Attenuation of radiation‐ and chemoradiation‐induced mucositis using gamma‐d‐glutamyl‐l‐tryptophan (SCV‐07)

Oral Diseases (2010) 16 , 655–660 Objective: To evaluate the efficacy of a novel immunomodulating peptide (SCV‐07) in attenuating the course of radiation‐induced mucositis in an established animal model of oral mucositis (OM). Material and Methods: In three separate experiments, golden Syrian hamsters received either an acute radiation challenge to the buccal mucosa of eight fractionated doses of 7.5 Gy of radiation over a 2‐week‐period, or a combination of acute radiation and cisplatin. In each experiment, animals were treated with varying doses or schedules of SCV‐07 or placebo. OM was scored in a blinded fashion using digital images obtained during the experimental period. Results: We found that SCV‐07 reduced the severity and duration of both acute and fractionated radiation‐induced OM. Similarly, when radiation and chemotherapy were used to induce OM, treatment with SCV‐07 significantly reduced the duration of ulcerative OM. The therapeutic benefit was dependent on both dose and schedule of administration. Conclusion: Taken together, we found SCV‐07 was able to modify the duration and severity of oral mucositis and was dependent on schedule and dose.     

Insulin‐like growth factor‐binding protein‐2 and ‐3 in gingival crevicular fluid

Takenouchi Y, Ohshima M, Yamaguchi Y, Nishida T, Senda N, Idesawa M, Otsuka K, Ito K. Insulin‐like growth factor‐binding protein‐2 and ‐3 in gingival crevicular fluid. J Periodont Res 2010; 45: 803–808. © 2010 John Wiley & Sons A/S Background and Objective: Insulin‐like growth factor‐binding proteins (IGFBPs) are crucial regulators of insulin‐like growth factor (IGF). They enhance or inhibit IGF functions, but also exhibit IGF‐independent effects. In a previous study, we detected, qualitatively, IGFBP‐2 and ‐3 in gingival crevicular fluid using a cytokine antibody array. Here we extended these results using an ELISA to determine the concentrations of IGFBP‐2 and ‐3 in gingival crevicular fluid. In addition, we explored whether the expression of IGFBP‐2 and IGFBP‐3 correlates with periodontal disease severity. Material and Methods: Gingival crevicular fluid samples from 92 sites of 12 patients affected with periodontal disease and from 100 sites of 19 healthy volunteers, were collected, divided into two groups and analyzed by ELISA for IGFBP‐2 and ‐3 expression. The potential correlation among probing depth, gingival index and the concentrations of IGFBP‐2 and ‐3 was analyzed. Results: Positive correlations were observed between the concentration of IGFBP‐2 and probing depth and gingival index, but not for IGFBP‐3. The IGFBP‐2 concentrations at bleeding on probing‐positive sites and at sites with a probing depth of ≥ 4 mm were higher than at bleeding on probing‐negative sites and at sites with a probing depth of ≤ 3 mm. Conclusion: These results indicate that IGFBP‐2 is a potential novel marker for periodontal disease progression. As IGFBP‐2 modulates bone metabolism and cell migration, IGFBP‐2 in the gingival crevicular fluid may reflect periodontal disease activity.     

Porcelain Fracture Resistance of Screw‐Retained,Cement‐Retained,and Screw‐Cement‐Retained Implant‐Supported Metal Ceramic Posterior Crowns

Purpose: The purpose of this in vitro study was to compare the porcelain fracture resistance between screw‐retained, cement‐retained, and combined screw‐ and cement‐retained metal–ceramic (MC) implant‐supported posterior single crowns; and to investigate the effect of offsetting the occlusal screw‐access opening on porcelain fracture resistance of screw‐retained and cement‐retained MC implant‐supported posterior single crowns. Materials and Methods: Forty standardized MC molar‐shaped restorations were fabricated. The 40 restorations were divided into four groups (SRC, SRO, CRP, and CSC) of 10 specimens each. Group SRC: screw‐retained, screw‐access hole placed in the center of the occlusal surface; Group SRO: screw‐retained, screw access hole placed 1 mm offset from the center of the occlusal surface toward the buccal cusp; Group CRP: cement‐retained, zinc phosphate cement was used; Group CSC: cement‐retained with a screw‐access hole in the center of the occlusal surface. The screw‐retained restorations and abutments were directly attached to 3i implant fixtures embedded in acrylic resin blocks. Subsequently, all test specimens were thermocycled and vertically loaded in a universal testing machine at a crosshead speed of 2 mm/min until fracture. Mean values of load at fracture (in N) were calculated in each group and compared with a one‐way ANOVA and Tukey's Studentized test (α= 0.05). Results: Mean values of loads required to fracture the restorations were as follows (N): Group SRC: 1721 ± 593; Group SRO: 1885 ± 491; Group CRP: 3707 ± 1086; Group CSC: 1700 ± 526. Groups SRC, SRO, and CSC required a significantly lower force to fracture the porcelain than did the CRP group (p < 0.05). Conclusion: The cement‐retained restorations showed significantly higher mean fracture loads than the restorations having screw‐access openings in their occlusal surface. The position of the screw‐access hole within the occlusal surface did not significantly affect the porcelain fracture resistance.     

