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[Management of maxillary deficiency through distraction osteogenesis. Report of 14 cases].
Emparanza, A; Zwetyenga, N; Siberchicot, F; Majoufre-Lefebvre, C
Maxillary protraction using elastics has been used routinely in patients with maxillary hypoplasia. Internal devices with bone anchorage allows more control of the distracted callus and more predictable results. The use of distraction splints with internal distractors simultaneously provides more accuracy in maxillary hypoplasia treatment. Three techniques using internal maxillary distractors and distraction splints are exposed for treatment of severe or partial maxillary hypoplasia. Fourteen patients have been treated from 1996 january 1 to 2000 june 30: twelve with a severe maxillary hypoplasia, two with a partial hypoplasia, among them eight in childhood or adolescence. The functionnal and aesthetic results have been satisfactory in all cases. Vertical maxillary hypoplasia treated by internal distractors techniques provides better results than traditionals inlay grafted Lefort I osteotomies. Segmental distractions can also be used in combination with classic orthognatic surgery. PMID:11534440
Maxillary distraction for the management of cleft maxillary hypoplasia with a rigid external distraction system.
Figueroa, A A; Polley, J W; Ko, E W
Maxillary hypoplasia is a common finding in patients with repaired orofacial clefts. Management of this condition has been a challenge to the reconstructive team. The introduction of distraction osteogenesis to treat craniofacial skeletal dysplasias has opened alternative approaches to manage these severe conditions. In this article, the authors present their technique to distract the hypoplastic cleft maxilla using a rigid external distraction device. The clinical assessment, indications, orthodontic procedure, surgical technique, and distraction protocol are reviewed. A case report shows the use of the technique. This technique allows the reconstructive team to treat patients in all age groups with predictable and stable results. PMID:10371940
Perpendicular serial maxillary distraction osteogenesis in cleft lip and palate patients
Ylikontiola, Leena P.; S├Īndor, George K.; Harila, Virpi
Background: Cleft lip and palate patients often have a retruded maxilla with a severely narrowed deficient maxillary arch. This report aims to describe the management of severe maxillary retrusion and constriction in cleft lip and palate patients using distraction osteogenesis applied in serial sequence in two directions perpendicular to each other. Materials and Methods: Two adult male cleft lip and palate patients were treated with maxillary distraction osteogenesis in two stages. In the first stage, surgically assisted rapid palatal expansion with a tooth-borne device was performed to significantly expand the maxillary arch in the transverse dimension. After the teeth were orthodontically aligned, the horizontal distraction of the maxilla was made by two internal maxillary distraction devices. Results: In the first patient, the maxilla was initially widened by 11 mm and then distracted forward by 20 mm. Despite the breakage of the shaft of one of the two distractors at the end of distraction, a satisfactory occlusion was found at the time of distractor device removal. The maxillary position has remained stable through 8 years of follow-up. In the second patient, the palate was widened by 14 mm and the maxilla was distracted forward by 22 mm. The maxillary position has remained stable through 3 years of follow-up. Conclusion: Sequential serial distraction of maxilla in two planes perpendicular to each other is a safe and stable approach for the treatment of cleft lip and palate patients with severe transverse and anteroposterior discrepancies. PMID:26981462
Correction of an asymmetric maxillary dental arch by alveolar bone distraction osteogenesis.
Ohba, Seigo; Tobita, Takayoshi; Tajima, Nobutaka; Matsuo, Kyoko; Yoshida, Noriaki; Asahina, Izumi
This case report describes a new surgical orthodontic approach involving alveolar bone distraction osteogenesis for correction of an asymmetric maxillary dental arch. The treatment was combined with conventional orthognathic surgery to improve the mandibular lateral deviation. This new treatment strategy produced an ideal dental arch and a symmetric facial appearance efficiently and effectively. PMID:23374934
Skeletal stability and complications in transantral maxillary distraction in patients with cleft lip and palate.
Nkenke, Emeka; Vairaktaris, Elefterios; Hanke, Sebastian; Hoffmann, Bettina; Schlittenbauer, Tilo
The current prospective study aimed at assessing skeletal stability and complications arising from transantral maxillary distraction adopted for advancements of less than 12 mm in patients with cleft lip, alveolus, and palate malformations.The recruited patients with cleft lip, alveolus, and palate were followed up for 12 months. Lateral skull radiographs were obtained before surgery (T0), at the end of the activation period of the distractors (T1), and after completion of the follow-up interval (T2). Length and height of the maxilla were assessed at the different points of time. The relapse rate of maxillary advancement was calculated. Complications such as infections, distractor breakage and loosening, nonunions, and the need for reoperation were documented.Seven patients were included in this study (mean [SD] age, 19.5 [2.6] y). The length of the maxilla significantly increased by 6.4 ▒ 1.1 mm at T1 (P = 0.018) but showed a significant relapse by 7.5% at T2 (P = 0.018). As a complication, a case of infection of the cheek occurred during the consolidation period, which could be treated conservatively. In an additional patient, there was a loosening of a distractor at the end of the distraction period, which required reoperation with conventional fixation of the maxilla in the intended position. At the time of removal of the distractors and the conventional osteosynthesis plates, no cases of nonunion could be identified.It seems that the low horizontal relapse rate of transantral maxillary distraction in patients with cleft lip and palate outweighs the possible complications of this procedure in cases of limited distances of advancement of less than 12 mm. PMID:24621725
Repair of segmental bone defects in the maxilla by transport disc distraction osteogenesis: Clinical experience with a new device.
Boonzaier, James; Vicatos, George; Hendricks, Rushdi
The bones of the maxillary complex are vital for normal oro-nasal function and facial cosmetics. Maxillary tumor excision results in large defects that commonly include segments of the alveolar and palatine processes, compromising eating, speech and facial appearance. Unlike the conventional approach to maxillary defect repair by vascularized bone grafting, transport disc distraction osteogenesis (TDDO) stimulates new bone by separating the healing callus, and stimulates growth of surrounding soft tissues as well. Bone formed in this way closely mimics the parent bone in form and internal structure, producing a superior anatomical, functional and cosmetic result. Historically, TDDO has been successfully used to close small horizontal cleft defects in the maxilla, not exceeding 25 mm. Fujioka et al. reported in 2012 that "no bone transporter corresponding to the (large) size of the oro-antral fistula is marketed. The authors report the successful treatment of 4 cases involving alveolar defects of between 25 mm and 80 mm in length. PMID:26389041
Maxillary and mandibular distraction osteogenesis in growing patients: lessons learned after 14 years and update on indications.
Diner, P A; Tomat, C; Hamou, C; Vazquez, M P; Picard, A
In the past decade, distraction osteogenesis (DO) has become increasingly popular and has opened new therapeutic perspectives for the treatment of numerous congenital and acquired craniofacial skeletal anomalies. However, DO mechanisms still remain unclear and different treatment protocols are applied by different groups. Here the authors use their 14 years-clinical experience to evaluate DO parameters such as maxillary and mandibular DO stability over time, especially in growing patients, DO effects on soft tissues and the correlation between the bone gain and lengthening capabilities of the device. Based on these data, clinical indications and treatment protocols for mandibular and maxillary DO are suggested. The application of DO to the membranous bones of the craniofacial skeleton has opened a new chapter in the surgical treatment of several congenital and acquired craniofacial deformities. Based on this experience, the authors recommend DO indications guidelines in selected cases of hemifacial microsomia, maxillary hypoplasia and narrow mandible with anterior dental crowding. PMID:22073464
Le Fort I distraction using internal devices for maxillary hypoplasia in patients with cleft lip, palate, and alveolus: complications and their prevention and management.
Mitsukawa, Nobuyuki; Satoh, Kaneshige; Morishita, Tadashi
In recent years, advancement has been made in distraction osteogenesis in the facial area. It has been applied actively to treat maxillary hypoplasia in patients with cleft lip, palate, and alveolus. Le Fort I distraction using internal devices does not lead to disability in daily living, including during the retention period, and has low surgical invasiveness, facile management, and superior aesthetics. Thus, there have been occasional reports on this procedure in recent years. Because an internal device is unidirectional, the greatest disadvantage is the inability to adjust the direction of distraction after its placement. However, past reports have emphasized its advantages, and its complications have rarely been discussed. We performed Le Fort I distraction using internal devices on 15 young patients. Our results showed notable complications in a few cases. When serial cephalometric analysis was performed after maxillary distraction, it demonstrated that the maxilla assumes various three-dimensional distraction morphologies. In particular, cases with insufficient bone grafting of alveolar clefts developed collapse mainly in the alveolar cleft region during postoperative distraction. Mobility and deviation of the maxillary bone fragment occurred. We implemented preventative measures against complications such as using modifications to place the devices parallel on the left and right sides and using a bite splint for distraction. These measures produced improved outcomes, and we describe here the details. PMID:20856032
Maxillary distraction osteogenesis for treatment of cleft lip and palate in a patient with X-linked agammaglobulinemia.
Sato, Yutaka; Mishimagi, Takashi; Katsuki, Yuko; Harada, Kiyoshi
X-linked agammaglobulinemia (XLA) is a congenital immune deficiency disorder caused by abnormal antibody production. It is a rare disease with an estimated frequency of 1 in 379,000 that has X-linked recessive heredity and develops only in males. The clinical problems include bacterial infection such as otitis media, sinusitis, and bronchitis. In recent years it has become possible to diagnose XLA in the early stage and intravenous immunoglobulin replacement therapy has permitted survival to adulthood. However, there have been no reports of oral surgery in patients with XLA. Here, we describe a case in which immunoglobulin replacement therapy given pre- and postoperatively was used to control infection in oral surgery and maxillary distraction osteogenesis performed for improving occlusion and appearance of a cleft lip and palate in a patient with XLA. PMID:24947966
Combined use of alveolar distraction osteogenesis and segmental osteotomy in anterior vertical ridge augmentation
├¢nc├╝, Elif; Isik, Kubilay; Alaaddino─¤lu, E. Emine; U├¦kan, Sina
Introduction Vertical defects of the anterioral veolar ridge are challenging cases in implant dentistry. Various techniques, such as onlay bone grafting, segmental osteotomy (SO) oral veolar distraction osteogenesis (ADO), have been suggested to manage those situations. ADO has an advantage of being capable of enhancing both hard and soft tissue simultaneously. Presentation of case One of the possible complications of ADO is rotation ortilting the transport segment (TS). In this report, we present a 30-year old woman who had a severe anterior vertical deficiency. ADO was started to manage the case, but advancement of the TS lagged on the left side and the segment rotated. A SO was planned and the lagged side was corrected. Two years after the surgery, hard and soft tissue gains were found to be preserved. Discussion Vertical alveolar bone deficiencies are challenging cases for dental implantology. Alveolar DO promotes soft tissue along with hard tissue, and the bone regeneration process and shows lower infection rates and greater stability over the long term. However, the technique has some disadvantages and can lead to complications, such as breaking of the distraction device, nerve injury or paresthesia, fracture of transport bone, hematoma, wound dehiscence, severe bleeding, and even jaw fractures. Deviation of the TS from the distraction path is another undesired situation. The rigidity of the device, the width of the mucosa, the volume of the transport and anchor segments, and the amount of augmentation can affect vector deviation. Conclusion We suggest that SO can be used in similar cases in which TS could not be distracted on a straight vector line. PMID:25661636
Surgical accuracy of three-dimensional virtual planning: a pilot study of bimaxillary orthognathic procedures including maxillary segmentation.
Stokbro, K; Aagaard, E; Torkov, P; Bell, R B; Thygesen, T
This retrospective study evaluated the precision and positional accuracy of different orthognathic procedures following virtual surgical planning in 30 patients. To date, no studies of three-dimensional virtual surgical planning have evaluated the influence of segmentation on positional accuracy and transverse expansion. Furthermore, only a few have evaluated the precision and accuracy of genioplasty in placement of the chin segment. The virtual surgical plan was compared with the postsurgical outcome by using three linear and three rotational measurements. The influence of maxillary segmentation was analyzed in both superior and inferior maxillary repositioning. In addition, transverse surgical expansion was compared with the postsurgical expansion obtained. An overall, high degree of linear accuracy between planned and postsurgical outcomes was found, but with a large standard deviation. Rotational difference showed an increase in pitch, mainly affecting the maxilla. Segmentation had no significant influence on maxillary placement. However, a posterior movement was observed in inferior maxillary repositioning. A lack of transverse expansion was observed in the segmented maxilla independent of the degree of expansion. PMID:26250603
Adjacent segment degeneration after single-level anterior cervical decompression and fusion: disc space distraction and its impact on clinical outcomes.
Li, Jia; Li, Yongqian; Kong, Fanlong; Zhang, Di; Zhang, Yingze; Shen, Yong
The purpose of this study was to find whether excessive distraction of the disc space for cage insertion was a risk factor for adjacent segment degeneration (ASD) after anterior cervical decompression and fusion (ACDF). One hundred and sixteen consecutive patients who underwent ACDF for single-level cervical disc herniation between June 2006 and November 2008 were retrospectively reviewed. Preoperative, postoperative and final follow-up disc height (DH), sagittal segmental alignment (SSA), and sagittal alignment of the cervical spine (SACS) were measured and compared between the ASD group and non-ASD group. In 116 patients, ASD was radiographically proven in 28 (24.1%) patients. The clinical outcomes were significantly improved compared to the preoperative scores in both groups. However, the postoperative and final follow-up DH of the ASD group were significantly higher than in the non-ASD group (p<0.05). In addition, the postoperative DH was significantly correlated with the postoperative or final follow-up SSA (p<0.05). However, postoperative DH was not found to significantly correlate with postoperative or final follow-up SACS (p=0.072 and p=0.096, respectively). Multivariate analysis showed that postoperative DH was the most significant risk factor for ASD. The clinical outcomes of ACDF for single-level degenerative cervical disc disease were satisfactory. Postoperative DH (the distracted distance) had the greatest impact on the incidence of ASD. Excessive disc space distraction is a considerable risk factor for the development of radiographic ASD. PMID:25487176
Improvement in chronic low back pain in an aviation crash survivor with adjacent segment disease following flexion distraction therapy: a case study
Greenwood, Dean M.
Objective The purpose of this case study is to describe the chiropractic management of chronic low back pain in a patient with adjacent segment disease. Clinical Features The patient was a 30-year-old man with a 3-year history of chronic nonspecific low back pain following a lumbar disk herniation. Two years before this incident, he had severe lumbar fractures and cauda equina injury due to an aviation accident that required multilevel lumbar fusion surgery, vertebrectomy, and cage reconstruction. Intervention and Outcome The patient received chiropractic management using Cox Flexion Distraction over a 4-week period. A complete reduction of symptoms to 0/10 on a verbal numerical rating scale was achieved within 4 weeks. At 3 months, the patient was able to work 8 to 9 hours per day in his dental practice with no pain. At 9 months, the patient continued to report a complete reduction of symptoms. Conclusions This report describes the successful management of a patient with chronic low back pain associated with adjacent segment disease using Cox Flexion Distraction protocols. PMID:23843764
Initial Experience With a New Intraoral Midface Distraction Device.
Burstein, Fernando; Soldanska, Magdalena; Granger, Michael; Berhane, ChiChi; Schoemann, Mark
Maxillary hypoplasia that necessitates surgical advancement affects approximately 25% of patients born with cleft lip and palate. Syndromic conditions such as Crouzon may also be accompanied by significant maxillary hypoplasia. Severe maxillary hypoplasia can result in airway obstruction, malocclusion, proptosis, and facial disfigurement. For optimal stability, severe hypoplasia is best addressed with maxillary distraction osteogenesis. Twenty-two patients (15 boys, 7 girls, ages 6-16 years, mean age 10 years) with severe midface hypoplasia underwent midface distraction with new internal maxillary distraction (IMD) device at our institution. Total distraction distances ranged from 15 to 30 mm. There were no major complications, and all of them had improvement in functional and aesthetic parameters. There were 2 minor complications and 2 patients failed to distract the full distance because of converging vectors. Early maxillary distraction in patients with severe midface hypoplasia is a useful technique to provide interval correction of severe maxillary hypoplasia before skeletal maturity and definitive orthognathic surgery is contemplated, and it is a good tool to improve occlusion, aesthetics, and self-perception in younger patients. PMID:26080162
Bidimensional dentoalveolar distraction osteogenesis for treatment efficiency.
Uribe, Flavio; Agarwal, Sachin; Janakiraman, Nandakumar; Shafer, David; Nanda, Ravindra
This case report describes the treatment of a 16-year-old girl with a unilateral posterior buccal crossbite, a unilateral Class II molar relationship, and a maxillary right canine high in the labial sulcus. The treatment plan included surgically assisted unilateral maxillary expansion for the correction of the buccal crossbite, with simultaneous dentoalveolar distraction of the maxillary right canine into the extraction space of the first premolar aided by skeletal anchorage. Reduced orthodontic treatment time was facilitated by these 2 surgical procedures. A pleasing esthetic result and a good functional occlusion were achieved in 13 months. PMID:23910210
Bone dynamics in the upward direction after a maxillary sinus floor elevation procedure: serial segmentation using synchrotron radiation micro-computed tomography
Seo, Seung-Jun; Bark, Chung Wung; Lim, Jae-Hong; Kim, Yong-Gun
Objective Maxillary sinus floor augmentation has been shown to be the most predictable surgical technique for enhancing the bone volume in the posterior area of the maxilla. The purpose of this study was to analyze the serial slice image segmentation of newly formed bone and bone substitutes after sinus floor elevation using synchrotron radiation X-ray micro-computed tomography (SR-╬╝CT). Materials and methods Bone biopsy specimens were collected after 6 months of sinus floor augmentation. From the six bone biopsy specimens, the cross-sectional images at every 8 ╬╝m along the apical direction from the inferior border using serial segmentation from three-dimensional reconstructed X-ray images were analyzed. The amount of new bone and bone substitutes were measured at each slicing image (300ŌĆō430 images per specimen). Results The bone dynamics between the new bone and bone substitutes along the inferiorŌĆōsuperior direction in humans after maxillary sinus floor elevation (MSFE) were analyzed using the whole sample region. Although these observations suggest that the specimens are structurally inhomogeneous, sinus floor elevation was confirmed to be a reliable surgical procedure for increasing the amount of bone. Conclusion SR-╬╝CT is highly effective for obtaining high-resolution images. An analysis of biological specimens using SR-╬╝CT is quite reliable and this technique will be an important tool in the wide field of tissue engineering. PMID:26347146
... the road Your hands on the wheel Your mind on driving Distracted driving occurs when something gets in the way of you doing all 3 things. Examples include: Talking on a cell phone Reading or sending text messages Eating and drinking Grooming ( ...
Zuzek, Crystal
In 2011, the National Transportation Safety Board urged all states to ban the use of portable electronic devices while driving, including hand-held and hands-free devices. Texting while driving concerns several Texas legislators, who have filed bills, backed by the Texas Medical Association, to ban the practice. TMA physicians recognize that the use of hand-held and hands-free devices and other factors associated with distracted driving affect their patients' safety. PMID:23546834
Comprehensive treatment and rehabilitation of a patient with maxillary arteriovenous malformation.
Behnia, Hossein; Jafarian, Mohammad; Dehghani, Nima; Dehghani, Siavash; Seyedan, Kaveh
Arteriovenous malformations (AVMs) of the maxilla are rare and potentially life-threatening conditions that can pose a therapeutic dilemma. We reported the first case of maxillary AVM in a 15-year-old girl who was treated by marginal hemimaxillectomy including overlying palatal mucosa and immediate replantation of the segment after removing the AVM tissues and teeth and covering by a full-thickness pedicled temporal muscle flap rotated into the mouth. Then, this preserved bone underwent distraction osteogenesis and dental implant rehabilitation successfully. This method was previously used for the definitive treatment of mandibular AVMs, and in this case, we applied this method for the first time in maxillary AVMs. In conclusion, this surgical method may be considered as a safe, convenient, and effective treatment and reconstructive modality for such vascular malformations in the maxilla and restores function and symmetry of the jaws while obviating the need for bone harvesting and future major reconstructive operations. PMID:25148624
Esnault, Olivier
The contribution of the segmental osteotomies in the ortho-surgical protocols is no longer to demonstrate and found a new lease of life thanks to the combination with the bone distraction techniques. The osteotomy of K├Čle, initially described to close infraclusies, and then used to level very marked curves of Spee has more recently been used to correct anterior crowding. This support is therefore aimed at patients with an incisor and canine Class 2 but molar Class 1 with an isolated mandibular footprint. With minimal orthodontic preparation we can create in two weeks bilateral diastemas that will then be used to align the incisivocanin crowding without stripping or bicuspid extractions. Dental orthodontic movements can be resumed one month after the end of the distraction. This technique is therefore likely to avoid bicuspid extraction and replace some sagittal osteotomy advancement by correction of the overjet. It also helps to correct a incisors labial or lingual tipping playing on differential activation of the cylinders and the distractor. This segmental surgery can be combined with Le Fort 1 surgeries with correction of the transverse and associated meanings, but in a second time, to a mandibular advancement and/or a genioplasty. PMID:25888045
Vertical Alveolar Ridge Augmentation by Distraction Osteogenesis
Kumar, N. Nanda; Ravindran, C.
Introduction Compromised alveolar ridge in vertical and horizontal dimension is a common finding in patients visiting practitioners for dental prosthesis. Various treatment modalities are available for correction of deficient ridges among which alveolar distraction osteogenesis is one. Aim To study the efficacy of alveolar distraction osteogenesis in augmentation of alveolar ridges deficient in vertical dimension. Materials and Methods Ten patients aged 16 to 46 years with deficient alveolar ridge underwent ridge augmentation in 11 alveolar segments using the distraction osteogenesis method. For each patient a custom made distraction device was fabricated. The device was indigenously manufactured with SS-316 (ISO 3506). Results The vertical bone gain reached more than 10mm without the use of bone transplantation. Certain complications like incorrect vector of distraction, paresthesia, pain and loss of transport segment were encountered during the course of the study. Conclusion Alveolar vertical distraction osteogenesis is a reliable and predictable technique for both hard and soft tissue genesis. Implant placement is feasible with primary stability in neogenerated bone at the level of the distracted areas. PMID:26816991
Strayer, David L; Cooper, Joel M
We address several themes that emerged in the commentaries related to our target article. First, we consider the relationship between cognitive distraction and crash risk. Second, we discuss the development of our cognitive distraction scale. Third, we weigh issues of self-regulation, appropriate baselines, and satisficing. Finally, we identify several areas where additional research is needed to refine our understanding of driver distraction and crash risk. PMID:26534853
Surgically assisted rapid maxillary expansion in adults.
Pogrel, M A; Kaban, L B; Vargervik, K; Baumrind, S
Twelve adults with maxillary width discrepancy of greater than 5 mm were treated by surgically assisted rapid maxillary expansion. The procedure consisted of bilateral zygomatic buttress and midpalatal osteotomies combined with the use of a tooth-borne orthopedic device postoperatively. Mean palatal expansion of 7.5 mm (range of 6 to 13 mm), measured in the first molar region, was achieved within 3 weeks in all patients. Expansion remained stable during the 12-month study period, with a mean relapse for the entire group of 0.88 +/- 0.48 mm. Morbidity was limited to mild postoperative discomfort. The results of this preliminary study indicated that surgically assisted rapid maxillary expansion is a safe, simple, and reliable procedure for achieving a permanent increase in skeletal maxillary width in adults. Further study is necessary to document the three-dimensional movements of the maxillary segments and long-term stability of the skeletal and dental changes. PMID:1453038
Weksler, Marc E; Weksler, Babette B
Multitasking is a rapidly growing phenomenon affecting all segments of the population but is rarely as successful as its proponents believe. The use of mobile electronic devices contributes importantly to multitasking and cognitive overload. Although personal electronic devices provide many benefits, their adverse effects are frequently overlooked. Personal observation and a review of the scientific literature supports the view that overuse or misuse of personal electronic devices promotes cognitive overload, impairs multitasking and lowers performance at all ages but particularly in the elderly. This phenomenon appears to be rapidly increasing and threatens to become a tsunami as spreading electronic waves cause an 'epidemic of distraction'. Mobile electronic devices often bring benefits to their users in terms of rapid access to information. However, there is a dark side to the increasing addiction to these devices that challenges the health and well-being of the entire population, targeting, in particular, the aged and infirm. New approaches to information gathering can foster creativity if cognitive overload is avoided. PMID:22572729
Orthodontic fine adjustment after vertical callus distraction of an ankylosed incisor using the floating bone concept.
Kinzinger, Gero S M; J├żnicke, Siegfried; Riediger, Dieter; Diedrich, Peter R
The outcome of vertical callus distraction of a segment of tooth-supporting alveolar process might be functionally and esthetically unsatisfactory because of the unidirectional impact of intraoral distraction devices. In this case report, we describe how, with a shortened consolidation phase and application of the floating bone effect, the tooth-supporting osteotomy segment can be successfully aligned 3 dimensionally. We applied orthodontic force systems that went beyond the unidirectional vector preset by the mechanical properties of the distraction device. PMID:14614427
Distracted driving: prevalence, problems, and prevention.
Overton, Tiffany L; Rives, Terry E; Hecht, Carrie; Shafi, Shahid; Gandhi, Rajesh R
While the number of motor vehicle crashes has declined over the years, crashes resulting from distracted driving are increasing in the United States resulting in significant morbidity and mortality. The national public seems to be aware of the dangers associated with using technology while driving, but continues to engage in this dangerous behaviour, and may be unaware of or underestimate the impact of cell phone use on their own driving performance. Problems associated with distracted driving are not limited to novice or teenage drivers; multifaceted universal prevention efforts aimed at impacting large segments of the population may have the greatest impact. Legislation limiting drivers' cell phone use has had little impact, possibly due to low regulation and enforcement. Behaviour change programmes, improved vehicle safety, and public awareness campaigns have been developed as potential preventive efforts to reduce accidents caused by distracted drivers. PMID:24499372
[Principles of callus distraction].
Hankemeier, S; Bastian, L; Gosling, T; Krettek, C
Callus distraction is based on the principle of regenerating bone by continuous distraction of proliferating callus tissue. It has become the standard treatment of significant leg shortening and large bone defects. Due to many problems and complications, exact preoperative planning, operative technique and careful postoperative follow-up are essential. External fixators can be used for all indications of callus distraction. However, due to pin tract infections, pain and loss of mobility caused by soft tissue transfixation, fixators are applied in patients with open growth plates, simultaneous lengthening with continuous deformity corrections, and increased risk of infection. Distraction over an intramedullary nail allows removal of the external fixator at the end of distraction before callus consolidation (monorail method). The intramedullary nail protects newly formed callus tissue and reduces the risk of axial deviation and refractures. Recently developed, fully intramedullary lengthening devices eliminate fixator-associated complications and accelerate return to normal daily activities. This review describes principles of callus distraction, potential complications and their management. PMID:15452653
Electronic gaming as pain distraction.
Jameson, Eleanor; Trevena, Judy; Swain, Nic
The current study investigated whether active distraction reduces participants' experience of pain more than passive distraction during a cold pressor task. In the first experiment, 60 participants were asked to submerge their hand in cold (2░C) water for as long as they could tolerate. They did this with no distraction, and then with active (electronic gaming system) and passive (television) distraction, in randomly assigned order. Tolerance time, pain intensity ratings and task absorption ratings were measured for each condition. A second experiment attempted to control for participants' expectations about the effects of distraction on pain. Forty participants underwent the same experimental procedure, but were given verbal suggestions about the effects of distraction by the experimenter before each distraction condition. Participants in both experiments had a significantly higher pain tolerance and reported less pain with the active distraction compared with passive or no distraction. Participants reported being more absorbed, and were significantly more willing to do the task again when they had the active distraction compared with both passive distraction and no distraction. They also had more enjoyment, less anxiety and greater reduction in pain with active distraction than with passive distraction. There was no effect of suggestion. These experiments offer further support for the use of electronic games as a method of pain control. PMID:21369538
Bilateral Alveolar Distraction for Large Alveolar Defects: Case Report.
Aravindaksha, Shyam Prasad; Batra, Puneet; Sadhu, Partha
Distraction osteogenesis has become a very popular technique, as the ability to reconstruct combined deficiencies in bone and soft tissue makes this process unique and invaluable to all types of reconstructive surgeons. We document a case in which an intraoral tooth-borne distractor was designed and segmental alveolar distraction was performed in a large alveolar defect in a patient with bilateral cleft lip and palate. Cosmetic dentistry was performed to attain a pleasing result. This article aims at highlighting the use of distraction in large defects in which bone grafting only is not a suitable procedure. PMID:25279587
Salvage rapid maxillary expansion for the relapse of maxillary transverse expansion after Le Fort I with parasagittal osteotomy.
Lee, Hyun-Woo; Kim, Su-Jung; Kwon, Yong-Dae
Maxillary transverse deficiency is one of the most common deformities among occlusal discrepancies. Typical surgical methods are segmental Le Fort I osteotomy and surgically-assisted rapid maxillary expansion (SARME). This patient underwent a parasagittal split with a Le Fort I osteotomy to correct transverse maxillary deficiency. During follow-up, early transverse relapse occurred and rapid maxillary expansion (RME) application with removal of the fixative plate on the constricted side was able to regain the dimension again. RME application may be appropriate salvage therapy for such a case. PMID:25922822
Salvage rapid maxillary expansion for the relapse of maxillary transverse expansion after Le Fort I with parasagittal osteotomy
Maxillary transverse deficiency is one of the most common deformities among occlusal discrepancies. Typical surgical methods are segmental Le Fort I osteotomy and surgically-assisted rapid maxillary expansion (SARME). This patient underwent a parasagittal split with a Le Fort I osteotomy to correct transverse maxillary deficiency. During follow-up, early transverse relapse occurred and rapid maxillary expansion (RME) application with removal of the fixative plate on the constricted side was able to regain the dimension again. RME application may be appropriate salvage therapy for such a case. PMID:25922822
Versatility of Distraction Osteogenesis for the Craniofacial Skeleton.
Klement, Kristen A; Black, Jonathan S; Denny, Arlen D
Malformations of the craniofacial skeleton are common. Restoration of anatomic shape, size, and position has been traditionally accomplished using autologous bone grafting to fill gaps created by surgery and segmental movement. The authors present their practice using distraction in many different ages and settings over 20 years. A retrospective review was performed of all craniofacial patients treated using distraction osteogenesis for mandible, midface, and calvarium. The authors identified 205 patient. Mandible: 112 patients were treated at an average age of 3.4 years. 18.8% of patients required repeat distraction. There was no difference in the neonatal versus older group (PŌĆŖ=ŌĆŖ0.71). There were significantly higher reoperation rates in syndromic children (PŌĆŖ<ŌĆŖ0.01). Midface: 58 patients underwent Lefort III distraction at an average age of 13.6 years. One (1.7%) required repeat distraction (Miller syndrome). Five (8.6%) patients underwent subsequent Lefort I advancement for occlusal changes. Calvarium: 33 patients were treated at an average age of 4.7 years. No repeat distractions were performed. One patient required an additional advancement procedure. Distraction demonstrates successful long-term correction of defects in the craniofacial skeleton with the versatility and control needed to treat the wide spectrum of deformity. PMID:26999694
Distractions in Everyday Driving
Distractions in Everyday Driving AAA Foundation for Traffic Safety Did you know that Americans spend about one hour and 15 minutes in their vehicles every ... vehicle or fail to respond in an emergency. AAA Foundation for Traffic Safety participants in two states, ...
Distracted Biking: An Observational Study.
Wolfe, Elizabeth Suzanne; Arabian, Sandra Strack; Breeze, Janis L; Salzler, Matthew J
Commuting via bicycle is a very popular mode of transportation in the Northeastern United States. Boston, MA, has seen a rapid increase in bicycle ridership over the past decade, which has raised concerns and awareness about bicycle safety. An emerging topic in this field is distracted bicycle riding. This study was conducted to provide descriptive data on the prevalence and type of distracted bicycling in Boston at different times of day. This was a cross-sectional study in which observers tallied bicyclists at 4 high traffic intersections in Boston during various peak commuting hours for 2 types of distractions: auditory (earbuds/phones in or on ears), and visual/tactile (electronic device or other object in hand). Nineteen hundred seventy-four bicyclists were observed and 615 (31.2%), 95% CI [29, 33%], were distracted. Of those observed, auditory distractions were the most common (N = 349; 17.7%), 95% CI [16, 19], p = .0003, followed by visual/tactile distractions (N = 266; 13.5%), 95% CI [12, 15]. The highest proportion (40.7%), 95% CI [35, 46], of distracted bicyclists was observed during the midday commute (between 13:30 and 15:00). Distracted bicycling is a prevalent safety concern in the city of Boston, as almost a third of all bicyclists exhibited distracted behavior. Education and public awareness campaigns should be designed to decrease distracted bicycling behaviors and promote bicycle safety in Boston. An awareness of the prevalence of distracted biking can be utilized to promote bicycle safety campaigns dedicated to decreasing distracted bicycling and to provide a baseline against which improvements can be measured. PMID:26953533
Long-term stability of LeFort III distraction osteogenesis with a rigid external distraction device in a patient with Crouzon syndrome.
Kuroda, Shingo; Watanabe, Keiichiro; Ishimoto, Kyoko; Nakanishi, Hideki; Moriyama, Keiji; Tanaka, Eiji
A 6-year-old boy, diagnosed with Crouzon syndrome, had moderate exorbitism, a concave profile, an anterior crossbite of -4.0 mm, and a skeletal Class III jaw-base relationship caused by midfacial hypoplasia. At age 8 years 9 months, a LeFort III osteotomy was performed, and distraction osteogenesis was immediately started with the rigid external distractor system. The midface was advanced approximately 10.0 mm for 6 days, including overcorrection. After the distraction, a reverse headgear was used for 6 years to prevent relapse and to accelerate expected growth. At age 16 years 5 months, after extraction of the maxillary first premolars and mandibular third molars, 0.022-in preadjusted edgewise brackets were placed to treat the edge-to-edge incisor relationship and minor crowding. After 13 months of treatment, the facial profile was significantly improved, and an acceptable occlusion was achieved. During the 9-year observation period after the distraction, acceptable facial growth occurred, and no relapse of the maxillary advancement was observed. However, syndrome-specific growth and methodologically induced relapse should be considered when planning a LeFort III distraction in children for the treatment of Crouzon syndrome. PMID:21967944
Distraction subtalar arthrodesis.
Jackson, J Benjamin; Jacobson, Lance; Banerjee, Rahul; Nickisch, Florian
There is a high potential for disability following calcaneal fracture. This potential exists whether a patient is treated with conservative or operative management. Subfibular impingement and irritation of the peroneal tendon and sural nerve may also be present. Posttraumatic arthritis of the subtalar joint can occur. In patients with symptomatic calcaneal malunion, systematic evaluation is required to determine the source of pain. Nonsurgical treatment may be effective. One surgical treatment option is subtalar distraction arthrodesis. High rates of successful arthrodesis and patient satisfaction have been reported with this surgical option in correctly selected patients. PMID:26043248
A customized distraction device for alveolar ridge augmentation and alignment of ankylosed teeth.
Nocini, Pier Francesco; De Santis, Daniele; Ferrari, Francesca; Bertele, Gian Paolo
The purpose of this study was to develop an extraosseous, tooth-supported miniature intraoral device that could produce prosthetically driven bone distraction of small atrophic alveolar ridge segments. Extraosseous distraction requires that the distraction device be anchored to a dental implant previously placed into the ridge according to its anatomic axis. A distractor can also correct the position of implants placed in young patients before skeletal growth is completed. Similarly, it allows the alignment of ankylosed teeth not treatable by orthodontics. The device is made of (1) an engine consisting of an orthodontic micrometric screw; (2) a joint between the implant and the engine, ie, the ball attachment/o-ring system; and (3) an anchorage system to the oral cavity provided by an orthodontic appliance and a mini-implant for possible additional support. Surgery involves an osteotomy of the atrophic alveolar ridge segment, incorporating the implant, from the basal bone; afterward the device can be applied and distraction of the segment can be carried out. Distraction was successfully performed in 3 clinical cases: 2 bone-implant segments and 1 bone-ankylosed tooth segment. All cases were clinically uneventful. This mini-device for osteogenic distraction of small atrophic ridge segments can provide for accurate and precise ridge augmentation, as is required for ideal prosthetic rehabilitation. PMID:14982366
Neural Basis of Visual Distraction
ERIC Educational Resources Information Center
Kim, So-Yeon; Hopfinger, Joseph B.
The ability to maintain focus and avoid distraction by goal-irrelevant stimuli is critical for performing many tasks and may be a key deficit in attention-related problems. Recent studies have demonstrated that irrelevant stimuli that are consciously perceived may be filtered out on a neural level and not cause the distraction triggered byŌĆ"
Neural Basis of Visual Distraction
ERIC Educational Resources Information Center
Kim, So-Yeon; Hopfinger, Joseph B.
The ability to maintain focus and avoid distraction by goal-irrelevant stimuli is critical for performing many tasks and may be a key deficit in attention-related problems. Recent studies have demonstrated that irrelevant stimuli that are consciously perceived may be filtered out on a neural level and not cause the distraction triggered byģ
Peters, G A; Peters, B J
A serious health problem is developing from automobile collisions caused by distracted drivers. This is a result of the rapid proliferation of portable cellular telephones and personal organisers used while driving, the development of more sophisticated entertainment systems and instrument panel controls, the advent of navigation and television displays in vehicles and promises of sophisticated wireless e-mail, FAX and Internet services in the vehicle. Preoccupation with electronic gadgets may also degrade human driving performance. Many drivers however, sincerely believe they have the talent to do several things at the same time, such as hold and look at a cellular telephone in one hand and drive with a beverage container in the other hand whilst at the same time, exercise their personal skills. Obviously, they believe that they do not need two hands on the steering wheel and two eyes on the road. This is a unique situation requiring intensive health promotion as distracted or 'offensive driving' may be habit forming and difficult to change, any significant design remedies will be slow to arrive and may be circumvented, and the regulatory laws have proved difficult or impossible to enforce. This special need may require research to determine the most effective techniques for health promotion. PMID:11329694
Young and Older Adults' Reading of Distracters
ERIC Educational Resources Information Center
Kemper, Susan; Mcdowd, Joan; Metcalf, Kim; Liu, Chiung-Ju
Eye-tracking technology was employed to examine young and older adults' performance in the reading with distraction paradigm. Distracters of 1, 2, and 4 words that formed meaningful phrases were used. There were marked age differences in fixation patterns. Young adults' fixations to the distracters and targets increased with distracter length.ģ
Get the message: distracted driving and teens.
Adeola, Ruth; Gibbons, Mallory
Distracted driving is a growing problem in the United States. With the integration of wireless devices into everyday life, cell phone use behind the wheel is a distraction requiring increasing concern. Teen drivers are most susceptible to the dangers of distracted driving as made evident in the overrepresentation of teens in distraction-related motor vehicle crashes. This article describes the causes, consequences, and statistics related to distracted driving in teenagers and an injury prevention program for teenagers. PMID:24005117
Distracted Driving Raises Crash Risk
... Raises Crash Risk Video technology and in-vehicle sensors showed that distracted driving, especially among new drivers, ... whenever the cars were moving. A suite of sensors recorded acceleration, sudden braking or swerving, and other ...
Context effects on auditory distraction
Chen, Sufen; Sussman, Elyse S.
The purpose of the study was to test the hypothesis that sound context modulates the magnitude of auditory distraction, indexed by behavioral and electrophysiological measures. Participants were asked to identify tone duration, while irrelevant changes occurred in tone frequency, tone intensity, and harmonic structure. Frequency deviants were randomly intermixed with standards (Uni-Condition), with intensity deviants (Bi-Condition), and with both intensity and complex deviants (Tri-Condition). Only in the Tri-Condition did the auditory distraction effect reflect the magnitude difference among the frequency and intensity deviants. The mixture of the different types of deviants in the Tri-Condition modulated the perceived level of distraction, demonstrating that the sound context can modulate the effect of deviance level on processing irrelevant acoustic changes in the environment. These findings thus indicate that perceptual contrast plays a role in change detection processes that leads to auditory distraction. PMID:23886958
Distracted driving: a neglected epidemic.
Dildy, Dale W
In 2009, the National Highway Traffic Safety Administration (NHTSA) estimated nearly 6,000 distracted driver fatalities and 515,000 injuries in the United States alone. Distracted driving is a worldwide problem that needs to be addressed. Software is available to disable cell phone usage while driving, but using the advanced technology may require legislation along with a renewed sense of driver responsibility. PMID:23061239
Biologic model of bone transport distraction osteogenesis and vascular response.
DeCoster, T A; Simpson, A H; Wood, M; Li, G; Kenwright, J
We developed an experimental model in the rabbit of distraction osteogenesis through bone transport that closely corresponds to the clinical use of bone transport in humans. We also applied injection angiography to study the arterial response of a limb undergoing bone transport. This model includes a proximal osteotomy and bone transport to fill in a segmental tibial diaphyseal defect. Regenerate bone formed well in the gap that was created that trailed the transport segment, and slow healing at the docking site was observed, as seen in humans. The angiographic techniques clearly revealed, by radiography and anatomic dissection, the arterial response to bone transport. The results showed that the transport segment had an arterial supply after osteotomy and after transport. They also demonstrated an extensive increase in vessels in limbs that had undergone distraction osteogenesis, an observation made clinically in humans but not well demonstrated experimentally. Furthermore, angiography showed proximal stretching and distal kinking of the major artery of the leg. This model closely resembles distraction osteogenesis through bone transport in humans and definitively demonstrates that the transport segment can maintain blood supply and remain viable during the transport process. The results of this study provide a basis for further work on factors that enhance and interfere with successful bone transport in humans. PMID:10221841
Leading to distraction: Driver distraction, lead car, and road environment.
Kountouriotis, G K; Merat, N
Driver distraction is strongly associated with crashes and near-misses, and despite the attention this topic has received in recent years, the effect of different types of distracting task on driving performance remains unclear. In the case of non-visual distractions, such as talking on the phone or other engaging verbal tasks that do not require a visual input, a common finding is reduced lateral variability in steering and gaze patterns where participants concentrate their gaze towards the centre of the road and their steering control is less variable. In the experiments presented here, we examined whether this finding is more pronounced in the presence of a lead car (which may provide a focus point for gaze) and whether the behaviour of the lead car has any influence on the driver's steering control. In addition, both visual and non-visual distraction tasks were used, and their effect on different road environments (straight and curved roadways) was assessed. Visual distraction was found to increase variability in both gaze patterns and steering control, non-visual distraction reduced gaze and steering variability in conditions without a lead car; in the conditions where a lead car was present there was no significant difference from baseline. The lateral behaviour of the lead car did not have an effect on steering performance, a finding which indicates that a lead car may not necessarily be used as an information point. Finally, the effects of driver distraction were different for straight and curved roadways, indicating a stronger influence of the road environment in steering than previously thought. PMID:26785327
Chronic odontogenic maxillary sinusitis.
Ugincius, Paulius; Kubilius, Ricardas; Gervickas, Albinas; Vaitkus, Saulius
The aim of the present study was to estimate average age of the patients in both sexes treated for MS, distribution by sex, amount of dexter and sinister MS with and without the fistulas into the maxillary sinus, with and without the foreign-bodies, length of stay in the Department of Maxillofacial Surgery at Kaunas Hospital of University of Medicine during the period from 1999 till 2004. The retrospective data analysis of the patients' treated from chronic MS was made. 346 patients (213 females and 133 males) were treated for chronic MS. 55 cases of chronic dexter MS with a fistula into maxillary sinus, 98 cases of chronic dexter MS without a fistula, 45 cases of chronic sinister MS with a fistula, 112 cases chronic sinister MS without a fistula, 16 cases of foreign-bodies in dexter maxillary sinus, 20 cases of foreign-bodies in sinister maxillary sinus have been detected. The main age of the female was 46.6+/-15.0, the main age of the men was 42.1+/-14.4. Statictically significant difference in the age difference of the women and the men was found (p=0.0024). It was determined, that females diagnosed and treated with chronic MS were 1.6 times more than males during the period from 1999 till 2004 in Kaunas Hospital of University of Medicine. Females treated for chronic MS were 4.5 years older than males. PMID:16861848
Distraction Osteogenesis Update: Introduction of Multidirectional Cranial Distraction Osteogenesis
Sunaga, Ataru; Kamochi, Hideaki; Oguma, Hirofumi; Sugawara, Yasushi
In this review, we discuss in detail our current procedure for treating craniosynostosis using multidirectional cranial distraction osteogenesis (MCDO). The MCDO method allows all phenotypes of skull deformity to be reshaped by distraction osteogenesis, except in patients who are 5 months of age or younger and patients with posterior cranial vault problems. We report the results of clinical data of 36 children with craniosynostosis who underwent MCDO between 2005 and 2014 in our institute. This method has the following benefits, such as a high flexibility of reshaping, shorter treatment period and less invasive secondary intervention. We also discuss the other distraction osteogenesis techniques that are used to treat craniosynostosis and compare them with MCDO. The preferred procedure for correction of craniosynostosis may depend on the patient's age, the extent of deformity, and the extent of correction achievable by surgery. We can arrange the combinations of various methods according to the advantage and disadvantage of each technique. PMID:27226854
Pre-arthroplastic and simultaneous mandibular distraction for correction of facial deformity in temporomandibular joint ankylosis
Chellappa, A.L.; Mehrotra, D.; Vishwakarma, K.; Mahajan, N.; Bhutia, D.P.
Introduction In cases of temporomandibular joint (TMJ) ankylosis, interposition arthroplasty allows return of functional jaw movements. In order to improve the facial appearance, distraction osteogenesis is the treatment of choice, and may be timed either as a pre-arthroplastic, simultaneous or post-arthroplastic procedure. This study was planned to compare the treatment outcomes of pre-arthroplastic distraction (PAD) and simultaneous arthroplastic distraction (SAD) to establish the better treatment modality in terms of improvement in function and aesthetics. Materials and methods This prospective randomized experimental study included 20 children and adolescents suffering from facial deformity due to long standing unilateral TMJ ankylosis. They were randomly allocated to the two surgical groups with ten in each group. Result Both groups resulted in good facial symmetry and aesthetics. Initially, during the distraction period, mouth opening of SAD group scored less than that of PAD group but became comparable in 30 days. More pain at the distraction site and over the normal TMJ was observed in PAD group. The excursive movements were almost comparable in both the groups. Conclusion We conclude that both procedures are effective in correcting the post-ankylotic deformity and improving function. Although PAD has better control over movement of the distracting segment, the contralateral TMJ may experience pain. SAD requires a shorter management period but is associated with a temporary decrease in function. Also, control of distraction may be difficult and chances of reankylosis are always there. PMID:26587380
Pivot technique combined with mandibular backward distraction osteogenesis for the patient with high risk for relapse.
Yamauchi, Kensuke; Takahashi, Tetsu; Kaneuji, Takeshi; Nogami, Shinnosuke; Miyamoto, Ikuya; Lethaus, Bernd
Severe skeletal relapse is one of the most difficult problems after mandibular advancement, and the management to overcome such problems tends to require more compromised methods and longer treatment period. We described that mandibular backward distraction osteogenesis with maxillomandibular fixation at an appropriate occlusion. Furthermore, to avoid inappropriate distraction vector, the distal plates of the distraction device were fixed with 1 screw to work as a pivot after the manipulation of the condyle to the glenoid fossa at the end of distraction activation. This technique was applied to 3 female patients with mandibular deficiency. The intraoral distractors were set on the lateral surface of the mandibular body; the fixation of the distal plate was fixed with 1 monocortical screw to make the proximal segment including the condyle manipulating at the end of the distraction phase by releasing the maxillomandibular fixation. The distraction rate was 1 mm/d, and the latency period was 7 days. The follow-up period after mandibular backward distraction osteogenesis ranged from 26 to 56 months. No specific complication, such as broken device, severe infection, or bony nonunion, occurred. Postoperative relapse was not observed during the follow-up period. This technique might become 1 choice to apply for mandibular deficiency in a patient with high risk for relapse. PMID:22565870
Rapid canine retraction with periodontal distraction in Class II division 1 malocclusion: a case report.
Durgekar, Sujala G; Kumar, Priyanka Sethi; Kolur, Nagaraj
This case report describes the treatment of an 18-year-old post-pubertal male patient with a class II division 1 malocclusion. Rapid canine retraction was planned after extraction of first premolars in maxillary arch 7 mm of canine retraction was achieved in 19 days with customized periodontal distractor with minimal change (10 degrees) in canine inclination. The maxillary molars were able to withstand the retraction forces with minimal vertical anchor loss (0.5mm). During distraction phase, patient experienced slight discomfort which vanished in 2-3 days. After distraction, anterior teeth retraction was rapid because of fibrous bony tissue distal to the lateral incisor. Orthodontic treatment continued for 12 months with no clinical and radiographic evidence of complications like root fracture, resorption, ankylosis and soft tissue dehiscence. Good overjet and overbite was achieved at the end of treatment with dramatic improvement in facial esthetics. Periodontal distraction is an effective alternative to shorten treatment time eliminating need for additional anchorage. PMID:23413638
Biomechanical optimization of the diameter of distraction screw in distraction implant by three-dimensional finite element analysis.
Lu, Songhe; Li, Tao; Zhang, Yongqiang; Lu, Chunlei; Sun, Yingying; Zhang, Junrui; Xu, Dezhong
Three-dimensional (3D) finite element models of a posterior mandibular segment and a distraction implant (DI) were created and assembled in this study. The diameter of distraction screw (DS) was set as input variable, ranging from 1.0 to 3.0mm, to analyze the stress and displacement, in order to obtain an optimal outcome of the DI. The results indicate that when the diameter of DS was 2.0mm, the stresses in jaw bone and DS and the displacement of DS reached a relatively low range. The diameter of DS significantly affects the stress distribution in DI and surrounding bone. The present study demonstrates that from clinical and biomechanical points of view, the optimal diameter of DS is 2.0mm. PMID:24209940
An unusual foreign body in the maxillary sinus: Dental impression material.
Deniz, Y; Zengin, A Z; Karli, R
Foreign bodies in paranasal sinuses are very rare and most of them are encountered in the maxillary sinus. These foreign bodies may be organic or inorganic and can enter the maxillary sinus through an oro-antral fistula. The oro-antral fistula is formed by a break in the bony segment of the maxillary sinus floor and usually arises subsequent to maxillary premolar and molar extractions. A 63-year-old female patient evaluated for a nonhealing, left, toothless palate lesion and chronic headache occurring over 4 years. Radiography and computed tomography revealed bone discontinuity in the left floor of the maxillary sinus and calcifications within the antrum. A blue foreign body, later identified as dental impression material, was removed by intranasal endoscopy. A careful oral examination is recommended prior to prosthetic restorations. In addition, paranasal sinus foreign bodies should be surgically removed to prevent secondary soft tissue reactions. PMID:26856299
Effects of lateral osteotomy on surgically assisted rapid maxillary expansion.
Oliveira, T F M; Pereira-Filho, V A; Gabrielli, M A C; Gon├¦ales, E S; Santos-Pinto, A
This study aimed to assess the potential effects of two different osteotomy designs of the maxillary lateral wall on dental and skeletal changes after surgically assisted rapid maxillary expansion (SARME). Thirty adult patients were divided into two groups according to the lateral osteotomy design: group 1 (n=16) underwent lateral osteotomy performed in a horizontal straight fashion, and group 2 (n=14) underwent lateral osteotomy performed in parallel to the occlusal plane with a step at the zygomatic buttress. Cone beam computed tomography scans were obtained preoperatively (T1), immediately after expansion (T2), and 6 months after expansion (T3). Mixed analysis of variance (ANOVA) was used for the statistical analysis. The results showed no significant interaction effect between groups and time points. Therefore, maxillary expansion was effective in both groups. Statistically significant increases in all dental and skeletal measurements were observed immediately after expansion (P<0.001). Relapse of the nasal floor width, tipping of the supporting teeth, and an increase in root distance in molars occurred at T3 (P<0.05). In summary, the maxillary lateral osteotomy design did not influence the results of SARME, which occurred mainly through the inclination of maxillary segments. PMID:26688294
Distracted by Your Mind? Individual Differences in Distractibility Predict Mind Wandering
ERIC Educational Resources Information Center
Forster, Sophie; Lavie, Nilli
Attention may be distracted from its intended focus both by stimuli in the external environment and by internally generated task-unrelated thoughts during mind wandering. However, previous attention research has focused almost exclusively on distraction by external stimuli, and the extent to which mind wandering relates to external distraction isŌĆ"
A simple solution for vector control in vertical alveolar distraction osteogenesis.
Kocyigit, Ismail Doruk; Tuz, Hakan H; Ozgul, Ozkan; Coskunses, Fatih Mehmet; Kisnisci, Reha S
One of the important and frequent complications in alveolar distraction osteogenesis is vectorial change of the transport segment. This report presents a simple solution for vector angulation control by placing intermaxillary fixation screws intraoperatively. Advantages of the technique are also discussed. PMID:25295887
Catastrophizing delays the analgesic effect of distraction
Campbell, Claudia M.; Witmer, Kenny; Simango, Mpepera; Carteret, Alene; Loggia, Marco L.; Campbell, James N.; Haythornthwaite, Jennifer A.; Edwards, Robert R.
Behavioral analgesic techniques such as distraction reduce pain in both clinical and experimental settings. Individuals differ in the magnitude of distraction-induced analgesia, and additional study is needed to identify the factors that influence the pain relieving effects of distraction. Catastrophizing, a set of negative emotional and cognitive processes, is widely recognized to be associated with increased reports of pain. We sought to evaluate the relationship between catastrophizing and distraction analgesia. Healthy participants completed three sessions in a randomized order. In one session (Pain Alone), pain was induced by topical application of a 10% capsaicin cream and simultaneous administration of a tonic heat stimulus. In another session (Pain + Distraction), identical capsaicin+heat application procedures were followed, but subjects played video games that required a high level of attention. During both sessions, verbal ratings of pain were obtained and participants rated their degree of catastrophizing. During the other session (Distraction Alone) subjects played the video games in the absence of any pain stimulus. Pain was rated significantly lower during the distraction session compared to the ŌĆ£pain aloneŌĆØ session. In addition, high catastrophizers rated pain significantly higher regardless of whether the subjects were distracted. Catastrophizing did not influence the overall degree of distraction analgesia; however, early in the session high catastrophizers had little distraction analgesia, though later in the session low and high catastrophizers rated pain similarly. These results suggest that both distraction and catastrophizing have substantial effects on experimental pain in normal subjects and these variables interact as a function of time. PMID:20188470
Mucopyocele of the maxillary sinus.
Kshar, Avinash; Patil, Abhijeet; Umarji, Hemant; Kadam, Sonali
Mucoceles are defined as chronic, cystic lesions in the paranasal sinuses. When the mucocele content becomes infected, the lesion is defined as mucopyocele. Most mucoceles are located in the frontal and anterior ethmoid sinuses and normally they involve the frontal-ethmoid complex, expanding to the superior-medial region of the orbit, leading to ocular disorders; maxillary sinus presentation is rare. In the present article, the authors described a rare case of mucopyocele in the maxillary sinus. PMID:24688571
Mucopyocele of the maxillary sinus
Kshar, Avinash; Patil, Abhijeet; Umarji, Hemant; Kadam, Sonali
Mucoceles are defined as chronic, cystic lesions in the paranasal sinuses. When the mucocele content becomes infected, the lesion is defined as mucopyocele. Most mucoceles are located in the frontal and anterior ethmoid sinuses and normally they involve the frontal-ethmoid complex, expanding to the superior-medial region of the orbit, leading to ocular disorders; maxillary sinus presentation is rare. In the present article, the authors described a rare case of mucopyocele in the maxillary sinus. PMID:24688571
Experience with mandibular reconstruction using transport-disc-distraction osteogenesis.
