Evaluation of the muscle relaxant cyclobenzaprine after third-molar extraction.

PubMed

de Santana Santos, Thiago; Calazans, Anna Carla Maranhão; Martins-Filho, Paulo Ricardo Saquete; Silva, Luiz Carlos Ferreira da; de Oliveira E Silva, Emanuel Dias; Gomes, Ana Claudia Amorim

2011-10-01

Pain, swelling and trismus are undesirable effects of extraction of impacted mandibular third molars. The authors conducted a study to evaluate the effectiveness of the muscle relaxant cyclobenzaprine when used as a supplement to cryotherapeutic, antibiotic and steroidal anti-inflammatory treatment with the aim of reducing undesirable consequences after third-molar extraction. The authors conducted a prospective, randomized, double-masked, placebo-controlled clinical trial involving 50 participants aged 18 to 29 years randomly assigned to receive cyclobenzaprine or the placebo. The authors used a split-mouth design, so each participant acted as his or her own control. For each participant, the authors extracted one impacted mandibular third molar on each side of the mouth at different times. Participants received 10 milligrams of cyclobenzaprine or a placebo once per day the day before surgery, the day of surgery and the first day after surgery. The authors assessed the participants' postoperative pain by means of a visual analog scale at four, six, eight, 12, 24 and 48 hours. They measured the participants' swelling and maximal interincisor distance at 48 hours and seven days. The authors assessed both sides of each participant's mouth for differences in pain, swelling and trismus. They found no statistically significant differences between sides of the mouth regarding these three variables. The results of this trial indicate that the influence of cyclobenzaprine over pain, swelling and trismus does not justify prescribing additional medication for patients undergoing third-molar extraction. The muscle relaxant cyclobenzaprine was ineffective in reducing pain, swelling and trismus after third-molar extraction.

Photodynamic therapy associated with full-mouth ultrasonic debridement in the treatment of severe chronic periodontitis: a randomized-controlled clinical trial

PubMed Central

BALATA, Maybel Lages; de ANDRADE, Lyla Prates; SANTOS, David Barros Nunes; CAVALCANTI, Andrea Nóbrega; TUNES, Urbino da Rocha; RIBEIRO, Érica Del Peloso; BITTENCOURT, Sandro

2013-01-01

Background: Photodynamic therapy (PDT) is a method of microbial reduction which can benefit periodontal treatment in areas of difficult access, such as deep pockets and furcations. The aim of this randomized controlled clinical trial was to evaluate the effects of PDT as an adjunct to full-mouth ultrasonic debridement in the treatment of severe chronic periodontitis. Material and Methods: Twenty-two patients with at least one pocket with a probing depth (PD) of ≥7 mm and one pocket with a PD of ≥5 mm and bleeding on probing (BOP) on each side of the mouth were included, characterizing a split mouth design. The control group underwent full-mouth ultrasonic debridement and the test group received the same treatment associated with PDT. The PDT was performed on only one side of the mouth and the initial step consisted of subgingival irrigation with 0.005% methylene blue dye. Two minutes after applying the photosensitizer, the low power laser - AsGaAl (Photon Lase III - PL7336, DMC, São Carlos -São Paulo, Brazil) was applied (660 nm, 100 mW, 9 J, 90 seconds per site, 320 J/cm2, diameter tip 600 µm).The following clinical parameters were evaluated: plaque index, gingival index, BOP, gingival recession (GR), PD, and clinical attachment level (CAL). All parameters were collected before, 1, 3 and 6 months after treatment. Results: An improvement in BOP, PD and CAL was observed after treatment, in both groups, but without any difference between them. After 6 months, the PD decreased from 5.11±0.56 mm to 2.83±0.47 mm in the test group (p<0.05) and from 5.15±0.46 mm to 2.83±0.40 mm in the control group (p<0.05). The CAL changed, after 6 months, from 5.49±0.76 mm to 3.41±0.84 mm in the test group (p<0.05) and from 5.53±0.54 to 3.39±0.51 mm in the control group (p<0.05). Conclusion: Both approaches resulted in significant clinical improvements in the treatment of severe chronic periodontits, however, the PDT did not provide any additional benefit to those obtained with full-mouth ultrasonic debridement used alone. PMID:23739857

Effect of chlorhexidine varnish on gingival growth in orthodontic patients: a randomized prospective split-mouth study.

PubMed

Pretti, Henrique; Barbosa, Gabriella Lopes de Rezende; Lages, Elizabeth Maria Bastos; Gala-García, Alfonso; Magalhães, Claudia Silami de; Moreira, Allyson Nogueira

2015-10-01

Fixed orthodontic appliances patients suffer limitations on the effective control of biofilm by mechanical methods, bringing the need of a coadjutant in the control of inflammation and oral health improvement. The aim of this prospective split-mouth blind study was to analyze the effect of a 40% chlorhexidine (CHX) varnish on gingival growth of patients with orthodontic fixed appliances. Healthy teenage patients with fixed orthodontic appliances and increased gingival volume were recruited (n = 30). Each individual was his own control, having in the maxilla one control side and one treatment side. An application of varnishes occurred on the vestibular area of the upper premolars and first molar crowns, on the control side (placebo varnish) and on the experimental side (EC40(r) Biodentic CHX varnish). The varnishes and sides were randomly chosen and its identification and group was kept by a third party observer and it was not revealed to the researchers and participants until the end of study. In order to establish a baseline registration, digital photographs were taken by a trained photographer before varnish application at baseline (T0), as well as 14 days (T14) and 56 days (T56) after the application. The gingival volume was calculated indirectly using the vestibular areas (mm2) of the upper second premolars' clinical crowns by RapidSketch(r) software, at all study times. The data were analyzed using ANOVA and the Turkey-Krammer test. It was observed, in the final sample of 30 individuals, that at T0, the control and treatment groups were similar. At T14 and T56, a progressive reduction of the clinical crown area was seen in the control group, and an increase in the average area was detected in the experimental group (p < 0,05). The use of 40% CHX varnish decreases the gingival overgrowth in patients undergoing orthodontic treatment. Further studies are necessary to set the action time and frequency of application.

Effect of chlorhexidine varnish on gingival growth in orthodontic patients: a randomized prospective split-mouth study

PubMed Central

Pretti, Henrique; Barbosa, Gabriella Lopes de Rezende; Lages, Elizabeth Maria Bastos; Gala-García, Alfonso; de Magalhães, Claudia Silami; Moreira, Allyson Nogueira

2015-01-01

Introduction: Fixed orthodontic appliances patients suffer limitations on the effective control of biofilm by mechanical methods, bringing the need of a coadjutant in the control of inflammation and oral health improvement. Objective: The aim of this prospective split-mouth blind study was to analyze the effect of a 40% chlorhexidine (CHX) varnish on gingival growth of patients with orthodontic fixed appliances. Methods: Healthy teenage patients with fixed orthodontic appliances and increased gingival volume were recruited (n = 30). Each individual was his own control, having in the maxilla one control side and one treatment side. An application of varnishes occurred on the vestibular area of the upper premolars and first molar crowns, on the control side (placebo varnish) and on the experimental side (EC40(r) Biodentic CHX varnish). The varnishes and sides were randomly chosen and its identification and group was kept by a third party observer and it was not revealed to the researchers and participants until the end of study. In order to establish a baseline registration, digital photographs were taken by a trained photographer before varnish application at baseline (T0), as well as 14 days (T14) and 56 days (T56) after the application. The gingival volume was calculated indirectly using the vestibular areas (mm2) of the upper second premolars' clinical crowns by RapidSketch(r) software, at all study times. The data were analyzed using ANOVA and the Turkey-Krammer test. Results: It was observed, in the final sample of 30 individuals, that at T0, the control and treatment groups were similar. At T14 and T56, a progressive reduction of the clinical crown area was seen in the control group, and an increase in the average area was detected in the experimental group (p < 0,05). Conclusions: The use of 40% CHX varnish decreases the gingival overgrowth in patients undergoing orthodontic treatment. Further studies are necessary to set the action time and frequency of application. PMID:26560823

Effect of single-dose low-level helium-neon laser irradiation on orthodontic pain: a split-mouth single-blind placebo-controlled randomized clinical trial.

PubMed

Sobouti, Farhad; Khatami, Maziar; Chiniforush, Nasim; Rakhshan, Vahid; Shariati, Mahsa

2015-01-01

Pain is the most common complication of orthodontic treatment. Low-level laser therapy (LLLT) has been suggested as a new analgesic treatment free of the adverse effects of analgesic medications. However, it is not studied thoroughly, and the available studies are quite controversial. Moreover, helium neon (He-Ne) laser has not been assessed before. This split-mouth placebo-controlled randomized clinical trial was performed on 16 male and 14 female orthodontic patients requiring bilateral upper canine retraction. The study was performed at a private clinic in Sari, Iran, in 2014. It was single blind: patients, orthodontist, and personnel were blinded of the allocations, but the laser operator (periodontist) was not blinded. Once canine retractor was activated, a randomly selected maxillary quarter received a single dose of He-Ne laser irradiation (632.8 nm, 10 mw, 6 j/cm(2) density). The other quarter served as the placebo side, treated by the same device but powered off. In the first, second, fourth, and seventh days, blinded patients rated their pain sensed on each side at home using visual analog scale (VAS) questionnaires. There was no harm identified during or after the study. Pain changes were analyzed using two- and one-way repeated-measures ANOVA, Bonferroni, and t-test (α = 0.01, β > 0.99). This trial was not registered. It was self-funded by the authors. Sixteen males and 11 females remained in the study (aged 12-21). Average pain scores sensed in all 4 intervals on control and laser sides were 4.06 ± 2.85 and 2.35 ± 1.77, respectively (t-test P < 0.0001). One-way ANOVA showed significant pain declines over time, in each group (P < 0.0001). Two-way ANOVA showed significant effects for LLLT (P < 0.0001) and time (P = <0.0001). Single-dose He-Ne laser therapy might reduce orthodontic pain caused by retracting maxillary canines.

Lack of adjunctive benefit of Er:YAG laser in non-surgical periodontal treatment: a randomized split-mouth clinical trial.

PubMed

Rotundo, Roberto; Nieri, Michele; Cairo, Francesco; Franceschi, Debora; Mervelt, Jana; Bonaccini, Daniele; Esposito, Marco; Pini-Prato, Giovanpaolo

2010-06-01

This split-mouth, randomized, clinical trial aimed to evaluate the efficacy of erbium-doped:yttrium-aluminium-garnet (Er:YAG) laser application in non-surgical periodontal treatment. A total of 27 patients underwent four modalities of non-surgical therapy: supragingival debridement; scaling and root planing (SRP)+Er:YAG laser; Er:YAG laser; and SRP. Each strategy was randomly assigned and performed in one of the four quadrants. Clinical outcomes were evaluated at 3 and 6 months. Subjective benefits of patients have been evaluated by means of questionnaires. Six months after therapy, Er:YAG laser showed no statistical difference in clinical attachment gain with respect to supragingival scaling [0.15 mm (95% CI -0.16; 0.46)], while SRP showed a greater attachment gain than the supragingival scaling [0.37 mm (95% CI 0.05; 0.68)]. No difference resulted between Er:YAG laser+SRP and SRP alone [0.05 mm (95% CI -0.25; 0.36)]. The adjunctive use of Er:YAG laser to conventional SRP did not reveal a more effective result than SRP alone. Furthermore, the sites treated with Er:YAG laser showed similar results of the sites treated with supragingival scaling.

Effectiveness of erythrosine-mediated photodynamic antimicrobial chemotherapy on dental plaque aerobic microorganisms: A randomized controlled trial.

PubMed

Bhat, Manohar; Acharya, Swathi; Prasad, Kakarla Veera Venkata; Kulkarni, Raghavendra; Bhat, Anithraj; Bhat, Devikripa

2017-01-01

Dental plaque is one of the predominant causes of major oral diseases. Although mechanical and chemical methods are extensively followed to control the development of plaque, plaque-related diseases still persist. Therefore, this necessitates for alternative measures of plaque control, one such alternative is photodynamic antimicrobial chemotherapy (PACT). Split mouth randomized clinical trial (CTRI/2017/03/008239) was conducted on 30 participants who reported to the hospital. Participants were asked to rinse their mouth for 1 min using 10 ml of 25 μM erythrosine solutions. Same tooth on both quadrants of the same jaw are selected as the test and control. Intervention used was halogen-based composite curing light with wavelength of 500-590 nm. Plaque sample from the control tooth and test tooth was collected before and after exposure, respectively, and sent to microbiological laboratory for colony count. Logarithmic mean and standard deviation of control group with 10 2 dilutions of aerobic microbial count were found to be 5.34 ± 0.94, and for experimental group, it was 4.47 ± 1.37. The statistical difference between mean CFU values between aerobic bacterial counts was significant ( P = 0.006). Erythrosine-mediated PACT reduces the extent of dental plaque microbial count and has a potential preventive and therapeutic use in day-to-day life and dental clinics.

Biomechanical comparison of a novel engine-driven ridge spreader and conventional ridge splitting techniques.

PubMed

Jung, Gyu-Un; Kim, Jun Hwan; Lim, Nam Hun; Yoon, Gil Ho; Han, Ji-Young

2017-06-01

Ridge splitting techniques are used for horizontal ridge augmentation in implant dentistry. Recently, a novel engine-driven ridge splitting technique was introduced. This study compared the mechanical forces produced by conventional and engine-driven ridge splitting techniques in porcine mandibles. In 33 pigs, mandibular premolar areas were selected for the ridge splitting procedures, designed as a randomized split-mouth study. The conventional group underwent a chisel-and-mallet procedure (control group, n = 20), and percussive impulse (Newton second, Ns) was measured using a sensor attached to the mallet. In the engine-driven ridge spreader group (test group, n = 23), a load cell was used to measure torque values (Newton centimeter, Ncm). Horizontal acceleration generated during procedures (control group, n = 10 and test group, n = 10) was compared between the groups. After ridge splitting, the alveolar crest width was significantly increased both in the control (1.23 ± 0.45 mm) and test (0.98 ± 0.41 mm) groups with no significant differences between the groups. The average impulse of the control group was 4.74 ± 1.05 Ns. Torque generated by rotation in the test group was 9.07 ± 2.15 Ncm. Horizontal acceleration was significantly less in the test group (0.82 ± 1.05 g) than the control group (64.07 ± 42.62 g) (P < 0.001). Narrow edentulous ridges can be expanded by novel engine-driven ridge spreaders. Within the limits of this study, the results suggested that an engine-driven ridge splitting technique may be less traumatic and less invasive than a conventional ridge splitting technique. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The use of leucocyte and platelet-rich fibrin in socket management and ridge preservation: a split-mouth, randomized, controlled clinical trial.

PubMed

Temmerman, Andy; Vandessel, Jeroen; Castro, Ana; Jacobs, Reinhilde; Teughels, Wim; Pinto, Nelson; Quirynen, Marc

2016-11-01

To investigate the influence of the use L-PRF as a socket filling material and its ridge preservation properties. Twenty-two patients in need of single bilateral and closely symmetrical tooth extractions in the maxilla or mandible were included in a split-mouth RCT. Treatments were randomly assigned (L-PRF socket filling versus natural healing). CBCT scans were obtained after tooth extraction and three months. Scans were evaluated by superimposition using the original DICOM data. Mean ridge width differences between timepoints were measured at three levels below the crest on both the buccal and lingual sides (crest -1 mm (primary outcome variable), -3 mm and -5 mm). Mean vertical height changes at the buccal were -1.5 mm (±1.3) for control sites and 0.5 mm (±2.3) for test sites (p < 0.005). At the buccal side, control sites values were, respectively, -2.1 (±2.5), -0.3 mm (±0.3) (p < 0.005) and -0.1 mm (±0.0), and test sites values were, respectively, -0.6 mm (±2.2) (p < 0.005), -0.1 mm (±0.3) and 0.0 mm (±0.1). Significant differences (p < 0.005) were found for total width reduction between test (-22.84%) and control sites (-51.92%) at 1 mm below crest level. Significant differences were found for socket fill (visible mineralized bone) between test (94.7%) and control sites (63.3%). The use of L-PRF as a socket filling material to achieve preservation of horizontal and vertical ridge dimension at three  months after tooth extraction is beneficial. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Dexamethasone injection into the pterygomandibular space in lower third molar surgery.

PubMed

Boonsiriseth, K; Latt, M M; Kiattavorncharoen, S; Pairuchvej, V; Wongsirichat, N

2017-07-01

The objective of this study was to evaluate the effects of 8mg dexamethasone injection into the pterygomandibular space on the postoperative sequelae of lower third molar surgery. A prospective, randomized, controlled, split-mouth study was designed involving 62 lower third molar extractions (31 patients). Prior to surgery, the study group received 2ml of 4mg/ml (8mg) dexamethasone injection through the pterygomandibular space following local anaesthesia; the control group received 2ml normal saline injection. Facial swelling, mouth opening, pain on a visual analogue scale (VAS), and the number of analgesics consumed were assessed. Descriptive statistics and the independent-samples t-test were used to compare the two groups at P<0.05. There was a significant reduction in swelling on day 2 postoperative in the dexamethasone group. Mouth opening was also significantly greater on day 2 in the dexamethasone group. The VAS pain score was significantly lower on the day of the operation and first postoperative day in the dexamethasone group, but did not differ significantly between the groups on the other postoperative days. The injection of 8mg dexamethasone into the pterygomandibular space was effective in reducing postoperative swelling, limited mouth opening, and pain following impacted lower third molar extraction. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Influence of Leukocyte- and Platelet-Rich Fibrin (L-PRF) in the Healing of Simple Postextraction Sockets: A Split-Mouth Study.

PubMed

Marenzi, Gaetano; Riccitiello, Francesco; Tia, Mariano; di Lauro, Alessandro; Sammartino, Gilberto

2015-01-01

The aim of this study was to evaluate the effects of leukocyte- and platelet-rich fibrin (L-PRF) on the pain and soft tissue healing after tooth extractions. Twenty-six patients (9 males and 17 females) were treated with multiple extractions (2 to 8), with a total of 108 extractions. This was an exploratory single blinded randomized clinical trial with a split-mouth design. The pain after the surgery was assessed in each patient by the VAS scale (1 to 10) at intervals of 24-48-72-96 hours. The soft tissue healing was clinically evaluated at 3, 7, 14, and 21 days after surgery by the same examiner surgeon, using the modified Healing Index (4 to 12). The mean value of postextraction pain was 3.2 ± 0.3 in the experimental sides and 4.1 ± 0.1 in the control sides. After 7 days from the extractions, the values of modified Healing Index in the experimental and control groups were, respectively, 4.8 ± 0.6 and 5.1 ± 0.9. The use of L-PRF in postextraction sockets filling can be proposed as a useful procedure in order to manage the postoperative pain and to promote the soft tissue healing process, reducing the early adverse effects of the inflammation.

Influence of Leukocyte- and Platelet-Rich Fibrin (L-PRF) in the Healing of Simple Postextraction Sockets: A Split-Mouth Study

PubMed Central

Riccitiello, Francesco; Tia, Mariano; di Lauro, Alessandro; Sammartino, Gilberto

2015-01-01

The aim of this study was to evaluate the effects of leukocyte- and platelet-rich fibrin (L-PRF) on the pain and soft tissue healing after tooth extractions. Twenty-six patients (9 males and 17 females) were treated with multiple extractions (2 to 8), with a total of 108 extractions. This was an exploratory single blinded randomized clinical trial with a split-mouth design. The pain after the surgery was assessed in each patient by the VAS scale (1 to 10) at intervals of 24-48-72-96 hours. The soft tissue healing was clinically evaluated at 3, 7, 14, and 21 days after surgery by the same examiner surgeon, using the modified Healing Index (4 to 12). The mean value of postextraction pain was 3.2 ± 0.3 in the experimental sides and 4.1 ± 0.1 in the control sides. After 7 days from the extractions, the values of modified Healing Index in the experimental and control groups were, respectively, 4.8 ± 0.6 and 5.1 ± 0.9. The use of L-PRF in postextraction sockets filling can be proposed as a useful procedure in order to manage the postoperative pain and to promote the soft tissue healing process, reducing the early adverse effects of the inflammation. PMID:26273612

Effects of platelet-rich fibrin on healing of intra-bony defects treated with anorganic bovine bone mineral.

PubMed

Sezgin, Yasemin; Uraz, Ahu; Taner, I Levent; Çulhaoğlu, Rana

2017-01-26

Anorganic bovine bone mineral (ABBM) is extensively used in the treatment of intra-bony defects. Platelet-rich fibrin (PRF) is a new-generation platelet concentrate with a simplified technique. Although certain studies have reported the use of PRF in the treatment of intra-bony defects, to date, none of them have evaluated its additive effects with ABBM. Therefore, a randomised, split-mouth clinical trial was conducted to compare healing of intra-bony defects treated with an ABBM-PRF combination with healing of those treated with ABBM alone. By using a split-mouth design, 15 paired intra-bony defects were randomly treated with either ABBM alone (control group) or ABBM-PRF combination (test group). Following clinical parameters and radiographical measurements were recorded at baseline and 6 months after treatment: plaque index (PI), gingival index (GI), probing depth (PD), gingival recession (GR), clinical attachment level (CAL), vertical bone loss, depth of defect and defect angle. Preoperative clinical and radiographical measurements were similar for the test and control groups. Statistically significant reductions in GI, PD, CAL, vertical bone loss, depth of intra-bony defect and widening of defect angle were detected after treatment in both groups. With respect to inter-group analysis, gain in CAL was significantly greater in the test group than in the control group, whereas no inter-group differences were observed in any other parameter. The results of this study indicate that both therapies are effective in the treatment of intra-bony defects.

MicroSaw and Piezosurgery in Harvesting Mandibular Bone Blocks from the Retromolar Region: A Randomized Split-Mouth Prospective Clinical Trial.

PubMed

Hanser, Thomas; Doliveux, Romain

The aim of this randomized prospective split-mouth clinical trial was to evaluate the outcome of bone block harvesting from the retromolar region using the MicroSaw and Piezosurgery. Fifty-three patients for extensive bilateral bone grafting procedures with or without concomitant implant placement in the maxilla and/or mandible were scheduled. In each patient, bone blocks were harvested in the retromolar area within the external oblique ridge of the mandible. Using a randomized protocol, bone blocks were harvested with the MicroSaw and Piezosurgery either from the right or the left side. Clinical outcome parameters were the comparison of osteotomy time; volume of block graft; and clinical determination of intraoperative complications such as hemorrhage, nerve injury, pain, swelling, and healing of the donor site. The mean osteotomy time for harvesting including luxating a bone block was 5.63 (± 1.37) minutes using the MicroSaw and 16.47 (± 2.74) minutes using Piezosurgery (P < .05). A mean graft volume of 1.62 (± 0.27) cm 3 was measured with the MicroSaw and 1.26 (± 0.27) cm 3 with the piezoelectric surgical device (P < .05). No heavy bleeding at the donor site occurred in any of the cases. Complications due to injury of adjacent teeth or nerve lesion of the mandibular nerve were not observed in any cases. According to a scale, there was little postoperative pain with both instruments, and it decreased within 14 days postoperatively (P > .05). Swelling did not appear significantly different either (P > .05), and none of the donor sites showed primary healing complications. The data described in this randomized prospective split-mouth clinical trial indicate that the MicroSaw and Piezosurgery allowed efficient and safe bone block harvesting from the external oblique ridge. Clinically, concerning harvesting time and volume of the grafts, the MicroSaw performed significantly better, whereas pain, swelling, and healing did not appear to be considerably different. Given the improved visibility, precise cut geometries, and the margin of safety afforded by the MicroSaw and Piezosurgery, they are both instruments of choice when harvesting bone from the retromolar area.

Comparison of applying particulate demineralized bone matrix (DBM), putty DBM and open flap debridement in periodontal horizontal bone defects. A 12-month longitudinal, multi-centre, triple-blind, split-mouth, randomized, controlled clinical study. Part 2 - evaluation of the interdental soft tissue.

PubMed

Kaya, Y; Yalim, M; Bahçecitapar, M; Baloş, K

2009-07-01

To date, there have been many studies clinically evaluating periodontal regenerative procedures by the help of routinely used hard and soft tissue parameters; however, these parameters are not capable of assessing interdental soft tissue located above the regenerative periodontal surgery area. The purpose of this study was to assess interproximal soft tissue changes following application of (i) particulate form demineralized bone matrix (DBM), (ii) putty form DBM and (ii) open flap debridement (OFD, control), using modified curtain technique in the treatment of interproximal suprabony (horizontal) defects located in anterior maxillary region, as previously reported. Twenty-five chronic periodontitis patients with 125 interproximal surgery sites (radiologically >or=4 mm horizontal bone defect) were also participate in this second stage of the triple-blind, split mouth, randomized, controlled clinical trial. Surgery sites were assessed by (i) plaque index (PI), (ii) gingival index (GI), (iii) the presence of interdental soft tissue clefts or craters and (iv) the loss of interdental papilla height by using papilla presence index (PPI), during the healing period. At the baseline and 3, 6, 9 and 12 months after the operations, these measurements were repeated. In all groups, there is a significant increase in the prevalence of soft tissue cleft and crater formation (P < 0.01), with increase in PI and GI scores at interdental soft tissue defect areas (P < 0.001), 3 months after the operations. There was also an increase in PPI scores after the operations in all treatment groups (P < 0.01). Three procedures affected the interproximal soft tissues similarly. There was no significant difference among groups in terms of all parameters (P > 0.05). Particulate DBM, putty DBM and OFD demostrated similar interproximal soft tissue changes especially increasing interproximal PI and GI scores in 3 months follow-up.

Does Topical Ozone Therapy Improve Patient Comfort After Surgical Removal of Impacted Mandibular Third Molar? A Randomized Controlled Trial.

PubMed

Sivalingam, Varun P; Panneerselvam, Elavenil; Raja, Krishnakumar V B; Gopi, Gayathri

2017-01-01

To assess the influence of topical ozone administration on patient comfort after third molar surgery. A single-blinded randomized controlled clinical trial was designed involving patients who required removal of bilateral impacted mandibular third molars. The predictor variable was the postoperative medication used after third molar surgery. Using the split-mouth design, the study group received topical ozone without postoperative systemic antibiotics, whereas the control group did not receive ozone but only systemic antibiotics. The 2 groups were prescribed analgesics for 2 days. The assessing surgeon was blinded to treatment assignment. The primary outcome variables were postoperative mouth opening, pain, and swelling. The secondary outcome variable was the number of analgesic doses required by each group on postoperative days 3 to 5. Data analysis involved descriptive statistics, paired t tests, and 2-way analysis of variance with repeated measures (P < .05). SPSS 20.0 was used for data analysis. The study sample included 33 patients (n = 33 in each group). The study group showed statistically relevant decreases in postoperative pain, swelling, and trismus. Further, the number of analgesics required was smaller than in the control group. No adverse effects of ozone gel were observed in any patient. Ozone gel was found to be an effective topical agent that considerably improves patient comfort postoperatively and can be considered a substitute of postoperative systemic antibiotics. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Efficacy of resin infiltration of proximal caries in primary molars: 1-year follow-up of a split-mouth randomized controlled clinical trial.

PubMed

Ammari, Michelle Mikhael; Jorge, R C; Souza, I P R; Soviero, V M

2018-04-01

The main purpose of this split month, randomized, controlled clinical trial was evaluate the efficacy of caries infiltration in controlling the progression of non-cavitated proximal lesions in primary molars. Anxiety and time required for the caries infiltration was also evaluated. Fifty healthy children, 5 to 9 years, presenting two primary molars with proximal caries lesions (1/2 of the enamel or outer 1/3 of dentin), were included. Lesions were randomly allocated to the test group (fluoridated toothpaste + flossing + infiltration) or to the control group (fluoridated toothpaste + flossing). Caries risk was based on the Cariogram model. The main outcome after 1-year radiographic follow up was assessed by an independent blinded examiner A facial image scale (FIS) was applied to assess dental anxiety and time required to perform the infiltration was recorded. Of the sample, 92.9% corresponded to high or medium caries risk. In 42 patients (1-year follow up), caries progression was observed in 11.9% (5/42) of the test lesions compared with 33.3% (14/42) of the control lesions (p < 0.05). Five control and three test lesions progressed to the middle 1/3 of dentin and were restored. No side effects were observed. Anxiety was both low before and after the treatment, and mean time required for the infiltration was 11.29 min (± 1.16 min). Caries infiltration of proximal caries lesions in primary molars is significantly more efficacious than standard therapy alone (fluoride toothpaste + flossing). Caries infiltration is an applicable and well-accepted method be used in children, representing a promising micro-invasive approach.

Comparative evaluation of photoablative efficacy of erbium: yttrium-aluminium-garnet and diode laser for the treatment of gingival hyperpigmentation. A randomized split-mouth clinical trial.

PubMed

Giannelli, Marco; Formigli, Lucia; Bani, Daniele

2014-04-01

The use of lasers in periodontology is a matter of debate, mainly because of the lack of consensual therapeutic protocols. In this randomized, split-mouth trial, the clinical efficacy of two different photoablative dental lasers, erbium:yttrium-aluminum-garnet (Er:YAG) and diode, for the treatment of gingival hyperpigmentation is compared. Twenty-one patients requiring treatment for mild-to-severe gingival hyperpigmentation were enrolled. Maxillary or mandibular left or right quadrants were randomly subjected to photoablative deepithelialization with either Er:YAG or diode laser. Masked clinical assessments of each laser quadrant were made at admission and days 7, 30, and 180 postoperatively by an independent observer. Histologic examination was performed before and soon after treatment and 6 months after irradiation. Patients also compiled a subjective evaluation questionnaire. Both diode and Er:YAG lasers gave excellent results in gingival hyperpigmentation. However, Er:YAG laser induced deeper gingival tissue injury than diode laser, as judged by bleeding at surgery, delayed healing, and histopathologic analysis. The use of diode laser showed additional advantages compared to Er:YAG in terms of less postoperative discomfort and pain. This study highlights the efficacy of diode laser for photoablative deepithelialization of hyperpigmented gingiva. It is suggested that this laser can represent an effective and safe therapeutic option for gingival photoablation.

Increase in Periodontal Interleukin-1β Gene Expression Following Osseous Resective Surgery Using Conventional Rotary Instruments Compared with Piezosurgery: A Split-Mouth Randomized Clinical Trial.

PubMed

Aimetti, Mario; Ferrarotti, Francesco; Bergandi, Loredana; Saksing, Laura; Parducci, Francesca; Romano, Federica

2016-01-01

The purpose of this study was to evaluate the early inflammatory response following osseous resective surgery (ORS) with Piezosurgery compared to commonly used diamond burs. A sample was selected of 24 bilateral posterior sextants requiring ORS in 12 chronic periodontitis patients in a split-mouth design. In 12 sextants, bone recontouring was performed using a piezoelectric device. In the contralateral sextants, rotary instruments were used. Sextants treated with Piezosurgery obtained similar 12-month clinical results but lower postsurgical gene expression of interleukin-1β (IL-1β), a well-known proinflammatory cytokine, and lower patient morbidity compared with sextants treated with rotary instruments. In spite of the longer surgical time, the use of Piezosurgery for ORS seems to promote more favorable wound healing compared with rotary instruments, as the lower pain and the low levels of IL-1β mRNA at the surgical sites suggest a milder underlying inflammatory response.

Evaluation of Turmeric Chip Compared with Chlorhexidine Chip as a Local Drug Delivery Agent in the Treatment of Chronic Periodontitis: A Split Mouth Randomized Controlled Clinical Trial.

PubMed

Singh, Abhilasha; Sridhar, Raja; Shrihatti, Ravi; Mandloy, Akash

2018-01-01

The aim of this study was to evaluate and compare the effect of chlorhexidine (CHX) chip and turmeric chip as a local drug delivery (LDD) agent in the treatment of patients with chronic periodontitis. A total of 120 sites with pocket depths 5-8 mm were chosen as a split mouth design at 3 sites in the same patient. Selected sites were randomly divided into three groups to receive CHX chip in addition to scaling and root planing (SRP) in group A, turmeric chip in addition to SRP in group B, and SRP only in group C. Clinical parameters, that is, plaque index (PI), gingival index (GI), probing pocket depth (PPD), and relative attachment level (RAL) were recorded at baseline, 1 month, and 3 months interval. On applying statistical analysis, results revealed that there was a significant reduction in all the clinical parameters, that is, PI, GI, PPD, and gain in RAL from baseline to 1 month and 3 months in all the three groups. These results were found to be significantly high in the CHX group and turmeric group than in the SRP group. Also, the results in both the test groups were maintained till the end of the study periods, but SRP group showed a significant deterioration after 1 month as was seen by increase in PPD and decrease in RAL scores after 3 months in the SRP group. Both the treatment modalities with the application of LDD as an adjunct to SRP proved to be equally beneficial in the treatment of chronic periodontitis.

The clinical evaluation of platelet-rich plasma on free gingival graft's donor site wound healing.

PubMed

Samani, Mahmoud Khosravi; Saberi, Bardia Vadiati; Ali Tabatabaei, S M; Moghadam, Mahdjoube Goldani

2017-01-01

It has been proved that platelet-rich plasma (PRP) can promote wound healing. In this way, PRP can be advantageous in periodontal plastic surgeries, free gingival graft (FGG) being one such surgery. In this randomized split-mouth controlled trial, 10 patients who needed bilateral FGG were selected, and two donor sites were randomly assigned to experience either natural healing or healing-assisted with PRP. The outcome was assessed based on the comparison of the extent of wound closure, Manchester scale, Landry healing scale, visual analog scale, and tissue thickness between the study groups at different time intervals. Repeated measurements of analysis of variance and paired t -test were used. Statistical significance was P ≤ 0.05. Significant differences between the study groups and also across different time intervals were seen in all parameters except for the changes in tissue thickness. PRP accelerates the healing process of wounds and reduces the healing time.

Comparison of Piezosurgery and Conventional Rotary Instruments for Removal of Impacted Mandibular Third Molars: A Randomized Controlled Clinical and Radiographic Trial

PubMed Central

Shokry, Mohamed; Aboelsaad, Nayer

2016-01-01

The purpose of this study was to test the effect of the surgical removal of impacted mandibular third molars using piezosurgery versus the conventional surgical technique on postoperative sequelae and bone healing. Material and Methods. This study was carried out as a randomized controlled clinical trial: split mouth design. Twenty patients with bilateral mandibular third molar mesioangular impaction class II position B indicated for surgical extraction were treated randomly using either the piezosurgery or the conventional bur technique on each site. Duration of the procedure, postoperative edema, trismus, pain, healing, and bone density and quantity were evaluated up to 6 months postoperatively. Results. Test and control sites were compared using paired t-test. There was statistical significance in reduction of pain and swelling in test sites, where the time of the procedure was statistically increased in test site. For bone quantity and quality, statistical difference was found where test site showed better results. Conclusion. Piezosurgery technique improves quality of patient's life in form of decrease of postoperative pain, trismus, and swelling. Furthermore, it enhances bone quality within the extraction socket and bone quantity along the distal aspect of the mandibular second molar. PMID:27597866

Clinical Comparison of At-Home and In-Office Dental Bleaching Procedures: A Randomized Trial of a Split-Mouth Design.

PubMed

Machado, Lucas Silveira; Anchieta, Rodolfo Bruniera; dos Santos, Paulo Henrique; Briso, André Luiz; Tovar, Nick; Janal, Malvin N; Coelho, Paulo Guilherme; Sundfeld, Renato Herman

2016-01-01

The objective of this split-mouth clinical study was to compare a combination of in-office and at-home dental bleaching with at-home bleaching alone. Two applications of in-office bleaching were performed, with one appointment per week, using 38% hydrogen peroxide. At-home bleaching was performed with or without in-office bleaching using 10% carbamide peroxide in a custom-made tray every night for 2 weeks. The factor studied was the bleaching technique on two levels: Technique 1 (in-office bleaching combined with home bleaching) and Technique 2 (home bleaching only). The response variables were color change, dental sensitivity, morphology, and surface roughness. The maxillary right and left hemiarches of the participants were submitted to in-office placebo treatment and in-office bleaching, respectively (Phase 1), and at-home bleaching (Phase 2) treatment was performed on both hemiarches, characterizing a split-mouth design. Enamel surface changes and roughness were analyzed with scanning electron microscopy and optical interferometry using epoxy replicas. No statistically significant differences were observed between the bleaching techniques for either the visual or the digital analyses. There was a significant difference in dental sensitivity when both dental bleaching techniques were used, with in-office bleaching producing the highest levels of dental sensitivity after the baseline. Microscopic analysis of the morphology and roughness of the enamel surface showed no significant changes between the bleaching techniques. The two techniques produced similar results in color change, and the combination technique produced the highest levels of sensitivity. Neither technique promoted changes in morphology or surface roughness of enamel.

A split-mouth randomized clinical trial to evaluate the performance of piezosurgery compared with traditional technique in lower wisdom tooth removal.

PubMed

Mantovani, Edoardo; Arduino, Paolo Giacomo; Schierano, Gianmario; Ferrero, Luca; Gallesio, Giorgia; Mozzati, Marco; Russo, Andrea; Scully, Crispian; Carossa, Stefano

2014-10-01

The surgical removal of mandibular third molars is frequently accompanied by significant postsurgical sequelae, and different protocols have been described to decrease such adverse events. The aim of this study was to investigate the performance of piezosurgery compared with traditional rotating instruments during mandibular third molar removal. A single-center, randomized, split-mouth study was performed using a consecutive series of unrelated healthy patients attending the Oral Surgery Unit of the University of Turin for surgical removal of bilateral mandibular third molar teeth. Each patient was treated, at the same appointment, using bur removal on 1 side of the mandible and a piezoelectric device on the contralateral side. The primary outcomes reported were postoperative pain, objective orofacial swelling, and surgical duration; secondary outcomes were gender, age, and possible adverse events. Analysis of variance or paired t test was used as appropriate to test any significant differences at baseline according to each treatment subgroup, and categorical variables were analyzed by χ(2) test. The study sample consisted of 100 otherwise healthy patients. The mean pain evaluation reported by patients who underwent surgery with piezosurgery was significantly lower than that reported after bur (conventional) removal, reaching statistical difference after 4 days (P = .043). The clinical value of orofacial swelling at day 7, normalized to baseline, was lower in the piezosurgery group (P < .005). The average surgical duration was significantly shorter in the bur group than in the piezosurgery group (P < .05). Three patients having bur removal developed short-term complications (2 dry sockets and 1 temporary paraesthesia), which totally resolved by 4 weeks. To date, this prospective investigation is the largest reported split-mouth study on piezosurgery for lower third molar tooth removal. This study also compared surgeons with different degrees of experience. It is evident that using a piezoelectric device can enhance the patient experience and decrease postoperative pain and swelling. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Platelet rich fibrin combined with decalcified freeze-dried bone allograft for the treatment of human intrabony periodontal defects: a randomized split mouth clinical trail.

PubMed

Agarwal, Ashish; Gupta, Narinder Dev; Jain, Avikal

2016-01-01

Polypeptide growth factors of platelet rich fibrin (PRF) have the potential to regenerate periodontal tissues. Osteoinductive property of demineralized freeze-dried bone allograft (DFDBA) has been successfully utilized in periodontal regeneration. The aim of the present randomized, split mouth, clinical trial was to determine the additive effects of PRF with a DFDBA in the treatment of human intrabony periodontal defects. Sixty interproximal infrabony defects in 30 healthy, non-smoker patients diagnosed with chronic periodontitis were randomly assigned to PRF/DFDBA group or the DFDBA/saline. Clinical [pocket depth (PD), clinical attachment level (CAL) and gingival recession (REC)] and radiographic (bone fill, defect resolution and alveolar crest resorption) measurements were made at baseline and at a 12-month evaluation. Compared with baseline, 12-month results indicated that both treatment modalities resulted in significant changes in all clinical and radiographic parameters. However, the PRP/DFDBA group exhibited statistically significantly greater changes compared with the DFDBA/saline group in PD (4.15 ± 0.84 vs 3.60 ± 0.51 mm), CAL (3.73 ± 0.74 vs 2.61 ± 0.68 mm), REC (0.47 ± 0.56 vs 1.00 ± 0.61 mm), bone fill (3.50 ± 0.67 vs 2.49 ± 0.64 mm) and defect resolution (3.73 ± 0.63 vs 2.75 ± 0.57 mm). Observations indicate that a combination of PRF and DFDBA is more effective than DFDBA with saline for the treatment of infrabony periodontal defects.

[Applicational evaluation of split tooth extractions of upper molars using piezosurgery].

PubMed

Li, D; Guo, C B; Liu, Y; Wang, E B

2016-02-18

To evaluate the efficacy of Piezosurgery in split teeth extractions. A single-center, randomized, split-mouth study was performed using a consecutive serious of unrelated healthy patients attending the departing of oral and maxillofacial surgery, Peking University School and Hospital of Stomatology. 40 patients were selected for extraction of maxillary molars without reservation value,splitting or nonvital teeth. They were divided into control (20 patients) and test groups (20 patients) randomly. Surgical treatments for both groups were under local anesthesia. Molar teeth of control group were extracted by common equipments like dental elevators, chisels, forceps, etc. While molar teeth of experimental group were extracted by Piezosurgery, aided with the use of common equipments if needed. Then we compared the duration of surgery, frequency of the usage of chisels, expansion of postoperative bony socket surgical discomfort and postoperative pain between two groups. The average of operation time was (629.5±171.0) s in control group and (456.0±337.2) s in test group. The buccal alveolar bone reduced (1.07±0.64) mm in control group and (1.49±0.61) mm in test group. There was a significant difference between the two groups (P<0.05). The duration of surgery for experimental group was significantly longer than that of the control group, but the change of buccal alveolar bone was lower than the control group. For visual analogue scale (VAS) value of surgical discomfort, expansion of postoperative bony socket and the operative fear rate, there were no significant difference between the two groups (P>0.05). Piezosugery can be better to preserve alveolar bone, reduce trauma and patient's fear. Application of the piezosugery reflect the characteristics of minimally invasive extraction, which has the value of promotion. The Piezosurgery technique have the advantage of reducing change of buccal alveolar bone during the surgery, but a longer surgical time was required when compared with the conventional technique. VAS value of surgical discomfort, expansion of postoperative bony socket and the operative fear rate, there were no significant difference. Minimally invasive tooth extraction technique has good clinical results and high satisfaction. Piezosurgery proved its worth as the instrument adapted to limiting the destruction of bone tissue.

[Applicational evaluation of split tooth extractions of upper molars using piezosurgery].

PubMed

Li, D; Guo, C B; Liu, Y; Wang, E B

2016-08-18

To evaluate the efficacy of Piezosurgery in split teeth extractions. A single-center, randomized, split-mouth study was performed using a consecutive serious of unrelated healthy patients attending the departing of oral and maxillofacial surgery, Peking University School and Hospital of Stomatology. 40 patients were selected for extraction of maxillary molars without reservation value,splitting or nonvital teeth. They were divided into control (20 patients) and test groups (20 patients) randomly. Surgical treatments for both groups were under local anesthesia. Molar teeth of control group were extracted by common equipments like dental elevators, chisels, forceps, etc. While molar teeth of experimental group were extracted by Piezosurgery, aided with the use of common equipments if needed. Then we compared the duration of surgery, frequency of the usage of chisels, expansion of postoperative bony socket surgical discomfort and postoperative pain between two groups. The average of operation time was (629.5±171.0) s in control group and (456.0±337.2) s in test group. The buccal alveolar bone reduced (1.07±0.64) mm in control group and (1.49±0.61) mm in test group. There was a significant difference between the two groups (P<0.05). The duration of surgery for experimental group was significantly longer than that of the control group, but the change of buccal alveolar bone was lower than the control group. For visual analogue scale (VAS) value of surgical discomfort, expansion of postoperative bony socket and the operative fear rate, there were no significant difference between the two groups (P>0.05). Piezosugery can be better to preserve alveolar bone, reduce trauma and patient's fear. Application of the piezosugery reflect the characteristics of minimally invasive extraction, which has the value of promotion. The Piezosurgery technique have the advantage of reducing change of buccal alveolar bone during the surgery, but a longer surgical time was required when compared with the conventional technique. VAS value of surgical discomfort, expansion of postoperative bony socket and the operative fear rate, there were no significant difference. Minimally invasive tooth extraction technique has good clinical results and high satisfaction. Piezosurgery proved its worth as the instrument adapted to limiting the destruction of bone tissue.

Comparative effect of fluoride, essential oil and chlorhexidine mouth rinses on dental plaque and gingivitis in patients with and without dental caries: a randomized controlled trial.

PubMed

Charugundla, B R; Anjum, S; Mocherla, M

2015-05-01

The objective of this study was to compare the effectiveness of fluoride, essential oil (EO) and chlorhexidine (CHX)-containing mouth rinses on dental plaque and gingivitis and to compare their relative efficacy in patients with and without dental caries. A randomized, controlled, double- blind, crossover clinical trial was conducted for a period of 8 weeks. Thiry-six qualifying subjects, aged 12-44 years, were included in the study. Subjects were divided into caries and caries-free groups and were randomly assigned to one of the following mouth rinse groups: fluoride; EO; CHX and saline as negative control. Subjects used their respective mouth rinse for a period of 7-days each with 1-week wash-out periods. Primary efficacy variables were Quigley-Hein plaque index (PI) and Loe and Silness gingival index. Fluoride and CHX mouth rinses showed significant reduction in plaque after use of mouth rinses (P < 0.05). However, no significant differences were observed with respect to each other in reducing gingivitis (P > 0.05). Further significant differences were found in reducing plaque and gingivitis in caries-free subjects in comparison to those with caries (P < 0.05). All the three mouth rinses significantly reduced plaque accumulation and gingivitis especially in caries-free subjects in comparison to those with caries, and amongst the three, fluoride and CHX proved to be more effective than EO mouth rinse. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Light-activated disinfection using a light-emitting diode lamp in the red spectrum: clinical and microbiological short-term findings on periodontitis patients in maintenance. A randomized controlled split-mouth clinical trial.

PubMed

Mongardini, Claudio; Di Tanna, Gian Luca; Pilloni, Andrea

2014-01-01

Eradication or suppression of pathogens is a major goal in periodontal therapy. Due to the increase in antibiotic resistance, the need of new disinfection therapies is raising. Photodynamic therapy (PDT) has demonstrated anti-infective potential. No data are available on the use of light-emitting diode (LED) lights as the light source in PDT. The aim of this study was to investigate the microbiological and clinical adjunctive outcome of a new photodynamic LED device, compared to scaling and root planing in periodontitis patients in maintenance [supportive periodontal therapy (SPT)]. In this masked, split-mouth design study, 30 treated chronic periodontitis subjects (mean age, 46.2 years; 13 males) in SPT were included. Two residual interdental sites with probing pocket depth (PPD) ≥ 5 mm in two opposite quadrants, with positive bleeding on probing (BOP) and comparable periodontal breakdown, were selected. PPD, BOP and subgingival microbiological samples for real-time PCR analysis (Carpegen® PerioDiagnostics, Carpegen GmbH, Münster, Germany) were recorded at baseline and 1 week after treatment. Scaling and root planing was performed under local anesthesia. Randomly one of the sites was selected to receive adjunctive photodynamic therapy by inserting a photosensitizer (toluidine blue O solution) and exposing it to a LED light in the red spectrum (Fotosan, CMS Dental, Copenhagen, Denmark), according to the manufacturer's instructions. After 1 week, 73 % of the control sites and 27 % of the test sites were still BOP+. These differences compared to baseline values and in-between groups were statistically significantly different (p < 0.001). Mean PPD decreased from 5.47 mm (±0.68) to 4.73 mm (±0.74, p < 0.001) in control sites and from 5.63 mm (±0.85) to 4.43 mm (±1.25, p < 0.001, test vs control p = 0.01) in the test group. Microbiologically, higher reductions of relative proportions of red complex bacteria were observed in test sites (68.1 vs. 4.1 %; p = 0.01). This study showed that adjunctive photodynamic treatment by LED light may enhance short-term clinical and microbiological outcome in periodontitis subjects in SPT.

The use of mucograft collagen matrix to augment the zone of keratinized tissue around teeth: a pilot study.

PubMed

Nevins, Myron; Nevins, Marc L; Kim, Soo-Woo; Schupbach, Peter; Kim, David M

2011-01-01

This prospective split-mouth pilot case series compared the use of a bilayer collagen matrix (CM) to an autogenous gingival graft (AGG) in the ability to increase the zone of keratinized attached gingiva. Five patients with inadequate amounts of keratinized attached gingiva bilaterally in the posterior mandible were enrolled using a split-mouth design. There were statistically significant increases in attached gingiva at all test (CM) and control (AGG) sites. The CM sites at 12 months blended well with surrounding tissues, while the AGG sites were morphologically dissimilar to the adjacent areas. Biopsy results showed intrapatient histologic similarity between CM and AGG treatments, with all sites exhibiting mature connective tissue covered by keratinized epithelium. Thus, the obtained data support further investigations in evaluating the role of CM as a viable alternative to AGG in augmenting areas deficient in keratinized gingiva.

Comparative evaluation of stress levels before, during, and after periodontal surgical procedures with and without nitrous oxide-oxygen inhalation sedation.

PubMed

Sandhu, Gurkirat; Khinda, Paramjit Kaur; Gill, Amarjit Singh; Singh Khinda, Vineet Inder; Baghi, Kamal; Chahal, Gurparkash Singh

2017-01-01

Periodontal surgical procedures produce varying degree of stress in all patients. Nitrous oxide-oxygen inhalation sedation is very effective for adult patients with mild-to-moderate anxiety due to dental procedures and needle phobia. The present study was designed to perform periodontal surgical procedures under nitrous oxide-oxygen inhalation sedation and assess whether this technique actually reduces stress physiologically, in comparison to local anesthesia alone (LA) during lengthy periodontal surgical procedures. This was a randomized, split-mouth, cross-over study. A total of 16 patients were selected for this randomized, split-mouth, cross-over study. One surgical session (SS) was performed under local anesthesia aided by nitrous oxide-oxygen inhalation sedation, and the other SS was performed on the contralateral quadrant under LA. For each session, blood samples to measure and evaluate serum cortisol levels were obtained, and vital parameters including blood pressure, heart rate, respiratory rate, and arterial blood oxygen saturation were monitored before, during, and after periodontal surgical procedures. Paired t -test and repeated measure ANOVA. The findings of the present study revealed a statistically significant decrease in serum cortisol levels, blood pressure and pulse rate and a statistically significant increase in respiratory rate and arterial blood oxygen saturation during periodontal surgical procedures under nitrous oxide inhalation sedation. Nitrous oxide-oxygen inhalation sedation for periodontal surgical procedures is capable of reducing stress physiologically, in comparison to LA during lengthy periodontal surgical procedures.

Statistical Approaches to Adjusting Weights for Dependent Arms in Network Meta-analysis.

PubMed

Su, Yu-Xuan; Tu, Yu-Kang

2018-05-22

Network meta-analysis compares multiple treatments in terms of their efficacy and harm by including evidence from randomized controlled trials. Most clinical trials use parallel design, where patients are randomly allocated to different treatments and receive only one treatment. However, some trials use within person designs such as split-body, split-mouth and cross-over designs, where each patient may receive more than one treatment. Data from treatment arms within these trials are no longer independent, so the correlations between dependent arms need to be accounted for within the statistical analyses. Ignoring these correlations may result in incorrect conclusions. The main objective of this study is to develop statistical approaches to adjusting weights for dependent arms within special design trials. In this study, we demonstrate the following three approaches: the data augmentation approach, the adjusting variance approach, and the reducing weight approach. These three methods could be perfectly applied in current statistic tools such as R and STATA. An example of periodontal regeneration was used to demonstrate how these approaches could be undertaken and implemented within statistical software packages, and to compare results from different approaches. The adjusting variance approach can be implemented within the network package in STATA, while reducing weight approach requires computer software programming to set up the within-study variance-covariance matrix. This article is protected by copyright. All rights reserved.

Mesenchymal Stem Cells and Platelet Gel Improve Bone Deposition within CAD-CAM Custom-Made Ceramic HA Scaffolds for Condyle Substitution

PubMed Central

Ciocca, L.; Donati, D.; Ragazzini, S.; Dozza, B.; Rossi, F.; Fantini, M.; Spadari, A.; Romagnoli, N.; Landi, E.; Tampieri, A.; Piattelli, A.; Iezzi, G.; Scotti, R.

2013-01-01

Purpose. This study evaluated the efficacy of a regenerative approach using mesenchymal stem cells (MSCs) and CAD-CAM customized pure and porous hydroxyapatite (HA) scaffolds to replace the temporomandibular joint (TMJ) condyle. Methods. Pure HA scaffolds with a 70% total porosity volume were prototyped using CAD-CAM technology to replace the two temporomandibular condyles (left and right) of the same animal. MSCs were derived from the aspirated iliac crest bone marrow, and platelets were obtained from the venous blood of the sheep. Custom-made surgical guides were created by direct metal laser sintering and were used to export the virtual planning of the bone cut lines into the surgical environment. Sheep were sacrificed 4 months postoperatively. The HA scaffolds were explanted, histological specimens were prepared, and histomorphometric analysis was performed. Results. Analysis of the porosity reduction for apposition of newly formed bone showed a statistically significant difference in bone formation between condyles loaded with MSC and condyles without (P < 0.05). The bone ingrowth (BI) relative values of split-mouth comparison (right versus left side) showed a significant difference between condyles with and without MSCs (P < 0.05). Analysis of the test and control sides in the same animal using a split-mouth study design was performed; the condyle with MSCs showed greater bone formation. Conclusion. The split-mouth design confirmed an increment of bone regeneration into the HA scaffold of up to 797% upon application of MSCs. PMID:24073409

Mesenchymal stem cells and platelet gel improve bone deposition within CAD-CAM custom-made ceramic HA scaffolds for condyle substitution.

PubMed

Ciocca, L; Donati, D; Ragazzini, S; Dozza, B; Rossi, F; Fantini, M; Spadari, A; Romagnoli, N; Landi, E; Tampieri, A; Piattelli, A; Iezzi, G; Scotti, R

2013-01-01

This study evaluated the efficacy of a regenerative approach using mesenchymal stem cells (MSCs) and CAD-CAM customized pure and porous hydroxyapatite (HA) scaffolds to replace the temporomandibular joint (TMJ) condyle. Pure HA scaffolds with a 70% total porosity volume were prototyped using CAD-CAM technology to replace the two temporomandibular condyles (left and right) of the same animal. MSCs were derived from the aspirated iliac crest bone marrow, and platelets were obtained from the venous blood of the sheep. Custom-made surgical guides were created by direct metal laser sintering and were used to export the virtual planning of the bone cut lines into the surgical environment. Sheep were sacrificed 4 months postoperatively. The HA scaffolds were explanted, histological specimens were prepared, and histomorphometric analysis was performed. Analysis of the porosity reduction for apposition of newly formed bone showed a statistically significant difference in bone formation between condyles loaded with MSC and condyles without (P < 0.05). The bone ingrowth (BI) relative values of split-mouth comparison (right versus left side) showed a significant difference between condyles with and without MSCs (P < 0.05). Analysis of the test and control sides in the same animal using a split-mouth study design was performed; the condyle with MSCs showed greater bone formation. The split-mouth design confirmed an increment of bone regeneration into the HA scaffold of up to 797% upon application of MSCs.

Valeriana officinalis L. for conscious sedation of patients submitted to impacted lower third molar surgery: A randomized, double-blind, placebo-controlled split-mouth study.

PubMed

Pinheiro, Marcos Luciano Pimenta; Alcântara, Carlos Eduardo Pinto; de Moraes, Márcio; de Andrade, Eduardo Dias

2014-04-01

Anxiety is one of the components of patient stress in the dental office and is recognized as one of the main factors that negatively affect treatment. The control of anxiety can be performed through conscious sedation, for which benzodiazepine is the drug of choice in dental practice, however present side-effects. The objective of the following study is to evaluate the efficacy of Valeriana officinalis L. (Valerian) for control of anxiety during the third molar surgery. A single oral dose of either Valerian (100 mg) or placebo was randomly administered 1 h before each surgical procedure to 20 volunteers between 17 and 31 years of age. Anxiety level was assessed by physiological parameters (blood pressure and heart rate [HR]) and the observation of signs. Descriptive analysis, Chi-square test, Friedman test, Wilcoxon test and effect size test were performed (P < 0.05). According to the researcher's (80%) and surgeon's (75%) evaluations, the patients treated with Valerian were calmer and more relaxed during surgery. Valerian had a greater effect on the maintenance of systolic blood pressure and HR after surgery. Valerian was more effective at controlling anxiety than a placebo when used for the conscious sedation of adult patients submitted to impacted lower third molar surgery.

Effect of surgical periodontal treatment associated to antimicrobial photodynamic therapy on chronic periodontitis: A randomized controlled clinical trial.

PubMed

Martins, Sérgio H L; Novaes, Arthur B; Taba, Mario; Palioto, Daniela B; Messora, Michel R; Reino, Danilo M; Souza, Sérgio L S

2017-07-01

This randomized controlled clinical trial evaluated the effects of an adjunctive single application of antimicrobial photodynamic therapy (aPDT) in Surgical Periodontal Treatment (ST) in patients with severe chronic periodontitis (SCP). In a split-mouth design, 20 patients with SCP were treated with aPDT+ST (Test Group, TG) or ST only (Control Group, CG). aPDT was applied in a single episode, using a diode laser and a phenothiazine photosensitizer. All patients were monitored until 90 days after surgical therapy. Levels of 40 subgingival species were measured by checkerboard DNA-DNA hybridization at baseline, 60 and 150 days. Clinical and microbiological parameters were evaluated. In deep periodontal pockets depth (PPD ≥5 mm), Test Group presented a significantly higher decrease in PPD than Control Group at 90 days after surgical therapy (p < .05). Test Group also demonstrated significantly less periodontal pathogens of red complex (Treponema denticola) (p < .05). A single episode of aPDT used in adjunct to open flap debridement of the root surface in the surgical treatment of SCP: i) significantly improved clinical periodontal parameters; ii) eliminates periodontal pathogens of the red complex more effectively (NCT02734784). © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effect of mouth cleaning with hinokitiol-containing gel on oral malodor: a randomized, open-label pilot study.

PubMed

Iha, Kosaku; Suzuki, Nao; Yoneda, Masahiro; Takeshita, Toru; Hirofuji, Takao

2013-10-01

The aim of the study was to evaluate the effect of mouth cleaning with hinokitiol-containing gel on oral malodor. An open-label, randomized, controlled trial was conducted to assess oral malodor and clinical parameters related to oral malodor before and after mouth cleaning with hinokitiol-containing gel (n = 9) or with gel not including hinokitiol (n = 9). Mouth cleaning included the teeth, gingiva, and tongue and was carried out 3 times per day for 4 weeks. Organoleptic test (OLT) scores (P = .021), levels of hydrogen sulfide (P = .008) and methyl mercaptan (P = .020), frequency of bleeding on probing, average probing pocket depth, and plaque index significantly improved in the group using hinokitiol. In contrast, only the OLT score (P = .031) significantly improved in the control group after the treatment regimen. Mouth cleaning with hinokitiol-containing gel may be effective for reduction of oral malodor. Copyright © 2013 Elsevier Inc. All rights reserved.

Reduced somatosensory impairment by piezosurgery during orthognathic surgery of the mandible.

PubMed

Brockmeyer, Phillipp; Hahn, Wolfram; Fenge, Stefan; Moser, Norman; Schliephake, Henning; Gruber, Rudolf Matthias

2015-09-01

This clinical trial aimed to test the hypothesis that piezosurgery causes reduced nerval irritations and, thus, reduced somatosensory impairment when used in orthognathic surgery of the mandible. To this end, 37 consecutive patients with Angle Class II and III malocclusion were treated using bilateral sagittal split osteotomies (BSSO) of the mandible. In a split mouth design, randomized one side of the mandible was operated using a conventional saw, while a piezosurgery device was used on the contralateral side. In order to test the individual qualities of somatosensory function, quantitative sensory testings (QSTs) were performed 1 month, 6 months and 1 year after surgery. A comparison of the data using a two-way analysis of variance (ANOVA) revealed a significant reduction in postoperative impairment in warm detection threshold (WDT) (P = 0.046), a decreased dynamic mechanical allodynia (ALL) (P = 0.002) and a decreased vibration detection threshold (VDT) (P = 0.030) on the piezosurgery side of the mandible as opposed to the conventionally operated control side. In the remaining QSTs, minor deviations from the preoperative baseline conditions and a more rapid regression could be observed. Piezosurgery caused reduced somatosensory impairment and a faster recovery of somatosensory functions in the present investigation.

Controlled, prospective, randomized, clinical split-mouth evaluation of partial ceramic crowns luted with a new, universal adhesive system/resin cement: results after 18 months.

PubMed

Vogl, Vanessa; Hiller, Karl-Anton; Buchalla, Wolfgang; Federlin, Marianne; Schmalz, Gottfried

2016-12-01

A new universal adhesive with corresponding luting composite was recently marketed which can be used both, in a self-etch or in an etch-and-rinse mode. In this study, the clinical performance of partial ceramic crowns (PCCs) inserted with this adhesive and the corresponding luting material used in a self-etch or selective etch approach was compared with a self-adhesive universal luting material. Three PCCs were placed in a split-mouth design in 50 patients. Two PCCs were luted with a combination of a universal adhesive/resin cement (Scotchbond Universal/RelyX Ultimate, 3M ESPE) with (SB+E)/without (SB-E) selective enamel etching. Another PCC was luted with a self-adhesive resin cement (RelyX Unicem 2, 3M ESPE). Forty-eight patients were evaluated clinically according to FDI criteria at baseline and 6, 12 and 18 months. For statistical analyses, the chi-square test (α = 0.05) and Kaplan-Meier analysis were applied. Clinically, no statistically significant differences between groups were detected over time. Within groups, clinically significant increase for criterion "marginal staining" was detected for SB-E over 18 months. Kaplan-Meier analysis revealed significantly higher retention rates for SB+E (97.8 %) and SB-E (95.6 %) in comparison to RXU2 (75.6 %). The 18-month clinical performance of a new universal adhesive/composite combination showed no differences with respect to bonding strategy and may be recommended for luting PCCs. Longer-term evaluation is needed to confirm superiority of SB+E over SB-E. At 18 months, the new multi-mode adhesive, Scotchbond Universal, showed clinically reliable results when used for luting PCCs.

Machined versus roughened immediately loaded and finally restored single implants inserted flapless: Preliminary 6-month data from a split- mouth randomised controlled trial.

PubMed

Cannizzaro, Gioacchino; Felice, Pietro; Loi, Ignazio; Viola, Paolo; Ferri, Vittorio; Leone, Michele; Lazzarini, Matteo; Trullenque-Eriksson, Anna; Esposito, Marco

To compare the outcome of immediately loaded single implants with a machined or a roughened surface. Fifty patients had two implant sites randomly allocated to receive flaplessplaced single Syra implants (Sweden & Martina), one with a machined and one with a roughened surface (sand-blasted with zirconia powder and acid etched), according to a split-mouth design. To be loaded immediately, implants had to be inserted with a torque superior to 50 Ncm. Implants were restored with definitive crowns in direct occlusal contact within 48 h. Patients were followed for 6 months after loading. Outcome measures were prosthetic and implant failures and complications. Two machined implants and four roughened implants were not loaded immediately. Six months after loading no dropout occurred. One implant loaded late, which had a rough implant surface, failed 20 days after loading (P (McNemar test) = 0.625; difference in proportions = -0.04; 95% CI: -0.15 to 0.07). Three crowns had to be remade on machined implants and four on roughened implants (P (McNemar test) = 1.000; difference in proportions = -0.02; 95% CI: -0.12 to 0.08). Three machined and five roughened implants experienced complications (P (McNemar test) = 0.625; difference in proportions = -0.04; 95% CI: -0.15 to 0.07). There were no statistically significant differences between groups for crown and implant losses as well as complications. Up to 6 months after loading both machined and roughened flapless-placed and immediately loaded single implants provided good and similar results, however, longer follow-ups are needed to evaluate the long-term prognosis of implants with different surfaces.

Dental wax decreases calculus accumulation in small dogs.

PubMed

Smith, Mark M; Smithson, Christopher W

2014-01-01

A dental wax was evaluated after unilateral application in 20 client-owned, mixed and purebred small dogs using a clean, split-mouth study model. All dogs had clinical signs of periodontal disease including plaque, calculus, and/or gingivitis. The wax was randomly applied to the teeth of one side of the mouth daily for 30-days while the contralateral side received no treatment. Owner parameters evaluated included compliance and a subjective assessment of ease of wax application. Gingivitis, plaque and calculus accumulation were scored at the end of the study period. Owners considered the wax easy to apply in all dogs. Compliance with no missed application days was achieved in 8 dogs. The number of missed application days had no effect on wax efficacy. There was no significant difference in gingivitis or plaque accumulation scores when comparing treated and untreated sides. Calculus accumulation scores were significantly less (22.1 %) for teeth receiving the dental wax.

Comparative evaluation of stress levels before, during, and after periodontal surgical procedures with and without nitrous oxide-oxygen inhalation sedation

PubMed Central

Sandhu, Gurkirat; Khinda, Paramjit Kaur; Gill, Amarjit Singh; Singh Khinda, Vineet Inder; Baghi, Kamal; Chahal, Gurparkash Singh

2017-01-01

Context: Periodontal surgical procedures produce varying degree of stress in all patients. Nitrous oxide-oxygen inhalation sedation is very effective for adult patients with mild-to-moderate anxiety due to dental procedures and needle phobia. Aim: The present study was designed to perform periodontal surgical procedures under nitrous oxide-oxygen inhalation sedation and assess whether this technique actually reduces stress physiologically, in comparison to local anesthesia alone (LA) during lengthy periodontal surgical procedures. Settings and Design: This was a randomized, split-mouth, cross-over study. Materials and Methods: A total of 16 patients were selected for this randomized, split-mouth, cross-over study. One surgical session (SS) was performed under local anesthesia aided by nitrous oxide-oxygen inhalation sedation, and the other SS was performed on the contralateral quadrant under LA. For each session, blood samples to measure and evaluate serum cortisol levels were obtained, and vital parameters including blood pressure, heart rate, respiratory rate, and arterial blood oxygen saturation were monitored before, during, and after periodontal surgical procedures. Statistical Analysis Used: Paired t-test and repeated measure ANOVA. Results: The findings of the present study revealed a statistically significant decrease in serum cortisol levels, blood pressure and pulse rate and a statistically significant increase in respiratory rate and arterial blood oxygen saturation during periodontal surgical procedures under nitrous oxide inhalation sedation. Conclusion: Nitrous oxide-oxygen inhalation sedation for periodontal surgical procedures is capable of reducing stress physiologically, in comparison to LA during lengthy periodontal surgical procedures. PMID:29386796

Influence of postoperative low-level laser therapy on the osseointegration of self-tapping implants in the posterior maxilla: a 6-week split-mouth clinical study.

PubMed

Mandić, Borka; Lazić, Zoran; Marković, Aleksa; Mandić, Bojan; Mandić, Miška; Djinić, Ana; Miličić, Biljana

2015-03-01

Low-level laser therapy (LLLT) has been proven to stimulate bone repair, affecting cellular proliferation, differentiation and adhesion, and has shown a potential to reduce the healing time following implant placement. The aim of this clinical study was to investigate the influence of postoperative LLLT osseointegration and early success of self-tapping implants placed into low-density bone. Following the split-mouth design, self-tapping implants n = 44) were inserted in the posterior maxilla of 12 patients. One jaw side randomly received LLLT (test group), while the other side was placebo (control group). For LLLT, a 637 nm gallium-aluminum-arsenide (GaAlAs) laser (Medicolaser 637, Technoline, Belgrade, Serbia) with an output power of 40 mW and continuous wave was used. Low-level laser treatment was performed immediately after the surgery and then repeated every day in the following 7 days. The total irradiation dose per treatment was 6.26 J/cm2 per implant. The study outcomes were: implant stability, alkaline-phosphatase (ALP) activity and early implant success rate. The follow-up took 6 weeks. Irradiated implants achieved a higher stability compared with controls during the entire follow-up and the difference reached significance in the 5th postoperative week (paired t-test, p = 0.030). The difference in ALP activity between the groups was insignificant in any observation point (paired t-test, p > 0.05). The early implant success rate was 100%, regardless of LLLT usage. LLLT applied daily during the first postoperative week expressed no significant influence on the osseointegration of self-tapping implants placed into low density bone of the posterior maxilla. Placement of self-tapping macro-designed implants into low density bone could be a predictable therapeutic procedure with a high early success rate regardless of LLLT usage.

Effect of an essential oil-containing mouth rinse on VSC-producing bacteria on the tongue.

PubMed

Thaweboon, Sroisiri; Thaweboon, Boonyanit

2011-03-01

The objective of the present study was to investigate the inhibitory effect of a commercially available essential oil-containing mouth rinse 12 hours after a single rinse and two weeks of twice daily rinsing, on volatile sulphur compounds (VSC) producing bacteria on the tongue. The study was a randomized, double-blind, controlled crossover design. Thirty-six healthy subjects, aged 20-48 years, volunteered to participate in the study. Subjects were randomly assigned to rinse twice daily with either an essential oil-containing mouth rinse (Cool Mint Listerine Antiseptic) or a negative control rinse. Bacteria samples were taken from the dorsum of the tongue at baseline, after the first rinse and two weeks later. They were plated on OOPS medium to enumerate the VSC-producing bacteria. Intergroup comparisons of log10 transformed colony-forming units of the samples were made using analysis of covariance. Each comparison was performed at a 5% significance level. The mean VSC-producing bacteria in subjects using the essential oil mouth rinse were significantly lower than those using the control rinse twice daily. In healthy subjects, rinsing with an essential oil-containing mouth rinse can have a significant effect on VSC-producing bacteria on the tongue and may be useful for controlling intrinsic oral malodor over prolonged periods.

Treatment of gingival recession defects with a coronally advanced flap and a xenogeneic collagen matrix: a multicenter randomized clinical trial.

PubMed

Jepsen, Karin; Jepsen, Søren; Zucchelli, Giovanni; Stefanini, Martina; de Sanctis, Massimo; Baldini, Nicola; Greven, Björn; Heinz, Bernd; Wennström, Jan; Cassel, Björn; Vignoletti, Fabio; Sanz, Mariano

2013-01-01

To evaluate the clinical outcomes of the use of a xenogeneic collagen matrix (CM) in combination with the coronally advanced flap (CAF) in the treatment of localized recession defects. In a multicentre single-blinded, randomized, controlled, split-mouth trial, 90 recessions (Miller I, II) in 45 patients received either CAF + CM or CAF alone. At 6 months, root coverage (primary outcome) was 75.29% for test and 72.66% for control defects (p = 0.169), with 36% of test and 31% of control defects exhibiting complete coverage. The increase in mean width of keratinized tissue (KT) was higher in test (from 1.97 to 2.90 mm) than in control defects (from 2.00 to 2.57 mm) (p = 0.036). Likewise, test sites had more gain in gingival thickness (GT) (0.59 mm) than control sites (0.34 mm) (p = 0.003). Larger (≥3 mm) recessions (n = 35 patients) treated with CM showed higher root coverage (72.03% versus 66.16%, p = 0.043), as well as more gain in KT and GT. CAF + CM was not superior with regard to root coverage, but enhanced gingival thickness and width of keratinized tissue when compared with CAF alone. For the coverage of larger defects, CAF + CM was more effective. © 2012 John Wiley & Sons A/S.

Effectiveness of cold therapy in reducing pain, trismus, and oedema after impacted mandibular third molar surgery: a randomized, self-controlled, observer-blind, split-mouth clinical trial.

PubMed

Zandi, M; Amini, P; Keshavarz, A

2016-01-01

Cold therapy is a conventional and widely used modality for reducing pain, trismus, and oedema after dentoalveolar surgeries. However, information reported in the literature on its effectiveness is insufficient and controversial. This study was performed to evaluate the effect of local cold application in reducing pain, trismus, and swelling after impacted mandibular third molar surgery. Thirty patients (seven males and 23 females) with bilateral symmetrical mandibular impacted third molars were enrolled in this randomized, self-controlled, observer-blind clinical trial. The patients were aged between 18 and 30 years. After surgical removal of the tooth on one side (intervention), ice pack therapy was given for 24h after surgery; for the other side (control), no cold therapy was given. The time interval between the two surgeries was at least 4 weeks. The amount of pain, trismus, and facial swelling was measured on days 2 and 7 postoperative, and patient satisfaction with the cold therapy vs. no cold therapy was assessed. The amount of pain, trismus, and facial swelling, and the extent of patient satisfaction were not significantly different between the intervention and control sides. Cold therapy had no beneficial effects on postoperative sequelae after impacted mandibular third molar surgery. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Valeriana officinalis L. for conscious sedation of patients submitted to impacted lower third molar surgery: A randomized, double-blind, placebo-controlled split-mouth study

PubMed Central

Pinheiro, Marcos Luciano Pimenta; Alcântara, Carlos Eduardo Pinto; de Moraes, Márcio; de Andrade, Eduardo Dias

2014-01-01

Introduction: Anxiety is one of the components of patient stress in the dental office and is recognized as one of the main factors that negatively affect treatment. The control of anxiety can be performed through conscious sedation, for which benzodiazepine is the drug of choice in dental practice, however present side-effects. Objective: The objective of the following study is to evaluate the efficacy of Valeriana officinalis L. (Valerian) for control of anxiety during the third molar surgery. Materials and Methods: A single oral dose of either Valerian (100 mg) or placebo was randomly administered 1 h before each surgical procedure to 20 volunteers between 17 and 31 years of age. Anxiety level was assessed by physiological parameters (blood pressure and heart rate [HR]) and the observation of signs. Descriptive analysis, Chi-square test, Friedman test, Wilcoxon test and effect size test were performed (P < 0.05). Results: According to the researcher's (80%) and surgeon's (75%) evaluations, the patients treated with Valerian were calmer and more relaxed during surgery. Valerian had a greater effect on the maintenance of systolic blood pressure and HR after surgery. Conclusion: Valerian was more effective at controlling anxiety than a placebo when used for the conscious sedation of adult patients submitted to impacted lower third molar surgery. PMID:24741279

Efficacy of Benzocaine 20% Topical Anesthetic Compared to Placebo Prior to Administration of Local Anesthesia in the Oral Cavity: A Randomized Controlled Trial.

PubMed

de Freiras, Guilherme Camponogara; Pozzobon, Roselaine Terezinha; Blaya, Diego Segatto; Moreira, Carlos Heitor

2015-01-01

The aim of the present study was to compare the effects of a topical anesthetic to a placebo on pain perception during administration of local anesthesia in 2 regions of the oral cavity. A split-mouth, double-blind, randomized clinical trial design was used. Thirty-eight subjects, ages 18-50 years, American Society of Anesthesiologists I and II, received 4 anesthetic injections each in regions corresponding to the posterior superior alveolar nerve (PSA) and greater palatine nerve (GPN), totaling 152 sites analyzed. The side of the mouth where the topical anesthetic (benzocaine 20%) or the placebo was to be applied was chosen by a flip of a coin. The needle used was 27G, and the anesthetic used for administration of local anesthesia was 2% lidocaine with 1:100,000 epinephrine. After receiving the administration of local anesthesia, each patient reported pain perception on a visual analog scale (VAS) of 100-mm length. The results showed that the topical anesthetic and the placebo had similar effects: there was no statistically significant VAS difference between the PSA and the GPN pain ratings. A higher value on the VAS for the anesthesia of the GPN, relative to the PSA, was observed for both groups. Regarding gender, male patients had higher values on the VAS compared with female patients, but these differences were not meaningful. The topical anesthetic and the placebo had similar effects on pain perception for injection of local anesthesia for the PSA and GPN.

Efficacy of Benzocaine 20% Topical Anesthetic Compared to Placebo Prior to Administration of Local Anesthesia in the Oral Cavity: A Randomized Controlled Trial

PubMed Central

de Freiras, Guilherme Camponogara; Pozzobon, Roselaine Terezinha; Blaya, Diego Segatto; Moreira, Carlos Heitor

2015-01-01

The aim of the present study was to compare the effects of a topical anesthetic to a placebo on pain perception during administration of local anesthesia in 2 regions of the oral cavity. A split-mouth, double-blind, randomized clinical trial design was used. Thirty-eight subjects, ages 18–50 years, American Society of Anesthesiologists I and II, received 4 anesthetic injections each in regions corresponding to the posterior superior alveolar nerve (PSA) and greater palatine nerve (GPN), totaling 152 sites analyzed. The side of the mouth where the topical anesthetic (benzocaine 20%) or the placebo was to be applied was chosen by a flip of a coin. The needle used was 27G, and the anesthetic used for administration of local anesthesia was 2% lidocaine with 1:100,000 epinephrine. After receiving the administration of local anesthesia, each patient reported pain perception on a visual analog scale (VAS) of 100-mm length. The results showed that the topical anesthetic and the placebo had similar effects: there was no statistically significant VAS difference between the PSA and the GPN pain ratings. A higher value on the VAS for the anesthesia of the GPN, relative to the PSA, was observed for both groups. Regarding gender, male patients had higher values on the VAS compared with female patients, but these differences were not meaningful. The topical anesthetic and the placebo had similar effects on pain perception for injection of local anesthesia for the PSA and GPN. PMID:26061572

Influence of finger and mouth action observation on random number generation: an instance of embodied cognition for abstract concepts.

PubMed

Grade, Stéphane; Badets, Arnaud; Pesenti, Mauro

2017-05-01

Numerical magnitude and specific grasping action processing have been shown to interfere with each other because some aspects of numerical meaning may be grounded in sensorimotor transformation mechanisms linked to finger grip control. However, how specific these interactions are to grasping actions is still unknown. The present study tested the specificity of the number-grip relationship by investigating how the observation of different closing-opening stimuli that might or not refer to prehension-releasing actions was able to influence a random number generation task. Participants had to randomly produce numbers after they observed action stimuli representing either closure or aperture of the fingers, the hand or the mouth, or a colour change used as a control condition. Random number generation was influenced by the prior presentation of finger grip actions, whereby observing a closing finger grip led participants to produce small rather than large numbers, whereas observing an opening finger grip led them to produce large rather than small numbers. Hand actions had reduced or no influence on number production; mouth action influence was restricted to opening, with an overproduction of large numbers. Finally, colour changes did not influence number generation. These results show that some characteristics of observed finger, hand and mouth grip actions automatically prime number magnitude, with the strongest effect for finger grasping. The findings are discussed in terms of the functional and neural mechanisms shared between hand actions and number processing, but also between hand and mouth actions. The present study provides converging evidence that part of number semantics is grounded in sensory-motor mechanisms.

Retention of Moisture-tolerant and Conventional Resin-based Sealant in Six- to Nine-year-old Children.

PubMed

Khatri, Sachin G; Samuel, Srinivasan Raj; Acharya, Shashidhar; Patil, Snehal; Madan, Kavita

2015-01-01

The purpose of this study was to evaluate and compare the retention rates and development of caries in permanent molars in children sealed with moisture-tolerant, resin-based (Embrace WetBond), and conventional resin-based (Helioseal) sealant over a period of one year. This was a double blind, split-mouth, randomized controlled trial among six- to nine-year-olds. Sixty-eight permanent mandibular first molars in 34 children were randomly assigned to be sealed with Embrace WetBond or Helioseal sealant. The final sample was 32 children with 64 teeth. At 12 months, 23 of 32 (72 percent) sealants were completely retained in Embrace WetBond, whereas only 16 of 32 (50 percent) were retained in the Helioseal group. There was a statistically significant difference in retention rates of Embrace WetBond and Helioseal sealants at 12 months (P<.05). At 12 months follow-up, only two teeth developed caries in Embrace WetBond; in the Helioseal group, five teeth developed caries (two initial and three enamel caries). Embrace WetBond was superior to Helioseal sealant, as Embrace exhibited higher retention and lower caries scores. Embrace WetBond can be preferred over conventional resin-based sealants for community and outreach sealant programs where use of rubber dam for moisture control is difficult to practice.

Clinical efficacy analysis of the mouth rinsing with pomegranate and chamomile plant extracts in the gingival bleeding reduction.

PubMed

Batista, Ana Luzia Araújo; Lins, Ruthineia Diógenes Alves Uchôa; de Souza Coelho, Renata; do Nascimento Barbosa, Danielle; Moura Belém, Nayara; Alves Celestino, Frayni Josley

2014-02-01

Medicinal plants represent important therapeutic resources to health restoration, including the use of herbal products in the mouth conditions treatment. A randomized controlled clinical trial was performed in order to evaluate the effectiveness of mouth rinse with pomegranate and chamomile plant extracts, against chlorhexidine 0.12% in the gingiva bleeding condition. The mouth rinses with the herbal products were effective for this case, showing thus, antimicrobial and anti-inflammatory properties similar to that of chlorhexidine 0.12%. Copyright © 2013 Elsevier Ltd. All rights reserved.

Evaluation of Operating Time and Patient Perception Using Conventional Impression Taking and Intraoral Scanning for Crown Manufacture: A Split-mouth, Randomized Clinical Study.

PubMed

Haddadi, Yasser; Bahrami, Golnosh; Isidor, Flemming

To compare operating time and patient perception of conventional impression (CI) taking and intraoral scanning (IOS) for manufacture of a tooth-supported crown. A total of 19 patients needing indirect full-coverage restorations fitting the requirements for a split-mouth design were recruited. Each patient received two lithium disilicate crowns, one manufactured from CI taking and one from IOS. Both teeth were prepared following the manufacturers' recommendations. For both impression techniques, two retraction cords soaked in 15% ferric sulphate were used for tissue management. CIs were taken in a full-arch metallic tray using one-step, two-viscosity technique with polyvinyl siloxane silicone. The operating time for each step of the two impression methods was registered. Patient perception associated with each method was scored using a 100-mm visual analog scale (VAS), with 100 indicating maximum discomfort. Median total operating time for CI taking was 15:47 minutes (interquartile range [IQR] 15:18 to 17:30), and for IOS was 5:05 minutes (IQR 4:35 to 5:23). The median VAS score for patient perception was 73 (IQR 16 to 89) for CI taking and 6 (IQR 2 to 9) for IOS. The differences between the two groups were statistically significant (P < .05) for both parameters. IOS was less time consuming than CI taking, and patient perception was in favor of IOS.

Valley Phase and Voltage Control of Coherent Manipulation in Si Quantum Dots.

PubMed

Zimmerman, Neil M; Huang, Peihao; Culcer, Dimitrie

2017-07-12

With any roughness at the interface of an indirect-bandgap semiconducting dot, the phase of the valley-orbit coupling can take on a random value. This random value, in double quantum dots, causes a large change in the exchange splitting. We demonstrate a simple analytical method to calculate the phase, and thus the exchange splitting and singlet-triplet qubit frequency, for an arbitrary interface. We then show that, with lateral control of the position of a quantum dot using a gate voltage, the valley-orbit phase can be controlled over a wide range, so that variations in the exchange splitting can be controlled for individual devices. Finally, we suggest experiments to measure the valley phase and the concomitant gate voltage control.

Relief of Injection Pain During Delivery of Local Anesthesia by Computer-Controlled Anesthetic Delivery System for Periodontal Surgery: Randomized Clinical Controlled Trial.

PubMed

Chang, Hyeyoon; Noh, Jiyoung; Lee, Jungwon; Kim, Sungtae; Koo, Ki-Tae; Kim, Tae-Il; Seol, Yang-Jo; Lee, Yong-Moo; Ku, Young; Rhyu, In-Chul

2016-07-01

Pain from local anesthetic injection makes patients anxious when visiting a dental clinic. This study aims to determine differences in pain according to types of local anesthetizing methods and to identify the possible contributing factors (e.g., dental anxiety, stress, and sex). Thirty-one patients who underwent open-flap debridement in maxillary premolar and molar areas during treatment for chronic periodontitis were evaluated for this study. A randomized, split-mouth, single-masked clinical trial was implemented. The dental anxiety scale (DAS) and perceived stress scale (PSS) were administered before surgery. Two lidocaine ampules for each patient were used for local infiltration anesthesia (supraperiosteal injection). Injection pain was measured immediately after local infiltration anesthesia using the visual analog pain scale (VAS) questionnaire. Results from the questionnaire were used to assess degree of pain patients feel when a conventional local anesthetic technique (CNV) is used compared with a computer-controlled anesthetic delivery system (CNR). DAS and PSS did not correlate to injection pain. VAS scores were lower for CNR than for CNV regardless of the order in which anesthetic procedures were applied. VAS score did not differ significantly with sex. Pearson coefficient for correlation between VAS scores for the two procedures was 0.80, also indicating a strong correlation. Within the limitations of the present study, relief from injection pain is observed using CNR.

Association Splitting: A randomized controlled trial of a new method to reduce craving among inpatients with alcohol dependence.

PubMed

Schneider, Brooke C; Moritz, Steffen; Hottenrott, Birgit; Reimer, Jens; Andreou, Christina; Jelinek, Lena

2016-04-30

Association Splitting, a novel cognitive intervention, was tested in patients with alcohol dependence as an add-on intervention in an initial randomized controlled trial. Preliminary support for Association Splitting has been found in patients with obsessive-compulsive disorder, as well as in an online pilot study of patients with alcohol use disorders. The present variant sought to reduce craving by strengthening neutral associations with alcohol-related stimuli, thus, altering cognitive networks. Eighty-four inpatients with verified diagnoses of alcohol dependence, who were currently undergoing inpatient treatment, were randomly assigned to Association Splitting or Exercise Therapy. Craving was measured at baseline, 4-week follow-up, and six months later with the Obsessive-Compulsive Drinking Scale (primary outcome) and the Alcohol Craving Questionnaire. There was no advantage for Association Splitting after three treatment sessions relative to Exercise Therapy. Among Association Splitting participants, 51.9% endorsed a subjective decline in craving and 88.9% indicated that they would use Association Splitting in the future. Despite high acceptance, an additional benefit of Association Splitting beyond standard inpatient treatment was not found. Given that participants were concurrently undergoing inpatient treatment and Association Splitting has previously shown moderate effects, modification of the study design may improve the potential to detect significant effects in future trials. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Immediate Implants Placed in Fresh Sockets Associated with Periapical Pathology: A Split-Mouth Design and Survival Evaluation after 1-Year Follow-Up.

PubMed

Hita-Iglesias, Cristina; Sánchez-Sánchez, Francisco J; Montero, Javier; Galindo-Moreno, Pablo; Mesa, Francisco; Martínez-Lara, Ildefonso; Sánchez-Fernández, Elena

2016-12-01

To compare the immediate implant success rates between sites with chronic apical lesions and healthy sites in the same patients 1 year postdelayed loading. One hundred sixty-eight immediate implants were placed in sixty patients at upper incisor, canine, and premolar sites. A split-mouth design was used, placing a minimum of two implants, one in a fresh socket associated with chronic periapical disease, the average lesion size was larger than 4 mm and less than 8 mm (test group), and the other(s) in a healthy fresh socket (control group). Implant survival rate at 1 year postloading delayed was compared between the groups. The implant survival rate was 98.2% for the total sample (n = 168); out of the three implants lost, two were from the test group, and one was from the control group (in the same patient as one of the former). Among the surviving implants, five were also considered failures due to excessive bone loss (n = 3) and also because of the recurrence of the periapical lesions (n = 2). Survival rates were significantly lower in the test than control sites at 12 months postloading. Implant survival rates were significantly lower after the immediate implantation in postextraction sockets associated with chronic periapical disease (90.8%) than in healthy postextraction sockets (98.1%). © 2015 Wiley Periodicals, Inc.

Can shielded brackets reduce mucosa alteration and increase comfort perception in orthodontic patients in the first 3 days of treatment? A single-blind randomized controlled trial.

PubMed

Pires, Lívia Pereira Brocos; de Oliveira, Augusto Henrique Alves; da Silva, Hillionne Ferreira; de Oliveira, Patrícia Teixeira; dos Santos, Patrícia Bittencourt Dutra; Pinheiro, Fabio Henrique de Sá Leitão

2015-12-01

Orthodontic patients can experience pain and discomfort on the oral mucosa from trauma caused by friction with the brackets and the wires. In this split-mouth design, single-blind randomized controlled trial, we aimed to investigate whether brackets with a self-snapping customized plastic shield would induce less mucosa alteration and discomfort than those without the shield. The overall sample comprised 42 patients (22 female, 20 male) from a government-funded orthodontic practice, with a mean age of 16.7 years. Eligibility criteria included, among others, no history of mouth ulcers or systemic diseases. Customized shields for the maxillary and mandibular brackets were fabricated and inserted on one side of the mouth. The null hypothesis was that bracket shielding would have no advantage. The primary outcomes were mucosal and discomfort assessments. As the secondary outcome, the numbers of spontaneous detachments of the shields were reported. Treatment allocation was mainly implemented using a random number table for selection of the intervention side. Only the raters in charge of assessing the oral mucosa were blinded to the side of the mouth where the shields had been placed. The mucosa was assessed by 3 calibrated raters at the following time points: immediately before bracket placement (baseline assessment, T0), 3 days after delivering the shields (direct assessment of intervention, T1), and 4 days after removal of the shields (indirect assessment of intervention, T2). The raters used a newly devised yardstick in which the higher the score, the more severe the alteration. Discomfort was assessed at T1 and T2 using a visual analog scale. The Mann-Whitney U test was performed at the 5% level of significance. Of 60 patients, 42 were eligible, and 35 were randomly selected to have one side of the mouth receive the intervention. Two patients discontinued the intervention at T1, and 5 stopped at T2. Seven additional patients were recruited and completed all time points. Thus, 42 patients participated at T0, 40 at T1, and 35 at T2. Thirty-five patients participated at all time points. At T1, no statistically significant difference in terms of mucosa alteration was observed between the 2 sides (median of all differences [MD], 0.0; 95% CI, 0.0-1.0; P = 0.11). The same occurred at T2 (MD, 0.0; 95% CI, 0.0-0.0; P = 1.00). The comfort level was statistically higher at T1 on the shielded side (MD, 14.0; 95% CI, 1.0-36.0; P = 0.04), whereas no difference was observed at T2 (MD, 0.0; 95% CI, 0.0-1.0, P = 0.81). No serious harm was observed. The customized bracket shields were effective in reducing discomfort during the first 3 days of orthodontic treatment despite no significant difference in terms of visible mucosa alteration. This trial was not registered. The protocol was not published before trial commencement. Expenses for the fabrication of the shields were covered by the main author (L.P.B.P.). Orthodontic materials were from the Center for Dental Specialties in Cajazeiras, Brazil. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Effect of Topical Anesthesia with Lidocaine-prilocaine (EMLA) Cream and Local Pressure on Pain during Infiltration Injection for Maxillary Canines: A Randomized Double-blind clinical trial.

PubMed

Milani, Amin S; Zand, Vahid; Abdollahi, Amir A; Froughreyhani, Mohammad; Zakeri-Milani, Parvin; Jafarabadi, Mohammad A

2016-07-01

This study compared the effect of local pressure and topical lidocaine-prilocaine (EMLA) cream on pain during infiltration injection for maxillary canine teeth. A total of 140 volunteer students participated in this split-mouth design randomized clinical trial. The subjects were randomly divided into four groups (n = 35). Before administration of anesthesia, in each group, one side was randomly selected as the experimental and the opposite side as the control. In group 1, finger pressure was applied on the alveolar mucosa on the experimental side and on the tooth crown on the control side. In group 2, 5% EMLA cream and placebo; in group 3, finger pressure and 5% EMLA cream; and in group 4, 5% EMLA cream and 20% benzocaine gel were applied. In all the groups, a buccal infiltration procedure was carried out. Pain during injection was recorded with visual analog scale (VAS). Wilcoxon and McNemar tests were used for statistical analysis of the results. Statistical significance was set at p < 0.05. The results showed that EMLA reduced the injection pain significantly more than benzocaine (p = 0.02). Also, injection pain was significantly lower with the use of EMLA in comparison to placebo (p = 0.00). Application of local pressure reduced the injection pain, but the difference from the control side was not significant (p = 0.05). Furthermore, the difference between application of local pressure and EMLA was not statistically significant (p = 0.08). Topical anesthesia of 5% EMLA was more effective than 20% benzocaine in reducing pain severity during infiltration injection. However, it was not significantly different in comparison to the application of local pressure.

