(S)-(-)-Curvularin als Leitstruktur für die Synthese neuartiger antiinflammatorischer Wirkstoffe

Ziel dieser Arbeit war die Darstellung antiinflammatorischer Wirkstoffe basierend auf (S)-(-)-Curvularin. Zur Ermittlung von Struktur-Aktivitäts-Beziehungen sollte eine möglichst große Zahl an Derivaten dargestellt und in Zusammenarbeit mit pharmakologischen und mikrobiologischen Arbeitsgruppen. Es wurde ein neuer und effizienter totalsynthetischer Zugang zu Curvularin sowie analogen Ringsystemen erarbeitet mit einer Ringschluss-Metathese als Schlüsselschritt zur Bildung des Makrocyclus. Ausgehend von den Synthesebausteinen 3,5-Dihydroxyphenylessigsäure und (S)-Propenoxid gelang die Darstellung des Naturstoffes (S) ( )-Curvularin mit einer Gesamtausbeute von 10 % über sieben Stufen. Der Naturstoff Curvularin selbst wurde durch Modifikationen an den phenolischen Funktionen, durch elektrophile aromatische Substitution, Reduktion sowie konjugierte Addition an den Naturstoff 10,11-Dehydrocurvularin derivatisiert. Mit diesen synthetischen Ansätzen konnten die Strukturelemente des Naturstoffes systematisch variiert werden und es konnten insgesamt 28 Makrolactone synthetisiert werden. Anhand der biologischen Evaluierung der Verbindungen ließen sich Rückschlüsse auf die pharmakophoren Gruppen des Naturstoffes ziehen, bei vier der synthetisierten Verbindungen konnten im Vergleich zu Curvularin eine höhere biologische Aktivität erzielt werden. Anhand der Erkenntnisse aus den biologischen Tests ließen sich strukturell einfachere Verbindungen als potentielle Wirkstrukturen entwerfen. Es wurden verschiedene ortho-acylierte 3,5-Dihydroxyphenylessigsäurederivate sowie substituierte 6,8-Dihydoxytetralon- und 6,8-Dihydroxyisochinolon-Verbindungen synthetisiert. Diese vereinfachten Partialstrukturen zeigten eine geringere biologischen Aktivität als der Naturstoff.

Synthesis and characterization of oligo(thiophene carboxamide)s

Die vorliegende Arbeit besteht aus zwei Teilen: Im ersten Teil der Arbeit werden supramolekulare Strukturen betrachtet, die durch unterschiedliche Fällungsbedingungen von Polyethylenoxid-block-oligo-p-benzamid-copolymeren erhalten wurden. Durch tropfenweise Zugabe des gelösten Polymers zu Chloroform, ein für Polyethylenoxid selektives Lösemittel, konnten verschiedenste Aggregate hergestellt werden. Von großen Hohlkugel mit einem Durchmesser von mehreren Mikrometern, bis zu kleinen Stäbchen mit den Abmessungen von zehn Nanometern in der Breite und einigen hundert Nanometern Länge, konnten beobachtet werden.rnDer Hauptteil der Arbeit handelt von der Synthese und Charakterisierung eines neuen, konjugierten Oligomers: Oligothiophencarbonsäureamid. Das hierfür nötige Monomer, eine 2-Aminothiophen-5-carbonsäure konnte mittels Gewald-Synthese, eine multikomponenten Ringschlussreaktion dargestellt werden. Diese Methode erlaubt die Herstellung von vierfach substituierten Thiophenen, wobei 3- und 4-Position meist Alkylketten und Ester sind. Das so hergestellte Material konnte in der stufenweise Synthese von Oligothiophencarbonsäureamiden genutzt werden. Die neuen Oligomere zeigten interessante Absorptions- und Fluoreszenzeigenschaften. In Dichlormethan wurde eine bathochrome Verschiebung der Absorptionsbande in Abhängigkeit der Oligomerlänge beobachtet. Das Pentamer erreichte eine Absorptionsenergie, die der Bande des Polythiophencarbonsäureamids entspricht, was bedeutetet, dass die effektive Konjugationslänge erreicht wurde. Im Gegensatz zu den Messungen in Dichlormethan, zeigten die Oligomere Aggregationstendenzen ab dem Trimer in N,N-Dimethylformamid. Die auftretende Charge-Transfer Bande verschwand mit steigenden Konzentrationen. Eine mögliche hypsochrome Verschiebung dieser Bande, deutet auf eine Bildung von H Aggregaten hin. Fluoreszenz und zeitaufgelöste Fluoreszenzmessungen ergaben die für konjugierte Systeme zu erwartenden Effekte. Die Konjugation entlang des Amids konnte ebenfalls mittels quantenmechanischer Berechnung nachgewiesen werden.

