Classification of Angelica species found in various foods using an LC-QTOF/MS-based metabolomics approach.

In Korea, Angelica gigas is commonly known as Danggui. However, two other species on the market, Angelica acutiloba and Angelica sinensis, are also commonly called Danggui. Since the three Angelica species have different biologically active components, thus, different pharmacological activities, clear discrimination between them is needed to prevent their misuse. A. gigas is used not only as a cut or powdered product but also in processed foods, where it is mixed with other ingredients. To discriminate between the three Angelica species, reference samples were analysed as non-targeted using liquid chromatography-quadrupole time of flight/mass spectrometry (LC-QTOF/MS) and a metabolomics approach in which a discrimination model was established by partial least squares-discriminant analysis (PLS-DA). Then, the Angelica species in the processed foods were identified. First, 32 peaks were selected as marker compounds and a discrimination model was created using PLS-DA, and its validation was confirmed. Classification of the Angelica species was undertaken using the YPredPS value, and it was confirmed that all 21 foods examined contained the appropriate Angelica species indicated on the product packaging. Likewise, it was confirmed that all three Angelica species were accurately classified in the samples to which they were added.

Discrimination of three Angelica herbs using LC-QTOF/MS combined with multivariate analysis.

Angelica gigas, a popular medicinal herb in Korea, is locally called Danggui; this name is similarly used for Angelica acutiloba and Angelica sinensis, which are also sold in the retail market. These three herbs have differing therapeutic effects and should be used according to their prescribed purposes. In some retail markets, though, all three herbs are known by the same common name rather than a scientific name and can therefore be confused with each other. In particular, in the case of powdered products, intentional or unintentional wrong sales activity by the seller may occur. In this study, non-targeted analysis was performed using liquid chromatography quadrupole time-of-flight mass spectrometry to discriminate between the three Angelica herbs, and marker compounds were identified by principal component analysis. Principal component analysis was applied to the whole dataset with the variables being sample name, peak name (m/z with retention time), and ion intensity extracted in advance by peak finding, alignment, and filtering. All three herbs were visually and clearly differentiated in the score plot, and the marker compounds that contributed to their discrimination were found in the loading plot through principal component variable grouping (PCVG). Among the marker compounds, coumarins contributed to the classification of A. gigas, and phthalides contributed to the classification of A. sinensis. The three Angelica herbs were well discriminated from each other. Within the three Angelica species investigated, marker compounds can determine the species of even powdered or extracted samples that cannot be visually identified.

Tumorigenic mechanisms of estrogen and Helicobacter pylori cytotoxin-associated gene A in estrogen receptor α-positive diffuse-type gastric adenocarcinoma.

BACKGROUND: Diffuse-type gastric cancer (DGC), for which Helicobacter pylori infection is a causal factor, is associated with poor prognosis among young women, possibly due to female hormones such as estrogen. We aimed to identify the carcinogenesis induced by estrogen and H. pylori in DGC. METHODS: We screened and selected estrogen receptor alpha (ERα)-positive (MKN45) and ERα-negative (SNU5) DGC cell lines. H. pylori strain 60190 and its isogenic mutant strain lacking cytotoxin-associated gene A (60190ΔCagA) were used to infect MKN45 cells. And the cytotoxin-related gene A (CagA) cDNA which was cloned into pSP65-SR-HA (cagA-pSP65SRa) vector was used to transfect MKN45 cells. Tumor samples were used for DGC organoid culture. RESULTS: In MKN45 cells, we found that estradiol promotes epithelial-mesenchymal transition (EMT) and stemness phenotypes via HOTAIR expression. These effects were further enhanced by the addition of CagA secreted by H. pylori but were reversed by co-treatment with fulvestrant (ICI 182,780), a selective ER degrader. We also validated the effect of estrogen on DGC organoids. ERα expression was associated with tumor invasion and HOTAIR expression in DGC patients with overt H. pylori infection. CONCLUSIONS: These findings may explain the rapid DGC progression in young women with physiologically high levels of estrogen and suggest that fulvestrant with ovarian function suppression could serve as a tumor-suppressive agent in premenopausal patients with DGC.

