Kazuhide Kobayashi

Correlation between cortical plate proximity and apical root resorption

Root resorption is one of the most common iatrogenic sequelae of orthodontic treatment. Recently, root contact with the labial or palatal cortical plate at root apex level during orthodontic tooth movement was reported to be related to root resorption, and dentofacial morphology was suggested to predispose certain persons to root contact with the cortical plate. In this study, we constructed a best-fit straight line for the maxillary palatal cortical plate and set a line for the labial cortical plate from A point to Prosthion point in order to obtain measurements of proximity of root apices with the cortical plates of the maxillary alveolus. We investigated the correlation between apical root resorption and the measured variables. Our findings suggest that root approximation to the palatal cortical plate during orthodontic treatment could explain approximately 12% of the variance observed in the level of root resorption and the maxillary alveolar bone width about 2%. Tooth extrusion and crown lingualization also contributed to root resorption. We concluded that maxillary central incisor apical root resorption is influenced by root approximation to the palatal cortical plate during orthodontic treatment.

Force-Induced Osteoclast Apoptosis In Vivo Is Accompanied by Elevation in Transforming Growth Factor β and Osteoprotegerin Expression

The mechanism controlling the disappearance of osteoclasts from bone surfaces after bone resorption in vivo is largely unknown. This is because there is no suitable experimental system to trace the final fate of osteoclasts. Here, we used an experimental model of tooth movement in rats to show that preexisting osteoclasts disappeared from the bone surface through apoptosis during a force‐induced rapid shift from bone resorption to formation. On the distal alveolar bone surface of the maxillary molar in growing rats, many mature osteoclasts were present. When light tensional force was applied to the bone surface through an orthodontic appliance, these preexisting osteoclasts gradually disappeared. One day after the application of force, about 24% of the osteoclasts exhibited apoptotic morphology and the proportion of apoptotic cells was increased to 41% by day 2, then decreased afterward. These changes were undetectable on the control distal alveolar bone surface, which is free from tensional force. As shown by in situ hybridization, a marked increase in transforming growth factor β1 (TGF‐β1) and osteoprotegerin (OPG) messenger RNA (mRNA) was observed in the stretched cells on the tensioned distal bone surface, simultaneously with the loss of osteoclasts. Both of these factors are known to have a negative effect on osteoclast recruitment and survival. As early as 2 days after force application, some of these stretched cells were identified as cuboidal osteoblasts showing intense signals for both factors. Our data suggest there may be a sequential link in tensional force applied on the bone lining cells, up‐regulation of TGF‐β1/OPG, and disappearance of osteoclasts.

In vivo measurement of the elastic modulus of the human periodontal ligament

The present study was designated to determine the elastic properties of the periodontal ligament (PDL) in human subjects. A maxillary central incisor was experimentally translated so that stress or strain could be uniformly distributed in the PDL by applying a single force passing through the center of resistance. Displacements were measured under different magnitudes of load using a magnet-magnetic sensing system. From the load-displacement relations, Youngs modulus of the PDL was calculated. The values determined were approximately 0.12 MPa under load ranging from 0 to 0.5 N, 0.25 MPa within the range of 0.5-1.0 N, 0.44 MPa under load 1.0-1.5 N, and between 0.69 and 0.96 MPa with 1.5-2.0 N. The values of Youngs moduli increased almost exponentially with the increment of load due to a non-linear elasticity of the PDL.

Effects of local administration of osteocalcin on experimental tooth movement

The purpose of this study was to evaluate the effects of local administration of osteocalcin, a major noncollagenous bone matrix protein, on experimental tooth movement in rats. An orthodontic elastic band was inserted between the upper first and second molars, and the first molar was moved mesially. Purified osteocalcin (0 to 10 micrograms) in 20 microliters of phosphate-buffered saline was injected into the region of the root bifurcation of the first molar daily for 4 days. Tooth movement increased significantly following the injections. Histological studies revealed that the injections markedly stimulated the appearance of osteoclasts on the pressured side of the alveolar bone surface. The results suggest that osteocalcin has an additive effect on the rate of orthodontic tooth movement through the enhancement of osteoclastogenesis on the pressured side.

Knowledge and attitudes of Japanese dental health care workers towards HIV-related disease.

OBJECTIVE The present study was undertaken to investigate knowledge of AIDS and HIV infection among Japanese dental health care workers, the source of that knowledge and attitudes of dental workers towards infected patients. METHODS The study population surveyed by means of a self-administered questionnaire consisted of 174 dental health workers at Nagasaki University Dental Hospital, including students and trainee hygienists. RESULTS Most respondents (100% response) claimed their major source of AIDS knowledge to be derived from the media. Almost all considered their knowledge of AIDS and HIV infection to be more than moderate but still inadequate. The majority of respondents would be hesitant about performing dental treatment on HIV-positive patients. It was widely anticipated that dental patients infected with HIV would increase in the next few years and many were anxious about the increasing occupational risk of HIV infection. Only 22.4% of respondents had the same attitude towards treating HIV-positive and HIV-negative patients. Most also considered that they would be able to take care of the oral opportunistic diseases associated with HIV. Over 90.0% of respondents requested additional education about HIV, particularly information about the prevention and spread of the virus and cross-infection requirements. CONCLUSION It is concluded that further training in the medical and psychological aspects of treating HIV-positive patients is indicated in Japan.

