Acetylcholine receptors (AChR) including muscarinic and nicotinic AChR are widely expressed and mediate a variety of physiological cellular responses in neuronal and non-neuronal cells. Notably, a functional cholinergic system exists in oral epithelial cells, and nicotinic AChR (nAChR) mediates cholinergic anti-inflammatory responses. However, the pathophysiological roles of AChR in periodontitis are unclear. Here, we show that activation of AChR elicits increased cytosolic $Ca^{2+}([Ca^{2+}]_i)$, transient cytotoxicity, and induction of receptor activator of nuclear factor kappa-B ligand (RANKL) expression. Intracellular $Ca^{2+}$ mobilization in human gingival fibroblast-1 (hGF-1) cells was measured using the fluorescent $Ca^{2+}$ indicator, fura-2/AM. Cytotoxicity and induction of gene expression were evaluated by measuring the release of glucose-6-phosphate dehydrogenase and RT-PCR. Activation of AChR in hGF-1 cells by carbachol (Cch) induced $[Ca^{2+}]_i$ increase in a dose-dependent manner. Treatment with a high concentration of Cch on hGF-1 cells caused transient cytotoxicity. Notably, treatment of hGF-1 cells with Cch resulted in upregulated RANKL expression. The findings may indicate potential roles of AChR in gingival fibroblast cells in bone remodeling.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.43
no.2
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pp.120-124
/
2017
Osteonecrosis of the jaw (ONJ) is commonly described as an adverse effect of the use of bisphosphonates. A few cases of ONJ associated with tyrosine kinase inhibitors (sunitinib, imatinib) have been reported in the literature and usually they occurred in patients simultaneously treated with bisphosphonates. We report an atypical case of ONJ related only to imatinib. A 72-year-old male patient was treated with imatinib for metastases from gastrointestinal stromal tumors (GISTs). The patient developed ONJ after 22 months of imatinib only therapy. During his whole life, the patient had never been treated with bisphosphonates or radiotherapy. Microscope examination of the tissues confirmed the clinical diagnosis of diffuse osteonecrosis and showed absence of neoplastic cells. Thus, secondary localisations from GISTs were ruled out. Osteonecrosis of the lower jaw appeared 22 months after initial and exclusive therapy with imatinib. Therefore, imatinib monotherapy can induce ONJ in patients that have never been treated with bisphosphonates or radiotherapy.
Journal of Dental Rehabilitation and Applied Science
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v.28
no.4
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pp.397-406
/
2012
Loss of tooth results in remodeling and resorption of surrounding alveolar bone which causes atrophic edentulous ridge and gradually decreasing gingival attachment. As a result, edentulous patients face difficulty in using dentures due to pain, decrease of support, decline of masticatory efficiency of complete denture. To improve this, overdenture with implant in the mandible and attachment are considered as a treatment of choice as a favorable treatment. In this case, a patient with edentulous ridge for long period is rehabilitated by complete denture in maxilla and implant overdenture using Locator$^{(R)}$ attachment in mandible.
Ghost cell odontogenic carcinoma (GCOC) is a rare malignant neoplasm characterized by the presence of ghost cells. It is considered to originate from either a calcifying odontogenic cyst(COC) or a dentinogenic ghost cell tumor(DGCT). Its clinical and radiographic characteristics are non-specific, including slow growth, locally aggressive behavior, and eventual metastasis. This case report describes a 43-year-old Thai man with plain radiographs and cone-beam computed tomographic images revealing a unilocular radiolucency with non-corticated borders surrounding an impacted left canine associated with radiopaque foci around the cusp tip. Based on the microscopic findings, the lesion was diagnosed as GCOC. Partial maxillectomy of the right maxilla was performed, and radiotherapy was administered. An obturator was made to support masticatory functions Three years later, the lesion showed complete bone remodeling and no signs of recurrence, and long-term follow-up was done regularly.
The most frequently encountered problems at fixture-implantation sites are lack of adequate bone and proximity to anatomic structures. It is generally accepted that growth factors play an essential role in the healing process and tissue formation, and they have become the focus of grafting materials research. The granules in platelets contain high concentrations of various growth factors. In particular, platelet-rich fibrin (PRF) is a second-generation platelet concentrate that allows the production of fibrin membranes enriched with platelets and growth factors from an anticoagulant-free blood harvest. This study investigated the in vitro effects of PRF on osteoblasts, in terms of the key cellular functions, and especially the effects on two growth factors, the homodimer of platelet-derived growth factor subunit B (BPDGF-BB) and transforming growth factor (TGF)-${\beta}1$, which are associated with wound healing and regeneration (i.e., proliferation and differentiation). The following parameters were investigated: PDGF-BB and TGF-${\beta}1$ levels in PRF, cell viability, alkaline phosphatase (ALP) activity, type 1 collagen synthesis, and the expressions of osteoblast differentiation markers (ALP and runt-related transcription factor 2) and bone matrix proteins (type 1 collagen). The release of autologous growth factors from PRF was maintained for a reasonable period of time, and exerted positive effects on the proliferation and differentiation of osteoblasts. The use of PRF thus appears to be a promising method for enhancing bone healing and remodeling.
