Relationship of maxillary 3-dimensional posterior occlusal plane to mandibular spatial position and morphology.

INTRODUCTION: The purpose of this study was to examine the relationship of the 3-dimensional (3D) posterior occlusal plane (POP) and the mandibular 3D spatial position. The relationship of the POP to mandibular morphology was also investigated. METHODS: Retrospective data from a convenience sample of pretreatment diagnostic cone-beam computed tomography scans were rendered using InVivo software (Anatomage, San Jose, Calif). The sample consisted of 111 subjects (51 male, 60 female) and included growing and nongrowing subjects of different races and ethnicities. The 3D maxillary POP was defined by selecting the cusp tips of the second premolars and the second molars on the rendered images of the subjects. The angles made by this plane, in reference to the Frankfort horizontal plane, were measured against variables that described the mandibular position in the coronal, sagittal, and axial views. The POP was also compared with bilateral variables that described mandibular morphology. RESULTS: There were significant differences of the POP among the different skeletal malocclusions (P <0.0001). The POP showed significant correlations with mandibular position in the sagittal (P <0.0001), coronal (P <0.05), and axial (P <0.05) planes. The POP also showed a significant correlation with mandibular morphology (P <0.0001). CONCLUSIONS: These findings suggest that there is a distinct and significant relationship between the 3D POP and the mandibular spatial position and its morphology.

A computerized tomography study of the morphological interrelationship between the temporal bones and the craniofacial complex.

The hypothesis that the temporal bones are at the center of the dynamics of the craniofacial complex, directly influencing facial morphology, has been put forward long ago. This study examines the role of the spatial positioning of temporal bones (frontal and sagittal inclination) in terms of influencing overall facial morphology. Several 3D linear, angular and orthogonal measurements obtained through computerized analysis of virtual models of 163 modern human skulls reconstructed from cone-beam computed tomography images were analyzed and correlated. Additionally, the sample was divided into two subgroups based on the median value of temporal bone sagittal inclination [anterior rotation group (n = 82); posterior rotation group (n = 81)], and differences between groups evaluated. Correlation coefficients showed that sagittal inclination of the temporal bone was significantly (P < 0.01) related to midline flexion, transversal width and anterior-posterior length of the basicranium, to the anterior-posterior positioning of the mandible and maxilla, and posterior midfacial height. Frontal inclination of the temporal bone was significantly related (P < 0.01) to basicranium anterior-posterior and transversal dimensions, and to posterior midfacial height. In comparison with the posterior rotation group, the anterior rotation group presented a less flexed and anterior-posteriorly longer cranial base, a narrower skull, porion and the articular eminence located more superiorly and posteriorly, a shorter posterior midfacial height, the palatal plane rotated clockwise, a more retrognathic maxilla and mandible, and the upper posterior occlusal plane more inclined and posteriorly located. The results suggest that differences in craniofacial morphology are highly integrated with differences in the positional relationship of the temporal bones. The sagittal inclination of the temporal bone seems to have a greater impact on the 3D morphology of the craniofacial complex than frontal inclination.

Basic helix-loop-helix transcription factor DEC1 negatively regulates cyclin D1.

DEC1 (also known as Stra13/Bhlhb2/Sharp2) and DEC2 (also known as Bhlhb3/Sharp1) are two paralogous basic helix-loop-helix (bHLH) transcriptional regulators which exhibit a robust circadian gene expression pattern in the suprachiasmatic nucleus (SCN) and in peripheral organs. DEC1 has been suggested to play key roles in mammalian cell differentiation, the cell cycle and circadian regulation, hypoxia response, and carcinogenesis. Here we show that DEC1 overexpression exhibits delayed wound healing and reduces cell proliferation, migration, and invasion. DEC1 strongly repressed the promoter activity of cyclin D1. We further identify a possible DEC-response element in the cyclin D1 promoter region, and confirmed the direct binding of DEC1 to that element. Forced expression of DEC1 efficiently repressed the cyclin D1 promoter and expression. Our clinical data provide the first evidence that there is a strong inverse correlation between DEC1 and cyclin D1 expression in oral cancer, and DEC1 expression significantly correlated with clinicopathological parameters. We suggest that radiation-induced DEC1 overexpression and Akt phosphorylation in cancer cells are mediated via PI-3K signalling. Overexpression of DEC1 activates the PI-3K/Akt signalling pathway through reactive oxygen species (ROS).

