The effect of tongue reduction for preventing adverse effects in patients undergoing class III orthognathic surgery: a three-dimensional comparative analysis.

OBJECTIVES: This study aims to evaluate the potential benefits of combining tongue reduction with mandibular setback surgery in patients undergoing class III orthognathic surgery. Specifically, we investigated whether this combined approach reduced the risk of surgical relapse, condylar resorption, and airway space reduction by mitigating tongue pressure on the mandible. MATERIAL AND METHODS: The study retrospectively enrolled patients who had undergone bilateral sagittal split ramus osteotomy (BSSRO) with at least 5 mm of setback and met the criteria of a body mass index > 20 kg/m2 and tongue volume > 100 mm3. The study included 20 patients with 10 in the tongue reduction group (TR, n = 10) and 10 in the BSSRO only group (SO, n = 10). RESULTS: The volumetric changes of the total airway space were significantly different between the TR and SO groups (p = 0.028). However, no significant differences were observed in the condylar resorption and postoperative relapse between the groups (p = 0.927 and 0.913, respectively). The difference between the resorption of the anterior and posterior segments of the condyle was also statistically insignificant (p = 0.826). Postoperative counterclockwise rotation of the proximal segment only demonstrated a significant correlation with postoperative relapse (p = 0.048). CONCLUSIONS: The reduction in tongue volume demonstrated a preventive effect on the reduction of the airway space after mandibular setback, although it did not yield statistical significance concerning surgical relapse and condylar volume. The counterclockwise rotation of the proximal segment might be responsible for the forward displacement of the distal segment and postoperative relapse. However, the clinical implications of this finding should be interpreted with caution owing to the limited sample size CLINICAL RELEVANCE: Tongue reduction could potentially serve as a preventive measure in preserving the airway space and might be beneficial in mitigating the risk of obstructive sleep apnea in patients with class III deformity.

Gastric cancer exosomes contribute to the field cancerization of gastric epithelial cells surrounding gastric cancer.

BACKGROUND: A dynamic molecular interaction between cancer and the surrounding normal cells is mediated through exosomes. We investigated whether exosomes derived from gastric cancer cells affected the fate of the surrounding gastric epithelial cells. METHODS: We analyzed the cell viability and immortalization of primary normal stomach epithelial cells (PNSECs) after treatment with exosomes derived from AGS gastric cancer cells and/or H. pylori CagA. Cell proliferation and apoptosis were analyzed by BrdU incorporation, flow-cytometry, and colony formation assays. We examined telomere length, expression and activity of telomerase, and expression of telomere-related genes in PNSECs treated with cancer exosomes, and in 60 gastric cancer and corresponding mucosal tissues. The differentially expressed genes and transcriptional regulation of telomere-related genes were verified using real-time qPCR and ChIP analyses, respectively. RESULTS: Gastric cancer exosomes increased cell viability and the population-doubling levels but inhibited the cellular senescence and apoptosis of PNSECs. The internalization of cancer exosomes in PNSECs dramatically increased the number of surviving colonies and induced a multilayer growth and invasion into the scaffold. Treatment of PNSECs with cancer exosomes markedly increased the expression and activity of telomerase and the T/S ratio and regulated the expression of the telomere-associated genes, heat-shock genes, and hedgehog genes. Compared to gastric mucosae, gastric cancer showed increased hTERT expression, which was positively correlated with telomere length. Interestingly, seven (46.7%) of 15 non-cancerous gastric mucosae demonstrated strong telomerase activity. CONCLUSION: These results suggest that gastric cancer exosomes induced the transformation and field cancerization of the surrounding non-cancerous gastric epithelial cells.

The Envelope of Segmental Movement and Airway Changes After Mandibular Anterior Subapical Osteotomy in Skeletal Class II Protrusion Patients.

