Role of sodium tetraborate as a cardioprotective or competitive agent: Modulation of hypertrophic intracellular signals

Boron is an essential trace element in cellular metabolism; however, the molecular mechanism of boron in the heart is unclear. In this study, we examined the effect of sodium tetraborate (as boron source) as a possible protective agent or competitive inhibitor of cardiac hypertrophy in an in vitro murine model. We evaluated different previously reported sodium tetraborate concentrations and it was found that 13 μM improves viability without affecting the cellular structure. We demonstrated that cardiomyocytes pretreated with sodium tetraborate prevents cellular damage induced by isoproterenol (cardioprotective effect) by increasing proliferation rate and inhibiting apoptosis. In addition, the reduction of the expression of the α1AR and β1AR adrenergic receptors as well as Erk1/2 was notable. Consequently, the expression of the early response genes c-myc, c-fos and c-jun was delayed. Also, the expression of GATA-4, NFAT, NKx2.5 and myogenin transcription factors involved in sarcomere synthesis declined. In contrast, cardiomyocytes, when treated simultaneously with sodium tetraborate and isoproterenol, did not increase their size (cytoplasmic gain), but an increase in apoptosis levels was observed; therefore, the proliferation rate was reduced. Although the mRNA levels of α1AR and β1AR as well as Erk1/2 and Akt1 were low at 24 h, their expression increased to 48 h. Notably, the mRNA of expression levels of c-myc, c-fos and c-jun were lower than those determined in the control, while the transcription factors GATA-4, MEF2c, Nkx2.5, NFAT and CDk9 were determined in most cells. These results suggest that pretreatment with sodium tetraborate in cardiomyocytes inhibits the hypertrophic effect. However, sodium tetraborate attenuates isoproterenol induced hypertrophy damage in cardiomyocytes when these two compounds are added simultaneously.

Effect of Different Intraorifice Barriers and Bleaching Agents on the Fracture Resistance of Endodontically Treated Anterior Teeth

INTRODUCTION

Intraorifice barriers (IOBs) are usually used before internal bleaching for coronal sealing and the prevention of cervical resorption. The aim of this study was to investigate the effect of different IOBs on the fracture resistance (FR) of endodontically treated anterior teeth bleached with various bleaching agents (BAs).

METHODS

After performing root canal treatment for 72 extracted bovine upper incisors, the coronal 3 mm of gutta-percha was removed, and samples were classified into 3 based on the type of IOB: calcium-enriched mixture, mineral trioxide aggregate, and resin-modified glass ionomer. After applying IOBs, samples of each group were subdivided into 4 based on the BA: carbamide peroxide 45% (CP), hydrogen peroxide 35% (HP), sodium perborate (PB), and distilled water as the control. At the end of bleaching, the access cavities were restored with composite resin. The FR was measured with a universal testing machine at a crosshead speed of 5 mm/min. The data were analyzed using 2-way analysis of variance and least significant difference post hoc tests (P < .05).

RESULTS

The effect of BAs on the FR was significant (P < .05); however, the effect of the IOB and the interactive effect of these variables were not significant (P > .05). The FR in the HP and PB groups was significantly different from the control (P < .05) but that of CP was not significantly different from the control (P > .05).

CONCLUSIONS

Mineral trioxide aggregate and calcium-enriched mixture act similarly to resin-modified glass ionomer as an IOB. CP, unlike HP and PB, did not significantly decrease the FR.

18F-Tetrafluoroborate, a PET Probe for Imaging Sodium/Iodide Symporter Expression: Whole-Body Biodistribution, Safety, and Radiation Dosimetry in Thyroid Cancer Patients

We report the safety, biodistribution, and internal radiation dosimetry, in humans with thyroid cancer, of 18F-tetrafluoroborate (18F-TFB), a novel PET radioligand for imaging the human sodium/iodide symporter (hNIS). Methods: Serial whole-body PET scans of 5 subjects with recently diagnosed thyroid cancer were acquired before surgery for up to 4 h after injection of 184 ± 15 MBq of 18F-TFB. Activity was determined in whole blood, plasma, and urine. Mean organ-absorbed doses and effective doses were calculated via quantitative image analysis and using OLINDA/EXM software. Results: Images showed a high uptake of 18F-TFB in known areas of high hNIS expression (thyroid, salivary glands, and stomach). Excretion was predominantly renal. No adverse effects in relation to safety of the radiopharmaceutical were observed. The effective dose was 0.0326 ± 0.0018 mSv/MBq. The critical tissues/organs receiving the highest mean sex-averaged absorbed doses were the thyroid (0.135 ± 0.079 mSv/MBq), stomach (0.069 ± 0.022 mSv/MBq), and salivary glands (parotids, 0.031 ± 0.011 mSv/MBq; submandibular, 0.061 ± 0.031 mSv/MBq). Other organs of interest were the bladder (0.102 ± 0.046 mSv/MBq) and kidneys (0.029 ± 0.009 mSv/MBq). Conclusion: Imaging using 18F-TFB imparts a radiation exposure similar in magnitude to many other 18F-labeled radiotracers. 18F-TFB shows a biodistribution similar to 99mTc-pertechnetate, a known nonorganified hNIS tracer, and is pharmacologically and radiobiologically safe in humans. Phase 2 trials for 18F-TFB as an hNIS imaging agent are warranted.

