Inorganic polyphosphate: a possible stimulant of bone formation.

Inorganic polyphosphates [Poly(P)] are often distributed in osteoblasts. We undertook the present study to verify the hypothesis that Poly(P) stimulates osteoblasts and facilitates bone formation. The osteoblast-like cell line MC 3T3-E1 was cultured with Poly(P), and gene expression and potential mineralization were evaluated by reverse-transcription polymerase chain-reaction. Alkaline phosphatase activity, von Kossa staining, and resorption pit formation analyses were also determined. The potential role of Poly(P) in bone formation was assessed in a rat alveolar bone regeneration model. Poly(P) induced osteopontin, osteocalcin, collagen 1alpha, and osteoprotegerin expression and increased alkaline phosphatase activity in MC 3T3-E1 cells. Dentin slice pit formation decreased with mouse osteoblast and bone marrow macrophage co-cultivation in the presence of Poly(P). Promotion of alveolar bone regeneration was observed locally in Poly(P)-treated rats. These findings suggest that Poly(P) plays a role in osteoblastic differentiation, activation, and bone mineralization. Thus, local poly(P) delivery may have a therapeutic benefit in periodontal disease.

Tissue reaction to poly (lactic-co-glycolic acid) copolymer membrane in rhBMP used rabbit experimental mandibular reconstruction.

A rabbit experimental mandibular defect was reconstructed with 1% atelocollagen gel including rhBMP-2 10microg and a covering a poly (lactic-co-glycolic acid) copolymer (PLGA) membrane. For this experiment, eight male rabbits were used and a histological study was conducted. Our study purpose was to examine the effects and fate of PLGA membrane during bone reconstruction. PLGA membrane was phagocytized by foreign body giant cells and macrophages in the healing course of reconstruction osteogenesis. These histological data suggest that the PLGA membrane was gradually absorbed and replaced by fibrous connective tissue or bone tissue. In the osteogenesis course, the outer periphery of the new bone was maintained by PLGA membrane without expansion.

Three-dimensional observation of reconstruction course of rabbit experimental mandibular defect with rhBMP-2 and atelocollagen gel.

For the experimental animals, eight rabbits were chosen. A bone defect was made and was filled with 1% atelocollagen gel including rhBMP-2 10 microg. The reconstruction course was observed using micro-computed tomography (muCT) in vivo. In muCT observation, the density was slightly elevated at the bone marrow side at day 7, and the phenomenon gradually expanded during the course of this experiment which lasted for 28 days. By utilized muCT, we could construct 3D images, and that process enabled us to visualize bone formation more closely. These data suggest that the experimental animal model muCT and 3D image are extremely useful for follow-up of reconstruction of animal bone defects and that the atelocollagen gel is effective as a carrier of rhBMP-2.

Bone repair of rabbit mandibular transsection using rhBMP-2 and atelocollagen gel.

This experimental was carried out using 12 rabbits. A rabbit experimental mandibular transsection was reconstructed with 10mug of rhBMP-2 and 1% atelocollagen gel. The transsection gap was fixed with a titanium plate and screws, and covered with poly (lactic-co-glycolic acid) co-polymer (PLGA) membrane. Histopathological examination of 1-week specimens revealed that many spindle cells had proliferated and invaded blood clots, and a small amount of immature trabecular bone was formed in the transsection gap. In 2 and 3-week specimens, bone formation was gradually increased in the fibro-vascular tissues of the site. These histological findings were also observed in the control group specimens, but the bone formation was slightly less than in the experimental group. The results suggest the effectiveness of atelocollagen gel as a carrier of rhBMP-2 and PLGA as a covering membrane in this rabbit mandibular transsection reconstruction model.

Electrical phenomena at the surface of phospholipid membranes relevant to the sorption of ionic compounds.

The change in electrostatical potential-profile across the phospholipid membranes caused by the binding or sorption of ionic compounds (metal cations, ionic surfactants, lipid-soluble ions, and ionophore-metal complexes) can be estimated by the direct measuring method (combination of zeta potential of lipid vesicles and surface potential of lipid monolayer). The analysis of the data by a simple electrical double layer theory reveals the binding/sorption location of these ions. The coexistent effect of metal ions and lipid-soluble ions on the sorption behavior is described from the interfacial electrochemical view point. The coagulation of lipid vesicles caused by those ionic compounds is also discussed.

