Kit W-sh Mutation Prevents Cancellous Bone Loss during Calcium Deprivation.

Calcium is essential for normal bone growth and development. Inadequate calcium intake increases the risk of osteoporosis and fractures. Kit ligand/c-Kit signaling plays an important role in regulating bone homeostasis. Mice with c-Kit mutations are osteopenic. The present study aimed to investigate whether impairment of or reduction in c-Kit signaling affects bone turnover during calcium deprivation. Three-week-old male WBB6F1/J-Kit W /Kit W-v /J (W/W v ) mice with c-Kit point mutation, Kit W-sh /HNihrJaeBsmJ (W sh /W sh ) mice with an inversion mutation in the regulatory elements upstream of the c-Kit promoter region, and their wild-type controls (WT) were fed either a normal (0.6% calcium) or a low calcium diet (0.02% calcium) for 3 weeks. µCT analysis indicated that both mutants fed normal calcium diet had significantly decreased cortical thickness and cancellous bone volume compared to WT. The low calcium diet resulted in a comparable reduction in cortical bone volume and cortical thickness in the W/W v and W sh /W sh mice, and their corresponding controls. As expected, the low calcium diet induced cancellous bone loss in the W/W v mice. In contrast, W sh /W sh cancellous bone did not respond to this diet. This c-Kit mutation prevented cancellous bone loss by antagonizing the low calcium diet-induced increase in osteoblast and osteoclast numbers in the W sh /W sh mice. Gene expression profiling showed that calcium deficiency increased Osx, Ocn, Alp, type I collagen, c-Fms, M-CSF, and RANKL/OPG mRNA expression in controls; however, the W sh mutation suppressed these effects. Our findings indicate that although calcium restriction increased bone turnover, leading to osteopenia, the decreased c-Kit expression levels in the W sh /W sh mice prevented the low calcium diet-induced increase in cancellous bone turnover and bone loss but not the cortical bone loss.

Cortical Bone Loss in a Spontaneous Murine Model of Systemic Lupus Erythematosus.

Patients with systemic lupus erythematosus (SLE), a chronic inflammatory disease characterized by loss of T- and B-cell tolerance to autoantigens, are at increased risk for osteoporosis and fractures. Mice deficient in Fc gamma receptor IIb (FcγRIIB) exhibit spontaneous SLE and its restoration rescues the disease. To determine whether deleting FcγRIIB affects cortical bone mass and mechanical properties, we analyzed cortical bone phenotype of FcγRIIB knockouts at different ages. FACS analysis revealed that 6-month-old FcγRIIB-/- mice had increased B220lowCD138+ cells, markers of plasma cells, indicating active SLE disease. In contrast, 3-month-old FcγRIIB-/- mice did not develop the active SLE disease. µCT analysis indicated that FcγRIIB deletion did not affect cortical bone in 3-month-old mutants. However, 6- and 10-month-old FcγRIIB-/- males and females had osteopenic cortical bone and the severity of bone loss increased with disease duration. FcγRIIB deletion decreased cross-sectional area, cortical area, and marrow area in 6-month-old males. Cortical area and cortical thickness were decreased in 10-month-old FcγRIIB-/- males. Lack of FcγRIIB decreased cortical thickness without affecting cortical area in females. However, deletion of a single FcγRIIB allele was insufficient to induce cortical bone loss. The bending strength was decreased in 6- and 10-month-old FcγRIIB-deficient males compared to WT controls. A microindentation analysis demonstrated significantly decreased hardness in both 10-month-old FcγRIIB-/- males and females. Our data indicate that FcγRIIB contributes to the regulation of cortical bone homeostasis subsequent to SLE development and that deletion of FcγRIIB in mice leads to SLE-like disease associated with cortical bone loss and decreased bending strength and hardness.

Changes in Oral Health Policies and Guidelines During the COVID-19 Pandemic.

The aim of this study was to describe the changes in oral health policies and guidelines in response to the Coronavirus disease 2019 (COVID-19) pandemic in different countries and regions around the world. Information on oral health policies and guidelines from 9 countries (Canada, China including Hong Kong, Egypt, India, Japan, New Zealand, Nigeria, Switzerland, and Thailand) were summarized, and sources of the information were mostly the national or regional health authorities and/or dental council/associations. The changes made to the oral health guidelines depended on the severity of the COVID-19 pandemic. This included suspension of non-emergency dental care services at the peak of the COVID-19 outbreak, and easing the restrictions on non-essential and elective dental care when the pandemic became under control. The COVID-19 risk mitigation strategies include strict adherence to infection control practices (use of hand sanitizers, facemask and maintaining social distancing), reducing the amount of aerosol production in the dental setting, and managing the quality of air in the dental treatment rooms by reducing the use of air conditioners and improving air exchange. The COVID-19 pandemic has shown a major impact on dental practice. Dental professionals are trying to adapt to the new norms, while the medium to long-term impact of COVID-19 on dentistry needs further investigation.

