Influence of different thickeners in at-home tooth bleaching: a randomized clinical trial study.

OBJECTIVES: To evaluate the effects of 10% carbamide peroxide (CP) with two different thickeners, carbopol (CPc) and natrosol (CPn), on color variation (CV), tooth sensitivity (TS), and cytotoxicity (CC). METHODS: Seventy subjects were distributed into the CPc or CPn groups (n = 35), in a parallel group, randomized, controlled, single-blind clinical trial. Bleaching gels were used by volunteers for 4 h daily for 2 weeks. Color evaluation was performed using a reflectance spectrophotometer, before bleaching treatment (BT), immediately after the first and second weeks of BT, and 1 week and 1 month after BT ended. TS was evaluated using two pain scales, before, during, and after BT. CC was evaluated using MTT after exposure of MDPC-23 cells to the bleaching gels for 4 h. Epoxy replicas of the subjects teeth were made before and after BT and analyzed using a scanning electronic microscope. The data was analyzed using statistical methods. RESULTS: CV and TS showed similar variation between both bleaching gels (p ≤ 0.05). None of the protocols affected cellular metabolism or the surface morphology of enamel. CONCLUSIONS: Bleaching gels with carbopol and natrosol as thickening agents produced similarly effective tooth bleaching and TS, but did not cause cytotoxicity. CLINICAL RELEVANCE: Natrosol could be an alternative as a thickener used in bleaching gels due to its similar bleaching effect and TS when compared with Carbopol.

Calcium-Polyphosphate Submicroparticles (CaPP) Improvement Effect of the Experimental Bleaching Gels' Chemical and Cellular-Viability Properties.

The aim of this research was to develop and characterize the chemical and cellular-viability properties of an experimental high-concentration bleaching gel (35 wt%-H2O2) containing calcium-polyphosphate particles (CaPP) at two concentrations (0.5 wt% and 1.5 wt%). The CaPP submicroparticles were synthesized by coprecipitation, keeping a Ca:P ratio of 2:1. The CaPP morphology, size, and chemical and crystal profiles were characterized through scanning and transmission electron microscopy, energy-dispersive X-ray analysis, and X-ray diffraction, respectively. The assessed bleaching gels were experimental (without CaPP); 0.5% CaPP; 1.5% CaPP; and commercial. The gels' pH values and H2O2 concentrations (iodometric titration) were determined. The odontoblast-like cell viability after a gel's exposure was assessed by the MTT assay. The pH and H2O2 concentration were compared through a repeated-measures analysis of variance (ANOVA) and a Tukey's test and the cell viability through a one-way ANOVA and a Tukey's test using a GraphPad Prism (α < 0.05). The CaPP particles were spherical (with Ca and P, 135.7 ± 80.95 nm size) and amorphous. The H2O2 concentration decreased in all groups after mixing (p < 0.001). The 0.5% CaPP resulted in more-stable pH levels and higher viability levels than the experimental one (p < 0.05). The successful incorporation of CaPP had a positive impact on the bleaching gel's chemical and cellular-viability properties when compared to the experimental gel without these particles.

Effect of Different Bleaching Gels Thickeners on Cytotoxicity to Human Gingival Fibroblasts and Enamel Physical Properties: an in Situ Study.

Objective: This study evaluated in vitro, the effects of carbamide peroxide 10% (CP) associated with Carbopol® (CP-ct) and Aristoflex® (CP-at) thickeners on human gingival fibroblasts (HGF) cytotoxicity and assessed in situ their effects on dental enamel. Material and methods: The cytotoxicity was analyzed using MTT - Vybrant® proliferation test. For in situ stage, 144 bovine enamel/dentin blocks were randomized into seven groups (n=12). Samples were stained, fixed in intraoral palatal devices and bleached for 4 h, during 14 days, with: Carbopol thickener (ct), Aristoflex thickener (at), CP-ct, CP-at, CP without thickener (CP-wot), Commercial CP (CP-com). The samples had their microhardness (SMH), roughness (Ra) and color analyzed using a microdurometer, a rugosimeter and a spectrophotometer, respectively. The analyses were performed at baseline and 24-h after completion of tooth bleaching. Results: Different thickeners were similar regarding their cytotoxicity. The experimental gels with Carbopol exhibited lower SMH values, while the groups treated with CP exhibited higher Ra values. For the color change results, the groups treated with CP had values above the acceptability and perceptibility limits. Conclusion: CP-at was able to promote an effective bleaching with less alterations of the tooth surface compared to the CP-ct. Hence, Aristoflex stands as a promising thickener in conjunction with CP in order to preserve the physical properties of dental enamel after home bleaching.

