A cone-beam computed tomography evaluation of three-dimensional changes of circummaxillary sutures following maxillary protraction with alternate rapid palatal expansions and constrictions / 北京大学学报(医学版)

OBJECTIVE@#To assess three-dimensional (3D) changes of circummaxillary sutures following maxillary protraction with alternate rapid palatal expansions and constrictions (RPE/C) facemask protocol in maxillary retrusive children, and to investigate the relationship between the changes of circum-maxillary sutures and zygomaticomaxillary suture (ZMS) maturation, and to explore the factors of maxilla forward movement with RPE/C and facemask.@*METHODS@#In the study (clinical trial registration No: ChiCTR2000034909), 36 maxillary retrusive patients were recruited and block randomized to either the rapid palatal expansion (RPE) group or the RPE/C group. Patients aged 7 to 13 years, Class Ⅲ malocclusion, anterior crossbite, ANB less than 0°, Wits appraisal less than -2 mm, and A-Np less than 0 mm were included in the study. The RPE group received rapid palatal expansion, whereas the RPE/C group received alternate rapid palatal expansions and constrictions, and both with facemask protraction. Head orientations of cone-beam computed tomography (CBCT) images were implemented by Dolphin 11.7. 3D measurements of circummaxillary sutures on CBCT images were evaluated using Mimics 10.01 before (T0) and after treatment (T1). The changes were analyzed with independent t test, two-way ANOVA, Pearson correlation and regression analysis.@*RESULTS@#Two subjects in the RPE/C group were lost to follow-up. A total of 34 patients reached the completion criteria and were analyzed. Compared with the RPE group, sagittal changes of circummaxillary sutures were significantly increased in the RPE/C group with 1.21 mm advancement of zygomaticotemporal suture, 2.20 mm of ZMS, 1.43 mm of zygoma-ticofrontal suture (P < 0.05, respectively). Except for the zygomaticotemporal suture, the rest forward sagittal changes of other circummaxillary sutures showed no major difference in terms of the ZMS maturation. The Spearman's correlation in RPE/C indicated a strong positive correlation of sagittal changes between ZMS and point A (P < 0.01) with a regression analysis R2=42.5%.@*CONCLUSION@#RPE/C might be more effective on the treatment of maxillary retrusive children. As one of the major mechanical loading sutures during orthopedic therapy, ZMS showed a strong positive correlation with point A on sagittal changes.

A 5-year epidemiological follow-up study on hyperparathyroxinemia in Urumqi community residents / 中国医师杂志

Objective:Based on the previous epidemiological investigation of hyperparathyroxinemia in Urumqi community, a follow-up study was conducted to understand the changes of serum parathyroid hormone (PTH) level and clinical characteristics of residents with PTH.Methods:In the previous study (2013), an epidemiological cross-sectional study of hyperparathyroxinemia was conducted on 1 473 residents of the resident community, and 180 people with hyperparathyroxinemia were found. The serum PTH, parathyroid related laboratory indexes and vitamin D were observed in high PTH population of different genders.Results:According to the inclusion criteria, 159 patients with high PTH were included in the study. The total follow-up rate was 88.3% (159/180), including 24 males (15.09%) and 135 females (84.91%). The serum PTH level in the follow-up population was 68.60 (47.85-98.80)pg/ml, which was significantly different from that in the first visit ( P<0.01). There was no significant difference in serum PTH levels between men and women ( P>0.05). The levels of serum 25(OH)D, calcium, phosphorus, magnesium, creatinine, albumin and alkaline phosphatase in the follow-up population had no significant changes compared with the first visit population (all P>0.05); After stratified by sex, the serum creatinine level of men with high PTH was significantly higher than that of women ( P<0.01), and there was no significant difference in other PTH related laboratory indexes ( P>0.05); Although the vitamin D level was still deficient (<20 ng/ml), the proportion of people with sufficient vitamin D was significantly higher than that at the first visit. Conclusions:25(OH) D deficiency was still common in the follow-up population, but the vitamin D level of the residents with PTH was significantly improved and the serum PTH level was significantly lower than that in the first visit.

