Potential application of shape memory plastic as elastic material in clinical orthodontics

Polynorbornen, a shape memory plastic developed in Japan, has a glass transitional point of 35 degrees C. Once the environmental temperature exceeds the critical point, this plastic will begin to display an elastic property, then return to its original shape, if deformed. We examined whether the force generated during the elastic phase of polynorbornen could be used to displace human teeth. We found that the shape memory plastic wire of 1 mm in diameter stretched to two to three times of its original length at a temperature of 50 degrees C and a speed of 0.5 mm/sec would exert a relatively stable continuous light force of 119-156 g to move the teeth. This new material, compared with conventional elastic modules used in orthodontic therapy, exhibited a lesser degree of force degradation at a body temperature of 37 degrees C for a long period, and can be manufactured to near the tooth colour required. These advantages make feasible clinical application of the shape memory plastic in orthodontics.     

A trigeminal neuralgia-like paroxysmal pain condition presumably due to buccal nerve compression in the temporalis muscle

We encountered three patients with trigeminal neuralgia-like paroxysmal pain in the buccal nerve region. In all cases, paroxysmal pain was felt spreading to the receptive field of the ipsilateral buccal nerve, and clear tenderness was observed during intraoral palpation at the inner side of the mandibular ramus where the temporalis muscle runs and attaches. It was assumed that the paroxysmal pain might be caused by nerve compression related to temporalis muscle hyperactivity. To lend support to this hypothesis, we also studied the anatomical relationship between the buccal nerve and the masticatory muscles. In this autopsy study, the buccal nerve pierced the temporalis muscle in six (12%) of 52 specimens from 26 cadavers. These findings support the hypothesis that peripheral buccal nerve compression could be an etiology of paroxysmal neuropathic pain in the unilateral orofacial region.     

Association of tumor necrosis factor receptor type 2 +587 gene polymorphism with severe chronic periodontitis

BACKGROUND: Genetic polymorphisms for cytokines and their receptors have been proposed as potential markers for periodontal disease. Tumor necrosis factor receptor 2 (TNFR2) is one of the cell surface receptors for TNF-alpha. Recent studies have suggested that TNFR2 gene polymorphism is involved in autoimmune and other diseases. OBJECTIVES: The aim of the present study is to evaluate whether TNFR2(+587T/G) gene polymorphism is associated with chronic periodontitis (CP). METHODS: One hundred and ninety-six unrelated subjects (age 40-65 years) with different levels of CP were identified according to established criteria, including measurements of probing pocket depth (PPD), clinical attachment level (CAL), and alveolar bone loss (BL). All subjects were of Japanese descent and non-smokers. Single nucleotide polymorphism at position +587(T/G) in the TNFR2 gene was detected by a polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLP) method. RESULTS: The frequency and the positivity of the +587G allele were significantly higher in severe CP patients than in controls (p=0.0097; odds ratio=2.61, p=0.0075; odds ratio=3.06). In addition, mean values of PPD, CAL, and BL were significantly higher in the +587G allele positive than in the negative subjects (p=0.035, 0.022, and 0.018, respectively). CONCLUSIONS: These findings suggest that the TNFR2(+587G) polymorphic allele could be associated with severe CP in Japanese.     

Interleukin-6 receptor gene polymorphisms and periodontitis in a non-smoking Japanese population

AIM: The indispensable role of interleukin-6 receptor (IL-6R) in regulating IL-6 responses has been clearly established. We have previously reported that IL6R polymorphisms strongly influenced the serum levels of soluble IL-6R. In this study, we investigated the association between these genetic variations and periodontitis. MATERIAL AND METHODS: Among the seven novel IL6R single-nucleotide polymorphisms (SNPs) reported, we genotyped two important sites: the +48892 A/C in exon 9 and the -183 G/A in the promoter region. The SNP in exon 9 results in Asp-->Ala substitution in the proteolytic cleavage site of IL-6Ralpha. In total, 212 periodontitis cases and 210 healthy controls were genotyped using polymerase chain reaction, restriction fragment length polymorphisms and direct sequencing methods. RESULTS: Analysis of the genotype distribution of the +48892 A/C SNP in periodontitis patients and in controls revealed a suggestive association with aggressive (p = 0.04) and chronic periodontitis (p = 0.04). In addition, the carriage rate for the A allele was significantly higher in chronic periodontitis patients [p = 0.02, odds ratio (OR) = 2.25]. No association was found in the -183 G/A SNP. The two markers were in linkage disequilibrium (LD) (|D'| = 0.53). CONCLUSION: The IL6R+48892 A/C polymorphism could act as a risk factor for periodontitis; however, further association and biological studies are needed.     

