Evaluation of Head Position in Static and Dynamic Three-Dimensional Imaging:a review of the Literature

Background: The interest in three-dimensional imaging in orthognathic treatment planning has been growing, especially for evaluation of the natural head position. Several three-dimensional devices are available on the market. Three-dimensional evaluation of the patient will probably soon be a standard tool/method in orthognathic treatment planning.Purpose: The purpose of the study was a clarifi cation of the literature for studies regarding the natural head position in three-dimensional imaging.Materials and methods: A systematic search of the literature was conducted through PubMed to identify studies that evaluate head positions in three-dimensional imaging. Following search syntax was used: “3d imaging”, “three-dimensional”, “natural head position”, and “imaging head position”.Results: Only four studies have investigated the reproducibility and accuracy of head positions in three-dimensional imaging. The studies show that the natural head position is reproducible with the use of three-dimensional photography.Conclusion: Three-dimensional imaging to register the natural head position in orthognathic treatment planning shows promising results. Only four studies have evaluated its reproducibility. Future studies regarding its accuracy and reproducibility are essential.</p

The Use of Cryotherapy in Conjunction with Surgical Removal of Mandibular Third Molars: a Single-Blinded Randomized Controlled Trial

OBJECTIVES: Cryotherapy is frequently used to diminish postoperative sequelae following mandibular third molar surgery. The objective of this single-blinded randomized controlled trial was to assess the therapeutic efficiency of 30 minutes continuous cryotherapy on postoperative sequelae following surgical removal of mandibular third molars compared with no cryotherapy. MATERIAL AND METHODS: Thirty patients (14 male and 16 female) including 60 mandibular third molars were randomly allocated to 30 minutes of immediately cryotherapy or no cryotherapy. Outcome measures included pain (visual analogue scale score), maximum mouth opening (trismus) and quality of life (oral health impact profile-14). Outcome measures were assessed preoperatively and one day, three days, seven days and one month following surgical removal of mandibular third molars. Descriptive and generalized estimating equation analyses were made. Level of significance was 0.05. RESULTS: No cryotherapy following surgical removal of mandibular third molars revealed a statistically significant lower visual analogue scale score of pain compared to thirty minutes of continuous cryotherapy after one day (P < 0.05). However, no statistically significant difference in trismus or oral health-related quality of life were revealed at any time point compared with no cryotherapy. CONCLUSIONS: The therapeutic effect of 30 minutes continuous cryotherapy following surgical removal of mandibular third molars seem to be negligible. Thus, further randomized controlled trials assessing a prolonged application period of cryotherapy, alternative devices or use of intermittent cryotherapy are needed before definite conclusions and evidence-based clinical recommendations can be provided

Different Dosages of Corticosteroid and Routes of Administration in Mandibular Third Molar Surgery:a Systematic Review

Objectives: The objective of the present systematic review was to test the hypothesis of no difference in facial swelling, pain and trismus after surgical removal of mandibular third molar with different dosages of corticosteroids and administration routes. Material and Methods: A MEDLINE (PubMed), Embase database and Cochrane Library search in combination with a hand-search of relevant journals was conducted by including randomized controlled trials published in English until 1st December 2017. Results: Seven studies fulfilled the inclusion criteria. Considerable variation in the included studies prevented meta-analysis from being performed. Preoperative submucosal injection of corticosteroids significantly diminishes facial swelling, pain and trismus compared with placebo. However, different dosages of corticosteroid and administration routes reveal contrary results indicating that administration of a higher dosage of corticosteroids do not necessarily cause a further decrease in facial swelling, pain and trismus. Conclusions: Consequently, the optimal dosage of corticosteroids and administration route for diminishing postsurgical morbidity and improve quality of life after surgical removal of mandibular third molar is presently unknown. Therefore, further well-designed randomized clinical trials including a standardised protocol, patient-reported outcome measures and three-dimensional analysis of facial swelling is needed

Recurrent lower respiratory illnesses among young children in rural Kyrgyzstan:overuse of antibiotics and possible under-diagnosis of asthma. A qualitative FRESH AIR study

Abstract Lower respiratory tract illnesses (LRT-illnesses) in children under 5 years (U5s) are a leading cause of morbidity, hospitalisations and mortality worldwide, particularly in low-income countries. It is pertinent to understand possible inconsistent management. This study explored perceptions and practices among caregivers and health professionals on recurrent LRT-illnesses in U5s. Semi-structured interviews with 13 caregivers to U5s with recurrent LRT-illnesses and with 22 primary care health professional interviews in two rural provinces in Kyrgyzstan were triangulated. Data were thematically analysed. The majority (8/13) of caregivers described their young children as having recurrent coughing, noisy breathing and respiratory distress of whom several had responded positively to acute salbutamol and/or had been repeatedly hospitalised for LRT-illness. Family stress and financial burdens were significant. The health professionals classified young children with recurrent LRT-illnesses primarily with pneumonia and/or a multitude of bronchitis diagnoses. Broad-spectrum antibiotics and supportive medicine were used repeatedly, prescribed by health professionals or purchased un-prescribed by the caregivers at the pharmacy. The health professionals had never applied the asthma diagnosis to U5s nor had they prescribed inhaled steroids, and none of the interviewed caregivers’ U5s were diagnosed with asthma. Health professionals and caregivers shared a common concern for the children’s recurrent respiratory illnesses developing into a severe chronic pulmonary condition, including asthma. In conclusion, the study identified an inconsistent management of LRT-illnesses in U5s, with exorbitant use of antibiotics and an apparently systemic under-diagnosis of asthma/wheeze. When the diagnosis asthma is not used, the illness is not considered as a long-term condition, requiring preventer/controller medication

Region-specific drivers cause low organic carbon stocks and sequestration rates in the saltmarsh soils of southern Scandinavia

Saltmarshes are known for their ability to act as effective sinks of organic carbon (OC) and their protection and restoration could potentially slow down the pace of global warming. However, regional estimates of saltmarsh OC storage are often missing, including for the Nordic region. To address this knowledge gap, we assessed OC storage and accumulation rates in 17 saltmarshes distributed along the Danish coasts and investigated the main drivers of soil OC storage. Danish saltmarshes store a median of 10 kg OC m−2 (interquartile range, IQR: 13.5–7.6) in the top meter and sequester 31.5 g OC m−2 yr−1 (IQR: 41.6–15.7). In a global context, these values are comparatively low. Soils with abundant clay (&gt; 20%), older and stable saltmarshes in mesohaline settings, and with low proportion of algal organic material showed higher OC densities, stocks, and accumulation rates. Grazing led to significantly higher OC stocks than neighboring ungrazed locations, likely due to trampling modifying soil abiotic conditions (higher erosion-resistance and higher clay content) that slow carbon decay. Scaling up, Danish saltmarsh soils, comprising about 1% of the country's area, have the potential to yearly capture up to 0.1% of Denmark's annual consumption-based CO2 emissions. Our research expands the baseline data needed to advance blue carbon research and management in the Nordic region while highlighting the need for a more comprehensive approach to saltmarsh management that considers the full range of services of these ecosystems and does not only focus on climate benefits.</p