Helicobacter pylori in alcohol induced acute pancreatitis.

BACKGROUND AND AIMS: The objective of this study was to measure the association of Helicobacter pylori infection with alcoholic acute pancreatitis. MATERIAL AND METHODS: This study comprised of 50 patients with their first alcoholic pancreatitis and 50 alcoholic controls with no history of pancreatitis but similar alcohol use recruited from an alcohol rehabilitation center. Helicobacter infection was measured using Enzygnost EIA IgG-test. Complications and length of hospital stay were also recorded in patients with alcoholic pancreatitis. RESULTS: The seroprevalence of Helicobacter pylori was 10/50 (20%) in the pancreatitis group and 15/50 (30%) in the control group (p = NS). The median length of hospital stay of pancreatitis patients was 7 days, 11 days for those tested positive (range 6-25) and 6 days for those tested negative (range 3-47) for Helicobacter pylori, p = 0.013. As determined with the Atlanta criteria, seropositive patients tended to have more often severe pancreatitis, 4/10 (40%) vs. 6/40 (15%), OR 3.78 (95% CI 0.815-17.52), p = 0.097. CONCLUSIONS: This study suggests that Helicobacter pylori infection is not associated clinically significantly with the development of alcoholic pancreatitis. However, Helicobacter pylori infection may be associated with longer hospital stay due to more severe disease, which needs to be studied in a larger series of patients.

The use of patient specific polyetheretherketone implants for reconstruction of maxillofacial deformities.

PURPOSE: The aim of this study was to evaluate polyetheretherketone (PEEK) as a patient-specific implant (PSI) material in maxillofacial reconstructive surgery. MATERIALS AND METHODS: The retrospective study included a cohort of 24 patients who underwent maxillofacial surgery using PEEK PSIs. Each patient underwent preoperative multislice computed tomography (CT) with 0° tilt of gantry. Based on the CT scan, the PEEK PSIs were planned and manufactured using three-dimensional (3D) modeling and computer-aided design/computer-aided manufacturing (CAD/CAM) techniques. All procedures were performed under general anesthesia. Implants were placed intraorally, extraorally or through subciliary, transconjuctival or coronal incisions. RESULTS: In 22 of 24 cases, the PEEK PSI fit well without adjustments. Although the fit to the surrounding bone was perfect in almost all of the cases, the outer contour of the PSI was modified in nine cases before fixation. However, intraoperative implant modification did not affect the infection rate. In two cases, postoperative wound dehiscence and infection needed additional treatment and healed without removal of the implants. CONCLUSION: The follow-up data in this study showed good outcomes with reliable results for PSI made of PEEK in the maxillofacial region.

Need for preventive and interceptive intervention for malocclusion in 3--5-year-old Finnish children.

The need for preventive and interceptive intervention for malocclusion was studied in a sample of 931 Finnish children aged 3--5 years. Orthodontic intervention was estimated to be needed for 14.4% of the children due to crossbite or functional crossbite of the anterior or lateral segments, or to the early loss of primary molars with an observed tendency to space closure. Education was needed for 2.7% of the children in cases of finger-sucking, and restorative caries therapy for 12.2% of the children in cases with carious primary molars. The need for further inspection in order to follow up development was noted in 21.2% of the children. The indications occasioning this consideration were the numerical variation of primary teeth (1.4%), joined primary teeth (0.8%), the early loss of primary molars without observed risk of space closure (0.2%), luxated and exarticulated primary incisors (5.5%), true Class III (Angle) malocclusion (0.4%), and the dummy-sucking habit (13.1%).

Need for interceptive intervention for malocclusion in 6-year-old Finnish children.

