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1.
Biochem Biophys Res Commun ; 684: 149145, 2023 12 03.
Artigo em Inglês | MEDLINE | ID: mdl-37913587

RESUMO

Mechanical stimuli serve as crucial regulators of bone mass, promoting bone formation. However, the molecular mechanisms governing how mesenchymal stem cells (MSCs) respond to mechanical cues during their differentiation into osteogenic cells remain elusive. In this study, we found that cyclic stretching enhances MSC proliferation but does not increase the expression of osteoblast-related genes. We further revealed that this proliferative effect is mediated by fibroblast growth factor 2 (FGF-2), synthesized by MSCs in response to mechanical stress. Cell proliferation induced by cyclic stretching was inhibited upon the addition of either U0126, an inhibitor of mitogen-activated protein kinase kinase (MEK), or early growth response 1 (EGR1)-targeting small-hairpin RNA (shRNA), indicating the involvement of the extracellular signal-regulated kinase (ERK)/EGR1 signaling pathway. Osteoblast differentiation, evaluated through ALP activity, osteoblast-related gene expression, and mineralization, was stimulated by recombinant human FGF-2 (rhFGF-2) when applied during the proliferation phase, but not when applied during the differentiation stage alone. Our results suggest that FGF-2 indirectly promotes osteoblast differentiation as a downstream effect of stimulating cell proliferation. For the first time, we demonstrate that cyclic stretching induces MSCs to produce FGF-2, which in turn encourages cell proliferation through an autocrine/paracrine mechanism, consequently leading to osteoblast differentiation.


Assuntos
Células-Tronco Mesenquimais , Osteogênese , Humanos , Fator 2 de Crescimento de Fibroblastos/farmacologia , Fator 2 de Crescimento de Fibroblastos/metabolismo , Estresse Mecânico , Diferenciação Celular , Proliferação de Células , Osteoblastos/metabolismo
2.
Bull Tokyo Dent Coll ; 64(4): 115-124, 2023 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-37967938

RESUMO

Accurate orthodontic analysis and diagnosis based on anatomical landmarks is essential to the success of orthodontic treatment. Helical computed tomography (CT) has evolved markedly, and dentists can now quickly obtain 3-dimensional (3D) reconstruction data using this imaging modality. The planning of orthodontic treatment had traditionally been based on cephalometric analysis using 2D landmarks. This study aimed to collect 3D morphological data using CT images to establish new landmarks for analysis and diagnosis in orthodontic treatment. Twenty male and 20 female adult Japanese dry skulls with of normal occlusion were selected. The skulls were scanned using a multidetector helical CT system (SIEMENS, Volume Zoom Plus 4, Germany). Models were reconstructed using 3D measurement software (Simplant, Dentsply Sirona, Tokyo, Japan) and 45 landmarks determined. Three-dimensional measurement for a total of 30 items representing these landmarks was then performed. The results provided 3D standard values for maxillofacial morphology in adult Japanese individuals with normal occlusion. These measurement items should allow the disadvantages of 2D cephalometric analysis to be overcome.


Assuntos
Imageamento Tridimensional , Tomografia Computadorizada por Raios X , Adulto , Humanos , Masculino , Feminino , Japão , Imageamento Tridimensional/métodos , Reprodutibilidade dos Testes , Cefalometria/métodos , Tomografia Computadorizada de Feixe Cônico/métodos
3.
Bull Tokyo Dent Coll ; 63(3): 129-138, 2022 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-35965081

RESUMO

Whether there is a relationship between impaction of the third molars and the onset of crowding remains to be determined, and extraction of third molars after orthodontic treatment is left to the judgement of the practitioner. This report describes a case where a third molar caused external root resorption (ERR) of the mandibular second molar after orthodontic treatment. As ERR of the mandibular second molar was detected after non-extraction orthodontic treatment, the affected tooth was extracted and substituted with the third molar. External root resorption of the second molar occurred despite being determined as low risk given the state of the impacted third molar as observed on a panoramic radiograph obtained at the end of active treatment. The present results indicate that in cases where the mandibular third molar is present, the corpus length is short, and non-extraction treatment has been performed, it is necessary to obtain X-ray images on a regular basis or preventively extract the third molar to avoid ERR of the second molars.


