Craniofacial disorders in the course of Tourette’s syndrome - a review of the literature

INTRODUCTION: Tourette's syndrome is a neurological disorder in which the patient presents first symptoms, such as motor and voice tics, in childhood. If the disease significantly impairs proper functioning in society, symptomatic treatment is applied. Antipsychotics, dopaminergic receptor blockers, VMAT2 inhibitors, and non-pharmacological treatment are used, leading to a reduction in the incidence of tics by up to 50%. AIMS: The aim of the work is to present the symptoms of the disease, in particular concerning the craniofacial region and the possibility of implementing any treatment. MATERIALS AND METHODS: All data comes from the analysis of the PubMed database. The paper presents cases in which the structures of the oral cavity, eyes and the brain have been damaged. DESCRIPTION OF THE STATE OF KNOWLEDGE: Treatment with TS must take place on many levels and includes pharmacological and non-pharmacological treatment, therefore, patient care should be interdisciplinary.involving specialists such as psychologists, nutritionists, neurologists, anesthesiologists and dentists. The task of such a team is to diagnose the Tourette syndrome, improve patients quality of life, even by limiting the effects of medications (weight gain) or specialist treatment of damage and discomfort caused by symptoms. Psychological therapy remains the primary one, which is why a qualified team of psychologists and psychotherapists is important. Dentists are an important part of the interdisciplinary team, due to the high frequency of tics covering the oral cavity and the associated consequences. Decisions on treatment should be established jointly, referring to a comprehensive look at individual needs and priorities in patient therapy. SUMMARY: It was found that there is a variety of types and intensity of tics in patients with Tourette's syndrome. The clinical team supervising such a patient should be an interdisciplinary team including dentists, neurologists, psychologists or orthopedics to provide patients with comprehensive and multidirectional treatment

Epidemiology of mandibular fractures - frequency and trauma pattern comparison in seventies of twentieth century with modern times (2002-2012)

Introduction: Mandibular fractures are a group of most common trauma with which maxillofacial surgeons have to deal in their clinical practice. Aim of the study: Analysis of mandibular fractures epidemiology in the group of patients treated in the Clinic of Maxillofacial Surgery at Poznan University of Medical Science between 2002 and 2012 and comparison of results with data from the period 1961-1974. Material and methods: Material consisted of medical documentation of patients treated in the Clinic of Maxillofacial Surgery in Poznan due to mandibular fractures between 2002 and 2012. 1990 patients experienced mandibular trauma but only 1701 cases were described precisely enough to take part in the analysis. The population of patients were divided by sex and age (16th year of life was the border of the divide). Using this data, the amount of single and multi-fragmental fractures, percentage distribution of fractures among anatomical structures of the mandible, frequency of fractures in age groups and seasons of the year were calculated. Then, results were compared with a publication about the epidemiology of mandibular fractures between 1961-1974. Results: The population of 1701 patients consisted of 1426 males, 235 females and 40 children up to 16 years old (25 boys and 15 girls). Male to female ratio was 6,13:1. Most fractures affected patients at an age between 20 and 30 years old, regardless of sex. On average, 199 hospitalization due to mandibular fractures a year had a place in a period of 2002-2012 (involving all cases). Most of the hospitalizations due to mandibular fractures occurred between April and September. From 2002 to 2012, 1864 anatomical structures were broken. Body (783), left angle (274), right condyle (241), left condyle (239) and right angle (195) were structures that were fractured most often. 895 (52,62%) cases were single fractures , 806 (47,38%) were multi-fragmental fractures. The greater the average amount of patients a year, the reduction of male to female ratio, single fractures to multi-fragmental fractures ratio is about 1:1, left angle in the group of most frequently fractured structures are the main differences between period 1961-1974 and 2002-2012. Conclusion: Analysis indicates that the epidemiology of mandibular fractures is a complex problem. Some elements are constant but other changes dynamically across time. In the opinion of abroad scientists, the development of technology, motorization, and changes in human behavior are the main reasons for such evolution