[Effect of Polident denture cleansers on the properties of heat-polymerized denture base acrylic resin]

OBJECTIVE

To study the change in properties of heat-polymerized acrylic resin after using one denture cleanser.

METHODS

In the study, 20 disk-shaped (50.0 mm×0.5 mm) and 40 rectangular (34.0 mm×13.5 mm×1.3 mm) specimens prepared from heat-polymerized acrylic resin were randomly divided into four groups. The specimens were exposed to one of the three treatments as follows: Group 1 was without any treatment, Group 2 was exposed to air, Group 3 to distilled water, and Group 4 to Polident. The 4 exposures lasting 8 hours were conducted daily and repeated for 30 days. The color stability of heat-polymerized acrylic resin was determined by visual methods. The flexural strength and bonding strength of acrylic resin were measured using a universal testing machine. All the results were analyzed using ANOVA.

RESULTS

The flexural strength test of acrylic resin demonstrated significant differences between Group 4 and Group 1 (P<0.05), there were no significant differences among Group 1, Group 2 and Group 3. No significant differences were found in other properties of the test materials.

CONCLUSION

Long-term use of polident could alter the physical and mechnical properties of heat-polymerized acrylic resin. It may be related to the accelerating aging of resins caused by certain chemicals in denture cleansers. Polident may have some adverse effects on denture materials for decreasing flexural strength of heat-polymerized acrylic resin after 30-day immersion.

A double-blind, placebo-controlled pilot study to evaluate the effect of calcium fructoborate on systemic inflammation and dyslipidemia markers for middle-aged people with primary osteoarthritis

The objective of this pilot study was to determine whether 15 days of dietary supplementation with calcium fructoborate could acutely modulate inflammatory and lipid blood markers in individuals diagnosed with primary osteoarthritis. During 2 weeks, a placebo-controlled, randomized, double-blind study was conducted on 116 subjects that were initially recruited. Seventy-two subjects started the study, being divided into four groups, and only 60 completed the study as designed. The aim was to compare the effects of calcium fructoborate to placebo on subjects diagnosed with knee primary osteoarthritis. The obtained outcomes were inflammation biomarkers (C-reactive protein, fibrinogen, and erythrocyte sedimentation rate) and lipid markers (triglycerides, total cholesterol, LDL cholesterol, and HDL cholesterol). No serious adverse events were reported. The calcium fructoborate showed beneficial effect on the inflammatory markers for all groups subjected to the treatment when compared with the placebo group and slight changes in the lipid metabolism. This study suggests that short-term (2 weeks) calcium fructoborate supplementation in patients with osteoarthritis symptoms has a favorable prognosis on inflammation diseases.

[New potentialities in symptom-modifying therapy of osteoarthrosis]

AIM

To examine efficacy and tolerance of the drug Bora-Bora in patients with osteoarthrosis.

MATERIAL AND METHODS

Bora-Bora and nimesulid were given to 20 patients with a verified diagnosis of osteoarthrosis (OA). 20 control patients received nimesulid alone. Treatment efficacy was evaluated by quantitative parameters of articular syndrome, indices of periarticular muscles affection estimated before the treatment, 2, 6 and 8 weeks after the start of the treatment. Ultrasonic investigation of the joints and periarticular tissues was conducted before and after the treatment course.

RESULTS

The response to Bora-Bora was seen on day 10 of therapy. Bora-Bora attenuated pain syndrome in the joints and periarticular tissues, improved joint function more effectively than nimesulid (p < 0.05). Bora-Bora is a good anelgetic. It is well tolerated and can be recommended for OA treatment.

Chemesthetic responses to airborne mineral dusts: boric acid compared to alkaline materials

OBJECTIVES

(1) To assess the relation between occupationally relevant exposures to dust of boric acid and magnitude of feel in the eye, nose, and throat during activity (pedaling) equal to light industrial work. (2) To compare feel from the dust of boric acid with that of the alkaline dusts calcium oxide and sodium tetraborate pentahydrate (sodium borate). (3) To chart how magnitude of feel changes with time in exposures up to 3/4 h.

METHODS

Twelve subjects, six males and six females, participated in duplicate sessions of exposure to 2.5, 5, and 10 mg m(-3) of boric acid, 10 mg m(-3) of sodium borate, 2.5 mg m(-3) of calcium oxide presented as calcium oxide alone or diluted with hydrated calcium sulfate, and 0 mg m(-3) (blank). Exposures occurred in a plastic dome suspended over the head and closed around the neck with rubber dam. Measurements pre- and post-exposure included nasal secretion and nasal resistance. Measurements during exposure included rated magnitude of feel in the eye, nose, and throat, and respiration (Respitrace System). Six concentrations of carbon dioxide ranging from just below detectable to sharply stinging gave subjects references for their ratings.

