Mucocele in pediatric patients: Analysis of 36 children

Mucoceles are common benign lesions of the oral cavity that develop following extravasation or retention of mucous material from major or minor salivary glands. Most series report a higher incidence of mucocele in young patients but no studies exist for this specific age group. The records of 104 patients presenting with mucocele who underwent surgery in the Oral Diseases Clinic of the Department of Dermatology of the University of Sao Paulo, Brazil, between 1991 and 2006, were reviewed. Of these, 36 (34.6%) were 15 years old or younger, the youngest being 2 years old. Twenty-six patients were girls, 10 were boys. Lesions were located on the lower labial mucosa (30 patients), tongue (three), floor of the mouth (one), buccal mucosa (one), and in one patient the location was unknown. Histopathology revealed an extravasation pattern in 35 patients and a retention pattern in one. Of the distinct subtypes of mucocele, tongue lesions (mucocele of the glands of Blandin-Nuhn) seem to be more prevalent and retention mucoceles seem to be very rare in children.

Influence of rapid palatal expansion on maxillary incisor alignment stability

Introduction: The purpose of this retrospective study was to compare the long-term stability of maxillary incisor alignment in patients treated with and without rapid maxillary expansion (RME). Methods: The sample comprised 48 subjects with Class I and Class II malocclusions, treated without extractions with fixed edgewise appliances, divided into 2 groups according to the treatment protocol: group 1 comprised 25 patients (15 girls, 10 boys) at a mean initial age of 13.53 years (SD, 1.63), who had RME during orthodontic treatment. Group 2 comprised 23 patients (13 girls, 10 boys) at a mean initial age of 13.36 years (SD, 1.81 years), treated with fixed appliances without RME. Maxillary dental cast measurements were obtained at the pretreatment, posttreatment, and long-term posttreatment stages. Variables assessed were the irregularity index and maxillary arch dimensions. Intergroup comparisons were made with independent t tests. Results: Greater transverse increases were found during treatment in the group treated with RME. However, during the long-term posttreatment period, no significant difference was observed in the amount of incisor crowding relapse between the groups. Conclusions: RME did not influence long-term maxillary anterior alignment stability. (Am J Orthod Dentofacial Orthop 2010; 137: 164. e1-164.e6)

Relationship between breastfeeding duration and prevalence of posterior crossbite in the deciduous dentition

Introduction: This cross-sectional retrospective epidemiologic study assessed the relationship between exclusive breastfeeding duration and the prevalence of posterior crossbite in the deciduous dentition. Methods: Clinical examinations were performed in 1377 Brazilian children (690 boys, 687 girls), 3 to 6 years old, from 11 public schools in Sao Paulo, Brazil. Based on questionnaires answered by the parents, the children were classified into 4 groups according to the duration of exclusive breastfeeding: G1, never (119 subjects); G2, less than 6 months (720 subjects); G3, 6 to 12 months (312 subjects); and G4, more than 12 months (226 subjects). The statistical analyses included the chi-square test (P < 0.05) and the odds ratio. Results: The posterior crossbite was observed in 31.1%, 22.4%, 8.3%, and 2.2% of the children, in groups G1, G2, G3, and G4, respectively. The results showed a statistically significant relationship between exclusive breastfeeding duration and the prevalence of posterior crossbite. Conclusions: Children who were breastfed for more than 12 months had a 20-fold lower risk for the development of posterior crossbite compared with children who were never breastfed and a 5-fold lower risk compared with those breastfed between 6 and 12 months. (Am J Orthod Dentofacial Orthop 2010; 137:54-8)

Cephalometric evaluation in different phases of Jasper jumper therapy

Introduction: The aim of this study was to evaluate the dentoskeletal and soft-tissue effects of Class II malocclusion treatment with the Jasper jumper followed by Class II elastics at the different stages of therapy. Methods: The sample comprised 24 patients of both sexes (11 boys, 13 girls) with an initial age of 12.58 years, treated for a mean period of 2.15 years. Four lateral cephalograms were obtained of each patient in these stages of orthodontic treatment: at pretreatment (T1), after leveling and alignment (T2), after the use of the Jasper jumper appliance and before the use of Class II intermaxillary elastics (T3), and at posttreatment (T4). Thus, 3 treatment phases could be evaluated: leveling and alignment (T1-T2), use of the Jasper jumper (T2-T3), and use of Class II elastics (T3-T4). Dependent analysis of variance (ANOVA) and Tukey tests were used to compare the durations of the 3 treatment phases and for intragroup comparisons of the 4 treatment stages. Results: The alignment phase showed correction of the anteroposterior relationship, protrusion and labial inclination of the maxillary incisors, and reduction of overbite. The Jasper jumper phase demonstrated labial inclination, protrusion and intrusion of the mandibular incisors, mesialization and extrusion of the mandibular molars, reduction of overjet and overbite, molar relationship improvement, and reduction in facial convexity. The Class II elastics phase showed labial inclination of the maxillary incisors; retrusion, uprighting, and extrusion of the mandibular incisors; and overjet and overbite increases. Conclusions: The greatest amount of the Class II malocclusion anteroposterior discrepancy was corrected with the Jasper jumper appliance. Part of the correction was lost during Class II intermaxillary elastics use after use of the Jasper jumper appliance. (Am J Orthod Dentofacial Orthop 2011;140:e77-e84)

