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At least 1,081 records · Page 60Linked to original sources
PubMed2006

A comparison of commissure excursion following gracilis muscle transplantation for facial paralysis using a cross-face nerve graft versus the motor nerve to the masseter nerve.

BACKGROUND: The microneurovascular transfer of a free muscle transplant is the procedure of choice for facial animation in a child with facial paralysis. One of the critical factors of this procedure is the selection of a motor nerve to innervate the transplanted muscle. METHODS: From 1989 to 1999, 166 free segmental gracilis muscle transfers were performed in 121 children for facial animation. The cross-face nerve graft was used in 70 procedures (cross-face nerve graft group) to innervate the muscle by branches of the seventh nerve for the normal side. The ipsilateral masseteric nerve was used in 94 procedures (50 patients, masseter group) and the ipsilateral accessory nerve was used in two procedures (one patient). To compare the operative procedures between the first two groups, all charts were reviewed. The extent of oral commissure movement was determined by measurements taken from the tragion to the oral commissure, both at rest and with full smile. In the cross-face nerve graft group (n = 20), the extents were measured on both the normal side and the reconstructed side; in the masseter group (n = 16), they were measured on the left and right sides. RESULTS: No significant difference was found between the two groups (p < 0.05) for the mean age at the time of muscle transplantation, for the total operation time for muscle transplantation, and for the length of the muscle used or for the fraction of circumference of the segment of gracilis muscle used. Although the operative variables were similar between two groups, the muscle excursion differed. Excursion in the cross-face nerve graft group was less than that on the right (p = 0.0006) or left (p = 0.0000) in the masseter group. It was also less than on the normal side (p = 0.0000) of the cross-face nerve graft group. Also, there was no significant difference between the left and right sides within the masseter group (p < 0.05). Furthermore, the extent of oral commissure movement in the masseter group was similar to that of the normal side in the cross-face nerve graft group (p = 0.35, p = 0.61). CONCLUSION: These results indicate that segmental gracilis muscle transplantation using the motor nerve to the masseter nerve for facial animation in children is a very reproducible operation and provides a commissure excursion in the range of normal.

Body Weights and Measures↗
PubMedDate not supplied

Who's in the mirror? Self-other discrimination in specular images by four- and nine-month-old infants.

This research investigated the early determinants of self-other discrimination in infancy. Ninety-six 4- and 9-month-old infants were placed facing a live image either of themselves or of another person (experimenter) mimicking them. The specular image was either contingent (on-line), or contingent with a 2-s delay. After a first 1-min presentation, the video image of either the self or the other was suddenly frozen for 1 min (still-face episode). This was followed by a last minute of live presentation. From 4 months of age, infants appeared to perceive and act differentially when facing the specular image of themselves or the mimicking other. In general, infants tended to smile more, look more, and have more protracted first-look duration toward the mimicking other compared with the self. Developmentally, 9-month-olds showed markedly more social initiatives toward the mimicking other compared with the self during the still-face episode. In all, these results indicate that infants develop self-other discrimination in specular images long before mirror self-recognition, which is typically reported by the second year. Discrimination of the self from other is interpreted as a precursory ability and a perceptual foundation of later conceptual self development.

Attention↗
PubMed1982

Coping behavior: differences in barrier performance in full-term and premature infants.

Coping ability was assessed in 12- and 18-month-old premature and full-term children, using an experimental barrier situation consisting of a double fence of boards and boxes which the child had to remove to reach the center. No term differences were found for the 12-month-old children: the task was too difficult for them. The term differences found at 18 months indicated that the prematures rested more and tended to smile more than did full-terms. The most dramatic finding was that only 4 of the 17 children who completed the task were premature. None of the findings for the 18-month-old children were related to intelligence.

Birth Weight↗
PubMed1992

An observational study of the affective concomitants of mastery in infants.

