Influence of unilateral maxillary first molar extraction treatment on second and third molar inclination in Class II subdivision patients.

PubMed

Livas, Christos; Pandis, Nikolaos; Booij, Johan Willem; Halazonetis, Demetrios J; Katsaros, Christos; Ren, Yijin

2016-01-01

To assess the maxillary second molar (M2) and third molar (M3) inclination following orthodontic treatment of Class II subdivision malocclusion with unilateral maxillary first molar (M1) extraction. Panoramic radiographs of 21 Class II subdivision adolescents (eight boys, 13 girls; mean age, 12.8 years; standard deviation, 1.7 years) before treatment, after treatment with extraction of one maxillary first molar and Begg appliances and after at least 1.8 years in retention were retrospectively collected from a private practice. M2 and M3 inclination angles (M2/ITP, M2/IOP, M3/ITP, M3/IOP), constructed by intertuberosity (ITP) and interorbital planes (IOP), were calculated for the extracted and nonextracted segments. Random effects regression analysis was performed to evaluate the effect on the molar angulation of extraction, time, and gender after adjusting for baseline measurements. Time and extraction status were significant predictors for M2 angulation. M2/ITP and M2/IOP decreased by 4.04 (95% confidence interval [CI]: -6.93, 1.16; P  =  .001) and 3.67 (95% CI: -6.76, -0.58; P  =  .020) in the extraction group compared to the nonextraction group after adjusting for time and gender. The adjusted analysis showed that extraction was the only predictor for M3 angulation that reached statistical significance. M3 mesial inclination increased by 7.38° (95% CI: -11.2, -3.54; P < .001) and 7.33° (95% CI: -11.48, -3.19; P  =  .001). M2 and M3 uprighting significantly improved in the extraction side after orthodontic treatment with unilateral maxillary M1 extraction. There was a significant increase in mesial tipping of maxillary second molar crowns over time.

A cone-beam computed tomography study of maxillary first permanent molar root and canal morphology in a Chinese population.

PubMed

Zheng, Qing-hua; Wang, Yao; Zhou, Xue-dong; Wang, Qian; Zheng, Guang-ning; Huang, Ding-ming

2010-09-01

This study evaluated root and canal morphology of permanent maxillary first molars in a Chinese population using cone-beam computed tomography scanning. The sample included 775 cone-beam computed tomography images of maxillary first molars; 627 of the subjects had unilateral qualifying molars and 74 had bilateral qualifying molars. The following observations were made: (1) frequency of root and canal numbers, (2) frequency of additional canals in the mesiobuccal root by sex, age, and tooth position, and (3) unilateral and bilateral occurrence of additional canals in the mesiobuccal root. Fused roots were present in 2.71% of unilateral qualifying molars. Multiple canals were present in the following frequencies: two canals in 0.31%, three canals in 47.21%, four canals in 50.40%, five canals in 1.75%, and six canals in 0.31% of teeth. Additional canals were detected in 52.24% of mesiobuccal roots, 1.12% of distobuccal roots, and 1.76% of palatal roots. Patients aged 20 to 30 years showed a higher prevalence of additional mesiobuccal root canals. This prevalence did not differ with sex and tooth position. Most (71.11%) of the additional mesiobuccal root canals in subjects with bilateral qualifying molars were symmetric. Cone-beam computed tomography scanning is an effective method for studying external and internal dental morphology. The root and canal configurations of maxillary first molars in this Chinese population were consistent with previously reported data. More attention should be given to the detection of additional canals in patients between 20 and 30 years of age. These data may facilitate successful endodontic treatment. Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

The influence of premature loss of temporary upper molars on permanent molars.

PubMed

Cernei, E R; Maxim, Dana Cristiana; Zetu, Irina Nicoleta

2015-01-01

Premature loss of primary molars due to dental caries and their complications has been associated with space loss and eruptive difficulties, especially when the loss occurs early. The aim of our study was to determine the impact of premature loss of temporary upper molars upon the longitudinal axis of the first and second upper permanent molar. The study group included 64 patients 6-9 years old with premature loss of primary molars and a control group of 48 patients with intact temporary teeth. It was evaluated the angle between longitudinal axis of first and second upper permanent molars and occlusal plane. The sofware used is Easy Dent 4 Viewer®.The data were analyzed by using the Statistical Package for the Social Sciences (version 20.0; SPSS, Chicago, III). It was observed that premature loss of upper second deciduous molars modifies greater the vertical axis of the permanent molars than the premature loss of first upper primary molar. First upper primary molar loss cause an acceleration eruption of first premolar, which will produce a distal inclintion of the both permanent molars. The use of space maintainers after premature loss of the second upper temporary molar is a last solution in preventing tridimensional lesions in the dental arch and occlusion.

Retrospective chart analysis on survival rate of fixtures installed at the tuberosity bone for cases with missing unilateral upper molars: a study of 7 cases.

PubMed

Park, Young-Jin; Cho, Sung-Am

2010-06-01

To evaluate the survival rate of implants placed in the maxillary tuberosity region using the fixed prosthesis in partially edentulous cases. Of implant-treated patients who visited Kyung Pook National University Hospital, 7 partially edentulous patients (2 male and 5 female; mean age, 52.3 years; range, approximately 43 to 65) were selected according to the following criteria: 1) less than 3-mm thickness alveolar bone reaming at the first molar area and 2) 1 to 2 fixture premolars, with the additional implant at the maxillary tuberosity region. For the control group, patients who had nontuberosity areas were selected. After 1 to 7 years, marginal bone level, fixture mobility, and radiolucency of tuberosity fixtures of the fixed prostheses were evaluated by digital panorama (Starpacs, Infinitt, Seoul, Korea). None of the fixtures of the tuberosity-installed implants for 1 to 7 years failed. The marginal bone level around the implants of the maxillary tuberosity 1 to 6 years (average 3.4 years) after the final prostheses was approximately 0.6 to 1.3 mm, with an average of 0.94 mm. The fixture installation at the maxillary tuberosity using the unilateral partially edentulous implant-fixed prosthesis would be a clinically acceptable treatment module. 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Clinical measurement of force systems upon activation of transpalatal arch in the treatment of unilateral crossbite.

PubMed

Yoshida, N; Koga, Y; Jost-Brinkmann, P G; Kobayashi, K

2003-01-01

in this study, forces and moments acting on the molars were theoretically determined by means of small-deflection analysis when an asymmetric third-order activation of the TPA was carried out. the transpalatal arch (TPA) is used to correct unilateral crossbites through the application of buccal root torque to the anchorage molar and lingual root torque to the contralateral molar in crossbite, combined with expansion. Unfortunately, the complex force systems created at the molars upon activation of the TPA cannot be easily estimated. our computations revealed that the vertical forces developed on the molars when both ends of the TPA are inserted into the lingual sheaths (two-couple system) is four-times greater than those when only one end is tied to the lingual sheath as a single-point contact (one-couple system). we propose a method of clinical estimation of the force system in a two-couple system by directly measuring the vertical force produced by the one-couple system.

Early extraction: a silver bullet to avoid nerve injury in lower third molar removal?

PubMed

Zhang, Q-B; Zhang, Z-Q

2012-10-01

This retrospective study evaluated the effects of early extraction of immature lower third molar on preventing complications, particularly nerve injury following lower third molar removal. Patients were grouped according to age and radiographic results: group A (518 patients, ≤23 years, immature teeth with apical foramen not closed); group B (532 patients, >23 years, mature teeth with closed apical foramen). Group A included 230 males and 288 females (average age 17 years). In group A, 808 lower mandibular third molars were extracted bilaterally in 290 and unilaterally in 228 patients; the incidence of complications was 2.48% (20/808) (all were temporary), the incidence of nerve injury was 0%. Group B included 250 males and 282 females (average age 39 years). In group B, 810 lower third molars were extracted bilaterally in 278 and unilaterally in 254 patients; the incidence of complications was 10% (81/810), the incidence of nerve injury was 1.6% (13/810). All complications were temporary, except two removals of permanent inferior alveolar nerve numbness (>6 months). In this study, early removal of the lower third molar was effective in avoiding some postoperative complications, especially nerve injury. Early extraction of lower third molar in youngsters is recommended following a team consultation. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

A simple way to intrude overerupted upper second molars with miniscrews.

PubMed

Cao, Yang; Liu, Chufeng; Wang, Chunxian; Yang, Xiaoyu; Duan, Peijia; Xu, Chenrong

2013-12-01

Various methods of using skeletal anchorage for the intrusion of overerupted maxillary molars have been reported; however, it is difficult to intrude the overerupted upper second molars because of the low bone density in the region of the tuberosity. This article illustrates a new treatment method using partial fixed edgewise appliances and miniscrews to intrude the overerupted upper second molars. The miniscrews were applied to reinforce the anchorage of the upper first molar. The intrusive force was generated by the Ni-Ti wire. The clinical results showed a significant intrusion effect without root resorption or periodontal problems. This report demonstrates that the combination of partial conventional fixed appliances with miniscrews is a simple and effective treatment option to intrude overerupted upper second molars, especially in situations where miniscrews cannot be inserted directly next to the second molar. © 2013 by the American College of Prosthodontists.

Incidence of three-rooted mandibular first molars among contemporary Japanese individuals determined using multidetector computed tomography.

PubMed

Ishii, Namiko; Sakuma, Ayaka; Makino, Yohsuke; Torimitsu, Suguru; Yajima, Daisuke; Inokuchi, Go; Motomura, Ayumi; Chiba, Fumiko; Hoshioka, Yumi; Iwase, Hirotaro; Saitoh, Hisako

2016-09-01

The purpose of this study was to determine the incidence of three-rooted mandibular first molars in a contemporary Japanese population using multidetector computed tomography (MDCT) and examine whether this characteristic root form may be useful for identification purposes. Prior to their forensic autopsies, we obtained MDCT scans of 365 cadavers (255 males, 110 females) with mandibular first molars on both sides. Altogether, 730 mandibular first molars were examined morphologically on reconstructed CT images, and the incidence of three-rooted molars was recorded. The results were analyzed statistically to determine sex and left-right differences using the chi-square test. In all, 189 (25.9%) of the 730 mandibular first molars had three roots: 79 (31.0%) in the 255 males and 35 (31.8%) in the 110 females. No statistically significant difference was found between the sexes. In the 39 individuals who had unilateral three-rooted mandibular first molars, 7 (17.9%) were on the left side and 32 (82.1%) were on the right side, indicating a statistically significant predominance on the right side. The incidence of three-rooted mandibular first molars in contemporary Japanese individuals was 25.9%, with no statistically significant sex difference, but in the case of unilateral three-rooted teeth, with a statistically significant predominance on the right side. Our study found that Japanese and northeastern Asians have a high incidence of the three-rooted mandibular first molars among individuals of Mongolian origin; this finding may be a useful screening tool for identification of unknown individuals. Copyright © 2016. Published by Elsevier Ireland Ltd.

Incisor and molar overjet, arch contraction, and molar relationship in the mixed dentition in repaired complete unilateral cleft lip and palate: A qualitative and quantitative appraisal.

PubMed

Disthaporn, Suteeta; Suri, Sunjay; Ross, Bruce; Tompson, Bryan; Baena, Diogenes; Fisher, David; Lou, Wendy

2017-07-01

To compare the mixed dentition incisor and molar overjet, severity of contraction of the dental arch, and the sagittal molar relationship on the cleft side vs the noncleft side in children with repaired complete unilateral cleft of the lip and palate (UCLP). Orthodontic records taken prior to orthodontic preparation for alveolar bone grafting were screened to select study casts from patients with nonsyndromic repaired complete UCLP who did not have mandibular skeletal or dental asymmetry. The study sample comprised dental casts from 74 children aged 8.9 ± 1 years. Standardized digital photographs were acquired at 1:1 magnification. A coordinate system was developed using digital image-processing software (Photoshop CS4 and Adobe Illustrator). Incisor and molar overjet, Angle's classification, and arch contraction were recorded. Descriptive statistics, paired t-tests, and kappa statistics were used to compare the cleft and noncleft sides. A negative overjet of -1 to -5 mm was often present at the incisors, with greater frequency and magnitude on the cleft side. Class II molar relation was more frequent on the cleft side (61.1%) than on the noncleft side (47.2%). Significantly greater contraction of the cleft side deciduous canine and deciduous first molar was noted, while the difference was very minor at the first permanent molar. Cleft side maxillary arch contraction was most severe in the deciduous canine and first deciduous molar region and progressively less severe in the posterior region of the arch. A greater frequency and severity of negative overjet and Class II molar relationship was seen on the cleft side.

Three-dimensional morphology of first molars in relation to ethnicity and the occurrence of cleft lip and palate.

PubMed

Echtermeyer, Sandra; Metelmann, Philine H; Hemprich, Alexander; Dannhauer, Karl-Heinz; Krey, Karl-Friedrich

2017-01-01

This study aims to describe morphological peculiarities of maxillary and mandibular first molars in Europeans, Asians and Europeans with cleft lip and palate. Reflex microscopy was used to obtain three-dimensional morphometric landmarks from 40 models (11 Europeans and 13 Asians without cleft lip and palate, 16 Europeans with unilateral cleft lip and palate). The cases were examined using traditional morphometry and geometric morphometry, and visualized using thin-plate splines. Classic morphometry showed no right/left differences in the study groups and no significant differences with regard to the cleft side in patients with cleft lip and palate. In Asians, a significantly greater mesiodistal width was found. Geometric morphometry showed an enlarged centroid size in Asians (maxilla and mandible). In cleft patients, the cleft site did not appear to impact the morphology of first molars. Unilateral clefting did not affect the size and shape of molars; however, characteristic ethnicity-based differences were in fact identified. The results are relevant for orthodontic treatment with preadjusted appliances, and prosthetic CAD/CAM restorations.

Dietary Inference from Upper and Lower Molar Morphology in Platyrrhine Primates

PubMed Central

Allen, Kari L.; Cooke, Siobhán B.; Gonzales, Lauren A.; Kay, Richard F.

2015-01-01

The correlation between diet and dental topography is of importance to paleontologists seeking to diagnose ecological adaptations in extinct taxa. Although the subject is well represented in the literature, few studies directly compare methods or evaluate dietary signals conveyed by both upper and lower molars. Here, we address this gap in our knowledge by comparing the efficacy of three measures of functional morphology for classifying an ecologically diverse sample of thirteen medium- to large-bodied platyrrhines by diet category (e.g., folivore, frugivore, hard object feeder). We used Shearing Quotient (SQ), an index derived from linear measurements of molar cutting edges and two indices of crown surface topography, Occlusal Relief (OR) and Relief Index (RFI). Using SQ, OR, and RFI, individuals were then classified by dietary category using Discriminate Function Analysis. Both upper and lower molar variables produce high classification rates in assigning individuals to diet categories, but lower molars are consistently more successful. SQs yield the highest classification rates. RFI and OR generally perform above chance. Upper molar RFI has a success rate below the level of chance. Adding molar length enhances the discriminatory power for all variables. We conclude that upper molar SQs are useful for dietary reconstruction, especially when combined with body size information. Additionally, we find that among our sample of platyrrhines, SQ remains the strongest predictor of diet, while RFI is less useful at signaling dietary differences in absence of body size information. The study demonstrates new ways for inferring the diets of extinct platyrrhine primates when both upper and lower molars are available, or, for taxa known only from upper molars. The techniques are useful in reconstructing diet in stem representatives of anthropoid clade, who share key aspects of molar morphology with extant platyrrhines. PMID:25738266

Orthodontic uprighting of a horizontally impacted third molar and protraction of mandibular second and third molars into the missing first molar space for a patient with posterior crossbites.

PubMed

Baik, Un-Bong; Kim, Myung-Rae; Yoon, Kyu-Ho; Kook, Yoon-Ah; Park, Jae Hyun

2017-03-01

A 22-year-old woman came with a unilateral missing mandibular first molar and buccal crossbite. The open space was closed by protraction of the mandibular left second molar and uprighting and protraction of the horizontally impacted third molar using temporary skeletal anchorage devices, and her buccal crossbite was corrected with modified palatal and lingual appliances. The total active treatment time was 36 months. Posttreatment records after 9 months showed excellent results with a stable occlusion. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Multiple extraction patterns in severe discrepancy cases.

PubMed

Anderson, B D

1975-10-01

Thirty-five cases have been collected from colleagues which illustrate that removal of additional maxillary teeth, following first bicuspid extractions, can allow the successful resolution of difficult discrepancy and anchorage cases. Charts 1 and 2 describe the amounts of space that might be expected by removal of additional upper bicuspids, upper first molars, and upper second molars. The findings on upper second molars are admittedly limited. Anchorage values as expressed by an efficiency percentage were approximately what would be expected from a study of anchorage values of the roots of teeth. The removal of upper second bicuspids has a better anchorage efficiency potential than the upper first molar, but this may be overcome somewhat by the greater size of the molar. Clear guidance cannot be given as to which teeth to remove in a specific case, but it is the observation of the author that for cases that are still in full Class II following four bicuspid space closure, upper second bicuspid removal would be more helpful from an anchorage perspective, whereas for cases that are in end-to-end molar relationship or require only a few millimeters to move into Class I, the upper first molar might be the tooth of choice. Also, the supper first molar removal allows for a more "normal" appearing arch assuming normal alignment and size of the upper second and third molars. The comparison with the nonextraction control group showed an enormous difference in the amount of incisor retraction that extractions provide when related to the maxilla. The nonextraction control group, though experiencing dramatic correction of Class II relationships, showed no incisor movement within the maxilla. Some problems which appeared in the sample were described. Removal of upper teeth in addition to the four first bicuspids can be a solution to an occasional anchorage, skeletal, growth or cooperation problem.

Simple and Efficient Technique for Correction of Unilateral Scissor Bite Using Straight Wire.

PubMed

Dolas, Siddhesh Gajanan; Chitko, Shrikant Shrinivas; Kerudi, Veerendra Virupaxappa; Patil, Harshal Ashok; Bonde, Prasad Vasudeo

2016-03-01

Unilateral scissor bite is a relatively rare malocclusion. However, its correction is often difficult and a challenge for the clinician. This article presents simple and efficient technique for the correction of severe unilateral scissor bite in a 14 year old boy, using 0.020 S.S. A. J. Wilcock wire (premium plus) out of the spool, with minimal adjustments and placed in mandibular arch. After about six weeks time, good amount of correction was seen in the lower arch and the lower molar had been relieved of scissor bite.

A New Orthodontic Appliance with a Mini Screw for Upper Molar Distalization

PubMed Central

2016-01-01

The aim of this study is to present a new upper molar distalization appliance called Cise distalizer designed as intraoral device supported with orthodontic mini screw for upper permanent molar distalization. The new appliance consists of eight main components. In order to understand the optimum force level, the appliance under static loading is tested by using strain gage measurement techniques. Results show that one of the open coils produces approximately 300 gr distalization force. Cise distalizer can provide totally 600 gr distalization force. This range of force level is enough for distalization of upper first and second molar teeth. PMID:27528796

An in vitro morphological investigation of the endodontic spaces of third molars.

PubMed

Cosić, Jozo; Galić, Nada; Vodanović, Marin; Njemirovskij, Vera; Segović, Sanja; Pavelić, Bozidar; Anić, Ivica

2013-06-01

Aim of this paper was to investigate the particular anatomic features of the endodontic space of third molars in the general population of Croatia. A total of 106 fully developed third molars (56 maxillar and 50 mandibular) has been analyzed. The respective number of roots and of root canals, the structure of the roots, and the curvature and absolute length of the root-canals were analyzed. In most cases, upper third molars had three roots (83.9%), while most of the lower molars were single rooted (56.0%). Upper third molars had mostly three root canals (75.1%), lower third molars two (90.0%). In both jaws, most third molars had curved canals (60.7% in the upper and 84.0% in the lower jaw). 12.5% of upper third molars had lateral and accessory canals, whereas only 4.0% of the lower third molars were found to have them. The Student t-test showed statistically significant differences (p < 0.05) in the length of the root-canals, mesiobuccal and distobuccal canals being significantly shorter than palatinal canals. The same test showed that in the lower third molars the mesial root canals were significantly longer that the distal ones, although slightly. The results obtained are in compliance with similar results by other authors; however, they tend to show some specific population-related features.

Associations between orthopaedic disturbances and unilateral crossbite in children with asymmetry of the upper cervical spine.

PubMed

Korbmacher, Heike; Koch, L; Eggers-Stroeder, G; Kahl-Nieke, B

2007-02-01

The objective of the present study was to detect possible associations between unilateral crossbite and orthopaedic disturbances in children with asymmetry of the upper cervical spine. Fifty-five children aged 3-10 years (22 girls and 33 boys) with a unilateral crossbite and 55 gender- and age-matched children with a symmetric occlusion but no crossbite, who served as the control group, were selected from an orthopaedic cohort of 240 patients. In all children, asymmetry of the upper cervical region was confirmed by radiographs and palpation. The following orthopaedic aspects were investigated: oblique shoulder and pelvis, scoliosis, functional leg length difference, and laxity of ligaments of the foot. The differences between the groups were analysed by means of an unpaired t-test. An increased occurrence of orthopaedic parameters in the frontal plane was observed in children with a unilateral malocclusion. A unilateral crossbite was not necessarily combined with a pathological orthopaedic variable, but statistically, children with a unilateral malocclusion showed more often an oblique shoulder (P = 0.004), scoliosis (P = 0.04), an oblique pelvis (P = 0.007), and a functional leg length difference (P = 0.002) than children with symmetry. The results suggest that a unilateral crossbite in children with asymmetry of the upper cervical spine is associated with orthopaedic disturbances. There is no evidence of a causal link.

Rapid Palatal Expansion in the absence of posterior cross-bite to intercept maxillary incisor crowding in the mixed dentition: a CBCT evaluation of spontaneous changes of untouched permanent molars.

PubMed

Rosa, M; Lucchi, P; Manti, G; Caprioglio, A

2016-12-01

The aim of this study was to investigate the reaction of untouched permanent molars following RPE, anchored on deciduous teeth in the early mixed dentition, aimed to solve maxillary anterior crowding in the absence of posterior cross-bite. A prospective clinical trial comprised 35 consecutive patients (20 males and 15 females) treated by the same orthodontist (MR). All patients showed crowding of the upper permanent incisors in the early mixed dentition in the absence of posterior cross-bite. RPE was anchored on second deciduous molars and on the deciduous canines. CBCT was taken before and after the removal of the RPE appliance. The transverse linear changes in width and the variation in the torque of the permanent molars were measured in the coronal plane. Relief of incisor crowding was found in all patients. The transverse width between permanent molars increased significantly. The apices of the upper permanent molars spontaneously expanded more than the crowns, while the opposite happened on the lower permanent molars. Moreover, the untouched upper permanent molars spontaneously uprighted palatally, while the lower permanent molars spontaneously uprighted buccally. The variation in the torque of the permanent molars mirrored transverse normal growth. In the early mixed dentition and in the absence of posterior cross-bite, it is possible to expand transversally the palate while uprighting the upper permanent molars in the opposite direction. RPE anchored on the deciduous teeth in the early mixed dentition, in the absence of posterior cross-bite, provides an "anticipation of transverse growth" and could be indicated to expand the anterior portion of the maxillary arch perimeter to solve upper incisor crowding.

Scissor bite in a young patient treated with an orthodontic-orthopedic device. A case report.

PubMed

Favero, V; Sbricoli, L; Favero, L

2013-06-01

Scissor bite is a rare malocclusion that often leads to minor facial asymmetry. An orthodontic and orthopaedic correction is advisable in young patients to prevent subsequent temporomandibular diseases requesting maxillofacial intervention. In this case report a 8-year-old girl in mixed dentition with unilateral left scissor bite was treated with a modified Rapid Palatal Expander. To modify an overexpanded maxilla (width 39 mm measured between both upper first molars) the device was used to close rather than to expand, without need of patient compliance. Orthodontic correction was then completed with traditional bracketing. Results were tangible (width 36 mm) and remained stable even for at least 2 years after retention. This original device has proved to be useful in this kind of situations and can be easily applied to young patient to correct such malocclusions.

Simple and Efficient Technique for Correction of Unilateral Scissor Bite Using Straight Wire

PubMed Central

Dolas, Siddhesh Gajanan; Chitko, Shrikant Shrinivas; Kerudi, Veerendra Virupaxappa; Bonde, Prasad Vasudeo

2016-01-01

Unilateral scissor bite is a relatively rare malocclusion. However, its correction is often difficult and a challenge for the clinician. This article presents simple and efficient technique for the correction of severe unilateral scissor bite in a 14 year old boy, using 0.020 S.S. A. J. Wilcock wire (premium plus) out of the spool, with minimal adjustments and placed in mandibular arch. After about six weeks time, good amount of correction was seen in the lower arch and the lower molar had been relieved of scissor bite. PMID:27231682

Distraction of the temporomandibular joint condyle in patients with unilateral non-reducing disc displacement: Fact or fiction?

PubMed

Yıldız, Melih; Çağatay Dayan, Süleyman; Şakar, Olcay; Sülün, Tonguç

2017-07-24

This study investigated the distractive effect of a unilateral pivot splint on patients with unilateral disc displacement without reduction. The study group was comprised of 18 patients who had no history of treatment with removable prosthetic restorations of molars, premolars, or canine teeth, and no previous treatment for temporomandibular disorder. Joint spaces measurements made on magnetic resonance images indicated the affected side to be narrower than the healthy side. Unilateral distraction splints were made for all patients. An ultrasonic motion analyzer was used to measure the vertical shift occurring on the affected side as patients closed their mouths with maximal force with the splint in their mouths. Closing with maximal force on the unilateral distraction splint led to a noticeable downward movement of the affected condyle. The findings of this study indicate that the TMJ condyle of patients with unilateral disc displacement without reduction may be unilaterally distracted if the articular space is narrowed.

Forensic age estimation based on magnetic resonance imaging of third molars: converting 2D staging into 3D staging.

PubMed

De Tobel, Jannick; Hillewig, Elke; Verstraete, Koenraad

2017-03-01

Established methods to stage development of third molars for forensic age estimation are based on the evaluation of radiographs, which show a 2D projection. It has not been investigated whether these methods require any adjustments in order to apply them to stage third molars on magnetic resonance imaging (MRI), which shows 3D information. To prospectively study root stage assessment of third molars in age estimation using 3 Tesla MRI and to compare this with panoramic radiographs, in order to provide considerations for converting 2D staging into 3D staging and to determine the decisive root. All third molars were evaluated in 52 healthy participants aged 14-26 years using MRI in three planes. Three staging methods were investigated by two observers. In sixteen of the participants, MRI findings were compared with findings on panoramic radiographs. Decisive roots were palatal in upper third molars and distal in lower third molars. Fifty-seven per cent of upper third molars were not assessable on the radiograph, while 96.9% were on MRI. Upper third molars were more difficult to evaluate on radiographs than on MRI (p < .001). Lower third molars were equally assessable on both imaging techniques (93.8% MRI, 98.4% radiograph), with no difference in level of difficulty (p = .375). Inter- and intra-observer agreement for evaluation was higher in MRI than in radiographs. In both imaging techniques lower third molars showed greater inter- and intra-observer agreement compared to upper third molars. MR images in the sagittal plane proved to be essential for staging. In age estimation, 3T MRI of third molars could be valuable. Some considerations are, however, necessary to transfer known staging methods to this 3D technique.

[Study of the relationship between congenital missing of the third molar and the development of the mandibular angle].

PubMed

Chen, Yan-Na; Zheng, Bo-Wen; Liu, Yi

2017-02-01

Based on the research of the congenital missing of the third molar and the missing number, the relationship beteen congenital missing of the third molar and the development of the mandibular angle was evaluated. Patients were divided into experimental group and control group, the experimental group included 227 patients, each had at least one of the third molars congenital lost; 227 patients who had four third molar were selected as control group. Winceph software was used to measure the lateral cephalograms. SPSS17.0 software package was used to perform statistical analysis. Gonial angle, upper Gonial angle and lower Gonial angle between the experimental group and the control group showed significant difference and the values in the experimental group were significantly smaller than in the control group, but there was no gender difference between the two groups.There was no difference between Gonial angle, upper Gonial angle,lower Gonial angle and the missing number of the third molar. There is a close relationship between congenital missing third molar and Gonial angle, upper Gonial angle, lower Gonial angle, but there is no significant association with gender and the patients with congenital missing third molar have shorter craniofacial structure. Congenital missing number of the third molar has no significant association with Gonial angle, upper Gonial angle and lower Gonial angle.

Factors Predisposing to Maxillary Anchorage Loss: A Retrospective Study of 1403 Cases

PubMed Central

Su, Hong; Han, Bing; Li, Sa; Na, Bin; Ma, Wen; Xu, Tian-Min

2014-01-01

Anchorage loss is very disturbing for orthodontists and patients during orthodontic treatment, which usually results in bad treatment effects. Despite the same treatment strategy, different patients show different tendencies toward anchorage loss, which influences the treatment results and should preferably be predicted before the treatment is begun. However, relatively little research has been conducted on which patients are more likely to lose anchorage. The mesial tipping of the first molar marks the onset of anchorage loss, and changes in the angulation of the first molar are closely related to anchorage loss. This cross-sectional study aimed to determine how the mesiodistal angulation of the upper first molars changes during general orthodontic treatment and to identify the individual physiologic factors leading to these changes in a large sample of 1403 patients with malocclusion. The data indicate that the upper first molars tend to be tipped mesially during orthodontic treatment, and this constitutes a type of anchorage loss that orthodontists should consider carefully. Compared to treatment-related factors, patients' physiologic characteristics have a greater influence on changes in the angulation of the upper first molars during orthodontic treatment. The more distally tipped the upper first molars are before treatment, the more they will tip mesially during treatment. Mesial tipping of the upper first molars, and therefore, anchorage loss, is more likely to occur in adolescents, males, patients with class II malocclusion and patients who have undergone maxillary premolar extraction. This finding is of clinical significance to orthodontists who wish to prevent iatrogenic anchorage loss by tipping originally distally tipped upper molars forward, and provides a new perspective on anchorage during orthodontic treatment planning. PMID:25299164

Factors predisposing to maxillary anchorage loss: a retrospective study of 1403 cases.

PubMed

Su, Hong; Han, Bing; Li, Sa; Na, Bin; Ma, Wen; Xu, Tian-Min

2014-01-01

Anchorage loss is very disturbing for orthodontists and patients during orthodontic treatment, which usually results in bad treatment effects. Despite the same treatment strategy, different patients show different tendencies toward anchorage loss, which influences the treatment results and should preferably be predicted before the treatment is begun. However, relatively little research has been conducted on which patients are more likely to lose anchorage. The mesial tipping of the first molar marks the onset of anchorage loss, and changes in the angulation of the first molar are closely related to anchorage loss. This cross-sectional study aimed to determine how the mesiodistal angulation of the upper first molars changes during general orthodontic treatment and to identify the individual physiologic factors leading to these changes in a large sample of 1403 patients with malocclusion. The data indicate that the upper first molars tend to be tipped mesially during orthodontic treatment, and this constitutes a type of anchorage loss that orthodontists should consider carefully. Compared to treatment-related factors, patients' physiologic characteristics have a greater influence on changes in the angulation of the upper first molars during orthodontic treatment. The more distally tipped the upper first molars are before treatment, the more they will tip mesially during treatment. Mesial tipping of the upper first molars, and therefore, anchorage loss, is more likely to occur in adolescents, males, patients with class II malocclusion and patients who have undergone maxillary premolar extraction. This finding is of clinical significance to orthodontists who wish to prevent iatrogenic anchorage loss by tipping originally distally tipped upper molars forward, and provides a new perspective on anchorage during orthodontic treatment planning.

C-shaped maxillary permanent first molar: a case report and literature review.

PubMed

Martins, Jorge N R; Quaresma, Sérgio; Quaresma, Maria Carlos; Frisbie-Teel, Jared

2013-12-01

The C-shaped configuration is rare in the upper first molar.The purpose of this article is to present 2 cases diagnosed during endodontic therapy and perform a literature review of this anatomy in the upper first molar. Endodontic therapy was performed by using a dental operating microscope and a cone-beam computed tomography analysis for better understanding of this anatomy. A literature search was conducted to identify and compare all the published cases of C-shaped upper first molar. Before the cases reported in this article, only 5 cases were available in the published literature. Three different types of C-shaped configurations in the upper first molar have been presented. The C-shaped maxillary first molar is a rare anatomic configuration. The use of the dental operating microscope may help in the endodontic therapy of these cases. Three types of C-shaped configurations have been reported; the fusion of the distobuccal root with the palatal root appears to be the most usual one. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Four impacted fourth molars in a young patient: a case report

PubMed Central

CLEMENTINI, M.; OTTRIA, L.; PANDOLFI, C.; AGRESTINI, C.; BARLATTANI, A.

2013-01-01

Summary The occurrence of supernumerary teeth is a relatively uncommon dental anomaly and it’s rare for patients to have impacted fourth molars in all quadrant. Aim of this work is to describe the presence of bilateral fourth molars in the maxilla and the mandible in a young male patient aged 22 years came to our hospital with acute pericoronal infection around unerupted third inferior molars. Routine radiographic examination revealed impacted inferior third molars but also unerupted bilateral upper and inferior fourth molars. The acute infection was treated by local measures and the patient was subsequently admitted for removal of third and fourth impacted upper and lower molars under general anesthesia. PMID:23741604

Compensation trends of the angulation of first molars: retrospective study of 1403 malocclusion cases.

PubMed

Su, Hong; Han, Bing; Li, Sa; Na, Bin; Ma, Wen; Xu, Tian-Min

2014-09-01

We investigated the compensatory trends of mesiodistal angulation of first molars in malocclusion cases. We compared differences in the angulation of first molars in different developmental stages, malocclusion classifications and skeletal patterns. The medical records and lateral cephalogrammes of 1403 malocclusion cases taken before treatment were measured to evaluate compensation of molar angulation in relation to the skeletal jaw. The cases were stratified by age, Angle classification and skeletal patterns. Differences in the mesiodistal angulation of the first molars were compared among the stratifications. We observed three main phenomena. First, angulation of the upper first molar varied significantly with age and tipped most distally in cases aged <12 years and least distally in cases aged >16 years. The lower first molar did not show such differences. Second, in Angle Class II or skeletal Class II cases, the upper first molar was the most distally tipped, the lower first molar was the most mesially tipped, and opposite angulation compensation was observed in Class III cases. Third, in high-angle cases, the upper and lower first molars were the most distally tipped, and opposite angulation compensation was observed in low-angle cases. These data suggest that the angulation of the molars compensated for various growth patterns and malocclusion types. Hence, awareness of molar angulation compensation would help to adjust occlusal relationships, control anchorage and increase the chances of long-term stability.

Influence of maxillary posterior discrepancy on upper molar vertical position and facial vertical dimensions in subjects with or without skeletal open bite

PubMed Central

Aliaga-Del Castillo, Aron; Pérez-Vargas, Luis Fernando; Flores-Mir, Carlos

2016-01-01

Summary Objectives: To determine the influence of maxillary posterior discrepancy on upper molar vertical position and dentofacial vertical dimensions in individuals with or without skeletal open bite (SOB). Materials and methods: Pre-treatment lateral cephalograms of 139 young adults were examined. The sample was divided into eight groups categorized according to their sagittal and vertical skeletal facial growth pattern and maxillary posterior discrepancy (present or absent). Upper molar vertical position, overbite, lower anterior facial height and facial height ratio were measured. Independent t-test was performed to determine differences between the groups considering maxillary posterior discrepancy. Principal component analysis and MANCOVA test were also used. Results: No statistically significant differences were found comparing the molar vertical position according to maxillary posterior discrepancy for the SOB Class I group or the group with adequate overbite. Significant differences were found in SOB Class II and Class III groups. In addition, an increased molar vertical position was found in the group without posterior discrepancy. Limitations: Some variables closely related with the individual’s intrinsic craniofacial development that could influence the evaluated vertical measurements were not considered. Conclusions and implications: Overall maxillary posterior discrepancy does not appear to have a clear impact on upper molar vertical position or facial vertical dimensions. Only the SOB Class III group without posterior discrepancy had a significant increased upper molar vertical position. PMID:26385786

Influence of maxillary posterior discrepancy on upper molar vertical position and facial vertical dimensions in subjects with or without skeletal open bite.

PubMed

Arriola-Guillén, Luis Ernesto; Aliaga-Del Castillo, Aron; Pérez-Vargas, Luis Fernando; Flores-Mir, Carlos

2016-06-01

To determine the influence of maxillary posterior discrepancy on upper molar vertical position and dentofacial vertical dimensions in individuals with or without skeletal open bite (SOB). Pre-treatment lateral cephalograms of 139 young adults were examined. The sample was divided into eight groups categorized according to their sagittal and vertical skeletal facial growth pattern and maxillary posterior discrepancy (present or absent). Upper molar vertical position, overbite, lower anterior facial height and facial height ratio were measured. Independent t-test was performed to determine differences between the groups considering maxillary posterior discrepancy. Principal component analysis and MANCOVA test were also used. No statistically significant differences were found comparing the molar vertical position according to maxillary posterior discrepancy for the SOB Class I group or the group with adequate overbite. Significant differences were found in SOB Class II and Class III groups. In addition, an increased molar vertical position was found in the group without posterior discrepancy. Some variables closely related with the individual's intrinsic craniofacial development that could influence the evaluated vertical measurements were not considered. Overall maxillary posterior discrepancy does not appear to have a clear impact on upper molar vertical position or facial vertical dimensions. Only the SOB Class III group without posterior discrepancy had a significant increased upper molar vertical position. © The Author 2015. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Event-related Potentials During Target-response Tasks to Study Cognitive Processes of Upper Limb Use in Children with Unilateral Cerebral Palsy.

PubMed

Zielinski, Ingar Marie; Steenbergen, Bert; Baas, C Marjolein; Aarts, Pauline; Jongsma, Marijtje L A

2016-01-11

Unilateral Cerebral Palsy (CP) is a neurodevelopmental disorder that is a very common cause of disability in childhood. It is characterized by unilateral motor impairments that are frequently dominated in the upper limb. In addition to a reduced movement capacity of the affected upper limb, several children with unilateral CP show a reduced awareness of the remaining movement capacity of that limb. This phenomenon of disregarding the preserved capacity of the affected upper limb is regularly referred to as Developmental Disregard (DD). Different theories have been postulated to explain DD, each suggesting slightly different guidelines for therapy. Still, cognitive processes that might additionally contribute to DD in children with unilateral CP have never been directly studied. The current protocol was developed to study cognitive aspects involved in upper limb control in children with unilateral CP with and without DD. This was done by recording event-related potentials (ERPs) extracted from the ongoing EEG during target-response tasks asking for a hand-movement response. ERPs consist of several components, each of them associated with a well-defined cognitive process (e.g., the N1 with early attention processes, the N2 with cognitive control and the P3 with cognitive load and mental effort). Due to its excellent temporal resolution, the ERP technique enables to study several covert cognitive processes preceding overt motor responses and thus allows insight into the cognitive processes that might contribute to the phenomenon of DD. Using this protocol adds a new level of explanation to existing behavioral studies and opens new avenues to the broader implementation of research on cognitive aspects of developmental movement restrictions in children.

Unusual extraction treatment in Class II division 1 using C-orthodontic mini-implants.

PubMed

Chung, Kyu-Rhim; Cho, Jae-Hee; Kim, Seong-Hun; Kook, Yoon-Ah; Cozzani, Mauro

2007-01-01

This paper describes the treatment of a female patient, aged 23 years and 5 months, with a Class II division 1 malocclusion, who showed severe anterior protrusion and lower anterior crowding. Specially-designed orthodontic mini-implants were placed bilaterally in the interdental space between both the upper and the lower posterior teeth. Both lower first molars showed severe apical lesions. Therefore, the treatment plan consisted of extraction of both upper first premolars and lower first molars, en masse retraction of the upper six anterior teeth, lower anterior alignment, and protraction of all the lower molars. C-implants(R) were used as substitutes for maxillary posterior anchorage teeth during anterior retraction and as hooks for mandibular molar protraction. The correct overbite and overjet were obtained by intruding and retracting the upper six anterior teeth into their proper positions. The dentition was detailed using conventional orthodontic appliances. The upper C-implants contributed to an improvement in facial balance, and the lower C-implants made it possible to protract the lower second and third molars with less effect on the axis of the lower anterior teeth. The active treatment period was 29 months and the patient's teeth continued to be stable 11 months after debonding.

Sports Adaptations for Unilateral and Bilateral Upper-Limb Amputees: Archery/Badminton/Baseball/Softball/Bowling/Golf/Table Tennis.

ERIC Educational Resources Information Center

Cowart, Jim

1979-01-01

The booklet discusses sports adaptations for unilateral and bilateral upper limb amputees. Designs for adapted equipment are illustrated and information on adaptations are described for archery (including an archery release aid and a stationary bow holder); badminton (serving tray); baseball/softball (adaptations for catching, throwing, and…

Compensation trends of the angulation of first molars: retrospective study of 1 403 malocclusion cases

PubMed Central

Su, Hong; Han, Bing; Li, Sa; Na, Bin; Ma, Wen; Xu, Tian-Min

2014-01-01

We investigated the compensatory trends of mesiodistal angulation of first molars in malocclusion cases. We compared differences in the angulation of first molars in different developmental stages, malocclusion classifications and skeletal patterns. The medical records and lateral cephalogrammes of 1 403 malocclusion cases taken before treatment were measured to evaluate compensation of molar angulation in relation to the skeletal jaw. The cases were stratified by age, Angle classification and skeletal patterns. Differences in the mesiodistal angulation of the first molars were compared among the stratifications. We observed three main phenomena. First, angulation of the upper first molar varied significantly with age and tipped most distally in cases aged <12 years and least distally in cases aged >16 years. The lower first molar did not show such differences. Second, in Angle Class II or skeletal Class II cases, the upper first molar was the most distally tipped, the lower first molar was the most mesially tipped, and opposite angulation compensation was observed in Class III cases. Third, in high-angle cases, the upper and lower first molars were the most distally tipped, and opposite angulation compensation was observed in low-angle cases. These data suggest that the angulation of the molars compensated for various growth patterns and malocclusion types. Hence, awareness of molar angulation compensation would help to adjust occlusal relationships, control anchorage and increase the chances of long-term stability. PMID:24699185

Endodontic management of a fused mandibular third molar and distomolar: a case report.

PubMed

Zeylabi, Ali; Shirani, Farzaneh; Heidari, Fatemeh; Farhad, Ali Reza

2010-04-01

Careful management of fused teeth is essential as abnormal morphology can predispose a tooth to caries and periodontal disease. In this paper, a rare case of successful endodontic management of unilateral mandibular third molar fused to a distomolar is reported. Caries was removed from the tooth complex under local anaesthesia. The pulp chambers of the third molar and supernumerary tooth were accessed and the root canals were prepared using rotary instrumentation and copious irrigation with 2.5% sodium hypochlorite. Obturation using the lateral condensation technique with gutta-percha and AH26 sealer was subsequently performed. A 1-year recall showed a good treatment result.

Analysis of midpalatal miniscrew-assisted maxillary molar distalization patterns with simultaneous use of fixed appliances: A preliminary study

PubMed Central

Mah, Su-Jung; Kim, Ji-Eun; Ahn, Eun Jin; Nam, Jong-Hyun; Kim, Ji-Young

2016-01-01

Skeletal anchorage-assisted upper molar distalization has become one of the standard treatment modalities for the correction of Class II malocclusion. The purpose of this study was to analyze maxillary molar movement patterns according to appliance design, with the simultaneous use of buccal fixed orthodontic appliances. The authors devised two distinct types of midpalatal miniscrew-assisted maxillary molar distalizers, a lingual arch type and a pendulum type. Fourteen patients treated with one of the two types of distalizers were enrolled in the study, and the patterns of tooth movement associated with each type were compared. Pre- and post-treatment lateral cephalograms were analyzed. The lingual arch type was associated with relatively bodily upper molar distalization, while the pendulum type was associated with distal tipping with intrusion of the upper molar. Clinicians should be aware of the expected tooth movement associated with each appliance design. Further well designed studies with larger sample sizes are required. PMID:26877983

Maxillary Nine-year Molars: Prevalence and Associated Dental and Medical Conditions.

PubMed

Klein, Ulrich; Alford, Jacqueline A; Allshouse, Amanda A; Sain, Joel

2016-01-01

The purpose of this study was to determine, from a large number of panoramic images taken in the clinic of a pediatric dentistry residency program, the prevalence of maxillary nine-year molars (9YM), associated medical conditions (MCs), and the presence of coexisting tooth anomalies (TAs). Pantomograms from 13,140 patients were searched for 9YM. Radiographs from identified subjects were examined for coexisting TAs, and charted MCs were noted. For identified 9YM, Nolla's stage of tooth formation was determined and the subjects' dental ages were calculated. Among 53 subjects (68 percent females), 21 unilateral and 32 bilateral cases of 9YM occurred. Females and males were of similar age (7.98 versus 7.91 years old). Overall dental and chronological ages were significantly different: dental development in bilateral cases was delayed by 4.1 months in females and 2.9 months in both sexes (P=.003). In unilateral cases, it was accelerated by 3.6 months in females and 3.5 months in males. The specific tooth age for all 9YM was 4.95 years for females and 5.56 years for males (P=.018). The average count of associated findings (e.g., missing teeth, peg laterals, other TAs, and other eruption delays) was 0.62 in unilateral and 1.44 in bilateral cases (P=.02). Commonly associated MCs included clefting (N equals five), and Down syndrome (n equals three). The prevalence of nine-year molars was one in 248 (0.4 percent), and the average delay in dental development was 2.7 years.

Evaluation of Stress Distribution of Mini Dental Implant-Supported Overdentures in Complete Cleft Palate Models: A Three-Dimensional Finite Element Analysis Study.

PubMed

Soğancı, Gökçe; Yazıcıoğlu, Hüseyin

2016-01-01

Mini dental implants could be an alternative treatment method for prosthetic treatment of edentulous cleft palate. The aim of this study was to analyze stress distribution around the cortical bone and different plans using a varied number of mini dental implants in edentulous unilateral complete cleft palates. Three edentulous maxillary models were modified to create unilateral complete cleft palates. Mini dental implants (2.4 × 15 mm) were located as two mini implants at the premolar region, four mini implants at the premolar and molar region, and six mini implants at the first premolar, second premolar, and first molar regions in the models, respectively. Mucosa, o-ring/ball attachments, and overdentures were simulated. Vertical and horizontal loads of 100 N were applied on both the right and left molar teeth of the overdenture for each model. Maximum and minimum principal stress values and the distribution at cortical bone around the implants and cleft palates were evaluated by finite element analysis. Stress values under vertical loads were lower than values under horizontal loadings for all models. Stress values were found to be lower in the first model than in the second and third models. The highest stress values were found around implants in the second model. The unilateral feature of a complete cleft pattern affected the stress distribution. Stresses occured mostly around implants when the overdenture was supported by six implants; however, the stress distribution around implants was low with two implants because of tissue support.

Evaluation of a New Surgical Technique for Closing Oroantral Fistula Using Auto-transplanted Upper Third Molar: A 1-Year Follow-Up Study.

PubMed

Assad, Mounzer; Alkhaled, Maysaa; Alhajj, Mohammed N

2018-03-01

Oroantral fistula (OAF) is considered a frequent complication in dental practice. Many surgical techniques/methods have been proposed to close it. The aim of this study was to evaluate the auto-transplantation of upper third molar for closing OAF. Twenty patients participated in this study aged between 20 and 40 years old. The OAF was closed by auto-transplantation of upper third molar placed directly in the socket of the extracted tooth. Results were evaluated clinically and radiographically through the period of observation which lasted for 1 year. Final results showed that the success rate of closing OAF was 95% while the success rate of upper third molar auto-transplantation was 90%. This technique is simple, applicable, provides immediate replacement of the missing tooth, and does not require complicated instruments or procedures.

Two-Step Extraction of the Lower First Molar for Class III Treatment in Adult Patient.

PubMed

Almeida, Kélei Cristina de Mathias; Paulin, Ricardo Fabris; Raveli, Taísa Barnabé; Raveli, Dirceu Barnabé; Santos-Pinto, Ary

2016-01-01

The aim of this article is to describe a case report of Class III malocclusion treatment with lower first molar extraction. The 27-year-old Caucasian male patient presented a symmetric face with a straight profile, hyperdivergent growth pattern, molar and cuspid Class III relation, and an anterior crossbite as well as a mild crowding on cuspids area, in both upper and lower arches and a tendency to posterior crossbite. The treatment was performed by the use of Haas expansion appliance followed by an initial alignment and leveling of the upper and lower arches with a fixed edgewise appliance, extraction of lower teeth aiming the correction of the incisors proclination and end the treatment with a Class I molar relationship. It resulted in a significant change in the patient's profile, dentoalveolar Class III correction, upper arch expansion, leveling and alignment of the upper and lower arches, and improvement of tipping of the upper and lowers incisors. In cases of a dentoalveolar compensation in well positioned bone bases the treatment with fixed appliances is an alternative and extraction of lower teeth is considered.

Unusual treatment of bimaxillary dentoalveolar protrusion via miniscrews and molar extraction

PubMed Central

Al-Fraidi, Ahmad; Afify, Ahmed R.

2012-01-01

This case report describes the treatment of a Saudi female patient, aged 13 years 8 months at the start of treatment, with a Class I bimaxillary dentoalveolar protrusion and extracted maxillary first molars. Miniscrews were placed bilaterally in the interdental space between both the upper and the lower posterior teeth. The treatment plan consisted of extraction of both lower first permanent molars, distalization of upper and lower premolars using miniscrews followed by en masse retraction of the upper and lower six anterior teeth. The active treatment period was 2 years 8 months. Arch retention was done using upper wrap-around retainer and lower fixed 3-3 retainer. The use of miniscrews helped to resolve the bimaxillary protrusion regardless of extraction pattern used. PMID:24987626

An aegialodontid upper molar and the evolution of mammal dentition.

PubMed

Lopatin, Alexey V; Averianov, Alexander O

2006-08-25

The most obvious key synapomorphy of the therian mammals is the tribosphenic pattern of their molars. Tribosphenic teeth are capable of both shearing and grinding, which substantially increase effectiveness of food processing and, in turn, permit evolution of a wide range of dietary specializations. Functional tribospheny developed repeatedly during mammalian evolution but was successful only in the Boreosphenida. The earliest stage in the development of boreosphenidan tribospheny has remained poorly understood, being documented only by lower molars of aegialodontids. Here, we report a known upper molar of an aegialodontid mammal, Kielantherium, from the Early Cretaceous of Mongolia.

Pre-eruptive intracoronal resorption in a third upper molar: clinical, tomographic and histological analysis.

PubMed

Lenzi, R; Marceliano-Alves, M F; Alves, Frf; Pires, F R; Fidel, S

2017-06-01

Radiolucent or hypodense lesions in the crown of unerupted teeth may be due to pre-eruptive intracoronal resorption. Clinicians must be aware of this risk so that they can diagnose and appropriately treat this condition. The purpose of this study is to present a well-documented clinical case of pre-eruptive intracoronal resorption in an impacted third upper left molar of a 63 year old female patient. This was an unexpected finding, which occurred after cone-beam computed tomography was used to investigate the first upper left molar, which had an acute periradicular abscess. A multidisciplinary team followed up the case to describe clinical, radiographic and histological findings. The available treatment options were discussed, and the tooth extraction was the option chosen. Previous case studies describing such resorption in third upper molars have not been reported. This case shows that all permanent teeth in a pre-eruptive stage must be analysed radiographically to detect early pre-eruptive intracoronal resorption. © 2016 Australian Dental Association.

Quality of life after upper third molar removal: A prospective longitudinal study

PubMed Central

Avellaneda-Gimeno, Vanesa; Valmaseda-Castellón, Eduard

2017-01-01

Background Third molar extraction is a very common procedure in Dentistry. The aim of this study was to evaluate the quality of life (QoL) and satisfaction of patients undergoing extraction of an upper third molar under local anesthesia. A second objective was to describe the evolution of self-reported pain measured in a visual analogue scale (VAS) in the 7 days after surgery and its relationship with pre- and intraoperative factors. Material and Methods A prospective longitudinal cohort study was made. Fifty-five patients received a questionnaire assessing social and working isolation, eating and speaking ability, diet modifications, sleep impairment, physical appearance, discomfort at suture removal and overall satisfaction. Pain was registered daily on a VAS scale. A descriptive and bivariate analysis of the data was performed. Results Forty-seven patients were included. Pain decreased lineally across the 7 days, and relief was significant between days 2 and 3. Intraoperative complications were significantly associated with pain. The complication that showed the highest pain score was the tuberosity fracture. Conclusions Upper third molar removal significantly affects the patient’s quality of life, particularly during the first 2 days after extraction. Key words:Quality of life, upper third molar, extraction, complications. PMID:29053650

Mandibular biomechanics and temporomandibular joint function in primates.

PubMed

Smith, R J

1978-09-01

There is disagreement as to whether the mandibular condyles are stress-bearing or stress-free during mastication. In support of alternative models, analogies have been drawn with Class III levers, links, and couple systems. Physiological data are reviewed which indicate that maximum masticatory forces are generated when maxillary and mandibular teeth are in contact, and that this phase lasts for over 100 msec during many chewing strokes. During this period, the mandible can be modeled as a beam with multiple supports. Equations of simple beam theory suggest that large condylar reaction forces are present during mastication. With unilateral molar biting in man, the total condylar reaction force may be over 75% of the bite force. Analysis of a frontal projection demonstrates that up to 80% of the total condylar reaction force is borne by the contralateral (balancing side) condyle during unilateral molar biting. A comparison of human, chimpanzee (P. troglodytes), spider monkey (A. belzebuth), and macaque (Macaca sp.) morphology indicates that the frugivorous chimpanzee and spider monkey have a relatively lower condylar reaction force than the omnivorous macaque or man during molar biting. The percentage reaction force during incisal biting is lower in man than in the other primates, and lower in the frugivorous primates than in the macaque.

Comparison of different morphological parameters with duration of obstruction created experimentally in unilateral upper ureters: an animal model.

PubMed

Panda, Shasanka Shekhar; Bajpai, Minu; Mallick, Saumyaranjan; Sharma, Mehar C

2014-01-01

The objective of the following study is to determine and to compare the different morphological parameters with duration of obstruction created experimentally in unilateral upper ureters of rats. Unilateral upper ureteric obstruction was created in 60 adult Wistar rats that were reversed after predetermined intervals. Rats were sacrificed and ipsilateral kidneys were subjected for analysis of morphological parameters such as renal height, cranio-caudal diameter, antero-posterior diameter, lateral diameter, volume of the pelvis and average cortical thickness: Renal height. Renal height and cranio-caudal diameter of renal pelvis after ipsilateral upper ureteric obstruction started rising as early as 7 days of creating obstruction and were affected earlier than antero-posterior and lateral diameter and also were reversed earlier than other parameters after reversal of obstruction. Renal cortical thickness and volume of the pelvis were affected after prolonged obstruction (> 3 weeks) and were the late parameters to be reversed after reversal of obstruction. Cranio-caudal diameter and renal height were the early morphological parameters to be affected and reversed after reversal of obstruction in experimentally created ipsilateral upper ureteric obstruction.

Neurophysiological mechanisms and functional impact of mirror movements in children with unilateral spastic cerebral palsy.

PubMed

Kuo, Hsing-Ching; Friel, Kathleen M; Gordon, Andrew M

2018-02-01

Children with unilateral spastic cerebral palsy (CP) often have mirror movements, i.e. involuntary imitations of unilateral voluntary movements of the contralateral upper extremity. The pathophysiology of mirror movements has been investigated in small and heterogeneous cohorts in the literature. Specific pathophysiology of mirror movements and their impact on upper extremity function require systematic investigation in larger and homogeneous cohorts of children with unilateral spastic CP. Here we review two possible neurophysiological mechanisms underlying mirror movements in children with CP and those with typical development: (1) an ipsilateral corticospinal tract projecting from the contralesional motor cortex (M1) to both upper extremities; (2) insufficient interhemispheric inhibition between the two M1s. We also discuss clinical implications of mirror movements in children with unilateral CP and suggest that a thorough examination of the relationship between the pathophysiology and clinical manifestations of mirror movements is warranted. We suggest two premises: (1) the presence of mirror movements is indicative of an ipsilateral corticospinal tract reorganization; and (2) the corticospinal tract organization may affect patients' responses to certain treatment. If these premises are supported through future research, mirror movements should be clinically evaluated for patient selection to maximize benefits of therapy, hence promoting individualized medicine in this population. Mirror movements may be indicative of the underlying corticospinal tract reorganization in children with unilateral spastic cerebral palsy (CP). Future research will benefit from systematic investigations of the relationship between mirror movements and its pathophysiology. Mirror movements may be a potential biomarker for individualized medicine in children with unilateral spastic CP. © 2017 Mac Keith Press.

The Use of Unilateral Pericranial Flaps for the Closure of Difficult Medial Orbital and Upper Lateral Nasal Defects.

PubMed

Newman, Jason; Costantino, Peter; Moche, Jason

2003-11-01

We present 3 cases in which a unilateral pericranial flap was used to repair defects in the medial orbital and upper lateral nasal areas. All three patients had undergone previous excision of malignant tumors from the upper septum and ethmoid areas. Postoperatively, they all received radiation and then developed wound breakdown with fistula formation, particularly in the area of the incisional site. All 3 patients had undergone previous unsuccessful repair of the fistula. Closure of such fistulas requires well-vascularized nonradiated tissue, which can be provided by a unilateral pericranial flap. This flap is flexible, thin, and well suited to the sinonasal area. Use of this flap avoids the need for a paramedian forehead or other musculocutaneous flap. Cosmetic results were excellent, and there have been no flap breakdowns or complications to date.

Reliability of the Melbourne assessment of unilateral upper limb function.

PubMed

Randall, M; Carlin, J B; Chondros, P; Reddihough, D

2001-11-01

This study examines the reliability of the Melbourne Assessment of Unilateral Upper Limb Function: a quantitative test of quality of movement in children with neurological impairment. The assessment was administered to 20 children aged from 5 to 16 years (mean age 9 years 10 months, SD 2 years 10 months) who had various types and degrees of cerebral palsy (CP). The performances of the 20 children during assessment were videotaped for subsequent scoring by 15 occupational therapists. Scores were analyzed for internal consistency of test items, inter- and intrarater reliability of scorings of the same videotapes, and test-retest reliability using repeat videotaping. Results revealed very high internal consistency of test items (alpha=0.96), moderate to high agreement both within and between raters for all test items (intraclass correlations of at least 0.7) apart from item 16 (hand to mouth and down), and high interrater reliability (0.95) and intrarater reliability (0.97) for total test scores. Test-retest results revealed moderate to high intrarater reliability for item totals (mean of 0.83 and 0.79) for each rater and high reliability for test totals (0.98 and 0.97). These findings indicate that the Melbourne Assessment of Unilateral Upper Limb Function is a reliable tool for measuring the quality of unilateral upper-limb movement in children with CP.

Mini-implant-borne Pendulum B appliance for maxillary molar distalisation: design and clinical procedure.

PubMed

Wilmes, Benedict; Katyal, Vandana; Drescher, Dieter

2014-11-01

A treatment objective of upper molar distalisation may often be required during the correction of a malocclusion. Distalisation is not only indicated for the management of Class II patients, but also for Class III surgery patients who require decompensation in the upper arch if upper incisor retrusion is needed. Unfortunately, most conventional intra-oral devices for non-compliance maxillary molar distalisation experience anchorage loss. A Pendulum type of appliance and a mini-implant-borne distalisation mechanism have been designed which can be inserted at chair-side, without a prior laboratory procedure and immediately after mini-implant placement. For re-activation purposes, a distal screw may be added to the Pendulum B appliance.

Association between the eruption of the third molar and caries and periodontitis distal to the second molars in elderly patients.

PubMed

Chou, Yu-Hsiang; Ho, Pei-Shan; Ho, Kun-Yen; Wang, Wen-Chen; Hu, Kai-Fang

2017-05-01

The objective of this study was to verify whether caries and periodontal diseases, when present on the distal surface of the second molars (M2s), are associated with the eruption of the third molars (M3s). In this split-mouth study, we evaluated 70 elderly patients with unilateral maxillary or mandibular M3s who presented to the outpatient clinics of two hospitals. Patients underwent comprehensive oral examinations and radiographical measurements, and we assessed the outcomes of periodontal disease and caries. Periodontal measurements included plaque index, bleeding on probing, and periodontal probing pocket depth (PD). Moreover, caries were assessed through visual-tactile examination and radiography. We performed the χ 2 test to determine factors associated with M3 and non-M3 outcomes. Eighty-one unilateral erupted M3s were observed in the study patients. Both the distobuccal region (p<0.0001) and the distolingual region (p=0.006) had a higher PD on the nonextraction side than the extraction side, and the caries rate was significantly higher on the nonextraction side than on the extraction side (p <0.0001 on M2 with caries and p=0.003 on M2 with distal caries). M3 eruption, at the same or different occlusal plane levels of M2, is a risk factor for periodontal diseases and caries in M2s in elderly patients. M3s may continue to negatively impact dental health well into later life. Copyright © 2017. Published by Elsevier Taiwan.

A geometric morphometric analysis of hominin upper second and third molars, with particular emphasis on European Pleistocene populations.

PubMed

Gómez-Robles, Aida; Bermúdez de Castro, José María; Martinón-Torres, María; Prado-Simón, Leyre; Arsuaga, Juan Luis

2012-09-01

The study of dental morphology by means of geometric morphometric methods allows for a detailed and quantitative comparison of hominin species that is useful for taxonomic assignment and phylogenetic reconstruction. Upper second and third molars have been studied in a comprehensive sample of Plio- and Pleistocene hominins from African, Asian and European sites in order to complete our analysis of the upper postcanine dentition. Intraspecific variation in these two molars is high, but some interspecific trends can be identified. Both molars exhibit a strong reduction of the distal cusps in recent hominin species, namely European Homo heidelbergensis, Homo neanderthalensis and Homo sapiens, but this reduction shows specific patterns and proportions in the three groups. Second molars tend to show four well developed cusps in earlier hominin species and their morphology is only marginally affected by allometric effects. Third molars can be incipiently reduced in earlier species and they evince a significant allometric component, identified both inter- and intraspecifically. European Middle Pleistocene fossils from Sima de los Huesos (SH) show a very strong reduction of these two molars, even more marked than the reduction observed in Neanderthals and in modern human populations. The highly derived shape of SH molars points to an early acquisition of typical Neanderthal dental traits by pre-Neanderthal populations and to a deviation of this population from mean morphologies of other European Middle Pleistocene groups. Copyright © 2012 Elsevier Ltd. All rights reserved.

Estimation of distal arm joint angles from EMG and shoulder orientation for transhumeral prostheses.

PubMed

Akhtar, Aadeel; Aghasadeghi, Navid; Hargrove, Levi; Bretl, Timothy

2017-08-01

In this paper, we quantify the extent to which shoulder orientation, upper-arm electromyography (EMG), and forearm EMG are predictors of distal arm joint angles during reaching in eight subjects without disability as well as three subjects with a unilateral transhumeral amputation and targeted reinnervation. Prior studies have shown that shoulder orientation and upper-arm EMG, taken separately, are predictors of both elbow flexion/extension and forearm pronation/supination. We show that, for eight subjects without disability, shoulder orientation and upper-arm EMG together are a significantly better predictor of both elbow flexion/extension during unilateral (R 2 =0.72) and mirrored bilateral (R 2 =0.72) reaches and of forearm pronation/supination during unilateral (R 2 =0.77) and mirrored bilateral (R 2 =0.70) reaches. We also show that adding forearm EMG further improves the prediction of forearm pronation/supination during unilateral (R 2 =0.82) and mirrored bilateral (R 2 =0.75) reaches. In principle, these results provide the basis for choosing inputs for control of transhumeral prostheses, both by subjects with targeted motor reinnervation (when forearm EMG is available) and by subjects without target motor reinnervation (when forearm EMG is not available). In particular, we confirm that shoulder orientation and upper-arm EMG together best predict elbow flexion/extension (R 2 =0.72) for three subjects with unilateral transhumeral amputations and targeted motor reinnervation. However, shoulder orientation alone best predicts forearm pronation/supination (R 2 =0.88) for these subjects, a contradictory result that merits further study. Copyright © 2017 Elsevier Ltd. All rights reserved.

An in vitro assessment of type, position and incidence of isthmus in human permanent molars

PubMed Central

de LIMA, Fernando José Camello; MONTAGNER, Francisco; JACINTO, Rogério Castilho; AMBROSANO, Glaucia Maria Bovi; GOMES, Brenda Paula Figueiredo de Almeida

2014-01-01

Root canal anatomical complexities, such as isthmus, may limit the action of the endodontic instruments, irrigant solutions and intracanal medications, leading to endodontic treatment failure. Objectives This in vitro study assessed the type, position and incidence of isthmus in human permanent molars. Material and Methods One hundred and twenty eight upper and lower first and second permanent molars were analyzed. The roots were embedded in transparent resin, and then split at different distances from the apex (1.0-2.5-4.0-5.5-7.0 mm). Following the sample examination in stereomicroscope, the data were submitted to chi-square statistical test at a 5% significance level. Results The highest isthmus incidence was at 7.0 mm from the root apex in all samples, except the distal root of lower molars (at 5.5 mm). In upper and lower molars, type V (complete isthmus with a continuous opening between the two main root canals) was the most common classification of isthmus (28.8%). In the mesial root of first and second mandibular molars, type IV had the highest incidence (36% and 23.9%, respectively). Conclusion It was concluded that isthmus was widely found in flat roots, with a low percentage in areas close to the apex. In upper and lower molars, these structures were most frequently found at 7 mm from the apex. PMID:25141198

Molar loss and powder diet leads to memory deficit and modifies the mRNA expression of brain-derived neurotrophic factor in the hippocampus of adult mice.

PubMed

Takeda, Yosuke; Oue, Hiroshi; Okada, Shinsuke; Kawano, Akira; Koretake, Katsunori; Michikawa, Makoto; Akagawa, Yasumasa; Tsuga, Kazuhiro

2016-12-05

It is known that tooth loss is known to be a risk factor for Alzheimer's disease and soft diet feeding induces memory impairment. Recent studies have shown that brain-derived neurotrophic factor (BDNF) is associated with tooth loss or soft diet in young animal model, and that BDNF expression is decreased in patients with Alzheimer's disease. However, single or combined effect of tooth loss and/or soft diet on brain function has not fully understood. Here we examined the effect of molar loss and powder diet on memory ability and the expression of BDNF mRNA in the hippocampus of adult C57BL/6J mice. Twenty eight-weeks-old C57BL/6J mice were divided into intact molar group and extracted molar group. They were randomly divided into the I/S group (Intact upper molar teeth/Solid diet feeding), the E/S group (Extracted upper molar teeth/Solid diet feeding), the I/P group (Intact upper molar teeth/Powder diet feeding), and the E/P group (Extracted upper molar teeth/Powder diet feeding). The observation periods were 4 and 16-week. To analyze the memory ability, the step-through passive avoidance test was conducted. BDNF-related mRNA in the hippocampus was analyzed by real-time polymerase chain reaction (RT-PCR). At 4 weeks later, we performed memory test and isolated brains to analyze. There were no differences in memory function and BDNF mRNA level between these four groups. However, at 16 weeks later, E/S and E/P group showed memory impairment, and decreased level of BDNF mRNA. Whereas, the powder diet had no effect on memory function and BDNF mRNA level even at 16 weeks later. These results suggest that the effect of molar loss and powder diet on memory function and BDNF mRNA levels were different, molar loss may have a greater long-term effect on memory ability than powder diet does.

Facial soft-tissue asymmetry in three-dimensional cone-beam computed tomography images of children with surgically corrected unilateral clefts.

PubMed

Starbuck, John Marlow; Ghoneima, Ahmed; Kula, Katherine

2014-03-01

Cleft lip with or without cleft palate (CL/P) is a relatively common craniofacial malformation involving bony and soft-tissue disruptions of the nasolabial and dentoalveolar regions. The combination of CL/P and subsequent craniofacial surgeries to close the cleft and improve appearance of the cutaneous upper lip and nose can cause scarring and muscle pull, possibly resulting in soft-tissue depth asymmetries across the face. We tested the hypothesis that tissue depths in children with unilateral CL/P exhibit differences in symmetry across the sides of the face. Twenty-eight tissue depths were measured on cone-beam computed tomography images of children with unilateral CL/P (n = 55), aged 7 to 17 years, using Dolphin software (version 11.5). Significant differences in tissue depth symmetry were found around the cutaneous upper lip and nose in patients with unilateral CL/P.

Design and finite element analysis of a novel sliding rod microscrew implantation device for mandibular prognathism

PubMed Central

Li, Yanfeng; Lv, Yuan; Lu, Yongjin; Zeng, Pan; Zeng, Xianglong; Guo, Xiaoqian; Han, Weili

2015-01-01

Tooth distalization is an effective approach for mandibular prognathism. Current distalization devices are bulky and clinically complicated. Here, we designed a novel molar distalization device by using a sliding rod and a microscrew and performed a mechanical analysis and finite element model (FEM) analysis of force distribution and displacement of the upper canine, first and second premolar and first molar. A 2D FEM was constructed using the Beam3 element and a 3D FEM was constructed of the mandibular teeth, the periodontal membrane, and the alveolar bones using the UG software. The upper first molar was divided into 12 points on the dental surface to facilitate stress analysis. Force analysis using the ANSYS WORKBECNH revealed that, both horizontally and vertically, the traction force causing distalization of the first molar decreased when the spring coil moved down the L shaped sliding rod. The 3D FEM force analysis revealed distomedial displacement of the upper first molar when the sliding rod microscrew implantation device caused distalization of the molar. These findings support further exploration for the use of the sliding rod microscrew implants as an anchorage for group distal movement of the teeth of patients with mandibular prognathism. PMID:26379860

A geometric morphometric analysis of hominin lower molars: Evolutionary implications and overview of postcanine dental variation.

PubMed

Gómez-Robles, Aida; Bermúdez de Castro, José María; Martinón-Torres, María; Prado-Simón, Leyre; Arsuaga, Juan Luis

2015-05-01

Lower molars have been extensively studied in the context of hominin evolution using classic and geometric morphometric analyses, 2D and 3D approaches, evaluations of the external (outer enamel surface) and internal anatomy (dentine, pulp chamber, and radicular canals), and studies of the crown and root variation. In this study, we present a 2D geometric morphometric analysis of the crown anatomy of lower first, second, and third molars of a broad sample of hominins, including Pliocene and Lower, Middle, and Upper Pleistocene species coming from Africa, Asia, and Europe. We show that shape variability increases from first to second and third molars. While first molars tend to retain a relatively stable 5-cusped conformation throughout the hominin fossil record, second and third molars show marked distal reductions in later Homo species. This trend to distal reduction is similar to that observed in previous studies of premolars and upper second and third molars, and points to a correlated reduction of distal areas across the whole postcanine dentition. Results on lower molar variation, as well as on other postcanine teeth, show certain trends in European Pleistocene populations from the Atapuerca sites. Middle Pleistocene hominins from Sima de los Huesos show Neanderthal affinities and strong dental reduction, especially in the most distal molars. The degree of dental reduction in this population is stronger than that observed in classic Neanderthals. Homo antecessor hominins from Gran Dolina-TD6 have primitive lower teeth that contrast with their more derived upper teeth. The evolutionary implications of these dental affinities are discussed in light of recent paleogenetic studies. Copyright © 2015 Elsevier Ltd. All rights reserved.

Correlation between the frequency of eruption disorders for first permanent molars and the occurrence of malocclusions in early mixed dentition.

PubMed

Salbach, Anja; Schremmer, Britt; Grabowski, Rosemarie; Stahl de Castrillon, Franka

2012-08-01

We analyzed the incidence of eruption disorders in 6-year molars during the first phase of mixed dentition, and then determined the risks for later dental arch development according to specific combinations of orthodontic malocclusions. We, thus, aimed to derive potential conclusions for preventative orthodontics. In this cross-sectional study, 8,041 kindergarten and school children with early mixed dentition were randomly selected and clinically examined. Examinations were performed in two consecutive years during the standard dental screening that school children undergo. The average age was 6.9 years. We defined an eruption of the 6-year molars as being disturbed when (1) the distal cusps had erupted further than the mesial cusps, (2) the mesial inclination of the occlusal surface revealed disturbed eruption, and (3) the 6-year molar had erupted below the second primary molar. Disturbed eruption of the first permanent molars was observed in 102 of these children. The upper 6-year molars were affected more often (88.5%) than the lower molars. Bilateral disturbed eruption of the upper molars was the most frequent combination of symptoms found. Although disturbed eruption was diagnosed most often in 6- and 7-year-old children, the 8-year-old children presented 20% of the eruption disorders. Moreover, 72.6% of the children with disturbed eruption presented at least one additional orthodontic malocclusion. Crowding (p ≤ 0.001), lateral malocclusions (p ≤ 0.001), and mandibular prognathism (p = 0.009) were present significantly more often in children with disturbed eruption of 6-year molars. Delayed eruption and false direction of eruption of the upper 6-year molars may-already at an early stage-raise the likelihood of problems during later dental arch development, such as crowding in the sagittal and transverse directions or Class III developments.

Convergent dental adaptations in pseudo-tribosphenic and tribosphenic mammals.

PubMed

Luo, Zhe-Xi; Ji, Qiang; Yuan, Chong-Xi

2007-11-01

Tribosphenic molars of basal marsupials and placentals are a major adaptation, with the protocone (pestle) of the upper molar crushing and grinding in the talonid basin (mortar) on the lower molar. The extinct pseudo-tribosphenic mammals have a reversed tribosphenic molar in which a pseudo-talonid is anterior to the trigonid, to receive the pseudo-protocone of the upper molar. The pseudo-protocone is analogous to the protocone, but the anteriorly placed pseudo-talonid is opposite to the posterior talonid basin of true tribosphenic mammals. Here we describe a mammal of the Middle Jurassic period with highly derived pseudo-tribosphenic molars but predominantly primitive mandibular and skeletal features, and place it in a basal position in mammal phylogeny. Its shoulder girdle and limbs show fossorial features similar to those of mammaliaforms and monotremes, but different compared with those of the earliest-known Laurasian tribosphenic (boreosphenid) mammals. The find reveals a much greater range of dental evolution in Mesozoic mammals than in their extant descendants, and strengthens the hypothesis of homoplasy of 'tribosphenic-like' molars among mammals.

Dietary Ecology of Murinae (Muridae, Rodentia): A Geometric Morphometric Approach

PubMed Central

Gómez Cano, Ana Rosa; Hernández Fernández, Manuel; Álvarez-Sierra, M. Ángeles

2013-01-01

Murine rodents represent a highly diverse group, which displays great ecological versatility. In the present paper we analyse the relationship between dental morphology, on one hand, using geometric morphometrics based upon the outline of first upper molar and the dietary preference of extant murine genera, on the other. This ecomorphological study of extant murine rodents demonstrates that dietary groups can be distinguished with the use of a quantitative geometric morphometric approach based on first upper molar outline. A discriminant analysis of the geometric morphometric variables of the first upper molars enables us to infer the dietary preferences of extinct murine genera from the Iberian Peninsula. Most of the extinct genera were omnivore; only Stephanomys showed a pattern of dental morphology alike that of the herbivore genera. PMID:24236090

Quantitative analysis of the orthodontic and orthopedic effects of maxillary traction.

PubMed

Baumrind, S; Korn, E L; Isaacson, R J; West, E E; Molthen, R

1983-11-01

This article analyzes differences in displacement of ANS and of the upper first molar when different vectors of force are delivered to the maxilla in non-full-banded Phase I mixed-dentition treatment of Class II malocclusion. The sample is identical to that for which we have previously reported differences in change in several key measures of mandibular and facial shape. It includes a cervical-traction group, a high-pull-to-upper-molar group, a modified-activator group, and an untreated Class II control group. Using newly developed computer-conducted procedures, which are described, we have been able to partition the orthodontic and orthopedic components of upper molar displacement and also to isolate treatment effects from those attributable to spontaneous growth and development. In the region of ANS, small but statistically significant and clinically meaningful differences were noted between treatments. When the intercurrent effects of growth and development had been factored out (Table III), orthopedic distal displacement of ANS was significantly greater in the high-pull and cervical groups than in the activator group. Orthopedic downward displacement of ANS was seen to be significantly greater in the cervical group than in the high-pull and activator groups. In the region of the first molar cusp, mean distal displacement of the tooth as an orthopedic effect was found to be almost identical in the cervical and high-pull groups (although variability was greater in the cervical group), but the mean orthodontic effect was significantly greater in the high-pull group than in the cervical group. In the cervical group, where relatively light forces were used for relatively long treatment periods on average, more of the total distal displacement of the upper molar was of an orthopedic character than of an orthodontic character. Conversely, in the high-pull group, in which relatively heavier forces tended to be used for briefer treatment periods, most of the distal displacement at the upper molar was of an orthodontic character. These observations are contrary to expectations from conventional orthodontic theory. In the activator-treated group, roughly equal components of the treatment-associated distal displacement of the upper molar were of the orthodontic and orthopedic types. As concerns changes in the vertical direction in the region of the molar cusp, significant intrusion of both the orthopedic and orthodontic types was seen in the high-pull sample as compared to each of the other groups examined.(ABSTRACT TRUNCATED AT 400 WORDS)

Third molars and dental crowding: different opinions of orthodontists and oral surgeons among Italian practitioners.

PubMed

Gavazzi, Michela; De Angelis, Donato; Blasi, Sergio; Pesce, Paolo; Lanteri, Valentina

2014-11-22

The role of third molars as a cause of incisor crowding, especially in the lower arch, continues to be controversial. The aim of this work is to compare opinions of Italian oral surgeons and orthodontists on this topic. One hundred ninety-three Italian practitioners of the Society of Orthodontics (SIDO) and the Italian Society of Oral Surgery (SICOI) were asked to fill out an online questionnaire made up of six questions. Practitioners were asked to express their opinion on the relation between upper and lower third molar eruption and anterior crowding. One hundred sixty-six members of both societies completed the online research survey; response rate (RR) was 86%. There were no statistically significant differences between the two groups (P > 0.005). Both agree not to believe that third molars create a force responsible for anterior crowding in the upper (82.5% orthodontists, 83.8% surgeons) and in the lower arch (52.6% orthodontists, 63.8% surgeons). Both agree also not to consider the upper (89.7% orthodontists, 82.1% surgeons) and lower (58.8% orthodontists, 63.2% surgeons) third molar extraction useful to prevent crowding. Italian orthodontists and oral surgeons have the same opinion on the role of the third molar in causing anterior crowding. The majority of both groups of clinicians do not consider their preventive extraction useful in order to prevent anterior crowding.

Classification of upper limb disability levels of children with spastic unilateral cerebral palsy using K-means algorithm.

PubMed

Raouafi, Sana; Achiche, Sofiane; Begon, Mickael; Sarcher, Aurélie; Raison, Maxime

2018-01-01

Treatment for cerebral palsy depends upon the severity of the child's condition and requires knowledge about upper limb disability. The aim of this study was to develop a systematic quantitative classification method of the upper limb disability levels for children with spastic unilateral cerebral palsy based on upper limb movements and muscle activation. Thirteen children with spastic unilateral cerebral palsy and six typically developing children participated in this study. Patients were matched on age and manual ability classification system levels I to III. Twenty-three kinematic and electromyographic variables were collected from two tasks. Discriminative analysis and K-means clustering algorithm were applied using 23 kinematic and EMG variables of each participant. Among the 23 kinematic and electromyographic variables, only two variables containing the most relevant information for the prediction of the four levels of severity of spastic unilateral cerebral palsy, which are fixed by manual ability classification system, were identified by discriminant analysis: (1) the Falconer index (CAI E ) which represents the ratio of biceps to triceps brachii activity during extension and (2) the maximal angle extension (θ Extension,max ). A good correlation (Kendall Rank correlation coefficient = -0.53, p = 0.01) was found between levels fixed by manual ability classification system and the obtained classes. These findings suggest that the cost and effort needed to assess and characterize the disability level of a child can be further reduced.

Camouflage treatment of skeletal Class III malocclusion with multiloop edgewise arch wire and modified Class III elastics by maxillary mini-implant anchorage.

PubMed

He, Shushu; Gao, Jinhui; Wamalwa, Peter; Wang, Yunji; Zou, Shujuan; Chen, Song

2013-07-01

To evaluate the effect of the multiloop edgewise arch wire (MEAW) technique with maxillary mini-implants in the camouflage treatment of skeletal Class III malocclusion. Twenty patients were treated with the MEAW technique and modified Class III elastics from the maxillary mini-implants. Twenty-four patients were treated with MEAW and long Class III elastics from the upper second molars as control. Lateral cephalometric radiographs were obtained and analyzed before and after treatment, and 1 year after retention. Satisfactory occlusion was established in both groups. Through principal component analysis, it could be concluded the anterior-posterior dental position, skeletal sagittal and vertical position, and upper molar vertical position changed within groups and between groups; vertical lower teeth position and Wits distance changed in the experimental group and between groups. In the experimental group, the lower incisors tipped lingually 2.7 mm and extruded 2.4 mm. The lingual inclination of the lower incisors increased 3.5°. The mandibular first molars tipped distally 9.1° and intruded 0.4 mm. Their cusps moved 3.4 mm distally. In the control group, the upper incisors proclined 3°, and the upper first molar extruded 2 mm. SN-MP increased 1.6° and S-Go/N-ME decreased 1. The MEAW technique combined with modified Class III elastics by maxillary mini-implants can effectively tip the mandibular molars distally without any extrusion and tip the lower incisors lingually with extrusion to camouflage skeletal Class III malocclusions. Clockwise rotation of the mandible and further proclination of upper incisors can be avoided. The MEAW technique and modified Class III elastics provided an appropriate treatment strategy especially for patients with high angle and open bite tendency.

Orthodontic decompensation in class III patients by means of distalization of upper molars.

PubMed

Carlos, Villegas B; Giovanni, Oberti; Diego, Rey; Angela, Sierra; Baccetti, Tiziano

2009-01-01

Pre-surgical orthodontic treatments have the objective of establishing harmony between the dental arches by moving the teeth to ideal positions in relation to their bony bases, in order to achieve adequate antero-posterior occlusal and transverse relationships at the moment of surgery. Among the typical requirements in terms of dental compensations presented by Class III patients that require surgery, the inclination of anterior teeth must be changed in most cases by proclination of the lower incisors and retroclination of upper incisors. To achieve the inclination of the upper incisors, many different alternatives have been proposed, such as inter-proximal reduction, extractions, or distalization of upper molars, which has not been widely reported in the literature as a means to decompensate Class III malocclusion prior to surgery. This article describes the Bone Supported Pendulum (BSP) as an efficient therapeutic option to distalize molars through the use of an appliance stabilized to the palate by mini-implants, thus avoiding extractions and providing good interdigitation and coordination of the dental arches.

Assisted eruption of impacted teeth into an alveolar bone graft in a patient with cleft lip and palate.