CK2α/CSNK2A1 Induces Resistance to Doxorubicin through SIRT6-Mediated Activation of the DNA Damage Repair Pathway.

CK2α/CSNK2A1 is involved in cancer progression by phosphorylating various signaling molecules. Considering the role of CSNK2A1 in cancer progression and the phosphorylation of SIRT6 and the role of SIRT6 in chemoresistance through the DNA damage repair pathway, CSNK2A1 and SIRT6 might be involved in resistance to conventional anti-cancer therapies. We evaluated the expression of CSNK2A1 and phosphorylated SIRT6 in the 37 osteosarcoma patients and investigated the effects of CSNK2A1 and the phosphorylation of SIRT6 on Ser338 on resistance to the anti-cancer effects of doxorubicin. Higher expression of CSNK2A1 and phosphorylated SIRT6 was associated with shorter survival in osteosarcoma patients. U2OS and KHOS/NP osteosarcoma cells with induced overexpression of CSNK2A1 were resistant to the cytotoxic effects of doxorubicin, and the knock-down of CSNK2A1 potentiated the cytotoxic effects of doxorubicin. CSNK2A1 overexpression-mediated resistance to doxorubicin was associated with SIRT6 phosphorylation and the induction of the DNA damage repair pathway molecules. CSNK2A1- and SIRT6-mediated resistance to doxorubicin in vivo was attenuated via mutation of SIRT6 at the Ser338 phosphorylation site. Emodin, a CSNK2A1 inhibitor, potentiated the cytotoxic effects of doxorubicin in osteosarcoma cells. This study suggests that blocking the CSNK2A1-SIRT6-DNA damage repair pathway might be a new therapeutic stratagem for osteosarcomas.

Inhibition of SIRT6 potentiates the anti-tumor effect of doxorubicin through suppression of the DNA damage repair pathway in osteosarcoma.

BACKGROUND: SIRT6 has diverse roles in cells, and the role of SIRT6 in tumorigenesis is controversial. Considering the role of SIRT6 as an inducer of DNA damage repair, it might be involved in resistance to anti-cancer therapy. METHODS: We evaluated the prognostic significance of SIRT6 in 37 osteosarcomas and investigated the therapeutic efficacy of SIRT6 on the anticancer effects of doxorubicin, olaparib, and ATM inhibitor. RESULTS: Immunohistochemical expression of SIRT6 was significantly associated with shorter overall survival and relapse-free survival of osteosarcoma patients, especially in patients who received adjuvant chemotherapy. In U2OS and KHOS/NP osteosarcoma cells, knock-down of SIRT6 significantly potentiated apoptotic effects of doxorubicin and SIRT6 overexpression induced resistance to doxorubicin. Moreover, SIRT6 induced the DNA damage repair pathway and SIRT6-mediated resistance to doxorubicin was attenuated by blocking the DNA damage repair pathway with olaparib and ATM inhibitor. CONCLUSIONS: This study suggests that suppression of SIRT6 in combination with doxorubicin might be an effective modality in the treatment of osteosarcoma patients, especially for osteosarcomas with shorter survival with high expression of SIRT6.

Determination of 12 herbal compounds for estimating the presence of Angelica Gigas Root, Cornus Fruit, Licorice Root, Pueraria Root, and Schisandra Fruit in foods by LC-MS/MS.