An evaluation of self-reported oral health and health-related quality of life

The purpose of this study was to investigate the general and oral health status of patients at a dental hospital in Tokyo and examine the correlations between general health and oral health items. One hundred and seventy-four (174) new patients at the Dental Hospital of Tokyo Medical and Dental University participated in this study. The Visual Analog Scale (VAS) was employed to investigate dental demands and symptoms, as well as satisfaction with oral and general health conditions, while SF-36 served an indicator for health-related quality of life (HRQOL). The results were statistically analyzed at a significance level of p = 0.05. The results of VAS were further examined using factor analysis. Several VAS items showed significant correlations with SF-36 subscales (p<0.05). The factor analysis of VAS items suggested a structure involving three factors: self-cognition of oral status, related function and pain, and dental fear and discomfort. The dental fear and discomfort factor showed no significant correlations with SF-36 subscales (p>0.05). Emotional elements and esthetic demands on dental status, as well as physical symptoms, influence HRQOL. Dental discomfort proved to be independent of general health status and was considered a dental-specific item that needs to be measured separately from general health status.     

Ultrastructural differentiation in the distal ends of ameloblasts from the presecretory zone to the early secretory zone

Morphological differentiation of the distal ends of ameloblasts (AMs) from the late presecretory to early secretory zones of the rat upper incisor was studied by electron microscopy. Preameloblasts (PAs) showed a high columnar shape, with the nucleus located in the basal portion. The Golgi apparatus occupied the supranuclear region with type-1 vesicles, and microvilli were present at the distal cell membrane. Coarse-textured material was observed inside the type-1 vesicles and in the lateral intercellular spaces as well as along the distal cell membrane, whereas fine-textured material was found along the distal cell membrane. Near the region of initial enamel formation, large matrix islands were found in the lateral intercellular space. A thin electron-dense layer was observed on the dentin surface. This layer might have occurred as a result of diffusion after degradation of the coarse- or fine-textured material into a finer substance in the extracellular spaces. In the region of initial enamel formation, the distal cell membrane of AMs was flat, but shallow and narrow membrane invaginations were associated with the cell membrane close to the matrix islands. In the region of inner enamel formation, a cone-shaped Tomes' process was formed between large matrix islands which had developed in the intercellular spaces between the lateral portions of the distal ends of AMs. It was considered that the membrane invaginations which had existed at the distal end of PAs moved lower toward the distal terminal bar, thereafter becoming microvilli.     

The expressions of insulin-like growth factors, their receptors, and binding proteins are related to the mechanism regulating masseter muscle mass in the rat

OBJECTIVE: The mechanism regulating skeletal muscle mass is unclear. The purpose of the present study was to investigate the extent to which insulin-like growth factors (IGFs), their receptors (IGFRs), and binding proteins (IGFBPs) are involved in the regulation of skeletal muscle mass. DESIGN: We measured the mRNA expression levels for IGFs, IGFRs, and IGFBPs in the rat masseter muscle hypertrophied by oral administration of clenbuterol for 3 weeks and determined the correlations between the weight of masseter muscle and the mRNA expression levels. RESULTS: The mRNA expression levels for IGF-I and II, IGFR1 and 2, and IGFBP4 and 6 showed clenbuterol-induced elevations and positive correlations with the weight of masseter muscle. That for IGFBP3 only exhibited a clenbuterol-induced decrease and a strong negative correlation with the weight of masseter muscle. The mRNA expression levels for IGFBP2 and 5 showed no significant changes between the control and clenbuterol groups, and no significant correlations. IGFBP1 mRNA was not detectable. CONCLUSION: These results suggest that IGF-I, II, IGFR1 and 2, and IGFBP3, 4 and 6 are related to the mechanism regulating masseter muscle mass in the rat.     

Effects of age on the stress-strain and stress-relaxation properties of the rat molar periodontal ligament

OBJECTIVE: We examined the stress-strain and stress-relaxation properties of the periodontal ligament (PDL) in the rat molar at 2, 6, 12, and 24 months of age to elucidate age-related changes in the tooth support function of the PDL. DESIGN: From the dissected left and right mandibles in each rat, a pair of transverse sections (ca. 0.45 mm in thickness) of the first molar was cut at the middle part of the mesial root. We then obtained a load-deformation curve for the PDL, using one of the paired sections. The other section was loaded to as much as 50% of the maximum load as determined from the contralateral section, and keeping the deformation constant for 10 min, a load-relaxation curve was obtained and analysed. RESULTS: The maximum shear stress and tangent modulus decreased between 2 and 24 months of age. As the maximum shear strain increased with age (P < 0.001), the failure strain energy density did not change between 2 and 24 months of age. The stress-relaxation during the 10 min period decreased from 2 to 24 months of age (P < 0.01). The relaxation process of the PDL in each age was well described by a sum of three exponential decay functions. The age-related decrease in the relaxation was found to be mainly due to the increase in the relaxation time for the long-term relaxation component. CONCLUSION: These results indicate that the maximum shear stress and stiffness of the rat molar PDL decrease between 2 and 24 months of age; but its toughness remains unchanged due to an increase in the extensibility. Our findings further indicate that the fluid flow and movements of macromolecules within the stretched PDL fibres during the stress-relaxation decrease with advancing age.