Extracellular Matrix Mediates BMP-2 in a Model of Temporomandibular Joint Osteoarthritis.

Temporomandibular joint (TMJ) osteoarthritis (OA) is a complex disease that affects both cartilage and subchondral bone. It is accompanied by loss of extracellular matrix (ECM) and may be controlled by bone morphogenetic protein-2 (BMP-2). We analyzed the effect of BMP-2 in both cartilage and subchondral bone in a TMJ-OA animal model that is deficient in biglycan (Bgn) and fibromodulin (Fmod) (Bgn-/-Fmod-/-). Whole mandibles were dissected from 3-week-old wild-type (WT) and Bgn-/-Fmod-/- mice and incubated with and without 250 µg/mL BMP-2 for 2 days using an explant culture system. Condyle growth was measured by microCT and the expression levels of cartilage and bone-related genes were analyzed using RT-PCR or by immunohistochemistry from condyles that contained an intact cartilage/subchondral bone interface. Osteoclast activity was estimated by tartrate-resistant acid phosphatase (TRAP) staining and by TRAP, Rankl, and Adamts4 mRNA expression levels. Our results showed that most parameters examined were slightly up-regulated in WT samples treated with BMP-2, and this up-regulation was significantly enhanced in the Bgn-/-Fmod-/- mice. The up-regulation of both catabolic and anabolic agents did not appear to positively affect the overall growth of Bgn-/-Fmod-/- condyles compared to WT controls. In summary, the up-regulation of both anabolic and catabolic genes in the WT and Bgn-/-Fmod-/- TMJs treated with BMP-2 suggests that BMP increases matrix turnover in the condyle, and, further, that Bgn and Fmod could have protective roles in regulating this process.

Effects of Neodymium-Doped Yttrium Aluminium Garnet (Nd:YAG) Laser Irradiation on Bone Metabolism During Tooth Movement.

INTRODUCTION: The aim of this study is to evaluate the effects of low-level neodymium-doped yttrium aluminium garnet (Nd:YAG) laser irradiation on orthodontic tooth movement and histological examination. METHODS: Eleven male Wistar rats (aged 10 weeks) were included. To produce experimental tooth movement in rats, 10 g force was applied to maxillary first molars with nickel titanium closed coil springs. Right molars were irradiated with Nd:YAG laser on days 0, 1, 2, 3, 7, 10, 14, 17, 21 and 24, while un-irradiated left molars were used as control. Distance between mesial side of second molar and distal side of first molar was measured on µCT image during tooth movement and the rats were sacrificed 4 weeks after the initiation of tooth movement. RESULTS: The amount of tooth movement was significantly greater in the irradiation group (0.20 ± 0.06) than in the control group (0.14 ± 0.03) during the first week (P < 0.05). However, no statistically significant difference was found afterwards. There was a tendency of higher tartrate-resistant acid phosphatase (TRAP)-positive nuclei count in the pressure zones of the laser irradiation group, but it was not statistically significant. In immuno-histological examination, expressions of alkaline phosphatase (ALP) and receptor activator of nuclear factor kappa-B ligand (RANKL) were higher at the pressure site of the laser irradiation group than the control group, whereas there was no difference in osteoprotegerin (OPG) expression. CONCLUSION: The results suggest that low-level Nd:YAG laser may stimulate osteoclast and osteoblast activation and accelerate bone metabolism during tooth movement.

Role of articular disc in condylar regeneration of the mandible.

The articular disc in the temporomandibular joint plays an important role in mandibular growth. Functional appliances induce regeneration of the condyle even after condylectomy. The aim of this study was to examine the role of the articular disc in regeneration of the condyle after unilateral condylectomy with use of a functional appliance in growing rats. Fifty growing rats were subjected to unilateral condylectomy and then half of them underwent discectomy. The functional appliance was applied to half of the rats in each group to induce regeneration of the condyle. Four and eight weeks later, morphometric and histologic analyses of the mandible were performed. Regeneration of the condyle was demonstrated in the two condylectomy groups. In the condylectomy+appliance group, the shape and cartilage of the condyle were equivalent to a normal condyle. However, regeneration of the condyle was not observed in the two discectomy groups even with the use of the functional appliance. The articular disc appears to be crucial in the regeneration of a damaged condyle, suggesting that defects or damage to the articular disc may influence mandibular growth and regeneration or repair of the condyle.

Factors related to stability following the surgical correction of skeletal open bite.

OBJECTIVES: If a skeletal anterior open bite malocclusion is treated by orthognathic surgery directed only at the mandible, the lower jaw is repositioned upward in a counter-clockwise rotation. However, this procedure has a high risk of relapse. In the present study, the key factors associated with post-surgical stability of corrected skeletal anterior open bite malocclusions were investigated. MATERIAL AND METHODS: Eighteen orthognathic patients were subjected to cephalometric analysis to assess the dental and skeletal changes following mandibular surgery for the correction of an anterior open bite. The patients were divided into two groups, determined by an increase or decrease in nasion-menton (N-Me) distance as a consequence of surgery. Changes in overbite, the displacements of molars and positional changes in Menton were evaluated immediately before and after surgery and after a minimum of one year post-operatively. RESULTS: The group with a decreased N-Me distance exhibited a significantly greater backward positioning of the mandible. The group with an increased N-Me distance experienced significantly greater dentoalveolar extrusion of the lower molars. CONCLUSIONS: A sufficient mandibular backward repositioning is an effective technique in the prevention of open bite relapse. In addition, it is important not to induce molar extrusion during post-surgical orthodontic treatment to preserve stability of the surgical open bite correction.

Changes in the lip-line in asymmetrical cases treated with isolated mandibular surgery.

