Vertical stability of different orthognathic treatments for correcting skeletal anterior open bite: a systematic review and meta-analysis.

BACKGROUND: Several orthognathic procedures have been applied to correct skeletal anterior open bites (SAOB). Which method is most stable has been debated and no consensus has been reached and there is no conclusive evidence for clinicians to use. OBJECTIVE: To analyse whether maxillary, mandibular, or bimaxillary surgery provides a better stability. MATERIALS AND METHODS: A systematic search was conducted up to December 2020 using PubMed, EMBASE, Medline, Scopus, Web of Science, Cochrane CENTRAL, and Google Scholar. We made direct comparisons among the controlled trials and also made indirect comparisons via subgroup analysis on the aspects of occlusional, skeletal, and dento-alveolar stability to assess the overall stability of each method. RESULTS: Finally 16 cohort studies were identified. At the occlusional level, pooled change in overbite was 0.21 mm in maxillary surgery, 0.37 mm in bimaxillary surgery, and -0.32 mm in mandibular surgery. At the skeletal level, pooled sella-nasion-Point A angle (SNA) was -0.12 degrees in bimaxillary surgery, -0.37 degrees in maxillary surgery and -0.20 degrees in mandibular surgery. The sella-nasion to palatal plane angle (SNPP) relapsed to a statistically significant degree in all samples received single maxillary surgery. Relapse of the sella-nasion-Point B angle (SNB) was 0.47 degrees in mandibular setback, -1.8 degrees in mandibular advancement, and -0.48 degrees in maxillary surgery. The Sella-Nasion to mandibular plane angle (SNMP) relapsed more in procedures involving bilateral sagittal split osteotomy than in other procedures. As for dento-alveolar changes, intrusion of molars and extrusion of incisors took place in most patients. CONCLUSIONS: Bimaxillary surgery produced the most beneficial post-operative increase in overbite, maxillary surgery led to a lesser but still positive overbite change, and mandibular surgery correlated with some extent of relapse. Skeletally, bimaxillary surgery was more stable than maxillary surgery at both SNA and SNPP; SNB was more stable in mandibular setback than advancement; and SNMP was unstable in both mandibular and bimaxillary surgeries versus maxillary surgery with comparable surgical changes. Dento-alveolar compensation helped maintain a positive overbite. REGISTRATION NUMBER: CRD42020198088.

Infants' cortisol reactivity and infant-mother cortisol synchrony in urban Chinese families: The role of maternal control strategy.

Maternal control strategy refers to a mother's practices used to impel, inhibit, guide, or shape their children's behaviors during mother-child interaction. The present study examined control strategies used by Chinese urban mothers and how they associated with infants' cortisol trajectory and infant-mother cortisol synchrony during a separation task. Participants were 115 infant-mother dyads. Maternal control strategy was assessed during mother-infant free-play when the infants were 6 months (T1) and 1 year (T2) old. Salivary cortisol samples were collected from both infants and mothers during a stress-inducing task at T2. The results indicated that mothers most frequently adopted the moderate power control strategy, at both T1 and T2. T1 maternal low control strategy significantly predicted infants' cortisol response curve, namely infants of mothers who predominantly adopted a low power control strategy had a more dynamic reactivity and recovery in their cortisol response to the separation task. Positive cortisol synchrony was observed between mothers and infants during the separation stress condition. In addition, T2 maternal high power control strategy accounted for inter-individual variations in infant-mother cortisol synchrony, such that mothers who predominantly adopted a high power control strategy exhibited a heightened level of cortisol synchrony with their infants. Our findings suggest that targeted training in maternal control strategies could help mothers calibrate their infants' adrenocortical regulation.

Extended duration versus standard duration of peginterferon alfa-2a in treatment of chronic hepatitis B: A systematic review and meta-analysis.

