Abnormal Occlusion Research Articles

CD11b+Gr-1+ myeloid-derived suppressor cells reduce atherosclerotic lesion development in LDLr deficient mice.

Myeloid-derived suppressor cells (MDSCs) form a heterogeneous population of cells composed of early myeloid progenitor cells and immature myeloid cells, which strongly suppress pro-inflammatory immune cells in inflammatory diseases. Currently, it is unknown whether MDSCs contribute to atherosclerosis, a chronic inflammatory disease in which accumulation of lipoproteins in the arterial wall activates the immune system causing abnormal vascular remodelling and vessel occlusion. Here, we investigated whether and how MDSCs contribute to the development of atherosclerosis. We show that MDSCs arise in the bone marrow of LDLr(-/-) mice during atherosclerosis and strongly suppress proliferation of T cells. Adoptive transfer of MDSCs into both female and male LDLr(-/-) mice fed a Western-type diet (WTD) ameliorates atherosclerosis with 35%. We observed a 54% reduction in adventitial T cells, and more specifically, MDSCs suppress Th1 and Th17 cells. In addition, treatment with MDSCs reduces circulating pro-atherogenic B2 cells. We found two subsets of MDSCs in the bone marrow of hypercholesterolemic mice, monocytic and granulocytic MDSCs (mo- and gr-MDSCs, respectively), of which the percentage of mo-MDSCs significantly increased during WTD feeding. Moreover, mo-MDSCs completely abolished splenocyte proliferation, whereas gr-MDSCs were unable to suppress proliferation. Mechanistically, we show that MDSCs from atherosclerotic mice suppress T cells in an IFN-γ- and nitric oxide-dependent manner, which is associated with the action of mo-MDSCs. This study demonstrates that MDSCs develop during atherosclerosis and reduce atherosclerosis via suppression of pro-inflammatory immune responses.

THE ROLE OF TEMPOROMANDIBULAR JOINT DYSFUNCTION AND OCCLUSAL DISORDERS IN THE PATHOPHYSIOLOGY OF SOMATOGENIC COCHLEAR AND VESTIBULAR SYNDROME

Rationale: Temporomandibular joint (TMJ) dysfunction and occlusion abnormalities can cause cochlear and vestibular disorders. This issue is at the crossroads of several disciplines: otoneurology, physiotherapy, dentistry, medical rehabilitation and posturology, which often makes it difficult to timely diagnose them and delays the onset of treatment. Aim: To assess the role of abnormal dental occlusion and TMJ disorders in the pathophysiology and clinical manifestation of cochleovestibular syndrome. Materials and methods: We examined 300 subjects with clinical signs of cochleovestibular syndrome, asymmetry of occlusion and/or TMJ dysfunction (the main group), 55 patients with signs of TMJ structural and functional disorders and occlusal disorders without a cochleovestibular syndrome (the reference group), and 35 healthy volunteers (the control group). All patients were examined by a neurologist, an ENT specialist, a dentist and a physiotherapist. A series of additional investigations of the brachiocephalic vessels, cervical spine, TMJ, auditory and vestibular function, premature tooth contacts were performed. Results: The main group patients had high values of TMJ dysfunction in the Hamburg test (5.85 vs 2.2 in the reference group) and higher proportions of patients with moderate and severe TMJ dysfunction (n = 243, 81% and n = 13, 23.7%, respectively). The functional muscle test parameters and the results of manual muscle testing in the main group patients were significantly different from those in the control group (р < 0.05), whereas most values obtained in the reference group did not differ significantly (р > 0.05). Patients with cochleoves-tibular syndrome had 2 to 3-fold higher rates of vertebrogenic dysfunctions than those from the reference group. The video nystamography technique detected the positional cervical nystagmus in 100% (n = 300) of patients from the main group, whereas there were no nystagmus in those from the reference group. Voluntary dental occlusion in the main group patients was associated with a deterioration of postural tests in 61.8% (n = 185) of patients; in the reference group patients these parameters deteriorated in 38.2% (n = 21) of cases. According to T-SCAN assessment, 300 (100%) patients from the main group had in imbalance of total distribution of the occlusion force (р < 0.05 compared to the control group). The biggest number of patients from the main group (73.7%, n = 221) had an imbalance of occlusion force within 20 to 40%, and in most patients from the reference group this parameter was in the range of 10 to 30% (85.5%, n = 47), with 14.5% (n = 8) of this group having a normal balance of the occlusion force. Cerebrovascular reactivity parameters measured by ultrasound Doppler technique demonstrated a moderately significant (р < 0.05) strain of the cerebral hemodynamic reserve in the posterior arterial system in patients with cochleovestibular syndrome. Conclusion: Cochleovestibular disorders can be caused by a dysfunction of the dentoman-dibular system and/or cervical / masticatory myofascial syndrome. After exclusion of any otogenic pathology in patients with cochleovestibular syndrome, their neurological examination should include a visual assessment of the occlusion and mandibular movements, as well as testing of the cervical and masticatory muscles. If any abnormalities of occlusion and/or TMJ and local muscle dysfunction are revealed, then a dentist and a physiotherapist consultation should be performed.

