A Critical Role for ERO1α in Arterial Thrombosis and Ischemic Stroke.

BACKGROUND: Platelet adhesion and aggregation play a crucial role in arterial thrombosis and ischemic stroke. Here, we identify platelet ERO1α (endoplasmic reticulum oxidoreductase 1α) as a novel regulator of Ca2+ signaling and a potential pharmacological target for treating thrombotic diseases. METHODS: Intravital microscopy, animal disease models, and a wide range of cell biological studies were utilized to demonstrate the pathophysiological role of ERO1α in arteriolar and arterial thrombosis and to prove the importance of platelet ERO1α in platelet activation and aggregation. Mass spectrometry, electron microscopy, and biochemical studies were used to investigate the molecular mechanism. We used novel blocking antibodies and small-molecule inhibitors to study whether ERO1α can be targeted to attenuate thrombotic conditions. RESULTS: Megakaryocyte-specific or global deletion of Ero1α in mice similarly reduced platelet thrombus formation in arteriolar and arterial thrombosis without affecting tail bleeding times and blood loss following vascular injury. We observed that platelet ERO1α localized exclusively in the dense tubular system and promoted Ca2+ mobilization, platelet activation, and aggregation. Platelet ERO1α directly interacted with STIM1 (stromal interaction molecule 1) and SERCA2 (sarco/endoplasmic reticulum Ca2+-ATPase 2) and regulated their functions. Such interactions were impaired in mutant STIM1-Cys49/56Ser and mutant SERCA2-Cys875/887Ser. We found that ERO1α modified an allosteric Cys49-Cys56 disulfide bond in STIM1 and a Cys875-Cys887 disulfide bond in SERCA2, contributing to Ca2+ store content and increasing cytosolic Ca2+ levels during platelet activation. Inhibition of Ero1α with small-molecule inhibitors but not blocking antibodies attenuated arteriolar and arterial thrombosis and reduced infarct volume following focal brain ischemia in mice. CONCLUSIONS: Our results suggest that ERO1α acts as a thiol oxidase for Ca2+ signaling molecules, STIM1 and SERCA2, and enhances cytosolic Ca2+ levels, promoting platelet activation and aggregation. Our study provides evidence that ERO1α may be a potential target to reduce thrombotic events.

Surgical vs nonsurgical treatments in patients with anterior open-bite have similar effects in occlusal function: A 2-year follow-up study.

INTRODUCTION: This study aimed to investigate changes in bite force (BF) and occlusal contact area after anterior open-bite (AOB) treatment and compare the changes in surgical vs nonsurgical treatment. METHODS: This retrospective study included patients with AOB compared with normal occlusion. AOB was corrected by either intrusion of the maxillary molars (intrusion group, n = 19) or orthognathic surgery (surgery group, n = 37). The control group (n = 35) had a normal overbite relationship. Records of lateral cephalograms, BF, and occlusal contact area taken before (T0), immediately after (T1), and 2 years after (T2) orthodontic treatment were compared within and among the 3 groups. RESULTS: The open-bite group, including intrusion and surgery groups, had a lower BF and less occlusal contact area than the control group at T0 and T1 (P <0.001). However, there were no significant differences among the 3 groups at T2 (P >0.05). The intrusion and surgery groups showed no significant differences throughout the observation period extending from T0 to T2 (P >0.05). Although BF and occlusal contact area decreased at T1 compared with T0, they increased during retention and showed higher values at T2 than at T0. CONCLUSIONS: Treatment of AOB improved BF and occlusal contact area 2 years posttreatment. Orthognathic surgery and molar intrusion using orthodontic miniscrews can improve occlusal function similarly. Orthodontists can select either method depending on malocclusion severity and patient demand.

Three-dimensional evaluation of dentopalatal changes after rapid maxillary expansion in growing children.

