Effect of laser bleaching, ultrasonic scaling and powered tooth brushing on surface roughness and bacterial adherence of class V composite restorations

Objective

To evaluate and compare the effect of diode laser assisted bleaching, ultrasonic scaling and powered tooth brushing on surface roughness and bacterial adherence on class V cavities restored with composites.

Materials and methods

A total of one hundred and twenty samples (40 samples each of Brilliant Everglow, Beautifil II and Heytec-N) were prepared in standardized stainless steel molds. The samples were further subdivided into four subgroups i.e. one control group (without any intervention) and three experimental groups - diode laser assisted bleaching, ultrasonic scaling and powered tooth brushing consisting of 10 sample each. Surface roughness was measured quantitatively with the help of 3D Optical Profilometer. For bacterial adherence analysis S. mutans strain (ATCC 25175) was cultured in BHI medium and samples were evaluated for the presence of viable bacteria using the Colony Forming Unit (CFU) count. Results obtained were then tabulated and subjected to statistical analysis.

Results

Diode laser bleaching caused a significant increase in surface roughness and bacterial adherence with lowest mean change exhibited by Heytec-N followed by Beautifil II and highest by Brilliant Everglow group. Similarly, Ultrasonic scaling increased the surface roughness of all the three tested samples with significant difference between the groups. Powered tooth brushing had no effect on the surface roughness and bacterial adherence of the tested composites.

Conclusion

Diode assisted laser bleaching and ultrasonic caused significantly higher surface roughness and bacterial adherence values for all the tested composites. It may therefore be recommended to do finishing and polishing of restorations after such procedures.

Tailor-Made Temperature-Sensitive Micelle for Targeted and On-Demand Release of Anticancer Drugs

The design of nanomedicines from the tuned architecture polymer is a leading object of immense research in recent years. Here, smart thermoresponsive micelles were prepared from novel architecture four-arm star block copolymers, namely, pentaerythritol polycaprolactone-b-poly(N-isopropylacrylamide) and pentaerythritol polycaprolactone-b-poly(N-vinylcaprolactam). The polymers were synthesized and tagged with folic acid (FA) to render them as efficient cancer cell targeting cargos. FA-conjugated block copolymers were self-assembled to a nearly spherical (ranging from 15 to 170 nm) polymeric micelle (FA-PM) with a sufficiently lower range of critical micelle concentration (0.59 × 10(-2) to 1.52 × 10(-2) mg/mL) suitable for performing as an efficient drug carrier. The blocks show lower critical solution temperature (LCST) ranging from 30 to 39 °C with high DOX-loading content (24.3%, w/w) as compared to that reported for a linear polymer in the contemporary literature. The temperature-induced reduction in size (57%) of the FA-PM enables a high rate of DOX release (78.57% after 24 h) at a temperature above LCST. The DOX release rate has also been tuned by on-demand administration of temperature. The in vitro biocompatibilities of the blank and DOX-loaded FA-PMs have been studied by the MTT assay. The cellular uptake study proves selective internalization of the FA-PM into cancerous cells (C6 glioma) compared that into normal cells (HaCaT). In vivo administration of the DOX-loaded FA-PMs into the C6 glioma rat tumor model resulted in significant accumulation in tumor sites, which drastically inhibited the tumor volume by ∼83.9% with respect to control without any significant systemic toxicity.

GW627368X inhibits proliferation and induces apoptosis in cervical cancer by interfering with EP4/EGFR interactive signaling

PGE2, the major product of cyclooxygenases implicated in carcinogenesis, is significantly upregulated in cervical cancer. PGE2 via prostanoid receptor EP4 stimulates proliferation and motility while inhibiting apoptosis and immune surveillance. It promotes angiogenesis by stimulating the production of pro-angiogenic factors. The present study demonstrates GW627368X, a highly selective competitive EP4 antagonist, which hinders cervical cancer progression by inhibiting EP4/epithelial growth factor receptor (EGFR) interactive signaling. GW627368X reduced protein kinase A (PKA) phosphorylation which in turn leads to decreased cAMP response element-binding protein (CREB) activation. Decreased PKA phosphorylation also directly enhanced Bax activity and in part reduced glycogen synthase kinase 3 (GSK3)β phosphorylation. Owing to the interactive signaling between EP4 and EGFR, GW627368X lowered EGFR phosphorylation in turn reducing Akt, mitogen-activated protein kinase (MAPK) and GSK3β activity significantly. Sublethal dose of GW627368X was found to reduce the nuclear translocation of β-catenin in a time dependent manner along with time-dependent decrease in cytoplasmic as well as whole-cell β-catenin. Decreased CREB and β-catenin transcriptional activity restricts the aberrant transcription of key genes like EP4, cyclooxygenase (COX)-2, vascular endothelial growth factor and c-myc, which ultimately control cell survival, proliferation and angiogenesis. Reduced activity of EGFR resulted in enhanced expression of 15-hydroxyprostaglandin dehydrogenase increasing PGE2 degradation thereby blocking a positive feedback loop. In xenograft model, dose-dependent decrease in cancer proliferation was observed characterized by reduction in tumor mass and volume and a marked decrease in Ki67 expression. A diminished CD31 specific staining signified decreased tumor angiogenesis. Reduced expression of pAkt, pMAPK, pEGFR and COX-2 validated in vitro results. GW627368X therefore effectively inhibits tumor survival, motility, proliferation and angiogenesis by blocking EP4/EGFR interactive signaling. EP4 is a potent therapeutic target in cervical cancer and can be explored in combination with conventional therapies to attain superior outcomes and to overcome complications associated with organ toxicities, therapeutic resistance and disease relapse.

