RESUMO
OBJECTIVE: The purpose of this study was to evaluate the morphologic characteristics of MLD malocclusions using 3D imaging. MATERIALS AND METHODS: MLD characteristics were examined using CBCT data in 40 subjects. A 3D Cephalometric analysis was developed to describe the spatial position of the mandible and temporal bones. RESULTS: Vertical dental heights were shorter and the posterior occlusal plane (POP) presented a steeper sagittal inclination on the shifted side (the side of the laterally displaced bony chin) than on the contralateral side. (p < 0.01). The MLD was related to a superiorly inclined POP Cant in the same direction (r = 0.82; p < 0.01). The shifted side condyle was dislocated medially and was smaller. Temporal bone sagittal inclination showed a more forward and medial inclination on the contralateral side (p < 0.01). CONCLUSIONS: A unilateral decrease in the vertical height of the dentition and the subsequent steeper occlusal plane inclinations correlated with (1) mandibular rotational displacement and condylar lateral displacement, (2) mandibular and condylar morphologic changes (3) changes in temporal bone position.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Má Oclusão/diagnóstico por imagem , Mandíbula/diagnóstico por imagem , Adolescente , Adulto , Cefalometria/métodos , Assimetria Facial/diagnóstico por imagem , Feminino , Humanos , Imageamento Tridimensional , Masculino , Estudos Retrospectivos , Dimensão Vertical , Adulto JovemRESUMO
BACKGROUND AND AIMS: Examination of longitudinal relationships between childhood traumatic experiences and drug use across the life-course at the national level, with control of confounding by other forms of trauma, is needed. We aimed to estimate the prevalence of nine typologies of childhood traumas and the cumulative number experienced, correlation between traumas and associations between individual and cumulative number of traumas with drug use during adolescence, emerging adulthood and adulthood. DESIGN: Secondary data analysis using the National Longitudinal Study of Adolescent to Adult Health. SETTING: United States. PARTICIPANTS: A nationally representative sample of individuals in grades 7-12 (aged 11-21 years) during 1994-95, who were re-interviewed during emerging adulthood (2001-02; aged 18-28) and adulthood (2007-08; aged 24-34). The analytical sample comprised 12 288 participants with data at all three waves. MEASUREMENTS: Nine typologies of childhood traumas: neglect; emotional, physical and sexual abuse; parental incarceration and binge drinking; and witnessing, being threatened with and experiencing violence. Indicators of each were summed to measure cumulative dose. Outcomes were marijuana and cocaine use during adolescence, emerging adulthood and adulthood. FINDINGS: Approximately half experienced at least one childhood trauma; traumas were not highly correlated. We observed a dose-response relationship between the number of traumas and drug use in adolescence [marijuana, adjusted odds ratio (aOR) one trauma versus none = 1.65, 95% confidence interval (CI) = 1.42, 1.92; two traumas = 2.58, 95% CI = 2.17, 3.06; ≥ four traumas = 6.92, 95% CI = 5.17, 9.26; cocaine, aOR one trauma = 1.87, 95% CI = 1.23, 2.84; two traumas = 2.80, 95% CI = 1.74, 4.51; ≥ four traumas = 9.54, 95% CI = 5.93, 15.38]. Similar dose-response relationships with drug use were observed in emerging adulthood and adulthood. Each individual trauma was associated independently with either marijuana or cocaine use in adolescence, emerging adulthood and/or adulthood. CONCLUSIONS: Childhood trauma is prevalent in the United States, and individual types as well as the total number experienced are associated significantly with marijuana and cocaine use throughout the life-course.
Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/estatística & dados numéricos , Consumo Excessivo de Bebidas Alcoólicas , Abuso Sexual na Infância/estatística & dados numéricos , Filho de Pais com Deficiência/estatística & dados numéricos , Cocaína , Exposição à Violência/estatística & dados numéricos , Uso da Maconha/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Criança , Maus-Tratos Infantis/estatística & dados numéricos , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais , Masculino , Razão de Chances , Estudos Prospectivos , Estados Unidos/epidemiologia , Adulto JovemRESUMO
Child sexual abuse is associated with substance use and sexual risk behaviors during adolescence and adulthood, but no known studies have documented associations across the life course in a nationally representative U.S. SAMPLE: We used the National Longitudinal Study of Adolescent to Adult Health to measure associations between child sexual abuse and substance use and sexual risk behaviors during adolescence, young adulthood, and adulthood among males and females (n = 11,820). Approximately 10% of females and 7% of males reported child sexual abuse. Associations with substance use were strongest during adolescence and lessened over time. Increased odds of sexual risk among those with a history of child sexual abuse remained consistent through the life course. Significant gender differences existed for some associations (e.g., adulthood multiple partners: males adjusted odds ratio (AOR) = 1.73, 95%CI:1.18, 2.53; females AOR = 1.11, 95%CI:0.79, 1.56). Trauma-informed prevention interventions should address child sexual abuse among both males and females to prevent substance use and sexual risk behavior throughout the life course.
Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Abuso Sexual na Infância/psicologia , Infecções por HIV/psicologia , Assunção de Riscos , Comportamento Sexual/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Adulto , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino , Adulto JovemRESUMO
BACKGROUND: We examined associations between childhood trauma and adulthood prescription pain reliever misuse (PPRM) and injection drug use (IDU) in a nationally-representative U.S. sample to further understanding of factors associated with these epidemics. METHODS: National Longitudinal Study of Adolescent to Adult Health data (N=12,288) yielded nine childhood traumas: neglect; emotional, physical, sexual abuse; parental incarceration and binge drinking; witnessed, threatened with, and experienced violence. We estimated adjusted odds ratios (AOR) and 95% confidence intervals for the association of each trauma and cumulative trauma and drug initiation in emerging and later adulthood. RESULTS: Outcome prevalences were 20% (PPRM) and 1% (IDU) in emerging adulthood and 10% PPRM in adulthood. We observed dose-response relationships that varied across outcomes. Cumulative trauma (referent=none) was associated with 34-79% greater odds of PPRM (emerging adulthood) across one to five+ trauma categories. The gradient was most consistent and associations strongest for adulthood PPRM: one trauma AOR=1.46(1.12, 1.91); two AOR=1.71(1.23, 2.36); three AOR=2.16(1.43, 2.36); four AOR=2.70(1.42, 5.62); five+ AOR=3.09(1.52, 6.30). Dose-response was less consistent for IDU, but 4 and 5+ traumas were associated with approximately seven and five times the odds of IDU. Neglect, emotional abuse, and parental incarceration and binge drinking were associated with 25-55% increased odds of PPRM. Sexual abuse and witnessed violence were associated with nearly 3 and 5 times the odds of IDU. CONCLUSIONS: Associations between childhood trauma and PPRM/IDU highlight the need for trauma-informed interventions for drug users and early trauma screening and treatment for prevention of drug misuse over the life course.
Assuntos
Analgésicos/efeitos adversos , Maus-Tratos Infantis/psicologia , Uso Indevido de Medicamentos sob Prescrição/psicologia , Abuso de Substâncias por Via Intravenosa/epidemiologia , Abuso de Substâncias por Via Intravenosa/psicologia , Violência/psicologia , Adolescente , Adulto , Criança , Maus-Tratos Infantis/tendências , Feminino , Humanos , Estudos Longitudinais , Masculino , Dor/tratamento farmacológico , Dor/epidemiologia , Dor/psicologia , Uso Indevido de Medicamentos sob Prescrição/tendências , Delitos Sexuais/psicologia , Delitos Sexuais/tendências , Abuso de Substâncias por Via Intravenosa/diagnóstico , Violência/tendências , Adulto JovemRESUMO
INTRODUCTION: The purpose of this study was to examine the relationship of the 3-dimensional (3D) posterior occlusal plane (POP) and the mandibular 3D spatial position. The relationship of the POP to mandibular morphology was also investigated. METHODS: Retrospective data from a convenience sample of pretreatment diagnostic cone-beam computed tomography scans were rendered using InVivo software (Anatomage, San Jose, Calif). The sample consisted of 111 subjects (51 male, 60 female) and included growing and nongrowing subjects of different races and ethnicities. The 3D maxillary POP was defined by selecting the cusp tips of the second premolars and the second molars on the rendered images of the subjects. The angles made by this plane, in reference to the Frankfort horizontal plane, were measured against variables that described the mandibular position in the coronal, sagittal, and axial views. The POP was also compared with bilateral variables that described mandibular morphology. RESULTS: There were significant differences of the POP among the different skeletal malocclusions (P <0.0001). The POP showed significant correlations with mandibular position in the sagittal (P <0.0001), coronal (P <0.05), and axial (P <0.05) planes. The POP also showed a significant correlation with mandibular morphology (P <0.0001). CONCLUSIONS: These findings suggest that there is a distinct and significant relationship between the 3D POP and the mandibular spatial position and its morphology.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Imageamento Tridimensional , Má Oclusão/diagnóstico por imagem , Mandíbula/diagnóstico por imagem , Adolescente , Adulto , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
