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Biomedical subjects

U Hägg

Publications and source records attributed to U Hägg.

At least 19 recordsLinked to original sources
PubMed2006

Repeated mechanical loading enhances the expression of Indian hedgehog in condylar cartilage.

Indian hedgehog (Ihh) acts as a mechanotransduction mediator that converts mechanical strain into cellular proliferation and cartilage formation in mandibular condylar cartilage. The aim of this study was to examine the effect of repeated mechanical strain on the level of expression of Ihh and type II collagen mRNA in condylar growth. Two hundred and eighty 35 days old Sprague-Dawley rats were divided into 10 experimental and 10 control groups. Repeated mechanical loading was applied by advancing the mandible in a stepwise manner by fitting a stepwise bite jumping appliance. Animals were sacrificed together with their matched controls on 10 different time points. Total RNA was extracted from condylar cartilage immediately after dissection. Ihh and type II collagen mRNA was quantified using real-time PCR. In the experimental group, Ihh mRNA increased significantly on experimental day 7. Upon the second advancement, another peak was elicited 7 days later. Type II collagen showed a significant increase on days 21 and 44 of advancement. This indicated that mechanical loading in a repeated manner, triggers the expression of Ihh which in turn increases the number of replicating mesenchymal cells as well as the amount of the cartilage formed. Taken together these events increase condylar growth.

Animals↗
PubMed2006

Long-term dentofacial changes in Chinese obstructive sleep apnea patients after treatment with a mandibular advancement device.

The objective of this study was to evaluate long-term dentofacial changes in Chinese obstructive sleep apnea (OSA) patients treated with a mandibular advancement device (MAD). Lateral cephalograms in natural head posture were obtained from 67 consecutive OSA patients (mean age = 46.9 +/- 8.9 years) treated with an MAD. The cephalograms were obtained at start of treatment (T0), after 1 year (T1), 2 years (T2), and 3 years (T3) of treatment. The lateral cephalograms were digitized twice, and the average of two readings was used for statistical analyses. Small, but statistically significant changes occurred in some dentofacial variables. The lower anterior facial height steadily increased during the observation period, and this increase was significant for the T0-T1 and T1-T2 periods and marginally significant for the T2-T3 period. A significant increase in the mandibular plane angle was observed during the T0-T1 and T2-T3 periods only. Significant reductions in the overjet and overbite were observed for the T0-T1 period but not thereafter. Statistically significant dentofacial changes were observed in this study, but they were of small magnitude. The overjet and overbite changes observed mainly occurred at the initial stage of treatment.

Activator Appliances↗
PubMed2006

The impact of malocclusion and its treatment on quality of life: a literature review.

AIM: The aim of this paper is to review the literature relating to the impact of malocclusion, and the treatment of malocclusion, on physical, social and psychological health (i.e. quality of life, QoL). DESIGN: English-language papers, including cross-sectional studies, retrospective and prospective longitudinal studies, randomized controlled trials, and reviews and meta-analyses were reviewed to determine the impact of malocclusion and its treatment on QoL. RESULTS: Malocclusion and its treatment can affect physical health in terms of pain (e.g. temporomandibular disorders, and dental and gingival trauma), speech and mastication. In terms of psychological health, malocclusion and its treatment is reported to affect self-concept. Socially, malocclusion and its treatment can affect perceived attractiveness by others, social acceptance and perceived intelligence. However, the evidence is conflicting owing to differences in study designs, population's studied and methods of assessment of psychical, social and psychological health. CONCLUSION: Much controversy exists about the impact of malocclusion and its treatment on QoL. There is a need for a more comprehensive and rigorous assessment of the impact of malocclusion and its treatment on QoL, employing standardized, valid and reliable data collection instruments.

Humans↗
PubMed2006

A survey on the preference for continuing professional dental education amongst general dental practitioners who attended the 26th Asia Pacific Dental Congress.