In the last decade, PEG-IFNa-2a has been widely used in the treatment of chronic hepatitis B (CHB). The current standard duration is 48 weeks; however, several studies based on small sample sizes have indicated that treatment extended beyond 48 weeks improved clinical outcomes than standard 48 weeks of therapy. Therefore, we performed a meta-analysis to compare the efficacy and safety of extended duration versus standard duration treatment with PEG-IFNa-2a monotherapy for patients with CHB. Four studies comprising of 350 patients were included in our study. Our analysis showed that extended treatment resulted in a higher HBsAg clearance rate compared with the standard treatment at the end of treatment, 24 and 48 weeks post-treatment [odds ratio (OR)=2.45, 95% confidence intervals (CI) (1.17-5.11), P=0.02; OR=3.17, 95% CI (1.62-6.21), P<0.01; OR=5.02, 95% CI (1.63-15.45), P<0.01, respectively]. Higher HBeAg seroconversion rates were also obtained in the extended treatment group than the standard treatment group at the end of treatment and 48 weeks post-treatment [OR=2.09, 95% CI (1.10-3.98), P=0.02, and OR=2.67, 95% CI (1.39-5.13), P<0.01, respectively]. In addition, extended treatment was superior to standard treatment in HBV-DNA inhibition rate at 48 weeks post-treatment [OR=3.15, 95% CI (1.51-6.57), P<0.01]. Therefore, extended treatment with PEG-IFNa-2a beyond 48 weeks may be a promising strategy to achieve higher rates of sustained HBV-DNA inhibition, HBeAg seroconversion and HBsAg clearance off-therapy for patients with CHB.

Quantitative assessment of enamel hypomineralization by KaVo DIAGNOdent at different sites on first permanent molars of children in China.

PURPOSE: The purpose of this study was to identify the most caries-susceptible site of pits and fissures on first permanent molars by quantitative evaluation of the mineralization in both caries-active and caries-free children, and to provide helpful information for cost-effective, targeted prevention. METHODS: Eighty-four caries-free and 85 caries-active children were selected from 800 6- to 7-year-old children with fully erupted first permanent molars. Hypomineralization of the central fossa (CF) and lingual pit (LP) of the maxillary or buccal pit (BP) of mandibular first permanent molars were evaluated by KaVo DIAGNOdent. Statistical analysis included grouped t test and single-factor variance analysis and paired comparison. RESULTS: CF of mandibular first permanent molars had significantly greater hypomineralization than other sites. The hypomineralization of the maxillary CF is more severe than that of LP. The extent of the hypomineralization of each site at the first permanent molar in caries-active children was significantly higher than that in caries-free children. CONCLUSIONS: Central fossae of first mandibular molars are the most hypomineralized sites in both caries-free and caries-active groups. The results suggest that preventive interventions should be targeted at the CF of mandibular molars with special concern given to the caries-active population.

Putative stem cells in human dental pulp with irreversible pulpitis: an exploratory study.

INTRODUCTION: Although human dental pulp stem cells isolated from healthy teeth have been extensively characterized, it is unknown whether stem cells also exist in clinically compromised teeth with irreversible pulpitis. Here we explored whether cells retrieved from clinically compromised dental pulp have stem cell-like properties. METHODS: Pulp cells were isolated from healthy teeth (control group) and from teeth with clinically diagnosed irreversible pulpitis (diseased group). Cell proliferation, stem cell marker STRO-1 expression, and cell odonto-osteogenic differentiation competence were compared. RESULTS: Cells from the diseased group demonstrated decreased colony formation capacity and a slightly decreased cell proliferation rate, but they had similar STRO-1 expression and exhibited a similar percentage of positive ex vivo osteogenic induction and dentin sialophosphoprotein expression from STRO-1-enriched pulp cells. CONCLUSIONS: Our study provides preliminary evidence that clinically compromised dental pulp might contain putative cells with certain stem cell properties. Further characterization of these cells will provide insight regarding whether they could serve as a source of endogenous multipotent cells in tissue regeneration-based dental pulp therapy.

Management of a complicated crown-root fracture in a young permanent incisor using intentional replantation.

The purpose of this case presentation is to review the rationale for and illustrate the clinical procedures involved in intentional replantation of a maxillary central incisor following a complicated crown-root fracture. The treatment of complicated crown-root fractures in children often is compromised by a fracture below the gingival margin and/or bone. This makes isolation difficult and comprises the hermetic seal that is critical for a successful endodontic treatment. Orthodontic or surgical extrusion with gingivectomy has been suggested; however, these approaches can be expensive, time-consuming, esthetically compromising, and unsatisfactory when the fracture line is deep below the gingiva. Our presentation will discuss the treatment options for such cases and introduce the concept of intentional replantation as an option to manage complicated crown-root fractures in young permanent anterior teeth.