Ken-ichiro Ejima

Low-Level Laser Therapy Enhances the Stability of Orthodontic Mini-Implants via Bone Formation Related to BMP-2 Expression in a Rat Model

OBJECTIVE The aim of this study was to investigate the stimulatory effects of low-level laser therapy (LLLT) on the stability of mini-implants in rat tibiae. BACKGROUND DATA In adolescent patients, loosening is a notable complication of mini-implants used to provide anchorage in orthodontic treatments. Previously, the stimulatory effects of LLLT on bone formation were reported; here, it was examined whether LLLT enhanced the stability of mini-implants via peri-implant bone formation. MATERIALS AND METHODS Seventy-eight titanium mini-implants were placed into both tibiae of 6-week-old male rats. The mini-implants in the right tibia were subjected to LLLT of gallium-aluminium-arsenide laser (830 nm) once a day during 7 days, and the mini-implants in the left tibia served as nonirradiated controls. At 7 and 35 days after implantation, the stability of the mini-implants was investigated using the diagnostic tool (Periotest). New bone volume around the mini-implants was measured on days 3, 5, and 7 by in vivo microfocus CT. The gene expression of bone morphogenetic protein (BMP)-2 in bone around the mini-implants was also analyzed using real-time reverse-transcription polymerase chain reaction assays. The data were statistically analyzed using Students t test. RESULTS Periotest values were significantly lower (0.79- to 0.65-fold) and the volume of newly formed bone was significantly higher (1.53-fold) in the LLLT group. LLLT also stimulated significant BMP-2 gene expression in peri-implant bone (1.92-fold). CONCLUSIONS LLLT enhanced the stability of mini-implants placed in rat tibiae and accelerated peri-implant bone formation by increasing the gene expression of BMP-2 in surrounding cells.

Interventional radiology of synovial chondromatosis in the temporomandibular joint using a thin arthroscope

This case report describes, for the first time, the use of interventional radiology following arthroscopy with a thin arthroscope for the diagnosis and treatment of synovial chondromatosis (SC) of the temporomandibular joint (TMJ). Therapeutic joint irrigation concomitant with arthroscopic observation of the superior joint compartment (SJC) was performed in a patient with functional TMJ pain caused by SC. The thin arthroscope was inserted with the aid of an X-ray fluoroscope. Arthroscopy confirmed that the SC was at disease stage II and that synovitis existed throughout the SJC. The initial maximal interincisor opening (MIO) was 30 mm, while after the joint-irrigation procedure the MIO was 40 mm. In addition, the TMJ pain was greatly reduced after joint irrigation. Our findings demonstrate that interventional radiology with a thin arthroscope is clinically useful for the diagnosis and primary treatment of patients with painful SC in the TMJ.

Relationship between the thickness of the roof of glenoid fossa, condyle morphology and remaining teeth in asymptomatic European patients based on cone beam CT data sets

OBJECTIVES The aim of this study was to examine the relationship between the roof of the glenoid fossa (RGF) thickness and condyle morphology and the influence of the number of remaining teeth and age. METHODS Cone beam CT data sets from 77 asymptomatic European patients were analysed retrospectively in this study. The thinnest area of RGF was identified among the sagittal and coronal slices on a computer screen; distance measurement software was used to measure the thickness. Moreover, we applied a free digital imaging and communications in medicine viewer for classification of condyle head type. It was also used to analyse any relation between RGF thickness and the number of remaining teeth. We performed a correlation analysis for RGF, age and missing teeth. Finally, we investigated combining sagittal condyle morphological characterization with coronal condyle morphology in relation to the number of joints and RGF thickness. RESULTS The Kruskal-Wallis test revealed no significant differences in RGF thickness among any of the coronal condyle head morphology groups (p > 0.05). There were significant differences in the thinnest part of RGF in relation to the sagittal plane for condyle morphological characterization, because we observed increased RGF thickness in joints with osteoarthritis features (p < 0.05). There is a non-significant correlation between the thinnest part of the RGF and the number of remaining teeth (p > 0.05). CONCLUSIONS We found that the RGF thickness is unaffected by the coronal condyle head morphology and the number of remaining teeth. Osteoarthritic changes (sagittal condyle morphology) have an effect on RGF.

Evaluation of the usefulness of magnetic resonance imaging in the assessment of the thickness of the roof of the glenoid fossa of the temporomandibular joint.

OBJECTIVE The aim of this study was to evaluate the usefulness of magnetic resonance imaging (MRI) in measuring thickness of the roof of the glenoid fossa (RGF) of the temporomandibular joint (TMJ). STUDY DESIGN Minimum RGF thickness in 95 TMJs of 59 patients with temporomandibular disorders were measured and compared on both sagittal-section MRI and cone-beam computed tomography (CBCT). RGF thickness on MRI was also compared with MRI, CBCT, and arthrographic findings. RESULTS Minimum RGF thickness was greater on MRI (1.46 mm) than on CBCT (0.90 mm). Spearmans correlation coefficient by rank for these 2 types of measurements was 0.63. RGF thickness on MRI differed significantly between those with and without degenerative joint changes (1.69 vs 1.32 mm; P < .01) and between those with and without disk displacement (1.58 vs 1.35 mm; P = .04), but showed no associations with disk deformity, joint effusion, or disk perforation. CONCLUSIONS MRI is useful in measuring RGF thickness from diagnostic as well as radiation protection standpoints.

