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1.
Eur J Orthod ; 2020 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-32390057

RESUMO

INTRODUCTION: This prospective clinical cohort study investigated the potential influence of obesity on orthodontic treatment outcome. METHODS: A prospective cohort of adolescent patients undergoing routine fixed appliance treatment were recruited into normal-weight or obese groups based upon body mass index (BMI) centile and followed up until the completion of treatment. Primary outcome was treatment duration, and secondary outcomes included treatment outcome (occlusal change measured using peer assessment rating [PAR]), appointment characteristics, and compliance measures. RESULTS: A total of 45 patients mean age 14.8 (1.6) years were included in the final analysis. The normal-weight group included 23 patients with mean BMI 19.4 (2.4) kg/m2 and the obese group 22 patients with mean BMI 30.5 (3.8) kg/m2. There were no significant differences in baseline demographics between groups, except for BMI and pre-treatment PAR. The normal-weight group had a mean pre-treatment PAR of 25.6 (8.3) and the obese 33.3 (11.8) giving the obese group a more severe pre-treatment malocclusion (P = 0.02). There were no significant differences in treatment duration between groups (P = 0.36), but obese patients needed less time per each additional baseline PAR point compared to normal weight (P = 0.02). Obese patients also needed less appointments compared to normal-weight patients (P = 0.02). There were no significant differences between groups for appointment characteristics or compliance. Finally, obese patients were more likely to experience a great PAR reduction than normal-weight patients (relative risk = 2.6; 95% confidence interval = 1.2-4.2; P = 0.02). CONCLUSIONS: There were no significant differences in treatment duration between obese and normal-weight patients. Obesity does not appear to be a risk factor for negative orthodontic treatment outcome with fixed appliances.

2.
Nat Commun ; 11(1): 2275, 2020 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-32371876

RESUMO

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

3.
Nat Commun ; 11(1): 1994, 2020 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-32332736

RESUMO

Gas1 and Boc/Cdon act as co-receptors in the vertebrate Hedgehog signalling pathway, but the nature of their interaction with the primary Ptch1/2 receptors remains unclear. Here we demonstrate, using primordial germ cell migration in mouse as a developmental model, that specific hetero-complexes of Ptch2/Gas1 and Ptch1/Boc mediate the process of Smo de-repression with different kinetics, through distinct modes of Hedgehog ligand reception. Moreover, Ptch2-mediated Hedgehog signalling induces the phosphorylation of Creb and Src proteins in parallel to Gli induction, identifying a previously unknown Ptch2-specific signal pathway. We propose that although Ptch1 and Ptch2 functionally overlap in the sequestration of Smo, the spatiotemporal expression of Boc and Gas1 may determine the outcome of Hedgehog signalling through compartmentalisation and modulation of Smo-downstream signalling. Our study identifies the existence of a divergent Hedgehog signal pathway mediated by Ptch2 and provides a mechanism for differential interpretation of Hedgehog signalling in the germ cell niche.

4.
Am J Orthod Dentofacial Orthop ; 157(2): 148-155.e1, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32005465

RESUMO

INTRODUCTION: A prospective randomized study was undertaken to compare conventional study model-based manual Peer Assessment Rating (PAR) scoring with computer-based automated scoring using scanned study models or intraoral scanning. METHODS: The sample consisted of 67 patients, mean age 15.03 (range 11-37) years. Sixty-seven patients underwent alginate impression-taking and intraoral scanning (CS 3600; Carestream Dental, Stuttgart, Germany) at a single appointment in a randomized order. For each patient, a weighted PAR score was calculated manually by a calibrated examiner using study models and a PAR ruler (conventional group), and automatically using Carestream Dental CS Model+ software and data from scanned study models (indirect digital group) or intraoral scans (direct digital group). All procedures were timed, and each patient completed a binary questionnaire relating to their experience. RESULTS: There were no significant differences between methods for calculated mean weighted PAR score (P = 0.68). Mean (standard deviation) chairside time for impression-taking was 5.35 (± 1.16) minutes and for intraoral scanning, 7.76 (± 2.76) minutes (P <0.05). Mean (standard deviation) times taken to calculate weighted PAR scores were 2.86 (± 0.96), 5.58 (± 2.33), and 4.58 (± 2.18) minutes for conventional, indirect digital, and direct digital groups, respectively (P >0.05). A total of 61 patients (91%) preferred intraoral scanning to impression-taking. CONCLUSIONS: Automated PAR scoring using cast study models or intraoral scanning is valid, though both methods take longer than conventional scoring. Patients prefer intraoral scanning to impression-taking. REGISTRATION: ClinicalTrials.gov (NCT03405961). PROTOCOL: The protocol was not published before study commencement.