RESULTS

In general, feel increased for periods up to half an hour, then either declined or held at a plateau. Each material had a temporal signature. The nose led with the highest feel, followed by the throat, then the eyes. This hierarchy proved weakest for boric acid; at one level of exposure, magnitude in the throat overtook that in the nose. Accompanying measures implied that change of feel with time occurred neither because of an increase in dilution of the dissolved dusts in newly secreted mucus nor an increase of consequence in nasal resistance. Most likely, sensory adaptation determined the change. Boric acid of 10 mg m(-3) fell slightly and insignificantly below 10 mg m(-3) sodium borate in feel. Boric acid, though, showed a relatively flat dose-response relationship, i.e., a change in level caused little change in feel.

CONCLUSIONS

The time-constant for feel from dusts lies on the order of tens of minutes. A flat concentration-response function for boric acid and a notable response from the throat suggests that perceived dryness, not mediated by acidity but perhaps by osmotic pressure, may account for the feel evoked at levels of exposure at or below 10 mg m(-3). More acidic dusts that could actually change nasal pH may trigger sensations differently.

Conservative aesthetic techniques for discoloured teeth: 1. The use of bleaching

There is an increasing move towards more minimally invasive techniques in restorative dentistry. This series of two articles discusses conservative techniques for the treatment of discoloured teeth. A step-wise approach to treatment is promoted to encourage the most conservative solution to achieve satisfactory aesthetics. The first of these two articles will describe the use of bleaching, whilst part two will go on to describe microabrasion and the use of direct composite resin.

CLINICAL RELEVANCE

Discoloured teeth are a common dental problem. Bleaching provides a simple conservative solution in many cases.

Effect of tooth-bleaching on the tensile strength and staining by caries detector solution on bovine enamel and dentin

PURPOSE

To evaluate the tensile strength and staining of enamel and dentin after extracoronal or intracoronal bleaching using conventional bleaching agents.

METHODS

Extracted bovine incisors were divided into eight groups of 10 specimens. Individual groups were treated by extracoronal bleaching (E) using in-office and home techniques with different concentrations of hydrogen peroxide (H2O2) and carbamide peroxide (CP); no bleaching (EN), 35% H2O2 and 10% CP (E35H-10C), 35% H2O2 and 20% CP (E35H-20C), 35% CP and 10% CP (E35C-10C), 35% CP and 20% CP (E35C-20C). Intracoronal "walking bleaching" (I) was performed after 24 hours of root canal treatment in the three remaining groups; no bleaching (IN); sodium perborate dissolved in 35% H2O2 (ISP-35H); and sodium perborate in distilled water (ISP-W). Mini dumbbell shapes of enamel and dentin with central cross-section diameters of 1.5 x 0.5 mm and 3 x 1 mm respectively were prepared for tensile testing using an Instron machine. Fracture surfaces were examined using SEM. Bleached enamel and dentin specimens were stained and evaluated using Caries Detector solution. Staining scores were analyzed using Kruskal-Wallis H and Mann-Whitney test (P < 0.05).

RESULTS

Tensile strengths (mean +/- SD) of enamel and dentin respectively for each group in MPa were: EN = 30.5 +/- 3.3 and 85.4 +/- 3.0, E35H-10C = 14.8 +/- 2.3 and 58.9 +/- 2.0, E35H-20C = 10.6 +/- 2.6 and 55.5 +/- 2.2, E35C-10C = 25.4 +/- 3.4 and 70.8 +/- 2.5, E35C-20C = 20.3 +/- 4.1 and 67.2 +/- 3.3, IN = 26.5 +/- 4.1 and 85.9 +/- 2.5, ISP-35H = 13.6 +/- 3.1 and 46.7 +/- 2.3, ISP-W = 21.7 +/- 3.3 and 68.3 +/- 4.4. ANOVA and Tukey HSD test found statistically significant differences among and between groups respectively (P < 0.05). No significant difference was found between non-bleached groups (IN and EN) of enamel and dentin. Mean tensile strengths of all bleached groups were significantly lower than those of non-bleached groups. Fracture surfaces demonstrated the different morphologies for bleached and non-bleached enamel and dentin.

Sensory and associated reactions to mineral dusts: sodium borate, calcium oxide, and calcium sulfate

Occupational exposure limits (OELs) for irritant dusts have had no quantifiable bases. This study (1) charted chemosensory feel, denoted chemesthesis here, to dusts of calcium oxide (1 to 5 mg/m(3)), sodium tetraborate pentahydrate [sodium borate] (5 to 40 mg/m(3)), and calcium sulfate (10 to 40 mg/m(3)); (2) examined correlates of the chemesthetic sensations; and (3) sought to illuminate the basis for potency. Twelve screened men exercised against a light load while they breathed air in a dome fed with controlled levels of dust for 20 min. Measured parameters included nasal resistance, nasal secretion, minute ventilation, heart rate, blood oxygenation, mucociliary transport time, and chemesthetic magnitude, calibrated to pungency of carbon dioxide. Subjects registered time-dependent feel from exposures principally in the nose, secondarily in the throat, and hardly in the eyes. Calcium oxide had the greatest potency, followed by sodium borate, with calcium sulfate a distant third. Of the physiological parameters, amount of secretion showed the best association with chemesthetic potency. That measure, as well as mucociliary transport time and minute ventilation, went into calculation of mass of dust dissolved into mucus. The calculations indicated that the two alkaline dusts increased in equal molar amounts with time. At equal molar concentrations, they had, to a first approximation, equal chemesthetic magnitude. On the basis of mass concentration in air or dissolved into mucus, calcium oxide and sodium borate differed in potency by a factor just above five, equal to the difference in their molecular weights. This relationship could inform the setting of OELs for a critical effect of irritation.

