Three-dimensional study of different skeletal craniofacial patterns from the eighteenth to the twenty-first century in a Portuguese population.

Objective: To evaluate the most frequent skeletal craniofacial pattern.Methods: Cone beam computed tomography images were obtained for a sample of 332 skulls from the eighteenth, nineteenth and twentieth centuries. A sample of 150 individuals from the twenty-first century was also included. The different skeletal craniofacial patterns were then classified into subclasses according to Slavicek´s method.Results: Over the centuries, skeletal Class II malocclusion has been more prevalent, mainly in the nineteenth century. The skeletal Class I subclass neutral maxilla and neutral mandible (N-N) has presented higher values since the nineteenth century (above 60%), and the skeletal Class II subclass prognathic maxilla and neutral mandible (P-N) have been increasing.Conclusion: In the Portuguese population, the most common skeletal pattern was skeletal Class II malocclusion. From the nineteenth to twenty-first century, there is an increase in the value of skeletal Class I malocclusion, and subclass N-N is undoubtedly the most frequent.

Evaluation of horizontal condylar angle in malocclusions with mandibular lateral displacement using cone-beam computed tomography.

OBJECTIVES: To evaluate the horizontal condylar angle (HCA) in mandibular lateral displacement (MLD). MATERIALS AND METHODS: HCA in MLD malocclusions were examined using cone-beam computed tomography data in subjects with MLD and control subjects. RESULTS: HCA in joints of control patients and contralateral side joints of MLD patients were not significantly different. The mean HCA on the shifted side was larger than on the contralateral side (P < .001) in the different HCA groups. HCA was significantly larger on the shifted side than on the contralateral side in skeletal Class I, Class II, and Class III groups (P < .001). CONCLUSIONS: (1) There was no statistically significant difference between HCA in control patients and on the contralateral side in MLD patients. (2) HCA was significantly larger on the shifted side than on the contralateral side. (3) HCA on the shifted side and the contralateral side in MLD Class I, Class II, and Class III are significantly different.

Autonomic nervous activities associated with bruxism events during sleep.

OBJECTIVES: To confirm the relationship between sleep bruxism (SB) and autonomic nervous (AN) activities to elucidate SB physiology. METHODS: Subjects included 11 healthy males (mean age, 24.7 ± 2.3 years). These data were recorded in the sleep laboratory using a system composed of a two-axis accelerometer, an infrared camera, electroencephalography, electromyography, and electrocardiography. Time lapse analysis confirmed correlations between AN activity and SB events during sleep in subjects. Relationships between SB strength and length and AN activity were evaluated. RESULTS: Sympathetic nerve (SN) and parasympathetic nerve (PSN) activities occurred significantly in 93.3% of cases (p < 0.01), with similar predictable patterns during SB. Furthermore, SB length and SN activity in seven of the subjects (four subjects, p < 0.05; three subjects p < 0.01), and PSN and SB muscle activities (% maximum voluntary contraction) in five subjects (four subjects, p < 0.05; one subject, p < 0.01) were significantly correlated. DISCUSSION: The authors believe that SB is closely related to SN as well as PSN activities and may control the AN system.

Status of occlusal contact during sleep bruxism in patients who visited dental clinics - A study using a Bruxchecker®.

OBJECTIVE: Bruxism-induced mechanical load causes various dental problems, and its treatment is challenging. The present study analyzed upper and lower tooth contacts to determine actual occlusal contact during sleep bruxism. METHODS: Tooth contact patterns were analyzed in 49 patients attending dental clinics, using a Bruxchecker®, cephalograms, and condylographs. RESULTS: Approximately 80% of individuals demonstrated contact from the anterior teeth to the molar region (ICPM); about 96% had mediotrusive grinding and contact. The tooth contact area increased with the flatness of the anterior occlusal plane. The ratio of the contact area of the anterior teeth to the overall tooth contact area increased with overbite. Bilateral ICPM and mediotrusive contact patterns were associated with a high frequency of temporomandibular disorder symptoms, clicking, and/or pain. DISCUSSION: The tooth contact area, anterior occlusal plane, and overbite are closely related, suggesting that tooth contact with the anterior teeth should be controlled with occlusal therapy.