BACKGROUND: White spot lesions and gingivitis represent common, yet challenging, dilemmas for orthodontists. Fluoride has shown some benefit as a protective measure against demineralization; however, this is usually insufficient for orthodontic patients with less than ideal oral hygiene. Dentifrices containing calcium sodium phosphosilicate bioactive glass (NovaMin) have been proposed to aid in prevention of white spot lesions and gingival inflammation. Thus, the purpose of this study was to determine if the use of NovaMin reduces the formation of white spot lesions and improves gingival health in orthodontic patients. METHODS: This was a prospective, double-blind, randomized controlled trial. Forty-eight patients undergoing orthodontic treatment were randomly allocated to two groups. The control group consisted of 24 patients who received over-the-counter fluoride toothpaste (Crest®), while the study group consisted of 24 patients who were given the test dentifrice (ReNew™) containing 5 % NovaMin and fluoride. Patients were followed up for 6 months on a monthly basis. Decalcification, gingival health, plaque, and bacteria levels were evaluated every 3 months. Statistical analysis was performed using both parametric and non-parametric tests to identify differences between groups at different time points. RESULTS: There were no significant differences between the groups in regard to changes in white spot lesions, plaque, or gingival health (P > 0.05). There was a trend toward improvement in white spot lesions found in subjects using Crest® at the 3-month time point; however, this was not sustained throughout the study. CONCLUSIONS: Our results indicate that a toothpaste containing NovaMin does not differ significantly compared to traditional fluoride toothpaste for improving white spot lesions and gingivitis in orthodontic patients.
Assuntos
Cariostáticos/uso terapêutico , Cárie Dentária/prevenção & controle , Gengivite/prevenção & controle , Vidro , Aparelhos Ortodônticos , Cremes Dentais/uso terapêutico , Adolescente , Adulto , Carga Bacteriana , Criança , Placa Dentária/microbiologia , Índice de Placa Dentária , Método Duplo-Cego , Feminino , Fluoretos/uso terapêutico , Seguimentos , Humanos , Lactobacillus/isolamento & purificação , Masculino , Índice Periodontal , Estudos Prospectivos , Saliva/microbiologia , Streptococcus mutans/isolamento & purificação , Adulto JovemRESUMO
INTRODUCTION: In this study, we examined the impacts of age, sex, root length, bone levels, and bone quality on orthodontic tooth movement. METHODS: Clear aligners were programmed to move 1 central incisor 1 mm over the course of 8 weeks. Thirty subjects, ages 19 to 64, were enrolled, and measurements were made on digital models (percentage of tooth movement goal achieved). Morphometric features and bone quality were assessed with cone-beam computed tomography. Data from this study were combined with data from 2 similar studies to increase the power for some analyses. RESULTS: The mean percentage of tooth movement goal achieved was 57% overall. Linear regression modeling indicated a cubic relationship between age and tooth movement, with a decreasing rate of movement from ages 18 to 35 years, a slightly increasing rate from ages 35 to 50, and a decreasing rate from ages 50 to 70. The final decreasing trend was not apparent for women. As would be expected, the correlation was significant between the percentage of the goal achieved and the cone-beam computed tomography superimposed linear measures of tooth movement. A significant negative correlation was found between tooth movement and the measurement apex to the center of rotation, but bone quality, as measured by fractal dimension, was not correlated with movement. CONCLUSIONS: The relationship between age and tooth movement is complex and might differ for male and female patients. Limited correlations with cone-beam computed tomography morphology and rate of tooth movement were detected.
Assuntos
Aparelhos Ortodônticos , Técnicas de Movimentação Dentária/métodos , Dente/fisiologia , Adulto , Fatores Etários , Análise de Variância , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Técnicas de Movimentação Dentária/instrumentaçãoRESUMO
By using pseudorabies virus expressing green fluorescence protein, we found that efferent bone marrow-neural connections trace to sympathetic centers of the central nervous system in normal mice. However, this was markedly reduced in type 1 diabetes, suggesting a significant loss of bone marrow innervation. This loss of innervation was associated with a change in hematopoiesis toward generation of more monocytes and an altered diurnal release of monocytes in rodents and patients with type 1 diabetes. In the hypothalamus and granular insular cortex of mice with type 1 diabetes, bone marrow-derived microglia/macrophages were activated and found at a greater density than in controls. Infiltration of CD45(+)/CCR2(+)/GR-1(+)/Iba-1(+) bone marrow-derived monocytes into the hypothalamus could be mitigated by treatment with minocycline, an anti-inflammatory agent capable of crossing the blood-brain barrier. Our studies suggest that targeting central inflammation may facilitate management of microvascular complications.