Effect of Herbal and Fluoride Mouth Rinses on Streptococcus mutans and Dental Caries among 12–15-Year-Old School Children: A Randomized Controlled Trial

PubMed Central

Shenoy Panchmal, Ganesh; Kumar, Vijaya; Jodalli, Praveen S.; Sonde, Laxminarayan

2017-01-01

To assess and compare the effect of herbal and fluoride mouth rinses on Streptococcus mutans count and glucan synthesis by Streptococcus mutans and dental caries, a parallel group placebo controlled randomized trial was conducted among 240 schoolchildren (12–15 years old). Participants were randomly divided and allocated into Group I (0.2% fluoride group), Group II (herbal group), and Group III (placebo group). All received 10 ml of respective mouth rinses every fortnight for a period of one year. Intergroup and intragroup comparison were done for Streptococcus mutans count and glucan synthesis by Streptococcus mutans and dental caries. Streptococcus mutans count showed a statistically significant difference between Group I and Group III (p = 0.035) and also between Group II and Group III (p = 0.039). Glucan concentration levels showed a statistically significant difference (p = 0.024) between Group II and Group III at 12th month. Mean DMF scores showed no statistical difference between the three groups (p = 0.139). No difference in the level of significance was seen in the intention-to-treat and per-protocol analysis. The present study showed that both herbal and fluoride mouth rinses, when used fortnightly, were equally effective and could be recommended for use in school-based health education program to control dental caries. Trial registration number is CTRI/2015/08/006070. PMID:28352285

Effects of combination oral care on oral health, dry mouth and salivary pH of intubated patients: A randomized controlled trial.

PubMed

Jang, Chun Sun; Shin, Yong Soon

2016-10-01

Intubated patients are at risk of oral health problems. Although a variety of oral care regimens for intubated patients have been studied, there is a lack of research on the effects of combination oral care that includes tooth brushing, chlorhexidine and cold water. This open-labelled, randomized, controlled trial aimed to evaluate the effects of combination oral care on oral health status. Participants aged 20 years and older were recruited on the first day after intubation through convenience sampling in a medical intensive care unit. Random assignment was performed using an internet randomization service. The primary outcome was oral health status. Data were collected during May and June 2013. Participants were randomized to one of two groups (23 intervention and 21 control). The final analysis included 18 patients with combination oral care and 17 in the control group. The intervention group had better oral health (effect size = 1.56), less dry mouth and higher salivary pH than the control group. Any additional burden of providing combination oral care to patients who are mechanically ventilated is worthwhile in terms of clinical outcomes. © 2016 John Wiley & Sons Australia, Ltd.

The plaque- and gingivitis-inhibiting capacity of a commercially available essential oil product. A parallel, split-mouth, single blind, randomized, placebo-controlled clinical study.

PubMed

Preus, Hans Ragnar; Koldsland, Odd Carsten; Aass, Anne Merete; Sandvik, Leiv; Hansen, Bjørn Frode

2013-11-01

Studies have reported commercially available essential oils with convincing plaque and gingivitis preventing properties. However, no tests have compared these essential oils, i.e. Listerine(®), against their true vehicle controls. To compare the plaque and gingivitis inhibiting effect of a commercially-available essential oil (Listerine(®) Total Care) to a negative (22% hydro-alcohol solution) and a positive (0.2% chlorhexidine (CHX)) control in an experimental gingivitis model. In three groups of 15 healthy volunteers, experimental gingivitis was induced and monitored over 21 days, simultaneously treated with Listerine(®) Total Care (test), 22% hydro-alcohol solution (negative control) and 0.2% chlorhexidine solution (positive control), respectively. The upper right quadrant of each individual received mouthwash only, whereas the upper left quadrant was subject to both rinses and mechanical oral hygiene. Plaque, gingivitis and side-effects were assessed at day 7, 14 and 21. After 21 days, the chlorhexidine group showed significantly lower average plaque and gingivitis scores than the Listerine(®) and alcohol groups, whereas there was little difference between the two latter. Listerine(®) Total Care had no statistically significant effect on plaque formation as compared to its vehicle control.

Efficacy of antimicrobial photodynamic therapy as an adjuvant in periodontal treatment in Down syndrome patients.

PubMed

Martins, Fabiana; Simões, Alyne; Oliveira, Marcio; Luiz, Ana Claudia; Gallottini, Marina; Pannuti, Claudio

2016-12-01

Down syndrome (DS) has characteristics that include mental retardation, a characteristic phenotype, congenital heart defects, immune disorders, and increased risk of periodontal disease (PD). Antimicrobial photodynamic therapy (aPDT) is the combined use of photosensitizers associated with low-level laser (LLL) and oxygen, leading to singlet oxygen formation, which contributes to the antibacterial activity of the phagocytes, killing bacteria. The objective of this study was to evaluate the efficacy of aPDT as an adjuvant to conventional periodontal treatment of PD in DS patients. A double-blinded, controlled, randomized, split-mouth study was conducted. A total of 13 DS subjects who were 18 years or older and who presented at least one tooth in each quadrant of the mouth with probing pocket depth (PPD) equal to or greater than 5 mm were included. The patients were evaluated at three different times: at the baseline, PPD were obtained. After 1 week, conventional scaling and root planing (SRP) was performed, and two randomly selected quadrants also received aPDT. One month after SRP, all the patients were reevaluated. Periodontal conditions were improved among all the participants. The PDT-with-SRP group presented a nonsignificant reduction in PPD (mean = 1.27 mm, median = 1.17 mm) relative to that of the SRP group (mean = 1.00 mm, median = 0.95 mm). Changes over time were compared using the Wilcoxon test. A significant reduction in median PPD was observed in both groups (p = 0.001). Both types of periodontal treatment, with and without PDT, were similarly effective and were associated with good clinical response.

High performance liquid chromatography determination of dexamethasone in plasma to evaluate its systemic absorption following intra-space pterygomandibular injection of twin-mix (mixture of 2 % lignocaine with 1:200,000 epinephrine and 4 mg dexamethasone): randomized control trial.

PubMed

Bhargava, Darpan; Deshpande, Ashwini; Thomas, Shaji; Sharma, Yogesh; Khare, Piush; Sahu, Sanjeev Kumar; Dubey, Suyash; Pandey, Ankit; Sreekumar, K

2016-09-01

To determine systemic absorption of dexamethasone by detection of plasma concentration using high performance liquid chromatography following its administration along with local anesthetic agent as a mixture via pterygomandibular space. A prospective randomized double-blind clinical study was undertaken to analyze the plasma concentration of dexamethasone after intra-space pterygomandibular injection along with local anesthesia. The study was performed as per split mouth model where the mandibular quadrant allocation was done on a random basis considering each of the 30 patients is included in the two study interventions (SS and CS). For the study site (SS) procedures, dexamethasone was administered as a mixture (2 % lignocaine with 1:200,000 epinephrine and 4 mg dexamethasone) intra-space. In the control site (CS) procedures, a regular standard inferior alveolar nerve block was administered, and dexamethasone was given as intramuscular injection. The plasma dexamethasone determination was done in venous blood 30- and 60-min post injection using high performance liquid chromatography (HPLC). The clinical parameters like pain; swelling; and mouth opening on the first, third, and seventh post-operative day were analyzed and compared. No significant difference was found in the clinical parameters assessed; comparative evaluation showed less swelling in the SS interventions. The plasma concentration of dexamethasone for the CS interventions was 226 ± 47 ng/ml at 30-min and 316 ± 81.6 ng/ml at 60-min post injection, and for SS, it was 221 ± 81.6 ng/ml at 30-min and 340 ± 105 ng/ml at 60-min post injection. On inter-site (CS and SS) comparison, no statistically significant difference was ascertained in dexamethasone plasma concentration at 30-min post injection (P = 0.77) and at 60-min post injection. (P = 0.32). Intra-space (pterygomandibular space) administration of dexamethasone can achieve statistically similar plasma concentration of the drug as when the same dose is administered intramuscularly with demonstration of similar clinical effects.

Titanium alloy vs. stainless steel miniscrews: an in vivo split-mouth study.

PubMed

Bollero, P; Di Fazio, V; Pavoni, C; Cordaro, M; Cozza, P; Lione, R

2018-04-01

To compare in vivo Titanium Alloy (TiA) with Stainless Steel (SS) miniscrews Temporary Anchorage Devices (TADs) using removal torque and Scanning Electron Microscopic (SEM) analysis. 15 subjects (6 males and 9 females) who required maximum anchorage were recruited. For each patient, a TiA TAD and a SS TAD with same length and width were implanted following a randomized split-mouth study design. Retraction was carried out with nickel-titanium spring ligated directly from the anterior hooks of the archwire to the TADs to produce 90 to 100 g of force. When no further anchorage supplementation was needed, the TADs were removed. The removal torque values were registered with a digital screwdriver. After removal, the TADs were collected in a fixed solution and examined using SEM and X-ray microanalysis. All TADs remained intact, with a 100% success rate. There was no difference in removal torque between TiA and SS miniscrews (4.4 ± 1.3 N-cm and 5.1 ± 0.7 N-cm, respectively). All specimens' loss of gloss with signs of biological contaminations resulted in a dull implant surface. SEM photomicrographs of TiA miniscrews showed predominantly blood cells while SS miniscrews showed the precipitation of an amorphous layer with low cellular component. There was no difference in spectroscopic analysis between TiA and SS miniscrews. TiA and SS miniscrews had comparable removal torque values. SEM photomicrographs showed no evidence of osseointegration with both TADs having similar biological responses.

Long-term efficacy of a 0.07% cetylpyridinium chloride mouth rinse in relation to plaque and gingivitis: a 6-month randomized, vehicle-controlled clinical trial.

PubMed

Van Leeuwen, M P C; Rosema, N A M; Versteeg, P A; Slot, D E; Van Winkelhoff, A J; Van der Weijden, G A

2015-05-01

To evaluate the effectiveness of 0.07% cetylpyridinium chloride (CPC) mouth rinse for reduction of gingival inflammation and inhibition of plaque compared to a vehicle control (VC) mouth rinse over a 6-month period. Participants (n = 62) used their randomly assigned product as adjunct to toothbrushing. Bleeding, plaque and staining scores were assessed at baseline, 3 and 6 months. Plaque and saliva samples were taken at each assessment monitoring possible shifts in the composition of the microbiota. A significant difference (P = 0.002) in favour of the CPC mouth rinse, with respect to plaque scores, was found. Bleeding scores at 6 months were not significantly different (P = 0.089). However, when correcting for baseline values, a tendency towards a significant difference in bleeding scores at end trail was observed in favour of the CPC mouth rinse (P = 0.061). Regarding staining at 3 and 6 months, a small but significant difference (8.6% and 10.4%, respectively) (P < 0.0001) was observed with lower scores for the VC group. There was a significant reduction in total anaerobic count in the CPC group at 6 months (P < 0.05). The ratio of aerobes/anaerobes was markedly increased at 3 months, especially in the CPC group. No further differences were observed between groups at 6 months. The use of 0.07% CPC mouth rinse was significantly more effective in reducing plaque scores than the vehicle control. Bleeding scores were not different at 6 months. The test product was well accepted and did not cause any serious clinical side effects or negatively affected the microbiota. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Periodontal Responses to Augmented Corticotomy with Collagen Membrane Application during Orthodontic Buccal Tipping in Dogs

PubMed Central

Herr, Yeek; Kwon, Young-Hyuk; Kim, Seong-Hun; Kim, Eun-Cheol

2014-01-01

This prospective randomized split-mouth study was performed to examine the effects of absorbable collagen membrane (ACM) application in augmented corticotomy using deproteinized bovine bone mineral (DBBM), during orthodontic buccal tipping movement in the dog. After buccal circumscribing corticotomy and DBBM grafting into the decorticated area, flaps were repositioned and sutured on control sides. ACM was overlaid and secured with membrane tacks, on test sides only, and the flaps were repositioned and sutured. Closed coil springs were used to apply 200 g orthodontic force in the buccolingual direction on the second and third premolars, immediately after primary flap closure. The buccal tipping angles were 31.19 ± 14.60° and 28.12 ± 11.48° on the control and test sides, respectively. A mean of 79.5 ± 16.0% of the buccal bone wall was replaced by new bone on the control side, and on the test side 78.9 ± 19.5% was replaced. ACM application promoted an even bone surface. In conclusion, ACM application in augmented corticotomy using DBBM might stimulate periodontal tissue reestablishment, which is useful for rapid orthodontic treatment or guided bone regeneration. In particular, ACM could control the formation of mesenchymal matrix, facilitating an even bone surface. PMID:25276824

Pilocarpine tablets for the treatment of dry mouth and dry eye symptoms in patients with Sjögren syndrome: a randomized, placebo-controlled, fixed-dose, multicenter trial. P92-01 Study Group.

PubMed

Vivino, F B; Al-Hashimi, I; Khan, Z; LeVeque, F G; Salisbury, P L; Tran-Johnson, T K; Muscoplat, C C; Trivedi, M; Goldlust, B; Gallagher, S C

1999-01-25

Patients with Sjögren syndrome (SS) experience slowly progressive infiltration of lacrimal and salivary glands by mononuclear cells. This leads to diminished secretions, with resultant symptoms of xerostomia and xerophthalmia. Although pilocarpine hydrochloride tablets are currently indicated for the treatment of radiation-induced xerostomia, their effects on dry mouth or dry eyes in patients with SS are unclear. To assess the safety and efficacy of pilocarpine (Salagen) tablets as symptomatic treatment for dry mouth and dry eyes caused by SS in a multicenter, doubleblind, placebo-controlled trial. After providing written informed consent, 373 patients with primary or secondary SS and clinically significant dry mouth and dry eyes were randomized to receive 2.5-mg pilocarpine, 5-mg pilocarpine, or placebo tablets 4 times daily for 12 weeks. Symptoms were assessed by questionnaires with visual analog scales or categorical checkboxes. Whole-mouth salivary flow rates were measured. A significantly greater proportion of patients in the 5-mg pilocarpine group showed improvement compared with the placebo group (P< or =.01) in global assessments of dry mouth, dry eyes, and other symptoms of dryness (P< or =.05). Salivary flow was significantly increased 2- to 3-fold (P<.001) after administration of the first dose and was maintained throughout the 12-week study. The most common adverse effect was sweating, and no serious drug-related adverse experiences were reported. Administration of 5-mg pilocarpine tablets 4 times daily (20 mg/d) was well tolerated and produced significant improvement in symptoms of dry mouth and dry eyes and other xeroses in patients with SS.

A Split-Mouth Design Comparison for Lateral and Crestal Sinus Lift Techniques with Dental Implants Placements: Short Communication.

PubMed

Al-Almaie, Saad; Kavarodi, Abdul Majeed; Alorf, Ali; Alzahrani, Saeed

2017-01-01

The objective of this study is to compare and evaluate the effectiveness of implant placement and patient appraisal for two sinus lift techniques using both crestal and lateral techniques for bilateral sinus left in a split-mouth design. All implants were successfully osseointegrated without any clinical complications or peri-implant radiolucency during the follow-up period of maximum 3 years. In terms of outcomes postoperative vertigo showed to be a major concern with the crestal approach, this approach is preferred over the lateral technique because of the reduced time required for the procedure and because it is less invasive. Most patients preferred the crestal approach over the lateral approach due to the delay in implant placement.

Split-mouth comparison of physics forceps and extraction forceps in orthodontic extraction of upper premolars.

PubMed

Hariharan, Samyuktha; Narayanan, Vinod; Soh, Chen Loong

2014-12-01

We compared outcome variables (operative complications, inflammatory complications, and operating time) in patients being treated by orthodontic extraction of upper premolars with the Physics forceps or the universal extraction forceps. We organised a single blind, split-mouth clinical trial to compare the outcomes of the 2 groups (n=54 premolars). The Physics forceps group had lower mean (SD) visual analogue scores (VAS) for pain (0.59 (0.57)) on the first postoperative day than the other group (1.04 (0.85)) (p=0.03). There were no other significant differences between the 2 groups in any other variable studied. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

The effect of a supersaturated calcium phosphate mouth rinse on the development of oral mucositis in head and neck cancer patients treated with (chemo)radiation: a single-center, randomized, prospective study of a calcium phosphate mouth rinse + standard of care versus standard of care.

PubMed

Lambrecht, Maarten; Mercier, Carole; Geussens, Yasmyne; Nuyts, Sandra

2013-10-01

Mucosal damage is an important and debilitating side effect when treating head and neck cancer patients with (chemo-)radiation. The aim of this randomized clinical trial was to investigate whether the addition of a neutral, supersaturated, calcium phosphate (CP) mouth rinse benefits the severity and duration of acute mucositis in head and neck cancer patients treated with (chemo)radiation. A total of 60 patients with malignant neoplasms of the head and neck receiving (chemo)radiation were included in this study. Fifty-eight patients were randomized into two treatment arms: a control group receiving standard of care (n = 31) and a study group receiving standard of care + daily CP mouth rinses (n = 27) starting on the first day of (chemo-)radiation. Oral mucositis and dysphagia were assessed twice a week using the National Cancer Institute common toxicity criteria scale version 3, oral pain was scored with a visual analogue scale. No significant difference in grade III mucositis (59 vs. 71 %; p = 0.25) and dysphagia (33 vs. 42 %, p = 0.39) was observed between the study group compared to the control group. Also no significant difference in time until development of peak mucositis (28.6 vs. 28.7 days; p = 0.48), duration of peak mucositis (22.7 vs. 24.6 days; p = 0.31), recuperation of peak dysphagia (20.5 vs 24.2 days; p = 0.13) and occurrence of severe pain (56 vs. 52 %, p = 0.5). In this randomized study, the addition of CP mouth rinse to standard of care did not improve the frequency, duration or severity of the most common acute toxicities during and early after (chemo)radiation. There is currently no evidence supporting its standard use in daily practice.

Effectiveness of pre-treatment with chlorhexidine in restoration retention: A 36-month follow-up randomized clinical trial.

PubMed

Favetti, Morgana; Schroeder, Thaiane; Montagner, Anelise Fernandes; Correa, Marcos Britto; Pereira-Cenci, Tatiana; Cenci, Maximiliano Sergio

2017-05-01

This study evaluated the effect of the pre-treatment with 2% chlorhexidine digluconate (CHX) as coadjutant in restoration retention of noncarious cervical lesions (NCCL), after 36 months of follow-up. A randomized controlled split-mouth and triple-blind (operators, patients and evaluator) trial was carried out. Patients (n=42) with at least two non-carious cervical lesions were included. The teeth with NCCL were randomly assigned to two treatment groups: application of 2% CHX (experimental group) or a placebo solution (control group) for 60s after acid etching and before the adhesive application. A trained and calibrated examiner evaluated the restorations at baseline (1 week) and at each recall (6, 12, 24 and 36 months) using the FDI criteria. A total of 225 restorations were evaluated after 36-month follow-up. Data were subjected to survival analysis using the Kaplan-Meier method, and the log-rank test was used to evaluate the existence of differences between the survival curves (α=0.05). The restorations survival rate after 36 months of follow-up was 76.1%. There was no difference in the retention and failure rates between the experimental and the control group (p=0.968). There was an increased failure trend when restorations were located subgingival compared to those at the gingival level or supragingival. The pre-treatment with 2% chlorhexidine digluconate did not promote further restoration retention of noncarious cervical lesions. The cavity pre-treatment with chlorhexidine for inhibition of hybrid layer degradation does not add any beneficial effect to the clinical performance of restorations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Adjunctive clinical effect of a water-cooled Nd:YAG laser in a periodontal maintenance care programme: a randomized controlled trial.

PubMed

Slot, Dagmar E; Timmerman, Mark F; Versteeg, Paula A; van der Velden, Ubele; van der Weijden, Fridus A

2012-12-01

Various laser systems are currently available for intra-oral use. Neodymium:Yttrium-Aluminium Garnet lasers(Nd:YAG) have been approved by the US Food and Drug Administration for soft tissue treatment in the oral cavity. The aim of this study was to test whether the use of a water-cooled Nd:YAG laser during a maintenance care programme as an adjunct to supragingival and subgingival debridement (scaling and root planing, SRP) with hand and ultrasonic instruments results in clinical improvement compared with SRP alone. This study was an examiner-blind, randomized and controlled clinical trial using a split-mouth design. Thirty subjects were selected, originally diagnosed with moderate to severe generalized periodontitis, following a periodontal maintenance care programme (PMC). Immediately after SRP in two randomly assigned contra-lateral quadrants, all pockets ≥5 mm were additionally treated with a Nd:YAG laser (1064 nm, 4W, 250-μsec pulse). Clinical assessments [probing pocket depth PPD, bleeding on pocket probing (BOPP)] were performed pre-treatment and at 6 months. Based on these assessments, the periodontal inflamed surface area (PISA) was calculated. At 6 months, the clinical parameters had significantly improved for both regimens. No statistically significant differences between treatment modalities were observed for PPD and BOPP scores at any time. PISA scores supported these findings. In residual pockets ≥5 mm, treated in a PMC, the adjunctive use of an Nd:YAG laser does not provide a clinically significant additional advantage. © 2012 John Wiley & Sons A/S.

A double-blind, randomized, placebo-controlled study of cevimeline in Sjögren's syndrome patients with xerostomia and keratoconjunctivitis sicca.

PubMed

Petrone, Dianne; Condemi, John J; Fife, Rose; Gluck, Oscar; Cohen, Stanley; Dalgin, Paul

2002-03-01

To evaluate the safety and efficacy of 2 dosages of cevimeline for the treatment of xerostomia and keratoconjunctivitis sicca in patients with Sjögren's syndrome. A 12-week double-blind, randomized, placebo-controlled study was performed. Patients were randomly assigned to receive either placebo, 15 mg of cevimeline 3 times daily, or 30 mg of cevimeline 3 times daily. Patients were evaluated at baseline and throughout the study for their global assessment of dryness (mouth, eyes, overall) as well as their subjective assessment of the specific symptoms of dry mouth and dry eyes. Total saliva and tear flow also were measured. Patients taking 30 mg of cevimeline 3 times daily had statistically significant improvements in their subjective global assessment of dry eyes (P = 0.0453), dry mouth (P = 0.0004), and increased salivary flow (P = 0.007). Patients receiving the 30-mg dosage also showed greater objective improvement (increased salivary and lacrimal flow rates, as measured by Schirmer's test) than did patients receiving placebo. Frequently reported adverse events included headache, increased sweating, abdominal pain, and nausea. Treatment with cevimeline at a dosage of 30 mg 3 times daily resulted in substantive improvement by increasing the rate of saliva and tear flow in patients with Sjögren's syndrome, as well as improving subjective symptoms of dry mouth, dry eyes, and overall dryness. The 15-mg dosage relieved some symptoms, and both dosages were well tolerated.

Comparison of Antimicrobial Efficacy of Green Tea, Garlic with Lime, and Sodium Fluoride Mouth Rinses against Streptococcus mutans, Lactobacilli species, and Candida albicans in Children: A Randomized Double-blind Controlled Clinical Trial

PubMed Central

Thomas, Ann; Habib, Rishika

2017-01-01

Introduction With greater awareness worldwide, the use of herbs and herbal products has increased to a large extent. Objective To evaluate and compare the antimicrobial efficacy of green tea, garlic with lime, and 0.05% sodium fluoride (NaF) mouth rinses against Streptococcus mutans, Lactobacilli species, and Candida albicans. Materials and methods A total of 45 children aged 4 to 6 years with severe early childhood caries (S-ECC; based on decayed extracted filled [defs] score) were selected. Children were divided randomly into three equal groups and were asked to rinse with the prescribed mouth rinse once daily for 2 weeks after breakfast under supervision. A base-line and postrinsing nonstimulated whole salivary sample (2 mL) was collected and tested for the number of colony-forming units (CFUs). The data were statistically analyzed using Statistical Package for the Social Sciences (SPSS) version 16.0 software with one-way analysis of variance (ANOVA) and Tukey’s post hoc test. Results A statistically significant fall in colony count was found with the three mouth rinses in S. mutans (p < 0.001, p < 0.001) and Lactobacilli spp. (p < 0.001, p < 0.001), but not against C. albicans (p = 0.264, p = 0.264). On comparison, no statistically significant difference was found against S. mutans (p = 1, p = 0.554, p = 0.572), lactobacilli spp. (p = 0.884, p = 0.999, p = 0.819), and C. albicans (p = 0.999, p = 0.958, p = 0.983). Conclusion The findings of this study indicate that green tea and garlic with lime mouth rinse can be an economical alternative to NaF mouth rinse both for prevention and therapeutics. How to cite this article Thomas A, Thakur S, Habib R. Comparison of Antimicrobial Efficacy of Green Tea, Garlic with Lime, and Sodium Fluoride Mouth Rinses against Streptococcus mutans, Lactobacilli species, and Candida albicans in Children: A Randomized Double-blind Controlled Clinical Trial. Int J Clin Pediatr Dent 2017;10(3):234-239. PMID:29104381

Comparison of Antimicrobial Efficacy of Green Tea, Garlic with Lime, and Sodium Fluoride Mouth Rinses against Streptococcus mutans, Lactobacilli species, and Candida albicans in Children: A Randomized Double-blind Controlled Clinical Trial.

PubMed

Thomas, Ann; Thakur, Sneha; Habib, Rishika

2017-01-01

With greater awareness worldwide, the use of herbs and herbal products has increased to a large extent. To evaluate and compare the antimicrobial efficacy of green tea, garlic with lime, and 0.05% sodium fluoride (NaF) mouth rinses against Streptococcus mutans, Lactobacilli species, and Candida albicans. A total of 45 children aged 4 to 6 years with severe early childhood caries (S-ECC; based on decayed extracted filled [defs] score) were selected. Children were divided randomly into three equal groups and were asked to rinse with the prescribed mouth rinse once daily for 2 weeks after breakfast under supervision. A base-line and postrinsing nonstimulated whole salivary sample (2 mL) was collected and tested for the number of colony-forming units (CFUs). The data were statistically analyzed using Statistical Package for the Social Sciences (SPSS) version 16.0 software with one-way analysis of variance (ANOVA) and Tukey's post hoc test. A statistically significant fall in colony count was found with the three mouth rinses in S. mutans (p < 0.001, p < 0.001) and Lactobacilli spp. (p < 0.001, p < 0.001), but not against C. albicans (p = 0.264, p = 0.264). On comparison, no statistically significant difference was found against S. mutans (p = 1, p = 0.554, p = 0.572), lactobacilli spp. (p = 0.884, p = 0.999, p = 0.819), and C. albicans (p = 0.999, p = 0.958, p = 0.983). The findings of this study indicate that green tea and garlic with lime mouth rinse can be an economical alternative to NaF mouth rinse both for prevention and therapeutics. Thomas A, Thakur S, Habib R. Comparison of Antimicrobial Efficacy of Green Tea, Garlic with Lime, and Sodium Fluoride Mouth Rinses against Streptococcus mutans, Lactobacilli species, and Candida albicans in Children: A Randomized Double-blind Controlled Clinical Trial. Int J Clin Pediatr Dent 2017;10(3):234-239.

Alfuzosin

MedlinePlus

Alfuzosin comes as an extended-release (long-acting) tablet to take by mouth. It is usually taken ... often than prescribed by your doctor.Swallow the tablets whole; do not split, chew, or crush them. ...

Cardiopulmonary resuscitation by chest compression alone or with mouth-to-mouth ventilation.

PubMed

Hallstrom, A; Cobb, L; Johnson, E; Copass, M

2000-05-25

Despite extensive training of citizens of Seattle in cardiopulmonary resuscitation (CPR), bystanders do not perform CPR in almost half of witnessed cardiac arrests. Instructions in chest compression plus mouth-to-mouth ventilation given by dispatchers over the telephone can require 2.4 minutes. In experimental studies, chest compression alone is associated with survival rates similar to those with chest compression plus mouth-to-mouth ventilation. We conducted a randomized study to compare CPR by chest compression alone with CPR by chest compression plus mouth-to-mouth ventilation. The setting of the trial was an urban, fire-department-based, emergency-medical-care system with central dispatching. In a randomized manner, telephone dispatchers gave bystanders at the scene of apparent cardiac arrest instructions in either chest compression alone or chest compression plus mouth-to-mouth ventilation. The primary end point was survival to hospital discharge. Data were analyzed for 241 patients randomly assigned to receive chest compression alone and 279 assigned to chest compression plus mouth-to-mouth ventilation. Complete instructions were delivered in 62 percent of episodes for the group receiving chest compression plus mouth-to-mouth ventilation and 81 percent of episodes for the group receiving chest compression alone (P=0.005). Instructions for compression required 1.4 minutes less to complete than instructions for compression plus mouth-to-mouth ventilation. Survival to hospital discharge was better among patients assigned to chest compression alone than among those assigned to chest compression plus mouth-to-mouth ventilation (14.6 percent vs. 10.4 percent), but the difference was not statistically significant (P=0.18). The outcome after CPR with chest compression alone is similar to that after chest compression with mouth-to-mouth ventilation, and chest compression alone may be the preferred approach for bystanders inexperienced in CPR.

Split-mouth comparison of the accuracy of computer-generated and conventional surgical guides.

PubMed

Farley, Nathaniel E; Kennedy, Kelly; McGlumphy, Edwin A; Clelland, Nancy L

2013-01-01

Recent clinical studies have shown that implant placement is highly predictable with computer-generated surgical guides; however, the reliability of these guides has not been compared to that of conventional guides clinically. This study aimed to compare the accuracy of reproducing planned implant positions with computer-generated and conventional surgical guides using a split-mouth design. Ten patients received two implants each in symmetric locations. All implants were planned virtually using a software program and information from cone beam computed tomographic scans taken with scan appliances in place. Patients were randomly selected for computer-aided design/computer-assisted manufacture (CAD/CAM)-guided implant placement on their right or left side. Conventional guides were used on the contralateral side. Patients underwent operative cone beam computed tomography postoperatively. Planned and actual implant positions were compared using three-dimensional analyses capable of measuring volume overlap as well as differences in angles and coronal and apical positions. Results were compared using a mixed-model repeated-measures analysis of variance and were further analyzed using a Bartlett test for unequal variance (α = .05). Implants placed with CAD/CAM guides were closer to the planned positions in all eight categories examined. However, statistically significant differences were shown only for coronal horizontal distances. It was also shown that CAD/CAM guides had less variability than conventional guides, which was statistically significant for apical distance. Implants placed using CAD/CAM surgical guides provided greater accuracy in a lateral direction than conventional guides. In addition, CAD/CAM guides were more consistent in their deviation from the planned locations than conventional guides.

Comparative Evaluation of Efficacy of Physics Forceps versus Conventional Forceps in Orthodontic Extractions: A Prospective Randomized Split Mouth Study.

PubMed

Patel, Harsh S; Managutti, Anil M; Menat, Shailesh; Agarwal, Arvind; Shah, Dishan; Patel, Jigar

2016-07-01

Tooth extraction is one of the most commonly performed procedures in dentistry. It is usually a traumatic procedure often resulting in immediate destruction and loss of alveolar bone and surrounding soft tissues. Various instruments have been described to perform atraumatic extractions which can prevent damage to the paradental structures. Recently developed physics forceps is one of the instruments which is claimed to perform atraumatic extractions. The aim of the present study was to compare the efficacy of physics forceps with conventional forceps in terms of operating time, prevention of marginal bone loss & soft tissue loss, postoperative pain and postoperative complications following bilateral premolar extractions for orthodontic purpose. In this prospective split-mouth study, outcomes of the 2 groups (n = 42 premolars) requiring extraction of premolars for orthodontic treatment purpose using Physics forceps and Conventional forceps were compared. Clinical outcomes in form of time taken, loss of buccal soft tissue and buccal cortical plate based on extraction defect classification system, postoperative pain and other complication associated with extraction were recorded and compared. Statistically significant reduction in the operating time was noted in physics forceps group. Marginal bone loss and soft tissue loss was also significantly lesser in physics forceps group when compared to conventional forceps group. However, there was no statistically significant difference in severity of postoperative pain between both groups. The results of the present study suggest that physics forceps was more efficient in reducing operating time and prevention of marginal bone loss & soft tissue loss when compared to conventional forceps in orthodontically indicated premolar extractions.

A Split-Mouth Design Comparison for Lateral and Crestal Sinus Lift Techniques with Dental Implants Placements: Short Communication

PubMed Central

Al-Almaie, Saad; Kavarodi, Abdul Majeed; Alorf, Ali; Alzahrani, Saeed

2017-01-01

Objective: The objective of this study is to compare and evaluate the effectiveness of implant placement and patient appraisal for two sinus lift techniques using both crestal and lateral techniques for bilateral sinus left in a split-mouth design. Introduction: All implants were successfully osseointegrated without any clinical complications or peri-implant radiolucency during the follow-up period of maximum 3 years. Methods: In terms of outcomes postoperative vertigo showed to be a major concern with the crestal approach, this approach is preferred over the lateral technique because of the reduced time required for the procedure and because it is less invasive. Results: Most patients preferred the crestal approach over the lateral approach due to the delay in implant placement. PMID:29290838

Plaque, gingival bleeding and calculus formation after supragingival scaling with and without polishing: a randomised clinical trial.

PubMed

Zanatta, Fabricio Batistin; Pinto, Tatiana Militz; Kantorski, Karla Zanini; Rösing, Cassiano Kuchenbecker

2011-01-01

The aim of this study was to compare the effect of polishing after scaling and root planing on supragingival plaque, calculus formation, and gingival bleeding. The study was designed as a split-mouth randomised clinical trial. Seventy-six patients were submitted to supragingival scaling on the six mandibular anterior teeth with manual curettes until a smooth surface was achieved. Subsequently, quadrants were randomly selected to be polished (test) or not (control) with a rubber cup and pumice. One, two and three weeks following treatment, a blinded examiner evaluated the visible plaque index, gingival bleeding index and the presence of supragingival calculus on the lingual tooth surfaces. The results showed that unpolished surfaces exhibited higher mean percentages of visible plaque in the third week. No statistically significant differences were observed between unpolished and polished sites related to gingival bleeding. Calculus formation was higher on unpolished sites than on polished sites at 2 and 3 weeks. Dental polishing after supragingival scaling contributed to reducing plaque and calculus formation. Polishing exerts an inhibitory effect on plaque and calculus formation.

Effect of submucosal dexamethasone injection on postoperative pain, oedema, and trismus following mandibular third molar surgery: a prospective, randomized, double-blind clinical trial.

PubMed

Mojsa, I M; Pokrowiecki, R; Lipczynski, K; Czerwonka, D; Szczeklik, K; Zaleska, M

2017-04-01

The aim of this study was to investigate the effect of the submucosal injection of 1ml dexamethasone (4mg/ml) on pain, swelling, and trismus following the extraction of retained lower third molars. Ninety patients (mean age 23.5 years) were split randomly into three equal study groups (30 patients in each): the 'before' group received dexamethasone 15min before surgery and placebo 15min after surgery; the 'after' group received placebo 15min before surgery and dexamethasone 15min after surgery; the 'placebo' group received placebo 15min before surgery and placebo 15min after surgery. Postoperative pain was recorded by the patients using a visual analogue scale, numerical rating scale, and the McGill Pain Questionnaire at 1, 2, 4, 6, 8, 12, and 24h after surgery. The patients also recorded the total number of analgesic doses consumed during the 24h after the procedure. Swelling (determined using linear measurements of the face) and trismus (determined through measurement of maximum mouth opening) were assessed at 48h, 72h, and 7 days following surgery. Better control of pain, swelling, and trismus was demonstrated for dexamethasone in comparison to placebo. Postoperative dexamethasone provided better pain control than preoperative dexamethasone. There was no difference in total rescue analgesic intake between the preoperative and postoperative dexamethasone groups. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Reduction of erosive wear in situ by stannous fluoride-containing toothpaste.

PubMed

Huysmans, M C D N J M; Jager, D H J; Ruben, J L; Unk, D E M F; Klijn, C P A H; Vieira, A M

2011-01-01

Stannous fluoride (SnF) has been suggested as a dental erosion-preventive agent. The aim of this single-centre, randomized, double-blind, in situ study was to evaluate the effect of toothpastes with SnF in the prevention of erosive enamel wear. A combined split-mouth (extra-oral water or toothpaste brushing) and crossover (type of toothpaste) set-up was used. Twelve volunteers wore palatal appliances containing human enamel samples. Three toothpastes were used, in three consecutive runs, in randomized order: two toothpastes containing SnF (coded M and PE) and one toothpaste containing only sodium fluoride (coded C). On day 1 of each run the appliances were worn for pellicle formation. On days 2-5 the samples were also brushed twice with a toothpaste-water slurry or only water (control). Erosion took place on days 2-5 extra-orally 3 times a day (5 min) in a citric acid solution (pH 2.3). Enamel wear depth was quantified by optical profilometry. The effect of toothpastes was tested using General Linear Modeling. Average erosive wear depth of control samples was 23 μm. Both SnF toothpastes significantly reduced erosive wear: M by 34% (SD 39%) and PE by 26% (SD 25%). The control toothpaste reduced erosive wear non-significantly by 7% (SD 20%). Both SnF-containing toothpastes significantly reduced erosive wear compared to the sodium fluoride toothpaste. We conclude that SnF-containing toothpastes are able to reduce erosive tooth wear in situ. Copyright © 2011 S. Karger AG, Basel.

A randomized clinical trial in subjects with dry mouth evaluating subjective perceptions of an experimental oral gel, an oral rinse and a mouth spray compared to water.

PubMed

Jose, Anto; Siddiqi, Muhammad; Cronin, Matthew; DiLauro, Thomas S; Bosma, Mary Lynn

2016-02-01

This multicenter, randomized, parallel group study analyzed the effectiveness of an experimental oral gel, a commercially available oral rinse and a commercially available mouth spray versus water alone at relieving self-reported symptoms of dry mouth over a 28-day home use treatment period. The effects of the study treatments on dry mouth-related quality of life (QoL) were also investigated. Eligible subjects were stratified by dry mouth severity (mild, moderate or severe) and randomized to receive one of the study treatments. Prior to first use they completed a questionnaire designed to assess their baseline dry mouth-related QoL. Following first use and on Day 8 (2 hours post-treatment only) and Day 29, subjects completed the modified Product Performance and Attributes Questionnaire (PPAQ) I at 0.5, 1, 2 and 4 hours post-treatment. Subjects further assessed treatment performance using the PPAQ II questionnaire on Days 8 and 29 and the dry mouth-related QoL questionnaire on Day 29. In 396 randomized subjects almost all comparisons of responses to PPAQ I, including those for the primary endpoint (response to PPAQ I Question 1 'Relieving the discomfort of dry mouth' after 2 hours on Day 29), were statistically significant in favor of active treatment groups versus water (P < 0.05). All comparisons of responses to PPAQ II on Days 8 and 29 were statistically significant in favor of active treatments versus water (P < 0.05). Moreover, nearly all comparisons for dry mouth-related QoL scores on Day 29 were statistically significant in favor of the active treatments versus water. All the dry mouth management strategies in this trial were well tolerated.

Herbal Medicine for Xerostomia in Cancer Patients: A Systematic Review of Randomized Controlled Trials.

PubMed

Park, Bongki; Noh, Hyeonseok; Choi, Dong-Jun

2018-06-01

Xerostomia (dry mouth) causes many clinical problems, including oral infections, speech difficulties, and impaired chewing and swallowing of food. Many cancer patients have complained of xerostomia induced by cancer therapy. The aim of this systematic review is to assess the efficacy of herbal medicine for the treatment of xerostomia in cancer patients. Randomized controlled trials investigating the use of herbal medicines to treat xerostomia in cancer patients were included. We searched the following 12 databases without restrictions on time or language. The risk of bias was assessed using the Cochrane Risk of Bias Tool. Twenty-five randomized controlled trials involving 1586 patients met the inclusion criteria. A total of 24 formulas were examined in the included trials. Most of the included trials were insufficiently reported in the methodology section. Five formulas were shown to significantly improve the salivary flow rate compared to comparators. Regarding the grade of xerostomia, all formulas with the exception of a Dark Plum gargle solution with normal saline were significantly effective in reducing the severity of dry mouth. Adverse events were reported in 4 trials, and adverse effects of herbal medicine were reported in 3 trials. We found herbal medicines had potential benefits for improving salivary function and reducing the severity of dry mouth in cancer patients. However, methodological limitations and a relatively small sample size reduced the strength of the evidence. More high-quality trials reporting sufficient methodological data are warranted to enforce the strength of evidence regarding the effectiveness of herbal medicines.

The long-term effect of a zinc acetate and chlorhexidine diacetate containing mouth rinse on intra-oral halitosis-A randomized clinical trial.

PubMed

Erovic Ademovski, Seida; Mårtensson, Carina; Persson, Gösta Rutger; Renvert, Stefan

2017-10-01

To evaluate the long-term effects of a zinc acetate and chlorhexidine diacetate mouth rinse (Zn/CHX) on intra-oral halitosis. Forty-six adults with intra-oral halitosis were randomized into a 6-month, double-blind, placebo-controlled clinical study. The presence of intra-oral halitosis was evaluated at baseline, 3 and 6 months after treatment by assessment of organoleptic score (OLS) and by total volatile sulphur compounds (T-VSC), hydrogen sulphide (H 2 S) and methyl mercaptan (MM) concentrations in exhaled air. A Zn/CHX mouth rinse provided significantly better control of intra-oral halitosis than a placebo mouth rinse. At 3 and 6 months, individuals rinsing with the Zn/CHX rinse presented with reductions of the OLS, T-VSC (p < .01, respectively), H 2 S (p < .001), and MM (p < .01) in subjects' exhaled air. At 6 months, 68.2% of individuals using the Zn/CHX rinse experienced a 1 or 2 category improvement in OLS compared with 19.1% of placebo-treated subjects. 91% of subjects in the Zn/CHX group were categorized as being effectively treated for intra-oral halitosis (i.e. H 2 S < 112 ppb), compared to 43% in the placebo group. Zn/CHX mouth rinse provides effective long-term efficacy against intra-oral halitosis, assessed both objectively and subjectively. With regular rinsing, the effect was sustained for 6 months. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Evaluation of the effectiveness of a semi-finished occlusal appliance – a randomized, controlled clinical trial

PubMed Central

2013-01-01

Introduction Painful temporomandibular disorders (TMDs) are usually treated with physiotherapy, self-exercises, medication-based therapy and splint therapy. For splint therapy different types of splints are available. Therefore this randomized controlled study compared the effectiveness of a semi-finished occlusal appliance (SB) with a laboratory-made occlusal appliance (SS) in myofascial pain patients. Method The trial subjects allocated to the experimental groups with the (SB) occlusal appliance and those provided with a laboratory-made occlusal appliance (SS) did, in addition, receive conservative treatment (self-exercises, drug-based and manual therapy). The control group was given conservative therapy (CO) only. Overall, a total of 63 patients participated in the study with each group consisting of 21 subjects. Results When the first follow-up examination took place (14 days after splint insertion) mouth opening within the SB group was significantly enlarged. When the second examination was conducted (2.5 months after splint insertion) mouth opening was significantly enlarged in both splint groups when compared with the initial value. In the control group, no significant enlargement of mouth opening was detected. At no point there was a significant reduction in the number of pressure-sensitive areas of the TMJ. On palpation of the masticatory muscles however, a significant reduction in the number of pressure-sensitive areas could be observed within the CO group and the SS group after 2.5 months. When comparing pain reduction (muscle/joint pain) and mouth opening, no significant differences could be detected between the treatments. Conclusion The results suggest that TMD should be treated conservatively. In cases of restricted mouth opening, the additional use of occlusal appliances can eliminate the patient’s discomfort more quickly. In this context, the tested, semi-finished occlusal appliance appears to offer an immediately available, temporary alternative to laboratory-made splints. PMID:23351923

Does Topical Application of Placental Extract Gel on Postoperative Fibrotomy Wound Improve Mouth Opening and Wound Healing in Patients With Oral Submucous Fibrosis?

PubMed

Thakur, Gagan; Thomas, Shaji; Bhargava, Darpan; Pandey, Ankit

2015-07-01

Placental extract has been used as a therapeutic agent with application in various fields of medicine. Placental extract is well known for its effects on wound healing with anti-inflammatory, antiplatelet, and angiogenic effects and is also a biogenic modulator. The present study evaluated the effect of placental extract on wound healing, mouth opening, and postoperative patient discomfort in patients with oral submucous fibrosis treated with fibrotomy with buccal fat pad coverage and coronoidectomy. Ten subjects with oral submucous fibrosis who presented with mouth opening less than 20 mm were enrolled in the present prospective randomized controlled trial to assess the effects of placental extract on the fibrotomy wound covered with a pedicled buccal pad fat (5 patients allocated to the study group, group S and 5 to the control group, group C). The following criteria were used to analyze the postoperative effect of placental extract on fibrotomy wounds compared with that of the controls: subjective assessment of the wound, postoperative discomfort, and postoperative mouth opening assessed at 1, 2, and 4 weeks postoperatively. The average difference in the preoperative and fourth week postoperative mouth opening for group C was 13.8 ± 2.68 mm and was 21.20 ± 2.77 mm in group S. The median calculated for group C was a 15.0-mm increase in mouth opening and was 20.0 mm in group S. The results obtained with topical application of placental extract on fibrotomy wound healing and postoperative mouth opening were superior to those of the control group in whom placental extract was not used. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Plecanatide

MedlinePlus

Plecanatide comes as a tablet to take by mouth. It is usually taken once a day with or without food. Take plecanatide at around the ... often than prescribed by your doctor.Swallow the tablets whole; do not split or chew them.If ...

Sunitinib

MedlinePlus

Sunitinib comes as a capsule to take by mouth with or without food. For the treatment of gastrointestinal stromal tumors (GIST), or for the treatment ... often than prescribed by your doctor.Swallow the capsules whole; do not split, chew, or crush them. ...

Cinacalcet

MedlinePlus

Cinacalcet comes as a tablet to take by mouth. It is usually taken once a day with food or shortly after a meal. To help ... often than prescribed by your doctor.Swallow the tablets whole; do not split, chew, or crush them. ...

Effects of intra-alveolar placement of 0.2% chlorhexidine bioadhesive gel on dry socket incidence and postsurgical pain: a double-blind split-mouth randomized controlled clinical trial.

PubMed

Haraji, Afshin; Rakhshan, Vahid; Khamverdi, Naiemeh; Alishahi, Hadiseh Khanzadeh

2013-01-01

To assess the effects of intra-alveolar application of chlorhexidine gel on the incidence of alveolar osteitis (dry socket) and the severity of postsurgical pain. A total of 160 impacted mandibular third molars were extracted in 80 patients enrolled in this trial. In each subject, a socket was randomly selected and packed to the crest of the alveolar ridge with a gelatin sponge dressing saturated in 0.2% chlorhexidine gel. The contralateral socket was packed with a dry dressing as the placebo. None of the included patients took antibiotics or analgesics. The occurrence of dry socket and patients' pain levels were assessed at the first and third postoperative days. The data were analyzed using Spearman correlation coefficient, McNemar, Wilcoxon, and chi-square tests. Chlorhexidine gel significantly reduced dry socket incidence from 32.6% to 11.3% (P ≤ .001 [McNemar and chi-square], absolute risk reduction = 21.2%, relative risk reduction = 65.4%, odds ratio = 0.263, relative risk = 0.345). It also significantly relieved postoperative pain on both sides in all the patients (P ≤ .001 [Wilcoxon]) and also in the 54 subjects who did not develop dry socket (P ≤ .001 [Wilcoxon]). Besides decreasing the incidence of dry socket, chlorhexidine gel can reduce postsurgical pain in patients with and without dry socket.

Management of Chronic Periodontitis Using Chlorhexidine Chip and Diode Laser-A Clinical Study.

PubMed

Jose, Kachapilly Arun; Ambooken, Majo; Mathew, Jayan Jacob; Issac, Annie Valayil; Kunju, Ajithkumar Parachalil; Parameshwaran, Renjith Athirkandathil

2016-04-01

The use of adjuncts like chlorhexidine local delivery and diode laser decontamination have been found to improve the clinical outcomes of scaling and root planing in non-surgical periodontal therapy in patients with chronic periodontitis. To evaluate the effects of diode laser and chlorhexidine chip as adjuncts to scaling and root planing in the management of chronic periodontitis. The objective is to evaluate the outcome of chlorhexidine chip and diode laser as adjuncts to scaling and root planing on clinical parameters like Plaque Index, Gingival Index, probing pocket depth and clinical attachment level. Department of Periodontics. Randomized clinical trial with split mouth design. Fifteen chronic periodontitis patients having a probing pocket depth of 5mm-7mm on at least one interproximal site in each quadrant of the mouth were included in the study. After initial treatment, four sites in each patient were randomly subjected to scaling and root planing (control), chlorhexidine chip application (CHX chip group), diode laser (810 nm) decontamination (Diode laser group) or combination of both (Diode laser and chip group). Plaque Index (PI), Gingival Index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were assessed at baseline, one month and three months. Results were statistically analysed using paired T test, one-way ANOVA, Tukey's HSD test and repeated measure ANOVA. Post-treatment, the test and control sites showed a statistically significant reduction in PI, GI, PPD, and CAL. After three months, a mean PPD reduction of 1.47±0.52 mm in control group, 1.40±0.83 mm in diode laser group, 2.67±0.62 mm in CHX group, and 2.80± 0.77 mm in combination group was seen. The mean gain in CAL were 1.47±0.52 mm in the control group, 1.40±0.83 mm in diode laser group, 2.67± 0.49 mm in CHX group and 2.67± 0.82 mm in combination group respectively. The differences in PPD reduction and CAL gain between control group and CHX chip and combination groups were statistically significant (p<0.05) at three months, whereas, the diode laser group did not show any significant difference from the control group. Chlorhexidine local delivery alone or in combination with diode laser decontamination is effective in reducing probing pocket depth and improving clinical attachment levels when used as adjuncts to scaling and root planing in non-surgical periodontal therapy of patients with chronic periodontitis.

Management of Chronic Periodontitis Using Chlorhexidine Chip and Diode Laser-A Clinical Study

PubMed Central

Ambooken, Majo; Mathew, Jayan Jacob; Issac, Annie Valayil; Kunju, Ajithkumar Parachalil; Parameshwaran, Renjith Athirkandathil

2016-01-01

Introduction The use of adjuncts like chlorhexidine local delivery and diode laser decontamination have been found to improve the clinical outcomes of scaling and root planing in non-surgical periodontal therapy in patients with chronic periodontitis. Aim To evaluate the effects of diode laser and chlorhexidine chip as adjuncts to scaling and root planing in the management of chronic periodontitis. The objective is to evaluate the outcome of chlorhexidine chip and diode laser as adjuncts to scaling and root planing on clinical parameters like Plaque Index, Gingival Index, probing pocket depth and clinical attachment level. Study and Design Department of Periodontics. Randomized clinical trial with split mouth design. Materials and Methods Fifteen chronic periodontitis patients having a probing pocket depth of 5mm-7mm on at least one interproximal site in each quadrant of the mouth were included in the study. After initial treatment, four sites in each patient were randomly subjected to scaling and root planing (control), chlorhexidine chip application (CHX chip group), diode laser (810 nm) decontamination (Diode laser group) or combination of both (Diode laser and chip group). Plaque Index (PI), Gingival Index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were assessed at baseline, one month and three months. Statistical analysis Results were statistically analysed using paired T test, one-way ANOVA, Tukey’s HSD test and repeated measure ANOVA. Results Post-treatment, the test and control sites showed a statistically significant reduction in PI, GI, PPD, and CAL. After three months, a mean PPD reduction of 1.47±0.52 mm in control group, 1.40±0.83 mm in diode laser group, 2.67±0.62 mm in CHX group, and 2.80± 0.77 mm in combination group was seen. The mean gain in CAL were 1.47±0.52 mm in the control group, 1.40±0.83 mm in diode laser group, 2.67± 0.49 mm in CHX group and 2.67± 0.82 mm in combination group respectively. The differences in PPD reduction and CAL gain between control group and CHX chip and combination groups were statistically significant (p<0.05) at three months, whereas, the diode laser group did not show any significant difference from the control group. Conclusion Chlorhexidine local delivery alone or in combination with diode laser decontamination is effective in reducing probing pocket depth and improving clinical attachment levels when used as adjuncts to scaling and root planing in non-surgical periodontal therapy of patients with chronic periodontitis. PMID:27190958

Hounsfield unit change in root and alveolar bone during canine retraction.

PubMed

Jiang, Feifei; Liu, Sean S-Y; Xia, Zeyang; Li, Shuning; Chen, Jie; Kula, Katherine S; Eckert, George

2015-04-01

The objective of this study was to determine the Hounsfield unit (HU) changes in the alveolar bone and root surfaces during controlled canine retractions. Eighteen maxillary canine retraction patients were selected for this split-mouth design clinical trial. The canines in each patient were randomly assigned to receive either translation or controlled tipping treatment. Pretreatment and posttreatment cone-beam computed tomography scans of each patient were used to determine tooth movement direction and HU changes. The alveolar bone and root surface were divided into 108 divisions, respectively. The HUs in each division were measured. Mixed-model analysis of variance was applied to test the HU change distribution at the P <0.05 significance level. The HU changes varied with the directions relative to the canine movement. The HU reductions occurred at the root surfaces. Larger reductions occurred in the divisions that were perpendicular to the moving direction. However, HUs decreased in the alveolar bone in the moving direction. The highest HU reduction was at the coronal level. HU reduction occurs on the root surface in the direction perpendicular to tooth movement and in the alveolar bone in the direction of tooth movement when a canine is retracted. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Hounsfield Unit Change in Root and Alveolar Bone during Canine Retraction

PubMed Central

Jiang, Feifei; Liu, Sean Y.; Xia, Zeyang; Li, Shuning; Chen, Jie; Kula, Katherine S.; Eckert, George

2014-01-01

Objectives The objective of this study was to determine the Hounsfield unit (HU) changes in the alveolar bone and root surface during controlled canine retractions. Methods Eighteen maxillary canine retraction patients were selected for this split mouth design clinical trial. The canines in each patient were randomly assigned to receive either translation or controlled tipping treatment strategy. Pre- and post-treatment cone beam computed tomography scans of each patient were used to determine tooth movement direction and HU changes. The alveolar bone and root surface were divided into 108 divisions, respectively. The HU in each division was measured. The Mixed-model ANOVA was applied to test the HU change distribution at the p<0.05 significant level. Results The HU changes varied with the directions relative to the canine movement. The HU reduction occurred at the root surface. Larger reductions occurred in the divisions that were perpendicular to the moving direction. However, HU decreased in the alveolar bone in the moving direction. The highest HU reduction was at the coronal level. Conclusions HU reduction occurs on the root surface in the direction perpendicular to the tooth movement and in the alveolar bone in the direction of tooth movement when a canine is retracted. PMID:25836004

Evaluation of low-level laser at auriculotherapy points to reduce postoperative pain in inferior third molar surgery: study protocol for a randomized controlled trial.

PubMed

Sampaio-Filho, Hélio; Sotto-Ramos, Juliane; Pinto, Erika Horácio; Cabral, Marcia Regina; Longo, Priscila Larcher; Tortamano, Isabel Peixoto; Marcos, Rodrigo Labat; Silva, Daniela Fátima Teixeira; Pavani, Christine; Horliana, Anna Carolina Ratto Tempestini

2016-09-02

A comfortable postoperative return to daily activities has increased the need to control inflammation after third molar surgery. Anti-inflammatory drugs and analgesics are not exempt from adverse effects such as allergies and chronic gastritis, and they are not without cost. The association between low-level laser and auricular acupuncture can be an alternative when conventional drugs are contraindicated. Among its advantages, we can mention the low risk of side effects, low cost and simplicity of application. The objective of this study is to evaluate the efficiency of low-level laser at auriculotherapy points in reducing postoperative pain in lower third molar surgery. Ninety bilateral, symmetrical lower third molar surgeries will be performed in 45 healthy patients. Each patient will be their own control, through a split-mouth crossover study. One side of the mouth will be randomly chosen and, immediately after surgery, will be treated with low-level laser. After 21 days, the contralateral side will be operated on with low-level laser simulation used postoperatively. This regimen (laser application or not) will be repeated at 24 and 48 h after surgery. All patients will be requested to take analgesics (acetaminophen) if they have pain, i.e. in case of pain. Neither the surgeon nor the patients will know the assigned treatment. The primary variable will be postoperative pain assessed using a Visual Analog Scale, and the secondary variables will be trismus, edema, local temperature, dysphagia, presence of infection and painkiller ingestion. These variables will be assessed at baseline, 24 h, 48 h and 7 days after surgery. Blood samples for systemic inflammatory cytokine (TNF-α, IL-1, IL-6 and IL-8) analysis will be assessed at baseline and 24 h after surgery. Some authors believe that using a wavelength of 633 to 670 nm is a good option for laser therapy in the field of acupuncture. This wavelength can penetrate biological tissue to a depth of about 3 mm. However, for auriculotherapy points, the stimulus (mustard seeds, needles 1 to 2.5 mm) does not penetrate so deeply. For this reason, we chose a laser wavelength of 660 nm (red wavelength). ClinicalTrials.gov Identifier: NCT02657174 , registered on 11 January 2016.

Relaxation Therapy and Anxiety, Self-Esteem, and Emotional Regulation among Adults with Intellectual Disabilities: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Bouvet, Cyrille; Coulet, Aurélie

2016-01-01

This pilot study is a randomized controlled trial on the effects of relaxation on anxiety, self-esteem, and emotional regulation in adults with intellectual disabilities (ID) working in a center of supported employment in France. We studied 30 adults with mild or moderate ID who were split at random into a relaxation group (RG, 15 subjects), who…

Mouth-opening device as a treatment modality in trismus patients with head and neck cancer and oral submucous fibrosis: a prospective study.

PubMed

Li, Yu-Hsuan; Chang, Wei-Chin; Chiang, Tien-En; Lin, Chiun-Shu; Chen, Yuan-Wu

2018-04-26

This study investigated the clinical effectiveness of intervention with an open-mouth exercise device designed to facilitate maximal interincisal opening (MIO) and improve quality of life in patients with head and neck (H&N) cancer and oral submucous fibrosis (OSF). Sixty patients with H&N cancer, OSF, and trismus (MIO < 35 mm) participated in the functional rehabilitation program. An open-mouth exercise device intervention group and conventional group, each consisting of 20 patients, underwent a 12-week training and exercising program and follow-up. For the control group, an additional 20 patients were randomly selected to match the demographic characteristics of the aforementioned two groups. The patients' MIO improvements in the aforementioned three groups were 14.0, 10.5, and 1.3 mm, respectively. Results of this study confirm the significant improvement in average mouth-opening range. In addition, according to patient feedback, significant improvements in health-related quality of life and reductions in trismus symptoms occurred in the open-mouth exercise device group. This newly designed open-mouth exercise device can facilitate trismus patients with H&N cancer and OSF and improve mouth-opening range and quality of life.

Cleft Lip and Palate

MedlinePlus

... Safe Videos for Educators Search English Español Cleft Lip and Cleft Palate KidsHealth / For Kids / Cleft Lip and Cleft Palate ... the back of your mouth. What's a Cleft Lip or Cleft Palate? The word cleft means a gap or split ...

Plasma variations in stress markers: Clinical trial of two anesthetics used in regional block in the extraction of impacted inferior third molars

PubMed Central

Arteagoitia, Iciar; Zumarraga, Mercedes; Dávila, Ricardo; Barbier, Luis; Santamaría, Gorka

2014-01-01

Objectives: Was to evaluate the effect of different regional anesthetics (articaine with epinephrine versus prilocaine with felypressin) on stress in the extraction of impacted lower third molars in healthy subjects. Sutdy Desing: A prospective single-blind, split-mouth cross-over randomized study was designed, with a control group. The experimental group consisted of 24 otherwise healthy male volunteers, with two impacted lower third molars which were surgically extracted after inferior alveolar nerve block (regional anesthesia), with a fortnight’s interval: the right using 4% articaine with 1:100.000 epinephrine, and the left 3% prilocaine with 1:1.850.000 felypressin. Patients were randomized for the first surgical procedure. To analyze the variation in four stress markers, homovanillic acid, 3-methoxy-4-hydroxyphenylglycol, prolactin and cortisol, 10-mL blood samples were obtained at t = 0, 5, 60, and 120 minutes. The control group consisted of 12 healthy volunteers, who did not undergo either extractions or anesthetic procedures but from whom blood samples were collected and analyzed in the same way. Results: Plasma cortisol increased in the experimental group (multiple range test, P<0.05), the levels being significantly higher in the group receiving 3% prilocaine with 1:1.850,000 felypressin (signed rank test, p<0.0007). There was a significant reduction in homovanillic acid over time in both groups (multiple range test, P<0.05). No significant differences were observed in homovanillic acid, 3-methoxy-4-hydroxyphenylglycol or prolactin concentrations between the experimental and control groups. Conclusions: The effect of regional anesthesia on stress is lower when 4% articaine with 1:100,000 epinephrine is used in this surgical procedure. Key words:Stress markets, epinephrine versus felypressin. PMID:24316704

Effectiveness of green tea mouthwash in postoperative pain control following surgical removal of impacted third molars: double blind randomized clinical trial

PubMed Central

2013-01-01

Background Pain following surgical removal of impacted molars has remained an important concern among practitioners. Various protocols have been proposed to reduce postoperative pain. However, each one has special side effects and limitations. As green tea possesses anti-inflammatory and antibacterial properties, the aim of the current study was to evaluate the effectiveness of green tea mouthwash in controlling postoperative pain. Materials and methods In a study with split-mouth and double blind design, 44 patients in need of bilateral removal of impacted third molars underwent randomized surgical extraction; following one surgery patients rinsed with a green tea mouthwash from the first to seventh postoperative day and after other extraction rinsed with placebo mouthwash in the same duration. Both patients and surgeon were blinded to the type of mouthwash. The predictor variable was type of mouthwash and primary outcome variable was postoperative pain measured by visual analogue scale (VAS) during first week after surgery. In addition, number of analgesics patients used after surgery recorded. To measure the effect of green tea mouthwash, repeated measures test with confidence interval of 95% was performed. Results Total of 43 patients with mean age of 24 years underwent total of 86 surgeries. VAS value had no statistically difference prior rinsing among groups (P-value > 0.05). However, the mean value of VAS following rinsing with green tea was statistically lower than placebo in postoperative days of 3–7 (P-value < 0.05). In addition, while rinsing with green tea, patients took significantly lower number of analgesics after surgery (P-value < 0.05). No side effects reported. Conclusion Green tea mouthwash could be an appropriate and safe choice to control postoperative pain after third molar surgery. PMID:23866761

Clinical effectiveness of diode laser therapy as an adjunct to non-surgical periodontal treatment: a randomized clinical study.

PubMed

Dukić, Walter; Bago, Ivona; Aurer, Andrej; Roguljić, Marija

2013-08-01

The aim of this randomized clinical study is to evaluate the effect of a 980-nm diode laser as an adjunct to scaling and root planing (SRP) treatment. Thirty-five patients with chronic periodontitis were selected for the split-mouth clinical study. SRP was performed using a sonic device and hand instruments. Quadrants were equally divided between the right and left sides. Teeth were treated with SRP in two control quadrants (control groups [CG]), and the diode laser was used adjunctively with SRP in contralateral quadrants (laser groups [LG]). Diode laser therapy was applied to periodontal pockets on days 1, 3, and 7 after SRP. Baseline data, including approximal plaque index (API), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL), were recorded before the treatment and 6 and 18 weeks after treatment. Changes in PD and CAL were analyzed separately for initially moderate (4 to 6 mm) and deep (7 to 10 mm) pockets. The results were similar for both groups in terms of API, BOP, PD in deep pockets, and CAL. The laser group showed only significant PD gain in moderate pockets during the baseline to 18-week (P <0.05) and 6- to 18- week (P <0.05) periods, whereas no difference was found between LG and CG in the remaining clinical parameters (P >0.05). The present study indicates that, compared to SRP alone, multiple adjunctive applications of a 980-nm diode laser with SRP showed PD improvements only in moderate periodontal pockets (4 to 6 mm).

Efficacy of Exclusive Lingual Nerve Block versus Conventional Inferior Alveolar Nerve Block in Achieving Lingual Soft-tissue Anesthesia.

PubMed

Balasubramanian, Sasikala; Paneerselvam, Elavenil; Guruprasad, T; Pathumai, M; Abraham, Simin; Krishnakumar Raja, V B

2017-01-01

The aim of this randomized clinical trial was to assess the efficacy of exclusive lingual nerve block (LNB) in achieving selective lingual soft-tissue anesthesia in comparison with conventional inferior alveolar nerve block (IANB). A total of 200 patients indicated for the extraction of lower premolars were recruited for the study. The samples were allocated by randomization into control and study groups. Lingual soft-tissue anesthesia was achieved by IANB and exclusive LNB in the control and study group, respectively. The primary outcome variable studied was anesthesia of ipsilateral lingual mucoperiosteum, floor of mouth and tongue. The secondary variables assessed were (1) taste sensation immediately following administration of local anesthesia and (2) mouth opening and lingual nerve paresthesia on the first postoperative day. Data analysis for descriptive and inferential statistics was performed using SPSS (IBM SPSS Statistics for Windows, Version 22.0, Armonk, NY: IBM Corp. Released 2013) and a P < 0.05 was considered statistically significant. In comparison with the control group, the study group (LNB) showed statistically significant anesthesia of the lingual gingiva of incisors, molars, anterior floor of the mouth, and anterior tongue. Exclusive LNB is superior to IAN nerve block in achieving selective anesthesia of lingual soft tissues. It is technically simple and associated with minimal complications as compared to IAN block.

Efficacy of Exclusive Lingual Nerve Block versus Conventional Inferior Alveolar Nerve Block in Achieving Lingual Soft-tissue Anesthesia

PubMed Central

Balasubramanian, Sasikala; Paneerselvam, Elavenil; Guruprasad, T; Pathumai, M; Abraham, Simin; Krishnakumar Raja, V. B.

2017-01-01

Objective: The aim of this randomized clinical trial was to assess the efficacy of exclusive lingual nerve block (LNB) in achieving selective lingual soft-tissue anesthesia in comparison with conventional inferior alveolar nerve block (IANB). Materials and Methods: A total of 200 patients indicated for the extraction of lower premolars were recruited for the study. The samples were allocated by randomization into control and study groups. Lingual soft-tissue anesthesia was achieved by IANB and exclusive LNB in the control and study group, respectively. The primary outcome variable studied was anesthesia of ipsilateral lingual mucoperiosteum, floor of mouth and tongue. The secondary variables assessed were (1) taste sensation immediately following administration of local anesthesia and (2) mouth opening and lingual nerve paresthesia on the first postoperative day. Results: Data analysis for descriptive and inferential statistics was performed using SPSS (IBM SPSS Statistics for Windows, Version 22.0, Armonk, NY: IBM Corp. Released 2013) and a P < 0.05 was considered statistically significant. In comparison with the control group, the study group (LNB) showed statistically significant anesthesia of the lingual gingiva of incisors, molars, anterior floor of the mouth, and anterior tongue. Conclusion: Exclusive LNB is superior to IAN nerve block in achieving selective anesthesia of lingual soft tissues. It is technically simple and associated with minimal complications as compared to IAN block. PMID:29264294

Effect of Green Coffee Bean Extract on Streptococcus mutans Count: A Randomised Control Trial

PubMed Central

Kaushik, Mamta; Roshni, Roshni; Reddy, Pallavi; Mehra, Neha; Jain, Vallari; Rana, Ritu

2017-01-01

Introduction Mouth rinses have been popularly used as a supplementary oral hygiene aid. A lot of commercially available mouth rinses possess few adverse effects, which has necessitated the search for alternative and herbal mouth rinses. Aim The aim of the study was to assess the effect of rinsing with green coffee bean extract in comparison with chlorhexidine mouthwash and sterile water on salivary Streptococcus mutans count. Materials and Methods A randomized parallel controlled clinical trial was planned and 45 subjects aged between 18-22 years were selected. The subjects were divided into three groups (n=15 in each group): Group A: Study group: 2% Green coffee bean extract, Group B: Positive control: 0.2% Chlorhexidine (CHX), Group C: Negative control: Sterile water. Group A subjects rinsed mouth with 5 ml of 2% Green coffee bean extract for one minute. Group B subjects rinsed mouth with 5 ml 0.2% CHX mouthwash for one minute. Group C subjects rinsed mouth with 5 ml of Sterile water for one minute twice daily for two weeks. Baseline samples (Pre rinse) were collected on day 1 and post rinsing saliva samples were collected after 14 days. The samples were cultured using Mitis Salivarius Agar enriched with Bacitracin and colonies were counted using a hand held digital colony counter. The statistical analysis was done using paired t-test, One-way variance ANOVA and Post-Hoc tests. Results The Green coffee bean extract group showed a statistical significant reduction in Streptococcus mutans colony count before and after intervention which was comparable with CHX group. Conclusion Green coffee bean extract as a mouthwash can be explored as a safe and effective alternative to CHX mouthwash. PMID:28658911

Effect of the route of administration of methylprednisolone on oedema and trismus in impacted lower third molar surgery.

PubMed

Koçer, G; Yuce, E; Tuzuner Oncul, A; Dereci, O; Koskan, O

2014-05-01

Due to their anatomical position, the surgical removal of impacted third molars results in oedema, pain, and trismus. The purpose of this study was to evaluate the efficacy of supraperiosteal injection of methylprednisolone compared with an oral tablet form and intravenous (i.v.) injection in the prevention of postoperative pain and oedema associated with inflammation. This randomized, prospective, and controlled study included 44 patients. The patients were randomly divided into four groups: group 1 (control; no steroids), group 2 (local injection), group 3 (oral tablets), and group 4 (i.v. injection). On days 2 and 7 following surgery, linear oedema was determined using facial landmarks, and maximal mouth opening was measured. Postoperative mouth opening and swelling were evaluated for each route of methylprednisolone administration and compared. The female (59%) to male (41%) ratio was 1.44; the mean age of the patients was 29.6 years. The level of significance was set at P<0.01 for mouth opening and P<0.05 for oedema. With regard to trismus, all three routes of administration demonstrated better efficacy in comparison to the control. While oral administration and i.v. injection of methylprednisolone achieved similar results, masseter injection provided better results in reducing oedema and trismus when compared to the control following lower third molar surgery. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Efficacy of prokinetics with a split-dose of polyethylene glycol in bowel preparation for morning colonoscopy: a randomized controlled trial.

PubMed

Kim, Hyoung Jun; Kim, Tae Oh; Shin, Bong Chul; Woo, Jae Gon; Seo, Eun Hee; Joo, Hee Rin; Heo, Nae-Yun; Park, Jongha; Park, Seung Ha; Yang, Sung Yeon; Moon, Young Soo; Shin, Jin-Yong; Lee, Nae Young

2012-01-01

Currently, a split-dose of polyethylene glycol (PEG) is the mainstay of bowel preparation due to its tolerability, bowel-cleansing action, and safety. However, bowel preparation with PEG is suboptimal because residual fluid reduces the polyp detection rate and requires a more thorough colon inspection. The aim of our study was to demonstrate the efficacy of a sufficient dose of prokinetics on bowel cleansing together with split-dose PEG. A prospective endoscopist-blinded study was conducted. Patients were randomly allocated to two groups: prokinetic with split-dose PEG or split-dose PEG alone. A prokinetic [100 mg itopride (Itomed)], was administered twice simultaneously with each split-dose of PEG. Bowel-cleansing efficacy was measured by endoscopists using the Ottawa scale and the segmental fluidity scale score. Each participant completed a bowel preparation survey. Mean scores from the Ottawa scale, segmental fluid scale, and rate of poor preparation were compared between both groups. Patients in the prokinetics with split-dose PEG group showed significantly lower total Ottawa and segmental fluid scores compared with patients in the split-dose of PEG alone group. A sufficient dose of prokinetics with a split-dose of PEG showed efficacy in bowel cleansing for morning colonoscopy, largely due to the reduction in colonic fluid. Copyright © 2012 S. Karger AG, Basel.

Using histograms to introduce randomization in the generation of ensembles of decision trees

DOEpatents

Kamath, Chandrika; Cantu-Paz, Erick; Littau, David

2005-02-22

A system for decision tree ensembles that includes a module to read the data, a module to create a histogram, a module to evaluate a potential split according to some criterion using the histogram, a module to select a split point randomly in an interval around the best split, a module to split the data, and a module to combine multiple decision trees in ensembles. The decision tree method includes the steps of reading the data; creating a histogram; evaluating a potential split according to some criterion using the histogram, selecting a split point randomly in an interval around the best split, splitting the data, and combining multiple decision trees in ensembles.

Effect of regional and systemic fluorinated pyrimidine chemotherapy on quality of life in colorectal liver metastasis patients.

PubMed

Earlam, S; Glover, C; Davies, M; Fordy, C; Allen-Mersh, T G

1997-05-01

Since systemic and regional (HAI) fluorinated pyrimidine chemotherapies offer similar survival benefit in treatment of colorectal liver metastases (CLM), we sought to identify their impact on quality of life (QoL), which might be a useful indicator of treatment preference. We compared QoL in 135 CLM patients managed by symptom control (n = 49 patients), systemic fluorouracil (5FU)/folinic acid (n = 35), or hepatic arterial floxuridine (FUDR) (n = 51). Full blood count and liver function tests, World Health Organization (WHO) toxicity criteria, and QoL (Rotterdam Symptom Checklist [RSC], the Sickness Impact Profile [SIP], and the Hospital Anxiety and Depression scale [HAD]) were measured monthly in all patients. The HAD anxiety score was significantly increased in symptom control compared with chemotherapy patients 1 month after randomization. There was a significant increase in RSC physical score (repeated measures, P = .05), and in scores for sore mouth (P < .01), dry mouth (P < .01), and tingling hands and feet (P < .01) in systemic chemotherapy compared with symptom control patients. Significant QoL differences (repeated measures and Mann-Whitney U [MWU]) between HAI and symptom control patients were not detected. Systemic chemotherapy patients lived for significantly longer (log-rank test, P < or = .0001) with abnormal HAD anxiety, RSC psychosocial, or RSC sore mouth scores compared with HAI patients, but there were no overall survival differences. Randomization to symptom control only was associated with increased anxiety. QoL with systemic chemotherapy was impaired by side effects. HAI was associated with similar survival to systemic chemotherapy but with better sustained QoL.

Stability of implants placed in augmented posterior mandible after alveolar osteotomy using resorbable nonceramic hydroxyapatite or intraoral autogenous bone: 12-month follow-up.

PubMed

Dottore, Alexandre M; Kawakami, Paulo Y; Bechara, Karen; Rodrigues, Jose Augusto; Cassoni, Alessandra; Figueiredo, Luciene C; Piattelli, Adriano; Shibli, Jamil Awad

2014-06-01

This prospective, controlled split-mouth study evaluated the stability of dental implants placed in the augmented mandibular areas with alveolar segmental "sandwich" osteotomies using nonceramic hydroxyapatite (ncHA) or autogenous bone. This study included 11 bilaterally partially edentulous mandibular patients in a split-mouth design. Alveolar augmentation osteotomies were performed bilaterally with interpositional ncHA graft (test group) or interpositional intraoral autogenous bone graft (control group). After 6 months of healing, four implants (two implants in each side) were placed in each patient. Forty-four implants were inserted and loaded after 6-month healing period. At 1-year follow-up, radiographic, prosthetic, and resonance frequency analysis parameters were assessed. Success criteria included absence of pain, sensitivity, suppuration, and implant mobility; absence of continuous peri-implant radiolucency; and distance between the implant shoulder and the first visible bone contact (DIB) < 2 mm. After a 1-year loading period, the overall implant survival rate was 95.45%, with two implant losses (one of each group). Among the surviving implants (42 out of 44), two did not fulfill the success criteria; therefore, the implant success was 90.90%. DIB was 0.71 ± 0.70 and 0.84 ± 0.72 mm for ncHA and autogenous bone grafts, respectively (p > .05). Implant stability measurements were similar between the groups during the 12-month follow-up (p > .05). Within the limits of this study, the implants placed either in sites augmented with ncHA or autogenous bone seem to represent a safe and successful procedure, at least, after 12-month follow-up. © 2012 Wiley Periodicals, Inc.

Microbiological outcome of two screw-shaped titanium implant systems placed following a split-mouth randomised protocol, at the 12th year of follow-up after loading.

PubMed

Van Assche, Nele; Pittayapat, Pisha; Jacobs, Reinhilde; Pauwels, Martine; Teughels, Wim; Quirynen, Marc

2011-01-01

To compare the subgingival microbiota around two differently designed implant systems that were in function for more than 12 years in a randomised split-mouth study design, and to compare the outcome with natural dentition. A total of 18 partially edentulous patients received at least two TiOblast™ (Astra Tech) and two Brånemark (Nobel Biocare) implants following a split-mouth design. At the last follow-up visit, periodontal parameters (probing depth, bleeding on probing and plaque) were recorded and intraoral radiographs were taken to calculate bone loss. Subgingival plaque samples were collected for culture, qPCR and checkerboard DNA-DNA hybridisation analysis. These data were related to implant design and bone loss. This study setup allowed a comparison of 34 Astra Tech (Impl A) with 32 Brånemark (Impl B) implants. During the 12-year follow up, five patients dropped out. One Brånemark implant was lost before abutment connection in a dropout patient. Mean bone loss between loading and year 12 was 0.7 mm (range: -0.8-5.8) (Impl A), and 0.4 mm (range: -1.1-4.1) (Impl B). No significant microbiological differences (qualitative and quantitative) could be observed between both implant types. Compared to teeth, subgingival plaque samples from implants did not reach the concentration of pathogens, even after 12 years of function. These data show that both implant systems (with differences in macro-design and surface characteristics), in patients with good oral hygiene and a stable periodontal condition, can maintain a successful treatment outcome without significant subgingival microbiological differences after 12 years of loading. The presence of periodontopathogens did not necessarily result in bone loss.

[Hyaluronate sodium treatment for internal derangement of temporomandibular joint: a systematic review based on randomized controlled trials].

PubMed

Li, Chunjie; Zhang, Yifan; Jia, Yuanyuan; Lü, Jun; Li, Longjiang; Shi, Zong-Dao

2011-10-01

To assess the efficacy and safety of hyaluronate sodium (HS) for internal derangement of temporomandibular joint by means of systematic review on relevant randomized controlled trials. After identifing the study question of the efficacy and safety of HS for internal derangement of temporomandibular joint, Medline, Cochrane Controlled Trials Register, EMBASE, OPEN SIGLE and CBM were searched electronically till October 3rd 2010. Hand-searching covering 19 dental journals in Chinese were also performed. Risk of bias assessment, with Cochrane Collaboration's tool, and data extraction of included studies were conducted by two reviewers in duplicate. Meta analysis was done with Revman 5.0.23 and the quality of evidence was evaluated by GRADE. 10 randomized controlled trials met the eligibility criteria and were included. All these studies had unclear risk of bias. When compared with negative control, HS showed a significant advantage on maximal mouth opening in short and long-term (P < 0.05), and clinical overall assessment in short-term (P < 0.05), but its effect on pain control and long-term effect on clinical overall assessment had no extra benefit (P > 0.05). Additionally, when compared with glucocorticoids, the participants who received HS injection would get a better clinical overall assessment in short-term and less adverse drug reactions (P < 0.05), but presented a similar temporomandibular joint pain relief and maximal mouth opening (P > 0.05). To a certain extent, HS had good efficacy and better safety than controls when treating internal derangement of temporomandibular joint. However, as the quality of some included studies were limited, more randomized controlled trials are needed to reinforce the conclusion.

Meta-analysis: Risk of dry mouth with second generation antidepressants.

PubMed

Cappetta, Kiley; Beyer, Chad; Johnson, Jessica A; Bloch, Michael H

2018-06-08

The goal of this meta-analysis was to quantify the risk of dry mouth associated with commonly prescribed antidepressant agents and examine the potential implications of medication class, dose, and pharmacodynamics and dose on risk of treatment-induced dry mouth. A PubMed search was conducted to identify double-blind, randomized, placebo-controlled trials examining the efficacy and tolerability of second generation antidepressant medications for adults with depressive disorders, anxiety disorders, and OCD. A random-effects meta-analysis was used to quantify the pooled risk ratio of treatment-emergent dry mouth with second generation antidepressants compared to placebo. Stratified subgroup analysis and meta-regression was utilized to further examine the effects antidepressant agent, class, dosage, indication, and receptor affinity profile on the measured risk of dry mouth. 99 trials involving 20,868 adults. SNRIs (Relative Risk (RR)=2.24, 95% Confidence Interval (CI): 1.95-2.58, z=11.2, p<0.001) were associated with a significantly greater risk of dry mouth (test for subgroup differences χ 2 =7.6, df=1; p=0.006) compared to placebo than SSRIs (RR=1.65, 95% CI: 1.39-1.95, z=5.8, p<0.001). There was a significant difference found in the risk of dry mouth between diagnostic indications within the SNRI class (test for subgroup differences χ 2 =9.63, df=1; p=0.002). Anxiety diagnoses (RR=2.78, 95% CI: 2.29-3.38, z=10.32, p<0.001) were associated with a greater risk of dry mouth compared to depression (RR=1.80, 95% CI: 1.48-2.18, z=5.85, p<0.001). Decreased affinity for Alpha-1 (PE=0.18, 95% CI: 0.07-0.28, z=3.26, p=0.001) and Alpha-2 (PE=0.49, 95% CI: 0.22-0.75, z=3.64, p<0.001) receptors and SERT (PE=0.07, 95% CI: 0.01-0.14, z=2.10, p<0.05) was significantly associated with increased risk of dry mouth. The current meta-analysis suggests that SSRIs, SNRIs, and atypical antidepressants are all associated with varying degrees of increased risk of dry mouth. SNRIs were associated with a significantly greater risk of dry mouth compared to SSRIs. Copyright © 2017 Elsevier Inc. All rights reserved.

Different therapeutic strategies for burning mouth syndrome: preliminary data.

PubMed

Marino, Roberto; Torretta, Sara; Capaccio, Pasquale; Pignataro, Lorenzo; Spadari, Francesco

2010-09-01

To compare different therapeutic supportive approaches in patients with burning mouth syndrome. A prospective study was carried out for this purpose. The study involved 56 patients with burning mouth syndrome. They were randomly assigned to treatment with capsaicin, alpha-lipoic acid or lysozyme-lactoperoxidase (test drugs) or boric acid (control group). Symptoms were scored after 60 days treatment and 60 days after drug discontinuation. At the end of the treatment period, there was a significant reduction in the symptom scores of all of the patients who received the test drugs (P<0.01), and at the end of the follow-up period in the test groups as a whole (P<0.01); the reduction was not significant when considering each test group separately after the treatment period. All of the treatments were more effective than boric acid and there was no significant difference in the symptom scores of the control group at either of the study time-points. Our results demonstrate the similar effectiveness of capsaicin and alpha-lipoic acid in controlling the symptoms of burning mouth syndrome. Lysozyme-lactoperoxidase may be effective in the supportive care of BMS patients with xerostomia. The transitory effect observed after discontinuing drug administration justifies the use of prolonged therapy in chronically affected patients. © 2010 John Wiley & Sons A/S.

The effects of combined application of transcranial magnetic stimulation and language training on children with language retardation.

PubMed

Qiu, Aizhen; Li, Xinjian; Yang, Zhongxiu; Li, Zhilin; Wang, Jiping; Yuan, Huanxia; Jin, Xin

2016-10-28

The objective of the present manuscript was to explore the effects of combined application of transcranial magnetic stimulation (TMS) and language training on children with language retardation. Forty-five children with language retardation were selected as subjects and randomly divided into the treatment group with 24 patients and the control group with 21 patients. The control group was treated with traditional language training, while the treatment group was treated with TMS combined with language training. According to Gesell pediatric neuropsychological development schedules, the development quotient of children in the two groups were observed and compared before and after two courses of treatment. The evaluation of mouth movement was conducted with Dr. Speech supervised by East China Normal University. Development quotient scores and mouth movement evaluation scores of all Gesell parameters of children in the two groups after treatment were significantly higher than those before treatment (P<0.05). The body movement ability, linguistic competence, development quotient scores, and mouth movement evaluation scores in the treatment group after treatment were higher than those of the control group, and the differences were statistically significant (P<0.05). The combined application of TMS and language training can effectively improve linguistic competence, action ability, and mouth movement in children with language retardation.

Efficacy of a new oral lubricant solution in the management of psychotropic drug-induced xerostomia: a randomized controlled trial.

PubMed

Mouly, Stéphane J; Orler, Jean-Baptiste; Tillet, Yves; Coudert, Anne-Claude; Oberli, Frantz; Preshaw, Phillip; Bergmann, Jean-François

2007-10-01

Xerostomia is a subjective sensation of mouth dryness often occurring as an unwanted effect of psychotropic drugs. The clinical efficacy and acceptability of a new oxygenated glycerol triester (OGT) oral spray (1 or 2 sprays up to 4 times daily) in the treatment of xerostomia was compared with those of a commercially available artificial saliva substitute (ASS [Saliveze]) in a 2-week, open-labeled, randomized, parallel-group study. Clinical assessment of xerostomia included evaluation of mouth dryness by means of a 10-cm-long visual analog scale, objective blinded assessment of the oral tissue condition by a dental hygienist by means of a 4-point ordinal scale, and subjective patient-based assessment of dry mouth symptoms by means of dichotomous responses to a questionnaire. [Day 14 - baseline] patient-based mouth dryness score was the primary end point. Seventy-four patients (41 women and 33 men, 44 +/- 15 years) undergoing long-term psychotropic drug treatment were consecutively enrolled. At day 14, OGT resulted in better efficacy than ASS in mouth dryness score (mean difference, 1.2 +/- 0.4; P = 0.006), speech difficulties (mean difference, 1.2 +/- 0.4; P = 0.005), taste (mean difference, 1.1 +/- 0.4; P = 0.02), and overall mouth condition (mean difference, 1.4 +/- 0.9; P = 0.005). Taste of OGT was better than that of ASS (mean difference, 1.4 +/- 0.6; P = 0.04), as was OGT acceptability (mean difference, 1.4 +/- 0.9; P = 0.005). Oxygenated glycerol triester lubricant oral spray was superior to a commercially available ASS in improving xerostomia and overall condition of the oral tissue.

Sniffing position combined with mouth opening improves facemask ventilation in children with adenotonsillar hypertrophy.

PubMed

Cuvas, O; Dikmen, B; Yucel, F

2011-05-01

This study evaluates the influence of sniffing position combined with mouth opening on the effectiveness of facemask ventilation in paralyzed pediatric patients undergoing adenotonsillectomy during sevoflurane-N(2)O anesthesia. After Institutional Ethics Committee approval, 40 children 5-11 years of age who were scheduled for an elective adenotonsillectomy operation were enrolled in this prospective randomized study. After routine monitoring and pre-oxygenation, anesthesia was induced with sevoflurane 8% in a mixture of 50% N(2)O-O(2). Three minutes after the administration of vecuronium, the sequence of the positions was randomized. Three positions were applied during facemask ventilation: Position CN (closed mouth - neutral head and neck position), position CS (closed mouth-sniffing position) and position OS (opened mouth-sniffing position). Volume-controlled ventilation was started. Peak inspiratory pressure (PIP), tidal volume (V(T)), expired tidal volume (V(Texp)) and end-tidal CO(2) pressure were recorded. The percent of leakage was calculated. The primary endpoint of this study was the expired tidal volume (V(Texp)). There was a statistically significant difference among the three positions for V(Texp) and PIP values. The OS resulted in higher V(Texp) values when compared with CN (P=0.022). The OS was significantly better than the other two positions, resulting in lower PIP values (P<0.001 and P=0.004, for CN and CS, respectively). The OS also resulted in less leakage during facemask ventilation when compared with CN and CS. Sniffing position combined with mouth opening improves V(Texp) and PIP values during facemask ventilation during sevoflurane-N(2)O anesthesia in paralyzed pediatric patients with adenotonsillar hypertrophy.

Evaluation of the Oral Tolerance of Three Fluoride Toothpaste Formulations in a Dry Mouth Population: Results from Two Randomized Studies.

PubMed

Jose, Anto; Ward, John; Shneyer, Lucy; Skinner, Jacob; Jeal, Nathan; Cronin, Matthew; Bosma, Mary Lynn

2016-03-01

To evaluate the oral tolerance of three experimental toothpaste formulations containing sodium fluoride (NaF), compared with two marketed sodium monofluorophosphate (SMFP)-containing biotène® toothpastes, in a dry mouth population after 14 days (primary objective) and 7 days (secondary objective) of use. Toothpastes were tested in two separate dual-site, examiner-blind, randomized, parallel group studies in subjects (35-84 years) with self-reported dry mouth. Oral soft tissue (OST) and oral hard tissue (OHT) examinations were performed at screening, followed by a 7- to 28-day wash-in period using a control toothpaste. Subjects were randomized to receive a NaF-containing toothpaste (Study 1: commercially available toothpaste Pronamel® for Children, n = 82; Study 2: experimental plaque biofilm-loosening formula [PBF] toothpaste, n = 79; or experimental Gentle Mint toothpaste, n = 78) or a reference toothpaste (Study 1: biotène® Fresh Mint Original toothpaste [previously marketed formulation], n = 82; Study 2: biotène® Gentle Mint Gel toothpaste [previously marketed formulation], n = 77) during the 14-day treatment phase. Subjects brushed their teeth twice daily for one timed minute with a ribbon of toothpaste to cover the head of the toothbrush provided. Subjects received further OST and OHT examinations at Day 1 and Day 15, and an additional OST examination at Day 8. Adverse events (AEs) and serious AEs (SAEs) were reported throughout the study. Study 1: At Day 15, 42 oral treatment-emergent AEs (TEAEs) were reported in 33 subjects, of which seven in five subjects (commercially available toothpaste Pronamel for Children: n = 2; control: n = 3) were considered to be treatment-related. One SAE (dyspnea) was reported in a participant who was randomized but withdrew from the study before receiving the allocated toothpaste. Study 2: At Day 15, 41 oral TEAEs were reported in 38 subjects, of which two in two subjects (experimental Gentle Mint toothpaste: n = 1; control: n = 1) were considered treatment-related, according to the investigator. No SAEs were reported. In both studies, the experimental and reference toothpastes were well tolerated after 7 and 14 days of use. The experimental NaF-containing toothpastes offer potential alternatives to individuals with dry mouth.

Randomized, controlled clinical trial to evaluate a xenogeneic collagen matrix as an alternative to free gingival grafting for oral soft tissue augmentation.

PubMed

McGuire, Michael K; Scheyer, E Todd

2014-10-01

The standard of care for increasing keratinized tissue (KT) and vestibular area is an autogenous free gingival graft (FGG) and vestibuloplasty; however, there is morbidity associated with the harvest of autogenous tissue, and supply is limited. The purpose of this study is to determine if a xenogeneic collagen matrix (CM) might be as effective as FGG. This study is a single-masked, randomized, controlled, split-mouth study of 30 patients with insufficient zones of KT (<2 mm). It uses a within-patient treatment-comparison design to establish non-inferiority of the test (CM) versus control (FGG) therapy. The primary efficacy endpoint was change in KT width (∆KT) from surgery to 6 months post-surgery. Secondary endpoints included traditional periodontal measures, such as clinical attachment level, recession, and bleeding on probing. Patient-reported pain, discomfort, and esthetic satisfaction were also recorded. Biopsies were obtained at 6 months. Surgery and postoperative sequelae were uneventful, with normal healing observed at both test and control sites. The primary outcome, ∆KT width at 6 months, did not establish non-inferiority of CM compared to FGG (P = 0.9992), with the FGG sites averaging 1.5 mm more KT width than CM sites. However, the amount of new KT generated for both therapies averaged ≥2 mm. Secondary outcomes were not significantly different between test and control sites. All site biopsies appeared as normal mucoperiosteum with keratinized epithelium. CM sites achieved better texture and color matches, and more than two-thirds of patients preferred the appearance of their CM sites. With the proviso of sufficient KT (≈2 mm in width) and study goals of lower morbidity, unlimited supply, and patient satisfaction, CM appears to be a suitable substitute for FGG in vestibuloplasty procedures designed to increase KT around teeth.

