Biomaterials for orthopedics: anti-biofilm activity of a new bioactive glass coating on titanium implants.

This study evaluated adhesion and biofilm formation by Candida albicans, Pseudomonas aeruginosa and Staphylococcus epidermidis on surfaces of titanium (Ti) and titanium coated with F18 Bioactive Glass (BGF18). Biofilms were grown and the areas coated with biofilm were determined after 2, 4 and 8 h. Microscopy techniques were applied in order to visualize the structure of the mature biofilm and the extracellular matrix. On the BGF18 specimens, there was less biofilm formation by C. albicans and S. epidermidis after incubation for 8 h. For P. aeruginosa biofilm, a reduction was observed after incubation for 4 h, and it remained reduced after 8 h on BGF18 specimens. All biofilm matrices seemed to be thicker on BGF18 surface than on titanium surfaces. BGF18 showed significant anti-biofilm activity in comparison with Ti in the initial periods of biofilm formation; however, there was extensive biofilm after incubation for 48 h.

Preclinical study of a cost-effective photodynamic therapy protocol for treating oral candidoses.

Photodynamic therapy (PDT) is a promising treatment for oral candidoses. Its use as an alternative to antifungals prevents several adverse effects, including microbial resistance. However, most PDT protocols do not employ devices and consumables commonly available in dental practice, thus influencing treatment affordability. This study aimed to determine the efficacy of a PDT method based on light curing units' blue LEDs combined to a plaque-disclosing composition (5% erythrosine) against C. albicans in culture and in a murine model of oral candidosis. Standard and resistant fungal strains were tested in vitro in planktonic and biofilm forms. PDT (pre-irradiation time periods: 30 and 60 s; irradiation time: 3 min) was compared to control conditions without light and/or erythrosine. Mice with induced oral candidosis (n = 40) randomly received PDT or similar control conditions with subsequent C. albicans count. These mice underwent histological analysis, as well as 12 healthy mice submitted to experimental treatments. PDT completely inactivated C. albicans planktonic cells and biofilm. Control conditions presented minor differences (ANOVA, p < 0.05), with mean values ranging from 5.2 to 6.8 log10 (UFC/mL). Infected mice presented no significant difference in C. albicans counts consequent to treatments (ANOVA, p = 0.721), although the PDT protocol was able to enhance the inflammatory infiltrate in healthy mice. It can be concluded that the tested PDT protocol can inactivate C. albicans but still needs further investigation in order to achieve efficacy and safety.

Experimental tooth movement and photobiomodulation on bone remodeling in rats.

Photobiomodulation (PBM) is a therapy induced by a specific type of laser that affects biologic systems through non-thermal ways. The study of its basic mechanism has gained interest since little is known about the causes of the different effects of this treatment. In the present study, we investigated the action of the PBM application rate changes in the peri-implant tissues in rats subjected to tooth movement in different periods. Wistar rats (±250 g) received an apparatus in the region of the central incisors superiors tightly (70 g) or not, and they were also subjected to one or three PBM sessions. After 7 or 14 days, the rats were subjected to euthanasia and the jaws were dissected and processed for histology. For analysis, serial sections were made that were stained by Picrosirius Red for analysis of collagen fibers, Masson's trichrome for newly formed bone scan, and Hematoxylin-Eosin for quantification of osteoblasts. PBM applied in one or three sessions increased the population of osteoblasts. Still, the application of three sessions of PBM increased the density of collagen fibers and new bone formation compared to the controls. An increase was observed in the interincisal distance in irradiated groups with three PBM sessions and the application of force for both 7 or 14 days. These findings suggest that PBM can contribute positively to the orthodontic movement. So the laser therapy can be used as an adjunct procedure to be performed concurrently for orthodontic treatment in the dental clinic.

The effect of simvastatin treatment on bone repair of femoral fracture in animal model.

