Classification of oral clefts by affection site and laterality: a genotype-phenotype correlation study

Objectives – The aim of this study was to classify the phenotypes found in a series of patients with non‐syndromic cleft lip (CL) with or without cleft palate (CP) and isolated cleft palate. Additionally, the frequency distribution of cases belonging to families linked to markers on chromosomes 6 and 2 within these phenotypic patterns were estimated. Design – A retrospective examination of all the available affected cases collected in Italy. Setting and Sample Population – Ninety‐seven affected subjects aged 5–18 years belonging to 38 families were considered. Patterns were identified by variance of the cleft (lip, primary palate, secondary palate) and stratified according to the side of occurrence (right, left, or bilateral). Latent class analysis was used as main statistical tool for carrying out the results. Results – Three homogenous classes were identified (P < 0.0001) by means of latent class analysis. Individuals were assigned to the most suited class. All three variables (lip, primary and secondary cleft palate) generated a specific class. Optimal findings were reported in cases having `any isolated cleft lip' (class 1); `secondary CP with or without bilateral/right primary cleft palate + bilateral/right cleft lip' (class 2); and `left primary cleft palate + left/bilateral cleft lip with or without secondary CP' (class 3). Correspondence to the evidence of linkage to chromosome 6 showed that 9 of 10 cases presenting with `right primary CP + right CL with secondary cleft palate' (class 2) belonged to a linked family. The same combination, but occurring on the left side (class 3), revealed that only three of nine cases belong to families linked to chromosome 6 (P‐value=0.02). The two patterns (right and left) never occurred in the same family. Three reliable groups were identified based on laterality and the presence of a cleft. A single right sided pattern displayed a statistically different distribution of linkage to chromosome 6 when compared with the homologous left side. Conclusion – Non‐syndromic CL with/without CP can be classified according to laterality that can be under genetic control.     

多曲方丝弓技术矫治骨性Ⅲ类错前后变化的观察

目的对比多曲方丝弓(MEAW)技术矫治骨性Ⅲ类错畸形前后患者X线片变化,探讨MEAW技术矫治骨性Ⅲ类错畸形的机制。方法选用骨性Ⅲ类错畸形患者15例采用0.56mm×0.64mm的直丝弓托槽系统治疗。测量矫治前、后患者的定位X线头颅侧位片并进行比较。结果由于下后牙的远中直立,L6/MP,L7/MP平均增加了7.2°和7.6°,OP-FH平均减少4.23°,OP-MP平均增加5.64°。结论MEAW技术矫治骨性Ⅲ类错畸形主要通过下后牙的远中竖直,以及平面的改变来完成,而矫治前后骨组织及软组织的变化有限。     

种植体直径和长度在Ⅲ类骨质中的优化选择

目的应用Ansys DesignXplorer模块，分析圆柱形种植体直径和长度同时连续变化时对Ⅲ类骨质的颌骨应力的影响，为临床选择和设计种植体提供理论依据。方法建立包含圆柱状种植体的下颌骨Ⅲ类骨质的骨块三维有限元模型，设定种植体直径变化范围为3．0～5．0mm，种植体长度变化范围为6．0～16．0mm，观察直径和长度变化对颌骨Von Mises应力峰值的影响。同时进行颌骨Von Mises应力峰值对变量的敏感度分析。结果随着直径和长度的增加，垂直向加载时，皮、松质骨的EQV应力峰值分别降低了65．3％和76．8％；颊舌向加载时，皮、松质骨的VonMises应力峰值分别降低了76．1％和78．0％；当直径大于3．95mm，同时长度大于10．5mm时，应力峰值响应曲线的切斜率位于-1和0之间；在垂直向加载和颊舌向加载时，长度和直径分别对皮质骨EQV应力峰值的影响更明显。结论种植体直径增加更有利于改善颌骨颊舌向加载下的应力分布，种植体长度的增加更有利于改善颌骨垂直加载下的应力分布。从生物力学角度而言，对于m类骨质在临床上选择种植体时，种植体的直径应不小于3．95mm。种植体的长度应不小于10．5mm。     

Literaturübersicht und klinische Anwendung eines neu entwickelten Wurzelkanalfüllungsmaterials – erste klinische Erfahrungsberichte mit EndoREZ

Zusammenfassung  Guttapercha in Kombination mit einem Sealer dichtet den Wurzelkanal nicht optimal ab. Es wird nach Alternativen gesucht und im Zuge der dentinadh?siven Revolution in der Füllungstherapie wurden Kunststoffmaterialien für den Verschluss des Wurzelkanals entwickelt. Im nachfolgenden Beitrag werden in einer Literaturübersicht Studien über das neue adh?sive Wurzelkanalfüllmaterial EndoREZ vorgestellt. Es wird der Frage nachgegangen, ob sich EndoREZ im klinischen Alltag bew?hrt. Dazu wurden 10 Wurzelkanalfüllungen aus der t?glichen Praxis nach einem standardisierten Behandlungsprotokoll hergestellt und r?ntgenologisch nach 6–9 Monaten nachkontrolliert sowie relevante klinische Parameter erfasst. Die Ergebnisse werden kritisch diskutiert und Schlussfolgerungen für den praktisch t?tigen Zahnarzt dargestellt. Korrespondenz: Josef Herbert, Lessingstrasse 50, 39218 Sch?nebeck, Deutschland     

