A newly developed kit for dental apical root resorption detection: efficacy and acceptability

OBJECTIVES

To determine the efficacy of a newly developed kit in dentine sialophosphoprotein (DSPP) detection and compare it with enzyme-linked immunosorbent assay (ELISA). User acceptance was also determined.

MATERIALS AND METHODS

This cross-sectional study consisted of 45 subjects who were divided into 3 groups based on the severity of root resorption using radiographs: normal (RO), mild (RM), and severe (RS). DSPP in GCF samples was analyzed using both methods. Questionnaires were distributed to 30 orthodontists to evaluate future user acceptance.

RESULTS

The sensitivity and specificity of the kit were 0.98 and 0.8 respectively. The DSPP concentrations measured using ELISA were the highest in the RS group (6.33 ± 0.85 ng/mL) followed by RM group (3.77 ± 0.36 ng/mL) and the RO group had the lowest concentration (2.23 ± 0.55 ng/mL). The new kit portrayed similar results as the ELISA, the optical density (OD) values were the highest in the RS group (0.62 ± 0.10) followed by RM group (0.33 ± 0.03) and the RO group (0.19 ± 0.06). The differences among all the groups were statistically significant (p < 0.05) for both methods. The Pearson correlation coefficient showed a statistically significant (p < 0.001) strong and positive correlation between DSPP concentrations and OD values.

CONCLUSIONS

The new kit was validated to detect the colour intensities of different severity of root resorptions. Most of the responses to the survey were positive towards the new kit for being a safer and simpler method to detect apical root resorption.

Enhanced Osteogenesis Potential of MG-63 Cells through Sustained Delivery of VEGF via Liposomal Hydrogel

The challenges of using VEGF to promote osteoblastic differentiation include a short half-life and a narrow therapeutic window. A carrier system combining hydrogel and liposomes may improve the therapeutic efficacy of VEGF for bone regeneration. This study aimed to investigate the effects of delivery of VEGF via liposomal hydrogel on the osteogenesis of MG-63 cells. Liposomal hydrogel scaffold was fabricated and then characterized in terms of the morphological and chemical properties using FESEM and FTIR. In 2.5D analysis, the MG-63 cells were cultured on liposomal hydrogel + VEGF as the test group. The osteogenic effects of VEGF were compared with the control groups, i.e., hydrogel without liposomes + VEGF, osteogenic medium (OM) supplemented with a bolus of VEGF, and OM without VEGF. Cell morphology, viability, and differentiation and mineralization potential were investigated using FESEM, MTT assay, ALP activity, and Alizarin red staining. The characterization of scaffold showed no significant differences in the morphological and chemical properties between hydrogel with and without liposomes (p > 0.05). The final 2.5D culture demonstrated that cell proliferation, differentiation, and mineralization were significantly enhanced in the liposomal hydrogel + VEGF group compared with the control groups (p < 0.05). In conclusion, liposomal hydrogel can be used to deliver VEGF in a sustained manner in order to enhance the osteogenesis of MG-63 cells.

Association of early childhood caries and nutritional status: a scoping review

The most widespread non-communicable disease in the world is dental caries. Early childhood caries (ECC) is the presence of one or more decayed, missing or filled tooth surfaces in any primary tooth in children between birth and 71 months. The disease has been linked to failure to thrive, impaired speech and reduce food consumption due to pain and discomfort. Nutritional status of a child may also be affected by caries. Thus, we conducted a scoping review to review the association between ECC and nutritional status. A total of 492 articles published until December 2022 from three databases were obtained. 20 relevant articles meeting the inclusion criteria were included. From the included articles, dmft index was the most common dental assessment used, while all articles used anthropometric measurements for nutritional assessment except for two articles that used laboratory methods. Based on the results obtained, majority of the articles stated that there was an association between ECC in children with poor nutritional status, while only one study reported an association between ECC and overweight or obese children. Four papers showed no association. A more standardised and consistent study methodology, sample population and protocol in articles selected may help yield more reliable results.

Enabling Virtual Learning for Biomechanics of Tooth Movement: A Modified Nominal Group Technique

Virtual learning is a medium that can enhance students' understanding of a specific topic. The emergence of the COVID-19 pandemic provided an opportunity for dental education to shift from traditional learning to blended learning as it began to utilize technology to help students study effectively. In this study, we collaborated with experts in the field of dentistry to reach a consensus about which topics are appropriate to include in the virtual learning module about the biomechanics of tooth movement. We convened a panel of five experts who had a minimum of two years of experience in teaching orthodontics and introduced them to the Nominal Group Technique (NGT), which is a well-established, organized, multistep, assisted group meeting technique for generating consensus. The following ten key topics were identified for inclusion in the module: physiology of tooth movement; tooth movement-definition, type, theory, indications; force systems; anchorage; fixed appliances; biomaterials related to tooth movement; removable appliances; factors affecting tooth movement; iatrogenic effect of tooth movement; and current advances and evidence regarding tooth movement. The modified NGT approach led to the development of a ranked thematic list of the topics related to the biomechanics of tooth movement that can be delivered to students via virtual learning.

Quantitative Assessment of Dentine Sialophosphoprotein, Aspartate Aminotransferase and Lactate Dehydrogenase in Gingival Crevicular Fluid of Teeth with Root Resorption

Root resorption is a shortening of root dentine which occurs physiologically in deciduous teeth. The present study aimed to quantify dentine sialophosphoprotein (DSPP), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) in gingival crevicular fluid (GCF) during the physiological process of root resorption of deciduous teeth. A cross-sectional study was conducted with 25 children aged between 4 and 10 years old. GCF was collected from the gingival sulcus using periopaper strips from the upper first deciduous molar (n = 45). The samples were divided equally into three groups, no resorption (R0), moderate resorption (RM) and severe resorption (RS), based on the existing radiographs taken. The GCF samples were then analysed using an enzyme-linked immunosorbent assay (ELISA) kit to determine the DSPP concentration levels and BioAssays System kit for AST and LDH. One-way ANOVA was used to determine the statistical differences between the means of the DSPP, AST and LDH concentration level in the three groups. A difference was considered significant when p < 0.05. High concentration levels of DSPP were significantly noted in RS (p < 0.05), compared to RM and R0. AST also portrayed significant high activity level (p < 0.05) similar to DSPP but LDH showed no significant changes between groups (p > 0.05). The high quantification of DSPP and AST levels in the severe and moderately resorbed roots indicated the potential use of this protein as a biomarker for detecting moderate-severe stages of root resorption.

