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Five cases are presented to exemplify technical difficulties and complications which may be encountered when performing distraction osteogenesis in the facial skeleton. The procedure should be performed under close supervision by the surgical and orthodontic colleagues. Errors in the choice of vector may be managed by earlier removal of the distractor and subsequent traction on the previously osteotomized segments using orthodontic appliances and principles. Multiple distractors may be inserted in the same jaw and bimaxillary procedures are possible, increasing the likelihood of encountering technical difficulties. Detailed planning and close follow-up, with early recognition and active management of the complications, may be useful in ensuring a successful outcome of this versatile procedure.
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A new simple gag is presented securing the width of the tube of the laryngeal mask. The device is a 45 degrees-angled, u-shaped, synthetic-coated aluminium rod. This gag, while being additionally an aid to ensure the proper position of the laryngeal mask, is easy to handle and can be re-used after disinfection. Due to its rounded shape and the soft synthetic coating, accidental damage of the teeth seems to be nearly impossible.
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The am of this study was to evaluate subjective aspects from questionnaires dealing with dental trauma by applying different computerized inductive techniques within the field of artificial intelligence to questionnaires consisting of descriptive variables and of questions reflecting functional, personal, and social effects of patients' oral situation following dental trauma. As the methodology used is new to many readers in odontologic sciences, a detailed description of both the processes and the terminology is given. Utilizing a neural network as a first step in an analysis of data showed if relations existed in the training set, but the network could not make the relations explicit, so other methods, inductive methods, had to be applied. Inductive methods have the potential constructing rules from a set of examples. The rules combined with domain knowledge can reveal relations between the variables. It can be concluded that the usage of methods based on artificial intelligence can greatly improve explanatory value and make knowledge in databases explicit.
The thermal effects on dentin during CO2 laser irradiation on human enamel were investigated. To simulate the clinical practice, two cooling methods (air and water spray) were applied immediately after laser exposure, whereas one group without cooling was served as control. Three hundred and sixty uniform tooth blocks were obtained from freshly extracted human third molars. Temperature change measurements were made via electrical thermocouple implanted within the tooth block 2 mm away from the enamel surface. Experimental treatments consisted of lasing without cooling, lasing with 0.5-ml/sec water cooling, and lasing with 15-psi air cooling. Our results indicated that (1) both air- and water-cooling groups could reduce temperature elevation significantly; (2) the larger power energy resulted in the higher temperature elevation. In conclusion, for CO2 laser irradiation on human enamel both water- and air-cooling methods may be effective on prevention of thermal damage of pulp.
OBJECTIVE: This study was conducted to establish the operating parameters of the argon laser without thermal damage to the pulp tissue for clinical applications. SUMMARY BACKGROUND DATA: Previous studies have mainly compared the temperature modifications of the pulp chamber in a very limited situation, where a complete view of the thermal history cannot be obtained nor even extrapolated to new applications. METHODS: We used samples of molar and premolar tooth where a class V cavity was prepared and illuminated with an argon laser at different power levels, fixing the exposition area for all cases. Situations including open cavity and teeth restoration were analyzed. High-precision thermistors were placed in four different positions, one of which was inside the pulp chamber. The temperature evolution was monitored continuously by an interfaced computer during all laser exposure. Special attention was paid to the intrapulpal temperature variation because it is considered the most vulnerable thermal region. The temperature time evolution allowed the determination of the operating conditions (power-time-temperature variation) in which the use of the argon laser causes no pulpal damage. As a function of temperature variation, we divided the whole parameter space (power-time-temperature) into zones and the optimum zone of operation was determined. CONCLUSIONS: We created a diagram called power-time-temperature (PTT) where zones of temperature increased under laser irradiation allow the verification of which condition is safe for clinical laser application. The results have a broad use when this type of analysis is applicable.
No detailed analyses have been undertaken on the effects of Health Promoting Schools on oral health status. The objective of this study was to assess whether the oral health of 12-year-old children in supportive schools, where health promoting policies had been developed, was better than that of children in non-supportive schools. A sample of 1823 12-year-old children in 33 public (government-funded) schools were selected in deprived areas of Curitiba, Brazil. Principal component analysis, multiple regression, meta-analysis and meta-regression were used in the data analysis. Schools with a comprehensive curriculum were more likely to have a higher percentage of caries-free children (beta = 6.27, p = 0.02) and fewer children with dental trauma (beta = -5.04, p = 0.02). The commitment towards health and safety at school was strongly associated with dental trauma, as 9.7% fewer children had dental trauma (p = 0.00) in schools that demonstrated a commitment towards health and safety. At the school level, mother's education and family income were independently associated with children's caries experience and dental trauma, respectively. Children in supportive schools had better oral health than those in non-supportive schools. Our results suggest that some benefit can be obtained for the improvement of the oral health of children living in deprived areas if they attend supportive schools.
Autotransplantation of teeth, if carried out successfully, ensures that alveolar bone volume is maintained due to physiological stimulation of the periodontal ligament. Autotransplantation has been carried out for many years, but with varying success rates. As a result, it is seldom regarded as an appropriate treatment option for patients with missing teeth especially with the continued development of osseo-integrated implants. Since placement of osseo-integrated implants in growing alveolar bone is contra-indicated, transplantation of available teeth remains a suitable choice for replacing missing units in the young patient. The role of autotransplantation of teeth in several clinical situations, the clinical techniques involved and factors influencing success of the transplant are discussed. The aim of this paper is to underline the evidence based principles for successful autotransplantation and present the technique as a viable treatment option in present day orthodontic practice.
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