Developing Common Competencies for Southeast Asian General Dental Practitioners.

Current policy in Southeast Asian dental education focuses on high-quality dental services from new dental graduates and the free movement of dental practitioners across the region. The Southeast Asian Nations (ASEAN) Dental Councils have proposed the "Common Major Competencies for ASEAN General Dental Practitioners" to harmonize undergraduate dental education. This article discusses how the ASEAN competencies were developed and established to assist the development of general dental practitioners with comparable knowledge, skills, and attitudes across ASEAN. The competencies were developed through four processes: a questionnaire about current national oral health problems, a two-round Delphi process that sought agreement on competencies, a panel discussion by representatives from ASEAN Dental Councils, and data verification by the representatives after the meeting. Key themes of the ASEAN competencies were compared with the competencies from the U.S., Canada, Europe, Australia, and Japan. A total of 33 competency statements, consistent with other regions, were agreed upon and approved. Factors influencing the ASEAN competencies and their implementation include oral health problems in ASEAN, new knowledge and technology in dentistry, limited institutional resources, underregulated dental schools, and uneven distribution of dental practitioners. The ASEAN competencies will serve as the foundation for further developments in ASEAN dental education including policy development, curriculum revision, quality assurance, and staff development. Collaboration amongst stakeholders is essential for successful harmonization of ASEAN dental education.

Clinical evaluation of a resin-modified glass-ionomer liner for cervical dentin hypersensitivity treatment.

PURPOSE: To evaluate the effectiveness of two agents for treating cervical dentin sensitivity associated with gingival recession or noncarious cervical lesions. METHODS: 44 patients with at least mild sensitivity affecting cervical dentin were enrolled in a longitudinal randomized clinical trial. A resin-based desensitizer or an experimental glass-ionomer was assigned to treat at most two teeth from each side of the mouth. Sensitivity was assessed by tactile and cold tests, measured with a Visual Analogue Scale at baseline, after treatment, and at 1 week, 1, 3, 6, and 12 months after treatment. Other noteworthy clinical observations were recorded. RESULTS: Both treatments effectively reduced dentin sensitivity (mixed linear model analysis). Sensitivity score for the glass-ionomer was significantly lower than for the resin-based desensitizer after treatment and at all follow-up periods (P < 0.0001). Some overhanging margins were observed in the glass-ionomer group, which could accumulate plaque and cause gingivitis. Despite material loss from some teeth treated with the glass-ionomer, the follow-up sensitivity scores were still lower than baseline scores.

Comparison of the surface roughness of feldspathic porcelain polished with a novel alumina-zirconia paste or diamond paste.

This study compared the surface roughness of feldspathic porcelain polished with newly developed alumina-zirconia pastes or diamond paste. Porcelain discs were prepared and polished with sandpaper using a polishing-machine. The surface roughness (Ra) of each sample was measured using a profilometer. The samples were randomly divided into 6 groups (n=10). The control group was polished with diamond paste (DP), and the five remaining groups were polished with the newly developed alumina-zirconia paste with the following ratios of glycerin:alumina:zirconia by weight: 1:0.5:0.5 (Z0.5), 1:0.5:0.75 (Z0.75), 1:0.5:1 (Z1), 1:0.5:1.5 (Z1.5), and 1:0.5:2 (Z2). The specimens were polished for 120 s. The Ra values were determined again and the surface morphology of the porcelain samples was analyzed using SEM. The Ra values decreased as the amount of zirconia in the polishing paste increased, except for the Z2 group. The surface roughness as observed by SEM showed a correlation with the Ra values.

The synthesis and characterization of a novel potassium chloride-fluoridated hydroxyapatite varnish for treating dentin hypersensitivity.

Dentin hypersensitivity is treated using materials that occlude the dentinal tubules or release potassium ions that induce nerve desensitization. In this study we formulated a novel varnish containing potassium chloride and fluoridated hydroxyapatite and evaluated its physical properties and cytotoxicity. Potassium ion release from the varnish was measured. Dentin permeability was evaluated by measuring the hydraulic conductance of etched dentin discs treated with the varnish. The direct contact test and MTT assay were performed to evaluate the varnish's cytotoxicity. We found that the varnish released potassium ions over 6 h, and demonstrated a statistically higher reduction in dentin permeability compared to commercial fluoride varnish or control. Dentin disc scanning electron microscopy images demonstrated occluded dentinal tubules in the novel varnish group after brushing. The cytotoxicity tests indicated the varnish was biocompatible with gingival and pulpal fibroblasts. We propose the novel varnish is a potential material for use in hypersensitivity management.

