Evaluation of Lateral Incisor Resorption Caused by Impacted Maxillary Canines Based on CBCT: A Systematic Review and Meta-Analysis.

BACKGROUND: Root resorption (RR) of the adjacent teeth due to upper canine impaction requires an appropriate modification of the orthodontic treatment plan and the mechanotherapy used. AIM: The aim of this review was to assess scientific evidence published during the last decade, concerning the prevalence of lateral incisor RR caused by impacted maxillary canines, based only on cone-beam computed tomography (CBCT). The location of RR on this tooth, as well as the prevalence of RR on the other adjacent teeth, were additionally evaluated. METHODS: This review followed the criteria specified by the PRISMA statement. Four databases were searched for articles published between January 2008 and June 2021. Predefined and piloted data collection forms were used to record the necessary information. RESULTS: A total of 5098 records were initially screened. Only seven articles were finally eligible for further analysis. A total number of 540 participants (176 males and 364 females) was derived from the included studies. RR of maxillary lateral incisors was common (50%). RR of mild severity was more common (62%), more frequently located in the middle (52%) and apical (42%) thirds of the root. CONCLUSIONS: Further research with more homogeneous groups is required.

Teeth Eruption Disorders: A Critical Review.

Dental eruption refers to the vertical displacement of a tooth from its initial non-functional towards its functional position. Tooth eruption disorders may be expressed in various clinical conditions, which may be grouped as "primary retention" and "secondary retention". The purpose of this article is to review the literature and the clinical parameters of the various conditions related to tooth eruption disorders. Materials and Methods: The search strategy of this critical review included keywords in combination with MeSH terms in Medline, Scopus, and Cochrane Library until February 2022 and only in English. Results: "Primary Failure of Eruption" (PFE) occurs during the eruption process and includes clinical characteristics of both primary and secondary retention, which make diagnosis difficult. PFE is distinguished by Types I and II. In Type I, the defect in the eruption process occurs in all the relative teeth at the same time, whilst in Type II, the clinical expressions vary in multiple quadrants of the mouth, and the second molars erupt more. The variability of the PFE's clinical spectrum seems to be connected to a genetic origin. The differential diagnosis among single ankylosis, secondary retention, and PFE is based on the occlusal relationship between the upper and the lower teeth distally, most commonly the first molar, which has not yet fully erupted. The treatment approach depends on many factors and combines surgical and orthodontic techniques.

The biological basis of treating jaw discrepancies: An interplay of mechanical forces and skeletal configuration.

Jaw discrepancies and malrelations affect a large proportion of the general population and their treatment is of utmost significance for individuals' health and quality of life. The aim of their therapy is the modification of aberrant jaw development mainly by targeting the growth potential of the mandibular condyle through its cartilage, and the architectural shape of alveolar bone through a suture type of structure, the periodontal ligament. This targeted treatment is achieved via external mechanical force application by using a wide variety of intraoral and extraoral appliances. Condylar cartilage and sutures exhibit a remarkable plasticity due to the mechano-responsiveness of the chondrocytes and the multipotent mesenchymal cells of the sutures. The tissues respond biologically and adapt to mechanical force application by a variety of signaling pathways and a final interplay between the proliferative activity and the differentiation status of the cells involved. These targeted therapeutic functional alterations within temporo-mandibular joint ultimately result in the enhancement or restriction of mandibular growth, while within the periodontal ligament lead to bone remodeling and change of its architectural structure. Depending on the form of the malrelation presented, the above treatment approaches, in conjunction or separately, lead to the total correction of jaw discrepancies and the achievement of facial harmony and function. Overall, the treatment of craniofacial and jaw anomalies can be seen as an interplay of mechanical forces and adaptations occurring within temporo-mandibular joint and alveolar bone. The aim of the present review is to present up-to-date knowledge on the mechano-biology behind jaw growth modification and alveolar bone remodeling. Furthermore, future molecular targeted therapeutic strategies are discussed aiming at the improvement of mechanically-driven chondrogenesis and osteogenesis.

Continuous hydrostatic pressure induces differentiation phenomena in chondrocytes mediated by changes in polycystins, SOX9, and RUNX2.

PURPOSE: The present study aimed to investigate the long-term effects of hydrostatic pressure on chondrocyte differentiation, as indicated by protein levels of transcription factors SOX9 and RUNX2, on transcriptional activity of SOX9, as determined by pSOX9 levels, and on the expression of polycystin-encoding genes Pkd1 and Pkd2. MATERIALS AND METHODS: ATDC5 cells were cultured in insulin-supplemented differentiation medium (ITS) and/or exposed to 14.7 kPa of hydrostatic pressure for 12, 24, 48, and 96 h. Cell extracts were assessed for SOX9, pSOX9, and RUNX2 using western immunoblotting. The Pkd1 and Pkd2 mRNA levels were detected by real-time PCR. RESULTS: Hydrostatic pressure resulted in an early drop in SOX9 and pSOX9 protein levels at 12 h followed by an increase from 24 h onwards. A reverse pattern was followed by RUNX2, which reached peak levels at 24 h of hydrostatic pressure-treated chondrocytes in ITS culture. Pkd1 and Pkd2 mRNA levels increased at 24 h of combined hydrostatic pressure and ITS treatment, with the latter remaining elevated up to 96 h. CONCLUSIONS: Our data indicate that long periods of continuous hydrostatic pressure stimulate chondrocyte differentiation through a series of molecular events involving SOX9, RUNX2, and polycystins-1, 2, providing a theoretical background for functional orthopedic mechanotherapies.

Mechanotransduction pathways in bone pathobiology.

The skeleton is subject to dynamic changes throughout life and bone remodeling is essential for maintenance of bone functionality. The cell populations which predominantly participate in bone and cartilage remodeling, namely osteocytes, osteoblasts, osteoclasts and chondrocytes sense and respond to external mechanical signals and via a series of molecular cascades control bone metabolism and turnover rate. The aforementioned process, known as mechanotransduction, is the underlying mechanism that controls bone homeostasis and function. A wide array of cross-talking signaling pathways has been found to play an important role in the preservation of bone and cartilage tissue health. Moreover, alterations in bone mechanotransduction pathways, due to genetic, hormonal and biomechanical factors, are considered responsible for the pathogenesis of bone and cartilage diseases. Extensive research has been conducted and demonstrated that aberrations in mechanotransduction pathways result in disease-like effects, however only few signaling pathways have actually been engaged in the development of bone disease. The aim of the present review is to present these signaling molecules and cascades that have been found to be mechano-responsive and implicated in bone disease development, as revealed by research in the last five years. In addition, the role of these molecules as prognostic or diagnostic disease markers and their potential as therapeutic targets are also discussed.