enamel/dentin discs simulating different dental thicknesses. Material and methods: Discs with 2.3; 3.5; and 4.0 mm thickness were obtained to simulate low central incisors, upper central incisors and upper second pre-molars, respectively. For each thickness, the 10% H2O2 gel was applied for 3x 15 min, 1x 15 min or 1x 5 min. A gel with 35% H2O2 applied for 3x 15 min was used as positive control (PC) and no treatment was performed in negative control (NC). Odontoblast- like MDPC-23 cells were exposed for 1 h to the transenamel and trans-dentinal components collected immediately after bleaching. Cell viability, oxidative stress and mineralized nodule deposition were assessed as well as the quantification of H2O2 diffused through the discs. Results: The 10% H2O2 gel did not promote significant reduction on cell viability in comparison to NC for all tested protocols and thicknesses, resulting in H2O2 diffusion values significantly lower than PC. Only the protocol 10% H2O2 3x 15 min applied onto discs simulating incisors increased significantly the oxidative stress and reduced mineralized nodule deposition compared to NC; however, these effects were significantly lower than PC. Conclusion: According to the methodology employed in this laboratorial study, the application of a bleaching gel with 10% H2O2 for 5-45 min onto dental structure featured limited cytotoxicity to pulp cells, disregarding the enamel/dentin thicknesses.

Influência do gluconato de cálcio sobre a citotoxicidade trans-amelodentinária de um agente clareador com 20% de peróxido de hidrogênio / Influence of calcium gluconate on the trans-enamel and trans-dentinal cytotoxicity of a bleaching agent with 20% hydrogen peroxide

Objetivo: Avaliar a citotoxicidade de um agente clareador contendo 2% de gluconato de cálcio (GC) sobre células pulpares humanas (HDPCs). Materiais e Métodos: Discos de esmalte-dentina adaptados em câmaras pulpares artificiais (CPAs) foram posicionados em compartimentos de forma que a dentina permaneceu imersa em meio de cultura, enquanto que o esmalte foi submetido ao clareamento com géis a 20% de H2O2 contendo ou não GC, durante 1x 45, 1x15 ou 1x5 minutos. No controle positivo foi realizado clareamento com 35% de H2O2 aplicado por 1x 45 minutos, sendo que no controle negativo nenhum tratamento foi realizado sobre o esmalte. A viabilidade celular (teste do MTT) e a difusão trans-amelodentinária de H2O2 (violeta leuco- -cristal/peroxidase) foram avaliadas (ANOVA/Tukey α = 5%; n = 8). Resultados: Foi observada redução significativa na viabilidade celular em todos os grupos clareados quando comparados ao controle negativo (p < 0,05); no entanto, os grupos expostos aos géis contendo 20% de H2O2, com ou sem GC, apresentaram valores de viabilidade celular significativamente superiores ao controle positivo (p < 0,05). A redução da viabilidade celular e a difusão de H2O2 residual para os grupos clareados com 20% de H2O2 foi proporcional ao tempo de contato dos produtos com a superfície dental, sendo que a presença de GC resultou em minimização significativo do efeito tóxico/difusão de H2O2 para os protocolos 1x 15 e 1x 5 min (p < 0,05). Conclusão: A presença de 2% de GC nos géis com 20% de H2O2 resulta em redução da difusão de H2O2 residual pela estrutura dental e do efeito citotóxico sobre células pulpares humanas, quando o produto é aplicado por curtos períodos sobre a superfície dental.

Objective: To evaluate the cytotoxicity of a bleaching agent containing 2% calcium gluconate (CG) on human pulp cells (HDPCs). Materials and Methods: Enamel-dentin disks adapted in artificial pulp chambers (CPAs) were placed in compartments so that dentin remained immersed in culture medium, while the enamel was subjected to bleaching with 20% H2O2 gels containing or not CG for 1x 45, 1x15 or 1x5 minutes. In the positive control, bleaching was performed with 35% H2O2 applied for 1x 45 minutes, and in the negative control no treatment was performed on the enamel. Cell viability (MTT test) and transenamel and trans-dentinal diffusion of H2O2 (leuco-crystal violet / peroxidase) were evaluated (ANOVA / Tukey α = 5%, n = 8). Results: A significant reduction in cell viability was observed in all bleached groups when compared to the negative control (p <0.05); However, groups exposed to gels containing 20% H2O2, with or without CG, had significantly higher values of cell viability than the positive control (p <0.05). The reduction of cell viability and the diffusion of residual H2O2 to the bleached groups with 20% H2O2 was proportional to the contact time of the products with the dental surface, and the presence of CG resulted in a significant minimization of the toxic /diffusion effect of H2O2 For the 1x15 and 1x5min protocols (p <0.05). Conclusion: The presence of 2% GC in gels with 20% H2O2 results in reduction of residual H2O2 diffusion by dental structure and cytotoxic effect on human pulp cells when the product is applied for short periods on the dental surface.

