Biomarkers in the gingival crevicular fluid used to detect root resorption in patients undergoing orthodontic treatment: A systematic review.

OBJECTIVES: To evaluate whether changes in the concentration of different biomarkers in the gingival crevicular fluid (GCF) can be used to detect the root resorption process in adult or adolescent patients undergoing treatment with a fixed appliance, in comparison with untreated subjects or treated patients not showing signs of root resorption. MATERIAL AND METHODS: The following databases were analysed in the period between June 2017 and March 2018, without any language and initial date restrictions: PubMed, EMBASE, Scopus, Web of Science and Cochrane Library. A quality assessment instrument (QAI) was developed to establish the risk of bias. RESULTS: A total of 1127 articles were analysed. Based on the inclusion and exclusion criteria, seven studies qualified for the final review. The QAI tool revealed that five articles were at a moderate risk of bias and two articles were at a low risk of bias. CONCLUSION: Dentine phosphoprotein (DPP) may be considered a relatively useful marker for root resorption. Dentinal sialoprotein (DSP) could be a potential biomarker but is not highly helpful at detecting root shortening. Inflammatory cytokines (pro- and anti-resorption), osteopontin (OPN), osteoprotegerin (OPG), RANKL and alkaline phosphatase (ALP) are useful biomarkers to explain the biological mechanisms that occur during orthodontic movement but are not specific enough. Further studies are required to clarify the role of GM-CSF as a potential biomarker to distinguish subjects at a risk of severe root resorption in the early phase.

Reduced expression of selected FASCICLIN-LIKE ARABINOGALACTAN PROTEIN genes associates with the abortion of kernels in field crops of Zea mays (maize) and of Arabidopsis seeds.

Abortion of fertilized ovaries at the tip of the ear can generate significant yield losses in maize crops. To investigate the mechanisms involved in this process, 2 maize hybrids were grown in field crops at 2 sowing densities and under 3 irrigation regimes (well-watered control, drought before pollination, and drought during pollination), in all possible combinations. Samples of ear tips were taken 2-6 days after synchronous hand pollination and used for the analysis of gene expression and sugars. Glucose and fructose levels increased in kernels with high abortion risk. Several FASCICLIN-LIKE ARABINOGALACTAN PROTEIN (FLA) genes showed negative correlation with abortion. The expression of ZmFLA7 responded to drought only at the tip of the ear. The abundance of arabinogalactan protein (AGP) glycan epitopes decreased with drought and pharmacological treatments that reduce AGP activity enhanced the abortion of fertilized ovaries. Drought also reduced the expression of AthFLA9 in the siliques of Arabidopsis thaliana. Gain- and loss-of-function mutants of Arabidopsis showed a negative correlation between AthFLA9 and seed abortion. On the basis of gene expression patterns, pharmacological, and genetic evidence, we propose that stress-induced reductions in the expression of selected FLA genes enhance abortion of fertilized ovaries in maize and Arabidopsis.

Correlation between body mass index and obstructive sleep apnea severity indexes - A retrospective study.

PURPOSE: To evaluate if Body Mass Index (BMI) is correlated to Apnea-Hypopnea Index (AHI), mean arterial oxygen saturation (SaO2) and Nadir SaO2, which are all indexes defining the severity of the respiratory stress associated with Obstructive Sleep Apnea (OSA). MATERIALS AND METHODS: Seventy-five adult patients (mean age 51.4) referred for polysomnography were retrospectively recruited. BMI was calculated for each patient, as well as AHI, SaO2, and Nadir SaO2 recorded during polysomnography. Spearman's Rho test was used to evaluate if OSA severity was correlated to BMI values. First type error was set as p < 0.025. RESULTS: No correlation was observed between BMI and AHI, and between BMI and SaO2. A statistically significant negative correlation (r2 = 0.424; p < 0.001) was found between the BMI index and the Nadir SaO2. CONCLUSIONS: Higher BMI values were correlated with lower Nadir SaO2 during overnight polysomnography. Since hypoxia stress is a risk factor for cardiovascular diseases and alters the lipid metabolism, dietary consulting should be recommended in association with other treatment modalities for OSA.

