scholarly journals Orthodontic treatment time: can it be shortened?

2018 ◽  
Vol 23 (6) ◽  
pp. 90-105 ◽  
Author(s):  
Ricardo Moresca
Keyword(s):  
Orthodontic Treatment ◽  
Clinical Decision Making ◽  
Tooth Movement ◽  
Treatment Time ◽  
Treatment Options ◽  
Clinical Decision ◽  
Orthodontic Appliances ◽  
Factors Influencing ◽  
Determining Factors ◽  
Major Factors

Abstract Introduction: In the literature, no consensus has been reached about orthodontic treatment time. Similarly, the determining factors of the latter have not yet been completely elucidated. Objective: The aim of the present article was to deepen the discussion on the major factors influencing orthodontic treatment time, as well as to present some strategies that have proven effective in controlling and shortening it. Method: Based on evidences found in the literature, the method focussed in providing the basis for clinical decision-making. Conclusions: Treatment time varies according to the type of malocclusion and treatment options. Orthodontist’s influence, patient’s characteristics and compliance are all decisive in determining treatment time, while the effects provided by orthodontic appliances and methods used to speed tooth movement up seem little effective.

scholarly journals Orthodontics and Endodontics: clinical decision-making

2020 ◽  
Vol 25 (3) ◽  
pp. 20-29
Author(s):  
Alberto Consolaro ◽  
Dario Augusto Oliveira Miranda ◽  
Renata Bianco Consolaro
Keyword(s):  
Decision Making ◽  
Foreign Body ◽  
Orthodontic Treatment ◽  
Clinical Decision Making ◽  
Tooth Movement ◽  
Clinical Decision ◽  
Filling Material ◽  
Endodontically Treated Teeth ◽  
Gutta Percha ◽  
Tooth Apex

ABSTRACT Endodontically treated teeth may be moved, as endodontic treatment is not a contraindication for orthodontic treatment. Apical periodontal repair begins when the periapical or pulp lesion has completely resolved. This may happen immediately after treatment if the filling material causes little or no irritation of periapical tissues, and particularly if the material is fully contained within the canal. When it leaks, a foreign body granuloma forms and persists for some months or indefinitely, depending on the composition of the filling material. Materials containing calcium hydroxide with no resin components undergo phagocytosis and disappear in some months, as macrophages gradually remove them. Materials containing resins, silicone, ionomers, zinc oxide-eugenol, bioceramics or gutta-percha remain in the site and induce the formation of foreign body granulomas. Although this does not preclude tooth movement, patients should be followed up every three months using periapical images to control the position of the material in relation to the tooth apex. “Pseudo” overfilling may be avoided if permanent filling is delayed until the time when orthodontic treatment is completed.

Management of thoracic aortic lesions - the future is endovascular

VASA ◽  
2012 ◽  
Vol 41 (3) ◽  
pp. 163-176 ◽  
Author(s):  
Weidenhagen ◽  
Bombien ◽  
Meimarakis ◽  
Geisler ◽  
A. Koeppel
Keyword(s):  
Thoracic Aorta ◽  
Clinical Decision Making ◽  
Treatment Options ◽  
Clinical Decision ◽  
Clinical Results ◽  
Treatment Modalities ◽  
Traumatic Rupture ◽  
Descending Thoracic Aorta ◽  
New Treatment ◽  
Aneurysm Dissection

Open surgical repair of lesions of the descending thoracic aorta, such as aneurysm, dissection and traumatic rupture, has been the “state-of-the-art” treatment for many decades. However, in specialized cardiovascular centers, thoracic endovascular aortic repair and hybrid aortic procedures have been implemented as novel treatment options. The current clinical results show that these procedures can be performed with low morbidity and mortality rates. However, due to a lack of randomized trials, the level of reliability of these new treatment modalities remains a matter of discussion. Clinical decision-making is generally based on the experience of the vascular center as well as on individual factors, such as life expectancy, comorbidity, aneurysm aetiology, aortic diameter and morphology. This article will review and discuss recent publications of open surgical, hybrid thoracic aortic (in case of aortic arch involvement) and endovascular repair in complex pathologies of the descending thoracic aorta.