Assuntos
Reabsorção da Raiz , Dente Impactado , Humanos , Dente Molar/diagnóstico por imagem , Dente Serotino/diagnóstico por imagem , Contenções Ortodônticas/efeitos adversos , Reabsorção da Raiz/diagnóstico por imagem , Reabsorção da Raiz/etiologia , Dente Impactado/diagnóstico por imagem , Dente Impactado/terapia
4.
Bull Tokyo Dent Coll ; 62(3): 181-192, 2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34393142

RESUMO

Aggressive periodontitis mostly affects young people, causing rapid destruction of periodontal tissue and loss of supporting alveolar bone. The destruction of periodontal tissue induces pathological tooth movement, resulting in various types of malocclusion such as crowding or spacing in the dentition. This report describes orthodontic treatment for malocclusion due to generalized aggressive periodontitis. The patient was a 31-year-old woman who presented with the chief complaint of displacement in the anterior teeth. An oral examination revealed pathological tooth mobility throughout the entire oral cavity due to severe loss of periodontal support. Many gaps in the displaced maxillary anterior teeth and crowding in the mandibular anterior teeth were also observed. The goal of subsequent treatment was to achieve ideal overjet and overbite by aligning the teeth and closing the spaces via non-extraction orthodontic treatment with stripping. The periodontal disease was managed by a periodontist who provided guidance on oral hygiene and periodontal disease control throughout the course of orthodontic treatment. Appropriate occlusion and a good oral environment were achieved. The condition of the periodontal tissue stabilized during and after orthodontic treatment, and favourable occlusal stability was observed at the 2-year follow-up examination.


Assuntos
Periodontite Agressiva , Má Oclusão Classe II de Angle , Má Oclusão , Adolescente , Adulto , Periodontite Agressiva/terapia , Oclusão Dentária , Feminino , Humanos , Má Oclusão/terapia , Técnicas de Movimentação Dentária
5.
Bull Tokyo Dent Coll ; 62(4): 215-226, 2021 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-34776475

RESUMO

Repositioning of the jaw in orthognathic treatment generates changes in the soft tissues of the maxillofacial region, with consequent changes in the airway. The purpose of this study was to determine how type of orthognathic surgical procedure affected the 3-dimensional morphology of the upper airway. Forty patients were divided into the following 2 groups according to the type of surgical procedure used: a horseshoe osteotomy (HS) group (20 patients, comprising 11 men and 9 women; average age 24.3±4.5 years) who underwent bimaxillary surgery; and a LeFort I osteotomy (LF) group (20 patients, comprising 8 men and 12 women; average age 22.5±4.6 years) who also underwent bimaxillary surgery. Cephalometric measurements were taken and 3-dimensional pharyngeal morphology evaluated in each group. The amounts of maxilla rotation, posterior maxilla impaction, and mandibular setback all revealed a significantly larger value in the HS group. Evaluation of pharyngeal volume revealed a significant decrease in the upper pharyngeal segment in the LF group. A significant decrease in the lower pharyngeal segment was observed in both groups. Differences were noted in postoperative pharyngeal morphology between the two groups. The results of this study suggest that HS has less effect on the upper pharyngeal segment, regardless of the amount of posterior maxilla impaction.


Assuntos
Má Oclusão Classe III de Angle , Procedimentos Cirúrgicos Ortognáticos , Adolescente , Adulto , Cefalometria , Feminino , Humanos , Masculino , Má Oclusão Classe III de Angle/diagnóstico por imagem , Má Oclusão Classe III de Angle/cirurgia , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Maxila/diagnóstico por imagem , Maxila/cirurgia , Osteotomia de Le Fort , Osteotomia Sagital do Ramo Mandibular , Faringe/diagnóstico por imagem , Faringe/cirurgia , Adulto Jovem
6.
Bull Tokyo Dent Coll ; 62(1): 27-39, 2021 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-33583878

