Autoimmune diseases and their manifestations on oral cavity: diagnosis and clinical management

Oral signs are frequently the first manifestation of autoimmune diseases. For this reason, dentists play an important role in the detection of emerging autoimmune pathologies. Indeed, an early diagnosis can play a decisive role in improving the quality of treatment strategies as well as quality of life. This can be obtained thanks to specific knowledge of oral manifestations of autoimmune diseases. This review is aimed at describing oral presentations, diagnosis, and treatment strategies for systemic lupus erythematosus, Sjögren syndrome, pemphigus vulgaris, mucous membrane pemphigoid, and Behcet disease

Enamel remineralization and repair results of Biomimetic Hydroxyapatite toothpaste on deciduous teeth: an effective option to fluoride toothpaste

Background: Dental caries is a recognized worldwide public health problem. Despite being one of the most efective strategies against dental caries, the excessive use of fuorine may result in a potential risk of developing dental fuorosis especially in children under age of six. The purpose of this work is to analyze a fuorine-free toothpaste containing Biomimetic Hydroxyapatite to assess enamel re-mineralizing and repairing properties. Results: The study was performed in vitro and in vivo, comparing the hydroxyapatite toothpaste with two others toothpaste containing diferent fuorine concentrations. The coating efect of the micro-structured Hydroxyapatite nanoparticles reintegrates the enamel with a biomimetic flm reproducing the structure and the morphology of the biologic Hydroxyapatite of the enamel. As demonstrated, the coating is due to the deposit of a new layer of apatite, which presents fewer particles than the natural enamel, not based on the chemical—physical changes occurring in fuorinated toothpastes. Moreover, it shows resistance to brushing as a consequence of chemical bonds between the synthetic and natural crystals of the enamel. Conclusions: The use of Biomimetic Hydroxyapatite toothpastes has proven to be a valuable prevention measure against dental caries in primary dentition since it prevents the risk of fuorosis

Biomimetic toothpastes: remineralization potential of deciduous teeth

Aim: Primary teeth are subjected to a continuous process of de- and re-mineralization. To prevent loss of dental tissues, fluoride-containing toothpastes have been successfully applied as a global solution to mainly prevent dental caries and promote tooth re-mineralization. However, the swallowing of a high amount of fluoride in younger children would lead to potential risk of fluorosis. Newly developed biomimetic toothpastes have provided promising results in preventive den tistry, therefore, the aim of the present study was to analyse the ability of commercial toothpastes to diffuse into deciduous enamel layer to remineralize the crystal habitat. Materials and Methods: Previously extracted primary teeth (n=8) were manually brushed for 15 days (3 times/day), using 3 different pediatric toothbrushes: (a) commercial toothpaste containing fluorine 500 ppm; (b) commercial toothpaste containing fluorine 1400 ppm; (c) toothpaste containing hydroxyapatite nanocrystal. Elements used as control (n = 2) were subjected to the manual brushing with water. Then, specimens were assessed by means of variable pressure scanning electron microscopy (VP-SEM). Results: Toothpaste containing nanocrystals of hydroxyapatite seemed to better diffuse through the enamel layer of deciduous teeth. This biomimetic toothpaste might contribute to remineralize the loss of the mineral component and play a central role in the prevention of dental caries. Conclusion: Biomimetic toothpastes would be considered a reliable alternative to fluoride-containing toothpaste. These preliminary results not only would improve the synthesis of novel biomaterials for deciduous teeth, but also would represent a positive global economic impact since the wide prevalence of dental caries affecting primary teeth

The application of a fluoride-and-vitamin D solution to deciduous teeth promotes formation of persistent mineral crystals: a morphological ex-vivo study

Background: The use of effective, low-cost, and easy-to-use products for early caries management will avoid loss of dental vitality and impairment in oral function. The ability of fluoride to re-mineralize dental surfaces has been widely reported as well as vitamin D demonstrated to have significant potential in improving the remineralization of early lesions on enamel surfaces. The aim of the present ex vivo study was to evaluate the effect of a fluoride and vitamin D solution in terms of formation of mineral crystals on the enamel of primary teeth, and their permanence over time on dental surfaces. Methods: Sixteen extracted deciduous teeth were cut to obtain 64 specimens that were divided into two groups. The first consisted of immersion of specimens for 4 days in a fluoride solution (T1); in the second group, the specimens were immersed for 4 days (T1) in fluoride and Vitamin D solution, and for a further 2 (T2) and 4 days (T3) in saline solution. Then, samples were morphologically analyzed by using Variable Pressure Scanning Electron Microscope (VPSEM) and underwent 3D surface reconstruction. Results: After a 4-day immersion in both solutions, octahedral-shaped crystals were formed on the enamel surface of primary teeth, demonstrating any statistically significant differences in terms of number, size, and shape. Moreover, the binding of the same crystals seemed to be strong enough to be maintained until 4 days in saline solution. However, a partial dissolution was observed in a time-dependent manner. Conclusions: A topical application of fluoride and Vitamin D promoted the formation of persistent mineral crystals on enamel surfaces of deciduous teeth and should be further studied to be potentially used as an alternative strategy in preventive dentistry