Orthodontic Induced Inflammatory Root Resorption: The Process Involved and its Management - A Review of Literature

Orthodontically induced inflammatory root resorption (OIIRR) is inevitable as the force applied during orthodontic treatment to initiate tooth movement induces inflammation, causing iatrogenic root resorption. Even with the use of new technologies in orthodontic appliances, the traumatic effects on the periodontium are still present. Therefore, a proper understanding of the biological aspect of OIIRR such as its pathophysiology and the repair process is crucial to aid in its prevention or minimizing the damage to the apical region. Reported studies related to root resorption in orthodontics and its management until 2022 were searched electronically via PubMed, Scopus, and Google Scholar using keywords such as ‘root resorption’, ‘orthodontic treatment’, ‘root resorption repair’, and ‘management’. Other sources were taken from the references of the selected papers. The management of OIIRR has not changed much from the past, which is to temporarily stop the active orthodontic treatment for two to three months and a passive archwire can be used instead. However, interventions such as low-level laser therapy (LLLT), low-intensity pulsed ultrasound (LIPUS), and mechanical vibrational force were introduced to reduce the risk or enhance the healing process of OIIRR. Nevertheless, further studies are warranted to develop a proper usage protocol and the long-term effects of these methods.

Gene expression profiles for in vitro human stem cell differentiation into osteoblasts and osteoclasts: a systematic review

Background

There have been promising results published regarding the potential of stem cells in regenerative medicine. However, the vast variety of choices of techniques and the lack of a standard approach to analyse human osteoblast and osteoclast differentiation may reduce the utility of stem cells as a tool in medical applications. Therefore, this review aims to systematically evaluate the findings based on stem cell differentiation to define a standard gene expression profile approach.

Methods

This review was performed following the PRISMA guidelines. A systematic search of the study was conducted by retrieving articles from the electronic databases PubMed and Web of Science to identify articles focussed on gene expression and approaches for osteoblast and osteoclast differentiation.

Results

Six articles were included in this review; there were original articles of in vitro human stem cell differentiation into osteoblasts and osteoclasts that involved gene expression profiling. Quantitative polymerase chain reaction (qPCR) was the most used technique for gene expression to detect differentiated human osteoblasts and osteoclasts. A total of 16 genes were found to be related to differentiating osteoblast and osteoclast differentiation.

Conclusion

Qualitative information of gene expression provided by qPCR could become a standard technique to analyse the differentiation of human stem cells into osteoblasts and osteoclasts rather than evaluating relative gene expression. RUNX2 and CTSK could be applied to detect osteoblasts and osteoclasts, respectively, while RANKL could be applied to detect both osteoblasts and osteoclasts. This review provides future researchers with a central source of relevant information on the vast variety of gene expression approaches in analysing the differentiation of human osteoblast and osteoclast cells. In addition, these findings should enable researchers to conduct accurately and efficiently studies involving isolated human stem cell differentiation into osteoblasts and osteoclasts.

A two-year comparative assessment of retention of arch width increases between modified vacuum-formed and Hawley retainers: a multi-center randomized clinical trial

Objectives

To compare the clinical effectiveness of Hawley retainers (HRs) and modified vacuum-formed retainers (mVFRs) with palatal coverage in maintaining transverse expansion throughout a 24-month retention period and to assess the subjects’ perception toward the retainers.

Materials and methods

The trial accomplished blinding only by the outcome assessor and data analyst. Data were collected from post-orthodontic treatment patients who met the inclusion criteria. Thirty-five subjects were randomly allocated using a centralized randomization technique into either mVFR (n = 18) or HR group (n = 17). Dental casts of subjects were evaluated at debond (T0), 3-month (T1), 6-month (T2), 12-month (T3), and 24-month retention (T4). The intercanine width (ICW), interpremolar width (IPMW), interfirst molar mesiobuccal cusp width (IFMW1), and interfirst molar distobuccal cusp width (IFMW2) were compared between groups over time using Mixed ANOVA. A pilot-tested and validated questionnaire consisting of six items were given at T4. Subjects were instructed to rate their retainer in terms of fitting, speech, appearance, oral hygiene, durability, and comfort on a 100-mm Visual Analogue Scale (VAS).

Results

No statistically significant differences in arch width were found between the two groups at ICW (P = .83), IPMW (P = 0.63), IFMW1 (P = .22), and IFMW2 (P = .46) during the 24-month retention period. Also, no statistically significant differences were found between perception of both retainers in terms of fitting, speech, oral hygiene, durability, and comfort (P > .05) after 24-month wear. The appearance of mVFRs was rated significantly higher compared to HRs (P < .05).

Conclusions

HR and mVFR have similar clinical effectiveness for retention of transverse expansion cases in a 24-month retention period. Both retainers were perceived to be equal in terms of fitting, speech, oral hygiene, durability, and comfort. Subjects in the mVFRs group found their retainers to be significantly more esthetic than those in HRs group.

Profil Protein Sekretom Sel Stem Pulpa Gigi Manusia semasa Aruhan Asid Askorbik

Pembezaan sel stem secara in vitro kepada osteoblas secara umumnya melibatkan gabungan aruhan asid askorbik dan β-gliserofosfat. Namun, β-gliserofosfat didapati menyebabkan penurunan keviabelan sel. Maka, kajian ini adalah untuk menentukan potensi asid askorbik tanpa kehadiran β-gliserofosfat dalam mengaruh pembezaan osteoblas serta mengenal pasti perubahan keamatan pengekspresan sekretom bagi protein osteoblas. Sel stem pulpa gigi kekal (DPSC) yang dipencilkan; diaruh dengan 10 µg/mL asid askorbik selama 21 hari. Pengekspresan gen osteoblas pada hari ke-7 dan 21 ditentukan melalui transkripsi berbalik-tindak balas rantaian polimerase (RT-PCR). Selepas 21 hari aruhan, sel dieram dengan medium basal tanpa serum selama 12 jam dan dianalisis melalui pendekatan kromatografi cecair-spektrometri jisim/spektrometri jisim (LC-MS/MS). Kehadiran protein sekretom pada kedua-dua aruhan asid askorbik dan kawalan positif (gabungan asid askorbik + β-gliserofosfat) digunakan untuk menentukan proses biologi yang terlibat. Seterusnya, protein yang terlibat dalam pembezaan osteoblas serta mengalami perubahan terhadap keamatan pengekspresannya ditentukan melalui analisis UniProt dan PANTHER. Hubung kait antara protein sekretom ini ditentukan menggunakan STRING bagi penentuan tapak jalan pembezaan DPSC kepada osteoblas. Hasilnya, gen BSP didapati diekspreskan semasa perlakuan asid askorbik serta sebanyak 57 protein sekretom dikenal pasti terlibat semasa aruhan asid askorbik dan kawalan, dengan hanya tiga protein didapati berkaitan dengan pembezaan osteoblas serta mengalami perubahan keamatan pengekspresan melalui penggunaan UniProt dan PANTHER. Seterusnya, analisis menggunakan STRING mendapati hanya dua sekretom bagi DPSC dikenal pasti melibatkan tiga tapak jalan. Kesimpulannya, asid askorbik sahaja walaupun tanpa β-gliserofosfat berupaya mengaruh pengekspresan protein sekretom yang berkaitan dengan osteoblas. Inhibin beta rantai A dan fibrilin-2 dicadangkan sebagai penanda sekretom semasa pembezaan DPSC kepada osteoblas.

