Relationships between dental and skeletal maturity in Turkish subjects

The aim of this study was to investigate the relationships between the stages of calcification of various teeth and skeletal maturity stages among Turkish subjects. The samples were derived from dental panoramic and hand-wrist radiographs of 500 subjects (215 males and 285 females). Calcification of the mandibular canines, first and second premolars, and second and third molars was rated according to the system of Demirjian. To evaluate the stage of skeletal maturation of each hand-wrist radiograph, nine ossification events were determined according to the systems of Bj?rk, and Grave and Brown. Statistically significant relationships were determined between dental calcification and skeletal maturity stages according to Spearman rank-order correlation coefficients. Correlations between dental development and skeletal maturity ranged from .490 to 0.826 for females and .414 to .706 for males (P < .01). The second molar showed the highest correlation and the third molar showed the lowest correlation for female and male subjects. For both sexes, root formation of the canine as well as the first premolar was completed in the majority of the subjects at the MP3cap, PP1cap, Rcap stages. Because of the high correlation coefficients, this study suggests that tooth calcification stages from panoramic radiographs might be clinically useful as a maturity indicator of the pubertal growth period. It is appropriate to put these skeletal and dental maturation relationships into daily orthodontic diagnostic practice, when treating a Turkish patient.     

Lower vitamin D level is associated with poor coronary collateral circulation

Objectives. Vitamin D regulates calcium and bone homeostasis, and parathyroid hormone (PTH) secretion. Cross-sectional associations between lower vitamin D levels and cardiovascular diseases have been reported, but the relationship between vitamin D levels and collateral arteries in stable coronary artery disease (CAD) has not been reported before. Design. Two hundred and fourteen patients with above 95% stenosis in at least one epicardial coronary artery were consecutively recruited after coronary angiography (CAG) during the winter season. The coronary collateral circulation (CCC) was graded using Rentrop classification. Poor CCC group included patients with Rentrop Grade 0–1 CCC and control group included patients with Rentrop Grade 2–3 CCC. Vitamin D and PTH levels were measured on the day of CAG. Results. In the poor CCC group, vitamin D levels were lower (34 ± 25 pmol/L vs. 49 ± 33 pmol/L; p = 0.01) and the prevalence of vitamin D deficiency (< 37 pmol/L) was higher (67% vs. 43%; p = 0.01) compared to the controls. PTH levels, calcium, and phosphate levels were not significantly different between the groups. Female gender, lower HDL cholesterol, and lower vitamin D levels were independently correlated with poor CCC in the study population. Conclusion. Lower vitamin D levels may be associated with poor collateral development in patients with stable CAD.     

The bite force and craniofacial morphology in patients with acromegaly: A pilot study

Objectives: Acromegaly is a metabolic disorder caused by increased growth hormone secretion. As a consequence of acromegaly some typical craniofacial morphology changes appear. This pilot study was conducted to compare the bite force and the characteristic size and shape of the craniofacial components of acromegalic patients with the healthy Turkish individuals. In additon, the correlations between bite force and craniofacial morphology of patients with acromegaly and control individuals were evaluated. Study Design: The maximum bite force of the participants was recorded with strain-gage transducer. Lateral x-ray scans were made under standard conditions, in centric occlusion. On cephalograms, the linear and angular measurements was performed. Results: Patients with acromegaly showed increased anterior and posterior total face height, ramus length, width of frontal sinuse, gonial angle and a negative difference between maxillary and mandibular protrusions. In addition, females with acromegaly showed larger lower anterior face height and sella turcica, decreased facial angle, increased mandibular plane angle. The cephalometric measurements, except one did not showed correlation with the bite force in acromegalic patients. In control group, significant correlations were observed between anterior total face height and anterior lower face height, mandibular plane angle and gonial angle. Conclusions: The greater changes were observed in the mandible. The maximum bite force of patients with acromegaly showed no difference from healthy individuals. The non-significant difference of bite force between healthy participants and acromegalic patients provide important information for dental treatment and prosthetic rehabilitation of acromegalic patients. Key words:Acromegaly, bite force, cephalometric analysis, mandibular prognathism.     

The effect of preoperative anxiety on postoperative analgesia and anesthesia recovery in patients undergoing laparascopic cholecystectomy

Purpose

In patients who are hospitalized for surgery, anxiety disorders are frequently observed. Anxiety affects the patient’s perception of postoperative pain and has a negative impact on recovery from anesthesia. This study attempted to compare the effect of preoperative anxiety on postoperative pain control and recovery from anesthesia in patients undergoing laparoscopic cholecystectomy.

Methods

A total of 80 patients were enrolled who were undergoing laparoscopic cholecystectomy. Demographic characteristics of the patients were recorded. Beck’s anxiety ?nventory (BAI) was administered to the patients: patients with anxiety were included in the high-anxious patient group (group H) and patients without anxiety were enrolled in the low-anxious group (group L). Duration of surgery, duration of anesthesia, extubation time, and adverse effects were recorded. During the postoperative period, patient-controlled analgesia with tramadol was used for pain control. Visual analog scale (VAS) scores and tramadol consumption of all patients were recorded.

Results

Among all patients, 31 (38.75 %) patients had preoperative anxiety, and significant correlation was found between the days of hospitalization and preoperative score of BAI. In group L, extubation time, the time for the modified Aldrete score to reach 9, was seen as significantly shorter and fewer postoperative side effects were determined. Also in group L, postoperative VAS score and tramadol consumption were significantly lower, and less tenoxicam was needed.

Conclusion

A high preoperative anxiety level negatively affects recovery from anesthesia and control of postoperative pain. In this patient group, the increased need for postoperative analgesia must be adequately met.