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2.
Br J Oral Maxillofac Surg ; 57(3): 246-250, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30851998

RESUMO

Many indices and scoring systems exist for assessing skeletal patterns and malocclusion but none have been universally adopted by teams providing orthognathic surgery in the UK. Using a standardised objective measure of a patient's condition is important both for service provision, treatment allocation, and other clinical governance domains. The Severity and Outcome Assessment tool (SOA) developed by the British Orthodontic Society (BOS) and British Association of Oral and Maxillofacial Surgeons (BAOMS) provides a standardised method of assessing patients throughout the orthognathic pathway and lends itself to case selection, resource allocation and auditing treatment outcomes. The SOA uses 7 cephalometric skeletal, dental and soft tissue measures to produce an overall score.The SOA has been used by the current NHS Tayside orthognathic team since August 2006 to audit treatment outcomes. While we recognise that cephalometric analysis forms only one part of orthognathic treatment we believe that having an objective measure on which to assess treatment is useful. We present our experience of using this quick, simple and reproducible tool in auditing orthognathic treatment outcomes.


Assuntos
Má Oclusão , Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Cefalometria , Humanos , Sociedades Odontológicas , Resultado do Tratamento
3.
Br J Oral Maxillofac Surg ; 55(1): 31-36, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27608534

RESUMO

Our objective was to assess the accuracy of virtual and printed 3-dimensional models derived from cone-beam computed tomographic (CT) scans to measure the volume of alveolar clefts before bone grafting. Fifteen subjects with unilateral cleft lip and palate had i-CAT cone-beam CT scans recorded at 0.2mm voxel and sectioned transversely into slices 0.2mm thick using i-CAT Vision. Volumes of alveolar clefts were calculated using first a validated algorithm; secondly, commercially-available virtual 3-dimensional model software; and finally 3-dimensional printed models, which were scanned with microCT and analysed using 3-dimensional software. For inter-observer reliability, a two-way mixed model intraclass correlation coefficient (ICC) was used to evaluate the reproducibility of identification of the cranial and caudal limits of the clefts among three observers. We used a Friedman test to assess the significance of differences among the methods, and probabilities of less than 0.05 were accepted as significant. Inter-observer reliability was almost perfect (ICC=0.987). There were no significant differences among the three methods. Virtual and printed 3-dimensional models were as precise as the validated computer algorithm in the calculation of volumes of the alveolar cleft before bone grafting, but virtual 3-dimensional models were the most accurate with the smallest 95% CI and, subject to further investigation, could be a useful adjunct in clinical practice.


Assuntos
Enxerto de Osso Alveolar/métodos , Processo Alveolar/cirurgia , Impressão Tridimensional , Interface Usuário-Computador , Algoritmos , Processo Alveolar/diagnóstico por imagem , Processo Alveolar/patologia , Fenda Labial/diagnóstico por imagem , Fenda Labial/cirurgia , Fissura Palatina/diagnóstico por imagem , Fissura Palatina/cirurgia , Desenho Assistido por Computador , Tomografia Computadorizada de Feixe Cônico , Humanos , Reprodutibilidade dos Testes
4.
Cleft Palate Craniofac J ; 53(5): 539-49, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-26171570

RESUMO

Nonsyndromic orofacial clefting (OFC) describes a range of phenotypes that represent the most common craniofacial birth defects in humans, with an overall birth prevalence of 1:700 live births. Because of the lifelong negative implications on health and well-being associated with OFC and the numbers of people affected, quality research into its etiology, diagnosis, treatment outcomes, and preventative strategies is essential. A range of different methods is used for recording and classifying OFC subphenotypes, one of which is the International Classification of Diseases (ICD) system. However, there is a general perception that research is being hampered by a lack of sensitivity and specificity in grouping those with OFC into subphenotypes, with potential heterogeneity and confounding in epidemiologic, genetic, and genotype-phenotype correlation studies. This article provides a background to the necessity of OFC research, discusses current controversies within cleft subphenotyping, and provides a brief overview of current OFC classifications as well as their limitations. The LAHSHAL classification is described in the context of a potentially useful tool for OFC that could complement the ICD-10/ICD-11 Beta coding systems to become a simply understood, universally accepted, clinically friendly, and research-sensitive instrument. Empowering registries, clinicians, and researchers to use a common classification system would have significant implications for OFC research across the world at a time when accurate subphenotyping is crucial and health care research is becoming increasingly tailored toward the individual.


