
Editorial
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In recent years, there has been an increasing demand for clinical trials to study oral, dental, and craniofacial diseases and conditions. This has resulted from such factors as the increasing pace of discoveries requiring translational research to develop them for clinical use, FDA requirements for product approval, a need for additional data to support evidence-based dental practice, and the expansion of the NIDCR’s clinical research programs. The complexity, size, and duration of clinical trials often make them quite costly to conduct, and may impede the development of novel diagnostic, preventive, and therapeutic methods that could have a significant impact on clinical practice and inform public health policy.
Recent advances in such areas as genomics and proteomics, coupled with the development of new technologies, have expanded our knowledge of the etiology and pathogenesis of disease and, from this, have provided new insights into the design and conduct of clinical trials. The workshop, “Methods for Enhancing the Efficiency of Dental/Oral Health Clinical Trials: Current Status, Future Possibilities”, held on May 6–7, 2004, considered a variety of ways in which these insights are being, or have the potential to be, applied to clinical trials so as to enhance their efficiency and, hence, their cost-effectiveness, without diminishing the quality of information produced. The focus of this workshop was to assess the state of the science and identify research needs for the use of biomarkers, surrogate endpoints, and new technologies in oral disease clinical trials. Examples of ways in which clinical trials of other diseases have benefited from the use of new methods and technologies and FDA considerations were also discussed.
Craniosynostosis is a congenital disorder of premature ossification of cranial
sutures, occurring in one of approximately every 2500 live human births. This work
addressed a hypothesis that a cranial suture can be tissue-engineered from autologous
cells. Dermal fibroblasts were isolated subcutaneously from growing rabbits,
culture-expanded, and seeded in a gelatin scaffold. We fabricated a composite tissue
construct by sandwiching the fibroblast-seeded gelatin scaffold between two collagen
sponges loaded with recombinant human BMP2. Surgically created, full-thickness
parietal defects were filled with the composite tissue construct in the same rabbits
from which dermal fibroblasts had been obtained. After four-week
There have been few investigations on hemodynamic responses in the human cortex
resulting from dental stimulation. Identification of cortical areas involved in
stimulus perception may offer new targets for pain treatment. This initial study
aimed at establishing a cortical map of dental representation, based on non-invasive
fMRI measurements. Five right-handed subjects were studied. Eight maxillary and 8
mandibular teeth were stimulated after the vibratory perception threshold was
determined for each tooth. Suprathreshold stimulation was repeated thrice
Contralateral dominance in the activation of the primary sensorimotor cortex (S1/M1) during tongue movements (TMs) has been shown to be associated with a chewing-side preference (CSP). However, little is known about its interaction with chewing-related cortical activation. Functional magnetic resonance imaging was performed before and after gum-chewing in six subjects who exhibited a left CSP to determine the relationship between the CSP and activation patterns in the S1/M1 during TMs. Before the subjects chewed the gum, activation foci were found in the bilateral S1/M1. In the left hemisphere, both signal intensity and the area of activation significantly increased during TMs within 10 min after subjects chewed gum. Moreover, this augmented activation significantly decreased within 20 min during tongue protrusion and leftward movement. In the right hemisphere, there were no marked changes during TMs. These results suggest that bilateral gum-chewing enhances activation of the S1/M1 ipsilateral to the CSP during TMs.
The JP2 clone of
Studies on individuals with sex chromosome anomalies have demonstrated the promoting effect of the Y chromosome on tooth crown enamel and dentin growth. The present research investigated permanent tooth root lengths in 47,XYY males. The measurements were made from panoramic radiographs. The results indicate longer tooth roots in 47,XYY males compared with those in control males and females. The promoting effect of the Y chromosome on dental growth thus continues in the form of root dentin after the completion of crown growth. The results, together with those on tooth crown sizes in 47,XYY males, suggest that growth excesses are evident and final, beginning a few months after birth and continuing up to the age of 14 years, at least. The excess root dentin growth in 47,XYY males, as well as sexual dimorphism in the growth of crown and root dentin, might be caused by the same factor on the Y chromosome.
