Quantifying health utilities of young adult orthodontic patients using the time trade-off method: a cross-sectional study

ABSTRACT Objective: To study the feasibility of time trade-off (TTO) method in quantifying health utility ratings in different types of malocclusion. Material and Methods: In this cross-sectional study, 70 orthodontic patients aged 18 years or above, reporting for treatment/consultation, were included and interviewed. Malocclusion-related health utilities were assessed through the TTO method, and oral health-related quality of life was measured with the help of Orthognathic Quality of Life Questionnaire (OQLQ). Angle's classification of malocclusion was recorded. Bivariate analyses and multivariate Poisson's regression were done to find out an association between the oral health utility values, OQLQ and demographic and clinical characteristics. Results: Patients with skeletal Class III malocclusion had lower health utility values than those with Class I and Class II malocclusions (p=0.013). Poisson's regression showed that Angle's Class II division 1 (0.90, CI 0.84 to 0.97), Class III (0.68, CI 0.59 to 0.95) and Skeletal malocclusion (0.79, CI 0.71 to 0.87) and OQLQ scores (1.0, CI 1 to 1.003) were found to be significant predictors of TTO utility scores. Conclusions: TTO utilities were found to be valid and well correlated with clinical findings. Health utilities could serve as useful and reliable markers of health-related quality of life (HRQL) among individuals or communities and help cost-effective preventive or intervention programs planning.

RESUMO Objetivo: Estudar a viabilidade do método Time trade-off (TTO) para quantificar escores de valoração da saúde em diferentes tipos de má oclusão. Material e Métodos: Neste estudo transversal, foram incluídos e entrevistados 70 pacientes ortodônticos com idade igual ou superior a 18 anos, que compareceram para tratamento/consulta. A valoração da saúde em relação à má oclusão foi avaliada por meio do método TTO e a qualidade de vida relacionada à saúde bucal foi medida com a ajuda do Questionário de Qualidade de Vida Ortognática (Orthognathic Quality of Life Questionnaire, OQLQ). A classificação da má oclusão segundo Angle foi registrada, e análises bivariadas e regressão multivariada de Poisson foram feitas para verificar qualquer associação entre os escores de valoração da saúde bucal, OQLQ e características demográficas e clínicas. Resultados: Os pacientes com má oclusão esquelética de Classe III apresentaram escores de valoração da saúde mais baixos do que aqueles com má oclusão de Classe I e Classe II (p=0,013). A regressão de Poisson mostrou que a Classe II de Angle divisão 1 (0,90, IC 0,84 a 0,97), Classe III (0,68, IC 0,59 a 0,95), má oclusão esquelética (0,79, IC 0,71 a 0,87) e os escores do OQLQ (1,0, IC 1 a 1,003) foram considerados preditores significativos dos escores de valoração pelo método TTO. Conclusões: Os escores do TTO foram considerados válidos e bem correlacionados com os achados clínicos, e podem servir como marcadores úteis e confiáveis da qualidade de vida relacionada à saúde (health-related quality of life, HRQL) entre indivíduos ou comunidades, e ajudar no planejamento de programas de prevenção ou de intervenção, com uma boa relação custo-benefício.

Unusual intraosseous transmigration of impacted tooth

Transmigration of an impacted tooth through the symphyseal suture is a rare and special developmental anomaly of unknown etiology that is unique to the mandibular canine. Maxillary canine transmigration is even rarer. Transmigrated canines are particularly significant due to the aesthetic and functional importance. A maxillary lateral incisor crossing the mid-palatal suture has never been reported in the literature. The aim of this report is to present the first case of simultaneous transmigration of a lateral incisor and canine in the maxilla. The paper also reports four unusual cases of unilateral canine transmigration in the maxilla and mandible and successful eruption of one of the transmigrated mandibular canines following orthodontic traction. Etiology of transmigration and its clinical considerations are also discussed.

Transcutaneous electrical nerve stimulation and labor pain

To investigate the efficacy and safety of Transcutaneous Electrical Nerve Stimulation [TENS] on uterine activity, duration of labor, intrapartum fetal heart rate and Apgar score, in relieving the pain of parturition. A controlled study to investigate the role of TENS to relieve the pain of parturition at Department of Obstetrics, Kasturba Medical College Hospital, Manipal, India. Seventy gravid women with cephalic presentation in active labor, with no obstetric or medical complications were studied. Fifty women in GROUP I [Study group] [25 primi and 25 multigravida] received TENS stimulation and Twenty women [10 primigravida and 10 multigravida] in GROUP II [Control group] received SHAM TENS [placebo]. Fifty two percent [primi] and 64 percent [multi] gravida in Group I and 8 percent in the Group II experienced good to excellent relief of back pain. Eight percent in primi and 12 percent in multigravida had no relief in Group I. Few had benefit in the second stage. The duration of labor was reduced by 120 minutes in multi and by 77 minutes in primigravida in group I [P value <0.001]. There was no change in the intrapartum fetal heart rate in both the groups and none required immediate resuscitation. TENS seems an effective, simple to administer method of pain relief with no side effects on the mother or the child. It is effective in relieving the low back pain in 50 percent, but has no effect on the lower abdominal pain with the present stimulation technique

Effect of laparoscopic sterilization on the incidence of ectopic pregnancy

In order to assess the impact of the tubal sterilization on the incidence of Ectopic Pregnancy, a retrospective analysis of patients with ectopic pregnancy was carried out from January 1971 to December 1990. there was no change in the age groups during the study period in sterilized and nonsterilised groups. The incidence of parity was low in the nonsterilised compared to the sterilized group [p<0.05]. the total number of sterilizations [laparoscopic sterilization and tubectomy] and ectopic pregnancies were doubled during the period 1981-90 compared to 1971-80 periods [p<0.05]. a significant increase in ectopic pregnancy was observed mainly in the non sterilised group