Pathological Migration Research Articles

The Prognostic Value of Positron Emission Tomography/Computed Tomography in Clinical Stage I Lung Cancer Patients: A Propensity-Match Analysis.

Background: The application of positron emission tomography/computed tomography (PET/CT) helps provide accurate clinical staging for lung cancer patients. However, the effects and trends in early-stage lung cancer remain unclear. The aim of this study was to compare differences between clinical stage I lung cancer patients who received PET/CT for staging and those who did not. Methods: Data were obtained from the Taiwan Society of Cancer Registry. There were 6587 clinical stage I lung cancer patients between 2009 and 2014 analyzed in this study. We compared the characteristics of the PET/CT and no PET/CT groups. After propensity score matching, it resulted in both groups having 2649 patients. We measured the overall survival rates of all clinical stage I lung cancer patients and the overall survival rates of patients with PET/CT and without PET/CT. Results: The 1-, 3-, and 5-year survival rates of all clinical stage I lung cancer patients were 97.2%, 88.2%, and 79.0%, respectively. Patients with a larger tumor size tended to receive PET/CT for staging (stage Ib: 38.25% vs. 27.82%, p < 0.0001) and a larger resection (lobectomy: 74.62% vs. 66.61%, p < 0.0001). The 5-year survival rates were 79.8% in the PET/CT group and 78.2% in the no PET/CT group after propensity score matching (p = 0.6528). Conclusions: For clinical stage I lung cancer in Taiwan, patients with larger tumor sizes tend to have PET/CT for staging. Although PET/CT provided more precise clinical staging, these patients still received larger resections and had more pathological migration. However, there was no overall survival rate benefit after PET/CT.

Combination Treatment of Splinting with Wire Composite and Artificial Tooth Pontic for Improved Aesthetics: A Case Report

Advanced bone loss in patients with periodontitis often leads to increased tooth mobility, sometimes resulting in tooth loss. The mobility of teeth necessitates splinting to optimize periodontal treatment outcomes in terms of aesthetics and periodontal health. This case report presents a novel approach using an artificial tooth pontic as a periodontal splint, utilizing wire stabilization to prevent severe tooth mobility and enhance esthetics. A 37-year-old male with aggressive periodontitis (Stage III, Grade C) exhibited extensive periodontal destruction, particularly in the upper and lower anterior regions. Pathological migration was evident following the loss of teeth 31 and 41, with additional anterior teeth in the lower jaw showing mobility and trauma from occlusion, notably tooth 33. The patient underwent nonsurgical periodontal therapy, including scaling, subgingival debridement, occlusal adjustment, and splinting. Stabilization was achieved by applying a wire splint from teeth 34 to 43, incorporating an artificial tooth pontic. Subsequent evaluations revealed improvements in clinical parameters such as probing pocket depth, tooth mobility, and bleeding on probing during supportive periodontal therapy visits. The splint remained stable, and the patient expressed satisfaction with their appearance remaining unaffected. This case demonstrates that severe tooth mobility can be effectively stabilized using a composite wire splint and an artificial tooth pontic, enhancing the patient's esthetic outcomes.

Assessment of nutritional status in chronic periodontitis patients: A cross-sectional study.

This cross-sectional study compared the nutritional status of chronic periodontitis (CP) patients who presented with various degrees of severity with systemically healthy individuals using the Mini Nutritional Assessment (MNA®) tool along with laboratory analysis of macro- and micronutrients. This research enrolled a total of 84 participants, of which 63 belonged to the CP group while 21 served as healthy controls. The CP patients were divided into three groups of 21 each, based on severity as mild, moderate, and severe. Clinical periodontal parameters (plaque index, bleeding on probing, probing depth, clinical attachment level/loss, total number of teeth present [NOT-P], furcation involvement, pathological migration, and tooth mobility), biochemical parameters (lipid, protein, iron profiles, and Vitamin D3 and B12), and the MNA® tool were used to assess the nutritional status of all the participants. The results were analyzed statistically. NOT-P, MNA score, lipid profile (except very-low-density lipoprotein), iron profile (except total iron-binding capacity), and Vitamin D3 showed high significant differences (P < 0.001) among the groups. However, Vitamin B12 and protein profile except for total protein revealed significant differences (P < 0.05). CP can be a contributing risk factor for the development of malnutrition. MNA® tool can be used for assessing the nutritional status of CP patients.