[Combining artificial tears---are they always synergistic?]

We report one case of thick, sticky, palpebral and conjunctival deposits following administration of artificial tears in a patient treated for dry eye syndrome. Experimental data confirmed clinical observation. The association of Refresh artificial tears and Dacudoses or Dacryoserum used as a washing solution should be avoided.

Contact sensitivity to calcium hypochlorite

Eusol (an abbreviation for Edinburgh University solution), consisting of aqueous boric acid and calcium hypochlorite, is widely used in the management of open wounds left to heal by secondary intention (1).

Low frequency of infertility among workers in a borate processing facility

In order to rule out the possibility of omitting some individuals in the study at field visits described in previous articles, either because of the reluctance of the subject or because of his appointment elsewhere, fertility and infertility states of borate workers of the Borax and Acid Plants in Bandirma, Balikesir are given. Balikesir is one of the four provinces with large borate deposits of Turkey, and Bandirma is 1 of its 19 districts. This county is relatively far away from borate deposits, and drinking water piped out through the springs has a boron amount between 0.10 and 0.82 ppm B. That the participants are occupationally exposed to the mineral in essence is therefore conceivable. At the first phase of the investigation, 191 workers were interviewed, as detailed previously. Among these, there were six infertiles of the primary type with a rate 3.1%. Boron-unrelated infertile couples among sibs were found to be 2.6-3.6%, and 3.2% for three generation marriages-none being higher than those revealed in different sets of controls. In the second stage of work, computerized files of all workers of the facility and all employees of the general management sharing the same location were checked without an interview. Twenty-four subjects (3.4%) out of 712 workers were childless versus 2.7% among 108 employees, and 2.2% among 91 workers of a distantly located sulfuric acid plant of the same complex. The differences were not significant, and these recent findings support the conclusion already reached almost unambiguously that boron exposure at the present levels does not interfere with human reproduction.

Assessment of fertility and infertility in boron-exposed Turkish subpopulations: 3. Evaluation of fertility among sibs and in "borate families"

As a part of a work to reveal the health effects of boron and its compounds, fertility and infertility states of sibs of probands, contacted and interviewed in the field, and of their spouses were given. The purposes were to prevent duplications seemingly inevitable in a relatively small community with prevailing consanguinity while analyzing marriages over respective generations and to reveal if there occurred an aggregation of infertile couples. Any family without offspring after about the second year of marriage was considered primary infertile as adopted throughout the study and such families were ascertained through the individual pedigree charts set up according to the instructions of the proband, he (she) himself (herself) being excluded. The rates of childless families of this type were 0.0-3.4% among male and 0.9-3.8% among female sibs of the participant, and 2.3-10.0% among male and 0.0-5.6% among female sibs of his (her) spouse with averages of 2.3% of 1589, 2.6% of 1589, 4.0% of 1314, and 3.3% of 1436 instances, respectively. The differences were insignificant and the rates were not different from those concerning probands themselves and that of a comparable segment of the Turkish population. "Borate families/kindreds" with two or more members engaged in the borate industry were also assessed in order to detect if there was a significant clustering of infertiles within the kindred. Although it was difficult to compare with a matched group, few couples were examples of familial concentration of infertility. These results provided further support that boron exposure does not affect human reproduction primarily and most probably secondarily.

Effects of common ophthalmic preservatives on ocular health

Preservatives are an important component of ophthalmic preparations, providing antimicrobial activity in the bottle and preventing decomposition of active drug. Often underrecognized, however, are the significant cytotoxic effects of preservatives associated with long-term therapy and especially use of multiple preserved drugs. The most common preservatives in ophthalmic preparations for glaucoma and surface eye disease-benzalkonium chloride (BAK), chlorobutanol, sodium perborate, and stabilized oxychloro complex (SOC)-were reviewed. Compared with other preservatives, SOC caused the least amount of damage to rabbit corneal epithelial cells. BAK has demonstrated cytotoxic effects in cell culture, as well as in animal and human studies. Physicians should consider treatment with new-generation preparations containing low-risk preservatives such as SOC, especially in patients receiving multiple ophthalmic medications.

In vitro microleakage of composite restorations after nonvital bleaching

OBJECTIVE

After bleaching treatment, esthetic restorations often need to be replaced due to color changes. Some papers have shown alterations in the bond of adhesive restorations to bleached teeth. The purpose of this study was to evaluate tooth and resin composite adhesion when submitted to nonvital dental bleaching.