Assuntos
Desenho Assistido por Computador , Técnica de Moldagem Odontológica , Adolescente , Adulto , Criança , Modelos Dentários , Humanos , Imageamento Tridimensional , Estudos Prospectivos , Software , Adulto Jovem
5.
J Oral Maxillofac Surg ; 78(4): 630.e1-630.e9, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31881172

RESUMO

PURPOSE: This study evaluated the opinion of different observer groups about the influence of the submental length on perceived attractiveness and when surgical correction was deemed necessary. MATERIALS AND METHODS: The submental length of an idealized silhouette of a white male profile was altered incrementally between 5 and 95 mm. Images were rated for attractiveness on a Likert scale by pretreatment orthognathic surgery patients (n = 75), laypersons (n = 75), and clinicians (maxillofacial surgeons and orthodontists) (n = 35). RESULTS: For perceived attractiveness, the ideal submental length was approximately 50 mm (range, 40 to 75 mm). A submental length shorter than or equal to 30 mm was deemed unattractive by all 3 groups. Overall, a submental length less than 40 mm generally was judged less attractive than a comparable increase in length. Clinicians were generally least likely to suggest surgery for varying submental lengths. For this group, the cutoff at which the majority suggested surgery was a submental length of 25 mm or less. For the patient and layperson groups, the corresponding cutoff values were a length shorter than or equal to 30 mm or equal to 95 mm. CONCLUSIONS: A submental length of approximately 50 mm (range, 40 to 75 mm) was viewed by most observers as attractive. At 30 mm or less, it was generally deemed progressively less attractive. Clinicians were less likely to suggest corrective surgery than were the patient and layperson groups. For comparative proportional relationships, the submental length should be between the lower lip-chin height and lower facial height, assuming an otherwise proportional facial profile.

6.
J Evid Based Dent Pract ; 19(3): 283-294, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31732104

RESUMO

OBJECTIVE: The objective of this study was to assess the quality of reporting of full-text articles of dental diagnostic accuracy studies published in eight leading speciality dental journals in relation to the Standards for Reporting of Diagnostic Accuracy Studies (STARD) statement. METHODS: The full articles of all included studies were assessed for their adherence to the 30-item STARD checklist by two researchers independently. A score of 0-2 was attributed to each item. Inter-rater agreement was assessed. Univariate and multivariate linear regression analyses were carried out to evaluate differences in reporting qualities between journals and whether certain variables influenced reporting qualities. RESULTS: A total of 145 articles were identified. Full-article STARD checklist items relating to methodology and results were poorly reported. The overall mean quality score for full articles was 28.75. Articles published in the Journal of Cranio-Maxillofacial Surgery obtained the highest quality score. In the multivariate analysis, articles published in the Journal of Cranio-Maxillofacial Surgery had significantly higher reporting quality scores than those published in the European Journal of Orthodontics (ß = -6.97, 95% confidence interval [CI]: -11.62, -2.30, P < .05), the Journal of Prosthetic Dentistry (ß = -8.01, 95% CI: -14.60, -1.41, P < .05) and Oral Diseases (ß = -6.72, 95% CI: -11.57, -1.86, P < .05). Reporting quality improved each year (P < .028). CONCLUSION: Adherence of full articles to the STARD is suboptimal in dental journals.