AIMS: To identify the subjects of interest and to examine the modes as well as means of study for continuing professional dental education amongst general dental practitioners who attended the 26th Asia Pacific Dental Congress, 28 May-1 June 2004, Hong Kong. METHODS: A total of 381 general dental practitioners as the registered conference delegates from Hong Kong, Mainland China and other Asia-Pacific regions were randomly selected for the present survey. The survey was conducted through face-to-face interviews by a group of practising dentists in Hong Kong. RESULTS: Overall, orthodontics and prosthodontics were the most popular subjects for clinical degree programmes, whilst oral implantology and cosmetic dentistry were the highly preferred subjects for continuing education courses. Concerning the preferred mode of study for degree programmes, the part-time study mode was chosen by 68.3% of the participating dentists. A didactic teaching approach was preferred by most of the participants (81.7%) for postgraduate study. The majority of the interviewees (76.5%) were interested in a proposed clinical degree programme to be offered jointly by The University of Hong Kong and a leading university in the Mainland. Overall, there was no marked difference in the preference for continuing dental education amongst the respondents from Hong Kong, Mainland China and other Asia-Pacific regions. CONCLUSIONS: The present survey shows the currently preferred specialty areas and subjects for continuing professional dental education amongst the general dental practitioners who attended the 26th Asia Pacific Dental Congress, with didactic teaching as the most preferred mode of study on a part-time basis.

Asia↗
PubMed2006

The Gold Medal of the Conjoint M. Orth. Examination of the Royal College of Surgeons of Edinburgh and the College of Dental Surgeons of Hong Kong, surgical orthodontic cases.

The Conjoint Gold Medal was awarded to the candidate who scored the highest overall mark in Part II of the Membership of Orthodontics examination held by the Royal college of Surgeons of Edinburgh and the College of Dental Surgeons of Hong Kong. It is the intermediate examination for the orthodontic specialty training pathway in Hong Kong. Part of this examination involved the presentation of a fully documented fixed appliance case and a multidisciplinary case, and three other cases with condensed case histories. This article described two surgical orthodontic cases presented during the 1999 and 2002 examinations by the award winners.

Adult↗
PubMed2005

Skeletal effects of bite jumping therapy on the mandible - removable vs. fixed functional appliances.

UNLABELLED: AUTHORS: Shen G, Hagg U, Darendeliler MA. OBJECTIVE: Based on an extensive review of the literature, the aim of this study was to explore the mainstream consensus on the controversial topic of whether the bite jumping treatment could enhance mandibular growth. DESIGN: The data for removable and fixed functional appliances were respectively comprehended and analyzed with regard to their attributes in mandibular growth modification. Furthermore, numerous reported findings were assessed by relating them to some important factors influencing the effects of bite jumping, such as treatment timing, treatment duration and post-treatment follow-up, to allow for a more objective and accurate evaluation. RESULTS: The key differences between removable and fixed appliances are working hours (intermittent vs. continuous), length of treatment time (long vs. short), optimal treatment timing (before puberty growth vs. at or after puberty spurt), and mode of bite-jumping (considerable vertical opening vs. limited vertical opening). These different features lead to different treatment effects on mandibular and TMJ growth, such as the intensity of possibly increased growth (clinically less significant vs. significant), the direction of enhanced growth (vertical vs. horizontal), and the stability of treatment changes (unstable vs. stable). The short-term or long-term post-treatment relapse mainly relates to the rebound of dental position. CONCLUSION: The immediate effects of bite jumping functional appliances on the mandibular growth enhancement are convincing during actual treatment. This extra gain of growth might be sustainable during the short-term and long-term post-treatment period.

Age Factors↗
PubMed2005

Identification of temporal pattern of mandibular condylar growth: a molecular and biochemical experiment.

OBJECTIVES: Based on the phenomenon that expression of type X collagen and capillary endothelium correlates with endochondral ossification, the prime aim of this study was to establish the temporal pattern of condylar growth in Sprague-Dawley rats by biochemically identifying the expression of these two factors. DESIGN: Sprague-Dawley rats were divided into five groups representing five different stages during somatic pubertal growth. In situ hybridization and immunoperoxidase were performed to examine expression of type X collagen in hypertrophic zone and capillary endothelium in erosive zone of condylar cartilage. Computer-assisted imaging analyses were conducted to allow for a quantitative assessment of the expression of these two factors, from which the temporal pattern of condylar growth was inferred. RESULTS: (1) Synthesis of type X collagen and emergence of capillary endothelium were critical factors during the transition of condylar cartilage from chondrogenesis into osteogenesis, a biological pathway that leads to endochondral bone formation, the mode through which the condyle grows. (2) Quantitative analyses revealed the temporal pattern of the expression of these two factors, indicating that the thrust of natural growth of the condyle in the rats occurred in concomitance with somatic pubertal growth, featured by an acceleration starting from day 38, a maximum growth rate on day 56, followed by a decrease afterwards. CONCLUSION: It is suggested that the biochemical examination of growth markers, such as type X collagen, might be a new approach to accurately depict temporal pattern of condylar growth which is too delicate to be reflected by gross measurement not only in Sprague-Dawley rats but potentially also in other species.

