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PubMed1976

The relationship between affective and cognitive development in Down's Syndrome infants.

A close association between affective expression and cognitive development was demonstrated in a longitudinal study of 14 Down's syndrome infants. It was found that the Down's syndrome infants laughed to groups of stimulus items in the same order as did previous samples of normal infants. Although the process was delayed by several months, the retarded babies too laughed first at physically intrusive items and only later to items calling for greater cognitive sophistication. In addition, cognitive developmental status, assessed by the Bayley and Uzgiris-Hunt scales, paralleled and was predicted by the level of affective development. Predictive and concurrent correlations between Bayley mental scores and various indices of affectivity ranged from .68 to .92. There was striking individual consistency across affective, mental, and motor measures, suggesting the organized nature of retarded development. Finally, since Down's syndrome infants frequently smiled under conditions when normal babies would laugh, a role for tension production, in addition to cognitive factors, was suggested in accounting for the behavior of these infants.

Affect↗
PubMed2003

Parental evaluation of quality of life measures following pediatric dental treatment using general anesthesia.

The purpose of this study was to examine (a) parental satisfaction with the dental care their child received under general anesthesia, and (b) perception of the impact of this care on physical and social quality of life. The sample included 45 children (median age 50 months, 26 boys and 19 girls). Data were collected using a 1-page survey instrument completed by the parent at the first follow-up appointment. Dichotomous dependent variables were developed to measure parental satisfaction, dental outcome, and social impact of treatment. There was an overwhelmingly positive impression with dental outcomes (pain relief and improved masticatory efficiency). Parental perceptions in the social dimension were also positive. Parents reported more smiling, improved school performance, and increased social interaction. Relative to overall health, the majority of parents reported an improvement. Logit regression analysis revealed that absence of pain (P < .05) and increased social interaction (P < .01) had a significant impact on parents' perception of overall health. Our findings indicate that dental care under general anesthesia for preschool children has a high degree of acceptance by parents and is perceived to have a positive social impact on their child.

Anesthesia, Dental↗
PubMed2003

It's magic: a unique practice management strategy.

For thousands of years prior to the advent of modern dentistry, magic has been used to entertain, impress, and motivate individuals. Today's dental professionals are using the concept of The Magic of a Healthy Smile through their use of modern clinical techniques and as a means for practice marketing, patient education, and the reduction of patient stress and fear. This article describes how dentists/magicians have incorporated magic into their practices and the benefits of this useful patient management strategy. A script of the "Happy Tooth Magic Show" and resources for dentists to create their own dental magic show are provided.

Child↗
PubMedDate not supplied

Clinical effects of nitrous oxide conscious sedation in children.

PURPOSE: This study examined the clinical effects of nitrous oxide conscious sedation on children. METHODS: Fifty-nine healthy children (ages 4 to 13, mean age=7.7 yrs.) requiring dental restorative treatment with nitrous oxide sedation were studied. The behavior and clinical effects were assessed before and 5 minutes after 50% nitrous oxide sedation. In addition, the children were instructed to draw 4 selected figures from the Bender Visual Motor Gestalt Test to evaluate psychomotor performance and report on their perceived feelings with nitrous oxide. The total sample was divided into various groups for analysis by age, gender, and prior nitrous oxide experience. RESULTS: The most common effects of nitrous oxide sedation were open hands (90%), limp legs (81%), and facial smile (66%). Almost all of the children (95%) liked the nitrous oxide, and 86% reported feeling different. In the measure of psychomotor performance, 75% of the children had 2 or less errors initially and 5 or less errors with nitrous oxide. CONCLUSIONS: There are observable signs and perceived symptoms of nitrous oxide conscious sedation in children. In addition, nitrous oxide at a concentration of 50% has a small but significant effect on the psychomotor ability of children.

Adolescent↗
PubMed2005

Interdental papilla length and the perception of aesthetics.

UNLABELLED: The perception of dental aesthetics has been shown to vary significantly among patients and dental professionals. Smile evaluations should not be completed without establishing an ideal spatial relationship between the teeth and their respective papilla in the aesthetic zone. To date, no studies have evaluated the influence of papilla length on the perception of aesthetics and whether dental professionals or patients can discern variations. The purpose of this study was to determine the perception of aesthetics through symmetric alteration of the papilla length. LEARNING OBJECTIVES: This article reviews the importance of ideal papilla location for optimal aesthetics and its evaluation by dental professionals and patients. Upon reading this article, the reader should: Have a greater understanding of papilla length on the perception of aesthetics. Improve his or her familiarity with procedures and techniques applied to enhance soft tissue aesthetics.

Adult↗
PubMed2006

The urofacial (Ochoa) syndrome--first case in the central European population.

The urofacial (Ochoa) syndrome (UFS) is a very rare autosomal recessive disorder characterized by abnormal facial expression and urinary abnormalities. Patients with this syndrome have urinary tract infection, hydronephrosis, hydroureter and voiding dysfunctions resulting from neurogenic bladder, together with a peculiar inverted facial expression, mainly when smiling or crying. This syndrome has been so far observed in Colombia, USA, France and Spain. We report the first case of Ochoa syndrome in the central European population.