The hypothesis that attempts at motor mastery were accompanied by positive affective responses was tested in an observational study of 9-11-month old infants in a daycare setting. Five infants were observed as they attempted three age-appropriate motor tasks--pulling to stand, standing with support, and taking steps with support. Positive affective responses included smiling, babbling, and laughing. The five infants were observed for a total of 82 hours. The proportion of positive affective behaviors associated with practicing new motor tasks was compared to the proportion associated with well-practiced tasks. The hypothesis that more positive affective behaviors would be associated with attempts at mastering the new motor tasks was confirmed. There was no diminution in the association between the new motor tasks and positive affect as the infants continued to practice and master the three motor tasks. The results are discussed in terms of individual differences in mastery motivation and the often suggested continuity between early mastery motivation and later competencies.

Child↗
PubMed1993

A longitudinal study of neural maturation and early mother-infant interaction: a research note.

The development of postural control of the head and of looking towards and looking away from the mother is described; the age relationship between attainment of postural head control and looking towards the mother is investigated and the relation between smiling and "pleasure" vocalizations to looking towards and away is examined. Twelve normal, full-term mother-infant pairs participated in this home-based study. En face interaction was video-taped for maximally 15 min at 3, 6, 9, 12, 15 and 18 (or 21) weeks. We conclude that postural head control constitutes an important prerequisite for the emergence of socially directed behaviours during en face interaction.

Attention↗
PubMed2005

Assessment of dental appearance following changes in incisor proportions.

This study aimed to evaluate the assessment of attractiveness of standardized changes in incisor proportions. Two original photographs, showing the maxillary anterior teeth in the frame of a smile, were computer-manipulated. From the so-produced symmetrical 'golden standard' images, two sets were constructed. Each set contained one golden standard image and seven images with different standardized changes concerning (i) width-to-length ratios of the central incisors (60-96%) and (ii) tooth-to-tooth proportions between the widths of lateral and central incisors (43-87%). The judges, consisting of three groups of individuals (24 dentists, 24 medical students, and 179 patients), ranked each photo set for attractiveness on a visual analogue scale. The width-to-length ratios were assessed as most attractive within a range of 75-85% (medical students, patients) or 75-80% (dentists), respectively. The tooth-to-tooth proportions showed the best results concerning attractive appearance within a range of 50-74% (medical students, patients) or 56-68% (dentists), respectively. No significant differences between the participant groups were found except for some extreme variations. It was concluded that a most attractive 'golden range' could be identified for both the width-to-length ratios and the tooth-to-tooth proportions of the maxillary incisors.

Adolescent↗
PubMed1999

Comparing the perception of dentists and lay people to altered dental esthetics.

PURPOSE: This study was designed to determine the perceptions of lay people and dental professionals with respect to minor variations in anterior tooth size and alignment and their relation to the surrounding soft tissues. MATERIALS AND METHODS: Smiling photographs were intentionally altered with one of eight common anterior esthetic discrepancies in varying degrees of deviation, including variations in crown length, crown width, incisor crown angulation, midline, open gingival embrasure, gingival margin, incisal plane, and gingiva-to-lip distance. Forty images were randomized in a questionnaire and rated according to attractiveness by three groups: orthodontists, general dentists, and lay people; 300 questionnaires were distributed. RESULTS: The response rate was 88.2% for orthodontists, 51.8% for general dentists, and 60.6% for lay people. The results demonstrated threshold levels of noticeable difference between the varying levels of discrepancy. A maxillary midline deviation of 4 mm was necessary before orthodontists rated it significantly less esthetic than the others. However, general dentists and lay people were unable to detect even a 4-mm midline deviation. All three groups were able to distinguish a 2-mm discrepancy in incisor crown angulation. An incisal plane cant of 1 mm as well as a 3-mm narrowing in maxillary lateral incisor crown width were required by orthodontists and general dentists to be rated significantly less esthetic. Lay people were unable to detect an incisal plane asymmetry until it was 3 mm, or a lateral incisor narrowing until it reached 4 mm. Threshold levels for open gingival embrasure and gingiva-to-lip distance were both at 2 mm for the orthodontic group. Open gingival embrasure became detectable by the general dentists and lay people at 3 mm, whereas gingiva-to-lip distance was classified by these groups as noticeably unattractive at 4 mm. CLINICAL SIGNIFICANCE: The results of this study show that orthodontists, general dentists, and lay people detect specific dental esthetic discrepancies at varying levels of deviation, which may aid the dental professional in making specific treatment recommendations.

