Characterization by Electron Spin Resonance Spectroscopy of Reactive Oxygen Species Generated by Titanium Dioxide and Hydrogen Peroxide

Mitochondrial Redox Balance of Fibroblasts Exposed to Ti-6Al-4V Microplates Subjected to Different Types of Anodizing

Despite the high biocompatibility of titanium and its alloys, the need to remove titanium implants is increasingly being debated due to the potential for adverse effects associated with long-term retention. Therefore, new solutions are being sought to enhance the biocompatibility of titanium implants. One of them is to increase the thickness of the passive layer of the implant made of titanium dioxide. We were the first to evaluate the effect of hard-anodized (type II) Ti-6Al-4V alloy discs on the cytotoxicity, mitochondrial function, and redox balance of fibroblasts mitochondria compared to standard-anodized (type III) and non-anodized discs. The study used fibroblasts obtained from human gingival tissue. The test discs were applied to the bottom of 12-well plates. Cells were cultured for 24 h and 7, 14, and 21 days and mitochondria were isolated. We demonstrated the occurrence of oxidative stress in the mitochondria of fibroblasts of all tested groups, regardless of the presence and type of anodization. Type II anodization prevented changes in complex II activity (vs. control). The lowest degree of citrate synthase inhibition occurred in mitochondria exposed to titanium discs with type II anodization. In the last phase of culture, the presence of type II anodization reduced the degree of cytochrome c oxidase inhibition compared to the other tests groups and the control group, and prevented apoptosis. Throughout the experiment, the release of titanium, aluminium, and vanadium ions from titanium discs with a hard-anodized passive layer was higher than from the other titanium discs, but decreased with time. The obtained results proved the existence of dysfunction and redox imbalance in the mitochondria of fibroblasts exposed to hard-anodized titanium discs, suggesting the need to search for new materials perhaps biodegradable in tissues of the human body.

Avoiding implant-related complications in medically compromised patients with or without unhealthy lifestyle/Elevated oxidative stress

Increased human life expectancy broadens the alternatives for missing teeth and played a role in the widespread use of dental implants and related augmentation procedures for the aging population. Though, many of these patients may have one or more diseases. These systemic conditions may directly lead to surgical complications, compromise implant/bone healing, or influence long-term peri-implant health and its response to biologic nuisances. Offering patients credible expectations regarding intra- and postoperative complications and therapeutic prognosis is an ethical and legal obligation. Clear identification of potential types of adverse effects, complications, or errors is important for decision-making processes as they may be related to different local, systemic, and technical aspects. Therefore, the present review structures the underlying biological mechanisms, clinical evidence, and clinical recommendations for the most common systemic risk factors for implant-related complications.

Applications of Antioxidants in Dental Procedures

As people are paying more and more attention to dental health, various dental treatment procedures have emerged, such as tooth bleaching, dental implants, and dental restorations. However, a large number of free radicals are typically produced during the dental procedures. When the imbalance in distribution of reactive oxygen species (ROS) is induced, oxidative stress coupled with oxidative damage occurs. Oral inflammations such as those in periodontitis and pulpitis are also unavoidable. Therefore, the applications of exogenous antioxidants in oral environment have been proposed. In this article, the origin of ROS during dental procedures, the types of antioxidants, and their working mechanisms are reviewed. Additionally, antioxidants delivery in the complicated dental procedures and their feasibility for clinical applications are also covered. Finally, the importance of safety assessment of these materials and future work to take the challenge in antioxidants development are proposed for perspective.

Application of antibacterial nanoparticles in orthodontic materials

During the orthodontic process, increased microbial colonization and dental plaque formation on the orthodontic appliances and auxiliaries are major complications, causing oral infectious diseases, such as dental caries and periodontal diseases. To reduce plaque accumulation, antimicrobial materials are increasingly being investigated and applied to orthodontic appliances and auxiliaries by various methods. Through the development of nanotechnology, nanoparticles (NPs) have been reported to exhibit excellent antibacterial properties and have been applied in orthodontic materials to decrease dental plaque accumulation. In this review, we present the current development, antibacterial mechanisms, biocompatibility, and application of antibacterial NPs in orthodontic materials.

Effects of toothbrush abrasion on surface and antibacterial properties of hydroxyapatite-tryptophan complex with gray titania

Photocatalysts have attracted attention in the medical field for their antibacterial effects. However, typical photocatalysts are activated by ultraviolet rays, which may have adverse effects. Therefore, we focused on a new photocatalyst that is activated by visible light, hydroxyapatite (HAp), and amino acid complex with gray titania, and evaluated its antibacterial effects against Porphyromonas gingivalis and effect by toothbrushing. The test sample was a titanium alloy substrate, and four surface treatments were applied: (1) substrate only, (2) substrate with HAp complex, (3) substrate with HAp complex with gray titania, and (4) HAp-tryptophan complex with gray titania (TR). These surface treatments were evaluated with or without toothbrushing (8 total groups). Surface roughness (Sa), fluorescent X-ray analysis (XRF), and scanning electron microscopy (SEM) were used to evaluate surface properties. To investigate antibacterial effects, each sample was seeded with P. gingivalis, irradiated with red light, and total viable bacterial count was determined. For Sa measurement, TR showed no significant difference after toothbrushing. However, in XRF and SEM observation, TR exhibited peeling of the applied coating after toothbrushing. In the antibacterial test, TR showed a decrease in P. gingivalis under no toothbrushing condition. Conversely, with toothbrushing, the TR coating appeared to peel. However, no significant difference in P. gingivalis count was observed among all groups. HAp-tryptophan complex with gray titania coating showed an antibacterial effect against P. gingivalis when irradiated with visible light. However, toothbrushing can result in coat peeling and consequently reduce the antibacterial effect.

Microstructural effect of a laser-activated bleaching agent containing titanium dioxide on human enamel

Aim:

This study aimed to evaluate the effect of a laser-activated bleaching agent containing titanium dioxide (TiO₂) nanoparticles on enamel roughness and hardness.

Materials and Methods:

Twenty human premolars were randomized into two groups according to the bleaching treatments performed: HP – 35% hydrogen peroxide and HP + TiO₂ – 30% hydrogen peroxide containing TiO₂ light-activated by diode laser (980 nm). It was performed two bleaching sessions with an interval of 7 days. Microhardness and roughness of the enamel were assessed at three times: T0 – Before 1^st appointment, T1 – after 2^nd appointment, and T2–7 days after 2^nd appointment.

Results:

The HP + TiO₂ did not cause changes on enamel roughness and hardness and presented the same effects of the HP.

Conclusions:

Both bleaching agents showed no difference between them. Then, it is possible to conclude that both are viable for clinical use during in-office dental bleaching technique regarding the microstructural changes that they might cause.