INTRODUCTION: This study aimed to determine the envelope of anterior segmental movement and changes in the inferior pharyngeal airway space (IPAS) and position of the hyoid bone following mandibular anterior subapical osteotomy (ASO) under local anesthesia in skeletal Class II patients with protrusion. METHODS: The subjects were 33 skeletal Class II adult patients with lip protrusion. They were treated by extraction of 4 premolars and mandibular ASO under local anesthesia. Surgical movement of mandibular anterior segment and IPAS after surgery was evaluated by mandibular superimposition using lateral cephalograms between before and immediately after surgery. The depth of osteotomy and overlapping ratio were measured. RESULTS: The mean retraction of the mandibular incisor was 4.04 mm at the tip and 4.29 mm at the root apex. The mean vertical movement of the mandibular incisor was 3.33 mm intrusion at the tip and 3.42 mm at the root apex. The axis of the mandibular incisor did not change significantly. Patients with deep curve of Spee showed significantly more intrusion of incisors, whereas the incisor axis became more proclined. The IPAS became narrower, and the hyoid bone moved downward after surgery. The decreased IPAS was positively correlated with retraction of root apex and proclination of the mandibular incisors. CONCLUSION: To establish precise surgical treatment objectives, a balance between the amount of intrusion and changes in axis should be sought after considering anatomical limitations. Mandibular ASO should be performed with caution in skeletal Class II patients vulnerable to airway-related problems.

Gastrokine 1 inhibits gastric cancer cell migration and invasion by downregulating RhoA expression.

BACKGROUND: We investigated whether GKN1, a gastric tumor suppressor, contributes to the progression of gastric cancer by regulating RhoA expression. METHODS: We analyzed the expression of GKN1, RhoA, miR-185, and miR-34a in 35 gastric cancer tissues, and compared their expression with T category and TNM stage. Cell migration and invasion, as well as the expression of epithelial-to-mesenchymal transition (EMT)-related proteins, were assessed in GKN1- and RhoA small interfering RNA (siRhoA)-transfected and recombinant-GKN1-treated AGS and MKN1 gastric cancer cells. RESULTS: Expression of RhoA protein and messenger RNA (mRNA) was increased in 15 (42.9 %) and 17 (48.6 %) of 35 gastric cancer tissues respectively, and was associated with higher T category and TNM stage. GKN1 expression was significantly decreased in 27 gastric cancers (77.1 %) with a higher T category, and was inversely correlated with RhoA mRNA expression. In AGS and MKN1 cells, GKN1 expression increased miR-185 and miR-34a expression and reduced RhoA mRNA and protein expression. A positive relationship between GKN1 and miR-34a and miR-185 expression and an inverse relationship between miR-34a and RhoA expression were observed in gastric cancer tissues. Cell migration and invasiveness were markedly decreased in GKN1- and siRhoA-transfected cells. GKN1 expression and silencing of RhoA decreased the expression of the proteins Snail, Slug, and vimentin. Furthermore, miR-185 and miR-34a silencing in MKN1 cells transfected with GKN1 stimulated cell migration and invasion, and increased the expression of EMT-related proteins. CONCLUSION: Our data suggest that GKN1 may inhibit gastric cancer cell migration and invasion by downregulating RhoA expression in a miR-185- and miR-34a-dependent manner.

Double Anterior Segmental Osteotomy Under Local Anesthesia for Correcting Adult Protrusion With Thin Alveolus and Ankylosed Tooth.

BACKGROUNDS: This paper describes an additional benefit in double anterior segmental osteotomy to correct severe anterior protrusion in adult patients with extremely thin mandibular alveolus and ankylosed tooth. For the optimal anterior segmental retraction, an ankylosed posterior tooth needed surgical inclination reposition. During anterior segmental osteotomy surgery under local anesthesia, additional single tooth osteotomy was performed without challenge. METHODS: For anterior segment retraction, osteotomy cuts were made by the surgeon to define a block of bone embedding 6 mandibular anterior teeth. First premolars were extracted during initial orthodontic treatment period. But the ankylosed lower left lateral incisor and lower right second premolar root which remains mesially with uprighted crown hindered further anterior segment retraction. The authors removed cortical bone around second premolar root and repositioned to be upright. Anterior segment was retracted to proper position utilizing the space gained. RESULT: Thin alveolar mandibular anterior segment retraction and the second premolar uprighting were managed effectively with additional single tooth segmental osteotomy during anterior segmental osteotomy. CONCLUSION: Double anterior segmental osteotomy can be an effective alternative to conventional orthognathic surgery in selected adult patients.

Single-Tooth Osteotomy Combined Wide Linear Corticotomy Under Local Anesthesia for Correcting Anterior Protrusion With Ectopically Erupted Canine.

