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OBJECTIVE: To evaluate the mechanical stability and the proteolytic activity of bonds created by a two-step, etch-and-rinse adhesive applied to cross-linked and air-dried etched dentin. METHODS: Flat dentin surfaces were produced in 64 extracted sound human molars. The dentin was etched with 35% phosphoric acid for 15 seconds, and then the teeth were divided into groups according to the cross-linking solution applied on the etched dentin. Group 1: 5% grape seed extract (GSE), Group 2: 5% glutaraldehyde, Group 3: Gluma Desensitizer, or Group 4: deionized water (control). Solutions were applied for 60 seconds, followed by rinse and blot drying. Then, the teeth were separated into two subgroups where the etched dentin was kept moist or air-dried. The adhesive was applied followed by a composite resin buildup. After 24 hours, the teeth were cut into beams (0.81 mm²) that were tested for microtensile strength immediately or after 12 months of aging in a 37°C saliva-like buffer. Additional teeth (n=32) were bonded as described and cut into 0.5-mm-thick slabs. The slabs were prepared for nanoleakage (scanning electron microscopy) and in situ zymography (EnzChek Protease Assay Kit). Bond strength data were submitted to ANOVA and Tukey tests (α =0.05). RESULTS: Significant reduction in immediate bond strength (ca 65%) and increase in proteolytic activity was seen when the etched dentin was air dried without previous cross-linking biomodification. Conversely, bond strengths did not differ from those produced on wet dentin when collagen was cross-linked before air drying, irrespective of the solution applied. For both moist and air-dried etched dentin, collagen cross-linking resulted in mechanically stable bonds and reduced proteolytic activity after 12 months of storage. CONCLUSION: Bonds produced by the application of a two-step, etch-and-rinse adhesive to cross-linked, air-dried, etched dentin were mechanically stable and revealed reduced proteolytic activity after 1 year of aging.

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OBJECTIVES: This paper aims to assess the whitening effectiveness and toxicity of tooth-bleaching protocols applied to enamel/dentin disks simulating mandibular incisors (ICs) and premolars (PMs). MATERIALS AND METHODS: A 10% hydrogen peroxide (H2O2) gel was applied for 3 × 15, 1 × 15, or 1 × 5 min to enamel/dentin disks simulating mandibular ICs and PMs, and the trans-enamel and trans-dentinal diffusion products were applied to human dental pulp cells (1 h). Professional therapy (35% H2O2-3 × 15 min) was used as positive control, and non-bleached samples were used as negative control. Cell viability and morphology, oxidative stress generation, and odontoblastic marker expression were assessed. The H2O2 diffusion and enamel color change (ΔE) were also analyzed. RESULTS: The 10% H2O2 gel induced significant cell viability reduction only when applied 3 × 15 min, with the intensity of oxidative stress and down-regulation of odontoblastic markers being higher in the IC group. The other experimental bleaching protocols caused slight alterations regarding the cell parameters evaluated, with intensity being related to enamel/dentin thickness. These effects were also correlated with higher H2O2 diffusion in the IC group. ΔE values similar as positive control were found for the 10% 3 × 15 and 1 × 15 protocols on IC group, after 4 and 6 sessions. CONCLUSION: Application of a 10% H2O2 bleaching gel for 15 or 45 min to thin dental substrate significantly minimizes cell toxicity in comparison with highly concentrated gels associated with similar esthetic outcomes by increasing the number of bleaching sessions. CLINICAL RELEVANCE: Bleaching gels with 10% H2O2 applied in small teeth for short periods may be an interesting alternative to obtain whitening effectiveness without causing toxicity to pulp cells, which may be able to reduce the tooth hypersensitivity claimed by patients.