7.
Development ; 146(21)2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31719045

RESUMO

The tongue is a highly specialised muscular organ with a complex anatomy required for normal function. We have utilised multiple genetic approaches to investigate local temporospatial requirements for sonic hedgehog (SHH) signalling during tongue development. Mice lacking a Shh cis-enhancer, MFCS4 (ShhMFCS4/-), with reduced SHH in dorsal tongue epithelium have perturbed lingual septum tendon formation and disrupted intrinsic muscle patterning, with these defects reproduced following global Shh deletion from E10.5 in pCag-CreERTM; Shhflox/flox embryos. SHH responsiveness was diminished in local cranial neural crest cell (CNCC) populations in both mutants, with SHH targeting these cells through the primary cilium. CNCC-specific deletion of orofaciodigital syndrome 1 (Ofd1), which encodes a ciliary protein, in Wnt1-Cre; Ofdfl/Y mice led to a complete loss of normal myotube arrangement and hypoglossia. In contrast, mesoderm-specific deletion of Ofd1 in Mesp1-Cre; Ofdfl/Y embryos resulted in normal intrinsic muscle arrangement. Collectively, these findings suggest key temporospatial requirements for local SHH signalling in tongue development (specifically, lingual tendon differentiation and intrinsic muscle patterning through signalling to CNCCs) and provide further mechanistic insight into the tongue anomalies seen in patients with disrupted hedgehog signalling.

8.
J Orthod ; 46(4): 287-296, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31595815

RESUMO

OBJECTIVE: To carry out a UK national clinical audit of orthognathic acceptance criteria and information provided to orthognathic patients before treatment. DESIGN: National clinical audit. SETTING: Data collected using Bristol Online Surveys. PARTICIPANTS: Sixty-nine UK hospital orthodontic departments submitted data. METHODS: Data were collected at two time points using Bristol Online Surveys over a period of 12 months. These were before treatment at the first multidisciplinary clinic (MDT) and immediately after surgery. The data collected included: Index of Orthognathic Functional Treatment Need (IOFTN); Index of Orthodontic Treatment Need (IOTN); age; previous orthodontic treatment; attendance at an MDT; treatment times; and information provision. RESULTS: Eighty-five units agreed to take part in the audit with 69 submitting data, giving a response rate of 81%. The data from 3404 patients were uploaded, 2263 before treatment and 1141 immediately after surgery. Of patients, 91.07% had an IOFTN score of 4 or 5 and 88.73% had an IOTN score of 4 or 5. The mean age at the first MDT was 22 years in the first cohort and 21 years and 4 months in the second immediate post-surgery cohort. Of patients, 37.93% had undergone some form of previous orthodontic treatment, but only 0.28% had undergone previous orthognathic treatment; 96.93% had an MDT confirm that orthodontic treatment by itself was insufficient to adequately correct their functional symptoms. The average treatment time from bond up to surgery was 2 years and 6 months. With respect to information provision, patients received information from a number of sources, principally the British Orthodontic Society (BOS) patient information leaflets and the BOS website Your Jaw Surgery. CONCLUSIONS: In the UK, the majority of orthognathic cases fulfil the criteria for acceptance for NHS-funded orthognathic treatment, as outlined by the Chief Dental Officer's interim guidance on orthognathic treatment. This suggests any prior approval process would not be a good use of NHS resources in the commissioning of orthognathic treatment.


Assuntos
Procedimentos Cirúrgicos Ortognáticos , Sociedades Odontológicas , Adulto , Grupos Étnicos , Humanos , Índice de Necessidade de Tratamento Ortodôntico , Inquéritos e Questionários , Adulto Jovem
9.
Eur J Orthod ; 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31414115

RESUMO

BACKGROUND: Assessment of orthodontic treatment outcomes such as treatment duration in patients with hypodontia are lacking. OBJECTIVES: To assess the overall treatment duration of cases of bilateral absent upper lateral incisors treated with either orthodontic space closure (SC) or space opening (SO). The secondary aim was to determine factors which influence overall treatment duration. SUBJECTS AND METHODS: A retrospective cohort study was undertaken within the Orthodontic department at Kings College Hospital NHS Foundation Trust. Consecutively treated patients between 2008 and 2018 with bilateral absent upper lateral incisors were identified from clinic lists, clinical logbooks, and multidisciplinary clinics. All study data variables were collected by a single investigator using a pre-specified data collection sheet. RESULTS: In total, 52 cases were included, 29 in the SC group and 23 in the SO group. Overall non-extraction treatment was favoured (P = 0.001) with differences in restorations provided post-treatment evident (P = 0.01). Although not statistically significant, the mean overall orthodontic treatment duration was less in the SC group 25.7 months (SD 7.6) compared to the SO group 27.4 (SD 6.1). Overall treatment duration was reduced if treatment was carried out on an extraction basis (-7.02, 95% CI: -11.93, 2.11, P = 0.01) but increased as the amount of crowding in the lower arch increased (0.89, 95% CI: 0.08, 1.71, P = 0.03). CONCLUSIONS: Within the study limitations, there is no difference in the overall treatment duration between both treatment approaches. Treatment duration is reduced in both SO or SC treatment plans if extractions are undertaken. The presence of lower arch crowding increases the duration of treatment.