PENGARUH PENGETAHUAN ORANG TUA TENTANG ORTODONSI PREVENTIF DENGAN PERILAKU PENCEGAHAN MALOKLUSI PADA GIGI ANAK

Background: Malocclusion is abnormal occlusion which signed the unsimetric position of its teeth that caused by genetic factor, unappropiate development, bad habit and malnutrition. The children who got malocclusion problem doesn,t need any attention because children usually still lack of responsbility to take care the dental problem. That,s why the role of parents is very needed. Parents knowledge about preventive ortodensi can make easier to prevent children malocclusion. Purpose: The purpose of this research is to know the influence of parents knowledge about preventive ortodensi to prevent children malocclusion. Method: This research using analitic observational with survey cross sectional method. Data comes from kuisioner. The parents knowledge means everything about the prevention of malocclusion, meanwhile preventive action is the action to handle malocclusion itself. wIlcoxon experiment is used for analitical tool with p < 0.05. Result: The result shown that the parents knowledge about ortodensi will appear better to parents who got the bachelor or diploma degree (65.9%). And preventive action for malocclusion also shown better from parents with bachelor or diploma degree also (71.05%). Conclusion: The conclusion is the influence of parents knowledge about malocclusion prevention in children teethwith level of (p=0.001) with confident level 90%.

Systemic administration of strontium or NBD peptide ameliorates early stage cartilage degradation of mouse mandibular condyles

To determine whether mandibular condylar cartilage degradation induced by experimentally abnormal occlusion could be ameliorated via systemic administration of strontium or NBD peptide. Six-week-old female C57BL/6J mice were used. From the seventh day after mock operation or unilateral anterior crossbite (UAC) treatment, the control and UAC mice were further respectively pharmacologically treated for 2 weeks or 4 weeks of saline (CON + Saline and UAC + Saline groups), SrCl2 (CON + SrCl2 and UAC + SrCl2 groups) or NBD peptide (CON + NBD peptide and UAC + NBD peptide groups). Changes in condylar cartilage and subchondral bone were assessed 21 and 35 days after mock operation or UAC procedure by histology and micro-CT. Real-time PCR and/or immunohistochemistry (IHC) were performed to evaluate changes in expression levels of col2a1, aggrecan, ADAMTS-5, tnf-α, il-1β, nfkbia, nuclear factor-kappaB phospho-p65 in condylar cartilage, and rankl/rank/opg in both condylar cartilage and subchondral bone. Cartilage degradation with decreased col2a1 and aggrecan expression, and increased ADAMTS-5, tnf-α/il1-β, nfkbia and NF-κB phospho-p65 was observed in UAC + Saline groups. Subchondral bone loss with increased osteoclast numbers and decreased opg/rankl ratio was found in UAC + Saline groups compared to age-match CON + Saline groups. Cartilage degradation and subchondral bone loss were reversed by treatment of SrCl2 or NBD peptide while the same dosage in control mice induced few changes in condylar cartilage and subchondral bone. The results demonstrate reverse effect of systemic administration of strontium or NBD peptide on UAC-induced condylar cartilage degradation and subchondral bone loss.