Assuntos
Fenda Labial/classificação , Fissura Palatina/classificação , Fenótipo , Humanos , Classificação Internacional de Doenças , Prevalência , Sistema de Registros
5.
Cleft Palate Craniofac J ; 53(5): 568-77, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-26623548

RESUMO

OBJECTIVE: This study was undertaken to evaluate intraoral 3D scans for assessing dental arch relationships and obtain patient/parent perceptions of impressions and intraoral 3D scanning. MATERIALS & METHODS: Forty-three subjects with nonsyndromic unilateral cleft lip and palate (UCLP) had impressions taken for plaster models. These and the teeth were scanned using the R700 Orthodontic Study Model Scanner and Trios® Digital Impressions Scanner (3Shape A/S, Copenhagen, Denmark) to create indirect and direct digital models. All model formats were scored by three observers on two occasions using the GOSLON and modified Huddart Bodenham (MHB) indices. Participants and parents scored their perceptions of impressions and scanning from 1 (very good) to 5 (very bad). Intra- and interexaminer reliability were tested using GOSLON and MHB data (Cronbach's Alpha >0.9). Bland and Altman plots were created for MHB data, with each model medium (one-sample t tests, P < .05) and questionnaire data (Wilcoxon signed ranks P < .05) tested. RESULTS: Intra- and interexaminer reliability (>0.9) were good for all formats with the direct digital models having the lowest interexaminer differences. Participants had higher ratings for scanning comfort (84.8%) than impressions (44.2%) (P < .05) and for scanning time (56.6%) than impressions (51.2%) (P > .05). None disliked scanning, but 16.3% disliked impressions. Data for parents and children positively correlated (P < .05). CONCLUSIONS: Reliability of scoring dental arch relationships using intraoral 3D scans was superior to indirect digital and to plaster models; Subjects with UCLP preferred intra-oral 3D scanning to dental impressions, mirrored by parents/carers; This study supports the replacement of conventional impressions with intra-oral 3D scans in longitudinal evaluations of the outcomes of cleft care.


Assuntos
Arco Dental/anatomia & histologia , Técnica de Moldagem Odontológica , Modelos Dentários , Imageamento Tridimensional , Preferência do Paciente , Adolescente , Criança , Pré-Escolar , Fenda Labial , Fissura Palatina , Dinamarca , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Adulto Jovem
6.
Surgeon ; 11(6): 313-8, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23786963

RESUMO

OBJECTIVES: The CLEFTSiS (Cleft Service in Scotland) electronic patient record (EPR) contains pre-surgical photographs among other records and this study proposes to assess the reliability of diagnosis and accuracy of the type and extent of cleft. DESIGN AND SETTING: Retrospective study, University of Dundee. MATERIALS AND METHODS: From all 1092 cases contained by the CLEFTSiS EPR from inception (April 2000) until September 2011; syndromic, atypical and submucous clefts, still births, abortuses, cases with non-cleft velopharyngeal incompetence, Pierre Robin Sequence, or Simonart's bands were excluded to leave 730 case records for analysis. Observer 1 recorded the LAHSAL subphenotype using the pre-surgical photographs for each case. Images that were absent, only partially demonstrated the intended anatomical site or were unclear were excluded. The data for Observer 1 was compared to the EPR subphenotype using the Kappa statistic. Thirty randomly selected cases were recoded one month later to calculate intra-observer reliability and three further observers subphenotyped these cases to determine inter-examiner reliability, both using Kappa statistics. RESULTS: Intra- and inter-observer reliability of the LAHSAL system were excellent (0.809-0.992). The correspondence between Observer 1 and the original CLEFTSiS subphenotype was almost perfect (0.812-0.862) except the soft palate and the left alveolus, where agreement was substantial (0.638-0.776). Only 68 (9.3%) of the records fully demonstrated all six anatomical areas of the LAHSAL coding system with intra-oral images being the most frequently deficient views. CONCLUSIONS: The subphenotype data held on the CLEFTSiS EPR is accurate but incomplete. Only 9.3% of cases contained all relevant pre-surgical photographs. Subphenotyping using the LAHSAL classification has a high degree of intra- and inter-observer reliability.


