Epithelial cell rests of Malassez (ERM) are involved in the maintenance and homeostasis of the periodontal ligament. The objective of this study was to investigate the effect of mechanical stretching on cell growth, cell death and differentiation in the ERM. Cultured porcine ERM were stretched for 24 hr in cycles of 18% elongation for 1 sec followed by 1 sec relaxation. The numbers of cells and TUNEL-positive cells were then counted. The expression of mRNAs encoding gap junction protein α1 (Gja1), ameloblastin, bone morphogenetic protein 2 (BMP2), bone morphogenetic protein 4 (BMP4) and noggin were evaluated using quantitative real-time PCR. The number of cells in the stretching group was approximately 1.3-fold higher than that in the non-stretching controls at 24 hr (p<0.01). Apoptotic cells ranged from 1.9-2.5% in the stretching group at 24 hr, but were only 0.6% in the control group (p<0.01). The expression of Gja1, ameloblastin and noggin mRNAs in the stretching group was decreased at 24 hr compared with in the non-stretching group (p<0.01), whereas the expression of BMP2 and BMP4 mRNAs in the stretching group was significantly higher than that in the control group (p<0.01). Incorporation of 18 α-glycyrrhetinic acid (18GA, a gap junction inhibitor) promoted proliferation and apoptosis and confirmed both the increase of BMP2 and BMP4 and the decline of Gja1, ameloblastin and noggin in ERM. Thus, the ERM modulate cell proliferation and apoptosis, and inhibit differentiation by reducing expression of Gja1 under mechanical stretching.

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The aim of this study was to clarify the developmental mechanism of the temporomandibular joint (TMJ) cavity, using the relationship between Meckel's cartilage and the mandible to morphologically observe the process of TMJ formation in mouse fetuses. We investigated the involvement of apoptosis in the development of the mouse TMJ cavity. We attempted to 3-dimensionally clarify the developmental process of the mandible and Meckel's cartilage by observing the developmental process optically and reconstructing 3-dimensional images to observe 3-dimensional locations of the mandible and Meckel's cartilage. Formation of the upper joint cavity began on embryonal day 16, and a complete joint cavity was formed on embryonal day 18. Formation of the lower joint cavity began on embryonal day 18, and formation was almost completed on embryonal day 19. Meckel's cartilage adjacent to the mandible decreased with development of the mandible but was vestigial on embryonal day 19. The posterior region of Meckel's cartilage developed toward the posterior direction, and it was 3-dimensionally confirmed that the mandible and Meckel's cartilage were separated. Histological observation by the TUNEL method revealed the presence of solitary and diffuse apoptotic cells not only in the joint cavity, but also around the condyle.

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During the period of the growth and development of the dental arch, anterior-posterior and medial-lateral changes in the maxillary deciduous and permanent canines were longitudinally studied in children. A longitudinal series of dental casts were obtained from 50 children at 2-month intervals from the completion of deciduous dentition to the stable period of permanent dentition. Subjects were divided into two groups according to the arrangement of the permanent teeth: a normal dental arch group and a crowded dental arch group. The mesial and distal points of the deciduous and permanent canines and the most prominent points on the labial and lingual contours were observed longitudinally. The results indicated that the measurement points of the deciduous canines in the normal and crowded groups moved in the anterior and lateral direction. When the amount of movement in the normal group was compared to that in the crowded group, the normal group showed greater movement than the crowded group. The permanent canines in both groups moved in the anterior and medial directions. When the amount of movement in the normal group was compared to that in the crowded group, the normal group showed more anterior movement than the crowded group, and the crowded group showed more medial movement than the normal group. When the distal point of the permanent canine was compared with the point of the deciduous canine at the exfoliation period in the normal arch group, the permanent canine was in almost the same position or was in a more anterior position than the deciduous canine. In the crowded arch group, the permanent canine tended to drift posteriorly.

