The effect of glutathione on 2-hydroxyethylmethacrylate cytotoxicity and on resin-dentine bond strength.

AIM: To evaluate the influence of reduced glutathione (GSH) application on 2-hydroxyethylmethacrylate (HEMA) cytotoxicity on rat pulpal cells and evaluate the effect of etched-dentine treatment with GSH on the immediate microtensile bond strength (µTBS) of etch-and-rinse adhesive. METHODOLOGY: The cytotoxicity of 10 mmol L(-1) HEMA, 10 mmol L(-1) HEMA + 1 mmol L(-1) GSH, 10 mmol L(-1) HEMA + 5 mmol L(-1) GSH and 10 mmol L(-1) HEMA + 10 mmol L(-1) GSH was compared (6 h and 24 h). Cells viability was measured by means of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, followed by morphological observation of cells. Etched-dentine surfaces were rinsed and treated with one of the following solutions: 2% GSH, 5% GSH or 10% GSH, bonded with Adper Single Bond Plus (3M, ESPE, St. Paul, MN, USA) and restored with resin composite. The control group received no GSH treatment. After 1 day of water-storage at 37 °C, the specimens were subjected to µTBS testing. Cytotoxicity and µTBS data were analysed by one-way anova and Tukey post hoc tests (P < 0.05). RESULTS: There were significant differences between the groups. HEMA elicited a remarkable toxic effect. 10 mmol L(-1) GSH prevented HEMA-induced damage at both exposure times. Whilst 5 mmol L(-1) GSH lost its protective effect at 24-h exposure time and 1 mmol L(-1) GSH showed no protective effect at both exposure times, GSH had no significant effect on the immediate µTBS; however, 5% GSH had higher bond strength value when compared to 10% GSH (P = 0.003). CONCLUSION: Controlled concentrations of GSH had a protective effect against HEMA cytotoxicity. GSH had neither positive nor negative influence on µTBS.

Effect of Bleaching Treatments on the Mechanical Properties of the Dentin Matrix and on Collagen Biodegradation by Endogenous Protease.

This study evaluated the mechanical properties of demineralized dentin matrix submitted to different bleaching treatments, as well as the changes in mass and collagen biodegradation brought about by endogenous protease. Dentin collagen matrices were prepared to receive the following treatments (n=12): no bleaching treatment (C-control), 10% carbamide peroxide (CP-Opalescence PF, Ultradent, South Jordan, UT, USA) 10%/8 hours/ day/14 days, and 40% hydrogen peroxide (HP-Opalescence Boost, Ultradent), 40 minutes per session/3 sessions. The dentin matrices were evaluated for elastic modulus and mass before and after treatments and ultimate tensile strength after treatments. The solution collected during storage was evaluated for hydroxyproline release. There was no statistically significant difference between CP and C in terms of the elastic modulus (p=0.3697) or mass variation (p=0.1333). Dentin beams treated with HP and C presented significant mass loss after the first session (p=0.0003). HP treatment led to complete degradation of collagen matrices after the second bleaching session. After the second session, CP showed higher hydroxyproline concentration than C (p<0.0001). Ultimate tensile strength was lower for CP than C (p=0.0097). CP did not affect the elastic modulus or the dentin collagen matrix mass but did promote hydroxyproline release by endogenous protease and reduce the ultimate tensile strength. HP significantly affected the mechanical properties of dentin and promoted complete degradation of the demineralized dentin collagen matrix.

Effect of Calcium-phosphate Desensitizers on Staining Susceptibility of Acid-eroded Enamel.

OBJECTIVE: To investigate the effect of calcium-phosphate-based desensitizers, Teethmate AP paste (TMAP) and Teethmate Desensitizer (TMD) (Kuraray Noritake Dental, Tokyo, Japan), on the prevention of staining on acid-eroded enamel. METHODS AND MATERIALS: Forty polished enamel samples (4×4×1 mm) from bovine incisors were randomly divided into five groups (n=8). After immersion in 50 mL of 0.5% citric acid (pH 2.5) for 15 minutes to form acid-eroded surfaces, the surfaces were subjected to different treatments with TMAP, TMD, and NaF (0.21% means 950 ppm) for five minutes. Another eroded group was not treated with desensitizer. For the control group, the samples were not eroded or treated. All the samples were stored in artificial saliva (AS) at pH 7.2 for 24 hours at 37°C. The TMAP, TMD, or NaF was reapplied at eight and 16 hours during the 24 hours of storage time. The surface roughness (Sa) was evaluated following ISO 25178 for surface texture using confocal laser scanning microscopy (VK-X 150 series, Keyence, Osaka, Japan) before acid erosion, after acid erosion, and after 24 hours of incubation in AS. Afterward, the color difference was measured with a dental colorimeter (Shade Eye NCC, Shofu, Kyoto, Japan) before and after staining with tea solution. RESULTS: One-way repeated measures analysis of variance showed that acid erosion significantly increased Sa (p<0.001). TMAP- and TMD-treated groups exhibited lower Sa values than the NaF group and the no-desensitizer treatment group. The greatest staining was observed in the NaF group and the no-desensitizer group, while the TMAP and TMD groups significantly decreased the formation of stains. CONCLUSIONS: Acid-eroded enamel increased surface roughness and tended to absorb more stains. However, the application of TMAP and TMD moderated the roughness and thus prevented the formation of extrinsic stains.