Pingarr¾n-MartĒn, Lorena; Otero, T Gonzßlez; Gallo, L J Arias
The goal of transport-disc-distraction osteogenesis (TDDO) is to restore bone continuity by using in-situ bone. It may be useful following trauma, gunshot injuries, or tumor ablation, especially when there may be contraindications at the donor site or for prolonged surgery. To the best of the authors' knowledge, this is the first time TDDO has been used for mandibular reconstruction reporting additional procedures, which include osseointegrated dental implants rehabilitation and orthognathic surgery. A retrospective study is performed analyzing all mandibular reconstruction cases that may be suitable for distraction from January 2006 to December 2011. A thorough description of the documented cases includes details about sex, gender, complications, duration of hospitalization, etiology, size, and location of the defect. Eight cases of mandibular reconstruction were included. Six cases correspond to mandibular ameloblastoma. The remaining two cases were mandibular gunshot comminuted fractures. Range of the defects was from 45 to 60 mm. Length of the transport disc was 15 to 20 mm. Protocolized technique consisted of 5 days of latency period, 19 to 45 days of activation term (average 30 days), and 8 to 12 weeks for consolidation. Mean distraction length achieved was 40.45 mm. We can conclude that TDDO is an alternative to conventional and more invasive procedures, when we face severe segmental mandibular defects reconstruction. It shows the potential to restore a better anatomical bone regeneration, also providing soft tissues and reducing donor-site morbidity. Patients' education and awareness about the proper use of the transport-disc-distraction device is important to optimize functional outcomes. PMID:26000082
Distracted by your mind? Individual differences in distractibility predict mind wandering.
Forster, Sophie; Lavie, Nilli
Attention may be distracted from its intended focus both by stimuli in the external environment and by internally generated task-unrelated thoughts during mind wandering. However, previous attention research has focused almost exclusively on distraction by external stimuli, and the extent to which mind wandering relates to external distraction is as yet unclear. In the present study, the authors examined the relationship between individual differences in mind wandering and in the magnitude of distraction by either response-competing distractors or salient response-unrelated and task-irrelevant distractors. Self-reported susceptibility to mind wandering was found to positively correlate with task-irrelevant distraction but not with response-competition interference. These results reveal mind wandering as a manifestation of susceptibility to task-irrelevant distraction and establish a laboratory measure of general susceptibility to irrelevant distraction, including both internal and external sources. PMID:23957365
Distractions in the School Science Laboratory
ERIC Educational Resources Information Center
Hamza, Karim M.
In this article, I make a case for the potential educative worth of distractions for learning science in the school laboratory. Distractions are operationalized as experiences lying outside the main purpose of the laboratory activity, thereby diverting students' attention from that purpose. Through a practical epistemology analysis, IŌĆ"
Distractions in the School Science Laboratory
ERIC Educational Resources Information Center
Hamza, Karim M.
In this article, I make a case for the potential educative worth of distractions for learning science in the school laboratory. Distractions are operationalized as experiences lying outside the main purpose of the laboratory activity, thereby diverting students' attention from that purpose. Through a practical epistemology analysis, Iģ
The Neural Bases of Distraction and Reappraisal
ERIC Educational Resources Information Center
McRae, Kateri; Hughes, Brent; Chopra, Sita; Gabrieli, John D. E.; Gross, James J.; Ochsner, Kevin N.
Distraction and reappraisal are two commonly used forms of cognitive emotion regulation. Functional neuroimaging studies have shown that each one depends upon interactions between pFC, interpreted as implementing cognitive control, and limbic regions, interpreted as mediating emotional responses. However, no study has directly compared distractionģ
Family of Crouzon Syndrome Represents the Evolution of the Frontofacial Monobloc Advancement Technique: From Immediate Movement to Monobloc Distraction to Monobloc Bipartition Distraction.
Raposo-Amaral, Cassio Eduardo; Denadai, Rafael; Ghizoni, Enrico; Buzzo, Celso Luiz; Raposo-Amaral, Cesar Augusto
Crouzon syndrome (CS) is an autosomal dominant disorder characterized by premature fusion of cranial sutures, midface and supraorbital ridge retrusion, exorbitism, and in some clinical scenarios strabismus, parrot-beaked nose, short upper lip and hypertelorbitism. Treatment of CS is overlapped with the beginning of craniofacial surgery and is grounded on morphologic and functional objectives. The authors reported on the outcomes and complications of family members (mother and 2 siblings) with CS, who were operated on by different techniques of frontofacial advancement and have attained skeletal maturity. Operations were performed in different moments throughout the last 3 decades of craniofacial surgery history. A 10-year-old Crouzon progenitor underwent a monobloc osteotomy with acute advancement, using rigid fixation and bone grafting in the osteotomy sites. An 8-year-old Crouzon daughter underwent gradual lengthening of a monobloc segment, using an external, institutionally made distracter device. In addition, a 10-year-old Crouzon son underwent gradual lengthening of a monobloc segment associated to facial bipartition, using an internal distracter device. After 30 years, the mother presented a mild relapse on the orbit level, but her children had satisfactory stable outcomes. The family members with CS have undergone different modifications of the monobloc approach based on different chronological momentum, from acute monobloc advancement, to monobloc distraction, to monobloc facial bipartition distraction. PMID:26267562
Hemispheric asymmetries in auditory distraction.
S├Črqvist, Patrik; Marsh, John E; Jahncke, Helena
Serial-verbal short-term memory is impaired by irrelevant sound, particularly when the sound changes acoustically (the changing-state effect). In contrast, short-term recall of semantic information is impaired only by the semanticity of irrelevant speech, particularly when it is semantically related to the target memory items (the between-sequence semantic similarity effect). Previous research indicates that the changing-state effect is larger when the sound is presented to the left ear in comparison to the right ear, the left ear disadvantage. In this paper, we report a novel finding whereby the between-sequence semantic similarity effect is larger when the irrelevant speech is presented to the right ear in comparison to the left ear, but this right ear disadvantage is found only when meaning is the basis of recall (Experiments 1 and 3), not when order is the basis of recall (Experiment 2). Our results complement previous research on hemispheric asymmetry effects in cross-modal auditory distraction by demonstrating a role for the left hemisphere in semantic auditory distraction. PMID:20688422
Distractions in the School Science Laboratory
NASA Astrophysics Data System (ADS)
Hamza, Karim M.
In this article, I make a case for the potential educative worth of distractions for learning science in the school laboratory. Distractions are operationalized as experiences lying outside the main purpose of the laboratory activity, thereby diverting students' attention from that purpose. Through a practical epistemology analysis, I examined in close detail the conversations of three groups of high school students trying to explain how a real galvanic cell works. The three groups experienced the same two distractions, (1) a nonworking light-emitting diode and (2) negative readings on a voltmeter. The analysis reveals how one of the groups, through a series of contingencies, successively made the two distractions continuous with the main purpose of the activity. In the remaining two groups, no such continuity was established. The results show that (a) experiences initially being distracting, perplexing, and confusing may indeed acquire significance for the students' possibilities of coping with the main purpose of the activity but that (b) the outcome is highly contingent on the particular experiences drawn upon by the students to cope with the distractions. Consequently, I discuss ways in which teachers may turn distractions encountered in laboratory activities into educative experiences for more than a few lucky students.
75 FR 45696 - Pipeline Safety: Personal Electronic Device Related Distractions
Federal Register 2010, 2011, 2012, 2013, 2014
... Electronic Devices, 75 FR 9754, May 18, 2010; Limiting the Use of Wireless Communication Devices, 75 FR 16391... distractions caused by the use of PEDs. Such distractions may also hinder their prompt recognition and reaction... distractions caused by the use of PEDs. Such distractions may also hinder their prompt recognition and...
Diagnosing and understanding the maxillary lip-tie (superior labial, the maxillary labial frenum) as it relates to breastfeeding.
Kotlow, Lawrence A
Successful breastfeeding is dependent upon an infant's ability to correctly latch onto a mother's breast. If an infant is born with oral soft tissue abnormalities such as tongue-tie or lip-tie, breastfeeding may become challenging or impossible. During the oral evaluation of an infant presenting with breastfeeding problems, one area that is often overlooked and undiagnosed and, thus, untreated is the attachment of the upper lip to the maxillary gingival tissue. Historically, this tissue has been described as the superior labial frenum, median labial frenum, or maxillary labial frenum. These terms all refer to a segment of the mucous membrane in the midline of the upper lip containing loose connective tissue that inserts into the maxillary arch's loose, unattached gingival or tight, attached gingival tissue. There is no muscle contained within this tissue. In severe instances, this tissue may extend into the area behind the upper central incisors and incisive papilla. The author has defined and identified the restrictions of mobility of this tissue as a lip-tie, which reflects the clinical attachment of the upper lip to the maxillary arch. This article discusses the diagnosis and classifications of the lip-tie, as it affects an infant's latch onto the mother's breast. As more and more women choose to breastfeed, lip-ties must be considered as an impediment to breastfeeding, recognizing that they can affect a successful, painless latch and milk transfer. PMID:23821655
Distraction osteogenesis device to estimate the axial stiffness of the callus in Vivo.
Mora-Mac├Łas, J; Reina-Romo, E; Dom├Łnguez, J
Knowing the evolution of callus stiffness is very important in distraction osteogenesis and bone healing. It allows the characterization of the bone maturation process and the assessment of the moment to retire the fixator. A new distractor device that monitors the callus axial stiffness is presented in this study. It quantifies the callus stiffness during the bone transport process with some advantages over previous methods to assess stiffness during simple distraction and bone healing. This device avoids a misalignment between bone segments, uses real load conditions, monitors forces continuously, does not involve radiation for patients, and allows the study of the complete distraction process, i.e., the distraction and consolidation phases. The device was calibrated in vitro simulating different real bone load conditions depending on the stage of the process. The stiffness of the callus could be estimated for values between 4.2┬ĀN/mm and 9066.8┬ĀN/mm. The average relative error in measurements carried out in in vitro calibration tests was 7.8% during the distraction phase and 9.5% during the consolidation phase. These results improve the accuracy and increase the callus stiffness range of estimation with respect to other devices in the literature. In addition, the device was used successfully in vivo in a preliminary experiment. PMID:26320818
The effects of distraction on metacognition and metacognition on distraction: evidence from recognition memory
Beaman, C. Philip; Hanczakowski, Maciej; Jones, Dylan M.
The effects of auditory distraction in memory tasks have, to date, been examined with procedures that minimize participantsŌĆÖ control over their own memory processes. Surprisingly little attention has been paid to metacognitive control factors which might affect memory performance. In this study, we investigate the effects of auditory distraction on metacognitive control of memory, examining the effects of auditory distraction in recognition tasks utilizing the metacognitive framework of Koriat and Goldsmith (1996), to determine whether strategic regulation of memory accuracy is impacted by auditory distraction. Results replicated previous findings in showing that auditory distraction impairs memory performance in tasks minimizing participantsŌĆÖ metacognitive control (forced-report test). However, the results revealed also that when metacognitive control is allowed (free-report tests), auditory distraction impacts upon a range of metacognitive indices. In the present study, auditory distraction undermined accuracy of metacognitive monitoring (resolution), reduced confidence in responses provided and, correspondingly, increased participantsŌĆÖ propensity to withhold responses in free-report recognition. Crucially, changes in metacognitive processes were related to impairment in free-report recognition performance, as the use of the ŌĆ£donŌĆÖt knowŌĆØ option under distraction led to a reduction in the number of correct responses volunteered in free-report tests. Overall, the present results show how auditory distraction exerts its influence on memory performance via both memory and metamemory processes. PMID:24860543
The effects of distraction on metacognition and metacognition on distraction: evidence from recognition memory.
Beaman, C Philip; Hanczakowski, Maciej; Jones, Dylan M
The effects of auditory distraction in memory tasks have, to date, been examined with procedures that minimize participants' control over their own memory processes. Surprisingly little attention has been paid to metacognitive control factors which might affect memory performance. In this study, we investigate the effects of auditory distraction on metacognitive control of memory, examining the effects of auditory distraction in recognition tasks utilizing the metacognitive framework of Koriat and Goldsmith (1996), to determine whether strategic regulation of memory accuracy is impacted by auditory distraction. Results replicated previous findings in showing that auditory distraction impairs memory performance in tasks minimizing participants' metacognitive control (forced-report test). However, the results revealed also that when metacognitive control is allowed (free-report tests), auditory distraction impacts upon a range of metacognitive indices. In the present study, auditory distraction undermined accuracy of metacognitive monitoring (resolution), reduced confidence in responses provided and, correspondingly, increased participants' propensity to withhold responses in free-report recognition. Crucially, changes in metacognitive processes were related to impairment in free-report recognition performance, as the use of the "don't know" option under distraction led to a reduction in the number of correct responses volunteered in free-report tests. Overall, the present results show how auditory distraction exerts its influence on memory performance via both memory and metamemory processes. PMID:24860543
77 FR 51610 - Distracted Driving Grant Program
Federal Register 2010, 2011, 2012, 2013, 2014
...,000 motor-vehicle related deaths on our Nation's highways. Driving while distracted is a deadly habit... given such term in 23 U.S.C. 402(c). ``Texting'' means reading from or manually entering data into...
Distraction from emotional information reduces biased judgements.
Lench, Heather C; Bench, Shane W; Davis, Elizabeth L
Biases arising from emotional processes are some of the most robust behavioural effects in the social sciences. The goal of this investigation was to examine the extent to which the emotion regulation strategy of distraction could reduce biases in judgement known to result from emotional information. Study 1 explored lay views regarding whether distraction is an effective strategy to improve decision-making and revealed that participants did not endorse this strategy. Studies 2-5 focused on several established, robust biases that result from emotional information: loss aversion, desirability bias, risk aversion and optimistic bias. Participants were prompted to divert attention away from their feelings while making judgements, and in each study this distraction strategy resulted in reduced bias in judgement relative to control conditions. The findings provide evidence that distraction can improve choice across several situations that typically elicit robustly biased responses, even though participants are not aware of the effectiveness of this strategy. PMID:25787937
The Biobasis for Distraction and Dyslexia.
ERIC Educational Resources Information Center
Buckley, Robert E.
The article examines the neurological basis for hyperactivity/distraction and dyslexia. Overlapping symptoms are listed, nutritional and organic basis for hyperkinesis considered, and visual and motoric factors in dyslexia discussed. (CL)
Special considerations in distracted driving with teens.
Durbin, Dennis R; McGehee, Daniel V; Fisher, Donald; McCartt, Anne
Novice teen drivers have long been known to have an increased risk of crashing, as well as increased tendencies toward unsafe and risky driving behaviors. Teens are unique as drivers for several reasons, many of which have implications specifically in the area of distracted driving. This paper reviews several of these features, including the widespread prevalence of mobile device use by teens, their lack of driving experience, the influence of peer passengers as a source of distraction, the role of parents in influencing teens' attitudes and behaviors relevant to distracted driving and the impact of laws designed to prevent mobile device use by teen drivers. Recommendations for future research include understanding how engagement in a variety of secondary tasks by teen drivers affects their driving performance or crash risk; understanding the respective roles of parents, peers and technology in influencing teen driver behavior; and evaluating the impact of public policy on mitigating teen crash risk related to driver distraction. PMID:24776228
Special Considerations in Distracted Driving with Teens
Durbin, Dennis R; McGehee, Daniel V; Fisher, Donald; McCartt, Anne
Novice teen drivers have long been known to have an increased risk of crashing, as well as increased tendencies toward unsafe and risky driving behaviors. Teens are unique as drivers for several reasons, many of which have implications specifically in the area of distracted driving. This paper reviews several of these features, including the widespread prevalence of mobile device use by teens, their lack of driving experience, the influence of peer passengers as a source of distraction, the role of parents in influencing teensŌĆÖ attitudes and behaviors relevant to distracted driving and the impact of laws designed to prevent mobile device use by teen drivers. Recommendations for future research include understanding how engagement in a variety of secondary tasks by teen drivers affects their driving performance or crash risk; understanding the respective roles of parents, peers and technology in influencing teen driver behavior; and evaluating the impact of public policy on mitigating teen crash risk related to driver distraction. PMID:24776228
Temperament, Distraction, and Learning in Toddlerhood
Dixon, Wallace E.; Salley, Brenda J.; Clements, Andrea D.
The word and non-word learning abilities of toddlers were tested under various conditions of environmental distraction, and evaluated with respect to childrenŌĆÖs temperamental attentional focus. Thirty-nine children and their mothers visited the lab at child age 21-months, where children were exposed to fast-mapping word learning trials and nonlinguistic sequential learning trials. It was found that both word and nonword-learning was adversely affected by the presentation of environmental distractions. But it was also found that the effect of the distractions sometimes depended on childrenŌĆÖs level of attentional focus. Specifically, children high in attentional focus were less affected by environmental distractions than children low in attentional focus when attempting to learn from a model, whereas children low in attentional focus demonstrated little learning from the model. Translationally, these results may be of use to child health-care providers investigating possible sources of cognitive and language delay. PMID:17138290
Assessment of distraction from erotic stimuli by nonerotic interference.
Anderson, Alex B; Hamilton, Lisa Dawn
Distraction from erotic cues during sexual encounters is a major contributor to sexual difficulties in men and women. Being able to assess distraction in studies of sexual arousal will help clarify underlying contributions to sexual problems. The current study aimed to identify the most accurate assessment of distraction from erotic cues in healthy men (n = 29) and women (n = 38). Participants were assigned to a no distraction, low distraction, or high distraction condition. Distraction was induced using an auditory distraction task presented during the viewing of an erotic video. Attention to erotic cues was assessed using three methods: a written quiz, a visual quiz, and a self-reported distraction measure. Genital and psychological sexual responses were also measured. Self-reported distraction and written quiz scores most accurately represented the level of distraction present, while self-reported distraction also corresponded with a decrease in genital arousal. Findings support the usefulness of self-report measures in conjunction with a brief quiz on the erotic material as the most accurate and sensitive ways to simply measure experimentally-induced distraction. Insight into distraction assessment techniques will enable evaluation of naturally occurring distraction in patients suffering from sexual problems. PMID:24611908
Establishing the Attention-Distractibility Trait.
Forster, Sophie; Lavie, Nilli
Failures to focus attention will affect any task engagement (e.g., at work, in the classroom, when driving). At the clinical end, distractibility is a diagnostic criterion of attention-deficit/hyperactivity disorder (ADHD). In this study, we examined whether the inability to maintain attentional focus varies in the overall population in the form of an attention-distractibility trait. To test this idea, we administered an ADHD diagnostic tool to a sample of healthy participants and assessed the relationship between ADHD symptoms and task distraction. ADHD symptom summary scores were significantly positively associated with distractor interference in letter-search and name-classification tasks (as measured by reaction time), as long as the distractors were irrelevant (cartoon images) rather than relevant (i.e., compatible or incompatible with target names). Higher perceptual load during a task eliminated distraction irrespective of ADHD score. These findings suggest the existence of an attention-distractibility trait that confers vulnerability to irrelevant distraction, which can be remedied by increasing the level of perceptual load during the task. PMID:26667659
Distraction and Mind-Wandering Under Load
Forster, Sophie
Attention research over the last several decades has provided rich insights into the determinants of distraction, including distractor characteristics, task features, and individual differences. Load Theory represented a particularly important breakthrough, highlighting the critical role of the level and nature of task-load in determining both the efficiency of distractor rejection and the stage of processing at which this occurs. However, until recently studies of distraction were restricted to those measuring rather specific forms of distraction by external stimuli which I argue that, although intended to be irrelevant, were in fact task-relevant. In daily life, attention may be distracted by a wide range of stimuli, which may often be entirely unrelated to any task being performed, and may include not only external stimuli but also internally generated stimuli such as task-unrelated thoughts. This review outlines recent research examining these more general, entirely task-irrelevant, forms of distraction within the framework of Load Theory. I discuss the relation between different forms of distraction, and the universality of load effects across different distractor types and individuals. PMID:23734138
Sex determination using maxillary sinus
Kanthem, Ranjith Kumar; Guttikonda, Venkateswara Rao; Yeluri, Sivaranjani; Kumari, Geetha
Background: Individual identification is a subtle concept and often one of the most important priorities in mass disasters, road accidents, air crashes, fires, and even in the investigation of criminal cases. Matching specific features detected on the cadaver with data recorded during the life of an individual is an important aspect in forensics, and can be performed by fingerprint analysis, deoxyribonucleic acid matching, anthropological methods, radiological methods and other techniques which can facilitate age and sex identification. Sinus radiography is one such method that has been used for determination of the sex of an individual. Hence, an attempt is being made to use the different dimensions of the maxillary sinus in the determination of sex using coronal and axial sections of plain computed tomography (CT) scan. Materials and Methods: A total of 30 patients including 17 male and 13 female, visiting the Outpatient Department of the Mamata General Hospital were included as the study subjects. The dimensions of right and left maxillary sinuses of 30 subjects from plain CT were measured using SYNGO software and statistical analysis was done. Results: Sex determination using height, length, width, and volume of the maxillary sinus on both sides showed statistically significant results with a higher percentage of sexual dimorphism in the case of volume. Conclusion: Volume of the right maxillary sinus can be used as accurate diagnostic parameter for sex determination. PMID:26005308
The combination of endoscopy and distraction osteogenesis in the development of a canine midface advancement model.
Levine, J P; Rowe, N M; Bradley, J P; Williams, J K; Mackool, R J; Longaker, M T; McCarthy, J G
The requirements for reconstruction in patients with midface hypoplasia can be formidable: a bicoronal scalp incision, Le Fort III or monobloc skeletal advancement, harvesting and insertion of bone grafts, application of rigid (and occasionally intermaxillary) fixation, blood transfusions, and prolonged operative time and hospitalization. The introduction of the endoscope offers the possibility of minimally invasive surgery with improved visualization of the osteotomy sites. The development of distraction osteogenesis as a surgical technique allows controlled and gradual advancement of the osteotomized skeletal segment and associated soft tissue. The purpose of this study was to develop a canine model of an endoscopically assisted Le Fort III osteotomy with attendant midface distraction. Four mongrels (20 kg in weight) were study subjects. Three 2-cm skin incisions were made (two perpendicular to the zygomaticomaxillary suture and one perpendicular to the nasofrontal suture). The soft tissue and periosteum were evaluated bluntly. Retractors specially designed for the project created a space for endoscopic visualization. Bilateral zygomatic, nasofrontal, and medial orbital wall osteotomies, corticotomies, or both were performed under endoscopic visualization using a reciprocating saw; the medial orbital wall sectioning was specifically not completed (i.e., corticotomy) to avoid laceration of the mucosa and attendant bleeding. The pterygomaxillary osteotomy was completed with an osteotome and mallet. Finally, the nasal septum was only partially divided with an osteotome to avoid excessive blood loss. Four distraction devices were placed across the above-noted osteotomies (two across the nasofrontal osteotomy and one across each lateral osteotomy). The animals were distracted 1 mm per day for 16 to 40 days after surgery (16-40 mm of linear distraction). Cephalograms and computed tomography scans were obtained before and after distraction. The animals were killed after remaining in fixation for 4 to 6 weeks after distraction. All soft tissue was removed and the skull was examined. Photos were obtained throughout the experiment for documentation. The study demonstrated that Le Fort III osteotomies can be performed successfully via small incisions with endoscopic assistance in canine subjects with excellent visualization and minimal bleeding. The advancement of the midface segment can be achieved by activation of an external distraction device. PMID:9780909
Reflections of Distraction in Memory: Transfer of Previous Distraction Improves Recall in Younger and Older Adults
ERIC Educational Resources Information Center
Thomas, Ruthann C.; Hasher, Lynn
Three studies explored whether younger and older adults' free recall performance can benefit from prior exposure to distraction that becomes relevant in a memory task. Participants initially read stories that included distracting text. Later, they studied a list of words for free recall, with half of the list consisting of previously distractingŌĆ"
Bacteria in chronic maxillary sinusitis.
Karma, P; Jokipii, L; Sipil├ż, P; Luotonen, J; Jokipii, A M
Sixty-one chronically inflamed maxillary sinuses produced 131 bacterial strains from mucosal pieces that were taken during a Caldwell-Luc operation and cultured aerobically and anaerobically. Sinus secretions showed only 62 and nasal secretions 106 bacterial strains. Fourteen mucosal strains, including 11 Haemophilus influenzae, grew heavily. None of 24 mucosal anaerobes showed heavy growth. Of 52 antral mucosae with culturable bacteria, 37 disclosed mixed and 15 pure growth. The bacteriological characteristics of the diseased sinus and the nose did not correlate. The duration or extent of the disease, the macroscopic appearance of the diseased sinus, or the presence or absence of allergy were unrelated to bacteriological findings, except that H influenzae was concentrated in purulent sinuses. Intraoperative culture of antral mucosa seems to give the most reliable picture of the bacteriological condition in chronic maxillary sinusitis. PMID:313206
Management of flexion distraction injuries to the thoracolumbar spine.
Lopez, Alejandro J; Scheer, Justin K; Smith, Zachary A; Dahdaleh, Nader S
We present an updated overview of the literature regarding the management of flexion distraction injuries (FDI). FDI are unstable fractures of the thoracolumbar spine, which require surgical management by long segment open fusion or minimally invasive posterior fixation with pedicle screws. While associated with concomitant intra-abdominal injuries that may delay operative stabilization, FDI frequently involve reversible spinal cord injuries and rapid correction is indicated. Modern biomechanical studies have identified valuable prognostic indicators that may be elucidated from determining the mechanism of injury, including the degree of flexion and presence of compression at the time of injury. An improved understanding of FDI will contribute to more appropriate diagnoses and treatment of these fractures. PMID:26209922
Distraction can reduce age-related forgetting.
Biss, Ren├®e K; Ngo, K W Joan; Hasher, Lynn; Campbell, Karen L; Rowe, Gillian
In three experiments, we assessed whether older adults' generally greater tendency to process distracting information can be used to minimize widely reported age-related differences in forgetting. Younger and older adults studied and recalled a list of words on an initial test and again on a surprise test after a 15-min delay. In the middle (Experiments 1a and 2) or at the end (Experiment 3) of the delay, participants completed a 1-back task in which half of the studied words appeared as distractors. Across all experiments, older adults reliably forgot unrepeated words; however, older adults rarely or never forgot the words that had appeared as distractors, whereas younger adults forgot words in both categories. Exposure to distraction may serve as a rehearsal episode for older adults, and thus as a method by which general distractibility may be co-opted to boost memory. PMID:23426890
Divided maxillary artery in relation to the lateral pterygoid muscle.
Aland, R Claire; Shaw, Vivien
We describe an anatomical variation of the right maxillary artery. The variation loops deep, giving off a middle meningeal artery with an extremely short extracranial segment, then bifurcates into unequal branches. The smaller branch passes superficial to the lateral pterygoid head and distributes primarily to the masticatory muscles. The larger partially pierces the lateral pterygoid lower head, re-emerges superficially, branches again and passes into the pterygopalatine fossa. The larger lies superficial to the lingual and inferior alveolar nerves and deep to the buccal nerve. An embryonic development origin of the cranial arteries is suggested. PMID:26077959
Sadness increases distraction by auditory deviant stimuli.
Pacheco-Unguetti, Antonia P; Parmentier, Fabrice B R
Research shows that attention is ineluctably captured away from a focal visual task by rare and unexpected changes (deviants) in an otherwise repeated stream of task-irrelevant auditory distractors (standards). The fundamental cognitive mechanisms underlying this effect have been the object of an increasing number of studies but their sensitivity to mood and emotions remains relatively unexplored despite suggestion of greater distractibility in negative emotional contexts. In this study, we examined the effect of sadness, a widespread form of emotional distress and a symptom of many disorders, on distraction by deviant sounds. Participants received either a sadness induction or a neutral mood induction by means of a mixed procedure based on music and autobiographical recall prior to taking part in an auditory-visual oddball task in which they categorized visual digits while ignoring task-irrelevant sounds. The results showed that although all participants exhibited significantly longer response times in the visual categorization task following the presentation of rare and unexpected deviant sounds relative to that of the standard sound, this distraction effect was significantly greater in participants who had received the sadness induction (a twofold increase). The residual distraction on the subsequent trial (postdeviance distraction) was equivalent in both groups, suggesting that sadness interfered with the disengagement of attention from the deviant sound and back toward the target stimulus. We propose that this disengagement impairment reflected the monopolization of cognitive resources by sadness and/or associated ruminations. Our findings suggest that sadness can increase distraction even when distractors are emotionally neutral. PMID:24098923
[Callus distraction in tibial defect fractures].
Giebel, G
Lower leg fractures with an osseous defect can be treated effectively with the callus distraction technique by Bier-Ilizarov. Because osteocytes are cultivated at the site of the defect, a real biological system is working-in contrast to other methods. Especially in lower leg fractures with a denuded tibia, the technique of primary shortening to cover the soft-tissue defect with subsequent compensatory lengthening by callus distraction is valuable. This technique does not need special hospitals but skillful surgeons. A closed surgeon-patient relation ship is required because most treatments are done on an outpatient basis. The cosmetic and functional results are good. PMID:9035939
Comprehensive Review of Adipose Stem Cells and Their Implication in Distraction Osteogenesis and Bone Regeneration
Morcos, Mina W.; Al-Jallad, Hadil; Hamdy, Reggie
Bone is one of the most dynamic tissues in the human body that can heal following injury without leaving a scar. However, in instances of extensive bone loss, this intrinsic capacity of bone to heal may not be sufficient and external intervention becomes necessary. Several techniques are available to address this problem, including autogenous bone grafts and allografts. However, all these techniques have their own limitations. An alternative method is the technique of distraction osteogenesis, where gradual and controlled distraction of two bony segments after osteotomy leads to induction of new bone formation. Although distraction osteogenesis usually gives satisfactory results, its major limitation is the prolonged duration of time required before the external fixator is removed, which may lead to numerous complications. Numerous methods to accelerate bone formation in the context of distraction osteogenesis have been reported. A viable alternative to autogenous bone grafts for a source of osteogenic cells is mesenchymal stem cells from bone marrow. However, there are certain problems with bone marrow aspirate. Hence, scientists have investigated other sources for mesenchymal stem cells, specifically adipose tissue, which has been shown to be an excellent source of mesenchymal stem cells. In this paper, the potential use of adipose stem cells to stimulate bone formation is discussed. PMID:26448947
Distraction osteogenesis for bone repair in the 21st century: lessons learned.
Catagni, Maurizio A; Guerreschi, Francesco; Lovisetti, Luigi
Bone regeneration obtained by distraction osteogenesis is influenced by a series of factors. These include factors that are related to the mechanical stability of the system of distraction (internal or external devices), and to factors directly depending on the biology of the bone tissue, such as the method of bone interruption (osteotomy), the delay and rhythm of distraction, the anatomical site of the osteotomy, and the histological characteristics of the bone requiring reconstruction. The stability of the system of bone fixation depends on the rigidity of the frame, the connexion of the apparatus to the bone (wires, pins) and the intrinsic stability of the segment (length and level of maturation of bone regenerate). The radiological characteristics of bone regeneration (hypo- or hypertrophy) lead to the adaptation of the rhythm of distraction. Following more than 28 years of experience of application of the Ilizarov method for bone reconstruction, the authors describe the technique of frame assembly and the methods of evaluation and treatment of the complications of new bone formation. PMID:21530966
The Effects of Distraction on Cognitive Task Performance during Toddlerhood
ERIC Educational Resources Information Center
Wyss, Nancy M.; Kannass, Kathleen N.; Haden, Catherine A.
We investigated the effects of distraction on attention and task performance during toddlerhood. Thirty toddlers (24- to 26-month-olds) completed different tasks (2 of each: categorization, problem solving, memory, free play) in one of two conditions: No Distraction or Distraction. The results revealed that the distractor had varying effects onŌĆ"
A Source of Distractions in the Classroom: The Teacher.
ERIC Educational Resources Information Center
Wong, Lily Y. S.
This paper identifies distracting factors which take away pupils' attention from the lesson and focus it on the teacher. Distracting factors include teachers' irritating habits, improper attire, and mannerisms. Examples of distracting features of both males and females are listed in eight categories: (1) attire; (2) hair; (3) make-up; (4) personalģ
A Source of Distractions in the Classroom: The Teacher.
ERIC Educational Resources Information Center
Wong, Lily Y. S.
This paper identifies distracting factors which take away pupils' attention from the lesson and focus it on the teacher. Distracting factors include teachers' irritating habits, improper attire, and mannerisms. Examples of distracting features of both males and females are listed in eight categories: (1) attire; (2) hair; (3) make-up; (4) personalŌĆ"
77 FR 61048 - Distracted Driving Grant Program
Federal Register 2010, 2011, 2012, 2013, 2014
... grant program, 77 FR 51610 (Aug. 24, 2012), which established an application deadline of October 9, 2012...: Pursuant to the Moving Ahead for Progress in the 21st Century Act (MAP-21), the Department of... Progress in the 21st Century Act'' (MAP-21), Public Law 112-141, which created a new distracted...
The Neural Bases of Distraction and Reappraisal
ERIC Educational Resources Information Center
McRae, Kateri; Hughes, Brent; Chopra, Sita; Gabrieli, John D. E.; Gross, James J.; Ochsner, Kevin N.
Distraction and reappraisal are two commonly used forms of cognitive emotion regulation. Functional neuroimaging studies have shown that each one depends upon interactions between pFC, interpreted as implementing cognitive control, and limbic regions, interpreted as mediating emotional responses. However, no study has directly compared distractionŌĆ"
Consumption: Challenge to sustainable development ... or distraction?
Vincent, J.R.; Panayotou, T.
This editorial about sustainable development views it as a distraction to the main issues, pointing out that consumption patterns, not consumption levels is the critical problem. Topics include private consumption and environmental quality, private consumption and resource depletion, patterns versus levels. 21 refs.
Development and evolution of distraction devices: Use of indigenous appliances for Distraction Osteogenesis-An overview
Andrade, Neelam; Gandhewar, Trupti; Kalra, Rinku
An attempt has been made to review various devices as well as the outstanding studies done in the past for understanding the methodology of distraction for regeneration of bone. Lengthening of underdeveloped bones inclusive of the maxillofacial complex has been obtained by distraction osteogenesis by many authors. This could be achieved by the use of various extraoral or intraoral devices. Devices used for distraction osteogenesis must have a minimum of 2 important characteristics ŌĆō they should be able to transfer distraction forces directly to the bone and secondly, should offer adequate rigidity for osseous consolidation to occur. With advanced technology and biomechanical engineering, preformed intraoral distraction devices are now available worldwide. The introduction of these intraoral bone-bourne devices have eliminated the need for bulky, cumbersome extraoral distraction devices which had problems such as external scars, pin tract infections, nerve or tooth bud injuries and poor patient compliance. The design of completely internalized custom made appliance has opened new vistas in the field of Oral and Maxillofacial Surgery. Indigenous internal devices are also economical and locally available. PMID:23482829
Unusual external resorption of a maxillary lateral.
Giunta, J L; Kaplan, M A
This article defines an unusual previously unreported entity afflicting a maxillary lateral incisor. Labial idiopathic external root resorption just apical to the cemento-enamel presented as a gingival (periodontal) problem and was misinterpreted as cervical dental caries. This report defines a new possibility for a radicular defect in a maxillary lateral incisor that may cause periodontal problems. PMID:8054293
Dynamics of Driver Distraction: The process of engaging and disengaging.
Lee, John D
Driver distraction research has a long history, spanning nearly 50 years, but intensifying over the last decade. The dominant paradigm guiding this research defines distraction in terms of excessive workload and limited attentional resources. This approach largely ignores how drivers come to engage in these tasks and under what conditions they engage and disengage from driving-the dynamics of distraction. The dynamics of distraction identifies breakdowns of interruption management as an important contributor to distraction, leading to describe distraction in terms of failures of task timing, switching, and prioritization. The dynamics of distraction also identifies disengagement in driving (e.g., mind wandering) as a substantial challenge that secondary tasks might exacerbate or mitigate. Increasing vehicle automation accentuates the need to consider these dynamics of distraction. Automation offers drivers more opportunity to engage in distractions and disengage from driving, and can surprise drivers by unexpectedly requiring drivers to quickly re-engage in driving-placing greater importance of interruption management expertise. This review describes distraction in terms of breakdowns in interruption management and problems of engagement, and summarizes how contingency, conditioning, and consequence traps lead to problems of engaging and disengaging in driving and distractions. PMID:24776224
Dynamics of Driver Distraction: The process of engaging and disengaging
Lee, John D.
Driver distraction research has a long history, spanning nearly 50 years, but intensifying over the last decade. The dominant paradigm guiding this research defines distraction in terms of excessive workload and limited attentional resources. This approach largely ignores how drivers come to engage in these tasks and under what conditions they engage and disengage from drivingŌĆöthe dynamics of distraction. The dynamics of distraction identifies breakdowns of interruption management as an important contributor to distraction, leading to describe distraction in terms of failures of task timing, switching, and prioritization. The dynamics of distraction also identifies disengagement in driving (e.g., mind wandering) as a substantial challenge that secondary tasks might exacerbate or mitigate. Increasing vehicle automation accentuates the need to consider these dynamics of distraction. Automation offers drivers more opportunity to engage in distractions and disengage from driving, and can surprise drivers by unexpectedly requiring drivers to quickly re-engage in drivingŌĆöplacing greater importance of interruption management expertise. This review describes distraction in terms of breakdowns in interruption management and problems of engagement, and summarizes how contingency, conditioning, and consequence traps lead to problems of engaging and disengaging in driving and distractions. PMID:24776224
Determinant factors of Yemeni maxillary arch dimensions
Al-Zubair, Nabil Muhsen
Objective Information about maxillary arch and palatal dimensions in human populations is important for clinical orthodontics. This study was conducted to assess the determinants of maxillary arch dimensions in a sample of Yemeni individuals aged 18ŌĆō25┬Āyears. Materials and Methods The study sample comprised 214/765 adults (101 women, 113 men) who underwent clinical examination and fulfilled the study criteria. Study models were constructed and evaluated to measure maxillary arch and palatal dimensions. Results The majority of mean maxillary arch dimensions were significantly greater in men than in women, with interŌĆōsecond molar distance showing the greatest difference and palatal depth showing the least difference. Conclusion Measurements of palatal depth and relationships of the canines to one another and to other teeth thus had the widest ranges, implying that these dimensions are the strongest determinants of maxillary arch size. PMID:25544815
Odontogenic maxillary sinusitis: a review.
Simuntis, Regimantas; Kubilius, Ri─Źardas; Vaitkus, Saulius
Maxillary sinusitis of odontogenic origin is a well-known condition in both the dental and otolaryngology communities. It occurs when the Schneiderian membrane is violated by conditions arising from dentoalveolar unit. This type of sinusitis differs in its pathophysiology, microbiology, diagnostics and management from sinusitis of other causes, therefore, failure to accurately identify a dental cause in these patients usually lead to persistent symptomatology and failure of medical and surgical therapies directed toward sinusitis. Unilateral recalcitrant disease associated with foul smelling drainage is a most common feature of odontogenic sinusitis. Also, high-resolution CT scans and cone-beam volumetric computed tomography can assist in identifying dental disease. Sometimes dental treatment alone is adequate to resolve the odontogenic sinusitis and sometimes concomitant or subsequent functional endoscopic sinus surgery or Caldwell-Luc operation is required. The aim of this article is to give a review of the most common causes, symptoms, diagnostic and treatment methods of odontogenic maxillary sinusitis. Search on Cochrane Library, PubMed and Science Direct data bases by key words resulted in 35 articles which met our criteria. It can be concluded that the incidence of odontogenic sinusitis is likely underreported in the available literature. PMID:25209225
Distraction-induced driving error: an on-road examination of the errors made by distracted and undistracted drivers.
Young, Kristie L; Salmon, Paul M; Cornelissen, Miranda
This study explored the nature of errors made by drivers when distracted versus not distracted. Participants drove an instrumented vehicle around an urban test route both while distracted (performing a visual detection task) and while not distracted. Two in-vehicle observers recorded the driving errors made, and a range of other data were collected, including driver verbal protocols, forward, cockpit and driver video, and vehicle data (speed, braking, steering wheel angle, etc.). Classification of the errors revealed that drivers were significantly more likely to make errors when distracted; although driving errors were prevalent even when not distracted. Interestingly, the nature of the errors made when distracted did not differ substantially from those made when not distracted, suggesting that, rather than making different types of errors, distracted drivers simply make a greater number of the same error types they make when not distracted. Avenues for broadening our understanding of the relationship between distraction and driving errors are discussed along with the advantages of using a multi-method framework for studying driver behaviour. PMID:22727884
Surgical and topographic anatomy of the maxillary line: an important landmark for endoscopic nasal surgery.
Raikos, Athanasios; Waidyasekara, Pasan; Morrison, Amy Kathleen
The maxillary line is an important surgical landmark in the lateral nasal cavity. We investigated its location, variation, and relation to other landmarks in 47 formalin fixed cadaveric half-heads dissected in steps. Measurements and observations were made to describe the topography of the maxillary line, maxillary line midpoint (M-point), and their relationship with surgically important structures. The mean curved length of the maxillary line was 15 mm (SD 3.5) and can be classified into three types. The M-point had a mean vertical distance of 0.8mm (SD 2.9) below the nasolacrimal sac-duct junction. It was found below, above, or on the same level as the nasolacrimal sac-duct junction in 57.4%, 38.3%, and 4.3% of specimens, respectively. In 51.1% the M-point was anterior to the nasolacrimal duct axis and 48.9% overlapping the lacrimal apparatus. The maxillary line and its M-point are useful surgical landmarks for localizing the nasolacrimal duct segments. PMID:25466929
Biomechanical patterns of text-message distraction.
Le, Peter; Hwang, Jaejin; Grawe, Sarah; Li, Jing; Snyder, Alison; Lee, Christina; Marras, William S
The objective of this study was to identify biomechanical measures that can distinguish texting distraction in a laboratory-simulated driving environment. The goal would be to use this information to provide an intervention for risky driving behaviour. Sixteen subjects participated in this study. Three independent variables were tested: task (texting, visual targeting, weighted and non-weighted movements), task direction (front and side) and task distance (close and far). Dependent variables consisted of biomechanical moments, head displacement and the length of time to complete each task. Results revealed that the time to complete each task was higher for texting compared to other tasks. Peak moments during texting were only distinguishable from visual targeting. Peak head displacement and cumulative biomechanical exposure measures indicated that texting can be distinguished from other tasks. Therefore, it may be useful to take into account both temporal and biomechanical measures when considering warning systems to detect texting distraction. PMID:25867196
Maxillary tuberosity fracture and subconjunctival hemorrhage following extraction of maxillary third molar.
Thirumurugan, Kanagasabapathy; Munzanoor, Rathinam Ramesh Babu; Prasad, Gnanasekaran Arun; Sankar, Kannan
Extraction of teeth is the most common minor surgical procedure performed. Complication of extraction ranges from periodontal injury to fracture of jaw in the mandible and fracture of tuberosity and oroantral communication in the maxilla. Subconjunctival hemorrhage after extraction of maxillary molar is a very rare complication, and so far, only one case is reported in the literature. We report a case of subconjunctival hemorrhage with maxillary tuberosity fracture after maxillary third molar extraction. PMID:23633874
Sharing the responsibility for driver distraction across road transport systems: a systems approach to the management of distracted driving.
Young, Kristie L; Salmon, Paul M
Distracted driving is acknowledged universally as a large and growing road safety problem. Compounding the problem is that distracted driving is a complex, multifaceted issue influenced by a multitude of factors, organisations and individuals. As such, management of the problem is not straightforward. Numerous countermeasures have been developed and implemented across the globe. The vast majority of these measures have derived from the traditional reductionist, driver-centric approach to distraction and have failed to fully reflect the complex mix of actors and components that give rise to drivers becoming distracted. An alternative approach that is gaining momentum in road safety is the systems approach, which considers all components of the system and their interactions as an integrated whole. In this paper, we review the current knowledge base on driver distraction and argue that the systems approach is not currently being realised in practice. Adopting a more holistic, systems approach to distracted driving will not only improve existing knowledge and interventions from the traditional approach, but will enhance our understanding and management of distraction by considering the complex relationships and interactions of the multiple actors and the myriad sources, enablers and interventions that make up the distracted driving system. It is only by recognising and understanding how all of the system components work together to enable distraction to occur, that we can start to work on solutions to help mitigate the occurrence and consequences of distracted driving. PMID:24767853
Clinical and radiographic evaluation of maxillary central incisors exposure in patients undergoing maxillary advancement
Trento, Guilherme dos Santos; Bernab├®, Felipe Bueno Rosettti; da Costa, Delson Jo├Żo; Rebellato, Nelson Luis Barbosa; Kl├╝ppel, Leandro Eduardo; Scariot, Rafaela
Abstract Introduction: Patients with dentofacial deformities may undergo orthodontic or orthodontic-surgical treatment. Both modalities can affect esthetics. Objective: This study aims to evaluate clinical and radiographic changes in exposure of maxillary central incisors occurring after orthognathic surgery for maxillary advancement. Methods: A total of 17 patients who underwent orthognathic surgery for maxillary advancement between September, 2010 and July, 2011 were selected. Exposure of maxillary central incisors was evaluated clinically and by lateral cephalograms. Measurements were taken one week before and three months after surgery. Data were paired in terms of sex, age, nasolabial angle, height and thickness of the upper lip, the amount of maxillary advancement, clinical exposure and inclination of maxillary central incisor by statistical tests (CI 95%). Results: After maxillary advancement, incisor clinical exposure had increased even with relaxed lips and under forced smile. Moreover, there was a mean increase of 23.33% revealed by lateral cephalograms. There was an inverse correlation between upper lip thickness and incisors postsurgical exposure revealed by radiographic images (p = 0.002). Conclusions: Significant changes in the exposure of maxillary central incisors occur after maxillary advancement, under the influence of some factors, especially lip thickness. PMID:26691970
[An experimental study of a new bidirectional distraction appliance].
Lucas, R; Gounot, N; Cresseaux, P; Breton, P; Freidel, M; Ferez, C; Roger, T; Genevois, J P
The goals of mandibular distraction are to restore a normal length but also a normal shape to the hypoplastic mandible. These two goals are related to the elongation vector which is itself related to the location of the cortictomy and of the device. Other factors influence this elongation vector. So it is impossible to precisely predict the elongation vector. With the monodirectional distraction device no modification can be made during the distraction time. With a bidirectional distraction device offering the possibility to modulate the angulation between the two elongation rods it is possible to adjust the elongation vector during distraction. Precise distraction gap modeling is possible. This is particularly important to correct anterior open-bite. This device was tested on animals (pigs). PMID:9697234
Strategies for preventing distractions and interruptions in the OR.
Clark, Gregory J
Stakeholders in the automotive industry, airline industry, and anesthesia profession have identified critical periods of time in which distractions and interruptions of normal processes can have devastating effects. Just as reducing distractions improves safety in an automobile or airplane cockpit, limiting distractions and interruptions during critical times in the perioperative setting can increase patient safety. We assessed perioperative nurses and identified what they perceived as critical phases of nursing care. We also worked with our anesthesia partners to address their concerns about interruptions during the administration of nerve blocks. The perioperative nurses at our hospital initiated strategies to reduce distractions or interruptions to their practice at critical points, and, in┬Ācollaboration with surgical committee members, we developed strategies to reduce or┬Āeliminate distractions for anesthesia professionals during the preoperative administration of nerve blocks and to eliminate distractions for the┬ĀRN circulator and scrub person during the final counts. PMID:23722034
Method for Automated Bone Shape Correction within Bone Distraction Procedure
NASA Astrophysics Data System (ADS)
Blynskiy, F. Yu
The method for automated bone shape correction within bone distraction procedure is presented. High precision deformation angle measurement is provided by the software for X- Ray images processing. Special BDC v.1.0.1. application is designed. The purpose of the BDC is modeling of the bone geometry structure to calculate the appropriate distraction forces. The correction procedure control is realized by the hardware of the distraction system.
Maxillary sinus manifestations of methamphetamine abuse.
Faucett, Erynne A; Marsh, Katherine M; Farshad, Kayven; Erman, Audrey B; Chiu, Alexander G
Methamphetamines are the second most commonly used illicit drug worldwide and cost the United States health-care system ?$23.4 billion annually. Use of this drug affects multiple organ systems and causes a variety of clinical manifestations. Although there are commonly known sequelae of methamphetamine abuse such as "meth mouth," there is limited evidence regarding maxillary sinus manifestations. The following cases highlight the initial evaluation and management of two methamphetamine abusers with loculated purulent collections within the maxillary sinus as a result of methamphetamine abuse. Our aim was to delineate the otolaryngologic symptoms associated with the patients' methamphetamine abuse. Computed tomography and magnetic resonance imaging studies revealed loculated purulent collections within the maxillary sinus of probable odontogenic origin in both patients. Methamphetamine abuse leading to rampant caries and poor oral hygiene may predispose individuals for craniofacial infections and fluid collections. These cases illustrate the development of maxillary sinusitis and maxilla mucoceles that have been associated with methamphetamine use. PMID:25675268
Harrison, Emily L. R.; Fillmore, Mark T.
Background Recognition of the risks associated with alcohol intoxication and driver distraction has led to a wealth of simulated driving research aimed at studying the adverse effects of each of these factors. Research on driving has moved beyond the individual, separate examination of these factors to the examination of potential interactions between alcohol intoxication and driver distraction. In many driving situations, distractions are commonplace and might have little or no disruptive influence on primary driving functions. Yet, such distractions might become disruptive to a driver who is intoxicated. Methods The present study examined the interactive impairing effects of alcohol intoxication and driver distraction on simulated driving performance in 40 young adult drivers using a divided attention task as a distracter activity. The interactive influence of alcohol and distraction was tested by having drivers perform the driving task under four different conditions: 0.65 g/kg alcohol; 0.65 g/kg alcohol + divided attention; placebo; and placebo + divided attention. Results As hypothesized, divided attention had no impairing effect on driving performance in sober drivers. However, under alcohol, divided attention exacerbated the impairing effects of alcohol on driving precision. Conclusions Alcohol and distraction continue to be appropriate targets for research into ways to reduce the rates of driving-related fatalities and injuries. Greater consideration of how alcohol and distraction interact to impair aspects of driving performance can further efforts to create prevention and intervention measures to protect drivers, particularly young adults. PMID:21277119
External distraction impairs categorization performance in older adults
Wais, Peter E.; Gazzaley, Adam
The detrimental influence of distraction on memory and attention is well established, yet it is not as clear if irrelevant information impacts categorization abilities and if this impact changes in aging. We examined categorization with morphed prototype stimuli in both younger and older adults, using an adaptive staircase approach to assess participants' performance in conditions with and without visual distractors. Results showed that distraction did not affect younger adults, but produced a negative impact on older adults' categorization such that there was an interaction of age and distraction. These results suggest a relationship between the increased susceptibility to visual distraction in normal aging and impairment in categorization. PMID:25244485
Subtractive Fuzzy Classifier Based Driver Distraction Levels Classification Using EEG
Wali, Mousa Kadhim; Murugappan, Murugappan; Ahmad, Badlishah
[Purpose] In earlier studies of driver distraction, researchers classified distraction into two levels (not distracted, and distracted). This study classified four levels of distraction (neutral, low, medium, high). [Subjects and Methods] Fifty Asian subjects (n=50, 43 males, 7 females), age range 20ŌĆō35 years, who were free from any disease, participated in this study. Wireless EEG signals were recorded by 14 electrodes during four types of distraction stimuli (Global Position Systems (GPS), music player, short message service (SMS), and mental tasks). We derived the amplitude spectrum of three different frequency bands, theta, alpha, and beta of EEG. Then, based on fusion of discrete wavelet packet transforms and fast fourier transform yield, we extracted two features (power spectral density, spectral centroid frequency) of different wavelets (db4, db8, sym8, and coif5). Mean ┬▒ SD was calculated and analysis of variance (ANOVA) was performed. A fuzzy inference system classifier was applied to different wavelets using the two extracted features. [Results] The results indicate that the two features of sym8 posses highly significant discrimination across the four levels of distraction, and the best average accuracy achieved by the subtractive fuzzy classifier was 79.21% using the power spectral density feature extracted using the sym8 wavelet. [Conclusion] These findings suggest that EEG signals can be used to monitor distraction level intensity in order to alert drivers to high levels of distraction. PMID:24259914
Speech-Language Dissociations, Distractibility, and Childhood Stuttering
Conture, Edward G.; Walden, Tedra A.; Lambert, Warren E.
Purpose This study investigated the relation among speech-language dissociations, attentional distractibility, and childhood stuttering. Method Participants were 82 preschool-age children who stutter (CWS) and 120 who do not stutter (CWNS). Correlation-based statistics (Bates, Appelbaum, Salcedo, Saygin, & Pizzamiglio, 2003) identified dissociations across 5 norm-based speech-language subtests. The Behavioral Style Questionnaire Distractibility subscale measured attentional distractibility. Analyses addressed (a) between-groups differences in the number of children exhibiting speech-language dissociations; (b) between-groups distractibility differences; (c) the relation between distractibility and speech-language dissociations; and (d) whether interactions between distractibility and dissociations predicted the frequency of total, stuttered, and nonstuttered disfluencies. Results More preschool-age CWS exhibited speech-language dissociations compared with CWNS, and more boys exhibited dissociations compared with girls. In addition, male CWS were less distractible than female CWS and female CWNS. For CWS, but not CWNS, less distractibility (i.e., greater attention) was associated with more speech-language dissociations. Last, interactions between distractibility and dissociations did not predict speech disfluencies in CWS or CWNS. Conclusions The present findings suggest that for preschool-age CWS, attentional processes are associated with speech-language dissociations. Future investigations are warranted to better understand the directionality of effect of this association (e.g., inefficient attentional processes ŌåÆ speech-language dissociations vs. inefficient attentional processes ŌåÉ speech-language dissociations). PMID:26126203
Monobloc Le Fort III Distraction Osteogenesis for Correction of Severe Fronto-orbital and Midface Hypoplasia in Pediatric Crouzon Syndrome.
Hariri, Firdaus; Cheung, Lim Kwong; Rahman, Zainal Ariff Abdul; Mathaneswaran, Vickneswaran; Ganesan, Dharmendra
In severe syndromic craniosynostosis, distraction osteogenesis (DO) provides superior segmental advancement and allows progressive clinical monitoring to ensure that adequate skeletal expansion is achieved. We report two cases of Crouzon syndrome involving a 3-year-old boy and a 4-year-old girl, who were both treated with monobloc Le Fort III DO using a combination of external and internal distraction devices (Synthes, Oberdorf, Switzerland) to treat severe orbital proptosis and obstructed nasopharyngeal airway secondary to severe hypoplastic craniofacial skeletal components. Their skeletal segments were advanced in daily increments by 27 mm and 23 mm, respectively. Results at 18 months postoperatively showed successful outcomes, as evidenced by adequate eye protection, tracheostomy tube decannulation following objective evidence of patent nasopharyngeal airway, and acceptable facial appearance. Monobloc Le Fort III DO using a combination of external and internal devices produces favorable functional and clinical outcomes for the treatment of severe orbital and airway discrepancy in Crouzon syndrome. PMID:25650655
Unilateral Maxillary First Molar Extraction in Class II Subdivision: An Unconventional Treatment Alternative
Booij, J. W.; Livas, Christos
The asymmetrical intra-arch relationship in Class II subdivision malocclusion poses challenges in the treatment planning and mechanotherapy of such cases. This case report demonstrates a treatment technique engaging unilateral extraction of a maxillary first molar and Begg fixed appliances. The outcome stability and the enhancing effect on the eruption of the third molar in the extraction segment were confirmed by a 4-year follow-up examination. PMID:27200194
The biology of distraction osteogenesis for correction of mandibular and craniomaxillofacial defects: A review
Natu, Subodh Shankar; Ali, Iqbal; Alam, Sarwar; Giri, Kolli Yada; Agarwal, Anshita; Kulkarni, Vrishali Ajit
Limb lengthening by distraction osteogenesis was first described in 1905. The technique did not gain wide acceptance until Gavril Ilizarov identified the physiologic and mechanical factors governing successful regeneration of bone formation. Distraction osteogenesis is a new variation of more traditional orthognathic surgical procedure for the correction of dentofacial deformities. It is most commonly used for the correction of more severe deformities and syndromes of both the maxilla and the mandible and can also be used in children at ages previously untreatable. The basic technique includes surgical fracture of deformed bone, insertion of device, 5-7 days rest, and gradual separation of bony segments by subsequent activation at the rate of 1 mm per day, followed by an 8-12 weeks consolidation phase. This allows surgeons, the lengthening and reshaping of deformed bone. The aim of this paper is to review the principle, technical considerations, applications and limitations of distraction osteogenesis. The application of osteodistraction offers novel solutions for surgical-orthodontic management of developmental anomalies of the craniofacial skeleton as bone may be molded into different shapes along with the soft tissue component gradually thereby resulting in less relapse. PMID:24688555
Distalization pattern of whole maxillary dentition according to force application points
Sung, Eui-Hyang; Kim, Sung-Jin; Chun, Youn-Sic; Park, Young-Chel; Yu, Hyung-Seog
Objective The purpose of this study was to observe stress distribution and displacement patterns of the entire maxillary arch with regard to distalizing force vectors applied from interdental miniscrews. Methods A standard three-dimensional finite element model was constructed to simulate the maxillary teeth, periodontal ligament, and alveolar process. The displacement of each tooth was calculated on x, y, and z axes, and the von Mises stress distribution was visualized using color-coded scales. Results A single distalizing force at the archwire level induced lingual inclination of the anterior segment, and slight intrusive distal tipping of the posterior segment. In contrast, force at the high level of the retraction hook resulted in lingual root movement of the anterior segment, and extrusive distal translation of the posterior segment. As the force application point was located posteriorly along the archwire, the likelihood of extrusive lingual inclination of the anterior segment increased, and the vertical component of the force led to intrusion and buccal tipping of the posterior segment. Rotation of the occlusal plane was dependent on the relationship between the line of force and the possible center of resistance of the entire arch. Conclusions Displacement of the entire arch may be dictated by a direct relationship between the center of resistance of the whole arch and the line of action generated between the miniscrews and force application points at the archwire, which makes the total arch movement highly predictable. PMID:25667914
Clinical update--the teeth and the maxillary sinus: the mutual impact of clinical procedures, disease conditions and their treatment implications. Part 2. Odontogenic sinus disease and elective clinical procedures involving the maxillary antrum: diagnosis and management.