Label-free quantitative proteomic analysis of ascorbic acid-induced differentially expressed osteoblast-related proteins in dental pulp stem cells from deciduous and permanent teeth

BACKGROUND

Proteomic is capable of elucidating complex biological systems through protein expression, function, and interaction under a particular condition.

OBJECTIVE

This study was aimed to determine the potential of ascorbic acid alone in inducing differentially expressed osteoblast-related proteins in dental stem cells via liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) approach.

METHODS

The cells were isolated from deciduous (SHED) and permanent teeth (DPSC) and induced with 10 µg/mL ascorbic acid. Bone mineralisation and osteoblast gene expression were determined using von Kossa staining and reverse transcriptase-polymerase chain reaction, respectively. The label-free protein samples were harvested on days 7 and 21 followed by protein identification and quantification using LC-MS/MS. Based on the similar protein expressed throughout treatment and controls for both SHED and DPSC, overall biological processes followed by osteoblast-related protein abundance were determined using the PANTHER database. STRING database was performed to determine differentially expressed proteins as candidates for SHED and DPSC during osteoblast development.

RESULTS

Both cells indicated brownish mineral stain and expression of osteoblast-related genes at day 21. Overall, a total of 700 proteins were similar among all treatments on both days 7 and 21 with 482 proteins appearing in the PANTHER database. Osteoblast-related protein abundance indicated 31 and 14 proteins that related to SHED and DPSC, respectively. Further analysis by the STRING database identified only 22 and 11 proteins involved from the respective group. Differential expressed analysis of similar proteins from these two groups revealed ACTN4 and ACTN1 as proteins that are involved in both SHED and DPSC. In addition, three (PSMD11/RPN11, PLS3, and CLIC1) and one (SYNCRIP) proteins were differentially expressed specifically for SHED and DPSC, respectively.

CONCLUSION

Proteome differential expression showed that ascorbic acid alone can induce osteoblast-related proteins in both SHED and DPSC and generates specific differentially expressed protein markers.

Higher Concentration of Ascorbic Acid as a Sole Induction Factor for Osteogenesis on MC3T3-E1 Cell Model

This research aimed to investigate the potential of ascorbic acid (Asc) to act independently as an osteogenic induction factor in a murine pre-osteoblast (MC3T3-E1) model. MC3T3-E1 cells were seeded in culture wells and hydroxyapatite scaffold for two-dimensional and three-dimensional analyses respectively. Cell morphology, viability, osteoblast differentiation, and mineralisation potentials of MC3T3-E1 cells were compared between induction of standard (50 µg/mL) and doubled (100 µg/mL) Asc concentrations in growth media. Cells with fibroblast-like morphology became confluent earlier on day 6 in the standard group compared to the doubled group on day 9. Cell viability and differentiation potential were significantly increased in the doubled group (p < 0.01). Mineralisation occurred in the doubled group after 15 days of seeding but no mineralisation was seen in the standard group. Findings were similar in 3D analysis whereby mineralized nodules were seen only in the doubled group. The relative expression of collagen 1(α) and osteocalcin genes were increased in the doubled group than the standard group. Doubling Asc concentration in a growth medium to 100 µg/mL can induce viability, differentiation, and mineralisation of MC3T3-E1 cells. Thus, higher concentration of ascorbic acid can potentially be used as the sole induction factor in osteogenic medium.

Comparison between hydroxyapatite and polycaprolactone in inducing osteogenic differentiation and augmenting maxillary bone regeneration in rats

Background

The selection of appropriate scaffold plays an important role in ensuring the success of bone regeneration. The use of scaffolds with different materials and their effect on the osteogenic performance of cells is not well studied and this can affect the selection of suitable scaffolds for transplantation. Hence, this study aimed to investigate the comparative ability of two different synthetic scaffolds, mainly hydroxyapatite (HA) and polycaprolactone (PCL) scaffolds in promoting in vitro and in vivo bone regeneration.

Method

In vitro cell viability, morphology, and alkaline phosphatase (ALP) activity of MC3T3-E1 cells on HA and PCL scaffolds were determined in comparison to the accepted model outlined for two-dimensional systems. An in vivo study involving the transplantation of MC3T3-E1 cells with scaffolds into an artificial bone defect of 4 mm length and 1.5 mm depth in the rat's left maxilla was conducted. Three-dimensional analysis using micro-computed tomography (micro-CT), hematoxylin and eosin (H&E), and immunohistochemistry analyses evaluation were performed after six weeks of transplantation.

Results

MC3T3-E1 cells on the HA scaffold showed the highest cell viability. The cell viability on both scaffolds decreased after 14 days of culture, which reflects the dominant occurrence of osteoblast differentiation. An early sign of osteoblast differentiation can be detected on the PCL scaffold. However, cells on the HA scaffold showed more prominent results with intense mineralized nodules and significantly (p < 0.05) high levels of ALP activity with prolonged osteoblast induction. Micro-CT and H&E analyses confirmed the in vitro results with bone formation were significantly (p < 0.05) greater in HA scaffold and was supported by IHC analysis which confirmed stronger expression of osteogenic markers ALP and osteocalcin.

Conclusion

Different scaffold materials of HA and PCL might have influenced the bone regeneration ability of MC3T3-E1. Regardless, in vitro and in vivo bone regeneration was better in the HA scaffold which indicates its great potential for application in bone regeneration.

Multivariate versus univariate spectrum analysis of dentine sialophosphoprotein (DSPP) for root resorption prediction: a clinical trial

Background

A force applied during orthodontic treatment induces inflammation to root area and lead to root resorption known as orthodontically induced inflammatory root resorption (OIIRR). Dentine sialophosphoprotein (DSPP) is one of the most abundant non-collagenous proteins in dentine that was released into gingival crevicular fluid (GCF) during OIIRR. The aim of this research is to compare DSPP detection using the univariate and multivariate analysis in predicting classification level of root resorption.

