Treatment of a wide alveolar cleft with initial application of segmental distraction osteogenesis is reported, in order to minimise cleft size prior to secondary alveolar bone grafting. The lesser maxillary segment was mobilised with osteotomy at Le Fort I level and, a novel distractor, facilitated horizontal movement of the dental/alveolar segment along the curvature of the maxillary dental arch. Following a latency period of 4 days distraction was applied for 7 days at a rate of 0.5 mm twice daily. Radiographic, ultrasonographic and clinical assessment revealed new bone and soft tissue formation 8 weeks after completion of the distraction phase. Overall the maxillary segment did move minimising the width of the cleft, which allowed successful closure with a secondary alveolar bone graft.
Bousdras, Vasilios A.; Liyanage, Chandra; Mars, Michael; Ayliffe, Peter R
Various techniques have been proposed for the repair of palatal clefts. The first surgical closure technique that should be kept in mind is the use of adjacent mucosal flaps. When the palatal cleft is too large to close with adjacent mucosal flaps, distant flaps such as from the tongue or nasolabial region may be considered. This report presents a cleft patient who had previously undergone an unsuccessful palatal cleft repair with a tongue flap. The size of the large palatal fistula was reduced by approximating the segments to each other with maxillary anterior segmental distraction osteogenesis to make it more manageable using conventional mucosal flaps. PMID:17214539
Alkan, Alper; Ba?, Burcu; Ozer, Mete; Bayram, Mehmet
Severe bone loss due to pathology in the maxillary tuberosity region is a challenging problem both surgically and prosthetically. Large bone grafts have a poor survival rate due to the delicate bony architecture in this area and presence of the maxillary sinus. Our case presentation describes a new technique for reconstructing severe bony defect in the maxillary tuberosity with horizontal distraction osteogenesis in a 45-year-old man. A 4 × 6 × 3?cm cyst was discovered in the left maxillary molar region and enucleated. Three months postoperatively, the area had a severe bone defect extending to the zygomatic buttress superiorly and hamular notch posteriorly. Three months later, a bone segment including the right upper second premolar was osteotomised and distracted horizontally. The bone segment was distracted 15?mm distally. After consolidation, implants were placed when the distractor was removed. A fixed denture was loaded over the implants after 3 months. Complete alveolar bone loss extending to the cranial base can be reconstructed with transport distraction osteogenesis. Distalisation of the alveolar bone segment adjacent to the bony defect is an easy method for reconstructing such severe defects.
Ugurlu, F.; Basel, B.; Sener, B. Cem; Sertgoz, A.
Severe bone loss due to pathology in the maxillary tuberosity region is a challenging problem both surgically and prosthetically. Large bone grafts have a poor survival rate due to the delicate bony architecture in this area and presence of the maxillary sinus. Our case presentation describes a new technique for reconstructing severe bony defect in the maxillary tuberosity with horizontal distraction osteogenesis in a 45-year-old man. A 4 × 6 × 3?cm cyst was discovered in the left maxillary molar region and enucleated. Three months postoperatively, the area had a severe bone defect extending to the zygomatic buttress superiorly and hamular notch posteriorly. Three months later, a bone segment including the right upper second premolar was osteotomised and distracted horizontally. The bone segment was distracted 15?mm distally. After consolidation, implants were placed when the distractor was removed. A fixed denture was loaded over the implants after 3 months. Complete alveolar bone loss extending to the cranial base can be reconstructed with transport distraction osteogenesis. Distalisation of the alveolar bone segment adjacent to the bony defect is an easy method for reconstructing such severe defects. PMID:22701190
Ugurlu, F; Basel, B; Sener, B Cem; Sertgöz, A
Patients with cleft lip and palate with severe maxillary retrusion usually have a mandible with anterior-superior autorotation and subsequent overclosure and loss of the vertical facial dimension. Maxillary distraction osteogenesis can correct the sagittal maxillomandibular relationship and should simultaneously reestablish vertical dimension through maxillary vertical height increase and clockwise rotation of the mandible to restore facial balance. We present a two-dimensional mathematical model in the sagittal plane, which reestablishes sagittal and vertical skeletal deficiencies and proper occlusal alignment for planning maxillary advancement with distraction osteogenesis in patients with cleft lip and palate. The model is illustrated in a case of a 13-year-old boy with a complete bilateral cleft lip and palate and severe maxillary retrusion. The two-dimensional mathematical model described in this article allows the surgeon and orthodontist to calculate in a simple and accurate way the ideal distraction vector to advance the maxilla to its desired position. PMID:11314377
Swennen, G; Figueroa, A A; Schierle, H; Polley, J W; Malevez, C
Purpose: This study evaluated skeletal and dental relapse in the dog after anterior maxillary advancement using an implant-anchored distraction osteogenesis device.Materials and Methods: After the placement of implants into the palate, four dogs had a skeletally anchored distraction device fabricated and an anterior maxillary osteotomy performed. The distraction device was activated 0.5 mm two times each day to advance the
Michael S Block; Richard Akin; Andrew Chang; G. Bradley Gottsegen; Diana Gardiner
The effective maxillary orthopedic protraction is an innovative technique for maxillary protraction in Class III growing patients. It includes three components: a new 2-hinged rapid maxillary expander for a greater amount of anterior displacement of maxilla, repetitive weekly protocol of Alternate Rapid Maxillary Expansion and Constriction (Alt-RAMEC) for disarticulating the maxilla, and intraoral maxillary protraction springs for non-compliant protraction. On average, the maxilla could be protracted for 5.8 mm in 3 months and the result remains stable at least 2 years later. The rationale for this technique is sutural expansion/ protraction osteogenesis. Sutural expansion/ protraction osteogenesis is a form of distraction osteogenesis. However, it still needs to be scrutinized experimentally for the sutural reactions corresponding to the effective maxillary orthopedic protraction. PMID:16276426
Liou, Eric Jein-Wein
This case report describes a new surgical orthodontic approach involving alveolar bone distraction osteogenesis for correction of an asymmetric maxillary dental arch. The treatment was combined with conventional orthognathic surgery to improve the mandibular lateral deviation. This new treatment strategy produced an ideal dental arch and a symmetric facial appearance efficiently and effectively. PMID:23374934
Ohba, Seigo; Tobita, Takayoshi; Tajima, Nobutaka; Matsuo, Kyoko; Yoshida, Noriaki; Asahina, Izumi
Maxillary distraction osteogenesis (DO) is a reliable treatment for severe maxillary deficiency in cleft lip and palate (CLP). The objective was to analyze its long-term effects on the mandible. A retrospective study of 24 CLP treated with maxillary DO using the Polley and Figueroa technique was done; patients were followed for more than 4 years. Preoperative (T0), 6-12 months postoperative (T1), and ? 4 years postoperative (T2) cephalometric radiographs were evaluated. A classical cephalometric analysis was used to assess treatment stability, and a Procrustes superimposition method was used to assess local changes in the shape of the mandible. The mean age of patients at T0 was 15.4 ± 4.1 years. SNA increased at T1 and T2 (P < 0.001), with no significant relapse between T1 and T2, indicating stability at 1 year after treatment (T0 = 72.4 ± 5.3°; T1 = 81.3 ± 6.2°; T2 = 79.9 ± 6.1°). SNB, facial angle, gonial angle, and symphyseal angle remained stable. Long-term analysis of the mandible demonstrated a minimal counter-clockwise rotation of the body (mandibular plane = -0.2 ± 3.2°) and ramus (-0.6 ± 4.3°). Maxillary DO in CLP had no significant effect on the shape or rotation of the mandible. The maxillary advancement remained stable after 1 year. PMID:24630071
Doucet, J-C; Herlin, C; Bigorre, M; Bäumler, C; Subsol, G; Captier, G
Maxillary mucoceles are a relatively rare entity especially following surgical procedures involving osteotomies of the maxilla. The etiology of maxillary mucoceles has been ascribed to facial trauma (fractures), sinus surgery, and chronic inflammatory diseases or infections. Mucoceles can follow injury to the sinus mucosa and/or sinus outflow tract with a resulting expansile cystic mass. The clinical presentation ranges from swelling, pain, a palpable mass, proptosis, enophthalmos, and diplopia. The treatment involves either open or endoscopic incision and drainage of the cyst, mucosal resection, and an antrostomy for drainage.We report the case of a patient with Pfeiffer syndrome who underwent Le Fort III distraction osteogenesis and developed a symptomatic mucocele 15 years postoperatively. PMID:24220390
Patel, Parit A; Warren, Stephen M; McCarthy, Joseph G
Severe obstructive sleep apnea syndrome (OSAS) threatens patients' lives. To solve ventilation problem, snoring, and avoid another orthognathic surgery for mandibular advancement, bone-anchored rapid maxillary expansion and bilateral interoral mandibular distraction osteogenesis were tried on a 20-year-old Chinese male patient with severe skeletal class II malocclusion and OSAS.The patient had polysomnography (apnea-hypopnea index 54.2), body mass index measurement (19.7 kg/m), and cephalometry before the treatment. Bone-anchored rapid maxillary expansion was performed for the correction of maxillary transverse and minor sagittal deficiency and the improvement of nasal airflow by decreasing nasal resistance. Bilateral interoral mandibular distraction osteogenesis was operated to lengthen the small, retruded mandible by 15 mm. Orthodontic treatment after the maxillary expansion and mandibular distraction osteogenesis can help obtain stable occlusion.The Epworth Sleepiness Scale, a questionnaire for temporomandibular joint, cephalometric analysis, polysomnography, acoustic rhinometry, and multislice spiral computed tomography were performed to evaluate changes from the treatment. All the results showed that the patient had a significantly alleviated OSAS. In addition, an acceptable occlusion was also obtained. PMID:23714918
Nie, Ping; Zhu, Min; Lu, Xiao-Feng; Fang, Bing
The loss of mandibular molars can result in a maxillary dentoalveolar extrusion, leading to an insufficient interarch space. In severe cases, this space must be regained before the prosthetic reconstruction of the opposite edentulous area. The posterior maxillary segmental osteotomy (PMSO) is a simple but precision technique to manage this problem; without which one can achieve a good surgical outcome but a poor final occlusion. The purpose of this paper was to present a case of PMSO for mandibular implant placement and to discuss the important steps. PMID:17052616
Meningaud, Jean-Paul; Pitak-Arnnop, Poramate; Corcos, Laurent; Bertrand, Jacques-Charles
This study aimed to evaluate, via computed tomography, the direction and magnitude of the segmental tilting that may occur after surgically assisted rapid maxillary expansion (SARME) in patients with a transverse maxillary deficiency. Thirty adult patients with a transverse maxillary deficiency greater than 5mm were treated by SARME. The procedures consisted of bilateral zygomatic buttress and midpalatal osteotomies combined with the use of a tooth-borne orthopaedic device postoperatively. Axial and coronal images were obtained before and 6 months after SARME to evaluate the segment tilting. The greatest expansion occurred in the most inferior (5.4 ± 1.1 mm) and anterior (4.0 ± 1.3 mm) regions of the maxilla. The expanded segment tilted outward inferiorly and anteriorly in coronal and axial images, respectively. The segment tilting was 2.0 mm (2.3%) inferiorly and 3.1mm (12.8%) anteriorly. It can be concluded that an outward tilting occurs in the most inferior and anterior portions of the maxilla during SARME procedures. Hence the direction and magnitude of such segmental tilting must be considered preoperatively when determining the surgical objectives. PMID:24042067
Daif, E T
In the last few years, distraction techniques have been used successfully to correct the hypoplastic human mandible. In patients with cleft lip and palate, normal growth of the maxilla may be impaired by early cleft repair, and many of them do not respond to orthodontic procedures alone. Maxillary distraction is an alternative technique to correct maxillary hypoplasia during mixed dentition. In the last 3 years, the procedure was performed in 38 patients aged between 6 and 12 years; 18 patients had unilateral cleft lip and palate, 9 patients had bilateral cleft lip and palate, 7 patients had unilateral cleft palate, 2 patients had prognathism, and 2 patients had nasomaxillary dysplasia. Photographs, posteroanterior and lateral cephalograms, and dental models are obtained preoperatively (as well as an orthopantomogram) to locate the tooth buds. A subperiosteal dissection is performed exposing the anterior and lateral aspects of the maxilla, and an incomplete horizontal osteotomy is done above the tooth buds. Using a facial mask and an intraoral fixed appliance system as an anchorage, we initiate on the fifth postoperative day the application of distraction forces. Maxillary advancement between 4 and 12 mm is achieved during 3 to 4 weeks, and a satisfactory class I or II molar relationship is also obtained. A combination of forward and downward distraction forces can be used to achieve simultaneous advancement and elongation of the hypoplasic maxilla. The aesthetic results are excellent, and the nasolabial angle is increased, including a more anterior projection of the upper lip. Nasal breathing is improved as well as the air flow and patency of the nasal airway. Velopharyngeal function remains unchanged after the procedure. The follow-up in this series varied from 6 months to 3 years. No relapses have been observed. PMID:9514327
Molina, F; Ortiz Monasterio, F; de la Paz Aguilar, M; Barrera, J
X-linked agammaglobulinemia (XLA) is a congenital immune deficiency disorder caused by abnormal antibody production. It is a rare disease with an estimated frequency of 1 in 379,000 that has X-linked recessive heredity and develops only in males. The clinical problems include bacterial infection such as otitis media, sinusitis, and bronchitis. In recent years it has become possible to diagnose XLA in the early stage and intravenous immunoglobulin replacement therapy has permitted survival to adulthood. However, there have been no reports of oral surgery in patients with XLA. Here, we describe a case in which immunoglobulin replacement therapy given pre- and postoperatively was used to control infection in oral surgery and maxillary distraction osteogenesis performed for improving occlusion and appearance of a cleft lip and palate in a patient with XLA. PMID:24947966
Sato, Yutaka; Mishimagi, Takashi; Katsuki, Yuko; Harada, Kiyoshi
Background The purpose of this study was to investigate the lip and occlusal cant changes in hemifacial microsomia (HFM) cases after\\u000a simultaneous maxilla and mandibular distraction osteogenesis (DO) of the mandible.\\u000a \\u000a \\u000a \\u000a \\u000a Patients and Methods Retrospective analysis of all HFM cases at Balaji Dental and Craniofacial Hospital were performed. Patient of either gender\\u000a with all medical imaging records and pre and post-operative (6 months)
S. M. Balaji
A model was established in 39 dogs to investigate the growth factor modulation of regenerate bone in distraction osteogenesis. A segment of the diaphysis of the radius was resected unilaterally. An osteotomy was made proximal to the segmental defect to create a transport segment. A monolateral external fixator was applied. After a latency period, the segment was transported across the defect. One week after the transport assembly contacted the distal pin clamp, an ipsilateral osteotomy of the proximal ulna was performed. In 20 dogs, transforming growth factor-beta was injected into the regenerate bone halfway through the transport period. Four dogs were sacrificed before docking, when the regenerate bone was still immature. In specimens harvested halfway through the transport period, evidence was found of intramembranous ossification during distraction. In specimens harvested after the transport assembly contacted the distal pin clamp, evidence was found that the mature regenerate formed by endochondral ossification. Therefore, a combined mechanism of ossification is proposed for this segmental defect model that includes mechanical stimulus for bone differentiation. The one-time administration of transforming growth factor-beta retarded the formation of a stable, united regenerate. It is concluded that transforming growth factor-beta caused an effect opposite to that which was desired. PMID:11127665
Sciadini, M F; Dawson, J M; Banit, D; Juliao, S F; Johnson, K D; Lennington, W J; Schwartz, H S
Surgically assisted rapid maxillary expansion (SARME) is a well-documented and established procedure indicated to treat maxillary transverse deficiencies in the adult patient. Currently, the most popular SARME technique consists of performing a Le Fort I osteotomy without downfracture and a midline osteotomy that splits the maxilla into 2 halves between the central incisors. It is supposed that the 2 halves expand equally during the activation phase. However, after completion of the osteotomies, the expander is supported by only mobile segments; thus, if 1 side remains more resistant than the other, the less resistant side expands more than the other, resulting in asymmetric expansion of the maxilla. When this complication occurs in SARME, an open revision surgery is necessary to remove bone interferences that prevent bone movement on the resistant segment or to create resistance on the other half. An alternative SARME technique consists of performing an osteotomy above the maxillary apical roots, similar to the Le Fort I osteotomy, and bilateral transalveolar osteotomies between the lateral incisors and canines, dividing the maxilla into 3 segments: a central fixed segment containing the incisors and 2 lateral segments that are expanded. Some advantages of 3-segment SARME have been described, such as a less esthetic compromise resulting from the midline diastema, less midline dental papilla compromise, preservation of the nasopalatine bundle, and greater acceptance of the procedure. This article describes another advantage of 3-segment SARME: the possibility to treat asymmetric expansions of the maxilla with an easy and conservative technique. PMID:24045191
Pary, Augusto; Cal-Neto, Julio P
We investigated the reconstruction of a surgically created critical size mandibular defect in sheep using a newly developed automatic distraction device. The device has an implantable component, which is fixed to the mandible to allow the transfer of the transport disc across the created defect, and an external component which is mounted on the activation pump and secured away from the site of bone distraction. Compression of the bellows in the external component causes fluid to be forced through the connecting tube into the distraction component. Distraction at a rate of 1 mm over 24 h was achieved in six sheep. New bone generated at the site of the created defects both anterior (compression side) and posterior (tension side) to the transport disc and had similar radiodensity to the adjacent mandibular bone eight weeks after the completion of distraction. PMID:11601816
Ayoub, A F; Richardson, W; Koppel, D; Thompson, H; Lucas, M; Schwarz, T; Smith, L; Boyd, J
Abstract.Distraction osteogenesis is an alternative method for reconstructing atrophic alveolar bone. Fourteen patients underwent vertical alveolar distraction by the LEAD SYSTEM™-Endosseous Alveolar Distraction System (Stryker Leibinger, Kalamazoo, MI). An alveolar segmental osteotomy was carried out and the vertical distraction device was mounted. In patients with an extensive alveolar defect, two distraction devices were placed in order to better control the
A. Rachmiel; S. Srouji; M. Peled
Distraction osteogenesis is an alternative treatment option for patients with facial asymmetry and mandibular hypoplasia. New bone is formed between bone segment surfaces that are gradually separated by incremental traction. The purpose of this article is to report the treatment of a 22-year-old man with hemifacial microsomia, facial asymmetry, and a skeletal Class II profile. The patient's left mandibular ramus was lengthened with distraction osteogenesis, and miniscrew-assisted rapid palatal expansion was used to correct the maxillary transverse deficiency. Postoperative orthodontic treatment achieved tooth alignment and closure of the posterior open bite. The total treatment period was 27 months. These therapeutic treatments improved the patient's facial appearance. PMID:24373657
Choi, Sung-Hwan; Kang, Da-Young; Hwang, Chung-Ju
Experimental tibial lengthening was achieved in 61 rabbits to examine the effect of continuous local infusion of recombinant human fibroblast growth factor-2 (rhFGF-2) on bone healing of the lengthened segment. The tibial diaphysis was separated by osteotomy and was subjected to slow progressive distraction (rate: 0.35 mm/12 h) using a monolateral external fixator. There were a lag phase for 1 week, a distraction phase for 2 weeks, and a consolidation phase for 5 weeks in this experiment. At various stages of distraction, rhFGF-2 was infused continuously for 2 weeks into the lengthened segment (rate: 14.28 microg/60 microl/day) using an osmotic pump implanted under the skin. Bone healing was significantly accelerated when rhFGF-2 was infused in the beginning of consolidation phase, but not in the distraction phase or in the lag phase. Infusion of normal saline (N/S) using the same osmotic pump had no effect. Dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computerized tomography (pQCT) studies demonstrated that rhFGF-2-treated tibia had increased bone mineral density (BMD), bone mineral content (BMC) and cortical bone thickness (CBT) when compared with N/S-treated tibia. Three-point bending test demonstrated that rhFGF-2-treated bone had significantly stronger mechanical properties than N/S-treated bone. Finally, distribution of the infused materials was checked by using Indian ink or radio-opaque. The dyes distributed widely but exclusively in the lengthened segment. Based on these results, we conclude that direct delivery of rhFGF-2 into the lengthened segment can shorten the consolidation phase of limb lengthening and the method is applicable to the clinical treatment. PMID:17939975
Abbaspour, Aziz; Takata, Shinjiro; Sairyo, Koichi; Katoh, Shinsuke; Yukata, Kiminori; Yasui, Natsuo
Objective The purpose of this case study is to describe the chiropractic management of chronic low back pain in a patient with adjacent segment disease. Clinical Features The patient was a 30-year-old man with a 3-year history of chronic nonspecific low back pain following a lumbar disk herniation. Two years before this incident, he had severe lumbar fractures and cauda equina injury due to an aviation accident that required multilevel lumbar fusion surgery, vertebrectomy, and cage reconstruction. Intervention and Outcome The patient received chiropractic management using Cox Flexion Distraction over a 4-week period. A complete reduction of symptoms to 0/10 on a verbal numerical rating scale was achieved within 4 weeks. At 3 months, the patient was able to work 8 to 9 hours per day in his dental practice with no pain. At 9 months, the patient continued to report a complete reduction of symptoms. Conclusions This report describes the successful management of a patient with chronic low back pain associated with adjacent segment disease using Cox Flexion Distraction protocols.
Greenwood, Dean M.
BACKGROUND CONTEXT The intervertebral disc is a common source of low back pain. Prospective studies suggest that treatments that intermittently distract the disc might be beneficial for chronic low back pain. Although the potential exists for distraction therapies to affect the disc biomechanically their effect on intradiscal stress is debated. PURPOSE To determine if distraction alone, distraction combined with flexion or distraction combined with extension can reduce nucleus pulposus pressure and posterior anulus compressive stress in cadaveric lumbar discs compared to simulated standing or lying. STUDY DESIGN Laboratory study using single cadaveric motion segments. OUTCOME MEASURES Strain gauge measures of nucleus pulposus pressure and compressive stress in the anterior and posterior annulus fibrosus METHODS Intradiscal stress profilometry was performed on 15 motion segments during 5 simulated conditions: standing, lying, and 3 distracted conditions. Disc degeneration was graded by inspection from 1 (normal) to 4 (severe degeneration). RESULTS All distraction conditions markedly reduced nucleus pressure compared to either simulated standing or lying. There was no difference between distraction with flexion and distraction with extension in regard to posterior annulus compressive stress. Discs with little or no degeneration appeared to distributed compressive stress differently than those with moderate or severe degeneration. CONCLUSIONS Distraction appears to predictably reduce nucleus pulposus pressure. The effect of distraction therapy on the distribution of compressive stress may be dependent in part on the health of the disc.
Gay, Ralph E.; Ilharreborde, Brice; Zhao, Kristin D.; Berglund, Lawrence J.; Bronfort, Gert; An, Kai-Nan
Articular hip distraction can be applied either by using a monolateral articulated distractor or a circular fixator. The fixator should be aligned such that its axis is aligned with the transverse axis of the hip joint. Following distraction, the range of motion is maintained with regular physiotherapy. It is a useful salvage procedure in older children with hip stiffness, when other methods of containment are not applicable. PMID:21742148
Hosny, Gamal Ahmed
This case report describes the treatment of a 16-year-old girl with a unilateral posterior buccal crossbite, a unilateral Class II molar relationship, and a maxillary right canine high in the labial sulcus. The treatment plan included surgically assisted unilateral maxillary expansion for the correction of the buccal crossbite, with simultaneous dentoalveolar distraction of the maxillary right canine into the extraction space of the first premolar aided by skeletal anchorage. Reduced orthodontic treatment time was facilitated by these 2 surgical procedures. A pleasing esthetic result and a good functional occlusion were achieved in 13 months. PMID:23910210
Uribe, Flavio; Agarwal, Sachin; Janakiraman, Nandakumar; Shafer, David; Nanda, Ravindra
Background: The objectives of this study were to evaluate the rate of canine distalization by segmental alveolar distraction method in first premolar extraction cases, to evaluate the displacement of the canine and first molar teeth, to assess the effects of the procedure on the pulpal vitality of the canines, and to determine the amount of root resorption in retracted canines. Materials & Methods: The sample of the study consisted of 20 teeth in 7 patients (five females and two males, mean age 18.5 years). After the osteotomy procedure distractor was fixed. After 3 days of consolidation period, the distractor was activated 3 quarter turns per day(0.75 mm/day) till the canines comes in contact with second premolar. An electrical vitality test was applied before and after the distraction procedure and during the follow-up period. Results: The mean distal retraction of canines was 7.262 ± 0.4864 mm. The distal displacement of the canine was mainly a combination of tipping and translation. The mean distraction procedure was completed in 14.60 ±1.536 days. The duration of retraction was less for mandibular canine compared to maxillary canine. The mean posterior anchorage loss was mean 0.50±0.688 mm. The amount of root resorption that occurred during distraction was clinically insignificant. None of the teeth reacted negatively to the electrical vitality test that was performed 6 months after the completion of the distraction procedure. There was no clinical sign of discoloration or pulpal pain in any tooth. Conclusion: With dentoalveolar distraction, as canines can be fully retracted in 12 to 16 days, the non-compliance patients, patients with root-shape malformations, periodontal problems, or ankylosed teeth will benefit from this technique. The anchorage teeth can withstand the retraction forces better with no anchorage loss, and without clinical or radiographic evidence of root resorption, ankylosis, periodontal problems, and soft tissue dehiscence. This technique reduces orthodontic treatment duration by 6 to 9 months in patients who need extraction, with no need for any sort of anchorage reinforcement. How to cite this article: Kumar N, Prashantha GS, Raikar S, Ranganath K, Mathew S, Nambiar S. Dento-Alveolar Distraction Osteogenesis for rapid Orthodontic Canine Retraction. J Int Oral Health 2013; 5(6):31-41 .
Kumar, Naveen; Prashantha, GS; Raikar, Sudhir; Ranganath, Krishnappa; Mathew, Silju; Nambiar, Sandeep
Background: The objectives of this study were to evaluate the rate of canine distalization by segmental alveolar distraction method in first premolar extraction cases, to evaluate the displacement of the canine and first molar teeth, to assess the effects of the procedure on the pulpal vitality of the canines, and to determine the amount of root resorption in retracted canines. Materials & Methods: The sample of the study consisted of 20 teeth in 7 patients (five females and two males, mean age 18.5 years). After the osteotomy procedure distractor was fixed. After 3 days of consolidation period, the distractor was activated 3 quarter turns per day(0.75 mm/day) till the canines comes in contact with second premolar. An electrical vitality test was applied before and after the distraction procedure and during the follow-up period. Results: The mean distal retraction of canines was 7.262 ± 0.4864 mm. The distal displacement of the canine was mainly a combination of tipping and translation. The mean distraction procedure was completed in 14.60 ±1.536 days. The duration of retraction was less for mandibular canine compared to maxillary canine. The mean posterior anchorage loss was mean 0.50±0.688 mm. The amount of root resorption that occurred during distraction was clinically insignificant. None of the teeth reacted negatively to the electrical vitality test that was performed 6 months after the completion of the distraction procedure. There was no clinical sign of discoloration or pulpal pain in any tooth. Conclusion: With dentoalveolar distraction, as canines can be fully retracted in 12 to 16 days, the non-compliance patients, patients with root-shape malformations, periodontal problems, or ankylosed teeth will benefit from this technique. The anchorage teeth can withstand the retraction forces better with no anchorage loss, and without clinical or radiographic evidence of root resorption, ankylosis, periodontal problems, and soft tissue dehiscence. This technique reduces orthodontic treatment duration by 6 to 9 months in patients who need extraction, with no need for any sort of anchorage reinforcement. How to cite this article: Kumar N, Prashantha GS, Raikar S, Ranganath K, Mathew S, Nambiar S. Dento-Alveolar Distraction Osteogenesis for rapid Orthodontic Canine Retraction. J Int Oral Health 2013; 5(6):31-41 . PMID:24453442
Kumar, Naveen; Prashantha, Gs; Raikar, Sudhir; Ranganath, Krishnappa; Mathew, Silju; Nambiar, Sandeep
In 2011, the National Transportation Safety Board urged all states to ban the use of portable electronic devices while driving, including hand-held and hands-free devices. Texting while driving concerns several Texas legislators, who have filed bills, backed by the Texas Medical Association, to ban the practice. TMA physicians recognize that the use of hand-held and hands-free devices and other factors associated with distracted driving affect their patients' safety. PMID:23546834
Surgically assisted rapid maxillary expansion (SARME) is commonly used to correct maxillary transverse deficiency. The aim of this study was to analyse the need for intraoperative liberation of the nasal septum during the procedure. SARME was performed in 25 patients by combining a lateral osteotomy with an inter-radicular maxillary osteotomy. The deviation of the nasal septum after SARME was evaluated by comparing measurements between radiologically defined landmarks on pre- and postoperative computed tomographic images. Two defined angles (angle I, between crista galli-symphysis mandibulae and crista galli-septum nasi; angle II, between maxillary plane and septum nasi) were measured based on four representative planes and septal movement was analysed. The mean changes in angles I (0.03° ± 0.78°) and II (0.25° ± 1.04°) did not differ significantly from zero (p=0.87 and p=0.24, respectively). Observed variations and displacements were considered to be acceptable because they were insignificant in every respect. Intranasal airway function was also examined pre- and postoperatively to evaluate any loss of ventilation. The described surgical technique is a successful method of maxillary segment distraction. The authors found no compelling reason to release the nasal septum in the context of SARME. PMID:23092854
Reinbacher, K E; Wallner, J; Pau, M; Feichtinger, M; Kärcher, H; Quehenberger, F; Zemann, W
Introduction Postoperative alopecia is a relatively rare event, and therefore both patients and surgeons are puzzled once it develops even\\u000a though it is said to improve spontaneously with time in most cases. We report a parieto-occipital pressure-induced alopecia\\u000a firstly developed in a patient who had undergone repeated surgery for 10 years after a traffic accident.\\u000a \\u000a \\u000a \\u000a \\u000a Case report A 29-year-old male underwent segmental osteotomy
Kazuhiro Matsushita; Nobuo Inoue; Kazuhiro Ooi; Yasunori Totsuka
James Sidman, MD, and Sherard A. Tatum, MD, address the following questions for discussion and debate. Is neonatal distraction osteogenesis (DO) better than lip-tongue adhesion or tracheotomy for micrognathic airway compromise? What role does DO have in adult orthognathic surgery situations? In monobloc and Le Fort III procedures, are internal or external devices preferable? What role does DO play in craniofacial microsomia? Is endoscopic DO better than open procedures for synostosis management? How has your technique changed or evolved over the past 5 years and what has doing this technique taught you? PMID:24290998
Sidman, James; Tatum, Sherard Austin
Anterior maxillary osteotomy is frequently applied to skeletal Class II cases with maxillary protrusion. In addition to the anteroposterior problem, these cases are often accompanied with a long midfacial ap- pearance and display of incisors and gingiva during smiling. In the ap- plication of anterior maxillary osteotomy to such patients, it is neces- sary to move the anterior maxillary segments
Chiharu Murakami; Takahiro Takeshima; Maxillofacial Orthognathics
Distraction osteogenesis (DO) can generate new bone in a gap between 2 vascularized bone surfaces in response to application of graduated tensile stress across the bone gap. The authors present the clinical result in a cleft patient with severe maxillary deficiency treated by a rigid external distraction (RED) device. A boy complained of both masticatory and psychological problems because of cleft with severe midfacial retrusion. The treatment aimed to create a well-balanced facial profile, increase maxillary incisal display, create proper overjet and overbite, and align his dentition. By the RED system, the traction is applied to the maxilla through the dentition by an intraoral splint. A complete Le Fort I osteotomy was performed, including pterygomaxillary and septal disjunction, with mobilization. Once osteotomy was completed, the halo portion of the RED device was adjusted for the width of the neurocranium and was rigidly fixed around the head with 2 scalp screws on each side. A well-balanced facial profile and a good alignment of the dentition were obtained. The patients had considerable improvement in his self-esteem. Clinical reports have suggested that maxillary advancements achieved by distraction are more stable than those achieved with orthognathic surgery with a minimal influence on velopharyngeal competence. PMID:24769612
Lucchese, Alessandra; Gherlone, Enrico F; Asperio, Paolo; Baena, Ruggero Rodriguez y
Background: The aim of this clinical prospective study is to apply and evaluate an approach to reduce the overall orthodontic treatment time, by means of dentoalveolar distraction osteogenesis to achieve rapid canine retraction using an indigenously developed intra-oral tooth-borne distraction device. Materials & Methods: This study was carried out in the Department of Orthodontics and Dentofacial Orthopedics. Four patients selected for the purpose of Maxillary and/or Mandibular canine distraction with a rigid custom-made, intra-oral distraction device made of stainless steel and were scheduled for orthodontic treatment with bilateral first premolar extraction and then subsequent bilateral canine teeth distalization. Results: In all the patients the canine teeth moved distally and made contact with the second premolars within 14-16 days range after which they were kept passive, with the appliance for a week of consolidation. The amount of canine retraction was in 7-7.5mms range, in all the patients, in each of the four quadrants studied. Bodily movement, tipping and buccal flaring of the canine teeth were noticed in all the cases. Conclusion: Combination of newer orthodontic appliances and the principles of biomechanics to maintain the control over rapid tooth movement, rapid canine distalization using distraction osteogenesis awaits further development before routine application, of this innovative and exciting approach. How to cite the article: Nair A, Kumar JP, Venkataramana V, Yuvaraj A, Reddy VS, Kumar SK. Dento-Alveolar distraction osteogenesis using rigid intra-oral tooth borne distraction device. J Int Oral Health 2014;6(2):106-13. PMID:24876710
Nair, Arvind; Kumar, J Phani; Venkataramana, V; Yuvaraj, A; Reddy, V Sridhar; Kumar, S Kishore
Background: The aim of this clinical prospective study is to apply and evaluate an approach to reduce the overall orthodontic treatment time, by means of dentoalveolar distraction osteogenesis to achieve rapid canine retraction using an indigenously developed intra-oral tooth-borne distraction device. Materials & Methods: This study was carried out in the Department of Orthodontics and Dentofacial Orthopedics. Four patients selected for the purpose of Maxillary and/or Mandibular canine distraction with a rigid custom-made, intra-oral distraction device made of stainless steel and were scheduled for orthodontic treatment with bilateral first premolar extraction and then subsequent bilateral canine teeth distalization. Results: In all the patients the canine teeth moved distally and made contact with the second premolars within 14-16 days range after which they were kept passive, with the appliance for a week of consolidation. The amount of canine retraction was in 7-7.5mms range, in all the patients, in each of the four quadrants studied. Bodily movement, tipping and buccal flaring of the canine teeth were noticed in all the cases. Conclusion: Combination of newer orthodontic appliances and the principles of biomechanics to maintain the control over rapid tooth movement, rapid canine distalization using distraction osteogenesis awaits further development before routine application, of this innovative and exciting approach. How to cite the article: Nair A, Kumar JP, Venkataramana V, Yuvaraj A, Reddy VS, Kumar SK. Dento-Alveolar distraction osteogenesis using rigid intra-oral tooth borne distraction device. J Int Oral Health 2014;6(2):106-13.
Nair, Arvind; Kumar, J Phani; Venkataramana, V; Yuvaraj, A; Reddy, V Sridhar; Kumar, S Kishore
The author, in continuation of a series of experiments begun previous to 1915 (cf. Kansas Univ. Science Bull., 1915, ^W9,^n 197-243), has discovered that the sounder test, although a severe one on the subject, can be mastered or overcome under unfavorable conditions of distraction and fatigue. The test serves well to determine individual differences in ability to overcome distraction and
F. C. Dockeray
Multitasking is a rapidly growing phenomenon affecting all segments of the population but is rarely as successful as its proponents believe. The use of mobile electronic devices contributes importantly to multitasking and cognitive overload. Although personal electronic devices provide many benefits, their adverse effects are frequently overlooked. Personal observation and a review of the scientific literature supports the view that overuse or misuse of personal electronic devices promotes cognitive overload, impairs multitasking and lowers performance at all ages but particularly in the elderly. This phenomenon appears to be rapidly increasing and threatens to become a tsunami as spreading electronic waves cause an 'epidemic of distraction'. Mobile electronic devices often bring benefits to their users in terms of rapid access to information. However, there is a dark side to the increasing addiction to these devices that challenges the health and well-being of the entire population, targeting, in particular, the aged and infirm. New approaches to information gathering can foster creativity if cognitive overload is avoided. PMID:22572729
Weksler, Marc E; Weksler, Babette B
Objective?This study examined whether increasing the demand for central cognitive processing involved in a distraction task, by involving the child in ongoing, effortful interaction with the distraction stimulus, would increase children's tolerance for cold pressor pain.?Methods?Seventy-nine children ages 6–15 years underwent a baseline cold pressor trial followed by two cold pressor trials in which they received interactive distraction (i.e., used voice commands to play a videogame) or passive distraction (in which they merely watched the output from the same videogame segment) in counterbalanced order. Both distraction conditions were presented via a virtual reality-type helmet.?Results?As expected, children demonstrated significant improvement in pain tolerance during distraction relative to baseline. Children showed the greatest improvement during the interactive distraction task.?Conclusion?The effects of distraction on children's cold pressor pain tolerance are significantly enhanced when the distraction task also includes greater demands for central cognitive processing.
Law, Emily F.; Sil, Soumitri; Weiss, Karen E.; Herbert, Linda Jones; Wohlheiter, Karen; Horn, Susan Berrin
... 3 restrict school bus drivers from texting. Crash Data Collection: Nearly all states include at least one category ... Criteria (MMUCC) guideline provides best practices on distraction data collection. Preemption Laws: Many localities have passed their own ...
Callus distraction is based on the principle of regenerating bone by continuous distraction of proliferating callus tissue. It has become the standard treatment of significant leg shortening and large bone defects. Due to many problems and complications, exact preoperative planning, operative technique and careful postoperative follow-up are essential. External fixators can be used for all indications of callus distraction. However, due to pin tract infections, pain and loss of mobility caused by soft tissue transfixation, fixators are applied in patients with open growth plates, simultaneous lengthening with continuous deformity corrections, and increased risk of infection. Distraction over an intramedullary nail allows removal of the external fixator at the end of distraction before callus consolidation (monorail method). The intramedullary nail protects newly formed callus tissue and reduces the risk of axial deviation and refractures. Recently developed, fully intramedullary lengthening devices eliminate fixator-associated complications and accelerate return to normal daily activities. This review describes principles of callus distraction, potential complications and their management. PMID:15452653
Hankemeier, S; Bastian, L; Gosling, T; Krettek, C
The goal of the system presented in this paper is to support several facial surgeries that are aiming to transform an unsymmetrical face to a symmetric one. There are two main techniques to achieve this goal: distraction of the lower jaw and adding or removing tissue or bone at certain facial regions. Both planning tasks are done based on segmented
Oliver Burgert; Tobias Salb; Tilo Gockel; Rüdiger Dillmann; Stefan Haßfeld; Robert Krempien; S. Walz; Joachim Mühling
A 6-year-old boy, diagnosed with Crouzon syndrome, had moderate exorbitism, a concave profile, an anterior crossbite of -4.0 mm, and a skeletal Class III jaw-base relationship caused by midfacial hypoplasia. At age 8 years 9 months, a LeFort III osteotomy was performed, and distraction osteogenesis was immediately started with the rigid external distractor system. The midface was advanced approximately 10.0 mm for 6 days, including overcorrection. After the distraction, a reverse headgear was used for 6 years to prevent relapse and to accelerate expected growth. At age 16 years 5 months, after extraction of the maxillary first premolars and mandibular third molars, 0.022-in preadjusted edgewise brackets were placed to treat the edge-to-edge incisor relationship and minor crowding. After 13 months of treatment, the facial profile was significantly improved, and an acceptable occlusion was achieved. During the 9-year observation period after the distraction, acceptable facial growth occurred, and no relapse of the maxillary advancement was observed. However, syndrome-specific growth and methodologically induced relapse should be considered when planning a LeFort III distraction in children for the treatment of Crouzon syndrome. PMID:21967944
Kuroda, Shingo; Watanabe, Keiichiro; Ishimoto, Kyoko; Nakanishi, Hideki; Moriyama, Keiji; Tanaka, Eiji
A 24-year-old man with a bilateral cleft lip and palate was treated by a multidisciplinary team composed of an orthodontist, plastic surgeon, and prosthodontist with assistance from an engineer. Before treatment, clinical photographs, dental casts, lateral and posteroanterior cephalograms, periapical and panoramic radiographs, and three-dimensional computed tomography (3D CT) images were obtained. He presented with a narrow and retrognathic maxilla with a 23-mm anterior open bite. Following maxillary expansion with rapid palatal expansion, a Le Fort I maxillary osteotomy was performed, and an internal distractor was placed. After a 5-day latency period, internal maxillary distraction was performed at a rate of 1 mm/day achieved by two activations per day. Cephalometric analysis showed a 7-mm maxillary advancement. Mandibular bilateral sagittal split osteotomy was also performed to close the open bite following maxillary distraction and a 3-month stabilization period. Finally, the treatment was completed with prosthetic rehabilitation. The changes in speech production were evaluated using an automatic speech recognition system. PMID:18788874
Sari, Emel; Ucar, Cihan; Türk, Oytun; Kurtulmus, Huseyin; Altug, H Ayberk; Pocan, Suheyl
The ability to maintain focus and avoid distraction by goal-irrelevant stimuli is critical for performing many tasks and may be a key deficit in attention-related problems. Recent studies have demonstrated that irrelevant stimuli that are consciously perceived may be filtered out on a neural level and not cause the distraction triggered by…
Kim, So-Yeon; Hopfinger, Joseph B.
Pathologic dilatation of the maxillary sinus by air is a rare condition with unclear etiology. We present a case of a 17 year old male with a maxillary air cyst diagnosed by computed tomography. The CT demonstrated air-filled expansion of the maxillary sinus beyond the normal anatomical limits with associated cortical bone thinning. The case report highlights the pathognomonic computed tomography findings of this rare entity and discusses the perplexing nomenclature, proposed etiologies and various treatment options.
Doucette-Preville, Stephane; Tamm, Alexander; Khetani, Justin; Wright, Erin; Emery, Derek
This study compares internal and external distraction devices in the treatment of midface retrusion. 20 patients were treated with midface distraction (12 Crouzon, 4 Apert, 4 others); 12 with internal distraction (MID device), 8 with external distraction (Red or Blue device). The two groups were compared regarding operation time, peroperative blood loss and complications. The groups were comparable regarding patient
T. R. Meling; H.-E. Høgevold; B. J. Due-Tønnessen; P. Skjelbred
This study analyzed the mental distractions of students while reading a text. Ss were asked to press a switch to record mental distractions as they occurred, and a treatment was designed to attempt to reduce the number of distractions. The hypothesis related to the treatment effect was that students given explicit training to reduce distractions…
Schutz, Samuel R.; And Others
Dental distraction is an orthodontic tooth movement technique that allows closure of extraction spaces, usually of premolars, in periods from 1 to 3 weeks, by bodily retraction of the canine. This article reports on canine distalization by using a distractor device obtained from a conventional hyrax screw. The patient was an adolescent boy, aged 17 years 9 months, who came to the clinic with the chief complaint of tooth crowding. The clinical examination showed a convex profile, retroclined and protruded maxillary incisors, buccally tipped and protruded mandibular incisors, and a Class I malocclusion. The treatment comprised extractions and rapid canine distraction procedures. Pretreatment, posttreatment, and 2-year follow-up records are shown and demonstrate that dental distraction is a viable alternative of treatment. With this treatment strategy, satisfactory results were obtained without additional anchorage devices, achieving an attractive smile and optimal occlusion. The main considerations about the treatment alternatives and their clinical concerns are discussed. PMID:23561416
Allgayer, Susiane; Rosenbach, Gabriella; Tavares, Carlos Alberto Estevanell; Polido, Waldemar Daudt
We report a case of an 11-year-old girl presenting with Apert syndrome characterized by midface concavity, protrusion of the eyeballs, and ocular hypertelorism. She had class III anterior crossbite, narrow upper and lower arches, and marked crowding. Based on cephalometric analysis, anterior crossbite associated with marked midfacial hypoplasia was diagnosed. Orthodontic treatment in combination with Le Fort II maxillary distraction was scheduled. The dentition was laterally extended using a Rapid palatal expander in the upper jaw and a Bihelix in the lower jaw. Multi-bracket appliances were simultaneously applied for leveling. Next, Le Fort II maxillary osteotomy was performed to distract the midface bone 16 mm anteroinferiorly using a rigid external distraction system. Orthodontic treatment was completed at 3.8 years after initiation. Bone distraction moved the upper jaw anteriorly downward, and the lower jaw subsequently rotated posteriorly downward, leading to a marked improvement in facial appearance and occlusion. Elongation of the dorsum of the nose, in particular, allowed esthetic improvement of the saddle nose. These improvements remain stable at 2 years after orthodontic treatment. PMID:23614948
Miyazaki, Haruyo; Katada, Hidenori; Ichinokawa, Yoshimi; Hirabayashi, Shinichi; Sueishi, Kenji
The purpose of the study was to test the hypothesis that sound context modulates the magnitude of auditory distraction, indexed by behavioral and electrophysiological measures. Participants were asked to identify tone duration, while irrelevant changes occurred in tone frequency, tone intensity, and harmonic structure. Frequency deviants were randomly intermixed with standards (Uni-Condition), with intensity deviants (Bi-Condition), and with both intensity and complex deviants (Tri-Condition). Only in the Tri-Condition did the auditory distraction effect reflect the magnitude difference among the frequency and intensity deviants. The mixture of the different types of deviants in the Tri-Condition modulated the perceived level of distraction, demonstrating that the sound context can modulate the effect of deviance level on processing irrelevant acoustic changes in the environment. These findings thus indicate that perceptual contrast plays a role in change detection processes that leads to auditory distraction. PMID:23886958
Chen, Sufen; Sussman, Elyse S
... the lower right-hand corner of the player. Teen Driving and Dangerous Distractions HealthDay January 2, 2014 Related MedlinePlus Pages Impaired Driving Motor Vehicle Safety Teen Health Transcript New teen drivers may hit the ...
