Issei Saitoh

Tongue posture improvement and pharyngeal airway enlargement as secondary effects of rapid maxillary expansion: A cone-beam computed tomography study

INTRODUCTION Rapid maxillary expansion (RME) is known to improve nasal airway ventilation. Recent evidence suggests that RME is an effective treatment for obstructive sleep apnea in children with maxillary constriction. However, the effect of RME on tongue posture and pharyngeal airway volume in children with nasal airway obstruction is not clear. In this study, we evaluated these effects using cone-beam computed tomography. METHODS Twenty-eight treatment subjects (mean age 9.96 ± 1.21 years) who required RME treatment had cone-beam computed tomography images taken before and after RME. Twenty control subjects (mean age 9.68 ± 1.02 years) received regular orthodontic treatment. Nasal airway ventilation was analyzed by using computational fluid dynamics, and intraoral airway (the low tongue space between tongue and palate) and pharyngeal airway volumes were measured. RESULTS Intraoral airway volume decreased significantly in the RME group from 1212.9 ± 1370.9 mm(3) before RME to 279.7 ± 472.0 mm(3) after RME. Nasal airway ventilation was significantly correlated with intraoral airway volume. The increase of pharyngeal airway volume in the control group (1226.3 ± 1782.5 mm(3)) was only 41% that of the RME group (3015.4 ± 1297.6 mm(3)). CONCLUSIONS In children with nasal obstruction, RME not only reduces nasal obstruction but also raises tongue posture and enlarges the pharyngeal airway.

Improvement of nasal airway ventilation after rapid maxillary expansion evaluated with computational fluid dynamics

INTRODUCTION Rapid maxillary expansion is known to improve nasal airway ventilation. However, it is difficult to precisely evaluate this improvement with conventional methods. The purpose of this longitudinal study was to use computational fluid dynamics to estimate the effect of rapid maxillary expansion. METHODS Twenty-three subjects (9 boys, 14 girls; mean ages, 9.74 ± 1.29 years before rapid maxillary expansion and 10.87 ± 1.18 years after rapid maxillary expansion) who required rapid maxillary expansion as part of their orthodontic treatment had cone-beam computed tomography images taken before and after rapid maxillary expansion. The computed tomography data were used to reconstruct the 3-dimensional shape of the nasal cavity. Two measures of nasal airflow function (pressure and velocity) were simulated by using computational fluid dynamics. RESULTS The pressure after rapid maxillary expansion (80.55 Pa) was significantly lower than before rapid maxillary expansion (147.70 Pa), and the velocity after rapid maxillary expansion (9.63 m/sec) was slower than before rapid maxillary expansion (13.46 m/sec). CONCLUSIONS Improvement of nasal airway ventilation by rapid maxillary expansion was detected by computational fluid dynamics.

Evaluation of upper airway obstruction in Class II children with fluid-mechanical simulation

INTRODUCTION The purpose of this study was to test the null hypothesis that dolichofacial and brachyfacial children with Class II malocclusion do not differ in upper airway obstruction. Furthermore, the ability of fluid-mechanical simulation to detect airway obstruction within the limitations of simulation was examined. METHODS Forty subjects from 7 to 11 years of age with Class II malocclusion participated and were divided into 2 groups, dolichofacial and brachyfacial, based on their Frankfort mandibular plane angles. Cone-beam computed tomography images supplied the shape of the entire airway. Two measures of respiratory function, air velocity and pressure, were simulated by using 3-dimensional images of the airway. The images and simulations were compared between the 2 facial types. RESULTS The size of the upper airway did not differ statistically between facial types; however, the simulated maximal pressure and velocity of the dolichofacial type were significantly higher than those of the brachyfacial type. CONCLUSIONS Airway obstruction differs with the Frankfort mandibular plane angle, even though the depth and cross-sectional area of the airway do not. The fluid-mechanical simulation system developed in this study detected differences in airway obstruction that were not apparent from morphologic studies.

Direct Injection of CRISPR/Cas9-Related mRNA into Cytoplasm of Parthenogenetically Activated Porcine Oocytes Causes Frequent Mosaicism for Indel Mutations

Some reports demonstrated successful genome editing in pigs by one-step zygote microinjection of mRNA of CRISPR/Cas9-related components. Given the relatively long gestation periods and the high cost of housing, the establishment of a single blastocyst-based assay for rapid optimization of the above system is required. As a proof-of-concept, we attempted to disrupt a gene (GGTA1) encoding the α-1,3-galactosyltransferase that synthesizes the α-Gal epitope using parthenogenetically activated porcine oocytes. The lack of α-Gal epitope expression can be monitored by staining with fluorescently labeled isolectin BS-I-B4 (IB4), which binds specifically to the α-Gal epitope. When oocytes were injected with guide RNA specific to GGTA1 together with enhanced green fluorescent protein (EGFP) and human Cas9 mRNAs, 65% (24/37) of the developing blastocysts exhibited green fluorescence, although almost all (96%, 23/24) showed a mosaic fluorescent pattern. Staining with IB4 revealed that the green fluorescent area often had a reduced binding activity to IB4. Of the 16 samples tested, six (five fluorescent and one non-fluorescent blastocysts) had indel mutations, suggesting a correlation between EGFP expression and mutation induction. Furthermore, it is suggested that zygote microinjection of mRNAs might lead to the production of piglets with cells harboring various mutation types.

