Dentoskeletal and soft tissue changes associated with miniscrew anchorage in customized lingual orthodontics.

OBJECTIVES: The goal of this study was to analyze skeletal, dental, and soft tissue changes of patients treated with customized lingual systems and to evaluate the clinical effectiveness of miniscrew anchorage. METHODS: Nine upper first premolar extraction patients who were treated with customized lingual appliances were included in this study. Miniscrews were used for reinforcement of molar anchorage. Cephalometric films and study models were obtained before treatment (T1), after alignment (T2), and after treatment (T3). Treatment effects were analyzed by cephalometric radiographs and study models. RESULTS: The upper anterior teeth were retracted significantly at T2 and T3 (4.41 ± 4.14 mm and 5.51 ± 2.48 mm, respectively). During space closure, the upper first molars showed slight mesial movement (1.50 ± 1.97 mm). The intercanine width of the upper arch increased at T2 (1.59 ± 1.81 mm), but decreased at T3 (0.11 ± 1.00 mm). The sella-nasion-A, A-nasion-B, and mandibular plane angles were not significantly changed at T3. The upper lip showed continuous retraction at both T2 and T3 (1.40 ± 1.46 mm and 2.32 ± 2.48 mm, respectively). CONCLUSIONS: By using miniscrew anchorage for lingual orthodontics, patients' dental and soft tissue changes considerably improved and molar anchorage was reinforced.

Middle Stone Age human teeth from Magubike rockshelter, Iringa Region, Tanzania.

In 2006, six isolated hominin teeth were excavated from Middle Stone Age (MSA) deposits at the Magubike rockshelter in southern Tanzania. They comprise two central incisors, one lateral incisor, one canine, one third premolar, and one fourth premolar. All are fully developed and come from the maxilla. None of the teeth are duplicated, so they may represent a single individual. While there is some evidence of post-depositional alteration, the morphology of these teeth clearly shares features with anatomically modern Homo sapiens. Both metric and non-metric traits are compared to those from other African and non-African dental remains. The degree of biological relatedness between eastern and southern African Stone Age hunter-gatherers has long been a subject of interest, and several characteristics of the Magubike teeth resemble those of the San of southern Africa. Another notable feature is that the three incisors are marked on the labial crown by scratches that are much coarser than microwear striations. These non-masticatory scratches on the Magubike teeth suggest that the use of the front teeth as tools included regularly repeated activities undertaken throughout the life of the individual. The exact age of these teeth is not clear as ESR and radiocarbon dates on associated snail shells give varying results, but a conservative estimate of their minimum age is 45,000 years.

Transition to agriculture in South-Eastern Arabia: Insights from oral conditions.

OBJECTIVES: In Southeast (SE) Arabia, agriculture is supposed to expand around 3000 BC, but its tempo and its actual role in populations' subsistence is still debated by archaeologists. Here, we compare dental health conditions of 11 skeletal samples from coastal and inland sites, dated from the Late Neolithic (ca. 4500-3100 BC) to the Early Bronze Age (EBA), conventionally divided into Hafit (ca. 3100-2700 BC) and Umm an-Nar period (ca. 2700-2000 BC). The goal is to assess long-term trends in subsistence patterns and regional variability during the local transition to agriculture. METHODS: Seven indicators of oral health and childhood stress were analyzed, including dental wear, calculus, caries, alveolar resorption, periapical lesions, ante-mortem tooth loss (AMTL), and linear enamel hypoplasia (LEH). RESULTS: Neolithic coastal populations are globally characterized by high dental wear, high calculus frequency, high LEH frequency, and frequent periodontal disease, whereas they exhibit low abscesses and AMTL frequencies and a total absence of carious lesions. Samples from the Hafit period present high dental wear, low rates of calculus and LEH, frequent periodontal disease, combined with low abscess and AMTL frequencies and absence of caries. By contrast, samples from the Umm an-Nar period exhibit much lower dental wear, calculus and LEH rates, whereas caries, periapical lesions and AMTL frequencies increase significantly. Marked differences were observed between coastal and inland Umm an-Nar groups, the latter presenting significantly higher frequencies of caries, periapical lesions, alveolar resorption and AMTL. DISCUSSION/CONCLUSION: Oral conditions from the Neolithic coastal populations denote a diet mainly composed of unprocessed and abrasive food, with high protein and low carbohydrate intakes, and frequent stress episodes. Although Hafit populations display some changes in oral pathologies, which indicate modifications in their lifestyle and a diversification of the diet, no markers of high carbohydrate intakes were observed in our samples. The impact of agriculture on oral health appears clearly only from the Umm an-Nar period, and is more intense inland than on the coast, where marine resources are still a main component of the diet.

