Msx homeobox gene family and craniofacial development

Vertebrate Msx genes are unlinked,homeobox-containing genes that bear homology to the Drosophila muscle segment homeobox gene.These genes are expressed at multiple sites of tissue-tissue interactions during vertebrate embryonic development.Inductive interactions mediated by the Msx genes are essential for normal craniofacial,limb and ectodermal organ morphogenesis,and are also essential to survival in mice,as manifested by the phenotypic abnormalities shown in knockout mice and in humans.This review summarizes studies on the expression,regulation,and functional analysis of Msx genes that bear relevance to craniofacial development in humans and mice.

The Craniofacial Morphology in Adult Patients with Unoperated Isolated Cleft Palate

Objective： To address the effect of intrinsic factors on craniofacial growth by analyzing the craniofacial morphology of unoperated isolated cleft palate in Chinese adult. Materials and Methods： This study included 37 nonsyndromic isolated cleft palate and 39 age and gender matched non-clefts. Twenty-six cephalometric measurements were employed to evaluate the facial morphology. Independent samples T test and Mann- Whitney U were used for comparison. Significant difference was defined at 95% level. Results： Data from this study showed patients with unoperated isolated cleft palate have a reduced maxillary sagittal length （ANS-PMP, A-PMP, P〈0.05）, a smaller ANB angle （ANB, P〈0.05） and a retrusive ANS point （S-N-ANS, P〈0.05; Ba-N-ANS, P〈0.05）. Measurements descripted position of maxilla （S-Ptm, P〉0.05）, depth of bony pharynx （Ba-PMP, P〉0.05）, anterior and posterior maxillary height （N-ANS, P〉0.05; R-PMP, P〉0.05） and mandible morphology （including linear measurements and angle measurements） did not show any significant difference between case and control groups. Conclusions： Patients with isolated cleft palate were characterized by maxillary retrusion. Mandible morphology and cranial basal morphology in isolated cleft palate showed no significant difference with nonclefts. Patients with isolated cleft palate are more vulnerable to cross bite than nonclefts. Intrinsic deficiencies did detrimental effect on maxilla sagittal length, but did no detrimental effect on maxilla position, mandible size and position.

In vitro antimicrobial effects of grape seed extract on peri-implantitis microflora in craniofacial implants

Objective:To determine the antimicrobial effects of grape seed on peri-implantitis microflora.Methods:The grape seed extract was tested against peri-implantitis microflora most commonly found in craniofacial implants including reference strains of Staphylococcus aureus(S.aureus),Escherichia coli(E.coli),Candida albicans(C.albicans)and clinical strains of S.aureus,Klebsiella pneumonia(K.pneumonia)and Candida parapsilosis(C.parapsilosis)by disk diffusion test.Minimum inhibitory concentrations(MIC)and minimum cidal concentrations(MCC)were determined using modified agar dilution millpore method.The extract was further combined with polyethylene glycol and propylene glycol,and was tested for antimicrobial effects.Results:Grape seed extract showed positive inhibitory effects with S.aureus at MIC of 0.625 mg/mL and MCC of1.25 mg/mL respectively.However the extracts showed minimal or no reactivity against strains of E.coli,K.pneumonia,C.parapsilosis and C.albicans.The use of grape seed extract in combination with polyethylene glycol and propylene glycol also showed dose dependent inhibitory effect on S.aureus.Conclusions:The results of the study showed that grape seed has potential antimicrobial effects which can be further studied and developed to be used in the treatment of infected skinabutment interface of craniofacial implants.

Perinatal stem cells: A promising cell resource for tissue engineering of craniofacial bone

In facing the mounting clinical challenge and suboptimal techniques of craniofacial bone defects resulting from various conditions, such as congenital malformations, osteomyelitis, trauma and tumor resection, the ongoing research of regenerative medicine using stem cells and concurrent advancement in biotechnology have shifted the focus from surgical reconstruction to a novel stem cell-based tissue engineering strategy for customized and functional craniofacial bone regeneration. Given the unique ontogenetical and cell biological properties of perinatal stem cells, emerging evidence has suggested these extraembryonic tissue-derived stem cells to be a promising cell source for extensive use in regenerative medicine and tissue engineering. In this review, we summarize the current achievements and obstacles in stem cell-based craniofacial bone regeneration and subsequently we address the characteristics of various types of perinatal stem cells and their novel application in tissue engineering of craniofacial bone. We propose the promising feasibility and scope of perinatal stem cell-based craniofacial bone tissue engineering for future clinical application.

