Long-term Effects of the Herbst Appliance on the Dental Arches and Arch Relationships: A Biometric Study

1995 ◽  
Vol 22 (2) ◽  
pp. 123-134 ◽  
Author(s):  
Ken Hansen ◽  
Pannamas Iemamnueisuk ◽  
Hans Pancherz

The purpose of this study was to evaluate biometrically the treatment and post-treatment effects of the Herbst appliance on the dental arches and arch relationships. The sample consisted of 53 Class II, division 1 malocclusion patients (33 boys and 20 girls) treated with the Herbst appliance. The mean age of the patients before treatment was 12·5 years (SD = 1·2 years). Dental casts were analysed before treatment, after treatment, 6 months post-treatment and at the end of the growth period (5–10 years post-treatment). The following variables were assessed: sagittal molar and canine relationships, overjet, overbite, maxillary and mandibular arch perimeters, and inter-molar and inter-canine dental arch widths. During treatment, the overjet, overbite, and sagittal molar relationship were overcorrected in most of the cases, while the sagittal canine relationship was normalized. The maxillary and mandibular arch perimeters increased during treatment, as did dental arch widths (moral and canine). In the long-term (mean = 6·7 years after treatment), Herbst appliance treatment resulted in a normal or over-corrected sagittal molar relationship in 79 per cent and a normal canine relationship in 68 per cent of the cases. Eighty-three per cent of the subjects has an overjet of 4·5 mm or less. In the long-term, the arch perimeters seemed to follow a normal dental development pattern. The increase of the upper molar and canine dental arch widths during treatment remained virtually stable whilst the lower intermolar arch widths seemed unaffected by treatment.

2019 ◽  
Vol 24 (1) ◽  
pp. 44-52
Author(s):  
Maheen Ahmed ◽  
Attiya Shaikh ◽  
Mubassar Fida

ABSTRACT Introduction: The alterations in the arch form during treatment are dictated by the dimensions of the archwires. Objective: This study aimed to determine the mean arch dimensions of a sample of Pakistani subjects and to evaluate the conformity of preformed archwires with mandibular arch form. Methods: The dental records of 1,500 adult subjects were evaluated. The mandibular casts of 42 subjects (males = females = 21) with balanced facial profile, Class I occlusion, ideal overjet and overbite were included. Brackets were bonded on all teeth. Arch dimensions were evaluated at canines, first premolars, second premolars, first and second molars, with digital vernier calipers. The arch widths at the level of aforementioned teeth were evaluated on the digitized archwires, using the mean arch depths of the subjects. Results: In males, the archwires were found to be wider at canines and premolars, and significantly narrower at first (p< 0.001, 95% CI = 2.03 - 5.74) and second molars (p< 0.001, 95% CI = 2.29 - 7.73) as compared to the arch dimensions of the mandibular casts. In females, the archwires were significantly narrower at canines (p< 0.001, 95% CI = 1.4 - 3.97), and first (p= 0.02, 95% CI = 0.402 - 4.41) and second molars (p< 0.001, 95% CI = 1.76 - 6.13). Conclusion: No single commercially available archwires evaluated in the present study conformed to the arch dimensions of our subjects. Utilization of the currently available archwires may result in unwarranted modification of arch form, which may lead to unstable post-treatment teeth position.


Reproduction ◽  
2015 ◽  
Vol 150 (6) ◽  
pp. 497-505
Author(s):  
Maurand Cappelletti ◽  
Kelly Ethun ◽  
Tracy Meeker ◽  
Gretchen Von Scherr ◽  
Kim Wallen

The 3-month injectable contraceptive medroxyprogesterone acetate (MPA; Depo-Provera) is a synthetic progestin that protects against pregnancy by suppressing ovulation. Studies have focused on the resumption of ovulation after MPA-treatment cessation but neglected potential long-term effects of MPA exposure on future successful reproduction. MPA is frequently administered to adolescent girls; however, long-term fertility effects of adolescent MPA exposure have not been explored. We investigated fertility after extended MPA exposure in a species of old world primate, the sooty mangabey (Cercocebus atys). Female sooty mangabeys (n=31) received chronic MPA-treatment for 4–8 years. At MPA-treatment onset, subjects were either parous adults (n=14) or nulliparous adolescents (n=17), with adolescent-treated subjects being further divided into those who had reached first ovulation (n=10) and those who had not (n=7). After MPA-treatment cessation, adolescent-treated females had a significantly higher incidence of stillbirth than did age-matched and parity-matched controls, whereas adult-treated females did not differ from their matched controls. Females placed on MPA-treatment prior to first ovulation had a significantly higher incidence of stillbirth post-treatment than did females placed on MPA-treatment after first ovulation. Diabetic females had an increased incidence of stillbirth as compared to nondiabetic females; however, when controlling for diabetes, MPA exposure prior to first ovulation was still a significant positive predictor of stillbirth. These findings suggest that the post-treatment fertility effects of chronic MPA exposure vary with the developmental timing of treatment onset and raise concern about the use of MPA as a contraceptive for adolescent girls.


