Can occlusal evaluation of children with unilateral cleft lip and palate help determine future maxillofacial morphology?

Objective : To investigate the change in occlusal evaluations from the 5-year-olds' index to the Goslon Yardstick and to compare the relationship between the evaluations and maxillofacial growth in patients with complete unilateral cleft lip and palate (UCLP). Design : A prospective longitudinal study. Subjects : The sample consisted of 85 patients with complete UCLP who underwent surgery from 1969 to 1994 and were treated at the Kyushu University Hospital in Fukuoka, Japan. Subjects had two serial dental casts performed at the ages of 5 and 10 years. Furthermore, each patient had lateral cephalographs taken at the age of 5 years, 76 of 85 subjects had films taken at the age of 10 years, and 54 subjects also had lateral cephalograms taken after the age of 15 years. Methods : Every dental cast was evaluated by the 5-year-olds' index and the Goslon Yardstick, respectively. The lateral cephalographs were traced and digitized, and angular dimensions were calculated. Outcomes were compared using Spearman's rank-order correlation analysis and the Kruskal-Wallis analysis. Results and Conclusion : Dental arch relationships were evaluated and rated as 2.96 in the 5-year-olds' index and 2.85 in the Goslon Yardstick, respectively. Both groupings showed a significant relationship, and they showed no change in 36 out of 85 subjects (42.3%), significant improvement in 30 (35.3%), and deterioration in 19 (22.3%). Two occlusal groupings and maxillofacial morphology on the cephalographs indicated that the grouping reflected the anteroposterior position of the mandible. Moreover, both groupings showed some relation to previous maxillofacial growth, but they did not show any relationship with future growth. The Goslon Yardstick may not predict maxillofacial morphology in adulthood.

Immunohistochemical analysis of interleukin-1 alpha, its type I receptor and antagonist in keratocystic odontogenic tumors.

BACKGROUND: Interleukin-1 alpha (IL-1 alpha) is thought to play a crucial role in the growth of keratocystic odontogenic tumors (KCOTs) in the jaw. The function of IL-1 alpha is regulated by the local levels of IL-1 alpha, its receptor and receptor antagonist (IL-1Ra) in tissues. In this study, the expression of these proteins was investigated both before and after marsupialization in KCOTs. METHODS: The expression of IL-1 alpha, IL-1 receptor type I (IL-1RI) and IL-1Ra was detected immunohistochemically in 10 specimens of KCOTs. RESULTS: IL-1 alpha was intensively expressed throughout the epithelium in all cases, while mild expression of IL-1 alpha was detected in the subepithelial layer endothelial cells and fibroblasts. Mild or intensive immunoreactivity for IL-1RI was also observed in the epithelial cells in all cases, and in the endothelial cells and fibroblasts in five cases respectively. The expression of IL-1Ra was detected in the epithelial cells in five cases, and in the endothelial cells and fibroblasts in three cases. After marsupialization, the immunoreactivity for IL-1 alpha and IL-1RI in the epithelial cells decreased, while the immunoreactivity for IL-1Ra in the epithelial cells increased. However, the immunoreactivity for IL-1RI and IL-1Ra in endothelial cells and fibroblasts did not change significantly. CONCLUSION: The effects of IL-1 alpha on the epithelial cells might be downregulated after marsupialization by changing the expression levels of IL-1 alpha, IL-1RI and IL-1Ra in the epithelium of KCOTs.

Marsupialization inhibits interleukin-1alpha expression and epithelial cell proliferation in odontogenic keratocysts.

BACKGROUND: Marsupialization results in the reduction of odontogenic cyst size. Interleukin-1alpha (IL-1alpha) is thought to play a crucial role for the expansion of odontogenic keratocysts. The aim of this study was to investigate the effects of marsupialization on the expression of IL-1alpha and on the proliferating activity of a lining epithelium in odontogenic keratocysts. METHODS: The concentrations of IL-1alpha, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) in the intracystic fluids of odontogenic keratocysts were measured by the enzyme-linked immunosorbent assay (ELISA). The expression of IL-1alpha mRNA in odontogenic keratocysts was measured before and after marsupialization by in situ hybridization. The expression of IL-1alpha and epithelial cell-proliferating activities in odontogenic keratocysts were also measured by immunohistochemistry using antibodies for human IL-1alpha and Ki-67 antigen, respectively. RESULTS: The intracystic fluid levels of IL-1alpha were significantly higher than those of IL-6 and TNF-alpha in odontogenic keratocysts. In situ hybridization and immunohistochemistry showed that strong expression of IL-1alpha mRNA and protein was mainly detected in the epithelial cells of odontogenic keratocysts. After marsupialization, the signal intensities for IL-1alpha mRNA and protein were significantly decreased. In addition, the Ki-67 labeling index of the epithelial cells was decreased proportionally with the grade of IL-1alpha mRNA expression after the marsupialization. CONCLUSION: Our findings suggest that marsupialization may reduce the size of odontogenic keratocyst by inhibiting IL-1alpha expression and the epithelial cell proliferation.