Association between dental scaling and metabolic syndrome and lifestyle.

PURPOSE: Periodontal disease is a risk factor for diabetes and metabolic syndrome, and non-surgical periodontal treatment has been shown to help maintain stable blood sugar in diabetic patients. Determining the level of preventive scaling in patients with metabolic syndrome will help manage the disease. The purpose of this study was to investigate the extent to which people with metabolic syndrome or bad lifestyle performed scaling and the association between preventive scaling and metabolic syndrome or lifestyle in a large population. METHODS: This study was conducted on adults aged 20 years or older from January 2014 to December 2017 in the National Health Insurance System (NHIS) database. Among 558,067 people who underwent health checkups, 555,929 people were included. A total of 543,791 people were investigated for preventive scaling. Metabolic syndrome components were abdominal obesity, lower high density lipoprotein cholesterol (HDL)-C, high triglycerides, high blood pressure and hyperglycemia. Unhealthy lifestyle score was calculated by assigning 1 point each for current smokers, drinkers, and no performing regular exercise. RESULTS: When multiple logistic regression analysis was performed after adjusting for age, sex, income, body mass index (BMI), smoking, drinking and regular exercise, the Odds ratios (OR) and 95% confidence intervals (CI) of the group with 5 metabolic syndrome components were 0.741 (0.710, 0.773) (p<0.0001). After adjustment for age, sex, income, BMI, smoking, drinking, regular exercise, diabetes, hypertension and dyslipidemia, the OR (95% CI) of the group with unhealthy lifestyle score = 3 was 0.612 (0.586, 0.640) (p<0.0001). CONCLUSIONS: The more metabolic syndrome components, and the higher unhealthy lifestyle score, the less scaling was performed.

High prevalence of stress and suicidal ideation in women with temporomandibular disorder: A population-based cross-sectional survey.

Objective: To investigate the association between temporomandibular disorders (TMD) and psychological factors according to gender in a large representative sample.Methods: Participants provided demographic, socio-economic, and behavioral information and responded to questionnaires assessing mental health status regarding perceived stress, mood disturbance, suicidal ideation, and diagnosis of depression. The association between TMD and its risk factors by gender and the association between psychological factors and TMD were statistically analyzed.Results: In men, perceived stress was highly associated with TMD. However, in women, not only perceived stress but suicidal ideation showed significantly high rates of TMD. The suicidal ideation was significantly associated with TMD in women after controlling confounders.Discussion: Current results provide evidence that TMD is associated with stress in both genders and with suicidal ideation, especially in women. This study has important implications for intense screening and evaluation of suicidal ideation among patients with TMD according to gender.

Association between sleeping time and temporomandibular disorders in a sample of the South Korean population.

Objective: This study investigated the relationship between sleeping time and temporomandibular disorders (TMDs).Methods: This study used data from the Fifth Korea National Health and Nutrition Examination Survey from 2010 to 2011. The final sample size consisted of 11,782 adults aged ≥19 years. Logistic regression analysis was performed to assess the relationship between sleeping time and TMD.Results: The adjusted odds ratios of the TMD group were 1.421 (1.067, 1.892) (Model 1), 1.388 (1.028, 1.873) (Model 2), and 1.360 (1.012, 1.826) (Model 3) for subjects with sleeping time ≤5 hours (p < 0.05) and 1.317 (0.992, 1.748) (Model 1), 1.358 (1.01, 1.827) (Model 2), and 1.352 (0.977, 1.872) (Model 3) for subjects with sleeping time ≥9 hours (p < 0.05).Conclusion: Sleeping time ≤5 hours and ≥9 hours were associated with an increased rate of TMD.

Investigation of the association between orthodontic treatment and temporomandibular joint pain and dysfunction in the South Korean population.

OBJECTIVE: This study investigated the relationship between orthodontic treatment and temporomandibular disorders (TMD) in South Korean population. METHODS: This study obtained data from the 2012 Korean National Health and Nutrition Examination Survey. The final sample size was 5,567 participants who were ≥ 19 years of age. Logistic regression analysis was performed to evaluate the relationship between orthodontic treatment and TMD. RESULTS: Participants who underwent orthodontic treatment showed higher educational level, lower body mass index, reduced chewing difficulty, and reduced speaking difficulty. The adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) for orthodontic treatment and TMD were 1.614 (1.189-2.190), 1.573 (1.162-2.129) and 1.612 (1.182-2.196) after adjusting for age, sex and psychosocial factors. Adjusted ORs and their 95% CIs for orthodontic treatment and clicking were 1.778 (1.289-2.454), 1.742 (1.265-2.400) and 1.770 (1.280-2.449) after adjusting for confounding factors. However, temporomandibular joint pain and functional impairment was not associated with orthodontic treatment. CONCLUSIONS: Temporomandibular joint pain and dysfunction was not associated with orthodontic treatment.

