A patient with skeletal Class Ⅲ malocclusion was treated in 2 phases during the early permanent dentition. In phase 1, maxillary protraction was combined with rapid palatal expansion; in phase 2, fixed appliances were placed. The results were good posttreatment, and, 1 year later, a favorable growth tendency could be observed. This report shows that treatment for a patient with skeletal Class Ⅲ malocclusion can be started in the early permanent dentition, with very good final results.

Environmental improvements can lead to greater size of skeletodental structures as the population comes closer to expressing its genetic growth potential. Such secular trends have been documented in many human settings, especially for increased stature and faster tempos of growth. The present study is based on 185 same-sex parent-offspring pairs of data for maximum buccolingual crown diameters of the permanent teeth from a cohort in Beijing, China, where parents experienced much of their development during and after World War Ⅱ with the deprivations of the changing regime. Their offspring enjoyed the relative stability of the established Communist system, where nutrition and stability were much improved. There were significant increases in buccolingual diameters of the premolars and molars in the offspring. Increase for premolars and molars was about 1%, but larger in females than males (1.6% vs. 0.5%). Opposite changes occurred in the incisors and canines (i.e., larger parental dimensions), but we contend that these are an age-related artifact brought on by greater passive eruption of older individuals' teeth that exposes a broader portion of the crown at the gingival margin. The secular trend in crown size coincides with other research in contemporary China, disclosing increases in body size and faster tempos of growth as health and nutrition continue to improve.

We have previously demonstrated that all-trans retinoic (atRA) induced growth inhibition and apoptosis in mouse embryonic palate mesenchymal cells (MEPM). In the present study, we investigated the molecular mechanisms of atRA-induced apoptosis and its putative action pathway. atRA-induced apoptosis is associated with activation of the initiator caspase-9 and the effector caspase-3, but not of the effector caspase-8. A broad caspase inhibitor (z-VAD-fmk), caspase-9 inhibitor z-LEHD-fmk and caspase-3 inhibitor (z-DEVD-fmk) blocked atRA-induced DNA fragmentation and sub-G1 fraction, but not caspase-8 inhibitor z-IETD-fmk. We further showed that atRA dosedependently promoted mRNA expression of retinoic acid receptor b (RAR-b) and g. A weaker increase in RAR-a mRNA was seen only at the highest concentration of atRA (5mM). The pan RAR antagonist, BMS493, completely abrogated atRA-induced DNA fragmentation, Sub-G1 fraction, and caspase-3 activation. Taken together, these findings show that caspase-mediated induction of apoptosis by atRA is an RAR-dependent signaling pathway.

In the Begg Technique, factors controlling the anterior intrusive force provided by the archwire have yet to be fully clarified. The rationale for bite opening with very light forces, the effect of Class H elastics on intrusive force magnitude and the intrinsic quality of 'Australian' wire in bite opening are examined in this paper. A formula is presented which allows the intrusive force that archwires exert in different individuals to be predicted. The values derived from the formula were compared with case model measurements. It was found that the intrusive force of the archwire was affected by the length of the individual dental arch. The magnitude of this intrusive force was seen to increase gradually during the period of bite opening and appeared to be related to the use of Class H elastics. The study revealed factors which affected the magnitude of the intrusive force.

Summary. In this retrospective cephalometric study, the lateral skull radiographs of 12 children with Class III malocclusions of skeletal origin were examined. An analysis ofthe changes produced during treatment revealed that whilst changes in apical base relationship were small, and were mainly limited to a reduction in angle SNB, the effects on the soft tissue profile were surprisingly effective.

SUMMARY Class Ⅱ elastics are usually employed in the treatment of excessive overbite and overjet with the Begg technique. The effect of Class Ⅱ elastics on bite opening and the extent of such an effect is uncertain. This article, based on measurements of 30 cases, illustrates that the effect of the vertical component of force from Class Ⅱ elastics in reducing the intrusive force generated by the anchor bands in the upper archwire is less than previously believed. The position of the circles in the archwire for intermaxillary elastics has the greatest influence on theanterior intrusive force of the upper archwire. The direction of the Class Ⅱ elastics and the lengthof the dental arch (a negative correlation) came second, while the force actually exerted by theelastics had the smallest influence. It is, therefore, suggested that the position of the intermaxillary elastic circles should be located according to the differing clinical objectives.