In Vitro Macrophage Immunomodulation by Poly(ε-caprolactone) Based-Coated AZ31 Mg Alloy

Due to its excellent bone-like mechanical properties and non-toxicity, magnesium (Mg) and its alloys have attracted great interest as biomaterials for orthopaedic applications. However, their fast degradation rate in physiological environments leads to an acute inflammatory response, restricting their use as biodegradable metallic implants. Endowing Mg-based biomaterials with immunomodulatory properties can help trigger a desired immune response capable of supporting a favorable healing process. In this study, electrospun poly(ε-caprolactone) (PCL) fibers loaded with coumarin (CM) and/or zinc oxide nanoparticles (ZnO) were used to coat the commercial AZ31 Mg alloy as single and combined formulas, and their effects on the macrophage inflammatory response and osteoclastogenic process were investigated by indirect contact studies. Likewise, the capacity of the analyzed samples to generate reactive oxygen species (ROS) has been investigated. The data obtained by attenuated total reflection Fourier-transform infrared (FTIR-ATR) and X-ray photoelectron spectroscopy (XPS) analyses indicate that AZ31 alloy was perfectly coated with the PCL fibers loaded with CM and ZnO, which had an important influence on tuning the release of the active ingredient. Furthermore, in terms of degradation in phosphate-buffered saline (PBS) solution, the PCL-ZnO- and secondary PCL-CM-ZnO-coated samples exhibited the best corrosion behaviour. The in vitro results showed the PCL-CM-ZnO and, to a lower extent, PCL-ZnO coated sample exhibited the best behaviour in terms of inflammatory response and receptor activator of nuclear factor kappa-B ligand (RANKL)-mediated differentiation of RAW 264.7 macrophages into osteoclasts. Altogether, the results obtained suggest that the coating of Mg alloys with fibrous PCL containing CM and/or ZnO can constitute a feasible strategy for biomedical applications.

Organic Degradation Potential of Real Greywater Using TiO2-Based Advanced Oxidation Processes

In keeping with the circular economy approach, reclaiming greywater (GW) is considered a sustainable approach to local reuse of wastewater and a viable option to reduce household demand for freshwater. This study investigated the mineralization of total organic carbon (TOC) in GW using TiO2-based advanced oxidation processes (AOPs) in a custom-built stirred tank reactor. The combinations of H2O2, O3, and immobilized TiO2 under either dark or UVA irradiation conditions were systematically evaluated—namely TiO2/dark, O3/dark (ozonation), H2O2/dark (peroxidation), TiO2/UVA (photocatalysis), O3/UVA (Ozone photolysis), H2O2/UVA (photo-peroxidation), O3/TiO2/dark (catalytic ozonation), O3/TiO2/UVA (photocatalytic ozonation), H2O2/TiO2/dark, H2O2/TiO2/UVA, H2O2/O3/dark (peroxonation), H2O2/O3/UVA (photo-peroxonation), H2O2/O3/TiO2/dark (catalytic peroxonation), and H2O2/O3/TiO2/UVA (photocatalytic peroxonation). It was found that combining different treatment methods with UVA irradiation dramatically enhanced the organic mineralization efficiency. The optimum TiO2 loading in this study was observed to be 0.96 mg/cm2 with the highest TOC removal (54%) achieved using photocatalytic peroxonation under optimal conditions (0.96 mg TiO2/cm2, 25 mg O3/min, and 0.7 H2O2/O3 molar ratio). In peroxonation and photo-peroxonation, the optimal H2O2/O3 molar ratio was identified to be a critical efficiency parameter maximizing the production of reactive radical species. Increasing ozone flow rate or H2O2 dosage was observed to cause an efficiency inhibition effect. This lab-based study demonstrates the potential for combined TiO2-AOP treatments to significantly reduce the organic fraction of real GW, offering potential for the development of low-cost systems permitting safe GW reuse.

Titanium dioxide nanotubes incorporated into bleaching agents: physicochemical characterization and enamel color change

Titanium dioxide nanotubes are nanostructures that can accelerate the oxidation reaction of bleaching procedures and promote a more effective whitening effect.

The Effect of TBB, as an Initiator, on the Biological Compatibility of PMMA/MMA Bone Cement

Acrylic bone cement is widely used in orthopedic surgery for treating various conditions of the bone and joints. Bone cement consists of methyl methacrylate (MMA), polymethyl methacrylate (PMMA), and benzoyl peroxide (BPO), functioning as a liquid monomer, solid phase, and polymerization initiator, respectively. However, cell and tissue toxicity caused by bone cement has been a concern. This study aimed to determine the effect of tri-n-butyl borane (TBB) as an initiator on the biocompatibility of bone cement. Rat spine bone marrow-derived osteoblasts were cultured on two commercially available PMMA-BPO bone cements and a PMMA-TBB experimental material. After a 24-h incubation, more cells survived on PMMA-TBB than on PMMA-BPO. Cytomorphometry showed that the area of cell spread was greater on PMMA-TBB than on PMMA-BPO. Analysis of alkaline phosphatase activity, gene expression, and matrix mineralization showed that the osteoblastic differentiation was substantially advanced on the PMMA-TBB. Electron spin resonance (ESR) spectroscopy revealed that polymerization radical production within the PMMA-TBB was 1/15–1/20 of that within the PMMA-BPO. Thus, the use of TBB as an initiator, improved the biocompatibility and physicochemical properties of the PMMA-based material.

Novel Osteogenic Behaviors around Hydrophilic and Radical-Free 4-META/MMA-TBB: Implications of an Osseointegrating Bone Cement

