Prioritization of risk factors of gingival hyperplasia during orthodontic treatment: the role of biofilm

Background: The mechanism of gingival growth that may occur during fixed orthodontic treatment is not yet fully understood and the amount of dental plaque is often incriminated. The objective of this study was to evaluate the prevalence of gingival growth during multi-attachment orthodontic treatment and to prioritize its risk factors Methods: This comprehensive cross-sectional descriptive study was conducted on 193 orthodontic patients in good general health, treated by a fixed appliance. Periodontal clinical parameters such as plaque index, gingival index, probing pocket depth, periodontal phenotype and gingival enhancement index were recorded. Likewise, the brushing habits and the date of the last scaling were noted. The orthodontic parameters studied were the duration of the treatment, the type of attachment, they alloys used for the arches and the type of ligatures. Descriptive statistics were carried out, then univariate analyses were achieved thanks to cross sectional tables and lastly, a multivariate analysis allowed a hierarchization of the risk factors. Results: Gingival growth occurred for 49.7% of patients included. The risk factors for this pathology during fixed orthodontic treatment were conventional metal brackets (OR = 3.5), oral ventilation (OR = 3), male gender (OR = 2.2), thick periodontium (OR = 2) and elastomeric ligations (OR = 2). After achievement of the logistic regression, the amount of plaque would not be directly related to the development of this gingival increase. Conclusions: Among the risk factors that underlie gingival growth during multi-attachment therapy, the amount of plaque is not found. The qualitative assessment of the plaque and its evolution during treatment could clarify the role of the biofilm in the occurrence of gingival overgrowth.

Twelve Step Psychotherapy

Twelve step psychotherapy is a time-limited, cost-effective depth psychotherapy that was developed gradually over several years of practising therapy in a public outpatient mental health service setting. Twelve step psychotherapy is structured as twelve discrete steps of one (two at most) session each. It blends clinical and cognitive behavioural psychology, emotionally focussed supportive psychotherapy, trauma therapy, attachment therapy, psychoanalytic investigation and insight, lifespan development, sociotherapy, archetypal psychology and mindfulness meditation. It reflects my particular skill set after 39 years of practising psychotherapy, but it is very teachable and does not take 39 years to learn. Whakarāpopotonga He wā-whakatina, he utunga whakahaere tōtika whakaoranga hinengaro hōhōnu te poutama tekau mā rua whakaora hinengaro, i whakawhanakehia mai i ngā tau maha whakamahinga haumanu i raro i te maru o te rātaonga hauora hinengaro tūmatanui. He whakatakotoranga āta wehea ai ngā tepe tekau mā rua kia kotahi (kāre e rahi ake i te rua) te wāhanga ia huinga. Whakatōpūhia ai te mātai haumanu te mātai hinengaro, te taituarā arotahi kare-ā-roto whakaora hinengaro, haumanu whētuki, haumanu here, rangahau me te whakamāramatanga wetewetenga hinengaro, whakawhanaketanga koiora, mātauranga haumanu hāpori, te hinengaro paerewa, me te āta whaiwhakaaro. E whakaatahia ana ōku ake pūkenga i roto i ngā tau toru tekau mā iwa e mahi ana i taku mahi kaiwhakaora hinengaro, engari ka taea noa ihotia te ako, ā, kāre e pau te toru tekau mā iwa tau te ako.

A Neural Model of Empathic States in Attachment-Based Psychotherapy

We build on a neuroanatomical model of how empathic states can motivate caregiving behavior, via empathy circuit-driven activation of regions in the hypothalamus and amygdala, which in turn stimulate a mesolimbic–ventral pallidum pathway, by integrating findings related to the perception of pain in self and others. On this basis, we propose a network to capture states of personal distress and (weak and strong forms of) empathic concern, which are particularly relevant for psychotherapists conducting attachment-based interventions. This model is then extended for the case of self-attachment therapy, in which conceptualized components of the self serve as both the source of and target for empathic resonance. In particular, we consider how states of empathic concern involving an other that is perceived as being closely related to the self might enhance the motivation for self-directed bonding (which in turn is proposed to lead the individual toward more compassionate states) in terms of medial prefrontal cortex–mediated activation of these caregiving pathways. We simulate our model computationally and discuss the interplay between the bonding and empathy protocols of the therapy.