Evaluation of the Demineralization Development around Different Types of Orthodontic Brackets

The aim of this study was to compare the demineralizations of the enamel surfaces around different types of orthodontic brackets in an artificial cariogenic environment. A total of 90 extracted human maxillary first premolar teeth were used in this in vitro study. The teeth were divided into 6 groups, 5 study and 1 control, each consisting of 15 samples. Victory metal, Gemini metal, Clarity self-ligating ceramic, APC Clarity Advanced ceramic and Clarity Advanced ceramic brackets (3M Unitek, Monrovia, Calif) used in the study groups were bonded to the teeth with the direct technique. The gingival, occlusal and proximal enamel surfaces adjacent to the brackets were measured with a DIAGNOdent pen (KaVo, Biberach, Germany) (T0). Then, the teeth were placed in a cariogenic suspension environment containing Streptococcus mutans, sucrose and artificial saliva. The teeth were removed from the cariogenic suspension at the end of 28 days. Enamel surfaces were remeasured with DIAGNOdent and the values were recorded (T1). Whether the obtained data were homogeneously distributed or not was determined by the Kolmogorov-Smirnov test, within-group comparisons were performed with the Wilcoxon test, and between-group comparisons were performed with Mann-Whitney U and Kruskal-Wallis tests. Significance level was accepted as p < 0.05. In all groups, the demineralization values of the enamel surfaces in the gingival, proximal and occlusal surfaces adjacent to the brackets were significantly higher in the T1 period than in the T0 period (p < 0.05). In the T1 period of Gemini metal, Clarity self-ligating ceramic and Clarity advanced ceramic bracket groups, the demineralization values of the proximal enamel surfaces were found to be significantly higher than the Victory metal and APC Clarity Advanced ceramic bracket groups (p < 0.05). In the T1 period, the demineralization values of the occlusal enamel surfaces of the Victory metal, APC Clarity Advanced ceramic bracket groups and control group were significantly lower than the Gemini metal, Clarity self-ligating ceramic and Clarity Advanced ceramic bracket groups (p < 0.05). Significant increases in enamel demineralization values were observed as a consequence of increased retention areas for microbial dental plaque on enamel surfaces adjacent to the bracket. Considering the importance of minimizing enamel demineralization in fixed orthodontic treatments, less enamel demineralization in Victory metal and APC Clarity Advanced ceramic bracket groups showed that these brackets can be preferred in patients with poor oral hygiene

Older age bipolar disorder

PURPOSE OF REVIEW: Older age bipolar disorder (OABD) refers to patients with bipolar disorder aged 50 years and over. There is a paucity of evidence-based guidelines specific to OABD, but in recent years, several studies have been published on OABD. The current review synthesizes previous literature (up to January 1, 2021) as well as most recent literature on OABD (since January 1, 2021). RECENT FINDINGS: This review covers the following themes: diagnosis and specifiers, clinical course, psychosocial functioning, cognition, physical comorbidities, and pharmacotherapy. On the basis of the latest data, specific clinical recommendations are proposed for each theme. SUMMARY: OABD forms a more complex subgroup of bipolar disorder, with an increased risk of cognitive deficits, physical comorbidities, impaired psychosocial functioning, and premature death. The distinctions between BD-I and BD-II and between EOBD and LOBD do not clinically represent relevant subtypes for OABD patients. Mental healthcare professionals should treat all OABD patients with an integrative care model that takes into account cognitive and physical comorbidities and that contains elements aimed at improvement of psychosocial functioning and quality of life. Older age itself should not be a reason to withhold lithium treatment. Future research should collect data on essential data domains using validated measurement scales

Retrospective analysis of the incidence of intracranial physiological calcifications with cone beam computed tomography

Background: The purpose of the present study was to evaluate the incidence of physiologic intracranial calcifications detected in cone beam computed tomography (CBCT) images of in a group Turkish Cypriot population.Methods: The CBCT scans of the full head of 100 patients that met our ascertainment criteria were evaluated retrospectively for the presence of physiological intracranial calcifications.Results: Intracranial calcification was found in 71 cases of 100 patients. The most common site of calcification was habenular with 48% followed by %14 caroticoclinoid ligament, 13% interclinoid ligament and 8% choroid plexus. In our study, petroclinoid ligament calcification was not observed at all.Conclusion: CBCT is widely used in many scientific investigations and anatomical studies. Intracranial physiological calcification are frequent incidental findings of CBCT scans.KEYWORDS CBCT, intracranial calcifications, petroclinoid ligament, habenul

