Condylar Resorption Following Compressive Mechanical Stress in Rabbit Model - Association of Matrix Metalloproteinases.

BACKGROUND/AIM: Idiopathic condylar resorption (ICR) is a morphological change of the condylar head that occurs following orthodontic treatment or orthognathic surgery. This complication is serious, as it can cause relapse after mandible treatment. The aim of this experimental study was to evaluate the mechanism of influence of condylar resorption on compressive mechanical stress in temporomandibular joint following a change in occlusal position by mandible advancement. MATERIALS AND METHODS: An osteotomy procedure at the midline of mandible was performed in 15 rabbits, with the left side moved forward by 3.5 mm. Advancement of the left side of the mandible resulted in compressive mechanical stress on condylar head on the left side. Samples were subjected to micro-computed tomography, histological staining and immunohistochemistry. RESULTS: The area and depth of anterior condylar resorption at two weeks were significantly different as compared to those at one week (p<0.05). TRAP staining confirmed the significantly largest number of TRAP-positive cells after two weeks (p=0.02), compared to one week. MMP-3 and MMP-13 immunostaining of the anterior condylar head at two weeks revealed high levels of both proteins from the surface to the deep layer of cartilage. CONCLUSION: Compressive mechanical stress following mandible advancement results in load on the anterior surface of the condylar head, which leads to bone resorption there, and induces MMP-3 and MMP-13 related to degradation of condylar head cartilage.

Impact of Dental Referral Prior to Elective Surgery on Postoperative Outcomes.

OBJECTIVES: Oral bacteria may contribute to postoperative infectious complications including postoperative pneumonia or surgical site infection. The aim of this study was to investigate the impact of preoperative dental care on postoperative outcomes among surgical patients under general anesthesia. DESIGN: Retrospective cohort study. SETTING AND PARTICIPANTS: We analyzed clinical records of major surgical patients at a university hospital between 2016 and 2018. Subjects were categorized into either the preoperative dental care group, those being referred to dentists by their surgeons based on an individual surgeon's judgment for dental care before surgery, or the control group. METHODS: The primary outcome was postoperative infectious complications. Secondary outcomes were postoperative inflammation markers (C-reactive protein and fever), and economic outcomes (postoperative length of hospital stay and medical expenses). As the main analysis, the average treatment effects of the preoperative dental care were obtained from the augmented inverse-probability weighting (AIPW) method with consideration of demographics and perioperative risk factors to estimate causal effect of the intervention from the observational data. Then, stratified analyses by age and surgical sites were conducted with the inverse-probability weighting and linear regression methods, respectively. RESULTS: In the AIPW estimation, compared with the control group, the care group saw a significantly lower rate of postoperative infection (average treatment effect -3.02) and shorter fever duration (-2.79 days). The stratified analysis by age revealed significant positive impact of dental care in all age groups, including the highest treatment effects observed among patients younger than 60. Also, treatment effect was observed in wider surgical sites than previously known. CONCLUSION/IMPLICATIONS: This study indicates a significant impact of preoperative dental care on preventing postoperative infection and inflammation. Along with old age or certain types of surgeries in which advantages of dental referral have been already known, preoperative dental referral could be beneficial for broader types of patients.

A comparative study on cephalometric differences in maxillofacial morphology between skeletal Class III cases with and without acromegaly: a pilot study.

OBJECTIVES: The most typical maxillofacial feature of patients with acromegaly is mandibular protrusion. This study aimed to determine differences in maxillofacial morphology between skeletal Class III patients with and without acromegaly using cephalometric analysis. METHODS: Cephalograms of 37 patients with acromegaly (Acro), 37 age-matched non-acromegalic patients with skeletal Class III malocclusion (C-III), and 37 age-matched Class I malocclusion patients (C-I; control) were retrospectively collected. The skeletal and dental morphology of each group was analyzed using cephalometric analysis, which included linear and angular measurements and facial profilograms. In addition, we analyzed diagnostic performance and cutoff values for discriminating acromegaly from skeletal Class III malocclusion using receiver operating characteristic (ROC) curve analysis. RESULTS: The mandibular ramus height was larger in the Acro group than in the other groups. The increase in L1/MP in the Acro group, which represented labial inclination of the mandibular central incisors, was the most characteristic feature in this study. ROC curve analysis indicated that a cutoff value of 88.4° for L1/MP had the highest diagnostic performance in discriminating acromegaly from non-acromegalic Class III malocclusion. CONCLUSIONS: Acromegaly was characterized by a greater degree of bimaxillary prognathism than was non-acromegalic Class III malocclusion. Focusing on labial inclination of the mandibular central incisors would be the most useful way to differentiate acromegaly from non-acromegalic Class III malocclusion.

