Management of a multiple dentoalveolar trauma in permanent dentition with avulsion of a canine: A 4-year follow-up

Traumatic dental injuries are relatively frequent accidents that typically involve teeth in the maxillary anterior segment. The emergency treatment and the clinical decisions must be efficiently made at the time of injury, and there is a need for long-term follow-up because of the high incidence of complications. The aim of this article was to present the emergency and rehabilitation treatments of a multiple dentoalveolar trauma in the permanent dentition involving different extensions of enamel-dentin crown fracture, pulp exposure, and the avulsion of a canine. The treatment outcomes are reported up to the 4-year follow-up, and the clinical approaches and their rationale are discussed.

Infiltration effects on sediment mobility under waves

Sediment mobility measurements with a horizontal sand bed under non-breaking waves are reported. Conditions include no seepage and steady downward seepage corresponding to head gradients up to 2.5. The results indicate that infiltration tends to inhibit sediment mobility for a horizontal bcd of 0.2 mm quartz sand exposed to moderated wave induced bed shear stresses. The effect is weak for the parameter range of the present study. The two opposing effects of shear stress increase due to boundary layer thinning and the stabilizing downward drag are successfully accounted for through the modified Shields parameter of Nielsen [Nielsen, P., 1997. Coastal groundwater dynamics. Proc. Coastal Dynamics '97, Plymouth, ASCE, Dp, 546-555] using coefficients derived from independent studies. That is, from the shear stress experiments of Conley [Conley, D.C., 1993. Ventilated oscillatory boundary layers. PhD Thesis, University of California, San Diego, 74 pp.] and the slope stability experiments of Martin and Aral [Martin, C.S. and M.M. Aral, 1971. Seepage force on interfacial bed particles. J. Hydraulics Div., proc. ASCE, Vol. 97, No. Hy7, pp. 1081-1100]. (C) 2001 Elsevier Science B.V. All rights reserved.

Comparison of oral versus sublingual piroxicam during postoperative pain management after lower third molar extraction

In this study, 53 patients received piroxicam, administered orally or sublingually, after undergoing removal of symmetrically positioned lower third molars, during two separate appointments. This study used a randomized, blind, cross-over protocol. Objective and subjective parameters were recorded for comparison of postoperative results for 7 days after surgery. Patients treated with oral or sublingual piroxicam reported low postoperative pain scores. The patients who received piroxicam orally took a similar average amount of analgesic rescue medication compared with patients who received piroxicam sublingually (p > 0.05). Patients exhibited similar values for mouth opening measured just before surgery and immediately following suture removal 7 days later (p > 0.05), and showed no significant differences between routes of piroxicam administration for swelling control during the second or seventh postoperative days (p > 0.05). In summary, pain, trismus and swelling after lower third molar extraction, independent of surgical difficulty, could be controlled by piroxicam 20 mg administered orally or sublingually and no significant differences were observed between the route of delivery used in this study.

Bite force, electromyography, and mandible mobility during the 6-month period after surgical treatment for isolated fractures of the zygomatico-orbital complex

Objective. The aim of this study was to identify the behavior of masticatory muscles after fractures of the zygomatico-orbital complex (ZOC) and subsequent surgical treatment, by using analyses of bite force, electromyography (EMG), and mandible mobility during a 6-month period after surgery. Study design. Five patients with fractured ZOCs treated surgically by using an intraoral approach and fixation exclusively in the region of the zygomaticomaxillary buttress were evaluated. The control group included 12 other patients. During postoperative follow-up, bite force, mandible mobility, and EMG analysis of the masticatory muscles were evaluated. Results. There was an increase in bite force with time, but a decline in EMG activity during the same period. In the mandible mobility analysis, only maximum mouth-opening values increased significantly after the surgical treatment. Conclusions. The masticatory musculature, according to bite force and EMG, returned to its normal condition by the second month after surgery, and maximum mouth opening was observed after the first month. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;111:e1-e7)

The structure of middle management remuneration packages: An application to Australian mine managers

This paper investigates the composition of remuneration packages for middle managers and relates the structure of remuneration contracts to firm-specific attributes. A statutorily defined position in a single industry is studied as an example of middle management. This allows us to control for differences in task complexity across managers and industry-induced factors that could determine differences in remuneration contracts. Higher-risk firms are expected to pay their mine managers a greater proportion of variable salaries and market and/or accounting-based compensation than low-risk firms. Results indicate that high-risk firms pay a higher proportion of variable salaries and more compensation based on market and/or accounting performance.

Clinical management and subsequent healing of teeth with horizontal root fractures

Horizontal root fractures are uncommon, mainly occurring on the cervical and middle third of the root of permanent upper incisors. The diagnosis is essentially radiographic and requires different healing patterns, depending on some pre- and postinjury factors. The aim of this article was to report the clinical management and different healing types in three cases of horizontal root fractures on permanent dentition. In case 1, the pulp tissue was vital and no treatment was necessary. In case 2, a root canal treatment of the cervical fragment was necessary and in case 3, pulpal necrosis was verified and an apical surgery was performed.

Developing community-based watershed management in Greater Sao Paulo: the case of Santo Andre

This paper describes how watershed protection is being combined with settlement upgrading and land-use management within an area that serves as one of Greater Sao Paulo's main sources of fresh water. This is being undertaken in the municipality of San to Andre. Unlike previous watershed protection measures, which proved ineffective, it recognizes the need to combine the protection of water-sheds with the improvement of conditions in existing settlements and guiding, rather than prohibiting, further settlement. The paper describes how, the community-based watershed management involves the inhabitants of illegal settlements and other stakeholders in an adaptive planning framework that first seeks consensus on what is to be planned before developing the plan, its implementation and its operation, maintenance and monitoring.

Hemiplegic shoulder pain: defining the problem and its management

Purpose: Hemiplegic shoulder pain can affect up to 70% of stroke patients and can have an adverse impact on rehabilitation outcomes. This article aims to review the literature on the suggested causes of hemiplegic shoulder pain and the therapeutic techniques that can be used to prevent or treat it. On the basis of this review, the components of an optimal management programme for hemiplegic shoulder pain are explored. Method: English language articles in the CINAHL and MEDLINE databases between 1990 and 2000 were reviewed. These were supplemented by citation tracking and manual searches. Results: A management programme for hemiplegic shoulder pain could comprise the following components: provision of an external support for the affected upper limb when the patient is seated, careful positioning in bed, daily static positional stretches, motor retraining and strapping of the scapula to maintain postural tone and symmetry. Conclusions: Research is required to evaluate the effectiveness of the components of the proposed management programme for the prevention and treatment of hemiplegic shoulder pain and to determine in what combination they achieve the best outcomes.

Cognitive behaviour therapy for the management of obsessive-compulsive disorder

Current research reflects conflict regarding best practice in the treatment of obsessive-compulsive disorder (OCD). The. present study reports on the psychological treatment of a 54-year-old woman diagnosed with OCD, and follows the implementation of pharmacological treatment. The study utilises both exposure and response prevention (ERP) and cognitive therapy (CT), although there was no attempt to compare these approaches in an experimental design. Measures of avoiding and neutralising behaviours were taken on three occasions across treatment. Measures were also taken of intrusive thoughts, appraisal of responsibility, and effective challenging, both across treatment and at follow-up. The results indicate that gains were made in addition to those reported following the implementation of medication. The results also suggest that the addition of CT to exposure and response prevention facilitates the extinction of neutralising behaviours.