In 2009, the National Highway Traffic Safety Administration (NHTSA) estimated nearly 6,000 distracted driver fatalities and 515,000 injuries in the United States alone. Distracted driving is a worldwide problem that needs to be addressed. Software is available to disable cell phone usage while driving, but using the advanced technology may require legislation along with a renewed sense of driver responsibility. PMID:23061239
Dildy, Dale W
Custom made maxillary mouthguards made from thermoplastic materials using dental impressions give valuable protection to the teeth and jaws of participants in contact sports. A bimaxillary mouthguard has been described which offers enhanced protection, but with considerable increase in cost. This paper describes a modification to current maxillary mouthguard design that is comfortable to wear, inexpensive to make and which may provide protection comparable to that of a bimaxillary type, while retaining other desirable features of the more complex appliance. Images Fig. 1
Chandler, N P; Wilson, N H; Daber, B S
Studies have documented a link between distracted driving and diminished safety; however, an association between distracted driving and traffic congestion has not been investigated in depth. The present study examined the behavior of teens and young adult...
A. A. Garner C. A. Franklin D. Ball D. Stavrinos K. K. Ball P. R. Fine V. Sisiopiku
Closure of large alveolar clefts and restoration by a fixed bridge supported by implants is a challenge in cleft alveolus treatment. A major aesthetic concern with distraction osteogenesis is obtaining a predictable position of the implant in relation to the newly generated bony alveolar ridge. We describe the treatment of a large cleft alveolus and palate reconstruction by distraction osteogenesis utilizing temporary anchorage devices (TADs) followed by a fixed implant-supported bridge. The method consists of segmental bone transport by distraction osteogenesis using a bone-borne distractor to minimize the alveolar cleft, followed by closure of the residual small defect by bone grafting three months later. During the active transport distraction, TADs were used exerting multidirectional forces to control the distraction vector forward and laterally for better interarch relation. A vertical alveolar distraction of the newly reconstructed bone of 15 mm facilitated optimal implant placement. The endosseous implants were osteointegrated and supported a fixed dental prosthesis. In conclusion, the large cleft alveolus defect was repaired in three dimensions by distraction osteogenesis assisted by TADs, and the soft tissues expanded simultaneously. Endosseous implants were introduced in the newly reconstructed bone for a fixed dental prosthesis enabling, rehabilitation of aesthetics, eating and speaking. PMID:23402733
Rachmiel, Adi; Emodi, Omri; Gutmacher, Zvi; Blumenfeld, Israel; Aizenbud, Dror
Approximately one quarter of vehicle crashes in the United States are estimated to result from the driver being inattentive, or distracted. As more wireless communication, entertainment and driver assistance systems proliferate the vehicle market, the incidence of distraction-related crashes is expected to escalate. In North America, Europe and Japan, driver distraction is a priority issue in road safety. However, the
Kristie Young; Michael Regan; Mike Hammer
Reviews research findings that distracting Ss while they are exposed to a persuasive message increases persuasive impact in certain situations. Various explanations for this phenomenon and the conceptual issues involved are discussed. It is concluded that (a) the distraction effect has empirical validity across many experimental contexts; (b) despite this generality, distraction is not useful as a persuasion technique in
Robert S. Baron; Penny H. Baron; Norman Miller
Distraction osteogenesis has revolutionised the management of craniofacial abnormalities. The technique however requires precise planning, patient selection, execution and follow-up to achieve consistent and positive results and to avoid unfavourable results. The unfavourable results with craniofacial distraction stem from many factors ranging from improper patient selection, planning and use of inappropriate distraction device and vector. The present study analyses the current standards and techniques of distraction and details in depth the various errors and complications that may occur due to this technique. The commonly observed complications of distraction have been detailed along with measures and suggestions to avoid them in clinical practice.
Behavioral analgesic techniques such as distraction reduce pain in both clinical and experimental settings. Individuals differ in the magnitude of distraction-induced analgesia, and additional study is needed to identify the factors that influence the pain relieving effects of distraction. Catastrophizing, a set of negative emotional and cognitive processes, is widely recognized to be associated with increased reports of pain. We sought to evaluate the relationship between catastrophizing and distraction analgesia. Healthy participants completed three sessions in a randomized order. In one session (Pain Alone), pain was induced by topical application of a 10% capsaicin cream and simultaneous administration of a tonic heat stimulus. In another session (Pain+Distraction), identical capsaicin+heat application procedures were followed, but subjects played video games that required a high level of attention. During both sessions, verbal ratings of pain were obtained and participants rated their degree of catastrophizing. During the other session (Distraction Alone) subjects played the video games in the absence of any pain stimulus. Pain was rated significantly lower during the distraction session compared to the "Pain Alone" session. In addition, high catastrophizers rated pain significantly higher regardless of whether the subjects were distracted. Catastrophizing did not influence the overall degree of distraction analgesia; however, early in the session high catastrophizers had little distraction analgesia, though later in the session low and high catastrophizers rated pain similarly. These results suggest that both distraction and catastrophizing have substantial effects on experimental pain in normal subjects and these variables interact as a function of time. PMID:20188470
Campbell, Claudia M; Witmer, Kenny; Simango, Mpepera; Carteret, Alene; Loggia, Marco L; Campbell, James N; Haythornthwaite, Jennifer A; Edwards, Robert R
Involuntary attention switches triggered by infrequent, unpredictably occurring sensory events (distraction) can be prevented when participants are made aware of the forthcoming distractor. Previous studies exploring this phenomenon presented visual cues before each stimulus in an auditory oddball sequence. In one condition, cues were completely reliable in predicting the forthcoming distractor or standard sound, in another, separate condition, they were completely unreliable. These studies found that in the condition with reliable cues, distraction was reduced compared to that with unreliable cues, as signaled by decreased reaction time delay as well as reduced P3a and reorienting negativity event-related potentials. Whereas these results are generally interpreted as the results of preparatory processes initiated by the cues, it could be argued that the preventive effect is a byproduct of increased information processing load in the condition with informative cues compared to that in the condition with uninformative ones. In the present study, using 80% reliable visual cues preceding tones in an oddball sequence, it was demonstrated that distraction can be prevented when the trials with valid and invalid cues were presented within a single experimental condition, as shown by reduced reaction time delay and P3a amplitude. These results are compatible with the notion that the distraction is prevented by means of preparatory processes initiated by the cues. PMID:22178734
Horváth, János; Bendixen, Alexandra
Advanced Driver Assistance (ADA) systems currently operate within vehicles, offering drivers assistance to either avoid hazardous situations, or information to make travelling easier. However, these devices have the potential to contribute to driver distraction as they require a certain level of driver attention in order to provide a benefit, taking cognitive, visual, auditory, and manual resources away from the main
Chad Brooks; Andry Rakotonirainy; Frederic Maire
We developed a rat model of limb lengthening to study the basic mechanism of distraction osteogenesis, using a small monolateral external fixator. In 11-week-old male rats we performed a subperiosteal osteotomy in the midshaft of the femur with distraction at 0.25 mm every 12 hours from seven days after operation. Radiological and histological examinations showed a growth zone of constant thickness in the middle of the lengthened segment, with formation of new bone at its proximal and distal ends. Osteogenic cells were arranged longitudinally along the tension vector showing the origin and the fate of individual cells in a single section. Typical endochondral bone formation was prominent in the early stage of distraction, but intramembraneous bone formation became the predominant mechanism of ossification at later stages. We also showed a third mechanism of ossification, 'transchondroid bone formation'. Chondroid bone, a tissue intermediate between bone and cartilage, was formed directly by chondrocyte-like cells, with transition from fibrous tissue to bone occurring gradually and consecutively without capillary invasion. In situ hybridisation using digoxigenin-11-UTP-labelled complementary RNAs showed that the chondroid bone cells temporarily expressed type-II collagen mRNA. They did not show the classical morphological characteristics of chondrocytes, but were assumed to be young chondrocytes undergoing further differentiation into bone-forming cells. We found at least three different modes of ossification during bone lengthening by distraction osteogenesis. We believe that this is the first report of such a rat model, and have shown the validity of in situ hybridisation techniques for the study of the cellular and molecular mechanisms involved in distraction osteogenesis. PMID:9331045
Yasui, N; Sato, M; Ochi, T; Kimura, T; Kawahata, H; Kitamura, Y; Nomura, S
Three-dimensional (3D) finite element models of a posterior mandibular segment and a distraction implant (DI) were created and assembled in this study. The diameter of distraction screw (DS) was set as input variable, ranging from 1.0 to 3.0mm, to analyze the stress and displacement, in order to obtain an optimal outcome of the DI. The results indicate that when the diameter of DS was 2.0mm, the stresses in jaw bone and DS and the displacement of DS reached a relatively low range. The diameter of DS significantly affects the stress distribution in DI and surrounding bone. The present study demonstrates that from clinical and biomechanical points of view, the optimal diameter of DS is 2.0mm. PMID:24209940
Lu, Songhe; Li, Tao; Zhang, Yongqiang; Lu, Chunlei; Sun, Yingying; Zhang, Junrui; Xu, Dezhong
Nodular fasciitis is a rare and benign inflammatory condition; however, it can be misdiagnosed as a malignant lesion. We report a unique case of nodular fasciitis arising from the maxillary sinus in a 2-year-old child. Our English literature review (PubMed search), revealed a total of 3 cases published as nodular fasciitis in the para-nasal sinuses, each with a different management approach. PMID:24445897
Alsaied, Abdulmalik S; Lotfy, Mohammed A
The objectives of this study were to investigate the treatment effect and stability of fronto-facial monobloc distraction osteogenesis. Five consecutive patients who underwent monobloc distraction were included (aged 4.8-18.4 years). Three patients had Crouzon syndrome, one had Apert syndrome, and one had Pfeiffer syndrome. The evaluation included clinical records, serial cephalograms for at least 1-year follow up (average 24.6 months). The treatment and post-treatment changes were measured. The intracranial volume, upper airway volume and globe protrusion were calculated from CT before and after treatment. After distraction, the supraorbital region was advanced 15.3mm forward, the midface demonstrated forward advancement of 17.7 mm, 22.1mm and 23.1mm at orbitale, anterior nasal spine and A point, respectively. The downward movement was 2-3mm at maxillary level. The intracranial volume increased 11%; the upper airway volume increased 85% on average. Globe protrusion reduced 3.7 mm on average, which was 20% of underlying skeletal movement. Facial growth demonstrated forward remodelling of the supraorbital region, mild downward but no further forward growth of the midface. Monobloc distraction is effective for relieving related symptoms and signs through differential external distraction at different vertical levels of the face. PMID:22094394
Ko, E W-C; Chen, P K-T; Tai, I C-H; Huang, C S
Two distinct cases of maxillary actinomycosis and maxillary candidosis in immunocompetent hosts are reported; These infections are rare and similar to mycotic extramucosal non allergic sinusitis. Microbiology and microscopic examination are mandatory to prompt and successful management. Endoscopic endonasal surgery by middle meatotomy seems to be an adequate treatment for these particular entities. PMID:9770038
Rombaux, P; Degols, J C; Hamoir, M; Garbar, C; Bertrand, B; Eloy
Attention may be distracted from its intended focus both by stimuli in the external environment and by internally generated task-unrelated thoughts during mind wandering. However, previous attention research has focused almost exclusively on distraction by external stimuli, and the extent to which mind wandering relates to external distraction is as yet unclear. In the present study, the authors examined the relationship between individual differences in mind wandering and in the magnitude of distraction by either response-competing distractors or salient response-unrelated and task-irrelevant distractors. Self-reported susceptibility to mind wandering was found to positively correlate with task-irrelevant distraction but not with response-competition interference. These results reveal mind wandering as a manifestation of susceptibility to task-irrelevant distraction and establish a laboratory measure of general susceptibility to irrelevant distraction, including both internal and external sources. PMID:23957365
Forster, Sophie; Lavie, Nilli
Distraction and reappraisal are two commonly used forms of cognitive emotion regulation. Functional neuroimaging studies have shown that each one depends upon interactions between pFC, interpreted as implementing cognitive control, and limbic regions, interpreted as mediating emotional responses. However, no study has directly compared distraction…
McRae, Kateri; Hughes, Brent; Chopra, Sita; Gabrieli, John D. E.; Gross, James J.; Ochsner, Kevin N.
...Safety Administration Distracted Driving Grant Program AGENCY: Department of Transportation...fiscal year (FY) 2013 funds to provide grants to States for enacting and enforcing distracted...Therefore, the amount available for the grants in FY 2013 may be less than the...
Many attempts were made in the past to monitor a driver's visual and cognitive distractions. Yet, most of the techniques did not become a practical application due to their contact-based nature of monitoring. In this paper, we describe research that aims to monitor the driver's distractions from a distance. The proposed method is based on the thermal signature of the
Avinash Wesley; Dvijesh Shastri; Ioannis Pavlidis
Background: Auditory distraction is known to affect serial recall (irrelevant sound effect), but there has been limited study about the effect of distraction on performance of more complex metalinguistic tasks, particularly as cognitive performance declines with normal ageing. The inhibitory deficit theory offers an explanation for this decline in performance with ageing, suggesting that older adults have difficulty limiting access
Pamela A. Smith
As computers and other information technology move into cars and trucks, distraction-related crashes are likely to become an important problem. This paper begins to address this problem by examining how alert strategy (graded and single-stage) and alert modality (haptic and auditory) affect how well collision warning systems mitigate distraction and direct drivers attention to the car ahead when it unexpectedly
John D. Lee; Joshua D. Hoffman; Elizabeth Hayes
This article describes a new method that enables vector control during alveolar distraction osteogenesis in the treatment of a cleft palate patient. The patient presented with unilateral complete cleft lip and palate, and the alveolar part of the defect was covered by a mobile buccal flap. The distraction was performed by sliding the surgically released tooth segment with the help of an intraoral distractor over 1.5-mm stainless steel archwires held by metal crowns. This vector-controlled method enabled new bone and attached gingiva formation in harmony with the proper alveolar shape. PMID:24024956
Erverdi, Ahmet Nejat; Yilmaz, Berza; Motro, Melih; Gozneli, R?fat; Ugurlu, Kemal
Background Bifocal distraction osteogenesis has been shown to be a reliable method for reconstructing segmental mandibular defects. However, there are few reports regarding the occurrence of inferior alveolar nerve regeneration during the process of distraction. Previously, we reported inferior alveolar nerve regeneration after distraction, and evaluated the regenerated nerve using histological and electrophysiological methods. In the present study, we investigated axons regenerated by bifocal distraction osteogenesis using retrograde transportation of horseradish peroxidase in the mandibles of dogs to determine their type and function. Methods and Findings Using a bifocal distraction osteogenesis method, we produced a 10-mm mandibular defect, including a nerve defect, in 11 dogs and distracted using a transport disk at a rate of 1 mm/day. The regenerated inferior alveolar nerve was evaluated by retrograde transportation of HRP in all dogs at 3 and 6 months after the first operation. At 3 and 6 months, HRP-labeled neurons were observed in the trigeminal ganglion. The number of HRP-labeled neurons in each section increased, while the cell body diameter of HRP-labeled neurons was reduced over time. Conclusions We found that the inferior alveolar nerve after bifocal distraction osteogenesis successfully recovered until peripheral tissue began to function. Although our research is still at the stage of animal experiments, it is considered that it will be possible to apply this method in the future to humans who have the mandibular defects.
Isomura, Emiko Tanaka
One-step transport-disk distraction osteogenesis (TDDO) is effective for repairing segmental mandibular defects. The authors studied whether it was effective for reconstructing angled large mandibular defects using a two-step TDDO procedure in seven patients suffering from neoplasm. In the two-step TDDO procedure, the first distraction (horizontal distraction) was initiated immediately after mandibulectomy, aimed at restoring the mandibular body. It was followed by the second distraction, which was obliquely vertical and aimed at restoring the height of the ramus. The distraction rate was set at twice 0.4mm/day. The treatment lasted for 14-18 months. The horizontal distraction length ranged from 48 to 55mm, and the vertical one from 33 to 43mm, with full ossification in the distraction area. No obvious shift of mandible, malocclusion or mouth opening limitation was observed. Patients had a regular diet and spoke clearly. In conclusion, the two-step TDDO is still an option for the reconstruction of large angled mandibular defects when patients are prudently selected, despite the long treatment period required. PMID:20430585
Chen, J; Liu, Y; Ping, F; Zhao, S; Xu, X; Yan, F
Driver distraction is recognised as a significant cause of road traffic incidents. However, the more objective measurement and ranking of the relative importance of individual distractions in contributing to incidents tend to differ from subjectively-held rankings. To investigate this, the present study examines qualitative characteristics of 14 driver distractions to determine if these characteristics might explain the discrepancy. The conclusion is that for laypersons, qualitative characteristics, such as equity and familiarity, do contribute to their ranking of driver distractions. This poses some interesting issues for risk managers. For example, should safety interventions aimed at driver distractions be based purely on factual data and life-saving potential, or should they accommodate qualitative factors of salience to the public? PMID:18215573
Patel, Jayesh; Ball, David J; Jones, Huw
Patients with complete or partial edentulism who have insufficient bone for endosseous dental implant treatment present a challenge for the dental practitioner. Alveolar distraction osteogenesis is a technique for creating bone and soft tissue, without the need for bone grafting and its potential complications. In this article, alveolar distraction osteogenesis is compared with traditional bone grafting techniques. A case is presented to illustrate successful bilateral mandibular vertical distraction osteogenesis with creation of adequate bone volume for endosseous implant-supported dental restoration. PMID:15763035
Walker, David A
Objective : Le Fort III osteotomy with distraction osteogenesis (DO) is used to improve the retruded midface in patients with Crouzon or Apert syndrome. This study aimed to evaluate sagittal and vertical preoperative and postoperative cephalometric changes of DO of the midface in patients with Crouzon or Apert syndrome. Design : Population-based case-control study. Patients and Methods : Records of patients with the syndrome of Crouzon (N = 6) or Apert (N = 7) were compared, before and after Le Fort III DO, with a nonsyndromic untreated control group (N = 486). Main Outcome Measures : Sagittal and vertical cephalometric maxillary landmarks and measurements were used to predict and measure midface advancement and rotation after Le Fort III DO. Cephalograms were taken before surgery (T0), 4 months after surgery at removal of the distraction device (T1), and 1 year after removal of the distraction device (T2). Analysis : Z scores were performed to compare cephalometric measures of syndromic patients with control subjects. Results : Cephalograms of 13 patients with Crouzon syndrome (N = 6) or Apert (N = 7) (age range 8.2 to 19.8 years) were evaluated. Treatment changes (T1-T2) showed statistically significant maxillary advancement, with no significant differences between the patients with the Crouzon or Apert syndrome. Conclusions : DO of the midface in patients with Crouzon or Apert syndrome seems to be stable in the sagittal direction after follow-up. Although Crouzon and Apert differ after DO, anteroposterior craniofacial dimensions were significantly improved and were closer to patterns of normal subjects. PMID:22909221
Reitsma, Jacobus H; Ongkosuwito, Edwin M; Buschang, Peter H; Adrichem, Léon N A V; Prahl-Andersen, Birte
Purpose The sinus lift procedure requires detailed knowledge of maxillary sinus anatomy and the possible anatomical variations. This study evaluated the location and prevalence of maxillary sinus septa using computed tomography (CT). Methods This study was based on the analysis of CT images for posterior maxilla which were obtained from patients who visited Chonbuk National University Dental Hospital during the period of June 2007 to December 2008. With the exclusion of cases presenting any pathological changes, 236 maxillary sinuses in 204 patients were retrospectively analyzed. The average age of the patients was 50.9. The cases were divided into two groups, an atrophy/edentulous segment and a non-atrophy/dentate segment, and maxillary sinus septa of less than 2.5 mm were not taken in-to consideration. The location of septa was also divided for analysis into 3 regions: the anterior (1st and 2nd premolar), middle (1st and 2nd molar) and posterior (behind 2nd molar) regions. Results In 54 (20.9%) of the 204 patients there were pathologic findings, and those patients were excluded from the analysis. Sinus septa were present in 58 (24.6%) of the 236 maxillary sinuses and in 55 (27%) of the 204 total patients. In the atrophy/edentulous ridge group (148 maxillary sinuses), 41 cases (27.7%) were found, and 17 cases (19.3%) were found in the non-atrophy/dentulous ridge group (88 maxillary sinuses). In terms of location, septa were found in 18 cases (27.3%) in the anterior, in 33 cases (50%) in the middle and in 15 cases (22.7%) in the posterior regions. Conclusions In the posterior maxilla, regardless of type of ridge (atrophy/edentulous or non-atrophy/dentate), the anatomical variation of sinus septa is diverse in its prevalence and location. Thus, accurate information on the maxillary sinus of the patient is essential and should be clearly understood by the surgeon to prevent possible complications during sinus lifting.
Lee, Won-Jin; Lee, Seung-Jae
Augmentation of the floor of the maxillary sinus is an extremely important technique for posterior site development in the maxilla prior to implant placement. A number of techniques have been suggested and used in the past to deal with membrane perforations such as suturing the membrane, application of fibrin sealants oxidized regenerated cellulose and collagen membranes. The most important aspect of sinus grafting is the integrity of the sinus membrane solely to confine the graft. If membrane tears are not taken care of, graft material can extravasate into the antrum and block the ostium. The fast-resorbing membranes are not good enough to form bone as their integrity is lost before woven bone forms. The novel technique demonstrates the use of a slow-resorbing membrane not only for perforations, but even in circumstances where the sinus is devoid of a membrane, thus bypassing the waiting period for schnederian membrane regeneration prior to grafting. PMID:23833502
Gandhi, Yazad R; Singh, Mayank; Singh, Nimisha; Hariram
Augmentation of the floor of the maxillary sinus is an extremely important technique for posterior site development in the maxilla prior to implant placement. A number of techniques have been suggested and used in the past to deal with membrane perforations such as suturing the membrane, application of fibrin sealants oxidized regenerated cellulose and collagen membranes. The most important aspect of sinus grafting is the integrity of the sinus membrane solely to confine the graft. If membrane tears are not taken care of, graft material can extravasate into the antrum and block the ostium. The fast-resorbing membranes are not good enough to form bone as their integrity is lost before woven bone forms. The novel technique demonstrates the use of a slow-resorbing membrane not only for perforations, but even in circumstances where the sinus is devoid of a membrane, thus bypassing the waiting period for schnederian membrane regeneration prior to grafting.
Gandhi, Yazad R.; Singh, Mayank; Singh, Nimisha; Hariram
The effects of auditory distraction in memory tasks have, to date, been examined with procedures that minimize participants’ control over their own memory processes. Surprisingly little attention has been paid to metacognitive control factors which might affect memory performance. In this study, we investigate the effects of auditory distraction on metacognitive control of memory, examining the effects of auditory distraction in recognition tasks utilizing the metacognitive framework of Koriat and Goldsmith (1996), to determine whether strategic regulation of memory accuracy is impacted by auditory distraction. Results replicated previous findings in showing that auditory distraction impairs memory performance in tasks minimizing participants’ metacognitive control (forced-report test). However, the results revealed also that when metacognitive control is allowed (free-report tests), auditory distraction impacts upon a range of metacognitive indices. In the present study, auditory distraction undermined accuracy of metacognitive monitoring (resolution), reduced confidence in responses provided and, correspondingly, increased participants’ propensity to withhold responses in free-report recognition. Crucially, changes in metacognitive processes were related to impairment in free-report recognition performance, as the use of the “don’t know” option under distraction led to a reduction in the number of correct responses volunteered in free-report tests. Overall, the present results show how auditory distraction exerts its influence on memory performance via both memory and metamemory processes.
Beaman, C. Philip; Hanczakowski, Maciej; Jones, Dylan M.
In the treatment of the first premolar extraction cases with certain techniques, incisor retraction is realized after canine distalization. In maximum anchorage cases, retraction of anterior segments require more posterior anchorage. This treatment concept is still valid, however, the difficult anchorage control is considered a major drawback. The purpose of this study is to introduce our technique for the "en masse" retraction of maxillary anterior teeth after first premolar extraction and discuss its effects. The technique consists of the application of extraoral traction on canines, followed by banding of maxillary anterior teeth, to form them as a mass. Advantages of our mechanics are as follows: (1) Anterior headgear may have the advantage of retracting anterior teeth with minimum strain on posterior anchorage. (2) The adjustability of the outer bow in relation to the premaxilla's center of resistance, provides effective desired movements. (3) Intrusion and torque control are achieved in the course of anterior segment retraction. PMID:9387832
Güray, E; Orhan, M
Novice teen drivers have long been known to have an increased risk of crashing, as well as increased tendencies toward unsafe and risky driving behaviors. Teens are unique as drivers for several reasons, many of which have implications specifically in the area of distracted driving. This paper reviews several of these features, including the widespread prevalence of mobile device use by teens, their lack of driving experience, the influence of peer passengers as a source of distraction, the role of parents in influencing teens' attitudes and behaviors relevant to distracted driving and the impact of laws designed to prevent mobile device use by teen drivers. Recommendations for future research include understanding how engagement in a variety of secondary tasks by teen drivers affects their driving performance or crash risk; understanding the respective roles of parents, peers and technology in influencing teen driver behavior; and evaluating the impact of public policy on mitigating teen crash risk related to driver distraction. PMID:24776228
Durbin, Dennis R; McGehee, Daniel V; Fisher, Donald; McCartt, Anne
Novice teen drivers have long been known to have an increased risk of crashing, as well as increased tendencies toward unsafe and risky driving behaviors. Teens are unique as drivers for several reasons, many of which have implications specifically in the area of distracted driving. This paper reviews several of these features, including the widespread prevalence of mobile device use by teens, their lack of driving experience, the influence of peer passengers as a source of distraction, the role of parents in influencing teens’ attitudes and behaviors relevant to distracted driving and the impact of laws designed to prevent mobile device use by teen drivers. Recommendations for future research include understanding how engagement in a variety of secondary tasks by teen drivers affects their driving performance or crash risk; understanding the respective roles of parents, peers and technology in influencing teen driver behavior; and evaluating the impact of public policy on mitigating teen crash risk related to driver distraction.
Durbin, Dennis R; McGehee, Daniel V; Fisher, Donald; McCartt, Anne
\\u000a Distraction osteogenesis of the facial skeleton has provided both a powerful tool to those who are interested in studying\\u000a the biology of bone and has added a powerful technique to the armamentarium of surgeons who treat facial disfi gurement. The\\u000a application of bone distraction to the facial skeleton has been largely derived from prior work in the lower extremity, and
Robert J. Havlik
The requirements for reconstruction in patients with midface hypoplasia can be formidable: a bicoronal scalp incision, Le Fort III or monobloc skeletal advancement, harvesting and insertion of bone grafts, application of rigid (and occasionally intermaxillary) fixation, blood transfusions, and prolonged operative time and hospitalization. The introduction of the endoscope offers the possibility of minimally invasive surgery with improved visualization of the osteotomy sites. The development of distraction osteogenesis as a surgical technique allows controlled and gradual advancement of the osteotomized skeletal segment and associated soft tissue. The purpose of this study was to develop a canine model of an endoscopically assisted Le Fort III osteotomy with attendant midface distraction. Four mongrels (20 kg in weight) were study subjects. Three 2-cm skin incisions were made (two perpendicular to the zygomaticomaxillary suture and one perpendicular to the nasofrontal suture). The soft tissue and periosteum were evaluated bluntly. Retractors specially designed for the project created a space for endoscopic visualization. Bilateral zygomatic, nasofrontal, and medial orbital wall osteotomies, corticotomies, or both were performed under endoscopic visualization using a reciprocating saw; the medial orbital wall sectioning was specifically not completed (i.e., corticotomy) to avoid laceration of the mucosa and attendant bleeding. The pterygomaxillary osteotomy was completed with an osteotome and mallet. Finally, the nasal septum was only partially divided with an osteotome to avoid excessive blood loss. Four distraction devices were placed across the above-noted osteotomies (two across the nasofrontal osteotomy and one across each lateral osteotomy). The animals were distracted 1 mm per day for 16 to 40 days after surgery (16-40 mm of linear distraction). Cephalograms and computed tomography scans were obtained before and after distraction. The animals were killed after remaining in fixation for 4 to 6 weeks after distraction. All soft tissue was removed and the skull was examined. Photos were obtained throughout the experiment for documentation. The study demonstrated that Le Fort III osteotomies can be performed successfully via small incisions with endoscopic assistance in canine subjects with excellent visualization and minimal bleeding. The advancement of the midface segment can be achieved by activation of an external distraction device. PMID:9780909
Levine, J P; Rowe, N M; Bradley, J P; Williams, J K; Mackool, R J; Longaker, M T; McCarthy, J G
Mucoceles are defined as chronic, cystic lesions in the paranasal sinuses. When the mucocele content becomes infected, the lesion is defined as mucopyocele. Most mucoceles are located in the frontal and anterior ethmoid sinuses and normally they involve the frontal-ethmoid complex, expanding to the superior-medial region of the orbit, leading to ocular disorders; maxillary sinus presentation is rare. In the present article, the authors described a rare case of mucopyocele in the maxillary sinus. PMID:24688571
Kshar, Avinash; Patil, Abhijeet; Umarji, Hemant; Kadam, Sonali
Attention research over the last several decades has provided rich insights into the determinants of distraction, including distractor characteristics, task features, and individual differences. Load Theory represented a particularly important breakthrough, highlighting the critical role of the level and nature of task-load in determining both the efficiency of distractor rejection and the stage of processing at which this occurs. However, until recently studies of distraction were restricted to those measuring rather specific forms of distraction by external stimuli which I argue that, although intended to be irrelevant, were in fact task-relevant. In daily life, attention may be distracted by a wide range of stimuli, which may often be entirely unrelated to any task being performed, and may include not only external stimuli but also internally generated stimuli such as task-unrelated thoughts. This review outlines recent research examining these more general, entirely task-irrelevant, forms of distraction within the framework of Load Theory. I discuss the relation between different forms of distraction, and the universality of load effects across different distractor types and individuals.
Surgically assisted rapid maxillary expansion (SARME), which combines orthodontics and surgery, is a well-established therapy for transverse maxillary hypoplasia in adults after sutural closure or completion of skeletal maturation. X-rays are usually the preferred monitoring technique for this treatment. Recently, ultrasound scanning has been used successfully in the follow-up of patients undergoing distraction osteogenesis. In this study, ultrasonography (US) was used in the evaluation of bone callus formation in the midpalatal suture in 3 patients undergoing SARME. For each patient, US was performed immediately after active expansion, at 2 and 4 months of the expansion period, at the removal of the expander 6 months later, and at 2 months after expander removal. The results indicated that US might be a useful and accurate method to assess bone fill in the midpalatal suture in patients undergoing SARME. However, further studies are necessary to clarify the US scores in a larger patient group undergoing SARME. PMID:22948650
Sumer, A Pinar; Ozer, Mete; Sumer, Mahmut; Danaci, Murat; Tokalak, Fuat; Telcioglu, N Tuba
A case is described of a severely ectopic maxillary canine, which underwent initial spontaneous improvement, and following extraction of the deciduous canine erupted satisfactorily. It provides a cautionary tale when considering surgical removal of ectopic maxillary canines. PMID:9800014
Kindelan, J; Cook, P
In 2000, the National Highway Traffic Safety Administration (NHTSA) held a workshop on distracted driving research. In the ten years that followed, electronic devices that have the potential for distraction have changed dramatically. Cell phone usage has ...
The National Highway Traffic Safety Administration conducted its second national survey of distracted driving to monitor the public's attitudes, knowledge, and self-reported behavior about cell phones, texting, and driver choices. The first distracted dri...
To report a rare case of maxillary canine with two root canals. The case describes the treatment of a maxillary canine with two root canals which was referred from department of prosthodontia for intentional root canal treatment for prosthetic rehabilitation. Clinical examination revealed a maxillary canine with carious lesion and responded within normal limits to electric pulp test. Radiographic examination revealed a distal carious lesion (close proximity to pulp) and also appeared to be an additional canal in this permanent maxillary canine.
Bolla, Nagesh; Kavuri, Sarath Raj
Our aim was to evaluate symphyseal distraction in relation to duration of expansion, and to propose an optimised procedure. Eighteen patients (mean (SD) age 19 (7) years) with transverse mandibular deficiency were treated by symphyseal distraction osteogenesis. The mean (SD) anterior dental crowding measured was 6.8 (4.2) mm. We retrospectively compared the width of expansion between the canines (ICE) and expansion between the first molars (IFME) after symphyseal distraction according to the distraction time. The median (range) duration of expansion was 13.6 (7-21) days. The median (range) ICE distraction width was 5.5 (3.4-8) mm and IFME width 3.3 (1-7.9) mm (p<0.001). There was a significant correlation between expansion width and distraction time (p<0.001). The transverse anterior and posterior expansion widths differed significantly until 14 days after expansion. The expansion ratio (ICE:IFME) decreased as expansion time increased. The results suggest that the duration of activated expansion can be predicted from the degree of incisal crowding using the formula: distraction time (days)=0.84+3.4×[IC (mm)]-0.2×[IC (mm)](2). PMID:23906850
Savoldelli, Charles; Chamorey, Emmanuel; Cizsek, Emmanuel; Lesne, Valentin; Manière-Ezvan, Armelle; Bettega, Georges
This retrospective study analyses the results of subtalar bone block distraction arthrodesis used in the treatment of late complications of calcaneal fractures, acute severely comminuted fractures, nonunion (and malunion) of attempted subtalar arthrodeses, avascular necrosis of the talus, and club-foot deformity. Of 39 patients (41 feet) who had this procedure, 35 (37 feet) returned for follow-up after a mean of 70 months (26 to 140). There were 24 men (25 feet) and 11 women (12 feet) with a mean age of 41 years (16 to 63). Each completed a standardised questionnaire, based on the hindfoot-scoring system of the American Orthopaedic Foot and Ankle Society and were reviewed both clinically and radiologically. Of the 37 operations, 32 (87%) achieved union. The mean hindfoot score (maximum of 94 points) increased from 21.1 points (8 to 46) preoperatively to 68.9 (14 to 82) at the final follow-up. The mean talocalcaneal and calcaneal pitch angles were 20.5 degrees and 4.9 degrees before operation, 25.9 degrees and 8.3 degrees immediately after, and 24.6 degrees and 7.7 degrees at the final follow-up, respectively. The mean talar declination angle improved from 6.5 degrees (-10 to 22) before operation to 24.8 degrees (14 to 32) at the final follow-up. The mean talocalcaneal height increased from 68.7 mm before operation to 74.5 mm immediately after and 73.5 mm at the final follow-up. Of the 37 arthrodeses available for review, 32 were successful; 29 patients (30 arthrodeses) were satisfied with the procedure. Minimal loss of hindfoot alignment occurred when comparing radiographs taken immediately after operation and at final follow-up. PMID:11521927
Trnka, H J; Easley, M E; Lam, P W; Anderson, C D; Schon, L C; Myerson, M S
We investigated the effects of distraction on attention and task performance during toddlerhood. Thirty toddlers (24- to 26-month-olds) completed different tasks (2 of each: categorization, problem solving, memory, free play) in one of two conditions: No Distraction or Distraction. The results revealed that the distractor had varying effects on…
Wyss, Nancy M.; Kannass, Kathleen N.; Haden, Catherine A.
Unobtrusive video camera units were installed in the vehicles of 70 volunteer drivers over 1-week time periods to study drivers’ exposure to distractions. The video data were coded based on a detailed taxonomy of driver distractions along with important contextual variables and driving performance measures. Results show distractions to be a common component of everyday driving. In terms of overall
Jane Stutts; John Feaganes; Donald Reinfurt; Eric Rodgman; Charles Hamlett; Kenneth Gish; Loren Staplin
Mildly-to-moderately depressed and nondepressed subjects were randomly assigned to spend 8 minutes focusing their attention on their current feeling states and personal characteristics (rumination condition) or on descriptions of geographic locations and objects (distraction condition). Depressed subjects in the rumination condition became significantly more depressed, whereas depressed subjects in the distraction condition became significantly less depressed. Rumination and distraction did
Susan Nolen-hoeksema; Jannay Morrow
Objective: The effects of interference, competition, and distraction on cognitive processing are unclearly understood, particularly regarding type and intensity of auditory distraction across a variety of cognitive processing tasks. Method: The purpose of this investigation was to report two experiments that sought to explore the effects of types of distraction (4-talker babble; word repetition; combined 4-talker babble with word repetition)
Leonard L. LaPointe; Gary R. Heald; Julie A. G. Stierwalt; Brett E. Kemker; Trisha Maurice
Our aim was to evaluate the function of a new optimised distraction implant. Six dogs with alveolar bone defects had a total of 18 distraction, and 6 normal, implants inserted into edentulous mandibular ridges after osteotomy. Five days after insertion the distraction implants were activated at a rate of 1 mm/2 days to achieve a distraction height of 6mm. Radiographs were taken at 0, 1, 2, and 3 months after distraction. Two dogs were killed after 1, 2, and 3 months, respectively, and 12 distraction implants taken from the different time points were evaluated by microcomputed tomographic (MicroCT) scanning and histological examination. The other 6 distraction, and the 6 normal, implants were compared after osseointegration with a fatigue test. The results showed that all the distraction implants had successfully distracted the bone to the anticipated height. Radiographs showed that the density of the regenerated bone increased steadily during the consolidation period. MicroCT showed that the regenerated bone was comparable with the native bone 3 months after distraction. Both native and regenerated bone had osseointegrated histologically by 1 month and 3 months after distraction. The experiment successfully confirmed the usefulness and feasibility of this new distraction implant, and suggests interesting clinical uses. PMID:23601834
Shao, Bo; Sun, Yingying; Gao, Yuan; Li, Tao; Li, Yongfeng; Zhang, Yongqiang; Ge, Xu; Liu, Baolin; Kong, Liang
Research shows that attention is ineluctably captured away from a focal visual task by rare and unexpected changes (deviants) in an otherwise repeated stream of task-irrelevant auditory distractors (standards). The fundamental cognitive mechanisms underlying this effect have been the object of an increasing number of studies but their sensitivity to mood and emotions remains relatively unexplored despite suggestion of greater distractibility in negative emotional contexts. In this study, we examined the effect of sadness, a widespread form of emotional distress and a symptom of many disorders, on distraction by deviant sounds. Participants received either a sadness induction or a neutral mood induction by means of a mixed procedure based on music and autobiographical recall prior to taking part in an auditory-visual oddball task in which they categorized visual digits while ignoring task-irrelevant sounds. The results showed that although all participants exhibited significantly longer response times in the visual categorization task following the presentation of rare and unexpected deviant sounds relative to that of the standard sound, this distraction effect was significantly greater in participants who had received the sadness induction (a twofold increase). The residual distraction on the subsequent trial (postdeviance distraction) was equivalent in both groups, suggesting that sadness interfered with the disengagement of attention from the deviant sound and back toward the target stimulus. We propose that this disengagement impairment reflected the monopolization of cognitive resources by sadness and/or associated ruminations. Our findings suggest that sadness can increase distraction even when distractors are emotionally neutral. PMID:24098923
Pacheco-Unguetti, Antonia P; Parmentier, Fabrice B R
A 30-year old male was referred by a dental practitioner to the Department of Oral Radiology at the University of Lund, Sweden, for a radiological evaluation of chronic symptoms of inflammation on the right side of the maxilla. According to the patient, at age 12 he had surgery to remove a non-erupted maxillary right second premolar. Postoperatively, a draining sinus tract appeared on the buccal aspect of the alveolar process. Thirteen years later, at age 25, surgery was again performed and the sinus tract reappeared. Intermittent discharge of exudate from the sinus tract occurred since the second surgery. Clinical and radiological examinations were conducted prior to a third surgery. The clinical examination revealed pus draining from the tract located on the buccal aspect of the alveolar process between the right maxillary first molar and first premolar. The radiological examination included periapical radiographs of the right maxillary first premolar and canine, a panoramic radiograph, and frontal tomograms of the maxillary right premolar area. PMID:12167893
Omnell, K A; Rohlin, M
Driver distraction research has a long history, spanning nearly 50 years, but intensifying over the last decade. The dominant paradigm guiding this research defines distraction in terms of excessive workload and limited attentional resources. This approach largely ignores how drivers come to engage in these tasks and under what conditions they engage and disengage from driving-the dynamics of distraction. The dynamics of distraction identifies breakdowns of interruption management as an important contributor to distraction, leading to describe distraction in terms of failures of task timing, switching, and prioritization. The dynamics of distraction also identifies disengagement in driving (e.g., mind wandering) as a substantial challenge that secondary tasks might exacerbate or mitigate. Increasing vehicle automation accentuates the need to consider these dynamics of distraction. Automation offers drivers more opportunity to engage in distractions and disengage from driving, and can surprise drivers by unexpectedly requiring drivers to quickly re-engage in driving-placing greater importance of interruption management expertise. This review describes distraction in terms of breakdowns in interruption management and problems of engagement, and summarizes how contingency, conditioning, and consequence traps lead to problems of engaging and disengaging in driving and distractions. PMID:24776224
Lee, John D
Driver distraction research has a long history, spanning nearly 50 years, but intensifying over the last decade. The dominant paradigm guiding this research defines distraction in terms of excessive workload and limited attentional resources. This approach largely ignores how drivers come to engage in these tasks and under what conditions they engage and disengage from driving—the dynamics of distraction. The dynamics of distraction identifies breakdowns of interruption management as an important contributor to distraction, leading to describe distraction in terms of failures of task timing, switching, and prioritization. The dynamics of distraction also identifies disengagement in driving (e.g., mind wandering) as a substantial challenge that secondary tasks might exacerbate or mitigate. Increasing vehicle automation accentuates the need to consider these dynamics of distraction. Automation offers drivers more opportunity to engage in distractions and disengage from driving, and can surprise drivers by unexpectedly requiring drivers to quickly re-engage in driving—placing greater importance of interruption management expertise. This review describes distraction in terms of breakdowns in interruption management and problems of engagement, and summarizes how contingency, conditioning, and consequence traps lead to problems of engaging and disengaging in driving and distractions.
Lee, John D.
This report primarily focuses on an attempt to document the level of driver distraction existing in Kentucky through analysis of crash data and by conducting an observational survey of drivers. Additional research is cited as a means of comparing other st...
J. G. Green
A driving simulator was used to examine the effects on driving performance of auditory cues in an in-vehicle information search task. Drivers' distraction by the search tasks was measured on a peripheral detection task. The difficulty of the search task was systematically varied to test the distraction caused by a quantified visual load. 58 participants completed the task. Performance on both search tasks and peripheral detection tasks was measured by mean response time and percent error. Analyses indicated that in-vehicle information search performance can be severely degraded when a target is located within a group of diverse distractors. Inclusion of an auditory cue in the visual search increased the mean response time as a result of a change in modality from auditory to visual. Inclusion of such an auditory cue seemed to influence distraction as measured by performance on the peripheral detection task; accuracy was lower when auditory cues were provided, and responses were slower when no auditory cues were provided. Distraction by the auditory cue varied according to the difficulty of the search task. PMID:21162452
Lin, Chih-Yung; Hsu, Chun-Chia
An attempt has been made to review various devices as well as the outstanding studies done in the past for understanding the methodology of distraction for regeneration of bone. Lengthening of underdeveloped bones inclusive of the maxillofacial complex has been obtained by distraction osteogenesis by many authors. This could be achieved by the use of various extraoral or intraoral devices. Devices used for distraction osteogenesis must have a minimum of 2 important characteristics - they should be able to transfer distraction forces directly to the bone and secondly, should offer adequate rigidity for osseous consolidation to occur. With advanced technology and biomechanical engineering, preformed intraoral distraction devices are now available worldwide. The introduction of these intraoral bone-bourne devices have eliminated the need for bulky, cumbersome extraoral distraction devices which had problems such as external scars, pin tract infections, nerve or tooth bud injuries and poor patient compliance. The design of completely internalized custom made appliance has opened new vistas in the field of Oral and Maxillofacial Surgery. Indigenous internal devices are also economical and locally available. PMID:23482829
Andrade, Neelam; Gandhewar, Trupti; Kalra, Rinku
As in the traditional combined surgical and orthodontic procedures, an Orthodontist can plays vital role in treatment planning and the orthodontic treatment of patient undergoing distraction osteogenesis. This role includes predistraction assessment of the craniofacial skeleton and occlusal function, pre-distraction, and post-distraction orthodontic care. Based on clinical evaluation, dental study models, photographic analysis, cephalometric evaluation, and three-dimensional computed tomographic analysis, the Orthodontist, in collaboration with the Surgeon, plans distraction device placement and the predicted vectors of distraction. Finally, as in other forms of orthognathic surgery, the practice of distraction osteogenesis depends on the cooperation and planning between orthodontist and surgeon as a team. Purpose of this paper is to review biomechanics and orthodontic treatment protocol of distraction osteogenesis in the maxillofacial region.
Maheshwari, Sandhya; Verma, Sanjeev K.; Tariq, Mohd.; Prabhat, K. C.; Kumar, Shailendra
Driver distraction has become a leading cause of motor-vehicle crashes. Although visual and cognitive distraction has been studied extensively, relatively little research has addressed their combined effects on drivers' behavior. To fill this gap, a medium-fidelity simulator study examined the driver behavior before, during and after three types of distraction. Driving without distraction was compared to visual distraction, cognitive distraction, and combined visual and cognitive distraction. The results show that the visual and combined distraction both impaired vehicle control and hazard detection and resulted in frequent, long off-road glances. The combined distraction was less detrimental than visual distraction alone. Cognitive distraction made steering less smooth, but improved lane maintenance. All distractions caused gaze concentration and slow saccades when drivers looked at the roadway, and cognitive and combined distraction increased blink frequency. Steering neglect, under-compensation, and over-compensation were three typical steering failures that were differentially associated with the different distractions: steering neglect and over-compensation with visual distraction and under-compensation with cognitive distraction. Overall, visual distraction interferes with driving performance more than cognitive distraction, and visual distraction dominates the performance decrements during combined distraction. These results suggest that minimizing visual demand is particularly important in the design of in-vehicle systems and in the development of distraction countermeasures. PMID:20380916
Liang, Yulan; Lee, John D
Background Oral breathing and maxillary deficiency are often associated with steep mandibular plane angle, and retrognathic mandible compared with the faces of healthy controls. Some studies suggested that after rapid maxillary expansion, improvement in nasal breathing and repositioning of mandible with transitory increasing of facial height and, in some cases, spontaneous forward repositioning might occur. The abovementioned mandibular effects could contribute to enlarge oropharynx volume with repositioning of tongue and soft palate with an improvement of upper airway volume after treatment. The aim of this study was to investigate by cone beam computed tomography the role of oropharyngeal volume and mandibular position changes after rapid maxillary expansion in patients showing improved breathing pattern confirmed by polysomnography exam. Methods The final sample of this retrospective study comprised 14 Caucasian patients (mean age 7.6 years) who undergone rapid maxillary expansion with Haas-type expander banded on second deciduous upper molars. Cone beam computed tomography scans and polysomnography exams were collected before placing the appliance (T0) and after 12 months (T1). Mandibular landmarks localization and airway semiautomatic segmentation on cone beam computed tomography scans allowed airway volume computing and measurements. Results No significant differences were found between oropharyngeal airway changes and mandibular displacement after rapid maxillary expansion in growing patients. Conclusions The suggested improvement in upper airway and breathing after rapid maxillary expansion should be further related to different compartments of airway such as rhinopharynx and nasal cavity.