Association between orthodontic treatment and periodontal diseases: Results from a national survey.

OBJECTIVE: To investigate the association between orthodontic treatment and periodontitis in a nationally representative sample of South Korea. MATERIALS AND METHODS: Data from the Fifth and Sixth Korean National Health and Nutrition Examination Survey (KNHANES V, VI-1, and VI-2), conducted from 2012 to 2014, were used in this study. The final sample size consisted of 14,693 adults aged ≥19 years. Logistic regression analysis was performed to assess the association between orthodontic treatment and periodontitis. RESULTS: The orthodontic treatment group exhibited a lower prevalence of periodontitis compared with the nonorthodontic treatment group. The adjusted odds ratios for periodontitis in subjects with a history of orthodontic treatment compared with those with no history of orthodontic treatment were 0.553, 0.614, and 0.624, when adjusted for various confounding variables (P < .0001). The subjects with periodontitis were of higher age, body mass index, waist circumference, and white blood cell counts compared with the subjects without periodontitis regardless of history of orthodontic treatment. CONCLUSIONS: History of orthodontic treatment was associated with a decreased rate of periodontitis.

Association between temporomandibular disorders and obesity.

Psychological stress can induce altered eating patterns, and studies have indicated that there is a correlation between temporomandibular disorder (TMD) and psychological stress. This study investigated the relationship between TMD and body mass index (BMI) in a large representative sample of the South Korean population using data from the Korea National Health and Nutrition Examination Survey (KNHANES). Men and women with TMD showed decreased prevalence of abdominal obesity. Women with TMD had lower age, lower BMI, lower metabolic syndromic waist circumference, lower prevalence of metabolic syndrome, and lower prevalence of diabetes compared with the group without TMD. However, males with TMD didn't show any statistically significant difference between BMI, and metabolic syndromic waist circumference compared with the group without TMD, although there were similar tendencies in the female subject groups. Overall, TMD was associated with decreased BMI and abdominal obesity in women.

Efficacy of Alveolar Vertical Distraction Osteogenesis and Autogenous Bone Grafting for Dental Implants: Systematic Review and Meta-Analysis.

PURPOSE: The aim of this study was to assess the efficacy of alveolar vertical distraction osteogenesis and autogenous bone grafting in terms of bone gain, bone resorption, and implant survival and success rates and investigate the relationship between bone gain and resorption after alveolar vertical distraction osteogenesis. MATERIALS AND METHODS: A systematic search was done using MEDLINE, EMBASE, the Cochrane Library, and KoreaMed from inception to April 30, 2014. Supplementary manual searches of published full-text articles were also performed. RESULTS: Searches of four electronic databases and manual searches resulted in 1,538 articles. After selection, four studies were included in the systematic review and meta-analysis. The difference in bone gain at the end of distraction or bone grafting was statistically significant (weighted mean difference [WMD] 1.86, 95% CI 0.03 to 3.69, P = .05; heterogeneity: I(2) = 78%, P = .01). However, there was not a statistically significant difference between alveolar distraction osteogenesis and onlay bone grafting (WMD 0.30, 95% CI -0.99 to 1.59, P = .065). Bone resorption between the end of treatment and the time of implant placement was not statistically significant (WMD -0.12, 95% CI -1.10 to 0.85, P = .80; heterogeneity: I(2) = 78%, P = .01). A simple equation related to bone gain and resorption after alveolar vertical distraction was induced from these results. CONCLUSION: There was not a statistically significant difference between alveolar distraction osteogenesis and onlay bone grafting in terms of bone gain and bone resorption.

Osteogenic potential of adult stem cells from human maxillary sinus membrane by Simvastatin in vitro: preliminary report.

OBJECTIVES: The objective of this study is to determine the adequate concentration and to evaluate the osteogenic potential of simvastatin in human maxillary sinus membrane-derived stem cells (hSMSC). MATERIALS AND METHODS: Mesenchymal stem cells derived from the human maxillary sinus membrane were treated with various concentrations of simvastatin. The adequate concentration of simvastatin for osteogenic induction was determined using bone morphogenetic protein (BMP-2). The efficacy of osteogenic differentiation of simavastatin was verified using osteocalcin mRNA, and the mineralization efficacy of hSMSCs and simvastatin treatment was compared with alkaline phosphatase and von Kossa staining. RESULTS: Expression of BMP-2 mRNA and protein was observed after three days and was dependent on the concentration of simvastatin. Expression of osteocalcin mRNA was observed after three days in the 1.0 µM simvastatin-treated group. Mineralization was observed after three days in the simvastatin-treated group. CONCLUSION: These results suggest that simvastatin induces the osteogenic potential of mesenchymal stem cells derived from the human maxillary sinus membrane mucosa.