Comparative evaluation of treatment of angular bone defect related to over-erupted tooth using guided tissue regeneration (GTR) followed by orthodontic intrusion (OI) versus OI followed by GTR: a controlled clinical trial

BackgroundPrematurity resulted from pathological migration of periodontally involved teeth with the loss of vertical stopping points between teeth, which can lead to teeth over eruption with dimensional changes favoring occlusal discrepancies. Therefore, evaluating and comparing the effect of guided tissue regeneration followed by orthodontic intrusion as opposed to orthodontic intrusion tracked by guided tissue regeneration in the treatment of an over-erupted tooth with angular bone loss.MethodsTwenty teeth in ten cases were selected with at least two teeth with vertical over-eruption and angular bone loss with the presence of their opposing. In group one, ten teeth over-erupted were treated by guided tissue regeneration followed by orthodontic intrusion, whereas, in group two, ten teeth over-erupted were treated by orthodontic intrusion followed by guided tissue regeneration. They were evaluated clinically for pocket depth, bleeding on probing, and tooth mobility. Radiographical evaluation assessed by cone beam computed tomography.ResultsClinically, there existed a statistically significant difference (P value ≤ 0.05) in favor of group one at six months post and in favor of group two at one year from re-evaluation regarding pocket depth and tooth mobility. Radiographically, in group one, there was a statistically significant improvement (P value ≤ 0.05) at six months post-guided tissue regeneration or orthodontic intrusion regarding defect depth and dimensional changes of the defect area, with a statistically significant difference (P value ≤ 0.05) in favor of group two at one year from re-evaluation phase regarding defect depth and defect area dimensional changes.ConclusionThere was a short-term improvement in group one, which deteriorated over a long period compared with group two, so it is preferable to start orthodontic intrusion before guided tissue regeneration.

Three-dimensional finite element analysis of retracting pathological migration of the right upper central incisor with a clear aligner

We aimed to explore the best orthodontic step distance of the right upper central incisor with mild, moderate, and severe pathological displacement achieved via a clear aligner. Three-dimensional models of maxilla-tooth-periodontal ligament clear aligner of the right upper central incisors with five different steps of 0.1, 0.125, 0.15, 0.165, 0.25 mm and three different alveolar bone heights were established via finite element analysis. We analysed the changing trends in initial displacement, the periodontal ligament, the alveolar bone, and apical stress of right upper central incisor. In the process of retraction, the right upper central incisor a movement trend of the crown deviating from the distal root to the mesial, and with the decrease of the height of the alveolar bone and the increase of the displacement, the crown would appear distal labial torsion with a deepening trend of vertical overlay.The maximum stress distribution of the periodontal ligament and alveolar bone showed a positive correlation. The overall stress distribution of the periodontal ligament and apical stress increased with decrease of alveolar bone height and the increase of alveolar bone displacement. In patients with mild, moderate, and severe pathological displacement of the right upper central incisor, the best step distance of anterior tooth retraction is 0.165, 0.15, and 0.125 mm, respectively.

Levels of Pro-Inflammatory and Bone-Resorptive Mediators in Periodontally Compromised Patients under Orthodontic Treatment Involving Intermittent Forces of Low Intensities.

