Stress analysis in oral obturator prostheses: Imaging photoelastic

Maxillary defects resulting from cancer, trauma, and congenital malformation affect the chewing efficiency and retention of dentures in these patients. The use of implant-retained palatal obturator dentures has improved the self-esteem and quality of life of several subjects. We evaluate the stress distribution of implant-retained palatal obturator dentures with different attachment systems by using the photoelastic analysis images. Two photoelastic models of the maxilla with oral-sinus-nasal communication were fabricated. One model received three implants on the left side of the alveolar ridge (incisive, canine, and first molar regions) and the other did not receive implants. Afterwards, a conventional palatal obturator denture (control) and two implant-retained palatal obturator dentures with different attachment systems (O-ring; bar-clip) were constructed. Models were placed in a circular polariscope and a 100-N axial load was applied in three different regions (incisive, canine, and first molar regions) by using a universal testing machine. The results were photographed and analyzed qualitatively using a software (Adobe Photoshop). The bar-clip system exhibited the highest stress concentration followed by the O-ring system and conventional denture (control). Images generated by the photoelastic method help in the oral rehabilitator planning. © 2013 SPIE.

Mediação oral da literatura: a voz do bibliotecário lendo ou narrando

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo de vocábulos para avaliação de crianças com deficiência sem linguagem oral

Researchers in the field of Augmentative and Alternative Communication point out the lack of instruments for assessing children and young people with a complex communication needs. This study's focus is the selection of words for creating an instrument for the vocabulary range in non-speaking children aged two to eleven years and eleven months. Three studies were performed. The first study identified and described tools available for assessing receptive vocabulary and their respective word lists. The second identified and described research that presented word inventories or word lists. The third study identified the vocabulary reported by parents and teachers. The words that were identified in the three studies were analyzed according to: the number of times they occurred; the Picture Communication Symbols system classification; and a semantic and syntactic classification. Based on these studies the following criteria for vocabulary selection were established for word selection: the 45 words which appeared in all three studies, the words that occurred five times or more, considering the three studies, representing 167 (14.14%) words; the words identified in study one or two, but that had been reported by the families - 183 (19.37% out of 945 words) - or by teachers - 108 (11.43% out of 945 words). The word list was composed of 269 items, classified in 18 semantic and syntactic topics; it represents an initial tool for professionals in the field of health and education to set goals for beginning assessment of children and teenagers who are users of Augmentative and Alternative Communication systems.

Stress analysis in oral obturator prostheses over parallel and tilted implants: photoelastic imaging

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Stress analysis in oral obturator prostheses, part II: photoelastic imaging

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Mathematical Communication, Conceptual Understanding, and Students' Attitudes Toward Mathematics

This action research study of my 8th grade classroom investigated the use of mathematical communication, through oral homework presentations and written journals entries, and its impact on conceptual understanding of mathematics. This change in expectation and its impact on students’ attitudes towards mathematics was also investigated. Challenging my students to communicate mathematics both orally and in writing deepened the students’ understanding of the mathematics. Levels of understanding deepened when a variety of instructional methods were presented and discussed where students could comprehend the ideas that best suited their learning styles. Increased understanding occurred through probing questions causing students to reflect on their learning and reevaluate their reasoning. This transpired when students were expected to write more than one draft to math journals. By making students aware of their understanding through communicating orally and in writing, students realized that true understanding did not come from mere homework completion, but from evaluating and assessing their own and other’s ideas and reasoning. I discovered that when students were challenged to communicate their reasoning both orally and in writing, students enjoyed math more and thought math was more fun. As a result of this research, I will continue to require students to communicate their thinking and reasoning both orally and in writing.

Parental reports of the oral health-related quality of life of children with cerebral palsy

Background: The severity of physical and mental impairments and oral problems, as well as socioeconomic factors, may have an impact on quality of life of children with cerebral palsy (CP). The aim of this research was to assess the impact of impairments and oral health conditions, adjusted by socioeconomic factors, on the Oral Health-Related Quality of Life (OHRQoL) of children with CP using their parents as proxies. Methods: Sixty children, between 6-14 years of age were selected. Their parents answered a children's OHRQoL instrument (5 domains) which combines the Parental-Caregivers Perception Questionnaire (P-CPQ) and Family Impact Scale (FIS). The severity of dental caries, type of CP, communication ability, gross motor function, seizures and socioeconomic conditions were assessed. Results: Considering the total score of the OHRQoL instrument, only the reduction of communication ability and dental caries severity had a negative impact on the OHRQoL (p < 0.05). Considering each domain of the instrument, the severity of the type of CP and its reduction of communication ability showed a negative impact on oral symptoms and functional limitations domains (p < 0.05). Seizures have a negative impact on oral symptoms domain (p = 0.006). The multivariate fitted model showed that the severity of dental caries, communication ability and low family income were negatively associated with the impact on OHRQoL (p = 0.001). Conclusions: The severity of dental caries, communication ability, and family income are conditions strongly associated with a negative impact on OHRQoL of children with CP.