METHOD AND MATERIALS

One hundred and twenty bovine teeth were assigned to 3 groups (n = 40); paste of sodium perborate and water; 37% carbamide peroxide gel; and no bleaching (control). After 3 weeks of continuous bleaching treatment, standardized Class V cavities were prepared at the cementoenamel junction and restored with Single Bond adhesive system and Z100 resin composite. The samples were thermocycled 1,500 times (5 +/- 1/55 +/- 1 degrees C) with a 1-minute dwell time. Then, they were immersed in a 2% methylene blue solution (pH 7) for 4 hours, sectioned, and analyzed by stereomicroscopy. Microleakage analyses were done, using scores from 0 to 4, considering leakage on the incisal wall (enamel) and the cervical wall (dentin). Data were analyzed by Kruskal-Wallis and Mann-Whitney tests (alpha = 0.05).

RESULTS

The results showed that sodium perborate and carbamide peroxide gel significantly increase the microleakage in Class V resin composite restorations to dentin but not to enamel margins.

CONCLUSION

The risk of microleakage in dentin margins is increased soon after bleaching treatment.

Association of reversible alopecia with occupational topical exposure to common borax-containing solutions

Boron is widely used in industrial materials, most frequently as the salt borax. Systemic exposure (eg, ingestion) to boron in boric acid been associated with reversible toxic alopecia among other manifestations. There is scant clinical literature on alopecia caused by topical exposure to boron. We observed a series of 3 patients in 2 workplaces who suffered reversible alopecia from cutaneous boron exposure. The scalp alopecia was global in 1 patient and patchy in 2 patients. Alopecia was completely reversed by elimination or reduction of exposure to boron-containing materials in all 3 patients. We conclude that occupational topical exposure to boron in solutions may cause reversible alopecia.

Carcinoma of the ear: a case report of a possible association with chlorinated disinfectants

In this report we present a case of squamous cell carcinoma developing in a mastoid cavity after prolonged exposure to the chemical disinfectant, Eusol. The efficacy and safety of Eusol and other chloric acid (hypochlorous acid) derivatives in clinical use is debated.

Comparative toxicology of borates

Inorganic borates, including boric acid, Na, ammonium, K, and Zn borates generally display low acute toxicity orally, dermally, and by inhalation. They are either not irritant or mild skin and eye irritants. Exceptions owing to physiochemical properties do occur. Longer-term toxicological studies have been reported mainly on boric acid or borax where the properties are generally similar on an equivalent boron (B) basis. The critical effects in several species are male reproductive toxicity and developmental toxicity. The doses that cause these effects are far higher than any levels to which the human population could be exposed. Humans would need to consume daily some 3.3 g of boric acid (or 5.0 g borax) to ingest the same dose level as the lowest animal NOAEL. No effects on fertility were seen in a population of workers exposed to borates or to a population exposed to high environmental borate levels. There is remarkable similarity in the toxicological effects of boric acid and borax across different species. Other inorganic borates that simply dissociate to boric acid are expected to display similar toxicity, whereas those that do not dissociate simply to boric acid may display a different toxicological profile.

Eusol: the plastic surgeon's choice?

Many products are currently promoted for use on wounds. Edinburgh University Solution of Lime (Eusol) has recently received adverse publicity regarding its use in wound management. One hundred and twenty-four consultant plastic surgeons were surveyed regarding their use of Eusol. Ninety-five replies were obtained (77%); of those who replied, 78 (82%) still use Eusol, while nine out of 17 who do not are prevented from using it as they are unable to obtain necessary supplies. In plastic surgery, Eusol is still being used by plastic surgeons in specific situations.

Human disodium octaborate tetrahydrate exposure following carpet flea treatment is not associated with significant dermal absorption

Disodium octaborate tetrahydrate is used for indoor flea control on carpets and furniture. Disodium octaborate tetrahydrate was applied to a 100% nylon carpet as a solution using a powered rug brush at a rate of approximately 200 micrograms/cm2 carpet. Two randomly chosen groups of volunteers (18 females, 4 males) wore either bathing suits which provided 75% or more skin exposure or whole-body, cotton dosimeters consisting of socks, union suits, and gloves. The volunteers performed a 20-minute set of Jazzercise routines. The availability of boron was demonstrated by covering portions of the carpet with a cotton dosimeter and rolling it with a weighted roller. Additionally, disodium octaborate tetrahydrate was transferred to the whole-body dosimeter. Volunteers also collected 24-hour urine specimens prior to and following the exercise period. The specimens were analyzed for total boron by inductively coupled plasma emission spectroscopy. No evidence of contact transfer and dermal absorption was obtained. The mean daily boron levels (mg/g creatinine) were 1.17, 1.33, and 1.31 for the group with exposed skin and 1.26, 1.12, and 1.26 for those who wore dosimeters which prevented contact. Daily urine boron levels were not significantly different when compared using a two sample t-test assuming equal variances (P > 0.05). Direct dermal contact with disodium octaborate tetrahydrate-treated carpet at a nominal rate of 200 micrograms/cm2 did not produce any adverse effects or change urinary boron clearance.