Methods

The subjects for this study consisted of 30 patients in 3 group classified as normal, mild, and severe groups of OIIRR. The GCF samples were taken from upper permanent central incisors in the normal and mild group while the upper primary second molars in the severe group. The DSPP qualitative detection limit was determined by analyzing the whole absorption spectrum utilizing multivariate analysis embedded with different preprocessing method. The multivariate analysis represents the multi-wavelength spectrum while univariate analyzes the absorption of a single wavelength.

Results

The results showed that the multivariate analysis technique using partial least square-discriminate analysis (PLS-DA) with the preprocess method has successfully improved in classification prediction for the normal and mild group at 0.88 percent accuracy. The multivariate using PLS-DA algorithm with Mean Center preprocess method was able to predict normal and mild tooth resorption classes better than the univariate analysis. The classification parameters have improved in term of the specificity, precision and accuracy.

Conclusion

Therefore, the multivariate analysis helps to predict an early detection of tooth resorption complimenting the sensitivity of the univariate analysis.

Trial registration NCT 05077878 (14/10/2021).

Chemometrics analysis for the detection of dental caries via UV absorption spectroscopy

Caries is one of the non-communicable diseases that has a high prevalence trend. The current methods used to detect caries require sophisticated laboratory equipment, professional inspection, and expensive equipment such as X-ray imaging device. A non-invasive and economical method is required to substitute the conventional methods for the detection of caries. UV absorption spectroscopy coupled with chemometrics analysis has emerged as a good potential candidate for such an application. Data preprocessing methods such as mean centre, autoscale and Savitzky-Golay smoothing were implemented to enhance the signal-to-noise ratio of spectra data. Various classification algorithms namely K-nearest neighbours (KNN), logistic regression (LR) and linear discriminant analysis (LDA) were implemented to classify the severity of dental caries into International Caries Detection and Assessment System (ICDAS) scores. The performance of the prediction model was measured and comparatively analysed based on the accuracy, precision, sensitivity, and specificity. The LDA algorithm combined with the Savitzky-Golay preprocessing method had shown the best result with respect to the validation data accuracy, precision, sensitivity and specificity, where each had values of 0.90, 1.00, 0.86 and 1.00 respectively. The area under the curve of the ROC plot computed for the LDA algorithm was 0.95, which indicated that the prediction algorithm was capable of differentiating normal and caries teeth excellently.

A Comparative Analysis of Ascorbic Acid-induced Cytotoxicity and Differentiation between SHED and DPSC

Aim:

The aim of this study was to compare dental pulp tissue in human exfoliated deciduous teeth (SHEDs) and dental pulp stem cells (DPSCs) in response to ascorbic acid as the sole osteoblast inducer.

Background:

A cocktail of ascorbic acid, β-glycerophosphate, and dexamethasone has been widely used to induce osteoblast differentiation. However, under certain conditions, β-glycerophosphate and dexamethasone can cause a decrease in cell viability in stem cells.

Objectives:

This study aims to determine the cytotoxic effect and potential of ascorbic acid as the sole inducer of osteoblast differentiation.

Methods:

Cytotoxicity analyses in the presence of 10-500 µg/mL ascorbic acid were performed in both cell types using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The concentrations below the IC50 (i.e., 10-150 µg/mL) were used to determine osteoblast differentiation potential of ascorbic acid using the alkaline phosphatase (ALP) assay, von Kossa staining, and reverse transcription-polymerase chain reaction.

Results:

SHEDs and DPSCs proliferated for 21 days, expressed a Mesenchymal Stem Cell (MSC) marker (CD73+), and did not express Hematopoietic Stem Cell (HSC) markers (CD34- and SLAMF1-). SHEDs had a higher range of IC50 values (215-240 µg/mL ascorbic acid), while the IC50 values for DPSCs were 177-211 µg/mL after 24-72 hours. SHEDs treated with 10-100 µg/mL ascorbic acid alone exhibited higher ALP-specific activity and a higher percentage of mineralisation than DPSCs. Both cell types expressed osteoblast markers on day 21, i.e., RUNX2+ and BSP+, in the presence of ascorbic acid.

Conclusions:

SHEDs survive at higher concentrations of ascorbic acid as compared to DPSC. The cytotoxic effect was only exhibited at ≥250 µg/mL ascorbic acid. In addition, SHED exhibited better ALP and mineralization activities, but lower osteoblast marker expression than DPSC in response to ascorbic acid as the sole inducer.

One-year comparative assessment of retention of arch width increases between modified vacuum-formed and Hawley retainers

OBJECTIVES

To compare the clinical effectiveness of Hawley retainers (HRs) and modified vacuum-formed retainers (mVFRs) with palatal coverage in maintaining transverse expansion during a 12-month retention period.

MATERIALS AND METHODS

Data were collected from postorthodontic treatment patients who met the inclusion criteria. A total of 35 patients were randomly allocated using a centralized randomization technique into either mVFR (n = 18) or HR group (n = 17). The outcome assessor and data analyst were blinded to the retention method. Dental casts of patients were evaluated at debond, 3 months, 6 months, and 12 months of retention. Intercanine width (ICW), interpremolar width (IPMW), interfirst molar mesiobuccal cusp width 1 (IFMW1), and interfirst molar distobuccal cusp width 2 (IFMW2) were compared between groups over time using mixed analysis of variance.

RESULTS

No statistically significant differences were found between the two groups for ICW (P = .76), IPMW (P = .63), IFMW1 (P = .16), and IFMW2 (P = .40) during the 12-month retention period.

CONCLUSIONS

The null hypothesis could not be rejected. HR and mVFR had similar clinical effectiveness in the retention of transverse expansion cases during a 12-month retention period.

Mesenchymal stem cells: A comprehensive methods for odontoblastic induction

BACKGROUND

In the area of oral and maxillofacial surgery, regenerative endodontics aims to present alternative options to conventional treatment strategies. With continuous advances in regenerative medicine, the source of cells used for pulp tissue regeneration is not only limited to mesenchymal stem cells as the non-mesenchymal stem cells have shown capabilities too. In this review, we are systematically assessing the recent findings on odontoblastic differentiation induction with scaffold and non-scaffold approaches.