Improvement in Jaw Motion Following Treatment of Unilateral Crossbite in a Child with Primary Dentition: A Case Report

ABSTRACT This case report examines jaw motion during both habitual opening-closing and gum chewing in a young (3 years, 10 months) patient with unilateral crossbite at the primary dentition stage. Jaw motion was measured three times: 1. before treatment; 2. after active treatment; and 3. after retention. The abnormal habitual open-close pathway seen prior to treatment was improved after retention. Prior to treatment, movement of the affected-side condyle preceded movement of the non-affected-side condyle during opening. After retention, the movement of the condyles was better coordinated. The chopping type chewing pattern, with less lateral movement, before treatment changed to a more grinding type pattern on the affected side after activation. This study suggests that the prescribed treatment effectively improved both the patients morphology and function. However, neither the open-close pathways nor the chewing patterns were completely normal after retention. The results in this case suggest that early treatment of functional unilateral crossbite can be effective.

The effect of rapid maxillary expansion on pharyngeal airway pressure during inspiration evaluated using computational fluid dynamics.

INTRODUCTION Recent evidence suggests that rapid maxillary expansion (RME) is an effective treatment of obstructive sleep apnea syndrome (OSAS) in children with maxillary constriction. Nonetheless, the effect of RME on pharyngeal airway pressure during inspiration is not clear. The purpose of this retrospective study was to evaluate changes induced by the RME in ventilation conditions using computational fluid dynamics. METHODS Twenty-five subjects (14 boys, 11 girls; mean age 9.7 years) who required RME had cone-beam computed tomography (CBCT) images taken before and after the RME. The CBCT data were used to reconstruct 3-dimensional shapes of nasal and pharyngeal airways. Measurement of airflow pressure was simulated using computational fluid dynamics for calculating nasal resistance during exhalation. This value was used to assess maximal negative pressure in the pharyngeal airway during inspiration. RESULTS Nasal resistance after RME, 0.137 Pa/(cm(3)/s), was significantly lower than that before RME, 0.496 Pa/(cm(3)/s), and the maximal negative pressure in the pharyngeal airway during inspiration was smaller after RME (-48.66 Pa) than before (-124.96 Pa). CONCLUSION Pharyngeal airway pressure during inspiration is decreased with the reduction of nasal resistance by the RME. This mechanism may contribute to the alleviation of OSAS in children.

A Cross-Sectional Study of Developing Resting Masseter Activity in Different Angle Classifications in Adolescence

Abstract The purpose of this study was to determine whether the development of masseter muscle activity at mandibular rest position is characteristic for different angle classifications. The sample consisted of 64 boys and 108 girls, aged ten to 18. Electromyographic (EMG) activity from the right and left masseter muscles was recorded using an EMG scanner. First or second order polynomials were used to separately model the age-related changes in resting muscle activity of each gender and Angle’s classification. The EMG activity of Class I boys and girls were expressed in positive second order polynomials. The EMG activities of Class II and Class III subjects were expressed in first order polynomials, and the EMG levels in Class III subjects were lower than in Class II subjects. These results indicated that development of resting activity levels might distinguish and characterize the anteroposterior mandibular position relative to craniofacial region.

Induction of tissue-specific stem cells by reprogramming factors, and tissue-specific selection

Although induced pluripotent stem (iPS) cells have significant implications for overcoming most of the ethical issues associated with embryonic stem (ES) cells, there are still several unresolved issues related to the use of iPS cells for clinical applications, such as teratoma formation. In this study, we were able to generate tissue-specific stem (induced tissue-specific stem; iTS) cells from the pancreas (iTS-P) or liver (iTS-L) by transient overexpression of reprogramming factors, combined with tissue-specific selection. The generation of iTS cells was easier than that of iPS cells. The iTS-P/iTS-L cells express genetic markers of endoderm and pancreatic/hepatic progenitors and were able to differentiate into insulin-producing cells/hepatocytes more efficiently than ES cells. Subcutaneous transplantation of both types of iTS cells into immunodeficient mice resulted in no teratoma formation. The technology used for the transient overexpression of reprogramming factors and tissue-specific selection may be useful for the generation of other tissue-specific stem cells, and the generation of iTS cells could have important implications for the clinical application of stem cells.

Jaw motion during gum-chewing in children with primary dentition.

Abstract This study was undertaken to characterize jaw motion during mastication in children with primary dentition and to compare jaw motion with that in adults. The means and the variances of the traditional parameters for the chewing cycle, i.e., duration, excursive ranges and 3-D distances of travel at the lower incisor, molars and condyles were analyzed and compared in 23 children and 25 female adults. The duration of opening in children was significantly shorter than that of adults. Significant differences between children and adults were observed in lateral and vertical excursion of the incisor, lateral excursion at the molars, and vertical excursion at the condyles. Many of these measurements had larger between-subject and between-cycle variances in children than adults, suggesting that chewing motion in children has not yet matured. The results of this study indicate that chewing motion in children is different from that of adults.

Normalization of Masticatory Function of a Scissors-Bite Child with Primary Dentition: A Case Report

Abstract Normalization of mandibular function in children is important for normal orofacial development because their function is not still matured. This case report examined jaw movement during chewing in a young patient with unilateral scissors-bite. He could hardly chew on the affected side, preferring to chew only on the unaffected side, and his minimum opening position was initially unstable, i.e., he had two positions before active treatment. Retention did not stabilize his minimal opening position and his dual-bite was not corrected. His minimal opening position was stabilized after equipping his upper canines with a resin cap. Although orthodontic treatment morphologically improved the patient’s malocclusion, his function did not improve. Normal jaw movement on both sides was achieved after interfering with his old chewing pattern. Because normalization is needed for acquisition of normal function in children, long-term observations of their growth and functional changes are necessary after orthodontic treatment.