Shunsuke Nakata

Hereditary factors in the craniofacial morphology of Angle's Class II and Class III malocclusions

We attempted to assess the role of heredity in the development of Angles Class II and Class III malocclusions by comparing craniofacial morphologic differences between parents with Class II offspring and those with Class III offspring and by analyzing the parent-offspring correlations within each Class II and Class III malocclusion group. Lateral and frontal roentgenographic cephalograms were obtained for ninety-six patients with Class II malocclusion, 104 patients with Class III malocclusion, and their respective parents. Mean cephalometric profile diagrams were superimposed between the two groups of parents as well as between their offspring. Within the two groups, the parent-offspring correlation coefficients were computed for nineteen variables connecting cephalometric landmarks. The differences in the craniofacial complex were evident in the two groups of parents as well as in their offspring. High correlation coefficient values were seen between parents and their offspring in the Class II and Class III groups. Thus, there appears to be a strong familial tendency in the development of Class II and Class III malocclusions. We conclude that the hereditary pattern must be taken into consideration in the diagnosis and treatment of patients with these classes of malocclusion.

Root Resorption and Immune System Factors in the Japanese

The objective of this study was to determine whether there is an association between excessive root resorption and immune system factors in a sample of Japanese orthodontic patients. The records of 60 orthodontic patients (18 males, age 17.7 +/- 5.7 years; 42 females, age 16.4 +/- 6.0 years) and 60 pair-matched controls (18 males, age 15.9 +/- 4.5 years; 42 females, age 18.5 +/- 5.2 years) based on age, sex, treatment duration, and the type of malocclusion were reviewed retrospectively. The validity of our hypothesis was tested using the logistic regression analysis. The pretreatment records revealed that the incidence of allergy and root morphology abnormality was significantly higher in the root resorption group (P = .030 and .001), with a mean odds ratio of 2.794 and 6.317 and 95% confidence interval of 1.107-7.053 and 2.043-19.537, respectively. The incidence of asthma also tended to be higher in the root resorption group. From these results, we concluded that allergy, root morphology abnormality, and asthma may be high-risk factors for the development of excessive root resorption during orthodontic tooth movement in Japanese patients.

Effect of Facial Convexity on Antero-posterior Lip Positions of the Most Favored Japanese Facial Profiles

Soft tissue analyses are basic tools in planning orthodontic treatment. However, the perception of a well-balanced Japanese facial profile has not yet been established, particularly with respect to changes in facial convexity. The purpose of this study was to assess and determine the range of antero-posterior (A-P) lip positions of the top three most favored, well-balanced profiles from a series of various facial silhouettes with changing facial convexity. The average profile was constructed from the profiles of 30 Japanese males and females with Class I occlusions. Changes in facial convexity were established by altering the A-P chin position by protruding or retruding the chin in increments of 5 degrees and 10 degrees from the average profile. A series of 11 profiles were developed from each of the four changes in facial convexity. The lips were then protruded or retruded in one-mm increments from the average profile. Forty orthodontists were asked to rate the top three most favored, well-balanced profiles. We found that the raters tended to prefer more retruded lip positions as facial convexity decreased, for both males and females. The raters also tended to prefer slightly more protruded lip positions as the facial convexity increased. Because chin position is inherent in each patient, others may equate a retrusive or protrusive chin with certain personalities, thus, it is important for orthodontists to take into account the balance between the lips and the chin.

Expression of cathepsin K mRNA and protein in odontoclasts after experimental tooth movement in the mouse maxilla by in situ hybridization and immunoelectron microscopy.

Abstract This study demonstrated the simultaneous expression of cathepsin K (CK) mRNA by in situ hybridization and CK protein by immunoelectron microscopy in odontoclasts in mouse maxillae after experimental tooth movement. On the pressure side (the area under pressure during tooth movement), CK mRNA was detected in odontoclasts in resorption lacunae in the tooth root, in osteoclasts in bone resorption lacunae, and in fibroblasts in the periodontal ligament. Using electron microscopy, CK protein was detected at the apex of odontoclasts, intracellularly in vesicles and granules, and extracellularly in irregularly shaped vacuoles (extracellular spaces), on the plasma membrane of the ruffled border, and on and between typical striated type I collagen fibrils in the lacunae. These vesicles and granules appeared to fuse with irregular vacuoles containing CK-positive fragmented fibril-like structures close to the ruffled border. In the basolateral portion of odontoclasts, small amounts of CK-positive rough endoplasmic reticulum (ER) were found. CK-positive intracellular vacuoles (not extracellular spaces) also appeared to fuse with the vesicles and granules. However, these fused organelles rarely contained fragmented fibril-like structures. They are probably endolysosomes. The distribution of CK in odontoclasts was similar to that previously seen in osteoclasts. Furthermore, CK-positive fibril-like structures were found in the vacuoles of fibroblasts. These results indicated that during tooth movement CK is synthesized in odontoclasts on the pressure side and secreted into the tooth resorption lacunae. Therefore, CK may take part in the degradation of the dentin matrix (type I collagen fibrils and non-collagenous protein) of the tooth root, and in the subsequent intracellular degradation of endocytosed fragmented fibril-like structures in endolysosomes.

Relationship between tongue volume and lower dental arch sizes

The interrelation between the tongue volume and the lower dental arch sizes (arch width and area) was studied by the original methods that we developed. A plane perpendicular to the occlusal plane and 40 mm posterior to the lower incisal point was taken as the posterior border of the tongue and the arch. The tongue volume and the lower dental arch sizes were measured anterior to this border with plaster models. The correlations between the parameters obtained from 74 Japanese adults (37 men and 37 women) with normal occlusion were statistically analyzed. The results showed that (1) both the mean tongue volume and the mean lower dental arch sizes were significantly larger in men than in women; (2) the tongue volume and the lower dental arch sizes were significantly correlated; and (3) these correlations tended to be higher at the more posterior part of the dental arch.