Semi-synthetic bile acids as novel drug candidate in liver diseases: physico-chemical characterization and HPLC-ES-MS/MS methods for their quali-quantitative analysis in different experimental animal models

The physico-chemical characterization, structure-pharmacokinetic and metabolism studies of new semi synthetic analogues of natural bile acids (BAs) drug candidates have been performed. Recent studies discovered a role of BAs as agonists of FXR and TGR5 receptor, thus opening new therapeutic target for the treatment of liver diseases or metabolic disorders. Up to twenty new semisynthetic analogues have been synthesized and studied in order to find promising novel drugs candidates. In order to define the BAs structure-activity relationship, their main physico-chemical properties (solubility, detergency, lipophilicity and affinity with serum albumin) have been measured with validated analytical methodologies. Their metabolism and biodistribution has been studied in “bile fistula rat”, model where each BA is acutely administered through duodenal and femoral infusion and bile collected at different time interval allowing to define the relationship between structure and intestinal absorption and hepatic uptake ,metabolism and systemic spill-over. One of the studied analogues, 6α-ethyl-3α7α-dihydroxy-5β-cholanic acid, analogue of CDCA (INT 747, Obeticholic Acid (OCA)), recently under approval for the treatment of cholestatic liver diseases, requires additional studies to ensure its safety and lack of toxicity when administered to patients with a strong liver impairment. For this purpose, CCl4 inhalation to rat causing hepatic decompensation (cirrhosis) animal model has been developed and used to define the difference of OCA biodistribution in respect to control animals trying to define whether peripheral tissues might be also exposed as a result of toxic plasma levels of OCA, evaluating also the endogenous BAs biodistribution. An accurate and sensitive HPLC-ES-MS/MS method is developed to identify and quantify all BAs in biological matrices (bile, plasma, urine, liver, kidney, intestinal content and tissue) for which a sample pretreatment have been optimized.