Poly(methyl methacrylate) (PMMA)-based bone cement, which is widely used to affix orthopedic metallic implants, is considered bio-tolerant but lacks osteoconductivity and is cytotoxic. Implant loosening and toxic complications are significant and recognized problems. Here we devised two strategies to improve PMMA-based bone cement: (1) adding 4-methacryloyloxylethyl trimellitate anhydride (4-META) to MMA monomer to render it hydrophilic; and (2) using tri-n-butyl borane (TBB) as a polymerization initiator instead of benzoyl peroxide (BPO) to reduce free radical production. Rat bone marrow-derived osteoblasts were cultured on PMMA-BPO, common bone cement ingredients, and 4-META/MMA-TBB, newly formulated ingredients. After 24 h of incubation, more cells survived on 4-META/MMA-TBB than on PMMA-BPO. The mineralized area was 20-times greater on 4-META/MMA-TBB than PMMA-BPO at the later culture stage and was accompanied by upregulated osteogenic gene expression. The strength of bone-to-cement integration in rat femurs was 4- and 7-times greater for 4-META/MMA-TBB than PMMA-BPO during early- and late-stage healing, respectively. MicroCT and histomorphometric analyses revealed contact osteogenesis exclusively around 4-META/MMA-TBB, with minimal soft tissue interposition. Hydrophilicity of 4-META/MMA-TBB was sustained for 24 h, particularly under wet conditions, whereas PMMA-BPO was hydrophobic immediately after mixing and was unaffected by time or condition. Electron spin resonance (ESR) spectroscopy revealed that the free radical production for 4-META/MMA-TBB was 1/10 to 1/20 that of PMMA-BPO within 24 h, and the substantial difference persisted for at least 10 days. The compromised ability of PMMA-BPO in recruiting cells was substantially alleviated by adding free radical-scavenging amino-acid N-acetyl cysteine (NAC) into the material, whereas adding NAC did not affect the ability of 4-META/MMA-TBB. These results suggest that 4-META/MMA-TBB shows significantly reduced cytotoxicity compared to PMMA-BPO and induces osteoconductivity due to uniquely created hydrophilic and radical-free interface. Further pre-clinical and clinical validations are warranted.

Antioxidant properties of ALD grown nanoceria films with tunable valency

Herein, we provide the first account of a method to control cerium oxide's mixed valence states (as Ce³⁺ to Ce⁴⁺ ratio) in ultra-thin films formed via atomic layer deposition (ALD). It is determined that modulation of Ce³⁺/Ce⁴⁺ ratio occurs with respect to film thickness and is analogous to the change in surface chemistry observed for cerium oxide nanoparticles with varying particle diameter. The influence of film thickness on enzyme-mimetic radical scavenging is also characterized. Higher film thicknesses show 9-fold increase in catalytic activity. In vitro biocompatibility (apoptosis < 4%) and electrochemical biosensing (lowest concentration: 18 ppt) studies were performed to demonstrate the potential of ALD-grown nanoceria films for biomedical applications.

Glutathione Metabolism, Mitochondria Activity, and Nitrosative Stress in Patients Treated for Mandible Fractures

The aim of the study was to evaluate the effect of titanium bone fixations on mitochondrial activity, reactive oxygen species (ROS) production, glutathione metabolism, and selected markers of oxidative/nitrosative stress in the periosteum-like tissue of patients treated with mandible fractures. The study group consisted of 30 patients with bilateral fractures of the mandible body eligible for surgical treatment. Our study is the first one that indicates disturbances of mitochondrial activity as well as a higher production of ROS in the periosteum-like tissue covering titanium fixations of the mandible. We also found significantly higher levels of reduced glutathione and enhanced activity of glutathione reductase in the periosteum homogenates of patients in the study group compared to the control group. Levels of nitrosative (S-nitrosothiols, peroxynitrite, nitrotyrosine) and oxidative stress biomarkers (malondialdehyde, protein carbonyls, dityrosine, kynurenine, and N-formylkynurenine) were statistically elevated in periosteum-like tissue covering titanium fixations. Although exposure to titanium fixations induces local antioxidant mechanisms, patients suffer oxidative damage, and in the periosteum-like tissue the phenomenon of metallosis was observed. Titanium implants cause oxidative/nitrosative stress as well as disturbances in mitochondrial activity.

Factors impacting the interactions of engineered nanoparticles with bacterial cells and biofilms: Mechanistic insights and state of knowledge

Since their advent a few decades ago, engineered nanoparticles (ENPs) have been extensively used in consumer products and industrial applications and their use is expected to continue at the rate of thousands of tons per year in the next decade. The widespread use of ENPs poses a potential risk of large scale environmental proliferation of ENPs which can impact and endanger environmental health and safety. Recent studies have shown that microbial biofilms can serve as an important biotic component for partitioning and perhaps storage of ENPs released into aqueous systems. Considering that biofilms can be one of the major sinks for ENPs in the environment, and that the field of biofilms itself is only three to four decades old, there is a recent and growing body of literature investigating the ENP-biofilm interactions. While looking at biofilms, it is imperative to consider the interactions of ENPs with the planktonic microbial cells inhabiting the bulk systems in the vicinity of surface-attached biofilms. In this review article, we attempt to establish the state of current knowledge regarding the interactions of ENPs with bacterial cells and biofilms, identifying key governing factors and interaction mechanisms, as well as prominent knowledge gaps. Since the context of ENP-biofilm interactions can be multifarious-ranging from ecological systems to water and wastewater treatment to dental/medically relevant biofilms- and includes devising novel strategies for biofilm control, we believe this review will serve an interdisciplinary audience. Finally, the article also touches upon the future directions that the research in the ENP-microbial cells/biofilm interactions could take. Continued research in this area is important to not only enhance our scientific knowledge and arsenal for biofilm control, but to also support environmental health while reaping the benefits of the 'nanomaterial revolution'.

Long-term antimicrobial assessment of orthodontic brackets coated with nitrogen-doped titanium dioxide against Streptococcus mutans

Background

The antimicrobial properties of orthodontic wire and brackets with nitrogen-doped titanium dioxide (N-doped TiO2) coating have been studied in the past. However, the evaluation period had been short and limited to 30 days. The aim of the present study was to extend the evaluation period (up to 90 days) of assessing the long-term antimicrobial effects of stainless steel orthodontic brackets coated with nitrogen-doped titanium dioxide (N-doped TiO2).

Methods

A total of 40 stainless steel pre-adjusted premolar brackets were equally divided into two groups; namely the control group (n=20, uncoated brackets) and the experimental group (n=20, coated brackets). RF magnetron sputtering was used to apply a thin film of TiO2 on the bracket surface. The crystalline structure of the thin film was assessed using X-ray diffraction. The antimicrobial property of the brackets against Streptococcus mutans (S. mutans) was evaluated using the survival rate by colony-forming units (CFU) at four intervals: 24 hours (T0), 30 days (T1), 60 days (T2), and 90 days (T3). 2-way ANOVA Repeated Measures was used to compare the effects between the groups over the time.

Results

There was no significant interaction between group and time (p = 0.568). The orthodontic brackets coated with the N-doped TiO2 thin film showed a significant CFU reduction (37.71 ± 5.21, 37.81 ± 5.03, 37.98 ± 5.37, and 37.74 ± 5.21 at T0, T1, T2, and T3, respectively) compared to the uncoated brackets (400.91 ± 14.67, 401.58 ± 14.01, 400.31 ± 14.68, and 402.04 ± 13.98 at T0, T1, T2, and T3, respectively) through visible light (p < 0.001).

Conclusion

N-doped TiO2 coated orthodontic brackets showed strong antimicrobial property against S. mutans over a period of 90 days, which is effective in preventing enamel decalcification during orthodontic therapy.