Chitosan whiskers from shrimp shells incorporated into dimethacrylate-based dental resin sealant.

A resin-based sealant containing chitosan whiskers was developed for use as a pit and fissure sealer. Chitosan whiskers were synthesized and then characterized using Fourier transform infrared spectrometry and transmission electron microscopy. The whiskers were next incorporated into dimethacrylate monomer at various ratios by weight and subsequently analyzed for their antimicrobial and physical properties. The dimethacrylate-based sealant containing chitosan whiskers had a greater antimicrobial activity than control sealant and they were comparable with antimicrobial commercial resin sealants. The inclusion of the whiskers did not reduce the curing depth or degree of double bond conversion and the reduction in hardness was minimal. In conclusion, a resin-based sealant containing chitosan whiskers can be considered an effective antimicrobial pit and fissure sealant.

A novel glass ionomer cement containing MgCO(3 )apatite induced the increased proliferation and differentiation of human pulp cells in vitro.

This study aimed to investigate the in vitro biological response of human dental pulp cells to glass ionomer cement (GIC, Fuji IX GP(®)) containing 2.5% magnesium carbonate apatite (MgCO(3)Ap). MgCO(3)Ap was synthesized by wet method and characterized using FT-IR, XPS, and SEM. Fuji IX GP(®) served as a control. Test and control cements were prepared by encapsulated mixing the powder with Fuji IX-liquid (P/L=3.6:1). Eluates from cements extracted by 1 mL culture medium were collected at day 1, 7 and 14, and used for WST-1 proliferation assay. For ALPase activity, cells were maintained with cements in transwells, harvested and enzyme activity was measured at day 1, 4, 7, 14, and 21. We found a higher cell proliferation and increased ALPase activity by pulp cells in the test group compared to the control. This suggests the potential of GIC containing this novel biological apatite as a restorative material for pulp-dentin regeneration.

Chemical analyses of hydroxyapatite formation on SAM surfaces modified with COOH, NH(2), CH(3), and OH functions.

Hydroxyapatite formation was examined at the surface of self-assembled monolayers (SAMs) modified with four functional groups, -COOH, -NH(2), -CH(3), and -OH. For COOH-SAM and NH(2)-SAM, scanning electron spectroscopic observation showed that flake-like sheet crystals covered the whole wafer and small broccoli-like crystals were observed occasionally on the flake-like crystal base layer. For CH(3)-SAM and OH-SAM, no flake-like sheet crystals were observed; broccoli-like crystals were observed in a dispersed manner for CH(3)-SAM, but in localized spots for OH-SAM. X-ray diffraction patterns showed a strong apatite pattern oriented toward the c-axis direction for COOH-SAM. ESCA analysis revealed distinct Ca, P, O peaks for COOH-, NH(2)-, CH(3)-, and OH-SAM. Surface plasmon resonance (SPR) analysis indicated that during the supply of supersaturated calcium phosphate solution, the deposition of precipitates increased monotonically with time for COOH-SAM, increased slightly for NH(2)-SAM, but little increase in deposition was detected for CH(3)-SAM and OH-SAM.

The effect of casein phosphopeptide-amorphous calcium phosphate and a cola soft drink on in vitro enamel hardness.

BACKGROUND: The authors conducted an in vitro study to compare the hardness of normal enamel with enamel eroded by a cola soft drink and enamel remineralized by casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) or artificial saliva. MATERIALS AND METHODS: The authors immersed 40 extracted sound central and lateral incisors alternately in a cola soft drink or artificial saliva for 10 cycles of five seconds each. They repeated this procedure two times at six-hour intervals. They divided the samples randomly into four groups and applied CPP-ACP to the samples, immersed them in artificial saliva, deionized water or both. They measured the hardness on the labial surface at baseline, after erosion and after remineralization and analyzed the data with one-way repeated-measures analysis of variance and two-way analysis of variance. RESULTS: The cola soft drink significantly decreased enamel hardness. CPP-ACP and CPP-ACP and artificial saliva significantly increased the hardness of eroded enamel. CPP-ACP and CPP-ACP and artificial saliva increased the hardness of eroded enamel significantly more than artificial saliva did. CONCLUSIONS: CPP-ACP increased the hardness of eroded enamel. CPP-ACP had a greater effect on enamel hardness than did artificial saliva. CLINICAL IMPLICATIONS: Consumption of a cola soft drink can cause tooth erosion. CPP-ACP may significantly remineralize eroded enamel compared with artificial saliva.