Bioestimulação de células pulpares humanas expostas a sinvastatina / Biostimulation of human pulp cells exposed to simvastatin

O objetivo desse estudo foi avaliar o potencial bioativo da sinvastatina (SV), aplicada por diferentes períodos sobre células da polpa dental humana (HDPCs). Para isto, HDPCs em 80% de confluência (n=6) foram tratadas com meio osteogênico suplementado com 0,01 µM de SV pelos períodos de 24 h, 72 h ou continuamente por até 21 dias. No controle negativo, as células foram mantidas em meio osteogênico. A viabilidade celular (MTT) foi avaliada em períodos de 1, 3, 7, 14 e 21 dias, e a deposição de matriz mineralizada (alizarin red) após 14 e 21 dias de cultivo celular. Os dados foram submetidos aos testes ANOVA e Tukey (α=5%). Foi observado que nos períodos de 1, 3, 7 e 14 dias não houve diferença significativa na viabilidade das células submetidas aos tratamentos com SV em comparação ao controle (p<0,05); no entanto, redução tardia foi observada aos 21 dias para as células tratadas com SV por 72 h ou de modo contínuo (p<0,05). Em contrapartida, aumento na deposição de matriz mineralizada foi observado para o tratamento contínuo com SV aos 21 dias, quando comparado ao controle (p<0,05). Foi possível concluir que o tratamento contínuo de células pulpares humanas com 0,01µM de SV foi capaz de bioestimular a deposição de matriz mineralizada in vitro.

The objective of this study was to evaluate the bioactive potential of simvastatin (SV), applied during different periods on human dental pulp cells (HDPCs). For this, HDPCs at 80% confluency (n = 6) were treated with osteogenic medium supplemented with 0.01 µM SV for periods of 24 h, 72 h or continuously up to 21 days. In the negative control group, the cells were cultivated in osteogenic medium. The cell viability (MTT) was evaluated after 1, 3, 7, 14 and 21 days, and the mineralized matrix deposition (alizarin red) was assessed at 14 and 21 days of cell culture. Data were submitted to ANOVA and Tukey's test (α=5%). No significant difference in cell viability was observed at 1, 3, 7 and 14 days for the cells exposed to SV compared to negative control (p<0.05); however, significant reduction was observed at 21 days for cells treated with SV during 72 h or continuously (p<0.05). On the other hand, increase in mineralized matrix deposition at 21 days was observed for cells treated continuously with SV when compared to control (p<0.05). It was possible to conclude that the continuous treatment of human pulp cells with 0.01 µM of SV was able to biostimulate mineralized matrix deposition in vitro.

A diferenciação cognitiva na infância: um estudo de perfis cognitivos aos 5, 7 e 9 anos / Cognitive differentiation during childhood: A study on cognitive profiles of 5, 7, and 9-year-old children

Resumo No seio do debate sobre se a inteligência é mais bem definida por um fator geral ou por aptidões específicas, ganha relevância a hipótese da diferenciação cognitiva. Análises recentes enfatizam o interesse dessa questão para a investigação e alertam para a relevância das suas implicações na área educativa. Este estudo analisou a possibilidade de a diferenciação das aptidões cognitivas ocorrer já na infância e também o efeito moderador do Quociente de Inteligência na magnitude da relação entre as habilidades cognitivas. Aplicou-se uma bateria de provas que avaliam várias funções cognitivas a uma amostra de 231 crianças com 5, 7 e 9 anos, distribuídas por três grupos de desempenho cognitivo. Os resultados de uma análise de clusters hierárquica e de uma análise de variância apontam para a não diferenciação das funções cognitivas na infância. Contudo, uma análise mais cuidadosa aponta para alguma diferenciação suportada pela hete-rogeneidade dos perfis cognitivos junto dos alunos com Quociente de Inteligência elevado.

Abstract Within the debate about whether intelligence is best defined by a general factor or specific skills, the hypothesis of cognitive differentiation gains relevance. Recent analyses have emphasized the importance of this issue in the investigation of cognitive skills and have highlighted its implications in education. This study examined the possibility that the differentiation of cognitive abilities may occur during childhood and investigated the moderating effect of Intelligence Quotient on the magnitude of the relationship between cognitive abilities. A battery of tests for assessing cognitive function was administered to 231 children aged 5, 7, and 9 years old, who were divided into three cognitive performance groups. The results of hierarchical cluster analysis and variance analysis indicate the lack of differentiation of cognitive functions during childhood. However, a more careful analysis suggests some differentiation supported by the heterogeneity of cognitive profiles among students with high Intelligence Quotient.