METHODS

A comprehensive search was conducted in Pubmed, and Scopus, and relevant studies published between 2015 and 2020 were selected following the PRISMA guideline. The main inclusion criteria were that articles must be revolving on method for osteoblast differentiation in vitro study. Therefore, in vivo and human or animal clinical studies were excluded. The search outcomes identified all articles containing the word "odontoblast", "differentiation", and "mesenchymal stem cell".

RESULTS

The literature search identified 99 related studies, but only 11 articles met the inclusion criteria. These include 5 odontoblastic differentiation induction with scaffold, 6 inductions without scaffolds. The data collected were characterised into two main categories: type of cells undergo odontoblastic differentiation, and odontoblastic differentiation techniques using scaffolds or non-scaffold.

CONCLUSION

Based on the data analysis, the scaffold-based odontoblastic induction method seems to be a better option compared to the non-scaffold method. In addition of that, the combination of growth factors in scaffold-based methods could possibly enhance the differentiation. Thus, further detailed studies are still required to understand the mechanism and the way to enhance odontoblastic differentiation.

Comparative evaluation of osteogenic differentiation potential of stem cells derived from dental pulp and exfoliated deciduous teeth cultured over granular hydroxyapatite based scaffold

BACKGROUND

Mesenchymal stem cells isolated from the dental pulp of primary and permanent teeth can be differentiated into different cell types including osteoblasts. This study was conducted to compare the morphology and osteogenic potential of stem cells from exfoliated deciduous teeth (SHED) and dental pulp stem cells (DPSC) in granular hydroxyapatite scaffold (gHA). Preosteoblast cells (MC3T3-E1) were used as a control group.

METHODOLOGY

The expression of stemness markers for DPSC and SHED was evaluated using reverse transcriptase-polymerase chain reaction (RT-PCR). Alkaline phosphatase assay was used to compare the osteoblastic differentiation of these cells (2D culture). Then, cells were seeded on the scaffold and incubated for 21 days. Morphology assessment using field emission scanning electron microscopy (FESEM) was done while osteogenic differentiation was detected using ALP assay (3D culture).

RESULTS

The morphology of cells was mononucleated, fibroblast-like shaped cells with extended cytoplasmic projection. In RT-PCR study, DPSC and SHED expressed GAPDH, CD73, CD105, and CD146 while negatively expressed CD11b, CD34 and CD45. FESEM results showed that by day 21, dental stem cells have a round like morphology which is the morphology of osteoblast as compared to day 7. The osteogenic potential using ALP assay was significantly increased (p < 0.01) in SHED as compared to DPSC and MC3T3-E1 in 2D and 3D cultures.

CONCLUSION

gHA scaffold is an optimal scaffold as it induced osteogenesis in vitro. Besides, SHED had the highest osteogenic potential making them a preferred candidate for tissue engineering in comparison with DPSC.

Label-free quantitative proteomic analysis of gingival crevicular fluid to identify potential early markers for root resorption

Background

Orthodontically-induced root resorption is an iatrogenic effect and it cannot be examined regularly due to the harmful effects of sequential doses of radiation with more frequent radiography. This study aims to compare protein abundance (PA) of pre-treatment and during orthodontic treatment for root resorption and to determine potential early markers for root resorption.

Methods

Ten subjects (n = 10) who had upper and lower fixed appliances (MBT, 3 M Unitek, 0.022″ × 0.028″) were recruited for this study. Human gingival crevicular fluid (GCF) was obtained using periopaper strips at pre-treatment (T0), 1 month (T1), 3 months (T3), and 6 months (T6) of orthodontic treatment. Periapical radiographs of the upper permanent central incisors were taken at T0 and T6 to measure the amount of root resorption. Identification of changes in PA was performed using liquid chromatography-tandem mass spectrometry. Student’s t-test was then performed to determine the significance of the differences in protein abundance before and after orthodontic treatment.

Results

Our findings showed that all ten subjects had mild root resorption, with an average resorption length of 0.56 ± 0.30 mm. A total of 186 proteins were found to be commonly present at T0, T1, T3, and T6. There were significant changes in the abundance of 16 proteins (student’s t-test, p ≤ 0.05). The increased PA of S100A9, immunoglobulin J chain, heat shock protein 1A, immunoglobulin heavy variable 4–34 and vitronectin at T1 suggested a response to stress that involved inflammation during the early phase of orthodontic treatment. On the other hand, the increased PA of thymidine phosphorylase at T3 suggested growth promotion and, angiogenic and chemotactic activities.

Conclusions

The identified proteins can be potential early markers for root resorption based on the increase in their respective PA and predicted roles during the early phase of orthodontic treatment. Non-invasive detection of root resorption using protein markers as early as possible is extremely important as it can aid orthodontists in successful orthodontic treatment.

Effects of the Sintering Process on Nacre-Derived Hydroxyapatite Scaffolds for Bone Engineering

A hydroxyapatite scaffold is a suitable biomaterial for bone tissue engineering due to its chemical component which mimics native bone. Electronic states which present on the surface of hydroxyapatite have the potential to be used to promote the adsorption or transduction of biomolecules such as protein or DNA. This study aimed to compare the morphology and bioactivity of sinter and nonsinter marine-based hydroxyapatite scaffolds. Field emission scanning electron microscopy (FESEM) and micro-computed tomography (microCT) were used to characterize the morphology of both scaffolds. Scaffolds were co-cultured with 5 × 104/cm2 of MC3T3-E1 preosteoblast cells for 7, 14, and 21 days. FESEM was used to observe the cell morphology, and MTT and alkaline phosphatase (ALP) assays were conducted to determine the cell viability and differentiation capacity of cells on both scaffolds. Real-time polymerase chain reaction (rtPCR) was used to identify the expression of osteoblast markers. The sinter scaffold had a porous microstructure with the presence of interconnected pores as compared with the nonsinter scaffold. This sinter scaffold also significantly supported viability and differentiation of the MC3T3-E1 preosteoblast cells (p < 0.05). The marked expression of Col1α1 and osteocalcin (OCN) osteoblast markers were also observed after 14 days of incubation (p < 0.05). The sinter scaffold supported attachment, viability, and differentiation of preosteoblast cells. Hence, sinter hydroxyapatite scaffold from nacreous layer is a promising biomaterial for bone tissue engineering.

Detection methods of orthodontically induced inflammatory root resorption (OIIRR): a review

Background

Orthodontically induced inflammatory root resorption (OIIRR) is unwelcome iatrogenic damage associated with orthodontic treatment. Patients with a high risk of developing OIIRR are commonly monitored using radiographic techniques. Alternative, more sensitive methods using biological markers facilitate the early detection of OIIRR, which can minimise root surface damage and allow the timely cessation of orthodontic treatment in order to facilitate a reparative process.