A wide variety of plant raw materials thought to promote health are used as herbal medicines as well as foods. However, there is no legal maximum or minimum concentration limit on any herbal compound when these plant raw materials are used in processed foods. Legally, these processed foods are regulated only for harmful substances, and there is no other guarantee of their contents. Therefore, the objective of this study was to determine the concentrations of 12 herbal compounds (nodakenin, decursin, decursinol angelate, morroniside, loganin, glycyrrhizic acid, liquiritigenin, puerarin, daidzin, schisandrin, gomisin A, gomisin N) in commonly used plant raw materials, such as "Angelica Gigas root", "Cornus Fruit", "Liquorice Root", "Pueraria Root", and "Schisandra Fruit"; and also in 45 processed foods, using high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS). Method validation was performed successfully using the parameters of specificity, linearity, limit of detection (LOD), limit of quantification (LOQ), accuracy, precision, matrix effect, extraction recovery, and stability. The 12 herbal compounds were determined to be present in all the foods advertised as containing each ingredient, although in very low concentrations in some cases. Three solid samples labelled as 100% pure material from one herbal species also contained herbal compounds found in others, so that intentional or unintentional adulteration was suspected.

Efficacy of Oral Appliance Therapy as a First-Line Treatment for Moderate or Severe Obstructive Sleep Apnea: A Korean Prospective Multicenter Observational Study.

BACKGROUND AND PURPOSE: Responses to oral appliances (OAs) in obstructive sleep apnea (OSA) vary, and have not been fully evaluated in Korean patients. In this study we aimed to determine the efficacy of OAs for the first-line treatment of Korean patients with moderate or severe OSA. METHODS: This multicenter prospective observational study included 45 patients with moderate or severe OSA that had been newly diagnosed between March 2017 and May 2018 and who underwent OA treatment for 1 month. Questionnaires were completed and polysomnography (PSG) was performed before and after OA treatment. The primary outcome measures were improvement in the absolute apnea-hypopnea index (AHI) and the percentage reduction in the AHI. The secondary outcomes were improvements in the questionnaire scores related to sleep-associated symptoms and PSG parameters. RESULTS: The patients were aged 47.4±12.1 years (mean±SD), only two of them were female, and their AHI at baseline was 29.7±10.9/h. After OA treatment the AHI had reduced by 63.9±25.8%, with the reduction was similar between the patients with moderate OSA and those with severe OSA. Overall 31.1% of the patients achieved a normal AHI (<5/h), and 64.4% had an AHI of ≤10/h after the treatment. The body mass index (BMI) was the most reliable factor for predicting the percentage reduction in the AHI. The OAs also improved the sleep architecture and subjective sleep-related symptoms. CONCLUSIONS: The OAs were effective in patients with moderate or severe OSA. The OAs reduced the mean AHI to 63.9% of the baseline value, and this reduction was influenced by the BMI.

Designing a mandibular advancement device with topology optimization for a partially edentulous patient.

STATEMENT OF PROBLEM: Patients with partial tooth loss treated with implant-supported fixed partial dentures (FPDs) have difficulty using conventional mandibular advancement devices (MADs) because of the risk of side effects. Also, which design factors affect biomechanical stability when designing MADs with better stability is unclear. PURPOSE: The purpose of this finite element (FE) analysis study was to analyze the effect of the MAD design on biomechanical behavior and to propose a new design process for improving the stability of MADs. MATERIAL AND METHODS: Each 3D model consisted of the maxillofacial bones, teeth, and implant-supported FPDs located in the left tooth loss area from the first premolar to the second molar and a MAD. Three types of custom-made MADs were considered: a complete-coverage MAD covering natural tooth-like conventional MADs, a shortened MAD excluding the coverage on the implant-supported FPD, and a newly designed MAD without anterior coverage. For the new MAD design, topology optimization was conducted to reduce the stress exerted on the teeth and to improve retention of the MAD. The new MAD design was finished by excluding the coverage of the maxillary and mandibular central incisors based on the results of the topology optimization. A mandibular posterior restorative force for a protrusion amount of 40% was used as the loading condition. The principal stress and pressure of the cancellous bone and periodontal ligaments (PDLs) were identified. RESULTS: Considering the load concentration induced by the complete-coverage MAD, bone resorption risk and root resorption risk were observed at both ends of the mandibular teeth. The shortened MAD resulted in the highest stress concentration and pressure with the worst stability. However, in the case of the complete-coverage MAD, the pressure in the PDLs was reduced to the normal range, and the risk of root resorption was reduced. CONCLUSIONS: For patients with implant-supported FPDs, MAD designs with different extents of coverage had an influence on biomechanical behavior in terms of stress distribution in cancellous bone and PDLs. A MAD design without anterior coverage provided improved stability compared with complete-coverage or shortened designs. The presented method for MAD design, which combined FE analysis and topology optimization, could be effectively applied in the design of such improved MADs.