Exposure to Ti4Al4V Titanium Alloy Leads to Redox Abnormalities, Oxidative Stress, and Oxidative Damage in Patients Treated for Mandible Fractures

Due to the high biotolerance, favourable mechanical properties, and osseointegration ability, titanium is the basic biomaterial used in maxillofacial surgery. The passive layer of titanium dioxide on the surface of the implant effectively provides anticorrosive properties, but it can be damaged, resulting in the release of titanium ions to the surrounding tissues. The aim of our work was to evaluate the influence of Ti6Al4V titanium alloy on redox balance and oxidative damage in the periosteum surrounding the titanium miniplates and screws as well as in plasma and erythrocytes of patients with mandibular fractures. The study included 31 previously implanted patients (aged 21-29) treated for mandibular fractures and 31 healthy controls. We have demonstrated increased activity/concentration of antioxidants both in the mandibular periosteum and plasma/erythrocytes of patients with titanium mandibular fixations. However, increased concentrations of the products of oxidative protein and lipid modifications were only observed in the periosteum of the study group patients. The correlation between the products of oxidative modification of the mandible and antioxidants in plasma/erythrocytes suggests a relationship between the increase of oxidative damage at the implantation site and central redox disorders in patients with titanium miniplates and screws.

Antimicrobial effect of titanium dioxide after ultraviolet irradiation against periodontal pathogen

We focused on the antimicrobial effects of titanium dioxide (TiO2) after stopping ultraviolet (UV) irradiation as an adjunctive treatment for peri-implantitis in this study. The aim was to determine the continuous photocatalytic effects of TiO2 after UV irradiation and its antimicrobial activity against periodontal pathogen. The continuous photocatalytic effects of TiO2 after UV irradiation were determined by electron spin resonance (ESR) spectroscopy using TiO2 particles of various sizes with various UV irradiation times. In addition, antimicrobial activity against Porphyromonas gingivalis was investigated by quantitation of colony-forming units (CFUs). The results showed that the ESR signal ratio for the UV-irradiated TiO2 was significantly higher than that of the non-irradiated TiO2. UV-irradiated TiO2 significantly reduced the number of P. gingivalis when compared with non-irradiated controls. These results suggest that TiO2 has a continuous photocatalytic effect even after stopping UV irradiation and that it showed antimicrobial activity against periodontal pathogen.

The Redox Balance in Erythrocytes, Plasma, and Periosteum of Patients with Titanium Fixation of the Jaw

Titanium miniplates and screws are commonly used for fixation of jaw fractured or osteotomies. Despite the opinion of their biocompatibility, in clinical practice symptoms of chronic inflammation around the fixation develop in some patients, even many years after the application of miniplates and screws. The cause of these complications is still an unanswered question. Taking into account that oxidative stress is one of the toxic action of titanium, we have evaluated the antioxidant barrier as well as oxidative stress in the erythrocytes, plasma and periosteum covering the titanium fixation of the jaw. The study group was composed of 32 patients aged 20–30 with inserted miniplates and screws. The antioxidant defense: catalase (CAT), glutathione peroxidase (GPx), superoxide dismutase-1 (SOD1), uric acid (UA), total antioxidant capacity (TAC), as well as oxidative damage products: advanced oxidation protein products (AOPP), advanced glycation end products (AGE), dityrosine, kynurenine, N-formylkynurenine, tryptophan, malondialdehyde (MDA), 4-hydroxynonenal (4-HNE), total oxidant status (TOS), and oxidative status index (OSI) were evaluated. SOD1 activity (↓37%), and tryptophan levels (↓34%) showed a significant decrease while AOPP (↑25%), TOS (↑80%) and OSI (↑101%) were significantly elevated in maxillary periosteum of patients who underwent bimaxillary osteotomies as compared to the control group. SOD-1 (↓55%), TAC (↓58.6%), AGE (↓60%) and N-formylkynurenine (↓34%) was statistically reduced while AOPP (↑38%), MDA (↑29%), 4-HNE (↑114%), TOS (↑99%), and OSI (↑381%) were significantly higher in the mandibular periosteum covering miniplates/screw compared with the control tissues. There were no correlations between antioxidants and oxidative stress markers in the periosteum of all patients and the blood. As exposure to the Ti6Al4V titanium alloy leads to disturbances of redox balance in the periosteum surrounding titanium implants of the maxilla and the mandible so antioxidant supplementation should be recommended to the patients undergoing treatment of dentofacial deformities with the use of titanium implants. The results we obtained may also indicate a need to improve the quality of titanium jaw fixations through increase of TiO₂ passivation layer thickness or to develop new, the most highly biodegradable materials for their production.

Melatonin: A Review of Its Potential Functions and Effects on Dental Diseases

Melatonin is a hormone synthesised and secreted by the pineal gland and other organs. Its secretion, controlled by an endogenous circadian cycle, has been proven to exert immunological, anti-oxidant, and anti-inflammatory effects that can be beneficial in the treatment of certain dental diseases. This article is aimed at carrying out a review of the literature published about the use of melatonin in the dental field and summarising its potential effects. In this review article, an extensive search in different databases of scientific journals was performed with the objective of summarising all of the information published on melatonin use in dental diseases, focussing on periodontal diseases and dental implantology. Melatonin released in a natural way into the saliva, or added as an external treatment, may have important implications for dental disorders, such as periodontal disease, as well as in the osseointegration of dental implants, due to its anti-inflammatory and osseoconductive effects. Melatonin has demonstrated to have beneficial effects on dental pathologies, although further research is needed to understand the exact mechanisms of this molecule.

Characterization of titanium dioxide nanoparticles modified with polyacrylic acid and H2O2 for use as a novel radiosensitizer

An induction of polyacrylic acid-modified titanium dioxide with hydrogen peroxide nanoparticles (PAA-TiO₂/H₂O₂ NPs) to a tumor exerted a therapeutic enhancement of X-ray irradiation in our previous study. To understand the mechanism of the radiosensitizing effect of PAA-TiO₂/H₂O₂ NPs, analytical observations that included DLS, FE-SEM, FT-IR, XAFS, and Raman spectrometry were performed. In addition, highly reactive oxygen species (hROS) which PAA-TiO₂/H₂O₂ NPs produced with X-ray irradiation were quantified by using a chemiluminescence method and a EPR spin-trapping method. We found that PAA-TiO₂/H₂O₂ NPs have almost the same characteristics as PAA-TiO₂. Surprisingly, there were no significant differences in hROS generation. However, the existence of H₂O₂ was confirmed in PAA-TiO₂/H₂O₂ NPs, because spontaneous hROS production was observed w/o X-ray irradiation. In addition, PAA-TiO₂/H₂O₂ NPs had a curious characteristic whereby they absorbed H₂O₂ molecules and released them gradually into a liquid phase. Based on these results, the H₂O₂ was continuously released from PAA-TiO₂/H₂O₂ NPs, and then released H₂O₂ assumed to be functioned indirectly as a radiosensitizing factor.

