Orofacial dysfunction screening examinations in children with sleep-disordered breathing symptoms

Orofacial myofunctional disorders (OMD) and sleep-disordered breathing (SDB) may present as comorbidities. Orofacial characteristics might serve as a clinical marker of SDB, allowing early identification and management of OMD and improving treatment outcomes for sleep disorders. The study aims to characterize OMD in children with SDB symptoms and to investigate possible relationships between the presence of various components of OMD and symptoms of SDB. A cross-sectional study of healthy children aged 6-8 from primary schools was conducted in central Vietnam in 2019. SDB symptoms were collected using the parental Pediatric Sleep Questionnaire, Snoring Severity Scale, Epworth Daytime Sleepiness Scale, and lip-taping nasal breathing assessment. Orofacial myofunctional evaluation included assessment of tongue mobility, as well as of lip and tongue strength using the Iowa Oral Performance Instrument, and of orofacial characteristics by the protocol of Orofacial Myofunctional Evaluation with Scores. Statistical analysis was used to investigate the relationship between OMD components and SDB symptoms. 487 healthy children were evaluated, of whom 46.2% were female. There were 7.6% of children at high risk of SDB. Children with habitual snoring (10.3%) had an increased incidence of restricted tongue mobility and decreased lip and tongue strength. Abnormal breathing patterns (22.4%) demonstrated lower posterior tongue mobility and lower muscle strength. Daytime sleepiness symptoms were associated with changes in muscle strength, facial appearance, and impaired orofacial function. Lower strengths of lip and tongue or improper nasal breathing were more likely to be present in children with reported sleep apnea (6.6%). Neurobehavioral symptoms of inattention and hyperactivity were linked to anomalous appearance/posture, increases in tongue mobility and oral strength. This study demonstrates a prevalence of orofacial myofunctional anomalies in children exhibiting SDB symptoms. Children with prominent SDB symptoms should be considered as candidates for further orofacial myofunctional assessment.

Pilot study: Correlation between nasalance scores and cephalometric parameters in Estonian cleft palate children

BACKGROUND AND OBJECTIVE

According to Klassen et al. (2012), the overall quality of life of CL/P children is most affected by appearance and quality of speech, as these differences are most noticeable to others. To what extent changes in craniofacial growth have an impact on speech quality has yet to be clarified. Therefore, we aimed to determine which cephalometric parameters differed between healthy and cleft palate groups.

MATERIAL AND METHODS

17 healthy and 11 children born with CL/P were included. We conducted a cross-sectional and comparative study. A combination of objective and subjective assessment methods was performed: nasalance scores were calculated, and lateral cephalograms were evaluated by indirect digitization using Dolphin Imaging Software.

RESULTS

The analysis showed differences in the length of the hard (PNS-A) and soft palate (PNS-P), and in the width of the lower oropharyngeal airway (AW5-AW6). The mean length of the hard palate was 3.7 mm and the soft palate 3.0 mm shorter in the CL/P group compared to the healthy group. Hypernasal resonance was related to (1) the length of the hard palate, (2) the distance between the hyoid bone from the third cervical vertebra, and (3) the angle formed by the NA line and the NB line (ANB). Only 11 CL/P children met the inclusion criteria. Thus, the results may have been affected by the small sample size. The Control group consisted of children who visited ENT doctors or orthodontists.

CONCLUSION

The results showed differences in cephalometric parameters in the two groups. Still, we continue to collect data and plan to conduct the analysis on larger and more homogenous sample size.

The impact of occlusal support on temporomandibular disorders: a literature review

Temporomandibular disorders are a multifactorial disease. Occlusal support and the number of teeth in dentition have significant effects on the masticatory system. The current study aims to review the role of occlusal support in association with findings of temporomandibular disorders. Data sources were PubMed, Web of Science and Google Scholar, with 1411 citations published over the period 1992–2019. The selection criteria stipulated that articles must have reported the association between the number of teeth, occlusal unit, occlusal support and temporomandibular disorders. A total of 15 full-text articles was finally accessed for eligibility in the current review. The studies on temporomandibular disorders were collected from various sources, including articles reporting temporomandibular disorder symptoms ( n=1), temporomandibular disorder signs ( n=5), temporomandibular joint osseous changes ( n=1), temporomandibular joint dysfunction using the Helkimo index ( n=2), and temporomandibular disorder classification ( n=6). Of these articles, significant associations were found between: the number of missing teeth and temporomandibular disorders ( n=5); the number of occlusal units and occlusal supports and temporomandibular disorders ( n=3); the position of the lost occlusal units and temporomandibular disorders ( n=1). Loss of the occlusal unit has more impact on temporomandibular disorders than the loss of posterior teeth. The total loss of unilateral occlusal support seems to be an aetiological factor for temporomandibular disorders, and maintenance of balanced posterior occlusal support has a role in the prevention and management of temporomandibular disorders.

Association analysis of juvenile idiopathic arthritis genetic susceptibility factors in Estonian patients

Background

Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic condition of childhood. Genetic association studies have revealed several JIA susceptibility loci with the strongest effect size observed in the human leukocyte antigen (HLA) region. Genome-wide association studies have augmented the number of JIA-associated loci, particularly for non-HLA genes. The aim of this study was to identify new associations at non-HLA loci predisposing to the risk of JIA development in Estonian patients.

Methods

We performed genome-wide association analyses in an entire JIA case–control sample (All-JIA) and in a case–control sample for oligoarticular JIA, the most prevalent JIA subtype. The entire cohort was genotyped using the Illumina HumanOmniExpress BeadChip arrays. After imputation, 16,583,468 variants were analyzed in 263 cases and 6956 controls.

Results

We demonstrated nominal evidence of association for 12 novel non-HLA loci not previously implicated in JIA predisposition. We replicated known JIA associations in CLEC16A and VCTN1 regions in the oligoarticular JIA sample. The strongest associations in the All-JIA analysis were identified at PRKG1 (P = 2,54 × 10⁻⁶), LTBP1 (P = 9,45 × 10⁻⁶), and ELMO1 (P = 1,05 × 10⁻⁵). In the oligoarticular JIA analysis, the strongest associations were identified at NFIA (P = 5,05 × 10⁻⁶), LTBP1 (P = 9,95 × 10⁻⁶), MX1 (P = 1,65 × 10⁻⁵), and CD200R1 (P = 2,59 × 10⁻⁵).

Conclusion

This study increases the number of known JIA risk loci and provides additional evidence for the existence of overlapping genetic risk loci between JIA and other autoimmune diseases, particularly rheumatoid arthritis. The reported loci are involved in molecular pathways of immunological relevance and likely represent genomic regions that confer susceptibility to JIA in Estonian patients.