Effects of laser vs ultrasound on bone healing after distraction osteogenesis: A histomorphometric analysis.

OBJECTIVE: To assess the effects of low-level laser irradiation vs ultrasound irradiation on bone healing after distraction osteogenesis. MATERIALS AND METHODS: Distraction osteogenesis was performed with rapid maxillary expansion devices (Hyrax-Morelli, Sorocaba, São Paulo Brazil) in 24 rabbits (Oryctolagus cuniculus). After a 2-day latency period, the distraction devices were activated for 10 days at a rate of 1 mm/d. Four groups of six animals were treated as follows: (1) control, (2) laser irradiation on the right side, (3) ultrasound irradiation on the right side, and (4) laser irradiation on the right side and ultrasound on the left side. Histomorphometric analysis was used to assess the bone healing area. Analysis of variance was used to perform the statistical analyses. RESULTS: The influence of low-intensity laser associated with ultrasound irradiation on bone healing was statistically significant. The analyses showed the greatest amount of bone healing in the jaws of animals in group 4, which received treatment with both ultrasound and laser. CONCLUSION: This study concluded that bone healing is accelerated with the application of laser irradiation. The greatest effects were observed with combined ultrasound and laser treatment.

A pilot study on spatial changes in the maxilla caused by osteopathic therapy.

OBJECTIVES: A variety of theories on the pathogenesis of temporomandibular disorders (TMD) exists resulting in treatment approaches ranging from the fabrication of occlusal splints to alternative treatment modalities such as osteopathy. The goal of this pilot study was to investigate whether osteopathic treatment causes spatial changes in the maxilla. METHOD AND MATERIALS: Following ethics commission approval and informed patient consent, three patients diagnosed with TMD participated in this investigation. In addition to regular treatment, an individualized mandibular occlusal splint was fabricated and a maxillary silicone impression was made. Following osteopathic treatment, the splint was adapted intraorally and another maxillary impression was made. Before and after treatment, the splint and the impressions were scanned three-dimensionally. The resulting images were superimposed using best-fit matching algorithms. RESULTS: Inconsistent spatial changes in the posterior areas were observed both in the maxillary impressions as well as in the mandibular splints reaching maximum absolute values of 0.50 mm. CONCLUSION: Based on this pilot study, it appears that osteopathic treatment may be capable of inducing spatial changes in the maxilla due to sutural movement thereby validating the fundamental principles of osteopathic treatment. Although, based on the study conducted, it cannot be concluded that osteopathy constitutes a successful treatment alternative in TMD patients, practitioners should be aware of this treatment modality.

Root canal morphology of Chalcolithic and early bronze age human populations of El Mirador Cave (Sierra de Atapuerca, Spain).

This study provides a morphological characterization of the inner anatomy of the root canals of permanent first and second molars in Chalcolithic and early Bronze Age human fossils using cone-beam computed tomography. The general evolutionary trend in present-day human dentition is related to morphological simplification. As little is known about when this trend appeared in Homo sapiens populations, the aim of this work is to test the presence of modern radicular morphology 4,400 years ago. Fifty-four permanent first and second maxillary and mandibular molars of 17 individuals were included in the study. All maxillary first and second molars showed three separate roots. Almost all the lower molars analyzed (100% of first molars and 75% of second molars) had two separate roots. More differences in the canal system configuration were documented in the maxillary mesiobuccal roots than in the palatal or distobuccal roots. The most variable tooth in root and canal configuration is the maxillary second molar. It should be pointed out that 12.5% of the teeth analyzed showed a C-shaped root configuration.

