Establishment of a new rehabilitation program using masticatory training food for jaw deformity patients

Background/purpose: Patients with jaw deformities may show a reduction in masticatory function as a result of postoperative hypofunction. This study aimed to establish a novel rehabilitation program using a commercially available masticatory training food for patients with jaw deformities after orthognathic surgery. Materials and methods: Nine patients with mandibular prognathism (the training group: n = 5, and the non-training group: n = 4) and 6 control participants with normal occlusion were included in this study. For the rehabilitation program with masticatory exercise, patients were instructed to chew the training food once a day for 60 days starting from 10 days after the surgery. The effects of the rehabilitation program were assessed by determining the maximum bite force (MBF) and the masticatory performance (MP). Clinical assessments were performed just before orthognathic surgery (Pre) and at 10 days (T0), 1 month (T1), 2 months (T2), and 3 months (T3) after surgery. Results: Compared with the non-training group, the training group showed a trend toward greater recovery amount of MBF from Pre to T3, and a significantly greater recovery amount in MP (p < 0.05) from Pre to T3. When the time-series change of MP was evaluated in both groups from T0 to T3, a significant difference was observed in the interaction terms (p = 0.03). This result indicates that the effectiveness of the training may be demonstrated by following the postoperative course further. Conclusion: The rehabilitation using this training food may become a useful method for postoperative hypofunction in patients with jaw deformities

Utilização exames de tomografia computadorizada da maxila e mandíbula e sua correlação com as vértebras cervicais objetivando o rastreamento de pacientes com risco de osteoporose

Objetivos: avaliar a correlação da densidade mineral óssea (DMO) da maxila e mandíbula com as vértebras cervicais, utilizando unidades de Hounsfield (HU), utilizando tomografia computadorizada (TC) multislice, para verificar se a TC pode ser útil como ferramenta de rastreamento da osteoporose. Métodos: 79 exames de tomografia computadorizada multislice de pacientes que foram submetidos a CTs de maxila, mandíbula e vértebras cervicais simultaneamente foram incluídos. As seguintes regiões anatômicas esquerda e direita foram avaliadas: ramo da mandíbula; cabeça mandibular; a área abaixo do primeiro molar inferior e a área abaixo das cúspides superiores. HU foram medidos em cada área usando uma região de interesse (ROI) de 0.1cm posicionada no centro do corte tomográfico. Resultados: Foi encontrada uma correlação significativa entre a coluna cervical e a região posterior da mandíbula, bem como uma correlação significativa entre a região anterior da maxila e a coluna cervical. No entanto, nenhuma correlação foi encontrada entre a coluna cervical e outros locais da mandíbula, como o ramo mandibular e a cabeça. Conclusões: Como os valores de HU do osso anterior e posterior da mandíbula se correlacionam com os valores de HU do osso cervical, este exame pode ser aplicado a ferramentas de rastreio da osteoporose.Objectives: to evaluate the correlation of the bone mineral density (BMD) from maxilla and mandible with that of the cervical vertebrae, using Hounsfield units (HU) and multislice computed tomography (CT) to verify whether CT could be a useful osteoporosis screening tool. Methods: 79 multislice CT examinations from patients who underwent CT examinations of maxilla, mandible and cervical vertebrae simultaneously were included. The following left and right anatomical regions were assessed: mandible ramus; mandible head; the area below the inferior first molar and the area below the upper cuspids. HU were measured in each area using a 0.1 cm region of interest (ROI) positioned in the center of the slice. Results: a significant correlation between the cervical spine and the posterior region of the mandible was found, as well as a significant correlation between the anterior maxilla and the cervical spine. However, no correlation was found between the cervical spine and other parts of the mandible, such as ramus and head of mandible. Conclusions: As anterior maxillary bone and posterior mandible bone HU values correlate with cervical bone HU values, this examination may be applied as osteoporosis screening tool