During orthodontic treatment, diverse cytokines, enzymes, and osteolytic mediators produced within the teeth surrounding periodontal tissues determine the rate of alveolar bone remodeling and consequent teeth movement. In patients with teeth presenting reduced periodontal support, periodontal stability should be ensured during orthodontic treatment. Thus, therapies based on the application of low-intensity intermittent orthodontic forces are recommended. To determine if this kind of treatment is periodontally well tolerated, this study aimed to analyze the production of receptor activator of nuclear factor kappa-B ligand (RANKL), osteoprotegerin (OPG), interleukin (IL)-6, IL-17A, and matrix metalloproteinase (MMP)-8 in periodontal tissues of protruded anterior teeth with reduced periodontal support and undergoing orthodontic treatment. Patients with periodontitis-associated anterior teeth migration received non-surgical periodontal therapy and a specific orthodontic treatment involving controlled low-intensity intermittent orthodontic forces. Samples were collected before periodontitis treatment, after periodontitis treatment, and at 1 week to 24 months of the orthodontic treatment. During the 2 years of orthodontic treatment, no significant differences were detected in the probing depth, clinical attachment level, supragingival bacterial plaque, and bleeding on probing. In line with this, the gingival crevicular levels of RANKL, OPG, IL-6, IL-17A, and MMP-8 did not vary between the different evaluation time-points of the orthodontic treatment. When compared with the levels detected during the periodontitis, the RANKL/OPG ratio was significantly lower at all the analyzed time-points of the orthodontic treatment. In conclusion, the patient-specific orthodontic treatment based on intermittent orthodontic forces of low intensities was well tolerated by periodontally compromised teeth with pathological migration.

“Z PLASTY- AN ELIXIR FOR MUCOGINGIVAL DEFORMITY”

Objective- The objective of this case report is to assess whether a Z-plasty of the lower labial frenum can increase the vestibular depth, the width of attached gingiva, and eliminate the aberrant frenal attachment. A 29 year ol Clinical consideration- d female presented for esthetic rectication associated with gingival recession and pathological migration of lower central incisors. The mandibular central incisors were associated with gingival recession due to shallow vestibular depth, high frenal attachment and inadequate width of attached gingiva. Z plasty of lower labial frenum was done to manage this predicament. Satisfactory clinical results were observed This case report demonstrates a type of single stage Conclusionperiodontal plastic surgery aimed at increasing the vestibular depth, replace the sentence - removing aberrant frenal attachments, and widening the width of attached gingiva. The results of the study are encouraging and warrant further case-controlled studies

Loss of BMP2 and BMP4 Signaling in the Dental Epithelium Causes Defective Enamel Maturation and Aberrant Development of Ameloblasts.

BMP signaling is crucial for differentiation of secretory ameloblasts, the cells that secrete enamel matrix. However, whether BMP signaling is required for differentiation of maturation-stage ameloblasts (MA), which are instrumental for enamel maturation into hard tissue, is hitherto unknown. To address this, we used an in vivo genetic approach which revealed that combined deactivation of the Bmp2 and Bmp4 genes in the murine dental epithelium causes development of dysmorphic and dysfunctional MA. These fail to exhibit a ruffled apical plasma membrane and to reabsorb enamel matrix proteins, leading to enamel defects mimicking hypomaturation amelogenesis imperfecta. Furthermore, subsets of mutant MA underwent pathological single or collective cell migration away from the ameloblast layer, forming cysts and/or exuberant tumor-like and gland-like structures. Massive apoptosis in the adjacent stratum intermedium and the abnormal cell-cell contacts and cell-matrix adhesion of MA may contribute to this aberrant behavior. The mutant MA also exhibited severely diminished tissue non-specific alkaline phosphatase activity, revealing that this enzyme’s activity in MA crucially depends on BMP2 and BMP4 inputs. Our findings show that combined BMP2 and BMP4 signaling is crucial for survival of the stratum intermedium and for proper development and function of MA to ensure normal enamel maturation.

MANAGEMENT OF STAGE III PERIODONTITIS: AN INTERDISCIPLINARY APPROACH

Periodontitis is a chronic inflammatory disease with varied symptoms that may be bleeding gums, malodour, tooth mobility or irritation and inflammation of the gingiva. Signs of severe periodontitis include tooth loss, masticatory dysfunction, negative effects on aesthetics and function. Depending upon the severity of the symptoms the treatment varies from case to case. This case report describes the management of a Stage III periodontitis in a 23 years old female patient, who was concerned by the impact of pathological migration on aesthetics. Treatment planning was done with focus on management of the pathology keeping in mind the concerns presented by the patient. The primary treatment was focused on management of periodontitis by removal of local factors and antimicrobial therapy to prevent further destruction of periodontal tissues. The prosthetic phase was planned to address the aesthetic concerns of the patient.Hence, an interdisciplinary approach was used to restore function and aesthetics.