Swallowing and Temporomandibular Disorders in Adults.

INTRODUCTION: Temporomandibular disease (TMD) etiology is multifactorial and is related to many perpetuating, predisposing, and initiating factors. The daytime parafunctions may have an important role in TMD pathogenesis. The most frequent parafunctions analyzed were the static parafunction (ie, clenching) and the dynamic parafunction (ie, grinding). In the present paper, the authors evaluated the swallowing (an oral function/parafunction) with the surface electromyography in patients with TMD. MATERIALS AND METHODS: Twenty patients with TMD problems (nonhealthy patients, NHP) (mean age: 33 ±â€Š1.994; 8 men and 12 women) and 20 healthy matched subjects (HP) (34.4 ±â€Š2.782; 6 men and 14 women) were selected and examined. On each patient, an 8-channel surface electromyography was done during saliva swallowing. RESULTS: Nonhealthy patients presented higher masseter and temporalis activation (P < 0.05) and an unbalancing of temporalis and submental muscles activation (P < 0.05) than the HP. DISCUSSION: Nonhealthy patients presented a time of swallow higher than HP (P < 0.001). Nonhealthy patients presented a higher muscles activation and time of swallow than HP and a decrease of muscles balancing activation.

Retrospective evaluation of treatment time and efficiency of a predictable cantilever system for orthodontic extrusion of impacted maxillary canines.

INTRODUCTION: Orthodontic extrusion of impacted maxillary canines requires careful biomechanical planning and the use of physiologic force. The aim of this study was to evaluate the time needed for orthodontic extrusion of impactions of different severities, using a device that can predictably apply forces under 0.6 N. METHODS: Twenty-two patients who were consecutively treated were selected retrospectively, and a total of 30 impacted canines were studied. Indexes of impaction were used to measure severity on pretreatment panoramic radiographs. Statistical analysis was used to detect interactions between treatment time, complexity of impaction, age, and sex. RESULTS: Treatment time was highly dependent on the patient's age; the shortest treatment time was observed in 11- to 12-year old patients. On the other hand, the severity of impaction had no effect on treatment time. CONCLUSIONS: Applying physiologic force with the proposed device resulted in a short treatment time, which depended on the patient's age more than the impaction complexity. Few complications were associated with use of this device. Future prospective studies are needed to replicate these findings and confirm the recommended use of this device.

Predictable method to deliver physiologic force for extrusion of palatally impacted maxillary canines.

INTRODUCTION: Orthodontic treatment of palatally impacted maxillary canines raises many difficulties; to minimize complications, careful planning of orthodontic extrusion and the use of physiologic force are crucial. The aim of this study was to quantitatively evaluate a simple and reproducible system for orthodontic extrusion of impacted canines that can provide the correct amount of force. METHODS: Ten specimens were constructed, consisting of a cantilever made with a 0.6-mm or 0.7-mm stainless steel wire modeled around a transpalatal bar with 3, 5, or 7 loops in the shape of a helical torsion spring. A mechanical testing machine was used to measure the force produced by the cantilever at 3, 6, 9, 12, and 15 mm of activation. RESULTS: The force values ranged from 1.24 ± 0.13 N for the 0.7-mm wire with 3 loops to 0.48 ± 0.04 N for the 0.6-mm wire with 7 loops. The forces measured for the 0.6-mm wire with 3 loops and the 0.7-mm wire with 7 loops were similar at 15 mm of deflection. CONCLUSIONS: The proposed system has a simple and robust design, is easy to construct and manage, and can provide the desired amount of force by changing the wire diameter and number of loops.

Arsenic-contaminated freshwater: assessing arsenate and arsenite toxicity and low-dose genotoxicity in Gammarus elvirae (Crustacea; Amphipoda).

