Orthodontic and orthopaedic treatment for anterior open bite in children (Review)

Background: Anterior open bite occurs when there is a lack of vertical overlap of the upper and lower incisors. The aetiology is multifactorial including: oral habits, unfavourable growth patterns, enlarged lymphatic tissue with mouth breathing. Several treatments have been proposed to correct this malocclusion, but interventions are not supported by strong scientific evidence. Objectives: The aim of this systematic review was to evaluate orthodontic and orthopaedic treatments to correct anterior open bite in children. Search methods: The following databases were searched: the Cochrane Oral Health Group's Trials Register (to 14 February 2014); the Cochrane Central Register of Controlled Trials (CENTRAL)(The Cochrane Library 2014, Issue 1); MEDLINE via OVID (1946 to 14 February 2014); EMBASE via OVID (1980 to 14 February 2014); LILACS via BIREME Virtual Health Library (1982 to 14 February 2014); BBO via BIREME Virtual Health Library (1980 to 14 February 2014); and SciELO (1997 to 14 February 2014). We searched for ongoing trials via ClinicalTrials.gov (to 14 February 2014). Chinese journals were handsearched and the bibliographies of papers were retrieved. Selection criteria: All randomised or quasi-randomised controlled trials of orthodontic or orthopaedic treatments or both to correct anterior open bite in children. Data collection and analysis: Two review authors independently assessed the eligibility of all reports identified. Risk ratios (RRs) and corresponding 95% confidence intervals (CIs) were calculated for dichotomous data. The continuous data were expressed as described by the author. Main results: Three randomised controlled trials were included comparing: effects of Frankel's function regulator-4 (FR-4) with lip-seal training versus no treatment; repelling-magnet splints versus bite-blocks; and palatal crib associated with high-pull chincup versus no treatment.The study comparing repelling-magnet splints versus bite-blocks could not be analysed because the authors interrupted the treatment earlier than planned due to side effects in four of ten patients.FR-4 associated with lip-seal training (RR = 0.02 (95% CI 0.00 to 0.38)) and removable palatal crib associated with high-pull chincup (RR = 0.23 (95% CI 0.11 to 0.48)) were able to correct anterior open bite.No study described: randomisation process, sample size calculation, there was not blinding in the cephalometric analysis and the two studies evaluated two interventions at the same time. These results should be therefore viewed with caution. Authors' conclusions: There is weak evidence that the interventions FR-4 with lip-seal training and palatal crib associated with high-pull chincup are able to correct anterior open bite. Given that the trials included have potential bias, these results must be viewed with caution. Recommendations for clinical practice cannot be made based only on the results of these trials. More randomised controlled trials are needed to elucidate the interventions for treating anterior open bite

Restless legs syndrome in post-polio syndrome: A series of 10 patients with demographic, clinical and laboratorial findings

Background: Few studies have described the occurrence of restless legs syndrome in post-polio syndrome.Methods: We studied 10 consecutive patients with post-polio syndrome and symptoms of restless legs syndrome. We look at demographic, clinical and laboratorial data.Results: A remarkable finding was the concomitant onset of symptoms of both diseases, suggesting a possible underlying mechanism. Severity of restless legs symptoms was moderate to very severe.Conclusion: Epidemiological studies with larger samples are needed to better establish the relationship and the incidence of restless legs syndrome in post-polio syndrome. (C) 2011 Elsevier B.V. All rights reserved.Universidade Federal de São Paulo, Neurosono Sleep Ctr, BR-01547000 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Neurol & Neurosurg, Neuromuscular Disorders Ctr, BR-01547000 São Paulo, BrazilUniversidade Federal de São Paulo, Neurosono Sleep Ctr, BR-01547000 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Neurol & Neurosurg, Neuromuscular Disorders Ctr, BR-01547000 São Paulo, BrazilWeb of Scienc

Restless legs syndrome: A qualitative analysis of psychosocial suffering and interdisciplinary attention

