Bite force changes after surgical correction of mandibular prognathism in subjects with increased vertical dimension : A prospective clinical trial.

PURPOSE: Occlusal bite force (OBF) is the most important parameter in assessing biting efficiency. The aim of this study was to record OBF changes after surgical correction of high angle maxillary/mandibular (Max/Mand) class III patients and to compare these with that recorded in class III patients with average Max/Mand angle. MATERIALS AND METHODS: Initially included were 42 patients with severe class III skeletal malocclusion who were scheduled for orthodontic surgery: group 1-22 patients with increased vertical relationship scheduled for bimaxillary surgery; group 2-20 patients with average vertical relationship scheduled for mandibular setback only. OBF measurements before surgery (T0), at debonding (T1) and at least 3 months after debonding (T2) were recorded using a portable occlusal force gauge. The following were also measured: maximum OBF (MOBF) achieved by the subject on each side, averaged OBF on each side (AOBF) and maximum OBF at the incisal region (MIOBF). At T2, only 33 patients (group 1: 17 and group 2: 16) were included in the analysis due to loss to follow-up. RESULTS: MOBF increased significantly in group 1, while no significant changes were detected in group 2. MIOBF increased after surgical correction in both groups. Significant increase in MIOBF was observed at T1 (P < 0.001) followed by an insignificant decrease during the observation period (3-6 months after treatment; P > 0.05). The two groups differed significantly in MOBF at T1 and T2, while no statistically significant differences were detected between the groups for MIOBF changes at the various time intervals (P > 0.05). The number of posterior teeth with occlusal contacts increased in both groups. Relapse was detected in group 1 where the number of posterior teeth in contact decreased during the observation period (T1-T2). CONCLUSION: OBF greatly improved after surgical correction of the vertical morphology. Correction of high angle mandibular prognathism improves oral function in addition to esthetics.

A 12-Month Randomized Clinical Trial of 38% SDF vs. Restorative Treatment.

PURPOSE: The aim of this 2-arm, parallel-group, 12-mo randomized clinical trial was to compare the effectiveness of semiannual application of 38% silver diamine fluoride (SDF) versus restorative treatment (RT) to manage cavitated caries lesions in primary teeth in a diverse population of children in Michigan. METHODS: Children aged 2 to 10 y with at least 1 soft cavitated lesion (International Caries Detection and Assessment System 5 or 6) with no pain or signs/symptoms of irreversible pulpitis were recruited and randomly assigned to 2 intervention groups. One random lesion per child received 38% SDF (twice, at a 6-mo interval) or RT. All interventions and assessments were done by calibrated dentists. Primary outcome measures were clinical failure rates: minor (e.g., reversible pulpitis, active/soft lesion or progression, restoration loss or need for replacement/repair, secondary caries) and major (e.g., irreversible pulpitis, abscess, extraction). Parent, child, and provider acceptability was also assessed. RESULTS: Ninety-eight children were enrolled and randomized, with a mean (SD) age of 4.8 y (1.8); 46% were female and their mean dmft + DMFT was 6.3 (3.9). Sixty-nine children were assessed at 12 mo (sample was within the planned 30% attrition rate). There were significantly more teeth with minor failures (SDF = 65%, RT = 23%, P ≤ 0.001) and major failures (SDF = 13%, RT = 3%, P ≤ 0.001) in the SDF group than the RT group; 74% of SDF-treated lesions were hard at 12 mo vs. 57% at 6 mo. Providers stated that SDF was easier, faster, and more preferable than RT (P ≤ 0.001). No significant differences were found in parental satisfaction and acceptability. At 12 mo, children in the RT arm felt significantly (P < 0.05) happier with their tooth appearance and stated that their visit to the dentist hurt less. CONCLUSION: At 12 mo, SDF-treated lesions had significantly more minor and major failures than RT, suggesting that SDF-treated teeth need to be closely monitored in a population at high caries risk (ClinicalTrials.gov NCT02601833). KNOWLEDGE OF TRANSFER STATEMENT: The results of this study can be used by clinicians when deciding whether to restore or apply silver diamine fluoride to cavitated lesions in primary teeth. Information on treatment outcomes and parent, child, and provider acceptability can help guide appropriate treatment decisions and need for monitoring.

Water pipe (shisha) smoking among male students of medical colleges in the eastern region of Saudi Arabia.

BACKGROUND AND OBJECTIVES: Shisha smoking, one of the commonest methods of smoking tobacco among Arabs, increases the risk of cardiovascular and respiratory diseases. The objective of this study was to determine the prevalence of shisha smoking among male students of three colleges and to identify factors associated with shisha smoking. METHODS: This cross-sectional study included 500 male students of three colleges (medicine, applied medical sciences and dentistry). Data were collected from 371 students using a self-administered questionnaire. RESULTS: The overall prevalence of shisha smoking was 12.6% (8.6% shisha only and 4.0% both shisha and cigarettes). Thirty students (63.8%) started shisha smoking at ages of 16 to 18 years. Seven students (15%) smoked shisha daily. Cafiotas or restaurants were the favorite places for smoking (70.2% of students). There was a high prevalence of shisha smoking among students whose mothers had a secondary (19.1%) and higher (53.3%) education. CONCLUSIONS: There was a high prevalence of shisha smoking among university students. The majority of students started shisha smoking at a young age. Public health measures, including the banning of smoking in public places are recommended.

Emotional disorders among medical students in a Malaysian private medical school.

INTRODUCTION: A study was done between December 2005 and January 2006 to determine the prevalence of emotional disorders among medical students in a private medical school in Ipoh, Perak, Malaysia and to determine the demographical characteristics, contributing factors and the key person consulted for emotional problems. METHODS: Medical students in the private medical school completed the 12-item English version of the General Health Questionnaire (GHQ-12) and a demographical questionnaire. A cut-off point of 3/4 for the GHQ was used to determine negative and positive scores for emotional disorders. RESULTS: Out of 292 medical students, 86.6 percent completed the questionnaires. A total of 117 students (46.2 percent) were found to have emotional disorders. There was no significant association of ethnicity, gender, age group, number of examinations sat, examination performances, past medical conditions and relationships with parents, siblings, course-mates and lecturers with positive GHQ scores. A significant association, however, was found between positive GHQ scores for emotional disorders and the year of study, pressure faced due to examinations, and not having a love relationship. 39 percent of the students stated friends as their main preference for consultation of any emotional problem. CONCLUSION: The prevalence of emotional disorders among medical students was high. Further studies and diagnostic measures are recommended, including a more systematic screening and counselling programme by the medical school for early diagnosis and treatment to prevent complications.