PubMed

Peamkaroonrath, Chonthicha; Manosudprasit, Montien; Godfrey, Keith

2008-11-01

To assist the eruption of impacted upper teeth into an alveolar bone graft in a patient with a unilateral cleft lip and palate. An 8-year-old Thai boy with left unilateral complete cleft lip and palate had the chief complaint of anterior crossbite. He presented with a mild skeletal 3, dental Class III subdivision malocclusion, anterior crossbite, left unilateral posterior crossbite, moderate crowding in the upper arch with impaction of upper the left lateral incisor (tooth 22) and canine (tooth 23). In the first phase of treatment the posterior crossbite was corrected with a removable appliance with a 3-way screw. In the second phase the impacted teeth were surgically exposed, moved into the alveolar bone graft and the teeth aligned with fixed appliances. The upper left lateral incisor was extracted because of its questionable longevity. The orthodontic treatment resulted in normal overjet, overbite and an acceptable facial profile. A prosthesis replaced tooth 22. Forced eruption of impacted teeth can be carried out successfully in the cleft patients after an appropriate treatment plan has been formulated and following preparation of alveolar bone graft in the cleft site.

Analyzing at-home prosthesis use in unilateral upper-limb amputees to inform treatment & device design.

PubMed

Spiers, Adam J; Resnik, Linda; Dollar, Aaron M

2017-07-01

New upper limb prosthetic devices are continuously being developed by a variety of industrial, academic, and hobbyist groups. Yet, little research has evaluated the long term use of currently available prostheses in daily life activities, beyond laboratory or survey studies. We seek to objectively measure how experienced unilateral upper limb prosthesis-users employ their prosthetic devices and unaffected limb for manipulation during everyday activities. In particular, our goal is to create a method for evaluating all types of amputee manipulation, including non-prehensile actions beyond conventional grasp functions, as well as to examine the relative use of both limbs in unilateral and bilateral cases. This study employs a head-mounted video camera to record participant's hands and arms as they complete unstructured domestic tasks within their own homes. A new 'Unilateral Prosthesis-User Manipulation Taxonomy' is presented based observations from 10 hours of recorded videos. The taxonomy addresses manipulation actions of the intact hand, prostheses, bilateral activities, and environmental feature-use (aiïordances). Our preliminary results involved tagging 23 minute segments of the full videos from 3 amputee participants using the taxonomy. This resulted in over 2,300 tag instances. Observations included that non-prehensile interactions outnumbered prehensile interactions in the affected limb for users with more distal amputation that allowed arm mobility.

Examination and treatment of patients with unilateral vestibular damage, with focus on the musculoskeletal system: a case series.

PubMed

Wilhelmsen, Kjersti; Kvåle, Alice

2014-07-01

Persistent dizziness and balance problems have been reported in some patients with unilateral vestibular pathology. The purpose of this case series was to address the examination and treatment of musculoskeletal dysfunction in patients with unilateral vestibular hypofunction. The musculoskeletal system was evaluated with the Global Physiotherapy Examination, dynamic balance was measured during walking with triaxial accelerometers positioned on the lower and upper trunk, and symptoms and functional limitations were assessed with standardized self-report measures. The 4 included patients had symptoms of severe dizziness that had lasted more than 1 year after the onset of vestibular dysfunction and a moderate level of perceived disability. Musculoskeletal abnormalities typically included postural misalignment, restricted abdominal respiration, restricted trunk movements, and tense muscles of the upper trunk and neck. The patients attended a modified vestibular rehabilitation program consisting of body awareness exercises addressing posture, movements, and respiration. After the intervention, self-reported symptoms and perceived disability improved. Improvements in mobility and positive physical changes were found in the upper trunk and respiratory movements. The attenuation of mediolateral accelerations (ie, body oscillations) in the upper trunk changed; a relatively more stable upper trunk and a concomitantly more flexible lower trunk were identified during walking in 3 patients. The recovery process may be influenced by self-inflicted rigid body movements and behavior strategies that prevent compensation. Addressing physical dysfunction and enhancing body awareness directly and dizziness indirectly may help patients with unilateral vestibular hypofunction break a self-sustaining cycle of dizziness and musculoskeletal problems. Considering the body as a functional unit and including both musculoskeletal and vestibular systems in examination and treatment may be important. © 2014 American Physical Therapy Association.

Distal displacement of the maxilla and the upper first molar.

PubMed

Baumrind, S; Molthen, R; West, E E; Miller, D M

1979-06-01

Data from a sample of 198 Class II cases treated with various appliances which deliver distally directed forces to the maxilla were examined to determine the frequency of absolute distal displacement of the upper first molar and of the maxilla. Analysis revealed that such distal displacement is possible and that it is, in fact, a frequent finding following treatment. Long-range stability of distal displacement was not assessed.

Opinions of American and Swedish orthodontists about the role of erupting third molars as a cause of dental crowding.

PubMed

Tüfekçi, E; Svensk, D; Kallunki, J; Huggare, J; Lindauer, S J; Laskin, D M

2009-11-01

To compare the opinions of Swedish orthodontists and American orthodontists regarding the association between third molar eruption and dental crowding. A survey was distributed to Swedish orthodontists (n = 230) asking their views on the force exerted by erupting third molars, its relationship to crowding, and their recommendations for prophylactic removal. Results were compared with those from a similar study conducted in the United States. Chi square analysis was used to determine differences in responses to questions between Swedish and American orthodontists. P < or = .05 was considered significant. Both Swedish and American orthodontists believed that lower third molars were more likely than upper third molars to cause force (65% and 58% for Swedish and American orthodontists, respectively) and crowding (42% and 40%, respectively). No statistically significant differences were seen between the answers of American and Swedish orthodontists regarding the role of upper and lower third molars in causing crowding. Although only 18% of Swedish orthodontists "generally" or "sometimes" recommended prophylactic removal of mandibular third molars, 36% of American orthodontists "generally" or "sometimes" recommended removal (P < .0001). Most orthodontists in the United States and Sweden do believe that erupting lower third molars exert an anterior force; however, they also believe that these teeth "rarely" or "never" cause crowding of the dentition. The reason that more American orthodontists recommend prophylactic removal of mandibular third molars remains unexplained.

Strain Distribution in a Kennedy Class I Implant Assisted Removable Partial Denture under Various Loading Conditions

PubMed Central

Shahmiri, Reza; Aarts, John M.; Bennani, Vincent; Swain, Michael V.

2013-01-01

Purpose. This in vitro study investigates how unilateral and bilateral occlusal loads are transferred to an implant assisted removable partial denture (IARPD). Materials and Methods. A duplicate model of a Kennedy class I edentulous mandibular arch was made and then a conventional removable partial denture (RPD) fabricated. Two Straumann implants were placed in the second molar region, and the prosthesis was modified to accommodate implant retained ball attachments. Strain gages were incorporated into the fitting surface of both the framework and acrylic to measure microstrain (μStrain). The IARPD was loaded to 120Ns unilaterally and bilaterally in three different loading positions. Statistical analysis was carried out using SPSS version 18.0 (SPSS, Inc., Chicago, IL, USA) with an alpha level of 0.05 to compare the maximum μStrain values of the different loading conditions. Results. During unilateral and bilateral loading the maximum μStrain was predominantly observed in a buccal direction. As the load was moved anteriorly the μStrain increased in the mesial area. Unilateral loading resulted in a twisting of the structure and generated a strain mismatch between the metal and acrylic surfaces. Conclusions. Unilateral loading created lateral and vertical displacement of the IARPD. The curvature of the dental arch resulted in a twisting action which intensified as the unilateral load was moved anteriorly. PMID:23737788

Upper limb performance and the structuring of joint movement in teenagers with cerebral palsy: the reciprocal role of task demands and action capabilities.

PubMed

Figueiredo, Priscilla Rezende Pereira; Silva, Paula Lanna; Avelar, Bruna Silva; da Fonseca, Sérgio Teixeira; Bootsma, Reinoud J; Mancini, Marisa Cotta

2015-04-01

Individuals with unilateral cerebral palsy (CP) demonstrate reduced performance in upper limb tasks compared to typically developing (TD) peers. We examined whether task conditions modify differences between teenagers with and without CP during a reciprocal aiming task. Twenty teenagers (nine CP and 11 TD) moved a pointer between two targets as fast as possible without missing a target. Task conditions were manipulated by changing the targets' size, by modifying the inertial properties of the pointer and by varying the upper limb used to perform the task (preferred/non-affected and non-preferred/affected upper limbs). While compared to TD peers, CP teenagers exhibited lower performance (longer movement times). Such differences were attenuated when the task was performed with the preferred upper limb and when accuracy requirements were less stringent. CP teenagers were not differentially affected by the pointer inertia manipulation. Task conditions not only affected performance but also joint kinematics. CP teenagers revealed less movement at the elbow and more movement at the shoulder when performing the task with their less skilled upper limb. However, both CP and TD teenagers demonstrated a larger contribution of trunk movement when facing more challenging task conditions. The overall pattern of results indicated that the joint kinematics employed by individuals with unilateral CP constituted adaptive responses to task requirements. Thus, the explanation of the effects of unilateral CP on upper limb behavior needs to go beyond a context-indifferent manifestation of the brain injury to include the interaction between task demands and action capabilities.

The effect of first and second premolar extractions on third molars: A retrospective longitudinal study.

PubMed

Miclotte, A; Grommen, B; Cadenas de Llano-Pérula, M; Verdonck, A; Jacobs, R; Willems, G

2017-06-01

To analyse the effect of first and second premolar extractions on eruption space for upper and lower third molars and on third molar position and angulation during orthodontic treatment. The sample consisted of 296 patients of which 218 patients were orthodontically treated without extraction and 78 patients with extraction of first or second premolars. The eruption space for third molars was measured on pre- and posttreatment lateral cephalograms, whereas the angulation, vertical position, the relation with the mandibular canal and the mineralization status of third molars were evaluated using pre- and posttreatment panoramic radiographs. All data were statistically analyzed. The increase in eruption space and the change in vertical position of upper and lower third molars significantly differed between patients treated with and without premolar extractions, whereas the change in angulation, relationship with the mandibular canal and mineralization status of the third molars did not significantly differ between patients treated with and without premolar extractions. The retromolar space and the position of third molars significantly change during orthodontic treatment in growing patients. Premolar extractions have a positive influence on the eruption space and vertical position of third molars, whereas they do not influence the angular changes of third molars. Due to the retrospective character of the study, these conclusions should be carefully considered. Further prospective research is necessary for better insights into this complex topic. This study stresses the importance of considering the possible effects of orthodontic treatment on third molars during treatment planning. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Unilateral and bilateral upper extremity weight-bearing effect on upper extremity impairment and functional performance after brain injury

PubMed Central

REISTETTER, TIMOTHY; ABREU, BEATRIZ C.; BEAR-LEHMAN, JANE; OTTENBACHER, KENNETH J.

2010-01-01

The purpose of the study was to investigate the effect of upper extremity (UE) weight bearing on UE impairment functional performance of persons with acquired brain injury (BI). A quasi-experimental design was used to examine a convenience sample of 99 persons with acquired BI and 22 without BI (WBI) living in a community re-entry centre. A computerized force-sensing array pressure map system was used to determine the UE pressure during unilateral and bilateral conditions. Differences between groups were examined using t-tests. Correlations were computed between UE weight bearing and hand function, and functional performance as measured by the Fugl-Meyer scale and functional independence measure (FIM) scale. The group of people with BI exerted significantly lower UE weight bearing during unilateral conditions as compared with persons WBI [left: t (119) = 2.34, p = 0.021; right: t (119) = 4.79, p = 0.043). UE weight-bearing measures correlated strongly with FIM motor scores with bilateral UE conditions yielded the highest significant correlation (bilateral left r = 0.487, p < 0.001; bilateral right r = 0.469, p < 0.01). The results indicated that UE weight-bearing pressure differs in unilateral and bilateral conditions, between persons with and WBI and between persons with stroke and traumatic brain injury. These findings may have implications for occupational therapists that use unilateral versus bilateral motor training for rehabilitation. There is a need to replicate the study design with a randomized and stratified sample of persons with BI. PMID:19551694

Finishing occlusion in Class II or Class III molar relation: therapeutic Class II and III.

PubMed

Nangia, A; Darendeliler, M A

2001-11-01

The most frequent extraction regime consists of the removal of upper and lower premolars. Depending on anchorage requirements, camouflage treatment options, surgical intervention, or the absence of teeth in only one arch, it may become necessary to finalize the occlusion with a one-dental-unit discrepancy between the upper and lower dental arches. Guidelines are presented for finishing occlusions in Class II or Class III molar relation.

Visualisation of upper limb activity using spirals: A new approach to the assessment of daily prosthesis usage.

PubMed

Chadwell, Alix; Kenney, Laurence; Granat, Malcolm; Thies, Sibylle; Head, John S; Galpin, Adam

2018-02-01

Current outcome measures used in upper limb myoelectric prosthesis studies include clinical tests of function and self-report questionnaires on real-world prosthesis use. Research in other cohorts has questioned both the validity of self-report as an activity assessment tool and the relationship between clinical functionality and real-world upper limb activity. Previously, 1 we reported the first results of monitoring upper limb prosthesis use. However, the data visualisation technique used was limited in scope. Methodology development. To introduce two new methods for the analysis and display of upper limb activity monitoring data and to demonstrate the potential value of the approach with example real-world data. Upper limb activity monitors, worn on each wrist, recorded data on two anatomically intact participants and two prosthesis users over 1 week. Participants also filled in a diary to record upper limb activity. Data visualisation was carried out using histograms, and Archimedean spirals to illustrate temporal patterns of upper limb activity. Anatomically intact participants' activity was largely bilateral in nature, interspersed with frequent bursts of unilateral activity of each arm. At times when the prosthesis was worn prosthesis users showed very little unilateral use of the prosthesis (≈20-40 min/week compared to ≈350 min/week unilateral activity on each arm for anatomically intact participants), with consistent bias towards the intact arm throughout. The Archimedean spiral plots illustrated participant-specific patterns of non-use in prosthesis users. The data visualisation techniques allow detailed and objective assessment of temporal patterns in the upper limb activity of prosthesis users. Clinical relevance Activity monitoring offers an objective method for the assessment of upper limb prosthesis users' (PUs) activity outside of the clinic. By plotting data using Archimedean spirals, it is possible to visualise, in detail, the temporal patterns of upper limb activity. Further work is needed to explore the relationship between traditional functional outcome measures and real-world prosthesis activity.

Odontometric sex estimation from clinically extracted molar teeth in a North Indian population sample.

PubMed

Tabasum, Qutsia; Sehrawat, Jagmahender Singh; Talwar, Manjit Kaur; Pathak, Raj Kamal

2017-01-01

Different dental features have contributed significantly toward sex determination in the forensic anthropological contexts. Population-specific standards (discriminant functions or regression formulae) have been suggested for various population groups to identify the sex of an unknown individual from dental dimensions and other odontometric features. The main purpose of the present investigation was to examine the degree of sexual dimorphism exhibited by the human teeth of North Indians and identify importance as a forensic tool in sex determination. The linear and diagonal dimensions were recorded at both crown and cementoenamel junction levels of 58 upper and 72 lower molars of 130 Northwest Indian subjects (73 males and 57 females). The measurements were subjected to appropriate statistical analyses to estimate the sex estimation accuracy from lower and upper molars separately. Univariate analyses revealed that molar teeth had greater dimensions in males than the females and the mesiodistal cervical diameter (MDCV) was found to be the most suitable variable for sex determination of the molars. The classification results were in agreement with the previously conducted studies. The index of sexual dimorphism (ISD) was calculated to be higher in lower molars than the upper molars, and the highest sex differences were observed for MDCV based on the ISD. The overall sex estimation accuracy obtained from multivariate discriminant function analysis and regression analysis of pooled data was 70.0% (74% males, 64.9% females) and 66.9% (78.1% males, 52.6% females), respectively. Odontometrics can play a significant role in establishing the biological identity of an unknown individual even from a single tooth in the absence of other sophisticated molecular or biochemical techniques used for this purpose.

Odontometric sex estimation from clinically extracted molar teeth in a North Indian population sample

PubMed Central

Tabasum, Qutsia; Sehrawat, Jagmahender Singh; Talwar, Manjit Kaur; Pathak, Raj Kamal

2017-01-01

Background: Different dental features have contributed significantly toward sex determination in the forensic anthropological contexts. Population-specific standards (discriminant functions or regression formulae) have been suggested for various population groups to identify the sex of an unknown individual from dental dimensions and other odontometric features. The main purpose of the present investigation was to examine the degree of sexual dimorphism exhibited by the human teeth of North Indians and identify importance as a forensic tool in sex determination. Materials and Methods: The linear and diagonal dimensions were recorded at both crown and cementoenamel junction levels of 58 upper and 72 lower molars of 130 Northwest Indian subjects (73 males and 57 females). The measurements were subjected to appropriate statistical analyses to estimate the sex estimation accuracy from lower and upper molars separately. Results: Univariate analyses revealed that molar teeth had greater dimensions in males than the females and the mesiodistal cervical diameter (MDCV) was found to be the most suitable variable for sex determination of the molars. The classification results were in agreement with the previously conducted studies. The index of sexual dimorphism (ISD) was calculated to be higher in lower molars than the upper molars, and the highest sex differences were observed for MDCV based on the ISD. The overall sex estimation accuracy obtained from multivariate discriminant function analysis and regression analysis of pooled data was 70.0% (74% males, 64.9% females) and 66.9% (78.1% males, 52.6% females), respectively. Conclusions: Odontometrics can play a significant role in establishing the biological identity of an unknown individual even from a single tooth in the absence of other sophisticated molecular or biochemical techniques used for this purpose. PMID:29657498

Three-dimensional finite element analysis of vertical and angular misfit in implant-supported fixed prostheses.

PubMed

Assunção, Wirley Gonçalves; Gomes, Erica Alves; Rocha, Eduardo Passos; Delben, Juliana Aparecida

2011-01-01

Three-dimensional finite element analysis was used to evaluate the effect of vertical and angular misfit in three-piece implant-supported screw-retained fixed prostheses on the biomechanical response in the peri-implant bone, implants, and prosthetic components. Four three-dimensional models were fabricated to represent a right posterior mandibular section with one implant in the region of the second premolar (2PM) and another in the region of the second molar (2M). The implants were splinted by a three-piece implant-supported metal-ceramic prosthesis and differed according to the type of misfit, as represented by four different models: Control = prosthesis with complete fit to the implants; UAM (unilateral angular misfit) = prosthesis presenting unilateral angular misfit of 100 μm in the mesial region of the 2M; UVM (unilateral vertical misfit) = prosthesis presenting unilateral vertical misfit of 100 μm in the mesial region of the 2M; and TVM (total vertical misfit) = prosthesis presenting total vertical misfit of 100 μm in the platform of the framework in the 2M. A vertical load of 400 N was distributed and applied on 12 centric points by the software Ansys, ie, a vertical load of 150 N was applied to each molar in the prosthesis and a vertical load of 100 N was applied at the 2PM. The stress values and distribution in peri-implant bone tissue were similar for all groups. The models with misfit exhibited different distribution patterns and increased stress magnitude in comparison to the control. The highest stress values in group UAM were observed in the implant body and retention screw. The groups UVM and TVM exhibited high stress values in the platform of the framework and the implant hexagon, respectively. The three types of misfit influenced the magnitude and distribution of stresses. The influence of misfit on peri-implant bone tissue was modest. Each type of misfit increased the stress values in different regions of the system.

Case report: Management of severe posterior open bite due to primary failure of eruption.

PubMed

Mc Cafferty, J; Al Awadi, E; O'Connell, A C

2010-06-01

Primary failure of tooth eruption (PFE) is a rare condition affecting any or all posterior quadrants. Unilateral involvement of maxillary and mandibular quadrants causes a dramatic posterior open bite that requires complex management strategies. An 8 year-old boy attended the Dublin Dental School and Hospital regarding infra-occlusion of his right maxillary and mandibular primary molars. Both right first permanent molars had also failed to erupt. All permanent teeth were present radiographically. Facial appearance and soft tissues were normal and oral function was not affected. The patient had no significant medical history and his siblings had no similar dental abnormalities. The infra-occluded right first and second primary molars were extracted, and the right first permanent molars were surgically exposed. Eruption of the premolars and molars was monitored over the next 2 years. The premolars showed signs of eruption and continued root development. Exfoliation of the remaining primary teeth proceeded as usual. The right first permanent molars did not erupt and were subsequently extracted. Continued eruption of the canines and premolars reduced the inter-arch separation. A removable tongue shield appliance was suggested but declined by the patient. At age 13 years, orthodontic extrusion was used to further reduce the inter-dental distance between the canine and premolars. The reduction was from 5 mm to 1.5 mm between the right first premolars and from 10 mm to 5 mm between the right second premolars. Extrusion of the canine teeth was also attempted to improve the smile line. The canine extruded 1 mm to give a 2 mm overlap. There were no changes in centric occlusion and the midline was unaffected. In the 2 years since orthodontic treatment, the spaces have reopened slightly to 3 mm between first premolars and 6 mm between second premolars. The patient is now aged 16 years and is aware that an improved aesthetic smile line may be achieved by use of onlay restorations. In this unique case, a profound unilateral posterior open bite occurred due to primary failure of eruption of the maxillary and mandibular teeth on the affected side. Orthodontic therapy was used to modify the position of the permanent canines and premolars to reduce the posterior open bite.

Image analysis of the eruptive positions of third molars and adjacent second molars as indicators of age evaluation in Thai patients.

PubMed

Mahasantipiya, Phattaranant May; Pramojanee, Sakarat; Thaiupathump, Trasapong

2013-12-01

This study was performed to determine the relationship between the stage of tooth eruption (both vertical and mesio-angular) and chronological age. Indirect digital panoramic radiographs were used to measure the distances from the dentinoenamel junction (DEJ) of the second molars to the occlusal plane of the second molar teeth and of the adjacent third molars in 264 Thai males and 437 Thai females using ImageJ software. The ratio of those distances was calculated by patient age, and the correlation coefficient of the ratio of the third molar length to the second molar length was calculated. The correlation between the height of the vertically erupted upper third molar teeth and age was at the intermediate level. The age range of ≥15 to <16 years was noted to be the range in which the correlation between the chronological age determined from the eruptional height and actual chronological age was statistically significant. The mean age of the female subjects, in which the position of the right upper third molar teeth was at or above the DEJ of the adjacent second molar but below one half of its coronal height was 19.9±2.6 years. That for the left side was 20.2±2.7 years. The mean ages of the male subjects were 20.1±3.3 years and 19.8±2.7 years for the right and left sides, respectively. It might be possible to predict chronological age from the eruption height of the wisdom teeth.

Congenital unilateral absence of the upper extremity may give rise to a specific kind of thoracolumbar curve.

PubMed

Olgun, Z Deniz; Demirkiran, Gokhan; Polly, David; Yazici, Muharrem

2018-03-01

There is an increased incidence of scoliosis in patients with congenital malformations of the upper extremity even in the absence of overt vertebral abnormalities. In this case series, we summarize the curve characteristics of four patients presenting to two spine surgery clinics with unilateral amelia or phocomelia and a progressive scoliotic curve with the apex on the side of deficiency. All patients required orthopedic intervention for their curves. Amelia and phocomelia are severe congenital malformations of the upper limb affecting trunk balance and, conceivably, causing scoliosis with the absence of counterbalancing weight on the affected side. The combination of upper limb absence and same-sided scoliosis in these patients may provide a clue of the mechanical factors causing scoliosis in other disorders. In this article, we attempt to define this exceptional deformity, theorize on its etiology, and draw attention to this particular combination of problems. Case series; Level IV.

Differences between the chewing and non-chewing sides of the mandibular first molars and condyles in the closing phase during chewing in normal subjects.

PubMed

Tomonari, Hiroshi; Kwon, Sangho; Kuninori, Takaharu; Miyawaki, Shouichi

2017-09-01

This study aimed to assess differences between the closing paths of the chewing and non-chewing sides of mandibular first molars and condyles during natural mastication, using standardized model food in healthy subjects. Thirty-two healthy young adults (age: 19-25 years; 22 men, 10 women) with normal occlusion and function chewed on standardized gummy jelly. Using an optoelectric jaw-tracking system with six degrees of freedom, we recorded the path of the mandibular first molars and condyles on both sides for 10 strokes during unilateral chewing. Variables were compared between the chewing side and the non-chewing side of first molars and condyles on frontal, sagittal, and horizontal views during the early-, middle- and late-closing phases. On superior/inferior displacements, the chewing side first molar and condyle were positioned superior to those on the non-chewing side during the early- and middle-closing phases. Conversely, the first molar and condyle on the non-chewing side were positioned significantly superior to those on the chewing side during the late-closing phase. On anterior/posterior displacements, the chewing side mandibular first molar and condyle were positioned significantly posterior to those on the non-chewing side throughout all closing phases. Our results showed the differences between the mandibular first molars and condyles on both sides with respect to masticatory path during natural chewing of a model food. These differences can be useful for informing initial diagnostic tests for impaired masticatory function in the clinical environment. Copyright © 2017 Elsevier Ltd. All rights reserved.

Metastatic carcinoma of the breast: a case with the unusual presentation of unilateral periorbital edema.

PubMed

Kuo, Shu-Chen; Hsiao, Shih-Chuan; Chiou, Chien-Chun; Chen, Fen-Fen; Huang, Kuo-Chan

2008-01-01

Metastasis of mammary cancer involving the orbit is common, and it typically presents with enophthalmos and restrictions of ocular motility. We report a case of mammary cancer with the unusual presentation of unilateral periorbital edema only. The possible mechanisms of unilateral periorbital swelling are discussed. Metastasis of breast cancer involving unilateral eyelid edema was diagnosed in a 66-year-old woman. A biopsy was performed to confirm the etiology after vague neuroimaging findings. The diagnosis was based on the histopathologic features of carcinomatous cells in the excised specimen. Insidious, progressive unilateral upper and lower eyelid swelling of the right eye disappeared after one cycle of palliative chemotherapy. Neither restriction nor proptosis developed in the whole course. Possible metastasis should be considered as a possible etiology of unilateral eyelid edema, even without a palpable mass or limitation of ocular motility. A biopsy should be performed in cases of unexplained eyelid edema.

Bimanual Force Coordination in Children with Spastic Unilateral Cerebral Palsy

ERIC Educational Resources Information Center

Smits-Engelsman, B. C. M.; Klingels, K.; Feys, H.

2011-01-01

In this study bimanual grip-force coordination was quantified using a novel "Gripper" system that records grip forces produced while holding a lower and upper unit, in combination with the lift force necessary to separate these units. Children with unilateral cerebral palsy (CP) (aged 5-14 years, n = 12) were compared to age matched typically…

Biomechanics of the lower thoracic spine after decompression and fusion: a cadaveric analysis.

PubMed

Lubelski, Daniel; Healy, Andrew T; Mageswaran, Prasath; Benzel, Edward C; Mroz, Thomas E

2014-09-01

Few studies have evaluated the extent of biomechanical destabilization of thoracic decompression on the upper and lower thoracic spine. The present study evaluates lower thoracic spinal stability after laminectomy, unilateral facetectomy, and unilateral costotransversectomy in thoracic spines with intact sternocostovertebral articulations. To assess the biomechanical impact of decompression and fixation procedures on lower thoracic spine stability. Biomechanical cadaveric study. Sequential surgical decompression (laminectomy, unilateral facetectomy, unilateral costotransversectomy) and dorsal fixation were performed on the lower thoracic spine (T8-T9) of human cadaveric spine specimens with intact rib cages (n=10). An industrial robot was used to apply pure moments to simulate flexion-extension (FE), lateral bending (LB), and axial rotation (AR) in the intact specimens and after decompression and fixation. Global range of motion (ROM) between T1-T12 and intrinsic ROM between T7-T11 were measured for each specimen. The decompression procedures caused no statistically significant change in either global or intrinsic ROM compared with the intact state. Instrumentation, however, reduced global motion for AR (45° vs. 30°, p=.0001), FE (24° vs. 19°, p=.02), and LB (47° vs. 36°, p=.0001) and for intrinsic motion for AR (17° vs. 4°, p=.0001), FE (8° vs. 1°, p=.0001), and LB (12° vs. 1°, p=.0001). No significant differences were identified between decompression of the upper versus lower thoracic spine, with trends toward significantly greater ROM for AR and lower ROM for LB in the lower thoracic spine. The lower thoracic spine was not destabilized by sequential unilateral decompression procedures. Addition of dorsal fixation increased segment rigidity at intrinsic levels and also reduced overall ROM of the lower thoracic spine to a greater extent than did fusing the upper thoracic spine (level of the true ribs). Despite the lack of true ribs, the lower thoracic spine was not significantly different compared with the upper thoracic spine in FE and LB after decompression, although there were trends toward significance for greater AR after decompression. In certain patients, instrumentation may not be needed after unilateral decompression of the lower thoracic spine; further validation and additional clinical studies are warranted. Copyright © 2014 Elsevier Inc. All rights reserved.

A comparison of upper limb amputees and patients with upper limb injuries using the Disability of the Arm, Shoulder and Hand (DASH).

PubMed

Davidson, Judith

To use the Disability of the Arm Shoulder and Hand (DASH) scale to measure the disability of patients with upper limb amputation(s) and to compare these to other upper limb injuries. All 274 patients over the age of 18 years presenting to Prince Henry Hospital in Sydney over a 4-year time frame were given the DASH assessment tool and asked to complete it under supervision of the Occupational Therapist. Patients with brachial plexus injuries, Complex Regional Pain Syndrome and bilateral upper limb amputations demonstrated significantly higher levels of disability to patients with unilateral upper limb amputations. Partial hand amputees reported a higher level of disability than major unilateral upper limb amputees. For the 48 patients who completed pre- and post-treatment assessments, there was a significant improvement in their health status. Further research is required to understand the factors that affect a patient's perceptions of their disability. Perhaps the definitive nature of an amputation and the immediate involvement of highly skilled health professionals serve to assist patients to accept their injury and therefore minimizes the level of disability.

Image analysis of the eruptive positions of third molars and adjacent second molars as indicators of age evaluation in Thai patients

PubMed Central

Pramojanee, Sakarat; Thaiupathump, Trasapong

2013-01-01

Purpose This study was performed to determine the relationship between the stage of tooth eruption (both vertical and mesio-angular) and chronological age. Materials and Methods Indirect digital panoramic radiographs were used to measure the distances from the dentinoenamel junction (DEJ) of the second molars to the occlusal plane of the second molar teeth and of the adjacent third molars in 264 Thai males and 437 Thai females using ImageJ software. The ratio of those distances was calculated by patient age, and the correlation coefficient of the ratio of the third molar length to the second molar length was calculated. Results The correlation between the height of the vertically erupted upper third molar teeth and age was at the intermediate level. The age range of ≥15 to <16 years was noted to be the range in which the correlation between the chronological age determined from the eruptional height and actual chronological age was statistically significant. The mean age of the female subjects, in which the position of the right upper third molar teeth was at or above the DEJ of the adjacent second molar but below one half of its coronal height was 19.9±2.6 years. That for the left side was 20.2±2.7 years. The mean ages of the male subjects were 20.1±3.3 years and 19.8±2.7 years for the right and left sides, respectively. Conclusion It might be possible to predict chronological age from the eruption height of the wisdom teeth. PMID:24380069

Sequencing bilateral and unilateral task-oriented training versus task oriented training alone to improve arm function in individuals with chronic stroke.

PubMed

McCombe Waller, Sandy; Whitall, Jill; Jenkins, Toye; Magder, Laurence S; Hanley, Daniel F; Goldberg, Andrew; Luft, Andreas R

2014-12-14

Recovering useful hand function after stroke is a major scientific challenge for patients with limited motor recovery. We hypothesized that sequential training beginning with proximal bilateral followed by unilateral task oriented training is superior to time-matched unilateral training alone. Proximal bilateral training could optimally prepare the motor system to respond to the more challenging task-oriented training. Twenty-six participants with moderate severity hemiparesis Intervention: PARTICIPANTS received either 6-weeks of bilateral proximal training followed sequentially by 6-weeks unilateral task-oriented training (COMBO) or 12-weeks of unilateral task-oriented training alone (SAEBO). A subset of 8 COMB0 and 9 SAEBO participants underwent three functional magnetic resonance imaging (fMRI) scans of hand and elbow movement every 6 weeks. Fugl-Meyer Upper extremity scale, Modified Wolf Motor Function Test, University of Maryland Arm Questionnaire for Stroke, Motor cortex activation (fMRI). The COMBO group demonstrated significantly greater gains between baseline and 12-weeks over all outcome measures (p = .018 based on a MANOVA test) and specifically in the Modified Wolf Motor Function test (time). Both groups demonstrated within-group gains on the Fugl-Meyer Upper Extremity test (impairment) and University of Maryland Arm Questionnaire for Stroke (functional use). fMRI subset analyses showed motor cortex (primary and premotor) activation during hand movement was significantly increased by sequential combination training but not by task-oriented training alone. Sequentially combining a proximal bilateral before a unilateral task-oriented training may be an effective way to facilitate gains in arm and hand function in those with moderate to severe paresis post-stroke compared to unilateral task oriented training alone.

Unilateral RS3PE in a Patient of Seronegative Rheumatoid Arthritis.

PubMed

Varshney, Ankur Nandan; Kumar, Nilesh; Tiwari, Ashutosh; Anand, Ravi; Prasad, Sashi Ranjan; Anand, Arvind; Mishra, Abhinandan; Singh, N K

2013-01-01

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare but well-reported clinical entity. It is classically described as symmetrical involvement of both upper extremities. Asymmetrical involvement had also been reported, but unilateral presentation is very rare. We hereby report a case of unilateral RS3PE in a patient of seronegative rheumatoid arthritis which was initially misdiagnosed as cellulitis and was given high dose antibiotics without any significant improvement. Later a rheumatologic consultation leads to a prompt diagnosis, and treatment with steroids leads to dramatic reversal of symptoms. This case demonstrates the rare presentation of this rare clinical entity and highlights the necessity of awareness regarding unilateral disease to clinicians.

Evolution and function of the upper molar talon and its dietary implications in microbats.

PubMed

Gutzwiller, Sarah C; Hunter, John P

2015-11-01

The evolution of mammalian molars has been marked by transitions representing significant changes in shape and function. One such transition is the addition and elaboration of the talon, the distolingual region of the ancestral tribosphenic upper molar of therian mammals and some extinct relatives. This study uses suborder Microchiroptera as a case study to explore the adaptive implications of the expansion of the talon on the tribosphenic molar, specifically focusing on the talon's role in the compression and shear of food during breakdown. Three-dimensional computer renderings of casts of the upper left first molars were created for microbat species of a variety of dietary categories (frugivore, etc.) and physical properties of food (hard and soft). Relief Index (RFI) was measured to estimate the topography and function of the whole tooth and of the talon and trigon (the remaining primitive tribosphenic region) individually, in order to examine 1) how the shape of the whole tooth, trigon, and talon reflects the compromise between their crushing and shearing functions, 2) how whole tooth, trigon, and talon function differs according to diet, and 3) how the presence of the talon affects overall molar function. Results suggest that RFI of both the whole tooth and the trigon varies according to dietary groups, with frugivores having greater crushing function when compared with the other groups. The talon, however, consistently has low RFI (a flatter topography), and its presence lowers the RFI of the whole tooth across all dietary categories, suggesting that the talon is primarily functioning in crushing during food breakdown. The potential benefits of a crushing talon for microbats of various dietary groups are discussed. © 2015 Wiley Periodicals, Inc.

Site specific mineral composition and microstructure of human supra-gingival dental calculus.

PubMed

Hayashizaki, Junko; Ban, Seiji; Nakagaki, Haruo; Okumura, Akihiko; Yoshii, Saori; Robinson, Colin

2008-02-01

Dental calculus has been implicated in the aetiology of several periodontal conditions. Its prevention and removal are therefore desirable clinical goals. While it is known that calculus is very variable in chemical composition, crystallinity and crystallite size little is known about site specific variability within a dentition and between individuals. With this in mind, a study was undertaken to investigate the comparative site specific nature and composition of human dental supra-gingival dental calculus obtained from 66 male patients visiting for their dental check-up using fluorescent X-ray spectroscopy, X-ray diffractometry and Fourier transform infrared spectroscopy. The supra-gingival dental calculus formed on the lingual surfaces of lower anterior teeth and the buccal surfaces of upper molar teeth were classified into four types based on calcium phosphate phases present. There was significant difference in composition of the crystal phase types between lower and upper teeth (p<0.01). There was no significant difference in crystal size between dental calculus on anterior or molar teeth of all samples. The degree of crystallinity of dental calculus formed on the upper molar teeth was higher than that formed on the lower anterior teeth (p<0.01). The CO(3)(2-) contents in dental calculus formed on the lower anterior teeth were higher than on upper molar teeth (p<0.05) which might explain the difference in crystallinity. Magnesium and Si contents and Ca:P ratio on the other hand showed no significant difference between lower and upper teeth. It was concluded that the crystal phases, crystallinity and CO(3)(2-) contents of human dental supra-gingival dental calculus is related to its location in the mouth.

Finite element analysis of stress distribution on the mandible and condylar fracture osteosynthesis during various clenching tasks.

PubMed

Hijazi, Loai; Hejazi, Wael; Darwich, Mhd Ayham; Darwich, Khaldoun

2016-12-01

The purpose of the study was to evaluate the effect of clenching tasks on the stress and strain of condylar osteosynthesis screws and plates, as well as on the stress, strain distribution and displacement on the whole mandible and bone surrounding screws. Three-dimensional finite element models of the mandible, two straight four-hole plates and eight screws were established. Six static clenching tasks were simulated in this study: incisal clench (INC), intercuspal position (ICP), right unilateral molar clench (RMOL), left unilateral molar clench (LMOL), right group function (RGF) and left group function (LGF). Based on the simulation of the six clenching tasks, none of the inserted screws and plates were broken or bended. For the whole mandibular bone, the maximum von Mises stress and von Mises strain observed were yielded by the ICP. For the bone surrounding the inserted screws, the maximum von Mises stress and von Mises strain were yielded by the LMOL (49.2 MPa and 3795.1 μ). Clenching tasks had significant effects on the stress distribution on the condylar osteosynthesis and the bone surrounding screws. Contralateral occlusion task (LMOL) had the maximal results of von Mises stress and strain and healing problems could be occur, this result confirms the importance of soft diet after surgery.

Dental age assessment of young Iranian adults using third molars: A multivariate regression study.

PubMed

Bagherpour, Ali; Anbiaee, Najmeh; Partovi, Parnia; Golestani, Shayan; Afzalinasab, Shakiba

2012-10-01

In recent years, a noticeable increase in forensic age estimations of living individuals has been observed. Radiologic assessment of the mineralisation stage of third molars is of particular importance, with regard to the relevant age group. To attain a referral database and regression equations for dental age estimation of unaccompanied minors in an Iranian population was the goal of this study. Moreover, determination was made concerning the probability of an individual being over the age of 18 in case of full third molar(s) development. Using the scoring system of Gleiser and Hunt, modified by Köhler, an investigation of a cross-sectional sample of 1274 orthopantomograms of 885 females and 389 males aged between 15 and 22 years was carried out. Using kappa statistics, intra-observer reliability was tested. With Spearman correlation coefficient, correlation between the scores of all four wisdom teeth, was evaluated. We also carried out the Wilcoxon signed-rank test on asymmetry and calculated the regression formulae. A strong intra-observer agreement was displayed by the kappa value. No significant difference (p-value for upper and lower jaws were 0.07 and 0.59, respectively) was discovered by Wilcoxon signed-rank test for left and right asymmetry. The developmental stage of upper right and upper left third molars yielded the greatest correlation coefficient. The probability of an individual being over the age of 18 is 95.6% for males and 100.0% for females in case four fully developed third molars are present. Taking into consideration gender, location and number of wisdom teeth, regression formulae were arrived at. Use of population-specific standards is recommended as a means of improving the accuracy of forensic age estimates based on third molars mineralisation. To obtain more exact regression formulae, wider age range studies are recommended. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Class, type and position of 9148 surgically removed third molars in 3206 patients: A retrospective study

PubMed Central

Rocha-Navarro, Miriam L.; Acosta-Veloz, Anselmo L.; Juárez-Hernández, Angélica

2012-01-01

Objective: To investigate the class, type, position, diagnosis and most common procedures used in the surgical removal of third molars, and evaluate the sex and age distribution in a representative sample of Mexican patients. Study Design: A retrospective descriptive study was made covering the period 1993-2008 in relation to 9148 extracted third molars in 3206 patients treated in the Dental School of Salle Bajío University, A.C. (Mexico). Patients of either sex and aged 11-59 years, with at least one third molar programmed for surgical removal, were included in the study. A descriptive statistical study was made. Results: The mean patient age was 27.6 ± 10.6 years. There were 2093 females (65.3%) and 1111 males (34.6%). In relation to the 4025 upper molars, extraction was decided for prophylactic reasons in 3827 cases (95.08%). Type A presentations were recorded in 1929 cases (47.9%), with a vertical position in 1931 teeth (48%). In relation to the 5123 lower third molars, extraction was likewise most often indicated for prophylactic reasons (4424 cases, 86.36%). A total of 2353 teeth corresponded to type A (45.9%), 2545 were class I cases (49.7%), and a mesioangular position was observed in 1850 cases (36.1%). Conclusions: The present study shows that in Mexican patients, upper third molars most often correspond to type A and class I, with a vertical position, while lower third molars predominantly correspond to type A and class I, with a mesioangular position. This information can help dental surgeons take better decisions before and after surgery, to the benefit of their patients. Key words:Third molars, retrospective review, surgical removal. PMID:22143723

Association between third molar agenesis and craniofacial structure development.

PubMed

Ramiro-Verdugo, Jara; De Vicente-Corominas, Elena; Montiel-Company, José María; Gandía-Franco, José Luís; Bellot-Arcís, Carlos

2015-11-01

The aim of this investigation was to study the relationship between third molar agenesis-including the number of ageneses-and craniofacial structure growth. We reviewed 305 clinical histories of patients treated at the Orthodontics Unit of the Faculty of Medicine and Dentistry at the University of Valencia in Spain. This included radiographic records of optimal quality. Of these, 40 patients who had agenesis of at least 1 third molar were included in the study group. A control group was formed with another 40 patients with all 4 third molars present. For both groups, a further criterion for inclusion was cone-beam computed tomography records. The cephalometric analysis was performed with NemoCeph 3D software (version 11.3.1.38; Nemotec, Madrid, Spain). The only significant differences between the 2 groups were in the total gonial angle and the upper gonial angle (P ≤0.05), both of which were smaller in the study group. Third molar agenesis is associated with a reduction in Jarabak's gonial angle and upper gonial angle, characteristic of patients with a more horizontal or brachyfacial skeletal pattern. No significant differences were found in other measurements. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Analgesic and sedative effects of intranasal dexmedetomidine in third molar surgery under local anaesthesia.

PubMed

Cheung, C W; Ng, K F J; Liu, J; Yuen, M Y V; Ho, M H A; Irwin, M G

2011-09-01

Dexmedetomidine (DEX) is an alpha 2-adrenoreceptor agonist, which induces sedation and analgesia. This study aimed to determine whether intranasal DEX offered perioperative sedation and better postoperative analgesia. Patients having unilateral third molar surgery under local anaesthesia were recruited and allocated to receive either intranasal DEX 1 µg kg(-1) (Group D) or same volume of saline (Group P) 45 min before surgery. Patient-controlled sedation with propofol was offered as a rescue sedative. Perioperative sedation, postoperative pain relief and analgesic consumption, vital signs, adverse events, postoperative recovery, and satisfaction in sedation and analgesia were assessed. Thirty patients from each group were studied. Areas under curve (AUC) of postoperative numerical rating scale (NRS) pain scores 1-12 h at rest and during mouth opening were significantly lower in Group D (P=0.003 and 0.009, respectively). AUC BIS values and OAA/S sedation scores were significantly lower before surgery and at the recovery area (all P<0.01) with significantly less intra-operative propofol used in group D (P<0.01). In group D, heart rate was significantly lower at recovery period (P=0.005) while systolic blood pressure in different periods of the study (all P<0.01), but the decreases did not require treatment. More patients from placebo group experienced dizziness (P=0.026) but no serious adverse event was found. No difference was found in postoperative psychomotor recovery and satisfaction in pain relief and sedation. Patients receiving intranasal DEX for unilateral third molar surgery with local anaesthesia were more sedated perioperatively with better postoperative pain relief. No delay in psychomotor recovery was seen.

Unilateral RS3PE in a Patient of Seronegative Rheumatoid Arthritis

PubMed Central

Varshney, Ankur Nandan; Kumar, Nilesh; Tiwari, Ashutosh; Anand, Ravi; Prasad, Sashi Ranjan; Anand, Arvind; Mishra, Abhinandan; Singh, N. K.

2013-01-01

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare but well-reported clinical entity. It is classically described as symmetrical involvement of both upper extremities. Asymmetrical involvement had also been reported, but unilateral presentation is very rare. We hereby report a case of unilateral RS3PE in a patient of seronegative rheumatoid arthritis which was initially misdiagnosed as cellulitis and was given high dose antibiotics without any significant improvement. Later a rheumatologic consultation leads to a prompt diagnosis, and treatment with steroids leads to dramatic reversal of symptoms. This case demonstrates the rare presentation of this rare clinical entity and highlights the necessity of awareness regarding unilateral disease to clinicians. PMID:23662237

Posterior Percutaneous Endoscopic Cervical Foraminotomy and Diskectomy With Unilateral Biportal Endoscopy.

PubMed

Park, Jae Hyun; Jun, Su Gi; Jung, Je Tae; Lee, Sang Jin

2017-09-01

This report describes a new, minimally invasive procedure, posterior percutaneous endoscopic cervical diskectomy, performed with a unilateral biportal endoscopic approach. The procedure is used to treat cervical foraminal soft disk protrusion. This report also describes the short-term results with this procedure. In 2015, 14 patients underwent this new, minimally invasive procedure. The technique was applied with a standard arthroscopy device and conventional spine instruments. The Neck Disability Index and visual analog scale scores for the neck and upper arm were evaluated, and 13 consecutive patients were included in the analysis. Mean follow-up was 14.8 months (range, 12-18 months). The Neck Disability Index decreased from 27.0±2.5 to 6.8±1.4 at the last follow-up (P<.05). Visual analog scale scores for the neck and upper arm also decreased significantly (neck, 6.2±0.8 to 2.4±0.9; upper arm, 7.0±1.1 to 2.2±0.6). Posterior percutaneous endoscopic cervical diskectomy with a uniportal endoscope provides a clear operative field because of continuous endoscopic saline irrigation and requires only a short hospitalization and no postoperative rehabilitation. Posterior percutaneous endoscopic cervical diskectomy with a unilateral biportal endoscopic approach also can be performed efficiently because of the wide field of visualization and familiar surgical field. Thus, posterior percutaneous endoscopic cervical diskectomy with the unilateral biportal endoscopic approach may be an alternative procedure for cervical foraminal soft disk protrusion. [Orthopedics. 2017; 40(5):e779-e783.]. Copyright 2017, SLACK Incorporated.

Orthodontic Replacement of Lost Permanent Molar with Neighbor Molar: A Six-Year Follow-Up

PubMed Central

Shintcovsk, Ricardo Lima; Knop, Luegya Amorim Henriques; Sampaio, Luana Paz

2017-01-01

Extraction is very frequent indication in orthodontic planning, especially when there are crowding, biprotrusion, and aesthetically unpleasant profiles. Next to extraction comes space closure, which represents a challenge for orthodontists because of extended treatment time, discomfort created for the patient, tissue tolerance, and stability concerns. When it comes to what mechanics to choose for space closure, loops present two major advantages in relation to sliding mechanics: absence of abrasion and possibility to reach pure dental translation. A case is presented where an adult female patient with early loss of the first lower permanent molars, minor lower crowding, and tooth biprotrusion was treated with upper first bicuspids extraction along with upper and lower space closure done with T-loops to promote best space closure control in order to correct the malocclusion and enhance facial aesthetics. PMID:29318054

Cohort study of pain symptoms and management following impacted mandibular third molar extraction.

PubMed

Motonobu, A; Hidemichi, Y; Eri, U; Takashi, T; Kenichi, K

2017-01-01

The aim of this study was to investigate the possibility of intravenous sedation as a useful pain-relieving option for impacted third molar extractions. A prospective cohort study was conducted among patients who underwent bilateral mandibular third molar extractions under local anaesthesia and intravenous sedation (sedation group) and patients who underwent unilateral mandibular third molar extraction under local anaesthesia alone (local anaesthesia group). The frequency of use of postoperative oral analgesia and the intensity of pain assessed using the full cup test were compared between the two groups. The maximum pain intensity (0-100) on postoperative day 1 in the sedation and local anaesthesia groups was 72.8 ± 16.98 and 84.8 ± 15.84, respectively, and the mean pain intensity was 42.2 ± 16.00 and 49.6 ± 18.94. The maximum and mean pain intensities in the sedation group were significantly milder than those in the local anaesthesia group. The number of oral analgesic doses in the sedation group was significantly smaller on the day of surgery and on postoperative day 1 than in the local anaesthesia group. The results of this study suggest that bilateral impacted mandibular third molar extractions under intravenous sedation could be a recommended treatment option. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Evaluation of unilateral cleft lip and palate using anthropometry measurements post-alveolar bone grafting

NASA Astrophysics Data System (ADS)

Simorangkir, H. J.; Hak, M. S.; Tofani, I.

2017-08-01

Rehabilitation of patients with unilateral cleft lip and palate (UCLP) requires multiple steps and coordination of multidisciplinary sciences to produce optimal results. Alveolar bone-grafting (ABG) is an important procedure in the treatment of such patients because it influences the eruption of teeth and stabilizes the maxilla. To evaluate the effect and suitability of alveolar bone grafting procedure at Cleft Center Harapan Kita Maternal and Child Hospital on nasal deformity from anthropometry with photogrammetry and aesthetic proportional in patients with unilateral cleft lip and palate with UCLP. Patients with UCLP were evaluated post-ABG using anthropometry and photogrammetry to investigate the results anteriorly, laterally, and basally. Anthropometric measurements taken photogrammetrically used 14 points and 11 distance items. Evaluations were made of upper lip length, upper lip projection, and nostril sill elevation for both the cleft and non-cleft sides of patients’ faces. A t-test showed that the values for upper lip length and projection were significantly increased, and a correction test using a Fisher exam gave a value of 1. The ABG treatment protocol for patients with UCLP at the Cleft Lip and Palate Unit at Harapan Kita Maternal and Child Hospital is suitable to be performed; it aesthetically satisfies patients and their families.

Unilateral Trans-cerebellomedullary Fissure Approach for Occipital Artery to Posterior Inferior Cerebellar Artery Bypass during Aneurysmal Surgery.

PubMed

Abe, Hiroshi; Miki, Koichi; Kobayashi, Hiromasa; Ogata, Toshiyasu; Iwaasa, Mitsutoshi; Matsushima, Toshio; Inoue, Tooru

2017-06-15

Occipital artery (OA) to the posterior inferior cerebellar artery (PICA) bypass is indispensable for the management of complex aneurysms of the PICA that cannot be reconstructed with surgical clipping or coil embolization. Although OA-PICA bypass is a comparatively standard procedure, the bypass is difficult to perform in some cases because of the location and situation of the PICA. We describe the usefulness of the unilateral trans-cerebellomedullary fissure (CMF) approach for OA-PICA bypass. Thirty patients with aneurysms in the vertebral artery (VA) or PICA were treated using OA-PICA bypasses between 2010 and 2015. Among them, the unilateral trans-CMF approach was used for OA-PICA anastomosis in 13 patients. The surgical procedures performed on and the medical records of all the patients were retrospectively reviewed. The unilateral trans-CMF approach was performed for two reasons depending on the PICA location or situation: either because the caudal loop could not be used as a recipient artery because of arterial dissection (3 patients) or because the tonsillo-medullary segment that was located in the upper part of the CMF did not have a caudal loop that was large enough (10 patients). The trans-CMF approach provided a good operative field for the OA-PICA bypass and the anastomosis were successfully performed in all patients. When the recipient artery was located in the upper part of the CMF, the unilateral trans-cerebello-medullary fissure approach provided a sufficient operative field for OA-PICA anastomosis.

Unilateral Trans-cerebellomedullary Fissure Approach for Occipital Artery to Posterior Inferior Cerebellar Artery Bypass during Aneurysmal Surgery

PubMed Central

ABE, Hiroshi; MIKI, Koichi; KOBAYASHI, Hiromasa; OGATA, Toshiyasu; IWAASA, Mitsutoshi; MATSUSHIMA, Toshio; INOUE, Tooru

2017-01-01

Occipital artery (OA) to the posterior inferior cerebellar artery (PICA) bypass is indispensable for the management of complex aneurysms of the PICA that cannot be reconstructed with surgical clipping or coil embolization. Although OA-PICA bypass is a comparatively standard procedure, the bypass is difficult to perform in some cases because of the location and situation of the PICA. We describe the usefulness of the unilateral trans-cerebellomedullary fissure (CMF) approach for OA-PICA bypass. Thirty patients with aneurysms in the vertebral artery (VA) or PICA were treated using OA-PICA bypasses between 2010 and 2015. Among them, the unilateral trans-CMF approach was used for OA-PICA anastomosis in 13 patients. The surgical procedures performed on and the medical records of all the patients were retrospectively reviewed. The unilateral trans-CMF approach was performed for two reasons depending on the PICA location or situation: either because the caudal loop could not be used as a recipient artery because of arterial dissection (3 patients) or because the tonsillo-medullary segment that was located in the upper part of the CMF did not have a caudal loop that was large enough (10 patients). The trans-CMF approach provided a good operative field for the OA-PICA bypass and the anastomosis were successfully performed in all patients. When the recipient artery was located in the upper part of the CMF, the unilateral trans-cerebello-medullary fissure approach provided a sufficient operative field for OA-PICA anastomosis. PMID:28484132

Marcus Gunn jaw-winking synkinesis: clinical features and management.

PubMed

Demirci, Hakan; Frueh, Bartley R; Nelson, Christine C

2010-07-01

To evaluate the clinical features including eyelid excursion and management of Marcus Gunn jaw-winking synkinesis (MGJWS). Observational case series. Forty-eight consecutive patients with MGJWS. Clinical features and management of 48 patients with MGJWS were reviewed retrospectively. Upper eyelid excursion was measured and graded. Complications of surgical intervention were evaluated. Resolution of MGJWS and symmetry of upper eyelids in primary position. Excursion of the ptotic eyelid with jaw movement in MGJWS was graded as mild (<2 mm) in 16% of patients, moderate (2-4 mm) in 76% of patients, and severe (> or = 5 mm) in 8% of patients. Thirty patients with moderate or severe MGJWS underwent disabling of the involved levator muscle and bilateral or unilateral frontalis suspension and had more than 6 months of follow-up. After a mean follow-up of 62 months, MGJWS resolved in 29 (97%) patients and improved from 6 mm to 2 mm in 1 (3%) patient. Relative upper eyelid height was within 1 mm in 87% of patients in primary position and within 1 mm in 80% of patients in downgaze. Twenty-six patients had bilateral frontalis suspension with disabling of unilateral levator muscle on the involved side. Relative upper eyelid height was within 1 mm in 88% of patients in the primary position and within 1 mm in 88% of patients in downgaze. Four non-amblyopic patients had unilateral frontalis suspension with levator muscle disabling. Relative upper eyelid height was symmetrical in 75% of the patients in primary position and in 25% of patients in downgaze. Complications included eyelash ptosis in 10% of the patients, loss of eyelid crease in 10%, and entropion in 3%. Most of the patients with MGJWS exhibited moderate eyelid excursion. Disabling of the involved levator muscle and bilateral frontalis suspension and, in selected cases, disabling of the involved levator muscle and unilateral frontalis suspension were effective in the treatment of MGJWS. Eyelash ptosis and loss of eyelid crease were the most common complications, each occurring in 10% of the patients. The author(s) have no proprietary or commercial interest in any materials discussed in this article. Copyright 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Skeletal and dental stability after maxillary distraction with a rigid external device in adult cleft lip and palate patients.

PubMed

Aksu, Muge; Saglam-Aydinatay, Banu; Akcan, Cenk Ahmet; El, Hakan; Taner, Tulin; Kocadereli, Ilken; Tuncbilek, Gokhan; Mavili, Mehmet Emin

2010-02-01

To evaluate skeletal and dental stability in adult cleft lip and palate patients treated with a rigid external distraction system at the end of distraction and during the postdistraction period. Lateral cephalograms of 7 patients were obtained before distraction, at the end of distraction, and during the postdistraction period. The mean age before distraction was 21.56 +/- 4.73 years. The mean follow-up was 37.3 +/- 12.4 months. The assessment of findings showed that skeletal maxillary sagittal movement was achieved in a superoanterior direction. The maxillary depth angle and effective maxillary length increased significantly (2 degrees and 9 mm, respectively) after distraction, whereas the palatal plane angle increased by 8 degrees , resulting in an anterior movement of the maxilla with a counterclockwise rotation. The lower facial height showed no significant changes after distraction. The sagittal movement of the upper incisors and the angulation of the upper first molars increased significantly (4.5 mm and 5.5 degrees , respectively). During the postdistraction period, the maxilla showed a slight relapse (22%). The effective maxillary length decreased by 2 mm. The palatal plane angle almost returned to its original position, showing 7 degrees of clockwise rotation. The lower facial height remained stable. The upper incisors moved anteriorly and the upper first molars showed a significant mesioangular change during follow-up. After distraction, significant maxillary advancement was achieved with a counterclockwise rotation. The upper incisors moved labially, and the upper first molars angulated mesially. After 3 years, a 22% relapse rate was seen in the maxilla. The counterclockwise rotation of the maxilla was returned to its original position. The upper incisors moved more anteriorly. Copyright 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Diet of upper paleolithic modern humans: evidence from microwear texture analysis.

PubMed

El Zaatari, Sireen; Hublin, Jean-Jacques

2014-04-01

This article presents the results of the occlusal molar microwear texture analysis of 32 adult Upper Paleolithic modern humans from a total of 21 European sites dating to marine isotope stages 3 and 2. The occlusal molar microwear textures of these specimens were analyzed with the aim of examining the effects of the climatic, as well as the cultural, changes on the diets of the Upper Paleolithic modern humans. The results of this analysis do not reveal any environmentally driven dietary shifts for the Upper Paleolithic hominins indicating that the climatic and their associated paleoecological changes did not force these humans to significantly alter their diets in order to survive. However, the microwear texture analysis does detect culturally related changes in the Upper Paleolithic humans' diets. Specifically, significant differences in diet were found between the earlier Upper Paleolithic individuals, i.e., those belonging to the Aurignacian and Gravettian contexts, and the later Magdalenian ones, such that the diet of the latter group was more varied and included more abrasive foods compared with those of the former. Copyright © 2014 Wiley Periodicals, Inc.

Modified Constraint-Induced Movement Therapy Combined with Bimanual Training (mCIMT-BiT) in Children with Unilateral Spastic Cerebral Palsy: How Are Improvements in Arm-Hand Use Established?

ERIC Educational Resources Information Center

Aarts, Pauline B.; Jongerius, Peter H.; Geerdink, Yvonne A.; van Limbeek, Jacques; Geurts, Alexander C.

2011-01-01

A recent randomized controlled trial indicated that modified Constraint-Induced Movement Therapy followed by Bimanual Training (mCIMT-BiT) is an effective intervention to improve spontaneous use of the affected upper limb in children with unilateral spastic cerebral palsy (CP). The present study aimed to investigate how the above-mentioned…

Six-year follow-up in skeletal Class III patient aged over 40 receiving orthognathic surgery and autotransplantation: a case report.

PubMed

Motegi, Etsuko; Takane, Yumi; Tokunaga, Eri; Sueishi, Kenji; Takano, Nobuo; Shibahara, Takahiko; Saito, Chikara

2009-08-01

This paper describes the post-operative course of care in a patient requiring orthognathic surgery for skeletal mandibular protrusion in whom autotransplantation of a third molar was performed. A lower third molar that had to be removed for sagittal split ramus osteotomy (SSRO) was transplanted to replace the missing right second molar during pre-surgical orthodontic treatment, contributing to post-treatment occlusal stability. A 44-year-old woman presented with mandibular protrusion. The upper left second molar was congenitally missing and the lower right second molar had been extracted. She was diagnosed as having skeletal mandibular protrusion with excess vertical growth of the mandible and anterior open bite. Correction of the skeletal problem required orthognathic surgery by SSRO and Le Fort I osteotomy without orthodontic tooth extraction. At month 5 during 18 months of pre-surgical orthodontic treatment, the lower left third molar was transplanted to the lower right second molar site. Active treatment was completed after 7 months of post-surgical orthodontic treatment. The patient wore upper and lower Begg-type removable retainers for approximately 2 years. She returned for a recall checkup at 6 years post-treatment. Although radiographic examination revealed root resorption and ankylosis of the autotransplanted tooth at 8 years after transplantation, occlusion has remained stable with no clinically significant complications. The autotransplanted tooth helped stabilize her occlusion and acted as a kind of temporary tooth prior to the final decision on treatment to be given such a dental implant.

Asymmetric severe skeletal Class II division 1 patient with temporomandibular joint disorder treated with zygomatic anchorage devices and Ni-Ti alloy wires.

PubMed

Ishida, Takayoshi; Ono, Takashi

2014-09-01

To describe the orthodontic treatment of a nongrowing 30-year-old woman with asymmetric severe skeletal Class II malocclusions (asymmetric Angle Class II), large overjet (16 mm), large overbite (8 mm), two congenitally missing mandibular incisors (presenting a deciduous anterior tooth), and signs and symptoms of temporomandibular joint disorder (TMD). We used novel improved super-elastic Ni-Ti alloy wires (ISWs) combined with Ni-Ti alloy coil springs, power hooks, and a zygomatic implant as reinforced anchorage to provide a constant and continuous mild force to the dentition. We successfully distalized maxillary molars, premolars, and retracted anterior teeth and corrected the asymmetric Angle Class II molar relationship using this system of zygomatic anchorage in conjunction with ISWs, Ni-Ti alloy open-coil springs, and crimpable power hook. The maxillary molars were distalized, and postero-occlusal relationships were improved to achieve Class I canine and molar relationships on both sides. Intrusion of the upper molars made the mandibular plane close. Ideal overbite and overjet relationships were established. Facial esthetics were improved with decreased upper and lower lip protrusion, and no symptoms of TMD were observed after treatment. The orthodontic treatment described here is a promising anchorage technique alternative to traditional techniques to improve severe skeletal Class II with TMD.

The effectiveness of pendulum, K-loop, and distal jet distalization techniques in growing children and its effects on anchor unit: A comparative study.

PubMed

Marure, Pravinkumar S; Patil, Raju Umaji; Reddy, Sumitra; Prakash, Amit; Kshetrimayum, Nillachandra; Shukla, Rajeevkumar

2016-01-01

A common strategy to correct Class II malocclusions using a nonextraction protocol in children is to move the maxillary molars distally using molar distalization appliances, which usually derive their anchorage from maxillary premolars, causing mesialization of premolars and protrusion of incisors. To evaluate the skeletal, dental and soft tissue changes produced by three different distalizing appliances, namely, pendulum, K-loop, and distal jet appliances. Sixty-six children of mean age 14.13 years requiring molar distalization were divided into three groups: Group I (pendulum appliance), Group II (K-loop), and Group III (distal jet). Lateral cephalometric films were taken before and after 5 months of molar distalization and following cephalometric parameters were used to assess the effects of maxillary molar distalization, namely, anteroposterior skeletal (SNA/SNB/ANB), vertical skeletal (face height ratio/Frankfort-mandibular plane [FMA]/angle formed between Maxillary plane & Mandibular plane (MM)), interdental (overjet/overbite), maxillary dentoalveolar, and soft tissue parameters. There was no significant age difference between the three groups. In overall treatment changes among the three groups, the Anteroposterior skeletal changes were not statistically significant, vertically FMA angle increased by 1.79° ± 2.25° and overbite reduced by 2.38 ± 1.83 mm. The maxillary first molars were distalized by an average of 4.70 ± 3.01 mm (Upper 6 [U6] to pterygoid vertical [PTV]). The maxillary central incisor labial tipping increased to an average of 1.61 ± 2.73 mm and cant of upper lip increased by 3.40° ± 5.88° are statistically significant (P < 0.05). All three distalization techniques in growing children produced significant effects on anchor unit. There was an increase in FMA angle, significant bite opening, proclination of the maxillary incisors and increase in the cant of the upper lip.

Dental occlusion analysis in the Mesolithic-Neolithic Age, Bronze Age, and Roman to Medieval times in Serbia: Tooth size comparison in skeletal samples.

PubMed

Pajević, Tina; Glišić, Branislav

2017-05-01

Anthropological studies have reported that tooth size decreases in the context of diet changes. Some investigations have found a reverse trend in tooth size from the prehistoric to the modern times. The aims of this study were to analyze tooth size in skeletal samples from Mesolithic-Neolithic Age, Bronze Age, and Roman to Medieval times to determine sex differences and establish a temporal trend in tooth size in the aforementioned periods. Well-preserved permanent teeth were included in the investigation. The mesiodistal (MD) diameter of all teeth and buccolingual (BL) diameter of the molars were measured. Effects of sex and site were tested by one-way ANOVA, and the combined effect of these factors was analyzed by UNIANOVA. Sexual dimorphism was present in the BL diameters of all molars and MD diameters of the upper first and the lower third molar. The lower canine was the most dimorphic tooth in the anterior region. The MD diameter of most teeth showed no significant difference between the groups, (sample from: Mesolithic-Neolithic Age-group 1; Bronze Age-group 2; Roman times-group 3; Medieval times-group 4), whereas the BL diameters of the upper second and the lower first molar were the largest in the first group. Multiple comparisons revealed a decrease in the BL diameter of the upper second and the lower first molar from the first to the later groups. Lower canine MD diameter exhibited an increase in the fourth group compared to the second group. On the basis of the MD diameter, a temporal trend could not be observed for most of the teeth. The lower canine exhibited an increase in the MD diameter from the prehistoric to the Medieval times. Changes of BL diameter were more homogeneous, suggesting that the temporal trend of molar size decreased from the Mesolithic-Neolithic to Medieval times in Serbia. Copyright © 2017. Published by Elsevier Ltd.

Post-treatment occlusal changes in Class II division 2 subjects treated with the Herbst appliance.

PubMed

Bock, Niko; Ruf, Sabine

2008-12-01

The aim of this retrospective study was to analyse and compare the post-treatment occlusal changes of Class II division 2 treatment with the Herbst appliance in early adolescent, late adolescent, and adult subjects. The subjects were 37 Class II division 2 patients (19 females and 18 males) treated at the Orthodontic Department, University of Giessen, Germany. All were in the late mixed or permanent dentition and exhibited a Class II molar relationship > or =0.5 cusp width (CW) bilaterally or > or =1.0 CW unilaterally, an overbite (OB) >3.0 mm, and two upper central incisors retroclined. The subjects were divided into three skeletal maturity groups based on evaluation of hand wrist radiographs: early adolescent (n = 10, stages MP3-E to MP3-FG at start of treatment, age range: 11.3-13.2 years), late adolescent (n = 14, stages MP3-G to MP3-I at start of treatment, age range: 14.1-16.4 years), and adult (n = 13, stages R-I to R-J at the start of treatment, age range: 16.3-25.6 years). Study casts from before treatment (T1), after Herbst-Tip-Edge-Multibracket appliance treatment (T2), and after an average retention time of 27 months (T3) were analysed. Statistical analysis was undertaken using t-tests for paired and unpaired samples. For the whole sample, the molar relationship at T3 was stable in 82.4 per cent, the canine relationship in 82.9 per cent, and OB in 75.7 per cent of the cases. In the different skeletal maturity groups, the stability of the molars, canines, and overbite was as follows: early adolescents: 95.0, 100.0, and 70.0 per cent, respectively; late adolescents: 92.9, 74.1, and 85.7 per cent, respectively; and adults 61.5, 80.8, 69.2 per cent, respectively. Occlusal correction of Class II division 2 malocclusions with Herbst treatment was relatively stable 2 years post-treatment. The outcome of treatment of adolescents was more stable than that of adults.

Unilateral eyelid angioedema with congestion of the right bulbar conjunctiva due to loxoprofen sodium.

PubMed

Tsuruta, Daisuke; Oshimo, Tomoko; Sowa, Junko; Ishii, Masamitsu; Kobayashi, Hiromi

2011-01-01

Angioedema is a variant of urticaria that causes deep dermal and subcutaneous swelling. It frequently is a unilateral reaction and usually lasts for several hours but may persist for several days. We report 2 cases of angioedema that involved the right upper and lower eyelids and was associated with congestion of the right bulbar conjunctiva; the symptoms started approximately 1 to 2 hours after taking loxoprofen sodium. All of the symptoms subsided after oral corticosteroid therapy. In both cases, an oral challenge test with 60 mg of loxoprofen sodium (contained in a tablet) caused swelling of the right upper eyelid within several hours, followed by swelling of the right bulbar conjunctiva. We believe the drug reaction in both patients is angioedema.

Taxonomic differences in deciduous upper second molar crown outlines of Homo sapiens, Homo neanderthalensis and Homo erectus.

PubMed

Bailey, Shara E; Benazzi, Stefano; Souday, Caroline; Astorino, Claudia; Paul, Kathleen; Hublin, Jean-Jacques

2014-07-01

A significant number of Middle to Late Pleistocene sites contain primarily (and sometimes only) deciduous teeth (e.g., Grotta del Cavallo, Mezmaiskaya, Blombos). Not surprisingly, there has been a recent renewed interest in deciduous dental variation, especially in the context of distinguishing Homo neanderthalensis and Homo sapiens. Most studies of the deciduous dentition of fossil hominins have focused on standard metrical variation but morphological (non-metric and morphometric) variation also promises to shed light on long standing taxonomic questions. This study examines the taxonomic significance of the crown outline of the deciduous upper second molar through principal components analysis and linear discriminant analysis. We examine whether or not the crown shape of the upper deciduous second molar separates H. neanderthalensis from H. sapiens and explore whether it can be used to correctly assign individuals to taxa. It builds on previous studies by focusing on crown rather than cervical outline and by including a large sample of geographically diverse recent human populations. Our samples include 17 H. neanderthalensis, five early H. sapiens, and 12 Upper Paleolithic H. sapiens. In addition, we include two Homo erectus specimens in order to evaluate the polarity of crown shape differences observed between H. neanderthalensis and H. sapiens. Our results show that crown outline shape discriminates H. sapiens and H. neanderthalensis quite well, but does not do well at distinguishing H. erectus from H. sapiens. We conclude that the crown outline shape observed in H. sapiens is a primitive retention and that the skewed shape observed in H. neanderthalensis is a derived condition. Finally, we explore the phylogenetic implications of the results for the H. erectus molars. Copyright © 2014 Elsevier Ltd. All rights reserved.

Carabelli's trait revisited: an examination of mesiolingual features at the enamel-dentine junction and enamel surface of Pan and Homo sapiens upper molars.

PubMed

Ortiz, Alejandra; Skinner, Matthew M; Bailey, Shara E; Hublin, Jean-Jacques

2012-10-01

Carabelli's trait is a morphological feature that frequently occurs on the mesiolingual aspect of Homo sapiens upper molars. Similar structures also referred to as Carabelli's trait have been reported in apes and fossil hominins. However, the morphological development and homology of these mesiolingual structures among hominoids are poorly understood. In this study, we employ micro-computed tomography to image the enamel-dentine junction (EDJ) and outer enamel surface (OES) of Pan (n = 48) and H. sapiens (n = 52) upper molars. We investigate the developmental origin of mesiolingual features in these taxa and establish the relative contribution of the EDJ and enamel cap to feature expression. Results demonstrate that mesiolingual features of H. sapiens molars develop at the EDJ and are similarly expressed at the OES. Morphological variation at both surfaces in this taxon can satisfactorily be assessed using standards for Carabelli's trait developed by the Arizona State University Dental Anthropology System (ASUDAS). Relative to H. sapiens, Pan has an even greater degree of correspondence in feature expression between the EDJ and OES. Morphological manifestations in Pan molars are not necessarily limited to the protocone and are best characterized by a lingual cingulum that cannot be captured by the ASUDAS. Cusp-like structures, similar to those seen in marked Carabelli's trait expressions in H. sapiens, were not found in Pan. This study provides a foundation for further analyses on the evolutionary history of mesiolingual dental traits within the hominoid lineage. It also highlights the wealth of morphological data that can be obtained at the EDJ for understanding tooth development and for characterizing tooth crown variation in worn fossil teeth. Copyright © 2012 Elsevier Ltd. All rights reserved.

Effects of first molar extraction on third molar angulation and eruption space.

PubMed

Bayram, Mehmet; Ozer, Mete; Arici, Selim

2009-02-01

The aim was to investigate the effects of orthodontic treatment with 4 first molar extractions on the angulations and eruption spaces of all third molars and to compare these changes with outcomes of nonextraction samples used as a control group. This study was carried out on standardized panoramic radiographs of 41 subjects (8 male, 33 female) with a mean age of 16.6 years (range 13 to 20 years). Twenty-one of the subjects were orthodontically treated with extraction of the 4 first permanent molars, and 20 had nonextraction treatment. The angulational changes and eruption spaces of third molars were evaluated on the panoramic radiographs taken before treatment and at the end of the observation period. Analysis of the linear variables demonstrated a statistically significant difference between the 2 groups for all third molar eruption spaces (P < .001). The mean differences in the third molar eruption spaces between the pretreatment and posttreatment values for the first molar extraction group were higher than those of the nonextraction cases. Orthodontic treatment accomplished with extractions of the permanent first molars increases the eruption spaces of third molars and decreases their impaction. In addition, it has greater favorable effect on the angulation of the upper third molars than of the lower third molars.

Impact of Intensive Upper Limb Rehabilitation on Quality of Life: A Randomized Trial in Children with Unilateral Cerebral Palsy

ERIC Educational Resources Information Center

Sakzewski, Leanne; Carlon, Stacey; Shields, Nora; Ziviani, Jenny; Ware, Robert S.; Boyd, Roslyn N.

2012-01-01

Aim: The aim of this study was to determine whether constraint-induced movement therapy is more effective than bimanual training in improving the quality of life of children with unilateral cerebral palsy (CP). Method: Sixty-three children (mean age 10y 2mo [SD 2y 6mo]; 33 males, 30 females) with CP of the spastic motor type (n = 59) or with…

An alternative clinical approach to achieve greater anterior than posterior maxillary expansion in cleft lip and palate patients.

PubMed

Oliveira, Dauro Douglas; Bartolomeo, Flávia Uchôa Costa; Cardinal, Lucas; Figueiredo, Daniel Santos Fonseca; Palomo, Juan Martin; Andrade, Ildeu

2014-11-01

Cleft lip and palate patients commonly present maxillary constriction, particularly in the anterior region. The aim of this case report was to describe an alternative clinical approach that used a smaller Hyrax screw unconventionally positioned to achieve greater anterior than posterior expansion in patients with complete unilateral cleft lip and palate. The idea presented here is to take advantage of a reduced dimension screw to position it anteriorly. When only anterior expansion was needed (patient 1), the appliance was soldered to the first premolar bands and associated to a transpalatal arch cemented to the first molars. However, when overall expansion was required (patient 2), the screw was positioned anteriorly, but soldered to the first molar bands. Intercanine, premolar, and first molar widths were measured on dental casts with a digital caliper. Pre-expansion and postexpansion radiographs and tomographies were also evaluated. A significant anterior expansion and no intermolar width increase were registered in the first patient. Although patient 2 also presented a greater anterior than posterior expansion, a noteworthy expansion occurred at the molar region. The alternative approach to expand the maxilla in cleft patients reported here caused greater anterior than posterior expansion when the Mini-Hyrax was associated to a transpalatal arch, and its reduced dimension also minimized discomfort and facilitated hygiene.

[The clinic skill in fixed appliance based on characteristics of Chinese normal occlusion].

PubMed

Bai, Ding; Luo, Song-jiao; Chen, Yang-xi; Xiao, Li-wei

2005-02-01

To study the bracket placement and arch wire bending based on ethnic differences and individual differences of normal occlusion. The prominence, tip, torque, upper first molar offset of crown and arch form between Chinese and Caucasian normal occlusion were compared. The results showed the ethnic differences of prominence, tip, torque, upper first molar offset of crown and arch form between Chinese and Caucasian normal occlusion. The placement of bracket was influenced by the crown morphology. The adjustments of the bracket placement and arch wire bending with Edgewise and pre-adjusted appliance are necessary to adapt to ethnic difference and individual difference.

Dentoskeletal and Soft Tissue Effects in the Treatment of Class II Malocclusion with Klammt's Elastic Open Activator.

PubMed

Inamassu-Lemes, Sheila Marques; Fuziy, Acácio; Costa, André Luiz Ferreira; Carvalho, Paulo Eduardo Guedes; Nahás-Scocate, Ana Carla Raphaelli

2016-01-01

The purpose of this study was to evaluate the dentoskeletal and soft tissue effects resulting from treatment with Klammt's elastic open activator (EOA) functional orthopedic appliance in patients with Class II malocclusion characterized by mandibular deficiency. Teleradiographs were evaluated in the lateral aspect of the initial (T1) and final (T2) orthopedic phases for 16 patients with Class II, Division 1 malocclusion. The age range was from 9 to 11.2 years, with a mean age of 9.9 years. The cephalometric points were demarcated, and cephalometric measurements were obtained by the same investigator to avoid interobserver variability. The EOA promoted increased lower anterior facial height (LAFH), increased effective mandibular length, clockwise rotation of the mandible, retrusion and verticalization of the upper incisors, proclination and protrusion of the lower incisors, extrusion of the upper molars, mesial movement of the lower molars and anterior projection of the lower lip. Skeletal changes characterized by an increase in mandibular length and dentoalveolar changes with an emphasis on the verticalization and retrusion of the upper incisors, proclination of the lower incisors and mesial positioning of the lower molars were key to improving the occlusal relationship and esthetic facial factors. The EOA is well indicated in patients with Class II malocclusion due to mandibular deficiency with increased overbite, proclined upper incisors and verticalized lower incisors.

Delayed dental maturity in dentitions with agenesis of mandibular second premolars.

PubMed

Daugaard, S; Christensen, I J; Kjaer, I

2010-11-01

To evaluate dental maturity in the mandibular canine/premolar and molar innervation fields in children with agenesis of the 2nd mandibular premolar and to associate these findings with normal control material. Department of Orthodontics, Institute of Odontology, University of Copenhagen. Eighty-three panoramic radiographs (27 girls and 31 boys with agenesis of one mandibular 2nd premolar and 17 girls and eight boys with agenesis of both mandibular 2nd premolars) represented all mandibular second premolar agenesis cases from a material of 2847 radiographs. On each radiograph, dental maturity of all available mandibular premolars, canines and 2nd molars was evaluated and categorized in maturity stages according to Haavikko whose material served as control material. Descriptive statistics given by sample mean, standard deviation and range for each tooth stratified by gender and agenesis. Ninety-five percentage confidence limits and T-statistics were used. p-values <5% were considered significant. In unilateral agenesis, the canines are specifically delayed in both girls and boys, with a larger delay in girls (p=0.009). The second molar is not delayed in boys (p=0.98) but is in girls (p=0.04). The differences in delay for the canine compared to the second molar are significant for both girls and boys. The results show a considerable delay in tooth maturation within the canine/premolar innervation field predominantly in girls. The 2nd molar is delayed in girls but not in boys. © 2010 John Wiley & Sons A/S.

Maxillary molar distalization with first class appliance

PubMed Central

Ramesh, Namitha; Palukunnu, Biswas; Ravindran, Nidhi; Nair, Preeti P

2014-01-01

Non-extraction treatment has gained popularity for corrections of mild-to-moderate class II malocclusion over the past few decades. The distalization of maxillary molars is of significant value for treatment of cases with minimal arch discrepancy and mild class II molar relation associated with a normal mandibular arch and acceptable profile. This paper describes our experience with a 16-year-old female patient who reported with irregularly placed upper front teeth and unpleasant smile. The patient was diagnosed to have angles class II malocclusion with moderate maxillary anterior crowding, deep bite of 4 mm on a skeletal class II base with an orthognathic maxilla and retrognathic mandible and normal growth pattern. She presented an ideal profile and so molar distalization was planned with the first-class appliance. Molars were distalised by 8 mm on the right and left quadrants and class I molar relation achieved within 4 months. The space gained was utilised effectively to align the arch and establish a class I molar and canine relation. PMID:24577171

Examining the Feasibility, Tolerability, and Preliminary Efficacy of Repetitive Task-Specific Practice for People With Unilateral Spatial Neglect

PubMed Central

Lang, Catherine E.; Birkenmeier, Rebecca; Holm, Margo; Rubinstein, Elaine; Van Swearingen, Jessie; Skidmore, Elizabeth R.

2016-01-01

OBJECTIVE. We examined the feasibility, tolerability, and preliminary efficacy of repetitive task-specific practice for people with unilateral spatial neglect (USN). METHOD. People with USN ≥6 mo poststroke participated in a single-group, repeated-measures study. Attendance, total repetitions, and satisfaction indicated feasibility and pain indicated tolerability. Paired t tests and effect sizes were used to estimate changes in upper-extremity use (Motor Activity Log), function (Action Research Arm Test), and attention (Catherine Bergego Scale). RESULTS. Twenty participants attended 99.4% of sessions and completed a high number of repetitions. Participants reported high satisfaction and low pain, and they demonstrated small, significant improvements in upper-extremity use (before Bonferroni corrections; t = –2.1, p = .04, d = .30), function (t = –3.0, p < .01, d = .20), and attention (t = –3.4, p < .01, d = –.44). CONCLUSION. Repetitive task-specific practice is feasible and tolerable for people with USN. Improvements in upper-extremity use, function, and attention may be attainable. PMID:27294994

Novel human mutation and CRISPR/Cas genome-edited mice reveal the importance of C-terminal domain of MSX1 in tooth and palate development

PubMed Central

Mitsui, Silvia Naomi; Yasue, Akihiro; Masuda, Kiyoshi; Naruto, Takuya; Minegishi, Yoshiyuki; Oyadomari, Seiichi; Noji, Sumihare; Imoto, Issei; Tanaka, Eiji

2016-01-01

Several mutations, located mainly in the MSX1 homeodomain, have been identified in non-syndromic tooth agenesis predominantly affecting premolars and third molars. We identified a novel frameshift mutation of the highly conserved C-terminal domain of MSX1, known as Msx homology domain 6 (MH6), in a Japanese family with non-syndromic tooth agenesis. To investigate the importance of MH6 in tooth development, Msx1 was targeted in mice with CRISPR/Cas system. Although heterozygous MH6 disruption did not alter craniofacial development, homozygous mice exhibited agenesis of lower incisors with or without cleft palate at E16.5. In addition, agenesis of the upper third molars and the lower second and third molars were observed in 4-week-old mutant mice. Although the upper second molars were present, they were abnormally small. These results suggest that the C-terminal domain of MSX1 is important for tooth and palate development, and demonstrate that that CRISPR/Cas system can be used as a tool to assess causality of human disorders in vivo and to study the importance of conserved domains in genes. PMID:27917906

Novel human mutation and CRISPR/Cas genome-edited mice reveal the importance of C-terminal domain of MSX1 in tooth and palate development.