Background The Pierre Robin Sequence features were first described by Robin in 1923 and include micrognathia, glossoptosis and respiratory distress with an incidence estimated as 1:8,500 to 1:20,000 newborns. Upper airway obstruction and feeding difficulties are the main concerns related to the pathology. Mandibular distraction should be considered a treatment option (when other treatments result inadequate). Patiants and methods Ten patients between the ages of 1 month and 2 years with severe micrognathia and airway obstruction were treated with Mandibular Distraction Osteogenesis (MDO). All patients underwent fibroscopic examination of the upper airway and a radiographic imaging and/or computed tomography scans to detect malformations and to confirm that the obstruction was caused by posterior tongue displacement. All patients were evaluated by a multidisciplinary team. Indications for surgery included frequent apneic episodes with severe desaturation (70%). Gavage therapy was employed in all patients since oral feeding was not possible. The two tracheotomy patients were 5 months and 2 years old respectively, and the distraction procedure was performed to remove the tracheotomy tube. All patients were treated with bilateral mandibular distraction: two cases with an external multivector distraction device, six cases with an internal non-resorbable device and two cases with an internal resorbable device. In one case, the patient with Goldenhar's Syndrome, the procedure was repeated. Results The resolution of symptoms was obtained in all patients, and, when present, tracheotomy was removed without complications. Of the two patients with pre-existing tracheotomies, in the younger patient (5 months old) the tracheotomy was removed 7 days postoperatively. In the Goldenhar's syndrome case (2 years old) a Montgomery device was necessary for 6 months due to the presence of tracheotomy-inducted tracheomalacia. Patients were discharged when the endpoint was obtained: symptoms and signs of airway obstruction were resolved, PAS and maxillomandibular relationship improved, and tracheotomy, when present, removed. During the follow-up, no injury to the inferior alveolar nerve was noted and scarring was significant in only the two cases treated with external devices. Conclusion Mandibular Distraction Osteogenesis is a good solution in solving respiratory distress when other procedures are failed in paediatric patients with severe micrognatia.
A case of primary extracranial meningioma of the maxillary antrum is reported. A 45-year-old male presented with symptoms of chronic sinusitis. Imaging studies showed a soft tissue mass with calcification, filling the maxillary antrum. The mass was removed surgically, and pathological studies revealed a ribroblastic meningioma. The maxillary antrum is an uncommon location of primary extracranial meningioma, and our case is the sixth to be reported in that location. ImagesFigure 1Figure 2Figure 3Figure 4
El-Daly, Ahmed; Pitman, Karen T.; Ferguson, Berrylin J.; Snyderman, Carl H.
Occurrence of the second mesiobuccal canal (MB2) is a frequent finding. Literary reports have shown it to be found more in the cases of the maxillary first molar. However the maxillary second molars have also been found with this variation in a number of canals. This paper presents a case report on the occurrence of a second mesiobuccal canal or the MB2 in the maxillary second molar. PMID:17347545
Prakash, R; Bhargavi, N; Rajan, Jeyavel; Joseph, Reuben; Velmurugan, N; Kandaswamy, D
This article describes an intraoral radiographic technique for identifying lesions located on the buccal surfaces of the maxillary alveolar process. An intraoral film is placed behind the maxillary tuberosity and the X-ray beam exposes the film perpendicularly, running laterally to the buccal surface of the cortical bone. As a result, any external alteration can be seen clearly, with no superimposed maxillary teeth or osseous tissues. PMID:23032228
Dias da Silveira, Heloisa Emilia; Delamare, Eduardo Luiz; Liedke, Gabriela Salatino; Vizzotto, Mariana Boessio; Dias da Silveira, Heraldo Luis; Dalla-Bona, Reni Raymundo
An unilateral maxillary sinusitis is frequently caused by dental pathology. An odontogenic cyst in the maxillary sinus usually lacks accompanying symptoms of infection. In three patients, a 35-year-old man and two women aged 16 and 28, an odontogenic cyst in the maxillary sinus was diagnosed. Consultation of a maxillofacial surgeon is needed because orthopantomographic imaging is diagnostically most helpful. In these patients combined treatment by an ENT surgeon and a maxillofacial surgeon is important. PMID:9550780
Arendse, J W; Koopmans, R; Manni, J J
Limb length discrepancy and segmental bone defects can be difficult problems to manage after fractures of the lower limb. Distraction osteogenesis can be applied to lengthen bone or to bridge intercalary defects by segmental bone transport. The purpose of this study was to assess the functional outcome and long-term quality of life after distraction osteogenesis of the lower limb when applied for post-traumatic problems. Three patients were treated with segmental transport for bone loss secondary to infection and debridement after a tibia fracture. Leg lengthening was performed in 12 patients with consolidated fractures (eight femurs and four tibias). Long-term functional outcomes were evaluated with the Short Form-36 Health Survey (SF-36) and the Lower Extremity Functional Scale (LEFS) in all patients. The mean follow-up was 9 years. Functional outcomes indicated moderate difficulty in patients after segmental transport and a little difficulty in patients after lengthening of consolidated fractures. The SF-36 scores varied two points for physical functioning and one point for bodily pain as compared to the SF-36 norm-based scores. In all other six domains, patient scores were comparable with the general population. In conclusion, the quality of life and functional outcome returned to normal after post-traumatic distraction osteogenesis of the lower limb.
van Lieshout, Esther M. M.; Patka, Peter; Vogels, Lucas M. M.
In this review we describe the advantages, complications, and preventive considerations encountered as a result of the use of a halo for distraction of a retrusive nasomaxillary complex. Distraction osteogenesis is a well accepted combined orthodontic-surgical technique used in the treatment of patients with hypoplastic craniofacial components. The rigid external distraction (RED) system is a useful external distraction device for the advancement of severe retrusive maxilla especially in cleft palate patients. However, the addition of this new technique to the surgeon's armamentarium is accompanied by new complications and risks. Review of the literature on complications of the use of halo revealed that most complications are pin related. Complications with the use of RED have mainly included the penetration of intracranial pins. Risk management and preventive considerations propose several procedures to minimize the side effects when using RED: preoperative skull computerized tomography, pediatric neurosurgical consultation, proper pin care during distraction, frequent monitoring of the patient's general condition, proper pin and torque design, and special attention to the removal process of the RED. PMID:18230386
Aizenbud, Dror; Rachmiel, Adi; Emodi, Omri
Knowledge regarding the anatomic morphology of maxillary molars is absolutely essential for the success of endodontic treatment. The morphology of the permanent maxillary first molar has been reviewed extensively; however, the presence of two canals in a two-rooted maxillary first molar has rarely been reported in studies describing tooth and root canal anatomies. This case report presents a patient with a maxillary first molar with two roots and two root canals, who was referred to the Department of Endodontics, Tabriz University of Medical Sciences, Iran.
Rahimi, Saeed; Ghasemi, Negin
Nasal malformations such as hemiarrhinia and arrhinia have a very low incidence, although many treatment protocols have been described. In this article, we describe 2 surgical techniques to treat arrhinia depending on the age at the beginning of treatment. In our practice, we use Le Fort III osteotomy with distraction osteogenesis as a pillar of the reconstruction because it allows to improve anteroposterior and vertical projections of the midface, giving a proper platform for nasal reconstruction, decreasing the number of interventions. We report a patient with a hemiarrhinia who has completed appropriate reconstruction results and a patient with total arrhinia in whom the distraction was achieved to create a nasal bone support and improve midface projection. PMID:24670275
Prada, José Rolando; Mendoza, María Bibiana
When two target stimuli (T1 and T2) are presented in close succession within a stimulus sequence, detection or discrimination performance for T2 is often impaired; this phenomenon is called the attentional blink (AB). Growing evidence suggests that the AB is present not only for visual, but also for auditory stimuli. Because sounds have a strong potential to attract attention when they are presented after longer silent intervals or in a sequence from which they stand out because of their rare or novel physical features, it seems possible that the involuntary and excessive allocation of attention to T1 (distraction) may contribute to the AB. By varying the saliency of T1, we showed that distraction does contribute to the auditory AB effect, but the contribution is short-lived: Only stimuli immediately following T1 are affected. PMID:21264693
Horváth, János; Burgyán, Annamária
The purpose of the present study is to develop more precise methods to explore the interaction between contextual factors in teacher instructions in regular classroom settings and students’ abilities to use symbolic information in the instruction. The ability to easily show symbolic behavior could be expected to influence student’s capacity to be active and participate. The present study examines distraction in students’ shifts from the use of “non-symbolic” to “symbolic” behavior in regular classroom settings. The 53 students (29 boys and 24 girls), ages 11–13?years old, who participated in the study were from three classes in the same Swedish compulsory regular school. Based on their test performances in a previous study, 25 students (47%) were defined as showing symbolic behavior (symbolic), and 28 students (53%) as not showing it (non-symbolic). In the present study, new test trials with distractors were added. Students from both the symbolic and non-symbolic groups scored significantly fewer correct answers on the post-training test trials with distraction stimuli (p?0.05) than in post-training test trials without distraction. In the post-training test trials with competing arbitrary distractors, both groups were distracted significantly more than in the post-training test trials with competing non-arbitrary distractors (p?0.05). The results indicate that a relatively easily administered and socially acceptable procedure seems to give observational data about variations in students’ symbolic behavior in relation to contextual factors in regular classroom. The main conclusion to be drawn from the results is that the observational procedure used in this study seems to have a potential to be used to explore the interaction between contextual factors and more complex student behavior such as cognition and the pragmatic use of language in regular classroom.
Stakeholders in the automotive industry, airline industry, and anesthesia profession have identified critical periods of time in which distractions and interruptions of normal processes can have devastating effects. Just as reducing distractions improves safety in an automobile or airplane cockpit, limiting distractions and interruptions during critical times in the perioperative setting can increase patient safety. We assessed perioperative nurses and identified what they perceived as critical phases of nursing care. We also worked with our anesthesia partners to address their concerns about interruptions during the administration of nerve blocks. The perioperative nurses at our hospital initiated strategies to reduce distractions or interruptions to their practice at critical points, and, in collaboration with surgical committee members, we developed strategies to reduce or eliminate distractions for anesthesia professionals during the preoperative administration of nerve blocks and to eliminate distractions for the RN circulator and scrub person during the final counts. PMID:23722034
Clark, Gregory J
Purpose To determine if automated continuous distraction osteogenesis at rates > 1mm/day would result in clinical and radiographic bone formation in a minipig model. Materials and Methods An automated, continuous, curvilinear distraction device was placed across a mandibular osteotomy in 10 minipigs. After 12 mm of distraction and 24 days fixation, animals were sacrificed and bone healing evaluated. The continuous distraction rates were 1.5 (n=5) and 3 mm/day (n=5). A semiquantitative scale was used to assess ex-vivo clinical appearance of the distraction gap (3= osteotomy not visible; 2= <50%; 1= >50%; 0= 100% visible); stability (3 = no mobility; 2 and 1 = mobility in 2 or 1 plane respectively; 0= mobility in 3 planes); radiographic density (4 = 100% gap opaque, 3= >75%, 2 = 50% – 75%, 1= <50%, or 0 = radiolucent). Groups of 4 minipigs distracted discontinuously at 1, 2, and 4 mm/day served as controls. Results The continuous DO 1.5 mm/day group had significantly higher scores for appearance and radiographic density compared to the discontinuous 4 mm/day group. The continuous DO 3mm/day group had significantly higher scores for appearance and radiographic density compared to the discontinuous 4 mm/day group, and higher stability compared to the discontinuous 2 and 4 mm/day groups. Conclusions Results of this preliminary study indicate that continuous DO at rates of 1.5 and 3.0 mm/day produces better bone formation when compared to discontinuous DO at rates faster than 1mm/day.
Peacock, Zachary S.; Tricomi, Brad; Murphy, Brian; Magill, John; Kaban, Leonard B.; Troulis, Maria
Seven patients with craniosynostosis (mean age 8 years, Apert syndrome, n = 4, Crouzon's disease, n = 3) underwent lengthening of the skull by gradual bone distraction. Three patients (group A) were treated by coronal craniectomy reaching the orbital fissure and gradual bone distraction. The other four (group B) underwent monobloc craniofacial disjunction and gradual bone distraction. The patients' progress was monitored clinically as well as by radiographs and photographs. The results showed that craniofacial disjunction followed by gradual bone distraction produced complete correction of exophthalmus and an improvement in the functional and aesthetic aspects of the middle third of the face without the need for bone grafts. PMID:9075285
do Amaral, C M; Di Domizio, G; Tiziani, V; Galhardi, F; Buzzo, C L; Rinco, T; Kharmandayan, P; Bueno, M A; Bolzani, N; Sabbatini, R M; Lopes, L D; Lopes, P F; Paiva, B; Paiva, R M; Turchiari, L A
Facial hemiatrophies are anomalies of the first branchial arch and affect one in 4000-5000 newborns. Bone distraction is the technique of choice for the treatment of these dysmorphoses. Mandibular osteodistraction requires prior determination of the characteristics of the distraction vector whose three components will serve to activate the distractor. The patient, aged 5 years, presented with a right facial hemiatrophy, Grade IB according to the classification of Pruzansky. Tomodensitometric acquisition was obtained with a CT scanner. Software specifically designed for this application allows segmentation of the anatomical elements by a region-growing algorithm. The 3D representation of each element is added to a 3D scene, in which are placed the built-up landmarks necessary for the surgical simulation after 3D cephalometric analysis. The surgical cleavage plane is oriented according to the surgeon's requirements while preserving the predominant anatomical elements. The software allows performance of rotations and translations of the bone segments rendered independently from the cleavage plane. The distances and angles covered during the virtual movement are measured at its conclusion. The aim of moving the bone segments is to render the mandibular occlusion plane parallel to the reference occlusion plane. The vertical growth of the maxilla is realized by secondary recuperation. The distractor used was of an external multidirectional type allowing elongation of the mandibular ramus and mandibular corpus, closure of the goniac angle, and lateralization or medialization of the ramus. On the 15th day, the mandibular angle was reduced by 10 degrees, which allowed closure of the anterior gap and recentering of the incisive areas by a half-cuspid. The patient presented with a complex bone deficit in the three spatial directions, which allowed the development of software for modeling the distraction. Other clinical cases will be necessary to validate this 3D imaging-based technique. PMID:17957533
Diemunsch, C; Faure, F; Trunde, F; Morgon, L; Bossard, D; Jourlin, M; Coudert, J L; Disant, F
Driver distraction represents a significant problem in the public transport sector. Various methods exist for investigating distraction; however, the majority are difficult to apply within the context of naturalistic bus driving. This article investigates the nature of bus driver distraction at a major Australian public transport company, including the sources of distraction present, and their effects on driver performance, through the application of a novel framework of ergonomics methods. The framework represents a novel approach for assessing distraction in a real world context. The findings suggest that there are a number of sources of distraction that could potentially distract bus drivers while driving, including those that derive from the driving task itself, and those that derive from the additional requirements associated with bus operation, such as passenger and ticketing-related distractions. A taxonomy of the sources of bus driver distraction identified is presented, along with a discussion of proposed countermeasures designed to remove the sources identified or mitigate their effects on driver performance. PMID:20883979
Salmon, Paul M; Young, Kristie L; Regan, Michael A
Maxillary sinus foreign bodies are commonly due to penetrating trauma and iatrogenic events. A foreign body is usually identified during initial assessment and subsequently removed. We present a rare method of maxillary sinus trauma with retained and subsequent discharged foreign body twelve years following the initial injury.
Blythe, RJ; Abbas-Ali, M
Primary paragangliomas of the paranasal sinuses are very rare conditions with only few cases described in the literature. Paragangliomas are locally aggressive, often recur and can metastasize. Usually, open surgery is used to resect such tumors from the sinonasal tract. Here, a case of a large paraganglioma of the left maxillary sinus and nasal cavity, which was successfully removed using the Onyx® embolic agent two days prior to minimally invasive image guided endoscopic sinus surgery, is reported. This case demonstrates that large vascular tumors of the sinonasal tract can be successfully managed by endoscopic endonasal sinus surgery. The patient has no evidence of recurrence after 12 months of follow-up. PMID:23265579
Kisser, Ulrich; Braun, Thomas; Mayr, Doris; Leunig, Andreas
Cervical fractures can result in severe neurological compromise and even death. One of the most commonly injured segments is the C2 vertebrae, which most frequently involves the odontoid process. In this report, we present the unusual case of a 28-year-old female who sustained a C2 vertebral body fracture (comminuted transverse fracture through the body and both transverse processes) that had both a significant distractive and rotational component, causing the fracture to be highly unstable. Application of halo bracing was unsuccessful. The patient subsequently required a C1-C4 posterior spinal fusion. Follow-up computer tomography imaging confirmed fusion and the patient did well clinically thereafter.
Lau, Darryl; Shin, Samuel S; Patel, Rakesh; Park, Paul
Correction of a relapsed clubfoot deformity by distraction with an external fixator is a recognized alternative to open surgery. Most published series report a good outcome but none are prospective observational studies using the scoring system of the International Clubfoot Study Group (ICFSG). We present a series of 9 relapsed club feet treated with closed gradual distraction using this scoring method.
Bashoura, Abdo; Berjawi, Ghina; Afeiche, Nadim; Elkattah, Rayan
Performed 2 experiments in an investigation of the effects of distraction and emotional arousal on the proofreading performance of 60 dieting and nondieting female undergraduates. In Exp I, it was found that distraction initially impaired the performance of dieters and facilitated the performance of nondieters, a pattern previously shown by J. Rodin to apply to obese and normal weight Ss,
C. Peter Herman
Selective attention in the presence of distraction is a key aspect of healthy cognition. The underlying neurobiological processes, have not, however, been functionally well characterized. In the present study, we used functional magnetic resonance imaging to determine how ecologically relevant distracting noise affects cortical activity in 27…
Smucny, Jason; Rojas, Donald C.; Eichman, Lindsay C.; Tregellas, Jason R.
When facing penalty kicks in football (soccer), goalkeepers frequently incorporate strategies that are designed to distract the kicker. However, no direct empirical evidence exists to ascertain what effect such visual distractions have on the attentional control, and performance, of footballers. Eighteen experienced footballers took five penalty kicks under counterbalanced conditions of threat (low vs. high) and goalkeeper movement (stationary vs.
Greg Wood; Mark R. Wilson
Abnormal involuntary attention leading to enhanced distractibility may account for different behavioral and cognitive problems in children with attention deficit hyperactivity disorder (ADHD). This was investigated in the present experiment by recording event-related brain potentials (ERPs) to distracting novel sounds during performance of a visual discrimination task. The overall performance in the visual task was less accurate in the ADHD
V. Gumenyuk; O. Korzyukov; C. Escera; M. Hämäläinen; M. Huotilainen; T. Häyrinen; H. Oksanen; R. Näätänen; L. von Wendt; K. Alho
Previous treatments of eyewitness lineups have focused exclusively on the importance of homogeneity (similarity of common features) in the physical characteristics of lineup members. This has led to some confusion about the proper way to select distracters. We argue that distracters should not be selected for their similarity to the suspect but rather for their similarity to the witness's description
C. A. Elizabeth Luus; Gary L. Wells
Objective: The effects of interference, competition, and distraction on cognitive processing are unclearly understood, particularly regarding type and intensity of auditory distraction across a variety of cognitive processing tasks. Method: The purpose of this investigation was to report two experiments that sought to explore the effects of types…
LaPointe, Leonard L.; Heald, Gary R.; Stierwalt, Julie A. G.; Kemker, Brett E.; Maurice, Trisha
Objective: The aim of this study was to illuminate behavioral and event-related potential (ERP) effects of attentional orienting and reorienting obtained in a newly developed auditory distraction paradigm, to provide more precise indicators about the neural generators of the ERP effects using scalp current density (SCD) analysis, and to evaluate the stability of the distraction effects.Methods: In two sessions separated
Erich Schröger; M.-H Giard; Ch Wolff
Dental ankylosis often presents a significant vertical alveolar defect that is an esthetic problem for prosthetic rehabilitation. Moreover, surgical-orthodontic treatment by corticotomies and distraction devices provides special attention to avoid the loss of blood supply to the segment; furthermore, gingival recessions may appear because the gingival tissues cannot proliferate as fast as the immediate repositioning of the tooth.This case report presents a surgical technique for buccal, palatal, and vertical movements, and examines the effects of a tooth/arch-borne tooth distractor appliance, for the alignment of ankylosed teeth.The slow movements of tooth and bone block and fine cut simplifies orthodontic treatment in patients and makes it possible to achieve complex movements in a relatively short period. The reported dislocation procedure allows a use of buccal-lingual vertical osteotomy with horizontal osteotomy to correct tooth positions via bony block movement maintaining gingival tissues in position. The used sonic saw have proven to be a valuable alternative to manual or rotating tools, oscillating saws, or piezoelectric units because it is faster and easier for surgical approach. PMID:24777021
Agabiti, Ivo; Capparè, Paolo; Gherlone, Enrico Felice; Mortellaro, Carmen; Bruschi, Giovanni B; Crespi, Roberto
Objective: Posterior vault remodeling by distraction osteogenesis is a relatively new technique used for initial correction of turribrachycephaly in children with bicoronal craniosynostosis. We present a new potential complication from this procedure; a case of pan-suture synostosis subsequent to posterior vault distraction. Methods: We report an infant girl who presented with bicoronal synostosis in the setting of Saethre-Chotzen syndrome. She underwent posterior vault distraction and was distracted a total of 34 millimeters, with successful osteogenesis at the site. Results: One year postoperatively, the patient was found to have incidental, asymptomatic pan-suture synostosis on computed tomography. Conclusions: To our knowledge, this is the first reported case of delayed craniosynostosis after posterior vault distraction in the literature. The possible pathogenesis and significance of this case are discussed with a review of the current literature.
Chu, Katrina F.; Sullivan, Stephen R.; Taylor, Helena O.
Distraction osteogenesis is a method of inducing new bone formation by applying mechanical strains on preexisting bone. The process of osteogenesis in the periodontal ligament during orthodontic tooth movement is similar to the osteogenesis in the midpalatal suture during rapid palatal expansion. A new concept of “distracting the periodontal ligament” is proposed to elicit rapid canine retraction in two weeks. At the time of first premolar extraction, the interseptal bone distal to the canine was undermined with a bone bur, grooving vertically inside the extraction socket along the buccal and lingual sides and extending obliquely toward the socket base. Then, a tooth-borne, custom-made, intraoral distraction device was placed to distract the canine distally into the extraction space. It was activated 0.5 mm/day, immediately after the extraction. Canine was distracted 6.5 mm into the extraction space within two weeks.
Prabhat, K. C.; Maheshwari, Sandhya; Gupta, N. D.; Verma, Sanjeev K.; Goyal, Lata
Unexpected events often distract us. In the laboratory, novel auditory stimuli have been shown to capture attention away from a focal visual task and yield specific electrophysiological responses as well as a behavioral cost to performance. Distraction is thought to follow ineluctably from the sound's low probability of occurrence or, put more simply, its unexpected occurrence. Our study challenges this view with respect to behavioral distraction and argues that past research failed to identify the informational value of sound as a mediator of novelty distraction. We report an experiment showing that (1) behavioral novelty distraction is only observed when the sound announces the occurrence and timing of an upcoming visual target (as is the case in all past research); (2) that no such distraction is observed for deviant sounds conveying no such information; and that (3) deviant sounds can actually facilitate performance when these, but not the standards, convey information. We conclude that behavioral novelty distraction, as observed in oddball tasks, is observed in the presence of novel sounds but only when the cognitive system can take advantage of the auditory distracters to optimize performance. PMID:20338553
Parmentier, Fabrice B R; Elsley, Jane V; Ljungberg, Jessica K
Entering a new millennium seems a good time to challenge some old ideas, which in our view are implausible, have little supportive evidence, and might best be left behind. In this essay, we summarize a decade of work, raising four issues that involve toxicology, nutrition, public health, and government regulatory policy. (a) Paracelsus or parascience: the dose (trace) makes the poison. Half of all chemicals, whether natural or synthetic, are positive in high-dose rodent cancer tests. These results are unlikely to be relevant at the low doses of human exposure. (b) Even Rachel Carson was made of chemicals: natural vs. synthetic chemicals. Human exposure to naturally occurring rodent carcinogens is ubiquitous, and dwarfs the general public's exposure to synthetic rodent carcinogens. (c) Errors of omission: micronutrient inadequacy is genotoxic. The major causes of cancer (other than smoking) do not involve exogenous carcinogenic chemicals: dietary imbalances, hormonal factors, infection and inflammation, and genetic factors. Insufficiency of many micronutrients, which appears to mimic radiation, is a preventable source of DNA damage. (d) Damage by distraction: regulating low hypothetical risks. Putting huge amounts of money into minuscule hypothetical risks damages public health by diverting resources and distracting the public from major risks. PMID:10686303
Ames, B N; Gold, L S
Extraction of teeth is the most common minor surgical procedure performed. Complication of extraction ranges from periodontal injury to fracture of jaw in the mandible and fracture of tuberosity and oroantral communication in the maxilla. Subconjunctival hemorrhage after extraction of maxillary molar is a very rare complication, and so far, only one case is reported in the literature. We report a case of subconjunctival hemorrhage with maxillary tuberosity fracture after maxillary third molar extraction.
Thirumurugan, Kanagasabapathy; Munzanoor, Rathinam Ramesh Babu; Prasad, Gnanasekaran Arun; Sankar, Kannan
Extraction of teeth is the most common minor surgical procedure performed. Complication of extraction ranges from periodontal injury to fracture of jaw in the mandible and fracture of tuberosity and oroantral communication in the maxilla. Subconjunctival hemorrhage after extraction of maxillary molar is a very rare complication, and so far, only one case is reported in the literature. We report a case of subconjunctival hemorrhage with maxillary tuberosity fracture after maxillary third molar extraction. PMID:23633874
Thirumurugan, Kanagasabapathy; Munzanoor, Rathinam Ramesh Babu; Prasad, Gnanasekaran Arun; Sankar, Kannan
Objective The aims of this study were to compare different surgical approaches to rapid canine retraction by designing and selecting the most effective method of reducing resistance by a three-dimensional finite element analysis. Material and Methods Three-dimensional finite element models of different approaches to rapid canine retraction by reducing resistance and distraction were established, including maxillary teeth, periodontal ligament, and alveolar. The models were designed to dissect the periodontal ligament, root, and alveolar separately. A 1.5 N force vector was loaded bilaterally to the center of the crown between first molar and canine, to retract the canine distally. The value of total deformation was used to assess the initial displacement of the canine and molar at the beginning of force loading. Stress intensity and force distribution were analyzed and evaluated by Ansys 13.0 through comparison of equivalent (von Mises) stress and maximum shear stress. Results The maximum value of total deformation with the three kinds of models occurred in the distal part of the canine crown and gradually reduced from the crown to the apex of the canine; compared with the canines in model 3 and model 1, the canine in model 2 had the maximum value of displacement, up to 1.9812 mm. The lowest equivalent (von Mises) stress and the lowest maximum shear stress were concentrated mainly on the distal side of the canine root in model 2. The distribution of equivalent (von Mises) stress and maximum shear stress on the PDL of the canine in the three models was highly concentrated on the distal edge of the canine cervix. Conclusions Removal of the bone in the pathway of canine retraction results in low stress intensity for canine movement. Periodontal distraction aided by surgical undermining of the interseptal bone would reduce resistance and effectively accelerate the speed of canine retraction.
XUE, Junjie; YE, Niansong; YANG, Xin; WANG, Sheng; WANG, Jing; WANG, Yan; LI, Jingyu; MI, Congbo; LAI, Wenli
Observed 10-, 26-, and 42-month-olds playing under several distraction conditions to describe development of attention and distractibility. Found that casual attention decreased and focused attention increased with age. Ten-month-olds were more distractible than older children, even during focused attention. Infants were most distracted by the…
Ruff, Holly A.; Capozzoli, Mary C.
The aims of this study were to examine the effect of implant neck design and cortical bone thickness using 3D finite element analysis and to analyse the stability of clinical evidence based on micromotion and principal stress. Four commercial dental implants for a type IV bone and maxillary segments were created. Various parameters were considered, including the osseointegration condition, loading
I-Chiang Chou; Shyh-Yuan Lee; Ming-Chang Wu; Chia-Wei Sun; Cho-Pei Jiang
Introduction: Radial bone loss associated with gross manus valgus deformity can be managed by open reduction internal fixation using intervening strut bone graft, callus distraction using ring or monoaxial fixator, and achieving union by distraction histogenesis. These methods are particularly suitable when bone loss is small. Single or staged procedure is described for congenital as well as in acquired extensive bone loss of radius. Distraction through radial proximal to distal segments, to achieve reduction of distal radio-ulnar joint (DRUJ), is also described in acquired cases. In the present series, functional results of distraction through ulna to 2nd metacarpal is studied alongwith, functional status of hand, stability of wrist, level of patient's satisfaction are also studied. Materials and Methods: 7 unilateral cases of radial loss (M = 5, F = 2) affecting 4 right hands of mean age 17 years (range 9 to 24 years) were included in this study. They were treated by distracting through ulna to 2nd metacarpal to achieve DRUJ alignment in first stage. Subsequently ulna was osteotomised and translated to distal stump of radius. It was then fixed to the distal radial remnant in 30° pronation in dominant and 30° supination non dominant hands. Results: Union was achieved in all cases associated with beneficial cross union of distal ulna. Hand functions improved near to normal, with fully corrected stable wrist joint, hypertrophied ulna and without recurrence. All of them had practically complete loss of forearm rotations, however patients were fully satisfied. Conclusion: This method is particularly suitable when associated with 6 cm or more radial bone loss. But when loss is small, sacrifice of one bone may not be justifiable.
Pal, Jitendra N; Banik, Rajeeb
Background Management of post trauma tibia bone gap varied with orthopedic surgeons’ experience and tools available. Study aims to determine predictive factors for distraction by a monotube fixator (DMF) outcome in post tibia trauma limb length discrepancy. Methods A prospective descriptive cross sectional study of post traumatized tibia bone gap and limb length discrepancy patients at tertiary hospitals. Patient’s informed consent and institutional ethical committee approval were obtained. Bio-data, clinical and healing indexes were documented. DMF was applied for patient that met inclusion criteria. The Statistic tests used included the Chi-square, the Student’s two-tailed t test, and the Wilcox on rank-sum test when appropriate. Mantel-Haenszel Common Odds Ratio (OR) and 95% confidence intervals for poor outcome potential risk factors were recorded. Bivariate correlation and logistic regression were evaluated. Significance level was set at a p value <0.05. Results Thirty-six patients with mean age, 37.2?±?10.3 year and male/female ratio of 1:1.25 had DMF applied. Motorcycle accident accounted for 50.0% of patients and diaphyseal segment was most commonly affected 25 (69.4%). The mean bone lengthened was 10.1?±?4.0 cm (range: 5-21 cm) and mean duration of bone transport was 105.6?±?38.2 days. The means of rate of distraction, healing index and percentage of lengthening were 0.99?±?0.14 mm/day, 15.6?±?4.3 days/cm and 38.0?±?14.3 respectively. The mean follow up was 9.7 ±4.9 months (range: 2–17.0). Per operative complications varied and outcome was satisfactory in 30 (83.3%). Obesity (p <0.0001), multiple surgery (p?=?0.012) and transfusion (p?=?0.001) correlated to poor outcome. Percentage lengthening???50%, bone gap >10 cm, anemia, blood transfusion, general anesthesia administration, distraction rate >1 mm/day, osteomyelitis and prolong partial weight bearing were significant predictive factors for poor outcome in post traumatic tibia distraction. Conclusion Distraction by a monotube fixator appears effective in achieving correction >38.0% original tibia lengthening following traumatic bone gap. Predictive factors for poor outcome were useful for prognostication.
Distraction osteogenesis (DO) is a surgical technique producing bone lengthening by distraction of the fracture callus. Although a large number of experimental studies on the events associated with DO of craniofacial skeleton have been reported, the few employing rat mandibular bone DO used complicated designs and produced a small volume of newly formed bone. Thus, this study aims to present an original experimental model of mandibular DO in edentulous rats that produces a sufficient quantity and quality of intramembranous bone. Eight male Wistar rats, weighing 75 g, underwent extraction of lower molars. With rats weighing 350 g, right mandibular osteotomy was performed and the distraction device was placed. The distraction device was custom made using micro-implants, expansion screws, and acrylic resin. Study protocol: latency: 6 days, distraction: ¼ turn (0.175 mm) once a day during 6 d, consolidation: 28 d after distraction phase, sacrifice. DO-treated and contralateral hemimandibles were dissected and compared macroscopically and using radiographic studies. Histological sections were obtained and stained with H&E. A distraction gap filled with newly formed and mature bone tissue was obtained. This model of mandibular DO proved useful to obtain adequate quantity and quality of bone to study bone regeneration. PMID:21670853
Bigi, Maria Montserrat Pujadas; Lewicki, Marianela; Ubios, Angela Matilde; Mandalunis, Patricia Monica
Five cases of patients having supernumerary teeth in the distomolar regions of the mandibular and maxillary arches are reported. Supernumerary bicuspids were also seen in three of the five cases. The patients complained of pericoronitis or had no symptoms...
P. S. Grover L. Lorton
Postoperative maxillary cyst is a quite rare delayed complication of surgical intervention associated with maxillary sinuses. It occurs many years after surgery. This paper describes a 54-year-old woman presenting with swelling of left cheek for seven-years duration. The orthopantomograph revealed a unilocular cystic radiolucency with well-defined margins in left maxillary sinus. In the computerized tomography, the cyst had a sclerotic wall with bony condensations. Aspiration cytology revealed many neutrophil leukocytes. Cyst was drained and enucleated. Histopathologically, it had a fibrous wall with inflammation and focal reactive bone formation and lined by a respiratory-type epithelium. In the clinical history, it is learned that she had a maxillary sinus surgery 8 years ago and the diagnosis was made considering the clinical and histopathological findings.
Bulut, Asiye Safak; Sehlaver, Celal; Percin, Alp Korkut
We retrospectively reviewed a new preimplantation regenerative augmentation technique for a severely atrophic posterior maxilla using sinus lifting with simultaneous alveolar distraction, together with long-term oral rehabilitation with implants. We also analyzed the regenerated bone histomorphologically. This study included 25 maxillary sinus sites in 17 patients. The technique consisted of alveolar osteotomy combined with simultaneous sinus lifting. After sufficient sinus lifting, a track-type vertical alveolar distractor was placed. Following a latent period, patient self-distraction was started. After the required augmentation was achieved, the distractor was left in place to allow consolidation. The distractor was then removed, and osseointegrated implants (average of 3.2 implants per sinus site, 80 implants) were placed. Bone for histomorphometric analysis was sampled from six patients and compared with samples collected after sinus lifting alone as controls (n = 4). A sufficient alveolus was regenerated, and all patients achieved stable oral rehabilitation. The implant survival rate was 96.3% (77/80) after an average postloading followup of 47.5 months. Good bone regeneration was observed in a morphological study, with no significant difference in the rate of bone formation compared with control samples. This new regenerative technique could be a useful option for a severely atrophic maxilla requiring implant rehabilitation.
Kanno, Takahiro; Mitsugi, Masaharu; Paeng, Jun-Young; Sukegawa, Shintaro; Furuki, Yoshihiko; Ohwada, Hiroyuki; Nariai, Yoshiki; Ishibashi, Hiroaki; Katsuyama, Hideaki; Sekine, Joji
Maintaining a selective attention set allows us to efficiently perform sensory tasks despite the multitude of concurrent sensory stimuli. Unpredictably occurring, rare events nonetheless capture our attention, that is, we get distracted. The present study investigated the efficiency of control over distraction as a function of preparation time available before a forthcoming distracter. A random sequence of short and long tones (100 or 200 ms with 50-50 % probability) was presented. Independently from tone duration, occasionally (13.3 % of the time), the pitch of a tone was changed. Such rare pitch variants (distracters) usually lead to delayed and less precise discrimination responses, and trigger a characteristic series of event-related potentials (ERPs) reflecting the stages of distraction-related processing: starting with negative ERPs signaling the sensory registration of the distracter; a P3a-usually interpreted as a reflection of involuntary attention change and finally the so-called reorienting negativity signaling the restoration of the task-optimal attention set. In separate conditions, 663 or 346 ms before each tone (long or short cue-tone interval), a visual cue was presented, which signaled whether the forthcoming tone was a distracter (rare pitch variant), with 80 % validity. As reflected by reduced reaction time delays and P3a amplitudes, valid cues led to the prevention of distraction, but only in the long cue-tone interval condition. The analyses of the cue-related P3b and contingent negative variation showed that participants made more effort to utilize cue information to prevent distraction in the long cue-tone than in the short cue-tone interval condition. PMID:23975153
Clinical update--the teeth and the maxillary sinus: the mutual impact of clinical procedures, disease conditions and their treatment implications. Part 2. Odontogenic sinus disease and elective clinical procedures involving the maxillary antrum: diagnosis and management.
Although odontogenic sinusitis is a rare entity when compared to sinus disease of rhinogenic origin, it is extremely important to identify a dental aetiology when it occurs. The offending tooth or teeth would thus require endodontic treatment or extraction, and the sinus disease carefully assessed and appropriately managed. Aetiology and presentation of oro-antral fistulae are also discussed and guidelines for the management of this complication are recommended. Certain lesions such as cysts and tumours may involve the jaws and hence the maxillary antrum; some of these, such as a radicular cyst are quite common, but the rarer ones are included for completeness. Surgical techniques are continuously evolving to optimise form and function of the jaws, and when applied to the maxilla there may be some impact on nasal and sinus function. The advent, and now proven success, of osseointegrated jaw implants have brought with them innovations and refinements of bone grafting techniques, and more recently distraction osteogenesis for augmentation. Maxillary osteotomies for surgical orthodontics, and to facilitate prosthodontic treatment are briefly mentioned, as most of these inevitably involve the antrum and/or nose. This paper discusses, in summary form, important aspects of clinical dental practice which may involve the maxillary antrum. It is thus a broad overview of certain pathologic conditions and elective surgical procedures which have relevance to both medical and dental practitioners. PMID:11411074
Sandler, H J
Clinical diagnostic information was analysed and compared with conventional x-ray and B-scan examination in 90 patients with maxillary sinus diseases of dental origin. In certain diseases (sinusitis, cysts) the ultrasonic sonography offered little additional clinical-relevant information. On the other hand this modern noninvasive, picture yielding and ever reproducible method is predestined for objective confirmation of the late complaint after maxillary sinus operation. But the high apparatus technical investment limits its application in large scale. PMID:2526427
Nitzschke, M; Walter, U; Pilz, G
The aim of this study was to test how distraction influences pain, distress and anxiety in children during wound care. Sixty participants aged 5-12 years were randomized to three groups: serious gaming, the use of lollipops and a control group. Self-reported pain, distress, anxiety and observed pain behaviour were recorded in conjunction with wound care. Serious gaming, an active distraction, reduced the observed pain behaviour and self-reported distress compared with the other groups. A sense of control and engagement in the distraction, together, may be the explanation for the different pain behaviours when children use serious gaming. PMID:22819747
Nilsson, Stefan; Enskär, Karin; Hallqvist, Carina; Kokinsky, Eva
Activities that require focused attention, such as reading, are declining among American youth, while activities that depend on multitasking, such as instant messaging (IMing), are increasing. We hypothesized that more time spent IMing would relate to greater difficulty in concentrating on less externally stimulating tasks (e.g., academic reading). As hypothesized, the amount of time that young people spent IMing was significantly related to higher ratings of distractibility for academic tasks, while amount of time spent reading books was negatively related to distractibility. The distracting nature and the context of IMing in this population are described. PMID:17711365
Levine, Laura E; Waite, Bradley M; Bowman, Laura L
Background Maxillary sinus mucoceles are relatively rare among all paranasal sinus mucoceles. With the introduction of endoscopic sinus surgical techniques, rhinologic surgeons prefer transnasal endoscopic management of sinus mucoceles. The aim of this study is to describe the clinical presentation of maxillary sinus mucoceles and to establish the efficacy of endoscopic management of sinus mucoceles. Methods Between 2003 and 2005, 14 patients underwent endoscopic sinus surgery for maxillary sinus mucocele. The presenting sign and symptoms, radiological findings, surgical management and need for revision surgery were reviewed. Results There were eight males and six females with an age range of 14 to 65. Ten patients complained of nasal obstruction, five of nasal drainage, five of cheek pressure or pain and one of proptosis of the eye and cheek swelling. The maxillary sinus and ipsilateral ethmoid sinus involvement on computed tomographic studies was seen in 4 patients. Four patients had history of endoscopic ethmoidectomy surgery for ethmoid sinusitis and one had Caldwell-Luc operation in the past. Ethmoidectomy with middle meatal antrostomy and marsupialization of the mucocele was performed in all patients. Postoperative follow-up ranged between 8 to 48 months. All patients had a patent middle meatal antrostomy and healthy maxillary sinus mucosa. No patients need revision surgery. Conclusion The most common causes of mucoceles are chronic infection, allergic sinonasal disease, trauma and previous surgery. In 64% of the patients of our study cause remains uncertain. Endoscopic sinus surgery is an effective treatment for maxillary sinus mucoceles with a favorable long-term outcome.
Caylakli, Fatma; Yavuz, Haluk; Cagici, Alper Can; Ozluoglu, Levent Naci
Recent research has demonstrated that task-irrelevant stimuli presented simultaneously with a target-distractor stimulus reduce distraction and improve selective attention. In studies examining this reduced interference effect, visual selective attention tasks and concurrently presented task-irrelevant stimuli are used. We report first evidence for a similar effect in the auditory domain and with nonconcurrent stimuli (i.e., the task-irrelevant stimuli are presented before the target). The effect of nonconcurrently presented auditory tones on an auditory Stroop task developed by Leboe and Mondor (Psychological Research, 71, 568--575, 2007) was investigated. Stroop interference was reduced when task-irrelevant tones were presented before the Stroop stimulus. We conclude that task-irrelevant stimuli can improve selective attention not only when presented concurrently, but also when presented before the selective attention task. Our results are consistent with the hypothesis that interference reduction is due to perceptual dilution caused by task-irrelevant stimuli. PMID:21264700
Dittrich, Kerstin; Stahl, Christoph
A common dilemma in adult orthodontic treatment is deciding how best to treat missing posterior teeth. One treatment option is to orthodontically close the space. But closure can be difficult, especially if the open space is in the maxillary posterior area, because tooth movement through the maxillary sinus is limited. The increased difficulty of moving teeth in the maxillary sinus is similar to moving a tooth in the atrophic posterior mandibular ridge. If space closure is selected as a treatment method, proper mechanics and light forces should be applied. In this article, we report movement of teeth through the maxillary sinus and discuss various implications related to orthodontic treatment in the maxillary sinus. PMID:24373659
Park, Jae Hyun; Tai, Kiyoshi; Kanao, Akira; Takagi, Masato
...DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration...Docket No. PHMSA-2010-0194] Pipeline Safety: Personal Electronic Device Related Distractions AGENCY: Pipeline and Hazardous Materials Safety...
An experiment was conducted to assess the distraction potential of secondary tasks performed using in-vehicle systems (radio tuning, destination entry) and portable phones (10-digit dialing, selecting contacts, text messaging) while driving. One hundred p...