Short term clinical effectiveness of a 0.07% cetylpyridinium chloride mouth rinse in patients undergoing fixed orthodontic appliance treatment.

PubMed

Pahwa, Narinder; Kumar, Atul; Gupta, Siddharth

2011-07-01

To test the short term clinical effectiveness of commercially available 0.07%.cetylpyridinium chloride mouth rinse in patients undergoing fixed orthodontic treatment as compared to a placebo mouth rinse and patients using toothbrush and toothpaste. Forty-five subjects for this double blind study were assigned randomly into three groups of 15 each. Gingival inflammation, plaque accumulation, and bleeding on probing, were recorded at baseline (10 days after prophylaxis), and at the end of one month in all the three groups and compared. Paired t test showed significant differences in bleeding index for pre and post treatment recordings for cetylpyridinium group. Modified gingival index showed no significant difference in the cetylpyridinium group. For plaque index significant difference was found for cetylpyridinium and control groups. Cetylpyridinium mouth rinse 0.7% was found to be effective in reducing the bleeding and plaque index scores. It was not effective in reducing the modified gingival index scores. Cetylpyridinium mouth rinse 0.07% improves the oral hygiene of orthodontic patients when used as an adjunct to normal oral hygiene measures.

Periodontal ligament injection versus routine local infiltration for nonsurgical single posterior maxillary permanent tooth extraction: comparative double-blinded randomized clinical study.

PubMed

Al-Shayyab, Mohammad H

2017-01-01

The aim of this study was to evaluate the efficacy of, and patients' subjective responses to, periodontal ligament (PDL) anesthetic injection compared to traditional local-anesthetic infiltration injection for the nonsurgical extraction of one posterior maxillary permanent tooth. All patients scheduled for nonsurgical symmetrical maxillary posterior permanent tooth extraction in the Department of Oral and Maxillofacial Surgery at the University of Jordan Hospital, Amman, Jordan over a 7-month period were invited to participate in this prospective randomized double-blinded split-mouth study. Every patient received the recommended volume of 2% lidocaine with 1:100,000 epinephrine for PDL injection on the experimental side and for local infiltration on the control side. A visual analog scale (VAS) and verbal rating scale (VRS) were used to describe pain felt during injection and extraction, respectively. Statistical significance was based on probability values <0.05 and measured using χ 2 and Student t -tests and nonparametric Mann-Whitney and Kruskal-Wallis tests. Of the 73 patients eligible for this study, 55 met the inclusion criteria: 32 males and 23 females, with a mean age of 34.87±14.93 years. Differences in VAS scores and VRS data between the two techniques were statistically significant ( P <0.001) and in favor of the infiltration injection. The PDL injection may not be the alternative anesthetic technique of choice to routine local infiltration for the nonsurgical extraction of one posterior maxillary permanent tooth.

Effectiveness of advertising availability of prenatal ultrasound on uptake of antenatal care in rural Uganda: A cluster randomized trial

PubMed Central

Anguyo, Geoffrey; Meaney, Christopher; Yuan Kong, Ling; Malhame, Isabelle; Pace, Romina; Sodhi, Sumeet; Silverman, Michael

2017-01-01

In rural Uganda pregnant women often lack access to health services, do not attend antenatal care, and tend to utilize traditional healers/birth attendants. We hypothesized that receiving a message advertising that “you will be able to see your baby by ultrasound” would motivate rural Ugandan women who otherwise might use a traditional birth attendant to attend antenatal care, and that those women would subsequently be more satisfied with care. A cluster randomized trial was conducted across eight rural sub-counties in southwestern Uganda. Sub-counties were randomized to a control arm, with advertisement of antenatal care with no mention of portable obstetric ultrasound (four communities, n = 59), or an intervention arm, with advertisement of portable obstetric ultrasound. Advertisement of portable obstetric ultrasound was further divided into intervention A) word of mouth advertisement of portable obstetric ultrasound and antenatal care (one communitity, n = 16), B) radio advertisement of only antenatal care and word of mouth advertisement of antenatal care and portable obstetric ultrasound (one community, n = 7), or C) word of mouth + radio advertisement of both antenatal care and portable obstetric ultrasound (two communities, n = 75). The primary outcome was attendance to antenatal care. 159 women presented to antenatal care across eight sub-counties. The rate of attendance was 65.1 (per 1000 pregnant women, 95% CI 38.3–110.4) where portable obstetric ultrasound was advertised by radio and word of mouth, as compared to a rate of 11.1 (95% CI 6.1–20.1) in control communities (rate ratio 5.9, 95% CI 2.6–13.0, p<0.0001). Attendance was also improved in women who had previously seen a traditional healer (13.0, 95% CI 5.4–31.2) compared to control (1.5, 95% CI 0.5–5.0, rate ratio 8.7, 95% CI 2.0–38.1, p = 0.004). By advertising antenatal care and portable obstetric ultrasound by radio attendance was significantly improved. This study suggests that women can be motivated to attend antenatal care when offered the concrete incentive of seeing their baby. PMID:28403187

Effectiveness of advertising availability of prenatal ultrasound on uptake of antenatal care in rural Uganda: A cluster randomized trial.

PubMed

Cherniak, William; Anguyo, Geoffrey; Meaney, Christopher; Yuan Kong, Ling; Malhame, Isabelle; Pace, Romina; Sodhi, Sumeet; Silverman, Michael

2017-01-01

In rural Uganda pregnant women often lack access to health services, do not attend antenatal care, and tend to utilize traditional healers/birth attendants. We hypothesized that receiving a message advertising that "you will be able to see your baby by ultrasound" would motivate rural Ugandan women who otherwise might use a traditional birth attendant to attend antenatal care, and that those women would subsequently be more satisfied with care. A cluster randomized trial was conducted across eight rural sub-counties in southwestern Uganda. Sub-counties were randomized to a control arm, with advertisement of antenatal care with no mention of portable obstetric ultrasound (four communities, n = 59), or an intervention arm, with advertisement of portable obstetric ultrasound. Advertisement of portable obstetric ultrasound was further divided into intervention A) word of mouth advertisement of portable obstetric ultrasound and antenatal care (one communitity, n = 16), B) radio advertisement of only antenatal care and word of mouth advertisement of antenatal care and portable obstetric ultrasound (one community, n = 7), or C) word of mouth + radio advertisement of both antenatal care and portable obstetric ultrasound (two communities, n = 75). The primary outcome was attendance to antenatal care. 159 women presented to antenatal care across eight sub-counties. The rate of attendance was 65.1 (per 1000 pregnant women, 95% CI 38.3-110.4) where portable obstetric ultrasound was advertised by radio and word of mouth, as compared to a rate of 11.1 (95% CI 6.1-20.1) in control communities (rate ratio 5.9, 95% CI 2.6-13.0, p<0.0001). Attendance was also improved in women who had previously seen a traditional healer (13.0, 95% CI 5.4-31.2) compared to control (1.5, 95% CI 0.5-5.0, rate ratio 8.7, 95% CI 2.0-38.1, p = 0.004). By advertising antenatal care and portable obstetric ultrasound by radio attendance was significantly improved. This study suggests that women can be motivated to attend antenatal care when offered the concrete incentive of seeing their baby.

Alpha-2-Macroglobulin Levels in Gingival Crevicular Fluid Pre- and Post-scaling and Root Planing with Adjunctive Tetracycline Fibers in Chronic Periodontitis: A Randomized Controlled Trial.

PubMed

Chhina, Shivjot; Rathore, Ajit Singh; Juneja, Saurabh

2015-06-01

This split-mouth clinical study aimed to investigate levels of alpha-2-macroglobulin (a2M) in gingival crevicular fluid (GCF) of chronic periodontitis patients pre- and post-scaling and root planing (SRP) with or without adjunctive use of tetracycline fibers. In 30 patients of chronic periodontitis, samples of GCF were collected from the gingival sulcus before SRP. Recording of clinical parameters was conducted. This was followed by local drug delivery (LDD) of tetracycline fibers in test sites. In control sites, no LDD was done. Second samples of GCF were taken 90 days after treatment. Samples of crevicular fluid were analyzed to determine the levels of a2m. A gain of clinical attachment (CAL) of 3.30 mm for SRP and LDD and for SRP alone was 1.62 mm (p < 0.001). The pocket probing depth was significantly decreased by 2.43 mm for SRP and LDD and for SRP alone was 1.61 mm (p < 0.001) after 90 days. Alpha-2-macroglobulin was significantly reduced in GCF by SRP and SRP and LDD after 90 days (p < 0.001). Clinical and biochemical variables showed a more favorable outcome when SRP was combined with LDD of tetracycline fibers in management of patients suffering from chronic periodontitis.

Adjuvant antifungal therapy using tissue tolerable plasma on oral mucosa and removable dentures in oral candidiasis patients: a randomised double-blinded split-mouth pilot study.

PubMed

Preissner, Saskia; Kastner, Isabell; Schütte, Eyke; Hartwig, Stefan; Schmidt-Westhausen, Andrea Maria; Paris, Sebastian; Preissner, Robert; Hertel, Moritz

2016-07-01

Extended use of antimycotics in oral candidiasis therapy gives rise to problems related to fungal drug resistance. The aim of this pilot study was to investigate the efficacy of tissue tolerable plasma (TTP) in denture stomatitis patients. It was hypothesised that (I): erythema and (IIa): complaint remission would be accelerated and (IIb): colony forming unit (CFU) reduction would be improved. The halves of the upper jaws of eight patients were randomly assigned to control (nystatin, chlorhexidine and placebo treatment) and test sides (nystatin, chlorhexidine and TTP administered six times each 7 days). The patients and the investigators, who were different from the therapists, were both blinded. Compared to the control sides, the erythema surface was reduced significantly more extensively on the test sides between 2 and 6 weeks of antifungal therapy (P ≤ 0.05). Visual analogue scale values and the frequency of moderate or heavy growth of Candida post-treatment did not differ significantly between both sides (P > 0.05). The primary hypothesis was confirmed, which may be interpreted as an accelerated remission. As drug therapy is usually limited to the time in which signs of infection are present, TTP might help reducing antifungal use. Even though the secondary hypotheses were not confirmed, persistence of Candida might be only colonisation. © 2016 Blackwell Verlag GmbH.

Proline-Rich Peptide Mimics Effects of Enamel Matrix Derivative on Rat Oral Mucosa Incisional Wound Healing.

PubMed

Villa, Oscar; Wohlfahrt, Johan C; Mdla, Ibrahimu; Petzold, Christiane; Reseland, Janne E; Snead, Malcolm L; Lyngstadaas, Staale P

2015-12-01

Proline-rich peptides have been shown to promote periodontal regeneration. However, their effect on soft tissue wound healing has not yet been investigated. The aim of this study is to evaluate the effect of enamel matrix derivative (EMD), tyrosine-rich amelogenin peptide (TRAP), and a synthetic proline-rich peptide (P2) on acute wound healing after a full-thickness flap procedure in an incisional rat model. This experimental study has a split-mouth, randomized, placebo-controlled design. Test and control wounds were created on the palatal mucosa of 54 Sprague-Dawley rats. Wounds were histologically processed, and reepithelialization, leukocyte infiltration, and angiogenesis were assessed at days 1, 3, and 7 post-surgery. EMD and P2 significantly promoted early wound closure at day 1 (P <0.001 and P = 0.004, respectively). EMD maintained a significant acceleration of reepithelialization at day 3 (P = 0.004). Wounds treated by EMD and P2 showed increased angiogenesis during the first 3 days of healing (P = 0.03 and 0.001, respectively). Leukocyte infiltration was decreased in EMD-treated wounds at day 1 (P = 0.03), and P2 and TRAP induced a similar effect at days 3 (P = 0.002 and P <0.0001, respectively) and 7 (P = 0.005 and P <0.001). EMD and P2 promoted reepithelialization and neovascularization in full-thickness surgical wounds on rat oral mucosa.

Effect of adjunctive low level laser therapy (LLLT) on nonsurgical treatment of chronic periodontitis.

PubMed

Makhlouf, Mona; Dahaba, Mushira M; Tunér, Jan; Eissa, Sohair A; Harhash, Tarek A-H

2012-03-01

The aim of this split-mouth, double blinded, short-term, controlled clinical trial was to study the effect of low-level laser therapy (LLLT) as an adjunct to scaling and root planing (SRP) for treatment of chronic periodontitis. LLLT is reported to improve the outcome of traditional SRP, but the evidence is still weak. Sixteen patients with a probing pocket depth (PPD) of 4-6 mm involving at least three teeth in each quadrant were recruited for the study. Afterwards, SRP quadrants were randomly assigned for 10 sessions of LLLT. Results showed that when compared to sites treated with SRP alone, those treated with SRP+LLLT (10 sessions, 830 nm, 100 mW, 3 J per point, 3 J/cm(2)) exhibited greater reductions in PPD at 5 weeks and 3 months but not at 6 months. Further, SRP+LLLT-treated sites had a statistically significant increase in mean radiographic bone density when comparing 6- and 12-month data and overall from baseline to 12 months. There was a trend to reduce interleukin (IL)-1β but the difference between control and laser sites was not statistically significant. SRP combined with LLLT improved radiographic bone density and short-term PPD reduction in patients with chronic periodontitis, but did not significantly affect either the gingival crevicular fluid of IL-1β or the gingival or plaque index.

Adjunctive Effect of Autologus Platelet-Rich Fibrin to Barrier Membrane in the Treatment of Periodontal Intrabony Defects.

PubMed

Panda, Saurav; Sankari, Malaiappan; Satpathy, Anurag; Jayakumar, Doraiswamy; Mozzati, Marco; Mortellaro, Carmen; Gallesio, Giorgia; Taschieri, Silvio; Del Fabbro, Massimo

2016-05-01

Autologous platelet-rich fibrin (PRF) and barrier membranes in the treatment of intrabony defects in chronic periodontitis patients have shown significant clinical benefits. This study evaluates the additive effect of autologous PRF in combination with a barrier membrane versus the use of barrier membrane alone for the treatment of intrabony defects in chronic periodontitis patients. A randomized split-mouth design was used. Sixteen patients with 32 paired intrabony defects were included. In each patient 1 defect was treated using a resorbable collagen membrane along with PRF (test group) and the other defect by guided tissue regeneration alone (control group). The following clinical parameters were measured at baseline and after 9 months: plaque index, modified sulcus bleeding index, probing pocket depth, clinical attachment level, and gingival marginal level. The radiographic defect depth was also assessed at baseline and after 9 months. Test group showed a statistically significant improvement for probing depth (P = 0.002), clinical attachment level (P = 0.001), and radiographic defect depth (P < 0.001) after 9 months as compared with the control sites. Radiographic defect depth reduction was 58.19 ± 13.24% in the test group as compared with 24.86 ± 9.94% reduction in the control group. The adjunctive use of PRF in combination with barrier membrane is more effective in the treatment of intrabony defects in chronic periodontitis as compared with barrier membrane alone.

[Modified polyurethane foam as a local hemostatic agent after dental extractions].

PubMed

Selten, M H A; Broekema, F I; Zuidema, J; van Oeveren, W; Bos, R R M

2013-01-01

In this split mouth experiment, the feasibility ofpolyurethane foam as a local hemostatic agent after dental extractions was studied. Ten healthy patients underwent 2 extractions ofa dental element in 1 treatment session. The 10 patients were subsequently randomly divided in a gelatin group and a collagen group. In the gelatin group, a polyurethane foam (PU) was applied in 1 extraction socket, while in the other socket a commercially available gelatin foam was applied. In the collagen group, a PU was applied in 1 socket, and a collagen wadding in the other. All hemostats were removed after 2 minutes, after which the degree of coagulation was measured using a thrombin/antithrombin test and a fibrinogen test. This study suggests that polyurethane foam has hemostatic capacity. Large scale clinical research is needed to confirm this finding, and should indicate whether this hemostatic capacity is clinically relevant.

Tooth movements in foxhounds after one or two alveolar corticotomies.

PubMed

Sanjideh, Payam A; Rossouw, P Emile; Campbell, Phillip M; Opperman, Lynne A; Buschang, Peter H

2010-02-01

The aim of this split-mouth experimental study was to determine (1) whether corticotomy procedures increase tooth movement and (2) the effects of a second corticotomy procedure after 4 weeks on the rate of tooth movement. The mandibular third and maxillary second premolars of five skeletally mature male foxhounds, approximately 2 years of age, were extracted. One randomly selected mandibular quadrant had buccal and lingual flaps and corticotomies performed around the second premolar; the other quadrant served as the control. Both maxillary quadrants had initial buccal flaps and corticotomies; one randomly selected quadrant had a second buccal flap surgery and corticotomy after 28 days. Coil springs (200 g force), along with a 0.045 mm diameter tube on a 0.040 mm diameter guiding wire, were used to move the mandibular second and maxillary third premolars. Records, including digital calliper measurements and radiographs, were taken on days 0, 10, 14, 28, 42, and 56. Multilevel statistical procedures were used to model longitudinal tooth movements. The radiographic measurements initially showed increasing mandibular tooth movement rates, peaking between 22 and 25 days, and then decelerating. Total mandibular tooth movements were significantly (P < 0.05) greater on the experimental (2.4 mm) than on the control (1.3 mm) side. The rates of maxillary tooth movement slowed over time, with significantly (P < 0.05) more overall tooth movement on the side that had two (2.3 mm) than one (2.0 mm) corticotomy procedure. Alveolar corticotomy significantly increases orthodontic tooth movement. Performing a second corticotomy procedure after 4 weeks maintained higher rates of tooth movement over a longer duration and produced greater overall tooth movement than performing just one initial corticotomy, but the difference was small.

Effects of fixed orthodontic treatment and two new mouth rinses on gingival health: A prospective cohort followed by a single-blind placebo-controlled randomized clinical trial.

PubMed

Sobouti, Farhad; Rakhshan, Vahid; Heydari, Mohaddeseh; Keikavusi, Shohreh; Dadgar, Sepideh; Shariati, Mahsa

2018-03-01

Routine brushing protocols might not suffice to reduce the increased plaque accumulation in orthodontic patients. Antimicrobial mouth rinses are favorable in this regard. This two-phase study evaluated the effects of orthodontic treatment and the application of two mouthwashes not studied before on oral health indices. In this two-phase study (a prospective cohort followed by a parallel randomized controlled trial), plaque index (PI), gingival index (GI), gingival bleeding index (GBI), and pocket probing depth (PPD) were measured in 54 orthodontic patients before orthodontic treatment and 4 months later. Then patients were randomized into three groups of mouthrinses: Persica (herbal), Ortho-Kin (containing diluted chlorhexidine), and Placebo (n=18×3). The effects of orthodontic treatment and mouthrinses were analyzed statistically (α=0.05). All the 4 indices increased between the baseline and 4th month of treatment (P values<0.01, paired t-test). They decreased back to baseline levels or below them, after one month of mouthwash application (P values<0.002). Both mouthwashes showed therapeutic effects compared to placebo in terms of PI and GBI. In the case of GI, only Persica showed significantly better results compared to placebo. Regarding PPD, only Ortho-Kin acted better than placebo (P values≤0.05, Tukey). Lack of positive control (regular chlorhexidine mouth rinse) and negative control (a group with no mouthwashes, even without the placebo). Lack of sample size predetermination based on a priori power calculations. The difference between the regime of Persica with that of Ortho-Kin and placebo (which had similar application protocols) disallowed perfectly effective blinding of the patients (hence, single-blind). Fixed orthodontic treatment might disrupt gingival health. Antimicrobial mouthwashes might reverse this. Both evaluated mouthwashes might have therapeutic effects. Copyright © 2018 CEO. Published by Elsevier Masson SAS. All rights reserved.

Ultrathin Silicon Sheet in the Management of Unilateral Post-traumatic Temporo-Mandibuar Joint Ankylosis in Children: A Good Alternative to Conventional Techniques.

PubMed

Aggarwal, Sushil Kumar; Ankur, Bhatnagar; Jain, R K

2015-09-01

We have described a new technique of using ultra-thin silicon sheet (0.2 mm) between two transected bony ends for temporo-mandibular joint (TMJ) ankylosis in children with advantages of short operative time, minimal foreign material insertion and faster recovery time post-operatively which makes our technique a good alternative to conventional techniques. Our study is a non-randomized prospective study conducted on 10 children aged between 4 and 15 years who presented to our tertiary care institute with severe trismus after traumatic injury and were willing to undergo this new technique. The main outcome measure taken into consideration was difference between pre-operative, intra-operative (on table) and post-operative mouth opening (minimum 2 years follow-up). The pre-operative mouth opening in our cases varied from 1 to 5 mm. The intra-operative mouth opening achieved ranged from 2.8 to 3.2 cm. The mouth opening was about more than 2.7 cm in all our cases at 2 years of follow-up. Our technique is a good alternative to conventional techniques used for TMJ ankylosis in children but few more randomized controlled trials are required to assess its effectiveness in comparison to conventional techniques and for universal adoption of this technique.

Evaluation of laser therapy and alpha-lipoic acid for the treatment of burning mouth syndrome: a randomized clinical trial.

PubMed

Barbosa, Natália Guimarães; Gonzaga, Amanda Katarinny Goes; de Sena Fernandes, Luzia Leiros; da Fonseca, Aldilane Gonçalves; Queiroz, Salomão Israel Monteiro Lourenço; Lemos, Telma Maria Araújo Moura; da Silveira, Éricka Janine Dantas; de Medeiros, Ana Miryam Costa

2018-03-03

The aim of this study was to evaluate the efficacy of low-level laser therapy (LLLT) and alpha-lipoic acid (ALA) in the treatment of burning mouth syndrome (BMS) and secondary oral burning (SOB) by unstimulated sialometry, symptom assessment, and measurement of salivary TNF-α levels. Forty-four patients were randomized into four treatment groups: BMS/laser (n = 10), BMS/ALA (n = 5), SOB/laser (n = 15), and SOB/ALA (n = 14). The control group consisted of eight healthy female subjects. Unstimulated salivary flow was measured before and after treatment, and the collected saliva was stored at - 20 °C for the analysis of TNF-α. Symptoms were evaluated before and after treatment using a pain visual analog scale. Most patients were women (81.8%) during menopause (72.2%). LLLT and ALA were efficient in increasing salivary flow only in BMS but provided symptom relief in both conditions. TNF-α levels did not differ between patients with BMS and SOB or between those patients and the control group. No differences were observed in posttreatment TNF-α levels in either condition. The results of this study suggest that LLLT and ALA are efficient therapies in reducing burning mouth symptoms, with LLLT being more efficient than ALA.

Sensitivity and specificity of a new MRI method evaluating temporo-mandibular joint disc-condyle relationships: an in vivo study.

PubMed

Benbelaïd, R; Fleiter, B

2006-03-01

The aim of this study was to evaluate sensitivity and specificity of a new method to locate temporo-mandibular joint (TMJ) disc using magnetic resonance imaging (MRI) and analyze disc-condyle relationships, in asymptomatic subjects and patients with disc displacement. Twenty-nine sagittal MRI of 16 subjects, 8 asymptomatic volunteers and 8 subjects with anterior disc displacement, were carried out during controlled opening from intercuspal position up to a 25 mm opening. Selected sections were analyzed with a graphic computerized system of coordinates. The total surface area (TS) of disc section was separated into anterior surface area (AS) and posterior surface area. Areas were determined by computer. Two trained examiners drew images at random. The reliability of AS/TS ratio index was evaluated in a previous study. AS/TS ratio sensitivity (Se) and specificity (Sp) were calculated closed mouth, 5 mm open and 25 mm open mouth. Best sensitivity (Se=0.63) and specificity (Sp=0.81) were obtained when MRI was realized with closed mouth and 25 mm open mouth. Lower sensitivity was observed when MRI was performed either with closed mouth (Se=0.54) or 25 mm open mouth (Se=0.18). Lower specificity was observed with 5 mm open mouth (Sp=0.68). In conclusion, it was confirmed as well that MRI of anterior disc displacement should be performed with closed mouth and opened mouth. Thus, further studies are required to assess disc displacement and mechanical alterations and to evaluate the risk of direct damage on TMJ tissues.

Guided tissue regeneration and platelet rich growth factor for the treatment of Grade II furcation defects: A randomized double-blinded clinical trial - A pilot study.

PubMed

Jenabian, Niloofar; Haghanifar, Sina; Ehsani, Hodis; Zahedi, Ehsan; Haghpanah, Masumeh

2017-01-01

The treatment of furcation area defects remained as a challenging issue in periodontal treatments. Regeneration treatment of furcation defects is the most discussed periodontal treatment. Although not completely hopeless in prognosis, the presence of the furcation involvement significantly increases the chance of tooth loss. The current research was conductedeto compare theeadditive effect of combined guided tissue regeneration (GTR) and platelet-rich growth factor (PRGF) on the treatment of furcation bony defects. A randomized, triple-blinded, split-mouth study was designed. It included patients with a moderate to severe chronic periodontitis with bilateral Grade II furcation involvement of first or second mandibular molars. Each side of mouth was randomly allocated for the treatment with either Bio-Gide American Society of Anesthesiologists GTR or a PRGF or PRGF by itself. Plaque index, gingival index, vertical clinical attachment level, vertical probing depth, recession depth (REC), horizontal probing depth, fornix to alveolar crest (FAC), fornix to base of defect (FBD), furcation vertical component and furcation horizontal component (FHC) were recorded. The current research was conducted to compare the additive effect of combined GTR and PRGF on treatment of furcation bony defects. Altman's nomogram, Kolmogorov-Smirnov test, Friedman test, general linear model, repeated measures, and paired t -test were used as statistical analysis in this research. P < 0.05 was considered statistically significant. Eight patients were finally enrolled for this study. Overly, general and specific clinical and furcation parameters were improved except REC that was deteriorated insignificantly and FAC improved not significantly. Intergroup comparison revealed better improvement of FHC in GTR/PRGF group ( P = 0.02). A significant improvement in the Grade II furcation defects treated with either GTR or PRGF/GTR was noticed. Further large-scale trials are needed to reveal differences of mentioned treatment in more details.

Guided tissue regeneration and platelet rich growth factor for the treatment of Grade II furcation defects: A randomized double-blinded clinical trial - A pilot study

PubMed Central

Jenabian, Niloofar; Haghanifar, Sina; Ehsani, Hodis; Zahedi, Ehsan; Haghpanah, Masumeh

2017-01-01

Background: The treatment of furcation area defects remained as a challenging issue in periodontal treatments. Regeneration treatment of furcation defects is the most discussed periodontal treatment. Although not completely hopeless in prognosis, the presence of the furcation involvement significantly increases the chance of tooth loss. The current research was conductedeto compare theeadditive effect of combined guided tissue regeneration (GTR) and platelet-rich growth factor (PRGF) on the treatment of furcation bony defects. Materials and Methods: A randomized, triple-blinded, split-mouth study was designed. It included patients with a moderate to severe chronic periodontitis with bilateral Grade II furcation involvement of first or second mandibular molars. Each side of mouth was randomly allocated for the treatment with either Bio-Gide American Society of Anesthesiologists GTR or a PRGF or PRGF by itself. Plaque index, gingival index, vertical clinical attachment level, vertical probing depth, recession depth (REC), horizontal probing depth, fornix to alveolar crest (FAC), fornix to base of defect (FBD), furcation vertical component and furcation horizontal component (FHC) were recorded. The current research was conducted to compare the additive effect of combined GTR and PRGF on treatment of furcation bony defects. Altman's nomogram, Kolmogorov–Smirnov test, Friedman test, general linear model, repeated measures, and paired t-test were used as statistical analysis in this research. P < 0.05 was considered statistically significant. Results: Eight patients were finally enrolled for this study. Overly, general and specific clinical and furcation parameters were improved except REC that was deteriorated insignificantly and FAC improved not significantly. Intergroup comparison revealed better improvement of FHC in GTR/PRGF group (P = 0.02). Conclusion: A significant improvement in the Grade II furcation defects treated with either GTR or PRGF/GTR was noticed. Further large-scale trials are needed to reveal differences of mentioned treatment in more details. PMID:29238373

Effects of over-the-counter jaw-repositioning mouth guards on dynamic balance, flexibility, agility, strength, and power in college-aged male athletes.

PubMed

Golem, Devon L; Arent, Shawn M

2015-02-01

Improvements in muscular power and anaerobic performance have resulted from the use of jaw-repositioning mouth guards designed with advanced dental techniques. The high cost of such techniques has dissuaded the widespread use. Recently, more affordable, over-the-counter (OTC) jaw-repositioning mouth guards have become available. The primary objective of this study was to examine the effects of 2 OTC jaw-repositioning mouth guards on muscular power and strength performance in college-aged male athletes. It was hypothesized that similar to previous observations with advanced dentistry-designed mouth guards, OTC jaw-repositioning mouth guards would impart positive effects on muscular power but not have any effect on muscular strength. Secondary objectives of this study included the examination of the effects of 2 OTC jaw-repositioning mouth guards on other variables related to athletic performance. Male collegiate athletes (N = 20) participated in 4 separate testing sessions that consisted of assessment of muscular power, dynamic balance, flexibility, agility, and muscular strength. The 4 conditions, 1 per testing session, were assigned in a randomized order and consisted of a no-mouth guard control (CON), a placebo mouth guard, a self-adapted jaw-repositioning mouth guard (SA), and a custom-fitted jaw-repositioning mouth guard (CF). No significant differences were observed between conditions in muscular power (p = 0.78), dynamic balance (p = 0.99), agility (p = 0.22), or muscular strength (p = 0.47). The CF had significantly lower hip flexion than the CON (p = 0.014) and had significantly greater lumbar spine lateral flexion compared with the SA condition (p = 0.054). However, these flexibility differences lack practical relevance as the effect sizes remain very small (ES = -0.27 and -0.14, respectively). In conclusion, the jaw-repositioning technique used in the design of these OTC mouth guards did not affect performance. It is important to note that negative effects were not observed indicating that mouth guard use did not impede performance.

Evaluation of dental plaque control in patients wearing fixed orthodontic appliances: a clinical study.

PubMed

Ousehal, Lahcen; Lazrak, Laila; Es-Said, Rabia; Hamdoune, Hind; Elquars, Farid; Khadija, Amine

2011-03-01

Multibracket orthodontic appliances increase dental plaque retention and make teethbrushing more difficult for patients. As a result, advice from the orthodontist on oral hygiene along with patient motivation regarding teethbrushing are particularly important. The aim of this study was to compare the efficacy of electric toothbrushes with that of manual brushing associated with mouth-rinses comprising chlorhexidine (0.12%) and 0% alcohol. To this end, 84 patients receiving current orthodontic treatment were randomly selected from patients treated at the Dento-Facial Orthopedics department in the Casablanca Dental Consultation and Treatment Center. Selected patients were divided into three groups: Group 1: manual teethbrushing; Group 2: electric teethbrushing; Group 3: manual brushing combined with mouth rinse. Oral hygiene was assessed using the Loe-Silness plaque and gingival indices. Measurements were made before and 4 weeks after the observation period. Results were subjected to statistical comparison in order to determine the group showing greatest improvement and to deduce the best means of controlling bacterial plaque. The electric toothbrush and the chlorhexidine mouth rinse appear to control dental plaque more effectively than manual teethbrushing alone. Following this study, patients receiving multibracket treatment were invited to combine manual brushing with short clinical mouth-rinsing sessions or to use an electric toothbrush. Copyright © 2011 CEO. Published by Elsevier Masson SAS. All rights reserved.

Efficacy of Temporomandibular Joint Arthrocentesis with Sodium Hyaluronate in the Management of Temporomandibular Joint Disorders: A Prospective Randomized Control Trial.

PubMed

Gorrela, Harsha; Prameela, J; Srinivas, G; Reddy, B Vijay Baskar; Sudhir, Mvs; Arakeri, Gururaj

2017-12-01

This study was designed to investigate the efficacy of the temporomandibular joint arthrocentesis with and without injection of sodium hyaluronate (SH) in the treatment of temporomandibular joint disorders. A total of sixty two TMJs in 34 males and 28 females aged 20-65 years comprised the study material. The patients' complaints were limited mouth opening, TMJ pain, and joint noises during function. Patients were randomly divided into 2 groups in which arthrocentesis plus intra-articular injection of sodium hyaluronate was performed in 1 group and only arthrocentesis was performed in the other group. Both groups contained patients with disc displacement with reduction and without reduction. Clinical evaluation of the patients was done before the procedure, immediately after the procedure, at 1 week and 1, 3 and 6 months postoperatively. Intensity of TMJ pain was assessed using visual analog scales. Maximal mouth opening and lateral jaw movements also were recorded at each follow-up visit. Both techniques increased maximal mouth opening, lateral movements, and function, while reducing TMJ pain and noise. Although patients benefitted from both techniques, arthrocentesis with injection of SH seemed to be superior to arthrocentesis alone.

Short term clinical effectiveness of a 0.07% cetylpyridinium chloride mouth rinse in patients undergoing fixed orthodontic appliance treatment

PubMed Central

Pahwa, Narinder; Kumar, Atul; Gupta, Siddharth

2011-01-01

Objectives To test the short term clinical effectiveness of commercially available 0.07%.cetylpyridinium chloride mouth rinse in patients undergoing fixed orthodontic treatment as compared to a placebo mouth rinse and patients using toothbrush and toothpaste. Method Forty-five subjects for this double blind study were assigned randomly into three groups of 15 each. Gingival inflammation, plaque accumulation, and bleeding on probing, were recorded at baseline (10 days after prophylaxis), and at the end of one month in all the three groups and compared. Results Paired t test showed significant differences in bleeding index for pre and post treatment recordings for cetylpyridinium group. Modified gingival index showed no significant difference in the cetylpyridinium group. For plaque index significant difference was found for cetylpyridinium and control groups. Conclusion Cetylpyridinium mouth rinse 0.7% was found to be effective in reducing the bleeding and plaque index scores. It was not effective in reducing the modified gingival index scores. Cetylpyridinium mouth rinse 0.07% improves the oral hygiene of orthodontic patients when used as an adjunct to normal oral hygiene measures. PMID:23960507

Clinicobiochemical evaluation of turmeric with black pepper and nigella sativa in management of oral submucous fibrosis-a double-blind, randomized preliminary study.

PubMed

Pipalia, Pratik R; Annigeri, Rajeshwari G; Mehta, Ranjeeta

2016-12-01

To investigate the effectiveness of turmeric with black pepper and nigella sativa in oral submucous fibrosis (OSMF). Forty OSMF patients were randomly divided into two groups. The study was performed under a double-blind, randomized design. Group A received turmeric with black pepper and group B received nigella sativa for 3 months. Clinical evaluation was done every 15 days. Patients' serum superoxide dismutase (SOD) levels were assessed before and after treatment and also compared with healthy controls. The response to treatment was analyzed using analysis of variance, paired t test, and unpaired t test. After the treatment, groups A and B showed 3.85 ± 0.22 mm and 3.6 ± 0.07 mm improvement in mouth opening, respectively (P < .01); 87.90% and 78.91% reduction in burning sensation, respectively (P < .01); and +0.62 U/mL and +0.74 U/mL improvement in serum SOD levels, respectively (P < .05). The maximum mouth opening achieved was 8 mm in group A and 7 mm in group B. The mean pretreatment SOD level for controls and patients was 3.61 ± 0.24 U/mL in group A and 2.63 ± 0.18 U/mL in group B. Turmeric with black pepper and nigella sativa improved mouth opening, burning sensation, and SOD levels in the present OSMF study patients; however, further investigations are needed. Copyright © 2016 Elsevier Inc. All rights reserved.

A comparative study of surgical drain placement and the use of kinesiologic tape to reduce postoperative morbidity after third molar surgery.

PubMed

Genc, Aysenur; Cakarer, Sirmahan; Yalcin, Basak Keskin; Kilic, Beril Berivan; Isler, Sabri Cemil; Keskin, Cengizhan

2018-04-19

Our aim was to compare the effects of the surgical drain and kinesiotape applications on postoperative morbidity after mandibular third molar surgery in a split-mouth study design. A single-centre, split-mouth study was performed in 23 patients who needed surgical removal of bilateral mandibular third molars. Each patient was treated with a drain tube on one side of the mandible and Kinesio tape (KT) on the contralateral side. Swelling was significantly greater in the KT group than in the drain group throughout the study period. The groups did not differ significantly in the amount of trismus at any time point. The Visual Analogue Scale (VAS)-measured pain intensity was significantly lower in the drainage group. Patients with KT had greater postoperative discomfort than those with a drain tube. All patients were generally satisfied with their treatments. Although both treatments were useful, a surgical drain was significantly more effective at reducing swelling and pain intensity than Kinesio tape. The effects of both on trismus were similar.

Treatment of snorers with a volatile oil: a randomized, double-blind placebo-controlled trial.

PubMed

Ulfberg, J; Nyström, B

2001-01-01

Snoring is a significant problem both for the patient and for the bed partner. Seventy-two male and female heavy snorers and their bed partners participated in a double-blinded, placebo-controlled study on the effects of a volatile oil administered by gargling. The patients were diagnosed as heavy snorers after they underwent overnight polysomnography showing that their apnea indexes were below 5, thus sleep apnea patients were not included in the study. The participants and their partners filled out evaluations concerning snoring intensity, mouth dryness, nasal stuffiness and the Epworth Sleepiness Scale prior to and after using the volatile oil or placebo for 14 consecutive nights. There were no statistically significant decreases in snoring as graded by the bed partner or in mouth dryness, nasal stuffiness, or the Epworth Sleepiness Scale scores graded by the patients who were randomized to use the volatile oil. The results of this study indicate that this volatile oil is not an effective treatment in patients presenting with symptoms of snoring. Copyright 2001 S. Karger AG, Basel

Surgical microscope may enhance root coverage with subepithelial connective tissue graft: a randomized-controlled clinical trial.

PubMed

Bittencourt, Sandro; Del Peloso Ribeiro, Erica; Sallum, Enilson A; Nociti, Francisco H; Casati, Márcio Zaffalon

2012-06-01

Minimally invasive techniques have broadened the horizons of periodontal plastic surgery to improve treatment outcomes. Thus, the purpose of this clinical trial was to compare root coverage, postoperative morbidity, and esthetic outcomes of subepithelial connective tissue graft (SCTG) technique with or without the use of a surgical microscope in the treatment of gingival recessions. In this split-mouth study, twenty-four patients with bilateral Miller's Class I or II buccal gingival recessions ≥2.0 mm in canines or premolars were selected. Gingival recessions were randomly designated to receive treatment with SCTG with or without the assistance of the surgical microscope (test and control groups, respectively). Clinical parameters evaluated included the following: depth (RH) and width (RW) of the gingival defect, width (WKT) and thickness (TKT) of keratinized tissue, probing depth (PD), and clinical attachment level (CAL). Postoperative morbidity was evaluated by means of an analog visual scale and questionnaire. Patient satisfaction was also evaluated with a questionnaire. Descriptive statistics were expressed as mean ± SD. Repeated-measures analysis of variance was used for examination of differences regarding PD, CAL, and TKT. The Wilcoxon test was used to detect differences between groups and the Friedman test to detect differences within group regarding WKT, RH, and RW. The average percentages of root coverage for test and control treatments, after 12 months, were 98.0% and 88.3%, respectively (P <0.05). Complete root coverage was achieved in 87.5% and 58.3% of teeth treated in test and control groups, respectively. For all parameters except recession height, there was an improvement in the final examination but without difference between treatments. For the RH, a lower value was found in the test group compared to the control group (P <0.05). In the test group, all patients were satisfied with the esthetics obtained, and 19 patients (79.1%) were satisfied in the control group. For postoperative morbidity, 14 patients in each of the two treatment groups did not use analgesics for pain control. Both approaches were capable of producing root coverage; however, use of the surgical microscope was associated with additional clinical benefits in the treatment of teeth with gingival recessions.

Plaque and gingivitis in the elderly: a randomized, single-blind clinical trial on the outcome of intensified mechanical or antibacterial oral hygiene measures.

PubMed

Schiffner, Ulrich; Bahr, Mathias; Effenberger, Susanne

2007-12-01

To study the outcome of intensified mechanical oral hygiene compared with the effect of an adjunctive antibacterial mouth rinse on plaque and gingivitis in elderly people. In a randomized, single-blind, 6-month controlled clinical study, 106 subjects, 55 years or older, were divided into four groups: (I) Participants were instructed on improved mechanical oral hygiene, including interdental hygiene; (II) subjects used an antibacterial mouth rinse containing amine and stannous fluoride in addition to their usual oral hygiene practices; (III) both intensive mechanical and antibacterial measures were combined; and (IV) a control group with no specific regimen. Gingivitis and plaque were examined. After 6 months, both plaque and gingivitis scores were significantly lower than at baseline in all groups. Reductions in gingivitis differed significantly between the control group and all other groups but not between the three intervention groups. Only groups with improved mechanical oral hygiene showed significant improvements in plaque scores compared with control. Intensive mechanical oral hygiene resulted in greater plaque reduction than the combination of an antibacterial rinse and usual oral hygiene procedures. Gingivitis was reduced by both intensive oral hygiene and use of the amine/stannous fluoride rinse. Combining intensive mechanical oral hygiene with the antibacterial rinse did not result in further gingivitis reduction.

Mouth Rinsing with Maltodextrin Solutions Fails to Improve Time Trial Endurance Cycling Performance in Recreational Athletes.

PubMed

Kulaksız, Tuğba Nilay; Koşar, Şükran Nazan; Bulut, Suleyman; Güzel, Yasemin; Willems, Marcus Elisabeth Theodorus; Hazir, Tahir; Turnagöl, Hüseyin Hüsrev

2016-05-09

The carbohydrate (CHO) concentration of a mouth rinsing solution might influence the CHO sensing receptors in the mouth, with consequent activation of brain regions involved in reward, motivation and regulation of motor activity. The purpose of the present study was to examine the effects of maltodextrin mouth rinsing with different concentrations (3%, 6% and 12%) after an overnight fast on a 20 km cycling time trial performance. Nine recreationally active, healthy males (age: 24 ± 2 years; V ˙ O 2 m a x : 47 ± 5 mL·kg(-1)·min(-1)) participated in this study. A double-blind, placebo-controlled randomized study was conducted. Participants mouth-rinsed every 2.5 km for 5 s. Maltodextrin mouth rinse with concentrations of 3%, 6% or 12% did not change time to complete the time trial and power output compared to placebo (p > 0.05). Time trial completion times were 40.2 ± 4.0, 40.1 ± 3.9, 40.1 ± 4.4, and 39.3 ± 4.2 min and power output 205 ± 22, 206 ± 25, 210 ± 24, and 205 ± 23 W for placebo, 3%, 6%, and 12% maltodextrin conditions, respectively. Heart rate, lactate, glucose, and rating of perceived exertion did not differ between trials (p > 0.05). In conclusion, mouth rinsing with different maltodextrin concentrations after an overnight fast did not affect the physiological responses and performance during a 20 km cycling time trial in recreationally active males.

Immunogenicity and safety assessment of a trivalent, inactivated split influenza vaccine in Korean children: Double-blind, randomized, active-controlled multicenter phase III clinical trial.

PubMed

Han, Seung Beom; Rhim, Jung-Woo; Shin, Hye Jo; Lee, Soo Young; Kim, Hyun-Hee; Kim, Jong-Hyun; Lee, Kyung-Yil; Ma, Sang Hyuk; Park, Joon Soo; Kim, Hwang Min; Kim, Chun Soo; Kim, Dong Ho; Choi, Young Youn; Cha, Sung-Ho; Hong, Young Jin; Kang, Jin Han

2015-01-01

A multicenter, double-blind, randomized, active-control phase III clinical trial was performed to assess the immunogenicity and safety of a trivalent, inactivated split influenza vaccine. Korean children between the ages of 6 months and 18 y were enrolled and randomized into a study (study vaccine) or a control vaccine group (commercially available trivalent, inactivated split influenza vaccine) in a 5:1 ratio. Antibody responses were determined using hemagglutination inhibition assay, and post-vaccination immunogenicity was assessed based on seroconversion and seroprotection rates. For safety assessment, solicited local and systemic adverse events up to 28 d after vaccination and unsolicited adverse events up to 6 months after vaccination were evaluated. Immunogenicity was assessed in 337 and 68 children of the study and control groups. In the study vaccine group, seroconversion rates against influenza A/H1N1, A/H3N2, and B strains were 62.0% (95% CI: 56.8-67.2), 53.4% (95% CI: 48.1-58.7), and 54.9% (95% CI: 48.1-60.2), respectively. The corresponding seroprotection rates were 95.0% (95% CI: 92.6-97.3), 93.8% (95% CI: 91.2-96.4), and 95.3% (95% CI: 93.0-97.5). The lower 95% CI limits of the seroconversion and seroprotection rates were over 40% and 70%, respectively, against all strains. Seroconversion and seroprotection rates were not significantly different between the study and control vaccine groups. Furthermore, the frequencies of adverse events were not significantly different between the 2 vaccine groups, and no serious vaccination-related adverse events were noted. In conclusion, the study vaccine exhibited substantial immunogenicity and safety in Korean children and is expected to be clinically effective.

Periodontal ligament injection versus routine local infiltration for nonsurgical single posterior maxillary permanent tooth extraction: comparative double-blinded randomized clinical study

PubMed Central

Al-Shayyab, Mohammad H

2017-01-01

Aim The aim of this study was to evaluate the efficacy of, and patients’ subjective responses to, periodontal ligament (PDL) anesthetic injection compared to traditional local-anesthetic infiltration injection for the nonsurgical extraction of one posterior maxillary permanent tooth. Materials and methods All patients scheduled for nonsurgical symmetrical maxillary posterior permanent tooth extraction in the Department of Oral and Maxillofacial Surgery at the University of Jordan Hospital, Amman, Jordan over a 7-month period were invited to participate in this prospective randomized double-blinded split-mouth study. Every patient received the recommended volume of 2% lidocaine with 1:100,000 epinephrine for PDL injection on the experimental side and for local infiltration on the control side. A visual analog scale (VAS) and verbal rating scale (VRS) were used to describe pain felt during injection and extraction, respectively. Statistical significance was based on probability values <0.05 and measured using χ2 and Student t-tests and nonparametric Mann–Whitney and Kruskal–Wallis tests. Results Of the 73 patients eligible for this study, 55 met the inclusion criteria: 32 males and 23 females, with a mean age of 34.87±14.93 years. Differences in VAS scores and VRS data between the two techniques were statistically significant (P<0.001) and in favor of the infiltration injection. Conclusion The PDL injection may not be the alternative anesthetic technique of choice to routine local infiltration for the nonsurgical extraction of one posterior maxillary permanent tooth. PMID:29070950

[Prognosis and treatment of dry mouth. Systematic review].

PubMed

López-López, José; Jané Salas, Enric; Chimenos Küstner, Eduardo

2014-02-04

There are no clearly established protocols for the treatment of dry mouth. The aim of this paper is a systematic review of the literature of the past 10 years using the words « dry mouth », « prognosis », « treatment » and « dentistry ». The initial search found 1,450 entries and within the restriction « clinical trials OR randomized controlled trial OR systemic reviews » it has been reduced to 522, which 145 were meta-analysis and systematic reviews. Papers not relevant to the issue were removed reducing the entries to 53. Twenty-four were dismissed (8 irrelevant, 7 reviews without adequate information and 9 personal opinions). Of the 29 items tested, 15 were controlled trials, 2 uncontrolled trials, 4 observational studies, 2 systematic reviews and 5 non systematic reviews. The most studied patients were Sjögren's syndrome and the irradiated patients. Treatments are focused on the etiology, prevention, symptomatic, local salivary stimulation and systemic treatments. It can be concluded that treatment must be individualized, salivary substitutes and mechanical stimulation techniques can be applied. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Treatment of periodontal intrabony defects using β-TCP alone or in combination with rhPDGF-BB: a randomized controlled clinical and radiographic study.

PubMed

Maroo, Sneha; Murthy, K Raja V

2014-01-01

The need to increase the predictability of periodontal regeneration has encouraged clinicians and researchers to employ cell-stimulating proteins in combination with osteoconductive scaffolds, based on the principles of tissue engineering. The purpose of this clinical and radiographic study was to compare the regenerative potential of the combination of β-tricalcium phosphate (β-TCP) and recombinant human platelet-derived growth factor BB (rhPDGF-BB) in the grafting of intraosseous defects with the established technique of bone grafting with (β-TCP alone. A total of 30 sites from 15 patients with infrabony defects in two different quadrants were selected, and the sites were randomly divided into test sites (rhPDGF + β-TCP) and control sites (β-TCP alone) using a split-mouth design. Clinical parameters, including probing pocket depth, clinical attachment level, and gingival recession, were recorded at baseline, 6 months, and 9 months. Radiographic evaluation was carried out to evaluate defect fill, change in alveolar crest height, and percentage of defect fill at baseline, 6 months, and 9 months. Both the experimental groups showed statistically significant reduction in probing pocket depth and gain in clinical attachment level. On intergroup comparison, sites treated with rhPDGF + β-TCP demonstrated a significantly greater pocket depth reduction (P < .05) and greater gain in clinical attachment level (P < .01). Mean percentage defect fill was significantly greater in test sites as compared with control sites at 6 and 9 months (P < .01). rhPDGF + β-TCP-treated sites demonstrated a significant gain in mean alveolar crest height at 6 and 9 months (P < .05), while β-TCP-treated sites demonstrated crestal resorption. Both groups demonstrated potential in enhancing periodontal regeneration; however, on comparison between the two groups, the results obtained by rhPDGF + β-TCP were significantly better with respect to both clinical and radiographic parameters.

Non-contact profilometry of eroded and abraded enamel irradiated with an Er:YAG laser

PubMed Central

Scatolin, Renata Siqueira; Colucci, Vivian; Lepri, Taísa Penazzo; de Alexandria, Adílis Kalina; Maia, Lucianne Cople; Galo, Rodrigo; Borsatto, Maria Cristina; Corona, Silmara Aparecida Milori

2018-01-01

Abstract Literature has reported positive results regarding the use of lasers in the control of erosive lesions; however, evaluating whether they are effective in the control of the progression of erosive/abrasive lesions is important. Objectives This study aimed to evaluate the effect of the Er:YAG laser irradiation in controlling the progression of erosion associated with abrasive lesions in enamel. Material and methods Bovine incisors were sectioned, flattened and polished. Forty-eight enamel slabs were subjected to treatment in an intraoral phase. Twelve volunteers used an intraoral appliance containing one slab that was irradiated with an Er:YAG laser (5.2 J/cm2, 85 mJ, 2 Hz) and another non-irradiated slab on each side of the appliance, during one phase of 5 d, under a split-mouth design. Devices were subjected to erosive challenges (1% citric acid, 5 min, 3 times a day) and abrasive challenges one h after (brushing force of 1.5 N for 15 s) randomly and independently on each side of the device. Measurements of enamel loss were performed via 3D optical profilometry (μm). We analyzed data using the Kruskal-Wallis and Mann-Whitney tests and morphological characteristics via scanning electron microscopy. Results Following erosive and abrasive challenges, the group that was irradiated with the Er:YAG laser presented less loss of structure than the non-irradiated group. The group that underwent erosion and irradiation did not exhibit a significant difference from the non-irradiated group. Conclusion Irradiation with the Er:YAG laser did not control the loss of structure of enamel subjected to erosion but did control abrasion after erosion. PMID:29742259

Non-contact profilometry of eroded and abraded enamel irradiated with an Er:YAG laser.

PubMed

Scatolin, Renata Siqueira; Colucci, Vivian; Lepri, Taísa Penazzo; Alexandria, Adílis Kalina de; Maia, Lucianne Cople; Galo, Rodrigo; Borsatto, Maria Cristina; Corona, Silmara Aparecida Milori

2018-01-01

Literature has reported positive results regarding the use of lasers in the control of erosive lesions; however, evaluating whether they are effective in the control of the progression of erosive/abrasive lesions is important. Objectives This study aimed to evaluate the effect of the Er:YAG laser irradiation in controlling the progression of erosion associated with abrasive lesions in enamel. Material and methods Bovine incisors were sectioned, flattened and polished. Forty-eight enamel slabs were subjected to treatment in an intraoral phase. Twelve volunteers used an intraoral appliance containing one slab that was irradiated with an Er:YAG laser (5.2 J/cm2, 85 mJ, 2 Hz) and another non-irradiated slab on each side of the appliance, during one phase of 5 d, under a split-mouth design. Devices were subjected to erosive challenges (1% citric acid, 5 min, 3 times a day) and abrasive challenges one h after (brushing force of 1.5 N for 15 s) randomly and independently on each side of the device. Measurements of enamel loss were performed via 3D optical profilometry (μm). We analyzed data using the Kruskal-Wallis and Mann-Whitney tests and morphological characteristics via scanning electron microscopy. Results Following erosive and abrasive challenges, the group that was irradiated with the Er:YAG laser presented less loss of structure than the non-irradiated group. The group that underwent erosion and irradiation did not exhibit a significant difference from the non-irradiated group. Conclusion Irradiation with the Er:YAG laser did not control the loss of structure of enamel subjected to erosion but did control abrasion after erosion.

Unbiased split variable selection for random survival forests using maximally selected rank statistics.

PubMed

Wright, Marvin N; Dankowski, Theresa; Ziegler, Andreas

2017-04-15

The most popular approach for analyzing survival data is the Cox regression model. The Cox model may, however, be misspecified, and its proportionality assumption may not always be fulfilled. An alternative approach for survival prediction is random forests for survival outcomes. The standard split criterion for random survival forests is the log-rank test statistic, which favors splitting variables with many possible split points. Conditional inference forests avoid this split variable selection bias. However, linear rank statistics are utilized by default in conditional inference forests to select the optimal splitting variable, which cannot detect non-linear effects in the independent variables. An alternative is to use maximally selected rank statistics for the split point selection. As in conditional inference forests, splitting variables are compared on the p-value scale. However, instead of the conditional Monte-Carlo approach used in conditional inference forests, p-value approximations are employed. We describe several p-value approximations and the implementation of the proposed random forest approach. A simulation study demonstrates that unbiased split variable selection is possible. However, there is a trade-off between unbiased split variable selection and runtime. In benchmark studies of prediction performance on simulated and real datasets, the new method performs better than random survival forests if informative dichotomous variables are combined with uninformative variables with more categories and better than conditional inference forests if non-linear covariate effects are included. In a runtime comparison, the method proves to be computationally faster than both alternatives, if a simple p-value approximation is used. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Pulpal response following photo-biomodulation with a 904-nm diode laser: a double-blind clinical study.

PubMed

Liang, Ryan; George, Roy; Walsh, Laurence J

2016-12-01

The aim of this study was to evaluate pulpal responses in healthy human teeth to photo-biomodulation therapy (PBMT) with 904-nm GaAs diode laser. The study followed a double-blind split mouth design, with a randomly selected maxillary first premolar acting as a sham-irradiated control tooth, and the contralateral tooth receiving active laser treatment. Two coded but otherwise identical laser probes (Irradia™, SpectraMedics Ltd., NC, USA) were used to deliver the sham (placebo) and laser radiation, with both the operator and patient unaware of each probe's identity. The selection of teeth for sham or laser irradiation was randomised for each treatment. Pulpal responses were assessed using electric pulp testing (EPT), 2 min prior to exposure, and immediately after laser irradiation (60 s, 30 mW average power, 25 Hz pulse frequency, 3.6 J/cm 2 ). Treatment effects were analysed using the Wilcoxon-signed rank test. A total of 30 participants provided written informed consent. Majority of the participants (66.7 %) demonstrated an analgesic effect following PBMT (elevated EPT scores); however, nine participants (30 %) reported the lower EPT scores than the control. Both the treatment effects (stimulation and analgesia) were significant compared to the placebo. In most individuals, PBMT of healthy teeth with a 904-nm GaAs diode laser can induce analgesia, as witnessed by elevated EPT scores. A converse effect can occur in a minority of subjects.

Acellular dermal matrix seeded with autologous gingival fibroblasts for the treatment of gingival recession: a proof-of-concept study.

PubMed

Jhaveri, Hiral M; Chavan, Mahesh S; Tomar, Geetanjali B; Deshmukh, Vijay L; Wani, Mohan R; Miller, Preston D

2010-04-01

One of the most common esthetic concerns associated with periodontal tissues is gingival recession. There are multiple periodontal plastic surgery approaches documented in the literature for the treatment of such defects. With the tremendous advances being made in periodontal science and technology, tissue engineering could be considered among the latest exciting techniques for recession management. In this split-mouth, controlled, double-masked clinical case series, 20 sites from 10 patients with Miller Class I or II recessions affecting canines or premolars in the maxillary arch were selected. One tooth in each patient was randomized to receive either a subepithelial connective tissue graft (SCTG) (control group) or an acellular dermal matrix allograft (ADMA) seeded with autologous gingival fibroblasts (test group) under a coronally positioned flap. Clinical parameters, including recession depth, probing depth, clinical attachment level, width of keratinized tissue, attached gingiva, and plaque scores, were recorded by a calibrated examiner at baseline and 3 and 6 months. The inflammation of grafted sites was scored, and the healing time was calculated. The final esthetic outcome of treated sites was assessed by the root coverage esthetic score at the end of 6 months. There were no significant differences between test and control sites for all measured clinical parameters. However, the test sites demonstrated less inflammation in the early postoperative period. Within the limits of this case series, the results indicate that an ADMA seeded with autologous gingival fibroblasts by tissue-engineering technology may be explored as a substitute to an SCTG for the treatment of Miller Class I and II recession defects.

The effect of buccal corticotomy on accelerating orthodontic tooth movement of maxillary canine

PubMed Central

Jahanbakhshi, Mohammad Reza; Motamedi, Ali Mohammad Kalantar; Feizbakhsh, Masoud; Mogharehabed, Ahmad

2016-01-01

Background: Selective alveolar corticotomy is defined as an intentional injury to cortical bone. This technique is an effective means of accelerating orthodontic tooth movement. The aim of this study is to evaluate the effect of buccal corticotomy in accelerating maxillary canine retraction. Materials and Methods: The sample in this clinical trial study consisted of 15 adult female patients with therapeutic need for extraction of maxillary first premolars and maximum canine retraction. By use of split-mouth design, at the time of premolars extraction, buccal corticotomy was performed around the maxillary first premolar, randomly on one side of maxilla, and the other side was reserved as the control side. Canine retraction was performed by use of friction – less mechanic with simple vertical loop. Every 2 weeks, distance between canines and second premolars was measured until complete space closure. The velocity of space closure was calculated to evaluate the effect of this technique in accelerating orthodontic tooth movement. The obtained data were statistically analyzed using independent t-test, and the significance was set at 0.05. Results: The rate of canine retraction was significantly higher on the corticotomy side than the control side by an average of 1.8 mm/month versus 1.1 mm/month in the corticotomy side and control side, respectively (P < 0.001). Conclusion: Based on result of this study, corticotomy can accelerates the rate of orthodontic tooth movement about two times faster than conventional orthodontics and it is significant in early stages after surgical porsedure. Therefore Buccal corticotomy is a useful adjunct technique for accelerating orthodontic tooth movement. PMID:27605986

A Prospective, Randomized, Double-blind, Split-face Clinical Trial Comparing the Efficacy of Two Topical Human Growth Factors for the Rejuvenation of the Aging Face

PubMed Central

Goldman, Mitchel P.

2017-01-01

Background: Cosmeceutical products represent an increasingly important therapeutic option for anti-aging and rejuvenation, either used alone or in combination with dermatologic surgical procedures. Among this group of products, topical growth factors have demonstrated efficacy in randomized, controlled clinical trials. However, comparisons between different products remain uncommon. Objective: The objective of this randomized, double-blind, split-face clinical trial was to compare two different topical growth factor formulations derived from either human fibroblasts or human adipose tissue derived mesenchymal stem cells. Methods: This was an institutional review board-approved, randomized, double-blind, split-face clinical trial involving 20 healthy subjects with moderate-to-severe facial wrinkling secondary to photodamage. One half of the face was randomized to receive topical human fibroblast growth factors and the other topical human mesenchymal stem cell growth factors. Treatment was continued for three months, and evaluations were performed in a double-blind fashion. Results: Both growth factor formulations achieved significant improvement in facial wrinkling. Blinded investigator and subject evaluations did not detect any significant differences between the two formulations in terms of efficacy, safety, or tolerability. Conclusion: Both human fibroblast growth factors and human mesenchymal stem cell growth factors are effective at facial rejuvenation. Topical growth factors represent a useful therapeutic modality. PMID:28670356

A Prospective, Randomized, Double-blind, Split-face Clinical Trial Comparing the Efficacy of Two Topical Human Growth Factors for the Rejuvenation of the Aging Face.

PubMed

Wu, Douglas C; Goldman, Mitchel P

2017-05-01

Background: Cosmeceutical products represent an increasingly important therapeutic option for anti-aging and rejuvenation, either used alone or in combination with dermatologic surgical procedures. Among this group of products, topical growth factors have demonstrated efficacy in randomized, controlled clinical trials. However, comparisons between different products remain uncommon. Objective: The objective of this randomized, double-blind, split-face clinical trial was to compare two different topical growth factor formulations derived from either human fibroblasts or human adipose tissue derived mesenchymal stem cells. Methods: This was an institutional review board-approved, randomized, double-blind, split-face clinical trial involving 20 healthy subjects with moderate-to-severe facial wrinkling secondary to photodamage. One half of the face was randomized to receive topical human fibroblast growth factors and the other topical human mesenchymal stem cell growth factors. Treatment was continued for three months, and evaluations were performed in a double-blind fashion. Results: Both growth factor formulations achieved significant improvement in facial wrinkling. Blinded investigator and subject evaluations did not detect any significant differences between the two formulations in terms of efficacy, safety, or tolerability. Conclusion: Both human fibroblast growth factors and human mesenchymal stem cell growth factors are effective at facial rejuvenation. Topical growth factors represent a useful therapeutic modality.

Healing at the Interface Between Autologous Block Bone Grafts and Recipient Sites Using n-Butyl-2-Cyanoacrylate Adhesive as Fixation: Histomorphometric Study in Rabbits.

PubMed

De Santis, Enzo; Silva, Erick Ricardo; Martins, Evandro Neto Carneiro; Favero, Riccardo; Botticelli, Daniele; Xavier, Samuel Porfirio

2017-12-01

The aim of the present split-mouth (split-plot) study was to describe the sequential healing in the interface between autologous bone grafts and recipient parent bone, fixed using an n-butyl-2-cyanoacrylate adhesive with or without an additional titanium fixation screw. Bone grafts were collected from the calvaria and fixed to the lateral aspect of the mandible in 24 rabbits. The cortical layers of the recipient sites were perforated, and the grafts were randomly fixed using an n-butyl-2-cyanocrylate adhesive, either alone or in conjunction with a 1.5 mm × 6.0 mm titanium fixation screw. The animals were sacrificed after 3, 7, 20, and 40 days, and histomorphometric evaluations of the interface between graft and parent bone were performed. Only 2 of 6 grafts in each group were partially incorporated to the parent bone after 40 days of healing. The remaining grafts were separated from the parent bone by adhesive and connective tissue. It was concluded that the use of n-butyl-2-cyanoacrylate as fixation of an autologous bone graft to the lateral aspect of the mandible was able to maintain the fixation over time but did not incorporate the graft to the recipient sites. Use of fixation screws did not improve the healing.

Effects of mouthwash interventions on xerostomia and unstimulated whole saliva flow rate among hemodialysis patients: A randomized controlled study.

PubMed

Yu, I-Chen; Tsai, Yun-Fang; Fang, Ji-Tseng; Yeh, Mei-Ming; Fang, Jia-You; Liu, Chieh-Yu

2016-11-01

Dry mouth (xerostomia) is a common symptom in hemodialysis patients, which is associated with a reduced salivary flow. Xerostomia affects patients' oral health and quality of life. The aim of this study was to investigate using a mouthwash as a means to reduce xerostomia and improve saliva flow rates in hemodialysis patients. A randomized controlled trial. Three dialysis centers in Northern Taiwan served as the study sites. Patients were purposively sampled from three hemodialysis centers in Taiwan and randomly assigned to one of three groups: pure water mouthwash; n=41, licorice mouthwash; n=44, or no mouthwash (control); n=37. The Summated Xerostomia Inventory, and unstimulated whole salivary flow rate measured dry mouth and salivary flow, respectively. Data was collected at baseline, dialysis Day 5 and Day 10. One hundred twenty-two patients participated in this study. Baselines were adjusted for any imbalances in variables and generalized estimating equations analysed the data. Compared to control, a pure water mouthwash resulted in an increase in the unstimulated salivary flow rate of 25.85×10 -3 mL/min and 25.78×10 -3 mL/min (p<0.05) at Day 5 and Day 10, respectively. The estimated effect size was 1.38. However, there was no significant decrease in Summated Xerostomia Inventory scores. The licorice mouthwash also significantly improved the unstimulated salivary flow rates to 114.92×10 -3 mL/min, and 131.61×10 -3 mL/min at Day 5 and Day 10, respectively (p< 0.001). However, in contrast to the pure water mouthwash, the licorice mouthwash resulted in a significant improvement in the scores for the Summated Xerostomia Inventory (p<0.001). Although a pure water or a licorice mouthwash and improved the objective measure of salivary flow rate, only the licorice mouthwash provided subjective relief of xerostomia. This suggests the use of a licorice mouthwash may effectively relieve feelings of dry mouth in hemodialysis patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evidence regarding lingual fixed orthodontic appliances' therapeutic and adverse effects is insufficient.

PubMed

Afrashtehfar, Kelvin I

2016-06-01

Data sourcesMedline, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Virtual Health Library and Web of Science were systematically searched up to July 2015 without limitations. Scopus, Google Scholar, ClinicalTrials.gov, the ISRCTN registry as well as reference lists of the trials included and relevant reviews were manually searched.Study selectionRandomised (RCTs) and prospective non-randomised clinical trials (non-RCTs) on human patients that compared therapeutic and adverse effects of lingual and labial appliances were considered. One reviewer initially screened titles and subsequently two reviewers independently screened the selected abstracts and full texts.Data extraction and synthesisThe data were extracted independently by the reviewers. Missing or unclear information, ongoing trials and raw data from split-mouth trials were requested from the authors of the trials. The quality of the included trials and potential bias across studies were assessed using Cochrane's risk of bias tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. For parallel trials, mean difference (MD) and the relative risk (RR) were used for continuous (objective speech performance, subjective speech performance, intercanine width, intermolar width and sagittal anchorage loss) and binary outcomes (eating difficulty), respectively. The standardised mean difference (SMD) was chosen to pool, after conversion, the outcome (oral discomfort) that assessed both binary and continuous. Random-effects meta-analyses were conducted, followed by subgroup and sensitivity analyses.ResultsThirteen papers pertaining to 11 clinical trials (three parallel RCTs, one split-mouth RCT and seven parallel prospective non-RCTs) were included with a total of 407 (34% male/66% female) patients. All trials had at least one bias domain at high risk of bias. Compared with labial appliances, lingual appliances were associated with increased overall oral discomfort, increased speech impediment (measured using auditory analysis), worse speech performance assessed by laypersons, increased eating difficulty and decreased intermolar width. On the other hand, lingual appliances were associated with increased intercanine width and significantly decreased anchorage loss of the maxillary first molar during space closure. However, the quality of all analyses included was judged as very low because of the high risk of bias of the included trials, inconsistency and imprecision.ConclusionsBased on existing trials there is insufficient evidence to make robust recommendations for lingual fixed orthodontic appliances regarding their therapeutic or adverse effects, as the quality of evidence was low.

Connective tissue graft as a biological barrier for guided tissue regeneration in intrabony defects: a histological study in dogs.

PubMed

Ribeiro, Fernando Salimon; Pontes, Ana Emília Farias; Zuza, Elizangela Partata; da Silva, Vanessa Camila; Lia, Raphael Carlos Comelli; Marcantonio Junior, Elcio

2015-06-01

The use of the autogenous periosteal graft as biological barrier has been proposed for periodontal regeneration. The aim of this study was to evaluate the histometric findings of the subepithelial connective tissue graft as barrier in intrabony defects compared to a bioabsorbable membrane. Three-walled intrabony defects were created surgically in the mesial aspect of the right and left maxillary canines in five healthy mongrel dogs. The defects were chronified, and two types of barriers were randomly carried out for guided tissue regeneration in a split-mouth design: the test group with a subepithelial connective tissue graft and the control group with a bioabsorbable membrane. The specimens were processed for histometric analyses of the epithelium (E), connective tissue (CT), newly formed cementum (NC), new bone (NB), and total newly formed tissues (NFT). The test side showed smaller mean of NC (3.6 ± 1.2), NB (2.1 ± 0.7), and NFT (7.7 ± 0.8) than the control group (NC 7.3 ± 0.5; NB 5.3 ± 1.3; NFT 10.1 ± 2.2; P < 0.05). No statistically significant differences were verified for E (test 3.1 ± 2.0; control 2.8 ± 2.1; P > 0.05) and CT (test 2.5 ± 1.1; control 2.0 ± 0.5; P > 0.05) between groups. The bioabsorbable membrane was more effective in maintaining the space for periodontal regeneration than periosteal connective graft when used as barrier. The bioabsorbable membrane showed more favorable regenerative results in intrabony defects in dogs than the subepithelial connective tissue graft as biological barrier.

PDT in non-surgical treatment of periodontitis in kidney transplanted patients: a split-mouth, randomized clinical trial

NASA Astrophysics Data System (ADS)

Marinho, Kelly C. T.; Giovani, Elcio M.

2016-03-01

This study was to evaluate clinical and microbiological effectiveness of photodynamic therapy (PDT) in the treatment of periodontal disease in kidney-transplanted patients. Eight kidney transplanted patients treated at Paulista University were arranged in two groups: SRP performed scaling and root planning by ultrasound; SRP+PDT- in the same patient, which was held to PDT in the opposite quadrant, with 0.01% methylene blue and red laser gallium aluminum arsenide, wavelength 660 nm, power 100 mW. There was reduction in probing pocket depth after 45 days and 3 months regardless the group examined; plaque and bleeding index showed improvement over time, regardless the technique used, and bleeding index in the SRP+PDT group was lower when compared with the baseline the other times. There was no difference in the frequency of pathogens. Photodynamic therapy may be an option for treatment of periodontal disease in renal-transplanted patients and its effectiveness is similar to conventional therapy.

Therapeutic Options in Idiopathic Burning Mouth Syndrome: Literature Review

PubMed Central

Miziara, Ivan; Chagury, Azis; Vargas, Camila; Freitas, Ludmila; Mahmoud, Ali

2014-01-01

Introduction Burning mouth syndrome (BMS) is characterized by a burning sensation in the tongue, palate, lips, or gums of no well-defined etiology. The diagnosis and treatment for primary BMS are controversial. No specific laboratory tests or diagnostic criteria are well established, and the diagnosis is made by excluding all other possible disorders. Objective To review the literature on the main treatment options in idiopathic BMS and compare the best results of the main studies in 15 years. Data Synthesis We conducted a literature review on PubMed/MEDLINE, SciELO, and Cochrane-BIREME of work in the past 15 years, and only selected studies comparing different therapeutic options in idiopathic BMS, with preference for randomized and double-blind controlled studies. Final Comments Topical clonazepam showed good short-term results for the relief of pain, although this was not presented as a definitive cure. Similarly, α-lipoic acid showed good results, but there are few randomized controlled studies that showed the long-term results and complete remission of symptoms. On the other hand, cognitive therapy is reported as a good and lasting therapeutic option with the advantage of not having side effects, and it can be combined with pharmacologic therapy. PMID:25992157

Role of warm saline mouth rinse in prevention of alveolar osteitis: a randomized controlled trial.

PubMed

Osunde, Otasowie Daniel; Bassey, Godwin Obi

2015-01-01

The present study was aimed at determining the role warm saline rinse in the prevention of alveolar osteitis following dental extractions. Apparently patients aged 16 and above who were referred to the Oral Surgery Clinic of our institution, with an indication for non-surgical extraction of pathologic teeth were prospectively and uniformly randomized into warm saline group and control. The experimental group (n = 80) were instructed to gargle 6 times daily with warm saline and no such instructions were given to the second group (n = 80) to serve as controls. Information on demographic, indications for extraction, and development of alveolar osteitis were obtained and analyzed. Comparative statistics were done using Pearson's chi square or Fisher's exact test as appropriate. A p value of less than 0.05 was considered significant. The demographic and other baseline parameters such as indications for extractions were comparable among the study groups (p > 0.05). The overall prevalence of alveolar osteitis was 13.7%. There was a statistical significant difference between the study groups with respect to development of alveolar osteitis (X2 = 15.00, df = 1, p = 0.001).The risk of development of alveolar osteitis was 4 times higher in the control group (OR = 4.33, P = 0.001). Warm saline mouth rinse instruction is beneficial in the prevention of development of alveolar osteitis after dental extractions.

The effectiveness of corticotomy and piezocision on canine retraction: A systematic review.

PubMed

Viwattanatipa, Nita; Charnchairerk, Satadarun

2018-05-01

The aim of this systematic review was to evaluate the effectiveness and complications of corticotomy and piezocision in canine retraction. Five electronic databases (PubMed, SCOPUS, Web of Science, Embase, and CENTRAL) were searched for articles published up to July 2017. The databases were searched for randomized control trials (RCTs), with a split-mouth design, using either corticotomy or piezocision. The primary outcome reported for canine retraction was either the amount of tooth movement, rate of tooth movement, or treatment time. The secondary outcome was complications. The selection process was based on the PRISMA guidelines. A risk of bias assessment was also performed. Our search retrieved 530 abstracts. However, only five RCTs were finally included. Corticotomy showed a more significant (i.e., 2 to 4 times faster) increase in the rate of tooth movement than did the conventional method. For piezocision, both accumulative tooth movement and rate of tooth movement were twice faster than those of the conventional method. Corticotomy (with a flap design avoiding marginal bone incision) or flapless piezocision procedures were not detrimental to periodontal health. Nevertheless, piezocision resulted in higher levels of patient satisfaction. The main limitation of this study was the limited number of primary research publications on both techniques. For canine retraction into the immediate premolar extraction site, the rate of canine movement after piezocision was almost comparable to that of corticotomy with only buccal flap elevation.

Prospective randomized controlled trial: fibrin sealant reduces split skin graft donor-site pain.

PubMed

Healy, Ciaran; Greig, Aina V H; Murphy, Adrian D; Powell, Christopher; Pinder, Richard J; Saour, Samer; Abela, Christopher; Knight, William; Geh, Jenny L C

2013-07-01

Pain at split skin graft donor sites is common. Fibrin sealant has been demonstrated to reduce time to hemostasis at wound sites, and patients receiving this treatment were incidentally noted to report less pain. This study aimed to evaluate pain and incapacity in split skin graft donor sites treated with and without fibrin sealant. Fifty patients requiring thigh donor-site split skin grafts were prospectively randomized to receive either a self-adhesive fabric dressing alone or fibrin sealant plus the self-adhesive fabric dressing as primary donor-site dressings. External secondary dressings were the same. Patients were blinded with regard to treatment group. Using visual analogue scales (scored 0 to 5), patients rated their donor-site pain and incapacity for 14 days postoperatively. Secondary endpoints were length of hospital stay and duration of requirement for dressings. Forty patients were included in the study analysis and completed self-reported pain and incapacity scores. Twenty received the fibrin sealant plus self-adhesive fabric dressing and 20 received the fabric dressing only (controls). Patients using the fibrin sealant plus the dressing reported significantly less pain (mean score, 0.42 versus 1.60, p < 0.001) and significantly less incapacity (mean score, 0.48 versus 1.71, p < 0.001). Patients allocated to the fibrin sealant group recorded shorter lengths of stay and faster time to discontinuation of dressing, though statistical significance was not achieved. Patients whose split skin graft donor sites were dressed with fibrin sealant plus self-adhesive fabric dressing experienced significantly less pain and incapacity than patients with self-adhesive fabric dressings alone, allowing a more rapid return to normal activity. Therapeutic, II.

Local delivery of hyaluronan as an adjunct to scaling and root planing in the treatment of chronic periodontitis.

PubMed

Johannsen, Annsofi; Tellefsen, Monica; Wikesjö, Ulf; Johannsen, Gunnar

2009-09-01

The aim of the present study was to evaluate the adjunctive effect of the local application of a hyaluronan gel to scaling and root planing in the treatment of chronic periodontitis. Twelve patients with chronic periodontitis were recruited to participate in a study with a split-mouth design and provided informed consent. Plaque formation and bleeding on probing were evaluated pretreatment (baseline) and at 1, 4, and 12 weeks post-treatment. Probing depths and attachment levels were evaluated at baseline and at 12 weeks. The patients received full-mouth scaling and root planing. A hyaluronan gel was administered subgingivally in the test sites at baseline and after 1 week. Significant differences between test and control were evaluated using the paired t test, repeated-measures analysis of variance (Wilks lambda), and a non-parametric Wilcoxon signed-rank test. A significant reduction in bleeding on probing scores and probing depths was observed in both groups at 12 weeks (P <0.05). Significantly lower bleeding on probing scores were observed in the hyaluronan group compared to control at 12 weeks (P <0.05). Mean probing depth reductions between baseline and 12 weeks were 1.0 +/- 0.3 mm and 0.8 +/- 0.2 mm for the hyaluronan and control groups, respectively. The difference between the groups was statistically significant (P <0.05). The local application of hyaluronan gel in conjunction with scaling and root planing may have a beneficial effect on periodontal health in patients with chronic periodontitis.

Association between clinical and salivary microbial parameters during orthodontic treatment with removable appliances with or without use of fluoride mouth rinse.

PubMed

Zingler, S; Pritsch, M; Lux, C J; Kneist, S

2016-09-01

To evaluate the correlation between clinical and salivary microbial parameters during treatment with removable orthodontic appliances with or without use of fluoride mouth rinse. A group of 48 patients completed this randomized, controlled, parallel-group, clinical pilot study. 24 patients of the test group (TG) rinsed after tooth brushing with a fluoride mouth rinse (100 ppm AmF/150 ppm NaF) while 21 patients of the control group (CG) did not. Clinical parameters [Approximal Plaque Index (API), Papillary Bleeding Index (PBI)] as well as levels of salivary mutans streptococci (MS) and lactobacilli (LB) were assessed at baseline and after 3, 6, 9 and 12 months. Compliance was documented by participants. Appliance wear-times were estimated retrospectively by the patients. All participants received the same brushing instructions and were supplied with the same toothbrush/toothpaste. A significant correlation of API values with MS levels (p=0.0003) or with LB levels (p=0.001) was observed. Furthermore, appliance wear-times were significantly associated with API values (p=0.02). The changes of MS or LB levels between beginning and end of the study did not differ significantly between study groups. The changes of the API scores showed slightly different median values (-3.5 in the TG vs. 0 in the CG), the difference, however, was not significant. The results emphasise the need for a careful monitoring of the oral hygiene status in patients with removable orthodontic appliances. Larger controlled clinical trials are necessary to investigate treatment options such as use of supplementary fluoride mouth rinse.

Acupuncture in Treating Dry Mouth Caused By Radiation Therapy in Patients With Head and Neck Cancer | Division of Cancer Prevention

Cancer.gov

RATIONALE: Acupuncture may help relieve dry mouth caused by radiation therapy. PURPOSE: This randomized phase III trial is studying to see how well one set of acupuncture points work in comparison to a different set of acupuncture points or standard therapy in treating dry mouth caused by radiation therapy in patients with head and neck cancer. |

The Effects of Diode Laser Therapy as an Adjunct to Scaling and Root Planing in the Treatment of Aggressive Periodontitis: A 1-Year Randomized Controlled Clinical Trial.

PubMed

Matarese, Giovanni; Ramaglia, Luca; Cicciù, Marco; Cordasco, Giancarlo; Isola, Gaetano

2017-12-01

The aim of this study was to investigate and compare the clinical, microbial, and inflammatory effects of a diode laser as an adjunct to scaling and root planing (SRP) versus SRP alone for the treatment of generalized aggressive periodontitis (GAgP). Using a split-mouth design, 31 patients with GAgP were enrolled in the study. The maxillary right and left quadrants were randomly assigned to SRP+diode laser or SRP alone. Patients were examined on a regular basis for clinical, microbiological, and inflammatory mediator changes over a 1-year period. Clinical attachment level (CAL) was the primary outcome variable chosen. In addition, subgingival biofilm samples and gingival crevicular fluid (GCF) inflammatory mediators were analyzed at each follow-up session. Compared to baseline, both treatments demonstrated an improvement in periodontal parameters at 1 year. However, SRP+diode laser produced a significant improvement in probing depth (PD; 2.56 ± 0.44 vs. 3.36 ± 0.51 mm, p < 0.05) and CAL (3.47 ± 0.25 vs. 4.11 ± 0.26 mm, p < 0.05) values compared to SRP alone. Similarly, in the SRP+diode laser group, the bacteria of orange complex group were significantly reduced at 30 and 60 days compared to SRP alone. Moreover, SRP+diode laser determined a reduction in mean GCF level of interleukin (IL)-1β and IL-1β/IL-10 ratio at 15 and 30 days compared to SRP alone (p < 0.05). At 1 year, SRP+diode laser yielded a significant reduction in some clinical parameters, while microbial and inflammatory mediator changes were not significantly reduced compared to SRP alone.

Combined photoablative and photodynamic diode laser therapy as an adjunct to non-surgical periodontal treatment: a randomized split-mouth clinical trial.

PubMed

Giannelli, Marco; Formigli, Lucia; Lorenzini, Luca; Bani, Daniele

2012-10-01

Comparing the efficacy of photoablative and photodynamic diode laser in adjunct to scaling -root planing (SRP) and SRP alone for the treatment of chronic periodontitis. Twenty-six patients were studied. Maxillary left or right quadrants were randomly assigned to sham-laser treatment + SRP or laser + SRP. This consisted of photoablative intra/extra-pocket de-epithelization with diode laser (λ = 810 nm), followed by single SRP and multiple photodynamic treatments (once weekly, 4-10 applications, mean ± SD: 3.7 ± 2.4) using diode laser (λ = 635 nm) and 0.3% methylene blue as photosensitizer. The patients were monitored at days 0 and 365 by clinical assessment (probing depth, PD; clinical attachment level, CAL; bleeding on probing, BOP) and at days 0, 15, 30, 45, 60, 75, 90, 365 by cytofluorescence analysis of gingival exfoliative samples taken in proximity of the teeth to be treated (polymorphonuclear leukocytes, PMN; red blood cells, RBC; damaged epithelial cells, DEC; bacteria). At day 365, compared with the control quadrants, the laser + SRP therapy yielded a significant (p < 0.001) reduction in PD (-1.9 mm), CAL (-1.7 mm) and BOP (-33.2% bleeding sites), as well as in bacterial contamination - especially spirochetes - and PMN and RBC shedding in the gingival samples (p < 0.001). Diode laser treatment (photoablation followed by multiple photodynamic cycles) adjunctive to conventional SRP improves healing in chronic periodontitis patients. © 2012 John Wiley & Sons A/S.

The Use of Immersive Visualization for the Control of Dental Anxiety During Oral Debridement.

PubMed

Padrino-Barrios, Carmelo; McCombs, Gayle; Diawara, Norou; De Leo, Gianluca

2015-12-01

The purpose of this study was to evaluate the effects of Immersive Visualization (IV) eyewear on anxious, adult patients during oral debridement. Thirty adult volunteers (n=23 females; n=7 males) were enrolled in the study. Participants were required to be 18 years or older, exhibit at least moderate anxiety (score 9 or higher) on the Corah's Dental Anxiety Scale-Revised (DAS-R), and be generally healthy. Individuals were excluded from participation if they presented with severe dental calculus, periodontal disease, or dental caries, were taking psychotropic drugs, had a history of convulsive disorders, vertigo, or equilibrium disorders, or required antibiotic pre-medication. Subjects received a full mouth oral prophylaxis (supra- and subgingival scaling and selective polishing) by a single experienced dental hygienist. A split mouth design was utilized whereby each subject served as their own control. Subjects were randomly divided into 2 groups: Group A used IV eyewear during the first one-half of the appointment (right side of the mouth) and Group B used IV eyewear during the second one-half of the appointment (left side of the mouth). At screening, medical and dental histories were obtained, full mouth oral examinations were performed, and DAS-R was scored to determine eligibility. At baseline, the DAS-R was re-scored to validate anxiety levels. The Calmness Scale was scored pre- and post-IV treatment on a Likert scale ranging from 1 (very calm) to 7 (less calm). At the end of the study, subjects completed a Post IV Opinion survey. Data were entered into Microsoft Excel for Mac 2011 (Microsoft Corporation Version 14.3.5) and analyzed using SAS® 9.3 statistical software. Thirty subjects with a mean age of 29.9 years completed the study. Data analysis indicated no statistically significant difference between Group A and B with regard to mean DAS-R anxiety levels at baseline (3.15 and 2.40, respectively), with a p-value of 0.07. Data showed a significant difference when comparing the calmness mean scores within Group A pre- and post-IV treatments (4.66 and 2.93, respectively), with a p-value 0.01. Within Group B the data revealed a statistically significant difference between pre- and post-IV treatments (p<0.01, 4.33 and 2.13, respectively). Both treatment groups experienced a decrease in anxiety levels from pre to post IV treatments. Moreover, combined mean calmness scores of the 30 subjects (Group A and B) expressed in mean standard deviation showed there was a decrease from 4.50±1.31 in pre-IV treatment to 2.53±1.17 in post-IV treatment. Further investigation of the data showed that there was a significant correlation between calmness and gender; females reported higher levels of anxiety than men before and after IV treatment. Results from this study support the use of IV eyewear as an effective technique to reduce anxiety in adults during oral debridement. The use of the IV eyewear was well received by all subjects. The portable, affordable and easy-to-operate IV system makes this technique an appealing approach of reducing dental anxiety. Copyright © 2015 The American Dental Hygienists’ Association.

The effectiveness of nasal mask vs face mask ventilation in anesthetized, apneic pediatric subjects over 2 years of age: a randomized controlled trial.

PubMed

Itagaki, Taiga; Gubin, Tatyana A; Sayal, Puneet; Jiang, Yandong; Kacmarek, Robert M; Anderson, Thomas Anthony

2016-02-01

We hypothesized that anesthetized, apneic children could be ventilated equivalently or more efficiently by nasal mask ventilation (NMV) than face mask ventilation (FMV). The aim of this randomized controlled study was to test this hypothesis by comparing the expiratory tidal volume (Vte) between NMV and FMV. After the induction of anesthesia, 41 subjects, 3-17 years of age without anticipated difficult mask ventilation, were randomly assigned to receive either NMV or FMV with neck extension. Both groups were ventilated with pressure control ventilation (PCV) at 20 cmH2 O of peak inspiratory pressure (PIP) with positive end-expiratory pressure (PEEP) levels of 0, 5, and 10 cmH2 O. An additional mouth closing maneuver (MCM) was applied for the NMV group. The Vte was higher in the FMV group compared with the NMV group (median difference [95% CI]: 8.4 [5.5-11.6] ml·kg(-1) ; P < 0.001) when MCM was not applied. NMV achieved less PEEP than FMV (median difference [95% CI]: 5.0 [4.3-5.3] cmH2 O at 10 cmH2 O; P < 0.001) though both groups achieved the set PIP level. In the NMV group, MCM markedly increased Vte (median increase [95% CI]: 5.9 [2.5-9.0] ml·kg(-1) ; P < 0.005) and PEEP (median increase [95% CI]: 5.0 [0.6-8.6] cmH2 O at 10 cmH2 O; P < 0.005); however, PEEP was highly variable and lower than that of FMV (median difference [95% CI]: 2.5 [0.8-8.5] cmH2 O at 10 cmH2 O; P < 0.05). In anesthetized, apneic children greater than 2 years of age ventilated with an anesthesia ventilator and neck extension, FMV established a greater Vte than NMV regardless of mouth status. NMV could not maintain the set PEEP level due to an air leak from the mouth. The MCM increased the Vte and PEEP. © 2016 John Wiley & Sons Ltd.

Influence of immediate post-extraction socket irrigation on development of alveolar osteitis after mandibular third molar removal: a prospective split-mouth study, preliminary report.

PubMed

Tolstunov, L

2012-12-01

The aim of this prospective comparative split-mouth study was to evaluate the role of socket irrigation with a normal saline solution routinely used at the end of extraction on the development of alveolar osteitis (AO) after removal of impacted mandibular third molars (MTMs). Thirty-five patients who satisfied the inclusion criteria were involved in the study and underwent extraction of four third-molars. To be included in the study, the mandibular third molars had to be impacted (partial or full bone) and require an osteotomy for extraction with use of a motorised drill. All surgeries were done under local anaesthesia or IV sedation. This was a prospective split-mouth study. The patient's left (assistant) side was a control side; it had a standard extraction technique of an impacted mandibular third molar that required a buccal full-thickness flap, buccal trough (osteotomy) and extraction of the tooth (with or without splitting the tooth into segments), followed by a traditional end-of-surgery debridement protocol consisting of a gentle curettage, bone filing of the socket walls, socket irrigation with approximately 5 ml of sterile normal saline solution and socket suctioning. The patient's right (operator) side was an experimental side; it also had a standard extraction technique of an impacted mandibular third molar at the beginning with a flap and osteotomy, but it was followed by a modified end-of-surgery protocol. It consisted of gentle curettage but the socket was not irrigated and not suctioned. It was simply left to bleed. The gauze was placed on top of the socket for haemostasis on both sides and the patient was asked to bite. On both sides, the buccal flap was positioned back without the suture. All patients were seen for a follow-up appointment four to seven days after the surgery to assess healing and check for symptoms and signs of alveolar osteitis, if present, on both irrigated and non-irrigated sides. This study followed the ethical guidelines of human subjects based on the Helsinki Declaration. Thirty-five patients or 70 sockets were evaluated. Eleven out of 35 patients in the study were subjected to a dry socket syndrome (31.4%). The higher number of AO was likely related to specifics of MTM selection in this study - only impacted (partial and full bone) MTMs were chosen. Among eleven patients with AO, two patients had a bilateral condition. By excluding two patients with bilateral dry sockets from the study, there were nine patients (18 extraction sites) with unilateral AO in the study. Seven out of nine patients (14 extraction sites) developed unilateral dry socket on the control (irrigated) side (77.8%) and only two (four extraction sites) on the experimental (non-irrigated) side (22.2%). Therefore, in this study there were 3.5 times more patients (extraction sites) with dry socket syndrome on the irrigated (control) side than patients (extraction sites) in the non-irrigated (experimental) side. A noticeable difference of dry socket syndromes (77.8% on the irrigated versus 22.2% on non-irrigated side) was demonstrated between the traditional extraction protocol versus modified approach without the end-of-surgery irrigation. The study demonstrated that the post-extraction socket bleeding is very important for the proper uncomplicated socket healing. If it's not washed away with irrigation solution at the end of extraction, the normal blood clot has a higher likelihood to form, and therefore, can potentially lead to an uncomplicated socket healing without development of alveolar osteitis. Socket bleeding at the extraction site creates a favourable environment for the formation of a blood clot - a protective dressing - necessary for a favourable osseous healing of the socket.

Change in clinical indices following laser or scalpel treatment for periodontitis: A split-mouth, randomized, multi-center trial

NASA Astrophysics Data System (ADS)

Harris, David M.; Nicholson, Dawn M.; McCarthy, Delwin; Yukna, Raymond A.; Reynolds, Mark A.; Greenwell, Henry; Finley, James; McCawley, Thomas K.; Xenoudi, Pinelopi; Gregg, Robert H.

