Extraction versus non-extraction treatment of bimaxillary proclination [abstract]

Bimaxillary proclination (BP) is a relatively common malocclusion in Negroid and Mongloid populations but rarely seen in Caucasians. for this reason, orthodontic publications (in English) offer very little guidance on treatment of BP based on sound evidence. BP patients present for orthodontic treatment at the University of the West Indies School of Dentistry frequently, so a need and opportunity for research to be done to provide a better quality health service for them exists. To address this, the study described here has been proposed. The aim of this work was to determine the effects of extractions on the facial profile and relapse in patients treated for BP. Female BP patients will be treated with orthodontic fixed appliances (FAs) and compared as two groups of 50. Extractions of 4 premolars will be done before FA treatment in 50 patients; no extractions will be performed in the age and race-matched control group. Lateral cephalometric radiographs will be made: before and after FA treatment; immediately after retention is stopped; and 5 years after retention. Intra-oral measurements and dental casts (study models) will also be made at these times. Computer-aided production of composite silhoutte images from the cephalometric radiographs will be used to determine lay people's perception of facial profile changes in the two groups also. Statistical analysis of measurements made using the radiographs, silhoutte images, clinical examination and study models will be done. The results (from analysis of cephalometric measurements, lay people's perceptions, incisor irregularity, molar relationship and overjet measurements) should show whether or not extraction therapy has a deleterious effect on the facial profile and increases risk of relapse in BP patients. (AU)

A comparative study of pregnancy outcome in teenage girls and mature women

The objective was to compare the pregnancy outcome of teenage girls and mature women. The design was a retrospective study of births from January to December 1990, based on the antenatal clinic and labour ward, University Hospital of the West Indies, Jamaica. Teenage mothers, 13 to 19 years old, and a control group of mothers, 22 to 23 years old, were selected from the records of 2,394 live, singleton births between 200 and 305 days' gestation. The main outcome measures were birth weight, crown heel length, head circumference: length ratio, ponderal index and placental weight. The results showed that in the teenage group, weight body mass index at booking, haemoglobin concentration in each trimester, and minimum haemoglobin level during pregnancy were lower than in the control group. Systolic blood pressure in the first and the second trimesters was lower than in controls, but there was no significant difference in the third trimester nor in the delivery systolic blood pressure. Babies of teenage mothers had lower birth weights and smaller head circumferences than the babies of the control group, but there was no significant difference between the groups in crown heel length, ponderal index, head circumference: length ratio, and placental weight. These data support the hypothesis that teenaged girls are not physically mature and, as a consequence, their offspring have lower birth weights and smaller head circumferences (AU)

A study of nasal respiratory resistance and craniofacial dimensions in white and West Indian black children

Two studies have shown that there are morphologic differences in the nasopharynx between the major racial groups. This investigation was conducted to see whether these morphologic differences affected nasal respiration. Twenty-two West Indian and 24 white children (mean age of 13 years 11 months) were studied to examine the relationship between nasorespiratory function and nasopharyngeal and dentofacial structure. The nasorespiratory function was measured in terms of nasal respiratory resistance, NRR, (Pascals/cm3 per second), both by anterior and posterior methods, with a computerized rhinomanometer. Nasopharyngeal structure described in terms of cephalometric variables. The West Indian cephalometric profile generally conformed to its existing description in the literature including prognathic jaws and bimaxillary proclination; in addition, the West Indians were found to have a greater bony nasopharyngeal width (posterior nasal spine-basion) and shallower nasopharyngeal roof angle (posterior nasal spine-hormion-basion). All rhinomanometry were significantly lower in the West Indian group, especially when posterior rhinomanometry was used. The correlation coefficients between the cephalometric and the rhinomanometric measurements were statistically significant but low. In addition, the measure of mandibular prognathism (angle SNB) was also found to be significantly correlated with the nasorespiratory resistance (AU)

Umbilical hernias and anterior fontanelle size in Jamaican children

This cross-sectional study documents the frequent occurrence of umbilical hernias among Jamaican children and suggests, for the first time, that the prescence of an umbilical hernia may be associated with larger anterior fontanelle dimensions. It also demonstrates that data about the people a community health officer serves can be recorded during a busy clinic schedule. (AU)

Head circumference and anterior fontanelle measurements of Jamaican children

This cross-sectional study documents, for the first time, head circumference measurements for normal children of Jamaica older than one year of age, and anterior fontanelle measurements for normal children of a developing nation. It demonstrates that medical data can be compiled by the community medical officer while attending to his clinical duties. (AU)

