[Application of double-layer soft tissue suture closure technique in the surgical treatment of patients with mandible medication-related osteonecrosis of the jaw of early and medium stages].

OBJECTIVE: To investigate the clinical application effect of double-layer soft tissue (DLST) suture closure technique in patients with mandible medication-related osteonecrosis of the jaw (MRONJ) of early and medium stages resulted in application of anti-bone-resorptive drugs. METHODS: Early to medium stage mandible MRONJ patients who underwent surgical treatment in the fourth ward of Peking University School and Hospital of Stomatology from October 2021 to September 2022 were included. Clinical information of the patients were collected, including primary disease, concomitant disease, medication regimen (drug type, duration of medication), MRONJ stage, clinical symptoms, imaging manifestations, etc. During surgery, after using marginal mandibulae resection to remove the necrotic bone, the wound was closed using DLST closure technique. Regular post-operative follow-up was performed to evaluate the therapeutic effect and complications of the DLST technique, the pain score and functional status of the patiens were evaluated. RESULTS: This study totally included 13 patients, 12 women and 1 man, aged (66.69±13.14) years. Seven patients had osteoporosis, 2 had lung cancer, 3 had breast cancer and 1 had prostate cancer among their primary diseases; 7 had no concomitant diseases, 2 had diabetes mellitus, 2 had cardiovascular disease and 1 had dry syndrome. Intravenous zoledronic acid were used in 9 patients, the average duration was (37.7±20.0) months, and other drugs, such as letrozole tablets were taken in 7 patients at the same time; Denosumab injection was used in 3 patients for an average of (10.3±11.9) months; Alendronate sodium tablets were taken in 5 patients for an average of (55.20±27.20) months, and prednisone acetate tablets or acarbose tablets were taken to varying degrees in 2 patients. The average post-operative follow-up was 11.9 months (9 to 17 months), and all the 13 patients were cured without complications, such as pus overflow and so forth. The pre-operative score of Karnofsky performance status (KPS) in the patients was 68.46±14.05, and the post-operative score was 82.31±15.36, and the difference was statistically significant (P < 0.05). The pre-operative score of visual analogue scale (VAS) in the patients was 5.77±0.73 and the post-operative score was 0.38±0.51, and the difference had statistical significance (P < 0.001). CONCLUSION: The double-layer soft tissue suture closure technique can achieve good clinical results in patients with MRONJ of the mandible using anti-bone-resorptive drugs alone, and can provide clinical treatment ideas for MRONJ patients with more complicated drug use.

[Left mandibular osteonecrosis following herpes zoster of the third branch of left trigeminal nerve: A case report].

Herpes zoster of trigeminal nerve was a common skin disease caused by varicella-zoster virus infection. Simple involvement of the third branch of trigeminal nerve was rare, and so were oral complications such as pulpitis, periodontitis, spontaneous tooth loss, bone necrosis, etc. This article presented a case of herpes zoster on the third branch of the left trigeminal nerve complicated with left mandibular osteonecrosis. We reported the case of a 64-year-old man with sudden pain in the left half of the tongue 1 month ago, and then herpes on the left facial skin appeared following with acute pain.The local hospital diagnosed it as herpes zoster and treated it with external medication. A few days later, he developed gum pain in the left mandibular posterior tooth area. He was admitted to Peking University School and Hospital of Stomatology one week ago with loose and dislodged left posterior tooth accompanied by left mandibular bone surface exposure. Clinical examination showed bilateral symmetry and no obvious restriction of mouth opening. Visible herpes zoster pigmentation and scarring on the left side of the face appeared. The left mandibular posterior tooth was missing, the exposed bone surface was about 1.5 cm×0.8 cm, and the surrounding gingiva was red and swollen, painful under pressure, with no discharge of pus. The remaining teeth in the mouth were all Ⅲ degree loosened. Imageological examination showed irregular low-density destruction of the left mandible bone, unclear boundary, and severe resorption of alveolar bone. The patient was diagnosed as left mandibular osteonecrosis. Under general anesthesia, left mandibular lesion exploration and curettage + left mandibular partial resection + adjacent flap transfer repair were performed. The patient was re-exmained 6 months after surgery, there was no redness, swelling or other abnormality in the gums and the herpes pigmentation on the left face was significantly reduced. Unfortunately, the patient had complications of postherpetic neuralgia. This case indicate that clinicians should improve their awareness of jaw necrosis, a serious oral complication of trigeminal zoster, and provide early treatment. After the inflammation was initially controlled, surgical treatment could be considered to remove the necrotic bone, curettage the inflammatory granulation tissue, and extraction of the focal teeth to avoid further deterioration of the disease.