2014-02-01

Data are presented from a multi-center, prospective, longitudinal, clinical trial comparing four different treatments for periodontitis, (1) the LANAPTM protocol utilizing a FR pulsed-Nd:YAG laser; (2) flap surgery using the Modified Widman technique (MWF); (3) traditional scaling and root planing (SRP); and (4) coronal debridement (CD). Each treatment was randomized to a different quadrant. Fifty-one (54) subjects were recruited at five centers that included both private practice and university-based investigators. At 6-months and 12 months post-treatment the LANAPTM protocol and MWF yielded equivalent results based on changes in probing depths. The major difference observed between the two procedures was that patients reported significantly greater comfort following the LANAP™ procedure than following the MWF (P<0.001). There was greater reduction in bleeding in the LANAPTM quadrant than in the other three at both 6 and 12 months. Improvements following SRP were better than expected at 6 months and continued to improve, providing outcomes that were equivalent to both LANAPTM and MWF at 12 months. The improvement in the SRP quadrants suggests the hypothesis that an aspect of the LANAPTM protocol generated a significant, positive and unanticipated systemic (or trans-oral) effect on sub-gingival wound healing.

Successful Treatment of Dry Mouth and Dry Eye Symptoms in Sjögren's Syndrome Patients With Oral Pilocarpine: A Randomized, Placebo-Controlled, Dose-Adjustment Study.

PubMed

Papas, Athena S; Sherrer, Yvonne S; Charney, Michael; Golden, Harvey E; Medsger, Thomas A; Walsh, Bridget T; Trivedi, Madhu; Goldlust, Barry; Gallagher, Susan C

2004-08-01

: Sjögren's syndrome is characterized by the presence of xerostomia and/or xerophthalmia. Pilocarpine, a muscarinic cholinergic agonist, has been proven to be efficacious in treating radiation-induced xerostomia (up to 30 mg/day) and symptoms of dry mouth in Sjögren's patients (up to 20 mg/day). : To compare the safety and efficacy of oral pilocarpine (dose-adjusted) versus placebo in the treatment of dry eye and dry mouth symptoms in Sjögren's syndrome at 6 and 12 weeks. : In this 11-center, 256-patient placebo-controlled study, the safety and efficacy of oral pilocarpine (20 mg to 30 mg daily) for relief of Sjögren's-related dry mouth and dry eye symptoms was assessed. Changes in symptoms and salivary flow were measured over 12 weeks. : Compared with placebo, salivary flow was significantly increased in the pilocarpine group (P

Partial-mouth periodontal examination protocols for the determination of the prevalence and extent of gingival bleeding in adolescents.

PubMed

Machado, Michely Ediani; Tomazoni, Fernanda; Casarin, Maísa; Ardenghi, Thiago M; Zanatta, Fabricio Batistin

2017-10-01

To compare the performance of partial-mouth periodontal examination (PMPE) protocols with different cut-off points to the full-mouth examination (FME) in the assessment of the prevalence and extent of gingival bleeding in adolescents. A cross-sectional study was conducted involving 12-year-old adolescents. Following a systematic two-stage cluster sampling process, 1134 individuals were evaluated. Different PMPE protocols were compared to the FME with six sites per tooth. Sensitivity, specificity, area under the ROC curve (AUC), intraclass correlation coefficient (ICC), relative and absolute biases and the inflation factor were assessed for each PMPE protocol with different cut-off points for the severity of gingival bleeding. The highest AUC values were found for the six-site two-diagonal quadrant (2-4) (0.97), six-site random half-mouth (0.95) and Community Periodontal Index (0.95) protocols. The assessment of three sites [mesiobuccal (MB), buccal (B) and distolingual (DL)] in two diagonal quadrants and the random half-mouth protocol had higher sensitivity and lower specificity than the same protocols with distobuccal (DB) sites. However, the use of DB sites led to better specificity and improved the balance between sensitivity and specificity, except for the two-diagonal quadrant (1-3) protocol. The ≥1 cut-off point led to the most discrepant results from the FME. Six-site two-diagonal quadrant (2-4) and random half-mouth assessments perform better in the evaluation of gingival bleeding in adolescents. However, when a faster protocol is needed, a two-diagonal quadrant assessment using only MB, B and DL sites can be used with no important loss of information. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Single-dose lubiprostone along with split-dose PEG solution without dietary restrictions for bowel cleansing prior to colonoscopy: a randomized, double-blind, placebo-controlled trial.

PubMed

Stengel, Joel Z; Jones, David P

2008-09-01

Proper colonic cleansing prior to colonoscopy is paramount to ensuring complete mucosal visualization and polyp identification. In a double-blind fashion, we compared single-dose lubiprostone (24 microg) versus placebo pretreatment prior to a split-dose polyethylene glycol electrolyte (PEG-E) bowel preparation without dietary restriction to determine the efficacy, safety, and patient tolerability. Two hundred patients referred for outpatient colorectal cancer screening were randomized to receive a single-dose of unlabeled lubiprostone (24 microg) or placebo prior to a split-dose PEG-E bowel preparation without dietary restriction. The patients were surveyed prior to the colonoscopy on the tolerability of the bowel preparation, and any adverse events were recorded. The cleanliness of the colon was graded by the endoscopist during the procedure utilizing the Ottawa bowel preparation scale. One hundred ninety-one patients completed the study (95%). Split-dose PEG-E with lubiprostone pretreatment was found to be more effective at bowel cleansing in each segment of the colon when compared with split-dose PEG-E with placebo (P < 0.001). Patients enrolled in the lubiprostone treatment arm rated the overall experience as more tolerable (P 0.003) and complained of less abdominal bloating (P 0.049). No differences were observed between the groups for treatment-emergent side effects or adverse events (P > 0.05). Single-dose lubiprostone prior to split-dose PEG-E without dietary restriction significantly improves colonic mucosa visualization during colonoscopy and is well tolerated by patients.

Microvessel Density Evaluation of the Effect of Enamel Matrix Derivative on Soft Tissue After Implant Placement: A Preliminary Study.

PubMed

Guimarães, George Furtado; de Araújo, Vera Cavalcanti; Nery, James Carlos; Peruzzo, Daiane Cristina; Soares, Andresa Borges

2015-01-01

Enamel matrix derivative (EMD) is commonly used in periodontal therapy and has been used successfully for periodontal regeneration. In addition, this material has a possible angiogenic effect that has been associated with enhanced wound healing. The aim of this study was to evaluate the effect of EMD on microvessel density (angiogenesis) on the soft tissues surrounding newly placed implants after 14 days. Five patients were selected, each requiring at least one implant on each side of the maxilla, in a split-mouth experimental design. The implants were placed in a two-stage procedure. Each side was then randomized as test or control. On the test side, 0.1 mL of EMD was topically applied to the soft tissues surrounding the implants, while the control side did not receive any treatment. Second-stage surgery was performed after 14 days. A 6-mm punch biopsy was performed for each implant, with the samples subsequently prepared for histology and immunohistochemistry. Quantitative vascularization analysis was performed, which involved counting three areas or "hotspots" containing vessels strongly positive for CD34 and CD105, a pan-endothelial and new vessel marker, respectively. There was no significant difference between test and control groups when evaluating the formation of new blood vessels. The total number of blood vessels, however, was significantly higher in the group treated with EMD (test group). Within the limits of the present study, it can be concluded that topical application of EMD on the soft tissues surrounding newly placed implants resulted in an increased number of blood vessels at 14 days, suggesting that EMD may play a beneficial role in this aspect of wound healing.

Coronally advanced flap and connective tissue graft with or without plasma rich in growth factors (PRGF) in treatment of gingival recession

PubMed Central

Jenabian, Niloofar; Motallebnejad, Mina; Zahedi, Ehsan; Angelov, Nikola

2018-01-01

Background Several researchers have tried to improve the results of gingival recession treatment techniques. One of the methods is to use growth factors The present study was undertaken to evaluate the effect of CAF (coronally advanced flap) + CTG (connective tissue graft) + PRGF (plasma rich in growth factors) in the treatment of Miller Class I buccal gingival recession. Material and Methods Twenty-two teeth with Miller Class I gingival recession in 6 patients 26 ‒ 47 years of age were included in a split-mouth designed randomized controlled trial (RCT). In each patient, one side was treated with CAF + CTG + PRGF (test) and the other side was treated with CAF + CTG (control). The following parameters were measured before surgery and up to 6 months after surgery on the mid-buccal surface of the tooth: keratinized tissue width (KTW), clinical attachment level (CAL), probing depth (PD), vertical recession depth (VRD), recession depth (RD), gingival thickness (GT), root coverage in percentage (RC%) and the distance between the CEJ and mucogingival junction (MGJL). Data were analyzed with paired t-test and repeated measures ANOVA. Results After 6 months noticeable improvements were observed in both groups in all the variables measured except for PD; however, the differences between the two groups were not significant. RC% was 80 ± 25% and 67 ± 28% in the test and control groups, respectively, after 6 months. Conclusions Both CAF + CTG + PRGF and CAF + CTG treatment modalities resulted in favorable root coverage; however, the addition of PRGF added no measurable significant effect. Key words:Connective tissue graft, dental root coverage, gingival recession, growth factors, mucogingival surgery, periodontal plastic surgery. PMID:29849966

Coronally advanced flap and connective tissue graft with or without plasma rich in growth factors (PRGF) in treatment of gingival recession.

PubMed

Jenabian, Niloofar; Motallebnejad, Mina; Zahedi, Ehsan; Sarmast, Nima D; Angelov, Nikola

2018-05-01

Several researchers have tried to improve the results of gingival recession treatment techniques. One of the methods is to use growth factors The present study was undertaken to evaluate the effect of CAF (coronally advanced flap) + CTG (connective tissue graft) + PRGF (plasma rich in growth factors) in the treatment of Miller Class I buccal gingival recession. Twenty-two teeth with Miller Class I gingival recession in 6 patients 26 ‒ 47 years of age were included in a split-mouth designed randomized controlled trial (RCT). In each patient, one side was treated with CAF + CTG + PRGF (test) and the other side was treated with CAF + CTG (control). The following parameters were measured before surgery and up to 6 months after surgery on the mid-buccal surface of the tooth: keratinized tissue width (KTW), clinical attachment level (CAL), probing depth (PD), vertical recession depth (VRD), recession depth (RD), gingival thickness (GT), root coverage in percentage (RC%) and the distance between the CEJ and mucogingival junction (MGJL). Data were analyzed with paired t-test and repeated measures ANOVA. After 6 months noticeable improvements were observed in both groups in all the variables measured except for PD; however, the differences between the two groups were not significant. RC% was 80 ± 25% and 67 ± 28% in the test and control groups, respectively, after 6 months. Both CAF + CTG + PRGF and CAF + CTG treatment modalities resulted in favorable root coverage; however, the addition of PRGF added no measurable significant effect. Key words: Connective tissue graft, dental root coverage, gingival recession, growth factors, mucogingival surgery, periodontal plastic surgery.

Local Application of Platelet-Rich Fibrin During Lower Third Molar Extraction Improves Treatment Outcomes.

PubMed

He, Yun; Chen, Junliang; Huang, Yue; Pan, Qin; Nie, Minhai

2017-12-01

Application of platelet-rich fibrin (PRF) during tooth extraction is able to accelerate wound healing, stimulate osseous and soft tissue regeneration, and reduce unwanted side effects. The aim of this meta-analysis was to investigate the effect of local application of PRF on controlling postoperative signs and symptoms after the extraction of an impacted lower third molar. A systematic search of PubMed, Web of Science, Embase, and the Cochrane Library was performed to identify all studies published up to October 2016 that investigated the effect of PRF on lower third molar extraction. Pain, swelling, trismus, alveolar osteitis (AO), and osteoblastic activity were extracted to evaluate the effect of PRF. After quality assessment, meta-analysis was performed with RevMan software (version 5.3; Cochrane Library Software, Oxford, UK). After the search and selection process, 10 studies were selected in this meta-analysis, including 468 cases of PRF application and 467 cases of non-PRF application. Of the studies, 9 were randomized controlled trials, including 7 split-mouth studies, and there was 1 retrospective case-control study. The results indicated that PRF significantly relieves pain (P = .01) and 3-day postoperative swelling (P = .03) and reduces the incidence of AO (P < .0001). However, there were no significant differences between the PRF and non-PRF groups with respect to 1-day postoperative swelling and osteoblastic activity. Local application of PRF after lower third molar extraction is a valid method for relieving pain and 3-day postoperative swelling and reducing the incidence of AO. For patients undergoing complicated surgical extraction, PRF might be a recommendation for local application into the sockets. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Little evidence for the use of diode lasers as an adjunct to non-surgical periodontal therapy.

PubMed

Dederich, Douglas N

2015-03-01

Medline, PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL) and Embase databases. Randomised controlled trials (RCTs) using thermal diode lasers as an adjunct to non-surgical conventional periodontal initial therapy conducted in patients ≥18 years old written in English or Dutch were considered. Study assessment data extraction and quality assessment was carried out independently by two reviewers. The main outcome variables were probing pocket depth (PPD) and clinical attachment loss (CAL), but plaque scores (PS), bleeding scores (BS) and the Gingival Index (GI) were also considered. Meta-analysis was carried out using a random effects model. Nine studies involving 247 patients were included. Seven studies were of split mouth design and two were parallel group studies. The study designs showed considerable heterogeneity and follow up ranged from six weeks to six months. Meta-analysis found no significant effect on PPD, CAL and PS. There was however a significant effect for GI and BS favouring adjunctive use of the diode laser. The collective evidence regarding adjunctive use of the diode laser with SRP indicates that the combined treatment provides an effect comparable to that of SRP alone. With respect to BS the results showed a small but significant effect favouring the diode laser, however, the clinical relevance of this difference remains uncertainStandard . This systematic review questions the adjunctive use of diode laser with traditional mechanical modalities of periodontal therapy in patients with periodontitis. The strength of the recommendation for the adjunctive use of the diode laser is considered to be 'moderate' for changes in PPD and CAL.

Influence of chlorhexidine digluconate on the clinical performance of adhesive restorations: a 3-year follow-up.

PubMed

Sartori, Neimar; Stolf, Sheila C; Silva, Silvana B; Lopes, Guilherme C; Carrilho, Marcela

2013-12-01

The aim of this clinical study was to evaluate the long-term clinical performance of non-carious Class V restorations with and without application of chlorhexidine digluconate to acid-etched dentine. After the approval of the Ethics and Informed Consent Committee, 70 non-carious cervical lesions were selected and randomly assigned into two groups, according to the split mouth design. The control group was restored with a two-step etch-and-rinse adhesive (Adper Single Bond 2) following manufacturer's instructions; whereas in the experimental group 2% chlorhexidine digluconate solution was applied to acid etched dentine for 30s after etching and prior to the adhesive application. All lesions were restored with a nanofilled composite resin (Filtek Supreme XT) and polymerized with a light-curing unit operating at 600mW/cm(2). Clinical performance was recorded after 1 week, 6, 12, and 36 months using modified Ryge/USPHS criteria in terms of retention, marginal discoloration, marginal integrity, post-operative sensitivity, and secondary caries incidence. Data were analyzed using Chi-Square, Fisher's exact test and McNemar tests (α=.05). After 36 months the control group showed a success rate of 88% in comparison to 76% of experimental group; however, no statistically difference between them was found (p=.463). Moreover, no statistical differences were observed between groups in the criteria post-operative sensitivity, marginal discoloration, marginal integrity, and secondary caries incidence between the two groups. The addition of 2% chlorhexidine digluconate conditioning step does not improve the clinical durability of adhesive restorations. Copyright © 2013 Elsevier Ltd. All rights reserved.

Fluoridated elastomers: effect on the microbiology of plaque.

PubMed

Benson, Philip E; Douglas, C W Ian; Martin, Michael V

2004-09-01

The objective of this study was to investigate the effect of fluoridated elastomeric ligatures on the microbiology of local dental plaque in vivo. This randomized, prospective, longitudinal, clinical trial had a split-mouth crossover design. The subjects were 30 patients at the beginning of their treatment with fixed orthodontic appliances in the orthodontic departments of the Liverpool and the Sheffield dental hospitals in the United Kingdom. The study consisted of 2 experimental periods of 6 weeks with a washout period between. Fluoridated elastomers were randomly allocated at the first visit to be placed around brackets on tooth numbers 12, 11, 33 or 22, 21, 43. Nonfluoridated elastomers were placed on the contralateral teeth. Standard nonantibacterial fluoridated toothpaste and mouthwash were supplied. After 6 weeks (visit 2), the elastomers were removed, placed in transport media, and plated on agar within 2 hours. Nonfluoridated elastomers were placed on all brackets for 1 visit to allow for a washout period. At visit 3, fluoridated elastomers were placed on the teeth contralateral to those that received them at visit 1. At visit 4, the procedures at visit 2 were repeated. Samples were collected on visits 2 and 4. A logistic regression was performed, with the presence or absence of streptococcal or anaerobic growth as the dependent variable. A mixed-effects analysis of variance was carried out with the percentage of streptococcal or anaerobic bacterial count as the dependent variable. The only significant independent variables were the subject variable (P =<.001) for the percentage of streptococcal and anaerobic bacterial count and the visit variable for the percentage of streptococcal count (P =<.001). The use of fluoridated or nonfluoridated elastomers was not significant for percentage of either streptococcal (P =.288) or anaerobic count (P =.230). Fluoridated elastomers are not effective at reducing local streptococcal or anaerobic bacterial growth after a clinically relevant time in the mouth.

The immediate effects of atlanto-occipital joint manipulation and suboccipital muscle inhibition technique on active mouth opening and pressure pain sensitivity over latent myofascial trigger points in the masticatory muscles.

PubMed

Oliveira-Campelo, Natalia M; Rubens-Rebelatto, José; Martí N-Vallejo, Francisco J; Alburquerque-Sendí N, Francisco; Fernández-de-Las-Peñas, César

2010-05-01

A randomized controlled trial. To investigate the immediate effects on pressure pain thresholds over latent trigger points (TrPs) in the masseter and temporalis muscles and active mouth opening following atlanto-occipital joint thrust manipulation or a soft tissue manual intervention targeted to the suboccipital muscles. Previous studies have described hypoalgesic effects of neck manipulative interventions over TrPs in the cervical musculature. There is a lack of studies analyzing these mechanisms over TrPs of muscles innervated by the trigeminal nerve. One hundred twenty-two volunteers, 31 men and 91 women, between the ages of 18 and 30 years, with latent TrPs in the masseter muscle, were randomly divided into 3 groups: a manipulative group who received an atlanto-occipital joint thrust, a soft tissue group who received an inhibition technique over the suboccipital muscles, and a control group who did not receive an intervention. Pressure pain thresholds over latent TrPs in the masseter and temporalis muscles, and active mouth opening were assessed pretreatment and 2 minutes posttreatment by a blinded assessor. Mixed-model analyses of variance (ANOVA) were used to examine the effects of interventions on each outcome, with group as the between-subjects variable and time as the within-subjects variable. The primary analysis was the group-by-time interaction. The 2-by-3 mixed-model ANOVA revealed a significant group-by-time interaction for changes in pressure pain thresholds over masseter (P<.01) and temporalis (P = .003) muscle latent TrPs and also for active mouth opening (P<.001) in favor of the manipulative and soft tissue groups. Between-group effect sizes were small. The application of an atlanto-occipital thrust manipulation or soft tissue technique targeted to the suboccipital muscles led to an immediate increase in pressure pain thresholds over latent TrPs in the masseter and temporalis muscles and an increase in maximum active mouth opening. Nevertheless, the effects of both interventions were small and future studies are required to elucidate the clinical relevance of these changes. Therapy, level 1b.J Orthop Sports Phys Ther 2010;40(5):310-317, Epub 12 April 2010. doi:10.2519/jospt.2010.3257.

A randomised crossover comparison of mouth-to-face-shield ventilation and mouth-to-pocket-mask ventilation by surf lifeguards in a manikin.

PubMed

Adelborg, K; Bjørnshave, K; Mortensen, M B; Espeseth, E; Wolff, A; Løfgren, B

2014-07-01

Thirty surf lifeguards (mean (SD) age: 25.1 (4.8) years; 21 male, 9 female) were randomly assigned to perform 2 × 3 min of cardiopulmonary resuscitation on a manikin using mouth-to-face-shield ventilation (AMBU LifeKey) and mouth-to-pocket-mask ventilation (Laerdal Pocket Mask). Interruptions in chest compressions, effective ventilation (visible chest rise) ratio, tidal volume and inspiratory time were recorded. Interruptions in chest compressions per cycle were increased with mouth-to-face-shield ventilation (mean (SD) 8.6 (1.7) s) compared with mouth-to-pocket-mask ventilation (6.9 (1.2) s, p < 0.0001). The proportion of effective ventilations was less using mouth-to-face-shield ventilation (199/242 (82%)) compared with mouth-to-pocket-mask ventilation (239/240 (100%), p = 0.0002). Tidal volume was lower using mouth-to-face-shield ventilation (mean (SD) 0.36 (0.20) l) compared with mouth-to-pocket-mask ventilation (0.45 (0.20) l, p = 0.006). No differences in inspiratory times were observed between mouth-to-face-shield ventilation and mouth-to-pocket-mask ventilation. In conclusion, mouth-to-face-shield ventilation increases interruptions in chest compressions, reduces the proportion of effective ventilations and decreases delivered tidal volumes compared with mouth-to-pocket-mask ventilation. © 2014 The Association of Anaesthetists of Great Britain and Ireland.

Curative effects of microneedle fractional radiofrequency system on skin laxity in Asian patients: A prospective, double-blind, randomized, controlled face-split study.

PubMed

Lu, Wenli; Wu, Pinru; Zhang, Zhen; Chen, Jinan; Chen, Xiangdong; Ewelina, Biskup

2017-04-01

To date, no studies compared curative effects of thermal lesions in deep and superficial dermal layers in the same patient (face-split study). To evaluate skin laxity effects of microneedle fractional radiofrequency induced thermal lesions in different dermal layers. 13 patients underwent three sessions of a randomized face-split microneedle fractional radiofrequency system (MFRS) treatment of deep dermal and superficial dermal layer. Skin laxity changes were evaluated objectively (digital images, 2 independent experts) and subjectively (patients' satisfaction numerical rating). 12 of 13 subjects completed a course of 3 treatments and a 1-year follow-up. Improvement of nasolabial folds in deep dermal approach was significantly better than that in superficial approach at three months (P=.0002) and 12 months (P=.0057) follow-up. Effects on infraorbital rhytides were only slightly better (P=.3531). MFRS is an effective method to improve skin laxity. Thermal lesion approach seems to provide better outcomes when applied to deep dermal layers. It is necessary to consider the skin thickness of different facial regions when choosing the treatment depth.

Do preoperative oral carbohydrates improve postoperative outcomesin patients undergoing coronary artery bypass grafts?

PubMed

Şavluk, Ömer Faruk; Kuşçu, Mehmet Ali; Güzelmeriç, Füsun; Gürcü, Mustafa Emre; Erkılınç, Atakan; Çevirme, Deniz; Oğuş, Halide; Koçak, Tuncer

2017-12-19

Background/aim: The aim of this prospective study was to determine whether the preoperative oral intake of carbohydrate-rich drinks by patients undergoing a coronary artery bypass graft attenuates postoperative insulin requirements, improves postoperative patient discomfort, provides inotropic support, shortens the length of the ICU stay, and shortens the duration of postoperative mechanical ventilation. Materials and methods: This randomized prospective clinical study included 152 patients with coronary artery disease who were divided into 4 groups. Carbohydrates were administered to 3 groups at different hours and doses before operation. The fourth group had an 8-h preoperative fasting period. The inotropic and vasopressor requirements, ventilation time, and ICU stay time were recorded for all of the groups. Patient wellbeing, mouth dryness, hunger, anxiety, and nausea were assessed using VAS scores of 1-10. Results: Mouth dryness and hunger were significantly higher in the control group (P = 0.03, P = 0.02). The increase in blood glucose level was significantly higher in the control group (P = 0.04). The exogenous insulin requirement was significantly higher in the control group than in the other groups (P = 0.04). Conclusion: The administration of carbohydrates before elective cardiac surgery reduced insulin resistance. Based on the VAS scores, the intake of carbohydrates reduced mouth dryness and hunger. Overall, preoperative oral carbohydrate treatments can improve the postoperative outcomes of coronary artery bypass graft surgeries.

The Efficacy of Daily Prefrontal Repetitive Transcranial Magnetic Stimulation (rTMS) for Burning Mouth Syndrome (BMS): A Randomized Controlled Single-blind Study.

PubMed

Umezaki, Yojiro; Badran, Bashar W; DeVries, William H; Moss, Jkeonye; Gonzales, Theresa; George, Mark S

2016-01-01

Burning mouth syndrome (BMS) is a burning oral sensation without any corresponding abnormal findings. In some cases, BMS is refractory to pharmacologic treatments. Repetitive transcranial magnetic stimulation (rTMS) over left prefrontal cortex induces analgesic effect in both acute and chronic pain. However, its effect for BMS has not been evaluated. The aim of this randomized, controlled, single-blind study was to assess the efficacy of prefrontal rTMS for BMS. Twenty patients with BMS were recruited and randomized to receive 30,000 pulses in total at 10 Hz TMS (n = 12) or sham TMS (n = 8). We assessed the change of BMS pain condition, functional status and mood until 2 months after the beginning of treatment. In the real group, the BMS pain intensity decreased 67%, and 75% of the patients reported >50% pain decrease on final assessment compared to baseline, without heavy side effects. There was significant pain reduction in subjects in the real group immediately after 1 week of treatment, whereas there was none in those in the sham group. Similar tendency was confirmed in change of functional status. Mood and the affective aspect of pain were not changed in this study. BMS pain was significantly improved with 2 weeks of treatment of high frequency rTMS over left DLPFC compared to sham stimulation. Further study is needed to refine and improve TMS as a potential treatment of BMS. Copyright © 2016 Elsevier Inc. All rights reserved.

Impact of different concentrations of an octenidine dihydrochloride mouthwash on salivary bacterial counts: a randomized, placebo-controlled cross-over trial.

PubMed

Lorenz, Katrin; Jockel-Schneider, Yvonne; Petersen, Nicole; Stölzel, Peggy; Petzold, Markus; Vogel, Ulrich; Hoffmann, Thomas; Schlagenhauf, Ulrich; Noack, Barbara

2018-03-02

This bi-centric, placebo-controlled, randomized, evaluator-blinded, incomplete cross-over clinical phase II trial was initialized to identify the most appropriate concentration of octenidine dihydrochloride (OCT) in mouth rinses. Rinses of 0.10, 0.15, and 0.20% OCT were compared to a saline placebo rinse regarding the reduction of salivary bacterial counts (SBCs) in 90 gingivitis patients over 4 days. Changes in plaque (PI) and gingival index (GI), taste perception, and safety issues were evaluated. At baseline, the first OCT (0.10, 0.15, 0.20%) rinse resulted in a decrease of SBC (reduction by 3.63-5.44 log 10 colony forming units [CFU]) compared to placebo (p < 0.001). Differences between OCT concentrations were not verified. After 4 days, the last OCT rinse again resulted in a significant SBC decrease (3.69-4.22 log 10 CFU) compared to placebo (p < 0.001). Overall, SBC reduction between baseline and day 4 was significantly higher in OCT 0.15 and 0.20% groups compared to OCT 0.10% and placebo. Mean GI/PIs were significantly lower in OCT groups than in the placebo group (p < 0.001). Differences in GI/PI between OCT groups were not verified. Adverse effects increased with increasing OCT concentrations. Considering antibacterial efficacy, frequency of adverse events, and user acceptance, 0.10% OCT was identified as the preferred concentration to be used in future clinical trials. Due to its low toxicity and pronounced antibacterial properties, octenidine dihydrochloride (OCT) is a promising candidate for the use in antiseptic mouth rinses. OCT concentrations of 0.10% are recommended for future clinical trials evaluating the plaque-reducing properties of OCT mouth rinses. ( www.clinicaltrials.gov , NCT022138552).

Randomized clinical trial of encapsulated and hand-mixed glass-ionomer ART restorations: one-year follow-up.

PubMed

Freitas, Maria Cristina Carvalho de Almendra; Fagundes, Ticiane Cestari; Modena, Karin Cristina da Silva; Cardia, Guilherme Saintive; Navarro, Maria Fidela de Lima

2018-01-18

This prospective, randomized, split-mouth clinical trial evaluated the clinical performance of conventional glass ionomer cement (GIC; Riva Self-Cure, SDI), supplied in capsules or in powder/liquid kits and placed in Class I cavities in permanent molars by the Atraumatic Restorative Treatment (ART) approach. A total of 80 restorations were randomly placed in 40 patients aged 11-15 years. Each patient received one restoration with each type of GIC. The restorations were evaluated after periods of 15 days (baseline), 6 months, and 1 year, according to ART criteria. Wilcoxon matched pairs, multivariate logistic regression, and Gehan-Wilcoxon tests were used for statistical analysis. Patients were evaluated after 15 days (n=40), 6 months (n=34), and 1 year (n=29). Encapsulated GICs showed significantly superior clinical performance compared with hand-mixed GICs at baseline (p=0.017), 6 months (p=0.001), and 1 year (p=0.026). For hand-mixed GIC, a statistically significant difference was only observed over the period of baseline to 1 year (p=0.001). Encapsulated GIC presented statistically significant differences for the following periods: 6 months to 1 year (p=0.028) and baseline to 1 year (p=0.002). Encapsulated GIC presented superior cumulative survival rate than hand-mixed GIC over one year. Importantly, both GICs exhibited decreased survival over time. Encapsulated GIC promoted better ART performance, with an annual failure rate of 24%; in contrast, hand-mixed GIC demonstrated a failure rate of 42%.

Creating ensembles of decision trees through sampling

DOEpatents

Kamath, Chandrika; Cantu-Paz, Erick

2005-08-30

A system for decision tree ensembles that includes a module to read the data, a module to sort the data, a module to evaluate a potential split of the data according to some criterion using a random sample of the data, a module to split the data, and a module to combine multiple decision trees in ensembles. The decision tree method is based on statistical sampling techniques and includes the steps of reading the data; sorting the data; evaluating a potential split according to some criterion using a random sample of the data, splitting the data, and combining multiple decision trees in ensembles.

Controls on delta formation, area, and topset slope: New predictive relationships developed using a global delta dataset

NASA Astrophysics Data System (ADS)

Caldwell, R. L.; Edmonds, D. A.; Baumgardner, S. E.; Paola, C.; Roy, S.; Nienhuis, J.

2017-12-01

River deltas are irreplaceable natural and societal resources, though they are at risk of drowning due to sea-level rise and decreased sediment delivery. To enhance hazard mitigation efforts in the face of global environmental change, we must understand the controls on delta growth. Previous empirical studies of delta growth are based on small datasets and often biased towards large, river-dominated deltas. We are currently lacking relationships that predict delta formation, area, or topset slope across the full breadth of global deltas. To this end, we developed a global dataset of 5,229 rivers (with and without deltas) paired with nine upstream (e.g., sediment discharge) and four downstream (e.g., wave height) environmental variables. Using Google Earth imagery, we identify all coastal river mouths (≥ 50 m wide) connected to an upstream catchment, and define deltas as river mouths that split into two or more distributary channels, end in a depositional protrusion from the shoreline, or do both. Delta area is defined as the area of the polygon connecting the delta node, two lateral shoreline extent points, and the basinward-most extent of the delta. Topset slope is calculated as the average, linear slope from the delta node elevation (extracted from SRTM data) to the main channel mouth, and shoreline and basinward extent points. Of the 5,229 rivers in our dataset, 1,816 (35%) have a delta. Using 495 rivers (those with data available for all variables), we build an empirically-derived relationship that predicts delta formation with 76% success. Delta formation is controlled predominantly by upstream water and sediment discharge, with secondary control by downstream waves and tides that suppress delta formation. For those rivers that do form deltas, we show that delta area is best predicted by sediment discharge, bathymetric slope, and drainage basin area (R2 = 0.95, n = 170), and exhibits a negative power-law relationship with topset slope (R2 = 0.85, n = 1,342). Topset slope is best predicted by grain size and wave height (R2 = 0.50, n = 358). These empirical relationships can aid in forecasting delta response to continued global environmental change.

Exploring the reproducibility of functional connectivity alterations in Parkinson’s disease

PubMed Central

Onu, Mihaela; Wu, Tao; Roceanu, Adina; Bajenaru, Ovidiu

2017-01-01

Since anatomic MRI is presently not able to directly discern neuronal loss in Parkinson’s Disease (PD), studying the associated functional connectivity (FC) changes seems a promising approach toward developing non-invasive and non-radioactive neuroimaging markers for this disease. While several groups have reported such FC changes in PD, there are also significant discrepancies between studies. Investigating the reproducibility of PD-related FC changes on independent datasets is therefore of crucial importance. We acquired resting-state fMRI scans for 43 subjects (27 patients and 16 normal controls, with 2 replicate scans per subject) and compared the observed FC changes with those obtained in two independent datasets, one made available by the PPMI consortium (91 patients, 18 controls) and a second one by the group of Tao Wu (20 patients, 20 controls). Unfortunately, PD-related functional connectivity changes turned out to be non-reproducible across datasets. This could be due to disease heterogeneity, but also to technical differences. To distinguish between the two, we devised a method to directly check for disease heterogeneity using random splits of a single dataset. Since we still observe non-reproducibility in a large fraction of random splits of the same dataset, we conclude that functional heterogeneity may be a dominating factor behind the lack of reproducibility of FC alterations in different rs-fMRI studies of PD. While global PD-related functional connectivity changes were non-reproducible across datasets, we identified a few individual brain region pairs with marginally consistent FC changes across all three datasets. However, training classifiers on each one of the three datasets to discriminate PD scans from controls produced only low accuracies on the remaining two test datasets. Moreover, classifiers trained and tested on random splits of the same dataset (which are technically homogeneous) also had low test accuracies, directly substantiating disease heterogeneity. PMID:29182621

Effect of a Simulation Exercise on Restorative Identification Skills of First Year Dental Hygiene Students.

PubMed

Lemaster, Margaret; Flores, Joyce M; Blacketer, Margaret S

2016-02-01

This study explored the effectiveness of simulated mouth models to improve identification and recording of dental restorations when compared to using traditional didactic instruction combined with 2-dimensional images. Simulation has been adopted into medical and dental education curriculum to improve both student learning and patient safety outcomes. A 2-sample, independent t-test analysis of data was conducted to compare graded dental recordings of dental hygiene students using simulated mouth models and dental hygiene students using 2-dimensional photographs. Evaluations from graded dental charts were analyzed and compared between groups of students using the simulated mouth models containing random placement of custom preventive and restorative materials and traditional 2-dimensional representations of didactically described conditions. Results demonstrated a statistically significant (p≤0.0001) difference: for experimental group, students using the simulated mouth models to identify and record dental conditions had a mean of 86.73 and variance of 33.84. The control group students using traditional 2-dimensional images mean graded dental chart scores were 74.43 and variance was 14.25. Using modified simulation technology for dental charting identification may increase level of dental charting skill competency in first year dental hygiene students. Copyright © 2016 The American Dental Hygienists’ Association.

Immediate effects of atlanto-occipital joint manipulation on active mouth opening and pressure pain sensitivity in women with mechanical neck pain.

PubMed

Mansilla-Ferragut, Pilar; Fernández-de-Las Peñas, César; Alburquerque-Sendín, Francisco; Cleland, Joshua A; Boscá-Gandía, Juan José

2009-02-01

The purpose of this study was to investigate the effects of a spinal thrust manipulation directed to the upper cervical segments (atlanto-occipital joint) on active mouth opening and pressure pain sensitivity in a trigeminal nerve innervated region (sphenoid bone) in women with mechanical neck pain. Thirty-seven women, ages 21 to 50 years old (mean age, 35 +/- 8 years) with mechanical neck pain were recruited for this study. Participants were randomly assigned into 1 of 2 groups as follows: an experimental group that received a spinal manipulation of the atlanto-occipital joint and a control group that received a manual contact placebo intervention. Outcomes collected were assessed pretreatment and 5 minutes posttreatment by an assessor blinded to the treatment allocation and included active mouth opening and pressure pain thresholds (PPTs) over both sides of the sphenoid bone. A 2-way repeated measures analysis of variance (ANOVA) with time (pre-post) as the within subjects variable and group (control, experimental) as the between subjects variable was used to examine the effects of the intervention. The hypothesis of interest was group-time interaction. The ANOVA showed a significant effect for time (F = 23.1; P < .001) and an interaction between group and time (F = 37.7; P < .001) for active mouth opening as follows: the experimental group showed a greater improvement when compared to the control group. A large positive within-group effect size (d > 1.5) for the experimental group, whereas a negative medium within-group effect size (d = -0.5) for the control group were identified. The ANOVA showed a significant interaction between group and time (F = 14.4; P < .001) for PPT levels at the sphenoid bone as follows: the experimental group showed a greater improvement when compared to the control group. A medium positive within-group effect size (d = -0.5) for the experimental group, whereas a negative medium within-group effect size (d = -0.5) for the control group was found. Our findings suggest that the application of an atlantoaxial joint thrust manipulation resulted in an increase in active mouth opening and PPT over a trigeminal nerve distribution area (sphenoid bone) in women with mechanical neck pain.

Additive Effect of Plasma Rich in Growth Factors With Guided Tissue Regeneration in Treatment of Intrabony Defects in Patients With Chronic Periodontitis: A Split-Mouth Randomized Controlled Clinical Trial.

PubMed

Ravi, Sheethalan; Malaiappan, Sankari; Varghese, Sheeja; Jayakumar, Nadathur D; Prakasam, Gopinath

2017-09-01

Periodontal regeneration can be defined as complete restoration of lost periodontal tissues to their original architecture and function. A variety of treatment modalities have been proposed to achieve it. Plasma rich in growth factors (PRGF) is a concentrated suspension of growth factors that promotes restoration of lost periodontal tissues. The objective of the present study is to assess the effect of PRGF associated with guided tissue regeneration (GTR) versus GTR only in the treatment of intrabony defects (IBDs) in patients with chronic periodontitis (CP). Patients with CP (n = 14) with 42 contralateral 2- and 3-walled defects were randomly assigned to test (PRGF+GTR) and control (GTR alone) treatment groups. Clinical and radiographic assessments performed at baseline and after 6 months were: 1) gingival index (GI), 2) probing depth (PD), 3) clinical attachment level (CAL), 4) radiologic defect depth, and 5) bone fill. Comparison of parameters measured at baseline and after 6 months showed mean PD reduction of 3.37 ± 1.62 mm in the control group (P <0.001) and 4.13 ± 1.59 mm in the test group (P <0.001). There was a significant difference in mean change in CAL (P <0.001) in the control group (5.42 ± 1.99) and the test group (5.99 ± 1.77). Mean change in GI was 1.89 ± 0.32 and 1.68 ± 0.58 in the control group and test group, respectively, and the difference was statistically significant (P <0.001). When compared between groups, clinical parameters did not show any statistically significant variations. Mean radiographic bone fill was 1.06 ± 0.81 and 1.0 ± 0.97 in the control group and test group, respectively. However, the difference was not statistically significant. PRGF with GTR, as well as GTR alone, was effective in improving clinical and radiographic parameters of patients with CP at the 6-month follow-up. There was no additive effect of PRGF when used along with GTR in the treatment of IBDs in patients with CP in terms of both clinical and radiologic outcomes.

How and why of orthodontic bond failures: An in vivo study

PubMed Central

Vijayakumar, R. K.; Jagadeep, Raju; Ahamed, Fayyaz; Kanna, Aprose; Suresh, K.

2014-01-01

Introduction: The bonding of orthodontic brackets and their failure rates by both direct and in-direct procedures are well-documented in orthodontic literature. Over the years different adhesive materials and various indirect bonding transfer procedures have been compared and evaluated for bond failure rates. The aim of our study is to highlight the use of a simple, inexpensive and ease of manipulation of a single thermo-plastic transfer tray and the use the of a single light cure adhesive to evaluate the bond failure rates in clinical situations. Materials and Methods: A total of 30 patients were randomly divided into two groups (Group A and Group B). A split-mouth study design was used, for, both the groups so that they were distributed equally with-out bias. After initial prophylaxis, both the procedures were done as per manufactures instructions. All patients were initially motivated and reviewed for bond failures rates for 6 months. Results: Bond failure rates were assessed for over-all direct and indirect procedures, anterior and posterior arches, and for individual tooth. Z-test was used for statistically analyzing, the normal distribution of the sample in a spilt mouth study. The results of the two groups were compared and P value was calculated using Z-proportion test to assess the significance of the bond failure. Conclusion: Over-all bond failure was more for direct bonding. Anterior bracket failure was more in-direct bonding than indirect procedure, which showed more posterior bracket failures. In individual tooth bond failure, mandibular incisor, and premolar brackets showed more failure, followed by maxillary premolars and canines. PMID:25210392

Classes of Split-Plot Response Surface Designs for Equivalent Estimation

NASA Technical Reports Server (NTRS)

Parker, Peter A.; Kowalski, Scott M.; Vining, G. Geoffrey

2006-01-01

When planning an experimental investigation, we are frequently faced with factors that are difficult or time consuming to manipulate, thereby making complete randomization impractical. A split-plot structure differentiates between the experimental units associated with these hard-to-change factors and others that are relatively easy-to-change and provides an efficient strategy that integrates the restrictions imposed by the experimental apparatus. Several industrial and scientific examples are presented to illustrate design considerations encountered in the restricted randomization context. In this paper, we propose classes of split-plot response designs that provide an intuitive and natural extension from the completely randomized context. For these designs, the ordinary least squares estimates of the model are equivalent to the generalized least squares estimates. This property provides best linear unbiased estimators and simplifies model estimation. The design conditions that allow for equivalent estimation are presented enabling design construction strategies to transform completely randomized Box-Behnken, equiradial, and small composite designs into a split-plot structure.

Intravenous amoxicillin/clavulanate for the prevention of bacteraemia following dental procedures: a randomized clinical trial.

PubMed

Limeres Posse, J; Álvarez Fernández, M; Fernández Feijoo, J; Medina Henríquez, J; Lockhart, P B; Chu, V H; Diz Dios, P

2016-07-01

Although controversy exists regarding the efficacy of antibiotic prophylaxis for patients at risk of infective endocarditis, expert committees continue to publish recommendations for antibiotic prophylaxis regimens. This study aimed to evaluate the efficacy of four antimicrobial regimens for the prevention of bacteraemia following dental extractions. The study population included 266 adults requiring dental extractions who were randomly assigned to the following five groups: control (no prophylaxis); 1000/200 mg of amoxicillin/clavulanate intravenously; 2 g of amoxicillin by mouth; 600 mg of clindamycin by mouth; and 600 mg of azithromycin by mouth. Venous blood samples were collected from each patient at baseline and at 30 s, 15 min and 1 h after dental extractions. Samples were inoculated into BACTEC Plus culture bottles and processed in the BACTEC 9240. Conventional microbiological techniques were used for subcultures and further identification of the isolated bacteria. The trial was registered at ClinicalTrials.gov with ID number NCT02115776. The incidence of bacteraemia in the control, amoxicillin/clavulanate, amoxicillin, clindamycin and azithromycin groups was: 96%, 0%, 50%, 87% and 81%, respectively, at 30 s; 65%, 0%, 10%, 65% and 49% at 15 min; and 18%, 0%, 4%, 19% and 18% at 1 h. Streptococci were the most frequently identified bacteria. The percentage of positive blood cultures at 30 s post-extraction was lower in the amoxicillin/clavulanate group than in the amoxicillin group (P < 0.001). The incidence of bacteraemia in the clindamycin group was similar to that in the control group. Bacteraemia following dental extractions was undetectable with amoxicillin/clavulanate prophylaxis. Alternative antimicrobial regimens should be sought for patients allergic to the β-lactams. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

A prospective, randomized study on the efficacy of tongue protector in patients with burning mouth syndrome.

PubMed

López-Jornet, P; Camacho-Alonso, F; Andujar-Mateos, P

2011-04-01

To apply a tongue protector with habit-modifying therapy through self-control, in the patients with burning mouth syndrome (BMS). A prospective, randomized study was made of 65 consecutive patients with BMS. Fifty subjects were randomized to two groups: group A (informed) and group B (informed and the application of a tongue protector). The symptoms were evaluated by VAS, whereas the psychological profile was assessed using the HAD, with application of the quality of life questionnaires SF-36 and OHIP-49. The duration of treatment was 2 months. Fifty patients (46 females and 4 males) completed the study. The VAS scores in group B were 8.2 at baseline and 4.5 after 2 months. The respective scores in group A were 7.1 and 5.6 - the differences between the two groups being significant (P < 0.001). In group B the OHIP-49 yielded lower scores for most of the scales, with significant differences vs group A. In group B the SF 36 yielded significant differences vs group A in physical role, bodily pain, general health and emotional role. Parafunctional traumatism of the tongue should be taken into account in the pathogenesis of BMS with a view to exploring new therapeutic options. © 2010 John Wiley & Sons A/S.

A randomized clinical trial of an intervention to relieve thirst and dry mouth in intensive care unit patients.

PubMed

Puntillo, Kathleen; Arai, Shoshana R; Cooper, Bruce A; Stotts, Nancy A; Nelson, Judith E

2014-09-01

To test an intervention bundle for thirst intensity, thirst distress, and dry mouth, which are among the most pervasive, intense, distressful, unrecognized, and undertreated symptoms in ICU patients, but for which data-based interventions are lacking. This was a single-blinded randomized clinical trial in three ICUs in a tertiary medical center in urban California. A total of 252 cognitively intact patients reporting thirst intensity (TI) and/or thirst distress (TD) scores ≥3 on 0-10 numeric rating scales (NRS) were randomized to intervention or usual care groups. A research team nurse (RTN#1) obtained patients' pre-procedure TI and TD scores and reports of dry mouth. She then administered a thirst bundle to the intervention group: oral swab wipes, sterile ice-cold water sprays, and a lip moisturizer, or observed patients in the usual care group. RTN#2, blinded to group assignment, obtained post-procedure TI and TD scores. Up to six sessions per patient were conducted across 2 days. Multilevel linear regression determined that the average decreases in TI and TD scores from pre-procedure to post-procedure were significantly greater in the intervention group (2.3 and 1.8 NRS points, respectively) versus the usual care group (0.6 and 0.4 points, respectively) (p < 0.05). The usual care group was 1.9 times more likely than the intervention group to report dry mouth for each additional session on day 1. This simple, inexpensive thirst bundle significantly decreased ICU patients' thirst and dry mouth and can be considered a practice intervention for patients experiencing thirst.

To compare the gingival melanin repigmentation after diode laser application and surgical removal.

PubMed

Mahajan, Gaurav; Kaur, Harjit; Jain, Sanjeev; Kaur, Navnit; Sehgal, Navneet Kaur; Gautam, Aditi

2017-01-01

The aim of the present study is to compare the gingival melanin repigmentation after diode laser application and surgical removal done by scraping with Kirkland knife. This study was a randomized split-mouth study where 10 patients presenting with unattractive, diffuse, dark brown to black gingival discoloration on the facial aspect of the maxillary gingiva were treated by diode laser application and surgical removal and followed up for 3-, 6-, and 9-month intervals. The results showed a statistically significant difference in repigmentation between the groups at the interval of 3 months ( P = 0.040), but the difference was statistically not significant at 6 months ( P = 0.118) and 9 months ( P = 0.146). On surgically treated sites, all cases showed repigmentation of the gingiva, but in laser treated, there were two individuals which did not show repigmentation of the gingiva even at the end of 9-month observation time. The incidence of repigmentation was slightly less in laser-treated sites as compared to surgical depigmentation although the difference was statistically significant only up to 3 months.

Low-Level Lasers as an Adjunct in Periodontal Therapy in Patients with Diabetes Mellitus

PubMed Central

Kesić, Ljiljana; Mihailović, Dragan; Jovanović, Goran; Antić, Slobodan; Brkić, Zlata

2012-01-01

Abstract Background Diabetes mellitus (DM) increases the risk of periodontitis, and severe periodontitis often coexists with severe DM. The proposed dual pathway of tissue destruction suggests that control of chronic periodontal infection and gingival inflammation is essential for achieving long-term control of DM. The purpose this study is to evaluate the effects of low-level laser therapy (LLLT) by exfoliative cytology in patients with DM and gingival inflammation. Subjects and Methods Three hundred patients were divided in three equal groups: Group 1 consisted of patients with periodontitis and type 1 DM, Group 2 of patients with periodontitis and type 2 DM, and Group 3 of patients with periodontitis (control group). After oral examination, smears were taken from gingival tissue, and afterward all of the patients received oral hygiene instructions, removal of dental plaque, and full-mouth scaling and root planing. A split-mouth design was applied; on the right side of jaws GaAlAs LLLT (670 nm, 5 mW, 14 min/day) (model Mils 94; Optica Laser, Sofia, Bulgaria) was applied for five consecutive days. After the therapy was completed, smears from both sides of jaws were taken. The morphometric analysis was done using the National Institutes of Health Image software program and a model NU2 microscope (Carl Zeiss, Jena, Germany). Results Investigated parameters were significantly lower after therapy compared with values before therapy. After therapy on the side subjected to LLLT, there was no significantly difference between patients with DM and the control group. Conclusions It can be concluded that LLLT as an adjunct in periodontal therapy reduces gingival inflammation in patients with DM and periodontitis. PMID:22928615

Hemostasis and Post-operative Care of Oral Surgical Wounds by Hemcon Dental Dressing in Patients on Oral Anticoagulant Therapy: A Split Mouth Randomized Controlled Clinical Trial.

PubMed

Kumar, K R Ashok; Kumar, Jambukeshwar; Sarvagna, Jagadesh; Gadde, Praveen; Chikkaboriah, Shwetha

2016-09-01

Hemostasis is a fundamental management issue post-operatively in minor oral surgical procedures. To ensure safety and therapeutic efficacy in patients, under oral anti coagulant therapy, is complicated by necessity for frequent determination of prothrombin time or international normalised ratio. The aim of the study was to determine whether early hemostasis achieved by using Hemcon Dental Dressing (HDD) will affect post-operative care and surgical healing outcome in minor oral surgical procedures. A total of 30 patients, aged 18 years to 90 years, except those allergic to seafood, who consented to participate, were enrolled into this study. Patients were required to have two or more surgical sites so that they would have both surgical and control sites. All patients taking Oral Anticoagulation Therapy (OAT) were included for treatment in the study without altering the anticoagulant regimens. Institutional Review Board approval was obtained for the same. The collected data was subjected to statistical analysis using unpaired t-test. All HDD surgically treated sites achieved hemostasis in 1.49 minutes and control wounds in 4.06 minutes (p < 0.001). Post-operative pain at HDD treated sites (1.87,1.27 on 1 st and 3 rd day respectively) was significantly lower than the control sites (4.0,1.87 on 1 st and 3 rd day respectively) p-value (0.001, 0.001 respectively). HDD treated oral surgery wounds achieved statistically significant improved healing both at 1 st and 3 rd post-operative days (p <0.0001). The HDD has been proven to be a clinically effective hemostatic dressing material that significantly shortens bleeding time following minor oral surgical procedures under local anaesthesia, including those patients taking OAT. Patients receiving the HDD had improved surgical wound healing as compared to controls.

Safety and Efficacy of a Mouth-Rinse with Granulocyte Colony Stimulating Factor in Patients with Chemotherapy-Induced Oral Mucositis.

PubMed

Wang, Lin; Huang, Xin-En; Ji, Zhu-Qing; Liu, Meng-Yan; Qian, Ting; Li, Li

2016-01-01

To assess the safety and effectiveness of a mouth-rinse with G-CSF (JiSaiXin, produced by NCPC Biotechnology Co., Ltd) in treating patients with chemotherapy-induced oral mucositis (CIM). A consecutive cohort of patients with advanced cancers and CIM were treated with mouth-rinse G-CSF. All chemotherapy for patients with advanced cancers was adopted from regimens suggested by NCCN guidelines. The mouth-rinse with G-CSF at a dose of 150-300ug plus 100ml-500ml normal saline was started from the time of oral mucositis was confirmed and continuously used for at least 7 days as one course. After at least two courses of treatment, safety and efficacy were evaluated. There were 7 female and 7 male patients with advanced cancer and CIM recruited into this study, including 5 with colorectal, 2 with lung, 1 patient with gastric, 1 with cervical and 1 with pancreatic cancer, as well as 2 patients with diffuse large B cell lymphomas, 1 with nasopharyngeal and 1 with gastric cancer. The median age was 57 (41-79) years. Grade 1 to 2 myelosuppression was observed in 3/14 patients, and Grade 4 myelosuppression in 1/14. Adverse effects on the gastrointestinal tract were documented in 5/14 patients, and were Grade 1 to Grade 3. No treatment related death was documented. Regarding CIM, the median response time to mouth rinse of G-CSF was 2 (1-5) days, and all patients with CIM demonstrated a positive response. Mouth-rinse with G-CSF proved to be safe and effective in treating patients with advanced cancers and CIM. However, further randomized controlled studies should be conducted to clarify the effectiveness of this treatment with other lesions.

The analgesic effect of photobiomodulation therapy (830 nm) on the masticatory muscles: a randomized, double-blind study.

PubMed

Costa, Sabrina Araújo Pinho; Florezi, Giovanna Piacenza; Artes, Gisele Ebling; Costa, Jessica Ribeiro da; Gallo, Rosane Tronchin; Freitas, Patricia Moreira de; Witzel, Andrea Lusvarghi

2017-12-18

This study assesses the efficacy of photobiomodulation therapy (830 nm) for myalgia treatment of masticatory muscles. Sixty patients with muscular myalgia were selected and randomly allocated into 2 groups (n=30): Group A comprised patients given a placebo (control), and Group B consisted of those undergoing photobiomodulation therapy (PBMT). PBMT and placebo were applied bilaterally to specific points on the masseter and temporal muscles. Referred pain elicited by palpation and maximum mouth opening were measured before (EV1) and after (EV2) the treatments. The data were analyzed using statistical tests, considering a significance level of 5%. No significant differences in range were observed for active or passive mouth opening (p ≥ 0.05). Comparing the final outcomes (EV1-EV2) of both treatments, statistical significance was verified for total pain in the right masseter muscle (p = 0.001) and total pain (p = 0.005). In EV2, significant differences in pain reported with palpation were found between Groups A and B for the following: left posterior temporal muscle (p = 0.025), left superior masseter muscle (p = 0.036), inferior masseter muscle (p = 0.021), total pain (left side) (p = 0.009), total masseter muscle (left side) (p = 0.014), total temporal (left side) (p = 0.024), and total pain (p = 0.035). We concluded that PBMT (830 nm) reduces pain in algic points, but does not influence the extent of mouth opening in patients with myalgia.

Meroplankton Monitoring Data from a Fixed Platform in the Chesapeake Bay Mouth, 1982-1983.

DTIC Science & Technology

1984-11-01

the field in 10% formalin in seawater. During .., the sorting process in the laboratory, samples were split as required following the "CVS" method of...8217 -23- [3 =NUSTON 0 -- WACE cJ LLJ to LuJ Lcm *pJ SL O Q_* J FMRA M J JR A5O NO0 1983 Figure 3. Density of Anchoa mitchilli eggs by depth by semimonth

Clinical and radiographical evaluation of a bioresorbable collagen membrane of fish origin in the treatment of periodontal intrabony defects: A preliminary study.

PubMed

Santosh Kumar, B B; Aruna, D R; Gowda, Vinayak S; Galagali, Sushama R; Prashanthy, R; Navaneetha, H

2013-09-01

Recently, there has been interest in non-mammalian collagen sources such as fish collagen in periodontal regeneration. In the present study, collagen barrier membrane of fish origin was assessed in the treatment of periodontal intrabony defects. Ten systemically healthy chronic periodontitis patients having a paired osseous defect in the mandibular posterior teeth were selected and randomly assigned to receive a collagen membrane (test) or open flap debridement (control) in a split mouth design. Clinical parameters such as Plaque index, Gingival bleeding index, Probing pocket depth, Relative attachment level, and Recession were recorded at baseline, 3, 6, and at 9 months, while radiographic evaluation was done to assess alveolar crestal bone level and percentage of defect fill at 6 and 9 months using autoCAD 2007 software. Student's t test (two-tailed, dependent) was used to find the significance of study parameters on continuous scale. Significance was set at 5% level of significance. Wilcoxon signed rank test was used to find the significance of percentage change of defect fill. The comparison between the two groups did not show any statistically significant differences in the parameters assessed (P > 0.05) but, within each group, clinical parameters showed statistically significant differences from baseline to 9 months (P < 0.05). Within the limits of the study, it can be inferred that no significant differences were found either by using collagen membrane of fish origin or open flap debridement in the treatment of periodontal intrabony defects.

Caries prevention during orthodontic treatment: In-vivo assessment of high-fluoride varnish to prevent white spot lesions.

PubMed

Perrini, Federico; Lombardo, Luca; Arreghini, Angela; Medori, Silvia; Siciliani, Giuseppe

2016-02-01

Our objective was to evaluate the efficacy of a fluoridated varnish in preventing white spot lesions in patients with fixed appliances. A laser-induced fluorescence device was used to determine any correlations between the degree of demineralization and the length of the observation period, the arch sector, the frequency of varnish application, and the specific tooth site. A split-mouth study design was used for 24 orthodontic patients, allocated randomly to 2 subgroups with differing frequencies of Duraphat varnish (Colgate-Palmolive, New York, NY) application. Repeated measures of the degree of demineralization were taken on the vestibular surfaces of 12 teeth (6 varnished and 6 unvarnished controls). Measurements were taken at 4 sites using a DIAGNOdent Pen 2190 laser (KaVo, Biberach an der Riss, Germany) and then subjected to statistical analysis. Generalized linear model and coefficient model analysis showed differences in the degrees of demineralization between treated and untreated teeth, but this was not statistically significant in terms of time point, frequency of application, or specific tooth site. However, when we analyzed the position of the teeth, the varnished anterior teeth showed a statistically significant reduction in demineralization compared with their unvarnished counterparts. Periodic application of fluoride varnish can offer some protection against white spots, but not to a statistically significant degree if the patients have excellent oral hygiene. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Histologic evaluation of human pulp tissue after orthodontic intrusion.

PubMed

Lazzaretti, Dieison Nardi; Bortoluzzi, Gianna Steffens; Torres Fernandes, Lauren Fioreze; Rodriguez, Rubens; Grehs, Renésio Armindo; Martins Hartmann, Mateus Silveira

2014-10-01

The forces applied during orthodontic treatment bring about effects on the teeth and surrounding tissues. The aim of this study was to evaluate the possible changes in the human pulpal tissue resulting from orthodontic intrusion in a 21-day period using histologic examination. The sample consisted of 17 young individuals of both sexes between the ages of 12 and 19 years. A total of 34 premolars were evaluated with orthodontic indication of extraction. Because it is a split-mouth study, in each patient, intrusion force of 60 g was applied randomly on 1 of the dental elements experimental group for 21 days. The counterpart control group received no force. After extractions, these dental elements were fixed in 10% formaldehyde, processed automatically, submitted to histotechnical preparation, and stained with hematoxylin-eosin for analysis under optical microscope. The paired Fisher exact test (P ≤ .05) showed a significant increase of fibrous tissue in the experimental group. The nonparametric paired Wilcoxon test (P ≤ .05) showed a significant increase in the number of pulpal nodules in the elements of the experimental group and showed no difference in the number of blood vessels between the groups. Large-caliber vessels and congested elements were observed in 8 of the experimental group elements. The orthodontic intrusion force, in these conditions, caused vascular changes in the pulpal tissue and also increased the presence of fibrosis and the number of pulp calcifications in the experimental elements. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Hypnosis/Relaxation therapy for temporomandibular disorders: a systematic review and meta-analysis of randomized controlled trials.

PubMed

Zhang, Yuqing; Montoya, Luis; Ebrahim, Shanil; Busse, Jason W; Couban, Rachel; McCabe, Randi E; Bieling, Peter; Carrasco-Labra, Alonso; Guyatt, Gordon H

2015-01-01

To conduct a systematic review and meta-analysis to evaluate the effectiveness of hypnosis/relaxation therapy compared to no/minimal treatment in patients with temporomandibular disorders (TMD). Studies reviewed included randomized controlled trials (RCTs) where investigators randomized patients with TMD or an equivalent condition to an intervention arm receiving hypnosis, relaxation training, or hyporelaxation therapy, and a control group receiving no/minimal treatment. The systematic search was conducted without language restrictions, in Medline, EMBASE, CENTRAL, and PsycINFO, from inception to June 30, 2014. Studies were pooled using weighted mean differences and pooled risk ratios (RRs) for continuous outcomes and dichotomous outcomes, respectively, and their associated 95% confidence intervals (CI). Of 3,098 identified citations, 3 studies including 159 patients proved eligible, although none of these described their method of randomization. The results suggested limited or no benefit of hypnosis/relaxation therapy on pain (risk difference in important pain -0.06; 95% CI: -0.18 to 0.05; P = .28), or on pressure pain thresholds on the skin surface over the temporomandibular joint (TMJ) and masticatory muscles. Low-quality evidence suggested some benefit of hypnosis/relaxation therapy on maximal pain (mean difference on 100-mm scale = -28.33; 95% CI: -44.67 to -11.99; P =.007) and active maximal mouth opening (mean difference on 100-mm scale = -2.63 mm; 95% CI: -3.30 mm to -1.96 mm; P < .001) compared to no/minimal treatment. Three RCTs were eligible for the systematic review, but they were with high risk of bias and provided low-quality evidence, suggesting that hypnosis/relaxation therapy may have a beneficial effect on maximal pain and active maximal mouth opening but not on pain and pressure pain threshold. Larger RCTs with low risk of bias are required to confirm or refute these findings and to inform other important patient outcomes.

Sinus Floor Augmentation Using Straumann® BoneCeramic™ and Bio-Oss® in a Split Mouth Design and Later Placement of Implants: A 5-Year Report from a Longitudinal Study.

PubMed

Mordenfeld, Arne; Lindgren, Christer; Hallman, Mats

2016-10-01

Straumann® BoneCeramic™ is a synthetic biphasic calcium phosphate (BCP) aimed for sinus floor augmentation. Long-term follow-up of implants placed in BCP after sinus augmentation is still missing. The primary aim of the study was to compare survival rates and marginal bone loss of Straumann SLActive implants placed in either BCP (test) or Bio-Oss® (DBB) (control) after sinus floor augmentation. The secondary aim was to calculate graft sinus height at different time points. Bilateral sinus floor augmentation was performed in a split mouth model. Eleven patients (mean age 67 years) received 100% BCP on one side and 100% DBB on the contralateral side. After 8 months of graft healing, 62 Straumann SLActive implants were placed. After 5 years of functional loading (6 years after augmentation) of implants, marginal bone levels and grafted sinus height were measured, and implant survival and success rates were calculated. After 5 years of loading, all prosthetic constructions were in function although two implants were lost in each grafting material. The overall implant survival rate was 93.5% (91.7% for BCP, 91.3% for DBB, and 100% for residual bone). The success rates were 83.3% and 91.3% for BCP and DBB, respectively. There was no statistically significant difference in mean marginal bone level after 5 years between BCP (1.4 ± 1.2 mm) and DBB (1.0 ± 0.7 mm). Graft height reduction (GHR) after 6 years was limited to 6.6% for BCP and 5.8% for DBB. In this limited RCT study, the choice of biomaterial used for sinus floor augmentation did not seem to have any impact on survival rates and marginal bone level of the placed implants after 5 years of functional loading and GHR was minimal. © 2015 Wiley Periodicals, Inc.

Effect of the use of combination uridine triphosphate, cytidine monophosphate, and hydroxycobalamin on the recovery of neurosensory disturbance after bilateral sagittal split osteotomy: a randomized, double-blind trial.

PubMed

Vieira, C L; Vasconcelos, B C do E; Leão, J C; Laureano Filho, J R

2016-02-01

The change in neurosensory lesions that develop after bilateral sagittal split osteotomy (BSSO) was explored, and the influence of the application of combination uridine triphosphate (UTP), cytidine monophosphate (CMP), and hydroxycobalamin (vitamin B12) on patient outcomes was assessed. This was a randomized, controlled, double-blind trial. The study sample comprised 12 patients, each evaluated on both sides (thus 24 sides). All patients fulfilled defined selection criteria. Changes in the lesions were measured both subjectively and objectively. The sample was divided into two patient groups: an experimental group receiving medication and a control group receiving placebo. The statistical analysis was performed using SPSS software. Lesions in both groups improved and no statistically significant difference between the groups was observed at any time. 'Severe' injuries in the experimental group were more likely to exhibit a significant improvement after 6 months. Based on the results of the present study, it is concluded that the combination UTP, CMP, and hydroxycobalamin did not influence recovery from neurosensory disorders. Copyright © 2015. Published by Elsevier Ltd.

A comparison of the conditional inference survival forest model to random survival forests based on a simulation study as well as on two applications with time-to-event data.

PubMed

Nasejje, Justine B; Mwambi, Henry; Dheda, Keertan; Lesosky, Maia

2017-07-28

Random survival forest (RSF) models have been identified as alternative methods to the Cox proportional hazards model in analysing time-to-event data. These methods, however, have been criticised for the bias that results from favouring covariates with many split-points and hence conditional inference forests for time-to-event data have been suggested. Conditional inference forests (CIF) are known to correct the bias in RSF models by separating the procedure for the best covariate to split on from that of the best split point search for the selected covariate. In this study, we compare the random survival forest model to the conditional inference model (CIF) using twenty-two simulated time-to-event datasets. We also analysed two real time-to-event datasets. The first dataset is based on the survival of children under-five years of age in Uganda and it consists of categorical covariates with most of them having more than two levels (many split-points). The second dataset is based on the survival of patients with extremely drug resistant tuberculosis (XDR TB) which consists of mainly categorical covariates with two levels (few split-points). The study findings indicate that the conditional inference forest model is superior to random survival forest models in analysing time-to-event data that consists of covariates with many split-points based on the values of the bootstrap cross-validated estimates for integrated Brier scores. However, conditional inference forests perform comparably similar to random survival forests models in analysing time-to-event data consisting of covariates with fewer split-points. Although survival forests are promising methods in analysing time-to-event data, it is important to identify the best forest model for analysis based on the nature of covariates of the dataset in question.

Effect of topical application of dipyrone on dental sensitivity reduction after in-office dental bleaching: A randomized, triple-blind multicenter clinical trial.

PubMed

Rezende, Márcia; Chemin, Kaprice; Vaez, Savil Costa; Peixoto, Aline Carvalho; Rabelo, Jéssica de Freitas; Braga, Stella Sueli Lourenço; Faria-E-Silva, André Luis; Silva, Gisele Rodrigues da; Soares, Carlos José; Loguercio, Alessandro D; Reis, Alessandra

2018-05-01

Tooth sensitivity commonly occurs during and immediately after dental bleaching. The authors conducted a trial to compare tooth sensitivity after in-office bleaching after the use of either a topical dipyrone or placebo gel. A split-mouth, triple-blind, randomized, multicenter clinical trial was conducted among 120 healthy adults having teeth that were shade A2 or darker. The facial tooth surfaces of the right or left sides of the maxillary arch of each patient were randomly assigned to receive either topical dipyrone or placebo gel before 2 in-office bleaching sessions (35% hydrogen peroxide) separated by 2 weeks. Visual analog and numerical rating scales were used to record tooth sensitivity during and up to 48 hours after bleaching. Tooth color change from baseline to 1 month after bleaching was measured with shade guide and spectrophotometer measures. The primary outcome variable was absolute risk of tooth sensitivity. An intention-to-treat analysis was used to analyze data from all patients who were randomly assigned to receive the dipyrone and placebo gels. No statically significant difference was found in the absolute risk of tooth sensitivity between the dipyrone and placebo gels (83% and 90%, respectively, P = .09; relative risk, 0.92; 95% confidence interval, 0.8 to 1.0). A whitening effect was observed in both groups with no statistically significant difference (P > .05) between them. No adverse effects were observed. Topical use of dipyrone gel before tooth bleaching, at the levels used in this study, did not reduce the risk or intensity of bleaching-induced tooth sensitivity. Topical application of dipyrone gel does not reduce bleaching-induced tooth sensitivity. Copyright © 2018 American Dental Association. Published by Elsevier Inc. All rights reserved.

Efficacy of Connective Tissue with and without Periosteum in Regeneration of Intrabony Defects

PubMed Central

Esfahanian, Vahid; Golestaneh, Hedayatollah; Moghaddas, Omid; Ghafari, Mohammad Reza

2014-01-01

Background and aims. Connective tissue grafts with and without periosteum is used in regenerative treatments of bone and has demonstrated successful outcomes in previous investigations. The aim of present study was to evaluate the effectiveness of connective tissue graft with and without periosteum in regeneration of intrabony defects. Materials and methods. In this single-blind randomized split-mouth clinical trial, 15 pairs of intrabony defects in 15 patients with moderate to advanced periodontitis were treated by periosteal connective tissue graft + ABBM (test group) or non-periosteal connective tissue graft + ABBM (control group). Probing pocket depth, clinical attachment level, free gingival margin position, bone crestal position, crest defect depth and defect depth to stent were measured at baseline and after six months by surgical re-entry. Data was analyzed by Student’s t-test and paired t-tests (α=0.05). Results. Changes in clinical parameters after 6 months in the test and control groups were as follows: mean of PPD reduction: 3.1±0.6 (P<0.0001); 2.5±1.0 mm (P<0.0001), CAL gain: 2.3±0.9 (P<0.0001); 2.2±1.0 mm (P<0.0001), bone fill: 2.2±0.7 mm (P<0.0001); 2.2±0.7 mm (P<0.0001), respectively. No significant differences in the position of free gingival margin were observed during 6 months compared to baseline in both groups. Conclusion. Combinations of periosteal connective tissue graft + ABBM and non-periosteal connective tissue graft + ABBM were similarly effective in treating intrabony defects without any favor for any group. Connective tissue and perio-steum can be equally effective in regeneration of intrabony defects. PMID:25587379

Healing of Postextraction Sockets Preserved With Autologous Platelet Concentrates. A Systematic Review and Meta-Analysis.

PubMed

Del Fabbro, Massimo; Bucchi, Cristina; Lolato, Alessandra; Corbella, Stefano; Testori, Tiziano; Taschieri, Silvio

2017-08-01

The true benefit of autologous platelet concentrates (APCs) for enhancing the healing of postextraction sites is still a matter of debate, and in recent years several clinical trials have addressed this issue. The purpose of this study was to determine the effectiveness of an APC adjunct in the preservation of fresh extraction sockets. An electronic search was performed on Medline, Embase, Scopus, and the Cochrane Central Register of Controlled Trials. Only controlled clinical trials or randomized clinical trials were included. Selected articles underwent risk-of-bias assessment. The outcomes were complications and adverse events, discomfort and quality of life, bone healing and remodeling assessed by histologic and radiographic techniques, and soft tissue healing. Thirty-three comparative studies were included. Nine articles had a parallel design and 24 had a split-mouth design. Twenty studies were considered to have a low risk of bias and 13 were considered to have a high risk. Overall, 1,193 teeth were extracted from 911 patients. Meta-analysis showed that soft tissue healing, probing depth at 3 months, and bone density at 1, 3, and 6 months were statistically better for the APC group. Qualitative analysis suggested that APCs might be associated with a decrease in swelling and trismus. However, no relevant difference among groups was found for probing depth at 1 month, incidence of alveolar osteitis, acute inflammation or infection, percentage of new bone, and indirect measurement of bone metabolism. APCs should be used in postextraction sites to improve clinical and radiographic outcomes such as bone density and soft tissue healing and postoperative symptoms. The actual benefit of APCs on decreasing pain in extraction sockets is still not quantifiable. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Role of "diseased" root cementum in healing following treatment of periodontal disease. A clinical study.

PubMed

Nyman, S; Westfelt, E; Sarhed, G; Karring, T

1988-08-01

This clinical trial was undertaken to examine whether root debridement in the treatment of periodontal disease must include the removal of the exposed cementum in order to achieve periodontal health. The study included 11 adult patients with moderate to advanced periodontal disease. In a split-mouth design, the dentition of each patient was by random selection divided into test- and control quadrants comprising the incisors, canines and premolars. Following a baseline examination, all patients were given a case presentation and a detailed instruction in self-performed oral hygiene measures. The patients were then subjected to periodontal surgery. Following reverse bevel incisions, buccal and lingual mucoperiosteal flaps were elevated and all granulation tissue was removed. In 2 jaw quadrants (control quadrants) in each patient, the denuded root surfaces were carefully scaled and planed in order to remove soft and hard deposits as well as all cementum, using hand instruments and flame-formed diamond stones. In the contralateral quadrants (test quadrants) the roots were not scaled and planed but soft microbial deposits were removed by polishing the root surfaces with the but soft microbial deposits were removed by polishing the root surfaces with the use of rubber cups, interdental rubber tips and a polishing paste. Calculus in the test quadrants was removed by the use of a curette, but precaution was taken to avoid the removal of cementum. The flaps were repositioned to their original level and sutured. The patients were following active treatment enrolled in a supervised maintenance care program including "professional tooth cleaning" once every 2 weeks for a 3-month period.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparability of clinical wear measurements by optical 3D laser scanning in two different centers.

PubMed

Stober, Thomas; Heuschmid, Navina; Zellweger, Gaby; Rousson, Valentin; Rues, Stefan; Heintze, Siegward D

2014-05-01

The purpose of this study was to compare the use of different variables to measure the clinical wear of two denture tooth materials in two analysis centers. Twelve edentulous patients were provided with full dentures. Two different denture tooth materials (experimental material and control) were placed randomly in accordance with the split-mouth design. For wear measurements, impressions were made after an adjustment phase of 1-2 weeks and after 6, 12, 18, and 24 months. The occlusal wear of the posterior denture teeth of 11 subjects was assessed in two study centers by use of plaster replicas and 3D laser-scanning methods. In both centers sequential scans of the occlusal surfaces were digitized and superimposed. Wear was described by use of four different variables. Statistical analysis was performed after log-transformation of the wear data by use of the Pearson and Lin correlation and by use of a mixed linear model. Mean occlusal vertical wear of the denture teeth after 24 months was between 120μm and 212μm, depending on wear variable and material. For three of the four variables, wear of the experimental material was statistically significantly less than that of the control. Comparison of the two study centers, however, revealed correlation of the wear variables was only moderate whereas strong correlation was observed among the different wear variables evaluated by each center. Moderate correlation was observed for clinical wear measurements by optical 3D laser scanning in two different study centers. For the two denture tooth materials, wear measurements limited to the attrition zones led to the same qualitative assessment. Copyright © 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Computational and clinical investigation on the role of mechanical vibration on orthodontic tooth movement.

PubMed

Liao, Zhipeng; Elekdag-Turk, Selma; Turk, Tamer; Grove, Johnathan; Dalci, Oyku; Chen, Junning; Zheng, Keke; Ali Darendeliler, M; Swain, Michael; Li, Qing

2017-07-26

The aim of this study is to investigate the biomechanics for orthodontic tooth movement (OTM) subjected to concurrent single-tooth vibration (50Hz) with conventional orthodontic force application, via a clinical study and computational simulation. Thirteen patients were recruited in the clinical study, which involved distal retraction of maxillary canines with 1.5N (150g) force for 12weeks. In a split mouth study, vibration and non-vibration sides were randomly assigned to each subject. Vibration of 50Hz, of approximately 0.2N (20g) of magnitude, was applied on the buccal surface of maxillary canine for the vibration group. A mode-based steady-state dynamic finite element analysis (FEA) was conducted based on an anatomically detailed model, complying with the clinical protocol. Both the amounts of space closure and canine distalization of the vibration group were significantly higher than those of the control group, as measured intra-orally or on models (p<0.05). Therefore it is indicated that a 50Hz and 20g single-tooth vibration can accelerate maxillary canine retraction. The volume-average hydrostatic stress (VHS) in the periodontal ligament (PDL) was computationally calculated to be higher with vibration compared with the control group for maxillary teeth and for both linguo-buccal and mesial-distal directions. An increase in vibratory frequency further amplified the PDL response before reaching a local natural frequency. An amplification of PDL response was also shown to be induced by vibration based on computational simulation. The vibration-enhanced OTM can be described by mild, vigorous and diminishing zones among which the mild zone is considered to be clinically beneficial. Copyright © 2017 Elsevier Ltd. All rights reserved.

Deficits in working memory, reading comprehension and arithmetic skills in children with mouth breathing syndrome: analytical cross-sectional study.

PubMed

Kuroishi, Rita Cristina Sadako; Garcia, Ricardo Basso; Valera, Fabiana Cardoso Pereira; Anselmo-Lima, Wilma Terezinha; Fukuda, Marisa Tomoe Hebihara

2015-01-01

Mouth breathing syndrome is very common among school-age children, and it is possibly related to learning difficulties and low academic achievement. In this study, we investigated working memory, reading comprehension and arithmetic skills in children with nasal and mouth breathing. Analytical cross-sectional study with control group conducted in a public university hospital. 42 children (mean age = 8.7 years) who had been identified as mouth breathers were compared with a control group (mean age = 8.4 years) matched for age and schooling. All the participants underwent a clinical interview, tone audiometry, otorhinolaryngological evaluation and cognitive assessment of phonological working memory (numbers and pseudowords), reading comprehension and arithmetic skills. Children with mouth breathing had poorer performance than controls, regarding reading comprehension (P = 0.006), arithmetic (P = 0.025) and working memory for pseudowords (P = 0.002), but not for numbers (P = 0.76). Children with mouth breathing have low academic achievement and poorer phonological working memory than controls. Teachers and healthcare professionals should be aware of the association of mouth breathing with children's physical and cognitive health.

Which route of antibiotic administration should be used for third molar surgery? A split-mouth study to compare intramuscular and oral intake.

PubMed

Crincoli, V; Di Comite, M; Di Bisceglie, M B; Petruzzi, M; Fatone, L; De Biase, C; Tecco, S; Festa, F

2014-01-01

To compare the effectiveness of two different routes of antibiotic administration in preventing septic complications in patients undergoing third molar extraction. Twenty-four healthy patients requiring bilateral surgical removal of impacted mandibular third molars were successfully enrolled for this study. Depth of impaction, angulation, and relationship of the lower third molars with the mandibular branch had to be overlapping on both sides. A split-mouth design was chosen, so each patient underwent both the first and second surgeries, having for each extraction a different antibiotic route of administration. The second extraction was carried out 1 month later. To compare the effects of the two routes of antibiotic administration, inflammatory parameters, such as edema, trismus, pain, fever, dysphagia and lymphadenopathy were evaluated 2 and 7 days after surgery. Side effects of each therapy were evaluated 48 h after surgery. Oral and intramuscular antibiotic therapies overlap in preventing post-operative complications in dental surgery (p>0.05), even if the oral intake, seems to promote the onset of significant gastrointestinal disorders (p=0.003). This study could help dentists in their ordinary practice to choose the right route of antibiotic administration in the third molar surgery. At the same effectiveness, the higher cost and the minor compliance of the patient seem not to justify a routine antibiotic intramuscular therapy, reserving it for patients with gastrointestinal disorders.

Clinical evaluation of coverage of open wounds: Polyglycolic acid sheet with fibrin glue spray vs split thickness skin

PubMed Central

Mochizuki, Yumi; Tomioka, Hirofumi; Tushima, Fumihiko; Shimamoto, Hiroaki; Hirai, Hideaki; Oikawa, Yuu; Harada, Hiroyuki

2016-01-01

Purpose: This study aimed to evaluate the coverage of oral wounds using either a polyglycolic acid (PGA) sheet or split-thickness skin grafting (STSG). Materials and Methods: A total of 119 cases of wound coverage using a PGA sheet and fibrin glue spray as well as 132 cases of wound coverage cases using STSG were reviewed retrospectively. The site of the excision area, perioperative conditions, and postoperative functional problems were evaluated. Results: The PGA group had significantly shorter operation time, earlier start of oral intake, and shorter hospitalization than the STSG group. If the PGA sheet over the wound with exposed bone could be protected by a surgical sprint, oral food intake could be started on the day after surgery at the earliest. When the size of the wound in the buccal excisional area was classified into two groups (<6 or ≥6 cm2), mouth opening in the STSG group was significantly larger at 3 months postoperatively. When the size of the wound in the tongue and floor of mouth was classified into two groups (<12 or ≥12 cm2), the STSG group had a significantly higher score in postoperative speech intelligibility. Conclusion: Selection of a PGA sheet or STSG based on the consideration of defect size, tumor location, patients’ local and general condition and tolerance for surgery could reduce the patients’ postsurgical dysfunctional problems. PMID:28299263

Antiseptic mouth rinses: an update on comparative effectiveness, risks and recommendations.

PubMed

Osso, Diane; Kanani, Nehal

2013-02-01

Antiseptic mouth rinses are widely recommended and marketed to improve oral health. This article summarizes current studies on the comparative effectiveness of selected antiseptic mouth rinses in controlling plaque and gingivitis, as well as risks associated with daily exposure, including salivary flow rate, oral cancer and wear of composite restorations. Electronic database searches were conducted using Google Scholar and PubMed to identify articles comparing the effectiveness of 4 commercially marketed antiseptic mouth rinses differing in active ingredients (0.12% chlorhexidine gluconate, essential oils (menthol, thymol and eucalyptol) and methyl salicylate, 0.7% cetylpyridinium chloride and 20% aloe vera gel) for controlling plaque and gingivitis. Criteria for inclusion included controlled clinical trials and systematic reviews appearing in English language publications evaluating the comparative effectiveness of the mouth rinses in controlling plaque and gingivitis, as well as risks associated with daily usage. The majority of studies have shown mouth rinses containing chlorhexidine gluconate or essential oils and methyl salicylate provide clinically significant anti-gingivitis and anti-plaque benefits. Cetylpyridinium chloride has been found to provide only limited clinical benefits compared to inactive control mouth rinse. Inadequate evidence is available to evaluate the clinical effectiveness of aloe vera gel. Chlorhexidine, essential oils and cetylpyridinium have been found to be safe. However, limited data are available on the effects of the mouth rinse on wear patterns of dental restorations. Studies reviewed reported no significant difference in salivary flow rate related to alcohol based mouth rinse. Research supports the effectiveness of antiseptic mouth rinses in reducing plaque and gingivitis as an adjunct to home care. Insufficient evidence is available to support the claim that oral antiseptics can reduce the risk of developing periodontitis or the rate of progression of periodontitis.

A method for automated control of belt velocity changes with an instrumented treadmill.

PubMed

Hinkel-Lipsker, Jacob W; Hahn, Michael E

2016-01-04

Increased practice difficulty during asymmetrical split-belt treadmill rehabilitation has been shown to improve gait outcomes during retention and transfer tests. However, research in this area has been limited by manual treadmill operation. In the case of variable practice, which requires stride-by-stride changes to treadmill belt velocities, the treadmill control must be automated. This paper presents a method for automation of asymmetrical split-belt treadmill walking, and evaluates how well this method performs with regards to timing of gait events. One participant walked asymmetrically for 100 strides, where the non-dominant limb was driven at their self-selected walking speed, while the other limb was driven randomly on a stride-by-stride basis. In the control loop, the key factors to insure that the treadmill belt had accelerated to its new velocity safely during the swing phase were the sampling rate of the A/D converter, processing time within the controller software, and acceleration of the treadmill belt. The combination of these three factors resulted in a total control loop time during each swing phase that satisfied these requirements with a factor of safety that was greater than 4. Further, a polynomial fit indicated that belt acceleration was the largest contributor to changes in this total time. This approach appears to be safe and reliable for stride-by-stride adjustment of treadmill belt speed, making it suitable for future asymmetrical split-belt walking studies. Further, it can be incorporated into virtual reality rehabilitation paradigms that utilize split-belt treadmill walking. Copyright © 2015 Elsevier Ltd. All rights reserved.

The effectiveness of a saline mouth rinse regimen and education programme on radiation-induced oral mucositis and quality of life in oral cavity cancer patients: A randomised controlled trial.

PubMed

Huang, B-S; Wu, S-C; Lin, C-Y; Fan, K-H; Chang, J T-C; Chen, S-C

2018-03-01

Radiation therapy (RT) and concurrent chemotherapy RT (CCRT) generate radiation-induced oral mucositis (OM) and lower quality of life (QOL). This study assessed the impact of a saline mouth rinse regimen and education programme on radiation-induced OM symptoms, and QOL in oral cavity cancer (OCC) patients receiving RT or CCRT. Ninety-one OCC patients were randomly divided into a group that received saline mouth rinses and an education programme and a control group that received standard care. OM symptoms and QOL were assessed with the WHO Oral Toxicity Scale, MSS-moo and UW-QOL. Data were collected at the first postoperative visit to the radiation department (T0) and at 4 weeks and 8 weeks after beginning RT or CCRT. Patients in both groups had significantly higher levels of physical and social-emotional QOL at 8 weeks after beginning RT or CCRT compared to the first visit. Patients in the saline rinse group had significantly better physical and social-emotional QOL as compared to the standard care group at 8 weeks. Radiation-induced OM symptoms and overall QOL were not different between the groups. We thus conclude the saline rinse and education programme promote better physical and social-emotional QOL in OCC patients receiving RT/CCRT. © 2018 John Wiley & Sons Ltd.

Is hydroxychloroquine effective in treating primary Sjogren's syndrome: a systematic review and meta-analysis.

PubMed

Wang, Shi-Qin; Zhang, Li-Wei; Wei, Pan; Hua, Hong

2017-05-12

To systematically review and assess the efficacy and safety of hydroxychloroquine (HCQ) for treating primary Sjogren's syndrome (pSS). Five electronic databases (Pubmed, EMBASE, Web of science, Ovid, Cochrane Library) were searched for randomized controlled trials and retrospective or prospective studies published in English that reported the effect of HCQ on pSS. The subjective symptoms (sicca symptoms, fatigue and pain) and the objective indexes (erythrocyte sedimentation rate and Schirmer test) were assessed as main outcome measures. A meta-analysis and descriptive study on the efficacy and safety of HCQ were conducted. The estimate of the effect of HCQ treatment was expressed as a proportion together with 95% confidence interval, and plotted on a forest plot. Four trials with totals of 215 SS patients, including two randomized controlled trials, one double blind crossover trial and one retrospective open-label study, were analyzed in this review. For dry mouth and dry eyes, the effectiveness of HCQ treatment was essentially the same as placebo treatment. For fatigue, the effectiveness of HCQ was lower than placebo. The efficacy of HCQ in treating pain associated with pSS was superior to that of the placebo. There was no significant difference between HCQ-treated groups and controls in terms of Schirmer test results, but HCQ could reduce the erythrocyte sedimentation rate compare with placebo. A descriptive safety assessment showed that gastrointestinal adverse effects were the most common adverse effects associated with HCQ. This systematic review showed that there is no significant difference between HCQ and placebo in the treatment of dry mouth and dry eye in pSS. Well-designed, randomized, controlled trials are needed to provide higher-quality evidence to confirm our findings, and future studies should focus on some other index or extraglandular measures, such as cutaneous manifestations, to further explore the therapeutic effect of HCQ in pSS.

Randomized clinical trial of encapsulated and hand-mixed glass-ionomer ART restorations: one-year follow-up

PubMed Central

Freitas, Maria Cristina Carvalho de Almendra; Fagundes, Ticiane Cestari; Modena, Karin Cristina da Silva; Cardia, Guilherme Saintive; Navarro, Maria Fidela de Lima

2018-01-01

Abstract Objective This prospective, randomized, split-mouth clinical trial evaluated the clinical performance of conventional glass ionomer cement (GIC; Riva Self-Cure, SDI), supplied in capsules or in powder/liquid kits and placed in Class I cavities in permanent molars by the Atraumatic Restorative Treatment (ART) approach. Material and Methods A total of 80 restorations were randomly placed in 40 patients aged 11-15 years. Each patient received one restoration with each type of GIC. The restorations were evaluated after periods of 15 days (baseline), 6 months, and 1 year, according to ART criteria. Wilcoxon matched pairs, multivariate logistic regression, and Gehan-Wilcoxon tests were used for statistical analysis. Results Patients were evaluated after 15 days (n=40), 6 months (n=34), and 1 year (n=29). Encapsulated GICs showed significantly superior clinical performance compared with hand-mixed GICs at baseline (p=0.017), 6 months (p=0.001), and 1 year (p=0.026). For hand-mixed GIC, a statistically significant difference was only observed over the period of baseline to 1 year (p=0.001). Encapsulated GIC presented statistically significant differences for the following periods: 6 months to 1 year (p=0.028) and baseline to 1 year (p=0.002). Encapsulated GIC presented superior cumulative survival rate than hand-mixed GIC over one year. Importantly, both GICs exhibited decreased survival over time. Conclusions Encapsulated GIC promoted better ART performance, with an annual failure rate of 24%; in contrast, hand-mixed GIC demonstrated a failure rate of 42%. PMID:29364343

Clinical Efficacy of a Mouth-Exercising Device Adjunct to Local Ointment Intra-Lesional Injections and Surgical Treatment for Oral Submucous Fibrosis: a Randomized Controlled Trial.

PubMed

Patil, Pravinkumar; Hazarey, Vinay; Chaudhari, Rekha; Nimbalkar-Patil, Smita

2016-01-01

Oral physiotherapy or mouth exercise is considered to be an adjunct but mandatory treatment modality for oral submucous fibrosis (OSMF). This study planned to evaluate the clinical efficacy of a newly designed mouth exercising device (MED) in OSMF patients receiving local ointment, intra-lesional drugs and surgical treatment. A total of 231 OSMF patients were selected and treated with basic regime including topical corticosteroids, oral antioxidants and the icecream-stick exercise regime and allotted randomly to two equal groups A and B. Group-A patients were additionally given MED. Subgroups A1 and B1 patients with an inter-incisal distance (IID) 20-35mm were not given any additional therapy; subgroup A2 and B2 patients (IID 20-35mm) were treated additionally with intra-lesional injections. Subgroups A3 and B3 with IID<20mm were managed surgically. IID was measured at baseline and at 6 months recall. The change in IID measurements was calculated and statistically analyzed using 2-way ANOVA and Tukeys multiple post hoc analysis. Average improvement in IID after six months of recall visits was observed to be 8.4 mm in subgroup-A1 (n-53) compared to 5.5 mm in B1(n-50) (p<0.01). The IID improvement in subgroup-A2 was found to be 9.3mm (n-46) compared to 5.1 mm in B2 (n-48) (p<0.01). In the surgery group, mouth opening improvement was observed to be 9.6 mm in subgroup A3 (n-18) compared to 4.8 mm for B3 (n-16) (p<0.01). Use of the MED appears to be effective for increasing oral opening in OMSF patients in conjunction with local, injection and/or surgical treatment.

Changes in masseter muscle trigger points following strain-counterstrain or neuro-muscular technique.

PubMed

Ibáñez-García, Jordi; Alburquerque-Sendín, Francisco; Rodríguez-Blanco, Cleofás; Girao, Didac; Atienza-Meseguer, Albert; Planella-Abella, Sergi; Fernández-de-Las Peñas, César

2009-01-01

The aim of this study was to compare the immediate effects, on pressure pain sensitivity and active mouth opening, following the application of neuromuscular or strain/counter-strain technique in latent myofascial trigger points (MTrPs) in the masseter muscle. Seventy-one subjects, 34 men and 37 women, aged 20-65 years old, participated in this study. Subjects underwent a screening process to establish the presence of MTrPs in the masseter muscle. Subjects were divided randomly into three groups: group A which was treated with a neuromuscular intervention, group B treated with the strain/counter-strain technique, and group C as control group. Each treatment group received a weekly treatment session during 3 consecutive weeks. Outcomes measures were pressure pain thresholds (PPTs), active mouth opening and local pain (visual analogue scale, VAS) elicited by the application of 2.5kg/cm(2) of pressure over the MTrP. They were captured at baseline and 1 week after discharge by an assessor blinded to the treatment allocation of the subject. The ANOVA found a significant groupxtime interaction (F=25.3; p<0.001) for changes in PPT, changes in active mouth opening (F=10.5; p<0.001), and local pain evoked by 2.5kg/cm(2) of pressure (F=10.1; p<0.001). Within-group effect sizes were large (d>1) for PPT and mouth opening, and moderate for local pain (d<0.7, 0.5) in both intervention groups; but small (d<0.2) for the control group in all outcomes. No significant differences between both intervention groups were found for any outcome (p>0.8). Our results suggest that neuromuscular or strain/counter-strain technique might be employed in the management of latent MTrPs in the masseter muscle.