RESUMO

Aggressive periodontitis during adolescence has a poor prognosis due to rapid alveolar bone resorption. Few studies have investigated long-term follow-up after surgical orthodontic treatment performed in conjunction with that for invasive periodontitis. Here, we report a case of mandibular prognathism accompanied by generalized aggressive periodontitis and crowding. A 31-year-old woman was referred to our department for treatment of masticatory dysfunction due to reverse overjet. The patient exhibited a class III molar relationship, protrusion of the ANB of -6.0°, and severe maxillary crowding. Initial periodontal examination revealed deep periodontal pockets and extensive inflammation. Mandibular prognathism accompanied by generalized aggressive periodontitis and crowding was diagnosed. Therefore, it was necessary to adopt an interdisciplinary approach involving surgical, orthodontic, and periodontal treatment. Prior to commencement of orthodontic treatment, plaque control, scaling, and root planing of all teeth were performed by a periodontist to suppress inflammation and reduce probing depth. During pre-surgical orthodontic treatment, the maxillary first premolars were extracted to reduce crowding of the maxillary incisors. To correct the mandibular prognathism, the mandible was repositioned by sagittal split ramus osteotomy. Proper occlusion of the incisors and maximum intercuspation were achieved by post-surgical orthodontic treatment. After completion of active orthodontic treatment, acceleration of inflammation was observed together with aggravated resorption of the alveolar bone surrounding the molars. However, reduction of probing depth and inflammation were observed after scaling and root planing. The surgical-orthodontic treatment time was 1 year and 11 months, which was followed by a 2-year retention period. There was no tooth loss due to periodontitis, and an overall satisfactory outcome was achieved.


Assuntos
Periodontite Agressiva , Má Oclusão Classe III de Angle , Má Oclusão , Prognatismo , Adulto , Feminino , Seguimentos , Humanos , Má Oclusão Classe III de Angle/cirurgia , Mandíbula , Prognatismo/cirurgia
7.
Bull Tokyo Dent Coll ; 61(4): 255-264, 2020 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-33177271

RESUMO

This case report describes the unusual choice of extraction of maxillary incisors with short roots as part of an orthodontic treatment plan. The patient was a 20-year-old woman referred to our department in whom the diagnosis was maxillary protrusion and open bite. Both of the maxillary central incisors had short roots. Two treatment options were considered. The first involved extraction of the 4 first premolars with the aim of improving dentoalveolar protrusion and crowding. If preservation of the central incisors subsequently became difficult due to root resorption, prosthetic options were to be considered. The second treatment option involved extraction of the maxillary central incisors with short roots and the mandibular first premolars. The second treatment option was selected as survival of the central incisors following orthodontic movement was uncertain and the patient also wanted to minimize the risk of future extractions and the use of prosthetics. Active treatment was performed over a span of 31 months, and circumferential type retainers were used on both arches for retention. For such treatment to be successful, careful diagnosis and orthodontic treatment planning must be taken to ensure the anterior dental esthetics are properly restored.


Assuntos
Má Oclusão , Mordida Aberta , Reabsorção da Raiz , Adulto , Feminino , Humanos , Incisivo , Maxila , Mordida Aberta/terapia , Técnicas de Movimentação Dentária , Adulto Jovem
8.
Bull Tokyo Dent Coll ; 61(4): 243-253, 2020 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-33177274

RESUMO

This report describes a patient with severe high angle class II malocclusion and mandibular retrusion in whom surgical orthodontic treatment to prevent an increase in ramus height resulted in a significant improvement in esthetics and long-term stability. The patient was a woman aged 30 years 5 months who presented with the chief complaint of maxillary protrusion. She had a convex facial type, a chin button on lip sealing, and a gummy smile. Cephalometric analysis revealed a normal maxilla anterior-posterior position, but significant mandibular retrusion with pronounced clockwise rotation. The anterior maxillary tooth axis was standard, but labially inclined in the mandible. Based on these findings, the diagnosis was skeletal class II high angle malocclusion and mandibular retrusion. The proposed treatment plan comprised 2-jaw surgery with premolar extraction. Le Fort I osteotomy, in particular, was planned in the maxilla to move the ANS upward by 3.0 mm and the PNS downward by 3.0 mm. Sagittal split ramus osteotomy (SSRO) was planned to adjust the mandible and move the mandible forward by 10.0 mm. To prevent postoperative relapse, the short lingual split method was used in performing the SSRO. The mandible was split to minimize stretching of the median pterygoid muscle. Postoperatively, the ANS, PNS, and pogonion showed movement of 2.0 mm upward, 3.0 mm downward, and 8.0 mm forward, respectively. Additionally, lip closure was now natural, and the gummy smile had markedly improved. At 6 years postoperatively, there has been no change skeletally or dentally. Follow-up is being continued to monitor further progress.