The need for interceptive intervention for malocclusion was studied in a sample of 839 Finnish children aged 6 years. The children had participated in an organized preventive orthodontic program, and nearly 10% of them had received preventive or interceptive orthodontic treatment at the age of 3-5 years (stage I of the preventive orthodontic program of the author). Orthodontic intervention was estimated to be needed for 5.9% of the children due to crossbite of the permanent central incisors, to crossbite or scissors-bite of the permanent first molars, to ectopic eruption of the permanent first molars, to numerical variation of the permanent incisors, or to functional open bite. The need for further inspection in order to follow-up development of the dentition was noted in 2.7% of the children. The indications occasioning this consideration were initial severe crowding, extreme incisal overjet, and early loss of the primary mandibular canines. The relatively low prevalence rates seemed to indicate advantageous results of the preventive and interceptive orthodontic measures.

Epidemiologic characteristics of dental caries: relation of DMFT and DMFS to proportion of children with DMF teeth.

The relation of the age-specific mean DMFT and mean DMFS to the age-specific proportion of children with DMF teeth has been studied using the original data of Knutson and data of a recent Finnish material. When studying the relationship between the mean DMFT (x) and the proportion of children with DMF teeth (y), three models of regression were compared. For low caries populations, a specific correction exponential curve y = 1-abx seemed to fit caries data somewhat better than the other models. The relationship between the mean DMFS (x) and the proportion of children with DMF teeth (y) could be expressed by a curvilinear model y = e[b(lnx) + a]; this applied to low caries populations (y approximately less than 0.7) as well, but the unexplained residual variation was about 6%.

Epidemiologic characteristics of dental caries: relation of DMFS to DMFT.

The relationship between the age-specific mean number of DMF teeth and the age-specific mean number of DMF surfaces in the population has been studied using the original data of Knutson and epidemiologic data from five Finnish materials, including data of 4718 subjects examined. Two models of regression between the variables were evaluated statistically by making a comparison between a linear and a curvilinear model of regression. For Knutson's original data, both models were suitable, apart from one data set with a relatively high caries prevalence, for which the association between the variables could be better expressed by the linear model. Concerning the recent Finnish materials, the difference in accuracy between the models seemed to be related to the range of the measurements; the larger the range of the measured caries prevalences, including low and high prevalence rates, the more proponderant the curvilinear model. For very low caries populations as well, the curvilinear model, a correction exponential curve, seemed to fit caries data somewhat better than the straight line.

Variability in assessment of need for orthodontic treatment when using certain treatment-need indices.

The need for orthodontic treatment was assessed in a sample of 29 children by using four treatment-need indices (ISMHB by the Swedish Medical Health Board, HMAR by Salzmann, INOT by Ingervall & Rönnerman, and TPI by Grainger). Furthermore, the need for treatment was evaluated clinically according to the criteria of Järvinen. When scoring the cases, and when selecting the cases with the highest scores, the study showed a marked variation between the indices, and indicated that the different methods selected different groups of children for treatment. Indirectly, the conclusion could be drawn that there were differences in the validity of the indices, even though it was not possible to evaluate the degree of validity on the basis of the knowledge we have today about the disadvantages and consequences of malocclusions.

Epidemiologic study of joined primary teeth in Finnish children.

The frequency of germinated and fused primary teeth was studied in a sample of 1141 Finnish children aged 3-4 years. The prevalence was 0.7%. All the joined teeth were found in the anterior area of the mouth. In seven cases the diagnosis was a fusion of two separate teeth, and in one case it was a germination of a single tooth. A correlation between joined teeth in primary dentition and numerical variations of teeth in permanent dentition was noted in three cases.

Saddle angle and maxillary prognathism: a radiological analysis of the association between the NSAr and SNA angles.

In cephalometric radiography, two angles have been commonly used, the saddle angle (NSAr) and the SNA angle. The former has been regarded as the cranial base angle, the latter as an indicator of the antero-posterior relation of the maxilla to the cranial base. In this study, a sample of 138 lateral skull radiographs of untreated orthodontics patients aged 7-15 years and analysed. The sample consisted of Angle's Class I, Class II, and Class III malocclusion cases. Means and standard deviations of the NSAr and SNA angles and the S-N and S-Ar lines for different malocclusion groups were estimated, and for each malocclusion group, the model of linear regression (y = bx + a) between the SNA and NSAr angles was computed. The mean of the NSAr angle was significantly larger in the Class II malocclusion group than in the Class III malocclusion group (p less than 0.05). The computed regressions indicated that about 14-40 per cent of the variation of the SNA angle in different malocclusion groups and about 24 per cent in the whole sample could be explained by the variation of the NSAr angle. Because at least a part of the correlation between the NSAr and SNA angles had a topographical causation, the main cause of this topographical correlation probably being the rotation of the S-N plane, the SNA angle was regarded as an unreliable indicator, the use of which can lead to considerable errors.