E. Parmer E. N. Mazzae G. H. S. Baldwin J. Martin T. A. Ranney
The process of rapid canine distalization through the distraction of the periodontal ligament is similar to the process in the midpalatal suture during rapid palatal expansion. Rapid canine distalization can be achieved in three weeks with this technique. The aim of this research was to evaluate the effects of rapid canine distalization on dentoalveolar tissues during the rapid distalization of canine teeth with semirigid, individual tooth-borne distractors. The study was carried out on 43 canine teeth in 18 (seven male and 11 female) patients who required first premolar extractions. The mean age of the patients was 16.7 years. The second premolars and first molars were used as anchor units. Orthodontic models, cephalometric and panoramic radiographs, and standard photographs of all the patients were taken before treatment and after the consolidation period. Periapical radiographies of the canines and anchor units were obtained once a week during the distalization period. The distractors were activated 0.25 mm three times a day, and the canines were distalized efficiently an average of three weeks. The within-group differences were evaluated with the Wilcoxon test. The maxillary canines were distalized an average of 5.76 mm with 11.47 degrees distal tipping. The maxillary first molars moved mesially 0.56 mm and extruded 0.64 mm. The maxillary incisors showed 1.44 degrees of palatal tipping. The mean distal movement of the mandibular canines was 3.5 mm with 7.16 degrees distal tipping. Anchorage loss was not observed in the mandibular first molars. PMID:15264639
Sayin, Seher; Bengi, A Osman; Gürton, A Umit; Ortako?lu, Kerim
Arthroscopic ankle arthrodesis has shown high rates of union comparable to those with open arthrodesis but with substantially less postoperative morbidity, shorter operative times, less blood loss, and shorter hospital stays. To easily perform arthroscopic resection of the articular cartilage, sufficient distraction of the joint is necessary to insert the arthroscope and instruments. However, sometimes, standard noninvasive ankle distraction will not be sufficient in post-traumatic ankle arthritis, with the development of arthrofibrosis and joint contracture after severe ankle trauma. In the present report, we describe a technique to distract the ankle joint by inserting a 4.6-mm stainless steel cannula with a blunt trocar inside the joint. The cannula allowed sufficient intra-articular distraction, and, at the same time, a 4.0-mm arthroscope can be inserted through the cannula to view the joint. Screws can be inserted to fix the joint under fluoroscopic guidance without changing the patient's position or removing the noninvasive distraction device and leg holder, which are often necessary during standard arthroscopic arthrodesis with noninvasive distraction. PMID:24717518
Kim, Hyong Nyun; Jeon, June Young; Noh, Kyu Cheol; Kim, Hong Kyun; Dong, Quanyu; Park, Yong Wook
The advent of stem cell-based therapies makes current models of mandibular distraction osteogenesis unwieldy. We thereby designed an isogenic model of distraction osteogenesis whose purpose was to allow for the free transfer of cells and components between rats. As immune response plays a significant role in healing and prevention of infection, an immune-competent mode is desirable rather than an athymic rat/xenograft model. The purposes of this study were as follows: (1) to replicate established models of distraction osteogenesis in a rodent model using an isogenic rat strain, and (2) to characterize the differences between inbred, isogenic rats and outbred rats in mandibular distraction osteogenesis via radiomorphometry and biomechanical response analysis. We demonstrated successful distraction osteogenesis to 5.1 mm in all Lewis (isogenic) rat mandibles as well as all Sprague-Dawley (outbred) rat mandibles, with no significant difference in volume-normalized radiomorphometrics, trending difference in non-volume-normalized radiomorphometrics and significant differences in biomechanical response parameters. We attribute the differences demonstrated to the decreased size of the Lewis rat mandible in comparison to Sprague-Dawley mandibles. We also provide information with caring with the additional needs of the Lewis rat. Given these differences, we find that Lewis rats function as an excellent model for isogenic mandibular distraction osteogenesis, but data procured may not be comparable between isogenic and nonisogenic models. PMID:23524737
Deshpande, Sagar S; Weiss, Daniela M; Donneys, Alexis; Gallagher, Katherine K; Tchanque-Fossuo, Catherine N; Sarhaddi, Deniz; Buchman, Steven R
The purpose of this study was to describe our technique of bilateral mandibular distraction for micrognathia and to highlight the ultrasonic scalpel as an alternative to conventional saws in performing osteotomies for mandibular distraction osteogenesis. To do so, we retrospectively reviewed all patients who underwent mandibular distraction with an ultrasonic scalpel for tongue-based upper airway obstruction due to micrognathia between 2010 and 2011. Study outcome measures include operative blood loss, length of surgery, postoperative complications, and avoidance of a tracheostomy. Excel (Microsoft) was used to calculate averages, P values (2-tailed Student t test), and SDs for operative data, sleep studies, and cephalometric analysis. Nine patients--7 females and 2 males--were distracted for a mean distance of 17 ± 6 mm. Mean blood loss was 15 ± 7 mL, and the average length of surgery was 111 ± 27 minutes. One patient returned to the operating room for debridement/washout of a wound infection, but distraction was continued without sequelae. There were no other postoperative complications. Resolution of airway obstruction was evidenced by clinical examination and avoidance of a tracheostomy in all cases. Based on these data, we feel that mandibular distraction with univector, internal distractors, and ultrasonic osteotomies at the mandibular angle is safe and efficacious at relieving tongue-based upper airway obstruction and avoiding a tracheostomy. PMID:22948652
Chung, Cyndi Uy; Yu, Jason W; Bastidas, Nicholas; Bartlett, Scott P; Taylor, Jesse Adam
Automobile driving is a safety-critical real-world example of multitasking. A variety of roadway and in-vehicle distracter tasks create information processing loads that compete for the neural resources needed to drive safely. Drivers with mind and brain aging may be particularly susceptible to distraction due to waning cognitive resources and control over attention. This study examined distracted driving performance in an instrumented vehicle (IV) in 86 elderly (mean=72.5 years, SD=5.0 years) and 51 middle-aged drivers (mean=53.7 years, SD=9.3 year) under a concurrent auditory-verbal processing load created by the Paced Auditory Serial Addition Task (PASAT). Compared to baseline (no-task) driving performance, distraction was associated with reduced steering control in both groups, with middle-aged drivers showing a greater increase in steering variability. The elderly drove slower and showed decreased speed variability during distraction compared to middle-aged drivers. They also tended to "freeze up", spending significantly more time holding the gas pedal steady, another tactic that may mitigate time pressured integration and control of information, thereby freeing mental resources to maintain situation awareness. While 39% of elderly and 43% of middle-aged drivers committed significantly more driving safety errors during distraction, 28% and 18%, respectively, actually improved, compatible with allocation of attention resources to safety critical tasks under a cognitive load. PMID:22269561
Thompson, Kelsey R; Johnson, Amy M; Emerson, Jamie L; Dawson, Jeffrey D; Boer, Erwin R; Rizzo, Matthew
Selective attention involves the exclusion of irrelevant information in order to optimize perception of a single source of sensory input; failure to do so often results in the familiar phenomenon of distraction. The term 'distraction' broadly refers to a perceptual phenomenon. In the present study we attempted to find the electrophysiological correlates of distraction using an auditory discrimination task. EEG and event-related potential responses to identical stimuli were compared under two levels of distraction (continuous broad-band noise or continuous speech). Relative to broad-band noise, the presence of a continuous speech signal in the unattended ear impaired task performance and also attenuated the N1 peak evoked by nontarget stimuli in the attended ear. As the magnitude of a peak in the event-related potential waveform can be modulated by differences in intertrial power but also by differences in the stability of EEG phase across trials, we sought to characterize the effect of distraction on intertrial power and intertrial phase locking around the latency of the N1. The presence of continuous speech resulted in a prominent reduction of theta EEG band intertrial phase locking around the latency of the N1. This suggests that distraction may act not only to disrupt a sensory gain mechanism but also to disrupt the temporal fidelity with which the brain responds to stimulus events. PMID:22314684
Ponjavic-Conte, Karla D; Dowdall, Jarrod R; Hambrook, Dillon A; Luczak, Artur; Tata, Matthew S
The sensitivity of involuntary attention to top-down modulation was tested using an auditory-visual distraction task and a working memory (WM) load manipulation in subjects performing a simple visual classification task while ignoring contingent auditory stimulation. The sounds were repetitive standard tones (80%) and environmental novel sounds (20%). Distraction caused by the novel sounds was compared across a 1-back WM condition
Iria Sanmiguel; María-josé Corral; Carles Escera
The standard treatment in the early stage of maxillary sinus cancer is surgical resection followed by postoperative radiation therapy. However, for locally advanced maxillary sinus cancer, a multimodality treatment approach is strongly recommended to improve the survival rate and quality of life of the patient. We determined the treatment outcomes of induction chemotherapy, concurrent chemoradiation therapy, and surgical resection for locally advanced maxillary sinus cancer. Forty-four patients with locally advanced maxillary sinus cancer, who had been treated between January 1990 and April 2008 at Kangnam St. Mary's Hospital, were retrospectively analyzed. The objective response rates were 70%, 53%, and 57% in the intra-arterial induction chemotherapy, intravenous induction chemotherapy, and concurrent chemoradiation therapy groups, respectively. The orbital preservation rates were 83%, 100%, and 75% in the intra-arterial induction chemotherapy, intravenous induction chemotherapy, and surgical resection groups, respectively. In seven of nine patients in whom the orbit could be preserved after induction chemotherapy, the primary tumors were removed completely. However, although the orbits were preserved in three patients who underwent surgical resection as a primary treatment, all three cases were confirmed to be incomplete resections. We found that active induction chemotherapy for locally advanced cancer of the maxillary sinus increased the possibility of complete resection with orbital preservation as well as tumor down-staging.
Won, Hye Sung; Chun, Sang Hoon; Kim, Bum-soo; Chung, So Ryoung; Yoo, Ie Ryung; Jung, Chan-Kwon; Kim, Yeon-Sil; Sun, Dong-il; Kim, Min Sik; Kang, Jin-Hyoung
Summary Background When the incisors do not erupt at the expected time, it is crucial for the clinician to determine the etiology and formulate an appropriate treatment plan. Aim The aim of this report is to provide useful information for immediate diagnosis and management of impacted maxillary incisors using the interceptive treatment: removal of obstacles and rapid maxillary expansion (RME). Design An accurate diagnosis may be obtained with clinical and radiographic exam such as panoramic radiograph, computerized tomography (CT) and cone beam computerized tomography (CBCT). It’s important to know the predictive measurements of eruption evaluated on panoramic radiograph: distance from the occlusal plane, maturity, angulation and vertical position of the unerupted incisors. Early diagnosis is important and interceptive orthodontic treatment, such as removal of obstacles and orthopedic rapid maxillary expansion (RME), may correct disturbances during the eruption through recovering space for the incisors and improving the intraosseus position of delayed teeth. Results RME treatment following the surgical removal of the obstacle to the eruption of maxillary incisors leads to an improvement of the intraosseus position of the tooth. Conclusions The angulation and the vertical position of the delayed tooth appear to be important in trying to predict eruption. The improvement of the intraosseus position of the unerupted incisor, obtained by removal of the odontoma and rapid maxillary expansion, permits a conservative surgery and the achievement of an excellent esthetics and periodontal result.
Pavoni, Chiara; Mucedero, Manuela; Lagana, Giuseppina; Paoloni, Valeria; Cozza, Paola
Segmental odontomaxillary dysplasia (SOD) is a rare developmental disorder of the maxilla, characterized by variability of its clinical and radiological features and may mimic other fibro-osseous lesions. Clinically, the disorder is often diagnosed in early childhood due to a unilateral buccolingual expansion of the posterior alveolar process, gingival enlargement, absence of one or both premolars in the affected region, delayed eruption of the adjacent teeth, and malformations of the primary molars. We describe a rare case of a SOD in a 19-year-old female comprising findings similar to earlier reports, but for the first time SOD is reported along midline. She presented with pre-maxillary enlargement and abnormal pattern of eruption of anterior maxillary permanent teeth. Radiographic imaging showed abnormal bony trabeculation. Histopathologic findings showed characteristic features of SOD. We herein report a case of this rare unusual anomaly and review the literature. Clinicians should be aware of its presence when encountering patients presenting with facial asymmetry unresponsive to treatment. PMID:23483745
Shah, Ajaz; Latoo, Suhail; Ahmed, Irshad; Malik, Altaf H; Hassan, Shahid; Bhat, Abraar; Mir, Shazia; Jain, Nitul
Segmental odontomaxillary dysplasia (SOD) is a rare developmental disorder of the maxilla, characterized by variability of its clinical and radiological features and may mimic other fibro-osseous lesions. Clinically, the disorder is often diagnosed in early childhood due to a unilateral buccolingual expansion of the posterior alveolar process, gingival enlargement, absence of one or both premolars in the affected region, delayed eruption of the adjacent teeth, and malformations of the primary molars. We describe a rare case of a SOD in a 19-year-old female comprising findings similar to earlier reports, but for the first time SOD is reported along midline. She presented with pre-maxillary enlargement and abnormal pattern of eruption of anterior maxillary permanent teeth. Radiographic imaging showed abnormal bony trabeculation. Histopathologic findings showed characteristic features of SOD. We herein report a case of this rare unusual anomaly and review the literature. Clinicians should be aware of its presence when encountering patients presenting with facial asymmetry unresponsive to treatment.
Shah, Ajaz; Latoo, Suhail; Ahmed, Irshad; Malik, Altaf H.; Hassan, Shahid; Bhat, Abraar; Mir, Shazia; Jain, Nitul
This study evaluated different techniques for surgically assisted rapid maxillary expansion (SARME) according to the type of transverse maxillary deficiency using computed tomography (CT). Six adult patients with bilateral transverse maxillary deficiencies underwent SARME. The patients were equally divided into three groups: Group I, maxillary atresia in both the anterior and posterior regions; Group II, greater maxillary atresia in the anterior region; and Group III, increased maxillary atresia in the posterior region. In Group I, a subtotal Le Fort I osteotomy was used. In Group II, a subtotal Le Fort I osteotomy was used without pterygomaxillary suture disjunction. In Group III, a subtotal Le Fort I osteotomy was used with pterygomaxillary suture disjunction and fixation of the anterior nasal spine with steel wire. The midpalatal suture opening was evaluated preoperatively and immediately after the activation period using CT. For Group I, the opening occurred parallel to midpalatal suture; for Group II, the opening comprised a V-shape with a vertex on the posterior nasal spine; and for Group III, the opening comprised a V-shape with a vertex at the anterior nasal spine. The conclusion was that the SARME technique should be individualized according to the type of transverse maxillary deficiency. PMID:22578567
Pereira, M D; de Abreu, R A M; Prado, G P R; Ferreira, L M
A young man, 19 years of age, with the chief complaint of an anterior open bite, came for orthodontic treatment with a skeletal Class I relationship, anterior open bite, shortened maxillary incisor roots, and relative macroglossia. The malocclusion was treated by extracting the maxillary first premolars and using a fixed edgewise appliance. A partial glossectomy was performed before the orthognathic surgery with a 3-piece segmental LeFort I mandibular setback, and advancement was achieved with a reduction genioplasty. A functional and esthetic occlusion with an improved facial profile was established, and the apex of the maxillary left central incisor became slightly rounded after prolonged and significant tooth movement. Four years after treatment, there was occlusal stability of the results, and no further root shortening was observed. PMID:23810054
Tanaka, Orlando Motohiro; Guariza-Filho, Odilon; Carlini, João Luiz; Oliveira, Dauro Douglas; Pithon, Matheus Mello; Camargo, Elisa Souza
Micro-displacements (fringe patterns) in the bones of the craniofacial complex as seen through laser holography during midpalatal sutural expansion with the Hyrax appliance are used to define the centers of rotation of the maxillary halves in both the frontal and occlusal views. Biomechanical analyses of the maxillary expansion force system are concomitant with the holographic findings and strongly suggest that the stainless steel wires joining the teeth to any expansion device be of the largest diameter possible. In addition, in the case of the Hyrax expansion device, it is recommended that the manufacturer increase the diameter of the activating screw as well as those of the 2 adjacent wire guides. And, importantly, the use of acrylic as a structural member to join the teeth to a sutural expansion device should be avoided if tipping of the maxillary halves is to be minimized, as the acrylic lacks sufficient rigidity. PMID:10982925
Braun, S; Bottrel, J A; Lee, K G; Lunazzi, J J; Legan, H L
Chronic sinusitis, especially maxillary sinusitis is a common disorder in humans. Seromucous sinusitis is rarely described in the literature. The present study deals with the clinical and laboratory characteristics of a group of patients suffering from the above disorder. During the last 10 years, 32 patients suffering from seromucous maxillary sinusitis were enrolled in the study. Patients' charts were reviewed and tabulated according to age, sex, history, clinical symptoms and laboratory findings. Treatment was based on punction and drainage of the seromucous effluent. Results were also statistically evaluated. Flight trips and atypical episodes of nasal infection were the predisposing factors for seromucous maxillary sinusitis. The only clinical manifestation was coughing, for at least 12 weeks before diagnosis. Sinus effluent was composed by serous and mucous constituents with glue like structure. There were no differences between sexes in predisposing factors, or x-ray findings. The treatment is paracentesis and drainage and in one case of recurrence, middle meatotomy and sinus endoscopy. PMID:11256194
Assimakopoulos, D; Danielides, V; Kontogiannis, N; Skevas, A; Evangelou, A; Van Cauwenberge, P
In this study, we documented the prevalence of coronal axis malalignment in a series of 93 tibias (from 54 patients) lengthened with monolateral fixation. The average length obtained by distraction osteogenesis was 8.9 cm (range, 3.5-15.6) or 38% of the original bone length (range, 11-78%). Fifty (54%) of 93 tibias had documented valgus angulation of > or = 10 degrees or had fixator manipulation during the lengthening process for undesirable or progressive angulation; no cases of varus angulation were noted. Thirteen (14%) segments had later corrective osteotomy for unsatisfactory valgus malalignment. Statistical analysis revealed two factors to have a significant effect on the rate of malalignment. Those cases that had tibial osteotomy below the proximal one third of the original tibial length and those cases in which the fixator was placed > 5 degrees out of parallel had higher rates of angulation or manipulation (p < 0.001 and p = 0.002). Although the percentage of original bone lengthened was not statistically significant (p = 0.083), it did have an important effect on rates of axial malalignment. From this study we conclude that relatively high rates of malalignment in the tibia during distraction osteogenesis with monolateral external fixation are predominately the result of more distal osteotomies and nonparallel fixator placement. Attention to these details in general, and particularly where long lengthenings are planned, may significantly reduce this common complication. PMID:9580305
Leyes, M; Noonan, K J; Forriol, F; Cañadell, J
This study relates two behaviours, each well documented within its own literature but not previously considered together: closing-in behaviour (CIB) and the effect of visual distractors on reaching. CIB is common in typically developing children, and in adults with dementia, and classically manifests as the tendency to perform graphic copying tasks very close to, or on the top of the model. The effect of visual distractors on reaching has been studied extensively in normal adults. Distractors induce characteristic deviations of the reach, usually away from the distractor, which imply that a competing response towards the distractor is automatically primed, and actively suppressed. It is possible that CIB reflects a failure to inhibit motor distraction, such that the acting hand is attracted automatically to a salient stimulus (the model, during copying tasks). This hypothesis predicts that CIB should be associated with distractor effects during reaching, characterised by veering towards, rather than away from the distractor. We tested this prediction in groups of pre-school children with and without CIB, and in young adults, using task-relevant and task-irrelevant distractors. Both groups of children showed greater veering towards distractors than did adults, implying a lower capacity to inhibit automatic responses. Crucially, this effect was stronger in children with CIB than without CIB when a task-irrelevant distractor was presented. These findings support the idea that CIB reflects a failure to inhibit automatically primed actions towards salient stimuli. PMID:22230227
Ambron, Elisabetta; Della Sala, Sergio; McIntosh, Robert D
Objective: Recent research has suggested that driver distraction is a major cause of driving performance impairment and motor vehicle collisions. Research on the topic has focused on passenger vehicles, with studies suggesting that drivers may be distracted nearly 33 percent of the time spent driving. To date, no study has examined the prevalence of distraction specifically among public transit bus drivers. Methods: Over a 3-month period, trained investigators observed and recorded distraction behaviors of bus drivers. Distraction prevalence was compared by route characteristics (e.g., geographic area, travel speed) using chi-square test. A general estimating equation logistic regression was used to estimate P values for distraction prevalence by driver demographics. Results: Overall, there was a 39 percent prevalence of distraction. The most prevalent distractions were due to interactions with another passenger. Distractions were more prevalent among drivers <30 years of age or ?50 years of age, on city streets or highways (relative to residential streets), and when there were more than 20 passengers. Distractions were the least prevalent in suburban areas, with the highest prevalence observed in city centers and rural areas. Conclusions: Driver distraction is a common problem for public transit bus drivers, mainly due to other passengers. Drivers should be educated on the hazards of distracted driving and on ways to avoid distraction. PMID:24433192
Griffin, Russell; Huisingh, Carrie; McGwin, Gerald
Selective attention in the presence of distraction is a key aspect of healthy cognition. The underlying neurobiological processes, have not, however, been functionally well characterized. In the present study, we used functional magnetic resonance imaging to determine how ecologically relevant distracting noise affects cortical activity in 27 healthy adults during two versions of the visual Sustained Attention To Response Task (SART) that differ in difficulty (and thus attentional load). A significant condition (noise or silence) by task (easy or difficult) interaction was observed in several areas, including dorsolateral prefrontal cortex (DLPFC), fusiform gyrus (FG), posterior cingulate (PCC), and pre-supplementary motor area (PreSMA). Post hoc analyses of interaction effects revealed deactivation of DLPFC, PCC, and PreSMA during distracting noise under conditions of low attentional load, and activation of FG and PCC during distracting noise under conditions of high attentional load. These results suggest that distracting noise may help alert subjects to task goals and reduce demands on cortical resources during tasks of low difficulty and attentional load. Under conditions of higher load, however, additional cognitive resources may be required in the presence of noise. PMID:23291265
Smucny, Jason; Rojas, Donald C; Eichman, Lindsay C; Tregellas, Jason R
Selective attention in the presence of distraction is a key aspect of healthy cognition. The underlying neurobiological processes, have not, however, been functionally well characterized. In the present study, we used functional magnetic resonance imaging to determine how ecologically relevant distracting noise affects cortical activity in 27 healthy adults during two versions of the visual sustained attention to response task (SART) that differ in difficulty (and thus attentional load). A significant condition (noise or silence) by task (easy or difficult) interaction was observed in several areas, including dorsolateral prefrontal cortex (DLPFC), fusiform gyrus (FG), posterior cingulate (PCC), and pre-supplementary motor area (PreSMA). Post-hoc analyses of interaction effects revealed deactivation of DLPFC, PCC, and PreSMA during distracting noise under conditions of low attentional load, and activation of FG and PCC during distracting noise under conditions of high attentional load. These results suggest that distracting noise may help alert subjects to task goals and reduce demands on cortical resources during tasks of low difficulty and attentional load. Under conditions of higher load, however, additional cognitive resources may be required in the presence of noise.
Smucny, Jason; Rojas, Donald C.; Eichman, Lindsay C.; Tregellas, Jason R.
Patients with schizophrenia frequently report difficulties paying attention during important tasks, because they are distracted by noise in the environment. The neurobiological mechanism underlying this problem is, however, poorly understood. The goal of this study was to determine if early sensory processing deficits contribute to sensitivity to distracting noise in schizophrenia. To that end, we examined the effect of environmentally relevant distracting noise on performance of an attention task in 19 patients with schizophrenia and 22 age and gender-matched healthy comparison subjects. Using electroencephalography, P50 auditory gating ratios also were measured in the same subjects and were examined for their relationship to noise-induced changes in performance on the attention task. Positive symptoms also were evaluated in patients. Distracting noise caused a greater increase in reaction time in patients, relative to comparison subjects, on the attention task. Higher P50 auditory gating ratios also were observed in patients. P50 gating ratio significantly correlated with the magnitude of noise-induced increase in reaction time. Noise-induced increase in reaction time was associated with delusional thoughts in patients. P50 ratios were associated with delusional thoughts and hallucinations in patients. In conclusion, the observation of noise effects on attention in patients is consistent with subjective reports from patients. The observed relationship between noise effects on reaction time and P50 auditory gating support the hypothesis that early inhibitory processing deficits may contribute to susceptibility to distraction in the illness.
Smucny, Jason; Olincy, Ann; Eichman, Lindsay C.; Lyons, Emma; Tregellas, Jason R.
This study attempts to determine changes in carpal canal volume with distraction across the wrist. Uniform longitudinal distraction was maintained with two external fixators on the radial and ulnar aspects of the forearm axis of five cadaver specimens. After CT scanning, volume determinations were made at 5 mm increments beginning at the lunocapitate joint to a point 1.5 cm distal to the middle finger carpometacarpal joint. There was a statistically significant decrease of the mean total carpal canal volume from 0 to 4.54 kg of distraction, with no statistically significant decrease from 0 to 2.27 kg or 2.27 to 4.54 kg. The largest decrease occurred at 15 and 20 mm distal to the proximal edge of the transverse carpal ligament corresponding to the level of the hamate hook. Reduction in mean carpal canal volume was 10.2% and 7.5% at these distances, respectively, from 0 to 4.54 kg of distraction. Progressive distraction across the wrist causes a decrease in total carpal canal volume. PMID:18977835
Cho, M S; Means, K R; Shrout, J A; Segalman, K A
Distraction osteogenesis of the mid-face alleviates the requirements of substantial autogenous bone grafts and donor site morbidity and alleviates the restriction of the soft-tissue envelope in gaining advancement of the mid-face. A prospective study, over a 14-month period, was initiated to evaluate the results of seven consecutive patients undergoing mid-facial advancement who were treated with Le Fort III internal distraction using the MID device. All patients had syndromic craniosynostoses and six patients had previously undergone fronto-orbital advancement. Four patients had symptoms of airway obstruction and one patient was tracheostomy dependent. Six of the patients completed the distraction as planned. Lateral cephalograms were analyzed and the mean linear distraction was 18 mm with a range of 8 mm to 23 mm. Complications included infection (one patient), mechanical failure (one patient), intraoperative fragment dysjunction (three patients), velopharyngeal insufficiency (one patient), conjunctivitis (two patients), trismus (six patients), and bony irregularities. It was concluded that in our Unit's future protocol for managing infant syndromic synostoses, synostectomies and cranial vault remodeling will be undertaken in infants as before, but that in early childhood, patients with severe mid-facial hypoplasia and/or respiratory compromise will be offered distraction osteogenesis as a substitute for the traditional Le Fort III advancement and bone grafting. PMID:12000884
Holmes, Anthony D; Wright, Graeme W; Meara, John G; Heggie, Andrew A; Probert, Timothy C
The successful outcome of distraction osteogenesis depends in part on the adequate adaptation of the surrounding soft tissue. We characterized the adaptation of the tibialis anterior during distraction osteogenesis at different rates (0.7 and 1.4 mm/day) and amounts (15 and 30%) of lengthening. We documented the increased expression of neonatal and slow myosin heavy chain in the tibialis anterior of skeletally immature rabbits. There was neither expression of neonatal myosin heavy chain in the experimental soleus or in the slow muscle fibers of the tibialis anterior nor increased expression of slow myosin heavy chain in the soleus or gastrocnemius. The increased amount of neonatal myosin heavy chain was concentrated in the distal half of the muscle, whereas the increase in the number of fibers that were labeled with antibodies to slow myosin occurred to the same extent throughout the tibialis anterior. Electrophysiological methods showed that the tibialis anterior was functionally intact during and after distraction osteogenesis. We concluded that in the tibialis anterior of young, skeletally immature animals, distraction osteogenesis seems to induce a recapitulation of the developmental process without leading to functional changes. In addition, during distraction osteogenesis, a fiber-type transformation occurs similar to that observed in models of muscle overloading. PMID:10459763
De Deyne, P G; Hayatsu, K; Meyer, R; Paley, D; Herzenberg, J E
Patients with schizophrenia frequently report difficulties paying attention during important tasks, because they are distracted by noise in the environment. The neurobiological mechanism underlying this problem is, however, poorly understood. The goal of this study was to determine if early sensory processing deficits contribute to sensitivity to distracting noise in schizophrenia. To that end, we examined the effect of environmentally relevant distracting noise on performance of an attention task in 19 patients with schizophrenia and 22 age and gender-matched healthy comparison subjects. Using electroencephalography, P50 auditory gating ratios also were measured in the same subjects and were examined for their relationship to noise-induced changes in performance on the attention task. Positive symptoms also were evaluated in patients. Distracting noise caused a greater increase in reaction time in patients, relative to comparison subjects, on the attention task. Higher P50 auditory gating ratios also were observed in patients. P50 gating ratio significantly correlated with the magnitude of noise-induced increase in reaction time. Noise-induced increase in reaction time was associated with delusional thoughts in patients. P50 ratios were associated with delusional thoughts and hallucinations in patients. In conclusion, the observation of noise effects on attention in patients is consistent with subjective reports from patients. The observed relationship between noise effects on reaction time and P50 auditory gating supports the hypothesis that early inhibitory processing deficits may contribute to susceptibility to distraction in the illness. PMID:23590872
Smucny, Jason; Olincy, Ann; Eichman, Lindsay C; Lyons, Emma; Tregellas, Jason R
To find objects of interest in a cluttered and continually changing visual environment, humans must often ignore salient stimuli that are not currently relevant to the task at hand. Recent neuroimaging results indicate that the ability to prevent salience-driven distraction depends on the current level of attentional control activity in frontal cortex, but the specific mechanism by which this control activity prevents salience-driven distraction is still poorly understood. Here, we asked whether salience-driven distraction is prevented by suppressing salient distractors or by preferentially up-weighting the relevant visual dimension. We found that salient distractors were suppressed even when they resided in the same feature dimension as the target (that is, when dimensional weighting was not a viable selection strategy). Our neurophysiological measure of suppression--the PD component of the event-related potential--was associated with variations in the amount of time it took to perform the search task: distractors triggered the PD on fast-response trials, but on slow-response trials they triggered activity associated with working memory representation instead. These results demonstrate that during search salience-driven distraction is mitigated by a suppressive mechanism that reduces the salience of potentially distracting visual objects. PMID:24741056
Gaspar, John M; McDonald, John J
Distraction has shown to be a helpful pain intervention for children; however, few investigations have studied the effectiveness of this method with adolescents. The aim of this study was to evaluate the usefulness of an easy and practical musical distraction in reducing adolescents' immunization pain. Furthermore, to examine whether musical distraction techniques (with or without headphones) used influenced the pain outcome. Hundred and eighteen 14-year-old adolescents, scheduled for polio immunization, participated. Adolescents were randomly assigned to one of three research groups; musical distraction with headphones (n=38), musical distraction without headphones (n=41) and standard care control (n=39). Results showed adolescents receiving musical distraction were less likely to report pain compared to the control group, controlling for covariates. Comparing musical distraction techniques, eliminating headphone emerged as a significant predictor of no pain. Results suggest that an easy and practical musical distraction intervention, implemented without headphones, can give some pain relief to adolescents during routine vaccination. PMID:20409050
Kristjánsdóttir, Ólöf; Kristjánsdóttir, Guðrún
The present study replicates findings of Van Breukelen and Jansen (1987) concerning the role of distractions and inhibition in response times, but using a different task. The distraction hypothesis states that a fair amount of the reaction time consists o...
R. W. T. L. Jansen G. J. P. van Breukelen
Maxillary sinusitis is a common medical complaint, affecting more than 30 million people per year in the United States alone. Very little palaeopathological work on this disease has been carried out, probably because of the enclosed nature of the sinuses in intact skulls and the lack of a suitable method for examination. This study tested the hypothesis that maxillary sinusitis was more common in people with leprosy than in people without it in Medieval England. The prevalence of maxillary sinusitis by age and sex was recorded in 133 individuals, some diagnosed as being leprous, derived from a later Medieval (12th to 17th centuries AD) urban hospital population at Chichester, Sussex, England using both macroscopic and endoscopic methods of examination. Of the 133 individuals with one or both sinuses available for examination, 54.9% (73) had evidence of bone change within the sinuses. There was no difference in prevalence between those with leprosy and those without, although clinical studies suggest that over 50% of lepromatous leprous individuals may develop sinusitis. Comparison with another study on Medieval British sites with a 3.6% prevalence (3 of 83) indicates that the prevalence at Chichester is much greater. The problems with diagnosing sinusitis are addressed and reasons behind the high frequency in this study are discussed. Aetiological factors predisposing to maxillary sinusitis are considered with reference to possible environmental conditions prevailing in the later Medieval period in Britain. PMID:8599382
Boocock, P; Roberts, C A; Manchester, K
Fibrous Histiocytoma is an uncommon neoplasm of the Head and Neck region and quite rare in the paranasal sinuses. We are reporting a case of Benign Fibrous Histiocytoma in the Maxillary sinus from the Department of Otorhinolaryngology of Bolani Hospital, Bolani with a description of clinical and histological features of the neoplasm. PMID:23119389
Majumder, A B; Singh, M
Fobrous Histiogytoma is an uncommon neoplasm of the Head and Neck region and quite rare in the paranasal sinuses. We are reporting a case of Benign Fibrous Histiocytoma in the Maxillary sinus from the Department of Otorhinolaryngology of Bolani Hospital, Bolani with a description of clinical and histological features of the neoplasm. PMID:23119482
Majurrider, A B
Fibrous dysplasia is usually a slowly progressive, benign disease that develops over several years and presents with deformity or mild symptomatology. Five of 34 patients (ages 4–21 years), who were subsequently diagnosed histologically as having fibrous dysplasia of the maxillary sinus, rapidly developed soft tissue masses of the malar region over a period of less than 4 months with accompanying
Lorraine G. Shapeero; Daniel Vanel; Lauren V. Ackerman; Marie-Josée Terrier-Lacombe; Dominique Housin; Guy Schwaab; Robert Sigal; Jacques Masselot
We describe the imaging and histologic findings of a case of nodular fascitiis in the maxillary region in a 54-year-old man. The rapid growth and tissue distortion of this lesion may mimic malignant tumors. Therefore, proper diagnosis is essential to avoid unnecessarily aggressive treatment. PMID:23172476
Boffano, Paolo; Campisi, Paola; Forni, Paolo; Ramieri, Guglielmo; Berrone, Sid
The otolaryngologist has long relied on routine x-ray examination in the diagnosis of pathological and congenital diseases involving the maxillary sinus. In recent years there has been an increasing reliance on special methods of investigation, now made feasible by developments in polydirectional tomography, selective angiography, and entirely new diagnostic modalities, such as thermography, isotope scanning, and, more recently, computerized tomography.
G. Wortzman; R. C. Holgate
Aim To describe vascular anatomy of the maxillary sinus in dentate specimens dissected from human cadavers. Methods Twenty dentate maxillary specimens were dissected, anatomically prepared, and injected with liquid latex for a better visualization of the maxillary sinus artery. Results We found an intraosseous anastomosis in 100% and an extraosseous anastomosis in 90% of the cases. The anterior lateral wall of the maxillary sinus was transversed by two anastomoses between the posterior superior alveolar artery (PSAA) and the infraorbital artery (IOA). The PSAA was divided into a gingival and dental branch. The gingival branch anastomosed with the terminal extraosseous branch of the extraosseous anastomosis (EOA) and the dental branch with the intraosseous branch of the intraosseous anastomosis (IOA). The mean distances from the alveolar ridge to the extraosseus anastomosis were 16 mm for the second maxillary molar, 12.3 mm for the first maxillary molar, and 13.1 mm for the second maxillary premolar. The mean distances from the intraosseous anastomosis to the alveolar ridge were 17.7 mm for the second maxillary molar, 14.5 mm for the first maxillary molar, and 14.66 mm for the second maxillary premolar. Conclusion These findings provide relevant data for clinical dentistry in order to avoid bleeding complications and minimize the risk of injury to the arterial network of the maxillary sinus during surgical procedures in the dentate maxilla region.
Kqiku, Lumnije; Biblekaj, Robert; Weiglein, Andreas H.; Kqiku, Xhylsime; Stadtler, Peter
Bisphosphonates (BPs) are widely used as bone-stabilizers, but side effects of BP therapy include bisphosphonate-related osteonecrosis of the jaw (BRONJ), which is resistant to therapy. The aim of this study was to evaluate the outcome of maxillary BRONJ involving sinusitis maxillaris. 21 patients presenting with maxillary BRONJ, from 2005 to 2008, were included in the study. In 18 cases BP had been administered for carcinoma and in 3 cases for osteoporosis, with an average exposure time of 47.4 months. 12 patients spontaneously developed BRONJ. The 10 patients diagnosed with stage III BRONJ presented with concomitant sinusitis maxillaris. Despite treatment, there were six recurrences of BRONJ, four of them with additional sinusitis maxillaris. Whether BRONJ occurred spontaneously or after extraction there was no difference in the outcome. Patients with advanced maxillary BRONJ often suffer from sinusitis maxillaris, both of which are frequently resistant to therapy. PMID:21163624
Maurer, P; Sandulescu, T; Kriwalsky, M S; Rashad, A; Hollstein, S; Stricker, I; Hölzle, F; Kunkel, M
Fatigue and distraction effects in drivers represent a great risk for road safety. For both types of driver behavior problems, image analysis of eyes, mouth and head movements gives valuable information. We present in this paper a system for monitoring fatigue and distraction in drivers by evaluating their performance using image processing. We extract visual features related to nod, yawn, eye closure and opening, and mouth movements to detect fatigue as well as to identify diversion of attention from the road. We achieve an average of 98.3% and 98.8% in terms of sensitivity and specificity for detection of driver's fatigue, and 97.3% and 99.2% for detection of driver's distraction when evaluating four video sequences with different drivers.
Jiménez-Moreno, R.; Orjuela, S. A.; Van Hese, P.; Prieto, F. A.; Grisales, V. H.; Philips, W.
Past research has demonstrated that the occurrence of unexpected task-irrelevant changes in the auditory or visual sensory channels captured attention in an obligatory fashion, hindering behavioral performance in ongoing auditory or visual categorization tasks and generating orientation and re-orientation electrophysiological responses. We report the first experiment extending the behavioral study of cross-modal distraction to tactile novelty. Using a vibrotactile-visual cross-modal oddball task and a bespoke hand-arm vibration device, we found that participants were significantly slower at categorizing the parity of visually presented digits following a rare and unexpected change in vibrotactile stimulation (novelty distraction), and that this effect extended to the subsequent trial (postnovelty distraction). These results are in line with past research on auditory and visual novelty and fit the proposition of common and amodal cognitive mechanisms for the involuntary detection of change. PMID:21517219
Parmentier, Fabrice B R; Ljungberg, Jessica K; Elsley, Jane V; Lindkvist, Markus
The constriction of the maxilla can be treated different ways, depending on the age of the patient, on the severity of the malocclusion and on the jaw mainly affected by the problem. If the maxilla is 4-5 mm narrower than it should be and the patient is minimum in the late mixed dentiton phase, rapid palatal expansion technique can be carried out. Changes in the maxillary arch can be followed by changes in the mandibular arch. The patient was a 14-year-2-month-old girl at the beginning of the treatment. She had unilateral crossbite on the right side that was caused by the skeletal and dental constriction of the maxilla and the mandibular asymmetry. The upper jaw was 6 mm narrower in the molar and 5 mm narrower in the premolar area than in the mandible. Lateroocclusion couldn't have been recognised. The buccal corridor was big and unesthetic that is a sign of the narrow maxilla. The patient was treated by the hyrax appliance. After overexpansion had been carried out, the achievement was sustained by one month retention. The treatment was carried on with the multiband appliance and with a modified transpalatal arch that extended until the mesial end of the first premolar, that was altered to a transpalatal arch after 3 months retention. The crossbite-problem has been solved, now uprighting of the left mandibular lateral segment is being done. During rapid palatal expansion heavy forces are applied to the teeth and bone. The long-term success of the treatment is also dependant of the treatment basing on the right diagnosis and of the adequate retention periode. According to this case report, rapid maxillary expansion therapy is succesful at the age of 14-15 years. PMID:23240493
An oral distraction was investigated as a way to reduce struggle and heart rate of beef cattle undergoing freeze branding. Oral distraction reduced the struggle of steers, regardless of branding treatment. No effect on heart rate was found. Distractions may provide a way to reduce struggle by animals during restraint.
Aitken, Brooke L.; Stookey, Joseph M.; Noble, Scott; Watts, Jon; Finlay, Don
The present study investigated the effect of cognitive distraction on the endorsement of gender role stereotypes in one sample of African American female participants. Participants' awareness and endorsement of gender role stereotypes for male and females was assessed. Following random assignment to distraction or no distraction conditions, they…
Smith, Kalynda; Craig-Henderson, Kellina
Past research has shown that rumination exacerbates dysphoric mood whereas distraction attenuates it. This research examined whether the practice of mindfulness meditation could reduce dysphoric mood even more effectively than distraction. A dysphoric mood was induced in 139 female and 38 male participants who were then randomly assigned to a rumination, distraction, or meditation condition. As predicted, participants instructed to
Patricia C. Broderick
Distracted driving, a significant public safety issue, is typically categorized as cell phone use and texting. The increase of distracted driving behavior (DDB) has resulted in an increase in injury and death. The purpose of this study was to identify the frequency and perception of DDB in adults. A 7-question SurveyMonkey questionnaire was distributed to a convenience sample of adults. Standard demographics included age, gender, and highest levels of education. Primary outcome questions were related to frequency of DDB, and overall perceptions specific to distracted driving. Results were compared on the basis of demographics. Chi-square testing and the Kruskal-Wallis analysis of variance were applied, with statistical significance defined as P ? .05. There were 1857 respondents to the survey: 1721 were aged 23-64 years (93%); 1511 were women (81%); 1461 had high school education or greater (79%). A total of 168 respondents (9%) reported being involved in a car accident while distracted. The highest reported frequency of DDB included cell phone use (69%), eating/drinking (67%), and reaching for an object in the care (49%). Younger age (18-34 years) and higher level of education (bachelor's degree or greater) were statistically associated with these DDB; gender demonstrated no statistical significance. Text messaging was reported by 538 respondents (29%), with a statistically significant association with age (18-34 years), higher education (bachelor's degree or greater), and gender (males). A total of 1143 respondents (63%) believed that they could drive safely while distracted. This study demonstrates that DDB in adults is not restricted to reading and sending text messages. Moreover, these results indicated that people fail to perceive the dangers inherent in distracted driving. Prevention and outreach education should not be limited to texting and cell phone use but should target all forms of DDB. The age group 18-34 years should be the primary target in the adult population. PMID:23459429
Hoff, Jane; Grell, Jennifer; Lohrman, Nicole; Stehly, Christy; Stoltzfus, Jill; Wainwright, Gail; Hoff, William S
In this paper, we present the results obtained and insights gained through the analysis of TRB contest data. We used exploratory analysis, regression, and clustering models for gaining insights into the driver behavior in a dilemma zone while driving under distraction. While simple exploratory analysis showed the distinguishing driver behavior patterns among different popu- lation groups in the dilemma zone, regression analysis showed statically signification relationships between groups of variables. In addition to analyzing the contest data, we have also looked into the possible impact of distracted driving on the fuel economy.
Li, Jan-Mou [ORNL] [ORNL; Malikopoulos, Andreas [ORNL] [ORNL; Thakur, Gautam [ORNL] [ORNL; Vatsavai, Raju [ORNL] [ORNL
In the April-June 2002 special issue of the IEEE Pervasive Computing journal, a team from Carnegie Mellon University contributed with a discussion of their Project Aura. The project's goal is to increase computing efficiency, particularly in wireless environments, so that "distractions such as poor performance and failures" are minimized. With greater system reliability and fewer distractions, users can make better use of their time and focus on the task at hand. This article describes the specifics of Project Aura, bringing together many areas that are being studied to accomplish the team's goals. The Aura home page gives further insights into research and additional papers.
Garlan, David.; Siewiorek, Daniel P.; Steenkiste, Peter A.
Use of cell phones in the general population has become increasingly commonplace. The distracting effects of cell phones among automobile drivers are well established, and legislation prohibits the use of handheld cell phones while driving in several states. Recent research has focused on the similar distracting effects of cell phones in the pedestrian population. In this report, an older gentleman suffered extensive facial trauma requiring surgery as a direct effect of cell phone use at the time the trauma occurred. This case highlights the role that portable electronic devices can play as a cause of ocular trauma. PMID:23579597
Edell, Aimée R; Jung, Jesse J; Solomon, Joel M; Palu, Richard N
This case report describes the use of a segmented appliance for space closure prior to using Invisalign. The maxillary right canine was retracted into the extracted first premolar space with a sectional wire from the first molar to the canine with no visible brackets in the incisor region. The advantage of this technique is the ability to achieve better root and rotational control during space closure with a fixed appliance that also has limited visibility. A maxillary fixed appliance was used to refine the esthetics in the maxillary arch due to the limitations of the Invisalign appliance in achieving rotational and vertical movements. PMID:22299111
Uribe, Flavio; Cutrera, Alice; Nanda, Ravinda
Objective To test the hypothesis that there is no difference in the active treatment effects for maxillary advancement induced by bone-anchored maxillary protraction (BAMP) and the active treatment effects for face mask in association with rapid maxillary expansion (RME/FM). Materials and Methods This is a study on consecutively treated patients. The changes in dentoskeletal cephalometric variables from start of treatment (T1) to end of active treatment (T2) with an average T1–T2 interval of about 1 year were contrasted in a BAMP sample of 21 subjects with a RME/FM sample of 34 patients. All subjects were prepubertal at T1. Statistical comparison was performed with t-tests for independent samples. Results The BAMP protocol produced significantly larger maxillary advancement than the RME/FM therapy (with a difference of 2 mm to 3 mm). Mandibular sagittal changes were similar, while vertical changes were better controlled with BAMP. The sagittal intermaxillary relationships improved 2.5 mm more in the BAMP patients. Additional favorable outcomes of BAMP treatment were the lack of clockwise rotation of the mandible as well as a lack of retroclination of the lower incisors. Conclusions The hypothesis is rejected. The BAMP protocol produced significantly larger maxillary advancement than the RME/FM therapy.