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AIM: To evaluate the effects of infrared light-emitting diode (LED) irradiation on stem cells from human exfoliated deciduous teeth (SHEDs). METHODOLOGY: Exfoliated primary teeth were obtained (n = 3), and SHEDs obtained from the teeth were seeded on the pulpal surface of 0.2-mm-thick dentine discs produced from permanent molars. The cells were incubated for 24 h by placing the discs in plain Dulbecco's modified Eagle's medium (DMEM). The DMEM was then replaced with new culture medium formulated for odontoblast differentiation. After 12 h in the second medium, SHEDs were irradiated through the dentine discs using an infrared LED (850 nm) with a power density of 80 mW cm-2 . Energy doses (EDs) delivered to the occlusal surface of the dentine discs were 0 (control), 2 and 4 J cm-2 (n = 6). Subsequent tests were performed 72 h after irradiation. These tests included cell viability (MTT), alkaline phosphatase activity (ALP), total protein production (TP), scanning electron microscopy (SEM), as well as gene expression for ALP, Col I, DSPP and DMP-1. Data were analysed using Kruskal-Wallis and Mann-Whitney t-tests (α = 0.05). RESULTS: Both EDs (2 and 4 J cm-2 ) significantly increased cell viability and ALP activity. For TP, ALP and Col I gene expression, only the 4 J cm-2 group had significantly higher values compared to the control group. Cell morphology was not affected by irradiation. CONCLUSION: Infrared LED irradiation was capable of biostimulating SHEDs through a 0.2 mm thickness of dentine, especially at the 4 J cm-2 level.

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Previous studies have demonstrated that high biostimulation takes place when cells under stress are subjected to phototherapy by laser or light-emitting-diode (LED) devices. Several studies selected nutritional deprivation by reducing the concentration of fetal bovine serum (FBS) in the culture medium or the exposure of cultured cells to lipopolysaccharide (LPS) as an in vitro cellular stress condition. However, there are no data certifying that these stimuli cause stressful conditions for cultured cells. This investigation assessed the induction of cellular stress by decreasing the concentration of FBS or adding LPS to culture medium. Odontoblast-like cells (MDPC-23) were cultured in complete culture medium (DMEM) containing 10% FBS. After a 12-hour incubation period, the DMEM was replaced by fresh medium containing 10% FBS (control), low concentrations of FBS (0, 0.2, 0.5, 2, or 5%) or LPS from Escherichia coli (10µg/ml). After an additional 12-hour incubation, cell viability, total cell-counting, total protein production, and gene expression of heat shock protein 70 (HSP70) were assessed. Data were statistically analyzed by ANOVA complemented by the Tukey test, with 5% considered significant. Cell viability was negatively affected only for 0% FBS, while reduced viable cell numbers and total protein production were detected for FBS concentrations lower than 2%. Higher HSP70 gene expression was also observed for FBS concentrations lower than 2% and for cells exposed to LPS. The nutritional deprivation model with culture medium lower than 2% of FBS can be safely used to induce cellular stress for in vitro photobiomodulation studies.

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This study evaluated the photoinactivation of Candida albicans in a murine model of oral candidiasis using chloro-aluminum phthalocyanine (ClAlP) encapsulated in cationic nanoemulsions (NE) and chloro-aluminum phthalocyanine (ClAlP) diluted in DMSO (DMSO) as photosensitizer (PS). Seventy-five 6-week-old female Swiss mice were immunosuppressed and inoculated with C. albicans to induce oral candidiasis. PDT was performed on the tongue by the application of the photosensitizers and LED light (100 J cm(-2) -660 nm). Twenty-four hours and 7 days after treatments, microbiological evaluation was carried out by recovering C. albicans from the tongue of animals (CFU ml(-1) ). Then, mice were sacrificed and the tongues were surgically removed for histological and biomolecular analysis of pro- and anti-inflammatory cytokines. Data were analyzed by ANOVA followed by Tukey's post hoc test. ClAlP-NE-mediated PDT reduced 2.26 log10 of C. albicans recovered from the tongue when compared with the control group (P-L-) (P < 0.05). PDT did not promote adverse effects on the tongue tissue. Seven days after treatment, all animals were completely healthy. In summary, PDT mediated by chloro-aluminum phthalocyanine entrapped in cationic nanoemulsions was effective in reducing C. albicans recovered from the oral lesions of immunocompromised mice.

