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ABSTRACT: To examine the effects of botulinum toxin injection application for the treatment of upper airway obstruction due to hyperactive lateral pterygoid muscle contraction, we applied botulinum toxin injection. A 20 year-old male patient had involuntary mouth opening after a diabetic coma. His mouth opened excessively (84 mm) particularly when he was in a nervous or stressed condition. This resulted in a bilateral temporomandibular dislocation and, consequently, upper airway collapse. The differential diagnosis of jaw-opening oromandibular dystonia was made. Botulinum toxin type A was bilaterally injected into the lateral pterygoid muscle. The excessive mouth opening was reduced, and the patient showed no temporomandibular joint (TMJ) dislocation or experienced any further airway collapse after the injections. We successfully applied botulinum toxin to a patient with upper airway obstruction and TMJ dislocation relative to jaw-opening dystonia.
Cranio: the journal of craniomandibular practice 08/2006; 24(3):217-22. · 0.66 Impact Factor
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ABSTRACT: Impairment of sensory input to the soft palate has been reported in patients with obstructive sleep apnea syndrome. To investigate the reaction in the central nervous system related to soft palate perception, we measured the somatosensory evoked magnetic fields following air-puff stimulation in seven healthy volunteers by using a helmet-shaped 122-channel neuromagnetometer. The air-puffs were produced using compressed nitrogen and directed to the middle of the soft palate with an intraoral device. To evaluate the laterality of responses we used another appliance in which the air-puffs were directed to the middle and right side of the soft palate. In all the subjects, responses were identified symmetrically in the bilateral parietotemporal regions with a mean latency of about 130 ms from the soft palate stimulation. Prior to this peak, no distinct early responses were observed. There was no significant difference in the responses between the middle and right side stimulation. Corresponding equivalent current dipoles were estimated around the Sylvian fissures. These results suggested that the responses were derived from the second somatosensory areas. In conclusion, we could record long-latency responses to air-puff stimulation of the soft palate in the bilateral second somatosensory areas.
Neuroscience Research 07/2006; 55(2):116-22. · 2.25 Impact Factor
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ABSTRACT: This clinical study is the first to quantitatively evaluate both regional bone structure by computed tomography preoperatively and dental implant stability by resonance frequency analysis at the time of surgery to explore the relation between local bone structure and dental implant stability in humans. Implant stability at the time of installation is often difficult to achieve in lower density bone and implant stability might influence treatment efficacy. Few clinical studies have reported detailed bone characteristics obtained using computed tomography prior to surgery and comprehensive implant stability measurements at the time of surgery. We hypothesized that thicker cortical bone would improve the stability of the dental implant at the time of placement. Before radiographic examination, diagnostic radiographic templates were made by incorporating radiopaque indicators. Computed tomography scans were obtained for 50 edentulous subjects prior to surgery. Preoperatively, the thickness of the cortical bone at the sites of implant insertion was measured digitally, and then implant insertion surgery was performed. A total of 225-implant stability measurements were made using a resonance frequency analyzer. There was a strong linear correlation between cortical bone thickness and resonance frequency (r = 0.84, P < 0.0001). The implant length had a weak negative correlation with stability (r = -0.25, P < 0.0005). These results suggest that the initial stability at the time of implant installation is influenced more by cortical bone thickness than by implant length. The cortical and cancellous ratio of local bone is extremely important for implant stability at the time of surgery and determining the local bone condition is critical for treatment success.
Bone 01/2006; 37(6):776-80. · 4.02 Impact Factor
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ABSTRACT: Treatment with denture for edentulous people is highly important for maintaining quality of life. However, its effect on the brain is unknown. In this experimental study, we hypothesized that dental prosthesis can recover not only the physical condition of mastication system but also the regional brain activity. We evaluated functional brain imaging of edentulous subjects fixed by dental implant prosthesis with clenching tasks by multi-channel near-infrared optical topography. Results revealed a significantly (P<0.001; paired t-test) increased cerebral regional blood volume during maximum voluntary clenching task by implant-retained prosthesis. There were no statistically significant differences between patients with and without prosthesis in the latency to the maximum regional blood volume after the task. Conclusively, clenching can be effective for increasing cerebral blood volume; accordingly maintenance of normal chewing might prevent the brain from degenerating.