Comparison of Japanese and European overbite depth indicator and antero-posterior dysplasia indicator values.

This study evaluated cephalometric differences between 113 Japanese (43 males and 70 females, aged 14.1 ± 5 years) and 106 European subjects (36 males and 70 females, aged 13.5 ± 7.3 years) using two compound angular measurements and their single components: the overbite depth indicator (ODI) for the assessment of vertical skeletal relationships and the antero-posterior dysplasia indicator (APDI) for an evaluation of sagittal dysgnathia. Both populations were assigned to groups representing Angle Classes I, II, and III, and an anterior open bite (AOB) group. Two sample t- and Wilcoxon signed-ranks tests were performed (P < 0.05). The ODI values showed no statistically significant differences between the Japanese and European samples. The Japanese sample showed a significantly smaller APDI but only in the Class II group. In the Japanese Class II and III subjects, the malocclusion patterns were more pronounced than those in the Caucasian sample (overbite, overjet, and APDI).

Three-dimensional study of different skeletal craniofacial patterns from the eighteenth to the twenty-first century in a Portuguese population.

Objective: To evaluate the most frequent skeletal craniofacial pattern.Methods: Cone beam computed tomography images were obtained for a sample of 332 skulls from the eighteenth, nineteenth and twentieth centuries. A sample of 150 individuals from the twenty-first century was also included. The different skeletal craniofacial patterns were then classified into subclasses according to Slavicek´s method.Results: Over the centuries, skeletal Class II malocclusion has been more prevalent, mainly in the nineteenth century. The skeletal Class I subclass neutral maxilla and neutral mandible (N-N) has presented higher values since the nineteenth century (above 60%), and the skeletal Class II subclass prognathic maxilla and neutral mandible (P-N) have been increasing.Conclusion: In the Portuguese population, the most common skeletal pattern was skeletal Class II malocclusion. From the nineteenth to twenty-first century, there is an increase in the value of skeletal Class I malocclusion, and subclass N-N is undoubtedly the most frequent.

Chewing reduces sympathetic nervous response to stress and prevents poststress arrhythmias in rats.

Reducing stress is important in preventing sudden death in patients with cardiovascular disease, as stressful events may cause autonomic imbalance and trigger fatal arrhythmias. Since chewing has been shown to inhibit stress-induced neuronal responses in the hypothalamus, we hypothesized that chewing could ameliorate stress-induced autonomic imbalance and prevent arrhythmias. To test this hypothesis, we analyzed changes in radiotelemetered electrocardiograms in rats that were allowed to chew a wooden stick during a 1-h period of immobilization stress. Chewing significantly reduced the occurrence of ventricular premature beats (VPBs) and complex ventricular ectopy after immobilization and prevented stress-induced prolongation of the QT interval of VPBs throughout the 10-h experimental period. It also prevented prolongation of the QRS complex and fluctuations in the QT interval in normal sinus rhythm beats preceding VPBs during both immobilization and in the poststress period. Fast Fourier transform-based spectral analysis of heart-rate variability further showed that chewing significantly inhibited the stress-induced increase in the power ratio of low-to-high frequency activity (LF/HF: a marker of sympathetic activity) during immobilization and in addition was associated with blunting of the stress-induced increase in plasma noradrenaline observed at the termination of immobilization. Similar suppressive effects on the occurrence of VPBs and the LF/HF were observed in rats that were administered the ß-adrenergic blocker propranolol before immobilization. These results indicate that chewing can ameliorate sympathetic hyperactivity during stress and prevent poststress arrhythmias and suggest that chewing may provide a nonpharmacological and cost-effective treatment option for patients with a high risk of stress-induced fatal arrhythmia.

