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PubMedDate not supplied

Esthetic re-creation of soft tissue architecture in replacing missing maxillary anterior teeth.

Replacing missing maxillary anterior teeth while providing an adequate esthetic can present a considerable challenge. A substantial effort is directed toward achieving a better tooth-to-soft tissue relationship, regardless of whether the restorative modalities are implants, naturally supported fixed bridges, or removable partial dentures. The interdental papilla is critical to the esthetically pleasant architecture and contributes to successful harmonious restoration, especially in patients with a high smile. There are several techniques for restoring the indental papilla. The best result comes from careful planning and good communication with the patient.

Adult↗
PubMed2004

[Videomimicography: a new objective evaluation of facial motor function].

OBJECTIVE: To develop a new method, videomimicography (VMG), to evaluate facial motor function. METHODS: During VMG, 11 landmarks were placed on the face, and 5 movements (forehead lifting, eye closure, nose wrinkling, lip puckering and smiling) with maximal contraction were requested. A digital video film was recorded then fed in a computer to be analyzed. Ten normal subjects were used as normal control. RESULTS: Area measures were found better than distance measures in evaluating facial movements. The best measure for each movement was determined. Then a global index of facial motor function was derived from these measures. This index was found well correlated with the facial paralysis House-Brackmann grade in 48 patients with facial paralysis (r = -0.928). CONCLUSION: VMG is an objective, quantitative, relative simple method. It has good reproducibility. So it can be used in clinic for evaluating facial motor function.

Adolescent↗
PubMed2004

Warming up to composites.

Patient demand for composite restorations has increased dramatically over the past decade. Anterior composites, for teeth that are visible when smiling, have been the standards of practice for many years. For the less visible teeth, it is estimated that the 50% mark for composite restorations in the posterior region was surpassed in 2000.

Composite Resins↗
PubMed1992

[Use of gestures to support speech comprehension of a hearing, nonverbal severely mentally handicapped adult with autistic behavior].

In the present single case study the reactions of a severely mentally handicapped adult with autistic behaviour to simple instructions were investigated; in each case with and without gestural facilitation. This procedure was varied both with regard to persons and to situations. The correct following of requests as well as special behaviour such as uncertainty, smiling, delay of reactions and enthusiasm was registered and analysed by videotape. It could be clearly proved that the requests which were supported by gestures were more often performed correctly. On top of that it could be observed that under these circumstances the handicapped person was less uncertain, showed fewer stereotypies and was generally more interested. No influence could be noticed on the delay of reaction as well as on the person's enthusiasm. No difference could be seen between different persons and situations. Further research projects should particularly analyse how far the use of gestures does not only serve more communication but also has an influence on the range of behavioural disorders.

Adult↗
PubMedDate not supplied

Selling to the moneyed masses.

Over the past decade, the distribution of household incomes has shifted so much that a much larger proportion of consumers now earn significantly higher-than-average incomes--while still falling short of being truly rich. As a result, what used to be a no-man's-land for new product introductions has in many categories become an extremely profitable "new middle ground." How can marketers capitalize on this new territory? The key, say the authors, is to rethink the positioning and design of offerings and the ways they can be brought to market. Take, for instance, how Procter & Gamble redefined the positioning map for tooth-whitening solutions. A decade ago, dental centers were popularizing expensive bleaching techniques that put the price of a professionally brightened smile in the 400 dollars range. At the low end, consumers also had the choice of whitening toothpastes that cost anywhere from 2 dollars to 8 dollars. P&G wisely positioned itself between the two ends, successfully targeting the new mass market with its 35 dollars Whitestrips. In product categories where it's clear the middle ground has already been populated, it's important for companies to design or redesign offerings to compete. An example is the Polo shirt. How do you sell a man yet another one after he's bought every color he wants? Add some features, and call it a golf shirt. Here, marketers have introduced designs based on the concept of "occasional use" in order to stand out. Finally, companies wishing to reach the "almost rich" can change how they go to market. Perhaps no mass retailer has made a stronger bid for the mass affluent than Target Stores, which has pioneered a focus the company itself characterizes as upscale discount. The strategy has made Target an everyday shopping phenomenon among well-heeled urbanites and prosperous professionals.

Consumer Behavior↗
PubMedDate not supplied

Early cerebral images of Alexander disease: report of one case.

