Intraoral approach for the treatment of non­infiltrating angiolipoma of the floor of the mouth in an elderly patient: A case report with review of the literature.

A 75-year-old male patient visited Gangneung-Wonju National University Dental Hospital (Gangneung, South Korea) with a 35-mm fluctuant lesion on the floor of the mouth. It was a dome-shaped exophytic lesion with its top on Wharton's duct orifice area. The encapsulated lesion was excised cautiously and the final diagnosis was non-infiltrating angiolipoma. To the best of our knowledge, this is the first report of an intraoral approach for the treatment of a non-infiltrating angiolipoma on the floor of the mouth in an elderly patient. Differentiating it from a ranula is essential for the surgical approach and, as there is a higher transition to infiltrating angiolipoma, definite treatment should be considered in elderly patients.

Administration of 4­hexylresorcinol increases p53­mediated transcriptional activity in oral cancer cells with the p53 mutation.

The p53 mutation is inherent in over 50% of human cancers. In head and neck squamous cell carcinoma, the p53 mutation is associated with a poor prognosis. 4­Hexylresorcinol (4HR) is a pharmacologic chaperone. The present study aimed to investigate the effect of 4HR on p53 transcriptional activity in oral carcinoma cells with p53 mutations. To identify conformational changes induced by 4HR administration, peptides including the DNA­binding domain from mutant and wild­type p53 were synthesized, and Fourier transform infrared spectroscopy was performed. To determine the effect of 4HR on p53 mutant carcinoma cells, western blot analysis, p53 transcriptional activity analysis, MTT assay and apoptosis immunocytochemistry were performed. The YD­15 cell line has a mutation in the DNA binding domain of p53 (Glu258Ala). When p53 Ala­258 was coupled by 4HR, the p53 Ala­258 structure lost its original conformation and approached a conformation similar to that of p53 Glu­258. In the cell experiments, 4HR administration to p53 mutant cells increased p53 transcriptional activity and the expression levels of apoptosis­associated proteins such as B­cell lymphoma 2 (BCL2), BCL2­associated X (BAX) and BCL2­associated agonist of cell death (BAD). Accordingly, 4HR administration on YD­15 cells decreased cell viability and increased apoptosis. In conclusion, 4HR is a potential substance for use in the recovery of loss­of­function in mutant p53 as a pharmacologic chaperone.

4-Hexylresorcinol Treatment before Degumming Increases the ß-Sheet Structure of Silk Sericin and BMP-2 Expression in RAW264.7 Cells.

Silk sericin is a degumming product used by the silk industry. The degumming process can affect the protein structure and molecular weight of silk sericin. The present study examined how pretreatment with 4-hexylresorcinol (4HR) affects the biomedical properties of silk sericin. Before the degumming process, silkworm cocoons were treated with 4HR solution. The protein structure of the final degumming product was evaluated by Fourier transform infrared spectroscopy (FT-IR) and scanning electron microscopy. Untreated silk sericin (S) and silk sericin pretreated with 4HR (S+4HR) were added to RAW264.7 cells, and the expression of BMP-2 was determined. The bone-regenerating capacity of S+4HR was evaluated using the critical-sized rat calvarial defect model. Compared with S, S+4HR showed an increase in ß-sheet structures. Administration of S+4HR to RAW264.7 cells increased expression of BMP-2, mainly via the TLR-mediated signaling pathway. Bone volume, as measured by micro-computerized tomography, was significantly greater in the S+4HR group than in the S, gelatin alone, and unfilled control groups (p < 0.05 each). Expression of BMP-2 and runx2 in tissue specimens was significantly higher following treatment with S+4HR than with S (p < 0.05). Taken together, these findings show that 4HR pretreatment before the degumming process increased the ß-sheet structure of silk sericin, as well as inducing BMP-2 expression and bone regeneration ability.

Silk sericin application increases bone morphogenic protein-2/4 expression via a toll-like receptor-mediated pathway.

