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Background: Increased daytime sleepiness is a frequently reported symptom in patients with pronounced dysgnathia. Objectives: This study investigated possible correlations using home peripheral arterial tonometry (PAT) and oropharyngeal airway volume determination in patients with dysgnathia and daytime sleepiness. Methods: Twenty patients (13 male, median age 27.6 ± 6.8 years) with abnormal sleep history and 10 skeletal neutral configured controls (6 male, median age 29.5 ± 4.2 years) with normal sleep history were examined. Patients and controls were evaluated for apnoea–hypopnoea index (AHI), respiratory disturbance index (RDI), oxygen desaturation index (ODI), snoring volume (dB), total sleep time (TST) and REM‐percentage (REM). Airway volumetry was measured via CBCT. Individual user experience for PAT was assessed using the User Experience Questionnaire (UEQ). Results: Patients had significantly higher respiratory scores than controls. AHI increased 4.6‐fold (p =.006), RDI 2.5‐fold (p =.008) and ODI 6.4‐fold (p <.001). Oropharyngeal volumes showed a 30% decrease (p =.003). dB, TST and REM showed no significant differences. AHI (r = −.51; p =.005), ODI (r = −.60; p <.001) and RDI (r = −.45; p =.016) correlated negatively with pharyngeal volume. Wits appraisal correlated negatively with oropharyngeal volume (r = −.47; p =.010) and positively with AHI (r =.41; p =.03) and ODI (r =.49; p =.007). dB and TST (r = −.49; p =.008) and REM and RDI (r = −.43; p =.02) correlated negatively. UEQ‐KPI (2.17 ± 0.24) confirmed excellent usability of PAT. Conclusion: Patients with mandibular retrognathia and abnormal sleep history showed significantly higher respiratory indices and smaller oropharyngeal volumes than neutrally configured controls. The dygnathia severity directly influenced the risk of obstructive sleep apnoea. [ABSTRACT FROM AUTHOR]

Objective: The treatment of orthodontic patients who survive head and neck tumors is challenging because of dentoskeletal deformities and other unexpected dental and facial complications. This case report describes the case of a 26‐year‐old woman who presented with mandibular retrognathia after survival from osteosarcoma. Clinical considerations: Camouflage orthodontic treatment was chosen instead of combined orthodontic‐orthognathic surgery after primary reconstructive surgery with an iliac bone graft. Genioplasty distraction osteogenesis (DO) was performed to achieve an optimal facial profile. Although unexpected condyle dislocation and epithelial hyperplasia occurred during treatment, a favorable facial profile and optimal skeletal and dental relationships were accomplished after 32 months of treatment. Conclusions: The patient underwent genioplasty DO and experienced unexpected left condyle dislocation. However, the treatment achieved esthetic goals after intermaxillary elastics were applied. [ABSTRACT FROM AUTHOR]

Skeletal malocclusions are common phenotypes in humans and have a strong influence on genetic factors. Transforming growth factor beta (TGFβ) controls numerous functions of the human body, including cell proliferation, differentiation, and migration. Thus, this study is aimed at evaluating whether genetic polymorphisms in TGFB1 and its receptor TGFBR2 are associated with mandibular retrognathism in German children and adolescents. Children and teenagers older than 8 years in the mixed or permanent dentition were included in this study. Patients with syndromes and facial trauma and patients with congenital alterations were excluded. Digital cephalometric tracings were performed using the anatomical landmarks point A, point B, sella (S), and nasion (N). Patients that have a retrognathic mandible (SNB < 78 °) were selected as case group, and the patients with an orthognathic mandible (SNB = 78 °– 82°) were selected as the control group. Genomic deoxyribonucleic acid (DNA) from saliva was used to evaluate four genetic polymorphisms in TGFB1 (rs1800469 and rs4803455) and TGBR2 (rs3087465 and rs764522) using real-time PCR. Chi-square or Fisher exact tests were used to compare gender, genotype, and allele distribution among groups. Genotype distribution was calculated in an additive and recessive model. Haplotype analysis was also performed. The established alpha of this study was 5%. A total of 146 patients (age ranging from 8 to 18 years) were included in this epidemiological genetic study. The genetic polymorphism rs3087465 in TGFBR2 was associated with mandibular retrognathism. Carrying the AA genotype in the rs3087465 polymorphism decreased the chance of having mandibular retrognathism (odds ratio = 0.25 , confidence interval 95 % = 0.06 to 0.94, p = 0.045). None of the haplotypes was associated with mandibular retrognathism (p > 0.05). In conclusion, we found that the genetic polymorphism rs3087465 in the promoter region of the TGFBR2 was associated with mandibular retrognathism in Germans. [ABSTRACT FROM AUTHOR]

Background: Refractory jaw osteonecrosis that occurs in osteoporotic or cancer patients treated with bisphosphonates is called medication-related osteonecrosis of the jaw but its underlying mechanism is unclear. Statins, therapeutic agents for dyslipidemia, lower blood low-density lipoprotein cholesterol. Fluvastatin promotes the healing of tooth extraction sockets and reduces the risk of developing medication-related osteonecrosis of the jaw-like lesions. We used a rat model to investigate whether injecting fluvastatin at extraction sites promoted the healing of medication-related osteonecrosis of the jaw-like lesions.Methods: Upper first molars of rats administered zoledronate and dexamethasone for 2 weeks were extracted. Two weeks after tooth extraction, rats with medication-related osteonecrosis of the jaw-like lesions (bone exposure) were included in this study. A single injection of fluvastatin was administered in the vicinity of the medication-related osteonecrosis of the jaw-like onset site in rats.Results: The distance between the edges of the epithelia, the length of the necrotic bone exposed toward the oral cavity, the area of the necrotic bone, and the necrotic bone ratio were significantly smaller in the fluvastatin-administered group compared with the saline group. A single application of fluvastatin near the site of medication-related osteonecrosis of the jaw onset showed a tendency to close the epithelium, reduce necrotic bone, and form new bone, even when symptoms had already developed.Conclusion: This study suggests that a single topical administration of fluvastatin may be a novel treatment for medication-related osteonecrosis of the jaw. [ABSTRACT FROM AUTHOR]

Background: Pierre Robin sequence (PRS) is a rare congenital anomaly. Respiratory disorders and feeding difficulties represent the main burden. Objective: The aim of this study was to investigate the epidemiology of PRS using a cohort of cases from EUROCAT, the European network of population‐based registries of congenital anomalies. Methods: We analysed cases of PRS born in the period 1998‐2017 collected by 29 population‐based congenital anomaly registries in 17 different countries. We calculated prevalence estimates, prenatal detection rate, survival up to 1 week, and proportions of associated anomalies. The effect of maternal age was tested using a Poisson regression model. Results: Out of 11 669 155 surveyed births, a total of 1294 cases of PRS were identified. The estimate of the overall prevalence was 12.0 per 100 000 births (95% CI 9.9, 14.5). There was a total of 882 (68.2%) isolated cases, and the prevalence was 7.8 per 100 000 births (95% CI 6.7, 9.2). A total of 250 cases (19.3%) were associated with other structural congenital anomalies, 77 cases (6.0%) were associated with chromosomal anomalies and 77 (6.0%) with genetic syndromes. The prenatal detection rate in isolated cases was 12.0% (95% CI 9.8, 14.5) and increased to 16.0% (95% CI 12.7, 19.7) in the sub‐period 2008‐2017. The prevalence rate ratio of non‐chromosomal cases with maternal age ≥35 was higher than in cases with maternal age <25 for total (PRR 1.26, 95% CI 1.05, 1.51) and isolated cases (PRR 1.33, 95% CI 1.00, 1.64). Survival of chromosomal cases (94.2%) and multiple anomaly cases (95.3%) were lower than survival of isolated cases (99.4%). Conclusions: This epidemiological study using a large series of cases of PRS provides insights into the epidemiological profile of PRS in Europe. We observed an association with higher maternal age, but further investigations are needed to test potential risk factors for PRS. [ABSTRACT FROM AUTHOR]