“ADMINISTRATION OF PLATELET RICH PLASMA- A SHIFT IN ACCELERATED ORTHODONTICS– A REVIEW “

2021 ◽  
pp. 44-45
Author(s):  
Saraa Angel .L ◽  
Abhijeet Jaiswal
Keyword(s):  
Human Population ◽  
Orthodontic Treatment ◽  
Tooth Movement ◽  
Treatment Time ◽  
Platelet Rich Plasma ◽  
Invasive Procedures ◽  
Non Invasive ◽  
Surgical Methods ◽  
Accelerated Orthodontics ◽  
Economical Alternative

Increasing awareness towards self-appearance and aesthetics has led to increase in overall patients willing to undergo orthodontic treatment. Various surgical and non surgical methods have been tried to reduce the overall orthodontic treatment time. Painless, non invasive procedures are preferred over the traumatic methods. Platelet Rich Plasma (PRP) injection has recently gained popularity due to its safe , relatively painless and economical alternative in accelerating the tooth movement. This article briefs on the researches done in animal and human population so far using PRPand their cumulative effects on tooth movement.

scholarly journals Saliva Leptin Levels in Tooth Movement during Initial Stage of Orthodontic Alignment: A Pilot Study

2017 ◽  
Vol 16 ◽  
pp. 1-8
Author(s):  
Noraini Abu Bakar ◽  
Wisam Kamil ◽  
Lina Al Bayati ◽  
Basma Ezzat Mustafa
Keyword(s):  
Pilot Study ◽  
Mechanical Stress ◽  
Orthodontic Treatment ◽  
Tooth Movement ◽  
Orthodontic Tooth Movement ◽  
Biologically Active ◽  
Orthodontic Appliances ◽  
Initial Alignment ◽  
Periodontal Tissues ◽  
Before And After

Introduction: During orthodontic tooth movement, the early response of periodontal tissues to mechanical stress is an acute inflammatory reaction. Mechanical stress from orthodontic appliances is believed to induce cells in the periodontal ligament (PDL) to form biologically active substances, such as enzymes and cytokines, responsible for connective tissue remodeling (Nishijima Y et al 2006). Leptin, a polypeptide hormone has been classified as a cytokine (Zhang et al 1994). Earlier findings concluded that leptin at high local concentrations protects the host from inflammation and infection as well as maintaining bone levels. It has been also suggested that leptin plays a significant role in bone formation by its direct effect on osteoblasts (Alparslan et al 2010). This pilot study aimed to study leptin in saliva and its association with tooth movement during initial orthodontic alignment. Objectives: To determine if there are any differences in saliva leptin level before and after orthodontic alignment. Material and methods: Ten orthodontic patients (7 girls and 3 boys; mean age, 16.76 ± 1.1 years) with crowding (up to 5mm) that required orthodontic fixed appliances, on a non-extraction basis as part of the treatment plan, were recruited in this longitudinal study. Orthodontic study models were constructed at baseline and at 6- weeks after orthodontic treatment commenced. Full fixed orthodontic appliances with initial 0.014” Nickel Titanium archwire placed. The amount of crowding was measured, before and after initial alignment with an electronic digital caliper (Max-Cal, Japan Micrometer Ltd, Tokyo, Japan) with an accuracy of up to 0.01mm. Unstimulated morning saliva sample were collected at all visits, after at least an 8-hour period of fasting and no-toothbrushing. After centrifugation (4000x g;10min), the samples were stored at -25C and tested using Leptin Abnova LEP Human ELISA kit (KA3080) which was subsequently analyzed. Subjects’ periodontal health status was also monitored throughout the study. Ethical approval (ID IREC 262) was received on 7th April 2014 from International Islamic University Malaysia Research Ethics Committee (IREC). Results: Leptin concentration in saliva was significantly decreased in a time-dependant manner (t(9)=8.60, p<0.001), from before orthodontic treatment (7016.45± 425.15 pg/mL) and 6 weeks after bond-up (4901.92±  238.64 pg/mL). Conclusion: Leptin concentration in saliva is decreased during orthodontic tooth movement in initial alignment stage.