Assuntos
Medula Óssea/inervação , Medula Óssea/patologia , Sistema Nervoso Central/patologia , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/patologia , Inflamação/patologia , Animais , Medula Óssea/efeitos dos fármacos , Sistema Nervoso Central/efeitos dos fármacos , Sistema Nervoso Central/metabolismo , Citocinas/metabolismo , Ensaio de Imunoadsorção Enzimática , Proteínas de Fluorescência Verde/metabolismo , Hematopoese/efeitos dos fármacos , Herpesvirus Suídeo 1/efeitos dos fármacos , Herpesvirus Suídeo 1/fisiologia , Humanos , Inflamação/complicações , Inflamação/metabolismo , Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Microglia/efeitos dos fármacos , Microglia/metabolismo , Microglia/patologia , Minociclina/farmacologia , Modelos Biológicos , Monócitos/efeitos dos fármacos , Monócitos/metabolismo , Monócitos/patologia , Neurônios/efeitos dos fármacos , Neurônios/metabolismo , Neurônios/patologia , Neurotransmissores/metabolismo , Proteínas Proto-Oncogênicas c-fos/metabolismo , Ratos , Ratos Wistar , Sistema Nervoso Simpático/efeitos dos fármacos , Sistema Nervoso Simpático/metabolismo , Sistema Nervoso Simpático/patologiaRESUMO
OBJECTIVES: To explore changes in distribution of stage at diagnosis among individuals with oral and pharyngeal cancers over the past two decades and whether the changes differ by race. METHODS: We obtained 1991-2008 cancer incidence data for nine anatomic sites of the oral and pharyngeal structure from the Florida Cancer Data System. These cancers were grouped into oral squamous cell carcinoma (SCC), pharyngeal SCC, and other head and neck cancers. Annual percent change was calculated for each group to characterize trends in age-adjusted cancer incidence over time by race and stage at diagnosis. RESULTS: During 1991-2008, the overall age-adjusted oral SCC incidence was decreasing for both races, with a greater decline observed among Blacks. There was a large drop in incidence of regional-stage diagnoses among Blacks. For pharyngeal SCC, the age-adjusted incidence of localized- and regional-stage diagnoses was increasing for Whites during 1991-2008, with the largest increase in the incidence of regional-stage diagnoses. The percentage of localized-stage diagnoses was increasing for both races for oral SCC. A slight increase in percentage of localized-stage diagnoses was observed for Blacks for pharyngeal SCC, whereas no obvious change was observed among Whites. CONCLUSIONS: Blacks continued to have lower percentages of localized-stage diagnoses than Whites for nearly all sites, but an increasing percentage of localized-stage diagnoses was observed for oral SCC among Blacks. For pharyngeal SCC, the increase in incidence among Whites was accompanied by an increasing percentage of late-stage diagnoses. Coordinated public health approaches with a special emphasis on screening underserved populations are needed.
Assuntos
Negro ou Afro-Americano/estatística & dados numéricos , Carcinoma de Células Escamosas/epidemiologia , Disparidades nos Níveis de Saúde , Neoplasias Bucais/epidemiologia , Neoplasias Faríngeas/epidemiologia , População Branca/estatística & dados numéricos , Adulto , Detecção Precoce de Câncer/estatística & dados numéricos , Feminino , Florida/epidemiologia , Neoplasias de Cabeça e Pescoço/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Soalho Bucal/patologia , Neoplasias Nasofaríngeas/epidemiologia , Estadiamento de Neoplasias , Neoplasias Palatinas/epidemiologia , Vigilância da População , Sistema de Registros , Neoplasias das Glândulas Salivares/epidemiologia , Neoplasias da Língua/epidemiologia , Adulto JovemRESUMO
A breath-based adherence system to document ingestion of oral medications (e.g., HAART) was investigated. Specifically, the food additive 2-butanol, which can be easily packaged with a drug, is converted via alcohol dehydrogenase to the volatile metabolite 2-butanone that rapidly appears in breath, indicating adherence. In healthy adults using a portable sensor and GC-MS, the following experiments were performed: yield of 2-butanone in breath following ingestion of 2-butanol, adherence system accuracy, and potential interference of the adherence system by food or misplacement of 2-butanol on the tongue. During feasibility testing, every subject exhaled 2-butanone with 6.6 ± 1.5 min to peak concentrations of 548 ± 235 ppb following ingestion of 2-butanol (40 mg). ROC areas at 5 and 10 min were 0.95 (0.86-1.00) and 1.00 (1.00-1.00). Food did not interfere. Tongue application resulted in large concentrations of 2-butanol, but not 2-butanone. A breath test to provide definitive evidence of oral medication adherence appears technically feasible.