β2-Adrenergic signal transduction plays a detrimental role in subchondral bone loss of temporomandibular joint in osteoarthritis.

The present study tested whether activation of the sympathetic tone by aberrant joint loading elicits abnormal subchondral bone remodeling in temporomandibular joint (TMJ) osteoarthritis. Abnormal dental occlusion was created in experimental rats, which were then intraperitoneally injected by saline, propranolol or isoproterenol. The norepinephrine contents, distribution of sympathetic nerve fibers, expression of β-adrenergic receptors (β-ARs) and remodeling parameters in the condylar subchondral bone were investigated. Mesenchymal stem cells (MSCs) from condylar subchondral bones were harvested for comparison of their β-ARs, pro-osteoclastic gene expressions and pro-osteoclastic function. Increases in norepinephrine level, sympathetic nerve fiber distribution and β2-AR expression were observed in the condylar subchondral bone of experimental rats, together with subchondral bone loss and increased osteoclast activity. β-antagonist (propranolol) suppressed subchondral bone loss and osteoclast hyperfunction while β-agonist (isoproterenol) exacerbated those responses. MSCs from experimental condylar subchondral bone expressed higher levels of β2-AR and RANKL; norepinephrine stimulation further increased their RANKL expression and pro-osteoclastic function. These effects were blocked by inhibition of β2-AR or the PKA pathway. RANKL expression by MSCs decreased after propranolol administration and increased after isoproterenol administration. It is concluded that β2-AR signal-mediated subchondral bone loss in TMJ osteoarthritisis associated with increased RANKL secretion by MSCs.

Tratamiento médico quirúrgico de una secuela de fractura mandibular infectada: reporte de caso

Aproximadamente 22 millones de niños sufren lesiones anualmente en el mundo, el 12% es resultado de traumas. Las fracturas mandibulares se encuentran entre ellas pudiendo, potencialmente, generar complicaciones en la erupción dental, pérdidas de dientes, alteración de la oclusión, crecimiento y desarrollo facial. Las causas frecuentes son caídas, accidentes deportivos y vehiculares. El diagnóstico es complejo, por la poca colaboración de los pacientes. Existen controversias respecto al tratamiento en pediátricos. Estas fracturas deben ser tratadas lo antes posible, teniendo en cuenta la edad, ubicación de la fractura, tiempo, etc. Se pueden presentar algunas complicaciones postoperatorias como: infecciones, alteraciones en la sensibilidad, deformidades faciales, etc. Se reporta el manejo médico quirúrgico de un paciente pediátrico, con diagnóstico de proceso infeccioso moderado agudo, asociado a secuelapostquirúrgica de fractura mandibular. Fue tratado en el Servicio de Cirugía Oral y Maxilofacial de la Facultad de Estomatología de la Universidad Peruana Cayetano Heredia. Lima-Perú. Conclusiones: Lasfracturas en el cuerpo mandibular rara vez infl uyen en el crecimiento óseo si el tratamiento es realizado rápida y correctamente. Las miniplacas reabsorbibles y metálicas son recomendables de acuerdo aloperador para las fracturas maxilofaciales, no influyendo en las complicaciones postoperatorias.