Three-dimensional morphological characterization of malocclusions with mandibular lateral displacement using cone-beam computed tomography.

OBJECTIVE: The purpose of this study was to evaluate the morphologic characteristics of MLD malocclusions using 3D imaging. MATERIALS AND METHODS: MLD characteristics were examined using CBCT data in 40 subjects. A 3D Cephalometric analysis was developed to describe the spatial position of the mandible and temporal bones. RESULTS: Vertical dental heights were shorter and the posterior occlusal plane (POP) presented a steeper sagittal inclination on the shifted side (the side of the laterally displaced bony chin) than on the contralateral side. (p < 0.01). The MLD was related to a superiorly inclined POP Cant in the same direction (r = 0.82; p < 0.01). The shifted side condyle was dislocated medially and was smaller. Temporal bone sagittal inclination showed a more forward and medial inclination on the contralateral side (p < 0.01). CONCLUSIONS: A unilateral decrease in the vertical height of the dentition and the subsequent steeper occlusal plane inclinations correlated with (1) mandibular rotational displacement and condylar lateral displacement, (2) mandibular and condylar morphologic changes (3) changes in temporal bone position.

Relationship of maxillary 3-dimensional posterior occlusal plane to mandibular spatial position and morphology.

INTRODUCTION: The purpose of this study was to examine the relationship of the 3-dimensional (3D) posterior occlusal plane (POP) and the mandibular 3D spatial position. The relationship of the POP to mandibular morphology was also investigated. METHODS: Retrospective data from a convenience sample of pretreatment diagnostic cone-beam computed tomography scans were rendered using InVivo software (Anatomage, San Jose, Calif). The sample consisted of 111 subjects (51 male, 60 female) and included growing and nongrowing subjects of different races and ethnicities. The 3D maxillary POP was defined by selecting the cusp tips of the second premolars and the second molars on the rendered images of the subjects. The angles made by this plane, in reference to the Frankfort horizontal plane, were measured against variables that described the mandibular position in the coronal, sagittal, and axial views. The POP was also compared with bilateral variables that described mandibular morphology. RESULTS: There were significant differences of the POP among the different skeletal malocclusions (P <0.0001). The POP showed significant correlations with mandibular position in the sagittal (P <0.0001), coronal (P <0.05), and axial (P <0.05) planes. The POP also showed a significant correlation with mandibular morphology (P <0.0001). CONCLUSIONS: These findings suggest that there is a distinct and significant relationship between the 3D POP and the mandibular spatial position and its morphology.

Ameliorating effects of Juzentaihoto on restraint stress and P. gingivalis-induced alveolar bone loss.

OBJECTIVE: Juzentaihoto (JTX) is a traditional Japanese medicine that consists of 10 herbs. The purpose of this study was to evaluate the efficacy of multi-herbal medicine JTX as a preventive and therapeutic drug for periodontal bone resorption and for reducing restraint stress. MATERIALS AND METHODS: Porphyromonas gingivalis ATCC 33277 was used for testing the antibacterial activity of JTX and a rat experimental periodontitis model. To evaluate the effect of JTX against P. gingivalis infection, we determined the differences in alveolar bone loss among experimental groups. The concentrations of adrenocorticotropic hormones were measured as stress markers, and atrophy of the thymus and spleen was assessed. RESULTS: JTX had antibacterial activity against P. gingivalis ATCC 33277. JTX treatment of mouse bone marrow cells at a concentration of 0.1 µg/ml significantly inhibited osteoclast formation. Administration of JTX to rats with P. gingivalis infection and restraint stress significantly reduced alveolar bone loss compared with the case with just the combination of P. gingivalis infection and restraint stress. In the restrained groups, stress markers were elevated, and the thymus and spleen were atrophied. The groups with administration of JTX showed not only inhibition of the decrease of weight but also normalization of corticosterone and cortisol values. CONCLUSION: JTX effectively inhibited restraint stress and osteoclastogenesis. It appears that the effects of JTX inhibit the destruction of periodontal tissue by suppressing stress. Our study demonstrated that JTX affects the correlation between restraint stress and periodontitis.