PubMed

Mitsui, Silvia Naomi; Yasue, Akihiro; Masuda, Kiyoshi; Naruto, Takuya; Minegishi, Yoshiyuki; Oyadomari, Seiichi; Noji, Sumihare; Imoto, Issei; Tanaka, Eiji

2016-12-05

Several mutations, located mainly in the MSX1 homeodomain, have been identified in non-syndromic tooth agenesis predominantly affecting premolars and third molars. We identified a novel frameshift mutation of the highly conserved C-terminal domain of MSX1, known as Msx homology domain 6 (MH6), in a Japanese family with non-syndromic tooth agenesis. To investigate the importance of MH6 in tooth development, Msx1 was targeted in mice with CRISPR/Cas system. Although heterozygous MH6 disruption did not alter craniofacial development, homozygous mice exhibited agenesis of lower incisors with or without cleft palate at E16.5. In addition, agenesis of the upper third molars and the lower second and third molars were observed in 4-week-old mutant mice. Although the upper second molars were present, they were abnormally small. These results suggest that the C-terminal domain of MSX1 is important for tooth and palate development, and demonstrate that that CRISPR/Cas system can be used as a tool to assess causality of human disorders in vivo and to study the importance of conserved domains in genes.

Molar incisor hypomineralization: proportion and severity in primary public school children in Graz, Austria.

PubMed

Buchgraber, Barbara; Kqiku, Lumnije; Ebeleseder, Kurt A

2018-03-01

The aim of this study was to determine the proportion and severity of molar incisor hypomineralization (MIH) in primary school children in Graz (southeast of Austria). In 1111 children aged 6 to 12 years (mean age 9.0 ± 1.2), a wet examination of all teeth was performed by three trained examiners using a dental chair, optimal illumination, a dental mirror, and a dental explorer. All teeth with MIH lesions were registered so that different definitions of MIH were applicable. According to the European Academy of Pediatric Dentistry criteria that were considered valid at the time of the investigation, MIH was diagnosed when at least one first primary molar (FPM) was affected. MIH was present in 78 children (7.0%). In 64 children (5.8%), at least one molar and one incisor were affected (so-called M + IH). Additionally, in 9 children, only incisors were affected. In 7 affected children, teeth other than FPMs and incisors had MIH lesions. Almost an equal number of males (38) and females (40) were affected. The upper and lower molars were equally affected. The upper incisors were more frequently affected than the lower ones. Demarcated enamel opacities were the predominant types of defects. The proportion of MIH was 7.0% in Graz, which is similar to other comparable trials. This study has proven that MIH is an existing dental problem in Graz.

Adaptive behaviour and motor skills in children with upper limb deficiency.

PubMed

Mano, Hiroshi; Fujiwara, Sayaka; Haga, Nobuhiko

2018-04-01

The dysfunction of individuals with upper limb deficiencies affects their daily lives and social participation. To clarify the adaptive behaviours and motor skills of children with upper limb deficiencies. Cross-sectional survey. The subjects were 10 children ranging from 1 to 6 years of age with unilateral upper limb deficiencies at the level distal to the elbow who were using only cosmetic or passive prostheses or none at all. To measure their adaptive behaviour and motor skills, the Vineland Adaptive Behavior Scales, Second Edition was used. They were evaluated on the domains of communication, daily living skills, socialization and motor skills. We also examined the relationship of the scores with age. There were no statistically significant scores for domains or subdomains. The domain standard score of motor skills was significantly lower than the median scores of the domains and was negatively correlated with age. Children with upper limb deficiencies have individual weaknesses in motor skill behaviours, and these weaknesses increase with age. It may be helpful in considering approaches to rehabilitation and the prescription of prostheses to consider the characteristics and course of children's motor skill behaviours. Clinical relevance Even if children with unilateral upper limb deficiencies seem to compensate well for their affected limb function, they have or will experience individual weaknesses in motor skills. We should take this into consideration to develop better strategies for rehabilitation and prostheses prescriptions.

Intracortical inhibition and facilitation with unilateral dominant, unilateral nondominant and bilateral movement tasks in left- and right-handed adults.

PubMed

McCombe Waller, Sandy; Forrester, Larry; Villagra, Federico; Whitall, Jill

2008-06-15

To investigate intracortical inhibition and facilitation in response to unilateral dominant, nondominant and bilateral biceps activation and short-term upper extremity training in right- and left-handed adults. Paired-pulse transcranial magnetic stimulation was used to measure intracortical excitability in motor dominant and nondominant cortices of 26 nondisabled adults. Neural facilitation and inhibition were measured in each hemisphere during unilateral dominant, nondominant and bilateral arm activation and after training in each condition. No differences were seen between right- and left-handed subjects. Intracortical facilitation and decreased inhibition were seen in each hemisphere with unilateral activation/training of contralateral muscles and bilateral muscle activation/training. Persistent intracortical inhibition was seen in each hemisphere with ipsilateral muscle activation/training. Inhibition was greater in the nondominant hemisphere during dominant hemisphere activation (dominant arm contraction). Strongly dominant individuals show no difference in intracortical responses given handedness. Intracortical activity with unilateral and bilateral arm activation and short-term training differs based on hemispheric dominance, with the motor dominant hemisphere exerting a larger inhibitory influence over the nondominant hemisphere. Bilateral activation and training have a disinhibitory effect in both dominant and nondominant hemispheres.

An incidental finding on a diagnostic CBCT: a case report.

PubMed

Lyros, Ioannis; Fora, Eleni; Damaskos, Spyridon; Stanko, Peter; Tsolakis, Apostolos

2014-05-01

It is known that Cone Beam Computed Tomography (CBCT) provides reliable spatial data and has many clinical applications for dental and particularly orthodontic patients. The present article provides a short review of the literature and reports an unusual CBCT finding in an orthodontic patient referred for the assessment of impacted upper canines. A unilateral lesion in the left maxillary sinus, was an incidental finding. Following a histological examination, which revealed unilateral nasal polyps, surgical removal was performed as the treatment of choice.

Maximal strength and power assessment in novice weight trainers.

PubMed

Cronin, John B; Henderson, Melanie E

2004-02-01

The purpose of this study was to investigate whether changes in maximal strength and power output occurred over time in the absence of strength and power training in novice weight trainers. It also investigated whether differences existed between upper- and lower-body assessments and unilateral and bilateral assessments. The power output and maximal strength (1 repetition maximum [1RM]) of 10 male novice subjects were measured on 4 occasions, each assessment 7-10 days apart. The exercises used to measure the upper- and lower-body strength and power outputs were the bench press and supine squat, respectively. Significant (p < 0.05) changes in unilateral (9.8-16.8%) and bilateral 1RM (6.8-15.0%) leg strength were found, the first assessment being significantly different from all other assessments and assessment 2 significantly different from assessment 4. Changes in the upper body (10-13.6%) were also observed. The only significant difference was between assessment 1 and the other testing occasions. No differences in power output were observed for both the upper and lower body during the study. It would seem that considerable changes in maximal strength occur rapidly and in the absence of any formal strength training program in novice weight trainers.

Genomic regions controlling shape variation in the first upper molar of the house mouse

PubMed Central

Pantalacci, Sophie; Turner, Leslie M; Steingrimsson, Eirikur; Renaud, Sabrina

2017-01-01

Numerous loci of large effect have been shown to underlie phenotypic variation between species. However, loci with subtle effects are presumably more frequently involved in microevolutionary processes but have rarely been discovered. We explore the genetic basis of shape variation in the first upper molar of hybrid mice between Mus musculus musculus and M. m. domesticus. We performed the first genome-wide association study for molar shape and used 3D surface morphometrics to quantify subtle variation between individuals. We show that many loci of small effect underlie phenotypic variation, and identify five genomic regions associated with tooth shape; one region contained the gene microphthalmia-associated transcription factor Mitf that has previously been associated with tooth malformations. Using a panel of five mutant laboratory strains, we show the effect of the Mitf gene on tooth shape. This is the first report of a gene causing subtle but consistent variation in tooth shape resembling variation in nature. PMID:29091026

Lymphoedema of the upper limb: a rare complication of thyroid surgery?

PubMed Central

Stephen, Christopher; Munnoch, David Alexander

2016-01-01

A 40-year-old woman underwent an elective thyroidectomy for a non-toxic, multinodular goitre. In the early postoperative period, the patient developed a significant unilateral swelling of the right upper limb, which was subsequently confirmed to be lymphoedema. This was eventually treated successfully using liposuction and compression garment therapies. We report the case due to its rarity and present a possible explanation for such an unexpected complication based on known anatomical variations of lymphatic drainage of the upper limb. PMID:27090542

Panoramic radiographic survey of hypodontia in Australian Defence Force recruits.

PubMed

Lynham, A

1990-02-01

Comprehensive dental examinations and panoramic radiographs were used to determine the prevalence of hypodontia in 662 Australian Defence Force recruits. Of the sampled population, 6.3 per cent exhibited some degree of hypodontia (third molar agenesis excluded). Previous studies produced similar results. Third molar agenesis occurred in 22.7 per cent of the sample which again is in agreement with other studies. There was no statistical difference between the sexes in third molar agenesis; however, there was a significant difference with upper second premolars. Females exhibited an extremely low incidence of absence of maxillary lateral incisors.

Enamel thickness variation of deciduous first and second upper molars in modern humans and Neanderthals.

PubMed

Fornai, Cinzia; Benazzi, Stefano; Svoboda, Jiří; Pap, Ildikó; Harvati, Katerina; Weber, Gerhard W

2014-11-01

Enamel thickness and dental tissue proportions have been recognized as effective taxonomic discriminators between Neanderthal and modern humans teeth. However, most of the research on this topic focused on permanent teeth, and little information is available for the deciduous dentition. Moreover, although worn teeth are more frequently found than unworn teeth, published data for worn teeth are scarce and methods for the assessment of their enamel thickness need to be developed. Here, we addressed this issue by studying the 2D average enamel thickness (AET) and 2D relative enamel thickness (RET) of Neanderthal and modern humans unworn to moderately worn upper first deciduous molars (dm(1)s) and upper second deciduous molars (dm(2)s). In particular, we used 3D μCT data to investigate the mesial section for dm(1)s and both mesial and buccal sections for dm(2)s. Our results confirmed previous findings of an Neanderthal derived condition of thin enamel, and thinner enamel in dm(1)s than dm(2)s in both Neanderthal and modern humans. We demonstrated that the Neanderthal 2D RET indices are significantly lower than those of modern humans at similar wear stages in both dm(1)s and dm(2)s (p < 0.05). The discriminant analysis showed that using 2D RET from dm(1) and dm(2) sections at different wear stages up to 93% of the individuals are correctly classified. Moreover, we showed that the dm(2) buccal sections, although non-conventionally used, might have an advantage on mesial sections since they distinguish as well as mesial sections but tend to be less worn. Therefore, the 2D analysis of enamel thickness is suggested as a means for taxonomic discrimination between modern humans and Neanderthal unworn to moderately worn upper deciduous molars. Copyright © 2014 Elsevier Ltd. All rights reserved.

Variations in tooth size and arch dimensions in Malay schoolchildren.

PubMed

Hussein, Khalid W; Rajion, Zainul A; Hassan, Rozita; Noor, Siti Noor Fazliah Mohd

2009-11-01

To compare the mesio-distal tooth sizes and dental arch dimensions in Malay boys and girls with Class I, Class II and Class III malocclusions. The dental casts of 150 subjects (78 boys, 72 girls), between 12 and 16 years of age, with Class I, Class II and Class III malocclusions were used. Each group consisted of 50 subjects. An electronic digital caliper was used to measure the mesio-distal tooth sizes of the upper and lower permanent teeth (first molar to first molar), the intercanine and intermolar widths. The arch lengths and arch perimeters were measured with AutoCAD software (Autodesk Inc., San Rafael, CA, U.S.A.). The mesio-distal dimensions of the upper lateral incisors and canines in the Class I malocclusion group were significantly smaller than the corresponding teeth in the Class III and Class II groups, respectively. The lower canines and first molars were significantly smaller in the Class I group than the corresponding teeth in the Class II group. The lower intercanine width was significantly smaller in the Class II group as compared with the Class I group, and the upper intermolar width was significantly larger in Class III group as compared with the Class II group. There were no significant differences in the arch perimeters or arch lengths. The boys had significantly wider teeth than the girls, except for the left lower second premolar. The boys also had larger upper and lower intermolar widths and lower intercanine width than the girls. Small, but statistically significant, differences in tooth sizes are not necessarily accompanied by significant arch width, arch length or arch perimeter differences. Generally, boys have wider teeth, larger lower intercanine width and upper and lower intermolar widths than girls.

Effect of display type, DICOM calibration and room illuminance in bitewing radiographs.

PubMed

Kallio-Pulkkinen, Soili; Huumonen, Sisko; Haapea, Marianne; Liukkonen, Esa; Sipola, Annina; Tervonen, Osmo; Nieminen, Miika T

2016-01-01

To compare observer performance in the detection of both anatomical structures and caries in bitewing radiographs using consumer grade displays with and without digital imaging and communications in medicine (DICOM) calibration, tablets (third generation iPad; Apple, Cupertino, CA) and 6-megapixel (MP) displays under different lighting. 30 bitewing radiographs were blindly evaluated on four displays under bright (510 lx) and dim (16 lx) ambient lighting by two observers. The dentinoenamel junction, enamel and dentinal caries, and the cortical border of the alveolar crests were evaluated. Consensus was considered as reference. Intraobserver agreement was determined. The proportion of equivalent ratings and weighted kappa were used to assess reliability. The proportion of equivalent ratings with consensus differed significantly between uncalibrated and DICOM-calibrated consumer grade display in enamel caries in upper and lower molars in bright (p = 0.013 and p = 0.003) lighting, and in dentinal caries in lower molars in both bright (p = 0.022) and dim (p = 0.004) lighting. The proportion also differed significantly between DICOM-calibrated consumer grade and 6-MP display in dentinal caries in lower molars in bright lighting (p = 0.039), tablet and consumer grade display in enamel caries in upper molars (p = 0.017) in bright lighting, tablet and 6-MP display in dentinal caries in lower molars (p = 0.003) in bright lighting and in enamel caries in lower molars (p = 0.012) in dim lighting. DICOM calibration improves the detection of enamel and dentinal caries in bitewing radiographs, particularly in bright lighting. Therefore, a calibrated consumer grade display can be recommended as a diagnostic tool for viewing bitewing radiographs.

Prognostic factors of a satisfactory functional result in patients with unilateral amputations of the upper limb above the wrist that use an upper limb prosthesis.

PubMed

Dabaghi-Richerand, A; Haces-García, F; Capdevila-Leonori, R

2015-01-01

The purpose of this study is to determine the prognostic factors of a satisfactory functional outcome in patients using upper extremity prosthetics with a proximal third forearm stump, and above, level of amputation. All patients with longitudinal deficiencies and traumatic amputations of upper extremity with a level of amputation of proximal third forearm and above were included. A total of 49 patients with unilateral upper extremity amputations that had used the prosthetic for a minimum of 2 years were included in the protocol. The Disability arm shoulder hand (DASH) scale was used to determine a good result with a cut-off of less than 40%. The independent variables were the level of amputation, the etiology for its use, initial age of use and number of hours/day using the prosthesis. It was found that patients with a congenital etiology and those that started using the prosthetic before 6 years of age had better functional results. It was found that when adapting a patient with an upper extremity prosthetic, which has a high rejection rate of up to 49%, better functional outcomes are found in those who started using it before 6 years of age, and preferably because of a congenital etiology. It was also found that the number of hours/day strongly correlates with a favorable functional outcome. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

A survey of overuse problems in patients with acquired or congenital upper limb deficiency.

PubMed

Burger, Helena; Vidmar, Gaj

2016-08-01

Little is known about secondary impairments and overuse problems in patient with acquired or congenital upper limb deficiency. Our aim was to estimate the frequency of overuse problems in persons after unilateral upper limb deficiency and identify the factors relevant for development of these problems. Cross-sectional study conducted at the University Rehabilitation Institute in Ljubljana. In total, 65 persons after unilateral upper limb deficiency who had visited our subspecialist outpatient clinic during the 2011-2013 period (excluding those with other possible medical causes of overuse-type problems) were interviewed about the frequency, duration and severity of neck, elbow and shoulder pain and the presence of carpal tunnel syndrome and filled in the Orthotics and Prosthetics User Survey-Upper Extremity Functional Status questionnaire. The most frequent problem was carpal tunnel syndrome, followed by shoulder pain, neck pain and elbow pain. No statistically significant association of deficiency level, cause of deficiency, time since deficiency, extent of daily prosthesis use or type of prosthesis with frequency or severity of pain or number of problems was found. The presence of carpal tunnel syndrome decreased from wearing no prosthesis through aesthetic and body-powered to myoelectric prosthesis (p = 0.014). Factors contributing to overuse problems after upper limb deficiency are not straightforward, so a large multicentric study is warranted. Persons with acquired or congenital upper limb deficiency are under a heightened risk of developing overuse problems but the contributing factors are not clear, so regular individual follow-up is required. © The International Society for Prosthetics and Orthotics 2015.

[Radiographic study of maxillary sinus associated with molars in adult].

PubMed

Hu, Zhi; Sun, Daming; Zhou, Quansheng; Wang, Yuli; Gu, Jingcheng; Han, Yaohua

2014-12-01

to explore the relationship between the maxillary sinus volume and the amount of alveolar bone, and the effect of molar loss upon the maxillary sinus was further analyzed,by measuring adult maxillary sinus volume, sinus ridge distance, and calculating the gasification coefficient of maxillary sinus. One hundred and ninety cases (361 maxillary sinus) with CT examinations were collected, they were divided into group A and group B, 121 cases (242 maxillary sinus) of normal subjects served as group A, 42 cases (65 maxillary sinus) with molar part off were B group, in which 31 maxillary sinus with a molar loss were group B1,22 maxillary sinus with two molar loss were B2 group,12 maxillary sinus with three molar loss (one molar remains) were B3 group, 27 cases (54 maxillary sinus) with upper teeth off were C group. Bymeasureing the maxillary sinus volume, sinus ridge distance and the size of the maxillary sinus, calculating the gasification coefficient, we analyzed the relationship between maxillary volume and sinus ridge distance, and comparatively analyzed the differences among the three groups in the size, gasification coefficient, volume of maxillary sinus and sinus ridge distance. In the normal group,the volume of maxillary sinus and sinus ridge distance had a correlation coefficient of -0. 63,(P< 0.05); Sinus ridge distance in group A was larger than the other two groups (P<0.05), and larger in B group than in C group (P<0. 05), anteroposterior maxillary sinus diameter and reft-right diameter in C group was greater than in A group and B group(P<0.05), group C gasification coeffiecent was less than A group and B group (P<0. 05). The volume of maxillary sinus is negatively correlated with the amont of alveolar bone; Upper teeth's shedding promotes maxillary sinus deformation; Maxiuary sinus volume has a tendency to decrease.

The chronology and sequence of eruption of human permanent teeth in Northern Ireland.

PubMed

Kochhar, R; Richardson, A

1998-12-01

To ascertain the average and range of ages and sequence of eruption of human permanent teeth, taking into account the effect of premature loss of primary antecedents. Longitudinal study. Caucasian subjects in Northern Ireland. Study casts at 6-monthly intervals from age 5 to 15 years of 276 children (146 males and 130 females) enrolled in the Belfast Growth Study. The mean and range of ages of eruption of each individual tooth were computed. Comparisons were made between the mean ages of eruption with and without premature loss of primary antecedents, between upper and lower arches, between right and left sides and between males and females. The sequence of eruption was also investigated. The means and ranges of eruption ages are reported. Premature loss of primary antecedents delayed eruption of permanent successors except for the upper premolars which were accelerated. The differences relating to the upper first premolar and lower canine were not statistically significant. Each lower tooth erupted before its upper counterpart except for the premolars. There was no significant difference in age of eruption between right and left sides. Females tended to erupt teeth before males with the exception of the second molars in both arches; however, the only differences to reach statistical significance related to upper and lower canines and upper lateral incisors. The most frequent orders of eruption were unique to the subject. These occurred in 22% of upper and 33% of lower arches. The classic sequences: first molar-central incisor-lateral incisor-first premolar-canine-second premolar-second molar (M1-I1-I2-PM1-C-PM2-M2) in the upper arch and I1-M1-I2-C-PM1-PM2-M2 in the lower arch occurred in only 16% of upper arches and 13% of lower arches. Males adhered to the textbook sequence (20% upper, 17% lower) more than females (12% upper, 8% lower). In the upper arch of females, the order M1-I1-I2-PM1-PM2-C-M2 in 10% of subjects was almost as frequent as the classic sequence. The ages, ranges and orders of eruption found in this study are more reliable than many which are frequently quoted on account of its longitudinal nature and the fact that the effect of premature loss of primary antecedents is taken into account. The exclusively Caucasian sample makes the data quite precise but limits applicability to patients of this ethnic origin.

Pressure production in oral vestibule during gum chewing.

PubMed

Nishiura, M; Ono, T; Yoshinaka, M; Fujiwara, S; Yoshinaka, M; Maeda, Y

2015-12-01

The aim of this study was to record oral vestibule pressure (OVP) by the lip and cheek contraction during gum chewing, to examine the characteristics of these pressures and coordination between the OVP and jaw movement. The subjects were eight healthy adult men (mean age of 29·3 ± 3·3 years). An experimental plate that incorporated four pressure sensors on the midline of the upper jaw (Ch. 1), upper right canine (Ch. 2), upper right first molar (Ch. 3) and upper left first molar (Ch. 4) was used for measuring OVP. The right masseter electromyogram (EMG) was recorded simultaneously. Subjects chewed gum on the right side 20 times, and eight consecutive strokes were used for the analysis of the sequential order, maximal magnitude and duration of each OVP. Onset of OVP was observed at the molar on the non-chewing side (Ch. 4) before chewing side (Ch. 3), and offset was largely simultaneous at each site. On the chewing side (Chs. 1-3), OVP onset during the interval of EMG activity reached to the peak around the end of interval and offset in the duration of EMG activity. The maximal pressure was significantly larger at Chs. 1-3 than at Ch. 4, but no significant differences were observed in duration of pressure among each site. These results suggest that OVP is coordinated with jaw movement during gum chewing, and larger pressure is produced on the chewing side than on the non-chewing side. Our findings are quantitative indices for the evaluation of lip and cheek function during mastication. © 2015 John Wiley & Sons Ltd.

Diagnosis of unilateral trapezius muscle palsy: 54 Cases.

PubMed

Seror, Paul; Stojkovic, Tanya; Lefevre-Colau, Marie Martine; Lenglet, Timothée

2017-08-01

We assessed medical and surgical causes of unilateral trapezius muscle (TM) palsy and/or wasting. Clinical and electrodiagnostic data were collected in 54 patients with TM impairment over 21 years. In total, 35 cases had a medical origin: neuralgic amyotrophy (NA, n = 22), idiopathic unilateral TM palsy (n = 5), regional neck radiotherapy for different conditions (n = 2), facioscapulohumeral dystrophy (FSH) (n = 4), abnormal loop of the jugular vein (n = 1), or basilar impression (n = 1). Other etiologies were neck surgery (n = 16), cervicofacial lift (n = 2), or trauma (n = 1). There were 5 main diagnostic findings in unilateral TM palsy: (1) dynamic examination of the scapula provides a new clinical sign; (2) NA is the most frequent medical cause; (3) in medical cases, partial preservation of the upper TM can offer good recovery; (4) FSH must be considered, especially in young patients; and (5) minor neck surgery can lead to severe TM palsy. Muscle Nerve 56: 215-223, 2017. © 2016 Wiley Periodicals, Inc.

Radiographic evaluation of third molar development in 6- to 24-year-olds

PubMed Central

Jung, Yun-Hoa

2014-01-01

Purpose This study investigated the developmental stages of third molars in relation to chronological age and compared third molar development according to location and gender. Materials and Methods A retrospective analysis of panoramic radiographs of 2490 patients aged between 6 and 24 years was conducted, and the developmental stages of the third molars were evaluated using the modified Demirjian's classification. The mean age, standard deviation, minimal and maximal age, and percentile distributions were recorded for each stage of development. A Mann-Whitney U test was performed to test the developmental differences in the third molars between the maxillary and mandibular arches and between genders. A linear regression analysis was used for assessing the correlation between the third molar development and chronological age. Results The developmental stages of the third molars were more advanced in the maxillary arch than the mandibular arch. Males reached the developmental stages earlier than females. The average age of the initial mineralization of the third molars was 8.57 years, and the average age at apex closure was 21.96 years. The mean age of crown completion was 14.52 and 15.04 years for the maxillary and the mandibular third molars, respectively. Conclusion The developmental stages of the third molars clearly showed a strong correlation with age. The third molars developed earlier in the upper arch than the lower arch; further, they developed earlier in males than in females. PMID:25279338

Prosthetic Cost Projections for Servicemembers with Major Limb Loss from Vietnam and OIF/OEF

DTIC Science & Technology

2010-01-01

death rates ), DOD = Department of Defense, DSS = Decision Support Sys- tem, MFCL = Medicare Functional Classification Level, OEF = Operation...age-sex-race-adjusted death rates . Figure 3. Markov model for unilateral upper limb and bilateral upper limbs for Operation Iraqi Freedom...Operation Enduring Freedom (OIF/OEF) group. ASR = age-sex-race-adjusted death rates . 394 JRRD, Volume 47, Number 4, 2010 higher, one level lower, or

First Early Hominin from Central Africa (Ishango, Democratic Republic of Congo)

PubMed Central

Crevecoeur, Isabelle; Skinner, Matthew M.; Bailey, Shara E.; Gunz, Philipp; Bortoluzzi, Silvia; Brooks, Alison S.; Burlet, Christian; Cornelissen, Els; De Clerck, Nora; Maureille, Bruno; Semal, Patrick; Vanbrabant, Yves; Wood, Bernard

2014-01-01

Despite uncontested evidence for fossils belonging to the early hominin genus Australopithecus in East Africa from at least 4.2 million years ago (Ma), and from Chad by 3.5 Ma, thus far there has been no convincing evidence of Australopithecus, Paranthropus or early Homo from the western (Albertine) branch of the Rift Valley. Here we report the discovery of an isolated upper molar (#Ish25) from the Western Rift Valley site of Ishango in Central Africa in a derived context, overlying beds dated to between ca. 2.6 to 2.0 Ma. We used µCT imaging to compare its external and internal macro-morphology to upper molars of australopiths, and fossil and recent Homo. We show that the size and shape of the enamel-dentine junction (EDJ) surface discriminate between Plio-Pleistocene and post-Lower Pleistocene hominins, and that the Ishango molar clusters with australopiths and early Homo from East and southern Africa. A reassessment of the archaeological context of the specimen is consistent with the morphological evidence and suggest that early hominins were occupying this region by at least 2 Ma. PMID:24427292

The effects of local administration of Zoledronate solution on the tooth movement and periodontal ligament.

PubMed

Liu, Chang; Sun, Xinhua; Chen, Yuanping; Hu, Min; Liang, Tang

2002-07-01

To investigate the effects of local administration of Zoledronate solution on the tooth movement and periodontal ligament. Orthodontic tooth movement of upper first molar was performed in 42 rats with coil spring. Zoledronate solution was injected into the palatal submucosal area adjacent to the left upper first molar in experimental group 3 days prior to the use of the appliance. In control group, same amount of 0.9% NaCl solution was injected into the palatal submucosal area adjacent to the left and right upper first molar. The injection was applied every third day. The application of mesial force lasted 0.3, 7, 14, 21 days respectively. After the rats were sacrificed, the distance of tooth movement was measured. Sections were stained and then observed with microscope. 1. The distance of tooth movement in the experimental group was significantly smaller than that in the control group. 2. The number of osteoclast on the pressure side in the experiment group was significantly smaller than that in the control group through the experimental period, but there was no distinct difference between experimental group and control group (except for 14 days) for the number of odontoclast in interradicular area. 3. The osteoclasts and odontoclasts were the main target cell of Zoledronate in periodontal tissue. Zoledronate may be a useful agent for anchorage control and reducing the number of osteoclast on pressure side of alveolar bone.

RS3PE presenting in a unilateral pattern: case report and review of the literature.

PubMed

Keenan, Robert T; Hamalian, Gareen M; Pillinger, Michael H

2009-06-01

To review the clinical features and pathophysiologic implications of remitting seronegative symmetrical synovitis with pitting edema (RS(3)PE) presenting in a unilateral manner. We identified and characterized an index case of RS(3)PE presenting in a unilateral pattern. We subsequently performed a systematic literature search to identify other reports of patients with unilateral RS(3)PE. The index case was a 76-year-old male with a prior history of right hemiparesis owing to a cerebrovascular accident 25 years prior, who developed a classic picture of RS(3)PE involving hand (metacarpophalageal and wrist joint) arthritis and dorsal pitting edema, accompanied by an elevated erythrocyte sedimentation rate, but only in the nonhemiparetic hand. The condition responded rapidly to low-dose prednisone. Our literature search identified 5 other cases of unilateral RS(3)PE, including 2 presented only in the Italian or German literature. Of the 5 cases, 2 were in patients with preexisting neurologic disease, in which the neurologically affected side was spared. One additional case initially presented as unilateral disease but rapidly progressed to bilaterality. Two cases presented in a fully unilateral manner despite no reported neurologic abnormalities on the unaffected sides. While RS(3)PE is almost always a symmetric disease of the upper extremities, it may rarely present in a unilateral fashion. The apparent ability of neuropathic changes to protect against the expression of RS(3)PE in an extremity suggests a role for neural and possibly other local factors in the genesis/modulation of the onset or maintenance of RS(3)PE.

Morphologic analysis of third-molar maturity by digital orthopantomographic assessment.

PubMed

Introna, Francesco; Santoro, Valeria; De Donno, Antonio; Belviso, Maura

2008-03-01

Accurate timing of the eruption of first and permanent teeth is an important parameter in forensic odontology to establish the age of dead or live individuals. Determination of adulthood may determine, for example, whether an individual convicted of a crime is sentenced as an adult and incarcerated in a state penal institution or as a juvenile and sent to a juvenile camp. At present, there is a large immigrant population in Italy, and young foreign criminals sometimes have false passports bearing a later birth date, with the aim of evading punishment. In such circumstances, age determination is becoming a significant forensic issue.Late in adolescence, after formation of the premolars and canines, only the third molars continue to develop. According to several studies, although the third molars are the most variable teeth in the dentition, they remain the most reliable biologic indicator available for estimation of age during the middle teens and early twenties.In this study, the authors test the possibilities offered by orthopantomography executed by means of digital technology, with the aim of exploiting the advantages of the computerized digital technique compared with the conventional technique, to determine adult age on the basis of root development of the third molar.Digital radiography is simple to use, quick, and effective, allowing superimposition and enlargement; the images can be electronically stored and transported. In comparison with traditional orthopantomography, the digital technique features greater diagnostic accuracy of some anatomic structures: upper and lower front teeth, root apexes, floor of the nasal fossa and maxillary sinus, nasal septum, mandibular condylus. Moreover, digital orthopantomography suffers less from artifacts.The digital orthopantomographies of 83 Caucasian subjects (43 females and 40 males) aged between 16 and 22 years were analyzed in standard conditions, assessing the degree of maturation of the upper and lower third molars. A standardized computer procedure was used to acquire the x-ray images, recording 3 per plate: the overall orthopantomography and 2 enlargements of optical type of the left and right sides, to reveal the third molars while maintaining unaltered the image resolution.For the analysis, the authors adopted Demirjian's staging system that classifies development of the third molar in 8 stages (A, B, C, D, E, F, G, H) on the basis of morphologic criteria. This has been statistically proved to feature notable precision and high predictive ability.To assess any sex-related variations in mineralization speed, the series was subdivided by gender. The study demonstrated that such differences are more evident under the age of 18 years.Overall, the observation of 245 third molars showed faster development of the upper than the lower third molars, a prevalence of stages D to G in the age range between 16 and 18 years, and a clear predominance of stage H in individuals over 18 years of age. Finally, an intermediate stage between G and H was demonstrated in subjects aged between 17 and 21 years.

[Distal movement of the mandibular dentition in the treatment of patients with Class III skeletal pattern].

PubMed

Mou, Lan; Xu, Gengchi; Han, Yaohui; Ge, Zhenlin

2015-06-01

To evaluate the outcome of patients with skeletal Class III malocclusion treated with extraction of mandibular third molars and distalization of molars using implant anchorage combined with MBT appliance. Fifteen patients (mean age 24.0 ± 5.8) with skeletal Class III malocclusion were selected. The mandibular third molars were extracted and the mandibular molars were moved distally using implant combined with MBT appliance. Cephalometric analysis was carried out before and after treatment. After active treatment, ANB, Wits distance, AB-NP and the distance between upper and lower lip position to SnPg' increased by 1.65° ± 1.04°, (4.39 ± 1.93) mm, 3.20° ± 1.61° and (1.13 ± 0.99) mm, respectively. The differences were statistically significant (P < 0.05). The skeletal Class III patients in the permanent dentition could be treated successfully with extraction of mandibular third molars and distalization of mandibular molars using implant anchorage combined with MBT appliance. The soft-tissue profile was improved.

Maxillary molars with morphologic variations of the palatal root canals: a report of four cases.

PubMed

Holderrieth, Silke; Gernhardt, Christian Ralf

2009-07-01

The purpose of this article was to show the importance of the knowledge of the anatomy of root canals. Unusual root and root canal morphologies associated with both buccal roots of upper molars have been recorded in several studies in the literature. However, scientific information focusing on variations of the palatal root is rare. In this report, four cases are presented involving the root canal treatment of maxillary first and second molars with unusual morphologic configurations of the palatal root canals. During root canal treatment, type IV and V configurations as defined by Vertucci of the palatal canals of two first and two second maxillary molars were identified. After mechanical instrumentation, the canals were obturated. Radiologic and clinical re-evaluation showed no signs of inflammation. This report describes and discusses the possibility of different root and canal variations of the maxillary molars from a clinical point of view. Anatomic variations can occur in any tooth, and palatal roots of maxillary first and second molars are no exception. Therefore, careful examination of radiographs and internal anatomy of teeth is essential.

A case of tooth fracture occurred upon medicating bisphosphonate for an elderly person: Preservation therapy and responses for Stage 0 of bisphosphonate-related osteonecrosis of jaw

PubMed Central

Suzuki, Noriko; Oguchi, Hitoshi; Yamauchi, Yu; Karube, Yasuyo; Suzuki, Yukimi; Hosoya, Noriyasu

2017-01-01

This case report aimed to report the progress of preservation therapy and response of symptoms and signs for Stage 0 of bisphosphonate-related osteonecrosis of jaw (BRONJ). A 68-year-old female was recognized having a tooth at the left upper first molar fracture upon medicating bisphosphonate (BP) in 2007. At that time, the extraction of the tooth was an absolute contraindication. Therefore, we performed preservation therapy. We observed the symptoms and signs every month. After 5 months, swelling and redness in the entire first molar tooth were seen and fistula formed partly. Bone exposure was not seen. We administrated antibiotics immediately. As a result, symptoms disappeared. On April 10, 2009, the patient visited us as she felt a sense of incongruity in the lower left first and second molar teeth. Clinically, there were no symptoms of pain. However, we observed the radiolucent finding in about 5 mm diameter at apical position by X-ray photography; we considered a possibility of Stage 0 for BRONJ. We immediately administered medicine for 5 days and the symptoms disappeared. At present, no inflammation with signs and symptoms at the upper left first molar and lower left first, second molar parts is shown. We performed preservation therapy for tooth fracture case medicating of BP. Immediate responses for inflammation and symptoms of the Stage 0 of BRONJ have led to success. Hence, dentists should perform regular clinical observation, and enough education to the patient for BRONJ is necessary. PMID:28729804

Postrenal acute kidney injury in a patient with unilateral ureteral obstruction caused by urolithiasis: A case report.

PubMed

Kazama, Itsuro; Nakajima, Toshiyuki

2017-10-01

In patients with bilateral ureteral obstruction, the serum creatinine levels are often elevated, sometimes causing postrenal acute kidney injury (AKI). In contrast, those with unilateral ureteral obstruction present normal serum creatinine levels, as long as their contralateral kidneys are preserved intact. However, the unilateral obstruction of the ureter could affect the renal function, as it humorally influences the renal hemodynamics. A 66-year-old man with a past medical history of hypertension and diabetes mellitus came to our outpatient clinic because of right abdominal dullness. Unilateral ureteral obstruction caused by a radio-opaque calculus in the right upper ureter and a secondary renal dysfunction. As oral hydration and the use of calcium antagonists failed to allow the spontaneous stone passage, extracorporeal shock wave lithotripsy (ESWL) was performed. Immediately after the passage of the stone, the number of red blood cells in the urine was dramatically decreased and the serum creatinine level almost returned to the normal range with the significant increase in glomerular filtration rate. Unilateral ureteral obstruction by the calculus, which caused reflex vascular constriction and ureteral spasm in the contralateral kidney, was thought to be responsible for the deteriorating renal function.

Asymmetric rapid maxillary expansion in true unilateral crossbite malocclusion: a prospective controlled clinical study.

PubMed

Ileri, Zehra; Basciftci, Faruk Ayhan

2015-03-01

To investigate the short-term effects of the asymmetric rapid maxillary (ARME) appliance on the vertical, sagittal, and transverse planes in patients with true unilateral posterior crossbite. Subjects were divided into two groups. The treatment group was comprised of 21 patients with unilateral posterior crossbite (mean age  =  13.3 ± 2.1 years). Members of this group were treated with the ARME appliance. The control group was comprised of 17 patients with Angle Class I who were kept under observation (mean age  =  12.3 ± 0.8 years). Lateral and frontal cephalograms were taken before the expansion (T1), immediately after expansion (T2), and at postexpansion retention (T3) in the treatment group and at preobservation (T1) and postobservation (T2) in the control group. A total of 34 measurements were assessed on cephalograms. For statistical analysis, the Wilcoxon test and analysis of covariance were used. The ARME appliance produced significant increases in nasal, maxillary base, upper arch, and lower arch dimensions (P < .01) and a clockwise rotation of the occlusal plane (P  =  .001). The ARME appliance created asymmetric increments in the transversal dimensions of the nose, maxilla, and upper arch in the short term. Asymmetric expansion therapy for subjects with unilateral maxillary deficiency may provide satisfactory outcomes in adolescents, with the exception of mandibular arch expansion. The triangular pattern of expansion caused clockwise rotation of the mandible and the occlusal plane and produced significant alterations in the vertical facial dimensions, whereas it created no displacement in maxilla in the sagittal plane.

A comparison of vestibular evoked myogenic potential (VEMP) between definite Meniere's disease patients and normal healthy adults.

PubMed

Jariengprasert, Chanchai; Tiensuwan, Montip; Euasirirattanapaisan, Khongpol

2013-12-01

To compare the results of VEMP between unilateral definite Meniere's disease patients and normal healthy adults. Thirty-two patients with unilateral definite Meniere's disease patients and 32 age-matched normal healthy adults (control) underwent VEMP tests with short tone burst of 500 Hz at 90 dBnHL. Student-t test was used for comparison of means of all parameters between two groups. Absent VEMP response was found in 14 MD patients and abnormal asymmetry ratio (AR) was found in five MD patients. Normal responses were found in all subjects of the control group. The mean P1 and N1 latencies, VEMP amplitude between unilateral MD, and control were not significantly different between two groups. However the difference between the mean AR of both groups showed statistically significant (p-value < 0.05). The upper limit of normal AR was calculated to be of 35.15%. The absence of VEMP response and AR of VEMP were more dominant than other parameters such as P1 and N1 latencies or VEMP amplitude in the detection of saccular dysfunction in MD. The results suggested that AR should be used as a tool in interpretation of VEMP response for the diagnostic batteries in MD. The upper limit of normal AR of < or = 35% should be recommended.

Pattern of dental development in Hominid XVIII from the Middle Pleistocene Atapuerca-Sima de los Huesos site (Spain).

PubMed

Bermudez De Castro, J M; Rosas, A

2001-04-01

. We describe the pattern of dental development of Hominid XVIII from the Middle Pleistocene Sima de los Huesos (SH) site of the Sierra de Atapuerca (Burgos, Spain). As expected, this pattern is similar to that of modern humans. A delay of development of the lower and upper canines was observed. In contrast, the relative advanced development of the lower second molars and, especially, the upper and lower third molars is noteworthy. This latter feature seems to be common in Pleistocene hominids, and suggests that the pattern of dental development evolved in the genus Homo during the Pleistocene. In European Middle Pleistocene hominids, this pattern probably was facilitated by the extra space available in the mandible and maxilla for developing teeth. Copyright 2001 Wiley-Liss, Inc.

Fusion of the 2nd maxillary molar with the impacted 3rd molar.

PubMed

Strecha, J; Jurkovic, R; Siebert, T

2012-01-01

Subject matter: The dentist has to deal with complicated cases of fused molars, which are rather rare and morphologically very varied. A wrong or incomplete diagnosis can considerably complicate a planned therapy. The authors describe a case of apical periodontal complication of fused teeth that had to be removed surgically. The upper 2nd molar fused with the impacted 3rd molar and was diagnosed for extraction. Even a careful diagnostic procedure and X-ray image sometimes may not indicate the exact location and mutual position of the fused teeth. The authors make us aware of the possible occurrence of fused roots, and the necessity to inform the patient ahead of time about the course of endodontic or surgical interventions, possible complications and their removal. They describe the positive influence of PRP (platelet rich plasma) in wound healing. In order to establish the exact indication and therapy, they emphasize the importance of using CT imaging diagnostics or a 3D-CT examination (Fig. 7, Ref. 15).

Measure Of Frequency Of Alveolar Osteitis Using Two Different Methods Of Osteotomy In Mandibular Third Molar Impactions: A Double-Blind Randomized Clinical Trial.

PubMed

Rashid, Hina; Hussain, Azmina; Sheikh, Abdul Hafeez; Azam, Kehkishan; Malik, Sofia; Amin, Muhammad

2018-01-01

Dento-alveolar surgical procedures involving third molar teeth are the most common surgical procedure in the field of surgery. The objective of this research was to analyse the impact of surgery on the incidence of alveolar osteitis after surgical removal of mandibular third molar and to compare two different bone cutting methods following impacted mandibular third molar surgery.. This double blinded randomized clinical trial was executed at the OPD of Department of Oral and Maxillofacial Surgery, Dow University of Health Sciences, Karachi. The study duration was four months. It was conducted on 60 patients needing unilateral mandibular third molar impaction removal. Patients were randomized to two groups (i.e., physio dispenser group and slow speed handpiece group) before surgery. The surgical procedure was performed under local anaesthesia by using standardized cross infection protocol. The frequency of alveolar osteitis was evaluated on thirdday postoperatively. Alveolar osteitis was diagnosed and confirmed by patient's history and clinical evaluation. Post-operative sequelae were observed and recorded objectively. Out of 60 patients', five patients experienced alveolar osteitis, and the incidence rate was 8.3%. A significant pvalue of 0.000 was calculated using binomial test for comparison of alveolar osteitis among both groups. Inter-examiner reliability was assessed by kappa and good (62%) agreement, which was found among the examiners, who diagnosed alveolar osteitis clinically. Post-operative sequelae were insignificant in slow speed hand piece group. It was observed that alveolar osteitis was reported in physio-dispenser group; similarly, post-operative complications were also more in this group as compared with slow speed-hand piece group. No surgical complications were observed in slow speed-hand piece group suggesting slow speed hand piece mode of osteotomy to be safer for third molar extraction as compared with physio-dispenser.

Risk of osteoradionecrosis after extraction of impacted third molars in irradiated head and neck cancer patients.

PubMed

Oh, Hee-Kyun; Chambers, Mark S; Garden, Adam S; Wong, Pei-Fong; Martin, Jack W

2004-02-01

This study was performed to compare the risk of osteoradionecrosis (ORN) in head and neck cancer patients in whom 1 or more impacted third molars were extracted before radiotherapy with patients whose impacted third molars were left intact. Eighty-one patients were selected from the medical records from 1989 to 1998. Patients had at least 1 impacted third molar and received radiotherapy for a head and neck cancer. These patients were divided into 2 groups on the basis of preirradiation extraction: group 1, patients who had impacted third molars extracted before radiotherapy (n = 55), and group 2, patients whose impacted third molars were left intact before radiotherapy (n = 38). In 12 patients of combined groups 1 and 2, at least 1 but not all of the impacted third molars were extracted before radiotherapy. Before radiotherapy, a total of 99 impacted third molars were extracted from the 55 patients in group 1 and a total of 55 impacted third molars were left intact in the 38 patients in group 2. After radiotherapy, a total of 7 impacted third molars were removed from 5 patients as treatment for infection (5 lower molars) or discomfort (2 upper molars). A total of 4 patients (2 from group 1 and 2 from group 2) developed ORN in the mandible. Of these 4 cases of ORN, 1 from group 1 appeared to be related to a dry socket that developed after preirradiation extraction of a lower impacted third molar, 1 from group 2 seemed to be related to infection of a lower impacted third molar after radiotherapy, and the remaining 2 cases appeared to be unrelated to an impacted third molar. Because few patients in this study developed ORN, the study failed to demonstrate whether preirradiation extraction versus retention of impacted third molars affects the risk for ORN.

Laser vocal cordectomy fails to effectively reduce respiratory noise in horses with laryngeal hemiplegia.

PubMed

Brown, Jennifer A; Derksen, Frederik J; Stick, John A; Hartmann, William M; Robinson, N Edward

2005-01-01

To report the effect of unilateral laser vocal cordectomy on respiratory noise and airway function in horses with experimentally induced laryngeal hemiplegia (LH). Experimental study. Six Standardbred horses without upper airway abnormalities at rest or during high-speed treadmill exercise. Respiratory sounds and inspiratory trans-upper airway pressure (P(Ui)) were measured before (baseline) and 14 days after induction of LH by left recurrent laryngeal neurectomy, and again 30, 60, 90, and 120 days after endoscopically assisted laser cordectomy of the left vocal cord. Data were collected with the horses exercising on a treadmill at a speed producing maximum heart rate (HR(max)). In horses exercising at HR(max), induction of LH caused a significant increase in P(Ui), sound level (SL), and the sound intensity of formant 2 (F(2)) and 3 (F(3)). The sound intensity of formant 1 (F(1)) was unaffected by induction of LH. Laser vocal cordectomy had no effect on SL, or on the sound intensity of F(1) and F(3). At 30, 60, 90, and 120 days after surgery, P(Ui) and the sound intensity of F(2) were significantly reduced, but these variables remained significantly different from baseline values. Unilateral laser vocal cordectomy did not effectively improve upper airway noise in horses with LH. The procedure decreased upper airway obstruction to the same degree as bilateral ventriculocordectomy. Currently, laser vocal cordectomy cannot be recommended for the treatment of upper airway noise in horses with LH.

[Stress distribution in abutment teeth and related tissues under different design of connector: three-dimensional finite element analysis].

PubMed

Bai, Li-Ming; Li, Guo-Qiang; Zhang, Qiang; Dong, Xian

2016-08-01

To compare the stress distribution in abutment teeth and related tissues under the same material and different loading between improved major connector design and traditional major connector design. One 55-year-old male patient with unilateral maxillary first molar and second molar missing was chosen. The stress distribution in abutment teeth and related tissues were evaluated with spiral CT scanning, Mimics, Geomagic Studio software, a study model was built and finite element analysis was performed using ANSYS software. With the improved major connector design, the stress of abutment decreased significantly, the stress of periodontal decreased, the stress of edentulous mucosa increased significantly and became more balanced, the trend of stimulated absorption of alveolar bone decreased. For patients with distal free defect of dentition, the design of improved major connector has the effect of stress interruption, can protect the abutment better, detract the stress of the denture and has an good protective effect on the edentulous mucosa and alveolar bone.

Exophthalmos associated to orbital zygomatic mucocele and complex maxillary malformation in a puppy

PubMed Central

Cirla, Alessandro; Rondena, Marco; Bertolini, Giovanna; Barsotti, Giovanni

2017-01-01

A case of exophthalmos due to zygomatic mucocele in a puppy with ipsilateral segmental maxillary atrophy is reported. A 7-month-old, mixed breed, male dog suffered the sudden-onset of unilateral painful exophthalmos and a gradual swelling of the right temporal region. A compressing, right retrobulbar mass was observed by ultrasound. Computed tomography revealed a large multiloculated cyst-like lesion of the right zygomatic gland projecting into the orbital space, thus displacing the eyeball. The ipsilateral molar part of the maxillary bone was underdeveloped, besides showing crowded, abnormal, multiple, unerupted maxillary molar teeth in the caudal maxillary region. Modified lateral orbitotomy and a selective caudal maxillary bone access were performed. The cyst-like lesion was removed and the zygomatic gland and the wall was collected for histology, which confirmed the mucocele. Clinical and imaging examinations six months after surgery showed neither recurrence of the mucocele nor ocular abnormalities. A possible common pathogenic mechanism involving these two conditions could be hypothesized. PMID:28884074

Dental Age Estimation (DAE): Data management for tooth development stages including the third molar. Appropriate censoring of Stage H, the final stage of tooth development.

PubMed

Roberts, Graham J; McDonald, Fraser; Andiappan, Manoharan; Lucas, Victoria S

2015-11-01

The final stage of dental development of third molars is usually helpful to indicate whether or not a subject is aged over 18 years. A complexity is that the final stage of development is unlimited in its upper border. Investigators usually select an inappropriate upper age limit or censor point for this tooth development stage. The literature was searched for appropriate data sets for dental age estimation and those that provided the count (n), the mean (x¯), and the standard deviation (sd) for each of the tooth development stages. The Demirjian G and Demirjian H were used for this study. Upper and lower limits of the Stage G and Stage H data were calculated limiting the data to plus or minus three standard deviations from the mean. The upper border of Stage H was limited by appropriate censoring at the maximum value for Stage G. The maximum age at attainment from published data, for Stage H, ranged from 22.60 years to 34.50 years. These data were explored to demonstrate how censoring provides an estimate for the correct maximum age for the final stage of Stage H as 21.64 years for UK Caucasians. This study shows that confining the data array of individual tooth developments stages to ± 3sd provides a reliable and logical way of censoring the data for tooth development stages with a Normal distribution of data. For Stage H this is inappropriate as it is unbounded in its upper limit. The use of a censored data array for Stage H using Percentile values is appropriate. This increases the reliability of using third molar Stage H alone to determine whether or not an individual is over 18 years old. For Stage H, individual ancestral groups should be censored using the same technique. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Interceptive management of eruption disturbances: case report.

PubMed

Cozza, Paola; Marino, Alessandra; Lagana, Giuseppina

2004-01-01

The aim of the present report is to describe a case of a patient with eruption disturbances of an ankylosed lower primary second molar, delayed development of a maxillary permanent canine associated with an odontoma and a class III dental malocclusion. In such a case the objectives of treatment are: to prevent impaction of the lower second premolar and tipping of the lower first molar; to establish correct anterior overbite and overjet and to control the development of the permanent upper canine.

Dentoalveolar class III treatment using retromolar miniscrew anchorage.

PubMed

Poletti, Laura; Silvera, Aimara A; Ghislanzoni, Luis T Huanca

2013-05-23

In this article, we report the successful use of miniscrews in the distalization of the lower dentition to correct an Angle class III malocclusion with lower anterior crowding in a dolichofacial adult patient. Conventional intraoral and extraoral appliances have many disadvantages, including the need for patient cooperation, potential for anchorage loss, and vertical extrusion of upper molars and lower incisors. Extrusion should be prevented or minimized when treating long-faced patients with reduced overbite. After third molar extractions, miniscrews were placed in the retromolar area. A sliding jig was applied to distalize the lower molars, while the anterior teeth were bonded and retracted secondarily to avoid round tripping. After 18 months of treatment, molar and canine class I relationship with normal overjet and overbite were achieved. In addition, there was an esthetic improvement in the profile with only a small increase of the lower anterior facial height. These results remained stable at a 12-month follow-up.

Skeletal anchorage for intrusion of bimaxillary molars in a patient with skeletal open bite and temporomandibular disorders

PubMed Central

Iwasa, Akihiko; Horiuchi, Shinya; Kinouchi, Nao; Izawa, Takashi; Hiasa, Masahiro; Kawai, Nobuhiko; Yasue, Akihiro; Hassan, Ali H.; Tanaka, Eiji

2017-01-01

The treatment of severe skeletal anterior open bite is extremely difficult in adults, and orthognathic surgery is generally selected for its treatment. We report the case of an 18-year-old adult patient with skeletal anterior open bite and temporomandibular disorders who was successfully treated using temporary anchorage devices. She had an open bite of −2.0 mm and an increased facial height. Miniplates were implanted in both the maxilla and mandible, and molar intrusion resulted in counterclockwise rotation of the mandible over a period of 12 months. After active treatment, her upper and lower first molars were intruded by approximately 2 mm and her overbite became +2.5 mm. Her retrognathic profile improved with counterclockwise rotation of the mandible. Orthodontic treatment aided with skeletal anchorage is beneficial for intrusion of bimaxillary molars in patients with anterior open bite. PMID:29119097

Dental stigmata and enamel thickness in a probable case of congenital syphilis from XVI century Croatia.

PubMed

Lauc, Tomislav; Fornai, Cinzia; Premužić, Zrinka; Vodanović, Marin; Weber, Gerhard W; Mašić, Boris; Rajić Šikanjić, Petra

2015-10-01

To analyse the dental remains of an individual with signs of congenital syphilis by using macroscopic observation, CBCT and micro-CT images, and the analysis of the enamel thickness. Anthropological analysis of human skeletal remains from the 16th century archaeological site Park Grič in Zagreb, Croatia discovered a female, 17-20 years old at the time of death, with dental signs supportive of congenital syphilis: mulberry molars and canine defects, as well as non-specific hypoplastic changes on incisors. The focus of the analysis was on three aspects: gross morphology, hypoplastic defects of the molars, canines and incisors, as well as enamel thickness of the upper first and second molars. The observed morphology of the first molars corresponds to the typical aspect of mulberry molars, while that of the canines is characterised by hypomineralisation. Hypoplastic grooves were observed on the incisal edges of all incisors. The enamel of the first molars is underdeveloped while in the second molars a thick-enamelled condition is observed. Our observations for the dental and skeletal evidence are supportive to a diagnosis of congenital syphilis for this specimen from XVI century Croatia. The use of CT imaging helped documenting the diagnostic features and quantifying the effect of the dental stigmata on first molars. Copyright © 2015 Elsevier Ltd. All rights reserved.

Use of third molar transplantation for closure of the oroantral communication after tooth extraction: a report of 2 cases.

PubMed

Kitagawa, Yoshimasa; Sano, Kazuo; Nakamura, Mikiko; Ogasawara, Toshiyuki

2003-04-01

This clinical report introduces a promising and unique method for the immediate closure of the oroantral communication (OAC) after tooth extraction: the use of the transplanted third molar with closed apices. In 2 adult patients, OAC caused by the extraction of an upper molar was immediately closed by using a transplanted third molar with complete root formation. After tooth extraction at the recipient site, OAC with perforated mucosa of the sinus floor was confirmed and the donor third molar was transferred to the prepared recipient socket. Endodontic therapy of the transplanted third molar began at 3 weeks after surgery, and prosthetic treatment was completed at 5 months after the operation. These 2 patients were carefully observed both clinically and radiographically. Closure of the OAC was successfully performed, and the transplanted teeth became fixed with the passage of time in these 2 patients. Root resorption did not occur, and good functional results were obtained without any complications. Tooth transplantation of a mature third molar for closure of the OAC is a simple and excellent method because the transplanted tooth not only closes the communication to the maxillary sinus, but it also satisfactorily functions at the recipient site during mastication, even in adult patients.

Upper-arm anthropometry: an alternative indicator of nutritional health to body mass index in unilateral lower-extremity amputees?

PubMed

Miller, Michelle; Wong, Wing Ki; Wu, Jing; Cavenett, Sally; Daniels, Lynne; Crotty, Maria

2008-10-01

To evaluate the utility of body mass index (BMI) and corrected-arm-muscle area (CAMA) as measures of nutritional health for lower-limb amputees attending prosthetics clinics. Cross-sectional study. Prosthetics clinic in Australia. Unilateral lower-extremity amputees (N=58; age range, 21-91y; 37 transtibial, 21 transfemoral) attending a regional prosthetics clinic between May and November 2003. Not applicable. Weight (without prosthesis), corrected and uncorrected for the amputated limb was used with height estimated from knee height to calculate corrected BMI (cBMI) and uncorrected BMI (uBMI). CAMA was calculated using the mean of triplicate mid-upper-arm circumference (MUAC) and triceps skinfold thickness (TST) measurements. The Mini Nutritional Assessment (MNA) and Assessment of Quality of Life were administered according to recommended protocols. The Pearson correlation was used to determine the strength and significance of associations between variables, and bivariate regression analyses were performed to determine whether an association existed between the nutritional variables (BMI, CAMA, MNA) and quality of life (QOL). There were no statistically significant differences in the measures of nutritional health according to site (transtibial, transfemoral) of amputation. MUAC, TST, and CAMA all showed moderate to high positive correlations (r range, .541-.782) with both cBMI and uBMI. The strength of the relationship between the MNA and cBMI/uBMI was weaker (r=.383, r=.380, respectively) but remained positive and statistically significant (P=.003). QOL was not associated with cBMI or uBMI but was related to CAMA (beta=-.132; P=.030) and MNA (beta=-.561; P=.017). For persons with unilateral lower-extremity amputation, measurement of upper-arm anthropometry may be a more useful indicator of nutritional health and its consequences than BMI.

Methodological considerations on descriptive studies of induced periodontal diseases in rats.

PubMed

Galvão, Mariane Ponzio; Chapper, Ana; Rösing, Cassiano Kuchenbecker; Ferreira, Maria Beatriz; de Souza, Maria Antonieta

2003-01-01

The aim of this study was to show the technique and the methodological approach used in describing histological characteristics of induced periodontal disease in rats. To reach that inflammatory process, periodontal disease was induced by ligature, with or without sucrose-rich diet. Twenty-four female adult (60 days old) Wistar rats were divided in four groups: Group 1, or control (which received standard diet), Group 2 (which received ligature around the upper second molars and a standard diet), Group 3 (which received a sucrose-rich diet), and Group 4 (which received ligature around the upper second molars and a sucrose-rich diet). The animals were followed for a period of 30 days, after which they were sacrificed. The upper second molars were removed, processed, and the histological characteristics were analyzed by a descriptive dichotomous method. The results were analyzed by the Fisher's exact test (significance level of 95%) and by a residual test, which showed the relation between groups and histological characteristics. The animals which received ligature (Groups 2 and 4) showed histological characteristics related with periodontitis, whilst the animals without ligatures showed no periodontal destruction. This was shown by a distribution of these groups in extremes of a graphic representation. The use of a ligature, as done in this study, was able to promote a chronic inflammatory process in the periodontium of rats, regardless of the adopted diet. The correspondence factorial analysis was capable of showing these characteristics, being one more tool to be used in histological research.

Selective transarterial embolization with n-butyl-2-cyanoacrylate for the treatment of arterial hemorrhage after third molar extraction.

PubMed

Sagara, Yoshiko; Kiyosue, Hiro; Tanoue, Shuichi; Shimada, Ryuichi; Hongo, Norio; Kohno, Tatsuyuki; Kawano, Kenji; Mori, Hiromu

2013-06-01

Comprehensive reports concerning selective embolization for arterial bleeding from third molar removal have not been published. We analyzed cases of arterial bleeding from third molar extraction that required transarterial embolization, and we demonstrate representative cases. Five consecutive patients (three men and two women, aged 24 to 37 years) who underwent transarterial embolization at our institution were included in this study. Four of them showed postoperative bleeding after lower third molar removal, and one suffered bleeding after upper third molar extraction. The period of time from extraction to embolization varied from 5 h to 5 weeks. Angiography revealed pseudoaneurysms at the inferior alveolar artery in four cases and at the superior alveolar artery in one case. The pseudoaneurysms were selectively embolized using 25-33 % n-butyl-2-cyanoacrylate (NBCA)-lipiodol. All of the cases showed good results angiographically and clinically. Transit hypoesthesia at the region of the mental nerve was observed in one patient. Selective transarterial embolization is an effective technique for arterial bleeding from third molar removal when it is difficult to obtain hemostasis by dental procedures. Injection of NBCA can be useful when the alveolar artery is too small to embolize with coils.

Cross-education of muscular strength following unilateral resistance training: a meta-analysis.

PubMed

Manca, A; Dragone, D; Dvir, Z; Deriu, Franca

2017-11-01

Cross-education (CE) of strength is a well-known phenomenon whereby exercise of one limb can induce strength gains in the contralateral untrained limb. The only available meta-analyses on CE, which date back to a decade ago, estimated a modest 7.8% increase in contralateral strength following unilateral training. However, in recent years new evidences have outlined larger contralateral gains, which deserve to be systematically evaluated. Therefore, the aim of this meta-analysis was to appraise current data on CE and determine its overall magnitude of effect. Five databases were searched from inception to December 2016. All randomized controlled trials focusing on unilateral resistance training were carefully checked by two reviewers who also assessed the eligibility of the identified trials and extracted data independently. The risk of bias was assessed using the Cochrane Risk-of-Bias tool. Thirty-one studies entered the meta-analysis. Data from 785 subjects were pooled and subgroup analyses by body region (upper/lower limb) and type of training (isometric/concentric/eccentric/isotonic-dynamic) were performed. The pooled estimate of CE was a significant 11.9% contralateral increase (95% CI 9.1-14.8; p < 0.00001; upper limb: + 9.4%, p < 0.00001; lower limb: + 16.4%, p < 0.00001). Significant CE effects were induced by isometric (8.2%; p = 0.0003), concentric (11.3%; p < 0.00001), eccentric (17.7%; p = 0.003) and isotonic-dynamic training (15.9%; p < 0.00001), although a high risk of bias was detected across the studies. Unilateral resistance training induces significant contraction type-dependent gains in the contralateral untrained limb. Methodological issues in the included studies are outlined to provide guidance for a reliable quantification of CE in future studies.

Bilateral and multiple cavitation sounds during upper cervical thrust manipulation

PubMed Central

2013-01-01

Background The popping produced during high-velocity, low-amplitude (HVLA) thrust manipulation is a common sound; however to our knowledge, no study has previously investigated the location of cavitation sounds during manipulation of the upper cervical spine. The primary purpose was to determine which side of the spine cavitates during C1-2 rotatory HVLA thrust manipulation. Secondary aims were to calculate the average number of pops, the duration of upper cervical thrust manipulation, and the duration of a single cavitation. Methods Nineteen asymptomatic participants received two upper cervical thrust manipulations targeting the right and left C1-2 articulation, respectively. Skin mounted microphones were secured bilaterally over the transverse process of C1, and sound wave signals were recorded. Identification of the side, duration, and number of popping sounds were determined by simultaneous analysis of spectrograms with audio feedback using custom software developed in Matlab. Results Bilateral popping sounds were detected in 34 (91.9%) of 37 manipulations while unilateral popping sounds were detected in just 3 (8.1%) manipulations; that is, cavitation was significantly (P < 0.001) more likely to occur bilaterally than unilaterally. Of the 132 total cavitations, 72 occurred ipsilateral and 60 occurred contralateral to the targeted C1-2 articulation. In other words, cavitation was no more likely to occur on the ipsilateral than the contralateral side (P = 0.294). The mean number of pops per C1-2 rotatory HVLA thrust manipulation was 3.57 (95% CI: 3.19, 3.94) and the mean number of pops per subject following both right and left C1-2 thrust manipulations was 6.95 (95% CI: 6.11, 7.79). The mean duration of a single audible pop was 5.66 ms (95% CI: 5.36, 5.96) and the mean duration of a single manipulation was 96.95 ms (95% CI: 57.20, 136.71). Conclusions Cavitation was significantly more likely to occur bilaterally than unilaterally during upper cervical HVLA thrust manipulation. Most subjects produced 3–4 pops during a single rotatory HVLA thrust manipulation targeting the right or left C1-2 articulation; therefore, practitioners of spinal manipulative therapy should expect multiple popping sounds when performing upper cervical thrust manipulation to the atlanto-axial joint. Furthermore, the traditional manual therapy approach of targeting a single ipsilateral or contralateral facet joint in the upper cervical spine may not be realistic. PMID:23320608

Evolution of the hypercarnivorous dentition in mammals (Metatheria, Eutheria) and its bearing on the development of tribosphenic molars.

PubMed

Solé, Floréal; Ladevèze, Sandrine

2017-03-01

One major innovation of mammals is the tribosphenic molar, characterized by the evolution of a neomorphic upper cusp (=protocone) and a lower basin (=talonid) that occlude and provide shearing and crushing functions. This type of molar is an evolutionarily flexible structure that enabled mammals to achieve complex dental adaptations. Among carnivorous mammals, hypercarnivory is a common trend that evolved several times among therians (marsupials, placentals, and stem relatives). Hypercarnivory involves an important simplification of the carnassial molar pattern from the ancestral tribosphenic molar pattern, with the modification of the triangular tooth crown, and the loss of several cusps and cuspids typical of the tribosphenic molar. These losses confer to the molars of the hypercarnivorous mammals a plesiomorphic/paedomorphic morphology that resembles more the earliest mammaliaforms than the earliest therians. Here, we demonstrate that the modification of the molar morphology is fully explained by a patterning cascade mode of cusp development. Contrary to what was previously proposed, our study concludes that the metaconid (mesiolingual cusp of lower molars, associated with a puncturing function) does not influence cusp development of the talonid (distal crushing heel of lower molars). Moreover, it provides a new example of how heterochronic changes were crucial to the evolution of mammal dentition. To overcome the difficulty of applying behavioral or ecological definitions of diets to fossil animals, we characterize hypercarnivorous dentitions on the basis of the molar morphology and more particularly on the loss or retention of crushing structures, each dentition resulting from adaptations to a distinct ecomorphotype. Despite repeated and convergent evolution of hypercarnivorous forms, hypercarnivory appears as a highly constrained specialization (i.e., "dead end") that is unlikely to evolve back to omnivorous dentition, especially when the crushing structures are lost. © 2017 Wiley Periodicals, Inc.

Combat Injury Coding: A Review and Reconfiguration

DTIC Science & Technology

2013-01-01

the clavicle , scapula, and pelvic girdle were grouped with the torso where they are anatomically located rather than in the upper and lower extremities...incomplete return to previous cognitive state Clavicle or scapula fracture, unilateral Burns, second or third degree, hand, wrist, elbow or shoulder

Comparative study of intravenous Tramadol versus Ketorolac for preventing postoperative pain after third molar surgery--a prospective randomized study.

PubMed

Gopalraju, Prathibha; Lalitha, Ramanujapuram Manikarnike; Prasad, Kavitha; Ranganath, Krishnappa

2014-07-01

The aim of this comparative, prospective, randomized, controlled study was to evaluate two different regimens of analgesics: a preoperative intravenous dose of either Tramadol or Ketorolac given 10 min prior to surgery to assess their impact on clinical recovery after third molar surgery. Forty patients requiring surgical extraction of unilateral impacted mandibular third molars similar in position were enrolled in the study. Patients were randomly divided into two groups based on permuting the numbers. Patients in Group 1 and Group 2 were administered either Tramadol 50 mg or Ketorolac 30 mg, intravenously, 10 min prior to surgery. The difference in postoperative pain was assessed by four primary points: pain intensity as measured by a 10 mm visual analogue scale hourly for 12 h, median time to rescue analgesics, number of analgesics consumed and patient's overall 5-point global assessment scale. Throughout the 12 h investigation period, patients treated with Ketorolac reported significantly lower pain intensity scores, significantly longer time to rescue analgesics (Acetaminophen 500 mg) and less intake of postoperative analgesics. In Group 2, 40% of the patient had good overall assessment as compared to Group 1 where only 25% of patients had good overall assessment. The current study shows that pre-emptive use of Inj. Ketorolac 30 mg intravenously can reduce the severity of the postoperative sequelae of asymptomatic impacted mandibular third molar surgery. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Radiographic study of the mandibular retromolar canal: an anatomic structure with clinical importance.

PubMed

von Arx, Thomas; Hänni, Andrea; Sendi, Pedram; Buser, Daniel; Bornstein, Michael M

2011-12-01

The retromolar canal is an anatomic structure of the mandible with clinical importance. This canal branches off from the mandibular canal behind the third molar and travels to the retromolar foramen in the retromolar fossa. The retromolar canal might conduct accessory innervation to the mandibular molars or contain an aberrant buccal nerve. Patients referred for panoramic radiography were consecutively enrolled, provided a limited cone-beam computed tomography (CBCT) scan had also been taken in the area of interest. Radiographs were retrospectively screened for the presence of a retromolar canal, and linear measurements (distance to second molar, height, width) were taken. One hundred twenty-one sides in 100 patients were evaluated (100 unilateral and 21 bilateral cases). A total of 31 retromolar canals were identified with CBCT (25.6%). Only 7 of these canals were also seen on the corresponding panoramic radiographs. The existence of a retromolar canal was not statistically related to gender or side. With regard to the linear measurements, the mean distance from the retromolar canal to the second molar was 15.16 mm (±2.39 mm), the mean height of the canal was 11.34 mm (±2.36 mm), and the mean width was 0.99 mm (±0.31 mm). This radiographic study documents a frequency of 25% for the presence of a retromolar canal. The clinician is advised to preserve this anatomic variation when performing surgery in the retromolar area and to consider additional locoregional anesthesia in the case of failed mandibular block anesthesia. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Evaluation of the Alteration of Occlusal Distribution in Unilateral Free-End and Intermediate Missing Cases.

PubMed

Kon, Kazuhiro; Shiota, Makoto; Sakuyama, Aoi; Ozeki, Maho; Kozuma, Wataru; Kawakami, Sawako; Kasugai, Shohei

2017-02-01

The present study aimed to evaluate the effect of implant prostheses on the occlusal force and area as well as the distribution of occlusal loading in unilateral free-end and intermediate missing cases. Fourteen healthy subjects (7 free-end missing cases in the first and second molars and 7 intermediate missing cases in the first molar region) were included. Six months after the implant prosthesis was placed, an occlusal evaluation was performed with or without the implant superstructure by using Dental Prescale film and an occluder device. In free-end missing cases, the total occlusal force and area, implant-side occlusal force and area, and implant-side occlusal force and area of the residual natural teeth were significantly affected by the implant prostheses. In intermediate missing cases, the implant-side occlusal force of the residual natural teeth was significantly affected by the implant prostheses. In free-end missing cases, the proportions of implant-side occlusal force, non-implant-side occlusal force, and implant-side occlusal force of the residual natural teeth relative to the total occlusal force were significantly affected by the implant prostheses. In the intermediate missing cases, the proportion of the implant-side occlusal force of the residual natural teeth relative to the total occlusal force was significantly affected by the implant prostheses. The proportion of the occlusal area was also significantly affected. In free-end missing cases, implant prostheses significantly increased the occlusal force and area, which resulted in the proper occlusal distribution. In intermediate missing cases, an implant prosthesis may only improve the same-side occlusal loading of the natural teeth.

Estimation of Flow Channel Parameters for Flowing Gas Mixed with Air in Atmospheric-pressure Plasma Jets

NASA Astrophysics Data System (ADS)

Yambe, Kiyoyuki; Saito, Hidetoshi

2017-12-01

When the working gas of an atmospheric-pressure non-equilibrium (cold) plasma flows into free space, the diameter of the resulting flow channel changes continuously. The shape of the channel is observed through the light emitted by the working gas of the atmospheric-pressure plasma. When the plasma jet forms a conical shape, the diameter of the cylindrical shape, which approximates the conical shape, defines the diameter of the flow channel. When the working gas flows into the atmosphere from the inside of a quartz tube, the gas mixes with air. The molar ratio of the working gas and air is estimated from the corresponding volume ratio through the relationship between the diameter of the cylindrical plasma channel and the inner diameter of the quartz tube. The Reynolds number is calculated from the kinematic viscosity of the mixed gas and the molar ratio. The gas flow rates for the upper limit of laminar flow and the lower limit of turbulent flow are determined by the corresponding Reynolds numbers estimated from the molar ratio. It is confirmed that the plasma jet length and the internal plasma length associated with strong light emission increase with the increasing gas flow rate until the rate for the upper limit of laminar flow and the lower limit of turbulent flow, respectively. Thus, we are able to explain the increasing trend in the plasma lengths with the diameter of the flow channel and the molar ratio by using the cylindrical approximation.

High-Resolution Manometry Evaluation of Pressures at the Pharyngo-upper Esophageal Area in Patients with Oropharyngeal Dysphagia Due to Vagal Paralysis.

PubMed

Pinna, Bruno Rezende; Herbella, Fernando A M; de Biase, Noemi; Vaiano, Thays C G; Patti, Marco G

2017-10-01

The motility of the pharynx, upper esophageal sphincter (UES), and proximal esophagus in patients with oropharyngeal dysphagia is still not entirely understood. High-resolution manometry (HRM) was recently added to the armamentarium for the study of this area. This study aims to describe HRM findings in patients with vagal paralysis. Sixteen patients (mean age 54 years, 69% females) with oropharyngeal dysphagia due to unilateral vagal paralysis were prospectively studied. All patients underwent HRM. Motility of the UES and at the topography of the velopharynx and epiglottis were recorded. (1) UES relaxation is compromised in a minority of patients, (2) epiglottis pressure does not follow a specific pattern, (3) vellum is hypotonic in half of the patients, (4) dysphagia is related to a low pharyngeal pressure, not to a flow obstruction at the level of the UES, and (5) aspiration is related to low pressures at the level of the UES and epiglottis and higher pressures at the level of the vellum. Pharyngeal motility is significantly impaired in patients with oropharyngeal dysphagia and unilateral vagal paralysis. In half of the cases, UES resting pressure is preserved due to unilateral innervation and relaxation is normal in most patients. Dysphagia therapy in these patients must be directed toward improvement in the oropharyngeal motility not at the UES.

Position Sense in Chronic Pain: Separating Peripheral and Central Mechanisms in Proprioception in Unilateral Limb Pain.

PubMed

Tsay, Anthony J; Giummarra, Melita J

2016-07-01

Awareness of limb position is derived primarily from muscle spindles and higher-order body representations. Although chronic pain appears to be associated with motor and proprioceptive disturbances, it is not clear if this is due to disturbances in position sense, muscle spindle function, or central representations of the body. This study examined position sense errors, as an indicator of spindle function, in participants with unilateral chronic limb pain. The sample included 15 individuals with upper limb pain, 15 with lower limb pain, and 15 sex- and age-matched pain-free control participants. A 2-limb forearm matching task in blindfolded participants, and a single-limb pointer task, with the reference limb hidden from view, was used to assess forearm position sense. Position sense was determined after muscle contraction or stretch, intended to induce a high or low spindle activity in the painful and nonpainful limbs, respectively. Unilateral upper and lower limb chronic pain groups produced position errors comparable with healthy control participants for position matching and pointer tasks. The results indicate that the painful and nonpainful limb are involved in limb-matching. Lateralized pain, whether in the arm or leg, does not influence forearm position sense. Painful and nonpainful limbs are involved in bilateral limb-matching. Muscle spindle function appears to be preserved in the presence of chronic pain. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Accuracy in the legal age estimation according to the third molars mineralization among Mexicans and Columbians.

PubMed

Costa, José; Montero, Javier; Serrano, Sarai; Albaladejo, Alberto; López-Valverde, Antonio; Bica, Isabel

2014-11-01

This study aims to assess the accuracy of age estimation according to two cut-off points of Demirjian's developmental stages (G and H) in the wisdom teeth, using panoramic radiographs from Colombian and Mexican teenagers. The degree of maturation of the third molars was classified according to Demirjian in 8 stages (from A to H) by a blinded trained assessor. The sensitivity, specificity and efficacy of two cut-off points (G and H) were calculated for both samples. The orthopantomographies of 316 subjects, 171 Colombians (54.1%) and 145 Mexicans (45.9%), were analyzed. The stage H was found to be the best threshold for detecting juveniles (because the high specificity) in all the third molars assessed. The specificity was higher for lower third molars than for upper third molars, but no asymmetrical discrepancy was noted. The stage H is the best cut-off point for detecting the adulthood when a high-specificity test is required. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Evaluation of stress distribution of implant-retained mandibular overdenture with different vertical restorative spaces: A finite element analysis

PubMed Central

Ebadian, Behnaz; Farzin, Mahmoud; Talebi, Saeid; Khodaeian, Niloufar

2012-01-01

Background: Available restorative space and bar height is an important factor in stress distribution of implant-supported overdentures. The purpose of this study was to evaluate the effect of different vertical restorative spaces and different bar heights on the stress distribution around implants by 3D finite element analysis. Materials and Methods: 3D finite element models were developed from mandibular overdentures with two implants in the interforaminal region. In these models, four different bar heights from gingival crest (0.5, 1, 1.5, 2 mm) with 15 mm occlusal plane height and three different occlusal plane heights from gingival crest (9, 12, 15 mm) with 2 mm bar height were analyzed. A vertical unilateral and a bilateral load of 150 N were applied to the central occlusal fossa of the first molar and the stress of bone around implant was analyzed by finite element analysis. Results: By increasing vertical restorative space, the maximum stress values around implants were found to be decreased in unilateral loading models but slightly increased in bilateral loading cases. By increasing bar height from gingival crest, the maximum stress values around implants were found to be increased in unilateral loading models but slightly decreased in bilateral loading cases. In unilateral loading models, maximum stress was found in a model with 9 mm occlusal plane height and 1.5 mm bar height (6.254 MPa), but in bilateral loading cases, maximum stress was found in a model with 15 mm occlusal plane height and 0.5 mm bar height (3.482 MPa). Conclusion: The reduction of bar height and increase in the thickness of acrylic resin base in implant-supported overdentures are biomechanically favorable and may result in less stress in periimplant bone. PMID:23559952

Melorheostosis involving the cervical and upper thoracic spine: radiographic, CT, and MR imaging findings.

PubMed

Motimaya, A M; Meyers, S P

2006-01-01

Melorheostosis, an uncommon mesenchymal dysplasia, rarely affects the axial skeleton. We describe the imaging findings of melorheostosis involving the cervical and upper thoracic spine. Radiographs and CT showed unilateral well-marginated undulating zones of cortical hyperostosis involving multiple vertebrae that were contiguous with a coalescent ossified right paravertebral mass. MR imaging showed zones of signal intensity void on all pulse sequences without contrast enhancement. Conservative management was elected because of lack of interval clinical and imaging changes for 8 years.

Cosmetic arm lengthening with monorail fixator.

PubMed

Agrawal, Hemendra Kumar; Singh, Balvinder; Garg, Mohit; Khatkar, Vipin; Batra, Sumit; Sharma, Vinod Kumar

2015-01-01

Upper limb length discrepancy is a rare occurrence. Humerus shortening may need specialized treatment to restore the functional and cosmetic status of upper limb. We report a case of humerus lengthening of 9 cm with a monorail external fixator and the result was observed during a 2-year follow-up. Humerus lengthening needs specialized focus as it is not only a cosmetic issue but also a functional demand. The monorail unilateral fixator is more functional and cosmetically acceptable, and thus becomes an effective treatment option.

Bilateral changes in forearm oxygen consumption at rest and after exercise in patients with unilateral repetitive strain injury: a case-control study.

PubMed

Brunnekreef, Jaap J J; Thijssen, Dick H J; Oosterhof, Jan; Hopman, Maria T E

2012-04-01

Case-control study. To investigate whether oxygen consumption and blood flow at rest and after exercise are lower in the affected arm of patients with repetitive strain injury (RSI) compared to controls, and lower in the healthy nonaffected forearm within patients with unilateral RSI. RSI is considered an upper extremity overuse injury. Despite the local presentation of complaints, RSI may be represented by systemic adaptations. Insight into the pathophysiology of RSI is important to better understand the development of RSI complaints and to develop effective treatment and prevention strategies. Twenty patients with unilateral RSI and 20 gender-matched control subjects participated in this study. Forearm muscle blood flow and oxygen consumption were measured using near-infrared spectroscopy at baseline and immediately after isometric handgrip exercises at 10%, 20%, and 40% of the individual maximal voluntary contraction. Unilateral RSI resulted in a lower oxygen consumption and blood flow in the affected forearm at baseline and lower oxygen consumption after incremental handgrip exercises compared to controls (P<.05). In addition, exercise-induced blood flow and oxygen consumption in the nonaffected forearm in patients with RSI were similarly reduced. Blood flow and oxygen consumption after exercise are similarly attenuated in the affected and nonaffected arms of patients with unilateral RSI. Our findings suggest that, despite the unilateral character in clinical symptoms, RSI demonstrates systemic adaptations in forearm blood flow and oxygen consumption at rest and after exercise.

[Mapping mini-implant anatomic sites in the area of the maxillary first molar with the aid of the NewTom 3G® system].

PubMed

Dumitrache, Marius; Grenard, Annabelle

2010-12-01

The goal of our study was to construct a map of the implant sites in the region of the attached gingiva around the maxillary first molars that would be appropriate locations for placement of miniscrews to serve as orthodontic anchorage. We conducted 58 radiographic examinations with the NewTom 3G(®) cone beam technique. For each interdental space, between upper second bicuspids and first molars (5/6) and between upper first and second molars (6/7), we studied the mesio-distal width and depth of bucco-lingual bone at two different levels, L1 and L2, that corresponded to the lower and upper limits of the attached gingiva in the general population. The widths of the interdental spaces varied very little between L1 and L2 and their variances were comparable. At the level of the 5/6 space, the interdental widths displayed a Gaussian distribution, which made it possible for us to determine the confidence intervals at the two borders of attached gingiva as a function of age: IC(99%) of L1 = [2.045 ; 3.462] from 12 to 17 years or [1.594 ; 2.519] from 18 to 24 or [1.613 ; 2.5] from 25 to 48 years and IC(99%) of L2 = [2.37 ; 3.69] from 12 to 17 years or [1.5 ; 2.613] from 18 to 24 or [1.546 ; 2.619] from 25 to 48 ans. The interdental depths increased in an apical direction and their variance diminished. Even if the adequacy of the Gaussian law is less reliable in the sagittal plane, we find a greater consistency in depths in the spaces around 5/6 that allows us to establish very precise confidence levels: IC(99%) of L1 = [9.213; 10.575] and IC(99%) of L2 = [10.295; 11.593]. The mesial areas of the first molars constitute safe zones for implantation of miniscrews with a maximum of 2-2.3 mm for 12 to 17 years old or 1.5-1.6 mm for 18 to 48 year olds and of a maximum of 9-10 mm in length whether the attached gingival level is strong or feeble. The distal areas of the first molars, because of their great variability, require an individualized radiographic study before any mini/screw can be placed. © EDP Sciences, SFODF, 2010.

A case of unilateral phthiriasis palpebrarum infestation involving the left eye.

PubMed

Ashraf, Mohammad; Waris, Abdul; Kumar, Ashwini; Akhtar, Nahid

2014-06-06

Phthiriasis palpebrarum is a rare cause of eyelid infestation. We report a case of unilateral phthiriasis palpebrarum. A 28-year-old man presented with moderate itching associated with lacrimation and irritation in the left eye. The initial evaluation of the patient revealed multiple white dots on the left upper eyelashes. Slit-lamp examination revealed multiple nits attached to the base and shaft of the cilia. There was no hyperaemia or discharge present in the conjunctiva and the cornea was clear and shiny. The right eye was perfectly normal. The patient was treated with moxifloxacin eye ointment and was completely cured in 1 week. 2014 BMJ Publishing Group Ltd.

An Approach with Hybrid Segmental Mechanics.

PubMed

Mishra, Harsh Ashok; Maurya, Raj Kumar

2016-06-01

Present case report provides an insight into the hybrid segmental mechanics with treatment of 13-year-old male, considering the side effects of sole continuous arch wire sliding mechanics. Patient was diagnosed as a case of skeletal class I jaw relationship, low mandibular plane angle, class II molar relation on right and class I molar relation on left side, anterior cross bite, crowding of 12mm in upper, 5mm in lower arch. He also had proclined upper and lower anteriors by 2mm, convex profile and incompetent lips. Total treatment duration was 20 months, during which segmental canine retraction was performed with TMA (Titanium, Molybdenum, Aluminum) 'T' loop retraction spring followed by consolidation of spaces with continuous arch mechanics. Most of the treatment objectives were met with good intraoral and facial results within reasonable framework of time. This approach used traditional twin brackets, which offered the versatility to use continuous arch-wire mechanics, segmental mechanics and hybrid sectional mechanics.

