Sterilization of elastic ligatures for intraoperative mandibulomaxillary immobilization

Sterilization can influence the mechanical properties of elastic ligatures used for mandibulomaxillary immobilization. The aim of this study was to compare different sterilization protocols (ethylene oxide, autoclave, irradiation, plasma sterilization, povidone-iodine for 24 hours and 70% isopropyl alcohol for 24 hours) of three elastomers (natural rubber, silicone rubber, and polyurethane). Three mechanical variables were assessed in a testing machine: breaking strength, tensile strength and tensile strength after a 24-hour load (material fatigue). Natural rubber was most susceptible to mechanical alteration by sterilization and lost 46% of its breaking strength and 43% of its tensile strength after autoclaving. Polyurethane was more resistant (multiple comparison, Tukey-Kramer), but polyurethane ligatures stuck together after autoclaving. The protocols for low-temperature sterilization, ethylene oxide, irradiation, and plasma were superior to autoclaving and the disinfecting solutions. These data suggest that polyurethane sterilized with ethylene oxide is the material of choice.     

Odontogenic ghost cell carcinoma: a case report with reference to the relation between apoptosis and ghost cells

The neoplastic variant of calcifying odontogenic cyst has various designations, and its malignant counterpart has been reported as aggressive epithelial odontogenic ghost cell tumor or odontogenic ghost cell carcinoma. We present a case of odontogenic ghost cell carcinoma with reference to the relation between the ghost cells and apoptosis. A 33-year-old man complained of a mandibular mass. The mass occupied the entire right side of the mandible with destruction of both buccal and lingual bone. The mass also infiltrated into submandibular and sublingual spaces. Histologically, the mass was composed of a solid proliferation of hyperchromatic and pleomorphic epithelial cells with abnormal mitoses. Islands of ghost cells were frequently admixed with nucleated cells, and there were foci of ameloblastic differentiation. Immunohistochemical stains for cytokeratins, involucrin, and apoptosis-related proteins such as Bcl-2, Bcl-X(L), and Bax were done. Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling (TUNEL) assay was also performed. The nucleated cells adjacent to the ghost cells expressed cytokeratins and involucrin, but the ghost cells had no reaction. Bcl-2 was negative. Both Bcl-X(L) and Bax were demonstrated in the nucleated cells adjacent to the ghost cells. The ghost cells exhibited Bax protein. Some nucleated cells adjacent to the ghost cells were positive with TUNEL assay. The above results indicate that ghost cells undergo abnormal terminal differentiation as an apoptotic process.     

Influence of polymerization conditions on monomer elution and microhardness of autopolymerized polymethyl methacrylate resin

Residual monomer contents and surface hardness are important factors in determining the serviceability of provisional restorations. The intent of this study was to systemically evaluate the effects of curing conditions on provisional polymethyl methacrylate (PMMA) resins which utilize a free-radical polymerization reaction. Combinations of the three curing factors of temperature, pressure, curing environment (water/air) were adjusted during the fabrication of autopolymerized specimen disks. The initial hardness of tested materials was measured with a microhardness tester 1 h after disc fabrication, and the amounts of residual methyl methacrylate (MMA) released into water were analyzed by reverse-phase HPLC after 7 d of water immersion. Results from multiple regressions showed that curing temperature was the dominant factor in improving resin surface hardness, whereas curing in water was the key factor for reducing the quantity of residual monomer. The pressure factor, which was thought to be critical for managing autopolymerized resins, showed no significant influences on the properties tested. ANOVA results showed that provisional PMMA resins cured in hot water, with or without pressure, significantly reduced the amount of residual MMA elution (up to 80%) and increased the microhardness values (up to 50%).     

Induction of dental pulp fibroblast matrix metalloproteinase-1 and tissue inhibitor of metalloproteinase-1 gene expression by interleukin-1alpha and tumor necrosis factor-alpha through a prostaglandin-dependent pathway

Matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) are involved in the degradation of extracellular matrix in many inflammatory diseases. Little is known regarding the expression of these mediators in dental pulp fibroblasts. The effects of proinflammatory cytokines (interleukin (IL)-1alpha and tumor necrosis factor-alpha (TNF-alpha)) and prostaglandin E2 (PGE2) on pulp fibroblast MMP-1 and TIMP-1 gene expression were investigated. Northern hybridization showed that IL-1alpha and TNF-alpha induced significant MMP-1 gene expression, with only little effect on TIMP-1 gene. Exogenous PGE2, however, upregulated TIMP-1 mRNA synthesis but not MMP-1. Concomitant addition of IL-1alpha and PGE2 or TNF-alpha and PGE2 suppressed MMP-1 mRNA production, compared with the groups treated with IL-1alpha or TNF-alpha alone. In contrast, PGE2 enhanced the upregulatory effects of TIMP-1 mRNA by IL-1alpha or TNF-alpha. Furthermore, cytokine stimulation of MMP-1 and TIMP-1 gene expressions can be enhanced or blocked by indomethacin, respectively, and reversed by exogenous PGE2. These results suggested that cytokine-stimulated MMP-1 and TIMP-1 gene expression in dental pulp fibroblasts was mediated, at least in part, by a prostaglandin-dependent pathway. The differential regulation of IL-1alpha or TNF-alpha-induced MMP-1 and TIMP-1 mRNA synthesis, as well as the direct upregulation of TIMP-1 gene expression by PGE2, also implied that prostaglandin may serve as a protective mechanism from excessive tissue breakdown during pulpitis.     