颌间Ⅲ类矫形力下TGF-β1mRNA在青春期恒河猴上颌骨缝中的表达

目的　检测在颌间Ⅲ类矫形力不同作用时间下转化生长因子β1(TGF-β1)在青春期恒河猴上颌骨周围骨 缝中的表达。方法　选用青春生长发育期雌性恒河猴6只,随机分为3、6月实验组和对照组。实验组戴用颌间Ⅲ 类双阻板磁力矫治器,对照组不戴。分别于实验后3个月、6个月处死实验猴,制备组织切片。图像分析系统分析 苏木精-伊红染色切片中的骨缝区细胞密度,原位杂交检测各骨缝中TGF-β1 mRNA的阳性率。结果　水平组的腭 颌缝和垂直组的翼上颌缝的细胞密度,在组间比较上无差异,其余各组均有明显差异;施加矫治力后TGF-β1 mRNA的表达明显增加,除颧颞缝和翼上颌缝6月实验组和对照组无显著差异外,其余各实验组和对照组间都有显 著差异(P<0·01),都表现为实验组表达强于对照组,3月实验组表达均强于6月实验组。结论　上颌骨骨缝在颌 间Ⅲ类矫形力牵引下,发生积极的组织改建。在骨缝改建的不同时期,TGF-β1 mRNA的表达不相同,这与加力的时 间、骨缝对矫形力的差异性反应以及TGF-β1在不同时期出现的不同生物学效能有关。     

Effects of transforming growth factor beta1 (TGFbeta-1) and dentin non-collagenous proteins (DNCP) on human embryonic ectomesenchymal cells in a three-dimensional culture system

Cranial neural crest-derived ectomesenchymal cells represent a population of pluripotent stem cells giving rise to many of the various oro-facial and dental tissues. The factors determining the terminal fate of these cells are still unclear. The potentiality of human embryonic ectomesenchymal cells from the first branchial arch have been investigated when isolated and grown in a three-dimensional (3D)-collagen gel culture system in the presence of dentin matrix-derived non-collagenous proteins (DNCP) and TGFbeta-1. Functional differentiation of cells showing some characteristics of odontoblast-like cells could be observed when the cells were cultured with DNCP+TGFbeta-1 or DNCP, however, only cytological differentiation was observed during culture with TGFbeta-1 alone. The characteristics of these cells was assessed by morphological appearance, expression of the odontoblast phenotype marker dentin sialophosphoprotein (DSPP), increased alkaline phosphatase levels and formation of mineralised nodules in vitro. The results indicate that these embryonic cells from the first branchial arch are capable of responding to the inductive stimulus of DNCP or DNCP+TGFbeta-1 when isolated and grown in the 3D collagen gel culture system. The capacity of the isolated cells to differentiate into mineralizing cells showing some characteristics of odontoblast-like cells under these growth conditions highlights the potential of such approaches for tissue engineering strategies for hard-tissue regeneration after injury.     

第三磨牙萌出年龄的调查研究

目的：调查在人群中第三磨牙的萌出年龄，为第三磨牙的研究提供相关资料。方法：采取整群抽样的方法，将第三磨牙的萌出情况依据姜元川文献报道分为一级萌出和萌出，对西安市部分中学和高校学生进行了第三磨牙萌出年龄的调查，调查人数共3831人。结果：第三磨牙的萌出年龄男性上颌为（20．09±1．57）岁，下颌为（20．56±2．16）岁；女性上颌为（19．98±1．51）岁，下颌为（19．84±1．57）岁。女性下颌萌出年龄早于男性（P〈0．05）。30岁前除先天缺失、阻生及萌出特别迟缓的第三磨牙外，能够萌出的第三磨牙已全部萌出。结论：第三磨牙的萌出年龄延迟，萌出率较低，这可能是人类进化过程中第三磨牙退化的结果。     

Role of helper T cells in the humoral immune responses against 53-kDa outer membrane protein from Porphyromonas gingivalis

Outer membrane protein with a 53-kDa molecular weight (Ag53) isolated from Porphyromonas gingivalis evokes strong humoral immune responses in many periodontitis patients. To examine the effects of cytokines produced by Ag53-specific Th cells on the IgG production against Ag53, we established Ag53-specific Th-cell lines from patients with early onset periodontitis and from healthy volunteers. We then developed a mixed lymphocyte culture system between Ag53-specific Th cells and auto- or allo-derived T-cell-depleted leukocytes produced from the subjects whose HLA class II haplotypes were completely matched. Interferon-gamma production was observed in all Th cell lines from patients and healthy subjects. As for Th2 type cytokines, interleukin (IL)-4, IL-5, IL-6 and IL-10 production varied greatly in Th cells regardless of the periodontal condition of the donor. Only Th cell lines with a high Th2/Th1 ratio induced Ag53-specific IgG production when cocultured with T-cell-depleted leukocytes. Thus, the difference in Th2/Th1 balance may regulate the Ag53-specific IgG production.     

One-year clinical evaluation of two composite materials used for anterior class V restorations

The purpose of the current study was to evaluate the clinical performance of two composite materials used for filling anterior cavity preparations. A total of 100 class V cavities of anterior tooth were restored with two different composite materials (Palfique Estelite and Palfique Toughwell, 50 cavities each, respectively) in combination with the same bonding agent (Mac Bond II). Colour match, cavosurface marginal discolouration, recurrent caries, wear, marginal integrity and surface texture were evaluated clinically for all restorations on the basis of the United States Public Health Service (USPHS) criteria immediately after insertion (baseline), after 6 months and after 1 year. In the comparison of baseline to 1-year evaluation, the Palfique Toughwell material showed significant changes in all factors except recurrent caries. The Palfique Estelite material, however, showed neither significant cavosurface marginal discolouration nor recurrent caries. No significant difference (P > 0b05) was observed between the two materials in clinical performance after 1 year, with the exception of caries rate, which was found to be significantly lower in the Palfique Estelite material. It was concluded that both composites were clinically reliable materials when used for anterior class V restorations.