Cytotoxicity and Effects of a New Cacium Hydroxide Nanoparticle Material on Production of Reactive Oxygen Species by LPS-Stimulated Dental Pulp Cells.

Introduction: The aim of this study was to synthesize and characterize calcium hydroxide (CH) nanoparticles [CH-NP] and compare the cytotoxicity of these materials with that of mineral trioxide aggregate (White MTA) in human dental pulp mesenchymal cells (hDPMCs) stimulated by lipopolysaccharide (LPS). Methods and Materials: The CH-NP were synthesized by the co-precipitation method, and the physical properties were investigated through X-ray diffraction, scanning electron microscopy (SEM) and energy dispersive x-ray spectrometry (EDS). LPS-stimulated hDPMCs were placed in contact with different dilutions of culture media previously exposed to CH-NP and white MTA for 24 h. The groups were tested for cell viability by MTT formazan and Alamar Blue assays, the production of nitric oxide (NO) by Griess method and the production of reactive oxygen species (ROS) by means of the fluorescent oxidant-sensing probe 2',7'-dichlorodihydrofluorescein diacetate (DCFH-DA). Control groups for viability test were maintained in DMEM (not LPS-stimulated). For NO and ROS production, negative control group was cells in DMEM, and positive control was cells stimulated by LPS. The results were statistically analyzed by two-way ANOVA, Tukey's test and Dunnett's test (ɑ=0.05). Results: The results showed that the cell viability remained above 50% in all materials, independent of the dilution in MTT formazan and Alamar Blue tests. MTA showed a reduction in NO production at dilutions of 1:4 to 1:32 compared with the positive control group (P<0.05). The tested materials exhibited lower ROS production by DPMCs than that by cells in the positive control group (P<0.05), and similar ROS production to the negative control group (P>0.05). Conclusion: The outcomes of present in vitro study showed that MTA and [CH-NP] were not cytotoxic materials, with MTA closer to the results of control group (DMEM). MTA and [CH-NP] reduced ROS production at basal levels, with MTA inhibiting NO production at higher dilutions.

"Metabolism of Odontoblast-like cells submitted to transdentinal irradiation with blue and red LED".

OBJECTIVES: The present study evaluated the trans-dentinal effect of light emitting diodes (LEDs) irradiation on the metabolism of odontoblast-like cells. METHODS: Seventy-two dentin discs (0.2mm thick) were obtained from human molar teeth. MDPC-23 cells (20,000 cells/disc) were seeded on the pulpal side of the discs using DMEM, supplemented with 10% fetal bovine serum (FBS). After 12h, the culture medium was replaced with DMEM containing 0.5% FBS. After additional 12h, blue (455±10nm) or red (630±10nm) LEDs were used at irradiances of 80 and 40mW/cm2, respectively, to irradiate the occlusal side of the discs. The energy doses were fixed at 2 or 4J/cm2. Cell viability, alkaline phosphatase activity (ALP), total protein production and collagen synthesis were evaluated 72h after irradiation. Data were submitted to Kruskal-Wallis and Mann-Whitney tests (α=0.05). RESULTS: Red light promoted proliferative effects at the energy dose of 4J/cm2. Conversely, cell cultures irradiated with 2J/cm2 emitted by the blue light showed reduced viability. ALP production was stimulated by red light in comparison with blue light at 4J/cm2. Total protein production was reduced after exposure to blue light at 4J/cm2, while no effect was observed on collagen production. CONCLUSIONS: Irradiation with red LED at 4J/cm2 bio-stimulated the viability of odontoblast-like cells, whilst blue light had unfavorable effects on the cellular metabolism.

Effects of low-level laser therapy and epidermal growth factor on the activities of gingival fibroblasts obtained from young or elderly individuals.