Effect of orthodontic tooth movement on keratinized gingival width / 北京大学学报(医学版)

OBJECTIVE@#The relationship between the orthodontic tooth movement and the change of keratinized gingival width was analyzed by measuring the keratinized gingival width and position of the teeth before and after 28 orthodontic treatments.@*METHODS@#The photos were matched to the model and the width of the keratinized gingival was obtained by measuring the length of the crown, and the keratinized gingiva. The pre- and post-treatment models were overlapped on rapidform 2006 and the change of tooth position before and after orthodontic movement could be accurately measured, and the relationship between tooth intrusion and extrusion, retraction and forward movement, torque variation and keratinized gingival width was statistically investigated.@*RESULTS@#Analysis of the correlation between data before and after treatments for 213 teeth in 28 patients revealed a strong correlation between changes in tooth torque angle and changes in keratinized gingiva width (r=-0.47, P<0.001). In the multi-level linear regression analysis, the correlation between them was verified (regression coefficient<0, P<0.001), and there was no significant correlation between the intrusion and retraction of the teeth and the change of the width of keratinized gingiva (P>0.05). Regression coefficient was negatively relative to the reference incisor between the teeth for the canines and premolars (canine regression coefficient=-0.35, premolar regression coefficient=-0.38, P<0.05). Therefore, the study found that there was a strong negative correlation between the changes in tooth torque angle and width of keratinized gingival (r=-0.41, P<0.001), that is, an increase in positive torque led to the reduction of width of keratinized gingiva, and on the contrary the increase of negative torque would cause the width of keratinized gingiva increase. There was no significant correlation between the intrusion and extrusion of the teeth for the width of keratinized gingiva. The sensitivity of different teeth for the width of keratinized gingiva differed, with incisor compared with canines and premolars that were more prone to keratinized gingiva width changes.@*CONCLUSION@#Tooth movement during orthodontics affected the width of the keratinized gingiva width, and the increase in positive torque was more likely to cause a reduction in the width of keratinized gingiva. There was no significant correlation between the intrusion and retraction of the teeth and the change in the width of keratinized gingiva. Incisors were more prone to changes in the width of keratinized gingiva relative to the cuspids and premolars during tooth movement. In the orthodontic process, it is possible to predict the effect of changes in the position of the teeth on the keratinized gingiva width, and attention shoud be to the changes in the keratinized gingiva width.

Occlusal changes before and after orthodontic treatment in patients with aggressive periodontitis / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the efficacy of occlusal improvement in the labial fixed orthodontic treatment in aggressive periodontitis patients and to explore the relationship between occlusal improvement and inflammation control.@*METHODS@#Twenty-two aggressive periodontitis patients who underwent combined periodontal-orthodontic treatment were included in this study. The patient's photos were matched to the dental models and digital three dimentional models were acquired using 3Shape R700 laser scanner. The occlusal force distribution maps were generated in the OrthoAnalyzer software. The newly established occlusal force distribution score (OFDS) and proximal contact score (PCS) were used to evaluate the occlusal distribution changes before and after labial fixed orthodontic treatment for assessing the effectiveness of orthodontic treatment. The multi-level linear regression analysis was used to explore the relationship between the probing depth changes and OFDS or PCS changes to screen out the favorable orthodontic strategy for inflammation control, which would provide clinical strategy for combined periodontal-orthodontic treatment in aggressive periodontitis patients.@*RESULTS@#At the patient level, OFDS was improved significantly after orthodontic treatment compared with the score before orthodontic treatment (84.5±20.9 vs.105.3±22.6, P <0.001) and PCS was improved significantly after orthodontic treatment compared with the score before orthodontic treatment (68.9±9.1 vs. 83.7±6.3, P <0.001).At the tooth level, the OFDS was significantly increased in the maxillary anterior teeth (P <0.001) while the PCS of the anterior teeth in both maxillary and mandible arches were significantly increased significantly (P <0.01). No significant changes were found in other tooth positions. The multilevel linear regression model showed that no significant correlation was found between age and gender and probing depth decrease (P >0.05). The baseline probing depth,OFDS improvements and PCS improvements (P <0.001) were positively correlated with probing depth decrease.@*CONCLUSION@#This study showed that the distribution of occlusal force was more reasonable and the proximal contacts were more ideal in aggressive periodontitis patients. Orthodontic treatment was effective in improving occlusal force distribution by the above two ways. Especially, the OFDS and PCS improvements were both positively correlated with probing depth decrease, indicating that in the combined periodontal-orthodontic treatment for aggressive periodontitis patients, occlusal force distribution and proximal contact should be improved in order to facilitate periodontal improvement.

