Intrabony defect management with a bone graft (hydroxyapatite and ß-tricalcium phosphate) alone and in combination with a diode laser: A randomized control trial.

Objectives: The current research was conducted to evaluate the use of a diode laser and a bone graft (hydroxyapatite [HA] + ß-tricalcium phosphate [ß-TCP]) in healing of intrabony defects. Materials and Methods: In this split-mouth evaluation, 40 patients with bilateral intrabony defects were treated with, Group I (control) - bone graft alone (HA + ß-TCP) and Group II, (test) - bone graft with a diode laser. The clinical and radiologic parameters of all patients, such as plaque index (PI), probing depth (PD), gingival index (GI), gingival recession (GR), and relative clinical attachment level (RCAL) were recorded at baseline, after 3 months and after 6 months. Results: Reductions in PI, PD, GI, GR, and RCAL were found after 6 months. Furthermore, significant differences were displayed in the intra-group comparison while those of the inter-group evaluation (P > 0.05) were insignificant. Conclusion: In both groups, considerable decrease in intrabony pockets was discovered; however, the inter-group comparison was insignificant in relation to GR and RCAL.

Finite element analysis to assess stress and deformation in bone with glass fiber-reinforced-poly-ether-ether-ketone, zirconia, and titanium implants.

Objectives: Recently, zirconia ceramic and glass or carbon fiber-reinforced poly-ether-ether-ketone (PEEK) composites have been introduced as newer implant biomaterials. This study was done to evaluate stress and deformation in bone with glass fiber-reinforced (GFR)-PEEK, zirconia, and titanium implants. Materials and Methods: A geometric model of mandibular molar replaced with implant-supported crown was generated. Implant of 12 mm length and 4.5 mm diameter was used in study. Finite element analysis models of implant assemblies of three materials GFR-PEEK, zirconium, and titanium were generated. 150 N loads were applied obliquely and vertically along the long axis of implant. Von Mises stresses and deformation generated were compared using ANSYS Workbench 17.0 and finite element software. Results: All three implant assemblies, i.e., GFR-PEEK, zirconia, and titanium, demonstrated similar stresses and deformation in bone without significant difference. Conclusion: It was concluded that GFR-PEEK and zirconia implants can be used as a substitute to titanium implants.

Communication Partners' Journey through Their Partner's Hearing Impairment.

The objective of this study was to further develop the Ida Institute model on communication partners' (CPs) journey through experiences of person with hearing impairment (PHI), based on the perspectives of CPs. Nine CPs of hearing aid users participated in this study, recruited through the Swansea hearing impaired support group. Semi-structured interviews were conducted, the data were analysed using qualitative thematic analysis and presented with the use of process mapping approach. Seven main phases were identified in the CP journey which includes: (1) contemplation, (2) awareness, (3) persuasion, (4) validation, (5) rehabilitation, (6) adaptation, and (7) resolution. The Ida Institute model (based on professionals' perspective) was compared with the new template developed (based on CPs' perspectives). The results suggest some commonalities and differences between the views of professionals and CPs. A new phase, adaptation, was identified from CPs reported experiences, which was not identified by professionals in the Ida Institute model. The CP's journey model could be a useful tool during audiological enablement/rehabilitation sessions to promote discussion between the PHI and the CP. In addition, it can be used in the training of hearing healthcare professionals.

Use of the 'patient journey' model in the internet-based pre-fitting counseling of a person with hearing disability: study protocol for a randomized controlled trial.

BACKGROUND: Hearing impairment is one of the most frequent chronic conditions. Persons with a hearing impairment (PHI) have various experiences during their 'journey' through hearing loss. In our previous studies we have developed a 'patient journey' model of PHI and their communication partners (CPs). We suggest this model could be useful in internet-based pre-fitting counseling of a person with hearing disability (PHD). METHODS/DESIGN: A randomized controlled trial (RCT) with waiting list control (WLC) design will be used in this study. One hundred and fifty eight participants with self-reported hearing disability (that is, score > 20 in the Hearing Handicap Questionnaire (HHQ)) will be recruited to participate in this study. They will be assigned to one of two groups (79 participants in each group): (1) Information and counseling provision using the 'patient journey' model; and (2) WLC. They will participate in a 30 day (4 weeks) internet-based counseling program based on the 'patient journey' model. Various outcome measures which focuses on hearing disability, depression and anxiety, readiness to change and acceptance of hearing disability will be administered pre (one week before) and post (one week and six months after) intervention to evaluate the effectiveness of counseling. DISCUSSION: Internet-based counseling is being introduced as a viable option for audiological rehabilitation. We predict that the 'patient journey' model will have several advantages during counseling of a PHD. Such a program, if proven effective, could yield cost and time-efficient ways of managing hearing disability. TRIAL REGISTRATION: ClinicalTrials.gov Protocol Registration System NCT01611129.

Parental reported benefits and shortcomings of cochlear implantation: Pilot study findings from Southeast Asia.