Functioning in older adults with bipolar disorder: A report on recommendations by the International Society of bipolar disorder (ISBD) older adults with bipolar disorder (OABD) task force

OBJECTIVES: Despite the importance of psychosocial functioning impairment in Bipolar Disorder (BD), its role among Older Adults with BD (OABD) is not well known. The development of guidelines for the assessment of psychosocial functioning helps to facilitate a better understanding of OABD and can lead to better tailored interventions to improve the clinical outcomes of this population. METHODS: Through a series of virtual meetings, experts from eight countries in the International Society of Bipolar Disorder (ISBD) on OABD task force developed recommendations for the assessment of psychosocial functioning. RESULTS: We present (1) a conceptualization of functioning in OABD and differences compared with younger patients; (2) factors related to functioning in OABD; (3) current measures of functioning in OABD and their strengths and limitations; and, (4) other potential sources of information to assess functioning. CONCLUSIONS: The task force created recommendations for assessing functioning in OABD. Current instruments are limited, so measures specifically designed for OABD, such as the validated FAST-O scale, should be more widely adopted. Following the proposed recommendations for assessment can improve research and clinical care in OABD and potentially lead to better treatment outcomes

Sex Differences Among Older Adults With Bipolar Disorder: Results From the Global Aging & Geriatric Experiments in Bipolar Disorder (GAGE-BD) Project

OBJECTIVE: Sex-specific research in adult bipolar disorder (BD) is sparse and even more so among those with older age bipolar disorder (OABD). Knowledge about sex differences across the bipolar lifespan is urgently needed to target and improve treatment. To address this gap, the current study examined sex differences in the domains of clinical presentation, general functioning, and mood symptoms among individuals with OABD. METHODS: This Global Aging & Geriatric Experiments in Bipolar Disorder (GAGE-BD) study used data from 19 international studies including BD patients aged ≥50 years (N = 1,185: 645 women, 540 men).A comparison of mood symptoms between women and men was conducted initially using two-tailed t tests and then accounting for systematic differences between the contributing cohorts by performing generalized linear mixed models (GLMMs). Associations between sex and other clinical characteristics were examined using GLMM including: age, BD subtype, rapid cycling, psychiatric hospitalization, lifetime psychiatric comorbidity, and physical health comorbidity, with study cohort as a random intercept. RESULTS: Regarding depressive mood symptoms, women had higher scores on anxiety and hypochondriasis items. Female sex was associated with more psychiatric hospitalizations and male sex with lifetime substance abuse disorders. CONCLUSION: Our findings show important clinical sex differences and provide support that older age women experience a more severe course of BD, with higher rates of psychiatric hospitalization. The reasons for this may be biological, psychological, or social. These differences as well as underlying mechanisms should be a focus for healthcare professionals and need to be studied further

Bipolar symptoms, somatic burden and functioning in older-age bipolar disorder: A replication study from the global aging & geriatric experiments in bipolar disorder database (GAGE-BD) project

Objectives: The Global Aging & Geriatric Experiments in Bipolar Disorder Database (GAGE-BD) project pools archival datasets on older age bipolar disorder (OABD). An initial Wave 1 (W1; n = 1369) analysis found both manic and depressive symptoms reduced among older patients. To replicate this finding, we gathered an independent Wave 2 (W2; n = 1232, mean ± standard deviation age 47.2 ± 13.5, 65% women, 49% aged over 50) dataset. Design/Methods: Using mixed models with random effects for cohort, we examined associations between BD symptoms, somatic burden and age and the contribution of these to functioning in W2 and the combined W1 + W2 sample (n = 2601). Results: Compared to W1, the W2 sample was younger (p < 0.001), less educated (p < 0.001), more symptomatic (p < 0.001), lower functioning (p < 0.001) and had fewer somatic conditions (p < 0.001). In the full W2, older individuals had reduced manic symptom severity, but age was not associated with depression severity. Age was not associated with functioning in W2. More severe BD symptoms (mania p ≤ 0.001, depression p ≤ 0.001) were associated with worse functioning. Older age was significantly associated with higher somatic burden in the W2 and the W1 + W2 samples, but this burden was not associated with poorer functioning. Conclusions: In a large, independent sample, older age was associated with less severe mania and more somatic burden (consistent with previous findings), but there was no association of depression with age (different from previous findings). Similar to previous findings, worse BD symptom severity was associated with worse functioning, emphasizing the need for symptom relief in OABD to promote better functioning