Vertical facial height and its correlation with facial width and depth: Three dimensional cone beam computed tomography evaluation based on dry skulls.

INTRODUCTION: The aim of the present study was to evaluate how vertical facial height correlates with mandibular plane angle, facial width and depth from a three dimensional (3D) viewing angle. METHODS: In this study 3D cephalometric landmarks were identified and measurements from 43 randomly selected cone beam computed tomography (CBCT) images of dry skulls from the Weisbach collection of Vienna Natural History Museum were analyzed. Pearson correlation coefficients of facial height measurements and mandibular plane angle and the correlation coefficients of height-width and height-depth were calculated, respectively. RESULTS: The mandibular plane angle (MP-SN) significantly correlated with ramus height (Co-Go) and posterior facial height (PFH) but not with anterior lower face height (ALFH) or anterior total face height (ATFH). The ALFH and ATFH showed significant correlation with anterior cranial base length (S-N), whereas PFH showed significant correlation with the mandible (S-B) and maxilla (S-A) anteroposterior position. CONCLUSIONS: High or low mandibular plane angle might not necessarily be accompanied by long or short anterior face height, respectively. The PFH rather than AFH is assumed to play a key role in the vertical facial type whereas AFH seems to undergo relatively intrinsic growth.

Chronic stress induces neurotrophin-3 in rat submandibular gland.

PURPOSE: Plasma neurotrophin-3 (NT-3) levels are associated with several neural disorders. We previously reported that neurotrophins were released from salivary glands following acute immobilization stress. While the salivary glands were the source of plasma neurotrophins in that situation, the association between the expression of neurotrophins and the salivary gland under chronic stress conditions is not well understood. In the present study, we investigated whether NT-3 levels in the salivary gland and plasma were influenced by chronic stress. MATERIALS AND METHODS: Expressions of NT-3 mRNA and protein were characterized, using real-time polymerase chain reactions, enzyme-linked immunosorbent assay, and immunohistochemistry, in the submandibular glands of male rats exposed to chronic stress (12 h daily for 22 days). RESULTS: Plasma NT-3 levels were significantly increased by chronic stress (p<0.05), and remained elevated in bilaterally sialoadenectomized rats under the same condition. Since chronic stress increases plasma NT-3 levels in the sialoadenectomized rat model, plasma NT-3 levels were not exclusively dependent on salivary glands. CONCLUSION: While the salivary gland was identified in our previous study as the source of plasma neurotrophins during acute stress, the exposure to long-term stress likely affects a variety of organs capable of releasing NT-3 into the bloodstream. In addition, the elevation of plasma NT-3 levels may play important roles in homeostasis under stress conditions.

Stress and chewing affect blood flow and oxygen levels in the rat brain.

OBJECTIVE: Mastication, including chewing, would be of great importance not only for food intake, but also for the mental, physical and physiological functioning of the body. Our study showed that mastication, especially chewing, suppresses the stress response and was regarded as a biological response to defend against various stresses. Although mastication altered brain function during stress, the underlying mechanisms have not been elucidated. METHODS: The effects of chewing during restraint stress on blood flow and oxygen partial pressure (PO(2)) levels in the rat amygdala and hypothalamus were measured using laser Doppler flowmetry and O(2)-selective electrodes. RESULTS: Amygdaloidal and hypothalamic blood flow were not affected by restraint stress, but PO(2) levels were significantly reduced by restraint stress for 180 min compared to unrestrained control rats. The decrease in amygdaloidal and hypothalamic PO(2) levels during restraint stress was reduced after chewing for 30 min. CONCLUSION: These results suggested that it is possible to evaluate hypothalamic and amygdaloidal blood flow and PO(2) levels in rat brains during restraint stress. Restraint stress reduced cerebral PO(2) levels. In addition, chewing would lead to increased blood flow and to recover cerebral PO(2) levels.

A computerized tomography study of the morphological interrelationship between the temporal bones and the craniofacial complex.