Cevidanes, Lucia; Baccetti, Tiziano; Franchi, Lorenzo; McNamara, James A.; De Clerck, Hugo
Transverse maxillary deficiency is commonly found in patients with sleep apnea and is also related to abnormal breathing patterns. Maxillary expansion procedures promote widening of the nasal floor and reduce the resistance to airflow, and have a positive influence on nasopharynx function. In order to evaluate volume changes in the upper airway, 15 adult patients with transverse maxillary deficiency underwent surgically assisted rapid maxillary expansion (RME) until a slight overcorrection of the crossbite was obtained. Cone beam computed tomography (CBCT) volumetric images were obtained at three predefined time points. The mean age of the patients was 30.2 (±7.4) years; nine were females and six were males. The area, volume, and the smallest transverse section area of the airway were assessed using Dolphin Imaging 3D software. Statistical comparisons were made of the changes between time periods. No statistically significant differences were found for volume or area. However a significant difference was found between the preoperative and immediate postoperative smallest transverse section area (P<0.05). Maxillary expansion, as an isolated procedure, does not result in a statistically significant improvement in the airway dimensions and results in an inferior relocation of the smallest transverse section area. PMID:24361243
Pereira-Filho, V A; Monnazzi, M S; Gabrielli, M A C; Spin-Neto, R; Watanabe, E R; Gimenez, C M M; Santos-Pinto, A; Gabrielli, M F R
Mechanisms underlying exogenous attention to central and peripheral distracters were temporally and spatially explored while 30 participants performed a digit categorization task. Neural (event-related potentials-ERPs-, analyzed both at the scalp and at the voxel level) and behavioral indices of exogenous attention were analyzed. Distracters were either biologically salient or neutral, in order to test whether the exogenous attention bias to the former observed in previous studies is independent of, or interacts with, distracter eccentricity. Two subcomponents of the N2 component of the ERPs, N2olp and N2ft, reflected processes related to peripheral distracters processing. N2olp effects, located in the dorsal attention network (supplementary motor area), were probably related to covert reorientation to peripheral distracters. N2ft effects, located in the default mode network (posterior cingulate cortex), appeared to reflect less effort in the ongoing task when peripheral distracters were presented. N2ft also showed a biological saliency effect which was independent of eccentricity and was located in the polar/ventral prefrontal cortex. P3 showed greater amplitudes to centrally presented distracters. These latter effects were located in TEO (visual cortex), and would be functionally associated with spatial interference between the target and central distracters. Behavior showed the relevance of both central and peripheral distracters in exogenous attention. These results indicate that exogenous attention to peripheral distracters differed in temporal and spatial terms from exogenous attention to central distracters and that it is biased towards biologically salient events irrespective of their eccentricity. PMID:23816957
Carretié, Luis; Albert, Jacobo; López-Martín, Sara; Hoyos, Sandra; Kessel, Dominique; Tapia, Manuel; Capilla, Almudena
We longitudinally investigated the development of endogenous control of attention in 2 types of tasks that involve competition for attentional focus at 7, 9, and 31 months of age. At all 3 sessions, children participated in a multiple object free play task and a distractibility task. The results revealed both developmental differences and…
Kannass, Kathleen N.; Oakes, Lisa M.; Shaddy, D. Jill
The effect of age on bone formation in the limb lengthening model of distraction osteogenesis (DO) was investigated in two studies using Sprague–Dawley (SD) rats from two colonies at various ages (CAMM: 9 vs 24 months, Harlan: 4 vs 24 months). External fixators were placed on the right tibiae of 30 male SD rats (20 CAMM, 10 Harlan) and mid-diaphyseal
J. Aronson; G. G. Gao; X. C. Shen; S. G. McLaren; R. A. Skinner; T. M. Badger; C. K. Lumpkin
Four groups of male undergraduates were instructed to perform complex cognitive operations when randomly presented single digits of a dichotic listening paradigm. An erotic tape recording was played into the nonattended ear. Sexual arousal varied directly as a function of the complexity of the distracting cognitive operations. (Author)
Geer, James H.; Fuhr, Robert
The objective of this paper is to systematically review the airway outcomes following distraction osteogenesis of midface with the goal of (1) deriving clinically oriented insights and (2) identifying gaps in knowledge to stimulate future research. Medline, EMBASE and Cochrane databases were searched and studies were included if subjects of any age had midface retrusion/hypoplasia and underwent midface distraction osteogenesis. Outcome measures of interest were any respiratory or airway associated measures, and reports of adverse events. A total of 368 abstracts were generated from the literature searches; 16 studies met the criteria for data extraction and analysis. All 16 studies were observational. Generally, midface distraction osteogenesis was reported to improve respiratory status and was well tolerated. Specifically, favorable outcomes in cephalometry (9 studies), polysomnography (9 studies), and decannulation rates (8 studies) were reported. In conclusion, upper airway status was improved in most patients who underwent midface distraction osteogenesis, yet long-term results and consistent objective measures are lacking. Studies reviewed were retrospective case series and details regarding patients who did not improve were deficient. A standardized prospective multicenter cohort trial with long-term patient follow up is required. PMID:24631233
Taylor, B A; Brace, M; Hong, P
Nine patients with severely atrophic edentulous mandibles were treated by distraction osteogenesis with subperiosteal distractors for vertical augmentation of the anterior alveolar bone before insertion of implants. All the patients had severe complications and we conclude that the use of subperiosteal devices for vertical augmentation of edentulous mandibles is hazardous and offers no advantage over other surgical methods. PMID:15908080
Enislidis, G; Fock, N; Ewers, R
Sensory flooding, particularly during auditory stimulation, is a common problem for patients with schizophrenia. The functional consequences of this impairment during cross-modal attention tasks, however, are unclear. The purpose of this study was to examine how auditory distraction differentially affects task-associated response during visual attention in patients and healthy controls. To that end, 21 outpatients with schizophrenia and 23 healthy comparison subjects performed a visual attention task in the presence or absence of distracting, environmentally relevant “urban” noise while undergoing functional magnetic resonance imaging at 3T. The task had two conditions (difficult and easy); task-related neural activity was defined as difficult – easy. During task performance, a significant distraction (noise or silence) by group (patient or control) interaction was observed in the left dorsolateral prefrontal cortex, right hippocampus, left temporoparietal junction, and right fusiform gyrus, with patients showing relative hypoactivation during noise compared to controls. In patients, the ability to recruit the dorsolateral prefrontal cortex during the task in noise was negatively correlated with the effect of noise on reaction time. Clinically, the ability to recruit the fusiform gyrus during the task in noise was negatively correlated with SANS affective flattening score, and hippocampal recruitment during the task in noise was positively correlated with global functioning. In conclusion, schizophrenia may be associated with abnormalities in neural response during visual attention tasks in the presence of cross-modal noise distraction. These response differences may predict global functioning in the illness, and may serve as a biomarker for therapeutic development.
Smucny, Jason; Rojas, Donald C.; Eichman, Lindsay C.; Tregellas, Jason R.
We sought to determine if attentional distraction in adolescents can modulate event-related desynchronization or synchronization (ERD or ERS) of the theta band during emotion regulation. Event-related theta oscillations were collected from 48 adolescents and young adults as they performed a distraction (counting) task while viewing affective pictures. Consistent with data from adult participants, positive and negative pictures elicited a larger theta ERS than did neutral pictures within a 100-400 ms window, indicating that early theta ERS is indicative of motivated attention to biologically salient stimuli. Counting as a distraction strategy attenuated early affective modulation of theta ERS. Moreover, theta ERS increased with age in the anterior regions of the brain regardless of valence; however, no age differences were found in the posterior regions. These results suggest that distraction depends on a top-down attentional mechanism that disrupts theta ERS for affective pictures at an early stage. Furthermore, adolescents undergo a developmental increase in oscillatory brain reorganization. PMID:23827226
Zhang, Wenhai; Li, Xiying; Liu, Xia; Duan, Xinxing; Wang, Dahua; Shen, Jiliang
Unexpected and task-irrelevant sounds can capture our attention and may cause distraction effects reflected by impaired performance in a primary task unrelated to the perturbing sound. The present auditory-visual oddball study examines the effect of the informational content of a sound on the performance in a visual discrimination task. The…
Wetzel, Nicole; Widmann, Andreas; Schroger, Erich
Systems and methods provide audio-visual distraction to a patient while the patient is undergoing a surgical or other such medical procedure. When used in the context of a surgical procedure, local anesthetics are used to eliminate the pain of the procedu...
Distracted driving has burgeoned with the proliferation of cell phones, global positioning systems and other in-vehicle and personal electronic devices. Annually more than 3,300 people are killed and an additional 400,000 are injured in the United States in distracted driving crashes. The United States (U.S.) federal and state governments have responded to this public health problem with policies and laws; however, a more comprehensive and more effective approach is still needed. Some restrictions on the use of electronic devices while driving by federal employees and some voluntary guidelines and recommendations have been issued. Public opinion polls show support for addressing the issue of distracted driving with state laws. The majority of states have laws banning text messaging while driving and prohibiting the use of an electronic device by teenage or novice drivers. Some states prohibit all drivers from using a hand-held cellphone. Currently no state has a total ban on the use of personal electronic devices while driving. Successful past traffic safety campaigns changing driver behavior have demonstrated the necessity to adopt a “three Es” approach of Enactment of a law, Education of the public about the law, and rigorous Enforcement of the law. Experience reveals that this approach, along with future federal regulation of in-vehicle electronic devices and the employment of technology to limit the use of electronic devices while driving, is needed to alter personal behavior in order to reduce distractions and keep drivers focused on the driving task.
Catherine Chase, J.D.
Recent studies have demonstrated that brief periods of training facilitate the ability to overcome distraction during future performance of a given task, and researchers have proposed that these effects rely on relational memory systems that enable individuals to link specific attentional states to their learned context. In the current work, we examined whether medial temporal lobe (MTL) structures critical for relational and contextual learning contribute to these effects. A group of amnesic patients with bilateral MTL damage and a group of matched comparison subjects both completed an attentional-capture task in which a brief training session typically leads to decreased distraction in a subsequent testing session. Whereas the comparison subjects showed normal training-related decreases in distractibility, the amnesic patients did not. Thus, our results indicate that MTL-mediated learning plays a critical role in the ability to use past experience to overcome distraction. This suggests a tight linkage between MTL-dependent relational-learning mechanisms and cognitive control. PMID:23761926
Cosman, Joshua D; Vecera, Shaun P
Fifteen paranoid schizophrenics, 15 nonparanoid schizophrenics, and 15 nonschizophrenic psychiatric inpatients were given 3 of Babcock's tests of psychomotor retardation, and a test of overinclusive thinking based on Benjamin's proverbs. In addition, they took part in a simple and multiple-choice auditory reactiontime experiment in which the presence and number of distracting stimuli were varied. As predicted, the reaction times of
R. W. Payne; W. K. Caird
Distracted driving has burgeoned with the proliferation of cell phones, global positioning systems and other in-vehicle and personal electronic devices. Annually more than 3,300 people are killed and an additional 400,000 are injured in the United States in distracted driving crashes. The United States (U.S.) federal and state governments have responded to this public health problem with policies and laws; however, a more comprehensive and more effective approach is still needed. Some restrictions on the use of electronic devices while driving by federal employees and some voluntary guidelines and recommendations have been issued. Public opinion polls show support for addressing the issue of distracted driving with state laws. The majority of states have laws banning text messaging while driving and prohibiting the use of an electronic device by teenage or novice drivers. Some states prohibit all drivers from using a hand-held cellphone. Currently no state has a total ban on the use of personal electronic devices while driving. Successful past traffic safety campaigns changing driver behavior have demonstrated the necessity to adopt a "three Es" approach of Enactment of a law, Education of the public about the law, and rigorous Enforcement of the law. Experience reveals that this approach, along with future federal regulation of in-vehicle electronic devices and the employment of technology to limit the use of electronic devices while driving, is needed to alter personal behavior in order to reduce distractions and keep drivers focused on the driving task. PMID:24776229
Catherine Chase, J D
Distraction osteogenesis is a well-known technique in which new bone tissue is created when a distraction displacement is applied through an external frame. This orthopedic process is nowadays focus of intense research, both experimentally and numerically, as there are still many aspects not well understood. The aim of this study is to simulate bone distraction by means of a combined discrete-continuum approach based on a lattice formulation. Existing computational models simulate the main processes of distraction osteogenesis from a continuum perspective, considering as state variables the population of cells and tissue distributions. Results of the continuum and lattice-based approaches are similar with respect to the global evolution of the different cells but rather different in terms of the type of ossification process. Differences in the size of the soft interzone in the gap have also been found. In addition, the discrete-continuum formulation allows including a more realistic approach of the migration/proliferation process with a discrete random walk model instead of the Fick's law used in continuum approaches. Also, blood vessel growth can be simulated explicitly in this model with the inclusion of the endothelial cells. Further study is needed to provide additional insights to understand coupled phenomena at different scales in the cell-tissue interactions. However this work provides a first preliminary step for improving multiscale models. PMID:23036307
Reina-Romo, E; Gómez-Benito, M J; Domínguez, J; García-Aznar, J M
Older adults are known to have reduced inhibitory control and therefore to be more distractible than young adults. Recently, we have proposed that sensory modality plays a crucial role in age-related distractibility. In this study, we examined age differences in vulnerability to unimodal and cross-modal visual and auditory distraction. A group of 24 younger (mean age=21.7 years) and 22 older adults (mean age=65.4 years) performed visual and auditory n-back tasks while ignoring visual and auditory distraction. Whereas reaction time data indicated that both young and older adults are particularly affected by unimodal distraction, accuracy data revealed that older adults, but not younger adults, are vulnerable to cross-modal visual distraction. These results support the notion that age-related distractibility is modality dependent. PMID:23337081
Guerreiro, Maria J S; Murphy, Dana R; Van Gerven, Pascal W M
The volume of air passing through the nose and nasopharinx is limited by its shape and diameter. Continuous airflow through the nasal passage during breathing induces a constant stimulus for the lateral growth of maxilla and for lowering of the palatal vault. Maxillary morphological differences exist between patients with airway problems and control groups, identifying a potential etiological role in these patients. The purpose of this article was to review the literature on the interaction between airway problems and expressed maxillary morphology including specific dental and skeletal malocclusions. Statistically significant differences were found between patients with airway problems and control groups, in maxillary skeletal morphology including shorter maxillary length, more proclined maxillary incisors, thicker and longer soft palate, narrower maxillary arch and higher palatal vault. PMID:19756202
Gungor, Ahmet Yalcin; Turkkahraman, Hakan
Maxillary reconstruction is still an evolving art when compared to the reconstruction of the mandible. The defects of maxilla apart from affecting the functions of the speech, swallowing and mastication also cause cosmetic disfigurement. Rehabilitation of the form and function in patients with maxillary defects is either by using an obturator prosthesis or by a surgical reconstruction. Literature is abundant with a variety of reconstructive methods. The classification systems are also varied, with no universal acceptance of any one of them. The oncologic safety of these procedures is still debated, and conclusive evidence in this regard has not emerged yet. Management of the orbit is also not yet addressed properly. Tissue engineering, that has been hyped to be one of the possible solutions for this vexing reconstructive problem, has not come out with reliable and reproducible results so far. This review article discusses the rationale and oncological safety of the reconstructing the maxillary defects, critically analyzes the classification systems, offers the different reconstructive methods and touches upon the controversies in this subject. The management of the retained and exenterated orbit associated with maxillectomy is reviewed. The surgical morbidity, complications and the recent advances in this field are also looked into. An algorithm, based on our experience, is presented.
Iyer, Subramania; Thankappan, Krishnakumar
This article studies the incidence and magnitude of delayed callus subsidence, which will also help in study the hypothesis of three cortex corticalisation to determine the time of fixator removal during distraction osteogenesis (DO). Eighty-one tibia segments with mean lengthening of 7.7?±?2.9 cm were studied with age, gender, skeletal maturity, amount and percentage of lengthening, callus pattern, callus shape, number of cortices seen at the time of fixator removal, bone mineral density (BMD) ratio, and callus diameter ratio analysed for their effect on callus subsidence. All segments had tibia callus subsidence ranging from 4 mm to 3.2 cm with 54% having significant subsidence of more than 1 cm. Multivariate regression analysis revealed only the amount of lengthening and callus patterns to be significant. In conclusion, we can say that tibia callus subsidence is a significant delayed complication and factors affecting it can be used to determine the time of fixator removal.
Shyam, Ashok K.; Singh, Surya Udai; Modi, Hitesh N.; Lee, Seok-Hyun; An, Hyonggin
Naso-ethmoido-maxillary protrusion (NEMP) is a rare dental and facial dysmorphosis, with excessive growth of basicranium, ethmoid, maxillary, and nasal bones. The clinical presentation includes nasal and upper lip protrusion, telecanthus, a class 2 malocclusion with maxillary protrusion and exoclusion. The craniofacial field is increased in Delaire's analysis. Contrary to isolated maxillary protrusion secondary to membranous ossification dysfunction, NEMP is a constitutional anomaly resulting from an excessive primary growth of the chondrocranium. The therapeutic management of NEMP should take into account these specificities. PMID:24630318
Konopnicki, S; Nicot, R; Sauvé, C; Raoul, G; Ferri, J
The sensitivity of involuntary attention to top-down modulation was tested using an auditory-visual distraction task and a working memory (WM) load manipulation in subjects performing a simple visual classification task while ignoring contingent auditory stimulation. The sounds were repetitive standard tones (80%) and environmental novel sounds (20%). Distraction caused by the novel sounds was compared across a 1-back WM condition and a no-memory control condition, both involving the comparison of two digits. Event-related brain potentials (ERPs) to the sounds were recorded, and the N1/MMN (mismatch negativity), novelty-P3, and RON components were identified in the novel minus standard difference waveforms. Distraction was reduced in the WM condition, both behaviorally and as indexed by an attenuation of the late phase of the novelty-P3. The transient/change detection mechanism indexed by MMN was not affected by the WM manipulation. Sustained slow frontal and parietal waveforms related to WM processes were found on the standard ERPs. The present results indicate that distraction caused by irrelevant novel sounds is reduced when a WM component is involved in the task, and that this modulation by WM load takes place at a late state of the orienting response, all in all confirming that involuntary attention is under the control of top-down mechanisms. Moreover, as these results contradict predictions of the load theory of selective attention and cognitive control, it is suggested that the WM load effects on distraction depend on the nature of the distractor-target relationships. PMID:18284343
SanMiguel, Iria; Corral, María-José; Escera, Carles
Intervertebral disc (IVD) pressure measurement is an appropriate method for characterizing spinal loading conditions. However, there is no human or animal model that provides sufficient IVD pressure data. The aim of our study was to establish physiological pressure values in the rabbit lumbar spine and to determine whether temporary external disc compression and distraction were associated with pressure changes. Measurements were done using a microstructure-based fibreoptic sensor. Data were collected in five control rabbits (N, measurement lying prone at segment L3/4 at day 28), five rabbits with 28 days of axial compression (C, measurement at day 28) and three rabbits with 28 days of axial compression and following 28 days of axial distraction (D, measurement at day 56). Disc compression and distraction was verified by disc height in lateral radiographs. The controls (N) showed a level-related range between 0.25 MPa-0.45 MPa. The IVD pressure was highest at level L3/4 (0.42 MPa; range 0.38-0.45) with a decrease in both cranial and caudal adjacent segments. The result for C was a significant decrease in IVD pressure (0.31 MPa) when compared with controls (P=0.009). D showed slightly higher median IVD pressure (0.32 MPa) compared to C, but significantly lower levels when compared with N (P=0.037). Our results indicate a high range of physiological IVD pressure at different levels of the lumbar rabbit spine. Temporary disc compression reduces pressure when compared with controls. These data support the hypothesis that temporary external compression leads to moderate disc degeneration as a result of degradation of water-binding disc matrix or affected active pumping mechanisms of nutrients into the disc. A stabilization of IVD pressure in discs treated with temporary distraction was observed. PMID:16133080
Guehring, Thorsten; Unglaub, Frank; Lorenz, Helga; Omlor, Georg; Wilke, Hans-Joachim; Kroeber, Markus W
Unexpected task-irrelevant changes in the auditory or visual sensory channels have been shown to capture attention in an ineluctable manner and distract participants away from ongoing auditory or visual categorization tasks. We extend the study of this phenomenon by reporting the first within-participant comparison of deviance distraction in the tactile and auditory modalities. Using vibro-tactile-visual and auditory-visual cross-modal oddball tasks, we found that unexpected changes in the tactile and auditory modalities produced a number of functional similarities: A negative impact of distracter deviance on performance in the ongoing visual task, distraction on the subsequent trial (post-deviance distraction), and a similar decrease - but not the disappearance - of these effects across blocks. Despite these functional similarities, deviance distraction only correlated between the auditory and tactile modalities for the accuracy-based measure of deviance distraction and not for response latencies. Post-deviance distraction showed no correlation between modalities. Overall, the results suggest that behavioral deviance distraction may be underpinned by both modality-specific and multimodal mechanisms, while post-deviance distraction may predominantly relate to modality-specific processes. PMID:22750743
Ljungberg, Jessica K; Parmentier, Fabrice B R
Background: Initial reports have shown the efficacy of fixed distraction for the treatment of ankle osteoarthritis. We hypothesized that allowing ankle motion during distraction would result in significant improvements in outcomes compared with distraction without ankle motion. Methods: We conducted a prospective randomized controlled trial comparing the outcomes for patients with advanced ankle osteoarthritis who were managed with anterior osteophyte removal and either (1) fixed ankle distraction or (2) ankle distraction permitting joint motion. Thirty-six patients were randomized to treatment with either fixed distraction or distraction with motion. The patients were followed for twenty-four months after frame removal. The Ankle Osteoarthritis Scale (AOS) was the main outcome variable. Results: Two years after frame removal, subjects in both groups showed significant improvement compared with the status before treatment (p < 0.02 for both groups). The motion-distraction group had significantly better AOS scores than the fixed-distraction group at twenty-six, fifty-two, and 104 weeks after frame removal (p < 0.01 at each time point). At 104 weeks, the motion-distraction group had an overall mean improvement of 56.6% in the AOS score, whereas the fixed-distraction group had a mean improvement of 22.9% (p < 0.01). Conclusion: Distraction improved the patient-reported outcomes of treatment of ankle osteoarthritis. Adding ankle motion to distraction showed an early and sustained beneficial effect on outcome. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Saltzman, Charles L.; Hillis, Stephen L.; Stolley, Mary P.; Anderson, Donald D.; Amendola, Annunziato
This study proposes a procedure to quantitatively estimate auditory distractions that are not accompanied by any visual diversions to clarify the influence of non-visual distractions on driving. In a laboratory experiment, spare mental capacities (measured in bits\\/s) for three arithmetic tasks were estimated for each subject driver, using the functional relation between the reaction time and the number of alternatives
Hiroshi Uno; Kaneo Hiramatsu
Mandibular bone transport (MBT) distraction osteogenesis devices are used for achieving reconstruction of mandibular defects in a predictable way, with few complications, less complexity than other alternative surgical procedures, and minimal tissue morbidity. However, selection of appropriate MBT device characteristics is critical for ensuring both their mechanical soundness and their optimal distraction function for each patient's condition. This article assesses six characteristics of currently available MBT devices to characterize their design and function and to classify them in a way that assists the selection of the best device option for each clinical case. In addition, the present work provides a framework for both the biomechanical conception of new devices and the modification of existing ones.
Zapata, Uriel; Elsalanty, Mohammed E.; Dechow, Paul C.
In a total of 30 tremor patients (14 with Parkinson's disease, 6 with cerebellar tremor, 4 with essential tremor, 4 with psychogenic tremor, 2 with enhanced physiological tremor), tremor was electromyographically recorded before, during and after contralateral distraction tasks (tapping with the index finger or the tip of the foot, sequential flexion of the 2nd to 5th finger towards the thumb, "keyboarding", and sensory discrimination). 22 of 26 patients with organic tremors spontaneously choose a volitional tapping frequency independent from their tremor frequency. In 4 patients with psychogenic tremor, frequencies of tremor and tapping were locked (n = 3), or tremor disappeared abruptly (n = 1) when contralateral tapping was started. Contralateral "keyboarding" and sensory discrimination revealed no clear differences between organic and psychogenic tremors. Contralateral tapping in further 23 patients (22 with organic tremors and 1 with psychogenic tremor) confirmed these findings. Contralateral tapping appears as the most valid distraction task and may help to differentiate psychogenic from organic tremors. PMID:9834478
Spiegel, J; Heiss, C; Frühauf, E; Fogel, W; Meinck, H M
The anatomical structures involved in distraction-related processing in the auditory domain were investigated using magnetoencephalography. Participants performed a duration-discrimination task on a sequence of 200 and 400 ms long tones. Infrequent (12%) task-irrelevant pitch changes resulted in slower discriminative responses and more errors. Event-related potentials to these changes show an increased N1, a mismatch negativity, a P3a, and a reorienting negativity. The event-related magnetic fields revealed focal activities in superior and medial temporal areas in the N1/mismatch negativity time range. No significant activity was found in the P3a interval. In the reorienting negativity interval, significant activity was located in the primary motor area. This suggests that action-selection-related activity also contributes to attentional reorientation after distraction. PMID:18287943
Horváth, János; Maess, Burkhard; Berti, Stefan; Schröger, Erich
Congenitally absent maxillary first permanent molars is a rare clinical finding. It usually occurs with severe oligodontia in association with other abnormalities of the integumentary system. This article presents the case of bilateral absent maxillary permanent molars with severe oligodontia and no other abnormalities. PMID:2369704
Lapeer, G L
Objective. This report investigates a possible correlation between chronic use of Viadent products and the subsequent development of leukoplakia in the maxillary vestibule. Study Design. A retrospective review of 88 patients with leukoplakia of the maxillary vestibule is presented. Prevalence of Viadent use was determined in this group and in a group of 100 randomly selected adults who presented themselves
Douglas D. Damm; Alice Curran; Dean K. White; James F. Drummond
The purpose of this implant study was to evaluate the transverse stability of the basal maxillary and mandibular structures. The sample included 25 subjects between 12 and 18 years of age who were followed for approximately 2.6 years. Metallic implants were placed bilaterally into the maxillary and mandibular corpora before treatment. Once implant stability had been confirmed, treatment (4 first
Luiz G. Gandini; Peter H. Buschang
We report a case of a diver who suffered an episode of maxillary sinus barotrauma that presented with decreased sensation over the cutaneous distribution of the infraorbital nerve after an ascent which produced facial pain and crepitus. This case illustrates a potential confusion between a decompression sickness etiology and a barotraumatic etiology for the observed sensory deficit. The clinical features of this case were most consistent with a barotraumatic etiology for the findings noted. The anatomy of the trigeminal nerve and previous reports of cranial nerve deficits following barotrauma are reviewed. PMID:10642073
Butler, F K; Bove, A A
The purpose of this research was to evaluate changes in upper arch dimension and form following rapid maxillary expansion (RME) using a modified Haas appliance in the primary dentition. The sample comprised 49 children [17 males, 32 females, mean age 7 years 5 months, standard deviation (SD) 1 year 1 month] with a crossbite or maxillary crowding. Twenty patients had a normal SN-GoGn angle (7 males, 13 females, mean 33.25 degrees, SD 2.10), three were low angle (1 male, 2 females, mean 27.67 degrees, SD 2.31), and 22 were high angle (8 males, 14 females, mean 39.95 degrees, SD 3.15). The vertical dimensions of four patients could not be measured, due to the unavailability of radiographs. Expansion was undertaken to either correct a crossbite or treat maxillary crowding. The upper dental casts were analysed using a computerized system: before treatment (T1), at appliance removal (T2), and 2 years 4 months after appliance removal (T3). Using bootstrap statistical analysis applied to distance ratio values [Euclidean distance matrix analysis (EDMA)], it was found that 48 patients showed a change in arch form. In 40.82 per cent (n = 20, group A), the arch form changed from T1 to T2, T1 to T3, and T2 to T3. In 32.65 per cent (n = 16, group B), it varied from T1 to T2 but relapsed at T3 to the form of T1. For 24.5 per cent (n = 12, group C), it changed from T1 to T2 but maintained the same form at T3. The favourable characteristics for obtaining expansion, identified by logistic regression analysis, were being male, of an immature stage of dental development (lateral incisor not fully erupted) and the presence of a lateral crossbite. Intercanine and intermolar widths, arch length, and the distance between the interincisive point and the line joining the canines (depth of the intercanine arch) at the different time points were analysed using a two-tailed t-test (P < 0.05). For the whole group, the increase in intercanine and intermolar width and in the depth of the intercanine arch was significant. Comparison between groups A, B, and C was undertaken using an analysis of variance, but there was no significant difference between the groups. This modified type of Haas appliance was able to increase the transverse dimension of the maxillary dental arch in the mixed dentition. The most appropriate timing for treatment appears to be before the eruption of the permanent lateral incisors. PMID:18791124
Mutinelli, Sabrina; Cozzani, Mauro; Manfredi, Mario; Bee, Marco; Siciliani, Giuseppe
Ectopic eruption of a tooth within the dentate region of the jaws is often noticed in clinical practice and is well documented in the literature. But the ectopic eruption into the non dentate region is rare and scantly documented. The maxillary sinus is one such a non dentate region, apart from nasal septum, mandibular condyle, coronoid process and the palate, to accommodate such ectopic eruptions of teeth. Due to its rarity and lack of consensus over its management, the incidence deserves to be added to the literature and discussed. Early surgical intervention for removal of ectopic tooth along with enucleation of the associated cyst, if any, is the treatment of choice.
Ramanojam, Shandilya; Halli, Rajshekhar; Hebbale, Manjula; Bhardwaj, Smita
Sensory flooding, particularly during auditory stimulation, is a common problem for patients with schizophrenia. The functional consequences of this impairment during cross-modal attention tasks, however, are unclear. The purpose of this study was to examine how auditory distraction differentially affects task-associated response during visual attention in patients and healthy controls. To that end, 21 outpatients with schizophrenia and 23 healthy comparison subjects performed a visual attention task in the presence or absence of distracting, environmentally relevant "urban" noise while undergoing functional magnetic resonance imaging at 3T. The task had two conditions (difficult and easy); task-related neural activity was defined as difficult - easy. During task performance, a significant distraction (noise or silence) by group (patient or control) interaction was observed in the left dorsolateral prefrontal cortex, right hippocampus, left temporoparietal junction, and right fusiform gyrus, with patients showing relative hypoactivation during noise compared to controls. In patients, the ability to recruit the dorsolateral prefrontal cortex during the task in noise was negatively correlated with the effect of noise on reaction time. Clinically, the ability to recruit the fusiform gyrus during the task in noise was negatively correlated with SANS affective flattening score, and hippocampal recruitment during the task in noise was positively correlated with global functioning. In conclusion, schizophrenia may be associated with abnormalities in neural response during visual attention tasks in the presence of cross-modal noise distraction. These response differences may predict global functioning in the illness, and may serve as a biomarker for therapeutic development. PMID:23560100
Smucny, Jason; Rojas, Donald C; Eichman, Lindsay C; Tregellas, Jason R
The present study investigated the reliability of CNV distraction and rebound effects, and their relation with reaction time. Twenty-four subjects were presented three blocks of trials: (1) a control block — a fixed foreperiod reaction time task consisting of a flash–tone–key press sequence; (2) a divided-attention block — randomly intermixed trials with and without a short-term memory task (three visually-presented
Frederick Travis; Joseph J Tecce
The experiment, aimed to evaluate the distracting effect of television, was carried out on 122 children, divided into three\\u000a groups. All groups performed the auditory vigilance test (AVT) to assess reaction time (RT) to an auditory stimulus and the\\u000a number of errors in responding to the stimulus. Children in group 1 performed the AVT while in front of a blank
Carlo V. Bellieni; Giulio Fontani; Franco Corradeschi; Lorenzo Iantorno; Marianna Maffei; Silvia Migliorini; Serafina Perrone; Giuseppe Buonocore
Unexpected and task-irrelevant sounds can capture our attention and may cause distraction effects reflected by impaired performance in a primary task unrelated to the perturbing sound. The present auditory–visual oddball study examines the effect of the informational content of a sound on the performance in a visual discrimination task. The informational content was modulated by varying the sound–target interval and
Nicole Wetzel; Andreas Widmann; Erich Schröger
The origin of chronic pain after external ankle sprain is better known with arthroscopy's contribution. Chronic hypertrophic synovitis of the anterolateral ankle region is seemingly the cause, resulting in "anterolateral ankle impingement." But is partial synovectomy with fibrosis resection under arthroscopy always possible without any distraction? Are results affected? This retrospective study concerned only patients with soft tissue ankle impingement. All cases with bone and joint diseases were excluded. The final sample of 24 patients had a mean age of 35 years (21-54 years) and presented anterolateral mechanical pain associated with oedema following external ankle sprain. Medical and rehabilitative treatment was undertaken for more than 6 months before arthroscopy. Average time between trauma and arthroscopy was 21 months (5-60 months). Clinical examination revealed no ankle instability or laxity. Debridement with joint lavage was systematically performed under arthroscopy without any distraction. Average patient follow-up was 22 months (12-92 months). All patients had a good Kitaoka score, with 22 patients registering excellent results. There were no septic complications or algodystrophy. Two transient hypoesthesias were observed in the dorsal surface and lateral border of the foot with full postoperative recovery at 6 months. Distraction was never used and simple dorsiflexion was sufficient to perform arthroscopic debridement. In this study, anterolateral ankle impingement diagnosis was primarily clinical. Arthroscopic treatment yielded significant benefits on pain, oedema and resumption of sport activities. Arthroscopic treatment of anterolateral ankle impingements is thus possible with simple dorsiflexion and no distraction, resulting in a possible decrease in complication rates. Level of evidence Retrospective cohort study, Level IV. PMID:24220747
Rouvillain, Jean Louis; Daoud, Wael; Donica, Adrian; Garron, Emmanuel; Uzel, André Pierre
Balloon dilation may offer a more expedient and cost-effective treatment method compared with traditional endoscopic sinus surgery for chronic maxillary atelectasis. We sought to demonstrate the feasibility of balloon dilation of the maxillary os as a treatment modality for patients with chronic maxillary atelectasis by investigating the short-term outcomes in a retrospective case series of 4 patients representing 5 sinuses treated between 2011 and 2013. All sinuses were successfully balloon dilated without complications. Follow-up ranged from 1 week to 4 months. Aeration of the treated sinuses without restenosis was confirmed by postoperative endoscopy, sinus computed tomography, or both. All patients reported subjective symptomatic improvement. Balloon dilation of the maxillary os may be a feasible treatment option for maxillary sinus atelectasis. Longer follow-up and a larger study sample will be needed to validate the safety of this technique and determine the rate of restenosis. PMID:23959819
Sun, Daniel Q; Dubin, Marc G
Drosophila melanogaster has an olfactory organ called the maxillary palp. It is smaller and numerically simpler than the antenna, and its specific role in behavior has long been unclear. Because of its proximity to the mouthparts, I explored the possibility of a role in taste behavior. Maxillary palp was tuned to mediate odor-induced taste enhancement: a sucrose solution was more appealing when simultaneously presented with the odorant 4-methylphenol. The same result was observed with other odors that stimulate other types of olfactory receptor neuron in the maxillary palp. When an antennal olfactory receptor was genetically introduced in the maxillary palp, the fly interpreted a new odor as a sweet-enhancing smell. These results all point to taste enhancement as a function of the maxillary palp. It also opens the door for studying integration of multiple senses in a model organism.
Infrequent, salient stimuli often capture attention despite their task-irrelevancy, and disrupt on-going goal-directed behavior. A number of studies show that presenting cues signaling forthcoming deviants reduces distraction, which may be a "by-product" of cue-processing interference or the result of direct preparatory processes for the forthcoming distracter. In the present study, instead of "bursts" of cue information, information on the temporal structure of the stimulus sequence was provided. Young adults performed a spatial discrimination task where complex tones moving left or right were presented. In the predictable condition, every 7th tone was a pitch-deviant, while in the random condition the position of deviants was random with a probability of 1/7. Whereas the early event-related potential correlates of deviance-processing (N1 and MMN) were unaffected by predictability, P3a amplitude was significantly reduced in the predictable condition, indicating that prevention of distraction was based on the knowledge about the temporal structure of the stimulus sequence. PMID:24657900
Volosin, Márta; Horváth, János
High-contrast markings, called distractive or dazzle markings, have been suggested to draw and hold the attention of a viewer, thus hindering detection or recognition of revealing prey characteristics, such as the body outline. We tested this hypothesis in a predation experiment with blue tits (Cyanistes caeruleus) and artificial prey. We also tested whether this idea can be extrapolated to the background appearance and whether high-contrast markings in the background would improve prey concealment. We compared search times for a high-contrast range prey (HC-P) and a low-contrast range prey (LC-P) in a high-contrast range background (HC-B) and a low-contrast range background (LC-B). The HC-P was more difficult to detect in both backgrounds, although it did not match the LC-B. Also, both prey types were more difficult to find in the HC-B than in the LC-B, in spite of the mismatch of the LC-P. In addition, the HC-P was more difficult to detect, in both backgrounds, when compared with a generalist prey, not mismatching either background. Thus, we conclude that distractive prey pattern markings and selection of microhabitats with distractive features may provide an effective way to improve camouflage. Importantly, high-contrast markings, both as part of the prey coloration and in the background, can indeed increase prey concealment. PMID:19324754
Dimitrova, Marina; Stobbe, Nina; Schaefer, H Martin; Merilaita, Sami
The clinical and radiological results of distraction lengthening in cases with posttraumatic radial club hand were evaluated. Five patients (3 men and 2 women, with average age of 21 years) with traumatic radial shortening (3 patients had nonunited fracture of distal end radius with bone loss and 2 patients had short radius after malunited fracture of radius or growth arrest of distal radial epiphysis, the average shortening was 4.2 cm) were treated with distraction lengthening using Ilizarov fixator and hybrid fixation technique. Patients were evaluated clinically for hand function and appearance, and radiologically for union. The average follow-up was 25 months. The preplanned length was achieved in all cases with good union and no bone graft was needed, clinically there was much improvement in hand function (the range of motion of the wrist increased and the power of hand grip increased) and appearance. Pin tract infection occurred in 3 cases, broken pin in 1 case, and stiff wrist in 1 case. These complications were treated and did not affect the final results. Acquired radial club hand is difficult to treat. Treatment with distraction lengthening is a good option with excellent results and mild complications that did not affect the overall results. PMID:24126335
Hosny, Gamal A; Kandel, Wael A
When the interval between a warning signal (WS) and an imperative signal (IS), termed the foreperiod (FP), is variable across trials, reaction time (RT) to the IS typically decreases with increasing FP length. Here we examined the auditory filled-FP effect, which refers to a performance decrement after FPs filled with irrelevant auditory stimulation compared to FPs without additional stimulation. According to one account, irrelevant stimulation distracts individuals from processing time and probability information during the FP (distraction-during-FP hypothesis). This should predominantly affect long-FP trials. Alternatively, the filled-FP effect may arise from a failure to shift attention from FP modality to IS modality (attention-to-modality hypothesis). The first hypothesis focuses on preparatory processing, predicting a selective RT increase on long-FP trials, whereas the second hypothesis focuses on target processing, only predicting a global RT increase irrespective of FP length. Across four experiments, a filled-FP (compared to a blank-FP) condition consistently yielded a selective RT increase on long-FP trials, irrespective of FP-IS modality pairing. This pattern of results contradicts the attention-to-modality hypothesis but corroborates the distraction-during-FP hypothesis. More generally, these data have theoretical implications by supporting a multi-process view of temporal preparation under time uncertainty. PMID:21333960
Steinborn, Michael B; Langner, Robert
Event-related potential (ERP) correlates of distraction are usually investigated in the oddball paradigm following a discrete, trial-by-trial stimulation protocol. In this design, participants perform a discrimination task while oddball stimuli deviate in a task-irrelevant stimulus feature. In our experiment, participants detected gaps in a continuous tone while infrequent frequency glides served as distracting events. Glides preceding a gap by 150ms delayed the response to the gap and elicited the ERP sequence of N1, probably MMN, P3a, and reorienting negativity, suggesting that these responses reflect distraction-related processes which are neither task- nor stimulation-specific. When participants watched a silent movie and the auditory stimulation was task-irrelevant, glides preceding a gap by 150ms enhanced the amplitude of the gap-elicited N1. However, when the auditory stimulation was task-relevant, the gap-elicited N1 was attenuated. These results show that the glides drew attention away from the ongoing task, both from watching the silent movie and from detecting gaps. PMID:20064580
Horváth, János; Winkler, István
In aviation, the sterile cockpit rule prohibits non-essential activities during critical phases of flight, takeoff and landing, phases analogous to induction of, and emergence from, anaesthesia. We studied distraction during 30 anaesthetic inductions, maintenances and emergences. Mean (SD) noise during emergence (58.3 (6.2) dB) was higher than during induction (46.4 (4.3) dB) and maintenance (52 (4.5) dB; p<0.001). Sudden loud noises, greater than 70 dB, occurred more frequently at emergence (occurring 34 times) than at induction (occurring nine times) or maintenance (occurring 13 times). The median (IQR [range]) of staff entrances or exits were 0 (0-2 [0-7]), 6 (3-10 [1-18]) and 10 (5-12 [1-20]) for induction, maintenance and emergence, respectively (p<0.001). Conversations unrelated to the procedure occurred in 28/30 (93%) emergences. These data demonstrate increased distraction during emergence compared with other phases of anaesthesia. Recognising and minimising distraction should improve patient safety. Applying aviation's sterile cockpit rule may be a useful addition to our clinical practice. PMID:21320085
Broom, M A; Capek, A L; Carachi, P; Akeroyd, M A; Hilditch, G
The aim of this study was to evaluate the effect of icariin on bone formation during mandibular distraction. 40 Rabbits were randomly divided into experimental and control groups. Mandibular distraction was performed 5 days after unilateral mandibular osteotomy using a custom-made external distractor at a rate of 0.5mm\\/12h for 10 days. From the first day of distraction, icariin (2.5mg\\/kg·day) was
H. Wei; L. Zili; C. Yuanlu; Y. Biao; L. Cheng; W. Xiaoxia; L. Yang; W. Xing
Infrequent task-irrelevant deviations in the frequency of a tone may distract our attention away from the processing of task-relevant tone duration. The distraction obtained in the auditory paradigm is reflected in prolonged reaction times in duration discrimination and in P3a. The P3a is followed by a late negative component, which may be related to a re-orienting process following distraction (RON,
Stefan Berti; Erich Schröger
The 3rd maxillary molar is a difficult tooth to remove by extraction or repulsion. A combined frontal and maxillary approach provides good exposure for repulsion of this tooth, debridement of the sinuses, and placement of an alveolar seal. The improved exposure should minimize operative difficulties and postoperative complications. Images Figure 1.
Boutros, C P; Koenig, J B
Distracted driving is now an increasingly deadly threat to road safety. We provide evidence that intoxicated driving is increasingly responsible for recent increases in fatalities from distracted driving crashes. This study describes trends in deaths on U.S. public roads caused by alcohol-involved and distracted drivers using the Fatality Analysis Reporting System (FARS)-a census of fatal crashes on U.S. public roads. Fatality rates per vehicle-miles traveled are calculated using data from the Federal Highway Administration. Alcohol-involved drivers who are simultaneously distracted were responsible for 1750 deaths in 2009, an increase of more than 63% from 2005 when there were 1072 deaths. Alcohol use while driving is increasingly responsible for a growing number of fatalities from distracted driving, accounting for 32% of deaths from distracted driving in 2009 versus 24% in 2005. The fatality rate from these crashes increased from 35.9 to 59.2 deaths per 100 billion vehicle-miles traveled after 2005. Alcohol use is quickly increasing as an important factor behind distracted driving fatalities. This has implications for policies combating distracted driving that do not address the role of alcohol use in distracted driving. PMID:24076300
Wilson, Fernando A; Stimpson, Jim P; Tibbits, Melissa K
The purpose of this study was to evaluate the effects of rapid maxillary expansion (RME) on conductive hearing loss in 35 subjects (21 girls and 14 boys) with an average age of 14 years 6 months. All patients had maxillary constriction with a high palatal vault and a conductive hearing loss. Pure-tone audiometric records were used to determine the hearing levels at four time intervals, namely, before RME, after sufficient midpalatal suture opening was obtained (mean: 18 days), after the retention period (mean: six months), and a final set two years after the retention period. Records were evaluated by the same otolaryngologist. Analysis of variance was used to assess the changes in the hearing level and the air-bone gap. Descriptive statistics were calculated for each subject at each period. The results indicated that significant changes occurred in both the hearing levels and air-bone gaps in both timing and frequency after the active treatment period (P < .001). For most patients (74%), these improvements were maintained two years after active treatment. PMID:14719731
Ta?pinar, Fatma; Uçüncü, Harun; Bishara, Samir E
The purpose of this report is to describe the dentoalveolar distraction (DAD) technique and to present its effects on the surrounding structures by presenting a Class II case. A 15-year-old skeletal and dental Class II female patient with an overjet of 9 mm was treated by DAD osteogenesis. A custom-made, rigid, tooth-borne intraoral distraction device was used for rapid canine retraction. Osteotomies surrounding the canines were made to achieve rapid movement of the canines within the dentoalveolar segment, in compliance with distraction osteogenesis principles. The amount of canine retraction was 7.5 mm in 12 days at a rate of 0.625 mm per day, with no posterior anchorage loss. The canine teeth showed 1.6 mm extrusion and 11 degrees inclination change (distal tipping) during the same period. Orthodontic treatment continued for 6 months with no clinical and radiographic evidence of complications such as root fracture, root resorption, ankylosis, and soft tissue dehiscence. The DAD technique is an innovative method, because it reduces overall orthodontic treatment time by about 50%, with no unfavorable effects on periodontal tissues and surrounding structures and with no need to use any intraoral or extraoral anchorage appliances. PMID:20050758
Kurt, Gökmen; I?eri, Haluk; Ki?ni?ci, Reha
Prompt responses to emotional, potentially threatening, stimuli are supported by neural mechanisms that allow for privileged access of emotional information to processing resources. The existence of these mechanisms can also make emotional stimuli potent distracters, particularly when task-irrelevant. The ability to deploy cognitive control in order to cope with emotional distraction is essential for adaptive behavior, while reduced control may lead to enhanced emotional distractibility, which is often a hallmark of affective disorders. Evidence suggests that increased susceptibility to emotional distraction is linked to changes in the processing of emotional information that affect both the basic response to and coping with emotional distraction, but the neural correlates of these phenomena are not clear. The present review discusses emerging evidence from brain imaging studies addressing these issues, and highlights the following three aspects. First, the response to emotional distraction is associated with opposing patterns of activity in a ventral “hot” affective system (HotEmo, showing increased activity) and a dorsal “cold” executive system (ColdEx, showing decreased activity). Second, coping with emotional distraction involves top–down control in order to counteract the bottom-up influence of emotional distraction, and involves interactions between the amygdala and the prefrontal cortex. Third, both the response to and coping with emotional distraction are influenced by individual differences affecting emotional sensitivity and distractibility, which are linked to alterations of both HotEmo and ColdEx neural systems. Collectively, the available evidence identifies specific neural signatures of the response to emotional challenge, which are fundamental to understanding the mechanisms of emotion-cognition interactions in healthy functioning, and the changes linked to individual variation in emotional distractibility and susceptibility to affective disorders.
Iordan, A. D.; Dolcos, S.; Dolcos, F.
Introduction Bone-anchored maxillary protraction has been shown to be an effective treatment modality for the correction of Class III malocclusions. The purpose of this study was to evaluate 3-dimensional changes in the maxilla, the surrounding hard and soft tissues, and the circummaxillary sutures after bone-anchored maxillary protraction treatment. Methods Twenty-five consecutive skeletal Class III patients between the ages of 9 and 13 years (mean, 11.10 ± 1.1 years) were treated with Class III intermaxillary elastics and bilateral miniplates (2 in the infrazygomatic crests of the maxilla and 2 in the anterior mandible). Cone-beam computed tomographs were taken before initial loading and 1 year out. Three-dimensional models were generated from the tomographs, registered on the anterior cranial base, superimposed, and analyzed by using color maps. Results The maxilla showed a mean forward displacement of 3.7 mm, and the zygomas and the maxillary incisors came forward 3.7 and 4.3 mm, respectively. Conclusions This treatment approach produced significant orthopedic changes in the maxilla and the zygomas in growing Class III patients.
Nguyen, Tung; Cevidanes, Lucia; Cornelis, Marie A.; Heymann, Gavin; de Paula, Leonardo K.; De Clerck, Hugo
Impaction of maxillary permanent central incisor is not a frequently reported case in dental practice, but its treatment is challenging because of its importance to facial esthetics. Early detection of such teeth is most important if complications are to be avoided. We report a case of a 14-year-old female with an impacted central incisor tooth in the maxillary anterior region. The impacted supernumerary tooth which was preventing the eruption of permanent incisor was surgically removed. Combined approach with surgical exposure and the application of an orthodontic force brought the impacted left maxillary central incisor down to its proper position in the dental arch.