Orthodontic traction has been suggested as the treatment of choice for intrusive luxation injuries. Prior research has shown orthodontic forces to be ineffective in the presence of ankylosis or in cases with zero mobility following the injury. If orthodontic traction is to be effective, it must be initiated prior to the onset of ankylosis. The purpose of this study was to describe the effects of intrusive luxation at various times following the injury, and to determine the time of the onset of ankylosis, and to examine what effect immediate partial luxation has on the onset of ankylosis. Eight young mongrel dogs were utilized for this study. Intrusive luxation was produced with an axial impact using a gravity hammer and a specially designed holding device on 4 teeth (2 max. and 2 man. first premolars) in each dog. The teeth were intruded approximately 3-4mm in an axial direction. One maxillary and one mandibular premolars were partially luxated with the other two teeth being untouched. Pre and posttrauma tooth position was documented with plaster models and radiographs taken with an individualized X-ray jig. Dogs were sacrificed immediately following the injury and at 1, 2, 4, 7, 10, 14 and 21 days respectively. Tetracycline was administered as a vital bone marker 24 hours before sacrifice. Block sections of the tooth and alveolus were prepared for decalcified and non decalcified histologic sections. The effects of traumatic intrusion were analyzed by means of model casts, radiographs, tetracycline bone marking and histologic preparations. The results obtained were as follows: 1. The animal sacrificed immediately following the injury displayed alveolar fractures, torn periodontal ligaments, and areas of direct tooth-bone contact. 2. The odontoblastic layer of the pulp was disorganized as early as 24 hours after the injury. 3. Bony remodeling was noted at 4 days along with active surface resorption. 4. Ankylosis was first seen 7 days after the injury. 5. Osteogenesis in the dentin (thick tetracycline bands) was observed 7 days after the injury. 6. There was no progressive root resorption and ankylosis where the periodontal ligament has been healed. 7. The Luxated group showed significantly more root resolution and ankylosis than the Nonluxated group with increased observation periods. The results suggest that ankylosis may occur within the first week following the injury, and hence orthodontic traction should be initiated as soon after the injury as possible.
Kim, Il-Kyu;Park, Jong-Won;Lee, Eon-Hwa;Yang, Jung-Eun;Chang, Jae-Won;Pyun, Yeong-Hun;Ju, Sang-Hyun;Wang, Boon
Maxillofacial Plastic and Reconstructive Surgery
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v.32
no.5
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pp.447-453
/
2010
The hemifacial microsomia is characterized by variable underdevelopment of the craniofacial skeleton, external ear, and facial soft tissues. So, patients with hemifacial microsomia have an occlusal plane canting and malocclusion with facial asymmetry. Distraction osteogenesis (DO) with an intraoral or extraoral device is a technique using tension to generate new bone with gradual bone movement and remodeling. DO has especially been used to correct craniofacial deformities such as a hemifacial microsomia, facial asymmetry, and mandible defect that could not adequately be treated by conventional reconstruction with osteotomies. It has a significant advantage to lengthen soft and hard tissue of underdeveloped site without bone graft and a few complication such as nerve injury or muscle contracture. A 13-years old girl visited our clinic for the chief complaint of facial asymmetry. She had a left hypoplastic maxilla and mandible, occlusal plane canting and malocclusion. We diagnosed hemifacial microsomia and lanned DO to lengthen the affected side. Le Fort I osteotomy, left mandibular ramus and symphysis osteotomy were performed. The internal distraction devices fixed with screw on maxillary and mandibular ramus osteotomy sites. External devices were adapted to lower jaw for DO on symphysis osteotomy site and to upper jaw for rapid maxillary expansion (RME). At 7days after surgery, distraction was started at the rate of 1mm per day for 13days, and after 4months consolidation periods, distraction devices were removed. Simultaneous multiple maxillo-mandibular distraction osteogenesis with RME resulted in a satisfactory success in correcting facial asymmetry as well as occlusal plane canting for our hemifacial microsomia.