This study evaluated the effects of low-level laser therapy (LLLT) and epidermal growth factor (EGF) on fibroblasts obtained from young and elderly individuals. Gingival fibroblasts from young (Y) and elderly (E) individuals were seeded in wells of 24-well plates with Dulbecco's modified Eagle's medium (DMEM) containing 10 % of fetal bovine serum (FBS). After 24 h, the cells were irradiated (LASERTable-InGaAsP-780 ± 3 nm, 25 mW, 3 J/cm2) or exposed to EGF (100 µM). After 72 h, cells were evaluated for viability, migration, collagen and vascular endothelial growth factor (VEGF) synthesis, and gene expression of growth factors. Data were analyzed by Kruskal-Wallis and Mann-Whitney tests (α = 5 %). Y and E fibroblasts irradiated with laser or exposed to EGF showed increased viability and collagen synthesis. Enhanced cell migration was observed for Y fibroblasts after both treatments, whereas only the LLLT stimulated migration of E cells. VEGF synthesis was higher for Y and E cells exposed to EGF, while this synthesis was reduced when E fibroblasts were irradiated. Increased gene expression of VEGF was observed only for Y and E fibroblasts treated with LLLT. Regardless of a patient's age, the LLLT and EGF applications can biostimulate gingival fibroblast functions involved in tissue repair.

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

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.

Red LED Photobiomodulates the Metabolic Activity of Odontoblast-Like Cells.

Phototherapy has been indicated as an adjunctive treatment for tissue repair, including the pulp tissue. However, there are no defined irradiation parameters, which is a great challenge to the clinical use of phototherapy. The aim of this study was to evaluate the effect of phototherapy with red LED on odontoblast-like MDPC-23 cells, using different parameter settings. Cells were seeded (104 cells/cm²), incubated for 12 h in complete DMEM and then the culture medium was replaced by DMEM supplemented with 0.5% FBS. After 12 h incubation, irradiations were performed (630±10 nm) using a LEDTable device with a 20 or 40 mW/cm² power density and 2 J/cm² energy dose. The cells were irradiated 1 or 3 times, at 1 min intervals. Non-irradiated cells served as control. The cells were evaluated for viability (MTT assay), total protein dosage (Lowry method) and number of viable cells (Trypan blue). The data (n=12 per group) were submitted to Kruskal-Wallis and Mann-Whitney tests (p=0.05). A single irradiation with 20 or 40 mW/cm² enhanced cell viability, which was negatively affected after 3 consecutive irradiations. Cells irradiated only once with 20 mW/cm² produced more proteins compared with those irradiated with 40 mW/cm². Reduction in the number of viable cells occurred only after 3 consecutive irradiations with 40 mW/cm². In conclusion, red LED was capable of biomodulating the metabolic activities of cultured MDPC-23 odontoblast-like cells. The best cell biostimulation was obtained when a single irradiation with 2 J/cm2 energy dose and 20 mW/cm2 power density was delivered to the pulp cells.

Red LED Photobiomodulates the Metabolic Activity of Odontoblast-Like Cells

Abstract Phototherapy has been indicated as an adjunctive treatment for tissue repair, including the pulp tissue. However, there are no defined irradiation parameters, which is a great challenge to the clinical use of phototherapy. The aim of this study was to evaluate the effect of phototherapy with red LED on odontoblast-like MDPC-23 cells, using different parameter settings. Cells were seeded (104 cells/cm²), incubated for 12 h in complete DMEM and then the culture medium was replaced by DMEM supplemented with 0.5% FBS. After 12 h incubation, irradiations were performed (630±10 nm) using a LEDTable device with a 20 or 40 mW/cm² power density and 2 J/cm² energy dose. The cells were irradiated 1 or 3 times, at 1 min intervals. Non-irradiated cells served as control. The cells were evaluated for viability (MTT assay), total protein dosage (Lowry method) and number of viable cells (Trypan blue). The data (n=12 per group) were submitted to Kruskal-Wallis and Mann-Whitney tests (p=0.05). A single irradiation with 20 or 40 mW/cm² enhanced cell viability, which was negatively affected after 3 consecutive irradiations. Cells irradiated only once with 20 mW/cm² produced more proteins compared with those irradiated with 40 mW/cm². Reduction in the number of viable cells occurred only after 3 consecutive irradiations with 40 mW/cm². In conclusion, red LED was capable of biomodulating the metabolic activities of cultured MDPC-23 odontoblast-like cells. The best cell biostimulation was obtained when a single irradiation with 2 J/cm2 energy dose and 20 mW/cm2 power density was delivered to the pulp cells.