Ethanol inhibits CCK-induced enzyme secretion by affecting calcium-pump activity in isolated rat pancreatic acini.

The aim of this study was to clarify the effect of ethanol on stimulus-secretion coupling in pancreatic exocrine secretion. We investigated the effects of 600 mM ethanol on cholecystokinin octapeptide (CCK-8)-stimulated amylase release, cytosolic free Ca2+ concentration ([Ca2+]i) and Ca2+ fluxes using in vitro isolated rat pancreatic acini. Ethanol, given alone, stimulated both the initial and the sustained phases of amylase release. On the other hand, ethanol inhibited only the sustained phase of amylase release stimulated by CCK-8. Ethanol also inhibited amylase release in response to fluoride, a direct activator of guanine nucleotide-binding protein, suggesting that ethanol affects intracellular signal transduction molecules. Ethanol had no influences on the initial rise but increased the sustained rise in [Ca2+]i stimulated by CCK-8 and inhibited CCK-8-stimulated Ca2+ outflux without affecting Ca2+ influx. 8-Bromoguanosine 3':5'-cyclic monophosphate, a membrane-permeable analogue of cGMP regulating membrane Ca(2+)-pump activity in various cells, completely reversed the ethanol-induced inhibition of amylase release and Ca2+ outflux in response to CCK-8 as well as fluoride. Given that Ca2+ plays a critical role in stimulus-secretion coupling in pancreatic exocrine secretion, our results indicate that 600 mM ethanol inhibits CCK-8-stimulated amylase release by inhibiting Ca(2+)-pump activity on the plasma membrane.

Comparison between Er:YAG laser and conventional technique for root caries treatment in vitro.

Effective ablation of dental hard tissues by means of the erbium-doped:yttrium-aluminum garnet (Er:YAG) laser has been reported recently, and its application to caries removal and cavity preparation has been expected. However, few studies have investigated the capability of the Er:YAG laser to treat caries. In the present study, the effectiveness of caries removal by using an Er:YAG laser in vitro was compared with that of conventional mechanical treatment. Thirty-one extracted human teeth with root caries were used. Half of the caries in each tooth was treated with the Er:YAG laser, and the other was removed with a conventional bur or was left untreated as a control. Laser treatment was performed by means of a combination of contact and non-contact irradiation modes with cooling water spray, with a new fiber delivery and contact probe system. Conventional bur treatment was conducted by means of a low-speed micromotor. Measurements of the time required for caries removal, histopathological observations of decalcified serial sections, scanning electron microscope (SEM) observations, and hardness measurements of the treated cavity-floor dentin were performed for each treatment. Due to the careful irradiation technique, a longer treatment time was required for the complete removal of carious dentin by the Er:YAG laser. However, the Er:YAG laser ablated carious dentin effectively with minimal thermal damage to the surrounding intact dentin, and removed infected and softened carious dentin to the same degree as the bur treatment. In addition, a lower degree of vibration was noted with the Er:YAG laser treatment. The SEM examination revealed characteristic micro-irregularities of the lased dentin surface. Our results show that the Er:YAG laser system is promising as a new technical modality for caries treatment.

Focal therapeutic efficacy of transcatheter arterial infusion of styrene maleic acid neocarzinostatin for hepatocellular carcinoma.

