Comparison of Different Types of Palatal Expanders: Scoping Review

Maxillary bone contraction is caused by genetics or ambiental factors and is often accompanied by dental crowding, with the possibility of canine inclusion, crossbite, class II and III malocclusion, temporomandibular joint disorder, and obstructive sleep apnea (OSAS). Transverse maxillary deficits, in which the maxillary growth is unusually modest, are frequently treated with maxillary expansion. The purpose of this study is to compare the dental and skeletal effects of different types of expanders, particularly the Leaf Expander, rapid and slow dental-anchored or skeletal-anchored maxillary expanders.

METHODS

We chose studies that compared effects determined by palatal expansion using a rapid palatal expander, expander on palatal screws, and leaf expander.

RESULTS

Reports assessed for eligibility are 26 and the reports excluded were 11. A final number of 15 studies were included in the review for qualitative analysis.

CONCLUSIONS

Clinically and radiographically, the outcomes are similar to those obtained with RME and SME appliances; Therefore, it might be a useful treatment choice as an alternative to RME/SME equipment in cases of poor patient compliance or specific situations. Finally, all of the devices studied produce meaningful skeletal growth of the palate. The use of skeletally anchored devices does, without a doubt, promote larger and more successful growth in adolescent patients.

Review of sensory modalities of sirenians and the other extant Paenungulata clade

Extant members of Paenungulata (sirenians, proboscideans, and hyracoideans) form a monophyletic clade which originated in Africa. While paenungulates are all herbivorous, they differ greatly in size, life history, and habitat. Therefore, we would expect both phylogenetically related similarities and ecologically driven differences in their use and specializations of sensory systems, especially in adaptations in sirenians related to their fully aquatic habitat. Here we review what is known about the sensory modalities of this clade in an attempt to better elucidate their sensory adaptations. Manatees have a higher frequency range for hearing than elephants, who have the best low-frequency hearing range known to mammals, while the hearing range of hyraxes is unknown. All paenungulates have vibrissae assisting in tactile abilities such as feeding and navigating the environment and share relatively small eyes and dichromatic vision. Taste buds are present in varying quantities in all three orders. While the olfactory abilities of manatees and hyraxes are unknown, elephants have an excellent sense of smell which is reflected by having the relatively largest cranial nerve related to olfaction among the three lineages. Manatees have the relatively largest trigeminal nerve-the nerve responsible for, among other things, mystacial vibrissae-while hyraxes have the relatively largest optic nerve (and therefore, presumably, the best vision) among the Paenungulata. All three orders have diverged significantly; however, they still retain some anatomical and physiological adaptations in common with regard to sensory abilities.

Developmental origins and homologies of the hyracoid dentition

Understanding the origins of morphological specializations in mammals is a key goal in evolutionary biology. It can be accomplished by studying dental homology, which is at the core of most evolutionary and developmental studies. Here, we focused on the evolution and development of the specialized dentition of hyraxes for which dental homologies have long been debated, and could have implications on early placental evolution. Specifically, we analysed dental mineralization sequences of the three living genera of hyraxes and 17 fossil species using X-ray computed microtomography. Our results point out the labile position of vestigial upper teeth on jaw bones in extant species, associated with the frequently unusual premolar shape of deciduous canines over 50 Ma of hyracoid evolution. We proposed two evolutionary and developmental hypotheses to explain these original hyracoid dental characteristics. (a) The presence of a vestigial teeth on the maxilla in front of a complex deciduous canine could be interpreted as extra-teeth reminiscent of early placental evolution or sirenians, an order phylogenetically close to hyracoids and showing five premolars. (b) These vestigial teeth could also correspond to third incisors with a position unusually shifted on the maxilla, which could be explained by the dual developmental origin of these most posterior incisors and their degenerated condition. This integrative study allows discussion on the current evolutionary and developmental paradigms associated with the mammalian dentition. It also highlights the importance of nonmodel species to understand dental homologies.

How elephants beat cancer

Elephants have significantly reduced their risk of cancer by duplicating an important gene called TP53.

TP53 copy number expansion is associated with the evolution of increased body size and an enhanced DNA damage response in elephants

A major constraint on the evolution of large body sizes in animals is an increased risk of developing cancer. There is no correlation, however, between body size and cancer risk. This lack of correlation is often referred to as 'Peto's Paradox'. Here, we show that the elephant genome encodes 20 copies of the tumor suppressor gene TP53 and that the increase in TP53 copy number occurred coincident with the evolution of large body sizes, the evolution of extreme sensitivity to genotoxic stress, and a hyperactive TP53 signaling pathway in the elephant (Proboscidean) lineage. Furthermore, we show that several of the TP53 retrogenes (TP53RTGs) are transcribed and likely translated. While TP53RTGs do not appear to directly function as transcription factors, they do contribute to the enhanced sensitivity of elephant cells to DNA damage and the induction of apoptosis by regulating activity of the TP53 signaling pathway. These results suggest that an increase in the copy number of TP53 may have played a direct role in the evolution of very large body sizes and the resolution of Peto's paradox in Proboscideans.