Animals↗
PubMed2004

Neovascularization and bone formation in the condyle during stepwise mandibular advancement.

The aims of this investigation were to identify the temporal expression of vascular endothelial growth factor (VEGF) in the mandibular condyle and to correlate it with the pattern of new bone formation during stepwise mandibular advancement. Two hundred and fifty female, 35-day-old Sprague-Dawley rats were randomly divided into 10 groups, with 10 rats allocated to the single-step bite-jumping subgroup, 10 rats to the stepwise advancement subgroup and five rats to the control subgroup. In the experimental groups, the mandibles were kept in a continuous forward position. The initial stepwise advancement commenced on day 35, whereas the second advancement started on day 65. The rats were sacrificed on experimental days 3, 7, 14, 21, 30, 33, 37, 44, 51 and 60. Sections (7 microm) were cut through the condyle in the parasagittal plane and stained with anti-VEGF antibody. Each section was counter-stained with haematoxylin for observation of the cellular response. The sections were digitized and quantitatively analysed with a computer-assisted image analysing system. The results showed that the initial advancement in the stepwise group led to significantly less expression of VEGF when compared with single advancement. However, the second advancement on day 30 resulted in a significant increase in VEGF expression when compared with the one-step group and the natural growth control group. Thus, it was concluded that changes in the amplitude of mechanical loading, produced by stepwise advancement, have a significant effect on the production of VEGF by the chondrocytes. During the later stages of advancement, more VEGF and more condylar bone was produced.

Analysis of Variance↗
PubMed2004

Forward mandibular positioning enhances condylar adaptation in adult rats.

The aim of this investigation was to assess quantitatively the adaptive changes in the condyles of adult rats to forward mandibular positioning. The level of types II and X collagen expressed in the condyles of adult rats was compared with that formed in response to forward mandibular positioning and the levels of expression were correlated to the amount of bone formed in response to mandibular advancement. Seventy-eight 120-day-old female Sprague-Dawley rats were included in this study. The rats were randomly allocated to six groups. Each group consisted of nine rats with bite-jumping devices and four untreated controls. The animals in each group were sacrificed on days 3, 7, 14, 21, 30, and 60. Immunostaining was used for the detection of types II and X collagen, while Alcian blue-PAS was used to observe the extracellular matrix and new bone formation. The results showed that new cartilage was formed in the posterior condyle. The highest level of expression of types II and X collagen were present on day 21, the amount of increase was 247.99 and 540.08 per cent, respectively. The highest level of new bone formation was measured at day 30 of advancement when the amount of increase in new bone formation was 318.91 per cent. These findings indicate that forward mandibular positioning causes changes in the biophysical environment of the temporomandibular joint (TMJ) of adult rats that leads to condylar adaptation.

Adaptation, Physiological↗
PubMed2004

The effect of fixed orthodontic appliances on the oral carriage of Candida species and Enterobacteriaceae.

The aim of this investigation was to evaluate the prevalence of Candida and Enterobacteriaceae in a group of adolescents during fixed orthodontic appliance (FOA) therapy. The experimental group was recruited from a larger sample of orthodontic patients who were clinically examined once to obtain baseline data before active treatment. The group comprised 27 subjects; 13 males, 14 females (mean age 15.5 +/- 2.3 years). Thereafter, the experimental group was examined three times during a 3 month follow-up period after insertion of the FOA. The whole mouth plaque score was obtained, and the oral cavity was then sampled for Candida species and Enterobacteriaceae using three different microbiological culture techniques, namely the oral rinse, pooled plaque and the imprint culture.A significant increase in candidal numbers was observed after FOA insertion when the imprint technique was used (P < 0.001), although the overall candidal prevalence rates obtained using the oral rinse and pooled plaque techniques did not demonstrate such a change. The predominant Candida species isolated was C. albicans and the number of coliform carriers significantly increased after the insertion of a FOA, as detected by the oral rinse (P < 0.05) and the pooled plaque (P < 0.05) techniques. In total, eight coliform species were isolated following FOA therapy compared with the three species isolated before insertion of the appliance. The results also revealed a significant increase in plaque index due to the introduction of a FOA. Taken together, these data imply that insertion of a FOA is likely to promote oral carriage of Candida and coliform species. Furthermore, it appears that routine oral hygiene instruction and information on appliance hygiene given to these patients may not necessarily reduce plaque accumulation and possible attendant effects. Further work with a larger cohort is required to confirm these findings.