Key Points • Juvenile idiopathic arthritis (JIA) is the most common childhood rheumatic disease with heterogeneous presentation and genetic predisposition. • Present genome-wide association study for Estonian JIA patients is first of its kind in Northern and Northeastern Europe. • The results of the present study increase the knowledge about JIA risk loci replicating some previously described associations, so adding weight to their relevance and describing novel loci. • The study provides additional evidence for the existence of overlapping genetic risk loci between JIA and other autoimmune diseases, particularly rheumatoid arthritis.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10067-021-05756-x.

The effect of velopharyngeal insufficiency on voice quality in Estonian Children with Cleft Palate

Most children born with cleft palate (CP) or cleft lip and palate (CL/P) have velopharyngeal insufficiency (VPI), some degree of hypernasal resonance, articulation disorders and laryngeal dysphonia. Combination of different CL/P specific problems may mask laryngeal dysphonia and therefore, it may remain undiagnosed and untreated by clinicians. The research aimed to study the effect of VPI on voice quality in Estonian CL/P children. We included 18 CL/P and 79 healthy children. Combination of objective (Multi-Dimensional Voice Program (MDVP)) and subjective (Pediatric Voice Handicap Index (pVHI), GRBAS scale, video-nasoendoscopy (VNE), video-laryngostroboscopy (VLS)) assessment methods were assisted and performed by our multidisciplinary cleft teams. We found that (1) overall quality of life is greatly affected by voice, resonance and articulation disorders in CL/P group, (2) more than half of the CL/P children had morphological changes of the vocal folds, (3) the severity of VPI did not result in worse outcomes of acoustic parameters of voice.

Nasalance scores for Vietnamese-speaking children with oral clefts

OBJECTIVE

The study aimed to obtain nasalance scores for Vietnamese-speaking patients with repaired cleft palate with or without cleft lip.

METHODS

A total of 29 children with cleft palate with or without cleft lip (4-18 years old, mean age 7.9±3.5 years old) were included in this study. Speech material was designed specifically for the Vietnamese language. The speech material consisted of oral stimuli (19 oral words and 18 oral sentences), oro-nasal stimuli (eight sentences), and nasal stimuli (seven sentences). The patients repeated the stimuli after the examiner. The Nasometer II (model 6450) was used to compute nasalance scores.

RESULTS

The mean nasalance scores were 27.1% for oral stimuli, 40.2% for oro-nasal stimuli, and 57.5% for nasal stimuli. Hypernasality was detected in 41.4% of the patients.

CONCLUSION

Vietnamese-speaking patients with repaired cleft palate with or without cleft lip who did not undergo speech therapy had poor speech outcomes.

Oral Health Status of Patients with Repaired Cleft Lip and Palate in Central Vietnam

PURPOSE

To determine the oral hygiene habits, levels of dental caries, and periodontal condition of patients with repaired cleft lip and/or palate (CL/P) in Central Vietnam.

MATERIALS AND METHODS

A total of 78 patients (1-54 years old; median: 6 years) with CL/P were examined for dental caries, gingivitis and periodontitis using the decayed, missing, and filled teeth (dmft/DMFT) index, gingival bleeding on probing and periodontal pocket depth. Data about dental visits, brushing habits and socioeconomic status were collected.

RESULTS

A majority of patients brushed their teeth at least once a day with fluoride dentifrice but did not floss. The caries prevalence was 87.2%. The dmft of patients aged ≤ 5 years and 6-12 years were 7.4 and 9.0. The DMFT of patients aged 6-12 years, and ≥ 13 years were 1.6, and 6.7; the difference was statistically significant (p < 0.05). The percentages of patients who had bleeding on probing and had periodontal pocket depth 3.5-5.5 mm were 57.7% and 5.3%, respectively.

CONCLUSIONS

Patients with repaired CL/P in Central Vietnam had a very high level of caries and had signs of gingivitis but not periodontitis. It is recommended to implement dental care in the treatment protocol for patients with CL/P.

Association of Temporomandibular Joint Osseous Changes with Anxiety, Depression, and Limitation of Mandibular Function in Elderly Vietnamese

OBJECTIVES

This study aimed (1) to determine the prevalence of anxiety, depression, and TMJ osseous changes in elderly Vietnamese according to sex and residence, and (2) to investigate the association of temporomandibular joint (TMJ) osseous changes with anxiety, depression, and limitation of mandibular function.

METHODS

Elderly people living in Danang, Vietnam were recruited. Participants were screened for anxiety and depression using the self-reported 7-item Generalized Anxiety Disorder Scale (GAD-7) and 9-item Patient Health Questionnaire (PHQ-9), respectively. Participants then self-rated the limitation of their mandibular function using the 20-item Jaw Functional Limitation Scale (JFLS-20) questionnaire. TMJ osseous changes (erosion, flattening, osteophytes, and sclerosis) were evaluated using digital orthopantomography.

RESULTS

Of 179 participants aged 65 to 74 years, 17.9% and 35.8% had anxiety and depression symptoms, respectively. Compared with urban residents, rural residents had higher prevalence of anxiety (23.3% vs 12.4%, p = 0.009) and depression (46.62% vs 24.7%, p = 0.019). The prevalence of TMJ osseous changes was 58.1%. The most common TMJ osseous change was flattening (41.3%), followed by erosion (34.6%), sclerosis (16.2%), and osteophytes (7.8%). Participants with or without TMJ osseous changes were comparable in terms of GAD-7 score, PHQ-9 score, and JFLS-20 score and sub-scores.

CONCLUSIONS

Anxiety and depression and TMJ osseous changes were prevalent in elderly Vietnamese. Rural residents had higher prevalence of anxiety and depression than urban residents. TMJ osseous changes were not associated with anxiety, depression, or limitation of mandibular function.

Application of a new patient-reported outcome measure in orofacial clefts: An exploratory study in two countries

Patients with repaired cleft lip and/or palate may vary in satisfaction with their treatment. The exploratory study investigated the satisfaction of patients with orofacial clefts, and their parents with cleft treatment outcomes using the Cleft Hearing, Appearance and Speech Questionnaire (CHASQ). The study included 29 Vietnamese and 27 Estonian patients aged ≥ 7 years with repaired cleft lip and/or palate. The CHASQ was translated into Vietnamese and Estonian. The questionnaire was completed independently by patients and their parents. There were nine items in the CHASQ associated with the cleft (Factor 1) and six items less associated with the cleft (Factor 2). Significant moderate positive correlations were related to Factor 1. Vietnamese patients self-rated lower than Estonian patients in most of the items except speech. The agreement between patients and parents varied from low to moderate positive correlations in the features associated with the cleft, and mainly in the Vietnam sample. Vietnamese patients were less satisfied than Estonian patients. CHASQ is an easy tool to evaluate patients' satisfaction with hearing, appearance, and speech.

Temporomandibular Disorder Signs, Occlusal Support, and Craniofacial Structure Changes Among the Elderly Vietnamese

Objective

The aim of study was to determine the association between signs of temporomandibular disorders (TMD), occlusal support, and alterations in the craniofacial structure of elderly Vietnamese by using cephalometric analysis.

Methods

The cross-sectional study consisted of 244 participants aged 65-74 years. Participants were examined for signs of TMD, including limited mouth opening, temporomandibular joint (TMJ) crepitus, TMJ tenderness, and muscle tenderness. Dentition was divided into four occlusal support zones based on occluding pairs of posterior teeth by using Eichner's classification: Class A = 4 support zones; Class B = 1-3 support zones or only contact in anterior teeth; Class C = 0 support zones. Fifteen angular and seven linear parameters were used for sagittal craniofacial skeleton analysis.

Results

10.3% of participants had limited mouth opening, 49.6% TMJ crepitus, 16.3% TMJ tenderness, and 24.2% muscle tenderness; 45.5% had Class A occlusal support, 38.5% Class B, and 16.0% Class C. Those with Class C had significantly smaller ramus inclination, articular angle, and angles formed by the mandibular plane and shorter facial height compared to Class A and Class B (P < .001). TMD signs were significantly associated with: angles formed by mandibular plane, gonial angle, cranial base angle, effective mandibular length, and anterior facial height (P < .05).

Conclusions

The alteration of craniofacial structures was significantly associated with TMD signs among elderly Vietnamese. The higher number of lost occlusal support zones, the more significant the changes to craniofacial structures.

Normative nasalance scores for Estonian children

Normative nasalance scores are essential for the treatment and assessment purposes for clinicians. Till date, no studies have been done on nasalance in Estonia. This research was conducted to develop Estonia-specific optimized speech stimuli for Nasometer II and establish the normative nasalance scores. Ninety-two randomly selected healthy and 14 cleft palate Estonian monolingual children, aged four to seven years, were included as participants. Estonian language-specific test material was developed. The Estonian test material consisted of 24 speech stimuli. Based on the phoneme content, the stimuli were divided into three groups: (1) sentences that included oral and nasal phonemes and targeted the same phoneme distribution as in spontaneous speech, (2) sentences that included only oral phonemes and (3) sentences that were loaded with nasal phonemes. Nasometer II software was used to calculate the nasalance scores for each child and each sentence. Results indicated that there were significant differences in nasalance scores for oronasal and oral stimuli scores, and no significant differences were found in nasal stimuli scores between the study and control group. The threshold for oronasal stimuli was 42.1-18.9, oral stimuli was 27.9-3.9 and nasal stimuli was 69.4-46.2. In conclusion, Estonia-specific optimized speech stimuli were developed and normative nasalance scores were established. These normative scores can be used for the diagnosis and follow-up treatment of patients with resonance disorders, especially for patients with cleft palate.

Nasolabial aesthetics of patients with repaired unilateral cleft lip and palate: A comparison of three rating methods in two countries

OBJECTIVES

The study aimed to compare nasolabial aesthetics of patients with unilateral cleft lip and palate (UCLP) treated in Vietnam and Estonia using three rating methods: five-point aesthetic index, a visual analogue scale (VAS), and reference scores method.

METHODS

A total of 56 patients with repaired UCLP (23 from Vietnam and 33 from Estonia) were included in this cross-sectional study. Patients' facial and profile photographs were cropped to reveal the nasolabial region and coded. Five examiners rated nasolabial aesthetics of the patients using three methods: five-point aesthetic index, 100 mm VAS, and reference scores method. Intraclass correlation coefficients were used to evaluate intrarater and interrater reliabilities.

RESULTS

The five-point aesthetic index had a higher reliability than VAS and reference scores method. The least aesthetic feature among Vietnamese and Estonian patients was nasal symmetry and nasolabial profile respectively. No differences in nasolabial aesthetics were found between Vietnamese and Estonian patients regardless of the rating methods (p > 0.05) except for nasal symmetry.

CONCLUSIONS

The five-point aesthetic index seems to produce more reproducible results. There were no significant differences in nasolabial aesthetics between the two countries. Overall average nasolabial appearance results were obtained using different treatment protocols in the two countries.

Oral Health Behaviour and Oral Health Status of Elderly Vietnamese

PURPOSE

To describe oral health behaviours and problems among elderly Vietnamese as well as determine their prevalence of caries and periodontal disease.

MATERIALS AND METHODS

This cross-sectional study examined 258 elderly persons aged 65-74 years living in Danang, Vietnam. All subjects self-reported oral health behaviour and problems. Dental caries was assessed using the DMFT index. Periodontal status was evaluated with the modified Community Periodontal Index, whereby all teeth were examined for gingival bleeding and periodontal pocket depth (PPD), and the index teeth were assessed for clinical attachment loss (CAL).

RESULTS

48.4% of the elderly brushed their teeth at least twice a day; 34% had never visited a dentist; 27.8% often had difficulty chewing foods. Of the sample, mean DMFT was 14.3 ± 8.7 (DT = 6.4 ± 5.5, MT = 7.7 ± 7.1, and FT = 0.2 ± 0.9), 88.8% had untreated caries, 21.0% had at least one tooth with a PPD ≥ 6 mm, and 49.8% had at least one sextant with CAL ≥ 6 mm. The mean number of teeth per person was 22.0, of which 19.5 teeth (88.6%) had gingival bleeding, 7.7 teeth (37.1%) with a PPD 4-5 mm, and 0.8 teeth (5.0%) with a PPD ≥ 6 mm. The mean number of sextants with CAL 4-5 mm and CAL ≥ 6 mm were 2.5 ± 2.0 and 1.3 ± 1.7, respectively. Rural residence was found to be negatively associated with MT, FT, and healthy periodontal status (p < 0.05).

CONCLUSIONS

Dental diseases are prevalent among elderly Vietnamese owing to a lack of awareness of oral health self-care behaviours, especially among those living in rural areas. This suggests that an oral health care programme is required to improve the oral health status of elderly Vietnamese.

Occlusal Support and Temporomandibular Disorders Among Elderly Vietnamese

PURPOSE

The aim of this study was to analyze the associations between missing teeth, occlusal support, and temporomandibular disorders (TMD) among elderly Vietnamese.

MATERIALS AND METHODS

The study consisted of 145 TMD and 112 non-TMD (control group) participants aged 65 to 74 years. TMD was evaluated using Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I. An occlusal unit (OU) was defined as the cusp of a tooth coupled with the fossa of its antagonist tooth. A premolar pair was counted as one OU and a molar pair as two OUs. Dentition was divided into four occlusal support zones (OSZs) based on occluding pairs of posterior teeth by using Eichner classification: Class A had 4 OSZs, Class B had 1 to 3 OSZs or only anterior teeth, and Class C had no OSZ.

RESULTS

The TMD group lost significantly more posterior teeth (mean ± SD 5.1 ± 4.7) than the control group (4.0 ± 3.9, P = .033). The mean ± SD OUs of the TMD and control groups were 5.1 ± 4.6 and 6.0 ± 4.3, respectively, which was nonsignificant (NS). The distribution of Class A (40.7%), Class B (40.0%), and Class C (19.3%) among the TMD group was not significantly different from the control group (50.0%, 38.4%, and 11.6%, respectively, NS). The odds of having TMD were positively associated with total unilateral loss of OUs (OR = 3.4, 95% CI = 1.2-9.4, P = .020) and total bilateral loss of OUs (OR = 2.7, 95% CI = 1.2-6.6, P = .027).

CONCLUSION

Total loss of OSZs on one or both sides of the mouth were found to be predictors of TMD among elderly Vietnamese.

Symptoms and signs of temporomandibular disorders among elderly Vietnamese

Background:

To assess the prevalence of the symptoms and signs of temporomandibular disorders (TMDs) and determine the prevalence of TMDs among elderly Vietnamese aged 65–74 years old.

Methods:

A cross-sectional study was conducted among 258 participants aged 65–74 years old (128 females and 130 males) using two strategies for TMD diagnosis: a clinical examination of the temporomandibular joint and its associated structures using the Diagnostic Criteria for Temporomandibular Disorders Axis I; and a set of 14 questions regarding TMD symptoms to obtain anamnestic data.

Results:

The prevalence of TMD symptoms was: headache 49.6%; temporomandibular joint noise 28.0%; orofacial pain 25.2%; jaw locking 3.1%; 62.5% of participants had at least one TMD symptom. Headaches were more prevalent in females than males ( p=0.009) and rural than urban residents ( p<0.001). The most frequent signs were temporomandibular joint crepitus (50.4%), clicking (48.1%) and mouth-opening deviation (37.6%). Temporomandibular joint crepitus and mouth-opening deviation were more frequent among rural than urban ( p=0.024 and p<0.001, respectively). TMD was found in 56.6% of the total sample. Of the TMD sufferers, 37.6% were diagnosed with disc displacement, 34.9% with degenerative joint disease, 3.5% with myalgia and 1.2% with arthralgia.

Conclusions:

More than half of elderly Vietnamese have at least one TMD symptom. TMD sounds were the most common clinical sign of TMD. There were no differences between the genders or place of residence and TMD diagnosis. Disc displacement and degenerative joint disease were most prevalent among elderly Vietnamese.

Occlusal features and need for orthodontic treatment in persons with osteogenesis imperfecta

The aim of the study was to (a) analyse dental occlusion and determine the need for orthodontic treatment of persons with osteogenesis imperfecta (OI) in comparison with the healthy population and (b) investigate the associations between OI and malocclusion. A case-control study included 26 OI persons and 400 healthy participants (control group). Occlusal features and the need for orthodontic treatment were defined according to Dental Health Component-Index of Orthodontic Treatment Need and Dental Aesthetic Index. Results showed that Angle Class I, II, and III relationship was found in 23.1%, 3.8%, and 73.1% of OI group, and in the control group, it was 67%, 17.5%, and 15.5%, respectively. OI group had significantly higher prevalence of reverse overjet >1 mm (76.9%), missing teeth (42.3%), posterior crossbite (34.6%), and open bite >2 mm (19.2%) compared to the control group (8.5%, 2.2%, 6.2%, and 3.5%, respectively). OI group had less incisal segment crowding and more incisal segment spacing than the control group (p < 0.05). The need for orthodontic treatment of OI group according to Dental Health Component-Index of Orthodontic Treatment Need and Dental Aesthetic Index was 88.5% and 61.5%, respectively, while in the control group, it was 24.8% and 51.8%. The malocclusion in OI persons was associated with reverse overjet > 1 mm (OR = 13.3, 95% CI = 3.9-44.7, p < .001), Angle Class III malocclusion (OR = 8.0, 95% CI = 2.0-30.8, p = .003), and missing teeth (OR = 4.7, 95% CI = 1.0-22.4, p = .049). In conclusion, there is the high probability of malocclusion in OI persons. Persons with OI require early orthodontic treatment because of significant correlation of OI disease with Angle Class III malocclusion, reverse overjet, and missing teeth.

EPMA-World Congress 2015

A1 Predictive and prognostic biomarker panel for targeted application of radioembolisation improving individual outcomes in hepatocellular carcinoma

Jella-Andrea Abraham, Olga Golubnitschaja

A2 Integrated market access approach amplifying value of “Rx-CDx”

Ildar Akhmetov

A3 Disaster response: an opportunity to improve global healthcare

Russell J. Andrews, Leonidas Quintana

A4 USA PPPM: proscriptive, profligate, profiteering medicine-good for 1 % wealthy, not for 99 % unhealthy

Russell J. Andrews

A5 The role of IDO in a murine model of gingivitis: predictive and therapeutic potentials

Babak Baban, Jun Yao Liu, Xu Qin, Tailing Wang, Mahmood S. Mozaffari

A6 Specific diets for personalised treatment of diabetes type 2

Viktoriia V. Bati, Tamara V. Meleshko, Olga B. Levchuk, Nadiya V. Boyko

A7 Towards personalized physiotherapeutic approach

Joanna Bauer, Ewa Boerner, Halina Podbielska

A8 Cells, animal, SHIME and in silico models for detection and verification of specific biomarkers of non-communicable chronic diseases

Alojz Bomba, Viktor O. Petrov, Volodymyr G. Drobnych, Rostyslav V. Bubnov, Oksana M. Bykova, Nadiya V. Boyko

A9 INTERACT-chronic care model: Self-treatment by patients with decision support e-Health solution

Hans-Peter Brunner-La Rocca, Lutz Fleischhacker, Olga Golubnitschaja, Frank Heemskerk, Thomas Helms, Tiny Jaarsma, Judita Kinkorova, Jan Ramaekers, Peter Ruff, Ivana Schnur, Emilio Vanoli, Jose Verdu

A10 PPPM in cardiovascular medicine in 2015

Hans-Peter Brunner-La Rocca

A11 Magnetic resonance imaging of nanoparticles in mice, potential for theranostic and contrast media development – pilot results

Rostyslav V. Bubnov, Sergiy A. Grabovetskyi, Olena M. Mykhalchenko, Natalia O. Tymoshok, Oleksandr B. Shcherbakov, Igor P. Semeniv, Mykola Y. Spivak

A12 Ultrasound diagnosis for diabetic neuropathy - comparative study

Rostyslav V. Bubnov, Tetyana V. Ostapenko

A13 Ultrasound for stratification patients with diabetic foot ulcers for prevention and personalized treatment - pilot results

Rostyslav V. Bubnov, Nazarii M. Kobyliak, Nadiya M. Zholobak, Mykola Ya. Spivak

A14 Project ImaGenX – designing and executing a questionnaire on environment and lifestyle risk of breast cancer

John Paul Cauchi

A15 Genomics – a new structural brand of predictive, preventive and personalized medicine or the new driver as well?

Dmitrii Cherepakhin, Marina Bakay, Artem Borovikov, Sergey Suchkov

A16 Survey of questionnaires for evaluation of the quality of life in various medical fields

Barbara Cieślik, Agnieszka Migasiewicz, Maria-Luiza Podbielska, Markus Pelleter, Agnieszka Giemza, Halina Podbielska

A17 Personalized molecular treatment for muscular dystrophies

Sebahattin Cirak

A18 Secondary mutations in circulating tumour DNA for acquired drug resistance in patients with advanced ALK + NSCLC

Marzia Del Re, Paola Bordi, Valentina Citi, Marta Palombi, Carmine Pinto, Marcello Tiseo, Romano Danesi

A19 Recombinant species-specific FcεRI alpha proteins for diagnosis of IgE-mediated allergies in dogs, cats and horses

Lukas Einhorn, Judit Fazekas, Martina Muhr, Alexandra Schoos, Lucia Panakova, Ina Herrmann, Krisztina Manzano-Szalai, Kumiko Oida, Edda Fiebiger, Josef Singer, Erika Jensen-Jarolim

A20 Global methodology for developmental neurotoxicity testing in humans and animals early and chronically exposed to chemical contaminants

Arpiné A. Elnar, Nadia Ouamara, Nadiya Boyko, Xavier Coumoul, Jean-Philippe Antignac, Bruno Le Bizec, Gauthier Eppe, Jenny Renaut, Torsten Bonn, Cédric Guignard, Margherita Ferrante, Maria Liusa Chiusano, Salvatore Cuzzocrea, Gerard O'Keeffe, John Cryan, Michelle Bisson, Amina Barakat, Ihsane Hmamouchi, Nasser Zawia, Anumantha Kanthasamy, Glen E. Kisby, Rui Alves, Oscar Villacañas Pérez, Kim Burgard, Peter Spencer, Norbert Bomba, Martin Haranta, Nina Zaitseva, Irina May, Stéphanie Grojean, Mathilde Body-Malapel, Florencia Harari, Raul Harari, Kristina Yeghiazaryan, Olga Golubnitschaja, Vittorio Calabrese, Christophe Nemos, Rachid Soulimani

A21 Mental indicators at young people with attributes hypertension and pre-hypertension

Maria E. Evsevyeva, Elena A. Mishenko, Zurida V. Kumukova, Evgeniy V. Chudnovsky, Tatyana A. Smirnova

A22 On the approaches to the early diagnosis of stress-induced hypertension in young employees of State law enforcement agencies

Maria E. Evsevyeva, Ludmila V. Ivanova, Michail V. Eremin, Maria V. Rostovtseva

A23 Сentral aortic pressure and indexes of augmentation in young persons in view of risk factors

Maria E. Evsevyeva, Michail V. Eremin, Vladimir I. Koshel, Oksana V. Sergeeva, Nadesgda M. Konovalova

A24 Breast cancer prediction and prevention: Are reliable biomarkers in horizon?

Shantanu Girotra, Olga Golubnitschaja

A25 Flammer Syndrome and potential formation of pre-metastatic niches: A multi-centred study on phenotyping, patient stratification, prediction and potential prevention of aggressive breast cancer and metastatic disease

Olga Golubnitschaja, Manuel Debald, Walther Kuhn, Kristina Yeghiazaryan, Rostyslav V. Bubnov, Vadym M. Goncharenko, Ulyana Lushchyk, Godfrey Grech, Katarzyna Konieczka

A26 Innovative tools for prenatal diagnostics and monitoring: improving individual pregnancy outcomes and health-economy in EU

Olga Golubnitschaja, Jan Jaap Erwich, Vincenzo Costigliola, Kristina Yeghiazaryan, Ulrich Gembruch

A27 Immunohistochemical assessment of APUD cells in endometriosis

Vadym M. Goncharenko, Vasyl O. Beniuk, Olga V. Kalenska, Rostyslav V. Bubnov

A28 Updating personalized management algorithm of endometrial hyperplasia in pre-menopause women

Vadym M. Goncharenko, Vasyl O. Beniuk, Rostyslav V. Bubnov, Olga Melnychuk

A29 The personified treatment approach of polimorbid patients with periodontal inflammatory diseases

Irina A. Gorbacheva, Lyudmila Y. Orekhova, Vadim V. Tachalov

A30 Ukrainian experience in hybrid war – the challenge to update algorithms for personalized care and early prevention of different military injuries

Olena I. Grechanyk, Rizvan Ya. Abdullaiev, Rostyslav V. Bubnov

A31 Tear fluid biomarkers: a comparison of tear fluid sampling and storage protocols

Suzanne Hagan, Eilidh Martin, Ian Pearce, Katherine Oliver

A32 The correlation of dietary habits with gingival problems during menstruation

Cenk Haytac, Fariz Salimov, Servin Yoksul, Anatoly A. Kunin, Natalia S. Moiseeva

A33 Genomic medicine in a contemporary Spanish population of prostate cancer: our experience

Bernardo Herrera-Imbroda, Sergio del Río-González, Maria Fernanda Lara, Antonia Angulo, Francisco Javier Machuca Santa-Cruz

A34 Challenges, opportunities and collaborations for personalized medicine applicability in uro-oncological disease

Bernardo Herrera-Imbroda, Sergio del Río-González, Maria Fernanda Lara

A35 Metabolic hallmarks of cancer as targets for a personalized therapy

John Ionescu

A36 Influence of genetic polymorphism as a predictor of the development of periodontal disease in patients with gastric ulcer and 12 duodenal ulcer

Alfiya Z. Isamulaeva, Anatoly A. Kunin, Shamil Sh. Magomedov, Aida I. Isamulaeva

A37 Challenges in diabetic macular edema

Tatjana Josifova

A38 Overview of the EPMA strategies in laboratory medicine relevant for PPPM

Marko Kapalla, Juraj Kubáň, Olga Golubnitschaja, Vincenzo Costigliola

A39 EPMA initiative for effective organization of medical travel: European concepts and criteria

Vincenzo Costigliola, Marko Kapalla, Juraj Kubáň, Olga Golubnitschaja

A40 Design and innovation in e-textiles: implications for PPPM

Anthony Kent, Tom Fisher, Tilak Dias

A41 Biobank in Pilsen as a member of national node BBMRI_CZ

Judita Kinkorová, Ondřej Topolčan

A42 Big data in personalized medicine: hype and hope

Matthias Kohl

A43 The 3P approach as the platform of the European Dentistry Department (DPPPD)

Anatoly A. Kunin, Natalia S. Moiseeva

A44 The endometrium cytokine patterns for predictive diagnosis of proliferation severity and cancer prevention

Andrii I. Kurchenko, Vasyl A. Beniuk, Vadym M. Goncharenko, Rostyslav V. Bubnov, Nadiya V. Boyko, Andriy M. Strokan

A45 A monocyte-based in-vitro system for testing individual responses to the implanted material: future for personalized implant construction

Julia Kzhyshkowska, Alexandru Gudima, Ksenia S. Stankevich, Victor D. Filimonov⁴, Harald Klüter, Evgeniya M. Mamontova, Sergei I. Tverdokhlebov

A46 Prediction and prevention of adverse health effects by meteorological factors: Biomarker patterns and creation of a device for self-monitoring and integrated care

Ulyana B. Lushchyk, Viktor V. Novytskyy, Igor P. Babii, Nadiya G. Lushchyk, Lyudmyla S. Riabets, Ivanna I. Legka

A47 Targeting "disease signatures" towards personalized healthcare

Mira Marcus-Kalish, Alexis Mitelpunkt, Tal Galili, Neta Shachar, Yoav Benjamini

A48 Influence of the skin imperfection on the personal quality of life and possible tools for objective diagnosis

Agnieszka Migasiewicz, Markus Pelleter, Joanna Bauer, Ewelina Dereń, Halina Podbielska

A49 The new direction in caries prevention based on the ultrastructure of dental hard tissues and filling materials

Natalia S. Moiseeva, Anatoly A. Kunin, Dmitry A. Kunin

A50 The use of LED radiation in prevention of dental diseases

Natalia S. Moiseeva, Yury A. Ippolitov, Dmitry A. Kunin, Alexei N. Morozov, Natalia V. Chirkova, Nakhid T. Aliev

A51 Status of endothelial progenitor cells in diabetic nephropathy: predictive and preventive potentials

Mahmood S. Mozaffari, Jun Yao Liu, Babak Baban

A52 The status of glucocorticoid-induced leucine zipper protein in salivary gland in Sjögren’s syndrome: predictive and personalized treatment potentials

Mahmood S. Mozaffari, Jun Yao Liu, Rafik Abdelsayed, Xing-Ming Shi, Babak Baban

A53 Maximal aerobic capacity - important quality marker of health

Jaroslav Novák, Milan Štork, Václav Zeman

A54 The EMPOWER project: laboratory medicine and Horizon 2020

Wytze P. Oosterhuis, Elvar Theodorsson

A55 Personality profile manifestations in patient’s attitude to oral care and adherence to doctor’s prescriptions

Lyudmila Y. Orekhova, Tatyana V. Kudryavtseva, Elena R. Isaeva, Vadim V. Tachalov, Ekaterina S. Loboda

A56 Results of an European survey on personalized medicine addressed to directions of laboratory medicine

Mario Pazzagli, Francesca Malentacchi, Irene Mancini, Ivan Brandslund, Pieter Vermeersch, Matthias Schwab, Janja Marc, Ron H.N. van Schaik, Gerard Siest, Elvar Theodorsson, Chiara Di Resta

A57 MCI or early dementia predictive speech based diagnosis techniques

Matus Pleva, Jozef Juhar

A58 Personalized speech based mobile application for eHealth

Matus Pleva, Jozef Juhar

A59 Circulating tumor cell-free DNA as the biomarker in the management of cancer patients

Jiří Polívka jr., Filip Janků, Martin Pešta, Jan Doležal, Milena Králíčková, Jiří Polívka

A60 Complex stroke care – educational programme in Stroke Centre University Hospital Plzen

Jiří Polívka, Alena Lukešová, Nina Müllerová, Petr Ševčík, Vladimír Rohan

A61 Sleep apnea and sleep fragmentation contribute to brain aging

Kneginja Richter, Lence Miloseva, Günter Niklewski

A62 Personalised approach for sleep disturbances in shift workers

Kneginja Richter, Jens Acker, Guenter Niklewski

A63 Medical travel and innovative PPPM clusters: new concept of integration

Olga Safonicheva, Vincenzo Costigliola

A64 Medical travel and women health

Olga Safonicheva

A65 Continuity of generations in the training of specialists in the field of reconstructive microsurgery

Maxim Sautin, Janna Sinelnikova, Sergey Suchkov

A66 Telemonitoring of stroke patients – empirical evidence of individual risk management results from an observational study in Germany

Songül Secer, Stephan von Bandemer

A67 Women’s increasing breast cancer risk with n-6 fatty acid intake explained by estrogen-fatty acid interactive effect on DNA damage: implications for gender-specific nutrition within personalized medicine

Niva Shapira

A68 Cytobacterioscopy of the gingival crevicular fluid as a method for preventive diagnosis of periodontal diseases

Aleksandr Shcherbakov, Anatoly A. Kunin, Natalia S. Moiseeva

A69 Use of specially treated composites in dentistry to avoid violations of aesthetics

Bogdan R. Shumilovich, Zhanna Lipkind, Yulia Vorobieva, Dmitry A. Kunin, Anastasiia V. Sudareva

A70 National eHealth system – platform for preventive, predictive and personalized diabetes care

Ivica Smokovski, Tatjana Milenkovic

A72 The common energy levels of Prof. Szent-Györgyi, the intrinsic chemistry of melanin, and the muscle physiopathology. Implications in the context of Preventive, Predictive, and Personalized Medicine

Arturo Solís-Herrera, María del Carmen Arias-Esparza, Sergey Suchkov

A73 Plurality and individuality of hepatocellular carcinoma: PPPM perspectives

Krishna Chander Sridhar, Olga Golubnitschaja

A74 Strategic aspects of higher medical education reforms to secure newer educational platforms for getting biopharma professionals matures

Maria Studneva, Sihong Song, James Creeden, Мark Мandrik, Sergey Suchkov

A75 Overview of the strategies and activities of the European Federation of Clinical Chemistry and Laboratory Medicine, (EFLM)

Elvar Theodorsson, EFLM

A76 New spectroscopic techniques for point of care label free diagnostics

Syed A. M. Tofail

A77 Tumor markers for personalized medicine and oncology - the role of Laboratory Medicine

Ondřej Topolčan, Judita Kinkorová, Ondřej Fiala, Marie Karlíková, Šárka Svobodová, Radek Kučera, Radka Fuchsová, Vladislav Třeška, Václav Šimánek, Ladislav Pecen, Jan Šoupal, Štěpán Svačina²

A78 Modern medical terminology (MMT) as a driver of the global educational reforms

Evgeniya Tretyak, Maria Studneva, Sergey Suchkov

A79 Juvenile hypertension; the relevance of novel predictive, preventive and personalized assessment of its determinants

Francesca M. Trovato, G. Fabio Martines, Daniela Brischetto, Daniela Catalano, Giuseppe Musumeci, Guglielmo M. Trovato

A80 Proteomarkers Biotech

George Th. Tsangaris, Athanasios K. Anagnostopoulos

A81 Proteomics and mass spectrometry based non-invasive prenatal testing of fetal health and pregnancy complications

George Th. Tsangaris, Athanasios K. Anagnostopoulos

A82 Integrated Ecosystem for an Integrated Care model for Heart Failure (HF) patients including related comorbidities (ZENITH)

José Verdú, German Gutiérrez, Jordi Rovira, Marta Martinez, Lutz Fleischhacker, Donna Green, Arthur Garson, Elena Tamburini, Stefano Cuomo, Juan Martinez-Leon, Teresa Abrisqueta, Hans-Peter Brunner-La Rocca, Tiny Jaarsma, Teresa Arredondo, Cecilia Vera, Giuseppe Fico, Olga Golubnitschaja, Fernando Arribas, Martina Onderco, Isabel Vara, on behalf of ZENITH consortium

A83 Predictive, preventive and personalized medicine in diabetes onset and complication (MOSAIC project)

José Verdú, Francesco Sambo, Barbara Di Camillo, Claudio Cobelli, Andrea Facchinetti, Giuseppe Fico, Riccardo Bellazzi, Lucia Sacchi, Arianna Dagliati, Daniele Segnani, Valentina Tibollo, Manuel Ottaviano, Rafael Gabriel, Leif Groop, Jacqueline Postma, Antonio Martinez, Liisa Hakaste, Tiinamaija Tuomi, Konstantia Zarkogianni, on behalf of MOSAIC consortium

A84 Possibilities for personalized therapy of diabetes using in vitro screening of insulin and oral hypoglycemic agents

Igor Volchek, Nina Pototskaya, Andrey Petrov

A85 The innovative technology for personalized therapy of human diseases based on in vitro drug screening

Igor Volchek, Nadezhda Pototskaya, Andrey Petrov

A86 Bone destruction and temporomandibular joint: predictive markers, pathogenetic aspects and quality of life

Ülle Voog-Oras, Oksana Jagur, Edvitar Leibur, Priit Niibo, Triin Jagomägi, Minh Son Nguyen, Chris Pruunsild, Dagmar Piikov, Mare Saag

A87 Sub-optimal health management – global vision for concepts in medical travel

Wei Wang

A88 Sub-optimal health management: synergic PPPM-TCAM approach

Wei Wang

A89 Innovative technologies for minimal invasive diagnostics

Andreas Weinhäusel, Walter Pulverer, Matthias Wielscher, Manuela Hofner, Christa Noehammer, Regina Soldo, Peter Hettegger, Istvan Gyurjan, Ronald Kulovics, Silvia Schönthaler, Gabriel Beikircher, Albert Kriegner, Stephan Pabinger, Klemens Vierlinger

A90 Rare disease diobanks for personalized medicine

Ayşe Yüzbaşıoğlu, Meral Özgüç, Member of EuroBioBank - European Network of DNA, Cell and Tissue Banks for Rare Diseases

The golden proportion in facial soft-tissues of Vietnamese females

Objective of the current study was to evaluate proportions of frontal facial soft-tissues of Vietnamese females correspond to the golden proportion (GP).

MATERIAL AND METHODS

Sixty frontal facial photographs of Vietnamese female students aged 19 years were selected. The selected participants had symmetrical face, a Class I relationship occlusion, complete lip closure, and no history of trauma and orthodontic treatment. The photographic record was set-up with a white backdrop, fill light, a reflector, a camera Canon 650D and subjects were asked to sit in a standard position. Trichion (TR), Temporal soft tissue (TS), Lateral canthus (LC), Lateral nasal (LN), Chilion (CH), and Menton (ME) point were used for photometric measurements on CorelDRAW Graphic X3 software.

RESULTS

The vertical facial proportions (mean, percentage compared with GP) were significantly higher than the GP including: LC-CH:CH-ME (1.661, 102%), LN-ME:LC-LN (1.729, 106%), TR-ME:LC-ME (1.739, 107%), TR-LN:LN-ME (1.759, 108%). Whereas TR-ME:LN-ME; CH-ME:LN-CH; LC-LN:LN-CH had ratios of 84% - 92% and were significantly smaller in comparison with GP. The horizontal facial proportions of CHR-L:LNR-L, LCR-L:CHR-L and TSR-L:LCR-L deviated from the GP with mean values of 1.221, 1.922 and 1.229, respectively. The new mean values of TR-ME:LC-ME (1.733), TR-LN:LN-ME (1.732), LC-ME:TR-LC (1.374), CH-ME:LN-CH (1.524), which were predictable changes in proportions, can be significantly converged to the GP if LC-CH:CH-ME is equal to the GP.

CONCLUSIONS

Soft-tissue facial proportions of Vietnamese females did not correspond to the GP. Changing the lower third face may create harmony vertical facial proportions.

A missense mutation in DUSP6 is associated with Class III malocclusion

Class III malocclusion is a common dentofacial phenotype with a variable prevalence according to ethnic background. The etiology of Class III malocclusion has been attributed mainly to interactions between susceptibility genes and environmental factors during the morphogenesis of the mandible and maxilla. Class III malocclusion shows familial recurrence, and family-based studies support a predominance of an autosomal-dominant mode of inheritance. We performed whole-exome sequencing on five siblings from an Estonian family affected by Class III malocclusion. We identified a rare heterozygous missense mutation, c.545C>T (p.Ser182Phe), in the DUSP6 gene, a likely causal variant. This variant co-segregated with the disease following an autosomal-dominant mode of inheritance with incomplete penetrance. Transcriptional activation of DUSP6 has been presumed to be regulated by FGF/FGFR and MAPK/ERK signaling during fundamental processes at early stages of skeletal development. Several candidate genes within a linkage region on chromosome 12q22-q23--harboring DUSP6--are implicated in the regulation of maxillary or mandibular growth. The current study reinforces that the 12q22-q23 region is biologically relevant to craniofacial development and may be genetically linked to the Class III malocclusion.

Non-syndromic Tooth Agenesis Associated with a Nonsense Mutation in Ectodysplasin-A (EDA)

Mutations in the ectodysplasin-A ( EDA) gene have been generally associated with X-linked hypohidrotic ectodermal dysplasia (XLHED). Recently, missense mutations in EDA have been reported to cause familial non-syndromic tooth agenesis. In this study, we report a novel EDA mutation in an Estonian family segregating non-syndromic tooth agenesis with variable expressivity. Affected individuals had no associated defects in other ectodermal organs. Using whole-exome sequencing, we identified a heterozygous nonsense mutation c.874G>T (p.Glu292X) in the TNF homology domain of EDA in all affected female patients. This protein-altering variant arose de novo, and the potentially causative allele was transmitted to affected offspring from the affected mother. We suggest that the dental phenotype variability described in heterozygous female carriers of EDA mutation may occur because of the differential pattern of X-chromosome inactivation, which retains reduced levels of EDA-receptor signaling in tissues involved in tooth morphogenesis. This results in selective tooth agenesis rather than XLHED phenotype. The present study broadens the mutation spectrum for this locus and demonstrates that EDA mutations may result in non-syndromic tooth agenesis in heterozygous females.

Variation in FGF1, FOXE1, and TIMP2 genes is associated with nonsyndromic cleft lip with or without cleft palate

BACKGROUND

Nonsyndromic cleft lip with or without cleft palate (CL/P) is a common complex birth defect caused by the interaction between multiple genes and environmental factors.

METHODS

Five hundred and eighty-seven single nucleotide polymorphisms in 40 candidate genes related to orofacial clefting were tested for association with CL/P in a clefting sample composed of 300 patients and 606 controls from Estonian, Latvian, and Lithuanian populations.

RESULTS

In case-control comparisons, the minor alleles of FGF1 rs34010 (p = 4.56 × 10(-4) ), WNT9B rs4968282 (p = 0.0013), and FOXE1 rs7860144 (p = 0.0021) were associated with a decreased risk of CL/P. Multiple haplotypes in FGF1, FOXE1, and TIMP2 and haplotypes in WNT9B, PVRL2, and LHX8 were associated with CL/P. The strongest association was found for protective haplotype rs250092/rs34010 GT in the FGF1 gene (p = 5.01 × 10(-4) ). The strongest epistatic interaction was observed between the COL2A1 and WNT3 genes.

CONCLUSIONS

Our results provide for the first time evidence implicating FGF1 in the occurrence of CL/P, and support TIMP2 and WNT9B as novel loci predisposing to CL/P. We have also replicated recently reported significant associations between variants in or near FOXE1 and CL/P. It is likely that variation in FOXE1, TIMP2, and the FGF and Wnt signaling pathway genes confers susceptibility to nonsyndromic CL/P in Northeastern European populations.

MTHFR and MSX1 contribute to the risk of nonsyndromic cleft lip/palate

Recent studies suggest that multiple interacting loci, with possible additional environmental factors, influence the risk for nonsyndromic oral clefts, one of the most common birth defects in humans. Advances in high-throughput genotyping technology allow the testing of multiple markers, simultaneously, in many candidate genes. We tested for associations between 176 haplotype-tagging single nucleotide polymorphisms (SNPs) in 18 candidate genes/loci and nonsyndromic clefts in a case-control study in an Estonian sample (153 patients, 205 controls). The most significant associations with nonsyndromic cleft lip with or without cleft palate (CL/P) were found for SNPs in MSX1, MTHFR, and PVRL2, including several common haplotypes in the MTHFR and MSX1 genes. The strongest association was observed for rs6446693 in the MSX1 region, which remained statistically significant after Bonferroni correction. The strongest association with nonsyndromic cleft palate (CP) was found for the SNP rs11624283 in the JAG2 gene. Epistatic interactions were observed for SNPs within PVRL2, between BCL3 and EDN1, and between IRF6 and MSX1 genes. This study provides further evidence implicating MSX1 and MTHFR in the etiology of nonsyndromic CL/P across different populations.

Genetic variants in COL2A1, COL11A2, and IRF6 contribute risk to nonsyndromic cleft palate

BACKGROUND

Orofacial clefts are among the most common birth defects with a strong genetic component. Nonsyndromic cleft palate (NSCP) is a complex malformation determined by the interaction between multiple genes and environmental risk factors.

METHODS

We conducted a case-control association study to investigate the role of 40 candidate genes in predisposition to orofacial clefting. Five hundred ninety-one haplotype tagging single nucleotide polymorphism (tagSNPs) were genotyped in a clefting sample from the Baltic region, composed of 104 patients with nonsyndromic cleft palate and 606 controls from an Estonian, Latvian, and Lithuanian population.

RESULTS

In case-control comparisons, the minor alleles of IRF6 rs17389541 (p = 5.45 × 10(-4)) and COL2A1 rs1793949 (p = 7.26 × 10(-4)) were associated with increased risk of NSCP. Multiple haplotypes in COL2A1 and COL11A2 and haplotypes in WNT3, FGFR1, and CLPTM1were associated with NSCP. The strongest associations were found for IRF6 haplotype rs17389541/rs9430018 GT (p = 2.23 × 10(-4)) and COL2A1 haplotype rs12822608/rs6823 GC (p = 3.68 × 10(-4)). The strongest epistatic interactions were observed between MSX1 and BMP2, FGF1 and PVRL2, and COL2A1 and FGF2 genes.

CONCLUSIONS

This study provides for the first time evidence of the implication of IRF6, COL2A1, and WNT3 in the occurrence of NSCP. It is likely that variation in cartilage collagen II and XI genes, IRF6, and the Wnt and FGF signaling pathway genes contributes susceptibility to nonsyndromic cleft palate in Northeastern European populations.

Malocclusion and the need for orthodontic treatment in patients with temporomandibular dysfunction

OBJECTIVE

The aim of the study was to investigate the signs and symptoms of temporomandibular disorders (TMD) as well as the relationships between TMD, malocclusion and the need for orthodontic treatment.

MATERIAL AND METHODS

Forty consecutive patients (36 F, 4 M) with a median age of 35 (IQR 18) years. Eighteen patients had Class I, 22 patients Class II malocclusion. A rating scale for the influence of TMJ pain/discomfort on the activities of daily living (ADL) was used simultaneously with clinical examination. Helkimo's Dysfunction Index (D(i)) and the Index of Orthodontic Treatment Need (IOTN) were determined for each participant.

RESULTS

Pain/discomfort in the TMJ area was positively correlated with interferences in laterotrusion (p=0.021), pain on palpation over the posterior aspects of TMJ (p=0.012) and pain in the masticatory muscles (p=0.023). The impact of TMJ pain/discomfort was greatest on the performance of a yawn and on opening the mouth wide. There was no statistically significant correlation between malocclusion, D(i)and IOTN. A comparison of Class I malocclusion patients to those with Class II malocclusion revealed no statistically relevant differences in Di and ADL.

CONCLUSION

In patients with malocclusion, pain from TMJ has a significant negative impact on activities of daily living. No significant differences were observed between Angle Class I and Class II groups of patients with respect to TMD. Orthodontic treatment was required for both groups.