Arsenic (As) contamination of freshwater is largely due to geogenic processes, but As is also released into the environment because of improper anthropic activities. The European regulatory limits in drinking water are of 10 µg L-1 As. However, knowledge of the genotoxic effects induced by low doses of As in freshwater environments is still scanty. This study was designed to investigate arsenate (As(V)) and arsenite (As(III)) toxicity and low-dose genotoxicity in Gammarus elvirae, which has proved to be a useful organism for genotoxicity assays in freshwater. As(V) and As(III) toxicity was assessed on the basis of the median lethal concentration, LC(50), while estimates of DNA damage were based on the Comet assay. The G. elvirae LC (50-240 h) value we calculated was 1.55 mg L-1 for As(V) and 1.72 mg L-1 for As(III). Arsenic exposure (240 h) at 5, 10, and 50 µg L-1 of As in assays with either arsenate or arsenite-induced DNA damage in hemocytes of G. elvirae in a concentration-dependent manner. Our study provides a basis for future genotoxic research on exposure to freshwater that contains low levels of arsenic.

Changes in hyoid bone and tongue position in Class I subjects after orthodontic treatment with rapid palatal expander.

OBJECTIVE: To evaluate the effects of the rapid palatal expander (RPE) on the hyoid bone and tongue position in skeletal Class I patients, compared to control groups. METHODS: Eighty-four Class I subjects, aged 6-14, were selected. Among these, 28 patients were treated with RPE, 28 with function-generating bite (FGB) appliance, and 28 were untreated. Lateral cephalograms taken before (T0) and after (T1) treatment were retrieved. Changes in the hyoid bone and tongue position were evaluated, and the area above the tongue was measured. RESULTS: No significant difference in the hyoid and tongue posture was observed across the groups. However, there were significant differences for HC3 (distance from H-point to the third cervical vertebrae), H2H (distance from H-point to SN plane), and TT-Eb (tongue length) between T0 and T1 in all groups. CONCLUSION: The results suggest that hyoid bone and tongue position changes were related to growth rather than treatment.

Long-term effect on adenoid dimensions and craniocervical angulation after maxillary expansion with fixed or functional appliances.

BACKGROUND: Maxillary expansion is a common orthodontic procedure that could have a positive effect also on airway patency. The aim of the present study was to evaluate the long-term effects of rapid maxillary expansion (RME) on nasopharyngeal area and cranio-cervical angulation in growing patients, compared to controls treated with a function-generating bite appliance (FGB). MATERIAL AND METHODS: Sixty patients aged 6-14 consecutively treated with RME or FGB were selected retrospectively and divided into two groups. Lateral cephalograms taken before and after treatment were retrieved, and the nasopharyngeal area, delimited superiorly by a sella-posterior nasal spine (PNS) line and inferiorly by a basion-PNS line, and the cranio-cervical angulation were measured. RESULTS: The mean observation time was 17.6 ± 8 months. No differences were present between the two groups regarding age and gender. The nasopharyngeal area increased significantly in both groups after treatment, but with no statistically significant difference between them. The cranio-cervical angulation showed no differences within or between groups. CONCLUSIONS: Maxillary deficiency treatment with either RME or FGB was followed by a comparable increase in nasopharyngeal area. Key words:Rapid maxillary expansion, Airway, Nasopharyngeal area, Adenoid.

Effect of Class II functional treatment on facial attractiveness, as perceived by professionals and laypeople.

The literature offers different perspectives for and against two-phase treatment of skeletal Class II malocclusion. Facial attractiveness is an important aspect to take into account, given that children with skeletal Class II are often bullied by their peers and have low self-esteem and a lower social perception. The aim of the present study was to evaluate the aesthetic perception of facial profiles by a large number of observers, before and after treatment with a functional appliance, compared to untreated controls. The pre- and post-treatment cephalograms of 20 Class II subjects treated with Sander's bite-jumping appliance and 20 untreated historical controls were collected and transformed into black and white silhouettes depicting only the lower third of the face. An online questionnaire comprising the silhouettes of the two groups, three "calibration" profiles and an "ideal" profile was submitted to dentists, orthodontists, undergraduates and laypeople, asking them to rate the profile's attractiveness using a Visual Analogue Scale (VAS). The effect of treatment, and observers' age, expertise and gender were analysed. The calibration images and the ideal profiles were used to evaluate the coherence of each observer's judgement. The protocol was approved by the local Ethics Committee. Nine-hundred and ten questionnaires were collected. Treated subjects showed a larger improvement of facial attractiveness compared to controls. A significant effect of gender on the observer's ratings was observed. Some observers showed incoherent judgement, which had a significant effect on the regression model. In conclusion, early treatment with functional appliances seems to improve patients' facial aesthetics. This improvement is perceived equally by dental professionals and laypeople.

