Effect of frenotomy on breastfeeding and reflux:results from the BRIEF prospective longitudinal cohort study

OBJECTIVES: To assess the Efficacy of Frenotomy with regard to Breastfeeding and Reflux Improvement (BRIEF) in infants with breastfeeding problems. MATERIALS AND METHODS: A cohort of 175 consecutive breastfeeding women with breastfeeding and reflux problems related to a tongue-tie or lip-tie fulfilling the inclusion criteria was longitudinally followed for 6 months. The effect of frenotomy on these problems was studied by a standardized oral assessment and completing the validated Breastfeeding Self-Efficacy Short Form (BSES-SF), nipple pain score (Visual Analogue Scale, VAS), and Infant Gastroesophageal Reflux Questionnaire Revised (I-GERQ-R) questionnaires pre-frenotomy and at 1 week, 1 month, and 6 months’ post frenotomy. RESULTS: All 175 women completed the 1-month follow-up and 146 women the 6 months’ follow-up. Frenotomy resulted in a significant improvement of BSES-SF, nipple pain score, and I-GERQ-R after 1 week, which improvement maintained to be significant after 1 month for BSES-SF and I-GERQ-R, and after 6 months for I-GERQ-R. The improvements were irrespective of the type lip-tie or tongue-tie underlying the breast feeding and reflux problems. No post-operative complications were observed. About 60.7% of infants still was breastfed 6 months after treatment. CONCLUSIONS: Frenotomy is a safe procedure with no post-operative complications and resulting in significant improvement of breastfeeding self-efficacy, nipple pain, and gastro-oesophageal reflux problems. CLINICAL RELEVANCE: Frenotomy of a tongue-tie and or lip-tie can lead to improvement of breastfeeding and reflux problems irrespective of the type of tongue-tie or lip-tie and should be considered by clinicians as a proper tool to resolve these problems if non-interventional support did not help. INTERNATIONAL TRIAL REGISTER: ISRCTN64428423 SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00784-020-03665-y

Inter- and intraobserver reproducibility of buccal bone measurements at dental implants with cone beam computed tomography in the esthetic region

BACKGROUND: Sufficient buccal bone is important for optimal esthetic results of implant treatment in the anterior region. It can be measured with cone beam computed tomography (CBCT), but background scattering and problems with standardization of the measurements are encountered. The aim was to develop a method for reliable, reproducible measurements on CBCTs. METHODS: Using a new method, buccal bone thickness was measured on ten CBCTs at six positions along the implant axis. Inter- and intraobserver reproducibility was assessed by repeated measurements by two examiners. RESULTS: Mean buccal bone thickness measured by observers 1 and 2 was 2.42 mm (sd: 0.50) and 2.41 mm (sd: 0.47), respectively. Interobserver intraclass correlation coefficient was 0.96 (95% CI 0.93 to 0.98). The mean buccal bone thickness of the first measurement and the second measurement of observer 1 was 2.42 mm (sd: 0.50) and 2.53 mm (sd: 0.49), respectively, with an intraobserver intraclass correlation coefficient of 0.93 (95% CI 0.88 to 0.96). The mean buccal bone thickness of the first measurement and the second measurement of observer 2 was 2.41 mm (sd: 0.47) and 2.52 mm (sd: 0.47), respectively, with an intraobserver intraclass correlation coefficient of 0.96 (95% CI 0.93 to 0.97). CONCLUSIONS: Applying the methods used in this study, CBCTs are suitable for reliable and reproducible measurements of buccal bone thickness at implants

Melvin solution with a dilaton potential

We find new Melvin-like solutions in Einstein-Maxwell-dilaton gravity with a Liouville-type dilaton potential. The properties of the corresponding solution in Freedman-Schwarz gauged supergravity model are extensively studied. We show that this configuration is regular and geodesically complete but do not preserve any supersymmetry. An exact solution describing travelling waves in this Melvin-type background is also presented.Comment: 12 pages, LaTeX, no figure

Buccal bone thickness at dental implants in the maxillary anterior region with large bony defects at time of immediate implant placement:A 1-year cohort study