Park, Beyoung Yun;Seo, Sang Woo;Lee, Won Jai;Ryu, Chang Woo;Rah, Dong Kyun;Son, Hyun Joo;Park, Jong Chul
Archives of Plastic Surgery
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v.32
no.2
/
pp.143-148
/
2005
Chemotactic migration of bone forming cell, osteoblast, is an important event during bone formation, bone remodeling, and fracture healing. Migration of cells is mediated by adhesion receptors, such as integrins, that link the cell to extracellular matrix ligands, type I collagen, fibronectin, laminin and depend on interaction between integrin and extracellular ligand. Our study was designed to investigate the effect of extracellular matrix like fibronectin, laminin, type I collagen on migration of osteoblast. Migration distance and speed of MC3T3-E1 cell on extracellular matrix-coated glass were measured for 24 hours using 0.01% type I collagen, 0.01% fibronectin, 100 microliter/ml laminin. The migration distance and speed of MC3T3-E1 cell was compared using a video-microscopy system. To determine migration speed, cells were viewed with a 4 phase- contrast lens and video recorded. Images were captured using a color CCD camera and saved in 8-bit full-color mode. The migration distance on 0.01% type I collagen or 0.01% fibronectin was longer than that on $100{\mu}l/ml$ laminin-coated glass. The migration speed on fibronectin-coated glass was 68 micrometer/hour which was fastest. The migration speed on type I collagen-coated glass was similar with that on fibronectin-coated glass. The latter two migration speeds were faster than that on no-coated glass. On the other hand, the average migration speed on laminin-coated glass was 37micrometer/hour and not different from that of control group. In conclusion, the extracelluar matrix ligands such as type I collagen and fibronectin seem to play an important role in cell migration. The type I collagen or fibronectin coated scaffold is more effective for migration of osteoblast in tissue engineering process.
Background : An area of the skull exposed by burn injury has been covered by various methods including local flap, skin graft, or free flap surgery. Each method has disadvantages, such as postoperative alopecia or donor site morbidities. Due to the risk of osteomyelitis in the injured skull during the expansion period, tissue expansion was excluded from primary reconstruction. However, successful primary reconstruction was possible in burned skull by tissue expansion. Methods : From January 2000 to 2011, tissue expansion surgery was performed on 10 patients who had sustained electrical burn injuries. In the 3 initial cases, removal of the injured part of the skull and a bone graft was performed. In the latter 7 cases, the injured skull tissue was preserved and covered with a scalp flap directly to obtain natural bone healing and bone remodeling. Results : The mean age of patients was $49.9{\pm}12.2$ years, with 8 male and 2 female. The size of the burn wound was an average of $119.6{\pm}36.7cm^2$. The mean expansion duration was $65.5{\pm}5.6$ days, and the inflation volume was an average of $615{\pm}197.6mL$. Mean defect size was $122.2{\pm}34.9cm^2$. The complications including infection, hematoma, and the exposure of the expander were observed in 4 cases. Nonetheless, only 1 case required revision. Conclusions : Successful coverage was performed by tissue expansion surgery in burned skull primarily and no secondary reconstruction was needed. Although the risks of osteomyelitis during the expansion period were present, constant coverage of the injured skull and active wound treatment helped successful primary reconstruction of burned skull by tissue expansion.
Discectomy is the oldest and most commonly performed operation for the painful temporomandibular joint with internal derangement. It is the one operation for which there are longest follow-up study, with Eriksson, Silver, and Tolvanen et al reporting good results in patients about 30 years after discectomy. About 80% to 90% of patients clinically experience relief from pain and dysfunction after discectomy, and interestingly, the results may improve with time. However such as Myrhaug found headache and Poswillo supposed pain and limitation of movement as postoperative complications, even though this operation had the longest follow-up term, several aspects of discectomy remain unclear. The controversies to discectomy for TMJ with pain and dysfunction have laid emphasis only upon clinical results, and then the histomorphological study was planned to evaluate the morphologic change of TMJ after discectomy. To clarify the nature of the change through an observation on the morphologic changes of articular cartilage and subchondral bone of the condyle resulting from experimental unilateral discectomy in rabbit, the author excised the left articular discs of 12 male rabbits(control 4 rabbits), weighing about 3kg, and at 1, 3, 6, 9 weeks following surgery, harvested both(left surgical site and right nonsurgical sits) TMJ. The specimens were examined with light microscope after H-E and MT stain and the obtained results were as follows. 1. Histopathological features showed thickening of articular zone and active proliferation of fibrocartilaginous zone associated with slight proliferative zone in surgical site than control group. Also replacement of chondrocytes in calcified cartilaginous zone into bone cells was observed. 2. There were thinning of thickness of each zone of articular cartilage except calcified cartilagnous zone was observed in nonsurgical site. 3. In MT stain of condylar trabeculae, there was increased calcification in nonsurgical site than control and surgical site and the degree of calcification was similar in surgical site and control group. 4. In both site of experimental group no features of degenerative changes were observed. From the above results, it is presumed that the morphologic changes of surgical site discectomy are compensatory remodeling process characterized by an hyperplastic reaction of the articular zone and fibrocartilaginous zone filling the void created by removing the disc, and the bone changes are secondary to changes in the cartilage. Increased degree of calcification seen in condylar trabeculae of nonsurgical site results from the excessive use of condyle of that site.
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