Analysis of Variance↗
PubMed2002

Esthetic treatment planning: the grid analysis system.

UNLABELLED: It is sometimes difficult to identify esthetic problems let alone pre-visualize an esthetic end-result. The Esthetic Grid Analysis is a system for analyzing the basic problems that detract from the concept of an attractive smile. A photograph is taken of the anterior teeth with the lips retracted. The upper and lower frame of the photograph is aligned parallel with the interpupillary line, assuming that the interpupillary line is parallel with the horizon. Where this is not the case, the vertical margins of the photograph are aligned parallel with the facial midline. Through orienting the photograph to the facial guidelines and incorporating the idealized positions of the incisal plane, highest lipline, midline axis, and proportionate contact areas, a grid is formed. The grid built from these components provides a method of demonstrating deviations from an esthetic arrangement of anterior teeth. CLINICAL SIGNIFICANCE: Integrating facial guidelines with the dental composition using a grid highlights deviations from the ideal. It thereby assists in the treatment planning process by communicating esthetic problems to the patient, laboratory personnel, and other specialists.

Adult↗
PubMed2003

Inaugural Geoffrey Heithersay oration in endodontics and oral biology.

Smiles are often a reflection of dental health, and as such provide great satisfaction to a dental practitioner who has successfully managed complex dental problems such as malformed, malpositioned or traumatically damaged teeth. A biological approach to the management of the pulpal and periodontal responses to dental trauma has been made possible by cumulative research, and application of this knowledge will enhance successful treatment.

Dental Pulp Diseases↗
PubMed2004

Disparity in orthodontic utilization and treatment need among high school students.

OBJECTIVES: The aim of this cross-sectional study was to assess the disparity in utilization of orthodontic services among high school students and to measure and characterize the extent of unmet treatment needs among untreated students at the time of examination. METHODS: The sample consisted of 2,808 tenth grade students enrolled in different public and private high schools. All subjects completed a dental survey that included questions on demographic, dental health, and orthodontic services, and assessment of smile using the visual analog scale. A subsample of dental study casts that were available for 561 untreated subjects were scored using the Dental Aesthetic Index (DAI) to estimate unmet treatment need. RESULTS: The orthodontic utilization rate was 37 percent. The odds of being orthodontically treated were 8.7 times greater among those with dental visits within the past year than among those without, and three times greater among Caucasians than among other ethnic groups. The DAI indicated that the unmet treatment need was 29 percent, with ethnic minority groups having 2.6 greater odds of needing treatment than Caucasians. CONCLUSION: Minority groups and infrequent dental attenders may experience disparities in unmet orthodontic treatment need.

Adolescent↗
PubMed2006

Oral health, related behaviors and oral health impacts among homeless adults.

OBJECTIVE: To assess the oral health needs, related behavior and oral health impact among homeless persons in Newark, New Jersey. METHODS: Participants represented a convenience sample of adults (n=46) participating in Homeless Services Day, an annual event sponsored by the Homeless Services Division of the Newark, NJ Department of Health and Human Services. Their mean age was 40.4 yr (SD=10.0), and 51.1% were female. The majority (76%) reported African-American ethnicity; remaining participants self-identified as Hispanic, White or Asian. Participants reported being homeless for a median of 11 months, with a range of 1 to 108 months. RESULTS: The 46 participants had 745 teeth (averaged 16.2 per person) that were either missing, had fillings or had untreated decay. Diseased teeth averaged 3.8 per person; missing teeth averaged 8.6 per person; and filled teeth averaged 3.7 per person. Only 28.3% had a dental visit in the past year. Approximately 87% reported negative oral health impacts impact: over half (55.6%) had current oral facial pain and two-thirds of our participants reported having dental-related face pain during the past year. Additional oral health impacts included: eating (42%), smiling (33%), concentrating (18%) and talking (16%). CONCLUSIONS: Consistent with other studies, this homeless sample presented with considerable oral health needs. Newark's homeless, like other homeless cohorts, face access to care and negative oral health impacts. This study informs the need for future research that can provide substantive evidence for care providers and policy makers.