2019 ◽  
Vol 41 (1) ◽  
pp. 43-50
Author(s):  
Mojgan Khademi ◽  
Mahmoud Hajiahmadi ◽  
Mahbobeh Faramarzi

Abstract Introduction Long-term psychodynamic psychotherapy (LTPP) emphasizes the centrality of intrapsychic and unconscious conflicts and their relation to development. Although there is evidence supporting the efficacy of LTPP in mental disorders, little research has been published on the efficacy of LTPP for depressive and anxiety disorders. Objective To examine whether patients with anxiety and depressive disorders demonstrate improvement in their attachment styles, defense styles, psychiatric symptoms, anxiety/depressive symptoms, and alexithymia with LTPP. Methods In this retrospective, descriptive study, the psychological outcomes of patients who were treated at the psychoanalytic clinic of Babol University of Medical Sciences were assessed. Fourteen patients diagnosed with depressive or anxiety disorder participated in the study of LTPP using the self-psychology approach. The Beck Depression Inventory II, Beck Anxiety Inventory, Adult Attachment Scale, 40-item Defense Style Questionnaire, and the 20-item Toronto Alexithymia Scale were administered at pre-treatment, post-treatment, and 6-month follow-up. Generalized estimating equations were used to analyze changes in psychological outcomes after each of the three assessments. Results The mean scores of depression and anxiety and secure attachment improved significantly after LTPP with self-psychology approach from baseline to post-treatment and follow-up. Also, the mean scores of neurotic and immature defenses, difficulty in identifying feelings, difficulty in describing feelings, externally oriented thinking, and total alexithymia scores decreased significantly from baseline to post-treatment and follow-up. Conclusion Symptoms of anxiety disorders, depressive disorders, insecure attachment styles, alexithymia, and neurotic/immature defense styles improved after the LTPP with self-psychology approach. Moreover, the improvements persisted at the 6-month follow-up.


2019 ◽  
Vol 42 (2) ◽  
pp. 151-156 ◽  
Author(s):  
Katri Keski-Nisula ◽  
Leo Keski-Nisula ◽  
Juha Varrela

Summary Objectives Our aim was to analyse dentoskeletal effects and long-term stability of Class II treatment carried out with an eruption guidance appliance (EGA) in early mixed dentition. Materials and methods Sixty-five Class II patients (38 females and 27 males), treated with an EGA in early mixed dentition, were compared with 58 children (26 females and 32 males) with untreated Class II malocclusion. The mean age in the treatment group at the start (T1) and end of treatment (T2) was 5.4 years (±0.4) and 8.5 years (±0.9), respectively, and at the final examination in the early permanent dentition (T3) 16.7 years (±0.4). In the control group, the mean age at T1 and T2 were 5.1 years (±0.5) and 8.4 years (±0.5), respectively. The independent and dependent sample t-tests, Chi-square test, and Fisher’s test were used in the statistical evaluation. Results In the treatment group, the frequency of Class II decreased from 100 to 14% during the treatment (T1–T2) and a significant correction took place in all occlusal variables. At T2, the treatment and control groups showed statistically significant differences (P &lt; 0.05) in all occlusal variables. In the treated children, mandibular length increased 5 mm more (P &lt; 0.001) from T1 to T2 compared to the control children, and the ANB angle became significantly smaller (P = 0.006). During the post-treatment period (T2–T3), the frequency of Class II in the treatment group decreased from 14 to 2% (P &lt; 0.05), overbite increased from 2.2 to 3.1 mm (P &lt; 0.05), and lower crowding increased from 2to 14% (P &lt; 0.05). Post-treatment changes in overjet and upper crowding were not statistically significant. At T3, the mean values of the SNA, SNB, and ANB angles were 83.0° (SD 3.9°), 81.3° (SD 3.8°), and 2.4° (SD 1.5°), respectively. Conclusions A clinically significant correction of the molar relationship, overjet, overbite, incisor alignment, and growth enhancement of the mandible were observed after treatment in early mixed dentition. The treatment results remained largely stable in the early permanent dentition. However, an increase was observed in overbite and lower crowding. None of the children treated in early mixed dentition needed a second treatment phase.