Orthodonticorthognathic treatment stability in skeletal class III malocclusion patients / 北京大学学报(医学版)

OBJECTIVE@#To investigate stability of skeletal hard tissues, dental hard tissues and soft tissues after orthodonticorthognathic treatment in a long term. This study reviewed longitudinal changes in orthodontic-orthognathic patients of skeletal class III malocculsion, using lateral cephalometric radiographs in 3-12 years after treatment in comparison to treatment finishing.@*METHODS@#Twenty-two patients with skeletal Class III malocclusion following orthodontic-orthognathic surgery in Peking University School and Hospital of Stomatology from January 1, 2000 to January 1, 2009 were observed. The lateral cephalometric radiographs of the following stages were collected: treatment finishing (T1), 3 to 12 years after treatment (T2). Statistical analyses of cephalometrics were evaluated. Paired student t test was performed by SPSS 17.0.@*RESULTS@#Data of all the 22 patients were studied in longitudinal timeline after treatment and 3-12 years after treatment. From T1 to T2, we evaluated 11-SN (angle between the upper incisors axis and SN plane), 11-NA angle (angle between the upper incisors axis and NA plane), 11-NA mm (perpendicular distance from upper incisors to NA plane), 11-41 (angle between the upper incisors axis and lower incisors axis), 41-NB angle (angle between lower incisors and NB plane), 41-NB (perpendicular distance from lower incisors to NB plane), 41-MP angle (angle between lower incisors and GoGn plane), and IMPA [angle between lower incisor and mandibular plane (tangent line to submandibular border)]. Most hard tissues of the teeth remained stable but upper anterior teeth angulations decreased, indicating by significantly reducing 11-SN (T1: 110.98°±6.77°; T2: 109.21°±5.80°; P=0.005); reducing 11-NA (T1: 28.31°±6.80°; T2: 26.49°±6.18°; P=0.002); increasing 11-41 (T1: 123.51°±8.14°; T2: 125.7°±10.01°; P=0.035). From T1 to T2, we also evaluated SNA (angle of sella-nasion-A-point), SNB (angle of sella-nasion-B-point), ANB (angle of A-point-nasion-B-point), GoGn-SN (angle between GoGn and SN plane), GoGn-FH (angle between GoGn and Frankfort plane), Y axis (angel between Sella-Gn and Frankfort plane), N-ANS (distance from nasion point to ANS point), ANS-Me (distance from ANS point to Menton point), N-Me (distance from nasion point to Menton point), ANS-Me/N-Me% (proportion of ANS-Me to N-Me), and FMA (angle between Frankfort and mandibular plane), Wits appraisal (horizontal distance between points A and B on functional occlusal plane). Skeletal hard tissues also remained relatively stable, only N-Me value changed significantly with a decreasing facial height (T1: 124.98°±11.98°; T2: 122.4°±11.05°; P=0.024). From T1 to T2, we finally evaluated FH-NsPg angle (angle between NsPg and Frankfort plane), H angle (angel between H line and NB), FH-A'UL angle (angle between A'UL and Frankfort plane), FH-B'LL angle (angle between B'LL and Frankfort plane), UL-LL (angle between UL and LL), UL-EP (distance between UL and E line), LL-EP (distance between LL and E line), Sn-H (perpendicular distance between Sn point and H line), Nls-H (distance of nose-lip-sulcus to H line), Li-H (lower lip to H line), Si-H (lower lip sulcus to H line), and NLA (nasolabial angle, angle of Cm-Sn-UL-point). Soft tissues changes were observed in decreasing UL-EP [T1: (-2.78±2.20) mm; (-3.29±2.44) mm; P=0.02] and H angle (T1: 8.27°±3.71°; 7.32°±3.83°; P=0.006). Other soft tissues remained relatively stable by retruding upper lip position and chin changes with no statistical significance.@*CONCLUSION@#Orthodontic-orthognathic treatment can improve esthetics and occlusal function in patients of skeletal class III malocclusion with a stable long-term outcome.

Chronic inflammation deteriorates structure and function of collagen fibril in rat temporomandibular joint disc / 国际口腔科学杂志·英文版

Collagen is the building component of temporomandibular joint (TMJ) discs and is often affected by inflammation in temporomandibular disorders. The macromechanical properties of collagen are deteriorated by chronic inflammation. However, the mechanism by which inflammation influences disc function remains unknown. The relationship between the ultrastructure and nanomechanical properties of collagen in inflamed discs should be clarified. Seven-week-old female Sprague-Dawley rats were randomly divided into two groups. Chronic TMJ inflammation was induced by intra-articular injection of complete Freund's adjuvant, and samples were harvested after 5 weeks. Picrosirius staining revealed multiple colours under polarized light, which represented alternative collagen bundles in inflamed discs. Using atomic force microscopy scanning, the magnitude of Young's modulus was reduced significantly accompanied with disordered collagen fibril arrangement with porous architecture of inflamed discs. Transmission electron microscopy scanning revealed a non-uniform distribution of collagen fibres, and oversized collagen fibrils were observed in inflamed discs. Fourier transform infrared microspectroscopy revealed a decrease in 1 338 cm/amide II area ratio of collagen in different regions. The peak positions of amide I and amide II bands were altered in inflamed discs, indicating collagen unfolding. Our results suggest that sustained inflammation deteriorates collagen structures, resulting in the deterioration of the ultrastructure and nanomechanical properties of rat TMJ discs.

