Ultrasonography, lateral cephalometry and 3D imaging of the human masseter muscle.

PURPOSE: To develop prediction equations to assist the clinician to derive cephalometric norms from the non-invasive investigations of ultrasonography (US) and 3D imaging. SETTING AND SAMPLE POPULATION: Adult volunteers from University of Adelaide participated in the study. METHODS: Eleven volunteers (eight women, three men; age range 22-30 years) were recruited for US and standard lateral radiographs measurements along with 3D facial imaging using a structured light technique. The three examinations were performed to assess the vertical and transverse dimensions of the face along with superficial masseter muscle dimensions. In total, 31 variables were statistically analysed for relationship among the three imaging modalities. RESULTS: Pearson's correlation coefficients showed highly significant correlations between lateral cephalometric (Co-Go to R3-R4) and US (volume--thickness) variables (r = 0.92, p < 0.0001; r = 0.95, p < 0.0001, respectively). Strong correlations were also observed with Co-Go and masseter muscle area derived from US r = 0.81 (p = 0.01). Similarly, strong correlations were seen between gonion-menton (Go-me) and facial width from 3D imaging (r = 0.83, p = 0.003). A high statistical significance (p > 0.0001) for curvilinear measurements compared with linear counterparts was revealed with the paired t-test. Factor analyses provided meaningful interrelationships for predictive equations generated for lateral cephalometric variables from 3D image coordinates. CONCLUSIONS: This preliminary investigation suggests that useful clinical information for treatment planning and follow-up can be gathered without repeated exposure to ionizing radiation. For more robust predictive equations, a larger sample would be required to validate such a model.

Trabecular anisotropy and collagen fibre orientation in the mandibular condyle following experimental functional appliance treatment using sheep.

In order to study the modifying effects of functional appliances on the mechanical environment of the temporomandibular joint (TMJ), we characterised the structure of the mandibular condyle subsequent to an experimental functional appliance intervention. Eight, four-month-old, castrated male Merino sheep, were randomly allocated to experimental and control groups (n = 4 in each group). Forward mandibular displacement was induced with an intraoral appliance. The study period was 15 weeks, during which time fluorochromes were administered to all of the animals. Midsagittal sections of the TMJ were selected for analysis and trabecular anisotropy was estimated using bone histomorphometry. Only the experimental group demonstrated that the trabecular bone in the central condylar region was less anisotropic when compared to the subchondral region. Also, the variation in trabecular anisotropy of the central condylar region was found to be smaller in the experimental group. The collagen fibre orientation was analysed under polarised light as the proportion of the dark or bright fibres observed in regions which existed before, and regions which formed during the experiment, as determined by the fluorochrome labels. In the experimental group, more bright collagen fibres were found in the most superior region of the mandibular condyle when compared with the controls. These results suggested that the experimental functional appliances changed the orientation and pattern of the mechanical forces acting on the mandibular condyle, and possibly increased the magnitude of the lateral functional forces applied to the most superior part of the condyle during such treatments.

The role of acyl-CoA: cholesterol acyltransferase in the metabolism of free cholesterol to cholesteryl esters or bile acids in primary cultures of rat hepatocytes.

Sandoz compound 58-035 has been shown to inhibit acyl-CoA: cholesterol acyltransferase activity in a variety of cell types. We have shown that it does not inhibit rat liver microsomal cholesterol 7 alpha-hydroxylase, the rate-limiting enzyme of bile-acid synthesis, but it does inhibit acyl-CoA: cholesterol acyltransferase in both the microsomal fraction and in rat hepatocyte monolayers. To test the role of acyl-CoA: cholesterol acyltransferase in these cells, monolayers were incubated over 5 h in the presence and absence of 58-035 and in the presence of increasing amounts of mevalonic acid to provide a source of cholesterol. The addition of mevalonic acid increased the secretion of bile acids by the cells, and this was further increased by the addition of 58-035. The secretion of cholesteryl esters was conversely inhibited by the addition of 58-035. The results help define the role of acyl-CoA: cholesterol acyltransferase in determining the fate of intracellular cholesterol.

The effects of 6-azacholest-4-en-3 beta-ol-7-one, an inhibitor of cholesterol 7 alpha-hydroxylase, on cholesterol metabolism and bile acid synthesis in primary cultures of rat hepatocytes.