Effects of retraction of anterior teeth and initial soft tissue variables on lip changes in Japanese adults

The aim of this study was to examine the effects of retraction of anterior teeth and the initial soft tissue profile variables on upper and lower lip changes in Japanese adults. Pre- and post-treatment cephalometric radiographs of 33 Japanese female adults (aged 23.0±5.0 years), with a Class II division 1 malocclusion, who had two or four first premolars extracted, were evaluated. Lateral cephalograms taken with the lips in a voluntary relaxed position were traced and compared. Nine linear and eight angular measurements were constructed for the hard tissue measurements and 16 linear and 2 angular for the soft tissue measurements. Stepwise multiple regression analysis revealed that the horizontal upper lip position could be explained by the position of the maxillary incisor cervical point and the occlusal plane to SN with a 54 percent contribution ratio, and horizontal lower lip position, maxillary incisor tip position, initial interlabial gap, and aesthetic line to the tip of lower lip with a 51 percent contribution ratio. All parameters employed explained the horizontal position of the upper and lower lip with higher than 96 percent confidence. While the horizontal positions could not be predicted by a limited number of parameters, the vertical positions of lips could be explained by three parameters with higher than 62 percent confidence. The predictability found in this study could be beneficial for orthodontists in treatment planning.

Capsaicin receptor expression in the rat temporomandibular joint

Experimentally, temporomandibular joint (TMJ) nerve units respond to capsaicin, which is used clinically to treat TMJ pain. However, the existence of capsaicin receptors in the TMJ has not previously been clearly demonstrated. Immunohistochemical analysis has revealed the presence of transient receptor potential vanilloid subtype 1 (TRPV1) expression in the nerves and synovial lining cells of the TMJ. TRPV1-immunoreactive nerves are distributed in the synovial membrane of the joint capsule and provide branches to the joint compartment. The disc periphery is supplied by TRPV1 nerves that are mostly associated with small arterioles, and occasional nerves penetrate to the synovial lining layer. Double immunofluorescence has shown that many TRPV1-immunoreactive nerves are labeled with neuropeptide calcitonin gene-related peptide, whereas few are labeled with IB4-lectin. The results provide evidence for the presence of TRPV1 in both nerves and synovial lining cells, which might thus be involved in the mechanism of nociception and inflammation in the TMJ.

Genetic and environmental factors in the development of so-called pseudo- and true mesioclusions

Abstract Separation of genetic and environmental factors related to the development of so-called pseudo- and true mesioclusions was attempted and the classification, which is in common use in clinical orthodontics, reconsidered. A differential diagnosis of these two types of mesioclusions was made depending on whether or not the mandible slid forward into displacement by incisal guidance. By means of lateral roentgenographic cephalograms obtained from 66 pseudo- and 48 true mesioclusion patients and 52 control subjects, and their respective parents, the craniofacial morphogenetic characteristics of each mesioclusion were determined. A familial tendency to prognathic skeletal profile was noted in cases of both pseudo- and true mesioclusions. Nearly all of the significant morphogenetic differences between the two groups of patients with mesioclusion were related to environmental factors. The terms “pseudo” and “true” are probably misleading expressions for these mesioclusions.

Comparison of anteroposterior lip positions of the most-favored facial profiles of Korean and Japanese people.

INTRODUCTION A consensus on the contemporary perception of beauty might have been developed between different countries because of increased worldwide access to variations in pleasing facial profiles. The objectives of this study were to determine, assess, and compare the ranges of values of the most-favored facial profiles rated by young Korean and Japanese adults. METHODS Average profiles were constructed from the profiles of 30 Japanese men and women with normal occlusions. A series of 13 profiles each was developed for men and women. In the series, the average profile was located in the center (number 7), and the lips were protruded or retruded in 1-mm increments from the average profile. Forty-six Korean dental students and 52 Japanese dental students were asked to rate the top 3 most-favored profiles. RESULTS Both the Korean and the Japanese dental students tended to select a slightly more retruded lip profile compared with the averages for men and women, and the tendency to prefer a more retruded lip position was evident for the women. CONCLUSIONS These findings suggest that young Korean and Japanese adults prefer a retruded profile, even though their profiles have historically been characterized by more convex facial features.

Evaluation of well-balanced lip position by Japanese orthodontic patients

INTRODUCTION The purposes of this study were to assess and determine the range of a well-balanced anteroposterior lip position as evaluated by orthodontic patients from a series of varying lip positions in facial silhouettes, and whether the raters sex and age were factors in the assessment. METHODS The average profiles were constructed from 30 Japanese male and female subjects with normal occlusion. A series of 13 profiles was developed for males and females, respectively. The lips were protruded or retruded by 1-mm increments from the average profile. One hundred fifty Japanese orthodontic patients were asked to choose the top 3 most-favored, well-balanced profiles for each sex. RESULTS The orthodontic patients tended to prefer a slightly retruded lip position than the average facial profile for both the male and female profiles. There was no significant difference between male and female raters in selecting the top 3 most-favored profiles. In the comparison of age groups, the over 30-year-old patients significantly preferred a more retruded lip position than did the 15- to 19-year-old and the 20- to 29-year-old patients for the female profile. CONCLUSIONS These results suggest that, when we formulate a treatment plan, we should ask the patients about lip position before we start treatment.