The aim of this research was to evaluate the fracture healing area in osteoporotic femur of female rats restrained by stainless steel wire by statin administration in two different doses (5 mg and 20 mg). Ninety female rats were divided into six groups (n = 15): SH, SH-5 mg, SH-20 mg, OVX, OVX-5 mg, and OVX-20 mg. The surgery consisted of the fracture of the left femur bone and stabilization by K-wire and the administration was restricted and weekly controlled in the drinking water. The euthanasia was conducted at three different moments, five animals per period: 7 d, 14 d, and 28 d. Densitometry, zymography, and histological analyses showed a significant difference between some groups. According to these findings, simvastatin promoted a positive action for bone repair, especially in the osteometabolic group treated with 20 mg of the drug.

Properties of the tibialis anterior muscle after treatment with laser therapy and natural latex protein following sciatic nerve crush.

INTRODUCTION: In this study we evaluated the characteristics of the tibialis anterior muscle after sciatic nerve crush and treatment with low-level laser therapy (LLLT) or the protein from natural latex (P1). METHODS: We studied the following 6 groups of male Wistar rats: control (CG); exposed nerve (EG); injured nerve (IG); injured nerve with LLLT (LG); injured nerve with P1 (PG); and injured nerve with P1 and LLLT (LPG). RESULTS: After 4 weeks, muscle morphology showed improvement in the treated groups; after 8 weeks, the treated groups resembled controls, especially the PG. Morphometry revealed muscle fiber atrophy after nerve injury, with time-dependent recovery. Histochemical analysis revealed increased intermediate fiber area. The PG was more similar to controls with NADH staining, whereas the LPG more closely resembled controls with SDH staining. CONCLUSION: Treatment using only P1 proved most efficient, revealing a negative interaction between P1 and LLLT.

Herbal mouthwash containing extracts of Baccharis dracunculifolia as agent for the control of biofilm: clinical evaluation in humans.

Baccharis dracunculifolia DC (Asteraceae), popularly known as "alecrim-do-campo," is largely distributed in South America, is shown to exhibit protective actions against gastric ulcers, has anti-inflammatory properties, and is hepatoprotective. Several essential oils obtained from Baccharis species possess biological activities, such as antimicrobial and antivirus activities. This randomized controlled trial evaluated the efficacy of B. dracunculifolia in the reduction of dental biofilm, comparing this natural product with other mouthwashes already known in the dental market. In measuring the time after use of mouthwash (t = 1), there was no difference between products (P = 0.602); that is, subjects in the study had a similar PI after the first use. After one week (t = 2), there was no difference between the four products evaluated (P = 0.674), so, all research individuals completed the study with a similar reduction in dental biofilm between themselves but it was different from initial state (Friedman test). It is possible to conclude that B. dracunculifolia had the same efficiency of the materials used to oral hygiene in reduction of dental plaque and, consequently, prevention of dental caries. Thus, we can consider B. dracunculifolia as a good candidate for new material to be implemented in dental care.

Morphological and morphometric analyses of crushed sciatic nerves after application of a purified protein from natural latex and hyaluronic acid hydrogel.

Hyaluronic acid hydrogels (HAHs) have been used as a carrier of substances and factors in the repair of nervous tissue. Natural latex protein (Hevea brasiliensis, F1) has shown positive effects in treating various types of tissues, including peripheral nerves. This study evaluated the F1 associated with a HAH in a controlled crush injury (axonotmesis) of the sciatic nerve in Wistar rats. The samples were photomicrographed for morphometric and quantitative analyzes using ImageJ 1.47k software (NIH, Bethesda, MD). Morphological, quantitative (myelin area/nerve area ratio and capillary density) and morphometric (minimum nerve fiber diameter, G-Ratio) data revealed an improvement in the recovery of the sciatic nerve with the application of HAH and the combination of HAH and F1 after 4 and 8 weeks of nerve injury. The most efficacious results were observed with the combination of both substances, F1 and HAH, revealing the regenerative capacity of this new biomaterial, which was hardly tested on nerve tissue.

