Light-emitting diode therapy in chemotherapy-induced mucositis.

BACKGROUND AND OBJECTIVE: Mucositis is the most common oral complication of cancer chemotherapy, which causes pain on mastication and swallowing, impairs patients' ability to eat and take oral drugs and may determine interruption of the treatment. The aim of this study was to evaluate the effect of light-emitting diode (LED) therapy on chemotherapy-induced mucositis in hamsters. STUDY DESIGN/MATERIALS AND METHODS: Animals of both experimental (Group I; n = 32) and positive control (Group II; n = 32) groups received intraperitoneal injections of 5-fluorouracil on days 0 and 2. All animals had their right and left cheek pouch irritated by superficial scratching on days 3 and 4. In Group I, LED irradiation (630 nm+/-10 nm, 160 mW, 12 J/cm2) was applied during 37.5 seconds at days 3, 4, 6, 8, 10, 12, and 14. In Group II, mucositis was induced, but LED therapy was not performed. The oral mucosa was photographed from day 4 to 14 at 2-day intervals. Photographs were randomly scored according to the severity of induced mucositis (0 to 5). In the negative control group (Group III; n = 6), no mucositis was induced. Biopsies of the cheek pouches of 8 animals (Group I and Group II) were surgically obtained on days 5, 9, 13 and 15 and processed for histological examination. RESULTS: The statistical analysis showed significant differences between irradiated and non-irradiated groups (P<0.05). However, muscular degeneration was observed in 18% of the samples of Group I. CONCLUSION: It may be concluded that the LED therapy protocol established for this in vivo study was effective in reducing the severity of oral mucositis, although the oral lesions were not completely prevented.

Mechanical and biological characterization of resin-modified glass-ionomer cement containing doxycycline hyclate.

OBJECTIVES: To characterize the mechanical and biological properties of a resin-modified glass ionomer cement (RMGIC) containing doxycycline hyclate. METHODS: The antibacterial effect of RMGIC containing 1.5, 3.0 and 4.5% doxycycline hyclate was assessed using two experiments - agar diffusion test for 24h and biofilm assay for 24h and 7 days - against some cariogenic bacteria. Briefly, base layers of BHI agar and 300µL of each inoculum were prepared in Petri dishes with 6 wells that were completely filled with materials. After 24h incubation, zones of bacterial growth inhibition were measured using a digital caliper. Biofilm assays were conducted using RMGIC specimens immersed in 24-well plates containing the inoculum in BHI broth. After 24h and 7 days, each specimen were removed, vortexed and the suspension diluted and inoculated in BHI plates for subsequent bacterial counting. Cytotoxicity tests used 50 specimens made in sterilized metal molds, including Vitrebond as positive control. Extracts from every specimen were applied on the MDPC-23 odontoblast-like cells for 24h. The MTT assay and SEM evaluation determined cell metabolism and morphology, respectively. 80 cylindrical specimens were made from the previously cited groups, and were submitted to testing with a universal testing machine (Instron 4411) using a crosshead speed of 1.0mm/min for compressive strength and 0.5mm/min for diametral tensile strength, respectively. Data from antibacterial and cytotoxic effects, and mechanical properties were submitted to appropriated statistical tests. RESULTS: All tested groups showed growth inhibition of all tested strains (p<0.05) in 24h for both microbiological tests, but only 4.5% doxycycline have antibacterial effect after 7 days. None of doxycycline concentrations caused toxic effect to the MDPC-23 cells or presenting alterations to mechanical properties. CONCLUSION: The incorporation of up to 4.5% doxycycline hyclate into RMGIC inhibits important oral microorganisms, without modifying biological and mechanical characteristics of the dental material, suggesting a new alternative for the treatment of dental caries.

Efeito de um gel de peróxido de carbamida a 10% sobre a resistência de união de restaurações adesivas à dentina / Effect of a 10% carbamide peroxide bleaching gel on bond strength of adhesive restorations to dentin substrate

Objetivo: Este estudo teve como objetivo principal, analisar a interferência do clareamento dentário com peróxido de carbamida (PC) a 10% sobre a resistência de união à dentina de restaurações de resina composta. Material e Método: Vinte cavidades foram preparadas na face vestibular de dentes bovinos. Após condicionamento ácido e aplicação de agente adesivo nas paredes de dentina e esmalte, as cavidades foram restauradas com resina composta. Os espécimes foram divididos em grupos de acordo com tratamento na superfície de esmalte/restauração: G1 ? controle (sem tratamento) e G2 (aplicação do gel de PC por 8h/dia, durante 14 dias). Após esse período, foram obtidos os corpos-de-prova em forma de palito com secção transversal de aproximadamente 0,81 mm2, os quais foram submetidos ao ensaio de microtração. As fraturas foram analisadas em lupa estereoscópica e classificadas em: coesiva da resina ou dentina, adesiva ou mista. Resultados: A análise estatística (ANOVA/ ?2) revelou que o fator tratamento interferiu na resistência adesiva, sendo que a resistência de união foi significantemente superior para os espécimes do grupo G2 (p<0,05). Fraturas adesivas predominaram em todos os grupos com valores que variaram de 48,3% a 75%. Fraturas mistas foram às segundas mais observadas em G1 e falhas coesivas da resina para G2. Conclusões: Conclui-se que o clareamento caseiro utilizando gel com 10% de PC aumentou a resistência de união de restaurações adesivas à dentina.