Sandler, H J
Although odontogenic sinusitis is a rare entity when compared to sinus disease of rhinogenic origin, it is extremely important to identify a dental aetiology when it occurs. The offending tooth or teeth would thus require endodontic treatment or extraction, and the sinus disease carefully assessed and appropriately managed. Aetiology and presentation of oro-antral fistulae are also discussed and guidelines for the management of this complication are recommended. Certain lesions such as cysts and tumours may involve the jaws and hence the maxillary antrum; some of these, such as a radicular cyst are quite common, but the rarer ones are included for completeness. Surgical techniques are continuously evolving to optimise form and function of the jaws, and when applied to the maxilla there may be some impact on nasal and sinus function. The advent, and now proven success, of osseointegrated jaw implants have brought with them innovations and refinements of bone grafting techniques, and more recently distraction osteogenesis for augmentation. Maxillary osteotomies for surgical orthodontics, and to facilitate prosthodontic treatment are briefly mentioned, as most of these inevitably involve the antrum and/or nose. This paper discusses, in summary form, important aspects of clinical dental practice which may involve the maxillary antrum. It is thus a broad overview of certain pathologic conditions and elective surgical procedures which have relevance to both medical and dental practitioners. PMID:11411074
Implementation Intentions and Test Anxiety: Shielding Academic Performance from Distraction
ERIC Educational Resources Information Center
Parks-Stamm, Elizabeth J.; Gollwitzer, Peter M.; Oettingen, Gabriele
College students whose test anxiety was measured completed a working memory-intensive math exam with televised distractions. Students were provided with implementation intentions (if-then plans; Gollwitzer, 1999) designed to either help them ignore the distractions (i.e., temptation-inhibiting plans) or focus more intently on the math exam (i.e.,ŌĆ"
Neuronal Effects of Auditory Distraction on Visual Attention
ERIC Educational Resources Information Center
Smucny, Jason; Rojas, Donald C.; Eichman, Lindsay C.; Tregellas, Jason R.
Selective attention in the presence of distraction is a key aspect of healthy cognition. The underlying neurobiological processes, have not, however, been functionally well characterized. In the present study, we used functional magnetic resonance imaging to determine how ecologically relevant distracting noise affects cortical activity in 27ŌĆ"
Interference by Process, Not Content, Determines Semantic Auditory Distraction
ERIC Educational Resources Information Center
Marsh, John E.; Hughes, Robert W.; Jones, Dylan M.
Distraction by irrelevant background sound of visually-based cognitive tasks illustrates the vulnerability of attentional selectivity across modalities. Four experiments centred on auditory distraction during tests of memory for visually-presented semantic information. Meaningful irrelevant speech disrupted the free recall of semanticŌĆ"
Effects of Auditory Distraction on Cognitive Processing of Young Adults
ERIC Educational Resources Information Center
LaPointe, Leonard L.; Heald, Gary R.; Stierwalt, Julie A. G.; Kemker, Brett E.; Maurice, Trisha
Objective: The effects of interference, competition, and distraction on cognitive processing are unclearly understood, particularly regarding type and intensity of auditory distraction across a variety of cognitive processing tasks. Method: The purpose of this investigation was to report two experiments that sought to explore the effects of typesŌĆ"
Orthodontic-restorative treatment as an option for biologic replacement of a maxillary central incisor: 5-year follow-up.
Rizzatto, Susana Maria Deon; Closs, Luciane Quadrado; Freitas, Maria Perp├®tua Mota; Rizzatto, Laura Escobar
The maxillary central incisor is the tooth most often affected by trauma, especially in the age range of 7 to 10 years, when high-impact sports are prevalent. The options for conservative treatment should be prioritized in these patients, aiming to achieve a biologic response that might provide continuity of growth of the alveolus, to provide functional and esthetic development of the affected region. This case report describes a patient with a history of trauma during the deciduous dentition with consequent intrusion, root dilaceration, and retention of the maxillary left central incisor. The treatment involved extraction of the traumatized tooth and mesial movement of the lateral incisor and posterior segments. PMID:22920706
Memory as discrimination: what distraction reveals.
Beaman, C Philip; Hanczakowski, Maciej; Hodgetts, Helen M; Marsh, John E; Jones, Dylan M
Recalling information involves the process of discriminating between relevant and irrelevant information stored in memory. Not infrequently, the relevant information needs to be selected from among a series of related possibilities. This is likely to be particularly problematic when the irrelevant possibilities not only are temporally or contextually appropriate, but also overlap semantically with the target or targets. Here, we investigate the extent to which purely perceptual features that discriminate between irrelevant and target material can be used to overcome the negative impact of contextual and semantic relatedness. Adopting a distraction paradigm, it is demonstrated that when distractors are interleaved with targets presented either visually (Experiment 1) or auditorily (Experiment 2), a within-modality semantic distraction effect occurs; semantically related distractors impact upon recall more than do unrelated distractors. In the semantically related condition, the number of intrusions in recall is reduced, while the number of correctly recalled targets is simultaneously increased by the presence of perceptual cues to relevance (color features in Experiment 1 or speaker's gender in Experiment 2). However, as is demonstrated in Experiment 3, even presenting semantically related distractors in a language and a sensory modality (spoken Welsh) distinct from that of the targets (visual English) is insufficient to eliminate false recalls completely or to restore correct recall to levels seen with unrelated distractors . Together, the study shows how semantic and nonsemantic discriminability shape patterns of both erroneous and correct recall. PMID:23661190
Maxillary sinus perforation by orthodontic anchor screws.
Motoyoshi, Mitsuru; Sanuki-Suzuki, Rina; Uchida, Yasuki; Saiki, Akari; Shimizu, Noriyoshi
To facilitate safe placement of orthodontic anchor screws (miniscrews), we investigated the frequency of maxillary sinus perforation after screw placement and the effect of sinus perforation on screw stability. Maxillary sinus perforations involving 82 miniscrews (diameter, 1.6 mm; length, 8 mm) were evaluated using cone-beam computed tomography. All miniscrews were placed in maxillary alveolar bone between the second premolar and first molar for anchorage for anterior retraction in patients undergoing first premolar extraction. The placement torque and screw mobility of each implant were determined using a torque tester and a Periotest device, and variability in these values in relation to sinus perforation was evaluated. Eight of the 82 miniscrews perforated the maxillary sinus. There was no case of sinusitis in patients with miniscrew perforation and no significant difference in screw mobility or placement torque between perforating and non-perforating miniscrews. The sinus floor was significantly thinner in perforated cases than in non-perforated cases. A sinus floor thickness of 6.0 mm or more is recommended in order to avoid miniscrew perforation of the maxillary sinus. PMID:26062857
Three-Dimensional Eyeball and Orbit Volume Modification After LeFort III Midface Distraction.
Smektala, Tomasz; Nysj├Č, Johan; Thor, Andreas; Homik, Aleksandra; Sporniak-Tutak, Katarzyna; Safranow, Krzysztof; Dowgierd, Krzysztof; Olszewski, Raphael
The aim of our study was to evaluate orbital volume modification with LeFort III midface distraction in patients with craniosynostosis and its influence on eyeball volume and axial diameter modification. Orbital volume was assessed by the semiautomatic segmentation method based on deformable surface models and on 3-dimensional (3D) interaction with haptics. The eyeball volumes and diameters were automatically calculated after manual segmentation of computed tomographic scans with 3D slicer software. The mean, minimal, and maximal differences as well as the standard deviation and intraclass correlation coefficient (ICC) for intraobserver and interobserver measurements reliability were calculated. The Wilcoxon signed rank test was used to compare measured values before and after surgery. PŌĆŖ<ŌĆŖ0.05 was considered statistically significant. Intraobserver and interobserver ICC for haptic-aided semiautomatic orbital volume measurements were 0.98 and 0.99, respectively. The intraobserver and interobserver ICC values for manual segmentation of the eyeball volume were 0.87 and 0.86, respectively. The orbital volume increased significantly after surgery: 30.32% (mean, 5.96ŌĆŖ mL) for the left orbit and 31.04% (mean, 6.31ŌĆŖ mL) for the right orbit. The mean increase in eyeball volume was 12.3%. The mean increases in the eyeball axial dimensions were 7.3%, 9.3%, and 4.4% for the X-, Y-, and Z-axes, respectively. The Wilcoxon signed rank test showed that preoperative and postoperative eyeball volumes, as well as the diameters along the X- and Y-axes, were statistically significant. Midface distraction in patients with syndromic craniostenosis results in a significant increase (PŌĆŖ<ŌĆŖ0.05) in the orbit and eyeball volumes. The 2 methods (haptic-aided semiautomatic segmentation and manual 3D slicer segmentation) are reproducible techniques for orbit and eyeball volume measurements. PMID:26086925
Finite element analysis of rapid canine retraction through reducing resistance and distraction
XUE, Junjie; YE, Niansong; YANG, Xin; WANG, Sheng; WANG, Jing; WANG, Yan; LI, Jingyu; MI, Congbo; LAI, Wenli
Objective The aims of this study were to compare different surgical approaches to rapid canine retraction by designing and selecting the most effective method of reducing resistance by a three-dimensional finite element analysis. Material and Methods Three-dimensional finite element models of different approaches to rapid canine retraction by reducing resistance and distraction were established, including maxillary teeth, periodontal ligament, and alveolar. The models were designed to dissect the periodontal ligament, root, and alveolar separately. A 1.5 N force vector was loaded bilaterally to the center of the crown between first molar and canine, to retract the canine distally. The value of total deformation was used to assess the initial displacement of the canine and molar at the beginning of force loading. Stress intensity and force distribution were analyzed and evaluated by Ansys 13.0 through comparison of equivalent (von Mises) stress and maximum shear stress. Results The maximum value of total deformation with the three kinds of models occurred in the distal part of the canine crown and gradually reduced from the crown to the apex of the canine; compared with the canines in model 3 and model 1, the canine in model 2 had the maximum value of displacement, up to 1.9812 mm. The lowest equivalent (von Mises) stress and the lowest maximum shear stress were concentrated mainly on the distal side of the canine root in model 2. The distribution of equivalent (von Mises) stress and maximum shear stress on the PDL of the canine in the three models was highly concentrated on the distal edge of the canine cervix. Conclusions Removal of the bone in the pathway of canine retraction results in low stress intensity for canine movement. Periodontal distraction aided by surgical undermining of the interseptal bone would reduce resistance and effectively accelerate the speed of canine retraction. PMID:24626249
Behavioral Distraction by Auditory Novelty Is Not Only about Novelty: The Role of the Distracter's Informational Value
ERIC Educational Resources Information Center
Parmentier, Fabrice B. R.; Elsley, Jane V.; Ljungberg, Jessica K.
Unexpected events often distract us. In the laboratory, novel auditory stimuli have been shown to capture attention away from a focal visual task and yield specific electrophysiological responses as well as a behavioral cost to performance. Distraction is thought to follow ineluctably from the sound's low probability of occurrence or, put moreŌĆ"
Chronic maxillary sinusitis and diabetes related maxillary osteonecrosis: a case report.
Huh, Suk; Lee, Chae-Yoon; Ohe, Joo-Young; Lee, Jung-Woo; Choi, Byung-Jun; Lee, Baek-Soo; Kwon, Yong-Dae
Dental infections and maxillary sinusitis are the main causes of osteomyelitis. Osteomyelitis can occur in all age groups, and is more frequently found in the lower jaw than in the upper jaw. Systemic conditions that can alter the patient's resistance to infection including diabetes mellitus, anemia, and autoimmune disorders are predisposing factors for osteomyelitis. We report a case of uncommon broad maxillary osteonecrosis precipitated by uncontrolled type 2 diabetes mellitus and chronic maxillary sinusitis in a female patient in her seventies with no history of bisphosphonate or radiation treatment. PMID:26734561
Chronic maxillary sinusitis and diabetes related maxillary osteonecrosis: a case report
Dental infections and maxillary sinusitis are the main causes of osteomyelitis. Osteomyelitis can occur in all age groups, and is more frequently found in the lower jaw than in the upper jaw. Systemic conditions that can alter the patient's resistance to infection including diabetes mellitus, anemia, and autoimmune disorders are predisposing factors for osteomyelitis. We report a case of uncommon broad maxillary osteonecrosis precipitated by uncontrolled type 2 diabetes mellitus and chronic maxillary sinusitis in a female patient in her seventies with no history of bisphosphonate or radiation treatment. PMID:26734561
Endoscopic sinus surgery for maxillary sinus mucoceles
Caylakli, Fatma; Yavuz, Haluk; Cagici, Alper Can; Ozluoglu, Levent Naci
Background Maxillary sinus mucoceles are relatively rare among all paranasal sinus mucoceles. With the introduction of endoscopic sinus surgical techniques, rhinologic surgeons prefer transnasal endoscopic management of sinus mucoceles. The aim of this study is to describe the clinical presentation of maxillary sinus mucoceles and to establish the efficacy of endoscopic management of sinus mucoceles. Methods Between 2003 and 2005, 14 patients underwent endoscopic sinus surgery for maxillary sinus mucocele. The presenting sign and symptoms, radiological findings, surgical management and need for revision surgery were reviewed. Results There were eight males and six females with an age range of 14 to 65. Ten patients complained of nasal obstruction, five of nasal drainage, five of cheek pressure or pain and one of proptosis of the eye and cheek swelling. The maxillary sinus and ipsilateral ethmoid sinus involvement on computed tomographic studies was seen in 4 patients. Four patients had history of endoscopic ethmoidectomy surgery for ethmoid sinusitis and one had Caldwell-Luc operation in the past. Ethmoidectomy with middle meatal antrostomy and marsupialization of the mucocele was performed in all patients. Postoperative follow-up ranged between 8 to 48 months. All patients had a patent middle meatal antrostomy and healthy maxillary sinus mucosa. No patients need revision surgery. Conclusion The most common causes of mucoceles are chronic infection, allergic sinonasal disease, trauma and previous surgery. In 64% of the patients of our study cause remains uncertain. Endoscopic sinus surgery is an effective treatment for maxillary sinus mucoceles with a favorable long-term outcome. PMID:16953897
Horizontally impacted maxillary premolar and bilateral canine transposition.
Halazonetis, Demetrios J
This case report describes the treatment of a patient whose maxillary left first premolar was impacted horizontally, and both maxillary canines were transposed relative to the first premolars. The patient was treated without extractions, and both canines were brought to their correct positions in the maxillary arch. Treatment mechanics during the various stages are discussed. PMID:19268838
Two-stage distraction lengthening of the forearm.
Taghinia, Amir H; Al-Sheikh, Ayman A; Panossian, Andre E; Upton, Joseph
Single-stage lengthening of the forearm using callus distraction is well described; however, forearm lengthening using a 2-stage technique of distraction followed by bone grafting has received less attention. A 2-staged technique can be a better alternative in cases where the surgeon desires extensive lengthening. A retrospective review was undertaken of eleven 2-stage forearm lengthening procedures performed by 1 surgeon over a 15-year period. Indications were radial longitudinal deficiency (8 patients), neonatal ischemic contractures (2 patients), and septic growth arrest (1 patient). Average follow-up was 2.8 years. Distraction was performed on patients an average of 82 mm over an average duration of 24 weeks. Average time to union from the time of distractor removal and grafting was 87 days. Average healing index was 32.1 d/cm. Distraction problems were common and related to the length of time that the distractor was in place; they included pain, pin-related infections, and multiple mechanical device difficulties. Three patients had nonunion, and another had delayed union; however, additional procedures resulted in ultimate bony union in all patients. Demineralized bone matrix and autologous corticocancellous bone grafts yielded predictable healing and good functional results in short-distance distractions. For longer distractions, free vascularized fibula transfer produced the best outcomes. Intercalary cortical allografts did not heal well. Patients with neonatal Volkmann contractures had the most difficulty with distraction and healing, ultimately obtaining little to no lengthening and poor functional outcomes. PMID:23348260
The Causes and Consequences of Distraction in Everyday Driving
Stutts, Jane; Feaganes, John; Rodgman, Eric; Hamlett, Charles; Reinfurt, Donald; Gish, Kenneth; Mercadante, Michael; Staplin, Loren
To document driversŌĆÖ exposure to potential distractions and the effects of these distractions on driving performance, inconspicuous video camera units were mounted in the vehicles of 70 volunteer subjects. The camera units automatically recorded a closeup view of the driverŌĆÖs face, a broader view of the interior of the vehicle, and the roadway immediately ahead of the vehicle whenever it was powered on. Three hours of randomly selected data per subject were coded based on a taxonomy of driver distractions (talking on cell phone, eating, tuning radio, etc.), contextual variables (whether vehicle stopped or moving, road type, traffic level, etc.) and observable measures of driver performance (eyes directed inside or outside vehicle, hands on or off steering wheel, and vehicle position in travel lane). Results were analyzed descriptively and using nonparametric bootstrap analysis techniques. The most common distractions in terms of overall event durations were eating and drinking (including preparations to eat or drink), distractions inside the vehicle (reaching or looking for an object, manipulating vehicle controls, etc.), and distractions outside the vehicle (often unidentified). Although many of the distractions were also associated with negative driving performance outcomes, further research is needed to clarify their impact on driving safety. PMID:12941228
[Treatment of fractures of a mandible by means of onteeth compression-distraction apparatus].
Mishchenko, O N
The present work describes the elaboration of onteeth compression-distraction apparatus and the treatment method for mandible fractures within dentition using onteeth compression-distraction apparatus. The conclusions are made regarding advantage of onteeth compression-distraction apparatus over intermaxillary and wire fixation of the bone fragments, as well as over helical onteeth compression-distraction apparatus. PMID:24013145
Maxillary involvement in hemifacial microsomia: an objective three-dimensional analysis of the craniofacial skeleton.
Wink, Jason D; Paliga, J Thomas; Tahiri, Youssef; Goldstein, Jesse A; Taylor, Jesse A; Bartlett, Scott P
The aim of our study is to better understand the maxillary involvement in relation to the mandibular deformation in hemifacial microsomia (HFM). To do so, consecutive patients with HFM treated at The Children's Hospital of Philadelphia from 2000 to 2012 were included in our study. Both two-dimensional and three-dimensional analyses of the bony and sinus structures of the midface and mandible were performed using three-dimensional segmentation software. Patients were stratified into groups based on the Kaban-Pruzansky classification--mild (0-1), moderate (2A), and severe (2B-3)--as well as rank ordering based on overall severity. Analyses involved paired t-tests within severity groups, 1-way analysis of variance when assessing across groups (ipsilateral/contralateral ratio), and regression to assess for trends. Thirty patients were included (4 mild, 12 moderate, and 14 severe). The mandibular volume ratio differed across all patient groups (P < 0.001) and trended with rank order (P < 0.001). No significant difference in maxillary bony volume ratio was found across all patient groups (P = 0.16). In patients with severe disease, the maxillary bone volume was found to be significantly decreased on the ipsilateral side as compared with the contralateral side (P = 0.0123). There was no difference in maxillary sinus volume between ipsilateral and contralateral sides within any patient groups or in comparing across groups (P = 0.10). No significant trend was found in the volume ratio of mandible and maxilla (P = 0.41). To conclude, the maxillary sinus seems to show no difference in volume when comparing between laterality and severity groupings. These findings suggest that there may be alternative influences other than the vascular insult acting as the driving force behind the mandibular deformity and the additional classic clinical findings of HFM. PMID:25006903
Active and passive distraction in children undergoing wound dressings.
Nilsson, Stefan; Ensk├żr, Karin; Hallqvist, Carina; Kokinsky, Eva
The aim of this study was to test how distraction influences pain, distress and anxiety in children during wound care. Sixty participants aged 5-12 years were randomized to three groups: serious gaming, the use of lollipops and a control group. Self-reported pain, distress, anxiety and observed pain behaviour were recorded in conjunction with wound care. Serious gaming, an active distraction, reduced the observed pain behaviour and self-reported distress compared with the other groups. A sense of control and engagement in the distraction, together, may be the explanation for the different pain behaviours when children use serious gaming. PMID:22819747
Electronic media use, reading, and academic distractibility in college youth.
Levine, Laura E; Waite, Bradley M; Bowman, Laura L
Activities that require focused attention, such as reading, are declining among American youth, while activities that depend on multitasking, such as instant messaging (IMing), are increasing. We hypothesized that more time spent IMing would relate to greater difficulty in concentrating on less externally stimulating tasks (e.g., academic reading). As hypothesized, the amount of time that young people spent IMing was significantly related to higher ratings of distractibility for academic tasks, while amount of time spent reading books was negatively related to distractibility. The distracting nature and the context of IMing in this population are described. PMID:17711365
Three-dimensional analysis of maxillary changes associated with facemask and rapid maxillary expansion compared with bone anchored maxillary protraction
Hino, Claudia Toyama; Cevidanes, Lucia H. S.; Nguyen, Tung T.; De Clerck, Hugo J.; Franchi, Lorenzo; McNamara, James A.
Introduction Our objectives in this study were to evaluate in 3 dimensions the growth and treatment effects on the midface and the maxillary dentition produced by facemask therapy in association with rapid maxillary expansion (RME/FM) compared with bone-anchored maxillary protraction (BAMP). Methods Forty-six patients with Class III malocclusion were treated with either RME/FM (n = 21) or BAMP (n = 25). Three-dimensional models generated from cone-beam computed tomographic scans, taken before and after approximately 1 year of treatment, were registered on the anterior cranial base and measured using color-coded maps and semitransparent overlays. Results The skeletal changes in the maxilla and the right and left zygomas were on average 2.6 mm in the RME/FM group and 3.7 mm in the BAMP group; these were different statistically. Seven RME/FM patients and 4 BAMP patients had a predominantly vertical displacement of the maxilla. The dental changes at the maxillary incisors were on average 3.2 mm in the RME/FM group and 4.3 mm in the BAMP group. Ten RME/FM patients had greater dental compensations than skeletal changes. Conclusions This 3-dimensional study shows that orthopedic changes can be obtained with both RME/FM and BAMP treatments, with protraction of the maxilla and the zygomas. Approximately half of the RME/FM patients had greater dental than skeletal changes, and a third of the RME/FM compared with 17% of the BAMP patients had a predominantly vertical maxillary displacement. PMID:24182587
Conservative management of a large maxillary cyst.
Rees, J S
This article describes the treatment of a large maxillary cyst by root canal treatment and decompression using a hollow drain made from surgical suction tubing. The rationale behind the use of this technique is reviewed and its advantages highlighted. PMID:9477796
Revisiting the Factors Underlying Maxillary Midline Diastema
Jaija, Abdullah M. Zakria; El-Beialy, Amr Ragab; Mostafa, Yehya A.
Aim. The aim of this study is to analyze the etiological factors underlying the presence of maxillary midline diastema in a sample of orthodontic patients. Materials and Methods. One hundred patients who fulfill the inclusion criteria were selected from 1355 patients seeking orthodontic treatment. The pretreatment orthodontic records were analyzed. The width of the maxillary midline diastema was measured clinically with a digital caliper at two levels: the mesioincisal angles of the central incisors and five millimeters from the incisal edge. The two measurements were averaged, and patients with diastema of more than 0.5 millimeter in width were enrolled. Results. Diastema is a multifactorial clinical finding with more than one underlying etiological cause. The interrelationship between the familial pattern of midline diastema and the microdontia, macroglossia, labial frenum, and alveolar cleft conforms was clear. The effect of a mesiodens and the upper lateral incisor whether bilaterally missing, unerupted, or peg shaped was minimal. Conclusion. Etiological factors underlying maxillary midline diastema are interconnected. Using a checklist as a guide during handling maxillary midline diastema is important in the different stages of treatment.
Maxillary sinus manifestations of methamphetamine abuse
Faucett, Erynne A.; Marsh, Katherine M.; Farshad, Kayven; Erman, Audrey B.
Methamphetamines are the second most commonly used illicit drug worldwide and cost the United States health-care system Ōł╝$23.4 billion annually. Use of this drug affects multiple organ systems and causes a variety of clinical manifestations. Although there are commonly known sequelae of methamphetamine abuse such as ŌĆ£meth mouth,ŌĆØ there is limited evidence regarding maxillary sinus manifestations. The following cases highlight the initial evaluation and management of two methamphetamine abusers with loculated purulent collections within the maxillary sinus as a result of methamphetamine abuse. Our aim was to delineate the otolaryngologic symptoms associated with the patients' methamphetamine abuse. Computed tomography and magnetic resonance imaging studies revealed loculated purulent collections within the maxillary sinus of probable odontogenic origin in both patients. Methamphetamine abuse leading to rampant caries and poor oral hygiene may predispose individuals for craniofacial infections and fluid collections. These cases illustrate the development of maxillary sinusitis and maxilla mucoceles that have been associated with methamphetamine use. PMID:25675268
Testing Thayer's hypothesis: can camouflage work by distraction?
Stevens, Martin; Graham, Julia; Winney, Isabel S; Cantor, Abi
One of the oldest theories of animal camouflage predicts that apparently conspicuous markings enhance concealment. Such 'distraction' marks are hypothesized to work by drawing the viewer's attention away from salient features, such as the body outline, that would otherwise reveal the animal. If distraction marks enhance concealment, then they offer a route for animals to combine camouflage markings with conspicuous signalling strategies, such as warning signals. However, the theory has never been tested and remains controversial. By using camouflaged artificial prey presented to wild avian predators, we test whether distractive markings enhance concealment. In contrast to predictions, we find that markings, both circular and irregular shapes, increase predation compared with unmarked targets. Markings became increasingly costly as their contrast against the prey increased. Our experiments failed to find any empirical support for the hypothesis that distraction markings are an important aspect of camouflage in animals. PMID:18842567
Individual differences in distractibility: An update and a model
S├Črqvist, Patrik; R├Čnnberg, Jerker
This paper reviews the current literature on individual differences in susceptibility to the effects of background sound on visual-verbal task performance. A large body of evidence suggests that individual differences in working memory capacity (WMC) underpin individual differences in susceptibility to auditory distraction in most tasks and contexts. Specifically, high WMC is associated with a more steadfast locus of attention (thus overruling the call for attention that background noise may evoke) and a more constrained auditory-sensory gating (i.e., less processing of the background sound). The relation between WMC and distractibility is a general framework that may also explain distractibility differences between populations that differ along variables that covary with WMC (such as age, developmental disorders, and personality traits). A neurocognitive task-engagement/distraction trade-off (TEDTOFF) model that summarizes current knowledge is outlined and directions for future research are proposed. PMID:25632345
Deviant sounds yield distraction irrespective of the sounds' informational value.
Parmentier, Fabrice B R
Oddball studies show that rare and unexpected changes in an otherwise repetitive or structured sequence of task-irrelevant sounds (deviant sounds among standard sounds) ineluctably break through attentional filters and yield longer response times in an ongoing task. Although this deviance distraction effect has generally been thought of as an involuntary and adaptive phenomenon, recent studies questioned this view by reporting that deviance distraction is observed when sounds predict the occurrence of a target stimulus (informative sounds) but that it disappears when sounds do not convey this information (uninformative sounds). Here, I challenge this conclusion and suggest that the apparent absence of deviance distraction with uninformative sounds results in fact from 2 opposite effects: deviance distraction when the previous trial involved a target and required responding, and a speeding up of responses by deviant sound following trials involving no target and requiring the withholding of responses. Data from a new experiment, new analyses of the data from 3 earlier studies, and the modeling of these data all converge in suggesting the existence of deviance distraction impervious to the sounds' informational value. These results undermine the proposition of a late top-down control mechanism gating behavioral distraction as a function of the sounds' informative value. (PsycINFO Database Record PMID:26727016
Distracted Driving in Elderly and Middle-Aged Drivers
Thompson, Kelsey R.; Johnson, Amy M.; Emerson, Jamie L.; Dawson, Jeffrey D.; Boer, Erwin R.
Automobile driving is a safety-critical real-world example of multitasking. A variety of roadway and in-vehicle distracter tasks create information processing loads that compete for the neural resources needed to drive safely. Drivers with mind and brain aging may be particularly susceptible to distraction due to waning cognitive resources and control over attention. This study examined distracted driving performance in an instrumented vehicle (IV) in 86 elderly (mean = 72.5 years, SD = 5.0 years) and 51 middle-aged drivers (mean = 53.7 years, SD = 9.3 year) under a concurrent auditory-verbal processing load created by the Paced Auditory Serial Addition Task (PASAT). Compared to baseline (no-task) driving performance, distraction was associated with reduced steering control in both groups, with middle-aged drivers showing a greater increase in steering variability. The elderly drove slower and showed decreased speed variability during distraction compared to middle-aged drivers. They also tended to ŌĆ£freeze upŌĆØ, spending significantly more time holding the gas pedal steady, another tactic that may mitigate time pressured integration and control of information, thereby freeing mental resources to maintain situation awareness. While 39% of elderly and 43% of middle-aged drivers committed significantly more driving safety errors during distraction, 28% and 18%, respectively, actually improved, compatible with allocation of attention resources to safety critical tasks under a cognitive load. PMID:22269561
Memory load modulates graded changes in distracter filtering
Shimi, Andria; Woolrich, Mark W.; Mantini, Dante; Astle, Duncan E.
Our ability to maintain small amounts of information in mind is critical for successful performance on a wide range of tasks. However, it remains unclear exactly how this maintenance is achieved. One possibility is that it is brought about using mechanisms that overlap with those used for attentional control. That is, the same mechanisms that we use to regulate and optimize our sensory processing may be recruited when we maintain information in visual short-term memory (VSTM). We aimed to test this hypothesis by exploring how distracter filtering is modified by concurrent VSTM load. We presented participants with sequences of target items, the order and location of which had to be maintained in VSTM. We also presented distracter items alongside the targets, and these distracters were graded such that they could be either very similar or dissimilar to the targets. We analyzed scalp potentials using a novel multiple regression approach, which enabled us to explore the neural mechanisms by which the participants accommodated these variable distracters on a trial-to-trial basis. Critically, the effect of distracter filtering interacted with VSTM load; the same graded changes in perceptual similarity exerted effects of a different magnitude depending upon how many items participants were already maintaining in VSTM. These data provide compelling evidence that maintaining information in VSTM recruits an overlapping set of attentional control mechanisms that are otherwise used for distracter filtering. PMID:25610387
A distraction can impair or enhance motor performance
Hemond, Christopher; Brown, Rachel M; Robertson, Edwin M
HumansŌĆÖ have a prodigious capacity to perform multiple tasks simultaneously. Being distracted while for example performing a complex motor skill, adds complexity to a task, and so leads to a performance impairment. Yet, it may not be just the presence or absence of a distraction that affects motor performance. Instead, the characteristics of the distraction may play a critical role in affecting human motor performance. Here we show that performance of a motor sequence can be substantially enhanced by simultaneously learning an independent color sequence. In contrast, performance of the same motor sequence was impaired by concurrently counting the number of red cues, which had made up the color sequence. The color and motor sequences had different lengths (10 vs. 12-item), different number of elements (5 vs. 4-elements) and temporal patterns (randomly intermittent vs. continuous), and so were independent of one another. These observations show that distracting information does not always impair motor performance, and so is not a sufficient explanation for the impaired performance. Instead, the influence which a distraction exerts upon performance is mediated by the type of processes engaged: when similar core processes are engaged motor performance is enhanced; whereas, when very different processes are engaged (i.e., counting and sequence performance) performance is impaired. Thus, these observations deepen our understanding of how a distraction can, depending on its characteristics, either impair or enhance performance, and may offer novel approaches to optimizing human cognition. PMID:20071529
Cisplatin inhibits bone healing during distraction osteogenesis.
Stine, Kimo C; Wahl, Elizabeth C; Liu, Lichu; Skinner, Robert A; Vanderschilden, Jacquelyn; Bunn, Robert C; Montgomery, Corey O; Suva, Larry J; Aronson, James; Becton, David L; Nicholas, Richard W; Swearingen, Christopher J; Lumpkin, Charles K
Osteosarcoma (OS) is the most common malignant bone tumor affecting children and adolescents. Many patients are treated with a combination of chemotherapy, resection, and limb salvage protocols. Surgical reconstructions after tumor resection include structural allografts, non-cemented endoprostheses, and distraction osteogenesis (DO), which require direct bone formation. Although cisplatin (CDP) is extensively used for OS chemotherapy, the effects on bone regeneration are not well studied. The effects of CDP on direct bone formation in DO were compared using two dosing regimens and both C57BL/6 (B6) and tumor necrosis factor receptor 1 knockout (TNFR1KO) mice, as CDP toxicity is associated with elevated TNF levels. Detailed evaluation of the five-dose CDP regimen (2ŌĆēmg/kg/day), demonstrated significant decreases in new bone formation in the DO gaps of CDP treated versus vehicle treated mice (pŌĆē<ŌĆē0.001). Further, no significant inhibitory effects from the five-dose CDP regimen were observed in TNFR1KO mice. The two-dose regimen significantly inhibited new bone formation in B6 mice. These results demonstrate that CDP has profound short term negative effects on the process of bone repair in DO. These data provide the mechanistic basis for modeling peri-operative chemotherapy doses and schedules and may provide new opportunities to identify molecules that spare normal cells from the inhibitory effects of CDP. PMID:24259375
Critical design errors in maxillary subperiosteal implants.
Linkow, L I; Ghalili, R
A maxillary full arch subperiosteal implant consists of a metallic framework that rests closely on the atrophied residual ridge beneath the mucoperiosteum and offers support for a dental prosthesis by means of posts or bars with O-ring protrusions or internal clip attachments. The maxillary subperiosteal implant is indicated for those patients presenting with advanced atrophy of the maxilla leaving the patient with three existing stable dense bony areas (the anterior nasal spine, the canine eminences, and the palatal surface of the existing crest) for its support. Over 300 cases with up to 12 years in function are presented. The importance of the basic anatomic and physiologic background required to optimize results are emphasized. The first 600+ subperiosteal implant cases that were placed prior to 1985 showed considerably lower success rates. PMID:10321207
Root canal system of the maxillary canine.
Uchiyama, Makiko; Anzai, Masaaki; Yamamoto, Akio; Uchida, Keiichi; Utsuno, Hajime; Kawase, Yuji; Kasahara, Etsuo
To better assess the efficacy of mechanical preparation of root canals, transparent specimens of 250 extracted maxillary canines were investigated for canal configuration, thickness and curvature of the root canal, condition of any accessory canals, and location of the apical foramen. Fewer than 40% of the specimens showed accessory canals that were mechanically impossible to clean. The majority of the lateral branches were small, greater than a #15 file, and none of the branches were larger than a #20 file. Although apical foramina located away from the apex were observed in 30% of the maxillary teeth, 96% of all apical foramina were within 0.5 mm of the apex. Data on the thickness of the root and main canal in the apical portion and curvature of the root canal suggest that, for adequate apical preparation, a #60 file must be able to reach the apical constriction. PMID:21516985
Impact of distracted driving on safety and traffic flow.
Stavrinos, Despina; Jones, Jennifer L; Garner, Annie A; Griffin, Russell; Franklin, Crystal A; Ball, David; Welburn, Sharon C; Ball, Karlene K; Sisiopiku, Virginia P; Fine, Philip R
Studies have documented a link between distracted driving and diminished safety; however, an association between distracted driving and traffic congestion has not been investigated in depth. The present study examined the behavior of teens and young adults operating a driving simulator while engaged in various distractions (i.e., cell phone, texting, and undistracted) and driving conditions (i.e., free flow, stable flow, and oversaturation). Seventy five participants 16-25 years of age (split into 2 groups: novice drivers and young adults) drove a STISIM simulator three times, each time with one of three randomly presented distractions. Each drive was designed to represent daytime scenery on a 4 lane divided roadway and included three equal roadway portions representing Levels of Service (LOS) A, C, and E as defined in the 2000 Highway Capacity Manual. Participants also completed questionnaires documenting demographics and driving history. Both safety and traffic flow related driving outcomes were considered. A Repeated Measures Multivariate Analysis of Variance was employed to analyze continuous outcome variables and a Generalized Estimate Equation (GEE) Poisson model was used to analyze count variables. Results revealed that, in general more lane deviations and crashes occurred during texting. Distraction (in most cases, text messaging) had a significantly negative impact on traffic flow, such that participants exhibited greater fluctuation in speed, changed lanes significantly fewer times, and took longer to complete the scenario. In turn, more simulated vehicles passed the participant drivers while they were texting or talking on a cell phone than while undistracted. The results indicate that distracted driving, particularly texting, may lead to reduced safety and traffic flow, thus having a negative impact on traffic operations. No significant differences were detected between age groups, suggesting that all drivers, regardless of age, may drive in a manner that impacts safety and traffic flow negatively when distracted. PMID:23465745
Non malignant maxillary lesions: our experience.
Damera, Naveen Chandra Rao; Vallabhaneni, Kalyan Chakravarthy; Tripuraneni, Satish Chandra; Madala, Sudhakar; Diddi, Ranga Rao
A wide variety of lesions occur in maxilla. Non specificity of clinical and radiological features makes diagnosis of these lesions a difficult task. We report six interesting cases of maxillary swelling among a total number of 37 such lesions of maxilla. These six cases are as follows two cases of central giant cell granuloma, two cases of fibrous dysplasia, one case of pigmented melanotic neuroectodermal tumor and one case of solitary myofibroma. PMID:24427620
Statistical analysis of axial deformity during distraction osteogenesis of the tibia.
Leyes, M; Noonan, K J; Forriol, F; Ca├▒adell, J
In this study, we documented the prevalence of coronal axis malalignment in a series of 93 tibias (from 54 patients) lengthened with monolateral fixation. The average length obtained by distraction osteogenesis was 8.9 cm (range, 3.5-15.6) or 38% of the original bone length (range, 11-78%). Fifty (54%) of 93 tibias had documented valgus angulation of > or = 10 degrees or had fixator manipulation during the lengthening process for undesirable or progressive angulation; no cases of varus angulation were noted. Thirteen (14%) segments had later corrective osteotomy for unsatisfactory valgus malalignment. Statistical analysis revealed two factors to have a significant effect on the rate of malalignment. Those cases that had tibial osteotomy below the proximal one third of the original tibial length and those cases in which the fixator was placed > 5 degrees out of parallel had higher rates of angulation or manipulation (p < 0.001 and p = 0.002). Although the percentage of original bone lengthened was not statistically significant (p = 0.083), it did have an important effect on rates of axial malalignment. From this study we conclude that relatively high rates of malalignment in the tibia during distraction osteogenesis with monolateral external fixation are predominately the result of more distal osteotomies and nonparallel fixator placement. Attention to these details in general, and particularly where long lengthenings are planned, may significantly reduce this common complication. PMID:9580305
Cholesterol granuloma of the maxillary antrum.
Gunes, H A; Almac, A; Canbay, E
The cholesterol granuloma is a particular form of granulation tissue developing as part of a variety of tissue reactions, Cholesterol granuloma is not related to cholesteatoma which may be regarded as an epidermoid cyst of the middle ear or temporal bone. Cholesterol granulomas are rarely associated with such cases (Friedmann, 1976; Gherini et al., 1985). Microscopically, the cholesterol granuloma consists of dense masses of cholesterol crystals which appear as clefts. They are surrounded by foreign body giant cells, foam cells, plasma cells and lymphocytes. There is frequently some fresh blood and some blood pigment (Wilhelm, 1977; Beales, 1979; Gibb, 1979). It seems probable that inflammation and prolonged obstruction of a bony cavity that is normally aerated, are the main ways in which cholesterol is concentrated in the paranasal sinuses. It could be expected to be relatively frequent in the maxillary and frontal sinus, but only a few cases have been reported in the literature and only nine cases affecting the maxillary sinus have been published over the last 22 years (Milton and Bickerton, 1986). We have recently found a cholesterol granuloma arising in the maxillary antrum. PMID:3411221
Maxillary reconstruction: Current concepts and controversies
Iyer, Subramania; Thankappan, Krishnakumar
Maxillary reconstruction is still an evolving art when compared to the reconstruction of the mandible. The defects of maxilla apart from affecting the functions of the speech, swallowing and mastication also cause cosmetic disfigurement. Rehabilitation of the form and function in patients with maxillary defects is either by using an obturator prosthesis or by a surgical reconstruction. Literature is abundant with a variety of reconstructive methods. The classification systems are also varied, with no universal acceptance of any one of them. The oncologic safety of these procedures is still debated, and conclusive evidence in this regard has not emerged yet. Management of the orbit is also not yet addressed properly. Tissue engineering, that has been hyped to be one of the possible solutions for this vexing reconstructive problem, has not come out with reliable and reproducible results so far. This review article discusses the rationale and oncological safety of the reconstructing the maxillary defects, critically analyzes the classification systems, offers the different reconstructive methods and touches upon the controversies in this subject. The management of the retained and exenterated orbit associated with maxillectomy is reviewed. The surgical morbidity, complications and the recent advances in this field are also looked into. An algorithm, based on our experience, is presented. PMID:24987199
Distraction-Induced Intestinal Growth: The Role of Mechanotransduction Mechanisms in a Mouse Model of Short Bowel Syndrome
Sueyoshi, Ryo; Ignatoski, Kathleen M. Woods; Okawada, Manabu
Novel strategies are needed to address the problem of patients with short bowel syndrome. We previously demonstrated a three-fold lengthening of pig bowel after 2 weeks of applied distractive forces, but we have not elucidated the mechanisms facilitating this growth. We used a mouse model of distraction-induced enterogenesis. High molecular weight polyethylene glycol (PEG) osmotically stretched an isolated small bowel segment (PEG-stretch). Significant increases in villus height and crypt depth and in intestinal epithelial cell length and numbers suggested epithelial remodeling in addition to proliferation during enterogenesis. LC-MS/MS analysis showed a two-fold upregulation of ╬▒-actinin-1 and -4. We also demonstrated that p-focal adhesion kinase (FAK), FAK, ╬▒-actinin, and Rac1 were significantly upregulated and that F-actin was relocalized in PEG-stretch versus controls. Blockade of the phosphotidyl inositol 3ŌĆ▓ kinase pathway failed to influence the increase in proliferation or decline in apoptosis after stretch, suggesting alternative signaling pathways are used, including MEK and P38MAPK, which were both upregulated during enterogenesis. Our data suggests that several known mechanotransduction pathways drive distraction-induced enterogenesis. PMID:24070252
[Naso-ethmoido-maxillary protrusion (NEMP): a specific dysmorphosis].
Konopnicki, S; Nicot, R; Sauvķ, C; Raoul, G; Ferri, J
Naso-ethmoido-maxillary protrusion (NEMP) is a rare dental and facial dysmorphosis, with excessive growth of basicranium, ethmoid, maxillary, and nasal bones. The clinical presentation includes nasal and upper lip protrusion, telecanthus, a class 2 malocclusion with maxillary protrusion and exoclusion. The craniofacial field is increased in Delaire's analysis. Contrary to isolated maxillary protrusion secondary to membranous ossification dysfunction, NEMP is a constitutional anomaly resulting from an excessive primary growth of the chondrocranium. The therapeutic management of NEMP should take into account these specificities. PMID:24630318
Early sensory processing deficits predict sensitivity to distraction in schizophrenia.
Smucny, Jason; Olincy, Ann; Eichman, Lindsay C; Lyons, Emma; Tregellas, Jason R
Patients with schizophrenia frequently report difficulties paying attention during important tasks, because they are distracted by noise in the environment. The neurobiological mechanism underlying this problem is, however, poorly understood. The goal of this study was to determine if early sensory processing deficits contribute to sensitivity to distracting noise in schizophrenia. To that end, we examined the effect of environmentally relevant distracting noise on performance of an attention task in 19 patients with schizophrenia and 22 age and gender-matched healthy comparison subjects. Using electroencephalography, P50 auditory gating ratios also were measured in the same subjects and were examined for their relationship to noise-induced changes in performance on the attention task. Positive symptoms also were evaluated in patients. Distracting noise caused a greater increase in reaction time in patients, relative to comparison subjects, on the attention task. Higher P50 auditory gating ratios also were observed in patients. P50 gating ratio significantly correlated with the magnitude of noise-induced increase in reaction time. Noise-induced increase in reaction time was associated with delusional thoughts in patients. P50 ratios were associated with delusional thoughts and hallucinations in patients. In conclusion, the observation of noise effects on attention in patients is consistent with subjective reports from patients. The observed relationship between noise effects on reaction time and P50 auditory gating supports the hypothesis that early inhibitory processing deficits may contribute to susceptibility to distraction in the illness. PMID:23590872
Mandibular symphyseal distraction osteogenesis: review of three techniques.
Alkan, A; Ozer, M; Ba┼¤, B; Bayram, M; Celebi, N; Inal, S; Ozden, B
Mandibular symphyseal distraction osteogenesis (MSDO) is an alternative strategy to correct mandibular transverse deficiencies and dental crowding. Only a limited number of practitioners have reported their clinical experience and potential complications of this procedure to widen the mandible in a large case series. This study involved retrospective analysis of 40 patients who underwent mandibular symphyseal distraction osteogenesis. Three different types of distractor were used to widen the mandible: tooth-borne in 21 patients, bone-borne in 5 patients and hybrid (both bone and tooth-borne) in 14 patients. The distraction amount ranged from 7 to 11 mm (mean 7.31 mm). While 39 patients underwent successful mandibular symphyseal distraction, there was one failure. Most of the complications were experienced in bone-borne distractors, such as breakage of the distractor rod, gingival recession, secondary infection and ptosis of the chin. In the light of these findings, it is suggested that a lingually placed tooth-borne hyrax appliance is more suitable and reliable than the other distraction devices. Further larger studies are needed in order to better evaluate the effectiveness of bone-borne or hybrid devices. PMID:17223309
Driver distraction and driver inattention: definition, relationship and taxonomy.
Regan, Michael A; Hallett, Charlene; Gordon, Craig P
There is accumulating evidence that driver distraction and driver inattention are leading causes of vehicle crashes and incidents. However, as applied psychological constructs, they have been inconsistently defined and the relationship between them remains unclear. In this paper, driver distraction and driver inattention are defined and a taxonomy is presented in which driver distraction is distinguished from other forms of driver inattention. The taxonomy and the definitions provided are intended (a) to provide a common framework for coding different forms of driver inattention as contributing factors in crashes and incidents, so that comparable estimates of their role as contributing factors can be made across different studies, and (b) to make it possible to more accurately interpret and compare, across studies, the research findings for a given form of driver inattention. PMID:21658505
Why segment the maxilla between laterals and canines?
Esteves, Lucas Senhorinho; dos Santos, Jean Nunes; Sullivan, Steven M.; Martins, Luana Maria Ros├Īrio; ├üvila, Carolina
Introduction: Maxillary surgery on a bone segment enables movement in the sagittal and vertical planes. When performed on multiple segments, it further provides movement in the transverse plane. Typical sites for interdental osteotomies are between laterals and canines, premolars and canines, or between incisors. Additionally, osteotomies can be bilateral, unilateral or asymmetric. The ability to control intercanine width, buccolingual angulation of incisors, and correct Bolton discrepancy are some of the advantages of maxillary segmentation between laterals and canines. Objective: This article describes important features to be considered in making a clinical decision to segment the maxilla between laterals and canines when treating a dentoskeletal deformity. It further discusses the history of this surgical approach, the indications for its clinical use, the technique used to implement it, as well as its advantages, disadvantages, complications and stability. It is therefore hoped that this paper will contribute to disseminate information on this topic, which will inform the decision-making process of those professionals who wish to make use of this procedure in their clinical practice. Conclusions: Segmental maxillary osteotomy between laterals and canines is a versatile technique with several indications. Furthermore, it offers a host of advantages compared with single-piece osteotomy, or between canines and premolars. PMID:27007769
CT maxillary sinus evaluation-A retrospective cohort study
Vaz, Paula; Faria-Almeida, Ricardo; Braga, Ana-Cristina; Felino, Ant├│nio
Background Proximity of the dental roots to the sinus floor makes dental disease a probable cause of maxillary sinusitis. The aim of this study was to find out if maxillary sinus pathologic changes were more prevalent in patients with dental disease and to evaluate the performance of computed tomography (CT) in analyzing and detecting apical periodontitis and other odontogenic causes on the maxillary sinusitis etiology in a Portuguese Caucasian population. Material and Methods Retrospective cohort study. The total sample of 504 patients and their CT was included in this study. The patients were from a private dental clinic, specializing in oral surgery, where the first complaint was not directly related to sinus disease, but with dental pathology. For each patient, the etiological factors of maxillary sinusitis and the imaging CT findings were analyzed. All the axial, coronal and sagittal CT slices were evaluated and general data were registered. The latter was selected based on the maxillary sinus CT published literature. Results 32.40% of patients presented normal sinus (without any etiological factor associated), 29.00% showed presence of etiological and imaging findings in the maxillary sinus, 20.60% had only imaging changes in the maxillary sinus and 18.00% of patients presented only etiological factors and no change in the maxillary sinus. Conclusions Radiological imaging is an important tool for establishing the diagnosis of maxillary sinus pathology. These results indicate that the CT scan should be an excellent tool for complement the odontogenic sinusitis diagnosis. Key words: Maxillary sinusitis/etiology, odontogenic, computed tomography, maxillary sinus. PMID:25858084
New-onset craniosynostosis after posterior vault distraction osteogenesis.
Tahiri, Youssef; Paliga, James Thomas; Bartlett, Scott P; Taylor, Jesse A
The aims of this study were to document the incidence of new-onset craniosynostosis (NOC) after posterior vault distraction osteogenesis (PVDO), to determine risk factors for the development of NOC, and to deduce the cranial ramifications of NOC. An institutional review board-approved retrospective review of all patients who underwent PVDO at the Children's Hospital of Philadelphia was performed. Demographics, perioperative data, as well as preoperative and postoperative three-dimensional computed tomographic scans were analyzed. Suture patency preoperatively and postoperatively was recorded.Thirty patients underwent PVDO for suspected increased intracranial pressure and/or severe turribrachicephaly from 2008 to 2013. Twenty-four patients had syndromic diagnoses. The average age at the time of PVDO was 2.03 years. Distraction distances ranged from 19 to 40 mm, with an average of 28.7 mm. Among the 19 patients who had patent lambdoid sutures before PVDO, new-onset lambdoid fusion was seen in 17 patients after PVDO (89.5%), whereas the suture remained open in 2 patients (10.5%). New-onset lambdoid fusion was not significantly associated with age at distraction (P = 0.28), sex (P = 0.47), length of distraction (P = 0.93), or diagnosis (P = 0.61). Similarly, new-onset sagittal synostosis was not associated with age at distraction (P = 0.06), sex (P = 0.64), length of distraction (P = 0.83), or diagnosis (P = 0.25). None of the patients who developed NOC had characteristic head shape changes such as mastoid bulges or scaphocephaly. New-onset lambdoid and sagittal synostoses occur frequently after PVDO. Although the diagnosis of NOC is obvious radiographically, the clinical importance of the diagnosis morphometrically, neurodevelopmentally, and in cranial growth has yet to be fully investigated. PMID:25469894
The prevalence of distraction among passenger vehicle drivers: a roadside observational approach
Huisingh, Carrie; Griffin, Russell; McGwin, Gerald
Objective Distracted driving contributes to a large proportion of motor vehicle crashes, yet little is known about the prevalence of distracted driving and the specific types of distracting behaviors. The objective of this study was to estimate the prevalence of driver distraction using a roadside observational study design. Methods A cross-sectional survey involving direct roadside observation was conducted at 11 selected intersections. Trained investigators observed a sample of passenger vehicles and recorded distraction-related behaviors, driver characteristics, and contextual factors such as vehicle speed and traffic flow. Results Of the 3,265 drivers observed, the prevalence of distracted driving was 32.7%. Among those involved in a distracting activity, the most frequently observed distractions included interacting with another passenger (53.2%, where passengers were present), talking on the phone (31.4%), external-vehicle distractions (20.4%), and texting/dialing a phone (16.6%). The prevalence of talking on the phone was higher among females than males (38.6% vs. 24.3%), whereas external vehicle distractions were higher among males than females (25.8% vs. 24.3%). Drivers <30 years were observed being engaged in any distracting activity, interacting with other passengers and texting/dialing more frequently than drivers aged 30ŌĆō50 and >50 years. Drivers were engaged in distracting behaviors more frequently when the car was stopped. Conclusions When using similar methodology, roadside observational studies generate comparable prevalence estimates of driver distraction as naturalistic driving studies. Driver distraction is a common problem among passenger vehicle drivers. Despite the increased awareness on the dangers of texting and cell phone use while driving, these specific activities were two of the most frequently observed distractions. There is a continued need for road safety education about the dangers of distracted driving, especially for younger drivers. PMID:24761827
Perineal Post Padding Technique to Improve Hip Distraction in Tall Patients
Kuhns, Benjamin D.; Erickson, Brandon J.; Bressler, Leah R.; Sarmast, Sara M.; Nho, Shane J.
Hip distraction is necessary for safe arthroscopic entry into the hip joint. Achieving sufficient distraction is difficult in exceedingly tall patients (>190.5 cm) because of size limitations of currently available hip distraction systems. Inadequate distraction can delay the surgical procedure and potentially lead to complications. By repurposing a foam head-positioning block, we report a safe and inexpensive positioning technique for extending the traction distance for tall patients by 2 inches. PMID:26870657
Analytics For Distracted Driver Behavior Modeling in Dilemma Zone
Li, Jan-Mou; Malikopoulos, Andreas; Thakur, Gautam; Vatsavai, Raju
In this paper, we present the results obtained and insights gained through the analysis of TRB contest data. We used exploratory analysis, regression, and clustering models for gaining insights into the driver behavior in a dilemma zone while driving under distraction. While simple exploratory analysis showed the distinguishing driver behavior patterns among different popu- lation groups in the dilemma zone, regression analysis showed statically signification relationships between groups of variables. In addition to analyzing the contest data, we have also looked into the possible impact of distracted driving on the fuel economy.
Cognitive Distraction and African American Women's Endorsement of Gender Role Stereotypes
ERIC Educational Resources Information Center
Smith, Kalynda; Craig-Henderson, Kellina
The present study investigated the effect of cognitive distraction on the endorsement of gender role stereotypes in one sample of African American female participants. Participants' awareness and endorsement of gender role stereotypes for male and females was assessed. Following random assignment to distraction or no distraction conditions, theyŌĆ"
Galhotra, Virat; Sheikh, Soheyl; Jindal, Sanjeev; Singla, Anshu
Segmental neurofibromatosis is a rare disorder, characterized by neurofibromas or caf?-au-lait macules limited to one region of the body. Its occurrence on the face is extremely rare and only few cases of segmental neurofibromatosis over the face have been described so far. We present a case of segmental neurofibromatosis involving the buccal mucosa, tongue, cheek, ear, and neck on the right side of the face. PMID:25565748
Benign schwannoma of the maxillary antrum.
Hegde, Oshin; Desai, Dinkar; Bhandarkar, Gowri P; Paul, Tony
Schwannoma also known commonly as neurilemmoma and schwann cell tumor is a benign nerve sheath tumor. About 1/3(rd) cases of schwannoma arise from the head and neck region but rarely from the nasal and paranasal sinuses. The recurrence rate in these cases has reported to be very rare. We report a rare case of schwannoma in a 60-year-old woman arising from the maxillary sinus further eroding the orbital floor and nasal bone. We have also described the clinical presentation, radiological, histological findings, and management of the case. PMID:27095911
Benign schwannoma of the maxillary antrum
Hegde, Oshin; Desai, Dinkar; Bhandarkar, Gowri P.; Paul, Tony
Schwannoma also known commonly as neurilemmoma and schwann cell tumor is a benign nerve sheath tumor. About 1/3rd cases of schwannoma arise from the head and neck region but rarely from the nasal and paranasal sinuses. The recurrence rate in these cases has reported to be very rare. We report a rare case of schwannoma in a 60-year-old woman arising from the maxillary sinus further eroding the orbital floor and nasal bone. We have also described the clinical presentation, radiological, histological findings, and management of the case. PMID:27095911
Odontogenic maxillary sinusitis obscured by midfacial trauma.