Adolescent↗
PubMed2004

Indian hedgehog: a mechanotransduction mediator in condylar cartilage.

Indian hedgehog (Ihh) is a critical mediator transducing mechanical signals to stimulate chondrocyte proliferation. To clarify the cellular signal transduction pathway that senses and converts mechanical signals into tissue growth in mandibular condyle, we evaluated Ihh expression and its relation to the kinetics of replicating mesenchymal cells in condylar cartilage during natural growth and mandibular advancement. Thirty-five-day-old Sprague-Dawley rats were fitted with functional appliances. Experimental animals with matched controls were doubly labeled with iododeoxyuridine and bromodeoxyuridine so that we could evaluate the cycles of the proliferative mesenchymal cells. Mandibular advancement triggered Ihh expression in condylar cartilage. A higher level of Ihh expression coincided with the increase of the replicating mesenchymal cells' population and the shortening of the turnover time. These findings suggested that Ihh acts as a mediator of mechanotransduction that converts mechanical signals resulting from anterior mandibular displacement to stimulate cellular proliferation in condylar cartilage.

Animals↗
PubMed2003

PTHrP regulates chondrocyte maturation in condylar cartilage.

PTHrP is a key factor regulating the pace of endochondral ossification during skeletal development. Mandibular advancement solicits a cascade of molecular responses in condylar cartilage. However, the pace of cellular maturation and its effects on condylar growth are still unknown. The purpose of this study was to evaluate the pattern of expression of PTHrP and correlate it to cellular dynamics of chondrocytes in condylar cartilage during natural growth and mandibular advancement. We fitted 35-day-old Sprague-Dawley rats with functional appliances. Experimental animals with matched controls were labeled with bromodeoxyuridine 3 days before their death, so that mesenchymal cell differentiation could be traced. Mandibular advancement increased the number of differentiated chondroblasts and subsequently increased the cartilage volume. Higher levels of PTHrP expression in experimental animals coincided with the slowing of chondrocyte hypertrophy. Thus, mandibular advancement promoted mesenchymal cell differentiation and triggered PTHrP expression, which retarded their further maturation to allow for more growth.

Analysis of Variance↗
PubMed2003

[An immunohistochemical study on neovascularization in TMJ during mandibular advancement].

OBJECTIVE: Neovascularization is proved to be closely correlated with ossification. This study was designed to determine the biochemical path through which the new bone formation is enhanced in TMJ during mandibular protrusion. METHODS: SD Rats were fitted with bite-jumping appliances to allow for an adequate advancement of the mandible. The animals were sacrificed 3, 7, 14, 21 and 30 days, respectively, after placement of the appliances. Slides with TMJ tissue were prepared for biochemical procedure. Immunohistochemical approaches were adopted to examine neovascularization in TMJ by immuno-localizing the newly formed endothelial cells. Computer-assisted image analysis system was applied to quantify the positive immunoreaction. RESULTS: Neovascularization in connective tissue close to the condyle was 200% higher in the experimental groups than that in the control, and, within the bony tissue of the condyle, neovascularization in experimental animals was found to be 103% higher than that of the control. CONCLUSION: Increased neovascularization triggered by mandibular protrusion might intensify new bone formation in condyle and glenoid fossa and finally lead to a growth adaptation of TMJ to bite-jumping therapy.

Animals↗
PubMed2002

The correlation between neovascularization and bone formation in the condyle during forward mandibular positioning.

The aim of the present study was to investigate the temporal pattern of expression of VEGF (Vascular Endothelial Growth Factor) and new bone formation in the condyle during forward mandibular positioning. The importance of vascularization during endochondral ossification was investigated during natural growth of the condyle and compared to that after forward mandibular positioning. The goal was to further our understanding of the cellular responses during functional appliance therapy with a view to extending the experiment into maturity. One hundred and fifty 35 days old Sprague-Dawley rats, 100 fitted with a bite-jumping appliance and 50 untreated, were divided into 10 groups. One group was sacrificed on each of experimental days 3, 7, 14, 21, 30, 33, 37, 44, 51 and 60 respectively. Sagittal sections were cut and stained with VEGF antibodies and Periodic acid and Schiff's reagent (PAS). Each section was quantitatively analyzed with a computer assisted analyzing program and the temporal sequence of expression of VEGF and new bone formation during natural growth and after mandibular forward positioning was compared. There was significant increase in both vascularization and mandibular bone growth upon forward mandibular positioning and the highest amount of both were expressed in the posterior region of the condyle. The highest acceleration of vascularization preceded that of new bone formation. Thus, forward mandibular positioning was found to solicit a sequence of cellular events leading to increased vascularization and subsequently new bone formation resulting in enhanced condylar growth.

