The Alpha omegan最新文献

Adult orthodontics poses a challenge for practitioners as it involves unique biomechanical considerations due to biologic age related changes and lack of skeletal growth potential. Dental risks in adult orthodontics include, amongst others, root resorption and periodontal complications. As modern life calls for quick and efficient orthodontic treatments, a novel orthodontic modality was developed utilizing adjunctive periodontal surgery that includes bone corticotomy combined with bone augmentation. This multidisciplinary team approach: Periodontally Accelerated Osteogenic Orthodontics (PAOO) or Wilckodontics seems to be promising not only for reducing orthodontic treatment duration, but also for biological aspects during and after orthodontic treatment. PAOO enhances bone remodeling and augmentation, accelerates tooth movement and significantly reduces the duration of treatment. The presented cases manifest the biologic benefit of profound enlargement in the envelope of motion reducing the need for extraction and eliminating the need for aggressive intervention of surgically-assisted rapid maxillary expansion. PAOO serves as a reasonable and safe option for the growing demand of shortened treatment duration of adult teeth movement in three dimensions. Further research is recommended for an in depth evaluation of the long-term stability claimed to be advantageous in this modality.

In the past, the approach for treating caries was mainly symptomatic and involved removal of caries, teeth restoration, oral hygiene instructions, and fluoride applications in cases that presented with significant disease. As the bacterial component of the disease was revealed, questions emerged concerning the significance of each strain present and intervention in the process of caries development. This article reviews the evidence that supports the implementation of the current caries risk assessment and management protocol (CAMBRA). It details the current risk factors, techniques and devices for assessing them and, interventions that should be considered in order to address the risk. The paper defines specific guidelines for managing risks related to caries. Intervention should be customized according to the risk determined for each specific patient.

Aggressive periodontitis comprises a group of rapidly progressive forms of periodontitis characterized by early onset of clinical manifestations at a young age and a distinctive tendency for cases to aggregate in families. Though once believed to be a rare condition, recent evidence suggest that aggressive periodontitis is more common than assumed. The etiology of aggressive periodontitis is probably due to the expression of highly virulent causative agents in combination with high levels of susceptibility of the individual patient. In addition, there are several factors, such as cigarette smoking and ethnicity, that are associated with higher prevalence or severity of aggressive periodontitis. Since the disease usually appears at a young age, the importance of early detection is paramount in order to avoid tooth loss in early childhood or adolescence.

Over two million children around the world are living with AIDS. Oral health and oral manifestations, such as dental caries and periodontitis, are important issues requiring focus when treating these children. Descriptive data of a project conducted at Rambam Hospital, financed by the Israeli Ministry of Health, are presented in order to investigate and characterize dental treatment for HIV infected children. Thirty-seven infected children, most originating from the Ethiopian community, participated in the project between 2006 and 2011. A total of 724 dental procedures during 185 dental appointments were performed successfully. These children should be provided proactive preventive dental care, while health service providers should undergo further training on prevention and early identification and management of orofacial manifestations. All dental and medical personnel should be made aware of this service in order to refer HIV infected children who can greatly benefit from this special program.

Background: Intravenous sedation is an efficient method to facilitate dental treatment delivery to uncooperative children. Entropy is used for monitoring anesthetic depth. Nonetheless, scarce data is found on entropy monitoring in intellectually-disabled patients during sedation.

Objective: This comparative study set out to evaluate entropy values of normal and intellectually-disabled patients during the steady state period of deep sedation and awakening. Additionally, the study aimed to establish whether normal and intellectually-disabled patients reached a comparable clinically assessed state of sedation and the doses of total anesthetic drugs administered.

Materials and methods: 30 patients were included in the study and divided into two groups: 16 normal and 14 intellectually-disabled children. Ages ranged between 2 to 16 years. All patients were assigned to receive dental treatment under intravenous sedation. Entropy tracings were recorded for all patients. Clinical sedation level was assessed every 5 minutes. Drug administration was guided clinically. The anesthesiologist was blinded to entropy tracing.

Results: Although sedation levels assessed clinically were similar between groups, entropy values were significantly lower in the group of intellectually-disabled patients both during sedation steady state and waking. The total amount of anesthetic drugs administered to normal patients was higher compared to intellectually-disabled patients.

Conclusion: In this study, entropy monitoring was found to be a more sensitive modality for assessing intra-operative brain activity during steady state sedation compared to clinical assessment of sedation. Despite similar clinical assessment of sedation level, brain activity was lower in the intellectually-disabled group as were their anesthetic drug requirements. We conclude that intellectually-disabled patients may need less anesthetic drugs to reach a good level of sedation. Whether the lower level of brain activity during sedation, reflected by lower entropy tracings, is characteristic of the intellectually disabled warrants additional studies.

The distraction osteogenesis principle that was originally developed by orthopedists for purposes of limb lengthening can now be used successfully for bones of the craniofacial region, including cleft palate deformities. Advancement of the cleft maxilla by means of distraction is based on the concept of using stretching forces to separate two bony elements at the midface region. The role of orthodontists in skeletal treatment of the maxilla utilizing distraction osteogenesis should be collaborative and adjunctive as part of a team approach to rehabilitate the patient. Advances over traditional techniques are mainly because of simultaneous adaptation of the surrounding soft-tissue envelope which contributes to the stability of the reconstruction, thus lessening the risk of relapse.