Microtensile Bond Strength of Etch-and-Rinse Adhesives in Different Hydroabrasion Conditionings.

The aim of the present study was to in vitro evaluate the effect of dentin conditioning with hydroabrasion on the microtensile bond strengths of three adhesive systems, compared to the standard etch-and-rinse technique. Sixty extracted human third molars were collected, and their midcoronal occlusal dentin was used for the microtensile bond strength test. Teeth were randomly assigned to three groups according to the adhesive system used: ExciTE F DSC, ENA Bond, and Scotchbond Universal. Specimens from each group were further divided into four subgroups: control specimens were treated with standard adhesive procedures; hydroabraded (HA) specimens were subjected to preventive hydroabrasion with three different intensity levels. After bonding procedures, composite crowns were incrementally built up. After thermocycling, specimens were subsequently sectioned into 1 × 1 mm sticks, and microtensile bond strengths were measured. Data were statistically analyzed. Failure mode analysis was performed. There were no significant differences in terms of bond strength between standard adhesion protocols and adhesion with HA preconditionings. On the other hand, the type of adhesive used had a significant effect on the tensile bond strength. Subgroups treated with hydroabrasion at higher intensity showed a slightly increased frequency of cohesive fractures. In conclusion, hydroabrasion can be used for dentin cavity preparation or finishing, since it does not seem to affect the bonding effectiveness.

Dimensional variability of orthodontic slots and archwires: an analysis of torque expression and clinical implications.

BACKGROUND: The loss of third-order information in pre-adjusted brackets due to torsional play is a problem in clinical orthodontics. The aim of this study was to evaluate the impact of slot height, archwire height, width and edge bevel's radius on the torsional play for three brackets/archwire systems. METHODS: Ninety brackets with a 0.022 × 0.028 in. slot with McLaughlin-Bennett-Trevisi prescription from three different manufacturers were selected, and the slot's height and depth were measured using a profile projector. Sixty stainless-steel rectangular archwires from three different manufacturers were sectioned and observed with a SEM to measure their height, width, and radius of edge bevel. The recorded data were used to calculate the theoretical torsional play between different slot-archwire combinations. One-way ANOVA was used to compare the measurements within different bracket types and among different manufacturers. RESULTS: Slot height was usually oversized. Archwire's height was usually undersized, but oversized wires were also observed. The radius edge bevel was the most variable parameter. A certain degree of torsional play is always present that differs from one bracket type to another of the same producer and that can even be doubled from one manufacturer to another. CONCLUSIONS: Due to production tolerance, differences between the nominal values and the real dimensions of any components of a slot/archwire system are common. This results in a torsional play that limits torque expression. The archwire's edge bevel plays an important role in torque expression, and clearer information should be provided by the manufacturers regarding this aspect.

Enamel preservation during composite removal after orthodontic debonding comparing hydroabrasion with rotary instruments.

The aim of the present study was to evaluate how hydroabrasion performs during composite removal. A standardized amount of composite was bonded to 40 enamel surfaces of extracted third molars, then removed with either a tungsten carbide bur mounted on a micro-motor handpiece without irrigation, a tungsten carbide bur mounted on a micro-motor handpiece with irrigation, a tungsten carbide bur mounted on an air-rotor handpiece, or hydroabrasion. The four treatment methods were compared using the enamel-surface-index and the adhesive-remnant-index and performing a Kruskal-Wallis statistical test to detect differences between each method' scores. Hydroabrasion produced significantly less damage to the enamel surface compared to the other three methods. Hydroabrasion was the cleaning method that produced less damages to the enamel surface, at a cost of a less efficient composite removal than tungsten carbide burs on micro-motor handpiece.