Occlusion factors influencing the magnitude of sleep bruxism activity.

The biomechanical load during strong bruxism activity reportedly causes many dental/oral problems. However, it is unknown whether the magnitude of muscle activity during sleep is controllable. In this study, the relationship between the magnitude of muscle activity during sleep and types of tooth contacts was examined, including anterior and posterior guidance, in order to clarify how occlusion factors contribute to sleep bruxism (SB). An EMG-2-axis accelerometer system was used for monitoring patterns and activities of SB. Bruxchecker was used to evaluate tooth contacts during SB, and a condylograph was used to measure posterior guidance (sagittal condylar inclination). Results show that grinding rather than clenching or tapping was observed in the high SB group, and there was Incisor-Canine-Premolar-Molar (ICPM) tooth contact during SB grinding movement. The canine occlusal guidance (COG) was flatter in the low SB group than in the moderate SB group. Relative canine occlusal guidance (rCOG), which is the difference between the sagittal condylar inclination (SCI) and COG, was larger in the low SB group than that in the high SB group. These findings suggest that the grinding pattern must be controlled to prevent strong bruxism, and that the muscle activity during bruxism can be reduced by controlling the tooth contact pattern during SB grinding.

The amount of TMJ displacement correlates with brain activity.

The aim of this functional magnetic resonance imaging (fMRI) study was to investigate the correlation between the severity of malocclusion and brain activation. The fMRI was used to measure blood-oxygenation- level-dependent (BOLD) signals of twelve healthy human subjects while they clenched in two different ways to simulate two types of malocclusion. In each malocclusion model, a custom-made splint forced the mandible to each of two retrusive positions (0.5 mm, 0.7 mm). A no-modification splint provided the control. We compared the BOLD signals measured at each clenching position with those measured during the corresponding resting conditions. The BOLD signals were significantly stronger in the amygdala and the prefrontal area (PFA) when subjects clenched in the two retrusive positions compared during clenching in the control position. In addition, the BOLD signal in the PFA increased as the simulated malocclusion became more severe. These results indicate that we may be able to objectively assess the severity of malocclusion via focus on the brain activity.

Evaluation of horizontal condylar angle in malocclusions with mandibular lateral displacement using cone-beam computed tomography.

OBJECTIVES: To evaluate the horizontal condylar angle (HCA) in mandibular lateral displacement (MLD). MATERIALS AND METHODS: HCA in MLD malocclusions were examined using cone-beam computed tomography data in subjects with MLD and control subjects. RESULTS: HCA in joints of control patients and contralateral side joints of MLD patients were not significantly different. The mean HCA on the shifted side was larger than on the contralateral side (P < .001) in the different HCA groups. HCA was significantly larger on the shifted side than on the contralateral side in skeletal Class I, Class II, and Class III groups (P < .001). CONCLUSIONS: (1) There was no statistically significant difference between HCA in control patients and on the contralateral side in MLD patients. (2) HCA was significantly larger on the shifted side than on the contralateral side. (3) HCA on the shifted side and the contralateral side in MLD Class I, Class II, and Class III are significantly different.

The Galectin-1 level in serum as a novel marker for stress.

Galectin-1(Gal-1), a carbohydrate-binding protein with an affinity for beta-galactoside, is widely expressed in various normal and pathological tissues and it also plays an important role in regulating immune cell homeostasis and tumorigenesis. This study investigated the effects of restraint stress on serum Gal-1 by Western blot analyses and enzyme-linked immunosorbent assays. The Gal-1 levels of the restraint-stress group were significantly higher than those of the control group. However, this increase by stress was not obvious in adolescent rats. The pattern of these changes was similar to that of corticosterone. Furthermore, this Gal-1 increase in the serum was prevented by pre-treatment with a neurotoxin 6-hydroxydopamine (6-OHDA), which destroys the noradrenergic nerve terminals. However, a bilateral adrenalectomy (ADX) had no effect on the Gal-1 increase. These results suggest that Gal-1 is a candidate stress marker protein and that the stress-induced increase of Gal-1 in serum is regulated by the sympathetic nervous system under stress conditions.