Relation of the Wits appraisal to the ANB angle: a statistical appraisal.

The hypothesis that the relationship between the ANB angle and the Wits appraisal can be expressed by measuring the individual variations in their reference systems and by constructing a model of regression between them and a few parameters describing the reference systems was tested with material consisting of 30 lateral cephalometric radiographs of untreated orthodontic patients with different types of skeletal and/or dentoalveolar malocclusions. The results indicated that approximately 93% of the variation of the Wits appraisal could be explained by the variation of the ANB, NSL/OL, and SNA angles. The study also showed that the results given by different measurements with different reference systems, such as the ANB angle and the Wits appraisal, cannot be directly compared. To obtain comparable interpretations, one should correct the results of both measurements in relation to the variations in their reference systems.

Indexes for orthodontic treatment need.

Orthodontic treatment need indexes are used extensively in Northern Europe, especially in selecting patients for treatment in public orthodontic health services and in determining the level of third party copayment. This article describes certain treatment need indexes and their uses in everyday practice. The reliability and validity of indexes are discussed.

Incisal overjet and traumatic injuries to upper permanent incisors. A retrospective study.

The relationships between traumatic injuries to upper incisors and incisal overjet were studied in a sample of 1445 orthodontically untreated children aged 7 to 16 years. Traumatic injuries of the hard dental tissues and exarticulations of teeth were recorded. The frequently of injuries was 14.2% in children with normal overjet (0--3 mm), 28.4% in children with increased overjet (3.1-6mm), and 38.6% in children with extreme overjet (greater than 6 mm). The severity of injuries was also greater in children with extreme overjet than in children with overjet ranging from 0 to 6 mm. Furthermore, the range of injuries increased in relation to the overjet. Two or more injured incisors were found in 19.2% of the children with normal overjet, in 22.2% of the children with increased overjet, and in 46.7% of those with extreme overjet.

Cephalometric findings in three cases of cleidocranial dysostosis.

Three cases of cleidocranial dysostosis, involving one boy and two girls 13 to 15 years of age, were analyzed cephalometrically. All the cases were characterized by real maxillary prominence in addition to mandibular prognathism. Although the skeletal development of the face in the present cases was atypical rather than typical of cleidocranial dysostosis, the possible individual variation should be noticed when a person with abnormal skeletal development is analyzed cephalometrically for diagnostic purposes.

Relation of the SNA angle to the saddle angle.

The degree of the individual facial prognathism, considering the relationship between the SNA and NSAr angles, was studied in a sample of forty-two children with Class I (Angle) malocclusion. A definite relationship was found between the NSAr and SNA angles. When the NSAr angle was large, the SNA angle was relatively small; on the contrary, when the NSAr angle was small, the SNA angle was significantly large. The conclusion was drawn that in persons with Class I malocclusion, a marked part of the variation of the SNA angle is to be explained by the variation of the NSAr angle. Since the value of the SNA angle can be affected by the configuration of the cranial base, it should be used with caution, especially if the value of the NSAr angle is abnormal.

Fractured and avulsed permanent incisors in Finnish children. A retrospective study.

The frequency of traumatic injuries to permanent incisors was studied in a sample of 1614 children from the city of Lahti in Southern Finland. The children, 801 girls and 813 boys, ranged in age from 6 to 16 years. Injuries to hard dental tissues and exarticulations of teeth were recorded. The prevalence of injuries was 19.8%--14.6% in girls and 25.0% in boys. A rapid growth in the prevalence rates was found at the ages of 9--11 years, at which the estimated mean annual incidence was about 5% in girls and 7% in boys. In 78.4% of the children with injured incisors, one tooth only was injured. The teeth most commonly injured were the upper central incisors, 81.7%; and the most frequent type of injury was an uncomplicated crown fracture, 90.5%.