Resumo Fototerapia tem sido indicada como um tratamento adjuvante para o reparo de tecidos, incluindo o tecido pulpar. Entretanto, não há parâmetros de irradiação definidos, o que representa um grande desafio para o uso clínico da fototerapia. O objetivo deste estudo foi avaliar o efeito da fototerapia com LED vermelho em células MDPC-23 com fenótipo odontoblastóide, usando vários parâmetros. As células foram semeadas (104 células/cm2), incubadas por 12 h em DMEM completo e então o meio de cultura foi trocado por DMEM com 0,5% SFB. Após 12 h de incubação, as irradiações foram realizadas (630±10 nm) usando um dispositivo com densidade de potência de 20 ou 40 mW/cm2 e dose de energia de 2 J/cm2. As células foram irradiadas 1 ou 3 vezes, com intervalos de 1 min. Células não irradiadas serviram como controle. Foram avaliadas a viabilidade (ensaio de MTT), dosagem de proteína total (método de Lowry) e número de células viáveis (ensaio de Trypan blue). Os dados (n=12 por grupo) foram submetidos aos testes de Kruskal-Wallis e Mann-Whitney (p=0,05). Uma única irradiação com 20 ou 40 mW/cm2 aumentou a viabilidade celular, a qual foi negativamente afetada após 3 irradiações. Células irradiadas apenas uma vez com 20 mW/cm2 produziram mais proteínas comparadas com aquelas irradiadas com 40 mW/cm2. Redução no número de células viáveis ocorreu apenas após 3 irradiações com 40 mw/cm2. Em conclusão, o LED vermelho foi capaz de biomodular a atividade metabólica de células MDPC-23. A melhor bioestimulação celular foi obtida quando uma única irradiação com dose de energia de 2 J/cm2 e densidade de potência de 20 mW/cm2 foi administrada às células pulpares.

Synthesis of dental matrix proteins and viability of odontoblast-like cells irradiated with blue LED.

To evaluate the effect of irradiation with light-emitting diode (LED; 455 nm) on the viability and synthesis of dentin matrix proteins by odontoblast-like cells, MDPC-23 cells were cultivated (10(4) cells/cm(2)) in 24-well culture plates. After 12 h incubation in Dulbecco's modified Eagle's medium (DMEM), the cells were submitted to nutritional restriction by means of reducing the concentration of fetal bovine serum (FBS) for an additional 12 h. Cells were irradiated one single time with one of the following energy densities (EDs): 0.5, 2, 4, 10, or 15 J/cm(2) and irradiance fixed at 20 mW/cm(2). Non-irradiated cells served as control. After 72 h, cells were evaluated with regard to viability (methylthiazol tetrazolium technique (MTT)), mineralization nodule (MN) formation, total protein (TP) production, alkaline phosphatase activity (ALP), and collagen synthesis (Sircol), n = 8. The data were submitted to Kruskal-Wallis and Mann-Whitney tests (p > 0.05). There was no statistical difference between the viability of cells irradiated or not (control), for all the EDs. However, an increase in TP was observed for all the EDs when compared with the control group. A reduced ALP activity was seen in all irradiated groups, except for the ED of 0.5 J/cm(2), which did not differ from the control. There was no difference between the irradiated groups and control regarding collagen synthesis, with the exception of the ED of 10 J/cm(2), which inhibited this cell function. Significant reduction in MN occurred only for the EDs of 0.5 and 2 J/cm(2). The single irradiation with blue LED (455 nm), irradiance of 20 mW/cm(2), and energy densities ranging from 0.5 to 15 J/cm(2) exerted no effective biostimulatory capacity on odontoblast-like cells.

Metabolic activity of odontoblast-like cells irradiated with blue LED (455 nm).