Tooth agenesis and craniofacial morphology in preorthodontic children with and without morphological deviations in the upper cervical spine

AIM: To analyze differences in prevalence and pattern of tooth agenesis and craniofacial morphology between non syndromic children with tooth agenesis with and without upper cervical spine morphological deviations and to analyze associations between craniofacial morphology and tooth agenesis in the two groups together. METHODS: One hundred and twenty-six pre-orthodontic children with tooth agenesis were divided into two groups with(19 children, mean age 11.9) and without(107 children, mean age 11.4) upper spine morphological deviations. Visual assessment of upper spine morphology and measurements of craniofacial morphology were performed on lateral cephalograms. Tooth agenesis was evaluated from orthopantomograms.RESULTS: No significant differences in tooth agenesis and craniofacial morphology were found between children with and without upper spine morphological deviations(2.2 ± 1.6 vs 1.94 ± 1.2, P > 0.05) but a tendency to a different tooth agenesis pattern were seen in children with morphological deviations in the upper spine. In the total group tooth agenesis was associated with the cranial base angle(n-s-ba, r = 0.23,P < 0.01), jaw angle(ML/RLar, r = 0.19, P < 0.05), mandibular inclination(NSL/ML, r =-0.21, P < 0.05), mandibular prognathia(s-n-pg, r = 0.25, P < 0.01), sagittal jaw relationship(ss-n-pg, r =-0.23, P < 0.5), overjet(r =-0.23, P < 0.05) and overbite(r =-0.25, P < 0.01). CONCLUSION: Etiology of tooth agenesis in children with upper spine morphological deviations was discussed. The results may be valuable for the early diagnosis and treatment planning of non syndromic children with tooth agenesis.

Two rare cases of craniofacial chondrosarcoma

The craniofacial region is a rare site for chondrosarcomas.These tumors may have osseous or extraosseous origin.Extraosseous chondrosarcomas have the same histological features as osseous chondrosarcomas.Chondrosarcomas usually present in the fifth to seventh decades of life,although several cases with younger age at presentation have been reported.They usually present as a painless mass that gradually progresses to various complaints,such visual impairment,nasal obstruction,and dental abnormalities.In this article,we present two cases of chondrosarcoma occurring at rather unusual locations.It is important to keep this rare malignancy in the list of differential diagnoses for a mass in the head and neck region,as these tumors may not always show the features typical of this malignancy.

Secondary craniofacial necrotizing fasciitis from a distant septic emboli: A case report

BACKGROUND Craniofacial necrotizing fasciitis(CNF)is an uncommon but fatal infection that can spread rapidly through the subfascial planes in the head and neck region.Symptoms usually progress rapidly,and early management is necessary to optimize outcomes.CASE SUMMARY A 43-year-old man visited our hospital with left hemifacial swelling involving the buccal and submandibular areas.The patient had fever for approximately 10 d before visiting the hospital,but did not report any other systemic symptoms.Computed tomography scan demonstrated an abscess with gas formation.After surgical drainage of the facial abscess,the patient’s systemic condition worsened and progressed to septic shock.Further examination revealed pulmonary and renal abscesses.Renal percutaneous catheter drainage was performed at the renal abscess site,which caused improvement of symptoms.The patient showed no evidence of systemic complications during the 4-mo post-operative follow-up period.CONCLUSION As the patient did not improve with conventional CNF treatment and symptoms only resolved after controlling the infection,the final diagnosis was secondary CNF with septic emboli.Aggressive surgical decompression is important for CNF management.However,if symptoms worsen despite early diagnosis and management,such as pus drainage and surgical intervention,clinicians should consider the possibility of a secondary abscess from internal organs.

A Case of Orbital Lipoma That Occurred in the Lateral Canthal Region of the Tessier no. 8 Craniofacial Cleft

We report a case of a 37-year-old Japanese female. She had a Tessier no. 8 craniofacial cleft and an orbital lipoma in the lateral canthal region. Excisional surgery and pathological examination revealed a genuine lipoma. No other case has been reported in the literature. Here, we present our case of a rare genuine lipoma located in lateral canthal region of the Tessier no. 8 cleft.