Periodontal and prosthetic treatment of maxillary incisors with pathological tooth migration: a case report with 10-year follow-up

Periodontal and prosthetic treatment of maxillary incisors with pathological tooth migration: a case report with 10-year follow-up

Cytohesin-2/ARNO: A Novel Bridge Between Cell Migration and Immunoregulation in Synovial Fibroblasts.

The guanine nucleotide exchange factor cytohesin-2 (ARNO) is a major activator of the small GTPase ARF6 that has been shown to play an important role(s) in cell adhesion, migration and cytoskeleton reorganization in various cell types and models of disease. Interestingly, dysregulated cell migration, in tandem with hyper-inflammatory responses, is one of the hallmarks associated with activated synovial fibroblasts (SFs) during chronic inflammatory joint diseases, like rheumatoid arthritis. The role of ARNO in this process has previously been unexplored but we hypothesized that the pro-inflammatory milieu of inflamed joints locally induces activation of ARNO-mediated pathways in SFs, promoting an invasive cell phenotype that ultimately leads to bone and cartilage damage. Thus, we used small interference RNA to investigate the impact of ARNO on the pathological migration and inflammatory responses of murine SFs, revealing a fully functional ARNO-ARF6 pathway which can be rapidly activated by IL-1β. Such signalling promotes cell migration and formation of focal adhesions. Unexpectedly, ARNO was also shown to modulate SF-inflammatory responses, dictating their precise cytokine and chemokine expression profile. Our results uncover a novel role for ARNO in SF-dependent inflammation, that potentially links pathogenic migration with initiation of local joint inflammation, offering new approaches for targeting the fibroblast compartment in chronic arthritis and joint disease.

Comparison of Transverse Dentofacial Dimensions in Adults with Skeletal Class I and Class II Malocclusion, Horizontal Growth Pattern and Mild to Moderate Periodontitis using CBCT- A Retrospective Study

Introduction: Knowledge of transverse dentofacial dimensions is crucial for accurate diagnosis and treatment planning. Periodontitis can alter the widths of the arches by causing pathological migration of teeth and the concurrent bone loss can affect the transverse width of the arches. Aim: To compare the transverse dentofacial widths in adults with skeletal class I and class II malocclusions with horizontal growth pattern and with mild to moderate periodontitis using Cone Beam Computed Tomography (CBCT). Materials and Methods: This retrospective observational study was conducted in Department of Orthodontics, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India, from January 2019 to January 2021. Total 96 CBCT samples (48 skeletal Class I, 48 skeletal Class II) of patients between age group of 25-35 years, patients having mild to moderate periodontitis based on bone loss seen on CBCT and patients having a horizontal growth pattern with the angle between sella-nasion and mandibular plane less than 320 degrees were included in the study. Transverse dentofacial measurements were made on the coronal plane of the CBCT scans. Data were analysed using Statistical Package for Social Sciences (SPSS) version 20. Chi-square test and Student’s t-test were used to compare age, linear measurements and angular measurements between the skeletal class I and skeletal Class II groups. A p-value of &lt;0.05 was considered statistically significant at 95% class interval. Results: In this study the mean age of patients with skeletal class I and class II was 30.89±3.23 and 30.97±3.28 years, respectively. There were 24 females and 24 males belonging to class I and class II groups, each. There was a statistically significant difference in the mean interjugal width and the antegonial width. The mean interjugal width in skeletal Class I and Class II group was 56.95±5.68 mm and 51.28±5.94 mm respectively (p-value was &lt;0.001). The maxillomandibular difference (p-value=0.002), the mean maxillary buccal alveolar crest width difference (p-value &lt;0.001) and mandibular buccal alveolar crest width difference (p-value &lt;0.001) was also statistically significant. The palatal height in skeletal Class I group (21.77 mm) was significantly higher (p value &lt;0.001) and the mean maxillary palatal alveolar crest width in skeletal Class I (36.47 mm) was lower than in the Class II group (37.97 mm). Conclusion: The dentofacial transverse widths such as the interjugal width, antegonial width, maxillomandibular difference, maxillary buccal alveolar crest width and mandibular buccal alveolar crest width were higher in skeletal Class I groups compared to skeletal Class II groups. The maxillary palatal alveolar crest width was higher in skeletal Class II groups compared to skeletal Class I group.