Assuntos
Técnicas e Procedimentos Diagnósticos/classificação , Registros Eletrônicos de Saúde/normas , Anormalidades Maxilomandibulares/diagnóstico , Feminino , Humanos , Recém-Nascido , Masculino , Fenótipo , Curva ROC , Reprodutibilidade dos Testes , Estudos Retrospectivos , Escócia
7.
Cleft Palate Craniofac J ; 50(6): e115-20, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23157577

RESUMO

Objective : To determine the accuracy of volumetric measurement of a simulated alveolar bone defect using cone-beam computed tomography (CBCT) scans. Design : Laboratory-based observational study. Setting : University dental teaching hospital. Methods : Scans of a dried skull with an artificially created maxillary bone defect. Main Outcome Measures : The skull was scanned using an i-CAT CBCT scanner (Imaging Sciences International, Hatfield, PA) at 0.2 mm resolution. The superior and inferior aspects of the void were identified, and the volume was calculated by three-dimensional (3D) computational analysis of the CBCT scan using an algorithm created with MATLAB software (The Mathworks Inc., R2009a, Natick, MA). The skull was then scanned using micro computed tomography (micro-CT) at 0.0934 mm resolution, and the volume of the defect was determined using the Studio Max 2.2 program (Volume Graphics, 2012, Heidelberg, Germany). The process was repeated two additional times, and the volumes were compared using a two-sample t test (P < .05). To determine the interobserver reproducibility of the identification of the superior and inferior aspects of the defect, the slices chosen to represent these extremities were selected by four separate observers and the data assessed using an F-test (P < .05). Results : The interobserver reproducibility of the identification of the superior and inferior boundaries of the defect was good (P = .18). The volumes computed from the i-CAT CBCT images were 4.11% lower than those computed from the micro-CT images; however, the difference was not statistically significant (P = .71). Conclusions : 3D volumetric measurement of simulated alveolar bone defects using i-CAT CBCT scans is similar to the volumes determined using micro-CT.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Microtomografia por Raio-X , Humanos , Processamento de Imagem Assistida por Computador , Imageamento Tridimensional , Maxila/diagnóstico por imagem , Reprodutibilidade dos Testes
8.
Eur J Orthod ; 34(4): 466-9, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21459834

RESUMO

The aims of this study were to evaluate the quality and reliability of UK websites providing information on orthognathic and jaw surgery to patients. An Internet search engine (www.google.com) was used to identify websites containing medical information on 'orthognathic surgery' and 'jaw surgery'. Of over 144,000 links for orthognathic surgery and 700,000 for jaw surgery, the first 100 were examined in detail. After excluding discussion groups, news and video feeds, and removing duplicate sites, only 25 relevant websites remained which were then evaluated using the DISCERN instrument (www.discern.org.uk/discern_instrument.php). Through the 16 questions assessing the reliability and quality of the consumer information which are scored from 1 to 5, a relative index of the quality of the information is produced. The maximum score attainable for an excellent website is 80. Of the 25 websites that were scored, DISCERN indicated the majority of websites fell well below the maximum score. The highest score achieved by one of the websites according to the DISCERN tool was 64 of 80 and the lowest score achieved was 21 of 80. The websites achieving maximum and minimum score were Wikipedia and qualitydentistry.com, respectively. By directing patients to validated websites, clinicians can ensure patients find appropriate information; however, further development of websites relating to orthognathic surgery is required. Internet information should be updated on a regular basis to account for improvements in orthodontic and surgical care.