Clinical Oral Implants Research 12/2005; 16(6):723-7. · 2.51 Impact Factor
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Journal of Oral and Maxillofacial Surgery 08/2005; 63(7):989-95. · 1.64 Impact Factor
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Journal of Oral and Maxillofacial Surgery 04/2005; 63(3):410-2. · 1.64 Impact Factor
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ABSTRACT: We identified seven novel germline mutations of the PTCH gene in eight unrelated Japanese patients with nevoid basal cell carcinoma syndrome (NBCCS). In order to ensure genetic diagnosis, all 23 coding exons of the PTCH gene were amplified from genomic DNA by polymerase chain reaction (PCR) and sequenced. Mutations were found in all eight patients with NBCCS. The mutations detected in this study include one insertion/deletion mutation, one 1-bp insertion, two 1-bp deletions, one nonsense mutation and two missense mutations. None of the mutations have been previously reported. Five mutations caused premature stop codons that are predicted to result in a truncated protein. In the two missense mutations, the strong basic residue arginine was substituted by serine or glycine in highly conserved components of the putative transmembrane domain of PTCH, and these mutations may therefore affect the conformation and function of the PTCH protein. No phenotype-genotype relationships were found in the Japanese NBCCS patients, consistent with results of previous studies on NBCCS in African-American and Caucasian patients.
Archives for Dermatological Research 02/2005; 296(7):303-8. · 2.28 Impact Factor
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ABSTRACT: Bone morphology is genetically encoded and it is usually difficult to change its structure without invasive surgery. We have tried to stimulate bone augmentation by a combination of guided bone regeneration techniques and cell transplants with collagen scaffolds for the suitable skeletal framework. In vitro-expanded tibia periosteum cells were used to promote osteogenesis with collagen scaffolds and titanium (Ti) or poly-L-lactic acid (PLLA) caps as barriers to create a space facing connective tissue under calvarium skin. This approach was assessed in the defective skull bone of a rabbit model. After a 12-week healing period, histomorphometric analyses were performed to determine the percentage of newly formed mineralized tissue in the cap. The mean percentage of newly formed mineralized tissue within the cap was 15.4%+/-3.99 for the Ti cap group, 15.5%+/-4 for the PLLA cap group, 6.19%+/-4.94 for the PLLA cap+collagen carrier group and 23.1%+/-23.1 for the PLLA+collagen carrier+cell transplants group. The cell transplant group showed a significantly higher value than other groups (P<0.05, Wilcoxon signed rank test, Mann-Whitney U-test). This approach of guided bone augmentation and cultured cell transplants with collagen carrier exhibited significantly greater morphogenesis of mineralized tissue than the control over a 12-week experimental period.
Clinical Oral Implants Research 07/2004; 15(3):308-14. · 2.51 Impact Factor
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ABSTRACT: The aim of this study was to investigate the clinical results and efficacy of arthroscopic anterolateral capsular release achieved through the use of a holmium:YAG laser or electrocautery for the management of patients with internal derangements of the temporomandibular joint (TMJ).
We studied internal derangement (106 joints) and osteoarthritis (46 joints) of the TMJ in 129 patients. Preoperatively, the mean mouth-opening degree was 31 mm and 129 TMJs exhibited moderate to severe arthralgia. All patients underwent arthroscopic anterolateral capsular release achieved with a holmium:YAG laser (84 TMJs) or through electrocautery (68 TMJs).
At the end of each patient's respective follow-up period, which ranged from 2 to 72 months (mean, 19 months), the mean mouth-opening degree was 43 mm (P<.0001). Also during that time, 105 joints were discovered to exhibit no arthralgia and 36 had mild arthralgia. The total success rates with 2 sets of criteria were 92.8% and 95.6%.
Arthroscopic anterolateral capsular release is a minimally invasive and effective surgical method for the treatment of patients with TMJ intracapsular disorders.
Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontics 06/2004; 97(5):546-51; discussion 552. · 1.46 Impact Factor
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ABSTRACT: Jaw-deviation dystonia is characterized by the lateral shift of the mandible due to involuntary masticatory muscle contraction, causing difficulties in speech or mastication. We evaluated a patient with jaw-deviation dystonia by recording movement-related cortical potentials (MRCPs) and treated with muscle afferent block (MAB). MRCP associated with mandibular movements (mouth opening, closing, and left and right lateral movements) was recorded in the patient and ten age-matched healthy subjects. In the control subjects, the amplitude of Bereitschaftspotential (BP)/negative slope (NS') was significantly higher for left lateral movements than for the mouth closing. The cortical map of BP/NS' prior to mouth opening and closing showed symmetric distribution, whereas those of lateral movements showed a slight predominance in the ipsilateral hemisphere. The patient showed lower amplitude as compared with control subjects. The right lateral movement (homonymous task) showed task-specific markedly reduced potentials. After MAB by intramuscular injection of lidocaine and ethanol to the inferior head of the left lateral pterygoid muscle, the deviation abolished and severity in speech and mastication was significantly improved. This study suggests that jaw-deviation dystonia might have the same etiology as other focal dystonias.
Cranio: the journal of craniomandibular practice 11/2003; 21(4):295-300. · 0.66 Impact Factor
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ABSTRACT: The potential of a bioactive bone cement (BABC) as an onlay graft material for the mandible with and without the periosteum was investigated in rabbits. Its matrix consists of bisphenol-alpha-glycidyl methacrylate (Bis-GMA) and triethylene-glycol dimetacrylate (TEGDMA) and its filler is silane-treated CaO-SiO2-P2O5-MgO-CaF2 glass (A-W glass-ceramic) powder. The BABC was pasted onto the mandible under the periosteum in Group 1, and onto the mandible with the periosteum removed in Group 2 and allowed to set in situ. In both groups, the cement-bone interface was filled by new bone at 4, 12 and 48 weeks, and bone grew from adjacent bone tissue into the cement-soft tissue interface at 12 and 48 weeks. There were no differences in the rate of bone formation between the groups. The shearing strength increased progressively from 0.25+/-0.10 MPa (mean+/-SD) at week 1 to 7.98+/-0.62 MPa at week 48. The results suggest that the BABC has good handling properties, a high bonding strength and good biocompatibility, and that it has potential for clinical application as a substitute material for autogenous bone transplantation.
Clinical Oral Implants Research 11/2003; 14(5):659-67. · 2.51 Impact Factor
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ABSTRACT: Therapy using recombinant human bone morphogenetic protein-2 (rhBMP-2) is expected to promote bone healing and regeneration. Previous studies using protein or virus vectors for direct clinical application had problems, including a lack of efficiency, safety, and simplicity of the delivery system, and required an expensive protein, carrier matrix, or antigenic viral vector. In vivo gene transfer by electroporation is a simple and inexpensive method that only requires a plasmid and an electroporation device. Here, we created a plasmid-based human BMP-2 construct (pCAGGS-BMP-2) and examined the induction of bone in the skeletal muscle of rats after transferring different doses of this plasmid (25 microg, 100 microg, and 400 microg) by transcutaneous electroporation (8 electrical pulses of 100 V and 50 msec, in 1 to 5 sessions). First, we verified the gene transfer by transcutaneous electroporation using pCAGGS-lacZ. Next, the BMP-2 gene transfer and the production and localization of BMP-2 were identified by reverse transcription-polymerase chain reaction (RT-PCR), Western blots, and immunohistochemistry. Ectopic bone formation was verified by radiography, histologic and immunohistochemical analyses, and quantitative examination. Ectopic bone formation, consisting of active osteoblasts and osteoclasts, was observed in all rats treated with electroporation. Thus, transcutaneous electroporation with pCAGGS-BMP-2 induced ectopic bone formation in the skeletal muscle of rats. This supports the possibility of applying human BMP-2 gene transfer using transcutaneous electroporation clinically.