Ti3C2Tx/MXene Composite Aerogel Flexible Biosensor for Measuring Occlusal Force In Situ.

Occlusal force is an important parameter for evaluating the function of the occlusal system. Traditional occlusal forces can only be measured qualitatively. Here, we report a flexible piezoresistive pressure sensor with high sensitivity and a wide measurement range for in situ occlusal force measurements through the articulating paper. The sensing layer of the flexible piezoresistive sensor is a 3D porous MXene composite aerogel, which is fabricated by vacuum freezing. The MXene piezoresistive sensor is composed of the interdigital electrodes, the sensing layer, the PI encapsulation layer, and an articulating paper encapsulation layer. The sensor shows perfect performance with high sensitivity (210.21 kPa-1), wide measurement range (∼420 kPa), and a fast response time (123 ms response time, 163 ms recovery time). The amplitude of the occlusal force, which varied with time, can be observed on the mobile phone through the wireless system with the Bluetooth module. This technique has broad application prospects in oral health. In this work, we propose a simple method and a new idea for manufacturing high-performance wearable bioelectronic sensors.

Biomimetic Robust All-Polymer Porous Coatings for Passive Daytime Radiative Cooling.

Passive daytime radiation cooling (PDRC) has gained considerable attention as an emerging and promising cooling technology. Polymer-based porous materials are one of the important candidates for PDRC application due to their easy processing, free of inorganic particle doping, and multifunctionality. However, the mechanical properties of these porous materials, which are critical in outdoor services, have been overlooked in previous studies. Herein, a nonsolvent-induced phase separation (NIPS) method combined with ambient pressure drying to prepare polyethylene-polysilicate all-polymer porous coatings is developed. The coatings possess a Cyphochilus beetle-like skeleton structure with optimal skeleton size, laminated anisotropy, and high volume fraction (64 ± 1%). These structure features ensure a maximum skeleton density without optical crowding, thus enhancing light scattering and stress dispersion, and balancing optical and mechanical properties. The coatings exhibit significant mechanical robustness (only ≈70 µm thickness reduction after 1000 Taber abrasion cycles at a 750 g load without influencing optical performance), durability, optical properties (a solar reflectance of ≈95% and an average near-normal thermal emittance of ≈96%), and PDRC performance (realizing sub-ambient cooling of ≈3-6 °C at midday with different weather conditions). The work provides a new solution to improve the practicability of polymer-based porous coatings in PDRC outdoor services and other fields.

Biological characteristics of microRNAs secreted by exosomes of periodontal ligament stem cells due to mechanical force.

BACKGROUND: Orthodontic tooth movement (OTM) has previously been considered an inflammatory process. However, recent studies suggest that exosomes may play an important role in the cellular microenvironment of OTM. microRNAs (miRNAs) are one of the major constituents of exosomes. This study aims to investigate the biological characteristics of miRNAs secreted by exosomes of periodontal ligament stem cells (PDLSCs) due to mechanical forces. MATERIALS AND METHODS: First, we established a mechanical stress model. The PDLSCs were loaded under different force values and exosomes were extracted after 48 h. High-throughput sequencing of exosomal miRNAs was performed to further evaluate their biological functions and underlying mechanisms. RESULTS: The morphology and functions of exosomes were not significantly different between the loading and non-loading PDLSC groups. The optimal loading time and force were 48 h and 1 g/cm2, respectively. After sequencing, gene ontology (GO) and Kyoto encyclopaedia of genes and genomes (KEGG) pathway and network analyses were performed and 10 differentially expressed miRNAs were identified according to a literature search. These are miR-99a-5p, miR-485-3P, miR-29a-3p,miR-21-5p, miR-146a-5p, miR140-3p, miR-1306-5p, miR-126-5p, miR-125a-5p, and miR-23a-3p. LIMITATIONS: Extracting exosomes needs a large amount of PDLSCs. More functional experiments need to be done to confirm the exact mechanism of exosomal miRNAs of PDLSCs due to mechanical force. CONCLUSIONS: The expression levels of miRNAs secreted by PDLSC-derived exosomes due to mechanical force were very different compared to PDLSC-derived exosomes under nonmechanical stress. The function of many of the identified exosomal miRNAs was found to be related to osteoblasts and osteoclasts. Further validation is required. A functional investigation of these miRNA could provide novel insights into their mechanism.