Adjunctive Effects of A Piscean Collagen-Based Controlled-Release Chlorhexidine Chip in the Treatment of Chronic Periodontitis: A Clinical and Microbiological Study

PubMed Central

John, Priya; Lazarus, Flemingson; Selvam, Arul; Prabhuji, Munivenkatappa Lakshmaiah Venkatesh

2015-01-01

Introduction PerioChip a bovine origin gelatine based CHX chip has shown beneficial effects in the management of Chronic Periodontitis. A new fish collagen based CHX chip similar to PerioChip is currently available; however this product has not been thoroughly researched. Aim The aim of the present study was to evaluate the effectiveness of a new Piscean collagen-based controlled-release chlorhexidine chip (CHX chip) as an adjunctive therapy to scaling and root planing (SRP). Settings and Design The study was conducted as a randomised, split-mouth, controlled clinical trial at Krishnadevaraya College of Dental Sciences, Bangalore, India. Materials and Methods In a split–mouth study involving 20 sites in 10 patients with chronic periodontitis, control sites received scaling and root planing and test sites received scaling and root planing (SRP) and the intrapocket CHX chip placement as an adjunct. Subgingival plaque samples were collected from both control and test sites at baseline, 11 days and 11 weeks and the anaerobic colony count were assessed. Clinical parameters that were recorded at baseline and 11 weeks were gingival index, Plaque index, Probing pocket depth (PPD), and Clinical attachment level (CAL). Plaque index was recorded additionally at 11 days. Results In the test group there was a statistically significant reduction in the total anaerobic colony count, gingival index and plaque scores from baseline as compared to control sites at all time intervals. An additional 0.8mm reduction in mean probing pocket depth was noted in the test group. Gain in Clinical attachment level was comparable in both groups. Conclusion The adjunctive use of the new collagen-based CHX chip yielded significant antimicrobial benefit accompanied by a reduction in probing depth and a clinical attachment level gain as compared to SRP alone. This suggests that it may be a useful treatment option of nonsurgical periodontal treatment of chronic periodontitis. PMID:26155567

The effect of a calcium phosphate mouth rinse on (chemo) radiation induced oral mucositis in head and neck cancer patients: a prospective study.

PubMed

Stokman, M A; Burlage, F R; Spijkervet, F K L

2012-08-01

Promising results of a calcium phosphate (CP) mouth rinse on reduced severity of oral mucositis have been reported. The aim of this study was to determine the effect of a CP mouth rinse on the frequency, duration and severity of (chemo) radiation induced oral mucositis in patients with head-neck cancer. patients with oral malignancies, treated with (chemo) radiotherapy, were included. Patients rinsed four times a day with a CP mouth rinse. Patients not willing to rinse with the CP mouth rinse served as control. Mucositis was scored according to the WHO score at baseline and twice a week during the full course of (chemo) radiotherapy. Patient's self-reported mouth-throat soreness (MTS) was evaluated at the same time interval using a diary in the CP mouth rinse group. The outcomes on MTS were compared with a historical control group. Fifty-two patients were analysed: 25 CP mouth rinse group, 11 control group and 16 historical group. There was no significant difference between the CP group and control group on development and severity of oral mucositis. No significant difference was found for subjective outcomes on MTS between the CP group and the historical group. The CP mouth rinse seems to have no influence on the frequency, duration and severity of oral mucositis during (chemo) radiation in patients with head and neck cancer. A trend to develop less MTS for drinking and eating was found when applying the CP mouth rinse. © 2012 John Wiley & Sons A/S.

Natural products for the management of xerostomia: a randomized, double-blinded, placebo-controlled clinical trial.

PubMed

Navarro Morante, Anabel; Wolff, Andy; Bautista Mendoza, Gloria Rocio; López-Jornet, Pia

2017-02-01

The aim of this study was to evaluate the clinical performance of lycopene-enriched virgin olive oil in spray form used to treat patients with drug-induced xerostomia, comparing this with a placebo spray. This double-blind, randomized clinical trial included elderly subjects with drug-induced xerostomia (n = 60). Resting salivary flow was measured using the draining technique. The Xerostomia Inventory (XI) was used to assess symptoms and the Oral Health Impact Profile 14 (OHIP-14) to assess patient quality of life. Evaluations were made before and after 12 weeks of product/placebo application. Sixty patients took part in the study. Symptoms improved among the treatment group (n = 30) after 12 weeks in the following XI domains: 'Rate the difficulty you experience in speaking because of dryness' (P = 0.03); 'Rate how much saliva is in your mouth' (P = 0.03); and 'Rate the dryness of your lips' (P = 0.04). The placebo group (n = 30) underwent improvements in: 'Rate how much saliva is in your mouth' (P = 0.02) and 'Rate the dryness of your mouth' (P = 0.01). A significant improvement (P = 0.001) in oral-related quality of life (OHIP-14) was identified in the treatment group, while no significant differences were observed in the placebo group (P > 0.05). The topical application of lycopene-enriched virgin olive oil and its placebo counterpart improved xerostomia-related symptoms significantly (but not salivary flow rate) in patients with drug-induced xerostomia. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Periodontal treatment with an Er:YAG laser compared to ultrasonic instrumentation: a pilot study.

PubMed

Sculean, Anton; Schwarz, Frank; Berakdar, Mohammad; Romanos, George E; Arweiler, Nicole B; Becker, Jürgen

2004-07-01

The aim of the present study was to compare the effectiveness of an Er:YAG laser to that of ultrasonic scaling for non-surgical periodontal treatment. Twenty patients with moderate to advanced periodontal disease were randomly treated in a split-mouth design with a single episode of subgingival debridement using either an Er:YAG laser device (160 mJ/pulse, 10 Hz) combined with a calculus detection system with fluorescence induced by 655 nm InGaAsP diode laser radiation (ERL), or an ultrasonic instrument (UI). Clinical assessments of full-mouth plaque score (FMPS), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), and clinical attachment level (CAL) were made at baseline and at 3 and 6 months following therapy. No differences in any of the investigated parameters were observed at baseline between the two groups. The mean value of BOP decreased in the ERL group from 40% at baseline to 17% after 6 months (P<0.0001) and in the UI group from 46% at baseline to 15% after 6 months (P<0.0001). The sites treated with ERL demonstrated mean CAL gain of 1.48 +/- 0.73 mm (P<0.001) and of 1.11 +/- 0.59 mm (P<0.001) at 3 and 6 months, respectively. The sites treated with UI demonstrated mean CAL gain of 1.53 +/- 0.67 mm (P<0.001) and of 1.11 +/- 0.46 mm (P<0.001) at 3 and 6 months, respectively. No statistically significant differences were observed between the groups (P>0.05). Within the limits of the present study, it can be concluded that both therapies led to significant improvements of the investigated clinical parameters.

Recruiting Diverse Smokers: Enrollment Yields and Cost

PubMed Central

Brodar, Kaitlyn E.; Hall, Marissa G.; Butler, Eboneé N.; Parada, Humberto; Stein-Seroussi, Al; Hanley, Sean; Brewer, Noel T.

2016-01-01

To help tobacco control research better include vulnerable populations, we sought to identify effective ways to recruit diverse smokers. In 2014–2015, we recruited 2149 adult cigarette smokers in California and North Carolina, United States, to participate in a randomized trial of pictorial cigarette pack warnings. The most effective means of recruiting smokers were the classified advertising website Craigslist (28% of participants), word of mouth (23%), Facebook (16%), and flyers or postcards (14%). Low-income and African American smokers were more likely to respond to interpersonal contact (including staff in-person recruitment and word of mouth) than were high-income and non-African American smokers (all p < 0.05). Hispanic and gay, lesbian, and bisexual smokers were more likely to be recruited by Craigslist than non-Hispanic and straight smokers (both p < 0.05). Of the recruitment methods requiring cost, the cheapest was Craigslist ($3–7 per smoker). The most expensive methods were newspaper ads in California ($375 per smoker) and staff in-person recruiting in North Carolina ($180 per smoker). Successfully recruiting diverse smokers requires using multiple methods including interpersonal, online, and other media. Craigslist and word of mouth are especially useful and low-cost ways to recruit diverse smokers. PMID:27999280

Recruiting Diverse Smokers: Enrollment Yields and Cost.

PubMed

Brodar, Kaitlyn E; Hall, Marissa G; Butler, Eboneé N; Parada, Humberto; Stein-Seroussi, Al; Hanley, Sean; Brewer, Noel T

2016-12-16

To help tobacco control research better include vulnerable populations, we sought to identify effective ways to recruit diverse smokers. In 2014-2015, we recruited 2149 adult cigarette smokers in California and North Carolina, United States, to participate in a randomized trial of pictorial cigarette pack warnings. The most effective means of recruiting smokers were the classified advertising website Craigslist (28% of participants), word of mouth (23%), Facebook (16%), and flyers or postcards (14%). Low-income and African American smokers were more likely to respond to interpersonal contact (including staff in-person recruitment and word of mouth) than were high-income and non-African American smokers (all p < 0.05). Hispanic and gay, lesbian, and bisexual smokers were more likely to be recruited by Craigslist than non-Hispanic and straight smokers (both p < 0.05). Of the recruitment methods requiring cost, the cheapest was Craigslist ($3-7 per smoker). The most expensive methods were newspaper ads in California ($375 per smoker) and staff in-person recruiting in North Carolina ($180 per smoker). Successfully recruiting diverse smokers requires using multiple methods including interpersonal, online, and other media. Craigslist and word of mouth are especially useful and low-cost ways to recruit diverse smokers.

A case-control evaluation of fungiform papillae density in burning mouth syndrome.

PubMed

Naud, Jason M; Benca, Laura; Drangsholt, Mark T; LeResche, Linda; Coldwell, Susan E

2018-04-01

It has been hypothesized that high fungiform papillae density may be a risk factor for developing the taste and pain alterations characteristic of burning mouth syndrome. Evaluate whether fungiform papillae density, taste sensitivity, and mechanical pain sensitivity differ between burning mouth syndrome cases and controls. This case-control study compared cases diagnosed with primary burning mouth syndrome with pain-free controls. Participants (17 female cases and 23 female controls) rated the intensity of sucrose, sodium chloride, citric acid, and quinine applied separately to each side of the anterior tongue and sampled whole mouth. Mechanical pain sensitivity was assessed separately for each side of the tongue using weighted pins. Digital photographs of participants' tongues were used to count fungiform papillae. Burning mouth syndrome cases had increased whole mouth taste intensity. Cases also had increased sensitivity to quinine on the anterior tongue, as well as increased mechanical pain sensitivity on the anterior tongue. Fungiform papillae density did not differ significantly between cases and controls. Fungiform papillae density on the left and right sides of the tongue were correlated in controls; however, there was no left/right side correlation in cases. Cases had increased pain and taste perception on the anterior tongue. The lack of correlation between left and right fungiform papillae density in cases may be an indication of asymmetrical lingual innervation in these patients. 3b. Laryngoscope, 128:841-846, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Effect of British hunting ban on fox numbers.

PubMed

Baker, Philip J; Harris, Stephen; Webbon, Charlotte C

2002-09-05

Pressure to ban the hunting of foxes with hounds in Britain has fuelled debate about its contribution to the control of fox populations. We took advantage of a nationwide one-year ban on fox-hunting during the outbreak of foot-and-mouth disease (FMD) in 2001 to examine this issue and found that the ban had no measurable impact on fox numbers in randomly selected areas. Our results argue against suggestions that fox populations would increase markedly in the event of a permanent ban on hunting.

Nonsurgical management of partial adhesive small-bowel obstruction with oral therapy: a randomized controlled trial

PubMed Central

Chen, Shyr-Chyr; Yen, Zui-Shen; Lee, Chien-Chang; Liu, Yueh-Ping; Chen, Wen-Jone; Lai, Hong-Shiee; Lin, Fang-Yue; Chen, Wei-Jao

2005-01-01

Background Patients with partial adhesive small-bowel obstruction are usually managed conservatively, receiving intravenous hydration and nothing by mouth. Previous studies have suggested that this approach is associated with longer hospital stays and an increased risk of delayed surgery. We conducted a randomized controlled trial to see if combining standard conservative treatment with oral administration of a laxative, a digestant and a defoaming agent would reduce the frequency of subsequent surgical intervention and reduce the length of hospital stay. Methods We identified 144 consecutive patients admitted between February 2000 and July 2001 with adhesive partial small-bowel obstruction and randomly assigned 128 who met the inclusion criteria to either the control group (intravenous hydration, nasogastric-tube decompression and nothing by mouth) or the intervention group (intravenous hydration, nasogastric-tube decompression and oral therapy with magnesium oxide, Lactobacillus acidophilus and simethicone). The primary outcome measures were the number of patients whose obstruction was successfully treated without surgery and the length of hospital stay. We also monitored rates of complications and recurring obstructions. Results Of the 128 patients, 63 were in the control group and 65 in the intervention group; the mean ages were 54.4 (standard deviation [SD] 15.9) years and 53.9 (SD 16.3) years respectively. Most of the patients were male. More patients in the intervention group than in the control group had successful treatment without surgery (59 [91%] v. 48 [76%], p = 0.03; relative risk 1.19, 95% confidence interval 1.03–1.40). The mean hospital stay was significantly longer among patients in the control group than among those in the intervention group (4.2 [SD 2.7] v. 1.0 [SD 0.7] days, p < 0.001). The complication and recurrence rates did not differ significantly between the 2 groups. Interpretation Oral therapy with magnesium oxide, L. acidophilus and simethicone was effective in hastening the resolution of conservatively treated partial adhesive small-bowel obstruction and shortening the hospital stay. PMID:16275967

Does grafting of third molar extraction sockets enhance periodontal measures in 30- to 35-year-old patients?

PubMed

Hassan, Khalid S; Marei, Hesham F; Alagl, Adel S

2012-04-01

This study was designed to evaluate the use of xenograft plus a membrane as grafting material for periodontal osseous defects distal to the mandibular second molar compared with nongrafted extraction sites after removal of impacted mandibular third molars. We performed a single-blind, randomized, controlled clinical trial, and the sample comprised of subjects at high risk for the development of periodontal osseous defects distal to the second molar after third molar extraction (aged 30-35 years), pre-existing osseous defects distal to the second molar, and horizontal third molar impaction. The predictor variable was the treatment status of the second molar osseous defects. The third molar extraction sites were grafted with an anorganic xenograft plus a membrane. The other sites received a full-thickness flap and extraction of the third molar without placement of the grafting materials. The outcome variables were the change in gingival index, pocket probing depth, and clinical attachment level on the distobuccal aspect of the second molar preoperatively and at 3, 6, 9, and 12 months after surgery. Data were statistically analyzed by multivariate analysis of variance, and the statistical significance was set at P < .05. The study was composed of 28 sites that were selected by use of a split-mouth design for each patient, and this was randomly determined through a biased coin randomization. Twelve months after third molar removal, there was a statistically significant gain in the clinical attachment level and a reduction in the probing pocket depth in the grafted sites compared with the nongrafted sites (P < .001). Moreover, there was a significant difference in the alveolar bone height during the monitoring periods for the grafted sites compared with the nongrafted sites (P < .001). Grafting of osseous defects distal to mandibular second molars with an anorganic xenograft plus a membrane predictably resulted in a significant reduction in the probing pocket depth, clinical attachment level gain, and bone fill, which suggests that grafting the extraction sites with an anorganic xenograft plus a membrane could prevent periodontal disease in the future. Published by Elsevier Inc.

Efficacy of curcumin in the treatment for oral submucous fibrosis - A randomized clinical trial.

PubMed

Hazarey, Vinay K; Sakrikar, Aditee R; Ganvir, Sindhu M

2015-01-01

Oral submucous fibrosis (OSF) is a chronic, insidious disease that is associated with significant functional morbidity and an increased risk for malignancy. Turmeric and its active ingredient "curcumin" are being studied upon as chemopreventive agents in various diseases. The present study aims to determine the efficacy of curcumin in the treatment of OSF. Thirty clinically diagnosed OSF patients were divided into two groups, 15 patients in each group from the Outpatient Department. Test group patients were treated with Longvida (curcumin) lozenges and control group with Tenovate ointment (clobetasol propionate (0.05%). The treatment was given for 3 months duration and follow-up was done for 6 months. Both the groups were advised for physiotherapy exercises by mouth exercise device. The baseline and follow-up results were compared for IIO (interincisal distance on maximum mouth opening), Visual Analogue Scale (VAS) for normal food and VAS for spicy food. The test group showed 5.93 (±2.37) mm increase in mouth opening compared to 2.66 (±1.76) mm of the control group. In relation to VAS scale with spicy and normal food the average reduction was 64 (42-73) and 77 (70.5-82) as compared to 34 (14.5-64.5) and 64 (46-75.5) respectively in control group. The test group results achieved in the treatment span was sustained in the follow-up (P < 0.05) compared to control group which showed statistically significant (P < 0.05) relapse. It can be concluded that combination strategies for the management of OSF which include the stoppage of causative ill habits, appropriate medicinal and physiotherapy management is more efficient than single therapeutic modality. It is evident from the study that curcumin holds good promise in the treatment of OSF in future.

Development of fetal yawn compared with non-yawn mouth openings from 24-36 weeks gestation.

PubMed

Reissland, Nadja; Francis, Brian; Mason, James

2012-01-01

Although some research suggests that fetuses yawn, others disagree arguing that is it simple mouth opening. Furthermore there is no developmental account of fetal yawning compared with simple mouth opening. The aim of the present study was to establish in a repeated measures design the development of fetal yawning compared with simple mouth opening. Video recordings were made of the fetal face and upper torso visualized by means of 4D full frontal or facial profile ultrasound recordings. Fifteen healthy fetuses were scanned four times at 24, 28, 32 and 36 weeks gestation. Yawning was distinguished from non-yawning in terms of the length of time it took to reach the apex of the mouth stretch, with yawns being defined as more than 50% of the total time observed. To assess changes in frequency, a Poisson mixed effects model was fitted to the count of number of yawn and simple mouth opening events with age and gender as fixed effects, and person as a random effect. For both yawns and simple mouth openings a smooth varying age effect was significant. The number of yawns observed declined with age from 28 weeks gestation, whereas simple mouth openings were less frequent and the decline was observed from 24 weeks. Gender was not significant either for yawn and simple mouth openings. Yawning can be reliably distinguished from other forms of mouth opening with the potential of using yawning as an index of fetal healthy development.

The White Diet is preferred, better tolerated, and non-inferior to a clear-fluid diet for bowel preparation: A randomized controlled trial.

PubMed

Butt, Joshua; Bunn, Cate; Paul, Eldho; Gibson, Peter; Brown, Gregor

2016-02-01

Dietary restrictions contribute to the unpleasantness of bowel preparation for colonoscopy. We compare the effectiveness and tolerability of a low residue diet of white-colored foods ("White Diet") with a clear-fluid diet the day prior to colonoscopy in an endoscopist-blinded randomized non-inferiority trial. Adults undergoing outpatient colonoscopy were randomized with stratification by procedure timing to a White Diet or clear-fluid diet. All received a 2-L polyethylene glycol lavage solution with ascorbate, sodium sulfate, and electrolytes, the day-before for morning and as a split-dose for afternoon procedures. The primary end-point was successful bowel preparation (A or B on the Harefield Cleansing Scale). Regimen tolerance/acceptance was assessed by questionnaire. An intention-to-treat analysis with a predefined non-inferiority margin of 15% was used to compare efficacy. A total of 226 patients (average age 52 years, 51% male) were randomized (111 clear diet, 115 White Diet). Bowel preparation was successful in 91% on the clear-fluid diet vs 84.4% on the White Diet, difference being -6.6% (lower one sided 95% CI -13.8%), with no difference according to diet. The split-dose regimen (in 55%) had a higher success rate than day-before regimen (96% vs 80%, p < 0.001). The White Diet was preferred with less hunger and interference with daily activities (p < 0.001). Procedural/withdrawal time and polyp/adenoma detection were similar between groups. The White Diet was preferred and better tolerated by patients without detriment to the success of bowel preparation or colonoscopy performance, especially with the split-dose regimen. © 2015 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Randomized, Double-Blind, Split-Face Study Evaluating Fractional Ablative Erbium:YAG Laser-Mediated Trans-Epidermal Delivery of Cosmetic Actives and a Novel Acoustic Pressure Wave Ultrasound Technology for the Treatment of Skin Aging, Melasma, and Acne Scars.

PubMed

Alexiades, Macrene

2015-11-01

Fractional laser resurfacing enhances trans-epidermal delivery (TED), however laser penetration depths >250- μm fail to substantively increase drug delivery. Evaluate the safety and efficacy of a novel acoustic pressure wave ultrasound device following fractional ablative Er:YAG 2940-nm laser (FELR) and topical agents for rhytids, melasma, and acne scars. Randomized, blinded, parallel group split-face side-by-side, controlled study evaluating FELR and topical anti-aging and anti-pigment agents to entire face succeeded by ultrasound to randomized side. Fifteen subjects were enrolled to three treatment arms:rhytids, melasma, and acne scars. Two monthly treatments were administered with 1, 3, and 6 month follow-up. Efficacy was assessed by Comprehensive Grading Scale of Rhytids, Laxity, and Photoaging by Investigator and two blinded physician evaluators. Subject assessments, digital photographs, and reflectance spectroscopic analyses were obtained. Rhytid severity was reduced from a mean of 3.25 to 2.60 on the 4-point grading scale. Spectrophotometric analysis demonstrated increases in lightness (L*) and reductions in redness (a*) and pigment (b*), with greater improvements on the ultrasound side as compared to FELR and topicals alone. Moderate erythema post-treatment resolved in 7 days and no serious adverse events were observed. In this randomized, paired split-face clinical study, FELR-facilitated TED of topical anti-aging actives with ultrasound treatment is safe and effective with improvement in rhytids, melasma, and acne scars. Statistically significant greater improvement in pigment levels was observed on the ultrasound side as compared to FELR-TED and topical agents alone.

Does the hybrid light source (LED/laser) influence temperature variation on the enamel surface during 35% hydrogen peroxide bleaching? A randomized clinical trial.

PubMed

de Freitas, Patricia Moreira; Menezes, Andressa Nery; da Mota, Ana Carolina Costa; Simões, Alyne; Mendes, Fausto Medeiros; Lago, Andrea Dias Neves; Ferreira, Leila Soares; Ramos-Oliveira, Thayanne Monteiro

2016-01-01

The present study investigated how a hybrid light source (LED/laser) influences temperature variation on the enamel surfaces during 35% hydrogen peroxide (HP) bleaching. Effects on the whitening effectiveness and tooth sensitivity were analyzed. Twenty-two volunteers were randomly assigned to two different treatments in a split-mouth experimental model: group 1 (control), 35% HP; group 2 (experimental), 35% HP + LED/laser. Color evaluation was performed before treatment, and 7 and 14 days after completion of bleaching, using a color shade scale. Tooth sensitivity was assessed using a visual analog scale (VAS; before, immediately, and 24 hours after bleaching). During the bleaching treatment, thermocouple channels positioned on the tooth surfaces recorded the temperature. Data on color and temperature changes were subjected to statistical analysis (α = 5%). Tooth sensitivity data were evaluated descriptively. Groups 1 and 2 showed mean temperatures (± standard deviation) of 30.7 ± 1.2 °C and 34.1 ± 1.3 °C, respectively. It was found that there were statistically significant differences between the groups, with group 2 showing higher mean variation (P < .0001). The highest temperature variation occurred for group 2, with an increase of 5.3 °C at the enamel surface. The color change results showed no differences in bleaching between the two treatment groups (P = .177). The variation of the average temperature during the treatments was not statistically associated with color variation (P = .079). Immediately after bleaching, it was found that 36.4% of the subjects in group 2 had mild to moderate sensitivity. In group 1, 45.5% showed moderate sensitivity. In both groups, the sensitivity ceased within 24 hours. Hybrid light source (LED/ laser) influences temperature variation on the enamel surface during 35% HP bleaching and is not related to greater tooth sensitivity.

Anxiety in children during occlusal ART restorations in primary molars placed in school environment and hospital dental setup.

PubMed

Roshan, N M; Sakeenabi, B

2012-01-01

To evaluate the anxiety in children during occlusal atraumatic restorative treatment (ART) in the primary molars of children; and compare the anxiety for ART procedure performed in school environment and in hospital dental setup. A randomized controlled trial where one dentist placed 120 ART restorations in 60 five- to seven year-olds who had bilateral matched pairs of occlusal carious primary molars. A split-mouth design was used to place restorations in school and in hospital dental setup, which were assigned randomly to contralateral sides. Anxiety was evaluated by Modified Venhem score and the heart rate of the children at five fixed moments during dental treatment. At the entrance of the children into the treatment room, statistically significant difference between treatment in school environment and treatment in hospital dental setup for venham score and heart rate could be found (P = 0.023 and P = 0.037 respectively). At the start of the treatment procedure higher venham score and heart rate was observed in children treated in hospital dental setup in comparison with the children treated in school environment, finding was statistically significant (P = 0.011 and P = 0.029 respectively). During all other three points of treatment, the Venham scores of the children treated in school were lower than those of the children treated in hospital dental setup but statistically not significant (P > 0.05). Positive co-relation between Venham scores and Heart rate was established. No statistically significant relation could be established between boys and girls. Overall anxiety in children for ART treatment was found to be less and the procedure was well accepted irrespective of environment where treatment was performed Hospital dental setup by itself made children anxious during entrance and starting of the treatment when compared to children treated in school environment.

Quantification of Posterior Ankle Exposure Through an Achilles Tendon-Splitting Versus Posterolateral Approach

DTIC Science & Technology

2012-10-01

Ankle Exposure Through an Achilles Tendon - Splitting Versus Posterolateral Approach Jeanne C. Patzkowski, MD1; Kevin L. Kirk, DO1; Justin D. Orr, MD2...surgical exposure to the posterior ankle for trauma and reconstruction is a source of debate. We hypothesized that the Achilles tendon -splitting approach...fresh-frozen cadavers. Achilles tendon - splitting and posterolateral approaches were performed using a randomized crossover design for surgical

Experimental gingivitis, bacteremia and systemic biomarkers: a randomized clinical trial.

PubMed

Kinane, D F; Zhang, P; Benakanakere, M; Singleton, J; Biesbrock, A; Nonnenmacher, C; He, T

2015-12-01

Bacteremia and systemic inflammatory markers are associated with periodontal and systemic diseases and may be linking mechanisms between these conditions. We hypothesized that in the development of gingival inflammation, systemic markers of inflammation and bacteremia would increase. To study the effect of bacteremia on systemic inflammatory markers, we recruited 80 subjects to participate in an experimental gingivitis study. Subjects were stratified based on gender, smoking and the number of bleeding sites and then randomized to one of two groups: control group (n = 40) or experimental gingivitis group (n = 40). Subjects in the control group conducted an oral hygiene regimen: brushing twice daily with a regular sodium fluoride cavity protection dentifrice and a standard manual toothbrush, flossing twice daily, and mouth rinsing with an anti-cavity fluoride rinse once daily. The experimental group stopped brushing and flossing, and used only the fluoride anti-cavity mouth rinse for 21 d. Seventy-nine of 80 subjects were evaluable. One subject in the control group was excluded from the results due to antibiotic use during the study. Our data showed the experimental gingivitis group exhibited a significant (p < 0.05) increase in dental plaque level and gingival inflammatory indices relative to baseline and the control group but a decrease in bacteremia and soluble intercellular adhesion molecule-1 levels vs. baseline. Bacteremia was negatively correlated with gingival inflammatory indices and soluble intercellular adhesion molecule-1 levels in the experimental gingivitis group, thus negating our hypothesis. We conclude that there are marked differences in systemic cytokine levels over the course of short-term experimentally induced gingivitis and further conclude that a long-term periodontitis study must be considered to address mechanisms whereby oral diseases may affect systemic diseases. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The effects of steroids in preventing facial oedema, pain, and neurosensory disturbances after bilateral sagittal split osteotomy: a randomized controlled trial.

PubMed

Widar, F; Kashani, H; Alsén, B; Dahlin, C; Rasmusson, L

2015-02-01

A randomized, prospective, controlled trial was conducted to determine the efficacy of single and repeated betamethasone doses on facial oedema, pain, and neurosensory disturbances after bilateral sagittal split osteotomy. Thirty-seven patients (mean age 23.62 years, range 17-62 years) with either mandibular prognathism or retrognathism were enrolled consecutively into the study and divided into three groups: control (n=12), repeated dose 4+8+4mg betamethasone (n=14), single dose 16mg betamethasone (n=11). The intake of diclofenac and paracetamol was assessed individually. Measurements of facial oedema, pain, and sensitivity in the lower lip/chin were obtained 1 day, 7 days, 2 months, and 6 months postoperatively. Furthermore, we investigated the possible influences of gender, age, total operating time, amount of bleeding, postoperative hospitalization, and advancement versus setback of the mandible. A significant difference (P=0.017) was observed in percentage change between the two test groups and the control group regarding facial oedema (1 day postoperatively). Less bleeding was associated with improved pain recovery over time (P=0.043). Patients who required higher postoperative dosages of analgesics due to pain had significantly delayed recovery of the inferior alveolar nerve at 6 months postoperatively (P<0.001). Betamethasone did not reduce neurosensory disturbances over time. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Impact of Partial-Mouth Periodontal Examination Protocols on the Association Between Gingival Bleeding and Oral Health-Related Quality of Life in Adolescents.

PubMed

Ediani Machado, Michely; Tomazoni, Fernanda; Ruffo Ortiz, Fernanda; Ardenghi, Thiago Machado; Zanatta, Fabricio Batistin

2017-07-01

It is not clear how using partial-mouth periodontal examination (PMPE) protocols affects estimates of the association between gingival bleeding (GB) and oral health-related quality of life (OHRQoL). The aim of the present study is to assess impact of different PMPEs on the association between GB and OHRQoL in 12-year-old adolescents. A total of 1,134 adolescents were evaluated for clinical and subjective variables. GB was determined by full-mouth examination (FME) of six sites (disto-buccal [DB], mid-buccal [B], mesio-buccal [MB], disto-lingual [DL], mid-lingual, and mesio-lingual [ML]) and different PMPEs were calculated using a 15% cut-off point: 1) full-mouth (MB-B-DB/MB-B-DL); 2) two diagonal quadrants (six sites/MB-B-DB/MB-B-DL); 3) two randomly selected half-mouth quadrants (six sites/MB-B-DB/ MB-B-DL/MB-DB-ML-DL); and 4) the community periodontal index. OHRQoL was assessed using the Child Perceptions Questionnaire (CPQ 11-14 ). Adjusted negative binomial regression models were used to calculate the rate ratio of CPQ 11-14 scores for each PMPE. Adolescents with GB showed significantly poorer OHRQoL than their counterparts when FME was used. In contrast, more than half of PMPE protocols did not detect significant associations between GB and CPQ 11-14 scores in the adjusted analysis. Using PMPE to assess GB in adolescents significantly affects associations with OHRQoL outcomes, depending on the protocol used. PMPEs that evaluated MB-B-DL sites of randomly selected half-mouth quadrants (1 or 2 and 3 or 4) achieved results closer to those obtained with FME.

A clinical trial of the effect of a mouth-rinse prepared with Lippia sidoides Cham essential oil in dogs with mild gingival disease.

PubMed

Girão, V C C; Nunes-Pinheiro, D C S; Morais, S M; Sequeira, J L; Gioso, M A

2003-05-30

We evaluated the effect of a mouth-rinse prepared using Lippia sidoides essential oil (EO) in dogs with marginal gingivitis. German Shepherd dogs were distributed in two groups: control (control mouth-rinse) and EO (EO mouth-rinse). Both mouth-rinses were applied on the dogs' teeth every 2 days for 2 weeks. At day 0 and day 15, the scores for plaque-bacteria (P), calculus (C), gingivitis (G) and the inflammatory infiltrate (INF) were evaluated blindly. The results were analyzed by the Wilcoxon signed-rank and Mann-Whitney tests (P

Dental arch dimensional changes after adenotonsillectomy in prepubertal children.

PubMed

Petraccone Caixeta, Anna Cristina; Andrade, Ildeu; Bahia Junqueira Pereira, Tatiana; Franco, Letícia Paiva; Becker, Helena Maria Gonçalves; Souki, Bernardo Quiroga

2014-04-01

The purposes of this study were to investigate the dental arch changes after adenotonsillectomies in prepubertal children and to compare the dental arch dimensions of mouth-breathing and nasal-breathing children. The sample included 49 prepubertal severely obstructed mouth-breathing children and 46 prepubertal nasal-breathing children. Twenty-four of the 49 mouth-breathing children had an adenotonsillectomy and composed the adenotonsillectomy subgroup. The 25 children in whom the mouth-breathing pattern was unchanged during the 1-year study period composed the control subgroup. The mouth-breathing children showed a deeper palatal vault, a larger mandibular width, and a larger mandibular arch length in comparison with the nasal-breathing children. After airway clearance, the adenotonsillectomy group showed a significant maxillary transverse width gain compared with the control subgroup. The control subgroup showed a significant deepening of the palatal height when compared with the adenotonsillectomy subgroup after 1 year. The adenotonsillectomy subgroup had a significantly different pattern of arch development compared with the untreated controls. After adenotonsillectomy, the mouth-breathing children showed greater maxillary transverse development than did the controls. The palatal vault deepened in the untreated children. The mouth-breathing children showed a deeper palatal vault, a larger mandibular width, and a larger mandibular arch length in comparison with the nasal-breathing children. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Pit and fissure sealants for preventing dental decay in the permanent teeth of children and adolescents.

PubMed

Ahovuo-Saloranta, A; Hiiri, A; Nordblad, A; Worthington, H; Mäkelä, M

2004-01-01

Fissure sealants used on occlusal tooth surfaces were introduced in the 1960s for protecting pits and fissures from dental caries. Although sealants have demonstrated to be effective in preventing caries, their efficacy may be related to the background caries prevalence in the population. The primary objective of this review was to evaluate the caries prevention of resin based pit and fissure sealants and glass ionomer cements or sealants in children and adolescents. We searched the Cochrane Oral Health Group's Trials Register (last update December 2002), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 4, 2002), MEDLINE via OVID (1966 to December 2002), EMBASE (1974 to February 2002), SCISEARCH, SIGLE, CAplus, INSPEC, JICST-EPLUS, NTIS, PASCAL (February 2002) and DARE, NHS EED, HTA (March 2002). Reference lists from included articles and review articles were searched for additional relevant articles. All relevant studies in most languages were considered and translated. Randomised or quasi-randomised controlled trials of at least 12 months in duration in which sealants were used for preventing caries in children and adolescents under 20 years of age were included. The primary outcome was the increment in the numbers of carious occlusal surfaces of premolars and molars. In the first phase, two reviewers independently examined whether a given study was likely to be relevant on the basis of the title, key words and abstract. In the second phase, four of the reviewers independently classified studies to be included in final analyses. Study authors were contacted for additional information. In the split-mouth studies relative risk ratios were calculated for the paired differences of tooth surfaces being carious or not. In studies comparing resin based sealant with no treatment, fixed effect meta-analyses were used to combine the estimates of relative risk ratios. In one parallel group study, the mean DFS data as continuous data, the effect estimate being the difference in mean DFS, was calculated from data of occlusal surfaces of teeth included in the test and control groups. Eight trials were included in this review of which seven trials were split-mouth studies and one a parallel group study. Six studies provided data for comparing sealant with no treatment and three studies for comparing glass ionomers with resin based sealants. The overall effectiveness of resin based sealants in preventing dental decay on first molars was high. Based on five split-mouth studies with 5 to 10 year old children there were significant differences in favour of the second-generation resin sealant compared with no treatment with pooled relative risk values of 0.14, 0.24, 0.30, 0.43 at 12, 24, 36 and 48 to 54 months respectively. The reductions in caries therefore ranged from 86% at 12 months to 57% at 48 to 54 months. The 24 month parallel group study comparing second-generation resin sealant with control in 12 to 13 year old children found also significantly more caries in the control group children with DFS = 0.65 (95% CI 0.47 to 0.83). Allocation concealment was classified adequate in three of these six studies. However the information on background levels of caries in the population was insufficient to conduct further analyses to estimate the effectiveness of resin based sealants related to baseline caries prevalence. Only one study provided data for the comparison between glass ionomer sealant and control. Based on this, there is not enough information to say whether ionomer sealants are effective, or not. The results of three studies comparing resin sealants with glass ionomer sealants were conflicting and the meta-analyses were not carried out. Sealing with resin based sealants is a recommended procedure to prevent caries of the occlusal surfaces of permanent molars. However, we recommend that the caries prevalence level of both individuals and the population should be taken into account. In practice, the benefit of sealing should be considered locally and specified guidelines for clinicians should be used. The methodological quality of published studies concerning pit and fissure sealants was poorer than expected.

Remineralization Capacity of Three Fissure Sealants with and without Gaseous Ozone on Non-Cavitated Incipient Pit and Fissure Caries.

PubMed

Unal, M; Oztas, N

2015-01-01

The purpose of this study was to investigate the remineralization activation of the application of three fissure sealants (FSs), alone or with gaseous ozone (GO), on non-cavitated initial caries and evaluate the clinical success of FS. Sixty children who had DIAGNOdent scores between 10-30 on bilateral symmetric mandibular first permanent molars were included in study. In a split-mouth design, teeth were assigned to experimental (with GO) and control (without GO) groups. GO was applied to teeth on one side and then the same brand of randomly selected FSs was applied to the teeth on both sides. Children were divided into 3 groups based on type of FS (Group 1: Aegis {Bosworth Co, North Hamlin Avenue Skokie, Illinois, USA}, Group 2: Fuji Triage {GC, Tokyo, Japan}, Group 3: Helioseal {Ivoclar Vivadent, Liechtenstein, Germany}). All FSs were then examined for retention rates at 1, 3, 6, 9, and 12 months; at the end of 12 months, all FSs were removed with an air-abrasion device and DIAGNOdent scores noted to compare with the initial values. The application of GO with either Fuji Triage or Aegis FS was effective on remineralization (p<0.05); however, the application of Helioseal FSs was not effective (p>0.05). The 1(st) and 12(th) months' full retention rates of Fuji Triage FSs was a significant difference (p<0.05) from other FSs (Aegis and Helioseal) (p>0.05). GO+Aegis FS showed the highest remineralization; and, at the end of 12 months, its clinical success was higher than other FSs.

Histological and Histometrical Evaluation of two Synthetic Hydroxyapatite Based Biomaterials in the Experimental Periodontal Defects in Dogs.

PubMed

D'lima, Johnson Prakash; Paul, Jose; Palathingal, Plato; Varma, Brr; Bhat, Mahalinga; Mohanty, Mira

2014-09-01

The present study was to evaluate histologically and histometrically the efficacy of Chitra granules in the regeneration of alveolar bone and to compare it with that of OsteoGenR (HA Resorb)(TM) in iatrogenically created alveolar bone defects in mongrel dogs. Four dogs (16 sites) were used for this split-mouth study. The animals were divided randomly into two groups of two animals. Same animals were used as control and test. Each dog had four implantation sites. The periodontal defects were prepared by acute defect model. Animals were sacrificed at 3 months (n=2), 6 months (n=2) and histologic and histometric evaluation was carried out. The data was analysed using statistical package Graph pad Software. Comparison of the hard and soft tissue parameters in the two groups was done using the Wilcoxan (Man Whitney), two tailed t-test. A p-value less than 0.05 were considered significant. Maturing bone with immature periodontal ligament fibers were observed at three months and advanced osteogenesis at six months with both the types of bone graft materials. The mean values showed that amount of new bone formed with OsteoGenR (HA Resorb)(TM) was slightly more than that obtained by Chitra granules in histometric evaluation. Histological study showed similar healing pattern with both the types of bone graft materials with maturing bone at 3 months and advanced osteogenesis at six months in experimental intraosseous periodontal defects in dogs. However, histological evaluation for longer period is necessary to determine the time taken for complete replacement of the bone graft materials with new bone.

Laser-treated stainless steel mini-screw implants: 3D surface roughness, bone-implant contact, and fracture resistance analysis

PubMed Central

Kang, He-Kyong; Chu, Tien-Min; Dechow, Paul; Stewart, Kelton; Kyung, Hee-Moon

2016-01-01

Summary Background/Objectives: This study investigated the biomechanical properties and bone-implant intersurface response of machined and laser surface-treated stainless steel (SS) mini-screw implants (MSIs). Material and Methods: Forty-eight 1.3mm in diameter and 6mm long SS MSIs were divided into two groups. The control (machined surface) group received no surface treatment; the laser-treated group received Nd-YAG laser surface treatment. Half in each group was used for examining surface roughness (Sa and Sq), surface texture, and facture resistance. The remaining MSIs were placed in the maxilla of six skeletally mature male beagle dogs in a randomized split-mouth design. A pair with the same surface treatment was placed on the same side and immediately loaded with 200g nickel–titanium coil springs for 8 weeks. After killing, the bone-implant contact (BIC) for each MSI was calculated using micro computed tomography. Analysis of variance model and two-sample t test were used for statistical analysis with a significance level of P <0.05. Results: The mean values of Sa and Sq were significantly higher in the laser-treated group compared with the machined group (P <0.05). There were no significant differences in fracture resistance and BIC between the two groups. Limitation: animal study Conclusions/Implications: Laser treatment increased surface roughness without compromising fracture resistance. Despite increasing surface roughness, laser treatment did not improve BIC. Overall, it appears that medical grade SS has the potential to be substituted for titanium alloy MSIs. PMID:25908868

Piezosurgery or conventional rotatory instruments for inferior third molar extractions?

PubMed

Piersanti, Luigi; Dilorenzo, Matteo; Monaco, Giuseppe; Marchetti, Claudio

2014-09-01

The purpose of this study was to compare the discomfort and surgical outcomes of a piezosurgery device with those of rotatory instruments in lower third molar extraction. A split-mouth, randomized, unblinded clinical study was designed; the 2 molars had to have the same extraction difficulty score. The test side was extracted using a piezosurgery technique and the control side was extracted using a conventional handpiece. The primary endpoint was patient discomfort evaluated with the Postoperative Symptom Severity (PoSSe) scale, which was administered to each patient; secondary endpoints were pain, trismus, swelling, and surgical time evaluation. Paired-samples t test and repeated-measures analysis of variance were used to compare outcomes within patients. Ten consecutive patients (6 female, 4 male; mean age, 22.4 ± 2.3 yr) were recruited. The total score on the PoSSe scale was significantly lower for piezosurgery compared with the conventional rotating handpiece (24.7 ± 10.3 vs 36.0 ± 7.6; t = -4.27; P = .002). Moreover, postoperative swelling 1 week after surgery was significantly lower for piezosurgery than for the conventional rotating handpiece (2.75 ± 0.23 vs 3.1 ± 0.39 cm; t = -2.63; P = .027). Piezosurgery was associated with less postoperative discomfort and yielded better results for swelling. Piezosurgery seems to be a good technique in daily surgical practice, especially if applied in the critical steps in which safety and respect for soft tissue, bone, and nerves are necessary. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

[The anesthetic effects of Gow-Gates technique of inferior alveolar nerve block in impacted mandibular third molar extraction].

PubMed

Yang, Jieping; Liu, Wei; Gao, Qinghong

2013-08-01

To evaluate the anesthetic effects and safety of Gow-Gates technique of inferior alveolar nerve block in impacted mandibular third molar extraction. A split-mouth study was designed. The bilateral impacted mandibular third molar of 32 participants were divided into Gow-Gates technique of inferior alveolar nerve block (Gow-Gates group) and conventional technique of inferior alveolar nerve block (conventional group) randomly with third molar extracted. The anesthetic effects and adverse events were recorded. All the participants completed the research. The anesthetic success rate was 96.9% in Gow-Gates group and 90.6% in conventional group with no statistical difference ( P= 0.317); but when comparing the anesthesia grade, Gow-Gates group had a 96.9% of grade A and B, and conventional group had a rate of 78.1% (P = 0.034). And the Gow-Gates group had a much lower withdrawn bleeding than conventional group (P = 0.025). Two groups had no hematoma. Gow-Gates technique had a reliable anesthesia effects and safety in impacted mandibular third molar extraction and could be chosen as a candidate for the conventional inferior alveolar nerve block.

Direct pulp capping in primary molars using a resin-modified Portland cement-based material (TheraCal) compared to MTA with 12-month follow-up: a randomised clinical trial.

PubMed

Erfanparast, L; Iranparvar, P; Vafaei, A

2018-05-16

This study was to compare the success of resin-modified Portland cement-based material (TheraCal) with MTA in direct pulp capping (DPC) of primary molars. Symmetrical bilateral primary molars (92) from 46 healthy subjects aged 5-7 years were included in this split-mouth randomised clinical trial. DPC for small non-contaminated pulp exposures using either TheraCal or MTA were randomly performed in symmetrical molars. Thereafter, teeth were restored with amalgam. Clinical and radiographic evaluations were performed at 6 and 12 month follow-ups. Data were analysed using Chi square test at a significance level of 0.05. At the final follow-up session 74 teeth were available. After 12 months, the overall success rates for MTA and TheraCal were 94.5 and 91.8%, respectively. The difference between outcomes of the two groups was not statistically significant (P > 0.05). Within the limitations of the current study, radiographic and clinical findings revealed that TheraCal exhibited a comparable outcome to MTA in DPC of primary molars after 12 months.

Influence of surrounding structures upon the aerodynamic and acoustic performance of the outdoor unit of a split air-conditioner

NASA Astrophysics Data System (ADS)

Wu, Chengjun; Liu, Jiang; Pan, Jie

2014-07-01

DC-inverter split air-conditioner is widely used in Chinese homes as a result of its high-efficiency and energy-saving. Recently, the researches on its outdoor unit have focused on the influence of surrounding structures upon the aerodynamic and acoustic performance, however they are only limited to the influence of a few parameters on the performance, and practical design of the unit requires more detailed parametric analysis. Three-dimensional computational fluid dynamics(CFD) and computational aerodynamic acoustics(CAA) simulation based on FLUENT solver is used to study the influence of surrounding structures upon the aforementioned properties of the unit. The flow rate and sound pressure level are predicted for different rotating speed, and agree well with the experimental results. The parametric influence of three main surrounding structures(i.e. the heat sink, the bell-mouth type shroud and the outlet grille) upon the aerodynamic performance of the unit is analyzed thoroughly. The results demonstrate that the tip vortex plays a major role in the flow fields near the blade tip and has a great effect on the flow field of the unit. The inlet ring's size and throat's depth of the bell-mouth type shroud, and the through-flow area and configuration of upwind and downwind sections of the outlet grille are the most important factors that affect the aerodynamic performance of the unit. Furthermore, two improved schemes against the existing prototype of the unit are developed, which both can significantly increase the flow rate more than 6 %(i.e. 100 m3·h-1) at given rotating speeds. The inevitable increase of flow noise level when flow rate is increased and the advantage of keeping a lower rotating speed are also discussed. The presented work could be a useful guideline in designing the aerodynamic and acoustic performance of the split air-conditioner in engineering practice.

Clinical evaluation of subepithelial connective tissue graft and guided tissue regeneration for treatment of Miller’s class 1 gingival recession (comparative, split mouth, six months study)

PubMed Central

Bhavsar, Neeta-V.; Dulani, Kirti; Trivedi, Rahul

2014-01-01

Objectives: The present study aims to clinically compare and evaluate subepithelial connective tissue graft and the GTR based root coverage in treatment of Miller’s Class I gingival recession. Study Design: 30 patients with at least one pair of Miller’s Class I gingival recession were treated either with Subepithelial connective tissue graft (Group A) or Guided tissue regeneration (Group B). Clinical parameters monitored included recession RD, width of keratinized gingiva (KG), probing depth (PD), clinical attachment level (CAL), attached gingiva (AG), residual probing depth (RPD) and % of Root coverage(%RC). Measurements were taken at baseline, three months and six months. A standard surgical procedure was used for both Group A and Group B. Data were recorded and statistical analysis was done for both intergroup and intragroup. Results: At end of six months % RC obtained were 84.47% (Group A) and 81.67% (Group B). Both treatments resulted in statistically significant improvement in clinical parameters. When compared, no statistically significant difference was found between both groups except in RPD, where it was significantly greater in Group A. Conclusions: GTR technique has advantages over subepithelial connective tissue graft for shallow Miller’s Class I defects and this procedure can be used to avoid patient discomfort and reduce treatment time. Key words:Collagen membrane, comparative split mouth study, gingival recession, subepithelial connective tissue graft, guided tissue regeneration (GTR). PMID:25136420

External apical root resorption in maxillary root-filled incisors after orthodontic treatment: a split-mouth design study.

PubMed

Llamas-Carreras, José María; Amarilla, Almudena; Espinar-Escalona, Eduardo; Castellanos-Cosano, Lizett; Martín-González, Jenifer; Sánchez-Domínguez, Benito; López-Frías, Francisco Javier

2012-05-01

The purpose of this study was to compare, in a split mouth design, the external apical root resorption (EARR) associated with orthodontic treatment in root-filled maxillary incisors and their contralateral teeth with vital pulps. The study sample consisted of 38 patients (14 males and 24 females), who had one root-filled incisor before completion of multiband/bracket orthodontic therapy for at least 1 year. For each patient, digital panoramic radiographs taken before and after orthodontic treatment were used to determine the root resortion and the proportion of external root resorption (PRR), defined as the ratio between the root resorption in the endodontically treated incisor and that in its contralateral incisor with a vital pulp. The student's t-test, chi-square test and logistic regression analysis were used to determine statistical significance. There was no statistically significant difference (p > 0.05) between EARR in vital teeth (1.1 ± 1.0 mm) and endodontically treated incisors (1.1 ± 0.8 mm). Twenty-six patients (68.4%) showed greater resorption of the endodontically treated incisor than its homolog vital tooth (p > 0.05). The mean and standard deviation of PPR were 1.0 ± 0.2. Multivariate logistic regression suggested that PRR does not correlate with any of the variables analyzed. There was no significant difference in the amount or severity of external root resorption during orthodontic movement between root-filled incisors and their contralateral teeth with vital pulps.

Oxybutynin as a treatment for generalized hyperhidrosis: a randomized, placebo-controlled trial.

PubMed

Schollhammer, M; Brenaut, E; Menard-Andivot, N; Pillette-Delarue, M; Zagnoli, A; Chassain-Le Lay, M; Sassolas, B; Jouan, N; Le Ru, Y; Abasq-Thomas, C; Greco, M; Penven, K; Roguedas-Contios, A M; Dupré-Goetghebeur, D; Gouedard, C; Misery, L; Le Gal, G

2015-11-01

Hyperhidrosis is a disorder that can impair quality of life. Localized treatments may be cumbersome and ineffective, and no systemic treatments have proven to be significantly beneficial. To evaluate the effectiveness and tolerance of low-dose oxybutynin for hyperhidrosis. We conducted a prospective, randomized, placebo-controlled trial. From June 2013 to January 2014, 62 patients with localized or generalized hyperhidrosis were enrolled. Oxybutynin was started at a dose of 2·5 mg per day and increased gradually to 7·5 mg per day. The primary outcome was defined as improvement of at least one point on the Hyperhidrosis Disease Severity Scale (HDSS). Dermatology Life Quality Index (DLQI) and tolerance were also reported. Most patients (83%) in our study had generalized hyperhidrosis. Oxybutynin was superior to placebo in improving the HDSS: 60% of patients treated with oxybutynin, compared with 27% of patients treated with placebo, improved at least one point on the HDSS (P = 0·009). The mean improvement in quality of life measured by DLQI was significantly better in the oxybutynin arm (6·9) than in the placebo arm (2·3). The most frequent side-effect was dry mouth, which was observed in 43% of the patients in the oxybutynin arm, compared with 11% in the placebo arm. Treatment with low-dose oxybutynin is effective in reducing symptoms of hyperhidrosis in generalized or localized forms. Side-effects were frequent but minor and mainly involved dry mouth. © 2015 British Association of Dermatologists.

Xenogeneic collagen matrix with coronally advanced flap compared to connective tissue with coronally advanced flap for the treatment of dehiscence-type recession defects.

PubMed

McGuire, Michael K; Scheyer, E Todd

2010-08-01

For root coverage therapy, the connective tissue graft (CTG) plus coronally advanced flap (CAF) is considered the gold standard therapy against which alternative therapies are generally compared. When evaluating these therapies, in addition to traditional measures of root coverage, subject-reported, qualitative measures of esthetics, pain, and overall preferences for alternative procedures should also be considered. This study determines if a xenogeneic collagen matrix (CM) with CAF might be as effective as CTG+CAF in the treatment of recession defects. This study was a single-masked, randomized, controlled, split-mouth study of dehiscence-type recession defects in contralateral sites; one defect received CTG+CAF and the other defect received CM+CAF. A total of 25 subjects (8 male, 17 female; mean age: 43.7 +/- 12.2 years) were evaluated at 6 months and 1 year. The primary efficacy endpoint was recession depth at 6 months. Secondary endpoints included traditional periodontal measures, such as width of keratinized tissue and percentage of root coverage. Subject-reported values of pain, discomfort, and esthetic satisfaction were also recorded. At 6 months, recession depth was on average 0.52 mm for test sites and 0.10 mm for control sites. Recession depth change from baseline was statistically significant between test and control, with an average of 2.62 mm gained at test sites and 3.10 mm gained at control sites for a difference of 0.4 mm (P = 0.0062). At 1 year, test percentage of root coverage averaged 88.5%, and controls averaged 99.3% (P = 0.0313). Keratinized tissue width gains were equivalent for both therapies and averaged 1.34 mm for test sites and 1.26 mm for control sites (P = 0.9061). There were no statistically significant differences between subject-reported values for esthetic satisfaction, and subjects' assessments of pain and discomfort were also equivalent. When balanced with subject-reported esthetic values and compared to historical root coverage outcomes reported by other investigators, CM+CAF presents a viable alternative to CTG+CAF, without the morbidity of soft tissue graft harvest.

Evaluation of moxifloxacin-hydroxyapatite composite graft in the regeneration of intrabony defects: A clinical, radiographic, and microbiological study

PubMed Central

Nagarjuna Reddy, Y. V.; Deepika, P. C.; Venkatesh, M. P.; Rajeshwari, K. G.

2016-01-01

Background: The formation of new connective periodontal attachment is contingent upon the elimination or marked reduction of pathogens at the treated periodontal site. An anti-microbial agent, i.e. moxifloxacin has been incorporated into the bone graft to control infection and facilitate healing during and after periodontal therapy. Materials and Methods: By purposive sampling, 15 patients with at least two contralateral vertical defect sites were selected. The selected sites in each individual were divided randomly into test and control sites according to split-mouth design. Test site received moxifloxacin-hydroxyapatite composite graft and control site received hydroxyapatite-placebo gel composite graft. Probing depth (PD) and Clinical attachment level (CAL) were assessed at baseline, 3, 6, 9, and 12 months. Bone probing depth (BPD) and hard tissue parameters such as amount of defect fill, percentage of defect fill, and changes in alveolar crest were assessed at baseline, 6, and 12 months. Changes in subgingival microflora were also assessed by culturing the subgingival plaque samples at baseline and at 3-month follow-up. The clinical, radiographic, and microbiological data obtained were subjected to statistical analysis using descriptive statistics, paired sample t-test, independent t-test, and contingency test. Results: On intragroup comparison at test and control sites, there was a significant improvement in all clinical and radiographic parameters. However, on intergroup comparison of the same, there was no statistically significant difference between test and control sites at any interval. Although test sites showed slightly higher amount of bone fill, it was not statistically significant. There was a significant reduction in the counts of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis at both sites from baseline to 3 months. In addition, there was a significant reduction at test sites as compared to control sites at 3-month follow-up (P = 0.003 and P = 0.013). Conclusion: The reduction in microbial counts found in test sites at 3-month follow-up could not bring similar significant improvements in the clinical and radiographic parameters though the test sites showed slightly higher bone fill. PMID:27630501

Does Implant Design Affect Implant Primary Stability? A Resonance Frequency Analysis-Based Randomized Split-Mouth Clinical Trial.

PubMed

Gehrke, Sergio Alexandre; da Silva, Ulisses Tavares; Del Fabbro, Massimo

2015-12-01

The purpose of this study was to assess implant stability in relation to implant design (conical vs. semiconical and wide-pitch vs narrow-pitch) using resonance frequency analysis. Twenty patients with bilateral edentulous maxillary premolar region were selected. In one hemiarch, conical implants with wide pitch (group 1) were installed; in the other hemiarch, semiconical implants with narrow pitch were installed (group 2). The implant allocation was randomized. The implant stability quotient (ISQ) was measured by resonance frequency analysis immediately following implant placement to assess primary stability (time 1) and at 90 days after placement (time 2). In group 1, the mean and standard deviation ISQ for time 1 was 65.8 ± 6.22 (95% confidence interval [CI], 55 to 80), and for time 2, it was 68.0 ± 5.52 (95% CI, 57 to 77). In group 2, the mean and standard deviation ISQ was 63.6 ± 5.95 (95% CI, 52 to 78) for time 1 and 67.0 ± 5.71 (95% CI, 58 to 78) for time 2. The statistical analysis demonstrated significant difference in the ISQ values between groups at time 1 (P = .007) and no statistical difference at time 2 (P = .54). The greater primary stability of conical implants with wide pitch compared with semiconical implants with narrow pitch might suggest a preference for the former in case of the adoption of immediate or early loading protocols.

A 12 month clinical study of bond failures of recycled versus new stainless steel orthodontic brackets.

PubMed

Cacciafesta, Vittorio; Sfondrini, Maria Francesca; Melsen, Birte; Scribante, Andrea

2004-08-01

The purpose of this prospective longitudinal randomized study was to compare the clinical performance of recycled brackets with that of new stainless steel brackets (Orthos). Twenty patients treated with fixed appliances were included in the investigation. Using a 'split-mouth' design, the dentition of each patient was divided into four quadrants. In 11 randomly selected patients, the maxillary left and mandibular right quadrants were bonded with recycled brackets, and the remaining quadrants with new stainless steel brackets. In the other nine patients the quadrants were inverted. Three hundred and ten stainless steel brackets were examined: 156 were recycled and the remaining 154 were new. All the brackets were bonded with a self-cured resin-modified glass ionomer (GC Fuji Ortho). The number, cause, and date of bracket failures were recorded over 12 months. Statistical analysis was performed by means of a paired t-test, Kaplan-Meier survival estimates, and the log-rank test. No statistically significant differences were found between: (a) the total bond failure rate of recycled and new stainless steel brackets; (b) the upper and lower arches; (c) the anterior and posterior segments. These findings demonstrate that recycling metallic orthodontic brackets can be of benefit to the profession, both economically and ecologically, as long as the orthodontist is aware of the various aspects of the recycling methods, and that patients are informed about the type of bracket that will be used for their treatment.

Development of Fetal Yawn Compared with Non-Yawn Mouth Openings from 24–36 Weeks Gestation

PubMed Central

Reissland, Nadja; Francis, Brian; Mason, James

2012-01-01

Background Although some research suggests that fetuses yawn, others disagree arguing that is it simple mouth opening. Furthermore there is no developmental account of fetal yawning compared with simple mouth opening. The aim of the present study was to establish in a repeated measures design the development of fetal yawning compared with simple mouth opening. Methodology/Findings Video recordings were made of the fetal face and upper torso visualized by means of 4D full frontal or facial profile ultrasound recordings. Fifteen healthy fetuses were scanned four times at 24, 28, 32 and 36 weeks gestation. Yawning was distinguished from non-yawning in terms of the length of time it took to reach the apex of the mouth stretch, with yawns being defined as more than 50% of the total time observed. To assess changes in frequency, a Poisson mixed effects model was fitted to the count of number of yawn and simple mouth opening events with age and gender as fixed effects, and person as a random effect. For both yawns and simple mouth openings a smooth varying age effect was significant. The number of yawns observed declined with age from 28 weeks gestation, whereas simple mouth openings were less frequent and the decline was observed from 24 weeks. Gender was not significant either for yawn and simple mouth openings. Conclusions/Significance Yawning can be reliably distinguished from other forms of mouth opening with the potential of using yawning as an index of fetal healthy development. PMID:23185638

Treatment of Facial Photodamage With Mass Market Topical Products vs Non-ablative Fractional Laser.

PubMed

Reich, Hilary; Wallander, Irmina; Schulte, Lacie; Goodier, Molly; Zelickson, Brian

2016-11-01

In this split-face, evaluator-blinded study, 18 subjects were randomly assigned to receive either the SSR or NFL treatments on each side of the face. For the SSR facial sides subjects followed two morning-evening regimens. On the NFL sides subjects were treated 3 times with the 1927-nm laser at 4-week intervals. Three physician evaluators were asked to rate hyperpigmentation, global photoaging, and ne lines and wrinkles for each side of the face at baseline and at 3 months using a 5-point scale. The SSR and NFL treatments provided comparable results for each skin attribute. Improvement from baseline was signi - cant in both treatment programs for each skin attribute. The greatest 3-month improvement for both programs was in hyperpigmen- tation. For global photoaging and ne lines and wrinkles, positive responses were slightly greater in the NFL than in the SSR facial sides. Subject preference for the SSR over the NFL was greatest for ne lines around the eyes, ne lines around the mouth, smooth texture, radiant complexion, and overall improvement while the NFL was preferred for skin rmness and evenness. When the study was completed5 of 18 split-face subjects decided to undergo NFR laser treatment on the non laser treated side along with using the SSR product and 13 of the 18 subjects continued to use the SSR products to their full face after the study. The mass market skin care system of the present study provides improvement in hyperpigmentation, global photoaging, and ne lines and wrinkles comparable to that of a series of treatments with a non-ablative fractional laser. J Drugs Dermatol. 2016;15(11):1366-1372..

Platelet growth factors from allogeneic platelet-rich plasma for clinical improvement in split-thickness skin graft.

PubMed

Sonker, Atul; Dubey, Anju; Bhatnagar, Ankur; Chaudhary, Rajendra

2015-01-01

Platelets are a source of numerous growth factors which facilitate repair and healing. Thus platelet rich plasma has been increasingly used as a treatment modality in the field of reconstructive surgeries for wound healing. This preliminary study was carried out to explore whether platelet growth factors from platelet rich plasma could be used for enhancement of split thickness skin graft survival. Twenty patients (13 males and 7 females) requiring split thickness skin graft for various clinical reasons were enrolled in the study. Platelet rich plasma was collected by apheresis and frozen at -80° C. It was thawed at room temperature immediately before its intended application. PRP was applied only on one half of the wound, while another half served as control. Patient was followed for 6 weeks. The effect was assessed at first dressing in terms of graft uptake and subsequently as time taken for complete healing. There was 100% uptake of the graft in the area where platelet rich plasma was applied. In the control area, there was complete graft loss in 4 cases, partial loss in 7 cases and complete uptake in 9 cases. This study demonstrated promising results on application of PRP to split thickness skin grafts. Further randomized studies with greater sample size may be undertaken to establish platelet rich plasma as a validated treatment modality.

Empowering Latino Families: Effects of a Culturally Responsive Intervention for Low-Income Immigrant Latino Parents on Children's Behaviors and Parental Stress

ERIC Educational Resources Information Center

Ceballos, Peggy L.; Bratton, Sue C.

2010-01-01

This randomized, controlled study examined the effectiveness of Child Parent Relationship Therapy (CPRT) in school settings with 48 low-income Latino immigrant parents whose children were identified with behavioral concerns. Results from a 2 (group) x 2 (measures) split plot analysis of variance indicated that parents who participated in 11 weeks…

A systematic review of non-pharmacological interventions for primary Sjögren's syndrome.

PubMed

Hackett, Katie L; Deane, Katherine H O; Strassheim, Victoria; Deary, Vincent; Rapley, Tim; Newton, Julia L; Ng, Wan-Fai

2015-11-01

To evaluate the effects of non-pharmacological interventions for primary SS (pSS) on outcomes falling within the World Health Organization International Classification of Functioning Disability and Health domains. We searched the following databases from inception to September 2014: Cochrane Database of Systematic Reviews; Medline; Embase; PsychINFO; CINAHL; and clinical trials registers. We included randomized controlled trials of any non-pharmacological intervention. Two authors independently reviewed titles and abstracts against the inclusion/exclusion criteria and independently assessed trial quality and extracted data. A total of 1463 studies were identified, from which 17 full text articles were screened and 5 studies were included in the review; a total of 130 participants were randomized. The included studies investigated the effectiveness of an oral lubricating device for dry mouth, acupuncture for dry mouth, lacrimal punctum plugs for dry eyes and psychodynamic group therapy for coping with symptoms. Overall, the studies were of low quality and at high risk of bias. Although one study showed punctum plugs to improve dry eyes, the sample size was relatively small. Further high-quality studies to evaluate non-pharmacological interventions for PSS are needed. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology.

Yukmijihwang-tang for the treatment of xerostomia in the elderly: study protocol for a randomized, double-blind, placebo-controlled, two-center trial.

PubMed

Han, Gajin; Park, Jae-Woo; Ko, Seok-Jae; Son, Jihee; Seon, Jongki; Kim, Juyeon; Kim, Seulki; Yeo, Inkwon; Ryu, Bongha; Kim, Jinsung

2013-09-03

Xerostomia, a subjective sense of dry mouth, is not generally regarded a disease despite its high prevalence among the elderly, and therefore continues to impair affected patients' quality of life. In traditional Korean medicine, 'Yin-Deficiency' has been implicated in the pathogenesis of xerostomia among the elderly. Yukmijihwang-tang is a famous herbal prescription used to relieve 'Yin-Deficiency', and reportedly has antioxidant effects; therefore, it is postulated that Yukmijihwang-tang can be used to treat xerostomia in the elderly. However, to our knowledge, no clinical trial has been conducted on the effects of Yukmijihwang-tang on xerostomia. Thus, we designed a randomized clinical trial to investigate the effects and safety of Yukmijihwang-tang on xerostomia in the elderly. In addition, we will clarify the aforementioned assumption that 'Yin-Deficiency' is the major cause of xerostomia in the elderly by identifying a correlation between xerostomia and 'Yin-Deficiency'. This randomized, double-blind, placebo-controlled trial will be carried out at two centers: Kyung Hee University Korean Medicine Hospital and Kyung Hee University Hospital at Gangdong. We will recruit 96 subjects aged 60-80 years who have experienced xerostomia for 3 months prior to participation. Subjects who present with score >40 on the visual analogue scale for xerostomia and unstimulated salivary flow rate under 0.3mL/min will be included and the randomization will be carried out by an independent statistician by using a random number creation program. The subjects and all researchers except the statistician will be blinded to the group assignment. Yukmijihwang-tang or placebo will be administered to each group for 8 weeks. The primary outcome is change in the scores for the visual analogue scale for xerostomia and the dry mouth symptom questionnaire from 0 to 8 weeks. It will be assessed whether Yukmijihwang-tang can be used as a new herbal treatment for xerostomia in the elderly by demonstrating its therapeutic effects in a well-designed clinical trial. ClinicalTrials.gov Identifier: NCT01579877.

Yukmijihwang-tang for the treatment of xerostomia in the elderly: study protocol for a randomized, double-blind, placebo-controlled, two-center trial

PubMed Central

2013-01-01

Background Xerostomia, a subjective sense of dry mouth, is not generally regarded a disease despite its high prevalence among the elderly, and therefore continues to impair affected patients’ quality of life. In traditional Korean medicine, ‘Yin-Deficiency’ has been implicated in the pathogenesis of xerostomia among the elderly. Yukmijihwang-tang is a famous herbal prescription used to relieve ‘Yin-Deficiency’, and reportedly has antioxidant effects; therefore, it is postulated that Yukmijihwang-tang can be used to treat xerostomia in the elderly. However, to our knowledge, no clinical trial has been conducted on the effects of Yukmijihwang-tang on xerostomia. Thus, we designed a randomized clinical trial to investigate the effects and safety of Yukmijihwang-tang on xerostomia in the elderly. In addition, we will clarify the aforementioned assumption that ‘Yin-Deficiency’ is the major cause of xerostomia in the elderly by identifying a correlation between xerostomia and ‘Yin-Deficiency’. Methods/Design This randomized, double-blind, placebo-controlled trial will be carried out at two centers: Kyung Hee University Korean Medicine Hospital and Kyung Hee University Hospital at Gangdong. We will recruit 96 subjects aged 60-80 years who have experienced xerostomia for 3 months prior to participation. Subjects who present with score >40 on the visual analogue scale for xerostomia and unstimulated salivary flow rate under 0.3mL/min will be included and the randomization will be carried out by an independent statistician by using a random number creation program. The subjects and all researchers except the statistician will be blinded to the group assignment. Yukmijihwang-tang or placebo will be administered to each group for 8 weeks. The primary outcome is change in the scores for the visual analogue scale for xerostomia and the dry mouth symptom questionnaire from 0 to 8 weeks. Discussion It will be assessed whether Yukmijihwang-tang can be used as a new herbal treatment for xerostomia in the elderly by demonstrating its therapeutic effects in a well-designed clinical trial. Trial registration ClinicalTrials.gov Identifier: NCT01579877 PMID:24004451

Ridge preservation using a composite bone graft and a bioabsorbable membrane with and without primary wound closure: a comparative clinical trial.

PubMed

Engler-Hamm, Daniel; Cheung, Wai S; Yen, Alec; Stark, Paul C; Griffin, Terrence

2011-03-01

The aim of this single-masked, randomized controlled clinical trial is to compare hard and soft tissue changes after ridge preservation performed with (control, RPc) and without (test, RPe) primary soft tissue closure in a split-mouth design. Eleven patients completed this 6-month trial. Extraction and ridge preservation were performed using a composite bone graft of inorganic bovine-derived hydroxyapatite matrix and cell binding peptide P-15 (ABM/P-15), demineralized freeze-dried bone allograft, and a copolymer bioabsorbable membrane. Primary wound closure was achieved on the control sites (RPc), whereas test sites (RPe) left the membrane exposed. Pocket probing depth on adjacent teeth, repositioning of the mucogingival junction, bone width, bone fill, and postoperative discomfort were assessed. Bone cores were obtained for histological examination. Intragroup analyses for both groups demonstrated statistically significant mean reductions in probing depth (RPc: 0.42 mm, P = 0.012; RPe: 0.25 mm, P = 0.012) and bone width (RPc: 3 mm, P = 0.002; RPe: 3.42 mm, P <0.001). However, intergroup analysis did not find these parameters to be statistically different at 6 months. The test group showed statistically significant mean change in bone fill (7.21 mm; P <0.001). Compared to the control group, the test group showed statistically significant lower mean postoperative discomfort (RPc 4 versus RPe 2; P = 0.002). Histomorphometric analysis showed presence of 0% to 40% of ABM/P-15 and 5% to 20% of new bone formation in both groups. Comparison of clinical variables between the two groups at 6 months revealed that the mucogingival junction was statistically significantly more coronally displaced in the control group than in the test group, with a mean of 3.83 mm versus 1.21 mm (P = 0.002). Ridge preservation without flap advancement preserves more keratinized tissue and has less postoperative discomfort and swelling. Although ridge preservation is performed with either method, ≈27% to 30% of bone width is lost.

Dry Mouth Treatment: Tips for Controlling Dry Mouth

MedlinePlus

... Dry Mouth Mouthwash, which also offer protection against tooth decay. Avoid using over-the-counter antihistamines and decongestants ... and drinks because they increase your risk of tooth decay. Brush with a fluoride toothpaste — ask your dentist ...

Photodynamic therapy as an adjunct to non-surgical periodontal treatment: a randomized, controlled clinical trial.

PubMed

Christodoulides, Nicos; Nikolidakis, Dimitris; Chondros, Panagiotis; Becker, Jürgen; Schwarz, Frank; Rössler, Ralf; Sculean, Anton

2008-09-01

Recent preclinical and clinical data have suggested a potential benefit of photodynamic therapy (PDT) in the treatment of periodontitis. However, there are very limited data from controlled clinical trials evaluating the effect of PDT in the treatment of periodontitis. The aim of this study was to evaluate the clinical and microbiologic effects of the adjunctive use of PDT to non-surgical periodontal treatment. Twenty-four subjects with chronic periodontitis were randomly treated with scaling and root planing followed by a single episode of PDT (test) or scaling and root planing alone (control). Full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), probing depth (PD), gingival recession, and clinical attachment level (CAL) were measured at baseline and 3 and 6 months after therapy. Primary outcome variables were changes in PD and CAL. Microbiologic evaluation of Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia (previously T. forsythensis), Treponema denticola, Parvimonas micra (previously Peptostreptococcus micros or Micromonas micros), Fusobacterium nucleatum, Campylobacter rectus, Eubacterium nodatum, Eikenella corrodens, and Capnocytophaga spp. was performed at baseline and 3 and 6 months following therapy by using a commercially available polymerase chain reaction test. At 3 and 6 months after treatment, there were no statistically significant differences between the groups with regard to CAL, PD, FMPS, or microbiologic changes. At 3 and 6 months, a statistically significantly greater improvement in FMBS was found in the test group. The additional application of a single episode of PDT to scaling and root planing failed to result in an additional improvement in terms of PD reduction and CAL gain, but it resulted in a significantly higher reduction in bleeding scores compared to scaling and root planing alone.

The short-term treatment effects on the microbiota at the dorsum of the tongue in intra-oral halitosis patients--a randomized clinical trial.

PubMed

Ademovski, Seida Erovic; Persson, G Rutger; Winkel, Edwin; Tangerman, Albert; Lingström, Peter; Renvert, Stefan

2013-03-01

This study aims to assess the effects of rinsing with zinc- and chlorhexidine-containing mouth rinse with or without adjunct tongue scraping on volatile sulfur compounds (VSCs) in breath air, and the microbiota at the dorsum of the tongue. A randomized single-masked controlled clinical trial with a cross-over study design over 14 days including 21 subjects was performed. Bacterial samples from the dorsum of the tongue were assayed by checkerboard DNA-DNA hybridization. No halitosis (identified by VSC assessments) at day 14 was identified in 12/21 subjects with active rinse alone, in 10/21 with adjunct use of tongue scraper, in 1/21 for negative control rinse alone, and in 3/21 in the control and tongue scraping sequence. At day 14, significantly lower counts were identified only in the active rinse sequence (p < 0.001) for 15/78 species including, Fusobacterium sp., Porphyromonas gingivalis, Pseudomonas aeruginosa, Staphylococcus aureus, and Tannerella forsythia. A decrease in bacteria from baseline to day 14 was found in successfully treated subjects for 9/74 species including: P. gingivalis, Prevotella melaninogenica, S. aureus, and Treponema denticola. Baseline VSC scores were correlated with several bacterial species. The use of a tongue scraper combined with active rinse did not change the levels of VSC compared to rinsing alone. VSC scores were not associated with bacterial counts in samples taken from the dorsum of the tongue. The active rinse alone containing zinc and chlorhexidine had effects on intra-oral halitosis and reduced bacterial counts of species associated with malodor. Tongue scraping provided no beneficial effects on the microbiota studied. Periodontally healthy subjects with intra-oral halitosis benefit from daily rinsing with zinc- and chlorhexidine-containing mouth rinse.

Does Graft Particle Type and Size Affect Ridge Dimensional Changes After Alveolar Ridge Split Procedure?

PubMed

Kheur, Mohit G; Kheur, Supriya; Lakha, Tabrez; Jambhekar, Shantanu; Le, Bach; Jain, Vinay

2018-04-01

The absence of an adequate volume of bone at implant sites requires augmentation procedures before the placement of implants. The aim of the present study was to assess the ridge width gain with the use of allografts and biphasic β-tricalcium phosphate with hydroxyapatite (alloplast) in ridge split procedures, when each were used in small (0.25 to 1 mm) and large (1 to 2 mm) particle sizes. A randomized controlled trial of 23 subjects with severe atrophy of the mandible in the horizontal dimension was conducted in a private institute. The patients underwent placement of 49 dental implants after a staged ridge split procedure. The patients were randomly allocated to alloplast and allograft groups (predictor variable). In each group, the patients were randomly assigned to either small graft particle or large graft particle size (predictor variable). The gain in ridge width (outcome variable) was assessed before implant placement. A 2-way analysis of variance test and the Student unpaired t test were used for evaluation of the ridge width gain between the allograft and alloplast groups (predictor variable). Differences were considered significant if P values were < .05. The sample included 23 patients (14 men and 9 women). The patients were randomly allocated to the alloplast (n = 11) or allograft (n = 12) group before the ridge split procedure. In each group, they were assigned to a small graft particle or large graft particle size (alloplast group, small particle in 5 and large particle size in 6 patients; allograft group, small particle in 6 and large particle size in 6). A statistically significant difference was observed between the 2 graft types. The average ridge width gain was significantly greater in the alloplast group (large, 4.40 ± 0.24 mm; small, 3.52 ± 0.59 mm) than in the allograft group (large, 3.82 ± 0.19 mm; small, 2.57 ± 0.16 mm). For both graft types (alloplast and allograft), the large particle size graft resulted in a greater ridge width gain compared with the small particle size graft (P < .05). Within the limitations of the present study, we suggest the use of large particle alloplast as the graft material of choice for staged ridge split procedures in the posterior mandible. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Combined glucose ingestion and mouth rinsing improves sprint cycling performance.

PubMed

Chong, Edwin; Guelfi, Kym J; Fournier, Paul A

2014-12-01

This study investigated whether combined ingestion and mouth rinsing with a carbohydrate solution could improve maximal sprint cycling performance. Twelve competitive male cyclists ingested 100 ml of one of the following solutions 20 min before exercise in a randomized double-blinded counterbalanced order (a) 10% glucose solution, (b) 0.05% aspartame solution, (c) 9.0% maltodextrin solution, or (d) water as a control. Fifteen min after ingestion, repeated mouth rinsing was carried out with 11 × 15 ml bolus doses of the same solution at 30-s intervals. Each participant then performed a 45-s maximal sprint effort on a cycle ergometer. Peak power output was significantly higher in response to the glucose trial (1188 ± 166 W) compared with the water (1036 ± 177 W), aspartame (1088 ± 128 W) and maltodextrin (1024 ± 202 W) trials by 14.7 ± 10.6, 9.2 ± 4.6 and 16.0 ± 6.0% respectively (p < .05). Mean power output during the sprint was significantly higher in the glucose trial compared with maltodextrin (p < .05) and also tended to be higher than the water trial (p = .075). Glucose and maltodextrin resulted in a similar increase in blood glucose, and the responses of blood lactate and pH to sprinting did not differ significantly between treatments (p > .05). These findings suggest that combining the ingestion of glucose with glucose mouth rinsing improves maximal sprint performance. This ergogenic effect is unlikely to be related to changes in blood glucose, sweetness, or energy sensing mechanisms in the gastrointestinal tract.

Prospective randomized comparison of scar appearances between cograft of acellular dermal matrix with autologous split-thickness skin and autologous split-thickness skin graft alone for full-thickness skin defects of the extremities.

PubMed

Yi, Ju Won; Kim, Jae Kwang

2015-03-01

The purpose of this study was to evaluate the clinical outcomes of cografting of acellular dermal matrix with autologous split-thickness skin and autologous split-thickness skin graft alone for full-thickness skin defects on the extremities. In this prospective randomized study, 19 consecutive patients with full-thickness skin defects on the extremities following trauma underwent grafting using either cograft of acellular dermal matrix with autologous split-thickness skin graft (nine patients, group A) or autologous split-thickness skin graft alone (10 patients, group B) from June of 2011 to December of 2012. The postoperative evaluations included observation of complications (including graft necrosis, graft detachment, or seroma formation) and Vancouver Scar Scale score. No statistically significant difference was found regarding complications, including graft necrosis, graft detachment, or seroma formation. At week 8, significantly lower Vancouver Scar Scale scores for vascularity, pliability, height, and total score were found in group A compared with group B. At week 12, lower scores for pliability and height and total scores were identified in group A compared with group B. For cases with traumatic full-thickness skin defects on the extremities, a statistically significant better result was achieved with cograft of acellular dermal matrix with autologous split-thickness skin graft than with autologous split-thickness skin graft alone in terms of Vancouver Scar Scale score. Therapeutic, II.

MIP models and hybrid algorithms for simultaneous job splitting and scheduling on unrelated parallel machines.

PubMed

Eroglu, Duygu Yilmaz; Ozmutlu, H Cenk

2014-01-01

We developed mixed integer programming (MIP) models and hybrid genetic-local search algorithms for the scheduling problem of unrelated parallel machines with job sequence and machine-dependent setup times and with job splitting property. The first contribution of this paper is to introduce novel algorithms which make splitting and scheduling simultaneously with variable number of subjobs. We proposed simple chromosome structure which is constituted by random key numbers in hybrid genetic-local search algorithm (GAspLA). Random key numbers are used frequently in genetic algorithms, but it creates additional difficulty when hybrid factors in local search are implemented. We developed algorithms that satisfy the adaptation of results of local search into the genetic algorithms with minimum relocation operation of genes' random key numbers. This is the second contribution of the paper. The third contribution of this paper is three developed new MIP models which are making splitting and scheduling simultaneously. The fourth contribution of this paper is implementation of the GAspLAMIP. This implementation let us verify the optimality of GAspLA for the studied combinations. The proposed methods are tested on a set of problems taken from the literature and the results validate the effectiveness of the proposed algorithms.

Treating pain on skin graft donor sites: Review and clinical recommendations.

PubMed

Sinha, Sarthak; Schreiner, Amanda J; Biernaskie, Jeff; Nickerson, Duncan; Gabriel, Vincent A

2017-11-01

Split-thickness skin grafting is the most common reconstructive procedure in managing burn injuries. Harvesting split-thickness skin creates a new partial thickness wound referred to as the donor site. Pain at the donor site is reported to be one of the most distressing symptoms during the early postoperative period. Here, we (a) identify strategies for managing donor site pain, (b) assess the quality of individual studies, and (c) formulate evidence-based recommendations based on the amount and consistency of evidence. Our analysis revealed five distinct approaches to minimize donor site pain. These include: continuous subcutaneous local anesthetic infusion (three studies), subcutaneous anesthetic injection (five studies), topical agents (six studies), nonpharmacological interventions (three studies), and wound dressings (18 studies). Available randomized control trials typically evaluated pain on standardized scales (i.e. Visual Analog Scale, Numerical Rating Scale), and compared the experimental group with standard care. Recommended treatments include: (a) subcutaneous anesthetic injection of adrenaline-lidocaine; (b) ice application; (c) topical agents, such as lidocaine and bupivacaine; and (d) hydrocolloid- and polyurethane-based wound dressings accompanied with fibrin sealant. Methodologically sound randomized control trials examining the efficacy of modified tumescent solution, ropivacaine, plasma therapy, noncontact ultrasound, and morphine gels are lacking and should be a priority for future research.

External apical root resorption in maxillary root-filled incisors after orthodontic treatment: A split-mouth design study

PubMed Central

Amarilla, Almudena; Espinar-Escalona, Eduardo; Castellanos-Cosano, Lizett; Martín-González, Jenifer; Sánchez-Domínguez, Benito; López-Frías, Francisco J.

2012-01-01

Introduction: The purpose of this study was to compare, in a split mouth design, the external apical root resorption (EARR) associated with orthodontic treatment in root-filled maxillary incisors and their contralateral teeth with vital pulps. Methodology: The study sample consisted of 38 patients (14 males and 24 females), who had one root-filled incisor before completion of multiband/bracket orthodontic therapy for at least 1 year. For each patient, digital panoramic radiographs taken before and after orthodontic treatment were used to determine the root resortion and the proportion of external root resorption (PRR), defined as the ratio between the root resorption in the endodontically treated incisor and that in its contralateral incisor with a vital pulp. The student’s t-test, chi-square test and logistic regression analysis were used to determine statistical significance. Results: There was no statistically significant difference (p > 0.05) between EARR in vital teeth (1.1 ± 1.0 mm) and endodontically treated incisors (1.1 ± 0.8 mm). Twenty-six patients (68.4%) showed greater resorption of the endodontically treated incisor than its homolog vital tooth (p > 0.05). The mean and standard deviation of PPR were 1.0 ± 0.2. Multivariate logistic regression suggested that PRR does not correlate with any of the variables analyzed. Conclusions: There was no significant difference in the amount or severity of external root resorption during orthodontic movement between root-filled incisors and their contralateral teeth with vital pulps. Key words:Endodontics, orthodontics, root canal treatment, root resorption. PMID:22143731

TRAP-Positive Multinucleated Giant Cells Are Foreign Body Giant Cells Rather Than Osteoclasts: Results From a Split-Mouth Study in Humans.

PubMed

Lorenz, Jonas; Kubesch, Alica; Korzinskas, Tadas; Barbeck, Mike; Landes, Constantin; Sader, Robert A; Kirkpatrick, Charles J; Ghanaati, Shahram

2015-12-01

This study compared the material-specific tissue response to the synthetic, hydroxyapatite-based bone substitute material NanoBone (NB) with that of the xenogeneic, bovine-based bone substitute material Bio-Oss (BO). The sinus cavities of 14 human patients were augmented with NB and BO in a split-mouth design. Six months after augmentation, bone biopsies were extracted for histological and histomorphometric investigation prior to dental implant insertion. The following were evaluated: the cellular inflammatory pattern, the induction of multinucleated giant cells, vascularization, the relative amounts of newly formed bone, connective tissue, and the remaining bone substitute material. NB granules were well integrated in the peri-implant tissue and were surrounded by newly formed bone tissue. Multinucleated giant cells were visible on the surfaces of the remaining granules. BO granules were integrated into the newly formed bone tissue, which originated from active osteoblasts on their surface. Histomorphometric analysis showed a significantly higher number of multinucleated giant cells and blood vessels in the NB group compared to the BO group. No statistical differences were observed in regard to connective tissue, remaining bone substitute, and newly formed bone. The results of this study highlight the different cellular reactions to synthetic and xenogeneic bone substitute materials. The significantly higher number of multinucleated giant cells within the NB implantation bed seems to have no effect on its biodegradation. Accordingly, the multinucleated giant cells observed within the NB implantation bed have characteristics more similar to those of foreign body giant cells than to those of osteoclasts.

Efficacy of low-level laser therapy for the treatment of burning mouth syndrome: a randomized, controlled trial

NASA Astrophysics Data System (ADS)

Spanemberg, Juliana Cassol; López, José López; de Figueiredo, Maria Antonia Zancanaro; Cherubini, Karen; Salum, Fernanda Gonçalves

2015-09-01

The aim of the present study was to assess the effect of low-level laser therapy (LLLT) in the treatment of burning mouth syndrome (BMS). A diode laser was used in 78 BMS patients who were randomly assigned into four groups: IR1W, n=20 (830 nm, 100 mW, 5 J, 176 J/cm2, 50 s, LLLT weekly sessions, 10 sessions); IR3W, n=20 (830 nm, 100 mW, 5 J, 176 J/cm2, 50 s, three LLLT weekly sessions, 9 sessions); red laser, n=19 (685 nm, 35 mW, 2 J, 72 J/cm2, 58 s, three LLLT weekly sessions, 9 sessions); and control-group (CG), n=19. Symptoms were assessed at the end of the treatment and eight weeks later; quality of life related to oral health was assessed using the Oral Health Impact Profile (OHIP-14). Statistical analysis was carried out using repeated measures analysis of variance followed by the posthoc Tukey test. There was significant reduction of the symptoms in all groups at the end of the treatment, which was maintained in the follow-up. The scores of the IR1W and IR3W laser groups differed significantly from those of the CG. There was also a decrease in the OHIP-14 scores in the four groups. The IR3W laser group scores differed significantly from those of the CG. LLLT reduces the symptoms of BMS and may be an alternative therapeutic strategy for the relief of symptoms in patients with BMS.

Systematic literature review: xerostomia in advanced cancer patients.

PubMed

Hanchanale, Sarika; Adkinson, Lucy; Daniel, Sunitha; Fleming, Michelle; Oxberry, Stephen G

2015-03-01

Dry mouth (xerostomia) is one of the commonest symptoms in cancer patients and can adversely affect quality of life. The aim of this review was to determine the effectiveness of pharmacological and non-pharmacological interventions in treating xerostomia in adult advanced cancer patients. The literature search was performed in February 2014 using databases including EMBASE, MEDLINE, CINAHL, BNI and Cochrane library. The search was carried out using standard MeSH terms and was limited to adult population and English language. Studies investigating xerostomia secondary to head and neck cancer treatment and autoimmune disease were excluded. Titles and abstracts were screened and reviewed for eligibility. Only studies involving primary research were included in the analysis. Six studies met the eligibility criteria for review: three randomized controlled trials and three prospective studies. The quality assessment and reporting was performed using PRISMA, Jadad and STROBE. These studies compared acupuncture, pilocarpine, Saliva Orthana and chewing gum with each other or with placebo. All interventions were considered effective in treating xerostomia. However, effectiveness versus placebo could not be demonstrated for Saliva Orthana. Meta-analysis could not be performed due to heterogeneity of the study type and intervention. Limited published data exists reporting the effectiveness of measures in the treatment of xerostomia in cancer patients. Based on primary research of low quality, firm conclusions cannot be drawn. However, pilocarpine, artificial saliva, chewing gum and acupuncture can be tried based on the available data. This highlights the explicit need to improve our evidence base. Properly constructed randomized controlled trials demonstrating effectiveness of pharmacological and non-pharmacological interventions for dry mouth are required.

A clinical investigation of the efficacy of a commercial mouthrinse containing 0.05% cetylpyridinium chloride to control established dental plaque and gingivitis.