Evaluation of maxillary three-dimensional changes in maxillary protraction with alternating rapid palatal expansion and constriction based on the cone-beam computed tomography / 北京大学学报(医学版)

OBJECTIVE@#To use the cone-beam computed tomography (CBCT) to evaluate the three-dimensional (3D) changes of maxillary landmarks in the maxillary protraction with alternating rapid palatal expansion and constriction and with rapid palatal expansion, and to provide some clinical suggestions for the early treatment of Class III malocclusion.@*METHODS@#A total of 36 maxillary retrusive patients were included and randomized in a 1:1 ratio to either the intervention group (alternating rapid palatal expansion and constriction group, RPE/C) or the control group (rapid palatal expansion group, RPE). Randomization was accomplished with permuted block randomization based on participation sequence. The patients in the RPE/C were treated for 10 weeks (0.5 mm/d) with the repetition of two-week palatal expansion and two-week palatal constriction. The patients in the RPE were taught to complete rapid palatal expansion for 2 weeks (0.5 mm/d ). The patients were instructed to come to the office for the follow-up to ensure the correct procedures. Damaged expanders were repaired (or replaced) and rebanded quickly. Sequential CBCT images including pretreatment (T1), post-expansion (T2) and post-protraction (T3) were required for 3D reconstruction, establishment of landmarks, measurement and analysis by Mimics 10.01.@*RESULTS@#There was significant forward movement of subspinale (A) in the RPE/C after the treatment with (3.06±1.29) mm, compared with RPE (2.16±1.27) mm, P<0.05. There were more symmetrical changes of the landmarks in the RPE/C and there was no statistic significance of the entire treatment time between the two groups. Moreover, the maxillary skeletal landmarks had the following 3D changes of a forward and downward movement during the expansion stages T2-T1, a forward and upward movement during the protraction stages T3-T2 and a forward and downward movement during the total treatments T3-T1 compared with the control group. And the width between the bilateral landmarks increased during the expansion stages T2-T1, narrowed down during the protraction stages T3-T2 and increased during the total treatments T3-T1.@*CONCLUSION@#The maxillary protraction with alternating rapid palatal expansion and constriction provided clinical benefits on maxillary advancement and symmetrical changes in the orthopedic treatment of the patients with maxillary retrognathism and it required further study on the orthodontic analysis and measurements of CBCT.

Extraction-orthodontic treatment on patients with chronicperiodontitis: a preliminary study / 北京大学学报(医学版)

OBJECTIVE@#To retrospectively evaluate clinical and radiographic records of chronic periodontitis patients who underwent extraction-orthodontic treatment, in order to determine the effect of the treatment on probing depth, alveolar bone height of teeth adjacent to the extraction sites.@*METHODS@#In the study, 33 chronic periodontitis patients who had finished extraction-orthodontic treatment were selected, the periodontal examination system tables and panoramic tomography were recorded before treatment (T0) and after treatment (T1), and the periodontal probing depth (PD), residual alveolar bone height (RBH) of the teeth adjacent to extraction sites (TAES) and the non-teeth adjacent to extraction sites (NTAES) were measured at T0 and T1.@*RESULTS@#There was insignificant difference in PD of TAES and NTAES at T0 [(2.40±0.51) mm vs. (2.42±0.55) mm,P>0.05], neither was that at T1 [(2.70±0.67) mm vs. (2.67±0.64) mm, P>0.05]; From T0 to T1, PD of TAES and NTAES had mean increases of 0.3 mm [(2.40±0.51) mm vs. (2.70±0.67) mm,P<0.01] and 0.25 mm [(2.42±0.55 mm vs. (2.67±0.64) mm, P<0.01], respectively. And PD of TAES and NTAES increased from T0 to T1 statistically in the same degree [(0.30±0.64) mm vs. (0.25±0.58) mm,P>0.05]; at T0, RBH of TAES was 0.024 smaller than that of NTAES (0.74±0.16 vs. 0.76±0.16,P<0.05), but there was no difference in RBH between the TAES and NTAES at T1 (0.78±0.14 vs. 0.79±0.12,P>0.05); From T0 to T1, RBH of TAES and NTAES had mean increases of 0.04 (0.74±0.16 vs.0.78±0.14,P<0.05) and 0.02 (0.76±0.16 vs. 0.79±0.12,P<0.05), respectively. And the change of RBH between TAES and NTAES from T0 to T1 had no statistical difference (0.04±0.11 vs. 0.02±0.08,P>0.05)RBH of TAES in the side close to extraction sites was as the same as that of TAES in the side away from the extraction sites at T0 (0.73±0.17 vs. 0.74±0.16,P>0.05). From T0 to T1, RBH of both sides of TAES had mean increases of 0.04 (0.73±0.11 vs. 0.77±0.11,P<0.05) and 0.04 (0.74±0.11 vs. 0.78±0.11,P<0.05), respectively. But for both sides of TAES, from T0 to T1, there was no significant difference in change of RBH (0.04±0.11 vs. 0.04±0.11,P>0.05).@*CONCLUSIONS@#With strict control of periodontal inflammation and maintenance of oral hygiene, orthodontic treatment preserves the periodontal conditions in patients with chronic periodontitis, and the extraction-orthodontic treatment can preserve the bone height of the teeth adjacent to extraction sites.