The aim of this study is to investigate psychosocial factors related to the diagnosis and treatment of patients with restless legs syndrome. Fifteen patients were interviewed at the Neuro-Sono Outpatient Clinic, Universidade Federal de São Paulo. the results were submitted to a qualitative analysis. We identified four content categories: illness description, illness history, illness experience, and relationships. Lack of control over the body and lack of recognition by professionals produce stigma and lead patients to suffering. the research underscores the relevance of psychosocial factors to the diagnosis and treatment of patients with restless legs syndrome and the importance of having interdisciplinary teams when attending patients with restless legs syndrome.Universidade Federal de São Paulo, BR-01547000 São Paulo, BrazilUniversidade Federal de São Paulo, BR-01547000 São Paulo, BrazilWeb of Scienc

Orthodontic and orthopaedic treatment for anterior open bite in children

BackgroundAnterior open bite occurs when there is a lack of vertical overlap of the upper and lower incisors. the aetiology is multifactorial including: oral habits, unfavourable growth patterns, enlarged lymphatic tissue with mouth breathing. Several treatments have been proposed to correct this malocclusion, but interventions are not supported by strong scientific evidence.ObjectivesThe aim of this systematic review was to evaluate orthodontic and orthopaedic treatments to correct anterior open bite in children.Search methodsThe following databases were searched: the Cochrane Oral Health Group's Trials Register (to 14 February 2014); the Cochrane Central Register of Controlled Trials (CENTRAL)(The Cochrane Library 2014, Issue 1); MEDLINE via OVID (1946 to 14 February 2014); EMBASE via OVID (1980 to 14 February 2014); LILACS via BIREME Virtual Health Library (1982 to 14 February 2014); BBO via BIREME Virtual Health Library (1980 to 14 February 2014); and SciELO (1997 to 14 February 2014). We searched for ongoing trials via ClinicalTrials.gov (to 14 February 2014). Chinese journals were handsearched and the bibliographies of papers were retrieved.Selection criteriaAll randomised or quasi-randomised controlled trials of orthodontic or orthopaedic treatments or both to correct anterior open bite in children.Data collection and analysisTwo review authors independently assessed the eligibility of all reports identified.Risk ratios (RRs) and corresponding 95% confidence intervals (CIs) were calculated for dichotomous data. the continuous data were expressed as described by the author.Main resultsThree randomised controlled trials were included comparing: effects of Frankel's function regulator-4 (FR-4) with lip-seal training versus no treatment; repelling-magnet splints versus bite-blocks; and palatal crib associated with high-pull chincup versus no treatment.The study comparing repelling-magnet splints versus bite-blocks could not be analysed because the authors interrupted the treatment earlier than planned due to side effects in four of ten patients.FR-4 associated with lip-seal training (RR = 0.02 (95% CI 0.00 to 0.38)) and removable palatal crib associated with high-pull chincup (RR = 0.23 (95% CI 0.11 to 0.48)) were able to correct anterior open bite.No study described: randomisation process, sample size calculation, there was not blinding in the cephalometric analysis and the two studies evaluated two interventions at the same time. These results should be therefore viewed with caution.Authors' conclusionsThere is weak evidence that the interventions FR-4 with lip-seal training and palatal crib associated with high-pull chincup are able to correct anterior open bite. Given that the trials included have potential bias, these results must be viewed with caution. Recommendations for clinical practice cannot be made based only on the results of these trials. More randomised controlled trials are needed to elucidate the interventions for treating anterior open bite.Brazilian Cochrane Centre, BrazilCochrane Oral Health Group Global Alliance, UKBritish Association of Oral Surgeons, UKBritish Orthodontic Society, UKBritish Society of Paediatric Dentistry, UKBritish Society of Periodontology, UKCanadian Dental Hygienists Association, CanadaMayo Clinic, USANational Center for Dental Hygiene Research Practice, USANew York University College of Dentistry, USARoyal College of Surgeons of Edinburgh, UKNational Institute for Health Research (NIHR), UKUniversidade Federal de São Paulo, Dept Neurol, Neurosono Sleep Ctr, BR-01547000 São Paulo, BrazilFundacao Univ Cardiol IC FUC, Inst Cardiol RS, Porto Alegre, RS, BrazilJames Cook Univ, Sch Med & Dent, Dept Orthodont, Cairns, AustraliaUniversidade Federal de São Paulo, Dept Neurol, BR-01547000 São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Neurol, BR-01547000 São Paulo, BrazilWenzhou Med Univ, Coll Stomatol, Orthodont Dept, Wenzhou, Peoples R ChinaUniversidade Federal de São Paulo, Dept Neurol, Neurosono Sleep Ctr, BR-01547000 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Neurol, BR-01547000 São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Neurol, BR-01547000 São Paulo, BrazilWeb of Scienc