Background: Passive mandibular advancement with functional appliances is commonly used to treat juvenile patients with mandibular retrognathism. Objective: The aim of this study was to investigate whether active repetitive training of the mandible into an anterior position would result in a shift of the habitual mandibular position (HMP). Methods: Twenty adult healthy subjects were randomly assigned to one of two groups: a training group receiving six supervised functional training sessions of 10 min each and a control group without training. Bonded lateral biteplates disengaged occlusion among both groups throughout the 15‐day experiment. Customised registration‐training appliances consisted of a maxillary component with an anterior plane and a mandibular component with an attached metal sphere. Training sessions consisted of repeated mouth‐opening/closing cycles (frequency: 30/min) to hit an anteriorly positioned hemispherical target notch with this metal sphere. The HMP was registered at defined times during the experiment. Results: The HMP in the training group showed a statistically significant anterior shift of 1.6 mm (interquartile range [IQR]: 1.2 mm), compared with a significant posterior shift of −0.8 mm (IQR: 2.8 mm) in the control group (p <.05). Although the anterior shift among the training group showed a partial relapse 4 days after the first training block, it then advanced slightly in the 4‐day interval after the second training block, which might indicate neuroplasticity of the masticatory motor system. Conclusions: Motor learning by repetitive training of the mandible into an anterior position might help to improve the results of functional appliance therapy among patients with mandibular retrognathism. [ABSTRACT FROM AUTHOR]

Background: Temporomandibular disorders (TMDs) are multifactorial, and high levels of stress seem to increase symptoms. The association with exposure to violence has not been explored in adolescent populations. Objective: To examine the association of self‐reported symptoms of temporomandibular pain and jaw dysfunction with child physical abuse, intimate partner violence, forced sexual intercourse, and bullying victimisation. Methods: An epidemiological, cross‐sectional, school‐based study was conducted in Olinda, northeast Brazil. The sample comprised 2,431 adolescents aged 14–19 years. TMD‐related symptoms and exposure to violence were assessed with questions from the 3Q/TMD screener and queries on exposure to different forms of violence. Multilevel logistic regressions were conducted to evaluate how 3Q screen‐positive responses are associated with self‐reported exposure to violence. Results: Self‐reported TMD‐related symptoms had a prevalence of 40.5%. Significantly more females than males screened positive to all 3Q/TMD questions (p <.001). Adolescents experiencing intimate partner violence (p =.012) and bullying (p <.001) had significantly higher odds of 3Q positive responses than those who reported no exposure to violence. Significant associations of TMD‐related symptoms with forced sexual intercourse (p =.014) and with bullying (p =.007) were observed. Conclusion: Adolescents with self‐reported symptoms of temporomandibular pain and jaw dysfunction were significantly more often exposed to some type of violence. The number of adolescents reporting TMD‐related symptoms increased in a dose‐response manner with the number of violence forms the individual had experienced. [ABSTRACT FROM AUTHOR]

Background: Plasma cell neoplasms are characterized by the proliferation of a single clone of plasma cells with production of a monoclonal immunoglobulin. They can manifest as a single lesion (plasmacytoma) or as multiple lesions (multiple myeloma). Methods: Paraffin‐embedded tissue blocks of patients microscopically diagnosed with plasma cell neoplasms in the jaws were retrieved from five pathology files. Data including clinical, radiographic, microscopic and immunohistochemical findings, treatment employed and follow‐up status were retrieved from the pathology reports. Results: Fifty‐two cases were retrieved (mean age: 59.4 years) without sex predilection. The mandible was the most affected site (67.3%), usually associated with pain and/or paresthesia (53.8%). Lesions in other bones besides the jaws were reported for 24 patients (46.2%). Radiographically, tumours usually presented as poorly defined osteolytic lesions with unilocular or multilocular images, while microscopy revealed diffuse proliferation of neoplastic plasma cells with nuclear displacement and abundant eosinophilic cytoplasm. Two cases were classified as anaplastic, and amyloid deposits were found in two other cases. Immunohistochemistry was positive for plasma cell markers and negative for CD20 and CD3, and monoclonality for kappa light chain predominated. The overall survival rate after 5 years of follow‐up was 26.6%. Conclusion: Plasma cell neoplasms are aggressive tumours with a poor prognosis and involvement of the jaws may be the first complaint of the patient. Thus, oral pathologists, head and neck surgeons and dentists should be aware of their clinical, radiographic and microscopic manifestations. [ABSTRACT FROM AUTHOR]

Background: Little is known regarding the functional properties of single motor units (SMUs) in the medial pterygoid muscle (MPt) during jaw movements. Objectives: The aims are (a) to report the thresholds of onset of MPt SMUs during 4 goal‐directed jaw movement tasks, and (b) to determine whether the threshold of onset of SMU activation varies with the velocity of jaw movement and the location within the muscle. Methods: Intra‐muscular electrodes were inserted in the right MPt of 18 participants performing ipsilateral (right), contralateral, protrusive and opening‐closing jaw movements recorded at 2 velocities. Task phases were as follows: BEFORE, OUT, HOLDING, RETURN and AFTER. SMU onset thresholds were determined from the displacement (mm) of the lower mid‐incisor point. Electrode location within 4 arbitrary muscle divisions was determined with computer tomography. Statistical tests: Spearman's correlations, Kruskal‐Wallis tests; significance accepted at P <.05. Results: A significant inverse relation occurred between velocity and threshold for the RETURN of the ipsilateral movement (n = 62 SMU thresholds), while a significant positive relation occurred for the OUT of the contralateral movement (n = 208); there were no significant associations for the protrusive (n = 131) and opening‐closing (n = 58) tasks. Significant threshold differences occurred across the 4 muscle divisions only during the OUT of the contralateral and protrusive movements. Some evidence was provided for gender differences in MPt SMU properties. Conclusions: The absence of a significant inverse relation between velocity and SMU threshold for most recorded movements suggests the MPt acts as a stabilizer of the jaw in horizontal and opening‐closing jaw movements. [ABSTRACT FROM AUTHOR]

Purpose. To investigate the association of ptosis, levator, and jaw winking in Marcus Gunn jaw-winking synkinesis (MGJWS), and the risk factor of preservation and outcomes of the unilateral levator excision and frontalis suspension. Methods. Clinical features of MGJWS case series from 2011 to 2018 were retrospectively reviewed. Association between jaw winking and ptosis/levator function was statistically analyzed. The patients underwent unilateral levator excision and frontalis suspension using silicone rod or autogenous fascia lata. Clinical outcomes were evaluated in operated patients and the independent risk factors of residual jaw winking were investigated after a long follow-up. Results. There were 42 MGJWS patients in 2011 to 2018, accounting for 2.87% of all congenital blepharoptosis. 80% of mild jaw winking was accompanied with mild ptosis and fair levator function, and moderate-to-severe jaw winking was often accompanied with moderate-to-severe ptosis and poor levator function (P<0.05). Ptosis showed a strong association with excursion of jaw winking (R = 0.785, P<0.01). Jaw winking was resolved in all 34 operated patients with good correction of ptosis. Severity of jaw winking is an independent risk factor for the residual synkinesis after surgery. Severe preoperative jaw winking had an 18.05 times increased risk of postoperative residual synkinesis compared with moderate jaw winking (P<0.05). Conclusions. In MGJWS eyelid excursion of jaw winking has a direct correlation with ptosis and dysfunction of levator muscle. Unilateral levator aponeurosis excision and frontalis suspension is an efficient approach for MGJWS. Severe jaw winking is a risk factor of residual eyelid synkinesis after surgery. [ABSTRACT FROM AUTHOR]