Early evaluation of necrotizing fasciitis with use of CT.

Gas bubbles are one of the important signs in the clinical diagnosis of necrotizing fasciitis, and radiographs are mandatory. An instance where gas bubbles not found on the plain radiographs were clearly shown by CT, which is a useful method for close monitoring and decompression of gas bubbles situated deeply in the spaces of the maxillo-facial and neck regions.

Oxidation of cysteamine induced by gas-phase radicals from combustion smoke of poly (methyl methacrylate).

In order to obtain fundamental knowledge on biological damage caused by the smoke from combustion of poly(methyl-methacrylate) (PMMA), we investigated the oxidation of cysteamine induced by PMMA smoke. We suggest that the long-lived and oxygen-centered radicals involved in PMMA smoke should play an important role in the oxidation of cysteamine. The mechanism for the oxidation of cysteamine by combustion smoke of PMMA was postulated as radical initiated chain reactions, taking into account the effect of pH, oxygen and radical concentrations.

Radiographic study of bone loss of mandibular lingual cortical plate accompanied by third molar development.

OBJECTIVE: The purpose was to determine the features of mandibular lingual cortical bone loss around the root of the mandibular third molar. STUDY DESIGN: We examined occlusal radiographs in 2210 persons aged 11 to 78 years. RESULTS: Prominent increase of incidence of bone loss was evident in subjects in their third decade compared with those in their second decade. The incidence was not decreased into the sixties. The incidence of bone loss in men was significantly higher than that in women. The incidence was not influenced by inflammation around the tooth crown of the third molar, by tooth caries, or by metal fillings present in the third molar. CONCLUSIONS: The present observations suggest that bone loss is induced by physiologic processes that accompany root formation of the third molar after mandibular growth.

Influence of adjacent teeth on impacted third molars in the upper and lower jaws.

Panoramic radiographs of 1834 patients older than 21 years were evaluated for the prevalence of impacted teeth at different ages. The frequency of impacted teeth by age was constant, that is, the presence of completely impacted teeth could not be related to age. The interrelationship between the angulation of impacted teeth and the existence of adjacent teeth was studied in individuals older than 61 years. The angulation of most of the completely impacted teeth in the upper-third molar region was horizontal when adjacent teeth were not present, whereas impacted teeth in the upper-third molar region showed vertical angulation when adjacent teeth were present, suggesting that vertically impacted teeth may become exposed by bone resorption or infection and should be removed. The angulation of impacted lower third molars was horizontal irrespective of the presence of adjacent teeth. It appears that the interrelationship between the angulation of completely impacted teeth and the presence of adjacent teeth is different between the upper and lower third molar regions. The angulation of completely impacted teeth and the presence of adjacent teeth should be included in those criteria which determine whether or not completely impacted teeth should be removed.

Incidence of inflammation in completely impacted lower third molars.

The influence of ageing and the contact of the adjacent tooth on purulent inflammation associated with the completely impacted lower third molar was assessed in 26 patients with clinical symptoms of infection out of 800 patients who had roentgenographically-confirmed completely impacted lower third molars. These 26 patients were 23 years of age or older. The 9 with pain alone ranged from 25 to 44 years of age, whereas the 17 patients with inflammation ranged from 29 to 67 years of age, and non-contact to adjacent tooth was associated with purulent inflammation in older patients, indicating completely impacted lower third molars may cause pain only until 45 years of age; but purulent inflammation occurs even in the group of non-contact to adjacent tooth after 45 years of age. The authors recommend that a completely impacted lower third molar should be removed if the risk factors of advanced age and contact with the adjacent tooth are present.

Supernumerary impactions of the mandibular cuspids and bicuspids. Case report.

A case involving the presence of supernumerary cuspids and bicuspids is described. The condition was probably an inherited one because of the family history and the bilateral incidence. The supernumerary teeth erupted because of alveolar resorption in which inflammatory factors probably played a role. Radiographic follow-up of the site of supernumerary impacted teeth and alveolar resorption should be undertaken.

Completely impacted teeth in dentate and edentulous jaws.