Reducing dietary loading decreases mouse temporomandibular joint degradation induced by anterior crossbite prosthesis

Purpose: Loading on temporomandibular joint (TMJ) originates from the contraction of jaw-closing muscles. Variations in food properties, such as volume or hardness, will initiate different levels of masticatory muscle contraction via periodontal-muscular reflex, leading to differences in levels of occlusal force and TMJ loading. Soft diet will cause growing rats a thinning cartilage, enhanced cartilage catabolic activity and decreased subchondral bone volume fraction in condyles. Aberrant biomechanical stimulation from abnormal dental occlusion plays an important role in TMJ osteoarthritis (OA) development. Incisors of rodent animals function more than other teeth because when a rodent catches or cuts foods they used to move the mandible in the sagittal direction following the incisal guidance. Unilateral anterior crossbite prosthesis will heavily interfere with this function because the totally opposite guidances will be provided by the normal incisor pair and the crossbite incisor pair while the TMJ can support only one pattern of them at the same time. A small-size diet may diminish the requirement of the cutting function of incisors, and thus may reduce the harmful biomechanical stimulation from the anterior crossbite prosthesis. Hence, in the present study, we exposed the mice that received the unilateral anterior crossbite prosthesis to a small-size versus a large-size diet. The aim was to test whether mice receiving soft diet have a decreased TMJ degradation induced by the unilateral anterior crossbite prosthesis using our reported methods. Methods: Forty 6-week-old female C57BL/6J mice were randomly divided into two experimental and two control groups (n = 10), one experimental and one control group received small-size diet, less than 3mm thick and the other two groups received large-size diet, about 12.5mm in diameter and 15-20mm in length. For experimental groups, metal tubes made of pinheads were bonded onto the mouse left maxillary and mandibular incisors to create unilateral anterior crossbite relationship. For the control groups, the mice underwent the similar procedures but no metal tubes were bonded. No differences in degrading changes were found between the left side and right side TMJs in the experimental mice as we reported. Left side TMJ tissue blocks from six mice of each group were fixed, decalcified and embedded in paraffin. Sagittal sections were prepared for Hematoxylin & Eosin (H-E) staining, toluidine blue staining, Safranin O staining, tartrate-resistant acid phosphatase (TRAP) staining and immunohistochemical staining of Collagen II, OPG and RANKL. For each group, the condylar cartilages and subchondral bones of the other 14 TMJs were respectively separated and preserved at -80°C. Four to five condyles from 3 or 4 different mice were pooled to create a single sample of the cartilage or subchondral bone respectively for RNA extraction to compare the mRNA expression levels of Col2a1, Aggrecan, ADAMTS-5, RANK, OPG, RANKL. Differences were set at 0.05 level (α=0.05). Results: Thinner and degraded cartilage, reduced cartilage cellular density, decrease in toluidine blue staining (reflecting reduced proteoglycan levels) in cartilage, decreased expression levels of Collagen II and Aggrecan, loss of subchondral bone assessed by histomorphometry, and enhanced osteoclast activity were observed in both experimental groups. However, the cartilage degradation phenotype was less severe and cartilage ADAMTS-5 mRNA was lower while OPG/RANKL ratio in both cartilage and subchondral bone was higher in the small-size diet than the large-size experimental group. In contrast, no differences of histomorphology and OPG/RNAKL expression were found in the two control groups. Conclusions: The current findings suggest that a lower level of functional loading by providing small-size diet could reduce TMJ degradation induced by the biomechanical stimulation from abnormal occlusion.

One-Stage Treatment to Condylar Osteochondroma Combined With Secondary Jaw Bone Deformities by Sliding Vertical Ramus Osteotomy and Mandibular Contouring

Osteochondroma of the mandibular condyle could cause secondary facial asymmetry; besides, it could affect the function of the temporomandibular joint (TMJ) and occlusion. Conventional treatments include total condylectomy or local resection of the lesion and condylar reconstruction. But it cannot effectively ameliorate the facial asymmetry. Thus, this article presents the application of combination surgeries including condylectomy, sliding vertical ramus osteotomy, and mandibular contouring in the treatments of this kind of disease. From 2007 to 2012, 12 patients with osteochondroma of the mandibular condyle were included. All of them accepted condylectomy, sliding vertical ramus osteotomy, and mandibular contouring at 1 stage. Mandibular contouring included mandibular inferior border ostectomy, mandibular outer cortex ostectomy, and horizontal osteotomy genioplasty according to the characters of jaw deformity. In addition, maximal mouth opening, pain in the TMJ, and numbness of the lower lip were recorded preoperatively and postoperatively to evaluate the therapeutic effects. All of patients obtained satisfactory results; TMJ dysfunction, facial asymmetry, and abnormal occlusion were improved greatly. No patients developed recurrence of the tumor during the follow-up period. In conclusion, after condylectomy, sliding vertical ramus osteotomy and mandibular contouring were operated at 1 stage, which effectively ameliorated the condylar osteochondroma patient's facial asymmetry and abnormal occlusion and achieved good therapeutic effects.

