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Quiescent stem cells are activated in response to a mechanical or chemical injury to their tissue niche. Activated cells rapidly generate a heterogeneous progenitor population that regenerates the damaged tissues. While the transcriptional cadence that generates heterogeneity is known, the metabolic pathways influencing the transcriptional machinery to establish a heterogeneous progenitor population remains unclear. Here, we describe a novel pathway downstream of mitochondrial glutamine metabolism that confers stem cell heterogeneity and establishes differentiation competence by countering post-mitotic self-renewal machinery. We discovered that mitochondrial glutamine metabolism induces CBP/EP300-dependent acetylation of stem cell-specific kinase, PAS domain-containing kinase (PASK), resulting in its release from cytoplasmic granules and subsequent nuclear migration. In the nucleus, PASK catalytically outcompetes mitotic WDR5-anaphase-promoting complex/cyclosome (APC/C) interaction resulting in the loss of post-mitotic Pax7 expression and exit from self-renewal. In concordance with these findings, genetic or pharmacological inhibition of PASK or glutamine metabolism upregulated Pax7 expression, reduced stem cell heterogeneity , and blocked myogenesis in vitro and muscle regeneration in mice. These results explain a mechanism whereby stem cells co-opt the proliferative functions of glutamine metabolism to generate transcriptional heterogeneity and establish differentiation competence by countering the mitotic self-renewal network via nuclear PASK., Competing Interests: MX, CW, GM, BK, DC, LY, SM, SD, EM, PS, AD, MG, LB, RS, CK No competing interests declared, (© 2023, Xiao, Wu, Meek et al.)

Maxillofacial trauma caused by automobile accidents can result in extensive loss of alveolar bone, teeth, and gingival tissues as well as a cleft palate. Patients who have undergone such trauma may experience a loss of vertical dimension of occlusion, esthetic deformity, and difficulties in speaking, chewing, and swallowing. Both prosthodontic and surgical treatment are required in these cases. This case report describes the use of palatoplasty and maxillary and mandibular complete overdentures with a ball attachment system supported by natural roots as rehabilitative treatment for a 65-year-old man who had been injured in an automobile accident 24 years previously. Palatoplasty was performed to close the cleft palate that resulted from the trauma. Other procedures, including tooth extractions, endodontic treatment, cementation of ball attachments, and fabrication of temporary removable partial dentures to reestablish the vertical dimension of occlusion, were performed before the overdentures were placed. This treatment reestablished the patient's chewing, phonetic, and esthetic functions at a lower cost than other treatment options. At the 1-year follow-up evaluation, the patient's oral health was satisfactory, with no loss of abutment teeth, and the prostheses were functioning correctly., Competing Interests: No conflicts of interest reported.

The purpose of this in vitro study was to compare the 3- and 90-day bond strengths of 3 cements used for luting metal-ceramic crowns. Zinc phosphate cement (ZPC; SS White), resin-modified glass ionomer cement (RMGIC; Fuji Plus), and self-adhesive resin cement (SARC; RelyX U200) were assessed in 2 different treatment conditions (with and without microsandblasting of the alloy) and at 2 experimental times (3 days [E1] and 90 days [E2] after cementation). The buccal surfaces of 84 bovine teeth were ground until the dentin was exposed, and 84 nickel-chromium alloy plates cast from a resin model were cemented to the dentin surfaces with 1 of the 3 cements (n = 28). In half of the specimens of each group (n = 14), the bonding surfaces of the nickel-chromium plates received 6 seconds of microsandblasting with 45-μm aluminum oxide particles prior to cementation. The compressive shear bond strengths of the specimens were evaluated in a universal testing machine at E1 and E2 (n = 7). The SARC group showed the greatest bond strength, followed by the RMGIC group, while the bond strength of the ZPC group was significantly lower (P < 0.01). For the RMGIC specimens subjected to microsandblasting, there was a statistically significant difference between the mean bond strengths at E1 and E2 (P = 0.040). All of the other cement and treatment groups showed statistically similar adhesion results at E1 and E2 (P > 0.05). The complementary test by Šidák revealed that the cements Fuji Plus and RelyX U200 showed higher values at E2 and were statistically similar to each other (P > 0.05). Although RMGIC specimens showed a lower initial bond strength than SARC specimens, the fact that the microsandblasted RMGIC subgroup was the only one that demonstrated a significant increase in bond strength with aging suggests that RMGIC can be a material of first choice because it also costs less than SARC., Competing Interests: The authors report no conflict of interest pertaining to any of the products or companies discussed in this article.

The internal derangement of the temporomandibular joint (TMJ) represents 8% of all cases of temporomandibular disorders (TMD) posing difficulties to establish an accurate diagnosis and treatment because of its low prevalence. This article presents the case of an 18-year-old Caucasian female patient who came to our Orofacial Pain and TMD Outpatient Service with complaints of intense pain on the right TMJ and limitation of mouth opening (maximum interincisal opening of 29 mm) with deviation to right, which she had been experiencing for the past 3 years. After a detailed clinical interview, a diagnosis hypothesis of nonreducing disc displacement with mouth opening limitation was established. The proposed treatment consisted of intra-joint infiltration with anesthetic in the right TMJ followed by jaw manipulation to recapture the articular disc, which was impeding the complete translation movement of the affected TMJ. After jaw manipulation, a new evaluation was done and showed the re-establishment of jaw dynamics with mouth opening and closing without deviation to the right side, clicking, opening limitation or pain. The patient was followed up at 6 months intervals. Two years after treatment, the patient was reevaluated and her mandibular range of motion without aid increased to 54 mm with no clicking, deviation to right, trismus or pain on the TMJ, indicating success of the treatment approach without recurrence of the pathology.