On-surface chemical reactions on an insulating substrate

Diese Arbeit beschreibt zum ersten Mal die kovalente Verknüpfung organischer Moleküle auf einer Isolatoroberfläche, motiviert im Hinblick auf die Nutzung der Synthesemethode für die molekulare Elektronik und verwandte Anwendungen. Durch die Verwendung der Nichtkontakt-Rasterkraftmikroskopie und der Kelvinprobe-Mikroskopie bei Raumtemperatur wurden grundlegende molekulare Prozesse der Wechselwirkungen zwischen Molekülen und der Calcit(10.4) Oberfläche sowie die chemische Reaktivität der Moleküle auf der Oberfläche analysiert. Das Zusammenspiel zwischen intermolekularen und Molekül-Oberfläche Wechselwirkungen zeigt sich für Biphenyl-4,4'-dicarbonsäure (BPDCA) durch die Koexistenz zweier unterschiedlicher molekularer Strukturen, die einen Einblick in die treibenden Kräfte der molekularen Selbstorganisation bieten. Die sehr ausgeprägte Reihenstruktur basiert auf der optimalen geometrischen Struktur der BPDCA Moleküle zu den Abmessungen des Substrats, während die zweite Struktur durch Wasserstoffbrücken zwischen den Molekülen gekennzeichnet ist. Der Deprotonierungsvorgang von 2,5-Dihydroxybenzoesäure (DHBA)-Molekülen auf Calcit wird bei Zimmertemperatur gezeigt. Zwei Phasen werden beobachtet, die nach Aufbringen der Moleküle koexistieren. Mit der Zeit geht eine bulk-ähnliche Phase in eine stabile, dicht gepackte Phase über. Der Übergang wird durch Betrachtung des Protonierungszustands der Moleküle erklärt. Die bulk-ähnliche Phase benötigt Wasserstoffbrückbindungen zur Strukturbildung. Werden die Moleküle deprotoniert, so wird die resultierende dicht gepackte Phase durch die elektrostatische Wechselwirkung der deprotonierten Carboxylatgruppen mit den Oberflächen-Calciumkationen stabilisiert. 4-Iodbenzoesäure (IBA)-Moleküle bilden auf Calcit nur Inseln an Stufenkanten, was auf die schwache Molekül-Oberflächen-Wechselwirkung zurückzuführen ist. Für einen stärkeren Einfluss des Substrats durchlaufen die Moleküle einen kontrollierten Übergangsschritt vom protonierten zum deprotonierten Zustand. Im deprotonierten Zustand nehmen die Moleküle eine wohldefinierte Adsorptionsposition auf dem Substrat ein. Die deprotonierte Säuregruppe wird ausgenutzt, um die Desorption der halogensubstituierten Benzoesäure-Moleküle bei der thermischer Aktivierung für die Vernetzungsreaktion zu vermeiden. Darüber hinaus wird die Carboxylatgruppe als starker Elektronendonor verwendet um die Phenyl-Halogen-Bindung zu schwächen und somit die homolytische Spaltung dieser Bindung auch bei moderaten Temperaturen zu ermöglichen. Diesem Konzept folgend ist die erste erfolgreiche kovalente Verknüpfung von 2,5-Diiod-benzoesäure, 2,5-Dichlorbenzoesäure, 3,5-Diiod Salicylsäure und 4-Iod-benzoesäure zu durchkonjugierten molekularen Drähten, Zick-Zack-Strukturen sowie Dimere gezeigt durch Ausnutzen von unterschiedlichen Substitutionsposition sowie Ändern der Anzahl der substituierten Halogenatome. Aufbauend auf diesem Erfolg, wird eine zweistufige Vernetzungsreaktion vorgestellt. Zum Induzieren der ortsspezifischen und sequentiellen kovalenten Verknüpfung wird ein Ausgangsmolekül gewählt, das sowohl eine Bromphenyl als auch eine Chlorphenyl Gruppe mit unterschiedlichen Dissoziationsenergien für die homolytische Spaltung besitzt. Die Reaktionsstellen und sequentielle Reihenfolge für die Reaktion sind somit in der molekularen Struktur einkodiert und bisher unerreichte Reaktionspfade können mithilfe der kovalente Verknüpfung organischer Moleküle auf einer Isolatoroberfläche beschritten werden.

[Topical therapy of ulcerative colitis]

The availability of new topical preparations for the treatment of left sided ulcerative colitis ulcerosa offers a therapy optimization for many patients. Rectal application of steroids and 5-aminosalicylic acid (5-ASA) is associated with fewer side effects and has a higher therapeutic efficacy in mild to moderate-active left-sided colitis as compared to a systemic therapy. Often it is argued that the patients' compliance is insufficient with a rectal therapy. However, with sufficient information on the proven advantages this is usually not the case. The rectal application of drugs in distal ulcerative colitis is suitable also for the maintenance of remission. Therefore the new therapy guidelines recommend topical therapy more than in former times. Subsequently, these manuscripts focussed specifically on the topical therapy of distal colitis, to elucidate that clear treatment advantages are present in daily practice.

Effect of tin-chloride pretreatment on bond strength of two adhesive systems to dentin