Mandibular growth comparisons of Class I and Class II division 1 skeletofacial patterns

To determine class and sex differences in mandibular growth and modeling. A mixed-longitudinal sample of 130 untreated French-Canadian adolescents, 77 (45 boys and 32 girls) with Class I (normal or abnormal) occlusion and 53 (26 boys and 27 girls) with Class II division 1 malocclusion, was used. Based on eight landmarks, eight traditional measurements were used to compare the anteroposterior position of the maxilla and mandible, relationship between the jaws, and mandibular size. Mandibular superimpositions were used to compare the horizontal and vertical changes of condylion, gonion, and menton. While there were no differences in maxillary position based on the SNA angle, Class IIs had more retrognathic mandibles than did Class Is. Total mandibular length was greater in Class Is than in Class IIs at 15 years of age. Superior and total growth and modeling changes at condylion and gonion, respectively, were greater for Class Is than Class IIs. Boys were more prognathic than girls; they had larger mandibles and exhibited greater size increases and growth changes than girls did. There are both class and sex differences in mandibular growth and modeling.

Nonsyndromic oligodontia: A rare case report

Oligodontia is generally defined as agenesis of six or more teeth excluding the third molars. It is a rare finding which has not been frequently documented in Indian children. Most often oligodontia appears as a part of some congenital syndromes. The exact etiology for oligodontia is unknown. The consequences of missing teeth include abnormal occlusion or altered facial appearance, which can cause psychological distress in some patients.

Reducing dietary loading decreases mouse temporomandibular joint degradation induced by anterior crossbite prosthesis

Dietary loading has been reported to have an effect on temporomandibular joint (TMJ) remodeling via periodontal-muscular reflex. We therefore examined whether reducing dietary loading decreased TMJ degradation induced by the unilateral anterior crossbite prosthesis as we recently reported. Forty 6-week-old female C57BL/6J mice were randomly divided into two experimental and two control groups. One experimental and one control group received small-size diet and the other two groups received large-size diet. Unilateral anterior crossbite prosthesis was created in the two experimental groups. The TMJ samples were collected 3 weeks after experimental operation. Histological changes in condylar cartilage and subchondral bone were assessed by Hematoxylin & Eosin, toluidine blue, Safranin O and tartrate-resistant acid phosphatase staining. Real-time polymerase chain reaction (PCR) and/or immunohistochemistry were performed to evaluate the expression levels of Collagen II, Aggrecan, a disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS-5) and RANKL/RANK/OPG in TMJ condylar cartilage and/or subchondral bone. Thinner and degraded cartilage, reduced cartilage cellular density, decreased expression levels of Collagen II and Aggrecan, loss of subchondral bone and enhanced osteoclast activity were observed in TMJs of both experimental groups. However, the cartilage degradation phenotype was less severe and cartilage ADAMTS-5 mRNA was lower while OPG/RANKL ratio in cartilage and subchondral bone was higher in the small-size than large-size diet experimental group. No differences of histomorphology and the tested molecules were found between the two control groups. The current findings suggest that a lower level of functional loading by providing small-size diet could reduce TMJ degradation induced by the biomechanical stimulation from abnormal occlusion.