Case of Unilateral Peripheral Cone Dysfunction

Purpose: Peripheral cone dystrophy is a subgroup of cone dystrophy, and only 4 cases have been reported. We present a patient with unilateral peripheral cone dysfunction and report the functional changes determined by electrophysiological tests and ultrastructural changes determined by spectral domain optical coherence tomography (SD-OCT). Case: A 34-year-old woman complained of blurred vision in both eyes. Our examination showed that her visual acuity was 0.05 OD and 0.2 OS. A relative afferent pupillary defect was present in her right eye. The results of slit-lamp examination, ophthalmoscopy, and fluorescein angiography were normal except for pallor of the right optic disc. SD-OCT showed a diffuse thinning of the retina in the posterior pole of the right eye. A severe constriction of the visual fields was found in both eyes but more in the right eye. The photopic full-field electroretinograms (ERGs) were reduced in the right eye but normal in the left eye. The multifocal ERGs were severely reduced throughout the visual field except in the central area of the right eye. The multifocal ERGs from the left eye were normal. The pattern visual evoked responses were within the normal range in both eyes. She had a 5-year history of sniffing paint thinner. Results: Although the visual dysfunction was initially suspected to be due to psychological problems from the results of subjective tests, objective tests indicated a peripheral cone dysfunction in the right eye. The pathophysiological mechanism and the relationship with thinner sniffing were not determined. Conclusions: Our findings indicate that peripheral cone dysfunction can occur unilaterally. Electrophysiology and SD-OCT are valuable tests to perform to determine the pathogenesis of unusual ocular findings objectively

Fish mesonephric model of polycystic kidney disease in medaka (Oryzias latipes) pc mutant

Fish mesonephric model of polycystic kidney disease in medaka (Oryzias latipes) pc mutant.BackgroundPolycystic kidney disease (PKD) is a common hereditary disease. A number of murine and zebrafish mutants have been generated and used for the study of PKD as metanephric and pronephric models, respectively. Here, we report a medaka (Oryzias latipes) mutant that develops numerous cysts in the kidney in adulthood fish in an autosomal-recessive manner as a mesonephric model of PKD.MethodsThe phenotypes of the medaka pc mutant were described in terms of morphologic, histologic, and ultrastructural features. The pc see-through stock was produced by crossing a pc mutant and a fish from the see-through stock and used for observing the kidney through the transparent body wall of a live fish.ResultsThe mutant developed bilateral massive enlargement of the kidney in adulthood. They sexually matured normally within 2 months of age and died within 6 months of age. The affected kidney was occupied by numerous, fluid-filled cysts, which were lined by attenuated squamous epithelial cells. Developmentally, cystic formation began in the pronephros in 10-day-old fry and in the mesonephros in 20-day-old fry at the microscopic level. The pc see-through stock was useful in observing disease progression in live fish.ConclusionThe kidney disorder that develops in the medaka pc mutant is a mesonephric counterpart of PKD, particularly an autosomal-dominant PKD, based on its morphologic, histologic, and ultrastructural features, and slow progression

Evaluation of basilar expansion and internal septa of human sphenoidal sinus using cone beam computed tomography

The objective of this study was to assess the types and frequencies of basilar expansion of the sphenoidal sinus and internal septa by using cone beam computed tomography. Archived images from 300 adult subjects of both genders were retrieved. A descriptive analysis relating age and gender to basilar expansion of the sphenoidal sinus and internal septa types and frequencies was performed. The associations between basilar expansion of the sphenoidal sinus, internal septa and gender for each age group were assessed using the chi-square test or Fisher’s exact test. Among all the images evaluated, 69% showed basilar expansion of the sphenoidal sinus, of which 81% were considered critical. Internal septa were observed in 60% of the images. There was no relationship between the presence of basilar expansion of the sphenoidal sinus and gender and age. Internal septa were independent of gender; however, of the subjects older than age 40, 36% had only a main septum, 6% had accessory septa, and 18% had both types of septa. Cone beam computed tomography is an accurate method that should be considered for the evaluation of this anatomic segment in order to avoid unnecessary exposure to radiation.O objetivo deste estudo foi avaliar os tipos e as frequências de expansão basilar do seio esfenoidal e septos internos utilizando tomografia computadorizada de feixe cônico. Imagens arquivadas de 300 indivíduos adultos de ambos os gêneros foram recuperadas. Foi realizada uma análise descritiva relacionando idade e gênero à expansão basilar do seio esfenoidal e a tipos de septos internos e frequências. As associações entre expansão basilar do seio esfenoidal, septos internos e gênero para cada grupo de idade foram avaliadas por meio do teste do qui-quadrado ou teste exato de Fisher. Entre todas as imagens avaliadas, 69% apresentaram expansão basilar do seio esfenoidal, das quais 81% foram consideradas críticas. Septos internos foram observados em 60% das imagens. Não houve relação entre presença de expansão basilar do seio esfenoidal, gênero e idade. Septos internos apresentaram-se independentes do gênero; no entanto, dentre os indivíduos com mais de 40 anos de idade, 36% tinham apenas um septo principal, 6% tinham septos acessórios, e 18% tinham ambos os tipos de septos. A tomografia computadorizada é um método preciso que deve ser considerado para a avaliação desse segmento anatômico a fi m de evitar a exposição desnecessária à radiação

