A two-year retrospective study on traumatic dental injury in the primary dentition.

The aim of this study was to analyze the causes, clinical characteristics, social factors, and current status of treatment of traumatic dental injury (TDI) in the primary dentition. A retrospective analysis was performed on 144 children (213 teeth) with TDI in the primary dentition from our hospital between December 2017 and June 2020. Data were analyzed using the chi-square test and the Mann-Withney-Wilcoxon test. Boys accounted for 68.1% (98/144) and girls for 31.9% (46/144) of all 144 children with TDI in the primary dentition, with a boy-girl ratio of 2.13:1. The primary age of TDI in deciduous teeth was 2 to 4 years old, accounting for 59% of all cases. Collision with others and fall were the 2 main causes of trauma to the deciduous teeth, making up 52.1% and 44.4% of all causes, respectively. Crown fracture injury was the most common type of TDI in the primary dentition, accounting for 37% of all cases (53/144). Of the 144 cases, 17.4% (25/144) was accompanied by soft tissue laceration, while 22.2% (32/144) by swelling or contusion of tissue. Maxillary teeth (92.4%) were more vulnerable to injury than mandibular teeth (7.5%), with maxillary incisor being the most vulnerable 1 (91.5%). The percentage of children arrived at the hospital for treatment 24 hours after the injury was the highest (57.0%, 82/144). After the hospital visit, 74.3% of children received treatment for the dental trauma. In terms of the treatment modalities, extraction of the traumatized teeth (27.1%) and pulpectomy + resin filling (or preformed crown) restoration were predominant. Approximately 28.5% (41/144) of cases were reviewed within 2 years, with the proportion of children with pulpitis or periapical infection being the highest (29.3%, 12/41). Age, gender, collision, and fall are the factors linked to a higher risk of TDI in the primary dentition in children under the age of 7. Resin filling (or preformed crown) restoration and pulpectomy are effective in preserving the affected tooth and controlling infection. However, the preservation of the affected tooth and the prevention of infection may be hampered by late visits and low follow-up rates.

MiR-20a promotes osteogenic differentiation in bone marrow-derived mesenchymal stem/stromal cells and bone repair of the maxillary sinus defect model in rabbits.

Introduction: This study aimed to determine whether miR-20 promoted osteogenic differentiation in bone marrow-derived mesenchymal stem/stromal cells (BMSCs) and accelerated bone formation in the maxillary sinus bone defect model in rabbits. Methods: BMSCs were transfected with miR-20a or anti-miR-20a for 12 h, followed by detection of RUNX2, Sp7 mRNA, bone morphogenetic protein 2 (BMP2), and RUNX2 protein expression. Alkaline phosphatase (ALP) activity and Alizarin Red S staining were used to detect calcified nodule deposition. In the rabbit maxillary sinus bone defect model, miR-20a loaded with AAV and BMP2 protein were mixed with Bio-Oss bone powder for filling the bone defect. At 4 weeks and 8 weeks, bone density was detected by cone beam computed tomography (CBCT), and new bone, osteoblasts, and collagen type 1 were evaluated by hematoxylin and eosin (HE) staining and immunohistochemical (IHC) staining. Results: Overexpression of miR-20a enhanced the mRNA and protein levels of BMP2, RUNX2, and SP7, the activity of ALP, and the levels of matrix mineralization, whereas the levels and activity of the aforementioned factors were decreased by anti-miR-20a treatment of BMSCs. Furthermore, miR-20a significantly increased the bone density, the number of osteoblasts, and the secretion of collagen type 1 in bone defects compared with Bio-Oss bone powder in the rabbit maxillary sinus bone defect model. Conclusion: Overall, miR-20a can induce osteogenic differentiation in BMSCs and accelerate bone formation of maxillary sinus defects in rabbits.

Treatment of a mandibular functional shift in an adolescent boy with temporomandibular disorder and crossbites.

A mandibular functional shift usually poses a challenge for orthodontists, especially when it is accompanied by a temporomandibular disorder (TMD). Accurate diagnosis and complete elimination of the etiologic factors are the keys to an esthetic and stable outcome. This article describes the treatment of a teenager with a mandibular functional shift, TMD symptoms, and facial asymmetry resulting from an asymmetric maxillary arch form and multiple crossbites as occlusal interferences. The treatment alternatives and effective orthodontic techniques are described. To optimize the treatment results and prevent the recurrence of the TMD after treatment, the displaced mandible was repositioned by full-time wearing of a splint for 10 months. Adhesive bite-blocks were used to maintain the newly acquired mandibular position during fixed appliance treatment. A series of nickel-titanium and stainless steel rectangular archwires was placed in the maxillary arch to reshape it for 8 months after alignment. Finally, the displaced mandible was steadily seated into its physiologic position with fine occlusion. The TMD symptoms disappeared and never relapsed after treatment. At 2 years 3 months of retention, there was good stability. The combined splint and fixed appliance approach resolved an intractable clinical problem and avoided using additional appliances. An esthetic, functional, and stable outcome was achieved that satisfied both the patient and his parents.

miRNA expression profile during fluid shear stress-induced osteogenic differentiation in MC3T3-E1 cells.