Effect of electromagnetic field on bone regeneration around dental implants after immediate placement in the dog mandible: a pilot study.

BACKGROUND: Accelerating bone healing around dental implants can reduce the long-term period between the insertion of implants and functional rehabilitation. OBJECTIVE: This in vivo study evaluated the effect of a constant electromagnetic field (CEF) on bone healing around dental implants in dogs. MATERIALS AND METHODS: Eight dental implants were placed immediately after extraction of the first pre-molar and molar teeth on the mandible of two male dogs and divided into experimental (CEF) and control groups. A CEF at magnetic intensity of 0.8 mT with a pulse width of 25 µs and frequency of 1.5 MHz was applied on the implants for 20 min per day for 2 weeks. RESULT AND CONCLUSION: After qualitative histological analysis, a small quantity of newly formed bone was observed in the gap between the implant surface and alveolar bone in both groups.

Clinical feasibility of mandibular implant overdenture retainers submitted to immediate load.

INTRODUCTION: Millions of people around the world do not have access to the benefits of osseointegration. Treatments involving oral rehabilitation with overdentures have been widely used by specialists in the oral medicine field. This is an alternative therapy for retention and stability achievement in total prosthesis with conventional treatment, and two implants are enough to establish a satisfactory overdenture. OBJECTIVE: The objectives of the study were to evaluate 16 patients of both sexes, with an average age of 47.4±4 years, using electromyographic analysis of masseter and temporal muscles and analyse the increase of incisive and molar maximal bite force with their existing complete dentures and following mandibular implant overdenture therapy to assess the benefits of this treatment. MATERIALS AND METHODS: For these tests, the Myosystem-BR1 electromyograph and the IDDK Kratos dynamometer were used. Statistical analysis was performed using the repeated measures test (SPSS 17.0). RESULTS: A decrease in electromyographic activity during the rest, lateral and protrusion movements and increase of the maximal incisive and molar bite force after 15months with a mandibular implant overdenture was observed. CONCLUSION: All the patients in this study reported a considerable improvement in the masticatory function and prostheses stability following treatment. It is possible to propose that the use of mandibular implants overdenture should become the selected treatment for totally edentulous patients to facilitate oral function and quality of life.

Evaluation of tissue in repair with natural latex and / or hyaluronic acid in surgical bone defects.

This study evaluated the bone repair in surgical defects of rats treated with hyaluronic acid (HA) associated or not with Hevea brasiliensis fraction protein (F-1). Bone defect were created in 15 albino Wistar rats divided into 3 groups (n=5): Control group (1) - blood clot; HA group (2) - 0.5% hyaluronic acid; HAF1 group (3) - 0.1% F-1 protein fraction dissolved in 0.5% hyaluronic acid. After 4 weeks, the animals were euthanized and the bone repair was evaluated through histomorphometric analysis, zymography and immunohistochemistry. The neoformed bone area did not show a significant difference (p = 0.757), but there was a tendency for bone trabeculation to increase in the groups HA and HAF1. For immunohistochemically analysis, there was a difference in vascular endothelial growth factor (VEGF) labeling (p = 0.023), being higher in the groups HA and HAF1 than the control group. No significant difference in bone sialoprotein (BSP) (p = 0.681), osteocalcin (p = 0.954), however, significant difference in platelet endothelial cell adhesion molecule-1 (CD-31) (p = 0.040), with HAF1 group being significantly lower than the control. For zymographic analysis, there was no significant difference for metalloproteinase-2 (MMP-2) (p = 0.068), but there was a tendency to increase MMP-2 in the HA group. Despite the influence on angiogenic factors and the apparent tendency for greater trabeculation in the HA and HAF1 groups, there was no significant difference in the area of ​​newly formed bone tissue in the analyzed period.