Role of physical and chemical interactions in the antibacterial behavior of ZnO nanoparticles against E. coli

Zinc oxide (ZnO) nanoparticles (NPs) exhibit antibacterial activity against both Gram-positive and Gram-negative bacteria. However, the antimicrobial mechanism of ZnO NPs remains unclear. In this study, we investigated the interactions among ZnO NPs, released chemicals (Zn(2+) and Reactive Oxygen Species, ROS) and Escherichia coli (E. coli) cells. ZnO NPs without contacting with bacterial cells showed strong antibacterial effect. The results of the leakage of intracellular K(+) and integrity of carboxyfluoresce in-filled liposomes showed that ZnO NPs have antimicrobial activity against E. coli by non-specifically disrupting E. coli membranes. Traces of zinc ions (1.25mg/L) and hydrogen peroxide (from 1.25 to 4.5μM/L) were detected in ZnO NPs suspensions, but was insufficient to cause the antibacterial effect. However, the addition of radical scavengers suppressed the bactericidal effect of ZnO coated films against E. coli, potentially implicating ROS generation, especially hydroxyl radicals, in the antibacterial ability of ZnO NPs.

The role of angiogenesis in implant dentistry part I: Review of titanium alloys, surface characteristics and treatments

Background

Angiogenesis plays an important role in osseointegration process by contributing to inflammatory and regenerative phases of surrounding alveolar bone. The present review evaluated the effect of titanium alloys and their surface characteristics including: surface topography (macro, micro, and nano), surface wettability/energy, surface hydrophilicity or hydrophobicity, surface charge, and surface treatments of dental implants on angiogenesis events, which occur during osseointegration period.

Material and Methods

An electronic search was performed in PubMed, MEDLINE, and EMBASE databases via OVID using the keywords mentioned in the PubMed and MeSH headings regarding the role of angiogenesis in implant dentistry from January 2000-April 2014.

Results

Of the 2,691 articles identified in our initial search results, only 30 met the inclusion criteria set for this review. The hydrophilicity and topography of dental implants are the most important and effective surface characteristics in angiogenesis and osteogenesis processes. The surface treatments or modifications of dental implants are mainly directed through the enhancement of biological activity and functionalization in order to promote osteogenesis and angiogenesis, and accelerate the osseointegration procedure.

Conclusions

Angiogenesis is of great importance in implant dentistry in a manner that most of the surface characteristics and treatments of dental implants are directed toward creating a more pro-angiogenic surface on dental implants. A number of studies discussed the effect of titanium alloys, dental implant surface characteristic and treatments on agiogenesis process. However, clinical trials and in-vivo studies delineating the mechanisms of dental implants, and their surface characteristics or treatments, action in angiogenesis processes are lagging.

Key words:Angiogenesis, dental implant, osseointergration.

Biocompatibility of 4-META/MMA-TBB resin used as a dental luting agent

STATEMENT OF PROBLEM

The bonding and biological properties of currently used luting/cementing materials need to be improved. 4-Acryloyloxyethyl trimellitate anhydride/methyl methacrylate-tri-n-butylborane (4-META/MMA-TBB) resin is primarily used for splinting mobile teeth or treating fractured teeth. It undergoes moisture-resistant polymerization and bonds strongly to dentin and metals.

PURPOSE

The purpose of this in vitro study was to compare the biological and biochemical properties META/MMA-TBB resin with those of conventional polymethyl methacrylate (PMMA)-MMA resin and other currently used luting materials in order to determine whether it may be a viable dental luting agent.

MATERIAL AND METHODS

The degree of polymerization of 4-META/MMA-TBB resin, PMMA-MMA autopolymerizing resin, 10-methacryloyloxydecyl dihydrogen phosphate-dimethacrylate (MDP-DMA) adhesive resin, and a glass ionomer cement was measured by Fourier-transformed infrared spectroscopy. Free radical production during setting was evaluated by electron spin resonance (ESR) spectroscopy. Rat dental pulp cells cultured on these materials were examined for cell viability, attachment, proliferation, and functional phenotype.

RESULTS

The degree of polymerization of 4-META/MMA-TBB resin was 82% thirty minutes after preparation, compared to 66% for PMMA-MMA autopolymerizing resin. ESR spectroscopy revealed free radical production from 4-META/MMA-TBB resin and glass ionomer cement was equivalent 24 hours after preparation, with no spike in radical generation observed. In contrast, free radical production from PMMA-MMA and MDP-DMA adhesive resins was rapid and sustained and 10 to 20 times greater than that from 4-META/MMA-TBB. The percentage of viable dental pulp cells 24 hours after seeding was considerably higher on MDP-DMA and 4-META/MMA-TBB resin than on glass ionomer cement. Cell number, proliferation, and alkaline phosphatase activity were highest on 4-META/MMA-TBB resin and lowest on the glass ionomer cement.

CONCLUSIONS

4-META/MMA-TBB resin is at least as biocompatible, and perhaps even more biocompatible, than other current luting materials, with fast, favorable, and nontoxic polymerization properties. Further in vivo and human studies of 4-META/MMA-TBB resin as a dental luting agent are warranted.

On the use of capillary cytometry for assessing the bactericidal effect of TiO2. Identification and involvement of reactive oxygen species

The photocatalytic antimicrobial properties of TiO2 were studied on Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa bacterial strains taken as model strains for pathogenic species mainly implied in nosocomial infections. Capillary cytometry, coupled to a double-staining method for visualizing membrane integrity as a cell viability indicator, was highlighted as a rapid, easy-to-use, and automated numeration technique for quantitative and reproducible determination of cellular viability and thus, was able to give an accurate evaluation of the bactericidal effect of UV-A photocatalysis. Cytometry also enabled the study of TiO2-bacteria interactions and aggregation in the dark as well as TiO2 cytotoxicity. Compared with the traditional agar plate cultivation method, a significatively weaker reduction in cell viability was recorded by cytometry whatever the bacteria, TiO2 concentration, and duration of the photocatalytic treatment. The mismatch between both numeration methods was attributed to: (i) the presence of mixed bacteria-TiO2 aggregates that could interfere with bacteria measurement on plates, (ii) prolonged contact of the bacteria with TiO2 during incubation, which could cause additional cytotoxic damage to the bacterial wall, and (iii) the counting of viable but non-culturable bacteria as live bacteria in cytometry, whereas they cannot grow on solid media. A more pronounced difference was observed for P. aeruginosa and S. aureus bacteria, for which 2.9 and 1.9 log10 survival reduction overestimations were measured by plate counting, respectively. Using chemiluminescence, full restoration of cell viability by controlled addition of the O2˙(-) scavenger superoxide dismutase enzyme suggests that O2˙(-) acts, in our conditions, as the main reactive oxygen species responsible for the photocatalytic attack towards the targeted bacteria.