Aspects of Orthodontic-Prosthetic Rehabilitation of Dentofacial Anomalies

Skeletal class III malocclusion is one of the most difficult dentofacial anomalies, characterized by deviation in the development of the mandible and maxilla in the sagittal plane, where the mandible is dominant in relation to the maxilla. In patients with class III malocclusion, anomalies in the dentoalveolar level and esthetic discrepancies are also frequent. The etiology of class III malocclusion is multifactorial due to the interaction of hereditary and environmental factors. Rehabilitation and treatment of malocclusion is one of the major goals of modern dentistry. This article presents the orthodontic-prosthetic therapy and rehabilitation of a 45-year-old patient with an abnormal occlusal vertical dimension and a skeletal class III malocclusion. The patient came to the clinic complaining about degraded esthetics and disordered functions of the orofacial region (functions of eating, swallowing, speech) and also pain in the temporomandibular joint. After the diagnosis was made, the patient was first referred to orthodontic treatment with fixed orthodontic appliances (self-ligating brackets system Rot 0.22). Upon completion of the orthodontic treatment, the patient was sent for further prosthetic treatment. Fixed prosthetic restorations were made in the upper and lower jaw, thus achieving a satisfactory result in terms of esthetics and function of the stomatognathic system.

Effect of a hyperbolide mastication apparatus for the treatment of severe sleep bruxism in a child with cerebral palsy: Long-term follow-up

Sleep bruxism is common among the various oromotor alterations found in individuals with cerebral palsy (CP). Few studies have investigated the use of the mastication device denominated "hyperbola" (HB) and none was found describing the use of such a device for the treatment of bruxism in children with CP. The aim of the present study was to evaluate the effect of the HB on electromyographic (EMG) activity in the jaw-closing muscles and the reduction in sleep bruxism in a child with CP using surface EMG analysis before and after nine months of treatment. A seven-year-old boy with severe spastic CP and sleep bruxism was enrolled in this study. The HB was chosen as the treatment option for sleep bruxism in this case because the child did not accept an occlusal splint. The HB has a hyperbolic shape and is made of soft, non-toxic, odorless, tasteless silicone. There are five different sizes of HB manufactured based on the diversity of tooth sizes. This device produces proprioceptive excitation in the dentoalveolar nerve, spindles and Golgi tendon organs. HB has been employed for the treatment of temporomandibular disorder, abnormal oro-dental development, abnormal occlusion, xerostomy, halitosis and bruxism. HB therapy was performed for 5min six times a day over a nine-week period. Surface EMG of the mandible at rest and during maximum contraction was performed on the masseter and temporalis muscles bilaterally to evaluate electromyographic activity before and after nine months of HB usage. HB usage led to a visible tendency toward the reorganization of mastication dynamics, achieving a marked balance in electromyographic activity of the jaw-closing muscles and improving the child's quality of life. Based on the findings of the present study, this noninvasive therapy may be useful for individuals with cerebral palsy due to its positive effects and low cost, which allows its use in the public health realm. Further clinical studies with a larger sample size are needed to validate these results and allow the development of a new treatment protocol for patients with spastic cerebral palsy.

The effectiveness of local anesthetic and sodium hyaluronate injection for the posterior disc displacement: A case report

Posterior disc displacement of the temporomandibular joint is rare. We present a unique treatment method and magnetic resonance (MR) images of this condition. The patient was a 43-year-old male with a chief complaint of abnormal occlusion. Regarding the present status, there was no occlusion on the right side. No temporomandibular joint pain, myalgia, or clicking were observed while mouth opening. On MR images, the posterior disc displacement without reduction on the right was observed and it was assumed that occlusal abnormality was due to this condition. We treated him with the following methods. After injection into the superior articular cavity with 2% lidocaine, a sodium hyaluronate preparation was injected followed by intermaxillary traction applied using rubber. The recovery of occlusion was confirmed in follow-up at 5 days after treatment. In the 13th days, the intermaxillary traction was removed. On MR images, the right disc condition was changed to anterior disc displacement with reduction. We consider our treatment methods are effective for this clinical condition.