Balancing the highs and lows: Diagnostics, understanding and treatment of recurrence in older adults with bipolar disorder

The first aim of this thesis was to expand our knowledge on the diagnostics and assessment methods in OABD. With this aim, we first examined whether different depression scales can be harmonized in order to create larger datasets. Then, we examined the reliability and validity of the Functioning Assessment Short Test (FAST) for Older adults (FAST-O). Next, we compared cognitive functioning in OABD with cognitive functioning in late life depression and healthy controls. The second aim of our thesis was to create a greater understanding of the clinical phenotype in OABD and its mutual interactions. For this aim, we first examined the relationship between cognitive and social functioning in OABD. Thereafter, we studied the influence of social, psychological and cognitive factors on the clinical course in OABD. Next, we studied psychiatric symptoms during the COVID-19 outbreak in OABD and at last, we studied the course of these psychiatric symptoms in OABD during the first 6 months of the COVID-19 pandemic. Our third aim was to assess the feasibility and acceptability of new treatment approaches in OABD. We first examined a group intervention for mild cognitive impairment in OABD and thereafter we studied an intervention of group interpersonal and social rhythm therapy (IPSRT) for recurrent mood disorders. All in all, this thesis shows the population of OABD is a distinct and complex group. However, with the appropriate adjustments, currently existing diagnostic instruments and treatment strategies can be adapted in order to be used in the OABD group. There is still a lot unknown in the OABD group, but results show that progress can be gained in this field of research. Since OABD patients show great variability in clinical phenotype, it is always important to not blindly follow findings from treatment studies or guidelines and to try to never lose sight of the individual patient

Evaluation of Paranasal Sinus Septa Types, Orientations, and Angles Using Cone Beam Computed Tomography

Purpose: This study aimed to determine the characteristics of the paranasal sinus septa and evaluate the gender differences using cone beam computed tomography (CBCT). Materials and Methods: CBCT images of 300 patients were used in this study. The number, types, and orientations of septa and the angle between the septa and the midline was measured separately on the right and left side of the maxillary, frontal and sphenoid sinuses. Coronal, axial, and sagittal sections were used for evaluations. CBCT scans were taken with Newton 3G and the images were evaluated with the NNT software program. Results: As a result of the study, it was determined that the most common type of septa in the maxillary sinus was 1 septum on one side with a rate of 28.3%. While the incidence of 1 septa on one side was the highest in the frontal sinus at 28%, and also 3 septa were found on one side with a rate of 1.3%. In the sphenoid sinus, 31% of cases with 2 septa on one side and 1 septa on the other side had the highest prevalence. There was no significant difference between men and women in terms of septa orientations and angles (p˃0.05). Conclusion: CBCT is frequently used to determine anatomical structure and variations. These results provide us with information about the anatomical characteristics and variations of the evaluated population. It is important to evaluate anatomical variations with CBCT, which provides 3-dimensional imaging using low-dose radiation, to reduce the risk of complications before surgical intervention and to perform safe sinus surgery

Morphometric analysis of the infraorbital foramen, canal and groove using cone beam CT: Considerations for creating artificial organs

WOS: 000375382700004PubMed ID: 26868217Purpose: The aim of this study was to examine the anatomy and variations of the infraorbital foramen and its surroundings via morphometric measurements using cone beam computed tomography (CBCT) scans derived from a 3D volumetric rendering program. Methods: 354 sides of CBCT scans from 177 patients were examined in this study. DICOM data from these images were exported to Maxilim (R) software in order to generate 3D surface models. The morphometric measurements were done for infraorbital foramen (IOF), infraorbital groove (IOG) and infraorbital canal (IOC). All images were evaluated by 1 radiologist. To assess intra-observer reliability, the Wilcoxon matched-pairs signed rank test was used. Differences between sex, side, age and measurements were evaluated using chi-square and paired t-test and measurements were evaluated using 1-way ANOVA tests. Differences were considered significant when p0.05). No significant difference was found according to age groups (p>0.05). Conclusions: These results provide detailed knowledge of the anatomical characteristics in this particular area. CBCT imaging with lower radiation dose and thin slices can be a powerful tool for anesthesia procedures like infra orbital nerve blocks, for surgical approaches like osteotomies and neurectomies and also for generating artificial prostheses