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PubMed2002

Neural substrates of human facial expression of pleasant emotion induced by comic films: a PET Study.

Laughter or smile is one of the emotional expressions of pleasantness with characteristic contraction of the facial muscles, of which the neural substrate remains to be explored. This currently described study is the first to investigate the generation of human facial expression of pleasant emotion using positron emission tomography and H(2)(15)O. Regional cerebral blood flow (rCBF) during laughter/smile induced by visual comics and the magnitude of laughter/smile indicated significant correlation in the bilateral supplementary motor area (SMA) and left putamen (P < 0.05, corrected), but no correlation in the primary motor area (M1). In the voluntary facial movement, significant correlation between rCBF and the magnitude of EMG was found in the face area of bilateral M1 and the SMA (P < 0.001, uncorrected). Laughter/smile, as opposed to voluntary movement, activated the visual association areas, left anterior temporal cortex, left uncus, and orbitofrontal and medial prefrontal cortices (P < 0.05, corrected), whereas voluntary facial movement generated by mimicking a laughing/smiling face activated the face area of the left M1 and bilateral SMA, compared with laughter/smile (P < 0.05, corrected). We demonstrated distinct neural substrates of emotional and volitional facial expression and defined cognitive and experiential processes of a pleasant emotion, laughter/smile.

Adult↗
PubMed1975

Psychological problems of the physically handicapped patient.

There is increasing concern about the difficulty encountered by handicapped patients in obtaining adequate dental health care. In addition to the problems of availability and accessibility of dental care there are social and psychological problems affecting the acceptability of dental health care. To overcome these difficulties the dentist must understand the bases of his own perceptions as well as those of his patients which interact in the dentist-patient treatment situation. Although many of the physical problems can be solved by such measures as wheel chair ramps, the major difficulty is the social acceptability of the handicapped. The same degree of handicap may cause different problems depending on the way in which the individual adjusts to it. Orofacial defects cause particular difficulties because they cannot be hidden in the same way as, for example, a missing or deformed limb. Often the relatively minor defects encountered in dental practice may cause greater problems than a more major deformity, since the near normal person strives harder to be considered as normal. Studies of babies' responses to normal and abnormal facial appearances have demonstrated the tremendous importance of the facial area in communication. Smiling responses were common with a normal face whereas grotesque faces induced anxiety in children. In later life facial abnormalities tend to evoke both aesthetic and sexual aversion so interfering with the process of social interaction. The dentist must become more aware of the psychological state of physically handicapped patients and of his own reaction to them.

Adaptation, Psychological↗
PubMed2002

The sandwich technique and strip crowns: an esthetic restoration for primary incisors.

The restoration of carious, fractured, or discolored primary incisors is rewarding to dentists because it gives them the satisfaction of knowing they have restored the smile and self-confidence of a growing child. However, restoring primary teeth can be a strenuous task because of the difficulty in keeping these patients' teeth dry and the uncooperative behavior of the child that sometimes occurs. Dentists are always seeking procedures that are esthetic, easy to use, and relatively quick to complete. This article describes a relatively easy technique that produces a beautiful outcome in a comparatively short time. The author has used this procedure on hundreds of children for more than 20 years, modifying the approach as appropriate when new methods and materials become available.

Acid Etching, Dental↗
PubMed2002

Three cases of anterior maxillary osteotomy under orotracheal intubation.

