Boyen Huang

Activities related to the occurrence of traumatic dental injuries in 15- to 18-year-olds.

OBJECTIVE To assess the activities related to the occurrence of traumatic dental injuries (TDI) in order to establish the relationship between gender, socio-economic status (SES) and major TDI related events, using classification and examination procedures suitable for epidemiological purposes, in a sample of 15- to 18-year-old students in Taiwan. METHODS A random sample of 6312 15- to 18-year-old senior high school students in southern Taiwan was selected. Each was examined with standard clinical procedures and a questionnaire. RESULTS The prevalence of TDI was 19.9%. The major TDI related events included sports and leisure activities (30.8%), eating (20.5%), falls (19.4%), traffic accidents (10.2%) and collisions (7.1%). Within TDI victims, sports and leisure related TDI were more prevalent among males (P = 0.001, OR = 1.640, 95% CI = 1.225, 2.195) and high SES adolescents (P = 0.014, OR = 1.991, 95% CI = 1.149, 3.449). The occurrence of non-accidental TDI was not related to age, gender and SES (P > or = 0.643). CONCLUSION Traumatic dental injuries have become an important issue in public health and dentistry. Prevention and treatment of TDI should be emphasised to the public, the health professional and the policy maker. Future investigations into the relationship between TDI related events and their determinants are indicated.

Interactions between BMP-7 and USAG-1 (Uterine Sensitization-Associated Gene-1) Regulate Supernumerary Organ Formations

Bone morphogenetic proteins (BMPs) are highly conserved signaling molecules that are part of the transforming growth factor (TGF)-beta superfamily, and function in the patterning and morphogenesis of many organs including development of the dentition. The functions of the BMPs are controlled by certain classes of molecules that are recognized as BMP antagonists that inhibit BMP binding to their cognate receptors. In this study we tested the hypothesis that USAG-1 (uterine sensitization-associated gene-1) suppresses deciduous incisors by inhibition of BMP-7 function. We learned that USAG-1 and BMP-7 were expressed within odontogenic epithelium as well as mesenchyme during the late bud and early cap stages of tooth development. USAG-1 is a BMP antagonist, and also modulates Wnt signaling. USAG-1 abrogation rescued apoptotic elimination of odontogenic mesenchymal cells. BMP signaling in the rudimentary maxillary incisor, assessed by expressions of Msx1 and Dlx2 and the phosphorylation of Smad protein, was significantly enhanced. Using explant culture and subsequent subrenal capsule transplantation of E15 USAG-1 mutant maxillary incisor tooth primordia supplemented with BMP-7 demonstrated in USAG-1+/− as well as USAG-1−/− rescue and supernumerary tooth development. Based upon these results, we conclude that USAG-1 functions as an antagonist of BMP-7 in this model system. These results further suggest that the phenotypes of USAG-1 and BMP-7 mutant mice reported provide opportunities for regenerative medicine and dentistry.

Phenotypes of CCAAT/enhancer-binding protein beta deficiency: hyperdontia and elongated coronoid process.

OBJECTIVES This investigation aimed to conduct a case-control study of mandibular morphology and dental anomalies to propose a relationship between mandibular/dental phenotypes and deficiency of CCAAT/enhancer-binding protein beta (CEBPB). MATERIALS AND METHODS Skulls of CEBPB(-/-), CEBPB(+/-) and CEBPB(+/+) mice were inspected with micro-computed tomography. Mandibular morphology was assessed with a method of Euclidean distance matrix analysis. RESULTS Elongation of the coronoid process was identified in CEBPB(+/-) (P ≤ 0.046) and CEBPB(-/-) 12-month-olds (P ≤ 0.028) but not in 14-day-olds (P ≥ 0.217) and 0-day-olds (P ≥ 0.189) of either genotype. Formation of supernumerary teeth in CEBPB(-/-) adult mice was demonstrated (χ(2) = 6.00, df = 1, P = 0.014). CONCLUSIONS CEBPB deficiency was related to elongation of the coronoid process and formation of supernumerary teeth. The mandibular and dental phenotypes of CEBPB deficiency were unseen by the 14th day after birth. Future investigations into the influence of CEBPB on mandibular and dental development are needed.

Id2 controls chondrogenesis acting downstream of BMP signaling during maxillary morphogenesis

Maxillofacial dysmorphogenesis is found in 5% of the population. To begin to understand the mechanisms required for maxillofacial morphogenesis, we employed the inhibitors of the differentiation 2 (Id2) knock-out mouse model, in which Id proteins, members of the regulator of basic helix-loop-helix (bHLH) transcription factors, modulate cell proliferation, apoptosis, and differentiation. We now report that spatially-restricted growth defects are localized at the skull base of Id2 KO mice. Curiously, at birth, neither the mutant Id2 KO nor wild-type (WT) mice differed, based upon cephalometric and histological analyses of cranial base synchondroses. In postnatal week 2, a narrower hypertrophic zone and an inhibited proliferative zone in presphenoid synchondrosis (PSS) and spheno-occipital synchondrosis (SOS) with maxillary hypoplasia were identified in the Id2 mutant mice. Complementary studies revealed that exogenous bone morphogenetic proteins (BMPs) enhanced cartilage growth, matrix deposition, and chondrocyte proliferation in the WT but not in the mutant model. Id2-deficient chondrocytes expressed more Smad7 transcripts. Based on our results, we assert that Id2 plays an essential role, acting downstream of BMP signaling, to regulate cartilage formation at the postnatal stage by enhancing BMP signals through inhibiting Smad7 expression. As a consequence, abnormal endochondral ossification was observed in cranial base synchondroses during the postnatal growth period, resulting in the clinical phenotype of maxillofacial dysmorphogenesis.