BACKGROUNDS: This article presents the alternative surgical treatments of both anterior protrusion by carrying out retraction on mandibular anterior fragment, meanwhile applying retraction force on maxilla anterior teeth and ectopically erupted canine with using platelet-rich fibrin (PRF). METHODS: Anterior segmental osteotomy was combined with linear corticotomy under local anesthesia. The correction of right ectopic canine was achieved through 2 stages. First, dento-osseous osteotomy on palatal side was performed. Then second osteotomy with immediate manual repositioning of the canine with concomitant first premolar extraction was enhanced with PRF, which was prepared by centrifuging patient's blood, applied into buccal side of high canine during osteotomy. Mandibular retraction was accomplished by anterior segmental osteotomy. RESULTS: Single-tooth osteotomy is a more effective surgical method for ankylosed or ectopically erupted tooth in orthodontic treatment. It can reduce the total orthodontic treatment time and root resorption, 1 common complication. Significant improved bone formation was seen with the addition of PRF on noncritical size defects in the animal model. It is reasonable to think that PRF can promote bone regeneration. So early bone formation also can reduce the complication such as postoperative infection. CONCLUSIONS: As an alternative to anterior protrusion and ectopically erupted canine treatment, segmental osteotomy and corticotomy combined platelet-rich plasma can enhance orthodontic treatment outcome.

Low-Power, Self-Rectifying, and Forming-Free Memristor with an Asymmetric Programing Voltage for a High-Density Crossbar Application.

A Pt/NbOx/TiOy/NbOx/TiN stack integrated on a 30 nm contact via shows a programming current as low as 10 nA and 1 pA for the set and reset switching, respectively, and a self-rectifying ratio as high as ∼105, which are suitable characteristics for low-power memristor applications. It also shows a forming-free characteristic. A charge-trap-associated switching model is proposed to account for this self-rectifying memrisive behavior. In addition, an asymmetric voltage scheme (AVS) to decrease the write power consumption by utilizing this self-rectifying memristor is also described. When the device is used in a 1000 × 1000 crossbar array with the AVS, the programming power can be decreased to 8.0% of the power consumption of a conventional biasing scheme. If the AVS is combined with a nonlinear selector, a power consumption reduction to 0.31% of the reference value is possible.

Resolving voltage-time dilemma using an atomic-scale lever of subpicosecond electron-phonon interaction.

Nanoelectronic memory based on trapped charge need to be small and fast, but fundamentally it faces a voltage-time dilemma because the requirement of a high-energy barrier for data retention under zero/low electrical stimuli is incompatible with the demand of a low-energy barrier for fast switching under a modest programming voltage. One solution is to embed an atomic-level lever of localized electron-phonon interaction to autonomously reconfigure trap-site's barrier in accordance to the electron-occupancy of the site. Here we demonstrate an atomically levered resistance-switching memory built on locally flexible amorphous nanometallic thin films: charge detrapping can be triggered by a mechanical force, the fastest one being a plasmonic Lorentz force induced by a nearby electron or positron bunch passing in 10(-13) s. The observation provided the first real-time evidence of an electron-phonon interaction in action, which enables nanometallic memory to turn on at a subpicosecond speed yet retain long-term memory, thus suitable for universal memory and other nanoelectron applications.

Electrical performance and scalability of Pt dispersed SiO2 nanometallic resistance switch.

Highly reproducible bipolar resistance switching was recently demonstrated in a composite material of Pt nanoparticles dispersed in silicon dioxide. Here, we examine the electrical performance and scalability of this system and demonstrate devices with ultrafast (<100 ps) switching, long state retention (no measurable relaxation after 6 months), and high endurance (>3 × 10(7) cycles). A possible switching mechanism based on ion motion in the film is discussed based on these observations.

Promotion of Probabilistic Bit Generation in Mott Devices by Embedded Metal Nanoparticles.

Considerable attention has been drawn to the use of volatile two-terminal devices relying on the Mott transition for the stochastic generation of probabilistic bits (p-bits) in emerging probabilistic computing. To improve randomness and endurance of bit streams provided by these devices, delicate control of the transient evolution of switchable domains is required to enhance stochastic p-bit generation. Herein, it is demonstrated that the randomness of p-bit streams generated via the consecutive pulse inputs of pump-probe protocols can be increased by the deliberate incorporation of metal nanoparticles (NPs), which influence the transient dynamics of the nanoscale metallic phase in VO2 Mott switches. Among the vertically stacked Pt-NP-containing VO2 threshold switches, those with higher Pt NP density show a considerably wider range of p-bit operation (e.g., up to ≈300% increase in ΔVprobe upon going from (Pt NP/VO2)0 to (Pt NP/VO2)11) and can therefore be operated under the conditions of high speed (400 kbit s-1), low power consumption (14 nJ per bit), and high stability (>105 200 bits) for p-bit generation. Thus, the study presents a novel strategy that exploits nanoscale phase control to maximize the generation of nondeterministic information sources for energy-efficient probabilistic computing hardware.