OBJECTIVES: To determine the effect on resin composite-to-dentin bond strength of incorporation of an acidic tin-chloride pretreatment in two adhesive systems. MATERIALS AND METHODS: Human molars were ground to expose mid-coronal dentin. For microtensile bond strength (μTBS) testing, dentin was treated with Optibond FL or Clearfil SE according to one of six protocols (n = 22/group). Group 1: Phosphoric acid etching, Optibond FL Prime, Optibond FL Adhesive (manufacturer's instructions; control); Group 2: Tin-chloride pretreatment, Optibond FL Prime, Optibond FL Adhesive; Group 3: Phosphoric acid etching, tin-chloride pretreatment, Optibond FL Prime, Optibond FL Adhesive; Group 4: Clearfil SE Primer, Clearfil SE Bond (manufacturer's instructions; control); Group 5: Phosphoric acid etching, Clearfil SE Primer, Clearfil SE Bond; and Group 6: Tin-chloride pretreatment, Clearfil SE Primer, Clearfil SE Bond. The molars were then built up with resin composite (Clearfil Majesty Esthetic). After storage (1 week, 100  % humidity, 37 °C) the μTBS was measured and failure mode was determined. Additionally, pretreated dentin surfaces were evaluated using SEM and EDX. The μTBS results were analyzed statistically by a Welch Two Sample t-test and a Kruskal-Wallis test followed by exact Wilcoxon rank sum tests with Bonferroni-Holm adjustment for multiple testing (α = 0.05). RESULTS: When Optibond FL was used, partial or total replacement of phosphoric acid with tin-chloride decreased μTBS significantly. In contrast, when Clearfil SE was used, inclusion of a tin-chloride pretreatment in the adhesive procedure increased μTBS significantly. CONCLUSIONS: Tin-chloride pretreatment had a beneficial influence on the bond promoting capacity of the MDP-containing adhesive system Clearfil SE.

Effect of a chitosan additive to a Sn(2+)-containing toothpaste on its anti-erosive/anti-abrasive efficacy-a controlled randomised in situ trial

OBJECTIVES It is well known that Sn(2+) is a notable anti-erosive agent. There are indications that biopolymers such as chitosan can enhance the effect of Sn(2+), at least in vitro. However, little information exists about their anti-erosive/anti-abrasive in situ effects. In the present in situ study, the efficacy of Sn(2+)-containing toothpastes in the presence or absence of chitosan was tested. METHODS Ten subjects participated in the randomised crossover study, wearing mandibular appliances with human enamel specimens. Specimens were extraorally demineralised (7 days, 0.5 % citric acid, pH 2.6; 6 × 2 min/day) and intraorally exposed to toothpaste suspensions (2 × 2 min/day). Within the suspension immersion time, one half of the specimens were additionally brushed intraorally with a powered toothbrush (5 s, 2.5 N). Tested preparations were a placebo toothpaste (negative control), two experimental toothpastes (F/Sn = 1,400 ppm F(-), 3,500 ppm Sn(2+); F/Sn/chitosan = 1,400 ppm F(-), 3,500 ppm Sn(2+), 0.5 % chitosan) and an SnF2-containing gel (positive control, GelKam = 3,000 ppm Sn(2+), 1,000 ppm F(-)). Substance loss was quantified profilometrically (μm). RESULTS In the placebo group, tissue loss was 11.2 ± 4.6 (immersion in suspension) and 17.7 ± 4.7 (immersion in suspension + brushing). Immersion in each Sn(2+)-containing suspension significantly reduced tissue loss (p ≤ 0.01); after immersion in suspension + brushing, only the treatments with GelKam (5.4 ± 5.5) and with F/Sn/chitosan (9.6 ± 5.6) significantly reduced loss [both p ≤ 0.05 compared to placebo; F/Sn 12.8 ± 6.4 (not significant)] CONCLUSION Chitosan enhanced the efficacy of the Sn(2+)-containing toothpaste as an anti-erosive/anti-abrasive agent. CLINICAL RELEVANCE The use of Sn(2+)- and chitosan-containing toothpaste is a good option for symptomatic therapy in patients with regular acid impacts.

Glutamate and nitric oxide as regulatory transmitters in developing rabbit retina