Combined Use of the Points Shenmai and Zhaohai for Treatment of Craniofacial Diseases

Shenmai (BL 62) and Zhaohai (KI 6), first recorded in A Classic of Acupuncture and Moxibustion (针灸甲乙经), are respectively the starting point of the YangqiaoChannel and the Yinqiao Channel, and they are two of the eight confluence points. Although records about the right-left compatible use of these two points can be found in documents, the same-side compatible use of them has never been heardabout. Inspired by the good therapeutic effects in the treatment of paralytic strabismus by means of the same-side compatible use of these two points1, the author has applied this compatible use of them in the treatment of craniofacial diseases and obtained obvious therapeutic effects. Some of the sample cases are reported in the following. ……

The influence of the eruption of mandibular third molars on the craniofacial morphology in Han youth of North China

Teeth affect not only oral problems but also facial morphology.In China,there are few reports about the influence of the third molars on the craniofacial morphology of Han youths.Using in vivo imaging software,3D reconstruction of craniofacial CTs were performed on 32 Chinese Han youths without mandibular third molars and 25 Chinese Han youth with full mandibular third molars.The morphology of their mandible and mandibular tissue was measured to identify differences.Among the morphological characteristics of hard tissues,except for∠ANB,people with a full eruption of the mandibular third molars had statistically significantly larger angle indicators than people without the eruption of the third molars.The soft tissue indicators also showed statistically significant discrepancies in terms of morphological facial height,mouth to gnathion distance,lip height,and mouth breadth.The most influential index for mandibular third molars was length of symphysis,followed by the four indicators of soft tissue and mandible length and height.Morphology facial height,mouth to gnathion distance,lip height,and height of symphysis were moderately correlated.The experimental results show that among Han youth in North China,the third molar eruption has a widespread influence on mandibular morphology,especially in angle,length,and height indicators.It also has a certain influence on maxillofacial soft tissue morphology.These results can be applied to future clinical risk assessment of the wisdom teeth and forensic personal identification of the cranial and maxillofacial region.

Personalized composite scaffolds for accelerated cell-and growth factor-free craniofacial bone regeneration

Approaches to regenerating bone often rely on integrating biomaterials and biological signals in the form of cells or cytokines.However,from a translational point of view,these approaches are challenging due to the sourcing and quality of the biologic,unpredictable immune responses,complex regulatory paths,and high costs.We describe a simple manufacturing process and a material-centric 3D-printed composite scaffold system(CSS)that offers distinct advantages for clinical translation.The CSS comprises a 3D-printed porous polydiolcitrate-hydroxyapatite composite elastomer infused with a polydiolcitrate-graphene oxide hydrogel composite.Using a micro-continuous liquid interface production 3D printer,we fabricate a precise porous ceramic scaffold with 60 wt%hydroxyapatite resembling natural bone.The resulting scaffold integrates with a thermoresponsive hydrogel composite in situ to fit the defect,which is expected to enhance surface contact with surrounding tissue and facilitate biointegration.The antioxidative properties of citrate polymers prevent long-term inflammatory responses.The CSS stimulates osteogenesis in vitro and in vivo.Within 4 weeks in a calvarial critical-sized bone defect model,the CSS accelerated ECM deposition(8-fold)and mineralized osteoid(69-fold)compared to the untreated.Through spatial transcriptomics,we demonstrated the comprehensive biological processes of CSS for prompt osseointegration.Our material-centric approach delivers impressive osteogenic properties and streamlined manufacturing advantages,potentially expediting clinical application for bone reconstruction surgeries.