To evaluate the prevalence of temporomandibular disorder pain (TMD‐pain), temporomandibular joint (TMJ) noises, oral behaviours in an Italian adult population sample, their possible association with gender, oral behaviours, self‐reported facial trauma and orthodontic treatment. Subjects older than 18 years were recruited from general population in public spaces during their daily life. A specific questionnaire was developed to collect data on TMD‐pain, TMJ noises, oral behaviours, orthodontic treatment and facial trauma. A total of 4299 subjects were included in the study. The most common symptom in the sample was TMJ clicking (30.7%), followed by TMD‐pain (16.3%) and TMJ crepitus (10.3%). Oral behaviours were reported in 29% of the sample; 43.6% of the sample reported a previous or ongoing orthodontic treatment. TMD‐pain and TMJ clicking were significantly associated to gender, oral behaviours and a positive history of previous facial trauma. Crepitus was significantly associated to oral behaviours, facial trauma and higher age. Ongoing orthodontic treatment was significantly associated to TMD‐pain and TMJ sounds. In a general Italian adult population sample, TMD‐pain is associated to female gender and is less prevalent than TMJ clicking. TMDs are associated to trauma and oral behaviours. [ABSTRACT FROM AUTHOR]

Objective: The present study compared the changes in the upper airway dimensions and sleep-related breathing disorder (SRBD) condition between functional treatment with the headgear Herbst (HG-Herbst) and headgear Twin Block (HG-TB) appliance. Soft tissues were assessed on lateral cephalometric X-ray and magnetic resonance imaging (MRI).Materials and Methods: Consecutive patients who sought orthodontic treatment at the Faculty of Dentistry of The University of Hong Kong were screened. Adolescents (12-17 year sold for boys and 10-15 years old for girls), with class II molar relationship and overjet >5 mm, with no severe transverse maxillary deficiency, were recruited. Patients were assigned either to the HG-Herbst or to the HG-TB treatment by stratified block randomisation, with sex as the stratification factor. Lateral cephalograms, magnetic resonance imaging (MRI), and the Paediatric Sleep Questionnaire (PSQ) were obtained at baseline and after treatment.Results: 28 patients were enrolled, and 26 patients (13 in each group) completed the treatment. Following 1 year of functional appliance treatment, a significantly lower increase of the lower anterior facial height was observed in the HG-Herbst group compared to the HG-TB group (p = 0.024). However, no significant differences were observed in the upper airway structures or SRBD between the two groups.Conclusion: The changes in upper airway dimensions and SRBD condition were not significantly different between the HG-Herbst and the HG-TB appliance treatment. Additional studies with larger sample size are warranted. [ABSTRACT FROM AUTHOR]

Summary: Background: Oromandibular dystonia (OMD) with involuntary jaw and tongue movements may be misdiagnosed as temporomandibular disorders (TMD) and because of the complex muscle activity and involvement of several small muscles, OMD is also considered difficult to treat. Objectives: The aim was to evaluate OMD in patients 8‐10 years after start of treatment with botulinum toxin (BoNT) by self‐reported and standardised global scales and questionnaires. Methods: Of 21 previously reported patients with OMD, 14 responded to a mail health questionnaire to describe the disease course and treatment effect as well as the overall impact of OMD by a visual analogue scale (VAS), the Patient Health Questionnaire (PHQ) for depression and anxiety, and the Jaw Functional Limitation Scale (JFLS). The results were analysed with non‐parametric statistical analysis (Wilcoxon matched‐pairs test and Spearman's rank‐order correlations). Results: The OMD was still present in 13 patients. In nine patients, the BoNT treatment had continued as monotherapy or combined with oral medication. VAS for OMD was significantly reduced (P < 0.04) over the years, and most patients felt improvement from the treatment. However, the patients had still some functional limitations, typically regarding jaw mobility and communication, and both JFLS and mental distress (PHQ) were significantly correlated with the OMD VAS (rS 0.77 and 0.74). Conclusion: The results showed marked reduction of the experienced OMD with treatment and over time, and also stressed similarities between OMD and TMD. Both dentists and neurologists should be aware of this overlap and reduce misdiagnosis by applying an interdisciplinary approach. [ABSTRACT FROM AUTHOR]

Summary: Temporomandibular disorder (TMD) is an umbrella condition presenting several signs and symptoms including pain in the temporomandibular joint (TMJ) and masticatory muscles, articular noises, earache, headache, irregular or restricted jaw function, chewing difficulty, and limited mouth opening. Such TMD impairment may cause disorders during the chewing process. Therefore, the purpose of this systematic review was to assess chewing dysfunctions measured by sEMG, and their association with TMD. A combination and variation in the descriptors “temporomandibular joint disorders”, “masticatory dysfunctions”, and electromyography were used to perform the searches across databases. The databases chosen were: LILACS, PubMed, Science Direct, Scopus, and Web of Science. Additionally, grey literature was assessed using Google Scholar, ProQuest, and OpenGrey. Studies in adults that diagnosed TMD through the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) or Helkimo Protocol were selected. Furthermore, those studies should have evaluated chewing processes through surface electromyography (sEMG). Risk of bias of the included studies was assessed through the Meta‐Analysis of Statistics Assessment and Review Instrument (MAStARI) tool. Eleven included studies shown significant results; however, they evaluated discrepant parameters, presented high inconsistency in the application, and had chosen different tasks to analyse the sEMG and hence, there was no consensus in the results of studies. In conclusion, strength of recommendations was very low due to a series of limitations on studies and it was not possible to made categorical statement about association between TMD and chewing dysfunctions in adults when parameters of sEMG were analysed. [ABSTRACT FROM AUTHOR]

Abstract: An accurate assessment of the biting shark size is paramount for better understanding the agonistic behavior of a species toward humans. The gray reef shark is involved in many accidental bites. Based on the capture of 35 gray sharks, we calculated the algorithm that allows the assessment of the shark size, through the interdental distance (IDD) inferred from teeth marks on human wounds. Our results show a negative allometric relationship and that IDD calculated from imprints perpetrated by the upper jaw are globally similar with those from the lower jaw, in spite of heterodonty. We applied our findings to two cases of accidental bites by this species. Both of the victims had declared that the shark length was “at least 2 m”. Based on our algorithm, the assessment of the shark TL was approx. 180 and 160 cm, respectively, which correspond to an overestimation of ≥20% by the victims. [ABSTRACT FROM AUTHOR]

Abstract: Dynamic jaw delivery on the TomoTherapy H‐series platform, entitled TomoEDGE™, is an effective tool to decrease the patient dose along the superior and inferior edges of the treatment target. The aperture of the TomoTherapy jaws, that is, field width (FW), defines the longitudinal dose profile. A consistent FW dose profile is an important quantity for accurate and reproducible dose delivery in TomoTherapy. To date, no evaluation has been made of the accuracy and precision of the dose profiles produced by dynamic jaws. This study aims to provide a long‐term evaluation of the dynamic jaw FW dose profiles obtained on TomoTherapy utilizing the TomoTherapy Quality Assurance procedure (TQA). A total of 840 dose profiles were measured during 84 TQA procedures, performed over a 2‐yr period. The full width at half maximum (FWHM) and constancy of the FW dose profile measurements were analyzed and compared with the tolerances proposed by AAPM Task Group 148 (TG‐148) and those used by the manufacturer. The FWHM evaluation showed that the FWs > 2.0 cm respect the TG‐148 tolerance of 1%, while the asymmetric FWs ≤ 2.0 cm were outside the limit in 17.3% of measurements. Constancy results evaluated along the full profiles showed that 95.2% of measurements were within 3% of the baseline for symmetric FWs and 94.8% of measurements were within 4% of the baseline for asymmetric FWs. In conclusion, the analysis confirms the accuracy and precision of TomoEDGE™ technology in jaw positioning. This study has identified the potential to establish an appropriate QA tolerance for the asymmetric FWs used in dynamic jaw movement. Finally, the clinical significance of the observed discrepancies should be studied further to understand the dosimetric effect on patient treatments. [ABSTRACT FROM AUTHOR]