Assessment of quality and interpretation of panoramic radiographs obtained in the Lao People’s Democratic Republic as part of a teleradiology collaboration with Japan

As part of quality assessment of a teleradiology program we evaluated the validity of patient information received, the quality of panoramic radiography imaging in Laos, and the ability of a Laotian radiologist to detect temporomandibular joint abnormalities. The amount of patient information gathered from 2,021 scans of panoramic radiographs was evaluated by triage before image diagnosis. Among the radiographs from 2,021 patients, primary triage indicated that there was insufficient information for 794 (39.3%) patients. Secondary triage to assess imaging failure included 1,227 radiographs, four of which were excluded from imaging diagnosis because of unacceptable image flaws. In total, 2,446 joints from 1,223 radiographs were evaluated for temporomandibular joint abnormalities in order to compare the image interpretation abilities of Laotian and Japanese radiologists. The kappa coefficient was 0.836 (P < 0.01) for the agreement between the two observers in detecting temporomandibular joint abnormalities on radiographs. We conclude that additional efforts are needed in order to overcome the challenges of maintaining quality in imaging techniques and diagnoses in Laos.

Measuring bone density at orthodontic miniscrew implantation sites using microcomputed tomography.

PURPOSE This study was performed to determine the accuracy of measurements of bone mineral density (BMD) and cortical bone thickness (CBT) at miniscrew implantation sites in small animals and to verify the usefulness of in vivo microcomputed tomography (micro-CT). MATERIALS AND METHODS Rat femurs were scanned before and after placing miniscrews using in vivo micro-CT. The images were superimposed using a subtraction method with bone volume measurement software. At each screw site, the total BMD was calculated as the average BMD of a cylinder 1.6 mm in diameter and 2.0 mm in depth, while the cortical BMD was the average BMD of a cylinder 1.6 mm in diameter and 1.0 mm in depth. CBT was measured three times on transaxial images of the rat femurs, and the average value was used. All miniscrews were placed using the maximum torque, verified with a digital torque tester. To verify the usefulness and accuracy of in vivo micro-CT, CBT on micro-CT images was compared with that measured on histologic sections. RESULTS Significant correlations were observed between placement torque and cortical BMD (R = 0.572), total BMD (R = 0.732), and CBT (R = 0.788). There was a significant correlation between CBT measured via field-emission scanning electron microscopy images and CBT measured with in vivo micro-CT (R = 0.974). CONCLUSIONS The BMD over a narrow range can be measured accurately in small animals with high reproducibility of the trabecular structure using a combination of high-resolution in vivo micro-CT and image superimposition using a three-dimensional subtraction method.

Locomotion pattern and trunk musculoskeletal architecture among Urodela

We comparatively examined the trunk musculature and prezygapophyseal angle of mid-trunk vertebra in eight urodele species with different locomotive modes (aquatic Siren intermedia, Amphiuma tridactylum, Necturus maculosus and Andrias japonicus; semi-aquatic Cynops pyrrhogaster, Cynops ensicauda; and terrestrial Hynobius nigrescens, Hynobius lichenatus and Ambystoma tigrinum). We found that the more terrestrial species were characterized by larger dorsal and abdominal muscle weight ratios compared with those of the more aquatic species, whereas muscle ratios of the lateral hypaxial musculature were larger in the more aquatic species. The lateral hypaxial muscles were thicker in the more aquatic species, whereas the M. rectus abdominis was more differentiated in the more terrestrial species. Our results suggest that larger lateral hypaxial muscles function for lateral bending during underwater locomotion in aquatic species. Larger dorsalis and abdominal muscles facilitate resistance against sagittal extension of the trunk, stabilization and support of the ventral contour line against gravity in terrestrial species. The more aquatic species possessed a more horizontal prezygapophyseal angle for more flexible lateral locomotion. In contrast, the more terrestrial species have an increasingly vertical prezygapophyseal angle to provide stronger column support against gravity. Thus, we conclude trunk structure in urodeles differs clearly according to their locomotive modes.

Reduction of moving artifacts caused by breathing in rats for in vivo micro-computed tomography

AbstractObjectives This study developed software for the reduction of moving artifacts caused by breathing in rats by means of teeth tracking when CT images were taken using in vivo micro-computed tomography (micro-CT).MethodsRaw projection data from the CT of teeth in rats were chosen retrospectively, and then correlated with moving artifacts caused by breathing. An m-mode image was reconstructed from the projection data and used to calculate motion as a function of position. The projection data were corrected and the CT images were reconstructed using the corrected projection data.ResultsThe reconstructed CT images were sharper than the original CT images. There was fog in the periodontal ligament space in the original images because of motion artifacts. The images were clearer after processing.ConclusionsThe artifacts caused by breathing in in vivo micro-CT images of rat teeth were reduced using this software.

Micro-CT observation of in vivo temporal change in mandibular condyle morphology in BMAL1 knockout mice

Brain and muscle Arnt-like protein-1 (BMAL1) knockout mice exhibit accelerated aging, abnormal glucose metabolism, and impaired adipocyte differentiation, among other phenotypes, which are effects associated with the BMAL1 gene. No study has investigated temporal changes in the deformation of the mandibular condyle and the presence of calcification in areas surrounding the mandibular condyle. In a study of 12 C57/BL strain mice under inhalation anesthesia, we collected images of the mandibular condyle at 6 weeks after birth and then every 5 weeks from 10 to 25 weeks after birth. At 25 weeks, deformation of the mandibular condyle was seen in 8 of 12 joints in BMAL1 knockout mice and in 2 of 12 joints in wild-type mice. At 20 and 25 weeks, deformation in areas surrounding the mandibular condyle, which are known to undergo calcification, was seen in 2 of 12 joints in BMAL1 knockout mice and in 0 of 12 joints in wild-type mice. BMAL1 knockout mice exhibited premature aging of the mandibular condyle, which suggests that circadian rhythms affect mandibular condyle morphology.