Effects of Prosthetic Rehabilitation on Temporomandibular Disorders: Protocol for a Randomized Controlled Trial

BackgroundLoss of teeth or occlusal imbalance is one of the proposed dental risk factors for temporomandibular disorders (TMDs). Losing some non–free-end teeth cause the original occluding tooth/teeth to supraerupt from the original upright position and causes neighboring tooth/teeth to shift in an angle, causing biomechanical imbalance on the mandible. Based on these sequelae, rehabilitation of missing teeth is the first step in managing TMD in edentulous patients. Even though the prevalence of TMD in association with edentulism and in rehabilitated patients has been increasing, proper guidelines for the management of such cases have not been established. This study describes the protocol to analyze the effect of prosthetic rehabilitation on patients with TMD.ObjectiveThis study aims to determine the effectiveness of prosthetic rehabilitation in the reduction of pain in edentulous patients with TMD and to determine the effect of the span of edentulism, the number of quadrants involved, pathological migration, the type of Kennedy classification, and the prosthetic status on temporomandibular joint dysfunction signs and symptoms.MethodsIn this randomized controlled trial, 300 patients diagnosed with TMD will be grouped into one of the three interventional groups based on the type of their edentulous state. The interventional groups are (1) partially edentulous arch: Kennedy Class I and II (prosthetic rehabilitation without splint); (2) partially edentulous arch: Kennedy Class III and IV (prosthetic rehabilitation with a splint); and (3) completely edentulous arches (prosthetic rehabilitation without splint). All three of the mentioned interventional groups have corresponding control groups that will receive symptomatic treatment and comprehensive counseling. The measured primary outcomes are pain and electromyogram, and the secondary outcomes include pain drawing, Graded Chronic Pain Scale, Jaw Functional Limitation Scale, Oral Behaviours Checklist, depression, physical symptoms, and anxiety. The outcome measurements will be recorded at baseline and at the end of 24 hours, 7 days, 28 days, and 3 months.ResultsEthical approval was obtained from the Institutional Review Board of Amrita Institute of Medical Sciences, Kochi, India. Study participants’ recruitment began in May 2021 and is expected to conclude in March 2023. This clinical trial protocol was developed based on the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) 2013 Statement.ConclusionsThe purpose of this study is to gather data on prosthetic rehabilitation as a treatment for TMD. Obtaining this goal will aid in the development of evidence-based therapy protocols for prosthetic rehabilitation in TMD management.Trial RegistrationClinical Trials Registry - India CTRI/2020/06/026169; http://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=42381International Registered Report Identifier (IRRID)DERR1-10.2196/33104

Morin Acts as a USP7 Inhibitor to Hold Back the Migration of Rheumatoid Arthritis Fibroblast-Like Synoviocytes in a "Prickle1-mTORC2" Dependent Manner.

The aim of this study is to investigate the effect and detailed mechanisms of morin, an anti-arthritis compound widely distributed in foods of plant origin, on the pathological migration of fibroblast-like synoviocytes (FLS). The migration of FLS collected from arthritis rats and MH7A cells is induced by platelet-derived growth factor, and an arthritis model in rats is established by Freund's complete adjuvant. The results show that morin remarkably restrains FLS migration but slightly affects FLS apoptosis and proliferation. Moreover, in the progression of FLS migration, focal adhesion (FA) turnover is inhibited by morin via lowering the activation of Paxillin and focal adhesion kinase (FAK) and internalization of integrin β1. Morin disrupts the formation of mTOR complex 2 (mTORC2) and the activation of AKT (S473) and PKCα (S657), and MHY1485 reverses morin-limited FLS migration. Of note, the protein stability of Prickle1, a binding factor of Rictor, is reduced by morin, and MG132 but not Baf A1 shows a repressive effect. Finally, the target protein is identified as ubiquitin-specific protease 7 (USP7) but not USP9X. USP7 overexpressing plasmid weakens morin-affected protein and ubiquitination of Prickle1, and mechanisms are confirmed in vivo by using an overexpressing plasmid and inhibitor. Morin restricts FLS migration and arthritis by intervening in "USP7-Prickle1-mTORC2" signaling and FA turnover.