Anti-angiogenic drug aggravates the degree of anti-resorptive drug-based medication-related osteonecrosis of the jaw by impairing the proliferation and migration function of gingival fibroblasts.

BACKGROUND: Long-term use of anti-resorptive or anti-angiogenic drugs in cancer patients with odontogenic infections may lead to medication-related osteonecrosis of the jaw (MRONJ). This study investigated whether anti-angiogenic agents aggravate MRONJ occurrence in anti-resorptive-treated patients. METHODS: The clinical stage and jawbone exposure of MRONJ patients caused by different drug regimens were analyzed to ascertain the aggravation effect of anti-angiogenic drugs on anti-resorptive drug-based MRONJ. Next, a periodontitis mice model was established, and tooth extraction was performed after administering anti-resorptive and/or anti-angiogenic drugs; the imaging and histological change of the extraction socket were observed. Moreover, the cell function of gingival fibroblasts was analyzed after the treatment with anti-resorptive and/or anti-angiogenic drugs in order to evaluate their effect on the gingival tissue healing of the extraction socket. RESULTS: Patients treated with anti-angiogenic and anti-resorptive drugs had an advanced clinical stage and a bigger proportion of necrotic jawbone exposure compared to patients treated with anti-resorptive drugs alone. In vivo study further indicated a greater loss of mucosa tissue coverage above the tooth extraction in mice treated with sunitinib (Suti) + zoledronate (Zole) group (7/10) vs. Zole group (3/10) and Suti group (1/10). Micro-computed tomography (CT) and histological data showed that the new bone formation in the extraction socket was lower in Suti + Zole and Zole groups vs. Suti and control groups. In vitro data showed that the anti-angiogenic drugs had a stronger inhibitory ability on the proliferation and migration function of gingival fibroblasts than anti-resorptive drugs, and the inhibitory effect was obviously enhanced after combining zoledronate and sunitinib. CONCLUSION: Our findings provided support for a synergistic contribution of anti-angiogenic drugs to anti-resorptive drugs-based MRONJ. Importantly, the present study revealed that anti-angiogenic drugs alone do not induce severe MRONJ but aggravate the degree of MRONJ via the enhanced inhibitory function of gingival fibroblasts based on anti-resorptive drugs.

Bone morphogenetic protein receptor 1α promotes osteolytic lesion of oral squamous cell carcinoma by SHH-dependent osteoclastogenesis.

Oral squamous cell carcinoma (OSCC) is an aggressive tumor that usually invades the maxilla or mandible. The extent and pattern of mandibular bone invasion caused by OSCC are the most important factors determining the treatment plan and patients' prognosis. Yet, the process of mandibular invasion is not fully understood. The following study explores the molecular mechanism that regulates the mandibular invasion of OSCC by focusing on bone morphogenetic protein receptor 1α (BMPR1α) and Sonic hedgehog (SHH) signals. We found that BMPR1α was positively correlated to bone defect of OSCC patients. Mechanistically, BMPR1α signaling regulated the differentiation and resorption activity of osteoclasts through the interaction of OSCC cells and osteoclast progenitors, and this process was mediated by SHH secreted by tumor cells. The inhibition of SHH protected bone from tumor-induced osteolytic activity. These results provide a potential new treatment strategy for controlling OSCC from invading the jawbones.

Aqueous synthesis of PEGylated Ag2S quantum dots and their in vivo tumor targeting behavior.

With significantly decreased light scattering and tissue autofluorescence, fluorescence imaging in the second near infrared (NIR-II, 1000-1700 nm) region has been heavily explored in biomedical field recently. Silver sulfide quantum dots (Ag2S QDs) with unique optical properties were one of the most classic NIR-II imaging probes. However, the Ag2S QDs for in vivo purpose were mainly obtain by oil phase-based high-temperature route at present. Here, we proposed a mild aqueous route to prepare NIR-II emissive Ag2S QDs for in vivo tumor imaging. Original Ag2S QDs was obtained by mixing sodium sulfide and silver nitrate in a thiol-terminated polyethylene glycol (mPEG-SH) solution. Treating the original Ag2S QDs with extra mPEG-SH ligands produced highly PEGyalted Ag2S QDs. These re-PEGylated Ag2S QDs exhibited much better blood circulation and tumor accumulation in vivo comparing with the original ones, which can serve as excellent tumor imaging probes. The whole-body blood vessel imaging of living mice was achieved with high resolution, the bio-distribution of these QDs were studied by NIR-II imaging as well. This work also highlighted the importance of ligand density for tumor targeting.