Influence of oestrogen deficiency and excessive mechanical stress on condylar head of mandible.

OBJECTIVE: We assessed the aetiology of idiopathic condylar resorption by examining the effects of oestrogen and compressive mechanical stress under a low systemic oestrogen condition in temporomandibular joints (TMJ) caused by an ovariectomy. MATERIALS AND METHODS: Female rabbits were divided into non-ovariectomy (non-OVX) and ovariectomy (OVX) groups. A cortical osteotomy was performed with a custom device that was increased in length by 0.25 mm every 12 hr for 1 week after the operation, during which the TMJs in the rabbits received compressive mechanical stress. Samples from both groups were examined with micro-computed tomography and histological staining. RESULTS: Area and depth of bone resorption were both greater in the OVX group. Furthermore, a significantly earlier and greater prevalence of sub-condylar bone resorption was noted in that group, while cells positive for tartrate-resistant acid phosphatase were increased in the OVX group. CONCLUSIONS: The present findings suggest that oestrogen induced a much greater amount of bone resorption on the anterior surface of the condylar head at an earlier stage in the TMJs of the present model rabbits. Thereafter, restoration of TMJ function appeared to occur in a normal manner.

Effect of exposure parameters and gutta-percha cone size on fracture-like artifacts in endodontically treated teeth on cone-beam computed tomography images.

OBJECTIVES: To ascertain the effects of exposure parameters (tube current and tube voltage) and the gutta-percha cone (GPC) size on root fracture-like artifacts obtained with cone-beam computed tomography (CBCT). METHODS: Fracture-like artifacts appearing on CBCT images of nine extracted human mandibular premolars filled with GPCs of size #50 or #80 were analyzed using six exposure factors: two tube voltages (80 kV and 110 kV); and three tube currents (4 mA, 7 mA, and 10 mA). On axial images, the gray value (GV) was recorded at three points: the mesiobuccal portion (MBP) as the sound dentin, the mesial portion (MP) as the artifact line, and the water area (WA). The rate of decrease in the GV (RDGV) of the artifact line was calculated using the formula: RDGV (%) = (GV of MBP - GV of MP) × 100/(GV of MBP - GV of WA). RESULTS: Comparison of the #80 group and the #50 group with equal tube voltages and tube currents shows that artifact lines in the #80 group were more obvious than those in the #50 group. The artifact lines with 80 kV were markedly more visible than those with 110 kV for each tube current and GPC size. Tube current changes did not affect the artifact line for any tube voltage or GPC size. CONCLUSIONS: For the reduction of artifacts, we recommend selection of higher tube voltages and lower tube currents when taking CBCT images of teeth with each GPC size.

Detection of EGFR Gene Mutation by Mutation-oriented LAMP Method.

BACKGROUND/AIM: Epidermal growth factor receptor (EGFR) is a target of molecular therapeutics for non-small cell lung cancer. EGFR gene mutations at codons 746-753 promote constitutive EGFR activation and result in worst prognosis. However, these mutations augment the therapeutic effect of EGFR-tyrosine kinase inhibitor. Therefore, the detection of EGFR gene mutations is important for determining treatment planning. The aim of the study was to establish a method to detect EGFR gene mutations at codons 746-753. MATERIALS AND METHODS: EGFR gene mutation at codons 746-753 in six cancer cell lines were investigated. A loop-mediated isothermal amplification (LAMP)-based procedure was developed, that employed peptide nucleic acid to suppress amplification of the wild-type allele. RESULTS: This mutation-oriented LAMP can amplify the DNA fragment of the EGFR gene with codons 746-753 mutations within 30 min. Moreover, boiled cells can work as template resources. CONCLUSION: Mutation oriented-LAMP assay for EGFR gene mutation is sensitive on extracted DNA. This procedure would be capable of detecting EGFR gene mutation in sputum, pleural effusion, broncho-alveolar lavage fluid or trans-bronchial lung biopsy by chair side.

Factors Affecting the Occurrence of Complications in the Early Stages After Dental Implant Placement: A Retrospective Cohort Study.