Assuntos
Informação de Saúde ao Consumidor/normas , Internet , Cirurgia Ortognática , Informação de Saúde ao Consumidor/estatística & dados numéricos , Humanos , Internet/normas , Reino Unido
9.
Cleft Palate Craniofac J ; 49(5): 530-4, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21214319

RESUMO

OBJECTIVE: To determine if three-dimensional (3D) digital study models could replace plaster study models for the evaluation of dental arch relationships for patients with unilateral cleft lip and palate. DESIGN: Observational study involving plaster study models from a records archive. SETTING: U.K. National Health Service. PATIENTS, PARTICIPANTS: Thirty sets of study models of 5-year-old patients with unilateral cleft lip and palate were identified and scanned to produce 3D digital study models by ESM Digital Solutions Ltd. (Swords, Co. Dublin, Ireland) using an R250 Orthodontic Study Model Scanner (3Shape A/S, Copenhagen, Denmark). INTERVENTIONS: None. MAIN OUTCOME MEASURE(S): The plaster and 3D digital study models were scored using the 5-year-olds' and modified Huddart Bodenham indices and analyzed using the Friedman test (p < .05) and two-way ANOVA, respectively. Intra-observer and interobserver reproducibility were calculated from the 5-year-olds' index data using the weighted kappa statistic for both the plaster and 3D digital models. RESULTS: Intra-observer and interobserver reproducibility were good (0.62 to 0.83 and 0.64 to 0.78, respectively). There were no statistically significant differences between the scores for the 3D digital study models when compared to the plaster study models for either the 5-year-olds' index (p  =  .12) or for the modified Huddart Bodenham index (p  =  .506). CONCLUSIONS: Three-dimensional digital models are a valid alternative to traditional plaster study models for the evaluation of dental arch relationships in patients with unilateral cleft lip and palate.


Assuntos
Fenda Labial/patologia , Fissura Palatina/patologia , Arco Dental/patologia , Modelos Dentários , Pré-Escolar , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Reino Unido
10.
Eur J Orthod ; 34(5): 640-5, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21791712

RESUMO

The objective of this study was to determine if increased overjet (greater than 6 mm) influences the magnitude and reproducibility of natural smile and maximal smile in Caucasian adult females. Twenty adult females with an increased overjet (6-10 mm) and 20 control adult females (overjet 2-4 mm) with no history of orthodontic treatment volunteered to participate. The mean age in the control group was 30.1 ± 6.4 years and the mean age in the test group was 31.9 ± 10.8 years. Three-dimensional stereophotogrammetric images were captured of each subject for three expressions: at rest, natural smile, and maximal smile. The images were recorded twice on two separate occasions, 6 weeks apart. Images were landmarked and a partial ordinary Procrustes superimposition was used to adjust for the differences in head posture between the same expressions. The magnitude of movement relative to the rest position, averaged over all the landmarks, was calculated and compared between the groups using analysis of variance (linear mixed-effects model); the intra- and inter-session reproducibility of both expressions was assessed. There was greater mean movement, averaged over all the landmarks, in the control group than in the increased overjet group for both natural smile and maximal smile (P = 0.0068). For these expressions, there were no statistically significant differences in reproducibility within sessions (P = 0.5403) or between sessions (P = 0.3665). Increased overjet had a statistically significant effect on the magnitude of smiling but did not influence the reproducibility of natural or maximal smile relative to controls.