Anterior maxillary osteotomy is frequently applied to skeletal Class II cases with maxillary protrusion. In addition to the anteroposterior problem, these cases are often accompanied with a long midfacial appearance and display of incisors and gingiva during smiling. In the application of anterior maxillary osteotomy to such patients, it is necessary to move the anterior maxillary segments upward as well as backward. Since the upward movement occasionally interferes with the intranasal endotracheal tube, orotracheal intubation is recommended for the operation. Recently, the use of a resin replica of the mandibular dental arch was introduced to place the anterior maxillary segment correctly in the planned position and to obtain the correct occlusion. This article reports on 3 maxillary protrusive skeletal Class II patients with deep overbites and vertical esthetic problems treated by this method. The treatment results show that all 3 patients exhibited large upward and backward movements of the anterior maxillary segments and desirable facial profiles, with a reduction of the deep overbites after the treatment. This case report demonstrates that the anterior maxillary osteotomy under orotracheal intubation with the use of a resin replica is a useful method to treat maxillary protrusive skeletal Class II patients with a large alveolar height.

Adult↗
PubMedDate not supplied

Refining the art of porcelain laminate veneers.

As with any other operative or restorative technique, the long-term results, both esthetic and functional, depend directly on [figure: see text] the effort made by the dentist. Attention to detail, allowing enough time, and a steady hand are necessary to obtain the desired result. A few operative tips have been provided to aid the dentist in achieving these sometimes-elusive maximum results. Proper diagnosis, canine-guided occlusion, and attention to detail will help you give your patients that dazzling new smile!

Cuspid↗
PubMed2003

[Autochthonous recollection in early schizophrenia].

Autochthonous recollection in early schizophrenia is a subordinate symptom of autochthonous experiences, one of the four major symptoms specific to early schizophrenia as described by Nakayasu. Autochthonous recollection is detected most frequently in early schizophrenia. I am under the impression that the contents of autochthonous recollection tend to be unpleasant according to the patients' complaints. At the medical reformatory where I worked I experienced a case in which the autochthonous recollection of unpleasant contents seemed to form new symptoms in the patient, which elevated impulsivity and caused misconduct. Since then, I have performed symptomatic examinations of autochthonous recollection through cross-sectional and longitudinal methods upon 87 cases of early schizophrenia. In the cross-sectional aspect, past experiences of recollection consisted of 5 categories: , , , and . The number of categories of autochthonous recollection per patient was one category in 61 cases (70.1%), two in 20 cases (23.0%), three in 4 cases (4.6%), four in 1 case (1.2%), and five in 1 case (1.2%). The prevalence of recollections ranked by categories showed in 58 cases (66.7%), in 11 cases (12.6%), in 5 cases (5.7%), in 6 cases (6.9%), and in 42 cases (48.3%). Examination of the longitudinal aspect of symptomformation with autochthonous recollection revealed that in 19 cases new symptoms were formed and most were based on recollection of unpleasant experiences. They are: 1. elevated aggression towards him/herself and others, neurotic manifestation 2. silly smile, monologue 3. autochthonous fantasy images 4. rarefaction of sense of personal possession 5. ideas of reference 6. delusion of persecution, delusional memory The mechanisms of these symptomformations were suspected as follows: Ordinary psychogenic reaction for 1 and 2, induction of manifestation of other early symptoms for 3, and progression to full-blown stage of schizophrenia for 4, 5 and 6 (4, the beginning of disorder of self; 5, the beginning of delusion formation; 6, a delusion of full-blown stage).

Adolescent↗
PubMed2002

Immediate implant placement and temporization in extraction and healing sites.

While single tooth replacement can be predictably accomplished using implant therapy, this procedure is challenging in the esthetic zone where numerous criteria must be evaluated by the restorative team. If the gingival and osseous architecture of the failing tooth is acceptable, the therapeutic goal is to maintain the existing morphological condition. The optimal tridimensional implant is placed in the esthetic zone immediately after extraction or 8 to 12 weeks after extraction. The abutment connection and the nonfunctional temporary tooth restoration are prepared in advance and should respect the forms of contour of the contralateral tooth. In some specific clinical cases, not only can the patient's smile be returned after only a few hours of clinical work, but more importantly, initial capital of soft and hard tissues can be preserved. After healing, maturation, and stabilization during the 3 to 6 months of osseointegration, a compressive impression of the implant site can be taken and the implant restoration can be cemented. A multi-centric study performed by several dentists during the past 3 years have drawn interesting statistics on the rate of success, the different type of implants, and the variation of the peri-implant bone and gingival contour.