Aortoiliac Reconstruction

2017 ◽  
Author(s):  
Mark K. Eskandari ◽  
Michael J Nooromid
Keyword(s):  
Clinical Decision Making ◽  
Preoperative Evaluation ◽  
Treatment Options ◽  
Surgical Techniques ◽  
Clinical Decision ◽  
Occlusive Disease ◽  
Aortobifemoral Bypass ◽  
Aortoiliac Occlusive Disease ◽  
Atherosclerotic Occlusive Disease ◽  
Aortoiliac Reconstruction

This review outlines the preoperative evaluation, clinical decision making, and surgical treatment options for patients with aortoiliac occlusive disease. It also details the open surgical techniques for the treatment of aortoiliac occlusive disease and reviews endovascular treatment options. The discussion of treatment options includes the potential complications and expected outcomes, as well as steps that can be taken to optimize surgical results. Key words: aortobifemoral bypass, aortoiliac reconstruction, atherosclerotic occlusive disease, endovascular reconstruction, femoral endarterectomy, iliac angioplasty, iliac stenting, peripheral vascular disease 

Neuralgic amyotrophy: a paradigm shift in diagnosis and treatment

2020 ◽  
Vol 91 (8) ◽  
pp. 879-888 ◽  
Author(s):  
Clemens Gstoettner ◽  
Johannes A Mayer ◽  
Stephanie Rassam ◽  
Laura A Hruby ◽  
Stefan Salminger ◽  
...  
Keyword(s):  
High Resolution ◽  
Peripheral Nerve ◽  
Clinical Decision Making ◽  
Current Knowledge ◽  
Treatment Options ◽  
Treatment Algorithm ◽  
Clinical Decision ◽  
Neuralgic Amyotrophy ◽  
Positive Effects ◽  
Nerve Surgery

Neuralgic amyotrophy (NA), also known as Parsonage-Turner syndrome, is characterised by sudden pain attacks, followed by patchy muscle paresis in the upper extremity. Recent reports have shown that incidence is much higher than previously assumed and that the majority of patients never achieve full recovery. Traditionally, the diagnosis was mainly based on clinical observations and treatment options were confined to application of corticosteroids and symptomatic management, without proven positive effects on long-term outcomes. These views, however, have been challenged in the last years. Improved imaging methods in MRI and high-resolution ultrasound have led to the identification of structural peripheral nerve pathologies in NA, most notably hourglass-like constrictions. These pathognomonic findings have paved the way for more accurate diagnosis through high-resolution imaging. Furthermore, surgery has shown to improve clinical outcomes in such cases, indicating the viability of peripheral nerve surgery as a valuable treatment option in NA. In this review, we present an update on the current knowledge on this disease, including pathophysiology and clinical presentation, moving on to diagnostic and treatment paradigms with a focus on recent radiological findings and surgical reports. Finally, we present a surgical treatment algorithm to support clinical decision making, with the aim to encourage translation into day-to-day practice.

A Multiscale Specimen-Specific Data Set to Enable Comprehensive Modeling and Simulation of the Tibiofemoral Joint

2013 ◽  
Author(s):  
Snehal Chokhandre ◽  
Ahmet Erdemir
Keyword(s):  
Clinical Decision Making ◽  
Mechanical Response ◽  
Multiple Scales ◽  
Treatment Options ◽  
Complex Structure ◽  
Clinical Decision ◽  
Fe Analysis ◽  
Data Set ◽  
Tibiofemoral Joint ◽  
Joint Biomechanics

The tibiofemoral joint is a complex structure and its overall mechanical response is dictated by its numerous substructures at both macro and micro levels. An in-depth understanding of the mechanics of the joint is necessary to develop preventative measures and treatment options for pathological conditions and common injuries. Finite element (FE) analysis is a widely used tool in joint biomechanics studies focused on understanding the underlying mechanical behavior at joint, tissue and cell levels [1]. Studies, regardless of their purpose (descriptive or predictive), when employing FE analysis, require anatomical and mechanical data at single or multiple scales. It is also critical that FE representations are validated and closely represent specifics of the joint of interest, anatomically and mechanically. This is an utmost need if these models are intended to be used to support clinical decision making (in surgery or for rehabilitation) and for the development of implants.