Assuntos
Expressão Facial , Má Oclusão de Angle Classe II/complicações , Sorriso/fisiologia , Adulto , Estudos de Casos e Controles , Face , Feminino , Humanos , Imageamento Tridimensional , Modelos Lineares , Má Oclusão de Angle Classe II/fisiopatologia , Fotogrametria , Reprodutibilidade dos Testes
11.
Eur J Orthod ; 32(2): 177-85, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20083809

RESUMO

The objective of this study was to evaluate asymmetry of the parental craniofacial skeleton of subjects with a cleft lip, with or without cleft palate [CL(P)], and isolated cleft palate (CP). The postero-anterior (PA) cephalograms of 52 parents of children with CL(P) and 40 parents of children with CP from a sample of 196 children with non-syndromic clefts in the west of Scotland were analysed. A conventional cephalometric asymmetry analysis was used to evaluate size-related right:left asymmetry comprising eight linear distances, nine angular, and three facial area measurements. Right:left ratios of the mean values identified the direction of the asymmetry and two-sample t-tests determined statistical significance. A shape-related asymmetry analysis was also undertaken. The configurations of landmarks were optimally superimposed and scaled using Procrustes algorithms. Euclidean distance matrix analysis (EDMA) was then compared and the shape of the left and the right landmark configurations were statistically tested using a non-parametric bootstrap technique. For the parents of CL(P) children, size-related asymmetry was identified and the area of the craniofacial polygon was statistically significantly larger on the right than on the left side. EDMA detected the presence of shape-related asymmetry (T statistic = 1.304; P = 0.003). For the parents of CP children, although size-related asymmetry was identified, EDMA did not identify shape-related asymmetry (T statistic = 1.281; P = 0.065). Size and shape directional asymmetries are characteristic features of the parental craniofacial skeleton in CL(P). Although directional size asymmetry is present in the parental craniofacial skeleton in CP, shape asymmetry is not a characteristic feature.


Assuntos
Fenda Labial/genética , Fissura Palatina/genética , Assimetria Facial/genética , Desenvolvimento Maxilofacial/genética , Adulto , Algoritmos , Cefalometria , Criança , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Análise Numérica Assistida por Computador , Pais , Estatísticas não Paramétricas
13.
Br Dent J ; 200(1): 3-4, 2006 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-16415800
14.
Eur J Orthod ; 26(4): 375-84, 2004 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-15366381

RESUMO

The parental craniofacial morphology in orofacial clefting (OFC) has been shown to differ from that of the non-cleft population when evaluated using conventional cephalometric analyses comprising a variety of linear, angular, and area measurements. In spite of this, the shape of the parental craniofacial complex is of greater importance in the search for the morphogenes involved in OFC. This retrospective case-control study employed three morphometric techniques [discriminant analysis of the principal components of shape (PCS), Euclidean distance matrix analysis (EDMA), and thin-plate spline analysis (TPS)] to localize the craniofacial skeletal shape differences between (a) the parents of children with OFC and a comparison group, (b) the parents of children with cleft lip and palate [CL(P)] and cleft palate (CP), and (c) the male and female parents of children with OFC. The postero-anterior (PA) cephalograms of 92 parents of children with non-syndromic OFC and 43 comparison group volunteers were scanned and digitized. The configurations of 24 reproducible landmarks were optimally superimposed using Procrustes algorithms to allow shape data to be derived using PCS, EDMA, and TPS. The parental craniofacial shape statistically significantly differed from that of the comparison group using PCS (P < 0.001) and EDMA (P = 0.001). However PCS, EDMA, and TPS differed in their localization of the shape differences, explainable by the different mathematical methods used by the individual techniques. Interestingly, the parental craniofacial shapes in CL(P) and CP were morphologically similar when tested using PCS (P = 0.03) and EDMA (P = 0.027). However, there was no shape-related sexual dimorphism in parental craniofacial morphology in OFC when tested using PCS (P = 0.35) and EDMA (P = 0.525). Thus, the parental craniofacial shape in OFC differs from the non-cleft population, the parental craniofacial shape does not differ between CL(P) and CP and there is no sexual dimorphism in the parental craniofacial morphology in OFC, as viewed on PA cephalograms.