Upregulation of FosB/ΔFosB in limbic circuits after tooth exodontia-induced occlusal instability in an experimental model of unpredictable chronic stress.

Psychological stress and occlusal alterations are contributing etiologic factors for temporomandibular and muscular disorders in the orofacial area. The neural modulation recruited for this relationship, however, is not elucidated. The aim of this study was to investigate potential central mechanisms involved in the exodontia-induced occlusal instability associated with unpredictable chronic stress (UCS). Male adult Wistar rats were submitted to occlusal instability (unilateral molar teeth extraction) and/or to a UCS protocol and treated with diazepam or vehicle. The anxiety-like behavior was evaluated by elevated plus maze (EPM) and open field (OF) tests. Limbic structures such as the central nucleus of the amygdala (CeA), paraventricular nucleus of the hypothalamus (PVN), dorsal periaqueductal gray matter (dPAG) and nucleus accumbens core (NAc) were analyzed for expression of FosB/ΔFosB (immediate early genes) by immunohistochemistry. Exodontia and/or UCS decreased the time spent in the open arms at the EPM and the distance travelled at the OF, and increased the immobility time at the OF, suggesting anxiety-like behavior. In addition, exodontia induction resulted in an upregulation of FosB/ΔFosB in the CeA, PVN and dPAG, while UCS and exodontia + UCS upregulate FosB/ΔFosB immunoreactivity in the CeA, PVN, dPAG and NAc. Treatment with diazepam decreased the expression of FosB/ΔFosB in all analyzed structures of animals subject to UCS and exodontia + UCS, while promoted a reduction in the FosB/ΔFosB expression in the CeA, PVN and dPAG in animals subject to exodontia. Our findings showed an anxiogenic effect of exodontia and UCS, which is correlated with intranuclear neuron activation of limbic structures in a spatially dependent manner and that is prevented by the administration of diazepam.

Effect of recombinant human bone morphogenetic protein-2 on bone formation in the acute distraction osteogenesis of rat mandibles.

BACKGROUND: Distraction osteogenesis (DO) is a method of producing new bone directly from the osteotomy site by gradual traction of the divided bone fragments. AIM: The purpose of the present study was to evaluate histomorphometrically whether acute DO would constitute a viable alternative to the conventional continuous distraction treatment and also to verify the capacity of a recombinant human BMP (rhBMP-2) associated with monoolein gel to stimulate bone formation in the acute distraction process. MATERIALS AND METHODS: Forty-eight Wistar rats were assigned to three groups: Group 1, treated at a conventional continuous distraction rate (0.5 mm/day), Group 2, treated with acute distraction of 2.5 mm at the time of the surgical procedure, and Group 3, subjected to acute distraction associated with rhBMP-2. The animals from each experimental group were killed at the end of the second or fourth post-operative weeks and the volume fraction of newly formed bone trabeculae was estimated in histological images by a differential point-counting method. RESULTS: The results showed that after 2 and 4 weeks, bone volumes in the rhBMP-2 group were significantly higher than in the other groups (P<0.05), but no significant difference was observed in the volume fraction of newly formed bone between the continuous and acute DO groups. CONCLUSION: In conclusion, the study indicates that rhBMP-2 can enhance the bone formation at acute DO, which may potentially reduce the treatment period and complications related to the distraction procedure.

Use of checkerboard DNA-DNA hybridization to evaluate the internal contamination of dental implants and comparison of bacterial leakage with cast or pre-machined abutments.