Blue light emitting diodes (LEDs) are frequently used in dentistry for light activation of resin-based materials; however, their photobiostimulatory effects have not yet been fully investigated. This study aimed to investigate the effect of blue LED (455 nm) on the metabolism of odontoblast-like cells MDPC-23. Energy doses of 2 and 4 J/cm(2) were used at 20 mW/cm(2) fixed power density. MDPC-23 cells were seeded at 10,000 cells/cm(2) density in Dulbecco's modified Eagle's medium (DMEM) containing 10 % fetal bovine serum (FBS). After 12 h, the culture medium was replaced with new DMEM supplemented with 0.5 % of FBS, and the cells were incubated for further 12 h. After that, single irradiation was performed to the culture, under selected parameters. Cell viability evaluations (Alamar Blue Assay, n = 12), number of viable cells (Trypan Blue Assay, n = 12), morphological analysis by scanning electron microscopy (SEM, n = 2), gene expression (n = 6) of alkaline phosphatase (Alp), collagen (Col-1a1), and dental matrix protein (Dmp-1) (quantitative polymerase chain reaction (qPCR)) were performed 72 h after irradiation. Data were analyzed by Kruskal-Wallis, ANOVA, and Tukey tests (p < 0.05). Direct light application at 4 J/cm(2) energy dose had no negative effects on cell viability, while irradiation with 2 J/cm(2) reduced cell metabolism. None of doses affected the number of viable cells compared with the control group. The two energy doses downregulated the expression of Alp; however, expression of Col-1a1 and Dmp-1 had no alteration. Cells presented change in the cytoskeleton only when irradiated with 2 J/cm(2). In conclusion, the blue LED (455 nm) irradiation, under the evaluated parameters, had no biostimulatory effects on MDPC-23 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.

Dose-responses of Stem Cells from Human Exfoliated Teeth to Infrared LED Irradiation.

Despite several reports regarding tissue regeneration, including pulp repair induced by different light sources, only limited data have been reported concerning the effects of light-emitting diodes (LED) on stem cells from human exfoliated deciduous teeth (SHEDs). The aim of this study was to evaluate the effects of different energy densities of infrared LED on the cell viability, number of cells and mineralized tissue production by SHEDs. SHEDs were obtained from near-exfoliation primary teeth (n=3), seeded in plain DMEM (104 cells/cm2), and irradiated by a LED prototype (LEDTable 850 nm, 40 mW/cm2) delivering 0 (control), 2, 4, 8, 15 or 30 J/cm2 (n=9). Cell viability (MTT assay), cell proliferation (trypan blue assay), and mineralized nodule (MN) formation (alizarin red stain) were assessed 12 and 72 h post-irradiation. Data were subjected to Kruskal-Wallis and Mann-Whitney tests (α=0.05). Cells irradiated with 2 or 4 J/cm2 exhibited higher metabolism at 72 h, and all energy densities provided increase in cell proliferation after 12 h. Regarding MN formation, the best results were observed at 72 h after SHED irradiation with 8 and 15 J/cm2. It was concluded that the cell viability, cell number and MN formation by pulp cells are enhanced after exposure to infrared LED irradiation. Overall, the greatest SHED biostimulation was obtained with 4 and 8 J/cm2.

Dose-responses of Stem Cells from Human Exfoliated Teeth to Infrared LED Irradiation

Despite several reports regarding tissue regeneration, including pulp repair induced by different light sources, only limited data have been reported concerning the effects of light-emitting diodes (LED) on stem cells from human exfoliated deciduous teeth (SHEDs). The aim of this study was to evaluate the effects of different energy densities of infrared LED on the cell viability, number of cells and mineralized tissue production by SHEDs. SHEDs were obtained from near-exfoliation primary teeth (n=3), seeded in plain DMEM (104 cells/cm2), and irradiated by a LED prototype (LEDTable 850 nm, 40 mW/cm2) delivering 0 (control), 2, 4, 8, 15 or 30 J/cm2 (n=9). Cell viability (MTT assay), cell proliferation (trypan blue assay), and mineralized nodule (MN) formation (alizarin red stain) were assessed 12 and 72 h post-irradiation. Data were subjected to Kruskal-Wallis and Mann-Whitney tests (α=0.05). Cells irradiated with 2 or 4 J/cm2 exhibited higher metabolism at 72 h, and all energy densities provided increase in cell proliferation after 12 h. Regarding MN formation, the best results were observed at 72 h after SHED irradiation with 8 and 15 J/cm2. It was concluded that the cell viability, cell number and MN formation by pulp cells are enhanced after exposure to infrared LED irradiation. Overall, the greatest SHED biostimulation was obtained with 4 and 8 J/cm2.

