Orthodontics & Craniofacial Research最新文献

This review aims to summarise the current understanding of the biological processes involved in socket healing after tooth extraction and the contribution of mesenchymal stem/progenitor cells (MSCs) during these processes. Additionally, it seeks to explore the mechanisms underlying medication-related osteonecrosis of the jaw (MRONJ), often linked to tooth extraction, to provide insights for future research directions. Socket healing is a complex biological process consisting of three phases: inflammatory, proliferative and modelling/remodelling. MSCs, particularly those derived from periodontal ligament (PDL) cells and bone lining cells, are known to play a significant role in the initial and subsequent stages of healing. However, the exact contributions of MSCs from surrounding tissues, such as PDL, alveolar bone marrow and periosteum, remain unclear. Recent advancements in cell lineage tracing techniques have provided new perspectives on the origin and role of MSCs in socket healing. Furthermore, the MRONJ conditions suppress MSC activities and lead to apoptosis, resulting in impaired socket healing. It may contribute to the development of MRONJ. Proper understanding of the cellular and molecular mechanisms underlying socket healing is crucial for improving clinical outcomes in dental procedures and managing complications like MRONJ. Continued research on the roles of MSCs and the application of advanced techniques will enhance therapeutic strategies for socket healing and related conditions.

Objective: It is well-established that occlusion and dental arch form are related to the morphology and function of the oral soft tissues. Oral soft tissue dynamic assessment is important for elucidating the causes of malocclusion and developing effective treatment methods. We previously developed a small mouthguard-type sensing device for measuring oral soft tissue pressure; however, its continuous measurement performance had not been thoroughly evaluated. This study assessed the device's ability to continuously measure tongue pressure applied to the palatal surfaces of the maxillary anterior teeth during multiple swallowing cycles.

Materials and methods: The device consisting of a pressure sensor, wireless communicator and battery was created. Tongue pressure on the palatal surface of the left maxillary central incisor during swallowing was measured during the swallowing of 10 mL of water, repeated 10 times in a row in one subject.

Results: The number of pressure spikes corresponded to the number of swallows, enabling clear discrimination of each swallowing event. The mean tongue pressure per swallow was 181.97 ± 31.84 g/cm², with a maximum of 224.97 g/cm² and a minimum of 137.72 g/cm². The mean tongue pressure per swallow measured was comparable to previously reported values for tongue pressure during swallowing.

Conclusions: The MG-type pressure-sensing device developed in this study successfully measured tongue pressure continuously in one subject. Future studies with an expanded sample cohort will facilitate a comprehensive assessment of the device for its ability to continuously monitor oral soft tissue pressure, which fluctuates throughout the day over extended periods.

Objective(s): In this pilot study, exosomes from saliva were isolated and tested for the presence of metabolomic biomarkers for physiological external root resorption and/or pathological alveolar bone resorption.

Settings and sample population: Saliva samples of 20 individuals in the mixed dentition stage of dental development.

Materials and methods: Saliva was obtained from healthy control children with resorbing primary teeth or children with localised aggressive periodontitis (LAP) showing alveolar bone loss but little root resorption. Exosomes were isolated by differential centrifugation and analysed by electron microscopy, nanoparticle tracking analysis (NTA) and enzyme-linked immunosorbent assay (ELISA). Subsequently, exosomes were subjected to mass spectrometry to identify and quantitate metabolites. Differences between groups were statistically determined.

Results: Over 2000 metabolites were detected in salivary exosomes. Metabolites that differed significantly between exosomes from the saliva of LAP patients and controls included L-pipecolic acid, acetylcholine, creatinine, N-acetylneuraminate and numerous unidentified molecules.

Conclusion: This pilot study provided a proof-in-principle for using metabolites from salivary exosomes as biomarkers.