Traumatic injuries to upper permanent incisors related to age and incisal overjet. A retrospective study.

The relationship between traumatic injuries to upper permanent incisors and incisal overjet, with special reference to the age at which the trauma occurred, was studied in a sample of 1437 orthodontically untreated children aged 7--16 years. Traumatic injuries to hard dental tissues and exarticulations of teeth were recorded. Before 10 years of age, the increase of the prevalence rates was most rapid in the extreme (greater than 6 mm) overjet group in both sexes; the ratios between the extreme and normal (0--3 mm) overjet groups being 6.5/1 in girls and 5.0/1 in boys. According to the estimate, about 50% of the girls and 70% of the boys in this overjet group with injuries were affected before the age of 10 years.

An analysis of the variation of the ANB angle: a statistical appraisal.

The variation of the ANB angle was studied in a sample which consisted of 138 orthodontically untreated children 7 to 15 years of age with Class I, Class II, or Class III (Angle) malocclusion. A regression analysis was used in order to describe the proportion of the distorting variation caused by some usual changes in the cranial and facial skeleton. The results revealed that a part of the variation of the ANB angle could be attributed to factors other than the actual apical base difference, among these factors being the rotation of the S-N plane, the relative length of the S-N plane, and the rotation of the jaws. Because the ANB angle can vary without any marked abnormalities in the sagittal jaw relationship, the use of the so-called normal limits for the ANB angle is not justified. It would be better to replace the ANB angle with a more accurate indicator.

[Evaluation of the applicability of a mathematical model in the x-ray cephalometric diagnosis of sagittal bite anomalies. A clinical test]. / Bewertung der Anwendbarkeit eines mathematischen Modells in der röntgenkephalometrischen Diagnostik der sagittalen Gebissanomalien. Ein klinischer Test.

The mathematical model (Järvinen) for measuring the sagittal difference between the maxillary and mandibular apical bases has been clinically tested. The material for this study consisted of 30 lateral skull radiographs of orthodontically untreated children (aged seven to 15 years) with different types of skeletal and/or dento-alveolar malocclusions. A comparison of the model with two conventional and two more developed methods to measure the sagittal apical base difference showed that the correlation between the new and the older methods increased as the errors of the older methods were eliminated. The results seemed to indicate that sagittal malocclusions could be accurately diagnosed by means of the model.

A study of the factors causing differences in the relative variability of linear radiographic cephalometric measurements.

Certain factors causing variation of linear radiographic cephalometric measurements were evaluated using the regression analysis. The material of the study consisted of data from three earlier investigations and included 73 measurements of four separate samples of children and young adults. Approximately 75% of the variation of the variation coefficient (V) could be attributed to the variation in the length of the measurements (means) and thus mainly to the mathematic properties of V. Thus, differences in the relative variation did not always indicate differences in the absolute variation (SD). Two factors were extracted that had an increasing effect upon the variability--the location of the reference points on an osseous contour and the location of the reference points (one or both) in the mandible. The great variability of the reference points located on osseous contours was probably caused by local changes in bone configurations, and the great variability of the measurements involving the mandible probably indicated some specific growth changes in the size, form, and rotation movements of this bone. In clinical use such reference points that include relevant information only and that could be fixed by consistent features of the local morphology should be preferred.

On the causes of traumatic dental injuries with special reference to sports accidents in a sample of Finnish children. A study of a clinical patient material.

Causes of traumatic dental injuries were studied in a sample of 321 Finnish children with injured permanent incisors. In girls the most common cause was falls (36.7%), and with boys sports (33.6%). Among the sports accidents, gymnastics dominated for girls and ice hockey for boys. Bicycling was also a markedly frequent cause of accidents for boys. The proportion of severe injuries was significantly higher in ice hockey and bicycling accidents than in other sports accidents.