Using extracted teeth for research: the effect of storage medium and sterilization on dentin bond strengths

BACKGROUND: The Centers for Disease Control and Prevention has adopted guidelines for infection control of extracted teeth used for research and teaching, requiring that teeth be sterilized before use. The authors conducted a study to test the null hypothesis that the storage medium and sterilization method have no effect on composite-to-dentin bond strengths. MATERIALS AND METHODS: The authors collected 170 bovine incisors, cleaned them and placed them randomly into one of six storage media at 37 degrees C for 60 days: distilled water (dH(2)O), 0.9 percent sodium chloride, 0.5 percent chloramine-T, 5.25 percent sodium hypochlorite (NaClO), 2 percent glutaraldehyde and 10 percent formalin. For sterilization, they autoclaved a subset of 10 specimens from every sample, while they stored another subset of 10 specimens from every sample (except for the 10 percent formalin sample) in 10 percent formalin for 14 days. The authors then embedded the specimens in epoxy and ground flat the facial surface to expose middle-depth dentin, which they polished to 600 grit. They used a dental adhesive to apply composite to the exposed dentin. The authors tested the composite-to-dentin shear bond strength 24 hours after bonding. They analyzed the data using global analysis of variance and, when appropriate, multiple post hoc tests (P = .05). RESULTS: Storage in NaClO resulted in significantly lower bond strength than that of the other treatment specimens. Sterilization with the autoclave negatively affected the bond strength of specimens stored initially in dH(2)O or 10 percent formalin, while sterilization with formalin alone had no significant effect on bond strengths. CONCLUSIONS: Storing bovine teeth in 5.25 percent NaClO may negatively affect composite-to-dentin bond strengths. Immersion in 10 percent formalin might be the best option for storage and sterilization of bovine teeth that are to be used in dental bonding studies in vitro.     

Effect of bisphosphonates on anodized and heat-treated titanium surfaces: an animal experimental study

Background: Recent investigations reported that osseointegration of titanium implants can be significantly reinforced with a nanostructure treated with anodic oxidation and heat treatment. This experimental study investigates the effect of bisphosphonates on the nanotubular implant surface in rats. Methods: Thirty‐six titanium implants were divided into three groups: 1) machine‐turned (MT), 2) anodized and heat‐treated (AH), and 3) anodized and heat‐ and bisphosphonate‐treated (AHB) groups. The 36 implants were randomly placed in both tibias of 18 male Wistar rats. After 2 and 4 weeks, the levels of osseointegration of the implants were evaluated by a removal torque test and microcomputerized tomography (μCT). Peri‐implant bone tissue on the extracted region was examined for the expression of type I collagen and osteocalcin. Results: The AHB group showed the highest removal torque at 2 and 4 weeks (13.92 ± 1.51 Ncm and 18.10 ± 2.15 Ncm, respectively) followed, in order, by the AH group (11.63 ± 1.58 Ncm at 2 weeks and 14.80 ± 2.34 Ncm at 4 weeks) and MT group (4.30 ± 0.76 Ncm at 2 weeks and 6.20 ± 1.33 Ncm at 4 weeks) with statistically significant differences between the MT and other two groups at both time points. μCT images also revealed a denser appearance around implants in the AHB group than in the other groups. Levels of type I collagen and osteocalcin expression were similar between the MT and AH groups; however, the values were significantly higher in the AHB group compared to the other groups, which were 220.85% ± 71.09% and 363.04% ± 100.21%, respectively (P <0.05). Conclusion: Within the limits of this experiment, it was concluded that surface loading with bisphosphonates significantly improved the degree of osseointegration of titanium implants with a nanostructure.     

Mechanical properties of computer-aided design/computer-aided manufacturing resin composites assuming perfect silane coupling using in silico homogenization of cryo-electron microscopy images

Purpose

The aim of this study was to determine the mechanical properties of computer-aided design/computer-aided manufacturing (CAD/CAM) resin composites for dental restoration assuming perfect silane coupling by in silico homogenization analysis using a three-dimensional model constructed from cryo-electron microscopy (cryo-EM) images.