The role of sphingosine-1-phosphate signaling pathway in cementocyte mechanotransduction.

Iatrogenic external root resorption can become a serious pathological condition with clinical tooth movement. Little is known regarding how cementum responds to mechanical loading in contrast to bone, especially under compressive stress. In the field of bone biology, several studies have established the contribution of sphingosine-1-phosphate (S1P) signaling in bone remodeling, mechanical transduction and homeostasis. As osteocytes and cementocytes share similar morphological and functional characteristics, this study aimed to investigate the mechanotransduction ability of cementocytes and to explore the contribution of S1P signaling under compressive stress induced mechanotransduction. We found that compressive stress inhibited major S1P signaling and promoted the expression of anabolic factors in IDG-CM6 cells, a novel immortalized murine cementocyte cell line. By inhibiting S1P signaling, we verified that S1P signaling played a vital role in regulating the expression of the mechanotransduction factors prostaglandin E2 (PGE2) and ß-catenin, as well as factors responsible for cementogenesis and cementoclastogenesis in IDG-CM6 cells. These results support the hypothesis that cementocytes act as key mechanically responsive cells in cementum, responding to compressive stress and directing local cementum metabolism.

Influence of Hydrophobic Chains in Nanocarriers on Antitumor Efficacy of Docetaxel Nanoparticles.

The composition of amphiphilic nanocarriers can affect the antitumor efficacy of drug-loaded nanoparticles and should be researched systematically. In this paper, to study the influence of hydrophobic chains, an amphiphilic copolymer (PEG45PCL17) and hydrophilic PEG (PEG45) were utilized as nanocarriers to prepare docetaxel-loaded nanoparticles (DTX/PEG45PCL17 nanoparticles and DTX/PEG45 nanoparticles) through an antisolvent precipitation method. The two DTX nanoparticles presented a similar drug loading content of approximately 60% and a sheet-like morphology. During the preparation procedure, the drug loading content affected the morphology of DTX nanoparticles, and the nanocarrier composition influenced the particle size. Compared with DTX/PEG45 nanoparticles, DTX/PEG45PCL17 nanoparticles showed a smaller mean diameter and better in vitro and in vivo antitumor activity. The cytotoxicity of DTX/PEG45PCL17 nanoparticles against 4T1 cells was 1.31 µg mL-1, 3.4-fold lower than that of DTX/PEG45 nanoparticles. More importantly, DTX/PEG45PCL17 nanoparticles showed significantly higher antitumor activity in vivo, with an inhibition rate over 80%, 1.5-fold higher than that of DTX/PEG45 nanoparticles. Based on these results, antitumor activity appears to be significantly affected by the particle size, which was determined by the composition of the nanocarrier. In summary, to improve antitumor efficacy, the amphiphilic structure should be considered and optimized in the design of nanocarriers.

Thermosensitive Hydrogel Based on Poly(2-Ethyl-2-Oxazoline)-Poly(D,L-Lactide)-Poly(2-Ethyl-2-Oxazoline) for Sustained Salmon Calcitonin Delivery.

This study developed a thermosensitive hydrogel based on poly(2-ethyl-2-oxazoline)-poly(D,L-lactide)-poly(2-ethyl-2-oxazoline) (PPP) for the delivery of salmon calcitonin to improve the hypocalcemic effect. The tube inversion and rheological tests revealed that the copolymer solution underwent temperature-dependent sol-gel-sol transitions. Observation by scanning electron microscopy (SEM) showed that the hydrogel exhibited a porous three-dimensional network. The swelling test demonstrated that there was a maximum swelling ratio at low temperature (25°C) as compared with the high temperature (37°C). In vitro release revealed that the PPP hydrogel were capable of sustained release of salmon calcitonin (sCT). The in vivo biodegradability study indicated the good degradability of PPP hydrogel. More importantly, the in vivo retention time of the hydrogel in situ was significantly prolonged after subcutaneous injection of the PPP hydrogel compared to the F127 hydrogel. In vivo pharmacodynamics analysis showed that the hypocalcemic effect of both PPP and F127 hydrogel was significantly greater than that of sCT solution, and the mean serum Ca reduction effect could be maintained for 24 h of PPP hydrogel, indicating that PPP hydrogel could achieve a significant enhanced hypocalcemic effect. In conclusion, the PPP hydrogel has been shown to be prospective as a controlled release carrier for injection delivery of protein drugs.