INTRODUCTION: In growing children with transverse malocclusion problems, various types of rapid maxillary expanders (RMEs) have been effectively used in skeletal and dental expansions. We evaluated 3-dimensional dentopalatal changes in growing children who underwent maxillary expansion using RMEs and bonded RMEs. METHODS: We investigated dentopalatal changes in 20 patients treated with bonded RMEs, 19 with RMEs, and 38 control patients. Dental plaster models before and after expansion were scanned 3-dimensionally and superimposed to evaluate transverse expansion, expansion ratio, angular expansion, and palatal expansion height ratio. RESULTS: Using bonded RMEs, similar anterior and posterior dental expansions were achieved with an efficiency of 69%-76% (expansion ratio), and palatal soft-tissue expansion occurred more apically in the posterior area (palatal expansion height ratio, 1.00) than in the anterior area (palatal expansion height ratio, 0.64). Using RMEs, a larger posterior dental expansion was achieved, with an efficiency of 106%-117% (expansion ratio), than anterior dental expansion (55%-60%), and palatal soft-tissue expansion occurred more apically in the posterior area (palatal expansion height ratio, 0.99) than anterior area (palatal expansion height ratio, 0.23). CONCLUSIONS: Dental expansions in the anterior and posterior areas were similar using bonded RMEs, whereas the posterior dental expansions were larger than those of the anterior area using RMEs. The entire palatal soft-tissue slope expanded in the posterior area, whereas the occlusal part expanded in the anterior area using RMEs and bonded RMEs.

Treatment outcome comparison of Invisalign vs fixed appliance treatment in first premolar extraction patients.

INTRODUCTION: In this study, we compared the dentitional changes after Invisalign and conventional orthodontic treatment with 4 first premolar extractions. METHODS: This retrospective study included 57 patients whose orthodontic treatment involved the extraction of 4 first premolars because of bialveolar protrusion. A total of 27 patients were treated with Invisalign (mean age, 25.5 ± 5.2 years) and 30 patients with the fixed appliance (mean age, 24.4 ± 5.8 years). The angular and linear changes of the maxillary and mandibular central incisors, second premolars, first molars, and second molars were measured from the recordings on the basis of the lateral cephalograms taken before and after treatment. The angular changes of the canines and second premolars were measured using panoramic radiographs. RESULTS: The overbite and interincisal angle increased significantly in the Invisalign group compared with in the conventional fixed appliance group (P <0.05). The maxillary central incisors showed increased lingual tipping in the Invisalign group (P <0.05), whereas there was no statistically significant difference in the angular change of the mandibular incisors between groups (P >0.05). The maxillary first and second molars showed mesial tipping in the Invisalign group (P <0.05). The maxillary second premolars, first and second molars, and the mandibular second molars showed mesial movement in the Invisalign group (P <0.05). CONCLUSIONS: The Invisalign group showed more statistically significant lingual tipping of the maxillary central incisors, distal tipping of the maxillary canines, and mesial tipping of the maxillary first and second molars after maximum retraction of the anterior teeth compared with the fixed appliance group.

Enzymatic transformation of esculetin as a potent class of α-glucosidase inhibitors.

A rapid and simple enzymatic transformation of the representative coumarin esculetin (1) with polyphenol oxidase originating from Agaricus bisporus afforded five new oxidized metabolites, esculetinins A (2), B (3), C (4), D (5), and E (6), together with the known compound isoeuphorbetin (7). The structures of the oligomerized transformation products were established on the basis of spectroscopic interpretations. The esculetin oligomers 2 and 3 revealed highly enhanced inhibitory activities against α-glucosidase, with IC50 values of 0.7 ± 0.1 and 2.3 ± 0.3 µM, respectively, as compared to the original esculetin. Kinetic analysis also exhibited that the two new potent metabolites 2 and 3 have competitive modes of action.

Correlation of masticatory muscle activity and occlusal function with craniofacial morphology: a prospective cohort study.