6-Azacholest-4-en-3 beta-ol-7-one (azacholesterol) was shown to be a specific inhibitor of cholesterol 7 alpha-hydroxylase. It inhibited cholesterol hydroxylation by a rat liver microsomal preparation with non-competitive kinetics and a Ki of 4 microM. No evidence was found for a time-dependent inhibition of activity. Azacholesterol did not inhibit acyl-CoA: cholesterol acyltransferase or 3-hydroxy-3-methylglutaryl coenzyme A reductase in rat liver microsomal preparations, or cholesterol esterification and synthesis in primary cultures of rat hepatocytes. The synthesis of bile acids was inhibited by azacholesterol in these cells in a dose-dependent way. When bile acid synthesis was inhibited by azacholesterol, newly-synthesized cholesterol from exogenous mevalonate was secreted by the hepatocyte cultures into the cell culture medium in several-fold excess over control incubations. No changes in the secretion of cholesteryl ester occurred in the presence of azacholesterol. This observation suggests that newly synthesised cholesterol that has entered the substrate pool for hydroxylation is no longer accessible to the substrate pool for esterification. This is further evidence for the compartmentation of cholesterol metabolism in the hepatocyte.

The effect of inhibition of cholesterol esterification on the fate of cholesterol derived from HDL in rat hepatocyte monolayers.

Rat HDL2 is known to stimulate bile acid synthesis in rat hepatocyte monolayers. The intracellular fate of the cholesterol derived from the HDL2 was studied using the inhibitor of cholesterol esterification, Sandoz compound 58-035. Rat HDL2 added to rat hepatocyte monolayers caused a stimulation of cholesterol esterification of 32%. This stimulation could be inhibited by 58-035. A small significant increase in bile acid synthesis was also observed in cells in the presence of HDL2, confirming our earlier observations. 58-035 prevented this increase. These observations imply that cholesterol entering the cell from HDL2 is first esterified and can only enter the substrate pool for bile acid synthesis after subsequent intracellular hydrolysis.

Shallow fluorine depth profiles of cementum in periodontal disease--a pilot study.

A nuclear resonant reaction depth profiling technique was used to analyze elemental fluorine distribution in the first 20 microns of human dental cementum. A pilot sample of six periodontally-involved teeth indicated greater levels of fluorine in exposed cementum (0.9 leads to 2.4%) compared to cementum apical to the zone of epithelial attachment (0.4 leads to 1.1%). Furthermore, the exposed cementum appeared to have fluorine levels within the surface 5 microns comparable to the hypermineralized layer previously reported by x-ray diffraction and microprobe techniques. The nuclear resonant reaction is a non-destructive technique which yields useful information of surface elemental distribution as a function of depth, and may be regarded as a potential means of analyzing changes in the inorganic constitution of cementum during various physico-chemical pre-treatments.

A cephalometric study of young marmosets (Callithrix jacchus).

Linear and angular measurements of young marmosets taken at three-month intervals from a series of cephalograms are presented. They show that linear craniofacial development was largely complete by six months of age, subsequent angular changes being mainly related to dental development. No sexual dimorphism was apparent, and there was substantial homogeneity in results for animals of the same age. Thus, marmosets, with their low cost, ease of handling, and rapid maturation, may provide a useful animal model for craniofacial research.

Microvascular luminal volume changes in aged mouse periodontal ligament.

Data for the microvascular bed in the aged periodontal ligament have not been established. This investigation tested the hypothesis that the luminal microvascular volume decreased in the aged ligament. Mice 35 days old and one year old were vascular-perfused and the mandibular first molar periodontal ligament processed for electron microscopy. Tissue quadrats from each circumferential third ligament region were recorded at 150-microns intervals from the alveolar crest to the apex for randomized sampling of blood vessel lumina. The data were analyzed with a generalized linear model at the p < 0.01 level for the interaction of the aging effect with differences across regions. Stereological parameters were established for vessel lumen volume, and for surface and length densities. Mean ligament width decreased from 119.9 +/- 16.94 (micron +/- SE) in young mice to 60.0 +/- 10.58 (micron +/- SE) in aged mice. The luminal volume of 8.63 +/- 1.37 (% +/- SE) in young ligament increased to 9.83 +/- 2.14 (% +/- SE) in aged ligament. Collecting venules and the combined group of arterio-venous anastomoses with terminal arterioles showed a two-fold increase in luminal volume density (p < 0.01). In aged ligament, regional shifts affected the microvascular bed distribution, but these changes were not consistent across regions, or with depth. The average cross-sectional tissue area served per capillary decreased from 2117 microns 2 to 1451 microns 2 for young and old. Average ligament thickness served per capillary dropped from 52.5 microns to 27.5 microns. These reductions in average diffusion distances indicated a change in the quality of the diffusion barrier with age.

Oxytalan fibre organization in marsupial mandibular periodontal tissues.

