Die kieferorthopädische Apparaturein Schritt zur Sensibilisierung gegen Metalle?

Zusammenfassung Chrom ist bis zu 20, Nickel zu mehr als 10 Gewichtsprozenten Bestandteil von Dentaledelstahl, wie er in der Kieferorthopädie für Bracket-und Bandmaterial verwendet wird. Chrom ist als essentielles Spurenelement toxikologische wie allergologisch weniger suspekt als Nickel, dem in Zahnheilkunde, Dermatologie und Arbeitsmedizin viel Aufmerksamkeit zukommt wegen der Auslösung von Kontaktstomatitiden und-dermatitiden. Da in einer ersten Untersuchung von der Tragezeit abhängige Korrosionserscheinungen mikroskopisch sichtbar gemacht werden konnten, wurden zur Klärung des Ausmaßes einer zusätzlichen oralen Metallexposition durch festsitzende kieferorthopädischen Behandlungsgeräte Speichelproben von Patienten vor Beginn und während kieferorthopädischer Behandlung auf Chrom und Nickel mit der elektrothermalen Atomabsorptionsspektrometrie spurenanalytisch untersucht. Die Resultate werden hinsichtlich der klinischen Bedeutung einer auf kieferorthopädische Behandlungsgeräte zurückzuführenden zusätzlichen oralen Exposition vor dem Hintergrund der Ergebnisse einer gleichzeitig von uns durchgeführten Allergieanamneseerhebung bei 472 unserer kieferorthopädischen Patienten und der einschlägigen Literatur diskutiert.

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Summary High-grade dental steel, such as is commonly used for banding and bracketing in orthodontics, consists of up to 20% chromium and more than 10% nickel by weight. As an essential trace element chromium is less likely to produce toxic or allergic side-effects than nickel, a metal which has attracted attention in dermatology, industrial medicine and dentistry on account of its allergic potential. Preliminary microscope examination revealed corrosion phenomena related to the period of appliance wear. Saliva specimens before and during orthodontic treatment were examined for nickel and chromium utilising electrothermal atomic absorption spectrometry in order to clarify the extent of additional oral metallic exposure from fixed appliances. These results are examined against the background of case histories simultaneously conducted on 472 of our orthodontic patients, as well as the relevant literature.

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Résumé L'acier spécial dentaire utilisé communément pour faire des bagues et des brackets en orthodonie, contient du chrome jusqu'à 20% et du nickel à plus de 10%. Comme oligo-élément essentiel, le chrome est moins soupçonné de produire des réactions secondaires que le nickel, métal qui retient l'attention particulière de la dermatologie, de la médecine du travail et de l'odontologie à cause de son potentiel allergique. Comme un premier examen microscopique a pu révéler des effects corrosifs en fonction de la durée de l'application des appareillages, des prélèvements de salive avant et pendant le traitement orthodontique ont été analysés pour déceler des oligo-éléments par la spectrométrie d'absorption atomatique électrothermale, afin de clarifier la mesure d'une exposition orale supplémentaire au métal due à l'emploi d'appareillages fixes. En vue de connaître l'importance clinique de l'exposition orale supplémentaire due aux apparaillages, on a analysé les résultats d'une enquète sur les allergies, basée simultanément sur les anamnèses de 472 de nos patients orthodontiques et de la littérature relative à ce sujet.

     

Influence of Orofacial Dysfunctions on Spatial and Temporal Dimensions of Swallowing Movements