Introduction. Patients with chronic liver failure (CLF) are faced with many complications, because this organ is involved in various metabolic activities. Hepatic osteodystrophy is one of the major health issues encountered by this group of patients. The current study evaluated osteoporosis and bone changes in oral panoramic radiographies of cirrhotic patients. Materials and Methods. In this study, 138 panoramic views of CLF patients, candidates for liver transplant (65 females, 73 males, aged 19-68 years) referred to Shiraz University Dental Clinic (Shiraz, Iran) for pretransplant oral examination, were evaluated. Also 138 healthy individuals (69 females, 69 males, aged 18-70 years) referred to the same clinic were examined. Abnormalities such as osteoporosis, pathologic radiolucencies, pathologic calcifications, tonsilloliths, condylar degeneration, and other findings in the alveolar bones were recorded. Results. Osteoporosis was a common finding in CLF patients (p<0.001), and the probability of detecting low bone density in the panoramic view was 20.37 times higher among patients than healthy subjects. The probability of detecting pathologic jaw radiolucencies was 8.92 times higher in the case group than in the controls (p<0.001). Other bone abnormalities such as condylar degeneration and idiopathic osteosclerosis were also more prevalent in CLF patients compared to healthy subjects (p<0.001). Conclusion. Cirrhotic patients are prone to osteoporosis of the alveolar bones. Also, pathologic jaw radiolucencies as a result of oral infections are more prevalent in this group of patients. Routine oral panoramic views are acceptable and cost-effective radiographies for use in detecting such abnormalities in the alveolar bones as well as overall dental health. These findings also support the importance of dental health examinations prior to liver transplantation to reduce the risk of organ rejection. [ABSTRACT FROM AUTHOR]

Objective. The objective of this study is to evaluate the effect of simvastatin on the jaw bone microstructural defect and autophagy in rats with high cholesterol diet (HCD). Methods. Male Sprague-Dawley rats were fed a standard rodent chow (NC group) or a high cholesterol diet for 32 weeks and the HCD-fed rats were treated with vehicle (HC group) or simvastatin (5 mg/kg orally daily for 8 weeks, HC + SIM group, and n=10/group). The static histomorphometric changes in the jaw bone tissues in individual rats were evaluated. The relative levels of OPG, RANKL, NF-κB, LC3, and p62 in the jaw bone tissues were determined by quantitative RT-PCR and/or immunohistochemistry. Results. Compared with the NC group, the HC groups had lower trabecular bone volume, trabecular thickness and trabecular number, and increased ratios of RANKL/OPG in the jaw bone, accompanied by enhanced NF-κB activation and autophagy. Simvastatin treatment inhabited these changes, including the decreased levels of serum proinflammatory cytokines and increased autophagy. Conclusion. Simvastatin treatment could inhibit the hyperlipidemia-induced jaw bone microstructural defect in rats by increasing autophagic flux. [ABSTRACT FROM AUTHOR]

Objective: To present a case of early diagnosis mandibular Paget's disease of bone (PDB), recognised by a general dentist.Background: PDB is responsible of rapid bone resorption and disorganised bone formation.Materials and Methods: The patient was a 72-year-old female patient complaining of dental malposition and blatant prognathism.Conclusion: Clinicians should consider PDB in differential diagnosis for an elderly patient undergoing unexplained alteration in face profile and occlusion. [ABSTRACT FROM AUTHOR]

Objective: To estimate the association between sickle cell anaemia and trait with dental and jaw bone abnormalities. Subjects and Methods: Subjects (n = 369) were allocated to three groups: sickle cell anaemia, trait and control. Dental shape, number, size and position and changes in pulp chamber, root and periapex were analysed by intra‐oral periapical radiographs. Integrity of lamina dura, quality of cancellous bone and bone trabeculation were also evaluated. Prevalence ratios (PR) were calculated (α = 0.05). Results: Sickle cell anaemia had higher prevalence (PR:8.31) and number of teeth (PR:13.40) with external resorption; higher number of teeth with pulp calcification; partial and total loss of lamina dura; and higher prevalence of changes in trabecular structure of maxilla (PR:6.45) and mandible (PR:5.34). Sickle cell trait showed higher prevalence (PR:1.26) and higher number of teeth (PR:1.98) with partial loss of lamina dura; higher number of teeth with hypercementosis, changes in shape, size, periapex, total loss of lamina dura; and higher prevalence of changes in mandibular trabecular bone (PR:1.43). Conclusion: Pulp calcification and external resorption of the root were the most frequent dental alterations in sickle cell anaemia group, while in trait was higher frequency of changes in shape, size, periapex and root. Jaw bone changes were most prevalent in both homozygous and heterozygous subjects. [ABSTRACT FROM AUTHOR]

Objectives: Plain radiography has been widely used in dentistry. Because of the variability of the quality of equipment, radiographic technique, accuracy of interpretation, and radiation risk to the patients, the field is ripe for the introduction of other newer diagnostic modalities. In this report, we demonstrate the utility of ultrasonography in the diagnostic workup of cystic or cystlike lesions of the jaw. Methods: We used a transfacial ultrasonographic scanning approach to examine 32 patients with clinical or radiographic presentation of a jaw cyst. Computed tomography and histopathologic analysis were used as the reference standards to confirm the findings. Results: Ultrasonography could establish the presence or absence of a lesion, erosion of the buccal cortical plate, and identification of associated soft tissue involvement in all cases (sensitivity and specificity, 100% and 100%, respectively; area under the receiver operating characteristic curve, 1.0; P < .001). Conclusions: Our observations revealed the usefulness of ultrasonography and demonstrated its potential value when introduced as a routine office‐based imaging method for dentistry. [ABSTRACT FROM AUTHOR]

Objectives: To estimate maximum jaw-opening forces in healthy participants of diverse ancestry and to estimate whether opening forces are associated with sex, age and anthropometric parameters such as height, weight and BMI.Setting and Sample Population: One hundred and forty-nine participants aged 20-60 years with overall good oral and general health. Exclusion criteria included myofascial or neck pain, symptomatic temporomandibular joint disorders (TMD), current orthodontic treatment or the absence of a natural dentition.Material and Methods: Jaw-opening forces were measured with an adjustable rigid extra-oral device connected to a 1000 N load cell. Seven attempts were recorded, with 10 seconds interval. Median force values were obtained after discarding the first and last attempt. The height and weight of each participant were measured and recorded, alongside age, sex and ethnicity.Results: Men had greater maximum opening force median values than women (P < .001). Median (IQR) values for women were 41.16 N (30.44) and 79.00 N for men (63.86). Jaw-opening force values were poorly associated with biological and anthropometric parameters.Conclusion: In this study, which included a large sample of participants of broad age range and from a demographically diverse background, jaw-opening force values were greater in males than in females; however, force values were poorly associated with biological and anthropometric parameters. Future studies should explore the potential of this method as a screening tool for TMJ disorders and other conditions. [ABSTRACT FROM AUTHOR]

Objective: This study evaluated the relationship between follow-up temporomandibular joint positional change and mandibular stability among patients who had orthognathic and orthodontic treatment for a skeletal Class II malocclusion.Methods: Thirty-seven patients who underwent 2-jaw surgery (Le Fort I osteotomy, bilateral sagittal split ramus osteotomy and genioplasty with rigid internal fixation) were included with an average follow-up length of 8.10 ± 2.06 years. They were categorized into a stable and unstable group according to follow-up mandibular change in the sagittal direction. Temporomandibular joint spaces were measured on serial magnetic resonance images, prior to orthodontic treatment (T0), upon completion of orthodontic treatment following surgery (T1), and at least 5 years post-completion of the treatment (T2).Results: While the maxillary position was stable during the follow-up period, the mandibular positional change was statistically significant (the relapse amount was -0.81 ± 1.52 mm at B point). An increase in the anterior joint space and superior joint space was found to correlate with the follow-up mandibular backward movement.Conclusions: Patients who underwent orthognathic and orthodontic treatment to correct mandibular retrognathism displayed follow-up mandibular relapse in the sagittal direction. The relapse is accompanied by condylar positional change. [ABSTRACT FROM AUTHOR]