Facies↗
PubMed2006

Diagnostic protocol in cases of congenitally missing maxillary lateral incisors.

Patients with congenitally missing maxillary lateral incisors may seek treatment from an orthodontist for several reasons; unpleasant smile, dental arch disharmony, and midline deviations are among the most frequent complaints. Orthodontists and prosthodontists have raised important questions about the esthetics, occlusion, periodontal health, and psychological conditions noted in these patients. The decision to open lateral incisor spaces for prosthetics or close spaces by mesial movement of the canines requires a careful diagnosis and comprehensive multidisciplinary treatment planning. The purpose of this article is to present a diagnostic protocol to assist in the decision-making process, while analyzing patients with absent maxillary lateral incisors. The basis for a sound diagnosis and an effective treatment plan resides in careful consideration of the facial and dental characteristics of each patient. All information gathered during the clinical examination should be added to data obtained with other diagnostic tools, such as cephalometric analysis and orthodontic waxups, to achieve the treatment option that best suits the patient's expectations.

Anodontia↗
PubMed1992

Anatomic variations of the nasolabial fold.

The nasolabial fold varies considerably from person to person. Three main groups may be distinguished: convex, concave, and straight. It is the muscles of smiling that are directly responsible for the shape and depth of the fold, and in their absence of function, as in facial palsy, the nasolabial fold disappears. Cadavers were selected in accordance with the nasolabial fold they presented and were dissected to analyze the difference in underlying anatomy between one fold shape in one cadaver and another fold shape in another. The study demonstrates that the nasolabial fold is the result of a conflict between soft and dynamic tissues of the middle face or an interaction between the skin and fat envelope on one side and the underlying muscles on the other. The greater this conflict, the more excess there is of cheek skin and the more pronounced a nasolabial fold. The mechanism that creates the nasolabial fold and the anatomy of the fold are described in this paper.

Cadaver↗
PubMed1990

[Visibility of front and side teeth].

Anterior and posterior tooth visibility was analysed in a population of 220 subjects. Scoring photographic data gave the percentages of anterior and posterior teeth shown in different situations: speaking, laughing, exaggerated smiling. The consequences for planning and manufacturing dentures are shown by examples.

Esthetics, Dental↗
PubMed1981

Teaching interview skills to mentally retarded persons.

Five types of behavior found to be predictive of impressions made by mentally retarded persons in interviews were designated as targets of interview skills training: responsiveness to questions, speech intelligibility, eye contact, smiling, and attractiveness. Two training conditions, using an instruction-modeling-rehearsal-feedback format and differing only in type of feedback (video tape and verbal vs. verbal alone), were compared to a placebo condition. Although formal training proved to be little more effective than did the placebo experience, significant improvements in responsiveness and eye contact in the verbal-feedback condition and other trends pointed to the feasibility of improving interview skills with minimal intervention.

Education of Persons with Intellectual Disabilitie↗
PubMed1995

Cosmetics and the esthetic patient and laboratory communication.

With increasing consumer awareness of the innovative procedures available for cosmetic dentistry, this area of practice is growing rapidly and has become an excellent source for patient referrals. Unfortunately, it can also be a large source of stress for the practitioner. Esthetics has been described by The Pocket Oxford Dictionary as "the philosophy of beautiful"; its perception varies from individual to individual. In the field of dentistry, there are criteria which define one tooth as being more esthetic than another and one individual's smile as more pleasing than another. However, that which is esthetically pleasing to the clinician may not be esthetically pleasing to the patient.

Adult↗
PubMed1996

Influence of residual ridge resorption patterns on fixture placement and tooth position, Part III: Presurgical assessment of ridge augmentation requirements.

Implant diagnostic methods using computed tomography with barium-coated templates have revealed the relationship between the optimal final tooth position and the residual alveolar process or ridge. While information with regard to emergence axis, anatomic limitations, fixture length, buccolingual cantilever, and prediction of the the final prosthetic design is available, presurgical information relating to the reconstruction potential of smile zone deformities remains elusive. The use of a complete provisional wax-up and the modification of a barium-coated template design can provide the implant team with presurgical information regarding the need for augmentation of hard tissue and soft tissue and the volume of tissue needed for reconstruction. This information can assist the implant team in the development of realistic treatment objectives and in more accurately addressing the needs and concerns of the patient during presurgical treatment planning.

Alveolar Bone Loss↗
PubMed1996

Direct bonding in diastema closure--high drama, immediate resolution.

Aesthetic rehabilitation in complex diastema closure cases is guided by the principles of proportion. The width to length ratio of the centrals must be pleasing. Achievement of this proper balance dictates treatment. It determines the following: 1) the amount of distal proximal reduction; 2) the decision to completely veneer the incisors vs. just adding to the interproximal; 3) the number of teeth to be treated; 4) the placement and location of naturally occurring prominences and concavities to create the illusion of a narrower tooth. The proper accommodation of these four topics will permit the maintenance or restoration of acceptable dimensions in the centrals. If they are made to appear harmonious then the principle of "golden proportion" (1.6:1:0.6) can be achieved among the centrals, laterals and cuspids. Direct bonding in diastema closure cases allow the dentist and the patient complete control in the formation of that smile. This treatment modality is challenging and ultimately rewarding for the patient and the dentist. At times it enables us to restore form and function and to make our patients whole again not just figuratively but literally.