Stress change of periodontal ligament of the anterior teeth at the stage of space closure in lingual appliances: a 3-dimensional finite element analysis / 北京大学学报(医学版)

OBJECTIVE@#To analyze the stress distribution in the periodontal ligament (PDL) under different loading conditions at the stage of space closure by 3D finite element model of customized lingual appliances.@*METHODS@#The 3D finite element model was used in ANSYS 11.0 to analyze the stress distribution in the PDL under the following loading conditions: (1) buccal sliding mechanics (0.75 N,1.00 N,1.50 N), (2) palatal sliding mechanics (0.75 N,1.00 N,1.50 N), (3) palatal-buccal combined sliding mechanics (buccal 1.00 N + palatal 0.50 N, buccal 0.75 N + palatal 0.75 N, buccal 0.50 N+ palatal 1.00 N). The maximum principal stress, minimum principal stress and von Mises stress were evaluated.@*RESULTS@#(1) buccal sliding mechanics(0.75 N,1.00 N,1.50 N): maximum principal stress: at the initial of loading, maximum principal stress, which was the compressed stress, distributed in labial PDL of cervix of lateral incisor, and palatal distal PDL of cervix of canine. With increasing loa-ding, the magnitude and range of the stress was increased. Minimum principal stress: at the initial of loading, minimum principal stress which was tonsil stress, distributed in palatal PDL of cervix of lateral incisor and mesial PDL of cervix of canine. With increasing loading, the magnitude and range of minimum principal stress was increased. The area of minimum principal stress appeared in distal and mesial PDL of cervix of central incisor. von Mises stress:it distributed in labial and palatal PDL of cervix of lateral incisor and distal PDL of cervix of canine initially. With increasing loading, the magnitude and range of stress was increased towards the direction of root. Finally, there was stress concentration area at mesial PDL of cervix of canine. (2) palatal sliding mechanics(0.75 N,1.00 N,1.50 N): maximum principal stress: at the initial of loading, maximum principal stress which was the compressed stress, distributed in palatal and distal PDL of cervix of canine, and distal-buccal and palatal PDL of cervix of lateral incisor. With increasing loading, the magnitude and range of the stress was increased. Minimum principal stress: at the initial of loading, minimum principal stress which was tonsil stress, distributed in distal-interproximal PDL of cervix of lateral incisor and mesial-interproximal PDL of cervix of canine. With increasing loading, the magnitude and range of the stress was increased.von Mises stress: von Mises stress distributed in palatal and interproximal PDL of cervix of canine. With increasing loading, the magnitude and range of stress was increased. Finally, von Mises stress distributing area appeared at distal-palatal PDL of cervix of canine. (3) palatal-buccal combined sliding mechanics: maximum principal stress: maximum principal stress still distributed in distal-palatal PDL of cervix of canine. Minimum principal stress: minimum principal stress distributed in palatal PDL of cervix of lateral incisor when buccal force was more than palatal force. As palatal force increased, the stress concentrating area transferred to mesial PDL of cervix of canine.von Mises stress: it was lower and more well-distributed in palatal-buccal combined sliding mechanics than palatal or buccal sliding mechanics.@*CONCLUSION@#Using buccal sliding mechanics,stress majorly distributed in PDL of lateral incisor and canine, and magnitude and range of stress increased with the increase of loading; Using palatal sliding mechanics, stress majorly distributed in PDL of canine, and magnitude and range of stress increased with the increase of loading; With palatal-buccal combined sliding mechanics, the maximum principal stress distributed in the distal PDL of canine. Minimum principal stress distributed in palatal PDL of cervix of lateral incisor when buccal force was more than palatal force. As palatal force was increasing, the minimum principal stress distributing area shifted to mesial PDL of cervix of canine. When using 1.00 N buccal force and 0.50 N palatal force, the von Mises stress distributed uniformly in PDL and minimal stress appeared.

