Influence of the banded Herbst appliance on dental changes in mixed dentition

OBJECTIVE: This prospective clinical study was conducted with the purpose of evaluating the influence of the banded Herbst appliance on dental changes during the early treatment of Class II malocclusion. METHOD: The sample consisted of 15 prepubertal subjects (12 boys and 3 girls, initial age: 9 years and 6 months) who were treated with the Herbst appliance. Treatment effects were compared with those of a Class II Division 1 group of 15 subjects (8 boys and 7 girls, mean initial age 9 years and 1 month), not treated orthodontically. Statistical analysis was performed using Student t-test with 5% significance level. RESULTS: The results showed that treatment with the banded Herbst appliance in the mixed dentition stage tended to upright maxillary incisors (mean: 4.14°). The maxillary molars were distalized and intruded significantly (mean 2.65 mm and 1.24 mm, respectively), the lower incisors slightly protruded anteriorly (mean 1.64 mm) and the molars showed no significant changes in the horizontal and vertical directions. Furthermore, significant improvements were noted in overbite (1.26 mm), overjet (4.8 mm) and molar relationship (12.08 mm). CONCLUSIONS: Changes in the upper dental arch were found to be greater than changes in the lower arch. Furthermore, mandibular anchorage loss was reduced due to the anchorage system used in the study.

Cephalometric evaluation of skeletal alterations induced by Herbst appliance during mixed dentition

OBJECTIVE: The present prospective clinical study was designed in order to evaluate horizontal and vertical skeletal alterations induced by the use of Herbst appliance in individuals with Class II, division 1 malocclusion during mixed dentition stage. METHODS: The sampling consisted of 15 pre-pubertal individuals (12 boys and 3 girls; initial age 9 years and 6 months), who were treated with Herbst appliance for a period of 7 months. The effects of the treatment were compared to a group of 15 individuals with Class II, division 1 malocclusion (8 boys and 7 girls, initial age averaged 9 years and 1 month), orthodontically untreated, who were followed up for a period of 12 months. Statistical analysis was performed with Student's t-test with significance level at 5%. RESULTS: It was showed that the treatment with Herbst appliance in mixed dentition stage has restricted maxilla growth. Mandibular and palatal planes have not undergone significant alteration; however, anterior and posterior facial heights have increased significantly. Facial convexity and maxillomandibular relationship were altered positively. Mandible has positioned significantly forward and its effective length increased 2.5 times more than the increase observed in control group. CONCLUSION: It was possible to conclude that Herbst appliance was able to provide satisfactory results in individuals during mixed dentition stage.

High frequencies of plexiform neurofibromas, mental retardation, learning difficulties, and scoliosis in Brazilian patients with neurofibromatosis type 1

A clinical study of Brazilian patients with neurofibromatosis type 1 (NF1) was performed in a multidisciplinary Neurofibromatosis Program called CEPAN (Center of Research and Service in Neurofibromatosis). Among 55 patients (60% females, 40% males) who met the NIH criteria for the diagnosis of NF1, 98% had more than six café-au-lait patches, 94.5% had axillary freckling, 45% had inguinal freckling, and 87.5% had Lisch nodules. Cutaneous neurofibromas were observed in 96%, and 40% presented plexiform neurofibromas. A positive family history of NF1 was found in 60%, and mental retardation occurred in 35%. Some degree of scoliosis was noted in 49%, 51% had macrocephaly, 40% had short stature, 76% had learning difficulties, and 2% had optic gliomas. Unexpectedly high frequencies of plexiform neurofibromas, mental retardation, learning difficulties, and scoliosis were observed, probably reflecting the detailed clinical analysis methods adopted by the Neurofibromatosis Program. These same patients were screened for mutations in the GAP-related domain/GRD (exons 20-27a) by single-strand conformation polymorphism. Four different mutations (Q1189X, 3525-3526delAA, E1356G, c.4111-1G>A) and four polymorphisms (c.3315-27G>A, V1146I, V1317A, c.4514+11C>G) were identified. These data were recently published.

Effect of intraperitoneal or incisional bupivacaine on pain and the analgesic requirement after ovariohysterectomy in dogs

Objective To compare the effect of intraperitoneal (IP) or incisional (INC) bupivacaine on pain and the analgesic requirement after ovariohysterectomy in dogs.Study design Prospective, randomized clinical study.Animals Thirty female dogs undergoing ovariohysterectomy (OHE).Methods Dogs admitted for elective OHE were anesthetized with acepromazine, butorphanol, thiopental and halothane. Animals were randomly assigned to one of three groups (n = 10 per group). The treatments consisted of preincisional infiltration with saline solution (NaCl 0.9%) or bupivacaine with epinephrine and/or IP administration of the same solutions, as follows: INC and IP 0.9% NaCl (control group); INC 0.9% NaCl and IP bupivacaine (5 mg kg(-1), IP group); INC bupivacaine (1 mg kg(-1)) and IP 0.9% NaCl (INC group). Postoperative pain was evaluated by a blinded observer for 24 hours after extubation by means of a visual analog scale (VAS) and a numeric rating scale (NRS). Rescue analgesia (morphine, 0.5 mg kg(-1), IM) was administered if the VAS was > 5/10 or the NRS > 10/29.Results At 1 hour after anesthesia, VAS pain scores were [medians (interquartile range)]: 6.4 (3.1-7.9), 0.3 (0.0-2.6) and 0.0 (0.0-7.0) in control, IP and INC groups, respectively. VAS pain scores were lower in the IP compared to the control group. Over the first 24 hours, rescue analgesia was administered to 7/10, 5/10 and 3/10 dogs of the control, INC and IP groups, respectively. Total number of dogs given rescue analgesia over the first 24 hours did not differ significantly among groups.Conclusions and clinical relevance Intraperitoneal bupivacaine resulted in lower pain scores during the first hour of the postoperative period and there was a trend towards a decreased need for rescue analgesia after OHE in dogs.

Spondylothoracic dysplasia in two siblings

The spondylothoracic dysplasia syndrome is characterized by congenital malformations of vertebrae and ribs. As a consequence of the anomalous development of the vertebral column, the neck and thorax are short, and the normal head looks as if emerging from the shoulders. The thorax is short and asymmetric with an increased anteroposterior diameter. Dorsolumbar lordosis and a protuberant abdomen are present. The extremities though normal in length appear long relative to the shortened trunk. Short stature results from the vertebral abnormalities. The syndrome was seen in 2 siblings of nonconsanguineous parents.

Experimental infection of bovines with oocysts of Toxoplasma gondii

Calves aged 3 mth were readily infected with oocysts and cysts of Toxoplasma gondii administered by the oral route. Fever, respiratory distress, nasal discharge, and hyperemia of the conjunctivas were the most significant clinical signs noted in the infected animals. Parasitemia was demonstrated in all infected calves. It occurred on different days and up to 62 days after the infection. Toxoplasma was demonstrated in tissues of all infected calves, and the organ most frequently parasitized was the lymph node. Parasitism of the retina was demonstrated in 2 calves. All infected animals had antibody against T. gondii in their serum. The Sabin-Feldman dye test and the indirect immunofluorescent test were both useful in detecting antitoxoplasma antibody.