2019 ◽  
Vol 32 (4) ◽  
pp. e100040
Author(s):  
Weiliang Wang ◽  
Yuqiu Zhou ◽  
Nannan Chai ◽  
Dongwei Liu

BackgroundTo date, cognitive–behavioural therapy (CBT) trials have primarily focused on clinical recovery; however, personal recovery is actually the fundamental aspect of the recovery process. The aim of this study was to summarise and synthesise the existing evidence regarding the effectiveness of CBT for personal recovery in patients with schizophrenia.AimThis study aimed to determine the effectiveness of CBT for personal recovery in patients with schizophrenia.MethodsA systematic search of the literature in PsycINFO, PubMed, Cochrane (CENTRAL), Embase and Web of Science (SCI) was conducted to identify randomised controlled trials reporting the impact of CBT interventions on personal recovery in patients with schizophrenia. The estimated effect sizes of the main study outcomes were calculated to estimate the magnitude of the treatment effects of CBT on personal recovery. We also evaluated the CBT’s effect size at the end-of-treatment and long-term (follow-up) changes in some aspects of personal recovery.ResultsTwenty-five studies were included in the analysis. The effect of CBT on personal recovery was 2.27 (95% CI 0.10 to 4.45; I2=0%; p=0.04) at post-treatment and the long-term effect size was 2.62 (95% CI 0.51 to 4.47; I2=0%; p=0.02). During the post-treatment period, the pooled effect size of CBT was 0.01 (95% CI −0.12 to 0.15; I2=33.0%; p>0.05) for quality of life (QoL), 0.643 (95% CI 0.056 to 1.130; I2=30.8%; p<0.01) for psychological health-related QoL, −1.77 (95% CI −3.29 to −0.25; I2=40%; p=0.02) for hopelessness and 1.85 (95% CI 0.69 to 3.01; I2=41%; p<0.01) for self-esteem. We also summarised the effects of CBT on QoL (subscale scores not included in the evaluation of the pooled effect size), self-confidence and connectedness, and all results corresponded to positive effects. However, there was insufficient evidence regarding the long-term effects of CBT on personal recovery.ConclusionsCBT is an effective therapy with meaningful clinical effect sizes on personal recovery and some aspects of personal recovery of schizophrenia after treatment. However, the effect is relatively immediate and rapidly decreases as time progresses. Therefore, in the future, more studies should focus on the mechanism of CBT for personal recovery and the factors that influence the long-term effects of CBT.Trial registration numberCRD42018085643.


2011 ◽  
Vol 114 (2) ◽  
pp. 432-440 ◽  
Author(s):  
Erin S. Murphy ◽  
Gene H. Barnett ◽  
Michael A. Vogelbaum ◽  
Gennady Neyman ◽  
Glen H. J. Stevens ◽  
...  

Object The authors sought to determine the long-term tumor control and side effects of Gamma Knife radiosurgery (GKRS) in patients with vestibular schwannomas (VS). Methods One hundred seventeen patients with VS underwent GKRS between January 1997 and February 2003. At the time of analysis, at least 5 years had passed since GKRS in all patients. The mean patient age was 60.9 years. The mean maximal tumor diameter was 1.77 ± 0.71 cm. The mean tumor volume was 1.95 ± 2.42 ml. Eighty-two percent of lesions received 1300 cGy and 14% received 1200 cGy. The median dose homogeneity ratio was 1.97 and the median dose conformality ratio was 1.78. Follow-up included MR imaging or CT scanning approximately every 6–12 months. Rates of progression to surgery were calculated using the Kaplan-Meier method. Results Of the 117 patients in whom data were analyzed, 103 had follow-up MR or CT images and 14 patients were lost to follow-up. Fifty-three percent of patients had stable tumors and 37.9% had a radiographically documented response. Imaging-documented tumor progression was present in 8 patients (7.8%), but in 3 of these the lesion eventually stabilized. Only 5 patients required a neurosurgical intervention. The estimated 1-, 3-, and 5-year rates of progression to surgery were 1, 4.6, and 8.9%, respectively. One patient (1%) developed trigeminal neuropathy, 4 patients (5%) developed permanent facial neuropathy, 3 patients (4%) reported vertigo, and 7 patients (18%) had new gait imbalance following GKRS. Conclusions Gamma Knife radiosurgery results in excellent local control rates with minimal toxicity for patients with VS. The authors recommend standardized follow-up to gain a better understanding of the long-term effects of GKRS.


2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Takehito Iwase ◽  
Hirotaka Yokouchi ◽  
Masayasu Kitahashi ◽  
Mariko Kubota-Taniai ◽  
Takayuki Baba ◽  
...  