OBJECTIVES: Masticatory function, including masticatory muscle activity and occlusal function, can be affected by craniofacial morphology. This study aimed to investigate the relationship between craniofacial morphology and masticatory function in participants who had completed orthodontic treatment at least two years before and had stable occlusion. MATERIALS AND METHODS: Fourty-two healthy participants were prospectively enrolled and divided into three vertical cephalometric groups according to the mandibular plane angle. Masticatory muscle activity (MMA) in the masseter and anterior temporalis muscles was assessed using surface electromyography. The occlusal contact area (OCA) and occlusal force (OF), defined as occlusal function in this study, were evaluated using occlusal pressure mapping system. Masticatory muscle efficiency (MME) was calculated by dividing MMA by OF. The craniofacial morphology was analyzed using a lateral cephalogram. The masticatory function was compared using one-way analysis of variance. Pearson correlations were used to assess relationships between craniofacial morphology and masticatory function. RESULTS: The hypodivergent group had the lowest MMAand the highest MME in the masseter (167.32 ± 74.92 µV and 0.14 ± 0.06 µV/N, respectively) and anterior temporalis muscles (0.18 ± 0.08 µV/N, p < 0.05). MMA in the masseter showed a positive relationship with mandibular plane angle (r = 0.358), whereas OCA (r = -0.422) and OF (r = -0.383) demonstrated a negative relationship (p < 0.05). The anterior temporalis muscle activity negatively correlated with ramus height (r = -0.364, p < 0.05). CONCLUSIONS: Vertical craniofacial morphology was related to masticatory function. Hypodivergent individuals may have low MMA and high occlusal function, resulting in good masticatory muscle efficiency. CLINICAL RELEVANCE: Hypodivergent individuals require careful consideration in orthodontic diagnosis and prosthetic treatment planning.

Lightweight and Energy-Efficient Deep Learning Accelerator for Real-Time Object Detection on Edge Devices.

Tiny machine learning (TinyML) has become an emerging field according to the rapid growth in the area of the internet of things (IoT). However, most deep learning algorithms are too complex, require a lot of memory to store data, and consume an enormous amount of energy for calculation/data movement; therefore, the algorithms are not suitable for IoT devices such as various sensors and imaging systems. Furthermore, typical hardware accelerators cannot be embedded in these resource-constrained edge devices, and they are difficult to drive real-time inference processing as well. To perform the real-time processing on these battery-operated devices, deep learning models should be compact and hardware-optimized, and hardware accelerator designs also have to be lightweight and consume extremely low energy. Therefore, we present an optimized network model through model simplification and compression for the hardware to be implemented, and propose a hardware architecture for a lightweight and energy-efficient deep learning accelerator. The experimental results demonstrate that our optimized model successfully performs object detection, and the proposed hardware design achieves 1.25× and 4.27× smaller logic and BRAM size, respectively, and its energy consumption is approximately 10.37× lower than previous similar works with 43.95 fps as a real-time process under an operating frequency of 100 MHz on a Xilinx ZC702 FPGA.

Deep Learning Accelerators' Configuration Space Exploration Effect on Performance and Resource Utilization: A Gemmini Case Study.

Though custom deep learning (DL) hardware accelerators are attractive for making inferences in edge computing devices, their design and implementation remain a challenge. Open-source frameworks exist for exploring DL hardware accelerators. Gemmini is an open-source systolic array generator for agile DL accelerator exploration. This paper details the hardware/software components generated using Gemmini. The general matrix-to-matrix multiplication (GEMM) of different dataflow options, including output/weight stationary (OS/WS), was explored in Gemmini to estimate the performance relative to a CPU implementation. The Gemmini hardware was implemented on an FPGA device to explore the effect of several accelerator parameters, including array size, memory capacity, and the CPU/hardware image-to-column (im2col) module, on metrics such as the area, frequency, and power. This work revealed that regarding the performance, the WS dataflow offered a speedup of 3× relative to the OS dataflow, and the hardware im2col operation offered a speedup of 1.1× relative to the operation on the CPU. For hardware resources, an increase in the array size by a factor of 2 led to an increase in both the area and power by a factor of 3.3, and the im2col module led to an increase in area and power by factors of 1.01 and 1.06, respectively.

Development of a Propidium Monoazide-Based Viability Quantitative PCR Assay for Red Sea Bream Iridovirus Detection.