Assuntos
Má Oclusão Classe III de Angle , Má Oclusão Classe II de Angle , Retrognatismo , Adulto , Cefalometria , Estética Dentária , Feminino , Humanos , Má Oclusão Classe II de Angle/cirurgia , Mandíbula/cirurgia , Maxila/cirurgia , Osteotomia de Le Fort
9.
Bull Tokyo Dent Coll ; 61(4): 213-219, 2020 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-33177272

RESUMO

The aim of this study was to investigate 3-dimensional (3D) airway volume in patients with unilateral cleft lip and palate (UCLP) using computed tomography (CT). The study population comprised 15 UCLP patients (UCLP group) scheduled to receive alveolar bone grafts and 15 with impacted teeth (control group). The clinical requirements for a CT scan were met in both groups. Measurements were recorded from 3D reconstructions of Digital Imaging and Communications in Medicine data obtained from the CT images. Airway volume, cross-sectional area, and linear and angular measurements were recorded. Airway volume and cross-sectional area showed no significant difference between the two groups. The narrowest section of the airway in the UCLP group was tighter than that in the control group, however (p=0.017). The results of this study suggest that this difference in the measurements of the narrowest section of the airway is involved in the particular maxillofacial morphology found in UCLP patients.


Assuntos
Fenda Labial , Fissura Palatina , Fenda Labial/diagnóstico por imagem , Fissura Palatina/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Humanos , Imageamento Tridimensional , Faringe/diagnóstico por imagem
10.
Bull Tokyo Dent Coll ; 60(2): 139-149, 2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-30971679

RESUMO

Here, we report retention following surgical orthodontic treatment in a patient with vertical maxillary excess associated with temporomandibular joint osteoarthritis (TMJOA) and marked mandibular retrusion. The patient was a man aged 20 years 10 months who presented with the chief complaint of maxillary protrusion. The facial profile was of the convex type due to marked mandibular retrusion. In addition, the patient had a gummy smile. Intraoral findings revealed a Class II molar relation, +11 mm overjet, and 0 mm overbite. Mandibular dentition arch length discrepancy showed crowding of -2 mm, and the maxillary dentition showed a spaced arch of +5 mm. Panoramic radiographs confirmed flattening of the condylar head and proliferation of the bone margin. Cephalometric analysis of the skeletal pattern revealed that, horizontally, the maxilla was anterior and the mandible posterior; vertically, a dolichofacial pattern was noted. The anterior maxillary tooth axis was standard, but the anterior mandibular tooth axis showed labial inclination. Based on these findings, skeletal maxillary protrusion associated with TMJOA was diagnosed. Surgical orthodontic treatment comprised bilateral mandibular first premolar extraction with two-jaw surgery and genioplasty. Orthodontic treatment was performed with a multibracket system using a 0.22-slot pre-adjusted edgewise appliance. At 2 years and 11 months after initiation of treatment, the maxilla was transposed 6 mm upwards by orthognathic surgery and the mandible 17 mm anteriorly and 5 mm upwards by counterclockwise rotation. At 3 years and 10 months, the Pogonion was moved 6 mm anteriorly by genioplasty. At 4 years, orthodontic treatment was concluded on confirming satisfactory occlusion and improvement in facial features. At 2 years after completion of treatment, occlusion and the maxillofacial morphology remain stable, with almost no relapse. In addition, no temporomandibular joint disorder symptoms have occurred. Careful comprehensive follow-up observation will be continued.


