Análisis comparativo de los niveles sistémicos de citocinas, lipoperóxidos y de metales pesados/oligoelementos en pelo de portadores de implantes dentales y/o amalgamas dentales

El presente estudio ha sido diseñado para comparar los niveles de una serie de metales pesados (Al, Sb, As, Ba, Be, Bi, Cd, Pb, Hg, Pt, Tl Th, U, Ni, Ag, Sn, Ti) y/o de oligoelementos (Ca++, Mg++, Na+, K+, Cu++, Zn++, Mn++, Cr, V, Mo, B, I, Li, P, Se, Sr, S, Fe++, Ge, Rb), en los pacientes portadores de implantes de titanio y de amalgamas dentales (A+I, media: 15 años en boca, n=34) frente a sus respectivos niveles detectados en aquellos portadores únicamente de amalgamas dentales (A, n=27) y también en controles sanos (sin amalgamas y sin implantes, n=13). Dichos metales pesados/oligoelementos han sido medidos en pelo por espectrometría de masas (ICP-MS) y expresados como µg/g de pelo (media del grupo en cuestión + error estándar de la media: S.E.M. del inglés). Por otra parte, hemos analizado los niveles sistémicos de citoquinas proinflamatorias (IL-1β y MCP-1) por la técnica de ELISA y los niveles de Glutatión (GSH; forma reducida) y de malonaldehido sistémico (MDA: índice de peroxidación lipídica) por técnicas colorimétricas, al ser considerados marcadores de estrés oxidativo. Los datos indican bajos niveles de selenio (Se) junto a los reducidos ratios de Se/Ag como de Se/Hg evidenciados en los pacientes con implantes de titanio y amalgamas dentales (A+I), frente a portadores únicamente de amalgamas dentales (A). Además, los pacientes con implantes y amalgamas mostraban diferencias significativas relativas a los niveles de magnesio (Mg++), sodio (Na+) y potasio (K+). Dado que los niveles de glutatión reducido (GSH) disminuyen y aumentan significativamente tanto los de citoquinas proinflamatorias (IL-1β, MCP-1) como los de Malonaldehido (MDA) sistémicos en pacientes con implantes de titanio y amalgamas frente a sus portadores de amalgamas dentales, sugerimos que el grupo (A+I) es más susceptible a la inflamación y al estrés oxidativo. Como además sus niveles de plata (Ag) en (A+I) aumentan significativamente en comparación al grupo únicamente con amalgamas dentales, sugerimos que la plata podría migrar a órganos distales. Los niveles de níquel (Ni) y el oligoelemento cobalto (Co) también aumentan significativamente en el grupo (A+I), lo que podría incrementar los niveles de citoquinas proinflamatorias indicadas frente a los portadores de amalgamas dentales (A). Por otra parte, los niveles de los demás metales procedentes de las amalgamas dentales (Hg, Sn, Zn++, Cu++) y de las aleaciones de los implantes de titanio (Ti-6Al-4V) no difieren significativamente entre el grupo (A+I) en relación al grupo con amalgamas (A). En su conjunto, nuestros hallazgos indican que los bajos ratios tanto de Se/Ag y Se/Hg evidenciados en los pacientes con implantes dentales de titanio y amalgamas dentales (A+I) podrían predisponerles a un mayor estrés metabólico e incluso conducir a ciertos déficits de oligoelementos. De hecho, el grupo (A+I) tiene niveles significativamente más bajos de litio (Li) y de rubidio (Rb) que sus respectivos portadores de amalgamas dentales (A). Además, evidencian cambios significativos en los niveles de oligoelementos como magnesio (Mg++), sodio (Na+) y potasio (K+). También detectamos correlaciones significativas entre los niveles de selenio, plata o mercurio con sus respectivos ratios (Se/Ag, Se/Hg) en el grupo (A+I). Sin embargo, no es posible establecer una relación causa-efecto directa entre el aumento de los niveles de plata (Ag) y la deficiencia de selenio (Se) detectada en aquellos con implantes de titanio y amalgamas dentales. Finalmente, los niveles de Bario (Ba) aumentan significativamente en aquellos pacientes con implantes de titanio y amalgamas dentales (A+I) frente a sus respectivos portadores de amalgamas dentales (A). Los niveles de otros metales pesados y oligoelementos analizados también en el presente estudio no difieren significativamente entre el grupo (A+I) y el grupo con amalgamas dentales (A). The present study have been designed to whether levels of a plethora of heavy metals and/or oligoelements could differ among patients who have long-term dental titanium implants and amalgams (n=34), and those with long-term dental amalgams only (n=27) and controls (n=13, without long-term titanium implants and dental amalgams), respectively. These dental biomaterials are present in their mouth during at least 10 years (average: 15 years). We have compared a plethora of heavy metals and/or among these experimental groups by Inductible Couple Mass Spectrometry (ICP-MS) in hair’s samples and all results were expressed as µg/g of hair [metals: Al, Sb, As, Ba, Be, Bi, Cd, Pb, Hg, Pt, Tl, Th, U, Ni, Ag, Sn, Ti; oligoelements (Ca++, Mg++, Na+, K+, Cu++, Zn++, Mn++, Cr, V, Mo, B, I, Li, P, Se, Sr, S, Fe++, Ge, Rb)]. In addition, we have compared their systemic IL-1β and MCP-1 proinflammatory cytokine levels by ELISA. We also determined the serum levels of Glutathione (reduced form: GSH) and Malonaldehide (MDA) levels by colorimetric assays among these experimental groups. These biomarkers are mediators of oxidative stress and inflammation, respectively. We have detected low selenium levels as well as reduced Se/Ag and decreased Se/Hg ratios among patients with long-term dental implants and amalgams (A+I) as compare to patients with long-term dental amalgams only (A); In addition, they (A+I) have significant changes on magnesium (Mg++), sodium (Na+) and potassium (K+) levels. These Glutathione levels (GSH: reduced form) were lower in patients with long-term dental titanium implants and amalgams (A+I) and they have higher their systemic MDA (Malonaldehide) and proinflammatory IL-1β and MCP-1 (Macrophage Colony Protein-1) levels than patients with long-term dental amalgams only (A). These features suggest they (A+I group) are more susceptible to inflammation and oxidative stress than patients with amalgams only (A). As higher Silver (Ag) levels were found among patients with long-term titanium implants and amalgams (A+I) as compare to patients with amalgams only (A), we suggest that silver could migrate to distal organs. In addition, other heavy metal such as nickel (Ni) together the oligoelements cobalt (Co) were higher among patients with (A+I), which could rise proinflammatory cytokine levels as compare to those with long-term dental amalgams only (A). However, other metals detected from dental amalgams (Hg, Sn, Zn++, Cu++) or implant alloys (Ti-6Al-4V) did not significantly differed among (A+I) vs (A) groups. Collectively, our finding suggest that lower Se/Ag and Se/Hg ratios found among patients who have long-term titanium implants and dental amalgam could predispose them to oxidative stress. In fact, they have (A+I) group lower lithium (Li) and rubidium (Rb) levels than patients with long-term dental amalgams only (A). In addition, they (A+I) have changes on magnesium (Mg++), sodium (Na+) and potassium (K+) levels. We also detected correlations among selenium, silver or mercury levels and their ratios (Se/Ag and Se/Hg) in (A+I) group. However, the causal relationship was not established between exposure to silver (Ag) and low detected selenium (Ag) levels in patients with long-term dental implants and amalgams. Levels of barium (Ba) were higher among patients with long-term dental titanium implants and amalgams (A+I) than reached values by patients with long-term dental amalgams only (A). Finally, several heavy metals and oligoelements analyzed in the present study did not significantly differed among experimental groups