Chronic stress affects the expression of brain-derived neurotrophic factor in rat salivary glands.

Plasma brain-derived neurotrophic factor (BDNF) levels are associated with several neural disorders. Previously, we reported that BDNF is produced from salivary glands under acute immobilization stress. Additionally, salivary glands are the origin of plasma BDNF during stress; however, the association between the expression of BDNF by the salivary glands under chronic stress conditions is not known. In the present study, we investigated whether plasma BDNF levels in chronic stress depend on the salivary glands. Expression of BDNF mRNA and protein were identified in the submandibular glands when male rats were exposed to chronic restraint stress (12 h daily for 22 days). Chronic stress significantly increased plasma BDNF concentration, as well as adrenocorticotropic hormone and corticosterone levels, but was not altered under chronic stress in bilaterally sialoadenectomized rats. Since chronic stress increases plasma BDNF levels in the sialoadenectomized rat model, the plasma BDNF level was not dependent on BDNF from the salivary glands. Although the salivary glands were the source of plasma BDNF in acute stress conditions in our previous study, it seems that that the increased BDNF expression in the salivary glands in chronic stress does not contribute importantly to the increased circulating BDNF level. The increased plasma BDNF levels may play important roles in homeostasis under stress conditions.

Salivary glands as the source of plasma brain-derived neurotrophic factor in stressed rats engaged in biting behavior.

Brain-derived neurotrophic factor (BDNF) is crucial for the survival and differentiation of the central and peripheral nervous systems. Recently, BDNF has been reported to exert broader biological activity on non-neural cells. A previous study examined the effect of immobilization stress on BDNF and its receptor tyrosine receptor kinase B in male rat submandibular glands. In the present study, we found that the rat submandibular gland is the major source of plasma BDNF during acute immobilization stress. Biting modulates the mRNA and protein levels of BDNF in the rat hippocampus, so we also investigated whether the plasma BDNF concentration is influenced by biting. Two hours of acute immobilization stress significantly increased the amount of BDNF mRNA within the rat submandibular glands. Moreover, allowing biting behavior for the second half of the 2-h stress exposure significantly increased the amount of salivary gland BDNF mRNA relative to stress alone. Similar results were found with plasma BDNF concentrations under the same conditions. We confirmed that biting during stress attenuates the increases in plasma adrenocorticotropic hormone and corticosterone concentrations, but this was not dependent on the submandibular glands. Increased BDNF, mRNA and protein expressions were observed in salivary duct cells as a result of immobilization stress and biting behavior, as demonstrated by real-time polymerase chain reaction, immunohistochemistry, western blotting, and enzyme-linked immunosorbent assay. Taken together, the findings indicate that the submandibular glands evidently contribute to the increase in plasma BDNF upon biting.

Hypothermic and normothermic ischemia-reperfusion activate microglia differently in hippocampal formation.

Using immunohistochemical methods, we investigated microglial profiles under normothermic ischemia and hypothermic ischemia using an anti-ionized calcium-binding adapter molecule 1 (Iba-1) antibody. In the early stages of ischemia-reperfusion, Iba-1-immunoreactive microglial cells under normothermic ischemia were characterized by swollen somata with short and thick processes, while fine long-branched processes in greater numbers were seen emanating from microglial somata under hypothermic ischemia. In animals subjected to hypothermic ischemia, immunoreactive microglial areas in the hippocampal CA1 sector were significantly increased after 5 and 8 h of reperfusion when compared with those under normothermic ischemia. In the dentate gyrus, an increase in the microglial area under hypothermic ischemia was already evident at 2 h after reperfusion; this increased level was maintained up to 8 h. Considering the various neuroprotective roles of hypothermic ischemia, the characteristic features of microglia under hypothermic ischemia may be associated with the formation of a neuroprotective environment.

Bruxism affects stress responses in stressed rats.