Alexander disease is a neurodegenerative disorder characterized pathologically by demyelination and accumulation of eosinophilic hyaline bodies (Rosenthal fibers) within astrocytes. Demonstration of Rosenthal fibers on histological examination is considered a prerequisite for a definitive diagnosis. However, the CT and MRI scans may be highly suggestive of the disorder. We describe a patient who presented with subtle seizures at the age of 4 months. On examination, he was floppy with evident head lag. There was no visual following or social smiling. At that time, the brain MRI showed abnormal findings, with more white matter involvement and a characteristic periventricular rim. A diagnosis of Alexander disease was not made until he was one year old, when a repeated MRI showed the full-blown pictures typically seen in Alexander disease. The images fulfilled the diagnostic criteria proposed by van der Knaap in 2001. The early brain MRI findings in Alexander disease can be very characteristic and greatly different from those in the late stage.

Alexander Disease↗
PubMed2004

Too quiet.

The child with a fever (or a reported fever, as in this case) has a wide range of potential illnesses that must be considered. The pediatric community approaches children in three age groups: those younger than three months, those between 3-24 months, and those over 24 months. Those under three months of age are most at risk for serious problems, and the physical examination of the child is most unreliable. Infants most at risk for infection have smaller birth weights, mothers with infectious diseases such as chlamydia or HIV, and labor following premature rupture of membranes. Infants cannot offer complaints; have poorly functional muscles that do not allow the demonstration of neck stiffness or stiff joints; and cannot cough productively to demonstrate pneumonia. The most strenuous activity for an infant is eating, so ill infants will often feed poorly. The emergency physician or pediatrician will want the prehospital emergency provider to observe the behavior of an ill child to gain an indication of the seriousness of the illness. The Yale Observation Scale uses six criteria to stratify the ill child. The ill child will have poor color, a weak or high-pitched cry, poor hydration (dry diaper and mucous membranes), little reaction to parental stimulation, little arousal or continuous sleeping and no smile. This child demonstrated many criteria of an ill child. Her temperature was likely high at the onset of illness (while in her crib), which was not detectable by the time the EMS crew did its evaluation. Difficulty breathing is a common observation in ill infants by their parents, and the child had a dry diaper. A quiet child is not to be considered a healthy child, and like many EMS situations, the crew was appropriately "worried most about the quiet one."

Emergency Medical Services↗
PubMed1992

Counseling parents about childhood discipline.

Traditional disciplinary methods include rewards to reinforce good behavior and punishment for unacceptable behavior. Rewards may take the form of verbal praise, a smile, special attention or activities, physical affection, extra privileges or material benefits. Punishment may include verbal disapproval, an unhappy look, ignoring the behavior (extinction), temporary isolation ("time-out") or temporary removal of a privilege. Rewards are more effective than punishment. Discipline should be consistent, reasonable and appropriate to the child's age. Rules should be as few and as clear as possible. Parents should be exemplary role models for their children. Punishment, when required, should be immediate and inevitable. Punishment should be just and directed toward the undesired behavior rather than the child. Parents should discipline their children with love, understanding, patience and tolerance.

Child↗
PubMed2002

Neural networks in recognition of electrical signals recorded from two facial muscle sites.

The present aim was to develop signal analysis methods to recognize muscle action potentials recorded with electromyography (EMG) from two facial muscle sites, corrugator supercilii (the muscle activated in frowning) and zygomaticus major (the muscle activated in smiling). Fourteen subjects produced volitional activations on both muscle sites, first, on a single muscle site activation basis and finally combinatory activations of both muscle sites. Wavelets and neural networks were used to analyse these voluntarily produced bursts of electric signals. Our results showed well over 90% recognition rates for all signal types. It is possible to utilize these communicative signals, for example, for multimodal human-computer interaction.

Action Potentials↗
PubMed2004

[Prosthetic rehabilitation and accompaniment of growth in cases of early tooth loss in children].

Teeth, in the general phenomenon of growth contribute to the blooming and the growth of the young child. It plays a paramount role in the communication while taking part in the development of the language and of the phonation, and by perfecting the shape of the face. The prosthetic rehabilitations are addressed to children who present more or less significant early losses of teeth, whose origin could be congenital, structural, post-decays or traumatic, and bearing on temporary, mixed or final teeth. The series of case presented clarifies the methods which we employ in our service for the design and the practical realization of the prosthetic rehabilitations. The dental lose seriously disturbs the physical development of the child, it can slow down its school development and affect in a pathological way its relational life. The installation of prosthesis makes it possible to the child to feel like the others, to eat normally, to better sleep, to be able to present its face without causing mocking remarks. Among our patients candidates with the prosthetic rehabilitation, the children in low-age are most numerous and present the highest frequency of the traumatisms. Their first real smile is already the justification of the decision of the specialist. Nevertheless, the number of toothless children who profit from this type of rehabilitation is very small.

