Substance P expression in the gingival tissue after upper third molar extraction: effect of ketoprofen, a preliminary study.

The aim of this study was to evaluate substance P (SP) levels and the effect of a non-steroidal anti-inflammatory drug (NSAID), ketoprofen, on SP in the pericoronal gingival tissue after extraction of upper third molars. A sample of 20 young non-smoking systemically healthy adults of both sexes, with a healthy upper third molar to extract for orthodontic purposes, was selected. After extraction, a sample of the gingival tissue of the pericoronal region was collected with a sterile scalpel, placed into test tubes and kept frozen at -20°C until the SP determination. SP levels were determined by using a commercially available enzyme immunoassay (ELISA) kit. The subjects were randomly divided into two groups: group 1 received a single dose of ketoprofen 30 minutes prior to the experimental procedure. The subjects of group 2 did not receive any kind of drug administration before extraction. The patients were asked to complete a diary on the postoperative pain. A relevant amount of SP was measured in all the gingival samples. No statistically significant difference could be detected in SP expression between the two groups. In group 1 pain appearance was significantly delayed (6.2±0.13 hours) in comparison with group 2 (3.95±0.2 hours). In this small selected group of subjects and limited study design, preventive administration of ketoprofen did not significantly affect the gingival levels of SP, the clinical recommendation emerging is that of NSAID administration postoperatively but before pain appearance in order to optimize the management of pain of the patient.

Correlation between unstimulated salivary flow, pH and streptococcus mutans, analysed with real time PCR, in caries-free and caries-active children.

AIM: Evaluate the correlations between unstimulated salivary flow, pH and level of S. mutans, analysed through real time PCR, in caries-free and caries-active children. MATERIALS AND METHODS: Thirty healthy children were divided into 2 groups: test group (DMFT/dmft ≥ 3 and at least 1 active caries lesion) and control group (DMFT/dmft=0). Un-stimulated saliva was collected, pH was measured and S. mutans and total bacterial amount were evaluated with real-time PCR analysis. RESULTS: Unstimulated salivary flow in the test group was significantly lower (p = 0.0269) compared to group control. The level of S. mutans was higher in the test group (p = 0.176), and an inverse correlation was recorded between total bacterial amount and un-stimulated salivary flow (p = 0.063). In the control group a positive relationship was found between total bacterial amount and S. mutans (p = 0.045) and an inverse correlation between pH and S. mutans (p = 0.088). A t-test and a linear regression analysis were performed. CONCLUSION: A higher salivary flow and an increased salivary pH seem to represent protective factors against caries in children, while high levels of S. mutans are correlated with caries active lesions. Caries risk assessment should be performed considering all parameters involved in the development of the disease.

Salivary pH after a glucose rinse: effect of a new mucoadhesive spray (Cariex) based on sodium bicarbonate and xylitol.

OBJECTIVE: This study evaluated whether sodium bicarbonate applied on the oral mucosa through a new mucoadhesive spray (Cariex) could control a drop in salivary pH after a glucose rinse, and therefore enhance the buffering potential of saliva. METHODS: A sample of 50 healthy adults was selected. At day 1, the measurement of salivary pH was performed in the lower fornix in correspondence with the lower molars. Each subject rinsed with 10 ml of a 10% glucose solution and then pH was monitored continually for 40 minutes. At day 2, the same experimental procedure was repeated and three shots of the spray were administered on the oral mucosa. The tested spray is composed of sodium bicarbonate, xylitol, and excipients. RESULTS: Without the mucoadhesive spray, salivary pH became significantly lower following the glucose rinse (p < 0.01). Following the spray, the time in which the pH remained lower than 6.0 was reduced statistically significantly (p < 0.01). A continual rise of salivary pH was observed for the 40 minutes in which the pH recording was performed. Conclusions: The use of a sodium bicarbonate spray on the mucosa was shown to control the lowering of salivary pH following carbohydrate consumption, and might therefore add to the prevention of caries and dental erosion.

Oral Signs and HLA-DQB1∗02 Haplotypes in the Celiac Paediatric Patient: A Preliminary Study.

Celiac disease (CD) diagnosis can be extremely challenging in the case of atypical patterns. In this context, oral signs seem to play a decisive role in arousing suspicion of these forms of the disease. At the same time, the different expressions of the HLA-DQB1∗02 allele apparently seem to facilitate the interpretation of signs and highlighted symptoms. The aim of this work was to verify whether it is possible to identify a correlation between the development of oral signs and different DQ2 haplotypes in celiac pediatric patients. 44 celiac patients with a medium age of 9.9 were studied. Oral examinations were performed in order to identify recurrent aphthous stomatitis (RAS) and dental enamel defects (DED). The diagnosis of DED resulted as being related to allele expression (P value = 0.042) while it was impossible to find a similar correlation with RAS. When both oral signs were considered, there was an increase in correlation with HLA-DQB1∗02 expression (P value = 0.018). The obtained results identified both the fundamental role that dentists can play in early diagnosis of CD, as well as the possible role of HLA haplotype analysis in arousing suspicion of atypical forms of the disease.

pH of tooth surface in healthy adolescents at rest and after a glucose rinse: effect of 72 hours of plaque accumulation.