Evaluation of the position variation of mandibular foramen

INTRODUCTION: Mandibular foramen is located on the internal surface of the ramus of the mandible. Through this opening mandibular nerve and vessels enter the mandibular canal. As there are no palpable landmarks that allow determining the position of the mandibular foramen precisely, it is helpful to use radiological imaging methods for this purpose. Mainly X-ray techniques are used, especially panoramic radiograph for its accessibility and wide range of diagnostic applications. Knowledge of the position of the mandibular foramen is essential for the correct and effective performance of the inferior alveolar nerve block, which is one of the most common anaesthesia in dental practice. AIMS: The purpose of the study was to examine and find possible correlations between sex, age, posterior teeth loss and relative localization of the mandibular foramen. SUBJECTS AND METHODS: Selected parameters were measured on 50 digital panoramic radiographic images of 50 patients, including 33 males and 17 females, hospitalized in the Maxillofacial Surgery Ward of the Heliodor Swiecicki Clinical Hospital in Poznan. RESULTS: Localization of the mandibular foramen does not correlate with age, nor the posterior teeth loss and sex has only a slight impact on its vertical location. CONCLUSIONS: Since none of the parameters proved to be particularly useful in predicting the location of the mandibular foramen. The operator should administer inferior alveolar nerve anaesthesia in accordance with standard rules

Machine learning methods as an aid in planning orthodontic treatment on the example of Cone-Beam Computed Tomography analysis: a literature review

Convolutional neural networks (CNNs) are used in many areas of computer vision, such as object tracking and recognition, security, military, and biomedical image analysis. In this work, we describe the current methods, the architectures of deep convolutional neural networks used in CBCT. Literature from 2000-2020 from the PubMed database, Google Scholar, was analyzed. Account has been taken of publications in English that describe architectures of deep convolutional neural networks used in CBCT. The results of the reviewed studies indicate that deep learning methods employed in orthodontics can be far superior in comparison to other high-performing algorithms

Botulinum toxin type A as an alternative way to treat trigeminal neuralgia: a systematic review

Introduction. Trigeminal neuralgia (TN) is one of the most common neurological diseases involving the orofacial region. It affects mainly the older population, usually after the age of 60, and more commonlywomen. It involves the fifth cranial nerve and manifests as paroxysmal, unilateral, severe, shock-like or knife-like pain of from a second to two minutes’ duration. Usually pain attacks arise spontaneously, but they can also be precipitated by triggers such as cold weather, brushing teeth or shaving. The ICHD-3 classification divides TN into classical, secondary and idiopathic. Current treatment includes pharmacological and surgical methods. Anticonvulsants, such as carbamazepine and oxcarbazepine, are the first line therapy. Microvascular decompression is the most common and most effective way to treat TN surgically.However, none of these methods is free from complications. Moreover, 25–50% of patients became refractory to drug therapy. Some studies have shown that a new therapy that uses a Botulinum toxin type A can be a safe and effective way to treat trigeminal neuralgia.Methods. Literature from the PubMed base and the Main Medical Library from the last 18 years was analysed. Forty-three items were obtained; after verification, seven articles were included.Aim of the study. To look at current guidelines about treating trigeminal neuralgia with Botulinum Toxin type A in patients who are refractory to drug therapy or who do not want to undergo surgical treatment.Conclusion. BoNT-A therapy is a safe and effective method of treating trigeminal neuralgia

Craniofacial disorders in the course of Angelman syndrome - a review of the literature

Angelman syndrome is a neurogenetic disorder with an estimated prevalence of 1 in 10.000 to 1 in 40.000 cases. Clinical presentation is based on characteristic neurobehavioral and emotional disorders, a function of the nervous and pulmonary system as well as dysmorphic features within craniofacial and neurocranium. The aim of the study is an evaluation based on the literature reviewing disorders in the craniofacial region in patients with Angelman Syndrome, with particular emphasis on the oral cavity. Literature from the PubMed base and the Main Medical Library from the last 30 years was analysed. sixteen items were obtained; after verification,  the requirements were met by 16 publications, which together contained a description of the craniofacial and oral cavity disorders in 226 patients. Disorders associated with Angelman syndrome affected many aspects related to health, basic life functions and interpersonal relationships. Proper substantive preparation for working with such a patient enables effective prevention and health monitoring, adjustment of the treatment plan, as well as readiness for any unexpected situations.</p