11.
J Orthod ; 46(1_suppl): 5, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31135276
12.
J Orthod ; 46(1): 5, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-31056058
13.
Angle Orthod ; 89(6): 930-935, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-30920872

RESUMO

OBJECTIVES: To investigate the effects of obesity on biomarker levels within lower incisor gingival crevicular fluid (GCF) in subjects undergoing routine fixed appliance orthodontic treatment. MATERIALS AND METHODS: This was a cross-sectional clinical cohort study. GCF was collected from normal-weight and obese subjects at completion of alignment at least 1 month after placement of 0.019 × 0.025-inch stainless-steel archwires. The primary outcome was the difference in GCF biomarker levels between groups. Secondary outcomes included differences in clinical parameters of plaque and gingival indices, unstimulated whole-mouth saliva, and GCF flow rates. RESULTS: Thirty-eight subjects (18 male, 20 female) with a mean age of 25.6 (SD, 6.3) years and mean body mass index (BMI) of 22.6 (1.6) in normal-weight and 32.4 (2.2) kg/m2 in obese groups were investigated. Apart from BMI (P < .0001), there were no statistically significant differences in essential demographics between groups. Significantly increased levels of the adipokine leptin (P < .009) and the tissue-remodeling biomarker matrix metalloproteinase-9 (MMP9; P < .020) were identified in the obese cohort. For the remainder of the biomarkers, including the RANKL bone-remodeling marker and several inflammatory markers, there were no significant differences between groups. No correlation was observed between plaque index or gingival index for any GCF biomarker for either group (P = .07-1.00). CONCLUSIONS: This study investigated the GCF biochemical profile of obese and normal-weight subjects undergoing fixed-appliance orthodontic treatment. Significantly increased levels of the adipokine leptin and the tissue-remodeling biomarker MMP9 were identified in the obese group. These data provide evidence of differences in GCF biochemistry between obese and normal-weight subjects undergoing fixed appliance orthodontic treatment.


Assuntos
Biomarcadores , Líquido do Sulco Gengival , Obesidade , Aparelhos Ortodônticos Fixos , Adulto , Biomarcadores/análise , Estudos de Coortes , Estudos Transversais , Feminino , Líquido do Sulco Gengival/química , Humanos , Masculino
14.
J Periodontal Res ; 54(3): 300-309, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30511378