Phosphoserine enhanced Cu-doped bioactive glass dynamic dual-network hydrogel for craniofacial bone defect repair

Flexible hydrogels containing various osteogenic inorganic constituents,which can accommodate complicated shape variations,are considered as ideal grafts for craniofacial bone defect reconstruction.However,in most hybrid hydrogels,poor interaction between the polymer network and particles has detrimental effects on hydrogel rheological and structural properties,clinical manipulation and repair efficacy.In this article,we designed and prepared a series of hyaluronic acid composite hydrogel containing Cu-doped bioactive glass(CuBG)and phosphoserine(PS),in which hyaluronic acid was modified by methacrylate groups and phenylboronic acid groups to form a double crosslinked network.PS acted as an interaction bridge of CuBG particles and HAMA-PBA network to improve the mechanical properties of the composite hydrogels.The CuBG/PS hydrogels exhibited suitable rheological properties(injectable,self-healing,shape-adaptable),bone tissue integrating ability and anti-bacterial property.Meanwhile,we found that CuBG and PS have synergistic effect on improving osteogenic efficiency both in vitro and in vivo,particularly when the ratio of CuBG to PS is lower than 3(9CB/3PS).This work provided a versatile and scalable approach to enhanced the interaction within inorganic particles and polymer network in hydrogels without extra modification on components.

Advancing collagen-based biomaterials for oral and craniofacial tissue regeneration

The oral and craniofacial region consists of various types of hard and soft tissues with the intricate organization.With the high prevalence of tissue defects in this specific region,it is highly desirable to enhance tissue regeneration through the development and use of engineered biomaterials.Collagen,the major component of tissue extracellular matrix,has come into the limelight in regenerative medicine.Although collagen has been widely used as an essential component in biomaterial engineering owing to its low immunogenicity,high biocompatibility,and convenient extraction procedures,there is a limited number of reviews on this specific clinic sector.The need for mechanical enhancement and functional engineering drives intensive efforts in collagen-based biomaterials concentrating on therapeutical outcomes and clinical translation in oral and craniofacial tissue regeneration.Herein,we highlighted the status quo of the design and applications of collagen-based biomaterials in oral and craniofacial tissue reconstruction.The discussion expanded on the inspiration from the leather tanning process on modifications of collagen-based biomaterials and the prospects of multi-tissue reconstruction in this particular dynamic microenvironment.The existing findings will lay a new foundation for the optimization of current collagen-based biomaterials for rebuilding oral and craniofacial tissues in the future.

Spoon-assisted autologous particulate bone graft harvesting technique

Particulate bone plays a crucial role in various oral and maxillofacial surgical procedures,including reconstruction,implantation,and craniofacial surgery.Autologous bone and deproteinized bovine bone xenografts are the two primary resources used for such procedures,with the former demonstrating superior cost-effectiveness and reduced comorbidity rates,particularly in cases involving donor zones.However,a significant challenge lies in acquiring uniformly sized autologous particulate bone specimens,with existing tools often yielding coarse particles at a high cost.Consequently,commercial bone xenograft solutions are frequently favored despite lower standards.This technical note introduces a novel technique for swiftly,safely,and efficiently obtaining autologous particulate bone specimens.The procedure involves the use of a motor handpiece fitted with a micro drill and surgical spoon to collect the bone particles.The continuous irrigation with saline maintains a clear surgical field during the milling process.The collected bone particles are then transferred to a metal capsule for further use.This technique offers a promising solution to the challenge of inconsistent particle size associated with harvesting using traditional methods,providing surgeons with a reliable and efficient method of obtaining autologous particulate bone samples.

Notch signaling:Its essential roles in bone and craniofacial development

Notch is a cellecell signaling pathway that is involved in a host of activities including development,oncogenesis,skeletal homeostasis,and much more.More specifically,recent research has demonstrated the importance of Notch signaling in osteogenic differentiation,bone healing,and in the development of the skeleton.The craniofacial skeleton is complex and understanding its development has remained an important focus in biology.In this review we briefly summarize what recent research has revealed about Notch signaling and the current understanding of how the skeleton,skull,and face develop.We then discuss the crucial role that Notch plays in both craniofacial development and the skeletal system,and what importance it may play in the future.

Craniofacial resection of advanced oral and maxillofacial malignant tumors

Objective To evaluate the clinical outcome of craniofacial resection for advanced malignant tumors in oral and maxillofacial regions.Methods Forty-six patients who underwent craniofacial resection for malignancies involving the anterior and middle cranial fossa over a 20-year period between June 1978 and December 1997 at our department were evaluated. Twenty patients received radiation therapy and an adjuvant therapy after the operation. Eleven patients received chemotherapy of various types as an adjuvant therapy.Results The 3- and 5-year survival rates were 48.8% (20/41) and 35.1% (13/37), respectively, while the 10-year survival rate was 20% (4/20).Conclusions Our results revealed good prospects of using craniofacial resection on patients with advanced malignancies in the oral and maxillofacial regions.