Comparison of Physicochemical Characteristics of Garlic Produced from South Korea and China.

Garlic is widely cultivated and frequently used as a spice in South Korea, due to its characteristic flavor. It is rich in sulfur-containing compounds (for example, allicin) and nonsulfur elements (for example, phosphorus and potassium). During the last few years, the cultivation area of garlic in South Korea has gradually decreased, one of the reasons being the increase in low-priced imported garlic from China. Several studies have reported the discrimination of foods originating from different geographical areas by analyzing their physicochemical properties using various statistical methods. In this study, the differentiation of geographical origin of garlic between South Korea (60 samples) and China (41 samples) was performed by analyzing their physicochemical properties (for example, pH, soluble solid, moisture, free sugars, mineral elements, total flavonoid, and total phenolic contents) combined with statistical methods. The significant difference between domestic garlic from South Korea and imported garlic from China was investigated in terms of pH, moisture content, total flavonoid content, and all trace minerals except for manganese and magnesium. Logistic regression analysis was performed to determine the geographical origin (South Korea or China) of garlic after selecting the appropriate independent variables. As a result, the calculated logistic regression equation from the analysis of copper, iron, phosphorus, zinc, and sucrose contents could be used to determine whether the geographical origin of garlic was South Korea or China. PRACTICAL APPLICATION: Despite being widely used in South Korea, the cultivation area of garlic in South Korea has gradually decreased over the last few years. One of the reasons is the increase in low-priced imported garlic from China. To discriminate the geographical origin of garlic between South Korea and China, analyzed physicochemical properties (that is, Cu, Fe, P, Zn, and sucrose contents) of garlic in combination with logistic regression analysis can be helpful for scientists working on food forensics. This discrimination technique can help to maintain the quality of garlic and prevent economic fraud by confirming the authenticity of garlic from South Korea.

Characterization of pork patties containing dry radish (Raphanus sativus) leaf and roots.

OBJECTIVE: This study investigated the effects of dry radish leaf and root on the quality of pork patties during refrigeration storage. METHODS: The patties were divided into the following three groups: the control containing 0% dry radish leaf root powder, RL1 containing 0.5% dry radish leaf root powder, and RL2 and RL3 containing 1% and 2% dry radish leaf root powder, respectively. Proximate composition, pH, cooking loss, microbial analysis, lipid oxidation analysis, color, texture profile analysis and sensory test were performed. RESULTS: Moisture, crude protein, and crude ash contents in RL2 and RL3 were significantly higher than those in other groups (p<0.05), whereas crude fat contents in RL2 and RL3 were significantly lower than other groups (p<0.05). Lightness was significantly lower in RL2 and RL3 than in CON (p<0.05). Cooking loss for RL2 and RL3 were significantly lower than those for the other groups (p<0.05). The pH, thiobarbituric acid levels, and total plate counts of RL2 and RL3 were significantly lower than those of CON at days 7 and 14 (p<0.05). Hardness values of RL2 and RL3 were significantly lower than those of CON, whereas chewiness values were higher than those of CON (p<0.05). In addition, the juiciness of RL2 were significantly greater (p<0.05) than those of the other groups. CONCLUSION: Dried radish leaves and roots improved the proximate composition and quality characteristics of pork patties, providing a basis to produce high-quality patties with extended expiration dates. Thus, dried radish leaves and roots are effective ingredients for health or functional foods.