PubMed

Silva, Milton Fernando de A; dos Santos, Natanael Barbosa; Stewart, Bernal; DeVizio, William; Proskin, Howard M

2009-01-01

The objective of this independent, double-blind, parallel, six-week clinical study was to assess the efficacy of a commercially available mouthrinse containing 0.05% cetylpyridinium chloride (CPC) for controlling established dental plaque and gingivitis relative to that of a control mouthrinse without CPC. Adult male and female subjects from the Maceió, Brazil area reported to the clinical facility, after having refrained from any oral hygiene procedures for 12 hours, and from eating, drinking, and smoking for four hours, for an assessment of the oral soft and hard tissues, and for a baseline gingivitis and dental plaque evaluation. Qualifying subjects were randomly assigned to one of the two treatment groups, and were provided with their assigned mouthrinse, and an adult soft-bristled toothbrush and toothpaste for home use. Over the six-week period of home use, during which there were no restrictions regarding diet or smoking habits, subjects were instructed to brush their teeth for one minute twice daily with the supplied toothbrush and a commercially available fluoride toothpaste, to rinse their mouths with water after brushing, and then to rinse with their assigned mouthrinse for one minute before expectorating. The use of any other oral hygiene products or procedures, such as floss or interdental stimulators, was not permitted during the study. After six weeks of product use, subjects returned to the clinical facility, having followed the same restrictions with respect to oral-hygiene procedures, eating and drinking, as with the baseline visit, and the oral soft and hard tissue assessments and gingivitis and dental plaque evaluations were repeated. One-hundred and ten subjects complied with the protocol and completed the study. With regard to supragingival plaque, after six weeks of product use, the subjects using the 0.05% CPC mouthrinse exhibited statistically significant reductions from baseline in whole-mouth Plaque Index scores (32.1%), in Plaque Index scores measured at interproximal sites (31.3%), and in Plaque Severity Index scores (84.8%). Subjects using the control mouthrinse exhibited statistically significant reductions from baseline in whole-mouth Plaque Index scores (7.0%), in Plaque Index scores measured at interproximal sites (6.4%), and in Plaque Severity Index scores (24.5%). When compared to the control mouthrinse group, the 0.05% CPC mouthrinse group presented statistically significant greater reductions in whole-mouth Plaque Index scores (27.9%), in Plaque Index scores measured at interproximal sites (27.9%), and in Plaque Severity Index scores (81.1%) after six weeks of product use. With regard to gingivitis, after six weeks of product use, subjects using the 0.05% CPC mouthrinse exhibited statistically significant reductions from baseline in whole-mouth Gingival Index scores (25.0%), in Gingival Index scores measured at interproximal sites (25.3%), and in Gingivitis Severity Index scores (42.4%). Subjects using the control mouthrinse exhibited statistically significant reductions from baseline in whole-mouth Gingival Index scores (6.5%), in Gingival Index scores measured at interproximal sites (5.5%), and in Gingivitis Severity Index scores (11.6%). When compared to the control mouthrinse group, the 0.05% CPC mouthrinse group presented statistically significant greater reductions in whole-mouth Gingival Index scores (19.8%), in Gingival Index scores measured at interproximal sites (20.7%), and in Gingivitis Severity Index scores (35.5%) after six weeks of product use. The results of this double-blind, parallel, six-week clinical study support the conclusion that a mouthrinse containing 0.05% CPC is efficacious for controlling established dental plaque and gingivitis. As measurements were conducted 12 hours after product use, the results also demonstrate that the 0.5% CPC mouthrinse provides 12-hour protection against plaque and gingivitis.

The effectiveness of computer reminders versus postal reminders for improving quality assessment for point-of-care testing in primary care: a randomized controlled trial.

PubMed

Siersma, Volkert; Kousgaard, Marius Brostrøm; Reventlow, Susanne; Ertmann, Ruth; Felding, Peter; Waldorff, Frans Boch

2015-02-01

This study aimed to evaluate the relative effectiveness of electronic and postal reminders for increasing adherence to the quality assurance programme for the international normalized ratio (INR) point-of-care testing (POCT) device in primary care. All 213 family practices that use the Elective Laboratory of the Capital Region, Denmark, and regularly conduct INR POCT were randomly allocated into two similarly sized groups. During the 4-month intervention, these practices were sent either computer reminders (ComRem) or computer-generated postal reminders (Postal) if they did not perform a split test to check the quality of their INR POCT for each calendar month. The adherence of the practices was tracked during the subsequent 8 months subdivided into two 4-month periods both without intervention. Outcomes were measures of split test procedure adherence. Both interventions were associated with an increase in adherence to the split test procedure - a factor 6.00 [95% confidence interval (CI) 4.46-7.72] and 8.22 [95% CI 5.87-11.52] for ComRem and Postal, respectively - but there is no evidence that one of the interventions was more effective than the other. In the ComRem group, the expected number of split tests (out of four) was 2.54 (95% CI 2.33-2.76) versus 2.44 (95% CI 2.24-2.65) in the Postal group, P = 0.14. There was a slight decrease in adherence over the two follow-ups, but neither intervention was better than the other in achieving a lasting improvement in adherence. Computer reminders are as efficient as postal reminders in increasing adherence to a quality assurance programme for the INR POCT device in primary care. © 2014 John Wiley & Sons, Ltd.

Topical Botulinum Toxin Type A Liposomal Cream for Primary Axillary Hyperhidrosis: A Double-Blind, Randomized, Split-Site, Vehicle-Controlled Study.

PubMed

Lueangarun, Suparuj; Sermsilp, Chairat; Tempark, Therdpong

2018-04-13

Despite its effectiveness in treating primary axillary hyperhidrosis (PAH), topical botulinum toxin type A (BTX-A) is highly resistant to transdermal absorption. Topical BTX-A liposomal cream is recommended as a novel, noninvasive modality to enhance skin penetration. To evaluate the efficacy and safety of topical BTX-A liposomal cream in comparison with liposomal vehicle cream alone in the treatment of PAH. A prospective, randomized, double-blinded, split-site study was conducted in 20 subjects, aged 18 to 50 years, all of whom had symmetrical axillary sweating with Hyperhidrosis Disease Severity Scale scores between 2 to 4. All subjects were double-blinded to treatment regimens and randomly given 2 bottles, one containing topical BTX-A liposomal cream and one containing the vehicle cream without BTX-A, to be applied consistently to the same axilla nightly for 7 consecutive days. Clinical improvement and adverse reactions were evaluated at every follow-up visit. Axillary skin treated with topical BTX-A demonstrated superior sweat reduction and patient satisfaction to vehicle cream-treated axillary skin, with clinical and statistical significance, at baseline, weeks 2, 4, 6, and 8 of follow-up, without adverse effects. Topical BTX-A liposomal cream pharmaceutically enhances drug delivery, is painless, cost-effective, and overall an innovative treatment of PAH.

Dental movement acceleration: Literature review by an alternative scientific evidence method

PubMed Central

Camacho, Angela Domínguez; Cujar, Sergio Andres Velásquez

2014-01-01

The aim of this study was to analyze the majority of publications using effective methods to speed up orthodontic treatment and determine which publications carry high evidence-based value. The literature published in Pubmed from 1984 to 2013 was reviewed, in addition to well-known reports that were not classified under this database. To facilitate evidence-based decision making, guidelines such as the Consolidation Standards of Reporting Trials, Preferred Reporting items for systematic Reviews and Meta-analyses, and Transparent Reporting of Evaluations with Non-randomized Designs check list were used. The studies were initially divided into three groups: local application of cell mediators, physical stimuli, and techniques that took advantage of the regional acceleration phenomena. The articles were classified according to their level of evidence using an alternative method for orthodontic scientific article classification. 1a: Systematic Reviews (SR) of randomized clinical trials (RCTs), 1b: Individual RCT, 2a: SR of cohort studies, 2b: Individual cohort study, controlled clinical trials and low quality RCT, 3a: SR of case-control studies, 3b: Individual case-control study, low quality cohort study and short time following split mouth designs. 4: Case-series, low quality case-control study and non-systematic review, and 5: Expert opinion. The highest level of evidence for each group was: (1) local application of cell mediators: the highest level of evidence corresponds to a 3B level in Prostaglandins and Vitamin D; (2) physical stimuli: vibratory forces and low level laser irradiation have evidence level 2b, Electrical current is classified as 3b evidence-based level, Pulsed Electromagnetic Field is placed on the 4th level on the evidence scale; and (3) regional acceleration phenomena related techniques: for corticotomy the majority of the reports belong to level 4. Piezocision, dentoalveolar distraction, alveocentesis, monocortical tooth dislocation and ligament distraction technique, only had case series or single report cases (4th level of evidence). Surgery first and periodontal distraction have 1 study at level 2b and corticision one report at level 5. Multiple orthodontic acceleration reports on humans were identified by an alternative evidence level scale, which is a simple and accurate way of determining which techniques are better and have a higher rate of effectiveness. The highest level of evidence for a specific procedure to accelerate orthodontic dental movement up to October 2013 was surgery first followed by low level laser application, corticotomy and periodontal distraction located on level 2, recommendation grade b from this proposed scientific evidence-based scale. PMID:25332914

A comparative clinical study of the efficacy of subepithelial connective tissue graft and acellular dermal matrix graft in root coverage: 6-month follow-up observation

PubMed Central

Thomas, Libby John; Emmadi, Pamela; Thyagarajan, Ramakrishnan; Namasivayam, Ambalavanan

2013-01-01

Aims: The purpose of this study was to compare the clinical efficacy of subepithelial connective tissue graft and acellular dermal matrix graft associated with coronally repositioned flap in the treatment of Miller's class I and II gingival recession, 6 months postoperatively. Settings and Design: Ten patients with bilateral Miller's class I or class II gingival recession were randomly divided into two groups using a split-mouth study design. Materials and Methods: Group I (10 sites) was treated with subepithelial connective tissue graft along with coronally repositioned flap and Group II (10 sites) treated with acellular dermal matrix graft along with coronally repositioned flap. Clinical parameters like recession height and width, probing pocket depth, clinical attachment level, and width of keratinized gingiva were evaluated at baseline, 90th day, and 180th day for both groups. The percentage of root coverage was calculated based on the comparison of the recession height from 0 to 180th day in both Groups I and II. Statistical Analysis Used: Intragroup parameters at different time points were measured using the Wilcoxon signed rank test and Mann–Whitney U test was employed to analyze the differences between test and control groups. Results: There was no statistically significant difference in recession height and width, gain in CAL, and increase in the width of keratinized gingiva between the two groups on the 180th day. Both procedures showed clinically and statistically significant root coverage (Group I 96%, Group II 89.1%) on the 180th day. Conclusions: The results indicate that coverage of denuded root with both subepithelial connective tissue autograft and acellular dermal matrix allograft are very predictable procedures, which were stable for 6 months postoperatively. PMID:24174728

Effect of Porous Titanium Granules on Bone Regeneration and Primary Stability in Maxillary Sinus: A Human Clinical, Histomorphometric, and Microcomputed Tomography Analyses.

PubMed

Dursun, Ceyda Kanli; Dursun, Erhan; Eratalay, Kenan; Orhan, Kaan; Tatar, Ilkan; Baris, Emre; Tözüm, Tolga Fikret

2016-03-01

The aim of this randomized controlled study was to comparatively analyze the new bone (NB), residual bone, and graft-bone association in bone biopsies retrieved from augmented maxillary sinus sites by histomorphometry and microcomputed tomography (MicroCT) in a split-mouth model to test the efficacy of porous titanium granules (PTG) in maxillary sinus augmentation. Fifteen patients were included in the study and each patient was treated with bilateral sinus augmentation procedure using xenograft (equine origine, granule size 1000-2000 μm) and xenograft (1 g) + PTG (granule size 700-1000 μm, pore size >50 μm) (1 g), respectively. After a mean of 8.4 months, 30 bone biopsies were retrieved from the implant sites for three-dimensional MicroCT and two-dimensional histomorphometric analyses. Bone volume and vital NB percentages were calculated. Immediate after core biopsy, implants having standard dimensions were placed and implant stability quotient values were recorded at baseline and 3 months follow-up. There were no significant differences between groups according to residual bone height, residual bone width, implant dimensions, and implant stability quotient values (baseline and 3 months). According to MicroCT and two-dimensional histomorphometric analyses, the volume of newly formed bone was 57.05% and 52.67%, and 56.5% and 55.08% for xenograft + PTG and xenograft groups, respectively. No statistically significant differences found between groups according to NB percentages and higher Hounsfield unit values were found for xenograft + PTG group. The findings of the current study supports that PTG, which is a porous, permanent nonresorbable bone substitute, may have a beneficial osteoconductive effect on mechanical strength of NB in augmented maxillary sinus.

Evaluation of efficacy of a bioresorbable membrane in the treatment of oral lichen planus

PubMed Central

Kapoor, Anoop; Sikri, Poonam; Grover, Vishakha; Malhotra, Ranjan; Sachdeva, Sonia

2014-01-01

Background: Gingival involvement is commonly seen in lichen planus, a chronic mucocutaneous inflammatory condition of the stratified squamous epithelia. It is often painful and may undergo malignant transformation and thus warrants early diagnosis and prompt treatment. The aim of this study is to evaluate the use of a bioresorbable membrane (Polyglactin 910) in the management of erosive lichen planus of gingiva. Materials and Methods: A split-mouth randomized controlled trial was carried out. Fifteen patients with identical bilateral lesions of lichen planus on gingiva were included in the study. Three parameters were selected for the clinical assessment of gingival lesions: Surface texture, color, and burning sensation. After complete oral prophylaxis, an excisional biopsy procedure was carried out for lesions on both sides, but on the experimental side, the biopsy procedure was combined with placement of the bioresorbable membrane. The statistical significance of intergroup differences in measurements was tested by using an independent sample t-test. A two-tailed P-value less than 0.05 was considered as statistically significant. Results: Intragroup comparisons revealed a statistically significant difference between mean value of grades at 6, 12, and 24 weeks in both groups for the surface texture, color, and burning sensation of gingiva, respectively. For intergroup comparison of change in surface texture, color, and burning sensation of gingiva between group A and group B, differences were statistically nonsignificant. Conclusion: Surgical management of the lesion accomplished significant improvement of lesion with no significant additional clinical benefits with the application of bioresorbable membrane. Worsening of baseline scores was not observed in any case at the end of the study. PMID:25097651

Local adjunct effect of antimicrobial photodynamic therapy for the treatment of chronic periodontitis in type 2 diabetics: split-mouth double-blind randomized controlled clinical trial.

PubMed

Castro Dos Santos, Nídia Cristina; Andere, Naira Maria Rebelatto Bechara; Araujo, Cássia Fernandes; de Marco, Andrea Carvalho; Dos Santos, Lúcio Murilo; Jardini, Maria Aparecida Neves; Santamaria, Mauro Pedrine

2016-11-01

Diabetes has become a global epidemic. Its complications can have a significant impact on quality of life, longevity, and public health costs. The presence of diabetes might impair the prognosis of periodontal treatments due to its negative influence on wound healing. Antimicrobial photodynamic therapy (aPDT) is a local approach that can promote bacterial decontamination in periodontal pockets. The aim of this study was to investigate the local effect of adjunct aPDT to ultrasonic periodontal debridement (UPD) and compare it to UD only for the treatment of chronic periodontitis in type 2 diabetic patients. Twenty type 2 diabetic patients with moderate to severe generalized chronic periodontitis were selected. Two periodontal pockets with probing depth (PD) and clinical attachment level (CAL) ≥5 mm received UPD only (UPD group) or UPD plus adjunct aPDT (UPD + aPDT group). Periodontal clinical measures were collected and compared at baseline and 30, 90, and 180 days. After 180 days of follow-up, there were statistically significant reductions in PD from 5.75 ± 0.91 to 3.47 ± 0.97 mm in the UPD group and from 6.15 ± 1.27 to 3.71 ± 1.63 mm in the UPD + aPDT group. However, intergroup analysis did not reveal statistically significant differences in any of the evaluated clinical parameters (p > 0.05). The adjunct application of aPDT to UPD did not present additional benefits for the treatment of chronic periodontitis in type 2 diabetic patients. The ClinicalTrials.gov identifier of the present study is NCT02627534.

Histological and Histometrical Evaluation of two Synthetic Hydroxyapatite Based Biomaterials in the Experimental Periodontal Defects in Dogs

PubMed Central

Paul, Jose; Palathingal, Plato; Varma, BRR; Bhat, Mahalinga; Mohanty, Mira

2014-01-01

Aim: The present study was to evaluate histologically and histometrically the efficacy of Chitra granules in the regeneration of alveolar bone and to compare it with that of OsteoGenR (HA Resorb)TM in iatrogenically created alveolar bone defects in mongrel dogs. Materials and Methods: Four dogs (16 sites) were used for this split-mouth study. The animals were divided randomly into two groups of two animals. Same animals were used as control and test. Each dog had four implantation sites. The periodontal defects were prepared by acute defect model. Animals were sacrificed at 3 months (n=2), 6 months (n=2) and histologic and histometric evaluation was carried out. Statistical Analysis: The data was analysed using statistical package Graph pad Software. Comparison of the hard and soft tissue parameters in the two groups was done using the Wilcoxan (Man Whitney), two tailed t-test. A p-value less than 0.05 were considered significant. Results: Maturing bone with immature periodontal ligament fibers were observed at three months and advanced osteogenesis at six months with both the types of bone graft materials. The mean values showed that amount of new bone formed with OsteoGenR (HA Resorb)TM was slightly more than that obtained by Chitra granules in histometric evaluation. Conclusion: Histological study showed similar healing pattern with both the types of bone graft materials with maturing bone at 3 months and advanced osteogenesis at six months in experimental intraosseous periodontal defects in dogs. However, histological evaluation for longer period is necessary to determine the time taken for complete replacement of the bone graft materials with new bone. PMID:25386523

Efficacy of curcumin in the treatment for oral submucous fibrosis - A randomized clinical trial

PubMed Central

Hazarey, Vinay K; Sakrikar, Aditee R; Ganvir, Sindhu M

2015-01-01

Introduction: Oral submucous fibrosis (OSF) is a chronic, insidious disease that is associated with significant functional morbidity and an increased risk for malignancy. Turmeric and its active ingredient “curcumin” are being studied upon as chemopreventive agents in various diseases. The present study aims to determine the efficacy of curcumin in the treatment of OSF. Materials and Methods: Thirty clinically diagnosed OSF patients were divided into two groups, 15 patients in each group from the Outpatient Department. Test group patients were treated with Longvida (curcumin) lozenges and control group with Tenovate ointment (clobetasol propionate (0.05%). The treatment was given for 3 months duration and follow-up was done for 6 months. Both the groups were advised for physiotherapy exercises by mouth exercise device. The baseline and follow-up results were compared for IIO (interincisal distance on maximum mouth opening), Visual Analogue Scale (VAS) for normal food and VAS for spicy food. Results: The test group showed 5.93 (±2.37) mm increase in mouth opening compared to 2.66 (±1.76) mm of the control group. In relation to VAS scale with spicy and normal food the average reduction was 64 (42–73) and 77 (70.5–82) as compared to 34 (14.5–64.5) and 64 (46–75.5) respectively in control group. The test group results achieved in the treatment span was sustained in the follow-up (P < 0.05) compared to control group which showed statistically significant (P < 0.05) relapse. Conclusion: It can be concluded that combination strategies for the management of OSF which include the stoppage of causative ill habits, appropriate medicinal and physiotherapy management is more efficient than single therapeutic modality. It is evident from the study that curcumin holds good promise in the treatment of OSF in future. PMID:26604488

Efficacy of lycopene in the treatment of gingivitis: a randomised, placebo-controlled clinical trial.

PubMed

Chandra, Rampalli Viswa; Prabhuji, M L Venkatesh; Roopa, D Adinarayana; Ravirajan, Sandhya; Kishore, Hadal C

2007-01-01

The aim of the present study was to compare the effect of systemically administered lycopene (LycoRed) as a monotherapy and as an adjunct to scaling and root planing in gingivitis patients. Twenty systemically healthy patients showing clinical signs of gingivitis were involved in a randomised, double-blind, parallel, split-mouth study. The subjects were randomly distributed between the two treatment groups: experimental group (n = 10), 8 mg lycopene/day for 2 weeks; and controls (n = 10), placebo for 2 weeks. Quadrant allocation within each group was randomised with two quadrants treated with oral prophylaxis (OP) and two quadrants not receiving any form of treatment (non-OP). Bleeding index (SBI) and non-invasive measures of plaque (PI) and gingivitis (GI) were assessed at baseline, 1 and 2 weeks. Salivary uric acid levels were also measured. All the treatment groups demonstrated statistically significant reductions in the GI, SBI and PI. Treatment with OP-lycopene resulted in a statistically significant decrease in GI when compared with OP-placebo (p < 0.05) and non-OP-placebo (p < 0.01). Treatment with non-OP-lycopene resulted in a statistically significant decrease in GI when compared with non-OP-placebo (p < 0.01). The OP-lycopene group showed a statistically significant reduction in SBI values when compared with the non-OP-lycopene group (p < 0.05) and the non-OP-placebo group (p < 0.001). There was a strong negative correlation between the salivary uric acid levels and the percentage reduction in GI at 1 and 2 weeks in the OP-lycopene group (r = -0.852 and -0.802 respectively) and in the non-OP-lycopene group (r = -0.640 and -0.580 respectively). The results presented in this study suggest that lycopene shows great promise as a treatment modality in gingivitis. The possibility of obtaining an additive effect by combining routine oral prophylaxis with lycopene is also an exciting possibility, which deserves further study.

How do schizophrenia patients use visual information to decode facial emotion?

PubMed

Lee, Junghee; Gosselin, Frédéric; Wynn, Jonathan K; Green, Michael F

2011-09-01

Impairment in recognizing facial emotions is a prominent feature of schizophrenia patients, but the underlying mechanism of this impairment remains unclear. This study investigated the specific aspects of visual information that are critical for schizophrenia patients to recognize emotional expression. Using the Bubbles technique, we probed the use of visual information during a facial emotion discrimination task (fear vs. happy) in 21 schizophrenia patients and 17 healthy controls. Visual information was sampled through randomly located Gaussian apertures (or "bubbles") at 5 spatial frequency scales. Online calibration of the amount of face exposed through bubbles was used to ensure 75% overall accuracy for each subject. Least-square multiple linear regression analyses between sampled information and accuracy were performed to identify critical visual information that was used to identify emotional expression. To accurately identify emotional expression, schizophrenia patients required more exposure of facial areas (i.e., more bubbles) compared with healthy controls. To identify fearful faces, schizophrenia patients relied less on bilateral eye regions at high-spatial frequency compared with healthy controls. For identification of happy faces, schizophrenia patients relied on the mouth and eye regions; healthy controls did not utilize eyes and used the mouth much less than patients did. Schizophrenia patients needed more facial information to recognize emotional expression of faces. In addition, patients differed from controls in their use of high-spatial frequency information from eye regions to identify fearful faces. This study provides direct evidence that schizophrenia patients employ an atypical strategy of using visual information to recognize emotional faces.

Development of Understory Vegetation in Pine and Pine-Hardwood Shelterwood Stands in the Ouachita Mountains-the First 3 Years

Treesearch

Michael G. Shelton

1997-01-01

The shelterwood reproduction cutting method using two overstory compositions (a pine basal area of 30 ft* per acre with and without 15 ft’ per acre of hardwoods) and two methods of submerchantable hardwood control (chain-saw felling with and without stump-applied herbicide) was tested in a 2x2 factorial, split-plot design with four randomized complete blocks....

Nano-hydroxyapatite and calcium-enriched mixture for pulp capping of sound primary teeth: a randomized clinical trial.

PubMed

Haghgoo, Roza; Asgary, Saeed; Mashhadi Abbas, Fatemeh; Montazeri Hedeshi, Roshanak

2015-01-01

Nano-hydroxyapatite (NHA) has been used for regeneration of osseous defects. Calcium-enriched mixture (CEM) cement is also used for various dental treatments. This trial compared the efficacy of NHA and CEM cement for direct pulp capping (DPC) of sound primary teeth. In this randomized clinical trial with split-mouth design, after attaining informed consent, 20 sound primary canines scheduled for orthodontic extraction, were selected. After mechanical pulp exposure, the exposed site was capped with either NHA or CEM cement and then immediately restored with glass-ionomer and resin composite. The teeth were extracted after two months and examined histologically. Parameters of hard tissue bridge (HTB) formation, its type and quality as well as pulpal inflammation scores were compared between the two experimental groups. The data were analyzed using the Mann Whitney U and Fisher's exact test. The level of significance was set at 0.001. All CEM specimens showed inflammation score of 0 (less than 10%). However, in NHA group, inflammation scores of 0 (less than 10%), 1 (10%-30%) and 2 (30%-50%) were observed in 2 (20%), 4 (40%) and 4 (40%) specimens, respectively (P<0.001). HTB was formed in all CEM specimens while it was developed in 2 specimens of NHA (20%; P<0.001). All CEM specimens showed normal pulp; only two cases in NHA group (20%) demonstrated uninflamed normal pulp. CEM cement was superior to NHA as a DPC agent in terms of HTB formation and pulp inflammation scores. It is a suitable material for the DPC of primary teeth.

Clinical evaluation of fiber-reinforced composite crowns in pulp-treated primary molars: 12-month results

PubMed Central

Mohammadzadeh, Zahra; Parisay, Iman; Mehrabkhani, Maryam; Madani, Azam Sadat; Mazhari, Fatemeh

2016-01-01

Objective: The aim of this study was to evaluate the clinical performance of tooth-colored fiber-reinforced composite (FRC) crowns in pulp-treated second primary mandibular teeth. Materials and Methods: This split-mouth randomized, clinical trial performed on 67 children between 3 and 6 years with two primary mandibular second molars requiring pulp treatment. After pulp therapy, the teeth were randomly assigned to stainless steel crown (SSC) or FRC crown groups. Modified United States Public Health Service criteria were used to evaluate marginal integrity, marginal discoloration, and secondary caries in FRC crowns at intervals of 3, 6, and 12 months. Retention rate and gingival health were also compared between the two groups. The data were analyzed using Friedman, Cochran, and McNemar's tests at a significance level of 0.05. Results: Intact marginal integrity in FRC crowns at 3, 6, and 12 months were 93.2%, 94.8%, and 94.2%, respectively. Marginal discoloration and secondary caries were not found at any of the FRC crowns. The retention rates of the FRC crowns were 100%, 98.3%, and 89.7% at 3, 6 and 12 months, respectively, whereas all the SSCs were found to be present and intact after 12 months (P = 0.016). There was no statistically significant difference between the two groups in gingival health. Conclusion: According to the results of this study, it seems that when esthetics is a concern, in cooperative patients with good oral hygiene, FRC crowns can be considered as a valuable procedure. PMID:28042269

Clinical Comparison: Fast-Acting and Traditional Topical Dental Anesthetic

PubMed Central

DiMarco, Arthur C.; Wetmore, Ann O'Kelley

2016-01-01

A randomized, nonblinded clinical trial compared the effectiveness of an application method of a fast-acting refrigerant topical agent to a 20% benzocaine gel topical. In a split-mouth design, right and left anterior middle superior alveolar injections (N = 30) were administered with a 27-gauge needle at least 24 hours apart with preinjection topicals. Using a cotton-tipped applicator, a refrigerant topical was applied for 5 seconds and 20% benzocaine gel for 2 minutes on opposite sides at 2 separate appointments. Subjects self-reported pain perception after each injection using a visual analog scale (VAS). The mean VAS ratings demonstrated no significant difference between the 5-second application of the refrigerant (M = 16.2, SD = 17.7) and the 2-minute application of 20% benzocaine topical gel anesthetic (M = 17.9, SD = 18.2). Fifty-seven percent of the subjects reported greater pain reduction with the refrigerant, 33% reported greater pain reduction with 20% benzocaine, and 10% reported no difference. Results suggest the described method of application of a refrigerant as an oral topical anesthetic has a faster onset and provides similar benefit in pain reduction compared with 20% benzocaine gel. The refrigerant was easy to accomplish and well received by subjects, indicating potential for routine use in dentistry. PMID:27269661

Clinical Comparison: Fast-Acting and Traditional Topical Dental Anesthetic.

PubMed

DiMarco, Arthur C; Wetmore, Ann O'Kelley

2016-01-01

A randomized, nonblinded clinical trial compared the effectiveness of an application method of a fast-acting refrigerant topical agent to a 20% benzocaine gel topical. In a split-mouth design, right and left anterior middle superior alveolar injections (N = 30) were administered with a 27-gauge needle at least 24 hours apart with preinjection topicals. Using a cotton-tipped applicator, a refrigerant topical was applied for 5 seconds and 20% benzocaine gel for 2 minutes on opposite sides at 2 separate appointments. Subjects self-reported pain perception after each injection using a visual analog scale (VAS). The mean VAS ratings demonstrated no significant difference between the 5-second application of the refrigerant (M = 16.2, SD = 17.7) and the 2-minute application of 20% benzocaine topical gel anesthetic (M = 17.9, SD = 18.2). Fifty-seven percent of the subjects reported greater pain reduction with the refrigerant, 33% reported greater pain reduction with 20% benzocaine, and 10% reported no difference. Results suggest the described method of application of a refrigerant as an oral topical anesthetic has a faster onset and provides similar benefit in pain reduction compared with 20% benzocaine gel. The refrigerant was easy to accomplish and well received by subjects, indicating potential for routine use in dentistry.

Atraumatic restorative treatment (ART): a three-year clinical study in Malawi--comparison of conventional amalgam and ART restorations.

PubMed

Kalf-Scholte, Sonja M; van Amerongen, Willem E; Smith, Albert J E; van Haastrecht, Harry J A

2003-01-01

This study compares the quality of class I restorations made with the atraumatic restorative treatment (ART) technique and conventional class I amalgam restorations. The study was carried out among secondary school students in Mzuzu, Malawi. First-year students in 1987 who needed at least two class I restorations were selected. Based on a split-mouth design, each participant received both ART and conventional restorations. The 89 pairs of class I cavities were divided randomly into two groups, since two different cermet ionomer cement (CIC) filling materials were used. Impressions of the restorations and subsequent models were made shortly after restoration, after six months, one year, two years, and three years. The quality of the restorations was determined on the models following the US Public Health Service criteria. Bulk fracture, contour, marginal integrity, and surface texture of the restorations were recorded and evaluated separately. Survival rates were determined by the resultant score of all criteria. Though conventional amalgam restorations performed better on all criteria, this difference was significant only for the contour criterion. The survival rates of ART restorations after three years (81.0%) were lower than those of amalgam restorations (90.4%) (P=.067). The quality of ART class I restorations is competitive with that of conventional amalgam restorations.

Plaque retention by self-ligating vs elastomeric orthodontic brackets: quantitative comparison of oral bacteria and detection with adenosine triphosphate-driven bioluminescence.

PubMed

Pellegrini, Peter; Sauerwein, Rebecca; Finlayson, Tyler; McLeod, Jennifer; Covell, David A; Maier, Tom; Machida, Curtis A

2009-04-01

Enamel decalcification is a common problem in orthodontics. The objectives of this randomized clinical study were to enumerate and compare plaque bacteria surrounding 2 bracket types, self-ligating (SL) vs elastomeric ligating (E), and to determine whether adenosine triphosphate (ATP)-driven bioluminescence could be used for rapid assessment of bacterial load in plaque. Patients (ages, 11-17 years) were bonded with SL and E brackets in 14 maxillary and 12 mandibular arches by using a split-mouth design. Recall visits were at 1 and 5 weeks after bonding. Plaque specimens were assayed for oral bacteria and subjected to ATP-driven bioluminescence determinations with a luciferin-based assay. In most patients, teeth bonded with SL attachments had fewer bacteria in plaque than did teeth bonded with E brackets. At 1 and 5 weeks after bonding, the means for SL vs E brackets were statistically lower for total bacteria and oral streptococci (P <0.05). ATP bioluminescence values were statistically correlated to the total oral bacteria and oral streptococci, with correlation coefficients of 0.895 and 0.843, respectively. SL appliances promote reduced retention of oral bacteria, and ATP bioluminescence might be a useful tool in the rapid quantification of bacterial load and the assessment of oral hygiene during orthodontic treatment.

A laser-powered hydrokinetic system for caries removal and cavity preparation.

PubMed

Hadley, J; Young, D A; Eversole, L R; Gornbein, J A

2000-06-01

Laser systems have been developed for the cutting of dental hard tissues. The erbium, chromium:yttrium-scandium-gallium-garnet, or Er,Cr:YSGG, laser system used in conjunction with an air-water spray has been shown to be efficacious in vitro for cavity preparation. The authors randomly selected subjects for cavity preparation with conventional air turbine/bur dental surgery or an Er,Cr:YSGG laser-powered system using a split-mouth design. They prepared Class I, III and V cavities, placed resin restorations and evaluated subjects on the day of the procedure and 30 days and six months postoperatively for pulp vitality, recurrent caries, pain and discomfort, and restoration retention. Sixty-seven subjects completed the study. There were no statistical differences between the two treatment groups for the parameters measured with one exception; there was a statistically significant decrease in discomfort levels for the laser system at the time of cavity preparation for subjects who declined to receive local anesthetic. The Er,Cr:YSGG laser system is effective for preparation of Class I, III and V cavities and resin restorations are retained by lased tooth surfaces. Hard-tissue cutting lasers are being introduced for use in operative dentistry. In this study, an Er,Cr:YSGG laser has been shown to be effective for cavity preparation and restoration replacement.

A double-blind study on clonazepam in patients with burning mouth syndrome.

PubMed

Heckmann, Siegfried M; Kirchner, Elena; Grushka, Miriam; Wichmann, Manfred G; Hummel, Thomas

2012-04-01

In the treatment of burning mouth syndrome (BMS), various approaches have been tried with equivocal results. The aim of the present randomized clinical trial was to determine the efficacy of clonazepam, a GABA agonist designed as an antiepileptic drug that exerts the typical effects of benzodiazepines. Randomized clinical trial. Twenty patients with idiopathic BMS were carefully selected. Clonazepam (0.5 mg/day, n = 10) or placebo (lactose, n = 10) were randomly assigned to the patients. Patients on clonazepam significantly improved in pain ratings (P < .001). These changes were less pronounced in the placebo group (P < .11). No significant changes were observed in a mood scale (P = .56) or for depression scores (P = .56). Taste test and salivary flow increased over sessions, but were not different between groups (P = .83 and P = .06, respectively). Clonazepam appears to have a positive effect on pain in BMS patients. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

Impact of rheumatic diseases on oral health and quality of life.

PubMed

Ahola, K; Saarinen, A; Kuuliala, A; Leirisalo-Repo, M; Murtomaa, H; Meurman, J H

2015-04-01

We investigated the effects of rheumatic diseases on oral symptoms, health habits, and quality of life in subjects with and without rheumatic diseases. The hypothesis was that patients with rheumatic diseases have more oral symptoms impairing their quality of life than healthy controls. A questionnaire was mailed to a random sample of 1500 members of the Finnish Rheumatism Association, including those with and without rheumatic diseases. We focused on symptoms of the mouth and temporomandibular area, and health habits. Oral Health Impact Profile (OHIP14) was used to evaluate the oral health-related quality of life. We analyzed differences between subjects with and without rheumatic diseases, controlled for age, gender, smoking, and non-rheumatic chronic diseases. Completed questionnaires were received from 995 participants (response rate 66%). Of them, 564 reported rheumatic disease, 431 were used as controls. The patients reported significantly more all orofacial symptoms than controls. Severe dry mouth was reported by 19.6% of patients and 2.9% of controls (P < 0.001), and temporomandibular joint symptoms by 59.2% and 27.2% (P < 0.001), respectively. In the OHIP-14 questionnaire, the mean total score was significantly higher in patients (8.80 ± 11.15) than in controls (3.93 ± 6.60; P < 0.001). The study hypothesis was confirmed by showing that the patients with rheumatic diseases reported oral discomfort and reduced quality of life more often when compared with controls. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Preparation of laser micropore porcine acellular dermal matrix for skin graft: an experimental study.

PubMed

Chai, Jia-Ke; Liang, Li-Ming; Yang, Hong-Ming; Feng, Rui; Yin, Hui-Nan; Li, Feng-Yu; Sheng, Zhi-Yong

2007-09-01

In our previous study, we used composite grafts consisting of meshed porcine acellular dermal matrix (PADM) and thin split-thickness autologous epidermis to cover full thickness burn wounds in clinical practice. However, a certain degree of contraction might occur because the distribution of dermal matrix was not uniform in burn wound. In this study, we prepare a composite skin graft consisting of PADM with the aid of laser to improve the quality of healing of burn wound. PADM was prepared by the trypsin/Triton X-100 method. Micropores were produced on the PADM with a laser punch. The distance between micropores varied from 0.8, 1.0, 1.2 to 1.5mm. Full thickness defect wounds were created on the back of 144 SD rats. The rats were randomly divided into six groups: micropore groups I-IV in which the wound were grafted with PADM with micropores, in four different distances, respectively and split-thickness autograft; mesh group rats received meshed PADM graft and split-thickness autograft; control group received simple split-thickness autografting. The status of wound healing was histologically observed at regular time points after surgery. The wound healing rate and contraction rate were calculated. The wound healing rate in micropore groups I and II was not statistically different from that in control group, but was significantly higher than that in mesh group 6 weeks after grafting. The wound healing rate in micropore groups III and IV was lower than that in mesh and control groups 4 and 6 weeks after grafting. The wound contraction rate in micropore groups I and II was remarkably lower than that in control group 4 and 6 weeks after surgery and it was significantly much lower than that in mesh group 6 weeks after surgery. Histological examination revealed good epithelization, regularly arranged collagenous fibers and integral structure of basement membrane. Laser micropore PADM (0.8 or 1.0mm in distance) grafting in combination with split-thickness autografting can improve wound healing. The PADM with laser micropores in 1.0mm distance is the better choice.

Burning Mouth Syndrome: A Review of the Etiopathologic Factors and Management.

PubMed

Vellappally, Sajith

2016-02-01

Burning mouth syndrome (BMS) is characterized by pain in the mouth with or with no inflammatory signs and no specific lesions. Synonyms found in literature include glossodynia, oral dysesthesia, glossopyrosis, glossalgia, stomatopyrosis, and stomatodynia. Burning mouth syndrome generally presents as a triad: Mouth pain, alteration in taste, and altered salivation, in the absence of visible mucosal lesions in the mouth. The syndrome generally manifests spontaneously, and the discomfort is typically of a continuous nature but increases in intensity during evening and at night. The etiopathogenesis seems to be complex and in a large number of patients probably involves interactions among local, systemic, and/or psychogenic factors. The differential diagnosis requires the exclusion of oral mucosal lesions or blood test alterations that can produce burning mouth sensation. Management is always based on the etiological agents involved. If burning persists after local or systemic conditions are treated, then treatment is aimed at controlling neuropathic symptoms. Treatment of BMS is still unsatisfactory, and there is no definitive cure. As a result, a multidisciplinary approach is required to bring the condition under better control. The aim of this review was to discuss several aspects of BMS, update current knowledge, and provide guidelines for patient management.

Is there an association between flow diverter fish mouthing and delayed-type hypersensitivity to metals?-a case-control study.

PubMed

Kocer, Naci; Mondel, Prabath Kumar; Yamac, Elif; Kavak, Ayse; Kizilkilic, Osman; Islak, Civan

2017-11-01

Flow diverters are increasingly used in the treatment of complex and giant intracranial aneurysms. However, they are associated with complications like late aneurysmal rupture. Additionally, flow diverters show focal structural decrease in luminal diameter without any intimal hyperplasia. This resembles a "fish mouth" when viewed en face. In this pilot study, we tested the hypothesis of a possible association between flow diverter fish-mouthing and delayed-type hypersensitivity to its metal constituents. We retrospectively reviewed patient records from our center between May 2010 and November 2015. A total of nine patients had flow diverter fish mouthing. A control group of 25 patients was selected. All study participants underwent prospective patch test to detect hypersensitivity to flow diverter metal constituents. Analysis was performed using logistic regression analysis and Wilcoxon sign rank sum test. Univariate and multivariate analyses were performed to test variables to predict flow diverter fish mouthing. The association between flow diverter fish mouthing and positive patch test was not statistically significant. In multivariate analysis, history of allergy and maximum aneurysm size category was associated with flow diverter fish mouthing. This was further confirmed on Wilcoxon sign rank sum test. The study showed statistically significant association between flow diverter fish mouthing and history of contact allergy and a small aneurysmal size. Further large-scale studies are needed to detect a statistically significant association between flow diverter fish mouthing and patch test. We recommend early and more frequent follow-up imaging in patients with contact allergy to detect flow diverter fish mouthing and its subsequent evolution.

MIP Models and Hybrid Algorithms for Simultaneous Job Splitting and Scheduling on Unrelated Parallel Machines

PubMed Central

Ozmutlu, H. Cenk

2014-01-01

We developed mixed integer programming (MIP) models and hybrid genetic-local search algorithms for the scheduling problem of unrelated parallel machines with job sequence and machine-dependent setup times and with job splitting property. The first contribution of this paper is to introduce novel algorithms which make splitting and scheduling simultaneously with variable number of subjobs. We proposed simple chromosome structure which is constituted by random key numbers in hybrid genetic-local search algorithm (GAspLA). Random key numbers are used frequently in genetic algorithms, but it creates additional difficulty when hybrid factors in local search are implemented. We developed algorithms that satisfy the adaptation of results of local search into the genetic algorithms with minimum relocation operation of genes' random key numbers. This is the second contribution of the paper. The third contribution of this paper is three developed new MIP models which are making splitting and scheduling simultaneously. The fourth contribution of this paper is implementation of the GAspLAMIP. This implementation let us verify the optimality of GAspLA for the studied combinations. The proposed methods are tested on a set of problems taken from the literature and the results validate the effectiveness of the proposed algorithms. PMID:24977204

Selective attention to a facial feature with and without facial context: an ERP-study.

PubMed

Wijers, A A; Van Besouw, N J P; Mulder, G

2002-04-01

The present experiment addressed the question whether selectively attending to a facial feature (mouth shape) would benefit from the presence of a correct facial context. Subjects attended selectively to one of two possible mouth shapes belonging to photographs of a face with a happy or sad expression, respectively. These mouths were presented randomly either in isolation, embedded in the original photos, or in an exchanged facial context. The ERP effect of attending mouth shape was a lateral posterior negativity, anterior positivity with an onset latency of 160-200 ms; this effect was completely unaffected by the type of facial context. When the mouth shape and the facial context conflicted, this resulted in a medial parieto-occipital positivity with an onset latency of 180 ms, independent of the relevance of the mouth shape. Finally, there was a late (onset at approx. 400 ms) expression (happy vs. sad) effect, which was strongly lateralized to the right posterior hemisphere and was most prominent for attended stimuli in the correct facial context. For the isolated mouth stimuli, a similarly distributed expression effect was observed at an earlier latency range (180-240 ms). These data suggest the existence of separate, independent and neuroanatomically segregated processors engaged in the selective processing of facial features and the detection of contextual congruence and emotional expression of face stimuli. The data do not support that early selective attention processes benefit from top-down constraints provided by the correct facial context.

The statistical pitfalls of the partially randomized preference design in non-blinded trials of psychological interventions.

PubMed

Gemmell, Isla; Dunn, Graham

2011-03-01

In a partially randomized preference trial (PRPT) patients with no treatment preference are allocated to groups at random, but those who express a preference receive the treatment of their choice. It has been suggested that the design can improve the external and internal validity of trials. We used computer simulation to illustrate the impact that an unmeasured confounder could have on the results and conclusions drawn from a PRPT. We generated 4000 observations ("patients") that reflected the distribution of the Beck Depression Index (DBI) in trials of depression. Half were randomly assigned to a randomized controlled trial (RCT) design and half were assigned to a PRPT design. In the RCT, "patients" were evenly split between treatment and control groups; whereas in the preference arm, to reflect patient choice, 87.5% of patients were allocated to the experimental treatment and 12.5% to the control. Unadjusted analyses of the PRPT data consistently overestimated the treatment effect and its standard error. This lead to Type I errors when the true treatment effect was small and Type II errors when the confounder effect was large. The PRPT design is not recommended as a method of establishing an unbiased estimate of treatment effect due to the potential influence of unmeasured confounders. Copyright © 2011 John Wiley & Sons, Ltd.

The role of dental implant abutment design on the aesthetic outcome: preliminary 3-month post-loading results from a multicentre split-mouth randomised controlled trial comparing two different abutment designs.

PubMed

Esposito, Marco; Cardaropoli, Daniele; Gobbato, Luca; Scutellà, Fabio; Fabianelli, Andrea; Mascellani, Saverio; Delli Ficorelli, Gianluca; Mazzocco, Fabio; Sbricoli, Luca; Trullenque-Eriksson, Anna

To evaluate whether there are aesthetic and clinical benefits to using a newly designed abutment (Curvomax), over a conventional control abutment (GingiHue). A total of 49 patients, who required at least two implants, had two sites randomised according to a split-mouth design to receive one abutment of each type at seven different centres. The time of loading (immediate, early or delayed) and of prosthesis (provisional crowns of fixed prosthesis) was decided by the clinicians, but they had to restore both implants in a similar way. Provisional prostheses were replaced by definitive ones 3 months after initial loading, when the follow-up for the initial part of this study was completed. Outcome measures were: prosthesis failures, implant failures, complications, pink esthetic score (PES), peri-implant marginal bone level changes, and patient preference. In total, 49 Curvomax and 49 GingiHue abutments were delivered. Two patients dropped out. No implant failure, prosthesis failure or complication was reported. There were no differences at 3 months post-loading for PES (difference = -0.15, 95% CI -0.55 to 0.25; P (paired t test) = 0.443) and marginal bone level changes (difference = -0.02 mm, 95% CI -0.20 to 0.16; P (paired t test) = 0.817). The majority of the patients (30) had no preference regarding the two abutment designs; 11 patients preferred the Curvomax, while five patients preferred the GingiHue abutments (P (McNemar test) = 0.210). The preliminary results of the comparison between two different abutment designs did not disclose any statistically significant differences between the evaluated abutments. However the large number of missing radiographs and clinical pictures casts doubt on the reliability of the results. Longer follow-ups of wider patient populations are needed to better understand whether there is an effective advantage with one of the two abutment designs. Conflict of interest statement: This research project was originally partially funded by Biomax (Andover, MA, USA), the manufacturer of the Curvomax abutments evaluated in this investigation. Biomax, under pressure from some investigators, asked to modify the original agreed protocol. In a following phase, Zimmer-Biomet (Palm Beach Gardens, Florida, USA), the manufacturer of the implants and the GingiHue abutments, took over the funding of this project. Data belonged to the authors and the sponsors did not interfere with the publication of results.

Adhesives for fixed orthodontic bands.

PubMed

Millett, Declan T; Glenny, Anne-Marie; Mattick, Rye Cr; Hickman, Joy; Mandall, Nicky A

2016-10-25

Orthodontic treatment involves using fixed or removable appliances (dental braces) to correct the positions of teeth. It has been shown that the quality of treatment result obtained with fixed appliances is much better than with removable appliances. Fixed appliances are, therefore, favoured by most orthodontists for treatment. The success of a fixed orthodontic appliance depends on the metal attachments (brackets and bands) being attached securely to the teeth so that they do not become loose during treatment. Brackets are usually attached to the front and side teeth, whereas bands (metal rings that go round the teeth) are more commonly used on the back teeth (molars). A number of adhesives are available to attach bands to teeth and it is important to understand which group of adhesives bond most reliably, as well as reducing or preventing dental decay during the treatment period. To evaluate the effectiveness of the adhesives used to attach bands to teeth during fixed appliance treatment, in terms of:(1) how often the bands come off during treatment; and(2) whether they protect the banded teeth against decay during fixed appliance treatment. The following electronic databases were searched: Cochrane Oral Health's Trials Register (searched 2 June 2016), Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 5) in the Cochrane Library (searched 2 June 2016), MEDLINE Ovid (1946 to 2 June 2016) and EMBASE Ovid (1980 to 2 June 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. Randomised and controlled clinical trials (RCTs and CCTs) (including split-mouth studies) of adhesives used to attach orthodontic bands to molar teeth were selected. Patients with full arch fixed orthodontic appliance(s) who had bands attached to molars were included. All review authors were involved in study selection, validity assessment and data extraction without blinding to the authors, adhesives used or results obtained. All disagreements were resolved by discussion. Five RCTs and three CCTs were identified as meeting the review's inclusion criteria. All the included trials were of split-mouth design. Four trials compared chemically cured zinc phosphate and chemically cured glass ionomer; three trials compared chemically cured glass ionomer cement with light cured compomer; one trial compared chemically cured glass ionomer with a chemically cured glass phosphonate. Data analysis was often inappropriate within the studies meeting the inclusion criteria. There is insufficient high quality evidence with regard to the most effective adhesive for attaching orthodontic bands to molar teeth. Further RCTs are required.

"Look who's talking!" Gaze Patterns for Implicit and Explicit Audio-Visual Speech Synchrony Detection in Children With High-Functioning Autism.

PubMed

Grossman, Ruth B; Steinhart, Erin; Mitchell, Teresa; McIlvane, William

2015-06-01

Conversation requires integration of information from faces and voices to fully understand the speaker's message. To detect auditory-visual asynchrony of speech, listeners must integrate visual movements of the face, particularly the mouth, with auditory speech information. Individuals with autism spectrum disorder may be less successful at such multisensory integration, despite their demonstrated preference for looking at the mouth region of a speaker. We showed participants (individuals with and without high-functioning autism (HFA) aged 8-19) a split-screen video of two identical individuals speaking side by side. Only one of the speakers was in synchrony with the corresponding audio track and synchrony switched between the two speakers every few seconds. Participants were asked to watch the video without further instructions (implicit condition) or to specifically watch the in-synch speaker (explicit condition). We recorded which part of the screen and face their eyes targeted. Both groups looked at the in-synch video significantly more with explicit instructions. However, participants with HFA looked at the in-synch video less than typically developing (TD) peers and did not increase their gaze time as much as TD participants in the explicit task. Importantly, the HFA group looked significantly less at the mouth than their TD peers, and significantly more at non-face regions of the image. There were no between-group differences for eye-directed gaze. Overall, individuals with HFA spend less time looking at the crucially important mouth region of the face during auditory-visual speech integration, which is maladaptive gaze behavior for this type of task. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

Is There a Difference in Intra-Articular Injections of Corticosteroids, Hyaluronate, or Placebo for Temporomandibular Osteoarthritis?

PubMed

Liu, Yan; Wu, Jiashun; Fei, Wei; Cen, Xiao; Xiong, Yi; Wang, Shasha; Tang, Yaling; Liang, Xinhua

2018-03-01

Corticosteroids are widely used for treatment of temporomandibular joint (TMJ) osteoarthritis (OA). This study investigated the effects of corticosteroids on TMJOA compared with placebo or hyaluronate. The authors designed and implemented a systematic review and meta-analysis to compare the effects of intra-articular injection of corticosteroid, hyaluronate, or placebo for patients with TMJOA. The authors searched related randomized controlled studies electronically in multiple English- and Chinese-language electronic databases. The predictor variable was intra-articular injection with corticosteroid, hyaluronate, or placebo. Primary outcome variables were pain intensity and maximal mouth opening. Other variables included success rate and adverse events. Meta-analyses were performed with Rev Man 5.3. Eight studies met the inclusion criteria. Meta-analysis showed that corticosteroid injections after arthrocentesis were superior to placebo in relieving pain as assessed with the visual analog scale (mean difference [MD], -0.74; 95% confidence interval [CI], -1.34 to -0.13; P = .02; I 2  = 0%) in the long-term, but was inferior in increasing maximal mouth opening (MD, -2.06; 95% CI, -2.76 to -1.36; P < .00001; I 2  = 28%). Although corticosteroid and hyaluronate injections without arthrocentesis decreased pain and improved maximal mouth opening, the corticosteroid group had a significantly lower success rate (odds ratio = 0.41; 95% CI, 0.17-1.00; P = .05; I 2  = 0%) than the hyaluronate group in the short term. Corticosteroid injections after arthrocentesis are recommended for patients with TMJOA to relieve joint pain rather than increase maximal mouth opening. Corticosteroid and hyaluronate have marked effectiveness on TMJOA; however, hyaluronate might be the better alternative to some extent. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Coordinative structuring of gait kinematics during adaptation to variable and asymmetric split-belt treadmill walking - A principal component analysis approach.

PubMed

Hinkel-Lipsker, Jacob W; Hahn, Michael E

2018-06-01

Gait adaptation is a task that requires fine-tuned coordination of all degrees of freedom in the lower limbs by the central nervous system. However, when individuals change their gait it is unknown how this coordination is organized, and how it can be influenced by contextual interference during practice. Such knowledge could provide information about measurement of gait adaptation during rehabilitation. Able-bodied individuals completed an acute bout of asymmetric split-belt treadmill walking, where one limb was driven at a constant velocity and the other according to one of three designed practice paradigms: serial practice, where the variable limb belt velocity increased over time; random blocked practice, where every 20 strides the variable limb belt velocity changed randomly; random practice, where every stride the variable limb belt velocity changed randomly. On the second day, subjects completed one of two different transfer tests; one with a belt asymmetry close to that experienced on the acquisition day (transfer 1; 1.5:1), and one with a greater asymmetry (transfer 2; 2:1) . To reduce this inherently high-dimensional dataset, principal component analyses were used for kinematic data collected throughout the acquisition and transfer phases; resulting in extraction of the first two principal components (PCs). For acquisition, PC1 and PC2 were related to sagittal and frontal plane control. For transfer 1, PC1 and PC2 were related to frontal plane control of the base of support and whole-body center of mass. For transfer 2, PC1 did not have any variables with high enough coefficients deemed to be relevant, and PC2 was related to sagittal plane control. Observations of principal component scores indicate that variance structuring differs among practice groups during acquisition and transfer 1, but not transfer 2. These results demonstrate the main kinematic coordinative structures that exist during gait adaptation, and that control of sagittal plane and frontal plane motion are perhaps a trade-off during acquisition of a novel asymmetric gait pattern. Copyright © 2018 Elsevier B.V. All rights reserved.

Single-dose intra-alveolar chlorhexidine gel application, easier surgeries, and younger ages are associated with reduced dry socket risk.

PubMed

Haraji, Afshin; Rakhshan, Vahid

2014-02-01

Although dry socket (DS) is commonly investigated, many of its risk factors remain highly controversial. In addition, few studies are available to show the preventive effect of chlorhexidine gel on DS. Moreover, multivariable analyses of DS risk factors are scarce, and their interactions have not been assessed previously. Therefore, the simultaneous effect of chlorhexidine gel and 4 DS risk factors and their interactions were analyzed within a multivariable framework. Using a split-mouth randomized clinical trial design, the investigators enrolled a cohort of patients requiring extraction of 2 mandibular third molars. The primary predictor variable was extraction socket treatment status, classified as experimental or standard. Experimental treatment was the insertion of chlorhexidine gel (0.2%) into the extraction socket. Each patient had 1 third molar randomly selected as the treatment site. The contralateral third molar served as the control socket and was treated in the usual manner. The primary outcome variable was DS status, present or absent, assessed on postoperative day 3. Other study variables were categorized as demographic, smoking, and surgical difficulty according to the Pederson scale. Appropriate bivariate and multiple logistic regression statistics were used to measure the association between risk for DS and chlorhexidine gel use, age, gender, smoking, and surgical difficulty and their interactions (α = 0.05). The sample consisted of 90 bilateral extraction sockets in 45 patients (24 men; 21 smokers; mean age, 21.1 ± 2.7 yr). Regression analysis showed that when other factors and their interactions were controlled for, chlorhexidine gel application lowered the risk of DS (odds ratio [OR] = 0.05; P = .004). Increasing age (OR = 2.9; P = .030) was associated with an increased risk for DS. A similar association existed between increased difficulty level of extraction and DS risk (OR = 3.8; P = .051). The effect of gender was marginally significant (P = .091), whereas smoking did not have a significant influence (P = .4). Intra-alveolar application of chlorhexidine gel and practicing less traumatic surgeries are advocated, particularly in older patients. Smoking seems unlikely to affect DS frequency. The role of gender is inconclusive. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Evaluation of the efficacy of low-level laser in improving the symptoms of burning mouth syndrome.

PubMed

Arbabi-Kalati, Fateme; Bakhshani, Nour-Mohammad; Rasti, Maryam

2015-10-01

Burning mouth syndrome (BMS) is common conditions that affects menopause women, patients suffer from sever burning sensation. Up to now there is no definitive treatment for this disease. Present study was undertaken to evaluate the efficacy of low-level laser (LLL) in improving the symptoms of burning mouth syndrome. Twenty patients with BMS were enrolled in this study; they were divided in two groups randomly. In the laser group, in each patient, 10 areas on the oral mucosa were selected and underwent LLL irradiation at a wavelength of 630 nm, and a power of 30 mW for 10 seconds twice a week for 4 weeks. In the placebo group, silent/off laser therapy was carried out during the same period in the same areas. Burning sensation and quality of life were evaluated. Burning sensation severity and quality of life in the two groups after intervention were different significant statistically, (p= 0.004, p= 0.01 respectively) .Patients in laser group had better results. It can be concluded that low level laser might decrease the intensity of burning mouth syndrome. Pain, low-level laser, burning mouth syndrome, oral mucosa.

Evaluation of the efficacy of low-level laser in improving the symptoms of burning mouth syndrome

PubMed Central

Bakhshani, Nour-Mohammad; Rasti, Maryam

2015-01-01

Background Burning mouth syndrome (BMS) is common conditions that affects menopause women, patients suffer from sever burning sensation. Up to now there is no definitive treatment for this disease. Present study was undertaken to evaluate the efficacy of low-level laser (LLL) in improving the symptoms of burning mouth syndrome. Material and Methods Twenty patients with BMS were enrolled in this study; they were divided in two groups randomly. In the laser group, in each patient, 10 areas on the oral mucosa were selected and underwent LLL irradiation at a wavelength of 630 nm, and a power of 30 mW for 10 seconds twice a week for 4 weeks. In the placebo group, silent/off laser therapy was carried out during the same period in the same areas. Burning sensation and quality of life were evaluated. Results Burning sensation severity and quality of life in the two groups after intervention were different significant statistically, (p= 0.004, p= 0.01 respectively) .Patients in laser group had better results. Conclusions It can be concluded that low level laser might decrease the intensity of burning mouth syndrome. Key words:Pain, low-level laser, burning mouth syndrome, oral mucosa. PMID:26535101

Patients with burning mouth sensations. A clinical investigation of causative factors in a group of "compete denture wearers" Jordanian population.

PubMed

Mukatash-Nimri, Gadeer Elea; Al-Nimri, Marwan A; Al-Jadeed, Omar G; Al-Zobe, Zaid R; Aburumman, Khuzama K; Masarwa, Nader A

2017-01-01

To find out the prevalence of "true" burning mouth syndrome and study the association between patients' spontaneous complaints of burning mouth and systemic conditions in a group of middle age and elderly "denture wearers" patients in Jordan. A group of 129 patients (112 female and 17 male) of "complete denture wearers" subjects aged 40 years and over attended prosthetic clinic at King Hussein Medical Hospital complaining from oral burning, with no oral lesion possibly responsible for the burning sensations were selected. Assessment of oral and general status was done based on questioners, detailed history taking, medical records and extra and intraoral examination. The existed complete dentures retention, stability, jaw relationship and the free way space were evaluated. The current blood test and instrumental protocol for examination of patients with burning mouth complains were performed for each patient. Then those studied patients with burning mouth sensations including "true" burning mouth syndrome have been compared to the controls with regard to the presence of local problem, undermined local, systemic or psychological disease. The diagnosis of "true" burning mouth syndrome was established in (2.3%) of the studied population two females and one male. In most patients (58%) more than one site was affected. Significant positive associations were found between local factors (i.e., wearing complete dentures with unsatisfactory retention or jaw relationship, dry mouth or candidasis) and patients suffering from burning mouth sensation. The results also show that some systemic or psychological disorders were significantly more present among patients with burning mouth symptoms when compared to the control group ( p  < 0.05). Spontaneous symptoms of burning mouth without mucosal signs should be considered as a manifestation of undermind pathology and/or distress, and the multi-factorial causes of burning mouth syndrome and sensation need to be referred to the suitable specialist for better treatment results.

A randomized, controlled trial of oral sulfate solution plus polyethylene glycol as a bowel preparation for colonoscopy.

PubMed

Rex, Douglas K; McGowan, John; Cleveland, Mark vB; Di Palma, Jack A

2014-09-01

No bowel preparation for colonoscopy is optimal with regard to efficacy, safety, and tolerability. New options for bowel preparation are needed. To compare a new hybrid preparation consisting of a reduced dose of oral sulfate solution (OSS) plus 2 L of sulfate-free electrolyte lavage solution (SF-ELS) with 2 low-volume preparations based on polyethylene glycol electrolyte lavage solution (PEG-ELS). Two randomized, controlled trials. Twenty-four U.S. centers. A total of 737 outpatients undergoing colonoscopy. In study 1, OSS plus SF-ELS was given as a split dose, and in study 2, OSS plus SF-ELS was given in its entirety the evening before colonoscopy. In study 1, the active control was 2 L of PEG-ELS plus ascorbic acid (PEG-EA) given as a split dose. In study 2, the control was 10 mg of bisacodyl plus 2 L of SF-ELS taken the evening before colonoscopy. Rates of successful (good or excellent) bowel preparation. In study 1, the rates of successful (excellent or good) preparation with OSS plus SF-ELS and PEG-EA were identical at 93.5% for split-dose preparation. OSS plus SF-ELS was noninferior to PEG-EA (P < .001). In study 2, OSS plus SF-ELS resulted in successful preparation in 89.8% of patients compared with 83.5% with bisacodyl plus SF-ELS in a same-day preparation regimen. OSS plus SF-ELS was noninferior to bisacodyl plus SF-ELS (P <.001). In study 1, vomiting was more frequent with OSS plus SF-ELS (13.5% vs 6.7%; P = .042), and bloating was rated worse with PEG-EA (P = .025). In study 2, overall discomfort was rated worse with OSS plus SF-ELS (mean score 2.1 vs 1.8; P = .032). There were no deaths in either study and no serious adverse events considered related to the preparation. Bowel cleansing was not scored by colon segment. Adenoma detection was not compared between the regimens. OSS plus SF-ELS is a new, safe, and effective bowel preparation for colonoscopy. Copyright © 2014 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

Emergence of a spectral gap in a class of random matrices associated with split graphs

NASA Astrophysics Data System (ADS)

Bassler, Kevin E.; Zia, R. K. P.

2018-01-01

Motivated by the intriguing behavior displayed in a dynamic network that models a population of extreme introverts and extroverts (XIE), we consider the spectral properties of ensembles of random split graph adjacency matrices. We discover that, in general, a gap emerges in the bulk spectrum between -1 and 0 that contains a single eigenvalue. An analytic expression for the bulk distribution is derived and verified with numerical analysis. We also examine their relation to chiral ensembles, which are associated with bipartite graphs.

The characteristics of autonomic nervous system disorders in burning mouth syndrome and Parkinson disease.

PubMed

Koszewicz, Magdalena; Mendak, Magdalena; Konopka, Tomasz; Koziorowska-Gawron, Ewa; Budrewicz, Sławomir

2012-01-01

To conduct a clinical electrophysiologic evaluation of autonomic nervous system functions in patients with burning mouth syndrome and Parkinson disease and estimate the type and intensity of the autonomic dysfunction. The study involved 83 subjects-33 with burning mouth syndrome, 20 with Parkinson disease, and 30 controls. The BMS group included 27 women and 6 men (median age, 60.0 years), and the Parkinson disease group included 15 women and 5 men (median age, 66.5 years). In the control group, there were 20 women and 10 men (median age, 59.0 years). All patients were subjected to autonomic nervous system testing. In addition to the Low autonomic disorder questionnaire, heart rate variability (HRV), deep breathing (exhalation/inspiration [E/I] ratio), and sympathetic skin response (SSR) tests were performed in all cases. Parametric and nonparametric tests (ANOVA, Kruskal-Wallis, and Scheffe tests) were used in the statistical analysis. The mean values for HRV and E/I ratios were significantly lower in the burning mouth syndrome and Parkinson disease groups. Significant prolongation of SSR latency in the foot was revealed in both burning mouth syndrome and Parkinson disease patients, and lowering of the SSR amplitude occurred in only the Parkinson disease group. The autonomic questionnaire score was significantly higher in burning mouth syndrome and Parkinson disease patients than in the control subjects, with the Parkinson disease group having the highest scores. In patients with burning mouth syndrome, a significant impairment of both the sympathetic and parasympathetic nervous systems was found but sympathetic/parasympathetic balance was preserved. The incidence and intensity of autonomic nervous system dysfunction was similar in patients with burning mouth syndrome and Parkinson disease, which may suggest some similarity in their pathogeneses.

Foot-and-mouth disease virus receptors: multiple gateways to initiate infection

USDA-ARS?s Scientific Manuscript database

Since its discovery over 100 years ago as the causative agent of foot-and-mouth disease (FMD), research has been directed at understanding the biology of the foot-and-mouth disease virus (FMDV) so as to be able to control this devastating and highly contagious disease of cloven-hoofed livestock. Giv...

Custom-engineered chimeric foot-and-mouth disease vaccine elicits protective immune responses in pigs

USDA-ARS?s Scientific Manuscript database

Chimeric foot-and-mouth disease viruses (FMDV) of which the antigenic properties can be readily manipulated is a potentially powerful approach in the control of foot-and-mouth disease (FMD) in sub-Saharan Africa. FMD vaccine application is complicated by the extensive variability of the South Africa...

The impact of plasma rich in growth factors on clinical and biological factors involved in healing processes after third molar extraction.

PubMed

Mozzati, Marco; Martinasso, Germana; Pol, Renato; Polastri, Carolina; Cristiano, Antonio; Muzio, Giuliana; Canuto, Rosa

2010-12-01

Extraction of an impacted mandibular third molar is a common surgical procedure, although it still leads to several postoperative symptoms and complications. The study assessed the efficacy of autologous plasma rich in growth factors (PRGF) in the healing process by checking the difference of tissue cytokines and other healing factors produced by the mucosa after extraction between sites treated with PRGF and control sites and, at the same time, by evaluating the clinical efficacy of PRGF in terms of reduced pain and facial swelling. This study was a split-mouth study, in which the patient becomes his/her own control, to eliminate any individual response differences toward PRGF treatment. The parameters regarding inflammation and subsequent wound healing were all significantly higher at PRGF sites than at control sites. The increase at PRGF sites of the two proinflammatory cytokines evaluated, interleukin (IL)-1β and IL-6, was accompanied by the increase of two anti-inflammatory cytokines, IL-10 and transforming growth factor-β. Furthermore, IL-1β and IL-6 induce fibroblast and keratinocyte proliferation, important events in wound healing. Postoperative pain and the swelling, measured at all experimental times, were reduced in the presence of PRGF. © 2010 Wiley Periodicals, Inc. J Biomed Mater Res Part A, 2010.

Effect of piezocision on root resorption associated with orthodontic force: A microcomputed tomography study.

PubMed

Patterson, Braydon M; Dalci, Oyku; Papadopoulou, Alexandra K; Madukuri, Suman; Mahon, Jonathan; Petocz, Peter; Spahr, Axel; Darendeliler, M Ali

2017-01-01

The purpose of this study was to investigate the effect of piezocision on orthodontically induced inflammatory root resorption. Fourteen patients were included in this split-mouth study; 1 side was assigned to piezocision, and the other side served as the control. Vertical corticotomy cuts of 4 to 5 mm in length were performed on either side of each piezocision premolar, and 150-g buccal tipping forces were applied to the premolars. After 4 weeks, the maxillary first premolars were extracted and scanned with microcomputed tomography. There was a significantly greater total amount of root resorption seen on the piezocision sides when compared with the control sides (P = 0.029). The piezocision procedure resulted in a 44% average increase in root resorption. In 5 patients, there was noticeable piezocision-related iatrogenic root damage. When that was combined with the orthodontic root resorption found on the piezocision-treated teeth, there was a statistically significant 110% average increase in volumetric root loss when compared with the control side (P = 0.005). The piezocision procedure that initiates the regional acceleratory phenomenon may increase the iatrogenic root resorption when used in conjunction with orthodontic forces. Piezocision applied close to the roots may cause iatrogenic damage to the neighboring roots and should be used carefully. Copyright © 2017.

Prevalence and oral health-related quality of life of self-reported orofacial conditions in Sweden.

PubMed

Oghli, I; List, T; John, M; Larsson, P

2017-03-01

To (i) determine the prevalences of self-report in a Swedish adult population, of temporomandibular disorders, burning mouth syndrome, dry mouth, and bad breath and (ii) determine oral health-related quality-of-life impairment in subjects reporting these conditions. A cross-sectional, randomized sample of the adult Swedish population (response rate: 46%, N = 1309 subjects) self-reported their condition from the preceding month to assess prevalences of self-report for the studied conditions together with comorbidity group of subjects who reported more than one condition. The 49-item Oral Health Impact Profile (OHIP) used to assess oral health-related quality of life. The most prevalent condition was bad breath (39%), followed by dry mouth (22%), temporomandibular disorders (18%) and burning mouth syndrome (4%). High comorbidity of conditions occurred in 27% of the population. Quality-of-life impairment increased with the number of comorbid conditions. Among individual conditions, burning mouth syndrome and temporomandibular disorders (57% and 40% OHIP points) presented higher impairment than dry mouth and bad breath (32% and 26% OHIP points). Orofacial conditions were common and often coexist. The comorbidity group experienced the highest impact on oral health-related quality of life: the more the comorbid conditions, the greater the negative impact. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A study on the relationship between the protein supplements intake satisfaction level and repurchase intention: Verification of mediation effects of word-of-mouth intention.

PubMed

Kim, Ill-Gwang

2016-05-18

The purpose of this study is to examine the relationship between the protein supplements intake satisfaction level and repurchase intention of university students majoring in physical education and verify the mediation effects of word-of-mouth intention. To achieve the purpose of this study, 700 university students majoring in physical education from 10 universities in Korea were selected from October 2013 to December 2013 as the target of this study through the cluster random sampling and data of 228 university students who had experience in the intake of protein supplements among them was analyzed. The composite reliability of each factor was in between 0.869 and 0.958, and the convergent validity and discriminant validity were verified. SPSS 18.0 and Amos 22.0 were utilized as data processing methods and the verification of significance on the medication effects and indirect effects of word-of-mouth intention was carried out using the frequency analysis, correlation analysis, CFA, SEM, and Amos bootstrapping. The result is as follows. The protein supplements intake satisfaction level had a positive effect on the word-of-mouth intention and the word-of-mouth intention had a positive effect on the repurchase intention. Also, it was shown that the word-of-mouth intention played a full mediation role between the intake satisfaction level and the repurchase intention.

'Pharyngocise': Randomized Controlled Trial of Preventative Exercises to Maintain Muscle Structure and Swallowing Function During Head-and-Neck Chemoradiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Carnaby-Mann, Giselle, E-mail: gmann@phhp.ufl.edu; Crary, Michael A.; Schmalfuss, Ilona

2012-05-01

Purpose: Dysphagia after chemoradiotherapy is common. The present randomized clinical trial studied the effectiveness of preventative behavioral intervention for dysphagia compared with the 'usual care.' Methods and Materials: A total of 58 head-and-neck cancer patients treated with chemoradiotherapy were randomly assigned to usual care, sham swallowing intervention, or active swallowing exercises (pharyngocise). The intervention arms were treated daily during chemoradiotherapy. The primary outcome measure was muscle size and composition (determined by T{sub 2}-weighted magnetic resonance imaging). The secondary outcomes included functional swallowing ability, dietary intake, chemosensory function, salivation, nutritional status, and the occurrence of dysphagia-related complications. Results: The swallowing musculaturemore » (genioglossus, hyoglossuss, and mylohyoid) demonstrated less structural deterioration in the active treatment arm. The functional swallowing, mouth opening, chemosensory acuity, and salivation rate deteriorated less in the pharyngocise group. Conclusion: Patients completing a program of swallowing exercises during cancer treatment demonstrated superior muscle maintenance and functional swallowing ability.« less

Are there specific benefits of amoxicillin plus metronidazole in Aggregatibacter actinomycetemcomitans-associated periodontitis? Double-masked, randomized clinical trial of efficacy and safety.

PubMed

Mombelli, Andrea; Cionca, Norbert; Almaghlouth, Adnan; Décaillet, Fabien; Courvoisier, Delphine S; Giannopoulou, Catherine

2013-06-01

It has been suggested that prescription of amoxicillin plus metronidazole in the context of periodontal therapy should be limited to patients with specific microbiologic profiles, especially those testing positive for Aggregatibacter actinomycetemcomitans. The main purpose of this analysis is to determine if patients positive for A. actinomycetemcomitans with moderate to advanced periodontitis benefit specifically from amoxicillin plus metronidazole given as an adjunct to full-mouth scaling and root planing. This is a double-masked, placebo-controlled, randomized longitudinal study including 41 participants who were positive for A. actinomycetemcomitans and 41 participants who were negative for A. actinomycetemcomitans. All 82 patients received full-mouth periodontal debridement performed within 48 hours. Patients then received either systemic antibiotics (375 mg amoxicillin and 500 mg metronidazole, three times daily) or placebo for 7 days. The primary outcome variable was persistence of sites with a probing depth (PD) >4 mm and bleeding on probing (BOP) at the 3-month reevaluation. Using multilevel logistic regression, the effect of the antibiotics was analyzed according to the following factors (interaction effect): A. actinomycetemcomitans-positive or -negative at baseline, sex, age, smoking, tooth being a molar, and interdental location. At reevaluation, participants in the test group had significantly fewer sites with a persisting PD >4 mm and BOP than control patients (P <0.01). Being A. actinomycetemcomitans-positive or -negative did not change the effect of the antibiotics. Patients benefited from the antibiotics irrespective of sex, age, or smoking status. Molars benefited significantly more from the antibiotics than non-molars (P for interaction effect = 0.03). Patients who were positive for A. actinomycetemcomitans had no specific benefit from amoxicillin plus metronidazole. Sites on molars benefited significantly more from the antibiotics than non-molar sites.

Orofacial contracture management outcomes following partial thickness facial burns.

PubMed

Clayton, N A; Ward, E C; Maitz, P K M

2015-09-01

To examine clinical outcomes following non-surgical exercise for contracture management post partial thickness orofacial burn. A cohort of 229 patients with partial thickness orofacial burn was recruited over 3 years. Orofacial contracture management combining exercise and stretching was initiated within 48h of admission and continued until functional goals were consistently achieved. A second cohort of 120 healthy controls was recruited for normative comparison. Vertical and horizontal mouth opening measures were recorded at the start and completion of orofacial intervention for patients and once only for controls. At commencement of intervention, participants with orofacial burns had significantly (p<0.001) reduced vertical and horizontal mouth opening. Treatment duration averaged 30.7 days (SD=52.3). Post treatment significant (p<0.001) improvements in vertical and horizontal opening were noted. At treatment conclusion, a significant (p<0.01) difference remained between the burns cohort and control group for vertical mouth opening, though horizontal mouth opening was now statistically comparable to the controls. This study supports positive outcomes following orofacial contracture management for patients with partial thickness orofacial burn. Despite this, some functional loss remained with patients demonstrating persistent reduced vertical mouth opening at conclusion of treatment compared to their healthy counterparts. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Recombinant human osteogenic protein-1 (OP-1) stimulates periodontal wound healing in class III furcation defects.

PubMed

Giannobile, W V; Ryan, S; Shih, M S; Su, D L; Kaplan, P L; Chan, T C

1998-02-01

Osteogenic protein-1 (OP-1) is a member of the transforming growth factor beta superfamily and is a potent modulator of osteogenesis and bone cell differentiation. This preclinical study in dogs sought to assess the effects of OP-1 on periodontal wound healing in surgically created critical size Class III furcation defects. Eighteen male beagle dogs were subjected to the creation of bilateral mandibular 5 mm osseous defects. A split-mouth design was utilized which randomly assigned opposing quadrants to control therapy (surgery alone or collagen vehicle) or 1 of 3 ascending concentrations of OP-1 in a collagen vehicle (0.75 mg OP-1/g collagen, 2.5 mg/g, or 7.5 mg/g). Thus, 9 quadrants per test group received OP-1, 9 quadrants per control group received surgery alone, and 9 quadrants received collagen vehicle alone. Test articles were delivered by a surgeon masked to the treatment, and fluorogenic bone labels were injected at specified intervals post-treatment. Eight weeks after defect creation and OP-1 delivery, tissue blocks of the mandibulae were taken for masked histomorphometric analysis to assess parameters of periodontal regeneration (e.g., bone height, bone area, new attachment formation, and percent of defect filled with new bone). Histomorphometry revealed limited evidence of osteogenesis, cementogenesis, and new attachment formation in either vehicle or surgery-alone sites. In contrast, sites treated with all 3 concentrations of OP-1 showed pronounced stimulation of osteogenesis, regenerative cementum, and new attachment formation. Lesions treated with 7.5 mg/g of OP-1 in collagen regenerated 3.9+/-1.7 mm and 6.1+/-3.4 mm2 (mean +/-S.D.) of linear bone height and bone area, respectively. Furthermore, these differences were statistically different from both control therapies for all wound healing parameters (P < 0.0001). No significant increase in tooth root ankylosis was found among the treatment groups when compared to the surgery-alone group. We conclude that OP-1 offers promise as an attractive candidate for treating severe periodontal lesions.

Virtual reality distraction for pain control during periodontal scaling and root planing procedures.

PubMed

Furman, Elena; Jasinevicius, T Roma; Bissada, Nabil F; Victoroff, Kristin Z; Skillicorn, Robert; Buchner, Marc

2009-12-01

Although pain management during periodontal treatment usually is achieved with anesthesia, alternative methods are available. The authors conducted a study to evaluate the analgesic effect of immersive virtual reality (VR) during periodontal scaling and root planing (SRP) procedures. The authors recruited 38 patients. They used a within-patient/split-mouth design. Patients received SRP under three treatment conditions in three quadrants. The three conditions were control, watching a movie and VR. After each SRP procedure, patients responded to questions about their discomfort and/or pain by using a visual analog scale (VAS) (range, 0 to 10 in which lower numbers indicate less pain or discomfort). The authors also recorded patients' blood pressure (BP) and pulse rate (PR). Patients were asked which of the three treatment modalities they preferred. The mean (+/- standard deviation) VAS scores for five questions pertaining to control, movie and VR were 3.95 +/- 2.1, 2.57 +/- 1.8 and 1.76 +/- 1.4, respectively. Paired t tests revealed that VAS scores were significantly lower during VR compared with the movie (P <.001) and control (P <.001) conditions. Similarly, BP and PR were lowest during VR, followed by the movie and control conditions. Patients reported that they preferred the VR condition. The results of this study suggest that use of immersive VR distraction may be an effective method of pain control during SRP procedures. Practitioners can use immersive VR distraction for pain control during SRP procedures.

Experimental infection of giraffe (Giraffa camelopardalis) with SAT-1 and SAT-2 foot-and-mouth disease virus.

PubMed

Vosloo, W; Swanepoel, S P; Bauman, M; Botha, B; Esterhuysen, J J; Boshoff, C I; Keet, D F; Dekker, A

2011-04-01

The potential role of giraffe (Giraffa camelopardalis) in the epidemiology and spread of foot-and-mouth disease (FMD) SAT types was investigated by experimental infection and detection of virus in excretions using virus isolation on primary pig kidney cell cultures. In two experiments separated by a period of 24 months, groups of four animals were needle infected with a SAT-1 or SAT-2 virus, respectively and two in-contact controls were kept with each group. Viraemia was detected 3-9 days post-infection and virus isolated from mouth washes and faeces only occasionally up to day 13. The SAT-1 virus was transmitted to only one in-contact control animal, probably via saliva that contained virus from vesicles in the mouth of a needle-infected animal. None of the animals infected with the SAT-2 virus had any vesicles in the mouth, and there was no evidence of transmission to the in-contact controls. No virus was detected in probang samples for the duration of the experiments (60 days post-infection), indicating that persistent infection probably did not establish with either of these isolates. Giraffe most likely do not play an important role in FMD dissemination. Transmission of infection would possibly occur only during close contact with other animals when mouth vesicles are evident. © 2010 Blackwell Verlag GmbH.

Split-Attention and Redundancy Effects on Mobile Learning in Physical Environments

ERIC Educational Resources Information Center

Liu, Tzu-Chien; Lin, Yi-Chun; Tsai, Meng-Jung; Paas, Fred

2012-01-01

This study investigated split-attention and redundancy effects in a mobile learning environment on leaf morphology of plants as a function of different combinations of media. Eighty-one fifth-grade students were randomly assigned to the following three conditions: texts with pictures embedded in the mobile device (TP condition); texts embedded in…

Increase of crevicular interleukin 1beta under academic stress at experimental gingivitis sites and at sites of perfect oral hygiene.

PubMed

Deinzer, R; Förster, P; Fuck, L; Herforth, A; Stiller-Winkler, R; Idel, H

1999-01-01

This study analyses the effects of academic stress on crevicular interleukin-1beta(I1-1beta) both at experimental gingivitis sites and at sites of perfect oral hygiene. I1-1beta is thought to play a predominant role in periodontal tissue destruction. 13 medical students participating in a major medical exam (exam group) and 13 medical students not participating in any exam throughout the study period (control group) volunteered for the study. In a split-mouth-design, they refrained from any oral hygiene procedures in two opposite quadrants for 21 days (experimental gingivitis) while they maintained perfect hygiene levels at the remaining sites. Crevicular fluid was sampled for further I1-1beta analysis at teeth 5 and 6 of the upper jaw at days 1, 5, 8, 11, 14, 18 and 21 of the experimental gingivitis period. Exam students showed significantly higher I1-1beta levels than controls both at experimental gingivitis sites (area under the curve, exam group: 1240.64+/-140.07; control group: 697.61+/-111.30; p=0.004) and at sites of perfect oral hygiene (exam group: 290.42+/-63.19; control group: 143.98+/-42.71; p = 0.04). These results indicate that stress might affect periodontal health by increasing local I1-1beta levels especially when oral hygiene is neglected.

The efficacy of gum chewing in reducing postoperative ileus: a multisite randomized controlled trial.

PubMed

Forrester, David Anthony Tony; Doyle-Munoz, Janet; McTigue, Toni; D'Andrea, Stephanie; Natale-Ryan, Angela

2014-01-01

The purpose of this prospective, attention-controlled, randomized study was to determine whether postoperative gum chewing reduces the duration of postoperative ileus symptoms following elective open or laparoscopic sigmoid colectomy when compared with standard care or an attention-control intervention. Forty-seven subjects scheduled for either an open or laparoscopic colon resection participated in the study. Subjects were recruited preoperatively at the preadmission learning centers of the 2 acute care medical centers that comprised the study settings. Subjects were randomized to 3 groups: (1) standard postoperative care (n = 18); (2) standard care and a silicone-adhesive patch applied to the deltoid region of the upper arm as an attention control (n = 16); and (3) standard care and gum chewing (n = 13). Standard postoperative care included removal of the nasogastric tube, early ambulation, nothing by mouth with ice chips only until the first passage of flatus, and then advancement of diet until tolerance of solid food. No statistically significant differences were found among the 3 study groups for the 4 postoperative outcome variables measured: (1) first passage of flatus; (2) first bowel movement; (3) return of hunger; and (4) ability to tolerate solid food for one meal. Postoperative gum chewing was not found to be more effective than standard postoperative care or our attention-control intervention in reducing the duration of postoperative ileus symptoms, length of stay, or complications among patients following open/laparoscopic sigmoid colectomy.

Chamomile infusion cryotherapy to prevent oral mucositis induced by chemotherapy: a pilot study.

PubMed

Dos Reis, Paula Elaine Diniz; Ciol, Marcia A; de Melo, Nilce Santos; Figueiredo, Paulo Tadeu de Souza; Leite, André Ferreira; Manzi, Natália de Melo

2016-10-01

The aim of this study is to compare cryotherapy made only with water and cryotherapy made with chamomile infusion for prevention and reduction of intensity of oral mucositis in patients with cancer receiving 5-fluorouracil and leucovorin. This is a randomized pilot study with two groups: cryotherapy made only with water (control group, n = 18) and cryotherapy made with chamomile infusion (chamomile group, n = 20). Both groups were instructed to swish the ice around in their oral cavity for at least 30 min during chemotherapy. Assessment of oral mucosa occurred on days 8, 15, and 22 after the first day of chemotherapy. Fifty percent of the patients in the control and 30 % in the chamomile group developed oral mucositis. Mouth pain score was higher in patients in the control group on all evaluations (p = 0.02 for day 8, p = 0.09 for day 15, and p = 0.14 for day 22). Patients in the chamomile group never developed mucositis with grade 2 or higher. Presence of ulceration was statistically significant on day 8 (16 % in the control vs. 0 % in the chamomile group, p = 0.10), but not in days 15 and 22, although 11 % still had ulcerations in the control group and none in the chamomile group. The occurrence of oral mucositis was lower in patients in the chamomile group than in the control group. When compared to the controls, the chamomile group presented less mouth pain and had no ulcerations. Cryotherapy was well tolerated by both groups, and no toxicity related to chamomile was identified.

Piezosurgery for the Lingual Split Technique in Lingual Positioned Impacted Mandibular Third Molar Removal: A Retrospective Study.

PubMed

Ge, Jing; Yang, Chi; Zheng, Jiawei; Qian, Wentao

2016-03-01

The aim of this study was to evaluate the effect and safety of lingual split technique using piezosurgery for the extraction of lingual positioned impacted mandibular 3rd molars with the goal of proposing a more minimally invasive choice for this common surgery.Eighty-nine consecutive patients with 110 lingual positioned impacted mandibular 3rd molars requiring extraction were performed the lingual split technique using piezosurgery. One sagittal osteotomy line and 2 transverse osteotomy line were designed for lingual and occlusal bone removal. The success rate, operative time, postoperative outcome, and major complications (including nerve injury, mandible fracture, severe hematoma or edema, and severe pyogenic infection) were documented and analyzed.All impacted mandibular 3rd molars were successfully removed (110/110). The average time of operation was 14.6 minutes (ranged from 7 to 28 minutes). One hundred and seven extraction sites (97.3%) were primary healing. Pain, mouth opening, swelling, and PoSSe scores on postoperative 7-day were 0.34 ± 0.63, 3.88 ± 0.66(cm), 2.4 ± 0.2(cm), and 23.7 ± 5.9, respectively. There were 6 cases (5.5%) had lingual nerve disturbance and 3 cases (2.7%) developed inferior alveolar nerve impairment, and achieved full recovery within 2 months by neurotrophic drug treatment.Our study suggested piezosurgery for lingual split technique provided an effective way for the extraction of lingual positioned and deeply impacted mandibular 3rd molar.

Piezosurgery for the Lingual Split Technique in Lingual Positioned Impacted Mandibular Third Molar Removal

PubMed Central

Ge, Jing; Yang, Chi; Zheng, Jiawei; Qian, Wentao

2016-01-01

Abstract The aim of this study was to evaluate the effect and safety of lingual split technique using piezosurgery for the extraction of lingual positioned impacted mandibular 3rd molars with the goal of proposing a more minimally invasive choice for this common surgery. Eighty-nine consecutive patients with 110 lingual positioned impacted mandibular 3rd molars requiring extraction were performed the lingual split technique using piezosurgery. One sagittal osteotomy line and 2 transverse osteotomy line were designed for lingual and occlusal bone removal. The success rate, operative time, postoperative outcome, and major complications (including nerve injury, mandible fracture, severe hematoma or edema, and severe pyogenic infection) were documented and analyzed. All impacted mandibular 3rd molars were successfully removed (110/110). The average time of operation was 14.6 minutes (ranged from 7 to 28 minutes). One hundred and seven extraction sites (97.3%) were primary healing. Pain, mouth opening, swelling, and PoSSe scores on postoperative 7-day were 0.34 ± 0.63, 3.88 ± 0.66(cm), 2.4 ± 0.2(cm), and 23.7 ± 5.9, respectively. There were 6 cases (5.5%) had lingual nerve disturbance and 3 cases (2.7%) developed inferior alveolar nerve impairment, and achieved full recovery within 2 months by neurotrophic drug treatment. Our study suggested piezosurgery for lingual split technique provided an effective way for the extraction of lingual positioned and deeply impacted mandibular 3rd molar. PMID:27015214

A methodology for double patterning compliant split and design

NASA Astrophysics Data System (ADS)

Wiaux, Vincent; Verhaegen, Staf; Iwamoto, Fumio; Maenhoudt, Mireille; Matsuda, Takashi; Postnikov, Sergei; Vandenberghe, Geert

2008-11-01

Double Patterning allows to further extend the use of water immersion lithography at its maximum numerical aperture NA=1.35. Splitting of design layers to recombine through Double Patterning (DP) enables an effective resolution enhancement. Single polygons may need to be split up (cut) depending on the pattern density and its 2D content. The split polygons recombine at the so-called 'stitching points'. These stitching points may affect the yield due to the sensitivity to process variations. We describe a methodology to ensure a robust double patterning by identifying proper split- and design- guidelines. Using simulations and experimental data, we discuss in particular metal1 first interconnect layers of random LOGIC and DRAM applications at 45nm half-pitch (hp) and 32nm hp where DP may become the only timely patterning solution.

Non-random nectar unloading interactions between foragers and their receivers in the honeybee hive

NASA Astrophysics Data System (ADS)

Goyret, Joaquín; Farina, Walter M.

2005-09-01

Nectar acquisition in the honeybee Apis mellifera is a partitioned task in which foragers gather nectar and bring it to the hive, where nest mates unload via trophallaxis (i.e. mouth-to-mouth transfer) the collected food for further storage. Because forager mates exploit different feeding places simultaneously, this study addresses the question of whether nectar unloading interactions between foragers and hive-bees are established randomly, as it is commonly assumed. Two groups of foragers were trained to exploit a different scented food source for 5 days. We recorded their trophallaxes with hive-mates, marking the latter ones according to the forager group they were unloading. We found non-random probabilities for the occurrence of trophallaxes between experimental foragers and hive-bees, instead, we found that trophallactic interactions were more likely to involve groups of individuals which had formerly interacted orally. We propose that olfactory cues present in the transferred nectar promoted the observed bias, and we discuss this bias in the context of the organization of nectar acquisition: a partitioned task carried out in a decentralized insect society.

The degree of color change, rebound effect and sensitivity of bleached teeth associated with at-home and power bleaching techniques: A randomized clinical trial

PubMed Central

Moghadam, Fatemeh Velayati; Majidinia, Sara; Chasteen, Joseph; Ghavamnasiri, Marjaneh

2013-01-01

Aim: The purpose of the present randomized clinical trial was to evaluate the color change, rebound effect and sensitivity of at-home bleaching with 15% carbamide peroxide and power bleaching using 38% hydrogen peroxide. Materials and Methods: For bleaching techniques, 20 subjects were randomized in a split mouth design (at-home and power bleaching): In maxillary and mandibular anterior teeth (n = 20). Color was recorded before bleaching, immediately after bleaching, at 2 weeks, 1, 3 and 6 month intervals. Tooth sensitivity was recorded using the visual analog scale. The Mann-Whitney test was used to compare both groups regarding bleaching effectiveness (ΔE1), rebound effect (ΔE2) and color difference between the rebounded tooth color and unbleached teeth (ΔE3) while the Wilcoxon compared ΔE within each group. Distribution of sensitivity was evaluated using the Chi-square test (α =0.05). Results: There was no significant difference between groups regarding ΔE1 and ΔE3 (P > 0.05). Even though, ΔE2 showed no significant difference between groups after bleaching as well as at 2 week, 1 month and 3 month follow-up periods (P > 0.05). Although, significant difference was found in ΔE2 (P < 0.05 Mann-Whitney) between two methods after 6 months and a high degree of rebound effect was obtained with power bleaching. Within each group, there was no significant difference between ΔE1 and ΔE3 (P < 0.05 Wilcoxon). The distribution of sensitivity was identical with both techniques (P > 0.05). Conclusion: Bleaching techniques resulted in identical tooth whitening and post-operative sensitivity using both techniques, but faster color regression was found with power bleaching even though color regression to the baseline of the teeth in both groups was the same after 6 months. PMID:24932113

Clinical, histologic and histomorphometric evaluation of socket preservation using a synthetic nanocrystalline hydroxyapatite in comparison with a bovine xenograft: a randomized clinical trial.

PubMed

Gholami, Gholam Ali; Najafi, Babak; Mashhadiabbas, Fatemeh; Goetz, Werner; Najafi, Siamak

2012-10-01

The aim of this study was to compare a nanocrystalline hydroxyapatite (NCHA), NanoBone(®) and a deproteinized bovine bone mineral (DBBM), Bio-Oss(®) with a collagen membrane on the horizontal ridge width alterations following tooth extraction, in addition to histologic aspects of the grafted extraction sockets. In this randomized clinical trial, 28 symmetrical, non-molar, extraction sockets using a split-mouth design in 12 patients (eight women and four men; aged 21-60; mean 44.6 ± 11.4 years), were randomly selected in the first group to be grafted with DBBM granules covered with a collagen membrane and in the other group grafted with NCHA covered with a collagen membrane. Following extraction horizontal ridge width was measured using caliper and was blindly compared to the dimensions measured prior to implant placement, at the 6- to 8-month follow-up. Subsequently, a 2 × 6 mm trephine core was obtained with aid of acrylic stent and routine histologic preparation was performed on the specimens. The width of the DBBM group decreased from 7.75 ± 1.55 to 6.68 ± 1.85 mm (P < 0.05), whereas the width of the NCHA group decreased from 7.36 ± 1.94 to 6.43 ± 2.08 mm (P < 0.05). The mean between-group difference did not reach statistical significance (P = 0.62). Furthermore, histologic and histomorphometric analyses revealed 28.63 ± 12.53% vital bone in NCHA group vs. 27.35 ± 12.39% in DBBM group, and no statistically significant difference between the groups (P = 0.68). Socket preservation using either NCHA or DBBM in combination with collagen membrane, results in similar, limited horizontal ridge width alterations following tooth extraction. © 2011 John Wiley & Sons A/S.