Kannan, Prem Kumar Karupanna Pillai Subbiah; Palanisamy, Senthil Kumar Kullam Palayam; Kumar, Tamizharasi Senthil
A 6-month-old female crossbred dog with unilateral radial hemimelia was treated with a circular external fixator. During the first surgery, the dog underwent transverse osteotomy through the distal ulnar physis and rotation of the distal ulnar fragment (epiphysis) together with the forepaw in a lateral direction to achieve contact with the end of the proximal ulnar segment (shaft of the ulna); a circular external fixator was then applied. After removal of the fixator, a cast was applied. The initial intent was to preserve mobility of the ulnocarpal joint; however, the joint fused naturally. A second surgery was performed to lengthen the ulna by use of distraction osteogenesis. An Ilizarov external fixator was used, and the ulna was lengthened 25 mm. During the third surgery, osteotomy of the distal portion of the ulna was performed to treat residual deviation of the forepaw. The surgical treatment resulted in satisfactory use of the limb and a better quality of life. PMID:15646574
Rahal, Sheila C; Volpi, Reinaldo S; Ciani, Renata B; Vulcano, Luiz C
An immunocompetent 59-year-old man developed sinusitis over a 6- to 8-month period after cutting down a rotted maple tree (Acer sp.). A polypoid obstruction with a bloody drainage was evident in his right nasal cavity. A computed tomographic scan showed an opacification of the maxillary sinus. Surgery was performed to remove a fungus ball that had extended into the patient's medial sinus cavity. Sections of the sinonasal mucosa revealed marked acute and chronic sinusitis with inflammation, congestion, and hemorrhage. Sections from the pasty brown to black debrided material revealed a fungus ball consisting of an extensive network of brown-pigmented, septate, profusely branched hyphae. When grown on oat agar, the phaeoid fungus produced pycnidia and was identified as Pleurophomopsis lignicola. The genus Pleurophomopsis includes seven species, which are all known from plant material. This report documents for the first time a coelomycetous fungus, P. lignicola, causing sinusitis in an immunocompetent patient.
Padhye, A A; Gutekunst, R W; Smith, D J; Punithalingam, E
The aim of the study was to investigate the accuracy of a modified pin system for the vertical control of maxillary repositioning in bimaxillary osteotomies. The preoperative cephalograms of 239 consecutive patients who were to have bimaxillary osteotomies were superimposed on the postoperative films. Planned and observed vertical and horizontal movements of the upper incisor were analysed statistically. The mean deviations of -0.07 mm (95% confidence intervals (CIs) -0.17 to 0.04 mm) for the vertical movement and 0.12 mm (95% CI -0.06 to 0.30 mm) for the horizontal movement did not differ significantly from zero. Comparison of the two variances between intrusion and extrusion of the maxilla did not differ significantly either (p=0.51). These results suggest that the modified pin system for vertical control combined with interocclusal splints provides accurate vertical positioning of the anterior maxilla in orthognathic surgery. PMID:19577828
Kretschmer, W B; Zoder, W; Baciut, G; Bacuit, Mihaela; Wangerin, K
Solitary median maxillary central incisor syndrome (SMMCI) is a complex disorder consisting of multiple, mainly midline defects of development resulting from unknown factor(s) operating in utero about the 35th–38th day(s) from conception. It is estimated to occur in 1:50,000 live births. Aetiology is uncertain. Missense mutation in the SHH gene (I111F) at 7q36 may be associated with SMMCI. The SMMCI tooth differs from the normal central incisor, in that the crown form is symmetric; it develops and erupts precisely in the midline of the maxillary dental arch in both primary and permanent dentitions. Congenital nasal malformation (choanal atresia, midnasal stenosis or congenital pyriform aperture stenosis) is positively associated with SMMCI. The presence of an SMMCI tooth can predict associated anomalies and in particular the serious anomaly holoprosencephaly. Common congenital anomalies associated with SMMCI are: severe to mild intellectual disability, congenital heart disease, cleft lip and/or palate and less frequently, microcephaly, hypopituitarism, hypotelorism, convergent strabismus, oesophageal and duodenal atresia, cervical hemivertebrae, cervical dermoid, hypothyroidism, scoliosis, absent kidney, micropenis and ambiguous genitalia. Short stature is present in half the children. Diagnosis should be made by eight months of age, but can be made at birth and even prenatally at 18–22 weeks from the routine mid-trimester ultrasound scan. Management depends upon the individual anomalies present. Choanal stenosis requires emergency surgical treatment. Short stature may require growth hormone therapy. SMMCI tooth itself is mainly an aesthetic problem, which is ideally managed by combined orthodontic, prosthodontic and oral surgical treatment; alternatively, it can be left untreated.
Hall, Roger K
Objective: This study examines the effect of a computer-based training module on drivers’ attitudes and behaviors with respect to in-vehicle distraction. Background: Research findings on the negative performance implications of distraction call for the need to mitigate these adverse effects. Method: Forty drivers (ages 18 to 20 yrs) were divided into two groups: a training group that completed the module
William J. Horrey; Mary F. Lesch; Arthur F. Kramer; David F. Melton
Objective: The purpose of this study was to explore the interrelationship between driver distraction and characteristics of driver behavior associated with reduced highway traffic efficiency. Background: Research on the three-phase traffic theory and on behavioral driving suggests that a number of characteristics associated with efficient traffic flow may be affected by driver distraction. Previous studies have been limited, however, by
Joel M. Cooper; Ivana Vladisavljevic; Nathan Medeiros-Ward; Peter T. Martin; David L. Strayer
An ethnically diverse sample of high and low hypnotizable children (N=27) suffering from cancer or blood disorders were trained along with their parents to use both distraction and hypnosis to reduce pain and anxiety. Distraction produced significant positive effects for observer-rated distress scores for the low hypnotizable children. Discusses…
Smith, Julien T.; And Others
Previous studies in adults have revealed that attentional distraction modulates the late positive potential (LPP) during emotion regulation. To determine whether early visual components reflect developmental changes in attentional distraction during adolescence, we collected event-related potentials from 20 young adolescents, 18 older adolescents, and 18 young adults as they performed a distraction task (counting) while viewing affective images. Consistent with previous findings obtained in distraction studies, the distraction task (counting) reduced emotional modulation of the LPP. At an early stage of processing, counting reduced emotional modulation of P1 and increased the negativity bias of early frontal negativity (eFN) for negatively valenced pictures compared to simple viewing with no distraction. sLORETA analyses further revealed eFN indexing of rostral prefrontal cortical activation, a cortical area that has been shown in recent fMRI studies to be activated by distraction. Moreover, P1 amplitudes in young and older adolescents did not differ but were both larger than the P1s in young adults. In addition, eFN amplitudes significantly decreased with age. The dissociable distraction patterns between the posterior P1 and eFN provide evidence not only for the timing hypothesis of emotion regulation but also for different developmental trajectories of visual processing areas and the prefrontal cortex during affective processing in adolescence. PMID:24658081
Zhang, Wenhai; Li, Hong; Chen, Jie; Chen, Ning; Liu, Xia; Wang, Dahua; Shen, Jiliang
Previous research has found that self-focused rumination maintains or increases depressed mood, whereas distraction decreases depressed mood (S. Nolen-Hoeksema & J. Morrow, 1993; S. Nolen- Hoeksema, J, Morrow, & B. L. Fredrickson, 1993). The present series of experiments examined these mood regulation strategies in the context of an angry mood. In Experiments 1 and 3, rumination increased anger, whereas distraction
Cheryl L. Rusting; Susan Nolen-Hoeksema
The ability to ignore task-irrelevant information and overcome distraction is central to our ability to efficiently carry out a number of tasks. One factor shown to strongly influence distraction is the perceptual load of the task being performed; as the perceptual load of task-relevant information processing increases, the likelihood that…
Cosman, Joshua D.; Vecera, Shaun P.
Detecting the mental and physical states which occur in a driver immediately before a traffic accident and then providing information to or warning the driver is an effective means of reducing traffic accidents. This study is focused on driver distraction, a state which can easily lead to traffic accidents, and reproduced this distraction in a driving simulator by providing conversation
Masahiro MIYAJI; Mikio DANNO; Haruki KAWANAKA; Koji OGURI
This paper examines the results of research into the learning experiences of a group of adult learners in a university preparation programme in a college of Technical and Further Education in Sydney, NSW, Australia. The research was conducted over a three year period by the author as a teacher-researcher and is grounded in the phenomenological…
Abstract We explored the use of virtual reality distraction techniques for use as adjunctive therapy to treat chronic pain. Virtual environments were specifically created to provide pleasant and engaging experiences where patients navigated on their own through rich and varied simulated worlds. Real-time physiological monitoring was used as a guide to determine the effectiveness and sustainability of this intervention. Human factors studies showed that virtual navigation is a safe and effective method for use with chronic pain patients. Chronic pain patients demonstrated significant relief in subjective ratings of pain that corresponded to objective measurements in peripheral, noninvasive physiological measures. PMID:24892196
Wiederhold, Brenda K; Gao, Kenneth; Sulea, Camelia; Wiederhold, Mark D
Although many studies have investigated the effectiveness of distraction as a method of pain control, the cognitive processes by which attentional re-direction is achieved, remain unclear. In this study the role of executive functioning abilities (inhibition, task switching and working memory) in the effectiveness of distraction is investigated. We hypothesized that the effectiveness of distraction in terms of pain reduction
Katrien Verhoeven; Van Damme Stefaan; Eccleston Christopher; M. L. Van Ryckeghem Dimitri; Legrain Valéry; Crombez Geert
Despite the distracting effects of emotional stimuli on concurrent task performance, humans are able to uphold goal-directed behavior. Here, we investigated the hypothesis that this effect is due to the enhanced recruitment of task-specific neural resources. In a two-step functional magnetic resonance imaging study, we first localized those areas involved in mental arithmetics by contrasting arithmetic problems with a number detection task. The resulting activation maps were then used as masks in a second experiment that compared the effects of neutral and emotional distracter images on mental arithmetics. We found increased response times in the emotional distracter condition, accompanied by enhanced activation in task-specific areas, including superior parietal cortex, dorsolateral and dorsomedial prefrontal cortex. This activation increase correlated with larger behavioral impairment through emotional distraction. Similar error rates in both conditions indicate that cognitive task performance is preserved through enhanced recruitment of task-specific neural resources when emotional distracter stimuli are present. PMID:22302842
Wessa, Michèle; Heissler, Janine; Schönfelder, Sandra; Kanske, Philipp
When we pay attention to one task, irrelevant changes may interfere. The effect of changes on behavioral and electrophysiological responses has been studied in two separate research fields: Research on Distraction states that a rare irrelevant change takes attention away from the primary task. Research on Sequences states that any change in stimulus or response incurs a cost or benefit depending on the kind of change. To disentangle distraction from sequence effects, we made task-irrelevant changes rare in one condition and frequent in another while also assessing stimulus and response changes from trial to trial. Participants used key presses to classify syllables presented in two different, irrelevant voice pitches. We found that distraction and sequence interacted to alter reaction times and errors on the primary task and also to alter ERP markers of distraction (P3a). The sequential effects cannot, however, fully account for distraction. PMID:19207193
Roeber, Urte; Berti, Stefan; Müller, Dagmar; Widmann, Andreas; Schröger, Erich
Distraction osteogenesis (DO) is one of the most dramatic in vivo applications of mechanical stimulation as a means of inducing bone regeneration. A simple and reproducible murine model of tibia distraction osteogenesis was developed using a monolateral fixator. Bone formation was assessed histologically over a 35-day time course. The steady state expression of a broad family of angiogenesis-associated genes was assessed by microarray hybridization analyses over the same time course, while the immediate gene response that was induced during each cycle of distraction was assessed at 30 min and 8 h after the first and last rounds of activation of the fixator. Distraction osteogenesis promoted new bone formation primarily through an intramembranous process with maximal osteogenesis during the active distraction period. Histological analysis also showed that dense cortical bone continued to be formed, during the consolidation phase, for 2 weeks after distraction ended. The analysis of steady state mRNA expression levels over the time course of DO showed that VEGF-A and neuropilin, an alternate receptor for VEGF-A, both angiopoietin (Ang) 1 and 2 factors, and the Ang receptor Tie2 were the critical angiogenic factors during DO. A key transcriptional regulator of many of the angiogenic factors, hypoxia-induced factor1alpha (Hif-1a), the FGF binding protein pleiotropin/OSF1, and multiple MMP(s), were also induced during the active distraction period. Examination of the expression of angiogenic factors that were induced after each cycle of activation, demonstrated that Hif-1a, Nrp1, and VEGF-A were all cyclically induced after each increment of distraction. These results suggest that these factors are early mediators that are produced by distraction and contribute toward the processes that promote bone formation. These experiments represent the first step in defining the molecular mechanisms that regulate skeletal regeneration and the functional relationship between angiogenesis and osteogenesis during distraction osteogenesis. PMID:15121017
Carvalho, R S; Einhorn, T A; Lehmann, W; Edgar, C; Al-Yamani, A; Apazidis, A; Pacicca, D; Clemens, T L; Gerstenfeld, L C
Background The purpose of this study was to establish biomechanical outcomes measures to evaluate how mandibular distraction osteogenesis affects the overall quality of bone healing in the mandible. Strength and functional integrity of the regenerate was quantitatively determined after unilateral mandibular distraction osteogenesis in comparison to the contralateral mandible, and a partially reduced fracture. We hypothesized that the breaking load, yield and stiffness of mandibular distraction osteogenesis would be significantly reduced in comparison to both the contralateral mandible and a partially reduced fracture. Methods Sprague-Dawley rats underwent mandibular distraction osteogenesis (n=8) or a partially reduced fracture (n=6). External fixators were secured, unilateral osteotomies created behind the 3rd molar, followed by either mandibular distraction osteogenesis: 4days latency then 0.3mm Q12hrs × 8days (5.1mm) or a partially reduced mandibular fracture: fixed gap post-operatively (2.1mm). Both groups underwent 4 weeks consolidation. The contralateral mandibles were used as controls (n = 14). Mandibles were tension tested at 0.5mm/s to failure and then breaking load, yield and stiffness were determined. Results mandibular distraction osteogenesis had significantly lower breaking load, yield and stiffness when compared to the contralateral mandible, by 40%, 30% and 60%, respectively. Breaking load was reduced in partially reduced mandibular fractures by 40% when compared to mandibular distraction osteogenesis. Conclusion Utilizing a standard Ilizarov protocol, the strength and durability of the regenerate, as measured by breaking load, yield and stiffness in mandibular distraction osteogenesis was significantly lower than contralateral mandibles. Surprisingly, the breaking load of mandibular distraction osteogenesis was significantly greater than partially reduced mandibular fracture. These verifiable metrics of regenerate integrity can be utilized to discern optimal outcomes of mandibular distraction osteogenesis, and to extrapolate the data from the bench and bring it to the bedside, enhancing the clinical applications of this powerful technique.
Schwarz, Daniel A.; Arman, Krikor G.; Kakwan, Mehreen S.; Jamali, Ameen M.; Buchman, Steven R.
Evidence has suggested that women have greater emotional reactivity than men. However, it is unclear whether these differences in basic emotional responses are also associated with differences in emotional distractibility, and what the neural mechanisms that implement differences in emotional distractibility between women and men are. Functional MRI recording was used in conjunction with a working memory (WM) task, with emotional distraction (angry faces) presented during the interval between the memoranda and the probes. First, we found an increased impact of emotional distraction among women in trials associated with high-confidence responses, in the context of overall similar WM performance in women and men. Second, women showed increased sensitivity to emotional distraction in brain areas associated with "hot" emotional processing, whereas men showed increased sensitivity in areas associated with "cold" executive processing, in the context of overall similar patterns of response to emotional distraction in women and men. Third, a sex-related dorsal-ventral hemispheric dissociation emerged in the lateral PFC related to coping with emotional distraction, with women showing a positive correlation with WM performance in left ventral PFC, and men showing similar effects in the right dorsal PFC. In addition to extending to men results that have previously been reported in women, by showing that both sexes engage mechanisms that are similar overall in response to emotional distraction, the present study identifies sex differences in both the response to and coping with emotional distraction. These results have implications for understanding sex differences in the susceptibility to affective disorders, in which basic emotional responses, emotional distractibility, and coping abilities are altered. PMID:23293019
Iordan, Alexandru D; Dolcos, Sanda; Denkova, Ekaterina; Dolcos, Florin
Speech is often perturbed after placement of maxillary implant-retained prostheses. We tested the hypothesis that the rate of speech errors varies with prosthetic design. Thirty edentulous subjects with mandibular implant prostheses entered two within-subject crossover trials. Subjects wore maxillary fixed prostheses and removable long-bar overdentures (Trial 1), or overdentures with and without palates (Trial 2). Test words from a French
G. Heydecke; D. H. McFarland; J. S. Feine; J. P. Lund
Surgical repositioning is a treatment option for an impacted tooth with root dilaceration in an inverted position. In this case report, surgical repositioning of an abnormally impacted and labially dilacerated maxillary right central incisor is described. The impacted and dilacerated maxillary incisor was surgically repositioned in the early root development period and erupted into proper position with normal root development during a 2-year follow-up period. PMID:21206930
Choi, Sung Chul; Park, Jae Hong; Kwon, Yong-Dae; Yoo, Eun Kyu; Yoo, Jung Eun
We describe a rare case of traumatic pseudoaneurysm of the maxillary artery following a fall. The patient presented with epistaxis that could not be controlled with anterior and posterior nasal packing. She was urgently taken to the angiography suite for evaluation and ultimately underwent embolization of a left maxillary artery pseudoaneurysm with 500-700?micron Contour PVA followed by coiling with two 3?mm Tornado coils. Bleeding subsided after embolization, and the patient suffered no neurologic sequelae. PMID:22937363
Adil, Eelam; Setabutr, Dhave; Carr, Michele M
Context: Le Fort 1 maxillary osteotomy in operated patients of cleft lip and cleft palate (CLCP). Aims: To study stability of Le Fort 1 maxillary osteotomy in operated patients of CLCP by two-dimensional evaluation using cephalometric analysis. Settings and Design: Prospective study conducted at Army Dental Centre (Research and Referral) from May 2009-May 2012. Materials and Methods: Subjects included nine consecutively operated patients of CLCP with maxillary hypoplasia. Maxillary advancement by Le Fort 1 maxillary step osteotomy was performed. There were four males and five females with an age range of 16-18 years and follow-up range was 12-36 months. Presurgical and postsurgical changes were compared using cephalometrics for orthognathic surgery (COGS) system to determine stability of maxillary movement and quantify amount of relapse at 15 days and 12 months. Statistical Analysis: Student's t-test. Results: Mean linear horizontal advancement achieved along nasion (N) to anterior nasal spine (ANS) with reference to true vertical plane at 15 days and 12 months was 5.17 and 3.91 mm, respectively. The mean relapse in anteroposterior dimension was 21.63%. The mean vertical displacement observed along nasion and ANS with reference to true horizontal plane at 15 days and 12 months was 5.21 mm and 3.2, respectively with a resultant relapse of 41.54%. Conclusions: Based on clinical and COGS analysis, it is evident that Le Fort 1 advancement in operated cases of CLCP has inherent potential for relapse.
Kumari, Pushpa; Roy, S. K.; Roy, I. D.; Kumar, Prasanna; Datana, Sanjeev; Rahman, Serat
As planners and public health officials in many cities around the world seek to increase bicycle ridership, bicyclists who are performing a secondary task (such as listening to a portable music device) may pose a risk to public safety. This study examines bicycling safety and potentially distracted behavior in The Hague, the Netherlands, a place where bicycling is a common, everyday travel mode among all walks of life and where bicycling infrastructure is well developed. Based on 1360 observations of bicycling behavior, this study shows that bicyclists who were using a cell phone, listening to a portable music device, or talking with other bicyclists exhibited more unsafe behaviors than those bicyclists who were not performing a secondary task. Furthermore, bicyclists who were performing a secondary task also more frequently created situations where other people had to evade them to avoid an accident. As with distracted car driving, the performance of a secondary task while bicycling may be unsafe for the person engaging in the behavior as well as for other people around them. PMID:23643938
Although multiple neuroimaging studies suggest that affect labeling (i.e., putting feelings into words) can dampen affect-related responses in the amygdala, the consequences of affect labeling have not been examined in other channels of emotional responding. We conducted four studies examining the effect of affect labeling on self-reported emotional experience. In study one, self-reported distress was lower during affect labeling, compared to passive watching, of negative emotional pictures. Studies two and three added reappraisal and distraction conditions, respectively. Affect labeling showed similar effects on self-reported distress as both of these intentional emotion regulation strategies. In each of the first three studies, however, participant predictions about the effects of affect labeling suggest that unlike reappraisal and distraction, people do not believe affect labeling to be an effective emotion regulation strategy. Even after having the experience of affect labels leading to lower distress, participants still predicted that affect labeling would increase distress in the future. Thus, affect labeling is best described as an incidental emotion regulation process. Finally, study four employed positive emotional pictures and here, affect labeling was associated with diminished self-reported pleasure, relative to passive watching. This suggests that affect labeling tends to dampen affective responses in general, rather than specifically alleviating negative affect.
Lieberman, Matthew D.; Inagaki, Tristen K.; Tabibnia, Golnaz; Crockett, Molly J.
Driver distraction and safety concerns have been identified for new highway logo sign configurations. This study assessed driver perception of logo signs and distraction under nine-panel, overflow-combination, or standard six-panel formats. A nine-panel sign has nine business panels within a single sign; a six-panel sign has six panels within a sign; an overflow-combination consists of a standard six-panel sign and a six-panel sign displaying two different services (e.g., food and gas). In this study, twenty-four participants searched for target food business logos while driving in a high-fidelity driving simulation under each signage condition. Gas and lodging signs were also displayed along the road in conventional six-panel formats. Dependent variables included signal detection, visual attention allocation, and vehicle control measures. Experiment results showed nine-panel signs drew greater visual attention and produced lower average speed than overflow-combination signs, and produced a lower speeding percentage compared to six-panel signs. However, there was no evidence the new configurations (nine-panel and overflow) caused substantive performance changes with safety implications. This study suggested the use of nine-panel and overflow-combination logo signs may be suitable for interchanges where there are more than six qualifying businesses in a category in terms of driver performance and safety. PMID:23141432
Zhang, Yu; Harris, Elizabeth; Rogers, Meghan; Kaber, David; Hummer, Joseph; Rasdorf, William; Hu, Jia
Nowadays drivers have to get along with an increasing complex visual environment. More and more cars are on the road. There are not only distractions available within the vehicle, like radio and navigation system, the environment outside the car has also become more and more complex. Hoardings, advertising pillars, shop fronts and video screens are just a few examples. For this reason the potential risk of driver distraction is rising. But in which way do the advertisements at the roadside influence the driver's attention? The investigation which is described is devoted to this topic. Various kinds of advertisements played an important role, like illuminated and non-illuminated posters as well as illuminated animated ads. Several test runs in an urban environment were performed. The gaze direction of the driver's eye was measured with an eye tracking system. The latter consists of three cameras which logged the eye movements during the test run and a small-sized scene camera recording the traffic scene. 16 subjects (six female and ten male) between 21 and 65 years of age took part in this experiment. Thus the driver's fixation duration of the different advertisements could be determined.
Kettwich, Carmen; Klinger, Karsten; Lemmer, Uli
The load theory of visual attention proposes that efficient selective perceptual processing of task-relevant information during search is determined automatically by the perceptual demands of the display. If the perceptual demands required to process task-relevant information are not enough to consume all available capacity, then the remaining capacity automatically and exhaustively “spills-over” to task-irrelevant information. The spill-over of perceptual processing capacity increases the likelihood that task-irrelevant information will impair performance. In two visual search experiments, we tested the automaticity of the allocation of perceptual processing resources by measuring the extent to which the processing of task-irrelevant distracting stimuli was modulated by both perceptual load and top-down expectations using behavior, functional magnetic resonance imaging, and electrophysiology. Expectations were generated using a trial-by-trial cue that provided information about the likely load of the upcoming visual search task. When the cues were valid, behavioral interference was eliminated and the influence of load on frontoparietal and visual cortical responses was attenuated relative to when the cues were invalid. In conditions in which task-irrelevant information interfered with performance and modulated visual activity, individual differences in mean blood oxygenation level dependent responses measured from the left intraparietal sulcus were negatively correlated with individual differences in the severity of distraction. These results are consistent with the interpretation that a top-down biasing mechanism interacts with perceptual load to support filtering of task-irrelevant information.
Sy, Jocelyn L.; Guerin, Scott A.; Stegman, Anna; Giesbrecht, Barry
Unexpected and task-irrelevant sounds can capture our attention and may cause distraction effects reflected by impaired performance in a primary task unrelated to the perturbing sound. The present auditory-visual oddball study examines the effect of the informational content of a sound on the performance in a visual discrimination task. The informational content was modulated by varying the sound-target interval and the probability of target occurrence. Effects of informational content were examined with two types of distractors: a burst of white noise (deviant) and environmental sounds (novel). Behavioral results reveal the following. (1) Novel and deviant sounds do not necessarily cause behavioral distraction effects when they are uninformative with respect to both time and probability of occurrence of a visual target. (2) Novel, but not deviant, sounds cause an unspecific bias toward facilitation. (3) The informational content of task-irrelevant sounds speeds reaction times, indicating the use of information not directly related to the task for enhancing performance. (4) It is suggested that performance in deviant and novel trials is the sum of the costs of attentional orienting and benefits of information as well as benefits of unspecific activation for novels. PMID:22022895
Wetzel, Nicole; Widmann, Andreas; Schröger, Erich
Auditory distraction of random generation--a quintessentially executive control task--was explored in three experiments. Random number generation was impaired by the mere presence of irrelevant auditory sequences that comprise digits, but not letters, and then only if the digits were heard in a canonical order (1, 2, 3 … or 3, 2, 1 …), not in random order (Experiments 1 and 2). Random letter generation was impaired by irrelevant letters heard in alphabetical order (a, b, c …) and reversed alphabetical order (i, h, g …), but not by numbers in canonical order or letters in random order (Experiment 3). Attempting to ignore canonical sequences--with items that are members of the same category as the to-be-generated items--reduced the randomness of the generated sequence, by decreasing the tendency to change the direction of the produced sequence for random number generation, and by increasing resampling of responses for random letter generation. Like other selective attention tasks, the cost of distraction to random generation appears to stem from preventing habitual responses assuming the control of action. PMID:23548984
Marsh, John E; Sörqvist, Patrik; Halin, Niklas; Nöstl, Anatole; Jones, Dylan M
The purpose of this study was to evaluate cartoon movie viewing as a practical and low-cost intervention to decrease burned children's pain behavior during dressing changes. Thirteen children, 4 to 12 years of age, with a mean TBSA burn of 7.9% were assessed using a reversal, single-subject experimental design. The experimental condition consisted of the presentation of a cartoon movie as a nonpharmacologic intervention in conjunction with a standardized analgesic medication. In the control condition children's pain was treated with the standardized analgesic medication only. Behavioral distress was measured during the first six dressing changes postburn with the Observational Scale of Behavioral Distress. No significant effect of cartoon movie distraction on observed behavioral distress in patients was found. Interrater reliability of the Observational Scale of Behavioral Distress was good (kappa =.87-.98). Wound debridement was found to be the most painful part of the dressing change. A simple, easily applicable, and low-cost distraction intervention such as presenting cartoon movies does not seem to be sufficiently powerful to measurably reduce burned children's distress during dressing changes. Findings are based on purely observational data. Inclusion of self-report measures in future studies might reveal intervention effects on anxiety and subjective pain perception. PMID:11803316
Landolt, M A; Marti, D; Widmer, J; Meuli, M
Objective The purpose of this study was to evaluate the validity of the 3-dimensional (3D) superimposition method of digital models in patients who received treatment with rapid maxillary expansion (RME) and maxillary protraction headgear. Methods The material consisted of pre- and post-treatment maxillary dental casts and lateral cephalograms of 30 patients, who underwent RME and maxillary protraction headgear treatment. Digital models were superimposed using the palate as a reference area. The movement of the maxillary central incisor and the first molar was measured on superimposed cephalograms and 3D digital models. To determine whether any difference existed between the 2 measuring techniques, intra-class correlation (ICC) and Bland-Altman plots were analyzed. Results The measurements on the 3D digital models and cephalograms showed a very high correlation in the antero-posterior direction (ICC, 0.956 for central incisor and 0.941 for first molar) and a moderate correlation in the vertical direction (ICC, 0.748 for central incisor and 0.717 for first molar). Conclusions The 3D model superimposition method using the palate as a reference area is as clinically reliable for assessing antero-posterior tooth movement as cephalometric superimposition, even in cases treated with orthopedic appliances, such as RME and maxillary protraction headgear.
Choi, Jin-Il; Jost-Brinkmann, Paul-Georg; Choi, Dong-Soon; Jang, In-San
To establish a ratio of variable bone height (Infrazygomatic alveolar crest height) to constant bone height (Infraorbital zygomatic height) and, to estimate the relative sinus floor position from alveolar crest of maxillary first molar region of dentulous Indian males and females, using Digital panoramic radiographs. Panoramic radiographs of 74 patients were included in the study (37 male, 37 female) to measure maxillary posterior vertical bone height and their ratio in dentulous patients. Measurements were made from reference lines drawn from anatomic landmarks on soft digital versions of standardized panoramic radiographs using Kodak dental imaging software. Later the data were analyzed using normal test (Z-score). When the posterior maxillary bone height and their ratio were evaluated in Indian population, the vertical bone height (x, y, z) of males was more than the females. Ratio of Infrazygomatic-alveolar crest distance (y)/Infraorbital-zygomatic distance (x)-was 0.74 for Indian males and females. The relative sinus floor for Indian males was found to be 8.1 mm and that of Indian females to be 7.8 mm. The results are of significant value as "baseline" data, in serial studies where alveolar bone height for a single patient is compared at different times before and after tooth loss. The relative sinus floor position from alveolar crest can help in implant length selection. This study can be used as a diagnostic and predictive tool in implant treatment planning but further long-term evaluation is still required to prove the efficacy of this study. PMID:24431714
Jain, A; Chowdhary, R
Auditory distraction is a failure to maintain focus on a stream of sounds. We investigated the neural correlates of distraction in a selective-listening pitch-discrimination task with high (competing speech) or low (white noise) distraction. High-distraction impaired performance and reduced the N1 peak of the auditory Event-Related Potential evoked by probe tones. In a series of simulations, we explored two theories to account for this effect: disruption of sensory gain or a disruption of inter-trial phase consistency. When compared to these simulations, our data were consistent with both effects of distraction. Distraction reduced the gain of the auditory evoked potential and disrupted the inter-trial phase consistency with which the brain responds to stimulus events. Tones at a non-target, unattended frequency were more susceptible to the effects of distraction than tones within an attended frequency band. PMID:23326548
Ponjavic-Conte, Karla D; Hambrook, Dillon A; Pavlovic, Sebastian; Tata, Matthew S
Auditory distraction is a failure to maintain focus on a stream of sounds. We investigated the neural correlates of distraction in a selective-listening pitch-discrimination task with high (competing speech) or low (white noise) distraction. High-distraction impaired performance and reduced the N1 peak of the auditory Event-Related Potential evoked by probe tones. In a series of simulations, we explored two theories to account for this effect: disruption of sensory gain or a disruption of inter-trial phase consistency. When compared to these simulations, our data were consistent with both effects of distraction. Distraction reduced the gain of the auditory evoked potential and disrupted the inter-trial phase consistency with which the brain responds to stimulus events. Tones at a non-target, unattended frequency were more susceptible to the effects of distraction than tones within an attended frequency band.
Ponjavic-Conte, Karla D.; Hambrook, Dillon A.; Pavlovic, Sebastian; Tata, Matthew S.
The study's objectives were to determine the prevalence and types of distracting activities involved in serious crashes, and to explore the factors associated with such crashes. We interviewed 1367 drivers who attended hospital in Perth, Western Australia between April 2002 and July 2004 following a crash. A structured questionnaire was administered to each driver and supplementary data were collected from ambulance and medical records. Over 30% of drivers (433, 31.7%) cited at least one distracting activity at the time of crashing and driver distraction was reported to have contributed to 13.6% of all crashes. The major distracting activities were conversing with passengers (155, 11.3%), lack of concentration (148, 10.8%) and outside factors (121, 8.9%). Using logistic regression, a distracting activity at the time of a crash was significantly more likely among drivers with shorter driving experience (0-9 years, 38.3% versus >or=30 years, 21.0%, p<0.001). Distracting activities at the time of serious crashes are common and can cause crashes, and the types of activities reported are varied. Increased driver awareness of the adverse consequences of distracted driving with a focus on novice drivers, enforcement of existing laws (e.g. those requiring a driver to maintain proper control of a vehicle), and progress on engineering initiatives (such as collision warning systems) are needed to reduce injury. PMID:17034748
McEvoy, Suzanne P; Stevenson, Mark R; Woodward, Mark
The present study examined 100 lesbian and gay college students and 100 heterosexual students to determine whether group differences exist in frequency of a range of non-erotic cognitive distractions during sexual activity. Non-erotic cognitive distraction is a descriptive term for both self-evaluative cognitions related to physical performance and body image concerns, as well as additional cognitive distractions (e.g., contracting an STI or emotional concerns) during sexual activity. Participants were matched on gender (96 males and 104 females), age, and ethnicity, and completed questionnaires assessing frequency of non-erotic cognitive distractions during sexual activity, as well as measures of additional variables (trait and body image anxiety, attitudes toward sexual minorities, self-esteem, and religiosity). Results indicated that sexual minorities experienced significantly more cognitive distractions related to body image, physical performance, and STIs during sexual activity than heterosexuals. Regarding gender, men reported more distractions related to STIs than women. Interaction effects were observed between sexual orientation and gender for body image-, disease-, and external/emotional-based distractions. Implications of these findings are discussed. PMID:21796485
Lacefield, Katharine; Negy, Charles
Solitary plasmacytoma is a very rare form of neoplasia, part of the monoclonal gammopathies. It represents a tumoral proliferation of plasma cells in the form of a solitary mass which can be located in the bone marrow or extramedullary.Initial symptoms are vague and nonspecific. Being such a rare affliction, there is little information in the literature. Early diagnosis is difficult but very important due to therapy outcome.A high risk of progression towards a multiple myeloma has been reported. We present a rare case of a 52-year-old patient diagnosed with multiple solitary plasmacytomas. The tumours were separated from one another in time, over a 14 years period. The various medullograms did not show any sign of medullary plasma cell infiltrate. Initially, the affliction responded to chemotherapy, but later the haematologist recommended surgical resections followed by reconstruction.The maxillary localization required excision of the tumour with the preservation of the eye bulb despite the destruction of the orbital floor and with the regain of ocular functionality as well as aesthetic rehabilitation. This evolution highlights the benefits of surgical treatment in conjunction with chemotherapy in the treatment of this entity. PMID:24157122
Cioranu, V Ibric; Seceleanu, V Petrescu; Imre, M Melescanu; Nicolae, V; Cioranu, S Ibric
Distraction is a disruption of a selective attention set triggered by infrequent, unpredictable events. In the present study, two hypotheses on the nature of this attention change were contrasted in the auditory domain: (1) distraction is a specific attention-switch: attention is diverted from the task-relevant to the distracting information or (2) distraction is a general attention resetting, that is, a transition to a general attention set in which the organism is more capable of facing any event. The general attention resetting hypothesis predicts that any infrequent, unpredictable stimulus would trigger distraction, whereas the specific attention-switch hypothesis predicts that such a stimulus triggers distraction only if it deviates in a task-irrelevant stimulus aspect. To test this, a sequence of tone-pairs was presented. The participants' task was to respond according to the direction of within-pair pitch-change. Deviant trials were presented occasionally (10%). In the Relevant Deviance condition, the deviation concerned the task-relevant stimulus aspect (larger within-pair pitch-difference); in the Irrelevant Deviance condition the deviance occurred in a task-irrelevant stimulus aspect (spectral width of the second tone of the pair). In the Double Deviance condition, deviants featured both a larger pitch-difference and a spectral width difference. The elicitation pattern of the N2b/MMN, P3a and late negative components favors the specific attention-switch hypothesis, that is, distraction comprises an involuntary attention shift from the task-relevant information to the distracting one. The presence of deviance-related response time delay in the Relevant Deviance condition suggests that other effects unrelated to distraction also occurred. PMID:18634759
Horváth, János; Roeber, Urte; Bendixen, Alexandra; Schröger, Erich
Purpose This study investigated the relationship between the roots of the maxillary molars and the maxillary sinus using cone beam computed tomography (CBCT), and measured the distances between the roots of the maxillary molars and the sinus floor as well as the thickness of the bone between the root and the alveolar cortical plate. Materials and Methods The study sample consisted of 83 patients with normally erupted bilateral maxillary first and second molars. A total of 332 maxillary molars were examined using CBCT images. The vertical relationship of each root with the maxillary sinus was classified into four types on CBCT cross-sectional images. The distance between the sinus floor and root and the bone thickness between the root and alveolar cortical plate were measured. Results In the buccal roots of the maxillary molars, a root protruding into the sinus occurred most frequently. A root projecting laterally along the sinus cavity was most common in the palatal roots of the maxillary first molars. The mesiobuccal roots of the maxillary second molar were closest to the sinus. The mesiobuccal roots of the first molars were closest to the cortical plate. Conclusion The relationship between the roots of the maxillary molars and the sinus differed between the buccal and palatal roots. A root protruding into the sinus occurred more frequent in the buccal roots of the maxillary molars. The mesiobuccal root of the maxillary second molar was closest to the maxillary sinus floor and farthest from the alveolar cortical plate.
Load theory predictions for the effects of task coordination between and within sensory modalities (vision and hearing or vision only) on the level of distraction were tested. Response competition effects in a visual flanker task when it was coordinated with an auditory discrimination task (between-modality conditions) or a visual discrimination task (within-modality conditions) were compared with single-task conditions. In the between-modality conditions, response competition effects were greater in the two- (vs. single-) task conditions irrespective of the level of discrimination task difficulty. In the within-modality conditions, response competition effects were greater in the two-task (vs. single-task) conditions only when these involved a more difficult visual discrimination task. The results provided support for the load theory prediction that executive control load leads to greater distractor interference while highlighting the effects of task modality. PMID:18459262
Brand-D'Abrescia, Muriele; Lavie, Nilli
This study investigated implicit socioemotional modulation of working memory (WM) in the context of symptom severity and functional status in individuals with psychosis (N = 21). A delayed match-to-sample task was modified wherein task-irrelevant facial distracters were presented early and briefly during the rehearsal of pseudoword memoranda that varied incrementally in load size (1, 2, or 3 syllables). Facial distracters displayed happy, sad, or emotionally neutral expressions. Implicit socioemotional modulation of WM was indexed by subtracting task accuracy on nonfacial geometrical distraction trials from facial distraction trials. Results indicated that the amount of implicit socioemotional modulation of high WM load accuracy was significantly associated with negative symptoms (r = 0.63, P < 0.01), role functioning (r = ?0.50, P < 0.05), social functioning (r = ?0.55, P < 0.01), and global assessment of functioning (r = ?0.53, P < 0.05). Specifically, greater attentional distraction of high WM load was associated with less severe symptoms and functional impairment. This study demonstrates the importance of the WM-socioemotional interface in influencing clinical and psychosocial functional status in psychosis.
Mano, Quintino R.; Brown, Gregory G.; Mirzakhanian, Heline; Bolden, Khalima; Cadenhead, Kristen S.; Light, Gregory A.
Introduction Aural microsuction is a common ear, nose and throat procedure used in the outpatient setting. Some patients, however, find it difficult to tolerate owing to discomfort, pain or noise. This study evaluated the effect of audiovisual distraction on patients’ pain perception and overall satisfaction. Methods A prospective study was conducted for patients attending our aural care clinic requiring aural toileting of bilateral mastoid cavities over a three-month period. All microsuction was performed by a single clinical nurse specialist. Any patients with active infection were excluded. For each patient, during microsuction of one ear, they watched the procedure on a television screen while for the other ear they did not view the procedure. All patients received the same real time explanations during microsuction of both ears. After the procedure, each patient completed a visual analogue scale (VAS) to rate the pain they experienced for each ear, with and without access to the television screen. They also documented their preference and reasons why. Results A total of 37 patients were included in the study. The mean pain score for patients viewing the procedure was 2.43 compared with a mean of 3.48 for patients with no television view. This difference in patients’ pain perception was statistically lower in the group who observed the procedure on the television (p=0.003), consistent with the majority of patients reporting a preference to viewing their procedure (65%). Conclusions Audiovisual distraction significantly lowered patients’ VAS pain scores during aural microsuction. This simple intervention can therefore reduce patients’ perceived pain and help improve acceptance of this procedure.
Amer, I; Daniels, M; Wareing, MJ
Background: Resistant clubfoot deformities of the foot and ankle remain a difficult problem even for the most experienced surgeon. We report a series of neglected resistant clubfoot deformities treated by limited surgery and Ilizarov distraction histogenesis. Materials and Methods: Twenty one patients with 27 feet having resistant clubfoot deformities were managed by Ilizarov distraction histogenesis from April 2005 to May 2008. The mean age was 12 years (range 8–20 years). A limited soft tissue dissection like percutaneous Achilles sheath tenotomy and plantar fasciotomy were done. Progressive correction of the deformities was achieved through the standard and simple Ilizarov frame construct setting. After removal of Ilizarov frame, a short leg walking cast was used for an additional 6 weeks, followed by an ankle foot orthrosis for 3 months. Results: The mean followup period was 18.7 months (range 20-36 months). The mean duration of fixator application was 3.6 months (range 3–5 months). At the time of removal of the fixator, a plantigrade foot was achieved in 25 feet and gait was improved in all patients. There was residual varus hind foot deformity in two patients. Out of 27 feet, 3 (11.11%) were rated as excellent, 17 (62.96%) as good, 5 (18.51%) as fair, and 2 (7.40%) as poor according to Reinkerand Carpenter scale. Excellent and good results (74.07%) were considered satisfactory, while fair and poor results (25.92%) were considered unsatisfactory. Conclusion: The short term clinical and functional results of resistant clubfoot deformities with Ilizarov's external fixator is promising and apparently a good option.
Makhdoom, Asadullah; Qureshi, Pir Abdul Latif; Jokhio, Muhammad Faraz; Siddiqui, Khaleeque Ahmed
Background When a second target (T2) is presented in close succession of a first target (T1), people often fail to identify T2, a phenomenon known as the attentional blink (AB). However, the AB can be reduced substantially when participants are distracted during the task, for instance by a concurrent task, without a cost for T1 performance. The goal of the current study was to investigate the electrophysiological correlates of this paradoxical effect. Methodology/Principal Findings Participants successively performed three tasks, while EEG was recorded. The first task (standard AB) consisted of identifying two target letters in a sequential stream of distractor digits. The second task (grey dots task) was similar to the first task with the addition of an irrelevant grey dot moving in the periphery, concurrent with the central stimulus stream. The third task (red dot task) was similar to the second task, except that detection of an occasional brief color change in the moving grey dot was required. AB magnitude in the latter task was significantly smaller, whereas behavioral performance in the standard and grey dots tasks did not differ. Using mixed effects models, electrophysiological activity was compared during trials in the grey dots and red dot tasks that differed in task instruction but not in perceptual input. In the red dot task, both target-related parietal brain activity associated with working memory updating (P3) as well as distractor-related occipital activity was significantly reduced. Conclusions/Significance The results support the idea that the AB might (at least partly) arise from an overinvestment of attentional resources or an overexertion of attentional control, which is reduced when a distracting secondary task is carried out. The present findings bring us a step closer in understanding why and how an AB occurs, and how these temporal restrictions in selective attention can be overcome.
Wierda, Stefan M.; van Rijn, Hedderik; Taatgen, Niels A.; Martens, Sander
Background: In the modern day cities, home treadmill usage is increasing. Toddlers are prone to a special injury by the treadmill, during workout the toddler tries to get on the belt and the roller action pulls the fingers under the belt and get caught between the belt and a metal rod under the machine and the belt scrapes the fingers. If untreated some of these injuries will lead to flexion contracture. The usual treatment is release of contracture and skin grafting, however, graft discoloration and recurrence of contracture are the complications of this method and the patients usually seek treatment for the brown discoloration of the grafts at a later age. Objectives: In this study we assess the results of Z-plasty in combination with soft tissue distraction without skin grafting with long term usage of splint as an alternative treatment for these patients. Materials and Methods: In this retrograde descriptive cross-sectional study, we evaluated the patients presented with treadmill hand injuries between the years 2006 and 2011. Demographic data including age and sex in addition to other information including location of trauma, severity of trauma, time elapsed between the trauma and treatment, type of treatment including wound care and surgical method and treatment outcomes were assessed. Results: A total of 8 patients (3 girls and 5 boys) following finger treadmill injury were assessed. 15 fingers in 7 patients had volar injury. The middle finger was the most commonly injured finger. In all patients a minimum of 2 fingers were injured and in just 1 patient 3 fingers were injured. In long-term follow-up all the patients had acceptable volar skin and complete ROM of the fingers. Conclusions: Due to discoloration of the skin graft and recurrence of contracture following skin graft as the sole treatment for the injury, application of Z-plasty with soft tissue distraction and long term splints seems to be a proper alternative treatment for these patients.