The incidence of periodontal defects distal to the maxillary second molar after impacted third molar extraction.

PubMed

Coleman, Michael; McCormick, Adam; Laskin, Daniel M

2011-02-01

This study assessed the incidence of periodontal defects on the distal aspect of maxillary second molars after extraction of impacted maxillary third molars. Subjects enrolled in this institutional review board-approved prospective study consisted of healthy young patients having extraction of at least 1 asymptomatic impacted maxillary third molar adjacent to a second molar. Preoperative periodontal probing data were collected from 4 sites (midbuccal, distobuccal, midpalatal, and distopalatal) on each adjacent second molar, and a similar probing examination was performed at a mean of 6 months postoperatively. All subjects were treated under general anesthesia or conscious sedation by upper-level residents in the outpatient clinic. Twenty subjects with a total of 38 impacted maxillary third molars were treated. There were 9 male subjects (45%) and 11 female subjects (55%), with a mean age of 17 years (range, 14-22 years). The mean follow-up interval was 6 months, with a range of 3 to 15 months. Of the 152 probing sites measured, 92 (61%) decreased, 56 (37%) remained unchanged, and only 4 (2.6%) increased. A decrease in probing depth of 1 mm was found in 35 (23%) of the sites, a decrease of 2 mm was seen in 32 (21%), and 25 (16%) decreased by 3 mm or more. Of the 152 sites probed, 4 (2.6%) increased by 1 or 2 mm. Extraction of the impacted maxillary third molar does not result in significant periodontal defects on the distal aspect of the adjacent second molar, and in many cases it results in an improvement of the probing depths on these teeth. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Establishing the diagnostic criteria for eruption disorders based on genetic and clinical data.

PubMed

Rhoads, Stephanie Golubic; Hendricks, Heather M; Frazier-Bowers, Sylvia A

2013-08-01

Proper diagnosis and management of eruption disturbances remains challenging but is critical to a functional occlusion. The objective of this study was to establish definitive criteria to differentiate and diagnose eruption disorders, specifically primary failure of eruption (PFE) and ankylosis. Sixty-four affected persons were placed into 3 cohorts: PFE diagnosed through confirmed PTH1R mutation (n = 11), PFE diagnosed based on clinical criteria (n = 47), and ankylosis diagnosed based on clinical criteria (n = 6). These groups were assessed to identify clinical features that differentiate PFE and ankylosis. Ninety-three percent of the subjects in the genetic and clinical PFE cohorts combined (n = 58) and 100% in the genetic PFE cohort had at least 1 infraoccluded first permanent molar. Additionally, a novel functional PTH1R mutation, 1092delG, was identified and linked to PFE in the deciduous dentition. An infraoccluded, supracrestal first molar is a hallmark of PFE, often involving both arches in the permanent or deciduous dentition, and with unilateral or bilateral affection, infraoccluded second premolar or second molar, and multiple affected adjacent teeth. Our results further suggest that PFE and ankylosis might be clinically indistinguishable without knowledge of prior trauma, treatment history, genetic information, or obliteration of the periodontal ligament space. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Substance P expression in the gingival tissue after upper third molar extraction: effect of ketoprofen, a preliminary study.

PubMed

Abbate, G M; Mangano, A; Sacerdote, P; Amodeo, G; Moschetti, G; Levrini, L

2017-01-01

The aim of this study was to evaluate substance P (SP) levels and the effect of a non-steroidal anti-inflammatory drug (NSAID), ketoprofen, on SP in the pericoronal gingival tissue after extraction of upper third molars. A sample of 20 young non-smoking systemically healthy adults of both sexes, with a healthy upper third molar to extract for orthodontic purposes, was selected. After extraction, a sample of the gingival tissue of the pericoronal region was collected with a sterile scalpel, placed into test tubes and kept frozen at -20°C until the SP determination. SP levels were determined by using a commercially available enzyme immunoassay (ELISA) kit. The subjects were randomly divided into two groups: group 1 received a single dose of ketoprofen 30 minutes prior to the experimental procedure. The subjects of group 2 did not receive any kind of drug administration before extraction. The patients were asked to complete a diary on the postoperative pain. A relevant amount of SP was measured in all the gingival samples. No statistically significant difference could be detected in SP expression between the two groups. In group 1 pain appearance was significantly delayed (6.2±0.13 hours) in comparison with group 2 (3.95±0.2 hours). In this small selected group of subjects and limited study design, preventive administration of ketoprofen did not significantly affect the gingival levels of SP, the clinical recommendation emerging is that of NSAID administration postoperatively but before pain appearance in order to optimize the management of pain of the patient.

Facial Anthropometric Evaluation of Unilateral Cleft Lip and Palate Patients: Infancy Through Adolescence.

PubMed

Dehghani, Mahboobe; Jahanbin, Arezoo; Omidkhoda, Maryam; Entezari, Mostafa; Shadkam, Elaheh

2018-03-01

Craniofacial anthropometric studies measure the differences in humans' craniofacial dimensions. The aim of this study was to determine facial anthropometric dimensions of newborn to 12-year-old girls with nonsyndromic unilateral cleft lip and palate (UCLP). In this cross-sectional analytical study, data was collected from 65 infant to 12-year old girls with UCLP. Digital frontal and profile facial photographs were transferred to a computer and desired anthropometric landmarks were traced on each image. Fifteen anthropometric parameters were measured which were the angles of facial, nasofacial, nasomental, Z, nasolabial, inclination of nasal base and labial fissure, nasal deviation, mentocervical, facial convexity and also ratios of nasal prominence relative to nasal height, middle to lower facial third, upper lip to lower lip height, columellar length relative to upper lip, and incisal show relative to incisal width. Pearson coefficient and linear regression were used for statistical analysis. Upper lip to lower lip height ratio and angles of nasofacial, nasolabial, and facial convexity decreased with the age of the patients. In contrast, nasomental angle and the ratios of columellar length to upper lip length, middle facial height to lower facial height, and incisal show relative to incisal width increased. Other parameters studied did not appear to have any significant correlation with age. In the girls with UCLP, various craniofacial dimensions have different growth rates with some parts growing slower than others. Some of the parameters studied were significantly correlated with age, thus growth-related curves and equations were obtained and presented.

The arm posture in children with unilateral Cerebral Palsy is mainly related to antero-posterior gait instability.

PubMed

Meyns, Pieter; Duysens, Jacques; Desloovere, Kaat

2016-09-01

In this observational case-control study we aimed to determine whether altered arm postures in children with unilateral CP (uniCP) are related to gait instability in a specific direction. Antero-posterior and medio-lateral Foot Placement Estimator instability measures and arm posture measures (vertical and antero-posterior hand position, sagittal and frontal upper arm elevation angle) were determined in eleven uniCP (7 years-10 months) and twenty-four typically developing children (9 years-6 months) at two walking speeds. Spearman-rank correlation analyses were made to examine the relationship between antero-posterior and medio-lateral arm posture and gait instability. Arm posture in both planes was related to antero-posterior instability (e.g. sagittal and frontal upper arm elevation angle correlated moderately with antero-posterior instability; R=0.41, p<0.001, R=-0.47, p<0.001). In uniCP, increased antero-posterior instability was associated with a higher (R=-0.62, p=0.002) and more frontal position of the hemiplegic hand (R=-0.58, p=0.005), while the non-hemiplegic upper arm was rotated more backward (R=0.63, p=0.002) and both upper arms rotated more sideways (hemiplegic: R=-0.58, p=0.004; non-hemiplegic: R=-0.55, p=0.008). The altered non-hemiplegic (sagittal and frontal) arm posture in uniCP may be a compensation to reduce antero-posterior gait instability. Copyright © 2016 Elsevier B.V. All rights reserved.

Molar tooth structures in calcareous nodules, early Neoproterozoic Burovaya Formation, Turukhansk region, Siberia

NASA Astrophysics Data System (ADS)

Pope, Michael C.; Bartley, Julie K.; Knoll, Andrew H.; Petrov, Peter Yu.

2003-05-01

Molar tooth structures are abundant in large (1-2 m diameter) carbonate nodules within fine-grained, subtidal carbonates of the early Neoproterozoic (lower Upper Riphean) Burovaya Formation along the Sukhaya Tunguska River, Turukhansk Uplift, northwestern Siberia. Although molar tooth structures are regionally abundant in this unit, here they occur only within the nodules. Stable isotopic compositions of molar-tooth-filling dolomicrospar cements and of thinly bedded dolomicrite within and surrounding the nodules are indistinguishable from one another. The carbon isotopic compositions (mean δ13C=+2.8‰ PDB±0.4) reflect mean average oceanic surface water composition during their formation; the light oxygen isotopic compositions (mean δ18O=-6.4‰ PDB±2.2) are generally similar to those of other little-altered Meso- to Neoproterozoic limestones and dolostones. These molar tooth structures have no features that would support a tectonic origin; they more likely formed through bacterial processes. Carbonate cement filling of these voids occurred soon after their formation, but the mechanism responsible for this carbonate precipitation is currently uncertain. Local restriction of molar tooth structures to early diagenetic nodules suggests that penecontemporaneous lithification was required for the formation, or at least preservation, of these widespread Mesoproterozoic to Neoproterozoic features.

Generalized mechanical pain sensitivity over nerve tissues in patients with strictly unilateral migraine.

PubMed

Fernández-de-las-Peñas, César; Arendt-Nielsen, Lars; Cuadrado, María Luz; Pareja, Juan A

2009-06-01

No study has previously analyzed pressure pain sensitivity of nerve trunks in migraine. This study aimed to examine the differences in mechanical pain sensitivity over specific nerves between patients with unilateral migraine and healthy controls. Blinded investigators assessed pressure pain thresholds (PPT) over the supra-orbital nerves (V1) and peripheral nerve trunks of both upper extremities (median, radial, and ulnar nerves) in 20 patients with strictly unilateral migraine and 20 healthy matched controls. Pain intensity after palpation over both supra-orbital nerves was also assessed. A pressure algometer was used to quantify PPT, whereas a 10-point numerical pain rate scale was used to evaluate pain to palpation over the supra-orbital nerve. The analysis of covariance revealed that pain to palpation over the supra-orbital nerve was significantly higher (P<0.001) on the symptomatic side (mean: 3.4, SD: 1.5) as compared with the nonsymptomatic side (mean: 0.5, SD: 1.2) in patients with migraine and both the dominant (mean: 0.2, SD: 0.4) and nondominant (mean: 0.3, SD: 0.5) sides in healthy controls. PPT assessed over the supra-orbital nerve on the symptomatic side (mean: 1.05, SD: 0.2 kg/cm) was significantly lower (P<0.05) than PPT measurements on the nonsymptomatic side (mean: 1.35, SD: 0.3 kg/cm) and either the dominant (mean: 1.9, SD: 0.2 kg/cm) or nondominant (mean: 1.9, SD: 0.3 kg/cm) sides in controls (P<0.001). Finally, PPT assessed over the median, ulnar, and radial nerves were significantly lower in patients with migraine as compared with controls (P<0.001), without side-to-side differences (P>0.6). In patients with unilateral migraine, we found increased mechano-sensitivity of the supra-orbital nerve on the symptomatic side of the head. Outside the head, the same patients showed increased mechano-sensitivity of the main peripheral nerves of both upper limbs, without asymmetries. Such diffuse hypersensitivity of the peripheral nerves lends further evidence to the presence of a state of hyperexcitability of the central nervous system in patients with unilateral migraine.

Assessing physical function in adult acquired major upper-limb amputees by combining the Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Questionnaire and clinical examination.

PubMed

Ostlie, Kristin; Franklin, Rosemary J; Skjeldal, Ola H; Skrondal, Anders; Magnus, Per

2011-10-01

To describe physical function in adult acquired major upper-limb amputees (ULAs) by combining self-assessed arm function and physical measures obtained by clinical examinations; to estimate associations between background factors and self-assessed arm function in ULAs; and to assess whether clinical examination findings may be used to detect reduced arm function in unilateral ULAs. postal questionnaires and clinical examinations. Norwegian ULA population. Clinical examinations performed at 3 clinics. Questionnaires: population-based sample (n=224; 57.4% response rate). Clinical examinations: combined referred sample and convenience sample of questionnaire responders (n=70; 83.3% of those invited). SURVEY inclusion criteria: adult acquired major upper-limb amputation, resident in Norway, mastering of spoken and written Norwegian. Not applicable. The Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Questionnaire, and clinical examination of joint motion and muscle strength with and without prostheses. Mean DASH score was 22.7 (95% confidence interval [CI], 20.3-25.0); in bilateral amputees, 35.7 (95% CI, 23.0-48.4); and in unilateral amputees, 22.1 (95% CI, 19.8-24.5). A lower unilateral DASH score (better function) was associated with paid employment (vs not in paid employment: adjusted regression coefficient [aB]=-5.40, P=.033; vs students: aB=-13.88, P=.022), increasing postamputation time (aB=-.27, P=.001), and Norwegian ethnicity (aB=-14.45, P<.001). At clinical examination, we found a high frequency of impaired neck mobility and varying frequencies of impaired joint motion and strength at the shoulder, elbow, and forearm level. Prosthesis wear was associated with impaired joint motion in all upper-limb joints (P<.006) and with reduced shoulder abduction strength (P=.002). Impaired without-prosthesis joint motion in shoulder flexion (ipsilateral: aB=12.19, P=.001) and shoulder abduction (ipsilateral: aB=12.01, P=.005; contralateral: aB=28.82, P=.004) was associated with increased DASH scores. Upper-limb loss clearly affects physical function. DASH score limitation profiles may be useful in individual clinical assessments. Targeted clinical examination may indicate patients with extra rehabilitational needs. Such examinations may be of special importance in relation to prosthesis function. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Dental age estimation in living individuals using 3.0 T MRI of lower third molars.

PubMed

Guo, Yucheng; Olze, Andreas; Ottow, Christian; Schmidt, Sven; Schulz, Ronald; Heindel, Walter; Pfeiffer, Heidi; Vieth, Volker; Schmeling, Andreas

2015-11-01

In order to increase the validity of age estimation in adolescents and young adults when there is no legitimation for X-ray examinations, it seems desirable to be able to assess the mineralization of third molars using X-ray-free imaging procedures. In the present study, the mineralization stages of lower third molars were determined prospectively in 269 male and 248 female individuals aged 12 to 24 years using 3.0 T MRI. The classification system of Demirjian et al. was used to determine the stages. This study presents the minima and maxima, means and standard deviations, median values, and lower and upper quartiles separately for both sexes, for the mineralization stages B-H. Statistically significant sex differences were observed for the mineralization stages C, E, F, and G, and a faster developmental rate was observed for males. It was concluded that magnetic resonance imaging is an X-ray-free alternative to orthopantomography when assessing mineralization of third molars.

Maxillary Distraction Osteogenesis in Unilateral Cleft Lip and Palate Patients with Rigid External Distraction System.

PubMed

Alkhouri, Shadi; Waite, Peter D; Davis, Matthew B; Lamani, Ejvis; Kau, Chung How

2017-01-01

Distraction osteogenesis (DO) is a treatment option for patients with maxillary hypoplasia secondary to cleft lip and palate (CLP). The aim of this study is to present a technique for maxillary DO using Le Fort I osteotomy with rigid external distraction (RED) system. The patient presented in this paper was an Asian female with CLP aged 13 years and 6 months. She presented with severe midfacial deficiency with a Class III dental malocclusion with a negative overjet and concave facial profile. Cone-beam computed tomography images were recorded preoperatively and the operation performed involved a high Le Fort I osteotomy. The appliance fabricated was banded to upper first molars used for anchorage of the RED system. Distraction of the maxilla was initiated after 7-day latency period. Postoperative cephalometric analysis showed maxillary advancement anteriorly and superiorly, the total distraction treatment period was 10 days. The maxillary advancement was 10.5 mm and the SNA angle increased from 67.5° to 77.9°. Furthermore, the ANB angle changed from -9.8° to 1.6° and the occlusion changed from Class III to Class I. The profile of the face changed from concave to convex and a much better esthetic result was achieved. The study suggests RED system to be a reliable alternative procedure for the treatment of midfacial hypoplasia with or without cleft. Furthermore, it minimizes the risk of the surgical procedure and shortens the operating time.

Inhibitory effect of interferon-γ on experimental tooth movement in mice.

PubMed

Kohara, Haruka; Kitaura, Hideki; Yoshimatsu, Masako; Fujimura, Yuji; Morita, Yukiko; Eguchi, Toshiko; Yoshida, Noriaki

2012-09-01

The aim of this study was to investigate the effects of interferon (IFN)-γ on experimental tooth movement in mice using a murine experimental tooth movement model. An Ni-Ti closed-coil spring was inserted between the upper-anterior alveolar bones and the upper-left first molars in mice. We evaluated the relationship between local Ifn-γ mRNA levels and orthodontic tooth movement. In other experiments, IFN-γ was injected adjacent to each first molar every other day during tooth movement. After 12 days, the amount of tooth movement was measured. Tartrate-resistant acid phosphatase (TRAP)-positive cells at the pressure side of each experimental tooth were counted as osteoclasts. Local Ifn-γ mRNA expression increased with orthodontic tooth movement. The number of TRAP-positive cells increased on the pressure side of the first molar. In contrast, the degree of tooth movement and the number of TRAP-positive cells on the pressure side in IFN-γ-injected mice were less than those of control mice. IFN-γ was induced in experimental tooth movement, and could inhibit mechanical force-loaded osteoclastogenesis and tooth movement. These results suggest that IFN-γ might be useful in controlling orthodontic tooth movement because of its inhibitory action on excessive osteoclastogenesis during this movement.

A New Variant of Connective Tissue Nevus with Elastorrhexis and Predilection for the Upper Chest.

PubMed

Chu, Derek H; Goldbach, Hayley; Wanat, Karolyn A; Rubin, Adam I; Yan, Albert C; Treat, James R

2015-01-01

Localized changes in cutaneous elastic tissue often manifest with flesh-colored, hypopigmented, or yellow papules, plaques, and nodules. We present five children with clinically similar cobblestone plaques composed of multiple hypopigmented, nonfollicular, pinpoint papules located unilaterally over the upper chest. All lesions first appeared at birth or during early infancy. No associated extracutaneous abnormalities have been identified. Histopathology was remarkable for many, thick elastic fibers with elastorrhexis. We believe that these cases represent a distinct and unique variant of connective tissue nevi. © 2014 Wiley Periodicals, Inc.

Clinical studies on teenage Brazilian victims of thalidomide.

PubMed

Schmidt, M; Salzano, F M

1983-07-01

Ninety-three Brazilian teenagers with thalidomide embryopathy were studied. The pattern of distribution of their most significant defect was: upper limbs, 66; lower limbs, 8; all four limbs, 12; head, 7. Only 10 individuals presented the major defect unilaterally. In 30 of 83 with bilateral defects there were differences in severity between the two sides. Of the 31 patients whose spines had been X-rayed, 16 showed defects, the most common being spina bifida occulta at S1. Gynecomasty was found in three of the patients having major upper limb defects.

The maxillary second molar - anatomical variations (case report).

PubMed

Beshkenadze, E; Chipashvili, N

2015-01-01

To be acquainted with dental anatomical specificity is of great importance for dental endodontic treatment algorithm. The subject of present publication is 2 clinical cases of upper second molars, detailed characterization of, which is considered very important for enrichment of anatomical knowledge about dental anatomical variations. In one case, the reason for admission to the clinic of a 38-year-old woman was complains as of esthetic character as well as functional misbalance (disturbance of chewing function due to the damage of orthopedic construction). The patient indicated to the existence of coronary defects of large size aesthetic discomforts, damage and discolouration of old orthopedic construction (denture) in maxillary right molar area. According to the data obtained after clinical and visiographical examinations, chronic periodontitis of 17 teeth was identified as a result of incomplete endodontic treatment. According to the data obtained after clinical and visiographical examinations, the diagnosis of chronic periodontitis of 17 teeth was identified, tooth 17 with 2 roots and 2 canals. In the second clinical case, the reason for admission to the clinic of a 39-year-old woman was severe pain in the upper right molar area. The patient indicated to the caries on the tooth 17. After completion of proper survey clinical and visiographical examinations, acute pulpitis (K04.00) - with three roots and 4 canals was diagnosed. In both cases after the proper examinations and agreement with the patients a treatment plan envisaging: 17 teeth endodontic treatment, filling of caries defects and their preparation on one hand for orthopedic construction (denture) and on the other hand for restoration of anatomical integrity by light-cured composite, was scheduled. The present study is designed to prevent complications of endodontic treatment of the second molar, to optimize diagnosis and treatment algorithm, once again proving reliable information indicating to the individuality of treatment tactics.

Orthodontic space closure without counterbalancing extractions in patients with bilateral aplasia of the lower second premolars.

PubMed

Zimmer, Bernd; Rottwinkel, Yvonne

2002-09-01

Orthodontic space closure in situations with bilateral aplastic lower second premolars without maxillary extractions is a rarely practiced treatment method. Due to the high risk of severe side effects, preference is currently given to the maintenance of deciduous second molars and subsequent prosthodontic solutions. As a combination of Class I push and Class II pull mechanics seemed likely to reduce secondary effects by transferring the anchorage site from the reactive lower anterior teeth to the more resistant upper arch, a clinical study was carried out in order to investigate effects and secondary effects of the mechanics. Casts, panoramic radiographs and lateral headfilms of 13 consecutively treated, non-selected adolescents (seven boys, six girls, mean age at start of treatment 13 years 4 months) were evaluated. In six patients a Jasper Jumper trade mark was inserted in addition for a mean period of 6 months. The treatment outcome after a mean period of 3 years and 1 month showed in almost all cases the desired Class III molar occlusion of one cusp width (+/- 1/4 cw) with overbite and overjet within the normal range. Analyses of static and dynamic occlusion revealed anterior/canine protected articulation and a satisfactory number of centric contact points. A significant space gain (p

Treatment efficiency of mini-implant-borne distalization depending on age and second-molar eruption.

PubMed

Nienkemper, M; Wilmes, B; Pauls, A; Yamaguchi, S; Ludwig, B; Drescher, D

2014-03-01

The aim of this study was to evaluate the efficiency of molar distalization depending on age and second-molar eruption using the Beneslider. Treatment of 51 patients (mean age 17.8 ± 9.6 years) was investigated retrospectively by means of pre- and posttreatment cephalograms. Patients were divided into three groups: 14 children with unerupted upper second molars (group 1), 23 adolescents with second molar in place (group 2), and 14 adults (group 3). The distalization forces applied were 2.4 N in group 1 and 5.0 N in groups 2 and 3. Treatment changes were evaluated and examined statistically for significant differences. In all patients a Class I molar relationship was achieved. All mini-implants remained stable during treatment. Mean distalization distance as measured by the displacement of the center of resistance was 3.6 ± 1.9 mm (range 1.2-8.5 mm depending on treatment needs). Since no significant tipping was detected, the type of movement can be described as bodily movement. Mean overall distalization speed was 0.6 ± 0.4 mm per month. There were no statistical differences between the groups. We found the Beneslider to be an effective appliance that enables bodily distalization in adequate treatment time. The higher resistance due to erupted second molars can be compensated by the use of higher forces without significantly reducing distalization speed.

Extracellular Matrix-mediated Tissue Remodeling Following Axial Movement of Teeth

PubMed Central

Luan, Xianghong; Ito, Yoshihiro; Holliday, Sean; Walker, Cameron; Daniel, Jon; Galang, Therese M.; Fukui, Tadayoshi; Yamane, Akira; Begole, Ellen; Evans, Carla; Diekwisch, Thomas G.H.

2007-01-01

SUMMARY Tooth eruption is a multifactorial process involving movement of existing tissues and formation of new tissues coordinated by a complex set of genetic events. We have used the model of the unopposed rodent molar to study morphological and genetic mechanisms involved in axial movement of teeth. Following extraction of opposing upper molars, lower molars supererupted by 0.13 mm. Labeled tissue sections revealed significant amounts of new bone and cementum apposition at the root apex of the unopposed side following supereruption for 12 days. Newly apposited cementum and alveolar bone layers were approximately 3-fold thicker in the experimental vs the control group, whereas periodontal ligament width was maintained. Tartrate-resistant acid phosphatase staining indicated bone resorption at the mesial alveolar walls of unopposed molars and provided in tandem with new bone formation at the distal alveolar walls an explanation for the distal drift of molars in this model. Microarray analysis and semiquantitative RT-PCR demonstrated a significant increase in collagen I, integrin β5, and SPARC gene expression as revealed by comparison between the unopposed molar group and the control group. Immunohistochemical verification revealed increased levels of integrin β5 and SPARC labeling in the periodontal ligament of the unopposed molar. Together our findings suggest that posteruptive axial movement of teeth was accomplished by significant formation of new root cementum and alveolar bone at the root apex in tandem with upregulation of collagen I, integrin β5, and SPARC gene expression. PMID:17015623

Health-related quality of life in adults with congenital unilateral upper limb deficiency in Norway. A cross-sectional study.

PubMed

Johansen, Heidi; Østlie, Kristin; Andersen, Liv Øinæs; Rand-Hendriksen, Svend

2016-11-01

To examine subjective health-related quality of life (HRQoL) in adults with congenital unilateral upper limb deficiency (UULD) in Norway and to explore the associations between demographic and clinical factors and HRQoL. Cross-sectional study comparing HRQoL, measured by SF-36, among adults with UULD and an age- and gender-matched control group from the Norwegian general population (NGP). Seventy-seven respondents, median age 42 years (range: 20-82); 71% were women. Most had left-sided (61%), below elbow (53%), transverse (73%) deficiency. Compared to the NGP, the UULD group reported reduced HRQoL on all SF-36 subscales except for the role emotional (RE) scale (p=0.321), mental health (MH) (p=0.055) and mental component summary (MCS) (p=0.064). The greatest difference was on the bodily pain (BP) scale (point difference of 20.0). Multiple linear regression models showed significant association between several physical- and mental SF-36 subscales and occupational status, occurrence of comorbidity and chronic pain. Persons with UULD reported reduced HRQoL on most SF-36 subscales, mostly in the physical health domain. Employment status, occurrence of comorbidity and chronic pain seem to have a negative impact on the HRQoL. Measures that can reduce pain and loss of function should be given particular attention in UULD rehabilitation. Implications for Rehabilitation Persons with congenital unilateral upper limb deficiency (UULD) who experience pain and discomfort should seek professional help for evaluating their everyday coping strategies. Professionals who meet persons with UULD should examine anomalies, comorbidity, pain and employment status before choosing advices and actions. Individually adapted grip-improving devices, environments, physical exercise and pain management programs should be implemented early to reduce pain, loss of function and decreased HRQoL. A multidisciplinary approach is often necessary when counseling persons with UULD.

Metric and geometric morphometric analysis of new hominin fossils from Maba (Guangdong, China).

PubMed

Xiao, Dongfang; Bae, Christopher J; Shen, Guanjun; Delson, Eric; Jin, Jennie J H; Webb, Nicole M; Qiu, Licheng

2014-09-01

We present an analysis of a set of previously unreported hominin fossils from Maba (Guangdong, China), a cave site that is best known for the presence of a partial hominin cranium currently assigned as mid-Pleistocene Homo and that has been traditionally dated to around the Middle-Late Pleistocene transition. A more recent set of Uranium series dates indicate that the Maba travertine may date to >237 ka (thousands of years ago), as opposed to the original U-series date, which placed Maba at 135-129 ka. The fossils under study include five upper first and second molars and a partial left mandible with a socketed m3, all recovered from different parts of the site than the cranium or the dated sediments. The results of our metric and 2D geometric morphometric ('GM') study suggest that the upper first molars are likely from modern humans, suggesting a more recent origin. The upper second molars align more closely with modern humans, though the minimum spanning tree from the 2D GM analysis also connects Maba to Homo neanderthalensis. The patterning in the M2s is not as clear as with the M1s. The m3 and partial mandible are morphometrically intermediate between Holocene modern humans and older Homo sapiens. However, a minimum spanning tree indicates that both the partial mandible and m3 align most closely with Holocene modern humans, and they also may be substantially younger than the cranium. Because questions exist regarding the context and the relationship of the dated travertine with the hominin fossils, we suggest caution is warranted in interpreting the Maba specimens. Copyright © 2014 Elsevier Ltd. All rights reserved.

Age of patient at the extraction of the third molar.

PubMed

Kautto, A; Vehkalahti, M M; Ventä, I

2018-04-13

The purpose of this study was to assess the age of patients at the time of extraction of third molars. Our data included all routine and surgical extractions of third molars (n=8199 teeth) performed by general and specialist dentists of the public oral health services of the city of Helsinki over the period 2013-2014. Measurements included patient's age, gender, the identified third molar, the type of anaesthesia, the method of extraction, and the diagnosis at extraction. Patients' ages ranged from 10 to 99years. We found significant differences between younger and older age groups: third molar extractions occurred more often for women than for men below the age of 30years (P<0.001) and vice versa for patients older than 30. Extractions were more prevalent for the upper jaw (P<0.001), and surgical extractions were more common than routine extractions (P<0.001) below the age of 40years, but the corresponding prevalences reversed after the age of 40years. Diagnoses at extraction differed between younger and older patients. We conclude that the treatment pattern of third molars at public health services varies greatly over a lifetime, and that a greater variety exists than had been reported previously from oral and maxillofacial units. Copyright © 2018 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Analysis of factors associated with cracked teeth.

PubMed

Seo, Deog-Gyu; Yi, Young-Ah; Shin, Su-Jung; Park, Jeong-Won

2012-03-01

The purpose of this study was to analyze the characteristics, distribution, and associated factors of longitudinal fractured teeth according to the well-defined criteria of the American Association of Endodontists (AAE). One hundred seven teeth with longitudinal fracture from 103 patients were diagnosed and analyzed. The patients' signs, symptoms, age, and sex were noted as well as the tooth number, dental arch, filling materials, size/classification of restoration, crack direction, pulp vitality, whether the patient had undergone endodontic treatment, bite test results, percussion test results, wear facet, and periodontal pocket depth. Eighty-seven teeth were diagnosed with a cracked tooth (81.3%), 14 were diagnosed with vertical root fracture (VRF, 13.1%), 4 had a split tooth (3.7%), and 2 had a fractured cusp (1.9%); 82.2% showed a sensitive reaction on the bite test. Longitudinal tooth fractures were observed most frequently in patient in their 40s. The upper first molar (28.0%) was most frequently cracked, followed by the lower first molar (25.2%), the lower second molar (20.6%), and the upper second molar (16.8%). Most longitudinal tooth fractures (72.0%) occurred mainly in restored teeth, whereas only 28.0% were found in intact teeth. Compared with resin (4.7%) or porcelain (0.9%), the use of nonbonded inlay restoration materials such as gold (20.5%) or amalgam (18.7%) increased the occurrence of longitudinal tooth fractures. Out of 107 of longitudinal fractured teeth, 33 (30.8%) were treated endodontically and 74 (69.2%) were not. VRF was associated with endodontic treatment. The bite test is most reliable for reproducing symptoms. The combined use of various examination methods is recommended for detecting cracks and minutely inspecting all directions of a tooth. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Molar Macrowear Reveals Neanderthal Eco-Geographic Dietary Variation

PubMed Central

Fiorenza, Luca; Benazzi, Stefano; Tausch, Jeremy; Kullmer, Ottmar; Bromage, Timothy G.; Schrenk, Friedemann

2011-01-01

Neanderthal diets are reported to be based mainly on the consumption of large and medium sized herbivores, while the exploitation of other food types including plants has also been demonstrated. Though some studies conclude that early Homo sapiens were active hunters, the analyses of faunal assemblages, stone tool technologies and stable isotopic studies indicate that they exploited broader dietary resources than Neanderthals. Whereas previous studies assume taxon-specific dietary specializations, we suggest here that the diet of both Neanderthals and early Homo sapiens is determined by ecological conditions. We analyzed molar wear patterns using occlusal fingerprint analysis derived from optical 3D topometry. Molar macrowear accumulates during the lifespan of an individual and thus reflects diet over long periods. Neanderthal and early Homo sapiens maxillary molar macrowear indicates strong eco-geographic dietary variation independent of taxonomic affinities. Based on comparisons with modern hunter-gatherer populations with known diets, Neanderthals as well as early Homo sapiens show high dietary variability in Mediterranean evergreen habitats but a more restricted diet in upper latitude steppe/coniferous forest environments, suggesting a significant consumption of high protein meat resources. PMID:21445243

Autotransplantation of Immature Third Molars and Orthodontic Treatment After En Bloc Resection of Conventional Ameloblastoma.

PubMed

Osterne, Rafael Lima Verde; Moreira Neto, José Jeová Siebra; de Araújo Lima, Augusto Darwin Moreira; Nogueira, Renato Luiz Maia

2015-09-01

Ameloblastoma treatment can lead to significant bone defects; consequently, oral rehabilitation can be challenging. We present the case of a 14-year-old girl diagnosed with a conventional ameloblastoma in the mandible who was treated using en bloc resection and rehabilitated with autotransplantation of the immature third molars and orthodontic treatment. The lesion was in the region of the lower left canine and premolars, and en bloc resection resulted in a significant alveolar bone defect. Autotransplantation of the lower third molars to the site of the lower left premolars was performed. After 2 years, the upper left third molar was transplanted to the site of the lower left canine. During the orthodontic treatment period, considerable alveolar bone formation was observed in the region of the transplanted teeth, and roots developed. To the best of our knowledge, this is the first reported case of alveolar bone formation induction caused by tooth transplantation after ameloblastoma treatment. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Asymmetrical distalization of maxillary molars with zygomatic anchorage, improved superelastic nickel-titanium alloy wires, and open-coil springs.

PubMed

Ishida, Takayoshi; Yoon, Hyung Sik; Ono, Takashi

2013-10-01

In nongrowing patients with skeletal Class II malocclusion, premolar extraction or maxillary distalization can be used as camouflage treatment. Zygomatic anchorage enables distalization in uncooperative or noncompliant patients. We describe 1 such procedure in a 24-year-old woman. We used novel improved superelastic nickel-titanium archwires combined with nickel-titanium open-coil springs to provide a constant and continuous low force to the dentition. We were able to successfully eliminate the protrusive profile and correct the Class II molar relationship using this system of zygomatic anchorage. The posterior occlusal relationships were improved to achieve Class I canine and molar relationships on both sides, and ideal overbite and overjet relationships were established. Facial esthetics was improved with decreased protrusion of the upper and lower lips. The method used here is a promising alternative to traditional distalization techniques and might offer an effective and simple means of distalizing maxillary molars in uncooperative patients. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Comparison of mesiodistal tooth widths in Caucasian, African and Japanese individuals with Brazilian ancestry and normal occlusion.

PubMed

Fernandes, Thais Maria Freire; Sathler, Renata; Natalício, Gabriela Letícia; Henriques, José Fernando Castanha; Pinzan, Arnaldo

2013-01-01

To observe the presence of sexual dimorphism and compare the mesiodistal width of the teeth in Caucasian, African and Japanese individuals with Brazilian ancestry not orthodontically treated and with normal occlusion. One hundred pairs of dental casts were used. It was measured, from first molar to first molar in both arches, the teeth's mesiodistal widths, using a digital caliper. For the statistical analysis of results Kolmogorov-Smirnov, t test, ANOVA and Tukey's test (p < 0.05) were used. Sexual dimorphism occurred on the three evaluated groups, and the highest mesiodistal widths were found in males. There was statistically significant difference between racial groups in all evaluated teeth in males. However, in females, this same difference was found only on upper lateral incisor and first molar; and lower lateral incisor, canine, first premolar and first molar. Most of mesiodistal measures present particular characteristics in relation to gender, with higher values for males, and to race, with a tendency for African to present greater mesiodistal distance of the teeth, followed by Japanese and Caucasians, respectively, important for the correct diagnosis and orthodontic planning.

Multifocal synchronous ipsilateral Warthin tumors: case report and review of the literature.

PubMed

Hall, Joseph E; Statham, Melissa McCarty; Sheridan, Rachel M; Wilson, Keith M

2010-09-01

We report a case of a 73-year-old woman who presented with an enlarging superficial parotid mass, a concomitant ipsilateral deep-lobe parotid mass, and associated upper jugular lymphadenopathy. The clinical presentation and radiographic imaging were suggestive of malignancy, and the patient was treated with total parotidectomy with upper jugular lymph node sampling. Pathologic examination revealed two distinct masses, one in the superficial lobe and one in the deep lobe of the parotid gland, both consistent with synchronous Warthin tumors. Analysis of the upper jugular lymph nodes was consistent with reactive lymphoid hyperplasia. Although the true incidence of multicentricity in ipsilateral Warthin tumors may be underappreciated and underreported, this entity should remain in the differential diagnosis for unilateral parotid masses.

Dental morphology and the phylogenetic "place" of Australopithecus sediba.

PubMed

Irish, Joel D; Guatelli-Steinberg, Debbie; Legge, Scott S; de Ruiter, Darryl J; Berger, Lee R

2013-04-12

To characterize further the Australopithecus sediba hypodigm, we describe 22 dental traits in specimens MH1 and MH2. Like other skeletal elements, the teeth present a mosaic of primitive and derived features. The new nonmetric data are then qualitatively and phenetically compared with those in eight other African hominin samples, before cladistic analyses using a gorilla outgroup. There is some distinction, largely driven by contrasting molar traits, from East African australopiths. However, Au. sediba links with Au. africanus to form a South African australopith clade. These species present five apomorphies, including shared expressions of Carabelli's upper first molar (UM1) and protostylid lower first molar (LM1). Five synapomorphies are also evident between them and monophyletic Homo habilis/rudolfensis + H. erectus. Finally, a South African australopith + Homo clade is supported by four shared derived states, including identical LM1 cusp 7 expression.

[Prevalence of cross-bite in Mexican children].

PubMed

Ojeda León, S; De la Teja Angeles, E

1990-10-01

As observed, the problem of lining and accommodation of teeth in the child population is increasingly larger. This fact prompted the authors to attempt determining the prevalence of cross-bite in a sample of Mexican children. A total of 306 patients, aged between two and 17 and attending the Stomatology service of the National Institute of Pediatrics, were evaluated, from which all pertinent data regarding age, sex, molar-temporal relationship (terminal, rectus, distal, messial and exaggerated messial planes), permanent molar status (Angle I, II, III), cross-bite, type of dentition affected (primary, mixed or permanent), cross-bite classification (anterior, posterior or mixed), whether unilateral, bilateral, dental or skeletal, right or left, and number of teeth affected, were duly recorded. Out of 306 evaluated patients (160 males, 146 female), 112 evidenced cross-bite (36.6%), 56 of each sex; in 69.6% the teeth were anterior, in 17.8% they were posterior, and in 15.5% their position was mixed. Their average age was 8 years, and malocclusion was Angle class I. From this experience, it is to be concluded that early detection and correction of any dental occlusion abnormality will permit correcting defects in dentofacial development; it is thus necessary to ascertain the frequency of cross-bite.

Maxillary Distraction Osteogenesis in Unilateral Cleft Lip and Palate Patients with Rigid External Distraction System

PubMed Central

Alkhouri, Shadi; Waite, Peter D.; Davis, Matthew B.; Lamani, Ejvis; Kau, Chung How

2017-01-01

Aim: Distraction osteogenesis (DO) is a treatment option for patients with maxillary hypoplasia secondary to cleft lip and palate (CLP). Purpose: The aim of this study is to present a technique for maxillary DO using Le Fort I osteotomy with rigid external distraction (RED) system. Subjects and Methods: The patient presented in this paper was an Asian female with CLP aged 13 years and 6 months. She presented with severe midfacial deficiency with a Class III dental malocclusion with a negative overjet and concave facial profile. Cone-beam computed tomography images were recorded preoperatively and the operation performed involved a high Le Fort I osteotomy. The appliance fabricated was banded to upper first molars used for anchorage of the RED system. Distraction of the maxilla was initiated after 7-day latency period. Results: Postoperative cephalometric analysis showed maxillary advancement anteriorly and superiorly, the total distraction treatment period was 10 days. The maxillary advancement was 10.5 mm and the SNA angle increased from 67.5° to 77.9°. Furthermore, the ANB angle changed from −9.8° to 1.6° and the occlusion changed from Class III to Class I. The profile of the face changed from concave to convex and a much better esthetic result was achieved. Conclusion: The study suggests RED system to be a reliable alternative procedure for the treatment of midfacial hypoplasia with or without cleft. Furthermore, it minimizes the risk of the surgical procedure and shortens the operating time. PMID:28713737

Direction discrimination learning in normal and visually deprived cats and the effects of lateral suprasylvian lesions.

PubMed

Burnat, K; Zernicki, B

1997-01-01

We used 5 binocularly deprived cats (BD cats), 4 control cats reared also in the laboratory (C cats) and 4 cats reared in a normal environment (N cats). The cats were trained to discriminate an upward or downward-moving light spot versus a stationary spot (detection task) and then an upward versus a downward spot (direction task). The N and C cats learned slowly. The learning was slower than in previously studied discriminations of stationary stimuli. However, all N and C cats mastered the detection task and except one C cat the direction task. In contrast, 4 BD cats failed in the detection task and all in the direction task. This result is consistent with single-cell recording data showing impairment of direction analysis in the visual system in BD cats. After completing the training the upper part of the middle suprasylvian sulcus was removed unilaterally in 7 cats and bilaterally in 6 cats. Surprisingly, the unilateral lesions were more effective: the clear-cut retention deficits were found in 5 cats lesioned unilaterally, whereas only in one cat lesioned bilaterally.

A rare disease in an atypical location-Kimura's Disease of the upper extremity.

PubMed

Lam, Alan Cheuk Si; Au Yeung, Rex Kwok Him; Lau, Vince Wing Hang

2015-12-01

Kimura's disease is a rare chronic inflammatory disorder predominantly affecting young Asian male patients, occurring mainly in the head and neck regions. Kimura's disease of the upper extremity is extremely rare, and previous case reports in the literature show similar imaging characteristics with consistent location at the medial epitrochlear region, predominantly with unilateral involvement. We present the first reported case of Kimura's disease affecting the anterolateral aspect of the upper arm, sparing the medial epitrochlear region, illustrating that with typical MR appearance and serology, the involvement of this rare disease in an atypical location still warrants consideration of this diagnosis. There was also bilateral asymmetrical involvement in our patient, suggesting the possibility of a propensity for Kimura's disease affecting the upper extremities to have bilateral involvement, which may necessitate imaging of the clinically asymptomatic contralateral limb in these patients for early lesion identification and treatment.

Sciatic Nerve Stimulation and its Effects on Upper Airway Resistance in the Anesthetized Rabbit Model Relevant to Sleep Apnea.

PubMed

Schiefer, Matthew; Gamble, Jenniffer; Strohl, Kingman Perkins

2018-06-07

Obstructive sleep apnea (OSA) is a disorder characterized by collapse of the velopharynx and/or oropharynx during sleep when drive to the upper airway is reduced. Here, we explore an indirect approach for activation of upper airway muscles which might affect airway dynamics- unilateral electrical stimulation of the afferent fibers of the sciatic nerve- in an anesthetized rabbit model. A nerve cuff electrode was placed around the sciatic and hypoglossal nerves to deliver stimulus while air flow, air pressure, and alae nasi electromyogram (EMG) were monitored both prior to and after sciatic transection. Sciatic nerve stimulation increased respiratory effort, rate, and alae nasi EMG, which persisted for seconds after stimulation; however, upper airway resistance was unchanged. Hypoglossal stimulation reduced resistance without altering drive. While sciatic nerve stimulation is not ideal for treating obstructive sleep apnea, it remains a target for altering respiratory drive.

Facial growth and development in unilateral cleft lip and palate from the time of palatoplasty to the onset of puberty: a longitudinal study.

PubMed

Smahel, Z; Müllerová, Z

1995-01-01

X-ray cephalometry was used for the assessment of facial growth and development from the time of palate surgery to the onset of puberty (from 5 to 11 years) in 24 boys with unilateral cleft lip and palate treated with primary periosteoplasty (at 8 months) and palatal pushback supplemented by pharyngeal flap surgery (at 5 years). The lowest growth showed the depth of the maxilla and the height of the upper lip. An increasing protrusion of the mandible and in particular the increasing retrusion of the maxilla resulted in a flattening of the face and in an impairment of sagittal jaw relations. However, it was possible to attain an improvement of overjet produced by a substantial increase of the proclination of upper incisors and of the alveolar process. There was a deterioration of the prominence of the upper lip. Anterior growth rotation was absent during the development of the face, though a rotation in both directions was quite common in individual cases. The steepness of the mandibular body, vertical jaw relations, and facial vertical proportions remained unchanged. As compared to the pubertal period, the growth and development differed only by a more marked proclination of the dentoalveolar component of the maxilla and by an improvement of overjet. Facial convexity and sagittal jaw relations deteriorated in more than 90% of the patients, the overjet only in 20%, yet the prominence of the lip in 70%. Facial convexity and sagittal jaw relations were not correlated with mandibular rotation but they affected the overjet and the prominence of the upper lip.(ABSTRACT TRUNCATED AT 250 WORDS)

A finite element investigation of upper cervical instrumentation.

PubMed

Puttlitz, C M; Goel, V K; Traynelis, V C; Clark, C R

2001-11-15

The finite element technique was used to predict changes in biomechanics that accompany the application of a novel instrumentation system designed for use in the upper cervical spine. To determine alterations in joint loading, kinematics, and instrumentation stresses in the craniovertebral junction after application of a novel instrumentation system. Specifically, this design was used to assess the changes in these parameters brought about by two different cervical anchor types: C2 pedicle versus C2-C1 transarticular screws, and unilateral versus bilateral instrumentation. Arthrodesis procedures can be difficult to obtain in the highly mobile craniovertebral junction. Solid fusion is most likely achieved when motion is eliminated. Biomechanical studies have shown that C1-C2 transarticular screws provide good stability in craniovertebral constructs; however, implantation of these screws is accompanied by risk of vertebral artery injury. A novel instrumentation system that can be used with transarticular screws or with C2 pedicle screws has been developed. This design also allows for unilateral or bilateral implantation. However, the authors are unaware of any reports to date on the changes in joint loading or instrumentation stresses that are associated with the choice of C2 anchor or unilateral/bilateral use. A ligamentous, nonlinear, sliding contact, three-dimensional finite element model of the C0-C1-C2 complex and a novel instrumentation system was developed. Validation of the model has been previously reported. Finite element models representing combinations of cervical anchor type (C1-C2 transarticular screws vs. C2 pedicle screws) and unilateral versus bilateral instrumentation were evaluated. All models were subjected to compression with pure moments in either flexion, extension, or lateral bending. Kinematic reductions with respect to the intact (uninjured and without instrumentation) case caused by instrumentation use were reported. Changes in loading profiles through the right and left C0-C1 and C1-C2 facets, transverse ligament-dens, and dens-anterior ring of C1 articulations were calculated by the finite element model. Maximum von Mises stresses within the instrumentation were predicted for each model variant and loading scenario. Bilateral instrumentation provided greater motion reductions than the unilateral instrumentation. When used bilaterally, C2 pedicle screws approximate the kinematic reductions and instrumentation stresses (except in lateral bending) that are seen with C1-C2 transarticular screws. The finite element model predicted that the maximum stress was always in the region in which the plate transformed into the rod. To the best of the authors' knowledge, this is the first report of predicting changes in loading in the upper cervical spine caused by instrumentation. The most significant conclusion that can be drawn from the finite element model predictions is that C2 pedicle screw fixation provides the same relative stability and instrumentation stresses as C1-C2 transarticular screw use. C2 pedicle screws can be a good alternative to C2-C1 transarticular screws when bilateral instrumentation is applied.

[Comparison of treatment results between implant anchorage and traditional intraoral anchorage in patients with maxillary protrusion].

PubMed

Ma, Ning; Li, Wei-Ran; Chen, Xiao-Hong; Zheng, Xu

2016-08-01

To compare the treatment effects in patients with maxillary protrusion between implant anchorage and traditional intraoral anchorage. Thirty patients with maxillary protrusion treated with bilateral maxillary first premolars extractions and high anchorage were selected. They were randomly divided into implant anchorage group and traditional intraoral anchorage group. Each group had 15 cases. The casts and the cephalograms were obtained before treatment (T1) and after treatment (T2). Three-dimensional model analysis was used to compare the teeth movements between the two groups and cephalometric analysis was used to compare the changes of skeletal and soft tissues. The differences were analyzed with SPSS 17.0 software package. In the implant anchorage group, the upper central incisors were retracted by (6.661±1.328) mm and intruded by (0.129±1.815) mm. In the traditional intraoral anchorage group, the upper central incisors were retracted by (5.788±2.009) mm and extruded by (2.623±1.776) mm. There was no significant difference between the two groups in sagittal movement (P>0.05), but there was significant difference in vertical movement (P<0.05). In the implant anchorage group, the upper first molars were protracted by (0.608±1.045) mm, intruded by (0.608±1.045) mm and moved palatally by (0.477±0.904) mm. In the traditional intraoral anchorage group, the upper first molars were protracted by (1.503±0.945) mm, extruded by (0.072±0.690) mm and moved palatally by (0.883±0.752)mm. There was significant difference between the two groups in sagittal movement and vertical movement (P<0.05), but there was no significant difference in horizontal movement(P>0.05). There was no significant difference between the two groups in the changes of cephalometric measurements of skeletal and soft tissues (P>0.05). Implant anchorage may be superior in vertical control of the maxillary incisors and also superior in sagittal and vertical control of the maxillary molars to traditional intraoral anchorage during management of maxillary protrusion.

Surgical Correction of Whistle Deformity Using Cross-Muscle Flap in Secondary Cleft Lip

PubMed Central

Choi, Woo Young; Kim, Gyu Bo; Han, Yun Ju

2012-01-01

Background The whistle deformity is one of the common sequelae of secondary cleft lip deformities. Santos reported using a crossed-denuded flap for primary cleft lip repair to prevent a vermilion notching. The authors modified this technique to correct the whistle deformity, calling their version the cross-muscle flap. Methods From May 2005 to January 2011, 14 secondary unilateral cleft lip patients were treated. All suffered from a whistle deformity, which is characterized by the deficiency of the central tubercle, notching in the upper lip, and bulging on the lateral segment. The mean age of the patients was 13.8 years and the mean follow-up period was 21.8 weeks. After elevation from the lateral vermilion and medial tubercle, two muscle flaps were crossed and turned over. The authors measured the three vertical heights and compared the two height ratios before and after surgery for evaluation of the postoperative results. Results None of the patients had any notable complications and the whistle deformity was corrected in all cases. The vertical height ratios at the midline on the upper lip and the affected Cupid's bow point were increased (P<0.05). The motion of the upper lip was acceptable. Conclusions A cross muscle flap is simple and it leaves a minimal scar on the lip. We were able to reconstruct the whistle deformity in secondary unilateral cleft lip patients with a single state procedure using a cross-muscle flap. PMID:23094241

A Randomized, Controlled Trial of Mirror Therapy for Upper Extremity Phantom Limb Pain in Male Amputees.

PubMed

Finn, Sacha B; Perry, Briana N; Clasing, Jay E; Walters, Lisa S; Jarzombek, Sandra L; Curran, Sean; Rouhanian, Minoo; Keszler, Mary S; Hussey-Andersen, Lindsay K; Weeks, Sharon R; Pasquina, Paul F; Tsao, Jack W

2017-01-01

Phantom limb pain (PLP) is prevalent in patients post-amputation and is difficult to treat. We assessed the efficacy of mirror therapy in relieving PLP in unilateral, upper extremity male amputees. Fifteen participants from Walter Reed and Brooke Army Medical Centers were randomly assigned to one of two groups: mirror therapy ( n  = 9) or control ( n  = 6, covered mirror or mental visualization therapy). Participants were asked to perform 15 min of their assigned therapy daily for 5 days/week for 4 weeks. The primary outcome was pain as measured using a 100-mm Visual Analog Scale. Subjects in the mirror therapy group had a significant decrease in pain scores, from a mean of 44.1 (SD = 17.0) to 27.5 (SD = 17.2) mm ( p  = 0.002). In addition, there was a significant decrease in daily time experiencing pain, from a mean of 1,022 (SD = 673) to 448 (SD = 565) minutes ( p  = 0.003). By contrast, the control group had neither diminished pain ( p  = 0.65) nor decreased overall time experiencing pain ( p  = 0.49). A pain decrement response seen by the 10th treatment session was predictive of final efficacy. These results confirm that mirror therapy is an effective therapy for PLP in unilateral, upper extremity male amputees, reducing both severity and duration of daily episodes. NCT0030144 ClinicalTrials.gov.

Forensic age estimation based on development of third molars: a staging technique for magnetic resonance imaging.

PubMed

De Tobel, J; Phlypo, I; Fieuws, S; Politis, C; Verstraete, K L; Thevissen, P W

2017-12-01

The development of third molars can be evaluated with medical imaging to estimate age in subadults. The appearance of third molars on magnetic resonance imaging (MRI) differs greatly from that on radiographs. Therefore a specific staging technique is necessary to classify third molar development on MRI and to apply it for age estimation. To develop a specific staging technique to register third molar development on MRI and to evaluate its performance for age estimation in subadults. Using 3T MRI in three planes, all third molars were evaluated in 309 healthy Caucasian participants from 14 to 26 years old. According to the appearance of the developing third molars on MRI, descriptive criteria and schematic representations were established to define a specific staging technique. Two observers, with different levels of experience, staged all third molars independently with the developed technique. Intra- and inter-observer agreement were calculated. The data were imported in a Bayesian model for age estimation as described by Fieuws et al. (2016). This approach adequately handles correlation between age indicators and missing age indicators. It was used to calculate a point estimate and a prediction interval of the estimated age. Observed age minus predicted age was calculated, reflecting the error of the estimate. One-hundred and sixty-six third molars were agenetic. Five percent (51/1096) of upper third molars and 7% (70/1044) of lower third molars were not assessable. Kappa for inter-observer agreement ranged from 0.76 to 0.80. For intra-observer agreement kappa ranged from 0.80 to 0.89. However, two stage differences between observers or between staging sessions occurred in up to 2.2% (20/899) of assessments, probably due to a learning effect. Using the Bayesian model for age estimation, a mean absolute error of 2.0 years in females and 1.7 years in males was obtained. Root mean squared error equalled 2.38 years and 2.06 years respectively. The performance to discern minors from adults was better for males than for females, with specificities of 96% and 73% respectively. Age estimations based on the proposed staging method for third molars on MRI showed comparable reproducibility and performance as the established methods based on radiographs.

Treatment of Class III malocclusion in a young adult patient: a case report.

PubMed

Kiran, B H Jyothi; Kumar, Prashanth; Ravi, S; Shivalinga, B M; Bhagyalaxmi; Pradeep; Kudagi, Vishal

2012-01-01

This article describes the treatment of a young adult male with a concave profile, skeletal class III malocclusion because of a prognathic mandible and proclined upper incisors. The therapy included stages: 1. Pre-surgical orthodontics involving leveling and aligning of upper and lower arches, protraction of lower molars and retraction of upper incisors; 2. Surgical phase involving BSSO with mandibular setback and 3. Post-surgical orthodontics for finishing and detailing. The treatment lasted 23 months and improved facial esthetics significantly The treatment resulted in a functional occlusion with a lack of lateral cuspid guidance that could be accepted considering the difficulty of the case. Over jet and overbite are within norms.

Age assessment based on third molar mineralisation : An epidemiological-radiological study on a Central-European population.

PubMed

Hofmann, Elisabeth; Robold, Matthias; Proff, Peter; Kirschneck, Christian

2017-03-01

The method published in 1973 by Demirjian et al. to assess age based on the mineralisation stage of permanent teeth is standard practice in forensic and orthodontic diagnostics. From age 14 onwards, however, this method is only applicable to third molars. No current epidemiological data on third molar mineralisation are available for Caucasian Central-Europeans. Thus, a method for assessing age in this population based on third molar mineralisation is presented, taking into account possible topographic and gender-specific differences. The study included 486 Caucasian Central-European orthodontic patients (9-24 years) with unaffected dental development. In an anonymized, randomized, and blinded manner, one orthopantomogram of each patient at either start, mid or end of treatment was visually analysed regarding the mineralisation stage of the third molars according to the method by Demirjian et al. Corresponding topographic and gender-specific point scores were determined and added to form a dental maturity score. Prediction equations for age assessment were derived by linear regression analysis with chronological age and checked for reliability within the study population. Mineralisation of the lower third molars was slower than mineralisation of the upper third molars, whereas no jaw-side-specific differences were detected. Gender-specific differences were relatively small, but girls reached mineralisation stage C earlier than boys, whereas boys showed an accelerated mineralisation between the ages of 15 and 16. The global equation generated by regression analysis (age = -1.103 + 0.268 × dental maturity score 18 + 28 + 38 + 48) is sufficiently accurate and reliable for clinical use. Age assessment only based on either maxilla or mandible also shows good prognostic reliability.

Formation of cortical plasticity in older adults following tDCS and motor training

PubMed Central

Goodwill, Alicia M.; Reynolds, John; Daly, Robin M.; Kidgell, Dawson J.

2013-01-01

Neurodegeneration accompanies the process of natural aging, reducing the ability to perform functional daily activities. Transcranial direct current stimulation (tDCS) alters neuronal excitability and motor performance; however its beneficial effect on the induction of primary motor cortex (M1) plasticity in older adults is unclear. Moreover, little is known as to whether the tDCS electrode arrangement differentially affects M1 plasticity and motor performance in this population. In a double-blinded, cross-over trial, we compared unilateral, bilateral and sham tDCS combined with visuomotor tracking, on M1 plasticity and motor performance of the non-dominant upper limb, immediately post and 30 min following stimulation. We found (a) unilateral and bilateral tDCS decreased tracking error by 12–22% at both time points; with sham decreasing tracking error by 10% at 30 min only, (b) at both time points, motor evoked potentials (MEPs) were facilitated (38–54%) and short-interval intracortical inhibition was released (21–36%) for unilateral and bilateral conditions relative to sham, (c) there were no differences between unilateral and bilateral conditions for any measure. These findings suggest that tDCS modulated elements of M1 plasticity, which improved motor performance irrespective of the electrode arrangement. The results provide preliminary evidence indicating that tDCS is a safe non-invasive tool to preserve or improve neurological function and motor control in older adults. PMID:24367333

The bilateral movement condition facilitates maximal but not submaximal paretic-limb grip force in people with post-stroke hemiparesis

PubMed Central

DeJong, Stacey L.; Lang, Catherine E.

2012-01-01

Objectives Although healthy individuals have less force production capacity during bilateral muscle contractions compared to unilateral efforts, emerging evidence suggests that certain aspects of paretic upper limb task performance after stroke may be enhanced by moving bilaterally instead of unilaterally. We investigated whether the bilateral movement condition affects grip force differently on the paretic side of people with post-stroke hemiparesis, compared to their non-paretic side and both sides of healthy young adults. Methods Within a single session, we compared: 1) maximal grip force during unilateral vs. bilateral contractions on each side, and 2) force contributed by each side during a 30% submaximal bilateral contraction. Results Healthy controls produced less grip force in the bilateral condition, regardless of side (- 2.4% difference), and similar findings were observed on the non-paretic side of people with hemiparesis (- 4.5% difference). On the paretic side, however, maximal grip force was increased by the bilateral condition in most participants (+11.3% difference, on average). During submaximal bilateral contractions in each group, the two sides each contributed the same percentage of unilateral maximal force. Conclusions The bilateral condition facilitates paretic limb grip force at maximal, but not submaximal levels. Significance In some people with post-stroke hemiparesis, the paretic limb may benefit from bilateral training with high force requirements. PMID:22248812

Predictability of orthodontic movement with orthodontic aligners: a retrospective study.

PubMed

Lombardo, Luca; Arreghini, Angela; Ramina, Fabio; Huanca Ghislanzoni, Luis T; Siciliani, Giuseppe

2017-11-13

The aim of this study was to evaluate the predictability of F22 aligners (Sweden & Martina, Due Carrare, Italy) in guiding teeth into the positions planned using digital orthodontic setup. Sixteen adult patients (6 males and 10 females, mean age 28 years 7 months) were selected, and a total of 345 teeth were analysed. Pre-treatment, ideal post-treatment-as planned on digital setup-and real post-treatment models were analysed using VAM software (Vectra, Canfield Scientific, Fairfield, NJ, USA). Prescribed and real rotation, mesiodistal tip and vestibulolingual tip were calculated for each tooth and, subsequently, analysed by tooth type (right and left upper and lower incisors, canines, premolars and molars) to identify the mean error and accuracy of each type of movement achieved with the aligner with respect to those planned using the setup. The mean predictability of movements achieved using F22 aligners was 73.6%. Mesiodistal tipping showed the most predictability, at 82.5% with respect to the ideal; this was followed by vestibulolingual tipping (72.9%) and finally rotation (66.8%). In particular, mesiodistal tip on the upper molars and lower premolars were achieved with the most predictability (93.4 and 96.7%, respectively), while rotation on the lower canines was the least efficaciously achieved (54.2%). Without the use of auxiliaries, orthodontic aligners are unable to achieve programmed movement with 100% predictability. In particular, although tipping movements were efficaciously achieved, especially at the molars and premolars, rotation of the lower canines was an extremely unpredictable movement.

Enhanced left-finger deftness following dominant upper- and lower-limb amputation.

PubMed

Swanberg, Kelley M; Clark, Abigail M; Kline, Julia E; Yurkiewicz, Ilana R; Chan, Brenda L; Pasquina, Paul F; Heilman, Kenneth M; Tsao, Jack W

2011-09-01

After amputation, the sensorimotor cortex reorganizes, and these alterations might influence motor functions of the remaining extremities. The authors examined how amputation of the dominant or nondominant upper or lower extremity alters deftness in the intact limbs. The participants were 32 unilateral upper- or lower-extremity amputees and 6 controls. Upper-extremity deftness was tested by coin rotation (finger deftness) and pegboard (arm, hand, and finger deftness) tasks. Following right-upper- or right-lower-extremity amputation, the left hand's finger movements were defter than the left-hand fingers of controls. In contrast, with left-upper- or left-lower-extremity amputation, the right hand's finger performance was the same as that of the controls. Although this improvement might be related to increased use (practice), the finding that right-lower-extremity amputation also improved the left hand's finger deftness suggests an alternative mechanism. Perhaps in right-handed persons the left motor cortex inhibits the right side of the body more than the right motor cortex inhibits the left side, and the physiological changes induced by right-sided amputation reduced this inhibition.

The cross education of strength and skill following unilateral strength training in the upper and lower limbs.

PubMed

Green, Lara A; Gabriel, David A

2018-04-18

Cross education is the strength gain or skill improvement transferred to the contralateral limb following unilateral training or practice. The present study examined the transfer of both strength and skill following a strength training program. Forty participants (20M, 20F) completed a 6-week unilateral training program of dominant wrist flexion or dorsiflexion. Strength, force variability, and muscle activity were assessed pre-training, post-training, and following 6-weeks of detraining (retention). Analyses of covariance compared the experimental limb (trained or untrained) to the control (dominant or non-dominant). There were no sex differences in the training response. Cross education of strength at post-training was 6% (p<0.01) in the untrained arm and 13% (p<0.01) in the untrained leg. Contralateral strength continued to increase following detraining to 15% in the arm (p<0.01) and 14% in the leg (p<0.01). There was no difference in strength gains between upper and lower limbs (p>0.05). Cross education of skill (force variability) demonstrated greater improvements in the untrained limbs compared to the control limbs during contractions performed without concurrent feedback. Significant increases in V-wave amplitude (p=0.02) and central activation (p<0.01) were highly correlated with contralateral strength gains. There was no change in agonist amplitude or motor unit firing rates in the untrained limbs (p>0.05). The neuromuscular mechanisms mirrored the force increases at post-training and retention supporting central drive adaptations of cross education. The continued strength increases at retention identified the presence of motor learning in cross education, as confirmed by force variability.

Anchorage condition during canine retraction using transpalatal arch with continuous and segmented arch mechanics.

PubMed

Alhadlaq, Adel; Alkhadra, Thamer; El-Bialy, Tarek

2016-05-01

To compare anchorage condition in cases in which transpalatal arch was used to enhance anchorage in both continuous and segmented arch techniques. Twenty cases that required first premolar extraction for orthodontic treatment and transpalatal arch to enhance anchorage were included in this study. Ten cases were treated using the continuous arch technique, while the other 10 cases were treated using 0.019 × 0.025-inch TMA T-loops with posterior anchorage bend according to the Burstone and Marcotte description. Lateral cephalometric analysis of before and after canine retraction was performed using Ricketts analysis to measure the anteroposterior position of the upper first molar to the vertical line from the Pt point. Data were analyzed using an independent sample t-test. There was a statistically significant forward movement of the upper first molar in cases treated by continuous arch mechanics (4.5 ± 3.0 mm) compared with segmented arch mechanics (-0.7 ± 1.4 mm; P  =  .01). The posterior anchorage bend to T-loop used to retract the maxillary canine can enhance anchorage during maxillary canine retraction.

Oligocene sivaladapid primate from the Bugti Hills (Balochistan, Pakistan) bridges the gap between Eocene and Miocene adapiform communities in Southern Asia.

PubMed

Marivaux, Laurent; Welcomme, Jean-Loup; Ducrocq, Stéphane; Jaeger, Jean-Jacques

2002-04-01

A new species of Guangxilemur (Sivaladapidae, Adapiformes) is described from the early Oligocene Chitarwata Formation (Bugti Member) of the Bugti Hills, Sulaiman geological Province, Balochistan, Pakistan. Guangxilemur singsilai n. sp. provides further diagnostic morphological characters from its newly described upper and lower dentitions, confirming its intermediate phylogenetic position between Eocene and Miocene Asian sivaladapid adapiforms. G. singsilai possesses moderately developed shearing and puncturing molar features and maintains lingual cusps on upper molars as in Eocene hoanghoniines; in contrast, it possesses a typical molariform P(4) as in Miocene sivaladapines. The important paleogeographic changes that have affected South Asia during the Tertiary (related to the collision between the Indian and Eurasian Plates) have played a critical role in reforming circulation and climatic differentiation. The presence in Pakistan of an unique and well-diversified Oligocene primate fauna, clearly demonstrates that South Asia maintained favourable environmental conditions during the middle Caenozoic global climatic deterioration that coincides with drastic changes in faunal structure on the whole Holarctic Province, including the extinction of adapiform primates. Copyright 2002 Elsevier Science Ltd.

Permanent first molar extraction in adolescents and young adults and its effect on the development of third molar.

PubMed

Halicioglu, Koray; Toptas, Orcun; Akkas, Ismail; Celikoglu, Mevlut

2014-01-01

The aim of the present study was to determine the prevalence of permanent first molar (P1M) extraction among Turkish adolescents and young adult subpopulation, and to investigate the effects of P1M extraction on development of the third molars (3Ms) in the same quadrant. A retrospective study including 2,925 panoramic radiographs (PRs) taken from patients (aged 13-20 years) who were examined to identify cases of had at least one maxillary or mandibular P1Ms extracted was performed. Additionally, 294 PRs with the maxillary or mandibular unilateral loss of a P1M were used to assess the developmental grades of the 3Ms. Statistical analyses were performed by means of parametric tests after performing a Shapiro-Wilks normality test to the data. A total of 945 patients (32.3 %) presented with at least one P1M extraction with no gender difference (P = 0.297). There were more cases of mandibular P1Ms extracted (784 patients, 1,066 teeth) than maxillary P1Ms extracted (441 patients, 549 teeth) (P < 0.001). The development of the 3Ms on the extraction side, in the both maxilla and mandible, was significantly accelerated when compared with the contralateral teeth (P = 0.000, P = 0.000, respectively). No statistically significant differences were found in the differences in the developmental of the 3Ms between the maxilla and mandible (P = 0.718). High prevalence of P1Ms extraction among Turkish adolescents and young adults shows a need for targeted dental actions, including prevention and treatment. The development of the 3Ms on the extraction side, in the both maxilla and mandible, was significantly accelerated. To date, no information about prevalence of P1Ms extraction among Turkish adolescents and young adults is documented. In addition, the present study has a larger population and complementary information about 3Ms development than previous studies.

Chilean patients’ perception of oral health-related quality of life after third molar surgery

PubMed Central

Aravena, Pedro Christian; Delgado, Felipe; Olave, Hugo; Ulloa-Marin, Carolina; Perez-Rojas, Francisco

2016-01-01

Objective To describe the perception of the quality of life in oral health based on the Health-Related Quality of Life instrument in its Spanish version (HRQOL-sp) in Chilean patients with third molar extraction surgery. Patients and methods A cross-sectional study. The HRQOL-sp was administered to dental patients at the Public Hospital in Rio Bueno in southern Chile treated for unilateral third molar extraction between March and June 2014. The instrument was applied by phone survey on the first, third, fifth, and seventh days after surgery. For the ordinal scale, the response was considered interference in the quality of life when patients selected the options “quite a bit of trouble” or “lots of trouble” for oral function and general activity; and selected complications-related signs and symptoms, a pain level score with a Verbal Rating Scale (range 0 to 7), and worst pain perceived. The patient’s sociodemographic data, type of surgery, and the quality of life level were analyzed according to the domains of the HRQOL-sp instrument. Results A total of 106 patients were selected (age: 20.4±7.39 years; 71.7% women) and a total of 127 extracted third molars. On the first day of follow-up, most patients reported interference in their quality of life. The main problems were difficulty opening the mouth (50.94%) and swelling (83.02%). The worst symptom perceived was “bad breath” (>31%) and the worst pain felt was a mean of 4.31±1.62 on the Verbal Rating Scale. All items gradually reduced until the seventh day. Conclusion The HRQOL-sp revealed substantial interference in the quality of life on the first postoperative day. It is suggested that the risk factors associated with quality of life be analyzed and the instrument in Spanish be validated. PMID:27660421

Dimensional changes of upper airway after rapid maxillary expansion: a prospective cone-beam computed tomography study.

PubMed

Chang, Yoon; Koenig, Lisa J; Pruszynski, Jessica E; Bradley, Thomas G; Bosio, Jose A; Liu, Dawei

2013-04-01

The aim of this prospective study was to use cone-beam computed tomography to assess the dimensional changes of the upper airway in orthodontic patients with maxillary constriction treated by rapid maxillary expansion. Fourteen orthodontic patients (mean age, 12.9 years; range, 9.7-16 years) were recruited. The patients with posterior crossbite and constricted maxilla were treated with rapid maxillary expansion as the initial part of their comprehensive orthodontic treatments. Before and after rapid maxillary expansion cone-beam computed tomography scans were taken to measure the retropalatal and retroglossal airway changes in terms of volume, and sagittal and cross-sectional areas. The transverse expansions by rapid maxillary expansion were assessed between the midlingual alveolar bone plates at the maxillary first molar and first premolar levels. The measurements of the before and after rapid maxillary expansion scans were compared by using paired t tests with the Bonferroni adjustment for multiple comparisons. After rapid maxillary expansion, significant and equal amounts of 4.8 mm of expansion were observed at the first molar (P = 0.0000) and the first premolar (P = 0.0000) levels. The width increase at the first premolar level (20.0%) was significantly greater than that at the first molar level (15.0%) (P = 0.035). As the primary outcome variable, the cross-sectional airway measured from the posterior nasal spine to basion level was the only parameter showing a significant increase of 99.4 mm(2) (59.6%) after rapid maxillary expansion (P = 0.0004). These results confirm the findings of previous studies of the effect of rapid maxillary expansion on the maxilla. Additionally, we found that only the cross-sectional area of the upper airway at the posterior nasal spine to basion level significantly gains a moderate increase after rapid maxillary expansion. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Efficacy of baby-CIMT: study protocol for a randomised controlled trial on infants below age 12 months, with clinical signs of unilateral CP

PubMed Central

2014-01-01

Background Infants with unilateral brain lesions are at high risk of developing unilateral cerebral palsy (CP). Given the great plasticity of the young brain, possible interventions for infants at risk of unilateral CP deserve exploration. Constraint-induced movement therapy (CIMT) is known to be effective for older children with unilateral CP but is not systematically used for infants. The development of CIMT for infants (baby-CIMT) is described here, as is the methodology of an RCT comparing the effects on manual ability development of baby-CIMT versus baby-massage. The main hypothesis is that infants receiving baby-CIMT will develop manual ability in the involved hand faster than will infants receiving baby-massage in the first year of life. Method and design The study will be a randomised, controlled, prospective parallel-group trial. Invited infants will be to be randomised to either the baby-CIMT or the baby-massage group if they: 1) are at risk of developing unilateral CP due to a known neonatal event affecting the brain or 2) have been referred to Astrid Lindgren Children’s Hospital due to asymmetric hand function. The inclusion criteria are age 3–8 months and established asymmetric hand use. Infants in both groups will receive two 6-weeks training periods separated by a 6-week pause, for 12 weeks in total of treatment. The primary outcome measure will be the new Hand Assessment for Infants (HAI) for evaluating manual ability. In addition, the Parenting Sense of Competence scale and Alberta Infant Motor Scale will be used. Clinical neuroimaging will be utilized to characterise the brain lesion type. To compare outcomes between treatment groups generalised linear models will be used. Discussion The model of early intensive intervention for hand function, baby-CIMT evaluated by the Hand Assessment for Infants (HAI) will have the potential to significantly increase our understanding of how early intervention of upper limb function in infants at risk of developing unilateral CP can be performed and measured. Trial registration SFO-V4072/2012, 05/22/2013 PMID:24903062

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.

[Effects of T helper 1 cells and T helper 17 cells secreting cytokines on rat models of experimental periodontitis].

PubMed

Wang, Z X; Yang, L; Tan, J Y; Chen, L L

2017-12-09

Objectvie: To investigate the effects of secreting cytokines interferon-gamma (IFN-γ) and interleukin-17 (IL-17) of T helper 1 cells (Th1) and T helper 17 cells (Th17) on the peripheral blood and alveolar bone destruction, so as to provide a new explanation for cellular immunity-mediated alveolar bone destruction. Methods: Eighteen eight-week-old male Sprague-Dawley rats were divided, randomly and equally, into 3 groups: lipopolysaccharide (LPS) group, ligation group and normal control group. In the LPS group, Escherichia coli LPS was injected into the alveolar mucosa on the buccalmedian site of the left upper first molar, while the right upper first molar was injected with equal volume of physiological saline as self-controls. The injections were performed every other day for four times totally. In the ligation group, the left upper first molars were ligatured with 0.2 mm orthodontic cords, while the right upper first molars were left untreated as self-controls, and supplemented with high-sugar diet to promote the periodontitis status. The rats in normal control group were fed normally. The concentrations of IFN-γ and IL-17 in peripheral blood were measured using enzyme linked immunosorbent assay (ELISA) method at the fourth week after the start of injection and at the eighth week after ligation. The histological of periodontal tissues were observed after hematoxylin-eosin (HE) staining and osteoclast count was performed under light microscope. The histological of osteoclasts were observed after tartrate-resistant acid phosphatase (TRAP) staining. Expression of IFN-γ and IL-17 were detected by immunohistochemical assay. Results: The concentrations of IFN-γ in peripheral blood of LPS group [(185.0±50.7) ng/L] and ligation group [(202.9±60.4) ng/L] were significantly higher than that of normal control group [(106.3±17.2) ng/L]( P< 0.05). Meanwhile, histological examination showed inflammatory cells infiltration in the gingival epithelium, the height reduction of alveolar bone accompanied with absorption lacuna. There were significantly higher HE and TRAP stained osteoclasts in LPS group (9.50±1.05) and ligation group (10.83±1.17) than that in controlgroup (0.33±0.52)( P< 0.05). Moreover, the expressions of IL-17 in alveolar bone absorption area of LPS group and ligation group were significantly stronger than that in control group ( P< 0.05). Conclusions: The rat models of experimental periodontitis and alveolar bone resorption could be successfully established by means of ligationand LPS injection, respectively. The periodontal inflammatory responses were related to secreting cytokines IFN-γ and IL-17 of Th1 and Th17 cells, while Th17 cells might exert a positive effect on alveolar bone destruction.

Cognition and bimanual performance in children with unilateral cerebral palsy: protocol for a multicentre, cross-sectional study.

PubMed

Hoare, Brian; Ditchfield, Michael; Thorley, Megan; Wallen, Margaret; Bracken, Jenny; Harvey, Adrienne; Elliott, Catherine; Novak, Iona; Crichton, Ali

2018-05-08

Motor outcomes of children with unilateral cerebral palsy are clearly documented and well understood, yet few studies describe the cognitive functioning in this population, and the associations between the two is poorly understood. Using two hands together in daily life involves complex motor and cognitive processes. Impairment in either domain may contribute to difficulties with bimanual performance. Research is yet to derive whether, and how, cognition affects a child's ability to use their two hands to perform bimanual tasks. This study will use a prospective, cross-sectional multi-centre observational design. Children (aged 6-12 years) with unilateral cerebral palsy will be recruited from one of five Australian treatment centres. We will examine associations between cognition, bimanual performance and brain neuropathology (lesion type and severity) in a sample of 131 children. The primary outcomes are: Motor - the Assisting Hand Assessment; Cognitive - Executive Function; and Brain - lesion location on structural MRI. Secondary data collected will include: Motor - Box and Blocks, ABILHAND- Kids, Sword Test; Cognitive - standard neuropsychological measures of intelligence. We will use generalized linear modelling and structural equation modelling techniques to investigate relationships between bimanual performance, executive function and brain lesion location. This large multi-centre study will examine how cognition affects bimanual performance in children with unilateral cerebral palsy. First, it is anticipated that distinct relationships between bimanual performance and cognition (executive function) will be identified. Second, it is anticipated that interrelationships between bimanual performance and cognition will be associated with common underlying neuropathology. Findings have the potential to improve the specificity of existing upper limb interventions by providing more targeted treatments and influence the development of novel methods to improve both cognitive and motor outcomes in children with unilateral cerebral palsy. ACTRN12614000631606 ; Date of retrospective registration 29/05/2014.

Simple removable appliances to correct anterior and posterior crossbite in mixed dentition: Case report

PubMed Central

Bindayel, Naif A.

2012-01-01

Different techniques have been used to correct anterior and posterior crossbites in mixed dentition. This case report illustrates the treatment of anterior and unilateral posterior crossbites during the mixed dentition. The patient was a 9-year-old boy with a crossbite of the maxillary right permanent central incisor and a unilateral right posterior crossbite, both expressed by a functional shift in the sagittal and transverse dimensions. Two upper acrylic removable appliances, each with an expansion jackscrew, were used to correct the crossbites. The total active treatment time was 4 months; the treatment outcomes were successfully maintained for the subsequent 4 months. General and pediatric dentists, as well as orthodontists, may find this technique useful in managing crossbite cases of the mixed dentition and utilizing the discussion and illustrations for further clinical guidance. PMID:23960537

Impact of post-stroke unilateral spatial neglect on goal-directed arm movements: systematic literature review.

PubMed

Ogourtsova, Tatiana; Archambault, Philippe; Lamontagne, Anouk

2015-12-01

Unilateral spatial neglect (USN), a highly prevalent post-stroke impairment, refers to one's inability to orient or respond to stimuli located in the contralesional visual hemispace. Unilateral spatial neglect has been shown to strongly affect motor performance in functional activities, including non-affected upper extremity (UE) movements. To date, our understanding of the effects of USN on goal-directed UE movements is limited and comparing performance of individuals post-stroke with and without USN is required. To determine, in individuals with stroke, how does the presence of USN, in comparison to the absence of USN, impacts different types of goal-directed movements of the non-affected UE. The present review approach consisted of a comprehensive literature search, an assessment of the quality of the selected studies and qualitative data analysis. A total of 20 studies of moderate to high quality were selected. The USN-specific impairments were found in tasks that required a perceptual, memory-guided or delayed actions, and fewer impairments were found in tasks that required an immediate action to a predefined target. The results indicate that USN contributes to deficits observed in action execution with the non-effected UE that requires greater perceptual demands.

Electromyographic analysis of superior orbicularis oris muscle function in children surgically treated for unilateral complete cleft lip and palate.

PubMed

Szyszka-Sommerfeld, Liliana; Woźniak, Krzysztof; Matthews-Brzozowska, Teresa; Kawala, Beata; Mikulewicz, Marcin

2017-09-01

The aim of this study was to assess the electrical activity of the superior orbicularis oris muscle in children surgically treated for unilateral complete cleft lip and palate (UCCLP). The sample comprised 45 patients 6.38-12.68 years of age with UCCLP and 40 subjects 6.61-11.71 years of age with no clefts. Electromyographical (EMG) recordings were taken with a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany) in the rest position and during saliva swallowing, lip protrusion and reciprocal compression of the lips, as well as while producing the phonemes /p/, /b/, and /m/ combined with the vowel /a/. The electrical activity of the upper lip during saliva swallowing and lip compression was significantly greater in the cleft group. Similar resting level activity was observed in both groups. During the production of the /p/, /b/, and /m/ phonemes combined with the vowel /a/ the results showed no significant differences in the EMG activity between children with UCCLP and noncleft subjects. Patients with UCCLP have abnormal upper lip function characterized by increased activity of the superior orbicularis oris muscle during saliva swallowing and lip compression, and this may affect facial morphology. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Three-dimensional facial analysis of Chinese children with repaired unilateral cleft lip and palate

NASA Astrophysics Data System (ADS)

Othman, Siti Adibah; Aidil Koay, Noor Airin

2016-08-01

We analyzed the facial features of Chinese children with repaired unilateral cleft lip and palate (UCLP) and compared them with a normal control group using a three-dimensional (3D) stereophotogrammetry camera. This cross-sectional study examined 3D measurements of the facial surfaces of 20 Chinese children with repaired UCLP and 40 unaffected Chinese children aged 7 to 12 years old, which were captured using the VECTRA 3D five-pod photosystem and analyzed using Mirror software. Twenty-five variables and two ratios were compared between both groups using independent t-test. Intra- and inter-observer reliability was determined using ten randomly selected images and analyzed using intra-class correlation coefficient test (ICC). The level of significance was set at p < 0.0018. Intra- and inter-observers’ reliability was considered fair to excellent with an ICC value ranging from 0.54 to 0.99. Statistically significant differences (p < 0.0018) were found mainly in the nasolabial region. The cleft group exhibited wider alar base root width, flattened nose and broader nostril floor width on the cleft side. They tended to have shorter upper lip length and thinner upper vermillion thickness. Faces of Chinese children with repaired UCLP displayed meaningful differences when compared to the normal group especially in the nasolabial regions.

Capturing neuroplastic changes after bimanual intensive rehabilitation in children with unilateral spastic cerebral palsy: A combined DTI, TMS and fMRI pilot study

PubMed Central

Bleyenheuft, Yannick; Dricot, Laurence; Gilis, Nathalie; Kuo, Hsing-Ching; Grandin, Cécile; Bleyenheuft, Corinne; Gordon, Andrew M.; Friel, Kathleen M.