Assuntos
Antivirais/administração & dosagem , Testes Respiratórios/métodos , Butanóis/metabolismo , Infecções por HIV/tratamento farmacológico , Adesão à Medicação , Administração Oral , Terapia Antirretroviral de Alta Atividade , Antivirais/uso terapêutico , Cromatografia Gasosa , Estudos Cross-Over , Relação Dose-Resposta a Droga , Expiração , Estudos de Viabilidade , Infecções por HIV/psicologia , HumanosRESUMO
OBJECTIVE: Tocodynamometry (Toco; strain gauge technology) provides contraction frequency and approximate duration of labor contractions but suffers frequent signal dropout, necessitating repositioning by a nurse, and may fail in obese patients. The alternative invasive intrauterine pressure catheter (IUPC) is more reliable and adds contraction pressure information but requires ruptured membranes and introduces small risks of infection and abruption. Electrohysterography (EHG) reports the electrical activity of the uterus through electrodes placed on the maternal abdomen. This study compared all 3 methods of contraction detection simultaneously in laboring women. STUDY DESIGN: Upon consent, laboring women were monitored simultaneously with Toco, EHG, and IUPC. Contraction curves were generated in real-time for the EHG, and all 3 curves were stored electronically. A contraction detection algorithm was used to compare frequency and timing between methods. Seventy-three subjects were enrolled in the study; 14 were excluded due to hardware failure of 1 or more of the devices (n = 12) or inadequate data collection duration (n = 2). RESULTS: In comparison with the gold-standard IUPC, EHG performed significantly better than Toco with regard to the Contractions Consistency Index (CCI). The mean CCI for EHG was 0.88 ± 0.17 compared with 0.69 ± 0.27 for Toco (P < .0001). In contrast to Toco, EHG was not significantly affected by obesity. CONCLUSION: Toco does not correlate well with the gold-standard IUPC and fails more frequently in obese patients. EHG provides a reliable noninvasive alternative, regardless of body habitus.
Assuntos
Eletromiografia/métodos , Monitorização Fetal/métodos , Trabalho de Parto/fisiologia , Contração Uterina/fisiologia , Monitorização Uterina/métodos , Útero/fisiologia , Adulto , Feminino , Humanos , Gravidez , Monitorização Uterina/instrumentaçãoRESUMO
OBJECTIVE: To determine the proportion of cats entering a Florida animal shelter with serum antibody titers against feline panleukopenia virus (FPV), feline herpesvirus 1 (FHV1), and feline calicivirus (FCV) and to identify factors associated with seropositivity. DESIGN: Cross-sectional study. ANIMALS: 347 cats admitted to a Florida animal shelter. PROCEDURES: Within 24 hours after admission to the animal shelter, blood samples were collected from all cats ≥ 8 weeks of age. Serum antibody titers against FPV were determined via a hemagglutination inhibition assay, and those against FHV1 and FCV were determined via virus neutralization assays. Age, sex, environment (urban or rural), source (stray or previously owned), evidence of previous caregiving, health status (healthy or not healthy), and outcome (adoption, transfer, return to owner, or euthanasia) were evaluated as potential factors associated with antibody seropositivity. RESULTS: Of 347 cats, 138 (39.8%), 38 (11.0%), and 127 (36.6%) had antibody titers ≥ 40, ≥ 8, and ≥ 32 (ie, seropositive) against FPV, FHV1, and FCV, respectively. Factors associated with seropositivity included being neutered, age ≥ 6 months, and being relinquished by an owner. On multivariable analysis, health status at shelter admission, environment, vaccination at shelter admission, and outcome were not associated with seropositivity. CONCLUSIONS AND CLINICAL RELEVANCE: Most cats were seronegative for antibodies against FPV, FHV1, and FCV at the time of admission to an animal shelter. These findings supported current guidelines that recommend vaccination of all cats immediately after admission to animal shelters, regardless of the source or physical condition.