Background There is lack of studies regarding preservation and possible changes in BBT at dental implants. Purpose To assess, on cone beam computer tomograms, the presence of bone at the time of tooth extraction in the maxillary esthetic region and the mean buccal bone thickness 1 month and 1 year after final restoration placement in patients with large bony defects. Material and Methods In a cohort study, patients were selected presenting a failing tooth with a large bony defect (test group [n = 20]: large bony defect, immediate placed implant and delayed provisionalization). Results were compared with a group in which patients presented a failing tooth without or with a small bony defect: (control group [n = 20]: without or small bony defect, immediate placed implant and delayed provisionalization). Cone beam computer tomograms were made preoperatively, and 1 month and 1 year after placement of the restoration, and buccal bone thickness was analyzed. Results In both groups approximately 1 mm of buccal bone thickness was present after 1 month and 1 year, without a significant difference between the groups. Conclusion In patients with large bony defects at a failing tooth it was possible to create a bone layer buccally of the implant and this bone layer remained stable during a 1-year follow-up; there were no significant differences between thickness of buccal bone at 1 month and 1 year in patients with large buccal bony defects and patients without or with small bony defects

Immediate placement of single implants with or without immediate provisionalization in the maxillary aesthetic region:A 5-year comparative study

Aim To compare marginal bone level changes around immediately placed and immediately provisionalized implants with immediately placed and delayed provisionalized implants in the aesthetic region after five years of function. Materials and Methods Forty patients with a failing tooth in the maxillary anterior region were randomly assigned immediate implant placement with immediate (Group A: n = 20) or delayed (Group B: n = 20) provisionalization. Definitive crown placement occurred three months after provisionalization. The primary outcomes were changes in marginal bone level. In addition, survival rates, buccal bone thickness, soft peri-implant tissues, aesthetics and patient-reported outcomes were assessed. Results After 5 years, the mean mesial and distal marginal bone level changes were 0.71 +/- 0.68 mm and 0.71 +/- 0.71 mm, respectively, in group A and 0.49 +/- 0.52 mm and 0.54 +/- 0.64 mm, respectively, in group B; the difference between the groups was not significant (p = .305 and p = .477, respectively). Implant and restoration survivals were 100%. No clinically relevant differences in buccal bone thickness or in mid-facial peri-implant mucosal level, aesthetic and patient outcomes were observed. Conclusions The mean marginal bone level changes following immediate implant placement and provisionalization were comparable with immediate implant placement and delayed provisionalization. (: ISRCTN57251089 and : NL8255)

Immediate single-tooth implant placement with simultaneous bone augmentation versus delayed implant placement after alveolar ridge preservation in bony defect sites in the esthetic region:A 5-year randomized controlled trial

Background It is unclear if an intact buccal bony plate is a prerequisite for immediate implant placement in post-extraction sockets. The aim of this 5-year randomized controlled trial was therefore comparison of peri-implant soft and hard tissue parameters, esthetic ratings, and patient-reported satisfaction of immediate implant placement in post-extraction sockets with buccal bony defects of >= 5 mm in the esthetic zone, with delayed implant placement after ridge preservation. Methods Patients presenting a failing tooth in the esthetic region and a buccal bony defect of >= 5 mm after extraction were randomly assigned to immediate (Immediate group, n = 20) or delayed (Delayed group, n = 20) implant placement. Second-stage surgery and placement of a provisional restoration occurred 3 months after implant placement in both groups, followed by definitive restorations 3 months thereafter. The follow-up was 5 years. Marginal bone level (primary outcome), buccal bone thickness, soft tissue parameters, esthetics, and patient-reported satisfaction were recorded. Results Mean marginal bone level change was -0.71 +/- 0.35 mm and -0.54 +/- 0.41 mm in respectively the Immediate group and the Delayed group after 5 years (P = 0.202). This difference, and in other variables, was not significant. Conclusions Marginal bone level changes, buccal bone thickness, clinical outcomes, esthetics, and patients' satisfaction following immediate implant placement, in combination with bone augmentation in post-extraction sockets with buccal bony defects of >= 5 mm, were comparable to those following delayed implant placement after ridge preservation in the esthetic zone

High-Frequency Gravitational Waves from Spinning Non-Abelian Cosmic-Strings

We investigated the SU(2) Einstein-Yang-Mills system on a time-dependent non-diagonal cylindrical symmetric space-time. From the numerical investigation, wave-like solutions are found, consistent with the familiar string-like features. They possess an angle-deficit which depends on the initial form of the magnetic component of the YM field, i.e., the number of times it crosses the r-axis. The soliton-like behavior of the gravitational and YM waves show significant differences from the ones found in the Einstein-Maxwell system. The stability of the system is analyzed using the multiple-scale method. To first order a consistent set of equations is obtained.Comment: 26 pages in Revtex+ 10 eps figures. The other pictures can be obtained at http://www.asfyon.nl/slagt.html/webdoc.ht