In Vitro Shear Bond Strength of Orthodontic Brackets after Enamel Conditioning with Acid Etching and Hydroabrasion.

The purpose of this study was to evaluate the shear bond strength and adhesive remnant index ARI) of orthodontic brackets following enamel conditioning with acid etching, hydroabrasion, and with both procedures. Thirty extracted human premolars were divided into three groups and received either acid etching, hydroabrasion or both procedures. Orthodontic brackets were bonded with composite resin. Shear bond strength was tested with a tensile machine, then the teeth were observed under a stereomicroscope to evaluate ARI scores. The enamel morphology after each conditioning method was evaluated with scanning electron microscope imaging. A one-way ANOVA and a Kruskal-Wallis H test were used to compare the bond strength and the ARI scores among the three groups. Hydroabrasion alone produced shear bond strength values below clinical acceptability, while the combination of acid etching and hydroabrasion produced the highest values. The ARI scores in the hydroabrasion group were significantly different from the other groups. Hydroabrasion followed by acid etching was effective in increasing the shear bond strength of orthodontic brackets. Further in vivo studies are needed to confirm the cost and benefits of this technique.

Condylar long axis and articular eminence in MRI in patients with temporomandibular disorders.

OBJECTIVE: To compare morphologic findings in MRI and skeletal divergence of a group of patients with temporomandibular joint disorders (TMD) subdivided into condylar symmetric and asymmetric. METHODS: Fifty-nine adults (26.7 years old) with TMD were retrospectively recruited. Condylar height symmetry was evaluated by orthopantomography (Habets's method) and used to divide patients into Symmetric and Asymmetric groups; skeletal divergence was assessed on lateral cephalograms. MRI was used to evaluate the condylar long axis' angle, the glenoid fossa morphology, and the degree of disc displacement. RESULTS: Asymmetric subjects showed a hyperdivergent skeletal pattern (p = 0.036), asymmetric condylar long axis (p = 0.018), and deeper (p = 0.025) and asymmetric (p = 0.001) glenoid fossa compared to symmetric subjects. CONCLUSION: Patients with TMD and condylar asymmetry diagnosed with orthopantomography are more likely to show hyperdivergent skull in cephalometry, condylar asymmetry of both height and major axis, and a steeper glenoid fossa in MRI.

Effects of 1,4-butanediol dimethacrylate and urethane dimethacrylate on HL-60 cell metabolism.

The polymerization of methacrylic monomers present in dental composite resins never reaches completion and therefore the leakage of residual monomers into the oral cavity and into biological fluids can cause local and systemic adverse effects. This work was carried out to study the in vitro biochemical interactions of urethane dimethacrylate and 1,4-butanediol dimethacrylate monomers with HL-60 cells, a cell line assumed as an experimental model for simulating granulocyte behaviour. Our main finding was that both monomers induce cell differentiation at toxic concentrations and that cytotoxicity seems to be caused by alterations of glucose metabolism arising from mitochondrial dysfunction rather than from oxidative stress, which could not be altogether verified under our experimental conditions. Our study could be considered as a useful approach to investigate the biochemical mechanisms that contribute to the cytotoxicity of methacrylate compounds and it underlines the importance of assessing such parameters for testing biocompatibility in order to promote the development of better and safer dental materials.

Soft-tissue changes after Class II malocclusion treatment using the Sander bite-jumping appliance: a retrospective study.

BACKGROUND: The soft tissue profile outcome after functional treatment of Class II malocclusion is important for a patient's aesthetic and psychosocial results. The soft tissue effects of the Sander bite-jumping appliance (BJA), which is the device that produces the greatest mandibular advancement according to a systematic review, have never been investigated. The aim of the present study was to assess the soft tissue effects of the BJA in comparison to matched untreated controls. METHODS: A total of 19 patients treated with BJA during puberty were retrospectively recruited, and 15 untreated controls were retrieved from a previous growth study to match the treated group. Lateral cephalograms were used to evaluate the pre- and post-treatment differences in the ANB angle, the inclination of the upper and lower incisors, facial convexity, the nasolabial angle and the sagittal position of the skeletal and soft tissue at points A and B. Independent t-tests or Mann-Whitney U tests were used to detect differences between the two groups. RESULTS: Statistically significant differences were found for the ANB angle, the inclination of the upper incisors and facial convexity. CONCLUSIONS: Functional treatment of Class II patients with the Sander BJA during puberty was effective at improving the profile and reducing the facial convexity angle in the short term.