Assuntos
Infecções por Caliciviridae/veterinária , Calicivirus Felino/imunologia , Vírus da Panleucopenia Felina/imunologia , Panleucopenia Felina/imunologia , Infecções por Herpesviridae/veterinária , Herpesviridae/imunologia , Bem-Estar do Animal , Animais , Anticorpos Antivirais/sangue , Infecções por Caliciviridae/epidemiologia , Infecções por Caliciviridae/imunologia , Infecções por Caliciviridae/virologia , Gatos , Panleucopenia Felina/epidemiologia , Panleucopenia Felina/virologia , Feminino , Florida/epidemiologia , Herpesviridae/classificação , Infecções por Herpesviridae/epidemiologia , Infecções por Herpesviridae/imunologia , Infecções por Herpesviridae/virologia , Abrigo para Animais , MasculinoRESUMO
PURPOSE: This study's purpose was to compare parental perceptions of children's speech changes with a professional speech assessment following premature extractions of maxillary primary incisors (PEMPI). METHODS: Healthy 5- to 6-year-olds, with no cognitive and speech delay and who received PEMPI between the ages of 2 and 4 years old at a university-based clinic, were recruited for the study. First, their parents took part in a telephone interview regarding their perceptions of speech changes following the extractions. The children were then invited to undergo individual speech evaluations by a certified speech and language pathologist. RESULTS: Of 204 patients identified from the database, 57 parental interviews were completed. Sixty percent (34) felt their children sounded different following extractions, and 65% (37) reported difficulty with pronunciation of the "s" sound. For children who were perceived by their parents to sound different, 46% had problems pronouncing words with the letters s and z. For parents who did not perceive speech changes, none of the children had problems with s and z as determined by the professionally conduced speech evaluations (Fisher exact test P=.02). CONCLUSIONS: Children who undergo premature extractions of maxillary primary incisors show problems articulating words containing s and z, and there is an agreement between parental perceptions and actual disarticulations detected from a professional assessment.
Assuntos
Incisivo , Pais/psicologia , Fala , Criança , Pré-Escolar , HumanosRESUMO
Clear aligners provide a convenient model to measure orthodontic tooth movement (OTM). We examined the role of in vivo aligner material fatigue and subject-specific factors in tooth movement. Fifteen subjects seeking orthodontic treatment at the University of Florida were enrolled. Results were compared with data previously collected from 37 subjects enrolled in a similar protocol. Subjects were followed prospectively for eight weeks. An upper central incisor was programmed to move 0.5 mm. every two weeks using clear aligners. A duplicate aligner was provided for the second week of each cycle. Weekly polyvinyl siloxane (PVS) impressions were taken, and digital models were fabricated to measure OTM. Initial and final cone beam computed tomography (CBCT) images were obtained to characterize OTM. Results were compared to data from a similar protocol, where subjects received a new aligner biweekly. No significant difference was found in the amount of OTM between the two groups, with mean total OTM of 1.11 mm. (standard deviation (SD) 0.30) and 1.07 mm. (SD 0.33) for the weekly aligner and biweekly control groups, respectively (P = 0.72). Over eight weeks, in two-week intervals, material fatigue does not play a significant role in the rate or amount of tooth movement.
RESUMO
OBJECTIVE: While the overall incidence rates of oral and pharyngeal squamous cell carcinoma (SCC) have decreased in the United States, there is evidence of increasing incidence at selected anatomic sites, particularly among younger adults. The objective of this study was to examine trends in incidence rates of oral and pharyngeal cancers in Florida. METHODS: Using data from the Florida Cancer Data System, we examined the incidence of oral and pharyngeal carcinomas in Florida from 1981 through 2008. Factors of interest included sex, race, and trends over time. Percent change (PC) and annual percent change (APC) were computed to characterize trends over time. RESULTS: A total of 53,648 cases of oral or pharyngeal cancer were identified from 1981 through 2008. Significant increasing trends were observed only for pharyngeal cancers in males, with significant decreasing trends for pharyngeal cancer in females and oral cancer for both sexes. For tonsil and base of tongue cancers, increasing trends were detected for white males only. Further investigation among white males showed that, except for base of tongue cancer in the 20-44 age group, the incidence of both cancers increased across all age groups, with the largest increase for both sites found in the 45-64 age group. CONCLUSIONS: This study supports the finding of increasing incidence of SCC of the tonsil and base of tongue in males, in contrast to decreasing trends for most oral and pharyngeal carcinomas. However, we observed that this increase occurred in white males only and the most dramatic increase occurred in the 45-64 age group.