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AIM: To assess the initial cytotoxicity and the late phenotype marker expression of odontoblast-like cells (MDPC-23) subjected to less aggressive in-office bleaching therapies. METHODOLOGY: A 17.5% hydrogen peroxide (H2O2) gel was applied for 45, 15 or 5 min to enamel/dentine discs adapted to trans-wells positioned over cultured MDPC-23 cells. No treatment was performed on the negative control. Immediately after bleaching, the cell viability, gene expression of inflammatory mediators and quantification of H2O2 diffusion were evaluated. The ALP activity, DSPP and DMP-1 gene expression and mineralized nodule deposition (MND) were assessed at 7, 14 or 21 days post-bleaching and analysed statistically with Mann-Whitney U-tests (α = 5%). RESULTS: H2O2 diffusion, proportional to treatment time, was observed in all bleached groups. Reductions of approximately 31%, 21% and 13% in cell viability were observed for the 45-, 15- and 5-min groups, respectively. This reduction was significant (P < 0.05) for the 45- and 15-min groups, which also presented significant (P < 0.05) over-expression of inflammatory mediators. The 45-min group was associated with significant (P < 0.05) reductions in DMP-1/DSPP expression at all periods, relative to control. The ALP activity and MND were reduced only in initial periods. The 15-min group had less intense reduction of all markers, with no difference to control at 21 days. CONCLUSIONS: The 17.5% H2O2 applied to tooth specimens for 5 min caused no alteration in the odontoblast-like cells. When this gel was applied for 45 or 15 min, a slight cytotoxicity, associated with alterations in phenotypic markers, was observed. However, cells were able to recover their functions up to 21 days post-bleaching.

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Laminitis in horses is often associated with endocrine disorders, especially the pituitary pars intermedia dysfunction (PPID) in older animals. Morphologic exams of the laminar tissue of the hoof were performed in two horses with suspected PPID, with no clinical signs of laminitis. Changes compatible with laminitis of endocrine origin were observed, such as rounding of the nuclei of the basal cells, thinning and stretching of the secondary epidermal laminae and tissue proliferation. PPID horses with no clinical signs of laminitis may be affected by lesions of the laminar tissue of the hoof that compromise the integrity of the dermal-epidermal junction and may develop clinical symptoms of the disease. It has been suggested that the development stage of endocrine laminitis is longer, but further studies should be conducted to confirm it.

A laminite em cavalos está frequentemente associada a distúrbios endócrinos, como a disfunção da pars intermedia da pituitária (PPID) em animais mais velhos. Exames morfológicos do tecido laminar do casco foram realizados em dois cavalos com suspeita de PPID após o óbito, os quais não apresentaram sinais clínicos de laminite. Alterações compatíveis com a laminite de origem endócrina foram observadas, como arredondamento da núcleo das células basais, alongamento e afilamento das lâminas epidérmicas secundárias e proliferação tecidual. Cavalos com PPID sem sinais clínicos de laminite podem estar acometidos por lesões do tecido laminar do casco que comprometam a integridade das interdigitações dérmico-epidérmicas e podem desenvolver a sintomatologia clínica da doença. Sugere-se que o período de desenvolvimento da laminite endócrina seja mais longo, porém estudos adicionais devem ser realizados para confirmar essa hipótese.

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OBJECTIVE: Several local factors can affect the wound-healing process, delaying its progression and postponing tissue homeostasis. It is known that local inflammation is related to wound healing; however, the maintenance of the inflammatory reaction can impair the proliferation and migration of oral mucosal cells. The aim of this study was to evaluate the viability and chemokine expression of epithelial cells and gingival fibroblasts exposed to long-term lipopolysaccharide (LPS) treatment. DESIGN: Epithelial cells (HaCaT, Cell Lines Service, 300493) and human gingival fibroblasts (HGFs) were seeded (1×10(5) cells/well) in 24-well plates and incubated for 24h. To simulate the responses of cells to a local chronic oral mucosal inflammation, we added LPS of Escherichia coli (10 µg/ml) to Dulbecco's modified Eagle's medium (DMEM), kept in contact with fibroblasts and epithelial cells for 24, 48, and 72h. Then the cells were assessed for viability (alamarBlue assay), number (trypan blue assay), and expression of CCL2 and CCL5 inflammatory chemokines (enzyme-linked immunosorbent assay (ELISA)). Data were statistically analyzed by nonparametric Kruskal-Wallis and Mann-Whitney tests at a significance level of 5%. RESULTS: Cell treatment with LPS caused significant decrease in viability for both cell lines. No time-dependent effect was observed for epithelial cells. However, reduction in fibroblast viability was greater at 48 and 72 h. CCL2 and CCL5 synthesis was significantly increased for both LPS-treated cells, and this expression decreased with time. CONCLUSION: The maintenance of an inflammatory cell stimulus by LPS decreases the number and viability of cultured oral mucosal cells, which may be related to delayed wound healing.