BACKGROUND AND AIM: Tongue dysfunctions are of etiologic significance for the development of malocclusions and speech disorders. Electromagnetic articulography is a means of recording orofacial movements. The aim of this study was therefore to analyze differences in the spatial and temporal sequence of swallowing movements under the influence of lip and tongue dysfunctions in order to develop new means of objectifying the diagnosis of such a dysfunction. PATIENTS AND METHOD: Thirty-one subjects were monitored during reflex swallowing and while swallowing 20 ml of water. All probands also underwent evaluation by a speech pathologist as well as palatography. The entire cohort was then divided into a viscerally and a somatically swallowing group, and the movement sequences were analyzed with reference to spatial and temporal parameters. RESULTS: The temporal parameters revealed fewer significant differences than the spatial parameters. Most differences were recorded for the section between palate separation point and end of swallowing. Specific spatial or temporal variables revealing a maximum number of differences between the two groups were found for each tongue region. Swallowing water revealed notably more significant intergroup differences. The most suitable variables during the swallowing of water were the maximum distance of tongue-palate contact and the distance or time interval between palate separation point and end of swallowing. CONCLUSION: The analysis of swallowing movements by electromagnetic articulography offers opportunities to evaluate tongue dysfunctions. The most suitable combination of variables was found for each of the regions investigated. Spatial analysis of the movement pattern seems to be the most reliable method.     

Über chirurgisch-orthodontische Zusammenarbeit

Ohne ZusammenfassungMit 32 Abbildungen     

Anwendungsmöglichkeiten der Zonographie in der Kieferorthopädie

Zusammenfassung Der Röntgenapparat Zonarc ist ein speziell für den Kopfbereich entwickeltes Schichtgerät mit verschiedenen Schichtwahlmöglichkeiten. In der vorliegenden Arbeit wurden menschliche Knochenschädel unterschiedlicher Entwicklungsstufen mit diesem Gerät untersucht, es kamen folgende Projektionen zur Anwendung: das DENT-Programm, das JLA-spezial-Programm (bei geöffnetem und geschlossenem Mund) und das JSA-Programm (bei geöffnetem und geschlossenem Mund).Die Positionierung der Schädel sowie die korrekte Einstellung des Gerätes werden beschrieben und die Qualität der Wiedergabe der abgebildeten Strukturen diskutiert.Aus den Ergebnissen läß sich folgern, daß die Projektionen JLA (Kiefergelenk seitlich) und JSA (Kiefergelenk sagittal) in der kieferorthopädischen Diagnostik Bedeutung erlangen können; der apparative Aufwand ist jedoch sehr hoch.

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Summary The Zonarc is a panoramic device in maxillofacial radiology that is programmed to cover different image layers. In this study human skulls of various sizes and various stages of development were examined with the aid of this equipment. The following projections were used: DENT program, JLA (special) program (TMJ side view, mouth open and closed), JSA program (TMJ sagittal, mouth open and closed).The positioning of the skulls as well as the correct adjustment of the equipment have been described on the basis of this investigation. The quality of reproduction of the skeletal tissue is discussed.The results indicate that the projections JLA and JSA can be used to advantage in orthodontic diagnosis. However one has to take the cost factor into consideration.

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Résumé L'appareil de radiographie «Zonarc» a été spécialement développé pour la tomographie du crâne, permettant au médecin de choisir la profondeur (couche) voulue. Dans la présente étude, on s'est servi de cet apparaeil pour examiner des crânes humains à différents stades de développement en choisissant les projections suivantes: le programme DENT, le programme (spécial) JLA (jaw lateral articulation= articulation temporo mandibulaire, plan frontal) bouche overte et bouche fermée, le programme JSa (jaw sagittal articulation=articulation temporo-mandibulaire, plan sagittal)-bouche ouverte et bouche fermée.La présente étude décrit le positionnement de divers crânes ainsi que le réglage correct de l'appareil, et traite, d'un point de vue critique, de la qualité des reproductions des structures en question.Les résultats de cette étude permettent de conclure que les projections JLA (articulation temporo mandibulaire, plan frontal) et JSA (articulation temporo-mandibulaire, plan sagittal) trouveront sans doute leur place dans le diagnostic en orthopédie dento-faciale; les frais occasionnés par ces appareils sont cependant très importants.