2016-01-01

Intensive rehabilitation interventions have been shown to be efficacious in improving upper extremity function in children with unilateral spastic cerebral palsy (USCP). These interventions are based on motor learning principles and engage children in skillful movements. Improvements in upper extremity function are believed to be associated with neuroplastic changes. However, these neuroplastic changes have not been well-described in children with cerebral palsy, likely due to challenges in defining and implementing the optimal tools and tests in children. Here we documented the implementation of three different neurological assessments (diffusion tensor imaging-DTI, transcranial magnetic stimulation-TMS and functional magnetic resonance imaging-fMRI) before and after a bimanual intensive treatment (HABIT-ILE) in two children with USCP presenting differential corticospinal developmental reorganization (ipsilateral and contralateral). The aim of the study was to capture neurophysiological changes and to document the complementary relationship between these measures, the potential measurable changes and the feasibility of applying these techniques in children with USCP. Independent of cortical reorganization, both children showed increases in activation and size of the motor areas controlling the affected hand, quantified with different techniques. In addition, fMRI provided additional unexpected changes in the reward circuit while using the affected hand. PMID:26183338

A comparison of muscle activity in using touchscreen smartphone among young people with and without chronic neck-shoulder pain.

PubMed

Xie, Yanfei; Szeto, Grace P Y; Dai, Jie; Madeleine, Pascal

2016-01-01

This study aimed to examine differences in muscle activity between young people with and without neck-shoulder pain (n = 20 in each group), when they performed texting on a smartphone. Texting was compared between using both hands ('bilateral texting') and with only one hand ('unilateral texting'). Texting tasks were also compared with computer typing. Surface electromyography from three proximal postural muscles and four distal hand/thumb muscles on the right side was recorded. Compared with healthy controls, young people with neck-shoulder pain showed altered motor control consisting of higher muscle activity in the cervical erector spinae and upper trapezius when performing texting and typing tasks. Generally, unilateral texting was associated with higher muscle loading compared with bilateral texting especially in the forearm muscles. Compared with computer typing, smartphone texting was associated with higher activity in neck extensor and thumb muscles but lower activity in upper and lower trapezius as well as wrist extensors. This study demonstrated that symptomatic individuals had increased muscle activity in the neck–shoulder region when texting on a smartphone. Contemporary ergonomic guidelines should include advice on how to interact with handheld electronic devices to achieve a relaxed posture and reduced muscle load in order to reduce the risk of musculoskeletal disorders.

A standard set of upper extremity tasks for evaluating rehabilitation interventions for individuals with complete arm paralysis

PubMed Central

Cornwell, Andrew S.; Liao, James Y.; Bryden, Anne M.; Kirsch, Robert F.

2013-01-01

We have developed a set of upper extremity functional tasks to guide the design and test the performance of rehabilitation technologies that restore arm motion in people with high tetraplegia. Our goal was to develop a short set of tasks that would be representative of a much larger set of activities of daily living while also being feasible for a unilateral user of an implanted Functional Electrical Stimulation (FES) system. To compile this list of tasks, we reviewed existing clinical outcome measures related to arm and hand function, and were further informed by surveys of patient desires. We ultimately selected a set of five tasks that captured the most common components of movement seen in these tasks, making them highly relevant for assessing FES-restored unilateral arm function in individuals with high cervical spinal cord injury (SCI). The tasks are intended to be used when setting design specifications and for evaluation and standardization of rehabilitation technologies under development. While not unique, this set of tasks will provide a common basis for comparing different interventions (e.g., FES, powered orthoses, robotic assistants) and testing different user command interfaces (e.g., sip-and-puff, head joysticks, brain-computer interfaces). PMID:22773199

The influence of a constraint and bimanual training program using a variety of modalities on endurance and on the cardiac autonomic regulation system of children with unilateral cerebral palsy: A self-control clinical trial.

PubMed

Cohen-Holzer, Marilyn; Sorek, Gilad; Schweizer, Maayan; Katz-Leurer, Michal

2017-01-01

An intensive hybrid program, combining constraint with bimanual training, improves upper extremity function as well as walking endurance of children with unilateral cerebral palsy (UCP). Endurance improvement may be associated with the cardiac autonomic regulation system (CARS) adaptation, known to be impaired among these children. To examine the influence of an intensive hybrid program on CARS, walking endurance and the correlation with upper extremity function of children with UCP. Twenty-four children aged 6-10 years with UCP participated in a hybrid program, 10 days, 6 hours per day. Data were collected pre-, post- and 3-months post-intervention. Main outcome measures included the Polar RS800CX for heart rate (HR) and heart rate variability (HRV) data, the 6-Minute Walk Test (6MWT) for endurance, and the Assisting Hand Assessment (AHA) and Jebsen-Taylor Test of Hand Function (JTTHF) for bimanual and unimanual function. A significant reduction in HR and an increase in HRV at post- and 3-month post-intervention was noted (χ22= 8.3, p = 0.016) along with a significant increase in 6MWT with a median increase of 81 meters (χ22= 11.0, p = 0.004) at the same interval. A significant improvement was noted in unimanual and bimanual performance following the intervention. An intensive hybrid program effectively improved CARS function as well as walking endurance and upper extremity function in children with UCP (213).

Effect of parent-delivered action observation therapy on upper limb function in unilateral cerebral palsy: a randomized controlled trial.

PubMed

Kirkpatrick, Emma; Pearse, Janice; James, Peter; Basu, Anna

2016-10-01

To determine whether home-based, parent-delivered therapy comprising action observation (AO) and repeated practice (RP) improves upper limb function more than RP alone in children with unilateral cerebral palsy (UCP). single-blinded parallel-group randomized controlled trial with 1:1 allocation comparing AO+RP (intervention) with RP alone (control). computer-generated, with allocation concealment by opaque sequentially-numbered envelopes. northern England, August 2011 to September 2013. 70 children with UCP; mean age 5.6 years (SD 2.1), 31 female. home-based activities were provided, tailored to interests and abilities. 15 minutes/day, 5 days/week for 3 months. Assisting Hand Assessment (AHA; primary outcome measure), Melbourne Assessment 2 (MA2), and ABILHAND-Kids at baseline, 3 months, and 6 months. Outcome data was available at 3 months for 28 children in the AO+RP group and 31 controls, and at 6 months for 26 and 28 children respectively. There were no between-group differences in AHA, MA2, or ABILHAND-Kids at 3 or 6 months versus baseline (all p>0.05). Combined-group improvements (p<0.001), observed in AHA and MA2 at 3 months, were maintained at 6 months. ABILHAND-Kids also showed improvement at 3 months (p=0.003), maintained at 6 months. Parent-delivered RP (with or without AO) improves upper limb function and could supplement therapist input. © 2016 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.

Effect of Carbon Dioxide Laser on Increasing Vestibular Depth in Cleft Lip and Palate Patients.

PubMed

Yassaei, Sogra; Aghili, Hossein; Azam, Alireza Navab; Moghadam, Mahjobeh Gholdani; Safari, Isa

2017-09-01

Shallow upper buccal sulcus deformity in cleft lip and palate patients is one of the common secondary deformities after primary cleft lip and palate repair; this deformity may prevent or complicate orthodontic and prosthodontic procedures causing aesthetic and functional problems. A number of methods are described to increase the anterior maxillary sulcus in these patients. This study assessed the use of a carbon dioxide laser (CO 2 ) to increase the sulcus depth. Fifteen patients with cleft lip and palate (eight unilateral and seven bilateral) were studied. The surgical procedure was performed using CO 2 laser. The vestibular depth and lip length were measured at three time points namely before surgery (T0), 1 week following surgery (T1), and 4 months following surgery (T2). After data collection, statistical analyses were done using PASW ® version 18 SPSS. The mean values of vestibular depth were 9.46 ± 1.92, 13.83 ± 1.88, and 13.23 ± 1.76 mm for T0, T1, and T2, respectively. The vestibular depth significantly increased after 4 months of follow-up (p = 0.001). The mean amount of vestibular depth gain was not significantly different in unilateral and bilateral cleft groups (p = 0.908). The mean value of upper lip length increased by a mean of 1.23 mm and was statistically significant (p = 0.001). Upper buccal sulcus reconstruction with CO 2 laser provides successful and stable results. CO 2 laser application is suggested as an alternative to conventional vestibuloplasty.

Physiological asymmetry in etiolated pea epicotyls: relation to patterns of auxin distribution and phototropic behavior

NASA Technical Reports Server (NTRS)

Kuhn, H.; Galston, A. W.

1992-01-01

Etiolated pea seedlings require transformation of Pr phytochrome to Pfr before they display optimal phototropic response to unilateral blue light. This study investigates the possible role of auxin transport in explaining these phenomena. Labeled [2-14C]IAA applied to the intact terminal buds of dark-grown and red light-treated pea seedlings was measured 210 min later on the shaded and illuminated sides of the epicotyl as a function of direction and duration of irradiation with blue light. Totally darkened epicotyls show an asymmetry in distribution of radioactivity in the upper growth zone of the epicotyl, in favor of the side under the concave part of the apical hook. Red light, which greatly potentiates curvature toward subsequent unilateral blue light, lowers this asymmetry. Blue light directed to the epicotyl of red-pretreated plants in a plane parallel to the hook and from the side bearing the convex portion of the hook induces positive phototropic curvature as well as a surplus of radioactivity on the illuminated side of the upper epicotyl and on the shaded side of the lower growth zone of the epicotyl. Light directed to the side bearing the concave part of the hook also causes an accumulation of counts in the upper part of the lighted side but produces neither curvature of the epicotyl nor accumulation of counts in the lower shaded side. Because of this built-in physiological asymmetry in the growth zone just below the apical hook, it is difficult to explain the effects of red and blue light on curvature in terms of patterns of auxin distribution alone.

Esthetic composition of smile in individuals with cleft lip, alveolus, and palate: visibility of the periodontium and the esthetics of smile.

PubMed

Esper, Luis Augusto; Sbrana, Michyele Cristhiane; Cunha, Mércia Jussara da Silva; Moreira, Guilherme Santos; de Almeida, Ana Lúcia Pompéia Fraga

2012-01-01

Objective. To evaluate characteristics of smile related to visibility in individuals with cleft lip, alveolus, and palate. Design. Cross-sectional. Setting. HRAC/USP, Brazil. Patients. Individuals with repaired complete unilateral cleft lip and palate (n = 45), aged 15-30 years. Interventions. Frontal facial photographs were obtained in natural and forced smiles (n = 135). Six specialists in periodontics evaluated the photographs as to the smile line, thickness, and curve of the upper lip. Main Outcome Measures. The cleft area was compared with the contralateral region. Results were expressed as percentages and means. The findings were compared between groups of periodontists. Results. Statistically significant relationship was observed in the smile line between examiners and between natural and forced smiles, regardless of the association with the cleft side. The lip was thicker at rest and thinner in the forced smile, as also evaluated by the group not experienced with cleft care. The curve of the upper lip in natural and forced smiles was considered as close to straight by both groups, regardless of the cleft. Conclusion. The smile in individuals with clefts was regarded as average for both cleft and noncleft sides. The thickness was characterized as average to thin, being thinner in forced smile and when analyzed by the group not experienced with cleft care. In the average, the curve of the upper lip was considered as straight. The present study elucidates some characteristics related to the smile in individuals with repaired unilateral cleft lip, alveolus, and palate.

Esthetic Composition of Smile in Individuals with Cleft Lip, Alveolus, and Palate: Visibility of the Periodontium and the Esthetics of Smile

PubMed Central

Esper, Luis Augusto; Sbrana, Michyele Cristhiane; Cunha, Mércia Jussara da Silva; Moreira, Guilherme Santos; de Almeida, Ana Lúcia Pompéia Fraga

2012-01-01

Objective. To evaluate characteristics of smile related to visibility in individuals with cleft lip, alveolus, and palate. Design. Cross-sectional. Setting. HRAC/USP, Brazil. Patients. Individuals with repaired complete unilateral cleft lip and palate (n = 45), aged 15–30 years. Interventions. Frontal facial photographs were obtained in natural and forced smiles (n = 135). Six specialists in periodontics evaluated the photographs as to the smile line, thickness, and curve of the upper lip. Main Outcome Measures. The cleft area was compared with the contralateral region. Results were expressed as percentages and means. The findings were compared between groups of periodontists. Results. Statistically significant relationship was observed in the smile line between examiners and between natural and forced smiles, regardless of the association with the cleft side. The lip was thicker at rest and thinner in the forced smile, as also evaluated by the group not experienced with cleft care. The curve of the upper lip in natural and forced smiles was considered as close to straight by both groups, regardless of the cleft. Conclusion. The smile in individuals with clefts was regarded as average for both cleft and noncleft sides. The thickness was characterized as average to thin, being thinner in forced smile and when analyzed by the group not experienced with cleft care. In the average, the curve of the upper lip was considered as straight. The present study elucidates some characteristics related to the smile in individuals with repaired unilateral cleft lip, alveolus, and palate. PMID:23227326

Effects of unilateral laser-assisted ventriculocordectomy in horses with laryngeal hemiplegia.

PubMed

Robinson, P; Derksen, F J; Stick, J A; Sullins, K E; DeTolve, P G; Robinson, N E

2006-11-01

Recent studies have evaluated surgical techniques aimed at reducing noise and improving airway function in horses with recurrent laryngeal neuropathy (RLN). These techniques require general anaesthesia and are invasive. A minimally invasive transnasal surgical technique for treatment of RLN that may be employed in the standing, sedated horse would be advantageous. To determine whether unilateral laser-assisted ventriculocordectomy (LVC) improves upper airway function and reduces noise during inhalation in exercising horses with laryngeal hemiplegia (LH). Six Standardbred horses were used; respiratory sound and inspiratory transupper airway pressure (Pui) measured before and after induction of LH, and 60, 90 and 120 days after LVC. Inspiratory sound level (SL) and the sound intensities of formants 1, 2 and 3 (Fl, F2 and F3, respectively), were measured using computer-based sound analysis programmes. In addition, upper airway endoscopy was performed at each time interval, at rest and during treadmill exercise. In LH-affected horses, Pui, SL and the sound intensity of F2 and F3 were increased significantly from baseline values. At 60 days after LVC, Pui and SL had returned to baseline, and F2 and F3 values had improved partially compared to LH values. At 90 and 120 days, however, SL increased again to LH levels. LVC decreases LH-associated airway obstruction by 60 days after surgery, and reduces inspiratory noise but not as effectively as bilateral ventriculocordectomy. LVC may be recommended as a treatment of LH, where reduction of upper airway obstruction and respiratory noise is desired and the owner wishes to avoid risks associated with a laryngotomy incision or general anaesthesia.

Phrenic Nerve Palsy Secondary to Parsonage-Turner Syndrome: A Diagnosis Commonly Overlooked.

PubMed

McEnery, Tom; Walsh, Ronan; Burke, Conor; McGowan, Aisling; Faul, John; Cormican, Liam

2017-04-01

Neuralgic Amyotrophy (NA) or Parsonage-Turner syndrome is an idiopathic neuropathy commonly affecting the brachial plexus. Associated phrenic nerve involvement, though recognised, is thought to be very rare. We present a case series of four patients (all male, mean age 53) presenting with dyspnoea preceded by severe self-limiting upper limb and shoulder pain, with an elevated hemi-diaphragm on clinical examination and chest X-ray. Neurological examination of the upper limb at the time of presentation was normal. Diaphragmatic fluoroscopy confirmed unilateral diaphragmatic paralysis. Pulmonary function testing demonstrated characteristic reduction in forced vital capacity between supine and sitting position (mean 50%, range 42-65% predicted, mean change 23%, range 22-46%), reduced maximal inspiratory pressures (mean 61%, range 43-86% predicted), reduced sniff nasal inspiratory pressure (mean 88.25, range 66-109 cm H 2 O) and preserved maximal expiratory pressure (mean 107%, range 83-130% predicted). Phrenic nerve conduction studies confirmed phrenic nerve palsy. All patients were managed conservatively. Follow-up ranged from 6 months to 3 years. Symptoms and lung function variables normalised in three patients and improved significantly in the fourth. The classic history of severe ipsilateral shoulder and upper limb neuromuscular pain should be elicited and thus NA considered in the differential for a unilateral diaphragmatic paralysis, even in the absence of neurological signs. Parsonage-Turner syndrome is likely to represent a significantly under-diagnosed aetiology of phrenic nerve palsy. Conservative management as opposed to surgical intervention is advocated as most patients demonstrate gradual resolution over time in this case series.

Physiological asymmetry in etiolated pea epicotyls: relation to patterns of auxin distribution and phototropic behavior.

PubMed

Kuhn, H; Galston, A W

1992-01-01

Etiolated pea seedlings require transformation of Pr phytochrome to Pfr before they display optimal phototropic response to unilateral blue light. This study investigates the possible role of auxin transport in explaining these phenomena. Labeled [2-14C]IAA applied to the intact terminal buds of dark-grown and red light-treated pea seedlings was measured 210 min later on the shaded and illuminated sides of the epicotyl as a function of direction and duration of irradiation with blue light. Totally darkened epicotyls show an asymmetry in distribution of radioactivity in the upper growth zone of the epicotyl, in favor of the side under the concave part of the apical hook. Red light, which greatly potentiates curvature toward subsequent unilateral blue light, lowers this asymmetry. Blue light directed to the epicotyl of red-pretreated plants in a plane parallel to the hook and from the side bearing the convex portion of the hook induces positive phototropic curvature as well as a surplus of radioactivity on the illuminated side of the upper epicotyl and on the shaded side of the lower growth zone of the epicotyl. Light directed to the side bearing the concave part of the hook also causes an accumulation of counts in the upper part of the lighted side but produces neither curvature of the epicotyl nor accumulation of counts in the lower shaded side. Because of this built-in physiological asymmetry in the growth zone just below the apical hook, it is difficult to explain the effects of red and blue light on curvature in terms of patterns of auxin distribution alone.

Development of Endoscopic Diagnosis and Treatment for Chronic Unilateral Hematuria: 35 Years Experience.

PubMed

Tanimoto, Ryuta; Kumon, Hiromi; Bagley, Demetrius H

2017-04-01

Chronic unilateral hematuria (CUH) is also called lateralizing essential hematuria, benign essential hematuria, and benign lateralizing hematuria, which was defined as intermittent or continuous gross hematuria that cannot be diagnosed with standard radiology and hematology studies, together with unilateral bloody efflux by cystoscopy. CUH is rare, but sometimes confused with malignancy or life-threatening hemorrhage. Therefore, it can cause considerable anxiety to not only patients but also urologists. For this study, we summarized articles about endoscopic diagnosis and treatment of CUH, and discussed the development of endourology for CUH. We searched articles related to CUH that were indexed in the PubMed database and published in English. Key terms used were "unilateral," "lateralizing," "chronic," "benign," and "idiopathic" hematuria. We found 15 pertinent articles reporting CUH. Endoscopically, CUH can be classified into three categories: discrete lesion, diffuse lesion, or no (unidentified) lesion. Currently, endoscopic techniques for CUH are similar to the techniques for upper tract urothelial carcinoma, using semi-rigid and flexible ureteroscopes with diathermy fulguration or laser ablation for treatment. The overall success rate of endoscopic treatment for CUH, defined as resolution of gross hematuria after treatment, was 93% (190/205). The recurrence rate, defined as recurrent gross hematuria after treatment, was 10% (19/189). Advancements in endoscopic devices and techniques have enabled more accurate and less invasive diagnosis and treatment of CUH. Once CUH is defined, flexible ureteroscopy is the diagnostic and therapeutic technique of choice.

Accommodative Performance of Children With Unilateral Amblyopia

PubMed Central

Manh, Vivian; Chen, Angela M.; Tarczy-Hornoch, Kristina; Cotter, Susan A.; Candy, T. Rowan

2015-01-01

Purpose. The purpose of this study was to compare the accommodative performance of the amblyopic eye of children with unilateral amblyopia to that of their nonamblyopic eye, and also to that of children without amblyopia, during both monocular and binocular viewing. Methods. Modified Nott retinoscopy was used to measure accommodative performance of 38 subjects with unilateral amblyopia and 25 subjects with typical vision from 3 to 13 years of age during monocular and binocular viewing at target distances of 50, 33, and 25 cm. The relationship between accommodative demand and interocular difference (IOD) in accommodative error was assessed in each group. Results. The mean IOD in monocular accommodative error for amblyopic subjects across all three viewing distances was 0.49 diopters (D) (95% confidence interval [CI], ±1.12 D) in the 180° meridian and 0.54 D (95% CI, ±1.27 D) in the 90° meridian, with the amblyopic eye exhibiting greater accommodative errors on average. Interocular difference in monocular accommodative error increased significantly with increasing accommodative demand; 5%, 47%, and 58% of amblyopic subjects had monocular errors in the amblyopic eye that fell outside the upper 95% confidence limit for the better eye of control subjects at viewing distances of 50, 33, and 25 cm, respectively. Conclusions. When viewing monocularly, children with unilateral amblyopia had greater mean accommodative errors in their amblyopic eyes than in their nonamblyopic eyes, and when compared with control subjects. This could lead to unintended retinal image defocus during patching therapy for amblyopia. PMID:25626970

Effect of Surgical Intervention for Removal of Mandibular Third Molar on Periodontal Healing of Adjacent Mandibular Second Molar: A Systematic Review and Bayesian Network Meta-Analysis.

PubMed

Barbato, Luigi; Kalemaj, Zamira; Buti, Jacopo; Baccini, Michela; La Marca, Michele; Duvina, Marco; Tonelli, Paolo

2016-03-01

The aim of this systematic review is to evaluate and synthesize scientific evidence on the effect of surgical interventions for removal of mandibular third molar (M3M) on periodontal healing of adjacent mandibular second molar (M2M). The protocol was registered at PROSPERO (International Prospective Register of Systematic Reviews) as CRD42012003059. Medline, Cochrane, and EMBASE databases were interrogated to identify randomized controlled trials (RCTs) up to December 22, 2014. Patients with M3Ms fully developed, unilaterally or bilaterally impacted, were considered. Outcomes were clinical attachment level gain (CALg) and probing depth reduction (PDr) with a follow-up ≥ 6 months. Patient-subjective outcomes, such as pain, discomfort, and complications, and financial aspects and chair time, were also explored. A Bayesian network meta-analysis model was used to estimate direct and indirect effects and to establish a ranking of treatments. Sixteen RCTs were included and categorized into four groups investigating the following: 1) regenerative/grafting procedures (10 RCTs); 2) flap design (three RCTs); 3) type of suturing (one RCT); and 4) periodontal care of M2M (two RCTs). Guided tissue regeneration (GTR) with resorbable (GTRr) and non-resorbable (GTRnr) membrane and GTRr with anorganic xenograft (GTRr + AX) showed the highest mean ranking for CALg (2.99, 90% credible interval [CrI] = 1 to 5; 2.80, 90% CrI = 1 to 6; and 2.29, 90% CrI = 1 to 6, respectively) and PDr (2.83, 90% CrI = 1 to 5; 2.52, 90% CrI = 1 to 5; and 2.77, 90% CrI = 1 to 6, respectively). GTRr + AX showed the highest probability (Pr) of being the best treatment for CALg (Pr = 45%) and PDr (Pr = 32%). Direct and network quality of evidence were rated from very low to moderate. To the best of the authors' knowledge, the present review is the first one to evaluate quantitatively and qualitatively the effect of different interventions on periodontal healing distal to the second molar after extraction of the third molar. GTR-based procedures with or without combined grafting therapies provide some adjunctive clinical benefit compared to standard non-regenerative/non-grafting procedures. However, the overall low quality of evidence suggests a low degree of confidence and certainty in treatment effects. Evidence on variations of surgical M3M removal techniques based on flap design, type of suturing, and periodontal care of M2M is limited both qualitatively and quantitatively.

Evaluation of homeopathic Arnica montana for ecchymosis after upper blepharoplasty: a placebo-controlled, randomized, double-blind study.

PubMed

Kotlus, Brett S; Heringer, Dustin M; Dryden, Robert M

2010-01-01

Ecchymosis is commonly encountered after upper eyelid blepharoplasty. The use of homeopathic preparations of Arnica montana, a flowering herb, has been advocated by physicians, patients, and manufacturers for reduction of postsurgical ecchymosis. The authors evaluate its efficacy after upper eyelid blepharoplasty. A prospective, placebo-controlled, double-blind study was performed in which patients were randomly assigned to the administration of homeopathic A. montana or placebo concurrent with unilateral upper eyelid blepharoplasty followed by contralateral treatment at least 1 month later. Ecchymosis was evaluated at days 3 and 7 by rank order of severity and measurement of surface area of observable ecchymosis. There was no statistically significant difference in area of ecchymosis or rank order of ecchymosis severity for days 3 and 7 after treatment with A. montana versus placebo. Additionally, there was no difference in ease of recovery per patient report, and there was no difference in the rate of ecchymosis resolution. The authors find no evidence that homeopathic A. montana, as used in this study, is beneficial in the reduction or the resolution of ecchymosis after upper eyelid blepharoplasty.

Comparison of temporary anchorage devices and transpalatal arch-mediated anchorage reinforcement during canine retraction

PubMed Central

Kecik, Defne

2016-01-01

Objective: The purpose of this study was to compare the dental and skeletal effects of canine retraction using conventional anchorage reinforcement systems and comparing them with the usage of TADs. Materials and Methods: The sample consisted of 50 patients having Class I malocclusions with bimaxillary protrusion indicated for first premolar extraction, and allocated into two groups. The first group consisted of 25 patients with a mean age of 18,7 years (min:14, max:22 years, 16 girls and 9 boys) that TADs were applied as an anchorage mechanic between attached gingiva of upper second premolar and first molar teeth. The second group consisted of 25 patients with a mean age of 19,4 years (min:15, max:23 years, 14 girls and 11 boys) that conventional molar anchorage with Transpalatal arch (TPA) was applied for the anchorage mechanics against canine retraction. Results: The results showed that mean mesial movement and the tipping of the first molars in TAD group between T0 - T1 were insignificant (P > 0,05), however in the TPA group were significant (P<0,01). Vertical movement of the molars were not significant when two groups were compared (P>0,05). Conclusion: Although TPA is a useful appliance, it doesn't provide an effective anchorage control on anteroposterior movement maxillary first molar teeth concerning first premolar extraction treatment. TADs are more convenient to provide absolute anchorage during maxillary canine retraction in contrast to transpalatal arch. PMID:28042267

Comparison of temporary anchorage devices and transpalatal arch-mediated anchorage reinforcement during canine retraction.

PubMed

Kecik, Defne

2016-01-01

The purpose of this study was to compare the dental and skeletal effects of canine retraction using conventional anchorage reinforcement systems and comparing them with the usage of TADs. The sample consisted of 50 patients having Class I malocclusions with bimaxillary protrusion indicated for first premolar extraction, and allocated into two groups. The first group consisted of 25 patients with a mean age of 18,7 years (min:14, max:22 years, 16 girls and 9 boys) that TADs were applied as an anchorage mechanic between attached gingiva of upper second premolar and first molar teeth. The second group consisted of 25 patients with a mean age of 19,4 years (min:15, max:23 years, 14 girls and 11 boys) that conventional molar anchorage with Transpalatal arch (TPA) was applied for the anchorage mechanics against canine retraction. The results showed that mean mesial movement and the tipping of the first molars in TAD group between T0 - T1 were insignificant ( P > 0,05), however in the TPA group were significant ( P <0,01). Vertical movement of the molars were not significant when two groups were compared ( P >0,05). Although TPA is a useful appliance, it doesn't provide an effective anchorage control on anteroposterior movement maxillary first molar teeth concerning first premolar extraction treatment. TADs are more convenient to provide absolute anchorage during maxillary canine retraction in contrast to transpalatal arch.

The role of microbial iron reduction in the formation of Proterozoic molar tooth structures

NASA Astrophysics Data System (ADS)

Hodgskiss, Malcolm S. W.; Kunzmann, Marcus; Poirier, André; Halverson, Galen P.

2018-01-01

Molar tooth structures are poorly understood early diagenetic, microspar-filled voids in clay-rich carbonate sediments. They are a common structure in sedimentary successions dating from 2600-720 Ma, but do not occur in rocks older or younger, with the exception of two isolated Ediacaran occurrences. Despite being locally volumetrically significant in carbonate rocks of this age, their formation and disappearance in the geological record remain enigmatic. Here we present iron isotope data, supported by carbon and oxygen isotopes, major and minor element concentrations, and total organic carbon and sulphur contents for 87 samples from units in ten different basins spanning ca. 1900-635 Ma. The iron isotope composition of molar tooth structures is almost always lighter (modal depletion of 2‰) than the carbonate or residue components in the host sediment. We interpret the isotopically light iron in molar tooth structures to have been produced by dissimilatory iron reduction utilising Fe-rich smectites and Fe-oxyhydroxides in the upper sediment column. The microbial conversion of smectite to illite results in a volume reduction of clay minerals (∼30%) while simultaneously increasing pore water alkalinity. When coupled with wave loading, this biogeochemical process is a viable mechanism to produce voids and subsequently precipitate carbonate minerals. The disappearance of molar tooth structures in the mid-Neoproterozoic is likely linked to a combination of a decrease in smectite abundance, a decline in the marine DIC reservoir, and an increase in the concentration of O2 in shallow seawater.

Present and future in the use of micro-CT scanner 3D analysis for the study of dental and root canal morphology.

PubMed

Grande, Nicola M; Plotino, Gianluca; Gambarini, Gianluca; Testarelli, Luca; D'Ambrosio, Ferdinando; Pecci, Raffaella; Bedini, Rossella

2012-01-01

The goal of the present article is to illustrate and analyze the applications and the potential of microcomputed tomography (micro-CT) in the analysis of tooth anatomy and root canal morphology. The authors performed a micro-CT analysis of the following different teeth: maxillary first molars with a second canal in the mesiobuccal (MB) root, mandibular first molars with complex anatomy in the mesial root, premolars with single and double roots and with complicated apical anatomy. The hardware device used in this study was a desktop X-ray microfocus CT scanner (SkyScan 1072, SkyScan bvba, Aartselaar, Belgium). A specific software ResolveRT Amira (Visage Imaging) was used for the 3D analysis and imaging. The authors obtained three-dimensional images from 15 teeth. It was possible to precisely visualize and analyze external and internal anatomy of teeth, showing the finest details. Among the 5 upper molars analyzed, in three cases, the MB canals joined into one canal, while in the other two molars the two mesial canals were separate. Among the lower molars two of the five samples exhibited a single canal in the mesial root, which had a broad, flat appearance in a mesiodistal dimension. In the five premolar teeth, the canals were independent; however, the apical delta and ramifications of the root canals were quite complex. Micro-CT offers a simple and reproducible technique for 3D noninvasive assessment of the anatomy of root canal systems.

Laser fluorescence in monitoring the influence of targeted tooth brushing on remineralization of initial caries lesions on newly erupted molar teeth - RCT.

PubMed

Laitala, M-L; Jaanti, E; Vähänikkilä, H; Määttä, T; Heikka, H; Hausen, H; Anttonen, V

2017-11-01

This study aimed to monitor mineralization changes in initial caries lesions on newly erupted second molars using laser fluorescence (LF) scanning after a 1-month targeted tooth brushing intervention. Altogether, 124 13- to 14-year-old school children were invited to participate. Of those who fulfilled the clinical criteria (at least one initial lesion with LF value >10 in second molars), 51 gave their written consent to participate. Laser fluorescence values were registered at baseline and after 1-month follow-up period. All participants were individually taught targeted tooth brushing of their second molars and randomly provided tooth paste with 0 or 1500 ppm fluoride. Brushing frequency was investigated at baseline and after the follow-up. Change in LF values was compared considering the tooth, content of fluoride in the paste and brushing frequency. In lesions with LF values ≤30 at baseline, change in LF values demonstrated improvement. Improvement was detected especially in upper molars. In lesions with LF values >30 at baseline, improvement was least detected. Brushing frequency increased slightly during the intervention. Laser fluorescence is a simple method and useful in monitoring remineralization of incipient lesions even in weeks. Targeted tooth brushing seems to induce remineralization even in weeks. Laser fluorescence could be a valuable motivating tool in promoting patients' self-care. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Soft tissue, skeletal and dentoalveolar changes following conventional anchorage molar distalization therapy in class II non-growing subjects: a multicentric retrospective study.

PubMed

Fontana, Mattia; Cozzani, Mauro; Caprioglio, Alberto

2012-05-01

The purpose of this retrospective prolective study is to evaluate soft tissue, dentoalveolar and skeletal vertical changes following conventional anchorage molar distalization therapy in adult patients. Forty-six patients (34 females, mean age 25 years 6 months; and 12 males, mean age 28 years 4 months) were recruited from 4 specialists Board Certified. All subjects underwent molar distalization therapy according different distalization mechanics. Cephalometric headfilms were available for all subjects before (T0) and at the end of comprehensive treatment (T1). The initial and final measurements and treatment changes were compared by means of a paired t-test or a paired Wilcoxon test. Mean total treatment time was 3 years 3 months ± 8 months. Maxillary first and second molars distalized 2.16±0.84 mm and 2.01±0.69 mm respectively, but also maintained a slight distal tipping of 1.45° (min 2.22°, max -6.45°) and 3.35° (min 0.47°, max -15.48°) at the end of treatment. Distal movement of maxillary first molar contributed 57.6% to molar correction, and 42.4% was due to a mesial movement of mandibular first molar (1.59±0.46 mm). Dentoalveolar changes contributed to overjet correction; maxillary incisors retroclined 5.78°±3.17°, lower incisors proclined 7.49°±4.52° and occlusal plane rotated down and backward 2.32°±2.10°. A significant clockwise rotation of the mandible (1.97°±1.32°) and a significant increase in lower facial height (3.35±1.48) mm were observed. Upper lip slightly retruded (-1.76±1.70 mm) and lower lip protruded (0.96±0.99 mm) but these changes had a negligible impact on clinical appearance. Although maxillary molar distalization therapy can be performed in adult patients, significant proclination of the lower incisors, clockwise rotation of the occlusal plane and increase in vertical facial dimension should be expected. Nevertheless, in absence of maxillary third molars and in presence of mandibular third molars this procedure could be recommended. Copyright © 2011 Società Italiana di Ortodonzia SIDO. Published by Elsevier Srl. All rights reserved.

Effect of Intraoral Aging on Debris Accumulation and Friction of First Molar Tubes.

PubMed

Chaptini, Edmond; Khoury, Elie; Cacciafesta, Vittorio; Naaman, Nada

2016-11-01

The aim of this article was to evaluate the impact of intraoral aging and site specificity on debris accumulation and friction in molar tubes after intraoral use. A total of 80 intraorally used first molar convertible tubes were provided by 20 orthodontic adolescent patients after 6 months of treatment. The specimens were divided into eight groups (n = 10) according to the mouth quadrant and the type of examination [four groups of ten tubes for scanning electron microscope (SEM) and four groups of ten tubes for friction test]. Scanning electron microscope examination was performed after opening the convertible caps and friction test was executed using a 0.019'' × 0.025'' stainless steel wire, which was inserted in the tubes belonging to each group. The Mann-Whitney test, analysis of variance (ANOVA), and Bonferroni tests were performed for statistical analysis at 0.01 level of significance. There was a significant increase in the amount of debris and frictional force after 6 months of intraoral exposure (p < 0.0001). Debris scores were higher (10% increase) on the upper tubes when compared with the lower ones, with no statistical difference. Mean frictional force ranged from 0.22 to 0.26 N according to the mouth quadrant, but the difference between groups was also not significant. After 6 months of intraoral exposure, there was a significant increase in the amount of debris in the first molar tube slots, leading to significantly higher frictional forces during sliding mechanics. The influence of site specificity on the amount of debris and on frictional forces of the first molar tubes could not be demonstrated. Molar tubes should be cleaned, before and during sliding mechanics, in order to minimize friction.

Autotransplantation of immature third molars using a computer-aided rapid prototyping model: a report of 4 cases.

PubMed

Jang, Ji-Hyun; Lee, Seung-Jong; Kim, Euiseong

2013-11-01

Autotransplantation of immature teeth can be an option for premature tooth loss in young patients as an alternative to immediately replacing teeth with fixed or implant-supported prostheses. The present case series reports 4 successful autotransplantation cases using computer-aided rapid prototyping (CARP) models with immature third molars. The compromised upper and lower molars (n = 4) of patients aged 15-21 years old were transplanted with third molars using CARP models. Postoperatively, the pulp vitality and the development of the roots were examined clinically and radiographically. The patient follow-up period was 2-7.5 years after surgery. The long-term follow-up showed that all of the transplants were asymptomatic and functional. Radiographic examination indicated that the apices developed continuously and the root length and thickness increased. The final follow-up examination revealed that all of the transplants kept the vitality, and the apices were fully developed with normal periodontal ligaments and trabecular bony patterns. Based on long-term follow-up observations, our 4 cases of autotransplantation of immature teeth using CARP models resulted in favorable prognoses. The CARP model assisted in minimizing the extraoral time and the possible Hertwig epithelial root sheath injury of the transplanted tooth. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Effect of local injection of Zolena, zoledronic acid made in Iran, on orthodontic tooth movement and root and bone resorption in rats.

PubMed

Seifi, Massoud; Asefi, Sohrab; Hatamifard, Ghazal; Lotfi, Ali

2017-01-01

Background. Anchorage control is an essential part of orthodontic treatment planning, especially in adult patients who demand a more convenient treatment. Zoledronic acid (ZA) is an effective choice to address this problem. It is the most potent member of the bisphosphonates family that has an inhibitory effect on bone resorption by suppressing osteoclast function. Therefore, ZA might be a good option for orthodontic anchorage control. The current study evaluated the effect of local administration of Zolena (ZA made in Iran) on orthodontic tooth movement (OTM) and root and bone resorption. Methods. The experimental group consisted of 30 rats in 3 subgroups (n=10). Anesthesia was induced, and one closed NiTi coil spring was installed between the first molar and central incisor unilaterally, except for the negative control group. The positive control group received vestibular injection of 0.01 mL of saline next to the maxillary first molar, and 0.01 mL of the solution was injected at the same site in the ZA group. After 21 days, the rats were sacrificed and the distance between the first and second molars was measured with a leaf gauge. Histological analysis was conducted by a blind pathologist for the number of Howship's lacunae, blood vessels, osteoclast-like cells and root resorption lacunae. Data were analyzed with ANOVA, Tukey test and t-test. Results. There were no significant differences in OTM between the force-applied groups. ZA significantly inhibited bone/root resorption and angiogenesis compared to the positive control group. Conclusion. Zolena did not decrease OTM but significantly inhibited bone and root resorption. Zolena might be less potent than its foreign counterparts.

[Evaluation of accuracy of virtual occlusal definition in Angle class I molar relationship].

PubMed

Wu, L; Liu, X J; Li, Z L; Wang, X

2018-02-18

To evaluate the accuracy of virtual occlusal definition in non-Angle class I molar relationship, and to evaluate the clinical feasibility. Twenty pairs of models of orthognathic patients were included in this study. The inclusion criteria were: (1) finished with pre-surgical orthodontic treatment and (2) stable final occlusion. The exclusion criteria were: (1) existence of distorted teeth, (2) needs for segmentation, (3) defect of dentition except for orthodontic extraction ones, and (4) existence of tooth space. The tooth-extracted test group included 10 models with two premolars extracted during preoperative orthodontic treatment. Their molar relationships were not Angle class I relationship. The non-tooth-extracted test group included another 10 models without teeth extracted, therefore their molar relationships were Angle class I. To define the final occlusion in virtual environment, two steps were included: (1) The morphology data of upper and lower dentition were digitalized by surface scanner (Smart Optics/Activity 102; Model-Tray GmbH, Hamburg, Germany); (2) the virtual relationships were defined using 3Shape software. The control standard of final occlusion was manually defined using gypsum models and then digitalized by surface scanner. The final occlusion of test group and control standard were overlapped according to lower dentition morphology. Errors were evaluated by calculating the distance between the corresponding reference points of testing group and control standard locations. The overall errors for upper dentition between test group and control standard location were (0.51±0.18) mm in non-tooth-extracted test group and (0.60±0.36) mm in tooth-extracted test group. The errors were significantly different between these two test groups (P<0.05). However, in both test groups, the errors of each tooth in a single dentition does not differ from one another. There was no significant difference between errors in tooth-extracted test group and 1 mm (P>0.05); and the accuracy of non-tooth-extracted group was significantly smaller than 1 mm (P<0.05). The error of virtual occlusal definition of none class I molar relationship is higher than that of class I relationship, with an accuracy of 1 mm. However, its accuracy is still feasible for clinical application.

The Occurrence Rate and Diameter of Arteries Traveling Near the Mandible and an Assessment of the Relative Hemorrhage Risk in Implant Surgery.

PubMed

Katsumi, Yuji; Takagi, Ritsuo; Ohshima, Hayato

2016-10-01

Bleeding in the floor of the mouth during implant surgery is attributed to arterial injuries in the sublingual space. This study aimed to assess the relative hemorrhage risk during implant surgery. We investigated the occurrence rate and diameter of submental and sublingual arteries with special reference to their relationship with the course patterns of these arteries using 26 human cadavers. Three types of arteries were distinguished: main duct (MD), mucoperiosteal branches (MB), and cortical branches (CB). The occurrence rate of MB and CB was significantly high at the central incisor region in the upper part of the mylohyoid muscle, whereas the diameter of the MB and CB was significantly smaller than the occurrence rate of MD at the incisor regions. The occurrence rate of MD in the submental artery was significantly higher at the lateral incisor, canine, and premolar regions in the lower parts, whereas the occurrence rate of MD was significantly lower at the second and third molars in the upper parts. The susceptibility of the submental artery to injury is suggested at the incisors, canine, premolars, and first molar regions during implant surgery. © 2015 Wiley Periodicals, Inc.

Environmental stress increases variability in the expression of dental cusps.

PubMed

Riga, Alessandro; Belcastro, Maria Giovanna; Moggi-Cecchi, Jacopo

2014-03-01

Teeth are an important model for developmental studies but, despite an extensive literature on the genetics of dental development, little is known about the environmental influences on dental morphology. Here we test whether and to what extent the environment plays a role in producing morphological variation in human teeth. We selected a sample of modern human skulls and used dental enamel hypoplasia as an environmental stress marker to identify two groups with different stress levels, referred to as SG ("stressed" group) and NSG ("nonstressed" group). We collected data on the occurrence and the relative development of 15 morphological traits on upper molars using a standard methodology (ASU-DAS system) and then we compared the frequencies of the traits in the two groups. Overall, the results suggest that (a) stressors like malnutrition and/or systemic diseases have a significant effect on upper molar morphology; (b) stress generates a developmental response which increases the morphological variability of the SG; and (c) the increase in variability is directional, since individuals belonging to the SG have more developed and extra cusps. These results are consistent with the expectations of the current model of dental development. Copyright © 2013 Wiley Periodicals, Inc.

Amniotic Band Syndrome: A Review of 2 Cases.

PubMed

Madan, Siddharth; Chaudhuri, Zia

2018-04-03

Amniotic band syndrome is a rare congenital disorder caused by entrapment of fetal parts (usually a limb or digits) in fibrous amniotic bands while in utero that presents with complex multisystem anomalies. The authors report 2 children with amniotic band syndrome who presented to the ophthalmic unit of the authors' pediatric hospital. One of them presented with telecanthus, syndactyly, amputated toes, and unilateral epiphora diagnosed as congenital nasolacrimal duct obstruction. She was managed conservatively with lacrimal sac massage and provided with refractive correction while she simultaneously underwent multiple surgeries for correction of clubfoot and craniosynostosis. The second patient presented with cleft lip, cleft palate, multiple constriction bands in upper limbs and fingers with unilateral microphthalmos, microcornea, typical iris coloboma, and retinochoroidal coloboma, very similar to a case reported in literature. These 2 cases provide an overview of the clinical spectrum of ophthalmic manifestations along with their staged optimum rehabilitation.

Hyperthyroidism: an unusual case presentation.

PubMed

Scripture, D L

1998-02-01

Hyperthyroidism is the most common disorder of the thyroid. Patients typically present with complaints consistent with a hypermetabolic state, including nervousness, weight loss, heat intolerance, palpitations, irritability, and tremor. This case report reviews a 34-year-old woman who presented with unilateral upper extremity weakness, weight gain, and an episode of atrial fibrillation, the latter coinciding with a 36-hour lack of sleep and excess alcohol and caffeine intake. Although an extensive neurologic evaluation failed to identify any abnormality, the patient's laboratory analysis revealed elevations in thyroxine (T4) and triiodothyronine (T3) levels with unsuppressed thyroid-stimulating hormone levels. Subsequent treatment with the antithyroid drug methimazole (Tapazole) provided complete relief of symptoms. This case report illustrates how health care providers can be diverted to pursue a neurologic etiology when muscle weakness presents as a unilateral symptom. Plausible alternative causes for muscle weakness and other symptoms are presented.

[Inveterate squamous cell carcinoma of the upper eyelid: a case report].

PubMed

Rinaldi, S; Marcasciano, M; Pacitti, F; Toscani, M; Tarallo, M; Fino, P; Scuderi, G L

2013-01-01

Squamous cell carcinoma (SCC) is a malignant tumor of epithelium that shows squamous cell differentiation. It is the second most common cancer of the skin and usually occurs in areas exposed to the sun but it can rarely arise within the conjunctival epithelium with a deep component. We describe a woman with a history of chronic blepharoconjunctivitis unresponsive to topical medications. Examination disclosed a hyperaemic translucent patch with blurred margins of the upper palpebral conjunctiva. Tarsoconjunctival biopsy revealed intraepithelial squamous cell carcinoma. Management consisted of complete tumor excision with removal of the entire posterior lamella of the left upper eyelid and reconstruction. Histopathologic analysis confirmed primary squamous cell carcinoma arising from conjunctival epithelium, involving the underlying tarsus. Patients with unexplained chronic unilateral blepharoconjunctivitis or papillary hypertrophy of the palpebral conjunctiva should be considered for biopsy to rule out neoplasia, even when there is no sign of an evident mass.

Intranasal epidermoid cyst causing upper airway obstruction in three brachycephalic dogs.

PubMed

Murgia, D; Pivetta, M; Bowlt, K; Volmer, C; Holloway, A; Dennis, R

2014-08-01

This case report describes three brachycephalic dogs with intranasal epidermoid cysts that were causing additional upper airway obstruction. Although epidermoid cysts have been described in several locations in dogs, to the authors' knowledge intranasal epidermoid cysts have not been previously reported. All dogs had mucopurulent to haemorrhagic nasal discharge. Magnetic resonance imaging of the head revealed the presence of unilateral or bilateral intranasal cystic lesions obstructing the nasal cavities partially or completely, with atrophy of the ipsilateral nasal turbinates. The cystic lesions were surgically excised in all dogs using a modified lateral alveolar mucosal approach to the affected nasal cavity. Aerobic, anaerobic and fungal culture of the cystic contents were negative and histology of the excised tissue was consistent with a benign intranasal epidermoid cyst in each dog. Upper airway obstruction was clinically improved in two dogs. © 2014 British Small Animal Veterinary Association.

Modern mammal origins: evolutionary grades in the Early Cretaceous of North America.

PubMed

Jacobs, L L; Winkler, D A; Murry, P A

1989-07-01

Major groups of modern mammals have their origins in the Mesozoic Era, yet the mammalian fossil record is generally poor for that time interval. Fundamental morphological changes that led to modern mammals are often represented by small samples of isolated teeth. Fortunately, functional wear facets on teeth allow prediction of the morphology of occluding teeth that may be unrepresented by fossils. A major step in mammalian evolution occurred in the Early Cretaceous with the evolution of tribosphenic molars, which characterize marsupials and placentals, the two most abundant and diverse extant groups of mammals. A tooth from the Early Cretaceous (110 million years before present) of Texas tests previous predictions (based on lower molars) of the morphology of upper molars in early tribosphenic dentitions. The lingual cusp (protocone) is primitively without shear facets, as expected, but the cheek side of the tooth is derived (advanced) in having distinctive cusps along the margin. The tooth, although distressingly inadequate to define many features of the organism, demonstrates unexpected morphological diversity at a strategic stage of mammalian evolution and falsifies previous claims of the earliest occurrence of true marsupials.

A geometric morphometric analysis of hominin upper premolars. Shape variation and morphological integration.

PubMed

Gómez-Robles, Aida; Martinón-Torres, María; Bermúdez de Castro, José María; Prado-Simón, Leyre; Arsuaga, Juan Luis

2011-12-01

This paper continues the series of articles initiated in 2006 that analyse hominin dental crown morphology by means of geometric morphometric techniques. The detailed study of both upper premolar occlusal morphologies in a comprehensive sample of hominin fossils, including those coming from the Gran Dolina-TD6 and Sima de los Huesos sites from Atapuerca, Spain, complement previous works on lower first and second premolars and upper first molars. A morphological gradient consisting of the change from asymmetric to symmetric upper premolars and a marked reduction of the lingual cusp in recent Homo species has been observed in both premolars. Although percentages of correct classification based on upper premolar morphologies are not very high, significant morphological differences between Neanderthals (and European middle Pleistocene fossils) and modern humans have been identified, especially in upper second premolars. The study of morphological integration between premolar morphologies reveals significant correlations that are weaker between upper premolars than between lower ones and significant correlations between antagonists. These results have important implications for understanding the genetic and functional factors underlying dental phenotypic variation and covariation. Copyright © 2011 Elsevier Ltd. All rights reserved.

Temporomandibular joint fibrocartilage degeneration from unilateral dental splints.

PubMed

Henderson, Sarah E; Lowe, Jesse R; Tudares, Mauro A; Gold, Michael S; Almarza, Alejandro J

2015-01-01

The objective of this study was to determine the extent to which altered loading in the temporomandibular joint (TMJ), as might be associated with a malocclusion, drives degeneration of articulating surfaces in the TMJ. We therefore sought to quantify the effects of altered joint loading on the mechanical properties and biochemical content and distribution of TMJ fibrocartilage in the rabbit. Altered TMJ loading was induced with a 1mm splint placed unilaterally over the maxillary and mandibular molars for 6 weeks. At that time, TMJ fibrocartilage was assessed by compression testing, biochemical content (collagen, glycosaminoglycan (GAG), DNA) and distribution (histology), for both the TMJ disc and the condylar fibrocartilage. There were no changes in the TMJ disc for any of the parameters tested. The condylar fibrocartilage from the splinted animals was significantly stiffer and the DNA content was significantly lower than that in control animals. There was significant remodeling in the condylar fibrocartilage layers as manifested by a change in GAG and collagen II distribution and a loss of defined cell layers. A connection between the compressive properties of TMJ condylar fibrocartilage after 6 weeks of splinting and the changes in histology was observed. These results suggest a change in joint loading leads to condylar damage, which may contribute to pain associated with at least some forms of TMJ disease. Copyright © 2014 Elsevier Ltd. All rights reserved.

Temporomandibular Joint Fibrocartilage Degeneration from Unilateral Dental Splints

PubMed Central

Henderson, Sarah E.; Lowe, Jesse R.; Tudares, Mauro A.; Gold, Michael S.; Almarza, Alejandro J.

2014-01-01

Objective The objective of this study was to determine the extent to which altered loading in the temporomandibular joint (TMJ), as might be associated with a maloclussion, drives degeneration of articulating surfaces in the TMJ. We therefore sought to quantify the effects of altered joint loading on the mechanical properties and biochemical content and distribution of TMJ fibrocartilage in the rabbit. Design Altered TMJ loading was induced with a 1 mm splint placed unilaterally over the maxillary and mandibular molars for six weeks. At that time, TMJ fibrocartilage was assessed by compression testing, biochemical content (collagen, glycosaminoglycan (GAG), DNA) and distribution (histology), for both the TMJ disc and the condylar fibrocartilage. Results There were no changes in the TMJ disc for any of the parameters tested. The condylar fibrocartilage from the splinted animals was significantly stiffer and the DNA content was significantly lower than that in control animals. There was significant remodeling in the condylar fibrocartilage layers as manifested by a change in GAG and collagen II distribution and a loss of defined cell layers. Conclusions A connection between the compressive properties of TMJ condylar fibrocartilage after 6 weeks of splinting and the changes in histology was observed. These results suggest a change in joint loading, leads to condylar damage, which may contribute to pain associated with at least some forms of TMJ disease. PMID:25247778

Effects of conventional anchorage on premolar root development during treatment with a pendulum appliance.

PubMed

Kinzinger, Gero; Pantel, Cora; Ludwig, Björn; Gülden, Norbert; Glasl, Bettina; Lisson, Jörg

2010-07-01

By metrically analyzing orthopantomograms, we aimed in this study to retrospectively investigate whether maxillary premolars used as anchoring teeth during molar distalization with pendulum appliances would reveal inhibited root development. The upper molars were distalized with a modified pendulum appliance (Pendulum K) in 36 adolescents (14 males, 22 females, mean age 12.3 years). Mean treatment period was 19.5 weeks. Orthopantomograms of each patient were taken at the start (time point T1) and after completion of molar distalization (time point T2). The enlargement of the posterior region was ascertained individually quadrant by quadrant for each radiograph, followed by measurement of the vestibular tooth lengths of the premolars whose root development was for the most part not yet complete. To assess further root development in the premolar region, the differences were calculated between tooth lengths at the start and end of treatment. During treatment with the pendulum appliance a general increase in tooth lengths in the anchorage region was observed (1.37 +/- 1.70 mm, p<0.0001). Differentiated by dental age, we noted increases in tooth lengths of patients with second molars in the budding stage (patient group PG 1: 0.93 +/- 1.37 mm, p<0.0001) as well as of patients with fully-erupted second molars (patient group PG 2: 1.81 +/- 1.88 mm, p<0.0001). Both groups demonstrated greater increases in the second premolars than the first premolars; the increases group-wise were larger in PG 2 than PG 1. However, both the group comparison (PG 1 versus PG 2) and the side comparison (right versus left) (differentiated into first and second molars) showed no statistically relevant differences. Visual assessment of the radiographs revealed no evidence of treatment-related root deviations. A highly complex system of forces acts on the anchoring teeth during molar distalization with the conventionally-anchored Pendulum K. However, the Pendulum K appliance's specific biomechanics make it possible to transfer the reactive forces and moments to the anchorage unit so that they remain within the physiological range, allowing uninhibited premolar root development. This also applies after completed eruption of the second molars, when the treatment period and hence duration of exposure to the active and reactive forces and moments arising during molar distalization are comparatively increased.

Three-dimensional analysis of maxillary development in patients with unilateral cleft lip and palate during the first six years of life.

PubMed

Stancheva, Nadezhda; Dannhauer, Karl-Heinz; Hemprich, Alexander; Krey, Karl-Friedrich

2015-09-01

The purpose of this work was to analyse early upper-jaw development in patients with unilateral cleft lip and palate (UCLP) treated using two different concepts and to compare shape and size developments between these two groups and a group of noncleft patients. A total of 204 maxillary casts available for this study from 50 UCLP patients were analyzed for upper-jaw development based on three-dimensional measurements performed with a Reflex Microscope from birth up to 71 months of age. Thirty-five of these 50 patients were part of an early treatment group (two-stage cleft closure with single-stage palatoplasty at an age of 10-14 months) and 15 were part of a late treatment group (two-stage cleft closure with palatoplasty at an age of 4-7 years). The control group included 39 casts of 17 noncleft patients. Analysis of shape and size between the patients in the three groups yielded statistically significant differences between the cleft and the noncleft patients. In both treatment groups, we made observations typically associated with cleft formation like lateralization, asymmetry of the greater and lesser cleft segments, and pronounced vertical deviations of the segments. Viewed in all dimensions, however, the patients in the early treatment group approached the control group more closely, although a statistically significant difference was still observed. Our results suggest that the timing of hard-palate closure is not a decisive factor for upper-jaw development. Intrinsic factors (initial cleft width, presence of tooth buds) and the surgeon's skills appear to have a much more defining role.

Factors associated with interest in novel interfaces for upper limb prosthesis control

PubMed Central

Engdahl, Susannah M.; Chestek, Cynthia A.; Kelly, Brian; Davis, Alicia

2017-01-01

Background Surgically invasive interfaces for upper limb prosthesis control may allow users to operate advanced, multi-articulated devices. Given the potential medical risks of these invasive interfaces, it is important to understand what factors influence an individual’s decision to try one. Methods We conducted an anonymous online survey of individuals with upper limb loss. A total of 232 participants provided personal information (such as age, amputation level, etc.) and rated how likely they would be to try noninvasive (myoelectric) and invasive (targeted muscle reinnervation, peripheral nerve interfaces, cortical interfaces) interfaces for prosthesis control. Bivariate relationships between interest in each interface and 16 personal descriptors were examined. Significant variables from the bivariate analyses were then entered into multiple logistic regression models to predict interest in each interface. Results While many of the bivariate relationships were significant, only a few variables remained significant in the regression models. The regression models showed that participants were more likely to be interested in all interfaces if they had unilateral limb loss (p ≤ 0.001, odds ratio ≥ 2.799). Participants were more likely to be interested in the three invasive interfaces if they were younger (p < 0.001, odds ratio ≤ 0.959) and had acquired limb loss (p ≤ 0.012, odds ratio ≥ 3.287). Participants who used a myoelectric device were more likely to be interested in myoelectric control than those who did not (p = 0.003, odds ratio = 24.958). Conclusions Novel prosthesis control interfaces may be accepted most readily by individuals who are young, have unilateral limb loss, and/or have acquired limb loss However, this analysis did not include all possible factors that may have influenced participant’s opinions on the interfaces, so additional exploration is warranted. PMID:28767716

Factors associated with interest in novel interfaces for upper limb prosthesis control.

PubMed

Engdahl, Susannah M; Chestek, Cynthia A; Kelly, Brian; Davis, Alicia; Gates, Deanna H

2017-01-01

Surgically invasive interfaces for upper limb prosthesis control may allow users to operate advanced, multi-articulated devices. Given the potential medical risks of these invasive interfaces, it is important to understand what factors influence an individual's decision to try one. We conducted an anonymous online survey of individuals with upper limb loss. A total of 232 participants provided personal information (such as age, amputation level, etc.) and rated how likely they would be to try noninvasive (myoelectric) and invasive (targeted muscle reinnervation, peripheral nerve interfaces, cortical interfaces) interfaces for prosthesis control. Bivariate relationships between interest in each interface and 16 personal descriptors were examined. Significant variables from the bivariate analyses were then entered into multiple logistic regression models to predict interest in each interface. While many of the bivariate relationships were significant, only a few variables remained significant in the regression models. The regression models showed that participants were more likely to be interested in all interfaces if they had unilateral limb loss (p ≤ 0.001, odds ratio ≥ 2.799). Participants were more likely to be interested in the three invasive interfaces if they were younger (p < 0.001, odds ratio ≤ 0.959) and had acquired limb loss (p ≤ 0.012, odds ratio ≥ 3.287). Participants who used a myoelectric device were more likely to be interested in myoelectric control than those who did not (p = 0.003, odds ratio = 24.958). Novel prosthesis control interfaces may be accepted most readily by individuals who are young, have unilateral limb loss, and/or have acquired limb loss However, this analysis did not include all possible factors that may have influenced participant's opinions on the interfaces, so additional exploration is warranted.

[Fasciae latae perforator flap for breast reconstruction: An attractive alternative in case of DIEP contraindication].

PubMed

Lefèvre, M; Sarfati, B; Honart, J-F; Alkashnam, H; Rimareix, F; Leymarie, N; Kolb, F

2017-02-01

The musculocutaneous tensor fascia latae flap was one of the first free flaps described. It is possible to harvest a flap with the same skin paddle, vascularized by a septo-cutaneous perforator running through the tensor fascia lata muscle septum and coming from the ascending branch of the lateral circumflex femoral artery. The DIEP is currently the workhorse of autologous breast reconstruction, but there are some contraindications. The septo-cutaneous tensor fascia latae perforator flap may be an alternative for women with lateral upper thigh lipodystrophy. Between 2010 and 2014, three flaps have been performed in two patients for delayed breast reconstruction (one case of unilateral reconstruction, and one bilateral). Perforators were identified by preoperative angiography. The intervention was performed in a two-team approach, in only one operative position. Perforators were located in the horizontal axis of the upper rim of the pubis bone. One perforator artery was dissected for each flap. The mean caliber of the pedicle was 2.8mm, and the mean length was 6.4cm. The operative time was 240minutes for unilateral flap, 375minutes for bilateral flap. There was no case of total or partial necrosis, or complications on the donor site. Cosmetic results were considered satisfying by patients and surgeons with the reconstructed breast as well as the donor site. Septo-cutaneous fascia lata perforator flap is an attractive flap for breast reconstruction in patients with DIEP contraindication and lateral upper thigh lipodystrophy. It has many advantages: easy to harvest, length and calibre of the pedicle, double team approach, only one operating position, quality of reconstruction. It is necessary to carry out a larger series of cases to study the complication rate in the donor site. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Guided Endodontic Access in Maxillary Molars Using Cone-beam Computed Tomography and Computer-aided Design/Computer-aided Manufacturing System: A Case Report.

PubMed

Lara-Mendes, Sônia T de O; Barbosa, Camila de Freitas M; Santa-Rosa, Caroline C; Machado, Vinícius C

2018-05-01

The aim of this study was to describe a guided endodontic technique that facilitates access to root canals of molars presenting with pulp calcifications. A 61-year-old woman presented to our service with pain in the upper left molar region. The second and third left molars showed signs of apical periodontitis confirmed by the cone-beam computed tomographic (CBCT) scans brought to us by the patient at the initial appointment. Conventional endodontic treatment was discontinued given the difficulty in locating the root canals. Intraoral scanning and the CBCT scans were used to plan the access to the calcified canals by means of implant planning software. Guides were fabricated through rapid prototyping and allowed for the correct orientation of a cylindrical drill used to provide access through the calcifications. Second to that, the root canals were prepared with reciprocating endodontic instruments and rested for 2 weeks with intracanal medication. Subsequently, canals were packed with gutta-percha cones using the hydraulic compression technique. Permanent restorations of the access cavities were performed. By comparing the tomographic images, the authors observed a drastic reduction of the periapical lesions as well as the absence of pain symptoms after 3 months. This condition was maintained at the 1-year follow-up. The guided endodontic technique in maxillary molars was shown to be a fast, safe, and predictable therapy and can be regarded as an excellent option for the location of calcified root canals, avoiding failures in complex cases. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Hippocampus-dependent spatial memory impairment due to molar tooth loss is ameliorated by an enriched environment.

PubMed

Kondo, Hiroko; Kurahashi, Minori; Mori, Daisuke; Iinuma, Mitsuo; Tamura, Yasuo; Mizutani, Kenmei; Shimpo, Kan; Sonoda, Shigeru; Azuma, Kagaku; Kubo, Kin-ya

2016-01-01

Teeth are crucial, not only for mastication, but for overall nutrition and general health, including cognitive function. Aged mice with chronic stress due to tooth loss exhibit impaired hippocampus-dependent learning and memory. Exposure to an enriched environment restores the reduced hippocampal function. Here, we explored the effects of an enriched environment on learning deficits and hippocampal morphologic changes in aged senescence-accelerated mouse strain P8 (SAMP8) mice with tooth loss. Eight-month-old male aged SAMP8 mice with molar intact or with molars removed were housed in either a standard environment or enriched environment for 3 weeks. The Morris water maze was performed for spatial memory test. The newborn cell proliferation, survival, and differentiation in the hippocampus were analyzed using 5-Bromodeoxyuridine (BrdU) immunohistochemical method. The hippocampal brain-derived neurotrophic factor (BDNF) levels were also measured. Mice with upper molars removed (molarless) exhibited a significant decline in the proliferation and survival of newborn cells in the dentate gyrus (DG) as well as in hippocampal BDNF levels. In addition, neuronal differentiation of newly generated cells was suppressed and hippocampus-dependent spatial memory was impaired. Exposure of molarless mice to an enriched environment attenuated the reductions in the hippocampal BDNF levels and neuronal differentiation, and partially improved the proliferation and survival of newborn cells, as well as the spatial memory ability. These findings indicated that an enriched environment could ameliorate the hippocampus-dependent spatial memory impairment induced by molar tooth loss. Copyright © 2015 Elsevier Ltd. All rights reserved.

Computed tomography in the management of orbital infections associated with dental disease.

PubMed Central

Flood, T. P.; Braude, L. S.; Jampol, L. M.; Herzog, S.

1982-01-01

Two patients developed orbital infection secondary to dental infections. In one patient the infection spread from maxillary premolar and molar teeth to the infratemporal and pterygopalatine fossa and then through the inferior orbital fissure to the subperiosteal space. A subperiosteal abscess in the posterior orbital wall developed, which subsequently spread within the muscle cone. In the second patient infection of an anterior maxillary tooth caused a pansinusitis and unilateral orbital cellulitis. In both patients computed tomographic scanning of the orbit proved valuable in localising the infection and, in one case, planning a surgical approach to the orbit. The infection in both patients responded to treatment, with no permanent visual impairment. Appropriate antibiotics and prompt identification and surgical drainage of orbital abscesses are essential for the preservation of vision in cases of orbital infection. Images PMID:7066283

Poland syndrome with bilateral features: case description with review of the literature.

PubMed

Baban, Anwar; Torre, Michele; Bianca, Sebastiano; Buluggiu, Anna; Rossello, Mario Igor; Calevo, Maria Grazia; Valle, Maura; Ravazzolo, Roberto; Jasonni, Vincenzo; Lerone, Margherita

2009-07-01

Poland syndrome (PS) has been described as unilateral pectoral muscle deficiency variably associated with ipsilateral thoracic and upper limb anomalies. Bilateral hypoplasia/aplasia of the pectoralis muscle and upper limb defects in association with variable thoracic muscles, chest wall deformities and lower limb defects have been infrequently reported in the literature. We report on a 3(1/2)-year-old girl with clinical features consisting in bilateral asymmetric pectoral muscle defects (complete agenesis on the left side and agenesis of the sternocostal head on the right side), nipple hypoplasia, left rib defect, and right hand symbrachydactyly. In this study, we reviewed the bilateral features present in our patient and those described in the literature. Hypotheses explaining bilateral features in PS are reviewed.

Unilateral Eye Blinking Arising From the Ictal Ipsilateral Occipital Area.

PubMed

Falsaperla, Raffaele; Perciavalle, Valentina; Pavone, Piero; Praticò, Andrea Domenico; Elia, Maurizio; Ruggieri, Martino; Caraballo, Roberto; Striano, Pasquale

2016-07-01

We report on an 18-month-old boy with unilateral left eye blinking as a single ictal manifestation without facial twitching. The clinical onset of this phenomenon was first recorded (as an occasional event) at age 3 months, and it was overlooked. By age 6 months, the child's blinking increased to almost daily occurrence in clusters: during blinking the infant showed intact awareness and occasional jerks in the upper limbs and right leg. A video-electroencephalography (video-EEG) documented clinical correlation with a focal pattern arising from the left occipital region, and brain magnetic resonance imaging (MRI) revealed severe brain damage, consisting in poroencephalic hollows and increased spaces in the convexities involving a large area of the left cerebral hemisphere. The boy was prescribed sodium valproate (30 mg/kg/d), resulting in drastic reduction of his clinical seizures. Follow-up to his current age documented good general status, with persistent partial right hemilateral seizures. The blinking progressively disappeared, and is no longer recorded. The pathogenic hypotheses of the unilateral ictal blinking include involvement of the ipsilateral cerebral hemisphere and/or the cerebellar pathways. Review of previous reports of unilateral eye blinking, arising from the ictal ipsilateral brain, revealed that different damaged regions may give rise to blinking ictal phenomena, likely via the trigeminal fibres innervating the subdural intracranial structures and the pial vessels in the ipsilateral affected brain. The eye blinking in the present child represents a further example of an ictal phenomenon, which is predictive of the damaged brain region. © EEG and Clinical Neuroscience Society (ECNS) 2014.

An integrated study for mapping the moisture distribution in an ancient damaged wall painting.

PubMed

Capitani, Donatella; Proietti, Noemi; Gobbino, Marco; Soroldoni, Luigi; Casellato, Umberto; Valentini, Massimo; Rosina, Elisabetta

2009-12-01

An integrated study of microclimate monitoring, IR thermography (IRT), gravimetric tests and portable unilateral nuclear magnetic resonance (NMR) was applied in the framework of planning emergency intervention on a very deteriorated wall painting in San Rocco church, Cornaredo (Milan, Italy). The IRT investigation supported by gravimetric tests showed that the worst damage, due to water infiltration, was localized on the wall painting of the northern wall. Unilateral NMR, a new non-destructive technique which measures the hydrogen signal of the moisture and that was applied directly to the wall, allowed a detailed map of the distribution of the moisture in the plaster underlying the wall panting to be obtained. With a proper calibration of the integral of the recorded signal with suitable specimens, each area of the map corresponded to an accurate amount of moisture. IRT, gravimetric tests and unilateral NMR applied to investigate the northern wall painting showed the presence of two wet areas separated by a dry area. The moisture found in the lower area was ascribed to the occurrence of rising damp at the bottom of the wall due to the slope of the garden soil towards the northern exterior. The moisture found in the upper area was ascribed to condensation phenomena associated with the presence of a considerable amount of soluble, hygroscopic salts. In the framework of this integrated study, IRT investigation and gravimetric methods validated portable unilateral NMR as a new analytical tool for measuring in situ and without any sampling of the distribution and amount of moisture in wall paintings.

Interaction of peridotite with Ca-rich carbonatite melt at 3.1 and 6.5 GPa: Implication for merwinite formation in upper mantle, and for the metasomatic origin of sublithospheric diamonds with Ca-rich suite of inclusions

NASA Astrophysics Data System (ADS)

Sharygin, Igor S.; Shatskiy, Anton; Litasov, Konstantin D.; Golovin, Alexander V.; Ohtani, Eiji; Pokhilenko, Nikolay P.

2018-03-01

We performed an experimental study, designed to reproduce the formation of an unusual merwinite + olivine-bearing mantle assemblage recently described as a part of a Ca-rich suite of inclusions in sublithospheric diamonds, through the interaction of peridotite with an alkali-rich Ca-carbonatite melt, derived from deeply subducted oceanic crust. In the first set of experiments, we studied the reaction between powdered Mg-silicates, olivine and orthopyroxene, and a model Ca-carbonate melt (molar Na:K:Ca = 1:1:2), in a homogeneous mixture, at 3.1 and 6.5 GPa. In these equilibration experiments, we observed the formation of a merwinite + olivine-bearing assemblage at 3.1 GPa and 1200 °C and at 6.5 GPa and 1300-1400 °C. The melts coexisting with this assemblage have a low Si and high Ca content (Ca# = molar 100 × Ca/(Ca + Mg) > 0.57). In the second set of experiments, we investigated reaction rims produced by interaction of the same Ca-carbonate melt (molar Na:K:Ca = 1:1:2) with Mg-silicate, olivine and orthopyroxene, single crystals at 3.1 GPa and 1300 °C and at 6.5 GPa and 1400 °C. The interaction of the Ca-carbonate melt with olivine leads to merwinite formation through the expected reaction: 2Mg2SiO4 (olivine) + 6CaCO3 (liquid) = Ca3MgSi2O8 (merwinite) + 3CaMg(CO3)2 (liquid). Thus, our experiments confirm the idea that merwinite in the upper mantle may originate via interaction of peridotite with Ca-rich carbonatite melt, and that diamonds hosting merwinite may have a metasomatic origin. It is remarkable that the interaction of the Ca-carbonate melt with orthopyroxene crystals does not produce merwinite both at 3.1 and 6.5 GPa. This indicates that olivine grain boundaries are preferable for merwinite formation in the upper mantle.

Comparison of Marginal Circumference of Two Different Pre-Crimped Stainless Steel Crowns for Primary Molars After Re-Crimping.

PubMed

Afshar, Hossein; Ghandehari, Mehdi; Soleimani, Banafsheh

2015-12-01

It is not clear what type of pre-crimped crown is more successful in achieving greater marginal adaptation following re-crimping. This study aimed to assess the changes in the circumference of 3M ESPE and MIB pre-crimped stainless steel crowns (SSCs) for the primary maxillary and mandibular first and second molars following re-crimping. This was an in-vitro, experimental study. Initial photographs were obtained from the margins of 3M and MIB SSCs for the upper and lower primary molars using a digital camera. Crown margins were crimped by applying 0.2N force using 114 and 137 pliers. Post-crimping photographs were also obtained and the changes in crown circumference after crimping were calculated using AutoCad software. The percentage of reduction in the circumference of crowns for each tooth was statistically analyzed based on the type of crown using student t-test. The effect of crown design and the associated teeth on the decreased circumference percentage was statistically analyzed by two-sided ANOVA. The percentage of reduction in lower E SSC circumference was 3.71±0.39% in MIB and 6.29±0.62% in 3M crowns. These values were 3.55±0.55% and 7.15±1.13% for the lower Ds, and 3.95±0.43 and 6.24±0.85% for the upper Ds, respectively. For the upper Es, these values were found to be 3.12±0.65% and 5.14±0.94%, respectively. For each tooth, a significant difference was found between MIB and 3M SSCs in terms of the percentage of reduction in crown circumference following crimping. The magnitude of this reduction was smaller in MIB compared to 3M SSCs (P<0.001). Considering the significant reduction in the marginal circumference of precrimped SSCs following re-crimping, it appears that this manipulation must be necessarily performed for MIB and 3M pre-crimped SSCs. By using 3M SSCs, higher marginal adaptation can be achieved following crimping.

Comparison of Marginal Circumference of Two Different Pre-Crimped Stainless Steel Crowns for Primary Molars After Re-Crimping

PubMed Central

Afshar, Hossein; Ghandehari, Mehdi; Soleimani, Banafsheh

2015-01-01

Objectives: It is not clear what type of pre-crimped crown is more successful in achieving greater marginal adaptation following re-crimping. This study aimed to assess the changes in the circumference of 3M ESPE and MIB pre-crimped stainless steel crowns (SSCs) for the primary maxillary and mandibular first and second molars following re-crimping. Materials and Methods: This was an in-vitro, experimental study. Initial photographs were obtained from the margins of 3M and MIB SSCs for the upper and lower primary molars using a digital camera. Crown margins were crimped by applying 0.2N force using 114 and 137 pliers. Post-crimping photographs were also obtained and the changes in crown circumference after crimping were calculated using AutoCad software. The percentage of reduction in the circumference of crowns for each tooth was statistically analyzed based on the type of crown using student t-test. The effect of crown design and the associated teeth on the decreased circumference percentage was statistically analyzed by two-sided ANOVA. Results: The percentage of reduction in lower E SSC circumference was 3.71±0.39% in MIB and 6.29±0.62% in 3M crowns. These values were 3.55±0.55% and 7.15±1.13% for the lower Ds, and 3.95±0.43 and 6.24±0.85% for the upper Ds, respectively. For the upper Es, these values were found to be 3.12±0.65% and 5.14±0.94%, respectively. For each tooth, a significant difference was found between MIB and 3M SSCs in terms of the percentage of reduction in crown circumference following crimping. The magnitude of this reduction was smaller in MIB compared to 3M SSCs (P<0.001). Conclusion: Considering the significant reduction in the marginal circumference of precrimped SSCs following re-crimping, it appears that this manipulation must be necessarily performed for MIB and 3M pre-crimped SSCs. By using 3M SSCs, higher marginal adaptation can be achieved following crimping. PMID:27559353

How does the interaction of presumed timing, location and extent of the underlying brain lesion relate to upper limb function in children with unilateral cerebral palsy?

PubMed

Mailleux, Lisa; Klingels, Katrijn; Fiori, Simona; Simon-Martinez, Cristina; Demaerel, Philippe; Locus, Marlies; Fosseprez, Eva; Boyd, Roslyn N; Guzzetta, Andrea; Ortibus, Els; Feys, Hilde

2017-09-01

Upper limb (UL) function in children with unilateral cerebral palsy (CP) vary largely depending on presumed timing, location and extent of brain lesions. These factors might exhibit a complex interaction and the combined prognostic value warrants further investigation. This study aimed to map lesion location and extent and assessed whether these differ according to presumed lesion timing and to determine the impact of structural brain damage on UL function within different lesion timing groups. Seventy-three children with unilateral CP (mean age 10 years 2 months) were classified according to lesion timing: malformations (N = 2), periventricular white matter (PWM, N = 42) and cortical and deep grey matter (CDGM, N = 29) lesions. Neuroanatomical damage was scored using a semi-quantitative MRI scale. UL function was assessed at body function and activity level. CDGM lesions were more pronounced compared to PWM lesions (p = 0.0003). Neuroanatomical scores were correlated with a higher degree to UL function in the CDGM group (r s  = -0.39 to r s  = -0.84) compared to the PWM group (r rb  = -0.42 to r s  = -0.61). Regression analysis found lesion location and extent to explain 75% and 65% (p < 0.02) respectively, of the variance in AHA performance in the CDGM group, but only 24% and 12% (p < 0.03) in the PWM group. In the CDGM group, lesion location and extent seems to impact more on UL function compared to the PWM group. In children with PWM lesions, other factors like corticospinal tract (re)organization and structural connectivity may play an additional role. Copyright © 2017 European Paediatric Neurology Society. All rights reserved.

Organization of pERK-immunoreactive cells in trigeminal spinal nucleus caudalis, upper cervical cord, NTS and Pa5 following capsaicin injection into masticatory and swallowing-related muscles in rats.

PubMed

Tsujimura, Takanori; Shinoda, Masamichi; Honda, Kuniya; Hitomi, Suzuro; Kiyomoto, Masaaki; Matsuura, Shingo; Katagiri, Ayano; Tsuji, Kojun; Inoue, Makoto; Shiga, Yoshi; Iwata, Koichi

2011-10-12

Many phosphorylated extracellular signal-regulated kinase (pERK)-immunoreactive (IR) cells are expressed in the trigeminal spinal subnucleus caudalis (Vc), upper cervical spinal cord (C1-C2), nucleus tractus solitarii (NTS) and paratrigeminal nucleus (Pa5) after capsaicin injection into the whisker pad (WP), masseter muscle (MM), digastric muscle (DM) or sternohyoideus muscle (SM). The pERK-IR cells also showed NeuN immunoreactivity, indicating that ERK phosphorylation occurs in neurons. The pERK-IR cells were significantly reduced after intrathecal injection of MEK 1/2 inhibitor PD98059. The pERK-IR cells expressed bilaterally in the Vc and C1-C2 after capsaicin injection into the unilateral DM or SM, whereas unilaterally in the Vc and C1-C2 after unilateral WP or MM injection. After capsaicin injection into the WP or MM, the pERK-IR cell expression in the Vc was restricted rostrocaudally within a narrow area. However, the distribution of pERK-IR cells was more wide spread without a clear peak in the Vc and C1-C2 after capsaicin injection into the DM or SM. In the NTS, the unimodal pERK-IR cell expression peaked at 0-720μm rostral from the obex following capsaicin injection into WP, MM, DM or SM. In the ipsilateral Pa5, many pERK-IR cells were observed following capsaicin injection into the SM. The number of swallows elicited by distilled water administration was significantly smaller after capsaicin injection into the WP, MM or DM but not SM compared to that of vehicle-injected rats. Various noxious inputs due to the masticatory or swallowing-related muscle inflammation may be differentially involved in muscle pain and swallowing reflex activity. Copyright © 2011 Elsevier B.V. All rights reserved.

[Cervical cord infarction associated with unilateral vertebral artery dissection due to golf swing].

PubMed

Tokumoto, Kazuki; Ueda, Nobuhiko

2014-01-01

A-68-year-old man experienced nuchal pain and bilateral shoulder weakness that occurred suddenly after he performed a golf swing. He was conscious. His cranial nerves were normal, but bilateral deltoid and biceps muscle strengths weakened. Magnetic resonance image (MRI) showed no brain stem infarctions or cervical epidural hematoma. We tentatively diagnosed him with concussion of the spinal cord because of mild recovery of his bilateral upper limb weakness after several hours; he was later discharged. The next day, he suddenly developed serious tetraplegia and was admitted to the emergency department. His breathing was controlled by a respirator as he had expectoration difficulty and respiratory muscle paralysis. A lesion in the cervical cord became apparent on MRI; the right vertebral artery was not detected on magnetic resonance angiography. Cervical MRI showed the intimal flap and a lack of flow void in the right vertebral artery. These findings revealed a right vertebral artery dissection. Cervical cord infarction due to unilateral vertebral artery dissection is rarer than posterior cerebral infarction due to the same pathogenesis; however, some such cases have been reported. We consider the present case to be caused by cervical cord infarction associated with unilateral vertebral artery dissection resulting from golf swing.

[Multiple ocular coloboma (MOC) with persistent pupillary membrane in the snow leopard (Panthera uncia)].

PubMed

Schäffer, E; Wiesner, H; von Hegel, G

1988-01-01

In a litter of three snow leopards, bilateral colobomata of the upper temporal eyelids, bilateral persistent pupillary membranes and a unilateral coloboma of the optic nerve entrance are described as "Multiple Ocular Colobomata" (MOC). The causal pathogenesis of each of the colobomata is discussed comparatively. The colobomata of the eyelids, essential feature of the MOC syndrome in snow leopards, are most probably not of hereditary, but rather of intrauterine infectious viral origin.

[Maxillary advancement osteotomy with sequelae cleft lip and palate: Dilemma between occlusion and aesthetic profile].

PubMed

Vigneron, A; Morand, B; Lafontaine, V; Lesne, V; Lesne, C; Bettega, G

2015-11-01

Maxillary hypoplasia is a common sequela of cleft lip and palate. Its surgical treatment consists in a maxillary advancement by distraction or by conventional orthognathic surgery but morphological results are unpredictable. Our goal in this study was to see if the esthetical results (on the lip and the nose) of maxillary advancement were correlated to the preservation of lateral incisor space of the cleft side. This retrospective study included 38 patients operated between 2002 and 2013. Unilateral clefts were studied independently from bilateral clefts. Profile aesthetics was evaluated independently and subjectively by two surgeons and scored on an 8-point scale. The result was classified as "good" if the score was superior or equal to 6. The score was correlated to the following parameters: amount of maxillary advancement, upper incisor axis, preservation of the missing lateral incisor space. In the "good result" group, the space of the lateral incisor was less often preserved. The nasolabial angle was more open and the upper central incisor axis more vertical. These results were more pronounced in bilateral clefts, but also found in unilateral clefts. Under reservation of the subjective evaluation and of the small number of patients, it seemed that lateral incisor space closure improved the profile of patients treated by maxillary advancement for cleft lip and palate sequelae. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Capturing neuroplastic changes after bimanual intensive rehabilitation in children with unilateral spastic cerebral palsy: A combined DTI, TMS and fMRI pilot study.

PubMed

Bleyenheuft, Yannick; Dricot, Laurence; Gilis, Nathalie; Kuo, Hsing-Ching; Grandin, Cécile; Bleyenheuft, Corinne; Gordon, Andrew M; Friel, Kathleen M

2015-01-01

Intensive rehabilitation interventions have been shown to be efficacious in improving upper extremity function in children with unilateral spastic cerebral palsy (USCP). These interventions are based on motor learning principles and engage children in skillful movements. Improvements in upper extremity function are believed to be associated with neuroplastic changes. However, these neuroplastic changes have not been well-described in children with cerebral palsy, likely due to challenges in defining and implementing the optimal tools and tests in children. Here we documented the implementation of three different neurological assessments (diffusion tensor imaging-DTI, transcranial magnetic stimulation-TMS and functional magnetic resonance imaging-fMRI) before and after a bimanual intensive treatment (HABIT-ILE) in two children with USCP presenting differential corticospinal developmental reorganization (ipsilateral and contralateral). The aim of the study was to capture neurophysiological changes and to document the complementary relationship between these measures, the potential measurable changes and the feasibility of applying these techniques in children with USCP. Independent of cortical reorganization, both children showed increases in activation and size of the motor areas controlling the affected hand, quantified with different techniques. In addition, fMRI provided additional unexpected changes in the reward circuit while using the affected hand. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Dental age assessment of adolescents and emerging adults in United Kingdom Caucasians using censored data for stage H of third molar roots.

