Evaluation of a mobile health system for supporting postoperative patients following day surgery.

A system based on mobile phones with built-in cameras has been developed for the postoperative management of patients sent home after day surgery. The system allows patients to send pictures and pulse oximetry measurements to a hospital server in a few seconds. Health professionals can then see what patients are describing and make a more objective estimate of the patients' status. Over a five-month period, a total of 49 patients used the system. A total of 222 images were sent, the average image delivery time being 29 s (SD 11). In nine cases (18%), the availability of images modified the treatment, and a visit to an emergency unit was avoided in eight of them who had blood-stained dressings and normal haematomas. The patients who had their treatment modified sent more images (an average of 5.4/patient) than those for whom images confirmed the correct treatment (3.1/patient). Each telephone call lasted for a mean duration of 18 min (range 8-34). The patient satisfaction data showed that all the aspects studied were evaluated in a very positive way, with 96% of the patients completely satisfied with the attention received by the mobile health application.

Pattern of agenesis in the primary dentition: a radiographic study of 193 cases.

The purpose of this study was to examine radiographs of a large sample of children who had congenital absence of primary teeth and to determine the number and distribution of the missing teeth. Radiographs collected within the Danish Municipal Child Oral Health Care System were available of 193 children, all of whom had congenital absence of one or more primary teeth but no other abnormalities in the jaws or dentition. More than half of the children (54.9%) had agenesis of only one primary tooth, and 7.8% of more than two primary teeth. Agenesis was found twice as frequently in the maxillary lateral incisor region (119 children) than in the mandibular lateral incisor region (53 children). Congenital absence of primary molars, canines and maxillary central incisors was extremely rare. However, agenesis of one maxillary primary central incisor was found in two cases. A follow-up study will compare the agenesis patterns recorded with the pattern of agenesis in the permanent dentition of the same group of children.

Comparison of the pattern of agenesis in the primary and permanent dentitions in a population characterized by agenesis in the primary dentition.

The first aim of this study was to collect a large sample of radiographs from children with congenitally missing teeth (CMT) in the primary dentition and to analyse the local relationship between agenesis of a primary tooth and the presence/absence of its permanent successor. The second aim was to compare, in the same sample, the pattern of agenesis in the primary dentition with the developmental pattern seen in the permanent dentition. 124 dentists from 72 municipalities contributed to the investigation of a total of 213 children. The dentists were asked to lend existing radiographic material from patients with agenesis in the primary dentition. The analysis of the local occurrence of agenesis showed that agenesis of a primary incisor was often but not always followed by agenesis of the succedaneous tooth. In the molar region, agenesis of a primary tooth was in all cases but one followed by agenesis of the succedaneous tooth. Comparison of the pattern of CMT in the primary dentition with the pattern of tooth presence/absence in the permanent dentition in a group of 33 patients, for whom complete radiographic material was available showed that agenesis always occurred in the permanent dentition and that the pattern of agenesis in the permanent dentition differed from that in the primary dentition. Incisors were most frequently missing in the primary dentition and premolars in the permanent dentition. The number of congenitally missing teeth was substantially larger in the permanent dentition that in the primary dentition. Also, permanent teeth that are very rarely congenitally missing were missing in this sample, characterized by the occurrence of agenesis in the primary dentition.

1α,25-Dihydroxyvitamin D(3) down-regulates pleiotrophin messenger RNA expression in osteoblast-like cells.

