A Retrospective Study of Temporomandibular Joint Internal Derangement Treated with Arthrocentesis and Arthroscopy

Introduction: Internal Derangement of the Temporomandibular Joint is an intra-articular condition in which there is a disruption in the normal relationship of the articular disc to the articular eminence and the condyle when the joint is at rest or in function. Patients may complain of pain and/or limitation of mouth opening. Treatment of internal derangement of temporomandibular joint includes arthrocentesis and arthroscopy. The aims of this retrospective study are to examine the efficacy of arthrocentesis and arthroscopy in the treatment of internal derangement of temporomandibular joint, specifically in relation to joint movement and pain. Methods: Twenty consecutive patients with internal derangement of temporomandibular joint seen in National Dental Centre of Singapore, from 2010 to 2011, were included in this study. Nine patients underwent arthrocentesis and 11 had arthroscopic lysis and lavage. The pre and postoperative pain score, in Visual Analogue Scale (0 to 10) and maximal inter-incisal opening were recorded to evaluate the effectiveness of both treatment modalities. The patients were reviewed one week and one month post-operation. The data obtained were statistically analysed. Results: Significant increase in postoperative mouth opening and reduction in pain were found in both groups of patients. In the arthrocentesis group, the mean increase in maximal inter-incisal opening was 13 ± 5mm and reduction of pain in VAS was 4.56 ± 1.74. For the arthroscopy group, the mean increase in maximal inter-incisal opening was 6.6mm ± 4.8mm and the reduction of pain was 2.5 ± 2.2. Duration of symptoms prior to treatment appeared to have influenced the treatment outcome of both treatments. Conclusion: Arthrocentesis and arthroscopy are effective in the treatment of internal derangement of temporomandibular joint. Factors that may influence treatment outcomes need to be investigated to provide more information on the predictability of arthrocentesis and arthroscopy

Patient-reported outcome measures after routine periodontal and implant surgical procedures

OBJECTIVES: To compare patient-reported outcome measures (PROMs) after different dental surgical procedures over a 1-week post-surgical period and in relation to duration of the surgery, and periosteal releasing incisions. To evaluate the prevalence of post-surgical complications. MATERIAL & METHODS: Four hundred and sixty-eight healthy dental patients requiring surgeries, such as crown lengthening (CL), open flap debridement (OFD) and implant installation (IMP) in the National Dental Centre, Singapore (2009-2011), were consecutively recruited. PROMs on bleeding, swelling, pain and bruising were obtained using Visual Analogue Scales (VAS) on days 0, 3, 5 and 7 post-operatively. RESULTS: On the day of surgery, the IMP procedure gave the lowest median VAS for all four PROM parameters. After a week, OFD still had a significantly higher VAS for swelling, pain and bruising. Patients who underwent procedures lasting more than 60 min. had higher VAS for all parameters except bleeding. After considering other important confounders, type of surgery procedure was no longer associated with the VAS score for any of the parameters. Time after surgery, male gender and shorter surgery duration reduced post-operative VAS for one or more of the parameters. Longer surgeon experience helps reduce VAS scores only for bleeding. Prevalence for tenderness to palpation was 11.6%, 8.9% and 12.2% for IMP, CL and OFD, respectively, 1-week post-operatively. Swelling and suppuration occurred rarely. CONCLUSIONS: The median VAS scores for all PROM parameters were generally low and reduced to near zero over a week following all three surgical procedures tested. Time after surgery and shorter surgery duration were associated with lower VAS scores in all the PROM parameters in this cohort of patients. Surgery type was not associated significantly with VAS after adjustment with other important confounders. Low prevalences of post-surgical complications were reported

Sleep duration and growth outcomes across the first two years of life in the GUSTO study

Background and Aim: Short sleep duration is thought to be a factor contributing to increased body mass index (BMI) in both school-age children and adults. Our aim was to determine whether sleep duration associates with growth outcomes during the first two years of life.Study design: Participants included 899 children enrolled in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort study. Anthropometric data (weight and body length) and parental reports of sleep duration were collected at 3, 6, 9, 12, 18, and 24 months of age. A mixed-model analysis was used to evaluate the longitudinal association of BMI and body length with sleep duration. In subgroup analyses, effects of ethnicity (Chinese, Indian, and Malay) and short sleep at three months of age (?12?h per day) were examined on subsequent growth measures.Results: In the overall cohort, sleep duration was significantly associated with body length (??=?0.028, 95% confidence interval [CI] 0.002–0.053, p?=?0.033), but not BMI, after adjustment for potential confounding factors. Only in Malay children, shorter sleep was associated with a higher BMI (??=??0.042, 95% CI ?0.071 to ?0.012, p?=?0.005) and shorter body length (??=?0.079, 95% CI 0.030–0.128, p?=?0.002). In addition, shorter sleep was associated with a higher BMI and shorter body length in children who slept ?12?h per day at three months of age.Conclusion: The association between sleep duration and growth outcomes begins in infancy. The small but significant relationship between sleep and growth anthropometric measures in early life might be amplified in later childhood.<br/

Experience with Rover Navigation for Lunar-Like Terrains

Reliable navigation is critical for a lunar rover, both for autonomous traverses and safeguarded, remote teleoperation. This paper describes an implemented system that has autonomously driven a prototype wheeled lunar rover over a kilometer in natural, outdoor terrain. The navigation system uses stereo terrain maps to perform local obstacle avoidance, and arbitrates steering recommendations from both the user and the rover. The paper describes the system architecture, each of the major components, and the experimental results to date