OBJECTIVE: The aim of the study was to understand the reported benefits and shortcomings by parents of children with cochlear implants and who contribute towards the cost of the implant. METHOD: Thirty parents of children with cochlear implants from a hearing impaired school in Southeast Asia completed open-ended questionnaires and the data were analysed using content analysis. RESULTS: A wide range of benefits and shortcomings were reported. However, it is notable that the single most reported shortcoming was related to cost. DISCUSSION: The results suggest that, even though, in general, the reports about benefits and shortcomings were similar to previous results from western countries, the emphasis given to various aspects of shortcomings was different. In particular, it appears that parentally reported outcomes could be related to many factors including the hearing healthcare system with the costs involved for the implanted individuals and their families. These findings help us understand the parental perspectives of the success of cochlear implantation and will be useful during parental counselling sessions.

Audiological practice in India: an internet-based survey of audiologists.

The field of Audiology in India has expanded exponentially in recent years. Audiologists practice in a variety of work places. However, little is known about the practice trends across these several work places. An Internet-based survey probing into Audiology practice was conducted between June and September 2012. The survey focused on four domains, namely, demography, assessment, hearing aid (HA) fitting and protocol usage. A total of 199 audiologists completed the survey. A large proportion of these audiologists were from Southern India. Majority of the respondents provide hearing assessment and HA services for children and adults. Results indicate diverse practice among respondents, even in essential procedures such as otoscopy. Although a large proportion of audiologists reported performing HA fitting in children as well as adults, less than 12 % of them performed real ear or simulated real ear verification during any HA fitting. Implications for the development of preferred practice guidelines in India have been discussed.

Health behavior change in hearing healthcare: a discussion paper.

Health behavior change (HBC) refers to facilitating changes to habits and/or behavior related to health. In healthcare practice, it is quite common that the interactions between practitioner and patient involve conversations related to HBC. This could be mainly in relation to the practitioner trying to directly persuade the patients to make some changes in their health behavior. However, the patients may not be motivated to do so as they do not see this change as important. For this reason, direct persuasion may result in a breakdown of communication. In such instances, alternative approaches and means of indirect persuasion, such as empowering the patient and their family members, could be helpful. Furthermore, there are several models and/or theories proposed which explain the health behavior and also provide a structured framework for health behavior change. Many such models/approaches have been proven effective in facilitating HBC and health promotion in areas such as cessation of smoking, weight loss and so on. This paper provides an overview of main models/theories related to HBC and some insights into how these models/approaches could be adapted to facilitate behavior change in hearing healthcare, mainly in relation to: i) hearing help-seeking and hearing-aid uptake; and ii) hearing conservation in relation to music-induced hearing loss (MIHL). In addition, elements of current research related to this area and future directions are highlighted.

The genetic basis of auditory neuropathy spectrum disorder (ANSD).

OBJECTIVE: Auditory neuropathy is a hearing disorder where outer hair cell function within the cochlea is normal, but inner hair cell and/or the auditory nerve function is disrupted. It is a heterogeneous disorder which can have either congenital or acquired causes. Furthermore, the aetiology of auditory neuropathy is vast, which may include prematurity, hyperbilirubinaemia, anoxia, hypoxia, congenital brain anomalies, ototoxic drug exposure, and genetic factors. It is estimated that approximately 40% of cases have an underlying genetic basis, which can be inherited in both syndromic and non syndromic conditions. This review paper provides an overview of the genetic conditions associated with auditory neuropathy spectrum disorders (ANSDs) and highlights some of the defective genes that have been found to be linked to the pathological auditory changes. METHOD: Literature search was conducted using a number of resources including textbooks, professional journals and the relevant websites. RESULTS: The largest proportion of auditory neuropathy spectrum disorders (ANSDs) is due to genetic factors which can be syndromic, non-syndromic or mitochondrial related. The inheritance pattern can include all the four main types of inheritances such as autosomal dominant, autosomal recessive, X-linked and mitochondrial. CONCLUSION: This paper has provided an overview of mutation with some of the genes and/or loci discovered to be the cause for auditory neuropathy spectrum disorders (ANSDs). It has been noted that different gene mutations may trigger different pathological changes in patients with this disorder. These discoveries have provided us with vital information as to the sites of pathology in auditory neuropathy spectrum disorders (ANSDs), and the results highlight the heterogeneity of the disorder.

Music exposure and hearing disorders: an overview.

It has been generally accepted that excessive exposure to loud music causes various hearing symptoms (e.g. tinnitus) and consequently leads to a risk of permanent hearing damage, known as noise-induced hearing loss (NIHL). Such potential risk of NIHL due to loud music exposure has been widely investigated in musicians and people working in music venues. With advancements in sound technology and rapid developments in the music industry, increasing numbers of people, particularly adolescents and young adults, are exposing themselves to music on a voluntary basis at potentially harmful levels, and over a substantial period of time, which can also cause NIHL. However, because of insufficient audiometric evidence of hearing loss caused purely by music exposure, there is still disagreement and speculation about the risk of hearing loss from music exposure alone. Many studies have suggested using advanced audiological measurements as more sensitive and efficient tools to monitor hearing status as early indicators of cochlear dysfunction. The purpose of this review is to provide further insight into the potential risk of hearing loss caused by exposure to loud music, and thus contribute to further raising awareness of music induced hearing loss.