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A emissão de folhas, seu alongamento e a estrutura que conferem ao dossel forrageiro, são quantificados via morfogênese e característica estrutural do dossel. A emissão e o balanço de perfilhos é conhecido como perfilhamento. Ambos, morfogênese e perfilhamento, conferem ao pasto o potencial produtivo. Este processo é influenciado pela intensidade e a frequência de desfolhação. Pastos apresentam plasticidade fenotípica quando submetidos à pastejo intenso e frequente, com vistas a se adequar a esta condição adversa de ambiente. Ademais, fatores como a idade da planta e adubação influenciam no padrão de crescimento. Uma população com perfil etário jovem, ou um pasto adubado, apresenta taxas morfogênicas mais aceleradas, necessitando de ajustes no manejo do pastejo. Aliados a estes fatos, o padrão sazonal de distribuição de chuvas, temperatura e fotoperíodo, faz com que os pastos tenham padrão de crescimento distinto durante o ano. Quando estas condições são favoráveis ao crescimento das plantas, as taxas morfogênicas são aceleradas e ajustes no manejo são necessários. Sendo assim, o manejo do pastejo na época das águas e na época das secas, são distintos, principalmente por conta de padrões de crescimento diferentes nestas épocas. De fato, vários fatores influenciam o crescimento das plantas em pastejo, todavia, a devida manutenção do índice de área foliar (IAF) do pasto, seja em lotação continua ou lotação intermitente, faz com que resultados satisfatórios sejam obtidos em sistemas de exploração pecuária a pasto. Diante do exposto, metas de manejo considerando parâmetros morfogênicos da planta, aliados à manutenção de IAF adequado, mostram que pastos manejados em lotação continua devem ser mantidos em condições consideradas ótimas tanto para o crescimento da planta como para o consumo animal. Estas condições coincidem com alturas de manutenção de dossel forrageiro, recomendada para cada espécie ou cultivar dentro de espécie...

Leaf emergence and elongation and the structure they confer to the forage canopy are quantified based on morphogenetic and structural characteristics of the canopy. The emergence and balance of tillers is known as tillering. Both morphogenesis and tillering confer the production potential to the pasture. This process is influenced by the intensity and frequency of defoliation. Pastures exhibit phenotypic plasticity when submitted to intense and frequent grazing in order to adapt to this adverse environmental condition. Furthermore, factors such as plant age and fertilization influence the growth pattern. A population with a young age profile or a fertilized pasture has more accelerated rates of morphogenesis and requires adjustment in pasture management. In addition to these factors, the seasonal distribution pattern of rain, temperature and photoperiod leads to variations in the growth pattern of pastures over the year. When these conditions are favorable for plant growth, the rates of morphogenesis are accelerated and adjustments in management are necessary. Thus, pasture management differs between the rainy and dry seasons, mainly because of the different growth patterns during these periods. Indeed, several factors influence the growth of pasture plants; however, appropriate maintenance of the leaf area index (LAI) of the pasture under continuous or intermittent stocking provides satisfactory results of pasture-based farming systems. Given the above, management targets considering morphogenetic parameters of the plant, in conjunction with the maintenance of an adequate LAI, show that continuously stocked pastures should be kept under optimal conditions for both plant growth and animal consumption. These conditions coincide with the maintenance heights of the forage canopy recommended for each species or cultivar...