Increased risk of temporomandibular joint closed lock: A case-control study of ANKH polymorphisms

Objectives This study aimed to carry out a histological examination of the temporomandibular joint (TMJ) in ank mutant mice and to identify polymorphisms of the human ANKH gene in order to establish the relationship between the type of temporomandibular disorders (TMD) and ANKH polymorphisms. Materials and Methods Specimens from the TMJ of ank mutant and wild-type mice were inspected with a haematoxylin and eosin staining method. A sample of 55 TMD patients were selected. Each was examined with standard clinical procedures and genotyping techniques. Results The major histological finding in ank mutant mice was joint space narrowing. Within TMD patients, closed lock was more prevalent among ANKH-OR homozygotes (p = 0.011, OR = 7.7, 95% CI 1.6–36.5) and the elder (p = 0.005, OR = 2.4, 95% CI 1.3–4.3). Conclusions Fibrous ankylosis was identified in the TMJ of ank mutant mice. In the human sample, ANKH-OR polymorphism was found to be a genetic marker associated with TMJ closed lock. Future investigations correlating genetic polymorphism to TMD are indicated.

Aldehyded Dextran and ε-Poly(L-lysine) Hydrogel as Nonviral Gene Carrier

Background. The expression term of the gene transfected in cells needs to belong enough inorder to make a gene therapy clinically effective. The controlled release of the transfected gene can be utilized. The new biodegradable hydrogel material created by 20 w/w% aldehyded dextran and 10 w/w% ε-poly(L-lysine) (ald-dex/PLL) was developed. We examined whether it could be as a nonviral carrier of the gene transfer. Methods. A plasmid (Lac-Z) was mixed with ald-dex/PLL. An in vitro study was performed to assess the expression of Lac-Z with X-gal stain after gene transfer into the cultured 293 cells and bone marrow cells. As a control group, PLL was used as a cationic polymer. Results. We confirmed that the transfection efficiency of the ald-dex/PLL had a higher transfection efficiency than PLL in 293 cells (plasmid of 2 μg: ald-dex/PLL 1.1%, PLL 0.23%, plasmid of 16 μg: ald-dex/PLL 1.23%, PLL 0.48%). In bone marrow cells, we confirmed the expression of Lac-Z by changing the quantity of aldehyded dextran. In the groups using ald-dextran of the quantity of 1/4 and 1/12 of PLL, their transfection efficiency was 0.43% and 0.41%, respectively. Conclusions. This study suggested a potential of using ald-dex/PLL as a non-carrier for gene transfer.

Feasibility of Gene Therapy for Tooth Regeneration by Stimulation of a Third Dentition

[Extract] The tooth is a complex biological organ that consists of multiple tissues, including enamel, dentin, cementum, and pulp. Missing teeth is a common and frequently occurring problem in aging populations. To treat these defects, the current approach involves fixed or removable prostheses, autotransplantation, and dental implants. The exploration of new strategies for tooth replacement has become a hot topic. Using the foundations of experimental embryology, developmental and molecular biology, and the principles of biomimetics, tooth regeneration is becoming a realistic possibility. Several different methods have been proposed to achieve biological tooth replacement[1-8]. These include scaffold-based tooth regeneration, cell pellet engineering, chimeric tooth engineering, stimulation of the formation of a third dentition, and gene-manipulated tooth regeneration. The idea that a third dentition might be locally induced to replace missing teeth is an attractive concept[5,8,9]. This approach is generally presented in terms of adding molecules to induce de novo tooth initiation in the mouth. It might be combined with gene-manipulated tooth regeneration; that is, endogenous dental cells in situ can be activated or repressed by a gene-delivery technique to produce a tooth. Tooth development is the result of reciprocal and reiterative signaling between oral ectoderm-derived dental epithelium and cranial neural crest cell-derived dental mesenchyme under genetic control [10-12]. More than 200 genes are known to be expressed during tooth development (http://bite-it.helsinki.fi/). A number of mouse mutants are now starting to provide some insights into the mechanisms of supernumerary tooth formation. Multiple supernumerary teeth may have genetic components in their etiology and partially represent the third dentition in humans. Such candidate molecules or genes might be those that are involved in embryonic tooth induction, in successional tooth formation, or in the control of the number of teeth. This means that it may be possible to induce de novo tooth formation by the in situ repression or activation of a single candidate gene. In this review, we present an overview of the collective knowledge of tooth regeneration, especially regarding the control of the number of teeth for gene therapy by the stimulation of a third dentition.