Aim

The present review examines the current use of 2D and 3D radiographic techniques to detect and quantify OIIRR and, further, evaluates the latest literature on alternative detection methods of OIIRR.

Method

Published studies were searched electronically throughout PubMed, Scopus and ScienceDirect using keywords including ‘root resorption’, ‘OIIRR’, ‘radiograph’ and ‘biological markers’.

Results

The detection methods for OIIRR were divided into radiographic and biological marker methods. Orthopantomogram (OPG) and periapical radiography are currently the most widely used radiographic methods to detect and monitor OIIRR as they are readily available in most dental clinics, cost effective and have a relatively low radiation dose. However, the radiographic methods are not only subject to standardisation and magnification issues, but also require repeated radiation exposure to patients. Therefore, published research into the potential for biological markers as a safer and more sensitive alternative for the early detection of OIIRR was reviewed.

Conclusion

The result of the review highlights the potential for the use of biological markers in the early detection of OIIRR as a relatively safer and more sensitive alternative to conventional radiographic methods.

Insights into the Effects of the Dental Stem Cell Secretome on Nerve Regeneration: Towards Cell-Free Treatment

Cell-free treatment is emerging as an alternative to cell delivery to promote endogenous regeneration using cell-derived factors. The purpose of this article was to systematically review studies of the effects of the dental stem cell secretome on nerve regeneration. PubMed and Scopus databases were used where searched and related studies were selected. The primary search identified 36 articles with the utilized keywords; however, only 13 articles met the defined inclusion criteria. Eight out of thirteen articles included in vivo and in vitro studies. We classified the dental stem cell-derived secretome with its nerve regeneration potential. All studies demonstrated that dental stem cell-derived factors promote neurotrophic effects that can mechanistically stimulate nerve regeneration in neurodegenerative diseases and nerve injury. This data collection will enable researchers to gather information to create a precise formulation for future prescribed treatments.

Salivary Enzymological Profile Of Lactate Dehydrogenase (LDH), Tartrate Resistance Acid Phosphatase (TRAP), Alkaline Phosphatase (ALP) And Aspartate Aminotransferase (AST) During Orthodontic Treatment

Introduction: Orthodontic tooth movement is a complex process involving tooth and periodontal tissue, which release enzymes and biomarkers. The aim of this study was to investigate enzymes activities of salivary fluid during orthodontic treatment. Materials and Methods: A group of nineteen healthy subject (mean age 21.5 years) with Class II/1 malocclusion who required extraction of maxillary first premolar were recruited. Saliva samples were collected from these 19 patients that underwent canine traction using fixed appliances. Enzymes activities were measured before placement of fixed appliances (basal activity) followed with immediately before and weekly canine retraction for five weeks. The specific Lactate Dehydrogenase (LDH), Aspartate Aminotransferase (AST), Tartrate Resistance Acid Phosphatase (TRAP) and Alkaline Phosphatase (ALP) activities in saliva sample were analyzed using spectrophotometer (405nm). Result: No statistical significant (p> 0.05) difference was noted in LDH activity between basal activity and during canine retraction period. AST showed higher activity compared to basal activity from week 0 to week 1 with statistically significant increased (p<0.05) found in week 1. ALP showed significantly higher enzyme activity compared to basal activity from week 1 to 5, with the peak level at week 5. While TRAP showed significant increase in enzyme activity compared to basal activity only at week 2 after canine retraction. Conclusion(s):  Orthodontic tooth movement can be monitored through the expression of AST, TRAP and ALP activity in saliva. Saliva LDH cannot be used as a biomarker in monitoring tooth movement.

Impact of isolation method on doubling time and the quality of chondrocyte and osteoblast differentiated from murine dental pulp stem cells

Background

Stem cells are normally isolated from dental pulps using the enzymatic digestion or the outgrowth method. However, the effects of the isolation method on the quality of the isolated stem cells are not studied in detail in murine models. The aim of this study was to compare the matrices secreted by osteoblast and chondrocytes differentiated from dental pulp stem cells isolated through different means.

Method

DPSC from murine incisors were isolated through either the outgrowth (DPSC-OG) or the enzymatic digestion (DPSC-ED) method. Cells at passage 4 were used in this study. The cells were characterized through morphology and expression of cell surface markers. The cells’ doubling time when cultured using different seeding densities was calculated and analyzed using one-way ANOVA and Tukey’s multiple comparison post-test. The ability of cells to differentiate to chondrocyte and osteoblast was evaluated through staining and analysis on the matrices secreted.

Results

Gene expression analysis showed that DPSC-OG and DPSC-ED expressed dental pulp mesenchymal stem cell markers, but not hematopoietic stem cell markers. The least number of cells that could have been used to culture DPSC-OG and DPSC-ED with the shortest doubling time was 5 × 10² cells/cm² (11.49 ± 2.16 h) and 1 × 10² cells/cm² (10.55 h ± 0.50), respectively. Chondrocytes differentiated from DPSC-ED produced  2 times more proteoglycan and at a faster rate than DPSC-OG. FTIR revealed that DPSC-ED differentiated into osteoblast also secreted matrix, which more resembled a calvaria.

Discussion

Isolation approaches might have influenced the cell populations obtained. This, in turn, resulted in cells with different proliferation and differentiation capability. While both DPSC-OG and DPSC-ED expressed mesenchymal stem cell markers, the percentage of cells carrying each marker might have differed between the two methods. Regardless, enzymatic digestion clearly yielded cells with better characteristics than outgrowth.

Analyses of basal media and serum for in vitro expansion of suspension peripheral blood mononucleated stem cell

Transplantation of stem cells requires a huge amount of cells, deeming the expansion of the cells in vitro necessary. The aim of this study is to define the optimal combination of basal medium and serum for the expansion of suspension peripheral blood mononucleated stem cells (PBMNSCs) without resulting in loss in the differentiation potential. Mononucleated cells were isolated from both mice and human peripheral blood samples through gradient centrifugation and expanded in α-MEM, RPMI, MEM or DMEM supplemented with either NBCS or FBS. The suspension cells were then differentiated to osteoblast. Our data suggested that α-MEM supplemented with 10 % (v/v) NBCS gives the highest fold increase after 14 days of culture for both mice and human PBMNSCs, which were ~1.51 and ~2.01 times, respectively. The suspension PBMNSCs in the respective medium were also able to maintain osteoblast differentiation potential as supported by the significant increase in ALP specific activity. The cells are also viable during the differentiated states when using this media. All these data strongly suggested that α-MEM supplemented with 10 % NBCS is the best media for the expansion of both mouse and human suspension PBMNSCs.