Red sea bream iridovirus (RSIV) is an important aquatic virus that causes high mortality in marine fish. RSIV infection mainly spreads through horizontal transmission via seawater, and its early detection could help prevent disease outbreaks. Although quantitative PCR (qPCR) is a sensitive and rapid method for detecting RSIV, it cannot differentiate between infectious and inactive viruses. Here, we aimed to develop a viability qPCR assay based on propidium monoazide (PMAxx), which is a photoactive dye that penetrates damaged viral particles and binds to viral DNA to prevent qPCR amplification, to distinguish between infectious and inactive viruses effectively. Our results demonstrated that PMAxx at 75 µM effectively inhibited the amplification of heat-inactivated RSIV in viability qPCR, allowing the discrimination of inactive and infectious RSIV. Furthermore, the PMAxx-based viability qPCR assay selectively detected the infectious RSIV in seawater more efficiently than the conventional qPCR and cell culture methods. The reported viability qPCR method will help prevent the overestimation of red sea bream iridoviral disease caused by RSIV. Furthermore, this non-invasive method will aid in establishing a disease prediction system and in epidemiological analysis using seawater.

Evaluation of the dimensional alternation of the alveolar bone in patients with a congenitally missing mandibular lateral incisor using cone-beam computed tomography.

INTRODUCTION: The alveolar bone is an essential consideration when planning treatment for patients with tooth agenesis. This study evaluated the changes in the alveolar bone and adjacent teeth in patients with a congenitally missing mandibular lateral incisor using cone-beam computed tomography. METHODS: Twenty-three nonorthodontically treated adults with a unilateral congenitally missing mandibular lateral incisor were the missing group (M group). The control group (C group) consisted of 23 nonorthodontically treated adults with normal occlusion and no missing teeth. First, the difference in the arch perimeter between the groups was compared at the cementoenamel junction (CEJ) level and the root apex (RA) level. Next, the root divergence of the anterior teeth in the M group was observed. Finally, the alveolar bone thickness ratio was compared between the M and C groups at different vertical levels. RESULTS: The arch perimeter was significantly decreased in the M group at the CEJ and RA levels (P <0.05). Root divergence was observed adjacent to the missing site (P <0.0001). There were a reduction in total and cancellous cortical alveolar bone thickness (ABT) ratios at the 3-, 6-, and 9-mm positions (P <0.05). The buccal cortical ABT ratios decreased at the 3-and 6-mm positions. The lingual ABT ratio increased at the 9-mm position (P <0.05). CONCLUSIONS: The congenitally missing mandibular lateral incisor caused a reduction in the arch perimeter in the CEJ area and the RA area. The root divergences were observed in the teeth adjacent to the missing areas. A significant decrease in the buccal cortical bone and cancellous bone was observed in the missing area.

Factors influencing the successful eruption of the maxillary third molar after extraction of the maxillary second molar.

INTRODUCTION: This study evaluated the occlusal status of the maxillary third molars that erupted spontaneously after extraction of the maxillary second molars and investigated the factors that influenced the occlusal status of the maxillary third molars. METHODS: We assessed 136 maxillary third molars in 87 patients. Alignment, marginal ridge discrepancy, occlusal contact, interproximal contact, and buccal overjet were used to score the occlusal status. Occlusal status was classified as good (G group), acceptable (A group), and poor (P group) for the maxillary third molar at its full eruption (T1). The Nolla's stage, long axis angle, the vertical and horizontal position of the maxillary third molar, and the maxillary tuberosity space were assessed at the time of maxillary second molar extraction (T0) and T1 to identify factors influencing the eruption of the maxillary third molar. RESULTS: G, A, and P groups comprised 47.8%, 17.6,% and 34.6% of the sample, respectively. Age was the lowest in the G group at both T0 and T1. The maxillary tuberosity space at T1 and the amount of the change of maxillary tuberosity space were the largest in the G group. There was a significant difference in the distribution of the Nolla's stage at T0. The proportions of the G group were 60.0% in stage 4, 46.8% in stages 5 and 6, 70.4% in stage 7, and 15.0% in stages 8-10. According to multiple logistic regression analysis, stages 8-10 for the maxillary third molar at T0 and the amount of the change of maxillary tuberosity were negatively associated with the G group. CONCLUSIONS: Good-to-acceptable occlusion was seen in 65.4% of the maxillary third molars after maxillary second molar extraction. Insufficient increase in the maxillary tuberosity space and Nolla stage 8 or higher at T0 negatively influenced the maxillary third molar eruption.