Glutamate is the major excitatory neurotransmitter in the retina and serves as the synaptic messenger for the three classes of neurons which constitute the vertical pathway--the photoreceptors, bipolar cells and ganglion cells. In addition, the glutamate system has been localized morphologically, pharmacologically as well as molecularly during the first postnatal week of development before synaptogenesis occurs. The role which glutamate plays in the maturing visual system is complex but ranges from mediating developmental neurotoxicity to inducing neurite outgrowth.^ Nitric oxide/cGMP is a novel intercellular messenger which is thought to act in concert with the glutamate system in regulating a variety of cellular processes in the brain as well as retina, most notably neurotoxicity. Several developmental activities including programmed cell death, synapse elimination and synaptic reorganization are possible functions of cellular regulation modulated by nitric oxide as well as glutamate.^ The purpose of this thesis is to (1) biochemically characterize the endogenous pools of glutamate and determine what fraction exists extracellularly; (2) examine the morphological expression of NO producing cells in developing retina; (3) test the functional coupling of the NMDA subtype of glutamate receptor to the NO system by examining neurotoxicity which has roles in both the maturing and adult retina.^ Biochemical sampling of perfusates collected from the photoreceptor surface of ex vivo retina demonstrated that although the total pool of glutamate present at birth is relatively modest, a high percentage resides in extracellular pools. As a result, immature neurons without significant synaptic connections survive and develop in a highly glutamatergic environment which has been shown to be toxic in the adult retina.^ The interaction of the glutamate system with the NO system has been postulated to regulate neuronal survival. We therefore examined the developmental expression of the enzyme responsible for producing NO, nitric oxide synthase (NOS), using an antibody to the constitutive form of NOS found in the brain. The neurons thought to produce the majority of NO in the adult retina, a subpopulation of widefield amacrine cells, were not immunoreactive until the end of the second postnatal week. However, a unique developmental expression was observed in the ganglion cell layer and developing outer nuclear layer of the retina during the first postnatal week. We postulate NO producing neurons may not be present in a mature configuration therefore permitting neuronal survival in a highly glutamatergic microenvironment and allowing NO to play a development-specific role at this time.^ The next set of experiments constituted a functional test of the hypothesis that the absence of the prototypic NO producing cells in developing retina protects immature neurons against glutamate toxicity. An explant culture system developed in order to examine cellular responses of immature and adult neurons to glutamate toxicity showed that immature neurons were affected by NMDA but were less responsive to NMDA and NO mediated toxicity. In contrast, adult explants exhibited significant NMDA toxicity which was attenuated by NMDA antagonists, 2-amino-5-phosphonovaleric acid (APV), dextromethorphan (Dex) and N$\rm\sp{G}$-D-methyl arginine (metARG). These results indicated that pan-retinal neurotoxicity via the NMDA receptor and/or NO activation occurred in the adult retina but was not significant in the neonate. (Abstract shortened by UMI.) ^

Dentin Bond Strength of Two Recent CAD/CAM-Materials after Storage

Purpose: To investigate the bond strength to dentin of two recent resin-ceramic materials for computer-aided design/computer-aided manufacturing (CAD/CAM) after 24 hours and after six months storage. Methods and Materials: Ninety cylinders were milled out of Lava Ultimate (3M ESPE) and 90 cylinders out of VITA ENAMIC (VITA Zahnfabrik) (dimension of cylinders: ∅=3.6 mm, h=2 mm). All Lava Ultimate cylinders were sandblasted (aluminium oxide, grain size: 27 μm) and cleaned with ethanol, whereas all VITA ENAMIC cylinders were acid-etched (5% hydrofluoric acid) and cleaned with water-spray. According to the three groups of cements used, the cylinders (n=30/resin-ceramic material) were further pretreated with 1) Scotchbond Universal for RelyX Ultimate (3M ESPE), 2) CLEARFIL Ceramic Primer for PANAVIA F2.0 (Kuraray), or 3) no further pretreatment for Ketac Cem Plus (3M ESPE). The cylinders were then bonded to ground human dentin specimens with 1) Scotchbond Universal and RelyX Ultimate (light-cured), 2) ED PRIMER II and PANAVIA F2.0 (light-cured), or 3) no adhesive system; Ketac Cem Plus (self-cured). Shear bond strength (SBS) was measured after 24 hours for 15 specimens/group and after six months (37°C, 100% humidity) for the other 15 specimens/group. SBS-values were statistically analysed with nonparametric ANOVA followed by exact Wilcoxon rank sum tests (α=0.05). Results: SBS of the two resin-ceramic materials and the three cements after 24 hours and after six months storage are shown in Figure 1. The statistical analysis showed that the duration of storage had a significant effect on SBS of Lava Ultimate for all three cements but had no significant effect on SBS of VITA ENAMIC. For Lava Ultimate SBS-values were (MPa; medians after 24 hours/six months): 13.5/22.5 (p=0.04) for RelyX Ultimate, 11.4/5.8 (p=0.0006) for PANAVIA F2.0, and 0.34/0.09 (p=0.04) for Ketac Cem Plus (Fig. 1). For VITA ENAMIC SBS-values were (MPa; medians after 24 hours/six months): 16.0/21.2 (p=0.10) for RelyX Ultimate, 11.4/14.4 (p=0.06) for PANAVIA F2.0, and 0.43/0.41 (p=0.32) for Ketac Cem Plus (Fig. 1). After 24 hours, there was no significant difference in SBS between Lava Ultimate and VITA ENAMIC for all three cements (p≥0.37). After six months, there was no significant difference in SBS between Lava Ultimate and VITA ENAMIC for RelyX Ultimate and Ketac Cem Plus (p≥0.07) whereas for PANAVIA F2.0, SBS was significantly lower for Lava Ultimate than for VITA ENAMIC (p<0.0001). Conclusion: SBS of Lava Ultimate was more affected by six months storage and by the cement used than was VITA ENAMIC.

