Severe crowding and a dilacerated maxillary central incisor in an adolescent.

This study reports the treatment of an adolescent patient with dilacerated maxillary incisor. She complained of severe crowding with a high-positioned left upper canine. Her left central incisor had been impacted and moved to proper position at the age of eight years, resulting in a severe root dilaceration. To avoid any progression of root dilacerations and resorption in the maxillary incisor, maxillary lateral expansion and molar distalization plus multibracket appliance were selected as the best nonextraction treatment plan. The maxillary expansion and molar distalization should provide adequate space for the correction of the severe crowding, and treatment with a multibracket appliance was initiated. After a 17-month treatment with a multibracket appliance, an acceptable occlusion was achieved with a Class I molar relationship. An acceptable occlusion was maintained without recurrence of the crowding and impairment of the dilacerated root in the maxillary incisor during three years of retention. It is emphasized that careful planning is required to avoid any progression of the root dilaceration and resorption through orthodontic treatment. A shortening of the period of applying orthodontic force on the dilacerated incisor and avoidance of tooth extraction will minimize the risk factors.

Immunohistochemical study of matrilin-1 in arthritic articular cartilage of the mandibular condyle.

BACKGROUND: The objective of this study was to investigate the expression of matrilin-1 in arthritic articular cartilage of the mandibular condyle by means of immunohistochemical methods. METHODS: Condylar cartilage specimens were obtained from temporomandibular joints (TMJs) of 12 patients with arthritis (osteoarthritis and internal derangement) (mean age 51.8 years; age range 28-71 years) and four patients with TMJ ankylosis (mean age 44.0 years; age range 16-64 years), diagnosed clinically and with imaging examinations. Paraffin sections were immunostained with anti-matrilin-1 antibodies. RESULTS: Matrilin-1 expression was detected in both patient groups with TMJ ankylosis and arthritis, and the level was remarkably higher in arthritic cartilage. The mean percentage of matrilin-1-producing cells to the total chondrocytes was significantly (P < 0.05) greater in the arthritic group (43.9 +/- 19.2%) than in subjects with TMJ ankylosis (28.0 +/- 8.7%). CONCLUSIONS: Articular chondrocytes in the TMJ condyle can express matrilin-1 and the expression is enhanced in arthritic cartilage, suggesting a presence of functional or adaptive remodeling in the condyle in response to degenerative changes in the TMJ structures.