Adult Mesenchymal Stem Cells from Oral Cavity and Surrounding Areas: Types and Biomedical Applications

Adult mesenchymal stem cells are those obtained from the conformation of dental structures (DMSC), such as deciduous and permanent teeth and other surrounding tissues. Background: The self-renewal and differentiation capacities of these adult stem cells allow for great clinical potential. Because DMSC are cells of ectomesenchymal origin, they reveal a high capacity for complete regeneration of dental pulp, periodontal tissue, and other biomedical applications; their differentiation into other types of cells promotes repair in muscle tissue, cardiac, pancreatic, nervous, bone, cartilage, skin, and corneal tissues, among others, with a high predictability of success. Therefore, stem and progenitor cells, with their exosomes of dental origin and surrounding areas in the oral cavity due to their plasticity, are considered a fundamental pillar in medicine and regenerative dentistry. Tissue engineering (MSCs, scaffolds, and bioactive molecules) sustains and induces its multipotent and immunomodulatory effects. It is of vital importance to guarantee the safety and efficacy of the procedures designed for patients, and for this purpose, more clinical trials are needed to increase the efficacy of several pathologies. Conclusion: From a bioethical and transcendental anthropological point of view, the human person as a unique being facilitates better clinical and personalized therapy, given the higher prevalence of dental and chronic systemic diseases

