Publications and News

Speed Bracer "Menachem Roth, DMD, MMSc, moves fast in life and at the track"
Justin W. Sanders

“We’re always looking for more efficient ways to do things for the patient,” Roth says, “to make the experience better, to provide better customer service, and to improve the quality of the end result. There’s nobody looking over your shoulder in dentistry but you. There’s nobody challenging you to be better unless you’re challenging yourself. And it’s very easy to be OK with the status quo, but if you have that mentality you can be left behind.

Guided bone regeneration to repair an osseous defect.

Carvalho RS1, Nelson D, Kelderman H, Wise R.

The ultimate goal of orthodontic therapy is to establish functional and esthetic dental relationships in a balanced facial pattern. In patients with compromised periodontal support, the use of multidisciplinary treatment plans is essential in attaining these goals. This case report includes a thorough documentation of the orthodontic and periodontal treatments to demonstrate the effectiveness of guided bone regenerative procedures combined with a bone allograft to aid in correcting a dental malocclusion.

Get is Straight - Boston 25 News

Exploring myths of Invisalign with Dr. Menachem Roth. 

Mechanism of action and morphologic changes in the alveolar bone in response to selective alveolar decortication-facilitated tooth movement.
Baloul SS1, Gerstenfeld LC, Morgan EF, Carvalho RS1, Van Dyke TE, Kantarci A.
Background and Purpose

The aim of this study was to test if corticotomy-induced osteoclastogenesis and bone remodeling underlie orthodontic tooth movement and how selective alveolar decortication enhances the rate of tooth movement.

Replacing Missing Maxillary Lateral Incisors
Menachem Roth, DMD, MMSc

As a general rule, cases that lend themselves to canine substitution would be those with a reasonable Class I or mild Class II profile, a Class II dental relationship, and minimal lower arch crowding; or a Class I dental relationship with crowding in the lower arch that requires premolar extraction or dentoalveolar protrusion.1-2 A typical space-opening implant case has one or both maxillary lateral incisors are missing, an acceptable profile, Class I occlusion, and spacing or minimal crowding with the spaces for the lateral incisors intact. Only a limited number of patients fall into these more clear-cut categories.



Expression of angiogenic factors during distraction osteogenesis.

Pacicca DM1, Patel N, Lee C, Salisbury K, Lehmann W, Carvalho RS1, Gerstenfeld LC, Einhorn TA.​
Background and Purpose

Distraction osteogenesis is a unique and effective way to treat limb length inequality resulting from congenital and posttraumatic skeletal defects. However, despite its widespread clinical use, the cellular and molecular mechanisms by which this surgical treatment promotes new bone formation are not well understood. Previous studies in distraction osteogenesis have noted increased blood flow and vessel formation within the zone of distraction. These observations suggest that distraction osteogenesis may be driven in part by an angiogenic process. Using immunohistological analysis, the expression of two different angiogenic factors (VEGF and bFGF) was shown to localize at the leading edge of the distraction gap, where nascent osteogenesis was occurring. These cells were spatially adjacent to new vessels that were identified by staining for factor VIII. Microarray analysis detected maximal mRNA expression for a wide variety of angiogenic factors including angiopoietin 1 and 2, both Tie receptors, VEGF-A and -D, VEGFR2, and neuropilin 1. Expression of these factors was found to be maximal during the phase of active distraction. Expression of mRNA for extracellular matrix proteins and BMPs was also maximal during this period. A comparison between the patterns of gene expression in fracture healing and distraction osteogenesis revealed similarities; however, the expression of a number of genes showed selective expression in these two types of bone healing. These data suggest that bone formation during distraction osteogenesis is accompanied by the robust induction of factors associated with angiogenesis and support further investigations to elucidate the mechanisms by which angiogenic events promote bone repair and regeneration.

Predominant integrin ligands expressed by osteoblasts show preferential regulation in response to both cell adhesion and mechanical perturbation.
Carvalho RS1, Bumann A, Schaffer JL, Gerstenfeld LC.