Surface morphology changes in human enamel, dentin and cementum following bleaching: a scanning electron microscopy study

Extracted human premolars were cut, cleaned and divided into 6 experimental groups. Each group was treated with one of the following bleaching materials: 30% hydrogen peroxide, 10% carbamide peroxide, sodium perborate, Nu-Smile, Opalescence and DentlBright. Morphological changes in tooth surface occurred following treatment with most bleaching agents. Hydrogen peroxide and DentlBright were associated with surface changes in all dental tissues. Hydrogen peroxide, DentlBright, Nu-Smile and Opalescence were mainly associated with surface changes in the cementum, which exhibited more changes than the other tissues.

Euglena gracilis as a supplementary test organism for detecting biologically active compounds

The mutagenic activity of more than 120 antimicrobial agents and protective components was investigated. Only Kathon showed a consistent increase in revertant counts in the Ames test on Salmonella typhimurium. The hereditary bleaching test on Euglena gracilis used for detecting extranuclear mutations, showed positive results for Kathon, triethanolamine and diamine silver tetraborate.

Effect of bleaching agents on dentin permeability to Streptococcus faecalis

Bacterial contamination of dentin may be a contributing factor in the development of bleaching-associated root resorption. In this study, the effect of commonly used bleaching agents on the permeability of dentin tubules to Streptococcus faecalis was evaluated. Sixty extracted bovine incisors were horizontally sectioned apically to the cementoenamel junction. In each tooth, a standard cavity was prepared, the pulp tissue extirpated, and remnants of soft tissue and smear layer were removed. Following rinsing and repeated autoclave sterilization, the teeth were divided into four groups, each treated with one of the following materials: 30% hydrogen peroxide, sodium perborate mixed with 30% hydrogen peroxide, sodium perborate mixed with distilled water, and distilled water alone that served as control. The bleaching agents were sealed in the teeth and incubated at 37 degrees C for 7, 14, and 21 days. At each time interval the bleaching agents were removed and the teeth incubated at 37 degrees C in brain heart infusion infected with S. faecalis. Histological sections were prepared, and the maximal bacterial penetration for each group was measured using a computerized morphometric system. Statistical analysis of the results revealed that teeth treated with either 30% hydrogen peroxide alone or in combination with sodium perborate were significantly more permeable to S. faecalis than those treated with sodium perborate mixed with water (p < 0.0001). Sodium perborate mixed with water did not cause an increase in dentin permeability to S. faecalis and was similar to the water control. In conclusion, it seems that bleaching agents containing hydrogen peroxide in high concentrations may increase bacterial penetration through dentinal tubules.

Acute and chronic respiratory effects of sodium borate particulate exposures

This study examined work-related chronic abnormality in pulmonary function and work-related acute irritant symptoms associated with exposure to borate dust in mining and processing operations. Chronic effects were examined by pulmonary function at the beginning and end of a 7-year interval. Time-specific estimates of sodium borate particulate exposures were used to estimate cumulative exposure during the study interval. Change in pulmonary function over the 7 years was found unrelated to the estimate of cumulative exposure during that interval. Exposure-response associations also were examined with respect to short-term peak exposures and incidence of five symptoms of acute respiratory irritation. Hourly measures of health outcome and continuous measures of particulate exposure were made on each subject throughout the day. Whenever a subject reported one of the irritant symptoms, a symptom intensity score was also recorded along with the approximate time of onset. The findings indicated that exposure-response relationships were present for each of the specific symptoms at several symptom intensity levels. The associations were present when exposure was estimated by both day-long and short-term (15-min) time-weighted average exposures. Associations persisted after taking account of smoking, age, and the presence of a common cold. No significant difference in response rate was found between workers exposed to different types of sodium borate dusts.

Reproductive effects of inorganic borates on male employees: birth rate assessment

The purpose of this study was to investigate the potential for reproductive effects of inorganic borate compounds on male employees. The standardized birth ratio (SBR) methodology was used to assess fertility among male employees, using live births as the measured end point. The ratio of female to male births was also assessed. Data were collected via questionnaires and telephone follow-up interviews. Medical insurance records were assessed for nonresponders. Exposures were assessed using three semiquantitative categories. We found a statistically significant increase in fertility as measured by live births among the employees of the inorganic borate facility. There does not appear to be any decrease in fertility due to exposures either as analyzed by the borate exposure categories or over time, which is an indirect measure of exposures. We found a nonstatistically significant increase in the percentage of female offspring. This increase was due, not to a deficiency of male offspring, but rather to a marked increase in the numbers of female offspring. This increase in percentage female offspring does not appear to be related to exposures to inorganic borates. Based on the data, exposures to inorganic borates do not appear to adversely affect fertility in this population.

Reproductive effects of sodium borates on male employees: birth rate assessment

OBJECTIVES

The purpose of the study was to investigate potential reproductive effects of sodium borates on occupationally exposed male employees at a large mining and production facility in the Mojave Desert of California.

METHODS

The standardised birth ratio (SBR) was used to assess fertility of the male employees. Live births were the measured end point, and the rate of female to male offspring was also assessed. Data were collected through a questionnaire after a series of on site introductory and explanatory meetings with the employees. Initial non-responders were followed up by telephone. Medical insurance records were assessed for those who declined to participate.