Analysis of Variance↗
PubMed2002

Factors regulating mandibular condylar growth.

Factors regulating condylar growth have not been identified before. This study was designed to identify a series of these factors, such as Sox 9 transcription factor and vascular endothelial growth factor (VEGF), and also to correlate the amount of type X collagen expressed during natural growth to the amount of bone newly formed. We used 115 Sprague-Dawley rats, 35 days old, in this study. The expression of these factors was identified on protein level by using immunostaining. Type X collagen was identified on mRNA and protein levels. Sox 9 was expressed by cells in the proliferative layer and by chondrocytes. Type X was expressed only by hypertrophic chondrocytes, and its expression precedes the onset of endochondral ossification. VEGF is expressed by hypertrophic chondrocytes, and its maximum level of expression precedes the maximum level of bone formation. Condylar growth involves a sequence of transitory stages uniquely defined by molecules that are intrinsically synthesized by cells in the condyles.

Animals↗
PubMed2001

Occurrence of neurotrophin receptors and transmitters in the developing Xenopus gut.

The ontogeny of gut innervation in the anuran amphibian Xenopus laevis was studied using immunohistochemistry on sections of whole larvae from NF stages 38-52. Immunoreactivity to acetylated tubulin confirmed the presence of nerve fibres as early as stages 38-39. Actin immunoreactivity was found at stage 41, indicating the presence of smooth muscle cells. Trk-like neurotrophin receptors were occasionally found in nerve fibres as soon as stages 38-39. Vasoactive intestinal polypeptide (VIP) and pituitary adenylate cyclase-activating peptide (PACAP) immunoreactivities coexisted in nerves innervating the gut wall from stages 40-41, and nitric oxide synthase (NOS) from stage 42. Substance P/neurokinin A (SP/NKA) occurred at stage 42. In all these cases, the first fibres were observed in the oesophagus. Calcitonin gene-related peptide (CGRP) was first observed in nerves at stage 48. In general, VIP/PACAP and NOS innervation was denser than the tachykinin innervation. In conclusion, the development of nerve fibres in the Xenopus gut is probably dependent on neurotrophins that may act via Trk-like receptors and occur before the gut wall is fully organised morphologically. Feeding in Xenopus larvae starts at NF stage 45. The study demonstrates that several of the transmitters investigated are expressed in the gut innervation (and in endocrine cells) prior to this stage.

Animals↗
PubMed2001

An electromyographic investigation of the first six months of progressive mandibular advancement of the Herbst appliance in adolescents.

The effects of the progressive activation of the Herbst appliance on the activity of the masseter and temporalis elevator muscles of the mandible were monitored in a group of 14 consecutively treated 10-15-year-old subjects with an Angle Class II, division I malocclusion. A cast silver splint Herbst appliance was activated in multiple stages at a rate of 2 mm/2 mo. The functionality of the superficial masseter and anterior portion of the temporalis muscles was monitored at maximum bite force using surface electromyography (EMG). The EMG recordings were taken at an incisal edge-to-edge position and a retruded mandibular position, both at a vertical interincisal separation of 3 mm using an acrylic bite plate. Measurements of maximum voluntary isometric clenches were taken during adaptive functional changes at pretreatment (baseline) and during the first 6 months of Herbst appliance therapy. Results showed great individual and inter- and intrasessional differences in electromyographic activity of the muscles before and during treatment. At the retruded position, the masseteric activity increased by the sixth month while temporalis activity remained at the same level. Following treatment, the masseteric imbalance was reduced, but the temporalis imbalance was unchanged. At the edge-to-edge position, masseteric activity increased by the sixth month, while temporalis activity remained unchanged. The masseteric imbalance was reduced by the sixth month, while the temporalis imbalance was reduced from the fourth month into treatment. The results imply a favorable muscular response to a progressive regime of Herbst appliance activation.

Adolescent↗