AIM: This study was performed to evaluate the effect of a glucose rinse and of plaque accumulation on pH of tooth surface in healthy adolescents with a device used in gastroenterology and never tested in the oral cavity. MATERIALS AND METHODS: Values of pH were monitored in 12 adolescents using a portable device (pH-day 2® Menfis, bioMedica S.r.l., Bologna, Italy) with a disposable antimonium electrode kept in contact with the interproximal surface of the upper molars for 40 minutes respectively before and after a one-minute rinse with 10 ml of a 10% glucose solution. The same procedure was repeated in the same subjects after 72 hours of plaque accumulation. RESULTS: The device tested resulted difficult to use on the tooth surface because of the size of the active part of the probe. The glucose rinse caused a statistically significant decrease of the mean pH, restrained in basal conditions (d = -0.16, p <0.05), clinically relevant after plaque accumulation (d = -1.24, p <0.05). Time in minutes of pH < 6 grew considerably only in case of combination of plaque accumulation and glucose rinse (d = 20.90, p <0.05). A Stephan's curve of drop and recover of the pH values was not recorded. CONCLUSIONS: The continuous recording of pH of natural plaque present on the tooth could represent an alternative to other techniques found in literature. More studies are necessary to verify the suitability of this new device for the monitoring of pH in the oral cavity.

5-HT2 antagonists stereoselectively prevent the neurotoxicity of 3,4-methylenedioxymethamphetamine by blocking the acute stimulation of dopamine synthesis: reversal by L-dopa.

The active and inactive stereoisomers of the serotonin (5-HT2) antagonist, MDL 11,939, were used to examine the relationship between the acute effects of 3,4-methylenedioxymethamphetamine (MDMA) on the dopaminergic system and its long-term effects on the serotonergic system. Only the R-(+) stereoisomer of MDL 11,939 both reversed the acute stimulation of striatal dopamine synthesis by MDMA and prevented the deficit in forebrain 5-HT concentrations measured one week later. This acute activation of striatal dopamine synthesis by MDMA is a compensatory response to the carrier-mediated efflux of transmitter as shown by its sensitivity to the dopamine uptake inhibitor, nomifensine. It is suggested that in the absence of this enhanced synthesis, the dopaminergic neuron cannot sustain the carrier-mediated dopamine release which is a prerequisite for the development of MDMA-induced neurotoxicity. This hypothesis is supported by the observation that the administration of the dopamine precursor, L-dopa, with MDMA reverses the protective effects of 5-HT2 receptor antagonists.

Selective 5-hydroxytryptamine2 receptor antagonists protect against the neurotoxicity of methylenedioxymethamphetamine in rats.

The serotonergic deficits resulting from methylenedioxymethamphetamine (MDMA)-induced neurotoxicity were prevented by the simultaneous administration of 5-hydroxytryptamine2 (5-HT2) receptor antagonists such as MDL 11,939 or ritanserin. This effect was not region specific as protection was observed in the cortex, hippocampus and striatum 1 week after the administration of a single dose of MDMA. MDL 11,939 also showed some efficacy at reducing the deficits in 5-HT concentrations and tryptophan hydroxylase activity produced by multiple administrations of MDMA. Protection against the neurotoxicity required the administration of MDL 11,939 within 1 hr of MDMA indicating 5-HT2 receptor activation was an early event in the process leading to terminal damage. Examination of the effect of the 5-HT2 receptor blockade on the early neurochemical alterations induced by MDMA revealed an inhibitory effect on MDMA-stimulated dopamine synthesis. Analysis of these data and the associated changes in dopamine metabolites indicates that 5-HT2 receptor antagonists block MDMA-induced neurotoxicity by interfering with the ability of the dopamine neuron to maintain its cytoplasmic pool of transmitter and thereby sustain carrier-mediated dopamine release.

Chloral hydrate anesthesia antagonizes the neurotoxicity of 3,4-methylenedioxymethamphetamine.

We report that maintaining rats under chloral hydrate anesthesia for the first 3 h following the administration of 3,4-methylenedioxymethamphetamine (MDMA) blocks the decrease in forebrain concentrations of 5-hydroxytryptamine (5-HT) measured 1 week later. In contrast, the acute effect of MDMA (3 h) on forebrain 5-HT was not altered by the anesthetic. This protective effect of chloral hydrate was not due to an anesthetic-induced hypothermia but may be related to the hypothesized role of dopamine in the neurotoxic effects of MDMA.

Methylenedioxymethamphetamine-induced hyperthermia and neurotoxicity are independently mediated by 5-HT2 receptors.

Methylenedioxymethamphetamine (MDMA) produced a significant hyperthermia in rats which was antagonized in a competitive manner by the selective 5-HT2 antagonist, MDL 11,939. The 5-HT antagonist also blocked MDMA-induced neurotoxicity as assessed by the decline in regional 5-HT concentrations observed 1 week later. These two effects of MDL 11,939 were dissociated at higher doses of MDMA where the antagonist still provided virtually complete protection against the neurochemical deficits but only partially attenuated the hyperthermic response. In contrast to the effect of the 5-HT2 antagonist, haloperidol did not alter MDMA-induced hyperthermia but did antagonize its long-term neurochemical effects. Similarly, coadministration of the selective 5-HT uptake inhibitor, MDL 27,777, did not affect the hyperthermia produced by a high dose of MDMA but completely prevented the depletion of 5-HT. When the MDMA-induced hyperthermia was prevented by temporarily maintaining animals at reduced ambient temperature, the neurochemical changes normally observed 1 week later were also blocked. Although these results demonstrate that the drugs tested do not antagonize MDMA-induced neurotoxicity by interfering with its effect on body temperature, they do indicate that MDMA-induced hyperthermia may contribute to the development of the drug's long-term neurochemical effects.