The hypothesis that the temporal bones are at the center of the dynamics of the craniofacial complex, directly influencing facial morphology, has been put forward long ago. This study examines the role of the spatial positioning of temporal bones (frontal and sagittal inclination) in terms of influencing overall facial morphology. Several 3D linear, angular and orthogonal measurements obtained through computerized analysis of virtual models of 163 modern human skulls reconstructed from cone-beam computed tomography images were analyzed and correlated. Additionally, the sample was divided into two subgroups based on the median value of temporal bone sagittal inclination [anterior rotation group (n = 82); posterior rotation group (n = 81)], and differences between groups evaluated. Correlation coefficients showed that sagittal inclination of the temporal bone was significantly (P < 0.01) related to midline flexion, transversal width and anterior-posterior length of the basicranium, to the anterior-posterior positioning of the mandible and maxilla, and posterior midfacial height. Frontal inclination of the temporal bone was significantly related (P < 0.01) to basicranium anterior-posterior and transversal dimensions, and to posterior midfacial height. In comparison with the posterior rotation group, the anterior rotation group presented a less flexed and anterior-posteriorly longer cranial base, a narrower skull, porion and the articular eminence located more superiorly and posteriorly, a shorter posterior midfacial height, the palatal plane rotated clockwise, a more retrognathic maxilla and mandible, and the upper posterior occlusal plane more inclined and posteriorly located. The results suggest that differences in craniofacial morphology are highly integrated with differences in the positional relationship of the temporal bones. The sagittal inclination of the temporal bone seems to have a greater impact on the 3D morphology of the craniofacial complex than frontal inclination.

Chewing ameliorates stress-induced suppression of spatial memory by increasing glucocorticoid receptor expression in the hippocampus.

Chewing alters hypothalamic-pituitary-adrenal axis function and improves the ability to cope with stress in rodents. Given that stress negatively influences hippocampus-dependent learning and memory, we aimed to elucidate whether masticatory movements, namely chewing, improve the stress-induced impairment of spatial memory in conjunction with increased hippocampal glucocorticoid receptor expression. Male Sprague-Dawley rats were subjected to restraint stress by immobilization for 2h: the stress with chewing (SC) group were allowed to chew on a wooden stick during the latter half of the immobilization period, whereas the stress without chewing (ST) group were not allowed to do so. Performance in the Morris water maze test was significantly impaired in the ST group compared with the SC group. Further, the numbers of glucocorticoid receptor immunopositive neurons in the hippocampal cornu ammonis 1 region were significantly lower in the ST group than in the control and SC groups. The control and SC rats showed no significant differences in both the water maze performance and the numbers of glucocorticoid receptor-immunopositive neurons. The immunohistochemical finding correlated with the performance in the water maze test. These results suggest that chewing is a behavioral mechanism to cope with stress by increasing hippocampal glucocorticoid receptor expression.

Comparison of Japanese and European overbite depth indicator and antero-posterior dysplasia indicator values.

This study evaluated cephalometric differences between 113 Japanese (43 males and 70 females, aged 14.1 ± 5 years) and 106 European subjects (36 males and 70 females, aged 13.5 ± 7.3 years) using two compound angular measurements and their single components: the overbite depth indicator (ODI) for the assessment of vertical skeletal relationships and the antero-posterior dysplasia indicator (APDI) for an evaluation of sagittal dysgnathia. Both populations were assigned to groups representing Angle Classes I, II, and III, and an anterior open bite (AOB) group. Two sample t- and Wilcoxon signed-ranks tests were performed (P < 0.05). The ODI values showed no statistically significant differences between the Japanese and European samples. The Japanese sample showed a significantly smaller APDI but only in the Class II group. In the Japanese Class II and III subjects, the malocclusion patterns were more pronounced than those in the Caucasian sample (overbite, overjet, and APDI).

The amount of TMJ displacement correlates with brain activity.