Human Gene Therapy 11/2003; 14(16):1547-56. · 4.22 Impact Factor
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ABSTRACT: BMP-3b is a novel BMP-3-related protein and its biological functions are unknown. In order to investigate the biological actions of BMP-3b, we constructed a BMP-3b-expressing recombinant adenoviral vector (AxCAKBMP-3b). We show that over expression of BMP-3b stimulated the induction of differentiation and the osteoinduction activity of a human BMP-2-expressing recombinant adenoviral vector (AxCAOBMP-2). C2C12 cells were infected in vitro with AxCAKBMP-3b, AxCAOBMP-2 and a control vector containing no foreign genes (AxCAwt). Cells infected with AxCAOBMP-2 and AxCAKBMP-3b produced more alkaline phosphatase and secreted more osteocalcin into the culture medium than cells infected with AxCAOBMP-2 and AxCAwt. When AxCAOBMP-2, AxCAKBMP-3b, and AxCAwt were injected into the calf muscles of nude rats (F 344/N Jcl-rnu), the osteoinduction seen with AxCAOBMP-2 and AxCAKBMP-3b was greater than that seen with AxCAOBMP-2 and AxCAwt.
Life Sciences 03/2003; 72(15):1683-93. · 2.53 Impact Factor
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ABSTRACT: Oromandibular dystonia is a neurological disorder characterized by involuntary contraction of masticatory and/or tongue muscles. Cortical negative shifts preceding voluntary movements called "movement-related cortical potentials" (MRCPs) reflect a central motor control process. Reduced amplitude of MRCPs has been reported in other types of dystonia. To elucidate whether the abnormality is observed also in oromandibular dystonia, we compared MRCPs associated with mandibular movements in 6 patients with this condition and in 8 normal subjects. Electroencephalograms (EEGs) were recorded from 11 electrodes, and electromyograms (EMGs) were recorded from the masseter muscle and the suprahyoid muscles. The subjects were asked to repeat mouth opening, closing, and left and right lateral mandibular excursions. MRCPs were obtained by averaging the EEG using the EMG onset as the trigger signal. In the patient group, MRCP amplitudes over central and parietal areas for mouth opening and lateral movements were significantly reduced compared to normal subjects. In normal controls, the MRCPs at mouth opening and closing were symmetrically distributed, whereas those at lateral movements showed predominance over the hemisphere ipsilateral to the direction of the movement. This laterality was lost in the patient group. These results suggest impaired cortical preparatory process for jaw movements in oromandibular dystonia.
Movement Disorders 02/2003; 18(1):94-100. · 4.51 Impact Factor
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ABSTRACT: FK506 is an immunosuppressant that is used widely in organ transplantation, and it has recently been recognized as effective for promoting the growth of bone grafts [J. Bone Miner. Res. 15 (2000) 1147]. In this study, we evaluated the influence of FK506 on osteoinduction by recombinant human bone morphogenetic protein-2 (rhBMP-2) using atelopeptide type I collagen as a carrier. We administered FK506 (1 mg/kg/day intramuscularly) on days -2 to 0, -2 to 7, and -2 to sacrifice. rhBMP-2 was implanted into the calf muscle of Wistar rats (thirty per group) and the implant was sampled on days 7, 14, and 21. Radiographic evaluation, histological examination, and biochemical analysis were performed. It was found that FK506 promoted the early stage of osteoinduction after short-term administration. However, long-term administration of this agent accelerated both bone formation and bone resorption. In order to use FK506 effectively for promoting bone growth, we must further examine the appropriate dose, method, and period of administration.