Origanum majorana Essential Oil Inhalation during Neurofeedback Training Reduces Saliva Myeloperoxidase Activity at Session-1 in Bruxistic Patients

Introduction: Bruxism affects teeth and provokes sleep alterations. We evaluated whether saliva Myeloperoxidase (MPO) activity could be reduced after 21 neurofeedback training (NO) sessions in Origanum majorana (AE) bruxistic-treated patients (n = 12 patients, 120 saliva samples). The term divergence evaluates cerebral activity, which was compared between bruxistic patients with/without this essential oil exposure during 21 NO training sessions (n = 12, n = 120 saliva samples). The nasal filter used allow us to vehiculizate this Origanum majorana essential oil in patients. MPO activity was measured in six training NO sessions (Session S1, 6, 12, 18, 21). We included a total of 104 patients and 500 saliva samples. Results: there was a fast reduction in MPO activity after NO session-1 in bruxistic patients; divergence (an index of NO training brain efficacy) is the difference in cerebral activity found between pre-training and post-training levels. Thus, Divergence can fluctuate during NO training before reaching a final calm state after many sessions (21). Repeated NO training lead to habituation in so far as cerebral activity as well as MPO activity after 21 training sessions. Origanum majorana essential oil modulates cerebral activity at certain training sessions in bruxistic patients. Stress levels were reduced on the perceived stress scores (PSS: Cohen Scale) after 21 NO sessions than for those bruxistic without NO training sessions. Conclusions: MPO activity could predict stress level in bruxistic patients and repeated NO reduced their stress level; Origanum majorana essential oil enhanced these anxiolytic effects

The Long-Term Algae Extract (Chlorella and Fucus sp) and Aminosulphurate Supplementation Modulate SOD-1 Activity and Decrease Heavy Metals (Hg++, Sn) Levels in Patients with Long-Term Dental Titanium Implants and Amalgam Fillings Restorations

The toxicity of heavy metals such as Hg++ is a serious risk for human health. We evaluated whether 90 days of nutritional supplementation (d90, n = 16) with Chlorella vulgaris (CV) and Fucus sp extracts in conjunction with aminosulphurate (nutraceuticals) supplementation could detox heavy metal levels in patients with long-term titanium dental implants (average: three, average: 12 years in mouth) and/or amalgam fillings (average: four, average: 15 years) compared to baseline levels (d0: before any supplementation, n = 16) and untreated controls (without dental materials) of similar age (control, n = 21). In this study, we compared levels of several heavy metals/oligoelements in these patients after 90 days (n = 16) of nutritional supplementation with CV and aminozuphrates extract with their own baseline levels (d0, n = 16) and untreated controls (n = 21); 16 patients averaging 44 age years old with long-term dental amalgams and titanium implants for at least 10 years (average: 12 years) were recruited, as well as 21 non-supplemented controls (without dental materials) of similar age. The following heavy metals were quantified in hair samples as index of chronic heavy metal exposure before and after 90 days supplementation using inductively coupled plasma-mass spectrometry (ICP-MS) and expressed as μg/g of hair (Al, Hg++, Ba, Ag, Sb, As, Be, Bi, Cd, Pb, Pt, Tl, Th, U, Ni, Sn, and Ti). We also measured several oligoelements (Ca++, Mg++, Na+, K+, Cu++, Zn++, Mn++, Cr, V, Mo, B, I, P, Se, Sr, P, Co, Fe++, Ge, Rb, and Zr). The algae and nutraceutical supplementation during 90 consecutive days decreased Hg++, Ag, Sn, and Pb at 90 days as compared to baseline levels. The mercury levels at 90 days decreased as compared with the untreated controls. The supplementation contributed to reducing heavy metal levels. There were increased lithium (Li) and germanium (Ge) levels after supplementation in patients with long-term dental titanium implants and amalgams. They also (d90) increased manganesum (Mn++), phosphorum (P), and iron (Fe++) levels as compared with their own basal levels (d0) and the untreated controls. Finally, decreased SuperOxide Dismutase-1 (SOD-1) activity (saliva) was observed after 90 days of supplementation as compared with basal levels (before any supplementation, d0), suggesting antioxidant effects. Conversely, we detected increased SOD-1 activity after 90 days as compared with untreated controls. This SOD-1 regulation could induce antioxidant effects in these patients. The long-term treatment with algae extract and aminosulphurates for 90 consecutive days decreased certain heavy metal levels (Hg++, Ag, Sn, Pb, and U) as compared with basal levels. However, Hg++ and Sn reductions were observed after 90 days as compared with untreated controls (without dental materials). The dental amalgam restoration using activated nasal filters in conjunction with long-term nutritional supplementation enhanced heavy metals removal. Finally, the long-term supplementation with these algae and aminoazuphrates was safe and non-toxic in patients. These supplements prevented certain deficits in oligoelements without affecting their Na+/K+ ratios after long-term nutraceutical supplementation.Funds # 20151602 from CIROM (Murcia, Spain), Article processing charge (APC) supported by Nutergia Laboratories (San Sebastian)We acknowledge support by the CSIC Open Access Publication Initiative through its Unit of Information Resources for Research (URICI