Light-emitting diode photobiomodulation: effect on bone formation in orthopedically expanded suture in rats--early bone changes.

The aim of this experimental study was to evaluate histomorphometrically the effects of light-emitting diode (LED) photobiomodulation therapy (LPT) on bone formation in response to expansion of the interpremaxillary suture in rats. Twenty male, 50- to 60-day-old Wistar rats were divided into two equal groups (control and experimental). Both groups were subjected to expansion for 5 days, and 50 cN of force was applied to the maxillary incisors with helical spring. An OsseoPulse® LED device, 618-nm wavelength and 20-mW/cm(2) output power irradiation, was applied to the interpremaxillary suture for 10 days. Bone formation in the sutural area was histomorphometrically evaluated, including the amount of new bone formation (in square micrometers), number of osteoblasts, number of osteoclasts, and number of vessels. Mann-Whitney U test was used for statistical evaluation at p < 0.025 level. Significant differences were found between groups for all investigated histomorphometric parameters. New bone formation area (p = 0.024, 1.48-fold), number of osteoblasts (p < 0.001, 1.59-fold), number of osteoclasts (p = 0.004, 1.43-fold), and number of vessels (p = 0.007, 1.67-fold) showed higher values in the experimental group than the control. Bone histomorphometric measurements revealed that bone architecture in the LPT group was improved. The application of LPT can stimulate bone formation in the orthopedically expanded interpremaxillary suture during expansion and the early phase of the retention periods.

["Fiction and Truth": Goethe's anatomical research at the University of Jena]. / "Dichtung und Wahrheit": Goethes anatomische Forschung an der Universität Jena.

Johann Wolfgang von Goethe was one of the most renowned German poets of the late Age of Enlightenment. However, his engagement went far beyond literature especially relating to politics and natural science. Goethe, primarily trained as a lawyer, developed his own theory of colors and even challenged the concepts of Isaac Newton. His discovery of the human intermaxilary bone questioned all the dogmas of the religious-minded world of the 18th century. Together with the anatomy professor Justus Christian Loder, Goethe performed comparative anatomy and proved the conceptual uniformity of humans and animals on 27 March 1784. Even though, Félix Vicq d'Azyr described the intermaxilary bone simultaneously in Catholic France, Goethe's findings were politically accepted due to the liberal Protestantism of the Duchy of Weimar. Nevertheless, leading anatomists of the century (Johann Friedrich Blumenbach, Petrus Camper and Samuel Thomas v. Soemmerring) mainly rejected Goethe's postulates which led to a delayed publication in 1820; almost 36 years after writing his original manuscript. Today, Goethe's discovery is known to be a fundamental basis for the development of Charles Darwin's theory of phylogenetic evolution. Nowadays, the Department of Anatomy contains the Museum Anatomicum Jenense which was founded by the Duke of Weimar, Carl August and Goethe and entails Goethe's premaxillary bones as its main attraction. The University values the cultural heritage of Goethe's contribution to Medicine and provides access to the collection to the public and generations of medical students. Still today Goethe's legacy is noticeable in the halls of the Alma Mater Jenensis.

Three-dimensional analysis of maxillary anatomic landmarks for greater palatine nerve block anesthesia.