PPARγ delivered by Ch-GNPs onto titanium surfaces inhibits implant-induced inflammation and induces bone mineralization of MC-3T3E1 osteoblast-like cells

OBJECTIVES

To deliver the efficacy and safety of Ch-GNPs (Chitosan gold nanoparticles) conjugated anti-inflammatory molecules peroxisome proliferator activated receptor gamma (PPARγ) on implant surface titanium (Ti) to reduce implant-induced inflammation.

MATERIALS AND METHODS

The Ch-GNPs were conjugated with the PPARγ cDNA through a coacervation process. Conjugation was cast over Ti surfaces by dipping, and cells were seeded on different sizes (6 × 6 × 0.1 cm and 1 × 1 × 0.1 cm; n = 3) of Ti surfaces. The size of Ch-GNPs and surface characterization of Ti was performed using UV-vis spectroscopy, TEM (Transmission electron microscopy) and EDX (energy-dispersive X-ray). The DNA conjugation and transfection capacity of Ch-GNPs were simultaneously confirmed by agarose gel electrophoresis, β-galactosidase staining, and immunoblotting.

RESULTS

The Ch-GNPs were well dispersed and spherical in shape, with average size around 10-20 nm. Ti surfaces coated with Ch-GNPs/LacZ, as transfection efficacy molecule, showed strong β-galactosidase staining in MC-3T3 E1 cells. Cells cultured on Ch-GNPs/PPARγ-coated Ti surfaces were able to inhibit implant-induced inflammation by simultaneously suppressing the expression of tumor necrosis factor- alpha (TNF-α), interleukin-1 beta (IL-1β), inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), and matrix metalloproteinase-2 (MMP-2). The inhibition mechanism of Ch-GNPs/PPARγ was due to inhibition of both reactive oxygen species (ROS) and nitric oxide (NO) secretion (n = 3; P < 0.05). In addition, Ch-GNPs/PPARγ was able to increase expression of bone morphogenetic protein (BMP-7) and runt-related transcription factor-2 (RUNX-2). Furthermore, alkaline phosphatase activity (ALP) was also increased than that in control (n = 3; P < 0.01). Whereas, expression of receptor activator of NF-κB ligand (RANKL) was decreased.

CONCLUSIONS

The novel gene delivery materials, like Ch-GNPs, can carry the PPARγ cDNA into the required areas of the implant surfaces, thus aiding to inhibit inflammation and promote osteoblast function. Thus, the PPARγ on implant surfaces may promote its clinical application on peri-implantitis or periodontitis like diseases.

ESR investigation of ROS generated by H2O2 bleaching with TiO2 coated HAp

It is well known that clinical bleaching can be achieved with a solution of 30% hydrogen peroxide (H2O2) or H2O2/titanium dioxide (TiO2) combination. This study examined the hypothesis that TiO2 coated with hydroxyapatite (HAp-TiO2) can generate reactive oxygen species (ROS). ROS are generated via photocatalysis using electron spin resonance (ESR). The bleaching properties of HAp-TiO2 in the presence of H2O2 can be measured using hematoporphyrin litmus paper and extracted teeth. We demonstrate that superoxides (O2(•-)) and hydroxyl radicals (HO(•)) can be generated through excitation of anatase TiO2, rutile TiO2, anatase HAp-TiO2, and rutile HAp-TiO2 in the presence of H2O2. The combination of R HAp-TiO2 with H2O2 produced the highest level of HO(•) generation and the most marked bleaching effects of all the samples. The superior bleaching effects exhibited by R HAp-TiO2 with H2O2 suggest that this combination may lead to novel methods for the clinical application of bleaching treatments.

Study of the effects of total flavonoids of Astragalus on atherosclerosis formation and potential mechanisms

Astragalus mongholicus Bunge has long been used to treat cardiovascular disease in Chinese traditional medicine. However, its mechanisms are not fully understood. In this study, we explored potential mechanisms and protective effects of total flavonoids of Astragalus (TFA) on cardiovascular disease using in vitro experiments and diet-induced atherosclerotic rabbits. We identified six components and their proportion in TFA. The animal experiments showed that TFA significantly reduced plasma levels of total cholesterol and LDL cholesterol (P < 0.05 to 0.01), increased HDL cholesterol levels (P < 0.01), and reduced the aortic fatty streak area by 43.6 to 63.6% (P < 0.01). We also found that TFA scavenged superoxide and hydroxyl radicals and this effect increased with higher TFA concentration. In in vivo experiments, TFA effectively inhibited the free radical spectrum in the ischemia-reperfusion module. In conclusion, TFA was the active component of Astragalus mongholicus Bunge, which benefits cardiovascular disease attributing to the potent antioxidant activity to improve the atherosclerosis profile.

Assessments of salivary antioxidant activity using electron spin resonance spectroscopy

OBJECTIVE

In recent years, the function of saliva has been focused on evaluation of general status. The relationship between salivary antioxidant activity and periodontal disease progression is unclear. The aim of this study is to assess the relationship between periodontal disease and salivary antioxidant activity towards various reactive oxygen species (ROS) using electron spin resonance (ESR) technique.

METHODS

We demonstrated that whole saliva derived rats or human subjects scavenged ROS such as superoxide (O(2)(·-)) and hydroxyl radical (HO(·)) using ESR spectroscopy with spin trapping agent. In addition, we assessed the relationship between antioxidants activity towards ROS and periodontal index with superoxide dismutase (SOD) activity in human subject saliva.

RESULTS

Antioxidant activity towards O(2)(·-) was increased by Porphyromonas gingivalis (P. gingivalis) infection in rat, although antioxidant activity towards HO(·) was not changed. In human, a strong correlation (r = 0.88, p < 0.01) recognized between salivary antioxidant activity towards O(2)(·-) and probing pocket depth (PPD). In addition, the intensity of salivary antioxidant activity depended on SOD activity level. SOD activity was also correlated with PPD.

CONCLUSIONS

Rat salivary antioxidant activity towards O(2)(·-) was up-regulated by the inflammatory response caused by P. gingivalis infection. Similar response was recognized in human saliva with periodontal index. Additionally, a linear correlation between antioxidant activity towards O(2)(·-) and SOD activity was verified by ESR technique. Therefore, evaluation of the salivary antioxidant activity towards O(2)(·-) might be an effective parameter for the objective assessment of periodontal disease progression.