Nazerani, Shahram; Kalantar Motamedi, Mohammad Hosein; Keramati, Mohammad Reza; Rashidian, Nikdokht; Nazerani, Tara; Nazerani, Tina
Spinal instrumentation for the correction of spinal deformity began with Harrington and his rod system. The use of the Harrington rods was limited, however, because of the need for long-segment instrumentation, distraction, and the potential for hood dislodgment and construct failure. Luque subsequently introduced the next generation of spinal fixation techniques via the concept of segmental instrumentation; his use of sublaminar wires allowed the construct to be fixated to the spine at every level. This arrangement allowed greater control over correction of spinal deformities and significantly lessened the incidence of hardware dislodgment. Modern instrumentation systems, including the use of pedicle screws, permit even greater control of the spine in multiple planes during deformity correction. Newer strategies have decreased the incidence of neurological injury during implant application and provide greater stability. A review of segmental fixation, including surgical techniques, is provided in this article. PMID:18812915
Steinmetz, Michael P; Rajpal, Sharad; Trost, Gregory
Owing to failure to achieve positive long-term effects, the currently performed treatment methods for lumbar facet joint syndrome (LFJS) are still under debate. Interspinous distraction devices unload the facet joints. Thus, these devices might be an alternative surgical treatment method for LFJS. The aim of this study was to evaluate the clinical and radiological outcome of an interspinous distraction device for the treatment of LFJS. Subjects had verified single level LFJS at level L4–5. They received percutaneous facet joint denervation (PFJD). If pain persisted, they were offered implantation of an interspinous device (Coflex) and/or repeat PFJD. Clinical and radiological outcome was determined before and after PFJD or surgery up to 2 years afterwards in all cases. Forty-one patients with LFJS at L4–5 underwent PFJD. Twenty patients with persisting pain underwent a subsequent surgery for implantation of an interspinous device. Five patients with recurrent pain at 6–12 months opted for an additional PFJD. Three obese patients (body weight >100 kg) had persistent pain at 3 months after surgery and received additionally dorsal semi-dynamic stabilization. The clinical outcome improved significantly in the surgically treated patients; however, it did not differ compared with patients receiving PFJD only after 24 months. Radiological evaluation revealed a restricted range of motion (ROM) of the operated and an elevated ROM of the adjacent segment. Surgical or device-related complications were not observed. In conclusions, the implantation of an interspinous Coflex device in case of recurrent facet joint pain succeeds to improve facet joint pain in clinical short-and mid-term settings. However, it does not exceed the outcome of denervated patients.
Abbushi, Alexander; Woiciechowsky, Christian; Kroppenstedt, Stefan
Dorsolateral prefrontal cortex (DLPFC) is recruited during visual working memory (WM) when relevant information must be maintained in the presence of distracting information. The mechanism by which DLPFC might ensure successful maintenance of the contents of WM is, however, unclear; it might enhance neural maintenance of memory targets or suppress processing of distracters. To adjudicate between these possibilities, we applied time-locked transcranial magnetic stimulation (TMS) during functional MRI, an approach that permits causal assessment of a stimulated brain region's influence on connected brain regions, and evaluated how this influence may change under different task conditions. Participants performed a visual WM task requiring retention of visual stimuli (faces or houses) across a delay during which visual distracters could be present or absent. When distracters were present, they were always from the opposite stimulus category, so that targets and distracters were represented in distinct posterior cortical areas. We then measured whether DLPFC-TMS, administered in the delay at the time point when distracters could appear, would modulate posterior regions representing memory targets or distracters. We found that DLPFC-TMS influenced posterior areas only when distracters were present and, critically, that this influence consisted of increased activity in regions representing the current memory targets. DLPFC-TMS did not affect regions representing current distracters. These results provide a new line of causal evidence for a top-down DLPFC-based control mechanism that promotes successful maintenance of relevant information in WM in the presence of distraction. PMID:21987824
Feredoes, Eva; Heinen, Klaartje; Weiskopf, Nikolaus; Ruff, Christian; Driver, Jon
Patients with nasomaxillary hypoplasia have severe facial concavity and compromised skeletal class III malocclusion. Its treatment is still a challenge to surgeons. Our aim was to evaluate the combination of midfacial distraction and orthognathic surgery in the treatment of nasomaxillary hypoplasia. Four patients with nasomaxillary hypoplasia were enrolled in this study. After Le Fort II osteotomy, the rotational distraction of nasomaxillary complex was performed to rehabilitate facial convexity. Then bilateral sagittal split ramus osteotomy with or without Le Fort I osteotomy was used to correct malocclusion. All patients healed uneventfully, and the maxillae moved forward conspicuously. No obvious pain and severe discomfort were complained during distraction. A significant advancement and downward movement of the maxilla were shown by cephalometric analysis. The combination of midfacial distraction and orthognathic surgery provides us an ideal alternative in the treatment of nasomaxillary hypoplasia. PMID:24777005
Yu, Hongbo; Dai, Jiewen; Wang, Xudong; Zhang, Wenbin; Shen, Steve Guofang
Monobloc and Le Fort III distractions can improve midfacial hypoplasia, a characteristic feature of syndromic craniosynostosis. The purpose of treating midfacial hypoplasia is to improve exophthalmos and dental occlusion. Typically, in Le Fort III or monobloc distractions, the midface is mobilized en bloc, and the extent and direction of the mobilization is determined according to the preferred intermaxillary occlusion. However, to obtain the preferred functional and esthetic results while correcting midface hypoplasia, the most sensible approach is the use of different degrees of mobilization and vectors for the upper and lower halves of the midface. This report describes the case of an adolescent with Crouzon syndrome showing frontal recession exophthalmos and an anterior crossbite. His condition was treated with monobloc minus Le Fort I and Le Fort I distraction using only internal devices, which the authors have designated Le Fort IV plus I distraction. PMID:24280175
Sakamoto, Yoshiaki; Nakajima, Hideo; Tamada, Ikkei; Sakamoto, Teruo
Although public health efforts have made some progress in reducing risk of adolescent motor vehicle crashes over the last three decades, new technologies and evolving behavior patterns have focused attention on the risk of distracted driving. For many of the same reasons that alcohol-impaired driving represents a distinct risk for adolescents, distracted driving has an elevated impact on this age group. Similarly, many of the strategies used to reduce alcohol-impaired driving among adolescents might be applied to driver distraction, including adults serving as role models with high standards of behavior. The unique challenge posed by the proliferation of new technological distractions may accelerate this risk behavior and may lend itself to innovative prevention efforts. PMID:24759438
Bingham, C Raymond
To determine how distracted and normal driving differ, this report re-examines driving performance data from the advanced collision avoidance system (ACAS) field operational test (FOT), a naturalistic driving study (96 drivers, 136,792 miles). In terms of...
H. Eoh J. Oberholtzer J. Schweitzer P. A. Green P. E. Green T. Wada
The National Highway Traffic Safety Administration (NHTSA) sponsored a virtual conference on the Internet (held July 5-August 11, 2000) to understand the risks from distraction associated with the explosive growth of in-car electronics. The Internet Forum...
R. E. Llaneras
Recent studies have identified a subpopulation of persons with craniosynostosis who exhibit progressive or delayed-onset synostosis and mild cranial vault deformities. These persons may be good candidates for nonextirpation distraction osteogenesis. The present studies were designed to determine force-displacement parameters and assess the effects of distraction osteogenesis on coronal suture growth and morphologic characteristics in a rabbit model with congenital, delayed-onset craniosynostosis. Data were collected from a total of 178 rabbits: 71 normal controls; 16 normal controls with distraction; 72 with delayed-onset coronal suture synostosis; and 19 with delayed-onset coronal suture synostosis and distraction. At 10 days of age, all rabbits had amalgam markers placed on both sides of the coronal suture. In the force-displacement study, force-displacement distractors were placed across the coronal suture and distracted acutely for 1.0 mm at 42 days of age. Force-displacement curves for the coronal suture were best described by a third-order polynomial regression equation for both normal and synostosed groups. Significant differences (P < 0.05) were found in the mean force necessary to distract a normal suture 1 mm in distance (13.72 kg) compared with a suture with delayed-onset synostosis (48.39 kg). A significant (P < 0.05) relationship was also found between the extent of synostosis and the distractive force in rabbits with delayed-onset synostosis. In the distraction study, internal distractors were fixed across the coronal suture at 25 days of age and percutaneously and intermittently activated at an average of 0.11 mm/day for 42 days (4.54 mm total). Serial radiographs were taken at 10, 25, 42, and 84 days of age. Results revealed that rabbits with delayed-onset synostosis and distraction had significantly (P < 0.01) more coronal suture growth rates compared with rabbits with delayed-onset synostosis and no distraction. Coronal sutures were harvested at 84 days of age for qualitative histologic examination. Normal, distracted coronal sutures showed widened sutural ligaments and thin, active osteogenic fronts. In contrast, distracted coronal sutures from rabbits with delayed-onset synostosis showed narrowed sutural ligaments, thickened and blunt osteogenic fronts, and increased collagen and bony matrix deposition compared with controls. Results suggest that distraction osteogenesis without corticotomy may be a treatment alternative in persons with progressive, delayed-onset synostosis. However, these preliminary data also suggest that distractive forces may accelerate or stimulate osteogenesis differentially in persons with craniosynostosis, possibly through an underlying genetic disorder of bone and cytokine regulation. These differential osteogenic responses to distraction, if validated clinically, will need to be taken into account when planning distraction rate and rhythm protocols for patients with craniosynostosis. PMID:10388423
Losken, H W; Mooney, M P; Zoldos, J; Tschakaloff, A; Burrows, A M; Smith, T D; Cano, G; Arnott, R; Sherwood, C; Dechant, J; Cooper, G M; Kapucu, M R; Siegel, M I
This study examined the interaction of the cognitive and technological aspects of distracted driving as well as physical health among commercial drivers. Participants (n=55; 5 of which were excluded from analyses) were recruited from Alabama-based truckin...
C. Franklin D. Stavrinos D. Vance G. McGwin K. Heaton P. J. Foster P. R. Fine R. Griffin R. Hanowski
Novel sounds embedded in a repetitive stream of auditory stimuli impair performance of the visual task at hand. Parmentier et al. suggested that this distraction effect might be because of the shifting cost of moving attention from the task-irrelevant (auditory) to the task-relevant (visual) channel, or from their shifting of spatial locations. Here, the source location of the sounds in an audio-visual distraction paradigm was varied systematically (headphones and 0, -18, -72, 18, and 72 degrees), and the results revealed significant distracting effects of novel sounds occurring in the headphone and the right location conditions. This supports the assumption that in the behavioral cost observed in the audio-visual distraction paradigm a spatial shift of attention is involved. PMID:18797312
Corral, Maria-Jose; Escera, Carles
Summary Aim To provide clinicians with useful information for immediate diagnosis and management of impacted maxillary incisors due to trauma. Methods We present a case of post-traumatic impaction of a central right maxillary incisor in a young patient. The treatment plan consisted in the interceptive management (surgical and orthodontic), the valuation of the necessary space to move the impacted tooth in the normal position and the biomechanical approach for anchorage, avoiding prosthetic/implants replacement. Results The therapy of an impacted maxillary incisor due to trauma requires a multidisciplinary approach: orthodontic, surgical, endodontic and periodontal considerations are essential for successful treatment. Conclusions Surgical exposure and orthodontic traction is the treatment most often used in case of posttraumatic impacted incisor: this technique in fact can lead to suitable results at the periodontal, occlusal and esthetics levels at an early stage and more definitively than with other treatment options.
Paoloni, Valeria; Pavoni, Chiara; Mucedero, Manuela; Bollero, Patrizio; Lagana, Giuseppina; Cozza, Paola
Objective: The objective of the present review was to determine the effectiveness of maxillary sinus floor augmentation without bone grafts using lateral window technique. Materials and Methods: PubMed and Cochrane databases were searched for relevant articles. We also included articles by hand search until June 2012. The analysis included both human and animal studies which satisfied the following criteria: Minimum of 6 months follow-up, no use of bone grafts, and lateral window approach to the sinus. Results: We included 22 articles in the review. A descriptive analysis of the constructed evidence tables indicated that there is evidence of predictable a mount of bone formation in the maxillary sinus augmentation without the use of bone grafts. Conclusion: Within the limits of the articles and data available, maxillary sinus augmentation without bone graft might be considered effective inpredictable bone formation.
Kumar, D. Shiva; Jayakumar, N. D.; Padmalatha, O.; Sankari, M.; Varghese, Sheeja S.
This case report presents the clinical features and periodontal findings in a patient with a horizontally impacted maxillary central incisor that had been exposed and aligned after a closed-eruption surgical technique. By combining 3 treatment stages-maxillary expansion, crown exposure surgery, and induced eruption-the horizontally impacted incisor was successfully moved into proper position. The patient finished treatment with a normal and stable occlusion between the maxillary and mandibular arches, and an adequate width of attached gingiva, even in the area surrounding the crown. The 5-year follow-up of stability and periodontal health demonstrated esthetic and functional outcomes after orthodontically induced tooth eruption. Clinical evaluation showed that the treated central incisor had periodontal clinical variables related to visible plaque, bleeding on probing, width of attached gingiva, and crown length that resembled the contralateral incisor. PMID:23810053
Rizzatto, Susana Maria Deon; de Menezes, Luciane Macedo; Allgayer, Susiane; Batista, Eraldo Luiz; Freitas, Maria Perpétua Mota; Loro, Raphael Carlos Drumond
Neurofibromas are benign tumors of peripheral nerve tissue, frequently associated with neurofibromatosis type 1. Their isolated occurrence in the maxillary antrum is rare, with only 6 cases described in the English literature to the best of our knowledge. Primary neurogenic tumors in the maxillary sinus are unusual entities. The majority of the reported cases that have dealt with neurilemmomas and isolated neurofibromas are extremely rare. Here, a case of neurofibroma of the maxillary sinus. We present the case of a 60-year-old female patient with the chief complain of growth in the upper right back region of the jaw, which was preceded by exfoliation of teeth in the same region 1 month back.
Jain, Deepali; Chaudhary, Minal; Patil, Swati
The ability of irradiated tissue to support bony growth remains poorly defined, although there are anecdotal cases reported showing mixed results for the use of mandibular distraction osteogenesis after radiation for head and neck cancer. Many of these reports lack objective measures that would allow adequate analysis of outcomes or efficacy. The purpose of this experiment was to utilize a rat model of mandibular distraction osteogenesis after high dose and highly fractionated radiation therapy and to evaluate and quantify distracted bone formation under these conditions. Male Sprague–Dawley rats underwent 12 fractions of external beam radiation (48 Gray) of the left mandible. Following a two week recovery period, an external frame distractor was applied and gradual distraction of the mandible was performed. Tissue was harvested after a twenty-eight day consolidation period. Gross, radiologic and histological evaluations were undertaken. Those animals subjected to pre-operative radiation showed severe attenuation of bone formation including bone atrophy, incomplete bridging of the distraction gap, and gross bony defects or non-union. Although physical lengthening was achieved, the irradiated bone consistently demonstrated marked damaging effects on the normal process of distraction osteogenesis. This murine model has provided reliable evidence of the injurious effects of high dose radiation on bone repair and regeneration in distraction osteogenesis utilizing accurate and reproducible metrics. These results can now be used to assist in the development of therapies directed at mitigating the adverse consequences of radiation on the regeneration of bone and to optimize distraction osteogenesis so it can be successfully applied to post-oncologic reconstruction.
Sensory and slow cortical evoked potentials (EP) of female smokers were investigated under two conditions in separate sham and real smoking sessions: (1) a non-distraction (ND) condition consisting of a constant foreperiod S1-S2, i.e., a single-choice reaction time situation with a tone (S1)\\/light (S2) key press sequence, and (2) a task distraction (TD) condition identical to ND with the addition
Verner J. Knott
The iliofemoral distraction with Wagner's apparatus was conducted in 20 adult patients with untreated unilateral congenital dislocation of the hip (Crowe group IV) before total hip arthroplasty. During the distraction period of 8 to 17 days, this technique had effectively reduced high dislocation of 4.5 cm (range, 3.5 5 cm). No pin-tract infection was encountered. Surgical difficulties in total hip
Kuo-An Lai; Jain Liu; Tang-Kue Liu
Thrombin-related peptide 508 (TP508) accelerates bone regeneration during distraction osteogenesis (DO). We have examined\\u000a the effect of TP508 on bone regeneration during DO by immunolocalization of Runx2 protein, a marker of osteoblast differentiation,\\u000a and of osteopontin (OPN) and bone sialoprotein (BSP), two late markers of the osteoblast lineage. Distraction was performed\\u000a in tibiae of rabbits over a period of 6 days.
Lisa R. Amir; Gang Li; Ton Schoenmaker; Vincent Everts; Antonius L. J. J. Bronckers
Behavioral and event-related potential measures of distraction and reorientation were obtained from children (6 years), young (19–24 years) and elderly adults (62–82 years) in an auditory distraction-paradigm. Participants performed a go\\/nogo duration discrimination task on a sequence of short and long (50–50%) tones. In children, reaction times were longer and discrimination (d?) scores were lower than in adults. Occasionally (15%),
János Horváth; István Czigler; Emma Birkás; István Winkler; Judit Gervai
The present study focused on the control of involuntary attentional orienting and distraction in children (6–8, 10–12 years) and adolescents (17–18 years). In an auditory distraction paradigm, pitch deviants interspersed in a sequence of standard sounds were presented. In the predictable condition, the type of sound (standard or deviant) was announced by a preceding visual cue. In the unpredictable condition, the cue
Nicole Wetzel; Erich Schröger
Distractibility in primates may be influenced by central cholinergic systems. Two cholinomimetics, the m-1 muscarinic agonist (±)-cis-2-methyl-spiro(1,3-oxathiolane-5,3?)quinuclidine (AF102B, civemeline) and the cholinesterase inhibitor tetrahydroaminoacridine (THA, tacrine), were compared to vehicle controls for effects on distractibility in an automated visuospatial attention task. The task required visual pursuit of a moving target amongst distractor stimuli that acted to impair performance and was
Joseph O'Neill; Douglas W. Siembieda; K. Casey Crawford; Eric Halgren; Abraham Fisher; L. Jaime Fitten
Nicotine-enhanced attentional functions are purported to underlie improvements in behavioral performance in cognitive tasks but it is unclear as to whether these effects involve selective attention or attentional control under conditions of distraction. Behavioral and event-related potential measures were used to examine the effects of nicotine on distractibility in 21 non-smokers who were instructed to ignore task-irrelevant auditory stimuli while
Verner Knott; Adam Heenan; Dhrasti Shah; Kiley Bolton; Derek Fisher; Crystal Villeneuve
Maxillary tuberosity fractures during molar teeth extraction can occur commonly in dental practice; however, very few cases are reported and discussed in the literature. This article presents a case of large fracture of maxillary tuberosity during extraction of first maxillary molar tooth and its conservative treatment outcomes. PMID:19212477
Polat, Hidayet B; Ay, Sinan; Kara, M Isa
Purpose: To develop a clinical staging system for maxillary osteoradionecrosis (ORN) in irradiated nasopharyngeal carcinoma (NPC) patients. Methods and Materials: The data of maxillary ORN cases among 1,758 irradiated NPC patients were analyzed. A staging system based on the degrees of bone exposure (E), infection (I), and bleeding (B) was developed. Correlations between various clinical parameters and stages of maxillary
S.-J. Cheng; J.-J. Lee; L.-L. Ting; I.-Y. Tseng; H.-H. Chang; H.-M. Chen; Y.-S. Kuo; L.-J. Hahn; S.-H.. Kok
We present a case of long-standing unilateral cacosmia in a healthy 67-year-old man due to maxillary fungal infestation. Treatment with septoplasty had been attempted 10 years prior but no further investigation or management undertaken and symptoms continued. Subsequent MRI scan revealed significant opacification of the left maxillary sinus. This was readily amenable to treatment by balloon sinuplasty. This yielded viscous grey mucus which grew Scedosporium apiospermum. The case highlights the need for careful investigation of olfactory symptoms, including blood tests to exclude systemic causes, endoscopy and imaging where indicated. PMID:23563684
Erskine, Sally E; Schelenz, Silke; Philpott, Carl M
This study is to report the rare localization of a radicular groove on the palatal aspect of the maxillary lateral incisor and to discuss the pathology and management of the concomitant endo-periodontal defect. Unilateral palato-radicular groove was located on the Maxillary right lateral incisor of an 18-year-old female patient. The groove was associated with deep local periodontal pocket resulting in pulp necrosis and the formation of a large periapical lesion. A collaborative management was carried out using a combination of endodontic therapy, surgical enucleation, odontoplasty, and periodontal regenerative procedure resulting the successful healing of the periapical lesion.
Kishan, K. V.; Hegde, Vani; Ponnappa, K. C.; Girish, T. N.; Ponappa, M. C.
This study evaluated the eruption sequence of the permanent maxillary canine in patients to determine if it follows the previously established normal pattern: first premolar, second premolar, and canine. A total of 363 panoramic radiographs of patients 7-12 years of age were evaluated; in 261 (72%) of the patients, the permanent canine erupted after the first and second premolars. Based on the results obtained in this study, the eruption sequence of the permanent maxillary canine followed the historical normal pattern for the majority of patients in this population. The difference in eruption sequence for males versus females was not significant. PMID:24983186
Rawson, Kenneth G; Hofelich, Robyn; Welch, Dan B; Stoeckel, Daniel C
The objective of the present work was to improve the quality of diagnostics and the choice of optimal therapy for the management of odontogenic maxillary sinusitis associated with the localization of foreign bodies in the lateral parts of the maxillary sinuses. To this effect, multispiral computed tomography was used to enable the exact location of the foreign body inside the sinus and to choose the optimal approach for the surgical intervention. The modified Coldwell-Luc procedure was employed as the most adequate technique in the given clinical condition. PMID:24577021
Davydov, D V; Gvozdovich, V A; Stebunov, V E; Manakina, A Iu
Increased intra-individual variability in response time (RTSD) has been observed reliably in ADHD and is often used as a measure of inattention. RTSD is assumed to reflect attentional lapses and distractibility, though evidence for the validity of this connection is lacking. We assessed whether RTSD is an indicator of inattention by comparing RTSD on the stop-signal task (SST) to performance on the Delayed Oculomotor Response (DOR) Task, a measure of distractibility. Participants included 30 adults with ADHD and 28 controls. Participants completed the SST and the DOR task, which measured subjects’ ability to maintain attention and avoid distraction by inhibiting reflexive saccades toward distractors. On the SST, the ADHD group was slower to inhibit than controls, indicating poorer inhibitory control in ADHD. The ADHD group also displayed slower RTs, greater RTSD, and more omission errors. On the DOR task, the ADHD group displayed more premature saccades (i.e., greater distractibility) than controls. Greater variability in RT was associated with increased distraction on the DOR task but only in ADHD participants. Results suggest that RTSD is linked to distractibility among adults with ADHD and support the use of RTSD as a valid measure of inattention in ADHD.
Adams, Zachary W.; Roberts, Walter M.; Milich, Richard; Fillmore, Mark T.
Objective. The objective of our current study was to look for the EEG correlates that can reveal the engaged state of the brain while undertaking cognitive tasks. Specifically, we aimed to identify EEG features that could detect audio distraction during simulated driving. Approach. Time varying autoregressive (TVAR) analysis using Kalman smoother was carried out on short time epochs of EEG data collected from participants as they undertook two simulated driving tasks. TVAR coefficients were then used to construct all pole model enabling the identification of EEG features that could differentiate normal driving from audio distracted driving. Main results. Pole analysis of the TVAR model led to the visualization of event related synchronization/desynchronization (ERS/ERD) patterns in the form of pole displacements in pole plots of the temporal EEG channels in the z plane enabling the differentiation of the two driving conditions. ERS in the EEG data has been demonstrated during audio distraction as an associated phenomenon. Significance. Visualizing the ERD/ERS phenomenon in terms of pole displacement is a novel approach. Although ERS/ERD has previously been demonstrated as reliable when applied to motor related tasks, it is believed to be the first time that it has been applied to investigate human cognitive phenomena such as attention and distraction. Results confirmed that distracted/non-distracted driving states can be identified using this approach supporting its applicability to cognition research.
Dahal, Nabaraj; (Nanda Nandagopal, D.; Cocks, Bernadine; Vijayalakshmi, Ramasamy; Dasari, Naga; Gaertner, Paul
Objectives. We examined trends in distracted driving fatalities and their relation to cell phone use and texting volume. Methods. The Fatality Analysis Reporting System (FARS) records data on all road fatalities that occurred on public roads in the United States from 1999 to 2008. We studied trends in distracted driving fatalities, driver and crash characteristics, and trends in cell phone use and texting volume. We used multivariate regression analysis to estimate the relation between state-level distracted driving fatalities and texting volumes. Results. After declining from 1999 to 2005, fatalities from distracted driving increased 28% after 2005, rising from 4572 fatalities to 5870 in 2008. Crashes increasingly involved male drivers driving alone in collisions with roadside obstructions in urban areas. By use of multivariate analyses, we predicted that increasing texting volumes resulted in more than 16 000 additional road fatalities from 2001 to 2007. Conclusions. Distracted driving is a growing public safety hazard. Specifically, the dramatic rise in texting volume since 2005 appeared to be contributing to an alarming rise in distracted driving fatalities. Legislation enacting texting bans should be paired with effective enforcement to deter drivers from using cell phones while driving.
Stimpson, Jim P.
Glenberg et al. (1998) reported that episodic memory is impaired by visual distraction and argued that this effect is consistent with a trade-off between internal and external attentional focus. However, their demonstration that visual distraction impairs memory for lists used 15 consecutive word-lists, with analysis only of mid-list items, and has never been replicated. Experiment 1 (N = 37) replicated their methodology and found the same pattern of impairment for mid-list recall, but found no evidence of impairment for other items on the lists. Experiment 2 (N = 64) explored whether this pattern arises because the mid-list items are poorly encoded (by manipulating presentation rate) or because of interference. Experiment 3 (N = 36) also looked at the role of interference whilst controlling for potential item effects. Neither study replicated the pattern seen in Experiment 1, despite reliable effects of presentation rate (Experiment 2) and interference (Experiments 2 and 3). Experiment 2 found no effect of distraction for mid-list items, but distraction did increase both correct and incorrect recall of all items suggestive of a shift in willingness to report. Experiment 3 found no effects of distraction whatsoever. Thus, there is no clear evidence that distraction consistently impairs retrieval of items from lists and therefore no consistent evidence to support the embodied cognition account used to explain the original finding.
Rae, Pamela J. L.; Perfect, Timothy J.
Using a closed-set speech recognition paradigm thought to be heavily influenced by informational masking, auditory selective attention was measured in 38 children (ages 4-16 years) and 8 adults (ages 20-30 years). The task required attention to a monaural target speech message that was presented with a time-synchronized distracter message in the same ear. In some conditions a second distracter message or a speech-shaped noise was presented to the other ear. Compared to adults, children required higher target/distracter ratios to reach comparable performance levels, reflecting more informational masking in these listeners. Informational masking in most conditions was confirmed by the fact that a large proportion of the errors made by the listeners were contained in the distracter message(s). There was a monotonic age effect, such that even the children in the oldest age group (13.6-16 years) demonstrated poorer performance than adults. For both children and adults, presentation of an additional distracter in the contralateral ear significantly reduced performance, even when the distracter messages were produced by a talker of different sex than the target talker. The results are consistent with earlier reports from pure-tone masking studies that informational masking effects are much larger in children than in adults.
Wightman, Frederic L.; Kistler, Doris J.
Syndromic craniosynostosis is known to be associated with various obstructive respiratory disorders including sleep apnoea. We performed early midfacial distraction using a transfacial pinning technique in five syndromic craniosynostotic patients with obstructive respiratory disorders. Here, we report good results, indications and usefulness of this procedure. The subjects were five young children aged 7 months to 2 years who had respiratory disorders since birth due to midface hypoplasia. All subjects underwent midfacial distraction to avoid tracheotomy. The method involved Le Fort III osteotomy followed by the use of our original transfacial pinning system. This system consisted of devices connecting (1) transfacial pins penetrating the bilateral zygomatic bones and (2) Kirschner wires, which were passed through plates fixed on the bilateral temporal bones. The maxilla was distracted anteriorly at least 20 mm. Distraction was evaluated by comparing the pre- and postoperative polysomnography (PSG) and cephalograms. All patients had markedly improved respiratory conditions after distraction, and a tracheotomy was avoided. Postoperative PSG and cephalograms also showed great improvements compared with preoperative findings. A transfacial pinning system was considered useful and can be the most suitable method for early midfacial distraction in syndromic craniosynostosis with obstructive respiratory disorders. PMID:20347626
Mitsukawa, Nobuyuki; Satoh, Kaneshige
Acute stress has been shown to impair working memory (WM), and to decrease prefrontal activation during WM in healthy humans. Stress also enhances amygdala responses towards emotional stimuli. Stress might thus be specifically detrimental to WM when one is distracted by emotional stimuli. Usually, emotional stimuli presented as distracters in a WM task slow down performance, while evoking more activation in ventral 'affective' brain areas, and a relative deactivation in dorsal 'executive' areas. We hypothesized that after acute social stress, this reciprocal dorsal-ventral pattern would be shifted towards greater increase of ventral 'affective' activation during emotional distraction, while impairing WM performance. To investigate this, 34 healthy men, randomly assigned to a social stress or control condition, performed a Sternberg WM task with emotional and neutral distracters inside an MRI scanner. Results showed that WM performance after stress tended to be slower during emotional distraction. Brain activations during emotional distraction was enhanced in ventral affective areas, while dorsal executive areas tended to show less deactivation after stress. These results suggest that acute stress shifts priority towards processing of emotionally significant stimuli, at the cost of WM performance. PMID:21498384
Oei, Nicole Y L; Veer, Ilya M; Wolf, Oliver T; Spinhoven, Philip; Rombouts, Serge A R B; Elzinga, Bernet M
The present study focused on the control of involuntary attentional orienting and distraction in children (6-8, 10-12 years) and adolescents (17-18 years). In an auditory distraction paradigm, pitch deviants interspersed in a sequence of standard sounds were presented. In the predictable condition, the type of sound (standard or deviant) was announced by a preceding visual cue. In the unpredictable condition, the cue was not informative with respect to the type of sound. Subjects performed a sound duration discrimination task and were instructed to attend the cues in order to avoid distraction. In the unpredictable condition, regular behavioral and ERP effects of change detection (Mismatch Negativity), attentional orienting (P3a) and distraction (prolonged reaction times) were observed. In the predictable condition, no modulation of Mismatch Negativity amplitude was observed, whereas the amplitude of P3a and reaction time prolongations in deviant trials were reduced in all age groups. Results suggest that even young children are able to voluntarily control involuntary attentional orienting and behavioral distraction. However, significant age effects were observed for the level of behavioral distraction and the selective utilization of the visual cues (reflected by P3b). PMID:17506997
Wetzel, Nicole; Schröger, Erich
The presentation of auditory oddball stimuli (novels) among otherwise repeated sounds (standards) triggers a well-identified chain of electrophysiological responses: The detection of acoustic change (mismatch negativity), the involuntary orientation of attention to (P3a) and its reorientation from the novel. Behaviorally, novels reduce performance in an unrelated visual task (novelty distraction). Past studies of the cross-modal capture of attention by acoustic novelty have typically discarded from their analysis the data from the standard trials immediately following a novel, despite some evidence in mono-modal oddball tasks of distraction extending beyond the presentation of deviants/novels (postnovelty distraction). The present study measured novelty and postnovelty distraction and examined the hypothesis that both types of distraction may be underpinned by common frontally-related processes by comparing young and older adults. Our data establish that novels delayed responses not only on the current trial and but also on the subsequent standard trial. Both of these effects increased with age. We argue that both types of distraction relate to the reconfiguration of task-sets and discuss this contention in relation to recent electrophysiological studies. PMID:20178965
Parmentier, Fabrice B R; Andrés, Pilar
Unexpected stimuli are often able to distract us away from a task at hand. The present study seeks to explore some of the mechanisms underpinning this phenomenon. Studies of involuntary attention capture using the oddball task have repeatedly shown that infrequent auditory changes in a series of otherwise repeating sounds trigger an automatic response to the novel or deviant stimulus. This attention capture has been shown to disrupt participants' behavioral performance in a primary task, even when distractors and targets are asynchronous and presented in distinct sensory modalities. This distraction effect is generally considered as a by-product of the capture of attention by the novel or deviant stimulus, but the exact cognitive locus of this effect and the interplay between attention capture and target processing has remained relatively ignored. The present study reports three behavioral experiments using a cross-modal oddball task to examine whether the distraction triggered by auditory novelty affects the processing of the target stimuli. Our results showed that variations in the demands placed on the visual analysis (Experiment 1) or categorical processing of the target (Experiment 2) did not impact on distraction. Instead, the cancellation of distraction by the presentation of an irrelevant visual stimulus presented immediately before the visual target (Experiment 3) suggested that distraction originated in the shifts of attention occurring between attention capture and the onset of the target processing. Possible accounts of these shifts are discussed. PMID:17445791
Parmentier, Fabrice B R; Elford, Gregory; Escera, Carles; Andrés, Pilar; San Miguel, Iria
Objective. The objective of our current study was to look for the EEG correlates that can reveal the engaged state of the brain while undertaking cognitive tasks. Specifically, we aimed to identify EEG features that could detect audio distraction during simulated driving. Approach. Time varying autoregressive (TVAR) analysis using Kalman smoother was carried out on short time epochs of EEG data collected from participants as they undertook two simulated driving tasks. TVAR coefficients were then used to construct all pole model enabling the identification of EEG features that could differentiate normal driving from audio distracted driving. Main results. Pole analysis of the TVAR model led to the visualization of event related synchronization/desynchronization (ERS/ERD) patterns in the form of pole displacements in pole plots of the temporal EEG channels in the z plane enabling the differentiation of the two driving conditions. ERS in the EEG data has been demonstrated during audio distraction as an associated phenomenon. Significance. Visualizing the ERD/ERS phenomenon in terms of pole displacement is a novel approach. Although ERS/ERD has previously been demonstrated as reliable when applied to motor related tasks, it is believed to be the first time that it has been applied to investigate human cognitive phenomena such as attention and distraction. Results confirmed that distracted/non-distracted driving states can be identified using this approach supporting its applicability to cognition research. PMID:24809969
Dahal, Nabaraj; Nandagopal, D Nanda; Cocks, Bernadine; Vijayalakshmi, Ramasamy; Dasari, Naga; Gaertner, Paul
Using a qualitative methodology, we investigated novice and experienced therapists' experiences of and strategies for managing distracting self-awareness. We found that novice therapists were most aware of anxiety and critical self-talk, whereas experienced therapists were most aware of boredom and outside distracters. In addition, although therapists tended to manage distracting self-awareness through self-coaching and refocusing on the client, novice therapists
Elizabeth Nutt Williams; Devin Polster; M. Brighid Grizzard; Jeff Rockenbaugh; Ann B. Judge
A case is presented in which a mucous retention cyst that obliterated the right maxillary sinus caused symptoms due to pressure on two separate branches of the second branch of the fifth cranial nerve during a chamber dive to 112 feet. The symptoms of pai...
L. M. Garges
Primary small cell neuroendocrine carcinoma (SNEC) of the paranasal sinuses is an extremely rare and distinctive tumor with aggressive clinical behavior. Moreover, SNECs originating in the head and neck region have been reported to be highly aggressive and to have a poor prognosis. This report describes a patient with a maxillary sinus SNEC who was successfully treated with neoadjuvant chemotherapy and concurrent chemoradiotherapy.
Yadav, Santosh Kumar; Shetty, Premalatha
We report a previously unrecognized association between a hypertrophic frenulum separating the alveolar portion of the maxillary palatine suture with hypoplastic left heart syndrome in one fetus and seven children. A hypertrophic frenulum was not found in 25 pediatric cardiology patients without hypoplastic left heart syndrome. This finding may provide a marker for suspecting hypoplastic left heart syndrome in the
Mark A. Lovell; Nancy L. McDaniel
Purpose: The location of the gingival zenith in a medial-lateral position relative to the vertical tooth axis of the maxillary anterior teeth remains to be clearly defined. In addition, the apex of the free gingival margin of the lateral incisor teeth relative to the gingival zeniths of the adja- cent proximal teeth remains undetermined. Therefore, this investigation evaluated two clinical
STEPHEN J. CHU; JOCELYN H. P. TAN; CHRISTIAN F. J. STAPPERT; DENNIS P. TARNOW
Hard tissue defects resulting from trauma, infection, or tooth loss often lead to an unfavorable anatomy of maxillary and mandibular alveolar processes that become not suitable for implant therapy without bone grafting. The goal of pre-implant bone augmentation of the deficient alveolar ridge is reconstruction of the proper alveolar anatomy through the techniques of socket preservation, horizontal and vertical ridge augmentation, sinus bone grafting, and others. A variety of bone grafts and bone grafting materials have been used in the last 30 years for augmentation of deficient alveolar ridge for the purpose of implant treatment of partially and completely edentulous patients. Bone grafting options include autogenous, allogeneic, xenogeneic, synthetic bone, and combination of above. Autogenous bone grafts are considered "the gold standard" due to their compatibility and osteogenic potentials to form the new bone by processes of osteogenesis, osteoinduction, and osteoconduction. A particulate and block autogenous bone has been used for correction of alveolar ridge deficiency. Extraoral sites of autogenous block grafts include: ilium, calvarium, tibia, rib, and others. Intraoral sites of autogenous block grafts include symphysis and retromolar-ramus areas. In the clinical practice, a maxillary tuberosity bone graft has often been used as a particulate graft for augmentation of deficient alveolar ridge or maxillary sinus prior to or simultaneously with implant insertion. This article presents an innovative technique and reports a case of the maxillary tuberosity block bone graft that can be used to correct moderate to severe localized defects of the alveolar process prior to implant placement. PMID:19615588
To obtain an effective and compliance-free molar distalization without an anchorage loss, we designed the bone-anchored pendulum appliance (BAPA). The aim of this study was to evaluate the stability of the anchoring screw, distalization of the maxillary molars, and the movement of teeth anterior to maxillary first molars. The study group comprised 10 patients (mean age 13.5 +/- 1.8 years) with Class II molar relationship. A conventional pendulum appliance was modified to obtain anchorage from an intraosseous screw instead of the premolars. The screw was placed in the anterior paramedian region of the median palatal suture. Skeletal and dental changes were measured on cephalograms, and dental casts were obtained before and after distalization. A super Class I molar relationship was achieved in a mean period of 7.0 +/- 1.8 months. The maxillary first molars distalized an average of 6.4 +/- 1.3 mm in the region of the dental crown by tipping distally an average of 10.9 degrees +/- 2.8 degrees . Also, the maxillary second premolar and first premolar moved distally an average of 5.4 +/- 1.3 mm and 3.8 +/- 1.1 mm, respectively. The premolars tipped significantly distally. No anterior incisor movement was detected. The BAPA was found to be an effective, minimally invasive, and compliance-free intraoral distalization appliance for achieving both molar and premolar distalization without any anchorage loss. PMID:16808573
Kircelli, Beyza Hancio?lu; Pekta?, Zafer Ozgür; Kircelli, Cem
Tooth impaction rarely occurs in primary dentition. Most of the primary teeth impactions are seen in second molars. The purpose of this article is to present a 4-year-old girl with bilateral impaction of inverted primary maxillary central incisors which trauma had displaced their tooth germ before erupting.
Seraj, B.; Ghadimi, S.; Mighani, G.; Zare, H.; Rabbani, M.
A 62-year-old man was referred for routine treatment of hyperplasia of the mucosa in the anterior lower jaw. An oroantral fistula was detected in the right superior alveolar ridge. The patient had no complaints. Plain radiographs showed a radiopaque foreign body in the posterior region associated with opacification of the maxillary sinus. Computed tomography showed the same hyperdense foreign body
Moacyr-Tadeu V. Rodrigues; Etiene-de Andrade Munhoz; Camila-Lopes Cardoso; José-Humberto Damante
The hypothesis that an enjoyable distraction during exercise will augment the intensity of positive mood post-exercise was tested. A sample of 84 undergraduate students rated their mood and arousal before and after a standardized exercise, which consisted of walking on a treadmill at a pace of 3.6 mph for 10 minutes. During the work out session, participants watched the same television show, which they previously rated as enjoyable, or not enjoyable. As added controls, a third group exercised with no distraction (the TV was turned off); a fourth group did not exercise, but watched the television show. The results showed that exercise alone was sufficient to increase pleasant mood (95% CI 0.61, 1.46) and that including an enjoyable distraction during exercise significantly augmented pleasant mood compared to all other groups (95% CI 1.58, 2.99; R2 = 0.29). These results show that the enjoyment of a distraction is a key factor that can augment the intensity of positive mood following exercise. Key points The hypothesis that an enjoyable distraction during exercise will augment the intensity of positive mood post-exercise was tested. The results support this hypothesis by showing for the first time that while exercise alone was sufficient to increase the intensity of positive mood; combining exercise with an enjoyable distraction resulted in significantly greater increases in pleasant mood compared to exercise alone. Accounting for the enjoyment of a distraction type in future studies can increase the sensitivity of research designs used to detect changes in positive mood post-exercise.
Privitera, Gregory J.; Antonelli, Danielle E.; Szal, Abigail L.
The hypothesis that an enjoyable distraction during exercise will augment the intensity of positive mood post-exercise was tested. A sample of 84 undergraduate students rated their mood and arousal before and after a standardized exercise, which consisted of walking on a treadmill at a pace of 3.6 mph for 10 minutes. During the work out session, participants watched the same television show, which they previously rated as enjoyable, or not enjoyable. As added controls, a third group exercised with no distraction (the TV was turned off); a fourth group did not exercise, but watched the television show. The results showed that exercise alone was sufficient to increase pleasant mood (95% CI 0.61, 1.46) and that including an enjoyable distraction during exercise significantly augmented pleasant mood compared to all other groups (95% CI 1.58, 2.99; R(2) = 0.29). These results show that the enjoyment of a distraction is a key factor that can augment the intensity of positive mood following exercise. Key pointsThe hypothesis that an enjoyable distraction during exercise will augment the intensity of positive mood post-exercise was tested.The results support this hypothesis by showing for the first time that while exercise alone was sufficient to increase the intensity of positive mood; combining exercise with an enjoyable distraction resulted in significantly greater increases in pleasant mood compared to exercise alone.Accounting for the enjoyment of a distraction type in future studies can increase the sensitivity of research designs used to detect changes in positive mood post-exercise. PMID:24790478
Privitera, Gregory J; Antonelli, Danielle E; Szal, Abigail L
Sources of distraction are numerous and varied, and defining and measuring distraction and attention is complicated. The driving task requires constant adjustments and reallocation of attention to cognitive, motor, and visual processes. While it is fairly straightforward to measure distraction in an experimental situation (e.g., simulator, closed course), driver distraction in the real world is highly contextual. While no single metric is capable of capturing the complexities of distraction, several have proved useful in helping researchers gain fuller understanding of it. Few have reached a level of consensus among researchers and user interface designers. ISO and SAE may be considered the 'gold standard' for providing mechanisms through which open scientific consensus-based standards can be achieved.While there are a number of metrics used in predicting distraction, three have been studied closely and are going through the SAE and ISO standards process. They are (1) 'the occlusion method'; (2) the Lane Change Test (LCT); and (3) the Detection Response Task (DRT). The metrics described here apply generally to the experimental context where driving is tightly controlled. Like any method, there are limitations with each-and they don't necessarily agree with one another.Experimental methods and analyses are different than those in naturalistic driving (ND). ND relies more on data mining versus traditional experimental manipulation. ND data are a challenge precisely in that they lack experimental control.In future, driver metrics will go beyond specific measurement of task load, and will include how drivers self regulate when they choose to be distracted. PMID:24776223
McGehee, Daniel V
Bone augmentation is a vital part of surgical interventions of the oral and maxillofacial area including dental implantology. Prior to implant placement, sufficient bone volume is needed to reduce the risk of peri-implantitis. While augmentation using harvested autologous bone is still considered as gold standard, many surgeons prefer bone substitutes to reduce operation time and to avoid donor site morbidity. To assess the osteogenic efficacy of commercially available augmentation materials we analyzed drill cores extracted before implant insertion. In younger patients, distraction osteogenesis is successfully applied to correct craniofacial deformities through targeted bone formation. To study the influence of mesenchymal stem cells on bone regeneration during distraction osteogenesis, human mesenchymal stem cells were injected into the distraction gap of nude rat mandibles immediately after osteotomy. The distraction was performed over eleven days to reach a distraction gap of 6 mm. Both the rat mandibles and the drill cores were scanned using synchrotron radiation-based micro computed tomography. The three-dimensional data were manually registered and compared with corresponding two-dimensional histological sections to assess bone regeneration and its morphology. The analysis of the rat mandibles indicates that bone formation is enhanced by mesenchymal stem cells injected before distraction. The bone substitutes yielded a wide range of bone volume and degree of resorption. The volume fraction of the newly formed bone was determined to 34.4% in the computed tomography dataset for the augmentation material Geistlich Bio-Oss®. The combination of computed tomography and histology allowed a complementary assessment for both bone augmentation and distraction osteogenesis.
Ilgenstein, Bernd; Deyhle, Hans; Jaquiery, Claude; Kunz, Christoph; Stalder, Anja; Stübinger, Stefan; Jundt, Gernot; Beckmann, Felix; Müller, Bert; Hieber, Simone E.
Sources of distraction are numerous and varied, and defining and measuring distraction and attention is complicated. The driving task requires constant adjustments and reallocation of attention to cognitive, motor, and visual processes. While it is fairly straightforward to measure distraction in an experimental situation (e.g., simulator, closed course), driver distraction in the real world is highly contextual. While no single metric is capable of capturing the complexities of distraction, several have proved useful in helping researchers gain fuller understanding of it. Few have reached a level of consensus among researchers and user interface designers. ISO and SAE may be considered the ‘gold standard’ for providing mechanisms through which open scientific consensus-based standards can be achieved. While there are a number of metrics used in predicting distraction, three have been studied closely and are going through the SAE and ISO standards process. They are (1) ‘the occlusion method’; (2) the Lane Change Test (LCT); and (3) the Detection Response Task (DRT). The metrics described here apply generally to the experimental context where driving is tightly controlled. Like any method, there are limitations with each—and they don’t necessarily agree with one another. Experimental methods and analyses are different than those in naturalistic driving (ND). ND relies more on data mining versus traditional experimental manipulation. ND data are a challenge precisely in that they lack experimental control. In future, driver metrics will go beyond specific measurement of task load, and will include how drivers self regulate when they choose to be distracted.
McGehee, Daniel V.
The objective of this study was to measure intradiscal pressure (IDP) changes in the lower cervical spine during a manual cervical distraction (MCD) procedure. Incisions were made anteriorly, and pressure transducers were inserted into each nucleus at lower cervical discs. Four skilled doctors of chiropractic (DCs) performed MCD procedure on nine specimens in prone position with contacts at C5 or at C6 vertebrae with the headpiece in different positions. IDP changes, traction forces, and manually applied posterior-to-anterior forces were analyzed using descriptive statistics. IDP decreases were observed during MCD procedure at all lower cervical levels C4-C5, C5-C6, and C6-C7. The mean IDP decreases were as high as 168.7 KPa. Mean traction forces were as high as 119.2 N. Posterior-to-anterior forces applied during manual traction were as high as 82.6 N. Intraclinician reliability for IDP decrease was high for all four DCs. While two DCs had high intraclinician reliability for applied traction force, the other two DCs demonstrated only moderate reliability. IDP decreases were greatest during moving flexion and traction. They were progressevely less pronouced with neutral traction, fixed flexion and traction, and generalized traction.