Differences in the 3-dimensional aging changes of the lips among female adults with skeletal Class I, II, and III malocclusion.

INTRODUCTION: The objective of this study was to evaluate and compare the 3-dimensional (3D) aging changes of the lips among adult skeletal Class I, II, and III malocclusion. METHODS: Female adult orthodontic patients aged 20-50 years with pretreatment cone-beam computed tomography scans were retrospectively classified according to age (20s [20-29 years], 30s [30-39 years], and 40s [40-49 years]) and then subclassified by malocclusion into skeletal Class I, II, and III relationship (9 groups; n = 30 per group). Positional differences in midsagittal and parasagittal soft-tissue landmarks and 3D morphologic aging changes of the lips were evaluated using cone-beam computed tomography scans. RESULTS: Labiale superius and cheilion for patients in their 40s indicated a significant downward and backward position compared with those in their 20s, regardless of skeletal classifications (P <0.05). Accordingly, the upper lip height decreased, and the mouth width increased significantly (P <0.05). For Class III malocclusion, the upper lip vermilion angle was greater for patients in their 40s than those in their 20s (P <0.05), whereas the lower lip vermilion angle was only lower for patients with Class II malocclusion (P <0.05). CONCLUSIONS: Middle-aged adult females (40-49 years) had a lower upper lip height and greater mouth width than those in their 20s, regardless of skeletal malocclusion. However, prominent morphologic aging changes of the lips were noted on the upper lip for skeletal Class III malocclusion and the lower lip for skeletal Class II malocclusion, implying that the underlying skeletal features (or malocclusion) may influence 3D aging changes of the lips.

KISTI remote control room for CDF and Belle II collider experiments.

Particle collider experiments would be continued even when one is not present at the laboratory (on-site). To achieve this, we require an e-Science paradigm of studying particle physics anytime anywhere. One of the components for establishing this paradigm is a remote control room for data acquisition (DAQ). We developed and embedded a remote control room at the Korea Institute of Science and Technology Information (KISTI). Since then, we have been adopting on/offline shifts for conducting collider experiments at KISTI, that is, the experiments are done even when we are not on-site. In this paper, we introduce our experience of our remote control room for both CDF and Belle II experiments. This remote control room includes international networks, security, DAQ systems, data transfers, and monitoring systems. We also presented the results of the shifts done in the remote control room at KISTI.

Shear and Integrin Outside-In Signaling Activate NADPH-Oxidase 2 to Promote Platelet Activation.

[Figure: see text].

Molecular characterization and expression analysis of septin gene family and phagocytic function of recombinant septin 2, 3 and 8 of starry flounder (Platichthys stellatus).

Septin is an evolutionarily conserved family of GTP-binding proteins. Septins are known to be involved in a variety of cellular processes, including cell division, chromosome separation, cell polarity, motility, membrane dynamics, exocytosis, apoptosis, phagocytosis, DNA damage responses, and other immune responses. In this study, the sequences of the septin gene family of starry flounder were obtained using NGS sequencing, and the integrity of the sequences was verified through cloning and sequencing. At first, the amino acid sequence was annotated using the cDNA sequence, and then, the gene sequence was verified through multiple sequence alignment and phylogenetic analyses using the related conserved sequences. The septin gene family was classified into three subgroups based on the phylogenetic analysis. High conservation within the domain and homology between the genes reported in different species were confirmed. The expression level of septin gene family mRNA in each tissue of healthy starry flounder was evaluated to confirm the tissue- and gene-specific expression levels. Additionally, as a result of the analysis of mRNA expression after simulated pathogen infection, significant expression changes and characteristics were confirmed upon infection with bacteria (Streptococcus parauberis PH0710) and virus (VHSV). Based on the current results and that of previous studies, to confirm the immunological function, Septin 2, 3, and 8 were produced as recombinant proteins based on the amino acid sequences, and their role in phagocytosis was further investigated. The results of this study indicate that septin gene family plays a complex and crucial role in the host immune response to pathogens of starry flounder.

Red sea bream interleukin (IL)-1ß and IL-8 expression, subcellular localization, and antiviral activity against red sea bream iridovirus (RSIV).

