Class III treatment strategies

Communication presented at the International Joint Congress of the Multiloop Edgewise Arch-Wire Technique and Research Foundation (IJC-MEAW). Seoul, Korea, 1-3 October 2014

A computerized tomography study of the morphological interrelationship between the temporal bones and the craniofacial complex

"This is the pre-peer reviewed version of the following article: Journal of Anatomy. Volume 220, Issue 6, pages 544–554, June 2012, which has been published in final form at http://onlinelibrary.wiley.com/doi/10.1111/j.1469-7580.2012.01499.x/pdf ""The hypothesis that the temporal bones are at the center of the dynamics of the craniofacial complex, directly influencing facial morphology, has been put forward long ago. This study examines the role of the spatial positioning of temporal bones (frontal and sagittal inclination) in terms of influencing overall facial morphology. Several 3D linear, angular and orthogonal measurements obtained through computerized analysis of virtual models of 163 modern human skulls reconstructed from Cone-beam Computed Tomography (CBCT) images were analyzed and correlated. Additionally, the sample was divided into two subgroups based on the median value of temporal bone sagittal inclination [anterior rotation group (n=82); posterior rotation group (n=81)], and differences between groups evaluated. Correlation coefficients showed that sagittal inclination of the temporal bone was significantly (p <0.01) related to midline flexion, transversal width, and anterior-posterior length of the basicranium, to the anterior-posterior positioning of the mandible and maxilla, and posterior midfacial height. Frontal inclination of the temporal bone was significantly related (p <0.01) to basicranium anterior-posterior and transversal dimensions, and to posterior midfacial height. In comparison with the posterior rotation group, the anterior rotation group presented a less flexed and anterior-posteriorly longer cranial base, a narrower skull, porion and the articular eminence located more superiorly and posteriorly, a shorter posterior midfacial height, the palatal plane rotated clockwise, a more retrognathic maxilla and mandible, and the upper posterior occlusal plane more inclined and posteriorly located. The results suggest that differences in craniofacial morphological are highly integrated with differences in the positional relationship of the temporal bones. The sagittal inclination of the temporal bone seems to have a greater impact on the 3D morphology of the craniofacial complex than frontal inclination.

Child adjustment to separation or divorce of parents

Objetivo: O presente artigo procura relacionar e analisar evidências empíricas e teóricas sobre o impacto e os fatores associados ao impacto da separação ou divórcio dos pais no ajustamento da criança. Método: Realizou-se uma revisão agregativa da literatura, recorrendo às palavras-chave “divorce adjustment”, “child divorce” e “divorce impact”, nas bases de dados JSTOR, PsycInfo, SciELO e Medline e em livros da especialidade. Resultados: Respostas adaptativas e desadaptativas da criança são descritas, assim como potenciais resultados positivos. São principalmente discutidos os fatores mediadores e moderadores frequentemente referenciados na literatura no impacto da separação ou divórcio dos pais no ajustamento da criança. Entre esses estão: características da criança, problemas financeiros, sintomatologia psicopatológica dos pais, qualidade das práticas parentais e conflito interparental. Conclusão: Com base nas evidências empíricas e perspectivando o divórcio como uma transição desenvolvimental, levantamos a hipótese de que os problemas de ajustamento apresentados pelas crianças com pais divorciados possam ser mais bem explicados por outros fatores do que pelo divórcio/separação per se. Finalmente assumimos uma inovação conceptual de que essa transição familiar pode significar uma oportunidade de crescimento e de promoção desenvolvimental.Objective: Current theoretical and empirical evidences about the impact and the factors associated with the impact of parents’ separation/divorce in children’s adjustment were related and examined. Method: An aggregative literature review was made, using the keywords “divorce adjustment”, “child divorce” e “divorce impact”, from the databases JSTOR, PsycInfo, SciELO, and Medline and from reference books. Results: Child unadaptive and adaptive responses are described, as well as potential positive results. Mediators and moderators factors of the impact of parents’ separation/divorce in children’s adjustment often referenced in literature are mainly discussed. Among these are: characteristics of children, financial problems, parents’ psychopathological symptoms, quality of parenting practices and inter-parental conflict. Discussion: Based on the existing results, and considering the divorce as a developmental transition, we put a hypothesis that adjustment problems showed by children’s of divorce can be better explained by other factors than the divorce/separation by itself. Finally we assume a conceptual innovation that this familiar transition can represent a growth opportunity and developmental promotion

Ajustamento da criança à separação ou divórcio dos pais

OBJECTIVE: Current theoretical and empirical evidences about the impact and the factors associated with the impact of parents' separation/divorce in children's adjustment were related and examined. METHOD: An aggregative literature review was made, using the keywords "divorce adjustment", "child divorce" e "divorce impact", from the databases JSTOR, PsycInfo, SciELO, and Medline and from reference books. RESULTS: Child unadaptive and adaptive responses are described, as well as potential positive results. Mediators and moderators factors of the impact of parents' separation/divorce in children's adjustment often referenced in literature are mainly discussed. Among these are: characteristics of children, financial problems, parents' psychopathological symptoms, quality of parenting practices and inter-parental conflict. DISCUSSION: Based on the existing results, and considering the divorce as a developmental transition, we put a hypothesis that adjustment problems showed by children's of divorce can be better explained by other factors than the divorce/separation by itself. Finally we assume a conceptual innovation that this familiar transition can represent a growth opportunity and developmental promotion.OBJETIVO: O presente artigo procura relacionar e analisar evidências empíricas e teóricas sobre o impacto e os fatores associados ao impacto da separação ou divórcio dos pais no ajustamento da criança. MÉTODO: Realizou-se uma revisão agregativa da literatura, recorrendo às palavras-chave "divorce adjustment", "child divorce" e "divorce impact", nas bases de dados JSTOR, PsycInfo, SciELO e Medline e em livros da especialidade. RESULTADOS: Respostas adaptativas e desadaptativas da criança são descritas, assim como potenciais resultados positivos. São principalmente discutidos os fatores mediadores e moderadores frequentemente referenciados na literatura no impacto da separação ou divórcio dos pais no ajustamento da criança. Entre esses estão: características da criança, problemas financeiros, sintomatologia psicopatológica dos pais, qualidade das práticas parentais e conflito interparental. CONCLUSÃO: Com base nas evidências empíricas e perspectivando o divórcio como uma transição desenvolvimental, levantamos a hipótese de que os problemas de ajustamento apresentados pelas crianças com pais divorciados possam ser mais bem explicados por outros fatores do que pelo divórcio/separação per se. Finalmente assumimos uma inovação conceptual de que essa transição familiar pode significar uma oportunidade de crescimento e de promoção desenvolvimental

