Inhibition of the proliferation of human periodontal ligament fibroblasts by hyaluronidase

Hyaluronan (HA) exists in various living tissues as one of the major matrix macromolecules, and is well known to play an integral role in cell differentiation and proliferation. The present study was conducted to elucidate whether or not the proliferation of periodontal ligament (PDL) cells are affected specifically by the degradation of HA by hyaluronidasze (HAase). Human PDL fibroblasts were isolated and cultured with and without 15-150U/ml bovine testicular HAase from 1 to 11 days after seeding. The cells were also cultured with anti-CD44 antibody of 2 microg/ml. For the control against the anti-CD44 antibody treatment, 2 microg/ml IgG was used. The HA-dependent pericellular matrix was visualized by particle-exclusion assay. The number of cells was counted by MTT assay during the proliferation. The mRNA levels of HA synthases (HASs), HAases (HYALs) and CD44s were examined by a quantitative real-time PCR analysis. The cell proliferation was inhibited by the treatment with HAase and anti-CD44 antibody in cultured PDL fibroblasts. HASs mRNAs were down-regulated, whereas HYALs mRNAs were up-regulated significantly by the treatment with HAase and anti-CD44 antibody. The CD44s mRNA level exhibited no significant changes. These results suggest that HA may contribute to modulate the proliferation of cultured human PDL cells through a CD44-mediated mechanism.     

Deafness genes

The pathophysiology of sensorineural hearing impairment, which is a common clinical disorder, remains yet to be determined. For prelingual hearing loss, epidemiological data show that 1 neonate in 1,000 is born with severe to profound hearing loss, and in half of that number the loss is inherited. Some genes responsible for sensorineural hearing impairment have been cloned during the last several years, and the underlying mechanisms causing hearing impairment have begun to be clarified with the advent of recent developments in molecular genetics. Cases of non-syndromic deafness are classified by the mode of inheritance (DFNA, dominant; DFNB, recessive; DFN, X-linked), with the loci being numbered in the order of discovery. To date, 31 autosomal dominant, 28 autosomal recessive, and 6 X-linked non-syndromic sensorineural hearing impairment loci have been mapped, and 17genes have been cloned (Hereditary Hearing Loss Homepage, http://danallab-www.uia.ac.be.dnalab/hhh/). We have identified mutations in four of those 17 deafness genes in Japanese families. Clinical and genetic findings of the above disorders are reviewed.     

Implant-Supported Rehabilitation of the Severely Atrophic Maxilla: A Clinical Report

Implant-supported rehabilitation in the posterior maxillary region presents a series of challenges because of the possibility of increased pneumatization of the maxillary sinus after dental loss. In cases where significant maxillary bone resorption has occurred, efforts center on maximizing the use of the remaining bone to afford primary stability to the implants. This clinical report describes a patient with extreme maxillary atrophy for whom fixed rehabilitation supported on 8 implants was accomplished. A zygomatic implant, a pterygomaxillary implant, and 2 implants mesial and distal to both canine eminences were placed. This rehabilitation was accomplished with a less invasive technique and in a much shorter time period compared to a sinus lift procedure. One year after prosthetic loading, the clinical and radiological results remain satisfactory.     

Dentofacial features of a family with Crouzon syndrome. Case reports

Crouzon syndrome is an autosomal dominant condition characterized by craniosynostosis with associated dentofacial anomalies. This paper describes the variable clinical features in affected individuals over two generations of a family with particular reference to the dentofacial deformities and discussion of management strategies.     

Local ofloxacin delivery using a controlled-release insert (PT-01) in the human periodontal pocket

PT-01, a controlled-release insert, was developed for topical chemotherapy in periodontal disease. It is a soluble insert that consists of fast-release and sustained-release parts containing ofloxacin (OFLX) as an antibacterial agent. In this study, the release profile of OFLX from PT-01 was investigated in vitro. Twelve adult volunteers were administered OFLX as PT-01 or as an aqueous solution into their periodontal pockets, OFLX concentrations in gingival crevicular fluid (GCF) were evaluated from the viewpoint of pharmacokinetics. The in vitro release profile of OFLX from PT-01 showed a biphasic pattern. The release rate of OFLX was relatively rapid in the early phase and slow thereafter. When OFLX aqueous solution was administered into periodontal pockets, the OFLX level in GCF rapidly decreased to be about 1/100 after 30 minutes. When PT-01 was inserted into the pockets, the OFLX level in GCF immediately reached a peak (about 12 mg/ml), and gradually decreased until the 3rd day, and maintained a constant level above 2 micrograms/ml, the effective minimum antibacterial concentration for periodontopathic microorganisms, from the 3rd to 7th day after insertion. No side-effects were observed in the volunteers who received the PT-01 insert. The above results suggest that PT-01 is a suitable pharmaceutical preparation for periodontal chemotherapy.     

Primarily Research

Abstract: Composite materials have become an integral part of the wide range of filling materials currently available. Conditioning is necessary to achieve adequate bonding of the composite material to enamel and dentin. Normally, this is done by applying acid preparations to the dental surfaces. These acids have an etching effect that causes surface roughening. The increasing application of lasers in dentistry has introduced another possibility. Laser irradiation can cause roughening of enamel and dentin surfaces. Another interesting alternative is the so-called kinetic cavity preparation technique. This method also results in distinct surface roughening. The purpose of the present study, was to compare the described methods. Tensile bond strength tests and shear bond tests were carried out to examine the adhesion of a composite material to surfaces treated with these methods. Laser irradiation with certain devices and the air-abrasive technique yielded results similar to those with acid etching.     

Temporalis myofascial flap in maxillofacial reconstruction: clinical and histological studies of the oral healing process

Objectives—To report our experience with temporalis myofascial flaps (TMF), describe the healing process of uncovered flaps in the mouth, and the histology of the repaired mucosa in the long term. Design—Prospective clinical and histological study. Subjects—36 patients who received a TMF over a 6.5 year period for serial assessment of the oral healing, 24 patients whose scars over the reconstructed area were assessed clinically, and 11 whose repaired mucosa was assessed histologically. Main outcome measures—To follow the clinical process of oral healing of the TMF and describe the repaired mucosa healed over the flap. Results—The uncovered TMF in the mouth healed gradually starting with an acute inflammatory phase, going through chronic inflammatory and proliferative phases with eventual epithelialisation of the oral mucosa. There were no major complications. The healed mucosa showed mild scarring in 70% of cases and the repaired mucosa had characteristic histological features that were distinct from the normal mucosa. Conclusion—The TMF is an extremely reliable and versatile flap for maxillofacial reconstruction which heals gradually with eventual coverage by mildly scarred repaired mucosa.     

Anticipating the Future and Change

As in all of medicine, there are basic assumptions underlying the present system of dental education and delivery. These basic assumptions are facing challenges due in part to the marked reduction in the incidence of caries and the development of more effective therapies. This current period of time is described as an era of true change, rather than the mere modification of existing technology. Changes are going to occur in a number of areas. The move will be from government to private, from small to large, from generalist to specialist. Since change is inevitable, one can learn about and prepare for the stress of change, the changes happening now, and how to adapt to change. Although many changes are beyond the individual's control, their occurrence may be beneficial.