Objective To describe the clinical and genetic features of patients with cherubism. Material and Methods A descriptive analysis of 14 cases from nine different families was carried out. Clinicopathological, imaging, and follow-up data were retrieved from patients' medical files and correlated with the genetic profile of each patient. Genomic DNA isolated from buccal mucosa cells was subjected to direct sequencing analysis of the SH3 BP2 gene. Results Females were more affected than males (8:6), and the mean age at diagnosis was 8.6 years (range 3-30 years). Eleven patients exhibited simultaneous bilateral involvement of the maxilla and mandible. Two patients did not have a familial history of cherubism. Progressive growth pattern was found in six patients and stable lesions were observed in other seven patients, whereas in one patient, complete spontaneous remission was documented during the follow-up (31 years). Mutations were found in 13 cases and included the typical heterozygous missense mutations R415Q, P418T, and P418H at exon 9 of SH3 BP2. No correlation between the mutations and the clinical manifestations was observed. Conclusion Three different point mutations in the SH3 BP2 gene were detected with variable clinical involvement. Genotype-phenotype association studies in larger population with cherubism are necessary to provide important knowledge about molecular mechanisms related to the disease. [ABSTRACT FROM AUTHOR]

A central problem facing worldwide culture of yellowtail kingfish ( Seriola lalandi) is the presence of skeletal malformations, including jaw deformities. This study presents a morphological characterization of normal and abnormal cartilage jaw structures during early larval development. Samples of 70-150 larvae were collected from three cohorts from 2 to 9 days post hatching, anaesthetized and fixed for cartilage staining. Cartilaginous components were defined clearly at four days post hatch (dph) (4.65 ± 0.05 mm total length), and abnormal jaw structures were detectable at this time. Jaw deformities observed included extension of Meckel's cartilage with or without ventral bending of the anterior tip, displacement of ceratohyal and hypohyal cartilage ventrally and below Meckel's cartilage, and shortening and dorsal flexion of the lower jaw. At 4 dph, between 44% and 47% of all larvae examined had jaw abnormalities. The contribution of each deformity to the total number of deformities was variable among the three cohorts examined. To compare shape difference accurately we performed an exploratory, landmark-based geometric morphometric analysis using seven homologous landmarks. Larvae were classified into three jaw morphology groups. The geometric morphometric approach provides a useful tool to standardize classification of cartilage jaw abnormalities at early developmental larval stages. Early recognition of developing abnormalities is of importance for fish farmers in both improving fish selection efficiency and for evaluating effects of rearing parameters. [ABSTRACT FROM AUTHOR]

Temporomandibular disorder ( TMD) incidences are believed to be related to parafunctional behaviours like teeth clenching. This pilot study aimed to (i) develop an automated clench-detection algorithm, and (ii) apply the algorithm to test for differences in nocturnal clenching in women with and without TMD. Subjects gave informed consent to participate. Adult women were categorised using Diagnostic Criteria for TMD according to presence/absence (+/−) of both TM joint disc placement ( DD) and chronic pain (P) into two groups (+ DD+P, − DD−P) with 12 subjects each. Surface temporalis electromyography was recorded during oral tasks performed by subjects at two laboratory sessions. The data were used to characterise muscle activity per N of bite force ( μV/N) for each subject, develop the clench-detection algorithm and test its accuracy. Ambulatory surface temporalis electromyography was self-recorded by each subject over three nights and analysed using the algorithm and bite force (N) versus muscle activity μV/N calibrations. Bonferroni-adjusted homoscedastic t-tests assessed for significant between-group differences in clenching ( P < 0·05). Sensitivity, specificity and accuracy of algorithm-detected laboratory clenches were all ≥96%. During self-recordings 95% of clenches had durations of <4 s and peak forces of <10 N in both groups. Mean clench durations were significantly longer ( P = 0·042) in + DD+P (1·9 ± 0·8 s) than − DD−P subjects (1·4 ± 0·4 s). Mean temporalis duty factors (%clench time/total recording time) were significantly larger ( P = 0·041) in + DD+P (0·47 ± 0·34%) than − DD−P (0·26 ±0·22%) subjects. Nocturnal temporalis muscle activities detected by a validated algorithm were longer per clench and recording time in + DD+P compared to − DD−P women. [ABSTRACT FROM AUTHOR]

Objective. The aim of this study is to evaluate the factors that affect wearing time and patient behavior during reverse pull headgear therapy with a newly designed reverse pull headgear. Methods. In clinical practice, new reverse pull headgears were applied to fifteen patients. The patients were monitored during reverse pull headgear therapy and the data were evaluated. Statistical analysis was made. Results. During the study, patients were monitored successfully and the evaluations showed that patients wear the new reverse pull headgears mostly at night. There are differences between days of week and hours of day. Weekends are more popular than weekdays for wearing reverse pull headgear. Conclusions. This new type of reverse pull headgears can be used successfully in clinical practice and can help the clinician. Study showed that the most important factor that affects the cooperation of reverse pull headgear patient is aesthetic appearance. [ABSTRACT FROM AUTHOR]

The article examines the factors predicting difficult Endotracheal Intubation. It mentions that Endotracheal intubation is a common procedure in emergency medicine, and recognizing a potentially difficult intubation is imperative in planning for the procedure. It also mentions the consideration of airway adjuncts including video laryngoscopy, supraglottic airway devices, and cricothyrotomy.

Objectives: The observational study investigated whether women's perception of the facial profile is related to changes in sex hormones during the menstrual cycle and under the influence of personality traits.Setting and Sample Population: Participants were heterosexual Caucasian normally menstruating women not using oral contraceptives (N = 30, aged 20-44 years).Material and Methods: The profile attractiveness was assessed by grading of thirteen men's and women's Caucasian profile distortions by a visual analogue scale (0 = least to 100 = most attractive) in the non-ovulating phase and ovulating phase of the menstrual cycle. Male profiles were graded twice-in social and emotional contexts. Personality traits were assessed by Big Five Inventory.Results: The most attractive male profiles in both phases and contexts were a straight profile or mild lip retrusion. According to cluster analysis, non-ovulating females distinguish skeletal from dentoalveolar alterations; however, maxillary retrognathism was considered to be closer to an attractive profile, which were resulting from dentoalveolar manipulations only. Ovulating females, when considering emotional relationship, exhibit lowest preference for males with convex profiles and extreme concave profile, while they consider males with slightly prominent chins due to maxillary retrognathism, mandibular prognathism or pronounced lip retrusion closer to the most attractive males. No clear patterns of influence of personality traits were detected. Moderate lip protrusion was the most attractive female profile in ovulating and straight profile in non-ovulating phase.Conclusion: The favorable profiles, on average, are the same regardless of the female hormonal status and personality traits. [ABSTRACT FROM AUTHOR]

Cementoblastoma is a benign lesion of the odontogenic ectomesenchymal origin. It rarely occurs in primary dentition. This report describes a case of a cementoblastoma relating to the right mandibular second primary molar in a 7-year-old girl. Her panoramic radiograph revealed a well-defined radiopaque lesion with a radiolucent border extending from the distal surface of the mandibular right first primary molar to the distal surface of mandibular second primary molar. The tumor was attached to the mesial root of primary second molar and was excised along with the teeth involved and sent for histopathological evaluation, which showed irregular trabeculae of mineralized tissue interspersed with fibrovascular connective tissue, trabeculae of mineralized tissue with prominent reversal lines, and peripheral rimming of the mineralized tissue with blast cells. On a six-month follow-up, there has been no recurrence of the lesion. [ABSTRACT FROM AUTHOR]