Neurophysiological Studies and Non-Motor Symptoms Prior to Ataxia in a Patient with Machado-Joseph Disease: Trying to Understand the Natural History of Brain Degeneration

Spinocerebellar ataxia type 3 or Machado-Joseph disease is the most common spinocerebellar ataxia. in this neurological disease, anatomical, physiological, clinical, and functional neuroimaging demonstrate a degenerative process besides the cerebellum. We performed neurophysiological and neuroimaging studies-polysomnography, transcranial sonography, vestibular-evoked myogenic potential, single-photon emission computed tomography (SPECT) with Tc-99m-TRODAT-1, and a formal neuropsychological evaluation in a patient with sleep complaints and positive testing for Machado-Joseph disease, without cerebellar atrophy, ataxia, or cognitive complaints. Polysomnography disclosed paradoxical high amplitude of submental muscle, characterizing REM sleep without atonia phenomenon. Transcranial sonography showed hyperechogenicity of the substantia nigra. There was an absence of vestibular-evoked myogenic potentials on both sides in the patient under study, in opposite to 20 healthy subjects. Brain imaging SPECT with Tc-99m-TRODAT-1 demonstrated a significant lower DAT density than the average observed in six healthy controls. Electroneuromyography was normal. Neuropsychological evaluation demonstrated visuospatial and memory deficits. Impairment of midbrain cholinergic and pontine noradrenergic systems, dysfunction of the pre-synaptic nigrostriatal system, changes in echogenicity of the substantia nigra, and damage to vestibulo-cervical pathways are supposed to occur previous to cerebellar involvement in Machado-Joseph disease.Universidade Federal de São Paulo, Dept Neurol, Ataxia Unit, São Paulo, BrazilHosp Israelita Albert Einstein, São Paulo, BrazilUniv São Paulo, Dept Clin Neurosurg, São Paulo, BrazilUniv Estadual Ceara, Ctr Hlth Sci, Fortaleza, Ceara, BrazilUniversidade Federal de São Paulo, Dept Psychiat, São Paulo, BrazilUniversidade Federal de São Paulo, Behav Neurol Sect, Dept Neurol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Neurol, Ataxia Unit, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychiat, São Paulo, BrazilUniversidade Federal de São Paulo, Behav Neurol Sect, Dept Neurol, São Paulo, BrazilWeb of Scienc

Sleep habits and starting time to school in Brazilian children Hábitos de sono e período escolar em crianças brasileiras

OBJECTIVE: This study investigated the sleep habits in Brazilian children according to age, gender and starting time to school. METHOD: We investigated 2,482 scholars aged 7 to 10 years. We compared sleep habits, gender, and starting time to school (morning and afternoon). RESULTS: Sixty-one per cent of the children presented sleep rituals before sleep. Milk drinking before sleep was more frequent among seven years old children. We found a progressive reduction with age in keeping the lights on. Girls used to leave an object to bed more than boys did. Children that studied in the morning presented reduced total sleep time, sleep earlier, and nap more frequently than children that studied in the afternoon. CONCLUSION: Starting time to school deeply influences sleep habits in Brazilian children from São Paulo City, in whom bed-time rituals are highly prevalent.<br>OBJETIVOS: Estudar os hábitos de sono nas crianças brasileiras de acordo com a idade, sexo e período escolar. MÉTODO: Estudamos 2.482 crianças em idade escolar de 7 a 10 anos. Comparamos hábitos de sono, sexo e período escolar (matutino e vespertino). RESULTADOS: 61% das crianças apresentaram rituais de sono antes de dormir. Beber leite antes de dormir foi mais freqüente entre as crianças de 7 anos de idade. Encontramos redução progressiva com a idade em se manter a luz acesa. Meninas possuíam mais objetos para dormir que os meninos. As crianças que estudavam no período matutino apresentaram redução do tempo total de sono, tinham sono mais cedo e os cochilos eram mais freqüentes do que as crianças que estudavam no período vespertino. CONCLUSÃO: O horário escolar tem muita influência nos hábitos de sono das crianças brasileiras da cidade de São Paulo, os rituais de sono sendo muito prevalentes