Interleukin-1 beta (IL-1ß) is transcribed by monocytes, macrophages, and dendritic cells in response to activation of toll-like receptors (TLRs) by pathogen-associated molecular patterns (PAMPs) or cytokine signalling and causes a rapid inflammatory response to infection. IL-8, also known as chemokine C-X-C motif ligand (CXCL)-8, is regulated by IL-1ß and affects the chemotaxis of macrophages and neutrophils upon pathogen infection. In healthy red sea bream, rsbIL-1ß is most highly distributed in the liver, and rsbIL-8 is most highly distributed in the head kidney. In response to RSIV infection, rsbIL-1ß and rsbIL-8 mRNA are significantly upregulated in the kidney and spleen. This may be because the primary infection targets of RSIV are the kidney and spleen. In the gills, both genes were significantly upregulated at 7 days after RSIV infection and may be accompanied by a cytokine storm. In the liver, both genes were significantly downregulated at most observation points, which may be because the immune cells such as macrophages and dendritic cells expressing rsbIL-1ß or rsbIL-8 migrated to other tissues because the degree of RSIV infection was relatively low. Using a GFP fusion protein, it was confirmed that rsbIL-1ß and rsbIL-8 were localized to the cytoplasm of Pagrus major fin (PMF) cells. RsbIL-1ß overexpression induced the expression of interferon gamma (IFN-γ), myxovirus-resistance protein (Mx) 1, IL-8, IL-10, TNF-α, and MyD88, while rsbIL-8 overexpression induced the expression of IFN-γ, Mx1, rsbIL-1ß and TNF-α. In addition, overexpression of both genes significantly reduced the genome copies of RSIV and significantly reduced the viral titers. Therefore, rsbIL-1ß and rsbIL-8 in red sea bream play an antiviral role against RSIV through their normal signalling.

Morphologic changes of the incisive canal and its proximity to maxillary incisor roots after anterior tooth movement.

INTRODUCTION: The objectives were to evaluate the morphologic changes of the incisive canal (IC) and the influence of IC proximity to apical root resorption of maxillary central incisors after anterior tooth movement. METHODS: Pretreatment and posttreatment cone-beam computed tomography images of adults (aged 18-47 years) were retrospectively evaluated. Subjects were divided into control group with minimal incisor movement (n = 32; maxillary incisor tip movement <2 mm) and maximum retraction group (n = 35; maxillary incisor tip movement >4 mm). The shape, direction, morphologic changes of the IC, the proximity of the central incisor root to IC, and the amount of apical root resorption associated with the proximity after orthodontic treatment were compared. RESULTS: Changes in the shape of the IC were not observed in both control and retraction groups. However, 11.4% (4 of 35 subjects) in the retraction group indicated changes in the direction of the IC from slanted-straight to slanted-curved type after the direction of anterior retraction. The thickness of the cortical bone surrounding the IC and the distance between the incisor root and IC significantly decreased after orthodontic treatment in both groups (P <0.05). However, these changes were significantly greater in the retraction group than in control (P <0.0001). Contact or invasion of the incisor root to the IC was more prominent in the retraction group (42.8%-54.3%) than the control (10.9%-12.5%) (P <0.0001). The amount of root resorption indicated a tendency to increase in the order of separation, approximation, contact, and invasion in relation to IC. CONCLUSIONS: Although remodeling of IC was evident in some patients, contact or invasion of the maxillary central incisor roots to IC was fairly high after maximum anterior retraction.

Incidence and clinical risk factors associated with the development of labial protuberances after orthodontic treatment.