BACKGROUND: Mechanical stress plays an important role in the maintenance of bone homeostasis. Current hypotheses suggest that interstitial fluid flow is an important component of the system by which tissue level strains are amplified in bone. This study aimed to test the hypothesis that the short-term and appropriate fluid shear stress (FSS) is expected to promote the terminal differentiation of pre-osteoblasts and detect the expression profile of microRNAs in the FSS-induced osteogenic differentiation in MC3T3-E1 cells. METHODS: MC3T3-E1 cells were subjected to 1 hour of FSS at 12 dyn/cm(2) using a parallel plate flow system. After FSS treatment, cytoskeleton immunohistochemical staining and microRNAs (miRNAs) were detected immediately. Osteogenic gene expression and immunohistochemical staining for collagen type I were tested at the 24th hour after treatment, alkaline phosphatase (ALP) activity assay was performed at 24th, 48th, and 72 th hours after FSS treatment, and Alizarin Red Staining was checked at day 12. RESULTS: One hour of FSS at 12 dyn/cm(2) induced actin stress fiber formation and rearrangement, up-regulated osteogenic gene expression, increased ALP activity, promoted synthesis and secretion of type I collagen, enhanced nodule formation, and promoted terminal differentiation in MC3T3-E1 cells. During osteogenic differentiation, expression levels of miR-20a, -21, -19b, -34a, -34c, -140, and -200b in FSS-induced cells were significantly down-regulated. CONCLUSION: The short-term and appropriate FSS is sufficient to promote terminal differentiation of pre-osteoblasts and a group of miRNAs may be involved in FSS-induced pre-osteoblast differentiation.

Mechanical loading induced expression of bone morphogenetic protein-2, alkaline phosphatase activity, and collagen synthesis in osteoblastic MC3T3-E1 cells.

BACKGROUND: Bone morphogenetic protein (BMP)-2, alkaline phosphatase (ALP), and collagen type I are known to play a critical role in the process of bone remodeling. However, the relationship between mechanical strain and the expression of BMP-2, ALP, and COL-I in osteoblasts was still unknown. The purpose of this study was to investigate the effects of different magnitudes of mechanical strain on osteoblast morphology and on the expression of BMP-2, ALP, and COL-I. METHODS: Osteoblast-like cells were flexed at four deformation rates (0, 6%, 12%, and 18% elongation). The expression of BMP-2 mRNA, ALP, and COL-I in osteoblast-like cells were determined by real-time quantitative reverse transcription polymerase chain reaction, respectively. The results were subjected to analysis of variance (ANOVA) using SPSS 13.0 statistical software. RESULTS: The cells changed to fusiform and grew in the direction of the applied strain after the mechanical strain was loaded. Expression level of the BMP-2, ALP, and COL-I increased magnitude-dependently with mechanical loading in the experimental groups, and the 12% elongation group had the highest expression (P < 0.05). CONCLUSION: Mechanical strain can induce morphological change and a magnitude-dependent increase in the expression of BMP-2, ALP, and COL-I mRNA in osteoblast-like cells, which might influence bone remodeling in orthodontic treatment.

Rapid tooth movement through distraction osteogenesis of the periodontal ligament in dogs.

BACKGROUND: Animal models are needed for the study of rapid tooth movement into the extraction socket through distraction osteogenesis of the periodontal ligament. METHODS: Modified distraction devices were placed on eight dogs between the first and third mandibular premolars on the left sides; similar placement of traditional straight wise appliances on the right sides served as the control. The experimental distractors were activated (0.25 mm/d) twice a day and the control devices were activated (100 g) for two weeks with consolidation periods at weeks two, three, six, and ten. Two dogs were sacrificed at each consolidation time point; rates and patterns of tooth movement, loss of anchorage, and periapical films were evaluated, and the affected premolars and surrounding periodontal tissues were decalcified and examined histologically. General observations, X-ray periapical filming and histology examination were performed. RESULTS: Distal movement ((3.66+/-0.14) mm) measured two weeks after modified distraction exceeded that achieved using the traditional device ((1.15+/-0.21) mm; P<0.05). Loss of anchorage was minimally averaged (0.34+/-0.06) mm and (0.32+/-0.07) mm in the experimental and control sides, respectively. By radiography, apical and lateral surface root resorptions on both sides were minimal. Alveolar bone lesions were never evident. Fibroblasts were enriched in periodontal ligaments and bone spicules formed actively along directions of distraction. CONCLUSIONS: The canine model is suitable for the study of rapid tooth movement through distraction osteogenesis of the periodontal ligament. The technique accelerates tooth movement, periodontal remodeling, alveolar bone absorption, and may induce fibroblast formation, as compared to the traditional orthodontic method, without adversely affecting root absorption, bone loss, tooth mobility and anchorage loss.