Posterior maxillary alveolar vertical distraction osteogenesis by bi-directional distractor

AbstractA patient with severe posterior maxillary hypoplasia was simulated using a 3-dimensional model by rapid prototyping, and segmental vertical distraction osteogenesis was planned to advance the posterior maxillary segment. The bi-directional distractor was adapted to the alveolar ridge and zygomatic buttress. After a 7-day latency period, we started distraction at a rate of 0.35mm every 12h. 12mm of advancement of the posterior maxillary segment was achieved. This distraction osteogenesis using a bi-directional distractor with proper therapeutic planning and good surgical technique will help ensure adequate vector control to predictably regenerate the hard and soft tissues during alveolar distraction

Discovery of sediment indicating rapid lake-level fall in the late Pleistocene Gokarna Formation, Kathmandu Valley, Nepal: implication for terrace formation

Sediment indicating a rapid fall in lake level has been discovered in the late Pleistocene Gokarna Formation, Kathmandu Valley, Nepal. The indicator is observed along a widely traceable erosional surface in this formation, and is characterized by (1) gently inclined (ca. 10°) tabular cross-stratified sand beds of delta front origin consisting of coarser material and showing gradual decrease in elevation of its top to the progradation direction, (2) an antidune cross-laminated sand bed that interfingers with the delta front deposit, and (3) an approximately 5 m-deep erosional depression filled with convolute laminated sand beds and recognized at a location distal to that where deposits (1) and (2) were found. The early phase of rapid lake level fall caused minor erosion of the delta plain deposits by fluvial processes, introducing a higher rate of progradation of the delta front and resulting in the accumulation of deposit (1). The delta emerged as dry land due to further lowering of the lake level. The antidune cross-laminated sand bed shows evidence of having accumulated from a high-velocity stream that may have formed as the lake water drained from the delta front during the lowering of lake level. When the lake level fell below the level of the topographic high created by delta accumulation, incised valleys may have formed and part of them may have been filled with sediment at that time. The rapid fall in lake level is interpreted to have been the result of lake-wall failure, which would have occurred at the gorge outlet as the only discharge path for the basin. The initial rise of lake level causing accumulation of terrace sediments may have been due to the formation of a plug at this outlet, attributable to mass movement along the gorge

A tripartite paternally methylated region within the Gpr1-Zdbf2 imprinted domain on mouse chromosome 1 identified by meDIP-on-chip

The parent-of-origin specific expression of imprinted genes relies on DNA methylation of CpG-dinucleotides at differentially methylated regions (DMRs) during gametogenesis. To date, four paternally methylated DMRs have been identified in screens based on conventional approaches. These DMRs are linked to the imprinted genes H19, Gtl2 (IG-DMR), Rasgrf1 and, most recently, Zdbf2 which encodes zinc finger, DBF-type containing 2. In this study, we applied a novel methylated-DNA immunoprecipitation-on-chip (meDIP-on-chip) method to genomic DNA from mouse parthenogenetic- and androgenetic-derived stem cells and sperm and identified 458 putative DMRs. This included the majority of known DMRs. We further characterized the paternally methylated Zdbf2/ZDBF2 DMR. In mice, this extensive germ line DMR spanned 16 kb and possessed an unusual tripartite structure. Methylation was dependent on DNA methyltransferase 3a (Dnmt3a), similar to H19 DMR and IG-DMR. In both humans and mice, the adjacent gene, Gpr1/GPR1, which encodes a G-protein-coupled receptor 1 protein with transmembrane domain, was also imprinted and paternally expressed. The Gpr1-Zdbf2 domain was most similar to the Rasgrf1 domain as both DNA methylation and the actively expressed allele were in cis on the paternal chromosome. This work demonstrates the effectiveness of meDIP-on-chip as a technique for identifying DMRs

Sulfated Polysaccharide, Curdlan Sulfate, Efficiently Prevents Entry/Fusion and Restricts Antibody-Dependent Enhancement of Dengue Virus Infection In Vitro: A Possible Candidate for Clinical Application

10.1371/journal.pntd.0002188PLoS Neglected Tropical Diseases74

Postoperative pressure-induced alopecia after segmental osteotomy at the upper and lower frontal edentulous areas for distraction osteogenesis