Objective: The present study aimed to analyze the effects of tooth bleaching with 10% carbamide peroxide (CP) gel on the bond strength of resin composite restorations to dentin. Material and Methods: Twenty cavities were prepared on the buccal surface of bovine teeth. After acid etching and application of bonding agent on dentin and enamel, the cavities were restored with composite resin. The specimens were divided into groups according to treatment on the surface of enamel / restoration: G1 - control (no treatment) and G2 (10% PC gel application for 8h/day during 14 days). After this period, the teeth were cut to produce beams with 0.81 mm2 cross-sectional area, which were subjected to microtensile test. The fractures were examined with a stereomicroscope and classified as cohesive in resin or dentin, adhesive, or mixed. Results: The statistical analysis (ANOVA / ?2) revealed that the factor treatment interfered with the bond strength, which was significantly higher for specimens of G2 (p <0.05). Adhesive fractures occurred in most of specimens of both groups with values ranging from 48.3% to 75%. Mixed fractures were the second more frequent in G1 and cohesive resin failure in G2. Conclusion: It was concluded that tooth bleaching with 10% of PC increased the bond strength of adhesive restorations to dentin.

Efeito citotóxico de agentes clareadores a base de peróxido de hidrogênio a 20% e 38% sobre células odontoblastóides / Cytotoxic effect of a 20% and a 38% hydrogen peroxide bleaching agents on odontoblast-like cells

O objetivo deste estudo foi avaliar a citotoxicidade de diferentes técnicas de clareamento dentário, utilizando agentes clareadores com 20% e 38% de peróxido de hidrogênio (H2O2) sobre células odontoblastóides MDPC-23. Sessenta discos de esmalte/dentina foram adaptados em câmaras pulpares artificiais e divididos em seis grupos de acordo com o tratamento realizado sobre a superfície do esmalte: G1- 20% H2O2 (1 aplicação); G2- 20% H2O2 (2 aplicações); G3- 38% H2O2 (1 aplicação); G4- 38% H2O2 (2 aplicações); G5- 38% H2O2 (3 aplicações) e G6- controle. Em cada aplicação, os agentes clareadores com 20% ou 38% de H2O2 permaneceram sobre o esmalte por 45 ou 10 minutos, respectivamente. Após a última aplicação do gel, o meio de cultura em contato com a dentina foi obtido (extrato) e aplicado sobre as células previamente cultivadas (30.000 células/cm2). Foram realizadas avaliações do metabolismo (Teste de MTT) e da morfologia celular (MEV). A redução do metabolismo celular foi de 96,29%; 96,11%; 96,42%; 95,62% e 97,18% para G1, G2, G3, G4 e G5, respectivamente. Houve diferença estatisticamente significante apenas quando se comparou os grupos tratados com o grupo controle (G6) (Mann Whitney, p<0,05). Nestes grupos tratados, as poucas célulasque sobreviveram aos extratos apresentavam notáveis alterações morfológicas. Concluiu-se que ambas as técnicas de clareamento avaliadas resultaram em intenso efeito citotóxico trans-amelodentinário para ascélulas MDPC-23.

The aim of this in vitro study was to evaluate the trans-enamel and transdentinal cytotoxic effects of two in-office tooth bleaching techniques that employ bleaching gels containing 20% and 38% of H2O2 on cultured odontoblast-like cell line (MDPC-23). Sixty enamel/dentin discs were obtained from bovine central incisors and placed individually in artificial pulp chambers. Six groups were formed according to the following enamel treatments: G1- 20% H2O2 (1 application); G2- 20% H2O2 (2 applications); G3- 38% H2O2 (1 application); G4- 38% H2O2 (2 applications); G5- 38% H2O2 (3 applications); and G6- control (no treatment). In G1 and G2, the bleaching gel was left in contact with the enamel surface for 45 min in each application. However, in G3, G4, and G5 the bleaching gel was applied for only 10 min per application. After the last application, the extracts were collected and applied on previously cultured cells (30.000 cells/cm2) for 24 h. Cell metabolism was evaluated by the MTT assay and cell morphology was analysed by scanning electron microscopy. Cell metabolism decreased by 96.29%; 96.11%; 96.42%; 95.62%; and 97.18% in G1, G2, G3, G4, and G5, respectively. All treated groups differed significantly from non-treated control group (G6) (p < 0.05). However, the difference in cell metabolism among treated groups was not significant statistically. In addition, significant morphological cell alterations were observed in all treated groups. Under the tested experimental conditions, the extracts collected after both tooth bleaching techniques evaluated in this study caused severe toxic effects on cultured odontoblast-like cell MDPC-23.