Assuntos
Má Oclusão Classe II de Angle , Procedimentos de Ancoragem Ortodôntica , Osteoartrite , Retrognatismo , Adulto , Dente Pré-Molar , Cefalometria , Humanos , Masculino , Mandíbula , Maxila , Articulação Temporomandibular , Técnicas de Movimentação Dentária , Adulto Jovem
11.
Bull Tokyo Dent Coll ; 59(1): 1-14, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29563357

RESUMO

Surgical orthodontic treatment has been reported to improve oral health-related quality of life (OHRQL). Such treatment comprises three stages: pre-surgical orthodontic treatment; orthognathic surgery; and post-surgical orthodontic treatment. Most studies have focused on change in OHRQL between before and after surgery. However, it is also necessary to evaluate OHRQL at the pre-surgical orthodontic treatment stage, as it may be negatively affected by dental decompensation compared with at pre-treatment. The purpose of this prospective study was to investigate the influence of surgical orthodontic treatment on QOL by assessing change in condition-specific QOL at each stage of treatment in skeletal class III cases. Twenty skeletal class III patients requiring surgical orthodontic treatment were enrolled in the study. Each patient completed the Orthognathic Quality of Life Questionnaire (OQLQ), which was developed for patients with dentofacial deformity. Its items are grouped into 4 domains: "social aspects of dentofacial deformity"; "facial esthetics"; "oral function"; and "awareness of dentofacial esthetics". The questionnaire was completed at the pre-treatment, pre-surgical orthodontic treatment, and post-surgical orthodontic treatment stages. The results revealed a significant worsening in scores between at pre-treatment and pre-surgical orthodontic treatment in the domains of facial esthetics and oral function (p<0.01), and between at pre-surgical orthodontic and post-surgical orthodontic treatment in all domains except awareness of dentofacial esthetics (p<0.05, p<0.01). A significant correlation was observed between a negative change in overjet and worsening OQLQ scores at the pre-surgical orthodontic treatment stage. Significant correlations were also observed between improvement in upper and lower lip difference, soft tissue pogonion protrusion, and ANB angle and improvement in OQLQ scores at the post-surgical orthodontic treatment stage. These results indicate that morphologic change influences OHRQL in patients undergoing surgical orthodontic treatment not only after surgery, but also during pre-surgical orthodontic treatment.


Assuntos
Má Oclusão Classe III de Angle/terapia , Ortodontia Corretiva , Procedimentos Cirúrgicos Ortognáticos , Qualidade de Vida , Adolescente , Adulto , Terapia Combinada , Feminino , Humanos , Masculino , Estudos Prospectivos , Adulto Jovem
12.
Bull Tokyo Dent Coll ; 59(1): 43-51, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29563361

RESUMO

Here, we report a case of dental implant treatment involving computer-assisted surgery for bilateral agenesis of the maxillary lateral incisors. The patient was a 39-year-old woman with the chief complaint of functional and esthetic disturbance due to maxillary and mandibular malocclusion. The treatment plan comprised non-extraction comprehensive orthodontic treatment and prosthodontic treatment for space due to the absence of bilateral maxillary lateral incisors. A preliminary examination revealed that the mesiodistal spaces left by the absent bilateral maxillary lateral incisors were too narrow for implant placement (right, 5.49 mm; left, 5.51 mm). Additional orthodontic treatment increased these spaces to approximately 6 mm, the minimum required for implant placement if risk of damage to the adjacent teeth due to inaccuracies in directionality of drilling is to be avoided. For dental implant treatment with computer-assisted surgery, preoperative planning/simulation was performed using Simplant® ver.12 software and a toothsupported surgical template fabricated using stereolithography. Two narrow-diameter implants were placed in a two-stage procedure. It was confirmed that there was sufficient distance between the implant fixtures and the roots of the adjacent teeth, together with no exposure of alveolar bone. Following a 4-month non-loading period, second-stage surgery and provisional restoration with a temporary screw-retained implant crown were performed. Cement-retained superstructures made of customized zirconia abutment and a zirconia-bonded ceramic crown were fitted as the final restoration. At 5 years after implant surgery, there were no complications, including inflammation of the peri-implant soft tissue and resorption of peri-implant bone. Computer-assisted implant surgery is useful in avoiding complications in bilateral agenesis of the maxillary lateral incisors when only a narrow mesiodistal space is available for implant placement.