Panoramic radiographs from 1026 patients were examined for the presence of completely impacted teeth. The prevalence of completely impacted teeth in the edentulous jaw was lower than that in the dentate jaw in both the upper and lower jaws. The prevalence of completely impacted third molars in the edentulous jaw was also lower than that in the dentate jaw. However, there was no difference in the prevalence of completely impacted canine teeth and completely impacted anterior maxillary supernumerary teeth (mesiodens) in the edentulous jaw. These findings may indicate that completely impacted canine teeth and impacted anterior maxillary supernumerary teeth (mesiodens) are not influenced by the loss of erupted teeth.

Root resorption of mandibular second molar teeth associated with the presence of the third molars.

Although pressure resorption of second molars is associated with impacted and/or erupting third molars, the relationship between pressure resorption and age is unclear. In order to investigate this relationship, 3883 dental radiographs were studied in 3174 individuals of various ages. The incidence of superimposition of the second molar on the third molar was not elevated in any subgroup except that of women of 16-40 years of age. There were no age or sex differences for the incidence of second molar root resorption. In older individuals, root resorption associated with a completely impacted third molar was more frequent than with a partially impacted third molar, and root resorption at the apex was mainly seen in individuals over 50 years of age. There was a higher incidence of superimposition and root resorption in men than women. Apical root resorption may be seen long after the formation of completely impacted third molars in both genders.

Mechanism of transient mental nerve paraesthesia in sagittal split mandibular ramus osteotomy.

We investigated the mechanism involved in paraesthesia associated with sagittal split mandibular ramus osteotomy by three-dimensional computed tomography (3-D CT). Ten female patients underwent this procedure between 1988 and 1991. The inferior alveolar neuro-vascular bundles remained intact during the sagittal osteotomy in all cases. We examined the changes in the shape of the foramen mandibulae over a period of 6 months during which the transient mental nerve paraesthesia was recovered, and studied the distance from the foramen mandibulae to the spina mentalis (F-S distance) as measured on 3-D film. The postoperative 3-D CT scan showed bone resorption in front of the foramen mandibulae, and the F-S distance was shortened by an average of 2.94 mm. These findings suggest that possible causes of the paraesthesia is due to compression of the nerve trunk resulting from posterior movement of the mandibular ramus.

The assessment of fracture of the mandibular condyle by use of computerized tomography. Incidence of sagittal split fracture.

A survey was carried out to clarify the incidence of sagittal splitting fracture of the mandibular condyle using computerized tomography. There were 33 patients, between 11 and 67 years of age, with displaced or dislocated mandibular condylar process fractures (41 cases), seen at our clinic between 1986 and 1992. The incidence of no displacement was 4.9%; deviation and displacement, 34.1%; dislocation, 46.3%; and complete avulsion, 4.9%. A sagittal splitting fracture of condyle occurred with an incidence of 9.8%. Conservative treatment was effective in the treatment of sagittal splitting fracture. Therefore, classification of fracture of mandibular condyle should include the sagittal split fracture, and investigations should include computerized tomography.

Appearance of fracture caused by emphysema.

A case presenting radiographic appearance of a fracture line associated with emphysema which occurred in the removal of a mandibular third molar is reported. The cause of the fracture line in the radiograph is discussed together with the benefit of CT in diagnosis.

Inorganic polyphosphate induces osteoblastic differentiation.

Inorganic polyphosphate [Poly(P)] is especially prevalent in osteoblasts. We tested the hypothesis that Poly(P) stimulates osteoblastic differentiation and polyphosphate metabolism for bone formation. The osteoblast-like cell line, MC 3T3-E1, was cultured with Poly(P), and gene expression was evaluated by real-time reverse-transcription polymerase chain-reaction. Phosphatase activity and extracellular matrix mineralization were also determined. The role of Poly(P) was assessed in a beagle dog alveolar bone regeneration model. Poly(P) increased osteocalcin, osterix, bone sialoprotein, and tissue non-specific alkaline phosphatase gene expression, with a high level of end-polyphosphatase activity, resulting in low-chain-length Poly(P), inorganic pyrophosphate, and inorganic phosphate production. MC3T3-E1 cells differentiated into mature osteoblasts and showed expression of ectonucleotide pyrophosphatase phosphodiesterase 1, while mouse progressive ankylosis gene expression remained unchanged. Promotion of alveolar bone regeneration was observed in Poly(P)-treated beagle dogs. These findings suggest that Poly(P) induces osteoblastic differentiation and bone mineralization, and acts as a resource for mineralization.