Revised evaluation objectives of the Korean Dentist Clinical Skill Test: a survey study and focus group interviews

PURPOSE: This study aimed to propose a revision of the evaluation objectives of the Korean Dentist Clinical Skill Test by analyzing the opinions of those involved in the examination after a review of those objectives. METHODS: The clinical skill test objectives were reviewed based on the national-level dental practitioner competencies, dental school educational competencies, and the third dental practitioner job analysis. Current and former examinees were surveyed about their perceptions of the evaluation objectives. The validity of 22 evaluation objectives and overlapping perceptions based on area of specialty were surveyed on a 5-point Likert scale by professors who participated in the clinical skill test and dental school faculty members. Additionally, focus group interviews were conducted with experts on the examination. RESULTS: It was necessary to consider including competency assessments for "emergency rescue skills" and "planning and performing prosthetic treatment." There were no significant differences between current and former examinees in their perceptions of the clinical skill test's objectives. The professors who participated in the examination and dental school faculty members recognized that most of the objectives were valid. However, some responses stated that "oromaxillofacial cranial nerve examination," "temporomandibular disorder palpation test," and "space management for primary and mixed dentition" were unfeasible evaluation objectives and overlapped with dental specialty areas. CONCLUSION: When revising the Korean Dentist Clinical Skill Test's objectives, it is advisable to consider incorporating competency assessments related to "emergency rescue skills" and "planning and performing prosthetic treatment."

Gastrokine 1 regulates NF-κB signaling pathway and cytokine expression in gastric cancers.

Gastrokine 1 (GKN1) plays an important role in the gastric mucosal defense mechanism and also acts as a functional gastric tumor suppressor. In this study, we examined the effect of GKN1 on the expression of inflammatory mediators, including NF-κB, COX-2, and cytokines in GKN1-transfected AGS cells and shGKN1-transfected HFE-145 cells. Lymphocyte migration and cell viability were also analyzed after treatment with GKN1 and inflammatory cytokines in AGS cells by transwell chemotaxis and an MTT assay, respectively. In GKN1-transfected AGS cells, we observed inactivation and reduced expression of NF-κB and COX-2, whereas shGKN1-transfected HFE-145 cells showed activation and increased expression of NF-κB and COX-2. GKN1 expression induced production of inflammatory cytokines including IL-8 and -17A, but decreased expression of IL-6 and -10. We also found IL-17A expression in 9 (13.6%) out of 166 gastric cancer tissues and its expression was closely associated with GKN1 expression. GKN1 also acted as a chemoattractant for the migration of Jurkat T cells and peripheral B lymphocytes in the transwell assay. In addition, GKN1 significantly reduced cell viability in both AGS and HFE-145 cells. These data suggest that the GKN1 gene may inhibit progression of gastric epithelial cells to cancer cells by regulating NF-κB signaling pathway and cytokine expression.

The Efficacy of the Partial Glossectomy for Prevention of Airway Volume Reduction in Orthognathic Surgery of Class III Patients.

The aim of this study was to evaluate the effects of a partial glossectomy on volumetric changes of pharyngeal airway space (PAS) in patients with mandibular setback surgery. Overall, 25 patients showing clinical features related to macroglossia treated with mandibular setback surgery were included in this retrospective study. Subjects were divided into two groups: the control group (G1, n = 13, with BSSRO) and the study group (G2, n = 12, with both BSSRO and partial glossectomy). The PAS volume of both groups was measured by the OnDemand 3D program on CBCT taken shortly before operation (T0), 3 months post-operative (T1), and 6 months post-operative (T2). A paired t-test and repeated analysis of variance (ANOVA) were used for statistical correlation. Total PAS and hypopharyngeal airway space were increased after operation in Group 2 compared to Group 1 (p < 0.05), while oropharyngeal airway space showed no significant statistical difference with the tendency of increasing. The combination of partial glossectomy and BSSRO surgical techniques had a significant effect on increasing the hypopharyngeal and total airway space in class III malocclusion patients (p < 0.05).