Objective: To examine the frontal space (FS) distance in first-trimester fetuses with bilateral, unilateral or median cleft lip and palate and in those with retrognathia.Methods: This was a retrospective study using stored two-dimensional ultrasound images of fetal profiles that were recorded at the time of the nuchal translucency (NT) scan at three prenatal medical centers. Images of 300 normal fetuses and 53 fetuses with facial defects were obtained. To measure the FS distance, a line was drawn between the anterior edge of the mental protuberance of the mandible and anterior edge of the maxilla (MM line) and extended upwards in front of the forehead. The perpendicular distance (FS distance) between the MM line and the skin at the point of largest excursion of the fetal forehead was measured. In cases in which the MM line was located anteriorly to the forehead, the distance was measured in the same fashion but was multiplied by -1. Two operators measured the FS distance twice, independently of each other. FS distances were transformed into Z-scores based on the linear relationship with crown-rump length (CRL) in normal fetuses. The distribution of FS distances in fetuses with bilateral, unilateral or median cleft lip and palate and those with retrognathia were compared with that in the normal group using Student's t-test.Results: A search of the centers' databases identified 53 abnormal cases including 20, nine and eight with a bilateral, unilateral and median cleft lip and palate, respectively, and 16 cases of retrognathia. In fetuses with bilateral, unilateral and median clefts and those with retrognathia, median delta NT was 1.00 mm, 0.37 mm, 4.00 mm and 0.26 mm, respectively. Among these affected groups, 12 (60.0%), six (66.7%), two (25.0%) and eight (50.0%) fetuses had an abnormal karyotype. In the normal population, FS distance was dependent on CRL measurement (FS = 6.62 - (0.08 × CRL); r = -0.539; P < 0.0001). In fetuses with a bilateral and median cleft and in those with retrognathia, FS distance was significantly different from that in the normal population (all P < 0.0001), however, the difference was not significant in fetuses with unilateral clefts (P = 0.103). The respective Z-scores of FS distance for fetuses with bilateral, unilateral and median clefts and retrognathia were -9.7 ± 2.0, -3.1 ± 5.1, 8.2 ± 3.4 and -7.3 ± 2.3. Measurements were ≥ 99(th) and ≤ 1(st) centiles in all but one (98.1%) case.Conclusion: The FS distance appears to be a helpful tool in the detection of facial clefts at 11-13 weeks' gestation. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

The article discusses a study related to morphology and parentage association of shortened upper jaw deformity in hatchery-produced Japanese flounder. Topics include Japanese flounder, Paralichthys olivaceus as an important aquaculture fish species, collection of fish specimens from a commercial production lot produced in autumn of 2010 at Marua Suisan Co. Ltd., and no obvious infectious diseases or problems observed during juvenile production.

Tooth alterations of 281 rabbits from 10 different breeds were evaluated, starting at the age of three weeks until they were fully grown. All rabbits were kept in an outdoor facility, fed with a pelleted diet and had free access to water and hay. The most common finding in 3182 clinical examinations was a gap between the mandibular incisors (38 per cent). Skull X-rays from 4 adult breeding rabbits, 15 offspring with clinical signs of dental disease and 12 clinically healthy siblings were assessed by two different methods using cephalometric distances and anatomical reference lines. Repeatabilities of cephalometric distances were mostly low and no significant associations to tooth health were found. The anatomical reference lines revealed dental findings even in rabbits that were graded as tooth healthy in previous clinical examinations. On the basis of the demonstrated age-dependent development of tooth and jaw malformations a first examination and selection at the age of 12 weeks can be recommended. Also genetic aspects for tooth and jaw malformations were considered. The estimated heritability for brachygnathia superior was 0.254±0.169 for all examinations and 0.105±0.092 comprising the last examination of each rabbit when fully grown. [ABSTRACT FROM AUTHOR]

Triploid Atlantic salmon tend to develop a higher prevalence of skeletal anomalies. This tendency may be exacerbated by an inadequate rearing temperature. Early juvenile all-female diploid and triploid Atlantic salmon were screened for skeletal anomalies in consecutive experiments to include two size ranges: the first tested the effect of ploidy (0.2-8 g) and the second the effect of ploidy, temperature (14 °C and 18 °C) and their interaction (8-60 g). The first experiment showed that ploidy had no effect on skeletal anomaly prevalence. A high prevalence of opercular shortening was observed (average prevalence in both ploidies 85.8%) and short lower jaws were common (highest prevalence observed 11.3%). In the second experiment, ploidy, but not temperature, affected the prevalence of short lower jaw (diploids > triploids) and lower jaw deformity (triploids > diploids, highest prevalence observed 11.1% triploids and 2.7% diploids) with a trend indicating a possible developmental link between the two jaw anomalies in triploids. A radiological assessment ( n = 240 individuals) showed that at both temperatures triploids had a significantly ( P < 0.05) lower number of vertebrae and higher prevalence of deformed individuals. These findings (second experiment) suggest ploidy was more influential than temperature in this study. [ABSTRACT FROM AUTHOR]

Jaw malformations of hatchery reared golden pompano Trachinotus ovatus larvae were studied from 1 day post hatch ( DPH) to 31 DPH. The severity of jaw deformities was classified into three levels where '0' represents normal jaw; '1' is intermediate jaw malformation; and '2' is severe jaw malformation. The severe jaw malformations of golden pompano larvae were clearly observed on 3 DPH. Starting from 3 DPH, both intermediate and severe jaw malformations were observed and the total incidence of jaw malformations ranged from 9.6% to 46.6%. The highest severe jaw malformation occurred on 5 DPH, and 25% larvae exhibited serve jaw malformation. On 11 DPH, jaw malformations reached the peak with 46.6% fish exhibiting jaw malformations of either category 1 or 2. On 26 DPH, the percentage of intermediate jaw malformation reached the peak value (36.4%). This was the first study reporting jaw malformation of golden pompano larvae, and the result can be used as a reference point for future research on the control of jaw malformation in golden pompano. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study is to assess the utility of an intermediate ultrasound scan at 16(+0) to 18(+6)  weeks of gestation in euploid fetuses with increased nuchal translucency ≥ 3.5 mm.Methods: Three hundred eighty-nine fetuses with nuchal translucency (NT) ≥ 3.5 mm were identified in two prenatal centers between January 2008 and December 2012. Pregnancy work-up included karyotyping, monthly detailed ultrasound scan starting with a 16th-week scan, a cardioechography, and a genetic counseling. Abnormal findings and pregnancy outcomes were analyzed retrospectively.Results: Of the 389 fetuses included, 52% had normal karyotype. Among euploid fetuses, 51 (30.7%) structural defects were identified overall. First-trimester scan was useful to identify 16 of the major defects (31.3%), and the 16th-week scan was useful to identify an additional 21 of them (41.2%), whereas the 22nd-week pregnancy scan discovered an additional 14 (27.4%). Structural defects discovered with the 16th-week scan were cardiac defects (n = 7), polymalformative syndromes (n = 3), left diaphragmatic hernias (n = 3), limbs abnormalities (n = 2), genitourinary (n = 2), microretrognathism (n = 2), hydrops (n = 1), and exomphalos (n = 1). If the intermediate scan was normal, the chances of a favorable outcome were as high as 85% and were close to 100% after 20 weeks, irrespective of initial NT.Conclusion: The intermediate ultrasound was useful in fetuses with increased NT pregnancy work-up. [ABSTRACT FROM AUTHOR]