Inequalities in mortality of men by oral and pharyngeal cancer in Barcelona, Spain and São Paulo, Brazil, 1995–2003

Abstract Background Large inequalities of mortality by most cancers in general, by mouth and pharynx cancer in particular, have been associated to behaviour and geopolitical factors. The assessment of socioeconomic covariates of cancer mortality may be relevant to a full comprehension of distal determinants of the disease, and to appraise opportune interventions. The objective of this study was to compare socioeconomic inequalities in male mortality by oral and pharyngeal cancer in two major cities of Europe and South America. Methods The official system of information on mortality provided data on deaths in each city; general censuses informed population data. Age-adjusted death rates by oral and pharyngeal cancer for men were independently assessed for neighbourhoods of Barcelona, Spain, and São Paulo, Brazil, from 1995 to 2003. Uniform methodological criteria instructed the comparative assessment of magnitude, trends and spatial distribution of mortality. General linear models assessed ecologic correlations between death rates and socioeconomic indices (unemployment, schooling levels and the human development index) at the inner-city area level. Results obtained for each city were subsequently compared. Results Mortality of men by oral and pharyngeal cancer ranked higher in Barcelona (9.45 yearly deaths per 100,000 male inhabitants) than in Spain and Europe as a whole; rates were on decrease. São Paulo presented a poorer profile, with higher magnitude (11.86) and stationary trend. The appraisal of ecologic correlations indicated an unequal and inequitably distributed burden of disease in both cities, with poorer areas tending to present higher mortality. Barcelona had a larger gradient of mortality than São Paulo, indicating a higher inequality of cancer deaths across its neighbourhoods. Conclusion The quantitative monitoring of inequalities in health may contribute to the formulation of redistributive policies aimed at the concurrent promotion of wellbeing and social justice. The assessment of groups experiencing a higher burden of disease can instruct health services to provide additional resources for expanding preventive actions and facilities aimed at early diagnosis, standardized treatments and rehabilitation.

Phonetic Aspects of Speech Communication

Nadeina set out to develop methods of speech development in Russian as a mother tongue, focusing on improving diction, training in voice quality control, intonation control, the removal of dialect, and speech etiquette. She began with training in the receptive skills of language, i.e. reading and listening, since the interpretation of someone else's language plays an important role in language production. Her studies of students' reading speed of students showed that it varies between 40 and 120 words per minute, which is normally considered very slow. She discovered a strong correlation between speed of reading and speaking skills: the slower a person reads the worse is their ability to speak and has designed exercises to improve reading skills. Nadeina also believes that listening to other people's speech is very important, both to analyse its content and in some cases as an example, so listening skills need to be developed. Many people have poor pronunciation habits acquired as children. On the basis of speech samples from young Russians (male and female, aged 17-22), Nadeina analysed the commonest speech faults - nasalisation, hesitation and hemming at the end of sense-groups, etc. Using a group of twenty listeners, she looked for a correlation between how voice quality is perceived and certain voice quality parameters, e.g. pitch range, tremulousness, fluency, whispering, harshness, sonority, tension and audible breath. She found that the less non-linguistic segment variations in speech appeared, the more attractive the speech was rated. The results are included in a textbook aimed at helping people to improve their oral skills and to communicate ideas to an audience. She believes this will assist Russian officials in their attempts to communicate their ideas to different social spheres, and also foreigners learning Russian.