Bioactive cements: from biological properties to clinical applications

Aim: Calcium silicate-based cements represent safe and predictable materials widely used in different fields of endodontics. They can be applied as pulp dressing agents during vital pulp therapy (VPT) of carious-affected deciduous or permanent teeth with immature roots as well as endodontic cements in case of root perforation or regenerative endodontic procedures. Therefore, it’s crucial to demonstrate biocompatible and antibiofilm properties of bioactive cements (i.e. MTA and Biodentine) in order to support their successful use in the clinical field. Materials and Methods: Biocompatibility of ProRootMTA and Biodentine specimens was assessed through cell culture of Saos-2 cells and both cement extracts by viability assay, oxidative stress analysis and immunofluorescence evaluation; on the other hand, antibiofilm efficacy was assessed by evaluating the biofilm forming ability of Streptococcus mutans onProRootMTA and Biodentine disks using Crystal Violet assay. Results: Cells exposed to ProRootMTA and Biodentine showed a good cell viability, slightly better in presence of the first; moreover, cells seeded on ProRootMTA presented a higher degree of biocompatibility compared to Biodentine. Accordingly, Biodentine demonstrated lightly fewer promising outcomes in terms of oxidative stress and focal adhesions of cells than ProRoot MTA, although the differences were not statistically significant. Inhibition of superficial colonization as well as biofilm forming ability of S. mutants were successfully obtained with both evaluated cements, even though ProRootMTA demonstrated a more efficient time-dependent antibiofilm effect than Biodentine. Conclusion: Bioactive cements proved to be biocompatible and to possess antibiofilm properties. When compared, MTA would seem to perform slightly better and could be considered as the gold standard material in the endodontic procedures

Melatonin effects in normal and tumoral skeletal muscle cells: a preliminary study

Melatonin (MEL), also chemically known as N-acetyl-5-methoxytryptamine, is a hormone found in animals, plants, and microbes. It exhibits strong antioxidant effects and thanks to its structure it is able to diffuse through all the biological membranes, also overcoming the blood-brain barrier and the placenta (Salucci et al., 2014). Numerous in vitro and in vivo studies have documented Mel ability to induce apoptosis in tumor cells while inhibiting it in the normal ones (Cristofanos et al, 2009; Lanoix et al., 2011). In this study MEL activity has been investigated in vitro both in murine skeletal muscle (C2C12) and in alveolar rhabdomyosarcoma (RH30) cell lines by means of morpho-functional approaches. If MEL low concentrations are well tolerated by normal skeletal muscle cells, its effect appears completely different in tumor cells, where MEL can be considered a powerful apoptotic trigger. In RH30 cells, blebbing, chromatin condensation and margination, apoptotic bodies occur as well as necrotic cell death features. The latter appeared after prolonged exposure to MEL. In conclusion, the neuro-hormone shows a strong dose and time dependent pro-apoptotic activity and it could represent a potential tool in association with the current chemotherapeutic compounds to resolve alveolar rhabdomyosarcoma, the most common pediatric skeletal muscle tissue malignancy

Morpho-chemical observations of human deciduous teeth enamel in response to biomimetic toothpastes treatment

Today, biomaterial research on biomimetic mineralization strategies represents a new challenge in the prevention and cure of enamel mineral loss on delicate deciduous teeth. Distinctive assumptions about the origin, the growth, and the functionalization on the biomimetic materials have been recently proposed by scientific research studies in evaluating the different clinical aspects of treating the deciduous tooth. Therefore, appropriate morpho-chemical observations on delivering specific biomaterials to enamel teeth is the most important factor for controlling biomineralization processes. Detailed morpho-chemical investigations of the treated enamel layer using three commercial toothpastes (Biorepair, F1400, and F500) were performed through variable pressure scanning electron microscopy (VP-SEM) and energy dispersive X-ray spectroscopy (EDS) on deciduous teeth in their native state. A new microscopy methodology allowed us to determine the behaviors of silicate, phosphate, and calcium contents from the early stage, as commercially available toothpastes, to the final stage of delivered diffusion, occurring within the enamel layer together with their penetration depth properties. The reported results represent a valuable background towards full comprehension of the role of organic–inorganic biomaterials for developing a controlled biomimetic toothpaste in biofluid medi