Morphometric analysis of sella turcica in growing patients: an observational study on shape and dimensions in different sagittal craniofacial patterns.

The aim of this study was to evaluate the differences in sella dimensions and shape between growing patients with Class I, Class II, and Class III skeletal malocclusions, evaluated through morphometric analysis. Seventy-eight subjects aged between 9 and 13 years were selected and assigned to either the Class I, Class II, or Class III groups according to the measured ANB angle (the angle between the Nasion, skeletal A-point and skeletal B-point). Six landmarks were digitised to outline the shape of the sella turcica. Linear measurements of the sella length and depth were also performed. Procrustes superimposition, principal component analysis, and canonical variate analysis were used to evaluate the differences in sella shape between the three groups. A one-way MANOVA and Tukey's or Games-Howell tests were used to evaluate the presence of differences in sella dimensions between the three groups, gender, and age. The canonical variate analysis revealed a statistically significant difference in sella shape between the Class I and the Class II groups, mostly explained by the CV1 axis and related to the posterior clinoidal process and the floor of the sella. No differences were found regarding linear measurements, except between subjects with different age. These differences in sella shape, that are present in the earlier developmental stages, could be used as a predictor of facial growth, but further studies are needed.

Effect of methacrylic monomers on phagocytes reactive oxygen species: a possible BDDMA modulating action.

In the last years the studies regarding the biocompatibility of dental materials investigate, in addition to the classic cytotoxic tests, the interactions between the materials and the host cells to better explain the causes of the adverse effects observed sometimes in the clinical practice. In the present study the ability of diurethane dimethacrylate (DUDMA) and 1,4-butanediol dimethacrylate (BDDMA) methacrylic monomers present in dental composite resins to alter the functionality of peripheral blood monocytes (PBMs) and polymorphonucleate cells (PMNs) was examined. These cells are involve in the biological response to materials and in the host ability to respond to bacteria. The results obtained suggest that the examined methacrylates induce a relevant decrease of PBMs oxidative burst whereas the basal ROS production is only slightly decreased. In PMNs DUDMA induces a decrease of both basal and stimulated ROS production. BDDMA, on the contrary, it does not alter total oxidative burst in presence of stimulus while induces a statistically significant decrease of basal ROS production. Moreover this monomer alters the reaction kinetics of stimulated ROS production. The reported finding seems to indicate that this molecule could be able to stabilize PMNs in resting state and maximize their stimulated activity.

Movement of anterior teeth using clear aligners: a three-dimensional, retrospective evaluation.

BACKGROUND: Clear aligner treatment offers several advantages, but the available literature shows that some kind of tooth movements are unpredictable. In addition, the majority of the studies are focused on one clear aligner system, while different characteristics of various systems can provide different treatment outcomes. The aim of the present retrospective cohort study was to evaluate the predictability of Nuvola® aligner system in achieving torque movements of anterior teeth. METHODS: Thirty-nine adult patients, who were consecutively treated with clear aligners, were retrospectively selected, and digital models pre-treatment (T0), post-treatment (T1) and the digital setup models (TS) were collected. Only the first phase of treatment made of 12 aligners was considered for the present study. Torque of anterior teeth was measured as labiolingual inclination on digital models at T0, T1, and TS using VAM software. Any difference between the predicted and achieved torque movements was evaluated using Wilcoxon signed-rank test or paired sample t test. First-type error was set as p < 0.008. RESULTS: No statistically significant difference was found for all the anterior teeth between predicted and achieved torque movements. CONCLUSIONS: The studied clear aligner system was able to produce clinical outcomes comparable to the planning of the digital setup relative to torque movements of the anterior teeth.