We evaluated the focal therapeutic effect of oily carcinostatic agents administered by transcatheter arterial infusion (TAI) as the initial therapy in patients with hepatocellular carcinoma in a randomized controlled clinical trial. Group A (19 patients) received 4 mg of styrene maleic acid neocarzinostatin in 4 ml of Lipiodol, and group B (18 patients) received 100 mg of epirubicin in 4 ml of Lipiodol via the tumor feeding arteries as peripherally as possible. The grade of Lipiodol accumulation and the tumor regression rate were determined 2 weeks after TAI by computerized tomography. Adverse effects within 2 weeks after TAI were evaluated by subjective signs and symptoms such as fever (maximum body temperature) and the frequency of shaking chills and abdominal pain, and by biochemical parameters such as albumin, prothrombin time, and aspartate and alanine aminotransferases. Lipiodol accumulation in the tumor was significantly greater in group A (12/19; 63.2% showing grade IV Lipiodol accumulation) than in group B (3/18; 16.7% showing grade IV) (P<0.05). The tumor regression rate was also significantly greater in group A (8/17; 47.1% showing more than 25% tumor regression) than in group B (1/13; 7.7% showing more than 25% tumor regression) (P<0.05). Although clinically significant elevations of aminotransferases and reductions of cholinesterase, and shaking chills were observed more often in group A than in group B (P<0.0001), these factors had little influence on the clinical outcome. Our results suggest that styrene maleic acid neocarzinostatin in Lipiodol exerts a more favorable focal therapeutic effect than does epirubicin in Lipiodol in the initial treatment of hepatocellular carcinoma.

Multiple hepatic infarction after transcatheter arterial infusion with SMANCS.

We report a patient with hepatocellular carcinoma who developed multiple hepatic infarction after transcatheter arterial infusion (TAI) with a suspension of styrene maleic acid neocarzinostatin (SMANCS) and Lipiodol (SMANCS/Lipiodol). The parameters of hepatic functional reserve were apparently decreased after the second TAI with SMANCS/Lipiodol, and the patient died of hepatic failure 103 days after the second TAI. The autopsy liver specimen revealed multiple hepatic infarctions associated with peripheral arterial stenosis or occlusion, and portal thrombosis. It is speculated that both the arterial occlusion and the portal thrombosis caused the hepatic infarction, based on a long-term insufficiency of blood supply to the hepatocytes arising from toxic arteritis caused by SMANCS/Lipiodol.

Effect of alpha-glucosidase inhibitor on human pancreatic and salivary alpha-amylase.

The mode of inhibition of a new complex oligosaccharide that inhibits the alpha-glucoside hydrolase activity of pancreatic and salivary alpha-amylase was studied. Kinetic analysis revealed a non-competitive type of inhibition with a Ki of 1.47 +/- 0.03 micrograms when tested against human pancreatic alpha-amylase and 3.89 +/- 0.08 micrograms against human salivary alpha-amylase. The inhibitory action of alpha-glucoside hydrolase inhibitor (alpha-GHI) on pancreatic amylase was observed over a wide range of pH (6.0--7.9), whereas the inhibition of salivary amylase was optimal at pH 6.5. Column chromatographic investigations suggested the possible formation of an enzyme-inhibitor complex because the mixture of alpha-GHI and pancreatic alpha-amylase was eluted as a single component through a Sephadex G200 column. However, this enzyme-inhibitor complex was easily separated into each component and the enzyme activity was fully recovered after electrophoresis.

Monkey pulpal response and microtensile bond strength beneath a one-application resin bonding system in vivo.

OBJECTIVES: The aim of this in vivo study was to investigate the biocompatibility and microtensile bond strength of a one-application resin bonding system. METHODS: Class V cavities were prepared on the facial surfaces of 36 intact monkey teeth, and the cavities were restored with an experimental one-application resin bonding system (TOF-1; Tokuyama Corp., Tokuyama, Japan) and a hybrid resin composite (PALFIQUE ESTELITE; Tokuyama Corp., Tokuyama, Japan). Histopathological changes of the restored teeth were evaluated at 3, 30 and 90 days after operation (N = 10). Microtensile bond tests were performed at 3 and 90 days after operation (N = 10). RESULTS: Only two of 30 pulps showed a slight inflammatory cell infiltration. There were no statistically significant differences in the incidence of slight inflammatory cell infiltration among time periods. Bacterial penetration along the cavity walls could not be detected in any specimen. The mean microtensile bond strength at 3 days after operation was 20.6 MPa, and that at 90 days was 14.9 MPa. Differences in bond strengths between the 3 day specimen and the 90 day specimen were statistically significant (p < 0.05). CONCLUSIONS: The one-application resin bonding system exhibited acceptable biologic compatibility to the monkey pulp. Although there were statistically significant differences in bond strengths between the 3 day specimen and the 90 day specimen, this material provided a hermetic seal, eliminating bacterial microleakage.