Greater palatine nerve block anesthesia (GPNBA) is a local anesthetic procedure used for maxillary and nasal treatment. Investigation of the three-dimensional anatomic location of the greater palatine foramen (GPF) is important for successful local anesthesia. The study aim was to provide standards for anatomic structures in the oral cavity that can be easily referred to in GPNBA. Maxillary computed tomography data were obtained from patients between 8 and 16 years of age whose maxillary incisors and first molars had already erupted (the growth group, n = 103); changes in the maxilla were observed over time in this group. Reference values for GPNBA in adults were measured in 107 patients older than 18 years. Maxillary computed tomography images were reconstructed three-dimensionally. Regression analysis demonstrates that all maxillary measurements in the growth group except for the distance from the posterior nasal spine to the GPF in the coronal plane correlated significantly with age. In adults, the mean perpendicular distance from the interdental alveolar bone between the left and right central incisors (1alvB) to the GPF in the coronal plane was 46.16 mm, and the mean distance from 1alvB to the GPF was 51.05 mm. The mean distance from the maxillary central incisor to the GPF was 57.58 mm. The mean angle between the line from the maxillary central incisor to each GPF and the sagittal plane was 16.49 degrees. The mean perpendicular distance from the anterior nasal spine to the GPF in the coronal plane was 43.49 mm, whereas the mean perpendicular distance from the GPF to the bone plane was 12.67 mm, and the mean perpendicular distance from the GPF to the occlusal plane was 22.13 mm. These measurements can be used to find the height of the GPF. In adults, the measured perpendicular distance from the incisive foramen to the GPF in the coronal plane was 32.04 mm, and the perpendicular distance from the median of the line that connects both of the contact points between the maxillary tuberosity and the pterygoid plate to the GPF in the coronal plane was 5.23 mm. Three-dimensional reference values relative to the anatomic structures in the oral cavity may increase the success rate of GPNBA and reduce complications. Although the maxillary growth pattern was analyzed, a limitation of this study is that maxillary anatomic measurements were not analyzed with regard to race or ethnicity.

Morphological features of the maxillary incisors roots and relationship with neighbouring anatomical structures: possible implications in endodontic surgery.

The purpose of this study was to investigate the relationship between the root apex of the upper incisors and neighbouring anatomical structures as well as the morphology of the root-end foramen after apicoectomy. Fifty-seven patients requiring endodontic surgical treatment for a maxillary anterior root were enrolled. A preoperative diagnostic computed tomography (CT) scan was analysed to determine: the distance between the anterior wall of the nasopalatine duct and the central (CI-ND) incisor root 4mm from the apex; and the distance between the floor of the nasal cavity and the tip of either the central (CI-NF) or the lateral (LI-NF) incisor root. After apicoectomy, root-end foramen endoscopic pictures were taken in order to characterize their morphology. Fifty-nine central and 26 lateral incisors were evaluated. The average CI-ND was 4.71 ± 1.26 (SD) mm. The average CI-NF was 10.62 ± 2.25 mm. The average LI-NF was 13.05 ± 2.43 mm. The foramen shape after apicoectomy was ovoid to circular in about 90% of cases in both central and lateral incisors. A sound knowledge of the anatomical relationships at the surgical site is essential for the clinician to perform a safe endodontic surgical procedure.

The earliest evidence for anatomically modern humans in northwestern Europe.

The earliest anatomically modern humans in Europe are thought to have appeared around 43,000-42,000 calendar years before present (43-42 kyr cal BP), by association with Aurignacian sites and lithic assemblages assumed to have been made by modern humans rather than by Neanderthals. However, the actual physical evidence for modern humans is extremely rare, and direct dates reach no farther back than about 41-39 kyr cal BP, leaving a gap. Here we show, using stratigraphic, chronological and archaeological data, that a fragment of human maxilla from the Kent's Cavern site, UK, dates to the earlier period. The maxilla (KC4), which was excavated in 1927, was initially diagnosed as Upper Palaeolithic modern human. In 1989, it was directly radiocarbon dated by accelerator mass spectrometry to 36.4-34.7 kyr cal BP. Using a Bayesian analysis of new ultrafiltered bone collagen dates in an ordered stratigraphic sequence at the site, we show that this date is a considerable underestimate. Instead, KC4 dates to 44.2-41.5 kyr cal BP. This makes it older than any other equivalently dated modern human specimen and directly contemporary with the latest European Neanderthals, thus making its taxonomic attribution crucial. We also show that in 13 dental traits KC4 possesses modern human rather than Neanderthal characteristics; three other traits show Neanderthal affinities and a further seven are ambiguous. KC4 therefore represents the oldest known anatomically modern human fossil in northwestern Europe, fills a key gap between the earliest dated Aurignacian remains and the earliest human skeletal remains, and demonstrates the wide and rapid dispersal of early modern humans across Europe more than 40 kyr ago.