Assuntos
Anodontia/cirurgia , Implantação Dentária Endóssea/métodos , Implantes Dentários , Incisivo/anormalidades , Cirurgia Assistida por Computador , Adulto , Anodontia/patologia , Feminino , Humanos , Maxila
13.
Bull Tokyo Dent Coll ; 58(4): 259-267, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29269721

RESUMO

We performed orthodontic treatment, fitted prostheses, and provided restorative treatment in a patient with Bloch-Sulzberger syndrome and cleft lip and palate during the early mixed dentition period. We report the case after a subsequent 6-year retention phase including the period of pubertal growth. A girl aged 8 years 4 months visited our hospital with the chief complaint of crowding of the anterior teeth and anterior crossbite. She had bilateral cleft lip, alveolus, and palate; a Class II molar relationship; winging of both the maxillary bilateral central incisors; and spacing in the mandibular anterior teeth arches. Anterior crossbite comprised 0 mm overbite and -1 mm overjet. The crown diameter was at least one standard deviation smaller than normal in both the deciduous and permanent teeth, and the crowns were slightly peg-shaped. Panoramic radiograph confirmed congenital absence of 21 permanent teeth. Cephalometric analysis revealed poor growth of the maxilla, downward growth of the mandible, and lingual inclination of the maxillary central incisors. The diagnosis was skeletal anterior crossbite with cleft lip, alveolus, and palate, accompanied by hypodontia. Orthodontic treatment comprised an edgewise appliance and an expansion arch to improve crowding and anterior crossbite. The appliance was removed 2 years after treatment initiation, followed by crown restorations of the maxillary central incisors and mandibular deciduous anterior teeth. A metal retainer was then fitted to the maxillary dentition. She was subsequently placed in a 6-year retention phase including pubertal growth, during which occlusal stability and esthetics were maintained.


Assuntos
Fenda Labial/terapia , Fissura Palatina/terapia , Ortodontia Corretiva , Criança , Fenda Labial/complicações , Fissura Palatina/complicações , Feminino , Humanos , Incontinência Pigmentar/complicações
14.
J Orthod ; 41(4): 275-84, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24812100

RESUMO

OBJECTIVE: This study aimed to investigate the reason for high failure rates of mini-screws during orthodontic treatment. We hypothesized that decreasing the length of the mini-screw outside the bone relative to the length inside the bone (outside/inside length ratio) and equalising it to the tooth crown/root ratio would lead to increased stability of the mini-screw against lateral loading when assessed using finite element analysis. METHODS: We analysed stress distribution of mini-screws in the cortical and trabecular bone and von Mises stress levels when a 2-N force was applied to the head of four mini-screws of 6, 8, 10 and 12 mm in length. The direction of the force was perpendicular to the major axis of the screws. RESULTS: Stress levels of screws in cortical bone increased in proportion to the length of mini-screws outside the bone. The length of mini-screws inside the bone did not affect stress levels in the cortical bone. CONCLUSIONS: The results of this finite element analysis indicate that to stabilize the mini-screw, controlling the screw length outside the bone is more important than controlling the outside/inside length ratio.


Assuntos
Processo Alveolar/fisiologia , Parafusos Ósseos , Análise de Elementos Finitos , Procedimentos de Ancoragem Ortodôntica/instrumentação , Adolescente , Adulto , Fenômenos Biomecânicos , Densidade Óssea/fisiologia , Simulação por Computador , Materiais Dentários/química , Módulo de Elasticidade , Humanos , Imageamento Tridimensional/métodos , Modelos Biológicos , Desenho de Aparelho Ortodôntico , Estresse Mecânico , Propriedades de Superfície , Titânio/química , Coroa do Dente/anatomia & histologia , Raiz Dentária/anatomia & histologia , Adulto Jovem
15.
Bull Tokyo Dent Coll ; 55(1): 39-47, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24717929

