Wenli Lai

Interventions for accelerating orthodontic tooth movement A systematic review

OBJECTIVE To evaluate the effectiveness of interventions on accelerating orthodontic tooth movement. MATERIALS AND METHODS We searched the databases of PubMed, Embase, Science Citation Index, CENTRAL, and SIGLE from January 1990 to August 2011 for randomized or quasi-randomized controlled trials that assessed the effectiveness of interventions on accelerating orthodontic tooth movement. The processes of study search, selection, and quality assessment were conducted independently in duplicate by two review authors. Original outcome data, if possible, underwent statistical pooling by using Review Manager 5. RESULTS Through a predefined search strategy, we finally included nine eligible studies. Among them, five interventions were studied (ie, low-level laser therapy, corticotomy, electrical current, pulsed electromagnetic fields, and dentoalveolar or periodontal distraction). Six outcomes were evaluated in these studies (ie, accumulative moved distance or movement rate, time required to move tooth to its destination, anchorage loss, periodontal health, pulp vitality, and root resorption). CONCLUSION Among the five interventions, corticotomy is effective and safe to accelerate orthodontic tooth movement, low-level laser therapy was unable to accelerate orthodontic tooth movement, current evidence does not reveal whether electrical current and pulsed electromagnetic fields are effective in accelerating orthodontic tooth movement, and dentoalveolar or periodontal distraction is promising in accelerating orthodontic tooth movement but lacks convincing evidence.

Coronectomy vs. Total Removal for Third Molar Extraction A Systematic Review

The objective of this systematic review was to compare the outcomes between coronectomy and total removal for third molar extractions with high risk of nerve injury and to help practitioners make prudent decisions on whether and how third molars should be removed. PubMed, Embase, Web of Science, CENTRAL, and SIGLE were searched from January 1990 to October 2011 for randomized or non-randomized controlled trials. Four studies met our inclusion criteria. The pooled risk ratio (coronectomy vs. total removal) was 0.11 (95% CI = 0.03-0.36), 1.03 (95% CI = 0.54-1.98), 0.55 (95% CI = 0.28-1.05), and 1.14 (95% CI = 0.57-2.30) for inferior alveolar nerve injury, post-operative infection, dry socket, and pain at 1 wk after surgery, respectively. A relatively high rate of failed coronectomy in one study (38.3%, compared with 2.3%-9.4% in others) may be attributed to a higher proportion of narrowing roots and vertical impactions. Although root migration rate was high (13.2%-85.29%), the migration distances were short (3.06 ± 1.67 mm), and the directions were away from the nerves. Moreover, the rates of re-operation and root exposure were low. Therefore, coronectomy appears superior to total removal for reducing inferior alveolar nerve damage and could be used in clinical practice for third molar extractions with high risk of nerve injury.

Survival Time Comparison Between Hawley and Clear Overlay Retainers: A Randomized Trial

The objectives of this study were to compare the survival time of the Hawley retainer (HR) and the clear overlay retainer (COR) over one-year follow-up and to analyze risk factors contributing to their breakage. In this randomized, controlled clinical trial, we assigned 120 adolescent patients to receive either the HR or the COR. All specific data on breakage dates, the reasons for breakage, and the broken parts of the retainers were recorded. A survival analysis was used to describe retainer survival over time. No significant differences were observed in survival times between the 2 groups for either the maxillary retainer (p = 0.254) or the mandibular retainer (p = 0.188). Both retainers tended to fracture, but the fracture locations were different. The findings indicate that clinicians should avoid increasing buccal root torque and reinforce the retainer base plates. Breakage rates may not influence the choice of retainer (Trial Registration number is ChiCTR-TRC-00000055).