Management of class III malocclusion in patients with cleft is geared toward improving the maxillary position with maxillary protraction therapy with or without bone anchorage. This study aims at evaluating the effects of bone-anchored maxillary protraction (BAMP) and tooth-anchored maxillary protraction (TAMP) appliances in patients with cleft lip and palate (CLP). A search of PubMed MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science, ProQuest Dissertations and Theses Global, and ClinicalTrials.gov registry was performed. Prospective studies that evaluated the effect of BAMP and/or TAMP therapy in patients with CLP were screened. A meta-analysis was performed for the cephalometric parameters evaluating sagittal (SNA, SNB, ANB and Wits appraisal), vertical (mandibular plane angle), and dentoalveolar (U1 to PP, IMPA, overjet and overbite) effects following the BAMP or TAMP. Database research, elimination of duplicate studies, data extraction and risk of bias (RoB) assessment were performed by authors independently and in duplication. A random-effect meta-analysis was performed to evaluate the sagittal, vertical and dentoalveolar effects. BAMP increased SNA angle by 1.76 degrees (95% CI: 1.03 to 2.49), ANB angle by 2.08 (95% CI: 0.99 to 3.18), Wits appraisal by 2.17 mm (95% CI: 1.05 to 3.28), and overjet reduction by 2.03 mm (95% CI: 0.98 to 3.08). TAMP increased SNA by 2.56° (95% CI: 1.58 to 3.54), ANB angle by 4.40° (95% CI: 3.61 to 5.18), Wits appraisal by 5.53 mm (95% CI: 4.27 to 6.79). However, TAMP decreased SNB by 2.00° (95% CI: -2.61 to -1.39) and increased mandibular plane angle by 2.75 (95% CI: 1.73, 3.76). Sagittal correction is expected with BAMP and TAMP therapy in children with CLP. However, pronounced vertical or dentoalveolar side effects are expected with TAMP compared to BAMP therapy. Trial Registration: This systematic review was based on the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0, was registered at the PROSPERO database (CRD42021247529), and reported according to the PRISMA statement.

Hyperdivergent skeletal Class II malocclusion is largely genetically determined and poses significant challenges in orthodontic treatment, particularly due to compromised facial aesthetics, reduced bite force and airway narrowing. Traditionally, orthognathic surgery has been the standard treatment for correcting such skeletal discrepancies. However, the advent of temporary skeletal anchorage devices (TSADs) has expanded the possibilities for orthodontic camouflage by allowing effective vertical control. This narrative review outlines key diagnostic considerations-including vertical maxillary excess (VME) and its regional distribution, mandibular morphology and rotational pattern, overbite depth and occlusal plane steepness-that determine the selection of treatment targets and mechanics. Based on these factors, the treatment target may be limited to just posterior intrusion or might be expanded to total arch intrusion, involving either the maxillary arch alone or both arches. Treatment mechanics vary accordingly, with diverse TSAD placement strategies and the use of adjunctive appliances to enhance control. Clinical studies have reported successful skeletal changes such as counterclockwise mandibular rotation and improved overbite. Total arch intrusion, particularly in patients without anterior open bite, requires proportionally greater incisor intrusion and often involves dual-arch mechanics. The 'double arch intrusion' technique provides a simplified and efficient protocol using a minimal number of TSADs. Long-term outcomes of such camouflage treatments are comparable to surgical approaches, with most relapse occurring within the first year. Proper retention strategies are essential for maintaining stability.

Aim: To evaluate the association between vertical and sagittal facial profile characteristics and the diagnosis/severity of Obstructive Sleep Apnea (OSA) based on hospital-based polysomnography (PSG) in children attending their first orthodontic visit.

Materials and methods: 3671 children aged 7 to 9 years who attended a private practice for a first orthodontic consultation were included. Apnea/Hypopnea Index (AHI) was measured from PSG, while vertical and skeletal facial profile characteristics were assessed according to the Modified Sassouni Analysis on lateral cephalogram. Analysis of Variance (ANOVA) was used to compare sagittal and vertical patterns among patient subgroups divided according to AHI (AHI = 0, AHI 1-3, AHI 4-5, AHI 6-10, AHI ≥ 11).

Results: No statistically significant difference was found in the AHI according to gender (p = 0.84) and age (p = 0.61). It was observed that 87.3% of children with AHI ≥ 11 had a long facial pattern, whereas those with low AHI values (AHI = 0 or 1 ≤ AHI ≤ 3) were mostly classified as having a normal vertical pattern (p < 0.001). Furthermore, children with AHI ≥ 11 presented with a Class II facial profile or maxillomandibular retrusion, while children with maxillomandibular protrusion and a Class I profile had lower AHI values (AHI = 0 or 1 ≤ AHI ≤ 3, p < 0.001).

Conclusions: Class II profile, maxillomandibular retrusion, and increased anterior lower facial height are highly present in severe OSA children between the ages of 7 to 9 years. Therefore, orthodontists are encouraged to consider the possibility of breathing issues in children presenting with such craniofacial features.