Functional Differences In Gingival Fibroblasts Obtained from Young and Elderly Individuals

Abstract Fibroblasts participate in the wound repair process through proliferation and migration as well as the synthesis of factors growth and extracellular matrix molecules. However, cell aging and the individual himself can lead to reduction of cell functions and consequently, the ability of tissue repair. This study evaluated the activity of gingival fibroblasts from young (Y) and elderly (Y) patients and their responsiveness to tumor necrosis factor alpha (TNF-a). Gingival fibroblasts were isolated from six patients (3Y; and 3E) and seeded in complete culture medium (DMEM). For cell viability analysis, total protein production and collagen synthesis, fibroblasts were cultured in 96-well plates for 24, 48 or 72 h (n=36). Cell responses to TNF-a, was evaluated by application of this cytokine to cultured cells (100 ng/mL) for 24 h, followed by evaluation of reactive oxygen species (ROS), nitric oxide (NO) and CCL5 production (n=36). Data were analyzed by Kruskal-Wallis and the Mann-Whitney U tests (a = 0.05). Viability of E fibroblasts was higher than Y fibroblasts for 24 and 48 h, but these cells showed gradual reduction of viability over the course of time. For Y cells, reduced collagen synthesis was observed at 48 h. No difference was observed in ROS production for both cells after TNF-a exposure. However, both cultures showed increased production of NO and CCL5 in the presence of TNF-a. Functional differences and distinct responsiveness to TNF-a were observed according to patient's age.

Resumo Fibroblastos participam no processo de reparação de ferida através da proliferação e migração, bem como a síntese de fatores de crescimento e moléculas da matriz extracelular. No entanto, o envelhecimento celular e o próprio indivíduo podem levar à redução de funções celulares e, consequentemente, a capacidade de reparação de tecidos. Este estudo avaliou a atividade dos fibroblastos gengivais de pacientes jovens (J) e idosos (I) e sua capacidade de resposta frente ao fator de necrose tumoral alfa (TNF-a). Fibroblastos gengivais foram isolados de seis pacientes (3J e 3I) e semeados em meio de cultura completo (DMEM). Para a análise de viabilidade celular, a produção de proteína total e a síntese de colágeno, fibroblastos foram cultivados em placas de 96 poços, durante 24, 48 ou 72 h (n = 36). Respostas celulares frente ao TNF-a, foram avaliadas por aplicação desta citocina (100 ng/mL) nas células cultivadas durante 24 h, seguida por avaliação de espécies reativas de oxigênio (EROs), produção de óxido nítrico (NO) e produção CCL5 (n= 36). Os dados foram analisados por testes de Kruskal-Wallis e Mann-Whitney U (a = 0,05). A viabilidade de fibroblastos I foi mais elevada do que os fibroblastos J para 24 e 48 h, mas estas células mostraram uma redução gradual de viabilidade ao longo do tempo. Para as células de J, foi observada redução da síntese de colágeno em 48 h. Não foi observada diferença na produção de EROs para ambas as células após exposição ao TNF-a. No entanto, ambas as culturas apresentaram aumento da produção de NO e CCL5 na presença de TNF-a. Diferenças funcionais e alteração na capacidade de resposta ao TNF-a foram observadas de acordo com a idade do paciente.

Efeito citotóxico de géis clareadores com diferentes concentrações de peróxido de hidrogênio aplicados diretamente sobre a dentina / Cytotoxic effects of a bleaching gel with different concentrations of hydrogen peroxide applied directly on dentin

Objetivo: Avaliar os efeitos citotóxicos de agentes clareadores com diferentes concentrações de PH sobre células odontoblastóides, quando aplicados diretamente sobre a superfície de dentina humana. Material e método: Cinquenta discos de dentina (0,5 mm de espessura) foram adaptados em câmaras pulpares artificiais (CPAs) e células MDPC-23 foram semeadas na superfície pulpar dos discos. Cinco grupos (n=10) foram estabelecidos: G1: 7,5% PH; G2: 20% PH; G3: 35% PH; G4: gel sem PH; G5: DMEN (controle). Os produtos foram aplicados na superfície oclusal dos discos por 2x de 15 minutos. A viabilidade (ensaio de MTT) e a morfologia celular (MEV) foram avaliadas imediatamente após o clareamento. Os dados de viabilidade celular foram submetidos ao teste de Kruskal-Wallis e Mann-Whitney (α=0,05). Resultados: Redução significante na viabilidade celular em relação ao controle (G5) foi observada para todas as concentrações de PH (p<0,05), associada a intensas alterações na morfologia celular. Entretanto, nenhuma diferença significante foi observada entre as três concentrações de PH. Também, não houve diferença estatística entre o grupo controle e o grupo gel sem PH (G5 e G4). Conclusão: Todas as concentrações de PH causaram efeitos citotóxicos de severos sobre as células MDPC-23, quando aplicados diretamente sobre a dentina. Entretanto, a intensidade do efeito tóxico não foi influenciada pela concentração de PH no agente clareador. Relevância clínica: Apesar das limitações deste estudo in vitro, os resultados indicam que o clareamento dental não deve ser realizado diretamente em áreas com exposição da dentina.