Comparison of vertical bone resorption following various types of autologous block bone grafts.

BACKGROUND: This study aims to measure and compare the differences in vertical bone resorption after vertical augmentation using different types of autologous block bone. METHODS: Data were collected from 38 patients who had undergone vertical ridge augmentation using an autologous block bone before implant insertion. The patients were divided into three groups based on the donor sites: ramus bone (RB), chin bone (CB), and iliac crestal bone (IB). RESULTS: The surgical outcome of the augmentation was evaluated at the follow-up periods up to 60 months. In 38 patients, the mean amount of vertical bone gain was 8.36 ± 1.51 mm in the IB group, followed by the RB group (4.17 ± 1.31 mm) and the CB group (3.44 ± 1.08 mm). There is a significant difference in vertical bone resorption between the groups (p < 0.001), and the RB group demonstrated significantly lower resorption than the CB and IB groups (p = 0.011 and p < 0.001, respectively). The most common postoperative complications included neurosensory disturbance in the CB graft and gait disturbance in the IB graft. Out of the 92 implants inserted after augmentation, four implants were lost during the study period, resulting in an implant success rate of 95.65%. CONCLUSIONS: The RB graft might be the most suitable option for vertical augmentation in terms of maintaining postoperative vertical height and reducing morbidity, although the initial gain was greater with the IB graft compared to other block bones.

Implant placement with inferior alveolar nerve repositioning in the posterior mandible.

This case report presents inferior alveolar nerve (IAN) repositioning as a viable approach for implant placement in the mandibular molar region, where challenges of severe alveolar bone width and height deficiencies can exist. Two patients requiring implant placement in the right mandibular molar region underwent nerve transposition and lateralization. In both cases, inadequate alveolar bone height above the IAN precluded the use of short implants. The first patient exhibited an overall low alveolar ridge from the anterior to posterior regions, with a complex relationship with adjacent implant bone level and the mental nerve, complicating vertical augmentation. In the second case, although vertical bone resorption was not severe, the high positioning of the IAN within the alveolar bone due to orthognathic surgery raised concerns regarding adequate height of the implant prosthesis. Therefore, instead of onlay bone grafting, nerve transposition and lateralization were employed for implant placement. In both cases, the follow-up results demonstrated successful osseointegration of all implants and complete recovery of postoperative numbness in the lower lip and mentum area. IAN repositioning is a valuable surgical technique that allows implant placement in severely compromised posterior mandibular regions, promoting patient comfort and successful implant placement without permanent IAN damage.

Usefulness of the retromandibular transparotid approach for condylar neck and condylar base fractures.

Condyle fractures represent 20% to 30% of all mandibular fractures and are thus among the most common facial fractures. The fracture pattern can vary greatly and may occur anywhere along the line from the sigmoid notch to the mandibular angle. The main problems are access, difficulty in repositioning the extremely slender fragments, and fixation of the condyle.Eighty-seven patients were diagnosed with condylar neck or condylar base fractures from January 2007 to December 2009 in the Department of Oral & Maxillofacial Surgery of Kyung Hee University Dental Hospital. In this study, we included 35 patients who underwent open surgery and a total of 28 patients who were treated using a retromandibular transparotid approach.Surgical treatment aims were anatomic repositioning and rigid fixation of the fragments, occlusal stability, rapidly return to function, maintenance of vertical ramus dimension, no airway compromise, and reduced long-term temporomandibular joint dysfunction. Considering the high rate of occurrence of condylar fracture and the importance of the condylar as a growth center of the mandible, extraoral approaches for the open reduction of condylar fractures are considered effective and can be used widely.Short access route, easy reduction, short operating time, and stable postoperative occlusion are the advantages of the retromandibular transparotid approach. Also, there was no permanent damage from facial nerve injury, salivary leakage, or preauricular hypoesthesia. Therefore, the retromandibular transparotid approach is considered a safe and effective method for patients with a condylar neck or condylar base fracture classified according to the Strasbourg Osteosynthesis Research Group's classification, who require surgical treatment with an extraoral approach.