Adult↗
PubMed1987

Frequency code: orofacial correlates of fundamental frequency.

In the human voice, lip retraction as in smiling can be associated with high fundamental (Fo) and formant frequencies. The aim of this study was to investigate under naturalistic conditions the cross-species generality of the frequency code hypothesis and related orofacial correlates in Fo. Digital spectral, spectrographic, and cinegraphic measurements were made of spontaneous chimpanzee vocalizations and orofacial movements produced and recorded in the field. A significant decline in Fo was found in submissive-scream-to-aggressive-waahbark transitions as predicted by the frequency code. Teeth and lip opening distances during sounds were positively correlated with their duration, Fo, frequency rise and tempo. These positive correlates and a trivariate regression between orofacial opening and Fo give support to the coordination of these appeasing facial and vocal features proposed in the frequency code hypothesis.

Acoustics↗
PubMed1990

Treating those who fail to take themselves seriously: pathological aspects of humor.

A method of analyzing humor was presented. Patients are first made aware of their "being amused" by bringing their smiling and laughing to their attention. They can be then be led to see that their external life situation has predisposed them to experience an intrapsychic event--the spontaneous emergence of antithetical ideation into consciousness which has, in turn, given rise to three beliefs: (1) the ir-responsibility, (2) the incongruity, and (3) the inconsequentiality of the production and nature of this ideation. Two patients were presented to illustrate how foreknowledge of the three beliefs could aid the therapist in working through what might otherwise have been intractable pathology. The author is, generally, in favor of a more relaxed attitude about the use of humor and nonverbal expressive behavior in general, but urges that this material be integrated within the framework of a structured cognitive approach.

Adaptation, Psychological↗
PubMed2001

Children with autism display more social behaviors after repeated imitation sessions.

Based on earlier studies, an adult's imitations of the behaviors of children with autism lead to increased social behavior in the children. The present study explored the effects of repeated sessions of imitation. Twenty children were recruited from a school for children with autism to attend three sessions during which an adult either imitated all of the children's behaviors or simply played with the child. During the second session the children in the imitation group spent a greater proportion of time showing distal social behaviors toward the adult including: (1) looking; (2) vocalizing; (3) smiling; and (4) engaging in reciprocal play. During the third session, the children in the imitation group spent a greater proportion of time showing proximal social behaviors toward the adult including: (1) being close to the adult; (2) sitting next to the adult; and (3) touching the adult. These data suggest the potential usefulness of adult imitative behavior as an early intervention.

Attention↗
PubMed2003

Emotion in the infant's face: insights from the study of infants with facial anomalies.

Darwin viewed "experiments in nature" as an important strategy for elucidating the evolutionary bases of human emotional expressions. Infants with craniofacial anomalies are of special interest because morphological abnormalities and resulting distortions or deficits in their facial expressions could make it more difficult for caregivers to read and accurately interpret their signals. As part of a larger study on the effects of craniofacial anomalies on infant facial expression and parent-infant interaction, infants with different types of craniofacial conditions and comparison infants were videotaped interacting with their mothers at 3 and 6 months. The infants' facial expressions were coded with Baby FACS. Thirty-seven slides of 16 infants displaying 4 distinctive infant expressions (cry face, negative face, interest, and smile) were rated by 38 naive observers on a 7-point scale ranging from intense distress to intense happiness. Their ratings were significantly correlated with ratings based on objective Baby FACS criteria (r > 0.9 in all infant groups). A 4 (infant group) x 4 (expression category) ANOVA showed a significant main effect for expression category, F(3) 5 71.9, P 5 0.000, but no significant effect for infant group or group 3 expression interaction. The observers' ratings were thus highly "accurate" in terms of a priori Baby FACS criteria, even in the case of infants with severely disfiguring facial conditions. These findings demonstrate that the signal value of infant facial expressions is remarkably robust, suggesting that the capacity to read emotional meaning in infants' facial expressions may have a biological basis.

Affect↗
PubMed2001

Simulated shape design. Helping patients decide their esthetic ideal.