Assuntos
Cefalometria , Fenda Labial/genética , Fissura Palatina/genética , Pais , Algoritmos , Estudos de Casos e Controles , Cefalometria/estatística & dados numéricos , Criança , Fenda Labial/patologia , Fissura Palatina/patologia , Ossos Faciais/patologia , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Estudos Retrospectivos , Caracteres Sexuais , Crânio/patologia
15.
Water Sci Technol ; 48(7): 191-6, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14677528

RESUMO

The Cotton and Grains Adoption Program of the Queensland Rural Water Use Efficiency Initiative is targeting five major irrigation regions in the state with the objective to develop better irrigation water use efficiency (WUE) through the adoption of best management practices in irrigation. The major beneficiaries of the program will be industries, irrigators and local communities. The benefits will flow via two avenues: increased production and profit resulting from improved WUE and improved environmental health as a consequence of greatly reduced runoff of irrigation tailwater into rivers and streams. This in turn will reduce the risk of nutrient and pesticide contamination of waterways. As a side effect, the work is likely to contribute to an improved public image of the cotton and grain industries. In each of the five regions, WUE officers have established grower groups to assist in providing local input into the specific objectives of extension and demonstration activities. The groups also assist in developing growers' perceptions of ownership of the work. Activities are based around four on-farm demonstration sites in each region where irrigation management techniques and hardware are showcased. A key theme of the program is monitoring water use. This is applied both to on-farm storage and distribution as well as to application methods and in-field management. This paper describes the project, its activities and successes.


Assuntos
Agricultura , Conservação dos Recursos Naturais , Propriedade , Abastecimento de Água/economia , Monitoramento Ambiental , Indústrias , Relações Interinstitucionais , Opinião Pública , Queensland
16.
Cleft Palate Craniofac J ; 40(4): 416-25, 2003 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-12846607

RESUMO

OBJECTIVE: To evaluate the parental craniofacial morphology in orofacial clefting (OFC). DESIGN: Case-control posteroanterior cephalometric study. SETTING: The Department of Orthodontics, University of Dundee Dental School, Scotland, United Kingdom. PARTICIPANTS: Ninety-two parents from a completely ascertained sample of 286 Scottish babies with nonsyndromic OFC and 43 comparison group volunteers from the University of Dundee Dental School. MAIN OUTCOMES AND MEASURES: A conventional cephalometric analysis was used to measure linear distances and their ratios, angles, and areas. Two-sample Student's t tests and a discriminant analysis were applied to the data, and the clinically important statistically significant variables were identified using an accepted protocol. RESULTS: Sixty-four linear distances, 10 ratios, 52 angles, and 7 areas statistically significantly differed between the parental and comparison groups (p <.01). Of these, 62 linear distances (22%), 9 ratios (45%), 41 angles (41%), and 6 areas (24%) were clinically important. Asymmetry was a feature of the results. Canonical variates analysis correctly classified 91.3% of the parental group and 90.6% of the comparison group using a series of 36 variables. CONCLUSIONS: The parental craniofacial morphology in OFC differs significantly from the noncleft population. A larger superolateral face and smaller central midface and, in particular, a clinically significantly smaller maxillary width, in conjunction with skeletal asymmetry, characterize the parents of Scottish children with OFC. These features may be of morphogenetic importance in the etiopathogenesis of OFC in this ethnic group.


Assuntos
Fenda Labial/genética , Fissura Palatina/genética , Ossos Faciais/anatomia & histologia , Pais , Adulto , Análise de Variância , Estudos de Casos e Controles , Cefalometria , Análise Discriminante , Feminino , Predisposição Genética para Doença , Humanos , Masculino , Desenvolvimento Maxilofacial , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
17.
Br Dent J ; 194(12): 647, 2003 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-12830169
18.
J Orthod ; 29(4): 299-305; discussion 278-9, 2002 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-12444271

