Efficacy of selected complementary and alternative medicine interventions for chronic pain.

Complementary and alternative medicine (CAM) is a group of diverse medical and healthcare systems, therapies, and products that are not presently considered part of conventional medicine. This article provides an up-to-date review of the efficacy of selected CAM modalities in the management of chronic pain. Findings are presented according to the classification system developed by the National Institutes of Health National Center for Complementary and Alternative Medicine (formerly Office of Alternative Medicine) and are grouped into four domains: biologically based medicine, energy medicine, manipulative and body-based medicine, and mind-body medicine. Homeopathy and acupuncture are discussed separately as "whole or professionalized CAM practices." Based on the guidelines of the Clinical Psychology Division of the American Psychological Association, findings indicate that some CAM modalities have a solid track record of efficacy, whereas others are promising but require additional research. The article concludes with recommendations to pain practitioners.

Public assistance orthodontic treatment needs: a report from the state of Indiana.

OBJECTIVE: To determine how many of the orthodontic cases covered by Indiana Medicaid between 1999-2001 would be classified pretreatment as having a malocclusion severe enough to warrant treatment. METHODS: Six examiners were trained and then paired together to examine 249 patient orthodontic case records, consisting either of pre-treatment photographs only, pre-treatment models only, or both pre-treatment models and photos. The examiners applied the Index of Orthodontic Treatment Needs (IOTN) to assign each case a Grade of One to Five, with Grade One representing Ideal Occlusion and Grade Five being Extreme Malocclusion. When two examiners within a pair could not agree, a third examiner reviewed the case record to determine agreement. RESULTS: Of the 249 patient cases examined, 9 were not gradable. In the cases where only pretreatment models were available (n=157), 10% received a Grade of One or Two (Ideal Occlusion or Mild Malocclusion, respectively). Among the cases in which both pretreatment models and photos were available (n=46), 44% of the photos were graded One or Two, while only 2% of the models were graded as One or Two. In the cases where only pretreatment photographs were available (n=37), 27% of cases were Grade One or Two. CONCLUSION: While several of the cases (11%) submitted during the time period of 1999 to 2001 to the Indiana State Medicaid Division for reimbursement were rated as having Ideal Occlusions or Mild Malocclusions, the vast majority (89 %) were scored as having either Moderate, Severe, or Extreme Malocclusion.

Dental fracture fragment attachment: fracture model and luting agent comparisons.

PURPOSE: The purpose of this study was twofold: 1. To compare two different research models for simulating a traumatic anterior tooth fracture: the blunt trauma method (standard method) and an AL2O3 sectioning method (experimental method). 2. To compare the bond strength of tooth fragments bonded with resin modified glass ionomer vs. a light cured composite resin. METHODS: Two hundred bovine incisors were used in the study and kept in plain tap water throughout. The study consisted of five basic steps: 1. Fracture of the teeth by either blunt trauma (chisel and hammer) or AL2O3 sectioning disc. 2. Luting of the fractured fragments back to the teeth using either a composite resin or resin modified glass ionomer. 3. Thermocycling of the repaired teeth. 4. Dislodging the teeth to determine the strength of repair. 5. Determination of fracture type. RESULTS: One-way ANOVA revealed a statistically significant difference in the forces required to fracture the resin modified glass ionomer and composite resin regardless of whether the teeth were originally fractured with the blunt force method (p=0.030) or the disc sectioning method (p=.001). One-way ANOVA also revealed a statistically significant difference between the forces required for fracture by blunt trauma and the disc fracture techniques with the resin modified glass ionomer group (p=0.000345). However, there was no significant difference when the two techniques were compared for the composite resin (p= 0.2941). CONCLUSIONS: 1. The resin modified glass ionomer was significantly stronger than the composite resin when both the blunt trauma and the disc fracture techniques were employed. 2. The study's results do not support substituting the ease of the AL2O3 disc for the more time-consuming blunt trauma method.

Comparing infant oral glucose clearance with and without a water rinse.

The purpose of this study was to test the hypothesis that a small rinse of water in an infant's mouth immediately following formula consumption would significantly improve oral glucose clearance. Though statistically significant results were not obtained at all time intervals, this study lends validity to the hypothesis that a small water rinse immediately following formula feeding could help enhance oral glucose clearance in infants.