Assuntos
Carcinoma de Células Escamosas/epidemiologia , Neoplasias Bucais/epidemiologia , Neoplasias Faríngeas/epidemiologia , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Fatores Etários , Feminino , Florida/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Soalho Bucal , Sistema de Registros , Fatores Sexuais , Neoplasias Tonsilares/epidemiologia , População Branca/estatística & dados numéricos , Adulto JovemRESUMO
INTRODUCTION: Moving teeth rapidly and avoiding posttreatment relapse are fundamental goals of orthodontic treatment. In-vitro and animal studies suggest that the human hormone relaxin might increase the rate of movement and the stability through its effect on the periodontal ligament. The purpose of this study was to compare relaxin and a placebo with regard to tooth movement and stability in human subjects. METHODS: A single-center, blinded, placebo-controlled, randomized clinical trial was used to examine the effect of relaxin on tooth movement and stability. Forty subjects were randomized 1:1 and received weekly injections of 50 µg of relaxin or a placebo for 8 weeks. Aligners programmed to move a target tooth 2 mm during treatment were dispensed at weeks 0, 2, 4, and 6. Movement was measured weekly on polyvinyl siloxane impressions that were scanned and digitized. The subjects were followed through week 12 to assess relapse. RESULTS: Tooth movement over the 8-week treatment period did not differ by treatment group (P = 0.995). By using an intent-to-treat analysis, we found that the mean tooth movement for both groups was 0.83 mm (SE, 0.08 for relaxin and 0.09 for the placebo). Relapse from weeks 8 to 12 was the same in both groups (P = 0.986), and the mean was -0.75 (SE, 0.07 for relaxin and 0.08 for theplacebo). CONCLUSIONS: No differences in tooth movement over 8 weeks of treatment or relapse at 4 weeks posttreatment were detected when comparing subjects who received weekly injections of relaxin with those who received a placebo. In both groups, an average of less than half of the programmed tooth movement was obtained after 8 weeks of treatment. The local doses of relaxin might have been too low to affect tooth movement or short-term relapse.
Assuntos
Relaxina/uso terapêutico , Técnicas de Movimentação Dentária/métodos , Adolescente , Adulto , Estudos de Coortes , Feminino , Seguimentos , Humanos , Incisivo/patologia , Injeções , Masculino , Má Oclusão/terapia , Modelos Dentários , Desenho de Aparelho Ortodôntico , Ligamento Periodontal/efeitos dos fármacos , Placebos , Proteínas Recombinantes , Recidiva , Método Simples-Cego , Estresse Mecânico , Técnicas de Movimentação Dentária/instrumentação , Adulto JovemRESUMO
INTRODUCTION: The management of patients with Class II malocclusion has been an ongoing discussion in orthodontics. The aim of this study was to determine whether orthodontists agree among themselves and with each other about the etiology, timing, and difficulty of treating subjects with Class II malocclusion. METHODS: The initial records of 159 Class II subjects were sent to 8 orthodontists. In this sample, duplicate records of 18 subjects were dispersed. A questionnaire was sent with the records. RESULTS: The intrarater consistency values were 65% when determining the type of malocclusion, 60% when deciding which arch was at fault, and 81% when determining the need for immediate treatment. Consistency values were 33% regarding case difficulty and 77% regarding phase 2 treatment need. There was a significant negative correlation between the consistency of the orthodontists' responses and the peer assessment rating score. CONCLUSIONS: We found that practitioners had only moderate agreement among themselves when diagnosing a patient's type of malocclusion and which arch was at fault when a skeletal discrepancy was noted. Intrarater agreement improved as the peer assessment rating score increased, but the correlation was weak, and this was not consistent for all examiners. Because of insufficient intrarater agreement, interrater agreement was not examined.
Assuntos
Má Oclusão Classe II de Angle/etiologia , Má Oclusão Classe II de Angle/terapia , Ortodontia Corretiva/métodos , Criança , Feminino , Humanos , Má Oclusão Classe II de Angle/diagnóstico , Variações Dependentes do Observador , Aparelhos Ortodônticos , Ortodontia Corretiva/instrumentação , Revisão dos Cuidados de Saúde por Pares , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Retrospectivos , Estatísticas não Paramétricas , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Many researchers have examined the prevalence of dental injuries in children and adolescents. The purpose of this study was to examine the prevalence and incidence of incisor trauma in subjects who participated in a randomized clinical trial designed to investigate early growth modifications in the treatment of Class II malocclusion. METHODS: The subjects were randomized to 3 treatment groups during the initial phase of the study: (1) headgear or biteplane, (2) bionator, and (3) observation (no treatment). All 3 groups underwent phase 2 treatment with fixed appliances. Incisor injury was scored at every data collection point with the Ellis index by a blinded examiner using dental casts, intraoral photos, and panoramic and periapical x-rays. RESULTS: Twenty-five percent of the subjects had incisor trauma at the baseline examination, and 28% experienced new or worsening maxillary incisor injury during the study. No significant differences were found with regard to sex and prevalence of injury at baseline. No differences in incidence of trauma were found between the 3 treatment groups throughout the study (P = 0.19); however, boys were more likely to experience maxillary incisor injury (odds ratio estimate, 2.37; 95% CI, 1.33, 4.21), and those with an injury at baseline were more likely to experience an additional injury (odds ratio estimate, 1.81; 95% CI, 1.03, 3.17). CONCLUSIONS: Early orthodontic treatment did not affect the incidence of incisor injury. The majority of the injuries before and during treatment were minor; therefore, the cost-benefit ratio of orthodontic treatment primarily to prevent incisor trauma is unfavorable.