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A emissão de folhas, seu alongamento e a estrutura que conferem ao dossel forrageiro, são quantificados via morfogênese e característica estrutural do dossel. A emissão e o balanço de perfilhos é conhecido como perfilhamento. Ambos, morfogênese e perfilhamento, conferem ao pasto o potencial produtivo. Este processo é influenciado pela intensidade e a frequência de desfolhação. Pastos apresentam plasticidade fenotípica quando submetidos à pastejo intenso e frequente, com vistas a se adequar a esta condição adversa de ambiente. Ademais, fatores como a idade da planta e adubação influenciam no padrão de crescimento. Uma população com perfil etário jovem, ou um pasto adubado, apresenta taxas morfogênicas mais aceleradas, necessitando de ajustes no manejo do pastejo. Aliados a estes fatos, o padrão sazonal de distribuição de chuvas, temperatura e fotoperíodo, faz com que os pastos tenham padrão de crescimento distinto durante o ano. Quando estas condições são favoráveis ao crescimento das plantas, as taxas morfogênicas são aceleradas e ajustes no manejo são necessários. Sendo assim, o manejo do pastejo na época das águas e na época das secas, são distintos, principalmente por conta de padrões de crescimento diferentes nestas épocas. De fato, vários fatores influenciam o crescimento das plantas em pastejo, todavia, a devida manutenção do índice de área foliar (IAF) do pasto, seja em lotação continua ou lotação intermitente, faz com que resultados satisfatórios sejam obtidos em sistemas de exploração pecuária a pasto. Diante do exposto, metas de manejo considerando parâmetros morfogênicos da planta, aliados à manutenção de IAF adequado, mostram que pastos manejados em lotação continua devem ser mantidos em condições consideradas ótimas tanto para o crescimento da planta como para o consumo animal. Estas condições coincidem com alturas de manutenção de dossel forrageiro, recomendada para cada espécie ou cultivar dentro de espécie...(AU)

Leaf emergence and elongation and the structure they confer to the forage canopy are quantified based on morphogenetic and structural characteristics of the canopy. The emergence and balance of tillers is known as tillering. Both morphogenesis and tillering confer the production potential to the pasture. This process is influenced by the intensity and frequency of defoliation. Pastures exhibit phenotypic plasticity when submitted to intense and frequent grazing in order to adapt to this adverse environmental condition. Furthermore, factors such as plant age and fertilization influence the growth pattern. A population with a young age profile or a fertilized pasture has more accelerated rates of morphogenesis and requires adjustment in pasture management. In addition to these factors, the seasonal distribution pattern of rain, temperature and photoperiod leads to variations in the growth pattern of pastures over the year. When these conditions are favorable for plant growth, the rates of morphogenesis are accelerated and adjustments in management are necessary. Thus, pasture management differs between the rainy and dry seasons, mainly because of the different growth patterns during these periods. Indeed, several factors influence the growth of pasture plants; however, appropriate maintenance of the leaf area index (LAI) of the pasture under continuous or intermittent stocking provides satisfactory results of pasture-based farming systems. Given the above, management targets considering morphogenetic parameters of the plant, in conjunction with the maintenance of an adequate LAI, show that continuously stocked pastures should be kept under optimal conditions for both plant growth and animal consumption. These conditions coincide with the maintenance heights of the forage canopy recommended for each species or cultivar...(AU)

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Laminitis in horses is often associated with endocrine disorders, especially the pituitary pars intermedia dysfunction (PPID) in older animals. Morphologic exams of the laminar tissue of the hoof were performed in two horses with suspected PPID, with no clinical signs of laminitis. Changes compatible with laminitis of endocrine origin were observed, such as rounding of the nuclei of the basal cells, thinning and stretching of the secondary epidermal laminae and tissue proliferation. PPID horses with no clinical signs of laminitis may be affected by lesions of the laminar tissue of the hoof that compromise the integrity of the dermal-epidermal junction and may develop clinical symptoms of the disease. It has been suggested that the development stage of endocrine laminitis is longer, but further studies should be conducted to confirm it.(AU)

