Pharmacological management of pain during orthodontic treatment: a meta-analysis.

OBJECTIVES: To evaluate the effectiveness of non-steroidal anti-inflammatory drugs (NSAIDs) in managing pain arising from orthodontic interventions, such as archwire or separators placement. DATA SOURCES: Medline and Cochrane databases searched in February 2010 and updated in July 2010 using orthodontics and pain as the search terms. Additional studies located from Google Scholar, Clinical Trials and the reference lists of retrieved articles. STUDY SELECTION: Randomized controlled trials comparing NSAID to placebo using visual analogue scale (VAS) scores. DATA SYNTHESIS: Of the 1127 studies identified through database searches, seven were included for meta-analysis. Treatment effects (Hedges' g using random effects model) and 95% confidence intervals (CI) of the pain VAS scores were evaluated at 2, 6 and 24 h after intervention, during chewing and biting activities. Pain level at 2 h differed between the ibuprofen and placebo groups during biting (95% CI: -0.178 to -0.046), but not during chewing (95% CI: -0.551 to 0.148). At 6 h, the ibuprofen group exhibited lower pain levels during both activities (chewing 95% CI: -0.640 to -0.123, biting 95% CI: -0.857 to -0.172). At 24 h, no statistically significant difference could be detected between ibuprofen and placebo (chewing 95% CI: -0.642 to 0.112, biting 95% CI: -0.836 to 0.048). No statistically significant difference was found between ibuprofen and acetaminophen at any time point. CONCLUSION: Ibuprofen appears to lower orthodontic pain compared to placebo at 2 and 6 h after separators or archwire placement, but not at 24 h, when pain peaks.

Congenital infiltrating lipomatosis of the face with associated involvement of the TMJ structures. Case report and review of the literature.

We report a case of congenital infiltrating lipomatosis of the face (CILF) with right TMJ ankylosis causing asymmetry and reduced mouth opening. The management involved soft tissue debulking combined with a right TMJ arthroplasty and is explained in detail. A review of the relevant literature revealed the rarity of this condition. The diagnosis of CILF remains challenging. The currently accepted treatment strategy is less aggressive as facial asymmetry tends to recur. Infiltration of the facial structures from adipose tissue requires several surgical procedures in most cases. Bony hypertrophy on the affected side has been a common finding in reported cases. There have been no previous reports of TMJ ankylosis associated with this condition. CILF is a benign condition with a good long term prognosis. After 2 years of follow up our patient, has maintained full function despite facial asymmetry.

Is there an association between wheezing and pneumonia?

Objective The aim of this study was to investigate whether there is a relationship in school aged children between wheezing and pneumonia prior, during, or following the pneumonia episode. Patients-Methods One hundred and three children with community acquired pneumonia who were hospitalised were recruited along with 55 controls. Results During hospitalisation wheezing was audible in 11/103 (10.6%) patients with pneumonia and in none of the controls (p=0.009). Wheezing ever or asthma was elicited in 29/103(28%) patients with pneumonia and in 8/55 (14.5%) of the controls and this difference was not significant. Two years after the hospitalisation with pneumonia, wheezing episodes occurred in 12/103 with pneumonia and 1/55 of the controls (p=0.034). Among those who developed asthma following pneumonia 11/12 also had wheezing prior to pneumonia. Conclusion There is an excess of wheezing prior, during, and after an episode of pneumonia in school aged children and therefore children with pneumonia should be followed up carefully

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Is there an association between wheezing and pneumonia?

OBJECTIVE: The aim of this study was to investigate whether there is a relationship in school aged children between wheezing and pneumonia prior, during, or following the pneumonia episode. PATIENTS-METHODS: One hundred and three children with community acquired pneumonia who were hospitalised were recruited along with 55 controls. RESULTS: During hospitalisation wheezing was audible in 11/103 (10.6%) patients with pneumonia and in none of the controls (p=0.009). Wheezing ever or asthma was elicited in 29/103(28%) patients with pneumonia and in 8/55 (14.5%) of the controls and this difference was not significant. Two years after the hospitalisation with pneumonia, wheezing episodes occurred in 12/103 with pneumonia and 1/55 of the controls (p=0.034). Among those who developed asthma following pneumonia 11/12 also had wheezing prior to pneumonia. CONCLUSION: There is an excess of wheezing prior, during, and after an episode of pneumonia in school aged children and therefore children with pneumonia should be followed up carefully.

Fluctuating molar asymmetry in relation to environmental radioactivity.

OBJECTIVE: Fluctuating dental asymmetry is considered a sensitive indicator of environmental stress. We used fluctuating asymmetry of teeth in Greek children to assess the effect of the Chernobyl accident to the Greek population, which received relatively large radiation exposure compared to other European countries. DESIGN: Sixty dental casts were divided into two groups according to date of birth prior to or after the Chernobyl accident. The intercuspal distances of the mandibular first permanent molars were measured with digital calipers. We followed the data analysis procedure proposed by Palmer and Strobeck (2003). RESULTS: Fluctuating asymmetry was found at levels above measurement error in all traits except for the buccal measurement. Overall, there were no significant differences in the fluctuating asymmetry between the two groups, after removal of outliers. CONCLUSIONS: These results suggest that environmental radioactivity from the Chernobyl incident did not significantly affect the symmetry of lower permanent molar intercuspal distances in the specific population, even though increased levels of radionuclides have been reported in teeth and other tissues.

Invasive meningococcal disease in children in Greece: comparison of serogroup A disease with disease caused by other serogroups.

Although invasive meningococcal disease caused by serogroup A is not prevalent in developed countries, a considerable number of cases were recently recorded in Greece. In this study, serogroup A meningococcal disease was compared prospectively with meningococcal disease caused by other serogroups, using similar settings of testing and management during a 5-year period between 1999 and 2003. The Neisseria meningitidis serogroup was determined in 262 cases. Serogroup B predominated, accounting for 158 (60%) of the cases. Serogroup A was second most frequent (19%), followed by serogroups W135 (11%), C (8%), and Y (2%). No cases due to serogroup C were recorded during the last year of the study. Patients with serogroup A disease were older and had a milder course compared to patients infected with serogroups B or C. Toxic appearance, purpura, thrombocytopenia, abnormal coagulation tests, and the need for admission to the intensive care unit, fluid resuscitation, inotropic drugs, and mechanical ventilation were less common. Although morbidity and mortality were lower in these patients, the differences were not significant. Serogroup B is predominant in our area, and the introduction of an effective vaccine against it is a priority. Serogroup A has emerged as the second most common serogroup, but the illness associated with it is milder.