Ritually induced growth disturbances and deformities of the orofacial system – A contribution to cranial morphogenesis

Numerous ritual acts involving the skull result in orofacial changes. The present study focuses on ritual acts of Brazilian Zoé Indians. A distinct deformation effect of the ritual act (wearing a lip-plug) on the morphology of the orofacial system is demonstrated and documented using jaw models. The studies show that the lip-plug significantly influences tooth position and jaw growth. While the maxilla displays palatal displacement of the lateral incisors and elevation of the palate, retraction occurs in the mandible depending upon plug size. Additionally, both the plug and the nutritional habits of the Indians induce marked abrasion of all teeth. Moreover, it is shown that the duration of lip-plug wear is an essential determinant of sustained orofacial changes.     

Correlation of MRT imaging with real-time axiography of TMJ clicks

There is a series of tools useful for gathering diagnostic information on patients with temporomandibular joint disorders. Tracings of the joint movement (axiography) provide useful information about the motion of the joints. Since the availability of electronic axiographic tracers, the movement of the condyles can be resolved with high resolution both in space and in time. In order to obtain information about the anatomical relation of the joint surfaces and the disc, magnetic resonance tomography imaging (MRI) is routinely carried out. It is common practice to take MR images of the joints with the mouth closed and fully open. In order to correlate the MR images with the axiographic tracings, a series of images can provide much more information. In this study we examined patients with distinct temporomandibular joint (TMJ) clicks. In one case, the click occurs once a day, while in the other case the click happens every time the mouth is opened. In order to obtain information about both motion and anatomical relation of the TMJ at and around the position where the clicks occur, we recorded a series of MRI scans with the mouth gradually opened and before and after joint clicks. Real-time axiographic tracings during the click were taken with an optimized system where the polar moments were reduced as much as possible to follow the movement during the click. These tracings were correlated with the MRI scans to determine the exact internal conditions of the TMJ and the changes during the click. In particular cases, the additional information provided by this procedure can be useful in deciding whether and which therapeutic intervention is advisable.     

Changes in condylar cartilage after anterior mandibular displacement in juvenile pigs

Adaptive remodelling of the mandibular condyle in response to mandibular advancement is the mechanism exploited by orthodontic forward displacement devices.ObjectiveThis work investigated the expression of collagens, matrix metalloproteinases and vascular endothelial growth factor during this process.DesignTwenty juvenile pigs were randomly divided into two experimental groups, where the treatment group was fitted with mandibular advancement splints, and the control group was not. Changes in the mRNA content of condylar cartilage tissue was then were measured by real-time PCR using specific primers after 4 weeks of treatment.ResultsThe temporal pattern of the expression of Col1 and MMP13 during condylar adaptation coincided with that during natural condylar growth. The amount of the expression of Col10 during condylar adaptation was significantly lower (p < 0.05), whereas the expression of Col2, MMP8 and VEGF was significantly higher compared to natural growth (p < 0.05).ConclusionsIt is suggested that condylar adaptation in growing pigs triggered by mandibular forward positioning results not only from passive adaptation of cartilage, but also involves growth affected processes. Our results showed that mechanical strain produced by mandibular advancement induced remodelling and revascularization in the posteriocranial mandibular condyle. These results are mostly consistent with former published histological and histomorphometrical analyses.     

Effect of excessive methionine on the development of the cranial growth plate in newborn rats

ObjectiveMethionine is an essential amino acid and pivotal for normal growth and development. However, previous animal studies have shown that excessive maternal intake of methionine causes growth restrictions, organ damages, and abnormal growth of the mandible in newborn animals. However, the effect of excessive methionine on the development of the cranial growth plate is unknown. This study investigated histological alterations of the cranial growth plate induced by high methionine administration in newborn rats.DesignTwenty pregnant dams were divided into a control and an experimental group. The controls received a diet for rats and the experimental group was fed from the 18th gestational day with a special manufactured high methionine diet for rats. The high methionine diet was maintained until the end of the lactation phase (day 20). The offspring of both groups were killed at day 10 or 20 postnatally and their spheno-occipital synchondroses were collected for histological analysis.ResultsThe weight of the high-dose methionine treated experimental group was considerably reduced in comparison to the control group at day 10 and 20 postnatally. The cartilaginous area of the growth plate and the height of the proliferative zone were markedly reduced at postnatal day 10 in the experimental group.ConclusionsIn summary, the diet-induced hypermethioninemia in rat dams resulted in growth retardations and histomorphological changes of the spheno-occipital synchondrosis, an important craniofacial growth centre in newborns. This finding may elucidate facial dysmorphoses reported in patients suffering from hypermethioninemia.     

