Differentiation and proliferation of periosteal osteoblast progenitors are differentially regulated by estrogens and intermittent parathyroid hormone administration

The periosteum is now widely recognized as a homeostatic and therapeutic target for actions of sex steroids and intermittent PTH administration. The mechanisms by which estrogens suppress but PTH promotes periosteal expansion are not known. In this report, we show that intermittent PTH(1-34) promotes differentiation of periosteal osteoblast precursors as evidenced by the stimulation of the expression or activity of alkaline phosphatase as well as of targets of the bone morphogenetic protein 2 (BMP-2) and Wnt pathways. In contrast, 17beta-estradiol (E2) had no effect by itself. However, it attenuated PTH- or BMP-2-induced differentiation of primary periosteal osteoblast progenitors. Administration of intermittent PTH to ovariectomized mice induced rapid phosphorylation of the BMP-2 target Smad1/5/8 in the periosteum. A replacement dose of E2 had no effect by itself but suppressed PTH-induced phosphorylation of Smad1/5/8. In contrast to its effects to stimulate periosteal osteoblast differentiation, PTH promoted and subsequently suppressed proliferation of periosteal osteoblast progenitors in vitro and in vivo. E2 promoted proliferation and attenuated the antiproliferative effect of PTH. Both hormones protected periosteal osteoblasts from apoptosis induced by various proapoptotic agents. These observations suggest that the different effects of PTH and estrogens on the periosteum result from opposing actions on the recruitment of early periosteal osteoblast progenitors. Intermittent PTH promotes osteoblast differentiation from periosteum-derived mesenchymal progenitors through ERK-, BMP-, and Wnt-dependent signaling pathways. Estrogens promote proliferation of early osteoblast progenitors but inhibit their differentiation by osteogenic agents such as PTH or BMP-2.     

Blood Cells Attachment after Root Conditioning and PRP Application: An in vitro Study

Aim: Root conditioning is aimed at smear layer removal and at dental matrix collagen exposure, which may promote periodontal regeneration. This in vitro study assessed smear layer removal, collagen fiber exposure and the influence of PRP (platelet-rich plasma) application on adhesion of blood cells to the root surface using scanning electron microscopy (SEM). Materials and methods: Scaled root samples (n = 160) were set in five groups and conditioned with: group I - control group (saline solution); group II (EDTA 24%); group III (citric acid 25%); group IV (tetracycline hydrochloride 50 mg/ml); group V (sodium citrate 30%). Eighty samples were assessed using the root surface modification index (RSMI). The other eighty samples were set in two groups. The first group (n = 40) received PRP gel application with a soft brush and the second group (n = 40) received PRP application and then a blood drop. The fibrin clot formation was assessed in the first group and the blood cells adhesion was assessed in the second group using the BEAI (blood elements adhesion index). A previously trained, calibrated, and blind examiner evaluated photomicrographs. Statistical analysis was performed using the Kruskal-Wallis's and Dunn's tests. Results: Group III attained the best results for RSMI and BEAI. Moreover, it was the only group showing fibrin clot formation. Conclusion: Citric acid was the most efficient conditioner for smear layer removal, collagen fiber exposure and blood cell adhesion. Moreover, it was the only group showing fibrin clot formation after PRP application. Clinical significance: This study demonstrated that root conditioning followed by PRP application may favor blood cell adhesion on root surface which may optimize periodontal healing. Keywords: Root conditioning, Blood, Platelet-rich plasma, Smear layer, Edetic acid, Citric acid, Tetracycline, Laboratory research. How to cite this article: Dantas AAR, Fontanari LA, Ishi EP, Leite FRM, Zandim DL, Abi Rached RSG, Sampaio JEC. Blood Cells Attachment after Root Conditioning and PRP Application: An in vitro Study. J Contemp Dent Pract 2012;13(3):332-338. Source of support: The study was financially supported by CAPES-Coordination for the Improvement of Higher Education Personnel (Brasilia, DF, Brazil). Conflict of interest: None declared.     

Influence of concentration, time and method of application of citric acid and sodium citrate in root conditioning

Objective

The aim of this study was to establish the parameters of concentration, time and mode of application of citric acid and sodium citrate in relation to root conditioning.

Material and Methods

A total of 495 samples were obtained and equally distributed among 11 groups (5 for testing different concentrations of citric acid, 5 for testing different concentrations of sodium citrate and 1 control group). After laboratorial processing, the samples were analyzed under scanning electron microscopy. A previously calibrated and blind examiner evaluated micrographs of the samples. Non-parametric statistical analysis was performed to analyze the data obtained.

Results

Brushing 25% citric acid for 3 min, promoted greater exposure of collagen fibers in comparison with the brushing of 1% citric acid for 1 minute and its topical application at 1% for 3 min. Sodium citrate exposed collagen fibers in a few number of samples.

Conclusion

Despite the lack of statistical significance, better results for collagen exposure were obtained with brushing application of 25% citric acid for 3 min than with other application parameter. Sodium citrate produced a few number of samples with collagen exposure, so it is not indicated for root conditioning.     

Uterin choriocarcinoma revealed by pulmonary metastasis. A case report

Uterine choriocarcinoma is a rare trophoblastic tumor, characterized by its metastatic potentiality and its sensitivity to chemotherapy. Pulmonary metastases are frequent, but they rarely reveal the disease. We report the case of a 30-year-old patient with uterine choriocarcinoma. The disease occurred after a normal delivery and was revealed by a pulmonary metastasis. Through of this case and a review of literature, we remind of the diagnostic and prognostic particularities of uterine choriocarcinoma.     

Effect of cooling procedure on final denture base adaptation

Well-fitted dentures prevent hyperplasic lesions, provide chewing efficiency and promote patient's comfort. Several factors may affect final adaptation of dentures, as the type of the acrylic resin, the flask cooling procedure and the water uptake. This investigation evaluated the effect of water storage and two different cooling procedures [bench cooling (BC) for 2 h; running water (RW) at 20 degrees C for 45 min] on the final adaptation of denture bases. A heat-cured acrylic resin (CL, Clássico, Clássico Artigos Odontológicos) and two microwave-cured acrylic resins [Acron MC, (AC) GC Dent. Ind. Corp.; Onda Cryl (OC), Clássico Artigos Odontológicos] were used to make the bases. Adaptation was assessed by measuring the weight of an intervening layer of silicone impression material between the base and the master die. Data was submitted to ANOVA and Tukey's test (0.05). The following means were found: (BC) CL=0.72 +/- 0.03 a; AC=0.70 +/- 0.03 b; OC=0.76 +/- 0.04 c//(RW) CL= 1.00 +/- 0.11 a; AC=1.00 +/- 0.12 a; OC=0.95 +/- 0.10 a. Different labels join groups that are not statistically different (P > 0.05). Comparisons are made among groups submitted to the same cooling procedure (BC or RW). The conclusions are: interaction of type of material and cooling procedure had a statistically significant effect on the final adaptation of the denture bases (P < 0.05); water storage was not detected as a source of variance (P > 0.05) on the final adaptation.