Formulation and optimization of mouth dissolve tablets containing rofecoxib solid dispersion.

PubMed

Sammour, Omaima A; Hammad, Mohammed A; Megrab, Nagia A; Zidan, Ahmed S

2006-06-16

The purpose of the present investigation was to increase the solubility and dissolution rate of rofecoxib by the preparation of its solid dispersion with polyvinyl pyrrolidone K30 (PVP K30) using solvent evaporation method. Drug-polymer interactions were investigated using differential scanning calorimetry (DSC), x-ray diffraction (XRD), and Fourier transform infrared spectroscopy (FTIR). For the preparation of rofecoxib mouth dissolve tablets, its 1:9 solid dispersion with PVP K30 was used with various disintegrants and sublimable materials. In an attempt to construct a statistical model for the prediction of disintegration time and percentage friability, a 3(2) randomized full and reduced factorial design was used to optimize the influence of the amounts of superdisintegrant and subliming agent. The obtained results showed that dispersion of the drug in the polymer considerably enhanced the dissolution rate. The drug-to-carrier ratio was the controlling factor for dissolution improvement. FTIR spectra revealed no chemical incompatibility between the drug and PVP K30. As indicated from XRD and DSC data, rofecoxib was in the amorphous form, which explains the better dissolution rate of the drug from its solid dispersions. Concerning the optimization study, the multiple regression analysis revealed that an optimum concentration of camphor and a higher percentage of crospovidone are required for obtaining rapidly disintegrating tablets. In conclusion, this investigation demonstrated the potential of experimental design in understanding the effect of the formulation variables on the quality of mouth dissolve tablets containing solid dispersion of a hydrophobic drug.

[Study on preparation of laser micropore porcine acellular dermal matrix combined with split-thickness autograft and its application in wound transplantation].

PubMed

Liang, Li-Ming; Chai, Ji-Ke; Yang, Hong-Ming; Feng, Rui; Yin, Hui-Nan; Li, Feng-Yu; Sun, Qiang

2007-04-01

To prepare a porcine acellular dermal matrix (PADM), and to optimize the interpore distance between PADM and co-grafted split-thickness autologous skin. Porcine skin was treated with trypsin/Triton X-100 to prepare an acellular dermal matrix. Micropores were produced on the PADM with a laser punch. The distance between micropores varied as 0.8 mm, 1.0 mm, 1.2 mm and 1.5 mm. Full-thickness defect wounds were created on the back of 144 SD rats. The rats were randomly divided into 6 groups as follows, with 24 rats in each group. Micropore groups I -IV: the wounds were grafted with PADM with micropores in four different intervals respectively, and covered with split-thickness autologous skin graft. Mesh group: the wounds were grafted with meshed PADM and split-thickness autograft. with simple split-thickness autografting. The gross observation of wound healing and histological observation were performed at 2, 4, 6 weeks after surgery. The wound healing rate and contraction rate were calculated. Two and four weeks after surgery, the wound healing rate in micropore groups I and II was lower than that in control group (P < 0.05), but no obvious difference was between micropore groups I , II and mesh group (P > 0.05) until 6 weeks after grafting( P <0.05). The wound contraction rate in micropore groups I and II ([(16.0 +/- 2.6)%, (15.1 +/- 2.4)%] was remarkably lower than that in control group 4 and 6 weeks after grafting (P < 0.05), and it was significantly lower than that in mesh group [(19.3 +/- 2.4)%] 6 weeks after surgery (P <0.05). Histological examination showed good epithelization, regularly arranged collagenous fibers, and integral structure of basement membrane. Laser micropore PADM (0.8 mm or 1.0 mm in distance) grafting in combination with split-thickness autografting can improve the quality of wound healing. PADM with laser micropores in 1.0 mm distance is the best choice among them.

Cytological changes in the oral mucosa after use of a mouth rinse with alcohol: A prospective double blind control study

PubMed Central

Vera-Sempere, Francisco; Marzal, Cristina; Pellín-Carcelén, Ana; Martí-Bonmatí, Ezequiel; Bagan, Leticia

2012-01-01

Aim: The aim of this preliminary study was to detect cytological changes in the oral mucosa after using a mouth wash with alcohol. Material and Methods: A prospective double-blind, controlled study was performed, for 6 months. Group 1 consisted of 30 subjects who used a mouth rinse with 26.9% of alcohol [Listerine®] and Group 2 consisted of 30 subjects who used a mouth rinse with the same ingredients but with no alcohol. We obtained three cytological samples from the oral mucosa. The presence of cytological atypia, binucleation and karyorrhesis, and type of cells were studied. We also used a fluorescent in situ hybridization technique (FISH) in 15 samples in each group, for the micronucleus. Results: We found no clinical mucosal alteration after using the mouth wash at the end of the study in either group. We observed no cytological differences between the groups at the end of the study (p>0.05). Regarding the study of the micronucleus by FISH, we observed no significant difference between the groups (p>0.05). Conclusions: Our results showed no cytological alteration in patients using a mouth rinse with alcohol, but these findings should be considered preliminary results, to be confirmed in a greater sample of patients. Key words:Mouth wash, oral mucosa, cytological change, alcohol. PMID:23085712

Fixed, low radiant exposure vs. incremental radiant exposure approach for diode laser hair reduction: a randomized, split axilla, comparative single-blinded trial.

PubMed

Pavlović, M D; Adamič, M; Nenadić, D

2015-12-01

Diode lasers are the most commonly used treatment modalities for unwanted hair reduction. Only a few controlled clinical trials but not a single randomized controlled trial (RCT) compared the impact of various laser parameters, especially radiant exposure, onto efficacy, tolerability and safety of laser hair reduction. To compare the safety, tolerability and mid-term efficacy of fixed, low and incremental radiant exposures of diode lasers (800 nm) for axillary hair removal, we conducted an intrapatient, left-to-right, patient- and assessor-blinded and controlled trial. Diode laser (800 nm) treatments were evaluated in 39 study participants (skin type II-III) with unwanted axillary hairs. Randomization and allocation to split axilla treatments were carried out by a web-based randomization tool. Six treatments were performed at 4- to 6-week intervals with study subjects blinded to the type of treatment. Final assessment of hair reduction was conducted 6 months after the last treatment by means of blinded 4-point clinical scale using photographs. The primary endpoint was reduction in hair growth, and secondary endpoints were patient-rated tolerability and satisfaction with the treatment, treatment-related pain and adverse effects. Excellent reduction in axillary hairs (≥ 76%) at 6-month follow-up visit after receiving fixed, low and incremental radiant exposure diode laser treatments was obtained in 59% and 67% of study participants respectively (Z value: 1.342, P = 0.180). Patients reported lower visual analogue scale (VAS) pain score on the fixed (4.26) than on the incremental radiant exposure side (5.64) (P < 0.0003). The only side-effect was mild and transient erythema. Subjects better tolerated the fixed, low radiant exposure protocol (P = 0.03). The majority of the study participants were satisfied with both treatments. Both low and incremental radiant exposures produced similar hair reduction and high and comparable patient satisfaction. However, low radiant exposure diode laser treatments were less painful and better tolerated. © 2015 European Academy of Dermatology and Venereology.

Lumbar spinous process splitting decompression provides equivalent outcomes to conventional midline decompression in degenerative lumbar canal stenosis: a prospective, randomized controlled study of 51 patients.

PubMed

Rajasekaran, S; Thomas, Ashok; Kanna, Rishi M; Prasad Shetty, Ajoy

2013-09-15

Prospective, randomized controlled study. To compare the functional outcomes and extent of paraspinal muscle damage between 2 decompressive techniques for lumbar canal stenosis. Lumbar spinous process splitting decompression (LSPSD) preserves the muscular and liga-mentous attachments of the posterior elements of the spine. It can potentially avoid problems such as paraspinal muscle atrophy and trunk extensor weakness that can occur after conventional midline decompression. However, large series prospective randomized controlled studies are lacking. Patients with lumbar canal stenosis were randomly allocated into 2 groups: LSPSD (28 patients) and conventional midline decompression (23 patients). The differences in operative time, blood loss, time to comfortable mobilization, and hospital stay were studied. Paraspinal muscle damage was assessed by postoperative rise in creatine phosphokinase and C-reactive protein levels. Functional outcome was evaluated at 1 year by Japanese Orthopaedic Association score, neurogenic claudication outcome score, and visual analogue scale for back pain and neurogenic claudication. Fifty-one patients of mean age 56 years were followed-up for a mean 14.2 ± 2.9 months. There were no significant differences in the operative time, blood loss, and hospital stay. Both the groups showed significant improvement in the functional outcome scores at 1 year. Between the 2 groups, the Japanese Orthopaedic Association score, neurogenic claudication outcome score improvement, visual analogue scale for back pain, neurogenic claudication visual analogue scale, and the postoperative changes in serum C-reactive protein and creatine phosphokinase levels did not show any statistically significant difference. On the basis of the Japanese Orthopaedic Association recovery rate, it was found that 73.9% of conventional midline decompression group had good outcomes compared with only 60.7% after LSPSD. The functional outcome scores, back pain, and claudication pain in the immediate period and at the end of 1 year are similar in both the techniques. More patients had better functional outcomes after conventional decompression than the LSPSD technique. On the basis of this study, the superiority of one technique compared with the other is not established, mandating the need for further long-term studies. 2.

Physical properties of conventional and Super Slick elastomeric ligatures after intraoral use.

PubMed

Crawford, Nicola Louise; McCarthy, Caroline; Murphy, Tanya C; Benson, Philip Edward

2010-01-01

To investigate the change in the physical properties of conventional and Super Slick elastomeric ligatures after they have been in the mouth. Nine healthy volunteers took part. One orthodontic bracket was bonded to a premolar tooth in each of the four quadrants of the mouth. Two conventional and two Super Slick elastomeric ligatures were placed at random locations on either side of the mouth. The ligatures were collected after various time intervals and tested using an Instron Universal testing machine. The two outcome measures were failure load and the static frictional resistance. The failure load for conventional ligatures was reduced to 67% of the original value after 6 weeks in situ. Super Slick elastomeric ligatures showed a comparable reduction after 6 weeks in situ (63% of original value). There were no statistical differences in the static friction between conventional and Super Slick elastomerics that had been in situ for either 24 hours (P = .686) or 6 weeks (P = .416). There was a good correlation between failure load and static friction (r = .49). There were statistically significant differences in the failure loads of elastomerics that had not be placed in the mouth and those that had been in the mouth for 6 weeks. There were no differences in the static frictional forces produced by conventional and Super Slick ligatures either before or after they had been placed in the mouth. There appears to be a direct proportional relationship between failure load and static friction of elastomeric ligatures.

MiraLAX is not as effective as GoLytely in bowel cleansing before screening colonoscopies.

PubMed

Hjelkrem, Michael; Stengel, Joel; Liu, Mark; Jones, David P; Harrison, Stephen A

2011-04-01

Successful colonoscopies require good bowel preparations-poor bowel preparations can increase medical costs, rates of missed lesions, and procedure duration. The combination of polyethylene glycol (PEG) 3350 without electrolytes (MiraLAX; Schering-Plough Healthcare Products, Inc, Kenilworth, NJ) and 64 oz of Gatorade (PepsiCo, Inc, Purchase, NY) has gained popularity as a bowel preparation regimen. However, the efficacy and tolerability of this approach has not been compared with standard bowel preparations in clinical trials. We compared split-dose (PEG) 3350 with electrolytes (GoLytely; Braintree Laboratories, Inc, Braintree, MA) with split-dose MiraLAX alone and in combination with pretreatment medications (bisacodyl or lubiprostone) to determine the efficacy and patient tolerability of MiraLAX as an agent for bowel preparation. We performed a prospective, randomized, blinded, controlled trial at a tertiary care center. Patients (n=403) were randomly assigned to groups given GoLytely, MiraLAX, MiraLAX with bisacodyl (10 mg), or MiraLAX with lubiprostone (24 μg). MiraLAX was combined with 64 oz of Gatorade. All patients were surveyed regarding preparation satisfaction and tolerability. The Ottawa bowel preparation scale was used to grade colon cleanliness. GoLytely was more effective at bowel cleansing (average Ottawa score, 5.1) than MiraLAX alone (average Ottawa score, 6.9) or in combination with lubiprostone (average Ottawa score, 6.8), or bisacodyl (average Ottawa score, 6.3) (P<.001). MiraLAX was associated with a trend toward longer procedure duration (P=.096). Groups given MiraLAX rated the overall experience as more satisfactory than those given GoLytely (P<.001). There were no differences between polyp detection rates (P=.346) or adverse events (P=.823). Split-dose MiraLAX in 64 oz of Gatorade is not as effective as 4 L split-dose GoLytely in bowel cleansing for screening colonoscopies. Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.

Comparative evaluation of a bioabsorbable collagen membrane and connective tissue graft in the treatment of localized gingival recession: A clinical study

PubMed Central

Babu, Harsha Mysore; Gujjari, Sheela Kumar; Prasad, Deepak; Sehgal, Praveen Kumar; Srinivasan, Aishwarya

2011-01-01

Background: Gingival recession (GR) can result in root sensitivity, esthetic concern to the patient, and predilection to root caries. The purpose of this randomized clinical study was to evaluate (1) the effect of guided tissue regeneration (GTR) procedure using a bioabsorbable collagen membrane, in comparison to autogenous subepithelial connective tissue graft (SCTG) for root coverage in localized gingival recession defects; and (2) the change in width of keratinized gingiva following these two procedures. Materials and Methods: A total of 10 cases, showing at least two localized Miller's Class I or Class II gingival recession, participated in this study. In a split mouth design, the pairs of defects were randomly assigned for treatment with either SCTG (SCTG Group) or GTR-based collagen membrane (GTRC Group). Both the grafts were covered with coronally advanced flap. Recession depth (RD), recession width (RW), width of keratinized gingiva (KG), probing depth (PD), relative attachment level (RAL), plaque index (PI), and gingival index (GI) were recorded at baseline, 3 and 6 months postoperatively. Results: Six months following root coverage procedures, the mean root coverage was found to be 84.84% ± 16.81% and 84.0% ± 15.19% in SCTG Group and GTRC Group, respectively. The mean keratinized gingival width increase was 1.50 ± 0.70 mm and 2.30 ± 0.67 mm in the SCTG and GTRC group, respectively, which was not statistically significant. Conclusion: It may be concluded that resorbable collagen membrane can be a reliable alternative to autogenous connective tissue graft in the treatment of gingival recession. PMID:22368359

Effect of acidity of in-office bleaching gels on tooth sensitivity and whitening: a two-center double-blind randomized clinical trial.

PubMed

Loguercio, A D; Servat, F; Stanislawczuk, R; Mena-Serrano, A; Rezende, M; Prieto, M V; Cereño, V; Rojas, M F; Ortega, K; Fernandez, E; Reis, A

2017-12-01

The study aimed to compare the tooth sensitivity (TS) and bleaching efficacy of two hydrogen peroxide gels with different pHs (acid pH [Pola Office, SDI] and the neutral pH [Pola Office+, SDI]) used for in-office bleaching. Fifty-four patients from Brazil and Chile, with right superior incisor darker than A2, were selected for this double-blind, split-mouth randomized trial. Teeth were bleached in two sessions, with 1-week interval. Each session had three applications of 8 min each, according to the manufacturer's instructions. The color changes were evaluated by subjective (Vita Classical and Vita Bleachedguide) and objective (Easy shade spectrophotometer) methods. Participants recorded TS with 0-10 visual analog scale. Color change in shade guide units (SGU) and ΔE was analyzed by Student's t test (α = 0.05). The absolute risk and intensity of TS were evaluated by McNemar's test and Wilcoxon-paired test, respectively (α = 0.05). All groups achieved the same level of whitening after 30 days of clinical evaluation. The use of a neutral in-office bleaching gel significantly decreases the absolute risk of TS (28%, 95% CI 18-41) and intensity of TS when compared to the acid bleaching gel (absolute risk of 50%, 95% CI 37-63). The use of a neutral in-office bleaching agent gel produced the same whitening degree than an acid bleaching gel but with reduced risk and intensity of tooth sensitivity. Clinicians should opt to use in-office bleaching with a neutral gel than an acid product because the former causes a significant lower risk and intensity of tooth sensitivity.

In vitro study of the effect of an essential oil and a delmopinol mouth rinse on dental plaque bacteria.

PubMed

LuIs, Henrique Soares; Luis, Luis Soares; Bernardo, Mário

2016-01-01

Mouthrinses are used, by many of our patients, as a complement to daily dental hygiene routine. The use of a toothbrush and an interproximal cleaning method may not be enough to control dental plaque. Essential oils and delmopinol mouth rinses are effective for the prevention of dental caries and gingivitis. To study the effect of an essential oil and a delmopinol mouth rinse on dental plaque bacteria, an in vitro study was developed. The objective of this study was to determine the antibacterial activity of an essential oil and a delmopinol mouth rinse on Streptococcus mutans, Lactobacilli, and aerobic and anaerobic dental plaque nonspecific bacteria. Samples of human dental plaque were collected from consenting participants and bacteria isolated. Disk-diffusion tests were performed to obtain the minimum concentration of the mouth rinses necessary to inhibit bacterial growth. The ability of the commercial mouth rinses to inhibit bacterial growth was studied in comparison to a positive control (0.2% chlorhexidine) and a negative laboratorial control (sterilized water). The minimum inhibitory concentration was found to be inferior to the commercial essential oils and delmopinol mouth rinses concentrations. Delmopinol and essential oils have significant antibacterial properties shown in vitro only for aerobic bacteria, and for S. mutans, Lactobacillus, and anaerobic bacteria, the results were not statistically significant. Essential oils and chlorhexidine are statistically similar and better than delmopinol for aerobic bacteria growth inhibition. For the other bacteria, essential oils and delmopinol are not statistically promising. Results show that essential oils only may help patients to maintain good oral health as a complement to daily brushing and interproximal cleaning.

Does rational selection of training and test sets improve the outcome of QSAR modeling?

PubMed

Martin, Todd M; Harten, Paul; Young, Douglas M; Muratov, Eugene N; Golbraikh, Alexander; Zhu, Hao; Tropsha, Alexander

2012-10-22

Prior to using a quantitative structure activity relationship (QSAR) model for external predictions, its predictive power should be established and validated. In the absence of a true external data set, the best way to validate the predictive ability of a model is to perform its statistical external validation. In statistical external validation, the overall data set is divided into training and test sets. Commonly, this splitting is performed using random division. Rational splitting methods can divide data sets into training and test sets in an intelligent fashion. The purpose of this study was to determine whether rational division methods lead to more predictive models compared to random division. A special data splitting procedure was used to facilitate the comparison between random and rational division methods. For each toxicity end point, the overall data set was divided into a modeling set (80% of the overall set) and an external evaluation set (20% of the overall set) using random division. The modeling set was then subdivided into a training set (80% of the modeling set) and a test set (20% of the modeling set) using rational division methods and by using random division. The Kennard-Stone, minimal test set dissimilarity, and sphere exclusion algorithms were used as the rational division methods. The hierarchical clustering, random forest, and k-nearest neighbor (kNN) methods were used to develop QSAR models based on the training sets. For kNN QSAR, multiple training and test sets were generated, and multiple QSAR models were built. The results of this study indicate that models based on rational division methods generate better statistical results for the test sets than models based on random division, but the predictive power of both types of models are comparable.

Hedgehog activity controls opening of the primary mouth

PubMed Central

Tabler, Jacqueline M.; Bolger, Trióna G.; Wallingford, John; Liu, Karen J.

2014-01-01

To feed or breathe, the oral opening must connect with the gut. The foregut and oral tissues converge at the primary mouth, forming the buccopharyngeal membrane (BPM), a bilayer epithelium. Failure to form the opening between gut and mouth has significant ramifications, and many craniofacial disorders have been associated with defects in this process. Oral perforation is characterized by dissolution of the BPM, but little is known about this process. In humans, failure to form a continuous mouth opening is associated with mutations in Hedgehog (Hh) pathway members; however, the role of Hh in primary mouth development is untested. Here, we show, using Xenopus, that Hh signaling is necessary and sufficient to initiate mouth formation, and that Hh activation is required in a dose-dependent fashion to determine the size of the mouth. This activity lies upstream of the previously demonstrated role for Wnt signal inhibition in oral perforation. We then turn to mouse mutants to establish that SHH and Gli3 are indeed necessary for mammalian mouth development. Our data suggest that Hh-mediated BPM persistence may underlie oral defects in human craniofacial syndromes. PMID:25300580

A comparison between two simulation models for spread of foot-and-mouth disease.

PubMed

Halasa, Tariq; Boklund, Anette; Stockmarr, Anders; Enøe, Claes; Christiansen, Lasse E

2014-01-01

Two widely used simulation models of foot-and-mouth disease (FMD) were used in order to compare the models' predictions in term of disease spread, consequence, and the ranking of the applied control strategies, and to discuss the effect of the way disease spread is modeled on the predicted outcomes of each model. The DTU-DADS (version 0.100), and ISP (version 2.001.11) were used to simulate a hypothetical spread of FMD in Denmark. Actual herd type, movements, and location data in the period 1st October 2006 and 30th September 2007 was used. The models simulated the spread of FMD using 3 different control scenarios: 1) A basic scenario representing EU and Danish control strategies, 2) pre-emptive depopulation of susceptible herds within a 500 meters radius around the detected herds, and 3) suppressive vaccination of susceptible herds within a 1,000 meters radius around the detected herds. Depopulation and vaccination started 14 days following the detection of the first infected herd. Five thousand index herds were selected randomly, of which there were 1,000 cattle herds located in high density cattle areas and 1,000 in low density cattle areas, 1,000 swine herds located in high density swine areas and 1,000 in low density swine areas, and 1,000 sheep herds. Generally, DTU-DADS predicted larger, longer duration and costlier epidemics than ISP, except when epidemics started in cattle herds located in high density cattle areas. ISP supported suppressive vaccination rather than pre-emptive depopulation, while DTU-DADS was indifferent to the alternative control strategies. Nonetheless, the absolute differences between control strategies were small making the choice of control strategy during an outbreak to be most likely based on practical reasons.

A Comparison between Two Simulation Models for Spread of Foot-and-Mouth Disease

PubMed Central

Halasa, Tariq; Boklund, Anette; Stockmarr, Anders; Enøe, Claes; Christiansen, Lasse E.

2014-01-01

Two widely used simulation models of foot-and-mouth disease (FMD) were used in order to compare the models’ predictions in term of disease spread, consequence, and the ranking of the applied control strategies, and to discuss the effect of the way disease spread is modeled on the predicted outcomes of each model. The DTU-DADS (version 0.100), and ISP (version 2.001.11) were used to simulate a hypothetical spread of FMD in Denmark. Actual herd type, movements, and location data in the period 1st October 2006 and 30th September 2007 was used. The models simulated the spread of FMD using 3 different control scenarios: 1) A basic scenario representing EU and Danish control strategies, 2) pre-emptive depopulation of susceptible herds within a 500 meters radius around the detected herds, and 3) suppressive vaccination of susceptible herds within a 1,000 meters radius around the detected herds. Depopulation and vaccination started 14 days following the detection of the first infected herd. Five thousand index herds were selected randomly, of which there were 1,000 cattle herds located in high density cattle areas and 1,000 in low density cattle areas, 1,000 swine herds located in high density swine areas and 1,000 in low density swine areas, and 1,000 sheep herds. Generally, DTU-DADS predicted larger, longer duration and costlier epidemics than ISP, except when epidemics started in cattle herds located in high density cattle areas. ISP supported suppressive vaccination rather than pre-emptive depopulation, while DTU-DADS was indifferent to the alternative control strategies. Nonetheless, the absolute differences between control strategies were small making the choice of control strategy during an outbreak to be most likely based on practical reasons. PMID:24667525

Foot-and-mouth disease control and eradication in the Bicol Surveillance Buffer Zone of the Philippines.

PubMed

Windsor, P A; Freeman, P G; Abila, R; Benigno, C; Verin, B; Nim, V; Cameron, A

2011-10-01

Following the onset of an epidemic of foot and mouth disease (FMD) commencing in 1994 and affecting mainly pigs in the Philippines, a National Plan for the Control and Eradication of the disease was initiated. A disease surveillance buffer zone in the southern Luzon region of Bicol was established to protect the Visayas and Mindanao from infection and enable eventual elimination of the disease in Luzon. With achievement of Office International Epizooties (OIE)-certified FMD freedom with vaccination in the Philippines now imminent, the four components of the disease control strategy are reviewed, including quarantine and animal movement controls, strategic vaccination, surveillance and disease investigation, and enhanced public awareness with school on the air radio programmes. Although numbers of outbreaks declined following widespread vaccination, evaluation of serological responses in vaccinates suggested low levels of immune protection. The cessation of outbreaks was considered more likely a result of animal movement controls, improved surveillance and emergency response capability, and reduction in FMD-risk behaviours by livestock owners, particularly through efforts to enhance public awareness of biosecurity measures by the training of traders, livestock industry personnel and both commercial and smallholder farmers. A two-stage random sampling serosurveillance strategy enabled identification of residual infection that was not detected through opportunistic sampling and negative incident reporting. Intensive investigations of FMD outbreaks, particularly in Albay province in 1999, enabled improved understanding of the risk factors involved in disease transmission and implementation of appropriate interventions. The findings from this review are offered to assist development of FMD control and eradication programmes in other countries in south-east Asia that are now being encouraged to support the OIE goal of FMD freedom with vaccination by 2020. © 2011 Blackwell Verlag GmbH.

Video on Diet Before Outpatient Colonoscopy Does Not Improve Quality of Bowel Preparation: A Prospective, Randomized, Controlled Trial.

PubMed

Rice, Sean C; Higginbotham, Tina; Dean, Melanie J; Slaughter, James C; Yachimski, Patrick S; Obstein, Keith L

2016-11-01

Successful outpatient colonoscopy (CLS) depends on many factors including the quality of a patient's bowel preparation. Although education on consumption of the pre-CLS purgative can improve bowel preparation quality, no study has evaluated dietary education alone. We have created an educational video on pre-CLS dietary instructions to determine whether dietary education would improve outpatient bowel preparation quality. A prospective randomized, blinded, controlled study of patients undergoing outpatient CLS was performed. All patients received a 4 l polyethylene glycol-based split-dose bowel preparation and standard institutional pre-procedure instructions. Patients were then randomly assigned to an intervention arm or to a no intervention arm. A 4-min educational video detailing clear liquid diet restriction was made available to patients in the intervention arm, whereas those randomized to no intervention did not have access to the video. Patients randomized to the video were provided with the YouTube video link 48-72 h before CLS. An attending endoscopist blinded to randomization performed the CLS. Bowel preparation quality was scored using the Boston Bowel Preparation Scale (BBPS). Adequate preparation was defined as a BBPS total score of ≥6 with all segment scores ≥2. Wilcoxon rank-sum and Pearson's χ 2 -tests were performed to assess differences between groups. Ninety-two patients were randomized (video: n=42; control: n=50) with 47 total video views being tallied. There were no demographic differences between groups. There was no statistically significant difference in adequate preparation between groups (video=74%; control=68%; P=0.54). The availability of a supplementary patient educational video on clear liquid diet alone was insufficient to improve bowel preparation quality when compared with standard pre-procedure instruction at our institution.

Effectiveness of new vibration delivery system on pain associated with injection of local anesthesia in children.

PubMed

Shilpapriya, Mangalampally; Jayanthi, Mungara; Reddy, Venumbaka Nilaya; Sakthivel, Rajendran; Selvaraju, Girija; Vijayakumar, Poornima

2015-01-01

Pain is highly subjective and it is neurologically proven that stimulation of larger diameter fibers - e.g., using appropriate coldness, warmth, rubbing, pressure or vibration - can close the neural "gate" so that the central perception of itch and pain is reduced. This fact is based upon "gate control" theory of Melzack and Wall. The present study was carried out to investigate the effects of vibration stimuli on pain experienced during local anesthetic injections. Thirty patients aged 6-12 years old of both the genders with Frankel's behavior rating scale as positive and definitely positive requiring bilateral local anesthesia injections for dental treatment were included in the split-mouth cross over design. Universal pain assessment tool was used to assess the pain with and without vibration during the administration of local anesthesia and the results obtained were tabulated and statistically analyzed. Local anesthetic administration with vibration resulted in significantly less pain (P = 0.001) compared to the injections without the use of vibe. The results suggest that vibration can be used as an effective method to decrease pain during dental local anesthetic administration.

Accelerated tooth movement with piezocision and its periodontal-transversal effects in patients with Class II malocclusion.

PubMed

Aksakalli, Sertac; Calik, Berra; Kara, Burcak; Ezirganli, Seref

2016-01-01

To compare the extent of canine distalization and the transversal changes, postdistalization gingival indices, and mobility scores between patients who were undergoing orthodontic treatment involving upper premolar extraction with (experimental group) or without piezocision. Twenty maxillary canines of 10 patients were evaluated with split mouth design. Pre- and postdistalization dental casts were prepared and scanned with an orthodontic scanner to compare the extent of distalization and transversal changes between the two groups. The pre- and postdistalization gingival indices and mobility scores were also calculated. Three-dimensional analysis of the models revealed significant differences in tooth movement (lesser anchorage loss and greater canine distalization) between the experimental and control groups. Furthermore, the distalization time was shortened in the experimental group. There were no differences in the transversal changes, pre- and postdistalization gingival indices, or mobility scores between groups. Piezocision-assisted distalization accelerates tooth movement, decreases the anchorage loss for posterior teeth, and does not induce any maxillary transversal change. Moreover, piezocision does not have any adverse effects on periodontal health.

On-demand acoustic droplet splitting and steering in a disposable microfluidic chip.

PubMed

Park, Jinsoo; Jung, Jin Ho; Park, Kwangseok; Destgeer, Ghulam; Ahmed, Husnain; Ahmad, Raheel; Sung, Hyung Jin

2018-01-30

On-chip droplet splitting is one of the fundamental droplet-based microfluidic unit operations to control droplet volume after production and increase operational capability, flexibility, and throughput. Various droplet splitting methods have been proposed, and among them the acoustic droplet splitting method is promising because of its label-free operation without any physical or thermal damage to droplets. Previous acoustic droplet splitting methods faced several limitations: first, they employed a cross-type acoustofluidic device that precluded multichannel droplet splitting; second, they required irreversible bonding between a piezoelectric substrate and a microfluidic chip, such that the fluidic chip was not replaceable. Here, we present a parallel-type acoustofluidic device with a disposable microfluidic chip to address the limitations of previous acoustic droplet splitting devices. In the proposed device, an acoustic field is applied in the direction opposite to the flow direction to achieve multichannel droplet splitting and steering. A disposable polydimethylsiloxane microfluidic chip is employed in the developed device, thereby removing the need for permanent bonding and improving the flexibility of the droplet microfluidic device. We experimentally demonstrated on-demand acoustic droplet bi-splitting and steering with precise control over the droplet splitting ratio, and we investigated the underlying physical mechanisms of droplet splitting and steering based on Laplace pressure and ray acoustics analyses, respectively. We also demonstrated droplet tri-splitting to prove the feasibility of multichannel droplet splitting. The proposed on-demand acoustic droplet splitting device enables on-chip droplet volume control in various droplet-based microfluidic applications.

Expression of porcine fusion protein IRF7/3(5D) efficiently controls foot-and-mouth disease virus replication

USDA-ARS?s Scientific Manuscript database

Several studies have demonstrated that administration of type I, II, or III interferons (IFN) delivered using a replication defective human adenovirus 5 (Ad5) vector is effective to control Foot-and-Mouth Disease (FMD) in cattle and swine during experimental infections. However, high doses are requi...

Effect of village-wide use of long-lasting insecticidal nets on visceral Leishmaniasis vectors in India and Nepal: a cluster randomized trial.

PubMed

Picado, Albert; Das, Murari L; Kumar, Vijay; Kesari, Shreekant; Dinesh, Diwakar S; Roy, Lalita; Rijal, Suman; Das, Pradeep; Rowland, Mark; Sundar, Shyam; Coosemans, Marc; Boelaert, Marleen; Davies, Clive R

2010-01-26

Visceral leishmaniasis (VL) control in the Indian subcontinent is currently based on case detection and treatment, and on vector control using indoor residual spraying (IRS). The use of long-lasting insecticidal nets (LN) has been postulated as an alternative or complement to IRS. Here we tested the impact of comprehensive distribution of LN on the density of Phlebotomus argentipes in VL-endemic villages. A cluster-randomized controlled trial with household P. argentipes density as outcome was designed. Twelve clusters from an ongoing LN clinical trial--three intervention and three control clusters in both India and Nepal--were selected on the basis of accessibility and VL incidence. Ten houses per cluster selected on the basis of high pre-intervention P. argentipes density were monitored monthly for 12 months after distribution of LN using CDC light traps (LT) and mouth aspiration methods. Ten cattle sheds per cluster were also monitored by aspiration. A random effect linear regression model showed that the cluster-wide distribution of LNs significantly reduced the P. argentipes density/house by 24.9% (95% CI 1.80%-42.5%) as measured by means of LTs. The ongoing clinical trial, designed to measure the impact of LNs on VL incidence, will confirm whether LNs should be adopted as a control strategy in the regional VL elimination programs. The entomological evidence described here provides some evidence that LNs could be usefully deployed as part of the VL control program. ClinicalTrials.gov CT-2005-015374.

Evaluation of the effect of cryotherapy in preventing oral mucositis associated with chemotherapy - a randomized controlled trial.

PubMed

Katrancı, Nilgün; Ovayolu, Nimet; Ovayolu, Ozlem; Sevinc, Alper

2012-09-01

The goal of this study was to assess the effect of oral cryotherapy on the development of oral mucositis related to infusion of 5-fluorouracil (5-FU) with leucovorin. This study, a randomized controlled trial with random assignments to the experimental and control groups, was conducted with cancer patients. The study included 60 patients; 30 patients in the study group were instructed to hold ice cubes in their mouth shortly before, during, and shortly after infusion of 5-FU with leucovorin, the 30 patients in the control group received routine care. Oral mucositis in the patients was evaluated at 7, 14, and 21 days after chemotherapy. For analysis of data, chi-square, Fisher's tests were used; p < 0.05 was accepted as statistically significant. In the majority of patients receiving cryotherapy, oral mucositis was not observed (Grade 0) at 7 and 14 days. Similarly, incidence of Grades 1, 2, and 3 oral mucositis in the experimental group was quite a bit lower when compared to the control group (p < 0.05). On day 21, no statistically significant difference between the experimental and control groups was determined based on the development of oral mucositis (p > 0.05). We found that oral cryotherapy has a significant contribution to the protection of oral health by reducing mucositis score according to the WHO mucositis scale, especially on the 7th and 14th days. Nurses' awareness of how cryotherapy can affect patients and options for resolving problems will enable them to provide a higher standard of individualized care. Copyright © 2011 Elsevier Ltd. All rights reserved.

Consumers' use of HCAHPS ratings and word-of-mouth in hospital choice.

PubMed

Huppertz, John W; Carlson, Jay P

2010-12-01

To investigate the impact of the HCAHPS report of patient experiences and word-of-mouth narratives on consumers' hospital choice. Online consumer research panel of U.S. adults ages 18 and older. In an experiment, 309 consumers were randomly assigned to see positive or negative information about a hospital in two modalities: HCAHPS graphs and a relative's narrative e-mail. Then they indicated their intentions to choose the hospital for elective surgery. A simple, one-paragraph e-mail and 10 HCAHPS graphs had similar impacts on consumers' hospital choice. When information was inconsistent between the HCAHPS data and e-mail narrative, one modality attenuated the other's effect on hospital choice. The findings illustrate the power of anecdotal narratives, suggesting that policy makers should consider how HCAHPS data can be affected by word-of-mouth communication. © Health Research and Educational Trust.

Consumers' Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice

PubMed Central

Huppertz, John W; Carlson, Jay P

2010-01-01

Objective To investigate the impact of the HCAHPS report of patient experiences and word-of-mouth narratives on consumers' hospital choice. Data Sources Online consumer research panel of U.S. adults ages 18 and older. Study Design/Data Collection/Extraction Methods In an experiment, 309 consumers were randomly assigned to see positive or negative information about a hospital in two modalities: HCAHPS graphs and a relative's narrative e-mail. Then they indicated their intentions to choose the hospital for elective surgery. Principal Findings A simple, one-paragraph e-mail and 10 HCAHPS graphs had similar impacts on consumers' hospital choice. When information was inconsistent between the HCAHPS data and e-mail narrative, one modality attenuated the other's effect on hospital choice. Conclusions The findings illustrate the power of anecdotal narratives, suggesting that policy makers should consider how HCAHPS data can be affected by word-of-mouth communication. PMID:20698896

Optimizing the combination insulin bolus split for a high-fat, high-protein meal in children and adolescents using insulin pump therapy.

PubMed

Lopez, P E; Smart, C E; McElduff, P; Foskett, D C; Price, D A; Paterson, M A; King, B R

2017-10-01

To determine the optimum combination bolus split to maintain postprandial glycaemia with a high-fat and high-protein meal in young people with Type 1 diabetes. A total of 19 young people (mean age 12.9 ± 6.7 years) participated in a randomized, repeated-measures trial comparing postprandial glycaemic control across six study conditions after a high-fat and high-protein meal. A standard bolus and five different combination boluses were delivered over 2 h in the following splits: 70/30 = 70% standard /30% extended bolus; 60/40=60% standard/40% extended bolus; 50/50=50% standard/50% extended bolus; 40/60=40% standard/60% extended bolus; and 30/70=30% standard/70% extended bolus. Insulin dose was determined using the participant's optimized insulin:carbohydrate ratio. Continuous glucose monitoring was used to assess glucose excursions for 6 h after the test meal. Standard bolus and combination boluses 70/30 and 60/40 controlled the glucose excursion up to 120 min. From 240 to 300 min after the meal, the glucose area under the curve was significantly lower for combination bolus 30/70 compared with standard bolus (P=0.004). High-fat and high-protein meals require a ≥60% insulin:carbohydrate ratio as a standard bolus to control the initial postprandial rise. Additional insulin at an insulin:carbohydrate ratio of up to 70% is needed in the extended bolus for a high fat and protein meal to prevent delayed hyperglycaemia. © 2017 Diabetes UK.

Adaptive role switching promotes fairness in networked ultimatum game.

PubMed

Wu, Te; Fu, Feng; Zhang, Yanling; Wang, Long

2013-01-01

In recent years, mechanisms favoring fair split in the ultimatum game have attracted growing interests because of its practical implications for international bargains. In this game, two players are randomly assigned two different roles respectively to split an offer: the proposer suggests how to split and the responder decides whether or not to accept it. Only when both agree is the offer successfully split; otherwise both get nothing. It is of importance and interest to break the symmetry in role assignment especially when the game is repeatedly played in a heterogeneous population. Here we consider an adaptive role assignment: whenever the split fails, the two players switch their roles probabilistically. The results show that this simple feedback mechanism proves much more effective at promoting fairness than other alternatives (where, for example, the role assignment is based on the number of neighbors).

The effects of Alkanna tinctoria Tausch on split-thickness skin graft donor site management: a randomized, blinded placebo-controlled trial.

PubMed

Kheiri, Aliasghar; Amini, Shahideh; Javidan, Abbas Norouzi; Saghafi, Mohammad Mehdi; Khorasani, Ghasemali

2017-05-08

A prospective, randomized, placebo-controlled clinical trial was conducted to compare the healing effectiveness of Alkanna tinctoria (L.) Tausch (Boraginaceae) with standard dressing on wound healing at the donor site after removal of the skin graft. Enrolled patients were randomly allocated to receive topicalA. tinctoria extract ointment (20%) or standard dressing (dressing with base ointment) daily. Wound healing was assessed using the Bates-Jenson assessment tool at the 2 nd and 4 th weeks after intervention. Decreases in wound score were significantly greater in the A. tinctoria group compared with the placebo group (P <0.05). The surface areas of graft donor sites in the A. tinctoria group were significantly reduced as compared with the control group at day 28 of the intervention (P < 0.05). The proportion of patients in the A. tinctoria group achieving complete wound healing within 2 to 4 weeks was 50% and 96.66%, respectively, significantly higher than in patients receiving standard care: 0% and 23.3%, respectively. This clinical study showed that A. tinctoria dressing accelerates wound healing after graft harvesting. IRCT ID: IRCT201511165781N2 .

Relaxation therapy and anxiety, self-esteem, and emotional regulation among adults with intellectual disabilities: A randomized controlled trial.

PubMed

Bouvet, Cyrille; Coulet, Aurélie

2016-09-01

This pilot study is a randomized controlled trial on the effects of relaxation on anxiety, self-esteem, and emotional regulation in adults with intellectual disabilities (ID) working in a center of supported employment in France. We studied 30 adults with mild or moderate ID who were split at random into a relaxation group (RG, 15 subjects), who completed 10 sessions of relaxation therapy, and a control group (CG, 15 subjects), who were on a waiting list. The method used is the pretest and posttest. Variables were assessed by the State-Trait Anxiety Inventory form Y scale, the Rosenberg Self-Esteem scale, and the Emotion Regulation Questionnaire. We found that in the RG, relaxation significantly reduced state anxiety, t(14, 15) = 17.8***, d = -0.72, and improved self-esteem, t(14, 15) = -7.7***, d = 1.03, and cognitive reappraisal, t(14, 15) = -6.3***, d = 1.3, while the CG showed no change for these variables. We conclude that relaxation seems to be an interesting therapeutic option for reducing anxiety in people with ID in a supported employment setting. © The Author(s) 2015.

[Investigation of the clinical value of total salival flow rates].

PubMed

Wang, S; Zhao, Z; Li, J

1998-11-01

To investigate clinical value of total saliva flow rates. The symptom of dry mouth was correlated with unstimulated (UWSFR) and stimulated (SWSFR) whole saliva flow rates on chewing medical paraffin in 62 patients with dry mouth complaints (30 with Sjögren's syndrome, 32 with sialosis) and 23 controls. The symptom of dry mouth was classified into 0,1,2,3,4 according to a treatment emergent symptom scale (TESS). UWSFR and SWSFR were determined after fasting in the morning. UWSFR was (0.070 +/- 0.089) ml/min in Sjögren's syndrome, (0.175 +/- 0.115) ml/min in sialosis, (0.330 +/- 0.188) ml/min in controls. SWSFR was (0.709 +/- 0.720) ml/min in Sjögren's syndrome, (1.561 +/- 0.867) ml/min in sialosis, (1.894 +/- 0.661) ml/min in controls. A highly significant correlation was found between TESS score and UWSFR and between TESS score and SWSFR. Only UWSFR was decreased in the patients with a TESS score of 1 or 2, while both UWSFR and SWSFR were significantly decreased in patients with TESS scores of 3,4. It is concluded that UWSFR is more sensitive in relation to dry mouth complaints than SWSFR, and that a mild dry mouth is mainly related to decreased UWSFR.

Clinical effect of reducing curing times with high-intensity LED lights

PubMed Central

Ward, Justin D.; Wolf, Bethany J.; Leite, Luis P.; Zhou, Jing

2016-01-01

Objective To evaluate the clinical performance of brackets cured with a high-intensity, light-emitting diode (LED) with a shorter curing time. Materials and Methods Thirty-four patients and a total of 680 brackets were examined using a randomized split-mouth design. The maxillary right and mandibular left quadrants were cured for 6 seconds with a high-intensity LED light (3200 mW/cm2) and the maxillary left and mandibular right quadrants were cured for 20 seconds with a standard-intensity LED light (1200 mW/cm2). Alternating patients had the quadrants inverted for the curing protocol. The number and date of each first-time bracket failure was recorded from 199 to 585 days posttreatment. Results The bracket failure rate was 1.18% for both curing methods. The proportion of bracket failure was not significantly different between curing methods (P = 1.000), genders (P = 1.000), jaws (P = .725), sides (P = .725), or quadrants (P = .547). Posterior teeth exhibited a greater proportion of failures (2.21%) relative to anterior teeth (0.49%), although the difference was not statistically significant (P = .065). Conclusions No difference was found in bond failure rates between the two curing methods. Both methods showed bond failure rates low enough to be considered clinically sufficient. The high-intensity LED light used with a shorter curing time may be considered an advantage due to the reduced chair time. PMID:25760887

Histopathological comparative analysis of peri-implant soft tissue response after dental implant placement with flap and flapless surgical technique. Experimental study in pigs.

PubMed

Vlahovic, Zoran; Markovic, Aleksa; Golubovic, Mileta; Scepanovic, Miodrag; Kalanovic, Milena; Djinic, Ana

2015-11-01

The aim of this study was comparing the effect of flapless vs. flap technique of implant placement on inflammation degree of peri-implant soft tissue, through histopathological analysis. The experiment was conducted on five domestic pigs. Nine weeks after tooth extraction, implants were installed. Each animal received six implants in mandible. According to split-mouth design, randomly one side was used for flapless technique using mini-incision, while on the other side, flap was raised. After 7, 14, 21, 28, and 90 days, the experimental animals were sacrificed. Samples for histopathological analyzes were taken from the buccal side of peri-implant mucosa next to the neck of implants, from three levels. The degree of inflammatory response in the peri-implant soft tissue was estimated through ordinal scores from 0 to 3. In the flap group Score 3 indicating high degree of inflammation was present from day 7 to day 21, in contrast to flapless group where Score 3 was not recorded during the entire follow-up. Three months after implantation, there were no signs of inflammation neither around flap nor around flapless implants. Flapless surgical implantation technique using mini-incision decreases peri-implant soft tissue inflammatory reaction compared with flap surgery. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Survival of occlusal ART restorations in primary molars placed in school environment and hospital dental setup-one year follow-up study.

PubMed

Roshan, Noor-Mohammed; Sakeenabi, Basha

2011-11-01

The objectives of this clinical study were to: evaluate the survival of occlusal atraumatic restorative treatment (ART) restorations, on a longitudinal basis, in the primary molars of children; and compare the success rate of ART restorations placed in school environment and in hospital dental setup. One dentist placed 120 ART restorations in 60 five- to seven year-olds who had bilateral matched pairs of carious primary molars. A split-mouth design was used to place restorations in school and in hospital dental setup, which were assigned randomly to contralateral sides. Restorations were evaluated after 6 and 12 months using the ART criteria. The survival rate of ART restorations placed in school environment was 82.2% at the 6-month assessment and 77.77% at the 12-month assessment. The success rates of ART restorations placed in hospital dental setup in the 2 assessments were 87.7% and 81.48%, respectively. There was no statistically significant difference between the ART restorations placed in school environment and hospital dental setup in both assessments (P > O.05). The main cause of failure was the loss of restoration. The one year success rate of occlusal ART restorations in primary molars was moderately successful. The ART technique's done in hospital dental setup was not proven to be better than restorations placed in school environment.

Evaluation of periosteum eversion and coronally advanced flap techniques in the treatment of isolated Miller's Class I/II gingival recession: A comparative clinical study

PubMed Central

Debnath, Koel; Chatterjee, Anirban

2018-01-01

Aim: The present investigation aimed to evaluate root coverage (RC) with periosteum eversion technique (PET) using periosteum as a graft and coronally advanced flap (CAF) with platelet-rich fibrin (PRF) membrane as a graft in the treatment of isolated Miller's class I and II gingival recession defects. Materials and Methods: Thirty sites in 15 participants with Miller's Class I or II gingival recession were randomly treated either with PET using periosteum as graft and CAF + PRF as graft. In a split mouth design, the parameters such as recession depth, recession width at cementoenamel junction, probing depth, periodontal attachment level (PAL), and keratinized gingival width were assessed at baseline, 3 months, and 6 months postoperative follow-up with William's graduated probe and Vernier caliper. Results: Both the treatment modalities yielded statistically nonsignificant desirable treatment outcomes at both postoperative levels in terms of all the parameters The mean RC with probe method and Vernier method in CAF + PRF was 75.01% and 86.86%, respectively, and PET showed a mean RC of 61.112% and 83.971%, respectively, at 6-month interval period which showed a nonstatistically significant difference. Conclusion: Both the treatment modalities, i.e., CAF + PRF and PET are essentially and equally effective in the treatment of Miller's Class I or II gingival recession defects. PMID:29769769

Development of highly reliable static random access memory for 40-nm embedded split gate-MONOS flash memory

NASA Astrophysics Data System (ADS)

Okamoto, Shin-ichi; Maekawa, Kei-ichi; Kawashima, Yoshiyuki; Shiba, Kazutoshi; Sugiyama, Hideki; Inoue, Masao; Nishida, Akio

2015-04-01

High quality static random access memory (SRAM) for 40-nm embedded MONOS flash memory with split gate (SG-MONOS) was developed. Marginal failure, which results in threshold voltage/drain current tailing and outliers of SRAM transistors, occurs when using a conventional SRAM structure. These phenomena can be explained by not only gate depletion but also partial depletion and percolation path formation in the MOS channel. A stacked poly-Si gate structure can suppress these phenomena and achieve high quality SRAM without any defects in the 6σ level and with high affinity to the 40-nm SG-MONOS process was developed.

FIBER AND INTEGRATED OPTICS. FIBER WAVEGUIDE DEVICES: Vector solitons in fiber waveguides with a random birefringence

NASA Astrophysics Data System (ADS)

Kivshar', Yu S.; Konotop, V. V.

1990-12-01

A study is made of the propagation of soliton pulses in single-mode fiber waveguides with a birefringence that gives rise to a nonlinear interaction between the polarizations and to a difference between their group velocities. It is shown that a vector soliton decays if a parameter representing the birefringence intensity exceeds a certain critical value. The case when the birefringence can be described by a random function is of special interest. It is demonstrated that fluctuations of the birefringence then split the vector solitons into separate polarizations and the characteristic distance governing such splitting is calculated analytically.

Safety and immunogenicity of adjuvanted inactivated split-virion and whole-virion influenza A (H5N1) vaccines in children: a phase I-II randomized trial.

PubMed

Wu, Jiang; Liu, Shu-Zhen; Dong, Shan-Shan; Dong, Xiao-Ping; Zhang, Wu-Li; Lu, Min; Li, Chang-Gui; Zhou, Ji-Chen; Fang, Han-Hua; Liu, Yan; Liu, Li-Ying; Qiu, Yuan-Zheng; Gao, Qiang; Zhang, Xiao-Mei; Chen, Jiang-Ting; Zhong, Xiang; Yin, Wei-Dong; Feng, Zi-Jian

2010-08-31

Highly pathogenic avian influenza A virus H5N1 has the potential to cause a pandemic. Many prototype pandemic influenza A (H5N1) vaccines had been developed and well evaluated in adults in recent years. However, data in children are limited. Herein we evaluate the safety and immunogenicity of adjuvanted split-virion and whole-virion H5N1 vaccines in children. An open-labelled phase I trial was conducted in children aged 3-11 years to receive aluminum-adjuvated, split-virion H5N1 vaccine (5-30 microg) and in children aged 12-17 years to receive aluminum-adjuvated, whole-virion H5N1 vaccine (5-15 microg). Safety of the two formulations was assessed. Then a randomized phase II trial was conducted, in which 141 children aged 3-11 years received the split-virion vaccine (10 or 15 microg) and 280 children aged 12-17 years received the split-virion vaccine (10-30 microg) or the whole-virion vaccine (5 microg). Serum samples were collected for hemagglutination-inhibition (HI) assays. 5-15 microg adjuvated split-virion vaccines were well tolerated in children aged 3-11 years and 5-30 microg adjuvated split-virion vaccines and 5 microg adjuvated whole-virion vaccine were well tolerated in children aged 12-17 years. Most local and systemic reactions were mild or moderate. Before vaccination, all participants were immunologically naïve to H5N1 virus. Immune responses were induced after the first dose and significantly boosted after the second dose. In 3-11 years children, the 10 and 15 microg split-virion vaccine induced similar responses with 55% seroconversion and seroprotection (HI titer >or=1:40) rates. In 12-17 years children, the 30 microg split-virion vaccine induced the highest immune response with 71% seroconversion and seroprotection rates. The 5 microg whole-virion vaccine induced higher response than the 10 microg split-virion vaccine did. The aluminum-adjuvanted, split-virion prototype pandemic influenza A (H5N1) vaccine showed good safety and immunogenicity in children and 30 microg dose induced immune response complying with European Union licensure criteria. (c) 2010 Elsevier Ltd. All rights reserved.

Oral Glucosamine Hydrochloride Combined With Hyaluronate Sodium Intra-Articular Injection for Temporomandibular Joint Osteoarthritis: A Double-Blind Randomized Controlled Trial.

PubMed

Yang, Wenbin; Liu, Wei; Miao, Cheng; Sun, Haibin; Li, Longjiang; Li, Chunjie

2018-06-02

Temporomandibular joint (TMJ) disorders occur in many people and osteoarthritis (OA) is a severe form of this disease. Glucosamine has been used to treat OA of the large joints for many years and has been proved effective. A double-blinded randomized controlled trial was designed to investigate the effectiveness and safety of oral glucosamine hydrochloride pills combined with hyaluronate sodium intra-articular injection in TMJ OA. One hundred forty-four participants with TMJ OA were randomized to 4 hyaluronate sodium injections and oral glucosamine hydrochloride (1.44 g/day) for 3 months (group A) or 4 hyaluronate sodium injections and oral placebo for 3 months (group B). All participants were followed for 1 year. Eighteen participants were lost to follow-up. The intention-to-treat analysis showed that group A had similar maximal interincisal mouth opening and pain intensity during TMJ function at months 1 and 6 (P > .05). However, during long-term follow-up, group A had significantly greater maximal interincisal mouth opening compared with group B at month 12 (41.5 vs 37.9 mm; P < .001). For pain intensity, group A showed obviously lower visual analog scale scores than group B at month 6 (20.6 vs 29.2 mm; P = .007) and month 12 (17.4 vs 28.6 mm; P = .001). Twenty-four participants had gastrointestinal tract side effects, fatigue, and rash. Of these, 23 had slight side effects that were not correlated with glucosamine. There was no significant difference between the 2 groups (P > .05). The results of this study suggest that, compared with hyaluronate sodium injection alone, glucosamine hydrochloride pills added to hyaluronate sodium injection had no meaningful effect on TMJ OA in the short-term but did relieve the pain caused by TMJ OA and improved TMJ functions in the long-term. Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Usefulness of new wetness tester for diagnosis of dry mouth in disabled patients.

PubMed

Kakinoki, Yasuaki; Nishihara, Tatsuji; Arita, Masahiro; Shibuya, Koji; Ishikawa, Masao

2004-12-01

The condition of dry mouth is an influential factor in the incidence of caries, periodontal disease, fungal infections, masticatory dysfunctions and denture function. Bedridden elderly and disabled persons often suffer from oral dryness and the aim of this study was to evaluate the usefulness of measuring the amount of moisture in the oral mucosa for clinical diagnosis of dry mouth in this group. The subjects were 20 elderly bedridden individuals, age range 65-89 years old, living in a nursing home and six healthy laboratory researchers, aged 20-46 years old, used as controls. Tongue dorsum moisture measurements were performed using a newly developed wetness tester (L-SALIVO), in which the wet portion was measured after 10 s. Further, clinical diagnosis of dry mouth was carried out using a clinical classification scale of the tongue mucosa (grade range, 0-3). It was possible to measure tongue dorsum moisture in all subjects with the wetness tester. The average moisture value was 0.1+/-0.2 mm in elderly subjects with a dry mouth grade of 2 (n = 8) or 3 (n = 12), while the average moisture value in the control subjects was 3.67+/-1.75 mm with a dry mouth grade of 0 (n = 4) or 1 (n = 2). Tester values and cliniical classification showed a positive co-relationship (r = 0.31, p < 0.05). Our results show that this new tester could be useful for evaluating oral dryness and diagnosing dry mouth.

An Intention-Driven Semi-autonomous Intelligent Robotic System for Drinking.

PubMed

Zhang, Zhijun; Huang, Yongqian; Chen, Siyuan; Qu, Jun; Pan, Xin; Yu, Tianyou; Li, Yuanqing

2017-01-01

In this study, an intention-driven semi-autonomous intelligent robotic (ID-SIR) system is designed and developed to assist the severely disabled patients to live independently. The system mainly consists of a non-invasive brain-machine interface (BMI) subsystem, a robot manipulator and a visual detection and localization subsystem. Different from most of the existing systems remotely controlled by joystick, head- or eye tracking, the proposed ID-SIR system directly acquires the intention from users' brain. Compared with the state-of-art system only working for a specific object in a fixed place, the designed ID-SIR system can grasp any desired object in a random place chosen by a user and deliver it to his/her mouth automatically. As one of the main advantages of the ID-SIR system, the patient is only required to send one intention command for one drinking task and the autonomous robot would finish the rest of specific controlling tasks, which greatly eases the burden on patients. Eight healthy subjects attended our experiment, which contained 10 tasks for each subject. In each task, the proposed ID-SIR system delivered the desired beverage container to the mouth of the subject and then put it back to the original position. The mean accuracy of the eight subjects was 97.5%, which demonstrated the effectiveness of the ID-SIR system.

Socio-ecological factors and hand, foot and mouth disease in dry climate regions: a Bayesian spatial approach in Gansu, China

NASA Astrophysics Data System (ADS)

Gou, Faxiang; Liu, Xinfeng; Ren, Xiaowei; Liu, Dongpeng; Liu, Haixia; Wei, Kongfu; Yang, Xiaoting; Cheng, Yao; Zheng, Yunhe; Jiang, Xiaojuan; Li, Juansheng; Meng, Lei; Hu, Wenbiao

2017-01-01

The influence of socio-ecological factors on hand, foot and mouth disease (HFMD) were explored in this study using Bayesian spatial modeling and spatial patterns identified in dry regions of Gansu, China. Notified HFMD cases and socio-ecological data were obtained from the China Information System for Disease Control and Prevention, Gansu Yearbook and Gansu Meteorological Bureau. A Bayesian spatial conditional autoregressive model was used to quantify the effects of socio-ecological factors on the HFMD and explore spatial patterns, with the consideration of its socio-ecological effects. Our non-spatial model suggests temperature (relative risk (RR) 1.15, 95 % CI 1.01-1.31), GDP per capita (RR 1.19, 95 % CI 1.01-1.39) and population density (RR 1.98, 95 % CI 1.19-3.17) to have a significant effect on HFMD transmission. However, after controlling for spatial random effects, only temperature (RR 1.25, 95 % CI 1.04-1.53) showed significant association with HFMD. The spatial model demonstrates temperature to play a major role in the transmission of HFMD in dry regions. Estimated residual variation after taking into account the socio-ecological variables indicated that high incidences of HFMD were mainly clustered in the northwest of Gansu. And, spatial structure showed a unique distribution after taking account of socio-ecological effects.

Determination of the In Vitro and In Vivo Antimicrobial Activity on Salivary Streptococci and Lactobacilli and Chemical Characterisation of the Phenolic Content of a Plantago lanceolata Infusion

PubMed Central

Roberto, Lia; Ingenito, Aniello; Roscetto, Emanuela

2015-01-01

Introduction. Plant extracts may be suitable alternative treatments for caries. Aims. To investigate the in vitro and in vivo antimicrobial effects of Plantago lanceolata herbal tea (from flowers and leaves) on cariogenic bacteria and to identify the major constituents of P. lanceolata plant. Materials and Methods. The MIC and MBC against cariogenic bacteria were determined for P. lanceolata tea. Subsequently, a controlled random clinical study was conducted. Group A was instructed to rinse with a P. lanceolata mouth rinse, and Group B received a placebo mouth rinse for seven days. The salivary colonisation by streptococci and lactobacilli was investigated prior to treatment and on the fourth and seventh days. Finally, the P. lanceolata tea was analysed for its polyphenolic content, and major phenolics were identified. Results and Discussion. P. lanceolata teas demonstrate good in vitro antimicrobial activity. The in vivo test showed that Group A subjects presented a significant decrease in streptococci compared to Group B. The phytochemical analysis revealed that flavonoids, coumarins, lipids, cinnamic acids, lignans, and phenolic compounds are present in P. lanceolata infusions. Conclusions. P. lanceolata extract could represent a natural anticariogenic agent via an antimicrobial effect and might be useful as an ancillary measure to control the proliferation of cariogenic flora. PMID:25767805

Adjunctive Aripiprazole Versus Placebo for Antipsychotic-Induced Hyperprolactinemia: Meta-Analysis of Randomized Controlled Trials

PubMed Central

Li, Xianbin; Tang, Yilang; Wang, Chuanyue

2013-01-01

Objective To compare the safety and efficacy of adjunctive aripiprazole versus placebo for antipsychotic-induced hyperprolactinemia. Methods Population: adult patients presenting with antipsychotic-induced hyperprolactinemia diagnosed by prolactin level with or without prolactin-related symptoms. Interventions: adjunctive aripiprazole vs. adjunctive placebo. Outcome measures: adverse events and efficacy of treatment. Studies: randomized controlled trials. Results Five randomized controlled trials with a total of 639 patients (326 adjunctive aripiprazole, 313 adjunctive placebo) met the inclusion criteria. Adjunctive aripiprazole was associated with a 79.11% (125/158) prolactin level normalization rate. Meta-analysis of insomnia, headache, sedation, psychiatric disorder, extrapyramidal symptom, dry mouth, and fatigue showed no significant differences in the adjunctive aripiprazole treatment group compared with the placebo group (risk difference (Mantel-Haenszel, random or fixed) −0.05 to 0.04 (95% confidence interval −0.13 to 0.16); I2 = 0% to 68%, P = 0.20 to 0.70). However, sedation, insomnia, and headache were more frequent when the adjunctive aripiprazole dose was higher than 15 mg/day. Meta-analysis of the prolactin level normalization indicated adjunctive aripiprazole was superior to placebo (risk difference (Mantel-Haenszel, random) 0.76 (95% confidence interval 0.67 to 0.85); I2 = 43%, P<0.00001). The subgroup analysis confirmed that the subjects who received adjunctive aripiprazole 5 mg/day showed a degree of prolactin normalization similar to that of all participants. No significant differences between groups in discontinuation and improvements of psychiatric symptoms. Conclusion Adjunctive aripiprazole is both safe and effective as a reasonable choice treatment for patients with antipsychotic-induced hyperprolactinemia. The appropriate dose of adjunctive aripiprazole may be 5 mg/day. PMID:23936389

Digital subtraction radiographic analysis of the combination of bioabsorbable membrane and bovine morphogenetic protein pool in human periodontal infrabony defects

PubMed Central

GUIMARÃES, Maria do Carmo Machado; PASSANEZI, Euloir; SANT’ANA, Adriana Campos Passanezi; GREGHI, Sebastião Luiz Aguiar; TABA JUNIOR, Mario

2010-01-01

Objectives This study assessed the bone density gain and its relationship with the periodontal clinical parameters in a case series of a regenerative therapy procedure. Material and Methods Using a split-mouth study design, 10 pairs of infrabony defects from 15 patients were treated with a pool of bovine bone morphogenetic proteins associated with collagen membrane (test sites) or collagen membrane only (control sites). The periodontal healing was clinically and radiographically monitored for six months. Standardized presurgical and 6-month postoperative radiographs were digitized for digital subtraction analysis, which showed relative bone density gain in both groups of 0.034 ± 0.423 and 0.105 ± 0.423 in the test and control group, respectively (p>0.05). Results As regards the area size of bone density change, the influence of the therapy was detected in 2.5 mm2 in the test group and 2 mm2 in the control group (p>0.05). Additionally, no correlation was observed between the favorable clinical results and the bone density gain measured by digital subtraction radiography (p>0.05). Conclusions The findings of this study suggest that the clinical benefit of the regenerative therapy observed did not come with significant bone density gains. Long-term evaluation may lead to a different conclusions. PMID:20835573

The impact of eating methods on eating rate and glycemic response in healthy adults.

PubMed

Sun, Lijuan; Ranawana, Dinesh Viren; Tan, Wei Jie Kevin; Quek, Yu Chin Rina; Henry, Christiani Jeyakumar

2015-02-01

Singapore is an island state that is composed of three major ethnic groups, namely Chinese, Malay and Indian. Its inhabitants consume food either using chopsticks (Chinese), fingers (Malay and Indian) or spoon (Chinese, Malay and Indian). Previous work by our group showed that the degree of mastication significantly influenced the glycemic response. The degree of mastication in turn may depend on the eating method as the amount of food taken per mouthful and chewing time differs between eating methods. Eleven healthy volunteers came in on six non-consecutive days to the laboratory and evaluated three methods of eating white rice (spoon, chopsticks and fingers) once and the reference food (glucose solution) three times in a random order. Their glycemic response (GR) was measured for the subsequent 120 min. Mastication parameters were determined using surface electrode electromyography. The GR to white rice eating with chopsticks was significantly lower than spoon. The GI of eating rice with chopsticks was 68 which is significantly lower than eating with spoon (GI=81). However there were no differences between fingers and spoon, and between fingers and chopsticks either in GR 120 min or GI. The inter-individual number of mouthful, number of chews per mouthful, chewing time per mouthful and the total time taken to consume the whole portion of rice were significantly different between spoon and chopsticks groups. Significant correlations between the number of mouthful to take the entire portion of rice and amount of rice per mouthful during mastication and the GR were observed for eating rice with spoon and chopsticks, but not for fingers. The results suggest that individual differences in number of mouthful and amount of rice per mouthful may be two of the causes for inter-individual differences in the GR between spoon and chopsticks. The present study suggests that eating rice with different feeding tools has different chewing times and amount of food taken per mouthful and then alters the GI of the rice. Copyright © 2014 Elsevier Inc. All rights reserved.

Developing a Truly Global Delta Database to Assess Delta Morphology and Morphodynamics

NASA Astrophysics Data System (ADS)

Caldwell, R. L.; Edmonds, D. A.; Baumgardner, S. E.; Whaling, A.

2015-12-01

Delta morphology reflects the interplay of various environmental parameters, though these relationships have only been tested on small datasets with 30-50 deltas. These datasets are biased toward the largest deltas, which typically have compound morphologies, form on passive margins, and may not be representative of the full breadth in delta morphology. With the goal of building more robust predictions of delta morphology to enhance hazard mitigation and resiliency planning, we have developed a truly global delta database including every delta on the world's marine coastlines. Using Google Earth imagery, we first identified all fluvial river mouths (≥ 50 m wide) connected to an upstream catchment. Deltas are defined geomorphically as river mouths that split into two or more active or relict distributary channels, end in a depositional protrusion from the shoreline, or do both. In our database we identified 5,801 river mouths, and 1,426 of those coastal rivers (~25%) have a geomorphic delta. ~75% of deltas exhibit an active or relict distributary network, while the remaining ~25% are single channel deltas with a basinward protrusion. Preliminary morphometric analysis (ratio of shore-parallel width, W, to shore-perpendicular length, L) on a subset of 159 deltas suggests W:L values range from 0.52 (elongate) to 23.6 (broad/cuspate). The median W:L value is 2.68, suggesting the majority of deltas are roughly semi-circular (W:L = 2), and the distribution is heavily skewed to the broad/cuspate deltas (~28% are >4 times wider than they are long). Preliminary comparison to downstream significant wave height data shows that the 'wider' deltas relate to higher wave heights (R2 = 0.42), though the data are scattered. Ultimately, the database will include additional measured morphometrics, including number of channel mouths and delta area, and morphodynamic data derived from serial Landsat imagery.

Effect of a local anesthetic lozenge in relief of symptoms in burning mouth syndrome.

PubMed

Treldal, C; Jacobsen, C B; Mogensen, S; Rasmussen, M; Jacobsen, J; Petersen, J; Lynge Pedersen, A M; Andersen, O

2016-03-01

Patients with burning mouth syndrome (BMS) often represent a clinical challenge as available agents for symptomatic treatment are few and often ineffective. The aim was to evaluate the effect of a bupivacaine lozenge on oral mucosal pain, xerostomia, and taste alterations in patients with BMS. Eighteen patients (4 men and 14 women) aged 39-71 years with BMS were included in this randomized, double-blinded, placebo-controlled, crossover trial. Lozenges (containing bupivacaine or placebo) were administrated three times a day for 2 weeks for two separate treatment periods. Assessment of oral mucosal pain, xerostomia, and taste alterations was performed in a patient diary on a visual analog scale (ranging from 0 to 100 mm) before and after the lozenge was dissolved. The bupivacaine lozenge significantly reduced the burning oral pain (P < 0.001), increased the sense of taste disturbances (P < 0.001), and had no impact on xerostomia, when adjusted for the treatment period. Our results indicate that the bupivacaine lozenge offers a novel therapeutic modality to patients with BMS, although without alleviating effect on the associated symptoms, taste alterations, and xerostomia. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

No Improvement in Sprint Performance With a Neuromuscular Fitted Dental Splint.

PubMed

Fischer, Henrike; Weber, Daniel; Beneke, Ralph

2017-03-01

Mouth guards protect against orofacial and dental injuries in sports. However, special fitted dental splints have been claimed to improve strength and speed and, therefore, to enhance athletic performance. To test the effects of a neuromuscular fitted dental splint in comparison with a habitual verticalizing splint and a no-splint condition on cycling sprint performance in the Wingate Anaerobic Test (WAnT). Twenty-three men (26.0 ± 2.0 y, 1.82 ± 0.06 m, 79.4 ± 7.7 kg) performed 3 WAnTs, 1 with the neuromuscular fitted splint, 1 with a habitual verticalized dental splint of the same height and material, and 1 under control conditions without any mouth guard, in randomized order separated by 1 wk. No differences between any splint conditions were found in any aspect of WAnT performance (time to peak power, peak power, minimum power, power drop, and average power). Moderate to nearly perfect correlations between all splint conditions in all WAnT outcomes with coefficients of variation between 1.3% and 6.6% were found. Irrespective of habitual verticalization or myocentric positioning, dental splints have no effects on any aspect of WAnT performance. Results are comparable to those of test-retest experiments.

Xenogeneic Collagen Matrix Versus Connective Tissue Graft: Case Series of Various Gingival Recession Treatments.

PubMed

Chevalier, Grégoire; Cherkaoui, Selma; Kruk, Hanna; Bensaïd, Xavier; Danan, Marc

A xenogeneic collagen matrix recently has been suggested as an alternative to connective tissue graft for the treatment of gingival recession. The matrix avoids the second surgical site, and as a consequence could decrease surgical morbidity. This new matrix was used in various clinical situations and compared to connective tissue graft (CTG) in a split-mouth design case series. A total of 17 recessions were treated with a coronally advanced flap, 9 with CTG, and 8 with the matrix. Mean recession reduction was 2.00 mm with the CTG and 2.00 mm with the matrix. No significant statistical differences between the techniques were observed in this case report.

Xenogeneic Collagen Matrix Versus Connective Tissue Graft: Case Series of Various Gingival Recession Treatments.

PubMed

Chevalier, Grégoire; Cherkaoui, Selma; Kruk, Hanna; Bensaïd, Xavier; Danan, Marc

2016-08-24

A xenogeneic collagen matrix recently has been suggested as an alternative to connective tissue graft for the treatment of gingival recession. The matrix avoids the second surgical site, and as a consequence could decrease surgical morbidity. This new matrix was used in various clinical situations and compared to connective tissue graft (CTG) in a split-mouth design case series. A total of 17 recessions were treated with a coronally advanced flap, 9 with CTG, and 8 with the matrix. Mean recession reduction was 2.00 mm with the CTG and 2.00 mm with the matrix. No significant statistical differences between the techniques were observed in this case report.

Spin-polarized electron current from carbon-doped open armchair boron nitride nanotubes: Implication for nano-spintronic devices

NASA Astrophysics Data System (ADS)

Zhou, Gang; Duan, Wenhui

2007-03-01

Spin-polarized density functional calculations show that the substitutional doping of carbon (C) atom at the mouth changes the atomic and spin configurations of open armchair boron nitride nanotubes (BNNTs). The occupied/unoccupied deep gap states are observed with the significant spin-splitting. The structures and spin-polarized properties are basically stable under the considerable electric field, which is important for practical applications. The magnetization mechanism is attributed to the interactions of s, p states between the C and its neighboring B or N atoms. Ultimately, advantageous geometrical and electronic effects mean that C-doped open armchair BNNTs would have promising applications in nano-spintronic devices.

Photodynamic therapy using a new formulation of 5-aminolevulinic acid for wrinkles in Asian skin: A randomized controlled split face study.

PubMed

Shin, Hyun Tae; Kim, Jun Hwan; Shim, Joonho; Lee, Jong Hee; Lee, Dong Youn; Lee, Joo Heung; Yang, Jun Mo

2015-06-01

Photodynamic therapy (PDT) with intense pulsed light (IPL) was proven effective for photorejuvenation. Recently, a new formulation of 0.5% 5-aminolevulinic acid (ALA) liposomal spray has been available. We designed a randomized split face study to evaluate usefulness and safety of IPL-PDT using a liposomal spray for periorbital wrinkles in Asians. Patients received three treatments every 3 weeks. The half of the face was treated with IPL-PDT and the other half with long pulsed Nd:YAG laser (LPNY). Skin fluorescence was measured using a spectrophotometer for the guidance of PDT treatment. Wrinkle score was marked by two-blinded independent dermatologists. One patient dropped out due to 3-d lasting erythema on PDT side. The difference of mean reduction in lower and lateral periorbital wrinkle score on PDT side between the first and the last visit was statistically significant (p = 0.008 and p = 0.001, respectively). Lateral periorbital wrinkles treated with PDT showed better results than LPNY-treated sides. Twenty-five percent of patients reported good to excellent outcomes. This study demonstrated that PDT with a liposomal spray provided modest wrinkle reduction without serious adverse effect and it might be a promising treatment modality for wrinkle treatment in Asians.

Helmets and Mouth Guards: The Role of Personal Equipment in Preventing Sport-Related Concussions

PubMed Central

Daneshvar, Daniel H.; Baugh, Christine M.; Nowinski, Christopher J.; McKee, Ann C.; Stern, Robert A.; Cantu, Robert C.

2010-01-01

Every year, millions of athletes in the United States experience concussions. With athletes at all levels of play getting bigger, faster, and stronger, it has been suggested that newer technologies may provide an opportunity to reduce the risk and severity of these all too frequent injuries. Although helmets have been shown to decrease the rate of catastrophic head injuries, and mouth guards have decreased the risk of dental and oral injuries, the protective effect of helmets and mouth guards on concussions has not been conclusively demonstrated. In this review, the current literature pertaining to the effect that equipment has on concussions is evaluated. Understanding the role that this equipment plays in preventing concussions is complicated by many factors, such as selection bias in non-randomized studies, variations in playing style, and risk compensation in sports with mandatory protective equipment. At this point, there is little evidence supporting the use of specific helmets or mouth guards to prevent concussions outside of specific sports such as cycling, skiing, and snowboarding. Improving coach and player education about proper concussion management, encouraging neck strengthening exercises, and minimizing high-risk impacts may provide a more fruitful avenue to reduce concussions in sports. PMID:21074089

The recolonization hypothesis in a full-mouth or multiple-session treatment protocol: a blinded, randomized clinical trial.

PubMed

Zijnge, Vincent; Meijer, Henriette F; Lie, Mady-Ann; Tromp, Jan A H; Degener, John E; Harmsen, Hermie J M; Abbas, Frank

2010-06-01

To test recolonization of periodontal lesions after full-mouth scaling and root planing (FM-SRP) or multiple session-SRP (MS-SRP) in a randomized clinical trial and whether FM-SRP and MS-SRP result in different clinical outcomes. Thirty-nine subjects were randomly assigned to FM-SRP or MS-SRP groups. At baseline and after 3 months, probing pocket depth (PPD), plaque index (PlI) and bleeding on probing (BoP) were recorded. At baseline, immediately after treatment, after 1, 2, 7, 14 and 90 days, paper point samples from a single site from the maxillary right quadrant were collected for microbiological analysis of five putative pathogens by polymerase chain reaction. FM-SRP and MS-SRP resulted in significant reductions in PPD, BoP and PlI and the overall detection frequencies of the five species after 3 months without significant differences between treatments. Compared with MS-SRP, FM-SRP resulted in less recolonization of the five species, significantly for Treponema denticola, in the tested sites. FM-SRP and MS-SRP result in overall clinically and microbiologically comparable outcomes where recolonization of periodontal lesions may be better prevented by FM-SRP.

Evaluation of Amniotic Membrane Effectiveness in Skin Graft Donor Site Dressing in Burn Patients.

PubMed

Salehi, Seyed Hamid; As'adi, Kamran; Mousavi, Seyed Jaber; Shoar, Saeed

2015-12-01

Although the recipient site in burn wounds is dressed with universally accepted materials, the ideal management of split-thickness skin donor sites remains controversial. The aim of our study is to compare two methods of wound dressing in donor sites of split-thickness skin graft in patients undergoing burn wound reconstructive surgery. Forty-two consecutive patients with second- and third-degree burns with a total body surface area between 20 and 40 % were enrolled in this randomized clinical trial conducted in Motahari Burn Hospital in Tehran, Iran. In each patient, two anatomic areas with similar features were randomly selected as intervention and control donor sites. The intervention site was dressed with amniotic membrane, whereas the control site was treated with Vaseline-impregnated gauze. Wounds were examined daily by expert surgeons to measure the clinical outcomes including duration of healing, severity of pain, and infection rate. The mean ± SD age of patients was 31.17 ± 13.72 years; furthermore, burn percentage had a mean ± SD of 31.19 ± 10.56. The mean ± SD of patients' cooperation score was 1.6 ± 0.79 in the intervention group compared with 2.93 ± 0.71 in the control group, revealing a statistically significant difference (P < 0.05). Duration of wound healing was significantly shorter (P < 0.05) in the intervention group (17.61 ± 2.56 days) compared with the control group (21.16 ± 3.45 days). However, there was no significant difference in terms of wound infection rate between donor sites in the control and intervention groups (P > 0.05). Amniotic membrane as an alternative for dressing of skin graft donor sites provides significant benefits by increasing patients' comfort via diminishing the number of dressing changes and facilitating the process of wound healing.

Deformation-induced splitting of the isoscalar E 0 giant resonance: Skyrme random-phase-approximation analysis

NASA Astrophysics Data System (ADS)

Kvasil, J.; Nesterenko, V. O.; Repko, A.; Kleinig, W.; Reinhard, P.-G.

2016-12-01

The deformation-induced splitting of isoscalar giant monopole resonance (ISGMR) is systematically analyzed in a wide range of masses covering medium, rare-earth, actinide, and superheavy axial deformed nuclei. The study is performed within the fully self-consistent quasiparticle random-phase-approximation method based on the Skyrme functional. Two Skyrme forces, one with a large (SV-bas) and one with a small (SkP) nuclear incompressibility, are considered. The calculations confirm earlier results that, because of the deformation-induced E 0 -E 2 coupling, the isoscalar E 0 resonance attains a double-peak structure and significant energy upshift. Our results are compared with available analytic estimations. Unlike earlier studies, we get a smaller energy difference between the lower and upper peaks and thus a stronger E 0 -E 2 coupling. This in turn results in more pumping of E 0 strength into the lower peak and more pronounced splitting of ISGMR. We also discuss widths of the peaks and their negligible correlation with deformation.

Full-custom design of split-set data weighted averaging with output register for jitter suppression

NASA Astrophysics Data System (ADS)

Jubay, M. C.; Gerasta, O. J.

2015-06-01

A full-custom design of an element selection algorithm, named as Split-set Data Weighted Averaging (SDWA) is implemented in 90nm CMOS Technology Synopsys Library. SDWA is applied in seven unit elements (3-bit) using a thermometer-coded input. Split-set DWA is an improved DWA algorithm which caters the requirement for randomization along with long-term equal element usage. Randomization and equal element-usage improve the spectral response of the unit elements due to higher Spurious-free dynamic range (SFDR) and without significantly degrading signal-to-noise ratio (SNR). Since a full-custom, the design is brought to transistor-level and the chip custom layout is also provided, having a total area of 0.3mm2, a power consumption of 0.566 mW, and simulated at 50MHz clock frequency. On this implementation, SDWA is successfully derived and improved by introducing a register at the output that suppresses the jitter introduced at the final stage due to switching loops and successive delays.

A randomized trial of preoperative oral carbohydrates in abdominal surgery.

PubMed

Sada, Fatos; Krasniqi, Avdyl; Hamza, Astrit; Gecaj-Gashi, Agreta; Bicaj, Besnik; Kavaja, Floren

2014-01-01

Carbohydrate-rich liquid drinks (CRLDs) have been recommended to attenuate insulin resistance by shortening the preoperative fasting interval. The aim of our study the effect of preoperative oral administration of CRLDs on the well-being and clinical status of patients. A randomized, double blind, prospective study of patients undergoing open colorectal operations (CR) and open cholecyctectomy (CH) was conducted. Patients were divided into three groups: study, placebo, and control. Visual analogue scale (VAS) scores for seven parameters (thirst, hunger, anxiety, mouth dryness, nausea, weakness and sleep quality) were recorded and compared for two different time periods (up to 24 h postoperatively and from 36 to 48 h postoperatively). The Simplified Acute Physiology Score changes (SAPS)-II between the three groups were also studied. There were 142 patients American Society of Anesthesiology (ASA) I or II enrolled in the study (CR = 71 and CH = 71). There were no significant differences in postoperative SAPS-II scores or lengths of hospital stay (LOS) between the groups. However, in CR patients, the degree of thirst was partially improved by drinking CRLDs (P = 0.027). In CH patients, on the other hand, feelings of thirst, hunger, mouth dryness, nausea and weakness showed significant improvement (P < 0.05). Oral administration of carbohydrate-rich liquid drinks (CRLDs) improves the well-being in patients undergoing CH, but the effect is less evident in patients undergoing CR. No significant improvements were seen in clinical status or in length of hospital stay in either group. ANZCTR.org.au: ACTRN12614000995673 (registered on 16/09/2014).

A systematic review of randomized trials for the treatment of burning mouth syndrome.

PubMed

Kisely, Steve; Forbes, Malcolm; Sawyer, Emily; Black, Emma; Lalloo, Ratilal

2016-07-01

Burning mouth syndrome (BMS) is characterized by burning of the oral mucosa in the absence of underlying dental or medical causes. The results of previous systematic reviews have generally been equivocal. However, findings for most interventions are based on searches of 5-10years ago. This study therefore updates previous searches of randomized controlled trials (RCTs) for pain as assessed by Visual Analogue Scales (VAS). Secondary outcomes included quality of life, mood, taste and salivary flow. A search of MEDLINE and Embase up to 2016. 24 RCTs were identified. Meta-analyses were impossible because of wide variations in study method and quality. The commonest interventions were alpha-lipoic acid (ALA) (8 comparisons), capsaicin or an analogue (4 comparisons), clonazepam (3 comparisons) and psychotherapy (2 comparisons). ALA and capsaicin led to significantly greater improvements in VAS (4 studies each), as did clonazepam (all 3 studies), at up to two month follow-up. However, capsaicin led to prominent dyspepsia. Psychotherapy significantly improved outcomes in one study at two and 12month follow-up. Catauma and tongue-protectors also showed promise (one study each). There were no significant differences in any of the secondary outcomes except in the one study of tongue protectors. At least in some studies and for some outcomes, ALA, clonazepam, capsaicin and psychotherapy may show modest benefit in the first two months. However, these conclusions are limited by generally short follow-up periods, high study variability and low participant numbers. Further RCTs with follow-up of at least 12months are indicated. Copyright © 2016 Elsevier Inc. All rights reserved.

Cotton harvest at 40% versus 75% boll-splitting on yield and economic return under standard and proactive boll weevil (Coleoptera: Curculionidae) spray regimes.

PubMed

Showler, A T; Robinson, J R C

2008-10-01

The standard practice of two or three preemptive insecticide applications at the start of pinhead (1-2-mm-diameter) squaring followed by threshold-triggered (when 10% of randomly selected squares have oviposition punctures) insecticide applications for boll weevil, Anthonomus grandis grandis Boheman (Coleoptera: Curculionidae), control does not provide reliable protection of cotton, Gossypium hirsutum L., lint production. This study, conducted during 2004 and 2005, showed that three to six fewer spray applications in a "proactive" approach, in which spraying began at the start of large (5.5-8-mm-diameter) square formation and continued at approximately 7-d intervals while large squares were abundant, resulted in fewer infested squares and 1.4- to 1.7-fold more lint than the standard treatment. Fewer sprays and increased yield made proactive spraying significantly more profitable than the standard approach, which resulted in relatively low or negative economic returns. Harvest at 75% boll-split in the proactive spray regime of 2005 resulted in four-fold greater economic return than cotton harvested at 40% boll-split because of improved protection of large squares and the elimination of late-season sprays inherent to standard spray regime despite the cost of an extra irrigation in the 75% boll-split treatments. The earlier, 40% harvest trigger does not avoid high late-season boll weevil pressure, which exerts less impact on bolls, the predominant form of fruiting body at that time, than on squares. Proactive spraying and harvest timing are based on an important relationship between nutrition, boll weevil reproduction, and economic inputs; therefore, the tactic of combining proaction with harvest at 75% boll-split is applicable where boll weevils are problematic regardless of climate or region, or whether an eradication program is ongoing.

Traditional Chinese medicine compound ShengJinRunZaoYangXue granules for treatment of primary Sjögren's syndrome: a randomized, double-blind, placebo-controlled clinical trial.

PubMed

Hu, Wei; Qian, Xian; Guo, Feng; Zhang, Miaojia; Lyu, Chengyin; Tao, Juan; Gao, Zhong'en; Zhou, Zhengqiu

2014-01-01

Traditional Chinese medical treatment of primary Sjögren's syndrome has advantages over Western medicine in terms of fewer side effects and improved patient conditions. This study was a multicenter, randomized, double-blind, placebo-controlled clinical trial of the efficacy and safety of ShengJinRunZaoYangXue granules for the treatment of primary Sjögren's syndrome, including the symptoms of dry mouth and dry eye. We undertook a 6-week, double-blind, randomized trial involving 240 patients with primary Sjögren's syndrome at five centers in East China. A computer-generated randomization schedule assigned patients at a 2:1 ratio to receive either ShengJinRunZaoYangXue granules or placebo once daily. Patients and investigators were blinded to treatment allocation. The primary endpoints were the salivary flow rate, Schirmer test results, and sugar test results. Intention-to-treat and per-protocol analyses were performed. All 240 patients were randomly allocated to either the treatment group (n = 160, ShengJinRunZaoYangXue granules) or placebo group (n = 80) and were included in the intention-to-treat analysis. After program violation and loss to follow-up, a total of 199 patients were included in the per-protocol analysis. At six week, intention-to-treat and per-protocol analyses of the left-eye Schirmer I test results showed an improved difference of 1.36 mm/5 min (95% CI: 0.03 to 2.69 mm/5 min) and 1.35 mm/5 min (95% CI: 0.04 to 2.73 mm/5 min), respectively, and those of the right-eye Schirmer I test results showed an improved difference of 1.12 mm/5 min (95% CI: 0.02 to 2.22 mm/5 min) and 1.12 mm/5 min (95% CI: -0.02 to 2.27 mm/5 min), respectively. There was no significant difference between the two groups before treatment. After treatment, the between-group and within-group before-and-after paired comparison results were statistically significant (P < 0.05). Intention-to-treat and per-protocol analyses showed an improved salivary flow rate by 0.04 ml/15 min (95% CI: -0.49 to 0.58 ml/15 min) and 0.04 ml/15 min (95% CI: -0.52 to 0.60 ml/15 min), respectively, but the differences were not significant. Intention-to-treat and per-protocol analyses showed that the sugar test results were improved by 1.77 minutes (95% CI: 0.11 to 3.44 minutes) and 1.84 minutes (95% CI: 0.12 to 3.55 minutes), respectively, but the differences were not significant. For the secondary endpoint, intention-to-treat and per-protocol analyses showed significant improvement in the integrated evaluation of treated patients with dry eye and dry mouth after six weeks of treatment. The incidence of adverse events was 15.6% in the treatment group and 10.0% in the placebo group. Most (94%) adverse events were mild to moderate in the two groups, and only two cases of serious adverse events occurred in the treatment group; both were caused by autoimmune liver disease. Six-week treatment with ShengJinRun ZaoYangXue granules for primary Sjögren's syndrome in this large-scale study improved the symptoms of dry mouth, dry eyes, and low tear flow rate with minimal adverse events.

Quantitative evaluation of the orofacial morphology: anthropometric measurements in healthy and mouth-breathing children.

PubMed

Cattoni, Débora Martins; Fernandes, Fernanda Dreux Miranda; Di Francesco, Renata Cantisani; De Latorre, Maria Do Rosário Dias Oliveira

2009-11-01

The anthropometric orofacial measurements of mouth-breathing children were compared to those of children with no history of speech-language disorders, according to age. 100 children participated, both males and females, with ages ranging from 7 to 11 years and 11 months, leukoderm, in mixed dentition period, with a mouth-breathing diagnosis. The control group was comprised of 254 children, of both sexes, with ages ranging from 7 to 11 years and 11 months, leukoderm, in mixed dentition period, with no history of speech-language disorders. The control group did not demonstrate any mouth-breathing. The children were submitted to anthropometric assessment and the orofacial measurements obtained were upper lip, lower lip, philtrum, upper face, middle face, lower face, and sides of the face. The instrument used was the electronic digital sliding caliper Starrett Series 727. There was statistically significant difference between the majority of the orofacial measurements of mouth-breathing children and the measurements of children with no history of speech-language disorders. Some orofacial measurements were different in the studied populations. The possibility of comparing orofacial measurements of children with and without mouth-breathing behavior allows the clinician to determine normal and altered structures of the orofacial morphology. The main advantages of the anthropometry are its noninvasive nature, its technological simplicity, low cost and objective analysis. The anthropometric procedures also have clinical applications in myofunctional assessment and therapy.

Trophallaxis-inspired model for distributed transport between randomly interacting agents

NASA Astrophysics Data System (ADS)

Gräwer, Johannes; Ronellenfitsch, Henrik; Mazza, Marco G.; Katifori, Eleni

2017-08-01

Trophallaxis, the regurgitation and mouth to mouth transfer of liquid food between members of eusocial insect societies, is an important process that allows the fast and efficient dissemination of food in the colony. Trophallactic systems are typically treated as a network of agent interactions. This approach, though valuable, does not easily lend itself to analytic predictions. In this work we consider a simple trophallactic system of randomly interacting agents with finite carrying capacity, and calculate analytically and via a series of simulations the global food intake rate for the whole colony as well as observables describing how uniformly the food is distributed within the nest. Our model and predictions provide a useful benchmark to assess to what level the observed food uptake rates and efficiency in food distribution is due to stochastic effects or specific trophallactic strategies by the ant colony. Our work also serves as a stepping stone to describing the collective properties of more complex trophallactic systems, such as those including division of labor between foragers and workers.

Trophallaxis-inspired model for distributed transport between randomly interacting agents.

PubMed

Gräwer, Johannes; Ronellenfitsch, Henrik; Mazza, Marco G; Katifori, Eleni

2017-08-01

Trophallaxis, the regurgitation and mouth to mouth transfer of liquid food between members of eusocial insect societies, is an important process that allows the fast and efficient dissemination of food in the colony. Trophallactic systems are typically treated as a network of agent interactions. This approach, though valuable, does not easily lend itself to analytic predictions. In this work we consider a simple trophallactic system of randomly interacting agents with finite carrying capacity, and calculate analytically and via a series of simulations the global food intake rate for the whole colony as well as observables describing how uniformly the food is distributed within the nest. Our model and predictions provide a useful benchmark to assess to what level the observed food uptake rates and efficiency in food distribution is due to stochastic effects or specific trophallactic strategies by the ant colony. Our work also serves as a stepping stone to describing the collective properties of more complex trophallactic systems, such as those including division of labor between foragers and workers.