The aim of this functional magnetic resonance imaging (fMRI) study was to investigate the correlation between the severity of malocclusion and brain activation. The fMRI was used to measure blood-oxygenation- level-dependent (BOLD) signals of twelve healthy human subjects while they clenched in two different ways to simulate two types of malocclusion. In each malocclusion model, a custom-made splint forced the mandible to each of two retrusive positions (0.5 mm, 0.7 mm). A no-modification splint provided the control. We compared the BOLD signals measured at each clenching position with those measured during the corresponding resting conditions. The BOLD signals were significantly stronger in the amygdala and the prefrontal area (PFA) when subjects clenched in the two retrusive positions compared during clenching in the control position. In addition, the BOLD signal in the PFA increased as the simulated malocclusion became more severe. These results indicate that we may be able to objectively assess the severity of malocclusion via focus on the brain activity.

Chewing reduces sympathetic nervous response to stress and prevents poststress arrhythmias in rats.

Reducing stress is important in preventing sudden death in patients with cardiovascular disease, as stressful events may cause autonomic imbalance and trigger fatal arrhythmias. Since chewing has been shown to inhibit stress-induced neuronal responses in the hypothalamus, we hypothesized that chewing could ameliorate stress-induced autonomic imbalance and prevent arrhythmias. To test this hypothesis, we analyzed changes in radiotelemetered electrocardiograms in rats that were allowed to chew a wooden stick during a 1-h period of immobilization stress. Chewing significantly reduced the occurrence of ventricular premature beats (VPBs) and complex ventricular ectopy after immobilization and prevented stress-induced prolongation of the QT interval of VPBs throughout the 10-h experimental period. It also prevented prolongation of the QRS complex and fluctuations in the QT interval in normal sinus rhythm beats preceding VPBs during both immobilization and in the poststress period. Fast Fourier transform-based spectral analysis of heart-rate variability further showed that chewing significantly inhibited the stress-induced increase in the power ratio of low-to-high frequency activity (LF/HF: a marker of sympathetic activity) during immobilization and in addition was associated with blunting of the stress-induced increase in plasma noradrenaline observed at the termination of immobilization. Similar suppressive effects on the occurrence of VPBs and the LF/HF were observed in rats that were administered the ß-adrenergic blocker propranolol before immobilization. These results indicate that chewing can ameliorate sympathetic hyperactivity during stress and prevent poststress arrhythmias and suggest that chewing may provide a nonpharmacological and cost-effective treatment option for patients with a high risk of stress-induced fatal arrhythmia.

Direct projections from the central amygdaloid nucleus to the mesencephalic trigeminal nucleus in rats.

The amygdala is activated by fear and plays an important role in the emotional response to life-threatening situations. When rats feel threatened, they respond by biting fiercely. Bite strength is regulated by the trigeminal motor nucleus and the mesencephalic trigeminal nucleus (Me5). The Me5 relays proprioceptive signals from the masticatory muscles and the periodontal ligaments to the trigeminal motor and premotor nuclei. The amygdala projects to the trigeminal motor nucleus and the premotor reticular formation. However, it is unknown whether the amygdala projects directly to the Me5. In the present study, neurons of the central amygdaloid nucleus (ACe) were labeled following injection of a retrograde tracer, Fast Blue, into the caudal Me5, and fibers and terminal buttons from the ACe to the Me5 were examined after injections of an anterograde neuronal tracer, biotinylated dextran amine into the ACe. Furthermore, wheat germ agglutinin-conjugated to horseradish peroxidase was injected into the ACe, and labeled fibers and terminal buttons in the Me5 were examined by electron microscopy. Labeled terminal buttons on Me5 somata were more abundant in the caudal than the rostral Me5. Electron microscopic observation revealed that a part of these terminal buttons formed axo-somatic synapses. These results indicate that the ACe sends direct projections to the Me5, and suggest that the amygdala regulates bite strength by modifying neuronal activity in the Me5.

Occlusion factors influencing the magnitude of sleep bruxism activity.