The arrangement and distribution of oxytalan fibres in Australian marsupials has not previously been reported. Periodontal tissues of wombat, wallaby, possum, and marsupial mouse were examined to ascertain oxytalan fibre organization. Despite adaptation of the marsupial masticatory apparatus to different diets the oxytalan fibre organization in the periodontal ligament shows a basic pattern which corresponds with that reported in other animals. The oxytalan system forms a continuous meshwork of fine, branching fibres which completely invests each tooth root and connects adjacent teeth. Thick ribbon-like apico-occlusally orientated oxytalan fibres, thought to form by the coalescence of thinner fibres, are restricted to the periodontal ligament. The oxytalan fibres are embedded in cementum and attached to blood vessels in the pariodontal ligament. Oxytalan fibres do not insert into alveolar bone. Histological evidence indicates functional remodelling of the oxytalan fibre system in continuously erupting teeth.

Epithelial root-sheath changes during molar formation in the mouse.

The ultrastructure of the epithelial root-sheath was examined in the first mandibular molar teeth of 11, 16 and 21-day-old mice. The changing morphology of the sheath was related to root maturity. An initial, predominantly bicellular layer progressively shortened in an apical direction, the outer layer more so than the inner. The changing morphology appeared to involve maintenance of the inner layer largely at the expense of the outer. Some inner-layer cells persisted at spaced intervals adjacent to forming acellular cementum. Some epithelial rests, distant from the root surface, appeared to be formed early in root development at the time of initial root-sheath severance from the cervical loop of the enamel organ. Epithelial rests located along the acellular cementum appeared to arise from inner, rather than outer, epithelial root-sheath cells and at later stages in root development.

A scanning electron microscope study of microcorrosion casts of the microvasculature of the marmoset palate, gingiva and periodontal ligament.

In the hard palate, sagittally oriented capillary loops, 8-10 microns in diameter and 70-250 microns high, extended perpendicularly from a subcapillary plexus to the connective tissue papillae. These loops formed a well-delineated vascular spine beneath the rugal crests. Capillary loop density was estimated to be 200-270/mm2 on the rugal crest, 75-160/mm2 on the rugal slopes and 70-140/mm2 in the trough. In the gingiva, the crevicular loop system was separated by a gap from the vestibular, palatal and col loop systems. Anastomoses occurred between these systems at a deeper level. The crevicular circular plexus varied from 1 to 4 vessels. Apical to the gingival margin the buccal vasculature was composed of occluso-apically orientated loops draining towards the vestibular sulcus. The capillary loops were 60-120 microns high near the gingival margin, compared with 40-60 microns near the mucogingival junction. The mucogingival margin was demarcated by a change in capillary orientation. The periodontal ligament contained mainly postcapillary-sized venules, 10-25 microns in diameter, orientated occluso-apically. Capillary loops, 50-100 microns long and directed at right angles to the root surface, occurred in the cervical third. These microvascular patterns of the marmoset are different from those of the mouse and rat.

Evidence for endothelial junctions acting as a fluid flux pathway in tensioned periodontal ligament.

A continuous tension load of 1.0 N applied to the rat maxillary first molar for 30 min led to a significant increase (p < 0.05) in the mean number of junctions/microns of endothelial perimeter. The mean number of junctions/microns was compared with the mean number of tissue channels/microns 2 as previously reported by fitting linear and quadratic equations. An increase in the mean number of junctions/microns was associated with an increase in mean number of tissue channels/microns 2 (p < 0.01) in control and experimental periodontal ligament. Significant increases in the mean number of junctions/microns occurred in the middle-third zone for venous capillaries (p < 0.01) and in the tooth-third zone for postcapillary-sized venules (p < 0.001). It is concluded that the endothelial junctions of venous capillaries and postcapillary-sized venules provide significant pathways for fluid transport across the tensioned walls of the microvascular bed of the periodontal ligament.

A morphometric, electron microscopic analysis of tissue channels shown by ionic tracer in normal and tensioned rat molar apical periodontal ligament.

A 1.0 newton continuous, extrusive load was applied to the right maxillary molar for 30 min to determine the presence of channels as shown by the distribution of tracer across the interstitial compartment of normal and tensioned PDL. Sodium ferrocyanide (1% w/v), perfused via the common carotid arteries, was the tracer probe and tris(ethylenediamine) cobalt III chloride (1% w/v) the precipitating ion. Left molar control PDL had an overall mean of 0.43 +/- 0.05/microns2 tissue channels at 0.2 microns from the vascular endothelium, and 0.15 +/- 0.04/microns2 at 7-8 microns. On the experimental side, the overall mean number of tissue channels was 0.65 +/- 0.13/microns2 at 0-2 microns and 0.19 +/- 0.07/microns2 at 7-8 microns. A significant depth effect (P less than 0.01) was present in the control and experimental interstitial tissues for tissue channels adjacent to the endothelium of different categories of vessel. Extrusion increased the tissue channel density adjacent to arterial capillaries (P less than 0.01), venous capillaries (P less than 0.01) and postcapillary-sized venules (P less than 0.01). These findings implicate these three types of vessel as being functionally important in fluid exchange across endothelial boundaries in the PDL.