Zirconia implants and peek restorations for the replacement of upper molars

Abstract Background One of the disadvantages of the zirconia implants is the lack of elasticity, which is increased with the use of ceramic or zirconia crowns. The consequences that could result from this lack of elasticity have led to the search for new materials with improved mechanical properties. Case presentation A patient who is a 45-year-old woman, non-smoker and has no medical record of interest with a longitudinal fracture in the palatal root of molar tooth 1.7 and absence of tooth 1.6 was selected in order to receive a zirconia implant with a PEEK-based restoration and a composite coating. The following case report describes and analyses treatment with zirconia implants in molars following a flapless surgical technique. Zirconia implants are an alternative to titanium implants in patients with allergies or who are sensitive to metal alloys. However, one of the disadvantages that they have is their lack of elasticity, which increases with the use of ceramic or zirconia crowns. The consequences that can arise from this lack of elasticity have led to the search for new materials with better mechanical properties to cushion occlusal loads. PEEK-based restoration in implant prosthetics can compensate these occlusal forces, facilitating cushioning while chewing. Conclusion This procedure provides excellent elasticity and resembles natural tooth structure. This clinical case suggests that PEEK restorations can be used in zirconia implants in dentistry

<i>Origanum majorana</i> Essential Oil Inhalation during Neurofeedback Training Reduces Saliva Myeloperoxidase Activity at Session-1 in Bruxistic Patients

Introduction: Bruxism affects teeth and provokes sleep alterations. We evaluated whether saliva Myeloperoxidase (MPO) activity could be reduced after 21 neurofeedback training (NO) sessions in Origanum majorana (AE) bruxistic-treated patients (n = 12 patients, 120 saliva samples). The term divergence evaluates cerebral activity, which was compared between bruxistic patients with/without this essential oil exposure during 21 NO training sessions (n = 12, n = 120 saliva samples). The nasal filter used allow us to vehiculizate this Origanum majorana essential oil in patients. MPO activity was measured in six training NO sessions (Session S1, 6, 12, 18, 21). We included a total of 104 patients and 500 saliva samples. Results: there was a fast reduction in MPO activity after NO session-1 in bruxistic patients; divergence (an index of NO training brain efficacy) is the difference in cerebral activity found between pre-training and post-training levels. Thus, Divergence can fluctuate during NO training before reaching a final calm state after many sessions (21). Repeated NO training lead to habituation in so far as cerebral activity as well as MPO activity after 21 training sessions. Origanum majorana essential oil modulates cerebral activity at certain training sessions in bruxistic patients. Stress levels were reduced on the perceived stress scores (PSS: Cohen Scale) after 21 NO sessions than for those bruxistic without NO training sessions. Conclusions: MPO activity could predict stress level in bruxistic patients and repeated NO reduced their stress level; Origanum majorana essential oil enhanced these anxiolytic effects

Increased Zn/Glutathione Levels and Higher Superoxide Dismutase-1 Activity as Biomarkers of Oxidative Stress in Women with Long-Term Dental Amalgam Fillings: Correlation between Mercury/Aluminium Levels (in Hair) and Antioxidant Systems in Plasma.

