Wan-Chien Cheng

Immunosuppressive Effect of Quercetin on Dendritic Cell Activation and Function

Dendritic cells (DCs) play a crucial role in linking innate and adaptive immunity. Thus, DCs have been regarded as a major target of immunosuppressants for the control of harmful immune responses. In this study, we examined the effect of quercetin, a natural flavonoid found in many vegetables and fruits, on the activation and function of mouse DCs. Quercetin effectively inhibited LPS-induced DC activation by reducing the production of proinflammatory cytokines/chemokines and the expression levels of MHC class II and costimulatory molecules. In addition, quercetin uniquely blocked endocytosis by DCs and the LPS-induced DC migration was diminished by quercetin treatment. Furthermore, quercetin abrogated the ability of LPS-stimulated DCs to induce Ag-specific T cell activation, both in vitro and in vivo. Remarkably, coadministration of quercetin with 2,4-dinitro-1-fluorobenzene prevented 2,4-dinitro-1-fluorobenzene–induced contact hypersensitivity, indicating the potential of quercetin for treating delayed-type hypersensitive diseases. Blockage of LPS-induced ERK, JNK, Akt, and NF-κB activation contributed to the inhibitory effect of quercetin on DCs. These results strongly suggest that quercetin may be a potent immunosuppressive agent and could be used in the prevention and therapy of chronic inflammation, autoimmunity, and transplantation via the abolishment of DC activation and function.

Three‐dimensional analysis of the root morphology of mandibular first molars with distolingual roots

AIM To determine the prevalence of distolingual roots in mandibular first molar teeth in Taiwanese Han Chinese, and its impact on root morphology. METHODOLOGY The presence of distolingual roots in 375 subjects (521 molars) were assessed from 624 patients attending the dental clinics of medical centres around Taiwan island from August 2004 to April 2007 using computed tomography. The following observations were made: (i) numbers of roots and canals, (ii) mesial and distal root types and (iii) levels of furca in the molars presence or absence of distolingual root. RESULTS The mean age of the subject was 45; 43% were women. Among all the examined molars, 56%, 27% and 18% were two-, three- and four-rooted, respectively. Two per cent, 72% and 26% of molars had two, three and four canals, respectively. All of the four-rooted molars had four canals, but all of the molars with four canals varied in the number of roots. All molars with distolingual roots had two mesial canals. Bilateral consistency in terms of distolingual root, root canal number, root number and root type was observed in subjects with bilateral molars. In molars with distolingual roots, a higher prevalence of two mesial roots and a shorter mesial root trunk were observed than in teeth without distolingual roots. CONCLUSIONS A distolingual root was found in 22% of molars and in 24% of the subjects examined. Most subjects with a distolingual root had them bilaterally. The presence of a distolingual root was associated with variation in the root morphology, including the furcation level, the root type and the number of roots and canals.

Ameliorative effect of quercetin on the destruction caused by experimental periodontitis in rats.

BACKGROUND AND OBJECTIVE The purpose of this study was to evaluate the effect of quercetin, a flavonol that exhibits anti-inflammatory properties, on experimental periodontal destruction in rats. MATERIAL AND METHODS Osteoclast formation on maxillary palatal alveolus was induced with daily lipopolysaccharide (LPS) injections (0, 1 or 5 mg/mL) for 3 d. Five days later, the osteoclasts on bony surfaces were counted after histochemical staining for tartrate-resistant acid phosphatase. The effect of intragastric quercetin on the osteoclast formation was evaluated in the following three groups: quercetin (75 mg/kg/d by oral feeding); LPS (5 mg/mL); and quercetin plus LPS. Moreover, the effect of quercetin on the ligature-induced periodontitis around maxillary second and mandibular first molars was further evaluated by microcomputerized tomography (on days 0, 4, 8 and 12) and by histometry (on day 8). RESULTS A dose-dependent increase in osteoclasts occurred after LPS injections. However, quercetin (75 mg/kg) reduced the 5 mg/mL LPS-induced osteoclasts. Using microcomputerized tomography, the bone crest levels at ligation sites were found to be significantly more apical than at the control sites on days 8 and 12; however, the apically located bone crests rebounded in rats from the quercetin-plus-ligation group. Histometry demonstrated significantly more coronal alveolar crest bone levels, less inflammatory cell-infiltrated connective tissue areas and less connective tissue attachments in the ligation-plus-quercetin group compared with those in the ligation group. CONCLUSION As the quercetin could reduce the LPS-induced osteoclast formation and the ligature-enhanced periodontal inflammation and bone loss, we suggest that it may have an ameliorative effect on periodontal destruction.