Enhancement of osteoblast biocompatibility on titanium surface with Terrein treatment

Titanium is biocompatible with bodily tissues. However, the formation of ROS on the titanium surfaces might have negative response of the activity of the surroundings cells. Terrein was isolated from Penicullium sp. 20135 and found to reduce the effects of LPS-induced inflammation. This study examined the role of Terrein on the biocompatibility of titanium to determine if it can help improve osseointegration. MC-3T3 E1 cells were grown on titanium surfaces. The biocompatibility of Terrein was examined by adding it directly to the culture media at the indicated concentration. The cells on the titanium surface produced excessive ROS and decreased the activity of Cu/Zn SOD and Mn SOD. Moreover, the cells had higher activity towards oxidative stress molecules, such as MAPK, FAK and iNOS expression. In addition, MC-3T3 E1 osteoblast-like cells promoted osteoclast differentiation but reduced osteoblast differentiation and mineralization on the titanium surface. Interestingly, the cells given the Terrein treatment showed higher resistance towards oxidative stress through the up-regulation of ERK1/2 and FAK activity but the down-regulation of SAPK/JNK and iNOS activity. Moreover, Terrein promoted osteoblast differentiation and bone mineralization to elevate the activity of ALP, SPARC and down-regulate RANKL expression after blocking NF-κB translocation from the cytosol to the nucleus. In conclusion, the presence of Terrein on titanium surfaces increases osteoblast cell growth without inflammation. Moreover, Terrein, as a putative antioxidant agent, may enhance osseointegration by decreasing the level of ROS and having a potentially synergistic effect on osteoblast differentiation.

Evaluating cytotoxicity and cellular uptake from the presence of variously processed TiO2 nanostructured morphologies

We evaluated the cytotoxicity of various morphological classes of TiO(2) nanostructures (including 0-D nanoparticles, 1-D nanorods, and 3-D assemblies) toward living cells. These TiO(2) nanostructures were modified with fluorescent dye molecules, mediated via a dopamine linkage, in order to facilitate a confocal study of their internalization. Specifically, we noted that both TiO(2) 1-D nanorods and 0-D nanoparticles could internalize into cells after 24 h of incubation time. However, only incubation with TiO(2) 1-D nanorods and 3-D micrometer-scale sea urchin-like assemblies at concentrations of up to 125 microg/mL yielded data suggestive of cell viabilities of close to 100%. Moreover, upon irradiation with UV light for periods of a few minutes at energy densities of up to 1 J/cm(2), we observed up to 60% mortality rates, indicative of the cytotoxic potential of photoirradiated TiO(2) nanostructures due to the generation of reactive oxygen species.

ESR detection of ROS generated by TiO2 coated with fluoridated apatite

Specific materials used in the manufacture of dentures may enhance the removal of micro-organisms. The ultraviolet A (UVA) irradiation of acrylic resin containing titanium dioxide (TiO(2)) generates reactive oxygen species (ROS) by photocatalysis that shows antibacterial effects. In this study, we tested the hypothesis that TiO(2) coated with fluoridated apatite (FAp-TiO(2)) can generate ROS via photo-catalysis by using electron spin resonance (ESR), and that acrylic resin containing FAp-TiO(2) can show antifungal properties by measuring the viability of Candida albicans. We demonstrated that hydroxyl radicals (HO(*)) were generated through excitation of TiO(2), TiO(2) coated with apatite (HAp-TiO(2)), and FAp-TiO(2). The HO(*) generation through excitation of FAp-TiO(2) was higher than that of TiO(2) and HAp-TiO(2). Regarding antifungal activity, cell viability on acrylic resin containing FAp-TiO(2) was lower than that of TiO(2) and HAp-TiO(2). FAp-TiO(2) showed superior photocatalytic effects, and these characteristics may lead to novel methods for the clinical application of denture-cleaning treatments.

Actions of melatonin mixed with collagenized porcine bone versus porcine bone only on osteointegration of dental implants

This study evaluated the effect of the topical application of melatonin mixed with collagenized porcine bone on the osteointegration on the rough discrete calcium deposit (DCD) surface implants in Beagle dogs 3 months after their insertion. In preparation for subsequent insertion of dental implants, lower molars were extracted from 12 Beagle dogs. Each mandible received two parallel wall expanded platform implants with a DCD surface of 4 mm in diameter and 10 mm in length. The implants were randomly assigned to the distal sites on each mandible in the molar area and the gaps were filled with 5 mg lyophilized powdered melatonin and porcine bone and collagenized porcine bone alone. Ten histological sections per implant were obtained for histomorphometric studies. After a 4-wk treatment period, melatonin plus porcine bone significantly increased the perimeter of bone that was in direct contact with the treated implants (P < 0.0001), bone density (P < 0.0001), and new bone formation (P < 0.0001) in comparison with porcine bone alone around the implants. Melatonin plus collagenized porcine bone on DCD surface may act as a biomimetic agent in the placement of endo-osseous dental implants and enhance the osteointegration. Melatonin combined with porcine bone on DCD implants reveals more bone in implant contact at 12 wk (84.5 +/- 1.5%) compared with porcine bone alone treated area (67.17 +/- 1.2%).

Effect of titanium on lipoprotein lipase activity in vivo and in vitro

SUMMARY

Lipoprotein lipase (LPL) is a major lipolytic enzyme in the intravascular metabolism of postprandial triglyceride-rich lipoproteins. This enzyme is synthesized and secreted by tissues and transported to the capillary endothelial surface. Decreased activity of this enzyme is suggested to be involved in arterial sequestration of lipoproteins and thus in the progression of atherosclerosis. Titanium salts are widely used in industry, medicine, and pharmacy for tablet coating, pharmaceuticals and cosmetic products. In this study the effect of titanium on post-heparin LPL activity is reported in vivo and in vitro.

METHODS

Groups of Male Wistar rats were administered (i.p) with an acute dose of 2.5 mg/kg titanium chloride for 10 days and a chronic dose of 0.75 mg/kg for 30 and/or 60 days. Blood samples were then collected for LPL assay. For in vitro study, plasma aliquots were incubated in the presence of up to 50 mM titanium and the enzyme activity was measured.

RESULTS

Animals exposed to acute dose of titanium showed about 20% reduction in LPL activity, whereas 31% and 36% reductions were observed in animals chronically exposed for 30 and/or 60 days, respectively. Titanium in vitro also led to enzyme inhibition, so that a decrease of 28-53% was seen in the presence of 0.1-50 mM titanium. This inhibition by titanium was potentiated when citrate and/or bicarbonate was present.