A laminite em cavalos está frequentemente associada a distúrbios endócrinos, como a disfunção da pars intermedia da pituitária (PPID) em animais mais velhos. Exames morfológicos do tecido laminar do casco foram realizados em dois cavalos com suspeita de PPID após o óbito, os quais não apresentaram sinais clínicos de laminite. Alterações compatíveis com a laminite de origem endócrina foram observadas, como arredondamento da núcleo das células basais, alongamento e afilamento das lâminas epidérmicas secundárias e proliferação tecidual. Cavalos com PPID sem sinais clínicos de laminite podem estar acometidos por lesões do tecido laminar do casco que comprometam a integridade das interdigitações dérmico-epidérmicas e podem desenvolver a sintomatologia clínica da doença. Sugere-se que o período de desenvolvimento da laminite endócrina seja mais longo, porém estudos adicionais devem ser realizados para confirmar essa hipótese.(AU)

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Low-level laser therapy (LLLT) has been indicated as an adjuvant therapy for bisphosphonate-induced osteonecrosis. However, the effects of LLLT on bisphosphonate-treated cells are not yet clear. This study evaluated the effects of LLLT on the proliferation and apoptosis of gingival fibroblasts treated with zoledronic acid (ZA). Cells were exposed to ZA at 5µM for 48h. Irradiation was performed using a laser diode prototype (LaserTABLE, InGaAsP; 780nm±3nm, 25mW) at 0.5 or 3J/cm(2), three times every 24h. Cell proliferation and apoptosis were evaluated by fluorescence microscopy. Data were analyzed by Mann-Whitney test at the 5% level of significance. ZA decreased cell proliferation to 47.62% (interquartile range (IQR) 23.80-57.14%; P=0.007) and increased apoptosis of gingival fibroblasts to 27.7% (IQR 20.9-33.4%; P=0.0001). LLLT increased cell proliferation compared with non-irradiated cells, at 0.5J/cm(2) (57.14%, IQR 57.14-71.43%; P=0.003) and at 3J/cm(2) (76.19%, IQR 61.90-76.19%; P=0.0001), but did not increase cell proliferation in ZA-treated cells. Irradiated fibroblasts presented lower apoptosis rates than the ZA-treated cells, but apoptosis was no different in ZA-treated cells compared to those that were ZA-treated and also irradiated.

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AIM: To investigate the effect of infrared light-emitting diode (LED) irradiation on the oxidative stress induced in human dental pulp cells (HDPCs) by lipopolysaccharide (LPS). METHODOLOGY: Human dental pulp cells (HDPCs) were harvested from sound primary teeth that were near exfoliation. Cells were seeded (10(5)  cells cm(-2) ) using α-MEM supplemented with 10% FBS and after 24 h, were placed in contact with LPS (10 µg mL(-1) of culture medium). Immediately afterwards, HDPCs were subjected to a single irradiation with an infrared LED (855 nm) delivering different doses of energy (0, 2, 4, 8, 15 or 30 J cm(-2) ). For each dose, there was a control group without LPS application. Twenty-four hours after irradiation, groups were tested for nitric oxide (NO) quantification, cell viability (MTT assay) and qualitative assessment of reactive oxygen species (ROS). Data were submitted to Kruskal-Wallis and Mann-Whitney tests (α = 0.05). RESULTS: Lipopolysaccharide (LPS)-induced stress resulted in significant increase in NO production by HDPC without causing damage to cell respiratory metabolism. Irrespective of energy dose delivered, NO production was significantly reduced when LPS-stressed cells were irradiated with infrared LED (2 J cm(-2) , P = 0.003; 95% CI = 5.84-27.71; 4 J cm(-2) , P = 0.001; 95% CI = 7.52-26.39; 8 J cm(-2) , P = 0.0195; 95% CI = -2.86-16.01; 15 J cm(-2) , P = 0.0001; 95% CI = 12.10-30.96; 30 J cm(-2) , P = 0.007; 95% CI = 5.84-24.71). The highest decrease in NO production was observed when 15 J cm(-2) was delivered to cells. Infrared LED irradiation resulted in a decrease in ROS production, whilst HDPC metabolism was not significantly affected. CONCLUSION: Biomodulation of oxidative stress of HPDC can be achieved by irradiation with a single dose of infrared LED. Within the range investigated, 15 J cm(-2) resulted in the least production of NO.