RESUMO

OBJECTIVES: The inhibitory action of the superficial gingival connective tissues may limit the regenerative potential of alveolar bone in periodontal therapy or dental implant applications. The aims of this study were to investigate the hypothesis that gingival fibroblasts (GF) can inhibit bone morphogenetic protein (BMP)-induced osteoblastic differentiation, to determine their expression of BMP inhibitors, and finally to determine whether reduction of these inhibitors can relieve suppression of osteoblastic differentiation. METHODS: Gingival fibroblasts were co-cultured either directly or indirectly with calvarial osteoblasts to assess alkaline phosphatase inhibitory activity, a marker of osteoblastic differentiation. To test total BMP-inhibitory activity of rat GF, conditioned media (GFCM) were collected from cultures. ROS 17/2.8 osteoblastic cells were stimulated with BMP2, together with GFCM. Inhibitor expression was tested using RT-qPCR, Western blotting and in situ hybridization. Removal of inhibitors was carried out using immunoprecipitation beads. RESULTS: Co-culture experiments showed GF-secreted factors that inhibit BMP-stimulated ALP activity. 10 ng/ml BMP2 increased alkaline phosphatase expression in ROS cells by 41%. GFCM blocked BMP activity which was equivalent to the activity of 100 ng/ml Noggin, a well-described BMP inhibitor. Cultured gingival fibroblasts constitutively expressed BMP antagonist genes from the same subfamily, Grem1, Grem2 and Nbl1 and the Wnt inhibitor Sfrp1. Gremlin1 (6.7 × reference gene expression) had highest levels of basal expression. ISH analysis showed Gremlin1 expression was restricted to the inner half of the gingival lamina propria and the PDL. Removal of Gremlin1 protein from GFCM eliminated the inhibitory effect of GFCM on ALP activity in ROS cells. Subsequent addition of recombinant Gremlin1 restored the inhibitory activity. CONCLUSIONS: Factors secreted by gingival fibroblasts inhibit BMP-induced bone formation and a range of BMP inhibitors are constitutively expressed in gingival connective tissues. These inhibitors, particularly Gremlin1, may limit coronal alveolar bone regenerative potential during oral and periodontal surgery.


Assuntos
Proteína Morfogenética Óssea 2/farmacologia , Diferenciação Celular , Fibroblastos/fisiologia , Gengiva/citologia , Osteoblastos/fisiologia , Osteogênese , Fosfatase Alcalina/antagonistas & inibidores , Fosfatase Alcalina/metabolismo , Processo Alveolar/fisiologia , Animais , Proteína Morfogenética Óssea 2/antagonistas & inibidores , Regeneração Óssea/genética , Diferenciação Celular/efeitos dos fármacos , Células Cultivadas , Técnicas de Cocultura , Citocinas , Fibroblastos/metabolismo , Masculino , Proteínas do Tecido Nervoso/metabolismo , Osteogênese/efeitos dos fármacos , Proteínas/metabolismo , Ratos Wistar
15.
Angle Orthod ; 89(2): 183-189, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30372126

RESUMO

OBJECTIVES: To investigate, using a split-mouth randomized clinical design, the effect of micro-osteoperforation (MOP) on mini-implant supported canine retraction using fixed appliances. MATERIALS AND METHODS: Thirty subjects (seven males and 23 females) with a mean age of 22.2 (3.72) years were randomized into three canine retraction groups: Group 1 (MOP 4-weekly maxilla/8-weekly mandible; n = 10); Group 2 (MOP 8-weekly maxilla/12-weekly mandible; n = 10) and Group 3 (MOP 12-weekly maxilla/4-weekly mandible; n = 10) measured at 4-week intervals over 16 weeks. Subjects also completed pain (5-point Likert scale) and pain impact (Visual Analogue Scale) questionnaires. The primary outcome was the amount of canine retraction over 16 weeks at MOP (experimental) and non-MOP (control) sites. RESULTS: Mean overall canine retraction was 4.16 (1.62) mm with MOP and 3.06 (1.64) mm without. After adjusting for differences between jaws, all MOP groups exhibited significantly higher canine distalization than the control group: 0.89 mm more (95% confidence interval [CI] = 0.19 to 1.59 mm; P = .01) in the MOP-4 group, 1.08 mm more (95% CI = 0.49 to 1.68 mm; P = .001) in the MOP-8 group and 1.33 mm more (95% CI = 0.55 to 2.10 mm; P = .002) in the MOP-12 group. All subjects reported pain associated with MOP with 60% classifying it as moderate and 15% severe. The main impact of this reported pain was related to chewing and speech. CONCLUSIONS: MOP can increase overall mini-implant supported canine retraction over a 16-week period of observation but this difference is unlikely to be clinically significant.