Apesar de diversos estudos envolvendo regeneração tecidual, incluindo o reparo pulpar induzido por diferentes fontes de luz, dados limitados têm sido reportados a respeito dos efeitos da irradiação com diodos emissores de luz (LED) sobre células-tronco de dentes decíduos esfoliados (SHEDs). O objetivo do presente estudo foi avaliar os efeitos de diferentes doses de energia (DE) do LED infravermelho sobre a viabilidade celular, número de células viáveis e produção de nódulos mineralizados (NM) por SHEDs. As células foram obtidas a partir de dentes decíduos próximos ao período de esfoliação (n=3), semeadas em DMEM completo (10⁴ células/cm2) e irradiadas utilizando um protótipo de LED (LEDTable 850 nm, 40 mW/cm²⁾ com as doses de 0 (controle), 2, 4, 8, 15 ou 30 J/cm² (n=9). A viabilidade celular (MTT), o número de células viáveis (trypan blue assay) e a formação de NM (alizarin red stain) foram realizados 12 e 72 h após a irradiação. Os dados foram avaliados utilizando os testes Kruskal-Wallis e Mann-Whitney (α=0,05). As células irradiadas com 2 ou 4 J/cm² exibiram uma maior viabilidade em 72 h, e todas as DE aumentaram o número de células viáveis após 12 h. Para a formação de NM, os melhores resultados foram observados 72 h após a irradição das SHEDs, com as doses de 8 e 15 J/cm². Concluiu-se que a viabilidade celular, o número de células e a formação de NM por células pulpares são aumentados após exposição ao LED infravermelho. De um modo geral, a melhor bioestimulação celular (SHEDs) foi obtida com 4 e 8 J/cm².

Low-level laser therapy for osteonecrotic lesions: effects on osteoblasts treated with zoledronic acid.

PURPOSE: Clinical studies have shown that low-level laser therapy (LLLT) can improve local tissue healing of bisphosphonate-induced osteonecrosis of the jaw. However, the effects of laser irradiation on bisphosphonate-treated osteoblasts have not been completely elucidated. METHODS: Human osteoblasts were cultured in plain culture medium (DMEM). After 48 h, plain DMEM was replaced by DMEM with no fetal bovine serum, for a 24-h incubation followed by addition of zoledronic acid (5 µM) for additional 48 h. Cells were subjected to LLLT (InGaAsP; 780 ± 3 nm; 0.025 W) at 0.5, 1.5, 3, 5, and 7 J/cm(2), three times every 24 h. Cell viability, total protein production, alkaline phosphatase activity (ALP), mineral nodule formation, gene expression of collagen type I and ALP, and cell morphology were evaluated. RESULTS: LLLT at 0.5 J/cm(2) increased cell viability of cultured osteoblasts. ALP activity and gene expression, in addition to mineral nodule formation and Col-I gene expression, were not increased by LLLT. LLLT applied to ZA-treated cells increased Col-I expression at 0.5, 1.5, and 3 J/cm(2) but did not improve any other cell activity assessed. CONCLUSION: LLLT showed limited effects on bisphosphonate-treated osteoblasts.

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.

Inhibition of osteoblast activity by zoledronic acid / Inibição da atividade de osteoblastos expostos ao ácido zoledrônico

INTRODUCTION: Patients treated with nitrogen-containing bisphosphonates, such as zoledronic acid (ZA), have frequently shown oral bone exposure areas, termed osteonecrosis. In addition, these patients may also present low repair and regeneration potential, mainly after tooth extractions. These side-effects caused by bisphosphonates may be due to their inhibitory effects on oral mucosa and local bone cells. OBJECTIVE: To evaluate the effects of ZA on the mineralization capacity of cultured osteoblasts. MATERIALS AND METHODS: Human immortalized osteoblasts (SaOs-2) were grown in plain culture medium (Dulbecco's Modified Eagle Medium [DMEM] + 10% fetal bovine serum [FBS]) in wells of 24-well plates. After 48-hour incubation, the plain DMEM was replaced by a solution with ZA at 5 µM which was maintained in contact with cells for seven, 14 or 21 days. After these periods, cells were evaluated regarding alkaline phosphatase (ALP) activity and mineral nodule formation (alizarin red). Data were statistically analyzed by Mann-Whitney test, at 5% of significance level. RESULTS: ZA caused significant reduction on ALP activity and mineral nodules formation by cultured osteoblasts in all evaluated periods (p < 0.05). CONCLUSION: These data indicate that ZA causes inhibition on the osteogenic phenotype of cultured human osteoblasts, which, in turn, may reduce bone repair in patients subjected to ZA therapy.