A method for protrusive mandibular force measurement in children.

With this new method, protrusive mandibular force was studied in a homogeneous group of 69 children with similar occlusions. Maximum protrusive force ranged from 18.5 to 160 N (mean +/- SD = 81.3+/-31.6 N). Maximum protrusive force was significantly higher in males (90.7+/-30.2 N) than females (66.6+/-28.6 N) while fatigue time was not significantly different between the two groups (70.6+/-38.5 s for males and 65.1+/-33.6 s for females). Although protrusive force was stable in each session, it varied considerably between different experimental days within the same individual. No statistically significant correlation was found between maximum protrusive force and age, skeletal maturity, height, weight, overjet, maxillomandibular relation, facial height, facial widths or facial proportions.

Hypodontia of the permanent dentition. Case reports.

Hypodontia has been observed as one of the most common human dental developmental anomalies. It may be defined as agenesis of one or more teeth. The prevalence in the permanent lower central and lateral incisor region is low, ranging from 0.23 percent to 0.08 percent, respectively. This is compared with an overall incidence of hypodontia of 3.49 percent. However, significant racial variation occurs. Treatment options generally available are: no treatment, closure of spaces orthodontically, or prosthetic replacement. Aetiology, associated anomalies, and factors involved in treatment choice are discussed. A report of four cases of hypodontia of the permanent lower anterior teeth and their orthodontic management is presented.

Supernumerary teeth: a review of the literature and four case reports.

A review of the literature relating to supernumerary teeth is presented along with four case reports to illustrate some possible presentations, diagnostic features,and treatment options.

RME-induced root resorption and repair: a computerised 3-D reconstruction.

This study was designed to evaluate the 3-D relation of epithelial rests of Malassez (ERM) to orthodontically induced resorption lacunae in human tooth roots. First premolars were extracted following rapid maxillary expansion, then they were prepared for transmission electron microscopy and sectioned. Serial 1 micron sections were used for the 3-D reconstructions and ultra thin sections were utilized to verify the identification of epithelial cells and blood vessel types. Each serial section was photographed and profiles of the resorption bays, epithelial cells and blood vessels were digitized and computer reconstructions performed with an IBM-based software programme. The reconstructions supported the view that epithelial cell and blood vessel relation to the resorption lacunae appeared to be related to the level of activity of the bay. Possible functional roles for epithelial cells in the resorptive process are discussed.

Activator and Begg appliance management of a severe Angle Class II, division 1 malocclusion.

A male patient aged 12 years 11 months presented with the chief complaint of prominent, spaced upper teeth and was keen to overcome his dental problem.

Ultrastructural changes in postcapillary-sized venule morphology in aged mouse periodontal ligament.

The aim of this study was to compare the postcapillary-sized venule (PCV) morphology of four young ALCA mice (35 days) and four colony-related aged mice (365 days) using the transmission electron microscope (TEM). Right and left mandibular first molar mesial roots with associated periodontal ligament (PDL) and bony socket, were used for TEM assessment. Five PCV profiles were selected at each 160 microm interval, from the alveolar crest to the tooth apex. PCV profile dimensions were measured on standardised micrographs magnified x2900. Age affects were tested using multiple regression analysis. The number of PCV profiles in the tooth third of the PDL was higher in aged mice (p < 0.01) and comprised predominantly apericytic vessels (p < 0.001). The number of PCV profiles increased significantly (p < 0.001) in aged mice in the PDL middle circumferential third halfway down the molar root. Age had no significant affect on PCV diameter. Aged PDL permeability studies are needed to investigate whether the changes in aged PCV profile number are associated with functional modification of the PDL microvasculature.

An ultrastructural evaluation of the relationship between epithelial rests of Malassez and orthodontic root resorption and repair in man.

Contrary to previous reports, epithelial cell clusters with ultrastructural features similar to classically defined epithelial rests of Malassez were found, for the first time, in areas of repairing orthodontic root resorption. These observations were made on the buccal root surface of premolars extracted for orthodontic purposes from adolescent patients who had required rapid maxillary expansion. Ultrastructurally, the epithelial clusters ranged in size from 2-8 cells and were characterized by the presence of true desmosomes (macula adherens) and tonofilaments. Certain ultrastructural features of the epithelial cell clusters indicate that they may be involved in mediating repair cementogenesis subsequent to migration into the resorption bay.