Pulpal response to a new light-cured composite placed in etched glass-ionomer lined cavities.

This study evaluated the pulp biocompatability of a new light-cured composite resin which was placed in etched glass-ionomer-lined cavities of monkey teeth. The pulpal response to this material was less than that to zinc-oxide eugenol cement in each observation period. Therefore this material seems to meet acceptable biocompatability standards in nonhuman primates.

Short-term reaction of exposed monkey pulp beneath adhesive resins.

Monkey pulpal responses to four adhesive resin systems used as direct pulp capping agents were histopathologically evaluated at 3, 7, 14, 30, and 60 days after operation. No serious inflammatory reaction of the pulp, such as necrosis or abscess formation, was observed. Slight inflammatory cell infiltration was the main inflammatory reaction of the exposed pulp, and the exposed area became occluded with dentin bridging as the observation period increased. Healing of exposed dental pulp beneath adhesive resin capping slightly differed depending on the materials used.

Monkey pulpal response to adhesively luted indirect resin composite inlays.

Monkey pulpal responses to resin-bonded indirect resin composite inlays were histopathologically evaluated by placing them in either etched-enamel, total-etched, or adhesive-resin-lined cavities. Initial pulpal responses caused by re-exposure of the cut dentin surfaces and luting procedure subsided if a tight marginal seal was secured by final cementation of the inlay. The adhesive resin coating of freshly cut dentinal walls/floors seems to provide a new technique to protect the dentin and pulp in indirect restorations requiring temporary sealing.

Monkey pulpal responses to conventional and adhesive luting cements.

Monkey pulpal responses to metal inlays luted with a combination of an adhesive resin and luting composite and conventional dental cements were histopathologically evaluated. Initial pulpal responses caused by re-exposure of the cut dentin surfaces and luting procedure under hydraulic pressure subsided at 90 days after final cementation. There was no significant difference among pulpal reactions to conventional dental cements and a combination of an adhesive resin and luting composite. The adhesive resin coating of freshly cut dentinal walls/floors immediately after cavity preparation seems to provide protection for the dentin and pulp in indirect restorations requiring temporary sealing.

Biocompatibility of primer, adhesive and resin composite systems on non-exposed and exposed pulps of non-human primate teeth.

PURPOSE: To evaluate the histologic response of 332 non-exposed and 127 exposed monkey pulps applying nine adhesive systems. MATERIALS AND METHODS: Class V and Class I cavities were used in non-exposed and exposed monkey pulps at the three ISO usage time intervals. RESULTS: There were no histologic differences in pulp responses among the nine adhesive systems used in either Class V and/or Class I cavities when compared to pulp responses of Ca(OH)2 controls at the ISO time intervals. The nine adhesive systems and resin composites are non-toxic to either non-exposed or exposed pulps, being biologically compatible to pulp tissues when placed on mechanical pulp exposures following hemorrhage control with a 2.5% NaOCl and per manufacturers' directions. It is imperative that clinicians understand the biological importance of hemorrhage control as well as the technique sensitivity of hydrophilic primers in order to optimize the efficacy of adhesives for clinical success against microleakage of bacterial factors.

The effects on pulp tissue of microleakage in resin composite restorations.

The purpose of this study was to evaluate histopathologically the effect on pulp tissue of microleakage in resin composite restorations. Seventy-two class V cavities were prepared on buccal surfaces of monkeys and divided into 3 groups, F, O, and S. Every cavity was etched with 37% phosphoric acid. In group F cavities, each cavity was restored with photo-curable composite without any dentin adhesives. In group O, the cavities were left unfilled. In group S, each cavity was treated with a dentin adhesive system and restored with a restorative composite. After 3, 30, or 90 days, animals were sacrificed and the subjected teeth were immediately removed, then fixed and decalcified. Following sectioning and staining with hematoxylin and eosin or Taylor's modified bacteria staining, each sample was examined with a light microscope. In most teeth with group S cavities, bacterial invasion was not found indicating excellent marginal sealing. The pulpal reaction was much less than that in other groups. In group F as well as in group O, bacteria were frequently observed in the cavity; however, bacteria penetrated into dentinal tubules more in group F than in group O at 30 and 90 days. A correlation between the presence of bacteria and pulpal inflammation was strongly indicated. It was suggested that a leaky restoration was more harmful to the pulp than an open prepared cavity without restoration.

Biocompatibility of Clearfil Liner Bond 2 and Clearfil AP-X system on nonexposed and exposed primate teeth.