     

Hepatitis B and C in doctors and dentists in Nigeria

We surveyed a random sample (n = 75) of doctors and dentists at University College Hospital, Ibadan, Nigeria. They were offered anonymous testing for hepatitis B surface antigen (HBsAg), hepatitis Be antigen (HBeAG), antibodies to hepatitis B core antigen (anti-HBc) and to hepatitis C virus (anti-HCV), by enzyme immunoassay. The results suggest a high prevalence of hepatitis B virus (HBV) with a high potential of transmissibility, as well as a high prevalence of HCV infection. The majority of the doctors and dentists use universal precaution for protection against viral hepatitis on < 50% of the occasions when they carry out procedures on their patients. Infection with HBV was associated with type of specialty (surgeons, dentists) and lack of HBV vaccination (p < 0.05). After logistic regression, these factors were independently associated with HBV infection (p < 0.05). Sixty (80%) had not received prior HBV vaccination. Unvaccinated personnel were more likely to be surgeons, dentists, < 37 years of age, and have fewer years of professional activity (p < 0.05). After logistic regression, only fewer years of professional activity remained independently associated with lack of vaccination (p < 0.05). To reduce the occupational exposure of HBV, universal precautions must be rigorously adhered to when the doctors and dentists carry out procedures on their patients, and all health-care workers should be vaccinated with HBV vaccine and the HCV vaccine, when it becomes available.      

Prevalence of hypoglycemia among severe malaria children in a rural African population

ObjectiveTo determine the prevalence of hypoglycemia in severe malaria children in a rural African community.MethodsThirty two children who fulfilled the inclusion criteria were recruited for the study from two hospitals with intensive care facilities. Blood sugar levels of the patients were monitored serially at admission and then every 4 hours (after admission) for 24 hours using a glucometer; taking values <2.2 mmol/L as hypoglycemia. The children received intensive care according to WHO guidelines for severe malaria.ResultsFifteen out of 32 children recruited (representing 46.9%) had hypoglycemia with about 60% under 5 years of age. The mean age of the children was (4.49±2.89) years. The pre-correction and average post correction blood glucose levels were (2.04±0.13) mmol/L and (3.18±0.23) mmol/L, respectively.ConclusionsThe result has demonstrated that about 1 in 2 children with severe malaria may suffer from hypoglycemia in an African rural environment hence there is a need for at least three-point glucose estimation (at recruitment, 4 hours following correction and the end of the 24 hours).     

Resolution pattern of jaundice among children presenting with severe malaria in rural South-West Nigeria

Objective

To compare the pattern of jaundice resolution among children with severe malaria treated with quinine and artemether.

Methods

Thirty two children who fulfilled the inclusion criteria were recruited for the study from two hospitals with intensive care facilities. They were divided into two groups; ‘Q’ and ‘A’, receiving quinine and artemether, respectively. Jaundice was assessed by clinical examination.

Results

Sixteen out of 32 children recruited (representing 50%) presented with jaundice on the day of recruitment. The mean age was (7.00°C2.56) years. On day 3, four patients in ‘A’ and six patients in ‘Q’ had jaundice. By day 7, no child had jaundice.

Conclusion

The study has shown that both drugs resolve jaundice although artemether relatively resolves it faster by the third day.     

Lactogenic Activity of Rats Stimulated by Gunnera Perpensa L. (Gunneraceae) from South Africa

Gunnera perpensa L. (Gunneraceae) is a medicinal plant used by Zulu traditional healers to stimulate milk production. The effect of an aqueous extract of the rhizome of the plant on milk production in rats was investigated. Female lactating rats that received oral doses of the extract of G.perpensa significantly (p<0.05) produced more milk than controls. The plant extract did not however, significantly influence the levels of prolactin, growth hormone, progesterone, cortisol, ALT, AST and albumin in the blood. The mammary glands of rats treated with the extract showed lobuloalveolar development. The extract (0.8 µg/ml) was also found to stimulate the contraction of the uterus and inhibit (23%) acetylcholinesterase activity. The cytotoxicity of the extract (LC₅₀) to two human cell lines (HEK293 and HepG2) was 279.43 µg/ml and 222.33µg/ml, respectively. It is inferred that the plant extract exerts its activity on milk production and secretion by stimulating lobuloalveolar cell development and the contraction of myoepithelial cells in the alveoli. It is concluded that Gunnera perpensa contains constituents with lactogenic activity that apparently contribute to its effectiveness in folk medicine.