Assuntos
Dente Canino , Técnicas de Movimentação Dentária , Adulto , Dente Pré-Molar , Face , Feminino , Humanos , Masculino , Boca , Adulto Jovem
16.
Semin Cell Dev Biol ; 91: 45-54, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-29784581

RESUMO

The vertebrate tongue is a complex muscular organ situated in the oral cavity and involved in multiple functions including mastication, taste sensation, articulation and the maintenance of oral health. Although the gross embryological contributions to tongue formation have been known for many years, it is only relatively recently that the molecular pathways regulating these processes have begun to be discovered. In particular, there is now evidence that the Hedgehog, TGF-Beta, Wnt and Notch signaling pathways all play an important role in mediating appropriate signaling interactions between the epithelial, cranial neural crest and mesodermal cell populations that are required to form the tongue. In humans, a number of congenital abnormalities that affect gross morphology of the tongue have also been described, occurring in isolation or as part of a developmental syndrome, which can greatly impact on the health and well-being of affected individuals. These anomalies can range from an absence of tongue formation (aglossia) through to diminutive (microglossia), enlarged (macroglossia) or bifid tongue. Here, we present an overview of the gross anatomy and embryology of mammalian tongue development, focusing on the molecular processes underlying formation of the musculature and connective tissues within this organ. We also survey the clinical presentation of tongue anomalies seen in human populations, whilst considering their developmental and genetic etiology.

17.
PLoS One ; 13(9): e0204126, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30235284

RESUMO

Periodic patterning of iterative structures is diverse across the animal kingdom. Clarifying the molecular mechanisms involved in the formation of these structure helps to elucidate the process of organogenesis. Turing-type reaction-diffusion mechanisms have been shown to play a critical role in regulating periodic patterning in organogenesis. Palatal rugae are periodically patterned ridges situated on the hard palate of mammals. We have previously shown that the palatal rugae develop by a Turing-type reaction-diffusion mechanism, which is reliant upon Shh (as an inhibitor) and Fgf (as an activator) signaling for appropriate organization of these structures. The disturbance of Shh and Fgf signaling lead to disorganized palatal rugae. However, the mechanism itself is not fully understood. Here we found that Lrp4 (transmembrane protein) was expressed in a complementary pattern to Wise (a secreted BMP antagonist and Wnt modulator) expression in palatal rugae development, representing Lrp4 expression in developing rugae and Wise in the inter-rugal epithelium. Highly disorganized palatal rugae was observed in both Wise and Lrp4 mutant mice, and these mutants also showed the downregulation of Shh signaling, which was accompanied with upregulation of Fgf signaling. Wise and Lrp4 are thus likely to control palatal rugae development by regulating reaction-diffusion mechanisms through Shh and Fgf signaling. We also found that Bmp and Wnt signaling were partially involved in this mechanism.


Assuntos
Padronização Corporal , Proteínas Morfogenéticas Ósseas/metabolismo , Palato Duro/embriologia , Palato Duro/metabolismo , Receptores de LDL/metabolismo , Animais , Padronização Corporal/genética , Proteínas Morfogenéticas Ósseas/genética , Difusão , Regulação da Expressão Gênica no Desenvolvimento , Camundongos , Camundongos Mutantes , Palato Duro/patologia , Fenótipo , Receptores de LDL/genética , Transdução de Sinais
18.
Orthod Craniofac Res ; 21(4): 175-185, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30028077

RESUMO

The aim of this systematic review was to assess qualitative changes induced by fixed appliance orthodontic treatment on the subgingival microbiota. Seven databases were searched up to August 2017 for randomized and nonrandomized clinical studies assessing the effect of orthodontic appliances on the subgingival bacteria in human patients. After elimination of duplicate studies, data extraction and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of relative risks (RR) and their 95% confidence intervals (CIs) were performed. According to controlled studies, the presence of Aggregatibacter actinomycetemcomitans in the subgingival crevicular fluid of orthodontic patients was increased 3-6 months after fixed appliance insertion compared to untreated patients (2 studies; RR = 15.54; 95% CI = 3.19-75.85). There was still increased subgingival prevalence of Aggregatibacter actinomycetemcomitans (3 studies; RR = 3.98; 95% CI = 1.23-12.89) and Tannerella forsythia in orthodontic patients up to 6 months after appliance removal compared to untreated patients. However, caution is warranted due to high risk of bias and imprecision. Insertion of orthodontic fixed appliances seems to be associated with a qualitative change of subgingival microbiota, which reverts to some extent back to normal in the first months after appliance removal. However, there is limited evidence on the timing and extent of these changes.