INTRODUÇÃO: Pacientes em tratamento com bisfosfonatos, sobretudo com os nitrogenados, como o ácido zoledrônico (AZ), têm apresentado áreas de exposição de tecido ósseo na cavidade oral, caracterizadas como osteonecrose. Essas áreas apresentam limitada capacidade de reparo, principalmente após exodontias. Esses efeitos podem ser resultado do efeito inibitório causado por esse tipo de medicamento sobre as células da mucosa e do tecido ósseo local. OBJETIVO: Avaliar o efeito do AZ sobre a capacidade de mineralização de osteoblastos in vitro. MATERIAIS E MÉTODOS: Foi utilizada uma linhagem celular de osteoblastos humanos (SaOs-2). As células foram cultivadas em meio de cultura completo (Dulbecco's Modified Eagle Medium [DMEM] + 10% de soro fetal bovino [SFB]). Após 48 horas de incubação, o DMEM completo foi substituído por um novo DMEM sem SFB, ao qual foram adicionados 5 µM de AZ. Essa solução foi mantida em contato com as células por sete, 14 ou 21 dias. Após esse período, as células foram avaliadas quanto à atividade de fosfatase alcalina (ALP) e à produção de nódulos de mineralização (alizarin red). Os dados foram submetidos ao teste estatístico de Mann-Whitney, considerando nível de significância de 5%. RESULTADOS: A exposição das células ao AZ causou redução significativa na atividade de ALP e na formação de nódulos mineralizados em todos os períodos avaliados (p < 0,05). CONCLUSÃO: Esses resultados revelam que o AZ causa alteração inibitória no fenótipo osteogênico das células humanas em cultura, o que pode reduzir a capacidade de reparo do tecido ósseo após o contato com esse tipo de medicamento.

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 × 10(4) 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.

Schwartz-Jampel Syndrome: a paediatric dentistry approach / Síndrome de Schwartz-Jampel: uma abordagem odontopediátrica

Schwartz-Jampel syndrome (SJS) is a rare recessive disorder characterized mainly by myotonia. As the clinical signs and symptoms are manifested in the oromaxillofacial region, paediatric dentists may be first choice of parents that seek information and assistance to their children. A female patient diagnosed with SJS was brought to our clinic for dental treatment with main complain of difficulty on oral hygiene and mastication due to tooth crowding. The treatment included preventive measures, extraction of a supernumerary tooth and the maxillary primary second molars. Furthermore, the patient was referred to orthodontic treatment for correction of tooth crowding. When dealing with children with confirmed diagnosis of SSJ, paediatric dentists should be understand the need of planning the dental treatment considering the characteristics and possible complications associated with the syndrome in order to reduce the risks to patients, especially when surgical procedures are necessary

A síndrome de Schwartz Jampel (SSJ) é uma desordem autossômica recessiva rara, caracterizada principalmente pela miotonia. Desde que alguns dos sinais clínicos e sintomas são manifestados na região oromaxilofacial, o odontopediatra pode ser o primeiro profissional a se deparar com um paciente portador desta síndrome. Um paciente do sexo feminino diagnosticado com SJS procurou a nossa clínica para tratamento dental com queixa principal de dificuldade na realização da higiene oral e mastigação, devido ao mau posicionamento dentário. O tratamento incluiu medidas preventivas, extração de um dente supranumerário e dos segundos molares decíduos e encaminhamento para tratamento ortodôntico. Quando uma criança possui o diagnóstico confirmado para SSJ, o odontopediatra deve ter conhecimento específico para planejar e realizar o tratamento odontológico de forma adequada, considerando as características da síndrome e as possíveis complicações associadas, a fim de reduzir os riscos ao paciente, especialmente quando procedimentos cirúrgicos são necessários.

