Effets sur l'articulation temporo-mandibulaire du Twin-Block et d'un appareil myofonctionnel de classe II.

Introduction. Ce projet de recherche consiste en une étude cohorte prospective randomisée visant à évaluer les douleurs ressenties au niveau de l’articulation temporo-mandibulaire (ATM) lors d’une thérapie d’avancement mandibulaire grâce à un appareil fixe, le correcteur de classe II (CC) et d’un appareil amovible, le Twin-Block (TB). Matériels et méthodes. Cette étude comptait 26 patients (11 hommes et 15 femmes), âge moyen de 12ans 10mois (10ans 4mois à 15ans 10mois). Les sujets devaient avoir une malocclusion de classe II et être en croissance, CVM 2 ou 3 (Cervical Vertebral Maturation). Les patients étaient divisés en deux groupes : TB et CC. La douleur était évaluée selon l’axe I de l’examen du RDC/TMD (Research Diagnostic Criteria for Temporomandibular Disorders) à 7 reprises (T0 à T6). De plus, le patient devait remplir un questionnaire, à la maison, sur la douleur ressentie et la médication prise lors des 30 premiers jours. La douleur était évaluée avant l’insertion des appareils (T0), à 1 semaine (T1) post-insertion, 4 semaines plus tard (T2), 8 semaines (T3) où une expansion de 20 tours (environs 5 mm) était débutée, ensuite (T4) (T5) et (T6) chacun à 8 semaines d’intervalles. Les tests statistiques utilisés dans cette étude : le test «Wilcoxon à un échantillon» ainsi que le test «Mann-Whitney à échantillons indépendants ». Résultats et Discussion. La douleur à l’examen clinique est variable mais tend à diminuer avec le temps. Aucune différence, statistiquement significative, ne fut observée entre les 2 groupes en ce qui à trait aux diverses palpations effectuées. Parmi les patients ayant rapporté de la douleur, 40% l’ont ressentie surtout le matin et 63,3% ont dit qu’elle durait de moins d’une heure jusqu’à quelques heures. Conclusion. D’après nos résultats, lors d’une thérapie myofonctionnnelle, il n’y a pas de différence statistiquement significative entre la douleur occasionnée par un Twin-Block et celle produite par un correcteur de classe II fixe au niveau de l’ATM et des muscles du complexe facial.

Three-dimensional outcomes of twin-block appliance treatment and the influence of the postured wax bite

Aims 1 To identify the 3D soft tissue volumetric and linear landmark changes following treatment with the Twin-Block Appliance TBA. 2 To estimate the TBA treatment outcome on the soft tissue facial profile volumetric and linear landmark changes from the Postured Wax Bite (PWB). 3 To identify if there is any association between certain soft tissue landmark variables and successful treatment outcome of the TBA as measured by the reduction in overjet. 4 To assess the effects of TBA treatment on facial expressions. Materials and Methods Forty-seven Caucasian subjects with Class II division 1 were recruited. 3D images captured of each subject, pre-treatment (T1), with the PWB (T2) and at the end of treatment (T3). Soft tissue volumetric and linear changes as well as the correlation between facial parameters and successful treatment were calculated. Results The mean soft tissue volumetric change from T1 to T3 was 22.24 ± 16.73 cm³. Soft tissue profile linear changes from T1-T3 for lower facial landmarks were 4-5 mm. From T1-T3, the mean soft tissue volumetric change of the total sample was 60% of the change produced by the PWB (T1 to T2). Correlations were weak for all 3D facial parameters and successful overjet reduction. Facial expression changes were only significant for the lower landmarks. Conclusions 1 TBA treatment, in growing subjects, increased the lower facial soft tissue volume and caused forward movement of the lower soft tissue facial profile landmarks.2 The PWB can be used to estimate the treatment outcome of the TBA on soft tissue profile changes.3 No association was found between soft tissue landmark variables and successful overjet reduction.4 TBA treatment had no effect on the upper facial landmarks for each facial expression but it changed the lower facial expressions significantly except for maximal smile in males.

Avaliação tridimensional da via aérea superior de pacientes com apneia obstrutiva do sono que utilizaram aparelho de avanço mandibular