Perception of Need for Further Refinement in a Clear Aligner Treatment among Orthodontists, Dentists and Laypeople: A Retrospective Study

Clear aligner treatment often requires further refinement to improve the orthodontic treatment outcome. However, the perceptions of treatment outcomes evaluated by orthodontists and dentists are sparse, and laypeople’s perceptions have yet to be explored. Here, we explore the perceptions of orthodontists, dentists, and laypeople concerning the treatment outcomes achieved after completing the first sequence of aligners. This cross-sectional study involved 37 orthodontists, 67 dentists, and 93 laypeople. We administered an online questionnaire containing intra-oral photographs of nine completed cases with pre- and post-first sequences of aligners. As a control, we used a digital prediction system for the treatment outcome. Self-perception was reported using a visual analog scale. Both orthodontists and dentists had similar perceptions about treatment outcomes (p = 0.363) but significantly differed from laypeople (p ≤ 0.0001). Both orthodontists and dentists recommended further treatment; orthodontists were more critical than dentists (p ≤ 0.001). Orthodontists were more critical than dentists in their evaluations of the need for further treatments; however, their perceptions of treatment outcomes were similar. Laypeople were more satisfied with the treatment outcomes, were less concerned with occlusion, and were more focused on the aesthetic results of the treatment

Risk Factors Associated with Mini-Implant Failure: A Retrospective Study

This study aimed to evaluate the failure rate of mini-implants used at the orthodontic external clinic, Egas Moniz School of Health and Science. A retrospective cross-sectional investigation was performed. This included the insertion of 232 TADs into 125 consecutive patients and was always performed with an immediate loading protocol. The examined variables were: gender, age, Angle’s classification, presence of pathologies, medication, smoking, receiving jaw, placement side, and insertion site. Descriptive statistics were used and inferential analysis was performed, revealing the six-month failure rate of the used TADs to be 25%. A significant association was found between being a smoker, the failure rate (p = 0.036), and the placement site (p = 0.003)

J. Martins Carvalho: professional, professor and gentleman

Tributo de homenagem ao Professor Martins Carvalh

Portuguese-Brazilian evidence-based guideline on the management of hyperglycemia in type 2 diabetes mellitus

Background: In current management of type 2 diabetes (T2DM), cardiovascular and renal prevention have become important targets to be achieved. In this context, a joint panel of four endocrinology societies from Brazil and Portugal was established to develop an evidence-based guideline for the treatment of hyperglycemia in T2DM. Methods: MEDLINE (via PubMed) was searched for randomized clinical trials, meta-analyses, and observational studies related to diabetes treatment. When there was insufficient high-quality evidence, expert opinion was sought. Updated positions on treatment of T2DM patients with heart failure (HF), atherosclerotic CV disease (ASCVD), chronic kidney disease (CKD), and patients with no vascular complications were developed. The degree of recommendation and the level of evidence was determined using predefined criteria. Results and conclusions: In non-pregnant adults, the recommended HbA1c target is below 7%. Higher levels are recommended in frail older adults and patients at higher risk of hypoglycemia. Lifestyle modification is recommended at all phases of treatment. Metformin is the first choice when HbA1c is 6.5–7.5%. When HbA1c is 7.5–9.0%, dual therapy with metformin plus an SGLT2i and/or GLP-1RA (first-line antidiabetic agents, AD1) is recommended due to cardiovascular and renal benefits. If an AD1 is unaffordable, other antidiabetic drugs (AD) may be used. Triple or quadruple therapy should be considered when HbA1c remains above target. In patients with clinical or subclinical atherosclerosis, the combination of one AD1 plus metformin is the recommended first-line therapy to reduce cardiovascular events and improve blood glucose control. In stable heart failure with low ejection fraction ( 30 mL/min/1.73 m2, metformin plus an SGLT-2i is recommended to reduce cardiovascular mortality and heart failure hospitalizations and improve blood glucose control. In patients with diabetes-associated chronic kidney disease (CKD) (eGFR 30–60 mL/min/1.73 m2 or eGFR 30–90 mL/min/1.73 m2 with albuminuria > 30 mg/g), the combination of metformin and an SGLT2i is recommended to attenuate loss of renal function, reduce albuminuria and improve blood glucose control. In patients with severe renal failure, insulin-based therapy is recommended to improve blood glucose control. Alternatively, GLP-1RA, DPP4i, gliclazide MR and pioglitazone may be considered to reduce albuminuria. In conclusion, the current evidence supports individualizing anti-hyperglycemic treatment for T2DM.info:eu-repo/semantics/publishedVersio

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved