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Browsing by Author "Kula, Katherine S."
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Item 3D Assessment of Nasopharyngeal and Craniofacial Phenotypes in Ts65Dn Down Syndrome Mice Treated with a Dyrk1a Inhibitor(2014-04-11) Starbuck, John M.; Harrington, Emily; Kula, Katherine S.; Ghoneima, Ahmed A.; Roper, Randall J.Background: Down syndrome (DS) originates from having three copies of chromosome 21 (i.e. Trisomy 21). DS is associated with many detrimental phenotypes including intellectual disabilities, heart defects, abnormal craniofacial development, and obstructive sleep apnea, which develops from restricted nasopharyngeal airways and an underdeveloped mandible. Ts65Dn mice are trisomic for about half of the orthologs on human chromosome 21 and display many phenotypes associated with DS including craniofacial abnormalities. Dyrk1a is found in three copies in Ts65Dn mice and individuals with DS, and thought to be a root cause of the craniofacial phenotypes. Epigallocatechin 3-gallate (EGCG) is a green tea polyphenol and inhibitor of Dyrk1a activity. Purpose: We hypothesize that decreased Dyrk1a activity in Ts65Dn mice will ameliorate craniofacial dysmorphology. Methods: To test our hypothesis we compared Ts65Dn mice with two or three copies of Dyrk1a and compared Ts65Dn mice with and without prenatal EGCG treatment. EGCG treated mothers were fed 200mg/kg EGCG on gestational day 7. Six week old mice were sacrificed and their heads imaged using micro-computed tomography (μCT). From μCT images, we measured nasopharyngeal airway volume and anatomical landmarks (n = 54) from the facial skeleton, cranial vault, cranial base, and mandible. Mean nasopharyngeal airway volumes were graphically compared, and a landmark-based multivariate geometric morphometric approach known as Euclidean Distance Matrix Analysis (EDMA) was carried out to assess local differences in craniofacial morphology between trisomic mouse samples. Results: Our preliminary results indicate that EGCG treatment and reduced Dyrk1a copy number increases mean nasopharyngeal airway volume in Ts65Dn mice. Craniofacial morphometric differences were found among all samples. EGCG treatment increased portions of the mandible and decreased portions of the cranial vault and cranial base. Conclusion: Preliminary analyses suggest that both EGCG treatment and reduced Dyrk1a copy number affect craniofacial morphology.Item Airway dimensions and pathologies of trumpet players vs. non-trumpet players.(Office of the Vice Chancellor for Research, 2014-04-11) Kula, Katherine S.; Imburgia, A.; Halum, S.; Van Dis, M.; Ghoneima, Ahmed A.Objective: The objective of this retrospective, 3-dimensional cone beam computed tomography study was to determine if there is a significant difference between the most constricted area of the airway, the prevertebral soft tissue thickness and airway dimensions (length and volume) of the nasal cavity, nasopharynx, oropharynx, and maxillary sinuses of university trumpet players versus non-trumpet playing controls. The second objective was to determine significant differences in the prevalence of airway pathologies between university trumpet players and controls. Method: Following IRB approval and consent and reliability studies, measurements of airway parameters and pathology were compared between 66 Caucasian trumpeters and 22 ethnicmatched controls. An analysis of covariance, with age and sex included as covariates, was used to compare the airway measures. Since there was a significant difference in gender and age, comparisons between groups for the presence of any airway pathologies was made using logistic regression including age and sex as covariates. A 5% significance level was used for all comparisons. Result: The trumpet players had significantly smaller nasal cavity volume (18028 + 595 mm3 vs. 25266 + 1116 mm3; p<0.0001) and significantly greater soft tissue thickness at CV2ia (3.29 + 0.10 mm vs 2.70 + 0.10 mm; p=0.03) and CV3sa (4.55 + 0.13 mm vs 3.74 + 0.14 mm; p=0.005) than the controls. No other airway measure demonstrated a significant difference between the two groups. Trumpeters had significantly (p=0.002) more airway pathology (n=33; 50%) than the controls (n=4; 18%). Antral pseudocysts or polyps composed 52% of trumpeter pathologies as compared with 0% controls. Conclusion: The only significant differences in airway dimensions between trumpet players and controls were decreased nasal cavity volume and some areas of prevertebral soft tissue thickness. Trumpeters were almost three times as likely to exhibit airway pathology when compared with controls. Funding: IUPUI Signature Center Initiative – 3D Imaging of the Craniofacial Complex Center and the Joseph and Aida Jarabak Endowed Professorship.Item Association Analysis of Class II Division 2 Malocclusion and Two Genes Linked to Hypodontia (MSX1 and PAX9)(2009) Wall, Matthew D.; Kula, Katherine S.; Hartsfield, James K., Jr.; Shanks, James C.; Baldwin, James J. (James Joseph), 1925-; Stewart, Kelton T.Purpose of the Study: Determine if there is an association of the CII/D2 malocclusion and genes linked to hypodontia, namely PAX9 and MSX1. Methods and Materials: One hundred probands with CII/D2 and one hundred non-CII/D2 with no hypodontia were enrolled in this study. Clinical exam, photographs, models, radiographs, and saliva were gathered. DNA was isolated from the saliva and sent for genetic analysis. Single Nucleotide Polymorphisms (SNPs) from the PAX9 and MSX1 genes were analyzed using the LightCycler® 480 to verify the presence of each with the CII/D2 malocclusion. A Hardy-Weinberg test was used to screen for genotyping errors, then a chi-square test was used to evaluate the association of the SNP genotypes. A p-value of 0.05 was considered significant. Results: The Hardy-Weinberg test showed no significant differences between observed and expected counts thus we used them for association analysis. Chi-square analysis indicated no significant association between CII/D2 and the MSX1 rs3821949 and the PAX9 1955734 genotypes. Although a p-value of 0.06 for the PAX9 rs8004560 suggested association, it was considered a grey area and insufficient to conclude that there was significant association. Since the SNP PAX9 rs8004560 was insufficient, additional statistical analysis was also performed on the PAX9 rs8004560 genotype of the CII/D2 affected subjects reported to have hypodontia of any tooth including third molars and excluding third molars. A chi-square test yielded a p-value of 0.08 on the analysis of CII/D2 with hypodontia for any permanent tooth except third molars, which suggested association, but insufficient to conclude a significant association. All other analyses indicated a lack of association of the PAX9 rs8004560 SNP. Conclusions: There is no significant association of CII/D2 and the SNPs MSX1 rs3821949 and PAX9 rs1955734. There is a suggestion that there is an association of the SNP PAX9 rs8004560 and CII/D2. There is a suggestion that there is an association of SNP PAX9 rs8004560 and CII/D2 subjects with hypodontia of any tooth except third molars.Item Clinical Outcomes of 0.018-Inch and 0.022-Inch Bracket Slot Using the ABO Objective Grading System(E.H Angle Education and Research Foundation, 2010-05-01) Detterline, David A.; Isikbay, Serkis C.; Brizendine, Edward J.; Kula, Katherine S.; Orthodontics and Oral Facial Genetics, School of DentistryObjective: To determine if there is a significant difference in the clinical outcomes of cases treated with 0.018-inch brackets vs 0.022-inch brackets according to the American Board of Orthodontics (ABO) Objective Grading System (OGS). Materials and Methods: Treatment time and the ABO-OGS standards in alignment/rotations, marginal ridges, buccolingual inclination, overjet, occlusal relationships, occlusal contacts, interproximal contacts, and root angulations were used to compare clinical outcomes between a series of 828 consecutively completed orthodontic cases (2005–2008) treated in a university graduate orthodontic clinic with 0.018-inch- and 0.022-inch-slot brackets. Results: A two-sample t-test showed a significantly shorter treatment time and lower ABO-OGS score in four categories (alignment/rotations, marginal ridges, overjet, and root angulations), as well as lower total ABO-OGS total score, with the 0.018-inch brackets. The ANCOVA—adjusting for covariants of discrepancy index, age, gender, and treatment time—showed that the 0.018-inch brackets scored significantly lower than the 0.022-inch brackets in both the alignment/rotations category and total ABO-OGS score. Conclusions: There were statistically, but not clinically, significant differences in treatment times and in total ABO-OGS scores in favor of 0.018-inch brackets as compared with the 0.022-inch brackets in a university graduate orthodontic clinic (2005–2008).Item Comparison of movement rate with different initial moment-to-force ratios(Elsevier, 2019-08-01) Li, Shuning; Chen, Jie; Kula, Katherine S.; Mechanical Engineering and Energy, School of Engineering and TechnologyIntroduction: The objective of this clinical prospective study was to evaluate the effect of the two treatment strategies, translation or controlled tipping followed by root correction, on canine retraction efficiency, specifically canine movement rate. Methods: Twenty-one patients who needed bilateral maxillary canine retraction to close extraction space as part of their treatment plan were selected for this study. Segmental T-loops designed for controlled tipping or for translation were applied randomly to each side. Two digital maxillary dental casts (taken pre- and post-treatment) were used to measure the tooth displacements of each patient. The coordinate system located at the center of canine crown on the pre-treatment model with the three axes defined in the mesial-distal (M-D), buccal-lingual (B-L), and occlusal-gingival (O-G) directions was used to express the six tooth displacement components. The movement rates on the occlusal plane and in the M-D direction were computed. Movement rates were calculated by dividing the M-D displacements or the resultant displacement on the occlusal plane with the corresponding treatment time. Results: T-loops for controlled tipping moved canines faster (33.3% on occlusal plane and 38.5% in the M-D direction) than T-loops for translation. The differences are statistically significant (p = 0.041 on the occlusal plane and 0.020 in the M-D direction). Conclusion: 1. Moment-to-force ratio (M/F) impacts on the canine movement rate in a maxillary canine retraction treatment with segmented T-loop mechanism. 2. Within the neighborhood of the ratio for translation, lower M/F moves canine faster than higher M/F both on occlusal plane and in the M-D direction.Item The Effect of Anterior Tooth Position on Trumpet Performance Quality(Office of the Vice Chancellor for Research, 2013-04-05) Cilingir, H. Z.; Ghoneima, Ahmed A.; Dagg, J.; Kula, Katherine S.Objective: Music teachers contend that the arrangement of anterior teeth affects trumpet performance by influencing the embouchure. Since there is little quantitative data to support this claim, the purpose of this study was to determine whether trumpet performance skills are associated with the malalignment of anterior teeth. Methods: Following IRB approval, 70 trumpet students (55M:15F; aged 20-38.9 yrs.) from 11 universities were consented to complete a survey concerning dental history and trumpet playing habits. The students were asked to play a scripted performance skill test (flexibility, range, endurance, and articulation exercises) on their instrument in a soundproof music practice room while being audio and video recorded. A threedimensional (3D) cone beam computerized tomograph (CBCT) was taken of each student the same day as the skill test. Following reliability studies, overjet, overbite, and degree of anterior tooth irregularity (Little’s Index) were measured on the 3D CBCT. Nonparametric correlations, accepting p<.05 as significant, were used to determine if there were significant associations between Little’s Index in the maxillary and mandibular anterior dentition and any of the performance skills. Results: Interrater reliability was excellent (>0.8). Significant (p<0.05), but weak (r<0.30) associations were found only between Little’s Index of the mandibular anterior dentition and the performance skills: flexibility (exercises a, c and avg) and articulation (double tongue). No other associations were significant. Conclusions: University trumpet students with mandibular anterior teeth that are smoothly aligned have significantly better performance skills than those with misaligned mandibular anterior teeth; however, the association is weak.Item The effects of application time of a self-etching primer and debonding methods on bracket bond strength(Allen Press, 2012) Parrish, Brandon C.; Katona, Thomas R.; Isikbay, Serkis C.; Stewart, Kelton T.; Kula, Katherine S.; Orthodontics and Oral Facial Genetics, School of DentistryObjective: To test the manufacturer's recommendation for the application rubbing time of a self-etching primer (Transbond Plus, 3M Unitek) and to compare the resulting bond strength of a resin composite (Transbond XT, 3M Unitek) in the traditional laboratory tension on all four wings with a simulation of the clinical single-wing lift-off debonding instrument (LODI; 3M Unitek). Materials and methods: Flattened stainless-steel maxillary incisor orthodontic brackets (Victory Series, 3M Unitek) were bonded to 108 flattened bovine incisors. The enamel was rubbed with the self-etching primer for 0, 5 (the manufacturer's recommendation), and 10 seconds during a 10-second application. Traditional four-wing and LODI simulated debonding forces and the adhesive remnant index (ARI) were recorded. Results: One-way analysis of variance testing among rubbing times and debonding methods indicated a significant difference in strength with 0 and 5 seconds of rubbing and between traditional and LODI simulated tension. The bond strengths were higher in the ARI = 1 subset compared to the ARI = 3-5 subsets. Conclusions: The manufacturer's recommendation for primer rubbing time produced the highest bond strength. Less force is required for debonding when tension is applied to one wing (LODI simulation) vs on all four wings.Item Effects of mandibular advancement appliances on the upper airway dimensions(Office of the Vice Chancellor for Research, 2013-04-05) Finkelmeier, B.; Kula, Katherine S.; Eckert, George; Ghoneima, Ahmed A.Purpose: The aim of this retrospective cephalometric study was to investigate dentoskeletal and airway dimensional changes in a group of orthodontic patients with deficient mandible using Herbst vs. MARA appliances. Methods: Pre-treatment and post-treatment lateral cephalometric radiographs of 34 subjects with deficient mandible (aged 9-22 years) were selected from the postgraduate orthodontic clinic archives. The cephalograms were classified into 2 groups . Group 1 (n=17) consisted of cephalograms from individuals treated with a Herbst appliance and group 2 (n=17) consisted of cephalograms from individuals treated with a MARA appliance. Each cephalogram was traced manually and the selected dentoskeletal and airway parameters were recorded for all subjects. Intraclass correlations (ICC) were performed on duplicate measures of 10 cephalograms to assess reliability. Paired t-tests were used to differences in the airway parameters from pre-treatment to post-treatment within groups. Statistical significance was set at P < 0.05. Results: ICC values were ˃0.90 for all measurements. Significant changes were recorded in ANB, N-S, ANS-PNS, Go-Gn, Overbite, Overjet, Co-ANS, Co-Gn, TFH, AFH, and LAFH for both Herbst and MARA groups. Airway parameters such as soft tissue thickness of the posterior pharyngeal wall (Ba-ad1 and Ba-ad2), anteroposterior dimension of bony nasopharynx (Ba-PNS, AA-PNS and AA-ptm), and width of the nasopharyngeal airway space (PNS-ppw1) showed statistically significant decreases in both groups. The Herbst group also showed statistically significant decrease in the sagittal depth of pharyngeal lumen at the nasopharynx and oropharynx (ptm-ad1, PNS-ad1, and PNS-ppw2) while the MARA group demonstrated a statistically significant decrease in the angle represents the anteroposterior dimension of the nasopharynx (AA-S-PNS). Conclusion: Using mandibular advancement appliance decrease significantly the upper airway dimensions. The amount of the change in the upper airway size was variable between Herbst and MARA appliances.Item Hounsfield unit change in root and alveolar bone during canine retraction(Elsevier, 2015-04) Jiang, Feifei; Liu, Sean S.-Y.; Xia, Zeyang; Li, Shuning; Chen, Jie; Kula, Katherine S.; Eckert, George; Department of Orthodontics and Oral Facial Genetics, IU School of DentistryINTRODUCTION: The objective of this study was to determine the Hounsfield unit (HU) changes in the alveolar bone and root surfaces during controlled canine retractions. METHODS: Eighteen maxillary canine retraction patients were selected for this split-mouth design clinical trial. The canines in each patient were randomly assigned to receive either translation or controlled tipping treatment. Pretreatment and posttreatment cone-beam computed tomography scans of each patient were used to determine tooth movement direction and HU changes. The alveolar bone and root surface were divided into 108 divisions, respectively. The HUs in each division were measured. Mixed-model analysis of variance was applied to test the HU change distribution at the P <0.05 significance level. RESULTS: The HU changes varied with the directions relative to the canine movement. The HU reductions occurred at the root surfaces. Larger reductions occurred in the divisions that were perpendicular to the moving direction. However, HUs decreased in the alveolar bone in the moving direction. The highest HU reduction was at the coronal level. CONCLUSIONS: HU reduction occurs on the root surface in the direction perpendicular to tooth movement and in the alveolar bone in the direction of tooth movement when a canine is retracted.Item Orthodontic Soft Tissue Parameters: A Comparison of CBCT and 3dMD(Office of the Vice Chancellor for Research, 2013-04-05) Metzger, T. E.; Kula, Katherine S.; Eckert, George; Ghoneima, Ahmed A.Objectives: Orthodontists rely heavily on soft tissue analysis to determine esthetics and treatment stability. Although the reliability of three dimensional photography (3dMD) and cone beam computed tomography (CBCT) is established, little data exists comparing the soft tissue measurements between these two imaging modalities. The aim of this retrospective study is to compare the equivalence of soft tissue measurements between the 3dMD imaging system and the segmented skin surface derived from i-CAT CBCT. Methods: Seventy preexisting 3dMD extraoral photographs and CBCT scans taken within minutes of each other for the same subjects were superimposed using 3dMD Vultus software on soft tissue. Images were registered according to hard tissue planes in three dimensions. Following reliability studies, 28 soft tissue measurements were selected and recorded on both imaging modalities. The measures were then compared between the two images to analyze their equivalence. Intraclass correlation coefficients (all ICCs >.8) and Bland-Altman plots were used to assess the inter- / intra-examiner repeatability and agreement. Summary statistics were calculated for all measurements. To demonstrate equivalence of the two methods, the difference needed a 95% confidence interval contained entirely within the equivalence limits defined by repeatability results (twice the within-subject standard deviation of CBCT). Results: Statistically significant differences were reported for the following measurements: vermilion height (Ls-Li), mouth width (CH[R]–CH[L]), total facial width (Tr[R] – Tr[L]), mouth symmetry (Ch[R] to Sup. Facial Plane), ST Lip Thickness (LI to mand CI), and eye symmetry (Exoc R & L to Sup. Facial Plane). Conclusions: There are areas of non-equivalence between the two imaging methods. Differences are clinically acceptable from the orthodontic point of view.