Original ContributionsDental ImplantsPreoperative assessment of labial bone perforation for virtual immediate implant surgery in the maxillary esthetic zone: A computer simulation study

BACKGROUND In this computer simulation study, the authors investigated the frequency distribution of labial bone perforation (LBP) between various sagittal root position (SRP) classes with respect to the anterior maxillary osseous housing and evaluated the associated factors correlated with a higher risk of LBP when performing a virtual immediate implant surgery in the esthetic zone. METHODS The authors analyzed cone-beam computed tomography (CBCT) images from 285 qualified study participants (1,449 teeth) to determine the probability of LBP when associated with selected variables, such as tooth type, SRP class, and morphologic parameters. The authors examined associated factors and analyzed the adjusted odds ratios by means of multiple logistic regression analysis. RESULTS The overall probability of LBP was 81.7%, which presented statistically significant differences between each specific tooth type and SRP class (all P<.001). After adjusting for other factors, the authors found that the maxillary central incisor was 2.37 times more likely to have LBP than the canine. SRP class I was 4.9 times more likely to be associated with LBP when compared with SRP class IV. CONCLUSIONS When a clinician performs an immediate implant in the anterior esthetic zone, he or she should be aware that the specific tooth type, SRP class, and morphologic features of fossa concavities are associated with a risk of experiencing LBP. PRACTICAL IMPLICATIONS Presurgical cross-sectional images can be analyzed to identify anatomic features relative to LBP in the maxillary esthetic region, and this can avoid unpleasant complications, specifically when performing immediate implant procedures.

Complicated Root Canal Configuration of Mandibular First Premolars Is Correlated with the Presence of the Distolingual Root in Mandibular First Molars: A Cone-beam Computed Tomographic Study in Taiwanese Individuals

Introduction: The purpose of this study was to examine the frequency and bilateral consistency of distolingual roots (DLRs) in permanent mandibular first molars (PMFMs) and root canal configurations in PMFPs (permanent mandibular first premolars) and to determine the correlation between the root canal configurations of PMFPs with the appearance of DLRs in PMFMs. Methods: A total of 932 cone‐beam computed tomographic images of PMFMs and PMFPs were collected from 233 patients. The frequency and bilateral consistency of DLRs in PMFMs along with root canal configurations (root number and canal number) of PMFPs were recorded and evaluated ipsilaterally and contralaterally. Multivariable logistic regression analysis was used to evaluate the correlation between the root canal configurations of PMFPs with the appearance of DLRs in PMFMs. Results: The prevalence of PMFMs with DLRs was 24.7%, and the incidence of complicated root canal configurations of PMFPs was 26.6%. The incidence of complicated root canal configurations of PMFPs was 19.6% in the non‐DLR group, 37.2% in the unilateral DLR group, and 44.7% in the bilateral DLR group. After adjusting for categoric variables including sex, age, and side, the odds ratios for the frequency of complicated root canal configurations of PMFPs in the unilateral DLR and bilateral DLR groups compared with the non‐DLR group were 2.472 (95% confidence interval, 1.434–4.263; P = .001) and 3.392 (95% confidence interval, 1.976–5.823; P < .001), respectively. Conclusions: An increasing and corresponding trend between the presence of DLRs in PMFMs and complicated root canal configurations in PMFPs was noted in Taiwanese individuals. These results suggest that the clinicians should familiarize themselves with the anatomic variants of PMFMs and PMFPs before endodontic treatment.