Biomechanical effect of mandibular advancement device with different protrusion positions for treatment of obstructive sleep apnoea on tooth and facial bone: A finite element study.

BACKGROUND: The mandibular advancement device (MAD) is widely used for obstructive sleep apnoea (OSA) treatment, and several studies have demonstrated its effectiveness. However, no comprehensive studies have yet examined the biomechanical safety of the MAD. OBJECTIVES: The objective of this study was to analyse the biomechanical effect of different protrusion positions of a MAD on the teeth and facial bones. METHODS: The posterior restorative forces due to the stretched mandibular muscles were measured by pressure sensors attached to the experimental mandibular advancement device for mandibular protrusions of 10-70% of the maximum protrusion of the subject. A detailed three-dimensional biomechanical model of the study subject, constructed from computed tomography scans, was used in finite element analysis, with loading conditions calculated from the measured posterior restorative forces. The outcome measures were the principal stresses on the periodontal ligaments (PDL) and cancellous bone, and the pressure at the PDL surfaces. The measurements were used to analyse the risk of the tooth movement, tooth root resorption, and bone resorption. RESULTS: The lowest and highest restorative forces occurred at 40% and 70% of maximum protrusion, respectively. The highest risk of tooth movement occurred at the mandibular molar teeth. The mandibular second molar teeth had the highest risks of root and bone resorption. CONCLUSIONS: Mandibular advancement at 70% of maximum protrusion induces risks of tooth root resorption and bone resorption. The mandibular second molars were subjected to the highest stresses. Stress on the teeth and facial bones was the lowest at 40% of maximum mandibular advancement.

Effects of moderate intensity static magnetic fields on osteoclastic differentiation in mouse bone marrow cells.

Although we recently demonstrated that static magnetic fields (SMFs) of 3, 15, and 50 mT stimulate osteoblastic differentiation, the effects of SMFs on osteoclastogenesis are still poorly understood. This study focused on the suppressive effects of SMFs on receptor activator of nuclear factor κB ligand (RANKL)-induced osteoclastogenesis and bone resorption. Direct SMFs inhibit RANKL-induced multinucleated osteoclast formation, tartrate-resistant acid phosphatase activity, and bone resorption in mouse bone marrow-derived macrophage cells. The conditioned medium from osteoblasts treated with SMFs also resulted in the inhibition of osteoclast differentiation as well as resorption. The RANKL-induced expression of osteoclast-specific transcription factors, such as c-Fos and NFATc1, was remarkably downregulated by SMF at 15 mT. In addition, SMF inhibited RANKL-activated Akt, glycogen synthase kinase 3ß (GSK3ß), extracellular signal-regulated kinase, c-jun N-terminal protein kinase, mitogen-activated protein kinase (MAPK), and nuclear factor-κB (NF-κB) formation. These findings indicate that SMF-mediated attenuation of RANKL-induced Akt, GSK3ß, MAPK, and NF-κB pathways could contribute to the direct and indirect inhibition of osteoclast formation and bone resorption. Therefore, SMFs could be developed as a therapeutic agent against periprosthetic or peri-implant osteolysis. Additionally, these could be used against osteolytic diseases such as osteoporosis and rheumatoid arthritis. Bioelectromagnetics. 39:394-404, 2018. © 2018 Wiley Periodicals, Inc.

Discovery of a FLT3 inhibitor LDD1937 as an anti-leukemic agent for acute myeloid leukemia.