Stem cells, growth factors and scaffolds in craniofacial regenerative medicine

Current reconstructive approaches to large craniofacial skeletal defects are often complicated and challenging.Critical-sized defects are unable to heal via natural regenerative processes and require surgical intervention,traditionally involving autologous bone(mainly in the form of nonvascularized grafts)or alloplasts.Autologous bone grafts remain the gold standard of care in spite of the associated risk of donor site morbidity.Tissue engineering approaches represent a promising alternative that would serve to facilitate bone regeneration even in large craniofacial skeletal defects.This strategy has been tested in a myriad of iterations by utilizing a variety of osteoconductive scaffold materials,osteoblastic stem cells,as well as osteoinductive growth factors and small molecules.One of the major challenges facing tissue engineers is creating a scaffold fulfilling the properties necessary for controlled bone regeneration.These properties include osteoconduction,osteoinduction,biocompatibility,biodegradability,vascularization,and progenitor cell retention.This review will provide an overview of how optimization of the aforementioned scaffold parameters facilitates bone regenerative capabilities as well as a discussion of common osteoconductive scaffold materials.

Smyd1 is essential for myosin expression and sarcomere organization in craniofacial,extraocular,and cardiac muscles

Skeletal and cardiac muscles are striated myofibers that contain highly organized sarcomeres for muscle contraction.Recent studies revealed that Smyd1,a lysine methyltransferase,plays a key role in sarcomere assembly in heart and trunk skeletal muscles.However,Smyd1 expression and function in craniofacial muscles are not known.Here,we analyze the developmental expression and function of two smyd1 paralogous genes,smyd1 a and smyd1 b,in craniofacial and cardiac muscles of zebrafish embryos.Our data show that loss of smyd1a(smyd1a^(mb5))or smyd1b(smyd1b^(sa15678))has no visible effects on myogenic commitment and expression of myod and myosin heavy-chain m RNA transcripts in craniofacial muscles.However,myosin heavy-chain protein accumulation and sarcomere organization are dramatically reduced in smyd1b^(sa15678) single mutant,and almost completely diminish in smyd1a^(mb5);smyd1b^(sa15678) double mutant,but not in smyd1a^(mb5) mutant.Similar defects are also observed in cardiac muscles of smyd1b^(sa15678) mutant.Defective craniofacial and cardiac muscle formation is associated with an upregulation of hsp90α1 and unc45b mRNA expression in smyd1b^(sa15678) and smyd1a^(mb5);smyd1b^(sa15678) mutants.Together,our studies indicate that Smyd1b,but not Smyd1a,plays a key role in myosin heavy-chain protein expression and sarcomere organization in craniofacial and cardiac muscles.Loss of smyd1b results in muscle-specific stress response.

Latitudinal and climatic distributions of 3D craniofacial features among Holocene populations

The geographical and climatic patterning in craniofacial morphology among recent hominids has been regarded as relatively reliable evidence of environmental adaptation and natural selection,which is largely attributed to thermoregulation.However,the relative influence of genetic and environmental factors on craniofacial features is unclear.Our study employed 3D laser scanning techniques to evaluate the association between geographical(latitude),climatic(annual temperature)factors,and 3D craniofacial measurements in 18 recent populations through bivariate correlation analysis.Significant correlations were found among braincase surface area,zygomatic bone surface area,cranial-facial index(facial surface area relative to braincase surface area)and local temperature,and a clear latitudinal gradient was also found in variation of braincase surface area.No significant correlations were found between zygomatic bone surface area,cranial-facial index and latitude.Our analysis supports the idea that the braincase functions as a radiator and is closely related to direct sunlight.We also suggest that absolute/relative craniofacial surface area varies consistently with predictions derived from Bergmann’s Rule.The mosaic craniofacial traits of American Indians may reflect retention of cold-derived,ancestral features,as well as a response to a slightly warmer climate.Because different craniofacial regions preserve environmental/genetic signatures differentially,caution is suggested when craniofacial anatomy is used for phylogenetic reconstruction and functional-morphological analysis.