Behavioural responses and expression of P2X3 receptor in trigeminal ganglion after experimental tooth movement in rats

OBJECTIVE To explore the role of P2X(3) receptor in pain induced by experimental tooth movement. DESIGN Male Sprague-Dawley rats weighing 200-300g were used. P2X(3) receptor distribution in the caudal one-third portion of the trigeminal ganglion (TG) was studied by IHC. Next, the changes of P2X(3) expression were detected by Western blotting 4h, 1d, 2d, 3d, 5d, 7d, 14d after tooth movement. We then developed a behaviour pain model associated with directed mouth wiping. Finally, the effect of TNP-ATP on nociceptive-like behaviour was evaluated. RESULTS Our results showed that P2X(3) receptors were expressed mainly in small- and medium-sized cells and experimental tooth movement led to an increase in staining of mandibular P2X(3) receptors. In addition, following experimental tooth movement, the expression of P2X(3) receptor in TG was statistically significantly up-regulated from days 1 to 5, with a peak on day 3. It was also found that the time spent on directed mouth wiping was dramatically increased by experimental tooth movement from days 1 to 7. The rhythm change of P2X(3) receptor expression in TG and the mouth wiping behaviour were in concert with the initial orthodontic pain responses. The directed mouth wiping behaviour was modulated in a force-dependent manner and could be attenuated by peripheral and systemic morphine. Furthermore, peripherally administered TNP-ATP could exert an analgesic effect on this pain model. CONCLUSION These results suggest that directed mouth wiping behaviour can be a reliable measurement of pain following experimental tooth movement in rats. The P2X(3) receptor is important in the development and maintenance of tooth movement pain and thus may be peripheral targets for analgesics in orthodontic pain control.

Toxicity of Biodegradable Nanoscale Preparations

Nowadays, biodegradable nanoscale preparations such as liposomes, micelles, nanoparticles (NPs), and solid lipid nanoparticles (SLN) have attracted increasing attention from major researchers. Meanwhile the biosafety of the nanomaterials brings more and more attention. Toxicity of the biodegradable nanoscale preparations varies depending on their particle size, shape, surface structure, etc. This article aims to review the toxicity of the above-mentioned nanoscale preparations and the relative methodology. It may be significant for successful use of more nanoscale preparations in clinical practice.

Sequence analysis of PAX9, MSX1 and AXIN2 genes in a Chinese oligodontia family.

OBJECTIVES The goal of our research was to look into the clinical traits and genetic mutations in nonsyndromic oligodontia in a Chinese family and to gain insight into the role of mutations of PAX9, MSX1 and AXIN2 in oligodontia phenotypes. MATERIALS AND METHODS 6 subjects from a family underwent complete oral examination, including panoramic radiographs. Retrospective data were reviewed and blood samples were collected. PCR primers for PAX9, MSX1, and AXIN2 were designed through the Oligo Primer Analysis Software. PCR products were purified and sequenced using the BigDye Terminator Kit and analysed by the 3730 DNA Analyzer. RESULTS The proband missed 4 permanent canines, 2 permanent maxillary lateral incisors, 2 permanent mandibular lateral incisors, and 2 permanent mandibular central incisors, whilst his maternal grandfather lacked only 2 permanent mandibular central incisors. Moreover, the size of some permanent teeth appeared smaller than normal values of crown width of Chinese people. Oligodontia and abnormalities of teeth were not present in other family members. Radiographic examination showed that the proband and the rest of family members retained all germs of the third molars. There was one known mutation A240P (rs4904210) of PAX9 in the coding region in the proband and the maternal family members (II-2, II-3, and II-4), which possibly contributed to structural and functional changes of proteins. No mutations were identified in MSX1 and AXIN2. CONCLUSIONS Our findings may imply that the PAX9 A240P mutation is a risk factor for oligodontia in the Chinese population. A240P is likely to be a genetic cause of oligodontia though previous literature suggested it as a polymorphism only.

Cognitive Behavioral Therapy for Orthodontic Pain Control A Randomized Trial

The objective of this study was to evaluate the efficacy of cognitive behavioral therapy intervention for patients who experienced pain during orthodontic treatment. The baseline characteristics were assessed via questionnaires and oral examinations. Four hundred and fifty eligible individuals were recruited and randomized by computer-generated block randomization into three groups: cognitive behavioral therapy intervention (n = 150), ibuprofen intervention (n = 150), and no intervention (control; n = 150). Primary outcomes were the change from baseline in pain intensity measured with 100-mm Visual Analog Scale (VAS) scores at 1, 2, 3, 7, 14, and 30 days after initial archwire placement. Outcomes assessment was blinded and followed the intention-to-treat principle. One hundred forty-three (95.30%), 145 (96.70%), and 141 (94.00%) individuals in the cognitive behavioral therapy, the ibuprofen, and the control groups, respectively, completed the one-month follow-up evaluations. Those in the cognitive behavioral therapy group showed a greater decrease in mean VAS scores than did those in the control group over the previous five time-points (p < 0.001). Cognitive behavioral therapy was shown to be effective in pain control during the initial stage of orthodontic treatment. The study registration number was ChiCTR-TRC-00000556.