Objective: To evaluate the cytotoxic effects of bleaching gels with different concentrations of hydrogen peroxide (HP) on odontoblast-like cells, when applied directly on dentin. Material and method: Fifty dentin discs (0.5 mm thick) were adapted in artificial pulp chambers (APC) and MDPC-23 cells were seed on the pulpal side. The discs were divided into 5 groups (n=10): G1: HP 7.5%; G2: HP 20%; G3: HP 35%; G4: gel with no HP; and G5: no treatment (control). The gels were applied on the occlusal side of the discs for 2x of 15 min. Cellular viability (MTT assay) and morphology (SEM) were analyzed immediately after the bleaching procedure. Data of cellular viability were submitted to Kruskal-Wallis and Mann-Whitney tests (α=0.05). Results: Significant reduction in cellular viability was seen for all HP concentrations in comparison to the control (G5). However, no statistical significant difference was seen among the concentrations of HP. Likewise, there was no statistical difference between the control group (G5) and the group where the gel with no HP was applied (G4). Conclusion: All HP concentrations caused severe cytotoxic effects on the odontoblast-like cells when applied directly on dentin. However, the intensity of the cytotoxic effect was not influenced by the concentration of the HP included in the bleaching gel. Clinical significance: Within the limitations of this in vitro study, the results strongly indicate that dental bleaching procedures should not be performed directly on areas of dentin exposure.

Chitosan-collagen biomembrane embedded with calcium-aluminate enhances dentinogenic potential of pulp cells

Abstract The development of biomaterials capable of driving dental pulp stem cell differentiation into odontoblast-like cells able to secrete reparative dentin is the goal of current conservative dentistry. In the present investigation, a biomembrane (BM) composed of a chitosan/collagen matrix embedded with calcium-aluminate microparticles was tested. The BM was produced by mixing collagen gel with a chitosan solution (2:1), and then adding bioactive calcium-aluminate cement as the mineral phase. An inert material (polystyrene) was used as the negative control. Human dental pulp cells were seeded onto the surface of certain materials, and the cytocompatibility was evaluated by cell proliferation and cell morphology, assessed after 1, 7, 14 and 28 days in culture. The odontoblastic differentiation was evaluated by measuring alkaline phosphatase (ALP) activity, total protein production, gene expression of DMP-1/DSPP and mineralized nodule deposition. The pulp cells were able to attach onto the BM surface and spread, displaying a faster proliferative rate at initial periods than that of the control cells. The BM also acted on the cells to induce more intense ALP activity, protein production at 14 days, and higher gene expression of DSPP and DMP-1 at 28 days, leading to the deposition of about five times more mineralized matrix than the cells in the control group. Therefore, the experimental biomembrane induced the differentiation of pulp cells into odontoblast-like cells featuring a highly secretory phenotype. This innovative bioactive material can drive other protocols for dental pulp exposure treatment by inducing the regeneration of dentin tissue mediated by resident cells.

Response of a co-culture model of epithelial cells and gingival fibroblasts to zoledronic acid

Abstract Osteonecrosis of the jaw is an adverse effect of bisphosphonates. While the etiopathogenesis of this condition has been investigated, the interactions and effects of bisphosphonates on oral mucosa cells remain unclear. It is hypothesized that cell culture models, such as co-culture or three-dimensional cell culture models, can provide valuable insight. Therefore, the aim of this study was to evaluate the effects of zoledronic acid (ZA) on epithelial cells and gingival fibroblasts in a co-culture model. Briefly, epithelial cells were seeded on transwell inserts and gingival fibroblasts were seeded in the lower well of 24-well plates. The latter were treated with ZA (5 μM) for 24 or 48 h. Cell viability and synthesis of the inflammatory chemokine, CCL2, were subsequently assessed. Data were subjected to statistical analysis with a 5% significance level. In the presence of ZA, the epithelial cells exhibited significant toxicity in both cell culture models and at both time points. However, greater cytotoxicity was observed in the co-culture model. Greater viability for the gingival fibroblasts was also associated with the co-culture model, and ZA-mediated toxicity was observed for the 48 h time point. ZA promoted a significant increase in CCL2 synthesis in both sets of cells, with greater CCL2 synthesis detected in the gingival fibroblasts. However, this effect was diminished in the co-culture model. Taken together, these results confirm the specific response patterns of the cells seeded in the co-culture model and also demonstrate the protective mechanism that is mediated by epithelial/mesenchymal cell interactions upon exposure to ZA.