PubMed

Boonpitaksathit, Teelana; Hunt, Nigel; Roberts, Graham J; Petrie, Aviva; Lucas, Victoria S

2011-10-01

The root of the third permanent molar is the only dental structure that continues development after completion of growth of the second permanent molar. It is claimed that the lack of a clearly defined end point for completion of growth of the third permanent molar means that this tooth cannot be used for dental age assessment. The aim of this study was to estimate the mean age of attainment of the four stages (E, F, G, and H) of root development of the third molar. The way in which the end point of completion of stage H can be identified is described. A total of 1223 dental panoramic tomographs (DPTs) available in the archives of the Eastman Dental Hospital, London, were used for this study. The ages of the subjects ranged from 12.6 to 24.9 years with 63 per cent of the sample being female. Demirjan's tooth development stages (TDSs), for the first and second molars, were applied to the third molars by a single examiner. For each of stages E, F, and G and for stage H censored data, the mean ages of the males and females were compared, separately within each tooth morphology type using the two sample t-test (P < 0.01). The same test was used to compare the mean ages of the upper and lower third molars on each side, separately for each gender. The mean age of attainment and the 99 per cent confidence interval (CI) for each TDS were calculated for each third molar. The final stage H data were appropriately censored to exclude data above the age of completion of root growth. The results showed that, for each gender, the age in years at which individuals attained each of the four TDSs was approximately normally distributed. The mean age for appropriately censored data was always lower than the corresponding mean age of the inappropriately censored data for stage H (male UR8 19.57, UL8 19.53, LL8 19.91, and LR8 20.02 and female UR8 20.08, UL8 20.13, LL8 20.78, and LR8 20.70). This inappropriately censored data overestimated the mean age for stage H. The appropriately censored data for the TDSs of the third molar may be used to estimate the age of adolescents and emerging adults assuming average growth and development and recent attainment of stage H.

A Neanderthal lower molar from Stajnia Cave, Poland.

PubMed

Dąbrowski, P; Nowaczewska, W; Stringer, C B; Compton, T; Kruszyński, R; Nadachowski, A; Stefaniak, K; Urbanowski, M

2013-04-01

The primary aim of this study was to conduct a taxonomic assessment of the second of three isolated human teeth found in the Stajnia Cave (north of the Carpathians, Poland) in 2008. The specimen was located near a human tooth (S5000), which was identified by Urbanowski et al. (2010) as a Neanderthal permanent upper molar. Both of these teeth were excavated from the D2 layer, which belongs to the D stratigraphic complex comprising the archaeological assemblage associated with the Micoquian tradition. An Ursus spelaeus bone and Mammuthus primigenius tooth that were also excavated from the D2 layer were dated to >49,000 years BP (by AMS (14)C) and 52.9 ka BP (by U-Th), respectively. The sediment overlying stratigraphic complex D was dated to 45.9 ka BP by the OSL method. The S4300 tooth is a lower first or second permanent molar belonging to an individual other than that who once possessed the S5000 tooth. The S4300 tooth exhibits a combination of traits typical of Neanderthal lower molars, including a mid-trigonid crest, large anterior fovea, taurodontism and subvertical grooves on the interproximal face, indicating that this tooth belonged to a Neanderthal individual. The S4300 tooth from Stajnia Cave is one of the oldest human remains found in Poland. Copyright © 2013 Elsevier GmbH. All rights reserved.

Unbiased quantitative testing of conventional orthodontic beliefs.

PubMed

Baumrind, S

1998-03-01

This study used a preexisting database to test in hypothesis from the appropriateness of some common orthodontic beliefs concerning upper first molar displacement and changes in facial morphology associated with conventional full bonded/banded treatment in growing subjects. In an initial pass, the author used data from a stratified random sample of 48 subjects drawn retrospectively from the practice of a single, experienced orthodontist. This sample consisted of 4 subgroups of 12 subjects each: Class I nonextraction, Class I extraction, Class II nonextraction, and Class II extraction. The findings indicate that, relative to the facial profile, chin point did not, on average, displace anteriorly during treatment, either overall or in any subgroup. Relative to the facial profile, Point A became significantly less prominent during treatment, both overall and in each subgroup. The best estimate of the mean displacement of the upper molar cusp relative to superimposition on Anterior Cranial Base was in the mesial direction in each of the four subgroups. In only one extraction subject out of 24 did the cusp appear to be displaced distally. Mesial molar cusp displacement was significantly greater in the Class II extraction subgroup than in the Class II nonextraction subgroup. Relative to superimposition on anatomical "best fit" of maxillary structures, the findings for molar cusp displacement were similar, but even more dramatic. Mean mesial migration was highly significant in both the Class II nonextraction and Class II extraction subgroups. In no subject in the entire sample was distal displacement noted relative to this superimposition. Mean increase in anterior Total Face Height was significantly greater in the Class II extraction subgroup than in the Class II nonextraction subgroup. (This finding was contrary to the author's original expectation.) The generalizability of the findings from the initial pass to other treated growing subjects was then assessed by retesting modified hypotheses against a second database stored sample that earlier had been drawn randomly from two other orthodontic practices. The implications of the author's study strategy to the design of future shared digital databases is discussed briefly.

[Peculiarities of upper urinary tract drainage during surgical treatment of staghorn and multiple nephrolithiasis].

PubMed

Imamverdiev, S B; Talybov, T A; Mamedov, R N

2014-01-01

This work was designed to evaluate methods of kidney drainage used in the surgical treatment of 250 patients with staghorn and multiple nephrolithiasis (SMN). All of them underwent open surgery that was followed by drainage of the upper urinary tract in 192 patients. Internal stenting was used in 111 cases, pyelostomy in 28, nephrostomy in 47, and internal stenting with nephrostoma in 6 cases. 91 and 20 patients had a stent inserted into the upper urinary tract in a retrograde and antegrade manner respectively. Retrograde stenting was bilateral in 14 and unilateral in 66 cases. 85% of the cases with ureter stents were followed up as outpatients for 4-5 weeks and only 10% for 6-7 weeks. Forty and ten patients with stents presented with marked dysuria and hematuria respectively. On the whole, combined antibacterial treatment with drainage of the upper urinary tract significantly improved long-term results of SMN treatment. It is concluded that nephrostomy and pyelostomy should be performed on days 14-18 and 10-12 respectively whereas the stent needs to be removed between weeks 2 and 8 after surgery.

Innovative evaluation of local injective gel of curcumin on the orthodontic tooth movement in rats.

PubMed

Asefi, Sohrab; Seifi, Massoud; Fard, Ghazal Hatami; Lotfi, Ali

2018-01-01

Curcumin is the most active compound in turmeric. It can suppress the nuclear factor kappa-light-chain-enhancer of activated B cells pathway and prevent the osteoclastogenesis procedure. This study aimed to be the first to evaluate the effect of curcumin on the rate of orthodontic tooth movement (OTM). Forty rats were used as follows in each group: (1) negative control: Did not receive any appliance or injection; (2) positive control: received 0.03 cc normal saline and appliance; (3) gelatin plus curcumin (G): Received 0.03 cc hydrogel and appliance; and (4) chitosan plus curcumin (Ch): Received 0.03 cc hydrogel and appliance. They were anesthetized and closed nickel-titanium coil springs were installed between the first molars and central incisors unilaterally as the orthodontic appliance. After 21 days, the rats were decapitated, and the distance between the first and second molars was measured by a leaf gauge. Howship's lacunae, blood vessels, osteoclast-like cells, and root resorption lacunae were evaluated in the histological analysis. Data were analyzed by one-way ANOVA, Tukey's test, and t -test ( P < 0.05 consider significant). No significant difference was found in OTM between groups delivered orthodontic forces. Curcumin inhibited root and bone resorption, osteoclastic recruitment, and angiogenesis significantly. Curcumin had no significant inhibitory effect on OTM. While it had a significant role on decreasing bone or root resorption ( P > 0.05).

Does systemic administration of casein phosphopeptides affect orthodontic movement and root resorption in rats?

PubMed

Crowther, Lachlan; Shen, Gang; Almuzian, Mohammed; Jones, Allan; Walsh, William; Oliver, Rema; Petocz, Peter; Tarraf, Nour E; Darendeliler, M Ali

2017-10-01

To assess the potential effects of casein phosphopeptides (CPPs) on orthodontically induced iatrogenic root resorption (OIIRR) and orthodontic teeth movement. Forty Wistar rats (aged 11 weeks) were randomly divided into experimental group (EG; n = 20) that received a diet supplemented with CPP and control group (CG; n = 20) devoid of diet supplement. A 150 g force was applied using nickel titanium (NiTi) coil that was bonded on maxillary incisors and extended unilaterally to a maxillary first molar. At Day 28, animals in both groups were euthanized. Volumetric assessment of root resorption craters and linear measurement of maxillary first molars movement were blindly examined using a micro-computed tomography scan. Nine rats were excluded from the experiment due to loss during general anesthesia or appliances' failure. Intra-operator reproducibility was high in both volumetric and linear measurements, 92.8 per cent and 98.5-97.6 per cent, respectively. The results reveal that dietary CPP has statistically insignificant effect on the overall OIIRR and orthodontic movement. CPP seems to have statistically insignificant effect on the volume of OIIRR and orthodontic movement in rats. A long-term study with larger sample size using a different concentration of CPP is required to clarify the dentoalveolar effect of CPP. © The Author 2017. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com

Prevalence of vertical root fracture as the reason for tooth extraction in dental clinics.

PubMed

Yoshino, Koichi; Ito, Koji; Kuroda, Masahiko; Sugihara, Naoki

2015-07-01

The aim of this study was to investigate the prevalence, by gender, of vertical root fracture (VRF) as the main reason for the extraction of permanent teeth in dental clinics in Tokyo. Participating dentists were requested to provide information about extractions of permanent teeth they had performed from 1 January 2013 to 30 June 2013. The main reasons for extraction were categorized as follows: VRF, caries (horizontal root fracture included), periodontal disease and others. At a total of 24 clinics, 736 teeth were extracted from 626 patients during the 6-month period. A total of 233 teeth were extracted by VRF (31.7%), and 93.6% of these were endodontically treated teeth. Among non-vital extracted teeth, 82.1% (179/218) had cast posts or screw posts. The percentage of extraction due to VRF was 29.4% in males and 34.7% in females. In females, the percentage of extractions due to VRF (34.7%) was higher than for periodontal disease (28.1%). In males, the percentage of extractions due to VRF increased with age (p < 0.05). The tooth types with the highest percentage of extractions due to VRF were the upper canine (46.7%), lower second premolar (48.0%) and lower first molar (50.0%) in males and the upper first premolar (43.3%), upper second premolar (44.4%), lower second premolar (53.8%) and lower first molar (54.5%) in females. These results indicate that we need to pay more attention to maintaining vital teeth while being aware of the particular tooth types in which VRF most frequently occurs.

Brief communication: dental development timing in captive Pan paniscus with comparisons to Pan troglodytes.

PubMed

Bolter, Debra R; Zihlman, Adrienne L

2011-08-01

Dental eruption provides markers of growth and is one component of a chimpanzee's physical development. Dental markers help characterize transitions between life stages, e.g., infant to juvenile. Most of what we know about the timing of development in chimpanzees derives from Pan troglodytes. Much less is known about the sister species, Pan paniscus, with few in captivity and a restricted wild range in central Africa. Here we report on the dental eruption timing for female captive P. paniscus (n = 5) from the Milwaukee and San Diego Zoos whose ages are known and range from birth to age 8.54 years. Some observations were recorded in zoo records on the gingiva during life; others were made at death on the gingiva and on the skeleton. At birth, P. paniscus infants have no teeth emerged. By 0.83 years, all but the deciduous second molars (dm(2) ) (when both upper and lower dentitions are referenced collectively, no super or subscript notation is used) and canines (dc) are emerged. For permanent teeth, results show a sequence polymorphism for an early P4 eruption, not previously described for P. paniscus. Comparisons between P. paniscus and P. troglodytes document absolute timing differences of emergence in upper second incisors (I(2) ), and upper and lower canines (C) and third molars (M3). The genus Pan encompasses variability in growth not previously recognized. These preliminary data suggest that physical growth in captive P. paniscus may be accelerated, a general pattern found in captive P. troglodytes. Copyright © 2011 Wiley-Liss, Inc.

[A retrospective study of 180 cases of apical microsurgery].

PubMed

Wang, Hanguo; Li, Dan; Tian, Yu; Yu, Qing

2014-07-01

To evaluate the outcome and the potential prognostic factors of apical microsurgery. The teeth with persistent periapical diseases were treated by microsurgery using micro instruments, ultrasonic retrotips and mineral trioxide aggregate (MTA) under dental operate microscope. The procedure includes incision and flap retraction, osteotomy, apicoectomy, retro- preparation and retro- filling of root canal. Patients were recalled at 1, 3, 6, and 12- month intervals. The outcome was evaluated by clinical and radiographic examinations, and the potential prognostic factors were analyzed. One hundred and eighty cases (240 teeth), including 132 upper anterior teeth, 22 lower anterior teeth, 31 upper premolars, 18 lower premolars, 19 upper molars and 18 lower molars, were treated by microsurgery between July 2010 and December 2012. A total of 152 cases (207 teeth) were recalled. The application of the apical microsurgery included failure of previous endodontic treatment, periapical lesion with post, periapical cyst, calcified canals, separated instruments, overfilling, open apex, root facture, failure of previous apical surgery, apical fenestration, and special root canal system. The success rate was 90.8% (188/207). Age, sex, tooth position, type of periapical radiolucency, fistula and clinical application type appeared to have a negative effect on the outcome. Endo-perio lesion was a significant factor. Eighteen cases (19 teeth) failed mainly because of periodontally involved lesion and vertical root fracture. Apical microsurgery, which combines the magnification and illumination provided by the microscope with the proper use of micro instruments, can treat the teeth with persistent periapical diseases precisely and less traumatically with high success rate. Case selection and standardized operations play a key role for success.

Dental Number Anomalies and Their Prevalence According To Gender and Jaw in School Children 7 To 14 Years.

PubMed

Sejdini, Milaim; Çerkezi, Sabetim

2018-05-20

This study aimed to find the prevalence of Hypodontia and Hyperdontia in different ethnicities in patients from 7 to 14 years old. A group of 520 children were included aged 7 to 14 years, only the children who went to primary schools. Controls were performed by professional people to preserve the criteria of orthodontic abnormalities evaluation. The data were recorded in the individual card specially formulated for this research and all the patients suspected for hypodontia and hyperdontia the orthopantomography for confirmation was made. The data were analysed using descriptive statistical analysis using χ 2 test for the significant difference for p ˂ 0.05 and Fisher test for p < 0.05. Hypodontia, not counting the patients with missing third molars was found in 18 patients researched or 3.46%. The most commonly missing teeth were the second lower premolars, the second upper premolars, second upper lateral incisors followed by the lower incisors. Hyperdontia not including the third molars was found in 4 cases of the participants or 0.76% from which the most frequent atypical tooth mesiodens and one case of bilateral hypodontia of a lateral upper incisor with typical shape and size. But there were no significant differences when tested between genders and jaws. The prevalence we found is similar to the prevalence in the region. Our findings indicate that there is a difference between the genders in the prevalence of hypodontia, but without statistical significance, while for hyperdontia we can't see such a difference between the sexes.

Removal of an Upper Third Molar from the Maxillary Sinus

PubMed Central

Amorim, Klinger de Souza; da Silva, Vanessa Tavares; da Cunha, Rafael Soares; Souto, Maria Luisa Silveira; São Mateus, Carla Rocha; Souza, Liane Maciel de Almeida

2015-01-01

The maxillary sinus or antrum is the largest of the paranasal sinuses. It is located in the maxillary bone and has a proximity to the apexes of upper molars and premolars, which allows it to form a direct link between the sinus and the oral cavity. Dislocation of a foreign body or tooth to the interior of a paranasal sinus is a situation that can occur as a result of car accidents, firearm attacks, or iatrogenic in surgical procedures. Therefore, it is necessary to know how to treat this kind of situation. This study's objective is to report the case of a 23-year-old female patient, leucoderma, who sought treatment from the Surgical Unit at the Dental Faculty of the Federal University of Sergipe. She had a history of pain and edema in the right side of the genian region and two failed attempts at removing dental unit (DU) 18. The extraoral clinical exam revealed intense edema of the left hemiface with signs of infection, excoriation of the labial commissure, hematoma, a body temperature of 39°C, and a limited ability to open her mouth. The patient was medicated and treated surgically. The tooth was removed from the maxillary sinus with caution, as should have been done initially. PMID:25705524

A Transitional Gundi (Rodentia: Ctenodactylidae) from the Miocene of Israel

PubMed Central

López-Antoñanzas, Raquel; Gutkin, Vitaly; Rabinovich, Rivka; Calvo, Ran; Grossman, Aryeh

2016-01-01

We describe a new species of gundi (Rodentia: Ctenodactylidae: Ctenodactylinae), Sayimys negevensis, on the basis of cheek teeth from the Early Miocene of the Rotem Basin, southern Israel. The Rotem ctenodactylid differs from all known ctenodactylid species, including Sayimys intermedius, which was first described from the Middle Miocene of Saudi Arabia. Instead, it most resembles Sayimys baskini from the Early Miocene of Pakistan in characters of the m1-2 (e.g., the mesoflexid shorter than the metaflexid, the obliquely orientated hypolophid, and the presence of a strong posterolabial ledge) and the upper molars (e.g., the paraflexus that is longer than the metaflexus). However, morphological (e.g., presence of a well-developed paraflexus on unworn upper molars) and dimensional (regarding, in particular, the DP4 and M1 or M2) differences between the Rotem gundi and Sayimys baskini distinguish them and testify to the novelty and endemicity of the former. In its dental morphology, Sayimys negevensis sp. nov. shows a combination of both the ultimate apparition of key-characters and incipient features that would be maintained and strengthened in latter ctenodactylines. Thus, it is a pivotal species that bridges the gap between an array of primitive ctenodactylines and the most derived, Early Miocene and later, gundis. PMID:27049960

[Alteration of metabolic characteristics on the masseter muscle fiber of unilateral chewing rats and its adenosine monophosphate activated protein kinase regulatory mechanism].

PubMed

Andi, Shi; Lin, Zeng; Jing, Liu

2017-06-01

This study aims to determine the influence of unilateral chewing on metabolic characteristics of masseter muscle fibers in rats and the regulatory effect of an adenosine monophosphate activated protein kinase (AMPK) signal pathway on metabolism. Rats were submitted to exodontia of all the right maxillary molars and divided into 2, 4, 6, and 8 weeks groups, and corresponding control groups were set as well. Sections were stained by nicotine adenine dinucleotide tetrazolim reductase(NADH-TRase) to demonstrate the types, proportion, and density of masseter muscle fibers. AMPKα1 and p-AMPK(Thr172) levels in bilateral masseter muscles were detected by Western blot. In the 2-week group, the percentage of dark fibers augmented in the ipsilateral side, whereas the percentage of intermediary fibers in the contralateral side was increased accompanied by a decrease of light fibers, compared with the control group (P<0.05). The percentage of dark fibers was increased in the bilateral sides, whereas the percentage of dark fiber in the ipsilateral sides surpassed that of the contralateral sides in the 4, 6, and 8-week groups. The percentage of intermediary fibers was decreased in the bilateral sides in the 6 and 8-week groups (P<0.05). The percentage of light fibers was reduced in the ipsilateral sides in the 8-week group, whereas no alteration was observed in contralateral sides (P>0.05). In the ipsilateral sides, p-AMPK (Thr172)/AMPKα1 levels were increased in the 2 and 4-week groups (P<0.05), whereas no change was observed in the contralateral sides in either group (P>0.05). Unilateral chewing increases the oxidative metabolic ability in bilateral masseter muscle fibers especially in the non-working side accompanied with change of muscle fiber types. The improvement of aerobic metabolism ability is related to the AMPK signal pathway.
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Mandibular Denture Base Deformation with Locator and Ball Attachments of Implant-Retained Overdentures.

PubMed

ELsyad, Moustafa Abdou; Errabti, Hatem Mokhtar; Mustafa, Aisha Zakaria

2016-12-01

The aim of this in vitro study was to evaluate and compare mandibular denture base deformation between ball and Locator attachments of implant-retained overdentures. An experimental acrylic model covered with resilient silicone mucosal simulation was constructed. Two laboratory implants were placed in the canine areas of the model. Two duplicate experimental overdentures were constructed and connected to the implants with either ball (GI) or Locator (GII) attachments. To measure overdenture strain around the attachments, 3 strain gauges were attached to the lingual polished surface of the overdentures opposite to the right implant (loading side) 2 mm above the attachment level (Ch1), at the attachment level (Ch2), and 2 mm below the attachment level (Ch3). Another 3 gauges were bonded opposite to the left implant (non-loading side) in the same manner (Ch6, Ch7, and Ch8). To measure strain at the midline of the overdentures, two strain gauges were attached in the midline at 5 mm intervals (Ch4 and Ch5). A universal testing device was used to deliver vertical static load of 50 N unilaterally and bilaterally to the first molar area to measure strain using a multi-channel digital strain meter. During bilateral load application, GII recorded higher compressive strains than GI at the majority of channels. During unilateral load application, GI recorded higher tensile strains at Ch1, Ch2, and Ch3, and GII recorded higher strains than GI at Ch6, Ch7, and Ch8. During bilateral loading the highest strain was concentrated at Ch5 for both groups. During unilateral loading, the highest strain was concentrated at Ch2 for GI, and at Ch5 for GII. Ball attachments for implant-retained overdentures were associated with significant mandibular denture base deformation over the implants compared to Locator attachments. Therefore, denture base reinforcement may be recommended with ball attachmentz to increase fracture resistance of the base. © 2015 by the American College of Prosthodontists.

The John Kay Williams Gold Medal of the Royal College of Surgeons of England and Glasgow 2013.

PubMed

Clayton, Christopher Jonathan

2015-06-01

This paper describes the clinical treatment of two cases treated by the recipient of the 2013 Membership in Orthodontics John Kay Williams Gold Medal of the Royal College of Surgeons of England and Glasgow. The first case describes the management of a 12-year-old male with a class II division 1 malocclusion complicated by Molar Incisal Hypominaralization, an increased overjet and severe upper arch crowding using fixed appliances with anchorage support from temporary anchorage devices. The second case involves the management of a class II division 2 malocclusion complicated by crowding of the upper and lower arches treated on an extraction basis using fixed appliances.

Reasons and pattern of tooth mortality in a Nigerian Urban teaching hospital.

PubMed

Saheeb, B D; Sede, M A

2013-01-01

Studies from Nigeria have documented different reasons for tooth mortality and regular follow-up studies to determine any changes in reasons and pattern among Nigerians appears not to be common. The purpose of this study was to determine the reasons and pattern of tooth mortality among Nigerians and the changes that might have occurred after 38 years of the first report. The case records of patients seen at the Oral Surgery clinic of the University of Benin Teaching Hospital between March 2007 and February 2008 were retrieved from the Medical Records Department and analyzed for age, gender, reasons for extraction, tooth extracted, frequency of extraction, and mode of extraction. A total of 990 patients were referred for exodontia and 1050 teeth were extracted from 397 (40.1%) males and 593 (59.9%) females of age 14--89 years. The reasons for extraction include caries and its sequelae (n = 905, 86.2%), periodontal disease (n = 69, 6.6%), trauma (n = 41, 3.9%), orthodontics (n = 24, 2.3%), failed endodontics (n = 5, 0.5%), prosthetics (n = 4, 0.4%), pericoronitis (n = 2, 0.2%). The most frequently extracted teeth were the lower right first molars (n = 109, 10.4%) and the lower left first molars (n = 95, 9.0%), respectively. Molar teeth (n = 830, 79.0%) were more frequently extracted while canines (n = 13, 1.2%) were the least. The lower molars were more commonly extracted (n = 479, 45.6%) followed by upper molars (n = 351, 33.4%). The age range of 21-30 years was more commonly referred for extraction with the most frequently extracted teeth being the lower left first molars (n = 32, 3.0%) in females and (n = 27, 2.7%) in males, respectively. Tooth mortality in Nigerians is significantly associated with dental caries and its sequelae especially in younger patients.

Delayed retrieval of a displaced maxillary third molar from infratemporal space via trans-sinusoidal approach: a case report and the review of the literature.

PubMed

Sencimen, Metin; Gülses, Aydin; Secer, Sencer; Zerener, Tamer; Özarslantürk, Savaş

2017-03-01

The aim of this case report is to present the trans-sinusoidal pathway used to remove a displaced maxillary third molar from the infratemporal fossa and review the English literature regarding the techniques used. A 21-year-old male patient was referred with the findings of an oroantral fistula on the left maxillary vestibular first molar region and slight restriction of mouth opening. The patient underwent a maxillary sinus surgery in order to remove a sinus retention cyst via Caldwell-Luc access in a dental clinic 4 years ago. A computerized tomography scan showed the inverted third molar to be located in the infratemporal fossa, just between zygomatic arch and lateral pterygoid plate. The tooth was accessed through the remaining lateral bone defect from the Caldwell-Luc approach of the lateral sinus wall. The bone defect was extended. The posterior bony wall of the maxillary sinus was removed via a surgical burr. After that, the displaced tooth was exposed. The tooth was mobilized via Warwick James elevator downwards and removed with a forceps. Access for surgical removal of the tooth from the infratemporal fossa is not only difficult but also has potential for morbidity due to the structures running through it. Wide incision in the maxillary sulcus and blunt dissection are reported with lower success rates and usually necessitate a second intervention via extraoral route. Trans-sinusoidal approach might be an old fashioned but relatively successfully attempt in the removal of the upper third molars from the infratemporal fossa. Considering the time of removal, if no symptoms were present, it is beneficial to wait for a couple of weeks thus facilitating development of fibrous surrounding around the tooth.

Giant hydronephrosis in a case of ureterocele with duplex system: an entity yet not reported.

PubMed

Aeron, Ruchir; Sokhal, Ashok Kumar; Kumar, Manoj; Sankhwar, Satyanarayan

2017-08-10

Ureterocele, which is a cystic dilatation of the terminal ureter, is usually associated with the upper moiety in a case of the duplex system. Giant hydronephrosis, a rare entity, is usually due to pelviureteric junction obstruction and is usually diagnosed in infants and children. We report a unique case of a unilateral complete duplex system with ureterocele with giant hydronephrosis of the upper moiety in an adult woman presenting as an abdominal lump. To the best of our knowledge, this is the first case of giant hydronephrosis associated with ureterocele in an adult patient. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Sticky eyelid syndrome.

PubMed

Kortvelesy, J Scott; Buerger, George F

2004-11-01

To report on patients seen with an unusual condition affecting the eyelids. The syndrome manifests as a temporary adhesion which forms between the upper and lower eyelid associated with laxity of the lower lid retractors. This results in a peculiar closure of the lids. Retrospective case reports. Charts of affected patients were reviewed for their clinical histories, examination findings, external photographs, and the results of treatment. Ten consecutive patients with the associated findings were reviewed. All cases were unilateral. Seven patients were Asian and three were Caucasian. Nine patients were symptomatic; of these, all were treated conservatively except for one who requested surgery. Two cases are described and photographs are shown. Lower eyelid retractor laxity combined with a temporary adhesion between the upper and lower lid results in the clinical findings of Sticky Eyelid Syndrome.

Mirror therapy in complex regional pain syndrome type 1 of the upper limb in stroke patients.

PubMed

Cacchio, Angelo; De Blasis, Elisabetta; De Blasis, Vincenzo; Santilli, Valter; Spacca, Giorgio

2009-10-01

Complex regional pain syndrome type 1 (CRPSt1) of the upper limb is a painful and debilitating condition, frequent after stroke, and interferes with the rehabilitative process and outcome. However, treatments used for CRPSt1 of the upper limb are limited. . This randomized controlled study was conducted to compare the effectiveness on pain and upper limb function of mirror therapy on CRPSt1 of upper limb in patients with acute stroke. . Of 208 patients with first episode of unilateral stroke admitted to the authors' rehabilitation center, 48 patients with CRPSt1 of the affected upper limb were enrolled in a randomized controlled study, with a 6-month follow-up, and assigned to either a mirror therapy group or placebo control group. The primary end points were a reduction in the visual analogue scale score of pain at rest, on movement, and brush-induced tactile allodynia. The secondary end points were improvement in motor function as assessed by the Wolf Motor Function Test and Motor Activity Log. . The mean scores of both the primary and secondary end points significantly improved in the mirror group (P < .001). No statistically significant improvement was observed in any of the control group values (P > .001). Moreover, statistically significant differences after treatment (P < .001) and at the 6-month follow-up were found between the 2 groups. . The results indicate that mirror therapy effectively reduces pain and enhances upper limb motor function in stroke patients with upper limb CRPSt1.

Relationship of unilateral total hip arthroplasty (THA) to contralateral and ipsilateral knee joint degeneration - a longitudinal 3T MRI study from the Osteoarthritis Initiative (OAI).

PubMed

Jungmann, P M; Nevitt, M C; Baum, T; Liebl, H; Nardo, L; Liu, F; Lane, N E; McCulloch, C E; Link, T M

2015-07-01

To evaluate the association of prevalent unilateral total hip arthroplasty (THA) with worsening of degenerative knee abnormalities and clinical outcomes in the ipsilateral and contralateral knee. Both knees of 30 individuals in the Osteoarthritis Initiative (OAI) with unilateral THA (n = 14 left, n = 16 right) at baseline were assessed at baseline and at 4-year follow-up for Whole-organ MR Imaging Scores (WORMS), cartilage T2 relaxation times (only available for right knees), Western Ontario and McMasters Universities Arthritis Index (WOMAC) scores and upper leg isometric strength. Right knees of 30 individuals without THA were analyzed as controls. Contralateral knees were compared to ipsilateral knees with paired t-tests and to control knees with multivariate regression analysis adjusting for covariates. In paired analyses, compared to ipsilateral knees, contralateral knees had higher WORMS total (P = 0.008) and cartilage scores (P = 0.007) at baseline. Over 4 years contralateral knees worsened more on WORMS total score (P = 0.008). Cartilage T2 values were higher in knees contralateral to the THA (baseline, P = 0.02; follow-up, P < 0.001). Contralateral knees had greater declines in knee extension strength (P = 0.04) and had a trend for greater worsening in WOMAC pain, stiffness, function and total scores (P = 0.04-0.09). Similar results were found comparing contralateral knees with control knees in multivariate regression models. Prevalent unilateral THA is associated with an greater progression of degenerative findings for the knee contralateral to THA. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Validity and reliability of the VOAA-DDD to assess spontaneous hand use with a video observation tool in children with spastic unilateral cerebral palsy.

PubMed

Aarts, Pauline B M; Jongerius, Peter H; Geerdink, Yvonne A; Geurts, Alexander C

2009-11-25

In 2003 new computer software, the VOAA (Video Observations Aarts and Aarts), was designed to score and evaluate two important aspects of spontaneous upper limb use, i.e. overall duration and frequency of specific behaviours. The aim of this study was to investigate the test-retest, interrater and intrarater reliability and the construct validity of a new module, the VOAA-DDD, to determine developmental disregard in children with spastic unilateral cerebral palsy (CP). A test-retest design with three raters for reliability and a two-group design for construct validity were used. Subjects were a total of 20 children with spastic unilateral CP equally divided in two age groups (2.5-5 and 5-8 years), and 56 healthy children of the same age groups. Overall duration and frequency of specific behaviours of the affected arm and hand were assessed during a task demanding ('stringing beads') and a task stimulating ('decorating a muffin') the use of both hands. Reliability was estimated by intraclass correlation coefficients (ICCs). Construct validity was assessed by comparing children with CP to healthy children. All ICCs exceeded 0.87. In contrast with healthy children, children with CP used their affected hand less during the 'muffin' task compared to the 'beads' task. Of the children with CP, 90% in the age group of 2.5-5 years and 50% in the age group of 5-8 years showed values exceeding the extreme values of healthy controls, respectively, indicating developmental disregard. The VOAA-DDD is a reliable and valid instrument to assess spontaneous use of the affected arm and hand in order to determine developmental disregard in children with spastic unilateral CP.

Removable orthodontic appliances: new perspectives on capabilities and efficiency.

PubMed

Hamid Zafarmand, A; Mahdi Zafarmand, M

2013-06-01

Removable appliances are a dependable choice for many patients but like all orthodontic appliances, they have some limitations in use. Patient selection and appropriate appliance design are two key factors for success. Many patients, especially adults, prefer intra-oral appliances to extra-oral devices. Sometimes a removable intra-oral appliance can solve a dental problem in a shorter period of time compared to fixed treatment, and this has also been repeatedly seen in molar distalisation. From the interceptive perspective, the appliance can prevent or alleviate an impending crowding for erupting permanent incisors. This article describes 5 patients with different orthodontic problems: impending crowding for erupting upper canine with 2 approaches, provision of space for upper cuspids, resolution of chronic attrition of anterior teeth, relief of space shortage for upper canines eruption, and reduction of excess overjet. All subjects were treated with removable appliances of various designs.

Procedures adopted by orthodontists for space closure and anchorage control.

PubMed

Monini, André da Costa; Gandini Júnior, Luiz Gonzaga; dos Santos-Pinto, Ary; Maia, Luiz Guilherme Martins; Rodrigues, Willian Caetano

2013-01-01

The aim of this study was to identify the procedures adopted by Brazilian orthodontists in the following situations: extraction space closure, anchorage control in case of necessary anchorage for group A and frequency of skeletal anchorage use, especially in the upper jaw. A questionnaire was sent to the e-mail address of all dentists registered in the Brazilian Federal Council of Dentistry. The results showed that most Brazilian orthodontists usually perform extraction space closure by means of sliding mechanics. The use of palatal bar, inclusion of second molars in the archwire and space closure performed in two phases are the most used techniques for anchorage control in the upper jaw. The skeletal anchorage is referenced by 36.5% of specialists as a routine practice for the upper arch anchorage. There is a wide variety of procedures adopted by Brazilian orthodontists for orthodontic space closure and anchorage control.

[Pre-surgical orthodontic treatment of skeletal class II patients with gingival smile corrected by anterior maxillary segmental osteotomy].

PubMed

Li, Xiaobing; Xiao, Liwei; Chen, Song; Chen, Yangxi

2002-11-01

To discuss the pre-surgical orthodontic treatment of skeletal class II patients with gingiva smile corrected by AMSO. We analyzed the clinical features of 20 skeletal class II patients treated by AMSO combined with Orthodontic treatment and evaluated the effects of AMSO by means of cephalometric analysis. After the AMSO treatment, ANB angle, the height of anterior maxilla, the protrusion of the upper anterior teeth, and the of A point had reduced significantly (P < 0.05). After AMSO, the appearance of patients had been improved markedly. AMSO can correct the protrusion of the maxilla and gingival smie efficiently. The anchorage of molars should be controlled carefully. The anterior part of the upper arch should be expended orthodontically to make arch relationship. Extract the upper bicuspid half a year before the surgery was recommended. When necessary, genioplasty could be performed.

Fused primary first mandibular macromolar with a unique relation to its permanent successors: A rare tooth anomaly.

PubMed

Dhindsa, Abhishek; Garg, Shalini; Damle, S G; Opal, Shireen; Singh, Tavleen

2013-04-01

Dental anomalies of number and forms may occur in the primary and permanent dentition. Various terms have been used to describe dental twinning anomalies: Germination, fusion, concrescence, double teeth, conjoined teeth, twinned teeth, geminifusion, and vicinifusion. Fused tooth is a developmental anomaly that is seen more frequently in the primary than the permanent dentition. Double tooth involving deciduous anterior teeth is found mostly in the mandible. Very few cases of nonsyndromic double primary molar have been reported in the literature. The succeeding permanent tooth is often found missing congenitally in the same region. This article reports a very rare unilateral occurrence of an anomalous, primary mandibular first macromolar formed by fusion with a dysmorphic premolar like supernumerary tooth in deciduous dentition period. Instead of agenesis of succedaneous tooth, the double tooth has been succeeded by normally developing mandibular first premolar in the same region.

Modern mammal origins: evolutionary grades in the Early Cretaceous of North America.

PubMed Central

Jacobs, L L; Winkler, D A; Murry, P A

1989-01-01

Major groups of modern mammals have their origins in the Mesozoic Era, yet the mammalian fossil record is generally poor for that time interval. Fundamental morphological changes that led to modern mammals are often represented by small samples of isolated teeth. Fortunately, functional wear facets on teeth allow prediction of the morphology of occluding teeth that may be unrepresented by fossils. A major step in mammalian evolution occurred in the Early Cretaceous with the evolution of tribosphenic molars, which characterize marsupials and placentals, the two most abundant and diverse extant groups of mammals. A tooth from the Early Cretaceous (110 million years before present) of Texas tests previous predictions (based on lower molars) of the morphology of upper molars in early tribosphenic dentitions. The lingual cusp (protocone) is primitively without shear facets, as expected, but the cheek side of the tooth is derived (advanced) in having distinctive cusps along the margin. The tooth, although distressingly inadequate to define many features of the organism, demonstrates unexpected morphological diversity at a strategic stage of mammalian evolution and falsifies previous claims of the earliest occurrence of true marsupials. Images PMID:2740336

Infection, Alveolar Osteitis, and Adverse Effects Using Metronidazole in Healthy Patients Undergoing Third Molar Surgery: A Meta-analysis.

PubMed

Isiordia-Espinoza, Mario Alberto; Aragon-Martinez, Othoniel H; Bollogna-Molina, Ronell E; Alonso-Castro, Ángel J

2018-06-01

The aim of this systematic review and meta-analysis was to evaluate the risk of surgical infection, alveolar osteitis, and adverse effects using systemic metronidazole in comparison with placebo in healthy patients undergoing third molar surgery. The eligible reports were identified from diverse science sources. Clinical trials meeting the inclusion and exclusion criteria and an acceptable Oxford Quality Score were included in this study. The evaluation of risk was done using the Risk Reduction Calculator and Review Manager 5.3., from the Cochrane Library. A significant risk reduction was assumed when the upper limit of the 95% confidence intervals was <1 and the lower limit did not cross zero (negative number) alongside a p value of <0.05 for the overall test. Data of 667 patients from five clinical trials were used for the assessment of risk. Our analysis showed no reduction of the risk of infection or dry socket in patients receiving metronidazole compared to whom took placebo. Meanwhile, the adverse effects did not exhibit a difference between the studied groups. The routine use of systemic metronidazole to prevent surgical site infection and/or dry socket in healthy patients undergoing third molar surgery is not recommended.

Unilateral external and internal ophthalmoplegia caused by intracranial meningioma in a dog.

PubMed

Larocca, R.D.

2000-01-01

Unilateral internal and external ophthalmoplegia caused by an intracranial meningioma occurred in a 15-year-old Belgian Sheepdog. The dog initially presented with ventro-lateral strabismus of the left eye, and ptosis of the left upper eyelid. Anisocoria was present with the left pupil fixed and dilated. Both eyes were visual. Neuro-ophthalmic evaluation revealed a lesion located in the left oculomotor nerve. Pharmacological testing with dilute pilocarpine (0.1% in artificial tears) revealed evidence of parasympathetic denervation of the left eye. Further evaluation via magnetic resonance imaging (MRI) revealed a well-defined mass to the left of midline and lateral to the sella turcica. An attempt was made to excise/debulk the mass due to worsening conditions and the dog died the following day. Necropsy revealed a mass of randomly arranged bundles and streams of spindle cells. Immunohistochemistry demonstrated a strong avidity for vimentin and a negative response for S-100 protein. These findings suggest a diagnosis of meningioma.

Characteristics of bilateral hand function in individuals with unilateral dystonia due to perinatal stroke: sensory and motor aspects.

PubMed

de Campos, Ana Carolina; Kukke, Sahana N; Hallett, Mark; Alter, Katharine E; Damiano, Diane L

2014-05-01

The authors assessed bilateral motor and sensory function in individuals with upper limb dystonia due to unilateral perinatal stroke and explored interrelationships of motor function and sensory ability. Reach kinematics and tactile sensation were measured in 7 participants with dystonia and 9 healthy volunteers. The dystonia group had poorer motor (hold time, reach time, shoulder/elbow correlation) and sensory (spatial discrimination, stereognosis) outcomes than the control group on the nondominant side. On the dominant side, only sensation (spatial discrimination, stereognosis) was poorer in the dystonia group compared with the control group. In the dystonia group, although sensory and motor outcomes were uncorrelated, dystonia severity was related to poorer stereognosis, longer hold and reach times, and decreased shoulder/elbow coordination. Findings of bilateral sensory deficits in dystonia can be explained by neural reorganization. Visual compensation for somatosensory changes in the nonstroke hemisphere may explain the lack of bilateral impairments in reaching.

Characteristics of bilateral hand function in individuals with unilateral dystonia due to perinatal stroke: sensory and motor aspects

PubMed Central

de Campos, Ana Carolina; Kukke, Sahana N.; Hallett, Mark; Alter, Katharine E.; Damiano, Diane L.

2014-01-01

We assessed bilateral motor and sensory function in individuals with upper limb dystonia due to unilateral perinatal stroke and explored interrelationships of motor function and sensory ability. Reach kinematics and tactile sensation were measured in seven participants with dystonia and nine healthy volunteers. The dystonia group had poorer motor (hold time, reach time, shoulder/elbow correlation) and sensory (spatial discrimination, stereognosis) outcomes than the control group on the non-dominant side. On the dominant side, only sensation (spatial discrimination, stereognosis) was poorer in the dystonia group compared to the control group. In the dystonia group, although sensory and motor outcomes were uncorrelated, dystonia severity was related to poorer stereognosis, longer hold and reach times, and decreased shoulder/elbow coordination. Findings of bilateral sensory deficits in dystonia may be explained by neural reorganization. Visual compensation for somatosensory changes in the non-stroke hemisphere may explain the lack of bilateral impairments in reaching. PMID:24396131

Radiofrequency sensory ablation as a treatment for symptomatic unilateral lumbosacral junction pseudarticulation (Bertolotti's syndrome): a case report.

PubMed

Burnham, Robert

2010-06-01

Describe the clinical presentation, diagnostic evaluation, and successful treatment of a case of symptomatic unilateral lumbosacral junction pseudarticulation using a novel radiofrequency nerve ablation technique. A 56-year-old female patient who had suffered with low back and right upper buttock pain for 16 years experienced incomplete relief with L4/5 facet joint radiofrequency ablation. She was found to have an elongated right L5 transverse process that articulated with the sacral ala (Bertolotti's syndrome). Fluoroscopically guided local anesthetic/corticosteroid injection into the pseudarthrosis eliminated her residual right buttock pain for the duration of the local anesthetic only. Complete pain relief was achieved by injecting local anesthetic circumferentially around the posterior pseudarthrosis articular margin. Accordingly, bipolar radiofrequency strip thermal lesions were created at the same locations. Complete pain relief and full restoration of function was achieved for 16 months postprocedure. This case report describes a novel radiofrequency technique for treating symptomatic lumbosacral junction pseudarticulation that warrants further evaluation.

[Class III surgical patients facilitated by accelerated osteogenic orthodontic treatment].

PubMed

Wu, Jia-qi; Xu, Li; Liang, Cheng; Zou, Wei; Bai, Yun-yang; Jiang, Jiu-hui

2013-10-01

To evaluate the treatment time and the anterior and posterior teeth movement pattern as closing extraction space for the Class III surgical patients facilitated by accelerated osteogenic orthodontic treatment. There were 10 skeletal Class III patients in accelerated osteogenic orthodontic group (AOO) and 10 patients in control group. Upper first premolars were extracted in all patients. After leveling and alignment (T2), corticotomy was performed in the area of maxillary anterior teeth to accelerate space closing.Study models of upper dentition were taken before orthodontic treatment (T1) and after space closing (T3). All the casts were laser scanned, and the distances of the movement of incisors and molars were digitally measured. The distances of tooth movement in two groups were recorded and analyzed. The alignment time between two groups was not statistically significant. The treatment time in AOO group from T2 to T3 was less than that in the control group (less than 9.1 ± 4.1 months). The treatment time in AOO group from T1 to T3 was less than that in the control group (less than 6.3 ± 4.8 months), and the differences were significant (P < 0.01). Average distances of upper incisor movement (D1) in AOO group and control group were (2.89 ± 1.48) and (3.10 ± 0.95) mm, respectively. Average distances of upper first molar movement (D2) in AOO group and control group were (2.17 ± 1.13) and (2.45 ± 1.04) mm, respectively.No statistically significant difference was found between the two groups (P > 0.05). Accelerated osteogenic orthodontic treatment could accelerate space closing in Class III surgical patients and shorten preoperative orthodontic time. There were no influence on the movement pattern of anterior and posterior teeth during pre-surgical orthodontic treatment.

Effects of the bisphosphonate alendronate on molars of young rats after lateral luxation.

PubMed

Rothbarth, Cláudia Pires; Bradaschia-Correa, Vivian; Ferreira, Lorraine Braga; Arana-Chavez, Victor Elias

2014-12-01

The bisphosphonate alendronate (ALN) was employed with the aim of investigating its effects on dental and periodontal tissues after lateral luxation of developing molars. Twenty-one-day-old Wistar rats had their second upper molars laterally luxated. Daily 2.5 mg kg(-1) ALN injections started at the day of the luxation; controls received sterile saline solution. The teeth were analyzed 7, 14, and 21 days after the procedure. On the days cited, the maxillae were fixed, decalcified, and embedded in paraffin or Spurr resin. The paraffin sections were stained with H&E, incubated for TRAP histochemistry or immunolabeled for osteopontin (OPN). Spurr ultrathin sections were examined in a transmission electron microscope. After 21 days, the root apex of luxated molars without ALN was wide open and disorganized and also covered by an irregular layer of cellular cementum, which was not observed in ALN-treated animals. Ankylosis sites were observed in ALN rats in both luxated and non-luxated teeth. The TRAP-positive osteoclasts were more numerous in ALN group, despite their latent ultrastructural appearance without the presence of resorption apparatus compared to controls. OPN immunolabeling revealed a thick immunopositive line in the dentin that must be resultant from the moment of the luxation, while ALN-treated specimens did not present alterations in dentin. The present findings indicate that alendronate inhibits some alterations in dentin and cementum formation induced by dental trauma. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A parallel-group comparison study of celecoxib with loxoprofen sodium in third mandibular molar extraction patients.

PubMed

Yamashita, Y; Sano, N; Shimohira, D; Danjo, A; Goto, M

2014-12-01

Non-steroidal anti-inflammatory drugs (NSAIDs) are used widely, but they may damage the upper gastrointestinal mucosa owing to their mechanism of action. Selective cyclooxygenase 2 (COX-2) inhibitors are known to have a reduced risk for such damage. In this comparative study, the efficacy and safety of the selective COX-2 inhibitor celecoxib for pain after third mandibular molar extraction were compared with those of loxoprofen sodium. This was a parallel-group comparison study; 107 patients who had undergone third mandibular molar extraction were given celecoxib and 102 were given loxoprofen. The level of pain on a visual analogue scale (VAS) 15 min and 30 min after taking the experimental drug decreased over time, with no significant difference between the two groups. The percentage of patients taking a second dose was 64.5% for celecoxib and 80.4% for loxoprofen. The time to second dose was significantly longer for celecoxib (533.5 min) than for loxoprofen (387.4 min). There was no significant difference in the patients' impression of efficacy between the two groups, with ratings of 'excellent' and 'good' for 77.4% in the loxoprofen group and 74.5% in the celecoxib group. These results demonstrate that celecoxib is of equal clinical value to loxoprofen for acute pain after third mandibular molar extraction. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Skeletal anchorage for orthodontic correction of severe maxillary protrusion after previous orthodontic treatment.

PubMed

Tanaka, Eiji; Nishi-Sasaki, Akiko; Hasegawa, Takuro; Nishio, Clarice; Kawai, Nobuhiko; Tanne, Kazuo

2008-01-01

The correction of a severe maxillary protrusion in an adult by distal movement of the maxillary molars has been one of the most difficult biomechanical problems in orthodontics. This article reports on the treatment of an adult case of severe maxillary protrusion and a large overjet treated with a skeletal anchorage system. A female patient, age 22 years and 3 months, complained of the difficulty of lip closure due to severe maxillary protrusion with a gummy smile. Overjet and overbite were +7.6 mm and -0.9 mm, respectively. She had a history of orthodontic treatment in which her maxillary first premolars were extracted. In order to conduct distal movement of the maxillary molars, anchor plates were placed in the zygomatic process. After achieving a Class I molar relationship, retraction and intrusion of the maxillary incisors were performed. After a 2-year treatment, an acceptable occlusion was achieved with a Class I molar relationship. Her convex facial profile with upper lip protrusion was considerably improved, and the lips showed less tension in lip closure. After a 2-year retention period, an acceptable occlusion was maintained without recurrence of maxillary protrusion, indicating a stability of the occlusion. The result of this treatment indicated that skeletal anchorage is of great importance as a remedy for achieving intrusion and retraction of the maxillary incisors in cases of severe maxillary protrusion with a patient who had previous orthodontic treatment.

Feasibility and effectiveness of adding object-related bilateral symmetrical training to mirror therapy in chronic stroke: A randomized controlled pilot study.

PubMed

Rodrigues, Letícia Cardoso; Farias, Nayara Correa; Gomes, Raquel Pinheiro; Michaelsen, Stella Maris

2016-01-01

To evaluate the feasibility and effectiveness of adding object-related bilateral symmetrical training to mirror therapy (MT) to improve upper limb (UL) activity in chronic stroke patients. Sixteen patients with moderate UL impairment were randomly allocated to either the experimental (EG) or control (CG) group. Both groups performed 1 hour sessions, 3 days/week for 4 weeks, involving object-related bilateral symmetrical training. EG performed the tasks observing their nonparetic UL reflected in the mirror, while CG observed the paretic UL directly. The primary outcome measure was unilateral and bilateral UL activity according to the Test d'Évaluation des Membres Supérieurs de Personnes Âgées (TEMPA). All measurements were taken at baseline, post-training, and follow-up (2 weeks). TEMPA total score showed the main effect of time. Significant improvement was found for bilateral but not unilateral tasks. Both groups showed gains after training, with no differences between them. This study showed the feasibility of adding object-related bilateral training to MT. Both types of training improved UL bilateral activity; however, a larger sample is required for a definitive study. Other studies need to be carried out to evaluate the effectiveness of combining more distal-oriented movements and object-related unilateral training to improve these effects in chronic stroke patients.

Mirror Electromyografic Activity in the Upper and Lower Extremity: A Comparison between Endurance Athletes and Non-Athletes.

PubMed

Maudrich, Tom; Kenville, Rouven; Lepsien, Jöran; Villringer, Arno; Ragert, Patrick; Steele, Christopher J

2017-01-01

During unimanual motor tasks, muscle activity may not be restricted to the contracting muscle, but rather occurs involuntarily in the contralateral resting limb, even in healthy individuals. This phenomenon has been referred to as mirror electromyographic activity (MEMG). To date, the physiological (non-pathological) form of MEMG has been observed predominately in upper extremities (UE), while remaining sparsely described in lower extremities (LE). Accordingly, evidence regarding the underlying mechanisms and modulation capability of MEMG, i.e., the extent of MEMG in dependency of exerted force during unilateral isometric contractions are insufficiently investigated in terms of LE. Furthermore, it still remains elusive if and how MEMG is affected by long-term exercise training. Here, we provide novel quantitative evidence for physiological MEMG in homologous muscles of LE (tibialis anterior (TA), rectus femoris (RF)) during submaximal unilateral dorsiflexion in healthy young adults. Furthermore, endurance athletes (EA, n = 11) show a higher extent of MEMG in LE compared to non-athletes (NA, n = 11) at high force demands (80% MVC, maximum voluntary contraction). While the underlying neurophysiological mechanisms of MEMG still remain elusive, our study indicates, at least indirectly, that sport-related long-term training might affect the amount of MEMG during strong isometric contractions specifically in trained limbs. To support this assumption of exercise-induced limb-specific MEMG modulation, future studies including different sports disciplines with contrasting movement patterns and parameters should additionally be performed.

Mirror Electromyografic Activity in the Upper and Lower Extremity: A Comparison between Endurance Athletes and Non-Athletes

PubMed Central

Maudrich, Tom; Kenville, Rouven; Lepsien, Jöran; Villringer, Arno; Ragert, Patrick; Steele, Christopher J.

2017-01-01

During unimanual motor tasks, muscle activity may not be restricted to the contracting muscle, but rather occurs involuntarily in the contralateral resting limb, even in healthy individuals. This phenomenon has been referred to as mirror electromyographic activity (MEMG). To date, the physiological (non-pathological) form of MEMG has been observed predominately in upper extremities (UE), while remaining sparsely described in lower extremities (LE). Accordingly, evidence regarding the underlying mechanisms and modulation capability of MEMG, i.e., the extent of MEMG in dependency of exerted force during unilateral isometric contractions are insufficiently investigated in terms of LE. Furthermore, it still remains elusive if and how MEMG is affected by long-term exercise training. Here, we provide novel quantitative evidence for physiological MEMG in homologous muscles of LE (tibialis anterior (TA), rectus femoris (RF)) during submaximal unilateral dorsiflexion in healthy young adults. Furthermore, endurance athletes (EA, n = 11) show a higher extent of MEMG in LE compared to non-athletes (NA, n = 11) at high force demands (80% MVC, maximum voluntary contraction). While the underlying neurophysiological mechanisms of MEMG still remain elusive, our study indicates, at least indirectly, that sport-related long-term training might affect the amount of MEMG during strong isometric contractions specifically in trained limbs. To support this assumption of exercise-induced limb-specific MEMG modulation, future studies including different sports disciplines with contrasting movement patterns and parameters should additionally be performed. PMID:29085288

Treating post-traumatic tremor with deep brain stimulation: report of five cases.

PubMed

Issar, Neil M; Hedera, Peter; Phibbs, Fenna T; Konrad, Peter E; Neimat, Joseph S

2013-12-01

Post-traumatic tremor is one of the most common movement disorders resulting from severe head trauma. However, literature regarding successful deep brain stimulation (DBS) treatment is scarce, resulting in ambiguity regarding the optimal lead location. Most cases support the ventral intermediate nucleus, but there is evidence to defend DBS of the zona incerta, ventral oralis anterior/posterior, and/or a combination of these targets. We report five patients with disabling post-traumatic tremor treated with DBS of the ventral intermediate nucleus and of the globus pallidus internus. Patients were referred to the Vanderbilt Movement Disorders Division, and surgical intervention was determined by a DBS Multidisciplinary Committee. Standard DBS procedure was followed. Patients 1-4 sustained severe diffuse axonal injuries. Patients 1-3 underwent unilateral ventral intermediate nucleus DBS for contralateral tremor, while Patient 4 underwent bilateral ventral intermediate nucleus DBS. Patients 1-3 experienced good tremor reduction, while Patient 4 experienced moderate tremor reduction with some dystonic posturing of the hands. Patient 5 had dystonic posturing of the right upper extremity with tremor of the left upper extremity. He was treated with bilateral DBS of the globus pallidus internus and showed good tremor reduction at follow-up. Unilateral or bilateral DBS of the ventral intermediate nucleus and bilateral DBS of the globus pallidus internus may be effective and safe treatment modalities for intractable post-traumatic tremor. Further studies are needed to clarify the optimal target for surgical treatment of post-traumatic tremor. Published by Elsevier Ltd.

Hypnosis as a Valuable Tool for Surgical Procedures in the Oral and Maxillofacial Area.

PubMed

Montenegro, Gil; Alves, Luiza; Zaninotto, Ana Luiza; Falcão, Denise Pinheiro; de Amorim, Rivadávio Fernandes Batista

2017-04-01

Hypnosis is a valuable tool in the management of patients who undergo surgical procedures in the maxillofacial complex, particularly in reducing and eliminating pain during surgery and aiding patients who have dental fear and are allergic to anesthesia. This case report demonstrates the efficacy of hypnosis in mitigating anxiety, bleeding, and pain during dental surgery without anesthesia during implant placement of tooth 14, the upper left first molar.

Comparison of the clinical efficacy and safety of retroperitoneal laparoscopic ureterolithotomy and ureteroscopic holmium laser lithotripsy in the treatment of obstructive upper ureteral calculi with concurrent urinary tract infections.

PubMed

Jiang, Jun-Tao; Li, Wei-Guo; Zhu, Yi-Ping; Sun, Wen-Lan; Zhao, Wei; Ruan, Yuan; Zhong, Chen; Wood, Kristofer; Wei, Hai-Bin; Xia, Shu-Jie; Sun, Xiao-Wen

2016-07-01

The aim of this study is to compare the clinical efficacy and safety of retroperitoneal laparoscopic ureterolithotomy (RPLU) and ureteroscopic holmium laser lithotripsy (UHLL) as two minimally invasive procedures in managing obstructive upper ureteral calculi with concurrent urinary tract infections (UTI). The retrospective study included 189 patients who underwent unilateral obstructive upper ureteral stones with concurrent UTI from January 2007 to November 2014 at our institution. Patients received RPLU (81 cases) or UHLL (108 cases). All patients received preoperative anti-infection treatment (indwelling ureteral stent and/or preoperative antibiotics). Collected data, including sex, age, stone size, success rate, operation duration, post-operation hospitalization time, and post-operation complications, were compared. All patients were followed up for more than 6 months after surgeries, and no ureterostenosis occurred. The study included 189 patients, 41 (21.7 %) females and 148 (78.3 %) males with a medium age of 52 years (range 22-81 years). All surgeries were successfully performed without conversion to open surgery. Stone size in the RPLU group was larger than that of the UHLL group (16.1 ± 1.4 vs. 10.4 ± 1.6 mm, P = 0.012). Operative duration (P = 0.009) and hospitalization time (P < 0.001) in the UHLL group were significantly shorter than those in the RPLU group, whereas stone clearance rate was significantly higher in the RPLU group (100 vs. 88.9 %, P = 0.002). Of note, postoperative fever was more common in patients treated with UHLL (15 cases) versus RPLU (4 cases) (13.9 vs. 4.9 %, P = 0.043). Moreover, in the UHLL group, three patients without a preoperative indwelling ureteral stent were complicated with sepsis, which was not seen in RPLU group. In our study, the safety and stone clearance rate of RPLU are better than those of UHLL in the treatment of unilateral upper ureteric calculi with concurrent UTI. Preoperative antibiotics and indwelling ureteral stent may reduce the risk of postoperative infections.

Coordination of reach-to-grasp kinematics in individuals with childhood-onset dystonia due to hemiplegic cerebral palsy

PubMed Central

Kukke, Sahana N.; Curatalo, Lindsey A.; de Campos, Ana Carolina; Hallett, Mark; Alter, Katharine E.; Damiano, Diane L.

2015-01-01

Functional reaching is impaired in dystonia. Here, we analyze upper extremity kinematics to quantify timing and coordination abnormalities during unimanual reach-to-grasp movements in individuals with childhood-onset unilateral wrist dystonia. Kinematics were measured during movements of both upper limbs in a patient group (n = 11, age = 17.5 ± 5 years), and a typically developing control group (n = 9, age = 16.6 ± 5 years). Hand aperture was computed to study the coordination of reach and grasp. Time-varying joint synergies within one upper limb were calculated using a novel technique based on principal component analysis to study intra-limb coordination. In the non-dominant arm, results indicate reduced coordination between reach and grasp in patients who could not lift the grasped object compared to those who could lift it. Lifters exhibit incoordination in distal upper extremity joints later in the movement and non-lifters lacked coordination throughout the movement and in the whole upper limb. The amount of atypical coordination correlates with dystonia severity in patients. Reduced coordination during movement may reflect deficits in the execution of simultaneous movements, motor planning, or muscle activation. Rehabilitation efforts can focus on particular time points when kinematic patterns deviate abnormally to improve functional reaching in individuals with childhood-onset dystonia. PMID:26208359

Coordination of Reach-to-Grasp Kinematics in Individuals With Childhood-Onset Dystonia Due to Hemiplegic Cerebral Palsy.

PubMed

Kukke, Sahana N; Curatalo, Lindsey A; de Campos, Ana Carolina; Hallett, Mark; Alter, Katharine E; Damiano, Diane L

2016-05-01

Functional reaching is impaired in dystonia. Here, we analyze upper extremity kinematics to quantify timing and coordination abnormalities during unimanual reach-to-grasp movements in individuals with childhood-onset unilateral wrist dystonia. Kinematics were measured during movements of both upper limbs in a patient group ( n = 11, age = 17.5 ±5 years), and a typically developing control group ( n = 9, age = 16.6 ±5 years). Hand aperture was computed to study the coordination of reach and grasp. Time-varying joint synergies within one upper limb were calculated using a novel technique based on principal component analysis to study intra-limb coordination. In the non-dominant arm, results indicate reduced coordination between reach and grasp in patients who could not lift the grasped object compared to those who could lift it. Lifters exhibit incoordination in distal upper extremity joints later in the movement and non-lifters lacked coordination throughout the movement and in the whole upper limb. The amount of atypical coordination correlates with dystonia severity in patients. Reduced coordination during movement may reflect deficits in the execution of simultaneous movements, motor planning, or muscle activation. Rehabilitation efforts can focus on particular time points when kinematic patterns deviate abnormally to improve functional reaching in individuals with childhood-onset dystonia.

Functional outcomes of intramuscular botulinum toxin type a and occupational therapy in the upper limbs of children with cerebral palsy: a randomized controlled trial.

PubMed

Wallen, Margaret; O'Flaherty, Stephen J; Waugh, Mary-Clare A

2007-01-01

To investigate the functional outcomes of botulinum toxin type A (BTX-A) injections to the upper limb in combination with occupational therapy (OT) in children with cerebral palsy (CP). Randomized controlled trial with follow-up at 2 weeks, 3 months, and 6 months. Specialist outpatient physical disabilities clinic within a public pediatric teaching hospital. Eighty children with spastic quadriplegic, triplegic, or hemiplegic CP from these clinics were randomly assigned to BTX-A plus OT, BTX-A alone, OT alone, or a no-treatment control group. Single set of BTX-A (Botox) injections and 12 weeks of OT. Canadian Occupational Performance Measure (COPM) and Goal Attainment Scale (GAS). The combination of BTX-A and OT resulted in accelerated attainment of functional goals measured by the COPM and GAS. There were no differences between groups on the Melbourne Assessment of Unilateral Upper Limb Function, Quality of Upper Extremity Skills Test, Pediatric Evaluation of Disability Inventory, Child Health Questionnaire, or active and passive range of motion. As expected, there was a significant reduction in muscle tone at follow-up 2 weeks after injection, which returned to baseline level by 6 months. OT enhanced individualized functional outcomes following BTX-A injections in the upper limbs of children with CP.

A revision of hominin fossil teeth from Fontana Ranuccio (Middle Pleistocene, Anagni, Frosinone, Italy).

PubMed

Rubini, Mauro; Cerroni, Vittorio; Festa, Giulia; Sardella, Raffaele; Zaio, Paola

2014-12-01

The Fontana Ranuccio hominin teeth (FR, Latium, Italy) are dated to the Middle Pleistocene. In previous studies these teeth were classified as two lower (left and right) second molars, one lower left central incisor and a badly worn incisor crown, the exact position of which could not be determined. In 2012 these remains were acquired by the Anthropological Service of S.B.A.L. (Italian Ministry of Culture) and for this reason re-analysed. In a thorough revision we have reassessed them both morphologically and dimensionally as two lower (left and right) first molars, one lower left lateral incisor and a possible upper left canine. The comparison with penecontemporaneous and diachronic samples shows that the Fontana Ranuccio teeth are morphologically similar to Atapuerca-Sima de los Huesos, Arago XIII and Neanderthal samples. Copyright © 2014 Elsevier Ltd. All rights reserved.

Myositis ossificans traumatica of the medial pterygoid muscle following a third molar extraction.

PubMed

Torres, A M; Nardis, A C; da Silva, R A; Savioli, C

2015-04-01

Myositis ossificans (MO) is a rare disease involving heterotopic ossification in the muscle or soft tissue. Myositis ossificans traumatica (MOT) disease presents as a calcification within the injured muscle, resulting from a single or repetitive injury. There are few reports of MOT in the masticatory muscles. The case of a patient with MOT in the medial pterygoid muscle caused by a complication related to the extraction of an erupted upper third molar is reported. The major symptom was severe trismus. Despite surgical treatment, the disease relapsed. MOT can lead to serious consequences for the patient. Its aetiopathogenesis needs to be better understood, so that the most appropriate treatment is established and relapses are minimized. This will improve the quality of life of these patients. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Anatomoradiographic description of the teeth of pacas bred in captivity (Agouti paca, Linnaeus, 1766).

PubMed

Oliveira, F S; Canola, J C; Oliveira, P T; Pécora, J D; Capelli, A

2006-10-01

Two newborn males, two adult males 9 and 72 months old, one newborn female and two adult females of 30 and 54 months old pacas were used. Animals were radiographed on lateral recumbency, teeth were extracted and the vestibulolingual and mesiodistal lengths were achieved at the occlusal surface, besides the longitudinal length. The lower incisors presented greater length in relation to the other ones and sinuous shape; the upper incisors, relatively smaller, are practically straight. There is no canine tooth, and after a great diastema there is one premolar and three molars in each hemiarcade. In adult pacas, the enamel of incisors presents yellowish colour, mainly in the labial surface; in the premolars and molars, the enamel is present as internal sheets disposed nearly in a parallel way and in vestibulolingual direction, through practically all the dental length, which provides several joined teeth aspect.

Assessment of Low-Level Laser Therapy Effects After Extraction of Impacted Lower Third Molar Surgery

PubMed Central

Raiesian, Shahrokh; Khani, Mehdi; Khiabani, Kazem; Hemmati, Ershad; Pouretezad, Mohammad

2017-01-01

Introduction: The aim of this study was to assess the effect of low-level laser therapy (LLLT) on pain, swelling and maximum mouth opening in patients undergoing third molar surgery. Methods: A prospective, randomized double-blind study was undertaken on 44 patients at the Dental School, Ahvaz Jundishapur University of Medical Sciences, in 2015. A low-level laser was randomly applied on one of the two sides after surgery of 15 patients. The experimental side received 18 J/cm2 of energy density, wavelength of 980 nm, and output power of 1.8 W. On the control side, a hand-piece was applied intra-orally, but laser was not activated. In addition, in order to evaluate trismus, 13 patients were treated by unilateral laser therapy and 16 patients did not receive laser therapy at all. The laser was administered intraorally on two points of vestibular and lingual sides at 1 cm from the surgery site, and extraorally at the emergence of the masseter muscle, immediately after surgery, and repeated 24 hours later. The pain, swelling and maximum mouth opening (MMO) were compared between the two groups at 24 hours and a week after surgery. Results: The mean score of pain 24 hours after surgery in the laser therapy group (2.3 ± 3.5) was significantly lower than the mean score of pain in the drug therapy (4.19 ± 3.09) (P = 0.036). Moreover, the mean score of pain at one week after surgery in the laser therapy group (0.13 ± 2.33) was significantly lower than the drug therapy group (1.43 ± 2.45) (P = 0.046). The amount of swelling according to different measurements did not significantly differ between the two groups neither at 24 hours nor at 1 week after surgery. Conclusion: Our findings showed that LLLT was useful in reducing pain and could slightly reduce swelling compared to drug therapy in impacted third molar surgery. PMID:28912943

Tooth Eruption Results from Bone Remodelling Driven by Bite Forces Sensed by Soft Tissue Dental Follicles: A Finite Element Analysis

PubMed Central

Sarrafpour, Babak; Swain, Michael; Li, Qing; Zoellner, Hans

2013-01-01

Intermittent tongue, lip and cheek forces influence precise tooth position, so we here examine the possibility that tissue remodelling driven by functional bite-force-induced jaw-strain accounts for tooth eruption. Notably, although a separate true ‘eruptive force’ is widely assumed, there is little direct evidence for such a force. We constructed a three dimensional finite element model from axial computerized tomography of an 8 year old child mandible containing 12 erupted and 8 unerupted teeth. Tissues modelled included: cortical bone, cancellous bone, soft tissue dental follicle, periodontal ligament, enamel, dentine, pulp and articular cartilage. Strain and hydrostatic stress during incisive and unilateral molar bite force were modelled, with force applied via medial and lateral pterygoid, temporalis, masseter and digastric muscles. Strain was maximal in the soft tissue follicle as opposed to surrounding bone, consistent with follicle as an effective mechanosensor. Initial numerical analysis of dental follicle soft tissue overlying crowns and beneath the roots of unerupted teeth was of volume and hydrostatic stress. To numerically evaluate biological significance of differing hydrostatic stress levels normalized for variable finite element volume, ‘biological response units’ in Nmm were defined and calculated by multiplication of hydrostatic stress and volume for each finite element. Graphical representations revealed similar overall responses for individual teeth regardless if incisive or right molar bite force was studied. There was general compression in the soft tissues over crowns of most unerupted teeth, and general tension in the soft tissues beneath roots. Not conforming to this pattern were the unerupted second molars, which do not erupt at this developmental stage. Data support a new hypothesis for tooth eruption, in which the follicular soft tissues detect bite-force-induced bone-strain, and direct bone remodelling at the inner surface of the surrounding bony crypt, with the effect of enabling tooth eruption into the mouth. PMID:23554928

Tooth eruption results from bone remodelling driven by bite forces sensed by soft tissue dental follicles: a finite element analysis.

PubMed

Sarrafpour, Babak; Swain, Michael; Li, Qing; Zoellner, Hans

2013-01-01

Intermittent tongue, lip and cheek forces influence precise tooth position, so we here examine the possibility that tissue remodelling driven by functional bite-force-induced jaw-strain accounts for tooth eruption. Notably, although a separate true 'eruptive force' is widely assumed, there is little direct evidence for such a force. We constructed a three dimensional finite element model from axial computerized tomography of an 8 year old child mandible containing 12 erupted and 8 unerupted teeth. Tissues modelled included: cortical bone, cancellous bone, soft tissue dental follicle, periodontal ligament, enamel, dentine, pulp and articular cartilage. Strain and hydrostatic stress during incisive and unilateral molar bite force were modelled, with force applied via medial and lateral pterygoid, temporalis, masseter and digastric muscles. Strain was maximal in the soft tissue follicle as opposed to surrounding bone, consistent with follicle as an effective mechanosensor. Initial numerical analysis of dental follicle soft tissue overlying crowns and beneath the roots of unerupted teeth was of volume and hydrostatic stress. To numerically evaluate biological significance of differing hydrostatic stress levels normalized for variable finite element volume, 'biological response units' in Nmm were defined and calculated by multiplication of hydrostatic stress and volume for each finite element. Graphical representations revealed similar overall responses for individual teeth regardless if incisive or right molar bite force was studied. There was general compression in the soft tissues over crowns of most unerupted teeth, and general tension in the soft tissues beneath roots. Not conforming to this pattern were the unerupted second molars, which do not erupt at this developmental stage. Data support a new hypothesis for tooth eruption, in which the follicular soft tissues detect bite-force-induced bone-strain, and direct bone remodelling at the inner surface of the surrounding bony crypt, with the effect of enabling tooth eruption into the mouth.

Influence of shovel-shaped incisors on the dental arch crowding in Mongolian females.

PubMed

Hasegawa, Yuh; Terada, Kazuto; Kageyama, Ikuo; Tsukada, Shin-ichi; Uzuka, Satoshi; Nakahara, Rizako; Nakahara, Sen

2009-08-01

The aim of this study was to investigate the influences of shovel-shaped incisors on the dental arch crowding in the samples of modern young female adult Mongolians (belonging to the Khalkha-Mogol grouping) ranged between 18.5 and 25.0 years, with a mean age of 20.7 years. Materials in this study comprised of 33 dental casts. Plaster replicas of the A.S.U. system plaques were used to facilitate standardization in scoring and classify shoveling regarding both upper central and lateral incisors. Dimensions of the dental arch namely, overjet, overbite, arch depth, arch width and irregularity index were measured. The correlation between the shovel shape of the central incisor and the lateral incisor was highly significant. Significantly relations were found between the grades of shoveling and the mesiodistal diameters of upper first molars and lower incisors. Positive correlation was admitted between the shoveling and upper arch depth anterior, and upper arch depth. It may be considered that the grades of shoveling are indirectly related with upper and/or lower anterior crowding. Although crowding is looks like an expression of disharmony between teeth and alveolar arch, it may be caused by multiple etiologic factors interacted directly and/or indirectly.

A mongoose remain (Mammalia: Carnivora) from the Upper Irrawaddy sediments, Myanmar and its significance in evolutionary history of Asian herpestids

NASA Astrophysics Data System (ADS)

Egi, Naoko; Thaung-Htike; Zin-Maung-Maung-Thein; Maung-Maung; Nishioka, Yuichiro; Tsubamoto, Takehisa; Ogino, Shintaro; Takai, Masanaru

2011-11-01

A tooth of a mongoose (Mammalia: Carnivora: Herpestidae) was discovered from the Upper Irrawaddy sediments in central Myanmar. The age of the fauna is not older than the mid-Pliocene. It is identified as a right first upper molar of a small species of Urva (formally included in the genus Herpestes) based on its size and shape. The present specimen is the first carnivoran from the Upper Irrawaddy sediments and is the first record of mongooses in the Pliocene and early Pleistocene of Asia. It confirms that mongooses had already dispersed into Southeast Asia by the late Pliocene, being consistent with the previous molecular phylogenetic analyses. The fossil may belong to one of the extant species, but an assignment to a specific species is difficult due to the fragmentary nature of the specimen and the small interspecific differences in dental shape among the Asian mongooses. The size of the tooth suggests that the Irrawaddy specimen is within or close to the clade of Urva auropunctata + javanica + edwardsii, and this taxonomic assignment agrees with the geographical distribution.

Innovative evaluation of local injective gel of curcumin on the orthodontic tooth movement in rats

PubMed Central

Asefi, Sohrab; Seifi, Massoud; Fard, Ghazal Hatami; Lotfi, Ali

2018-01-01

Background: Curcumin is the most active compound in turmeric. It can suppress the nuclear factor kappa-light-chain-enhancer of activated B cells pathway and prevent the osteoclastogenesis procedure. This study aimed to be the first to evaluate the effect of curcumin on the rate of orthodontic tooth movement (OTM). Materials and Methods: Forty rats were used as follows in each group: (1) negative control: Did not receive any appliance or injection; (2) positive control: received 0.03 cc normal saline and appliance; (3) gelatin plus curcumin (G): Received 0.03 cc hydrogel and appliance; and (4) chitosan plus curcumin (Ch): Received 0.03 cc hydrogel and appliance. They were anesthetized and closed nickel-titanium coil springs were installed between the first molars and central incisors unilaterally as the orthodontic appliance. After 21 days, the rats were decapitated, and the distance between the first and second molars was measured by a leaf gauge. Howship's lacunae, blood vessels, osteoclast-like cells, and root resorption lacunae were evaluated in the histological analysis. Data were analyzed by one-way ANOVA, Tukey's test, and t-test (P < 0.05 consider significant). Results: No significant difference was found in OTM between groups delivered orthodontic forces. Curcumin inhibited root and bone resorption, osteoclastic recruitment, and angiogenesis significantly. Conclusion: Curcumin had no significant inhibitory effect on OTM. While it had a significant role on decreasing bone or root resorption (P > 0.05). PMID:29497446

Poland's syndrome and military personnel.

PubMed

Phaltankar, P M; Langdon, J; Clasper, J

2003-12-01

We describe three cases of undiagnosed Poland's syndrome in Army personnel and discuss their fitness according to the PULHHEEMS system. This syndrome has variable clinical features that include unilateral chest wall and upper limb abnormalities. The syndrome is not hereditary and is of unknown origin. If the syndrome was diagnosed prior to enlistment the potential recruit would normally be graded P8, and unfit to enlist. However, these individuals had managed to pass routine medical examination as well as successfully complete basic training. The suitability of continuation in the army of personnel with Poland's syndrome is discussed.

Ultrasonic scissors-assisted 'open-book' thyroidectomy in massive goiter compressing airway and causing unilateral vocal cord paralysis.

PubMed

M, Irfan; Yaroko, Ali Ango; S M, Najeb; Periasamy, Centilnathan

2013-04-01

A massive goiter may constrict the trachea resulting in shortness of breath. Recurrent laryngeal nerve compression may cause vocal cord paralysis. We highlight a case of a 62- year-old female with a 30 year history of an anterior neck swelling gradually increasing in size. She presented with acute symptoms of upper airway obstruction and voice changes. Emergency thyroidectomy was performed by dividing the middle part of the gland using ultrasonic scissors. The recovery was uneventful and the patient regained normal vocal cord function post operatively.

Validation of reaching in a virtual environment in typically developing children and children with mild unilateral cerebral palsy.

PubMed

Robert, Maxime T; Levin, Mindy F

2018-04-01

To compare three reaching movements made in two planes between a low-cost, game-based virtual reality and a matched physical environment in typically developing children and children with cerebral palsy (CP). To determine if differences in kinematics are related to sensory deficits. An observational study in which 27 children (typically developing, n=17, mean age 13y, [SD] 2y 2mo, range 9y 3mo-17y 2mo; CP, n=10, mean age 13y 8mo, [SD] 1y 8mo, range 11y 1mo-17y 1mo, Manual Ability Classification System levels I-II) performed 15 trials of three gestures in each of a virtual reality and a matched physical environment. Upper-limb and trunk kinematics were recorded using an electromagnetic system (G4, Polhemus, six markers, 120Hz). Compared to the physical environment, movements in virtual reality made by typically developing children were slower (p=0.002), and involved less trunk flexion (p=0.002) and rotation (p=0.026). Children with CP had more curved trajectories (p=0.005) and used less trunk flexion (p=0.003) and rotation (p=0.005). Elbow and shoulder kinematics differed from 2.8% to 155.4% between environments in both groups. Between groups, there were small, clinically insignificant differences with only the vertical gesture being longer in typically developing children. Children with CP who had greater tactile impairment used more trunk displacement. Clinicians and researchers need to be aware of differences in movement variables when setting goals or designing protocols for improving reaching in children with CP using low-cost, game-based virtual reality systems. Upper-limb kinematics differed in each group when reaching in physical versus virtual environments. There were small differences in movements made by children with mild unilateral cerebral palsy (CP) compared to typically developing children. Differences in reaching kinematics should be considered when goal setting using virtual reality interventions for children with mild unilateral CP. © 2018 Mac Keith Press.

Translation, reliability, and clinical utility of the Melbourne Assessment 2.

PubMed

Gerber, Corinna N; Plebani, Anael; Labruyère, Rob

2017-10-12

The aims were to (i) provide a German translation of the Melbourne Assessment 2 (MA2), a quantitative test to measure unilateral upper limb function in children with neurological disabilities and (ii) to evaluate its reliability and aspects of clinical utility. After its translation into German and approval of the back translation by the original authors, the MA2 was performed and videotaped twice with 30 children with neuromotor disorders. For each participant, two raters scored the video of the first test for inter-rater reliability. To determine test-retest reliability, one rater additionally scored the video of the second test while the other rater repeated the scoring of the first video to evaluate intra-rater reliability. Time needed for rater training, test administration, and scoring was recorded. The four subscale scores showed excellent intra-, inter-rater, and test-retest reliability with intraclass correlation coefficients of 0.90-1.00 (95%-confidence intervals 0.78-1.00). Score items revealed substantial to almost perfect intra-rater reliability (weighted kappa k w  = 0.66-1.00) for the more affected side. Score item inter-rater and test-retest reliability of the same extremity were, with one exception, moderate to almost perfect (k w  = 0.42-0.97; k w  = 0.40-0.89). Furthermore, the MA2 was feasible and acceptable for patients and clinicians. The MA2 showed excellent subscale and moderate to almost perfect score item reliability. Implications for Rehabilitation There is a lack of high-quality studies about psychometric properties of upper limb measurement tools in the neuropediatric population. The Melbourne Assessment 2 is a promising tool for reliable measurement of unilateral upper limb movement quality in the neuropediatric population. The Melbourne Assessment 2 is acceptable and practicable to therapists and patients for routine use in clinical care.

Comparative Analysis between Total Disc Replacement and Posterior Foraminotomy for Posterolateral Soft Disc Herniation with Unilateral Radiculopathy : Clinical and Biomechanical Results of a Minimum 5 Years Follow-up

PubMed Central

Kim, Kyoung-Tae; Cho, Dae-Chul; Sung, Joo-Kyung; Kim, Young-Baeg; Kim, Du Hwan

2017-01-01

Objective To compare the clinical outcomes and biomechanical effects of total disc replacement (TDR) and posterior cervical foraminotomy (PCF) and to propose relative inclusion criteria. Methods Thirty-five patients who underwent surgery between 2006 and 2008 were included. All patients had single-level disease and only radiculopathy. The overall sagittal balance and angle and height of a functional segmental unit (FSU; upper and lower vertebral body of the operative lesion) were assessed by preoperative and follow-up radiographs. C2–7 range of motion (ROM), FSU, and the adjacent segment were also checked. Results The clinical outcome of TDR (group A) was tended to be superior to that of PCF (group B) without statistical significance. In the group A, preoperative and postoperative upper adjacent segment level motion values were 8.6±2.3 and 8.4±2.0, and lower level motion values were 8.4±2.2 and 8.3±1.9. Preoperative and postoperative FSU heights were 37.0±2.1 and 37.1±1.8. In the group B, upper level adjacent segment motion values were 8.1±2.6 and 8.2±2.8, and lower level motion values were 6.5±3.3 and 6.3±3.1. FSU heights were 37.1±2.0 and 36.2±1.8. The postoperative FSU motion and height changes were significant (p<0.05). The patient’s satisfaction rates for surgery were 88.2% in group A and 88.8% in group B. Conclusion TDR and PCF have favorable outcomes in patients with unilateral soft disc herniation. However, patients have different biomechanical backgrounds, so the patient’s biomechanical characteristics and economic status should be understood and treated using the optimal procedure. PMID:28061490

Prevalence of Apical Periodontitis in Endodontically Treated Premolars and Molars with Untreated Canal: A Cone-beam Computed Tomography Study.

PubMed

Karabucak, Bekir; Bunes, Alf; Chehoud, Christel; Kohli, Meetu R; Setzer, Frank

2016-04-01

The purpose of this retrospective cohort study was to evaluate the incidence of missed canals in endodontically treated teeth in the Greater Philadelphia area patient population and to evaluate the effect of untreated canals on endodontic outcome. A total of 1397 cone-beam computed tomography (CBCT) volumes taken from January 2013 to July 2015 were investigated. Limited view CBCT images were taken with Kodak 9000 3D System field of view at voxel size, 76 μm or Morita Veraviewpocs 3D F40 field of view at voxel size, 125 μm. All root canal-treated premolars and molars were included in the study. Unfilled canals appearing from cementoenamel junction to apex including splitting from a main canal at coronal, mid, or apical third were defined as missed-untreated canal. A periapical lesion was diagnosed when disruption of the lamina dura was detected and the low density area associated with the radiographic apex was at least twice the width of the periodontal ligament space. The overall incidence of missed canals was 23.04%. The incidence of missed canals per tooth was highest in tooth #14 at 46.5% and tooth #3 at 41.3%. The incidence of missed canals was highest in the upper molars at 40.1% and lowest in the upper premolars at 9.5%. There was a significant difference in lesion prevalence when a canal was missed-untreated (P < .05). Teeth with a missed canal were 4.38 times more likely to be associated with a lesion. Limited field-of-view CBCT should be examined before any endodontic retreatment to identify missed canals. This knowledge would not only help clinicians to locate missed canals clinically but would also help in deciding the surgical approach. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

The home stroke rehabilitation and monitoring system trial: a randomized controlled trial.