Child↗
PubMed1992

Self-evaluation in young children.

A series of studies was conducted to examine the development of self-evaluation in children aged 1-5 years. Developmental changes in children's reactions to achievement-related outcomes were assessed in a variety of contexts, using different tasks and different criteria for success. The first study of 1-3-year-olds revealed an increased social orientation after the age of 21 months. Only children over this age were more likely to look up at the experimenter after they had produced an outcome themselves than after the same outcome had been produced by the experimenter. These older children were also more likely than younger children to call their mothers' attention to their achievements in a free-play situation. In a second study, on a task with visibly salient success versus failure outcomes, children aged 2-5 years responded to success with positive affect (e.g., smiling) and to failure with avoidance reactions (e.g., looking away from the experimenter). Praise enhanced children's positive affective reactions to success, but its effect was modest. In the final study, winning or losing on a competitive task was not understood by children below age 33 months and had no effect on their affective reactions to the task. In contrast, winning enhanced older children's pleasure in completing the task. Three stages are proposed in the development of self-evaluation. In the first stage, children experience joy in causality, but they lack the cognitive representational skills required for self-evaluation in a self-reflective sense, and they do not anticipate others' reactions to their performance. In the second stage, beginning before the age of 2 years, children anticipate adult reactions, seeking positive reactions to their successes and endeavoring to avoid negative reactions to failure. The proposed third stage involves a gradual internalization of external reactions, with children beginning to evaluate their performance and react emotionally to success and failure independently of their expectations of adult reactions. Although all studies focused on achievement outcomes, the development of self-evaluation in the moral domain may parallel this developmental sequence proposed for the achievement domain. It is also proposed that caretakers' reactions to rule violations might engender concerns about meeting adult expectations in achievement contexts.

Achievement↗
PubMed2004

Development of a questionnaire to measure perceptions of, and concerns derived from, dental fluorosis.

OBJECTIVE: To develop a questionnaire in English and Spanish to measure concerns caused by children's (and their parents') perceptions of dental appearance. MATERIALS AND METHODS: The questionnaire addressed concerns in the physical, mental, and social domains, perceptions about discolourations and other oral conditions including tooth colour. Test-retest and internal reliability, and construct and criterion validity, were assessed as part of the development process. Children in Mexico City, Mexico and Indianapolis, Indiana answered the questionnaire and were examined for fluorosis using the TSIF index. Data were analysed using Cronbach's alpha, Pearson's, Spearman's and intraclass correlations, and percentage agreement tests. RESULTS: Ninety-five children and 28 parents participated in Mexico City; fluorosis was diagnosed in 66% of children. Seventy-one children and 65 parents participated in Indianapolis; fluorosis was diagnosed in 63% of children. English and Spanish questionnaires had acceptable test-retest performance, and moderate internal reliability. Criterion validity was acceptable, and the translated versions retained acceptable construct validity. Perceptions of discolourations were associated with concerns of the participants. Level of concern was higher in Indianapolis than in Mexico City, generally. Many participants reported that they were at least occasionally distressed or worried over the appearance of the children's teeth, that it hindered children from smiling freely, and that it was an unsatisfactory appearance. CONCLUSION: The developed questionnaire allowed children and parents to report perceived dental appearance problems and concerns.

Adult↗
PubMedDate not supplied

Facial changes following treatment with a removable orthodontic appliance in adults.

The purpose of this study is to determine soft tissue facial changes in adults with mild Class I or Class II malocclusions, treated with a removable orthodontic appliance (Homeoblock '). Standardized intra-oral and frontal facial photographs of 25 adults were scanned and x, y coordinates of 16 maxillary arch and nine facial landmarks were digitized. Mean maxillary arch and facial configurations were subjected to finite-element analysis (FEA). Results showed that the mean pre- and post-treatment maxillary and facial configurations differed statistically (p < 0.05). Specifically, the maxillary arch showed a 30% relative size increase in the mid-palatal region with shape changes consistent with improved dental alignment and maxillary expansion in the transverse direction. For facial changes, a 10% size increase was localized in the nasomaxillary region, and the intercanthal angle changed from -4.6(0) to +4.2(0) (p < 0.05). It is concluded that dental and facial changes associated with the Homeoblock' removable orthodontic appliance are consistent with a broader smile and a more symmetrical facial appearance in non-growing adults.