It has been proposed that suppression of stress-related emotional responses leads to the simultaneous activation of both sympathetic and parasympathetic divisions of the autonomic nervous system (ANS) and that the expression of these emotional states has a protective effect against ulcerogenesis. In the present study, we investigated whether stress-induced bruxism activity (SBA) has a physiological effect of on the stress-induced changes of the stomach, thymus, and spleen as well as blood leukocytes, cortisol, and adrenaline. This study demonstrated that SBA attenuated the stress-induced ulcer genesis as well as degenerative changes of thymus and spleen. SBA also attenuated increases of adrenaline, cortisol, and neutrophils in the blood. In conclusion, expression of aggression through SBA during stress exposure attenuates both stress-induced ANS response, including gastric ulcer formation.

Morphologic, functional, and occlusal characterization of mandibular lateral displacement malocclusion.

INTRODUCTION: Mandibular lateral displacement (MLD) is clinically characterized by deviation of the chin, facial asymmetry, dental midline discrepancy, crossbite in the posterior region, and high prevalence of internal derangement of the temporomandibular joint. Morphologic and functional characteristics of MLD should be clarified to correct and prevent this malocclusion. METHODS: We examined the morphologic features, occlusal scheme, and functional behavior of MLD in 116 patients. Facial morphology was examined with posteroanterior cephalograms, occlusion guidance on the articulator after face-bow transfer, and condylar movement with the condylograph. RESULTS: The superiorly inclined occlusal plane was associated with mandibular deviation in the same direction. The posterior occlusal plane on the shifted side was significantly steeper than that on the nonshifted side. Functional analysis of condylar movement showed a close relationship between the direction of MLD and the direction of condylar lateral shift during opening and closing, and protrusion and retrusion. The occlusal guidance inclination in the buccal segment of the nonshifted side was steeper than that in the shifted side. CONCLUSIONS: The results suggested that reduced vertical height of the dentition on 1 side induced mandibular lateral adaptation with contralateral condylar shift (asymmetry); this leads to condylar lateral shift during functional movement.

The temporomandibular joint in a rheumatoid arthritis patient after orthodontic treatment.

A 32-year-old Japanese female patient consulted the authors' dental clinic with a 4.5-year history of rheumatoid arthritis (RA). She complained of pain during mouth opening and difficulty in eating due to masticatory dysfunction caused by an anterior open bite. Imaging showed severe erosion and flattening of both condyles. RA stabilized after pharmacological therapy and became inactive during the orthodontic therapy aimed at reconstructing an optimal occlusion capable of promoting functional repositioning of the mandible. At present, 4 years and 2 months postretention, the reconstructed occlusion remains stable, and both condyles continue to be remodeled. The distance from reference position to intercuspal position has gradually decreased throughout the 4-year posttreatment and postretention periods. Orthodontic therapy that comprehensively reconstructs occlusion and enhances the functioning of the mandible can induce remodeling of eroded condyles, even those with a history of rheumatoid arthritis.

Effects of mandibular deviation on brain activation during clenching: an fMRI preliminary study.

Using functional magnetic resonance imaging (fMRI) in eight healthy human subjects, the present study measured blood oxygenation level-dependent (BOLD) signals during clenching in a malocclusion model, using a custom-made splint that forced the mandible to a retrusive position and a splint of no modification for control, and compared the results to the BOLD signals during the corresponding resting conditions. An individual visual analog scale (VAS) score was also examined during clenching to evaluate the interactions between fMRI data and psychiatric changes. During both clenchings, activations in four brain regions (premotor cortex, prefrontal cortex, sensorimotor cortex, and insula) were seen. However, clenching in the malocclusion model, with psychological discomfort, increased additionally BOLD signals in the anterior cingulate cortex and the amygdala. Furthermore, there was a parallel relationship between BOLD signal intensities and VAS scores in these two regions. The findings may suggest the involvement of clenching with malocclusal conditions in the emotion and/or pain-related neural processing in the brain.

Allowing animals to bite reverses the effects of immobilization stress on hippocampal neurotrophin expression.