INTRODUCTION: Distinct, irregular, and hard, nodular labial protuberances (LPs) that were due to differential alveolar bone modeling can be noted on the labial gingival surface of the incisors after orthodontic treatment. Clinically, LPs cause patient discomfort and esthetic issues, but information on this phenomenon is limited. This study aimed to evaluate the incidence of LPs and demonstrate the etiology and clinical risk factors associated with this phenomenon. METHODS: Differential alveolar bone modeling was defined as present (+) when ≥1 distinct LPs (diameter >1 mm) developed after orthodontic treatment by comparing pretreatment and posttreatment intraoral photographs and casts of an orthodontic patient cohort treated with fixed appliances (n = 872). The incidence rate, affected sites, and their association with age, sex, and orthodontic treatment modalities were evaluated. RESULTS: The incidence rate of differential alveolar bone modeling among orthodontic patients was 3.2% (28 out of 872). The maxillary lateral incisor region was the most frequently affected site. Males (vs females) (odds ratio, 2.56 [95% confidence interval, 1.155-5.604]), adults (aged ≥ 20 years) (vs teens) (12.84 [3.003-54.866]), and those who had orthodontic extraction (vs nonextraction) (11.60 [3.434-39.156]) demonstrated significantly higher odds of developing LPs after orthodontic treatment (P <0.05). CONCLUSIONS: The incidence rate of the development of notable LPs after orthodontic treatment was 3.2%. Adult males and those who undergo orthodontic extraction have a higher risk of developing LPs. Clinicians should be aware that distinct LPs may develop when large amounts of incisal retraction are planned in adults.

Long-term follow-up of a patient with deepbite and severely resorbed maxillary central incisors treated by maxillary premolar and mandibular incisor extraction.

Deepbite is a common type of malocclusion, but it leads to difficulties in treatment and retention. We report the treatment of an adult patient with deepbite and severe crowding of teeth. Several teeth had to be restored, and the maxillary central incisors had short roots. Various treatment plans were considered, and extraction of the maxillary right and left first premolars, and mandibular right central incisor was planned. Successful treatment results were obtained with long-term retention.

Skeletal and alveolar changes in conventional rapid palatal expansion (RPE) and miniscrew-assisted RPE (MARPE): a prospective randomized clinical trial using low-dose CBCT.

BACKGROUND: This prospective randomized clinical trial aimed to evaluate the immediate and short-term skeletal, dentoalveolar, and periodontal effects of rapid palatal expansion (RPE) and miniscrew-assisted RPE (MARPE) in adolescent and young adult patients. METHODS: This study followed a two-arm, parallel, randomized clinical trial design that recruited patients with transverse maxillary deficiency in a 1:1 allocation ratio. Forty patients (14 men and 26 women) requiring maxillary expansion were randomly allocated to the RPE (n = 20, age = 14.0 ± 4.5) or MARPE (n = 20, age = 14.1 ± 4.2) groups. The assignment was performed via computer-generated block randomization, with a block size of four. Upon identical (35 turns) amount of expansion, low-dose cone-beam computed tomography images were taken before treatment (T0), immediately after expansion (T1), and after a 3-month consolidation period (T2). The primary outcome of this study comprised the assessment of midpalatal suture separation. Secondary outcomes included, skeletal, dentoalveolar, and periodontal measurements, which were performed at each time point. RESULTS: The frequency of midpalatal suture separation was 90% (18/20) and 95% (19/20) for the RPE and MARPE groups, respectively. A greater increase in nasal width in the molar region (M-NW) and greater palatine foramen (GPF) was observed immediately after the expansion (T1-T0) and consolidation periods (T2-T0) in the MARPE group compared to the RPE group (P < 0.05). The MARPE and RPE groups showed similar dentoalveolar changes except for the maxillary width (PM-MW, M-MW). The MARPE group presented greater bilateral first premolar (PM-MW) and molar (M-MW) maxillary width in relation to the RPE group (P < 0.05). Through the expansion and consolidation periods (T2-T0), lesser buccal displacement of the anchor teeth was observed in the MARPE group (PM-BBPT, PM-PBPT, M-BBPT [mesial and distal roots], and M-PBPT)( P < 0.05). CONCLUSIONS: Midpalatal suture separation was observed in 90% and 95% of patients in the RPE and MARPE groups, respectively. Both RPE and MARPE groups exhibited significant triangular basal bone expansion and skeletal relapse during consolidation. Under identical amounts of expansion, the MARPE group showed lower decrease in the skeletal, dentoalveolar and periodontal variables after consolidation. The reinforcement of RPE with miniscrews contributes to the maintenance of the basal bone during consolidation period. Trial registration WHO Institutional Clinical Trials Registry Platform (IRB No. KCT0006871 / Registration date 27/12/2021).