Tratamento de terceiros molares inclusos através da técnica coronectomia – aspectos clínicos

Nerve damage during third molars removal is an inherent risk of the procedure due to the anatomical proximity of these structures. Coronectomy is an effective technique that can reduce the risk of developing paresthesia caused by this injury. The present study aims to report a clinical case in which the coronectomy was performed describing its technique. The procedure was performed on a 25-year-old male patient, with third molars removal indication. The radiological exam suggested an intimate relationship between the lower right third molar roots and the mandibular canal. The coronectomy technique was performed under local anesthesia and the follow-up was performed after seven days, four months and four years. One week after surgery patient reported good recovery and does not showed radiographic signs or clinical symptoms of sensory or other pathological disorders. After four years, a new radiography was performed, where sign of peripheral bone formation and the absence of any pathological aspect or migration were observed. Considering the low complexity and morbidity of the technique, it becomes a good alternative to extraction, aiming to reduce the development of paresthesia in high-risk cases.

Pathological Migration Associated with Loss Of Posterior Teeth

Pathological Migration Associated with Loss Of Posterior Teeth

CONSERVATIVE MANAGEMENT OF TOOTH SIZE ARCH LENGTH DISCREPANCIES-A REPORT OF TWO CASES

Tooth size arch length discrepancies ideally require orthodontic treatment. But in certain exceptional cases like spacing due to aggressive periodontitis, pathological migration and non-compliance of the patient to undergo comprehensive orthodontic procedure, the scenario demands deviation from the routine treatment approaches and to customise the treatment plan based on the patient’s needs. This paper reports two cases: midline diastema in mandibular anteriors due to pathological migration managed with acrylic pontic retained by fiber reinforced composite restoration. The second case discusses anterior crowding managed conservatively by a fixed partial denture and the natural tooth pontic retained by fiber reinforced composite splint. KEYWORDS: Aesthetic transformation, cosmetic recontouring, fiber reinforced composite, natural tooth pontic.

Recreation of esthetic smile from flared anterior teeth with midline diastema utilizing zirconia ceramic fixed bridge: A case report

Recreation of esthetic smile from flared anterior teeth with midline diastema utilizing zirconia ceramic fixed bridge: A case report - APRD- Print ISSN No: - 2581-4796 Online ISSN No:- 2581-480X Article DOI No:- 10.18231/j.aprd.2019.028, IP Annals of Prosthodontics and Restorative Dentistry-IP Ann Prosthodont Restor De

Prevalence of Pathologic Migration in Patients with Periodontitis: A Retrospective Analysis

Periodontal disease is characterised by gingival inflammation loss of connective tissue attachment and bone loss. These changes are associated with pathologic tooth migration. The aim of the study was to assess the prevalence of pathological migration in patients with periodontitis. Retrospective data collection was conducted from June 2019 to March 2020 among 157 patients with generalised chronic periodontitis who reported to the Department of Periodontics, Saveetha Dental College and Hospitals, Chennai. Both clinical and radiographic images were used to assess the presence and type of pathological migration and the results were analysed. Among the various types of pathological migration studied like diastema, crowding, spacing, mesial tilt and distal tilt, it was found that spacing between the teeth (53 sites) was the most common and the distal tilt of the tooth (5 sites) was the least common type of pathologic migration.

Rotated Upper Central Incisor Complicated by Pathological Migration with Crowding in Upper and Lower Anterior Teeth Treated by Clear Aligners

Pathological tooth migration is difficult to treat; the improvement of the periodontal condition is necessary to stop the disease; fixed appliance gives extra obstacles for oral hygiene practices. Clear aligners make no difference in brushing and flossing during the treatment but have more limitations in tooth movements especially extrusion and derotation.