Acute immobilization stress alters the expression of neurotrophins, including brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3), in rat hippocampus. We found that biting may be associated with reduction of systemic stress responses. The purpose of this study was to examine whether neurotrophin expression in rat hippocampus is influenced by biting. Rats were exposed to immobilization stress for 2 h (stress group without biting) or biting for the latter half of 2-hour immobilization stress (biting group). Adrenocorticotropic hormone (ACTH) and corticosterone levels were markedly elevated in the stress group, while the increases in ACHT and corticosterone were suppressed in the biting group. Decreased BDNF mRNA and increased NT-3 mRNA expression in hippocampus were detected on real-time polymerase chain reaction (PCR) in the stress group. The decrease in BDNF mRNA under acute immobilization stress was recovered by biting. In addition, the magnitude of increase in NT-3 mRNA was decreased. No changes in expression of tyrosine receptor kinase B or C, the receptors for BDNF and NT-3, respectively, were observed in this model. These findings suggest that biting influences the alterations in neurotrophin levels induced by acute immobilization stress in rat hippocampus.

Longitudinal alteration of the occlusal plane and development of different dentoskeletal frames during growth.

INTRODUCTION: Valuable information about growth and development in different types of occlusions and skeletal frames can be obtained by analyzing longitudinal data, particularly the functional significance of the occlusal plane; this information is important for understanding the etiology, diagnosis, and treatment of malocclusion. The purpose of this study was to investigate the relationship between the cant of the occlusal plane and mandibular position to establish a functional determinant in the development of different dentoskeletal frames in longitudinal growth samples. METHODS: Several measurements were analyzed and compared in a total sample of 406 lateral cephalograms of 102 orthodontically untreated white patients taken at different ages of the growing period from the Burlington Growth Centre, Toronto, Ontario, Canada. RESULTS: Regarding changes related to the cant of the occlusal plane, a progressive tendency was seen through the years for consistency (significance and correlation) between maxillary posterior occlusal plane inclination (FH-OP[P] and Mx-OP[P] angles) and mandibular position (SNB angle) reflected in the appearance of a certain type of dentoskeletal frame (APDI and ANB angles). Statistically significant correlations (P <0.0000) were found between the angle of the Frankfort plane-maxillary posterior occlusal plane and the anteroposterior dysplasia indicator, the maxillary posterior occlusal plane angle and the anteroposterior dysplasia indicator, the maxillary posterior occlusal plane angle and the angle of the palatal plane-mandibular plane, the angle of the Frankfort plane-maxillary posterior occlusal plane and the SNB angle, and the maxillary posterior occlusal plane angle and the SNB angle. CONCLUSIONS: There is a possible relationship between the inclination of the maxillary posterior occlusal plane and mandibular position, consistent with the etiology of different dentoskeletal frames. Thus, a more comprehensive etiologic approach based on the inclination of the maxillary posterior occlusal plane should be considered in the correction of malocclusion.

Relationship of tooth grinding pattern during sleep bruxism and temporomandibular joint status.

The purpose of this study was to investigate the relationship between tooth grinding pattern during sleep bruxism and temporomandibular joint (TMJ) status based on condylar movement. Fifty subjects (21 males and 29 females) wore a bruxism recording device, BruxChecker, to record their grinding pattern during sleep bruxism. The grinding pattern was categorized into laterotrusive grinding (LG) and mediotrusive side grinding (MG). Furthermore, LG was divided into three types; incisor-canine (IC), incisor-canine-premolar (ICP) and incisor-canine-premolar-molar (ICPM) type. Condylar movements were also recorded using computer-aided axiograph to evaluate the signs of TMJ hypermobility. The average maximum separation distance of excursion and incursion and the average maximum condylar lateral deviation during protrusion/retrusion and open/close movements in the ICPM type and the ICPM+MG type were larger than those of the IC and ICP types. While reconstructing the occlusion, it is important to take into consideration the presence of bruxing patterns of the ICPM type and mediotrusive side grinding.