Adult↗
PubMed2004

Secrets of a pedodontist.

Treating children successfully requires the right temperament. Some dentists should refer children if they really do not like pediatric dentistry. New families often come to town and seek a pediatric dentist before they look for a general dentist for themselves. I refer many of these new families to local general dentists. It is a good idea to get on the good side of your local pediatric dentist. If you love to treat kids, tell-show-do is still the most useful technique if it is done well. Whether treating children or adults, prepare the patient with an introductory letter and things will go more smoothly for you. The most successful practices treating children have smiling, talkative dentists and staff. Pay attention to the patient and be careful not to ask yes or no questions.

Adult↗
PubMed2005

[How children show positive and negative relationships on their drawings].

This study analyses, whether pictures of children showing a positive relationship are significantly different from those showing a negative one with respect to several criteria. The study involved a random selection of 45 children aged 4;6 to 11;6 years. The children painted a picture with themselves and a person they liked and a picture of themselves with someone they disliked. For the most part, the children drew pictures of themselves with peers both with respect to positive as well as negative images. In an interview afterwards, the children specified the criteria in their drawings by which the quality of the particular relationship can be identified. Positive and negative relationship paintings differ in the character of activity described. The sun as an element in children's paintings is painted not more frequent on positive compared to negative pictures. The colour black is used more often in the drawings signifying negative relationships. While girls used more colour in negative relationship drawings, boys used more colour in the positive ones. There was no significant difference in the use of favourite colours and decorative elements between the two groups. Only in negative relationship drawings people were looking away from each other. Smiling individuals were more common in the positive relationship pictures and in pictures painted by the 6 to 8 year olds. A greater distance between the individuals emerged on negative relationship drawings of the girls.

Affect↗
PubMedDate not supplied

Esthetic restoration of discolored primary incisors.

Restoring primary teeth can be a strenuous task for many dentists who would like to have an esthetic, easy-to-use and relatively quick restoration for children. But, the restoration of carious, fractured or discolored primary incisors gives the dentist the satisfaction of knowing that he/she has restored the smile and self-confidence of a growing child. This article describes a technique which is relatively easy and produces a beautiful outcome in a relatively short time. The author has used the technique in hundreds of children for over twenty-five years. Modifications in the technique have been made as newer materials and techniques have evolved.

Acid Etching, Dental↗
PubMedDate not supplied

Aesthetic crown lengthening: classification, biologic rationale, and treatment planning considerations.

UNLABELLED: The rationale for crown lengthening procedures has progressively become more aesthetic-driven due to the increasing popularity of smile enhancement therapy. Although the biologic requirements are similar to the functionally oriented exposure of sound tooth structure, aesthetic expectations require an increased emphasis on the appropriate diagnosis of the hard and soft tissue relationships, as well as the definitive restorative parameters to be achieved. The development of a clinically relevant aesthetic blueprint and attendant surgical guide is of paramount importance for the achievement of successful outcomes. LEARNING OBJECTIVES: This article provides a classification system that clinicians can use when treatment planning for aesthetic crown lengthening. Upon reading this article, the reader should have: A clear understanding of the involved biological structures. Didactic instruction on the classification and treatment planning for aesthetic crown lengthening procedures.

Crown Lengthening↗
PubMed2005

Constructing something funny: levels of associative connection in Tom Swifties.

In the present study, redundancy (low, medium, or high association between the adverb and sentence content) and contextual connection (presence vs. absence of a meaning-based connection between the adverb and other information in the sentence) were manipulated systematically in Tom Swifties (single-sentence wordplays in which a pun is based on the adverb at the end of the sentence). Sixty-nine university students provided ratings of each Swifty's humorousness, cleverness, and coherence and of their reactions to each (tendency to smile, laugh, and groan). Added context led to greater perceived coherence. In keeping with optimal level of arousal arising from resolution of incongruity, an inverted-U redundancy effect was obtained for all scales except "groan." The authors suggest that a social setting is a required but not a sufficient condition for a pun to evoke a groan. It also requires material of greater length that includes some build-up, as found in a fable or shaggy-dog story.

Adolescent↗