Alveolar Process↗
PubMed2003

Restoring soft and hard dental tissues using a removable implant prosthesis with digital imaging for optimum dental esthetics: a clinical report.

Currently, most dental implants are placed in the esthetic zone with a delayed surgical protocol. This delay can result in loss of both soft and hard oral tissues following the healing period, necessitating guided tissue regeneration, distraction osteogenesis, or bone expansion and grafting procedures either prior to or at the time of implant placement. If a delayed placement protocol is used, or if grafting procedures are ineffectual, the prosthetic phase of implant dentistry must restore the missing structures artistically and functionally to integrate with the patient's existing dentition. This article presents the option of using a removable implant prosthesis for an esthetic anterior restoration of soft and hard tissues. A computer-assisted camera was used to record speaking, smiling, and active facial positions, with digital imaging to achieve realism for tooth position during the prosthetic phase. The captured patient images with the esthetic setups were transmitted by e-mail for direct viewing by both dentist and dental technician prior to case completion. These images were viewed as reference files during laboratory construction of the prosthesis to achieve the desired esthetic and functional results.

Adult↗
PubMed2003

[The buccal-dental health of drug addicts treated in the University hospital centre in Nice].

OBJECTIVE: Drug-addicts often suffer from rapidly progressive extensive dental decay. The objectives of this study were to determine the impact of illicit drugs on buccal and dental health and the use of illicit drugs for toothache. METHODS: Two groups of intravenous and non-intravenous drug-addicts were compared with two control groups of age matched non-addicted subjects. During a routine dental examination, medical and addictive history, periodontal and dental health and dental complaints were recorded. RESULTS: This study showed that intravenous heroin was responsible for rapidly progressive dental decay, even in four drug-addicts with satisfactory dental hygiene. Intravenous heroin users (14 women, 38 men, mean age 35) had a mean number of 10 missing and 10 decayed teeth, 6 of them to be extracted, and needed two dentures with 8 teeth each. Their masticatory function (45%) and smile did not permit normal alimentation or social life. Non-intravenous drug users (9 women, 29 men, mean age 26) had a mean number of one missing tooth and 4 decayed teeth to be treated. When compared to control groups, drug users of both categories exhibited more decayed teeth, reduced masticatory function and a lower periodontal health correlated with inadequate dental hygiene. Finally, 52% of heroin users and 21% of other illicit drug users admitted the use of illicit drugs as analgesics for toothache. CONCLUSION: The management of toothache should be proposed in the cessation protocols and dentures provided to intravenous drug-addicts, before any attempt at social reinsertion.

Adult↗
PubMed1992

Naltrexone open trial with a 5-year-old-boy. A social rebound reaction.

The neurobiological rationale for an opiate antagonist pharmacotherapy of autism is presented. Naltrexone efficacy in decreasing autistic behaviour and in increasing social-affiliative behaviour was explored in a 5-year-old autistic boy. Naltrexone (0.5 mg/kg 3 times peer week) was effective in immediately decreasing gross motor activity and stereotyped behaviour and caused a delayed increase of crying, smiling and rough-and-tumble play. This single case presents preliminary evidence that a therapeutically valuable rebound reaction is possible and that the human opioid system modulates social-affective processes. The possibility of psychological factors being instrumental in achieving this effect is discussed as being suitable for future clinical trials.

Attention Deficit Disorder with Hyperactivity↗
PubMed2003

The Umgeni bridge, a resin bonded pontic using a preformed fibre post an aesthetic procedure of low biological and fiscal cost.