Cytotoxicity effect of degraded and undegraded kappa and iota carrageenan in human intestine and liver cell lines

Background

Carrageenan is a linear sulphated polysaccharide extracted from red seaweed of the Rhodophyceae family. It has broad spectrum of applications in biomedical and biopharmaceutical field. In this study, we determined the cytotoxicity of degraded and undegraded carrageenan in human intestine (Caco-2; cancer and FHs 74 Int; normal) and liver (HepG2; cancer and Fa2N-4; normal) cell lines.

Methods

Food grade k-carrageenan (FGKC), dried sheet k-carrageenan (DKC), commercial grade k-carrageenan (CGKC), food grade i-carrageenan (FGIC) and commercial grade i-carrageenan (CGIC) were dissolved in hydrochloric acid and water to prepare degraded and undegraded carrageenan, respectively. Carrageenan at the concentration range of 62.5 – 2000.0 μg mL⁻¹ was used in the study. MTT assay was used to determine the cell viability while the mode of cell death was determined by May-Grunwald Giemsa (MGG) staining, acridine orange-ethidium bromide (AO/EtBr) staining, agarose gel electrophoresis and gene expression analysis.

Results

Degraded FGKC, DKC and CGKC showed IC₅₀ in 24, 48 and 72 hours treated Caco-2, FHs 74 Int, HepG2 and Fa2N-4 cell lines as tested by MTT assay. Degraded FGIC and CGIC only showed its toxicity in Fa2N-4 cells. The characteristics of apoptosis were demonstrated in degraded k-carrageenan treated Caco-2, FHs 74 Int, HepG2 and Fa2N-4 cells after MGG staining. When Caco-2 and HepG2 cells were undergone AO/EtBr staining, chromatin condensation and nuclear fragmentation were clearly seen under the microscope. However, DNA ladder was only found in HepG2 cells after gel electrophoresis analysis. Degraded k-carrageenan also inactivated PCNA, Ki-67 and survivin gene in HepG2. On the other hand, undegraded FGKC, DKC, CGKC, FGIC and CGIC treated cells showed no cytotoxic effect after analyzed by the same analyses as in degraded carrageenan.

Conclusion

Degraded k-carrageenan inhibited cell proliferation in Caco-2, FHs 74 Int, HepG2 and Fa2N-4 cell lines and the anti-proliferative effect was related to apoptosis together with inactivation of cell proliferating genes as determined by morphological observation and molecular analysis. However, no cytotoxic effect was found in undegraded carrageenan towards normal and cancer intestine and liver cell lines.

Enzyme activity profiles and ELISA analysis of biomarkers from human saliva and gingival crevicular fluid during orthodontic tooth movement using self-ligating brackets

AIM

Profiles of orthodontic tooth movement biomarkers, i.e., Lactate Dehydrogenase (LDH), Aspartate Aminotransferase (AST), Tartrate-resistant Acid Phosphatase (TRAP) and Alkaline Phosphatase (ALP), using Self-ligating Brackets (SLBs) and possible relationships among their activities and total enzymes produced were determined.

METHODS

Saliva and Gingival Crevicular Fluid (GCF) were collected from 19 subjects (n=19) before and during orthodontic treatment (5 weeks). The subjects were bonded with SLBs with 100 g or 150 g of orthodontic force. Enzyme assays, ELISA and tooth movement measurements were performed.

RESULTS

A statistical analysis (paired t-test) showed that compared to baseline values, significant differences (p<0.05) were observed in the saliva levels of AST at week 5, the levels of TRAP at week 2, and the levels of ALP at weeks 1 to 5. In the GCF, LDH showed significant differences (p<0.05) at weeks 2, 3 and 4 (100 g) and at weeks 1, 2 and 3 (150 g). AST showed significant differences (p<0.05) at weeks 4 and 5 (100 g) and at weeks 3 and 4 (150 g), while TRAP exhibited a significant difference at week 5 (100 g). Pearson's correlation test revealed a weak correlation between enzyme activities and total enzymes. The use of 100 g compared to 150 g of force for tooth movement was not significant (p>0.05).

CONCLUSION

Therefore, 100 g is recommended as a better force for patient comfort. AST, TRAP and ALP in the saliva and LDH, AST and TRAP in the GCF are potential biomarkers in orthodontic tooth movement using SLB systems.

In vitro chondrogenesis transformation study of mouse dental pulp stem cells

A major challenge in the application of mesenchymal stem cells in cartilage reconstruction is that whether the cells are able to differentiate into fully mature chondrocytes before grafting. The aim of this study was to isolate mouse dental pulp stem cells (DPSC) and differentiate them into chondrocytes. For this investigation, morphological, molecular, and biochemical analyses for differentiated cells were used. To induce the chondrocyte differentiation, DPSC were cultured in chondrogenic medium (Zen-Bio, Inc.). Based on morphological analyses using toluidine blue staining, proteoglycan products appear in DPSC after 21 days of chondrocyte induction. Biochemical analyses in differentiated group showed that alkaline phosphatase activity was significantly increased at day 14 as compared to control (P < 0.05). Cell viability analyses during the differentiation to chondrocytes also showed that these cells were viable during differentiation. However, after the 14th day of differentiation, there was a significant decrease (P < 0.05) in the viability proportion among differentiated cells as compared to the control cells. In RT-PCR molecular analyses, mouse DPSC expressed Cd146 and Cd166 which indicated that these cells belong to mesenchymal stem cells. Coll I and Coll II markers showed high expression after 14 and 21 days, respectively. In conclusion, this study showed that DPSC successfully differentiated into chondrocytes.

Proteomic analysis of saliva identifies potential biomarkers for orthodontic tooth movement

Orthodontic treatment has been shown to induce inflammation, followed by bone remodelling in the periodontium. These processes trigger the secretion of various proteins and enzymes into the saliva. This study aims to identify salivary proteins that change in expression during orthodontic tooth movement. These differentially expressed proteins can potentially serve as protein biomarkers for the monitoring of orthodontic treatment and tooth movement. Whole saliva from three healthy female subjects were collected before force application using fixed appliance and at 14 days after 0.014'' Niti wire was applied. Salivary proteins were resolved using two-dimensional gel electrophoresis (2DE) over a pH range of 3-10, and the resulting proteome profiles were compared. Differentially expressed protein spots were then identified by MALDI-TOF/TOF tandem mass spectrometry. Nine proteins were found to be differentially expressed; however, only eight were identified by MALDI-TOF/TOF. Four of these proteins-Protein S100-A9, immunoglobulin J chain, Ig alpha-1 chain C region, and CRISP-3-have known roles in inflammation and bone resorption.

