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Research on craniofacial genetics and developmental biology: implications for the future of academic dentistry.

The literature of biology abounds in awe-inspiring acts of iridescent genius. Although a law of nature is phrased in abstract language and is itself devoid of passion and sensibility, the history of its discovery may be an epic worthy of Homer, every page of which bears the stamp of the personality of people. Clearly, scientific truth can be defended by dispassionate logic, but its discovery cannot be promoted this way. The human factor in the creative equation is an important aspect. The discovery of the principles that now form the foundation of developmental craniofacial biology is a story of irony and paradox. Although much progress has been made in many scientific endeavors, many questions regarding craniofacial growth and development remain unanswered. One of the main problems encountered in studies of mammalian growth and development, specifically those dealing with developmental craniofacial biology, has been the apparent lack of application of advances in parallel fields of scientific endeavor. The time seems appropriate for commingling clinical problems with the recently acquired principles of cellular, molecular, and developmental biology.

Animals↗

Human prenatal palatal closure related to skeletal maturity of the jaws.

The purpose of the present study was to elucidate the stages of skeletal maturation of the maxilla and the mandible at the time of soft tissue palatal closure. Similar studies were not found in the literature. This investigation was based on maxillae and mandibles from 19 human embryos/fetuses selected by visual inspection of palatal structures, eight fetuses "just before palatal closure," and 11 fetuses "just after palatal closure." The findings are related to formerly described skeletal developmental stages in the maxilla, to stages in the symphysis menti region, and to development in the mandibular condylar region. The present study revealed that elevation of the palatal shelves takes place at a specific stage of maxillary skeletal maturity (stage Max III), at a time of mandibular development characterized by absence of condylar cartilage and by constancy in symphysis menti maturity (stage SM I). Knowledge of the normal sequence of prenatal skeletal development is considered essential for understanding the abnormal sequence of skeletal development.

Cartilage↗

Clinical usefulness of two-dimensional reformatted and three-dimensionally rendered computerized tomographic images: literature review and a survey of surgeons' opinions.

PURPOSE: This study compares the usefulness of axial computed tomography (CT) with two-dimensional (2D) reformats and three-dimensionally (3D) rendered CT data in the treatment planning and management of patients. PATIENTS AND METHODS: Twenty-nine patients who had been studied with CT were grouped into the following four clinical problems: 1) temporomandibular joint assessment (n = 8), 2) growth and development assessment (n = 4), 3) posttrauma and postoperative assessment (n = 13), 4) "other" (n = 4). The clinicians who treated these patients were surveyed for their opinions of the usefulness of CT with and without 2D/3D reformatting. RESULTS: In a majority of the cases within each of the four clinical groups, the clinicians believed that 2D and/or 3D reformatting of the CT data provided additional useful information for patient management. In most of the cases, 3D imaging provided information in addition to that provided by the axial or reformatted 2D images. CONCLUSION: 2D and 3D CT images can be useful to the clinician in diagnosis and treatment planning. These methods enhance the accuracy of diagnostic decisions and the establishment of appropriate treatment plans.

Attitude of Health Personnel↗

[T- and B-lymphocytes, interleukins and natural killers in patients with osteomyelitis developing after combined injuries to the maxillofacial and craniocerebral areas].

Forty-three patients with traumatic osteomyelitis developing after combined maxillofacial and craniocerebral injuries and thirty normal subjects were examined. Immunologic findings permit distinguishing two groups of patients: those with marked disorders of the T cellular immunity (reduced T helper and Tx counts, interleukin-2 synthesis, and Tx/T suppressor coefficient) and without such shifts. The therapy of patients without manifest immunity shifts was generally effective whereas in those with marked immunity disorders the therapy efficacy was inadequate and the immunity disorders persisted.

B-Lymphocytes↗

Dental management of neonates requiring prolonged oral intubation.

An orotracheal route is frequently the preferred method of intubation for premature infants. Nasal intubation may contribute to airway obstruction and possible hypoxia, further contributing to labored breathing. Additional complications include occlusion of the nasal aperture during a crucial period of development, nasal infections, and hypertrophy of the nasal lining. Oral mucosa is less susceptible to damage than nasal mucosa; however, orotracheal tubes must be stabilized against displacement from tongue and jaw movements to prevent discomfort and subsequent tissue trauma. Problems associated with rehabilitation of very-low-birth-weight neonates and other infants requiring long-term oral intubation include palatal grooving, acquired cleft palate, and damage to the primary dentition. Various intraoral aids have been used to reduce pressure application from intubation and feeding tubes on the palatal tissues. References to these procedures have yet to be reported in the prosthodontic literature. This article presents a rational for design and construction of an intraoral device which protects the palatal tissues and stabilizes the orotracheal tube.

Alveolar Process↗

Development of mandibular cartilages in the rat.

BACKGROUND: The mammalian mandible develops around Meckel's cartilage and other secondary cartilages, including the dentary. There have already been many studies of the development of the rat mandible that have employed histological serial sections. However, no previous investigators have captured the three-dimensional features of the developmental process. METHODS: In this study, the technique of double staining with alizarin red S and alcian blue was employed directly on whole body specimens to investigate the three-dimensional development of the rat mandible. RESULTS AND CONCLUSIONS: We found that the molar socket obstructs the developing mandible, causing it to emerge medial to Meckel's cartilage. Our results also indicate that the secondary mandibular cartilages may contribute to supplementary growth in response to local factors.

Alcian Blue↗

[Phylogenetic aspects of lip function].

Lips can be considered a phylogenic summary of nasolabial and facial muscle evolution. They represent the central point of facial morphogenesis. The progressive development of oral and facial functions is an elementary human necessity for feeding, suction, oral competence, swallowing, language, and mimics. Each discontinuity causes functional and anatomic disorders. Any damage to the lips creates facial unbalance. Precise knowledge of lip function is indispensable for optimal reconstruction.

Adolescent↗