Change in bite force and electromyographic activity of masticatory muscle in accordance with change of occlusal plane.

PURPOSE: The purpose of the present study was to evaluate effects of occlusal plane on masticatory function (biting force, masticatory muscle activity, biting efficiency) after bimaxillary orthognathic surgery. PATIENTS AND METHODS: The subjects of the present study consisted of a group of 55 adults who had undergone bimaxillary surgery more than 6 months earlier. Lateral cephalographs, bite force, and electromyographic measurements of the anterior temporal [EMG(t)] and masseter muscles [EMG(m)] were recorded before and after bimaxillary surgery. Statistical analyses were performed. RESULTS: In the increased occlusal plane group, the frequency of decreased EMG(t) was significantly high. The frequency of increased EMG(t) was also significantly high in the decreased occlusal plane group. A negative correlation was found between the postoperative occlusal plane angle and the biting force efficiency change. No significant difference was found between the group that moved from an abnormal to a normal range and the group that moved from a normal to an abnormal range. The occlusal plane change was significantly greater in the decreased EMG(t) group than in the increased EMG(t) group. CONCLUSIONS: The value of EMG(t) was related to the changes in the occlusal plane, and the biting efficiency was affected by the postoperative occlusal plane angle. However, normalization of the occlusal plane might not play a major role in masticatory function.

Postoperative condylar position by sagittal split ramus osteotomy with and without bone graft.

PURPOSE: The purpose of the present study was to determine how the condylar position is affected by the bone graft in the intersegmental space created by sagittal split ramus osteotomy. PATIENTS AND METHODS: We compared the position of the condyle after sagittal split ramus osteotomy, without the bone graft (control group, n = 30) and with the bone graft (study group, n = 30) using computed tomography with a 2-mm thickness. Using 3-dimensional images and a 3-dimensional computer program, the pre- and postoperative displacement and rotation of the condyle in the axial (rotation and mediolateral movement of the condyle) and sagittal plane (anteroposterior and superoinferior movement of the condyle and rotation of the proximal segment) were measured. In addition, the relationship of the amount of rotation and backward movement of the mandible and the change in the condylar position was analyzed. For the statistical analysis, the t test (P = .05) and Wilcoxon rank sum test were used. RESULTS: No statistically significant differences were found in any of the measurements of the 2 groups. Nevertheless, the mediolateral movement (P = .051) showed a relatively greater apparent difference, although the difference was not statistically significant. The condylar displacement had no relationship to the rotation of the mandible. However, the condylar displacement in relation to the amount of backward movement of the mandible was significant, especially when it was greater than 10 mm of setback. CONCLUSIONS: Using a bone graft in the intersegmental gap of a sagittal split ramus osteotomy is considered an effective clinical method to secure the desirable intersegmental position because it helps to maintain the space with ease. Especially in cases with greater than 10-mm setback of the mandible, it prevents excessive condylar displacement.

Adult stem cells derived from human maxillary sinus membrane and their osteogenic differentiation.

PURPOSE: To investigate the method and conditions of isolation and proliferation of multipotent mesenchymal stem cells (MSCs) from human maxillary sinus membrane in vitro and to induce osteogenic differentiation directly for identification. MATERIALS AND METHODS: A human maxillary sinus membrane specimen was collected in aseptic conditions from an orthognathic surgery patient and cultured. The cells at passage three were sorted by flow cytometry and treated with osteogenic differentiation media. To determine the osteogenic potential of these cells, the authors analyzed alkaline phosphatase (ALP) expression, mineralization of extracellular matrix, and osteocalcin expression; staining with alizarin red and von Kossa and reverse-transcriptase polymerase chain reaction were also performed. RESULTS: Maxillary sinus membrane-derived cells were positive for STRO-1 and CD105 and negative for CD34. After 7 days, ALP began to be expressed. After 21 and 28 days, most cells showed expression of ALP. Mineralization of the extracellular matrix was observed and, after 21 and 28 days, most of the cells showed mineralization. After 7 days, the osteocalcin gene was expressed; this expression was strongest on the 28th day. CONCLUSIONS: The results suggest that there are MSCs in human maxillary sinus membrane tissue, which can be differentiated into osteoblasts under osteogenic induction. This indicates that maxillary sinus membrane may be a useful source of MSCs for cell therapy.

Effect of estrogen on the expression of cytokines of the temporomandibular joint cartilage cells of the mouse.

PURPOSE: The purpose of this study was to evaluate the effect of estrogen on the synthesis of cytokines of the temporomandibular joint cells. METHODS: Mandibular condyles of 10 mice were resected. Twenty of these condylar cartilages were removed and placed in organ culture for 24 hours with media containing different concentrations of 17beta-estradiol. The chondroblasts from the mandibular condyles of 3 mice were cultured with different concentrations of 17beta-estradiol the same as above. Cytokine concentrations were measured by ELISA. RESULTS: The expression and concentration of IL-1 beta, IL-6, and IL-8 were increased with increasing concentration of 17beta-estradiol. The expression and concentration of IL-4 and IL-10 were not different from the control and experimental group. CONCLUSIONS: These findings suggest that estrogen has the potential to cause temporomandibular joint disease with induction of the proinflammatory cytokines, IL-1 beta, IL-6, and IL-8.