Comparative distalization effects of Jones jig and pendulum appliances

Introduction: In this study, we compared the dentoalveolar changes of Class II patients treated with Jones jig and pendulum appliances. Methods: The experimental group comprised 40 Class II malocclusion subjects, divided into 2 groups: group 1 consisted of 20 patients (11 boys, 9 girls) at a mean pretreatment age of 13.17 years, treated with the Jones jig appliance for 0.91 years; group 2 comprised 20 patients (8 boys, 12 grls) at a mean pretreatment age of 13.98 years, treated with the pendulum appliance for 1.18 years. Only active treatment time of molar distalization was evaluated in the predistalization and postdistalization lateral cephalograms. Molar, second premolar, and incisor angular and linear variables were obtained. The intergroup treatment changes in these variables were compared with independent t tests. Results: The maxillary second premolars showed greater mesial tipping and extrusion in the Jones jig group, indicating more anchorage loss during molar distalization with this appliance. The amounts and the monthly rates of molar distalization were similar in both groups. Conclusions: The Jones jig group showed greater mesial tipping and extrusion of the maxillary second premolars. The mean amounts and the monthly rates of first molar distalization were similar in both groups. (Am J Orthod Dentofacial Orthop 2009;135:336-42)

Craniocervical posture and hyoid bone position in children with mild and moderate asthma and mouth breathing

Introduction The objective of the present study was to assess the craniocervical posture and the positioning of the hyoid bone in children with asthma who are mouth breathers compared to non-asthma controls. Methods The study was conducted on 56 children, 28 of them with mild (n = 15) and moderate (n = 13) asthma (14 girls aged 10 79 +/- 1 31 years and 14 boys aged 9 79 +/- 1.12 years), matched for sex, height, weight and age with 28 non-asthma children who are not mouth breathers The sample size was calculated considering a confidence interval of 95% and a prevalence of 4% of asthma in Latin America. Eighteen variables were analyzed in two radiographs (latero-lateral teleradiography and lateral cervical spine radiography), both obtained with the head in a natural position The independent t-test was used to compare means values and the chi-square test to compare percentage values (p < 0 05) Intraclass correlation coefficient (ICC) was used to verify reliability. Results. The Craniovertebral Angle (CVA) was found to be significantly smaller in asthma than in control children (106.38 +/- 766 vs. 111 21 +/- 7.40. p = 0 02) and the frequency of asthma children with an absent or inverted hyoid triangle was found to be significantly higher compared to non-asthma children (36% vs 7%, p = 0.0001). The values of the inclination angles of the superior cervical spine in relation to the horizontal plane were significantly higher in moderate than in mild asthma children (CVT/Hor 85 10 +/- 725 vs. 90 92 +/- 6.69, p = 0 04 and C1/Hor. 80 93 +/- 5.56 vs 85 00 +/- 4 20, p = 0 04) Conclusions These findings revealed that asthma children presented higher head extension and a higher frequency of changes in hyoid bone position compared to non-asthma children and that greater the asthma severity greater the extension of the upper cervical spine. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

Heritability and gene-environment interactions for melanocytic nevus density examined in a U.K. adolescent twin study