Simuntis, Regimantas; Kubilius, Ri─Źardas; Ry┼Īkien─Ś, Silvija; Vaitkus, Saulius
We present a case of odontogenic maxillary sinusitis whose sinonasal symptomatology was thought to be the consequence of a previous midfacial trauma. The patient was admitted to the Clinic of Oral and Maxillofacial Surgery after more than 10 years of exacerbations of sinonasal symptoms, which began to plague soon after a facial contusion. We decided to perform CT of paranasal sinuses, and despite the absence dental symptomatology, the dental origin of sinusitis was discovered. The majority of sinonasal symptoms resolved after appropriate dental treatment, and there was no need for nasal or sinus surgery. PMID:26183855
Metastatic Lung Carcinoma Involving the Maxillary Gingiva.
Sawheny, Eva; Khawar, Muhammad Umair; Ahmad, Shoaib; Jones, Kellie
Metastatic spread of malignant tumors to the oral soft tissue is rare and account for 0.1% of all oral malignancies. Metastatic spread to the oral soft tissue can present as dental infections, which in turn can create a diagnostic challenge. Metastasis to the oral soft tissue from lung cancer is a rare situation. Here we describe a 52 year-old male patient treated initially with antibiotics for presumed oral abscess, who later was found to have metastatic lung cancer involving the maxillary gingiva. PMID:27027144
Are child occupants a significant source of driving distraction?
Koppel, Sjaan; Charlton, Judith; Kopinathan, Chelvi; Taranto, David
Driver distraction represents a well-documented and growing contribution to the road safety problem. This study used a naturalistic, observational approach to examine if children in vehicles are a significant source of driving distraction. Families with children aged between 1 and 8 years drove an instrumented "study vehicle" on their regular trips for 3 weeks. A discrete video recording system in the vehicle provided images of the driver and front seat passenger, the rear seat child passengers and the traffic ahead. The video-recordings inside and outside the vehicle were analysed to identify potential distracting activities, where 'distraction' was broadly defined as any activity that distracted the driver or competed for their attention while driving. In addition, all potentially distracting activities that involved the driver looking away from the forward roadway for more than 2s while the vehicle was in motion were also coded. Video-recordings were analysed for 92 driving journeys undertaken by 12 families including 25 children and 19 drivers. The mean journey duration was approximately 16 min (range: 2 min-3h 34 min). Most journeys were undertaken during the day (89%), with the mother driving (65%) and without a front seat passenger (64%). Driving journeys were predominantly undertaken in urban areas (97%), on suburban roads/streets (94%), and under low complexity traffic conditions (91%). Most journeys involved some source of potential driver distraction (98%), with drivers distracted for 18% of the driving journey. The most frequent types of distracting activities that drivers engaged in included: touching their head or their face (35%), interacting with child passengers in the rear seat (12%), and engaging with the front seat passenger (9%). Almost three-quarters of these potentially distracting activities were engaged in by the driver while the study vehicle was in motion (72%) and 14% of all potentially distracting activities involved the driver's eyes off the roadway for greater than 2s while the vehicle was in motion, thereby potentially doubling their crash risk. The most frequent child-related activities that drivers engaged in included: turning to look at the rear seated occupants or viewing the children using the rear-view mirror (76.4%), engaging in conversation with their children (16%), assisting their children (e.g., passing food and drink [7%]) and playing with their children (1%). Drivers spent significantly longer periods of time engaged in non-child occupant-related activities compared with child occupant-related activities and were significantly more likely to have their eyes off the forward roadway for greater than 2s while engaged in non-child occupant-related activities (14%) compared to child occupant-related activities (10%). The results suggest that drivers need to be educated about the potential crash and injury risks associated with both child occupant-related and non-child occupant-related activities while driving their vehicle. PMID:21376923
Treatment options of untreatable traumatized anterior maxillary teeth for future use of dental implantation.
Schwartz-Arad, Devorah; Levin, Liran; Ashkenazi, Malka
The anterior maxilla is the most traumatized region during childhood. Posttraumatic complications occasionally lead to tooth loss as well as the need for future implants. Unfortunately, it is contraindicated to place dental implants during childhood. A waiting period of approximately 8 to 10 years before completion of growth is required. For this patient to become a candidate for future dental implants, it is necessary to ensure the continuous growth and to preserve the dimensions of the alveolar process until growth has ceased from time of injury until joint maturation. To achieve these goals, it is essential to coordinate the treatment sequence at the time of trauma. After loss of a traumatized anterior permanent maxillary incisor in young adults, treatment options are limited: orthodontic closure of the gap and reshaping the adjacent teeth, or tooth extraction and maintaining the gap with a temporary restoration. Orthodontic space closure has limited indications and requires prosthetic restoration of at least 2 teeth. Extraction and temporary restoration will usually lead to bone augmentation before implantation. Other possible treatment options include orthodontic extrusion of the root remnant (in cases of untreatable root fracture or complicated crown-root fracture) and a temporary crown to serve the patient until the completion of growth and development, autogenous tooth transplantation, intentional extraction and immediate tooth replantation, distraction osteogenesis, and decoronation. Because general rules do not apply, individual treatment plans are necessary. PMID:15017299
Treatment options of untreatable traumatized anterior maxillary teeth for future use of dental implantation.
Schwartz-Arad, Devorah; Levin, Liran; Ashkenazi, Malka
The anterior maxilla is the most traumatized region during childhood. Posttraumatic complications occasionally lead to tooth loss as well as the need for future implants. Unfortunately, it is contraindicated to place dental implants during childhood. A waiting period of approximately 8 to 10 years before completion of growth is required. For this patient to become a candidate for future dental implants, it is necessary to ensure the continuous growth and to preserve the dimensions of the alveolar process until growth has ceased from time of injury until joint maturation. To achieve these goals, it is essential to coordinate the treatment sequence at the time of trauma. After loss of a traumatized anterior permanent maxillary incisor in young adults, treatment options are limited: orthodontic closure of the gap and reshaping the adjacent teeth, or tooth extraction and maintaining the gap with a temporary restoration. Orthdontic space closure has limited indications and requires prosthetic restoration of at least 2 teeth. Extraction and temporary restoration will usually lead to bone augmentation before implantation. Other possible treatment options include orthodontic extrusion of the root remnant (in cases of untreatable root fracture or complicated crown-root fracture) and a temporary crown to serve the patient until the completion of growth and development, autogenous tooth transplantation, intentional extraction and immediate tooth replantation, distraction osteogenesis, and decoronation. Because general rules do not apply, individual treatment plans are necessary. PMID:15179087
Musical Distracters, Personality Type and Cognitive Performance in School Children
ERIC Educational Resources Information Center
Furnham, Adrian; Stephenson, Rebecca
The aim of this study was to ascertain the nature of the interaction between the affective value of musical distraction, personality type and performance on the cognitive tasks of reading comprehension, free recall, mental arithmetic and verbal reasoning in children aged 11-12 years. It was hypothesized that the cognitive performance of extravertsŌĆ"
Auditory Distraction in Semantic Memory: A Process-Based Approach
ERIC Educational Resources Information Center
Marsh, John E.; Hughes, Robert W.; Jones, Dylan M.
Five experiments demonstrate auditory-semantic distraction in tests of memory for semantic category-exemplars. The effects of irrelevant sound on category-exemplar recall are shown to be functionally distinct from those found in the context of serial short-term memory by showing sensitivity to: The lexical-semantic, rather than acoustic,ŌĆ"
Distraction by emotional sounds: Disentangling arousal benefits and orienting costs.
Max, Caroline; Widmann, Andreas; Kotz, Sonja A; Schr├Čger, Erich; Wetzel, Nicole
Unexpectedly occurring task-irrelevant stimuli have been shown to impair performance. They capture attention away from the main task leaving fewer resources for target processing. However, the actual distraction effect depends on various variables; for example, only target-informative distractors have been shown to cause costs of attentional orienting. Furthermore, recent studies have shown that high arousing emotional distractors, as compared with low arousing neutral distractors, can improve performance by increasing alertness. We aimed to separate costs of attentional orienting and benefits of arousal by presenting negative and neutral environmental sounds (novels) as oddballs in an auditory-visual distraction paradigm. Participants categorized pictures while task-irrelevant sounds preceded visual targets in two conditions: (a) informative sounds reliably signaled onset and occurrence of visual targets, and (b) noninformative sounds occurred unrelated to visual targets. Results confirmed that only informative novels yield distraction. Importantly, irrespective of sounds' informational value participants responded faster in trials with high arousing negative as compared with moderately arousing neutral novels. That is, costs related to attentional orienting are modulated by information, whereas benefits related to emotional arousal are independent of a sound's informational value. This favors a nonspecific facilitating cross-modal influence of emotional arousal on visual task performance and suggests that behavioral distraction by noninformative novels is controlled after their motivational significance has been determined. PMID:26053245
Cognitive Factors in Sexual Arousal: The Role of Distraction
ERIC Educational Resources Information Center
Geer, James H.; Fuhr, Robert
Four groups of male undergraduates were instructed to perform complex cognitive operations when randomly presented single digits of a dichotic listening paradigm. An erotic tape recording was played into the nonattended ear. Sexual arousal varied directly as a function of the complexity of the distracting cognitive operations. (Author)
Learned control over distraction is disrupted in amnesia.
Cosman, Joshua D; Vecera, Shaun P
Recent studies have demonstrated that brief periods of training facilitate the ability to overcome distraction during future performance of a given task, and researchers have proposed that these effects rely on relational memory systems that enable individuals to link specific attentional states to their learned context. In the current work, we examined whether medial temporal lobe (MTL) structures critical for relational and contextual learning contribute to these effects. A group of amnesic patients with bilateral MTL damage and a group of matched comparison subjects both completed an attentional-capture task in which a brief training session typically leads to decreased distraction in a subsequent testing session. Whereas the comparison subjects showed normal training-related decreases in distractibility, the amnesic patients did not. Thus, our results indicate that MTL-mediated learning plays a critical role in the ability to use past experience to overcome distraction. This suggests a tight linkage between MTL-dependent relational-learning mechanisms and cognitive control. PMID:23761926
U.s. State and federal laws targeting distracted driving.
Catherine Chase, J D
Distracted driving has burgeoned with the proliferation of cell phones, global positioning systems and other in-vehicle and personal electronic devices. Annually more than 3,300 people are killed and an additional 400,000 are injured in the United States in distracted driving crashes. The United States (U.S.) federal and state governments have responded to this public health problem with policies and laws; however, a more comprehensive and more effective approach is still needed. Some restrictions on the use of electronic devices while driving by federal employees and some voluntary guidelines and recommendations have been issued. Public opinion polls show support for addressing the issue of distracted driving with state laws. The majority of states have laws banning text messaging while driving and prohibiting the use of an electronic device by teenage or novice drivers. Some states prohibit all drivers from using a hand-held cellphone. Currently no state has a total ban on the use of personal electronic devices while driving. Successful past traffic safety campaigns changing driver behavior have demonstrated the necessity to adopt a "three Es" approach of Enactment of a law, Education of the public about the law, and rigorous Enforcement of the law. Experience reveals that this approach, along with future federal regulation of in-vehicle electronic devices and the employment of technology to limit the use of electronic devices while driving, is needed to alter personal behavior in order to reduce distractions and keep drivers focused on the driving task. PMID:24776229
Distraction and Facilitation--Two Faces of the Same Coin?
ERIC Educational Resources Information Center
Wetzel, Nicole; Widmann, Andreas; Schroger, Erich
Unexpected and task-irrelevant sounds can capture our attention and may cause distraction effects reflected by impaired performance in a primary task unrelated to the perturbing sound. The present auditory-visual oddball study examines the effect of the informational content of a sound on the performance in a visual discrimination task. TheŌĆ"
Nonoperative Management of Craniocervical Ligamentous Distraction Injury: Literature Review.
Kaplan, Nathan B; Molinari, Christine; Molinari, Robert W
Study DesignŌĆāLiterature review and case report. ObjectiveŌĆāReview the existing literature and report the successful nonoperative management of a two-level craniocervical ligamentous distraction injury. MethodsŌĆāA PubMed and Medline review revealed only three limited reports involving the nonoperative management of patients with craniocervical distraction injury. This article reviews the existing literature and reports the case of a 27-year-old man who was involved in a motorcycle accident and sustained multiple systemic injuries and ligamentous distraction injuries to both occipitocervical joints and both C1-C2 joints. The patient's traumatic brain injury and bilateral pulmonary contusions precluded safe operative management of the two-level craniocervical distraction injury. Therefore, the patient was placed in a halo immobilization device. ResultsŌĆāThe literature remains unclear as to the specific indications for nonoperative management of ligamentous craniocervical injuries. Nonoperative management was associated with poor outcomes in the majority of reported patients. We report a patient who was managed for 6 months in a halo device. Posttreatment computed tomography and flexion-extension radiographs demonstrated stable occipitocervical and C1-C2 joints bilaterally. The patient reported minimal neck pain and had excellent functional outcome with a Neck Disability Index score of 2 points at 41 months postoperatively. He returned to preinjury level of employment without restriction. ConclusionsŌĆāFurther study is needed to determine which craniocervical injuries may be managed successfully with nonoperative measures. PMID:26682101
77 FR 15398 - Attentive Driving: Countermeasures for Distraction Forum
Federal Register 2010, 2011, 2012, 2013, 2014
... by both accident data and laboratory research. The purpose of this one-day forum is to examine... distracted driver research and will promote ongoing and future efforts to promote attentive driving and..., vehicle manufacturers, law enforcement, government, and the research community. Below is the...
Technology Transfer Automated Retrieval System (TEKTRAN)
The effect of age on bone formation in the limb lengthening model of distraction osteogenesis (DO) was investigated in two studies using Sprague-Dawley (SD) rats from two colonies at various ages (CAMM: 9 vs. 24 months, Harlan : 4 vs. 24 months). External fixators were placed on the right tibiae of...
Molecular signaling in bone fracture healing and distraction osteogenesis.
Liu, Z; Luyten, F P; Lammens, J; Dequeker, J
The process of fracture healing has been described in detail in many histological studies. Recent work has focused on the mechanisms by which growth and differentiation factors regulate the fracture healing process. Rapid progress in skeletal cellular and molecular biology has led to the identification of many signaling molecules associated with the formation of skeletal tissues, including members of the transforming growth factor-beta (TGF-beta) superfamily and the insulin-like growth factor (IGF) family. Increasing evidence indicates that they are critical regulators of cellular proliferation, differentiation, extracellular matrix biosynthesis and mineralization. Limb lengthening procedure (distraction osteogenesis) is a relevant model to investigate the in vivo correlation between mechanical stimulation and biological responses as the callus is stretched by a proper rate and rhythm of mechanical strain. This model also provides additional insights into the molecular and cellular events during bone fracture repair. TGF-beta 1 was significantly increased in both the distracted callus and the fracture callus. The increased level of TGF-beta 1, together with a low concentration of calcium and an enhanced level of collagen synthesis, was maintained in the distracted callus as long as mechanical strain was applied. Less mineralization is also associated with a low level of osteocalcin production. These observations provide further insights into the molecular basis for the cellular events during distraction osteogenesis. PMID:10212821
Nonoperative Management of Craniocervical Ligamentous Distraction Injury: Literature Review
Kaplan, Nathan B.; Molinari, Christine; Molinari, Robert W.
Study DesignŌĆāLiterature review and case report. ObjectiveŌĆāReview the existing literature and report the successful nonoperative management of a two-level craniocervical ligamentous distraction injury. MethodsŌĆāA PubMed and Medline review revealed only three limited reports involving the nonoperative management of patients with craniocervical distraction injury. This article reviews the existing literature and reports the case of a 27-year-old man who was involved in a motorcycle accident and sustained multiple systemic injuries and ligamentous distraction injuries to both occipitocervical joints and both C1ŌĆōC2 joints. The patient's traumatic brain injury and bilateral pulmonary contusions precluded safe operative management of the two-level craniocervical distraction injury. Therefore, the patient was placed in a halo immobilization device. ResultsŌĆāThe literature remains unclear as to the specific indications for nonoperative management of ligamentous craniocervical injuries. Nonoperative management was associated with poor outcomes in the majority of reported patients. We report a patient who was managed for 6 months in a halo device. Posttreatment computed tomography and flexionŌĆōextension radiographs demonstrated stable occipitocervical and C1ŌĆōC2 joints bilaterally. The patient reported minimal neck pain and had excellent functional outcome with a Neck Disability Index score of 2 points at 41 months postoperatively. He returned to preinjury level of employment without restriction. ConclusionsŌĆāFurther study is needed to determine which craniocervical injuries may be managed successfully with nonoperative measures. PMID:26682101
Mishra, Ajay; Aloimonos, Yiannis
The human visual system observes and understands a scene/image by making a series of fixations. Every fixation point lies inside a particular region of arbitrary shape and size in the scene which can either be an object or just a part of it. We define as a basic segmentation problem the task of segmenting that region containing the fixation point. Segmenting the region containing the fixation is equivalent to finding the enclosing contour- a connected set of boundary edge fragments in the edge map of the scene - around the fixation. This enclosing contour should be a depth boundary. We present here a novel algorithm that finds this bounding contour and achieves the segmentation of one object, given the fixation. The proposed segmentation framework combines monocular cues (color/intensity/texture) with stereo and/or motion, in a cue independent manner. The semantic robots of the immediate future will be able to use this algorithm to automatically find objects in any environment. The capability of automatically segmenting objects in their visual field can bring the visual processing to the next level. Our approach is different from current approaches. While existing work attempts to segment the whole scene at once into many areas, we segment only one image region, specifically the one containing the fixation point. Experiments with real imagery collected by our active robot and from the known databases 1 demonstrate the promise of the approach. PMID:20686671
Maxillary sinus carcinoma: result of radiation therapy
Shibuya, H.; Horiuchi, J.; Suzuki, S.; Shioda, S.; Enomoto, S.
This hundred and sixteen patients with carcinoma of the maxillary sinus received primary therapy consisting of external beam irradiation alone or in combination with surgery and/or chemotherapy at the Department of Radiology, Tokyo Medical and Dental University Hospital, between 1953 and 1982. In our institution, methods of treating cancer of the maxillary sinus have been changed from time to time and showed different control rates and clinical courses. An actuarial 10-year survival rate of 21% has been obtained by the megavoltage irradiation alone as well as 34% actuarial 10-year survival rate by megavoltage irradiation with surgery. After the introduction of conservative surgery followed by conventional trimodal combination therapy, the local control rate has been improved. The amount of functional, cosmetic, and brain damages have been remarkably decreased by this mode of therapy. The actuarial five year survival rate was 67%. In addition, along with the improvement of the local control rate, the control of nodal and distant organ metastases have been emerging as one of the important contributions to the prognosis of this disease.
Maxillary sinus disease of odontogenic origin.
Mehra, Pushkar; Murad, Haitham
Odontogenic sinusitis is a well-recognized condition and accounts for approximately 10% to 12% of cases of maxillary sinusitis. An odontogenic source should be considered in patients with symptoms of maxillary sinusitis who give a history positive for odontogenic infection or dentoalveolar surgery or who are resistant to standard sinusitis therapy. Diagnosis usually requires a thorough dental and clinical evaluation with appropriate radiographs. Common causes of odontogenic sinusitis include dental abscesses and periodontal disease perforating the Schneidarian membrane, sinus perforations during tooth extraction, or irritation and secondary infection caused by intra-antral foreign bodies. The typical odontogenic infection is now considered to be a mixed aerobic-anaerobic infection, with the latter outnumbering the aerobic species involved. Most common organisms include anaerobic streptococci, Bacteroides, Proteus, and Coliform bacilli. Typical treatment of atraumatic odontogenic sinusitis is a 3- to 4- week trial of antibiotic therapy with adequate oral and sinus flora coverage. When indicated, surgical removal of the offending odontogenic foreign body (primary or delayed) or treatment of the odontogenic pathologic conditions combined with medical therapy is usually sufficient to cause resolution of symptoms. If an oroantral communication is suspected, prompt surgical management is recommended to reduce the likelihood of causing chronic sinus disease. PMID:15064067
Maxillary molar distalization with first class appliance.
Ramesh, Namitha; Palukunnu, Biswas; Ravindran, Nidhi; Nair, Preeti P
Non-extraction treatment has gained popularity for corrections of mild-to-moderate class II malocclusion over the past few decades. The distalization of maxillary molars is of significant value for treatment of cases with minimal arch discrepancy and mild class II molar relation associated with a normal mandibular arch and acceptable profile. This paper describes our experience with a 16-year-old female patient who reported with irregularly placed upper front teeth and unpleasant smile. The patient was diagnosed to have angles class II malocclusion with moderate maxillary anterior crowding, deep bite of 4 mm on a skeletal class II base with an orthognathic maxilla and retrognathic mandible and normal growth pattern. She presented an ideal profile and so molar distalization was planned with the first-class appliance. Molars were distalised by 8 mm on the right and left quadrants and class I molar relation achieved within 4 months. The space gained was utilised effectively to align the arch and establish a class I molar and canine relation. PMID:24577171
Effect of lip adhesion on maxillary arch alignment and reduction of a cleft's width before definitive cheilognathoplasty in unilateral and bilateral complete cleft lip.
Gatti, Gian Luca; Lazzeri, Davide; Romeo, Gianfranco; Balmelli, Bruno; Massei, Alessandro
High tension and tissue dislocation caused by wide maxillary clefts could prevent an optimal aesthetic and functional outcome in primary cheilognathoplasty. Many surgical techniques or conservative (orthodontic and orthopaedic) devices have been proposed for the initial management of infants with complete cleft lip and palate to achieve a tension-free repair of the lip. Adhesion converts a wide unilateral complete cleft into a lesser deformity anatomically similar to an incomplete cleft lip. This study aimed to measure the effect of lip adhesion on the width of maxillary clefts. Between 2000 and 2007 lip adhesion was used on 49 consecutive infants affected by complete unilateral (n = 35) and bilateral (n = 14) cleft lip and palate. The indication for lip adhesion was the presence of a wide alveolar cleft (gap > 7 mm) with severely malpositioned maxillary segments. Lip adhesion was done at about 48 days, followed by definitive cheilognathoplasty at 98 days. Photographs and impressions were obtained before any operation. The width of the maxillary clefts was reduced by 60% in unilateral clefts and 61% in bilateral clefts. By converting a complete wide cleft lip to an incomplete cleft in both unilateral and bilateral clefts, adhesion of the lip achieved a better position and stabilised the arch in a symmetrical platform that eased both definitive closure of the defect in the lip and the restoration of the maxillary gap by periosteoplasty during definitive cheilognathoplasty. PMID:20136466
Histomorphometry of distraction osteogenesis in a caprine tibial lengthening model.
Welch, R D; Birch, J G; Makarov, M R; Samchukov, M L
Standardized histomorphometry of bone formation and remodeling during distraction osteogenesis (DO) has not been well characterized. Increasing the rhythm or number of incremental lengthenings performed per day is reported to enhance bone formation during limb lengthening. In 17 skeletally immature goats, unilateral tibial lengthenings to 20 or 30% of original length were performed at a rate of 0.75 mm/day and rhythms of 1, 4, or 720 times per day using standard Ilizarov external fixation and an autodistractor system. Two additional animals underwent frame application and osteotomy without lengthening and served as osteotomy healing controls. Histomorphometric indices were measured at predetermined regions from undecalcified tibial specimens. Within the distraction region, bone formation and remodeling activity were location dependent. Intramembranous bone formed linearly oriented columns of interconnecting trabecular plates of woven and lamellar type bone. Total new bone volume and bone formation indices were significantly increased within the distraction and osteotomy callus regions (Tb.BV/TV, 226% [p < 0.05]; BFR/BS, 235-650% [p < 0.01]) respectively, compared with control metaphyseal bone. Bone formation indices were greatest adjacent to the mineralization zones at the center of the distraction gap; mineral apposition rate 96% (p < 0.01); mineralized bone surfaces 277% [p < 0.001]); osteoblast surfaces 359% [p < 0.001]); and bone formation rate (650% [p < 0.01]). There was no significant difference (p < 0.14; R = 0.4) in the bone formation rate of the distracted callus compared with the osteotomy control callus. Within the original cortices of the lengthened tibiae, bone remodeling indices were significantly increased compared with osteotomy controls; activation frequency (200% [p < 0.05]); osteoclast surfaces (295% [p < 0.01]); erosion period (75%); porosity (240% [p < 0.001]). Neither the rhythm of distraction nor the percent lengthening appeared to significantly influence any morphometric parameter evaluated. Distraction osteogenesis shares many features of normal fracture gap healing. The enhanced bone formation and remodeling appeared to result more from increased recruitment and activation of bone forming and resorbing cells rather than from an increased level of individual cellular activity. PMID:9443783
The emotional side of cognitive distraction: Implications for road safety.
Chan, Michelle; Singhal, Anthony
Driver distraction is estimated to be one of the leading causes of motor vehicle accidents. However, little is known about the role of emotional distraction on driving, despite evidence that attention is highly biased toward emotion. In the present study, we used a dual-task paradigm to examine the potential for driver distraction from emotional information presented on roadside billboards. This purpose was achieved using a driving simulator and three different types of emotional information: neutral words, negative emotional words, and positive emotional words. Participants also responded to target words while driving and completed a surprise free recall task of all the words at the end of the study. The findings suggest that driving performance is differentially affected by the valence (negative versus positive) of the emotional content. Drivers had lower mean speeds when there were emotional words compared to neutral words, and this slowing effect lasted longer when there were positive words. This may be due to distraction effects on driving behavior, which are greater for positive arousing stimuli. Moreover, when required to process non-emotional target stimuli, drivers had faster mean speeds in conditions where the targets were interspersed with emotional words compared to neutral words, and again, these effects lasted longer when there were positive words. On the other hand, negative information led to better memory recall. These unique effects may be due to separate processes in the human attention system, particularly related to arousal mechanisms and their interaction with emotion. We conclude that distraction that is emotion-based can modulate attention and decision-making abilities and have adverse impacts on driving behavior for several reasons. PMID:23200451
Differential neural mechanisms underlying exogenous attention to peripheral and central distracters.
Carretiķ, Luis; Albert, Jacobo; L¾pez-MartĒn, Sara; Hoyos, Sandra; Kessel, Dominique; Tapia, Manuel; Capilla, Almudena
Mechanisms underlying exogenous attention to central and peripheral distracters were temporally and spatially explored while 30 participants performed a digit categorization task. Neural (event-related potentials-ERPs-, analyzed both at the scalp and at the voxel level) and behavioral indices of exogenous attention were analyzed. Distracters were either biologically salient or neutral, in order to test whether the exogenous attention bias to the former observed in previous studies is independent of, or interacts with, distracter eccentricity. Two subcomponents of the N2 component of the ERPs, N2olp and N2ft, reflected processes related to peripheral distracters processing. N2olp effects, located in the dorsal attention network (supplementary motor area), were probably related to covert reorientation to peripheral distracters. N2ft effects, located in the default mode network (posterior cingulate cortex), appeared to reflect less effort in the ongoing task when peripheral distracters were presented. N2ft also showed a biological saliency effect which was independent of eccentricity and was located in the polar/ventral prefrontal cortex. P3 showed greater amplitudes to centrally presented distracters. These latter effects were located in TEO (visual cortex), and would be functionally associated with spatial interference between the target and central distracters. Behavior showed the relevance of both central and peripheral distracters in exogenous attention. These results indicate that exogenous attention to peripheral distracters differed in temporal and spatial terms from exogenous attention to central distracters and that it is biased towards biologically salient events irrespective of their eccentricity. PMID:23816957
Successful Reconstruction of Nerve Defects Using Distraction Neurogenesis with a New Experimental Device
Yousef, Mohamed Abdelhamid Ali; Dionigi, Paolo; Marconi, Stefania; Calligaro, Alberto; Cornaglia, Antonia Icaro; Alfonsi, Enrico; Auricchio, Ferdinando
Introduction: Repair of peripheral nerve injuries is an intensive area of challenge and research in modern reconstructive microsurgery. Intensive research is being carried out to develop effective alternatives to the standard nerve autografting, avoiding its drawbacks. The aim of the study was to evaluate the effectiveness of a newly designed mechanical device for the reconstruction of the sciatic nerve in rats in comparison to nerve autografting and to assess the pain during the period of distraction neurogenesis. Methods: Fourteen Sprague Dawley rats were used and randomly assigned into 2 groups with 7 rats in each group; group A (Nerve Autografting group) in which a 10-mm segment of the sciatic nerve was resected and rotated 180 degrees, then primary end-to-end neurorrhaphy was performed in the reverse direction; group B (Nerve Lengthening group) in which the mechanical device was inserted after surgical resection of 10 mm of the sciatic nerve, then secondary end-to-end neurorrhaphy was performed after completing the nerve lengthening. Thirteen weeks later, assessment of the functional sciatic nerve recovery using static sciatic index (SSI) was performed. Furthermore, fourteen weeks after the nerve resection, assessment of the nerve regeneration with electrophysiological study and histological analysis were performed. Also, gastrocnemius wet weight was measured. For pain assessment in group B, Rat Grimace Scale (RGS) score was used. Results: Significantly better functional recovery rate (using the SSI) was reported in the nerve lengthening group in comparison to autografting group. Also, a statistically significant higher nerve conduction velocity was detected in the nerve lengthening group. On histological analysis of the distal nerve section at 3 mm distal to the nerve repair site, significant myelin sheath thickness was detected in the nerve lengthening group. Discussion: Distraction neurogenesis with the new experimental device is a reliable therapeutic method for the reconstruction of nerve defects. PMID:26649163
Giant complex odontoma in maxillary sinus.
Carvalho Visioli, Adriano Rossini; de Oliveira E Silva, Cl├®verson; Marson, Fabiano Carlos; Takeshita, Wilton Mitsunari
In this manuscript, we present a rare case report of giant complex odontoma in the maxillary sinus, where the applied therapy included complete excision of the lesion with a conservative approach. Odontomas are also called benign growth abnormalities or hamartomas. They represent a more common type of odontogenic tumor and are related to various disorders such as bad dental placements, expansion, increased volumetric bone, and no eruption of permanent teeth. Usually they have an asymptomatic evolutionary course. The etiologic factors, although obscure, are related to local trauma, infection, and genetic factor. The structural composition of an odontoma consists of mature dental tissues. Odontomas can be differentiated according to their anatomical presentations: Compound odontoma-clusters of several denticles and complex odontoma-well defined tumefaction mass. The diagnosis can be performed by radiographic examination. PMID:26389051
Giant complex odontoma in maxillary sinus
Carvalho Visioli, Adriano Rossini; de Oliveira e Silva, Cl├®verson; Marson, Fabiano Carlos; Takeshita, Wilton Mitsunari
In this manuscript, we present a rare case report of giant complex odontoma in the maxillary sinus, where the applied therapy included complete excision of the lesion with a conservative approach. Odontomas are also called benign growth abnormalities or hamartomas. They represent a more common type of odontogenic tumor and are related to various disorders such as bad dental placements, expansion, increased volumetric bone, and no eruption of permanent teeth. Usually they have an asymptomatic evolutionary course. The etiologic factors, although obscure, are related to local trauma, infection, and genetic factor. The structural composition of an odontoma consists of mature dental tissues. Odontomas can be differentiated according to their anatomical presentations: Compound odontoma-clusters of several denticles and complex odontoma-well defined tumefaction mass. The diagnosis can be performed by radiographic examination. PMID:26389051
Etiology of maxillary canine impaction: a review.
Becker, Adrian; Chaushu, Stella
This article is a review that enumerates the causes of impaction of the maxillary permanent canines, including hard tissue obstructions, soft tissue lesions, and anomalies of neighboring teeth, and discusses the much-argued relationship between environmental and genetic factors. These phenomena have been shown in many investigations to accompany the diagnosis of canine impaction and have been presented as unrelated anomalous features, each of which is etiologically construed as genetic, including the aberrant canine itself. While in general the influence of genetics pervades the wider picture, a guidance theory proposes an alternative etiologic line of reasoning and interpretation of these studies, in which the same genetically determined anomalous features provide an abnormal milieu in which the canine is reared and from which it is guided in its misdirected and often abortive path of eruption. PMID:26432311
Pulp revascularization of immature maxillary first premolar
Al-Ghamdi, Nuha S.; Al-Nazhan, Saad
An immature maxillary first premolar in an 8-year-old female was treated using a regenerative approach. The root canal was gently irrigated with 5.25% sodium hypochlorite without instrumentation under aseptic conditions and then medicated with calcium hydroxide (Ca[OH]2) for 3 weeks. The Ca(OH)2 was removed, and bleeding was initiated mechanically using a hand file to form an intracanal blood clot. Mineral trioxide aggregate was placed over the blood clot, and the access cavity was sealed with a double filling. Increases in root length and width were radiographically evident, at the 6-month follow-up exam. The case was followed for 3 years. The development of 3 roots with complete apical closure was confirmed using cone beam computed tomography. PMID:26752847
Pulp revascularization of immature maxillary first premolar.
Al-Ghamdi, Nuha S; Al-Nazhan, Saad
An immature maxillary first premolar in an 8-year-old female was treated using a regenerative approach. The root canal was gently irrigated with 5.25% sodium hypochlorite without instrumentation under aseptic conditions and then medicated with calcium hydroxide (Ca[OH]2) for 3 weeks. The Ca(OH)2 was removed, and bleeding was initiated mechanically using a hand file to form an intracanal blood clot. Mineral trioxide aggregate was placed over the blood clot, and the access cavity was sealed with a double filling. Increases in root length and width were radiographically evident, at the 6-month follow-up exam. The case was followed for 3 years. The development of 3 roots with complete apical closure was confirmed using cone beam computed tomography. PMID:26752847
Distraction osteogenesis of free flap reconstructed mandible following ameloblastoma resection for optimal functional rehabilitation.
Bousdras, V A; Kalavrezos, N
This case highlights the use of a custom-made distractor (Synthes GmbH, Oberdorf, Switzerland), used to increase bone height prior to rehabilitation with implant placement, in a patient following excision of an ameloblastoma and reconstruction of her mandible with a fibular flap. A 27-year-old patient had her mandible reconstructed following wide resection of an ameloblastoma. Although a 2.0 LOCK reconstruction plate (Synthes GmbH, Oberdorf, Switzerland) was used for fixation of the fibular bone, the vertical deficiency between the reconstructed segment and the occlusal plane made oral rehabilitation impossible. To overcome this, the fibular bone segment was vertically distracted following a latency period of 4 days. Distractor was left in place for 20 weeks for bone consolidation. Following device removal implants were placed. The novelty of this approach included fixation of the lower arm of the distractor on the LOCK plate. The distractor was unidirectional with two arms of different length. The lower arm composed of a 2.0 mini-plate to fit exactly on the 2.0 LOCK plate whereas the upper arm used a standard 1.5 mini-plate. Advantages of this custom-made distractor included: (i) No need for removal of the reconstruction plate, (ii) no need for an extraoral surgical approach, and (iii) no need for additional drilling to fit the lower arm of the distractor. Technical details and limitations are presented. PMID:25593885
Solitary median maxillary central incisor (SMMCI) syndrome
Hall, Roger K
Solitary median maxillary central incisor syndrome (SMMCI) is a complex disorder consisting of multiple, mainly midline defects of development resulting from unknown factor(s) operating in utero about the 35th¢38th day(s) from conception. It is estimated to occur in 1:50,000 live births. Aetiology is uncertain. Missense mutation in the SHH gene (I111F) at 7q36 may be associated with SMMCI. The SMMCI tooth differs from the normal central incisor, in that the crown form is symmetric; it develops and erupts precisely in the midline of the maxillary dental arch in both primary and permanent dentitions. Congenital nasal malformation (choanal atresia, midnasal stenosis or congenital pyriform aperture stenosis) is positively associated with SMMCI. The presence of an SMMCI tooth can predict associated anomalies and in particular the serious anomaly holoprosencephaly. Common congenital anomalies associated with SMMCI are: severe to mild intellectual disability, congenital heart disease, cleft lip and/or palate and less frequently, microcephaly, hypopituitarism, hypotelorism, convergent strabismus, oesophageal and duodenal atresia, cervical hemivertebrae, cervical dermoid, hypothyroidism, scoliosis, absent kidney, micropenis and ambiguous genitalia. Short stature is present in half the children. Diagnosis should be made by eight months of age, but can be made at birth and even prenatally at 18¢22 weeks from the routine mid-trimester ultrasound scan. Management depends upon the individual anomalies present. Choanal stenosis requires emergency surgical treatment. Short stature may require growth hormone therapy. SMMCI tooth itself is mainly an aesthetic problem, which is ideally managed by combined orthodontic, prosthodontic and oral surgical treatment; alternatively, it can be left untreated. PMID:16722608
Wnt6 is required for maxillary palp formation in Drosophila
Background Wnt6 is an evolutionarily ancient member of the Wnt family. In Drosophila, Wnt6 loss-of-function animals have not yet been reported, hence information about fly Wnt6 function is lacking. In wing discs, Wnt6 is expressed at the dorsal/ventral boundary in a pattern similar to that of wingless, an important regulator of wing size. To test whether Wnt6 also contributes towards wing size regulation, we generated Wnt6 knockout flies. Results Wnt6 knockout flies are viable and have no obvious defect in wing size or planar cell polarity. Surprisingly, Wnt6 knockouts lack maxillary palps. Interestingly, Wnt6 is absent from the genome of hemipterans, correlating with the absence of maxillary palps in these insects. Conclusions Wnt6 is important for maxillary palp development in Drosophila, and phylogenetic analysis indicates that loss of Wnt6 may also have led to loss of maxillary palps on an evolutionary time scale. PMID:24090348
Paecilomyces lilacinus as the cause of chronic maxillary sinusitis.
Rockhill, R C; Klein, M D
Paecilomyces lilacinus was isolated on two separate occasions from the left antrum of a patient with chronic maxillary sinusitis. The clinical presentation and characteristics of the fungus and the sinus debris histopathology are discussed. Images PMID:7430339
Reducing Smoking Among Distracted Individuals: A Preliminary Investigation
Wallaert, Matthew; Mann, Traci
Introduction: According to the attentional myopia model, salient cues that serve to inhibit behavior can be especially effective under conditions of limited attention. A small field study tested the implications of this model for smoking reduction. Methods: Twenty-three undergraduate smokers were exposed to a prominent health warning for 2 5-day experimental phases, with phase order counterbalanced across participants. During one phase, participants simply viewed the warning at regular intervals. During the other phase, participants viewed the warning for the same duration but also simultaneously performed a distracting cognitive load task. Results: Participants in the phase that combined a health warning with cognitive load reported smoking significantly fewer cigarettes and taking significantly fewer puffs of smoke as compared to a baseline comparison phaseŌĆöa reduction in smoking not observed in the absence of cognitive load. Conclusions: Sources of attentional distraction may heighten the impact of salient smoking warnings, resulting in significant reductions in smoking. PMID:25098673
Interference by process, not content, determines semantic auditory distraction.
Marsh, John E; Hughes, Robert W; Jones, Dylan M
Distraction by irrelevant background sound of visually-based cognitive tasks illustrates the vulnerability of attentional selectivity across modalities. Four experiments centred on auditory distraction during tests of memory for visually-presented semantic information. Meaningful irrelevant speech disrupted the free recall of semantic category-exemplars more than meaningless irrelevant sound (Experiment 1). This effect was exacerbated when the irrelevant speech was semantically related to the to-be-remembered material (Experiment 2). Importantly, however, these effects of meaningfulness and semantic relatedness were shown to arise only when instructions emphasized recall by category rather than by serial order (Experiments 3 and 4). The results favor a process-oriented, rather than a structural, approach to the breakdown of attentional selectivity and forgetting: performance is impaired by the similarity of process brought to bear on the relevant and irrelevant material, not the similarity in item content. PMID:19081558
Adaptive Training Diminishes Distractibility in Aging across Species
Mishra, Jyoti; de Villers-Sidani, Etienne; Merzenich, Michael; Gazzaley, Adam
SUMMARY Aging is associated with deficits in the ability to ignore distractions, which has not yet been remediated by any neurotherapeutic approach. Here, in parallel auditory experiments with older rats and humans, we evaluated a targeted cognitive training approach that adaptively manipulated distractor challenge. Training resulted in enhanced discrimination abilities in the setting of irrelevant information in both species that was driven by selectively diminished distraction-related errors. Neural responses to distractors in auditory cortex were selectively reduced in both species mimicking the behavioral effects. Sensory receptive fields in trained rats exhibited improved spectral and spatial selectivity. Frontal theta measures of top-down engagement with distractors were selectively restrained in trained humans. Finally, training gains generalized to group- and individual-level benefits in aspects of working memory and sustained attention. Thus, we demonstrate converging cross-species evidence for training-induced selective plasticity of distractor processing at multiple neural scales, benefitting distractor suppression and cognitive control. PMID:25467987
Guided imagery and distraction therapy in paediatric hospice care.
Russell, Carol; Smart, Susan
Available evidence indicates deficits in the pain management of children with analgesic drugs used outside licensed boundaries, in situations where their pharmacokinetics are untested. A case series is used to demonstrate the effectiveness of more holistic techniques such as guided imagery and distraction therapy in reducing the pain experienced by children in the hospice setting. Using these techniques it may be possible to reduce the amount of analgesia or the frequency of administration. PMID:17425126
U.S. State and Federal Laws Targeting Distracted Driving
Catherine Chase, J.D.
Distracted driving has burgeoned with the proliferation of cell phones, global positioning systems and other in-vehicle and personal electronic devices. Annually more than 3,300 people are killed and an additional 400,000 are injured in the United States in distracted driving crashes. The United States (U.S.) federal and state governments have responded to this public health problem with policies and laws; however, a more comprehensive and more effective approach is still needed. Some restrictions on the use of electronic devices while driving by federal employees and some voluntary guidelines and recommendations have been issued. Public opinion polls show support for addressing the issue of distracted driving with state laws. The majority of states have laws banning text messaging while driving and prohibiting the use of an electronic device by teenage or novice drivers. Some states prohibit all drivers from using a hand-held cellphone. Currently no state has a total ban on the use of personal electronic devices while driving. Successful past traffic safety campaigns changing driver behavior have demonstrated the necessity to adopt a ŌĆ£three EsŌĆØ approach of Enactment of a law, Education of the public about the law, and rigorous Enforcement of the law. Experience reveals that this approach, along with future federal regulation of in-vehicle electronic devices and the employment of technology to limit the use of electronic devices while driving, is needed to alter personal behavior in order to reduce distractions and keep drivers focused on the driving task. PMID:24776229
Preliminary clinical research on epiphyseal distraction in osteosarcoma in children
Background The feasibility of distal femur epiphysis preservation through epiphyseal distraction by external fixator in childhood osteosarcoma was explored. Methods Between July 2007 and May 2011, 10 children who were suffering from distal femur osteosarcoma received epiphyseal distraction by external fixator, combined with tumor resection and repair with massive allograft bone to preserve the epiphysis of the distal femur and knee function. There were six male and four female patients, 9- to 14-years old (average 10.5┬Āyears old). The tumors were staged clinically according to the Enneking staging method: six cases were classified as stage in IIA and four cases as stage in IIB. All patients were diagnosed by biopsy, then received chemotherapy before and after surgery. All patients received tumor bone resection and the defects of the bone were repaired with massive allograft bone that was fixed by intramedullary nails; the distracted epiphysis and allograft bone were fixed with cancellous screws. Results All cases received follow-up from 15 to 56┬Āmonths (average 38.5┬Āmonths). There were no local recurrences. One case died of lung metastasis and one case had poor incision healing for rejection of allograft bone. According to the functional evaluation criteria of the International Society of Limb Salvage (ISOLS) after operation, five cases were rated excellent, four cases good and one case fair. The ratio of excellent or good was 90.0%. There was no statistically significant difference in length between the operated and the normal lower limbs during the last review. Conclusions Epiphyseal distraction by external fixator can result in satisfactory limb length and joint function for children with a malignant bone tumor. PMID:25099460
Maxillary lateral incisor with two roots: a case report.
Ravindranath, Mithun; Neelakantan, Prasanna; Subba Rao, C V
Although the dental literature has indicated that 100% of maxillary lateral incisors have a single canal anatomy, it is possible for these teeth to have extra canals. These extra canals must be identified and debrided to prevent endodontic failure. This report presents an uncommon case involving a maxillary lateral incisor with two roots. Even when the frequency of radicular anatomy abnormality is extremely low, dentists must consider the possibility that a tooth has extra root canals or even extra roots. PMID:21613043
Cementoblastoma of posterior maxilla involving the maxillary sinus
Dadhich, Anuj S.; Nilesh, Kumar
Cementoblastoma is a rare neoplasm, representing <1% of all odontogenic tumors. It usually occurs in the posterior mandible and is associated with roots of a mandibular first molar or second premolar. This paper presents a rare case of cementoblastoma in the maxillary posterior region involving the maxillary sinus, in a young female patient. The clinical, radiological, and histopathological features of the lesion are discussed along with a review of previously reported cases in the literature. PMID:26389052
Relapse of a maxillary median diastema: closure and permanent retention.
Mattos, Claudia Trindade; da Silva, Dayanne Lopes; Ruellas, Antonio Carlos de Oliveira
The purpose of this article was to describe the closure of a maxillary median diastema of a 26-year-old woman that had been corrected before during orthodontic treatment but reopened after dental trauma in a car accident. A clear esthetic device made from a tray like those used for home bleaching was used, providing a comfortable, nearly undetectable, and efficient solution. A permanent fixed retainer was bonded again to the maxillary central incisors to prevent relapse. PMID:22196198
Management of an Unusual Maxillary Canine: A Rare Entity
Muppalla, Jaya Nagendra Krishna; Kavuda, Krishnamurthy; Punna, Rajani; Vanapatla, Amulya
Clinicians need to have intimate knowledge and thorough understanding of both pulp chamber and root canal anatomy. They should be aware of possibility of anatomical variations in the root canal system during endodontic treatment. Maxillary canines usually have single root and root canal but rarely may have single root with two root canals. This case describes a lengthier maxillary canine with two root canals. PMID:26779354
Radiographic appearance of maxillary sinus feed impaction in a horse.
Montgomery, James E; Carmalt, James L
A 15-year-old Belgian gelding presented in respiratory distress, with bilateral mucopurulent nasal discharge, and right-sided epistaxis. The horse had a 5-year history of dental disease and had been recently losing weight. Radiographs indicated tooth root abscessation of the right maxillary third molar tooth and probable maxillary sinus feed impaction. These findings were confirmed at surgery and necropsy. The stippled, granular radiographic appearance described here is highly characteristic of sinus feed impaction. PMID:24371923
Treatment of a Maxillary First Molar with Two Palatal Roots
Asghari, Vahideh; Rahimi, Saeed; Ghasemi, Negin; Talebzadeh, Bita; Norlouoni, Ahmad
Thorough knowledge of the morphology and internal anatomy of the root canal system is essential, because it determines the successful outcome of endodontic treatment. The main goal of endodontic treatment is to prevent apical periodontitis and/or to promote the healing of periapical lesion. Presence of two canals or roots on the palatal side of the first maxillary molar has rarely been reported. This case report presents a maxillary first molar with two separate palatal roots. PMID:26523146
Supraliminal But Not Subliminal Distracters Bias Working Memory Recall
Information of which observers are not consciously aware can nevertheless influence perceptual processes. Whether subliminal information might exert an influence on working memory (WM) representations is less clear, and relatively few studies have examined the interactions between subliminal and supraliminal information in WM. We present 3 experiments examining this issue. Experiments 1a and b replicated the finding that orientation stimuli can influence behavior subliminally in a visuomotor priming task. Experiments 2 and 3 used the same orientation stimuli, but participants had to remember a target orientation and report it back by adjusting a probe orientation after a memory delay. Before or after presentation of the target orientation, a subliminal or supraliminal distracter orientation was presented that was either irrelevant for task completion and never had to be reported (Experiment 2), or was relevant for task completion because it had to be reported on some trials (Experiment 3). In both experiments, presentation of a supraliminal distracter influenced WM recall of the target orientation. When the distracter was presented subliminally, however, there was no bias in orientation recall. These results suggest that information stored in WM is protected from influences of subliminal stimuli, while online information processing is modulated by subliminal information. PMID:25867502
Naturalistic distraction and driving safety in older drivers
Aksan, Nazan; Dawson, Jeffrey D.; Emerson, Jamie L.; Yu, Lixi; Uc, Ergun Y.; Anderson, Steven W.; Rizzo, Matthew
Objective This study aimed to quantify and compare performance of middle-aged and older drivers during a naturalistic distraction paradigm (visual search for roadside targets) and predict older driver performance given functioning in visual, motor, and cognitive domains. Background Distracted driving can imperil healthy adults and may disproportionally affect the safety of older drivers with visual, motor, and cognitive decline. Methods Two hundred and three drivers, 120 healthy older (61 men and 59 women, ages 65 years or greater) and 83 middle-aged drivers (38 men and 45 women, ages 40ŌĆō64 years), participated in an on-road test in an instrumented vehicle. Outcome measures included performance in roadside target identification (traffic signs and restaurants) and concurrent driver safety. Differences in visual, motor, and cognitive functioning served as predictors. Results Older drivers identified fewer landmarks and drove slower but committed more safety errors than middle-aged drivers. Greater familiarity with local roads benefited performance of middle-aged but not older drivers. Visual cognition predicted both traffic sign identification and safety errors while executive function predicted traffic sign identification over and above vision. Conclusion Older adults are susceptible to driving safety errors while distracted by common secondary visual search tasks that are inherent to driving. The findings underscore that age-related cognitive decline affects older driver management of driving tasks at multiple levels, and can help inform the design of on-road tests and interventions for older drivers. PMID:23964422
Concealed by conspicuousness: distractive prey markings and backgrounds.
Dimitrova, Marina; Stobbe, Nina; Schaefer, H Martin; Merilaita, Sami
High-contrast markings, called distractive or dazzle markings, have been suggested to draw and hold the attention of a viewer, thus hindering detection or recognition of revealing prey characteristics, such as the body outline. We tested this hypothesis in a predation experiment with blue tits (Cyanistes caeruleus) and artificial prey. We also tested whether this idea can be extrapolated to the background appearance and whether high-contrast markings in the background would improve prey concealment. We compared search times for a high-contrast range prey (HC-P) and a low-contrast range prey (LC-P) in a high-contrast range background (HC-B) and a low-contrast range background (LC-B). The HC-P was more difficult to detect in both backgrounds, although it did not match the LC-B. Also, both prey types were more difficult to find in the HC-B than in the LC-B, in spite of the mismatch of the LC-P. In addition, the HC-P was more difficult to detect, in both backgrounds, when compared with a generalist prey, not mismatching either background. Thus, we conclude that distractive prey pattern markings and selection of microhabitats with distractive features may provide an effective way to improve camouflage. Importantly, high-contrast markings, both as part of the prey coloration and in the background, can indeed increase prey concealment. PMID:19324754
Supraliminal but not subliminal distracters bias working memory recall.
Wildegger, Theresa; Myers, Nicholas E; Humphreys, Glyn; Nobre, Anna C
Information of which observers are not consciously aware can nevertheless influence perceptual processes. Whether subliminal information might exert an influence on working memory (WM) representations is less clear, and relatively few studies have examined the interactions between subliminal and supraliminal information in WM. We present 3 experiments examining this issue. Experiments 1a and b replicated the finding that orientation stimuli can influence behavior subliminally in a visuomotor priming task. Experiments 2 and 3 used the same orientation stimuli, but participants had to remember a target orientation and report it back by adjusting a probe orientation after a memory delay. Before or after presentation of the target orientation, a subliminal or supraliminal distracter orientation was presented that was either irrelevant for task completion and never had to be reported (Experiment 2), or was relevant for task completion because it had to be reported on some trials (Experiment 3). In both experiments, presentation of a supraliminal distracter influenced WM recall of the target orientation. When the distracter was presented subliminally, however, there was no bias in orientation recall. These results suggest that information stored in WM is protected from influences of subliminal stimuli, while online information processing is modulated by subliminal information. PMID:25867502
Specific foreknowledge reduces auditory distraction by irrelevant speech.
R├Čer, Jan Philipp; Bell, Raoul; Buchner, Axel
In a series of experiments, it was tested whether distraction by changing-state irrelevant speech is inevitable or can be modulated by foreknowledge of an imminent to-be-ignored distractor sequence. Participants were required to remember visually presented digits while ignoring background speech. In the foreknowledge condition of Experiment 1, the upcoming to-be-ignored sentence was presented auditorily and visually before each trial. With specific foreknowledge, the changing-state irrelevant sound effect (here, increased disruption by sentences compared with repeated words) was significantly attenuated relative to a condition without foreknowledge. This finding was replicated in Experiment 2, in which the information about the upcoming auditory distractor speech was presented only in the visual modality. Experiment 3 showed that only specific foreknowledge of the auditory distractor material has beneficial effects on the ability to ignore distraction. The mere notification that an unspecified distractor sentence would be presented next had no effect on distraction. In Experiment 4, there was only a small and not statistically significant reduction of the irrelevant speech effect when lists of randomly selected words were used as distractor material, suggesting that foreknowledge effects are more pronounced for highly variable, meaningful distractor material. We conclude that the disruption of short-term memory by irrelevant speech is not purely a stimulus-driven process that is immune to top-down control. A significant proportion of the effect can be modulated by specific knowledge about an imminent distractor sequence. PMID:25621576
Knowledge of sequence structure prevents auditory distraction: an ERP study.
Volosin, M├Īrta; Horv├Īth, J├Īnos
Infrequent, salient stimuli often capture attention despite their task-irrelevancy, and disrupt on-going goal-directed behavior. A number of studies show that presenting cues signaling forthcoming deviants reduces distraction, which may be a "by-product" of cue-processing interference or the result of direct preparatory processes for the forthcoming distracter. In the present study, instead of "bursts" of cue information, information on the temporal structure of the stimulus sequence was provided. Young adults performed a spatial discrimination task where complex tones moving left or right were presented. In the predictable condition, every 7th tone was a pitch-deviant, while in the random condition the position of deviants was random with a probability of 1/7. Whereas the early event-related potential correlates of deviance-processing (N1 and MMN) were unaffected by predictability, P3a amplitude was significantly reduced in the predictable condition, indicating that prevention of distraction was based on the knowledge about the temporal structure of the stimulus sequence. PMID:24657900
Maxillary sinus atelectasis in a wild born gibbon (Hylobates moloch).
Koppe, Thomas; R├Čhrer-Ertl, Olav; Breier, Silvana; Wallner, Claus-Peter
In a mixed sex sample of ten adult gibbon (Hylobates moloch) skulls, one cranium of a male with maxillary sinus atelectasis of the left side was identified. While external inspection revealed a slight drop of the left orbital floor, serial coronal computer tomography (CT) scans show characteristic changes of the left maxillary sinus and its surrounding structures. In addition to the sunken orbital floor, radiological features of the specimen include an inward bowing of the medial sinus wall, sinus opacification, and a reduction in maxillary sinus size to a slit-like cavity, which suggest a diagnosis of silent sinus syndrome. This report is the first, to our knowledge, of maxillary sinus atelectasis in a non-human primate. This finding is valuable for the understanding of the pathogenesis and etiology of maxillary sinus atelectasis. At the same time, however, paleoanthropologists and primatologists may refer to this information when dealing with the interpretation of maxillary sinus pneumatization of partially broken archaeological and fossil skulls. PMID:16091979
Permanent Maxillary Canine Agenesis: A Rare Case Report
Jain, Somya; Patil, Raju Umaji; Asokan, Alexander; Kambalimath, Deepashri
ABSTRACT Congenitally missing teeth (CMT) are among one of the commonly known dental anomalies. The most frequently missing teeth in the permanent dentition, excluding the third molars, are mandibular second premolars and maxillary lateral incisors. Exclusive agenesis of both maxillary canines is an extremely rare occurrence and only a few cases have been reported. Previous studies showed that the prevalence of maxillary canine agenesis varies between 0.07 and 0.13%. In recent studies on Indian population, no cases of maxillary canine agenesis have been documented. This paper reports a case of non-syndromic bilateral agenesis of permanent maxillary canines, along with agenesis of both mandibular central incisors in a healthy 13-year-old Indian female patient; and a brief literature review on prevalence, etiology and treatment modalities of the condition. How to cite this article: Kambalimath HV, Jain S, Patil RU, Asokan A, Kambalimath D. Permanent Maxillary Canine Agenesis: A Rare Case Report. Int J Clin Pediatr Dent 2015; 8(3):242-246. PMID:26604546
CT-based manual segmentation and evaluation of paranasal sinuses.