AIMS: To evaluate the checkerboard DNA-DNA hybridization method for detection and quantitation of bacteria from the internal parts of dental implants and to compare bacterial leakage from implants connected either to cast or to pre-machined abutments. MATERIALS AND METHODS: Nine plastic abutments cast in a Ni-Cr alloy and nine pre-machined Co-Cr alloy abutments with plastic sleeves cast in Ni-Cr were connected to Branemark-compatible implants. A group of nine implants was used as control. The implants were inoculated with 3 microl of a solution containing 10(8) cells/ml of Streptococcus sobrinus. Bacterial samples were immediately collected from the control implants while assemblies were completely immersed in 5 ml of sterile Tripty Soy Broth (TSB) medium. After 14 days of anaerobic incubation, occurrence of leakage at the implant-abutment interface was evaluated by assessing contamination of the TSB medium. Internal contamination of the implants was evaluated with the checkerboard DNA-DNA hybridization method. RESULTS: DNA-DNA hybridization was sensitive enough to detect and quantify the microorganism from the internal parts of the implants. No differences in leakage and in internal contamination were found between cast and pre-machined abutments. Bacterial scores in the control group were significantly higher than in the other groups (P<0.05). CONCLUSION: Bacterial leakage through the implant-abutment interface does not significantly differ when cast or pre-machined abutments are used. The checkerboard DNA-DNA hybridization technique is suitable for the evaluation of the internal contamination of dental implants although further studies are necessary to validate the use of computational methods for the improvement of the test accuracy.

Histological and histochemical effects after occlusion alteration in suprahyoid muscles.

This study verified the effect of unilateral teeth extraction on the suprahyoid muscles in gerbils (Meriones unguiculatus). Ten adult male gerbils weighing about 50g had induced occlusal alterations by upper molar teeth extraction on the left side while the other ten animals were only subjected to surgical stress, control group. After 60 days, animals of both groups, experimental and control had the suprahyoid muscles removed and processed for histological and histochemical (adenosine triphosphatase (ATPase), nicotine adenine dinucleotide tetrazolium reductase (NADH-TR) and succinate dehydrogenase (SDH)) purposes. The fiber type area was estimated in % according to Weibel method (point-counting method) using a test-system. The myosinic ATPase pH 4.7 activity in the control group of the digastric, milohyoid and geniohyoid muscles presented a small area of type I fiber and a larger area of type IIa fibers; in the experimental group, significant contractile capacity alteration was not observed. Samples of the digastric, milohyoid and geniohyoid muscles, after SDH activity, showed a small area with high metabolic activity fibers, and a large area with intermediary and low metabolic activity fibers in the control group. The milohyoid muscle of the experimental group presented low metabolic fibers in a reduced area, in both sides, however without significant difference. In the experimental group, high metabolic fibers were observed on the left side in a reduced area in the geniohyoid muscle, but without statistical significance. Thus, the geniohyoid muscle did not change the metabolic activity after occlusal alteration. In conclusion, 60 days of unilateral malocclusion induced was able to alter the fibers oxidative activity of the suprahyoid muscles, however, it does not affect the contractile property of the fibers. The digastric muscle has adequate fibers to produce fast contraction and able to resist to fatigue in intermediate degrees, but became more fatigable after unilateral exodontia.

Ultrastructural characteristics of the gerbil pterygoid medial muscle after experimental occlusal alteration.

Ten male young adult gerbils Meriones unguiculatus weighing 55g were divided in two groups: experimental (n=5) animals submitted to exodontia of the left upper molars, and sham-operated were used as control (n=5) group. The aim of the present study was to investigate the ultrastructural effects of occlusal alteration induced by unilateral exodontia on medial pterygoid muscle. After 60 days, the animals were sacrificed by perfusion intracardially with a modified Karnovsky solution after anesthetized with overdose of urethane (3g/kg i.p.). The small samples of this muscle were fixed in 2.5% glutaraldehyde solution and post-fixed in 1% buffered osmium tetroxide solution, dehydrated in ascending concentration of ethanol, and embedded in Spurr resin. Several micrographs data showed that in this period of time, the unilateral teeth extraction was able to induce modifications on the medial pterygoid muscle fibers and capillaries at ultrastructural levels as compared to control muscles and to the ones in the contralateral side of the experimental animals. Ultrastructural changes suggest that injury was greater in the hypofunctional muscle, ipsilateral to teeth extraction.