Gudavalli, M. R.; Potluri, T.; Carandang, G.; Havey, R. M.; Voronov, L. I.; Cox, J. M.; Rowell, R. M.; Kruse, R. A.; Joachim, G. C.; Patwardhan, A. G.; Henderson, C. N. R.; Goertz, C.
We used behavioral measures and functional magnetic resonance imaging (fMRI) to study the effects of parametrically varied task-irrelevant pitch changes in attended sounds on loudness-discrimination performance and brain activity in cortical surface maps. Ten subjects discriminated tone loudness in sequences that also included infrequent task-irrelevant pitch changes. Consistent with results of previous studies, the task-irrelevant pitch changes impaired performance in the loudness discrimination task. Auditory stimulation, attention-enhanced processing of sounds and motor responding during the loudness discrimination task activated supratemporal (auditory cortex) and inferior parietal areas bilaterally and left-hemisphere (contralateral to the hand used for responding) motor areas. Large pitch changes were associated with right hemisphere supratemporal activations as well as widespread bilateral activations in the frontal lobe and along the intraparietal sulcus. Loudness discrimination and distracting pitch changes activated common areas in the right supratemporal gyrus, left medial frontal cortex, left precentral gyrus, and left inferior parietal cortex. PMID:17368939
Rinne, Teemu; Kirjavainen, Siiri; Salonen, Oili; Degerman, Alexander; Kang, Xiaojian; Woods, David L; Alho, Kimmo
This study was conducted to assess the safety of humeral lengthening using an Ilizarov frame. We retrospectively reviewed 26 humeral segments in 17 patients that were lengthened at our department between 1993 and 2011. There were varying aetiologies including achondroplasia, epiphyseal dysplasia, Oilier disease, trauma or infection of the proximal humeral growth-plate, unicameral bone cyst and brachial plexus injury. Mean age at start of surgery was 17.05 years (range : 5-40). The mean lengthening achieved was 8.85 (3-13) cm. Mean lengthening percentage was 353% (range : 10-48). Average healing index was 30.56 days/cm (range : 17.46-4232). There was a significant difference in healing index between achondroplasia patients (28.79 days/cm) compared to others (33.41 days/cm). Minor problems included pin tract infection (14 segments). More important obstacles were temporary elbow flexion contracture (7 segments), premature consolidation (6 segments), radial nerve dysaesthesia (6 segments) and loosening of a Schanz screw (1 segment). Complications included one fracture and one progressive bowing after frame removal. One planned lengthening was not completely achieved. Despite a lot of obstacles, humeral lengthening using an Ilizarov frame provided a reliable method to treat the functional or cosmetic problems of upper limb shortening. PMID:24563967
Ruette, Peter; Lammens, Johan
In visual search, target detection times are relatively insensitive to set size when targets and distractors differ on a single feature dimension. Search can be confined to only those elements sharing a single feature, such as color (Egeth, Virzi, & Garbart, 1984). These findings have been taken as evidence that elementary feature dimensions support a parallel segmentation of a scene into discrete sets of items. Here we explored if relative depth (signaled by binocular disparity) could support a similar parallel segmentation by examining the effects of distributing distracting elements across two depth planes. Three important empirical findings emerged. First, when the target was a feature singleton on the target depth plane, but a conjunction search among distractors on the nontarget plane, search efficiency increased compared to a single depth plane. Second, benefits of segmentation in depth were only observed when the target depth plane was known in advance. Third, no benefit of segmentation in depth was observed when both planes required a conjunction search, even with prior knowledge of the target depth plane. Overall, the benefit of distributing the elements of a search set across two depth planes was observed only when the two planes differed both in binocular disparity and in the elementary feature composition of individual elements. We conclude that segmentation of the search array into two depth planes can facilitate visual search, but unlike color or other elementary properties, does not provide an automatic, preattentive segmentation. PMID:23847304
Finlayson, Nonie J; Remington, Roger W; Retell, James D; Grove, Philip M
The purpose of this clinical report was to present a case of a rare Tessier 2/12 craniofacial cleft, which was treated by using mandibular distractors in a reverse manner for the reapproximation of the craniofacial skeleton allowing for closure of the soft tissue component and palate of this cleft. The changes in the bony portions of the cleft were accomplished without osteotomies taking advantage of the mobility of the facial bones involving both normal bony sutures and the cleft bone. The bone movement allowed for easier adhesion of the midline lower facial soft tissue during the first year of life. The outcomes were both functionally and aesthetically satisfactory. Although the ability of distractor devices to regenerate bone is well documented, they can also accomplish the same effect in a reverse manner. This new use of distraction devices in a reverse manner to contract the craniofacial skeleton without osteotomies to the author's knowledge has not been previously reported and adds a valuable tool to closing large facial clefts. However, considering the severity and complexity of the deformities, long-term follow-up will be necessary to assess the benefits of the surgical interventions and the patient's quality of life. PMID:24717313
Konofaos, Petros; Alvarez, Sonia; Wallace, Robert D
Studies have examined the impact of distraction on basic task performance (e.g., working memory, motor responses), yet research is lacking regarding its impact in the domain of think-aloud cognitive assessment, where the threat to assessment validity is high. The Articulated Thoughts in Simulated Situations think-aloud cognitive assessment paradigm was employed to address this issue. Participants listened to scenarios under three conditions (i.e., while answering trivia questions, playing a visual puzzle game, or with no experimental distractor). Their articulated thoughts were then content-analyzed both by the Linguistic Inquiry and Word Count (LIWC) program and by content analysis of emotion and cognitive processes conducted by trained coders. Distraction did not impact indices of emotion but did affect cognitive processes. Specifically, with the LIWC system, the trivia questions distraction condition resulted in significantly higher proportions of insight and causal words, and higher frequencies of non-fluencies (e.g., “uh” or “umm”) and filler words (e.g., “like” or “you know”). Coder-rated content analysis found more disengagement and more misunderstanding particularly in the trivia questions distraction condition. A better understanding of how distraction disrupts the amount and type of cognitive engagement holds important implications for future studies employing cognitive assessment methods.
Hsu, Kean J.; Babeva, Kalina N.; Feng, Michelle C.; Hummer, Justin F.; Davison, Gerald C.
Studies have examined the impact of distraction on basic task performance (e.g., working memory, motor responses), yet research is lacking regarding its impact in the domain of think-aloud cognitive assessment, where the threat to assessment validity is high. The Articulated Thoughts in Simulated Situations think-aloud cognitive assessment paradigm was employed to address this issue. Participants listened to scenarios under three conditions (i.e., while answering trivia questions, playing a visual puzzle game, or with no experimental distractor). Their articulated thoughts were then content-analyzed both by the Linguistic Inquiry and Word Count (LIWC) program and by content analysis of emotion and cognitive processes conducted by trained coders. Distraction did not impact indices of emotion but did affect cognitive processes. Specifically, with the LIWC system, the trivia questions distraction condition resulted in significantly higher proportions of insight and causal words, and higher frequencies of non-fluencies (e.g., "uh" or "umm") and filler words (e.g., "like" or "you know"). Coder-rated content analysis found more disengagement and more misunderstanding particularly in the trivia questions distraction condition. A better understanding of how distraction disrupts the amount and type of cognitive engagement holds important implications for future studies employing cognitive assessment methods. PMID:24904488
Hsu, Kean J; Babeva, Kalina N; Feng, Michelle C; Hummer, Justin F; Davison, Gerald C
Sounds deviating from an otherwise repeated stream of task-irrelevant auditory stimuli (deviant sounds among standard sounds) are known to capture attention and impact negatively on ongoing behavioral performance (behavioral oddball distraction). Traditional views consider such distraction as the ineluctable consequence of the deviant sounds' low probability of occurrence relative to that of the standard. Contrary to this contention, recent evidence demonstrates that distraction by deviant sounds is not obligatory and occurs only when sounds (standards and deviants), though to be ignored, act as useful warning cues by providing information as to whether and when a target stimulus is to be presented (Parmentier, Elsley, & Ljungberg, 2010). The present study aimed to extend this finding by disentangling the roles of event information (target's probability of occurrence) and temporal information (target's time of occurrence). Comparing performance in a cross-modal oddball task where standard and deviant sounds provided temporal information, event information, both, or none, we found that distraction by deviant sounds emerged when sounds conveyed event information. These results suggest that unexpected changes in a stream of sounds yield behavioral distraction to the extent that standards and deviants carry relevant goal-directed information, specifically, the likelihood of occurrence of an upcoming target. PMID:22563629
Ljungberg, Jessica K; Parmentier, Fabrice B R; Leiva, Alicia; Vega, Nuria
Executive and attention dysfunctions are common in very preterm children. We studied their involuntary attention process by using behavioral measurements and auditory event-related potentials (AERP) with a distraction paradigm at age five years. The active task was to distinguish between two animal sounds. As an irrelevant feature the sounds were presented from frequent (standard) or infrequent (deviant, 11%) direction from two loudspeakers. Of the 28 preterm children, only 75% could accomplish the task, whereas all full-term children (n=15) could. When distinguishing the animal sounds, the reaction times were longer to the sounds from the deviant than from the standard direction in both groups, indicating involuntary distraction. The hit rates for the sounds from standard and deviant directions were similar in both groups. AERP amplitudes in the P1 interval and in the P3a interval elicited by standard and deviant stimuli were smaller in the preterm than in the control children. Deviants elicited P3a (indicating attentional orienting) and reorienting negativity (indicating attentional reorienting after distraction) in both groups. Comparable involuntary attentional orienting, distraction, and reorienting suggest similar maturation processes in 5-year-old preterm and full-term children. However, smaller AERP amplitudes in P1 and P3a interval suggest altered processing of auditory stimuli in those born preterm. As one-fourth of the preterm children could not accomplish the paradigm, less demanding paradigms should be used in studying children with increased distractibility. PMID:20362015
Mikkola, Kaija; Wetzel, Nicole; Leipälä, Jaana; Serenius-Sirve, Silve; Schröger, Erich; Huotilainen, Minna; Fellman, Vineta
A signal passed at danger (SPAD) event occurs when a train moves past a stop signal into a section of unauthorised track. SPAD events are frequently attributed to driver distraction and inattention, but few studies have explored the failure mode from the perspective of task demand and the ability of the driver to self-regulate in response to competing activities. This study aimed to provide a more informed understanding of distraction, inattention and SPAD-risk in the passenger rail task. The research approach combined focus groups with a generative task designed to stimulate situational insight. Twenty-eight train drivers participated from 8 different rail operators in Australia and New Zealand. Data were analysed thematically and revealed several moderating factors for driver distraction. Time-keeping pressure and certain aspects of the driver-controller dynamic were considered to distort performance, and distractions from station dwelling and novel events increased SPAD-risk. The results are conceptualised in a succinct model of distraction linking multiple factors with mechanisms that induced the attentional shift. The commonalities and inter-dynamics of the factors revealed insight into driving anxiety in the passenger rail mode, and suggested that SPAD-risk was intensified when three or more factors converged. The paper discusses these issues in the context of misappropriated attention, taxonomic implications, and directions for future research. PMID:24076301
We evaluated neural substrates related to the loss of control in college students with internet gaming disorder (IGD). We hypothesized that deficit in response inhibition under gaming cue distraction was the possible mechanism for the loss of control internet use. Eleven cases of IGD and 11 controls performed Go/NoGo tasks with/without gaming distraction in the functional magnetic resonance imaging scanner. When the gaming picture was shown as background while individuals were performing Go/NoGo tasks, the IGD group committed more commission errors. The control group increased their brain activations more over the right dorsolateral prefrontal cortex (DLPFC) and superior parietal lobe under gaming cue distraction in comparison with the IGD group. Furthermore, brain activation of the right DLPFC and superior parietal lobe were negatively associated with performance of response inhibition among the IGD group. The results suggest that the function of response inhibition was impaired under gaming distraction among the IGD group, and individuals with IGD could not activate right DLPFC and superior parietal lobe to keep cognitive control and attention allocation for response inhibition under gaming cue distraction. This mechanism should be addressed in any intervention for IGD. PMID:24388058
Liu, Gin-Chung; Yen, Ju-Yu; Chen, Chiao-Yun; Yen, Cheng-Fang; Chen, Cheng-Sheng; Lin, Wei-Chen; Ko, Chih-Hung
Although gradual bone transport may permit the restoration of large-diameter bones, complications are common owing to the long duration of external fixation. In order to reduce such complications, a new technique of bone transport involving the use of an external fixator and a locking plate was devised for segmental tibial bone defects. A total of ten patients (nine men, one woman) with a mean age at operation of 40.4 years (16 to 64) underwent distraction osteogenesis with a locking plate to treat previously infected post-traumatic segmental tibial defects. The locking plate was fixed percutaneously to bridge proximal and distal segments, and was followed by external fixation. After docking, percutaneous screws were fixed at the transported segment through plate holes. At the same time, bone grafting was performed at the docking site with the external fixator removed. The mean defect size was 5.9 cm (3.8 to 9.3) and mean external fixation index was 13.4 days/cm (11.8 to 19.5). In all cases, primary union of the docking site and distraction callus was achieved, with an excellent bony result. There was no recurrence of deep infection or osteomyelitis, and with the exception of one patient with a pre-existing peroneal nerve injury, all achieved an excellent or good functional result. With short external fixation times and low complication rates, bone transport with a locking plate could be recommended for patients with segmental tibial defects. PMID:24293598
Oh, C-W; Apivatthakakul, T; Oh, J-K; Kim, J-W; Lee, H-J; Kyung, H-S; Baek, S-G; Jung, G-H
This essay examines the conditions behind the 'Philippine Prison Thriller' video, a YouTube spectacle featuring the 1,500 inmates of Cebu Provincial Detention and Rehabilitation Centre (CPDRC) dancing to Michael Jackson's hit song 'Thriller'. The video achieved viral status after it was uploaded onto the video-sharing platform in 2007, and sparked online debates as to whether this video, containing recorded moving images of allegedly forced dancing, was a form of cruel and inhumane punishment or a novel approach to rehabilitation. The immense popularity of the video inspired creative responses from viewers, and this international popularity caused the CPDRC to host a monthly live dance show held in the prison yard, now in its seventh year. The essay explores how seemingly innocuous products of user-generated-content are imbued with ideologies that obscure or reduce relations of race, agency, power and control. By contextualising the video's origins, I highlight current Philippine prison conditions and introduce how video-maker/programme inventor/prison warden Byron Garcia sought to distance his facility from the Philippine prison majority. I then investigate the 'mediation' of 'Thriller' through three main issues. One, I examine the commodification and transformation from viral video to a thana-tourist destination; two, the global appeal of 'Thriller' is founded on public penal intrigue and essentialist Filipino tropes, mixed with a certain novelty factor widely suffused in YouTube formats; three, how dance performance and its mediation here are conducive to creating Foucault's docile bodies, which operate as a tool of distraction for the masses and ultimately serve the interests of the state far more than it rehabilitates(unconvicted and therefore innocent) inmates. PMID:24480892
This work describes an approach to develop a model of driver's distraction induced by an on-board information system basing on vehicle data. Machine learning techniques have been adopted to find the model able to better predict distraction, given a target value. Results pointed in favor of a model obtained with the ANFIS (adaptive neuro fuzzy inference system) technique. Further investigations
Fabio Tango; Caterina Calefato; Luca Minin; Luca Canovi
Background: Newborn hearing screening is currently replacing the health visitor distraction test (HVDT) conducted at eight months. Our previous research indicates that recall for further tests following newborn hearing screening can have a negative impact on the emotional well being of mothers, but it is not known if this is greater than that caused by recall following the distraction test.
Rachel Crockett; Holly Baker; Kai Uus; John Bamford; Theresa M Marteau
Objective This study provided the first direct test of the cognitive underpinnings of the attention-allocation model and attempted to replicate and extend past behavioral findings for this model as an explanation for alcohol-related aggression. Method A diverse community sample (55% African-American) of males (N = 159) between 21 and 35 years of age (M = 25.80) were randomly assigned to one of two beverage conditions (i.e., alcohol, no-alcohol control) and one of two distraction conditions (i.e., distraction, no-distraction). Following beverage consumption, participants were provoked via reception of electric shocks and a verbal insult from a fictitious male opponent. Participants’ attention-allocation to aggression words (i.e., aggression bias) and physical aggression were measured using a dot probe task and a shock-based aggression task, respectively. Results Intoxicated men whose attention was distracted displayed significantly lower levels of aggression bias and enacted significantly less physical aggression than intoxicated men whose attention was not distracted. However, aggression bias did not account for the lower levels of alcohol-related aggression in the distraction, relative to the no-distraction, condition. Conclusions These results replicated and extended past evidence that cognitive distraction is associated with lower levels of alcohol-related aggression in highly provoked males and provide the first known cognitive data to support the attentional processes posited by the attention-allocation model. Discussion focused on how these data inform intervention programming for alcohol-related aggression.
Gallagher, Kathryn E.; Parrott, Dominic J.
Patient with TMJ ankylosis are affected with mandibular hypoplasia which in turn causes functional and esthetic problems. Restoration of normal function and esthetics is the prime goal in treatment of such patients with distraction becoming an important treatment option. The present study also was conducted on patients with mandibular hypoplasia secondarily to TMJ ankylosis treated with distraction. Since function and esthetics improvement was the prime aim behind the treatment with distraction, evaluation of functional and esthetics outcome becomes an important aspect. Thus the study was indigenously designed and aimed at qualitative evaluation of the functional and esthetic outcome after correction of mandibular hypoplasia secondary to temporomandibular ankylosis with Distraction osteogenesis. Patients treated with distraction were evaluated on the basis of parameters for function and esthetics. Parameters for function were occlusion, airway, mouth opening and chewing-biting perception of patient pre and post distraction. Parameters for esthetics used were patient and panel perception. All parameters for function and occlusion improved with distraction in all the patients except one in whom occlusion and chewing- biting pattern worsened. It is concluded that distraction is a good option for improving patients functional and esthetic outcome in cases of mandibular hypoplasia secondary to temporomandibular ankylosis as the results achieved are stable with negligible chances of relapse. PMID:24822007
Gupta, Gaurav Mahesh; Gupta, Pranjali; Sharma, Ashish; Patel, Nehal; Singh, Abhishek
Freeman-Sheldon syndrome, or distal arthrogryposis type IIA (DA 2A), is a rare and severe multiple congenital contracture syndrome that is associated with upper airway obstruction. This obstruction has been clinically significant enough to warrant tracheostomy and has been associated with mortality. We describe a patient who presented to us as a neonate and the novel management of her respiratory obstruction in the setting of DA 2A. Bilateral mandibular osteotomies were performed and bilateral internal mandibular distracters were placed. She was distracted a total of 3 cm over 15 days without event and successfully extubated on the postoperative day 16. Preoperative polysomnogram demonstrated an obstructive apnea hypopnea index of 43.7, but a repeat polysomnogram demonstrated an apnea hypopnea index of 8.1. In this study, we report the first use of distraction osteogenesis in the setting of severe obstructive sleep apnea syndrome secondary to DA 2A. PMID:24777016
Toranto, Jason D; Ward, Sally Davidson; Lin, Aaron; Urata, Mark M
In this report the first experience with callus distraction lengthening using the intramedullary kinetic nail is described. This was performed on a left tibia with a total shortening of 34 mm. The distraction phase lasted 36 days and the rate of distraction was 0.95 mm per day. The full weight-bearing of the treated lower extremity was allowed at 12 weeks after surgery. Complete consolidation of the callus was achieved at 112 days and the consolidation index was 3.21 days/mm. No serious complications were recorded during the post-operative period. At 12 months after surgery, the patient showed a full range of motion in the knee, his ankle range of motion was S 15-0-35, and he achieved an excellent functional outcome on evaluation by Paley's classification. PMID:17877947
Visna, P; Beitl, E; Smídl, Z; Kalvach, J; Jaganjac, E
Gender differences in brain activity while processing emotional stimuli have been demonstrated by neuroimaging and electrophysiological studies. However, the possible differential effects of emotion on attentional mechanisms between women and men are less understood. The present study aims to elucidate any gender differences in the modulation of unexpected auditory stimulus processing using an emotional context elicited by aversive images. Fourteen men and fourteen women performed a well-established auditory-visual distraction paradigm in which distraction was elicited by novel stimuli within a neutral or negative emotional context induced by images from the IAPS. Response time increased after unexpected novel sounds as a behavioral effect of distraction, and this increase was larger for women, but not for men, within the negative emotional context. Novelty-P3 was also modulated by the emotional context for women but not for men. These results reveal stronger novelty processing in women than in men during a threatening situation. PMID:18722500
Garcia-Garcia, Manuel; Domínguez-Borràs, Judith; SanMiguel, Iria; Escera, Carles
Behavioral and electrophysiological brain responses were used to examine the relationship between the vulnerability to distraction and the orienting response in schizophrenia. Nineteen schizophrenics and nineteen matched healthy controls were instructed to ignore task-irrelevant auditory stimuli while they classified capital letters and digits. The auditory sequences contained repetitive standard tones occasionally replaced by complex novel sounds. Relative to controls, patients showed an increased behavioral distraction, as indicated by a larger response time increase caused by novel sounds, and a disturbance in the attention orienting toward distracting stimuli, as indicated by a reduced novelty-P3. This behavioral-electrophysiological dissociation may stem from a limited pool of available resources. Thus, the few attentional resources directed toward novel stimuli would be sufficient to cause an important decrease of the similarly reduced amount of resources assigned to task-relevant stimuli, resulting in a striking impairment of the ongoing task performance. PMID:18450358
Cortiñas, Miriam; Corral, María-José; Garrido, Gemma; Garolera, Maite; Pajares, Marta; Escera, Carles
The most difficult stage of automated target recognition (ATR) is segmentation. Current AFIT segmentation problems include faces and tactical targets; previous efforts to segment these objects have used intensity and motion cues. This thesis develops a co...
K. A. McCrae
This study examined the effects of electronic communication distractions, including cell-phone and texting demands, on true and false recognition, specifically semantically related words presented and not presented on a computer screen. Participants were presented with 24 Deese-Roediger-McDermott (DRM) lists while manipulating the concurrent presence or absence of cell-phone and text-message distractions during study. In the DRM paradigm, participants study lists of semantically related words (e.g., mother, crib, and diaper) linked to a non-presented critical lure (e.g., baby). After studying the lists of words, participants are then requested to recall or recognize previously presented words. Participants often not only demonstrate high remembrance for presented words (true memory: crib), but also recollection for non-presented words (false memory: baby). In the present study, true memory was highest when participants were not presented with any distraction tasks during study of DRM words, but poorer when they were required to complete a cell-phone conversation or text-message task during study. False recognition measures did not statistically vary across distraction conditions. Signal detection analyses showed that participants better discriminated true targets (list items presented during study) from true target controls (items presented during study only) when cell-phone or text-message distractions were absent than when they were present. Response bias did not vary significantly across distraction conditions, as there were no differences in the likelihood that a participant would claim an item as "old" (previously presented) rather than "new" (not previously presented). Results of this study are examined with respect to both activation monitoring and fuzzy trace theories. PMID:21198365
Smith, Theodore S; Isaak, Matthew I; Senette, Christian G; Abadie, Brenton G
Objective Vertebral distraction is routinely performed during anterior cervical discectomy and fusion (ACDF). Overdistraction can injure the facet joints and may cause postoperative neck pain consequently. The purpose of this study was to investigate the clinical relevance of distraction force during ACDF. Methods This study included 24 consecutive patients with single level cervical disc disease undergoing single level ACDF. We measure the maximum torque just before the the arm of the Caspar retractor was suspended by the rachet mechanism by turning the lever on the movable arm using a torque meter. In order to turn the lever using the torque driver, we made a linear groove on the top of the lever. We compared the neck disability index (NDI) and visual analogue scale (VAS) scores between the high torque group (distraction force>6 kgf·cm) and the low torque group (distraction force?6 kgf·cm) at routine postoperative intervals of 1, 3, 5 days and 1, 3, 6 months. Results The VAS scores for posterior neck pain had a linear correlation with torque at postoperative 1st and 3rd days (y=0.99×-1.1, r2=0.82; y=0.77×-0.63, r2=0.73, respectively). VAS scores for posterior neck pain were lower in the low torque group than in the high torque group on both 1 and 3 days postoperatively (3.1±1.3, 2.6±1.0 compared with 6.0±0.6, 4.9±0.8, p<0.01). However, the difference in NDI scores was not statistically significant in all postoperative periods. Conclusion Vertebral distraction may cause posterior neck pain in the immediate postoperative days. We recommend not to distract the intervertebral disc space excessively with a force of more than 6.0 kgf·cm.
Ha, Seung Man; Kim, Jeong Hoon; Oh, Seung Hun; Song, Ji Hwan; Kim, Hyoung Ihl
Modern driving involves frequent and potentially detrimental interactions with distracting in-vehicle tasks. Distraction has been shown to slow brake reaction time and decrease lateral and longitudinal vehicle control. It is likely that these negative effects will become more prevalent in the future as advances are made in the functionality, availability, and number of in-vehicle systems. This paper addresses this problem by considering ways to manage in-vehicle task presentation to mitigate their distracting effects. A driving simulator experiment using 48 participants was performed to investigate the existence of the Psychological Refractory Period in the driving context and its effect on braking performance. Drivers were exposed to lead vehicle braking events in isolation (single-task) and with a preceding surrogate in-vehicle task (dual-task). In dual-task scenarios, the time interval between the in-vehicle and braking tasks was manipulated. Brake reaction time increased when drivers were distracted. The in-vehicle task interfered with the performance of the braking task in a manner that was dependent on the interval between the two tasks, with slower reactions following a shorter inter-task interval. This is the Psychological Refractory Period effect. These results have implications for driver safety during in-vehicle distraction. The findings are used to develop recommendations regarding the timing of in-vehicle task presentation so as to reduce their potentially damaging effects on braking performance. In future, these guidelines could be incorporated into a driver workload management system to minimise the opportunity for a driver to be distracted from the ongoing driving task. PMID:22999382
Hibberd, Daryl L; Jamson, Samantha L; Carsten, Oliver M J
Background The impact of task relevance on event-related potential amplitudes of early visual processing was previously demonstrated. Study designs, however, differ greatly, not allowing simultaneous investigation of how both degree of distraction and task relevance influence processing variations. In our study, we combined different features of previous tasks. We used a modified 1-back task in which task relevant and task irrelevant stimuli were alternately presented. The task irrelevant stimuli could be from the same or from a different category as the task relevant stimuli, thereby producing high and low distracting task irrelevant stimuli. In addition, the paradigm comprised a passive viewing condition. Thus, our paradigm enabled us to compare the processing of task relevant stimuli, task irrelevant stimuli with differing degrees of distraction, and passively viewed stimuli. EEG data from twenty participants was collected and mean P100 and N170 amplitudes were analyzed. Furthermore, a potential connection of stimulus processing and symptoms of attention deficit hyperactivity disorder (ADHD) was investigated. Results Our results show a modulation of peak N170 amplitudes by task relevance. N170 amplitudes to task relevant stimuli were significantly higher than to high distracting task irrelevant or passively viewed stimuli. In addition, amplitudes to low distracting task irrelevant stimuli were significantly higher than to high distracting stimuli. N170 amplitudes to passively viewed stimuli were not significantly different from either kind of task irrelevant stimuli. Participants with more symptoms of hyperactivity and impulsivity showed decreased N170 amplitudes across all task conditions. On a behavioral level, lower N170 enhancement efficiency was significantly correlated with false alarm responses. Conclusions Our results point to a processing enhancement of task relevant stimuli. Unlike P100 amplitudes, N170 amplitudes were strongly influenced by enhancement and enhancement efficiency seemed to have direct behavioral consequences. These findings have potential implications for models of clinical disorders affecting selective attention, especially ADHD.
The gag reflex can be a normal, healthy defense mechanism to prevent foreign objects from entering the trachea. During certain dental procedures, however, gagging can greatly complicate the final result, especially during the maxillary complete denture final impression. A modification can be made to the maxillary custom acrylic resin tray to aid in securing a clinically acceptable elastomeric final impression. This modification involves forming a vacuum chamber at the posterior extent of the custom tray to which a saliva ejector tip is embedded. When the saliva ejector is connected to the low-volume evacuation hose, the chamber will trap any excess impression material that might extrude from the posterior border of the loaded tray. This results in a reduced chance of eliciting the patient's gag reflex. PMID:2664161
Callison, G M
Sinonasal undifferentiated carcinoma is an extremely rare malignancy of the paranasal sinuses and nasal cavity. It is of unknown etiology, and occurs more commonly in the elderly men, with a routinely shown aggressive behavior and poor prognosis for survival. Radiographically, it looks like severe osteomyelitis. Histopathologic study is essential to confirm diagnosis, and the undifferentiated histologic appearance often necessitates immunohistochemical studies for differentiation from other high-grade neoplasms. We present an 83-year-old man complaining of pain and unilateral swelling on the left side of the face due to a rare malignant tumor of maxillary sinus origin, a sinonasal undifferentiated carcinoma. He underwent hemimaxillectomy and radiotherapy, but refused chemotherapy. Maxillary sinus malignancy may be presented with unspecific symptoms mimicking sinusitis or dental pain. Coming across such symptoms, the physician or dentist must consider malignancies as well, and carry out medical and dental workups.
Mahdavi, Omid; Boostani, Najmehalsadat; Karimi, Sharareh; Tabesh, Adel
This article describes the orthodontic treatment of a 25-year-old Korean female patient with anterior crowding, including palatally displaced lateral incisors. Her facial profile was satisfactory, but 3.5 mm of maxillary anterior crowding was observed. To correct this crowding, we decided to minimize the use of the conventional fixed orthodontic appliances and employed a less bulky and more aesthetic appliance for applying light continuous force. We determined the final positions of the maxillary teeth via a working model for diagnostic set up and achieved space gaining and alignment with simple Ni-Ti spring and stainless steel round tubes. Tooth alignment was achieved efficiently and aesthetically without the conventional brackets.
Choi, Kyung-Hee; Lee, Yoonjung; Kim, Minji
Inflammatory myofibroblastic tumors (IMTs) are extremely rare neoplasms with a variable natural history and biologic behavior, ranging from completely benign to malignant tumors with fatal outcome. They have no common identifiable cause, although some authors have assumed that any inflammatory stimulus may cause these pseudotumors. They are most commonly found in the lungs. Extrapulmonary sites include abdomen, retroperitoneum and extremities. IMTs rarely affect the head and neck, but the most common subsites in this region include the orbit, larynx, mouth, tonsils, parapharyngeal space, thyroid, parotid and lacrimal glands. There are few reports of inflammatory pseudotumors in the paranasal sinuses. In the maxillary sinus, the initial presenting sign is usually a nonspecific sinonasal mass, which has been growing over a period of weeks or months. On rare occasions, IMT may exhibit malignant transformation. Herein we present a rare case of pathologically proved IMT with malignant transformation which originated in the maxillary sinus of a 29-year-old male.
Salehinejad, Jahanshah; Pazouki, Mahdi; Gerayeli, Mohammad Ali
Rare irregular sounds (deviants) embedded into a regular sound sequence have large potential to draw attention to themselves (distraction). It has been previously shown that distraction, as manifested by behavioral response delay, and the P3a and reorienting negativity (RON) event-related potentials, could be reduced when the forthcoming deviant was signaled by visual cues preceding the sounds. In the present study, we investigated the type of information used in the prevention of distraction by manipulating the information content of the visual cues preceding the sounds. Cues could signal the specific variant of the forthcoming deviant, or they could just signal that the next tone was a deviant. We found that stimulus-specific cue information was used in reducing distraction. The results also suggest that early P3a and RON index processes related to the specific deviating stimulus feature, whereas late P3a reflects a general distraction-related process. PMID:21310210
Horváth, János; Sussman, Elyse; Winkler, István; Schröger, Erich
Rare irregular sounds (deviants) embedded into a regular sound sequence have large potential to draw attention to themselves (distraction). It has been previously shown that distraction, as manifested by behavioral response delay, and the P3a and reorienting negativity (RON) event-related potentials, could be reduced when the forthcoming deviant was signaled by visual cues preceding the sounds. In the present study, we investigated the type of information used in the prevention of distraction by manipulating the information content of the visual cues preceding the sounds. Cues could signal the specific variant of the forthcoming deviant, or they could just signal that the next tone was a deviant. We found that stimulus-specific cue information was used in reducing distraction. The results also suggest that early P3a and RON index processes related to the specific deviating stimulus feature, whereas late P3a reflects a general distraction-related process.
Horvath, Janos; Sussman, Elyse; Winkler, Istvan; Schroger, Erich
Objective: To analyze the skeletal features of patients with maxillary canine impaction. Material and Methods: The complete pre-treatment records of 1674 orthodontic patients were examined. From the subjects with maxillary impacted canine 12 patients were excluded , remaining 108. The subjects with maxillary impacted canine were divided into two study groups: a palatally displaced canine group (PDCG) (77 patients) and a buccally displaced canine group (BDCG) (31 patients). The values of the skeletal features measured on the lateral cephalometric radiograph were compared with a control group (CG) of 121 subjects randomly selected from the initial sample without maxillary canine impaction. The statistical analysis of the difference between the study groups and the CG was tested using ?2 test and Fisher’s exact test. The level of significance was set at P ?0.05. Results: The CG was characterized by increased values of A point-Nasion-B point angle (ANB) and by a retro-positioned or smaller lower jaw. PDCG patients showed normal skeletal features compared to the CG, presenting mainly I class and lower rank of II and III sagittal skeletal features. PDCG subjects presented also normal values of the Steiner vertical skeletal relationship angles with normal facial divergence compared to the CG. PDCG cases were also characterized by horizontal and prognathic growth. BDCG did not present significant differences in skeletal features compared to the CG, except for an increased ANB. Conclusions: Palatally displaced canine (PDC) was frequently the only orthodontic problem of patients and was not associated whit altered skeletal features. The frequent absence of malocclusion in PDC patients explains the delayed identification of this problem. BDCG patients did not present significant differences in skeletal features with respect to the orthodontic population. The presence of both buccally displaced canine (BDC) and malocclusion makes the patient with BDC both aware of the need for, and motivated to undergo, orthodontic treatment. Key words:Canine impaction, palatal displacement, buccal displacement, skeletal features.
Mercuri, Emanuele; Cavallini, Costanza; Vicari, Donatella; Leonardi, Rosalia; Barbato, Ersilia
Summary Internal maxillary arterial or branch transection is a potential complication of maxillofacial surgery. We describe one such patient who developed acute massive nasal haemorrhage, an episode of which was controlled clinically just prior to performing endovascular embolization by employing the simple but effective clinical manoeuvre of manual carotid arterial compression. Six weeks later the haemorrhage recurred despite a seemingly adequate embolization of the affected arteries with microcoils and Spongistan due to re-establishment of flow through the coils.
Duncan, I.C.; Fourie, P.A.
We aimed to gather data on the current practice of surgically assisted rapid maxillary expansion (SARME) in the UK. Surveys were posted in the mail to all members of the British Association of Oral and Maxillofacial Surgeons (n=379) and 166 (44%) responded. In the previous year 69 responders (42%) had done at least one SARME operation. The technique used by individual surgeons may be more experience-based than evidence-based, which leads to considerable variation. PMID:23962594
MacLaine, James K; Thickett, Ellie M; Power, Susan M
Objective The purpose of this study was to investigate the effects of a newly developed rapid maxillary expansion screw-the memory screw-over 6 months. Methods Five subjects, aged between 11.7 and 13.75 years, were enrolled in this study. All subjects underwent placement of a maxillary expansion appliance containing superelastic nickel-titanium open-coil springs in its screw bed. The parents of the patients and/or the patients themselves were instructed to activate the expansion screw by 2 quarter-turns 3 times a day (morning, midday, and evening; 6 quarter-turns a day). The mean expansion period was 7.52 ± 1.04 days. Dentoskeletal effects of the procedure, including dentoalveolar inclination, were evaluated. Measurements of all the parameters were repeated after 6 months of retention in order to check for relapse. Results Sella-Nasion-A point (SNA) and Sella-Nasion/Gonion-Menton angles increased, and Sella-Nasion-B point (SNB) angle decreased in all the subjects during the expansion phase. However, they approximated to the initial values at the end of 6 months. On the other hand, the increments in maxillary apical base (Mxr-Mxl) and intermolar widths was quite stable. As expected, some amount of dentoalveolar tipping was observed. Conclusions The newly developed memory expansion screw offers advantages of both rapid and slow expansion procedures. It widens the midpalatal suture and expands the maxilla with relatively lighter forces and within a short time. In addition, the resultant increments in the maxillary apical base and intermolar width remained quite stable even after 6 months of retention.
Halicioglu, Koray; Kiki, Ali
Pneumatization of the maxillary sinus limits the quantity of alveolar bone available for implant placement and may result in a lack of primary stability and difficulty in achieving osseointegration. The purpose of this study was to retrospectively analyze a group of patients who had implants placed in the posterior maxilla, calculate the prevalence of sinus augmentation, and identify factors related to sinus augmentation. With institutional review board approval, dental records from a population of patients who had implants placed in the maxillary posterior region between January 2000 and December 2004 were used to create a database. Independent variables were classified as continuous (age of the patient at stage 1 implant surgery [S1], time between extraction and S1, time between extraction and sinus augmentation, and time between sinus augmentation and S1) and categorical (gender, implant failure, American Society of Anesthesiologists system classification, smoking, osteoporosis, residual crestal bone height, implant position, implant proximity, prostheses type, and implant diameter and length). The dependent variable was the incidence of a sinus augmentation procedure. Simple logistic regression was used to assess the influence of each factor on the presence of sinus augmentation (P < .05). The final database included 502 maxillary posterior implants with an overall survival rate of 93.2% over a mean follow-up period of 35.7 months. Of 502 implants, 272 (54.2%) were associated with a sinus augmentation procedure. Among variables, residual crestal bone height (P < .001), implant position (P < .001), implant proximity (P < .001), prosthesis type (P < .001), implant failure (P < .01), and implant diameter (P < .01), were statistically associated with sinus augmentation. Within the limitations of this retrospective study, the results suggest that more than half (54.2%) of the maxillary posterior implants were involved with a sinus augmentation procedure. The prevalence of sinus augmentation increased with decreased residual crestal bone height, more posterior implant locations, and complete or partial edentulism. Sinus augmentation was significantly associated with implant failure and wide implants. PMID:21651386
Seong, Wook-Jin; Barczak, Michael; Jung, Jae; Basu, Saonli; Olin, Paul S; Conrad, Heather J
We have compared students' responses on four multiple-choice force concept inventory (FCI) questions with similar responses to equivalent open-ended questions. Our results indicate a good agreement between the percentages of correct responses in each of the two formats, indicating that distracters on the FCI do not adversely affect performance as measured by the number of correct answers. However, a significant percentage of the open-ended responses fall into categories that are not included in the FCI multiple choices. When these alternative categories were presented to the students as distracters in a revised multiple-choice format, a significant percentage of the students chose these alternative responses.
Rebello, N. Sanjay; Zollman, Dean A.
Abstract Virtual reality (VR) has been used by clinicians to manage pain in clinical populations. This study examines the use of VR as a form of distraction for dental patients using both subjective and objective measures to determine how a VR system affects patients' reported anxiety level, pain level, and physiological factors. As predicted, results of self-evaluation questionnaires showed that patients experienced less anxiety and pain after undergoing VR treatment. Physiological data reported similar trends in decreased anxiety. Overall, the favorable subjective and objective responses suggest that VR distraction systems can reduce discomfort and pain for patients with mild to moderate fear and anxiety. PMID:24892198
Wiederhold, Mark D; Gao, Kenneth; Wiederhold, Brenda K
In a 48-year-old woman and a 35-year-old man, a sinusitis maxillaris resulting from overextension of root canal filling material after an endodontic treatment ofa maxillary molar could be diagnosed through computed tomography. The woman complained of nasal congestion and in the man 2 radiopaque abnormalities in the maxillary sinus were discovered coincidentally. The corpora aliena were removed surgically. Root canal filling materials containing zinc oxide or hydrocortisone may cause aspergillosis of the maxillary sinus because they encountergrowth of Aspergillus species. In case ofmaxillary sinusitis, surgical removal of overextended root canal filling material from the maxillary sinus is indicated. No treatment consensus consists for cases without maxillary sinusitis symptoms. PMID:23126175
Badarne, O; Koudstaal, M J; van Elswijk, J F A; Wolvius, E B
For patients whose orthodontic problems are so severe that neither growth modification nor camouflage offers a solution, surgery to realign the jaws or reposition dentoalveolar segments is the only possible treatment. Surgery is not a substitute for orthodontics in these patients. Instead, it must be properly coordinated with orthodontics and other dental treatments to achieve good overall results. Dramatic progress in recent years has made it possible for combined surgical orthodontic treatment to be carried out successfully for patients with a severe dentofacial problem of any type. This case report provides an overview of the current treatment methodology in managing a combination of asymmetrical mandibular prognathism and vertical maxillary excess.
Jose Cherackal, George; Thomas, Eapen; Prathap, Akhilesh
Objectives The aim of this study was to retrospectively evaluate the clinical survival rate of Astra Tech implants in the maxillary molar region performed with sinus lift and bone graft. Materials and Methods Ninety-nine Astra Tech implants (Osseospeed) placed in the maxillary molar region using sinus lift from September 2009 to February 2012 were selected with a minimum follow-up period of 1 year. The height of alveolar bone, sinus approach technique, bone material and implant survival rate were evaluated. Results Of the 99 implants, the survival rate was 90.9%; 8 implants failed within 1 year after implant placement, and 1 implant failed 1 year after implant loading. All failed implants were placed with sinus lift simultaneously. The average height of alveolar bone before implant placement was 6.9 mm, while the height of alveolar bone of failed implants was 2.1 mm, on average. Conclusion Astra Tech implants placed in the maxillary molar region had generally good survival rates, but the relationship between reduced pre-implant alveolar bone height and implant failure requires further attention.
Yoon, Wook-Jae; Jeong, Kyung-In; You, Jae-Seek; Oh, Ji-Su
A method of surgical treatment of patients with upper retro- and micrognathia is proposed, consisting in improving the fixation of osteotomied maxillary complex. Implantation of carbonic ceramics behind the maxillary tubercles and osteosynthesis of bone fragments with titanium miniplates helps do without prolonged intermaxillary fixation and permits exercise in the early postoperative period, thus cutting down the invalidity period. Analysis of the results attained in 14 patients showed no relapses of maxillary deformation and a stable functional and esthetic effect. PMID:8754542
Bezrukov, V M; Nabiev, F Kh; Rabukhina, N A; Salidzhanov, A Sh; Kuzerin, V V
Segmentation of colon CT images is the main factor that inhibits automation of virtual colonoscopy. There are two main reasons that make efficient colon segmentation difficult. First, besides the colon, the small bowel, lungs, and stomach are also gas-filled organs in the abdomen. Second, peristalsis or residual feces often obstruct the colon, so that it consists of multiple gas-filled segments. In virtual colonoscopy, it is very useful to automatically connect the centerlines of these segments into a single colon centerline. Unfortunately, in some cases this is a difficult task. In this study a novel method for automated colon segmentation and connection of colon segments' centerlines is proposed. The method successfully combines features of segments, such as centerline and thickness, with information on main colon segments. The results on twenty colon cases show that the method performs well in cases of small obstructions of the colon. Larger obstructions are mostly also resolved properly, especially if they do not appear in the sigmoid part of the colon. Obstructions in the sigmoid part of the colon sometimes cause improper classification of the small bowel segments. If a segment is too small, it is classified as the small bowel segment. However, such misclassifications have little impact on colon analysis.
Medved, Mario; Truyen, Roel; Likar, Bostjan; Pernus, Franjo
Introduction. Large maxillary cysts occasionally expand into the maxilla and erode the maxillary sinus and nasal cavity. The Caldwell-Luc procedure is the recommended treatment for large maxillary sinus cysts. However, it is hard to preserve the nasal space in the case of large maxillary sinus cysts that penetrate into the nasal cavity. Methods. A 22-year-old man who had large maxillary sinus cysts was referred to our department for a surgical treatment. After removing the cyst from the maxillary sinus using the Caldwell-Luc procedure, we used nasal airway and balloon catheter devices to preserve the space of the inferior nasal meatus and maxillary sinus. These devices were removed 10 days postoperatively. Insertion and removal of both devices were simple and painless. Findings. The nasal airway and balloon catheter devices were useful for performing maxillary sinus surgery to remove large cysts. Our method was satisfactorily safe and was an effective minimally invasive treatment that preserved the space of the inferior nasal meatus and maxillary sinus.
Fukumoto, Chonji; Higo, Morihiro; Endo-Sakamoto, Yosuke; Ogawara, Katsunori; Shiiba, Masashi; Tanzawa, Hideki; Uzawa, Katsuhiro
Fracture of the maxillary tuberosity sometimes can happen when pneumatization of the maxillary sinus extends between the roots of upper molars. Some factors may lead to this complication including prominent or curved roots, chronic periapical infection, hypercementosis, root ankylosis and tooth fusion. This paper reports a case with fracture of the maxillary tuberosity following extraction of an upper first molar in general dental practice. Prevention from any complication during extractions of maxillary molars with large antral enlargement is possible with careful preoperative examination and accurate surgical planning. The general dentist should be prepared to refer such cases to an oral surgeon when facing difficulties like the presented case. PMID:19208000
Altu?, Hasan Ayberk; Sahin, Sermet; Sencimen, Metin; Dogan, Necdet
Background Few reports have described the ophthalmic complications that occur after maxillary orthognathic surgery. Since cases of decreased reflex tearing after maxillary orthognathic surgery are extremely rare, we describe 2 cases of loss of reflex tearing after maxillary orthognathic surgery. Case presentation Two Asian women, an 18-year-old and a 32-year-old, suffered from unilateral dryness and irritation caused by maxillary orthognathic surgery. In both patients, Schirmer test (II) showed reduced reflex tearing in 1 eye. Computed tomography showed that the pterygoid plate had been fractured in both patients. Conclusions The pterygopalatine ganglion and its associated fibers in the pterygopalatine fossa may be injured during Le Fort osteotomy.