Assessing anteroposterior basal bone discrepancy with the Dental Aesthetic Index

OBJECTIVE To investigate dental appearance and cephalometric features, using a sample of orthognathic and/or orthodontic patients. A special interest was to identify the relationship of the Dental Aesthetic Index (DAI) with anteroposterior basal bone discrepancy (APBBD) and cephalometric indicators. MATERIALS AND METHODS A full sample of 159 patients in two Japanese hospitals was used. Each patient was assessed with a preorthodontic dental cast and cephalometric radiography. RESULTS Malocclusion with APBBD was more prevalent among high DAI subjects (P  =  .034, OR  =  1.04, 95% CI: 1.00-1.08), Class III malocclusion patients (P  =  .048, OR  =  2.32, 95% CI: 1.01-5.34) and male patients (P  =  .008, OR  =  2.96, 95% CI: 1.33-6.61). Participants scoring 88 points (the highest score in this sample) of the DAI had 16.84 times the risk of APBBD of those who scored 17 points (the lowest score in this sample). Patients with APBBD presented with a greater adjusted ANB angle (t  =  -8.10, P < .001) and a larger adjusted A-B/NF appraisal (t  =  -9.65, P < .001). The SNA angle (P < .001), the SNB angle (P  =  .002), the adjusted ANB angle (P  =  .001), and the adjusted A-B/NF appraisal (P  =  .035) were associated with DAI scores in cubic regression models. CONCLUSION This study has demonstrated a relationship between the DAI and APBBD. Feasibility of using the adjusted ANB angle and the adjusted A-B/NF appraisal to assess severity of APBBD has been confirmed. The DAI may provide a supportive method to evaluate orthognathic needs. Future investigations are indicated.

Prospective signs of cleidocranial dysplasia in Cebpb deficiency

BackgroundAlthough runt-related transcription factor 2 (RUNX2) has been considered a determinant of cleidocranial dysplasia (CCD), some CCD patients were free of RUNX2 mutations. CCAAT/enhancer-binding protein beta (Cebpb) is a key factor of Runx2 expression and our previous study has reported two CCD signs including hyperdontia and elongated coronoid process of the mandible in Cebpb deficient mice. Following that, this work aimed to conduct a case-control study of thoracic, zygomatic and masticatory muscular morphology to propose an association between musculoskeletal phenotypes and deficiency of Cebpb, using a sample of Cebpb-/-, Cebpb+/- and Cebpb+/+ adult mice. Somatic skeletons and skulls of mice were inspected with soft x-rays and micro-computed tomography (μCT), respectively. Zygomatic inclination was assessed using methods of coordinate geometry and trigonometric function on anatomic landmarks identified with μCT. Masseter and temporal muscles were collected and weighed. Expression of Cebpb was examined with a reverse transcriptase polymerase chain reaction (RT-PCR) technique.ResultsCebpb-/- mice displayed hypoplastic clavicles, a narrow thoracic cage, and a downward tilted zygomatic arch (p < 0.001). Although Cebpb+/- mice did not show the phenotypes above (p = 0.357), a larger mass percentage of temporal muscles over masseter muscles was seen in Cebpb+/- littermates (p = 0.012). The mRNA expression of Cebpb was detected in the clavicle, the zygoma, the temporal muscle and the masseter muscle, respectively.ConclusionsProspective signs of CCD were identified in mice with Cebpb deficiency. These could provide an additional aetiological factor of CCD. Succeeding investigation into interactions among Cebpb, Runx2 and musculoskeletal development is indicated.

Environmental and perceived stress in Australian dental undergraduates: Preliminary outcomes

Background. Dental students have reported a high prevalence of psychological stress and the causes are associated with the challenging dental environmental and demographic factors. This study aimed to conduct a preliminary investigation on dental students’ stress status, using a sample of first-to-third-year Bachelor of Dental Surgery students in an Australian university. Special interests included causes of dental environmental stress and access to help services. Methods. A sample of 145 students was surveyed with a modified Dental Environmental Survey and Depression Anxiety Stress Scale in 2014. The participants’ demographic information was also collected. Results. The response rate was 95.4%. Second-year (P = 0.042), third-year (P < 0.001) and employed students (P = 0.027) were more likely to report stress resulting from transition to clinical learning. Third-year students were more often stressed about communicating and approaching staff (P = 0.023) as well as different opinions between staff (P < 0.001) and reduced holidays (P < 0.001). Students that were younger than 21 years of age (P = 0.001), that were first years (P < 0.001), and that were not in a relationship (P = 0.010) more often found difficulty of course work stressful. Students who were not in a relationship more often considered learning manual dexterity a source of stress (P = 0.034). Students previously seeking professional help were more likely to be stressed (P = 0.010). Conclusion. Causes of dental environment stress varied among years of study and demographic backgrounds. Professional support to stressed students should be enhanced. Further investigation is indicated.