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The aim of the study was to evaluate the effects of a highly potent bisphosphonate, zoledronic acid (ZOL), on cultured odontoblast-like cells MDPC-23. The cells (1.5×10(4)cells/cm(2)) were seeded for 48h in wells of 24-well dished. Then, the plain culture medium (DMEM) was replaced by fresh medium without fetal bovine serum. After 24h, ZOL (1 or 5µM) was added to the medium and maintained in contact with the cells for 24h. After this period, the succinic dehydrogenase (SDH) enzyme production (cell viability - MTT assay), total protein (TP) production, alkaline phosphatase (ALP) activity, and gene expression (qPCR) of collagen type I (Col-I) and ALP were evaluated. Cell morphology was assessed by SEM. Five µM ZOL caused a significant decrease in SDH production. Both ZOL concentrations caused a dose-dependent significant decrease in TP production and ALP activity. ZOL also produced discret morphological alterations in the MDPC-23 cells. Regarding gene expression, 1µM ZOL caused a significant increase in Col-I expression. Although 5µM ZOL did not affect Col-I expression, it caused a significant alteration in ALP expression (ANOVA and Tukey's test, p<0.05). ZOL presented a dose-dependent cytotoxic effect on the odontoblast-like cells, suggesting that under clinical conditions the release of this drug from dentin could cause damage to the pulpo-dentin complex.

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An observational prospective cohort study was conducted with a historical control group and 140 infertile women with the laparoscopic diagnosis of ovarian endometrioma over 1 cm diameter. The groups were comparable regarding age, duration of infertility, and disease severity. All patients had a follow-up of 12 months after treatment, and at least one patent tube. The laparoscopic group (group A) consisted of 46 woman, 35 of whom received suppressive treatment with danazol, Gestinone, or leuprolide acetate for 4 to 6 months. In the control group (group B), 94 women underwent diagnostic laparoscopy plus 6 months of danazol or Gestinone therapy. After 3 months, microsurgery by laparotomy was performed. During the follow-up, period 24 pregnancies were achieved in group A (52%) and 58 in group B (61%, chi2 0.796). Fifteen (48%) of 31 women with cysts 1 to 3 cm in group A conceived, as did 52 (62%) of 81 in group B. Nine (60%) of the 15 with cysts over 3 cm in group A, and 7 (58%) of 12 in group B conceived. No significant difference was found among the suppressive drugs in either group. Only 4 (36%) of the 11 women in group A not receiving suppressive treatment became pregnant. No significant difference (p >0.05) was found when comparing the combined treatment group (57%). According to the revised classification of endometriosis, 18 (51%) of 35 pregnancies were achieved in women with moderate disease in group A and 41 (64%) of 64 in group B. In those with severe disease, 6 (55%) of 11 became pregnant in group A and 17 (57%) of 30 in group B. There was no significant difference between the groups when comparing global results, ovarian endometrioma size, medical treatment, and severity of endometriosis. Given comparable surgical expertise, operative laparoscopy should be the procedure of choice in the treatment of ovarian endometrioma whenever possible, due to its recognized advantages.

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Although amitriptyline is not usually regarded as toxic to the peripheral nervous system (PNS) and is even prescribed by some for neuropathic pain, there are sporadic reports of peripheral neuropathy following overdose or prolonged use of the drug. The scarcity of data leads us to report a case we have followed for 3 years clinically and electromyographically. A 54 year old man on oral amitriptyline 150 mg uninterruptedly for 2 years consulted us for lower limb paresthesias and was found on clinical examination to have reduced ankle jerks and mild distal global hypoesthesia. EMG yielded a pattern of sensorimotor neuropathy compatible with axonal disease in all four limbs. The history was unremarkable and the laboratory data were within normal limits. After discontinuation of amitriptyline therapy both the clinical and EMG pattern gradually normalized. We draw attention to the possible risk, infrequent though it is, of PNS neurotoxicity of a widely used drug reputedly harmless from this point of view.

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