An overview of decision making in veterinary nursing

2019 ◽  
Vol 10 (9) ◽  
pp. 460-464
Author(s):  
Mary Fraser
Keyword(s):  
Decision Making ◽  
Home Care ◽  
Communication Skills ◽  
Clinical Evidence ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Past Experience ◽  
Factors Influencing ◽  
Standard Operating ◽  
Work Up

Decision making takes place in all aspects of veterinary care. Throughout any consultation, work up, hospitalisation or ongoing home care, decisions need to be made about the next step to be taken. Clinical decision making is influenced by many different factors including past experience, emotions, owner wishes, financial concerns and communication skills. Within the veterinary team, it is important that everyone understands the factors influencing decisions. Decision making can follow a paternalistic, guardian or shared approach, which tends to be dominant in veterinary practice. Where practices adopt standard operating procedures, the use of clinical evidence and clear non-biased decisions need to be made.

Piezocision-assisted orthodontic treatment using CAD/CAM customized orthodontic appliances: a randomized controlled trial in adults

2019 ◽  
Vol 41 (5) ◽  
pp. 495-501 ◽  
Author(s):  
Carole Charavet ◽  
Geoffrey Lecloux ◽  
Nastasia Jackers ◽  
Adelin Albert ◽  
France Lambert
Keyword(s):  
Orthodontic Treatment ◽  
Treatment Time ◽  
Controlled Trial ◽  
Test Group ◽  
University Hospital ◽  
Control Group ◽  
Orthodontic Appliances ◽  
Overall Treatment Time ◽  
Randomized Controlled ◽  
Cad Cam

Summary Objective The aim of this study was to investigate the effects of piezocision (surgical protocol with sutures) in orthodontic treatment using CAD/CAM (computer-aided design and computer-aided manufacturing) customized orthodontic appliances. Design The study is designed as a parallel group, randomized controlled trial (RCT). Setting University Hospital. Ethical approval The study was approved by the ethic committee of the University Hospital Liege, Belgium. Subjects and methods This RCT was conducted on 24 adult patients requiring orthodontic treatment to release mild overcrowding. Patients were all treated with a customized appliance and randomly assigned by means of sealed envelopes containing group codes to either a test group treated with piezocision or a control group without any further treatment. A blinded orthodontist validated appliance removal or further adjustments based on the model study. Outcome measures The overall treatment time and the time between archwire changes were recorded. Moreover, clinical and radiological features such as tooth resorption, gingival recessions, and the presence of scars were evaluated. Results A total of 24 patients (12 control and 12 test) completed the study. The overall treatment time was significantly shorter in the test group than the control group. Likewise, the time difference between all arch changes was significantly lower when piezocision was performed, except for the first arch at the mandible and the last arches at both maxillae. During the fine-tuning phase, no significant difference was found between the two groups. All periodontal and radiographic parameters remained stable from the start to the end of treatment in both the groups. However, minor scars were found in 66 per cent cases. Limitations This trial was a single-centre trial. Conclusions Piezocision seems to be an effective method to accelerate orthodontic treatment in cases of mild overcrowding. However, the effect was only observed during the alignment phase and a greater efficiency was found in the maxilla. The technique may be contraindicated in patients with a high smile line since the risk of slight scarring exists. Registration ClinicalTrails.gov (Identifier: NCT03406130)

scholarly journals How Much? How Frequent? How Long? A Clinical Guide to New Therapies in Myelodysplastic Syndromes

Hematology ◽  
2010 ◽  
Vol 2010 (1) ◽  
pp. 314-321 ◽  
Author(s):  
William Blum
Keyword(s):  
Quality Of Life ◽  
Myelodysplastic Syndromes ◽  
Clinical Decision Making ◽  
Treatment Options ◽  
Clinical Decision ◽  
Clinical Results ◽  
Improve Quality ◽  
Substantial Impact ◽  
History Of

AbstractAdvances in the treatment of myelodysplastic syndromes (MDSs) over the last decade have given patients and their hematologists a multitude of treatment options. Therapeutic options now exist that reduce disease-related symptoms, improve quality of life, and alter the natural history of the disease. Three drugs are now specifically Food and Drug Administration-approved for treatment of MDS: (1) azacitidine, (2) decitabine, and (3) lenalidomide. Clinical results with each of these agents, plus results with immunosuppressive therapy, are reviewed to guide clinical decision making. Although each therapy has made a substantial impact in improving the care of patients with MDS, unfortunately MDS treatment in 2010 ultimately fails in most patients, but these therapies provide a foundation on which we can build to further improve outcomes.

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