The purpose of this study was to evaluate the long-term effects of half-time photodynamic therapy (PDT) on the retinal sensitivity in eyes with chronic central serous chorioretinopathy (CSC). Twenty-two eyes of 22 patients with chronic CSC were studied. PDT was applied with full-dose verteporfin and half-time laser duration. The best-corrected visual acuity (BCVA) and retinal sensitivity in the central 2 and 10 degrees were evaluated at the baseline, and at 12 and 24 months after the half-time PDT. The retinal sensitivity was determined by Macular Integrity Assessment microperimetry (MAIA, Centervue, Padova, Italy). The results showed that the mean retinal sensitivities in the central 2 and 10 degrees were significantly improved at 12 months (25.6±2.79 dB, median; 26.11 dB, 25.6±2.25 dB, median; 25.65 dB, respectively; P<0.001) and at 24 months (26.3±2.62 dB, median; 27.38 dB, 26.6±2.21 dB, median; 27.45 dB, respectively; P<0.001) after the treatment compared to that at the baseline (19.2±3.93 dB, median; 19.34 dB, 20.9±2.92 dB, median; 20.9 dB, respectively). The BCVA was also significantly improved from 0.18±0.19 median; 0.15 logarithm of the minimum angle of resolution (logMAR) units at the baseline to 0.07±0.15 median; 0 logMAR units at 12 months (P<0.001) and to 0.049±0.16 median; -0.039 logMAR units at 24 months (P<0.001). We conclude that half-time PDT results in a significant improvement of the mean central retinal sensitivity for at least 24 months in eyes with chronic CSC. Thus, half-time PDT is beneficial in resolving chronic CSC for a relatively long period.


2011 ◽  
Vol 105 (10) ◽  
pp. 1503-1511 ◽  
Author(s):  
S. L. Tey ◽  
R. Brown ◽  
A. Chisholm ◽  
A. Gray ◽  
S. Williams ◽  
...  

Nuts are known for their hypocholesterolaemic properties; however, to achieve optimal health benefits, nuts must be consumed regularly and in sufficient quantity. It is therefore important to assess the acceptability of regular consumption of nuts. The present study examined the long-term effects of hazelnut consumption in three different forms on ‘desire to consume’ and ‘overall liking’. A total of forty-eight participants took part in this randomised cross-over study with three dietary phases of 4 weeks: 30 g/d of whole, sliced and ground hazelnuts. ‘Overall liking’ was measured in a three-stage design: a pre- and post-exposure tasting session and daily evaluation over the exposure period. ‘Desire to consume’ hazelnuts was measured during the exposure period only. Ratings were measured on a 150 mm visual analogue scale. Mean ratings of ‘desire to consume’ were 92 (sd 35) mm for ground, 108 (sd 33) mm for sliced and 116 (sd 30) mm for whole hazelnuts. For ‘overall liking’, the mean ratings were 101 (sd 29) mm for ground, 110 (sd 32) mm for sliced and 118 (sd 30) mm for whole hazelnuts. Ground hazelnuts had significantly lower ratings than both sliced (P ≤ 0·034) and whole hazelnuts (P < 0·001), with no difference in ratings between sliced and whole hazelnuts (P ≥ 0·125). For each form of nut, ratings of ‘overall liking’ and ‘desire to consume’ were stable over the exposure period, indicating that not only did the participants like the nuts, but also they wished to continue eating them. Therefore, the guideline to consume nuts on a regular basis appears to be a sustainable behaviour to reduce CVD.


Author(s):  
G.J. Watson ◽  
P. Farrell ◽  
S. Stanton ◽  
L.C. Skidmore

The Solent European Marine Sites contain many tiers of habitat and species conservation, but also high levels of bait collection. Effective management strategies must be founded on up-to-date and locally based information from relevant studies of the impacts; these have been lacking for the collection of Nereis virens, a key bait species. The impacts on macrofauna were assessed through two approaches; (a) undug and dug sites in the Solent were compared over two years of repeat sampling; and (b) monitoring the long-term effects of simulated bait collection at an undug site through five years of yearly sampling. Dug sites had significantly higher densities of N. virens, but the mean weight was found to be significantly lower than those collected from the undug sites, but percentage maturity was not different. Organic content and sediment particle sizes differed between sites, and only the presence of gravel had a significant positive correlation with density. No clear patterns of other macrofauna species present were evident, although there was a significantly lower density of the terebellid polychaete Neoamphitrite figulus at the dug sites. Simulated bait collection did not alter overall macrofauna diversity, but certain species were affected. Abundance of N. figulus and the commensal Harmothoë glabra remained consistently lower in the dug area, whilst Cerastoderma edule numbers were reduced initially, but recovered. Numbers of Nephtys hombergii declined in both areas, but at a significantly greater rate in the dug area. A general decline in the abundance of many species, irrespective of digging, occurred over the period. The importance of these changes in Nereis virens populations and in the macrofauna community needs to be investigated prior to any management decisions on collection.


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