Patients with oral tumors. Part 2: Quality of life after treatment with resection prostheses. Resection prosthetics: evaluation of quality of life

In the present study, the oral health-related quality of life of 18 patients (13 men and 5 women) was evaluated using validated questionnaires as proposed by the European Organization of Research and Treatment of Cancer (EORTC). The patients belonged to a cohort of 48 patients, whose prosthetic treatment was performed during the years 2004-2007. In the course of tumor resection, 12 patients underwent graft surgery and 14 patients radiotherapy. One patient required a nasal epithesis since resection of the nose became necessary. Five patients underwent a full block resection of the mandible, and tumor resection in 3 patients resulted in a large oronasal communication. Prosthetic rehabilitation was performed in all patients, and the follow-up period with regular care covered a minimum of 3 years. Eleven patients received dental implants for better support and retention of the prostheses. In spite of compromised oral conditions, functional restrictions, and some difficulties with the prostheses, the answers to the questionnaire were quite positive. The majority judged their general health as good or even excellent. The subjective perception of the patients may contradict the objective view by the dentist. In fact, the individual patient's history and experience provide a better understanding of the impact of oral tumors on daily life. The overall assessment identified 4 items that were perceived as major problems by all patients: swallowing solid food, dry mouth, limited mouth opening, and appearance. Prosthetic rehabilitation has only a limited influence on such problems.

Patients with oral tumors. Part 1: Prosthetic rehabilitation following tumor resection. Resection prosthetics: surgery, implants and prosthetic treatment

The present study reports on the surgical and prosthodontic rehabilitation of 46 patients, 31 male and 15 female, after resection of oral tumors. The treatment was carried out from 2004 to 2007 at the Department of Prosthodontics, University of Bern, with a follow-up time of 3 to 6 years. The average age at diagnosis was 54 years. 76% of all tumors were squamous cell carcinoma, followed by adenocarcinoma. Resection of the tumors including soft and/or hard tissues was performed in all patients. 80% of them additionally underwent radiotherapy and 40% chemotherapy. A full block resection of the mandible was perfomed in 23 patients, and in 10 patients, the tumor resection resulted in an oronasal communication. 29 patients underwent grafting procedures, mostly consisting of a free fibula flap transplant. To enhance the prosthetic treatment outcome and improve the prosthesis stability, a total of 114 implants were placed. However, 14 implants were not loaded because they failed during the healing period or the patient could not complete the final treatment with the prostheses. The survival rate of the implants reached 84.2% after 4 to 5 years. Many patients were only partially dentate before the tumors were detected, and further teeth had to be extracted in the course of the tumor therapy. Altogether, 31 jaws became or remained edentulous. Implants provide stability and may facilitate the adaptation to the denture, but their survival rate was compromised. Mostly, patients were fitted with removable prostheses with obturators in the maxilla and implant-supported complete dentures with bars in the mandible. Although sequelae of tumor resection are similar in many patients, the individual intermaxillary relations, facial morphology and functional capacity vary significantly. Thus, individual management is required for prosthetic rehabilitation.

Cell-to-cell communication--periodontal regeneration.

BACKGROUND Although regenerative treatment options are available, periodontal regeneration is still regarded as insufficient and unpredictable. AIM This review article provides scientific background information on the animated 3D film Cell-to-Cell Communication - Periodontal Regeneration. RESULTS Periodontal regeneration is understood as a recapitulation of embryonic mechanisms. Therefore, a thorough understanding of cellular and molecular mechanisms regulating normal tooth root development is imperative to improve existing and develop new periodontal regenerative therapies. However, compared to tooth crown and earlier stages of tooth development, much less is known about the development of the tooth root. The formation of root cementum is considered the critical element in periodontal regeneration. Therefore, much research in recent years has focused on the origin and differentiation of cementoblasts. Evidence is accumulating that the Hertwig's epithelial root sheath (HERS) has a pivotal role in root formation and cementogenesis. Traditionally, ectomesenchymal cells in the dental follicle were thought to differentiate into cementoblasts. According to an alternative theory, however, cementoblasts originate from the HERS. What happens when the periodontal attachment system is traumatically compromised? Minor mechanical insults to the periodontium may spontaneously heal, and the tissues can structurally and functionally be restored. But what happens to the periodontium in case of periodontitis, an infectious disease, after periodontal treatment? A non-regenerative treatment of periodontitis normally results in periodontal repair (i.e., the formation of a long junctional epithelium) rather than regeneration. Thus, a regenerative treatment is indicated to restore the original architecture and function of the periodontium. Guided tissue regeneration or enamel matrix proteins are such regenerative therapies, but further improvement is required. As remnants of HERS persist as epithelial cell rests of Malassez in the periodontal ligament, these epithelial cells are regarded as a stem cell niche that can give rise to new cementoblasts. Enamel matrix proteins and members of the transforming growth factor beta (TGF-ß) superfamily have been implicated in cementoblast differentiation. CONCLUSION A better knowledge of cell-to-cell communication leading to cementoblast differentiation may be used to develop improved regenerative therapies to reconstitute periodontal tissues that were lost due to periodontitis.