Complicated Root Canal Morphology of Mandibular Lateral Incisors Is Associated with the Presence of Distolingual Root in Mandibular First Molars: A Cone-beam Computed Tomographic Study in a Taiwanese Population

Introduction: The aim of this study was to assess the root canal configurations in permanent mandibular lateral incisors (PMLIs) and the correlation between the root canal configurations of PMLIs with the appearance of a distolingual root (DLR) in permanent mandibular first molars (PMFMs) using cone‐beam computed tomographic (CBCT) imaging. Methods: A total of 1200 CBCT images (300 patients) of PMFMs and PMLIs were investigated. The frequency and distribution of DLRs in PMFMs along with root canal configurations of PMLIs were assessed ipsilaterally and contralaterally. Multivariable logistic regression analysis was used to evaluate the correlation between the root canal configurations of PMLIs with the appearance of a DLR in PMFMs. Results: The prevalence of PMFMs with a DLR was 24.3%, and the incidence of complicated root canal configurations in PMLIs was 25.0%. The most prevalent root canal systems of PMLIs were Vertucci types I (75%) and III (23.0%). The incidence of complicated root canal configurations in PMLIs was 19.5% in the non‐DLR group (ie, no DLR was found on either side of the PMFMs), 33.3% in the unilateral DLR (Uni‐DLR) group (ie, a DLR was found in 1 of the PMFMs [the left or right side] and a DLR was not found on the other PMFM), and 39.8% in the bilateral DLR (Bil‐DLR) group (ie, a DLR was found in both the right and left PMFMs). After adjusting for categoric variables including sex, age, and side, the odds ratios for the frequency of complicated root canal configurations of PMLIs in the Uni‐DLR and Bil‐DLR groups compared with the non‐DLR group were 2.12 (P = .003) and 2.707 (P < .001), respectively. Conclusions: The simultaneous appearance of DLRs in PMFMs and complicated root canal configurations in PMLIs is prominent in Taiwanese individuals. Clinicians should be aware of the correlation between the anatomic variants of PMFMs and PMLIs, which are important before endodontic treatment.

The Presence of Distolingual Root in Mandibular First Molars Is Correlated with Complicated Root Canal Morphology of Mandibular Central Incisors: A Cone-beam Computed Tomographic Study in a Taiwanese Population

Introduction: The aim of this study was to assess the prevalence of complicated root canals in permanent mandibular central incisors (PMCIs) and its correlation with the presence of a distolingual root (DLR) in permanent mandibular first molars (PMFMs) using cone‐beam computed tomographic imaging in a Taiwanese population. Methods: A total of 400 patients (800 pairs of PMCIs and PMFMs) were qualified for further analysis. The prevalence of DLRs in PMFMs along with root canal configurations of PMCIs were assessed at subject and tooth levels. Multivariable logistic regression analysis was used to evaluate the correlation between the root canal configurations of PMCIs with the existence of DLRs in PMFMs. Results: The prevalence of PMFMs with DLRs and complicated root canal configurations in PMCIs was 23.0% and 15.6%, respectively. A significant difference in age (<50 years vs ≥50 years) was found for complicated root canal configurations in PMCIs. The most prevalent root canal system in PMCIs was Vertucci type I (84.4%) followed by type III (13.5%). A positive correlation between the presence of DLRs in PMFMs and complicated root canal configurations in PMCIs was noted. After adjusting for categoric variables including sex, age, and side, the odds ratios for the occurrence of complicated root canal configurations of PMCIs in the unilateral DLR group and the bilateral DLR group compared with the non‐DLR group were 2.13 and 2.53, respectively. Conclusions: The concurrent appearance of DLRs in PMFMs and complicated root canal morphology in PMCIs is prominent in Taiwanese individuals.

Relationship of the Incidence of C-shaped Root Canal Configurations of Mandibular First Premolars with Distolingual Roots in Mandibular First Molars in a Taiwanese Population: A Cone-beam Computed Tomographic Study