Decreased phosphorylation of mitogen activated protein kinase and protein kinase B contribute to the inhibition of osteogenic differentiation mediated by activation of Toll like receptor in human periodontal ligament stem cells / 北京大学学报(医学版)

OBJECTIVE@#To investigate the effects of Toll like receptors on the osteogenesis of human pe-riodontal ligament stem cells (hPDLSCs) and probable molecular mechanism.@*METHODS@#Real-time PCR and flow cytometry were applied to test the expression of TLRs in hPDLSCs and the positive cell percentage of TLR. hPDLSCs were cultured in osteogenic medium for 7 to 14 days with different TLR agonists at various concentrations . The effect of different TLR on osteogenic differentiation of hPDLSCs was evaluated by alizarin red S staining, alkaline phosphatase (ALP) staining and ALP activity assay. Western blotting was used to analyze the phosphorylation levels of extracellular regulated protein kinases (ERK), c-Jun N-terminal protein kinase (JNK), P38, AKT and expression of Runx2 an osteogenic related gene after treatment with TLR agonists, compared with the effect of inhibitors of mitogen activated protein kinase (MAPK) or protein kinase B (PKB or AKT) on Runx2 expression of hPDLSCs cultured in osteogenic medium.@*RESULTS@#Higher expressions of TLR1,3,4,6 were found in hPDLSCs through real-time PCR. Positive cell percentage of TLR was determined by flow cytometry and described as TLR1: 2.82%±0.68%; TLR2: 1.26%±0.09%; TLR3: 13.23%±2.05%; TLR4: 3.64%±0.79%; TLR6: 3.21%±1.64%, whose tendency was comparable to their mRNA expression in hPDLSCs. Most TLR ligands had no effect on the ALP staining, activity and mineralization of hPDLSCs at lower concentration except for 0.1 mg/L PolyI:C could induce the osteogenic ability of hPDLSCs. On the contrary, Higher concentration of TLR ligands (PolyI:C: 10 mg/L, LPS: 10 mg/L , Pam3CSK4: 1 mg/L, FSL-1: 50 μg/L) had obviously inhibitory effect on osteogenic differentiation of hPDLSCs. Activation of TLR using higher concentration of TLR ligands could downregulate the phosphorylation levels of ERK, P38, JNK and AKT, and also reduced the expression of Runx2, compared with the untreated control. The inhibitors of MAPK (U0126, SP600125,SB203580) and inhibitor of AKT (perifosine) could also inhibit Runx2 expression.@*CONCLUSION@#Higher concentration of TLR ligands could inhibit osteogenic differentiation of hPDLSCs. This inhibitory effect seemed to be related to decreased phosphorylation of MAPK and AKT.

Clinical efficacy of internal fixation with miniature steel plate and kirschner pins in treatment for cervix metacarpal fracture / 局解手术学杂志

Objective To discuss the clinical efficacy of internal fixation with miniature steel plate and kirschner pins in treatment for metacarpal neck fracture.Methods A total of 142 patients with cervix metacarpal fracture in our hospital from January 2015 to December 2016 were divided into the control group(n =71) and the observation group(n =71) randomly.The patients in control group were treated with internal fixation with kirschner pins,and the patients in observation group were treated by internal fixation with miniature steel plate.The operative time,postoperative healing time,postoperative pain,metacarpophalangeal joint function and complications were compared between the two groups.Results The operation time of observation group was (38.4 ± 3.8) minutes,the fracture healing time was (3.1 ± 1.4)weeks,the excellent and good rate of TAM was 97.2％ after operation,the excellent and good rate of FAFS was 98.6％ after operation,all these indexes were significantly better than those in the control group with statistical significance (P ＜ 0.05).Conclusion Internal fixation with miniature steel plate in the treatment of cervix metacarpal fracture has the advantages of exact clinical effect,short operative time,quick fracture healing and good recovery of joint function.