Adult↗
PubMed1997

Altered passive eruption: an etiology of short clinical crowns.

The gingival complex plays a vital role in the overall beauty of a smile. To predictably achieve a successful esthetic and functional result, the dentist must be able to precisely predict the treatment outcome based on biologic determinants. In this article, the biologic requirements for gingival health are discussed. In addition, a differential diagnosis for excess gingival display and treatment options for this condition are discussed.

Adolescent↗
PubMed1997

Esthetic crown lengthening for maxillary anterior teeth.

In the maxillary anterior region, the gingival labial margin position is an important parameter in the achievement of an ideal smile. The relationship between the periodontium and the restoration is critical if gingival health and esthetics are to be achieved. Periodontal therapy is a necessary and useful adjunct when any anterior restoration is undertaken. Anterior surgical crown lengthening may be undertaken to avoid restorative margin impingement on the biologic width. Crown lengthening is also used to alter the gingival labial profiles. This article discusses the esthetic parameters of ideal gingival labial positions and presents a classification of crown-lengthening procedures and the procedure for a two-stage crown-lengthening technique. The two-stage crown-lengthening technique is surgically precise because healing is predictable.

Crown Lengthening↗
PubMed1998

Measurement of facial movement with computer software.

OBJECTIVE: To adapt desktop computer software to objectively grade facial movement. DESIGN: The criteria of the facial nerve grading system by House and Brackmann, the current "gold standard," are prone to ambiguous interpretation. Proposed objective grading systems compare the movement of points on each side of the face or use subtraction and thresholding of digitized images of the face to yield images that represent moving areas of the face. The movement of a point on the face and the area of motion determined by digital subtraction were compared during an increasing smile in healthy subjects. The Nottingham system (calculated using measurement of the movement of 4 points on the face) using desktop computer software (Adobe Photoshop 3.0, Adobe Systems Inc, Mountain View, Calif) to measure movement of the points was compared with the system by House and Brackmann. The computer software was used to subtract digitized images and derive a facial movement score, which was compared with the scores of the systems by Nottingham and House and Brackmann. SETTING: Academic otologic practice. STUDY PARTICIPANTS: Nine patients with varying degrees of facial nerve disability and 7 individuals with normal facial nerve function. RESULTS: The movement of the oral commissure compared with the apparent area of movement of the face determined by digital subtraction had high intersubject variability. In patients with facial weakness, the Nottingham score had a correlation coefficient of -0.97 compared with the House and Brackmann grade, and the digital subtraction score had a correlation coefficient of -0.62 (paired Student t test). CONCLUSIONS: The desktop computer software can be used to calculate the Nottingham score. Digital subtraction as a measure of facial function warrants further study.

CD-ROM↗
PubMed1998

Double or bifid zygomaticus major muscle: anatomy, incidence, and clinical correlation.

The anatomy of the double or bifid zygomaticus major muscle is investigated in a series of 50 hemifacial cadaver dissections. The double zygomaticus major muscle represents an anatomical variation of this muscle of facial expression. This bifid muscle originates as a single structure from the zygomatic bone. As it travels anteriorly, it then divides at the sub-zygomatic hollow into superior and inferior muscle bundles. The superior bundle inserts at the usual position above the comer of the mouth. The inferior bundle inserts into the modiolus below the corner of the mouth. The incidence of the double zygomaticus major muscle was 34% in the present study, as it was found to be present in 17 of 50 cadaver dissections. This study shows that variation in the individual morphology of the mimetic muscles can be a common finding. Clinically, the double or bifid zygomaticus major muscle may explain the formation of cheek "dimples." The inferior bundle was observed in several specimens to have a dermal attachment along its mid-portion, which tethers the overlying skin. When an individual with this anatomy smiles, traction on the skin may create a dimple due to this dermal tethering effect.

Cadaver↗
PubMed2001

Activity patterns assessed throughout 24-hour recordings in preterm and near term infants.

The motility of 10 low-risk infants, aged between 34 and 40 weeks of postmenstrual age, has been continuously recorded for 24 h. Four codes were distinguished: code 1 (absence of motility or occasional occurrence of startles), code 2 (presence of small general or isolated body movements, startles, smiles, grimaces, and other facial activity), code 3 (forceful and prolonged general movements, startles, and stretches), code 4 (vigorous and abrupt general body movements accompanied by crying). Changes with age concern mainly the increase of the duration of code 1 (quiescence) episodes. Confrontation between day and night showed higher levels of motility during the night than during the day. The last weeks before term represent a time for increase in the ability to sustain a quiet behavior and to reorganize day-night motility distribution.

Circadian Rhythm↗