Bone morphogenic protein-2/4 (BMP-2/4) is an osteoinductive protein that accelerates osteogenesis when administered to bony defects. Sericin is produced by silkworms, and has a biological activity that differs depending on the degumming method used. Our results indicated that the high molecular weight fraction of silk sericin (MW > 30 kDa) obtained via sonication had a more abundant ß-sheet structure than the low molecular weight fraction. Administration of the ß-sheet structure silk sericin increased BMP-2/4 expression in a dose-dependent manner in RAW264.7 cells and human monocytes. This sericin increased the expression levels of toll-like receptor (TLR)-2, TLR-3, and TLR-4 in RAW264.7 cells. Application of a TLR-2 antibody or TLR pathway blocker decreased BMP-2/4 expression following sericin administration. In the animal model, the bone volume and BMP-2/4 expression were higher in rats treated with a sericin-incorporated gelatin sponge than in rats treated with a gelatin sponge alone or a sponge-incorporated with denatured sericin. In conclusion, sericin with a more abundant ß-sheet structure increased BMP-2/4 expression and bone formation better than sericin with a less abundant ß-sheet structure.

The effect of 4-hexylresocinol administration on SCC-9 cells: mass spectrometric identification of proteins and cDNA microarray analysis.

BACKGROUND: In stress situations, bacteria produce dormancy-inducing factors to stop cell growth. The dormancy-inducing factors may have an inhibitory effect on tumor cell growth. Here we analyzed the differentially expressed protein profiles after 4-hexylresorcinol (4HR), one of the dormancy-inducing factors, administration using in vitro oral squamous carcinoma cells (SCC-9). METHOD: The control group was SCC-9 cells culture without 4HR administration. The experimental group received 10 µg/mL of 4HR. Collected proteins from each group were loaded for 2D electrophoresis. Among the separated proteins, 20 differentially expressed proteins were selected and processed for LC-MS/MS. RESULTS: In proteomic analysis, the expression of keratin 1, keratin 10, and histone H2B were increased. In cDNA microarray assay, the genes related to the cellular differentiation (involucrin, keratin 13, 14) were highly expressed in the 4HR treated group (fold ratio > 2.0; Table 2). Interestingly, histone family was upregulated in the cDNA microarray assay. CONCLUSION: The administration of 4HR on SCC-9 cells increased epithelial cell differentiation markers and histone.

Surgery-first approach reduces the overall treatment time without damaging long-term stability in the skeletal class III correction: a preliminary study.

BACKGROUND: Compared to the conventional approach, including preoperative orthodontic preparation, the so-called surgery-first approach (SFA) seems to reduce the overall treatment time in the correction of skeletal class III dentofacial deformity. However, there have been controversies about postoperative skeletal stability with SFA. Therefore, we investigated the long-term stability and the overall treatment time after maxillomandibular surgery for skeletal class III correction with or without preoperative orthodontic preparation. METHODS: This retrospective study included eight patients who underwent maxillomandibular surgery for class III correction with the SFA (SFA group) and 20 patients who underwent the conventional approach (CA group). A comparative study of the change in the maxillary and mandibular position on preoperative (T1), 1-day (T2), 6-month (T3), and 2-year (T4) postoperative lateral cephalograms. We calculated the overall treatment time for each group. RESULTS: At the presurgical stage (T1), there was no bias in the skeletal features between the two groups. In the surgical change from T1 to T2, the mandible (point B) of the CA group was significantly moved superiorly. Short-term changes from T2 to T3 revealed that the mandible moved forward in both groups, whereas the maxillary position showed no significant changes. Long-term changes from T3 to T4 demonstrated that none of the measured parameters showed any significant differences. Finally, the average of overall treatment time was 15.1 months in the SFA group and 26.0 months in the CA group. CONCLUSIONS: These findings suggest that SFA in bimaxillary orthognathic surgery for skeletal class III correction leads to predictable long-term skeletal stability, similar to surgery with CA. Furthermore, SFA reduced the overall treatment time compared to CA.

Increased Level of Vascular Endothelial Growth Factors by 4-hexylresorcinol is Mediated by Transforming Growth Factor-ß1 and Accelerates Capillary Regeneration in the Burns in Diabetic Animals.