Electrospun Nanofibrous Architectures of Thrombin-Loaded Poly(ethylene oxide) for Faster in Vivo Wound Clotting.

Wound healing materials to prevent blood loss are crucial during emergency medical treatment because uncontrolled bleeding can lead to patient death. Herein, bioabsorbable fibrous architectures of thrombin-loaded poly(ethylene oxide)-PEO/thrombin-are conceptualized and accomplished via electrospinning for faster wound clotting. Membranes with average fiber diameters ranging from 188 to 264 nm are achieved, where the active thrombin is entrapped within the nanofibers. The results of in vitro and in vivo wound healing activity tests revealed that when the nanofibers with thrombin-loaded capacity are in contact with the wound, the presence of water in the skin or blood catalyzes the degradation of the membranes, thus releasing thrombin. Thrombin then accelerates the wound clotting process. In contrast to other hemostatic materials, PEO/thrombin nanofibers do not require mechanical removal after application, and the viscoelastic nature of such biomaterials enables their conformation to a variety of wound topographies. Remarkably, PEO/thrombin membranes are promising functional materials and their use is a powerful strategy for hemostatic treatment, ranging from simple first aid and sealing to a wound to small surgical procedures.

Physicochemical characterization and cytotoxicity of articaine-2-hydroxypropyl-ß-cyclodextrin inclusion complex.

Articaine (ATC) is one of the most widely used local anesthetics in dentistry. Despite its safety, local toxicity has been reported. This study aimed to develop an ATC-2- hydroxypropyl-ß-cyclodextrin inclusion complex (ATC HPßCD) and to assess its toxicity in vitro. The inclusion complex was performed by solubilization, followed by a fluorimetric and job plot assay to determine the complex stoichiometry. Scanning electron microscopy, DOSY- 1 H-NMR, differential scanning calorimetry (DSC), and sustained release kinetics were used to confirm the inclusion complex formation. In vitro cytotoxicity was analyzed by MTT assay and immunofluorescence in HGF cells. Fluorimetric and job plot assay determined the inclusion complex stoichiometry (ATC:HPßCD = 1:1) and complex formation time (400 min), as indicated by a strong host/guest interaction (Ka = 117.8 M - 1), complexed fraction (f = 41.4%), and different ATC and ATC HPßCD melting points (172 °C e 235 °C, respectively). The mean of cell viability was 31.87% and 63.17% for 20-mM ATC and 20-mM ATC HPßCD, respectively. Moreover, remarkable cell toxicity was observed with free ATC by immunofluorescence. These results indicate the ATC HPßCD complex could be used to improve the safety of ATC. Further research are needed to establish the anesthetic safety and effectiveness in vivo .

The effect of two drug delivery systems in ropivacaine cytotoxicity and cytokine release by human keratinocytes and fibroblasts.

OBJECTIVES: Modified drug delivery systems have been developed to improve pharmacological properties of local anaesthetics. However, the inflammatory potential of these formulations was not investigated. This study compared the in-vitro effects of ropivacaine (ropi) in plain, liposomal (MLV) or 2-hydroxypropyl-ß-cyclodextrin (HP-ß-CD) formulations on cell viability, apoptosis and cytokine (IL-1α, TNF-α, IL-6 and IL-10) release. METHODS: Human immortalized keratinocytes (HaCaT) and human immortalized gingival fibroblasts (HGF) were exposed to 1-100 µm ropi concentrations. The cell viability was measured by XTT and LIVE/DEAD assay. Apoptosis was performed by flow cytometry, and cytokine release was measured by ELISA assay. KEY FINDINGS: Human immortalized keratinocyte viability was reduced by ropi and both drug delivery systems. However, none of the formulations induced apoptosis. Results showed a differential regulation of IL-1α TNF-α, IL-6 and IL-10 by HaCaT and HGF. Ropi-HP-ß-CD increased twofold the IL-6 release by HGF in comparison with the control, while 100 µm ropi-MLV led to an increased release of all pro-inflammatory cytokines by HGF. CONCLUSION: The loss in cell viability was not related to cellular apoptosis. Ropi complexed with HP-ß-CD showed a similar cytokine release pattern when compared to the plain formulation. Thus, the HP-ß-CD form was a better drug carrier than the MLV form for ropivacaine drug delivery.