Risk factors for melanoma include environmental (particularly ultraviolet exposure) and genetic factors. In rare families, susceptibility to melanoma is determined by high penetrance mutations in the genes CDKN2A or CDK4, with more common, less penetrant genes also postulated. A further, potent risk factor for melanoma is the presence of large numbers of melanocytic nevi so that genes controlling nevus phenotype could be such melanoma susceptibility genes. A large Australian study involving twins aged 12 y of predominantly U.K. ancestry showed strong evidence for genetic influence on nevus number and density. We carried out essentially the same study in the U.K. to gain insight into gene-environment interactions for nevi. One hundred and three monozygous (MZ) and 118 dizygous (DZ) twin pairs aged 10-18 y were examined in Yorkshire and Surrey, U.K. Nevus counts were, on average, higher in boys (mean = 98.6) than girls (83.8) (p = 0.009) and higher in Australia (110.4) than in the U.K. (79.2, adjusted to age 12 y, p < 0.0001), and nevus densities were higher on sun-exposed sites (92 per m(2)) than sun-protected sites (58 per m(2)) (p < 0.0001). Correlations in sex and age adjusted nevus density were higher in MZ pairs (0.94, 95% CI 0.92-0.96) than in DZ pairs (0.61, 95%CI 0.49-0.72), were notably similar to those of the Australian study (MZ = 0.94, DZ = 0.60), and were consistent with high heritability (65% in the U.K., 68% in Australia). We conclude that emergence of nevi in adolescents is under strong genetic control, whereas environmental exposures affect the mean number of nevi.

Comparing physical activity questionnaires for youth: Seasonal vs annual format

Background: In large cohort studies of older children, self-report is the only practical way to assess physical activity. Assessing usual activity over the entire year is desirable, but children and adolescents may overestimate activities with high seasonal variability. Use of questionnaires in which individuals report each activity by season may improve accuracy. Methods: A total of 6782 girls and 5110 boys, aged 9–14 years in 1996, completed self-administered activity questionnaires in 1996 and in 1997. In 1996, participants reported the average time spent in each of 17 activities during the previous 12 months; in 1997, we also asked for the average time spent in the previous year, but within each of the four seasons. Results: Girls reported a median of 12.8 hours/week total activity in 1996 and 10.4 hours/week in 1997. For boys, the estimates were 15.5 hours/week and 13.4 hours/week, respectively. Girls and boys within 1-year age strata (e.g., comparison of 10-year olds in 1996 with 10-year olds in 1997) reported an average of 3.7 and 3.1 fewer hours per week, respectively, on the 1997 seasonal format versus the 1996 annual format questionnaire. In longitudinal analyses, the difference between the annual and the seasonal estimates was greater if participants did the activity in fewer seasons in 1997. Conclusions: In comparison to an annual format questionnaire, a seasonal format questionnaire may improve accuracy of self-report of physical activity by reducing over-reporting of activities in which pre-adolescents and adolescents engage in fewer seasons.

Seasonal Effects on Transient Evoked Otoacoustic Emission Screening Outcomes in Infants versus 6-Year-Old Children

The purpose of this study was to compare transient evoked otoacoustic emission (TEOAE) screening outcomes (pass/fail) across the seasons (spring, autumn, and winter) between infants and schoolchildren. A total of 526 infants (275 boys, 251 girls) with a mean age of 2.0 months (SD = 0.38 months) and 975 schoolchildren (513 boys, 462 girls) with a mean age of 6.2 years (SD = 0.36 years) were screened using the ILO Otodynamics Quickscreen program. The same TEOAE pass/fail criterion was applied to the two groups. The results indicated a significant difference in pass rates between infants (91.2% of 1052 ears) and schoolchildren (86.0% of 1950 ears). A seasonal effect was found only for schoolchildren, with a significantly lower pass rate in winter than in spring or autumn. There was no difference in pass rates between spring and autumn. Implications for the seasonal effect on TEOAE screening outcomes for infants and schoolchildren are discussed.

Total Daily Energy Expenditure and Incidence of Upper Respiratory Tract Infection Symptoms in Young Females

A group of 31 young females, tennis players and non-athletes, aged 16 2 years (range: 14 - 21 years), with a wide range of physical activity levels was used to investigate the relationship between total daily energy expenditure and the incidence of upper respiratory tract infection symptoms. Methods: During a 12 week winter period, habitual daily activity (excluding training) was evaluated using a 3-day physical activity record. Tennis training was quantified using a validated method of estimating energy expenditure during play. Total daily energy expenditure was calculated from the sum of daily training plus mean habitual daily activity energy expenditures. The total group of subjects was divided in quartiles for total daily energy expenditure. A validated symptom checklist was used to assess the incidence and severity of upper respiratory tract infections, on a daily basis. Results: The girls in the highest quartile of total daily energy expenditure (greater than or equal to 17322 kJ/day) and in the lowest quartile (less than or equal to 10 047 kJ/day) had the greatest incidence of URTI symptomatology, although the moderately active girls in quartile three (12290-16410 kJ/day) presented the lowest incidence. Significant differences in number of upper respiratory tract infection episodes, sickness days and symptomatology index were found between quartiles three and one (p < 0.05) and quartiles three and four (p < 0.01). Peak severity of symptoms was significantly lower in quartile three compared with all other quartiles (p < 0.05).