Calcificação da cartilagem tritícea: características radiográficas

A cartilagem tritícea (TC) é uma pequena cartilagem de formato oval localizada na borda lateral da membrana tireo-hioidea entre o corno maior do osso hioide e o corno superior da cartilagem tireoide. A função exata do TC é desconhecida; sugere-se que a TC é o local de inserção do músculo trireoglosso. Nas radiografias panorâmicas, a TC pode apresentar-se calcificada, posicionando-se inferiormente ao corno maior do osso hioide e adjacente à borda superior da vértebra C4. O principal diagnóstico diferencial da calcificação da TC é a presença de ateroma calcificado da carótida, o que requer investigações imagiológicas adicionais. Este relato descreve e discute três casos em que as calcificações da TC foram incidentalmente encontradas em radiografias panorâmicas.The triticeal cartilage (TC) is a tiny oval-shaped cartilage located at the lateral border of the thyrohyoid membrane between the hyoid bone greater horn and the thyroid cartilage superior horn. The exact function o TC is unknown; it has been proposed that TC was the site of the attachment for the triticeoglossus muscle. On panoramic radiographs, calcified TC may be observed in the soft tissues of the pharynx region, positioned inferior to the greater horn of the hyoid bone and adjacent to the superior border of the C4 vertebrae. The major concern of a calcified TC found incidentally in a routine radiographic examination is the differentiation between this alteration and other calcified tissue manifestations that require additional investigations, such as carotid calcified atheroma artery or other neck pathology such as foreign bodies. Thus, this report describes 3 cases in which TC calcifications were incidentally found in panoramic radiographs

Canalis Sinuosus and radiographic procedures in the region of anterior maxilla

The Canalis Sinuosus (CS) is known as an anatomical variation of anterior superior alveolar nerve being a neurovascular bundle. Frequently, the anterior maxillary region receives surgical interventions of different specialties. The knowledge concerning anatomical structures in this region, is crucial to reach predictable and safe surgical procedures. The overlapping of anatomical structures in conventional imaging examinations have a limit in observing neurovascular canal, such as the CS. Thus, Cone Beam Computed Tomography (CBCT) images may give a great support in preoperative planning, since it allows the three-dimensional reconstruction of the anatomical details of its structures. In this report, the author describes an implant rehabilitation that may have possibly injured the anterior superior alveolar nerve

Assessment of Panoramic Radiomorphometric Indices of the Mandible in a Brazilian Population

The aim of this study was to evaluate radiomorphometric indices in dental panoramic radiographs in order to identify possible interrelationships between these indices and the sex and age of the patients analyzed. The study included 1287 digital panoramic radiographic images of patients that were grouped into five age groups (1 = age 17–20; 2 = age 21–35; 3 = age 36–55; 4 = age 56–69; 5 = over age 70). Two indices—cortical width at the gonion (GI) and below the mental foramen (MI)—were measured bilaterally in all panoramic radiographs. Statistical analysis was performed with Kruskal-Wallis and Mann-Whitney tests (alpha = 0.05). Results for the indices measurements showed significant differences among patient age groups of both sexes, considering that groups 4 and 5 presented lower values for the cortical width of both indices. The present paper supports the role of sex- and age-related changes in mandibular radiomorphometric indices in identifying skeletal osteopenia

医療を受ける子どもに対するプレパレーションの文献概観 : 2002年～2005年の文献を通して

本論では、日本のプレパレーションの現状について、学術論文を対象に内容の考察を行った。課題を明らかにし、今後の医療者の関わりについて検討した。現在日本でもプレパレーションの理念が普及し、医療機関などにおいて研究されている。しかし、狭義のプレパレーションまでの研究が多く、ディストラクションや処置後の遊びの研究は少ないため、意識的にこれらの関わりを行っていくことが課題である。幼児期後半を対象とした研究が多いが、倫理的観点から、全年齢においてプレパレーションを行うことが望まれる。幼児期前半以前を対象としたプレパレーションが今後の課題となる。また、特にディストラクションツールの開発が必要である