RESUMO

While osteomas often occur in the orofacial area, it is relatively rare for one to occur in the temporomandibular joint area. Here, we report a patient who underwent multidisciplinary treatment including high condylectomy for peripheral osteoma arising in the left mandibular condyle. The patient was a 46-year-old woman with the chief complaint of facial asymmetry. Cephalometric analysis revealed skeletal anterior crossbite due to anterior deviation of the mandible, with chin deviation of 10 mm to the right. A computed tomography scan revealed bone hyperplasia in the mesiodistal and inner areas of the left mandibular condyle, which exhibited outward anterior displacement. Bone scintigraphy showed a circular area of strong radioisotope accumulation with indistinct boundaries, consistent with the lesion in the left mandibular condyle. The above findings led to a diagnosis of skeletal mandibular prognathism with facial asymmetry due to peripheral osteoma originating in the left mandibular condyle. After orthodontic treatment and surgical resection of the tumor and mandibular condyle, preservation and prosthetic treatment were undertaken. A well-balanced facial appearance and good occlusion were achieved.


Assuntos
Assimetria Facial/diagnóstico , Côndilo Mandibular/patologia , Neoplasias Mandibulares/diagnóstico , Osteoma/diagnóstico , Equipe de Assistência ao Paciente , Cefalometria/métodos , Assimetria Facial/terapia , Feminino , Humanos , Má Oclusão Classe III de Angle/diagnóstico , Má Oclusão Classe III de Angle/terapia , Côndilo Mandibular/cirurgia , Neoplasias Mandibulares/cirurgia , Pessoa de Meia-Idade , Osteoma/cirurgia , Prognatismo/diagnóstico , Prognatismo/terapia , Amplitude de Movimento Articular/fisiologia , Tomografia Computadorizada por Raios X/métodos , Técnicas de Movimentação Dentária/métodos
16.
Quant Imaging Med Surg ; 14(2): 1652-1659, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38415165

RESUMO

Background: Sagittal split ramus osteotomy is an established procedure used in oral and maxillofacial surgery. Major bleeding is representative intraoperative complication involves vessels such as the inferior alveolar, facial, and maxillary arteries and accompanying veins, in particular the retromandibular vein (RMV). We previously described the RMV course patterns using embalmed cadavers. However, owing to the possible influence of formalin fixation and unclear skeletal classification of the jaws, the present study aimed to use contrast-enhanced computed tomography to confirm the RMV in patients with defined jaw deformities. Methods: Twenty patients with orthognathic jaw deformities (40 sides) were included. The RMV and the lateral and posterior views of the mandible were evaluated using contrast-enhanced computed tomography. Course patterns and RMV positions were classified as previously reported. Results: Three patterns were identified in the lateral view. Type A: RMV posterior to the posterior border of the ramus (n=25; 62.5%). Type B: adjoining the posterior border of the ramus (n=12; 30.0%). Type C: anterior to the posterior border of the ramus (n=3; 7.5%). Five course patterns were identified in the posterior view. Pattern I: rectilinear course running medial to the posterior border of the ramus (n=3; 7.5%). Pattern II: diagonal course running medially from immediately posterior to posterior border of the ramus (n=11; 27.5%). Pattern III: rectilinear course running immediately posterior to the posterior border of the ramus (n=12; 30.0%). Pattern IV: diagonal course running from lateral to medial relative to the posterior border of the ramus (n=8; 20.0%). Pattern V: diagonal course running from lateral to immediately posterior relative to the posterior border of the ramus (n=6; 15.0%). In the no-course pattern group, the RMV inferior to the lingula was lateral to its position and superior to that of the lingula. In half of the cases, the left and right sides exhibited different running patterns. We observed no correlation between the skeletal patterns of jaw deformities and the course of the RMV. Conclusions: Type B/Pattern II that runs in a straight line bordering the posterior margin of the ramus requires the most attention during surgery. These findings suggest the possibility of predicting intraoperative bleeding risk.