Articular disc position in association with mandibular setback surgery.

OBJECTIVE: The purpose of this study was to evaluate the influence of orthognathic surgery on articular disc position and temporomandibular disorder symptoms of skeletal class III patients by means of clinical and radiographic evaluation of the temporomandibular joint. STUDY DESIGN: Thirty-six patients with skeletal class III malocclusion, who were treated at Kangnam St. Mary's Hospital between January 2005 and January 2006, were evaluated by clinical examination and pre- and postoperative magnetic resonance imaging. RESULTS: The change of articular disc position after mandibular setback surgery by means of sagittal split ramus osteotomy was not statistically significant, but it tended to be positioned posteriorly. CONCLUSION: It can be suggested that orthognathic surgery does not significantly change the position of the articular disc.

Transforming growth factor-alpha and oral fibroma: Immunohistochemical and in situ hybridization study.

PURPOSE: Transforming growth factor-alpha (TGF-alpha) is usually expressed in cell lines derived from sarcomas. It is known as a mitogen for fibroblasts. The aim of this study was to determine whether there were any differences in the expression pattern of TGF-alpha between normal oral mucosa and oral fibroma. PATIENTS AND METHODS: Fourteen pathologic specimens (6 males and 8 females; 37.2 +/- 23.2 years) and 10 normal oral mucosal specimens (5 females and 5 males; 43.8 +/- 17.7 years) were used for this study. Identification of TGF-alpha was sought by using immunohistochemistry and in situ hybridization. RESULTS: The samples from normal oral mucosa did not express TGF-alpha. One sample from oral fibroma did not express TGF-alpha (7.1%). Five samples from oral fibroma expressed TGF-alpha sparsely (35.7%). Eight samples showed diffuse expression of TGF-alpha (57.1%). The immunopositive reaction to TGF-alpha in oral fibroma was localized in the basal layer and the fibroblasts that resided beneath the epithelium. This pattern was also shown in the in situ hybridization study as well. CONCLUSION: TGF-alpha is expressed in oral fibromas. It suggested that TGF-alpha might play a role in fibroblast proliferation in oral fibromas.

Long-term results of different condylotomy designs for the management of temporomandibular joint disorders.

OBJECTIVE: The purpose of this study was to compare the long-term results of the condylotomy techniques. STUDY DESIGN: Twenty-two patients (mean age, 20.8 years; occlusion: Class I in Angle's classification of malocclusion) were studied. All showed Wilkes stage II or early stage III. The Visual Analogue Scale (VAS), maximum mouth opening (MMO), and the positional change of the condylar segment were recorded preoperatively and postoperatively. The difference in each criterion according to the operative techniques was evaluated by means of a 1-way analysis of variance, and the difference between the preoperative value and the value in the long-term follow-up was evaluated by means of a paired t test. RESULTS: Six patients underwent an extraoral vertical ramus osteotomy (EVRO), 6 patients underwent a sagittal split ramus osteotomy (SSRO), and 10 patients underwent an intraoral vertico-sagittal split ramus osteotomy (IVSRO). The preoperative value of the maximum mouth opening (MMO) was 33.0 +/- 8.3 mm, 46.1 +/- 7.0 mm, or 40.0 +/- 7.4 mm for patients undergoing EVRO, IVSRO, or SSRO, respectively. In the long-term follow-up period, the MMO was 49.3 +/- 14.6 mm, 47.3 +/- 3.2 mm, or 48.7 +/- 5.1 mm for patients undergoing EVRO, IVSRO, or SSRO, respectively. There were no differences in the amount of the MMO among the operative techniques (P >.05). The preoperative VAS in the operated-on joints was 3.9 +/- 2.4, 5.0 +/- 1.6, or 4.7 +/- 1.4 for patients undergoing EVRO, IVSRO, or SSRO, respectively. In the long-term follow-up period, it was 1.4 +/- 2.2, 2.5 plus minus 2.0, or 3.7 +/- 1.7 for patients undergoing EVRO, IVSRO, or SSRO, respectively. There were no differences in the VAS among the operative techniques (P >.05). When each measurement preoperation was compared with the long-term follow-up, the difference was statistically significant (P =.018 in the MMO, P =.004 in the VAS). CONCLUSION: The curative effect of a condylotomy on the internal derangement of the temporomandibular joint was acceptable in the long-term follow-up, but the osteotomy procedure used may be only a minor contributing factor to the long-term results.