A missing anterior tooth or open embrasures destroys the aesthetics of a smile. The replacement of a missing anterior tooth is one of the most rewarding and challenging aspects of restorative dentistry. There are a number of techniques to do this, however, most involve the use of a technician, which means additional cost to the patient and multiple visits. In today's financial climate with practice expenses climbing and medical aid remuneration dwindling, one must seek methods to reduce costs and provide patients with more affordable dentistry. In addition, in crisis situations such as the traumatic loss of a tooth an immediate replacement technique albeit temporary is necessary. To replace a missing anterior tooth directly and immediately presents a rewarding challenge to the clinician. The Umgeni bridge named after the river that flows on the north side of Durban, is particularly useful in replacing congenitally missing laterals after completion of orthodontic treatment in the case of congenitally missing laterals and cleft palates.

Acid Etching, Dental↗
PubMed1978

Verbal and nonverbal interaction of mothers with their down's syndrome and nonretarded infants.

While it appears probable that parental expectancies due to early knowledge of the condition of Down's syndrome in infants affects parent-child interactions, little data are available showing how interactions are affected. In an observational, laboratory-based study, we compared verbal and nonverbal interactions between 10 mothers and their Down's syndrome infants and 10 mothers and their nonretarded infants. Although there was no difference between the groups in mothers' language complexity, mothers of Down's syndrome children spoke at a significantly faster rate. Observational measures of infants showed that Down's syndrome babies smiled and vocalized less, but mothers in the two groups failed to differ significantly on the nonverbal interactional behavior observed. The results were discussed in relation to the conclusions of other investigators who have speculated that language delays in Down's syndrome children may be due in part to differences in the environment provided by caregivers.

Adult↗
PubMed2003

Open wide--I meant your pocketbook: repercussions of the dental exclusion to the Medicare act.

For many Americans, dental coverage is merely a matter of cosmetics, a pretty smile. But for the elderly, a dental condition can affect nutrition, health, and financial well-being. In her note, Amanda Schwob explores the dental exclusion to Medicare, a provision of great concern to the elderly. Ms. Schwob seeks to define the scope of the dental exclusion by means of the plain language of the Medicare statute, case law, and legislative history. This analysis reveals startling uncertainty in this area of law. Next, Ms. Schwob considers several proposals before Congress as well as state reimbursement policies. The note concludes with concrete suggestions to remedy the ambiguity surrounding Medicare's dental exclusion.

Aged↗
PubMed2003

Single anterior tooth restoration using a self-etching adhesive system and a reinforced microfill composite.

Treatment for a single discolored anterior tooth may involve placement of a direct composite veneer to enhance a patient's smile and mask underlying discoloration. Among the challenges clinicians may face in this endeavor are the selection of suitable composite materials, application of an adhesive bonding system, and re-creation of the natural shade variations inherent in natural teeth. This article discusses the characteristics and placement protocol for a recently introduced self-etching adhesive system and a reinforced microfill composite when they are used to restore a single discolored central incisor.

Acid Etching, Dental↗
PubMed2003

Hypothalamic hamartoma and epilepsy in children: illustrative cases of possible evolutions.

The progresses of neuroimaging have allowed an earlier detection of hypothalamic hamartoma in children presenting with gelastic or dacrystic seizures. Associated symptoms can include other types of seizures, precocious puberty, and behavioral or cognitive deterioration. Combination of all these features is not constant and, when present, their evolution may be variable. When epilepsy proves intractable, surgery may be a solution but is not without risks. Therefore, it can only be justified on the basis of a considerable degree of certainty on the progressive character of the disorder, both in terms of epilepsy and global development. Even though epilepsy is a major and usually the most important problem, it is not always possible to predict its course and to be able to evaluate its potential effects on development. Available data suggests that deterioration is partly related to the epileptogenic activity. We reviewed data from 16 personal cases and discussed the possible evolutions of the epilepsy syndrome on the basis of 6 illustrative cases and a review of the literature. We point out that seizures may start early in life and evolve either towards a catastrophic encephalopathy or may be transiently severe and will progressively settle down. Intermediate situations also exist as well as cases presenting with a mild epilepsy. In almost all cases cognitive difficulties are present and may be associated with behavioral disturbances. They are of variable severity, usually in relation to the severity of the epilepsy and the evolution of the EEG abnormalities. Some of our cases also illustrate that, in young children whose seizures are limited to "a sensation of a pleasant feeling", "a pressure to laugh" or "smiling", early detection of the hamartoma may still be difficult and the epilepsy pattern may be misdiagnosed as an epilepsy temporal or frontal origin. Detailed analysis of the electro-clinical evolution of representative cases highlights the variable expression of the epilepsy syndrome and renders difficult any dogmatic position on early surgery. However, recent data suggests that a surgical solution must be sought early. Prospective studies are needed to evaluate, not only outcome in terms of control the seizures without unacceptable side effects but also on the evolution of the cognitive and behavioral profile of children with HH and epilepsy are needed.

