The biomechanical function of periodontal ligament fibres in orthodontic tooth movement

Orthodontic tooth movement occurs as a result of resorption and formation of the alveolar bone due to an applied load, but the stimulus responsible for triggering orthodontic tooth movement remains the subject of debate. It has been suggested that the periodontal ligament (PDL) plays a key role. However, the mechanical function of the PDL in orthodontic tooth movement is not well understood as most mechanical models of the PDL to date have ignored the fibrous structure of the PDL. In this study we use finite element (FE) analysis to investigate the strains in the alveolar bone due to occlusal and orthodontic loads when PDL is modelled as a fibrous structure as compared to modelling PDL as a layer of solid material. The results show that the tension-only nature of the fibres essentially suspends the tooth in the tooth socket and their inclusion in FE models makes a significant difference to both the magnitude and distribution of strains produced in the surrounding bone. The results indicate that the PDL fibres have a very important role in load transfer between the teeth and alveolar bone and should be considered in FE studies investigating the biomechanics of orthodontic tooth movement. © 2014 McCormack et al

Masticatory biomechanics in the rabbit : a multi-body dynamics analysis

Acknowledgement We thank Sue Taft (University of Hull) for the µCT-scanning of the rabbit specimen used in this study. We also thank Raphaël Cornette, Jacques Bonnin, Laurent Dufresne, and l'Amicale des Chasseurs Trappistes (ACT) for providing permission and helping us capture the rabbits used for the in vivo bite force measurements at la Réserve Naturelle Nationale de St Quentin en Yvelines, France.Peer reviewedPublisher PD

Inclusion of periodontal ligament fibres in mandibular finite element models leads to an increase in alveolar bone strains

Alveolar bone remodelling is vital for the success of dental implants and orthodontic treatments. However, the underlying biomechanical mechanisms, in particular the function of the periodontal ligament (PDL) in bone loading and remodelling, are not well understood. The PDL is a soft fibrous connective tissue that joins the tooth root to the alveolar bone and plays a critical role in the transmission of loads from the tooth to the surrounding bone. However, due to its complex structure, small size and location within the tooth socket it is difficult to study in vivo. Finite element analysis (FEA) is an ideal tool with which to investigate the role of the PDL, however inclusion of the PDL in FE models is complex and time consuming, therefore consideration must be given to how it is included. The aim of this study was to investigate the effects of including the PDL and its fibrous structure in mandibular finite element models. A high-resolution model of a human molar region was created from micro-computed tomography scans. This is the first time that the fibrous structure of the PDL has been included in a model with realistic tooth and bone geometry. The results show that omission of the PDL creates a more rigid model, reducing the strains observed in the mandibular corpus which are of interest when considering mandibular functional morphology. How the PDL is modelled also affects the strains. The inclusion of PDL fibres alters the strains in the mandibular bone, increasing the strains in the tooth socket compared to PDL modelled without fibres. As strains in the alveolar bone are thought to play a key role in bone remodelling during orthodontic tooth movement, future FE analyses aimed at improving our understanding and management of orthodontic treatment should include the fibrous structure of the PDL

Critical Path for Project Development

Overseeing the delivery of highway projects at the Kentucky Transportation Cabinet (KYTC) requires the successful coordination of activities and inputs from multiple external agencies and members of the agency’s Project Development team, who have varied disciplinary backgrounds. Despite the complexity of project delivery, the Cabinet presently does not estimate hours and project milestone dates until after it has selected a design consultant. Moving forward KYTC should explore requiring consultants to develop a critical path method (CPM) schedule. To facilitate this process, this report describes a methodology for producing CPMs for design contracts/projects based on procedures outlined in A Guide to the Project Management Body of Knowledge. In addition to reviewing the CPM, this document includes critical path templates that are representative of the Cabinet’s project design process. Templates were developed with the assistance of KYTC experts knowledgeable in areas such as project management, environmental processes, utilities, right of way, and highway design. Work-breakdown units, templates, and Gantt charts for three project contexts were developed: 1) Rural Federal Bridge Replacement (Categorical Exclusion I), 2) Urban Federal Bridge Replacement (Categorical Exclusion I), and 3) 4-Mile Rural Road Widening into Urban Intersection (Environmental Assessment, Finding of No Significant Impact). An in-depth glossary contains detailed explanations of work-breakdown units and flags issues and challenges that merit close attention during project development. With recourse to the tools and templates presented in this report, project managers and consultants can pursue project management in an organized manner and be ready to deal with any contingencies that may arise

Autophosphorylation-based calcium (Ca2+) sensitivity priming and Ca2+/Calmodulin inhibition of Arabidopsis thaliana Ca2+-dependent protein kinase 28 (CPK28)