4-Hexyl resorcinol (4HR) is an organic compound and has been used in skin care application. 4HR is an M2-type macrophage activator and elevates vascular endothelial growth factor (VEGF) expression via the hypoxia-inducible factor (HIF)-independent pathway. As endothelial cells are important in wound healing, the human umbilical vein endothelial cells (HUVECs) were treated with 4HR, and changes in VEGF-A, -C, and transforming growth factor-ß1 (TGF-ß1) expression were investigated. The administration of 4HR increased the expression level of VEGF-A, -C, and TGF-ß1. The application of TGF-ß1 protein also increased the expression level of VEGF-A and -C. Knockdown with small interfering RNA (siRNA) targeting to TGF-ß1 and the selective chemical inhibition (A83-01) to ALK5 confirmed the involvement of the TGF-ß signaling pathway in the 4-HR-mediated VEGFs expression. 4HR application in a burn model of diabetic rats demonstrated an increased level of angiogenic proteins with wound healing. Compared to sericin application, the 4HR application group showed more prominent capillary regeneration. Collectively, 4HR activated TGF-ß1/ALK5/VEGFs signaling in endothelial cells and induced vascular regeneration and remodeling for wound healing.

Botulinum toxin-A injection into the anterior belly of the digastric muscle for the prevention of post-operative open bite in class II malocclusions: a case report and literature review.

BACKGROUND: Class II malocclusion patients with hyperdivergent facial types are characterized by short mandibular body lengths and anterior open bite. Accordingly, the treatment for hyperdivergent skeletal class II malocclusion is a lengthening of the mandibular body length and a counterclockwise rotation of the mandible. To prevent post-operative relapse, botulinum toxin-A (BTX-A) injection can be a retention modality. CASE PRESENTATION: A class II open-bite patient received BTX-A injection to the anterior belly of her digastric muscle for the prevention of post-operative relapse. The relapse was evaluated via a clinical examination and a lateral cephalometric radiograph after the completion of post-surgical orthodontic treatment. The patient showed stable occlusion without any signs of relapse at 15 months post-operatively. CONCLUSION: In this case presentation, a single injection into the anterior belly of the digastric muscle was sufficient for the prevention of post-operative open bite.

The effect of botulinum toxin-A injection into the masseter muscles on prevention of plate fracture and post-operative relapse in patients receiving orthognathic surgery.

BACKGROUND: Botulinum toxin-A (BTX-A) injection into muscle reduces muscular power and may prevent post-operative complication after orthognathic surgery. The purpose of this study was (1) to evaluate BTX-A injection into the masseter muscle on the prevention of plate fracture and (2) to compare post-operative relapse between the BTX-A injection group and the no injection group. METHODS: Sixteen patients were included in this study. Eight patients received BTX-A injection bilaterally, and eight patients served as control. All patients received bilateral sagittal split ramus osteotomy for the mandibular setback and additional surgery, such as LeFort I osteotomy or genioplasty. Post-operative plate fracture was recorded. SNB angle, mandibular plane angle, and gonial angle were used for post-operative relapse. RESULTS: Total number of fractured plates in patients was 2 out of 16 plates in the BTX-A injection group and that was 8 out of 16 plates in the no treatment group (P = 0.031). However, there were no significant differences in post-operative changes in SNB angle, mandibular plane angle, and gonial angle between groups (P > 0.05). CONCLUSIONS: BTX-A injection into the masseter muscle could reduce the incidence of plate fracture.

The effect of 4-hexylresorcinol on xenograft degradation in a rat calvarial defect model.

BACKGROUND: The objective of this study was to evaluate xenograft degradation velocity when treated with 4-hexylresorcinol (4HR). METHODS: The scapula of a cow was purchased from a local grocery, and discs (diameter 8 mm, thickness 1 mm) were prepared by trephine bur. Discs treated with 4HR were used as the experimental group. Untreated discs were used as the control. X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), antibacterial test, endotoxin test, and scanning electron microscopy (SEM) were performed on the discs. In vivo degradation was evaluated by the rat calvarial defect model. RESULTS: The XRD and FT-IR results demonstrated successful incorporation of 4HR into the bovine bone. The experimental disc showed antibacterial properties. The endotoxin test yielded results below the level of endotoxin contamination. In the SEM exam, the surface of the experimental group showed needle-shaped crystal and spreading of RAW264.7 cells. In the animal experiments, the amount of residual graft was significantly smaller in the experimental group compared to the control group (P = 0.003). CONCLUSIONS: In this study, 4HR was successfully incorporated into bovine bone, and 4HR-incorporated bovine bone had antibacterial properties. In vivo experiments demonstrated that 4HR-incorporated bovine bone showed more rapid degradation than untreated bovine bone.