Characterization of mononucleated human peripheral blood cells

Unspecialized cells that can renew themselves and give rise to multiple differentiated cell types are termed stem cells. The objective of this study was to characterize and investigate, through molecular and biochemical analyses, the stemness of cells derived from isolated mononucleated cells that originated from peripheral blood. The isolated mononucleated cells were separated according to their physical characteristics (adherent and suspension), after 4 to 7 days into a 14-day culturing period in complete medium. Our results revealed that adherent and suspension cells were positive for mesenchymal stem cell (MSC) and hematopoietic stem cell (HSC) markers, respectively. Differentiation of adherent cells into osteoblasts was associated with expression of the OPN gene and increasing ALP enzyme activity, while differentiation of suspension cells into osteoclasts was associated with expression of the TRAP gene and increasing TRAP enzyme activity. In conclusion, molecular and biochemical analyses showed that mononucleated cells consist of MSC (adherent) and HSC (suspension), and both cell types are able to differentiate into specialized cells from their respective lineage: osteoblast (MSC) and osteoclast (HSC).

Molecular markers of dental pulp tissue during orthodontic tooth movement: a pilot study

Three specific orthodontic tooth movement genes, that is, FCRL1, HSPG2, and LAMB2 were detected at upper first premolar (with appliance) dental pulp tissue by using GeneFishing technique as compared to lower first premolar (without appliance). These three differentially expressed genes have the potential as molecular markers during orthodontic tooth movement by looking at molecular changes of pulp tissue.

Stem cell heterogeneity of mononucleated cells from murine peripheral blood: molecular analysis

The main purpose of this paper was to determine the heterogeneity of primary isolated mononucleated cells that originated from the peripheral blood system by observing molecular markers. The isolated cells were cultured in complete medium for 4 to 7 days prior to the separation of different cell types, that is, adherent and suspension. Following a total culture time of 14 days, adherent cells activated the Cd105 gene while suspension cells activated the Sca-1 gene. Both progenitor markers, Cbfa-1 and Ostf-1, were inactivated in both suspension and adherent cells after 14-day culture compared to cells cultured 3 days in designated differentiation medium. In conclusion, molecular analyses showed that primary mononucleated cells are heterogeneous, consisting of hematopoietic stem cells (suspension) and mesenchymal stem cells (adherent) while both cells contained no progenitor cells.

Cellular and molecular changes in orthodontic tooth movement

Tooth movement induced by orthodontic treatment can cause sequential reactions involving the periodontal tissue and alveolar bone, resulting in the release of numerous substances from the dental tissues and surrounding structures. To better understand the biological processes involved in orthodontic treatment, improve treatment, and reduce adverse side effects, several of these substances have been proposed as biomarkers. Potential biological markers can be collected from different tissue samples, and suitable sampling is important to accurately reflect biological processes. This paper covers the tissue changes that are involved during orthodontic tooth movement such as at compression region (involving osteoblasts), tension region (involving osteoclasts), dental root, and pulp tissues. Besides, the involvement of stem cells and their development towards osteoblasts and osteoclasts during orthodontic treatment have also been explained. Several possible biomarkers representing these biological changes during specific phenomenon, that is, bone remodelling (formation and resorption), inflammation, and root resorption have also been proposed. The knowledge of these biomarkers could be used in accelerating orthodontic treatment.

Differentiation analyses of adult suspension mononucleated peripheral blood cells of Mus musculus

Background

The purpose of this study is to determine whether isolated suspension mouse peripheral mononucleated blood cells have the potential to differentiate into two distinct types of cells, i.e., osteoblasts and osteoclasts.

Results

Differentiation into osteoblast cells was concomitant with the activation of the Opn gene, increment of alkaline phosphatase (ALP) activity and the existence of bone nodules, whereas osteoclast cells activated the Catk gene, increment of tartrate resistant acid phosphatase (TRAP) activity and showed resorption activities via resorption pits. Morphology analyses showed the morphology of osteoblast and osteoclast cells after von Kossa and May-Grunwald-Giemsa staining respectively.

Conclusions

In conclusion, suspension mononucleated cells have the potentiality to differentiate into mature osteoblasts and osteoclasts, and hence can be categorized as multipotent stem cells.

Intrinsic anticarcinogenic effects of Piper sarmentosum ethanolic extract on a human hepatoma cell line

Background

Piper sarmentosum, locally known as kaduk is belonging to the family of Piperaceae. It is our interest to evaluate their effect on human hepatoma cell line (HepG2) for the potential of anticarcinogenic activity.

Results

The anticarcinogenic activity of an ethanolic extract from Piper sarmentosum in HepG2 and non-malignant Chang's liver cell lines has been previously determined using (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl-tetrazolium bromide) (MTT) assays, where the IC₅₀ value was used as a parameter for cytotoxicity. The ethanolic extract that showed anticarcinogenic properties in HepG2 cells had an IC₅₀ of 12.5 μg mL^-1, while IC₅₀ values in the non-malignant Chang's liver cell line were greater than 30 μg mL^-1. Apoptotic morphological changes in HepG2 cells were observed using an inverted microscope and showed chromatin condensation, cell shrinkage and apoptotic bodies following May-Grunwald-Giemsa's staining. The percentage of apoptotic cells in the overall population (apoptotic index) showed a continuously significant increase (p < 0.05) in 12.5 μg mL^-1 ethanolic extract-treated cells at 24, 48 and 72 hours compared to controls (untreated cells). Following acridine orange and ethidium bromide staining, treatment with 10, 12 and 14 μg mL^-1 of ethanolic extracts caused typical apoptotic morphological changes in HepG2 cells. Molecular analysis of DNA fragmentation was used to examine intrinsic apoptosis induced by the ethanolic extracts. These results showed a typical intrinsic apoptotic characterisation, which included fragmentation of nuclear DNA in ethanolic extract-treated HepG2 cells. However, the non-malignant Chang's liver cell line produced no DNA fragmentation. In addition, the DNA genome was similarly intact for both the untreated non-malignant Chang's liver and HepG2 cell lines.

Conclusion

Therefore, our results suggest that the ethanolic extract from P. sarmentosum induced anticarcinogenic activity through an intrinsic apoptosis pathway in HepG2 cells in vitro.