Nonsurgical correction of a severe anterior deep overbite accompanied by a gummy smile and posterior scissor bite using a miniscrew-assisted straight-wire technique in an adult high-angle case / 대한치과교정학회지

In the present report, we describe the successful use of miniscrews to achieve vertical control in combination with the conventional sliding MBT™ straight-wire technique for the treatment of a 26-year-old Chinese woman with a very high mandibular plane angle, deep overbite, retrognathic mandible with backward rotation, prognathic maxilla, and gummy smile. The patient exhibited skeletal Class II malocclusion. Orthodontic miniscrews were placed in the maxillary anterior and posterior segments to provide rigid anchorage and vertical control through intrusion of the incisors and molars. Intrusion and torque control of the maxillary incisors relieved the deep overbite and corrected the gummy smile, while intrusion of the maxillary molars aided in counterclockwise rotation of the mandibular plane, which consequently resulted in an improved facial profile. After 3.5 years of retention, we observed a stable, well-aligned dentition with ideal intercuspation and more harmonious facial contours. Thus, we were able to achieve a satisfactory occlusion, a significantly improved facial profile, and an attractive smile for this patient. The findings from this case suggest that nonsurgical correction using miniscrew anchorage is an effective approach for camouflage treatment of high-angle cases with skeletal Class II malocclusion.

Inlfuence of Extreme Environment Changes on IL-6, INF-γ, sIgA and IL-10 Rat Lung / 世界科学技术-中医药现代化

This study was aimed to explore the influence of extreme environment changes on the lung immune function in rats. Artificial climate system was used to simulate six extreme weathers, which were the sudden temperature increase (ZS), sudden temperature drop (ZJ), continuous high temperature (CG), continuous low temperature (CD), high temperature and high humidity (GWGS), normal temperature and high humidity (CWGS). And then, the method of enzyme-linked immunosorbent assay (ELISA) was adopted to detect bronchoalveolar lavage fluid (BALF) and related immune substances in lung tissues. The results showed there was significant difference of ZJ on IL-10 (P<0.05). There were significant differences of CG, CD, GWGS, and CWGS on IL-6, INF-γ and sIgA (P<0.05). Contents of the GWGS group and CWGS group were higher than that of the CG group and CD group. There was very significant difference on IL-10 in the CD group (P<0.01). It was concluded that the extreme environment changes had different influence on body’s immune. And different intervention factors cause the body’s immune factors to response accordingly.

Analysis of the plaster casts of Class II division 1 non-extraction patients treated with Alexander technique / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the changes of arch width and arch length in Class II division 1 non-extraction patients treated with Alexander technique.</p><p><b>METHODS</b>Dental casts of 21 Class II division 1 non-extraction patients treated with Alexander appliance were taken before (T1) and after treatment (T2). All the casts were laser scanned. The arch width and arch length were digitally measured. The differences of arch width and arch length between T1 and T2 were recorded and analyzed.</p><p><b>RESULTS</b>The upper arch length decreased from (32.82 ± 2.51) mm to (31.97 ± 2.17) mm (P < 0.05). The lower arch length increased from (27.53 ± 2.61) mm to (28.80 ± 1.81) mm (P < 0.05). The intercanine width in the upper arch changed significantly from T1 to T2. The intermolar width in the upper and lower arches increased significantly from T1 to T2.</p><p><b>CONCLUSIONS</b>Class II division 1 non-extraction patients could be treated successfully by increasing the upper arch width.</p>

Preliminary three-dimensional analysis of posed smile / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To analyze the changes in facial feature region during posed smile three dimensionally.</p><p><b>METHODS</b>The three-dimensional facial images during posed smiles and resting position in 44 volunteers (18 men, 26 women, 26.7 ± 2.6 years old) were acquired by using FaceScan optical three-dimensional sensor. These scanned three-dimensional images were processed and superimposed with commercially-available reverse modeling software. Quantitative and qualitative three dimensional analyses of changes in facial feature region during posed smile were done by using color maps.</p><p><b>RESULTS</b>The changing area accounted for (29.65 ± 8.40)% during posed smile, and the difference of the left and right half face was 6.69% (2.07%, 13.11%). Displacements in cheilion, zygomatic area, lower lip were detected in every subject during posed smile. Women [(4.49 ± 1.51) mm] gained more changes than men [(3.25 ± 1.75) mm] did in nasolabial fold.</p><p><b>CONCLUSIONS</b>Posed smile was asymmetric. Displacement variation and ratio are different at facial feature regions.Women shows greater changes around lips during posed smile.</p>

Gummy smile correction by intruding upper incisors with mini-screw implant: an esthetic evaluation by the golden facial mask / 中华口腔医学杂志

