Valproic acid: a migraine prophylaxis alternative.

While studies have noted possible benefits of valproate for migraine prophylaxis, most have small study samples (range 22-34 patients). The more recent, larger clinical trial confirms the effectiveness of valproate in the prevention of migraines. The available evidence suggests that valproic acid should provide another alternative to conventional migraine prophylaxis. However, it would still be beneficial to see other large studies conducted to determine valproate's place among the migraine prophylactic therapies currently available. The Food and Drug Administration recently approved divalproex sodium for the prevention of migraine headaches. The usual starting dosage is 250 mg bid, titrating to 1000 mg/d if necessary.

Decreased treatment time due to changes in technique and practice philosophy.

A study was conducted to evaluate the impact of practice modifications on treatment time for patients in a private orthodontic office. Two patient groups were studied, consisting of Class I nonextraction, adult dentitions treated by one of the authors. One group (28 cases) was treated with the standard Begg technique and conventional motivation, hygiene, and finishing practices. The other (25 cases) was treated with the Tip-Edge appliance along with specific modifications to motivation, hygiene and finishing techniques. The average treatment time for the Tip-Edge group was 12.80 months versus 20.89 months for the Begg group. The use of motivational techniques and a specific mission and philosophy within a private orthodontic practice can help reduce total treatment time. The Tip-Edge appliance may reduce treatment time in Class I nonextraction therapy.