Reactive Oxygen Species Mediate Therapeutic Ultrasound-Induced, Mitogen-Activated Protein Kinase Activation in C28/I2 Chondrocytes.

Low-intensity pulsed ultrasound (LIPUS) has been used for the treatment of non-healing fractures because of its therapeutic properties of stimulating enhancing endochondral bone formation. However, its mechanism of action remains unclear. In this study, we hypothesized that LIPUS activates mitogen-activated protein kinases through generation of reactive oxygen species. C28/I2 cells were stimulated with LIPUS for 10 and 20 min, while the control group was treated using a sham LIPUS transducer. Through quantitative reverse transcription polymerase chain reaction and immunoblot analyses, we determined that LIPUS application increased reactive oxygen species generation and cell viability in C28/I2 cells. There were increases in the phosphorylation level of ERK1/2 and in expression of SOX9, COL2 A1 and ACAN genes. These effects were reversed when cells were treated with diphenylene iodonium, which is known to inhibit NADPH oxidase. It was concluded that exposure of chondrocytes to LIPUS led to reactive oxygen species generation, which activated MAPK signaling and further increased chondrocyte-specific gene markers involved in chondrocyte differentiation and extracellular matrix formation.

Role of Reactive Oxygen Species during Low-Intensity Pulsed Ultrasound Application in MC-3 T3 E1 Pre-osteoblast Cell Culture.

We evaluated the activation of mitogen-activated protein kinase (MAPK) activation through reactive oxygen species (ROS) by application of low-intensity ultrasound (LIPUS) to MC-3 T3 E1 pre-osteoblasts. The cells were subjected to one LIPUS application for either 10 or 20 min, and the control group was exposed to a sham transducer. For ROS inhibition, 10 µM diphenylene iodonium (DPI) was added to the cells an hour before LIPUS application. Samples were collected 1, 3, 6, 12 and 24 h after LIPUS application, and cells were evaluated for ROS generation, cell viability, gene expression and MAPK activation by immunoblot analyses. LIPUS caused a significant increase in ROS and cell viability in the non-DPI-treated group. Expression of RUNX2, OCN and OPN mRNA was higher in the LIPUS-treated groups at 1 h in both the DPI-treated and non-DPI-treated groups; RUNX2 and OCN mRNA levels increased at 6 h. ERK1/2 activation was increased in the LIPUS-treated groups. These results indicate that LIPUS activates MAPK by ROS generation in MC-3 T3 E1 pre-osteoblasts.

Effect of Increasing Low-Intensity Pulsed Ultrasound and a Functional Appliance on the Mandibular Condyle in Growing Rats.

OBJECTIVES: Functional appliances are used for treatment of lower-jaw deficiencies in growing individuals; however, their effectiveness is debatable. Low-intensity pulsed ultrasound (US) is a noninvasive method, which has been shown to stimulate cartilage and bone formation with 20 minutes of application. This study was designed to test the hypothesis that increasing low-intensity pulsed US application from 20 to 40 min/d will enhance mandibular condylar growth in growing rats, especially when combined with a functional appliance. METHODS: Fifty-four Sprague Dawley rats were divided into 6 groups (n = 9): control, low-intensity pulsed US for 20 minutes, low-intensity pulsed US for 40 minutes, the functional appliance, the functional appliance plus low-intensity pulsed US for 20 minutes, and the functional appliance plus low-intensity pulsed US for 40 minutes. Low-intensity pulsed US was applied for 28 days. All rats were then euthanized, and their mandibles were dissected for morphometric, histomorphometric, and micro-computed tomographic analyses. RESULTS: Among all study groups, the 20-minute US group showed significant increases in most of the measured variables (P < .05) except for condylar process length (P = .18), whereas the functional appliance-plus-40-min US group showed the least favorable results. The 20-minute US group showed increases in proliferative and hypertrophic cell counts and widths and enhanced microarchitecture of trabecular bone compared with the 40-minute US group. The functional appliance-plus-20-minute US group showed better results compared with the functional appliance-alone and functional appliance-plus-40-minute US groups. CONCLUSIONS: A daily application of low-intensity pulsed US for 20 minutes in growing rats affects mandibular growth, either alone or in combination with a functional appliance. Further study with a longer observation period is required to study the long-term effects and stability of newly formed bone.