CONCLUSION

Although the mechanism of titanium effect on LPL activity in vivo and in vitro demands more investigations, the inhibitory effect of titanium ion in vivo should be considered seriously in subjects exposed to this metal ion. Changes in LPL activity may affect whole body lipid metabolism, a condition favorable for development and progression of atherosclerosis.

Melatonin plus porcine bone on discrete calcium deposit implant surface stimulates osteointegration in dental implants

The aim of this study was to evaluate the effect of the topical application of melatonin mixed with collagenized porcine bone to accelerate the osteointegration on the rough discrete calcium deposit (DCD) surface implants in Beagle dogs 3 months after their insertion. In preparation for subsequent insertion of dental implants, lower premolars and molars were extracted from 12 Beagle dogs. Each mandible received three parallel wall implants with discrete calcium deposit (DCD) surface of 4 mm in diameter and 10 mm in length. The implants were randomly assigned to the distal sites on each side of the mandible in three groups: group I implants alone, group II implants with melatonin and group III implants with melatonin and porcine bone. Prior to implanting, 5 mg lyophylized powdered melatonin was applied to one bone hole at each side of the mandible. None was applied at the control sites. Ten histological sections per implant were obtained for histomorphometric studies. After a 4-wk treatment period, melatonin significantly increased the perimeter of bone that was in direct contact with the treated implants (P < 0.0001), bone density (P < 0.0001), new bone formation (P < 0.0001) in comparison with control implants. Topical application of melatonin on DCD surface may act as a biomimetic agent in the placement of endo-osseous dental implants and enhance the osteointegration. Melatonin combined with porcine bone on DCD implants reveals more bone to implant contact at 12 wk (84.5 +/- 1.5%) compared with melatonin treated (75.1 +/- 1.4%) and nonmelatonin treated surface implants (64 +/- 1.4%).

Optimisation of the hydrogen peroxide pre-treatment of titanium: surface characterisation and protein adsorption

BACKGROUND

Researchers have attempted to enhance titanium osseointegration by modifying its surface properties, including via H(2)O(2) pre-treatment, with reported treatment regimes varying from minutes/hours, to weeks.

OBJECTIVE

This study examined the effects of various H(2)O(2) treatments on titanium surface topography/roughness, chemical composition/oxide thickness, hydrophilicity and plasma protein adsorption.

MATERIALS AND METHODS

Titanium discs were treated with 30% H(2)O(2) for 0-24 h or 1-4 weeks and subjected to atomic force microscopy (AFM), scanning electron microscopy (SEM), profilometry, X-ray photon spectroscopy and contact angle analysis. For protein adsorption, whole plasma and FITC-conjugated serum albumin were added to 0-24 h and 1-4 week H(2)O(2)-treated discs and examined by SEM and fluorescence microscopy, respectively.

RESULTS

AFM, SEM and profilometry demonstrated that 1-6 h H(2)O(2)-treated discs exhibited subtle alterations in surface topography/roughness at the nanometre scale, although 24 h and 1-4 week H(2)O(2)-treated discs exhibited much greater increases in surface roughness, in the micrometre range. Maximal increases in surface oxide thickness and chemical modification were identified between 1 h-4 weeks and 3 h-4 weeks, respectively, although no increases in oxygen/titanium (O1s : Ti2p) molar ratio or in hydrophilicity were evident. Plasma and serum albumin adsorption increased on 1-24 h H(2)O(2)-treated discs, with further increases on 1-4 week H(2)O(2)-treated discs.

CONCLUSIONS

Based upon the present data and previous findings, this study supports the concept that surface topography/roughness and oxide composition/thickness, are more significantly modified by H(2)O(2) treatment and more influential to protein adsorption than hydrophilicity. Additionally, it can be hypothesized that the 24 h H(2)O(2) treatment of titanium surfaces, which induced micrometre scale changes in roughness and protein adsorption, to those associated with enhanced osteoblast attachment/behaviour, mineralisation and subsequent implant osseointegration, would be most beneficial.

N-acetyl cysteine (NAC)-mediated detoxification and functionalization of poly(methyl methacrylate) bone cement

Currently used poly(methyl methacrylate) (PMMA)-based bone cement lacks osteoconductivity and induces osteolysis and implant loosening due to its cellular and tissue-toxicity. A high percentage of revision surgery following the use of bone cement has become a significant universal problem. This study determined whether incorporation of the amino acid derivative N-acetyl cysteine (NAC) in bone cement reduces its cytotoxicity and adds osteoconductivity to the material. Biocompatibility and bioactivity of PMMA-based bone cement with or without 25mm NAC incorporation was examined using rat bone marrow-derived osteoblastic cells. Osteoconductive potential of NAC-incorporated bone cement was determined by microCT bone morphometry and implant biomechanical test in the rat model. Generation of free radicals within the polymerizing bone cement was examined using electron spin resonance spectroscopy. Severely compromised viability and completely suppressed phenotypes of osteoblasts on untreated bone cement were restored to the normal level by NAC incorporation. Bone volume formed around 25mm NAC-incorporated bone cement was threefold greater than that around control bone cement. The strength of bone-bone cement integration was 2.2 times greater for NAC-incorporated bone cement. For NAC-incorporated bone cement, the spike of free radical generation ended within 12h, whereas for control bone cement, a peak level lasted for 6 days and a level greater than half the level of the peak was sustained for 20 days. NAC also increased the level of antioxidant glutathione in osteoblasts. These results suggest that incorporation of NAC in PMMA bone cement detoxifies the material by immediate and effective in situ scavenging of free radicals and increasing intracellular antioxidant reserves, and consequently adds osteoconductivity to the material.

Melatonin stimulates osteointegration of dental implants

The aim of this study was to evaluate the effect of the topical application of melatonin on osteointegration of dental implants in Beagle dogs 14 days after their insertion. In preparation for subsequent insertion of dental implants, upper and lower premolars and molars were extracted from 12 Beagle dogs. Each mandible received cylindrical screw implants of 3.25 mm in diameter and 10 mm in length. The implants were randomly assigned to the mesial and distal sites on each side of the mandible. Prior to implanting, 1.2 mg lyophylized powdered melatonin was applied to one bone hole at each side of the mandible. None was applied at the control sites. Eight histological sections per implant were obtained for histomorphometric studies. After a 2-wk treatment period, melatonin significantly increased the perimeter of bone that was in direct contact with the treated implants (P < 0.0001), bone density (P < 0.0001), new bone formation (P < 0.0001) and inter-thread bone (P < 0.05) in comparison with control implants. Topical application of melatonin may act as a biomimetic agent in the placement of endo-osseous dental implants.