At-Home Bleaching: Color Alteration, Hydrogen Peroxide Diffusion and Cytotoxicity

This study evaluated the color change, cytotoxicity and hydrogen peroxide (HP) diffusion caused by different home bleaching protocols: 10% carbamide peroxide (CP) for 3 or 1.5 h, 6% hydrogen peroxide for 1.5 h or 45 min. To quantify the peroxide penetration, disks of bovine teeth were placed in artificial pulp chambers (APCs) containing acetate buffer, which was collected for evaluation in a spectrophotometer. For analysis of cytotoxicity, specimens were adapted in APCs containing culture medium, which subsequently was applied on MDPC-23 odontoblast-like cells for 1 h. Cellular metabolism was evaluated by methyl tetrazolium (MTT) assay and the color change of the specimens was analyzed using the CIE L * a * b * system. The data were submitted to ANOVA and Fisher test (α=5%). The treatment with 10% CP for 3 h was the most effective, and 6% HP for 45 min produced the lowest color change. The groups 10% CP for 1.5 h and 6% HP for 45 min had the lowest trans-enamel dentinal HP penetration, and the 6% HP for 1.5 h had the highest. None of the protocols affected cellular metabolism and morphology. In conclusion, reduced peroxide exposure time reduced the bleaching result; higher HP diffusion did not mean higher effectiveness.

Este estudo avaliou a alteração de cor, a citotoxicidade e a difusão de peroxido de hidrogênio ocorridos em diferentes protocolos clareadores caseiros: peróxido de carbamida (PC) 10% por 3 ou 1,5 h; peróxido de hidrogênio (PH) 6% por 1,5 h ou 45 min. Para a quantificação da penetração do peróxido, discos de dentes bovinos foram posicionados em câmaras pulpares artificiais (CPAs) contendo solução tampão de acetato, que foi coletada para avaliação em espectrofotômetro. Para análise da citotoxicidade, os espécimes foram adaptados nas CPAs contendo meio de cultura, que posteriormente foi aplicado sobre células odontoblastóides MDPC-23 por 1 h. O metabolismo celular foi avaliado pelo teste MTT e a alteração de cor dos espécimes foi analisada pelo sistema CIE L*a*b*. Os dados foram submetidos a ANOVA e teste de Fisher (α=5). O tratamento com PC10% por 3 horas foi o mais efetivo, enquanto que o tratamento com PH 6% por 45 min produziu a menor alteração cromática. Os grupos PC 10% por 1,5 h e PH 6% por 45 min causaram a menor penetração trans-amelodentinária do peróxido, e PH 6% por 1,5 h, a maior difusão. Nenhum tratamento alterou o metabolismo celular. A redução do tempo de exposição aos peróxidos comprometeu o resultado clareador; maior penetração de peroxido não significa maior efetividade clareadora.

Dose-Response and Time-Course of a-Tocoferol Mediating the Cytoprotection Of Dental Pulp Cells Against Hydrogen Peroxide

This in vitro study evaluated the potential protective effect of vitamin E alpha-tocopherol (α-T) isomer against the toxicity of hydrogen peroxide (HP) applied on dental pulp cells. Odontoblast-like MDPC-23 cells were seeded on 96-well plates for 72 h, treated with different concentrations of α-T (1, 3, 5, and 10 mM) for different times (1, 4, 8, and 24 h) and then exposed or not to a 0.018% HP solution for 30 min. In positive and negative control groups, cells were exposed to HP or culture medium (DMEM containing 5% DMSO), respectively. Cell viability was assessed by the MTT assay and the absorbance numeric data, expressed as percentage values, were subjected to the statistical analysis by Kruskal-Wallis and Mann-Whitney tests (α=5%). Considering the cells in the negative control as having 100% of cell viability, all combinations of α-T concentrations and pretreatment times showed a protective effect against HP cytotoxicity. Significant reduction of cell viability (59%) was observed in the positive control compared with the negative control. The highest values of pulp cell viability were obtained after pretreatment with 1 and 3 mM α-T concentrations for 24 h followed by exposure to HP (126% and 97% of cell viability, respectively). Under the tested conditions, the most effective cell protection against the cytotoxic effects of HP was provided by the lowest concentrations of α-T (1 and 3 mM) applied for 24 h.

Neste estudo, foi avaliado o potencial protetor do isômero alfa-tocoferol da vitamina E (-T) contra a ação tóxica do peróxido de hidrogênio (PH) aplicado sobre células pulpares. Células odontoblastóides MDPC-23 foram semeadas em placas de 96 compartimentos por 72 h, tratadas com diferentes concentrações de α-T (1, 3, 5 e 10 mM) por diferentes períodos (1, 4, 8 e 24 h) e, então, expostas ou não a uma solução com 0,0018% de PH por 30 min. Nos controles positivo e negativo, as células foram expostas ao PH ou meio de cultura (DMEM contendo 5% de DMSO), respectivamente. A viabilidade celular foi avaliada pelo teste do MTT e os valores numéricos de absorbância, expressos em porcentagem, foram submetidos a análise estatística pelos testes de Kruskal-Wallis e Mann-Whitney (α=5%). Considerando as células do grupo controle negativo como apresentando 100% de viabilidade celular, todas as combinações de α-T, nas diferentes concentrações, e tempos de pré-tratamento demonstraram um efeito protetor contra a citotoxicidade do PH. Redução significativa da viabilidade (59%) foi observada para o grupo controle positivo comparado ao controle negativo. Os maiores valores de viabilidade celular foram obtidos após pré-tratamento com 1 e 3 mM de α-T por 24 h seguido de exposição ao PH (126% e 97% de viabilidade celular, respectivamente). Assim, de acordo com as condições experimentais, o efeito protetor mais efetivo contra os efeitos tóxicos do PH foi observado para as menores concentrações de α-T (1 e 3 mM) aplicado por 24 h.