[Assessment of educational actions on the oral health of adolescents within the Family Health Strategy]. / Avaliação das ações de educação na saúde bucal de adolescentes dentro da Estratégia de Saúde da Família.

OBJECTIVE: to evaluate the actions of education on the oral health of adolescents within the scope of the Family Health Strategy. METHODOLOGY: A questionnaire was applied and a clinical exam conducted evaluating biofilm and gingival inflammation in 80 adolescents before and after interventions. A qualitative study of the brushing technique was also performed on 15 adolescents in the sample. RESULTS: there was an improvement in oral hygiene of adolescents who participated in actions at school and an increase in the number of adolescents who had healthy gums or only mild inflammation in the second test in school groups and home visits. With respect to the consumption of candies, both the weekly group and the school group saw a decrease in candy consumption between the first and second tests. There was an increased frequency of brushing in the school group. CONCLUSION: considering the importance of educational activities observed in this study, the process of training and joint planning of activities among the school staff and health professionals would appear to be important.

Avaliação das ações de educação na saúde bucal de adolescentes dentro da Estratégia de Saúde da Família / Assessment of educational actions on the oral health of adolescents within the Family Health Strategy

OBJETIVO: avaliar as ações de educação na saúde bucal de adolescentes dentro da Estratégia de Saúde da Família. METODOLOGIA: foi aplicado um questionário e realizado exame clínico avaliando biofilme e inflamação gengival em 80 adolescentes antes e depois das intervenções. Um estudo qualitativo da técnica de escovação também foi realizado em 15 adolescentes pertencentes à amostra. RESULTADOS: observou-se melhora na higiene oral dos que participaram das ações na escola, aumento no número daqueles que apresentaram gengiva saudável ou inflamação leve no segundo exame nos grupos escola e visita domiciliar. Com relação ao consumo de doces, o grupo semanal e da escola apresentou diminuição entre o 1º e o 2º exames. Houve um aumento na frequência de escovação no grupo escola. CONCLUSÃO: diante da importância das ações educativas verificadas neste estudo, parece-nos importante o processo de capacitação e o planejamento conjunto das ações entre os profissionais da escola e os profissionais de saúde.

OBJECTIVE: to evaluate the actions of education on the oral health of adolescents within the scope of the Family Health Strategy. METHODOLOGY: A questionnaire was applied and a clinical exam conducted evaluating biofilm and gingival inflammation in 80 adolescents before and after interventions. A qualitative study of the brushing technique was also performed on 15 adolescents in the sample. RESULTS: there was an improvement in oral hygiene of adolescents who participated in actions at school and an increase in the number of adolescents who had healthy gums or only mild inflammation in the second test in school groups and home visits. With respect to the consumption of candies, both the weekly group and the school group saw a decrease in candy consumption between the first and second tests. There was an increased frequency of brushing in the school group. CONCLUSION: considering the importance of educational activities observed in this study, the process of training and joint planning of activities among the school staff and health professionals would appear to be important.

Correlation between light transmission and permeability of human dentin.

The influence of dentin permeability on transdentinal LED light propagation should be evaluated since this kind of phototherapy may further be clinically used to stimulate the metabolism of pulp cells, improving the healing of damaged pulps. This study evaluated the influence of the dentin permeability on the transdentinal LED light (630 nm) transmission. Forty-five 0.5-mm-thick dentin disks were prepared from the coronal dentin of extracted sound human molars. An initial measurement of transdentinal LED light transmission was carried out by illuminating the discs in the occlusal-to-pulpal direction onto a light power sensor to determine light attenuation. The discs were treated with EDTA for smear layer removal, subjected to analysis of hydraulic conductance, and a new measurement of transdentinal LED light transmission was taken. Spearman's correlation coefficient was used for analysis of data and showed a weak correlation between dentin permeability and light attenuation (coefficient = 0.19). This result indicates that higher or lower dentin permeability does not reflect the transdentinal propagation of LED light. Significantly greater transdentinal propagation of light was observed after treatment of dentin surface with EDTA (Wilcoxon test, p < 0.05). According to the experimental conditions of this in vitro study, it may be concluded that dentin permeability does not interfere in the transdentinal LED light transmission, and that smear layer removal facilitates this propagation.