FMS-like receptor tyrosine kinase-3 (FLT3) belongs to the family of receptor tyrosine kinase (RTK), and the FLT3 mutation is observed in 1/3 of all acute myeloid leukemia (AML) patients. Potential FLT3 inhibitors have been investigated as potential therapeutic agents of AML. In this study, we identified a potent FLT3 inhibitor LDD1937 containing an indirubin skeleton. The potent inhibitory activity of LDD1937 against FLT3 was shown with an in vitro kinase assay (IC50 = 3 nM). The LDD1937 compound selectively inhibited the growth of MV-4-11 cells (GI50 = 1 nM) and induced apoptotic cell death. LDD1937 caused cell cycle arrest at the G2/M phase and increased the cell population at the sub-G1 phase. Phosphorylation of STAT5, which is the downstream signaling of FLT3, was significantly reduced by LDD1937 in a dose-dependent manner. The pharmacokinetic properties of LDD1937 were investigated in mice. Then, the in vivo anti-tumor effect was investigated using a MV-4-11 xenograft. With the intravenous administration of 5 and 10 mg/kg in nu/nu mice, the tumor volume and weight were significantly reduced compared to the control. LDD1937 is a promising therapeutic candidate to treat AML patients because of its ability to suppress tumor cell growth in vitro and in vivo.

The Effect of Fibronectin-Immobilized Microgrooved Titanium Substrata on Cell Proliferation and Expression of Genes and Proteins in Human Gingival Fibroblasts.

BACKGROUND: We aimed to determine the effect of fibronectin (FN)-immobilized microgrooved titanium (Ti) on human gingival fibroblast proliferation, gene expression and protein expression. METHODS: Photolithography was used to fabricate the microgrooved Ti, and amine funtionalization (silanization) was used for FN immobilization on titanium surfaces. Cell proliferation, gene expression and protein expression were analyzed, followed by multiple regression analysis for determining the influential factors on cell proliferation. RESULTS: FN-immobilized microgrooved Ti significantly enhanced the fibroblast proliferation in various timelines of culture, among which a burst of fivefold increase is induced at 96 h of culture compared to that on the control smooth Ti. We suggest a presence of the synergistic promotion effect of microgrooves and FN immobilization on fibroblast proliferation. Through a series of analyses on the expression of various genes and proteins involved in cell adhesion and proliferation, cyclin-dependent kinase 6, cyclin D1, integrin α5, oncogene c-Src, osteonectin, paxillin and talin-2 were determined as influential factors on promoting fibroblast proliferation induced by FN-immobilized microgrooved Ti. CONCLUSION: FN-immobilized microgrooved Ti can act as an effective surface for enhancing fibroblast proliferation, and can be used for promoting soft tissue response on the connective tissue attachment zone of biomaterial surfaces.

Analysis of dimensions and shapes of maxillary and mandibular dental arch in Korean young adults.

PURPOSE: The aim of this study was to investigate dental arch dimensions and to classify arch shape in Korean young adults. MATERIALS AND METHODS: The sample included 50 Koreans with age ranging from 24 to 32 years. Maxillary and mandibular casts were fabricated using irreversible hydrocolloid and type III dental stones. Incisor-canine distance, incisor-1st molar distance, incisor-2nd molar distance, intercanine distance, inter-1st molar distance, and inter-2nd molar distance in both the maxillary and mandibular arch were measured using a three-dimensional measuring device. The dental arch was classified into three groups using five ratios from the measured values by the K-means clustering method. The data were analyzed with one-way analysis of variance. RESULTS: Arch lengths (IM2D, incisal-2nd molar distance) were 44.13 mm in the maxilla and 40.40 mm in the mandible. Arch widths (M2W, inter 2nd molar width) were 64.12 mm in the maxilla and 56.37 mm in the mandible. Distribution of the dental arch form was mostly ovoid shape (maxilla 52% and mandible 56%), followed by the V-shape and the U-shape. The arch width for the U-shape was broader than for the other forms. CONCLUSION: This study establishes new reference data for dental arch dimensions for young Korean adults. The most common arch form is the ovoid type in the maxilla and mandible of Koreans. Clinicians should be aware of these references and classify arch type before and during their dental treatment for effective and harmonized results in Koreans.

Static magnetic fields promote osteoblastic/cementoblastic differentiation in osteoblasts, cementoblasts, and periodontal ligament cells.