Novos parâmetros para o clareamento dental: avaliação da eficácia, citotoxicidade e efeitos moleculares / New parameters for tooth bleaching: evaluation of bleaching effectiveness, cytotoxicity and molecular effects

Nesta pesquisa, foram analisadas a eficácia clareadora, citotoxicidade e características fenotípicas de células pulpares expostas a protocolos de clareamento de consultório experimentais. No primeiro estudo, discos de esmalte/dentina foram submetidos a 6 sessões clareadoras, caracterizadas por 1 ou 3 aplicações de peróxido de hidrogênio (H2O2) a 35% ou 17,5%, por 5 ou 15 min, ou de peróxido de carbamida (PC) a 37%, por 10 ou 20 min. A alteração de cor (ΔE) e quantificação da difusão de H2O2 (violeta leuco-cristal/peroxidase) foram avaliadas. Todos os protocolos testados promoveram alteração significativa de cor associados a redução na difusão de H2O2; no entanto, o gel com PC apresentou os piores resultados (Traço de Pilai; Bonferroni/p<0,05). Apenas os protocolos 35% H2O2/ 1x 15 e 3x 5 min, 17,5% H2O2/ 3x 15 min e 37% PC/ 3x 20 min apresentaram valores de E similares ao protocolo tradicional (35%/ 3x 15 min) em até 6 sessões de clareamento (ANOVA; SNK e Tamhane/p>0.05). No segundo estudo, foi avaliada a citotoxicidade trans-amelodentinária causada pela aplicação de protocolos experimentais usando 35% H2O2/ 1x 15 e 1x 5 min e 17,5% H2O2/ 3x 15, 1x 15 e 1x 5 min. O protocolo 35% H2O2/ 3x 15 min foi empregado como controle positivo. Os discos de esmalte/dentina foram adaptados em dispositivos trans-well, os quais foram posicionados sobre células odontoblastóides (MDPC-23) e cultura primária de células pulpares humanas (HDPCs) previamente semeadas. A viabilidade (MTT) e morfologia celular (MEV) foram avaliadas imediatamente e 72 h pós-clareamento, bem como o estresse oxidativo e lesão à membrana celular (microscopia de fluorescência). Todos os protocolos experimentais avaliados reduziram significativamente o dano celular quando comparados ao controle positivo (Kruskal-Wallis; MannWhitney/p<0,05). Esta redução foi tempo/concentração dependente. As células expostas aos protocolos com o gel contendo 17,5% de H2O2 apresentaram capacidade de recuperação em torno de 50% três dias pós-clareamento. No terceiro estudo, células pulpares (MDPC-23 e HDPCs) em cultura foram submetidas aos protocolos experimentais, utilizando-se para isto um gel com 17,5% de H2O2, o qual foi aplicado por 3x 15; 1x 15; e 1x 5 min sobre o esmalte. Então, foi avaliada a expressão de marcadores de diferenciação odontoblástica (expressão gênica de DMP-1, DSPP e ALP, deposição de nódulos de mineralização e atividade de ALP), em períodos de 7, 14 e 21 dias pós-clareamento, bem como a expressão gênica de mediadores inflamatórios (IL-1ß; TNF-α, IL-6 e COX-2) imediatamente após o procedimento clareador. Foi observado aumento significante na expressão gênica dos mediadores inflamatórios nas células clareadas proporcional ao tempo de tratamento (Kruskal-Wallis; Mann-Whitney/p<0,05). Houve, ainda, redução tempo/dependente na expressão dos marcadores de diferenciação em relação ao controle negativo (sem tratamento); no entanto, as células foram capazes de se recuperar da agressão em períodos de até 21 dias pós-clareamento, com exceção para a deposição nódulos de mineralização pelas HDPCs no grupo clareado por 45 min (Kruskal-Wallis; Mann-Whitney/p<0,05). Pode-se concluir que a redução na concentração e/ou freqüência de aplicação de géis clareadores à base de H2O2 sobre o esmalte promove clareamento efetivo, associado a reduzida difusão deste radical livre pela estrutura dental, o que minimiza seu efeito tóxico sobre as células pulpares. No entanto, o gel com 17,5% de H2O2 aplicado por curtos períodos sobre o esmalte apresentou-se como a alternativa clareadora mais interessante, visto que as células apresentaram maior capacidade de recuperação, bem como mantiveram seu potencial para diferenciação odontoblástica e deposição de matriz mineralizada