Previous studies have demonstrated that both mechanical perturbation and cell adhesion induced the expression of osteopontin (opn) by osteoblasts (Carvalho et al. [1998] J. Cell. Biochem. 70:376-390). The present study examined if these same stimuli on osteoblasts would induce the expression of other integrin binding proteins, specifically fibronectin (fn) and bone sialoprotein (bsp). All three genes showed three- to four-fold maximal induction in response to both cell adhesion and a single 2-h period of an applied spatially uniform, dynamic biaxial strain of 1.3% at 0.25 Hz. Each gene, however, responded with a different time course of induction to mechanical strain, with bsp, fn, and opn showing their maximal response at 1, 3, and 9 h, respectively, after the perturbation period. In contrast, peak induction to cell adhesion was observed at 24 h for bsp and opn, while fn levels peaked at 8 h. Interestingly, while both opn and fn mRNA expression returned to base line after cell adhesion, bsp mRNA levels remained elevated. Examination of collagen type I and osteocalcin mRNAs showed unaltered levels of expression in response to either type of perturbation. A common feature of the signal transduction pathways, which mediate the gene expression in response to both cell adhesion and mechanical perturbation, was the activation of specific tyrosine kinases based on the ablation of the induction of these genes by the tyrosine kinase inhibitor genistein. While cycloheximide blocked the induction of all three mRNAs in response cell adhesion, it failed to block the induction of any of these genes in response to mechanical perturbation. Such results suggest that the induction of these genes after mechanical perturbation was mediated by an immediate response to signal transduction, while cell adhesion mediated effects secondary to signal transduction. Depolymerization of microfilaments with cytochalasin D had no effect on the overall expression of any of these genes in response to cell adhesion and only blocked the induction of opn expression in response to mechanical perturbation. These results suggest that cytoskeletal integrity is only selectively important in the signal transduction of certain types of stimuli and for the regulation of certain genes. In summary, both mechanical perturbation and cell adhesion stimulated the expression of integrin binding proteins. Furthermore, while there are common features in the signal transduction processes that mediate the induction of these genes in response to both stimuli, specific genes are separately regulated by precise mechanisms that are unique to both forms of stimuli.

Selective adhesion of osteoblastic cells to different integrin ligands induces osteopontin gene expression.​​

Carvalho RS1, Kostenuik PJ, Salih E, Bumann A, Gerstenfeld LC.​

Skeletal homeostasis is partly regulated by the mechanical environment and specific signals generated by a cell's adhesion to the matrix. Previous studies demonstrated that osteopontin (OPN) expression is stimulated in response to both cellular adhesion and mechanical stimulation. The present studies examine if specific integrin ligands mediate osteoblast selective adhesion and whether opn mRNA expression is induced in response to these same ligands. Embryonic chicken calvaria osteoblastic cells were plated on bacteriological dishes coated with fibronectin (FN), collagen type I (Col1), denatured collagen/gelatin (G), OPN, vitronectin (VN), laminin (LN) or albumin (BSA). Osteoblastic cells were shown to selectively adhere to FN, Col1, G and LN, yet not to VN, OPN or BSA. Opn mRNA expression was induced by adhesion to Col1, FN, LN and G, but neither OPN nor VN induced this expression. Examination of the activation of the protein kinases A and C second signaling systems showed that only adhesion to FN induced protein kinase A and protein kinase C (PKC) activity while adherence to Col1 induced PKC. Evaluation of the intracellular distribution of focal adhesion kinase (FAK) and p-tyrosine within cells after adherence to FN, VN or BSA demonstrated that adherence to FN stimulated FAK translocation from the nucleus to the cytoplasm and high levels of p-tyrosine localization at the cell surface. However, cell adherence to VN or BSA did not show these morphological changes. These data illustrate that osteoblast selective adhesion is mediated by specific integrin ligands, and induction of intracellular second signal kinase activity is related to the nature of the ligand.​










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