Pirner, S; Tingelhoff, K; Wagner, I; Westphal, R; Rilk, M; Wahl, F M; Bootz, F; Eichhorn, Klaus W G
Manual segmentation of computed tomography (CT) datasets was performed for robot-assisted endoscope movement during functional endoscopic sinus surgery (FESS). Segmented 3D models are needed for the robots' workspace definition. A total of 50 preselected CT datasets were each segmented in 150-200 coronal slices with 24 landmarks being set. Three different colors for segmentation represent diverse risk areas. Extension and volumetric measurements were performed. Three-dimensional reconstruction was generated after segmentation. Manual segmentation took 8-10 h for each CT dataset. The mean volumes were: right maxillary sinus 17.4 cm(3), left side 17.9 cm(3), right frontal sinus 4.2 cm(3), left side 4.0 cm(3), total frontal sinuses 7.9 cm(3), sphenoid sinus right side 5.3 cm(3), left side 5.5 cm(3), total sphenoid sinus volume 11.2 cm(3). Our manually segmented 3D-models present the patient's individual anatomy with a special focus on structures in danger according to the diverse colored risk areas. For safe robot assistance, the high-accuracy models represent an average of the population for anatomical variations, extension and volumetric measurements. They can be used as a database for automatic model-based segmentation. None of the segmentation methods so far described provide risk segmentation. The robot's maximum distance to the segmented border can be adjusted according to the differently colored areas. PMID:18716789
"Distracters" Do Not Always Distract: Visual Working Memory for Angry Faces is Enhanced by Incidental Emotional Words.
Jackson, Margaret C; Linden, David E J; Raymond, Jane E
We are often required to filter out distraction in order to focus on a primary task during which working memory (WM) is engaged. Previous research has shown that negative versus neutral distracters presented during a visual WM maintenance period significantly impair memory for neutral information. However, the contents of WM are often also emotional in nature. The question we address here is how incidental information might impact upon visual WM when both this and the memory items contain emotional information. We presented emotional versus neutral words during the maintenance interval of an emotional visual WM faces task. Participants encoded two angry or happy faces into WM, and several seconds into a 9ŌĆēs maintenance period a negative, positive, or neutral word was flashed on the screen three times. A single neutral test face was presented for retrieval with a face identity that was either present or absent in the preceding study array. WM for angry face identities was significantly better when an emotional (negative or positive) versus neutral (or no) word was presented. In contrast, WM for happy face identities was not significantly affected by word valence. These findings suggest that the presence of emotion within an intervening stimulus boosts the emotional value of threat-related information maintained in visual WM and thus improves performance. In addition, we show that incidental events that are emotional in nature do not always distract from an ongoing WM task. PMID:23112782
Comparative characterization of maxillary expansion and alternate maxillary expansions and constrictions in rats.
Feng, Guang-yao; Zou, Bing-shuang; Zeng, Xiang-long
The purpose of this study was to evaluate whether the cranial and circumaxillary sutures react differently to maxillary expansion (ME) and alternate maxillary expansions and constrictions (Alt-MEC) in a rat model. Twenty-two male Sprague-Dawley rats (6 weeks old) were used and divided into three groups. In ME group (n=9), an expander was activated for 5 days. In Alt-MEC group (9 animals), an alternate expansion and constriction protocol (5-day expansion and 5-day constriction for one cycle) was conducted for 2.5 cycles (25 days total). The control group comprised 4 animals with no appliances used, each of two sacrificed on day 5 and day 25 respectively. Midpalatal suture expansion or constriction levels were assessed qualitatively and quantitatively by bite-wing X-rays and cast models. Distances between two central incisors and two maxillary first molars were measured on cast models after each activation. Circumaxillary sutures (midpalatal, maxillopalatine, premaxillary, zygomaticotemporal and frontonasal suture) in each group were characterized histologically. Results showed that midpalatal suture was widened and restored after each expansion and constriction. At the end of activation, the widths between both central incisors and first molars in Alt-MEC group were significantly larger than those in ME group (P<0.05). Histologically, all five circumaxillary sutures studied were widened in multiple zones in Alt-MEC group. However, only midpalatal suture was expanded with cellular fibrous tissue filling in ME group. Significant osteoclast hyperplasia was observed in all circumaxillary sutures after alternate expansions and constrictions, but osteoclast count increase was only observed in midpalatal suture in ME group. These results suggested that cranial and circumaxillary sutures were actively reconstructed after Alt-MEC, while only midpalatal suture had active reaction after ME. PMID:25480594
Three-dimensional densitometric analysis of maxillary sutural changes induced by rapid maxillary expansion
Lione, R; Franchi, L; Fanucci, E; Lagan├Ā, G; Cozza, P
Objective: This prospective study evaluated the density of the midpalatal and transverse sutures as assessed by low-dose CT before rapid maxillary expansion (T0), at the end of active expansion (T1) and after a retention period of 6 months (T2). Methods: The study sample comprised 17 pre-pubertal subjects (mean age 11.2 years) with constricted maxillary arches. Total amount of expansion was 7ŌĆēmm in all subjects. Multislice low-dose CT scans were taken at T0, T1 and T2. On the axial CT scanned images six regions of interest (ROIs) were placed along the midpalatal and transverse sutures and two in maxillary and palatal bony areas. Density was measured in Hounsfield units. MannŌĆōWhitney U test and Friedman analysis of variance with post hoc tests were used (pŌĆē<ŌĆē0.05). Results: The three ROIs in the midpalatal suture showed a significant decrease in density from T0 to T1, a significant increase from T1 to T2 and a lack of statistically significant differences from T0 to T2. Both ROIs located in the transverse suture showed a significant decrease in density from T0 to T1, followed by a non-significant increase in density from T1 to T2. Conclusions: At the end of the active phase of expansion a significant reduction in density along the midpalatal and transverse sutures was observed in all subjects. The sutural density of the midpalatal suture at T2 indicated reorganization of the midpalatal suture while the density along the transverse suture increased without reaching the pre-treatment values, possibly due to different morphology between midpalatal and transverse sutures. PMID:22996394
Maxillary posterior bone height in relation to maxillary sinus floor in Indian dentulous population.
Jain, A; Chowdhary, R
To establish a ratio of variable bone height (Infrazygomatic alveolar crest height) to constant bone height (Infraorbital zygomatic height) and, to estimate the relative sinus floor position from alveolar crest of maxillary first molar region of dentulous Indian males and females, using Digital panoramic radiographs. Panoramic radiographs of 74 patients were included in the study (37 male, 37 female) to measure maxillary posterior vertical bone height and their ratio in dentulous patients. Measurements were made from reference lines drawn from anatomic landmarks on soft digital versions of standardized panoramic radiographs using Kodak dental imaging software. Later the data were analyzed using normal test (Z-score). When the posterior maxillary bone height and their ratio were evaluated in Indian population, the vertical bone height (x, y, z) of males was more than the females. Ratio of Infrazygomatic-alveolar crest distance (y)/Infraorbital-zygomatic distance (x)-was 0.74 for Indian males and females. The relative sinus floor for Indian males was found to be 8.1┬Āmm and that of Indian females to be 7.8┬Āmm. The results are of significant value as "baseline" data, in serial studies where alveolar bone height for a single patient is compared at different times before and after tooth loss. The relative sinus floor position from alveolar crest can help in implant length selection. This study can be used as a diagnostic and predictive tool in implant treatment planning but further long-term evaluation is still required to prove the efficacy of this study. PMID:24431714
Validity of palatal superimposition of 3-dimensional digital models in cases treated with rapid maxillary expansion and maxillary protraction headgear
Choi, Jin-Il; Jost-Brinkmann, Paul-Georg; Choi, Dong-Soon; Jang, In-San
Objective The purpose of this study was to evaluate the validity of the 3-dimensional (3D) superimposition method of digital models in patients who received treatment with rapid maxillary expansion (RME) and maxillary protraction headgear. Methods The material consisted of pre- and post-treatment maxillary dental casts and lateral cephalograms of 30 patients, who underwent RME and maxillary protraction headgear treatment. Digital models were superimposed using the palate as a reference area. The movement of the maxillary central incisor and the first molar was measured on superimposed cephalograms and 3D digital models. To determine whether any difference existed between the 2 measuring techniques, intra-class correlation (ICC) and Bland-Altman plots were analyzed. Results The measurements on the 3D digital models and cephalograms showed a very high correlation in the antero-posterior direction (ICC, 0.956 for central incisor and 0.941 for first molar) and a moderate correlation in the vertical direction (ICC, 0.748 for central incisor and 0.717 for first molar). Conclusions The 3D model superimposition method using the palate as a reference area is as clinically reliable for assessing antero-posterior tooth movement as cephalometric superimposition, even in cases treated with orthopedic appliances, such as RME and maxillary protraction headgear. PMID:23173116
A simplified modification of a reconstruction plate into a mandibular transport distraction device: A technical note
Mohanty, Sujata; Dabas, Jitender; Gupta, Rekha
Transport distraction is nowadays gaining enormous popularity and is becoming a promising option for reconstruction of mandibular defects. However, the vast number of distraction device designs create huge confusion in the clinician's mind to choose the right one. Considering these complex and costly designs, the authors decided to find a simplified way of combining a modified conventional reconstruction plate and monofocal distraction device that can act as a transport distraction device for bridging of bony defects. A case performed by this technique and device has been presented along with the description of device design. PMID:26933289
Epithelioid Hemangioendothelioma of the Maxillary Sinus.
Avadhani, Vaidehi; Loftus, Patricia Anne; Meltzer, Daniel; Wang, Beverly; Tabaee, Abtin
The clinical course and pathologic features of a 72┬Āyear old female who presented with epistaxis are presented. Radiographic findings were notable for a large, soft tissue lesion filling the maxillary sinus with significant bony erosion and expansion. The patient was ultimately diagnosed with epithelioid hemangioendothelioma (EHE) and underwent endoscopic resection. She has no evidence of local, regional or distant recurrence 14┬Āmonths post-surgery. The rarity of this neoplasm, the unusual anatomic location and non-specific symptoms present diagnostic and management challenges. Epithelioid vascular tumors encompass a spectrum of benign and malignant tumors. EHE itself is thought to have an intermediate malignant behavior pattern, though cases with indolent behavior have been reported. Differentiation of EHE from other lesions has historically based on histopathology. Additionally, recent studies have described a recurrent genetic fusion WWTR1-CAMTA1 in EHE, involving t(1;3) (p36;q25). This represents the second reported case of EHE arising in a paranasal sinus. The histopathologic findings of this lesion are reviewed. PMID:25963905
Esthetics with prosthetics in case of maxillary canine transposition: a clinical report.
Yadav, S; Sheorain, A K; Madan, N; Bajaj, P
Transposition is a dental anomaly manifested by a positional interchange of two permanent teeth. The maxillary permanent canine usually transposes with the first premolar and occasionally with the lateral incisor. These are mainly genetically governed and are treated orthodontically if complete segment of tooth is present; in case of missing teeth, participation of cosmetic dentist is must. The present case report describes a situation where left canine to lateral incisor complete transposition was present along with a missing left central incisor. Esthetic rehabilitation of the "smile zone" was the major concern. Scrupulous treatment planning to esthetically contour transposed teeth according to their normal positions, i.e., transposed left canine to lateral incisor and transposed left lateral incisor to canine with replacement of missing tooth, was a challenge. PMID:22437104
[Maxillary prosthesis for better QOL--early setting and faster construction of maxillary prosthesis].
Usui, H; Sakakura, Y; Shimozato, K
The maxillofacial prosthesis (MFP) is well accepted as one of the modalities to ameliolate the postsurgical crippling in the patients with maxillary malignancy. In this report, we analyzed 55 primary cases of MFP out of 100, from July, 1981 to July, 1987 in terms of the time of start after operation, and the duration and procedure of the MFP-making. MFP-making set about within 4 weeks in 35% of patients, 8 weeks in 25%, 12 weeks in 22%, and more than 12 weeks in 18%. The completion of MFP-making averaged 10 days. As a result of simplifying of MFP-making, we shortened a period requiring MFP-making within 3 days in recent 10 cases. There were no adverse effects of early wear of MFP after operation. We believe that early wear of MFP after operation improve the quality of life of patients with maxillary malignancy and considered that wear of MFP is not the completion of treatment, but is one of the procedures of treatment for the patients undergone maxillectomy. PMID:1491275
3D evaluation of maxillary arches in unilateral cleft lip and palate patients treated with nasoalveolar moulding vs. Hotz's plate.
Cer├│n-Zapata, A M; L├│pez-Palacio, A M; Rodriguez-Ardila, M J; Berrio-Guti├®rrez, L M; De Menezes, M; Sforza, C
To compare the three-dimensional changes occurring in the maxillary arch during the use of modified pre-surgical nasoalveolar moulding (PNAM) and Hotz's plate. A clinical trial including 32 children with unilateral cleft lip and palate (UCLP), 16 treated with Hotz's plate and 16 with PNAM, was performed. Impressions of the maxillary arches were taken: A. prior to pre-surgical orthopaedics, B. before cheiloplasty and C. after cheiloplasty. Models were digitised using a stereophotogrammetric instrument, and geodesic distances were calculated: anterior, canine and posterior widths of the arch, and lengths and cleft depths of the larger and shorter segments. The time and treatment effects were assessed by two-factor anova. A significant effect of treatment was found for cleft depth at the larger segment: children treated with Hotz's plate had significantly deeper cleft than children treated with PNAM. All distances significantly changed during time: the anterior and canine widths decreased, while the posterior width, the lengths and depths of the cleft segments increased. Significant treatment per time interactions was found. The anterior and canine widths reduced more with PNAM between time points A and B while Hotz's treatment was more effective between B and C. The shorter segment depth increased more between B and C with PNAM, and between A and B with Hotz's plate. During pre-surgical orthopaedics, therapy with PNAM obtained the best results in reducing the width at the anterior segment of the cleft. This treatment gave a lower increase in cleft depth than treatment with Hotz's plate. PMID:26404105
Mandibular fracture patterns consistent with posterior maxillary fractures involving the posterior maxillary sinus, pterygoid plate or both: CT characteristics
Sukegawa, S; Kanno, T; Fujita, G; Yamamoto, N; Furuki, Y; Michizawa, M
Objectives: The aim of this study was to determine the incidence of posterior maxillary fractures involving the posterior maxillary sinus wall, pterygoid plate or both, unrelated to major midface fractures in patients with mandibular fractures, and to characterize associated fractures. Methods: A CT study was performed in patients with mandibular fractures to identify posterior maxillary fractures. Patients aged under 16 years, those with mandibular fractures involving only dentoalveolar components and those with concurrent major midfacial fractures were excluded. Results: 13 (6.7%) of 194 patients with mandibular fractures also had posterior maxillary fractures (case group). The injury pattern correlated with the external force directed to the lateral side of the mandible (pŌĆē<ŌĆē0.001), alcohol consumption (pŌĆē=ŌĆē0.049), the presence of multifocal fractures (pŌĆē=ŌĆē0.002) and the fracture regions in the symphysis/parasymphysis (pŌĆē=ŌĆē0.001) and the angle/ramus (pŌĆē=ŌĆē0.001). No significant difference between the case and non-case groups was seen for age, sex or cause of trauma. Non-displaced fractures in the ipsilateral posterior mandible occurred with significant frequency (pŌĆē=ŌĆē0.001) when the posterior maxillary fractures involved only the sinus. Conclusions: Mandibular fractures accompanied by posterior maxillary fractures are not rare. The finding of a unilateral posterior maxillary fracture on CT may aid the efficient radiological examination of the mandible based on possible patterns of associated fractures, as follows: in the ipsilateral posterior region as a direct fracture when the impact is a medially directed force, and in the symphysis/parasymphysis or contralateral condylar neck as an indirect fracture. PMID:24336313
Effect of rapid maxillary expansion on sleep characteristics in children
Ashok, Navya; Varma, N. K. Sapna; Ajith, V. V.; Gopinath, Siby
Introduction: Rapid maxillary expansion (RME) is an orthopedic treatment procedure routinely used to treat constricted maxillary arches and also a potential additional treatment in children presenting with sleep-disordered breathing (SDB). Aims and Objectives: The main objective of this study was to evaluate the effects of RME on sleep characteristics in children. Materials and Methods: Polysomnography was done on children of 8-13 years of age before expansion (T0), after expansion (T1) and after a period of 3 months after retention (T2). Bonded rapid maxillary expander was cemented in all children. Inter-molar distance was also measured at T0 and T2. Statistical Analysis: Nonparametric Friedman test was used for comparing the averages of sleep parameters at different time period (T0, T1, T2). Wilcoxon signed ranks test was used for comparing the averages of inter-molar width (T0-T2). P < 0.05 were considered as significant. Results: All children showed an improvement in sleep parameters with an increase in sleep efficiency, decreased in arousal and desaturation index after expansion. Total sleep time showed a statistically significant increase after expansion. A statistically significant increase in inter-molar distance was obtained after expansion. Conclusions: Rapid maxillary expansion is a useful treatment option for improving quality of sleep even in normal children without SDB. It also induces widening of the maxilla, corrects posterior crossbites and improves maxillary and mandibular dental arch coordination. PMID:25395765
Interactions of neural networks: models for distraction and concentration.
Wang, L P; Ross, J
We present a model of neural group interactions, which are projections from one neural network (network B) of McCulloch-Pitts neurons connected via a Hebbian rule, to another network (network A) of the same structure. We first consider the case in which the projecting network B is in a pattern different from the initial attracting state of network A. A critical projecting strength lambda c is found such that for lambda below this value there exists a noise threshold sigma lambda corresponding to each lambda. For the case where lambda less than lambda c and the noise level sigma less than sigma lambda, there are two possible retrievals, with different probabilities: the initial attracting state of network A and the projecting pattern. If lambda less than lambda c and sigma greater than sigma lambda, stable states of network A disappear. In the case lambda greater than lambda c, network A is pulled out of its initial basin of attraction and into that of the projecting pattern. This analysis provides a model for distraction. Second-order interactions reduce the distraction. When the projecting network B is in the same pattern as the initial attracting state of network A, the projection acts as an external reinforcement, which enables network A to retrieve in highly noisy conditions. Sharp noise thresholds for nonzero retrievals are shown to be eliminated by the projection. Higher-order connectivity improves the retrieval ability of the network. The second case serves as a model of concentration. We discuss the model of distraction and concentration (i) in connection with common experience of expectation of recognition and (ii) in connection with recent T-maze experiments on infant rats; finally, we suggest a refined version of the Bruner-Potter experiment to test our prediction of the disappearance of hysteresis. PMID:2402493
Interruptions and Distractions in Healthcare: Review and Reappraisal
Rivera, A. Joy; Karsh, Ben-Tzion
Healthcare settings can be hectic, demanding, time-constrained environments. Within these environments, health care professionals (HCP) are expected to perform tasks that often require their undivided attention. However, HCPs are frequently interrupted, which can distract their attention and add to the complexity of their work. That said, not all interruptions are bad; many interruptions are essential to the patient care process and provide HCPs with necessary information. This paper systematically reviews the peer-reviewed literature on interruptions in healthcare settings to determine the state of the science and to identify gaps. It then provides a complex sociotechnical systems approach to understanding interruptions in healthcare. PMID:20378621
Virtual reality as a distraction technique in chronic pain patients.
Wiederhold, Brenda K; Gao, Kenneth; Sulea, Camelia; Wiederhold, Mark D
We explored the use of virtual reality distraction techniques for use as adjunctive therapy to treat chronic pain. Virtual environments were specifically created to provide pleasant and engaging experiences where patients navigated on their own through rich and varied simulated worlds. Real-time physiological monitoring was used as a guide to determine the effectiveness and sustainability of this intervention. Human factors studies showed that virtual navigation is a safe and effective method for use with chronic pain patients. Chronic pain patients demonstrated significant relief in subjective ratings of pain that corresponded to objective measurements in peripheral, noninvasive physiological measures. PMID:24892196
Virtual Reality as a Distraction Technique in Chronic Pain Patients
Gao, Kenneth; Sulea, Camelia; Wiederhold, Mark D.
Abstract We explored the use of virtual reality distraction techniques for use as adjunctive therapy to treat chronic pain. Virtual environments were specifically created to provide pleasant and engaging experiences where patients navigated on their own through rich and varied simulated worlds. Real-time physiological monitoring was used as a guide to determine the effectiveness and sustainability of this intervention. Human factors studies showed that virtual navigation is a safe and effective method for use with chronic pain patients. Chronic pain patients demonstrated significant relief in subjective ratings of pain that corresponded to objective measurements in peripheral, noninvasive physiological measures. PMID:24892196
The use of intra-osseous versus extra-osseous distraction devices in atrophic mandibles.
Perdijk, F B T; Meijer, G J; Krenkel, Ch; Koole, R
To allow for implant placement in severe atrophic edentulous mandibles, distraction osteogenesis can be used to gain sufficient bone height. The efficacy of extra-osseous and intra-osseous devices is evaluated. In this retrospective study, 45 patients treated with an extra-osseous device (EOD) were compared with 43 patients treated with an intra-osseous device (IOD). From a statistical point of view, both patient groups were comparable for age and sex ratio. The IOD group gained more bone height (9.8 mm) than the EOD group (6.0mm). A significantly higher degree of backward tilting of the device was observed in the EOD group (12.1┬░), compared with the IOD group (3.0┬░). There were also significantly more fractures of the basal bone segment and sensory disturbances of the chin area in the EOD group than in the IOD group. The IOD group scored significantly better on bone height gained, backward tilting of the device, occurrence of fractures, and postoperative sensory disturbances. Despite the fact that the mean preoperative bone height for the IOD group was substantially higher (18.6mm) than for the EOD group (11.9 mm), it may be concluded that for augmentation procedures of the edentulous mandible, the IOD is more favourable. PMID:22218264
[The progress of research about anatomy of posterolateral wall of maxillary sinus in endoscopic surgery].
Gao, Li; Huang, Xinsheng
As an important landmark, the posterolateral wall of maxillary sinus can help to locate numbers of significant signs such as maxillary artery and its branches, maxillary nerve and infraorbital nerve, infratemporal fossa and pterygopalatine fossa etc. in the endoscopic surgery for paranasal sinuses and lateral skull base. This article reviewed related researches about the anatomy and endoscopic surgery of posterolateral wall of maxillary sinus. PMID:27093827
Camouflage treatment for class III malocclusion combined with traction of an impacted maxillary central incisor.
Closs, Luciane Quadrado; Mundstock, Karina Santos; Ribeiro, Darlene Santos; Reston, Eduardo Galia; Silva, Aurel├Łcio Novaes
This case report describes the treatment of a patient with an unerupted maxillary left central incisor, class III malocclusion with crossbite of the maxillary posterior teeth and lateral open bite. Treatment consisted of rapid maxillary expansion followed by anterior space opening, maxillary protraction and traction of the unerupted teeth with a light force system. Favorable results were obtained in terms of correcting incisor position and class III malocclusion. The results achieved remained stable throughout a 4-year retention period. PMID:20819408
The Use of Choice-Based Distraction to Decrease the Distress of Children at the Dentist
ERIC Educational Resources Information Center
Filcheck, Holly A.; Allen, Keith D.; Ogren, Hilary; Darby, James Brandt; Holstein, Brian; Hupp, Steve
This research was conducted to examine whether choice-based distraction provides an effective means of reducing the distress of children undergoing routine dental treatment. Sixty children between the ages of 5-12 who required restorative dental treatment were assigned randomly to either a Control group or a Distraction group in which theŌĆ"
Distractibility in daily life is reflected in the structure and function of human parietal cortex
Kanai, Ryota; Dong, Mia Yuan; Bahrami, Bahador; Rees, Geraint
We all appreciate that some of our friends and colleagues are more distractible than others. This variability can be captured by pencil and paper questionnaires in which individuals report such cognitive failures in their everyday life. Surprisingly, these self-report measures have high heritability, leading to the hypothesis that distractibility might have a basis in brain structure. In a large sample of healthy adults, we demonstrated that a simple self-report measure of everyday distractibility accurately predicted grey matter volume in a remarkably focal region of left superior parietal cortex. This region play a causal role in reducing distractibility because we found that disrupting its function with TMS increased susceptibility to distraction. Finally, we showed that the self-report measure of distractibility reliably predicted our laboratory-based measure of attentional capture. Our findings distinguish a critical mechanism in the human brain causally involved in avoiding distractibility, which importantly, bridges self-report judgments of cognitive failures in everyday life and a commonly used laboratory measure of distractibility to the structure of the human brain. PMID:21543590
Distracted Driving, A Major Preventable Cause of Motor Vehicle Collisions: "Just Hang Up and Drive".
Kahn, Christopher A; Cisneros, Victor; Lotfipour, Shahram; Imani, Ghasem; Chakravarthy, Bharath
For years, public health experts have been concerned about the effect of cell phone use on motor vehicle collisions, part of a phenomenon known as "distracted driving." The Morbidity and Mortality Weekly Report (MMWR) article "Mobile Device Use While Driving - United States and Seven European Countries 2011" highlights the international nature of these concerns. Recent (2011) estimates from the National Highway Traffic Safety Administration are that 10% of fatal crashes and 17% of injury crashes were reported as distraction-affected. Of 3,331 people killed in 2011 on roadways in the U.S. as a result of driver distraction, 385 died in a crash where at least one driver was using a cell phone. For drivers 15-19 years old involved in a fatal crash, 21% of the distracted drivers were distracted by the use of cell phones. Efforts to reduce cell phone use while driving could reduce the prevalence of automobile crashes related to distracted driving. The MMWR report shows that there is much ground to cover with distracted driving. Emergency physicians frequently see the devastating effects of distracted driving on a daily basis and should take a more active role on sharing the information with patients, administrators, legislators, friends and family. PMID:26759649
Why Does Working Memory Capacity Predict RAPM Performance? A Possible Role of Distraction
ERIC Educational Resources Information Center
Jarosz, Andrew F.; Wiley, Jennifer
Current theories concerning individual differences in working memory capacity (WMC) suggest that WMC reflects the ability to control the focus of attention and resist interference and distraction. The current set of experiments tested whether susceptibility to distraction is partially responsible for the established relationship betweenŌĆ"
Comparison of Hypnosis and Distraction in Severely Ill Children Undergoing Painful Medical Procedures.
ERIC Educational Resources Information Center
Smith, Julien T.; And Others
An ethnically diverse sample of high and low hypnotizable children (N=27) suffering from cancer or blood disorders were trained along with their parents to use both distraction and hypnosis to reduce pain and anxiety. Distraction produced significant positive effects for observer-rated distress scores for the low hypnotizable children. Discussesģ
Posterior P1 and early frontal negativity reflect developmental changes in attentional distraction during adolescence.
Zhang, Wenhai; Li, Hong; Chen, Jie; Chen, Ning; Liu, Xia; Wang, Dahua; Shen, Jiliang
Previous studies in adults have revealed that attentional distraction modulates the late positive potential (LPP) during emotion regulation. To determine whether early visual components reflect developmental changes in attentional distraction during adolescence, we collected event-related potentials from 20 young adolescents, 18 older adolescents, and 18 young adults as they performed a distraction task (counting) while viewing affective images. Consistent with previous findings obtained in distraction studies, the distraction task (counting) reduced emotional modulation of the LPP. At an early stage of processing, counting reduced emotional modulation of P1 and increased the negativity bias of early frontal negativity (eFN) for negatively valenced pictures compared to simple viewing with no distraction. sLORETA analyses further revealed eFN indexing of rostral prefrontal cortical activation, a cortical area that has been shown in recent fMRI studies to be activated by distraction. Moreover, P1 amplitudes in young and older adolescents did not differ but were both larger than the P1s in young adults. In addition, eFN amplitudes significantly decreased with age. The dissociable distraction patterns between the posterior P1 and eFN provide evidence not only for the timing hypothesis of emotion regulation but also for different developmental trajectories of visual processing areas and the prefrontal cortex during affective processing in adolescence. PMID:24658081
Comparison of Hypnosis and Distraction in Severely Ill Children Undergoing Painful Medical Procedures.
ERIC Educational Resources Information Center
Smith, Julien T.; And Others
An ethnically diverse sample of high and low hypnotizable children (N=27) suffering from cancer or blood disorders were trained along with their parents to use both distraction and hypnosis to reduce pain and anxiety. Distraction produced significant positive effects for observer-rated distress scores for the low hypnotizable children. DiscussesŌĆ"
Aberration in the palatal root of the maxillary first molar
Rajalbandi, Sandeep; Shingte, Sandhya Narayan; Sundaresh, K J; Mallikarjuna, Rachappa
Thorough knowledge of root canal morphology is essential for the endodontic therapy. Variations in the root and root canal morphology, especially in multirooted teeth, are a constant challenge for diagnosis and management. The dentist needs to be familiar with the various root canal configurations and their variations for successful endodontic therapy. There are rare variations in canal number and configuration in maxillary molars, which could affect treatment outcome. Two lingual root structures are occasionally found on human permanent maxillary molars. One of these is the normal lingual root, which is always present, the other is a supernumerary structure which can be located either mesiolingually (radix mesiolingualis) or distolingually (radix distolingualis). The purpose of this paper is to review the literature and to demonstrate a case report which describes the successful non-surgical endodontic management of an unusual maxillary first molar with four separate roots and four canals. PMID:23632609
Maxillary Chronic Osteomyelitis Caused by Domestic Violence: A Diagnostic Challenge
Oliveira, Tamyris In├Īcio; de Carli, Marina Lara; Ribeiro Junior, No├® Vital; Pereira, Alessandro Ant├┤nio Costa; Tatakis, Dimitris N.; Hanemann, Jo├Żo Adolfo Costa
Maxillary osteomyelitis is a rare condition defined as inflammation of the bone primarily caused by odontogenic bacteria, with trauma being the second leading cause. The present report documents a rare case of maxillary osteomyelitis in a 38-year-old female who was the victim of domestic violence approximately a year prior to presentation. Intraoral examination revealed a lesion appearing as exposed bony sequestrum, with significant destruction of gingiva and alveolar mucosa in the maxillary right quadrant, accompanied by significant pain, local edema, and continued purulence. Teeth numbers 11, 12, 13, 14, and 15 were mobile, not responsive to percussion, and nonvital. Treatment included antibiotic therapy for seven days followed by total enucleation of the necrotic bone tissue and extraction of the involved teeth. Microscopic findings confirmed the clinical diagnosis of chronic suppurative osteomyelitis. Six months postoperatively, the treated area presented complete healing and there was no sign of recurrence of the lesion. PMID:25610667
Neurofibroma of the maxillary antrum: A rare case
Jain, Deepali; Chaudhary, Minal; Patil, Swati
Neurofibromas are benign tumors of peripheral nerve tissue, frequently associated with neurofibromatosis type 1. Their isolated occurrence in the maxillary antrum is rare, with only 6 cases described in the English literature to the best of our knowledge. Primary neurogenic tumors in the maxillary sinus are unusual entities. The majority of the reported cases that have dealt with neurilemmomas and isolated neurofibromas are extremely rare. Here, a case of neurofibroma of the maxillary sinus. We present the case of a 60-year-old female patient with the chief complain of growth in the upper right back region of the jaw, which was preceded by exfoliation of teeth in the same region 1 month back. PMID:24808710
A Morphometric Study of Labial Grooves on Anterior Maxillary Dentition.
Li, Junying; Zhong, Lin; Zhang, Ling; Chen, Duanjing; Yu, Haiyang
This study was performed to investigate the shape, characteristics, and correlation of labial grooves on anterior maxillary dentition. Individual teeth (N = 621) were investigated using a microscopic three-dimensional digital image correlation system. The average length, width, and depth of grooves were quantified, and groove patterns in anterior maxillary teeth and the symmetry and correlation of grooves in anterior maxillary dentition were studied. There were nine common groove patterns in central incisors, eight in lateral incisors, and nine in canines. A good symmetry of grooves was found between the left and right dentition. The number of grooves and the groove pattern were correlated among central incisors, lateral incisors, and canines. This study may provide guidance for clinical design of labial grooves. PMID:26901309
Etiologies and Treatments of Odontogenic Maxillary Sinusitis: A Systematic Review
Akhlaghi, Fahimeh; Esmaeelinejad, Mohammad; Safai, Pooria
Context: Maxillary sinusitis is an important issue in dentistry and maxillofacial surgery. This study aims to present a systematic review of etiologies and treatments of odontogenic maxillary sinusitis. Evidence Acquisition: An electronic database search was performed based on related MeSH keywords. Articles published between January 2001 and December 2014 was selected according to the inclusion criteria. The information extracted from various studies was categorized in various tables. Results: The study selected 19 studies. In most studies, oroantral fistula (OAF) was the most common etiology of odontogenic sinusitis. Alpha-hemolytic streptococcus was the most common flora in sinusitis with dental origin. The literature shows that the Caldwell-Luc approach may be the best method for treating sinusitis in cases of displaced teeth. Conclusions: OAF is a common cause of odontogenic maxillary sinusitis and may easily be treated by endoscopy and fistula closure. Maxillofacial surgeons and dentists should consider this problem to avoid misdiagnosis and prevent complications. PMID:26756016
Interdisciplinary treatment of multiple maxillary anterior diastemas: case report.
Terzioglu, Hakan; Akcam, Okan; Yilmaz, Burak; Halil, Suleyman
This article describes an interdisciplinary (orthodontic and prosthodontic) approach for treating a 28-year-old woman who had multiple maxillary anterior diastemas, insufficient lip support, and inadequate anterior guidance. Although the patient also had diastemas among her mandibular anterior teeth, she declined orthodontic or restorative treatment for this arch. Initially, ceramic orthodontic brackets and polytetrafluoroethylene-coated arch wires were used. Orthodontic treatment involved leveling and aligning the maxillary dental arch, correcting the incisor angulations, and providing appropriate spaces for prosthetic restoration. After orthodontic treatment, IPS Empress 2 crowns were delivered to the six maxillary anterior teeth. This interdisciplinary approach produced a successful outcome and improved esthetics. The patient remained satisfied at the three-year follow-up examination. PMID:21466998
Bone production by human maxillary sinus mucosa cells.
Graziano, A; Benedetti, L; Massei, G; Cusella de Angelis, M G; Ferrarotti, F; Aimetti, M
The Schneider membrane is the mucosa that covers the inner part of the maxillary sinus cavities. The free surface is a ciliated pseudostratified epithelium, while the deeper portion is a highly vascularized connective tissue. The stromal fraction, bordering the bony wall of the sinus, after tooth loss can exhibit increased osteoclastic activity resulting in resorption of the bone in the posterior maxilla. Goal of our study was to isolate and characterize mesenchymal progenitors in the Schneider's membrane connective net and to evaluate their self ability to differentiate toward osteoblastic lineage, in absence of osteoinductive factors and osteoconductive biomaterials of support. This should indicate that maxillary sinus membrane represents an useful an approachable source of MSCs for bone tissue engineering and cell therapy and owns the intrinsic capacity to restore maxillary bone after tooth loss without the needing of biomaterials. PMID:22105430
Keep Your Eyes on the Road: Young Driver Crash Risk Increases According to Duration of Distraction
Simons-Morton, Bruce; Guo, Feng; Klauer, Sheila G; Ehsani, Johnathon P; Pradhan, Anuj K
Purpose Secondary task engagement that distracts the driver is a contributing factor to motor vehicle crashes among adults. However, the association between eye glance duration and crash risk with novice teenage drivers has not been determined. Methods Vehicles of 42 newly-licensed teenage drivers were instrumented with cameras, accelerometers, GPS, and other devices. Data were collected continuously for 18 months. Crashes and near crashes (CNCs) were identified by examining highly elevated gravitational force events. Video footage of the 6 seconds prior to each CNC and randomly sampled non-CNC road segments were coded for the duration of eye glances off the forward roadway and the presence of secondary task engagement. The likelihood (odds ratios) of CNC due to eye glance behavior was calculated by comparing the prevalence of secondary task engagement and duration of eyes off road prior to CNC with the prevalence and duration of eyes off road during non-CNC road segments. Results Crash risk increased with the duration of single longest glance during all secondary tasks (OR=3.8 for >2s) and wireless secondary task engagement (OR=5.5 for >2s). Single longest glance provided a more consistent estimate of crash risk than total time eyes off the forward roadway. Conclusions Eyes glances away from forward roadway involving secondary tasks increased the likelihood of CNC. The longer the duration of eye glance away from the road the greater the risk, regardless of type of secondary task. Education and policy discouraging secondary task engagement, particularly for prolonged periods, is warranted. PMID:24759443
Mindless feeding: Is maternal distraction during bottle-feeding associated with overfeeding?
Golen, Rebecca B; Ventura, Alison K
Mindless eating, or eating while distracted by surrounding stimuli, leads to overeating. The present study explored whether "mindless feeding," or maternal distraction during bottle-feeding, is associated with greater infant formula/milk intakes and lower maternal sensitivity to infant cues. Mothers and their Ōēż24-week-old bottle-feeding infants (NŌĆē=ŌĆē28) visited our laboratory for a video-recorded feeding observation. Infant intake was assessed by weighing bottles before and after the feedings. Maternal sensitivity to infant cues was objectively assessed by behavioral coding of video-records using the Nursing Child Assessment Feeding Scale. Maternal distraction was defined as looking away from the infant >75% of the feeding; using a mobile device; conversing with another adult; or sleeping. Twenty-nine percent (nŌĆē=ŌĆē8) of mothers were distracted. While differences in intakes for infants of distracted vs. not distracted mothers did not reach significance (pŌĆē=ŌĆē0.24), the association between distraction and infant intake was modified by two dimensions of temperament: orienting/regulation capacity (pŌĆē=ŌĆē0.03) and surgency/extraversion (pŌĆē=ŌĆē0.04). For infants with low orienting/regulation capacity, infants of distracted mothers consumed more (177.1ŌĆē┬▒ŌĆē33.8ŌĆēml) than those of not distracted mothers (92.4ŌĆē┬▒ŌĆē13.8ŌĆēml). Similar findings were noted for infants with low surgency/extraversion (distracted: 140.6ŌĆē┬▒ŌĆē22.5ŌĆēml; not distracted: 78.4ŌĆē┬▒ŌĆē14.3ŌĆēml). No association between distraction and intake was seen for infants with high orienting/regulation capacity or surgency/extraversion. A significantly greater proportion of distracted mothers showed low sensitivity to infant cues compared to not distracted mothers (pŌĆē=ŌĆē0.04). In sum, mindless feeding may interact with infant characteristics to influence feeding outcomes; further experimental and longitudinal studies are needed. PMID:25953601
Joint Preservation of the Wrist Using Articulated Distraction Arthroplasty: A Case Report of a Novel Technique
Fletcher, Matt D. A.
Distraction arthroplasty of the ankle, elbow, and hip has become widely accepted and used within the orthopaedic community with excellent initial results which appear sustained. To date it has not been applied to the wrist in the same manner. A novel technique, drawn upon past success of articulated ankle distraction and static wrist distraction, was devised and evaluated by application of articulated wrist distraction performed over a 12-week period in a patient with poor functional outcome following limited wrist fusion. Posttreatment results showed improvement in range of motion (100-degree arc), subjective pain, and functional outcome measures (DASH 21.7, Mayo Wrist Score 80) comparable or better than either limited wrist fusion or proximal row carpectomy. Articulated wrist distraction initially appears to be a promising therapeutic option for the management of the stiff and painful wrist to maintain maximal function for which formal wrist arthrodesis may be the only alternative. PMID:25767728
Understanding commercial truck drivers' decision-makin process concerning distracted driving.
Swedler, David I; Pollack, Keshia M; Gielen, Andrea C
A concurrent mixed methods design was used to explore personal and workplace factors, informed by the Theory of Planned Behavior, that affect truck drivers' decision-making about distracted driving on the job. Qualitative data were collected via semi-structured interviews with experts in truck safety and distracted driving, and quantitative data were collected via online survey of truck drivers in the United States. Findings from the interviews illustrated how drivers perceived distractions and the importance of supervisors enforcing organizational distracted driving policies. Survey results found that behavioral intentions were most important in regards to texting and crash and near-crash outcomes, while perceived norms from management best described the correlation between dispatch device use and negative crash-related outcomes. By using a mixed methods design, rather than two separate studies, these findings revealed nuanced differences into the influence of supervisors on distracted driving. PMID:25732132
Disentangling effects of auditory distraction and of stimulus-response sequence.
Roeber, Urte; Berti, Stefan; M├╝ller, Dagmar; Widmann, Andreas; Schr├Čger, Erich
When we pay attention to one task, irrelevant changes may interfere. The effect of changes on behavioral and electrophysiological responses has been studied in two separate research fields: Research on Distraction states that a rare irrelevant change takes attention away from the primary task. Research on Sequences states that any change in stimulus or response incurs a cost or benefit depending on the kind of change. To disentangle distraction from sequence effects, we made task-irrelevant changes rare in one condition and frequent in another while also assessing stimulus and response changes from trial to trial. Participants used key presses to classify syllables presented in two different, irrelevant voice pitches. We found that distraction and sequence interacted to alter reaction times and errors on the primary task and also to alter ERP markers of distraction (P3a). The sequential effects cannot, however, fully account for distraction. PMID:19207193
The effects of increasing neutral distraction on sexual responding of women with and without sexual problems.
Salemink, Elske; van Lankveld, Jacques J D M
This study examined the influence of distraction on genital and subjective sexual responses of women with (N=20) and without (N=21) sexual problems. Female-produced erotic film fragments were presented to induce sexual response and a vaginal photoplethysmograph was used to measure genital sexual responding. Subjective sexual arousal was assessed in real time using a rotating button and, retrospectively, with visual analogue scales. Distraction load was manipulated through different verbal instructions on how to deal with pairs of digits. The results revealed an equally strong impeding effect of distraction on genital sexual responses and on subjective sexual responses when these were measured retrospectively in women with and without sexual problems. However, distraction did not affect subjective sexual responses when these were measured in real time. The implications of the finding that distraction equally affects women with and without sexual problems are discussed. PMID:16752120
Perceptions of driver distraction by cellular phone users and nonusers.
Wogalter, Michael S; Mayhorn, Christopher B
The present study examined the perceptions of cellular phone users and nonusers on issues relating to vehicle control and driver distraction. Participants were asked if they own a cellular phone; if so, how much they use it; and their beliefs regarding cellular phone use while driving, including actions involving the use of cellular phones which could potentially cause vehicular accidents and the need for laws. A total of 330 individuals participated; 72% owned a cellular phone. The results indicate that nonusers of cellular phones believed more strongly than users that cellular phone use while driving negatively affects driving performance and that talking on the cellular phone could potentially cause an accident, and they also had a greater preference for new laws limiting such acts. Cellular phone users, more than nonusers, preferred no laws limiting cellular phone use and believed more strongly that other people driving while using a cellular phone were more dangerous than themselves doing the same. Implications of these results are discussed. Actual or potential applications of this research include interventions that limit driver distractibility. PMID:16170950
PRAL/DISTRACT: A platform for distributed active objects applications
Roux, P.; Fouquier, G.; Bras, D.
The object-oriented approach is now widely used in the world of sequential programming and is very promising for concurrent programming. Object-oriented models generally provide concurrency by allowing asynchronous message passing. Each object can be seen as an autonomous entity, called {open_quotes}active object{close_quotes}, with its own computing resources. The purpose of this paper is to describe a language, PRAL, based on the notion of active object, and its implementation. PRAL is a compiled language whose target code is a C++ extension, called {open_quotes}DISTRACT{close_quotes}. It permits the distribution of active objects on several logical sites, which can be on different workstations, by using the notion of execution kernel, that is the computing resource giving autonomy to the active objects. Several execution kernels can be chosen among SUN`s {open_quotes}lightweight process{close_quotes}, Solaris {open_quotes}threads{close_quotes}, Motif or XView notifier. All these capabilities make PRAL/DISTRACT very efficient and interesting when developing distributed object oriented applications.
Olfactory Identification Test Using Familiar Distracters for Koreans
Kim, Jae-Myung; Jeong, Mi Soon; Shin, Dong-Hyuk; Seol, Jeong-Hun; Hong, Seok-Chan; Cho, Jae Hoon
Objectives Odors used in an odor identification test should be familiar to the subject, but there are some unfamiliar distracters in Korean version of Sniffin' stick (KVSS) II identification test. In this study, we used the results of the original version of KVSS II identification to modify the KVSS II identification test. Methods Eighty-three participants took an original version of KVSS II identification test and a visual analogue scale of subjective odor function. KVSS II identification which has 16 items was performed to choose one out of four odors items. And visual analogue scale was checked from 0 to 10 points of their subjective olfactory function. Two weeks later they took the modified version of KVSS II identification test. Hyposmic or anosmic patients were excluded. Results The mean score of the original version of KVSS II identification and modified version of KVSS II identification were 11.3 and 12.5, respectively (P<0.05). The KVSS II identification test and subjective olfactory function were positively correlated (r=0.247, P<0.05), as were the modified KVSS II identification test and subjective olfactory function (r=0.329, P<0.05). Conclusion After modification of distracters, KVSS II identification test appears to be suited for assessment of olfactory function. PMID:24587876
Do advertisements at the roadside distract the driver?
NASA Astrophysics Data System (ADS)
Kettwich, Carmen; Klinger, Karsten; Lemmer, Uli
Nowadays drivers have to get along with an increasing complex visual environment. More and more cars are on the road. There are not only distractions available within the vehicle, like radio and navigation system, the environment outside the car has also become more and more complex. Hoardings, advertising pillars, shop fronts and video screens are just a few examples. For this reason the potential risk of driver distraction is rising. But in which way do the advertisements at the roadside influence the driver's attention? The investigation which is described is devoted to this topic. Various kinds of advertisements played an important role, like illuminated and non-illuminated posters as well as illuminated animated ads. Several test runs in an urban environment were performed. The gaze direction of the driver's eye was measured with an eye tracking system. The latter consists of three cameras which logged the eye movements during the test run and a small-sized scene camera recording the traffic scene. 16 subjects (six female and ten male) between 21 and 65 years of age took part in this experiment. Thus the driver's fixation duration of the different advertisements could be determined.
Unilateral cacosmia: a presentation of maxillary fungal infestation
Erskine, Sally E; Schelenz, Silke; Philpott, Carl M
We present a case of long-standing unilateral cacosmia in a healthy 67-year-old man due to maxillary fungal infestation. Treatment with septoplasty had been attempted 10ŌĆģyears prior but no further investigation or management undertaken and symptoms continued. Subsequent MRI scan revealed significant opacification of the left maxillary sinus. This was readily amenable to treatment by balloon sinuplasty. This yielded viscous grey mucus which grew Scedosporium apiospermum. The case highlights the need for careful investigation of olfactory symptoms, including blood tests to exclude systemic causes, endoscopy and imaging where indicated. PMID:23563684
Unilateral cacosmia: a presentation of maxillary fungal infestation.
Erskine, Sally E; Schelenz, Silke; Philpott, Carl M
We present a case of long-standing unilateral cacosmia in a healthy 67-year-old man due to maxillary fungal infestation. Treatment with septoplasty had been attempted 10 years prior but no further investigation or management undertaken and symptoms continued. Subsequent MRI scan revealed significant opacification of the left maxillary sinus. This was readily amenable to treatment by balloon sinuplasty. This yielded viscous grey mucus which grew Scedosporium apiospermum. The case highlights the need for careful investigation of olfactory symptoms, including blood tests to exclude systemic causes, endoscopy and imaging where indicated. PMID:23563684
Metastatic mammary carcinoma to the orbit masquerading as maxillary sinusitis
Abo-Shasha, Rami; Stepniak, Camilla; Yeh, David H.
Introduction: We report on a case of isolated metastatic breast cancer to the medial rectus muscle. This entity is exceedingly rare. Case: A 44-year-old female with a history of breast cancer presented with unilateral maxillary symptoms and was treated for sinusitis. Over time, she developed ocular pain, diplopia, blurred vision and eventually complete adduction deficit. Results: T1-weighted magnetic resonance imaging revealed a medial rectus lesion. Biopsy via transnasal transorbital endoscopic approach revealed metastatic mammary carcinoma. Discussion: Metastatic disease to the orbit should be considered in the differential diagnosis of refractory maxillary sinus pain in patients with a known underlying malignancy. PMID:27103558
Endodontic Management of a Maxillary Molar with Three Mesiobuccal Canals
Gundam, Sirisha; Maddu, Radhika; Gurram, Sindhura Reddy
It is imperative that the clinician should have comprehensive knowledge about the normal anatomy and its variations of the teeth as the deviations from the usual are very common. An increased awareness of unusual anatomy and a better understanding of the root canal system guide the clinician in accurate diagnosis and treatment of such variations in order to achieve a successful endodontic outcome. The maxillary first molar has been shown to have a wide variation in respect to the number of canals specifically noted in the mesiobuccal root. The current case report shows the successful management of a maxillary molar in which the mesiobuccal root had three canals. PMID:25505997
Management of Ectopically Erupting Maxillary Incisors: A Case Series
Suresh, Kotumachagi Sangappa; Uma, HL; Nagarathna, J
ABSTRACT Eruption disturbances related to the position include ectopic eruption and transpositions. The occurrence of ectopic eruption is most commonly associated with maxillary incisors. The normal eruption, position and morphology of these teeth are crucial to craniofacial development, facial esthetics as well as phonetics. It is essential that the clinicians have thorough knowledge of the eruption disturbances in order to make an appropriate, as well as timely intervention, as dictated by the complexity of the problem. How to cite this article: Suresh KS, Uma HL, Nagarathna J, Kumar P. Management of Ectopically Erupting Maxillary Incisors: A Case Series. Int J Clin Pediatr Dent 2015;8(3):227-233. PMID:26604543
Management of Ectopically Erupting Maxillary Incisors: A Case Series.
Suresh, Kotumachagi Sangappa; Uma, H L; Nagarathna, J; Kumar, Pravin
Eruption disturbances related to the position include ectopic eruption and transpositions. The occurrence of ectopic eruption is most commonly associated with maxillary incisors. The normal eruption, position and morphology of these teeth are crucial to craniofacial development, facial esthetics as well as phonetics. It is essential that the clinicians have thorough knowledge of the eruption disturbances in order to make an appropriate, as well as timely intervention, as dictated by the complexity of the problem. How to cite this article: Suresh KS, Uma HL, Nagarathna J, Kumar P. Management of Ectopically Erupting Maxillary Incisors: A Case Series. Int J Clin Pediatr Dent 2015;8(3):227-233. PMID:26604543
Multidisciplinary approach to a traumatized unerupted dilacerated maxillary central incisor.
de Oliveira Ruellas, Ant├┤nio Carlos; Mattos, Claudia Trindade
A patient with an impacted dilacerated maxillary left central incisor is presented. The 8-year-old girl also presented with protrusion of teeth and lips, posterior crossbite, anterior open bite, thumb-sucking habit, and transposition of the maxillary left lateral incisor and canine. The treatment consisted of a multidisciplinary approach, including surgery, orthodontics, endodontics, and prosthodontics. The dilacerated incisor was surgically exposed, tractioned, endodontically treated, and restored. Four premolars were extracted to correct the protrusion. The outcome was the accomplishment of a balanced and functional occlusion, resulting in a pleasant smile. PMID:22149545
Brookhaven segment interconnect
Morse, W.M.; Benenson, G.; Leipuner, L.B.; Larsen, R.C.; Black, J.K.; Blatt, S.R.; Campbell, M.K.; Kasha, H.; Schmidt, M.P.; Schwarz, C.; Adair, R.K.
We have performed a high energy physics experiment using a multisegment Brookhaven FASTBUS system. The system was composed of three crate segments and two cable segments. We discuss the segment interconnect module which permits communication between the various segments.
Extranodal B Cell Lymphoma with Prominent Spindle Cell Features Arising in Uterus and in Maxillary Sinus: Report of Two Cases and Literature Review.
Li, Yiting; Cui, Wei; Woodroof, Janet M; Zhang, Da
Primary B-cell lymphoma exhibiting a spindle dominant pattern is extremely rare and represents a potential diagnostic pitfall. Here we report two cases of extranodal B cell lymphoma with spindle cell dominant morphology (sp-BCL) of uterus and maxillary sinus. Case 1 was a 54-year-old female with a large mass in the lower uterine segment, inseparable from the wall of the rectum and the urinary bladder. This is the first report of primary sp-BCL arising in the lower uterine segment. Case 2 was a 54-year-old male with a permeative mass involving the maxillary sinus wall with extension into the premaxillary soft tissues. Biopsies of both cases revealed a diffuse infiltration by medium to large atypical spindle cells. A panel of immunohistochemical stains was performed to rule out the possibilities of sarcoma, carcinoma, or melanoma. The final diagnosis was diffuse large B cell lymphoma, germinal center type. This is the first report of sp-BCL incorporating molecular genetic studies and the next-generation sequencing analysis performed on the maxillary lymphoma revealed three genomic alterations in genes of EZH2 (Y646N), IRF8 (S55A), and TNFRSF14 (splice site 304+2T>C). These genes were reported to play important roles in the pathogenesis of diffuse large B cell lymphoma. Both patients achieved complete remission after excision and chemo-radiation therapy despite the extensive local involvement. PMID:27098631
Comparison of the Diagnostic Image Quality of the Canine Maxillary Dentoalveolar Structures Obtained by Cone Beam Computed Tomography and 64-Multidetector Row Computed Tomography.
Soukup, Jason W; Drees, Randi; Koenig, Lisa J; Snyder, Christopher J; Hetzel, Scott; Miles, Chanda R; Schwarz, Tobias
The objective of this blinded study was to validate the use of cone beam computed tomography (C) for imaging of the canine maxillary dentoalveolar structures by comparing its diagnostic image quality with that of 64-multidetector row CT Sagittal slices of a tooth-bearing segment of the maxilla of a commercially purchased dog skull embedded in methylmethacrylate were obtained along a line parallel with the dental arch using a commercial histology diamond saw. The slice of tooth-bearing bone that best depicted the dentoalveolar structures was chosen and photographed. The maxillary segment was imaged with cone beam CT and 64-multidetector row CT. Four blinded evaluators compared the cone beam CT and 64-multidetector row CT images and image quality was scored as it related to the anatomy of dentoalveolar structures. Trabecular bone, enamel, dentin, pulp cavity, periodontal ligament space, and lamina dura were scored In addition, a score depicting the evaluators overall impression of the image was recorded. Images acquired with cone beam CT were found to be significantly superior in image quality to images acquired with 64-multidetector row CT overall, and in all scored categories. In our study setting cone beam CT was found to be a valid and clinically superior imaging modality for the canine maxillary dentoalveolar structures when compared to 64-multidetector row CT. PMID:26415384
Immediate implants in anterior maxillary arch
Anitha, K.; Kumar, S. Senthil; Babu, M. R. Ramesh; Candamourty, Ramesh; Thirumurugan
Aim: The aim of the study was to evaluate the osseo-integration and soft tissue status of the endosseous implants placed in immediate extraction socket. Methodology: Seven patients (4 males and 3 females) aged 20-30 years were selected for the study. Nine implants were placed in seven patients in the maxillary arch. All the patients were clinically ╬▒nd thoroughly examined. Under local anesthesia, the indicated tooth was extracted. The extracted socket was prepared using standard drills with palatal wall as guide. The longest and widest implants were placed (Hi-Tec Implants). All implants showed good primary stability. The implants used in the study were tapered design endosseous implants with Threaded implants (TI) unit plasma-sprayed surface. Surgical re-entry (secondary surgery) was performed to remove the healing cap after 6 months for supra crestal fabrication. All patients were reviewed periodically at 3rd and 6th month interval and the following clinical parameters including modified plaque index (mPlI), modified bleeding index (mBI), probing depth (PD), attachment level (AL), and distance between the implant shoulder and mucosal margin (DIM), distance between the implant shoulder and first bone-implant contact, and Clinical Mobility Index were recorded. The results were computed and subjected to statistical evaluation. Results: The mPlI, mBI, PD, AL, and DIM were evaluated around the implants at baseline, 3rd and 6th month intervals and analyzed statistically by Friedman T-test. The results of the above were shown to be statistically non-significant. The distance between the implant shoulder and first bone implant contact was evaluated around the implants at base line, 3rd and 6th month intervals. The results proved to be statistically significant (0.01) implying that there was a bone apposition around the implants. Conclusion: During the course of the study, soft tissue status around implants was found to be healthy. Osseointegration as assessed by clinical and radiographic findings was found to be sound. PMID:24678203
Modified maxillary protraction headgear for the correction of class III skeletal malocclusion with anterior open bite.