A cone-beam computed tomography analysis of angulation and inclination of whole tooth and clinical crown in adults with normal occlusion.

OBJECTIVES: To identify the mesiodistal angulation and faciolingual inclination of whole tooth and clinical crown in Chinese young adults with normal occlusion, by examining CBCT digitalized images. SETTING AND SAMPLE POPULATION: Forty-two volunteers, who presented with normal occlusion and without previous orthodontic treatment, were selected for this study. MATERIALS AND METHODS: The subjects were advised to take dental CBCT and the digital images of the dentition were obtained. The widely recognized University of Southern California (USC) root vector analysis was adopted to detect the angulation and inclination of the whole tooth, as well as of the clinical crown. RESULTS: No statistically significant difference was detected between male and female subjects. The fluctuations of the angulation and the inclination of the whole tooth from anterior to posterior in both arches manifested distinctive trends. The changes in maxillary dentition seem relatively marked, whereas those in mandibular dentition show less obvious, demonstrating moderate fluctuation both in angulation or inclination. The angulation and inclination of clinical crown are obtained and are shown positively correlated with that of each whole tooth. CONCLUSIONS: The normal range of the mesiodistal angulation and faciolingual inclination of whole tooth and clinical crown in Chinese adults with normal occlusion are identified. This study could establish clinical standards for designing 3D dental data-based orthodontic appliances for Chinese, and for providing the guidance for orthodontic treatment.

Aerogels Derived from Polymer Nanofibers and Their Applications.

Aerogels are gels in which the solvent is supplanted by air while the pores and networks are largely maintained. Owing to their low bulk density, high porosity, and large specific surface area (SSA), aerogels are promising for many applications. Various inorganic aerogels, e.g., silica aerogels, are intensively studied. However, the mechanical brittleness of common inorganic aerogels has seriously restricted their applications. In the past decade, nanofibers have been developed as building blocks for the construction of aerogels to improve their mechanical property. Unlike traditional frameworks constructed by interconnected particles, nanofibers can form chemically cross-linked and/or physically entangled 3D skeletons, thus showing flexibility instead of brittleness. Therefore, excellent elasticity and toughness, ultralow density, high SSA, and tunable chemical composition can be expected for the polymer nanofiber-derived aerogels (PNAs). In this review, recent research progress in the fabrication, properties, and applications of PNAs is summarized. Various nanofibers, including nanocelluloses, nanochitins, and electrospun nanofibers are included, as well as carbon nanofibers from the corresponding organic precursors. Typical applications in supercapacitors, electrocatalysts for oxygen reduction reaction, flexible electrodes, oil absorbents, adsorbents, tissue engineering, stimuli-responsive materials, and catalyst carriers, are presented. Finally, the challenges and future development of PNAs are discussed.

An Optimized and Feasible Preparation Technique for the Industrial Production of Hydrogel Patches.