The purpose of the study was to analyze the effects of nonsurgical treatment on subjects with a severe skeletal Class Ⅲ deformity and to directly evaluate dental and facial profile changes. Eighteen patients with severe skeletal Class III malocclusions (5 males, 13 females), diagnosed as indication for orthognathic surgery, were included in the study. The average age was 13.7±2.5 years. All the cases were treated with Tip-Edge straight-wire technique or Begg light wire technique. Lateral cephalometric films taken at the beginning and at the end of treatment were analyzed with the Pancherz analysis and traditional cephalometric analysis. The arithmetic mean and standard deviation were calculated for each variable and paired t-test was performed. A mean reduction of 6.5mm in the overjet was noted (P<.001), with skeletal changes and dental changes contributing 20% and 80% to the overjet correction, respectively. The inclination of the upper incisors to the SN plane was increased 5.98 (P<.01). The inclination of the lower incisors to the mandibular plane was decreased 6.68 (P<.001). The difference between the distance of the upper lip and lower lip to Sn-Pg9 at the beginning of treatment changed from a negative value to a positive value with a significant difference (P<.001). Successful treatment effects can be obtained with nonsurgical therapy in severe skeletal Class Ⅲ malocclusions in the permanent dentition. A remarkable soft tissue change was noted after the treatment, and the concave facial profile changed to a straight profile (see two case reports).

all-trans retinoic acid (atRA), the oxidative metabolite of vitamin A, is essential for normal embryonic development. Also, high levels of atRA are teratogenic in many species and can effectively induce cleft palate in the mouse. Most cleft palate resulted from the failed fusion of secondary palate shelves, and maintenance of the normal cell proliferation is important in this process of shelf growth. Toclarify the mechanism by which atRA causes cleft palate, we investigated the effect of atRA on proliferation activity and cell cycle distribution in mouse embryonic palatal mesenchymal (MEPM) cells. atRAinhibited the growth of MEPM cells by inducing apoptosis in a dose-dependent manner. atRA also caused aG1 block in the cell cycle with an increase in the proportion of cells in G0/G1 and a decrease in the proportion of cells in S phase, as determined by flow cytometry. We next investigated the effects of atRA on molecules that regulate the G1 to S phase transition. These studies demonstrated that atRA inhibited expression of cyclins D and Eat the protein level. Furthermore, atRA treatment reduced phosphorylated Rb and decreased cdk2 and cdk4 kinase activity. These data suggest that atRA had antiproliferative activity by modulating G1/S cell cycle regulators and by inhibition of Rbphosphorylation in MEPM cells, which might account for the pathogenesis of cleft palate induced by retinoic acid.

To evaluate the characteristics of masticatory muscle activity in operated unilateral cleft lip and palate (UCLP) patients with anterior crossbite compared with normal individuals. Subjects: Sixteen male and 13 female Chinese patients with UCLP and an-terior crossbite. Fifteen male and 13 female Chinese individuals without cleft abnormalities served as a control group. Design: Electromyographic activity of the masseter muscles and anterior temporalis muscles was recorded bilaterally in different mandibular positions using bipolar surface electrodes. Results: Compared to noncleft controls, patients with UCLP demonstrated (1) higher activation levels of masseter and temporalis muscles in the rest position, (2) lower potential function of masseter and temporalis, (3) inharmonious activity of the masticatory muscles during mandibular border movement, (4) a higher asymmetry index of the masseter and temporalis muscles, and (5) longer silent periods of the two muscles. Conclusions: The function of masticatory muscles is different in patients with UCLP with anterior crossbite. Muscle function should be considered when evaluating cleft patients for orthodontic treatment and orthognathic surgery.

The purpose of the study was to use euclidean distance matrix analysis to compare dental arch forms between subjects with Class Ⅱ Division 1 malocclusions and normal occlusions. Methods: The sample consisted of 60 subjects with Class Ⅱ Division 1 malocclusions and 60 subjects with normal occlusions, all between 13 and 17 years of age. Fourteen landmarks, corresponding to cusp tips and incisor edges, were identified on the dental casts with a 3-dimensional measuring machine. All possible linear distances between pairs of landmarks in an arch were computed, and arch-form differences between Class Ⅱ Division 1 and normal-occlusion subjects were tested by euclidean distance matrix analysis. Results: In both sexes, the maxillary arches of the Class II Division 1 subjects were larger than the arches of the normal-occlusion subjects (1.8% and 2.7% larger for girls and boys, respectively), and arch shape was also significantly different (P<001). The posterior teeth contributed to the shape difference between 2 groups more than the anterior teeth, moreover the main factor was narrow maxillary posterior arch width in the Class Ⅱ Division 1 subjects. The mandibular arches of the Class Ⅱ Division 1 subjects were also slightly larger, and arch shape was not significantly different regardless of sex. Conclusions: Expanding the maxillary posterior arch width in Class Ⅱ Division 1 subjects might be an important method to harmonize maxillary and mandibular arch forms.