Os objetivos deste estudo foram avaliar o efeito do aparelho de avanço mandibular (Twin block - TB) no volume das vias aéreas superiores, por meio de tomografia computadorizada cone beam (CBCT); analisar, por meio da polissonografia, as mudanças no índice de apneia e hipopneia (IAH) e índice de apneia por hora de sono (IA), saturação de oxi-hemoglobina e eficiência do sono; e correlacionar o volume na CBCT e as polissonografias. Dezesseis pacientes portadores de apneia obstrutiva do sono, idade média de 47,06 anos, participaram deste estudo prospectivo, com acompanhamento médio de 7 meses. Foram feitas polissonografias iniciais (T1) e de acompanhamento (T2) com o TB em posição, e CBCT sem e com TB em posição. A segmentação e obtenção dos volumes das vias aéreas superiores foram realizadas e utilizados os testes t de Student pareado, de Wilcoxon e o índice de correlação de Spearman, com 5% de significância. Os resultados das polissonografias mostraram diferenças estatisticamente significativas entre T1 e T2 apenas para IAH (p<0,05). Houve aumento do volume da via aérea superior com TB quando comparado com o volume sem TB (p<0,05). Foi possível estabelecer-se correlação positiva entre volume da via aérea superior sem TB e IAH e IA em T1 (p<0,05), mas não houve correlação entre o volume da via aérea com TB e índices polissonográficos em T2. Pode-se concluir que, houve aumento de volume da via aérea superior com o TB e houve redução do IAH em T2 porém, sem correlação entre estes dados.

Les appareils myofonctionnels de correction de la Classe II : l’EMG.

Introduction: La correction de la Classe II avec un appareil myofonctionnel est un traitement commun chez les patients en croissance. Le Twin Block et le correcteur de Classe II fixe (CCF) sont des appareils populaires et plusieurs publications scientifiques ont décrit leurs effets sur les tissus orofaciaux. Plusieurs articles rapportent les changements de l’électromyographie des muscles de la mastication durant le traitement avec un Twin Block, mais peu d’articles ont étudié ces changements avec un CCF. Comme le Twin Block et le CCF ont des biomécaniques différentes, leur influence sur les muscles est possiblement différente. Objectifs: Évaluer les adaptations musculaires suite à un traitement par appareil myofonctionnel : Twin Block et CCF. Matériels et méthodes: Dans une étude cohorte prospective, 24 patients en pic de croissance ont été assignés aléatoirement à un traitement (13 Twin Block; 11 CCF) et l’EMG des muscles masséters et temporaux a été mesurée à 1, 5, 13, 21, 29, 37 semaines. Les muscles ont été mesurés sous trois états: au repos, en occlusion centré (OC) et en contraction volontaire maximal (CVM) Résultats: Les données ont été analysées à l’aide d’un modèle mixte linéaire à mesures répétées et ont été documentées pour chaque muscle selon quatre conditions: i- avec Twin Block en bouche, ii- sans Twin Block en bouche iii- avec CCF en bouche et iv- sans Twin Block comparé au groupe avec CCF. Dans la condition i, des résultats significatifs ont été observés au repos pour le masséter droit et gauche, ainsi que le temporal gauche avec une valeur-p≤0.005. En CVM, la condition i montre aussi des résultats significatifs pour le masséter droit et le temporal gauche avec une valeur-p≤0.05. Les conditions ii et iii ont obtenu des résultats non-significatifs en tout temps. Par contre, lorsque ces deux conditions sont comparées l’une à l’autre (condition iv), des résultats significatifs ont été obtenus en OC pour les temporaux gauche et droit avec une valeur-p=0.005. Conclusions: Avec le Twin Block en bouche, l’EMG augmente au cours du temps en CVM, mais diminue en OC. Par contre, sans le Twin Block en bouche et avec le CCF en bouche, l’EMG ne varie pas. Cependant, le Twin Block et le CCF sont différents au niveau des mesures de l’EMG au cours des neuf mois de traitement. Ceci peut être expliqué par le nivellement graduel de l’occlusion postérieure durant le traitement avec le CCF qui ne se produit pas avec le Twin Block.

Study on reactive extrusion processes of block copolymer

The anionic copolymerization process of styrene-buradiene (S/B) block copolymer in a closely intermeshing co-rotating twin screw extruder with butyl-lithium initiator was studied. According to the anionic copolymerization mechanism and the reactive extrusion characteristics, the mathematical models of monomer conversion, average molecular weight and fluid viscosity during the anionic copolymerization of S/B were constructed, and then the reactive extrusion process was simulated by means of the finite volume method and the uncoupled semi-implicit iterative algorithm. Finally, the influence of the feeding mixture composition on conversion was discussed. The simulated results were nearly in agreement with the experimental results.

Linkage and heritability analysis of migraine symptom groupings: A comparison of three different clustering methods on twin data

Migraine is a painful disorder for which the etiology remains obscure. Diagnosis is largely based on International Headache Society criteria. However, no feature occurs in all patients who meet these criteria, and no single symptom is required for diagnosis. Consequently, this definition may not accurately reflect the phenotypic heterogeneity or genetic basis of the disorder. Such phenotypic uncertainty is typical for complex genetic disorders and has encouraged interest in multivariate statistical methods for classifying disease phenotypes. We applied three popular statistical phenotyping methods—latent class analysis, grade of membership and grade of membership “fuzzy” clustering (Fanny)—to migraine symptom data, and compared heritability and genome-wide linkage results obtained using each approach. Our results demonstrate that different methodologies produce different clustering structures and non-negligible differences in subsequent analyses. We therefore urge caution in the use of any single approach and suggest that multiple phenotyping methods be used.