For hydrogel patches, the laboratory tests could not fully reveal the existing problems of full scale of industrial production, and there are few studies about the preparation technique for the industrial manufacturing process of hydrogel patches. So, the purpose of this work was to elucidate the effects of mainly technological operation and its parameters on the performance of hydrogel patches at the industrial-scale production. The results revealed the following: (1) the aqueous phase was obtained by polyvinylpyrrolidone (PVP) along with tartaric acid dissolved in purified water, then feeding this into a vacuum mixer as a whole in one batch, thus extended the crosslinking reaction time of hydrogel paste (matrix) and allowed the operation of coating/cutting-off to be carried out easily, and there was no permeation of backing layer; (2) the gel strength of the hydrogel patches increased with the increase of working temperature, however, once the temperature exceeded 35 ± 2 °C, the hydrogel paste would lose water severely and the resultant physical crosslinking structure which has lower gel/cohesive strength would easily bring gelatinization/residues during application; (3) the relative humidity (RH) of the standing-workshop was dynamically controlled (namely at 35 ± 2 °C, keeping the RH at 55 ± 5% for 4 days, then 65 ± 5% for 2 days), which would make patches with satisfactory characteristics such as better flexibility, higher adhesive force, smooth flat matrix surface, and without gelatinization/residues and warped edge during the using process; (4) the aging of the packaged hydrogel patches was very sensitive to storage temperature, higher temperature, higher gel strength and lower adhesiveness. The storage temperature of 10 ± 2 °C could effectively prevent matrix aging and adhesion losing, which would also facilitate the expiration date of patches extended obviously. In conclusion, this work provides an optimized and feasible preparation technique for the industrial production of the hydrogel patches and establishes the hydrogel patches as a novel carrier for transdermal drug delivery.

Biomimetic Gradient Polymers with Enhanced Damping Capacities.

Designing gradient structures, mimicking biological materials, such as pummelo peels and tendon, is a promising strategy for developing advanced materials with superior energy damping capacities. Here a facile and effective approach for fabricating polymers with composition gradients at millimeter length scale is presented. The gradient thiol-ene polymers (TEPs) are created by the use of density difference of ternary thiol-ene-ene precursors and the subsequent photo-crosslinking via thiol-ene reaction. The compositional gradients are analyzed via differential scanning calorimeter (DSC), compressive modulus testing, atomic force microscopy (AFM) indentation, and swelling measurements. In contrast to homogeneous TEPs networks, the resultant gradient polymer shows a broader effective damping temperature range combining with good mechanical properties. The present result provides an effective route toward high damping materials by the fabrication of gradient structures.

Prader-Willi syndrome in neonates: twenty cases and review of the literature in Southern China.

BACKGROUND: Prader-Willi syndrome is a rare genetic abnormality that can be challenging to diagnose early, but for which early interventions improve prognosis. METHODS: To improve understanding of Prader-Willi syndrome in neonates in Asia, we retrospectively analyzed the clinical records of 20 affected newborns diagnosed in the Department of Neonatology, Guangzhou Women and Children's Medical Center, Guangzhou, China from January 2007 to December 2014 and performed a review of the relevant literature. RESULTS: Fourteen boys and six girls presented with hypotonia, poor responsiveness, feeding difficulty, and infrequent, weak crying. Different from western patients, the 20 Asian patients exhibited at least five of the following typical features: prominent forehead, narrow face, almond-shaped eyes, small mouth, downturned mouth, thin upper lip, and micromandible. All 14 boys had a small scrotum, including nine with cryptorchidism. Diagnoses were made with microarray comparative genomic hybridization. All 20 infants required feeding tubes. Fifteen received swallowing training immediately after admission; the period of continuous tube feeding for these patients ranged from 8 to 22 days (mean, 14 ± 5.3 days). For the five patients who did not receive swallowing training, the period of continuous tube feeding ranged from 15 to 35 days (mean, 18 ± 4.3 days). Comprehensive care measures included: giving parents detailed health education and basic information about this disease, teaching skills to promote feeding and prevent suffocation, increasing children's passive activity, providing nutrition management for normal development, and preventing excessive or inadequate nutrient intake. CONCLUSIONS: Neonates with Prader-Willi syndrome in Asia have hypotonia, poor responsiveness, feeding difficulty, infrequent and weak crying, genital hypoplasia, and characteristic facial features. Recognition of the syndrome in neonates with confirmation by genetic testing is essential, because early diagnosis allows early intervention. Treatment measures including swallowing training can improve prognosis, prevent growth retardation and obesity, and elevate quality of life in individuals with Prader-Willi syndrome.

Severe Class II Division 1 malocclusion in an adolescent patient, treated with a novel sagittal-guidance Twin-block appliance.

Class II malocclusion is a challenging anomaly in orthodontic practice. Various types of functional appliances are used to correct Class II skeletal and occlusal disharmonies in growing patients, including the Twin-block. We used a modified sagittal-guidance Twin-block appliance combined with a fixed appliance and microimplant anchorage to treat a 13-year-old Chinese boy with a severe skeletal Class II malocclusion and mandibular retrognathia. Normal overjet and a Class I molar relationship were achieved because of the advancement of mandibular development, the restriction of maxillary growth, and dentoalveolar modifications in both the maxilla and the mandible. Favorable skeletal, dental, and soft tissue relationships were accomplished after 24 months of treatment. After 2 years of retention, the results remained stable.