In this study, the bleaching effectiveness, cytotoxicity and phenotypic characteristic of dental pulp cells exposed to experimental in-office bleaching protocols were analyzed. In the first study, enamel/dentin discs were subjected to 6 bleaching sessions, composed by 1 or 3 applications of a 35%- or 17.5%-H2O2 (hydrogen peroxide) gel, during 5 or 15 minutes, or by a 37%-CP (carbamide peroxide) gel, applied for 10 or 20 minutes. Color change (ΔE) and H2O2 diffusion (leucocrystal violet/ peroxidase) were analyzed. All the tested protocols promoted significant color alteration and reduction of H2O2 diffusion; however, the CP gel presented the worst results (Pillai's trace/ Bonferroni test; p<0.05). Only the protocols 35%-H2O2/ 1x 15, 35%-H2O2/ 3x 5 min, 17.5%-H2O2/ 3x 15 min and 37%-CP 3x 20 min presented similar E values than traditional protocol (35%-H2O2/ 3x 15 min) up to 6 sessions (ANOVA; SNK and Tamhane tests/p>0.05). In the second study, the trans-enamel and trans-dentinal cytotoxicity on dental pulp cells of selected experimental bleaching protocols (35%- H2O2/ 1x 15 and 1x 5 min; 17.5%-H2O2/ 3x 15, 1x 15 and 1x 5 min) were tested. The protocol 35%- H2O2/ 3x 15 min was considered as the positive control group. The enamel/dentin discs were adapted to trans-wells devices, which were positioned over odontoblast-like cells (MDPC-23) and primary culture of human dental pulp cells (HDPCs) previously seeded on culture plates. The cell viability (MTT) and morphology (SEM) were evaluated immediately and 72 h post-bleaching, as well as oxidative stress and cell membrane damage (fluorescence microscopy). The experimental protocols promoted significant minimization of cell damage, for all evaluated parameters, when compared to positive control, in a time/concentration fashion (Kruskal-Wallis; Mann-Whitney/ p<0.05). Cells exposed to protocols with the 17.5%-H2O2 gel presented cell recovery capability in around 50% three days after bleaching. In the third study, the cells were exposed to the experimental protocols with the 17.5%-H2O2 gel (3x 15, 1x 15 and 1x 5 min), and the expression of odontoblastic differentiation markers (gene expression of DMP-1, DSPP and ALP, mineralized nodule deposition and ALP activity) was analyzed 7, 14 and 21 days after bleaching. Gene expression of inflammatory mediators (IL-1ß; TNF-α, IL-6 e COX-2) was assessed immediately after bleaching. It was observed upregulation of inflammatory mediators gene expression on bleached cells, which was proportional to treatment time. Reduction on differentiation markers expression related to negative control (no treatment) in a time/dependent fashion was also observed on bleached cells; however, the cells were able to recovery up to 21 days, excepting for mineralized nodule deposition by HDPCs on the 45-minute group (Kruskal-Wallis; Mann-Whitney/p<0.05). It was concluded that the reduction on concentration and/or frequency of application of H2O2 based gels promotes effective bleaching, associated to reduction on H2O2 diffusion through dental structure, and consequently minimization of toxic effects over two cell lineages from pulp tissue. However, the 17.5%-H2O2 gel applied for short periods appeared to be an interesting alternative, as the cells presented capability to recovery its viability, as well as kept its potential for odontoblastic differentiation and deposition of mineralized matrix

Cytotoxic Effects of Zoledronic Acid on Human Epithelial Cells and Gingival Fibroblasts

Bisphosphonate-induced osteonecrosis has been related to the cytotoxicity of these drugs on oral mucosa cells. A previous study showed that 5 µM of zoledronic acid (ZA), a nitrogen-containing bisphosphonate, is the highest concentration of this drug found in the oral cavity of patients under treatment. Therefore, in order to simulate an osteonecrosis clinical condition, the aim of this study was to evaluate the highest concentration of ZA applied on human epithelial cells (HaCaT) and gingival fibroblasts. For this purpose, cells (3×104 cells/cm2) were seeded in wells for 48 h using complete culture medium (cDMEM). After 48 h incubation, the cDMEM was replaced by fresh serum-free culture medium (DMEM-FBS) in which the cells were maintained for additional 24 h. Then, 5 µM ZA were added to the DMEM–FBS and the cells incubated in contact with the drug for 48 h. After this period, the number of viable cells (trypan blue), cell viability (MTT assay), total protein (TP) production and cell morphology (SEM analysis) were assessed. Data were analyzed statistically by Mann-Whitney, ANOVA and Tukey's test (α=0.05). ZA caused a significant reduction in the number of viable cells and decreased the metabolic activity of both cell lines. However, decrease of TP production occurred only in the epithelial cell cultures. Morphological alterations were observed in both cell types treated with ZA. In conclusion, ZA (5 µM) was cytotoxic to human epithelial cells and gingival fibroblast cultures, which could be associated, clinically, with the development of bisphosphonate-induced osteonecrosis.