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Osteosarcoma of the head and neck is relatively rare and accounts for less than 10 percent of all osteosarcomas in general. We report a case of osteosarcoma in which imaging and histopathology of the hard palate of an 11-year-old boy yielded atypical findings. An approximately 8×15mm lesion found in the center of the palate was hard and healthy in color. Subsequent biopsy resulted in a diagnosis of nonepithelial malignant tumor. No abnormalities were observed in the maxillary bone or tooth on panoramic or occlusal radiographs. Computed tomography images revealed a mass lesion approximately 7×9×9mm in size on the hard palate extending into the maxilla. The cortex of the maxilla adjacent to the lesion was unclear in parts. The internal structures were slightly inhomogeneous and its density was lower than that of muscle. On magnetic resonance images, the lesion was represented by low signal intensity on T1-weighted (T1W) images and high signal intensity on T2-weighted images with fat-suppression. The margin of the lesion was a little unclear and the internal structures were slightly inhomogeneous. The lesion was enhanced homogeneously on post-contrast T1W images with fat-suppression. The histopathological diagnosis was fibrogenesis-type osteosarcoma. No findings specific to osteosarcoma such as localized enlargement of the periodontal ligament space alongside the root, cortical destruction, periosteal ossification or osteogenesis were found in this case.

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This study aimed to evaluate the effectiveness of Calvital^®, which is a calcium hydroxide formulation, on persistent apical periodontitis caused by over-enlargement of the apical foramen. The study included patients referred to the Department of General Dentistry at Tokyo Dental College Suidobashi Hospital on a diagnosis of persistent apical periodontitis at an external dental clinic. Of them, 20 showing considerable enlargement of the apical foramina were included in the study. Complete disappearance of symptoms was observed in all patients after intracanal application of Calvital^®. We believe that this was due to effective wound-healing brought about the strong alkaline nature of this formulation. We regard Calvital^® as a highly effective agent for root canal treatment of teeth with persistent apical periodontitis.

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The aim of this retrospective clinical study was to evaluate 2-year follow-up results following regenerative periodontal surgery for intrabony defects using enamel matrix derivative (EMD). Thirteen patients (mean age: 53 years) with a clinical diagnosis of chronic periodontitis were subjected to data analysis. A total of 25 sites with intrabony defects received regenerative therapy with EMD. Follow-up continued for a minimum of 2 years. Treatment of intrabony defects with EMD yielded a statistically significant improvement in the mean values of probing depth and gains in clinical attachment level (CAL) at 2 years compared with those at baseline (p<0.001). Sites treated with EMD demonstrated a mean CAL gain of 3.4 mm and 3.2 mm at 6 months and 2 years, respectively. No statistically significant difference in gain in CAL was found between the 6-month and 2-year results. A gain in CAL of ≥3 mm from at baseline was found in 17 sites at 2 years. This gain was achieved with minimal recession of gingival margin and was sustained over a given period of time. A trend toward a progressive increase in radiopacity, suggestive of bone-fill, was observed. In summary, treatment of intrabony defects with EMD resulted in clinically favorable outcomes. The clinical improvements obtained with regenerative therapy with EMD were maintained over a period of 2 years.

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The aim of the present study was to investigate the profile of surgical periodontal therapy performed at the Suidobashi Hospital of Tokyo Dental College, during the period of April 2010 through March 2011. A total of 112 periodontal surgeries in 69 patients (mean age: 51.4 years; 28 men and 41 women) were registered for the data analysis. The surgical interventions performed by 17 dentists comprised 79 cases of open flap debridement, 27 cases of periodontal regenerative therapy with enamel matrix derivative and 6 cases of periodontal plastic surgery. Eighty percent of the surgical sites were in the molar region and 41 cases had furcation involvement. In these patients, an improvement in oral hygiene status was observed prior to surgery: the mean plaque score of 45% at initial visit was significantly reduced to 31% after initial periodontal therapy (p<0.01). At sites that subsequently received open flap debridement or periodontal regenerative therapy, the mean probing depth and clinical attachment level after initial therapy was 6.4 mm and 7.6 mm, respectively. These values were significantly lower than those at initial visit (p<0.01). Lower prevalence of sites with positive bleeding on probing was observed after initial therapy. The initial periodontal therapy performed was considered to be effective in improving the periodontal condition of the sites prior to surgery. More effort, however, is indicated in improvement of patient oral hygiene status.

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