Tension force-induced ATP promotes osteogenesis through P2X7 receptor in osteoblasts.

Orthodontic tooth movement induces alveolar bone resorption and formation by mechanical stimuli. Force exerted on the traction side promotes bone formation. Adenosine triphosphate (ATP) is one of the key mediators that respond to bone cells by mechanical stimuli. However, the effect of tension force (TF)-induced ATP on osteogenesis is inadequately understood. Accordingly, we investigated the effect of TF on ATP production and osteogenesis in MC3T3-E1 cells. Cells were incubated in the presence or absence of P2X7 receptor antagonist A438079, and then stimulated with or without cyclic TF (6% or 18%) for a maximum of 24 h using Flexercell Strain Unit 3000. TF significantly increased extracellular ATP release compared to control. Six percent TF had maximum effect on ATP release compared to 18% TF and control. Six percent TF induced the expression of Runx2 and Osterix. Six percent TF also increased the expression of extracellular matrix proteins (ECMPs), ALP activity, and the calcium content in ECM. A438079 blocked the stimulatory effect of 6% TF on the expression of Runx2, Osterix and ECMPs, ALP activity, and calcium content in ECM. This study indicated that TF-induced extracellular ATP is released in osteoblasts, suggesting that TF-induced ATP promotes osteogenesis by autocrine action through P2X7 receptor in osteoblasts.

An Animal Model for Inducing Deviation of the Mandible.

PURPOSE: Altering the occlusal surface is still a common choice for inducing a deviated mandible in an animal model. Botulinum neurotoxin type A (BoTx/A) can block the action potential transmission in neuromuscular junctions by inhibiting acetylcholine release without damaging the nerves and muscle structures. Our present study was aimed at developing an easy-to-reproduce animal model of asymmetric mandibles in which injection of BoTx/A was applied. MATERIALS AND METHODS: A total of 96 healthy 4-week-old male Sprague-Dawley rats were divided into 2 groups: an experimental group (n = 48) with BoTx/A injection and a control group (n = 48) with sterile saline injection at 4 sites of the right masseter muscle. Twelve rats from each group were humanely euthanized at weeks 1, 2, 3, and 4 for morphometric analysis using the micro-computed tomography (CT) findings. RESULTS: The micro-CT scans revealed facial asymmetry in the experimental group, with no facial asymmetry in the control group after injection. Significant differences were found between the experimental and control groups regarding the indexes containing the mandibular length (length from condyle to menton, length from coronoid to menton, and length of mandibular corpus from gonion to menton) and ramus height (posterior border and middle region near coronoid, and height of anterior mandible at vertical distance from menton). CONCLUSION: Our data have indicated that this deviated mandible animal model induced by injection of BoTx/A is highly reproducible and might be proved suitable for future studies of the asymmetric mandible.

Asymmetric maxillary protraction for unilateral cleft lip and palate patients using finite element analysis.

OBJECTIVE: Unilateral cleft lip and palate (UCLP) patients frequently present with an asymmetry in the nasomaxillary complex and a maxillary hypoplasia. The aim of this study was to investigate biomechanic effects of asymmetric maxillary protraction in UCLP patients using finite element method. METHODS: A finite element model of a UCLP patient's skull was generated using data from spiral computed tomographic scans. On the basis of this finite element model, three groups of orthopedic forces were loaded. All forces were applied in a direction that was 30 degrees downward and forward to the occlusal plane on the region of the alveolar of the maxillary canine. The value of orthopedic force was 5 N in cleft side and 5 N in noncleft side (group A), 6 N in cleft side and 5 N in noncleft side (group B), and 7 N in cleft side and 5 N in noncleft side (group C), respectively. RESULTS: All 3 groups were effective in promoting maxilla forward. In group B, the displacement difference between the cleft side and the noncleft side was the smallest. The largest value difference between the cleft side and the noncleft side was found in group C. CONCLUSIONS: Maxillary protraction with a loading of 6 N in the cleft side and 5 N in the noncleft side produced the most favorable outcome. It can be suggested that it might be advantageous to perform asymmetric maxillary protraction on UCLP patients.