Copper-64 Labeled Macrobicyclic Sarcophagine Coupled to a GRP Receptor Antagonist Shows Great Promise for PET Imaging of Prostate Cancer

The gastrin-releasing peptide receptor (GRPr) is an important molecular target for the visualization and therapy of tumors and can be targeted with radiolabeled bombesin derivatives. The present study aims to develop statine-based bombesin receptor antagonists suitable for labeling with 64Cu for imaging by positron emission tomography (PET). The potent GRPr antagonist D-Phe-Gln-Trp-Ala-Val-Gly-His-Sta-Leu-NH2 was conjugated to the sarcophagine (3,6,10,13,16,19-hexaazabicyclo[6.6.6] icosane=Sar) derivative 5-(8-methyl-3,6,10,13,16,19-hexaaza-bicyclo[6.6.6]icosan-1-ylamino)-5-oxopentanoic acid (MeCOSar) via PEG4 (LE1) and PEG2 (LE2) spacers and radiolabeled with 64Cu2+ with >95% yield and specific activities of about 100 MBq/nmol. Both Cu(II) conjugates have high affinity for GRPr (IC50: natCu-LE1, 1.4±0.1 nM; natCu-LE2, 3.8±0.6 nM). The antagonistic properties of both conjugates were confirmed by Ca2+-flux measurements. Biodistribution studies of Cu-64-LE1 exhibited specific targeting of the tumor (19.6±4.7% IA/g at 1 h p.i.) and GRPr-positive organs. Biodistribution and PET images at 4 and 24 h postinjection showed increasing tumor-to-background ratios with time. This was illustrated by the acquisition of PET images showing high tumor-to-normal tissue contrast. This study demonstrates the high affinity of the MeCOSar-PEGx-bombesin conjugates to GRPr. The stability of 64Cu complexes of MeCOSar, the long half-life of 64Cu, and the suitable biodistribution profile of the 64Cu-labeled peptides lead to PET images of high contrast suitable for potential translation into the clinic.

Prevalence and Risk Factors for Therapy Escalation in Ulcerative Colitis in the Swiss IBD Cohort Study.

BACKGROUND Physicians traditionally treat ulcerative colitis (UC) using a step-up approach. Given the paucity of data, we aimed to assess the cumulative probability of UC-related need for step-up therapy and to identify escalation-associated risk factors. METHODS Patients with UC enrolled into the Swiss IBD Cohort Study were analyzed. The following steps from the bottom to the top of the therapeutic pyramid were examined: (1) 5-aminosalicylic acid and/or rectal corticosteroids, (2) systemic corticosteroids, (3) immunomodulators (IM) (azathioprine, 6-mercaptopurine, methotrexate), (4) TNF antagonists, (5) calcineurin inhibitors, and (6) colectomy. RESULTS Data on 996 patients with UC with a median disease duration of 9 years were examined. The point estimates of cumulative use of different treatments at years 1, 5, 10, and 20 after UC diagnosis were 91%, 96%, 96%, and 97%, respectively, for 5-ASA and/or rectal corticosteroids, 63%, 69%, 72%, and 79%, respectively, for systemic corticosteroids, 43%, 57%, 59%, and 64%, respectively, for IM, 15%, 28%, and 35% (up to year 10 only), respectively, for TNF antagonists, 5%, 9%, 11%, and 12%, respectively, for calcineurin inhibitors, 1%, 5%, 9%, and 18%, respectively, for colectomy. The presence of extraintestinal manifestations and extended disease location (at least left-sided colitis) were identified as risk factors for step-up in therapy with systemic corticosteroids, IM, TNF antagonists, calcineurin inhibitors, and surgery. Cigarette smoking at diagnosis was protective against surgery. CONCLUSIONS The presence of extraintestinal manifestations, left-sided colitis, and extensive colitis/pancolitis at the time of diagnosis were associated with use of systemic corticosteroids, IM, TNF antagonists, calcineurin inhibitors, and colectomy during the disease course.