Qazi, Haroon Shahid; Amjad, Al-Taki
This is a case report of a 10-year-old girl with a hyper divergent class III skeletal malocclusion caused primarily due to maxillary retrognathism. Treatment involved the use of a modified maxillary protraction face mask that carries the point of force application extra orally to pass through the centre of resistance of the maxillary dentoalveolar complex. After 8 months, the maxilla was displaced anteriorly without rotation. Maxillary occlusal plane showed a clockwise rotation. Maxillary incisors were extruded and retroclined. Mandible was displaced downward and backward. Another 18 months were required for fixed orthodontic treatment to achieve perfect interdigitation. PMID:16398983
Aneurysmal bone cyst of maxillary alveolus: A rare case report
Debnath, Subhas Chandra; Adhyapok, Apurba Kumar; Hazarika, Kriti; Malik, Kapil; Vatsyayan, Ashutosh
Aneurysmal bone cyst (ABC) is a nonneoplastic rare pathologic entity of the jaws. Its locally aggressive nature and high recurrence rate after curettage make surgical resection a better treatment option. Here, we present a case of ABC of maxillary alveolus and its management by alveolectomy followed by white head varnish pack application in the surgical defect. PMID:27041915
Sealing maxillary titanium obturators with removable flexible caps.
Reitemeier, Bernd; Schaal, Wolfgang; Wolf, Annette; Walter, Michael
Maxillary obturator prostheses with hollow metal obturators can be made of titanium to reduce weight. To prevent perforation of the hollow obturator during modifications, the obturator is slightly undersized and covered with a replaceable cap. This cap is made of a soft copolymer to facilitate uncomplicated modifications in the resection area and to improve function. PMID:26581659
Maxillary sinus infection caused by the homobasidiomycetous fungus Schizophyllum commune.
Kern, M E; Uecker, F A
We investigated a case of maxillary sinus infection caused by the medusoid mutant of the basidiomycetous fungus Schizophyllum commune. Morphologies of both typical and medusoid forms of S. commune were determined. Prior reports of pathogenic homobasidiomycetes are discussed. Images PMID:3711292
Longitudinal stability of rapid and slow maxillary expansion
Pinheiro, F├Ībio Henrique de S├Ī Leit├Żo; Garib, Daniela Gamba; Janson, Guilherme; Bombonatti, Roberto; de Freitas, Marcos Roberto
OBJECTIVE: The aim of this retrospective study was to compare the longitudinal stability of two types of posterior crossbite correction: rapid maxillary expansion (RME) and slow maxillary expansion (SME). METHODS: Study casts of 90 adolescent patients were assessed for interdental width changes at three different periods: pretreatment (T1), post-treatment (T2) and at least, five years post-retention (T3). Three groups of 30 patients were established according to the treatment received to correct posterior crossbite: Group A (RME), group B (SME) and group C (control- Edgewise therapy only). After crossbite correction, all patients received fixed edgewise orthodontic appliances. Paired t-tests and one-way ANOVA were used to identify significant intra and intergroup changes, respectively (P < 0.05). RESULTS: Except for intercanine distance, all widths increased in groups A and B from T1 to T2. In the long-term, the amount of relapse was not different for groups A and B, except for 3-3 widths which showed greater decrease in group A. However, the percentage of clinically relapsed cases of posterior crossbite was similar for rapid and slow maxillary expansion. CONCLUSION: Rapid and slow maxillary expansion showed similar stability in the long-term. PMID:25628082
Maxillary Antrolith: A Rare Cause of the Recurrent Sinusitis
Shenoy, Vijendra; Maller, Vijetha
Introduction. An antrolith is a calcified mass within the maxillary sinus. The origin of the nidus of calcification may be extrinsic (foreign body in sinus) or intrinsic (stagnant mucus and fungal ball). Most antroliths are small and asymptomatic. Larger ones may present as sinusitis with symptoms like pain and discharge. Case Report. We report a case of a 47-year-old lady who presented with heaviness on the left side of the face and loosening of the left 2nd molar tooth since two months. CT scan of the osteomeatal complex and paranasal sinuses showed an opacification of bilateral maxillary sinus and an amorphous area of bone density in the left maxillary sinus. Because of the size of the mass, benign neoplasms were considered in the differential diagnosis. During an endoscopic sinus surgery, it was found to be an antrolith, which was successfully managed by antrostomy and Caldwell-Luc Surgery. Discussion. Antrolith is a rare condition. Rhinoliths are known to invade into the maxillary antrum, but a localised lesion in the antrum is very unusual. A case of an isolated antrolith is presented for its rarity and for differential diagnosis of localised antral disease. Conclusion. Antrolith should be considered as differential diagnosis of unilateral radio-opaque paranasal sinus lesions. PMID:23476856
Bilateral maxillary fused second and third molars: a rare occurrence.
Liang, Rui-Zhen; Wu, Jin-Tao; Wu, You-Nong; Smales, Roger J; Hu, Ming; Yu, Jin-Hua; Zhang, Guang-Dong
This case report describes the diagnosis and endodontic therapy of maxillary fused second and third molars, using cone-beam computed tomography (CBCT). A 31-year-old Chinese male, with no contributory medical or family/social history, presented with throbbing pain in the maxillary right molar area following an unsuccessful attempted tooth extraction. Clinical examination revealed what appeared initially to be a damaged large extra cusp on the buccal aspect of the distobuccal cusp of the second molar. However, CBCT revealed that a third molar was fused to the second molar. Unexpectedly, the maxillary left third molar also was fused to the second molar, and the crown of an unerupted supernumerary fourth molar was possibly also fused to the apical root region of the second molar. Operative procedures should not be attempted without adequate radiographic investigation. CBCT allowed the precise location of the root canals of the right maxillary fused molar teeth to permit successful endodontic therapy, confirmed after 6 months. PMID:23222992
Neonatal nasal obstruction and a single maxillary central incisor.
Levison, John; Neas, Katherine; Wilson, Meredith; Cooper, Peter; Wojtulewicz, Julian
We present two neonates with nasal obstruction because of anterior choanal stenosis (congenital nasal pyriform aperture stenosis). An associated single maxillary central incisor was also shown on computed tomography imaging in the neonatal period. These midline anomalies are recognized minimal manifestations (microforms) of holoprosencephaly. We describe their neonatal investigation, multidisciplinary management and clinical course. PMID:16014147
Virtual-reality distraction and cold-pressor pain tolerance: does avatar point of view matter?
Dahlquist, Lynnda M; Herbert, Linda J; Weiss, Karen E; Jimeno, Monica
This study tested the effects of distraction using virtual-reality (VR) technology on acute pain tolerance in young adults. Forty-one undergraduate students, aged 18-23 years, used a VR head-mounted display helmet, steering wheel, and foot pedal to play an auto racing video game while undergoing exposure to very cold water (cold pressor set at 1 ┬░C). Two different game views were tested that were hypothesized to affect the degree to which participants felt "present" in the virtual environment: a first-person view, in which the participant saw the virtual environment through the eyes of the game character being manipulated; and a third-person view, in which the participant viewed the game character from a distance. The length of time participants tolerated the cold-water exposure (pain tolerance) under each distraction condition was compared to a baseline (no distraction) trial. Subjects also rated the degree to which they felt "present" in the virtual environment after each distraction trial. Results demonstrated that participants had significantly higher pain tolerance during both VR-distraction conditions relative to baseline (no distraction) trials. Although participants reported a greater sense of presence during the first-person condition than the third-person condition, pain-tolerance scores associated with the two distraction conditions did not differ. The types of VR applications in which presence may be more or less important are discussed. PMID:20950186
Non-erotic cognitive distractions during sexual activity in sexual minority and heterosexual young adults.
Lacefield, Katharine; Negy, Charles
The present study examined 100 lesbian and gay college students and 100 heterosexual students to determine whether group differences exist in frequency of a range of non-erotic cognitive distractions during sexual activity. Non-erotic cognitive distraction is a descriptive term for both self-evaluative cognitions related to physical performance and body image concerns, as well as additional cognitive distractions (e.g., contracting an STI or emotional concerns) during sexual activity. Participants were matched on gender (96 males and 104 females), age, and ethnicity, and completed questionnaires assessing frequency of non-erotic cognitive distractions during sexual activity, as well as measures of additional variables (trait and body image anxiety, attitudes toward sexual minorities, self-esteem, and religiosity). Results indicated that sexual minorities experienced significantly more cognitive distractions related to body image, physical performance, and STIs during sexual activity than heterosexuals. Regarding gender, men reported more distractions related to STIs than women. Interaction effects were observed between sexual orientation and gender for body image-, disease-, and external/emotional-based distractions. Implications of these findings are discussed. PMID:21796485
Characterization of a novel bidirectional distraction spinal cord injury animal model.
Seifert, J L; Bell, J E; Elmer, B B; Sucato, D J; Romero, M I
Scoliosis corrective surgery requires the application of significant multidirectional stress forces, including distraction, for correction of the curved spine deformity and the application of fixation rods. If excessive, spine distraction may result in the development of new neurological deficits, some as severe as permanent paralysis. Current animal models of spinal cord injury, however, are limited to contusion, transection, or unidirectional distraction injuries, which fail to replicate the multidirectional forces that occur during spine corrective surgery. To address such limitation, we designed a novel device that relies on intervertebral grip fixation and linear actuators to induce controllable bidirectional distraction injuries to the spine. The device was tested in three (i.e., 3, 5, and 7 mm) distention paradigms of the rat T9-T11 vertebra, and the resulting injuries were evaluated through electrophysiological, behavioral, and histological analysis. As expected, 3mm bilateral spine distractions showed no neurological deficit. In contrast, those with 5 and 7 mm showed partial and complete paralysis, respectively. The relationship between the severity of the spine distraction and injury to the spinal cord tissue was determined using glial fibrillary acidic protein immunocytochemistry for visualization of reactive astrocytes and labeling of ED1-positive activated macrophages/microglia. Our results demonstrate that this device can produce bidirectional spine distraction injuries with high precision and control and, thus, may be valuable in contributing to the testing of neuroprotective strategies aimed at preventing unintended new neurological damage during corrective spine surgery. PMID:21334381
When aging does not increase distraction: Evidence from pure auditory and visual oddball tasks.
Leiva, Alicia; Andr├®s, Pilar; Parmentier, Fabrice B R
Past research indicates that age increases deviance distraction in cross-modal oddball tasks, but results are few and less conclusive in purely auditory oddball tasks, with 3 studies not reporting age-related increase in deviance distraction against 1 that did (d = 1.04). This study aimed to (a) examine the effect of age on deviance distraction using the largest sample size to date to ensure adequate statistical power and (b) extend the study of same-modality deviance distraction to the visual modality. We compared 42 young and 42 older adults in auditory and visual duration discrimination tasks in which stimuli were presented with rare and unexpected task-irrelevant changes in pitch (in the auditory task) or location (in the visual task). The statistical power of our experiment to detect an effect size (d) of 1.04 was .999. Our results showed deviance distraction (longer response times for deviant stimuli than for standard stimuli) in both modalities. Importantly, these effects did not vary with age. Strong support for the absence of age-related variation in deviance distraction was further demonstrated by Bayes factor analysis. We conclude that aging does not appear to increase behavioral distraction by deviant stimuli in same-modality oddball tasks. PMID:26214503
Virtual-Reality Distraction and Cold-Pressor Pain Tolerance: Does Avatar Point of View Matter?
Herbert, Linda J.; Weiss, Karen E.; Jimeno, Monica
Abstract This study tested the effects of distraction using virtual-reality (VR) technology on acute pain tolerance in young adults. Forty-one undergraduate students, aged 18ŌĆō23 years, used a VR head-mounted display helmet, steering wheel, and foot pedal to play an auto racing video game while undergoing exposure to very cold water (cold pressor set at 1┬░C). Two different game views were tested that were hypothesized to affect the degree to which participants felt ŌĆ£presentŌĆØ in the virtual environment: a first-person view, in which the participant saw the virtual environment through the eyes of the game character being manipulated; and a third-person view, in which the participant viewed the game character from a distance. The length of time participants tolerated the cold-water exposure (pain tolerance) under each distraction condition was compared to a baseline (no distraction) trial. Subjects also rated the degree to which they felt ŌĆ£presentŌĆØ in the virtual environment after each distraction trial. Results demonstrated that participants had significantly higher pain tolerance during both VR-distraction conditions relative to baseline (no distraction) trials. Although participants reported a greater sense of presence during the first-person condition than the third-person condition, pain-tolerance scores associated with the two distraction conditions did not differ. The types of VR applications in which presence may be more or less important are discussed. PMID:20950186
Methods for the Study of the Zebrafish Maxillary Barbel
LeClair, Elizabeth E.; Topczewski, Jacek
Barbels are skin sensory appendages found in fishes, reptiles and amphibians. The zebrafish, Danio rerio, develops two pairs of barbels- a short nasal pair and a longer maxillary pair. Barbel tissue contains cells of ectodermal, mesodermal and neural crest origin, including skin cells, glands, taste buds, melanocytes, circulatory vessels and sensory nerves. Unlike most adult tissue, the maxillary barbel is optically clear, allowing us to visualize the development and maintenance of these tissue types throughout the life cycle. This video shows early development of the maxillary barbel (beginning approximately one month post-fertilization) and demonstrates a surgical protocol to induce regeneration in the adult appendage (>3 months post-fertilization). Briefly, the left maxillary barbel of an anesthetized fish is elevated with sterile forceps just distal to the caudal edge of the maxilla. A fine, sterile spring scissors is positioned against the forceps to cut the barbel shaft at this level, establishing an anatomical landmark for the amputation plane. Regenerative growth can be measured with respect to this plane, and in comparison to the contralateral barbel. Barbel tissue regenerates rapidly, reaching maximal regrowth within 2 weeks of injury. Techniques for analyzing the regenerated barbel include dissecting and embedding matched pairs of barbels (regenerate and control) in the wells of a standard DNA electrophoresis gel. Embedded specimens are conveniently photographed under a stereomicroscope for gross morphology and morphometry, and can be stored for weeks prior to downstream applications such as paraffin histology, cryosectioning, and/or whole mount immunohistochemistry. These methods establish the maxillary barbel as a novel in vivo tissue system for studying the regenerative capacity of multiple cell types within the genetic context of zebrafish. PMID:19935639
Automating skeletal expansion: An implant for distraction osteogenesis of the mandible
Magill, John C.; Byl, Marten F.; Goldwaser, Batya; Papadaki, Maria; Kromann, Roger; Yates, Brent; Morency, Joseph R.; Kaban, Leonard B.; Troulis, Maria J.
Background Distraction osteogenesis (DO) is a technique of bone lengthening that makes use of the bodyŌĆÖs natural healing capacity. An osteotomy is created and a rigid distraction device is attached to the bone. After a latency period, the device is activated 2ŌĆō4 times per day for a total of 1 mm/day of bone lengthening. This technique is used to correct a variety of congenital and acquired deformities of the mandible, midface and long bones. To shorten the treatment period and to eliminate the complications of patient activation of the device, an automated continuous distraction device would be desirable. It has been reported that continuous distraction generates adequate bone with lengthening at a rate of 2 mm/day, thereby reducing the treatment time. Method of Approach The device we describe here uses miniature high-pressure hydraulics, position feedback, and a digital controller to achieve closed-loop control of the distraction process. The implanted actuator can produce up to 40N of distraction force on linear trajectories as well as curved distraction paths. In the paper we detail the spring-powered hydraulic reservoir, controller, and user interface. Results Experiments to test the new device design were performed in a porcine cadaver head and in live pigs. In the cadaver head, the device performed an 11-day/11 mm distraction with a root-mean-squared position error of 0.09 mm. The device functioned for periods of several days in each of five live animals, though some component failures occurred, leading to design revisions. Conclusions The test series showed that the novel design of this system provides the capabilities necessary to automate distraction of the mandible. Further developments will focus on making the implanted position sensor more robust and then carrying out clinical trials. PMID:20740071
Stem Cells Rejuvenate Radiation-Impaired Vasculogenesis in Murine Distraction Osteogenesis
Deshpande, Sagar S.; Gallagher, Kathleen K.; Donneys, Alexis; Nelson, Noah S.; Guys, Nicholas P.; Felice, Peter A.; Page, Erin E.; Sun, Hongli; Krebsbach, Paul H.; Buchman, Steven R.
Background Radiotherapy is known to be detrimental to bone and soft-tissue repair. Bone marrow stromal cells have been shown to enhance bone regeneration during distraction osteogenesis following radiation therapy. The authors posit that transplanted bone marrow stromal cells will significantly augment the mandibular vascularity devastated by radiation therapy. Methods Nineteen male Lewis rats were split randomly into three groups: distraction osteogenesis only (n = 5), radiation therapy plus distraction osteogenesis (n = 7), and radiation therapy plus distraction osteogenesis with intraoperative placement of 2 million bone marrow stromal cells (n = 7). A mandibular osteotomy was performed, and an external fixator device was installed. From postoperative days 4 through 12, rats underwent a gradual 5.1-mm distraction followed by a 28-day consolidation period. On postoperative day 40, Microfil was perfused into the vasculature and imaging commenced. Vascular radiomorphometric values were calculated for regions of interest. An analysis of variance with post hoc Tukey or Games-Howell tests was used, dependent on data homogeneity. Results Stereologic analysis indicated significant remediation in vasculature in the bone marrow stromal cell group compared with the radiation therapy/distraction osteogenesis group. Each of five metrics idicated significant improvements from radiation therapy/distraction osteogenesis to the bone marrow stromal cell group, with no difference between the bone marrow stromal cell group and the distraction osteogenesis group. Conclusions Bone marrow stromal cells used together with distraction osteogenesis can rejuvenate radiation-impaired vasculogenesis in the mandible, reversing radiation therapyŌĆōinduced isotropy and creating a robust vascular network. Bone marrow stromal cells may offer clinicians an alternative reconstructive modality that could improve the lifestyle of patients with hypovascular bone. PMID:25415276
Treatment of lateral open bite with vertical dentoalveolar distraction osteogenesis.
Aras, I┼¤─▒l; Olmez, Sultan; Akay, Mehmet Cemal; Ozt├╝rk, Veli Ozgen; Aras, Aynur
The aim of this article is to describe the surgical, orthodontic, and periodontal treatment of an adult patient with a lateral open bite, anterior crowding, and gingival recession on the mandibular right lateral incisor. The lateral open bite, which resisted conventional mechanics, was successfully corrected by the combination of dento-osseous osteotomies and vertical alveolar distraction using orthodontic multibracket appliances in conjunction with nickel-titanium archwires and intermaxillary elastics. After the orthodontic treatment, the denuded root surface of the mandibular right lateral incisor was closed using a coronally advanced flap technique with platelet-rich fibrin. The results at the 2-year posttreatment follow-up were satisfactory from both the occlusal and the periodontal standpoints. PMID:26232841
Inhibitory Control During Emotional Distraction Across Adolescence and Early Adulthood
Cohen-Gilbert, Julia E.; Thomas, Kathleen M.
This study investigated the changing relation between emotion and inhibitory control during adolescence. One hundred participants between 11 and 25 years of age performed a go-nogo task in which task-relevant stimuli (letters) were presented at the center of large task-irrelevant images depicting negative, positive, or neutral scenes selected from the International Affective Picture System. Longer reaction times for negative trials were found across all age groups, suggesting that negative but not positive emotional images captured attention across this age range. However, age differences in accuracy on inhibitory trials suggest that response inhibition is more readily disrupted by negative emotional distraction in early adolescence relative to late childhood, late adolescence or early adulthood. PMID:23506340
The effects of coping style on virtual reality enhanced videogame distraction in children undergoing cold pressor pain.
Sil, Soumitri; Dahlquist, Lynnda M; Thompson, Caitlin; Hahn, Amy; Herbert, Linda; Wohlheiter, Karen; Horn, Susan
This study sought to evaluate the effectiveness of virtual reality (VR) enhanced interactive videogame distraction for children undergoing experimentally induced cold pressor pain and examined the role of avoidant and approach coping style as a moderator of VR distraction effectiveness. Sixty-two children (6-13┬Āyears old) underwent a baseline cold pressor trial followed by two cold pressor trials in which interactive videogame distraction was delivered both with and without a VR helmet in counterbalanced order. As predicted, children demonstrated significant improvement in pain tolerance during both interactive videogame distraction conditions. However, a differential response to videogame distraction with or without the enhancement of VR technology was not found. Children's coping style did not moderate their response to distraction. Rather, interactive videogame distraction with and without VR technology was equally effective for children who utilized avoidant or approach coping styles. PMID:23184062
Effects of first premolar extraction on maxillary and mandibular third molar angulation after orthodontic therapy
Gohilot, Avinash; Pradhan, Tejashri; Keluskar, Kanhoba Mahabaleshwar
Background/Aims To compare the change in the angulation of developing mandibular third molar in both first premolar extraction and non-extraction cases and to determine whether premolar extraction results in a more mesial movement of the mandibular buccal segment and causes favorable rotational changes in the mandibular third molar tilt, which can enhance later eruption of the third molars. Materials and methods Pretreatment (T1) and post treatment (T2) panoramic radiographs were taken of 25 subjects (age 14ŌĆō19 years) who had been treated by the extraction of all the first premolars and 25 subjects who had been treated with non-extraction. The horizontal reference plane was used to measure and compare the changes in the angles of the developing mandibular third molars. Results The mean uprighting of the maxillary third molars seen in the extraction group was 4┬Ā┬▒┬Ā9┬░ on the left side and ŌłÆ17┬Ā┬▒┬Ā13┬░ on the right side following treatment (T2 _ T1). For the non-extraction group the mean difference was ŌłÆ16┬Ā┬▒┬Ā12┬░ on the left side and 2┬Ā┬▒┬Ā13┬░ on the right side. There was a statistically significant difference between the groups (P _ 0.021 on the right side and P _ 0.041 on the left side). Mandibular 3rd molars in extraction group showed no statistical significant change in the angulation. Conclusion Premolar extractions had a positive influence on the developing maxillary third molar angulations both on right and left. Mandibular 3rd molar have shown change in the angulation but not statistically significant. Non-extraction therapy did not have any adverse effect. PMID:25737843
The effect of a safe zone on nurse interruptions, distractions, and medication administration errors.
Yoder, Mindy; Schadewald, Diane; Dietrich, Kim
Patient safety is a health care priority. Yet medical errors are ranked the eighth leading cause of death. Medication administration errors (MAEs) often result from multiple environmental and individual factors. This quality improvement initiative adapted a protocol based on airline industry safety measures to decrease nurse distractions and interruptions during medication administration, with the goal of decreasing MAEs. Sources of distractions, interruptions, and MAEs were measured pre and post intervention. Patient satisfaction scores were measured concurrently. Results of this initiative differ from previous studies in which similar interventions reduced both distractions and MAEs. An unexpected finding was dramatically increased patient satisfaction. PMID:25723837
Distraction techniques for children undergoing procedures: a critical review of pediatric research.
Koller, Donna; Goldman, Ran D
Pediatric patients are often subjected to procedures that can cause pain and anxiety. Although pharmacologic interventions can be used, distraction is a simple and effective technique that directs children's attention away from noxious stimuli. However, there is a multitude of techniques and technologies associated with distraction. Given the range of distraction techniques, the purpose of this article was to provide a critical assessment of the evidence-based literature that can inform clinical practice and future research. Recommendations include greater attention to child preferences and temperament as a means of optimizing outcomes and heightening awareness around child participation in health care decision making. PMID:21925588
Achieving the prediction results by visualized treatment objective following anterior maxillary segmental osteotomy. A retrospective study.
Venkatesh, V; Kumar, K A Jeevan; Mohan, A P; Kumar, B Pavan; Kunusoth, Ramesh; Kumar, M Pavan
This study used the manual visualized treatment objectives (VTO) as a tool to evaluate the predictive value of the computer-assisted VTO. Presurgical cephalometric tracing predictions generated by oral and maxillofacial surgeons and computer-assisted VTOs were compared with the postsurgical outcome as seen on lateral cephalometric tracings. Ten measurements of the predicted and actual postsurgical hard tissue landmarks were compared statistically. A paired Student's t test showed that in nine of ten measurements, there were no statistically significant differences in the mean values of manual VTO (MVTO). Statistically significant differences were found in one of the four linear measurements (cant of upper lip P┬Ā-┬Ā0.0001). For computer assisted (CAVTO) Student's t test showed that in nine of ten measurements, there were no statistically significant differences in the mean values. Statistically significant differences were found in one of the four linear measurements (nasolabial angle, P ┬Ā-┬Ā0.0001). From these data, it appears that both VTOs demonstrated good predictive comparative outcome, and are equally predictive, but CAVTO is precise. PMID:24431838
Not all distraction is bad: working memory vulnerability to implicit socioemotional distraction correlates with negative symptoms and functional impairment in psychosis.
Mano, Quintino R; Brown, Gregory G; Mirzakhanian, Heline; Bolden, Khalima; Cadenhead, Kristen S; Light, Gregory A
This study investigated implicit socioemotional modulation of working memory (WM) in the context of symptom severity and functional status in individuals with psychosis (N = 21). A delayed match-to-sample task was modified wherein task-irrelevant facial distracters were presented early and briefly during the rehearsal of pseudoword memoranda that varied incrementally in load size (1, 2, or 3 syllables). Facial distracters displayed happy, sad, or emotionally neutral expressions. Implicit socioemotional modulation of WM was indexed by subtracting task accuracy on nonfacial geometrical distraction trials from facial distraction trials. Results indicated that the amount of implicit socioemotional modulation of high WM load accuracy was significantly associated with negative symptoms (r = 0.63, P < 0.01), role functioning (r = -0.50, P < 0.05), social functioning (r = -0.55, P < 0.01), and global assessment of functioning (r = -0.53, P < 0.05). Specifically, greater attentional distraction of high WM load was associated with less severe symptoms and functional impairment. This study demonstrates the importance of the WM-socioemotional interface in influencing clinical and psychosocial functional status in psychosis. PMID:24724026
Le Fort II midfacial distraction combined with orthognathic surgery in the treatment of nasomaxillary hypoplasia.
Yu, Hongbo; Dai, Jiewen; Wang, Xudong; Zhang, Wenbin; Shen, Steve Guofang
Patients with nasomaxillary hypoplasia have severe facial concavity and compromised skeletal class III malocclusion. Its treatment is still a challenge to surgeons. Our aim was to evaluate the combination of midfacial distraction and orthognathic surgery in the treatment of nasomaxillary hypoplasia. Four patients with nasomaxillary hypoplasia were enrolled in this study. After Le Fort II osteotomy, the rotational distraction of nasomaxillary complex was performed to rehabilitate facial convexity. Then bilateral sagittal split ramus osteotomy with or without Le Fort I osteotomy was used to correct malocclusion. All patients healed uneventfully, and the maxillae moved forward conspicuously. No obvious pain and severe discomfort were complained during distraction. A significant advancement and downward movement of the maxilla were shown by cephalometric analysis. The combination of midfacial distraction and orthognathic surgery provides us an ideal alternative in the treatment of nasomaxillary hypoplasia. PMID:24777005
Le Fort IV + I distraction osteogenesis using an internal device for syndromic craniosynostosis.
Sakamoto, Yoshiaki; Nakajima, Hideo; Tamada, Ikkei; Sakamoto, Teruo
Monobloc and Le Fort III distractions can improve midfacial hypoplasia, a characteristic feature of syndromic craniosynostosis. The purpose of treating midfacial hypoplasia is to improve exophthalmos and dental occlusion. Typically, in Le Fort III or monobloc distractions, the midface is mobilized en bloc, and the extent and direction of the mobilization is determined according to the preferred intermaxillary occlusion. However, to obtain the preferred functional and esthetic results while correcting midface hypoplasia, the most sensible approach is the use of different degrees of mobilization and vectors for the upper and lower halves of the midface. This report describes the case of an adolescent with Crouzon syndrome showing frontal recession exophthalmos and an anterior crossbite. His condition was treated with monobloc minus Le Fort I and Le Fort I distraction using only internal devices, which the authors have designated Le Fort IV plus I distraction. PMID:24280175
Driver distraction: a perennial but preventable public health threat to adolescents.
Bingham, C Raymond
Although public health efforts have made some progress in reducing risk of adolescent motor vehicle crashes over the last three decades, new technologies and evolving behavior patterns have focused attention on the risk of distracted driving. For many of the same reasons that alcohol-impaired driving represents a distinct risk for adolescents, distracted driving has an elevated impact on this age group. Similarly, many of the strategies used to reduce alcohol-impaired driving among adolescents might be applied to driver distraction, including adults serving as role models with high standards of behavior. The unique challenge posed by the proliferation of new technological distractions may accelerate this risk behavior and may lend itself to innovative prevention efforts. PMID:24759438
[Rumination and distraction: selected findings related to the response styles theory].
Teismann, Tobias; Steinfeld, Beate; Willutzki, Ulrike; Michalak, Johannes
The response styles theory by Nolen-Hoeksema suggests that rumination in response to depressed mood exacerbates and prolongs depression, while distraction ameliorates it. This article reviews experimental, cross-sectional and longitudinal studies on the association between rumination, distraction and depressed affect. Furthermore studies on the influence of ruminative and distractive responses to the treatment of depressed patients are presented. Summarizing research results it can be said, that rumination puts persons at risk of experiencing intensified symptoms of depression as well as the onset of a major depressive episode. Whereas laboratory studies have reliably shown that inducing distractive responses reduces negative affect - cross-sectional and longitudinal studies have not produced clear or consistent results. Research results, research methodology and the scope of response styles theory are discussed. PMID:20225165
Nagashima, Lucy K; Newby, Michelle Rondon; Zakhary, Ibrahim E; Nagy, William W; Zapata, Uriel; Dechow, Paul C; Opperman, Lynne A; Elsalanty, Mohammed E
Purpose Bone transport distraction osteogenesis (BTDO) provides a promising alternative to traditional grafting techniques. However, existing BTDO devices have many limitations. The purpose of this research was to test a new device, the mandibular bone transport reconstruction plate (BTRP), in an animal model with comparable mandible size to humans and to histologically and mechanically examine the regenerate bone. Materials and methods Eleven adult foxhound dogs were divided into an unreconstructed control group of 5 animals, and an experimental group of 6 animals. In each animal, a 34 mm segmental defect was created in the mandible. The defect was reconstructed with BTRP. Histological and biomechanical characteristics of the regenerate and un-repaired defect were analyzed and compared to bone on the contralateral side of the mandible after 4 weeks of consolidation. Results The reconstructed defect was bridged with new bone, with little bone in the control defect. Regenerate density and microhardness were 22.3% and 42.6% lower than the contralateral normal bone, respectively. Likewise, the anisotropy of the experimental group was statistically lower than in the contralateral bone. Half the experimental animals showed non-union at the docking site. Conclusion The device was very stable and easy to install and activate. After one month of consolidation, the defect has been bridged with new bone with evidence of active bone formation. Regenerate bone was less mature than the control bone. Studies are underway to identify when the regenerate properties compare to normal bone, and to identify methods to augment bone union at the docking site. PMID:21601342
Matching Doses of Distraction With Child Risk for Distress During a Medical Procedure
McCarthy, Ann Marie; Kleiber, Charmaine; Hanrahan, Kirsten; Zimmerman, M. Bridget; Ersig, Anne; Westhus, Nina; Allen, Susan
Background Parents often want to provide support to their children during medical procedures, but not all parents are effective in providing distraction after brief training. Objective The aim of this study was to investigate the effects of three doses of distraction intervention for children at high and medium risk for procedure-related distress. Methods Children undergoing scheduled intravenous insertions for diagnostic or treatment purposes and their parents participated. A computerized application, Children, Parents and Distraction, was used to predict distress risk. Doses of intervention were basic (parents trained on providing distraction), enhanced (basic training plus tailored instructions, environmental modifications, and support and guidance from the research assistant), and professional (a trained research assistant provided distraction). Outcome measures were Observational Scale of Behavioral Distress-Revised for behavioral distress, Oucher for self-reported pain, parent report of child distress, and salivary cortisol for physiological distress. Results A total of 574 children, ages 4ŌĆō10, and their parents participated. The Children, Parents and Distraction predicted that the risk for distress was high for 156 children, medium for 372, and low for 46. Children predicted to have higher risk for distress displayed more behavioral distress (p < .01). Children in the medium-risk group who had the professional intervention displayed significantly less behavioral distress (p < .001). Children in the high-risk group tended to have less behavioral distress when receiving the professional intervention (p = .07). There were no significant group differences for self-report of pain, parent report of distress, or cortisol levels. Discussion Some parents may need additional training in providing distraction to their children during procedures, and some children at medium and high risk for distress may need professional support. Parents should be asked about their preferences in acting as the distraction coach and, if willing, be provided as much training and support as possible in the clinical situation. PMID:25350539
Computer-Simulated Arthroscopic Knee Surgery: Effects of Distraction on Resident Performance.
Cowan, James B; Seeley, Mark A; Irwin, Todd A; Caird, Michelle S
Orthopedic surgeons cite "full focus" and "distraction control" as important factors for achieving excellent outcomes. Surgical simulation is a safe and cost-effective way for residents to practice surgical skills, and it is a suitable tool to study the effects of distraction on resident surgical performance. This study investigated the effects of distraction on arthroscopic knee simulator performance among residents at various levels of experience. The authors hypothesized that environmental distractions would negatively affect performance. Twenty-five orthopedic surgery residents performed a diagnostic knee arthroscopy computer simulation according to a checklist of structures to identify and tasks to complete. Participants were evaluated on arthroscopy time, number of chondral injuries, instances of looking down at their hands, and completion of checklist items. Residents repeated this task at least 2 weeks later while simultaneously answering distracting questions. During distracted simulation, the residents had significantly fewer completed checklist items (P<.02) compared with the initial simulation. Senior residents completed the initial simulation in less time (P<.001), with fewer chondral injuries (P<.005) and fewer instances of looking down at their hands (P<.012), compared with junior residents. Senior residents also completed 97% of the diagnostic checklist, whereas junior residents completed 89% (P<.019). During distracted simulation, senior residents continued to complete tasks more quickly (P<.006) and with fewer instances of looking down at their hands (P<.042). Residents at all levels appear to be susceptible to the detrimental effects of distraction when performing arthroscopic simulation. Addressing even straightforward questions intraoperatively may affect surgeon performance. [Orthopedics. 2016; 39(2):e240-e245.]. PMID:26811955
Cementoblastoma Solely Involving Maxillary Primary Teeth--A Rare Presentation.
Urs, Aadithya B; Singh, Hanspal; Rawat, Garima; Mohanty, Sujata; Ghosh, Sujoy
Cementoblastoma is a rare benign neoplasm of odontogenic ectomesenchyme origin, involving the roots of any tooth, which occurs predominantly in second and third decade of life. Very few cases of cementoblastoma associated with a primary tooth or having a maxillary presentation have been reported in the past. Here, a rare case of a ten year old boy who presented to the department with a swelling in maxillary posterior region since one month is being discussed. The radiographic presentation was mimicking an odontoma. The final diagnosis was cementoblastoma. We have advocated the use of polarized microscopy to support the histopathological diagnosis with respect to its cemental origin. Cementoblastoma should be considered in the differential diagnosis of radio-opaque lesions in the transitional dentition. PMID:26950817
Primary sclerosing fibroinflammatory pseudotumor of the maxillary sinus.
Vivero, Richard J; Doshi, Pooja H; Eloy, Jean Anderson; Gomez-Fernandez, Carmen; Casiano, Roy R
Inflammatory pseudotumor is a well known but poorly understood pathologic entity. It is associated with an unusual growth of fibrotic tissue admixed with varying amounts of inflammation that displaces and compresses normal anatomic structures, resulting in dysfunction. Pseudotumors have been found in multiple locations-the orbit in particular-but to the best of our knowledge, none has previously been reported as an isolated sinus lesion. We describe a case of primary sclerosing fibroinflammatory pseudotumor of the maxillary sinus that manifested as recurrent unilateral maxillary sinusitis in a 47-year-old woman. The patient was managed with surgery and oral steroids with full resolution of her symptoms. We also review the presentation, diagnosis, and treatment of fibroinflammatory pseudotumors within the context of the current literature. PMID:22180112
Intraoperative assessment of maxillary perfusion during Le Fort I osteotomy.
Dodson, T B; Neuenschwander, M C; Bays, R A
Intraoperative maxillary blood flow was measured using laser Doppler flowmetry (LDF) in two groups of patients undergoing orthognathic surgery. Group 1 (n = 14) consisted of patients undergoing Le Fort I osteotomy and group 2 (n = 8) consisted of patients undergoing isolated mandibular osteotomies. In group 1, the mean gingival blood flow (GBF) decreased significantly over time during the course of the operation from 29.5 mL/min/100 g of tissue to 13.2 mL/min/100 g of tissue (P = .0001). The mean GBF did not change significantly over time in group 2 (P = .39). The results of this study demonstrate that 1) LDF may be used to measure intraoperative GBF during Le Fort I osteotomy with an acceptable level of variability, and 2) maxillary GBF decreased significantly over time during Le Fort I osteotomy procedures. PMID:8040736
Fragment Reattachment after Atypical Crown Fracture in Maxillary Central Incisor
Vaz, Vanessa Torraca Peraro; Presoto, Cristina Dupim; Jord├Żo, Keren Cristina Fagundes; Paleari, Andr├® Gustavo; Dantas, Andrea Abi-Rached; Segalla, Jos├® Claudio Martins; de Oliveira Junior, Osmir Batista
Background. Fracture by trauma is one of the most common types of dental injury in the permanent dentition among children and teenagers. Aim. The aim of this study was to report the treatment performed to an atypical dental trauma case in a maxillary central incisor of a young patient by means of reattachment of the tooth fragment. Case Description. A 12-year-old male patient suffered a vertical crown fracture to the maxillary right central incisor. After clinical and radiographic examinations, a conservative restorative treatment which consisted in the reattachment of the tooth fragment with flow resin was performed in order to preserve the dental element and to obtain maximum aesthetics. Conclusion. The reattachment of fractured fragment is a fast and easy technique that can be used successfully as an option to restore dental element which suffered trauma. Clinical Significance. This technique restores the aesthetics and function of the dental element with minimal discomfort to the patient. PMID:25610663
[Dissertations 25 years after date 26. Maxillary sutural surfaces].
Remmelink, H J
In the case of growing children with a deviation in the size or position of the upper jaw orthopaedic devices are often used to direct the growth at the level of the sutures. In the PhD thesis 'The postnatal development of the human maxillary sutural surfaces', published in 1985, the orientation and macroscopic morphology of the sutural surfaces of the maxilla in children's skulls were described. The existence of premaxillomaxillary and pterygomaxillary sutures could not be demonstrated. It was observed that the maxillary sutural surfaces were mainly sagittally oriented. Some sutural surfaces became increasingly rough with age, while the majority of the surfaces remained smooth. It was concluded that advice concerning the determination of the direction of orthopaedic forces in relation to the orientation of the sutures needed revision. Subsequent systematic reviews have reported that so far little is known about the long-term stability of orthopaedic effects in orthodontics. PMID:21761798
Ectopic primary olfactory neuroblastoma of the maxillary sinus.
Holmes, Margaret; Su, Shirley Y; Bell, Diana
Olfactory neuroblastoma (ONB) is a rare malignant tumor. Although the vast majority of cases arise in the nasal cavity, ONB is rarely reported in ectopic locations. We report a case of ONB in the maxillary sinus. A 63-year-old woman presented with left-sided nasal obstruction and epistaxis. Magnetic resonance imaging showed a nonenhancing left maxillary sinus tumor. Histologic sections showed ONB, Hyams grade IV, invading bone, skeletal muscle, and adjacent fibroadipose tissue. It is essential to be accurate when diagnosing sinonasal tumors because the differential diagnosis is broad, and one must consider the possibility of ectopic ONB, although it is rare. The behavior of ONB and other neuroendocrine tumors of the sinonasal region is quite different, and there are varied approaches to treatment. Therefore, an accurate diagnosis as well as correct grade and stage must be assigned. PMID:27180059
Maxillary Swelling as the First Evidence of Multiple Myeloma
Kasamatsu, Atsushi; Kimura, Yasushi; Tsujimura, Hideki; Kanazawa, Harusachi; Koide, Nao; Miyamoto, Isao; Endo-Sakamoto, Yosuke; Shiiba, Masashi; Tanzawa, Hideki; Uzawa, Katsuhiro
Multiple myeloma is a malignant neoplasm of plasma cells characterized by proliferation of a single clone of abnormal immunoglobulin-secreting plasma cells. Since the amount of hemopoietic bone marrow is decreased in the maxilla, oral manifestations of multiple myeloma are less common in the maxilla than in the mandible. We report the case of 33-year-old Japanese man who presented with a mass in the right maxillary alveolar region. Computed tomography and magnetic resonance images showed a soft tissue mass in the right maxilla eroding the anterior and lateral walls of the maxillary sinus and extending into the buccal space. The biopsy results, imaging, and laboratory investigations led to the diagnosis of multiple myeloma. This case report suggests that oral surgeons and dentists should properly address oral manifestations as first indications of multiple myeloma. PMID:26640721
Bioresorbable distraction device for the treatment of airway problems for infants with Robin sequence.
Breugem, Corstiaan; Paes, Emma; Kon, Moshe; Mink van der Molen, Aebele B; van der Molen, Aebele B Mink
Pierre Robin sequence is a well known craniofacial entity. There are numerous ways to treat the respiratory insufficiency, but sometimes surgical intervention is needed. Tracheotomy could be associated with morbidity, and distraction osteogenesis has been established as a stable method to obtain a safe airway. Distraction osteogenesis has traditionally been performed with an external device. In this manuscript we describe the feasibility of an internal bioresorbable device. Retrospective descriptive study was performed in a tertiary academic children's hospital. After multidisciplinary team consultation, 12 consecutive patients with Robin sequence were treated with this internal distraction device. The mean age at surgery was 32 days, and the average amount of mandibular distraction was 18 mm. All patients were extubated after an average of 7.5 days after the surgery. The average length of stay in the hospital was 17 days after surgery. There were no major surgical complications. A tracheotomy was prevented in all our patients, and complications were limited. Long-term studies are needed to evaluate the influence that internal distraction has on the growth of the mandible and teeth. The internal distraction system seems safe for infants with micrognathia and has certain benefits when compared to the external distractor. PMID:22009183
A Mobile App Offering Distractions and Tips to Cope With Cigarette Craving: A Qualitative Study
Smith, Wally; Pearce, Jon; Borland, Ron
Background Despite considerable effort, most smokers relapse within a few months after quitting due to cigarette craving. The widespread adoption of mobile phones presents new opportunities to provide support during attempts to quit. Objective To design and pilot a mobile app "DistractMe" to enable quitters to access and share distractions and tips to cope with cigarette cravings. Methods A qualitative study with 14 smokers who used DistractMe on their mobiles during the first weeks of their quit attempt. Based on interviews, diaries, and log data, we examined how the app supported quitting strategies. Results Three distinct techniques of coping when using DistractMe were identified: diversion, avoidance, and displacement. We further identified three forms of engagement with tips for coping: preparation, fortification, and confrontation. Overall, strategies to prevent cravings and their effects (avoidance, displacement, preparation, and fortification) were more common than immediate coping strategies (diversion and confrontation). Tips for coping were more commonly used than distractions to cope with cravings, because they helped to fortify the quit attempt and provided opportunities to connect with other users of the application. However, distractions were important to attract new users and to facilitate content sharing. Conclusions Based on the qualitative results, we recommend that mobile phone-based interventions focus on tips shared by peers and frequent content updates. Apps also require testing with larger groups of users to assess whether they can be self-sustaining. PMID:25099632
The congruency sequence effect emerges when the distracter precedes the target.
Weissman, Daniel H; Egner, Tobias; Hawks, Zoë; Link, Jacqueline
The congruency effect in distracter interference tasks is typically smaller when the previous trial was incongruent as compared to congruent, suggesting the operation of a control process that minimizes the influence of irrelevant stimuli on behavior. However, both the conditions under which this congruency sequence effect (CSE) can be most easily observed without the typical learning and memory confounds, and the control process underlying it, remain controversial. We therefore tested a recent hypothesis that the CSE is most easily observed without the typical confounds when the distracter is processed before the target. In line with this "distracter head start" hypothesis, in Experiments 1 and 2 the CSE was larger when the distracter appeared before, relative to with, the target. Further, in Experiment 3, we observed a negative congruency effect after incongruent trials when a long interval separated the distracter from the target, consistent with a modulation of the response engendered by the distracter but not with a shift of attention toward the target. These findings reveal an important determinant of CSE magnitude when the typical learning and memory confounds are absent and new insights into the nature of control processes that contribute to this phenomenon. PMID:25616120
The effects of distraction on exercise and cold pressor tolerance for chronic low back pain sufferers.
Johnson, M H; Petrie, S M
Distraction has been found to be effective for the attenuation of experimental and acute clinical pain but its efficacy for chronic pain management remains unclear. There are even some suggestions that distraction may be a counterproductive strategy for chronic pain sufferers. In this study we found that a word shadowing distraction task increased the ability of a group of 12 female and eight male chronic low back pain (CLBP) sufferers to carry out a brief (maximum 300 s) step-up exercise that temporarily increased their pain (P < 0.05). This 15% increase in exercise time was not accompanied by an increase in reported pain after the exercise. Interestingly, the same distraction task did not increase the cold pressor (CP) tolerance time for the CLBP group but produced a 26% increase in tolerance time for a pain-free control group consisting of nine females and nine males (P < 0.05). Also, performance on the distraction task during the CP was worse for the CLBP group than the controls (P < 0.05). Although these findings should be interpreted cautiously because of the parameters of the experiment, they do suggest that distraction is a potentially useful technique to assist chronic pain sufferers. PMID:9060011
When Distraction Holds Relevance: A Prospective Memory Benefit for Older Adults.
Louren├¦o, Joana S; Maylor, Elizabeth A
Evidence is accumulating to show that age-related increases in susceptibility to distracting information can benefit older more than young adults in several cognitive tasks. Here we focus on prospective memory (i.e., remembering to carry out future intentions) and examine the effect of presenting distracting information that is intention-related as a function of age. Young and older adults performed an ongoing 1-back working memory task to a rapid stream of pictures superimposed with to-be-ignored letter strings. Participants were additionally instructed to respond to target pictures (namely, animals) and, for half of the participants, some strings prior to the targets were intention-related words (i.e., animals). Results showed that presenting intention-related distracting information during the ongoing task was particularly advantageous for target detection in older compared to young adults. Moreover, a prospective memory benefit was observed even for older adults who showed no explicit memory for the target distracter words. We speculate that intention-related distracter information enhanced the accessibility of the prospective memory task and suggest that when distracting information holds relevance to intentions it can serve a compensatory role in prospective remembering in older adults. PMID:26067988
The Molecular and Cellular Events That Take Place during Craniofacial Distraction Osteogenesis
Rachmiel, Adi
Summary: Gradual bone lengthening using distraction osteogenesis principles is the gold standard for the treatment of hypoplastic facial bones. However, the long treatment time is a major disadvantage of the lengthening procedures. The aim of this study is to review the current literature and summarize the cellular and molecular events occurring during membranous craniofacial distraction osteogenesis. Mechanical stimulation by distraction induces biological responses of skeletal regeneration that is accomplished by a cascade of biological processes that may include differentiation of pluripotential tissue, angiogenesis, osteogenesis, mineralization, and remodeling. There are complex interactions between bone-forming osteoblasts and other cells present within the bone microenvironment, particularly vascular endothelial cells that may be pivotal members of a complex interactive communication network in bone. Studies have implicated number of cytokines that are intimately involved in the regulation of bone synthesis and turnover. The gene regulation of numerous cytokines (transforming growth factor-╬▓, bone morphogenetic proteins, insulin-like growth factor-1, and fibroblast growth factor-2) and extracellular matrix proteins (osteonectin, osteopontin) during distraction osteogenesis has been best characterized and discussed. Understanding the biomolecular mechanisms that mediate membranous distraction osteogenesis may guide the development of targeted strategies designed to improve distraction osteogenesis and accelerate bone regeneration that may lead to shorten the treatment duration. PMID:25289295
The effect of distraction strategies on pain perception and the nociceptive flexor reflex (RIII reflex).
Ruscheweyh, Ruth; Kreusch, Annette; Albers, Christoph; Sommer, Jens; Marziniak, Martin
Distraction from pain reduces pain perception, and imaging studies have suggested that this may at least partially be mediated by activation of descending pain inhibitory systems. Here, we used the nociceptive flexor reflex (RIII reflex) to directly quantify the effects of different distraction strategies on basal spinal nociception and its temporal summation. Twenty-seven healthy subjects participated in 3 distraction tasks (mental imagery, listening to preferred music, spatial discrimination of brush stimuli) and, in a fourth task, concentrated on the painful stimulus. Results show that all 3 distraction tasks reduced pain perception, but only the brush task also reduced the RIII reflex. The concentration-on-pain task increased both pain perception and the RIII reflex. The extent of temporal summation of pain perception and the extent of temporal summation of the RIII reflex were not affected by any of the tasks. These results suggest that some, but not all, forms of pain reduction by distraction rely on descending pain inhibition. In addition, pain reduction by distraction seems to preferentially affect mechanisms of basal nociceptive transmission, not of temporal summation. PMID:21925793
Results of distraction callus osteogenesis in hand and foot in Iran: A 15-year experience
Forootan, Kamal Seyed; Forootan, Nazila Seyed; Lebaschi, Amir Hussein
Background: Distraction osteogenesis (DS) is currently an important technique for lengthening shortened bones of the hand and foot. Authors report their experience in applying DS for various conditions of the hand and foot using a distractor that the senior author has designed. Materials and Methods: Records of patients who underwent DS for hand and foot conditions in a private clinic were retrieved between January 2001 and January 2015. Data concerning distraction, outcome, and complications were recorded. Results: There were 17 patients, 7 males, and 10 females with a total 24 distractions. The mean length gained was 21.2 mm (1.69) and the mean total treatment time was 198.58 (15.88) days. Overall, complications occurred in 9 (37.5%) distractions. Major complications occurred in 2 (8.33%) of distractions. Minor complications occurred in 7 (29.2%) distractions. Conclusion: DS is an effective modality for lengthening bones of the hand and feet for both traumatic and congenital conditions. Joint stiffness/contracture is an important complication following DS of the metatarsals. PMID:26487873
When Distraction Holds Relevance: A Prospective Memory Benefit for Older Adults
Louren├¦o, Joana S.; Maylor, Elizabeth A.
Evidence is accumulating to show that age-related increases in susceptibility to distracting information can benefit older more than young adults in several cognitive tasks. Here we focus on prospective memory (i.e., remembering to carry out future intentions) and examine the effect of presenting distracting information that is intention-related as a function of age. Young and older adults performed an ongoing 1-back working memory task to a rapid stream of pictures superimposed with to-be-ignored letter strings. Participants were additionally instructed to respond to target pictures (namely, animals) and, for half of the participants, some strings prior to the targets were intention-related words (i.e., animals). Results showed that presenting intention-related distracting information during the ongoing task was particularly advantageous for target detection in older compared to young adults. Moreover, a prospective memory benefit was observed even for older adults who showed no explicit memory for the target distracter words. We speculate that intention-related distracter information enhanced the accessibility of the prospective memory task and suggest that when distracting information holds relevance to intentions it can serve a compensatory role in prospective remembering in older adults. PMID:26067988
Trends in Fatalities From Distracted Driving in the United States, 1999 to 2008
Stimpson, Jim P.
Objectives. We examined trends in distracted driving fatalities and their relation to cell phone use and texting volume. Methods. The Fatality Analysis Reporting System (FARS) records data on all road fatalities that occurred on public roads in the United States from 1999 to 2008. We studied trends in distracted driving fatalities, driver and crash characteristics, and trends in cell phone use and texting volume. We used multivariate regression analysis to estimate the relation between state-level distracted driving fatalities and texting volumes. Results. After declining from 1999 to 2005, fatalities from distracted driving increased 28% after 2005, rising from 4572 fatalities to 5870 in 2008. Crashes increasingly involved male drivers driving alone in collisions with roadside obstructions in urban areas. By use of multivariate analyses, we predicted that increasing texting volumes resulted in more than 16 000 additional road fatalities from 2001 to 2007. Conclusions. Distracted driving is a growing public safety hazard. Specifically, the dramatic rise in texting volume since 2005 appeared to be contributing to an alarming rise in distracted driving fatalities. Legislation enacting texting bans should be paired with effective enforcement to deter drivers from using cell phones while driving. PMID:20864709
Neural correlates of auditory distraction revealed in ╬Ė-band EEG.
Ponjavic-Conte, Karla D; Dowdall, Jarrod R; Hambrook, Dillon A; Luczak, Artur; Tata, Matthew S
Selective attention involves the exclusion of irrelevant information in order to optimize perception of a single source of sensory input; failure to do so often results in the familiar phenomenon of distraction. The term 'distraction' broadly refers to a perceptual phenomenon. In the present study we attempted to find the electrophysiological correlates of distraction using an auditory discrimination task. EEG and event-related potential responses to identical stimuli were compared under two levels of distraction (continuous broad-band noise or continuous speech). Relative to broad-band noise, the presence of a continuous speech signal in the unattended ear impaired task performance and also attenuated the N1 peak evoked by nontarget stimuli in the attended ear. As the magnitude of a peak in the event-related potential waveform can be modulated by differences in intertrial power but also by differences in the stability of EEG phase across trials, we sought to characterize the effect of distraction on intertrial power and intertrial phase locking around the latency of the N1. The presence of continuous speech resulted in a prominent reduction of theta EEG band intertrial phase locking around the latency of the N1. This suggests that distraction may act not only to disrupt a sensory gain mechanism but also to disrupt the temporal fidelity with which the brain responds to stimulus events. PMID:22314684
Relative Effectiveness of Reappraisal and Distraction in Regulating Emotion in Late-Life Depression
Smoski, Moria J.; LaBar, Kevin S.; Steffens, David C.
Objectives The present study compares the effectiveness of two strategies, reappraisal and distraction, in reducing negative affect in older adults induced by focusing on personally relevant negative events and stressors. Participants included 30 adults with MDD and 40 never-depressed (ND) comparison participants ages 60 and over (mean age = 69.7 years). Design and Measurements Participants underwent three affect induction trials, each followed by a different emotion regulation strategy: distraction, reappraisal, and a no-instruction control condition. Self-reported affect was recorded pre- and post-affect induction, and at one-minute intervals during regulation. Results Across groups, participants reported greater reductions in negative affect with distraction than reappraisal or the no-instruction control condition. An interaction between group and regulation condition indicated that distraction was more effective in reducing negative affect in the MDD group than the ND group. Conclusions These results suggest that distraction is an especially effective strategy for reducing negative affect in older adults with MDD. Finding ways to incorporate distraction skills into psychotherapeutic interventions for late-life MDD may improve their effectiveness, especially for short-term improvement of affect following rumination. PMID:24021222
Informational masking of speech in children: Effects of ipsilateral and contralateral distracters
NASA Astrophysics Data System (ADS)
Wightman, Frederic L.; Kistler, Doris J.
Using a closed-set speech recognition paradigm thought to be heavily influenced by informational masking, auditory selective attention was measured in 38 children (ages 4-16 years) and 8 adults (ages 20-30 years). The task required attention to a monaural target speech message that was presented with a time-synchronized distracter message in the same ear. In some conditions a second distracter message or a speech-shaped noise was presented to the other ear. Compared to adults, children required higher target/distracter ratios to reach comparable performance levels, reflecting more informational masking in these listeners. Informational masking in most conditions was confirmed by the fact that a large proportion of the errors made by the listeners were contained in the distracter message(s). There was a monotonic age effect, such that even the children in the oldest age group (13.6-16 years) demonstrated poorer performance than adults. For both children and adults, presentation of an additional distracter in the contralateral ear significantly reduced performance, even when the distracter messages were produced by a talker of different sex than the target talker. The results are consistent with earlier reports from pure-tone masking studies that informational masking effects are much larger in children than in adults.