The influence of electron beam irradiation on colour stability and hardness of aesthetic brackets

Electron beam irradiation can be used to improve the mechanical properties of polymers. The aim of this study was to investigate the influence of electron beam irradiation with an energy dose of 100 kGy on the mechanical properties and colour stability of conventional polymer brackets and experimental filled composite brackets. The conventional brackets tested were Aesthetik-Line, Brillant, and Envision. The experimental brackets contained urethane dimethacrylate, as a monomer matrix and functional silane-treated SiO(2) fillers with a filler content of either 10 (Exper 1) or 40 (Exper 2) vol per cent. The influence of electron beam post-curing on Vickers hardness (VH) of the polymer brackets was investigated. Additionally, a possible discolouration of the brackets after electron beam irradiation was determined according to the three-dimensional L* a* b* colour space. The irradiated brackets were compared with untreated control groups. Statistical analysis was performed using the Wilcoxon test. With the exception of Brillant brackets, all investigated brackets showed a significant enhancement of VH after electron beam post-curing. However, the brackets suffered a significant increase in discolouration. Aesthetik-Line brackets showed the highest discolouration, ΔE, and Exper 2 brackets the lowest ΔE values. The discolouration of the examined brackets differed significantly. These results demonstrate that the mechanical properties of polymer brackets could be modified by electron beam irradiation. Nevertheless, clinical use of electron beam post-curing might be restricted because of unacceptable colour changes.     

Expanding the spectrum of PTH1R mutations in patients with primary failure of tooth eruption

Objectives

Primary failure of tooth eruption (PFE) is a rare autosomal-dominant disease characterized by severe lateral open bite as a consequence of incomplete eruption of posterior teeth. Heterozygous mutations in the parathyroid hormone 1 receptor (PTH1R) gene have been shown to cause PFE likely due to protein haploinsufficiency. To further expand on the mutational spectrum of PFE-associated mutations, we report here on the sequencing results of the PTH1R gene in 70 index PFE cases.

Materials and methods

Sanger sequencing of the PTH1R coding exons and their immediate flanking intronic sequences was performed with DNA samples from 70 index PFE cases.

Results

We identified a total of 30 unique variants, of which 12 were classified as pathogenic based on their deleterious consequences on PTH1R protein while 16 changes were characterized as unclassified variants with as yet unknown effects on disease pathology. The remaining two variants represent common polymorphisms.

Conclusions

Our data significantly increase the number of presently known unique PFE-causing PTH1R mutations and provide a series of variants with unclear pathogenicity which will require further in vitro assaying to determine their effects on protein structure and function.

Clinical relevance

Management of PTH1R-associated PFE is problematic, in particular when teeth are exposed to orthodontic force. Therefore, upon clinical suspicion of PFE, molecular DNA testing is indicated to support decision making for further treatment options.     

Effect of ionizing radiation on polymer brackets

Objective

The purpose of this study was to investigate whether the mechanical properties of polymer brackets can be improved without discoloration by electron beam (EB) irradiation applied with a Rhodotron electron accelerator using standard high-energy parameters including a 10 MV acceleration voltage and 100 kGy of energy. We analyzed polymer samples and several commercially available brackets.

Materials and methods

The first group included three polymeric base materials (polyoxymethylene, polycarbonate, polyurethane) currently used in various bracket systems. The second group included five bracket types, three of which are on the market (Aesthetik-Line and Brillant by Forestadent; Envision by Ortho Organizers) while the other two were experimental brackets containing urethane dimethacrylate as a monomer matrix and functional silane-treated SiO₂ fillers with a filler content of 10 or 40 vol%. Each category included 40 specimens previously irradiated by a commercial provider (Beta-Gamma-Service, Bruchsal, Germany) and another 40 nonirradiated controls. The polymer specimens were analyzed for fracture toughness, Vickers hardness, and wear resistance, and the bracket specimens for Vickers hardness and color stability. The Wilcoxon–Mann–Whitney U test was used for pairwise comparison to identify significant differences (p?≤?0.05).

Results

Significant increases in fracture toughness and Vickers hardness were observed in polycarbonate and polyurethane after EB irradiation, while EB irradiation of polyoxymethylene resulted in a significant decrease in these parameters. The polyurethane samples demonstrated significantly less postirradiation wear. All the commercially available brackets except for Brillant revealed significant increases in Vickers hardness. Significant discoloration was observed in all brackets after irradiation.

Conclusion

Although our evaluation of polymer brackets revealed considerable improvements in mechanical properties after EB irradiation, this benefit was marred by very obvious discoloration. We cannot therefore recommend industrial scale EB irradiation for any polymer bracket currently on the market.