Adolescent↗
PubMed2004

Endoscopic aesthetic facial surgery: technique and results.

The endoscopic approach to forehead and midface lifting has become popular method of face rejuvenation with minimal incisions. We have performed 67 endoscopic facelift procedures in the last four years. Forehead lifting technique included five small scalp incisions, wide subperiosteal elevation, endoscopic myotomy and forehead tissue fixation with srews, superficial temporal fascia (STF) suture to deep temporal fascia (DTF). Midface lifting technique included temporal 2.5 cm and 1.5 cm vertical intraoral incision, midface subperiosteal undermining and midface elevation with cable sutures Bichat's fat to DTF. Age mediana of patients who underwent endoscopic front lift was 46, patients who had endoscopic front lift and midface lift procedure age mediana was 40. Postoperative complication rate was 7.5% and included frontal branch weakness (n=2), hematoma (n=1), infraorbital nerve paresthesia (n=1) and asymmetrical smile (n=1). The main question is the quality of the results. We have reviewed 49 patients who were followed 6 months or more. Preoperative and postoperative life-size photographs were analyzed. The mean elevation mediana at medial canthus was 2.2 mm, at medial limbus 2.3 mm, at lateral limbus 2.5 mm, at lateral canthus 2.9 mm. Midface - lift effect resulted cheek elevation from 1.07 till 4.71 mm lip corner elevation 1.03 mm to 3.27 mm. We observed cheek elevation, improving nasolabial line, increasing volume of malar region, elevating lip angles in patients after endoscopic midface lift. We have found that important advantage of subperiosteal midface lift, when performed in conjunction with endoscopic brow lift, is its ability to move the cosmetic eye unit, proportionally, leading to a harmonious facial appearance. Endoscopic facelift is effective procedure for face rejuvenation especially for eyebrows and cheek elevation.

Adult↗
PubMed1978

Sensory reinforcement and contingency awareness of profoundly retarded children.

In two experiments, three of four profoundly retarded and physically handicapped children with MAs below 7 months demonstrated instrumental learning of a manipulatory response that produced either illumination or music. Discrimination of response-dependent from response-independent stimulation was demonstrated by the three subjects. Further, changes in two categories of collateral behavior, vacalizing and smiling, seemed to reflect recognition of changes in stimulus conditions. Results indicated that profoundly retarded children share with normally developing infants and children the capacity to be reinforced by sensory stimulation and to discriminate contingent from noncontingent events.

Acoustic Stimulation↗
PubMed2000

Standardized head position and reference planes for dento-facial aesthetics.

The angulations of the anterior teeth in the sagittal view are important for diagnosing lip support for pleasing smiles and proper facial profiles (Figure 19). In Figure 20, the slant of the occlusal plane (incisal-canine line), the off-center tilted midline, and the asymmetry of the gingival line (contours) of this patient in the frontal view are now obvious. A diagnosis can now be made for possible correction using the horizontal and vertical frames of the articulator as a bioesthetic guide.

Cephalometry↗