Roentgenographic skull volume in Jamaican children between the ages of one month and five years

Values for roentgenographic skull volume estimated with the help of McKinnon's formula in 331 black normocephalic children between the ages of one month and five years, using standard anteroposterior and lateral skull films, are presented. Mean skull volume was higher among boys at all ages after the first six months of life. Significant linear correlation was seen between log-age and skull volume for both sexes. The roentgenographic skull volume in Jamaican children was more or less similar to that of British and Indian children (AU)

Roentgenographic cranial-base and calvarial measurements of Jamaican children between one month and five years

Three hundred and thirty lateral skull films obtained from apparently healthy normocephalic Jamaican children between the age of one month and five years were studied, using bony reference points nasion (N), tuberculum sellae (Ts), internal occipital prominence (IOP), inion (I), bregma (B) and lambda (L). Cranial-base length was measured between N-Ts, Ts-IOP and N-I. Calvarial height was measured between Ts-B, N-Ts and Ts-L and N-I and Ts-L at all the ages and in both sexes. Ratios between lengths of anterior and posterior cranial-base, as well as between cranial-base lengths and anterior cranial heights, were nearly constant at all the ages and in both sexes. These observations support the view that there is definite proportionality between the growth of anterior calvarial height and cranial-base lengths. On the other hand, a significant increase with age was seen in the ratios N-Ts/Ts-L, N-I/Ts/L and Ts/B/Ts-L, suggesting a progressive decrease in growth of posterior calvarial height. A comparison of the data with previously published figures for Indian and Norwegian populations suggests a racial difference in the various cranial-base and calvarial ratios. (AU)

Body shape in young children with homozygous sickle cell disease

Body shape, defined by detailed anthropometric measurement, was compared in 64 children with homozygous sickle cell (SS) disease, and in 123 children with a normal hemoglobin (AA) genotype, aged 4 to 6 years. Children with homozygous sickle cell disease showed an average reduction in weight, height, sitting height, limb length, interacromial and intercristal diameters, and skinfold thickness. They showed increased anteroposterior chest diameter ratio. This report establishes that the effect of homozygous sickle cell disease on growth patterns in childhood is apparent before the age of 6 years. The relationship to changes in body shape, seen during adolescence and in affected adults, and their possible determinants, are discussed.(AU)

Longitudinal study of growth and development of young Jamaican children recovering from severe protein-energy malnutrition

The developmental level and nutritional status of a group of 17 children aged between six and 24 months who were admitted to hospital with severe protein-energy malnutrition were studied from admission to hospital until 36 months after returning home. They were compared with a group of 14 adequately nourished children of similar age who had been admitted to hospital for other reasons. Initially the malnourished group were markedly behind the controls in developmental level, and they fail to reduce their deficit in hospital. Over the following 36 months they showed a gradual improvement relative to the controls in developmental level, height and head circumference, but were still significantly behind at the end of the study. In contrast, they caught up in weight for height by one momth after returning home. When length of stay in hospital, age at admission, birthweight, mother's IQ and home background measures were taken into account, the direction of the differences between the two groups and significance levels were unchanged. (AU)

The size of Jamaican newborns from 27-42 weeks gestation

Birth-weight, vertex-heel length and head circumference were measured in 1,230 new-born infants delivered at the University Hospital of the West Indies and admitted to the New-born Nursery between January, 1974, and December, 1976. Twins, babies with congenital malformations and those of mothers with haemoglobinopathies or diabetes mellitus were excluded, as were those born outside the Hospital. Gestational age, assessed by physical examination differed by two weeks or more from that based on the unconfirmed mentrual history in 35 percent of the babies studied. The patterns of birth-weight at gestational ages based on mentrual history indicated that the menstrual history, when used alone, was not a reliable indicator of gestational age. Data for weight, length, head circumference and weight:length ratio at gestational periods from 27 - 42 weeks as determined by menstrual history confirmed by physical examination are presented. Jamaican babies weighed up to 200 grams less than their North American counter-parts from 32 to 38 weeks of gestation, whereas this difference was not notable at term (AU)

A note on the head circumference of Jamaican babies

The head circumference of a sample of Jamaican babies was recorded immediately after birth and classified according to gestational age, parity of the mother and sex of the child. The mean value (33.9 cm) was smaller than the same measurement recorded in other racial groups. The mean head circumference of male babies was significantly greater than that of female infants, and the mean head circumference of infants born to primiparous mothers was significantly greater than those born to multiparous mothers. Head circumference was strongly correlated with birth weight and crown-heel measurements. (summary)