Absorption, Pharmacokinetics and Disposition Properties of Solid Lipid Nanoparticles (SLNs)

In recent years, many researchers have paid more and more attentions on the use of Nanotechnology. Solid lipid nanoparticles (SLNs) are emerged as a promising alternation herein to emulsions, liposomes, microparticles and polymeric nanoparticles for their advantages. As promising drug carrier systems, SLNs are valuable for nanomedicine and have been widely used as delivery systems mostly for drugs and macromolecules like proteins, oligonucleotides and DNA by various application routes, such as intravenous, oral, duodenalous, intramuscular, pulmonary, intranasal, ocular, rectal and intraperitoneal administrations. It has been shown that SLNs can increase bioavailability, alter pharmacokinetic parameters and tissue distribution of the drug loaded. In this review, we will primarily focus on the absorption, pharmacokinetics and disposition properties of SLNs for their possible applications in drug delivery.

Accuracy of in-vitro tooth volumetric measurements from cone-beam computed tomography

INTRODUCTION The aims of this study were to determine the accuracy of volumetric measurements of teeth in vitro by cone-beam computed tomography (CBCT) and to analyze the factors affecting their volume measurements from the CBCT data. METHODS We used a sample of CBCT-scanned (voxel sizes: 0.125, 0.20, 0.25, 0.30, and 0.40 mm) and laser-scanned crowns (n = 40) and roots (n = 32). The Tukey test was used to assess the differences between the CBCT-scan and the laser-scan volumes. RESULTS There was a statistically significant difference between the laser-scan crown volume and each voxel size of CBCT-scan crown volume (P <0.05). CBCT-scan crown volumes at 0.30 and 0.40 mm were statistically significantly distinct from those at 0.125, 0.20, and 0.25 mm (P <0.05). There was a statistically significant difference between the laser-scan root volume and each voxel size of CBCT-scan root volume (P <0.05). The laser-scan root volume at 0.40 mm was statistically significantly distinct from the volumes at 0.125 and 0.20 mm (P <0.05). The in-vitro volume measurements from the CBCT scans were larger than those of the laser scans: from 21.73% to 43.92% in the crown halves, and from 18.27% to 41.58% in the root halves at the different voxel sizes. CONCLUSIONS With increasing voxel sizes during scanning, the volume measurements of teeth tended to be larger. The surface surrounding artifacts might lead to larger volumes.

Evaluation of pain in rats through facial expression following experimental tooth movement

This study was carried out to evaluate pain in rats by monitoring their facial expressions following experimental tooth movement. Male Sprague-Dawley rats were divided into the following five groups based on the magnitude of orthodontic force applied and administration of analgesics: control; 20 g; 40 g; 80 g; and morphine + 40 g. Closed-coil springs were used to mimic orthodontic forces. The facial expressions of each rat were videotaped, and the resulting rat grimace scale (RGS) coding was employed for pain quantification. The RGS score increased on day 1 but showed no significant change thereafter in the control and 20-g groups. In the 40- and 80-g groups, the RGS scores increased on day 1, peaked on day 3, and started to decrease on day 5. At 14 d, the RGS scores were similar in control and 20-, 40-, and 80-g groups and did not return to baseline. The RGS scores in the morphine + 40-g group were significantly lower than those in the control group. Our results reveal that coding of facial expression is a valid method for evaluation of pain in rats following experimental tooth movement. Inactivated springs (no force) still cause discomfort and result in an increase in the RGS. The threshold force magnitude required to evoke orthodontic pain in rats is between 20 and 40 g.