PURPOSE: Although static magnetic fields (SMFs) have been used in dental prostheses and osseointegrated implants, their biological effects on osteoblastic and cementoblastic differentiation in cells involved in periodontal regeneration remain unknown. This study was undertaken to investigate the effects of SMFs (15 mT) on the osteoblastic and cementoblastic differentiation of human osteoblasts, periodontal ligament cells (PDLCs), and cementoblasts, and to explore the possible mechanisms underlying these effects. METHODS: Differentiation was evaluated by measuring alkaline phosphatase (ALP) activity, mineralized nodule formation based on Alizarin red staining, calcium content, and the expression of marker mRNAs assessed by reverse transcription polymerase chain reaction (RT-PCR). Signaling pathways were analyzed by western blotting and immunocytochemistry. RESULTS: The activities of the early marker ALP and the late markers matrix mineralization and calcium content, as well as osteoblast- and cementoblast-specific gene expression in osteoblasts, PDLCs, and cementoblasts were enhanced. SMFs upregulated the expression of Wnt proteins, and increased the phosphorylation of glycogen synthase kinase-3ß (GSK-3ß) and total ß-catenin protein expression. Furthermore, p38 and c-Jun N-terminal kinase (JNK) mitogen-activated protein kinase (MAPK), and nuclear factor-κB (NF-κB) pathways were activated. CONCLUSIONS: SMF treatment enhanced osteoblastic and/or cementoblastic differentiation in osteoblasts, cementoblasts, and PDLCs. These findings provide a molecular basis for the beneficial osteogenic and/or cementogenic effect of SMFs, which could have potential in stimulating bone or cementum formation during bone regeneration and in patients with periodontal disease.

Analysis of crown size and morphology, and gingival shape in the maxillary anterior dentition in Korean young adults.

PURPOSE: The aim of this investigation was to analyze the dimensions of clinical crowns and to classify the crown and the gingival type in the anterior teeth in Korean young adults. MATERIALS AND METHODS: Casts were obtained from 50 subjects ranging in age from 24 to 32. Measurements of length and width were made on the casts using a pair of digital calipers on the entire dentition. Crown thickness and papilla height were also measured and MDW/CL (mesiodistal width to clinical length) and CW/CL (cervical width to clinical length) ratios of the maxillary anterior teeth were calculated. The K-clustering method was used for CW/CL to classify the anterior tooth shape into three groups (tapered, ovoid, and square), and one-way analysis of variance and Duncan's post-hoc comparison were used to evaluate statistical significance between the groups. Pearson's correlation analysis was performed between tooth shape and papillary height (PH) to demonstrate the correlation between tooth shape and gingival morphological characteristics. RESULTS: The average length of the maxillary central incisors was 9.89 mm; the mesio-distal width was 8.54 mm; and the ratio of width/length was 0.86 in Korean young adults. The average bucco-palatal thickness of the central incisor was 3.14 mm at the incisal 1/3 aspect. Ovoid type was the most common tooth shape (48%), followed by square type (29%) and taper type (23%) in the central incisors of Korean young adults. Tooth shape and gingival type were correlated with each other. CONCLUSION: New reference data were established for tooth size in Korean young adults and the data show several patterns of tooth shape and gingival type. Clinicians should diagnose and treat based on these characteristics for better results in the Korean population.

Reliability of a CAD/CAM Surgical Guide for Implant Placement: An In Vitro Comparison of Surgeons' Experience Levels and Implant Sites.