The Development of an Oral Health Charting System for Koalas(Phascolarctos Cinereus)

The koala is one of Australia's most highly specialized folivores with a diet exclusively of eucalyptus leaves to provide all nutritive needs and therefore requires to be free of oral disease as they are dependent on good dentition for optimal health and quality of life. We developed an oral examination methodology based on protocols for companion animals and human dentistry to chart the oral health of koalas. Thirty free-ranging koalas from South-East Queensland, Australia were examined for general body and oral health. Inspection of the oral cavity was conducted for the presence or absence of the indicators oforal disease such as caries or periodontal disease. Univariate and multivariate analyses were performed on the examination data and a prototype oral health chart developed. The prototype was then trialled and the methodology validated by the Kappa statistic using ten additional koalas examined by four multidisciplinary personnel involved in koala care. Trauma associated fractures, tooth displacement, abnormal occlusion and tooth wear compacted vegetation, extrinsic stain deposits, periodontal bone loss, gingivitis, tooth mobility, and calculus were present in the oral cavities of the examined koalas. A system of scoring between 0 and 3 was constructed in accordance with current koala general health charting formats. Validation of the charting method using Kappa coefficients of agreement statistics indicated that there was a good agreement among observers on recorded results except for inflammation and calculus scoring. Modifications were made and visual aids and index scales produced to further assist observers. Oral health surveillance has been proven in other species to be significant in diagnosing physiological disturbances derived from environmental genetic, and developmental causes. Veterinarians, dental researchers, and koala husbandry personnel will benefit in using this charting method and reporting the oral health of koala populations in their future findings. This unique form of oral health monitoring would be adaptable to other mammals.

Effects of obstructive sleep apnea hypopnea syndrome in children on multiple systems

Obstructive sleep apnea-hypopnea syndrome (OSAHS) may cause serious morbidities, such as systemic hypertension, diabetes, and cor pulmonale. However, currently no many reports on study of OSAHS in children are available. This study aimed to explore the effects of OSAHS on children's multiple systems. A total of 89 cases of children who came to the Sleep Treatment Center in the authors' hospital from March 2009 to December 2010 with snoring were tested with overnight polysomnography (PSG). They were classified into mild OSAHS group (n = 59, mean age of 5.71, SD = 2.46) and moderate to severe group (n = 30, mean age of 5.30, SD = 2.73) based on the PSG results, and 100 healthy children were selected as the control group (n = 100, mean age of 6 years, SD = 2.98). Data including height, weight, body mass index and blood pressure, peripheral blood routine, blood lipids, glucose and insulin, electrocardiogram and echocardiography were collected. Patients' adenoid face and abnormal occlusion were also recorded. Comparisons of the data were made among those groups. Mild OSAHS and moderate to severe group had significantly higher prevalence of adenoid face (23.7%, 26.7%), and abnormal occlusion (74.6%, 60.0%) than that in control group (0, 40%) (P < 0.05). There were no significant differences in terms of BMI between the OSAHS group and the control group, but the weight (kg) and height (cm) in the mild OSAHS group (23.3 ± 10.1, 114.9 ± 16.2) and moderate to severe group (21.9 ± 8.4, 110.8 ± 13.3) were lower than those of the control group (31.8 ± 10.1, 136.1 ± 15.1) (all P < 0.05). Compared with the control group, the level of HDL-C (mmol/L)and insulin (mU/L) in moderate and severe group decreased [(1.20 ± 0.30) vs. (1.40 ± 0.27), 2.79 (0.84 - 16.16) vs. 4.92 (0.76 - 16.80), P < 0.05], while the LDL-C (mmol/L) increased [(2.61 ± 0.75) vs. (2.32 ± 0.62), P < 0.05]. The red blood cell counts (× 10(12)/L) and the blood platelet counts (× 10(9)/L) in the mild OSAHS (4.93 ± 0.37, 292.92 ± 75.64) and moderate and severe OSAHS group (5.23 ± 0.22, 292.50 ± 63.05) were significantly higher in contrast to the control group (4.70 ± 0.31, 255.60 ± 69.12) (all P < 0.05), systolic blood pressure (mmHg) in mild group (98.54 ± 10.44) and moderate to severe group (99.13 ± 19.13) was significantly higher compared to control group (87.88 ± 11.37), and the heart rate (beats/min) in moderate to severe group (94.43 ± 10.64) was higher than those in control group (87.12 ± 16.20) (all P < 0.05). The mild OSAHS and moderate and severe OSAHS group had decreased right ventricular internal diameter [(14.24 ± 1.64) mm, (13.17 ± 2.07) mm ], increased main pulmonary artery diameter [(17.05 ± 3.33) mm, (16.33 ± 3.14) mm] and the thickness of right ventricular wall [(3.43 ± 0.26) mm, (3.57 ± 0.20) mm] compared to control group [ (16.10 ± 2.96) mm, (14.11 ± 2.52) mm, (3.32 ± 0.25) mm] (all P < 0.05). OSAHS in children may be associated with craniofacial malformations, and may contribute to slow growth and development, elevated blood viscosity and blood pressure, metabolic abnormalities, and change cardiac structure.