<p><b>OBJECTIVE</b>to use a golden facial mask to classify the gummy smile and then to evaluate the effectiveness of correction gummy smile by intruding upper incisors and canines with mini-screw implants.</p><p><b>METHODS</b>sixteen female and 1 male gummy smile patients with an age range of 16 - 40 years, 26.2 years on average, were involved in the study. The mini-screw implants were inserted buccally between upper lateral incisors and canines on both sides for intruding upper incisors together with fixed appliance. The golden facial mask was introduced to analyze the frontal view of smile pre- and post-treatment.</p><p><b>RESULTS</b>gummy smile of all patients involved in the study was reduced by intruding upper incisors and canines, and the average period for intruding about 9.8 months. According to the analysis of the golden facial mask, the reasons of gummy smile in different patients were different before treatment. However, the lips, teeth and gingiva were almost coincident with the golden facial mask after treatment.</p><p><b>CONCLUSIONS</b>analyzing the relationship among lip, teeth and gingiva by the golden facial mask, the inprovement of gummy smile by using mini-screw implants to intrude the upper incisors can be evaluated.</p>

A retrospective study for vertical control with high-pull headgear in the treatment of high angle cases / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To assess the effectiveness of vertical control with high-pull headgear in the treatment of high angle cases.</p><p><b>METHODS</b>Forty high angle cases (MP-SN >40 degrees) were included in this study and all the patients were treated with extraction. Twenty patients in the study group and control group, respectively. Totally 14 cephalometric measurements were selected for the assessment Paired t-test and independent t-test were used in the analysis.</p><p><b>RESULTS</b>No significant differences were found between the two groups (P > 0.05). In the study group, after treatment Y angle, MP-SN angle, MP-FH angle and U6-PP distance increased 1.9 degrees, 1.5 degrees, 2.3 degrees and 1.1 mm, respectively (P < 0.01).</p><p><b>CONCLUSIONS</b>High-pull headgear could not provide effective vertical control in high angle cases.</p>

Intruding upper incisors using mini-screw anchorage in patients with gummy smile / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the effectiveness of mini-screw anchorage on intruding upper incisors in patients with gummy smile.</p><p><b>METHODS</b>Sixteen female patients (mean age: 23.8 years) were involved in this study. The mini-screws were placed between upper lateral incisors and canines on both sides for intruding upper incisors together with fixed appliance. The cephalometric analysis was carried out.</p><p><b>RESULTS</b>Totally 63 teeth in 16 patients were intruded successfully and the deep overbite was decreased by (2.74 +/- 2.00) mm (P < 0.001). The distance from the edge of the upper incisor to palatal plane was reduced by (5.00 +/- 2.76) mm (P < 0.001), and the incisors were proclined by (9.34 +/- 10.06) degrees (P < 0.01). The duration for intrusion was 10.8 months on average.</p><p><b>CONCLUSIONS</b>It was practicable and effective to improve gummy smile by intruding upper incisors with mini-screw implant.</p>

A clinical study on orthodontic treatment after tooth autotransplantation / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the pulp vitality, the periodontal condition and the success rate of autotransplanted teeth after orthodontic treatment.</p><p><b>METHODS</b>A total of 20 permanent teeth (one of them had been treated by root canal therapy), 17 with completely developed roots and 3 with developing roots, were autotransplanted to the region of missing teeth in 16 admitted patients. Orthodontic treatment was carried out in all cases. Clinical and radiographic evaluation of the transplanted teeth was done.</p><p><b>RESULTS</b>The average time of postoperative orthodontic treatment was 1.9 months. In all, one autotransplanted tooth was lost because of periodontal disease during follow-up. Eight autotransplanted ones had positive electric pulp testing (EPT) response. Fifteen out of 20 autotransplanted teeth were surrounded by newly-formed periodontal space with normal size and lamina dura. The numbers of surviving and successful autotransplanted teeth were 19 and 15, respectively, after an average observation period of 24.5 months.</p><p><b>CONCLUSIONS</b>Orthodontic treatment of autotransplanted teeth was acceptable and the pulp vitality of the teeth might be preserved.</p>

Clinical trial on intrusion of overerupted maxillary molars with microscrew / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the imtrusion of overerupted molars with microscrews as anchorage.</p><p><b>METHODS</b>Thirteen adult patients were treated with microscrew anchorage and fixed appliances. Twenty-three overerupted posterior maxillary teeth were intruded. The intrusive movement was investigated on cephalometric radiographs.</p><p><b>RESULTS</b>The molars were intruded and the occlusal plane was corrected successfully in all patients. The treatment period of intrusion was from 5 to 18 months (mean 10.4 months). Significant true intrusion of overerupted maxillary molars, ranged from 0.45 mm to 7.00 mm [mean (2.86 +/- 1.80) mm], was achieved (P < 0.001). The apical root resorption was not clinically significant and the bone level was unchanged.</p><p><b>CONCLUSIONS</b>The microscrew anchorage and fixed appliances were applicable and efficacious for intrusion of overerupted maxillary molars.</p>