PURPOSE: This in vitro study evaluated the reliability of a surgical guide with regard to different levels of operator surgical experience and implant site. MATERIALS AND METHODS: A stereolithographic surgical guide for epoxy resin mandibles with three edentulous molar sites was produced using a computer-aided design/computer-assisted manufacture (CAD/CAM) system. Two surgeons with and two surgeons without implant surgery experience placed implants in a model either using or not using the CAD/CAM surgical guide. Four groups were created: inexperienced surgeon without the guide (group 1); experienced surgeon without the guide (group 2); inexperienced surgeon with the guide (group 3); and experienced surgeon with the guide (group 4). Planned implants and placed implants were superimposed using digital software, and deviation parameters were calculated. RESULTS: There were no significant differences in any of the deviation parameters between the groups when using the surgical guide. With respect to the implant sites, there were no significant differences among the groups in any parameter. CONCLUSION: Use of the CAD/CAM surgical guide reduced discrepancies among operators performing implant surgery regardless of their level of experience. Whether or not the guide was used, differences in the anterior-posterior implant site in the molar area did not affect the accuracy of implant placement.

Effects of static magnetic fields on bone regeneration of implants in the rabbit: micro-CT, histologic, microarray, and real-time PCR analyses.

OBJECTIVES: The aim of this study was to investigate the effects of static magnetic fields (SMFs) on bone regeneration around titanium implants by µCT, histologic analysis, microarrays, and quantitative real-time PCR (qRT-PCR). MATERIALS AND METHODS: Neodymium magnets provided the source of SMFs, the specimens were grade 5 titanium implants, and the animals were twenty-seven adult male New Zealand white rabbits. These implants were divided into six groups according to the presence of a magnet and predetermined healing period (1, 4, and 8 weeks). Each group comprised six specimens for µCT (n = 6) and histologic examination, and three specimens (n = 3) for microarrays and qRT-PCR, yielding a total of 54 specimens. RESULTS: The µCT data showed that SMFs increased bone volume fraction (bone volume/total volume, BV/TV), trabecular number (Tb.N), and trabecular thickness (Tb.Th). Histologic observation indicated that SMFs promoted new bone formation and direct bony contact with implants. Microarray analysis identified 293 genes upregulated (>twofold) in response to SMFs. The upregulated genes included extracellular matrix (ECM)-related genes (COL10A1, COL9A1, and COL12A1) and growth factor (GF)-related genes (CTGF and PDGFD), and the upregulation was confirmed by qRT-PCR. Gene Ontology (GO) and pathway analysis revealed the involvement of the mitogen-activated protein kinase (MAPK), Wnt, and PPAR-gamma signaling pathways in implant healing. CONCLUSIONS: µCT, histology, microarrays, and real-time PCR indicate that SMFs could be an effective approach to improving bone regeneration around dental implants.

Influence of the connection design and titanium grades of the implant complex on resistance under static loading.

PURPOSE: The purpose of this study was to evaluate the resistance to deformation under static overloading by measuring yield and fracture strength, and to analyze the failure characteristics of implant assemblies made of different titanium grades and connections. MATERIALS AND METHODS: Six groups of implant assemblies were fabricated according to ISO 14801 (n=10). These consisted of the combinations of 3 platform connections (external, internal, and morse tapered) and 2 materials (titanium grade 2 and titanium grade 4). Yield strength and fracture strength were evaluated with a computer-controlled Universal Testing Machine, and failed implant assemblies were classified and analyzed by optical microscopy. The data were analyzed using the One-way analysis of variance (ANOVA) and Student's t-test with the level of significance at P=.05. RESULTS: The group IT4S had the significantly highest values and group IT2 the lowest, for both yield strength and fracture strength. Groups IT4N and ET4 had similar yield and fracture strengths despite having different connection designs. Group MT2 and group IT2 had significant differences in yield and fracture strength although they were made by the same material as titanium grade 2. The implant system of the similar fixture-abutment interfaces and the same materials showed the similar characteristics of deformation. CONCLUSION: A longer internal connection and titanium grade 4 of the implant system is advantageous for static overloading condition. However, it is not only the connection design that affects the stability. The strength of the titanium grade as material is also important since it affects the implant stability. When using the implant system made of titanium grade 2, a larger diameter fixture should be selected in order to provide enough strength to withstand overloading.