Introduction: Postoperative alopecia is a relatively rare event, and therefore both patients and surgeons are puzzled once it develops even though it is said to improve spontaneously with time in most cases. We report a parieto-occipital pressure-induced alopecia firstly developed in a patient who had undergone repeated surgery for 10 years after a traffic accident. Case report: A 29-year-old male underwent segmental osteotomy at the upper and lower frontal edentulous areas for distraction osteogenesis. Throughout the operation, he was in the supine position with the hair covered with a paper cap and the head on a plastic vinyl chloride-covered soft foam horseshoe-shaped urethane sponge placed on the horseshoe-shaped headrest. About 2 weeks after the surgery, two patches of parieto-occipital alopecia were observed at the barber’s. It cured gradually during the follow-up visits. Conclusion: The pathophysiology of the condition is thought to be mostly pressure-induced ischemia of hair follicles, and then we have to try not to make the situation. Scalp massages and the head repositioning during the surgery should be one of the means of prevention

Tooth-borne distraction of the lower anterior subapical segment for correction of class II malocclusion, subsequent to genioplasty.

Introduction: Alveolar distraction is mainly used to increase height and width of the alveolar crest. This technique, however, is not typically used for lengthening the perimeter of the dental arch or　improving teeth axes. We applied alveolar distraction in a tooth-borne manner in the second stage of our original method and obtained favorable results. We therefore present an outline of this method. Case Report: Genioplasty was first performed to create an infrastructure for sequential advancement of the subapical alveolar segment. After bone union, anterior subapical alveolar osteotomy was performed. The stump of the osteotomized dentate segment was moved forward without changing the incisal edge position, and a box-type bioabsorbable plate with four holes was fixed only onto the dentate segment using two screws. After a latency period, two distraction devices were placed bilaterally to the brackets and activated at 1.0 mm/day. After reaching the desired position, the distractor was immobilized, and then replaced by resin temporary teeth to retain the created space. After the consolidation period, orthodontic treatment was restarted and teeth moved into the newly created space. Bimaxillary surgery was performed after completing pre-surgical orthodontic treatment. Finally, both desirable occlusion and functional masticatory function were obtained. Conclusion: This tooth-borne distraction system is one applicable method for patients with skeletal class II and crowding of lower anterior teeth, achieving good results particularly in combination with our original method

Chin Augmentation With Thin Cortical Bone Concomitant With Advancement Genioplasty

Genioplasty is a commonly performed procedure and various modifications of the technique have been described. One postoperative complication after advancement genioplasty is resorption of the genial segment, occasionally leading to so-called witch's chin appearance when combined with a deep labiomental fold. To prevent this condition, bone grafting onto the advanced genial segment is commonly performed. This method, however, should necessitate grafting of a certain volume of block bone or autologous bone marrow. The donor site should be set up, occasionally even far from the recipient site such as iliac bone. We present two cases in which a novel augmentation technique was taken. Thin cortical bone was harvested from the upper frontal sharp edge of the genial segment, where the sharp edge was sometimes reduced with a bur to avoid irritating surrounding tissues. This harvested bone was placed onto the advanced genial segment obliquely in the sagittal plane, just like covering the gap. Vacant space was made under the thin cortical bone. Neither particulate bone nor any substances were packed into the vacant space, instead keeping the space open. At least 8 months after augmentation, the space was filled with newly formed bone. This phenomenon indicated that voluminous bone is not always required, but preparing adequate environmental circumstances for bone formation is crucial and integral. This method may bring about a new concept of the bone grafting and augmentation

Factors related to patients' nutritional state after orthognathic surgery

Purpose The purpose of this study was to evaluate patients' nutritional state after orthognathic surgery. Methods The subjects were 40 female patients with dentofacial deformity aged 17-33 years who were undergoing bilateral sagittal splitting ramus osteotomy. Twenty patients were treated with intermaxillary fixation, and 20 patients were treated without intermaxillary fixation. Age and body mass index (kg/m(2)) were assessed as physical factors, operation time, blood loss, and amount of mandibular movement with or without intermaxillary fixation were assessed as operation stress factors, and the following laboratory data, total protein, serum albumin, total cholesterol, total lymphocytes, and cholinesterase were assessed as nutritional state factors at 1 and 2 weeks after surgery. Statistical analysis was performed for body weight loss and relationship between body weight loss and examination factors. Results Body weight significantly decreased 2.3% at 1 week and 3.9% at 2 weeks after surgery rather than preoperation. All laboratory data except total lymphocyte were decreased at 1 week after surgery and still remained significantly decreased at 2 weeks after surgery. There was a statistically significant relationship between body weight loss at 1 week after surgery and operation time. Conclusions These results indicate that long operation time caused body weight loss in orthognathic surgery