Life Sciences 01/2003; 72(3):247-56. · 2.53 Impact Factor
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ABSTRACT: To clarify the effect of recombinant human basic fibroblast growth factor (FGF-2) on the osteoinductive activity of recombinant human bone morphogenetic protein-2 (BMP-2) in vivo, different amounts of FGF-2 (0, 16, 80 and 400 ng, and 2, 10 and 50 micro g: n=10 in each group), BMP-2 (2 micro g) and type I collagen as a carrier were mixed and implanted into rat calf muscles. Three weeks after implantation, compared with the controls, the radiopaque shadows of the implants were increased in the 16, 80 and 400 ng FGF-2-treated groups, but decreased in the 2, 10 and 50 micro g FGF-2-treated groups. In addition, alkaline phosphatase activity was increased in the 16, 80 and 400 ng FGF-2-treated groups but decreased in the 50 micro g FGF-2-treated group. Histological examination revealed increased bone formation in the 16, 80 and 400 ng FGF-2-treated groups. These results show that combined treatment with FGF-2 and BMP-2 has a biphasic effect on osteoinductive activity, i.e. it increases with low doses of FGF-2 and decreases with high doses of FGF-2.
Archives of Oral Biology 09/2002; 47(8):577-84. · 1.60 Impact Factor
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ABSTRACT: To clarify the mechanism of osteoinduction by recombinant human bone morphogenetic protein-2 (rhBMP-2), we examined the time-course localization of bone morphogenetic proteins (BMPs) immunostained by an anti-BMP-2 monoclonal antibody after implantation of pellets consisting of rhBMP-2 and collagen in rat calf muscle pouch. On day 3 after implantation, BMP was detected in the entire lump, and the intensity of staining for BMP around the implant on day 7 was weaker than that on day 3. The staining for BMP decreased with time and the region of staining for BMP remained more centralized in the implant. On day 10 after implantation, BMP was observed in part of the newly induced cartilage, especially around chondrocytes. On day 14 after implantation, BMP was localized in the newly induced woven bone. On day 21, BMP staining was found in osteoblasts at the surface of the newly induced bone. Especially, the staining for BMP decreased from day 10 to day 21. These results indicate that the woven bone was replaced with mature lamellar bone from day 14 to day 21. The present findings suggest that rhBMP-2 plays an important role in osteoinduction, especially at the early stage.
Clinical Oral Implants Research 03/2002; 13(1):80-5. · 2.51 Impact Factor
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ABSTRACT: A combination of recombinant human bone morphogenetic protein-2 (rhBMP-2), atelopeptide Type I collagen (CL) as a carrier and porous hydroxyapatite (pHAP) was implanted in a calf muscle pouch of the rat. Three rhBMP-2-implanted groups (2, 10 and 50 g; each n = 5) and the control group (n = 5), in which only CL and pHAP were implanted, were established. Three weeks later, the implants were examined.
Journal of Cranio-Maxillofacial Surgery.
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ABSTRACT: Persistent vegetative state is a form of wakefulness without awareness. This report describes a dental appliance for the treatment of sleep breathing disorders in this condition. The device can be easily inserted and removed by the patient's family or nurse.
A 19-year-old woman had been in a persistent vegetative state since having hypoxic-ischemic encephalopathy because of cardiopulmonary arrest. Although she exhibited a sleep-wake cycle and normal respiration, she had sleep apnea and snoring, and produced snoring-like sounds even in an awake state. A three-piece device with Herbst attachments was fabricated to treat the symptoms. Overnight sleep studies were carried out to evaluate the effectiveness of the appliance.
The device could be handled by the patient's family. Snoring was satisfactorily reduced after insertion of the device. Sleep apnea, desaturation, and minimal oxygen saturation were markedly improved.
If the family of a persistent vegetative state patient wishes to treat sleep-disordered breathing, the appliance may be helpful as an alternative to relieve the symptoms. The device could be applied for sleep apnea patients who experience difficulties using other types of oral appliances.
The International journal of prosthodontics 16(4):350-4. · 1.38 Impact Factor
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ABSTRACT: Fifteen patients with odontogenic maxillary sinusitis examined using computed tomography (CT) and single photon emission computed tomography bone scintigraphy (bone SPECT) were reviewed. The changes in bone activity associated with causative maxillary alveolitis, evaluated by bone SPECT, before and after conservative therapy were correlated with the pathologic changes in the maxillary sinus mucosa and ostium demonstrated on CT images following conservative therapy. This combination of imaging methods is valuable for predicting the prognosis and selecting appropriate treatments for the disease.
Clinical Imaging 26(3):153-60. · 0.75 Impact Factor