Clinical and microbiological evaluation of high intensity diode laser adjutant to non-surgical periodontal treatment: a 6-month clinical trial.

PubMed

Euzebio Alves, Vanessa Tubero; de Andrade, Ana Karina Pinto; Toaliar, Janaita Maria; Conde, Marina Clemente; Zezell, Denise Maria; Cai, Silvana; Pannuti, Claudio Mendes; De Micheli, Giorgio

2013-01-01

This randomized split-mouth clinical trial was designed to evaluate the efficacy of scaling and root planing associated to the high-intensity diode laser on periodontal therapy by means of clinical parameters and microbial reduction. A total of 36 chronic periodontitis subjects, of both genders, were selected. One pair of contralateral single-rooted teeth with pocket depth >5 mm was chosen from each subject. All patients received non-surgical periodontal treatment, after which the experimental teeth were designated to either test or control groups. Both teeth received scaling, root planing and coronal polishing (SRP) and teeth assigned to the test group (SRP + DL) were irradiated with the 808 ± 5 nm diode laser, for 20 s, in two isolated appointments, 1 week apart. The laser was used in the continuous mode, with 1.5 W and power density of 1,193.7 W/cm(2). Clinical and microbiological data were collected at baseline, 6 weeks and 6 months after therapy. There was a significant improvement of all the clinical parameters-clinical attachment level (CAL), probing depth (PD), plaque index (PI) and Bleeding on Probing (BOP)-for both groups (P < 0.001), with no statistical difference between them at the 6 weeks and the 6 months examinations. As for microbiological analysis, a significant reduction after 6 weeks (P > 0.05) was observed as far as colony forming units (CFU) is concerned, for both groups. As for black-pigmented bacteria, a significant reduction was observed in both groups after 6 months. However, the difference between test and control groups was not significant. There was no association between group and presence of Porphyromonas gingivalis, Prevotella intermedia and Aggregatibacter actinomycetemcomitans at any time of the study. After 6 months of evaluation, the high-intensity diode laser has not shown any additional benefits to the conventional periodontal treatment. The high intensity diode laser did not provide additional benefits to non-surgical periodontal treatment. More studies are necessary to prove the actual need of this type of laser in the periodontal clinical practice.

The Significance of Brain Transcranial Sonography in Burning Mouth Syndrome: a Pilot Study.

PubMed

Zavoreo, Iris; Vučićević, Vanja; Boras; Zadravec, Dijana; Bašić, Vanja; Kes; Ciliga, Dubravka; Gabrić, Dragana

2017-03-01

Burning mouth syndrome (BMS) is a chronic disorder which is affecting mostly postmenopausal women and is characterized by burning symptoms in the oral cavity on the clinically healthy oral mucosa. Also, the results of previous studies suggested a possible role of peripheral and/or central neurological disturbances in these patients. The aim of this study was to analyze patients with burning mouth syndrome using transcranial sonography. By use of transcranial sonography of the brain parenchyma, substantia nigra , midbrain raphe and brain nucleus were evaluated in 20 patients with BMS (64.7±12.3 years) and 20 controls with chronic pain in the lumbosacral region (61.5±15). Statistical analysis was performed by use of Student t test with significance set at p<0.05. The results of this study have shown hypoechogenicity of the substantia nigra and midbrain raphe as well as hyperechogenicity of the brain nucleus in BMS patients (p<0,05) as compared to controls. Altered transcranial sonography findings of the brain parenchyma , midbrain raphe and brain nucl eus in patients with burning mouth syndrome might reflect central disturbances within this syndrome. Burning Mouth Syndrome; Transcranial Sonography; substantia nigra; Midbrain Raphe Nuclei; Red Nucleus.

The Influence of Serial Carbohydrate Mouth Rinsing on Power Output during a Cycle Sprint.

PubMed

Phillips, Shaun M; Findlay, Scott; Kavaliauskas, Mykolas; Grant, Marie Clare

2014-05-01

The objective of the study was to investigate the influence of serial administration of a carbohydrate (CHO) mouth rinse on performance, metabolic and perceptual responses during a cycle sprint. Twelve physically active males (mean (± SD) age: 23.1 (3.0) years, height: 1.83 (0.07) m, body mass (BM): 86.3 (13.5) kg) completed the following mouth rinse trials in a randomized, counterbalanced, double-blind fashion; 1. 8 x 5 second rinses with a 25 ml CHO (6% w/v maltodextrin) solution, 2. 8 x 5 second rinses with a 25 ml placebo (PLA) solution. Following mouth rinse administration, participants completed a 30 second sprint on a cycle ergometer against a 0.075 g·kg(-1) BM resistance. Eight participants achieved a greater peak power output (PPO) in the CHO trial, resulting in a significantly greater PPO compared with PLA (13.51 ± 2.19 vs. 13.20 ± 2.14 W·kg(-1), p < 0.05). Magnitude inference analysis reported a likely benefit (81% likelihood) of the CHO mouth rinse on PPO. In the CHO trial, mean power output (MPO) showed a trend for being greater in the first 5 seconds of the sprint and lower for the remainder of the sprint compared with the PLA trial (p > 0.05). No significant between-trials difference was reported for fatigue index, perceived exertion, arousal and nausea levels, or blood lactate and glucose concentrations. Serial administration of a CHO mouth rinse may significantly improve PPO during a cycle sprint. This improvement appears confined to the first 5 seconds of the sprint, and may come at a greater relative cost for the remainder of the sprint. Key pointsThe paper demonstrates that repeated administration of a carbohydrate mouth rinse can significantly improve peak power output during a single 30 second cycle sprint.The ergogenic effect of the carbohydrate mouth rinse may relate to the duration of exposure of the oral cavity to the mouth rinse, and associated greater stimulation of oral carbohydrate receptors.The significant increase in peak power output with the carbohydrate mouth rinse may come at a relative cost for the remainder of the sprint, evidenced by non-significantly lower mean power output and a greater fatigue index in the carbohydrate vs. placebo trial.Serial administration of a carbohydrate mouth rinse may be beneficial for sprint athletes as a method of performance enhancement that minimizes the risk of performance decrement through body mass increase and gastrointestinal disturbances associated with ingesting carbohydrate solutions.

Finding the right match: Mindfulness training may potentiate the therapeutic effect of non-judgment of inner experience on smoking cessation

PubMed Central

Schuman-Olivier, Zev D.; Hoeppner, Bettina B.; Evins, A. Eden; Brewer, Judson

2014-01-01

Mindfulness Training (MT) is an emerging therapeutic modality for addictive disorders. Non-judgment of inner experience, a component of mindfulness, may influence addiction treatment response. To test whether this component influences smoking cessation, tobacco smokers (n=85) in a randomized control trial of MT vs. Freedom from Smoking (FFS), a standard cognitive-behaviorally-oriented treatment, were divided into split-half subgroups based on baseline Five Facet Mindfulness Questionnaire non-judgment subscale. Smokers who rarely judge inner experience (non-judgment > 30.5) smoked less during follow-up when randomized to MT (3.9 cigs/d) vs. FFS (11.1 cigs/d), p <0.01. Measuring trait non-judgment may help personalize treatment assignments, improving outcomes. PMID:24611853

Treatment of primary Sjögren syndrome: a systematic review.

PubMed

Ramos-Casals, Manuel; Tzioufas, Athanasios G; Stone, John H; Sisó, Antoni; Bosch, Xavier

2010-07-28

A variety of topical and systemic drugs are available to treat primary Sjögren syndrome, although no evidence-based therapeutic guidelines are currently available. To summarize evidence on primary Sjögren syndrome drug therapy from randomized controlled trials. We searched MEDLINE and EMBASE for articles on drug therapy for primary Sjögren syndrome published between January 1, 1986, and April 30, 2010. Controlled trials of topical and systemic drugs including adult patients with primary Sjögren syndrome were selected as the primary information source. The search strategy yielded 37 trials. A placebo-controlled trial found significant improvement in the Schirmer and corneal staining scores, blurred vision, and artificial tear use in patients treated with topical ocular 0.05% cyclosporine. Three placebo-controlled trials found that pilocarpine was associated with improvements in dry mouth (61%-70% vs 24%-31% in the placebo group) and dry eye (42%-53% vs 26%). Two placebo-controlled trials found that cevimeline was associated with improvement in dry mouth (66%-76% vs 35%-37% in the placebo group) and dry eye (39%-72% vs 24%-30%). Small trials (<20 patients) found no significant improvement in sicca outcomes for oral prednisone or hydroxychloroquine and limited benefits for immunosuppressive agents (azathioprine and cyclosporine). A large trial found limited benefits for oral interferon alfa-2a. Two placebo-controlled trials of infliximab and etanercept did not achieve the primary outcome (a composite visual analog scale measuring joint pain, fatigue, and dryness); neither did 2 small trials (<30 patients) testing rituximab, although significant results were observed in some secondary outcomes and improvement compared with baseline. In primary Sjögren syndrome, evidence from controlled trials suggests benefits for pilocarpine and cevimeline for sicca features and topical cyclosporine for moderate or severe dry eye. Anti-tumor necrosis factor agents have not shown clinical efficacy, and larger controlled trials are needed to establish the efficacy of rituximab.

Adjunctive use of a facial moisturizer SPF 30 containing ceramide precursor improves tolerability of topical tretinoin 0.05%: a randomized, investigator-blinded, split-face study.

PubMed

Schorr, Ethlynn S; Sidou, Farzi; Kerrouche, Nabil

2012-09-01

To assess the benefit of adjunctive use of a SPF 30 moisturizing lotion in reducing local side effects associated with atopical tretinoin cream. This was a randomized, investigator/evaluator-blinded, split-face comparison in subjects with healthy skin. Subjects applied tretinoin cream 0.05% once daily to the whole face and Cetaphil 174; Dermacontrol Moisturizer (CDM) once daily to one side of the face based on randomization. Tolerability, perference and skin hydration were evaluated at each week, and a cosmetic acceptability questionnaire regarding CDM was completed at the end of the study. The majority (about 83% to 86%) of subjects experienced skin irritations on both sides of their face, though predominantly mild for the CDM + tretinoin treated side. Tolerability preferences favored the CDM+tretinoin sides. Adjunctive use of CDM with a topical tretinoin cream improves tolerance of the treatment.

Monte Carlo simulation of hard spheres near random closest packing using spherical boundary conditions

NASA Astrophysics Data System (ADS)

Tobochnik, Jan; Chapin, Phillip M.

1988-05-01

Monte Carlo simulations were performed for hard disks on the surface of an ordinary sphere and hard spheres on the surface of a four-dimensional hypersphere. Starting from the low density fluid the density was increased to obtain metastable amorphous states at densities higher than previously achieved. Above the freezing density the inverse pressure decreases linearly with density, reaching zero at packing fractions equal to 68% for hard spheres and 84% for hard disks. Using these new estimates for random closest packing and coefficients from the virial series we obtain an equation of state which fits all the data up to random closest packing. Usually, the radial distribution function showed the typical split second peak characteristic of amorphous solids and glasses. High density systems which lacked this split second peak and showed other sharp peaks were interpreted as signaling the onset of crystal nucleation.

A 3-year clinical follow-up of implants placed in two different biomaterials used for sinus augmentation.

PubMed

Lindgren, Christer; Mordenfeld, Arne; Johansson, Carina B; Hallman, Mats

2012-01-01

The aims of the present study were to compare a novel biphasic calcium phosphate (BCP) with deproteinized bovine bone (DBB) for maxillary sinus floor augmentation in a split-mouth design and to perform a clinical follow-up of dental implants placed in the augmented sinuses. Partially or completely edentulous patients requiring bilateral sinus augmentation were included in the study. The patients were randomized for augmentation with BCP (test) and DBB (control) in the contralateral side. Eight months after grafting, dental implants were placed. After 3 years of graft healing, core biopsy specimens were obtained from the grafted areas for histologic and histomorphometric analyses. After 3 years of functional implant loading, implant survival/success rates and clinical indices were assessed and radiographic examination and resonance frequency analysis were performed. Nine completely edentulous patients and two partially edentulous patients (mean age, 67 years) who required bilateral sinus augmentation were included in the study, and 62 implants were placed. The mean values for the area of newly formed bone in the retrieved specimens were 29% ± 14.3% and 32% ± 18.0% for BCP and DBB, respectively; the percentage of graft particles in contact with bone was 38% ± 10.9% in the BCP group and 44% ± 12.1% in the DBB group (no statistical significant differences between groups). The mean values for the area of BCP particles and DBB particles were 20% ± 7.5% and 24% ± 13.5%, respectively (difference not significant). One dental implant was lost from each group, resulting in an overall implant survival rate of 96.8% after 3 years of loading. After 3 years, a similar amount of newly formed bone was present regardless of the biomaterial used. The choice of biomaterial did not seem to influence implant survival rates.

Comparative clinical efficacy of three toothpastes in the control of supragingival calculus formation.

PubMed

Kraivaphan, Petcharat; Amornchat, Cholticha

2017-01-01

The purpose of this double-blind, parallel clinical study was to assess clinical efficacy in supragingival calculus formation reduction using Abhaibhubejhr Herbal Toothpaste compared to Colgate Total and Colgate Cavity Protection toothpastes. A total of 150 subjects participated in the pretest phase. All subjects were given oral soft/hard tissue evaluation, calculus examination using Volpe-Manhold calculus, and whole mouth oral prophylaxis. They received noncalculus control fluoride toothpaste and a soft-bristled toothbrush to brush for 1 min two times daily for 8 weeks. After which, subjects were given a test phase oral soft/hard tissue evaluation and calculus examination and were randomized into one of the three toothpaste groups. All subjects in the test phase received a whole mouth oral prophylaxis and were given their assigned toothpaste and a soft-bristled toothbrush to brush for 1 min two times a day for 12 weeks. Thereafter, subjects were assessed for their oral soft/hard tissue and calculus formation. Mean Volpe-Manhold calculus index scores for the Cavity Protection, Abhaibhubejhr, and Total toothpaste groups were 0.78, 0.62, and 0.48, respectively, at the 12-week test phase evaluation. Abhaibhubejhr and Total toothpaste groups show 20.51% and 38.46% significantly less calculus formation than the Cavity Protection toothpaste group ( P < 0.05). Total toothpaste group also show 22.58% significantly less calculus formation than the Abhaibhubejhr toothpaste group ( P < 0.05). The use of Colgate Total toothpaste over a 12-week period was clinically more effective than either Abhaibhubejhr or Colgate Cavity Protection toothpastes in controlling supragingival calculus formation.

Characteristics of the gait adaptation process due to split-belt treadmill walking under a wide range of right-left speed ratios in humans.

PubMed

Yokoyama, Hikaru; Sato, Koji; Ogawa, Tetsuya; Yamamoto, Shin-Ichiro; Nakazawa, Kimitaka; Kawashima, Noritaka

2018-01-01

The adaptability of human bipedal locomotion has been studied using split-belt treadmill walking. Most of previous studies utilized experimental protocol under remarkably different split ratios (e.g. 1:2, 1:3, or 1:4). While, there is limited research with regard to adaptive process under the small speed ratios. It is important to know the nature of adaptive process under ratio smaller than 1:2, because systematic evaluation of the gait adaptation under small to moderate split ratios would enable us to examine relative contribution of two forms of adaptation (reactive feedback and predictive feedforward control) on gait adaptation. We therefore examined a gait behavior due to on split-belt treadmill adaptation under five belt speed difference conditions (from 1:1.2 to 1:2). Gait parameters related to reactive control (stance time) showed quick adjustments immediately after imposing the split-belt walking in all five speed ratios. Meanwhile, parameters related to predictive control (step length and anterior force) showed a clear pattern of adaptation and subsequent aftereffects except for the 1:1.2 adaptation. Additionally, the 1:1.2 ratio was distinguished from other ratios by cluster analysis based on the relationship between the size of adaptation and the aftereffect. Our findings indicate that the reactive feedback control was involved in all the speed ratios tested and that the extent of reaction was proportionally dependent on the speed ratio of the split-belt. On the contrary, predictive feedforward control was necessary when the ratio of the split-belt was greater. These results enable us to consider how a given split-belt training condition would affect the relative contribution of the two strategies on gait adaptation, which must be considered when developing rehabilitation interventions for stroke patients.

The Oral Cavity State in Renal Transplant Recipients

PubMed Central

Gašpar, Marija; Glavina, Ana; Grubišić, Kristina; Sabol, Ivan; Bušić, Mirela; Mravak, Marinka

2015-01-01

Aim Patients with a solid organ transplant can have many different complications in the mouth, as a result of immunosuppression and side effects of drugs. The aim of this study was to examine the frequency and type of oral lesions in renal transplant patients, dental status, oral hygiene, oral lesions related to drugs which patients take and the time of transplantation as well as the frequency of patient’s visits to the dentist in the post-transplant period. Material and methods The study was performed in a period of two years and included 100 subjects with a renal transplant during their regular control visits to the Department of Nephrology and Dialysis, Clinical Hospital Centre Zagreb and the Department of Oral Medicine, School of Dental Medicine, University of Zagreb and 100 randomly selected control subjects at the Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb. Results Results showed a significantly higher incidence of oral lesions in patients with renal transplant (31%) compared to control subjects. The most frequent were erythematous (inflammatory changes), keratotic lesions and gingival hyperplasia. The average DMFT index was significantly lower in patients with renal transplant than in the control group. One third of patients had a subjective feeling of dry mouth. Oral hygiene was poor overall, and only a small number of subjects used the additional sustainers for oral hygiene. Most patients did not visit the dentist after the transplantation. Conclusion Renal transplant patients need a comprehensive and regular dental care during the pre- and post-transplant period and a doctor of dental medicine should be part of a multidisciplinary team of medical specialists. PMID:27688404

Triadic split-merge sampler

NASA Astrophysics Data System (ADS)

van Rossum, Anne C.; Lin, Hai Xiang; Dubbeldam, Johan; van der Herik, H. Jaap

2018-04-01

In machine vision typical heuristic methods to extract parameterized objects out of raw data points are the Hough transform and RANSAC. Bayesian models carry the promise to optimally extract such parameterized objects given a correct definition of the model and the type of noise at hand. A category of solvers for Bayesian models are Markov chain Monte Carlo methods. Naive implementations of MCMC methods suffer from slow convergence in machine vision due to the complexity of the parameter space. Towards this blocked Gibbs and split-merge samplers have been developed that assign multiple data points to clusters at once. In this paper we introduce a new split-merge sampler, the triadic split-merge sampler, that perform steps between two and three randomly chosen clusters. This has two advantages. First, it reduces the asymmetry between the split and merge steps. Second, it is able to propose a new cluster that is composed out of data points from two different clusters. Both advantages speed up convergence which we demonstrate on a line extraction problem. We show that the triadic split-merge sampler outperforms the conventional split-merge sampler. Although this new MCMC sampler is demonstrated in this machine vision context, its application extend to the very general domain of statistical inference.

Visuospatial asymmetries and interocular transfer in the split-brain rat.

PubMed

Adelstein, A; Crowne, D P

1991-06-01

Interocular transfer (IOT), hemispheric superiority, and cerebral dominance were examined in split-brain female albino rats. Callosum-sectioned and intact animals were monocularly trained in the Morris water maze and tested in IOT and reversal phases. In the IOT phase, split-brain rats entered more nontarget quadrants and headed less accurately toward the platform than did controls. For both split-brain animals and controls, right-eye training resulted in shorter latencies and fewer nontarget entries than did left-eye training. Analyses of cerebral dominance showed shorter latencies and smaller heading errors over all 3 phases in rats that were trained with the nondominant eye. Right-eye dominant controls were less affected by platform reversal. Split-brain rats were inferior to controls in latency to find the platform and in target quadrant entries. This finding establishes a spatial cognitive deficit from callosum section.

Comparison of the effectiveness of 0.5% tea, 2% neem and 0.2% chlorhexidine mouthwashes on oral health: a randomized control trial.

PubMed

Balappanavar, Aswini Y; Sardana, Varun; Singh, Malkeet

2013-01-01

The aim of this study was to evaluate and compare the effectiveness of 0.5% tea, 2% neem, and 0.2% chlorhexidine mouthwashes on oral health. A randomized blinded controlled trial with 30 healthy human volunteers of age group 18-25 years was carried out. The subjects were randomly assigned to 3 groups i.e., group A - 0.2% chlorhexidine gluconate (bench mark control), Group B - 2% neem, and group C - 0.5% tea of 10 subjects per group. Plaque accumulation and gingival condition were recorded using plaque index and gingival index. Oral hygiene was assessed by simplified oral hygiene index (OHIS). Salivary pH was assessed by indikrom pH strips. Plaque, gingival, and simplified OHI scores as well as salivary pH were recorded at baseline, immediately after 1 st rinse, after 1 week, 2 nd week, and 3 rd week. The 3 rd week was skipped for group A. Mean plaque and gingival scores were reduced over the 3 week trial period for experimental and control groups. Anti-plaque effectiveness was observed in all groups and the highest being in group C (P < 0.05). Neem and tea showed comparative effectiveness on gingiva better than chlorhexidine (P < 0.05). The salivary pH rise was sustained and significant in Group B and C compared to Group A. Oral hygiene improvement was better appreciated in Group B and Group C. The effectiveness of 0.5% tea was more compared to 2% neem and 0.2% chlorhexidine mouth rinse.

Two- and three-input TALE-based AND logic computation in embryonic stem cells.

PubMed

Lienert, Florian; Torella, Joseph P; Chen, Jan-Hung; Norsworthy, Michael; Richardson, Ryan R; Silver, Pamela A

2013-11-01

Biological computing circuits can enhance our ability to control cellular functions and have potential applications in tissue engineering and medical treatments. Transcriptional activator-like effectors (TALEs) represent attractive components of synthetic gene regulatory circuits, as they can be designed de novo to target a given DNA sequence. We here demonstrate that TALEs can perform Boolean logic computation in mammalian cells. Using a split-intein protein-splicing strategy, we show that a functional TALE can be reconstituted from two inactive parts, thus generating two-input AND logic computation. We further demonstrate three-piece intein splicing in mammalian cells and use it to perform three-input AND computation. Using methods for random as well as targeted insertion of these relatively large genetic circuits, we show that TALE-based logic circuits are functional when integrated into the genome of mouse embryonic stem cells. Comparing construct variants in the same genomic context, we modulated the strength of the TALE-responsive promoter to improve the output of these circuits. Our work establishes split TALEs as a tool for building logic computation with the potential of controlling expression of endogenous genes or transgenes in response to a combination of cellular signals.

Immediate effects of hamstring stretching alone or combined with ischemic compression of the masseter muscle on hamstrings extensibility, active mouth opening and pain in athletes with temporomandibular dysfunction.

PubMed

Espejo-Antúnez, Luis; Castro-Valenzuela, Elisa; Ribeiro, Fernando; Albornoz-Cabello, Manuel; Silva, Anabela; Rodríguez-Mansilla, Juan

2016-07-01

To assess the immediate effects of hamstrings stretching alone or combined with ischemic compression of the masseter muscle on hamstrings extensibility, active mouth opening and pain in athletes with temporomandibular dysfunction and hamstrings shortening. Forty-two participants were randomized to receive the stretching technique (n = 21) or the stretching plus the ischemic compression (n = 21). Outcome measures were: hamstrings extensibility, active mouth opening, pressure pain thresholds and pain intensity. Both interventions improved significantly active mouth opening (group 1: 35.7 ± 6.7 to 39.1 ± 7.6 mm, p < 0.001; group 2: 34.0 ± 6.2 to 37.6 ± 5.6 mm, p < 0.001), active knee extension (group 1: 33.1 ± 8.5 to 40.8 ± 8.2°, p < 0.001; group 2: 28.9 ± 6.5 to 35.5 ± 6.4°, p < 0.001) and pain. No significant differences were found between interventions. Hamstrings stretching induced an acute improvement in hamstrings extensibility, active mouth opening and pain. Moreover, the addition of ischemic compression did not induce further improvements on the assessed parameters. Copyright © 2016. Published by Elsevier Ltd.

Reinforcement Learning Trees

PubMed Central

Zhu, Ruoqing; Zeng, Donglin; Kosorok, Michael R.

2015-01-01

In this paper, we introduce a new type of tree-based method, reinforcement learning trees (RLT), which exhibits significantly improved performance over traditional methods such as random forests (Breiman, 2001) under high-dimensional settings. The innovations are three-fold. First, the new method implements reinforcement learning at each selection of a splitting variable during the tree construction processes. By splitting on the variable that brings the greatest future improvement in later splits, rather than choosing the one with largest marginal effect from the immediate split, the constructed tree utilizes the available samples in a more efficient way. Moreover, such an approach enables linear combination cuts at little extra computational cost. Second, we propose a variable muting procedure that progressively eliminates noise variables during the construction of each individual tree. The muting procedure also takes advantage of reinforcement learning and prevents noise variables from being considered in the search for splitting rules, so that towards terminal nodes, where the sample size is small, the splitting rules are still constructed from only strong variables. Last, we investigate asymptotic properties of the proposed method under basic assumptions and discuss rationale in general settings. PMID:26903687

Adaptive control of dynamic balance in human gait on a split-belt treadmill.

PubMed

Buurke, Tom J W; Lamoth, Claudine J C; Vervoort, Danique; van der Woude, Lucas H V; den Otter, Rob

2018-05-17

Human bipedal gait is inherently unstable and staying upright requires adaptive control of dynamic balance. Little is known about adaptive control of dynamic balance in reaction to long-term, continuous perturbations. We examined how dynamic balance control adapts to a continuous perturbation in gait, by letting people walk faster with one leg than the other on a treadmill with two belts (i.e. split-belt walking). In addition, we assessed whether changes in mediolateral dynamic balance control coincide with changes in energy use during split-belt adaptation. In nine minutes of split-belt gait, mediolateral margins of stability and mediolateral foot roll-off changed during adaptation to the imposed gait asymmetry, especially on the fast side, and returned to baseline during washout. Interestingly, no changes in mediolateral foot placement (i.e. step width) were found during split-belt adaptation. Furthermore, the initial margin of stability and subsequent mediolateral foot roll-off were strongly coupled to maintain mediolateral dynamic balance throughout the gait cycle. Consistent with previous results net metabolic power was reduced during split-belt adaptation, but changes in mediolateral dynamic balance control were not correlated with the reduction of net metabolic power during split-belt adaptation. Overall, this study has shown that a complementary mechanism of relative foot positioning and mediolateral foot roll-off adapts to continuously imposed gait asymmetry to maintain dynamic balance in human bipedal gait. © 2018. Published by The Company of Biologists Ltd.

Randomized, Controlled Trial of Fractional Carbon Dioxide Laser Resurfacing Followed by Ultrashort Incubation Aminolevulinic Acid Blue Light Photodynamic Therapy for Actinic Keratosis.

PubMed

Alexiades, Macrene

2017-08-01

Aminolevulinic acid (ALA) photodynamic therapy (PDT) is an established treatment option for actinic keratosis (AK), and recently fractional carbon dioxide (CO2) laser was shown to improve outcomes; but studies of short incubation photosensitizer are lacking. Assess the efficacy of short incubation ALA followed by blue light PDT with and without previous fractional CO2 treatment for the treatment of AK. Randomized, paired split-design, controlled trial of fractional CO2 followed by ultrashort 15-minute versus 30-minute incubation ALA and blue light PDT for the treatment of AK on the face. The complete clearance rates (CRs) at 8 weeks after ALA PDT with and without FxCO2 at 30- and 15-minute ALA incubation times were 89.78% (+FxCO2) versus 71.20% CR (-FxCO2) at 30', and 86.38% (+FxCO2) versus 69.23% (-FxCO2) at 15' ALA incubation. All lesion improvements were statistically significant. This randomized, comparative paired group controlled clinical study demonstrates that ultrashort 15- and 30-minute incubation ALA PDTs are of limited efficacy for the treatment of AK. Pretreatment with fractional ablative resurfacing yields statistically significant greater AK clearance with ALA-PDT at ultrashort ALA incubations followed by blue light.

The effects of physical training without equipment on pain perception and balance in the elderly: A randomized controlled trial.

PubMed

Patti, Antonino; Bianco, Antonino; Karsten, Bettina; Montalto, Maria Alessandra; Battaglia, Giuseppe; Bellafiore, Marianna; Cassata, Daniela; Scoppa, Fabio; Paoli, Antonio; Iovane, Angelo; Messina, Giuseppe; Palma, Antonio

2017-01-01

Research supports a link between exercise and falls prevention in the older population. Our aims were to evaluate pain perception and balance skills in a group of elderly subjects and to examine the consequences of a standardized equipment-free exercise program intervention on these variables. The study utilized a randomized controlled trial method. 92 subjects were recruited from a rural Sicilian village (Resuttano, Sicily, Italy). Subjects were randomly split into two groups, an experimental group (EG; n = 49) and a control group (CG; n = 43). Qualified fitness instructors delivered the standardized physical exercise program for the EG whilst the CG did not receive this exercise intervention. The Berg Balance Scale and the Oswestry Disability Index were administered in both groups before (T0) and after the intervention (T1). At T1, the EG group significantly improvement in balance (p < 0.0001) and pain perception (p < 0.0001). No significant differences were found within the CG both in BBS and ODI, respectively. Our findings suggest that a 13-weeks standardized exercise equipment-free program is effective in improving balance and perception of pain in the elderly. This type of intervention can consequently provide a low cost strategy to counteract the rate of disability in elderly.

Neurophysiological study on the effect of various short durations of deep breathing: A randomized controlled trial.

PubMed

Cheng, Kok Suen; Han, Ray P S; Lee, Poh Foong

2018-02-01

The study aims to study the effects of short duration deep breathing on the EEG power with topography based on parallel group randomized controlled trial design which was lacking in prior reports. 50 participants were split into 4 groups: control (CONT), deep breathing (DB) for 5 (DB5), 7 (DB7), and 9 (DB9) minutes. EEG recordings were obtained during baseline, deep breathing session, after deep breathing, and a follow-up session after 7 days of consecutive practice. Frontal theta power of DB5 and DB9 was significantly larger than that of CONT after the deep breathing session (p = 0.027 and p = 0.006, respectively) and the profound finding showed that the theta topography obtained a central-focused distribution for DB7 and DB9. The result obtained was consistent with previous literature, albeit for certain deep breathing durations only, indicating a possible linkage between the deep breathing duration and the neurophysiology of the brain. Copyright © 2017 Elsevier B.V. All rights reserved.

Vapocoolant Anesthesia for Cosmetic Facial Rejuvenation Injections: A Randomized, Prospective, Split-Face Trial.

PubMed

Zeiderman, Matthew R; Kelishadi, Shahrooz Sean; Tutela, John Paul; Rao, Arun; Chowdhry, Saeed; Brooks, Ronald M; Wilhelmi, Bradon J

2018-01-01

Background: Minimally invasive cosmetic procedures are the most commonly performed aesthetic techniques by plastic surgeons. Patients are interested in a pain-free experience. Surgeons desire patient satisfaction and time-efficient utilization of office staff and resources. Clinical evidence exists for use of vapocoolant technology to reduce pain associated with intravenous cannulation in the pediatric population and in hemodialysis patients. Applying vapocoolant technology to facial rejuvenation is a novel approach to decrease pain associated with neurotoxin or filler injection. Methods: A randomized, prospective study was conducted, testing 15 subjects receiving filler injections and another 15 patients receiving neurotoxin injections using a split-face model. The vapocoolant spray used was composed of a 95:5 ratio of 1,1,1,3,3-pentafluoropropane and 1,1,1,2-tetrafluoroethane. Within each group, individual patients randomly received injection (filler or neurotoxin) alone versus injection (filler or neurotoxin) plus vapocoolant on an equivalent half of his or her face. An independent examiner recorded from each patient on a scale of 1 to 10 perceived pain for injection alone versus injection plus vapocoolant spray. Results were calculated as a percentage change of pain scores experienced after injection for each person between the control (nonvapocoolant) and treatment (vapocoolant) sides of the face. Results: Vapocoolant spray at the time of cosmetic facial injections leads to a 59% decrease in perceived pain score with neurotoxin injections (range, 0%-100% change) and 64% decrease in perceived pain score with filler injections (range, 0%-100% change). These results were statistically significant with P < .05. Conclusion: Vapocoolant spray reduces pain associated with facial rejuvenation procedures.

[Effect of inspiratory muscle training on muscle strength and quality of life in patients with chronic airflow limitation: a randomized controlled trial].

PubMed

Serón, P; Riedemann, P; Muñoz, S; Doussoulin, A; Villarroel, P; Cea, X

2005-11-01

Chronic airflow limitation (CAL) is a significant cause of illness and death. Inspiratory muscle training has been described as a technique for managing CAL. The aim of the present study was to evaluate the effectiveness of inspiratory muscle training on improving physiological and functional variables. Randomized controlled trial in which 35 patients with CAL were assigned to receive either an experimental (n=17) or control (n=18) intervention. The experimental intervention consisted of 2 months of inspiratory muscle training using a device that administered a resistive load of 40% of maximal static inspiratory mouth pressure (PImax). Inspiratory muscle strength, exercise tolerance, respiratory function, and quality of life were assessed. Significant improvement in inspiratory muscle strength was observed in the experimental training group (P=.02). All patients improved over time in both groups (P<.001). PImax increased by 8.9 cm H2O per month of training. Likewise, the health-related quality of life scores improved by 0.56 points. Use of a threshold loading device is effective for strengthening inspiratory muscles as measured by PImax after the first month of training in patients with CAL. The long-term effectiveness of such training and its impact on quality of life should be studied in a larger number of patients.

An experimental investigation of justice-based service recovery on customer satisfaction, loyalty, and word-of-mouth intentions.

PubMed

Shapiro, Terri; Nieman-Gonder, Jennifer M; Andreoli, Nicole A; Trimarco-Beta, Darlene

2006-12-01

Service recovery is related to many important organizational outcomes such as customer satisfaction, loyalty, and profitability. Within the theoretical framework of organizational justice, an experiment using a simulated "live" service failure was used to assess the effects of justice-based service-recovery strategies on customer satisfaction, loyalty, positive word-of-mouth intentions, and negative word-of-mouth intentions. Analysis indicated that strategies including interactional justice, distributive justice, and a combination of these were equally effective in maintaining customer satisfaction, loyalty, and positive word of mouth, and minimizing negative word of mouth after a service failure. No support for the service recovery paradox, that is, increased satisfaction following service failure and recovery compared to never having a problem, was found. Satisfaction and loyalty for those in the failure conditions were equal to, although not higher than, in the no-failure control condition. Practical implications for organizational practices are discussed.

Ablative fractional lasers (CO(2) and Er:YAG): a randomized controlled double-blind split-face trial of the treatment of peri-orbital rhytides.

PubMed

Karsai, Syrus; Czarnecka, Agnieszka; Jünger, Michael; Raulin, Christian

2010-02-01

Ablative fractional lasers were introduced for treating facial rhytides in an attempt to achieve results comparable to traditional ablative resurfacing but with fewer side effects. However, there is conflicting evidence on how well this goal has generally been achieved as well as on the comparative value of fractional CO(2) and Er:YAG lasers. The present study compares these modalities in a randomized controlled double-blind split-face study design. Twenty-eight patients were enrolled and completed the entire study. Patients were randomly assigned to receive a single treatment on each side of the peri-orbital region, one with a fractional CO(2) and one with a fractional Er:YAG laser. The evaluation included the profilometric measurement of wrinkle depth, the Fitzpatrick wrinkle score (both before and 3 months after treatment) as well as the assessment of side effects and patient satisfaction (1, 3, 6 days and 3 months after treatment). Both modalities showed a roughly equivalent effect. Wrinkle depth and Fitzpatrick score were reduced by approximately 20% and 10%, respectively, with no appreciable difference between lasers. Side effects and discomfort were slightly more pronounced after Er:YAG treatment in the first few days, but in the later course there were more complaints following CO(2) laser treatment. Patient satisfaction was fair and the majority of patients would have undergone the treatment again without a clear preference for either method. According to the present study, a single ablative fractional treatment session has an appreciable yet limited effect on peri-orbital rhytides. When fractional CO(2) and Er:YAG lasers are used in such a manner that there are comparable post-operative healing periods, comparable cosmetic improvement occurs. Multiple sessions may be required for full effect, which cancels out the proposed advantage of fractional methods, that is, fewer side effects and less down time.

Design of a factorial experiment with randomization restrictions to assess medical device performance on vascular tissue.

PubMed

Diestelkamp, Wiebke S; Krane, Carissa M; Pinnell, Margaret F

2011-05-20

Energy-based surgical scalpels are designed to efficiently transect and seal blood vessels using thermal energy to promote protein denaturation and coagulation. Assessment and design improvement of ultrasonic scalpel performance relies on both in vivo and ex vivo testing. The objective of this work was to design and implement a robust, experimental test matrix with randomization restrictions and predictive statistical power, which allowed for identification of those experimental variables that may affect the quality of the seal obtained ex vivo. The design of the experiment included three factors: temperature (two levels); the type of solution used to perfuse the artery during transection (three types); and artery type (two types) resulting in a total of twelve possible treatment combinations. Burst pressures of porcine carotid and renal arteries sealed ex vivo were assigned as the response variable. The experimental test matrix was designed and carried out as a split-plot experiment in order to assess the contributions of several variables and their interactions while accounting for randomization restrictions present in the experimental setup. The statistical software package SAS was utilized and PROC MIXED was used to account for the randomization restrictions in the split-plot design. The combination of temperature, solution, and vessel type had a statistically significant impact on seal quality. The design and implementation of a split-plot experimental test-matrix provided a mechanism for addressing the existing technical randomization restrictions of ex vivo ultrasonic scalpel performance testing, while preserving the ability to examine the potential effects of independent factors or variables. This method for generating the experimental design and the statistical analyses of the resulting data are adaptable to a wide variety of experimental problems involving large-scale tissue-based studies of medical or experimental device efficacy and performance.

The impact of chlorhexidine mouth rinse on the bond strength of polycarbonate orthodontic brackets.

PubMed

Hussein, Farouk Ahmed; Hashem, Mohammed Ibrahim; Chalisserry, Elna P; Anil, Sukumaran

2014-11-01

The purpose of the current in-vivo study was to assess the effect of using 0.12% chlorhexidine (CHX) mouth rinse, before bonding, on shear bond strength of polycarbonate brackets bonded with composite adhesive. Eighteen orthodontic patients with a mean age 21.41 ± 1.2 years, who were scheduled to have 2 or more first premolars extracted, were included in this study. Patients were referred for an oral prophylaxis program which included, in part, the use of a mouth rinse. Patients were divided into 2 groups, a test group of 9 patients who used 0.12% CHX gluconate mouth rinse twice daily and a control group of 9 patients who used a mouth rinse without CHX, but with same color. After 1 week, polycarbonate brackets were bonded to first premolars with Transbond XT composite adhesive. Premolars were extracted after 28 days and tested for shear bond strength on a universal testing machine. Student's t-test was used to compare shear bond strengths of both groups. No statistically significant difference was found in bond strengths' values between both groups. The test group (with CHX) has mean shear bond strength of 14.21 ± 2.42 MPa whereas the control group (without CHX) revealed a mean strength of 14.52 ± 2.31 MPa. The use of 0.12% CHX mouth rinse, for one week before bonding, did not affect the shear bond strength of polycarbonate brackets bonded with Transbond composite. Furthermore, these brackets showed clinically acceptable bond strength.

Quiet Ego, Self-Regulatory Skills, and Perceived Stress in College Students.

PubMed

Wayment, Heidi A; Cavolo, Keragan

2018-04-13

Examine the unique contributions of self-control and grit subscales (perseverance, interest consistency) as potential mediators of the relationship between quiet ego characteristics and less perceived stress in college students. Data from 1117 college students were collected between October, 2015 and May, 2016. The sample was split randomly into exploratory and confirmatory samples. Multiple mediator models were tested with PROCESS module (SPSS v. 24) in both samples. Hypotheses were largely confirmed with self-control fully mediating the link between quiet ego and perceived stress in both samples. Although many self-regulatory constructs may argue for their positive impact on college student outcomes, interventions that strengthen self-control, and not grit, may be most promising to reduce perceived stress. Further, interventions to strengthen quiet ego characteristics may be beneficial for strengthening self-control in college students.

An Evidence-Based Review Literature About Risk Indicators and Management of Unknown-Origin Xerostomia

PubMed Central

Agha-Hosseini, Farzaneh; Moosavi, Mahdieh-Sadat

2013-01-01

This evidence-based article reviews risk indicators and management of unknown-origin xerostomia. Xerostomia and hyposalivation refer to different aspects of dry mouth. Xerostomia is a subjective sensation of dry mouth, whilst hyposalivation is defined as an objective assessment of reduced salivary flow rate. About 30% of the elderly (65 years and older) experience xerostomia and hyposalivation. Structural and functional factors, or both may lead to salivary gland dysfunction. The EBM literature search was conducted by using the medical literature database MEDLINE via PubMed and OvidMedline search engines. Results were limited to English language articles (1965 to present) including clinical trials (CT), randomized controlled trials (RCT), systematic reviews and review articles. Case control or cohort studies were included for the etiology. Neuropathic etiology such as localized oral alteration of thermal sensations, saliva composition change (for example higher levels of K, Cl, Ca, IgA, amylase, calcium, PTH and cortisol), lower levels of estrogen and progesterone, smaller salivary gland size, and illnesses such as lichen planus, are risk indicators for unknown-origin xerostomia. The management is palliative and preventative. Management of symptoms includes drug administration (systemic secretogogues, saliva substitutes and bile secretion-stimulator), night guard, diet and habit modifications. Other managements may be indicated to treat adverse effects. Neuropathic etiology, saliva composition change, smaller salivary gland size, and illnesses such as oral lichen planus can be suggestive causes for unknown-origin xerostomia. However, longitudinal studies will be important to elucidate the causes of unknown-origin xerostomia. PMID:25512755

Probiotics: health benefits in the mouth.

PubMed

Stamatova, Iva; Meurman, Jukka H

2009-12-01

Probiotics or health-beneficial bacteria have only recently been introduced in dentistry and oral medicine after years of successful use in mainly gastro-intestinal disorders. The concept of bacteriotherapy and use of health-beneficial micro-organisms to heal diseases or support immune function was first introduced in the beginning of the 20th century. Later the concept lead to the development of modem dairy industry and even today most probiotic strains are lactobacilli or bifidobacteria used in milk fermentation. The mechanisms of probiotic action are mainly unknown but the inter-microbial species interactions are supposed to play a key role in this together with their immuno-stimulatory effects. The introduction of probiotic bacteria in the mouth calls for ascertainment of their particular safety. Since acid production from sugar is detrimental to teeth, care must be taken not to select strains with high fermentation capacity. The first randomized controlled trials have nevertheless shown that probiotics may control dental caries in children due to their inhibitory action against cariogenic streptococci. Less evidence exists on their role in periodontal disease or oral yeast infections. Furthermore the best vehicles for oral probiotic applications need to be assessed. So far mainly dairy products have been investigated but other means such as probiotics in chewing gums or lozenges have also been studied. From the clinical practitioner's point of view direct recommendations for the use of probiotics cannot yet be given. However, scientific evidence so far indicates that probiotic therapy may be a reality also in dentistry and oral medicine in the future.

Efficacy evaluation of clonazepam for symptom remission in burning mouth syndrome: a meta-analysis.

PubMed

Cui, Y; Xu, H; Chen, F M; Liu, J L; Jiang, L; Zhou, Y; Chen, Q M

2016-09-01

Clonazepam has been used in the treatment of burning mouth syndrome (BMS) for several decades. We conducted a meta-analysis to investigate the efficacy of clonazepam in the treatment of BMS. We conducted a search of the PubMed, MEDLINE, EMBASE, Web of Science (TS), and the Cochrane Library databases for relevant studies that met our eligibility criteria (up to September 22, 2015). Statistical analyses were conducted using RevMan 5.2 and STATA 11.0 software. Three randomized controlled trials (RCTs) and two high-quality case-control studies involving 195 BMS patients were selected for this study. Our results show that clonazepam can reduce the oral pain sensation in patients with BMS (WMD: -3.72, 95% CI: -4.57, -2.86; P < 0.05; for all five studies). A positive therapeutic effect was demonstrated for both short-term (≤10 weeks) application (WMD: -1.44, 95% CI: -2.06, -0.82; P < 0.05) and long-term (>10 weeks) application (WMD: -4.50, 95% CI: -4.98, -4.03; P < 0.05). Both topical (WMD: -1.50, 95% CI: -2.14, -0.85; P < 0.05) and systemic (WMD: -3.81, 95% CI: -4.63, -2.98; P < 0.05) administration of clonazepam were confirmed to be effective. Clonazepam is effective in inducing symptom remission in patients with BMS. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Split-plot microarray experiments: issues of design, power and sample size.

PubMed

Tsai, Pi-Wen; Lee, Mei-Ling Ting

2005-01-01

This article focuses on microarray experiments with two or more factors in which treatment combinations of the factors corresponding to the samples paired together onto arrays are not completely random. A main effect of one (or more) factor(s) is confounded with arrays (the experimental blocks). This is called a split-plot microarray experiment. We utilise an analysis of variance (ANOVA) model to assess differentially expressed genes for between-array and within-array comparisons that are generic under a split-plot microarray experiment. Instead of standard t- or F-test statistics that rely on mean square errors of the ANOVA model, we use a robust method, referred to as 'a pooled percentile estimator', to identify genes that are differentially expressed across different treatment conditions. We illustrate the design and analysis of split-plot microarray experiments based on a case application described by Jin et al. A brief discussion of power and sample size for split-plot microarray experiments is also presented.

Provision of mouth-care in long-term care facilities: an educational trial.

PubMed

MacEntee, M I; Wyatt, C C L; Beattie, B L; Paterson, B; Levy-Milne, R; McCandless, L; Kazanjian, A

2007-02-01

This randomized clinical trial aimed to assess the effectiveness of a pyramid-based education for improving the oral health of elders in long-term care (LTC) facilities. Fourteen facilities matched for size were assigned randomly to an active or control group. At baseline in each facility, care-aides in the active group participated with a full-time nurse educator in a seminar about oral health care, and had unlimited access to the educator for oral health-related advice throughout the 3-month trial. Care-aides in the control group participated in a similar seminar with a dental hygienist but they received no additional advice. The residents in the facilities at baseline and after 3 months were examined clinically to measure their oral hygiene, gingival health, masticatory potential, Body Mass Index and Malnutrition Indicator Score, and asked to report on chewing difficulties. Clinical measures after 3 months were not significantly different from baseline in either group, indicating that education neither influenced the oral health nor the dental hygiene of the residents. A pyramid-based educational scheme with nurses and care-aides did not improve the oral health of frail elders in this urban sample of LTC facilities.

Unbalanced and Minimal Point Equivalent Estimation Second-Order Split-Plot Designs

NASA Technical Reports Server (NTRS)

Parker, Peter A.; Kowalski, Scott M.; Vining, G. Geoffrey

2007-01-01

Restricting the randomization of hard-to-change factors in industrial experiments is often performed by employing a split-plot design structure. From an economic perspective, these designs minimize the experimental cost by reducing the number of resets of the hard-to- change factors. In this paper, unbalanced designs are considered for cases where the subplots are relatively expensive and the experimental apparatus accommodates an unequal number of runs per whole-plot. We provide construction methods for unbalanced second-order split- plot designs that possess the equivalence estimation optimality property, providing best linear unbiased estimates of the parameters; independent of the variance components. Unbalanced versions of the central composite and Box-Behnken designs are developed. For cases where the subplot cost approaches the whole-plot cost, minimal point designs are proposed and illustrated with a split-plot Notz design.

Deep breathing exercises with positive expiratory pressure in patients with multiple sclerosis - a randomized controlled trial.

PubMed

Westerdahl, Elisabeth; Wittrin, Anna; Kånåhols, Margareta; Gunnarsson, Martin; Nilsagård, Ylva

2016-11-01

Breathing exercises with positive expiratory pressure are often recommended to patients with advanced neurological deficits, but the potential benefit in multiple sclerosis (MS) patients with mild and moderate symptoms has not yet been investigated in randomized controlled trials. To study the effects of 2 months of home-based breathing exercises for patients with mild to moderate MS on respiratory muscle strength, lung function, and subjective breathing and health status outcomes. Forty-eight patients with MS according to the revised McDonald criteria were enrolled in a randomized controlled trial. Patients performing breathing exercises (n = 23) were compared with a control group (n = 25) performing no breathing exercises. The breathing exercises were performed with a positive expiratory pressure device (10-15 cmH 2 O) and consisted of 30 slow deep breaths performed twice a day for 2 months. Respiratory muscle strength (maximal inspiratory and expiratory pressure at the mouth), spirometry, oxygenation, thoracic excursion, subjective perceptions of breathing and self-reported health status were evaluated before and after the intervention period. Following the intervention, there was a significant difference between the breathing group and the control group regarding the relative change in lung function, favoring the breathing group (vital capacity: P < 0.043; forced vital capacity: P < 0.025). There were no other significant differences between the groups. Breathing exercises may be beneficial in patients with mild to moderate stages of MS. However, the clinical significance needs to be clarified, and it remains to be seen whether a sustainable effect in delaying the development of respiratory dysfunction in MS can be obtained. © 2015 The Authors. The Clinical Respiratory Journal published by John Wiley & Sons Ltd.

Sham-controlled, randomized, feasibility trial of acupuncture for prevention of radiation-induced xerostomia among patients with nasopharyngeal carcinoma

PubMed Central

Meng, Zhiqiang; Garcia, M. Kay; Hu, Chaosu; Chiang, Joseph; Chambers, Mark; Rosenthal, David I.; Peng, Huiting; Wu, Caijun; Zhao, Qi; Zhao, Genming; Liu, Luming; Spelman, Amy; Palmer, J. Lynn; Wei, Qi; Cohen, Lorenzo

2013-01-01

Background Xerostomia (dry mouth) after head/neck radiation is a common problem among cancer patients. Quality of life (QOL) is impaired, and available treatments are of little benefit. This trial determined the feasibility of conducting a sham-controlled trial of acupuncture and whether acupuncture could prevent xerostomia among head/neck patients undergoing radiotherapy. Methods A sham controlled, feasibility trial was conducted at Fudan University Shanghai Cancer Center, Shanghai, China among patients with nasopharyngeal carcinoma undergoing radiotherapy. To determine feasibility of a sham procedure, 23 patients were randomized to real acupuncture (N = 11) or to sham acupuncture (N = 12). Patients were treated 3 times/week during their course of radiotherapy. Subjective measures were the Xerostomia Questionnaire (XQ) and MD Anderson Symptom Inventory for Head and Neck Cancer (MDASI-HN). Objective measures were unstimulated whole salivary flow rates (UWSFR) and stimulated salivary flow rates (SSFR). Patients were followed for 1 month after radiotherapy. Results XQ scores for acupuncture were significantly lower than sham controls starting in week 3 and lasted through the 1-month follow-up (all P’s < 0.001 except for week 3, which was 0.006), with clinically significant differences as follows: week 6 – RR 0.28 [95% CI, 0.10, 0.79]; week 11- RR 0.17 [95% CI, 0.03, 1.07]. Similar findings were seen for MDASI-HN scores and MDASI-Intrusion scores. Group differences for UWSFR and SSFR were not found. Conclusions In this small pilot study, true acupuncture given concurrently with radiotherapy significantly reduced xerostomia symptoms and improved QOL when compared with sham acupuncture. Large-scale, multi-center, randomized, placebo-controlled trials are now needed. PMID:22285177

Accelerated re-epithelialization of partial-thickness skin wounds by a topical betulin gel: Results of a randomized phase III clinical trials program.

PubMed

Barret, Juan P; Podmelle, Fred; Lipový, Břetislav; Rennekampff, Hans-Oliver; Schumann, Hauke; Schwieger-Briel, Agnes; Zahn, Tobias R; Metelmann, Hans-Robert

2017-09-01

The clinical significance of timely re-epithelialization is obvious in burn care, since delayed wound closure is enhancing the risk of wound site infection and extensive scarring. Topical treatments that accelerate wound healing are urgently needed to reduce these sequelae. Evidence from preliminary studies suggests that betulin can accelerate the healing of different types of wounds, including second degree burns and split-thickness skin graft wounds. The goal of this combined study program consisting of two randomized phase III clinical trials in parallel is to evaluate whether a topical betulin gel (TBG) is accelerating re-epithelialization of split-thickness skin graft (STSG) donor site wounds compared to standard of care. Two parallel blindly evaluated, randomised, controlled, multicentre phase III clinical trials were performed in adults undergoing STSG surgery (EudraCT nos. 2012-003390-26 and 2012-000777-23). Donor site wounds were split into two equal halves and randomized 1:1 to standard of care (a non-adhesive moist wound dressing) or standard of care plus TBG consisting of 10% birch bark extract and 90% sunflower oil (Episalvan, Birken AG, Niefern-Oeschelbronn, Germany). The primary efficacy assessment was the intra-individual difference in time to wound closure assessed from digital photographs by three blinded experts. A total of 219 patients were included and treated in the two trials. Wounds closed faster with TBG than without it (15.3 vs. 16.5 days; mean intra-individual difference=-1.1 days [95% CI, -1.5 to -0.7]; p<0.0001). This agreed with unblinded direct clinical assessment (difference=-2.1 days [95% CI, -2.7 to -1.5]; p<0.0001). Adverse events possibly related to treatment were mild or moderate and mostly at the application site. TBG accelerates re-epithelialization of partial thickness wounds compared to the current standard of care, providing a well-tolerated contribution to burn care in practice. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Comparison between self-formulation and compounded-formulation dexamethasone mouth rinse for oral lichen planus: a pilot, randomized, cross-over trial.

PubMed

Hambly, Jessica L; Haywood, Alison; Hattingh, Laetitia; Nair, Raj G

2017-08-01

There is a lack of appropriate, commercially-available topical corticosteroid formulations for use in oral lichen planus (OLP) and oral lichenoid reaction. Current therapy includes crushing a dexamethasone tablet and mixing it with water for use as a mouth rinse. This formulation is unpleasant esthetically and to use in the mouth, as it is a bitter and gritty suspension, resulting in poor compliance. Thus, the present study was designed to formulate and pilot an effective, esthetically-pleasing formulation. A single-blinded, cross-over trial was designed with two treatment arms. Patients were monitored for 7 weeks. Quantitative and qualitative data was assessed using VAS, numeric pain scales, the Treatment Satisfaction Questionnaire for Medication-9, and thematic analysis to determine primary patient-reported outcomes, including satisfaction, compliance, quality of life, and symptom relief. Nine patients completed the pilot trial. Data analysis revealed the new compounded formulation to be superior to existing therapy due to its convenience, positive contribution to compliance, patient-perceived faster onset of action, and improved symptom relief. Topical dexamethasone is useful in the treatment of OLP. When carefully formulated into a compounded mouth rinse, it improves patient outcomes. © 2016 John Wiley & Sons Australia, Ltd.

Changes in serum interleukin-6, C-reactive protein and thrombomodulin levels under periodontal ultrasonic debridement.

PubMed

Ushida, Yuka; Koshy, Geena; Kawashima, Yoko; Kiji, Makoto; Umeda, Makoto; Nitta, Hiroshi; Nagasawa, Toshiyuki; Ishikawa, Isao; Izumi, Yuichi

2008-11-01

This study aimed to compare the effect of single-visit full-mouth mechanical debridement (FMD) and quadrant-wise mechanical debridement (QMD) on the levels of serum interleukin (IL)-6, C-reactive protein (CRP) and soluble thrombomodulin. Thirty-six subjects with chronic periodontitis were randomly allocated to three groups: undergoing QMD, single-visit FMD with povidone iodine or with water. Serum IL-6 and soluble thrombomodulin were measured by enzyme-linked immunosorbent assay, and serum CRP was measured by the latex-enhanced nephelometric method. Serum IL-6 level increased significantly immediately after debridement in all the three groups, with this increase being greatest in the full-mouth groups. However, the increase in the full-mouth groups was not significantly higher than that of quadrant-wise group. In the quadrant-wise group, serum IL-6 level decreased significantly 1 month after debridement compared with baseline. Serum-soluble thrombomodulin decreased significantly in the full-mouth groups but not in the quadrant-wise group. Changes in CRP level were not significant at baseline or after debridement in all the three groups. FMD increased serum IL-6 and reduced serum-soluble thrombomodulin to a greater extent than QMD, suggesting that the former technique has stronger transient effects on systemic vascular endothelial functions than the latter.

Efficacy of petal fall and shuck split fungicides for control of scab on peach in middle Georgia, 2012

USDA-ARS?s Scientific Manuscript database

Fungicides were evaluated for control of scab in a mid-ripening experimental peach block (‘Flameprince’) located at the USDA-ARS Fruit and Tree Nut Research Laboratory (Byron, GA). Chemical formulations were applied at each application date: 3 Apr (petal fall to 1% shuck split), 10 Apr (shuck split ...

Heterogeneity in the antibody response to foot-and-mouth disease primo-vaccinated calves

USDA-ARS?s Scientific Manuscript database

Foot-and-mouth disease (FMD) is the most economically important viral disease of wild and domesticated biungulate species and presents a major constraint to international trade of livestock and their associated products. FMD vaccines are routinely used as effective control tools in large regions wor...

9 CFR 95.9 - Glue stock; requirements for unrestricted entry.

Code of Federal Regulations, 2014 CFR

2014-01-01

... SANITARY CONTROL OF ANIMAL BYPRODUCTS (EXCEPT CASINGS), AND HAY AND STRAW, OFFERED FOR ENTRY INTO THE... Agriculture to be infected with foot-and-mouth disease or rinderpest may be imported without other restriction...-and-mouth disease, and rinderpest, and to assure further the identity of such materials until loaded...

The Significance of Brain Transcranial Sonography in Burning Mouth Syndrome: a Pilot Study

PubMed Central

Zavoreo, Iris; Vučićević, Vanja; Zadravec, Dijana; Bašić, Vanja; Kes; Ciliga, Dubravka; Gabrić, Dragana

2017-01-01

Objective Burning mouth syndrome (BMS) is a chronic disorder which is affecting mostly postmenopausal women and is characterized by burning symptoms in the oral cavity on the clinically healthy oral mucosa. Also, the results of previous studies suggested a possible role of peripheral and/or central neurological disturbances in these patients. The aim of this study was to analyze patients with burning mouth syndrome using transcranial sonography. Methods By use of transcranial sonography of the brain parenchyma, substantia nigra, midbrain raphe and brain nucleus were evaluated in 20 patients with BMS (64.7±12.3 years) and 20 controls with chronic pain in the lumbosacral region (61.5±15). Statistical analysis was performed by use of Student t test with significance set at p<0.05. Results The results of this study have shown hypoechogenicity of the substantia nigra and midbrain raphe as well as hyperechogenicity of the brain nucleus in BMS patients (p<0,05) as compared to controls. Conclusions Altered transcranial sonography findings of the brain parenchyma, midbrain raphe and brain nucleus in patients with burning mouth syndrome might reflect central disturbances within this syndrome. Key words Burning Mouth Syndrome; Transcranial Sonography; substantia nigra; Midbrain Raphe Nuclei; Red Nucleus PMID:28740270

Treatment of multiple adjacent Miller class I and II gingival recessions with a Modified Coronally Advanced Tunnel (MCAT) technique and a collagen matrix or palatal connective tissue graft: a randomized, controlled clinical trial.

PubMed

Aroca, Sofia; Molnár, Bálint; Windisch, Péter; Gera, István; Salvi, Giovanni E; Nikolidakis, Dimitris; Sculean, Anton

2013-07-01

A newly developed collagen matrix (CM) of porcine origin has been shown to represent a potential alternative to palatal connective tissue grafts (CTG) for the treatment of single Miller Class I and II gingival recessions when used in conjunction with a coronally advanced flap (CAF). However, at present it remains unknown to what extent CM may represent a valuable alternative to CTG in the treatment of Miller Class I and II multiple adjacent gingival recessions (MAGR). The aim of this study was to compare the clinical outcomes following treatment of Miller Class I and II MAGR using the modified coronally advanced tunnel technique (MCAT) in conjunction with either CM or CTG. Twenty-two patients with a total of 156 Miller Class I and II gingival recessions were included in this study. Recessions were randomly treated according to a split-mouth design by means of MCAT + CM (test) or MCAT + CTG (control). The following measurements were recorded at baseline (i.e. prior to surgery) and at 12 months: Gingival Recession Depth (GRD), Probing Pocket Depth (PD), Clinical Attachment Level (CAL), Keratinized Tissue Width (KTW), Gingival Recession Width (GRW) and Gingival Thickness (GT). GT was measured 3-mm apical to the gingival margin. Patient acceptance was recorded using a Visual Analogue Scale (VAS). The primary outcome variable was Complete Root Coverage (CRC), secondary outcomes were Mean Root Coverage (MRC), change in KTW, GT, patient acceptance and duration of surgery. Healing was uneventful in both groups. No adverse reactions at any of the sites were observed. At 12 months, both treatments resulted in statistically significant improvements of CRC, MRC, KTW and GT compared with baseline (p < 0.05). CRC was found at 42% of test sites and at 85% of control sites respectively (p < 0.05). MRC measured 71 ± 21% mm at test sites versus 90 ± 18% mm at control sites (p < 0.05). Mean KTW measured 2.4 ± 0.7 mm at test sites versus 2.7 ± 0.8 mm at control sites (p > 0.05). At test sites, GT values changed from 0.8 ± 0.2 to 1.0 ± 0.3 mm, and at control sites from 0.8 ± 0.3 to 1.3 ± 0.4 mm (p < 0.05). Duration of surgery and patient morbidity was statistically significantly lower in the test compared with the control group respectively (p < 0.05). The present findings indicate that the use of CM may represent an alternative to CTG by reducing surgical time and patient morbidity, but yielded lower CRC than CTG in the treatment of Miller Class I and II MAGR when used in conjunction with MCAT. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The effects of a customized over-the-counter mouth guard on neuromuscular force and power production in trained men and women.

PubMed

Dunn-Lewis, Courtenay; Luk, Hui-Ying; Comstock, Brett A; Szivak, Tunde K; Hooper, David R; Kupchak, Brian R; Watts, Ashley M; Putney, Brendan J; Hydren, Jay R; Volek, Jeff S; Denegar, Craig R; Kraemer, William J

2012-04-01

Although mouth guards were originally designed for injury prevention, even elite athletes are now using performance mouth guards to improve athletic success. Both expensive custom models and over-the-counter models are available, but the efficacy is not well known. Some athletes remain wary of the perceived potential for detriments using a mouth guard to their performance. Thus, the purpose of this study was to examine various physical performance tests when using a mouth guard including a customized over-the-counter mouth guard. Twenty-six trained men (25 ± 4 years; 1.78 ± 0.07 m; 83.3 ± 11.4 kg) and 24 trained women (23 ± 3 years; 1.65 ± 0.08 m; 62.6 ± 7.8 kg) volunteered for the investigation. The subjects completed a familiarization period and then balanced and randomized treatment conditions that included: (a) a customized Power Balance performance mouth guard (PB MG); (b) a regular over the counter boil-and-bite mouth guard (Reg MG); and (c) a no mouth guard (No MG) treatment condition. At each visit, the subjects completed a testing protocol that was sequenced in the following order: sit-and-reach flexibility, medial-lateral balance, visual reaction time, vertical jump, 10-m sprint, bench throw, and plyo press power quotient (3PQ). Heart rate and rating of perceived exertion (RPE) were recorded around the 3PQ. Significance was set at p ≤ 0.05. Expected significant sex differences existed for all power, strength, and speed variables. Bench throw power (watts) and force (newtons) were significantly higher under PB MG than either Reg MG or No MG or in both men and women. The 3PQ power and force production were higher than that for the other 2 treatments for the PB MG for men only. There were no significant differences for treatment conditions in the heart rate or RPE after the 3PQ test. Men were better able to maintain significantly higher 3PQ power production under PB MG treatment condition compared with the other 2 treatment conditions. Rate of power development was significantly higher in men for the vertical jump when using the PB MG compared with that for other treatment conditions in men only. No differences were observed in flexibility, balance, visual reaction time, or sprint time. The PB MG performance mouth guard improves performance of upper-body loaded power exercises in both men and women and lower body power exercise in men without compromising performance on any other performance parameters.

Subjective pain perception during calculus detection with use of a periodontal endoscope.

PubMed

Poppe, Kjersta; Blue, Christine

2014-04-01

Periodontal endoscopes are relatively new to the dental field. The purpose of this study was to determine the amount of pain reported by subjects with periodontal disease after experiencing the use of a periodontal endoscope compared with the use of a periodontal probe during calculus detection. A total of 30 subjects with at least 4 sites of 5 to 8 mm pocket depths were treated with scaling and root planing therapy in a split-mouth design. The 2 quadrants were randomly assigned to either S/RP with tactile determination of calculus using an 11/12 explorer, or S/RP treatment with endoscopic detection of calculus. Each subject's pain experience was determined by via a Heft-Parker Visual Analogue Scale (VAS), which measured perceived pain level during periodontal probing and during subgingival visualization via endoscopy. Since subjects expressing some level of dental anxiety generally express increased levels of pain, a pre-treatment survey was also given to determine each subject's level of dental anxiety in order to eliminate dental anxiety as a confounding factor in determining the expressed level of pain. The level of perceived pain was significantly lower with the periodontal endoscope versus the probe (mean VAS 33.0 mm versus 60.2 mm, p<0.0001). Subjects who indicated some level of dental anxiety did express increased pain levels, but these levels were not statistically significant. Subjects did not find the periodontal endoscope to elicit significant anxiety or pain during subgingival visualization.

Atraumatic restorative treatment with resin-modified glass ionomer material: short-term results of a pilot study.

PubMed

Dülgergil, Coruh Türksel; Soyman, Mübin; Civelek, Arzu

2005-01-01

The aim of this study was to assess the feasibility of the resin-modified glass ionomer (RMGI) material in atraumatic restorative treatment (ART) approach and compare RMGI with the high-strength traditional glass ionomer cement (GIC) in permanent teeth with one or more surface-carious cavities. This study was conducted in a village school in rural southeastern Anatolia, Turkey. The RMGI and GIC restorations with the ART technique were placed randomly employing a split mouth design. In addition, the ART approach was used when necessary for both primary and/or permanent teeth with no pulpal involvement and no perceived pain before treatment. Ninety-one fillings were placed on contralateral molar pairs of 37 children. Baseline and 6-month evaluation of the fillings were made with the classic ART, modified Ryge and USPHS criteria. Based on the ART criteria, 100% of RMGI and 92.4% of GIC restorations were classified as successful after 6 months, and the difference between the 2 groups was statistically significant (p=0.009). While marginal discoloration was the commonest failure in the RMGI group according to both the modified Ryge and USPHS criteria, unsatisfactory surface texture and low anatomic form were the commonly seen failures in the ART technique. Generally, for each rating system, RMGI exhibited better clinical performance than GIC in all categories, except for marginal discoloration. Results based on the 6-month evaluation show that RMGI can be an alternative material to the GIC. Copyright (c) 2005 S. Karger AG, Basel.

Volumetric analysis of bone substitute material performance within the human sinus cavity of former head and neck cancer patients: A prospective, randomized clinical trial.

PubMed

Lorenz, Jonas; Eichler, Kathrin; Barbeck, Mike; Lerner, Henriette; Stübinger, Stefan; Seipel, Catherine; Vogl, Thomas J; Kovács, Adorján F; Ghanaati, Shahram; Sader, Robert A

2016-01-01

In numerous animal and human studies, it could be detected that in bone augmentation procedures, material's physicochemical characteristics can influence the cellular inflammatory pattern and therefore the integration in the host tissue. Histological, histomorphometrical, and clinical analyses of the integration of the biomaterial in the surrounding tissue are well established methodologies; however, they do not make a statement on volume and density changes of the augmented biomaterial. The aim of the present study was to assess the volume and density of a xenogeneic (Bio-Oss ® , BO) and a synthetic (NanoBone ® , NB) bone substitute material in split-mouth sinus augmentations in former tumor patients to complete histological and histomorphometrical assessment. Immediately and 6 months after sinus augmentation computed tomography scans were recorded, bone grafts were marked, and the volume was calculated with radiologic RIS-PACS software (General Electric Healthcare, Chalfont St. Giles, Great Britain) to determine the integration and degradation behavior of both biomaterials. Radiographic analysis revealed a volume reduction of the initial augmented bone substitute material (i.e. 100%) to 77.36 (±11.68) % in the BO-group, respectively, 75.82 (±22.28) % in the NB-group six months after augmentation. In both materials, the volume reduction was not significant. Bone density significantly increased in both groups. The presented radiological investigation presents a favorable method to obtain clinically relevant information concerning the integration and degradation behavior of bone substitute materials.

Exploratory and Confirmatory Analysis of the Trauma Practices Questionnaire

ERIC Educational Resources Information Center

Craig, Carlton D.; Sprang, Ginny

2009-01-01

Objective: The present study provides psychometric data for the Trauma Practices Questionnaire (TPQ). Method: A nationally randomized sample of 2,400 surveys was sent to self-identified trauma treatment specialists, and 711 (29.6%) were returned. Results: An exploratory factor analysis (N = 319) conducted on a randomly split sample (RSS) revealed…

Hemispheric specialisation for imitation of hand-head positions and finger configurations: a controlled study in patients with complete callosotomy.

PubMed

Lausberg, Hedda; Cruz, Robyn Flaum

2004-01-01

Several studies of patients with unilateral brain damage and a patient with spontaneous callosal disconnection [Journal of Neurology, Neurosurgery, and Psychiatry 61 (1996) 176; Neuropsychologia 37 (1999) 559; Neuropsychologia 39 (2001) 1432] suggest that the imitation of positions of the hand relative to the head is a strongly lateralised left hemispheric function. In contrast, the imitation of finger configurations draws on resources of both hemispheres with a predominance of the right hemisphere. While these findings suggest a specific pattern of imitation impairment in split-brain patients, thus far, no imitation deficits have been reported in split-brain patients. Three patients with complete callosotomy and two control groups, four patients with partial callosotomy and 10 healthy subjects, imitated hand-head positions and finger configurations with non-lateralised and tachistoscopic stimulus presentation. In addition, the influence of visual control on the imitation performance was examined. One split-brain patient showed the predicted dissociation as she had severe right hemispheric deficit in imitating hand-head positions, while finger configuration imitation was preserved. The other two split-brain patients had no impairment in hand-head position imitation. Withdrawal of visual control significantly deteriorated imitation of finger configurations in the split-brain group, but not in the controls, demonstrating that the split-brain patients relied heavily on visual control as a compensatory strategy indicating an imitation deficit in the separate hemispheres. The findings question the previously held belief that in split-brain patients both hemispheres are perfectly capable of imitating gestures and that imitation is not dependent on hemispherically specialised functions.

Three-dimensional morphological changes of the temporomandibular joint and functional effects after mandibulotomy.

PubMed

Al-Saleh, Mohammed A Q; Punithakumar, Kumaradevan; Lagravere, Manuel; Boulanger, Pierre; Jaremko, Jacob L; Wolfaardt, John; Major, Paul W; Seikaly, Hadi

2017-01-28

The midline and paramedian mandibulotomy are surgical procedures that divide the mandibular bone into two halves and disconnects the condylar heads of the TMJ from each other. This study aimed to prospectively evaluate the temporomandibular joint (TMJ) functional and morphological changes after mandibulotomy using a reconstructed 3D models of the TMJ. Sixteen adult patients diagnosed with oral and oropharyngeal tumors with planned surgical mandibulotomy (test group, 9 patients) or transoral (control group, seven patients) treatments were included in the study. MRI and CBCT images were obtained immediately preceeding surgery and 6-8 weeks after surgery. Using the MRI-CBCT registered images, TMJ tissues were segmented at the two occasions by the same operator and 3D models were reconstructed for morphological assessment. Changes across time were measured using the volume overlap and Hausdorff distance of the disc and condyle 3D models. Disc-condyle relationship was measured using point-based and color map analysis. To assess the early functional changes, the Jaw function limitation scale (JFLS) and the maximum mouth opening were measured. Two-sample Hotelling T 2 t-test was performed to determine the significance of the morphological and clinical outcomes' differences between the two groups. The two-sample Hotelling T 2 t-test showed significant differences (T 2 (df1,df2) = 0.97 (5,26), p <0.01) between the mean values of all outcomes among the 2 groups. The change in disc displacement was significantly different between the two groups (p <0.05). However, the condylar displacement was not significantly different between the two groups (p =0.3). The average of the JFLS score was five times larger after mandibulotomy, and was 2 times larger after transoral surgery (p < 0.01). Patients showed decrease in the average of the maximum interincisal mouth opening by 11 mm after mandibulotomy, and by 5.4 mm after transoral surgery. The quantitative assessment of the TMJ showed minimal changes of the condylar position and variable degrees of articular disc displacement associated with the paramedian split mandibulotomy. As well, limited jaw functions and vertical mouth opening were noticed more in the mandibultomy group compared to the transoral group in 6- weeks after surgery.

Running Performance With Nutritive and Nonnutritive Sweetened Mouth Rinses.

PubMed

Hawkins, Keely R; Krishnan, Sridevi; Ringos, Lara; Garcia, Vanessa; Cooper, Jamie A

2017-09-01

Using mouth rinse (MR) with carbohydrate during exercise has been shown to act as an ergogenic aid. To investigate if nutritive or nonnutritive sweetened MR affects exercise performance and to assess the influence of sweetness intensity on endurance performance during a time trial (TT). This randomized, single-blinded study had 4 treatment conditions. Sixteen subjects (9 men, 7 women) completed a 12.8-km TT 4 different times. During each TT, subjects mouth-rinsed and expectorated a different solution at time 0 and every 12.5% of the TT. The 4 MR solutions were sucrose (S) (sweet taste and provides energy of 4 kcal/g), a lower-intensity sucralose (S1:1) (artificial sweetener that provides no energy but tastes sweet), a higher-intensity sucralose (S100:1), and water as control (C). Completion times for each TT, heart rate (HR), and ratings of perceived exertion (RPE) were also recorded. Completion time for S was faster than for C (1:03:47 ± 00:02:17 vs 1:06:56 ± 00:02:18, respectively; P < .001) and showed a trend to be faster vs S100:1 (1:03:47 ± 00:02:17 vs 1:05:38 ± 00:02:12, respectively; P = .07). No other TT differences were found. Average HR showed a trend to be higher for S vs C (P = .08). The only difference in average or maximum RPE was for higher maximum RPE in C vs S1:1 (P = .02). A sweet-tasting MR did improve endurance performance compared with water in a significant manner (mean 4.5% improvement; 3+ min.); however, the presence of energy in the sweet MR appeared necessary since the artificial sweeteners did not improve performance more than water alone.

A Heuristic Parameterization for the Integrated Vertical Overlap of Cumulus and Stratus

NASA Astrophysics Data System (ADS)

Park, Sungsu

2017-10-01

The author developed a heuristic parameterization to handle the contrasting vertical overlap structures of cumulus and stratus in an integrated way. The parameterization assumes that cumulus is maximum-randomly overlapped with adjacent cumulus; stratus is maximum-randomly overlapped with adjacent stratus; and radiation and precipitation areas at each model interface are grouped into four categories, that is, convective, stratiform, mixed, and clear areas. For simplicity, thermodynamic scalars within individual portions of cloud, radiation, and precipitation areas are assumed to be internally homogeneous. The parameterization was implemented into the Seoul National University Atmosphere Model version 0 (SAM0) in an offline mode and tested over the globe. The offline control simulation reasonably reproduces the online surface precipitation flux and longwave cloud radiative forcing (LWCF). Although the cumulus fraction is much smaller than the stratus fraction, cumulus dominantly contributes to precipitation production in the tropics. For radiation, however, stratus is dominant. Compared with the maximum overlap, the random overlap of stratus produces stronger LWCF and, surprisingly, more precipitation flux due to less evaporation of convective precipitation. Compared with the maximum overlap, the random overlap of cumulus simulates stronger LWCF and weaker precipitation flux. Compared with the control simulation with separate cumulus and stratus, the simulation with a single-merged cloud substantially enhances the LWCF in the tropical deep convection and midlatitude storm track regions. The process-splitting treatment of convective and stratiform precipitation with an independent precipitation approximation (IPA) simulates weaker surface precipitation flux than the control simulation in the tropical region.

Psychological profile in burning mouth syndrome.

PubMed

Al Quran, Firas A M

2004-03-01

Thirty-two patients with burning mouth syndrome and 32 matched control subjects were evaluated for their personality profile using a comprehensive, reliable, and validated inventory. All subjects were requested to complete the Neo PI-R questionnaire that measures the 5 dimensions of personality and their facets. A t-test and univariate correlations (Pearson's correlation coefficient) were used to compare the 2 groups. Results show high significant differences in some personality factors. Neuroticism and all its facets, which include anxiety, angry hostility, depression, self-consciousness, impulsiveness and vulnerability, were significant at P<.001. Other domains like extraversion, openness, and conscientiousness showed significant differences also (P<.05). Many personality characteristics differentiate burning mouth syndrome patients from controllers according to the Neo PI-R and this should affect the treatment plan according to the identified characteristics.

Pre- and post-treatment experiences of fear, anxiety, and pain among chronic periodontitis patients treated by scaling and root planing per quadrant versus one-stage full-mouth disinfection: a 6-month randomized controlled clinical trial.

PubMed

Santuchi, Camila Carvalho; Cortelli, Sheila Cavalca; Cortelli, José Roberto; Cota, Luís Otávio Miranda; Alencar, Camila Oliveira; Costa, Fernando Oliveira

2015-11-01

To relate the clinical effects of two different forms of non-surgical periodontal therapy - scaling and root planing per quadrant (SRP-Q) and one-stage full-mouth disinfection (FMD) - to patient-based outcomes such as fear, anxiety, and pain of moderate chronic periodontitis patients. Dental Fear Survey (DFS) and Dental Anxiety Scale (DAS) questionnaires and Visual Analogue Scale (VAS) were applied to 78 patients randomized into two groups: SRP-Q (n = 37) and FMD (n = 41). Periodontal clinical parameters: probing pocket depth (PD), clinical attachment level (CAL), plaque index (PI), and gingival index (GI) were monitored at baseline and 6 months after treatment. Data were statistically analysed by chi-square, Fisher's exact, Mann-Whitney, Wilcoxon tests, Pearson's correlation, and Cluster analysis. All periodontal clinical parameters improved from baseline to 6 months. Patients with higher fear and anxiety showed a worse clinical periodontal status before and after treatment (mean CAL, PI, and GI). After both types of treatment, fear and anxiety decreased (FMD: p = 0.019; SRP-Q: p = 0.043) with no differences between the groups. Pain did not differ between groups (FMD: 20.6 ± 19.0 and SRP: 20.7 ± 20.0; p = 0.930). In moderate chronic periodontitis patients, SRP-Q and FMD provided periodontal clinical improvements and similar experiences of fear, anxiety, and pain. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Evaluation of active and passive recruitment methods used in randomized controlled trials targeting pediatric obesity

PubMed Central

RAYNOR, HOLLIE A.; OSTERHOLT, KATHRIN M.; HART, CHANTELLE N.; JELALIAN, ELISSA; VIVIER, PATRICK; WING, RENA R.

2016-01-01

Objective Evaluate enrollment numbers, randomization rates, costs, and cost-effectiveness of active versus passive recruitment methods for parent-child dyads into two pediatric obesity intervention trials. Methods Recruitment methods were categorized into active (pediatrician referral and targeted mailings, with participants identified by researcher/health care provider) versus passive methods (newspaper, bus, internet, television, and earning statements; fairs/community centers/schools; and word of mouth; with participants self-identified). Numbers of enrolled and randomized families and costs/recruitment method were monitored throughout the 22-month recruitment period. Costs (in USD) per recruitment method included staff time, mileage, and targeted costs of each method. Results A total of 940 families were referred or made contact, with 164 families randomized (child: 7.2±1.6 years, 2.27±0.61 standardized body mass index [zBMI], 86.6% obese, 61.7% female, 83.5% white; parent: 38.0±5.8 years, 32.9±8.4 BMI, 55.2% obese, 92.7% female, 89.6% white). Pediatrician referral, followed by targeted mailings, produced the largest number of enrolled and randomized families (both methods combined producing 87.2% of randomized families). Passive recruitment methods yielded better retention from enrollment to randomization (p <0.05), but produced few families (21 in total). Approximately $91 000 was spent on recruitment, with cost per randomized family at $554.77. Pediatrician referral was the most cost-effective method, $145.95/randomized family, but yielded only 91 randomized families over 22-months of continuous recruitment. Conclusion Pediatrician referral and targeted mailings, which are active recruitment methods, were the most successful strategies. However, recruitment demanded significant resources. Successful recruitment for pediatric trials should use several strategies. Clinical Trials Registration: NCT00259324, NCT00200265 PMID:19922036

Evaluation of active and passive recruitment methods used in randomized controlled trials targeting pediatric obesity.

PubMed

Raynor, Hollie A; Osterholt, Kathrin M; Hart, Chantelle N; Jelalian, Elissa; Vivier, Patrick; Wing, Rena R

2009-01-01

Evaluate enrollment numbers, randomization rates, costs, and cost-effectiveness of active versus passive recruitment methods for parent-child dyads into two pediatric obesity intervention trials. Recruitment methods were categorized into active (pediatrician referral and targeted mailings, with participants identified by researcher/health care provider) versus passive methods (newspaper, bus, internet, television, and earning statements; fairs/community centers/schools; and word of mouth; with participants self-identified). Numbers of enrolled and randomized families and costs/recruitment method were monitored throughout the 22-month recruitment period. Costs (in USD) per recruitment method included staff time, mileage, and targeted costs of each method. A total of 940 families were referred or made contact, with 164 families randomized (child: 7.2+/-1.6 years, 2.27+/-0.61 standardized body mass index [zBMI], 86.6% obese, 61.7% female, 83.5% Caucasian; parent: 38.0+/-5.8 years, 32.9+/-8.4 BMI, 55.2% obese, 92.7% female, 89.6% caucasian). Pediatrician referral, followed by targeted mailings, produced the largest number of enrolled and randomized families (both methods combined producing 87.2% of randomized families). Passive recruitment methods yielded better retention from enrollment to randomization (p<0.05), but produced few families (21 in total). Approximately $91,000 was spent on recruitment, with cost per randomized family at $554.77. Pediatrician referral was the most cost-effective method, $145.95/randomized family, but yielded only 91 randomized families over 22-months of continuous recruitment. Pediatrician referral and targeted mailings, which are active recruitment methods, were the most successful strategies. However, recruitment demanded significant resources. Successful recruitment for pediatric trials should use several strategies. NCT00259324, NCT00200265.

Polarization nondegenerate fiber Fabry-Perot cavities with large tunable splittings

NASA Astrophysics Data System (ADS)

Cui, Jin-Ming; Zhou, Kun; Zhao, Ming-Shu; Ai, Ming-Zhong; Hu, Chang-Kang; Li, Qiang; Liu, Bi-Heng; Peng, Jin-Lan; Huang, Yun-Feng; Li, Chuan-Feng; Guo, Guang-Can

2018-04-01

We demonstrate a type of microcavity with large tunable splitting of polarization modes. This polarization nondegenerate cavity consists of two ellipsoidal concave mirrors with controllable eccentricity by CO2 laser machining on fiber end facets. The experiment shows that the cavities can combine the advantages of high finesse above 104 and large tunable polarization mode splitting to the GHz range. As the splitting of the cavity can be finely controlled to match atom hyperfine levels or optomechanics phonons, it will blaze a way in experiments on cavity quantum electrodynamics and cavity optomechanics.

Burning mouth syndrome: a systematic review of treatments.

PubMed

Liu, Y F; Kim, Y; Yoo, T; Han, P; Inman, J C

2018-04-01

Burning mouth syndrome (BMS) is a chronic oral pain syndrome that primarily affects peri- and postmenopausal women. It is characterized by oral mucosal burning and may be associated with dysgeusia, paresthesia, dysesthesia, and xerostomia. The etiology of the disease process is unknown, but is thought to be neuropathic in origin. The goal of this systematic review was to assess the efficacy of the various treatments for BMS. Literature searches were conducted through PubMed, Web of Science, and Cochrane Library databases, which identified 22 randomized controlled trials. Eight studies examined alpha-lipoic acid (ALA), three clonazepam, three psychotherapy, and two capsaicin, which all showed modest evidence of potentially decreasing pain/burning. Gabapentin was seen in one study to work alone and synergistically with ALA. Other treatments included vitamins, benzydamine hydrochloride, bupivacaine, Catuama, olive oil, trazodone, urea, and Hypericum perforatum. Of these other treatments, Catuama and bupivacaine were the only ones with significant positive results in symptom improvement. ALA, topical clonazepam, gabapentin, and psychotherapy may provide modest relief of pain in BMS. Gabapentin may also boost the effect of ALA. Capsaicin is limited by its side effects. Catuama showed potential for benefit. Future studies with standardized methodology and outcomes containing more patients are needed. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

What sleep behaviors are associated with bruxism in children? A systematic review and meta-analysis.

PubMed

Guo, Huaqi; Wang, Tongxia; Li, Xuechao; Ma, Qiong; Niu, Xiaohong; Qiu, Jie

2017-12-01

The aim of this article was to assess the sleep behaviors that serve as risk factors related to bruxism in children ages 0 to 12 years by performing a systematic review and meta-analysis of published studies. Seven databases were searched to identify all peer-reviewed articles potentially relevant to the review. Data were pooled for random-effects modeling. Sleep risk factors related to bruxism in this age group are summarized using pooled odds ratios (ORs), 95% confidence intervals (CIs), and P values. Of 5637 initially identified articles, 14 met inclusion criteria. Study qualities of all case-control studies were high. Quality of cross-sectional studies was more variable. The pooled ORs, 95% CIs, and P values were as follows: snoring (2.86, 1.85-4.42, <0.0001), mouth breathing (1.51, 1.04-2.18, 0.029), restless sleep (2.31, 1.89-2.83, <0.0001), drooling (1.79, 1.07-2.97, 0.026), stomach position during sleep (1.70, 1.0-2.39, 0.003), and inadequate sleep time (2.56, 1.48-4.43, 0.001). Snoring, mouth breathing, restless sleep, drooling, stomach position during sleep, and lack of sleep were the risk factors related to bruxism in children.

A MEMS and agile optics-based dual-mode variable optical power splitter with no moving parts

NASA Astrophysics Data System (ADS)

Khwaja, Tariq S.; Suleman, Hamid; Reza, Syed Azer

2017-06-01

In this paper, we present a novel design of an optical power splitter. Owing to the inherent variable power split ratios that the proposed design delivers, it is ideal for use in communications, sensing and signal processing applications where variable power splitting is often quintessential. The proposed power splitter module is dual mode as it combines the use of a Micro-Electro-Mechanical Systems (MEMS) based Digital Micro-mirror Device (DMD) and an Electronically Controlled Tunable Lens (ECTL) to split the power of an input optical signal between two output ports - the designated port and the surplus port. The use of a reflective Digital Spatial Light Modulator (DSLM) such as the DMD provides a motion-free digital control of the split ratio between the two output ports. Although the digital step between two possible successive split ratios can be fairly minimal with the use of a high resolution DMD but it is a challenge to correctly ascertain the exact image pattern on the DMD to obtain any desired specific split ratio. To counter this challenge, we propose the synchronized use of a circular pattern on the DMD, which serves as a circular clear aperture with a tunable radius, and an ECTL. The radius of the circular pattern on the DMD provides a digital control of the split ratio between the two ports whereas the ECTL, depending on its controller, can provide either an analog or a digital control by altering the beam radius which is incident at the DMD circular pattern. The radius of the circular pattern on the DMD can be minimally changed by one micro-pixel thickness. Setting the radius of the circular pattern on the DMD to an appropriate value provides the closest "ball-park" split ratio whereas further tuning the ECTL aids in slightly altering from this digitally set value to obtain the exact desired split ratio in-between any two digitally-set successive split ratios that correspond to any clear aperture radius of the DMD pattern and its incremental minimal allowable change of one micropixel. We provide a detailed scheme to calculate the desired DMD aperture radius as well as the focal length setting of the ECTL to obtain any given split ratio. By setting tolerance limits on the split ratio, we also show that our method affords diversity by providing multiple possible solutions to achieve a desired optical power split ratio within the specified tolerances. We also demonstrate the validation of the proposed concept with initial experimental results and discussions. These experimental results show a repeatable splitter operation and the resulting power split ratios according to the theoretical predictions. With the experimental data, we also demonstrate the effectiveness of the method in obtaining any particular split ratio through different DMD and ECTL configurations with specific split ratio tolerance values.

Characteristics of the gait adaptation process due to split-belt treadmill walking under a wide range of right-left speed ratios in humans

PubMed Central

Ogawa, Tetsuya; Yamamoto, Shin-Ichiro; Nakazawa, Kimitaka

2018-01-01

The adaptability of human bipedal locomotion has been studied using split-belt treadmill walking. Most of previous studies utilized experimental protocol under remarkably different split ratios (e.g. 1:2, 1:3, or 1:4). While, there is limited research with regard to adaptive process under the small speed ratios. It is important to know the nature of adaptive process under ratio smaller than 1:2, because systematic evaluation of the gait adaptation under small to moderate split ratios would enable us to examine relative contribution of two forms of adaptation (reactive feedback and predictive feedforward control) on gait adaptation. We therefore examined a gait behavior due to on split-belt treadmill adaptation under five belt speed difference conditions (from 1:1.2 to 1:2). Gait parameters related to reactive control (stance time) showed quick adjustments immediately after imposing the split-belt walking in all five speed ratios. Meanwhile, parameters related to predictive control (step length and anterior force) showed a clear pattern of adaptation and subsequent aftereffects except for the 1:1.2 adaptation. Additionally, the 1:1.2 ratio was distinguished from other ratios by cluster analysis based on the relationship between the size of adaptation and the aftereffect. Our findings indicate that the reactive feedback control was involved in all the speed ratios tested and that the extent of reaction was proportionally dependent on the speed ratio of the split-belt. On the contrary, predictive feedforward control was necessary when the ratio of the split-belt was greater. These results enable us to consider how a given split-belt training condition would affect the relative contribution of the two strategies on gait adaptation, which must be considered when developing rehabilitation interventions for stroke patients. PMID:29694404

Semantics is crucial for the right-hemisphere involvement in metaphor processing: evidence from mouth asymmetry during speaking.

PubMed

Argyriou, Paraskevi; Byfield, Sarah; Kita, Sotaro

2015-01-01

Research on the neural basis of metaphor provides contradicting evidence about the role of right and left hemispheres. We used the mouth-opening asymmetry technique to investigate the relative involvement of the two hemispheres whilst right-handed healthy male participants explained the meaning of English phrases. This technique is based on the contralateral cortical control of the facial musculature and reflects the relative hemispheric involvement during different cognitive tasks. In particular, right-handers show a right-sided mouth asymmetry (right side of the mouth opens wider than the left) during linguistic tasks, thus reflecting the left-hemisphere specialization for language. In the current study, we compared the right-sided mouth asymmetry during metaphor explanation (e.g., explain the meaning of the phrase "to spin a yarn") and concrete explanation (e.g., explain the meaning of the phrase "to spin a golf ball") and during the production of content and function words. The expected right-sided mouth asymmetry reduced during metaphorical compared to concrete explanations suggesting the relative right-hemispheric involvement for metaphor processing. Crucially, this right-sided mouth asymmetry reduction was particularly pronounced for the production of content words. Thus, we concluded that semantics is crucial to the right-hemispheric involvement for metaphorical speech production.