Piezocision Through Computer-Guided Navigation.

Numerous surgical techniques have been developed as effective means to facilitate orthodontic treatment, although they may cause significant postoperative discomfort. Piezocision was established as a flapless and minimally invasive technique to accelerate orthodontic tooth movement by combining small vertical incisions and piezoelectric corticotomies. Computed tomography has been combined with the piezocision technique to fabricate computer-aided design and computer-aided manufacturing (CAD/CAM) surgical guides to prevent iatrogenic damage. A method to combine computer-assisted dynamic navigation with piezocision is introduced here. Cone-beam computed tomography was combined with motion-tracking technology to allow real-time tracing of the piezoelectric instruments during the surgical procedure. This technique delivers the location of piezoelectric knife in regard to roots and important anatomical structures to increase the safety and accuracy during corticotimies.

Interdisciplinary Approach to Treat Patients With Tooth Agenesis: A Case Report.

INTRODUCTION: Tooth agenesis is a type of dental anomaly in which individuals are missing teeth due to developmental failure as a result of genetic or environmental factors. With approximately one fourth of the population missing ≥1 third molar, tooth agenesis is considered a common dental anomaly. However, the severity of tooth agenesis can range from a missing single tooth to multiple teeth. When suffering from severe tooth agenesis, the patient's health and social relationships are often affected. CASE PRESENTATION: The patient in this report congenitally lost 11 teeth and suffered from compromised esthetics and impaired chewing function. In such a severe tooth agenesis case, interdisciplinary treatments involving orthodontics, periodontics, and prosthodontics were engaged to reconstruct the ideal biology, function, and esthetics for the patient. With an interdisciplinary approach, the periodontist played an important role in the rehabilitation of the edentulous regions with implants in combination with various hard and soft tissue augmentation procedures. In addition, the patient with severe tooth agenesis presented with additional dental anomalies. The periodontist, therefore, had to collaborate with other specialists to provide early detection and intervention to avoid future complications, such as the management of infraoccluded ankylosed deciduous molars and aberrant frenum. The patient at the end of treatment had a good occlusion with improved function and esthetics. CONCLUSION: This case report describes the interdisciplinary treatment approach used and points out the role of periodontists in the treatment of a patient with severe tooth agenesis.

Novel bioactivity of phosvitin in connective tissue and bone organogenesis revealed by live calvarial bone organ culture models.

Egg yolk phosvitin is one of the most highly phosphorylated extracellular matrix proteins known in nature with unique physico-chemical properties deemed to be critical during ex-vivo egg embryo development. We have utilized our unique live mouse calvarial bone organ culture models under conditions which dissociates the two bone remodeling stages, viz., resorption by osteoclasts and formation by osteoblasts, to highlight important and to date unknown critical biological functions of egg phosvitin. In our resorption model live bone cultures were grown in the absence of ascorbate and were stimulated by parathyroid hormone (PTH) to undergo rapid osteoclast formation/differentiation with bone resorption. In this resorption model native phosvitin potently inhibited PTH-induced osteoclastic bone resorption with simultaneous new osteoid/bone formation in the absence of ascorbate (vitamin C). These surprising and critical observations were extended using the bone formation model in the absence of ascorbate and in the presence of phosvitin which supported the above results. The results were corroborated by analyses for calcium release or uptake, tartrate-resistant acid phosphatase activity (marker for osteoclasts), alkaline phosphatase activity (marker for osteoblasts), collagen and hydroxyproline composition, and histological and quantitative histomorphometric evaluations. The data revealed that the discovered bioactivity of phosvitin mirrors that of ascorbate during collagen synthesis and the formation of new osteoid/bone. Complementing those studies use of the synthetic collagen peptide analog and cultured calvarial osteoblasts in conjunction with mass spectrometric analysis provided results that augmented the bone organ culture work and confirmed the capacity of phosvitin to stimulate differentiation of osteoblasts, collagen synthesis, hydroxyproline formation, and biomineralization. There are striking implications and interrelationships of this affect that relates to the evolutionary inactivation of the gene of an enzyme L-gulono-γ-lactone oxidase, which is involved in the final step of ascorbate biosynthesis, in many vertebrate species including passeriform birds, reptiles and teleost fish whose egg yolk contain phosvitin. These represent examples of how developing ex-vivo embryos of such species can achieve connective tissue and skeletal system formation in the absence of ascorbate.

Topographical distribution of phosphorylation sites of phosvitins by mass spectrometry.

Phosvitin, derived from the vitellogenin II gene protein, is a highly phosphorylated protein found in egg yolk. A second hypothetical protein has been predicted based on the vitellogenin I gene, but has not been defined at the protein level. Mass spectrometric analysis was used to identify the phosphopeptide sequences and the precise sites of phosphorylation of two phosvitins, phosvitin 1 and phosvitin 2 derived from vitellogenins I and II, respectively. Samples of native phosvitin were subjected to tryptic digestion followed by mass spectrometric analysis: (i) native phosvitin peptides, (ii) after treatment with NaOH, and (iii) after chemical derivatization of P-Ser/P-Thr residues by dithiothreitol under base-catalyzed conditions. A combination of these approaches led to the identification of 68 and 35 phosphopeptides with 89 (81 P-Ser and 8 P-Thr residues) and 62 (57 P-Ser and 5 P-Thr residues) phosphorylation sites of phosvitin 1 and phosvitin 2, respectively. These data for the first time documented on a large scale the major states and sites of phosphorylation of phosvitins with a total of 151 phosphorylation sites. Importantly, the present work also provided the first direct de novo protein amino-acid sequence data for phosvitin 1 protein and evidence for the full expression of vitellogenin I gene. BIOLOGICAL SIGNIFICANCE: We have for the first time generated a large number of phosphopeptides (~100) and identified 151 phosphorylation sites of phosvitin 1 and phosvitin 2, respectively. Importantly, this study also led to the discovery of a novel phosvitin 1 and provided the first direct de novo protein amino-acid sequence data for the full expression of vitellogenin I gene. There is considerable interest in naturally occurring phosphopeptides/phosphoproteins and their application in biomedical fields and in the food industry because of their molecular characteristics and non-toxic nature, hence, our work opens new avenues to pursue such endeavors. In addition, the results provide important fundamental biologic information relevant to evolutionary developments of vertebrate animals beginning with the earliest fish, reptiles, birds and more contemporary mammals. For instance, the abundance of phosvitins with a unique degree of phosphorylation in the egg yolk of fish, reptiles, and birds suggests potential biological functions of phosvitins which are critical to the development of embryos of these distant vertebrates.