DOI:http://dx.doi.org/10.7554/eLife.11994.001

As time passes, healthy cells are more likely to become cancerous because more and more damaging mutations accumulate in the cell’s DNA. Assuming that all cells have a similar risk of acquiring mutations, larger and longer-lived animals – like elephants – should have a higher risk of cancer than smaller, shorter-lived animals – like mice. However, there does not appear to be any link between the size of an animal and its risk of developing cancer. Consequently, a key question in cancer biology is how very large animals protect themselves against these diseases.

One gene that is often damaged during an animal’s lifetime is called TP53. This gene normally produces a tumor suppressor protein that senses when DNA is damaged or a cell is under stress and either briefly slows the cell’s growth while the damage is repaired or triggers cell death if the stress is overwhelming. One way that large animals could reduce their risk of cancer is to have extra copies of TP53 or other genes that encode tumor suppressor proteins.

Here Sulak et al. used an evolutionary genomics approach to study TP53 in 61 animals of various sizes, including several large animals such as African elephants and Minke whales. All of the animals studied had at least one copy of TP53, and several had a few extra copies, known as TP53 retrogenes. African elephants – the largest living land mammal – had more retrogenes than any of the others with 19 in total. To investigate why African elephants have so many TP53 retrogenes, Sulak et al. also analyzed DNA from Asian elephants and several other closely related, but now extinct species, including the woolly mammoth. As expected, as species evolved larger body sizes they also evolved more TP53 retrogenes.

Further experiments indicate that several of the TP53 retrogenes in African elephants are likely to be able to produce the tumor suppressor protein and that they contribute to elephant cells being better equipped to deal with DNA damage. The next step following on from this work will be to find out exactly how TP53 retrogenes help to protect animals from cancer.

DOI:http://dx.doi.org/10.7554/eLife.11994.002

A RETROSPECTIVE STUDY OF PATHOLOGIC FINDINGS IN CAPTIVE ROCK HYRAX (PROCAVIA CAPENSIS) IN THE UNITED STATES

A retrospective examination of gross and histologic reports was performed to find common lesions in young and adult captive rock hyrax ( Procavia capensis ) from multiple zoo populations. One hundred and thirty-seven reports were analyzed from specimens that were submitted to Northwest ZooPath from 1997 to 2013. Histologic findings from necropsy and biopsy reports and causes of mortality only from necropsy reports were compiled to determine the most common findings. Within the study population, 41 (30%) were male, 62 (45%) were female, and the remainder (34, 25%) were of undetermined sex. Of the 111 necropsies, 87 (78%) died naturally, and 24 (22%) were euthanatized. There were 26 (19%) biopsies with no known status of the animal. The most frequent causes of death or reason for euthanasia were bacterial septicemia (n = 29, 21%) and degenerative cardiomyopathy (n = 29, 21%). The other most prevalent lesions were hemosiderosis (n = 55, 40%), pancreatic islet and interstitial fibrosis (n = 36, 26%), pneumonia of undetermined cause (n = 26, 19%), enteritis/colitis (n = 24, 18%), and renal tubular necrosis (n = 20, 15%). In many animals of this study population (n = 115, 84%), multiple lesions affecting multiple organs were found.

Use of anterior maxillary distraction osteogenesis in two cleft lip and palate patients

Distraction osteogenesis (DO) has become a mainstream surgical technique for patients with jaw deformities. The aim of this study was to report the effect of DO done by a hyrax screw incorporated in an acrylic plate in the treatment of two maxillary deficient cases with cleft lip and palate. Two patients, a 24-year-old female and a 29-year-old male who suffered from maxillary deficiency and cleft lip and palate, were treated by DO. After making vertical cuts between the premolars on both sides and horizontal cuts similar to Le Fort 1, a hyrax screw was mounted on an acrylic plate for the slow anteroposterior expansion of maxillary arch. The expansion was achieved by turning the hyrax screw 0.8 mm per day after the latency period. Treatment was discontinued after achieving satisfactory over jet and occlusion. This study showed that anterior maxillary distraction is a reliable technique for correction of midfacial deformity arising out of cleft lip and palate. Incidences of complications are negligible compared to total maxillary distraction.

Reverse activated hyrax pressure appliance for treatment of a keloid located at auricula helix

Keloids are considered aberrations of the wound healing process, and various treatment regimens are described depending on the morphology and size of the lesion. Compression therapy using custom-made pressure clips or splints is widely used for the treatment of keloids. The most common complication of this therapy is ulceration due to excessive soft tissue pressure, resulting in delays and prolonged treatment time. This article describes the fabrication of a custom-made pressure appliance for the treatment of a keloid located at the auricle helix. The pressure appliance can be modified to fit the auricle helix and covers the area needing pressure.