Clustered binary responses are commonly encountered in dental research. Data analysis
may include modeling both the marginal response probabilities (
Non-syndromic cleft lip/palate (NSCLP) is a complex genetic trait. Linkage and association studies have suggested that a clefting locus could be located on chromosome 4p. Sixty Chilean families were recruited for this study; from these, we used unrelated trios to evaluate the possible linkage disequilibrium between MSX1 and NSCLP. An intragenic marker, MSX1-CA, and an extragenic marker, D4S432 at a distance of 0.8 cM from MSX1, were analyzed by means of polymerase chain-reaction with fluorescent-labeled forward primers, followed by electrophoresis on a laser-fluorescent sequencer. We carried out a transmission/disequilibrium test (TDT) for multiple alleles to evaluate the presence of linkage disequilibrium. Results showed a preferential transmission of the 169-bp allele of MSX1 (p = 0.03). Although there was no preferential transmission for the D4S432 marker, the overall extended TDT (ETDT) showed a significant result (p = 0.01). The authors’ findings support the hypothesis of the contribution of MSX1 in the etiology of NSCLP in the Chilean population.
Periodontal disease is a bacterial infection that results in inflammatory destruction of tissues that support the teeth, including connective tissue and bone. In this study, we report that transgenic mice that overexpress the 17-kDa form of IL-1α in the basal layer of oral mucosal epithelium develop a syndrome that possesses all of the cardinal features of periodontal disease, including epithelial proliferation and apical migration, loss of attachment, and destruction of cementum and alveolar bone. In this model, bacterial colonization and infection were not required, since levels of periodontal bacteria were equivalent in transgenic and wild-type mice, and continuous treatment with antibiotics from birth did not ameliorate the disease. Our findings therefore indicate that elevated levels of IL-1α in the oral micro-environment can mediate all of the clinical features of periodontal disease.
Interleukin-1α (IL-1α) is a powerful activator of osteoclast cells. However, the
underlying mechanism for this activation is unknown. In this study, we reveal that
IL-1α up-regulates the expression of cathepsin K protein, a key protease in bone
resorption, by five-fold. Northern blot analysis and promoter analysis show that this
induction occurs at the transcriptional level, in a dose-responsive and
time-dependent manner. No increase in expression occurs in the presence of either
pyrrolidine dithiocarbamate (PDTC), a selective inhibitor of NF-κB, or Genistein, a
protein tyrosine kinase inhibitor, suggesting that IL-1α up-regulation may be
How secondary palate formation is affected in the cleft lip genotype remains poorly
understood. The purpose of this study was to analyze regional patterns of cell
proliferation in CL/Fr mouse embryos with or without cleft lip. Pairs of palatal
shelves were dissected at E13.5 from CL/Fr normal embryos (CL/Fr-N), CL/Fr embryos
with bilateral cleft lip (CL/Fr-BCL), and a control strain of C57BL embryos (C57BL).
The explants were examined histologically after 48 hrs of organ culture. Cell
kinetics for proliferation in the palatal shelves was examined at E13.5 by the
bromodeoxyuridine method
An understanding of biofilm behavior of periodontopathic bacteria is key to the
development of effective oral therapies. We hypothesized that interspecies bacterial
aggregates play an important role in anaerobic biofilm establishment and
proliferation, and contribute to the survivability of the biofilm against therapeutic
agents. The system developed in this study assessed a multi-species (
Several studies have indicated differences in bond strength of dental materials to crown and root dentin. To investigate the potential differences in matrix properties between these locations, we analyzed upper root and crown dentin in human third molars for ultimate tensile strength and collagen biochemistry. In both locations, tensile strength tested perpendicular to the direction of dentinal tubules (undemineralized crown = 140.4 ± 48.6/root = 95.9 ± 26.1; demineralized crown = 16.6 ± 6.3/root = 29.0 ± 12.4) was greater than that tested parallel to the tubular direction (undemineralized crown = 73.1 ± 21.2/root = 63.2 ± 22.6; demineralized crown = 9.0 ± 3.9/root = 16.2 ± 8.0). The demineralized specimens showed significantly greater tensile strength in root than in crown. Although the collagen content was comparable in both locations, two major collagen cross-links, dehydrodihydroxylysinonorleucine/its ketoamine and pyridinoline, were significantly higher in the root (by ~ 30 and ~ 55%, respectively) when compared with those in the crown. These results indicate that the profile of collagen cross-linking varies as a function of anatomical location in dentin and that the difference may partly explain the site-specific tensile strength.