Little evidence for the use of diode lasers as an adjunct to non-surgical periodontal therapy.

DATA SOURCES: Medline, PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL) and Embase databases. STUDY SELECTION: Randomised controlled trials (RCTs) using thermal diode lasers as an adjunct to non-surgical conventional periodontal initial therapy conducted in patients ≥18 years old written in English or Dutch were considered. DATA EXTRACTION AND SYNTHESIS: Study assessment data extraction and quality assessment was carried out independently by two reviewers. The main outcome variables were probing pocket depth (PPD) and clinical attachment loss (CAL), but plaque scores (PS), bleeding scores (BS) and the Gingival Index (GI) were also considered. Meta-analysis was carried out using a random effects model. RESULTS: Nine studies involving 247 patients were included. Seven studies were of split mouth design and two were parallel group studies. The study designs showed considerable heterogeneity and follow up ranged from six weeks to six months. Meta-analysis found no significant effect on PPD, CAL and PS. There was however a significant effect for GI and BS favouring adjunctive use of the diode laser. CONCLUSIONS: The collective evidence regarding adjunctive use of the diode laser with SRP indicates that the combined treatment provides an effect comparable to that of SRP alone. With respect to BS the results showed a small but significant effect favouring the diode laser, however, the clinical relevance of this difference remains uncertainStandard . This systematic review questions the adjunctive use of diode laser with traditional mechanical modalities of periodontal therapy in patients with periodontitis. The strength of the recommendation for the adjunctive use of the diode laser is considered to be 'moderate' for changes in PPD and CAL.

In vitro osteogenic induction of human gingival fibroblasts for bone regeneration.

BACKGROUND AND OBJECTIVE: Periodontitis is an inflammatory disease causing bone loss, and is a primary cause of tooth loss. Gingival fibroblasts are readily available with minimal donor site morbidity and may be ideal for tissue engineering efforts in regenerating lost alveolar bone. Dexamethasone (Dex) is commonly employed for in vitro osteogenic induction of a variety of cells, but its effect on human gingival fibroblasts (HGF) is still controversial. Therefore, the aim of our study was to investigate the osteogenic differentiation of HGF following Dex treatment. METHODS: Cultured HGFs were exposed to osteogenic medium containing a wide range of Dex concentrations (0.01-10 µM). The osteogenic phenotype was assessed based on changes in alkaline phosphatase (ALP) activity, the mRNA expression of selected extracellular matrix proteins critical for mineralization and the extent of extracellular mineralization (Von Kossa staining and Ca-content). RESULTS: All assays showed a consistent and maximal osteogenic effect of Dex on HGF at 0.1 and 0.5 µM (weeks 3 and 4), as evidenced by significant osteopontin and osteocalcin expression and mineralization. Longer cultures (week 4) also yielded positive osteogenic effect of Dex at 0.01 µM. Moreover, ALP activity was significantly stimulated at 0.1 and 0.5 µM Dex initially after one week, but ALP was subsequently reduced under Dex. Higher Dex concentrations caused down regulation of osteogenic effects observed at the optimal (0.1-0.5 µM) concentrations. CONCLUSION: Under appropriate osteogenic conditioning, Dex treated HGFs could be a potential source of cells for cell-based therapy for periodontal bone regeneration.

Anabolic effects of low-intensity pulsed ultrasound on human gingival fibroblasts.