Diacerein-mediated inhibition of IL-6/IL-6R signaling induces apoptotic effects on breast cancer

Interleukin-6 (IL-6) signaling network has been implicated in oncogenic transformations making it attractive target for the discovery of novel cancer therapeutics. In this study, potent antiproliferative and apoptotic effect of diacerein were observed against breast cancer. In vitro apoptosis was induced by this drug in breast cancer cells as verified by increased sub-G1 population, LIVE/DEAD assay, cell cytotoxicity and presence of terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL)-positive cells, as well as downregulation of antiapoptotic proteins Bcl-2 and Bcl-xL and upregulation of apoptotic protein Bax. In addition, apoptosis induction was found to be caspase dependent. Further molecular investigations indicated that diacerein instigated apoptosis was associated with inhibition of IL-6/IL-6R autocrine signaling axis. Suppression of STAT3, MAPK and Akt pathways were also observed as a consequence of diacerein-mediated upstream inhibition of IL-6/IL-6R. Fluorescence study and western blot analysis revealed cytosolic accumulation of STAT3 in diacerein-treated cells. The docking study showed diacerein/IL-6R interaction that was further validated by competitive binding assay and isothermal titration calorimetry. Most interestingly, it was found that diacerein considerably suppressed tumor growth in MDA-MB-231 xenograft model. The in vivo antitumor effect was correlated with decreased proliferation (Ki-67), increased apoptosis (TUNEL) and inhibition of IL-6/IL-6R-mediated STAT3, MAPK and Akt pathway in tumor remnants. Taken together, diacerein offered a novel blueprint for cancer therapy by hampering IL-6/IL-6R/STAT3/MAPK/Akt network.

Leprosy among circus workers

Seven (2.31%) circus workers of two circus companies visiting Amritsar were detected to be suffering from leprosy. Whether or not they acquired the disease during their stay in circus is not so important, but it is necessary to detect and treat these itinerant persons. Our experience clearly underlines the necessity for undertaking surveys of various workers living in crowded conditions (like circus), because of their occupation.

Mesalazine in treatment of psoriasis

Mesalazine- a 5 lipoxygenase inhibitor was tried in this open trial on 20 psoriatics. Whereas 50% patients (10) had complete clearance in 4 weeks, by 12 weeks 85% (17) patients had good response and 15% (3) patients had no relief at all. No side effects were observed. Further longitudinal double-blind trials of this drug, which has an advantage of not causing bone marrow depression and oligospermia over sulfasalazine, another 5 lipoxygenase inhibitor, are advocated.

Sulfasalazine in treatment of psoriasis

A 5-lipoxygenase inhibitor-sulfasalazine was compared to a known effective drug-methotrexate in psoriasis. Fifteen patients each were put on sulfasalazine (1500 mg/day) and methotrexate (7.5 mg/week). Assessment was made on the basis of EST (Erythema, Scaling and Thickness) scale, initially and then weekly upto 4 weeks followed by 4 weekly upto 12 weeks. Efficacy was comparable for the 2 drugs: decrease in mean EST in patients on methotrexate and sulfasalazine therapy was 86.55% and 83.64% at 4 weeks; and 92.86% and 92.13% at 12 weeks respectively. Nine patients on sulfasalazine therapy and 10 patients on methotrexate therapy had complete clearance at the end of 12 weeks.

Relapse, reinfection or inadequate MDT ?

Relapse by all standard definitions is reported in a middle aged woman after PB MDT. Since she belonged to a family of treated leprosy sufferers (husband and his elder brother) and her daughter has now developed infectious type of leprosy, the possibility of reinfection can also not be ruled out.

Incontinentia pigmenti

A case of incontinentia pigmenti, a rare genodermatosis, is being presented.

Chromoblastomycosis

This is an account of twenty eight years of sufferings of a young sikh agriculturist, who ultimately succumbed to chromoblastomycosis- a not so uncommon mycotic infection, despite the use of toxic (amphoterecin-B) and newer antimycotic drugs (ketoconazole). Involvement of face, small and large gut, larynx and trachea are the other highlights of this case.

Pefloxacin in leprosy

Fluoroquinolones, a new class of compounds characterised by broad antimicrobial spectrum including mycobacteria together with limited toxicity, have recently been introduced in the chemotherapy of various human infectious diseases. Pefloxacin, one of the members of this class, was recently demonstrated to be bactericidal against M.leprae in the mouse foot-pad model and clinically beneficial in lepromatous leprosy patients. Clinical response to standard MDT with added pefloxacin in ten previously untreated (both PB and MB) was compared with that in ten similar patients on MDT alone in the present trial. The results of chemotherapy were quantified by a method of clinical scoring. This pilot study showed that addition of pefloxacin led to significant and rapid clinical improvement. There were no side effects attributable to pefloxacin.

Improving NLEP performance in a low endemic area

New innovative strategies of the medical officer of an upgraded urban leprosy centre of a low endemic state (Punjab) resulted in an increase in new case detection by seventy-four percent. Indigenous patients were much more regular than immigrant patients in colonies. The number of new indigenous punjabi patients has not shown any decline in last one decade, probably because of deficiencies in the functioning of NLEP. It is suggested that improved case detection by adopting strategies used by the authors and restricting free migration of untreated and partially treated patients would help in achieving the goals of NLEP.