Smile Attractiveness Evaluation of Patients Selected for a U.S.-Based Board Certification Examination

Objectives The aims of the study were to assess smile attractiveness of a collection of 68 smiling photographs of successfully treated cases submitted to the American Board of Orthodontics (ABO) clinical examination and identify variables that influence the assessment. Materials and Methods A panel of 81 non-Caucasian assessors from various clinical disciplines were instructed to score the smile attractiveness on a visual analog scale from 1 (least attractive) to 10 (most attractive) and to select which components contributed to a lesser attractive smile. The mean, standard deviations (SDs), and quartiles of the smile attractiveness were obtained with descriptive statistics. Multilinear regression analysis was performed to investigate the scores of the perceived quality of smile attractiveness when the clinical disciplines and gender of the assessors were the factors taken into consideration. Receiver operating characteristic (ROC) curve was generated to establish the relationship between smile attractiveness and the achievement of a perfect smile. Results The mean (SD) rating of each clinical photograph of the anterior occlusion on smiling ranged from 3.11 (1.47) as the least attractive smile to 7.59 (1.45) as the most attractive smile. The overall mean (SD) score for smile attractiveness was 5.30 (1.10). Problems associated with teeth, gingiva, and lips corresponded with a reduction of the smile attractiveness score by 1.56, 1.82, and 1.47, respectively. Gender was not associated with smile attractiveness ratings. Orthodontists, periodontists, and prosthodontists demonstrated no difference in the ratings, while plastic surgeons were more critical than orthodontists regarding smile attractiveness. Conclusions The study suggested that only 2 out of 68 AOB validated treatment finishes had a perfect and attractive smile.

FRCS Trauma and Orthopaedics Viva

FRCS Trauma and Orthopaedics Viva includes over 95 viva topics. Completely updated to include current clinical management guidelines and exam hot topics, the book is brought to you again from the team behind the highly successful Oxford revision course. Based on the principle that viva candidates improve their technique by observing and learning from others, the editor team have created a best-practice formula for dealing with the individual scenarios. The book is set out in a simple format and every viva topic is introduced by an initial clinical photograph, radiograph, or diagram. Sets of questions follow underneath with the suggested answers. This allows the reader to work in pairs, groups, or on their own.

GEORGE HENRY FOX'S Photographic illustrations of skin diseases and the clinical photograph in late nineteenth-century America

George Henry Fox was a New York physician and author in the late nineteenth century. His interest in collecting photographs of notable dermatological cases led to the publication of several photographically illustrated dermatology texts between 1879 and the early twentieth century. This thesis focuses on the fIrst and second editions of Fox's Photographic Illustrations of Skin Diseases, published in 1879 and 1885, respectively. The hand-coloured Artotype plates from these two editions are analyzed and contrasted in terms of the influence of studio portraiture, issues of patient anonymity and consent, and the aesthetic changes between editions. The power relationships and scientifIc classifIcation involved in depicting the body on ftlm are also considered. The books are on textualized with discussions of nineteenth-century American medical history, the use of clinical photographs as illustrations, photomechanical processes, late nineteenth-century dermatology texts, and Fox's biography.

GEORGE HENRY FOX'S Photographic illustrations of skin diseases and the clinical photograph in late nineteenth-century America

George Henry Fox was a New York physician and author in the late nineteenth century. His interest in collecting photographs of notable dermatological cases led to the publication of several photographically illustrated dermatology texts between 1879 and the early twentieth century. This thesis focuses on the fIrst and second editions of Fox's Photographic Illustrations of Skin Diseases, published in 1879 and 1885, respectively. The hand-coloured Artotype plates from these two editions are analyzed and contrasted in terms of the influence of studio portraiture, issues of patient anonymity and consent, and the aesthetic changes between editions. The power relationships and scientifIc classifIcation involved in depicting the body on ftlm are also considered. The books are on textualized with discussions of nineteenth-century American medical history, the use of clinical photographs as illustrations, photomechanical processes, late nineteenth-century dermatology texts, and Fox's biography.