PubMed

Linder, Susan M; Rosenfeldt, Anson B; Reiss, Aimee; Buchanan, Sharon; Sahu, Komal; Bay, Curtis R; Wolf, Steven L; Alberts, Jay L

2013-01-01

Because many individuals poststroke lack access to the quality and intensity of rehabilitation to improve upper extremity motor function, a home-based robotic-assisted upper extremity rehabilitation device is being paired with an individualized home exercise program. The primary aim of this project is to determine the effectiveness of robotic-assisted home therapy compared with a home exercise program on upper extremity motor recovery and health-related quality of life for stroke survivors in rural and underserved locations. The secondary aim is to explore whether initial degree of motor function of the upper limb may be a factor in predicting the extent to which patients with stroke may be responsive to a home therapy approach. We hypothesize that the home exercise program intervention, when enhanced with robotic-assisted therapy, will result in significantly better outcomes in motor function and quality of life. A total of 96 participants within six-months of a single, unilateral ischemic, or hemorrhagic stroke will be recruited in this prospective, single-blind, multisite randomized clinical trial. The primary outcome is the change in upper extremity function using the Action Research Arm Test. Secondary outcomes include changes in: upper extremity function (Wolf Motor Function Test), upper extremity impairment (upper extremity portion of the Fugl-Meyer Test), self-reported quality of life (Stroke Impact Scale), and affect (Centers for Epidemiologic Studies Depression Scale). Similar or greater improvements in upper extremity function using the combined robotic home exercise program intervention compared with home exercise program alone will be interpreted as evidence that supports the introduction of in-home technology to augment the recovery of function poststroke. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

Correlation between clinical and radiographic findings on the occurrence of furcation involvement in patients with periodontitis.

PubMed

Gusmão, Estela Santos; Picarte, Ana Carolina Lessa Cavalcanti; Ben Barbosa, Maria Bernadete Cavalcanti; Rösing, Cassiano Kuchenbecker; Cimoes, Renata

2014-01-01

Aim : The aim of the present study was to determine the occurrence of furcation involvement in the molars of patients with chronic periodontitis and correlate clinical and radiographic findings. Seventy subjects aged 35-69 years enrolled for treatment at a periodontics specialization program in Pernambuco, Brazil (EAP-SCDP-ABO/PE) participated in the study, comprising a total of 350 molars examined. The clinical diagnosis of furcation involvement was performed with a horizontal Nabers probe, whereas the radiographic examination was performed with periapical and bite-wing radiographs. The images were analyzed with an X-ray viewer at 3× magnification. The Chi-square test was used, with the level of significance set at 5%. A total of 64.5% individuals presented with furcation involvement, 43.1% of whom had degree II furcation. A significant association (P = 0.0060) was found between tooth type and frequency of furcation involvement. The first lower and upper molars were affected in 64.5 and 58.5% of cases, respectively. Adequate agreement (0.65) was observed between the clinical and radiographic findings. Taking into consideration the method employed and the results obtained, it may be concluded that the clinical and radiographic examinations performed are effective tools for diagnosing furcation involvement in teeth affected with periodontal disease.

New evidence for mammaliaform ear evolution and feeding adaptation in a Jurassic ecosystem

NASA Astrophysics Data System (ADS)

Luo, Zhe-Xi; Meng, Qing-Jin; Grossnickle, David M.; Liu, Di; Neander, April I.; Zhang, Yu-Guang; Ji, Qiang

2017-08-01

Stem mammaliaforms are forerunners to modern mammals, and they achieved considerable ecomorphological diversity in their own right. Recent discoveries suggest that eleutherodontids, a subclade of Haramiyida, were more species-rich during the Jurassic period in Asia than previously recognized. Here we report a new Jurassic eleutherodontid mammaliaform with an unusual mosaic of highly specialized characteristics, and the results of phylogenetic analyses that support the hypothesis that haramiyidans are stem mammaliaforms. The new fossil shows fossilized skin membranes that are interpreted to be for gliding and a mandibular middle ear with a unique character combination previously unknown in mammaliaforms. Incisor replacement is prolonged until well after molars are fully erupted, a timing pattern unique to most other mammaliaforms. In situ molar occlusion and a functional analysis reveal a new mode of dental occlusion: dual mortar-pestle occlusion of opposing upper and lower molars, probably for dual crushing and grinding. This suggests that eleutherodontids are herbivorous, and probably specialized for granivory or feeding on soft plant tissues. The inferred dietary adaptation of eleutherodontid gliders represents a remarkable evolutionary convergence with herbivorous gliders in Theria. These Jurassic fossils represent volant, herbivorous stem mammaliaforms associated with pre-angiosperm plants that appear long before the later, iterative associations between angiosperm plants and volant herbivores in various therian clades.

New evidence for mammaliaform ear evolution and feeding adaptation in a Jurassic ecosystem.

PubMed

Luo, Zhe-Xi; Meng, Qing-Jin; Grossnickle, David M; Liu, Di; Neander, April I; Zhang, Yu-Guang; Ji, Qiang

2017-08-17

Stem mammaliaforms are forerunners to modern mammals, and they achieved considerable ecomorphological diversity in their own right. Recent discoveries suggest that eleutherodontids, a subclade of Haramiyida, were more species-rich during the Jurassic period in Asia than previously recognized. Here we report a new Jurassic eleutherodontid mammaliaform with an unusual mosaic of highly specialized characteristics, and the results of phylogenetic analyses that support the hypothesis that haramiyidans are stem mammaliaforms. The new fossil shows fossilized skin membranes that are interpreted to be for gliding and a mandibular middle ear with a unique character combination previously unknown in mammaliaforms. Incisor replacement is prolonged until well after molars are fully erupted, a timing pattern unique to most other mammaliaforms. In situ molar occlusion and a functional analysis reveal a new mode of dental occlusion: dual mortar-pestle occlusion of opposing upper and lower molars, probably for dual crushing and grinding. This suggests that eleutherodontids are herbivorous, and probably specialized for granivory or feeding on soft plant tissues. The inferred dietary adaptation of eleutherodontid gliders represents a remarkable evolutionary convergence with herbivorous gliders in Theria. These Jurassic fossils represent volant, herbivorous stem mammaliaforms associated with pre-angiosperm plants that appear long before the later, iterative associations between angiosperm plants and volant herbivores in various therian clades.

Consequences of early extraction of compromised first permanent molar: a systematic review.

PubMed

Saber, Afnan M; Altoukhi, Doua H; Horaib, Mariam F; El-Housseiny, Azza A; Alamoudi, Najlaa M; Sabbagh, Heba J

2018-04-05

The aim of this study was to systematically review the literature to determine the sequelae of early extraction of compromised first permanent molars (FPMs) with regard to the skeletal and dental development of 5- to 15-year-old children. Meta-analysis was conducted when applicable. Our research protocol included a search strategy, inclusion/exclusion criteria, and a data extraction plan. The search engines used were PubMed, Scopus, and Science Direct. Study selection was performed independently by three reviewers. Articles published from 1960 to 2017 were reviewed based on inclusion and exclusion criteria. Meta-analysis was performed to compare space closure between upper and lower arches. Eleven studies fulfilled the inclusion criteria. The consequences were decrease in post extraction space, accelerated development and eruption of second permanents molars (SPMs) and third molars, a decrease in caries and/or fillings on the proximal surfaces of adjacent teeth, lingual tipping and retrusion of incisors, and counter clockwise rotation of the occlusal plane. There were several consequences of early extraction of FPMs, which were related to skeletal and dental development. Our systematic review suggests that comprehensive evaluation of the compromised FPMs should be performed before planning an extraction. The ideal time for FPM extraction is when the SPM is at the early bifurcation stage in order to achieve complete closure of the extraction space by the SPM. Benefits should be weighed over the risks to decrease the risk of unfavorable outcomes as much as possible. However, due to the limited evidence on the outcomes and variables that influence them, high-quality prospective studies are needed.

Development of the Hand Assessment for Infants: evidence of internal scale validity.

PubMed

Krumlinde-Sundholm, Lena; Ek, Linda; Sicola, Elisa; Sjöstrand, Lena; Guzzetta, Andrea; Sgandurra, Giuseppina; Cioni, Giovanni; Eliasson, Ann-Christin

2017-12-01

The aim of this study was to develop a descriptive and evaluative assessment of upper limb function for infants aged 3 to 12 months and to investigate its internal scale validity for use with infants at risk of unilateral cerebral palsy. The concepts of the test items and scoring criteria were developed. Internal scale validity and aspects of reliability were investigated on the basis of 156 assessments of infants at 3 to 12 months corrected age (mean 7.2mo, SD 2.5) with signs of asymmetric hand use. Rasch measurement model analysis and non-parametric statistics were used. The new test, the Hand Assessment for Infants (HAI), consists of 12 unimanual and five bimanual items, each scored on a 3-point rating scale. It demonstrated a unidimensional construct and good fit to the Rasch model requirements. The excellent person reliability enabled person separation to six significant ability strata. The HAI produced an interval-level measure of bilateral hand use as well as unimanual scores of each hand, allowing a quantification of possible asymmetry expressed as an asymmetry index. The HAI can be considered a valid assessment tool for measuring bilateral hand use and quantifying side difference between hands among infants at risk of developing unilateral cerebral palsy. The Hand Assessment for Infants (HAI) measures the use of both hands and quantifies a possible asymmetry of hand use. HAI is valid for infants at 3 to 12 months corrected age at risk of unilateral cerebral palsy. © 2017 Mac Keith Press.

Enhanced motor learning with bilateral transcranial direct current stimulation: Impact of polarity or current flow direction?

PubMed

Naros, Georgios; Geyer, Marc; Koch, Susanne; Mayr, Lena; Ellinger, Tabea; Grimm, Florian; Gharabaghi, Alireza

2016-04-01

Bilateral transcranial direct current stimulation (TDCS) is superior to unilateral TDCS when targeting motor learning. This effect could be related to either the current flow direction or additive polarity-specific effects on each hemisphere. This sham-controlled randomized study included fifty right-handed healthy subjects in a parallel-group design who performed an exoskeleton-based motor task of the proximal left arm on three consecutive days. Prior to training, we applied either sham, right anodal (a-TDCS), left cathodal (c-TDCS), concurrent a-TDCS and c-TDCS with two independent current sources and return electrodes (double source (ds)-TDCS) or classical bilateral stimulation (bi-TDCS). Motor performance improved over time for both unilateral (a-TDCS, c-TDCS) and bilateral (bi-TDCS, ds-TDCS) TDCS montages. However, only the two bilateral paradigms led to an improvement of the final motor performance at the end of the training period as compared to the sham condition. There was no difference between the two bilateral stimulation conditions (bi-TDCS, ds-TDCS). Bilateral TDCS is more effective than unilateral stimulation due to its polarity-specific effects on each hemisphere rather than due to its current flow direction. This study is the first systematic evaluation of stimulation polarity and current flow direction of bi-hemispheric motor cortex TDCS on motor learning of proximal upper limb muscles. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Habilitation of Patients with Congenital Malformations Associated with Thalidomide: Surgery of Limb Defects

PubMed Central

Hall, John E.

1963-01-01

The deformities commonly seen in “thalidomide babies” are described. These vary from relatively uncomplicated radial-ray defects to complete phocomelia of all four extremities. It is suggested that the care of these children is best carried out in a clinic accustomed to dealing with juvenile amputee problems. A plea is made for very early fitting of upper-extremity prostheses (at approximately three months of age) in cases of unilateral upper-limb deficiencies. A “bucket” for sitting should be supplied for children with quadrilateral phocomelia to sit in when they reach seven or eight months of age. Children with severe upper-limb malformations will be candidates for some form of externally powered prostheses. ImagesFig. 1a and 1bFig. 2a and 2bFig. 3a and 3bFig. 4a and 4bFig. 5a, b and cFig. 6a and 6bFig. 7Fig. 8Fig. 9a and 9bFig. 10a,bFig. 10c and d PMID:13952105

Radiographic Study of the Prevalence and Distribution of Hypodontia Associated with Unilateral and Bilateral Clef Lip and Palate in a Hungarian Population

PubMed Central

Berniczei-Roykó, Ádám; Tappe, Jan-Hendrik; Krinner, Axel; Gredes, Tomasz; Végh, András; Gábor, Katona; Linkowska-Świdzińska, Kamila; Botzenhart, Ute Ulrike

2016-01-01

Background Cleft defects are one of the most frequent birth-deformities of the orofacial region and they are commonly associated with anomalies of the tooth structure, size, shape, formation, eruption, and tooth number. The aim of our study was to evaluate the prevalence, distribution, and potential association of combined hypodontia in cleft-affected patients with regard to all types of teeth in both jaws in the permanent dentition. Material/Methods This retrospective radiographic analysis included patients with various types of clefts treated orthodontically in the Department of Orofacial Orthopedics and Orthodontics at Heim Pàl Children’s Hospital, Budapest. There were 150 patients (84 males, 66 females) with non-syndromic unilateral (UCLP; n=120 patients) or bilateral (BCLP; n=30 patients) cleft formation (lip, alveolus and palate) who met the inclusion criteria. Statistical analysis was performed using the chi-square test and Fisher’s exact test (significance level p<0.05). Results Hypodontia was significantly more frequent in patients with cleft-sided lateral incisor (104 patients, 69%), with a total of 235 missing teeth, followed by the second premolars of the upper and lower jaw. A significant correlation of congenital missing teeth was observed in left-sided clefts between the upper and lower second premolar in the cleft area. Conclusions Hypodontia inside and outside the cleft area was frequently observed. This should affect the therapy plans, especially if the cleft-sided premolar is also absent. Further comprehensive research including numerous random samples is necessary for better estimating other possible associations. PMID:27767023

Minimally invasive management with holmium laser in total urinary tract calculi.

PubMed

Zhang, Xiao; Yu, Jianjun; Yang, Ranxing

2013-05-01

The purpose of this article was to study the management of total urinary tract calculi using holmium laser minimally invasive techniques. It is rare for patients to present kidney stones, ureteral stones, and bladder stones simultaneously, and their treatment is considered to be complicated and difficult, specifically by minimally invasive techniques. We collected seven cases of total urinary tract calculi from May 2007 to September 2012. Three cases were unilateral, and the others were bilateral. All of the cases presented calculus in the bladder, ureter, and kidney, which were secondary to the long-term indwelling double J stent or lower urinary obstruction. Extracorporeal shock-wave lithotripsy (SWL) was administered first, followed by the operation. For patients with bilateral calculi, at one stage, ureteroscopic lithotripsy (URL) with holmium laser was performed in all four cases to remove the bladder and bilateral ureter stones. Then, all patients underwent percutaneous nephrolithotomy (PCNL) with holmium procedures to address the bilateral kidney and upper ureter stones at the second stage. The indwelling double J stents were removed at the same time. For the patients with unilateral calculi, we performed a single operation, but it was conducted using the same treatment sequence as the bilateral procedure. The related symptoms in all cases disappeared after the operation. Re-examination showed that the stones were nearly dissolved and that renal function was recovered. URL with holmium laser for the bladder and ureters combined with PCNL to dissolve kidney and upper ureteral stones could be the ideal choice for the treatment of total urinary tract calculi.

Treatment of a supernumerary large breast with medial pedicle reduction mammaplasty.

PubMed

Cinpolat, Anı; Bektas, Gamze; Seyhan, Tamer; Ozad, Ulvan; Coskunfirat, O Koray

2013-08-01

Accessory breast tissues including nipples, areolas, and glandular tissue may develop on the chest in addition to two normal breasts. An accessory breast with a complete ductal system, areola, and nipple is termed a "supernumerary breast." Supernumerary nipples are fairly common, but complete supernumerary breasts are rare. This report describes an 18-year-old woman who presented with a complete supernumerary breast including a nipple-areola complex located on the upper outer quadrant of her left breast and causing severe breast asymmetry. She was referred to the authors for aesthetic reasons. Unilateral reduction mammaplasty was performed to remove the supernumerary breast and correct the breast asymmetry. The medial pedicle Wise technique was used for en bloc resection of the ectopic breast, including the nipple-areola complex together with the upper outer breast quadrant. The woman's postoperative course was uneventful. At 8 months after surgery, she was very satisfied with the results. Ectopic breast tissue can be treated by a variety of methods such as liposuction or excision. However, breast deformation because of a complete supernumerary breast is very rare, and research on the treatment of such patients is lacking. No reports describing surgical treatment for this condition were identified in the literature. The authors suggest that unilateral breast reduction is the most appropriate treatment, allowing excision of the accessory tissues, with the best possible cosmetic outcome. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Microsurgical refinements with the use of internal mammary (IM) perforators as recipient vessels in transverse upper gracilis (TUG) autologous breast reconstruction

PubMed Central

Libondi, Guido; Ramakrishnan, Venkat

2017-01-01

Background The transverse upper gracilis (TUG) flap is the senior authors’ second choice for autologous breast reconstruction when the DIEP flap is not available. It provides durable, pliable tissue with well hidden scars. The main criticism of this flap is the limited volume, donor site complications, short pedicle and vessel mismatch depending on which recipient vessels are used. We described methods of reducing vessel mismatch, complications of venous coupler and refinements to help give a more superior aesthetic outcome. Methods We describe several maneuvers to help reduce vessel mismatch with the use of the internal mammary (IM) perforator vessels with a modification of the Harashina fish-mouth technique or the use of a vessel bifurcation to increase vessel diameter. We also describe the optimum method of perforator preparation and potential methods to prevent palpable venous couplers. The author’s describe their case series of 14 TUG flaps to reconstruct 13 breasts in 12 patients. Results Eight unilateral, 2 partial breast reconstruction, 1 bilateral and 1 bilateral TUG flap for a unilateral reconstruction was carried out. All flaps survived with one partial flap necrosis, one donor site seroma and two cases of palpable/tender venous couplers. The mean reconstructed breast was 320 grams. Conclusions The TUG flap is a reconstructive challenge, but with correct planning a good aesthetic outcome is possible. The IM perforator is our first choice recipient vessel in TUG breast reconstructions. With meticulous preparation and by overcoming vessel mismatch the use of this recipient vessel is a reliable option. PMID:28861378

Periodontal evaluation in patients undergoing maxillary expansion.

PubMed

Carmen, M; Marcella, P; Giuseppe, C; Roberto, A

2000-09-01

Maxillary transverse diameter expansion is a treatment various authors have claimed is related to the development of gingival recession on the teeth of the upper arch. The aim of the present study was to compare such an incidence in two different groups of patients: those treated with surgically assisted rapid maxillary expansion and orthopedic expansion, respectively. Both treatments achieved the goal of expanding the transverse dimension (5.3 and 4.4 mm, respectively), but a significant difference was shown by the chi 2 test for the incidence of gingival recession of premolar/molar upper teeth, more than double for the latter than for the former. Therefore, surgically assisted rapid maxillary expansion seems to be an orthodontically effective procedure, safer than the orthopedic treatment regarding the possible development of mucogingival problems.

Upper Limb Absence: Predictors of Work Participation and Work Productivity.

PubMed

Postema, Sietke G; Bongers, Raoul M; Brouwers, Michael A; Burger, Helena; Norling-Hermansson, Liselotte M; Reneman, Michiel F; Dijkstra, Pieter U; van der Sluis, Corry K

2016-06-01

To analyze work participation, work productivity, contributing factors, and physical work demands of individuals with upper limb absence (ULA). Cross-sectional study: postal survey (response rate, 45%). Twelve rehabilitation centers and orthopedic workshops. Individuals (n=207) with unilateral transverse upper limb reduction deficiency (RD) or acquired amputation (AA), at or proximal to the carpal level, between the ages of 18 and 65 years, and a convenience sample of control subjects (n=90) matched on age and sex. Not applicable. Employment status, self-reported work productivity measured with the Quality-Quantity method, and self-reported upper extremity work demands measured with the Upper Extremity Work Demands scale. Seventy-four percent of the individuals with RD and 57% of the individuals with AA were employed (vs 82% of the control group and 66% of the general population). Male sex, younger age, a medium or higher level of education, prosthesis use, and good general health were predictors of work participation. Work productivity was similar to that of the control group. Higher work productivity was inversely related to musculoskeletal complaint-related pain. When having predominantly mentally demanding work, individuals with ULA perceived higher upper extremity work demands compared with controls. Work participation of individuals with RD was slightly higher compared with that of the general population, whereas employment rates of individuals with AA were slightly lower. Furthermore, work productivity did not differ between individuals with RD, AA, and controls. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Periocular mexametric melanin and erythema indexes in adult glaucoma patients treated with topical prostaglandin analogs.

PubMed

Duman, Nilay; Duman, Reşat; Yavaş, Güliz Fatma; Doğruk Kaçar, Seval; Özuğuz, Pınar; Çetinkaya, Ersan

2017-03-01

Although topical prostaglandin analogs (PGAs) have been previously associated with periocular skin hyperpigmentation, studies using objective clinical methods are lacking. Furthermore changes in periocular skin erythema indexes associated with topical PGAs have not been reported previously. The purpose of the present study was to evaluate periocular melanin and erythema indexes in patients treated with topical PGA using an objective clinical method - Mexameter. About 45 glaucoma patients treated with topical PGA therapy, and 30 age-, and sex-matched controls were enrolled in the study. Demographic data, medical history including duration of therapy, PGA type, involved eye (unilateral, bilateral) were noted, and skin phototypes were evaluated. Melanin and erythema indexes on medial and lateral upper and lower eyelids, and normal skin from the upper cheeks were measured using Mexameter MX-18. The index of difference for lower/upper eyelid was calculated. Reading results of patients and controls were compared. Melanin and erythema indexes of upper/lower eyelids, and the index of differences for upper/lower eyelids were significantly higher in patients despite similar clinical findings (p < 0.05). Duration of therapy and type of PGA were not associated with skin changes (p > 0.05). Both periocular melanin and erythema indexes increased in both upper and lower eyelids due to PGA therapy compared to controls, despite similar clinical findings. Mexametric evaluation is more sensitive than clinical evaluation, and may be used as an objective, sensitive clinical method to evaluate periocular skin changes, even smallest changes, in such patients.

The occurrence of paraesthesia of the maxillary division of the trigeminal nerve after dental local anaesthetic use: a case report.

PubMed

Moorthy, Advan; Stassen, Leo F A

2015-01-01

Paraesthesia can be a complication of surgical intervention. Its occurrence after dental local anaesthetic use is a rare event in general dental practice. Reported cases have mainly described its presentation for the mandibular division of the trigeminal nerve with very few reports for the maxillary division of this nerve. This report describes a case of paraesthesia in the maxillary region following local anaesthetic use prior to removal of an upper molar tooth.

Thermometric diagnosis of peripheral nerve injuries. Assessment of the diagnostic accuracy of a new practical technique.

PubMed

Ya'ish, F M M; Cooper, J P; Craigen, M A C

2007-07-01

The diagnosis of nerve injury using thermotropic liquid crystal temperature strips was compared blindly and prospectively against operative findings in 36 patients requiring surgical exploration for unilateral upper limb lacerations with suspected nerve injury. Thermotropic liquid crystal strips were applied to affected and non-affected segments in both hands in all subjects. A pilot study showed that a simple unilateral laceration without nerve injury results in a cutaneous temperature difference between limbs, but not within each limb. Thus, for detection of a nerve injury, comparison was made against the unaffected nerve distribution in the same hand. Receiver operating characteristic curve analysis showed that an absolute temperature difference > or = 1.0 degrees C was diagnostic of a nerve injury (area under the curve = 0.985, sensitivity = 100%, specificity = 93.8%). Thermotropic liquid crystal strip assessment is a new, reliable and objective method for the diagnosis of traumatic peripheral nerve injuries. If implemented in the acute setting, it could improve the reliability of clinical assessment and reduce the number of negative surgical explorations.

Dental compensation for moderate Class III with vertical growth pattern by extraction of the lower second molars.

PubMed

Jacobs, Collin; Jacobs-Müller, Claudia; Hoffmann, Viviana; Meila, Dan; Erbe, Christina; Krieger, Elena; Wehrbein, Heiner

2012-01-01

Analysis of the effects and side effects of treatment of patients with moderate skeletal Class III and vertical growth pattern by means of extraction of the second molars in the lower jaw. A total of 20 patients with a mean age of 12.9 years were examined retrospectively. Inclusion criteria consisted of a Wits value of 0 to -5, a posterior growth pattern of the mandible (Hasund analysis), an overjet of -2 to 1 mm, and an overbite of 0 to -3 mm. Treatment was performed using a straight-wire appliance. As part of the treatment, the lower second molars were extracted and Class III elastics attached. Cephalograms and orthopantomograms taken before and after treatment were used for evaluation. Treatment resulted in a significant change in the mean overjet from 0.5 mm to 2.1 mm and the attainment of a positive mean overbite of -1.0 mm to 0.9 mm. The occlusal plane rotated anteriorly from 18.8° to 13.7°. The skeletal parameters showed a change in the Wits value from -3.3 mm to -1.4 mm and an anterior mandibular rotation (ML-NSL 35.5° vs. 32.0°). The soft tissues revealed an increase in the distance between the lower lip and the "esthetic line" to the posterior (-2.0 mm vs. -3.9 mm). Dental compensation of moderate skeletal Class III with a tendency to an anterior open bite with vertical growth pattern by extracting the lower second molars, combined with Class III elastics, resulted in an anterior rotation of the occlusal plane and mandible. Eighteen of 20 patients achieved a physiological overjet and positive overbite. A prerequisite for this therapy is the presence of lower wisdom teeth; a potential side effect is elongation of the upper second molars.

Virtual reality gaming in the rehabilitation of the upper extremities post-stroke.

PubMed

Yates, Michael; Kelemen, Arpad; Sik Lanyi, Cecilia

2016-01-01

Occurrences of strokes often result in unilateral upper limb dysfunction. Dysfunctions of this nature frequently persist and can present chronic limitations to activities of daily living. Research into applying virtual reality gaming systems to provide rehabilitation therapy have seen resurgence. Themes explored in stroke rehab for paretic limbs are action observation and imitation, versatility, intensity and repetition and preservation of gains. Fifteen articles were ultimately selected for review. The purpose of this literature review is to compare the various virtual reality gaming modalities in the current literature and ascertain their efficacy. The literature supports the use of virtual reality gaming rehab therapy as equivalent to traditional therapies or as successful augmentation to those therapies. While some degree of rigor was displayed in the literature, small sample sizes, variation in study lengths and therapy durations and unequal controls reduce generalizability and comparability. Future studies should incorporate larger sample sizes and post-intervention follow-up measures.

[Kinesiotaping--treatment of upper limb lymphoedema in patients after breast cancer surgery].

PubMed

Lubińska, Agnieszka; Mosiejczuk, Hanna; Rotter, Iwona

2015-01-01

The aim of this study was to examine the effectiveness of lymphatic kinesiotaping in patients after unilateral breast cancer surgery. Complex decongestive therapy in patients after right-side breast-conserving surgery was done once a week for 2 months (from November to December 2014). It involved manual lymph drainage and lymphatic application of kinesiotaping. An original kinesiology tape (Nitto Denko, Japan) was used for the treatment. Lymphoedema was measured at the beginning and at the end of treatment in centimetres in specific places: metatarsal, wrist, at the mid-length of the forearm, in the elbow and at the mid-length of the upper arm. The volume of oedema was assessed at the beginning and at the end of the treatment. The reduction of lymphoedema in different places. Kinesiotaping may be an alternative method in relation to the use of materials in complex decongestive therapy. However, this technique requires further research.

Expert opinions on success factors for upper-limb prostheses.

PubMed

Schultz, Aimee E; Baade, Susan P; Kuiken, Todd A

2007-01-01

The goal of this study was to gather the opinions of prosthetics experts on the most important factors for the successful use of upper-limb (UL) prostheses, compare them with those of prosthesis users, and ultimately direct research efforts in this field. UL prosthetics experts were asked to compare the importance of the comfort, function, and cosmesis of a prosthetic device for a transhumeral amputee. Categories were subdivided into weight, socket-interface comfort, power, agility, color, and shape. The majority of those who responded viewed comfort as the most important factor for a unilateral amputee and considered socket-interface comfort to be more important than weight. Function was considered to be the most important factor for a bilateral amputee, with agility considered more important than power. Cosmesis was consistently reported as being less important than comfort and function, and shape was considered more important than color.

Strength and coordination training are both effective in reducing the postural tremor amplitude of older adults.

PubMed

Keogh, Justin W L; Morrison, Steve; Barrett, Rod

2010-01-01

The current study investigated the effect of 2 different types of unilateral resistance training on the postural tremor output of 19 neurologically healthy men age 70-80 yr. The strength- (n = 7) and coordination-training (n = 7) groups trained twice a week for 6 wk, performing dumbbell biceps curls, wrist flexions, and wrist extensions, while the control group (n = 5) maintained their normal activities. Changes in index-finger tremor (RMS amplitude, peak, and proportional power) and upper limb muscle coactivation were assessed during 4 postural conditions that were performed separately with the trained and untrained limbs. The 2 training groups experienced significantly greater reductions in mean RMS tremor amplitude, peak, and proportional tremor power 8-12 Hz and upper limb muscle coactivation, as well as greater increases in strength, than the control group. These results further demonstrate the benefits of resistance training for improving function in older adults.

Isolated thalamic tuberculoma presenting as ataxic hemiparesis

PubMed Central

Sahu, Ritesh; Patil, Tushar B; Kori, Prakash; Shukla, Rakesh

2013-01-01

Lacunar syndrome is a neurodeficit secondary to a deep cerebral lesion, usually because of microatheroma of small arteries. Ataxic hemiparesis (AH) is a lacunar syndrome with unilateral pyramidal weakness and ipsilateral ataxia. Thalamic tuberculoma, as a cause of AH, has not been previously described in the literature. We describe an elderly man who presented with left hemiparesis and ipsilateral ataxia. Clinical examination revealed upper motor neuron left facial paresis and left-sided hemiparesis. The patient had incoordination in left upper and lower limbs. Mantoux test was positive and erythrocyte sedimentation rate was elevated. MRI of brain showed a conglomerated hypointense lesion in the right thalamus with a peripheral hyperintensity on T1-weighted imaging and a hyperintense lesion in T2-weighted imaging with significant perilesional oedema, suggesting a tuberculoma. The patient was treated with antitubercular therapy and was symptomatically better at the 9 months follow-up. PMID:23580686

Dentoalveolar growth of patients with complete unilateral cleft lip and palate by early two-stage furlow and push-back method: preliminary results.

PubMed

Kitagawa, Taiji; Kohara, Hiroshi; Sohmura, Taiji; Takahashi, Junzo; Tachimura, Takashi; Wada, Takeshi; Kogo, Mikihiko

2004-09-01

This study examined dentoalveolar growth changes prior to the time of palatoplasty up to 3 years of age by the early two-stage Furlow and push-back methods. Thirty-four Japanese patients with complete unilateral cleft lip and palate (UCLP) treated with either a two-stage Furlow procedure (Furlow group: seven boys, eight girls) from 1998 to 2002 or a push-back procedure (push-back group; 12 boys, 7 girls) from 1993 to 1997. Consecutive plaster models were measured by three-dimensional laser scanner, before primary palatoplasty, before hard palate closure (Furlow group only), and at 3 years of age. Bite measures were taken at 3 years of age. In the Furlow group, arch length, canine width, first and second deciduous molar width and cross-sectional area, and depth and volume at midpoint showed greater growth than in the push-back group. In the Furlow group, the crossbite score was also better than in the push-back group at 3 years of age. In comparison with the push-back group, inhibition of growth impediment in the anterior region was observed in the horizontal direction in the Furlow group. In the midregion, it was observed in the horizontal and vertical directions, and in the posterior region it was observed in the horizontal direction. The results demonstrate that the early two-stage Furlow method showed progressive alveolar growth. Therefore, the early two-stage Furlow method is a more beneficial procedure than the push-back method.

[Simultaneous intrusion and retraction of the anterior teeth using a three-piece base arch].

PubMed

Liu, D; Bai, D; Wang, C; Sun, W; Guo, J; Xi, R

2000-06-01

To evaluate the effects of the three-piece base arch on overbite correction of Class II malocclusion. 20 patients with high angle, flared incisors were treated using a three-piece base arch appliance. The intrusion force of four upper incisors was adjusted to approximately 50 g. The line of force action was 2 mm distally to the resistant center(RC) and the retraction force was 20 g, the right and left posterior segments were joined by a palatal bar. Cephalograms were taken before treatment (T1) and six months after treatment (T2). The upper molars moved mesially 0.60 +/- 0.35 mm and the distance of the vertical extrusion was 0.80 +/- 0.52 mm. The distances of the upper central incisor retraction and intrusion were -4.20 +/- 2.12 mm and 3.10 +/- 0.54 mm respectively. The RC of the central incisor retracted -4.12 +/- 1.96 mm and intruded 3.20 +/- 0.66 mm. The axial inclination of the upper incisor-palatal plane changed from 123.21 degrees +/- 4.26 degrees to 116.00 degrees +/- 3.96 degrees. The three-piece segmented approach can effectively intrude and retract the upper anterior teeth for flared incisors and deep overbite.

Identifying Genetic Sources of Phenotypic Heterogeneity in Orofacial Clefts by Targeted Sequencing.

PubMed

Carlson, Jenna C; Taub, Margaret A; Feingold, Eleanor; Beaty, Terri H; Murray, Jeffrey C; Marazita, Mary L; Leslie, Elizabeth J

2017-07-17

Orofacial clefts (OFCs), including nonsyndromic cleft lip with or without cleft palate (NSCL/P), are common birth defects. NSCL/P is highly heterogeneous with multiple phenotypic presentations. Two common subtypes of NSCL/P are cleft lip (CL) and cleft lip with cleft palate (CLP) which have different population prevalence. Similarly, NSCL/P can be divided into bilateral and unilateral clefts, with unilateral being the most common. Individuals with unilateral NSCL/P are more likely to be affected on the left side of the upper lip, but right side affection also occurs. Moreover, NSCL/P is twice as common in males as in females. The goal of this study is to discover genetic variants that have different effects in case subgroups. We conducted both common variant and rare variant analyses in 1034 individuals of Asian ancestry with NSCL/P, examining four sources of heterogeneity within CL/P: cleft type, sex, laterality, and side. We identified several regions associated with subtype differentiation: cleft type differences in 8q24 (p = 1.00 × 10 -4 ), laterality differences in IRF6, a gene previously implicated with wound healing (p = 2.166 × 10 -4 ), sex differences and side of unilateral CL differences in FGFR2 (p = 3.00 × 10 -4 ; p = 6.00 × 10 -4 ), and sex differences in VAX1 (p < 1.00 × 10 -4 ) among others. Many of the regions associated with phenotypic modification were either adjacent to or overlapping functional elements based on ENCODE chromatin marks and published craniofacial enhancers. We have identified multiple common and rare variants as potential phenotypic modifiers of NSCL/P, and suggest plausible elements responsible for phenotypic heterogeneity, further elucidating the complex genetic architecture of OFCs. Birth Defects Research 109:1030-1038, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Cure width potential for MOD resin composite molar restorations.

PubMed

Palin, William M; Senyilmaz, Dilek P; Marquis, Peter M; Shortall, Adrian C

2008-08-01

To investigate the capability of modern light-curing units exhibiting differences in emission spectra and light source exit window dimensions, for "one-shot" full-width curing of extensive (molar MOD) resin composite restorations. Specimens of Tetric (TT), Tetric Ceram HB (TC), Tetric Evoceram (TE) and Tetric Ceram Bleach (TB) resin composites containing varying ratios of Lucirin (TPO) and/or camphorquinone (CQ) photoinitiators were packed into a bar-shaped mould (12 mm length x 2 mm width x 2 mm thickness). Each product was irradiated using a halogen (Optilux 401; QTH), a conventional LED (LEDemetron; LED) and two so-called "third generation" oval-footprint LED light-curing units (LCUs) of the same model. The latter featured bimodal emission spectra (blue and ultraviolet diodes) with either high (unmodified output) and approximately 50% (modified output) blue light intensity (UltraLume-5; ULs, ULm, respectively). Vickers hardness number was obtained across the lateral extent of the bar at 1mm increments from the centre point on both upper and lower surfaces of the specimens. Significant linear relationships (R(2)=0.71-0.98) for each distance from the central position of all LCUs were identified between measured light intensity and corresponding upper and lower surface hardness values for each product (P<0.05). No significant differences (P>0.05) were recorded in total upper surface hardness of TC or TE cured with LED (68.7+/-3.2 and 70.5+/-2.5) or ULm (56.8+/-2.0 and 57.7+/-2.0). However, upper surface hardness of TT (CQ only) cured with ULm was significantly decreased (P<0.05) compared with other LCUs. When the ratio of hardness at the edge to central positions of the bar-shaped specimens for either surface was calculated, no significant difference (P>0.05) was identified for TB (containing TPO and decreased CQ) cured with either ULs or ULm (P>0.05) and was significantly increased (P<0.05) when cured with ULs compared with LED and QTH. Variability in light intensity across the curing-tip face, spectral output of dental light-curing units and differences in product photoinitiator chemistry all influence curing efficiency significantly across the width of extensive resin composite geometries.

Achieving an esthetic smile with fixed and removal prosthesis using extracoronal castable precision attachments

PubMed Central

Vaidya, Sharad; Kapoor, Charu; Bakshi, Yujika; Bhalla, Sonam

2015-01-01

Satisfactory restoration in a patient with a partially edentulous situation can be challenging especially when unilateral or bilateral posterior segment of teeth is missing. Successful restoration can be done with various conventional and contemporary treatment options. One such treatment modality is attachment-retained cast partial dentures. A key to success for an attachment retained cast partial denture is the strategic selection of teeth for retention. This clinical report discusses rehabilitation of a patient with the help of a combined prosthesis in the upper arch and stud retained overdenture in the lower arch. PMID:26929527

Photosynthesis of organic compounds in the atmosphere of Jupiter

NASA Technical Reports Server (NTRS)

Ferris, J. P.; Chen, C. T.

1975-01-01

An efficient conversion of CH4 to hydrocarbons and HCN takes place when NH3 is photolysed in the presence of CH4, H2, and He using a 184.9 nm light source. The extent of NH3 decomposition after a 1 hr exposure was determined spectrophotometrically; CH4, N2, and C2 and C3 hydrocarbons were detected and analyzed by mass spectrometry. Photolysis of one molar equivalent of NH3 results in the loss of 0.84 molar equivalent of CH4, which apparently reacts with hot hydrogen atoms produced by photolysis. The 8% of the NH3 which is not converted to N2 probably is converted to organic amines and nitrile derivatives. The results indicate that NH3 photolysis is a highly probable mechanism for the conversion of methane to more complex hydrocarbons in the upper atmosphere of Jupiter, and predict the occurrence of HCN, NH2NH2, and higher hydrocarbons in the Jovian atmosphere above the NH3 clouds.

A cast metal core for a deformed implant body: case report.

PubMed

Soeno, Kohyoh; Jimbo, Ryo; Sawase, Takashi; Taira, Yohsuke

2006-12-01

The present report consists of a clinical evaluation of an osseointegrated implant using a cast metal core instead of abutment for a deformed implant body. The intramobile connector insert for the implant in the mandibular left first premolar region broke 7 years after the superstructure was attached to the implant system. The intramobile connector insert was replaced, and the prosthesis was reattached, but the new intramobile connector insert broke again 2 weeks later. A thorough examination confirmed deformation of the upper section of the implant body in the mandibular left first molar region. Breakage of the new intramobile connector insert in the mandibular left first premolar region was believed to be due to deformation of the implant body in the mandibular left first molar region. Therefore, a cast metal core was used to deal with the deformation of the implant body in this region. Although slight bone resorption was observed around the implant body after 5 years, no major problems were found in the implant body itself.

Orthodontic treatment of an anterior openbite with the aid of corticotomy procedure: Case report

PubMed Central

Aljhani, Ali S.; Aldrees, Abdullah M.

2010-01-01

This case report illustrates the orthodontic treatment combined with the corticotomy technique in an adult patient to accelerate tooth movement and shorten the treatment time. The patient was a 22-year-old woman with an anterior open bite and flared and spaced upper and lower incisors. First, fixed orthodontic appliances (bidimensional edgewise brackets) were bonded, and a week later buccal and lingual corticotomy with alveolar augmentation procedure in the maxillary arch from the first molar to the contralateral first molar, and from canine to canine in the mandibular arch was performed. Orthodontic therapy proceeded with frequent activation of the appliances to retract the incisors every 2 weeks. The total treatment time was 5 months and no adverse effects were observed at the end of active treatment. The addition of the decortication procedure to the conventional orthodontic therapy decreased the duration of treatment significantly. Successful closure of the anterior open bite with adequate overbite and interdigitation of the teeth were achieved. PMID:24151417

Distalization of maxillary arch and correction of Class II with mini-implants: A report of two cases

PubMed Central

Tekale, Pawankumar Dnyandeo; Vakil, Ketan K.; Vakil, Jeegar K.; Gore, Ketan A.

2015-01-01

This article reports the successful use of mini-screws in the maxilla to treat two patients of age 21-year and 17-year-old girls. Both the patients had a skeletal Class II malocclusion with protrusive maxillary teeth and angels Class II mal-occlusion. Temporary anchorage devices (TADs) in the posterior dental region between maxillary second premolar and maxillary first molar teeth on both sides were used as anchorage for the retraction and intrusion of her maxillary anterior teeth. Those appliances, combined with a compensatory curved maxillary archwire, eliminated spacing, deep bite, forwardly placed and proclined upper front teeth and the protrusive profile, corrected the molar relationship from Class II to Class I. With no extra TADs in the anterior region for intrusion, the treatment was workable and simple. The patient received a satisfactory occlusion and an attractive smile. This technique requires minimal compliance and is particularly useful for correcting Class II patients with protrusive maxillary front teeth and dental deep bite. PMID:26097360

Orthodontic treatment of an anterior openbite with the aid of corticotomy procedure: Case report.

PubMed

Aljhani, Ali S; Aldrees, Abdullah M

2011-04-01

This case report illustrates the orthodontic treatment combined with the corticotomy technique in an adult patient to accelerate tooth movement and shorten the treatment time. The patient was a 22-year-old woman with an anterior open bite and flared and spaced upper and lower incisors. First, fixed orthodontic appliances (bidimensional edgewise brackets) were bonded, and a week later buccal and lingual corticotomy with alveolar augmentation procedure in the maxillary arch from the first molar to the contralateral first molar, and from canine to canine in the mandibular arch was performed. Orthodontic therapy proceeded with frequent activation of the appliances to retract the incisors every 2 weeks. The total treatment time was 5 months and no adverse effects were observed at the end of active treatment. The addition of the decortication procedure to the conventional orthodontic therapy decreased the duration of treatment significantly. Successful closure of the anterior open bite with adequate overbite and interdigitation of the teeth were achieved.

New Cricetid Rodents from Strata near the Eocene-Oligocene Boundary in Erden Obo Section (Nei Mongol, China).

PubMed

Li, Qian; Meng, Jin; Wang, Yuanqing

2016-01-01

New cricetids (Eucricetodon wangae sp. nov., Eucricetodon sp. and Pappocricetodon siziwangqiensis sp. nov.) are reported from the lower and middle parts of the "Upper Red" beds of the Erden Obo section in Nei Mongol, China. Eucricetodon wangae is more primitive than other known species of the genus from lower Oligocene of Asia and Europe in having a single anterocone on M1, a single connection between the protocone and the paracone, the anterior metalophule connection in M1-2 and weaker anteroconid and ectomesolophid in lower molars. Pappocricetodon siziwangqiensis is more advanced than other species of the genus in permanently missing P4 and having posterior protolophule connection. These fossils suggest that the age of the "Upper Red" of the Erden Obo section is younger than the age of the Upper Eocene Houldjin and Caijiachong formations, but older than those containing the Shandgolian faunas; the "Upper Red" is most closely correlative to the Ergilian beds in age, and probably close to the Eocene/Oligocene boundary. Given the age estimate, Eucricetodon wangae provides the new evidence to support that cricetid dispersal from Asia to Europe occurred prior to the Eocene-Oligocene boundary.

Evaluation of stress patterns produced by implant-retained overdentures and implant-retained fixed partial denture.

PubMed

Mazaro, José Vitor Quinelli; Filho, Humberto Gennari; Vedovatto, Eduardo; Pellizzer, Eduardo Piza; Rezende, Maria Cristina Rosifini Alves; Zavanelli, Adriana Cristina

2011-11-01

The purposes of this study were to photoelastically measure the biomechanical behavior of 4 implants retaining different cantilevered bar mandibular overdenture designs and to compare a fixed partial denture (FPD). A photoelastic model of a human edentulous mandible was fabricated, which contained 4 screw-type implants (3.75 × 10 mm) embedded in the parasymphyseal area. An FPD and 3 overdenture designs with the following attachments were evaluated: 3 plastic Hader clips, 1 Hader clip with 2 posterior resilient cap attachments, and 3 ball/O-ring attachments. Vertical occlusal forces of 100 N were applied between the central incisor and unilaterally to the right and left second premolars and second molars. Stresses that developed in the supporting structure were monitored photoelastically and recorded photographically. The results showed that the anterior loading, the overdenture with 3 plastic Hader clips, displayed the largest stress concentration at the medium implant. With premolar loading, the FPD and overdenture with 3 plastic Hader clips displayed the highest stresses to the ipsilateral terminal implant. With molar loading, the overdenture with 3 ball/O-ring attachments displayed the most uniform stress distribution in the posterior edentulous ridge, with less overloading in the terminal implant. It was concluded that vertical forces applied to the bar-clip overdenture and FPD created immediate stress patterns of greater magnitude and concentration on the ipsilateral implants, whereas the ball/O-ring attachments transferred minimal stress to the implants. The increased cantilever in the FPD caused the highest stresses to the terminal implant.

Asymmetric molar distalization with miniscrews to correct a severe unilateral Class III malocclusion.

PubMed

Ma, Qiao Ling; Conley, R Scott; Wu, Tuojiang; Li, Huang

2016-05-01

Asymmetries are among the most challenging problems in orthodontics. Proper diagnosis is critical to discern first whether the asymmetry is dental or skeletal. If it is dental, one must then determine whether one dental arch or both are at fault. Once diagnosed, the next challenge is determining not only an appropriate treatment plan, but also the appropriate mechanics plan. This aim of this article is to present a patient with a severe asymmetry to emphasize the importance of a problem-based differential diagnosis to develop both a sound treatment plan and a mechanics plan that successfully integrates miniscrews from the start of the process. An 18-year-old woman had a Class III subdivision left malocclusion, an asymmetric lower facial third, and a deviated midline. The treatment plan consisted of asymmetric distalization of the maxillary right and mandibular left posterior dentitions to create space to resolve the deviated midlines, correct the canted occlusal plane, and obtain an ideal occlusion. Active treatment with Clarity ceramic 0.022 × 0.028-in appliances (3M Unitek, Monrovia, Calif), temporary anchorage devices, and a pendulum appliance lasted 22 months. The final result and the 2-year retention records demonstrate that a harmonious facial balance, an attractive smile, ideal occlusal relationships, and a stable outcome were achieved. This case report shows that with proper planning, asymmetric use of temporary anchorage devices in multiple posterior quadrants can be used to obtain molar distalization, and this approach is an effective alternative to dental extraction therapy. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Relative tooth size at birth in primates: Life history correlates.

PubMed

Smith, Timothy D; Muchlinski, Magdalena N; Bucher, Wade R; Vinyard, Christopher J; Bonar, Christopher J; Evans, Sian; Williams, Lawrence E; DeLeon, Valerie B

2017-11-01

Dental eruption schedules have been closely linked to life history variables. Here we examine a sample of 50 perinatal primates (28 species) to determine whether life history traits correlate with relative tooth size at birth. Newborn primates were studied using serial histological sectioning. Volumes of deciduous premolars (dp 2 -dp 4 ), replacement teeth (if any), and permanent molars (M 1-2/3 ) of the upper jaw were measured and residuals from cranial length were calculated with least squares regressions to obtain relative dental volumes (RDVs). Relative dental volumes of deciduous or permanent teeth have an unclear relationship with relative neonatal mass in all primates. Relative palatal length (RPL), used as a proxy for midfacial size, is significantly, positively correlated with larger deciduous and permanent postcanine teeth. However, when strepsirrhines alone are examined, larger RPL is correlated with smaller RDV of permanent teeth. In the full sample, RDVs of deciduous premolars are significantly negatively correlated with relative gestation length (RGL), but have no clear relationship with relative weaning age. RDVs of molars lack a clear relationship with RGL; later weaning is associated with larger molar RDV, although correlations are not significant. When strepsirrhines alone are analyzed, clearer trends are present: longer gestations or later weaning are associated with smaller deciduous and larger permanent postcanine teeth (only gestational length correlations are significant). Our results indicate a broad trend that primates with the shortest RGLs precociously develop deciduous teeth; in strepsirrhines, the opposite trend is seen for permanent molars. Anthropoids delay growth of permanent teeth, while strepsirrhines with short RGLs are growing replacement teeth concurrently. A comparison of neonatal volumes with existing information on extent of cusp mineralization indicates that growth of tooth germs and cusp mineralization may be selected for independently. © 2017 Wiley Periodicals, Inc.

3D variations in human crown dentin tubule orientation: a phase-contrast microtomography study.

PubMed

Zaslansky, Paul; Zabler, Simon; Fratzl, Peter

2010-01-01

Tubules dominate the microstructure of dentin, and in crowns of human teeth they are surrounded by thick mineralized peritubular cuffs of high stiffness. Here we examine the three-dimensional (3D) arrangement of tubules in relation to enamel on the buccal and lingual aspects of intact premolars and molars. Specifically we investigate the angular orientation of tubules relative to the plane of the junction of dentin with enamel (DEJ) by means of wet, non-destructive and high-resolution phase-contrast (coherent) tomography. Enamel capped dentin samples (n=16), cut from the buccal and lingual surfaces of upper and lower premolar and molar teeth, were imaged in water by high-resolution synchrotron-based phase-contrast X-ray radiography. Reconstructed 3D virtual images were co-aligned with respect to the DEJ plane. The average tubule orientation was determined at increasing distances from the DEJ, based on integrated projections onto orthogonal virtual planes. The angle and curl of the tubules were determined every 100 microm to a depth of 1.4mm beneath the DEJ. Most tubules do not extend at right angles from the DEJ. Even when they do, tubules always change their orientations substantially within the first half-millimeter zone beneath the DEJ, both on the buccal and lingual aspects of premolar and molar teeth. Tubules also tend to curl and twist within this zone. Student t-tests indicate that lower teeth seem to have greater tilts in the tubule orientations relative to the DEJ normal with an average angle of 42 degrees (+/-2.0 degrees), whereas upper teeth exhibit a smaller change of orientation, with an average of 32 degrees (+/-2.1 degrees). Tubules are a central characteristic of dentin, with important implications on how it is arranged and what the properties are. Knowing about the path that tubules follow is important for various reasons, ranging form improving control over restorative procedures to understanding or simulating the mechanical properties of teeth. At increasing depths of dentin beneath enamel, tubules are significantly tilted relative to the DEJ norm, which may be important to understand clinical challenges such as sensitivity, effectiveness of bonding techniques or prediction of possible paths for bacterial invasion. Our data show dissimilar average tubule angles of upper versus lower teeth with respect to the DEJ which presumably contributes to different shear responses of the tissue under function. The degree to which this may warrant improved restoratives or new adhesive techniques to enhance adhesive restorations merits further investigation.

[Therapeutic evaluation of the correction of the severe bi-maxillary protrusion cases by Tweed-Merrifield technique].

PubMed

Huang, J Q; Liu, S Y; Jiang, J H

2016-06-18

To evaluate the influence of Tweed-Merrifield technique in correction of severe bimaxillary protrusion adult patients on the measurement of the dental and skeletal changes after orthodontic treatment by Johnston analysis and the regular cephalomatric analysis. Twelve adolescent patients with severe bimaxillary protrusion were included in this self-control retrospective study. Lateral cephalometric radiographs were taken before and after treatments. All the radiographs were traced and analyzed by the method of Johnston analysis. Other measurements were evaluated using a series of 13 linear and angular measurements including SNA, SNB, ANB, U1-SN, U1-NA, U1/NA, L1-NB, U1/NB, L1/MP, U1-L1, (U1+L1)/2-AB, MP/SN and MP/FH from regular cephalomatric analysis. These measurements were also applied to compare the differences between pre- and post-treatments, which clarify the dental and skeletal changes by Johnston analysis. The effect of orthodontic correction was determined using the non-parameters test. The maxillary moved backforward by 1.3 mm according to the stable skull base, while the mandible moved forward by 2.12 mm. The relative position between the maxillary and mandible (ABCH) changed 3.42 mm. The upper and lower incisors retracted significantly. The upper and lower molars moved slightly forward and the relative positions of upper and lower molars and anterior teeth after treatment were 3.44 mm and 4.23 mm respectively. After treatment, the parameters of ANB, U1-NA, U1/NA, U1-SN, L1-NB, L1/NB and L1-M were reduced by -(1.98±1.55)°(P=0.012), - (5.08±4.6) mm (P=0.002), -(11.79±1.21)°(P=0.004), -(13.55±6.32)°(P=0.047), -(3.17±3.07) mm (P=0.010), -(6.84±2.55)°(P=0.038) and -(4.13±2.24)°(P=0.048) on average, whose changes had the statistically significant effects. Tweed-Merrifield technique (directional force technique) can stabilize anchorage molar, retract anterior teeth and significantly improve the hard and soft tissue profile for patients with bimaxillary protrusion, and make a good vertical control which means this technique is applicable to the patients who need strong anchorage. Even for the severe bimaxillary protrusion adult patients, the Tweed-Merrifield technique can control the anchoragewell and make the profiles improved greatly.

Gravitropism in higher plant shoots. V - Changing sensitivity to auxin

NASA Technical Reports Server (NTRS)

Salisbury, Frank B.; Gillespie, Linda; Rorabaugh, Patricia

1988-01-01

The relationship in plants between the sensitivity to auxin and differential growth and bending was investigated experimentally. Decapitated and marked sunflower hypocotyl sections were immersed in buffered auxin solutions of different concentrations (0, 10 to the -8th, or 0.001 molar) and were photographed at 1/2 hr intervals; the negatives were analyzed with a digitizer/computer to evaluate surface-length changes in terms of Michaelis-Menten enzyme kinetics. It was found that bending decreased with increasing concentration of auxin. Increasing the auxin concentration inhibits the elongation growth of lower surfaces but promotes upper-surface growth, indicating that the lower surfaces have a greater Km sensitivity to applied auxin than the upper surfaces. At optimum auxin levels (maximum growth), the growth of bottom surfaces exceeded that of top surfaces, indicating that bottom tissues had a greater Vmax sensitivity.

First discovery of colobine fossils from the Late Miocene/Early Pliocene in central Myanmar.

PubMed

Takai, Masanaru; Thaung-Htike; Zin-Maung-Maung-Thein; Soe, Aung Naing; Maung, Maung; Tsubamoto, Takehisa; Egi, Naoko; Nishimura, Takeshi D; Nishioka, Yuichiro

2015-07-01

Here we report two kinds of colobine fossils discovered from the latest Miocene/Early Pliocene Irrawaddy sediments of the Chaingzauk area, central Myanmar. A left mandibular corpus fragment preserving M1-3 is named as a new genus and species, Myanmarcolobus yawensis. Isolated upper (M(1)?) and lower (M2) molars are tentatively identified as Colobinae gen. et sp. indet. Although both forms are medium-sized colobines, they are quite different from each other in M2 morphology. The isolated teeth of the latter show typical colobine-type features, so it is difficult to identify their taxonomic position, whereas lower molars of Myanmarcolobus have unique features, such as a trapezoid-shaped long median lingual notch, a deeply concave median buccal cleft, a strongly developed mesiobuccal notch, and rather obliquely running transverse lophids. Compared with fossil and living Eurasian colobine genera, Myanmarcolobus is most similar in lower molar morphology to the Pliocene Dolichopithecus of Europe rather than to any Asian forms. In Dolichopithecus, however, the tooth size is much larger and the median lingual notch is mesiodistally much shorter than that of Myanmarcolobus. The discovery of Myanmarcolobus in central Myanmar is the oldest fossil record in Southeast Asia not only of colobine but also of cercopithecid monkeys and raises many questions regarding the evolutionary history of Asian colobine monkeys. Copyright © 2015 Elsevier Ltd. All rights reserved.

Gravitropism and phototropism of oat coleoptiles: Post-tropic autostraightening and tissue shrinkage during tropism

NASA Astrophysics Data System (ADS)

Tarui, Y.; Iino, M.

1999-01-01

We measured changes in length on the two opposite sides of the red-light-grown oat (Avena sativa L.) coleoptiles subjected to either gravitropic or phototropic stimulation and subsequently rotated on a horizontal clinostat. The length measurement was conducted using three 5 mm-long zones delimited by ink markers from the tip. Curvature of each zone was analyzed from the length difference between the two sides. Gravitropism was induced by displacing the seedling from the vertical by 30° or 90° for 25 min. Phototropism was induced by exposing the coleoptile to unilateral blue light for 30 s, which provided a fluence (1.0 μmol m-2) optimal for the pulse-induced positive phototropism or a lower, suboptimal fluence (0.03 μmol m-2). After negatively gravitropic bending, the upper two zones straightened rapidly at either displacement angle. After positively phototropic bending, straightening occurred, but only in the top zone and at the lower fluence. The upper two zones straightened rapidly, however, when bilateral blue light (30 s; 15 μmol m-2 from either direction) was applied 25 min after unilateral stimulation at the higher fluence. Bilateral blue light alone induced no curvature. These results confirm that the straightening of gravitropically bent coleoptiles is autonomic, and suggest that a similar autonomic response participates in the straightening of phototropically bent coleoptiles. Suppression of elongation on the concave side of the coleoptile mainly accounted for gravitropic and phototropic curvatures. The concave side of the top zone shrank during both tropisms. This shrinkage progressed at a high rate from the beginning of curvature response, suggesting that a drop in turgor pressure is the main and direct cause of the shrinkage.

Risk Factors for Post-treatment Complex Regional Pain Syndrome (CRPS): An Analysis of 647 Cases of CRPS from the Danish Patient Compensation Association.

PubMed

Petersen, Pelle B; Mikkelsen, Kim L; Lauritzen, Jes B; Krogsgaard, Michael R

2018-03-01

Complex regional pain syndrome is a challenging condition that includes a broad spectrum of sensory, autonomic, and motor features predominantly in extremities recovering from a trauma. Few large-scale studies have addressed occurrence of and factors associated with complex regional pain syndrome (CRPS) following orthopedic treatment. The present study aimed to identify factors associated with post-treatment development of CRPS. Using the Danish Patient Compensation Association's database, we identified 647 patients claiming post-treatment CRPS between 1992 and 2015. Age, gender, initial diagnosis, treatment, and amount of compensation were extracted. Multivariate logistic regressions were performed to identify variables associated with approval of the claim. For carpal tunnel syndrome (CTS) patients, we registered whether symptoms were bilateral or unilateral and if neurophysiology prior to treatment was pathologic. The following ratios were found: women:men was 4:1, primary diagnosis to the upper limb:lower limb was 2.5:1, and surgical:nonsurgical treatment was 3:1. Mean age was 47.5 ± 13.7 years, and no intergender difference was detected. Antebrachial fracture (23%) and CTS (9%) were the most common primary conditions. Surgical treatment was associated with approval of the claim (odds ratio 3.5, 95% confidence interval 2.3 to 5.3; P < 0.001). Half of CTS patients had normal neurophysiology prior to surgery; among patients with unilateral symptoms, 71.4% had normal neurophysiology. Female gender, surgical treatment, and treatment to the upper limb were risk factors. Elective surgery accounted for a large number of post-treatment CRPS patients. In CTS patients developing CRPS, normal neurophysiological examination findings were common, and it could be suspected that these patients were suffering from an pre-clinical stage of CRPS, not CTS. © 2017 World Institute of Pain.

Maxillary reaction patterns identified by three-dimensional analysis of casts from infants with unilateral cleft lip and palate.

PubMed

Neuschulz, J; Schaefer, I; Scheer, M; Christ, H; Braumann, B

2013-07-01

In order to visualize and quantify the direction and extent of morphological upper-jaw changes in infants with unilateral cleft lip and palate (UCLP) during early orthodontic treatment, a three-dimensional method of cast analysis for routine application was developed. In the present investigation, this method was used to identify reaction patterns associated with specific cleft forms. The study included a cast series reflecting the upper-jaw situations of 46 infants with complete (n=27) or incomplete (n=19) UCLP during week 1 and months 3, 6, and 12 of life. Three-dimensional datasets were acquired and visualized with scanning software (DigiModel®; OrthoProof, The Netherlands). Following interactive identification of landmarks on the digitized surface relief, a defined set of representative linear parameters were three-dimensionally measured. At the same time, the three-dimensional surfaces of one patient series were superimposed based on a defined reference plane. Morphometric differences were statistically analyzed. Thanks to the user-friendly software, all landmarks could be identified quickly and reproducibly, thus, allowing for simultaneous three-dimensional measurement of all defined parameters. The measured values revealed that significant morphometric differences were present in all three planes of space between the two patient groups. Patients with complete UCLP underwent significantly larger reductions in cleft width (p<0.001), and sagittal growth in the complete UCLP group exceeded sagittal growth in the incomplete UCLP group by almost 50% within the first year of life. Based on patients with incomplete versus complete UCLP, different reaction patterns were identified that depended not on apparent severities of malformation but on cleft forms.

Biomechanical Analysis of the Proximal Adjacent Segment after Multilevel Instrumentation of the Thoracic Spine: Do Hooks Ease the Transition?

PubMed Central

Metzger, Melodie F.; Robinson, Samuel T.; Svet, Mark T.; Liu, John C.; Acosta, Frank L.

2015-01-01

Study Design Biomechanical cadaveric study. Objective Clinical studies indicate that using less-rigid fixation techniques in place of the standard all-pedicle screw construct when correcting for scoliosis may reduce the incidence of proximal junctional kyphosis and improve patient outcomes. The purpose of this study is to investigate whether there is a biomechanical advantage to using supralaminar hooks in place of pedicle screws at the upper-instrumented vertebrae in a multilevel thoracic construct. Methods T7–T12 spines were biomechanically tested: (1) intact; (2) following a two-level pedicles screw fusion from T9 to T11; and after proximal extension of the fusion to T8–T9 with (3) bilateral supra-laminar hooks, (4) a unilateral hook + unilateral screw hybrid, or (5) bilateral pedicle screws. Specimens were nondestructively loaded while three-dimensional kinematics and intradiscal pressure at the supra-adjacent level were recorded. Results Supra-adjacent hypermobility was reduced when bilateral hooks were used in place of pedicle screws at the upper-instrumented level, with statistically significant differences in lateral bending and torsion (p < 0.05 and p < 0.001, respectively). Disk pressures in the supra-adjacent segment were not statistically different among top-off techniques. Conclusions The use of supralaminar hooks at the top of a multilevel posterior fusion construct reduces the stress at the proximal uninstrumented motion segment. Although further data is needed to provide a definitive link to the clinical occurrence of PJK, this in vitro study demonstrates the potential benefit of “easing” the transition between the stiff instrumented spine and the flexible native spine and is the first to demonstrate these results with laminar hooks. PMID:27190735

Gravitropism and phototropism of oat coleoptiles: post-tropic autostraightening and tissue shrinkage during tropism.

PubMed

Tarui, Y; Iino, M

1999-01-01

We measured changes in length on the two opposite sides of the red-light-grown oat (Avena sativa L.) coleoptiles subjected to either gravitropic or phototropic stimulation and subsequently rotated on a horizontal clinostat. The length measurement was conducted using three 5 mm-long zones delimited by ink markers from the tip. Curvature of each zone was analyzed from the length difference between the two sides. Gravitropism was induced by displacing the seedling from the vertical by 30 degrees or 90 degrees for 25 min. Phototropism was induced by exposing the coleoptile to unilateral blue light for 30 s, which provided a fluence (1.0 micromoles m-2) optimal for the pulse-induced positive phototropism or a lower, suboptimal fluence (0.03 micromoles m-2). After negatively gravitropic bending, the upper two zones straightened rapidly at either displacement angle. After positively phototropic bending, straightening occurred, but only in the top zone and at the lower fluence. The upper two zones straightened rapidly, however, when bilateral blue light (30 s; 15 micromoles m-2 from either direction) was applied 25 min after unilateral stimulation at the higher fluence. Bilateral blue light alone induced no curvature. These results confirm that the straightening of gravitropically bent coleoptiles is autonomic, and suggest that a similar autonomic response participates in the straightening of phototropically bent coleoptiles. Suppression of elongation on the concave side of the coleoptile mainly accounted for gravitropic and phototropic curvatures. The concave side of the top zone shrank during both tropisms. This shrinkage progressed at a high rate from the beginning of curvature response, suggesting that a drop in turgor pressure is the main and direct cause of the shrinkage.

3D augmented reality mirror visual feedback therapy applied to the treatment of persistent, unilateral upper extremity neuropathic pain: a preliminary study.

PubMed

Mouraux, Dominique; Brassinne, Eric; Sobczak, Stéphane; Nonclercq, Antoine; Warzée, Nadine; Sizer, Phillip S; Tuna, Turgay; Penelle, Benoît

2017-07-01

Objective: We assessed whether or not pain relief could be achieved with a new system that combines 3D augmented reality system (3DARS) and the principles of mirror visual feedback. Methods: Twenty-two patients between 18 and 75 years of age who suffered of chronic neuropathic pain. Each patient performed five 3DARS sessions treatment of 20 mins spread over a period of one week. The following pain parameters were assessed: (1) visual analogic scale after each treatment session (2) McGill pain scale and DN4 questionnaire were completed before the first session and 24 h after the last session. Results: The mean improvement of VAS per session was 29% ( p  < 0.001). There was an immediate session effect demonstrating a systematic improvement in pain between the beginning and the end of each session. We noted that this pain reduction was partially preserved until the next session. If we compare the pain level at baseline and 24 h after the last session, there was a significant decrease ( p  < 0.001) of pain of 37%. There was a significant decrease ( p  < 0.001) on the McGill Pain Questionnaire and DN4 questionnaire ( p  < 0.01). Conclusion: Our results indicate that 3DARS induced a significant pain decrease for patients who presented chronic neuropathic pain in a unilateral upper extremity. While further research is necessary before definitive conclusions can be drawn, clinicians could implement the approach as a preparatory adjunct for providing temporary pain relief aimed at enhancing chronic pain patients' tolerance of manual therapy and exercise intervention. Level of Evidence: 4.

Oxidation and evaporation of sulfur species at atmospheric entry of iron sulfide fine particles

NASA Astrophysics Data System (ADS)

Isobe, H.; Murozono, K.

2017-12-01

Micrometeorites have the most abundant flux in current accumulation of planetary materials to the Earth. Micrometeorites are heated and reacted with upper atmosphere at atmospheric entry. Evaporation of meteoritic materials, especially sulfur species, may have environmental effect at upper atmosphere (e.g. Court and Sephton, 2011; Tomkins et al., 2016). Troilite is typical FeS phase in chondritic meteorites. In this study, quick heating and cooling experiments of FeS reagent particles were carried out with a fine particles free falling apparatus with controlled gas flow (Isobe and Gondo, 2013). Starting material reagent is inhomogeneous mixture of troilite, iron oxide and iron metal. Oxygen fugacity was controlled to FMQ +1.5 log unit. Maximum temperature of the particles was higher than 1400°C for approximately 0.5 seconds. Run products with rounded shape and smooth surface show the particles were completely melted. Chemical compositions of particles analyzed on cross sections are generally well homogenized from inhomogeneous starting materials by complete melting. Molar ratios of Fe in melted regions are close to 0.5, while compositions of S and O are various. Varieties of S and O compositions show various degree of oxidation and evaporation of sulfur. Distribution of compositions of melted regions in Fe-S-O system is plotted in liquidus compositions of FeO and FeS saturated melt. Troilite in micrometeorite is melted and oxidized by atmospheric entry. Compositions of FeS melt in fine spherules are following Fe-S-O phase relations even in a few seconds. Molar ratios of Fe in melt are close to 0.5, while compositions of S and O are various. Varieties of S and O compositions show various degree of oxidation and evaporation of sulfur. Evaporation of sulfur from meteoritic materials in atmospheric entry heating may depend on oxygen fugacity of the upper atmosphere. Sulfur supply from meteoritic materials to atmosphere may be limited on planets with oxygen-free atmosphere.

3D enamel thickness in Neandertal and modern human permanent canines.

PubMed

Buti, Laura; Le Cabec, Adeline; Panetta, Daniele; Tripodi, Maria; Salvadori, Piero A; Hublin, Jean-Jacques; Feeney, Robin N M; Benazzi, Stefano

2017-12-01

Enamel thickness figures prominently in studies of human evolution, particularly for taxonomy, phylogeny, and paleodietary reconstruction. Attention has focused on molar teeth, through the use of advanced imaging technologies and novel protocols. Despite the important results achieved thus far, further work is needed to investigate all tooth classes. We apply a recent approach developed for anterior teeth to investigate the 3D enamel thickness of Neandertal and modern human (MH) canines. In terms of crown size, the values obtained for both upper and lower unworn/slightly worn canines are significantly greater in Neandertals than in Upper Paleolithic and recent MH. The 3D relative enamel thickness (RET) is significantly lower in Neandertals than in MH. Moreover, differences in 3D RET values between the two groups appear to decrease in worn canines beginning from wear stage 3, suggesting that both the pattern and the stage of wear may have important effects on the 3D RET value. Nevertheless, the 3D average enamel thickness (AET) does not differ between the two groups. In both groups, 3D AET and 3D RET indices are greater in upper canines than in lower canines, and overall the enamel is thicker on the occlusal half of the labial aspect of the crown, particularly in MH. By contrast, the few early modern humans investigated show the highest volumes of enamel while for all other components of 3D enamel, thickness this group holds an intermediate position between Neandertals and recent MH. Overall, our study supports the general findings that Neandertals have relatively thinner enamel than MH (as also observed in molars), indicating that unworn/slightly worn canines can be successfully used to discriminate between the two groups. Further studies, however, are needed to understand whether these differences are functionally related or are the result of pleiotropic or genetic drift effects. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Apical root resorption during orthodontic treatment. A prospective study using cone beam CT.

PubMed

Lund, Henrik; Gröndahl, Kerstin; Hansen, Ken; Gröndahl, Hans-Göran

2012-05-01

To investigate the incidence and severity of root resorption during orthodontic treatment by means of cone beam computed tomography (CBCT) and to explore factors affecting orthodontically induced inflammatory root resorption (OIIRR). CBCT examinations were performed on 152 patients with Class I malocclusion. All roots from incisors to first molars were assessed on two or three occasions. At treatment end, 94% of patients had ≥1 root with shortening >1 mm, and 6.6% had ≥1 tooth where it exceeded 4 mm. Among teeth, 56.3% of upper lateral incisors had root shortening >1 mm. Of upper incisors and the palatal root of upper premolars, 2.6% showed root shortenings >4 mm. Slanted surface resorptions of buccal and palatal surfaces were found in 15.1% of upper central and 11.5% of lateral incisors. Monthly root shortening was greater after 6-month control than before. Upper jaw teeth and anterior teeth were significantly associated with the degree of root shortening. Gender, root length at baseline, and treatment duration were not. Practically all patients and up to 91% of all teeth showed some degree of root shortening, but few patients and teeth had root shortenings >4 mm. Slanted root resorption was found on root surfaces that could be evaluated only by a tomographic technique. A CBCT technique can provide more valid and accurate information about root resorption.

Dental arch relationship outcomes in one- and two-stage palatoplasty for Japanese patients with complete unilateral cleft lip and palate.

PubMed

Mikoya, Tadashi; Shibukawa, Toyoko; Susami, Takafumi; Sato, Yoshiaki; Tengan, Toshimoto; Katashima, Hirotaka; Oyama, Akihiko; Matsuzawa, Yusuke; Ito, Yumi; Funayama, Emi

2015-05-01

To compare dental arch relationship outcomes following one- and two-stage palatal repair. Nonrandomized, clinical trial with concurrent control. Hokkaido University Hospital. Sixty-eight consecutively treated Japanese patients with complete unilateral cleft lip and palate. Thirty-one of the 68 patients underwent two-stage palatoplasty with delayed hard palate closure, and 37 patients underwent one-stage pushback palatoplasty. Dental casts were taken at 4.9 to 6.3 (mean: 5.2) years of age in the two-stage group and at 4.0 to 6.3 (mean: 5.1) years of age in the one-stage group, and dental arch relationships were assessed using the 5-Year-Olds' Index (5-Y) by four raters and the Huddart/Bodenham Index (HB) by two raters. Intrarater and interrater reliabilities evaluated using weighted kappa statistics were good or better for the 5-Y and HB ratings. The mean 5-Y score was 2.94 in the two-stage group and 3.13 in the one-stage group (P value was not significant). However, there was a significant difference in distributions between the groups (P < .05). The HB scores of molars were significantly greater in the two-stage group than in the one-stage group (P < .05). The rank correlation coefficients between the 5-Y and total HB score (ρ = -0.840, P < .01) and between the 5-Y and the score of the incisors in the HB (ρ = -0.814, P < .01) were significantly increased. These results suggest that the anteroposterior relationship was not significantly different between the groups, but the transversal relationship was better in the two-stage group than in the one-stage group.

Quantitative assessment of paretic limb dexterity and interlimb coordination during bilateral arm rehabilitation training.

PubMed

Xu, Chang; Li, Siyi; Wang, Kui; Hou, Zengguang; Yu, Ningbo

2017-07-01

In neuro-rehabilitation after stroke, the conventional constrained induced movement therapy (CIMT) has been well-accepted. Existing bilateral trainings are mostly on mirrored symmetrical motion. However, complementary bilateral movements are dominantly involved in activities of daily living (ADLs), and functional bilateral therapies may bring better skill transfer from trainings to daily life. Neurophysiological evidence is also growing. In this work, we firstly introduce our bilateral arm training system realized with a haptic interface and a motion sensor, as well as the tasks that have been designed to train both the manipulation function of the paretic arm and coordination of bilateral upper limbs. Then, we propose quantitative measures for functional assessment of complementary bilateral training performance, including kinematic behavior indices, smoothness, submovement and bimanual coordination. After that, we describe the experiments with healthy subjects and the results with respect to these quantitative measures. Feasibility and sensitivity of the proposed indices were evaluated through comparison of unilateral and bilateral training outcomes. The proposed bilateral training system and tasks, as well as the quantitative measures, have been demonstrated effective for training and assessment of unilateral and bilateral arm functions.

Zero-Determinant Strategies in Iterated Public Goods Game

PubMed Central

Pan, Liming; Hao, Dong; Rong, Zhihai; Zhou, Tao

2015-01-01

Recently, Press and Dyson have proposed a new class of probabilistic and conditional strategies for the two-player iterated Prisoner’s Dilemma, so-called zero-determinant strategies. A player adopting zero-determinant strategies is able to pin the expected payoff of the opponents or to enforce a linear relationship between his own payoff and the opponents’ payoff, in a unilateral way. This paper considers zero-determinant strategies in the iterated public goods game, a representative multi-player game where in each round each player will choose whether or not to put his tokens into a public pot, and the tokens in this pot are multiplied by a factor larger than one and then evenly divided among all players. The analytical and numerical results exhibit a similar yet different scenario to the case of two-player games: (i) with small number of players or a small multiplication factor, a player is able to unilaterally pin the expected total payoff of all other players; (ii) a player is able to set the ratio between his payoff and the total payoff of all other players, but this ratio is limited by an upper bound if the multiplication factor exceeds a threshold that depends on the number of players. PMID:26293589

Role of medullary astroglial glutamine synthesis in tooth pulp hypersensitivity associated with frequent masseter muscle contraction.

PubMed

Watase, Tetsuro; Shimizu, Kohei; Ohara, Kinuyo; Komiya, Hiroki; Kanno, Kohei; Hatori, Keisuke; Noma, Noboru; Honda, Kuniya; Tsuboi, Yoshiyuki; Katagiri, Ayano; Shinoda, Masamichi; Ogiso, Bunnai; Iwata, Koichi

2018-01-01

Background The mechanisms underlying tooth pulp hypersensitivity associated with masseter muscle hyperalgesia remain largely underinvestigated. In the present study, we aimed to determine whether masseter muscle contraction induced by daily electrical stimulation influences the mechanical head-withdrawal threshold and genioglossus electromyography activity caused by the application of capsaicin to the upper first molar tooth pulp. We further investigated whether astroglial glutamine synthesis is involved in first molar tooth pulp hypersensitivity associated with masseter muscle contraction. Methods The first molar tooth pulp was treated with capsaicin or vehicle in masseter muscle contraction or sham rats, following which the astroglial glutamine synthetase inhibitor methionine sulfoximine or Phosphate buffered saline (PBS) was applied. Astroglial activation was assessed via immunohistochemistry. Results The mechanical head-withdrawal threshold of the ipsilateral masseter muscle was significantly decreased in masseter muscle contraction rats than in sham rats. Genioglossus electromyography activity was significantly higher in masseter muscle contraction rats than sham rats. Glial fibrillary acidic protein-immunoreactive cell density was significantly higher in masseter muscle contraction rats than in sham rats. Administration of methionine sulfoximine induced no significant changes in the density of glial fibrillary acidic protein-immunoreactive cells relative to PBS treatment. However, mechanical head-withdrawal threshold was significantly higher in masseter muscle contraction rats than PBS-treated rats after methionine sulfoximine administration. Genioglossus electromyography activity following first molar tooth pulp capsaicin treatment was significantly lower in methionine sulfoximine-treated rats than in PBS-treated rats. In the ipsilateral region, the total number of phosphorylated extracellular signal-regulated protein kinase immunoreactive cells in the medullary dorsal horn was significantly smaller upon first molar tooth pulp capsaicin application in methionine sulfoximine-treated rats than in PBS-treated rats. Conclusions Our results suggest that masseter muscle contraction induces astroglial activation, and that this activation spreads from caudal to the obex in the medullary dorsal horn, resulting in enhanced neuronal excitability associated with astroglial glutamine synthesis in medullary dorsal horn neurons receiving inputs from the tooth pulp. These findings provide significant insight into the mechanisms underlying tooth pulp hypersensitivity associated with masseter muscle contraction.

Systematics of the Platyrrhinus helleri species complex (Chiroptera: Phyllostomidae), with descriptions of two new species

USGS Publications Warehouse

Velazco, Paúl M.; Gardner, Alfred L.; Patterson, Bruce D.

2010-01-01

Platyrrhinus is a diverse genus of small to large phyllostomid bats characterized by a comparatively narrow uropatagium thickly fringed with hair, a white dorsal stripe, comparatively large inner upper incisors that are convergent at the tips, and three upper and three lower molars. Eighteen species are currently recognized, the majority occurring in the Andes. Molecular, morphological, and morphometric analyses of specimens formerly identified as Platyrrhinus helleri support recognition of Platyrrhinus incarum as a separate species and reveal the presence of two species from western and northern South America that we describe herein as new (Platyrrhinus angustirostris sp. nov. from eastern Colombia and Ecuador, north-eastern Peru, and Venezuela and Platyrrhinus fusciventris sp. nov. from Guyana, Suriname, French Guiana, Trinidad and Tobago, northern Brazil, eastern Ecuador, and southern Venezuela). These two new species are sister taxa and, in turn, sister to Platyrrhinus incarum.

Corticotomy-assisted orthodontic camouflage in a class III adult patient with a severe transverse discrepancy.

PubMed

Gracco, Antonio; Finotti, Marco; Bruno, Giovanni; de Stefani, Alberto

2018-04-06

A 25-year-old man presented with a maxillary transverse discrepancy, posterior cross bite, anterior open bite, molar and canine class III. Treatment included a corticotomy in the upper lateral and posterior teeth, a palatal expansor and a sectional archwire to assist the expansion. The following treatment phase included bonding with Incognito System lingual appliance, interproximal reduction to solve the crowding and bite blocks to control the verticality. Two months after the bonding intermaxillary class III elastics were used to solve the sagittal discrepancy and eight months after the bonding vertical elastics were used in order to solve the anterior open bite until the end of the treatment. A Boston splint was applied for the upper arch, an essix splint was applied for the lower arch. The patient compliance was an essential aspect in the success of the orthodontic treatment. Copyright © 2018. Published by Elsevier Masson SAS.

Efficacy of clear aligners in controlling orthodontic tooth movement: a systematic review.

PubMed

Rossini, Gabriele; Parrini, Simone; Castroflorio, Tommaso; Deregibus, Andrea; Debernardi, Cesare L

2015-09-01

To assess the scientific evidence related to the efficacy of clear aligner treatment (CAT) in controlling orthodontic tooth movement. PubMed, PMC, NLM, Embase, Cochrane Central Register of Controlled Clinical Trials, Web of Knowledge, Scopus, Google Scholar, and LILACs were searched from January 2000 to June 2014 to identify all peer-reviewed articles potentially relevant to the review. Methodological shortcomings were highlighted and the quality of the studies was ranked using the Cochrane Tool for Risk of Bias Assessment. Eleven relevant articles were selected (two Randomized Clinical Trials (RCT), five prospective non-randomized, four retrospective non-randomized), and the risk of bias was moderate for six studies and unclear for the others. The amount of mean intrusion reported was 0.72 mm. Extrusion was the most difficult movement to control (30% of accuracy), followed by rotation. Upper molar distalization revealed the highest predictability (88%) when a bodily movement of at least 1.5 mm was prescribed. A decrease of the Little's Index (mandibular arch: 5 mm; maxillary arch: 4 mm) was observed in aligning arches. CAT aligns and levels the arches; it is effective in controlling anterior intrusion but not anterior extrusion; it is effective in controlling posterior buccolingual inclination but not anterior buccolingual inclination; it is effective in controlling upper molar bodily movements of about 1.5 mm; and it is not effective in controlling rotation of rounded teeth in particular. However, the results of this review should be interpreted with caution because of the number, quality, and heterogeneity of the studies.

In vivo measurements of tooth wear over 12 months.

PubMed

Rodriguez, J M; Austin, R S; Bartlett, D W

2012-01-01

The aim of this study was to measure the progression of tooth wear in a cohort of 63 patients, 43 males and 20 females with a mean age of 39.1 years. Recruitment followed referral from general practice to Guy's Hospital for advice/management of tooth wear. Addition silicone impressions were taken at 6-month intervals for a total of 12 months; impressions were subsequently poured in type IV gypsum. Casts were scanned using a non-contacting laser profilometer and then superimposed using Geomagic® Qualify 11. Wear was measured in μm by tooth per time interval. A questionnaire highlighting dietary, parafunctional and gastric risk factors was obtained from each participant. Clustered multiple regression analysis was used to determine the relationship between tooth wear progression and risk factors. Maximum follow-up times were 6 months for 63 participants and 12 months for 30 participants. The measurement error was 15 μm. At the tooth level, 72.2% of 1,078 teeth wore <15 μm over a 6-month period. At the subject level, 77.7% of 63 participants showed median wear <15 μm over a 6-month period. There was a statistical trend towards tooth wear progression being associated with gastric risk factors (p < 0.05). The lower molars and the upper anterior teeth were the most commonly affected teeth; the lower molars and the upper central incisors were the most severely affected teeth. Tooth wear progression was slow in this cohort, suggesting that tooth wear may be cyclical and inactive in the majority of participants. Copyright © 2011 S. Karger AG, Basel.