TVAR modeling of EEG to detect audio distraction during simulated driving
NASA Astrophysics Data System (ADS)
Dahal, Nabaraj; (Nanda Nandagopal, D.; Cocks, Bernadine; Vijayalakshmi, Ramasamy; Dasari, Naga; Gaertner, Paul
Objective. The objective of our current study was to look for the EEG correlates that can reveal the engaged state of the brain while undertaking cognitive tasks. Specifically, we aimed to identify EEG features that could detect audio distraction during simulated driving. Approach. Time varying autoregressive (TVAR) analysis using Kalman smoother was carried out on short time epochs of EEG data collected from participants as they undertook two simulated driving tasks. TVAR coefficients were then used to construct all pole model enabling the identification of EEG features that could differentiate normal driving from audio distracted driving. Main results. Pole analysis of the TVAR model led to the visualization of event related synchronization/desynchronization (ERS/ERD) patterns in the form of pole displacements in pole plots of the temporal EEG channels in the z plane enabling the differentiation of the two driving conditions. ERS in the EEG data has been demonstrated during audio distraction as an associated phenomenon. Significance. Visualizing the ERD/ERS phenomenon in terms of pole displacement is a novel approach. Although ERS/ERD has previously been demonstrated as reliable when applied to motor related tasks, it is believed to be the first time that it has been applied to investigate human cognitive phenomena such as attention and distraction. Results confirmed that distracted/non-distracted driving states can be identified using this approach supporting its applicability to cognition research.
Stuck in the 70s: the role of social norms in distracted driving.
Atchley, Paul; Hadlock, Chelsie; Lane, Sean
Successful campaigns to end distracted driving must understand prevailing social norms for behaviors such as texting and phoning while driving. The current work examined this issue by asking younger drivers to read car crash scenarios and rate the responsibility of the driver for the crash, and to levy fines and assign jail time, as a function of whether the driver was attentive, had been drinking, or was distracted by phoning or texting. In the first experiment, ratings were performed in the absence of injunctive norm information (laws against drunk and distracted driving). In the second experiment, injunctive norm information was included. Impaired drivers were viewed as more responsible in both experiments, with texting drivers viewed as the most responsible. However, drunk drivers received the most fines and jail time. When compared to data from the 1970s, the results show that anti-drunk driving campaigns have changed how younger drivers view drunk driving, but that norms have not yet changed for distracted driving, despite consistent results showing they know the risk of driving distracted. Implications for social norm distracted driving campaigns are discussed. PMID:22664691
Cone beam computed tomographic analysis of maxillary premolars and molars to detect the relationship between periapical and marginal bone loss and mucosal thickness of maxillary sinus
Sekerci, Ahmet-Ercan; K├Čse, Emre; Sisman, Yildiray
Background This study assessed the relationship between mucosal thickness (MT) of the maxillary sinus and periodontal bone loss (PBL) and periapical condition of related teeth. We also aimed to identify the association between root apices and the inferior wall of the maxillary sinus using Cone beam computed tomography (CBCT). Material and Methods In this study, CBCT images of 205 patients with 410 maxillary sinuses were examined, retrospectively. A total of 582 maxillary molars and 587 premolars were observed. The relationship of each root with maxillary sinus and apical lesions of these roots were classified, PBL was examined and the situations of adjacent teeth were estimated. The effect of these conditions on sinus mucosal thickness (MT) was evaluated. Results There was a significant correlation between MT of maxillary sinus and both PBL and age (r = 0.52, p=0.000 and r = 0.111, p= 0.002, respectively). The frequency of MT increased as the severity of apical lesion enlarged. A positive correlation was found between MT and degree of PBL and periapical lesions. To reveal the association between MT and pulpoperiapical condition bivariate correlation was done and a significant relationship between the pulpoperiapical condition and MT was found (r = 0.17, p=0.000). Conclusions This retrospective study showed that MT of the maxillary sinus was common among patients with PBL and MT was significantly associated with PBL and apical lesions. The relationship of maxillary sinus to adjacent teeth had also positive correlation with MT. CBCT imaging enabled better evaluation of maxillary sinus, posterior teeth and surrounding structures compared to other imaging tools. Key words:Maxillary sinus mucosal thickness, apical periodontitis, periodontal bone loss, CBCT. PMID:26241459
Oral rehabilitation for a patient with oligodontia and maxillary hypoplasia
Chung, Da-Woon; Vang, Mong-Sook; Park, Sang-Won; Lim, Hyun-Pil
An 18 year old female with oligodontia and maxillary hypoplasia was treated using an interdisciplinary team approach involving orthodontists, maxillofacial surgeons and prosthodontists. Full mouth one-piece fixed partial dentures were the final restoration. The fixed partial dentures fabricated for the maxilla and mandible using the concept of a shortened dental arch resulted in improved esthetics and the masticatory function. This paper describes the treatment procedures for an oligodontia patient with alveolar bone hypoplasia. PMID:21165248
Masticatory efficiency after rehabilitation of acquired maxillary and mandibular defects
Vijayaraghavan, N. Vasantha; Ramesh, Ganesh; Thareja, Amit; Patil, Seema
The effect of oral cancer with its therapeutic intervention involves significant facial and functional disabilities. It is customary to rehabilitate these patients by surgical or prosthetic means. Studies have been done to assess mastication and other functions after rehabilitation. A review of these studies for assessing masticatory function has been done under separate sections for maxillary and mandibular defects. Different masticatory tests are mentioned. Further scope for research has been highlighted. PMID:26392731
[Two rare case report of maxillary sinus foreign body].
Wang, Yongliang; Zhu, Jiajing; Ma, Zhancheng
The maxillary sinus is the largest paranasal sinuses. Foreign bodies of nosal sinus can caused by car accidents, firearm attacks, or iatrogeniccause. We reported two rare cases of foreign body of pulp needle and loach. The clinical manifestations might include facial numbness, facial paresthesia, swelling, nasal congestion, facial pain, eye discomfort, limited mouth opening and relapse and etc. Both CT scan and the medical history were helpful in diagnosis. Functional endoscopic surgery would be the first choice of treatment. PMID:26911073
Composite orbital reconstruction using the vascularized segmentalized osteo-fascio-cutaneous fibula flap.
Lundgren, T Kalle; Pignatti, Marco; Halle, Martin; Boscaini, Giulia; Docherty Skogh, Ann-Charlotte; Luigi, Chiarini; De Santis, Giorgio
Reconstruction of composite orbital defects must address the orbit and an exposed skull base and/or maxillary region. The orbit should not only be covered but also reshaped to accommodate the orbital contents or an epithesis when warranted. This study presents a rationale for a near-anatomical reconstruction of the orbit, together with adjacent dead space obliteration, using the segmentalized osteo-fascia-cutaneous fibula flap. Before the flap transfer, a cutting template for the fibula is made according to the measures and requirements of the facial defect. The segmentalized bone is then osteosynthesized to the facial skeleton and revascularized. Thus, an orbital depth is created by the bony fibula, whereas the fascio-cutaneous part of the flap may be used for lining the orbit and obliteration of the skull base or the maxillary region, or resurface the palate and/or the nasal cavity. PMID:26687794
Humeral lengthening by distraction osteogenesis: a safe procedure?
Ruette, Peter; Lammens, Johan
This study was conducted to assess the safety of humeral lengthening using an Ilizarov frame. We retrospectively reviewed 26 humeral segments in 17 patients that were lengthened at our department between 1993 and 2011. There were varying aetiologies including achondroplasia, epiphyseal dysplasia, Oilier disease, trauma or infection of the proximal humeral growth-plate, unicameral bone cyst and brachial plexus injury. Mean age at start of surgery was 17.05 years (range : 5-40). The mean lengthening achieved was 8.85 (3-13) cm. Mean lengthening percentage was 353% (range : 10-48). Average healing index was 30.56 days/cm (range : 17.46-4232). There was a significant difference in healing index between achondroplasia patients (28.79 days/cm) compared to others (33.41 days/cm). Minor problems included pin tract infection (14 segments). More important obstacles were temporary elbow flexion contracture (7 segments), premature consolidation (6 segments), radial nerve dysaesthesia (6 segments) and loosening of a Schanz screw (1 segment). Complications included one fracture and one progressive bowing after frame removal. One planned lengthening was not completely achieved. Despite a lot of obstacles, humeral lengthening using an Ilizarov frame provided a reliable method to treat the functional or cosmetic problems of upper limb shortening. PMID:24563967
Removal of an upper third molar from the maxillary sinus.
Amorim, Klinger de Souza; da Silva, Vanessa Tavares; da Cunha, Rafael Soares; Souto, Maria Luisa Silveira; S├Żo Mateus, Carla Rocha; Souza, Liane Maciel de Almeida
The maxillary sinus or antrum is the largest of the paranasal sinuses. It is located in the maxillary bone and has a proximity to the apexes of upper molars and premolars, which allows it to form a direct link between the sinus and the oral cavity. Dislocation of a foreign body or tooth to the interior of a paranasal sinus is a situation that can occur as a result of car accidents, firearm attacks, or iatrogenic in surgical procedures. Therefore, it is necessary to know how to treat this kind of situation. This study's objective is to report the case of a 23-year-old female patient, leucoderma, who sought treatment from the Surgical Unit at the Dental Faculty of the Federal University of Sergipe. She had a history of pain and edema in the right side of the genian region and two failed attempts at removing dental unit (DU) 18. The extraoral clinical exam revealed intense edema of the left hemiface with signs of infection, excoriation of the labial commissure, hematoma, a body temperature of 39┬░C, and a limited ability to open her mouth. The patient was medicated and treated surgically. The tooth was removed from the maxillary sinus with caution, as should have been done initially. PMID:25705524
Removal of an Upper Third Molar from the Maxillary Sinus
Amorim, Klinger de Souza; da Silva, Vanessa Tavares; da Cunha, Rafael Soares; Souto, Maria Luisa Silveira; S├Żo Mateus, Carla Rocha; Souza, Liane Maciel de Almeida
The maxillary sinus or antrum is the largest of the paranasal sinuses. It is located in the maxillary bone and has a proximity to the apexes of upper molars and premolars, which allows it to form a direct link between the sinus and the oral cavity. Dislocation of a foreign body or tooth to the interior of a paranasal sinus is a situation that can occur as a result of car accidents, firearm attacks, or iatrogenic in surgical procedures. Therefore, it is necessary to know how to treat this kind of situation. This study's objective is to report the case of a 23-year-old female patient, leucoderma, who sought treatment from the Surgical Unit at the Dental Faculty of the Federal University of Sergipe. She had a history of pain and edema in the right side of the genian region and two failed attempts at removing dental unit (DU) 18. The extraoral clinical exam revealed intense edema of the left hemiface with signs of infection, excoriation of the labial commissure, hematoma, a body temperature of 39┬░C, and a limited ability to open her mouth. The patient was medicated and treated surgically. The tooth was removed from the maxillary sinus with caution, as should have been done initially. PMID:25705524
[Failure in anterior rehabilitation of agenesic maxillary lateral incisors].
Le Gall, Michel; Philippart-Rochaix, Martine; Philip-Alliez, Camille
Agenesis of the maxillary lateral incisors poses particular problems for dentists, orthodontists and patients. Treatment of these ageneses is still highly controversial, both functionally and esthetically. The patient's smile and anterior guidance are affected and must be restored. The diagnosis is easy. Few mistakes are possible. However, managing patients with missing maxillary lateral incisors can be a challenge, commonly involving two possible treatment approaches: space opening to replace the missing lateral incisor with a prosthetic unit (denture, bridge or implant) or orthodontic space closure replacing the missing lateral incisor with the maxillary canine camouflaged to mimic the appearance of a lateral incisor. One of these two options will be adopted using multiple means...liable to trigger a multitude of possible errors. Ultimately, optimal results can only be achieved if there is excellent coordination between different practitioners in various specialties. Each clinician will have a specific role to play. Also, the patient and family are at the heart of the decision-making process, by virtue of their consent (treatment duration, financial resources) and their motivation. This multi-factorial, multi-disciplinary decision process means that treatment of the lateral incisor is an ongoing challenge for the clinician striving for the best possible result. Each case is different. No set rules exist. No single factor can be neglected if we are to avoid "failure". PMID:27083223
Non-pulsatile traumatic pseudoaneurysm of the internal maxillary artery following trauma to mandible.
Soh, Hui Yuh; Muda, Ahmad Sobri; Jabar, Nazimi Abd; Nordin, Rifqah; Nabil, S; Ramli, Roszalina
Traumatic pseudoaneurysm involving the maxillary artery is rare. Owing to its anatomic location, internal maxillary artery is usually protected by its surrounding structures. Formation of pseudoaneurysm usually takes place after several weeks to months of the initial injury. In this case, we reported a pseudoaneurysm arising from left internal maxillary artery following blunt injuries within 3 hours after a road accident and the treatment with endovascular embolization with titanium coils prior to open reduction and internal fixation of the fractured mandibles. PMID:25903486
EEG-Based Attention Tracking During Distracted Driving.
Wang, Yu-Kai; Jung, Tzyy-Ping; Lin, Chin-Teng
Distracted driving might lead to many catastrophic consequences. Developing a countermeasure to track drivers' focus of attention (FOA) and engagement of operators in dual (multi)-tasking conditions is thus imperative. Ten healthy volunteers participated in a dual-task experiment that comprised two tasks: a lane-keeping driving task and a mathematical problem-solving task (e.g., 24+15=37?) during which their electroencephalogram (EEG) and behaviors were concurrently recorded. Independent component analysis (ICA) was employed as a spatial filter to separate the contributions of independent sources from the recorded EEG data. The power spectra of six components (i.e., frontal, central, parietal, occipital, left motor, and right motor) extracted from single-task conditions were fed into support vector machine (SVM) based on the radial basis function (RBF) kernel to build an FOA assessment system. The system achieved 84.6┬▒5.8% and 86.2┬▒5.4% classification accuracies in detecting the participants' FOAs on the math versus driving tasks, respectively. This FOA assessment system was then applied to evaluate participants' FOAs during dual-task conditions. The detected FOAs revealed that participants' cognitive attention and strategies dynamically changed between tasks to optimize the overall performance, as attention was limited and competed. The empirical results of this study demonstrate the feasibility of a practical system to continuously estimating cognitive attention through EEG spectra. PMID:25850090
Enhanced distraction by magnocellular salience signals in schizophrenia.
Leonard, Carly J; Robinson, Benjamin M; Hahn, Britta; Gold, James M; Luck, Steven J
Research on schizophrenia has provided evidence of both impaired attentional control and dysfunctional magnocellular sensory processing. The present study tested the hypothesis that these impairments may be related, such that people with schizophrenia would be differentially distracted by stimuli that strongly activate the magnocellular pathway. To accomplish this, we used a visual attention paradigm from the basic cognitive neuroscience literature designed to assess the capture of attention by salient but irrelevant stimuli. Participants searched for a target shape in an array of non-target shapes. On some trials, a salient distractor was presented that either selectively activated the parvocellular system (parvo-biased distractors) or activated both the magnocellular and parvocellular systems (magno+parvo distractors). For both manual reaction times and eye movement measures, the magno+parvo distractors captured attention more strongly than the parvo-biased distractors in people with schizophrenia, but the opposite pattern was observed in matched healthy control participants. These results indicate that attentional control deficits in schizophrenia may arise, at least in part, by means of an interaction with magnocellular sensory dysfunction. PMID:24561035
Escaping capture: bilingualism modulates distraction from working memory.
Hern├Īndez, Mireia; Costa, Albert; Humphreys, Glyn W
We ask whether bilingualism aids cognitive control over the inadvertent guidance of visual attention from working memory and from bottom-up cueing. We compare highly-proficient Catalan-Spanish bilinguals with Spanish monolinguals in three visual search conditions. In the working memory (WM) condition, attention was driven in a top-down fashion by irrelevant objects held in WM. In the Identify condition, attention was driven in a bottom-up fashion by visual priming. In the Singleton condition, attention was driven in a bottom-up fashion by including a unique distracting object in the search array. The results showed that bilinguals were overall faster than monolinguals in the three conditions, replicating previous findings that bilinguals can be more efficient than monolinguals in the deployment of attention. Interestingly, bilinguals were less captured by irrelevant information held in WM but were equally affected by visual priming and unique singletons in the search displays. These observations suggest that bilingualism aids top-down WM-mediated guidance of attention, facilitating processes that keep separate representations in WM from representations that guide visual attention. In contrast, bottom-up attentional capture by salient yet unrelated input operates similarly in bilinguals and monolinguals. PMID:21890125
Attraction and distraction of attention with roadside advertisements.
Crundall, David; Van Loon, Editha; Underwood, Geoffrey
The optimum positioning of roadside advertisements is recognized by the industry as an important factor in attracting the attention of passing drivers. Less acknowledged is the possibility that the location of an advertisement may distract attention from vital driving-related information. This study compared street-level advertisements (SLAs; predominantly bus shelters) with raised-level advertisements (RLAs) of the same size that were suspended 3 m above the ground, on their ability to attract attention under different task conditions. Participants were split into two groups and watched video clips of driving, rating them for hazardousness while their eye movements were recorded. One of the groups was additionally primed to attend to advertisements. SLAs received the most fixations when participants were solely looking for hazards, and the fewest fixations when primed to look for advertisements. Though SLAs also had longer fixations than the RLAs, they were more poorly recognized in a subsequent memory test. We conclude that SLAs attract and hold attention at inappropriate times compared to raised-level advertisements. PMID:16427019
Neural correlates of 'distracting' from emotion during autobiographical recollection.
Denkova, Ekaterina; Dolcos, Sanda; Dolcos, Florin
Remembering emotional autobiographical memories (AMs) is important for emotional well-being, and investigation of the role of emotion regulation (ER) during AM recollection has relevance for understanding mental health issues. Although significant progress has been made in understanding the brain mechanisms underlying ER and AM, less is known about the role of ER during AM recollection. The present study investigated how focusing away (or 'distracting') from the emotional content during AM recollection influences the subjective re-experiencing of emotions and the associated neural correlates, by manipulating the retrieval focus of participants who remembered emotional AMs while fMRI data were recorded. First, focusing away from emotion led to decreased self-reported emotional responses, along with increased engagement of ER-related regions (ventro-medial prefrontal cortex, vmPFC), and reduced activity in emotion-related regions (amygdala, AMY). Second, increased vmPFC activity was linked to reduced emotional ratings, during the non-emotional focus. Third, mediation analysis identified vmPFC as a functional hub integrating affective signals from AMY and mediating their impact on the subjective re-experiencing of emotion, according to the current retrieval focus. Collectively, these findings shed light on the neural mechanisms underlying the ability to effectively switch attentional focus away from emotions during AM recollections and have direct relevance for understanding, preventing and treating affective disorders, characterised by reduced ability to regulate emotions. PMID:24603021
Propolis accelerates the consolidation phase in distraction osteogenesis.
Bereket, Cihan; ├¢zan, Fatih; ┼×ener, ─░smail; Tek, Mustafa; Altunkaynak, Berrin Zuhal; Semirgin, Sibel U├¦ak; ┼×enel, Erman; ├¢zdemir, Muhsin
We evaluated the effect of propolis on new bone formation after distraction osteogenesis (DO). This study examined 3 groups: control group, P100, and P200. Rabbits underwent DO of the left mandible after an osteotomy between the first molar and the mental foramen. Bone mineral content and bone mineral density were evaluated using dual-energy x-ray absorption 1 and 4 weeks after the procedure. The volume of connective tissue and new bone and the number of capillaries were measured using stereologic analysis after the subjects were killed. Dual-energy x-ray absorption showed that the bone mineral content and bone mineral density were higher in the groups treated with propolis by week 4, and these parameters were higher in the P200 group. Stereologic analysis showed no significant differences in connective tissue volume and number of capillaries among the groups. New bone volume was lowest in the P200 group. We concluded that propolis accelerates bone formation and may shorten the consolidation phase with DO. PMID:25203585
Biomechanics of the canine mandible during bone transport distraction osteogenesis.
Zapata, Uriel; Dechow, Paul C; Watanabe, Ikuya; Elsalanty, Mohammed E; Opperman, Lynne A
This study compared biomechanical patterns between finite element models (FEMs) and a fresh dog mandible tested under molar and incisal physiological loads in order to clarify the effect of the bone transport distraction osteogenesis (BTDO) surgical process. Three FEMs of dog mandibles were built in order to evaluate the effects of BTDO. The first model evaluated the mandibular response under two physiological loads resembling bite processes. In the second model, a 5.0ŌĆēcm bone defect was bridged with a bone transport reconstruction plate (BTRP). In the third model, new regenerated bony tissue was incorporated within the defect to mimic the surgical process without the presence of the device. Complementarily, a mandible of a male American foxhound dog was mechanically tested in the laboratory both in the presence and absence of a BTRP, and mechanical responses were measured by attaching rosettes to the bone surface of the mandible to validate the FEM predictions. The relationship between real and predicted values indicates that the stress patterns calculated using FEM are a valid predictor of the biomechanics of the BTDO procedures. The present study provides an interesting correlation between the stiffness of the device and the biomechanical response of the mandible affected for bone transport. PMID:25162918
Complications in 54 frontofacial distraction procedures in patients with syndromic craniosynostosis.
Goldstein, Jesse A; Paliga, James Thomas; Taylor, Jesse A; Bartlett, Scott P
Patients with syndromic craniosynostosis manifest midfacial hypoplasia often treated by midfacial advancement. Benefits of midfacial advancement by distraction osteogenesis have been well studied; little is known about the perioperative morbidity of these procedures, specifically relating to device selection. This study compares the perioperative complications between semiburied- and halo-type distraction osteogenesis of the midface. A retrospective review was performed on all patients with syndromic craniosynostosis who underwent midface distraction with semiburied- or halo-type external distractors. Demographic information and operative/postoperative course were reviewed. Complications were categorized as hardware-related, infectious, and either as major (requiring additional intervention) or minor (requiring medication only). Chi-squared and Fisher exact test were used to compare variables.From 1999 to 2012, a total of 54 patients underwent midface distraction osteogenesis, including 23 patients with Apert syndrome, 19 patients with Crouzon syndrome, 10 patients with Pfeiffer syndrome, and 2 patients with other craniofacial syndromes. Thirty-three patients underwent a total of 34 subcranial Le Fort III distraction procedures and 21 underwent 21 monobloc distraction procedures. The mean age during surgery was 8.0 (range, 4.0-17.7) years, whereas the mean time between distractor placement and removal was 102.9 days. Thirty procedures were performed with external halo-type distractors (18 Le Fort III and 12 monobloc distractions), whereas 25 were performed with buried midface distractors (16 Le Fort III and 9 monobloc distractions). There were no significant differences in diagnoses or interventions between the distraction devices. Of the 19 distractor-related complications, there were a total of 10 (18.2%) in the halo group including 5 (9.1%) requiring separate operative intervention as well as 9 (16.4%) in the buried distractor group including 6 (10.1%) requiring separate operative intervention. Major infections were more common in the buried distractor group (n = 8) compared with the halo distractor group (n = 3) (P = 0.048). There were 4 (7.3%) patients in the halo group who had malposition or transcranial pin migration related to postoperative positioning or falls and required operative repositioning. Frontofacial distraction is an important technique in patients with syndromic craniosynostosis. Higher rates of halo displacement requiring surgery are offset with lower rates of infections compared with buried distractors. PMID:25569391
Fabrication of maxillary overdenture supported by custom waxed and cast locator abutments: case report.
Zinner, Ira D; Reid, Patrick E; Shapiro, Herbert J; Markovits, Stanley; Jansen, Curtis; Argerakis, George P
The fabrication of a maxillary overdenture supported and retained by custom waxed and cast locator attachments will be described. These angulated abutments were made necessary by a lack of maxillary bone due to advanced periodontal problems that contributed to the loss of all of the maxillary and mandibular teeth; thus, the maxillary anterior implants were placed in a labially or facially inclined position, which necessitated placement of labially inclined implant bodies. This article describes a method for correcting this angulation to create a more vertical path of placement and to allow the facially inclined implants to be used for an overdenture retentive device. PMID:23513543
Patterns of bilateral agenesis of maxillary third molars and agenesis of other teeth.
Sanpei, Sugako; Ishida, Rieko; Sanpei, Shinya; Endo, Saori; Tanaka, Satoshi; Endo, Toshiya; Sekimoto, Tsuneo
The purpose of this study was to investigate the patterns of bilateral agenesis of maxillary third molars and other tooth agenesis in Japanese orthodontic patients. A group of 262 subjects with bilateral agenesis of maxillary third molars (group A) was divided into three subgroups: group 1A consisting of 114 subjects without agenesis of mandibular third molars; group 2A, 31 subjects with unilateral agenesis of mandibular third molars; and group 3A, 117 subjects with agenesis of all third molars. As controls, 926 other subjects without third molar agenesis were selected (group C). Panoramic radiographs were mainly used to examine for tooth agenesis. The Chi square test and odds ratio were used to make statistical comparisons. The prevalence rates of agenesis of maxillary lateral incisors, mandibular incisors and maxillary and mandibular second premolars, and bilateral agenesis of maxillary lateral incisors and second premolars were significantly higher in any one of the third molar agenesis groups than in the control group. Characteristically, no significant increase in occurrence of bilateral agenesis of mandibular second premolars was demonstrated by the subjects with bilateral agenesis of maxillary third molars. Irrespective of whether unilateral or bilateral agenesis of mandibular third molars is present or not, the Japanese orthodontic patients with bilateral agenesis of maxillary third molars exhibited a significantly increased occurrence of unilateral or bilateral agenesis of maxillary lateral incisors, mandibular incisors and maxillary and mandibular second premolars, except for bilateral agenesis of mandibular incisors and second premolars. PMID:25636272
Odontogenic maxillary sinusitis with oro-nasal fistula: a case report
Carini, Fabrizio; Longoni, Salvatore; Amosso, Ernesto; Carini, Stefania; Garavello, Werner; Porcaro, Gianluca
Summary Aim of the study The odontogenic sinusitis has an incidence between 38 and 40.6%. Increased risk of maxillary sinusitis has been reported with the presence of periapical abscesses, periodontal disease, dental trauma, tooth extraction and implant placement when the sinusal membrane is perforated. Materials and methods A patient with odontogenic maxillary sinusitis associated with oro-nasal fistula was treated. Results The follow-up at six months showed the complete resolution of maxillary sinusitis, palatal fistula got closed and pain symptoms disappeared. Conclusion This case report describes a rare complication of odontogenic maxillary sinusitis: the oro-nasal fistula. PMID:25678949
Visual and cognitive distraction metrics in the age of the smart phone: A basic review
McGehee, Daniel V.
Sources of distraction are numerous and varied, and defining and measuring distraction and attention is complicated. The driving task requires constant adjustments and reallocation of attention to cognitive, motor, and visual processes. While it is fairly straightforward to measure distraction in an experimental situation (e.g., simulator, closed course), driver distraction in the real world is highly contextual. While no single metric is capable of capturing the complexities of distraction, several have proved useful in helping researchers gain fuller understanding of it. Few have reached a level of consensus among researchers and user interface designers. ISO and SAE may be considered the ŌĆśgold standardŌĆÖ for providing mechanisms through which open scientific consensus-based standards can be achieved. While there are a number of metrics used in predicting distraction, three have been studied closely and are going through the SAE and ISO standards process. They are (1) ŌĆśthe occlusion methodŌĆÖ; (2) the Lane Change Test (LCT); and (3) the Detection Response Task (DRT). The metrics described here apply generally to the experimental context where driving is tightly controlled. Like any method, there are limitations with eachŌĆöand they donŌĆÖt necessarily agree with one another. Experimental methods and analyses are different than those in naturalistic driving (ND). ND relies more on data mining versus traditional experimental manipulation. ND data are a challenge precisely in that they lack experimental control. In future, driver metrics will go beyond specific measurement of task load, and will include how drivers self regulate when they choose to be distracted. PMID:24776223
Visual and cognitive distraction metrics in the age of the smart phone: A basic review.
McGehee, Daniel V
Sources of distraction are numerous and varied, and defining and measuring distraction and attention is complicated. The driving task requires constant adjustments and reallocation of attention to cognitive, motor, and visual processes. While it is fairly straightforward to measure distraction in an experimental situation (e.g., simulator, closed course), driver distraction in the real world is highly contextual. While no single metric is capable of capturing the complexities of distraction, several have proved useful in helping researchers gain fuller understanding of it. Few have reached a level of consensus among researchers and user interface designers. ISO and SAE may be considered the 'gold standard' for providing mechanisms through which open scientific consensus-based standards can be achieved.While there are a number of metrics used in predicting distraction, three have been studied closely and are going through the SAE and ISO standards process. They are (1) 'the occlusion method'; (2) the Lane Change Test (LCT); and (3) the Detection Response Task (DRT). The metrics described here apply generally to the experimental context where driving is tightly controlled. Like any method, there are limitations with each-and they don't necessarily agree with one another.Experimental methods and analyses are different than those in naturalistic driving (ND). ND relies more on data mining versus traditional experimental manipulation. ND data are a challenge precisely in that they lack experimental control.In future, driver metrics will go beyond specific measurement of task load, and will include how drivers self regulate when they choose to be distracted. PMID:24776223
Combined micro computed tomography and histology study of bone augmentation and distraction osteogenesis
NASA Astrophysics Data System (ADS)
Ilgenstein, Bernd; Deyhle, Hans; Jaquiery, Claude; Kunz, Christoph; Stalder, Anja; St├╝binger, Stefan; Jundt, Gernot; Beckmann, Felix; M├╝ller, Bert; Hieber, Simone E.
Bone augmentation is a vital part of surgical interventions of the oral and maxillofacial area including dental implantology. Prior to implant placement, sufficient bone volume is needed to reduce the risk of peri-implantitis. While augmentation using harvested autologous bone is still considered as gold standard, many surgeons prefer bone substitutes to reduce operation time and to avoid donor site morbidity. To assess the osteogenic efficacy of commercially available augmentation materials we analyzed drill cores extracted before implant insertion. In younger patients, distraction osteogenesis is successfully applied to correct craniofacial deformities through targeted bone formation. To study the influence of mesenchymal stem cells on bone regeneration during distraction osteogenesis, human mesenchymal stem cells were injected into the distraction gap of nude rat mandibles immediately after osteotomy. The distraction was performed over eleven days to reach a distraction gap of 6 mm. Both the rat mandibles and the drill cores were scanned using synchrotron radiation-based micro computed tomography. The three-dimensional data were manually registered and compared with corresponding two-dimensional histological sections to assess bone regeneration and its morphology. The analysis of the rat mandibles indicates that bone formation is enhanced by mesenchymal stem cells injected before distraction. The bone substitutes yielded a wide range of bone volume and degree of resorption. The volume fraction of the newly formed bone was determined to 34.4% in the computed tomography dataset for the augmentation material Geistlich Bio-Oss®. The combination of computed tomography and histology allowed a complementary assessment for both bone augmentation and distraction osteogenesis.
Effects of distracting ads and cognitive control on the processing of online news stories with stereotype-related information.
Kononova, Anastasia G
An experiment (N=123) examined how individuals cognitively process online news stories depicting African-American characters with stereotype-consistent and -inconsistent attributes and whether distracting online ads interfere with story processing. Two cognitive control functions, updating and inhibition, were predicted to moderate the effects of distracting ads. Recall of characters' attributes and overall characters' description were included in the study as dependent measures. Findings indicated that distracting online ads hinder recall of information about and descriptions of story characters. Inhibition and updating affect dependent measures and moderate the effects of distracting online ads on characters' descriptions. PMID:23574346
Five years follow-up of implant-prosthetic rehabilitation on a patient after mandibular ameloblastoma removal and ridge reconstruction by fibula graft and bone distraction
Oteri, Giacomo; Ponte, Francesco Saverio De; Pisano, Michele; Cicci├╣, Marco
This case report presents a combination of surgical and prosthetic solutions applied to a case of oral implant rehabilitation in post-oncologic reconstructed mandible. Bone resection due to surgical treatment of large mandibular neoplasm can cause long-span defects. Currently, mandibular fibula free flap graft is widely considered as a reliable technique for restoring this kind of defect. It restores the continuity of removed segment and re-establishes the contour of the lower jaw. However, the limited height of grafted fibula does not allow the insertion of regular length implants, therefore favouring vertical distraction osteogenesis as an important treatment choice. This report presents a patient affected by extensive mandibular ameloblastoma who underwent surgical reconstruction by fibula free flap because of partial mandibular resection. Guided distraction osteoneogenesis technique was applied to grafted bone, in order to obtain adequate bone height and to realize a prosthetically guided placement of 8 fixtures. After osseointegration, the patient was rehabilitated with a full arch, screw-retained prosthetic restoration. At five-years follow up, excellent integration of grafted tissue, steady levels of bone around the fixtures and healthy peri-implant tissues were reported. PMID:22623943
Dentate transport discs can be used to reconstruct large segmental mandibular defects
Elsalanty, Mohammed E.; Malavia, Veera; Zakhary, Ibrahim; Mulone, Timothy; Kontogiorgos, Elias D.; Dechow, Paul C.; Opperman, Lynne A.
Purpose This study tests the use of a dentate transport segment for the reconstruction of a large U-shaped defect in the anterior segment of the canine mandible, using a novel curved reconstruction plate. The quality and quantity of bone regenerate formed by dentate versus edentulous transport segments was compared. Methods In five adult foxhound dogs, a defect of 70ŌĆō75 mm was created in the canine mandible by excising the mandible anterior to the right and left 4th premolars. Reconstruction was done by trifocal distraction osteogenesis using a bone transport reconstruction plate (BTRP-02Ōäó), with two transport units being activated simultaneously, one on either side of the defect, one dentate and one edentulous. Bilateral distraction proceeded at a rate of 1mm/day until the segments docked against each other in midline. After 39ŌĆō44 days consolidation, the animals were euthanized. The quantity and quality of bone regeneration on both sides were compared using micro-computed tomography. Results The defect reconstruction was successful. The amount and quality of bone formed by the transport segments was similar on both sides. There were no significant differences in the bone volume fraction and density of the regenerate bone formed by the two transport segments. The bone volume fraction and density of the regenerate was significantly lower than that of the host bone in the distal segments, likely due to the short consolidation period. Conclusions Bone transport remains a viable option in reconstructing anterior segmental defects in the mandible. The use of either dentate or edentulous transport segments for reconstruction provides options for the surgeon in often highly compromised patients requiring these surgeries. PMID:25661502
Diagnosis and conservative treatment of skeletal Class III malocclusion with anterior crossbite and asymmetric maxillary crowding.
Tseng, Linda L Y; Chang, Chris H; Roberts, W Eugene
A man, aged 28┬Āyears 9┬Āmonths, came for an orthodontic consultation for a skeletal Class III malocclusion (ANB┬Āangle, -3┬░) with a modest asymmetric Class II and Class III molar relationship, complicated by an anterior crossbite, a deepbite, and 12┬Āmm of asymmetric maxillary crowding. Despite the severity of the malocclusion (Discrepancy Index, 37), the patient desired noninvasive camouflage treatment. The 3-Ring diagnosis showed that treatment without extractions or orthognathic surgery was a viable approach. Arch length analysis indicated that differential interproximal enamel reduction could resolve the crowding and midline discrepancy, but a miniscrew in the infrazygomatic crest was needed to retract the right buccal segment. The patient accepted the complex, staged treatment plan with the understanding that it would require about 3.5┬Āyears. Fixed appliance treatment with passive self-ligating brackets, early light short elastics, bite turbos, interproximal enamel reduction, and infrazygomatic crest retraction opened the vertical dimension of the occlusion, improved the ANB angle by 2┬░, and achieved excellent alignment, as evidenced by a Cast Radiograph Evaluation score of 28 and a Pink and White dental esthetic score of┬Ā3. PMID:27021460
Olfactory sensilla on antennae and maxillary palps of Fannia hirticeps (Stein, 1892) (Diptera: Fanniidae).
Wang, Qi-Ke; Zhang, Ming; Li, Kai; Zhang, Dong
The Fanniidae is one of four families in the superfamily Muscoidea (Diptera), including some important medical and hygienic flies. There is a paucity of reports on the ultrastructure of olfactory sensilla for the fanniid species. To provide more information on the morphology of the antennal and palpal sensilla of fanniid fly, Fannia hirticeps (Stein, 1892) has been studied using scanning electron microscopy. The first two antennal segments, scape and pedicel, are covered by microtrichiae and several chaetic sensilla. Six distinct morphological types of sensilla are recorded on the antennal funiculus, including one trichoid, two basiconic, two coeloconic sensilla, and one clavate sensilla. The measurement and density of each sensilla type are also provided. The trichoid sensilla tend to be longer and denser toward the apex of antennal funiculus. Basiconic sensilla spread all over the funicular surface. F. hirticeps bears two types of coeloconic sensilla, type 2 coeloconic sensilla distributed on the distal part of the anterior surface, whereas type 1 distributed on the rest of the funiculus. Clavate sensilla are found on the base of antennal funiculus. Only one large sensory pit is located on the posterior surface. Maxillary palps bear one type of basiconic sensilla. These results are compared with eight other muscid flies. Our findings provide a morphological basis for future investigations on olfactory-mediated behavior of this group. PMID:22556028
[Finite-element investigation on center of resistance of maxillary anterior teeth].
Su, Jiehua; Liu, Jiali; Zhang, Duangqiang; Luo, Gusheng; Chen, Libing; Yu, Xiaonan; Lin, Zhiwei; Zhang, Jian
A three-dimensional finite element model of premaxillary bone and anterior teeth was established with ANSYS 13.0. The anterior teeth were fixed with strong stainless labial archwire and lingual frame. In the horizontal loading experiments, a horizontal retraction force of 1.5 N was applied bilaterally to the segment through hooks at the same height between 7 and 21 mm from the incisal edge of central incisor; in vertical loading experiments, a vertical intrusion force of 1.5 N was applied at the midline of lingual frame with distance between 4 and 16 mm from the incisal edge of central incisor. After loading, solution was done and displacement and maximum principle stress were calculated. After horizontal loading, lingual displacement and stress in periodontal membrane (PDM) was most homogeneous when the traction force was 14 mm from the edge of central incisor; after vertical loading, intrusive displacement and stress in PDM were most homogeneous when the traction force was 12 mm from the incisal edge of central incisor. The results of this study suggested that the location of center of resistance (CRe) of six maxillary anterior teeth is about 14 mm gingivally and 12 mm lingually to incisal edge of central incisor. The location can provide evidence for theoretical and clinical study in orthodontics. PMID:25764710
Three-dimensional maxillary and mandibular regional superimposition using cone beam computed tomography: a validation study.
Koerich, L; Burns, D; Weissheimer, A; Claus, J D P
This study aimed to validate a novel method for fast regional superimposition of cone beam computed tomography (CBCT) scans. The method can be used with smaller field of view scans, thereby allowing for a lower radiation dose. This retrospective study used two dry skulls and secondary data from 15 patients who had more than one scan taken using the same machine. Two observers tested two types of regional voxel-based superimposition: maxillary and mandibular. The registration took 10-15s. Three-dimensional surface models of the maxillas and mandibles were generated via standardized threshold segmentation, and the accuracy and reproducibility of the superimpositions were assessed using the iterative closest point technique to measure the root mean square (RMS) distance between the images. Five areas were measured and a RMSŌēż0.25 was considered successful. Descriptive statistics and the intra-class correlation coefficient (ICC) were used to compare the intra-observer measurement reproducibility. The ICC was Ōēź0.980 for all of the variables and the highest RMS found was 0.241. The inter-observer reproducibility was assessed case by case and was perfect (RMS 0) for 68% (23 out of 34) of the superimpositions done and not clinically significant (RMSŌēż0.25) for the other 32%. The method is fast, accurate, and reproducible and is an alternative to cranial base superimposition. PMID:26794399
Dancing to distraction: mediating 'docile bodies' in 'Philippine Thriller video'.
Mangaoang, Áine
This essay examines the conditions behind the 'Philippine Prison Thriller' video, a YouTube spectacle featuring the 1,500 inmates of Cebu Provincial Detention and Rehabilitation Centre (CPDRC) dancing to Michael Jackson's hit song 'Thriller'. The video achieved viral status after it was uploaded onto the video-sharing platform in 2007, and sparked online debates as to whether this video, containing recorded moving images of allegedly forced dancing, was a form of cruel and inhumane punishment or a novel approach to rehabilitation. The immense popularity of the video inspired creative responses from viewers, and this international popularity caused the CPDRC to host a monthly live dance show held in the prison yard, now in its seventh year. The essay explores how seemingly innocuous products of user-generated-content are imbued with ideologies that obscure or reduce relations of race, agency, power and control. By contextualising the video's origins, I highlight current Philippine prison conditions and introduce how video-maker/programme inventor/prison warden Byron Garcia sought to distance his facility from the Philippine prison majority. I then investigate the 'mediation' of 'Thriller' through three main issues. One, I examine the commodification and transformation from viral video to a thana-tourist destination; two, the global appeal of 'Thriller' is founded on public penal intrigue and essentialist Filipino tropes, mixed with a certain novelty factor widely suffused in YouTube formats; three, how dance performance and its mediation here are conducive to creating Foucault's docile bodies, which operate as a tool of distraction for the masses and ultimately serve the interests of the state far more than it rehabilitates(unconvicted and therefore innocent) inmates. PMID:24480892
Axial deformity correction in children via distraction osteogenesis
Ono, Craig M.; Antoci, Valentin; Raney, Ellen M.
We performed a retrospective analysis of the results of 62 tibial and 54 femoral lengthenings in 88 consecutive patients. The patients mean age was 13.5 years and mean follow-up was four years. There was a significant difference between metaphyseal (27┬▒1.2 days/cm) and diaphyseal (39.4┬▒1.7 days/cm), tibial (34┬▒1.7 days/cm) and femoral (31┬▒1.4 days/cm) lengthening (P<0.05), but no significant difference among the lengthening indexes when treating one-, two-, or three-dimensional deformities, congenital (34┬▒2.4 days/cm) and acquired (32┬▒1.0 days/cm) limb length discrepancy (LLD) (P>0.05). The lengthening index was 33┬▒1.1 days/cm, distraction regenerate length 6┬▒0.4┬Ācm, and lengthening percentage 21┬▒2.1. The scatter plots of new regenerate length against time and the scatter plots of neurological complication, residual deformities, broken pins, joint contractures, and hypertension rate against lengthening percentage showed a positive linear relationship (r=0.8). We found the correlations between quantitative and qualitative parameters that should help to predict the treatment outcomes. Lengthening index depends on the amount of length gained. Higher length of new bone regenerate leads to a decrease in lengthening index. Expected gain in bone length can aid in estimating the duration of treatment. The lengthening percentage correlates very well with the complication rate and can be used to predict the complication rate. PMID:16547715
A new method of morphological comparison for bony reconstructive surgery: maxillary reconstruction using scapular tip bone
NASA Astrophysics Data System (ADS)
Chan, Harley; Gilbert, Ralph W.; Pagedar, Nitin A.; Daly, Michael J.; Irish, Jonathan C.; Siewerdsen, Jeffrey H.
esthetic appearance is one of the most important factors for reconstructive surgery. The current practice of maxillary reconstruction chooses radial forearm, fibula or iliac rest osteocutaneous to recreate three-dimensional complex structures of the palate and maxilla. However, these bone flaps lack shape similarity to the palate and result in a less satisfactory esthetic. Considering similarity factors and vasculature advantages, reconstructive surgeons recently explored the use of scapular tip myo-osseous free flaps to restore the excised site. We have developed a new method that quantitatively evaluates the morphological similarity of the scapula tip bone and palate based on a diagnostic volumetric computed tomography (CT) image. This quantitative result was further interpreted as a color map that rendered on the surface of a three-dimensional computer model. For surgical planning, this color interpretation could potentially assist the surgeon to maximize the orientation of the bone flaps for best fit of the reconstruction site. With approval from the Research Ethics Board (REB) of the University Health Network, we conducted a retrospective analysis with CT image obtained from 10 patients. Each patient had a CT scans including the maxilla and chest on the same day. Based on this image set, we simulated total, subtotal and hemi palate reconstruction. The procedure of simulation included volume segmentation, conversing the segmented volume to a stereo lithography (STL) model, manual registration, computation of minimum geometric distances and curvature between STL model. Across the 10 patients data, we found the overall root-mean-square (RMS) conformance was 3.71+/- 0.16 mm
Improving dental experiences by using virtual reality distraction: a simulation study.
Tanja-Dijkstra, Karin; Pahl, Sabine; White, Mathew P; Andrade, Jackie; Qian, Cheng; Bruce, Malcolm; May, Jon; Moles, David R
Dental anxiety creates significant problems for both patients and the dental profession. Some distraction interventions are already used by healthcare professionals to help patients cope with unpleasant procedures. The present study is novel because it a) builds on evidence that natural scenery is beneficial for patients, and b) uses a Virtual Reality (VR) representation of nature to distract participants. Extending previous work that has investigated pain and anxiety during treatment, c) we also consider the longer term effects in terms of more positive memories of the treatment, building on a cognitive theory of memory (Elaborated Intrusions). Participants (n?=?69) took part in a simulated dental experience and were randomly assigned to one of three VR conditions (active vs. passive vs. control). In addition, participants were distinguished into high and low dentally anxious according to a median split resulting in a 3ū2 between-subjects design. VR distraction in a simulated dental context affected memories a week later. The VR distraction had effects not only on concurrent experiences, such as perceived control, but longitudinally upon the vividness of memories after the dental experience had ended. Participants with higher dental anxiety (for whom the dental procedures were presumably more aversive) showed a greater reduction in memory vividness than lower dental-anxiety participants. This study thus suggests that VR distractions can be considered as a relevant intervention for cycles of care in which people's previous experiences affect their behaviour for future events. PMID:24621518
Improving Dental Experiences by Using Virtual Reality Distraction: A Simulation Study
Tanja-Dijkstra, Karin; Pahl, Sabine; P. White, Mathew; Andrade, Jackie; Qian, Cheng; Bruce, Malcolm; May, Jon; Moles, David R.
Dental anxiety creates significant problems for both patients and the dental profession. Some distraction interventions are already used by healthcare professionals to help patients cope with unpleasant procedures. The present study is novel because it a) builds on evidence that natural scenery is beneficial for patients, and b) uses a Virtual Reality (VR) representation of nature to distract participants. Extending previous work that has investigated pain and anxiety during treatment, c) we also consider the longer term effects in terms of more positive memories of the treatment, building on a cognitive theory of memory (Elaborated Intrusions). Participants (nŌĆŖ=ŌĆŖ69) took part in a simulated dental experience and were randomly assigned to one of three VR conditions (active vs. passive vs. control). In addition, participants were distinguished into high and low dentally anxious according to a median split resulting in a 3├Ś2 between-subjects design. VR distraction in a simulated dental context affected memories a week later. The VR distraction had effects not only on concurrent experiences, such as perceived control, but longitudinally upon the vividness of memories after the dental experience had ended. Participants with higher dental anxiety (for whom the dental procedures were presumably more aversive) showed a greater reduction in memory vividness than lower dental-anxiety participants. This study thus suggests that VR distractions can be considered as a relevant intervention for cycles of care in which peopleŌĆÖs previous experiences affect their behaviour for future events. PMID:24621518
What determines sustained visual attention? The impact of distracter positions, task difficulty and visual fields compared.
Kraft, Antje; Pape, Nele; Hagendorf, Herbert; Schmidt, Sein; Naito, Aki; Brandt, Stephan A
We quantified the interference of distracter stimuli on sustained visuo-spatial attention as a function of the distribution of attended positions in the visual fields (bilateral/unilateral, left/right, upper/lower), distracter positions (peripheral, between attended positions, between fixation and attended positions) and task difficulty. Compared to distinct distracter positions, bilateral field and lower field presentation had much stronger influence on the performance. Additionally, interactive effects between task difficulty and distracter position were found. This result was at variance with the previous models of visuo-spatial attention, which attached much more importance to the role of distracter positions compared to visual field effects. In directly comparing the impact of the abovementioned factors, the converse finding is evident-visual field effects, in particular bilateral presentations have a much stronger importance. Moreover, metaphoric concepts of attention like the "zoom lens" are not compatible with these results. The findings are discussed in the light of alternative models of sustained visuo-spatial attention. The visual system architecture and top-down mechanisms are considered. PMID:17174284
Early detection and late cognitive control of emotional distraction by the prefrontal cortex
Garc├Ła-Pacios, Javier; Garc├®s, Pilar; Del R├Ło, David; Maest├║, Fernando
Unpleasant emotional distraction can impair the retention of non-emotional information in working memory (WM). Research links the prefrontal cortex with the successful control of such biologically relevant distractors, although the temporal changes in this brain mechanism remain unexplored. We use magnetoencephalography to investigate the temporal dynamics of the cognitive control of both unpleasant and pleasant distraction, in the millisecond (ms) scale. Behavioral results demonstrate that pleasant events do not affect WM maintenance more than neutral ones. Neuroimaging results show that prefrontal cortices are recruited for the rapid detection of emotional distraction, at early latencies of the processing (70-130ŌĆēms). Later in the processing (360-450ŌĆēms), the dorsolateral, the medial and the orbital sections of the prefrontal cortex mediate the effective control of emotional distraction. In accordance with the behavioral performance, pleasant distractors do not require higher prefrontal activity than neutral ones. These findings extend our knowledge about the brain mechanisms of coping with emotional distraction in WM. In particular, they show for the first time that overriding the attentional capture triggered by emotional distractors, while maintaining task-relevant elements in mind, is based on the early detection of such linked-to-survival information and on its later cognitive control by the prefrontal cortex. PMID:26067780
The Relationship between Dehydroepiandrosterone (DHEA), Working Memory and Distraction ŌĆō A Behavioral and Electrophysiological Approach
do Vale, S├│nia; Selinger, Lenka; Martins, Jo├Żo Martin; Gomes, Ana Coelho; Bicho, Manuel; do Carmo, Isabel; Escera, Carles
Dehydroepiandrosterone (DHEA) and dehydroepiandrosterone-sulphate (DHEAS) have been reported to have memory enhancement effects in humans. A neuro-stimulatory action and an anti-cortisol mechanism of action may contribute to that relation. In order to study DHEA, DHEAS and cortisol relations to working memory and distraction, we recorded the electroencephalogram of 23 young women performing a discrimination (no working memory load) or 1-back (working memory load) task in an audio-visual oddball paradigm. We measured salivary DHEA, DHEAS and cortisol both before each task and at 30 and 60 min. Under working memory load, a higher baseline cortisol/DHEA ratio was related to higher distraction as indexed by an enhanced novelty P3. This suggests that cortisol may lead to increased distraction whereas DHEA may hinder distraction by leading to less processing of the distractor. An increased DHEA production with consecutive cognitive tasks was found and higher DHEA responses attributed to working memory load were related to enhanced working memory processing as indexed by an enhanced visual P300. Overall, the results suggest that in women DHEA may oppose cortisol effects reducing distraction and that a higher DHEA response may enhance working memory at the electrophysiological level. PMID:25105970
Plugging the Attention Deficit: Perceptual Load Counters Increased Distraction in ADHD
Objective: Increased vulnerability to extraneous distraction is a key symptom of Attention-Deficit Hyperactivity Disorder (ADHD), which may have particularly disruptive consequences. Here we apply Load Theory of attention to increase understanding of this symptom, and to explore a potential method for ameliorating it. Previous research in nonclinical populations has highlighted increased perceptual load as a means of improving the ability to focus attention and avoid distraction. The present study examines whether adults with ADHD can also benefit from conditions of high perceptual load to improve their focused attention abilities. Method: We tested adults with ADHD and age- and IQ-matched controls on a novel measure of irrelevant distraction under load, designed to parallel the form of distraction that is symptomatic of ADHD. During a letter search task, in which perceptual load was varied through search set size, participants were required to ignore salient yet entirely irrelevant distractors (colorful images of cartoon characters) presented infrequently (10% of trials). Results: The presence of these distractors produced a significantly greater interference effect on the search RTs for the adults with ADHD compared with controls, p = .005, ╬Ęp2 = .231. Perceptual load, however, significantly reduced distractor interference for the ADHD group and was as effective in reducing the elevated distractor interference in ADHD as it was for controls. Conclusions: These findings clarify the nature of the attention deficit underlying increased distraction in ADHD, and demonstrate a tangible method for overcoming it. PMID:24219607
Assessment of Mandibular Distraction Regenerate Using Ultrasonography and Cone Beam Computed Tomography: A Clinical Study.
Dabas, Jitender; Mohanty, Sujata; Chaudhary, Zainab; Rani, Amita
Distraction osteogenesis (DO) is becoming a popular method of reconstruction for maxillofacial bony deformities or defects secondary to trauma or surgical tumor ablation. However, the technique is very sensitive in terms of the rate and rhythm of distraction. Because of this, there is a need for monitoring of the distraction regenerate during the distraction as well as the consolidation period. The present study was conducted to assess the regenerate using two imaging modalities, namely, ultrasonography (USG) and cone beam computed tomography (CBCT) to determine their relative efficacies and to weigh their clinical usefulness in assessment of DO regenerate. The study was conducted on 12 patients (18 sites) who underwent mandibular distraction for correction of facial deformities. The results showed that overall USG correlated better with the condition of regenerate (rŌĆē=ŌĆē0.606) as compared with CBCT (rŌĆē=ŌĆē0.476). However, USG was less effective as compared with CBCT in assessing the regenerate once corticomedullary differentiation occurred in the bone. PMID:26889351
Technology-related distracted walking behaviours in Manhattan's most dangerous intersections.
Basch, Corey H; Ethan, Danna; Rajan, Sonali; Basch, Charles E
Use of mobile devices has been cited as a distraction while driving, and more recently, among pedestrians crossing urban streets. In 2010, over half of New York City traffic fatalities were pedestrians. The aim of this study was to estimate the prevalence of distracted walking due to pedestrians' use of headphones, mobile phones, or both. Data were gathered by direct observations at the 10 intersections in Manhattan with the highest frequency of pedestrian-motor vehicle collisions. More than 1 in 4 of the >3500 pedestrians observed were distracted by mobile electronic devices while crossing during the 'walk' (28.8%) and 'don't walk' (26.3%) signals. Poisson regression analyses established there was a significant difference in individuals talking on a mobile device during the 'walk' signal versus the 'don't walk' signal; however, no other significant differences in other distracted walking behaviours were observed. This study contributes to the emerging literature on distracted walking behaviour by pedestrians in busy urban areas and can help to inform pedestrian-focused safety efforts. PMID:24667654
Increasing neutral distraction inhibits genital but not subjective sexual arousal of sexually functional and dysfunctional men.
van Lankveld, Jacques J D M; van den Hout, Marcel A
To assess the effects of distraction and level of erotic stimulation on physiological and subjective sexual arousal, sexually dysfunctional (n = 23) and functional (n = 26) men were studied. It was hypothesized from previous investigations that men with erectile dysfunction would show a different genital response pattern to distraction during sexual stimulation when compared with sexually functional men. Distraction load was manipulated through different verbal instructions about how to deal with pairs of random digits. Erotic stimulation level was manipulated through the selection of erotic video content. In both groups, increasing distraction was found to increasingly inhibit genital responding, but not to affect subjective arousal. Both physiological and subjective arousal were higher when erotic stimulation level was high. An interaction effect of distraction and erotic stimulation level was observed: the linear dose-response association that was found during high erotic stimulation was not found under low stimulation conditions, which may reflect a floor effect. The implications of the findings for the cognitive theory of sexual arousal disorder are discussed. PMID:15483369
Auditory distraction transmitted by a cochlear implant alters allocation of attentional resources
Finke, Mareike; Sandmann, Pascale; Kopp, Bruno; Lenarz, Thomas; B├╝chner, Andreas
Cochlear implants (CIs) are auditory prostheses which restore hearing via electrical stimulation of the auditory nerve. The successful adaptation of auditory cognition to the CI input depends to a substantial degree on individual factors. We pursued an electrophysiological approach toward an analysis of cortical responses that reflect perceptual processing stages and higher-level responses to CI input. Performance and event-related potentials on two cross-modal discrimination-following-distraction (DFD) tasks from CI users and normal-hearing (NH) individuals were compared. The visual-auditory distraction task combined visual distraction with following auditory discrimination performance. Here, we observed similar cortical responses to visual distractors (Novelty-N2) and slowed, less accurate auditory discrimination performance in CI users when compared to NH individuals. Conversely, the auditory-visual distraction task was used to combine auditory distraction with visual discrimination performance. In this task we found attenuated cortical responses to auditory distractors (Novelty-P3), slowed visual discrimination performance, and attenuated cortical P3-responses to visual targets in CI users compared to NH individuals. These results suggest that CI users process auditory distractors differently than NH individuals and that the presence of auditory CI input has an adverse effect on the processing of visual targets and the visual discrimination ability in implanted individuals. We propose that this attenuation of the visual modality occurs through the allocation of neural resources to the CI input. PMID:25798083
Auditory distraction transmitted by a cochlear implant alters allocation of attentional resources.