The biomechanical load during strong bruxism activity reportedly causes many dental/oral problems. However, it is unknown whether the magnitude of muscle activity during sleep is controllable. In this study, the relationship between the magnitude of muscle activity during sleep and types of tooth contacts was examined, including anterior and posterior guidance, in order to clarify how occlusion factors contribute to sleep bruxism (SB). An EMG-2-axis accelerometer system was used for monitoring patterns and activities of SB. Bruxchecker was used to evaluate tooth contacts during SB, and a condylograph was used to measure posterior guidance (sagittal condylar inclination). Results show that grinding rather than clenching or tapping was observed in the high SB group, and there was Incisor-Canine-Premolar-Molar (ICPM) tooth contact during SB grinding movement. The canine occlusal guidance (COG) was flatter in the low SB group than in the moderate SB group. Relative canine occlusal guidance (rCOG), which is the difference between the sagittal condylar inclination (SCI) and COG, was larger in the low SB group than that in the high SB group. These findings suggest that the grinding pattern must be controlled to prevent strong bruxism, and that the muscle activity during bruxism can be reduced by controlling the tooth contact pattern during SB grinding.

Basic helix-loop-helix transcription factor DEC1 negatively regulates cyclin D1.

DEC1 (also known as Stra13/Bhlhb2/Sharp2) and DEC2 (also known as Bhlhb3/Sharp1) are two paralogous basic helix-loop-helix (bHLH) transcriptional regulators which exhibit a robust circadian gene expression pattern in the suprachiasmatic nucleus (SCN) and in peripheral organs. DEC1 has been suggested to play key roles in mammalian cell differentiation, the cell cycle and circadian regulation, hypoxia response, and carcinogenesis. Here we show that DEC1 overexpression exhibits delayed wound healing and reduces cell proliferation, migration, and invasion. DEC1 strongly repressed the promoter activity of cyclin D1. We further identify a possible DEC-response element in the cyclin D1 promoter region, and confirmed the direct binding of DEC1 to that element. Forced expression of DEC1 efficiently repressed the cyclin D1 promoter and expression. Our clinical data provide the first evidence that there is a strong inverse correlation between DEC1 and cyclin D1 expression in oral cancer, and DEC1 expression significantly correlated with clinicopathological parameters. We suggest that radiation-induced DEC1 overexpression and Akt phosphorylation in cancer cells are mediated via PI-3K signalling. Overexpression of DEC1 activates the PI-3K/Akt signalling pathway through reactive oxygen species (ROS).

Oxidized galectin-1 reduces lipopolysaccharide-induced increase of proinflammatory cytokine mRNA in cultured macrophages.

BACKGROUND: Periodontitis is prevalent in older humans. Limiting the inflammation associated with periodontitis may provide a therapy for this condition, because Gram-negative bacteria expressing lipopolysaccharide (LPS) have a key role in initiation of inflammation by activating macrophage functions. Because oxidized galectin-1 regulates macrophage functions in other systems, we sought to establish whether this galectin-1 mRNA is expressed in the oral cavity, and whether it could dampen LPS-induced macrophage activation in vitro. METHODS: Using the reverse transcriptase polymerase chain reaction (RT-PCR), we measured galectin-1 mRNA expression to clarify its localization to rat gingival tissues and studied the effect of Porphyromonas gingivalis challenge on galectin-1 expression. Next, we tested the effects of adding oxidized galectin-1 to cultured LPS-activated peritoneal macrophages on mRNA expression of proinflammatory factors by RT-PCR and real-time RT-PCR. RESULTS: We established that galectin-1 mRNA is expressed in gingival tissues and also showed that galectin-1 mRNA was significantly increased by challenge with P. gingivalis, indicating that galectin-1 may regulate oral inflammation. On the other hand, LPS 100 ng/mL in serum-containing medium induced macrophages to upregulate mRNA associated with a proinflammatory response, ie, interleukins 1ß and 6, and inducible nitric oxide synthase. We showed that application of 0.1-10 ng/mL of oxidized galectin-1 to LPS-treated macrophages reduced the intense LPS- induced increase by serum in proinflammatory mRNA expression in a concentration-dependent manner. Furthermore, application of oxidized galectin-1 10 ng/mL to LPS-treated macrophages in serum-free medium also showed a similar effect on LPS activity. CONCLUSION: Oxidized galectin-1 restricts the proinflammatory actions of LPS, and this protein could limit the negative effects of inflammation.