A osteonecrose induzida por bisfosfonatos tem sido associada a um efeito citotóxico destes medicamentos sobre as células da mucosa oral. Um estudo recente demonstrou que 5 µM de ácido zoledrônico (AZ), um potente bisfosfonato nitrogenado, foi a maior concentração encontrada na cavidade oral da pacientes em tratamento com este medicamento. Portanto, para simular esta condição in vivo, o objetivo deste estudo foi avaliar o efeito da aplicação desta concentração de AZ sobre células epiteliais (HaCaT) e fibroblasto de gengiva. As células foram semeadas (3×104 células/cm2) e incubadas por 48 h em placas de 24 compartimentos, utilizando meio de cultura completo (cDMEM). Após permanecer por 24 h em DMEM sem soro fetal bovino (DMEM-SFB), 5 µM do AZ foram adicionados a este meio de cultura, o qual foi incubado em contato com as células por 48 h. Após este período, foram avaliados o número de células viáveis (trypan blue), viabilidade celular (teste de MTT), produção de proteína total e a morfologia celular (MEV). Os dados obtidos foram submetidos aos testes estatísticos de Mann-Whitney e ANOVA complementada por testes de Tukey (p>0,05). Foi demonstrado que o AZ causou diminuição significativa no número de células viáveis, além de redução do metabolismo celular para ambos os tipos celulares avaliados. Porém, redução na produção de proteína total ocorreu apenas para as células epiteliais. Alterações morfológicas foram observadas em ambos os tipos celulares tratados com AZ. Estes dados científicos indicam que a concentração de AZ avaliada neste estudo (5 µM) apresenta ação citotóxica sobre células epiteliais e fibroblastos de gengiva, o que poderia estar associado, clinicamente, ao desenvolvimento da osteonecrose induzida por bisfosfonatos.

Mineral Loss and Morphological Changes in Dental Enamel Induced by a 16% Carbamide Peroxide Bleaching Gel

The aim of this study was to compare the effect of a 16% carbamide peroxide (CP) gel and a 10% CP gel on mineralized enamel content and morphology. Enamel blocks from bovine incisors were subjected to a 14-day treatment (8 h/day) with 10% or 16% CP gels. Knoop microhardness was evaluated before bleaching and at 1, 7 or 14 days after this treatment (50 g/15 s). Mineral content (energy-dispersive x-ray spectroscopy), surface roughness and topography (atomic force microscopy) were evaluated at the 14-day period. Data were analyzed statistically by two-way ANOVA and Tukey's test (α=0.05). Significant microhardness reduction was observed at the 7 th and 14 th days for 10% CP gel, and for all bleaching times for 16% CP gel (p<0.05). At the 14-day period, a significant decrease in Ca and P content, increase on surface roughness (p<0.05) as well as on picks and valleys distance were observed when both bleaching gels were used. These enamel alterations were more intense for 16% CP gel. It was concluded that both CP-based gels promoted loss of mineral structure from enamel, resulting in a rough and porous surface. However, 16% CP gel caused the most intense adverse effects on enamel.

O objetivo do presente estudo foi comparar o efeito de um gel com 16% de peróxido de carbamida (PC) sobre a estrutura mineral e morfologia do esmalte dental com os efeitos de um gel com 10% de PC. Blocos de esmalte provenientes de incisivos bovinos foram submetidos a 14 dias de tratamento (8 h/dia) com géis com 10 ou 16% de PC. A microdureza Knoop foi avaliada antes do clareamento e 1, 7 e 14 dias pós-tratamento (50 g/15 s). O conteúdo mineral (EDX), rugosidade de superfície e topografia (MFA) foram avaliados no período de 14 dias (ANOVA a dois critérios e teste de Tukey; α=0,05). Redução significante na microdureza foi observada nos períodos de 7 e 14 dias para o gel com 10% de PC, e em todos os períodos para o gel com 16% de PC (p<0,05). No período de 14 dias, uma diminuição significante no conteúdo de Ca e P, aumento na rugosidade de superfície (p<0,05), bem como na distância entre picos e vales foram observados para ambos os agentes clareadores usados. Estas alterações foram mais intensas para o gel com 16% de PC. Pôde-se concluir que ambos os géis à base de PC promoveram perda de estrutura mineral do esmalte, resultando em superfície mais rugosa e porosa. Porém, o gel com 16% de PC causou efeitos adversos mais intensos no esmalte dental.