Time-dependent supraimplant mucosa changes: short communication

PURPOSE The aim of this short communication was to analyze time-dependent changes of the supraimplant mucosa architecture in the esthetic zone. MATERIALS AND METHODS Five patients underwent single-tooth replacement with implant crowns in the anterior maxilla. The supraimplant soft tissue was conditioned with fixed provisional crowns. Quadrantlike digital impressions were taken with an intraoral optical scanning device at three time points: t0, immediately after removal of the provisional (baseline); t1, after 5 minutes; and t2, after 10 minutes. To analyze time-dependent mucosal changes, the corresponding digital files were superimposed for each patient, and baseline (t0) scans were compared with t1 and t2 scans, respectively. Wilcoxon rank sum tests were used for statistical calculations with a strict level of significance at P < .01. RESULTS Mean values for supraimplant soft tissue changes were statistically significantly different after 5 minutes (5.5%; standard deviation ± 0.3%) in comparison to the results after 10 minutes (21.7%; standard deviation ± 1.8%). The direction of mucosa shrinkage showed a trend toward palatal sites. CONCLUSION Based on the findings of this analysis, changes in supraimplant mucosa architecture seem to be affected only slightly during the first 5 minutes after removal of soft tissue support.

Improving the Assessment of Communication Skills at the Swiss Federal Licensing Exam: Results of a Student's Needs Assessment

Introduction With a three year project the assessment of communication skills within the Swiss Federal Licensing Examinations (FLE) shall be improved. As a first step a needs assessment among communication experts and medical students of the Swiss Medical Faculties will be performed. In this presentation the results of the students’ needs assessment will be presented. Methods A bilingual student’s online questionnaire will be developed by an expert panel taking relevant literature, the Swiss Catalogue of Learning Objectives and other consensus statements for communication (e.g., the European and Basler consensus statements) into account. With a think aloud study response process validity evidence will be sought. The questionnaire will focus on the following topics related to communication skills: (1) What has been taught?, (2) What has been assessed in the faculty exams?, (3) What has been assessed in the FLE?, (4) What should have been assessed in the FLE and how should the assessment be improved? Results Results of the students’ needs assessment will be available by the end of 2015 and be presented. Conclusions/ Take-home message We hope for valuable input for improving the assessment of communications skills within the FLE also from the students’ side. Results of the needs assessment from the students and experts will be combined and taken as input for an international expert symposium on how to improve the communication skills assessment within the FLE.

The Adaptation Effect in Bilingual People who Stutter: An Examination of the Oral-Motor Rehearsal Theory

The present study provided further information about stuttering among bilingual populations and attempted to assess the significance of repeated oral-motor movements during an adaptation task in two bilingual adults. This was accomplished by requesting that bilingual people who stutter to complete an adaptation task of the same written passage in two different languages. Explored was the following research question: In bilingual speakers who stutter, what is the effect of altering the oral-motor movements by changing the language of the passage read during an adaptation task? Two bilingual adults were each requested to complete an adaptation task consisting of 10 readings in two separate conditions. Participants 1 and 2 completed two conditions, each of which contained a separate passage. Condition B consisted of an adaptation procedure in which the participants read five successive readings in English followed by five additional successive readings in Language 1 (L1). Following the completion of the first randomly assigned condition, the participant was given a rest period of 30 minutes before beginning the remaining condition and passage. Condition A consisted of an adaptation procedure in which the participants read five successive readings in L1 followed by five additional successive readings in English. Results across participants, conditions, and languages indicated an atypical adaptation curve over 10 readings characterized by a dramatic increase in stuttering following a change of language. Closer examination of individual participants revealed differences in stuttering and adaptation among languages and conditions. Participants 1 and 2 demonstrated differences in adaptation and stuttering among languages. Participant 1 demonstrated an increase in stuttering following a change in language read in Condition B and a decrease in stuttering following a change in language read in Condition A. It is speculated that language proficiency contributed to the observed differences in stuttering following a change of language. Participant 2 demonstrated an increase in stuttering following a change in language read in Condition A and a minimal increase in stuttering following a change in language read in Condition B. It is speculated that a change in the oral-motor plan contributed to the increase in stuttering in Condition A. Collectively, findings from this exploratory study lend support to an interactive effect between language proficiency and a change in the oral-motor plan contributing to increased stuttering following a change of language during an adaptation task.