Morphological study of cartilage cell death in patients affected by osteoarthritis and chondrocalcinosis

The role of chondrocyte death in the pathogenesis of osteoarthritis (OA) has been largely discussed in literature, but its relative contribution is difficult to assess (1). Chondrocyte death, be it apoptotic, necrotic or chondroptotic, has been clearly documented in OA and a certain correlation between the degree of cartilage damage and chondrocyte apoptosis has been demonstrated (2;3). Conversely, the relationship between the different types of cell death and chondrocalcinosis (CC) is still little known, as well as the presence and role of chondroptotic cells. The aim of this research was to compare chondrocyte behavior in the cartilage of osteoarthritic and chondrocalcinotic knees, evaluating the different types of cell death by means of optical and electron microscopy. During total knee replacement surgeries, cartilage specimens of femoral condyle have been withdrawn and their transversal semithin sections, stained with toluidine blue and alizarin solutions, have been investigated by optical microscopy. From the same samples, thin sections were obtained for transmission electron microscopy to evaluate, at high magnification, the specific ultrastructural features of different types of cell death. Cartilage specimens from both conditions revealed a thickness reduction of superficial layer and a high number of empty lacunae in the middle layer. Calcium pyrophosphate crystals appeared in the samples of patients affected by CC. In osteoarthritic cartilage, numerous chondrocytes revealed necrotic features, whereas, in chondrocalcinotic tissue, the middle zone was characterized by morphological patterns suggestive of chondroptosis, such as chromatin condensation mostly localized at the nuclear periphery, mitochondria alterations, a marked increase in endoplasmic reticulum, the presence of a diffuse autophagic component and the extrusion of cellular material into the lacunae. In conclusion, a different distribution of cell death types seems to characterize the intermediate layers of cartilage specimens from patients affected by CC compared to OA

Characterization of Scardovia wiggsiae biofilm by original scanning electron microscopy protocol

Early childhood caries (ECC) is a severe manifestation of carious pathology with rapid and disruptive progression. The ECC microbiota includes a wide variety of bacterial species, among which is an anaerobic newly named species, Scardovia wiggsiae, a previously unidentified Bifidobacterium. Our aim was to provide the first ultrastructural characterization of S. wiggsiae and its biofilm by scanning electron microscopy (SEM) using a protocol that faithfully preserved the biofilm architecture and allowed an investigation at very high magnifications (order of nanometers) and with the appropriate resolution. To accomplish this task, we analyzed Streptococcus mutans’ biofilm by conventional SEM and VP-SEM protocols, in addition, we developed an original procedure, named OsO4-RR-TA-IL, which avoids dehydration, drying and sputter coating. This innovative protocol allowed high-resolution and high-magnification imaging (from 10000× to 35000×) in high-vacuum and high-voltage conditions. After comparing three methods, we chose OsO4-RR-TA-IL to investigate S. wiggsiae. It appeared as a fusiform elongated bacterium, without surface specialization, arranged in clusters and submerged in a rich biofilm matrix, which showed a well-developed micro-canalicular system. Our results provide the basis for the development of innovative strategies to quantify the effects of different treatments, in order to establish the best option to counteract ECC in pediatric patients

Dark matter electron anisotropy: a universal upper limit

We study the dipole anisotropy in the arrival directions of high energy CR electrons and positrons (CRE) of Dark Matter (DM) origin. We show that this quantity is very weakly model dependent and offers a viable criterion to discriminate among CRE from DM or from local discrete sources, like e.g. pulsars. In particular, we find that the maximum anisotropy which DM can provide is to a very good approximation a universal quantity and, as a consequence, if a larger anisotropy is detected, this would constitute a strong evidence for the presence of astrophysical local discrete CRE sources, whose anisotropy, instead, can be naturally larger than the DM upper limit. We further find that the main source of anisotropy from DM is given by the fluctuation in the number density of DM sub-structures in the vicinity of the observer and we thus devote special attention to the study of the variance in the sub-structures realization implementing a dedicated Montecarlo simulation. Such scenarios will be probed in the next years by Fermi-LAT, providing new hints, or constraints, about the nature of DM.Comment: 23 pages, 7 figure