The induction of oxidative stress by Hg can affect antioxidant enzymes. However, epidemiological studies have failed to establish clear association between dental fillings presence and health problems.To determine whether heavy metals (in hair), antioxidant enzymes (SOD-1) and glutathione levels could be affected by the chronic presence of heavy metals in women who had dental amalgam fillings.55 hair samples (42 females with amalgam fillings and 13 female control subjects) were obtained. All subjects (mean age 44 years) who had dental amalgam filling for more than 10 years (average 15 years). Certain metals were quantified by ICP-MS (Mass Spectrophotometry) in hair (μg/g: Al, Hg, Ba, Ag, Sb, As, Be, Bi, Cd, Pb, Pt, Tl, Th, U, Ni, Sn, Ti) and SOD-1 and Glutathione (reduced form) levels in plasma. Data were compared with controls without amalgams, and analyzed to identify any significant relation between metals and the total number of amalgam fillings, comparing those with four or less (n = 27) with those with more than four (n = 15). As no significant differences were detected, the two groups were pooled (Amlgam; n = 42).Hg, Ag, Al and Ba were higher in the amalgam group but without significant differences for most of the heavy metals analyzed. Increased SOD-1 activity and glutathione levels (reduced form) were observed in the amalgam group. Aluminum (Al) correlated with glutathione levels while Hg levels correlated with SOD-1. The observed Al/glutathione and Hg/SOD-1 correlation could be adaptive responses against the chronic presence of mercury.Hg, Ag, Al and Ba levels increased in women who had dental amalgam fillings for long periods. Al correlated with glutathione, and Hg with SOD-1. SOD-1 may be a possible biomarker for assessing chronic Hg toxicity

Elevated Systemic L-Kynurenine/L-Tryptophan Ratio and Increased IL-1 Beta and Chemokine (CX3CL1, MCP-1) Proinflammatory Mediators in Patients with Long-Term Titanium Dental Implants

Titanium is the mean biocompatible metal found in dental titanium alloys (Ti-6Al-4V). The safety of certain dental biomaterial amalgams has been questioned in patients. The levels of several systemic cytokines (interleukin (IL)-1 beta, IL-4: pg/mL) and chemokines (monocyte chemoattractant protein-1 (MCP-1), soluble fractalkine (CX3CL1: pg/mL) were determined using ELISA and compared between these study groups. The study included 30 controls without dental materials (cont), 57 patients with long-term titanium dental implants plus amalgams (A + I group) as well as 55 patients with long-term dental amalgam alone (A group). All patients (except controls) have had dental titanium implants (Ti-6Al-4V) and/or amalgams for at least 10 years (average: 15 years). We evaluated whether systemic levels of cytokines/chemokines, kyn/L-trp ratio and aromatic amino acid levels (HPLC: mM/L, Phe, L-Trp, His, Treo) could be altered in patients with long-term dental titanium and/or amalgams. These systemic markers were evaluated in 142 patients. The A + I group had higher L-Kynurenine/L-Tryptophan ratios than patients with long-term dental amalgam fillings alone (A). In addition, levels of IL-1 Beta cytokine, CX3CL1 and MCP-1 chemokines were higher in the A + I group than in the A group (A). The increased L-kyn/L-trp ratio and MCP-1 and fractalkine receptor (CX3CR1) elevations could suggest enhanced chemotactic responses by these chemokines in the A + I group

The analysis of the dental filling number and levels of other heavy metal levels in hair did not shown significant differences between both amalgam groups (total number of amalgams; Pooled; n = 42); >4 (n = 15) or <4 (n = 27), as compared to controls (n = 13).

<p>There were no differences for Sn, Ni, Bi, Ti. Pb, Cd or either (data not shown: Sb, Be, Bi, Tl, Th, U; μg/g).p>0.05: n.s (<b>Sb, Be, Bi, TI, Th, U</b>); (p>0.05; n.s; data not shown</p><p>The analysis of the dental filling number and levels of other heavy metal levels in hair did not shown significant differences between both amalgam groups (total number of amalgams; Pooled; n = 42); >4 (n = 15) or <4 (n = 27), as compared to controls (n = 13).</p

Changes in heavy metal levels in hair (μg/g of hair) from women with dental amalgam fillings for more than ten10 years (n = 42) as compared to controls (n = 13).

<p>[A] mercury (Hg), [B] aluminium (Al), [C] silver (Ag) and [D] barium (Ba). Amalgam (Pooled; n = 42); (<4; n = 27), (>4; n = 15), (control; n = 13). * p<0.05 vs control.</p