Maxillary and mandibular base size in ancient skulls and of modern humans from Opi, Abruzzi, Italy: a cross-sectional study.

AIM: The size and shape of the jaws are related to occlusion and masticatory muscle function. Consequently, teeth and muscles are considered the functional matrix for the two jaws. Existing studies did not focus on the relationship between maxillary and mandibular base but on just their absolute dimensions. As the relationship between the two is of interest to orthodontists, the aim of this study was to calculate the maxillary-mandibular ratio (m-m ratio) in individuals from Central Italy and to compare it to that of ancient skulls from the same geographic area. METHODS: Forty individuals from Opi, a small, isolated mountain village in Central Italy, and 40 ancient skulls from the same region were the sample of this study. The lengths of the maxillary and mandibular base were assessed on lateral cephalograms, the m-m ratio was calculated, and the measurements between the groups were compared. RESULTS: Due to a significantly shorter maxillary base in the modern human sample, the m-m ratio was significantly lower in these subjects. CONCLUSION: This finding supports the hypothesis that growth of the skull is strongly modulated by the functional matrix, within which a morphologic unit develops.

A fourth hominin skull from Dmanisi, Georgia.

Newly discovered Homo remains, stone artifacts, and animal fossils from Dmanisi, Republic of Georgia, provide a basis for better understanding patterns of hominin evolution and behavior in Eurasia ca. 1.77 million years ago. Here we describe a fourth skull that is nearly complete, lacking all but one of its teeth at the time of death. Both the maxillae and the mandible exhibit extensive bone loss due to resorption. This individual is similar to others from the site but supplies information about variation in brain size and craniofacial anatomy within the Dmanisi paleodeme. Although this assemblage presents numerous primitive characters, the Dmanisi skulls are best accommodated within the species H. erectus. On anatomical grounds, it is argued that the relatively small-brained and lightly built Dmanisi hominins may be ancestral to African and Far Eastern branches of H. erectus showing more derived morphology.

Inconsistency of the maxilla and mandible in the Minatogawa Man No. 1 hominid fossil evaluated from dental occlusion.

The Minatogawa man hominid fossils are human fossils from Japan and the oldest from the Late Pleistocene period. Of the Minatogawa skeletal remains, Minatogawa Man No. 1 is best preserved and is accompanied by the mandible. When the maxillary and mandibular dentitions of Minatogawa Man No. 1 were occluded, the dentitions did not align with one another. The attrition pattern of the maxillary teeth was of an inclined type, which tilted from the buccal to lingual side, whereas that of the mandibular dentition was of a horizontal type. Moreover, both left maxillary and mandibular third molars exhibited attrition on the distal portion of the occlusal surface. The occlusal surfaces did not complement each other in the range of mandibular movement without temporomandibular joint dislocation and the curve of Spee produced by the left maxillary and mandibular occlusal planes did not match. These findings suggest that the maxilla and mandible of Minatogawa Man No. 1 are, in fact, from different individuals.

The effects of dietary naringenin supplementation on physiological changes in molar crestal alveolar bone-cemento-enamel junction distance in young rats.