Bacterial culture and DNA Checkerboard for the detection of internal contamination in dental implants.

PURPOSE: The aim of this in vitro study was to evaluate the bacterial leakage along the implant-abutment interface by the conventional bacterial culture and DNA Checkerboard hybridization method. MATERIALS AND METHODS: Twenty Branemark-compatible implants with a 3.75-mm diameter and external hexagonal platform were randomly placed in two groups of ten implant-abutment assemblies each. One group was used to analyze bacterial counts by DNA Checkerboard hybridization and the other by a conventional bacterial culture. Suspensions of Fusobacterium nucleatum (3 microl) were injected into the grooved internal cylinders of each implant assembly, and the abutment was connected by a 32 Ncm torque. The combined implant-abutments were individually placed in tubes containing the CaSaB culture medium and incubated in a bacteriological constant temperature oven for 14 days. The samples were observed daily as to the presence of turbidity, and after the designated time the microorganisms were collected from the implant interiors and analyzed by the two methods. RESULTS: After 14 days, six implant-abutment assemblies showed turbidity. Both methods indicated reduced microorganism counts in samples from the interior of the implant-abutment assemblies after incubation in the culture medium; however, the number of counts of F. nucleatum was higher by the DNA Checkerboard method when compared to the group analyzed by conventional bacterial cultures (p < 0.05). CONCLUSION: The DNA Checkerboard method was shown to be more sensitive than conventional cultures in the detection of microorganisms.

Effects of latex membrane on guided regeneration of long bones.

Natural latex extracted from Hevea brasiliensis is one of the materials pointed out as potential tissue regenerators. The use of latex-based membranes in bone regeneration might be an alternative to stimulate bone formation. The aim of this study was to evaluate the effects of latex membranes in guided bone regeneration of defects produced in long bones of rats. Sixty rats were equally divided into latex and control groups, and each group was subdivided into two subgroups according to treatment duration of 1 and 4 weeks. Bone defects with 2.5 mm in diameter were surgically made in the left tibia. In the animals of the latex group, a latex membrane was placed over the bone defect. The samples underwent quantitative histological analysis of bone formation and collagen matrix, immunohistochemical analysis of osteogenic protein markers, assessment of bone mechanical properties and bone densitometry, and radiological assessment. The osteocalcin immunostaining data were submitted to the generalized linear model test with two independent factors. For the other data, the multivariate ANOVA with two independent factors was performed. The use of the latex membrane significantly improved (p < 0.005) the volume of newly formed bone, collagen type I matrix, expression of osteopontin, and bone stiffness, both in the early and late stages of regeneration. In conclusion, the latex membrane was able to promote bone regeneration in long bones.

Application of Autologous Platelet-Rich Plasma on Tooth Extraction Site Prevents Occurence of Medication-Related Osteonecrosis of the Jaws in Rats.

This study evaluated the effects of local application of autologous platelet-rich plasma (PRP) on the tooth extraction site of rats presenting the main risk factors for medication-related osteonecrosis of the jaw (MRONJ). For seven weeks, senile rats were submitted to systemic treatment with vehicle (VEH and VEH-PRP) or 100 µg/Kg of zoledronate (ZOL and ZOL-PRP) every three days. After three weeks, the first lower molar was extracted. VEH-PRP and ZOL-PRP received PRP at the tooth extraction site. Euthanasia was performed at 28 days postoperatively. Clinical, histopathological, histometric and immunohistochemical analyses were carried out in histological sections from the tooth extraction site. ZOL showed lower percentage of newly formed bone tissue (NFBT), higher percentage of non-vital bone tissue (NVBT), as well as higher immunolabeling for TNFα and IL-1ß. In addition, ZOL presented lower immunolabeling for PCNA, VEGF, BMP2/4, OCN and TRAP. VEH and ZOL-PRP showed improvement in the tooth extraction site wound healing and comparable percentage of NFBT, VEGF, BMP2/4 and OCN. Local application of autologous PRP proved a viable preventive therapy, which is safe and effective to restore tissue repair capacity of the tooth extraction site and prevent the occurrence of MRONJ following tooth extraction.