Assuntos
Incisivo/lesões , Má Oclusão Classe II de Angle/terapia , Aparelhos Ativadores , Cefalometria , Criança , Esmalte Dentário/lesões , Polpa Dentária/lesões , Dentina/lesões , Aparelhos de Tração Extrabucal , Feminino , Florida/epidemiologia , Seguimentos , Humanos , Incidência , Estudos Longitudinais , Masculino , Má Oclusão Classe II de Angle/patologia , Estudos Prospectivos , Radiografia Interproximal , Radiografia Panorâmica , Fatores Sexuais , Coroa do Dente/lesões , Fraturas dos Dentes/epidemiologia , Perda de Dente/epidemiologia , Raiz Dentária/lesões , Dente não Vital/epidemiologia , Conduta ExpectanteRESUMO
INTRODUCTION: Our objective was too assess the effectiveness of 3 analgesics (ibuprofen, naproxen sodium, and acetaminophen) and a placebo administered before and after the placement of separators in reducing the severity of postseparator placement pain. We also examined the impact of treatment on chewing efficiency at 24 hours after separator placement. METHODS: Twenty-four subjects participated in the study. Each subject received 3 of 4 treatments: ibuprofen, naproxen sodium, acetaminophen, or placebo in random order at monthly intervals. The dosing times were 1 hour before separator placement and 3 and 7 hours after separator placement. Before placement, the subjects completed a masticatory efficiency test and a visual analog scale (VAS) for expected pain and pain experienced. A VAS pain diary was kept for 24 hours. Subjects returned to the clinic after 1 week for separator removal. RESULTS: VAS pain summary scores after separator placement were significantly affected by the administration of ibuprofen (P = 0.0298) and the time after separator placement (P <0.0001). Administering ibuprofen before and after separator placement significantly reduced pain compared with the placebo. The analgesic effects diminished by day 2, resulting in peak pain levels and decreased chewing efficiency. The expected pain after separator placement also played a role in experienced pain; subjects expecting more pain experienced more pain. CONCLUSIONS: Ibuprofen was superior to the placebo in relieving postseparator pain as measured by the VAS pain summary scores, whereas acetaminophen and naproxen sodium did not significantly differ from the placebo.
Assuntos
Analgésicos não Narcóticos/uso terapêutico , Aparelhos Ortodônticos/efeitos adversos , Dor/prevenção & controle , Acetaminofen/uso terapêutico , Adolescente , Adulto , Anti-Inflamatórios não Esteroides/uso terapêutico , Estudos Cross-Over , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Ibuprofeno/uso terapêutico , Masculino , Mastigação/efeitos dos fármacos , Mastigação/fisiologia , Naproxeno/uso terapêutico , Dor/psicologia , Medição da Dor , Placebos , Pré-Medicação , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVE: Cleft palate increases the risk of chronic middle ear disease and hearing loss. The goal of this report was to determine which of two palate surgeries and which timing of palate surgery were associated with better otologic and audiologic outcomes in children with unilateral cleft lip and palate at 5 to 6 years of age. DESIGN: Subjects were randomly assigned to the von Langenbeck with intravelar veloplasty or Furlow palate repair, to palate surgery at 9 to 12 months or 15 to 18 months of age, and to the Spina or Millard lip repair. SETTING: Centralized, tertiary care craniofacial treatment center. PATIENTS: A total of 673 infants with unilateral cleft lip and palate. INTERVENTIONS: Palate and lip were repaired using established techniques. Serial otoscopic and audiometric evaluations were performed. MAIN OUTCOME MEASURES: Hearing and otoscopic findings at 5 to 6 years old. RESULTS: There were 370 children available for analysis. Hearing and need for tympanostomy tube placement did not differ by palatoplasty, age at palatoplasty, cheiloplasty, or surgeon. Risk of developing cholesteatoma or perforation was higher with Millard cheiloplasty (odds ratio â=â 5.1, 95% confidence interval â=â 1.44 to 18.11, p â=â .012). Type and age at palatoplasty were not significantly associated with either the rate of developing these sequelae or the rate of achieving bilaterally normal hearing and ear examinations. CONCLUSIONS: Type of palatoplasty did not influence otologic and audiologic outcomes in 5- to 6-year-olds with unilateral cleft lip and palate. The potential influence of lip repair on otologic outcomes warrants further investigation.