Natural Head Postures of Patients With Facial Asymmetry in Frontal View Are Corrected After Orthognathic Surgeries.

PURPOSE: Although orthognathic surgeries focus on adjustment of facial asymmetry (FA), many clinicians know by experience that the natural head posture (NHP) also is corrected after the surgery. The authors examined whether this was indeed the case by the measuring the NHP during the course of orthognathic treatment. Factors associated with NHP correction also were evaluated. PATIENTS AND METHODS: In this retrospective study, clinical features, including the NHP, of patients with FA and those with facial symmetry (FS) were compared. They were outpatients of a private orthodontic dental clinic from December 2008 to March 2012. The degree of NHP tilt was evaluated using an interpupillary (IP) horizontal angle. The NHP of patients with FA were analyzed further before presurgical orthodontic treatment, after presurgical orthodontic treatment, after orthognathic surgery and postsurgical orthodontic treatment, and 1 year after completion of postsurgical orthodontic treatment. The NHP difference at each time point was analyzed using 1-way analysis of variance. An analysis of factors that influence NHP tilt correction was performed by linear regression. RESULTS: Thirty-one patients with FA and 27 with FS were evaluated. The NHP tilt was more profound in the FA group compared with the FS group. There were more patients with skeletal Class III in the FA group. The degree of NHP tilt in the FA group was decreased after orthognathic surgery and postsurgical orthodontic treatment and remained when measured 1 year later. Women were less prone than men to NHP tilt correction by orthognathic surgery. CONCLUSION: Patients with FA have a tilted NHP compared with those with FS. Orthognathic surgery for FA might correct a tilted NHP to a lesser degree in women.

Integration of blue light with near-infrared irradiation accelerates the osteogenic differentiation of human dental pulp stem cells.

Blue light is used less in photobiomodulation than red or near-infrared light because of concerns about its high energy. However, some reports have suggested that blue light releases NO from nitrosated proteins, affects cell signal regulation, and promotes stem cell differentiation. Because blue and red lights could have different mechanisms of action, their combination is expected to have new consequences. In this study, human dental pulp stem cells (hDPSCs) were sequentially exposed to blue and near-infrared light to study their effects on proliferation, osteogenic differentiation, and immunomodulation. We found that NIR irradiation applied after blue light can reduce blue light toxicity improving the cell viabiltiy. Delayed luminescence and transmission electron microscopy studies showed that this combination excited hDPSCs and activated mitochondrial biogenesis. Those modulations accelerated hDPSC differentiation, as shown by an increase of about 1.3-fold in alkaline phosphatase activity in vitro and an about 1.5-fold increase in the osteocalcin-positive regions in cells implanted in nude mice compared with mice exposed to near-infrared alone.

Quantification of three-dimensional facial asymmetry for diagnosis and postoperative evaluation of orthognathic surgery.

BACKGROUND: To evaluate the facial asymmetry, three-dimensional computed tomography (3D-CT) has been used widely. This study proposed a method to quantify facial asymmetry based on 3D-CT. METHODS: The normal standard group consisted of twenty-five male subjects who had a balanced face and normal occlusion. Five anatomical landmarks were selected as reference points and ten anatomical landmarks were selected as measurement points to evaluate facial asymmetry. The formula of facial asymmetry index was designed by using the distances between the landmarks. The index value on a specific landmark indicated zero when the landmarks were located on the three-dimensional symmetric position. As the asymmetry of landmarks increased, the value of facial asymmetry index increased. For ten anatomical landmarks, the mean value of facial asymmetry index on each landmark was obtained in the normal standard group. Facial asymmetry index was applied to the patients who had undergone orthognathic surgery. Preoperative facial asymmetry and postoperative improvement were evaluated. RESULTS: The reference facial asymmetry index on each landmark in the normal standard group was from 1.77 to 3.38. A polygonal chart was drawn to visualize the degree of asymmetry. In three patients who had undergone orthognathic surgery, it was checked that the method of facial asymmetry index showed the preoperative facial asymmetry and the postoperative improvement well. CONCLUSIONS: The current new facial asymmetry index could efficiently quantify the degree of facial asymmetry from 3D-CT. This method could be used as an evaluation standard for facial asymmetry analysis.

Additive beneficial effects of losartan combined with simvastatin in the treatment of hypercholesterolemic, hypertensive patients.

BACKGROUND: Biological mechanisms underlying statin and angiotensin II type 1 receptor blocker therapies differ. Therefore, we compared vascular and metabolic responses to these therapies either alone or in combination in hypercholesterolemic, hypertensive patients. METHODS AND RESULTS: This was a randomized, double-blind, placebo-controlled crossover trial with 3 treatment arms (each 2 months) and 2 washout periods (each 2 months). Forty-seven hypertensive, hypercholesterolemic patients were given simvastatin 20 mg and placebo, simvastatin 20 mg and losartan 100 mg, or losartan 100 mg and placebo daily during each 2-month treatment period. Losartan alone or combined therapy significantly reduced blood pressure compared with simvastatin alone. Compared with losartan alone, simvastatin alone or combined therapy significantly changed lipoproteins. All 3 treatment arms significantly improved flow-mediated dilator response to hyperemia and decreased plasma malondialdehyde and monocyte chemoattractant protein-1 levels relative to baseline measurements. However, these parameters were changed to a greater extent with combined therapy compared with simvastatin or losartan alone (both P<0.001 and P=0.030 for monocyte chemoattractant protein-1 by ANOVA). Combined therapy or losartan alone significantly increased plasma adiponectin levels and insulin sensitivity (determined by QUICKI) relative to baseline measurements. These changes were significantly greater than in the group treated with simvastatin alone (P<0.001 for adiponectin, P=0.029 for QUICKI by ANOVA). CONCLUSIONS: Simvastatin combined with losartan improves endothelial function and reduces inflammatory markers to a greater extent than monotherapy with either drug in hypercholesterolemic, hypertensive patients.

Postchallenge hyperglycemia but not hyperinsulinemia is associated with angiographically documented coronary atherosclerosis in Korean subjects.

Although hyperinsulinemia has attracted considerable attention as a possible risk factor for coronary artery disease (CAD), previous studies have not shown consistent results. Hyperglycemia could be an alternative explanation for the association between type 2 diabetes and atherosclerosis. Since previous studies have been mostly lacking coronary angiographic data, we analyzed the relationship between the presence and severity of coronary atherosclerosis based on angiography and hyperinsulinemia or hyperglycemia. Two hundred and thirty subjects underwent coronary angiography and a 75-g oral glucose tolerance test. Age, sex, waist-to-hip ratio, postchallenge 1-h and 2-h glucose levels, plasma triglyceride and HDL-cholesterol levels were different between those with or without CAD. However, there was no significant difference in the plasma insulin levels, area of insulin under the curve, and the ratio of the insulin- and glucose areas between the groups with and without CAD. Multiple logistic regression analysis including fasting-, 1-h, and 2-h glucose values and a variety of atherosclerosis risk factors showed that age, sex and postchallenge 2-h glucose levels were independent determinants of the presence of CAD. These results suggest that coronary atherosclerosis might be associated with postchallenge hyperglycemia, but not with hyperinsulinemia in Korean subjects.