OBJECTIVE: Recent studies have demonstrated that acid etching of vital dentin and pulpal tissue does not retard pulpal healing, odontoblastoid cell differentiation, or dentinal bridge formation when the pulp is capped with adhesive resins. The purpose of this study was to evaluate the pulpal response in nonexposed and exposed monkey pulps to treatment with the Clearfil Liner Bond 2 and Clearfil AP-X system. METHOD AND MATERIALS: Class V and Class I cavities in nonexposed and exposed pulps were observed at 7 or 8, 27, and 97 days. RESULTS: There were no differences in pulpal inflammation between the Clearfil Liner Bond 2/Clearfil AP-X specimens and calcium hydroxide controls in either Class V or Class I cavities at the various time periods. CONCLUSION: Clearfil Liner Bond 2 and Clearfil AP-X system is not toxic to either nonexposed or exposed pulpal tissues when placed according to manufacturer's directions.

Short- and long-term results of endoscopic variceal ligation for esophageal varices compared with injection sclerotherapy.

We assessed the efficacy and safety of endoscopic therapy for esophageal varices in Japanese patients comparing the results of ligation therapy performed in 101 patients with those of sclerotherapy with paravariceal injection of polidocanol in 40 patients. Both therapies were effective in controlling active hemorrhages. Hemostasis rates at the first endoscopic session were 100% in both groups and rebleeding rates were 40.0% in the sclerotherapy and 29.6% in the ligation group. Variceal eradication was achieved equally in both groups in approximately 90% of the patients. However, the ligation achieved eradication more quickly in fewer endoscopic sessions than did the sclerotherapy (mean; 2.1 vs. 3.7 sessions, P < 0.01). Complications such as rebleeding and intramural hematomas were less common in the ligation group. These results indicate some advantages of the ligation over the sclerotherapy. A disadvantage of the ligation therapy is that recurrence occurs more quickly than in the sclerotherapy, although the difference was not statistically significant.

[Interchangeability of resin composites and bonding agents based on bis-GMA or UDMA].

Recently, dentin bonding systems have been released separately from the resin composites, because the adhesive systems have been quickly improved. Since the merit of each material should be effectively utilized for each clinical case, the bonding systems and resin composites produced by different manufacturers may be combined according to the clinical purpose. The current restorative resins are basically categorized into two groups according to the main resin monomer, bis-GMA or UDMA resins. The purpose of this study was to evaluate the interchangeability between the bonding systems and resin composites, which were made by different manufacturers. Two bonding systems and five resin composites based on bis-GMA or UDMA were used in this study. The evaluation was performed by the tensile bond strength, fracture modes, and SEM observation, using the dentin surface of freshly-extracted bovine teeth. The highest bond strength (19.2 MPa) was shown by the combination of LBII sigma and AP-X. The bond strengths of nine other combinations were not statistically different (p > 0.05). There were many cohesive failures in dentin or resin composite, using all combinations. From the results, it was concluded that the interchangeability of the resin composites and bonding systems should be clinically acceptable.

Biological basis for clinical success: pulp protection and the tooth-restoration interface.

This article provides biological and technological information that strengthens clinicians' understanding of cohesive hybridization and pulp therapy in order to support their routine use of bonding and resin systems. Utilizing cohesive systems, clinicians should experience several advantages over traditional water-soluble base and liner systems. When properly applied, cohesive hybridization of vital dentin prevents immediate postoperative hypersensitivity under all restorations and completely seals the entire tooth-restoration interface, which provides a reduction in recurrent caries.

Evaluation of new treatment for incipient enamel demineralization using 45S5 bioglass.

Bioglass 45S5 is a silica-based bioactive glass capable of depositing a layer of hydroxyl carbonate apatite on the surface of the glass when immersed in body fluids. The present paper studies a new technique for treating early human dental enamel caries lesions by using a paste composed of 45S5 bioglass and phosphoric acid. Artificial caries lesions were induced in enamel flat surfaces by means of a decalcification solution. All specimens were exposed to a brushing-abrasion challenge to test the durability of any newly formed layer resulting from the application of 45S5 bioglass paste. The specimens treated with bioglass paste showed complete coverage with a layer of brushite crystals. The brushing-abrasion challenge did not statistically affect the percentage of enamel coverage with the crystalline layer formed by the application of bioglass (p<0.05). These crystals were converted to hydroxyapatite crystals when stored in artificial saliva for 14 days. The current technique suggests the possibility of restoring incipient enamel erosive lesion with an abrasion durable layer of hydroxyapatite crystals.