RESUMEN
Crohn's Disease (CD) is a chronic inflammatory disorder in which up to 50% of patients develop fistula within 20 years after the initial diagnosis, and half of these patients suffer perianal fistulizing disease. The etiopathogenesis of CD-related perianal fistula is still unclear, and its phenotypical and molecular characteristics are even more indefinite. A better understanding would be crucial to develop targeted and more effective therapeutic strategies. At present, the most accredited theory for the formation of CD-related fistula identifies the epithelial-to-mesenchymal transition (EMT) as the driving force. It has been well recognized that CD carries an increased risk of malignancy, particularly mucinous adenocarcinoma is often associated with long-standing fistula in CD patients. Despite the availability of multiple treatment options, perianal fistulizing CD represents a therapeutic challenge and is associated with an important impact on patients' quality of life. To date, the most effective management is multidisciplinary with the cooperation of gastroenterologists, surgeons, radiologists, and nutritionists and the best recommended treatment is a combination of medical and surgical approaches.
RESUMEN
The aim of the present study was to evaluate and compare the cytotoxic effects of eight composite resins on immortalized human gingival fibroblasts. Composite resins were eluted in cell culture medium for 48 or 72 h at 37 °C. Immortalized human gingival fibroblast-1 (HGF-1) cell lines were seeded in 96-well (1 × 104) plates and incubated for 24 h at 37 °C with the obtained extraction medium. The percentage of viable cells in each well (MTT test) was calculated relative to control cells, which were set to 100%. Data observed were not normally distributed, and nonparametric statistical methods were used for statistical analysis. The Wilcoxon test was used for intragroup comparison, and the Kruskal-Wallis test was used for intergroup multiple comparisons. Significance value was set as p < 0.05. All materials tested showed cytotoxic effects on gingival fibroblasts, recordable as noncytotoxic, mildly cytotoxic or severely cytotoxic, depending on the percentage of cell viability. The Wilcoxon test for intragroup comparison showed that the percentage of viable cells decreased significantly for extracts, for all composite resins tested. The composite resins contained monomers that displayed cytotoxic properties. BisGMA, TEGDMA and UDMA had inhibitory effects and induced apoptotic proteins in pulp fibroblast. Composite resins that contained lower percentages of unbound free monomers-and that released less ions-possessed superior biocompatibility in vitro.