Assuntos
Gengiva/microbiologia , Microbiota , Aparelhos Ortodônticos Fixos/efeitos adversos , Aparelhos Ortodônticos/efeitos adversos , Aggregatibacter actinomycetemcomitans/isolamento & purificação , Carga Bacteriana , Bases de Dados Factuais , Placa Dentária/microbiologia , Líquido do Sulco Gengival/microbiologia , Humanos , Ortodontia Corretiva , Tannerella forsythia/isolamento & purificação
19.
BMC Genomics ; 19(1): 429, 2018 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-29866044

RESUMO

BACKGROUND: Microdeletion of chromosome 22q11 is associated with significant developmental anomalies, including disruption of the cardiac outflow tract, thymic/parathyroid aplasia and cleft palate. Amongst the genes within this region, TBX1 is a major candidate for many of these developmental defects. Targeted deletion of Tbx1 in the mouse has provided significant insight into the function of this transcription factor during early development of the cardiac and pharyngeal systems. However, less is known about its role during palatogenesis. To assess the influence of Tbx1 function on gene expression profile within the developing palate we performed a microarray screen using total RNA isolated from the secondary palate of E13.5 mouse embryos wild type, heterozygous and mutant for Tbx1. RESULTS: Expression-level filtering and statistical analysis revealed a total of 577 genes differentially expressed across genotypes. Data were clustered into 3 groups based on comparison between genotypes. Group A was composed of differentially expressed genes in mutant compared to wild type (n = 89); Group B included differentially expressed genes in heterozygous compared to wild type (n = 400) and Group C included differentially expressed genes in mutant compared to heterozygous (n = 88). High-throughput quantitative real-time PCR (RT-PCR) confirmed a total of 27 genes significantly changed between wild type and mutant; and 27 genes between heterozygote and mutant. Amongst these, the majority were present in both groups A and C (26 genes). Associations existed with hypertrophic cardiomyopathy, cardiac muscle contraction, dilated cardiomyopathy, focal adhesion, tight junction and calcium signalling pathways. No significant differences in gene expression were found between wild type and heterozygous palatal shelves. CONCLUSIONS: Significant differences in gene expression profile within the secondary palate of wild type and mutant embryos is consistent with a primary role for Tbx1 during palatogenesis.


Assuntos
Deleção de Genes , Perfilação da Expressão Gênica , Palato/crescimento & desenvolvimento , Proteínas com Domínio T/deficiência , Proteínas com Domínio T/genética , Animais , Feminino , Genótipo , Camundongos
20.
J Clin Epidemiol ; 100: 44-52, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29705094

RESUMO

OBJECTIVES: Clinical trial registration is widely recommended because it allows tracking of trials that helps ensure full and unbiased reporting of their results. The aim of the present overview was to provide empirical evidence on bias associated with trial registration via a meta-epidemiological approach. STUDY DESIGN AND SETTINGS: Six databases were searched in September 2017 for randomized clinical trials and systematic reviews thereof assessing the effects of orthodontic clinical interventions. After duplicate study selection and data extraction, statistical analysis included a two-step meta-epidemiological approach within- and across-included meta-analyses with a Paule-Mandel random-effects model to calculate differences in standardized mean differences (ΔSMD) between registered and unregistered trials and their 95% confidence intervals (CI), followed by subgroup and sensitivity analyses. RESULTS: A total of 16 meta-analyses with 83 trials and 4,988 patients collectively were finally included, which indicated that registered trials reported less beneficial treatment effects than unregistered trials (ΔSMD = -0.36; 95% CI = -0.60, -0.12). Although some small-study effects were identified, sensitivity analyses according to precision and risk of bias indicated robustness. CONCLUSION: Signs of bias from lack of trial protocol registration were found with nonregistered trials reporting more beneficial intervention effects than registered ones. Caution is warranted by the interpretation of nonregistered randomized trials or systematic reviews thereof.


Assuntos
Protocolos Clínicos/normas , Ensaios Clínicos como Assunto , Projetos de Pesquisa/normas , Viés , Estudos Epidemiológicos , Humanos , Metanálise como Assunto , Ortodontia , Sistema de Registros/estatística & dados numéricos , Resultado do Tratamento
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