8A45 不正咬合に基づく頭部・頸部・胸背部の筋骨格系の力学場の解析(OS09 デンタルバイオメカニクス)

8A45 不正咬合に基づく頭部・頸部・胸背部の筋骨格系の力学場の解析(OS09 デンタルバイオメカニクス)

Non syndromic gingival fibromatosis in a mild mental retardation child

Gingival fibromatosis is a benign oral condition characterized by enlargement of gingival tissues. It usually develops as an isolated disorder but can be one of the features of a syndrome. This case report is of a 5-year-old male with severe gingival hyperplasia and mild mental retardation which was complicated by open bite, abnormal occlusion, open lip posture, and disabilities associated with mastication and speech. Full mouth gingivectomy in single sitting under general anesthesia was done with electrocautery.

Hereditary gingival fibromatosis: Report of four generation pedigree

Introduction: Gingival enlargement is defined as an overgrowth or increase in size of gingivae. Gingival enlargement is associated with multiple factors including inflammation, medications, neoplasia, hormonal disturbances and rarely heredity. Hereditary gingival fibromatosis (HGF) is a rare gingival lesion (1 in 7,50,000) that presents as localized or generalized fibrotic enlargement of the attached gingivae as well as the gingival margin and interdental papillae. The gingiva is characterized as pink, firm and fibrous, with little tendency to bleed. It causes aesthetic disfigurement, speech disturbances, abnormal tooth movement and dental occlusion problems. HGF can present as an isolated feature or as a part of the syndrome. HGF inheritance is transmitted through both autosomal dominant and recessive modes. Case Series: This report presents hereditary gingival fibromatosis in a family, described with multiple affected subjects in four generations, consistent with an autosomal dominant mode of inheritance. Conclusion: It is a unique report of pedigree presenting gingival enlargement in four generation. Very few papers are published previously on this topic. Like other reported family, in current family variable expression of HGF was seen because most of the affected persons had generalized gingival enlargement while some had localized involvement.

Use of a Dental Composite to Correct Beak Deviation in Psittacine Species

Beak deviation and abnormal beak occlusion are common presentations of parrot species to veterinary hospitals. There have been many published descriptions of techniques that have been used to treat abnormal beak occlusion in parrot species. Many of these techniques are difficult to apply and often result in iatrogenic beak trauma. The technique described in this article uses state-of-the-art dental cold curing dental composite and the patient's beak for support to reduce the incidence of beak damage caused by the corrective device. There are many variables (e.g., patient age, owner compliance, patient's ability to be hand fed) that should be considered when correcting a beak malocclusion with the technique described in this article. This recommended technique should serve as a possible option, among the previously described techniques, when correcting a parrot beak with abnormal beak occlusion.