Antimicrobial photodynamic therapy improves the alveolar repair process and prevents the occurrence of osteonecrosis of the jaws after tooth extraction in senile rats treated with zoledronate.

This study evaluated the effects of antimicrobial photodynamic therapy (aPDT) in the alveolar repair of rats with major risk factors for bisphosphonate-related osteonecrosis of the jaws (BRONJ). Senile rats received 0.45 ml of vehicle (VEH and VEH/aPDT) or 0.45 ml of zoledronate (ZOL and ZOL/aPDT) every three days for seven weeks. After three weeks of treatment, the first lower left molar was extracted. VEH/aPDT and ZOL/aPDT were submitted to aPDT on the extraction site at 0, 2 and 4 days postoperatively. Euthanasia was performed 28 days postoperatively and the extraction site was evaluated by clinical, histological, histometric, histochemical and immunohistochemical analysis. ZOL showed tissue repair impairment; lower percentage of newly formed bone tissue (NFBT); higher percentage of non-vital bone tissue (NVBT); fewer mature collagen fibers and increased immunolabeling for tumor necrosis factor (TNFα), interleukin (IL)-1ß and IL-6. ZOL/aPDT showed clinical and histological characteristics of the extraction site, percentage of NFBT and percentage of mature collagen fiber similar to VEH. Percentage of NVBT and immunolabeling for inflammatory cytokines in ZOL/aPDT was lower than in ZOL. Immunolabeling for tartarato-resistant acid phosphatase (TRAP) was lower in ZOL and ZOL/aPDT. aPDT in the dental extraction site improves tissue repair process and prevents the occurrence of BRONJ-like lesions after tooth extraction.

Action of nitric oxide on healthy and inflamed human dental pulp tissue.

Irreversible pulpitis has been associated with pain and an increase in the number of pulp inflammatory cells. Based on the action of nitric oxide (NO) elsewhere, NO may possibly participate in the sensory and autonomic innervation of the dental pulp, and may influence local inflammatory responses. The purpose of this study was to analyze normal and inflamed human dental pulp for the presence of NADPH-diaphorase (NADPH-d), as an index of NO system activity. Six non-carious second premolar pulp tissue samples were obtained from young patients who required extractions for orthodontic reasons and six inflamed samples were obtained from symptomatic carious second premolars clinically diagnosed with irreversible pulpitis. Pulp tissue was carefully removed, fixed by immersion in a cold 4% PFA buffered solution for 120 min, rinsed in cold phosphate buffer, and quickly-frozen for cryostat sectioning. Pulp tissue was sectioned perpendicularly to the vertical axis of the tooth at 20 microm and processed for histochemistry. Sections of each specimen were stained with hematoxylin-eosin and other sections were subjected to histochemical NADPH-d detection. Results indicated the presence of NADPH reactivity within the pulps of both normal and carious teeth. In the normal teeth NADPH-d activity was detected in a small number of vascular endothelial cells and fibroblasts. The inflammatory response of the pulp from carious premolars was detected in connective tissue by the presence of an increased number of fibroblasts, angioblasts and collagen fibers. It was possible to determine the extent of odontoblast reactivity since the odontoblast layer was usually absent in these split-peel preparations. There were no obvious signs of stained pulpal nerve fibers. Overall NADPH-d staining was significantly more intense within inflamed pulp tissues compared to normal healthy samples (Mann-Whitney test, p<0.002). These results suggest that NADPH-d may be used as a marker of inflammatory activity in pulpitis and provide the basis for further studies aiming to clarify the possible functions of NO in human dental pulp in pathophysiological situations.