Introduction The aim of this study was to determine the prevalence of C‐shaped canal configurations (CSs) and radicular grooves (RGs) in permanent mandibular first premolars (MPs) and to investigate the relevance of such complexities with the presence of distolingual roots (DLRs) in permanent mandibular first molars (MMs). Methods A total of 800 pairs of MPs and MMs were investigated using a cone‐beam computed tomographic system (NewTom 5G; QR srl, Verona, Italy). The frequency and symmetry of DLRs in MMs along with the occurrence of RGs and CSs in examined MPs were evaluated. Multivariable logistic regression analysis was applied to examine the correlation between the CSs of MPs with the appearance of DLRs in MMs. Results In the examined teeth, 23.0% of MMs had a DLR, whereas 16.6% of MPs had RGs and 12.5% of MPs had C‐shaped canals. Although the most common canal configuration in MPs is the single canal (74.1%), the other 25.9% still possess complicated root canals. Of these MPs that have different canal configurations, 54.6% had 2 canals, whereas 44.4% had CSs. Specifically, the CS showed a high prevalence of C3 morphologies at 98.9% followed by C1 at 1.1%. A corresponding and increasing frequency was noted in CSs and RGs of MPs and MMs with DLRs (P < .001). After adjusting for related categoric variables, the adjusted odds ratios for CSs of MPs in the bilateral DLR group compared with the non‐DLR group was 3.294 (P < .001). Conclusions This study showed an increased appearance of CSs in MPs when DLRs were present in MMs in the Taiwanese population.

Geometric features of second mesiobuccal canal in permanent maxillary first molars: a cone-beam computed tomography study

Background/purpose Inadequacy to locate the second mesiobuccal canal (MB2) canal leads to the highest probability of endodontic failure in permanent maxillary first molars (PMFMs) and still remains a constant challenge for many clinicians. The aim of this study was to characterize the geometrical features between MB2 and other orifices of examined PMFMs using cone-beam computed tomography images. Materials and methods A total of 108 teeth qualified in the cone-beam computed tomography image archives were enrolled in the present study. The intersecting point (T) was determined as the perpendicular line (h, altitude of triangle) projected from the vertex of the MB2 canal orifice to mesiobuccal canal orifice-palatal canal orifice line (MB1-P). We measured the geometric features of PMFMs with the MB2 canal, including the interorifice distances, area, altitude, and the ratio between the canal orifices. Results The average interorifice distance was found to be 1.91 ± 0.59 mm for MB1-MB2, 5.73 ± 0.66 mm for MB1-P, and 4.11 ± 0.79 mm for MB2-P, with significant gender difference for MB1-MB2 distance. For the MB1-T distance, a significant difference was found between genders (P = 0.02), with males averaging 1.78 ± 0.07 mm, and females 1.48 ± 0.11 mm. For the MB1-P distance, the majorities of both genders were found in the 20–40% cut-off. A portion of the males exhibited a tendency towards the 40–80% cut-off, while females shifted in the reverse direction towards the 0–20% cut-off. Conclusion In clinical scenarios, these anatomical characteristics of the root canals system could be beneficial to locating the MB2 canal.

Possible Protective Effect of Diacerein on Inflammation-Induced Alveolar Bone Loss in Rats

Periodontal diseases are characterized by destruction of the tooth-supporting structure, and may be hazardous to general health. Diacerein (DAR), one derivatives from anthraquinone, has been shown to have a variety of pharmacological activities on joint-derived tissues/cells for decades. However, the therapeutic potential of anthraquinone on periodontal destruction has not yet been investigated. In the present study, we evaluated the effects of DAR on the growth of P. gingivalis and A. actinomycetemcomitans in vitro by determining the IC50 value, and on the periodontal disease induced by ligature placement on upper second molar in a rat model. Male Sprague-Dawley rats were divided into three groups (each group had six animals): (1) animals without ligature placement receiving 1.2% carboxymethyl cellulose (vehicle, control group); (2) animals with ligature placement receiving empty vehicle (ligation group); (3) animals with ligature receiving DAR (50 mg/kg/day, DAR group). The animals were sacrificed on day 10, and the tissue samples were prepared for further analysis. The oneway ANOVA analysis and Bonferroni test were used to test the difference among groups. The results demonstrated that DAR treatment at a low dose (12.5 μM) could suppress the growth of P. gingivalis and A. actinomycetemcomitans in a short time period, and the administration of DAR significantly ameliorated the periodontal destruction at Day 10 (p ＜ 0.001). Histomorphological analyses revealed that DAR treatment decreased the infiltration of polymorphonuclear cells in periodontal tissues (p ＜ 0.001). These findings suggest that diacerein could constitute a potential therapeutic drug to treat periodontal disease.