Three-dimensional morphometric analysis of anterior cranial base in growing patients.

INTRODUCTION: The growth of the sphenoethmoidal and sphenofrontal suture in the anterior cranial base (ACB) terminates around 7 years old; therefore, ACB is used as a reference structure for superimposing radiographs in 2-dimensions (2D) and 3-dimensions (3D). The data in the literature regarding the cessation of growth of ACB in 3D is insufficient. The study aimed to evaluate the volumetric changes of ACB in growing patients on cone-beam computed tomography (CBCT) data in 3D. METHODS: The CBCT sample was obtained from a repository of scans of subjects (n = 30) aged 6-11 years with no craniofacial anomalies or growth-related disorders. CBCTs were taken at 2 time points (approximately 12 months apart). The mean age at the initial scan (T1) was 8.4 ± 0.89 years, and the follow-up scan (T2) was 9.6 ± 0.99 years. The bones of the ACB were segmented, and 3D models of the bones were generated using Mimics software. The volumetric measurement was performed on the 3D-rendered model. Linear measurements were performed on the slices. RESULTS: The volumetric analysis of the ACB between T1 and T2 showed a significant change (P <0.0001). There were no significant differences in volumetric changes of the ACB between the male and female subjects. The linear measurements on the right side of the cranial base showed continued growth between T1 and T2. CONCLUSIONS: In the studied sample, growth-related changes of ACB were observed through volumetric analysis after 7 years old.

Orthodontic Treatment in a Patient With Kniest Dysplasia: A Case Study and Review of Literature.

Kniest dysplasia is a rare autosomal dominant chondrodysplasia that is characterized by distinct musculoskeletal and craniofacial irregularities. These craniofacial abnormalities include cleft palate, midface anomalies, tracheomalacia, and hearing loss. This article illustrates a case of Kniest dysplasia that presented for orthodontic treatment. The purpose of this literature review is to describe clinical manifestations, radiographic features, histopathological features, genetic mutation, and management of Kniest dysplasia.

Recognizing Oral Manifestations of Multiple Myeloma.

Multiple myeloma exhibits varied clinical and radiographic presentations; therefore, awareness of suspicious oral lesions in patients with history of the disease is critical for proper diagnosis and treatment. This report illustrates a case where a patient with multiple myeloma initially presented with oral manifestations of the disease. Oral clinical and radiographic presentations of patients with myelomatous lesions can mimic other dental pathologies, leading to delays in diagnosis and treatment. Dentists should be familiar with oral clinical and radiographic presentation of multiple myeloma and know appropriate diagnostic tests in order to avoid misdiagnosis and treatment delays.

Molecular concepts in the pathogenesis of ameloblastoma: implications for therapeutics.

Ameloblastoma is a benign odontogenic neoplasm that may exhibit aggressive biological behavior as evidenced by its rapid growth and significance recurrence rates following initial surgical resection. Currently, the only therapy for ameloblastoma is surgical, and adjunctive treatment modalities are needed to mitigate tumor growth and to reduce the need for extensive and disfiguring surgeries. Many studies have identified markers expressed by ameloblastoma and these lend insight to our understanding of tumor progression. This review provides a summary of the specific molecular pathways implicated in tumor pathogenesis, including those involved in bone remodeling, apoptosis, cell signaling, and tumor suppression. Based on these data, we identify several prognostic or therapeutic markers that have been used successfully in the treatment of other neoplastic processes that may also have diagnostic and prognostic utility for ameloblastoma. Thus, it is important to determine which markers hold the greatest promise for clinical management of this benign neoplasm in order to improve treatment options, particularly in patients with aggressive forms of ameloblastoma.

Sera and salivary matrix metalloproteinases are elevated in patients with vesiculoerosive disease: a pilot study.

BACKGROUND: Oral vesiculoerosive (VE) diseases, such as lichen planus and mucous membrane pemphigoid, are immune-mediated pathoses. Matrix metalloproteinase (MMP)-2 and MMP-9 are elevated in oral lesional biopsy specimens of patients with VE disease. However, the systemic levels and activity of MMP-2 and MMP-9 in this patient population are poorly understood. We performed a pilot study to determine whether the levels and activity of MMP-2 and MMP-9 are elevated in the sera and saliva of patients with VE disease. STUDY DESIGN: We recruited patients with VE disease (n = 10) and healthy controls (n = 19). We collected sera and saliva and performed enzyme-linked immunosorbent assays to measure MMP levels. We used gelatin zymography and Biotrak assays to determine enzyme activity. Data were analyzed using the Mann-Whitney test. RESULTS: There was no difference in the activity of either MMP in the sera or saliva of patients with VE disease compared with controls. Significantly, MMP-2 levels were elevated in the sera of patients with VE disease (P < .0001), whereas MMP-9 was elevated in their saliva (P = .003). CONCLUSIONS: MMP-2 is elevated in the sera of patients with VE disease, and MMP-9 is increased in their saliva. Therefore, these enzymes may be potential markers of disease or therapeutic targets.