An assessment of maturity from anthropometric measurements

Purpose: The range of variability between individuals of the same chronological age (CA) in somatic and biological maturity is large and especially accentuated around the adolescent growth spurt. Maturity assessment is an important consideration when dealing with adolescents, from both a research perspective and youth sports stratification. A noninvasive, practical method predicting years from peak height velocity (a maturity offset value) by using anthropometric variables is developed in one sample and cross-validated in two different samples. Methods: Gender specific multiple regression equations were calculated on a sample of 152 Canadian children aged 8-16 yr (79 boys; 73 girls) who were followed through adolescence from 1991 to 1997, The equations included three somatic dimensions (height, sitting height, and leg length), CA, and their interactions. The equations were cross-validated on a Combined sample of Canadian (71 boys, 40 girls measured from 1964 through 1973) and Flemish children (50 boys, 48 girls measured from 1985 through 1999). Results: The coefficient of determination (R2) for the boys' model was 0.92 and for the girls' model 0.91 the SEEs were 0.49 and 0.50, respectively, Mean difference between actual and predicted maturity offset for the verification samples was 0.24 (SD 0.65) yr in boys and 0,001 (SD 0.68) yr in girls. Conclusion: Although the cross-validation meets statistical standards or acceptance, caution 1, warranted with regard to implementation. It is recommended that maturity offset be considered as a categorical rather than a continuous assessment. Nevertheless, the equations presented are a reliable, noninvasive and a practical solution for the measure of biological maturity for matching adolescent athletes.

Age and gender differences in objectively measured physical activity in youth

TROST. S. G., R. R. PATE, J. F. SALLIS, P. S. FREEDSON, W. C. TAYLOR, M. DOWDA, and J. SIRARD. Age and gender differences in objectively measured physical activity in youth. Med. Sci. Sports Ererc., Vol. 34, No. 2, pp. 350-355, 2002. Purpose: The purpose of this study was to evaluate age and gender differences in objectively measured physical activity (PA) in a population-based sample of students in grades 1-12. Methods: Participants (185 male, 190 female) wore a CSA 7164 accelerometer for 7 consecutive days. To examine age-related trends. students were grouped as follows: grades 1-3 (N = 90), grades 4-6 (N = 91), grades 7-9 (N = 96). and grades 10-12 (N = 92). Bouts of PA and minutes spent in moderate-to-vigorous PA (MVPA) and vigorous PA (VPA) were examined. Results: Daily MVPA and VPA exhibited a significant inverse relationship with grade level, with the largest differences occurring between grades 1d-3 and 4-6. Boys were more active than girls; however, for overall PA, the magnitudes of the gender differences were modest. Participation in continuous 20-min bouts of PA was low to nonexistent. Conclusion: Our results support the notion that PA declines rapidly during childhood and adolescence and that accelerometers are feasible alternatives to self-report methods in moderately sized population-level surveillance studies.

Estimation of body fatness from body mass index and bioelectrical impedance: comparison of New Zealand European, Maori and Pacific Island children

Objective: To compare percentage body fat (%BF) for a given body mass index (BMI) among New Zealand European, Maori and Pacific Island children. To develop prediction equations based on bioimpedance measurements for the estimation of fat-free mass (FFM) appropriate to children in these three ethnic groups. Design: Cross-sectional study. Purposive sampling of schoolchildren aimed at recruiting three children of each sex and ethnicity for each year of age. Double cross-validation of FFM prediction equations developed by multiple regression. Setting: Local schools in Auckland. Subjects: Healthy European, Maori and Pacific Island children (n = 172, 83 M, 89 F, mean age 9.4 +/- 2.8(s. d.), range 5 - 14 y). Measurements: Height, weight, age, sex and ethnicity were recorded. FFM was derived from measurements of total body water by deuterium dilution and resistance and reactance were measured by bioimpedance analysis. Results: For fixed BMI, the Maori and Pacific Island girls averaged 3.7% lower % BF than European girls. For boys a similar relation was not found since BMI did not significantly influence % BF of European boys ( P = 0.18). Based on bioimpedance measurements a single prediction equation was developed for all children: FFM (kg) = 0.622 height (cm)(2)/ resistance +0.234 weight (kg)+1.166, R-2 = 0.96, s. e. e. = 2.44 kg. Ethnicity, age and sex were not significant predictors. Conclusions: A robust equation for estimation of FFM in New Zealand European, Maori and Pacific Island children in the 5 - 14 y age range that is more suitable than BMI for the determination of body fatness in field studies has been developed. Sponsorship: Maurice and Phyllis Paykel Trust, Auckland University of Technology Contestable Grants Fund and the Ministry of Health.