Results of Transplanting Developing Third Molars as Part of Orthodontic Space Management

PATIENTS AND METHOD: The aim of the present study was to contribute to a more accurate indication and better integration of developing third molar transplantation into orthodontic space management, using the results gleaned from the authors' own pool of patients. For this purpose, a clinical and radiographic examination of 61 transplanted developing molars in 57 patients was carried out after an average of 3.3 years. RESULTS: The overall success rate was 85%. Failure was due in 10% of cases to impaired periodontal healing (inflammatory root resorption, ankylosis, or increased pocket probing depths) and in 5% of cases to insufficient or arrested postoperative root development accompanied by increased transplant mobility. The incidence of postoperative cessation of further root development was significantly higher (p = 0.011) in transplants at early developmental stages, which also had a negative impact on the final root length, the crown-root ratio and the mobility values of these transplants. CONCLUSIONS: The transplantation of developing third molars should be given stronger consideration in treatment plans for orthodontic space management although it represents a real alternative to orthodontic space closure only in exceptional cases. However, unlike implantological or prosthodontic treatment, it offers an opportunity to replace a missing or non-retainable tooth with a patient's own vital and fully functional tooth, provided the appropriate transplant is selected.     

Challenges that nurses face in caring for morbidly obese patients in the acute care setting.

BACKGROUND: Despite increasing numbers of morbidly obese patients admitted to acute care facilities for surgery or treatment of nonsurgical conditions, there is little evidence of the problems nurses face in providing care to these patients. Anecdotal evidence suggests that the care of these patients is more demanding than the care of nonobese patients. The objective of this study was to describe nurses' perceptions of the challenges that they face when caring for morbidly obese patients. METHODS: Focus groups of nurses from a tertiary care facility were convened. A trained facilitator posed questions to the group concerning various aspects of care for morbidly obese patients. Comments of respondents were categorized using NVIVO software. RESULTS: Nurses reported concerns about the increased staffing needs required for care of these patients and the particular challenges of the physical care. Concerns also included the availability, placement, and use of specialized equipment. Room size and the absence of some equipment were also problematic. Finally, nurses perceived safety issues, both for themselves and their patients. CONCLUSIONS: Morbidly obese patients in the acute care setting require specialized nursing care in terms of techniques, levels of staffing required, and the use of specialized equipment.     

Alveolar hydatid disease of the liver: Brief review and spectrum of adjacent organ invasion

The purpose of this study is to show the spectrum of adjacent organ invasion and to make a brief review of hepatic alveolar hydatid disease (AHD), using CT and MR imaging. We retrospectively reviewed CT and MR images of three patients with various adjacent organ invasions surgically and histologically proven to be AHD. Local invasion to right kidney and adrenal, right hemidiaphragm and lung were detected in one patient, right adrenal in another patient and gall bladder, duodenum, gastric wall and pancreas invasion in the other. AHD may rarely extend to the gall bladder, stomach, duodenum, pancreas, right adrenal and kidney, diaphragm, pleura and lung. The extension of the disease outside the liver is usually encountered in patients with large, peripherally located masses in the advanced stage of the disease.     

Endoscopically controlled sinus floor augmentation. A preliminary report.

Sinus augmentation has been advocated to be a surgical technique with predictable results in peri‐implant surgery. Endoscopic surgery of the maxillary sinus so far has been used as diagnostic procedure. In this paper, the use of endoscopy is described as a low invasive adjunctive technique in sinus floor augmentation. After preparation of the mucoperiosteum, bone grafts can be placed under endoscopic control between sinus floor and mucoperiosteum. A laterobasal approach via a small osteotomy and a transalveolar approach are possible for mucosal elevation and graft placement. First clinical results are reported. Endoscopic sinus lift may contribute to a reduction of perioperative morbidity, reduction of oroantal fistulae and control of graft position. The less invasive technique may allow to extend the indication for sinus augmentation.     

Universal standardization of forearm bone densitometry.

As part of an effort to quantify device-dependent differences in forearm bone density, 101 women, aged 20-80 years (approximately 16 women in each age decade), were scanned on six forearm bone densitometers: the Aloka DCS-600EX, the Hologic QDR-4500A, the Lunar PIXI, the Norland pDEXA, the Osteometer DTX-200, and the Pronosco X-posure System. Regression statistics are reported for all similar regions of interest (ROIs). However, comparisons were confounded because of large differences in the ROI size and placement. The number of ROIs reported for a single scan by each device varied from 1 to 12. The correlation coefficients ranged from 0.7 < r < 0.97, with the highest correlation coefficients and lowest SEs for comparisons between the most similar ROIs. Standardized units of bone mineral density are derived for distal (sdBMD), mid-(smBMD), and proximal (spBMD) ROTs that allow for comparable mean bone densities to be derived for patient populations. Five phantoms were scanned and characterized on five of the devices and the precision and mean values were reported. These phantom values will aid in the in vitro cross-calibration between manufacturers to recreate the presented in vivo relationships. Care should be exercised when using these equations for cross-calibrating patient databases or pooling clinical data from different devices because the least significant differences detectable from measurements taken on two different machines can be increased substantially.     

Deprivation of form vision suppresses diurnal cycling of retinal levels of leu-enkephalin

Deprivation of form vision by the fitting of translucent occluders suppressed the diurnal cycling of enkephalinergic amacrine cells (the ENSLI amacrine cells), in the chicken. Daily periods of normal vision or enforcing temporal contrast using strobe lighting appeared to restore normal functioning of the ENSLI cells. These results suggest that the ENSLI cells are involved in retinal circuits that assess the quality of the visual image and control eye growth.     

Application of the condylar positioning appliance in mandibular sagittal split osteotomies with rigid skeletal fixation.

During orthodontic-surgical treatment of dentofacial deformities, centric relation of the mandibular condylar head to the fossa articularis must be maintained. Intraoperative application of the condylar positioning appliance, in combination with different surgical splints, allows three-dimensional adjustment of the jaw segments. The condylar positioning appliance can be used in osteotomies of the mandible alone, in isolated Le Fort I osteotomies, or in simultaneous osteotomies of the maxilla and mandible.