In this review, most of the known and postulated mechanisms of osteopontin (OPN) and its role in bone remodeling and orthodontic tooth movement are discussed based on available literature. OPN, a multifunctional protein, is considered crucial for bone remodeling, biomineralization, and periodontal remodeling during mechanical tension and stress (orthodontic tooth movement). It contributes to bone remodeling by promoting osteoclastogenesis and osteoclast activity through CD44- and αvβ3-mediated cell signaling. Further, it has a definitive role in bone remodeling by the formation of podosomes, osteoclast survival, and osteoclast motility. OPN has been shown to have a regulatory effect on hydroxyapatite crystal (HAP) growth and potently inhibits the mineralization of osteoblast cultures in a phosphate-dependent manner. Bone remodeling is vital for orthodontic tooth movement. Significant compressive and tensional forces on the periodontium induce the signaling pathways mediated by various osteogenic genes including OPN, bone sialoprotein, Osterix, and osteocalcin. The signaling pathways involved in the regulation of OPN and its effect on the periodontal tissues during orthodontic tooth movement are further discussed in this review. A limited number of studies have suggested the use of OPN as a biomarker to assess orthodontic treatment. Furthermore, the association of single nucleotide polymorphisms (SNPs) in OPN coding gene Spp1 with orthodontically induced root resorption remains largely unexplored. Accordingly, future research directions for OPN are outlined in this review.

Objective To analyse through a systematic review the effectiveness of clear aligners by assessing: (a) predictability of clear aligners and (b) treatment outcome comparison of clear aligner therapy with fixed appliance therapy. Methods An electronic search was made from January 2014 to April 2019 using MEDLINE, Embase, Web of Science and LILACS databases without any limitations on language. Three reviewers independently assessed the articles. Quality assessment of observational studies and randomized control trial was done by using the ROBINS tool and Cochrane risk of bias tool, respectively. GRADE instrument was used to assess certainty level for each identified outcome. Results Seven eligible articles (one randomized controlled trial and six retrospective cohort) were included in our systematic review. Most of the studies (six out of seven) had a moderate risk of bias and one had a high risk of bias. Conclusions ‘Low to moderate level’ of certainty in regard to specific clear aligner therapy tooth movements’ efficiency was identified. Clear aligners may produce clinically acceptable outcomes that could be comparable to fixed appliance therapy for buccolingual inclination of upper and lower incisors in mild to moderate malocclusions. However, not all potential clinical scenarios have been assessed in the included studies. Most of the tooth movements may not be predictable enough to be accomplished with only one set of trays with clear aligners despite the recent advances in technology.

Cancer stem cells (CSCs) are a small and elusive subpopulation of self-renewing cancer cells with remarkable ability to initiate, propagate, and spread the malignant disease. In addition, they exhibit increased resistance to anticancer therapies, thereby contributing to disease relapse. CSCs are reported to be present in many tumor types such as melanoma, sarcoma, mammary tumors, colon cancer and other solid tumors. These cells from different tumors show unique energetic and metabolic pathways. For example, CSCs from one type of tumor may predominantly use aerobic glycolysis, while from another tumor type may utilize oxidative phosphorylation. Most commonly these cells use fatty acid oxidation and ketone bodies as the main source of energy production. CSCs have a remarkable ability to reprogram their metabolism in order to survive under adverse conditions such as hypoxia, acidosis, and starvation. There is increasing interest to identify molecular targets that can be utilized to kill CSCs and to control their growth. In this review, we discuss how an understanding of the unique metabolism of CSCs from different tumors can offer promising strategies for targeting CSCs and hence to prevent disease relapse and to treat the metastatic disease.