Effect of a 12‐methacryloyloxy‐dodecyl‐pyridinium‐bromide–containing adhesive with different post types on the long‐term bond strength to dentin

The use of matrix metalloproteinase (MMPs) inhibitors, such as 12‐methacryloyloxy‐dodecyl‐pyridinium‐bromide (MDPB), might improve the adhesion of glass‐fiber (GF) and polyfiber (PF) posts to root dentine. This study assessed the effect of an MDPB‐containing adhesive on the long‐term bond strength of GF or PF posts to bovine dentine. Bovine endodontically treated roots were randomly divided into six groups, according to the post type and adhesive system used, as follows: GF serrated post + MDBP‐free adhesive; GF serrated post + MDPB‐containing adhesive; GF smooth post + MDBP‐free adhesive; GF smooth post + MDPB‐containing adhesive; PF post + MDBP‐free adhesive; PF post + MDPB‐containing adhesive. Specimens were stored in water for 6 months, thermocycled (500 cycles wk^?1), and submitted to the pull‐out test and failure pattern analysis. The cement–dentin interface was evaluated using scanning electron microscopy. The pull‐out data were analyzed using anova and Tukey's test (α = 0.05). No significant interaction between the type of post and the adhesive system was found. Polyfiber posts showed lower bond strength than GF posts, whether serrated or smooth, and the bond strength of the serrated and smooth GF posts was not significantly different. Adhesive failures were predominant in all groups. The type of retainer influenced the bond strength, and MDPB‐containing adhesive did not improve the long‐term bond strength of posts to dentine.     

Computer‐simulated bi‐directional alveolar distraction osteogenesis

Objectives: Computer‐based surgical planning allows surgeons to evaluate bone morphology in three dimensions and to perform accurate virtual surgery preoperatively. This study was performed to evaluate the feasibility of using preoperative surgical simulation to enhance the clinical outcome in patients undergoing bi‐directional alveolar distraction osteogenesis. Material and methods: Nine patients (mean age, 49 years; range, 20–61 years) with maxillary segmental alveolar defects following post‐traumatic atrophy or disuse atrophy after periodontal tooth loss were enrolled in the study. All patients were scheduled for implant placement. Three‐dimensional (3‐D) morphological evaluation and virtual bi‐directional distraction were performed with SimPlant CMF/OMS surgical simulation software (Materialise). In addition, use of an extraosseous bi‐directional distraction device (V2‐Alveolar Distraction System; Medartis AG) was evaluated during the 3‐D alveolar regeneration simulation and resulting augmentation. Results: Alveolar height regeneration and labial‐buccal augmentation were planned preoperatively using surgical simulation software. New bone formation with sufficient vertical augmentation of 5.8 mm was observed. As we encountered strong palatal inclination, the angulation required for labial‐buccal augmentation during active distraction was the maximum angulation of 40°, even greater than that required in the preoperative simulation of 23.9°. Furthermore, the labial‐buccal augmented angulation was gradually decreased to 11.2° at the time of implant placement. In all cases, implantation was successful at the well‐augmented sites, with sufficient primary stability after a 3‐month consolidation period. Conclusions: Preoperative 3‐D simulation is a potentially valuable tool for treatment of the morphologically complicated oral‐maxillofacial region. More realistic surgical simulations are anticipated with ongoing effort to collect and integrate clinical data into next‐generation software.     

18β‐Glycyrrhetinic acid inhibits periodontitis via glucocorticoid‐independent nuclear factor‐κB inactivation in interleukin‐10‐deficient mice

Sasaki H, Suzuki N, AlShwaimi E, Xu Y, Battaglino R, Morse L, Stashenko P. 18β‐Glycyrrhetinic acid inhibits periodontitis via glucocorticoid‐independent nuclear factor‐κB inactivation in interleukin‐10‐deficient mice. J Periodont Res 2010; 45: 757–763. © 2010 John Wiley & Sons A/S Background and Objective: 18β‐Glycyrrhetinic acid (GA) is a natural anti‐inflammatory compound derived from licorice root extract (Glycyrrhiza glabra). The effect of GA on experimental periodontitis and its mechanism of action were determined in the present study. Material and Methods: Periodontitis was induced by oral infection with Porphyromonas gingivalis W83 in interleukin‐10‐deficient mice. The effect of GA, which was delivered by subcutaneous injections in either prophylactic or therapeutic regimens, on alveolar bone loss and gingival gene expressions was determined on day 42 after initial infection. The effect of GA on lipopolysaccharide (LPS)‐stimulated macrophages, T cell proliferation and osteoclastogenesis was also examined in vitro. Results: 18β‐Glycyrrhetinic acid administered either prophylactically or therapeutically resulted in a dramatic reduction of infection‐induced bone loss in interleukin‐10‐deficient mice, which are highly disease susceptible. Although GA has been reported to exert its anti‐inflammatory activity via downregulation of 11β‐hydroxysteroid dehydrogenase‐2 (HSD2), which converts active glucocorticoids to their inactive forms, GA did not reduce HSD2 gene expression in gingival tissue. Rather, in glucocorticoid‐free conditions, GA potently inhibited LPS‐stimulated proinflammatory cytokine production and RANKL‐stimulated osteoclastogenesis, both of which are dependent on nuclear factor‐κB. Furthermore, GA suppressed LPS‐ and RANKL‐stimulated phosphorylation of nuclear factor‐κB p105 in vitro. Conclusion: These findings indicate that GA inhibits periodontitis by inactivation of nuclear factor‐κB in an interleukin‐10‐ and glucocorticoid‐independent fashion.