Space-frequency block code with matched rotation for MIMO-OFDM system with limited feedback

This paper presents a novel matched rotation precoding (MRP) scheme to design a rate one space-frequency block code (SFBC) and a multirate SFBC for MIMO-OFDM systems with limited feedback. The proposed rate one MRP and multirate MRP can always achieve full transmit diversity and optimal system performance for arbitrary number of antennas, subcarrier intervals, and subcarrier groupings, with limited channel knowledge required by the transmit antennas. The optimization process of the rate one MRP is simple and easily visualized so that the optimal rotation angle can be derived explicitly, or even intuitively for some cases. The multirate MRP has a complex optimization process, but it has a better spectral efficiency and provides a relatively smooth balance between system performance and transmission rate. Simulations show that the proposed SFBC with MRP can overcome the diversity loss for specific propagation scenarios, always improve the system performance, and demonstrate flexible performance with large performance gain. Therefore the proposed SFBCs with MRP demonstrate flexibility and feasibility so that it is more suitable for a practical MIMO-OFDM system with dynamic parameters.

How to be masculine in the block area

This article focuses on the social interactions of several boys aged 3-5 years in the block area of a preschool classroom in a childcare setting. Using transcripts of video segments showing these boys engaged in daily play and interactions, the article analyses two episodes that occurred in the first weeks of the school year. At first glance, both episodes appear chaotic, with little appearance of order among the players. A closer analysis reveals a finely organized play taking place, with older boys teaching important lessons to the newcomers about how to be masculine in the block area. These episodes illustrate that masculinity is not a fixed character trait, but is determined through practice and participation in the activities of masculinity. Play and conflict are the avenues through which this occurs.

Analysis of linear relationships in block ciphers

This thesis is devoted to the study of linear relationships in symmetric block ciphers. A block cipher is designed so that the ciphertext is produced as a nonlinear function of the plaintext and secret master key. However, linear relationships within the cipher can still exist if the texts and components of the cipher are manipulated in a number of ways, as shown in this thesis. There are four main contributions of this thesis. The first contribution is the extension of the applicability of integral attacks from word-based to bitbased block ciphers. Integral attacks exploit the linear relationship between texts at intermediate stages of encryption. This relationship can be used to recover subkey bits in a key recovery attack. In principle, integral attacks can be applied to bit-based block ciphers. However, specific tools to define the attack on these ciphers are not available. This problem is addressed in this thesis by introducing a refined set of notations to describe the attack. The bit patternbased integral attack is successfully demonstrated on reduced-round variants of the block ciphers Noekeon, Present and Serpent. The second contribution is the discovery of a very small system of equations that describe the LEX-AES stream cipher. LEX-AES is based heavily on the 128-bit-key (16-byte) Advanced Encryption Standard (AES) block cipher. In one instance, the system contains 21 equations and 17 unknown bytes. This is very close to the upper limit for an exhaustive key search, which is 16 bytes. One only needs to acquire 36 bytes of keystream to generate the equations. Therefore, the security of this cipher depends on the difficulty of solving this small system of equations. The third contribution is the proposal of an alternative method to measure diffusion in the linear transformation of Substitution-Permutation-Network (SPN) block ciphers. Currently, the branch number is widely used for this purpose. It is useful for estimating the possible success of differential and linear attacks on a particular SPN cipher. However, the measure does not give information on the number of input bits that are left unchanged by the transformation when producing the output bits. The new measure introduced in this thesis is intended to complement the current branch number technique. The measure is based on fixed points and simple linear relationships between the input and output words of the linear transformation. The measure represents the average fraction of input words to a linear diffusion transformation that are not effectively changed by the transformation. This measure is applied to the block ciphers AES, ARIA, Serpent and Present. It is shown that except for Serpent, the linear transformations used in the block ciphers examined do not behave as expected for a random linear transformation. The fourth contribution is the identification of linear paths in the nonlinear round function of the SMS4 block cipher. The SMS4 block cipher is used as a standard in the Chinese Wireless LAN Wired Authentication and Privacy Infrastructure (WAPI) and hence, the round function should exhibit a high level of nonlinearity. However, the findings in this thesis on the existence of linear relationships show that this is not the case. It is shown that in some exceptional cases, the first four rounds of SMS4 are effectively linear. In these cases, the effective number of rounds for SMS4 is reduced by four, from 32 to 28. The findings raise questions about the security provided by SMS4, and might provide clues on the existence of a flaw in the design of the cipher.