Impact of Sn/F Pre-Treatments on the Durability of Protective Coatings against Dentine Erosion/Abrasion.

For preventing erosive wear in dentine, coating with adhesives has been suggested as an alternative to fluoridation. However, clinical studies have revealed limited efficacy. As there is first evidence that Sn(2+) increases bond strength of the adhesive Clearfil SE (Kuraray), the aim of the present study was to investigate whether pre-treatment with different Sn(2+)/F(-) solutions improves the durability of Clearfil SE coatings. Dentine samples (eight groups, n=16/group) were freed of smear layer (0.5% citric acid, 10 s), treated (15 s) either with no solution (control), aminefluoride (AmF, 500 ppm F(-), pH 4.5), SnCl2 (800/1600 ppm Sn(2+); pH 1.5), SnCl2/AmF (500 ppm F(-), 800 ppm Sn(2+), pH 1.5/3.0/4.5), or Elmex Erosion Protection Rinse (EP, 500 ppm F-, 800 ppm Sn(2+), pH 4.5; GABA International), then rinsed with water (15 s) and individually covered with Clearfil SE. Subsequently the specimens were subjected to an erosion/abrasion protocol consisting of 1320 cycles of immersion in 0.5% citric acid (5 °C/55 °C; 2 min) and automated brushing (15 s, 200 g, NaF-toothpaste, RDA 80). As the coatings proved stable up to 1320 cycles, 60 modified cycles (brushing time 30 min/cycle) were added. Wear was measured profilometrically. After SnCl2/AmF, pH 4.5 or EP pre-treatment all except one coating survived. In the other groups, almost all coatings were lost and there was no significant difference to the control group. Pre-treatment with a Sn(2+)/F(-) solution at pH 4.5 seems able to improve the durability of adhesive coatings, rendering these an attractive option in preventing erosive wear in dentine.

Evaluation of different types of enamel conditioning before application of a fissure sealant

The aim of the study was to compare fissure sealant quality after mechanical conditioning of erbium-doped yttrium aluminium garnet (Er:YAG) laser or air abrasion prior to chemical conditioning of phosphoric acid etching or of a self-etch adhesive. Twenty-five permanent molars were initially divided into three groups: control group (n = 5), phosphoric acid etching; test group 1 (n = 10), air abrasion; and test group 2, (n = 10) Er:YAG laser. After mechanical conditioning, the test group teeth were sectioned buccolingually and the occlusal surface of one half tooth (equal to one sample) was acid etched, while a self-etch adhesive was applied on the other half. The fissure system of each sample was sealed, thermo-cycled and immersed in 5% methylene dye for 24 h. Each sample was sectioned buccolingually, and one slice was analysed microscopically. Using specialized software microleakage, unfilled margin, sealant failure and unfilled area proportions were calculated. A nonparametric ANOVA model was applied to compare the Er:YAG treatment with that of air abrasion and the self-etch adhesive with phosphoric acid (α = 0.05). Test groups were compared to the control group using Wilcoxon rank sum tests (α = 0.05). The control group displayed significantly lower microleakage but higher unfilled area proportions than the Er:YAG laser + self-etch adhesive group and displayed significantly higher unfilled margin and unfilled area proportions than the air-abrasion + self-etch adhesive group. There was no statistically significant difference in the quality of sealants applied in fissures treated with either Er:YAG laser or air abrasion prior to phosphoric acid etching, nor in the quality of sealants applied in fissures treated with either self-etch adhesive or phosphoric acid following Er:YAG or air-abrasion treatment.