Severe Dental Open Bite Malocclusion With Tongue Reduction After Orthodontic Treatment

We treated a 21-year-old woman with a severe open bite and macroglossia with a standard edgewise appliance and without partial glossectomy. This was followed by retention using a Begg-type plate retainer for the upper dental arch and a fixed canine-to-canine for the lower arch. A crib was added to the upper plate retainer for suppression of a tongue thrust. The lower arch relapsed during the retention period, with a widening of the intermolar distance, flaring of the anterior teeth, and increased mobility of the teeth. We chose tongue reduction to resolve these problems and one-third of the middle dorsal part of the tongue was excised. After the tongue reduction, the patient experienced no functional problem in mastication, swallowing, and gustation, but she complained of mild speech difficulty and slight pain on the dorsal portion of her tongue. These symptoms disappeared 6 months after surgery. At this time, the mandibular dental arch was markedly improved. The flared lower dental arch had returned to an upright position and the tooth mobility reduced to normal. No appliance was used after surgery. Most of the recovery changes occurred within 4 months. This case highlights the importance of the teeth tending to move toward a balance between the tongue pressure from the inside and labio-buccal pressure from the outside.

Force-induced Rapid Changes in Cell Fate at Midpalatal Suture Cartilage of Growing Rats

The application of expansional force induces replacement of the cartilaginous tissue with bone at the midpalatal suture of growing rats. We examined the early cellular events evoked by force by analyzing the expression of proliferating cell nuclear antigen (PCNA), an operational marker of cell proliferation, and of several bone matrix proteins. A rectangular orthodontic appliance was set between the right and left upper molars of four-week-old rats, with 50 g of initial expansional force. Two days after application of the force, the pre-existing cartilage was separated laterally. Mesenchymal cells with stretched shapes were arranged parallel to the expansional force and filled the center of the suture. Only a few of these stretched cells exhibited nuclear accumulation of PCNA. In contrast, many polygonal mesenchymal cells distributed along the inner lateral side of the cartilaginous tissue exhibited strong immunoreactivity for PCNA. Localization of alkaline phosphatase activity overlapped into this proliferating cell zone. Nascent extracellular matrix under the proliferating cells was positive for osteocalcin, indicating commencement of active bone formation. These findings indicated that, among mesenchymal cells subjected to expansional forces, only cells located on the inner side of the cartilaginous tissue proliferate and differentiate into osteoblasts. In agreement with rapid bone growth progression, apoptosis was also observed in the zone of proliferating cells, as measured by TdT-mediated dUTP-biotin nick end labeling (TUNEL) assays.

A new method for qualitative and quantitative evaluation of tooth displacement under the application of orthodontic forces using magnetic sensors

The purpose of this study was to develop a new method for the quantitative and qualitative measurement of tooth displacement under load and to clarify the relationship between the force system acting on a tooth and a resultant movement. A combination of eight magnetic sensors and a magnet was employed to measure three-dimensional displacement. Two sets of sensors and a magnet were placed in front and at the back of a front tooth subjected to orthodontic forces. Magnets and sensors were fixed to the subject tooth and posterior teeth, respectively. Sensors detected displacements of two magnets extended from the subject tooth separately in real time. The tooth trajectories projected on the sagittal plane were studied. From displacements of two magnets, angle of tooth rotation, the position of center of rotation and the amount and direction of displacement of an arbitrary point on the tooth could be calculated with high accuracy. Also, the location of center of resistance could be determined. It was found that the center of rotation is moving substantially even with a small difference in the level of force application. Furthermore, a small amount of displacement of the center of resistance was observed with varying the force magnitude.

Expression and localization of MGP in rat tooth cementum

Tooth cementum, a calcified hard tissue covering the root surfaces, is an important component connecting the teeth to the collagenous fibres of the periodontal ligament. Although the overall composition of cementum may closely resemble that of bone, each part has not been fully characterized. Here, the localization of the matrix gamma-carboxyglutamic acid (Gla) protein (MGP), one of the major Gla-containing proteins in the body, in cementum was investigated using immunohistochemistry and in situ hybridization. (1) Strong MGP antigenicity was observed in the acellular cementum, but was only moderate in the cellular cementum; (2) polygonal periodontal ligament cells facing the acellular cementum and the uncalcified cellular cementum expressed MGP mRNA, indicating that these cells produced MGP and deposited it on the cementum; (3) MGP accumulated at the junction between the uncalcified and calcified cellular cementum; and (4) the distribution pattern of MGP antigenicity resembled that of osteopontin. As one function of MGP could be as a negative regulator for mineral apposition, the expression of MGP in the cells adjacent to the cementum may be important to prevent hyperapposition of minerals.

Cloning and sequencing of the groESL homologue from Porphyromonas gingivalis

The homologue of groESL from Porphyromonas gingivalis was cloned and sequenced. Nucleotide sequencing suggested an operon containing two open reading frames (ORFs) homologous to groESL operon of Escherichia coli. The upstream ORF consisted of 267 bp corresponding to 89 amino acid residues. The downstream ORF consisted of 1635 bp corresponding to 545 amino acid residues.