Plant calcium (Ca2+) dependent protein kinases (CPKs) are composed of a dual specificity (Ser/Thr and Tyr) kinase domain tethered to a Calmodulin-like domain (CLD) via an autoinhibitory junction (J) and represent the primary Ca2+-dependent protein kinase activities in plant systems. While regulation of CPKs by Ca2+ has been extensively studied, the contribution of autophosphorylation in the control of CPK activity is less well understood. Furthermore, whether Calmodulin (CaM) contributes to CPK regulation, as is the case for Ca2+/CaM-dependent protein kinases (CaMKs) outside the plant lineage, remains an open question. We screened a subset of plant CPKs for CaM-binding and found that CPK28 is a high-affinity Ca2+/CaM-binding protein. Using synthetic peptides and native gel electrophoresis, we coarsely mapped the CaM-binding domain to a site within the CPK28 J domain that overlaps with the known site of intramolecular interaction between the J domain and CLD. Peptide kinase activity of fully dephosphorylated CPK28 was Ca2+-responsive and inhibited by Ca2+/CaM. Using in situ autophosphorylated protein, we expand on the known set of CPK28 autophosphorylation sites, and demonstrate that, unexpectedly, autophosphorylated CPK28 had enhanced activity at physiological concentrations of Ca2+ compared to dephosphorylated protein, suggesting that autophosphorylation functions to prime CPK28 for Ca2+-activation. Furthermore, CPK28 autophosphorylation substantially reduced sensitivity of the kinase to Ca2+/CaM inhibition. Overall, our analyses uncover new complexities in the control of CPK28 and provide mechanistic support for Ca2+ signaling specificity through Ca2+ sensor priming

Subsequent Surgery After Revision Anterior Cruciate Ligament Reconstruction: Rates and Risk Factors From a Multicenter Cohort

BACKGROUND: While revision anterior cruciate ligament reconstruction (ACLR) can be performed to restore knee stability and improve patient activity levels, outcomes after this surgery are reported to be inferior to those after primary ACLR. Further reoperations after revision ACLR can have an even more profound effect on patient satisfaction and outcomes. However, there is a current lack of information regarding the rate and risk factors for subsequent surgery after revision ACLR. PURPOSE: To report the rate of reoperations, procedures performed, and risk factors for a reoperation 2 years after revision ACLR. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: A total of 1205 patients who underwent revision ACLR were enrolled in the Multicenter ACL Revision Study (MARS) between 2006 and 2011, composing the prospective cohort. Two-year questionnaire follow-up was obtained for 989 patients (82%), while telephone follow-up was obtained for 1112 patients (92%). If a patient reported having undergone subsequent surgery, operative reports detailing the subsequent procedure(s) were obtained and categorized. Multivariate regression analysis was performed to determine independent risk factors for a reoperation. RESULTS: Of the 1112 patients included in the analysis, 122 patients (11%) underwent a total of 172 subsequent procedures on the ipsilateral knee at 2-year follow-up. Of the reoperations, 27% were meniscal procedures (69% meniscectomy, 26% repair), 19% were subsequent revision ACLR, 17% were cartilage procedures (61% chondroplasty, 17% microfracture, 13% mosaicplasty), 11% were hardware removal, and 9% were procedures for arthrofibrosis. Multivariate analysis revealed that patients aged <20 years had twice the odds of patients aged 20 to 29 years to undergo a reoperation. The use of an allograft at the time of revision ACLR (odds ratio [OR], 1.79; P = .007) was a significant predictor for reoperations at 2 years, while staged revision (bone grafting of tunnels before revision ACLR) (OR, 1.93; P = .052) did not reach significance. Patients with grade 4 cartilage damage seen during revision ACLR were 78% less likely to undergo subsequent operations within 2 years. Sex, body mass index, smoking history, Marx activity score, technique for femoral tunnel placement, and meniscal tearing or meniscal treatment at the time of revision ACLR showed no significant effect on the reoperation rate. CONCLUSION: There was a significant reoperation rate after revision ACLR at 2 years (11%), with meniscal procedures most commonly involved. Independent risk factors for subsequent surgery on the ipsilateral knee included age <20 years and the use of allograft tissue at the time of revision ACLR

Updated international tuberous sclerosis complex diagnostic criteria and surveillance and management recommendations

Background Tuberous sclerosis complex (TSC) is an autosomal dominant genetic disease affecting multiple body systems with wide variability in presentation. In 2013, Pediatric Neurology published articles outlining updated diagnostic criteria and recommendations for surveillance and management of disease manifestations. Advances in knowledge and approvals of new therapies necessitated a revision of those criteria and recommendations. Methods Chairs and working group cochairs from the 2012 International TSC Consensus Group were invited to meet face-to-face over two days at the 2018 World TSC Conference on July 25 and 26 in Dallas, TX, USA. Before the meeting, working group cochairs worked with group members via e-mail and telephone to (1) review TSC literature since the 2013 publication, (2) confirm or amend prior recommendations, and (3) provide new recommendations as required. Results Only two changes were made to clinical diagnostic criteria reported in 2013: “multiple cortical tubers and/or radial migration lines” replaced the more general term “cortical dysplasias,” and sclerotic bone lesions were reinstated as a minor criterion. Genetic diagnostic criteria were reaffirmed, including highlighting recent findings that some individuals with TSC are genetically mosaic for variants in TSC1 or TSC2. Changes to surveillance and management criteria largely reflected increased emphasis on early screening for electroencephalographic abnormalities, enhanced surveillance and management of TSC-associated neuropsychiatric disorders, and new medication approvals. Conclusions Updated TSC diagnostic criteria and surveillance and management recommendations presented here should provide an improved framework for optimal care of those living with TSC and their families