An Analysis of Electronic Primary Dental Practice Tooth Wear Referrals

We evaluated the quality of general dental practitioner (GDP) tooth wear (TW) referrals to secondary care services in Kent, Surrey and Sussex. Prospective consecutive referrals received via an electronic pathway were assessed from 1 June to 30 October 2019. Reasons for referral, patient demographics, quality of referral, opinion of the triaging clinician and outcome were assessed. Of 671 referrals, 32% were for TW. Males were referred more commonly (1.7:1.0). The median age was 52. Patients were more likely to be referred from distant locations than places closer to the referral centre (p<0.001). Only 55% of referrals suggested a cause for the TW, 33% provided a clinical photograph and 1% recorded a tooth wear index of any type. Referring clinicians most commonly cited attrition as reason for referral (p<0.001). Those under 40 years were referred for erosion (p=0.001) and those over 40 years, attrition (p=0.019). The triaging clinician was more likely to allocate a tooth wear score of three for those under 40 years and a score of four for over 40 years (p<0.001). 47% of referrals were rejected. Males and referrals with photographs were more likely to be accepted for treatment (p=0.017 and p<0.001, respectively). There is a high demand for specialist TW services. The number of referrals being rejected has not changed using the electronic referral system. We advocate the inclusion of mandatory fields for completion by GDPs as well as compulsory clinical photographs and tooth wear indices (Smith and Knight Tooth Wear Index or a basic erosive wear examination - BEWE index).

Comparative study of oral tranexamic acid and triple combination versus tranexamic acid through microneedling in patients of melisma

<p class="abstract"><strong>Background:</strong> Melasma can be difficult to treat due to the refractory and recurrent nature of condition. The aim of this study is to compare and evaluate the efficacy of oral tranexamic acid and triple combination versus tranexamic acid through microneedling in patients of melisma.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study with a sample size of 20, 10 in each treatment arm.10 patients (group-A) were given topical triple combination to apply daily at night and along with oral tranexamic acid 250 mg twice a day, while in the other arm (group-B), 10 patients were given procedural treatment of microneedling with tranexamic acid (4 mg/ml). Patients were followed up for 3 consecutive months. Clinical photograph was taken after each visit, and a modified melasma area and severity index was performed at the beginning and end of the treatment.<strong></strong></p><p class="abstract"><strong>Results:</strong> According to melasma area and severity index, improvement in group-A was 65% as compared to 33% in group-B.</p><p class="abstract"><strong>Conclusions:</strong> Triple combination is known as gold standard treatment in melasma, but because of its long term steroidal and tretinoin side effects we can consider microneedling with TXA as an adjuvant treatment.</p><p> </p>

Large Cell Acanthoma of the Conjunctiva: Clinicopathologic and Immunohistochemical Features

Large cell acanthoma (LCA) was first described as a lesion on sun-exposed skin. All LCAs feature keratinocytes twice the size of normal cells (cytomegaly). Although infrequently diagnosed in the skin, it has been even more rarely described by ophthalmic pathologists in the eyelid skin and the conjunctiva. This report describes the third case of a conjunctival epithelial LCA, with the first published clinical photograph highlighting its leukoplakic and well-circumscribed character, as well as the most thorough analysis of the immunohistochemical features of this lesion. It is contrasted with squamous dysplasias and papillomas of the conjunctiva. A review of previous conjunctival LCA lesions discloses frequent recurrences after initial surgery and the remote but real potential for squamous dysplastic transformation. Immunohistochemical stains for certain cytokeratins, p53, and Ki-67 (proliferation index) will in the future be particularly helpful in establishing an early and accurate diagnosis of conjunctival LCA.

Ectomesenchymal Chondromyxoid Tumour of the Dorsal Tongue Presenting with Impaired Speech

Ectomesenchymal chondromyxoid tumours (ECTs) are rare mesenchymal soft tissue neoplasms that typically present as a slow-growing asymptomatic mass on the anterior dorsum of the tongue. Our patient presented with impaired speech articulation and pain associated with upper respiratory tract infections when the lesion on his dorsal tongue would swell, and he would accidentally bite down on it. Microscopically, ECTs appear as unencapsulated, well-circumscribed proliferations of uniform round to fusiform cells embedded within chondromyxoid matrices. Most cases of ECT have been detected in the third to the sixth decades of life, with no sex preference. ECT may cause a range of symptoms that negatively impact patients’ quality of life, including pain, dysphagia, odynophagia, bleeding, and, in the case of our patient, impairment of speech. We provide a unique preoperative clinical photograph and case description that should help readers in recognizing this neoplasm. Considering the rarity of ECT presenting clinically as well as in the literature, we believe this report will add to our growing understanding of ECT and its management. We report a case of ECT presenting on the anterior dorsal tongue that was successfully surgically resected under local anesthesia with clear margins, accompanied by a review of the pertinent literature.