RESUMO
OBJECTIVE: Introduction: This article discusses the problems of the current issue of modern orthodontics aimed at increasing the effectiveness of diagnosis and treatment of transversal anomalies of occlusion in patients in periods of alternating and permanent bites by using standard orthodontic equipment in combination with orthopedic treatment by physical rehabilitation methods. In this work, the features of cephalometric indices in patients with transversal anomalies of occlusion have been studied, which make it possible to approach the choice of orthodontic treatment method in a comprehensive way. The aim was to prove the efficiency of the combination of standard orthodontic equipment with orthopedic treatment by physical rehabilitation methods. PATIENTS AND METHODS: Materials and methods: In order to study the characteristics of cephalometric indices in 9-15 years old patients with transversal anomalies of occlusion and to determine the criteria for the treatment effectiveness. Depending on the method of treatment, the patients were further divided into 2 subgroups: A and B. The method of treatment of subgroup A consisted of orthodontic treatment, which was carried out simultaneously with osteopathic correction of postural muscle imbalance by physical rehabilitation methods. Patients of subgroup B were treated exclusively by orthodontic treatment. The analysis of teleradiograms in the frontal projection was carried out using Dolphin software. RESULTS: Results: The effectiveness of the proposed regimens was carried out with the help of clinical and cephalometric indices which were studied before and after the orthodontic intervention. Clinical effectiveness of the performed orthodontic treatment was established in the absence of aesthetic disorders of facial features, normalisation and synchronization of the sizes of the upper and lower dentition, physiological positioning of the mandible, restoration of nasal breathing, disappearance of difficulties while chewing. CONCLUSION: Conclusions: When using proposed method (complex orthodontic treatment combined with physical rehabilitation methods) of orthodontic treatment, cephalometric analysis indices showed better dynamics, especially with unilateral cross-bite.
Assuntos
Cefalometria , Oclusão Dentária , Má Oclusão/terapia , Ortodontia , Adolescente , Criança , Terapia Combinada , Humanos , Má Oclusão/reabilitação , Modalidades de Fisioterapia , Postura , Radiografia DentáriaRESUMO
We estimate the number of HIV cases diagnosed, costs, and cost per HIV case detected associated with integrating HIV counseling and testing (HCT) into primary health care facilities in Ukraine. The study uses a difference-in-difference design with four districts implementing the intervention compared to 20 districts where HCT were offered only at specialized HIV clinics. There was a 2.01 (95 % CI: 1.12-3.61) times increase in the number of HIV cases detected per capita in intervention districts compared to other districts. The incremental cost of the intervention was $21,017 and the incremental cost per HIV case detected was $369. The average cost per HIV case detected before the intervention was $558. Engaging primary health care facilities to provide HCT is likely desirable from an efficiency point-of-view. However, the affordability of the intervention needs to be assessed because expansion will require additional investment.