RESUMO

OBJECTIVE: To evaluate size-related and shape-related craniofacial skeletal asymmetries in the parents of children with orofacial clefting (OFC). DESIGN: Retrospective PA cephalometric study. SETTING: Glasgow/Dundee, Scotland. SUBJECTS: Ninety-two parental volunteers from a completely ascertained sample of 286 children born with OFC between 1980-1984 in the West of Scotland. INTERVENTIONS: None. MAIN OUTCOME MEASURES: A conventional cephalometric asymmetry analysis (CCAA) evaluated size-related right:left asymmetry comprising eight linear distance, nine angular, and three mid-facial area measurements. The right and left landmark configurations were uniformly scaled using Procrustes superimposition and Euclidean Distance Matrix Analysis (EDMA) evaluated shape-related right-left asymmetry. RESULTS: The three linear distances, nine angles and two areas differed between the right and left sides of the craniofacial complex (P <0.05) indicate size asymmetry characterized by a wider left side of the face and a shorter vertical dimension on the right side (directional asymmetry). EDMA detected shape asymmetry [T statistic = 2.671 (P = 0.10)]. Forty per cent of the EDMA ratios were clinically importantly larger or smaller on the left and right sides respectively, involving landmarks anatomically and morphogenetically important in OFC. CONCLUSION: Size and shape directional asymmetries characterize the parental craniofacial skeleton in OFC. This heritable directional craniofacial skeletal asymmetry could be of relevance in the left-sided predilection of OFC.


Assuntos
Fissura Palatina/genética , Assimetria Facial/genética , Cefalometria/métodos , Cefalometria/estatística & dados numéricos , Fenda Labial/genética , Saúde da Família , Humanos , Pais , Estudos Retrospectivos , Escócia
19.
Br Dent J ; 192(5): 251-5, 2002 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-11924952

RESUMO

The relationship between the eruption of the deciduous teeth and the general health of infants has been documented for over 5,000 years. A variety of physical disturbances (anything from minor upsets to potentially fatal illnesses) have historically been attributed to teething, however a number of recent publications have alluded to a clarification of some of the disputed features of teething. It is now accepted that the localised symptoms of teething vary between individuals, however, 'teething' continues to be an inappropriate diagnosis proffered by both healthcare professionals and lay people. Severe systemic upsets are unrelated to teething and, if present, the infant should be promptly referred to a physician for an accurate diagnosis and appropriate treatment. The treatment modalities used in teething have been diverse throughout the ages, frequently depending on the tenets of the medical profession and lay people, but now principally involve pain relief. This article examines the signs and symptoms frequently attributed to teething and their possible alternative causes. The contemporary principles of the management of teething are discussed, including supportive measures, the diverse range of available topical and systemic pharmacological preparations and the 'alternative' holistic therapies.


Assuntos
Colina/análogos & derivados , Dor Facial/terapia , Erupção Dentária , Acetaminofen/uso terapêutico , Analgésicos não Entorpecentes/uso terapêutico , Anestésicos Locais/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Colina/uso terapêutico , Terapias Complementares , Combinação de Medicamentos , Dor Facial/etiologia , Humanos , Lactente , Lidocaína/uso terapêutico , Salicilatos/uso terapêutico , Edulcorantes , Dente Decíduo/crescimento & desenvolvimento
20.
J Orthod ; 29(1): 23-9, 2002 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11907306

RESUMO

OBJECTIVE: To systematically review the cephalometric studies investigating the craniofacial morphology of the parents of children with orofacial clefting (OFC). SEARCH STRATEGY: The search strategy was based on the keywords 'parent', cephalometry', and 'cleft', identifying 17 studies, of which 15 'case/control' studies met the inclusion criteria Statistically significant clinically relevant cephalometric variables from univariate statistical tests and multivariate results were collated and presented unweighted. RESULTS/CONCLUSIONS: The parental craniofacial complex in OFC is distinctive in comparison to the non-cleft population. However, there is insufficient consistency in study designs and results to accurately characterize the parents of children with OFC. Although the craniofacial morphology of the parents of children with CL(P) differs to the parents of children with CP, there is insufficient information to accurately localize these differences.


Assuntos
Fissura Palatina/patologia , Face/anatomia & histologia , Facies , Pais , Adulto , Análise de Variância , Cefalometria , Criança , Análise por Conglomerados , Análise Discriminante , Feminino , Humanos , Masculino
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