The objective of this study was to evaluate the influence of dietary naringenin (NAR) supplementation on physiological molar crestal alveolar bone (CAB)-cemento-enamel junction (CEJ) distances in young male albino rats. The effects of diets supplemented with 0.09%, 0.18%, 0.36%, and 0.72% NAR, at the expense of dextrose, were tested on 40 young rats, divided equally into five groups, for a period of 42 days. Rat skulls were defleshed, and CAB-CEJ distance was scored according to the modified method of Keyes and Gold. Data were analyzed using one-way analysis of variance, post hoc Tukey's test, and Spearman's (R(2)) correlation. P < .05 was used to reject the null hypothesis. NAR showed a statistically significant inverse dose-dependent relationship on CAB-lingual alveolar bone distance (P < .05). In all cases lingual CAB-CEJ distance was larger than buccal CAB-CEJ distance. Thus dietary NAR supplementation was shown to significantly reduce molar CAB-CEJ distance (P < .001-.05) during alveolar development in young male rats.

Cephalometric evaluation of children with Down syndrome after early intervention with the stimulating plate.

The aim of stimulating plate therapy in patients with trisomy 21 is to correct orofacial dysfunctions and prevent the establishment of subsequent morphological characteristics such as protrusion of the incisors and pseudoprognathia. This study investigated the effectiveness of this type of therapy in improving skeletal traits of patients with Down syndrome. The lateral cephalograms of 22 consecutive juveniles with Down syndrome, whose orofacial dysfunctions had been successfully treated with a stimulating plate according to Castillo Morales in infancy (17 months +/- 24 months), were examined 136 months on average (minimum of 78 months, maximum of 231 months) after initiation of treatment. In 16 of the 22 patients, the anomaly-typical bialveolar protrusion of the anterior teeth was diagnosed. The cephalometric results indicated larger values of cephalometric parameters concerning cranial base and maxilla, and markedly larger mandibular cephalometric values when compared to untreated children with Down syndrome. These results show that a stimulating plate may not always be indicated in patients with Down syndrome with a skeletal Class III pattern and minor orofacial findings.

The effects of dietary bioflavonoid (rutin, quercetin, and naringin) supplementation on physiological changes in molar crestal alveolar bone-cemento-enamel junction distance in young rats.

The objective of this study was to evaluate the influence of dietary bioflavonoid (rutin [R], quercetin [Q], and naringin [N]) supplementation on physiological molar crestal alveolar bone(CAB)-cemento-enamel junction (CEJ) distances in young male albino rats. The effects of diets supplemented with 0.57% R, Q, or N, at the expense of dextrose, were tested on 40 young rats, divided into four groups, for a period of 42 days. Rat skulls were defleshed, and CAB-CEJ distance was scored according to the modified method of Keyes and Gold (Oral Surg Oral Med Oral Pathol 1955;8:492). Data were analyzed using one-way analysis of variance, post hoc Tukey's test, and Spearman's (R(2)) correlation. P <.05 was used to reject the null hypothesis. The N group demonstrated the lowest CAB-CEJ distance, followed by the R and Q groups (P <.001-.05), except in the mandibular lingual region, where the Q group had a lower CAB-CEJ distance than the N and R groups (P <.05). The control group showed the largest CAB-CEJ distances. Dietary bioflavonoid supplementation was shown to significantly reduce molar CAB-CEJ distance (P <.001-.05) during alveolar development in male young rats.

The triangle of safety: a modified posterior superior alveolar injection technique based on the anatomy of the PSA artery.

The posterior superior alveolar (PSA) injection technique is commonly used to anesthetize soft and hard tissues of the posterior maxilla. As with all injections, complications arise, including hematoma formation secondary to needle-induced vascular trauma. In an attempt to develop a hemorrhage-free PSA injection technique, 361 infratemporal dissections were completed on human cadaver specimens. Three distribution patterns were identified for the external branch of the PSA artery. Regardless of distribution pattern, an anatomical Triangle of Safety was found superior to the maxillary second molar that was free of neurovascular tissues in more than 99% of individuals. Injection into this area appears to meet anesthetic needs while reducing the risk of hematoma formation. The combination of this anatomical triangle with newer anesthetic agents and computerized delivery systems holds promise for continued improvement of the PSA injection technique.