Pleiotrophin (PTN)[heparin-binding-growth-associated molecule (HB-GAM), heparin-binding neurite-promoting factor (HBNF)] is a recently identified polypeptide that stimulates growth of fibroblasts and enhances neurite extension. PTN is expressed in many tissues but relatively high level of expression has been observed in brain and bone. We examined hormonal regulation of PTN mRNA expression in several osteoblast-like cell lines including MC3T3-E1 and ROS17/2.8. The levels of PTN mRNA in these cells was significantly reduced by treatment with 10(-8) M: 1α,25-dihydroxyvitamin D(3) (1,25(OH)(2)D(3)) for 24 h. However, PTN mRNA levels were increased when the non-osteoblastic cell line, ROS 25/1, was treated with 1,25(OH)(2)D(3). These effects were observed in a dose-dependent manner in a dose range between 10(-11) M: to 10(-8) M: . This effect was specific to 1,25(OH)(2)D(3), since PTN mRNA levels were not affected by other steroids such as retinoic acid and dexamethasone in MC3T3-E1 or ROS17/2.8 cells. Similar 1,25(OH)(2)D(3) down-regulation of PTN mRNA was also observed in primary cultures of osteoblast-enriched fetal rat calvaria cells as well as cultures of MC3T3-E1 and ROS17/2.8 cells. These observations suggest that PTN expression in osteoblasts is regulated by the calcitropic hormone, 1,25(OH)(2)D(3), and that PTN may play a role in vitamin D-dependent regulation of bone metabolism.

Aetiological aspects of mandibular tooth agenesis--focusing on the role of nerve, oral mucosa, and supporting tissues.

The purpose of the present investigation was to consider possible aetiological aspects of mandibular tooth agenesis by comparing the pattern of mandibular molar and premolar agenesis with radiological evidence of the mandibular canal. Orthopantomograms from 33 children affected by agenesis of at least four premolar and/or molar teeth in the mandible were investigated. Three children were affected by ectodermal dysplasia. Two anthropological mandibles with absence of mandibular canals were included in the study for comparison. According to the investigation, agenesis should be divided into three groups, based on an analysis of agenesis location, the presence of nerve canals in the jaws, and finally, data on possible bone, skin and oral mucosa abnormalities. The three aetiological groups suggested are: agenesis related to nerve tissue, agenesis related to the oral epithelium, and agenesis related to the supporting tissue.

Craniofacial morphology in patients with multiple congenitally missing permanent teeth.

The purpose of this study was to examine the association between the number of congenitally missing permanent teeth, excluding third molars, and the craniofacial morphology. The sample comprised 118 children with five or more congenitally missing teeth. Twenty-seven reference points were digitized from lateral cephalometric radiographs and 13 angular measurements of craniofacial morphology were calculated. After an initial analysis, the sample was divided into two subsamples, one with 5-12 missing teeth and the other with 13-21 missing teeth. Within each subsample there was no significant association between number of missing teeth and the angular variables, but a comparison between the two subsamples showed significantly smaller mandibular plane inclination (NSL/ML, NL/ML) and gonial angle (RL/ML), and a more prognathic mandible (s-n-pg) in the subsample with more than 12 teeth missing. It is suggested that the difference in morphology could be due to a reduced vertical development of the lower face, caused by a reduced occlusal support in the subsample with more than 12 congenitally missing teeth.

[Juvenile chronic arthritis. A clinical and radiographic study of the chewing apparatus]. / Juvenil chronisk arthritis--en klinisk og radiologisk undersögelse af tyggeapparatet.

The present investigation of a relatively large Danish sample of patients with Juvenile Chronic Arthritis (JCA) revealed high frequencies of symptoms from the masticatory apparatus. 63% of the patients had destructive changes in the region of the mandibular condyles caused by arthritis. In one third of these cases the destructions were severe. Three fourth of the patients with TMJ-affection showed bilateral affection, and one fourth had unilateral affection. TMJ-affection was positively correlated to the duration and the severity of the general disease at the time of examination. Fifty per cent of the patients with TMJ-affection had reduced mouth opening capacity and most of these patients were aware of the problem themselves. The frequency of other symptoms from the TMJ and the jaw musculature was relatively high in the patient group. However, there were no significant differences between these frequencies when the group with TMJ-affection was compared to the group without TMJ-affection except for mouth opening capacity. The patients with TMJ-affection had significantly higher frequencies of frontal and lateral open bite and midline devition when compared to the patients without TMJ-affection. Furthermore, the patients with TMJ-affection had a significantly higher frequency of crowding in the mandibular incisor region than the patients without TMJ-affection. Thus, the study showed that TMJ-affection is common among children with juvenile chronic arthritis, and that the TMJ-affection may result in both functional problems and malocclusion.