[Effects of mid-palatal suture opening and midfacial bony structure changes induced by maxillary skeletal expansion in adults].

PURPOSE: To analyze the opening of mid-palatal suture, transverse changes in dental and dentoalveolar measurements and shift of midfacial bony structures induced by maxillary skeletal expansion (MSE) with cone-beam CT (CBCT), and to evaluate the effect of maxillary skeletal expansion and its influence on adjacent bony structures in adults. METHODS: The study sample consisted of 12 adult patients with maxillary transverse deficiency (4 males, 8 females) at a mean age of (21.17±4.13) years old. All patients were treated with MSE. After treatment, the posterior crossbite was corrected, and the width of the maxillary arch was achieved the optimal width. Pre- and post-treatment CBCT exams were taken before and after MSE treatment. Multiplanar coronal and axial slices obtained from CBCT images were used to measure the changes in transverse widths, angular changes and tooth inclination with Dolphin Imaging 11.9. SPSS 26.0 software package was used for statistical analysis. RESULTS: After MSE treatment, the anterior nasal spine width increased by (2.38±1.01) mm, posterior nasal spine width increased by (2.25±1.08) mm (P<0.01). The inter-crown and inter-apex distance at the first molar increased by (5.56±1.38) mm and (4.14±1.29) mm, respectively (P<0.01). No significant difference was seen in terms of tooth inclination of the first molar(P>0.05). Pterygoid process angle, pterygoid process width, anterior inter-maxillary distance, upper and lower inter-zygomatic distance were significantly larger after treatment (P<0.01), while the inter-temporal distance and bilateral zygomaticomaxillary angle remained unchanged(P>0.05). CONCLUSIONS: MSE has a favorable effect in adult patients with parallel skeletal expansion of the mid-palatal suture achieved after expansion. The teeth present with certain buccal inclination but show no significant movement relative to the alveolar bone. The midfacial bony structures also shift in three-dimensional under the effect of the expansion force.

Evaluation of post-surgical stability in skeletal class II patients with idiopathic condylar resorption treated with functional splint therapy.

PURPOSE: To assess postsurgical stability of mandibular advancement combined with orthodontic treatment, following functional splint therapy, in patients with idiopathic condylar resorption (ICR). PATIENTS AND METHODS: Sixteen patients who were treated with functional splint therapy followed by orthognathic surgery combined with orthodontic treatment between 2010 and 2017 were included in this retrospective study. The primary outcome variable was skeletal stability, measured on the y-axis to point B (y-axis-B). Cephalometric analysis, including measurement of temporomandibular joint spaces, was carried out on serial magnetic resonance images (MRI) prior to orthognathic surgery (T0), immediately after surgery (T1), and after at least 1 year of follow-up (T2). The differences in the data between time points were compared using statistical analyses. RESULTS: All patients obtained an esthetic facial profile after orthognathic surgery, with normal occlusion as well as normal protrusive and laterotrusive excursion after treatment. Mean advancement of the mandible immediately following surgery (y-axis-B, T1 - T0) was 7.28 ± 5.79 mm. This was the only skeletal measurement that showed a sagittal positional change of the mandible. Mean backward movement (T2 - T1) was -1.04 ± 2.35 mm (p2 = 0.116). Thirteen out of 16 patients experienced no postsurgical relapse or less than 2 mm of mandibular backward movement (81.25%), while two out of 16 patients showed more than 2 mm of mandibular backward movement (12.5%). CONCLUSIONS: Patients who underwent mandibular advancement combined with orthodontic treatment, following functional splint therapy, exhibited a stable mandibular position at the 1-year follow-up. This study indicated that functional splint therapy prior to orthognathic surgery for mandibular advancement may be a good adjuvant treatment for ICR patients.

Icariin prevents oestrogen deficiency-induced alveolar bone loss through promoting osteogenesis via STAT3.

OBJECTIVES: Alveolar bone osteoporosis has attracted more and more attention because of its profound impact on stomatognathic function and treatment, but current treatments have not been targeted to alveolar bone and might even cause severe side effects. Thus, identifying the effects of anti-osteoporosis agents on alveolar bone is essential. Icariin ameliorates metabolic dysfunction of long bones, but its effects on alveolar bone remain unclarified. MATERIALS AND METHODS: BMSCs were isolated from rat mandibles (mBMSCs). The osteogenic potential of mBMSCs and the signalling pathway involved under icariin treatment were measured by ALP and alizarin red staining, reverse transcription-polymerase chain reaction (RT-PCR), Western blotting and immunofluorescence. Dual-luciferase assay, chromatin immunoprecipitation (ChIP) and co-immunoprecipitation were used to investigate the molecular mechanism. Ovariectomized and sham-operated rats treated with or without icariin were analysed by micro-CT, TRAP staining and calcein double labelling. RESULTS: We found that icariin promoted osteoblast differentiation of mBMSCs. Furthermore, STAT3 was critical for icariin-promoted osteoblast differentiation, as indicated by increased phosphorylation levels in icariin-treated mBMSCs, while preventing STAT3 activation blocked icariin-induced osteoblast differentiation. Mechanistically, icariin-promoted transcription of the downstream osteogenic gene osteocalcin (Ocn) through STAT3 and STAT3 bound to the promoter of Ocn. Notably, icariin prevented the alveolar bone osteoporosis induced by oestrogen deficiency through promoting bone formation. CONCLUSIONS: For the first time, our work provides evidence supporting the potential application of icariin in promoting osteogenesis and treating alveolar bone osteoporosis.