Salvation for hardware failure of resorbable fixation plates in bilateral mandibular angle fractures.

The resorbable fixation system is used for the treatment of facial bone fractures and has many merits. It does not require a fixture removal procedure and is biologically nontoxic. Also, it does not disturb normal growth in growing children. However, there are also many points to be considered, such as resorption time, foreign body reaction, infection rate, or fixation stability depending on the fracture pattern. Because of these factors, there is still controversy over the use of a resorbable system.We present a case of a patient who experienced malunion after using a resorbable fixation system to treat bilateral mandibular angle fracture, which was recovered by corrective osteotomy and vertical ramus osteotomy in our department.

Postoperative stability of 2-jaw surgery with clockwise rotation of the occlusal plane.

OBJECTIVE: The objective of this study was to investigate the skeletal stability after Le Fort I osteotomy with clockwise rotation and bilateral sagittal split osteotomy. MATERIALS AND METHODS: The sample consisted of 31 young Korean patients who were treated with Le Fort I osteotomy with clockwise rotation and setback bilateral sagittal split osteotomy. The lateral cephalographs were obtained before surgery (T1), right after surgery (T2), and on an average of 6.23 months after the operation (T3). The horizontal and vertical relations of landmarks to the reference line and soft tissue changes were evaluated. RESULT: During the T2 - T1 period, there was superior and anterior movement of the posterior part (PNS, UMD) and advancement and impaction of the anterior part (ANS, A point, UIE) of the maxilla. The mandible was moved superiorly and posteriorly. During the T3 - T2 period, maxillary segment showed counterclockwise rotational relapse. The posterior part was relatively stable especially in the vertical position and the anterior part moved in the posterior and superior directions. Mandibular landmarks showed forward relapse in the horizontal aspect and superior relapse in the vertical aspect. The posterior part (PNS and UMD) showed a significantly higher stability rate (>70%) in the vertical aspect and the anterior part of the maxilla (ANS, A point) demonstrated a significantly lower value (<30%) in the vertical aspect. According to the skeletal changes, the soft tissue of the lower facial profile is rotated clockwise. CONCLUSIONS: Two-jaw surgeries involving clockwise rotation of the occlusal plane showed stable results especially in the maxillary posterior landmarks. The clockwise rotational movement can be beneficial to increase skeletal stability and facial aesthetics in Asians.

Osteochondroma of the mandibular condyle: surgical excision followed by occlusal stabilization.

Osteochondroma of the mandibular condyle in adults can be treated by surgical excision, condylectomy followed by costochondral graft or orthognathic surgery. Such complex treatment plan may not be appropriate for patients with old age, affected with chronic osteochondroma of the condyle. In this clinical report, we present a patient with osteochondroma of the condyle treated by surgical excision. The patient's postoperative occlusion was a contraindication for orthognathic surgery because of the severe abrasion of the teeth and the chronic compensation of the dentition to the deviated mandible. Surgical excision of the lesion was carried out under general anesthesia, and the remaining condylar head was salvaged as much as possible. No graft materials or posthodontic condyle reconstruction was carried out. Because there was no occlusal stop to secure the mandible in a centric relation position of the condyle, a stabilization splint was delivered to position the condyle in a relatively stable position. The stability of the condyle position was evaluated by follow-up cone beam computed tomographic scans of the pathologic and the contralateral condyle, along with clinical factors such as occlusal contact points and mandible movements assayed by ARCUSdigma (KaVo). After significant condylar position was achieved, full prosthodontic reconstruction was performed to both the patient's and the dentist's satisfaction.

The autotransplantation and orthodontic treatment of multiple congenitally missing and impacted teeth.

Congenitally missing teeth are one of the most common dental anomalies. When permanent teeth are absent, various problems can occur It is important to consider the facial profile, position of the incisor teeth, skeletal and dental development, and available dental space before planning treatment. Possible treatment methods include preserving and retaining the deciduous tooth, replacing the missing tooth with prosthesis, placing an implant, or performing a transplant after extracting the deciduous tooth. Among these possibilities, autotransplantation combined with orthodontic treatment corrects both function and esthetics. This report describes the case of a 7-year-old girl with multiple congenitally missing teeth and an impacted right mandibular second premolar. Timely autotransplantation of the impacted mandibular tooth to the region of the congenitally missing right maxillary second premolar produced favorable results.