OBJECTIVE: To evaluate the background factors related to the occurrence of complications in the early stages after dental implant placement. MATERIALS AND METHODS: A total of 289 outpatients who received dental implants were retrospectively evaluated for the presence or absence of complications. Background factors, including age, sex, implant width, implant length, implant site, number of implants placed, Periotest values at the time of implant placement, presence/absence of systemic disease (particularly diabetes), and the use of anticoagulation therapy, were compared between patients with and without complications. Logistic regression analysis was performed to identify significant risk factors for the occurrence of complications after dental implant placement. RESULTS: Complications in the early stages after dental implant placement occurred in 25 (8.65%) patients. The patients with complications were older than those without complications (P = 0.003). In addition, the incidence of complications was significantly higher in patients with systemic diseases (P = 0.004) and in those receiving anticoagulation therapy (P = 0.005). Logistic regression analysis revealed that age was a significant risk factor (P = 0.025) for early-stage complications, whereas the number of implants, presence of diabetes, and the use of anticoagulation therapy were not significant risk factors. CONCLUSIONS: Our results show that age is a significant factor influencing the occurrence of complications in the early stages after dental implant placement. Therefore, clinicians should consider this factor when developing their treatment strategies.

Rapid and Specific Screening Assay for KRAS Oncogene Mutation by a Novel Gene Amplification Method.

BACKGROUND: Epidermal growth factor receptor (EGFR) is a target of molecular therapeutics for colorectal cancer. However, mutation of Kirsten rat sarcoma viral oncogene homolog (KRAS) gene at codons 12 and 13 attenuates the therapeutic effect of anti-EGFR therapies. Therefore, the detection of KRAS gene mutation is important for therapeutic decision-making. MATERIALS AND METHODS: KRAS gene mutation at codons 12 (c.34G>T, c.35G>C, c.35G>A) and 13 (c.38G>A) in six cancer cell lines were investigated. A loop-mediated isothermal amplification-based procedure was developed that employed peptide nucleic acid to suppress amplification of the wild-type allele. RESULTS: This mutation-oriented gene-amplification procedure can amplify the DNA fragment of the KRAS gene with codon 12 and codon 13 mutation within 30 min. Moreover, boiled cells can work as template resources. CONCLUSION: This newly developed procedure can be useful for patient stratification for anti-EGFR therapies.

Insulin-Like Growth Factor I Inhibits Alveolar Bone Loss Following Tooth Extraction in Rats.

BACKGROUND: Alveolar bone is often lost after tooth extraction. Few studies have assessed the longitudinal changes in bone volume that occur within these extraction sites. PURPOSE: To investigate the longitudinal morphological changes in extraction sockets following sustained continuous subcutaneous infusion of human recombinant insulin-like growth factor I (IGF-I). MATERIALS AND METHODS: Fourteen rats were subjected to right mandibular first molar extraction. Experimental rats (n = 7) received a continuous subcutaneous infusion of human recombinant IGF-I (320 mg/day) for 3 weeks by osmotic minipump. Control animals were treated with saline via the same method (n = 7). All rats were then housed for an additional 3 weeks. Micro-CT scanning was performed immediately after tooth extraction and at 1, 2, 3, and 6 weeks after extraction. RESULTS: New bone formation was markedly higher in the IGF-I-treated group as compared with the control group. The loss in alveolar ridge height in the IGF-I group was significantly lower than that in the control group at each time point after extraction on the buccal side and at 2, 3, and 6 weeks on the lingual side. CONCLUSIONS: IGF-I treatment increases the volume of newly formed bone and reduces the loss in alveolar ridge height following tooth extraction.

Blue-violet light-emitting diode irradiation in combination with hemostatic gelatin sponge (Spongel) application ameliorates immediate socket bleeding in patients taking warfarin.

OBJECTIVE: The control of bleeding after tooth extraction is a major concern in patients taking warfarin. Light-emitting diode (LED) irradiation with hemostatic gelatin sponge application was investigated. STUDY DESIGN: Patients who took warfarin and required tooth extraction were divided randomly into 3 groups. The first group was irradiated with blue-violet LED after tooth extraction. The second group was treated with a hemostatic gelatin sponge and LED irradiation. The third group was treated with only hemostatic gelatin sponges. Hemostasis was evaluated at 30 seconds after treatment. RESULTS: Less than 30% of the patients achieved hemostasis within 30 seconds in the hemostatic sponge group; approximately 50% of the patients in the simple LED irradiation group achieved hemostasis within 30 seconds; and 86.7% of the patients in the LED and hemostatic sponge combined group achieved hemostasis within 30 seconds, indicating that combined treatment with LED and hemostatic sponges provided a significantly higher hemostasis than in the hemostatic sponge group (P < .01). CONCLUSIONS: Blue-violet LED irradiation combined with hemostatic gelatin sponge treatment yielded hemostasis of the extraction socket within 30 seconds without suture in most cases.