BACKGROUND: Esthetic care is changing dentistry from a need-based to a want-based practice. Patients are asking for esthetic treatment, and clinicians are retooling their practices to satisfy this need. One important part of providing esthetic dentistry is ensuring that the patient is as well-informed as possible about treatment outcomes. DESCRIPTION OF TECHNIQUE: This article describes a tool dentists can use to show patients potential tooth sizes, shapes and arrangements before carrying out treatment. Simulated shape design, or SSD, is a reversible method of demonstrating potential esthetic outcomes that involves creating trial restoration shapes and placing them over a patient's teeth. SSD is a simple technique that any dentist can perform. In essence, the technician makes new tooth shapes in wax, the dentist places these in the patient's mouth and the patient evaluates them. The dentist then makes modifications in the SSD, which he or she reports to the technician. CLINICAL IMPLICATIONS: With the decisions of shape, arrangement and size made at chairside, the whole flow of esthetic treatment can be handled smoothly. Preparations can be cut more accurately to better support the restorative material; decisions can be made to open or not open the contacts; and shapes can be agreed on in the earliest stage of evaluation, then duplicated faithfully in the provisional and final restorations. There are no surprises for the patient, the dentist or the technician. Both the esthetic (smile design) and functional elements (anterior guidance) of the restoration can be checked with SSD. SSD could become the standard in determining whether or not to proceed with esthetic treatment.

Cuspid↗
PubMed1998

Measurement of facial soft tissue mobility in man.

OBJECTIVE: The assessment of facial mobility is a key element in the treatment of patients with facial motor deficits. In this study, we explored the utility of a three-dimensional tracking system in the measurement of facial movements. METHODS AND RESULTS: First, the three-dimensional movement of potentially stable facial soft-tissue, headcap, and dental landmarks was measured with respect to a fixed space frame. Based on the assumption that the dental landmarks are stable, their motion during a series of standardized facial animations was subtracted from that of the facial and headcap landmarks to estimate their movement within the face. This residual movement was used to determine which points are relatively stable (< or = 1.5 mm of movement) and which are not (> or = 1.5 mm of movement). Headcap landmarks were found to be suitable as references during smile, cheek puff, and lip purse animations, and during talking. In contrast, skin-based landmarks were unsuitable as references because of their considerable and highly variable movement during facial animation. Second, the facial movements of patients with obvious facial deformities were compared with those of matched controls to characterize the face validity of three-dimensional tracking. In all instances, pictures that appear to be characteristic of the various functional deficits emerged. CONCLUSIONS: Our results argue that tracking instrumentation is a potentially useful tool in the measurement of facial mobility.

Adolescent↗
PubMed2002

Validity of subjective evaluations for the assessment of lip scarring and impairment.

OBJECTIVE: In patients with cleft lip and palate, the aim of the study was (1) to determine and compare the level of agreement among examiners' subjective evaluations of static and dynamic lip form; (2) assess possible bias of examiners' subjective evaluations; and (3) determine the impact of lip scarring on an examiner's subjective assessment of dynamic lip form. SETTING: Patients and subjects were recruited from the University of North Carolina Cleft Lip and Palate Center and School of Dentistry. PATIENTS, PARTICIPANTS: Thirteen patients with unilateral cleft lip and palate and varying degrees of cleft scar severity were selected and one subject without cleft who wore artificial scars of varying severity. INTERVENTIONS: For the patients with cleft, a previously repaired complete cleft lip and palate. Photographs and videotape recordings were made of the patients with cleft and the subject without cleft, with and without the artificial scars, at rest and smiling. MAIN OUTCOME MEASURE(S): Rankings of cleft scar severity and impairment on a 6-point Likert scale by a lay and professional panel. RESULTS: Intra- and interexaminer reliability was good for the lower facial regions at rest but not during movement. Professionals gave ratings of greater severity and impairment than laypersons, and professionals agreed when rating the lower faces at rest more so than during movement. Lip scarring affected perceptions of impairment during movement by viewers in both panels. CONCLUSIONS: Subjective assessments can be affected by methodological approaches, professional experience, and stimulus type. Future research should focus on establishing objective methods to evaluate patients with cleft lip and palate at rest and during function.

Adolescent↗