Efeito transdentinário do LED em diferentes comprimentos de onda sobre células odontoblastóides / Transdentinal effect of LED irradiation in different wavelengths on odontoblast-like cells

Pesquisas recentes demonstraram que a irradiação transdentinária da polpa pode resultar em aumento na síntese de matriz de dentina e redução na resposta inflamatória local. Entretanto, os mecanismos que regem estes processos permanecem desconhecidos. Assim, o objetivo desta pesquisa foi investigar o efeito transdentinário do LED, em três comprimentos de onda (CO: 455nm, 630nm e 850nm) e duas doses de energia (DE: 4J/cm2 e 25 J/cm2), sobre células odontoblastóides MDPC-23 cultivadas em discos de dentina (molares humanos) com 0,2 mm de espessura. Foram realizadas análises do metabolismo celular (SDH), proteína total (PT) e fosfatase alcalina (ALP), através dos ensaios de MTT, Read Northcote e Ponto Final, respectivamente. O ensaio de RT-PCR foi aplicado para avaliação da expressão dos genes que codificam para colágeno tipo I (Col-1), fibronectina (FN) e fosfatase alcalina (ALP). Além disso, foi realizada a análise da morfologia celular em Microscopia Eletrônica de Varredura (MEV). Para a produção de PT, os resultados não apontaram diferença estatisticamente significante entre os grupos irradiados e controle (Mann-Whitney, p>0,05). Entretanto, para o metabolismo celular, o grupo irradiado com LED no CO de 630 nm, na DE de 25 J/cm2, obteve melhores resultados (aumento de 21,8 %), com diferença significante quando comparado ao grupo controle (Mann-Whitney, p<0,05). Para a produção de fosfatase alcalina, houve aumento significante pra todos os parâmetros utilizados (Mann-Whitney, p<0,05), com exceção da luz azul na dose de 4 J/cm2 (Mann-Whitney, p>0,05). Na análise por RT-PCR, houve maior expressão de Col-1 para o LED infravermelho na dose de 4 J/cm2. Um maior número de células MDPC-23 com morfologia normal aderidas aos discos de dentina, semelhante ao grupo controle, foi observado após irradiação com 25 J/cm2 , quando comparado 4 J/cm2 , para todos os comprimentos de onda avaliados. De acordo com a metodologia empregada na presente pesquisa, foi possível concluir que a irradiação com LED proporcionou bioestimulaçao celular transdentinária, sendo que a resposta celular foi dose e comprimento de onda-dependente

Several studies have demonstrated that the transdentinal irradiation of dental pulp may increase the dentin matrix synthesis as well as decrease the local inflammatory reaction. However, the mechanisms that regulate these processes remain unknown. Therefore, the objective of this in vitro study was to investigate the transdentinal effect of LED irradiation at three different wavelengths (λ= 455, 630 and 850 nm) and two doses (4J/cm2 and 25 J/cm2) on odontoblast-like cells seeded on 0.2-mm-thick dentin disks obtained from sound human molars. Cell metabolism (MTT), alkaline phosphatase expression (ALP), total protein synthesis, and cell morphology (MEV) were evaluated. The expression of genes that encode for collagen type-1 (Col-1), fibronectin (FN) and alkaline phosphatase (ALP) was analyzed by RT-PCR. For total protein synthesis, the results showed no statistical difference among irradiated and control groups (Mann-Whitney test, p>0.05). However, for cellular metabolism, the group irradiated with 630 nm LED (dose of 25 J/cm2) showed better results (21,8% increase), with significant difference when compared to control group (Mann-Whitney test, p<0.05). For alkaline phosphatase activity, a significantly increase was observed for all parameters (Mann-Whitney test, p<0.05), except for the blue light at a dose of 4 J/cm2 (Mann-Whitney test, p>0.05). RT-PCR showed a higher expression of Col- 1 for the infrared LED at a dose of 4 J/cm2. A larger number of MDPC-23 cells with normal morphology adhered to the dentin discs was observed after irradiation with 25 J/cm2 when compared to 4 J/cm2, for all wavelengths evaluated. It may be concluded that LED irradiation was effective for transdentinal cell biostimulation and the cellular response was dose and wavelength-dependent.