17.
J Clin Med ; 12(14)2023 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-37510990

RESUMO

The treatment of dentofacial deformities generally includes orthognathic surgery in which mandibular condyle changes following surgery are a common cause of relapse. This study investigated the changes in the mandibular condyle and related muscles to identify the factors that affected the changes in the mandibular condyle after orthognathic surgery in skeletal class II patients. This research studied 60 joints in 30 patients with skeletal class II dentofacial deformities who received surgical orthodontic treatment, including bilateral sagittal split ramus osteotomy, and underwent computed tomography before and after orthodontic treatment. The mandibular condyle, masseter, and medial pterygoid muscles were reconstructed and measured in 3D. Condylar positional and morphology changes, masseter and medial pterygoid muscle volume, temporomandibular joint (TMJ) pain, and distal segment movement were analyzed. The study observed that both the masseter and medial pterygoid muscle volumes decreased with statistical significance. The changes in the horizontal direction were positively correlated with the amount of movement. The findings indicated that mandibular condyle changes were significantly affected by the movement of the distal segment, the medial pterygoid muscle volume, and the direction of the distal segment, which influenced the treatment's long-term stability after orthognathic surgery.

18.
Sci Rep ; 13(1): 20011, 2023 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-37974018

RESUMO

Fully automated techniques using convolutional neural networks for cephalometric landmark detection have recently advanced. However, all existing studies have adopted X-rays. The problem of direct exposure of patients to X-ray radiation remains unsolved. We propose a model for detecting cephalometric landmarks using only facial profile images without X-rays. First, the model estimates the landmark coordinates using the features of facial profile images through high-resolution representation learning. Second, considering the spatial relationship of the landmarks, the model refines the estimated coordinates. The estimated coordinates are input into fully connected networks to improve the accuracy. During the experiment, a total of 2000 facial profile images collected from 2000 female patients were used. Experiments results suggested that the proposed method may perform at a level equal to or potentially better than existing methods using cephalograms. We obtained an MRE of 0.61 mm for the test data and a mean detection rate of 98.20% within 2 mm. Our proposed two-stage learning method enables a highly accurate estimation of the landmark positions using only facial profile images. The results indicate that X-rays may not be required when detecting cephalometric landmarks.


Assuntos
Redes Neurais de Computação , Humanos , Feminino , Raios X , Radiografia , Cefalometria/métodos , Reprodutibilidade dos Testes
19.
J Funct Biomater ; 14(7)2023 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-37504851

RESUMO

A lateral load was applied to anchor screws that had undergone surface treatment, and the structure, cellular dynamics, and quality of the bone surrounding anchor screws were analyzed to investigate the effect of this surface treatment on the peri-implant jawbone. In addition, bone microstructural characteristics were quantitatively evaluated for each site of loading on the bone around the anchor screw. Rats were euthanized after observation on days 3, 5, or 7, and bone quality analyses were performed. Bone-implant contact rate increased more rapidly at an early stage in the treated surface group than in the untreated surface group. Bone lacuna morphometry showed that the measured values adjacent to the screw at the screw neck on the compressed side (A) and at the screw tip on the uncompressed side (D) were significantly lower than those at the screw tip on the compressed side (B) and at the screw neck on the uncompressed side (C). Collagen fiber bundle diameter showed that the measured values adjacent to regions A and D were significantly higher than those at regions B and C. Anchor screw surface activation facilitates initial bone contact of the screw, suggesting that early loading may be possible in clinical practice.

20.
Diagnostics (Basel) ; 13(20)2023 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-37892057

RESUMO

Arch forms in orthodontics are considered to affect occlusal stability. This study's subjects were 47 patients (Class III S group) who visited the Chiba Dental Center of Tokyo Dental College and were surgical orthodontic cases, and 60 patients with Class I malocclusion were selected as the control group. A mandibular model of each subject was plotted with each tooth on a digitizer. The clinical bracket points of each tooth were plotted, and intercanine and intermolar measurements were taken. The least squares method was used to fit a quartic equation, and the arch form was drawn. The Class IIIS group was divided by Wits appraisal and facial pattern into a dolichofacial or brachyfacial pattern, and arch forms were compared. The results show that the Class IIIS group had a significantly smaller intermolar width, canine depth, and molar depth and a significantly larger canine W/D ratio. In those with a dolichofacial pattern, the anterior curve of the arch form tended to be flat and the posterior curve narrower. This is because, in skeletal mandibular prognathism, the mandibular anterior shows lingual tipping, and the molars show palatal tipping due to dental compensation, and it was inferred that this tendency was higher in high-angle cases.

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