The Influence of Parent Education on the Neurobehavior and Sucking Reflexes of Very Preterm Infants

The diagnosis of neurobehavioral problems in very preterm neonates helps with planning and applying proper and direct therapeutic interventions. (1) Background: The aim of this study was to determine the direct impact of neurobehavior on the sucking reflex and eating abilities of neonates. (2) Methods: We assessed 18 preterm neonates twice hospitalized at the Gynecology and Obstetrics Clinical Hospital through the use of the Neonatal Behavioral Assessment Scale (NBAS). (3) Results: We found that that a neonate’s sucking ability positively correlated with the activity level item from the motor system cluster of the NBAS. (4) Conclusions: Neurobehavior should be closely assessed in very preterm neonates. Firstly, because assessments can detect fundamental problems and help a practitioner plan for early intervention. Secondly, the education of parents regarding the neurobehavior of their child can help in the facilitation of feeding skills and the planning of early rehabilitation

The Evaluation of Facial Muscles by Surface Electromyography in Very Preterm Infants

Background: It is reported that 40% of preterm infants have problems with eating. Neonatal feeding disorders may be one of the factors increasing neonatal mortality. The aim of our study was to evaluate the muscles involved in suckling and swallowing in premature newborns using surface electromyography (sEMG). We would like to objectively describe the tension of muscles engaged in feeding in order to properly plan the therapy. Another aim was to compare sEMG measurements to gestational age, birth weight, and umbilical blood pH to show which parameters put children at risk of feeding problems. Methods: Sixteen preterm neonates with gestational age less than 32 weeks, birth weight less than 1500 g, and oral feeding difficulties were analyzed for muscle response and electrical activity of nerves using sEMG (surface electromyography). Results: We found a negative correlation indicating that preterm infants with a younger gestational age had higher suprahyoid muscle tension, and a positive correlation was found between pH value and suprahyoid muscles. The lower the pH value, the lower the tension in the suprahyoid muscles. Conclusions: sEMG may be a helpful diagnostic tool in the evaluation of the masticatory system of premature infants. Due to the abnormal tone of the muscles responsible for swallowing, it is advisable to rehabilitate as early as possible

The Importance of Monitoring Neurodevelopmental Outcomes for Preterm Infants: A Comparison of the AIMS, GMA, Pull to Sit Maneuver and ASQ-3

Background: Clinicians and parents should closely monitor the neurodevelopment of very preterm infants. The aim of our study was to compare whether neurodevelopmental assessments completed by parents and those done by specialists yielded similar outcomes. We wanted to check whether the assessments completed by specialists and parents were comparable in outcomes to emphasize the important roles of early assessment of a child and of the parents in their child&rsquo;s treatment and medical care. Another aim was to check whether or not the pull to sit maneuver from the Neonatal Behavioral Assessment Scale (NBAS) is still a parable item in well-known scales of neurodevelopment. Methods: We assessed 18 preterm neonates in the fourth month of corrected age with scales such as the General Movement Assessment (GMA), the Alberta Infant Motor Scale (AIMS), and the pull to sit maneuver from the NBAS. Finally, we asked parents to complete the Ages and Stages Questionnaire, Third Edition (ASQ-3). Results: We found that the respective assessments completed by specialists and parents are comparable in outcomes. We also found that the pull to sit item from the NBAS was still a valid test since it showed similar findings to those from the AIMS, the GMA, and the ASQ-3. Conclusions: The pull to sit item from the NBAS is an important item for assessment of very preterm infants. Specialists should also take into consideration the input and concerns of parents when planning for treatment and intervention