RESULTS

The questionnaire was a good method of ascertainment for live births. There was no evidence of selection bias in the results. There was a highly significant excess of offspring fathered by the male employees. There was no evidence of a relation between exposure and this excess of offspring, nor were there any temporal differences during the period of observation (> 30 years). Also, there was an excess of the percentage of female offspring fathered by these male employees. This excess of female offspring was not significant. There was no evidence of an exposure relation to sodium borates with this excess of female offspring nor were there any temporal differences.

CONCLUSION

Under the conditions studied, there were no adverse reproductive effects of high borate doses as reported from oral ingestion studies in animals.

Intracoronal bleaching: concerns and considerations

The history of intracoronal bleaching and the development of the walking bleach technique are reviewed. External cervical resorption associated with intracoronal bleaching is a serious sequela that has been reported in the literature. One explanation given for this phenomenon is that it results from an inflammatory process initiated by the presence of bleaching agents in the attachment apparatus. The basis for this conclusion is discussed. A review of published case reports on external cervical resorption associated with intracoronal bleaching revealed that: 100 per cent of the affected teeth had no intermediate dental base placed, 84 per cent were treated with a thermocatalytic technique, 80 per cent were bleached after the root canal sealer was fully set and 72 per cent had a history of trauma before bleaching. Based on these observations, it should be possible to safely bleach teeth intracoronally provided specific concerns and considerations are taken into account. These are: 1) the use of heat should be avoided; 2) an intermediate dental base should be placed with due respect to the attachment level; and 3) a base should be selected with due respect to its effectiveness in sealing tooth structure.

Application of an event marker in the occupational epidemiologic study of acute irritant symptoms

Field studies of occupational exposure to airborne irritants have predominantly relied on symptom surveys of study participants. As part of a new approach to the study of acute irritant symptoms, subjects exposed to sodium borate dusts recorded their symptom responses at hourly interviews as well as instantaneously on an electronic device called an event marker. Overall, the unprompted marks indicated fewer irritant events than the interviews. Marks were more frequent in the presence of more than one type of symptom and also appeared to reflect more severe symptoms. A proportion of the marked events occurred in time intervals when no symptoms were recalled during the interview. The exposure-response relations were similar regardless of whether they were based on the interview reports or the electronically marked symptoms. The event marker provided a means to examine the time of onset of the acute symptom event. It also made it possible to examine directly the timing profiles of symptom response in relation to changes in exposure levels in a field setting. Despite some inconsistencies, the finding suggests that the event marker may provide an alternative to frequent interviews of exposed workers to obtain irritant symptom responses for exposure-response modeling.

Shear bond strength of composite resin to unbleached and bleached human dentine

The purpose of this study was to compare the shear bond strength of composite resin to unbleached and bleached human dentine when used in conjunction with new dentine bonding systems. One hundred extracted, caries free, permanent human molars were used in this study. An in vitro walking bleach model was developed to stimulate clinical conditions during bleaching. It was found that the mean shear bond strength of composite resin to bleached dentine attained was lower than that to unbleached dentine. The value of 6.7 MPa bond strength to bleached human dentine demonstrated by All-Bond dentine conditioner and adhesive (Technique 1B) was much higher than in previous reports.

Dose related acute irritant symptom responses to occupational exposure to sodium borate dusts

A repeated measurement design was employed in the study of acute symptoms of eye and respiratory tract irritation resulting from occupational exposure to sodium borate dusts. The symptom assessment of the 79 exposed and 27 unexposed subjects comprised interviews before the shift began and then at regular hourly intervals for the next six hours of the shift, four days in a row. Exposures were monitored concurrently with a personal real time aerosol monitor. Two different exposure profiles, a daily average and short term (15 minute) average, were used in the analysis. Exposure-response relations were evaluated by linking incidence rates for each symptom with categories of exposure. Acute incidence rates for nasal, eye, and throat irritation, and coughing and breathlessness were found to be associated with increased exposure levels of both exposure indices. Steeper exposure-response slopes were seen when short term exposure concentrations were used. Results from multivariate logistic regression analysis suggest that current smokers tended to be less sensitive to the exposure to airborne sodium borate dust. There was no indication that anhydrous sodium borate was more potent than the other sodium borates in this work environment.

The use of hypochlorite solutions in wound management

Hypochlorite solutions have been an issue of controversy for many years. Research has highlighted their harmful effects and yet doctors and nurses continue to use them. This article will review the literature both for and against the use of hypochlorite solutions and will examine alternative wound dressings.

Sealing ability of two intermediate restorative materials in bleached teeth

This study compared the radicular penetration of bleaching agents in endodontically treated teeth containing an IRM base, a Cavit base, and no base. Forty-five extracted human maxillary central incisors treated with conventional endodontic therapy with laterally condensed gutta percha and sealer were randomly divided into three groups: (1) Cavit base, (2) IRM base and (3) no base. In groups 1 and 2, a 3.5 mm thickness of base material was placed at the time of obturation. After storage in saline for 1 week, the teeth were bleached with a mixture of 35% hydrogen peroxide and sodium perborate, combined with a 10% methylene blue dye solution, using a combination thermocatalytic and non-thermocatalytic bleaching technique. The apical distance of dye penetration was measured. The control group demonstrated dye penetration to the apex, indicating that a base is required to prevent leakage of bleaching agents when this combination of bleaching techniques is used. The mean distance of leakage was 3.43 mm (+/- 1.14) for the Cavit group and 5.94 mm (+/- 1.72) for the IRM group. Analysis with a t-test revealed that Cavit was a more effective barrier to leakage than IRM (T = 4.20, P less than 0.001).

Effect of bleaching agents on inorganic components of human dentin and cementum

The effect of bleaching agents on the inorganic composition of human dentin and cementum was examined. Intact teeth were crushed, pulverized, and separated to dentin and cementum powders. The pulverized tissues were exposed to treatments with 30% H2O2, 3% H2O2, 2% sodium perborate in 30% H2O2, 2% sodium perborate in 3% H2O2, and 2% sodium perborate in bidistilled water for periods of 15 min and 1, 24, and 72 h. The degree of dissolution and the percentage of inorganic material for both dentin and cementum were measured. Thirty percent H2O2 and 2% sodium perborate in 30% H2O2 treatments significantly increased the solubility of dentin and cementum. The degree of dissolutions and the percentage of inorganic material remaining in the undissolved dentin and cementum increased with time progression. The greatest increase occurred with 30% H2O2 and 2% sodium perborate in 30% H2O2 after 24- and 72-h treatments. It is concluded that 30% hydrogen peroxide treatment may cause alteration in the chemical structure of the dentin and cementum making them more susceptible to degradation.

For and against Eusol

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pH variation among materials used for intracoronal bleaching

Intracoronal bleaching of pulpless teeth with 30% hydrogen peroxide may result in external cervical root resorption. One of several suggested etiological factors associated with this complication is the pH of the bleaching materials. Because the available data on the pH values of bleaching materials were conflicting, it was the purpose of this study to measure the pH of the materials commonly used for bleaching pulpless teeth. The pH of different concentrations of sodium perborate and 30% hydrogen peroxide, alone or in combination, were measured for a period of 14 days. Sodium perborate was confirmed to be alkaline, whereas 30% hydrogen peroxide was acidic. The pH of the materials when mixed together gradually changed from acidic to alkaline as the concentration of sodium perborate was increased. A thick clinical consistency mixture of both materials was alkaline, and its alkalinity increased with time. These results do not support the theory relating bleaching-induced root resorption to an acidic pH of the bleaching pastes.

An epidemiologic approach to the study of acute reversible health effects in the workplace

We present an epidemiologic approach for the study of the irritant effects of sodium borate exposure that can be used to study acute reversible health effects more generally. Acute irritant responses, such as symptoms of nasal irritation or cough, are subjective. They may, however, be accompanied by transient airway obstruction, which can be objectively measured by a change in peak expiratory flow (PEF) or forced expiratory volume in one second (FEV1). Because these physiologic responses are reversible and follow short-term peaks of exposure, they cannot be studied effectively using conventional epidemiologic methods of design and analysis. The proposed study design is a short-term prospective cohort study with frequently repeated measures of health effects and simultaneous measures of exposure. Because each subject passes through periods of high and low short-term exposure, the study has the form of a crossover design. This design permits each acute response to be linked to the corresponding short-term average exposure, providing the data necessary for dose-response analyses within subject. We present the results of the sodium borate study to illustrate the analysis of such data.

Oesophageal stricture following inadvertent ingestion of Steradent tablets in the elderly

Two cases of benign oesophageal stricture following the inadvertent ingestion of Steradent tablets are presented. We stress the particular risk of this problem occurring in the elderly population.

Respiratory effects of borax dust

The relation of respiratory symptoms, pulmonary function, and abnormalities of chest radiographs to estimated exposures of borax dust has been investigated in a cross sectional study of 629 actively employed borax workers. Ninety three per cent of the eligible workers participated in the study and exposures ranged from 1.1 mg/m3 to 14.6 mg/m3. Symptoms of acute respiratory irritation such as dryness of the mouth, nose, or throat, dry cough, nose bleeds, sore throat, productive cough, shortness of breath, and chest tightness were related to exposures of 4.0 mg/m3 or more, and were infrequent at exposures of 1.1 mg/m3. Symptoms of persistent respiratory irritation meeting the definition of chronic simple bronchitis were related to exposure among non-smokers. Decrements in the FEV1 as a percentage of predicted were seen among smokers who had heavy cumulative borax exposures (greater than or equal to 80 mg/m3 years) but were not seen among less exposed smokers or among non-smokers. Radiographic abnormalities were uncommon and were not related to dust exposure. Borax dust appears to act as a simple respiratory irritant and perhaps causes small changes in the FEV1 among smokers who are heavily exposed.

Gastric damage from ingested acid in children

Acid ingestion occurs relatively rarely and produces a spectrum of injury that is markedly different from the more commonly encountered alkaline burns of the oropharynx and esophagus. Gastric damage results from pylorospasm with pooling of the ingested caustic in a dependent location. Symptoms may be delayed for days or weeks. Perforation and/or strictures may require extensive gastric surgery. Early fiberoptic endoscopy is essential.