Tooth wear is attributed to several factors many of which often remain unidentified. Management of tooth wear is challenging in preventive and restorative dentistry. Correct assessment of occlusal vertical dimension, interocclusal rest space, and centric relation records are critical for successful treatment. In order to evaluate different treatment modalities and select the treatment of choice some information can be obtained from study casts and diagnostic wax-up. In order to achieve a predictable and desirable result, a systematic approach may be helpful. This paper describes the full mouth rehabilitation of a 36-year-old bruxer with severely worn dentition and other dental problems such as unfavorable restorations. A diagnostic work-up was performed and provisional restorations were made; then, they were clinically evaluated and adjusted based on the criteria dictating esthetics, phonetics, and vertical dimension. After endodontic therapy, clinical crown lengthening was performed. Two short implants were inserted in the posterior mandible. Custom-cast dowel cores and metal-ceramic restorations were fabricated and a full occlusal splint was used to protect the restorations. We ensured stable contacts on all teeth with equal intensity in centric relation and anterior guidance in accord with functional jaw movements. [ABSTRACT FROM AUTHOR]

Precise knowledge of the 3D shape of clinical crowns is crucial for the treatment of malocclusion problems as well as several endodontic procedures. While computed tomography would present such information, it is believed there is no threshold radiation dose below which it is considered safe. In this study, the authors propose an appearance based approach which allows for the reconstruction of plausible human jaw 3D models given a single optical image with unknown illumination. Appearance bases are analytically constructed using the frequency-based representation of the irradiance equation while incorporating prior information about natural illumination and teeth reflectance. The inherent relation between the photometric information and the underlying 3D shape is formulated as a statistical model where the coupled effect of illumination and reflectance is modelled using the Helmholtz hemispherical harmonics-based irradiance harmonics whereas the principle component regression is deployed to carry out the estimation of 3D shapes. The authors' approach relaxes limiting assumptions of conventional shape-from-shading approaches while being able to reconstruct tooth occlusal surface with challenging conditions, such as scattered specular spots and significant changes in colour and albedo characteristics resulting from tooth filling. Vis-à-vis dental applications, the results demonstrate a significant increase in accuracy in favour of the proposed approach. [ABSTRACT FROM AUTHOR]

Age-related changes of jaws and soft tissue profile are important both for orthodontists and general dentists. Mouth profile is the areawhich ismanipulated during dental treatment. These changes should be planned in accordance with other components of facial profile to achieve ultimate aimof structural balance, functional efficacy, and esthetic harmony.Through this paper, the authors wish to discuss age changes of the hard and soft tissues of human face which would help not only the orthodontists but also oral surgeons, prosthodontists, pedodontists, and general dentists. [ABSTRACT FROM AUTHOR]

In the United States, an estimate of 1.3 million women suffering from epilepsy are in their childbearing age. Potential teratogenicity of antiepileptic drugs ( AEDs) is of concern to these women considering pregnancy because discontinuing pharmacotherapy during pregnancy may not be advised due to the risk of seizures that may be dangerous to the mother as well as the fetus. Using a Relational Online Analytical Processing ( ROLAP) software licensed by Simultek, we searched for medications reported for congenital jaw and oral cavity malformation on the FDA Adverse Event Reporting System ( AERS), a voluntary adverse event reporting program that contains over 55 million adverse event reports of medical products in the United.States. Our results indicate that various forms of valproic acid, and more importantly, newer generation antiepileptic agents including lamotrigine, topiramate, and gabapentin show signals for either congenital jaw or oral malformation. Although teratogenic potential of valproic acid has long been confirmed, information on teratogenicity of the newer generation antiepileptic drugs is relatively scarce and inconclusive. Early safety signals on the teratogenic potential of AEDs detected in this study are crude statistics that do not establish causation nor exclude confounding. The results require validation and further investigation via properly controlled epidemiological studies. [ABSTRACT FROM AUTHOR]

Objectives The loss of jaw bone caused by different kinds of pathologies leads to dysfunction and reduced quality of life in affected patients. Thus, the pivotal goal in bone tissue engineering is to reconstruct these defects. The essential precondition for new tissue generation is an extracellular matrix which acts as a scaffold so that cells can migrate, differentiate, and proliferate. Fibrin, a biopolymer responsible for blood clot formation, has been shown to be suitable for tissue engineering applications. The aim of the present study is a comparison of platelet rich fibrin ( PRF) with the commonly used collagen membrane BioGide® as a scaffold for human osteoblast cell seeding for bone tissue engineering. Material and methods Human osteoblasts were cultured with eluates from PRF ( n = 7) and BioGide® ( n = 8) membranes incubated in serum-free cell culture medium. Vitality of these cells was assessed by fluorescein diacetate and propidium iodide staining, biocompatibility with the lactate dehydrogenase test and proliferation levels with the MTT ([3-(4,5- Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium-bromide]), and BrdU (5-bromo-2-deoxyuridine) tests. In addition, human osteoblasts were seeded on both membrane systems and cell growth was compared by the water soluble tetrazolium (WST-1) (4-[3-(4-iodophenyl)-2-(4-nitrophenyl)-2H-5-tetrazolio]-1,3-benzene disulfonate) test and scanning electron microscopy ( SEM). Osteoblastic differentiation was assessed by alkaline phosphatase activity measured by ELISA in the supernatant of osteoblasts cultivated on PRF membranes ( n = 10), PRF clots ( n = 10), and BioGide® membranes ( n = 10). Results Lactate dehydrogenase test values were higher for PRF compared to BioGide®. The BrdU test showed superior cell growth after cultivation in eluate from PRF than in eluate from BioGide®. The WST-1 assay demonstrated superior cell proliferation on PRF than on BioGide®. SEM revealed osteoblast colonization of both membranes. Cultivation of osteoblasts on PRF membranes and PRF clots showed significantly higher alkaline phosphatase activity than on BioGide® membranes. Conclusion Metabolic activity and proliferation of human osteoblast cells in vitro were supported to a significant higher extent by eluates from PRF membranes. Both membranes are suitable as scaffolds for cultivation of human osteoblast cells in vitro; proliferation was significant higher on PRF membranes and on PRF clot than on BioGide® membranes. [ABSTRACT FROM AUTHOR]

doi: 10.1111/j.1741-2358.2012.00622.x Dental implications of bisphophonate-related osteonecrosis Objectives: The aim is to explore the current theories about clinical , pathological and dental management of bisphosphonate related osteonecrosis of the jaws. Also discussed are the actions of bisphosphonates, pathogenesis related to the susceptibility of jaws, the predisposing risk factors for the development of bisphosphonate-related osteonecrosis of the jaws (BRONJ) and diagnostic criteria based on the literature review. Discussion: Osteoporosis is a disease that generally affects the mineral status of both cortical and trabecular bone in post menopausal women. Bisphosphonates are a group of drugs that preserve and increase bone mass. Bisphosphonate drugs are classified according to use and method of delivery. The bisphosphonates used for the treatment of osteoporosis are taken orally. Little is known about the side effects and dangers of the long-term use of therapeutic doses of Bisphosphonates. A recent complication reported is osteonecrosis of jaws. The use of IV bisphosphonates for multiple myeloma and metastatic bone diseases suggests that dosage, length of treatment, and route of administration, as well as cofactors such as use of glucocorticoids and immunosuppressive agents, and dental surgery, could all be related to the incidence of BRONJ. This review provides an update on current knowledge about clinical, pathological and management aspects of BRONJ. Conclusions: Little evidence exists to direct the prosthodontic management of patients with a history of bisphosphonate use. Patients with active osteonecrosis related to bisphosphonate use have reduced tissue tolerance to function with removable prostheses and decreased potential for osseointegration of dental implants. Decisions should be based on clinical judgment tempered by the presenting conditions, medical profile, and patient needs. A better understanding would help in a dental setting to prevent any complication and help to improve the prognosis for those being treated for osteoradionecrosis.Until further evidence emerges regarding management of patients with active bisphosphonate- related osteonecrosis, conservative prosthodontic treatment is reasonable and prudent. [ABSTRACT FROM AUTHOR]