OBJECTIVE: The aim of this study was to investigate changes in the lip-line in asymmetrical cases treated with mandibular osteotomy alone. DESIGN: Retrospective study. SETTING: Hiroshima University Institute of Biomedical & Health Sciences, Hiroshima, Japan METHODS: The subjects in this study consisted of 30 patients with an altered lip-line inclination who underwent isolated mandibular osteotomy (bilateral or unilateral sagittal split ramus osteotomy or intraoral vertical ramus osteotomy) as part of their surgical correction. Frontal cephalograms and facial photographs, taken at the first examination and after treatment, were used to measure changes in the inclination of the lip-line and cant of the occlusal plane, as well as the lateral deviations of hard and soft tissue Menton. RESULTS: Inclination of the lip-line after active treatment was significantly improved compared with that before treatment. Menton on the hard and soft tissues after active treatment also experienced a significant improvement compared with its position at first examination. CONCLUSIONS: One-jaw mandibular osteotomy is able to improve the inclination of the lip-line even in the presence of an occlusal cant. The inclination of the lip-line is corrected in association with sufficient lateral movements of Menton on the mandible.

Uprighting of severely impacted mandibular second molars: a case report.

INTRODUCTION: The incidence of mandibular first and second molar impaction is increasing but still recorded as rare. Treatment methods involving uprighting, extraction, or autologous tooth transplantation have been described. AIM: The present study describes the uprighting of 3 impacted mandibular second molars presenting with eruptive disorders. METHODS: The application of limited and appropriate orthodontic therapy completed treatment in 11 months, 5 months, and 2 years and 3 months, respectively. Although no absolute anchorage in the form of miniscrews was required, no significant anchorage demands were considered necessary. Although the third molar tooth germs were identified and preserved in each case, no adverse influence on the uprighting of the second molars was encountered. RESULTS: The favourable molar repositioning results were likely due to the youth of the 3 patients as the third molars were in early development and bone remodelling was marked. Furthermore, no problems related to anchorage or alveolar bone loss were identified after treatment. CONCLUSION: The results indicated the benefits of limited orthodontic treatment and early intervention for the uprighting of impacted mandibular second molars.

Changes in cortical bone mineralization in the mouse mandible with regenerated condyle.

The objective of this study was to evaluate the effects of condylectomy and of a functional appliance on the mineral content, density, and area of the mandibular cortical bone in a growing mouse model. In the condylectomy group, a unilateral condylectomy was performed on the right side of the mouse mandible. In the condylectomy + appliance group, a functional appliance was used to reposition the mandible after the unilateral condylectomy. All mice were killed 4 wk after surgery. Each mandible was then subjected to analyses of cortical bone mineral content (CRT_CNT), cortical bone density (CRT_DEN), and cortical bone area (CRT_A) by peripheral quantitative computed tomography (pQCT). The CRT_CNT, CRT_DEN, and CRT_A values were significantly lower in the condylectomized mandible (right side) than in the non-condylectomized mandible (left side). However, in the condylectomized animals in which a functional appliance was used, the CRT_CNT, CRT_DEN, and CRT_A values became higher than those in the mice treated with condylectomy alone. No significant differences were found in the CRT_CNT, CRT_DEN, and CRT_A between non-condylectomized (left side) mandibles, mandibles treated with condylectomy + functional appliance (right side), and control mandibles. It was thus shown that a functional appliance used to reposition the condylectomized mandible forward in a symmetric position induced improvement of the cortical bone in a mouse model in terms of cortical bone mineral content, density, and area.

Activation of the hypoxia-inducible factor-1 in overloaded temporomandibular joint, and induction of osteoclastogenesis.

Vascular endothelial growth factor (Vegf) was previously shown to be expressed specifically in the condylar cartilage of temporomandibular joint-osteoarthritis (TMJ-OA) model rats. Here we demonstrate for the first time that hypoxia-inducible factor-1alpha (Hif-1alpha) is activated in mature chondrocytes of temporomandibular joint-osteoarthritis (TMJ-OA) model rat by mechanical overload, and that activated Hif-1 in chondrocytes can induce osteoclastogenesis via repression of osteoprotegerin (Opg) expression. In rat TMJs, degeneration of the condylar cartilage became prominent in proportion to the duration of overloading. Hif-1alpha expression was observed specifically in mature and hypertrophic chondrocytes, and Hif-1alpha-positivity, level of Vegf expression, and tartrate-resistant acid phosphatase (TRAP)-positive cell numbers all increased in the same manner. When ATDC5 cells induced differentiation by insulin were cultured under hypoxia, Hif-1alpha induction was observed in mature stage, but not in immature stage. Inductions of Hif-1-target genes showed a similar expression pattern. In addition, expression of Opg decreased in hypoxia, and Hif-1alpha played a role, in part, in its regulation.

Dynamic shear properties of the porcine molar periodontal ligament.

The role of the periodontal ligament (PDL) is to support the tooth during function and resist external forces applied to it. The dominant vertical component of these forces is associated with shear in the PDL. Little information, however, is available on the dynamic behavior of the PDL in shear. Therefore, the present study was designed to determine the dynamic shear properties of the PDL in the porcine molar (n=10). From dissected mandibles transverse sections of the mesial root of the first molar were obtained at the apical and coronal levels and used for dynamic shear tests. Shear strain (0.5%, 1.0%, and 1.5%) was applied in superoinferior direction parallel to the root axis with a wide range of frequencies (0.01-100 Hz). The dynamic complex and storage moduli increased significantly with the loading frequency, the dynamic loss modulus showed only a small increase. The dynamic elasticity was significantly larger in the coronal region than in the apical region although the dynamic viscosity was similar in both regions. The present results suggest that non-linearities, compression/shear coupling, and intrinsic viscoelasticity affect the shear material behavior of the PDL, which might have important implications for load transmission from tooth to bone and vice versa.