OBJECTIVE: Low-intensity pulsed ultrasound (LIPUS) demonstrated anabolic effects on cementoblasts, odontoblasts, and periodontal ligament cells. However, LIPUS effect on human gingival fibroblasts (HGF) remains to be investigated. Therefore, we evaluated the in vitro effects of LIPUS on HGF proliferation and differentiation to test its feasibility for periodontal therapy. DESIGN: LIPUS treatment (1.5MHz, 30mW/cm(2)) was applied to HGF in the experimental groups after 24-h of culture (5 or 10min/day for 28 days) and omitted in the control. Changes in HGF activities were evaluated in response to LIPUS treatment in dose-dependent (5 and 10min) and time-dependent (weeks 1-4) manner. The effects of LIPUS on HGF cell viability (MTT), proliferation (total DNA content and growth pattern), alkaline phosphatase (ALP) activity, and gene expression by reverse-transcriptase polymerase chain reaction (RT-PCR) were determined. RESULTS: Cell viability remained unchanged after LIPUS treatment during the 4 weeks of treatment as compared to the untreated control group which ensured a safe biological response. Both LIPUS treatments (5-10min/day) did not yield any significant changes in the proliferation, and expression of proliferating cell nuclear antigen (PCNA) and collagen-I (COL-I). Conversely, LIPUS treatment enhanced osteogenic differentiation potential of HGF as determined by significant up-regulation of specific ALP activity and osteopontin (OPN) expression, with optimum effect following 3 weeks of 5min/day LIPUS treatment. CONCLUSION: LIPUS treatment at 30mW/cm(2) selectively enhanced HGF differentiation but not proliferation. The ability of LIPUS to enhance HGF differentiation is promising for its application in cell-based periodontal therapy.

Replacement of missing maxillary canines with dental implants: prosthesis design considerations.

Replacing a missing canine with a dental implant is the optimal treatment plan. The strategic roles canines play in maintaining normal function and the high visibility of these teeth, especially in the maxilla, require a restoration that provides uncompromised function and aesthetics. Eliminating lateral forces on the implant can minimize implant complications, but in young patients (ie, with steep canine guidance) achieving such a goal presents a restorative challenge. This article discusses several considerations (ie, ease of maintenance, retrievability) that will affect the design of the definitive restoration.

Perceptions of dental schools from within and outside the university.

Perceptions of dental schools held by high-level administrators of their parent institutions and officials in the local community have great potential to influence the future of dental education. The intent of this investigation was to gain a preliminary knowledge of such perceptions at seven institutions in the United States and to use this information to formulate hypotheses that can provide the basis for further targeted investigations that provide evidence useful in decision making and planning processes within dental schools. Interviews with university administrators, executive directors of state dental associations, and state government officials in seven areas of the United States were conducted. The hypotheses drawn from these interviews are: 1) dental schools are generally too insular and need to interact more with their parent institutions and external community; 2) dental schools need to systematically and continually get the message of the value of their services out to the public and political constituencies; and 3) multidisciplinarity and integration with other units are important to university administrators but largely outside the concerns of those external to the university. We suggest that these hypotheses form the basis of subsequent, more targeted, follow-up investigations with the intent of formulating specific recommendations for action.

Lasers in dentistry: separating science from hype.

BACKGROUND: During the last two decades, much has been written in both the scientific literature and the popular press about lasers and their use in the dental office. Both soft- and hard-tissue applications have been discussed, including frenectomy, gingival contouring, caries removal and bleaching. OVERVIEW: Almost one-third of patients surveyed by the American Dental Association in the late 1990s thought it was very important that their dentists have lasers, which could put pressure on dentists to invest in this tool to attract patients. The authors describe the different types of dental lasers and examine the science behind their applications in dentistry. CONCLUSION AND CLINICAL IMPLICATIONS: Although lasers do have legitimate uses in dentistry, they do not take the place of any of the more conventional tools in the dentist's armamentarium. Before investing in a laser, dentists should fully understand the differences between the various types, including what the scientific literature says about their applications.

Laser curettage: where do we stand?

The literature suggests that curettage has no benefit beyond traditional scaling and root planing. However, claims abound as to the benefits of curettage with the laser, including less postoperative pain, less bleeding, and reduction in microbial count. This paper explores whether any of these claims are true and whether laser curettage has any benefit in periodontal treatment.

Laser curettage: an overview.

The literature suggests that subgingival curettage has no benefit beyond traditional scaling and root planing. In addition, mounting evidence suggests that there is a risk of clinically significant collateral damage to using Nd:YAG laser energy within the sulcus. There also appears to be some confusion regarding the standards of evidence upon which to judge the performance of adjunctive procedures such as laser curettage. This article presents a review of the literature and a synopsis of the current scientific consensus regarding laser curettage, its effectiveness, its potential for collateral damage, and the scientific standards that apply.