International Journal of Paediatric Dentistry 2012; 22: 280-285 Background. Based on measurements on dental casts, smaller permanent teeth in children with cleft palate have previously been reported in the literature; however, the early maturation of teeth and the size of the follicles and crowns have not been investigated. Hypothesis. The maturation of the mandibular permanent first molar (M1inf) is delayed, and the mesiodistal diameters of the follicle and crown of M1inf, respectively, are reduced in children with isolated cleft palate (ICP). Design. Retrospective, longitudinal. Cephalometric X-rays were available for 2 and 22 months old children with clefts (64 children with ICP, and a control group of 38 children with unilateral incomplete cleft lip). The width of the follicle and the crown of M1inf, and the maturation of M1inf were assessed. Intra-observer error was acceptable. Results. M1inf maturation was delayed in children with ICP at both 2 and 22 months of age. The mesiodistal diameter of the crown of M1inf in the ICP group was reduced. Thus, the two hypotheses could not be refuted. Conclusions. Children with ICP showed smaller dimensions of the M1inf, and in addition, the maturation of M1inf was delayed. [ABSTRACT FROM AUTHOR]

Objectives of the Study. Cleft lip and palate (CLP) is a prevalent congenital anomaly in the orofacial region. Autogenous iliac bone grafting has been frequently employed for the closure of bone defects at the jaw cleft site. Since the related surgical procedures are quite invasive for patients, it is of great importance to develop a new less invasive technique. The aim of this study was to examine bone regeneration with mesenchyme stem cells (MSCs) for the treatment of bone defect in artificially created jaw cleft in dogs. Materials and Methods. A bone defect was prepared bilaterally in the upper incisor regions of beagle dogs.MSCs derived from iliac bone marrow were cultured and transplanted with carbonated hydroxyapatite (CAP) particles into the bone defect area. The bone regeneration was evaluated by standardized occlusal X-ray examination and histological observation. Results. Six months after the transplantation, perfect closure of the jaw cleft was achieved on the experimental side. The X-ray and histological examination revealed that the regenerated bone on the experimental side was almost equivalent to the original bone adjoining the jaw cleft. Conclusion. It was suggested that the application of MSCs with CAP particles can become a new treatment modality for bone regeneration for CLP patients [ABSTRACT FROM AUTHOR]

To evaluate the effects of different levels of vertical misfit between implant and bar framework on distribution of static stresses in an overdenture-retaining bar system using finite element analysis. A 3D finite element model (11,718 elements and 21,625 nodes) was created and included two titanium implants and a bar framework placed in the medial region of the anterior part of a severely reabsorbed-jaw. All materials were presumed to be linear elastic, homogenous, and isotropic. Mechanical simulation software (NEiNastran 9.0) was used, where displacements were applied on the end of the bar framework to simulate the closure of the vertical misfits (5, 25, 50, 100, 200, and 300 μm) after tightening of the screws. Data were qualitatively evaluated using Von Mises stress given by the software. The models showed stress concentration in cortical bone, corresponding to the cervical part of the implant, and in cancellous bone, corresponding to the apical part of the implant; however, in these regions few changes were observed in stress to the misfits studied. While in the bar framework, retaining-screw neck, and implant platform, a considerable stress increase proportional to the misfit amplification was observed. The different levels of vertical misfit did not considerably influence the static stress levels in the peri-implant bone tissue; however, the mechanical components of the overdenture-retaining bar system are more sensitive to lack of passive fit. [ABSTRACT FROM AUTHOR]

Background. This work aimed at determining whether bisphosphonate therapy produces a sufficient condition for jaw osteonecrosis after tooth extraction. Methods. Rats were allocated into 3 groups: (1) 11 rats treated with alendronate, (2) 10 rats treated with zoledronic acid, and (3) 10 control rats. The animals were subjected to tooth extractions, and at the end of bisphosphonate therapy, they were humanely killed. Histologic sections of the surgical site were processed and analyzed. Results. The zoledronic acid group showed higher incidences of osteonecrosis, inflammatory infiltrate, and microorganisms. There was no significant difference for epithelial or connective tissue, root fragments, vital bone, and positive staining for vascular endothelial growth factor (VEGF) among the groups. Conclusion. Zoledronic acid is associated with jaw osteonecrosis, whereas alendronate did not produce a condition sufficient for osteonecrosis after tooth extraction. Neither zoledronic acid nor alendronate was associated with a reduced immunohistochemical expression of VEGF in vital bone at the tooth extraction site. [ABSTRACT FROM AUTHOR]

Structured Abstract Authors – Ueki K, Takeuchi N, Nakagawa K, Yamamoto E Objective – Aim of this study was to investigate the differences in stress on the temporomandibular joint (TMJ) between Class III patients with and without mandibular asymmetry using a rigid body spring model (RBSM). Design – Menton (Me), the centre point of occlusal force on the line that connected the bilateral buccal cusps of the second molars and the most lateral, superior and medial points of the condyle were plotted on frontal cephalograms, and stress on the condyles was calculated with the 2-dimensional RBSM program offortran. Setting and Sample Population – Eighty Japanese patients with diagnosed mandibular prognathism were divided into two groups, a symmetry group and asymmetry group on the basis of the Mx-Md midline position. Outcome measure – The degree (force partition) of the resultant force, the direction (angulation) and displacement ( X, Y) of each condyle were calculated. The horizontal displacement vector ( u), the vertical displacement vector ( v) and rotation angle (θ) of the mandibular body at Menton were also calculated. Results – There were significant differences between the deviated and non-deviated sides of both groups regarding resultant force (symmetry group: p = 0.0372, asymmetry group: p = 0.0054), X (symmetry group: p < 0.0001, asymmetry group: p = 0.0001) and Y (symmetry group: p = 0.0354, asymmetry group: p = 0.0043). For angulation, there was a significant difference between the deviated and non-deviated sides in the asymmetry group ( p = 0.0095). Conclusion – The results of this study suggest that difference in stress angulation on the condyles could be associated with asymmetry in mandibular prognathism. [ABSTRACT FROM AUTHOR]

Osteonecrosis of the jaws, or the threat of it, because of the use of bisphosphonates, is an increasing problem facing all dentists and oral surgeons. The link is somewhat circumstantial but compelling and there are emerging risk factors that increase a patient's susceptibility to developing osteonecrosis including the use of intravenous bisphosphonates, length of time taking the drug, smoking and possibly a genetic predisposition. There is a lack of randomised trial evidence regarding the best strategies for prevention and treatment of the condition. This article discusses current evidence, largely from observational studies on the development, prevention and management of bisphosphonate-related osteonecrosis. [ABSTRACT FROM AUTHOR]

The article cites a study assessing the bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) preponderance in patients with breast cancer. A retrospective study was carried on and a structured interviews were conducted to all patients. Results from the study show that 5.3% of the observed patients show prevalence of BP-ONJ.

Aim: To provide a classification system of mandibular prognathism (MP) as a guide for proper diagnosis and treatment planning of the various forms of skeletal discrepancies seen in mandibular prognathism and to a communication tool among orthodontists and surgeons. Materials and Methods: Six different types of MP were presented. Recommended surgical procedures for each MP categories were presented. Twenty-three consecutive MP patients were evaluated by a panel of three orthodontists. The panel categorized each patient according to Cho's MP classification system. The recommended surgery by the MP classification system and actual surgery performed for each were compared. Result: The recommended surgical procedure(s) respective to the MP category of each individual corresponded to the actual surgery performed with exception of a few individuals. Conclusion: This MP classification system proved to be a good diagnostic tool and led to an appropriate orthodontic and surgical treatment plan. [ABSTRACT FROM AUTHOR]