Lateral asymmetry as a function of motor practice type of complex upper- and lower-limb movement in young children.

PubMed

Marinsek, Miha

2016-01-01

The influence of different motor practice types on lateral asymmetry of performance was investigated in 40 preschool children. Lateral preference was measured prior the experiment. For the purpose of present study dribbling a ball with a hand and foot was used to assess lateral asymmetry of performance before and after three different motor practice types. Motor practice with the non-dominant, dominant, and both (contralateral) limbs took place in the indoor facility 4 times/week for 6 weeks. Each session lasted 30-40 min. Our results showed that unilateral practice of dribbling is more beneficial for diminishing lateral asymmetry of performance in comparison to bilateral practice. Moreover, participants who practiced with their dominant limb diminished lateral asymmetry of performance the most and made the largest overall improvement. We did not find important differences between acquisitions of dribbling with upper- and lower-extremity. In this sense, the results support the notion of lateral asymmetry of performance to be task-specific.

Strains Around Abutment Teeth with Different Attachments Used for Implant-Assisted Distal Extension Partial Overdentures: An In Vitro Study.

PubMed

ELsyad, Moustafa Abdou; Omran, Abdelbaset Omar; Fouad, Mohammed Mohammed

2017-01-01

The aim of this study was to evaluate and compare strain around abutment teeth with different attachments used for implant-assisted distal extension partial overdentures (IADEPODs). A mandibular Kennedy class I acrylic model (remaining teeth from first premolar to first premolar) was constructed. A conventional partial denture was constructed over the model (control, group 1). Two laboratory implants were then placed bilaterally in the first molar areas parallel to each other and perpendicular to the residual ridge. Three additional experimental partial overdentures (PODs) were constructed and connected to the implants using ball (group 2), magnetic (group 3), and Locator (group 4) attachments. Three linear strain gauges were bonded buccal, lingual, and distal to the first premolar abutment tooth at the right (loading) and the left (nonloading) sides. For each group, a universal testing device was used to apply a unilateral vertical static load (50 N) on the first molar area, and the strain was recorded using a multichannel digital strainometer. Significant differences between groups and between sites of strain gauges were detected. Strains recorded for all groups were compressive (negative) in nature. Group 1 demonstrated the highest strain, followed by group 3 and group 4; group 2 recorded the lowest strain. For group 2, the highest strain was recoded at the lingual nonloading side. For group 1, group 3, and group 4, the highest strain was recorded at the buccal loading side. Within the limitation of the present study, ball attachments used to retain IADEPODs to the implants were associated with lower strains around abutment teeth than Locator and magnetic attachments. The highest strain was recorded with conventional partial dentures. © 2015 by the American College of Prosthodontists.

On the hydrophilicity of polyzwitterion poly (N,N-dimethyl-N-(3-(methacrylamido)propyl)ammoniopropane sulfonate) in water, deuterated water, and aqueous salt solutions.

PubMed

Hildebrand, Viet; Laschewsky, André; Zehm, Daniel

2014-01-01

A series of zwitterionic model polymers with defined molar masses up to 150,000 Da and defined end groups are prepared from sulfobetaine monomer N,N-dimethyl-N-(3-(methacrylamido)propyl)ammoniopropanesulfonate (SPP). Polymers are synthesized by reversible addition-fragmentation chain transfer polymerization (RAFT) using a functional chain transfer agent labeled with a fluorescent probe. Their upper critical solution temperature-type coil-to-globule phase transition in water, deuterated water, and various salt solutions is studied by turbidimetry. Cloud points increase with polyzwitterion concentration and molar mass, being considerably higher in D2O than in H2O. Moreover, cloud points are strongly affected by the amount and nature of added salts. Typically, they increase with increasing salt concentration up to a maximum value, whereas further addition of salt lowers the cloud points again, mostly down to below freezing point. The different salting-in and salting-out effects of the studied anions can be correlated with the Hofmeister series. In physiological sodium chloride solution and in phosphate buffered saline (PBS), the cloud point is suppressed even for high molar mass samples. Accordingly, SPP-polymers behave strongly hydrophilic under most conditions encountered in biomedical applications. However, the direct transfer of results from model studies in D2O, using, e.g. (1)H NMR or neutron scattering techniques, to 'normal' systems in H2O is not obvious.

Dental erosion: a widespread condition nowadays? A cross-sectional study among a group of adolescents in Norway.

PubMed

Søvik, Jenny Bogstad; Tveit, Anne Bjørg; Storesund, Trond; Mulic, Aida

2014-10-01

This study aimed to investigate the prevalence, distribution and severity of erosive wear in a group of 16-18-year-olds in the western part of Norway. A second aim was to describe possible associations between caries experience, socioeconomic background and origin of birth. Adolescents (n = 795) attending recall examinations at Public Dental Service (PDS) clinics were also examined for dental erosive wear on index surfaces, using the Visual Erosion Dental Examination scoring system (VEDE). In total, 795 individuals were examined. Dental erosive wear was diagnosed in 59% of the population (44% erosive wear in enamel only, 14% combination of enamel and dentine lesions, 1% erosive wear in dentine only). The palatal surfaces of upper central incisors and occlusal surfaces of first lower molars were affected the most (33% and 48% of all surfaces, respectively). Cuppings on molars were registered in 66% of the individuals with erosive wear. Erosive wear was significantly more prevalent among men (63%) than women (55%) (p = 0.018). There were no significant associations between dental erosive wear and caries experience, socioeconomic background or origin of birth.

Unilateral versus bilateral robot-assisted rehabilitation on arm-trunk control and functions post stroke: a randomized controlled trial.

PubMed

Wu, Ching-Yi; Yang, Chieh-Ling; Chen, Ming-de; Lin, Keh-Chung; Wu, Li-Ling

2013-04-12

Although the effects of robot-assisted arm training after stroke are promising, the relative effects of unilateral (URT) vs. bilateral (BRT) robot-assisted arm training remain uncertain. This study compared the effects of URT vs. BRT on upper extremity (UE) control, trunk compensation, and function in patients with chronic stroke. This was a single-blinded, randomized controlled trial. The intervention was implemented at 4 hospitals. Fifty-three patients with stroke were randomly assigned to URT, BRT, or control treatment (CT). Each group received UE training for 90 to 105 min/day, 5 days/week, for 4 weeks. The kinematic variables for arm motor control and trunk compensation included normalized movement time, normalized movement units, and the arm-trunk contribution slope in unilateral and bilateral tasks. Motor function and daily function were measured by the Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), and ABILHAND Questionnaire. The BRT and CT groups elicited significantly larger slope values (i.e., less trunk compensation) at the start of bilateral reaching than the URT group. URT led to significantly better effects on WMFT-Time than BRT. Differences in arm control kinematics and performance on the MAL and ABILHAND among the 3 groups were not significant. BRT and URT resulted in differential improvements in specific UE/trunk performance in patients with stroke. BRT elicited larger benefits than URT on reducing compensatory trunk movements at the beginning of reaching. In contrast, URT produced better improvements in UE temporal efficiency. These relative effects on movement kinematics, however, did not translate into differential benefits in daily functions. ClinicalTrials.gov: NCT00917605.

Sound Source Localization and Speech Understanding in Complex Listening Environments by Single-sided Deaf Listeners After Cochlear Implantation.

PubMed

Zeitler, Daniel M; Dorman, Michael F; Natale, Sarah J; Loiselle, Louise; Yost, William A; Gifford, Rene H

2015-09-01

To assess improvements in sound source localization and speech understanding in complex listening environments after unilateral cochlear implantation for single-sided deafness (SSD). Nonrandomized, open, prospective case series. Tertiary referral center. Nine subjects with a unilateral cochlear implant (CI) for SSD (SSD-CI) were tested. Reference groups for the task of sound source localization included young (n = 45) and older (n = 12) normal-hearing (NH) subjects and 27 bilateral CI (BCI) subjects. Unilateral cochlear implantation. Sound source localization was tested with 13 loudspeakers in a 180 arc in front of the subject. Speech understanding was tested with the subject seated in an 8-loudspeaker sound system arrayed in a 360-degree pattern. Directionally appropriate noise, originally recorded in a restaurant, was played from each loudspeaker. Speech understanding in noise was tested using the Azbio sentence test and sound source localization quantified using root mean square error. All CI subjects showed poorer-than-normal sound source localization. SSD-CI subjects showed a bimodal distribution of scores: six subjects had scores near the mean of those obtained by BCI subjects, whereas three had scores just outside the 95th percentile of NH listeners. Speech understanding improved significantly in the restaurant environment when the signal was presented to the side of the CI. Cochlear implantation for SSD can offer improved speech understanding in complex listening environments and improved sound source localization in both children and adults. On tasks of sound source localization, SSD-CI patients typically perform as well as BCI patients and, in some cases, achieve scores at the upper boundary of normal performance.

Validity of semi-quantitative scale for brain MRI in unilateral cerebral palsy due to periventricular white matter lesions: Relationship with hand sensorimotor function and structural connectivity.

PubMed

Fiori, Simona; Guzzetta, Andrea; Pannek, Kerstin; Ware, Robert S; Rossi, Giuseppe; Klingels, Katrijn; Feys, Hilde; Coulthard, Alan; Cioni, Giovanni; Rose, Stephen; Boyd, Roslyn N

2015-01-01

To provide first evidence of construct validity of a semi-quantitative scale for brain structural MRI (sqMRI scale) in children with unilateral cerebral palsy (UCP) secondary to periventricular white matter (PWM) lesions, by examining the relationship with hand sensorimotor function and whole brain structural connectivity. Cross-sectional study of 50 children with UCP due to PWM lesions using 3 T (MRI), diffusion MRI and assessment of hand sensorimotor function. We explored the relationship of lobar, hemispheric and global scores on the sqMRI scale, with fractional anisotropy (FA), as a measure of brain white matter microstructure, and with hand sensorimotor measures (Assisting Hand Assessment, AHA; Jebsen-Taylor Test for Hand Function, JTTHF; Melbourne Assessment of Unilateral Upper Limb Function, MUUL; stereognosis; 2-point discrimination). Lobar and hemispheric scores on the sqMRI scale contralateral to the clinical side of hemiplegia correlated with sensorimotor paretic hand function measures and FA of a number of brain structural connections, including connections of brain areas involved in motor control (postcentral, precentral and paracentral gyri in the parietal lobe). More severe lesions correlated with lower sensorimotor performance, with the posterior limb of internal capsule score being the strongest contributor to impaired hand function. The sqMRI scale demonstrates first evidence of construct validity against impaired motor and sensory function measures and brain structural connectivity in a cohort of children with UCP due to PWM lesions. More severe lesions correlated with poorer paretic hand sensorimotor function and impaired structural connectivity in the hemisphere contralateral to the clinical side of hemiplegia. The quantitative structural MRI scoring may be a useful clinical tool for studying brain structure-function relationships but requires further validation in other populations of CP.

Home-based bimanual training based on motor learning principles in children with unilateral cerebral palsy and their parents (the COAD-study): rationale and protocols.

PubMed

Schnackers, Marlous; Beckers, Laura; Janssen-Potten, Yvonne; Aarts, Pauline; Rameckers, Eugène; van der Burg, Jan; de Groot, Imelda; Smeets, Rob; Geurts, Sander; Steenbergen, Bert

2018-04-18

Home-based training is considered an important intervention in rehabilitation of children with unilateral cerebral palsy. Despite consensus on the value of home-based upper limb training, no evidence-based best practice exists. Promoting compliance of children to adhere to an intensive program while keeping parental stress levels low is an important challenge when designing home-based training programs. Incorporating implicit motor learning principles emerges to be a promising method to resolve this challenge. Here we describe two protocols for home-based bimanual training programs, one based on implicit motor learning principles and one based on explicit motor learning principles, for children with unilateral spastic cerebral palsy aged 2 through 7 years. Children receive goal-oriented, task-specific bimanual training in their home environment from their parents for 3.5 h/week for 12 weeks according to an individualized program. Parents will be intensively coached by a multidisciplinary team, consisting of a pediatric therapist and remedial educationalist. Both programs consist of a preparation phase (goal setting, introductory meetings with coaching professionals, design of individualized program, instruction of parents, home visit) and home-based training phase (training, video-recordings, registrations, and telecoaching and home visits by the coaching team). The programs contrast with respect to the teaching strategy, i.e. how the parents support their child during training. In both programs parents provide their child with instructions and feedback that focus on the activity (i.e. task-oriented) or the result of the activity (i.e. result-oriented). However, in the explicit program parents are in addition instructed to give exact instructions and feedback on the motor performance of the bimanual activities, whereas in the implicit program the use of both hands and the appropriate motor performance of the activity are elicited via manipulation of the organization of the activities. With the protocols described here, we aim to take a next step in the development of much needed evidence-based home-based training programs for children with unilateral cerebral palsy.

Quantification of upper limb kinetic asymmetries in front crawl swimming.

PubMed

Morouço, Pedro G; Marinho, Daniel A; Fernandes, Ricardo J; Marques, Mário C

2015-04-01

This study aimed at quantifying upper limb kinetic asymmetries in maximal front crawl swimming and to examine if these asymmetries would affect the contribution of force exertion to swimming performance. Eighteen high level male swimmers with unilateral breathing patterns and sprint or middle distance specialists, volunteered as participants. A load-cell was used to quantify the forces exerted in water by completing a 30s maximal front crawl tethered swimming test and a maximal 50 m free swimming was considered as a performance criterion. Individual force-time curves were obtained to calculate the mean and maximum forces per cycle, for each upper limb. Following, symmetry index was estimated and breathing laterality identified by questionnaire. Lastly, the pattern of asymmetries along the test was estimated for each upper limb using linear regression of peak forces per cycle. Asymmetrical force exertion was observed in the majority of the swimmers (66.7%), with a total correspondence of breathing laterality opposite to the side of the force asymmetry. Forces exerted by the dominant upper limb presented a higher decrease than from the non-dominant. Very strong associations were found between exerted forces and swimming performance, when controlling the isolated effect of symmetry index. Results point that force asymmetries occur in the majority of the swimmers, and that these asymmetries are most evident in the first cycles of a maximum bout. Symmetry index stood up as an influencing factor on the contribution of tethered forces over swimming performance. Thus, to some extent, a certain degree of asymmetry is not critical for short swimming performance. Copyright © 2015 Elsevier B.V. All rights reserved.

Evaluation of mandibular angle ostectomy using three-dimensional finite element analysis.

PubMed

Song, Jian; Zhu, Songsong; Luo, En; Hu, Jing; Feng, Ge

2014-07-01

This study was designed to investigate the stress and the displacement distributions of the mandible after mandibular angle ostectomy (MAO) by means of three-dimensional finite element analysis. On the basis of a female patient with a prominent angle of the mandible, the finite element models were generated by helical computed tomography and related software and were analyzed under muscle forces and 3 kinds of biting conditions, including intercuspal position (ICP), incisal clenching (INC), and right unilateral molar clenching (RMOL). The mandibular stress and displacement distributions were analyzed by Abaqus software. In the model of MAO, the increased stress and the decreased displacement was found in ICP, INC, and RMOL at the area of mandibular angle. The stress and the displacement increased in ICP and RMOL, whereas the others remained unchanged in INC at the area of mandibular condylar neck. The results of this study have shown that MAO could alter biomechanical characteristics in the operated mandible, which suggested that a greater hit on face may lead to a higher incidence rate of condyle fracture and a lower incidence rate of angle fracture after MAO.

Melorheostosis of Leri: report of a case in a young African.

PubMed

Adeyomoye, A A O; Awosanya, G O G; Arogundade, R A

2004-09-01

Melorheostosis of Leri is a non-familial condition of hyperostosis of the cortical bone that usually presents unilaterally in long bones of the upper and lower limbs, but may also present in vertebra, ribs, skull and jaw. The incidence of this disease is quite rare, only about 300 cases have been reported worldwide. We present a case, which may be the first documented case in sub-Saharan Africa. S.K. is a 14 year old male student who presented to the hospital with an 18 month history of persistent pain in the joints of the right upper limb and a limb length discrepancy since birth which has worsened with growth. Examination revealed generalised hypoplasia of the right upper limb with shortening of the limb and atrophy of the muscles, also hypoplasia and contracture of the thumb was observed. The radiographs of the limb showed multiple areas of dense hyperostosis and scleroderma, which showed a linear distribution along the radial half of the bones. In children presentation of melorheostosis, is more likely be as limb length discrepancy, deformity or joint contractures which may be seen before radiographic evidence of any bony changes. Improvement in imaging techniques will therefore result in early diagnosis and greater success with conservative management. Also the increased frequency of tumours necessitates long-term follow up. melorheostosis, scleroderma.

Bilateral robots for upper-limb stroke rehabilitation: State of the art and future prospects.

PubMed

Sheng, Bo; Zhang, Yanxin; Meng, Wei; Deng, Chao; Xie, Shengquan

2016-07-01

Robot-assisted bilateral upper-limb training grows abundantly for stroke rehabilitation in recent years and an increasing number of devices and robots have been developed. This paper aims to provide a systematic overview and evaluation of existing bilateral upper-limb rehabilitation devices and robots based on their mechanisms and clinical-outcomes. Most of the articles studied here were searched from nine online databases and the China National Knowledge Infrastructure (CNKI) from year 1993 to 2015. Devices and robots were categorized as end-effectors, exoskeletons and industrial robots. Totally ten end-effectors, one exoskeleton and one industrial robot were evaluated in terms of their mechanical characteristics, degrees of freedom (DOF), supported control modes, clinical applicability and outcomes. Preliminary clinical results of these studies showed that all participants could gain certain improvements in terms of range of motion, strength or physical function after training. Only four studies supported that bilateral training was better than unilateral training. However, most of clinical results cannot definitely verify the effectiveness of mechanisms and clinical protocols used in robotic therapies. To explore the actual value of these robots and devices, further research on ingenious mechanisms, dose-matched clinical protocols and universal evaluation criteria should be conducted in the future. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

Congenital Becker's nevus with a familial association.

PubMed

Book, S E; Glass, A T; Laude, T A

1997-01-01

Becker's nevus is a unilateral, hyperpigmented cutaneous hamartoma usually with hypertrichosis. It occurs predominantly in boys, becoming apparent during adolescence, although several cases of congenital Becker's nevus have been reported. Rarely it may be familial and as such is transmitted in an autosomal dominant pattern. We report a 16-month-old black boy with a hyperpigmented patch on his right shoulder and upper pectoral area that extended down his arm. The patient's father has a similar lesion with hair on his left shoulder which has been present since childhood. Histology of the child's lesion was consistent with Becker's nevus. We believe this to be the first reported case of a congenital Becker's nevus with a familial association.

A comprehensive musculoskeletal and peripheral nervous system assessment of war-related bilateral upper extremity amputees.

PubMed

Allami, Mostafa; Mousavi, Batool; Masoumi, Mehdi; Modirian, Ehsan; Shojaei, Hadi; Mirsalimi, Fatemeh; Hosseini, Maryam; Pirouzi, Pirouz

2016-01-01

Upper limb amputations are one of the unpleasant war injuries that armed forces are exposed to frequently. The present study aimed to assess the musculoskeletal and peripheral nervous systems in Iraq-Iran war veterans with bilateral upper extremity amputation. The study consisted of taking a history and clinical examinations including demographic data, presence and location of pain, level of amputation, passive and active ranges of movement of the joints across the upper and lower extremities and spine, manual palpation, neurological examination, blood circulation pulses and issues related to a prosthetic limb. In this study, 103 Iranian bilateral upper extremity amputees (206 amputations) from the Iran-Iraq war were evaluated, and a detailed questionnaire was also administered. The most common level of amputation was the finger or wrist level (108, 52.4 %). Based on clinical examination, we found high frequencies of limited active and passive joint range of movement across the scapula, shoulder, elbow, wrist and metacarpophalangeal, interphalangeal and thumb joints. Based on muscle strength testing, we found varying degrees of weakness across the upper limbs. Musculoskeletal disorders included epicondylitis (65, 31.6 %), rotator cuff injury (24, 11.7 %), bicipital tendonitis (69, 33.5 %), shoulder drop (42, 20.4 %) and muscle atrophy (19, 9.2 %). Peripheral nerve disorders included carpal tunnel syndrome in 13 (6.3 %) and unilateral brachial plexus injury in 1 (1 %). Fifty-three (51.5 %) were diagnosed with facet joint syndrome at the level of the cervical spine (the most frequent site). Using a prosthesis was reported by 65 (63.1 %), both left and right sides. The back was the most common site of pain (71.8 %). The high prevalence of neuro-musculoskeletal disorders among bilateral upper extremity amputees indicates that they need regular rehabilitation care.

Uneventful upper cervical manipulation in the presence of a damaged vertebral artery.

PubMed

Michaud, Thomas C

2002-09-01

To discuss a case in which a patient with a previously injured vertebral artery underwent manipulation in the upper cervical spine without alteration of her symptom pattern. The literature concerning the relative safety of specific upper cervical manipulative techniques is reviewed. A 42-year-old woman had a 3-week history of unilateral suboccipital pain that she related to a sudden twisting of her head and neck that occurred while she was putting sheets of drywall on top of her car. Subsequent examination by a neurologist 2 weeks later was unremarkable, and a tension-type headache was diagnosed. Approximately 10 days later (3 weeks after injury), a single high-velocity upper-cervical manipulation (incorporating slight rotation and full lateral flexion) was performed with no change in her symptom pattern. Two weeks after that, the patient had development of a lateral medullary syndrome (also known as Wallenberg syndrome) after she briefly extended and rotated her upper cervical spine while painting a ceiling. The patient was treated with anticoagulant therapy, and the lateral medullary infarct healed without incident. The spinocerebellar and subtle motor symptoms also resolved, but the ipsilateral suboccipital headache and the loss of temperature sensation associated with the spinothalamic tract lesion were still present 9 months later. This case report demonstrates that vigorous manipulation of the upper cervical spine is possible without injuring an already damaged vertebral artery. It is suggested that the line of drive used during the single manipulation, almost pure lateral flexion with slight rotation, was responsible for the apparent innocuous response. Guidelines for the evaluation and management of vertebral artery dissection are reviewed. Because it is currently impossible to identify patients at risk of having a dissected vertebral artery with standard in-office examination procedures, rotational manipulation of the upper cervical spine should be abandoned by all practitioners, and schools should remove such techniques from their curriculums.

Three-dimensional development of the upper dental arch in unilateral cleft lip and palate patients after early neonatal cheiloplasty.

PubMed

Hoffmannova, E; Moslerová, V; Dupej, J; Borský, J; Bejdová, Š; Velemínská, J

2018-06-01

This prospective morphometric study evaluated the growth of the upper dental arch in UCLP patients after early neonatal cheiloplasty and compared the selected dimensions with published data on non-cleft controls and on later operation protocol patients. The sample comprised 36 Czech children with nonsyndromic complete UCLP (cUCLP) and 20 Czech children with nonsyndromic incomplete UCLP (UCLP + b). 2-D and 3-D analyses of palatal casts were made at two time points: before neonatal cheiloplasty at the mean age of 3 days (±1 day), and 10 months after surgery at the mean age of 10 months (±1 month). The upper dental arch of cUCLP and UCLP + b patients showed similar developmental changes, but the cleft type influenced growth significantly. The initial high shape variability in cUCLP patients diminished after 10 months, and approached the variability in UCLP + b patients. Both the width and length dimensions increased after surgery. Important growth concerned the anterior ends of both segments. The width and length dimensions illustrated similar growth trends with non-cleft controls and UCLP patients who underwent later cheiloplasty. Early neonatal cheiloplasty caused no reduction in the length or width dimensions during the first year of life. Our data suggest a reconstructed lip has a natural formative effect on the actively growing anterior parts of upper dental arch segments, which cause narrowing of the alveolar cleft. Copyright © 2018 Elsevier B.V. All rights reserved.

Analysis of Transforming Growth Factor- β1 Expression in Resorptive Lacunae following Orthodontic Tooth Movement in An Animal Model.

PubMed

Seifi, Massoud; Kazemi, Bahram; Kabiri, Sattar; Badiee, Mohammadreza

2017-01-01

Root resorption is a complication of orthodontic treatment and till date, there is a dearth of information regarding this issue. The aim of this study was to determine whether the expression of transforming growth factor-β1 (TGF-β1, an inflammatory cytokine) is related to orthodontic force. Moreover, if associated, the expression level may be helpful in differential diagnosis, control and ultimate treatment of the disease. In this experimental study, a total of 24 eight-week-old male Wistar rats were selected randomly. On day 0, an orthodontic appliance, which consisted of a closed coil spring, was ligated to the upper right first molar and incisor. The upper left first molar in these animals was not placed under orthodontic force, thus serving as the control group. On day 21, after anesthesia, the animals were sacrificed. The rats were then divided into two equal groups where the first group was subjected to histological evaluation and the second group to reverse transcriptase-polymerase chain reaction (RT-PCR). Orthodontic tooth movement was measured in both groups to determine the influence of the applied force. Statistical analysis of data showed a significant root resorption between the experimental group and control group (P<0.05), however, there was no significant difference in the expression level of the inflammatory cytokine, TGF-β1 . Based on the findings of this study, we suggest that there is a direct relationship between orthodontic force and orthodontic induced inflammatory root resorption. In addition, no relationship is likely to exist between root resorption and TGF-β1 expression in the resorptive lacunae.

The effects of systemic stress on orthodontic tooth movement.

PubMed

Gameiro, Gustavo Hauber; Nouer, Darcy Flávio; Pereira-Neto, Joáo Sarmento; Urtado, Marília Bertoldo; Novaes, Pedro Duarte; de Castro, Margaret; Veiga, Maria Cecília Ferraz Arruda

2008-11-01

To determine if systemic stress affects the biological reactions occurring during orthodontic tooth movement. Four groups of male 10 week-old Wistar rats were used. Group A animals (N=10) were restrained for one hour per day for 40 days; Group B animals (N=10) were restrained for one hour per day for three days; Group C (N=10) and Group D (N=8) animals were unrestrained. The upper left first molars in the rats in Groups A (long-term stress), B (short-term stress) and C (control) were moved mesially during the last 14 days of the experiment. The animals in Group D (N=8) were used for body weight and hormonal dosage comparisons only. They were not subjected to any stress and did not have appliances fitted. All animals were killed at 18 weeks of age and blood collected for measurement of plasma corticosterone. Tooth movement was measured with an electronic caliper. The right and left hemi-maxillae of five rats from each group were removed and the number of tartrate-resistant acid phosphatase (TRAP) positive cells, defined as osteoclasts, adjacent to the mesial roots of the upper first molars counted. The contralateral side in each animal served as the control (split-mouth design). Corticosterone levels were significantly higher in the stressed groups (Groups A and B) than in the control group (Group C). Tooth movement was significantly greater in Group A (long-term stress) compared with Group B (short-term stress) and Group C (control), which did not differ from each other. There were significantly more osteoclasts in the long-term stress group than in the short-term stress and control groups. Persistent systemic stress increases bone resorption during orthodontic tooth movement. Systemic stress may affect the rate of tooth movement during orthodontic treatment.

Comparison of changes in the transverse dental axis between patients with skeletal Class III malocclusion and facial asymmetry treated by orthognathic surgery with and without presurgical orthodontic treatment.

PubMed

Song, Han-Sol; Choi, Sung-Hwan; Cha, Jung-Yul; Lee, Kee-Joon; Yu, Hyung-Seog

2017-07-01

To evaluate transverse skeletal and dental changes, including those in the buccolingual dental axis, between patients with skeletal Class III malocclusion and facial asymmetry after bilateral intraoral vertical ramus osteotomy with and without presurgical orthodontic treatment. This retrospective study included 29 patients with skeletal Class III malocclusion and facial asymmetry including menton deviation > 4 mm from the midsagittal plane. To evaluate changes in transverse skeletal and dental variables (i.e., buccolingual inclination of the upper and lower canines and first molars), the data for 16 patients who underwent conventional orthognathic surgery (CS) were compared with those for 13 patients who underwent preorthodontic orthognathic surgery (POGS), using three-dimensional computed tomography at initial examination, 1 month before surgery, and at 7 days and 1 year after surgery. The 1-year postsurgical examination revealed no significant changes in the postoperative transverse dental axis in the CS group. In the POGS group, the upper first molar inclined lingually on both sides (deviated side, -1.8° ± 2.8°, p = 0.044; nondeviated side, -3.7° ± 3.3°, p = 0.001) and the lower canine inclined lingually on the nondeviated side (4.0° ± 5.4°, p = 0.022) during postsurgical orthodontic treatment. There were no significant differences in the skeletal and dental variables between the two groups at 1 year after surgery. POGS may be a clinically acceptable alternative to CS as a treatment to achieve stable transverse axes of the dentition in both arches in patients with skeletal Class III malocclusion and facial asymmetry.

Analysis of Transforming Growth Factor- β1 Expression in Resorptive Lacunae following Orthodontic Tooth Movement in An Animal Model

PubMed Central

Seifi, Massoud; Kazemi, Bahram; Kabiri, Sattar; Badiee, Mohammadreza

2017-01-01

Objective Root resorption is a complication of orthodontic treatment and till date, there is a dearth of information regarding this issue. The aim of this study was to determine whether the expression of transforming growth factor-β1 (TGF-β1, an inflammatory cytokine) is related to orthodontic force. Moreover, if associated, the expression level may be helpful in differential diagnosis, control and ultimate treatment of the disease. Materials and Methods In this experimental study, a total of 24 eight-week-old male Wistar rats were selected randomly. On day 0, an orthodontic appliance, which consisted of a closed coil spring, was ligated to the upper right first molar and incisor. The upper left first molar in these animals was not placed under orthodontic force, thus serving as the control group. On day 21, after anesthesia, the animals were sacrificed. The rats were then divided into two equal groups where the first group was subjected to histological evaluation and the second group to reverse transcriptase-polymerase chain reaction (RT-PCR). Orthodontic tooth movement was measured in both groups to determine the influence of the applied force. Results Statistical analysis of data showed a significant root resorption between the experimental group and control group (P<0.05), however, there was no significant difference in the expression level of the inflammatory cytokine, TGF-β1. Conclusion Based on the findings of this study, we suggest that there is a direct relationship between orthodontic force and orthodontic induced inflammatory root resorption. In addition, no relationship is likely to exist between root resorption and TGF-β1 expression in the resorptive lacunae. PMID:28670520

Global distribution of secondary organic aerosol particle phase state

NASA Astrophysics Data System (ADS)

Shiraiwa, M.; Li, Y., Sr.; Tsimpidi, A.; Karydis, V.; Berkemeier, T.; Pandis, S. N.; Lelieveld, J.; Koop, T.; Poeschl, U.

2016-12-01

Secondary organic aerosols (SOA) account for a large fraction of submicron particles in the atmosphere and play a key role in aerosol effects on climate, air quality and public health. The formation and aging of SOA proceed through multiple steps of chemical reaction and mass transport in the gas and particle phases, which is challenging for the interpretation of field measurements and laboratory experiments as well as accurate representation of SOA evolution in atmospheric aerosol models. SOA particles can adopt liquid, semi-solid and amorphous solid (glassy) phase states depending on chemical composition, relative humidity and temperature. The particle phase state is crucial for various atmospheric gas-particle interactions, including SOA formation, heterogeneous and multiphase reactions and ice nucleation. We found that organic compounds with a wide variety of functional groups fall into molecular corridors, characterized by a tight inverse correlation between molar mass and volatility. Based on the concept of molecular corridors, we develop a method to estimate glass transition temperatures based on the molar mass and molecular O:C ratio of SOA components, which is a key property for determination of particle phase state. We use the global chemistry climate model EMAC with the organic aerosol module ORACLE to predict the atmospheric SOA phase state. For the planetary boundary layer, global simulations indicate that SOA is mostly liquid in tropical and polar air with high relative humidity, semi-solid in the mid-latitudes, and solid over dry lands. We find that in the middle and upper troposphere (>500 hPa) SOA should be mostly in a glassy solid phase state. Thus, slow diffusion of water, oxidants, and organic molecules could kinetically limit gas-particle interactions of SOA in the free and upper troposphere, promote ice nucleation and facilitate long-range transport of reactive and toxic organic pollutants embedded within SOA.

Muscle activity of the core during bilateral, unilateral, seated and standing resistance exercise.

PubMed

Saeterbakken, Atle Hole; Fimland, Marius Steiro

2012-05-01

Little is known about the effect of performing common resistance exercises standing compared to seated and unilaterally compared to bilaterally on muscle activation of the core. Thus, the purpose of this study was to compare the electromyographic activity (EMG) of the superficial core muscles (i.e. rectus abdominis, external oblique and erector spinae) between seated, standing, bilateral and unilateral dumbbell shoulder presses. 15 healthy males performed five repetitions at 80% of one-repetition maximum of the exercises in randomized order. Results were analyzed with a two-way analysis of variance and a Bonferroni post hoc test. The position × exercise interaction was significantly different for rectus abdominis (P = 0.016), but not for external oblique (P = 0.100) and erector spinae (P = 0.151). The following EMG results were observed: For rectus abdominis: ~49% lower in seated bilateral versus unilateral (P < 0.001), similar in standing bilateral versus unilateral (P = 0.408), ~81% lower in bilateral seated versus standing (P < 0.001), ~59% lower in unilateral seated versus standing (P < 0.001); For external oblique: ~81% lower in seated bilateral versus unilateral (P < 0.001), ~68% lower in standing bilateral than unilateral (P < 0.001), ~58% lower in bilateral seated versus standing (P < 0.001), ~28% lower in unilateral seated versus standing (P = 0.002); For erector spinae: similar in seated bilateral versus unilateral (P = 0.737), ~18% lower in standing bilateral versus unilateral (P = 0.001), similar in seated versus standing bilateral (P = 0.480) and unilateral (P = 0.690). In conclusion, to enhance neuromuscular activation of the superficial core muscles, standing exercises should be used instead of seated exercises, and unilateral exercises should be used instead of bilateral exercises.

Dental and skeletal changes in the upper and lower jaws after treatment with Schwarz appliances using cone-beam computed tomography.

PubMed

Tai, Kiyoshi; Park, Jae Hyun

2010-01-01

The purpose of this research was to use cone-beam computed tomography (CBCT) images to evaluate dental and skeletal changes in upper and lower jaws after treatment with Schwarz appliances. 28 patients with Angle Class I molar relationships and crowding were randomly divided into two groups--14 non-expanded and 14 expanded patients. 3D-Rugle CBCT software was used to measure various reference points before treatment (TO) and during the retention period of approximately 9 months after 6 to 12 month expansion (T1). Cephalometric and cast measurements were used to evaluate treatment in both groups. To test whether there were any significant differences between the control and treatment groups at TO and T1, the Mann-Whitney U-test was used. The dental arch (including tooth root apices) had expanded in the upper and lower jaws. Alveolar bone expansion of up to 2 mm apical to the cementoenamel junction (CEJ) was detected. The midpalatal sutures were separated in some cases and subsequent expansion was observed at the inner surface of the nasal cavity at the inferior turbinates. However no significant (P > 0.05) difference was observed in the inter-width of the mandibular bodies, zygomatic bones, nasal cavity in the middle turbinate region, condylar heads, or antegonial notches. In mandibular and maxillary cast measurements, arch crowding and arch perimeter showed statistically significant changes in the expansion group. The mandibular width values demonstrated no significant changes as measured from a point 2 mm apical to the CEJ whereas the maxillary width values demonstrated significant changes as measured from a point 2 mm apical to the CEJ. This study indicates that the Schwarz appliance primarily affects the dento-alveolar complex, while it has little effect on either the mandibular bodies, any associated structures including the maxillary midpalatal suture and the inter-width of the nasal cavity in the middle turbinate region. In addition, the center of rotation of the mandibular and maxillary first molar was observed apical to the root apex.

A Chinese patient with pusher syndrome and unilateral spatial neglect syndrome.

PubMed

Chen, Xiao-Wei; Lin, Cheng-He; Zheng, Hua; Lin, Zhen-Lan

2014-07-01

To observe clinical manifestations, behavioral characteristics, and effects of rehabilitation on a patient with pusher syndrome and unilateral spatial neglect caused by right thalamic hemorrhage. Assessment of pusher syndrome was made by the Scale for Contraversive pushing (SCP), and unilateral spatial neglect syndrome was diagnosed using line cancellation, letter and star cancellation, line bisection tests and copy and continuation of graphic sequence test. Behavioral therapy, occupational therapy, reading training and traditional Chinese medicine methods were adopted for treatment of pusher syndrome and unilateral spatial neglect. The patient showed typical pusher syndrome and unilateral spatial neglect symptoms. The pusher syndrome and unilateral spatial neglect symptoms were significantly improved following rehabilitation treatments. Pusher syndrome and unilateral spatial neglect syndrome occurred simultaneously after right thalamic hemorrhage. Early rehabilitation therapy can reduce the symptoms of pusher syndrome and unilateral spatial neglect syndrome and improve motor function.

Dental health state utility values associated with tooth loss in two contrasting cultures.

PubMed

Nassani, M Z; Locker, D; Elmesallati, A A; Devlin, H; Mohammadi, T M; Hajizamani, A; Kay, E J

2009-08-01

The study aimed to assess the value placed on oral health states by measuring the utility of mouths in which teeth had been lost and to explore variations in utility values within and between two contrasting cultures, UK and Iran. One hundred and fifty eight patients, 84 from UK and 74 from Iran, were recruited from clinics at University-based faculties of dentistry. All had experienced tooth loss and had restored or unrestored dental spaces. They were presented with 19 different scenarios of mouths with missing teeth. Fourteen involved the loss of one tooth and five involved shortened dental arches (SDAs) with varying numbers of missing posterior teeth. Each written description was accompanied by a verbal explanation and digital pictures of mouth models. Participants were asked to indicate on a standardized Visual Analogue Scale how they would value the health of their mouth if they had lost the tooth/teeth described and the resulting space was left unrestored. With a utility value of 0.0 representing the worst possible health state for a mouth and 1.0 representing the best, the mouth with the upper central incisor missing attracted the lowest utility value in both samples (UK = 0.16; Iran = 0.06), while the one with a missing upper second molar the highest utility values (0.42, 0.39 respectively). In both countries the utility value increased as the tooth in the scenario moved from the anterior towards the posterior aspect of the mouth. There were significant differences in utility values between UK and Iranian samples for four scenarios all involving the loss of anterior teeth. These differences remained after controlling for gender, age and the state of the dentition. With respect to the SDA scenarios, a mouth with a SDA with only the second molar teeth missing in all quadrants attracted the highest utility values, while a mouth with an extreme SDA with both missing molar and premolar teeth in all quadrants attracted the lowest utility values. The study provided further evidence of the validity of the scaling approach to utility measurement in mouths with missing teeth. Some cross-cultural variations in values were observed but these should be viewed with due caution because the magnitude of the differences was small.

Rapid urease test (RUT) for evaluation of urease activity in oral bacteria in vitro and in supragingival dental plaque ex vivo.

PubMed

Dahlén, Gunnar; Hassan, Haidar; Blomqvist, Susanne; Carlén, Anette

2018-05-18

Urease is an enzyme produced by plaque bacteria hydrolysing urea from saliva and gingival exudate into ammonia in order to regulate the pH in the dental biofilm. The aim of this study was to assess the urease activity among oral bacterial species by using the rapid urease test (RUT) in a micro-plate format and to examine whether this test could be used for measuring the urease activity in site-specific supragingival dental plaque samples ex vivo. The RUT test is based on 2% urea in peptone broth solution and with phenol red at pH 6.0. Oral bacterial species were tested for their urease activity using 100 μl of RUT test solution in the well of a micro-plate to which a 1 μl amount of cells collected after growth on blood agar plates or in broth, were added. The color change was determined after 15, 30 min, and 1 and 2 h. The reaction was graded in a 4-graded scale (none, weak, medium, strong). Ex vivo evaluation of dental plaque urease activity was tested in supragingival 1 μl plaque samples collected from 4 interproximal sites of front teeth and molars in 18 adult volunteers. The color reaction was read after 1 h in room temperature and scored as in the in vitro test. The strongest activity was registered for Staphylococcus epidermidis, Helicobacter pylori, Campylobacter ureolyticus and some strains of Haemophilus parainfluenzae, while known ureolytic species such as Streptococcus salivarius and Actinomyces naeslundii showed a weaker, variable and strain-dependent activity. Temperature had minor influence on the RUT reaction. The interproximal supragingival dental plaque between the lower central incisors (site 31/41) showed significantly higher scores compared to between the upper central incisors (site 11/21), between the upper left first molar and second premolar (site 26/25) and between the lower right second premolar and molar (site 45/46). The rapid urease test (RUT) in a micro-plate format can be used as a simple and rapid method to test urease activity in bacterial strains in vitro and as a chair-side method for testing urease activity in site-specific supragingival plaque samples ex vivo.

Effects of Bulk Composition on the Atmospheric Dynamics on Close-in Exoplanets

NASA Astrophysics Data System (ADS)

Zhang, Xi; Showman, Adam P.

2017-02-01

Super Earths and mini Neptunes likely have a wide range of atmospheric compositions, ranging from low molecular mass atmospheres of H2 to higher molecular atmospheres of water, CO2, N2, or other species. Here we systematically investigate the effects of atmospheric bulk compositions on temperature and wind distributions for tidally locked sub-Jupiter-sized planets, using an idealized 3D general circulation model (GCM). The bulk composition effects are characterized in the framework of two independent variables: molecular weight and molar heat capacity. The effect of molecular weight dominates. As the molecular weight increases, the atmosphere tends to have a larger day-night temperature contrast, a smaller eastward phase shift in the thermal phase curve, and a smaller zonal wind speed. The width of the equatorial super-rotating jet also becomes narrower, and the “jet core” region, where the zonal-mean jet speed maximizes, moves to a greater pressure level. The zonal-mean zonal wind is more prone to exhibit a latitudinally alternating pattern in a higher molecular weight atmosphere. We also present analytical theories that quantitatively explain the above trends and shed light on the underlying dynamical mechanisms. Those trends might be used to indirectly determine the atmospheric compositions on tidally locked sub-Jupiter-sized planets. The effects of the molar heat capacity are generally small. But if the vertical temperature profile is close to adiabatic, molar heat capacity will play a significant role in controlling the transition from a divergent flow in the upper atmosphere to a jet-dominated flow in the lower atmosphere.

Long-Term Results of Mandibular Distraction Osteogenesis with a Resorbable Device in Infants with Robin Sequence: Effects on Developing Molars and Mandibular Growth.

PubMed

Paes, Emma C; Bittermann, Gerhard K P; Bittermann, Dirk; Muradin, Marvick M; van Hogezand, Rose; Etty, Erika; Mink van der Molen, Aebele B; Kon, Moshe; Breugem, Corstiaan C

2016-02-01

Mandibular distraction osteogenesis with a unidirectional resorbable device is an effective treatment option for severe upper airway obstruction in infants with Robin sequence. Long-term effects, especially with regard to tooth development and mandibular outgrowth, are not known. Robin sequence infants with a follow-up of greater than or equal to 5 years were included. Baseline characteristics were extracted from medical records. Panoramic and lateral cephalometric radiographs were analyzed and patients were recalled for physical examination. Ten infants underwent mandibular distraction osteogenesis at a mean age of 3.7 months (median, 19 months; range, 11 days to 27 months). Mean length of follow-up was 6.8 years (range, 5.0 to 7.9 years). Ten Robin sequence infants without mandibular distraction osteogenesis (mean length of follow-up, 7.4 years; range, 6.7 to 8.9 years) were the controls. Shape anomalies, positional changes, and root malformations of molars were seen significantly more often than in the control group (p = 0.007, p = 0.009, and p = 0.043, respectively). Mandibular length was shorter (p = 0.030), but mandibular ramus height was comparable (p = 0.838) with that of the non-mandibular distraction osteogenesis group. Compared with healthy controls, all Robin sequence infants had a significantly shorter mandible. Mandibular distraction osteogenesis with a resorbable system reveals overall good short- and long-term results, but the effects on developing molars and mandibular outgrowth likely necessitate secondary procedures. This factor should be considered when deciding on treatment options and counseling of parents. Therapeutic, III.

Ethnic Association of Cusp of Carabelli Trait and Shoveling Trait in an Indian Population

PubMed Central

Manju, M; Praveen, R; Umesh, W

2016-01-01

Introduction Variations in the structure of teeth have always been of great interest to the dentist from the scientific as well as practical point of view. Additionally, ever since decades inter trait relationships have been a useful means to categorize populations to which an individual belongs. Aim To determine the association between Cusp of Carabelli and Shoveling Trait in a selected Indian population native of Bangalore city, Karnataka, India. Materials and Methods A cross-sectional study was carried out in 1885 children aged between 7-10 years. Casts of the study subjects were made to study the presence of Cusp of Carabelli of right maxillary permanent molar and shoveling trait of right maxillary permanent central incisor using the Dahlberg’s classification and Hrdliucka’s classification respectively. Linear regression was used to assess the association of cusp of carabelli trait with the tooth dimensions and logistic regression was used to evaluate the association of the carabelli trait with gender and presence/absence of shoveling. Results A 40.5% of subjects had Cusp of Carabelli on first molar and 68.2% had shoveling on upper central incisor. The study revealed positive association between the two traits studied in the population. A significant difference was also found with presence of Cusp of Carabelli and the buccolingual tooth dimension of the maxillary molar (p<0.05). Conclusion There is an association between the Cusp of Carabelli and the shoveling trait in the present study population, and this will be valuable in the determination of ethnic origin of an individual. PMID:27135008

Lithium chloride attenuates root resorption during orthodontic tooth movement in rats.

PubMed

Wang, Yu; Gao, Shang; Jiang, Huan; Lin, Peng; Bao, Xingfu; Zhang, Zhimin; Hu, Min

2014-02-01

Root resorption is a common side effect of orthodontic treatment. In the current study, lithium chloride (LiCl), a Wnt signaling activator, was examined to determine its effect on root resorption. In total, 10 Sprague Dawley rats were randomly allocated into the experimental group (EG) and control group (CG). Each group consisted of five subjects. By using closed nickel-titanium coil springs, a 50-g force was applied between the upper incisors and the maxillary right first molars in order to mimic orthodontic biomechanics in the EG and CG for 14 days. During the 14 days, the EG rats were gavage-fed 200 mg/kg LiCl every 48 h. Next, digital radiographs were captured using a micro-computational tomography scanner. The movement of the maxillary first molars and the root resorption area ratio were measured electronically on the digital radiographs. The outcomes were analyzed using ANOVA. Following 14 days of experimental force application, all rats had spaces of varying sizes between the first and second right maxillary molars. The average distance measured in the CG was slightly higher than in the EG, however, the difference was not found to be statistically significant (P=0.224). Root resorption craters were observed in the groups following the experiment. Rough cementum areas were observed on the mesial surface of the distobuccal and distopalatal roots. The mean root resorption area ratio of CG was significantly greater than EG (P<0.05). Results of the present study indicate that LiCl can attenuate orthodontically induce root resorption during orthodontic tooth movement. The effect of LiCl on tooth movement is insignificant.

Association between unilateral or bilateral mastectomy and breast cancer death in patients with unilateral ductal carcinoma.

PubMed

Agarwal, Shailesh; Pappas, Lisa; Agarwal, Jayant

2017-01-01

Utilization of bilateral mastectomy for unilateral breast cancer is increasing despite cost and surgical risks with conflicting reports of survival benefit. Current studies evaluating death after bilateral mastectomy have included patients treated both with breast conservation therapy and unilateral mastectomy. In this study, we directly compared breast cancer-specific death of patients who underwent bilateral or unilateral mastectomy for unilateral breast cancer using a matched cohort analysis. This was an observational study of women diagnosed with unilateral breast cancer from 1998 through 2002, using the Surveillance, Epidemiology, and End Results (SEER) database. A 4-to-1 matched cohort of patients was selected including 14,075 patients. Mortality of the groups was compared using Cox proportional hazards models for cause-specific death. A total of 41,510 patients diagnosed with unilateral breast cancer were included. Unilateral mastectomy was performed in 93% of patients, while bilateral mastectomy was performed in the remaining 7% of patients. When 4-to-1 matching was performed, 11,260 unilateral mastectomy and 2,815 bilateral mastectomy patients were included. Patients with bilateral mastectomy did not have a significantly lower hazard of breast cancer-specific death when compared with patients with unilateral mastectomy (hazard ratio: 0.92 vs 1.00, p =0.11). Bilateral mastectomy did not provide a clinically or statistically significant breast cancer-specific mortality benefit over unilateral mastectomy based on a matched cohort analysis of a nationwide population database. These findings should be interpreted in the context of patient preference and alternative benefits of bilateral mastectomy.

Association between unilateral or bilateral mastectomy and breast cancer death in patients with unilateral ductal carcinoma

PubMed Central

Agarwal, Shailesh; Pappas, Lisa; Agarwal, Jayant

2017-01-01

Background Utilization of bilateral mastectomy for unilateral breast cancer is increasing despite cost and surgical risks with conflicting reports of survival benefit. Current studies evaluating death after bilateral mastectomy have included patients treated both with breast conservation therapy and unilateral mastectomy. In this study, we directly compared breast cancer–specific death of patients who underwent bilateral or unilateral mastectomy for unilateral breast cancer using a matched cohort analysis. Methods This was an observational study of women diagnosed with unilateral breast cancer from 1998 through 2002, using the Surveillance, Epidemiology, and End Results (SEER) database. A 4-to-1 matched cohort of patients was selected including 14,075 patients. Mortality of the groups was compared using Cox proportional hazards models for cause-specific death. Results A total of 41,510 patients diagnosed with unilateral breast cancer were included. Unilateral mastectomy was performed in 93% of patients, while bilateral mastectomy was performed in the remaining 7% of patients. When 4-to-1 matching was performed, 11,260 unilateral mastectomy and 2,815 bilateral mastectomy patients were included. Patients with bilateral mastectomy did not have a significantly lower hazard of breast cancer–specific death when compared with patients with unilateral mastectomy (hazard ratio: 0.92 vs 1.00, p=0.11). Conclusion Bilateral mastectomy did not provide a clinically or statistically significant breast cancer–specific mortality benefit over unilateral mastectomy based on a matched cohort analysis of a nationwide population database. These findings should be interpreted in the context of patient preference and alternative benefits of bilateral mastectomy. PMID:29180900

Impact of unilateral conductive hearing loss due to aural atresia on academic performance in children.

PubMed

Kesser, Bradley W; Krook, Kaelyn; Gray, Lincoln C

2013-09-01

This study evaluates the effect of unilateral conductive hearing loss secondary to aural atresia on elementary school children's academic performance. Case control survey and review of audiometric data. One hundred thirty-two surveys were mailed to families of children with aural atresia, and 48 surveys were sent to families of children with unilateral sensorineural hearing loss (SNHL) to identify rates of grade retention, use of any resource, and behavioral problems. Audiometric data of the cohort were tabulated. Of the 40 atresia patients, none repeated a grade, but 65% needed some resources: 12.5% currently use a hearing aid, 32.5% use(d) a frequency-modulated system in school, 47.5% had an Individualized Education Plan, and 45% utilized speech therapy. Compared to the unilateral SNHL group and a cohort of children with unilateral SNHL in an earlier study, children with unilateral atresia were less likely to repeat a grade. Children in both unilateral atresia and SNHL groups were more likely to utilize some resource in the academic setting compared to the unilateral SNHL children in the prior study. Unilateral conductive hearing loss due to aural atresia has an impact on academic performance in children, although not as profound when compared to children with unilateral SNHL. The majority of these children with unilateral atresia utilize resources in the school setting. Parents, educators, and health care professionals should be aware of the impact of unilateral conductive hearing loss and offer appropriate habilitative services. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

[Asymmetric negative pressure pulmonary edema after acute upper airway obstruction: case report].

PubMed

Peixoto, Aldo José

2002-06-01

Negative pressure pulmonary edema after acute upper airway obstruction is a well-described event, though infrequently diagnosed and reported. This report aimed at presenting a case of upper airway obstruction negative pressure pulmonary edema following acute upper airway obstruction characterized by pulmonary edema asymmetry, being more prominent in the right lung. A 4-year-old boy, 17 kg, phisical status ASA I submitted to combined tonsillectomy, adenoidectomy and turbinate cauterization under general anesthesia with sevoflurane/nitrous oxide/O2. Surgery duration was 90 minutes without complications. During anesthetic recovery and spontaneously breathing, patient reacted to tracheal tube, which was removed. Following, ventilatory efforts resulted in chest wall retraction without apparent air movement, being impossible to ventilate him with facial mask. Symptoms evolved to severe hypoxemia (50% SpO2) requiring reintubation. At this point, it was observed that the lung was stiffer and there were bilateral rales characterizing pulmonary edema. A chest X-ray showed diffuse bilateral infiltrates, right upper lobe atelectasis and marked pulmonary edema asymmetry (right greater than left). Patient was mechanically ventilated with PEEP for 20 hours when he was extubated. There was a progressive pulmonary edema improvement and patient was discharged 48 hours later. Negative pressure pulmonary edema (NPPE) is a rare event with high morbidity risk. It is often not diagnosed and requires from the anesthesiologist an updated knowledge and adequate management. It is usually bilateral, rarely unilateral, and exceptionally asymmetric as in this case. Most cases are treated by mechanical ventilation with PEEP or CPAP without any other therapy. The prognosis is favorable, with most cases recovering within the first 24 hours.

Simultaneous antegrade/retrograde upper urinary tract access: Bart's modified lateral position for complex upper tract endourologic pathologic features.

PubMed

Moraitis, Konstantinos; Philippou, Prodromos; El-Husseiny, Tamer; Wazait, Hassan; Masood, Junaid; Buchholz, Noor

2012-02-01

To determine whether the Bart's modified lateral position is safe and effective for achieving simultaneous anterograde and retrograde access in complex upper urinary tract pathologic features. From November 2006 to September 2010, 45 procedures were performed, with the patients in the modified lateral position. The indication for these procedures was the presence of complex unilateral upper urinary tract pathologic features. The patients with muscular and/or skeletal abnormalities were excluded. All procedures were performed using simultaneous anterograde and retrograde access with the patient under general anesthesia. The preoperative investigation protocol included assessment of the stone burden and location using enhanced abdominal computed tomography. The patients were routinely examined 6 weeks after the procedure with a combination of plain abdominal radiography and renal ultrasonography. For patients treated for conditions causing upper urinary tract obstruction (pelviureteral junction obstruction and/or ureteral strictures), a mercaptoacetyltriglycine renography was performed at 4, 12, and 24 months postoperatively. The mean patient age was 51.2 years (range 17-79). Stone clearance was achieved by a single combined procedure in 36 patients (80%). Successful recanalization was achieved in all patients with pelviureteral junction obstruction and ureteral strictures. In 4 patients (8.8%), persistent hematuria was noted, and 2 patients (4.4%) developed postoperative urinary sepsis and were treated conservatively. Modification to the lateral position compares equally with contemporary percutaneous nephrolithotomy series. It provides wide exposure of the flank, allowing the choice of multiple access sites, enhanced control, and a wide angle for handling of the antegrade instruments. Two surgeons can work simultaneously, addressing complex endourologic pathologic features in high-risk patients. Copyright © 2012. Published by Elsevier Inc.

Novel Sensor Technology To Assess Independence and Limb-Use Laterality in Cervical Spinal Cord Injury.

PubMed

Brogioli, Michael; Popp, Werner L; Albisser, Urs; Brust, Anne K; Frotzler, Angela; Gassert, Roger; Curt, Armin; Starkey, Michelle L

2016-11-01

After spinal cord injury (SCI), levels of independence are commonly assessed with standardized clinical assessments. However, such tests do not provide information about the actual extent of upper limb activities or the impact on independence of bi- versus unilateral usage throughout daily life following cervical SCI. The objective of this study was to correlate activity intensity and laterality of upper extremity activity measured by body-fixed inertial measurement units (IMUs) with clinical assessment scores of independence. Limb-use intensity and laterality of activities performed by the upper extremities was measured in 12 subjects with cervical SCI using four IMUs (positioned on both wrists, on the chest, and on one wheel of the wheelchair). Algorithms capable of reliably detecting self-propulsion and arm activity in a clinical environment were applied to rate functional outcome levels, and were related to clinical independence measures during inpatient rehabilitation. Measures of intensity of upper extremity activity during self-propulsion positively correlated (p < 0.05, r = 0.643) with independence measures related to mobility. Clinical measures of laterality were positively correlated (p < 0.01, r = 0.900) with laterality as measured by IMUs during "daily life," and increased laterality was negatively correlated (p < 0.01, r = -0.739) with independence. IMU sensor technology is sensitive in assessing and quantifying upper limb-use intensity and laterality in human cervical SCI. Continuous and objective movement data of distinct daily activities (i.e., mobility and day-to-day activities) can be related to levels of independence. Therefore, IMU sensor technology is suitable not only for monitoring activity levels during rehabilitation (including during clinical trials) but could also be used to assess levels of participation after discharge.

Unilateral and Immediate Stimulation of Acupuncture Points Xiaohai (SI8) and Jianwaishu (SI14) of the Small Intestine Meridian Increases Electromyographic Activity and Strength in the Ipsilateral and Contralateral Upper Trapezius Muscle.

PubMed

de Souza, Leandro L; de Araujo, Fernanda L B; da Silva, Fernanda A M; Mucciaroni, Thaís S; de Araujo, João E

2016-10-01

We previously showed that a yin meridian of the upper limb decreased electromyographic activity (root mean square) and muscle strength ipsilateral and contralateral to the side of stimulation. Here, we tested the upper trapezius (UT) muscle response after stimulation of a yang meridian of the upper limb, the small intestine (SI). Thirty-eight healthy volunteers were randomized into the following groups: UT muscle (SI14), distant of the UT muscle (SI8), without stimulation (CG), and sham (R3). An acupuncturist certificated by the Brazilian Society of Physical Therapists and Acupuncturists performed the needle insertion. Each volunteer received only one stimulation to the right upper limb. The evaluation occurred before, 5 minutes after, and 20 minutes after needle withdrawal. The root mean square activity increased on the right side in the UT muscle for the SI8 and SI14 groups (F 3,37  = 4.67; p < 0.025) at the 20-minute evaluation. The most vigorous response occurred on the contralateral side because the effects were maintained for 5 minutes after withdrawal (F 3,37  = 4.52; p < 0.025). Both groups showed an increase in the UT muscle strength at the 20-minute evaluation (F 3,37  = 3.41; p < 0.025). The CG and R3 groups did not show any changes. Our data indicate that SI a yang meridian increases the UT muscle response. Copyright © 2016. Published by Elsevier B.V.

Ureteropyeloscopy in the diagnosis of patients with upper tract hematuria: an initial clinical study.

PubMed

Yazaki, T; Kamiyama, Y; Tomomasa, H; Shimizu, H; Okano, Y; Iiyama, T; Iizumi, T; Umeda, T

1999-05-01

To study the usefulness and safety of ureteropyeloscopy in the diagnosis of upper tract hematuria of unknown etiology by standard diagnostic methods. Fifteen patients with upper tract hematuria of unknown etiology were the subjects of the present study. Prior to ureteropyeloscopy, they underwent standard diagnostic methods, including cystourethroscopy, excretory urography and computed tomography scan. The upper tract (ureter, renal pelvis and calyces) was inspected systematically with a flexible ureteropyeloscope under epidural anesthesia. A biopsy specimen was obtained when neoplasm of a suspicious lesion was seen. Bleeding and hemangiomatous lesions were fulgurated at the time of ureteropyeloscopy. Unilateral gross hematuria was seen in 12 patients. Imaging studies revealed a filling defect in four patients, ureteral stenosis in one patient and nutcracker phenomenon in one patient. Urine cytology was positive in three patients and suspicious in four patients. Results of ureteropyeloscopy were papillary tumor in three patients, whitish encrustation in one patient, redness of the renal pelvis in one patient, bleeding from the renal calyx in two patients, hemangiomatous lesion in one patient, ureteral stenosis in two patients and no abnormalities in five patients. Biopsies were performed in five patients. The pathology results were transitional cell carcinoma in four patients and no abnormality in one patient. Although a ureteral stent catheter was placed in one patient, no serious complications were encountered during or after the procedures. Ureteropyeloscopy was useful and relatively safe. This endoscopic examination can differentiate insignificant lesions from significant lesions by visual inspection of the lesions, in addition, pathological diagnosis by biopsy specimen can also be performed if deemed necessary. Ureteropyeloscopy is recommended in the diagnosis of upper tract hematuria of unknown etiology.

Evaluation of the Transverse Craniofacial Morphology of Adolescents With Repaired Unilateral Cleft Lip and Palate Using Cone-Beam Computed Tomography.

PubMed

Buyuk, Suleyman Kutalmiş; Celikoglu, Mevlut; Benkli, Yasin Atakan; Sekerci, Ahmet Ercan

2016-10-01

The aim of the study was to evaluate the transverse craniofacial morphology of the adolescent patients affected by unilateral cleft lip and palate (UCLP) and to compare the findings with age- and sex-matched control group without any cleft using their cone-beam computed tomography (CBCT) images. The study sample (n = 56 patients; mean age: 14.35 ± 3.06 years) consisted of 26 UCLP (n = 26 patients; 10 women and 16 men; mean age: 13.70 ± 2.94 years) and 30 control (n = 30 patients; 19 women and 11 men; mean age: 14.90 ± 3.10 years) subjects. Twenty-five conventional skeletal and dental tissue landmarks were identified. Twenty widely used frontal cephalometric variables (14 linear distances, 3 angles, and 3 ratios) were measured. The data were analyzed using the independent t-test between the groups. Patients affected by UCLP had statistically significantly smaller interorbital width (89.83 ± 4.16 mm), maxillary width (58.02 ± 5.77 mm), maxillary intermolar width (52.83 ± 4.83 mm), and upper face height (57.64 ± 4.57 mm) (P < 0.05) compared with the control group. Conversely, ANS-isf distance was significantly greater in the UCLP group (29.62 ± 5.19 mm) than in the control group (26.74 ± 3.99 mm) (P = 0.023). Moreover, alveolar cleft width had significant effect on Cr-ANS (r = 0.446, P = 0.022) and the ANS-isf (r = 0.459, P = 0.018) measurements. The UCLP group showed statistically significantly smaller values for interorbital width, maxillary width, maxillary intermolar width, and upper face height than the noncleft controls.

Pressure pain thresholds and musculoskeletal morbidity in automobile manufacturing workers.

PubMed

Gold, Judith E; Punnett, Laura; Katz, Jeffrey N

2006-02-01

Reduced pressure pain thresholds (PPTs) have been reported in occupational groups with symptoms of upper extremity musculoskeletal disorders (UEMSDs). The purpose of this study was to determine whether automobile manufacturing workers (n=460) with signs and symptoms of UEMSDs had reduced PPTs (greater sensitivity to pain through pressure applied to the skin) when compared with unaffected members of the cohort, which served as the reference group. The association of PPTs with symptom severity and localization of PE findings was investigated, as was the hypothesis that reduced thresholds would be found on the affected side in those with unilateral physical examination (PE) findings. PPTs were measured during the workday at 12 upper extremity sites. A PE for signs of UEMSDs and symptom questionnaire was administered. After comparison of potential covariates using t tests, linear regression multivariable models were constructed with the average of 12 sites (avgPPT) as the outcome. Subjects with PE findings and/or symptoms had a statistically significant lower avgPPT than non-cases. AvgPPT was reduced in those with more widespread PE findings and in those with greater symptom severity (test for trend, P

Prevalence of missing and impacted third molars in adults aged 25 years and above

PubMed Central

Jung, Yun-Hoa

2013-01-01

Purpose The purpose of this study was to determine the prevalence of missing and impacted third molars in people aged 25 years and above. Materials and Methods The study sample of 3,799 patients was chosen randomly from patients who visited Pusan National University Dental Hospital and had panoramic radiographs taken. The data collected included presence and impaction state, angulation, and depth of impaction of third molars, and radiographically detected lesions of third molars and adjacent second molars. Results A greater percentage of men than women retained at least one third molar. The incidence of third molars decreased with increasing age. The incidence of partially impacted third molars greatly declined after the age of 30. Vertically impacted maxillary third molars and horizontally impacted mandibular third molars were most frequent in all age groups. Among the maxillary third molars, those impacted below the cervical line of the second molar were most frequent in all age groups, and among the mandibular third molars, deeply impacted third molars were most frequent in those aged over 40. Dental caries was the most common radiographic lesion of the third molars. Mesioangularly impacted third molars showed radiographic lesions in 13 (9.5%) adjacent maxillary second molars and 117 (27.4%) mandibular second molars. Conclusion The number of remaining third molars decreased and the percentage of Class C depth increased with age. Caries was the most frequent lesion in third molars. Partially impacted mesioangular third molars showed a high incidence of caries or periodontal bone loss of the adjacent second molar. Regular oral examination will be essential to keep asymptomatic third molars in good health. PMID:24380060

European college of orthodontics: commission of affiliation and titularisation.

PubMed

Muller, Christine

2012-06-01

Date of birth: 28/4/1977; sex: female. A. (4/2006; 29 years). Tooth-arch discrepancy with bi-maxillary protrusion. Correction of bi-maxillary protrusion; avulsion of 15, 25, 35 and 45; fixed multi-bracket Incognito bi-maxillary appliance; mini-screw anchorage. B. POST-TREATMENT RECORDS DOCUMENTS: (9/2009; 32 years and 6 months). Permanent retainers using fixed upper and lower bonded wires. C. POST-RETENTION RECORDS: (7/2010; 33 years and 3 months). D. Reason for consultation: correction of crooked and "jutting" teeth. Extraoral examination: balanced facial levels; lateral view: predominant lower third; closed nasolabial angle; labial asymmetry with predominant lower lips. Endooral examination: young adult dentition; average dental status; large number of fillings; panorex confirms four devitalized teeth; good periodontal status; V-shaped upper arch with lingually ectopic 12 and 22; lower arch with slight incisor crowding; bi-lateral molar and canine Class I; crossbite of 12 and 22; 2-mm deepbite and 1-mm overjet. Copyright © 2012. Published by Elsevier Masson SAS.

Effectiveness of Serious Games for Leap Motion on the Functionality of the Upper Limb in Parkinson's Disease: A Feasibility Study.

PubMed

Oña, Edwin Daniel; Balaguer, Carlos; Cano-de la Cuerda, Roberto; Collado-Vázquez, Susana; Jardón, Alberto

2018-01-01

The design and application of Serious Games (SG) based on the Leap Motion sensor are presented as a tool to support the rehabilitation therapies for upper limbs. Initially, the design principles and their implementation are described, focusing on improving both unilateral and bilateral manual dexterity and coordination. The design of the games has been supervised by specialized therapists. To assess the therapeutic effectiveness of the proposed system, a protocol of trials with Parkinson's patients has been defined. Evaluations of the physical condition of the participants in the study, at the beginning and at the end of the treatment, are carried out using standard tests. The specific measurements of each game give the therapist more detailed information about the patients' evolution after finishing the planned protocol. The obtained results support the fact that the set of developed video games can be combined to define different therapy protocols and that the information obtained is richer than the one obtained through current clinical metrics, serving as method of motor function assessment.

Effectiveness of Serious Games for Leap Motion on the Functionality of the Upper Limb in Parkinson's Disease: A Feasibility Study

PubMed Central

Balaguer, Carlos; Collado-Vázquez, Susana; Jardón, Alberto

2018-01-01

The design and application of Serious Games (SG) based on the Leap Motion sensor are presented as a tool to support the rehabilitation therapies for upper limbs. Initially, the design principles and their implementation are described, focusing on improving both unilateral and bilateral manual dexterity and coordination. The design of the games has been supervised by specialized therapists. To assess the therapeutic effectiveness of the proposed system, a protocol of trials with Parkinson's patients has been defined. Evaluations of the physical condition of the participants in the study, at the beginning and at the end of the treatment, are carried out using standard tests. The specific measurements of each game give the therapist more detailed information about the patients' evolution after finishing the planned protocol. The obtained results support the fact that the set of developed video games can be combined to define different therapy protocols and that the information obtained is richer than the one obtained through current clinical metrics, serving as method of motor function assessment. PMID:29849550

Reduced mastication stimulates impairment of spatial memory and degeneration of hippocampal neurons in aged SAMP8 mice.

PubMed

Onozuka, M; Watanabe, K; Mirbod, S M; Ozono, S; Nishiyama, K; Karasawa, N; Nagatsu, I

1999-04-24

The involvement of reduced mastication in senile dementia was evaluated by examining the effect of cutting off the upper molars (molarless) on spatial memory and numbers of hippocampal neurons in aged SAMP8 mice. Molarless mice showed a decrease in both learning ability in a water maze and neuron density in the hippocampal CA1 region compared with control mice. These changes increased the longer the molarless condition persisted. The data suggest a possible link between reduced mastication and hippocampal neuron loss that may be one risk factor for senile impairment of spatial memory. Copyright 1999 Elsevier Science B.V.

Relationship Between Third Mandibular Molar Angulation and Distal Cervical Caries in the Second Molar.

PubMed

Claudia, Andreescu; Barbu, Horia Mihail; Adi, Lorean; Gultekin, Alper; Reiser, Vadim; Gultekin, Pinar; Mijiritsky, Eitan

2018-03-16

Third lower molar partially erupted is commonly encountered in dental practice. This situation challenges clinicians with the dilemma whether to remove or to monitor it, because this molar can cause pathology of the adjacent second molar. The aim of this retrospective study is to evaluate the relationship between third mandibular molar and distal cervical caries in second molar. This retrospective study analyzed 55 digital orthopantograms of adult patients and a total number of 95 mandibular third molars were assessed for eruption status, angulation, radiographic evidence of caries or restoration in the mandibular third molar, and radiographic evidence of caries or restoration in the distal surface of the mandibular second molar. The distal cervical caries in second molar is associated with fully erupted and partially erupted wisdom molar in horizontal, mesioangular and vertical position and less with presence of caries in third molar. There are caries lesions in distal second molars in mesioangular position when adjacent third molar is caries free.

Saving the 2(nd) Molar from the 3(rd) Is it Really the Guilt of the Tilt?

PubMed

Yadav, Pankaj; Pruthi, Preeti Jain; Nawal, Ruchika Roongta; Talwar, Sangeeta; Verma, Mahesh

2016-05-01

Clinicians often relate the distal caries in second molars to angulated third molars, which if left undetected can lead to gross decay that may further require removal of the tooth. Due to this fact, many third molars are advised for prophylactic removal to prevent decay in the second molar. But this approach would only be justified when the incidence of decay/loss of second molar due to third molar are reasonably high. We sought to determine incidence of caries experience and also sequel extraction in second molars associated with the third molars. The study was conducted to answer the basic question that whether the incidence of caries and subsequent extraction of second molar due to angulated third molars is high enough to justify the prophylactic removal of third molar or not. This study was conducted on radiographic records of 1187 patients. The effect of tilted third molar on the second molar was measured in relation with three parameters namely level & position of third molar with respect to second molar and the distribution among arches. The results indicated that out of total number of teeth examined only 5.4% of maxillary and 9.6% of mandibular second molars were affected by tilted third molars. Further, only 2.2% of mandibular and 2.9% of maxillary second molars were indicated for extraction. The data was statistically insignificant. It was concluded that distal caries in second molars is not very common. It may be present in some cases of third molar impactions and prophylactic removal of these impacted teeth may not be considered appropriate.

Periapical Status and Quality of Root Canal Fillings in a Moroccan Subpopulation

PubMed Central

El Merini, Hafsa; Lamzawaq, Amine; Hamza, Mouna

2017-01-01

Aim The aim of the study was to assess the prevalence of apical periodontitis (AP) and quality of root canal fillings in an adult Moroccan subpopulation. Methods In the study 508 patients were included, attending the Conservative Dentistry Clinic at the Faculty of Dentistry of Casablanca. 508 panoramic and 709 periapical radiographs were observed. The periapical status of all teeth (with the exception of third molars) was examined according to Ørstavik's periapical index. The statistical analysis was performed with the software Epi Info Version 6.04dfr, April 2001. Results A total of 12719 teeth were examined. 45.3% of patients had apical periodontitis. 4.2% of teeth were treated endodontically and 70.4% of these treatments were inadequate. 91,5% with inadequate endodontic treatment presented apical periodontitis, while only 8,2% with adequate endodontic treatment had apical periodontitis. The lower molars and the upper premolars were the most affected teeth. The presence of apical periodontitis was correlated significantly with insufficient root canal fillings (p < 0.05). Conclusions The present study found a high prevalence of apical periodontitis in this Moroccan population. Inadequate root canal fillings were associated with an increased prevalence of apical periodontitis. PMID:28713425

Chemical characterization of sediments and pore water from the upper Clark Fork River and Milltown Reservoir, Montana

USGS Publications Warehouse

Brumbaugh, W. G.; Ingersoll, C.G.; Kemble, N.E.; May, T.W.; Zajicek, J.L.

1994-01-01

The upper Clark Fork River basin in western Montana is widely contaminated by metals from past mining, milling, and smelting activities As part of a comprehensive ecological risk assessment for the upper Clark Fork River, we measured physical and chemical characteristics of surficial sediment samples that were collected from depositional zones for subsequent toxicity evaluations Sampling stations included five locations along the upper 200 km of the river, six locations in or near Milltown Reservoir (about 205 km from the river origin), and two tributary reference sites Concentrations of As, Cd, Cu, Mn, Pb, and Zn decreased from the upper stations to the downstream stations in the Clark Fork River but then increased in all Milltown Reservoir stations to levels similar to uppermost river stations Large percentages (50 to 90%) of the total Cd, Cu, Pb, and Zn were extractable by dilute (3 n) HCl for all samples Copper and zinc accounted for greater than 95% of extractable metals on a molar basis Acid-volatile sulfide (AVS) concentrations were typically moderate (0 6 to 23 μmol/g) in grab sediment samples and appeared to regulate dissolved (filterable) concentrations of Cd, Cu, and Zn in sediment pore waters Acid volatile sulfide is important in controlling metal solubility in the depositional areas of the Clark Fork River and should be monitored in any future studies Spatial variability within a sampling station was high for Cu, Zn, and AVS, therefore, the potential for toxicity to sediment dwelling organisms may be highly localized.

Morphologic study of the maxillary molars. Part II: Internal anatomy.

PubMed

Pécora, J D; Woelfel, J B; Sousa Neto, M D; Issa, E P

1992-01-01

The internal anatomy of three hundred and seventy (370) decalcified and cleared human maxillary molars was studied. Seventy-five percent of the first molars, 58% of the second molars and 68% of the third molars studied presented three (3) root canals and 25% of the first molars, 42% of the second molars and 32% of the third molars presented four (4) root canals. The authors observed that the incidence of two root canals in the mesiobuccal root was higher in second maxillary molars than in first maxillary molars.

Rapidly fluctuating anosmia: A clinical sign for unilateral smell impairment.

PubMed

Negoias, Simona; Friedrich, Hergen; Caversaccio, Marco D; Landis, Basile N

2016-02-01

Reports about fluctuating olfactory deficits are rare, as are reports of unilateral olfactory loss. We present a case of unilateral anosmia with contralateral normosmia, presenting as rapidly fluctuating anosmia. The olfactory fluctuation occurred in sync with the average nasal cycle duration. Examination after nasal decongestion, formal smell testing, and imaging revealed unilateral, left-sided anosmia of sinonasal cause, with right-sided normosmia. We hypothesize that the nasal cycle induced transient anosmia when blocking the normosmic side. Fluctuating olfactory deficits might hide a unilateral olfactory loss and require additional unilateral testing and thorough workup. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Saving the 2nd Molar from the 3rd Is it Really the Guilt of the Tilt?

PubMed Central

Yadav, Pankaj; Nawal, Ruchika Roongta; Talwar, Sangeeta; Verma, Mahesh

2016-01-01

Introduction Clinicians often relate the distal caries in second molars to angulated third molars, which if left undetected can lead to gross decay that may further require removal of the tooth. Due to this fact, many third molars are advised for prophylactic removal to prevent decay in the second molar. But this approach would only be justified when the incidence of decay/loss of second molar due to third molar are reasonably high. We sought to determine incidence of caries experience and also sequel extraction in second molars associated with the third molars. Aim The study was conducted to answer the basic question that whether the incidence of caries and subsequent extraction of second molar due to angulated third molars is high enough to justify the prophylactic removal of third molar or not. Materials and Methods This study was conducted on radiographic records of 1187 patients. The effect of tilted third molar on the second molar was measured in relation with three parameters namely level & position of third molar with respect to second molar and the distribution among arches. Results The results indicated that out of total number of teeth examined only 5.4% of maxillary and 9.6% of mandibular second molars were affected by tilted third molars. Further, only 2.2% of mandibular and 2.9% of maxillary second molars were indicated for extraction. The data was statistically insignificant. Conclusion It was concluded that distal caries in second molars is not very common. It may be present in some cases of third molar impactions and prophylactic removal of these impacted teeth may not be considered appropriate. PMID:27437353

Are bilateral idiopathic clubfeet more severe than unilateral feet? A severity and treatment analysis.

PubMed

Agarwal, Anil; Agrawal, Nargesh; Barik, Sitanshu; Gupta, Neeraj

2018-01-01

Evidences suggest that different subgroups of idiopathic clubfoot exist with differences in severity and treatment outcomes. This study compares the severity and treatment outcomes of unilateral and bilateral clubfoot. We retrospectively studied 161 patients (bilateral 66, unilateral 95) with primary idiopathic clubfeet to evaluate the differences in severity and treatment. The parameters analyzed were precasting Pirani score, number of casts required, pretenotomy Pirani score, pretenotomy dorsiflexion, rate of tenotomy, and post-tenotomy dorsiflexion achieved. A Pirani score of at least 5 was classified as very severe and 4.5 or less was classified as less severe. There were 49=(74.24%) male and 17 (25.75%) female patients in the bilateral group and 76 (80%) male and 19 (20%) female patients in the unilateral group. Out of 95 unilateral patients, 34 were left sided (35.8%). Comparing severity, the mean precasting Pirani score in bilateral patients (5.4 ± 0.6) was statistically more than the unilateral patients (4.9 ± 0.7). The number of casts required was significantly more in bilateral feet compared to unilateral (bilateral 5.3 ± 1.7, unilateral 4.7 ± 1.7; p < 0.011). Achilles tenotomy was required in all feet. Post Ponseti treatment, the foot deformity correction achieved (pretenotomy Pirani score, pretenotomy, and post-tenotomy dorsiflexion) was statistically similar in both unilateral and bilateral feet. Idiopathic bilateral clubfoot was more severe than unilateral foot at initial presentation and required more number of corrective casts. Post Ponseti treatment, the deformity correction in bilateral foot was similar to unilateral foot.

Unilateral photophobia or phonophobia in migraine compared with trigeminal autonomic cephalalgias.

PubMed

Irimia, P; Cittadini, E; Paemeleire, K; Cohen, A S; Goadsby, P J

2008-06-01

Our objective was to compare the presence of self-reported unilateral photophobia or phonophobia, or both, during headache attacks comparing patients with trigeminal autonomic cephalalgias (TACs)--including cluster headache, short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and paroxysmal hemicrania--or hemicrania continua, and other headache types. We conducted a prospective study in patients attending a referral out-patient clinic over 5 months and those admitted for an intramuscular indomethacin test. Two hundred and six patients were included. In episodic migraine patients, two of 54 (4%) reported unilateral photophobia or phonophobia, or both. In chronic migraine patients, six of 48 (13%) complained of unilateral photophobia or phonophobia, or both, whereas none of the 24 patients with medication-overuse headache reported these unilateral symptoms, although these patients all had clinical symptoms suggesting the diagnosis of migraine. Only three of 22 patients (14%) suffering from new daily persistent headache (NDPH) experienced unilateral photophobia or phonophobia. In chronic cluster headache 10 of 21 patients (48%) had unilateral photophobia or phonophobia, or both, and this symptom appeared in four of five patients (80%) with episodic cluster headache. Unilateral photophobia or phonophobia, or both, were reported by six of 11 patients (55%) with hemicrania continua, five of nine (56%) with SUNCT, and four of six (67%) with chronic paroxysmal hemicrania. Unilateral phonophobia or photophobia, or both, are more frequent in TACs and hemicrania continua than in migraine and NDPH. The presence of these unilateral symptoms may be clinically useful in the differential diagnosis of primary headaches.

Unilateral scrotal angiomas: An expression of underlying varicocele.

PubMed

Tromp, Elise E; Kouwenhoven, Stijn T P; Quint, Koen D; Gmelig Meijling, Kevin A; Genders, Roel E

2016-01-01

The current case report describes a 35-year-old man who presented with unilateral scrotal angiomas. The presence of unilateral scrotal angiomas was associated with an underlying varicocele on the ipsilateral side due to increased venous pressure. In case of unilateral scrotal angiomas further examination for underlying pathology is necessary.

Unusual Otolaryngologic Manifestations of Paracoccidioidomycosis: A Case Report and Review of Literature

PubMed Central

Lucinda, Lucas Resende; Polanski, José Fernando

2017-01-01

Paracoccidioidomycosis is a systemic mycosis caused by Paracoccidioides brasiliensis. It occurs more frequently in its chronic form, which particularly affects male adults from rural areas. These patients present with pulmonary involvement and systemic symptoms. Skin and mucosal lesions are rather typical and might suggest the diagnosis. The involvement of the upper airway mucosa is common and the patients usually complain of dysphagia and dysphonia. Nonetheless, in endemic areas, physicians should maintain a high level of suspicion even when faced with some atypical symptoms. We present the case of an adult diagnosed with nasopharyngeal paracoccidioidomycosis after presenting with an unusual otolaryngologic syndrome including unilateral soft palate paralysis with velopharyngeal insufficiency and hearing loss secondary to middle ear effusion. PMID:28500805

Unusual Otolaryngologic Manifestations of Paracoccidioidomycosis: A Case Report and Review of Literature.

PubMed

Lucinda, Lucas Resende; Polanski, José Fernando

2017-05-01

AbstractParacoccidioidomycosis is a systemic mycosis caused by Paracoccidioides brasiliensis . It occurs more frequently in its chronic form, which particularly affects male adults from rural areas. These patients present with pulmonary involvement and systemic symptoms. Skin and mucosal lesions are rather typical and might suggest the diagnosis. The involvement of the upper airway mucosa is common and the patients usually complain of dysphagia and dysphonia. Nonetheless, in endemic areas, physicians should maintain a high level of suspicion even when faced with some atypical symptoms. We present the case of an adult diagnosed with nasopharyngeal paracoccidioidomycosis after presenting with an unusual otolaryngologic syndrome including unilateral soft palate paralysis with velopharyngeal insufficiency and hearing loss secondary to middle ear effusion.

Redeposition of a straight-sided buckle under pressure.

PubMed

Colin, Jérôme; Coupeau, Christophe; Durinck, Julien; Cimetière, Alain; Grilhé, Jean

2014-03-01

The unilateral buckling of a stressed thin film on a substrate has been investigated theoretically in the framework of the Föppl-von Kármán theory of thin plates when an increasing overpressure is considered onto the upper free surface of the film. It is found that, depending on the initial stress in the film and overpressure, two scenarios of evolution may occur. The snap-through of the one-dimensional buckle leading to the full redeposition should take place for low values of the initial stress. When the initial stress exceeds a critical value, a partial redeposition of the buckle should proceed as the overpressure increases. A snap-through while the redeposition mechanism has taken place should also occur for higher values of the overpressure.