Genotype and malocclusion in patients with osteogenesis imperfecta.

OBJECTS: To investigate the relationship between genotype and severity of malocclusion in osteogenesis imperfecta (OI). SETTING AND SAMPLE POPULATION: A total of 49 patients participated in this cross-sectional study (age range: 5-19 years; 28 females; diagnoses: OI type I, N = 7; OI type III, N = 11; OI type IV, N = 27; OI type V, N = 2; OI type VI, N = 2). MATERIALS AND METHODS: Sequence analysis of COL1A1/COL1A2 and other OI-related genes was compared to the Peer Assessment Rating (PAR), an index reflecting the severity of malocclusion. RESULTS: The mutation spectrum was as follows: COL1A1, N = 22; COL1A2, N = 22, IFITM5, N = 2; SERPINF1, N = 2; no mutation detected, N = 1). Compared to patients with COL1A1 mutations, patients with COL1A2 mutations had significantly higher scores for total PAR, anterior cross-bite, anterior open bite and anteroposterior buccal occlusion. Males with COL1A2 mutations had significantly higher total PAR scores than females (median 36 vs 30, P = .047, Mann-Whitney test). Exploratory correlation between age and buccal vertical occlusion was noted in patients with COL1A2 mutations (Spearman correlation: r = .46, P = .03, power = .50). Two patients with OI type V (caused by IFITM5 mutations) had total PAR scores of 44 and 21. Both patients scored high for "segment." Patients with OI type VI (due to SERPINF1 mutations) scored similar to OI type V for "centreline." Considerable difference was observed in the total PAR score between the 2 patients with OI type VI. They had total PAR of 43 and 2. CONCLUSION: Type of disease-causing mutation affects the severity of malocclusion in individuals with OI.

Is oral health-related quality of life stable following rehabilitation with mandibular two-implant overdentures?

OBJECTIVES: The superiority of mandibular two-implant overdentures (IODs) over conventional complete dentures (CDs) in terms of quality of life is still questioned. Furthermore, the stability and magnitude of the treatment effect over time remain uncertain. This follow-up study aimed to determine the stability and magnitude of the effect of IODs on oral health-related quality of life (OHRQoL). MATERIAL AND METHODS: 172 participants (mean age 71 ± 4.5 years) randomly received CDs or IODs, both opposed by conventional maxillary dentures. OHRQoL was measured using the Oral Health Impact Profile (OHIP-20) at baseline, 1 and 2 years post-treatment. Repeated measures ANOVAs were conducted to assess the effects of time and treatment on the total OHIP and its individual domain scores. RESULTS: A statistically significant improvement in OHRQoL was seen for both treatment groups (P < 0.001). This improvement was maintained over the 2 year assessment. At both follow-ups, participants wearing IODs reported significantly better total OHIP scores than those wearing CDs (P < 0.001), with a 1.5 times larger magnitude of effect. In the CD group, baseline OHIP scores influenced the post-treatment scores (P < 0.001). This effect was not found in the IOD group. CONCLUSIONS: The effect of mandibular two-IODs on OHRQoL is stable over a 2-year period. The large magnitude of effect of this treatment supports its clinical significance.

Bacterial profile and bone healing in rats receiving cancer therapeutic doses of bisphosphonates and corticosteroids: a pilot study.

The microbial aetiology of bisphosphonate-related osteonecrosis of the jaw (BRONJ) remains undefined. This study investigated the oral microbiota and socket healing after zoledronic acid (ZA) and dexamethasone (DX) administration. Fourteen rats assigned randomly to experimental (n=8) and control (n=6) groups were injected with ZA+DX or saline, respectively, for 3 weeks prior to and 9 weeks after the extraction of left first upper and lower molars. Whole genomic DNA probes of 38 bacterial species and five Candida species were hybridized to DNA extracted from biofilm samples on exposed bone and adjacent teeth. Only experimental rats exhibited exposed bone at euthanasia. All BRONJ-like lesions were colonized by Staphylococcus pasteuri, Streptococcus parasanguinis, and Streptococcus mitis. A significant correlation was observed between the mean proportions of species colonizing BRONJ-like lesions and the teeth of experimental rats (r=0.818, P<0.001). Significant differences were seen in several species colonizing the teeth of control rats compared to experimental rats (P<0.05). Micro-computed tomography analyses revealed higher residual bone in mandibular (P=0.001) and maxillary (P=0.108) tooth sockets of experimental rats. BRONJ-like lesions were colonized mainly by non-pathogenic bacteria. ZA+DX administered to rats at doses equivalent to those given to cancer patients resulted in changes to the oral biofilm and impaired bone healing following tooth extraction.

The Kilogram and Measurements of Mass and Force.

This paper describes the facilities, measurement capabilities, and ongoing research activities in the areas of mass and force at the National Institute of Standards and Technology (NIST). The first section of the paper is devoted to mass metrology and starts with a brief historical perspective on the developments that led to the current definition of the kilogram. An overview of mass measurement procedures is given with a brief discussion of current research on alternative materials for mass standards and surface profiles of the U.S. national prototype kilograms. A brief outlook into the future possible redefinition of the unit of mass based on fundamental principles is included. The second part of this paper focuses on the unit of force and describes the realization of the unit, measurement procedures, uncertainty in the realized force, facilities, and current efforts aimed at the realization of small forces.

The outcomes of conservative and surgical treatment of stage 2 bisphosphonate-related osteonecrosis of the jaws: a case series.

The purpose of the current retrospective chart review is to describe the outcomes of conservative or surgical treatment of stage 2 bisphosphonate-related osteonecrosis of the jaws (BRONJ). 14 charts (mean patient age 69.07 ± 10.37 years) describing 19 BRONJ stage 2 sites were identified. According to the treatment protocol, all patients received conservative treatment. Surgical treatment was delivered only to sites that did not respond to conservative treatment. Conservative treatment alone was delivered to 11 sites in 8 patients (mean postoperative follow-up 17.6 ± 9.4 months). Surgical treatment was delivered to 8 sites in 6 patients (mean postoperative follow-up 10.0 ± 6.1 months). Bisphosphonate exposure ranged from 1 to 8 years. In most cases, tooth extractions and wearing dentures were reported as triggers for BRONJ. At the last follow-up, BRONJ stage 0 was noted in 7 sites that received conservative treatment and 5 sites that received surgical treatment. Within the limitations of the current chart review, the results showed that although conservative treatment for BRONJ stage 2 can provide favourable outcomes, surgical treatment represents a suitable alternative in non-responsive cases.