Finke, Mareike; Sandmann, Pascale; Kopp, Bruno; Lenarz, Thomas; B├╝chner, Andreas
Cochlear implants (CIs) are auditory prostheses which restore hearing via electrical stimulation of the auditory nerve. The successful adaptation of auditory cognition to the CI input depends to a substantial degree on individual factors. We pursued an electrophysiological approach toward an analysis of cortical responses that reflect perceptual processing stages and higher-level responses to CI input. Performance and event-related potentials on two cross-modal discrimination-following-distraction (DFD) tasks from CI users and normal-hearing (NH) individuals were compared. The visual-auditory distraction task combined visual distraction with following auditory discrimination performance. Here, we observed similar cortical responses to visual distractors (Novelty-N2) and slowed, less accurate auditory discrimination performance in CI users when compared to NH individuals. Conversely, the auditory-visual distraction task was used to combine auditory distraction with visual discrimination performance. In this task we found attenuated cortical responses to auditory distractors (Novelty-P3), slowed visual discrimination performance, and attenuated cortical P3-responses to visual targets in CI users compared to NH individuals. These results suggest that CI users process auditory distractors differently than NH individuals and that the presence of auditory CI input has an adverse effect on the processing of visual targets and the visual discrimination ability in implanted individuals. We propose that this attenuation of the visual modality occurs through the allocation of neural resources to the CI input. PMID:25798083
Students distracted by electronic devices perform at the same level as those who are focused on the lecture
Nalliah, Romesh P.
Background. Little is known about the characteristics of internet distractions that students may engage in during lecture. The objective of this pilot study is to identify some of the internet-based distractions students engage in during in-person lectures. The findings will help identify what activities most commonly cause students to be distracted from the lecture and if these activities impact student learning. Methods. This study is a quasi-experimental pilot study of 26 students from a single institution. In the current study, one class of third-year students were surveyed after a lecture on special needs dentistry. The survey identified self-reported utilization patterns of ŌĆ£smartŌĆØ devices during the lecture. Additionally, twelve quiz-type questions were given to assess the studentsŌĆÖ recall of important points in the lecture material that had just been covered. Results. The sample was comprised of 26 students. Of these, 17 were distracted in some form (either checking email, sending email, checking Facebook, or sending texts). The overall mean score on the test was 9.85 (9.53 for distracted students and 10.44 for non-distracted students). There were no significant differences in test scores between distracted and non-distracted students (p = 0.652). Gender and types of distractions were not significantly associated with test scores (p > 0.05). All students believed that they understood all the important points from the lecture. Conclusions. Every class member felt that they acquired the important learning points during the lecture. Those who were distracted by electronic devices during the lecture performed similarly to those who were not. However, results should be interpreted with caution as this study was a small quasi-experimental design and further research should examine the influence of different types of distraction on different types of learning. PMID:25279260
Students distracted by electronic devices perform at the same level as those who are focused on the lecture.
Nalliah, Romesh P; Allareddy, Veerasathpurush
Background. Little is known about the characteristics of internet distractions that students may engage in during lecture. The objective of this pilot study is to identify some of the internet-based distractions students engage in during in-person lectures. The findings will help identify what activities most commonly cause students to be distracted from the lecture and if these activities impact student learning. Methods. This study is a quasi-experimental pilot study of 26 students from a single institution. In the current study, one class of third-year students were surveyed after a lecture on special needs dentistry. The survey identified self-reported utilization patterns of "smart" devices during the lecture. Additionally, twelve quiz-type questions were given to assess the students' recall of important points in the lecture material that had just been covered. Results. The sample was comprised of 26 students. Of these, 17 were distracted in some form (either checking email, sending email, checking Facebook, or sending texts). The overall mean score on the test was 9.85 (9.53 for distracted students and 10.44 for non-distracted students). There were no significant differences in test scores between distracted and non-distracted students (p = 0.652). Gender and types of distractions were not significantly associated with test scores (p > 0.05). All students believed that they understood all the important points from the lecture. Conclusions. Every class member felt that they acquired the important learning points during the lecture. Those who were distracted by electronic devices during the lecture performed similarly to those who were not. However, results should be interpreted with caution as this study was a small quasi-experimental design and further research should examine the influence of different types of distraction on different types of learning. PMID:25279260
Modified Segmental Osteotomy for Relocation of Malpositioned Implant: Case Report
da Silva, Andr├® Luis Fernandes; Borba, Alexandre Meireles; Bandeca, Matheus Coelho; Volpato, Luiz Evaristo Ricci; Porto, Alessandra Nogueira; Freitas, Diogo Loureiro; Borges, Alvaro Henrique
Obtaining a good cosmetic and proper mastication in oral rehabilitation with dental implants are directly linked to the correct positioning of the implant in the alveolar bone. The malposition of the implant is a challenge in rehabilitation, which can often compromise the entire process. In cases of severely malpositioned implants, one has the option to remove it or leave it submerged under bone and gums. Another option is the modified segmental osteotomy that aims repositioning osseointegrated implant with the surrounding bone. The objective of this case report is to present a case where an implant was severely malpositioned after surgically assisted rapid maxillary expansion, requiring a modified segmental osteotomy technique to reposition it. PMID:26464556
Accuracy of virtual models in the assessment of maxillary defects
Kur┼¤un, ┼×ebnem; K─▒l─▒├¦, Cenk; ├¢zen, Tuncer
Purpose This study aimed to assess the reliability of measurements performed on three-dimensional (3D) virtual models of maxillary defects obtained using cone-beam computed tomography (CBCT) and 3D optical scanning. Materials and Methods Mechanical cavities simulating maxillary defects were prepared on the hard palate of nine cadavers. Images were obtained using a CBCT unit at three different fields-of-views (FOVs) and voxel sizes: 1) 60├Ś60 mm FOV, 0.125 mm3 (FOV60); 2) 80├Ś80 mm FOV, 0.160 mm3 (FOV80); and 3) 100├Ś100 mm FOV, 0.250 mm3 (FOV100). Superimposition of the images was performed using software called VRMesh Design. Automated volume measurements were conducted, and differences between surfaces were demonstrated. Silicon impressions obtained from the defects were also scanned with a 3D optical scanner. Virtual models obtained using VRMesh Design were compared with impressions obtained by scanning silicon models. Gold standard volumes of the impression models were then compared with CBCT and 3D scanner measurements. Further, the general linear model was used, and the significance was set to p=0.05. Results A comparison of the results obtained by the observers and methods revealed the p values to be smaller than 0.05, suggesting that the measurement variations were caused by both methods and observers along with the different cadaver specimens used. Further, the 3D scanner measurements were closer to the gold standard measurements when compared to the CBCT measurements. Conclusion In the assessment of artificially created maxillary defects, the 3D scanner measurements were more accurate than the CBCT measurements. PMID:25793180
Maxillary sinus squamous cell carcinoma with concurrent prolonged foreign body impaction.
Kim, Young-Ha; Cho, Jin Hee; Cho, Kwang Jae; Kim, Joohwan
Several elements in the maxillary sinus are reported to be carcinogenic. Also, foreign body reaction can cause cancer in any part of the body. We report a case of squamous cell carcinoma at the site in the maxillary sinus where a bullet splinter, analyzed as iron afterward, was inserted during the Korean War, approximately 60 years earlier. PMID:22446444
Consequences of relining on a maxillary complete denture: A clinical report.
Hsu, Yung-tsung
The position of a complete denture may change after relining, especially in the maxillary arch. This report reviews relining techniques and presents a situation with anterior displacement after the relining of a maxillary complete denture. Instead of providing a new denture, the displaced denture was repaired and the original tooth arrangement maintained. PMID:25858224
Segment alignment control system
NASA Technical Reports Server (NTRS)
Aubrun, JEAN-N.; Lorell, Ken R.
The segmented primary mirror for the LDR will require a special segment alignment control system to precisely control the orientation of each of the segments so that the resulting composite reflector behaves like a monolith. The W.M. Keck Ten Meter Telescope will utilize a primary mirror made up of 36 actively controlled segments. Thus the primary mirror and its segment alignment control system are directly analogous to the LDR. The problems of controlling the segments in the face of disturbances and control/structures interaction, as analyzed for the TMT, are virtually identical to those for the LDR. The two systems are briefly compared.
Traumatic Intrusion of a Maxillary Canine Tooth: 3 Cases.
Edstrom, Emily J; Smith, Mark M; Taney, Kendall; Smithson, Christopher W
Of the six recognized types of tooth luxation injuries, intrusion generally carries the most guarded long-term prognosis due to the high risk of complications, including root resorption, ankylosis, marginal bone loss, and pulp canal obliteration or necrosis. The degree of traumatic intrusion and stage of root development affects the outcome and treatment planning. This report describes the clinical history, oral and radiographic examination findings, and rationale for surgical extraction in 2 dogs and 1 cat with traumatic intrusion of a maxillary canine tooth. PMID:26197689
Is the Maxillary Sinus Really Suitable in Sex Determination? A Three-Dimensional Analysis of Maxillary Sinus Volume and Surface Depending on Sex and Dentition.
M÷hlhenrich, Stephan Christian; Heussen, Nicole; Peters, Florian; Steiner, Timm; H÷lzle, Frank; Modabber, Ali
The morphometric analysis of maxillary sinus was recently presented as a helpful instrument for sex determination. The aim of the present study was to examine the volume and surface of the fully dentate, partial, and complete edentulous maxillary sinus depending on the sex. Computed tomography data from 276 patients were imported in DICOM format via special virtual planning software, and surfaces (mm) and volumes (mm) of maxillary sinuses were measured. In sex-specific comparisons (women vs men), statistically significant differences for the mean maxillary sinus volume and surface were found between fully dentate (volume, 13,267.77 mm vs 16,623.17 mm, P?0.0001; surface, 3480.05 mm vs 4100.83 mm, P?0.0001) and partially edentulous (volume, 10,577.35 mm vs 14,608.10 mm, P?=?0.0002; surface, 2980.11 mm vs 3797.42 mm, P?0.0001) or complete edentulous sinuses (volume, 11,200.99 mm vs 15,382.29 mm, P?0.0001; surface, 3118.32 mm vs 3877.25 mm, P?0.0001). For males, the statistically different mean values were calculated between fully dentate and partially edentulous (volume, P?=?0.0022; surface, P?=?0.0048) maxillary sinuses. Between the sexes, no differences were only measured for female and male partially dentate fully edentulous sinuses (2 teeth missing) and between partially edentulous sinuses in women and men (1 teeth vs 2 teeth missing). With a corresponding software program, it is possible to analyze the maxillary sinus precisely. The dentition influences the volume and surface of the pneumatic maxillary sinus. Therefore, sex determination is possible by analysis of the maxillary sinus event through the increase in pneumatization. PMID:26594986
Management of Traumatic Injury to Maxillary Central Incisors associated with Inverted Mesiodens: A Case Report.
Pavuluri, Chaitanya; Nuvvula, Sivakumar
Maxillary incisors are the most frequently injured teeth in the primary and permanent dentition. Stage of adolescence show a significant number of dental injuries as they engage in contact sports. Children with accident prone profile, i.e. class II division I or class I type II malocclusion are more prone for injuries because of the proclined maxillary incisors. Supernumerary teeth are those that are additional to the normal complement. They occur in single or multiple, unilateral or bilateral in either of the jaws. This paper reports the presence of an inverted supernumerary tooth in the right maxillary central incisor region with trauma involving both maxillary central incisors and also the management of the supernumerary tooth and traumatized teeth in a 14-year-old boy. How to cite this article: Pavuluri C, Nuvvula S. Management of Traumatic Injury to Maxillary Central Incisors associated with Inverted Mesiodens: A Case Report. Int J Clin Pediatr Dent 2013;6(1):30-32. PMID:25206184
Progressive immediate loading of a perforated maxillary sinus dental implant: a case report
Al-Juboori, Mohammed Jasim
The displacement of a dental implant into the maxillary sinus may lead to implant failure due to exposure of the apical third or the tip of the implant beyond the bone, resulting in soft tissue growth. This case report discusses dental implant placement in the upper first molar area with maxillary sinus involvement of approximately 2 mm. A new technique for progressive implant loading was used, involving immediately loaded implants with maxillary sinus perforation and low primary stability. Follow-up was performed with resonance frequency analysis and compared with an implant placed adjacent in the upper second premolar area using a conventional delayed loading protocol. Implants with maxillary sinus involvement showed increasing stability during the healing period. We found that progressive implant loading may be a safe technique for the placement of immediately loaded implants with maxillary sinus involvement. PMID:25678816
Brooding, reflection, and distraction: Relation to non-suicidal self-injury versus suicide attempts
Polanco-Roman, Lillian; Jurska, Justyna; Qui├▒ones, Victoria; Miranda, Regina
Objectives The present study examined the relation between cognitive response styles (i.e., brooding, reflection, distraction) and cognitive inflexibility in differentially predicting history of non-suicidal self-injury (NSSI) only, suicide attempt (SA) only, or both (NSSI+SA). Methods College students (N = 352) completed self-report measures of rumination, distraction, and self-harm history, a diagnostic interview, and a computerized task measuring cognitive flexibility. Results Brooding uniquely predicted SA-only history, while reflection uniquely predicted history of NSSI-only and NSSI+SA. Distraction was associated with lower odds of NSSI-only and NSSI+SA. Cognitive inflexibility was not significantly associated with self-harm history. Conclusion Cognitive vulnerabilities may help identify individuals who are at risk for self-harm and may differentiate between NSSI and SA. PMID:25517765
Eye closure reduces the cross-modal memory impairment caused by auditory distraction.
Perfect, Timothy J; Andrade, Jackie; Eagan, Irene
Eyewitnesses instructed to close their eyes during retrieval recall more correct and fewer incorrect visual and auditory details. This study tested whether eye closure causes these effects through a reduction in environmental distraction. Sixty participants watched a staged event before verbally answering questions about it in the presence of auditory distraction or in a quiet control condition. Participants were instructed to close or not close their eyes during recall. Auditory distraction did not affect correct recall, but it increased erroneous recall of visual and auditory details. Instructed eye closure reduced this effect equally for both modalities. The findings support the view that eye closure removes the general resource load of monitoring the environment rather than reducing competition for modality-specific resources. PMID:21417514
Differential impact of affective and cognitive attributes on preference under deliberation and distraction
Wang, Zuo-Jun; Chan, Kai-Qin; Chen, Jiao-Jiao; Chen, Ai; Wang, Fei
Two experiments were designed to test the hypothesis that affective information looms relatively larger than cognitive information when individuals are distracted for a period of time compared to when they engage in deliberative thinking. In two studies, participants were presented with information about 4 decision alternatives: An affective alternative that scored high on affective attributes but low on cognitive attributes, a cognitive alternative with the opposite trade-off, and two fillers. They were then asked to indicate their attitudes toward each of four decision alternatives either immediately, after a period of deliberation, or after a period of distraction. The results of both experiments demonstrated that participants significantly preferred the affective alternative to the cognitive alternative after distraction, but not after deliberation. The implications for understanding when and how unconscious thought may lead to better decisions are being discussed. PMID:25983714
Effects of cell-phone and text-message distractions on true and false recognition.
Smith, Theodore S; Isaak, Matthew I; Senette, Christian G; Abadie, Brenton G
This study examined the effects of electronic communication distractions, including cell-phone and texting demands, on true and false recognition, specifically semantically related words presented and not presented on a computer screen. Participants were presented with 24 Deese-Roediger-McDermott (DRM) lists while manipulating the concurrent presence or absence of cell-phone and text-message distractions during study. In the DRM paradigm, participants study lists of semantically related words (e.g., mother, crib, and diaper) linked to a non-presented critical lure (e.g., baby). After studying the lists of words, participants are then requested to recall or recognize previously presented words. Participants often not only demonstrate high remembrance for presented words (true memory: crib), but also recollection for non-presented words (false memory: baby). In the present study, true memory was highest when participants were not presented with any distraction tasks during study of DRM words, but poorer when they were required to complete a cell-phone conversation or text-message task during study. False recognition measures did not statistically vary across distraction conditions. Signal detection analyses showed that participants better discriminated true targets (list items presented during study) from true target controls (items presented during study only) when cell-phone or text-message distractions were absent than when they were present. Response bias did not vary significantly across distraction conditions, as there were no differences in the likelihood that a participant would claim an item as "old" (previously presented) rather than "new" (not previously presented). Results of this study are examined with respect to both activation monitoring and fuzzy trace theories. PMID:21198365
Impact of social and technological distraction on pedestrian crossing behaviour: an observational study
Thompson, Leah L; Rivara, Frederick P; Ayyagari, Rajiv C; Ebel, Beth E
Objectives The objective of the present work was to study the impact of technological and social distraction on cautionary behaviours and crossing times in pedestrians. Methods Pedestrians were observed at 20 high-risk intersections during 1 of 3 randomly assigned time windows in 2012. Observers recorded demographic and behavioural information, including use of a mobile device (talking on the phone, text messaging, or listening to music). We examined the association between distraction and crossing behaviours, adjusting for age and gender. All multivariate analyses were conducted with random effect logistic regression (binary outcomes) and random effect linear regression (continuous outcomes), accounting for clustering by site. Results Observers recorded crossing behaviours for 1102 pedestrians. Nearly one-third (29.8%) of all pedestrians performed a distracting activity while crossing. Distractions included listening to music (11.2%), text messaging (7.3%) and using a handheld phone (6.2%). Text messaging, mobile phone use and talking with a companion increased crossing time. Texting pedestrians took 1.87 additional seconds (18.0%) to cross the average intersection (3.4 lanes), compared to undistracted pedestrians. Texting pedestrians were 3.9 times more likely than undistracted pedestrians to display at least 1 unsafe crossing behaviour (disobeying the lights, crossing mid-intersection, or failing to look both ways). Pedestrians listening to music walked more than half a second (0.54) faster across the average intersection than undistracted pedestrians. Conclusions Distracting activity is common among pedestrians, even while crossing intersections. Technological and social distractions increase crossing times, with text messaging associated with the highest risk. Our findings suggest the need for intervention studies to reduce risk of pedestrian injury. PMID:23243104
Mitigating the effects of in-vehicle distractions through use of the Psychological Refractory Period paradigm.
Hibberd, Daryl L; Jamson, Samantha L; Carsten, Oliver M J
Modern driving involves frequent and potentially detrimental interactions with distracting in-vehicle tasks. Distraction has been shown to slow brake reaction time and decrease lateral and longitudinal vehicle control. It is likely that these negative effects will become more prevalent in the future as advances are made in the functionality, availability, and number of in-vehicle systems. This paper addresses this problem by considering ways to manage in-vehicle task presentation to mitigate their distracting effects. A driving simulator experiment using 48 participants was performed to investigate the existence of the Psychological Refractory Period in the driving context and its effect on braking performance. Drivers were exposed to lead vehicle braking events in isolation (single-task) and with a preceding surrogate in-vehicle task (dual-task). In dual-task scenarios, the time interval between the in-vehicle and braking tasks was manipulated. Brake reaction time increased when drivers were distracted. The in-vehicle task interfered with the performance of the braking task in a manner that was dependent on the interval between the two tasks, with slower reactions following a shorter inter-task interval. This is the Psychological Refractory Period effect. These results have implications for driver safety during in-vehicle distraction. The findings are used to develop recommendations regarding the timing of in-vehicle task presentation so as to reduce their potentially damaging effects on braking performance. In future, these guidelines could be incorporated into a driver workload management system to minimise the opportunity for a driver to be distracted from the ongoing driving task. PMID:22999382
Comparison of acceptance and distraction strategies in coping with experimentally induced pain
Moore, Hazel; Stewart, Ian; Barnes-Holmes, Dermot; Barnes-Holmes, Yvonne; McGuire, Brian E
Background This study compared an acceptance-based strategy with a control-based strategy (distraction) in terms of the ability of participants to tolerate a painful stimulus, across two experiments. In addition, participants were either actively encouraged, or not, to link pain tolerance with pursuit of valued goals to examine the impact of pursuing a personally meaningful goal or value on the extent to which pain will be tolerated. Methods Participants in experiment 1 (n=41) and experiment 2 (n=52) were equally assigned to acceptance or distraction protocols. Further, half the participants in each group generated examples from their own lives in which they had pursued a valued objective, while the other half did not. In experiment 2, the values focus was enhanced to examine the impact on pain tolerance. Results There were no significant differences overall between the acceptance and distraction groups on pain tolerance in either experiment. However, in experiment 2, individuals classified as accepting in terms of general coping style and who were assigned to the acceptance strategy showed significantly better pain tolerance than accepting individuals who were in the distraction condition. Across both experiments, those with strong goal-driven values in both protocols were more tolerant of pain. Participants appeared to have more difficulty adhering to acceptance than to distraction as a strategy. Conclusion Acceptance may be associated with better tolerance of pain, but may also be more difficult to operationalize than distraction in experimental studies. Matching coping style and coping strategy may be most effective, and enhancement of goal-driven values may assist in pain coping. PMID:25834464
Does Distraction Reduce the Alcohol-Aggression Relation?: A Cognitive and Behavioral Test of the Attention-Allocation Model
Gallagher, Kathryn E.; Parrott, Dominic J.
Objective This study provided the first direct test of the cognitive underpinnings of the attention-allocation model and attempted to replicate and extend past behavioral findings for this model as an explanation for alcohol-related aggression. Method A diverse community sample (55% African-American) of males (N = 159) between 21 and 35 years of age (M = 25.80) were randomly assigned to one of two beverage conditions (i.e., alcohol, no-alcohol control) and one of two distraction conditions (i.e., distraction, no-distraction). Following beverage consumption, participants were provoked via reception of electric shocks and a verbal insult from a fictitious male opponent. ParticipantsŌĆÖ attention-allocation to aggression words (i.e., aggression bias) and physical aggression were measured using a dot probe task and a shock-based aggression task, respectively. Results Intoxicated men whose attention was distracted displayed significantly lower levels of aggression bias and enacted significantly less physical aggression than intoxicated men whose attention was not distracted. However, aggression bias did not account for the lower levels of alcohol-related aggression in the distraction, relative to the no-distraction, condition. Conclusions These results replicated and extended past evidence that cognitive distraction is associated with lower levels of alcohol-related aggression in highly provoked males and provide the first known cognitive data to support the attentional processes posited by the attention-allocation model. Discussion focused on how these data inform intervention programming for alcohol-related aggression. PMID:21500889
Distracted Driving, A Major Preventable Cause of Motor Vehicle Collisions: ŌĆ£Just Hang Up and DriveŌĆØ
Kahn, Christopher A.; Cisneros, Victor; Lotfipour, Shahram; Imani, Ghasem; Chakravarthy, Bharath
For years, public health experts have been concerned about the effect of cell phone use on motor vehicle collisions, part of a phenomenon known as ŌĆ£distracted driving.ŌĆØ The Morbidity and Mortality Weekly Report (MMWR) article ŌĆ£Mobile Device Use While Driving - United States and Seven European Countries 2011ŌĆØ highlights the international nature of these concerns. Recent (2011) estimates from the National Highway Traffic Safety Administration are that 10% of fatal crashes and 17% of injury crashes were reported as distraction-affected. Of 3,331 people killed in 2011 on roadways in the U.S. as a result of driver distraction, 385 died in a crash where at least one driver was using a cell phone. For drivers 15ŌĆō19 years old involved in a fatal crash, 21% of the distracted drivers were distracted by the use of cell phones. Efforts to reduce cell phone use while driving could reduce the prevalence of automobile crashes related to distracted driving. The MMWR report shows that there is much ground to cover with distracted driving. Emergency physicians frequently see the devastating effects of distracted driving on a daily basis and should take a more active role on sharing the information with patients, administrators, legislators, friends and family. PMID:26759649
Distraction osteogenesis of the sternum for thoracic expansion in a severe case of jeune syndrome: a preliminary report.
Imai, Yoshimichi; Kitanishi, Ryuta; Saiki, Yoshikatsu; Takeda, Atsushi; Tachi, Masahiro
Severe asphyxiating thoracic dystrophy (Jeune syndrome) is usually fatal. The authors used distraction osteogenesis in a severe case and achieved 45ŌĆēmm distraction of the sternum and improvement in tidal volume, lung compliance, and mean airway pressure. PMID:27009488
Older driver distraction: a naturalistic study of behaviour at intersections.
Charlton, Judith L; Catchlove, Matthew; Scully, Michelle; Koppel, Sjaan; Newstead, Stuart
This study examined older driver engagement in distracting behaviours (secondary activities) at intersections using naturalistic driving data from a larger study based in Melbourne, Australia. Of interest was whether engagement in secondary activities at intersections was influenced by factors such as driver gender and situational variables, in particular, those relating to the complexity of the driving environment. Specifically we expected that when making left/right turns, older drivers would reduce the proportion of time engaged in secondary behaviours at intersections which required gap judgements (partly controlled or uncontrolled) compared with intersections that were fully controlled by traffic signals. Consideration was given to engagement in secondary activity with hands off the wheel and when the vehicle was moving versus stationary. Older drivers aged between 65 and 83 years drove an instrumented vehicle (IV) on their regular trips for approximately two weeks. The IV was equipped with a video camera system, enabling recording of the road environment and driver and a data acquisition unit, enabling recording of trip distance, vehicle speed, braking, accelerating, steering and indicator use. Driving experience and demographics were collected and functional abilities were assessed using the Useful Field of View (UFOV), Trail Making Test B, Mini Mental Status Examination (MMSE), visual acuity and contrast sensitivity. The study yielded a total of 371 trips with 4493 km (99.8 h) of naturalistic driving data including 1396 left and right turns. Trips were randomly selected from the dataset and in-depth analysis was conducted on 200 intersection manoeuvres (approximately 50% left turns, 50% right turns). The most frequently observed secondary activities were scratching/grooming (42.5%), talking/singing (30.2%) and manipulating the vehicle control panel (12.2%). Glances "off road" 2s or longer were associated with reading, reaching and manipulation of the vehicle control panel. Hands off the wheel was associated with reading. Key parameters associated with the percent of intersection time that drivers engaged in secondary activities were intersection complexity, vehicle status (moving vs. stationary) and traffic density. In conclusion, older drivers appeared to engage selectively in secondary activities according to roadway/driving situations, supporting the notion that drivers self-regulate by engaging in secondary tasks less frequently when the driving task is more challenging compared with less challenging manoeuvres. PMID:23332726
Clinical Use of Virtual Reality Distraction System to Reduce Anxiety and Pain in Dental Procedures
Gao, Kenneth; Wiederhold, Brenda K.
Abstract Virtual reality (VR) has been used by clinicians to manage pain in clinical populations. This study examines the use of VR as a form of distraction for dental patients using both subjective and objective measures to determine how a VR system affects patients' reported anxiety level, pain level, and physiological factors. As predicted, results of self-evaluation questionnaires showed that patients experienced less anxiety and pain after undergoing VR treatment. Physiological data reported similar trends in decreased anxiety. Overall, the favorable subjective and objective responses suggest that VR distraction systems can reduce discomfort and pain for patients with mild to moderate fear and anxiety. PMID:24892198
Clinical use of virtual reality distraction system to reduce anxiety and pain in dental procedures.
Wiederhold, Mark D; Gao, Kenneth; Wiederhold, Brenda K
Virtual reality (VR) has been used by clinicians to manage pain in clinical populations. This study examines the use of VR as a form of distraction for dental patients using both subjective and objective measures to determine how a VR system affects patients' reported anxiety level, pain level, and physiological factors. As predicted, results of self-evaluation questionnaires showed that patients experienced less anxiety and pain after undergoing VR treatment. Physiological data reported similar trends in decreased anxiety. Overall, the favorable subjective and objective responses suggest that VR distraction systems can reduce discomfort and pain for patients with mild to moderate fear and anxiety. PMID:24892198
Malignant tumours of the maxillary complex: an 18-year review.
Stavrianos, S D; Camilleri, I G; McLean, N R; Piggot, T A; Kelly, C G; Soames, J V
Over an 18-year period, 147 patients with malignant tumours involving the maxillary complex were treated in a combined head and neck clinic, of whom 50 underwent surgery. There were 33 males and 17 females, the mean age was 57 years (range 11-87 years). The most common clinical presentations were either painful facial swelling, infraorbital anaesthesia, palatal ulceration or nasal obstruction. Preoperative investigations included EUA, biopsy and either CT or MRI scans. Of the 50 tumours, 62% were squamous cell carcinomas. Surgery consisted of either partial or total maxillectomy including craniofacial resection in nine patients. Reconstruction was by either split skin grafting or by free tissue transfer when the cranial contents had been exposed. Adjuvant radiotherapy was given in 82% of the patients. The mean follow-up was 5 years and 59% of patients are alive and disease free. The 5-year local control rate was 67%; it was greatly influenced by histological evidence of nerve invasion, local recurrence being the major cause of death. It was concluded that adequate surgical clearance, followed by planned postoperative radiotherapy, is the most effective treatment for malignant disease of the maxillary complex. PMID:10209459
Experimental maxillary sinus augmentation using a highly bioactive glass ceramic.
Vivan, Rodrigo Ricci; Mecca, Carlos Eduardo; Biguetti, Claudia Cristina; Renn├│, Ana Claudia Muniz; Okamoto, Roberta; Cavenago, Bruno Cavalini; Duarte, Marco H├║ngaro; Matsumoto, Mariza Akemi
Physicochemical characteristics of a biomaterial directly influence its biological behavior and fate. However, anatomical and physiological particularities of the recipient site also seem to contribute with this process. The present study aimed to evaluate bone healing of maxillary sinus augmentation using a novel bioactive glass ceramic in comparison with a bovine hydroxyapatite. Bilateral sinus augmentation was performed in adult male rabbits, divided into 4 groups according to the biomaterial used: BO-particulate bovine HA Bio-Oss(®) (BO), BO+G-particulate bovine HA + particulate autogenous bone graft (G), BS-particulate glass ceramic (180-212 μm) Biosilicate(®) (BS), and BS+G-particulate glass ceramic + G. After 45 and 90 days, animals were euthanized and the specimens prepared to be analyzed under light and polarized microscopy, immunohistochemistry, scanning electron microscopy (SEM), and micro-computed tomography (μCT). Results revealed different degradation pattern between both biomaterials, despite the association with bone graft. BS caused a more intense chronic inflammation with foreign body reaction, which led to a difficulty in bone formation. Besides this evidence, SEM and μCT confirmed direct contact between newly formed bone and biomaterial, along with osteopontin and osteocalcin immunolabeling. Bone matrix mineralization was late in BS group but became similar to BO at day 90. These results clearly indicate that further studies about Biosilicate(®) are necessary to identify the factors that resulted in an unfavorable healing response when used in maxillary sinus augmentation. PMID:26712707
Endoscopic lift of the maxillary sinus floor in Beagles.
Zheng, JiSi; Zhang, ShanYong; Lu, ErYi; Yang, Chi; Zhang, WenJie; Zhao, JingYang
The aim of this study was to introduce a modified endoscopic lift of the floor of the maxillary sinus in Beagles. Twelve operations (bilateral and randomly chosen) were done in 6 Beagles each in the test group (modified endoscopic operation), and the control group, in which the operation was done with an osteotome. All operations were evaluated by two indices of safety (perforation of the sinus membrane and nasal bleeding) and 3 effective indices (the intraoperative height after lifting, volume of bone grafts, and dislocation of the sinus grafts). The sinus membrane was not perforated and there were no nasal bleeds in either group. The intraoperative height after lifting was 13.7 (0.8) mm in the test group and 9.1 (0.5) mm in the control group, so it was significantly higher in the test group than the control group (p=0.0001). Similarly, the volume of bone graft was 0.9 (0.04) ml in the test group and 0.5 (0.02) ml in the control group (p=0.0001). The volume of the anterior and posterior bone grafts in the implant cavity in the test group did not differ significantly (p=0.102), while there were significant differences in the control group (p=0.002). Endoscopic lifting of the floor of the maxillary sinus is a safe and effective approach based on direct observation in Beagles. PMID:25174319
Root canal morphology of South Asian Indian maxillary molar teeth
Singh, Shishir; Pawar, Mansing
Objective: The objective was to study the root canal morphology of South Asian Indian Maxillary molars using a tooth clearing technique. Materials and Methods: Hundred teeth each comprising of first, second, and third molars collected from different dental schools and clinics in India were subjected to standard dye penetration, decalcification and clearing procedure before being studied. Results: The first molar mesiobuccal roots exhibited 69% Type I, 24% Type II, 4% Type IV, 2% Type V, and 1% exhibited a Vertuccis Type VIII canal anatomy. In the group with three separate roots the second molar mesiobuccal roots in exhibited 80.6% Type I, 15.3% Type II, 2.7% Type IV, and 1.4% Type V canal anatomy while the third molars mesiobuccal roots exhibited 57.4% Type I, 32% Type II, 2.1% Type III, 8.5% Type IV, 1% had a Type V canal anatomy in the similar group. Conclusion: A varied root canal anatomy was seen in the mesiobuccal root canal of the maxillary molars. PMID:25713497
A novel method for lateral callus distraction and its importance for the mechano-biology of bone formation.
Claes, L; Veeser, A; G├Čckelmann, M; Horvath, D; D├╝rselen, L; Ignatius, A
We introduce a novel method of lateral callus distraction for bone formation, which avoids the conventional splitting and weakening of bones. At the medial aspect of the sheep tibia the periosteum was resected and small holes were drilled into the cortex to connect the bone surface with the marrow. A distraction device with a hydroxyapatite-coated titanium plate was fixed over the drilled area. After 10 days latency the plate was distracted perpendicular to the bone's long axis twice a day by 0.27 mm for 10 days. The newly formed tissue was then allowed 50 days of maturation. In a control group the plate was fixed 5.4mm distant from the bone surface. After 70 days all sheep were sacrificed and investigated histo-morphologically and with pQCT. Significantly more bone had developed between the lateral bone surface and the plate in the distraction group compared to the control group. There was exclusively intra-membranous bone formation with trabeculae oriented in the direction of the applied distraction. The main calcification occurred weeks after the last distraction. In conventional callus distraction the tissue strain caused by distraction is superimposed by the tissue deformation due to the deformation of the fixation device. In contrast, in the newly introduced lateral callus distraction method pure uniaxial strain occurs. From a mechano-biological point of view these results suggest that pure uniaxial strain induces exclusively intra-membranous bone formation. Furthermore, it shows that the anabolic effect of tissue strain is present even 50 days after the last stimulation by distraction. PMID:20637324
Temporally coherent 4D video segmentation for teleconferencing
NASA Astrophysics Data System (ADS)
Ehmann, Jana; Guleryuz, Onur G.
We develop an algorithm for 4-D (RGB+Depth) video segmentation targeting immersive teleconferencing ap- plications on emerging mobile devices. Our algorithm extracts users from their environments and places them onto virtual backgrounds similar to green-screening. The virtual backgrounds increase immersion and interac- tivity, relieving the users of the system from distractions caused by disparate environments. Commodity depth sensors, while providing useful information for segmentation, result in noisy depth maps with a large number of missing depth values. By combining depth and RGB information, our work signi¯cantly improves the other- wise very coarse segmentation. Further imposing temporal coherence yields compositions where the foregrounds seamlessly blend with the virtual backgrounds with minimal °icker and other artifacts. We achieve said improve- ments by correcting the missing information in depth maps before fast RGB-based segmentation, which operates in conjunction with temporal coherence. Simulation results indicate the e±cacy of the proposed system in video conferencing scenarios.
Combined treatment with headgear and the Frog appliance for maxillary molar distalization: a randomized controlled trial
Objective To evaluate the efficiency of the Frog appliance (FA) alone or in combination with headgear for distalizing the maxillary molars. Methods Fifty patients (25 males and 25 females) aged 12.6 - 16.7 years who received treatment for Class II malocclusion at the Orthodontic Clinic of Al-Baath University were selected for this study and randomly divided into 2 equal groups. Maxillary molar distalization was achieved using the FA alone (group 1) or a combination of the FA with high-pull headgear worn at night (group 2). Lateral cephalograms were obtained before and after treatment. Results The maxillary molars moved distally by 5.51 and 5.93 mm in groups 1 and 2, respectively. Distal movements were associated with axial tipping by 4.96┬░ and 1.25┬░, and with loss of anchorage by mesial movement of the second maxillary premolars by 2.70 and 0.90 mm in groups 1 and 2, respectively. The combined use of the FA and nighttime high-pull headgear decreased the distalization time and improved the ratio of maxillary molar distalization movement relative to the overall opening space between the first maxillary molars and second premolars. Conclusions The FA can effectively distalize the maxillary molars, this distalization associates with some unfavorable changes. Nighttime use of high-pull headgear combined with the FA can reduce these unfavorable changes and improve treatment outcomes. PMID:23671835
A case of a divided maxillary artery in the infratemporal fossa.
Tadokoro, Osamu; Umemura, Yasunobu; Utsuno, Hajime; Inoue, Katsuhiro
A divided maxillary artery was found in the left infratemporal fossa of a 63-year-old male cadaver during a student dissection practice. The maxillary artery, which arose from the external carotid artery at the posterior border of the ramus of the mandible, was divided into two branches in the infratemporal fossa. The deep branch of the maxillary artery was deep to the lateral pterygoid muscle and the inferior alveolar, buccal and lingual nerves, giving off the anterior tympanic, middle meningeal, anterior deep temporal, buccal, and posterior superior alveolar arteries. The deep branch passed through the pterygomaxillary fissure. On the other hand, the superficial branch of the maxillary artery, which was superficial to the lateral pterygoid muscle, gave off the inferior alveolar artery and other branches. The maxillary artery on the right side displayed a normal branching pattern within the infratemporal fossa. These findings indicate that the deep and superficial branches of the maxillary artery remained without disappearing during the development of the maxillary artery originated from the stapedial artery. PMID:19227200
[Clinical study of routes of onset of inflammatory diseases in the maxillary sinuses].
Raci─ć, A; Janosevi─ć, Lj; Stosi─ć-Divjak, S; Djuki─ć, V; Radulovi─ć, R; Babi─ć, D; Janosevi─ć-Dotli─ć, S
Pathways of the maxillary sinus diseases is an interesting issue investigated by many authors during the past decades. The goal of this research was to study the pathways of infection spreading into the maxillary sinuses and to compare them in relation to their frequency, underlying causes and general epidemiologic characteristics of the involved population. A total number of 150 adult patients of both gender suffering different diseases of maxillary sinuses were included into the study. Pathways rising maxillary sinuses diseases were diagnosed on the basis of standard clinical procedures including CT scean and MRI of the region. We found inflammatory processes to dominate the tumorous ones (107:43 patients). Rhinogenic type of sinusitis was the most frequent disease (72 patients) while odontogenic sinusitis (35 patients) was significantly less frequent. No case of traumatic or hematogenic maxillary sinusitis was found. Rhinogenic maxillary sinusitis is characterised by spontaneous onset while odontogenic one is mostly of arteficial origin after surgical procedures in the oral cavity (88% of patients). In contrast to rhinogenic type, odontogenic maxillary sinusitis is far more frequent in younger patients. PMID:15756797
An Analysis of Maxillary Anterior Teeth Dimensions for the Existence of Golden Proportion: Clinical Study
Sandeep, Nalla; Satwalekar, Parth; Srinivas, Siva; Reddy, Chandra Sekhar; Reddy, G Ramaswamy; Reddy, B Anantha
Background: Appearance of the face is a great concern to everyone, as it is a significant part of self-image. The study analyzed the clinical crown dimensions of the maxillary anterior teeth with respect to their apparent mesiodistal widths, width-to-height ratio to determine whether golden proportion existed among the South Indian population. Materials and Methods: A total of 240 dentulous subjects were chosen for the study (120 males and 120 females) age ranging between 18 and 28 years. Full face and anterior teeth images of the subjects were made on specially designed device resembling a face-bow, mounted onto the wall under a standard light source. The width and height of the maxillary central incisors were measured on the stone casts using a digital caliper. Results: The mean perceived maxillary lateral incisor to central incisor width ratio was 0.67 in males and 0.703 in females. The mean perceived maxillary canine to lateral incisor width ratio was 0.744 in males and 0.714 in females. The mean width-to-height ratio of the maxillary central incisor was 79.49% in males and 79.197% in females. Conclusion: The golden proportion was not found between perceived mesiodistal widths of maxillary central and lateral incisors and nor between perceived mesiodistal widths of maxillary lateral incisors and canines. In the majority of subjects, the width-to-height ratio of maxillary central incisor was within 75-80%. There are no statistically significant differences in maxillary anterior teeth proportions between males and females. The results may serve as guidelines for treatment planning in restorative dentistry and periodontal surgery. PMID:26435610
The effects of nicotine dose expectancy and motivationally relevant distracters on vigilance.
Robinson, Jason D; Engelmann, Jeffery M; Cui, Yong; Versace, Francesco; Waters, Andrew J; Gilbert, David G; Gritz, Ellen R; Cinciripini, Paul M
The imminence of drug use (i.e., drug availability) has been found to be related to intensity of drug craving, but its effects on attentional bias to drug cues are unclear. This study investigated the effects of nicotine availability on attentional bias to smoking, affective, and neutral cues in a sample of adult smokers during a vigilance task. At the beginning of each of 4 laboratory sessions, overnight nicotine-deprived smokers (n = 51) were instructed that they would smoke a cigarette containing either nicotine (Told-NIC) or no nicotine (Told-DENIC) after completing the rapid visual information processing task with central emotional distracters (RVIP-CED). The RVIP-CED presented digits at a rapid pace, with participants instructed to respond with button presses to every third consecutive even or odd digit. Some digits were preceded by smoking, pleasant, unpleasant, or neutral distracter slides. During Told-NIC conditions, participants produced significantly longer reaction time (RT) latency than during Told-DENIC conditions. RT sensitivity (d'), a measure of the ability to discriminate true positives from false positives, was significantly lower during the Told-NIC than during the Told-DENIC conditions to targets following cigarette distracters. These results suggest that nicotine-deprived smokers expecting to imminently smoke a cigarette experience greater distraction, particularly to smoking-related stimuli, than when expecting to smoke a denicotinized cigarette. PMID:24841184
What Does Distractibility in ADHD Reveal about Mechanisms for Top-Down Attentional Control?
ERIC Educational Resources Information Center
Friedman-Hill, Stacia R.; Wagman, Meryl R.; Gex, Saskia E.; Pine, Daniel S.; Leibenluft, Ellen; Ungerleider, Leslie G.
In this study, we attempted to clarify whether distractibility in ADHD might arise from increased sensory-driven interference or from inefficient top-down control. We employed an attentional filtering paradigm in which discrimination difficulty and distractor salience (amount of image "graying") were parametrically manipulated. IncreasedŌĆ"
Distraction Control Processes in Free Recall: Benefits and Costs to Performance
ERIC Educational Resources Information Center
Marsh, John E.; S├Črqvist, Patrik; Hodgetts, Helen M.; Beaman, C. Philip; Jones, Dylan M.
How is semantic memory influenced by individual differences under conditions of distraction? This question was addressed by observing how participants recalled visual target words-drawn from a single category-while ignoring spoken distractor words that were members of either the same or a different (single) category. Working memory capacity (WMC)ŌĆ"
The Cognitive Locus of Distraction by Acoustic Novelty in the Cross-Modal Oddball Task
ERIC Educational Resources Information Center
Parmentier, Fabrice B. R.; Elford, Gregory; Escera, Carles; Andres, Pilar; San Miguel, Iria
Unexpected stimuli are often able to distract us away from a task at hand. The present study seeks to explore some of the mechanisms underpinning this phenomenon. Studies of involuntary attention capture using the oddball task have repeatedly shown that infrequent auditory changes in a series of otherwise repeating sounds trigger an automaticŌĆ"
Internal mandibular distraction to relieve airway obstruction in children with severe micrognathia.
Rachmiel, A; Emodi, O; Rachmiel, D; Aizenbud, D
Congenital craniofacial malformations such as Pierre Robin sequence or Treacher Collins syndrome are associated with mandibular micrognathia, resulting in obstructive sleep apnea (OSA) due to a decreased pharyngeal airway; in severe cases this leads to tracheostomy dependence. We present a series of 18 patients in whom we performed mandibular lengthening using internal distraction devices to relieve airway obstruction. Seven were tracheostomy-dependent and 11 were respiratory distressed without tracheostomy. The mandible was distracted at a rate of 1mm per day. Following 3 months of consolidation for bony maturation, the distraction devices were removed. Results demonstrated forward mandibular elongation of a mean 22mm (range 20-25mm) and an increase in SNB angle and in pharyngeal airway. All patients with tracheostomies were decannulated, and there was an improved airway with resolution of signs and symptoms of OSA and elimination of oxygen requirement in all patients. We conclude that mandibular distraction using internal devices is a useful and comfortable method for younger children to expand the mandible forward and increase the pharyngeal airway. PMID:25052572
Examining the impact of distraction on tic suppression in children and adolescents with Tourette syndrome.
Conelea, Christine A; Woods, Douglas W
Tourette syndrome (TS) is characterized by motor and/or vocal tics. Tics are thought to be temporarily suppressible, and it is believed that suppression requires significant attentional resources. The aim of the current study was to examine the impact of an attention-demanding distraction task on tic suppression. A secondary aim was to examine whether performance on that task decreased during concomitant periods of suppression. Nine children with TS, ages 9-15, participated in the study. An alternating treatment design was used to compare three conditions, free-to-tic baseline (BL), reinforced tic suppression (SUP) and reinforced tic suppression plus a distraction task (SUP+DIS). Tic frequencies were significantly higher during BL conditions than both SUP and SUP+DIS conditions, and tic frequencies during SUP and SUP+DIS did not differ. Accuracy on the distraction task decreased during SUP+DIS as compared to BL. Results suggest that contextual distractions may not negatively impact tic frequencies. In addition, accuracy on an attention-demanding task may be impacted if a child is simultaneously suppressing. PMID:18774126
In Vivo Distraction-Coping in the Treatment of Test Anxiety.
ERIC Educational Resources Information Center
Thyer, Bruce A.; And Others
Treated test-anxious college students with cognitive behavior therapy, relaxation training, and thermal biofeedback training. Experimental subjects also received in vivo distraction coping training. Overall program efficacy was demonstrated by reductions in anxiety and increases in rationality of personal belief systems. In vivo training did notŌĆ"
The effects of nicotine dose expectancy and motivationally relevant distracters on vigilance
Robinson, Jason D.; Engelmann, Jeffery M.; Cui, Yong; Versace, Francesco; Waters, Andrew J.; Gilbert, David G.; Gritz, Ellen R.; Cinciripini, Paul M.
The imminence of drug use (i.e., drug availability) has been found to be related to intensity of drug craving, but its effects on attentional bias to drug cues are unclear. This study investigated the effects of nicotine availability on attentional bias to smoking, affective, and neutral cues in a sample of adult smokers during a vigilance task. At the beginning of each of four laboratory sessions, overnight nicotine-deprived smokers (n = 51) were instructed that they would smoke a cigarette containing either nicotine (Told-NIC) or no nicotine (Told-DENIC) after completing the rapid visual information processing task with central emotional distracters (RVIP-CED). The RVIP-CED presented digits at a rapid pace, with participants instructed to respond with button presses to every third consecutive even or odd digit. Some digits were preceded by smoking, pleasant, unpleasant, or neutral distracter slides. During Told-NIC conditions, participants produced significantly longer RT latency than during Told-DENIC conditions. RT sensitivity (d'), a measure of the ability to discriminate true positives from false positives, was significantly lower during the Told-NIC than during the Told-DENIC conditions to targets following cigarette distracters. These results suggest that nicotine-deprived smokers expecting to imminently smoke a cigarette experience greater distraction, particularly to smoking-related stimuli, than when expecting to smoke a denicotinized cigarette. PMID:24841184
Does Response Variability Predict Distractibility among Adults with Attention-Deficit/Hyperactivity Disorder?
ERIC Educational Resources Information Center
Adams, Zachary W.; Roberts, Walter M.; Milich, Richard; Fillmore, Mark T.
Increased intraindividual variability in response time (RTSD) has been observed reliably in attention-deficit/hyperactivity disorder (ADHD) and has often been used as a measure of inattention. RTSD is assumed to reflect attentional lapses and distractibility, though evidence for the validity of this connection is lacking. We assessed whether RTSDŌĆ"
Hexapod external fixator closed distraction in the management of stiff hypertrophic tibial nonunions.
Ferreira, N; Marais, L C; Aldous, C
Tibial nonunion represents a spectrum of conditions which are challenging to treat, and optimal management remains unclear despite its high rate of incidence. We present 44 consecutive patients with 46 stiff tibial nonunions, treated with hexapod external fixators and distraction to achieve union and gradual deformity correction. There were 31 men and 13 women with a mean age of 35 years (18 to 68) and a mean follow-up of 12 months (6 to 40). No tibial osteotomies or bone graft procedures were performed. Bony union was achieved after the initial surgery in 41 (89.1%) tibias. Four persistent nonunions united after repeat treatment with closed hexapod distraction, resulting in bony union in 45 (97.8%) patients. The mean time to union was 23 weeks (11 to 49). Leg-length was restored to within 1 cm of the contralateral side in all tibias. Mechanical alignment was restored to within 5┬░ of normal in 42 (91.3%) tibias. Closed distraction of stiff tibial nonunions can predictably lead to union without further surgery or bone graft. In addition to generating the required distraction to achieve union, hexapod circular external fixators can accurately correct concurrent deformities and limb-length discrepancies. PMID:26430019
Brain activity during driving with distraction: an immersive fMRI study
Schweizer, Tom A.; Kan, Karen; Hung, Yuwen; Tam, Fred; Naglie, Gary; Graham, Simon J.
Introduction: Non-invasive measurements of brain activity have an important role to play in understanding driving ability. The current study aimed to identify the neural underpinnings of human driving behavior by visualizing the areas of the brain involved in driving under different levels of demand, such as driving while distracted or making left turns at busy intersections. Materials and Methods: To capture brain activity during driving, we placed a driving simulator with a fully functional steering wheel and pedals in a 3.0 Tesla functional magnetic resonance imaging (fMRI) system. To identify the brain areas involved while performing different real-world driving maneuvers, participants completed tasks ranging from simple (right turns) to more complex (left turns at busy intersections). To assess the effects of driving while distracted, participants were asked to perform an auditory task while driving analogous to speaking on a hands-free device and driving. Results: A widely distributed brain network was identified, especially when making left turns at busy intersections compared to more simple driving tasks. During distracted driving, brain activation shifted dramatically from the posterior, visual and spatial areas to the prefrontal cortex. Conclusions: Our findings suggest that the distracted brain sacrificed areas in the posterior brain important for visual attention and alertness to recruit enough brain resources to perform a secondary, cognitive task. The present findings offer important new insights into the scientific understanding of the neuro-cognitive mechanisms of driving behavior and lay down an important foundation for future clinical research. PMID:23450757
Comminuted fractures of the base of the first metacarpal treated by distraction-external fixation.
Schuind, F; Noorbergen, M; Andrianne, Y; Burny, F
A new technique is presented for the treatment of comminuted intraarticular fractures of the base of the thumb metacarpal. A triangular Hoffmann external radius and first- and second-metacarpal fixator is used. The reduction is maintained by prolonged distraction and abduction of the first metacarpal bone. The application of the technique in three cases is reported. PMID:3249258
Cognitive/Attentional Distraction in the Control of Conditioned Nausea in Pediatric Cancer Patients Receiving Chemotherapy.
ERIC Educational Resources Information Center
Redd, William H.; And Others
Investigated use of cognitive/attentional distraction (via commercially available video games) to control conditioned nausea in pediatric cancer patients receiving chemotherapy. Video game-playing resulted in significantly less nausea. The introduction and withdrawal of the opportunity to play video games produced significant changes (reductionŌĆ"
Eye Closure Reduces the Cross-Modal Memory Impairment Caused by Auditory Distraction
ERIC Educational Resources Information Center
Perfect, Timothy J.; Andrade, Jackie; Eagan, Irene
Eyewitnesses instructed to close their eyes during retrieval recall more correct and fewer incorrect visual and auditory details. This study tested whether eye closure causes these effects through a reduction in environmental distraction. Sixty participants watched a staged event before verbally answering questions about it in the presence ofģ
Using Virtual Reality to Distract Overweight Children from Bodily Sensations During Exercise.
Ba├▒os, Rosa M; Escobar, Patricia; Cebolla, Ausias; Guixeres, Jaime; Alvarez Pitti, Julio; Lis├│n, Juan Francisco; Botella, Cristina
This study analyzes the potential of virtual reality (VR) to enhance attentional distraction in overweight children as they experience bodily sensations during exercise. It has been suggested that one reason why obese children stop exercising is the perception of bodily sensations. In a counterbalanced design, a total of 109 children (33 overweight, 10-15 years old) were asked to walk twice for 6 minutes on a treadmill under one of two conditions: (a) traditional condition (TC)-focusing their attention on their physical feelings and sensations or (b) distraction condition (DC)-focusing their attention on a virtual environment. Attentional focus during exercise, bad-good feeling states (pre- and postexperimental), perceived exertion (3 minutes and post), heart rate, and enjoyment were assessed. Results indicated that overweight children focused on internal information under the TC, but they significantly shifted their attention to regard the external environment in the DC. This attentional distraction effect of VR was more intense in overweight than in normal-weight children. No differences between groups were found when examining changes in feeling states and perceived exertion. VR increased enjoyment during exercise, and children preferred exercise using virtual environments. VR is useful to promote distraction and may help overweight and obese children to enjoy exercise. PMID:26882326
Why Are Auditory Novels Distracting? Contrasting the Roles of Novelty, Violation of Expectation and Stimulus Change
ERIC Educational Resources Information Center
Parmentier, Fabrice B. R.; Elsley, Jane V.; Andres, Pilar; Barcelo, Francisco
Past studies show that novel auditory stimuli, presented in the context of an otherwise repeated sound, capture participants' attention away from a focal task, resulting in measurable behavioral distraction. Novel sounds are traditionally defined as rare and unexpected but past studies have not sought to disentangle these concepts directly. UsingŌĆ"
Speech Perception by 6- to 8-Month-Olds in the Presence of Distracting Sounds
ERIC Educational Resources Information Center
Polka, Linda; Rvachew, Susan; Molnar, Monika
The role of selective attention in infant phonetic perception was examined using a distraction masker paradigm. We compared perception of /bu/ versus /gu/ in 6- to 8-month-olds using a visual fixation procedure. Infants were habituated to multiple natural productions of 1 syllable type and then presented 4 test trials (old-new-old-new). PerceptionŌĆ"
Dial D for Distraction: The Making and Breaking of Cell Phone Policies in the College Classroom
ERIC Educational Resources Information Center
Berry, Michael J.; Westfall, Aubrey
Cell phones are nearly ubiquitous in the college classroom. This study asks two primary questions regarding the making and breaking of in-class cell phone policies. In what manner are students using their phones and how can faculty members minimize the potential for phone-related distractions? To answer these questions we analyze original surveyŌĆ"
Initial experiences using a new implant based distraction system for alveolar ridge augmentation.
Klein, C; Papageorge, M; Kov├Īcs, A; Carchidi, J E
With this case report we demonstrate a new technique useful in augmenting alveolar ridges after resection procedures or atrophic loss of volume. The augmentation is done by means of a new osteogenic distractor (manufactured by ACE Surgical Supply Co., Inc., Brockton, MA, USA), the distraction procedure is according to Ilizarov's principles. PMID:11405454
A longitudinal study of rumination and distraction in formerly depressed inpatients and community controls.
Huffziger, Silke; Reinhard, Iris; Kuehner, Christine
The response styles theory (S. Nolen-Hoeksema, B. E. Wisco, & S. Lyubomirsky, 2008) supposes that ruminative coping is a cognitive risk factor for the course of depression, whereas distractive coping has protective effects. The authors present a longitudinal study on reciprocal relations between coping styles and depressive symptoms. They investigated 82 formerly depressed inpatients 4 weeks, 6 months, and 3.5 years after hospital discharge together with 76 age- and gender-matched community controls. Depressive symptoms predicted future symptom-focused rumination over the initial short-term interval in both samples. In former inpatients, this predictive effect was also significant over the subsequent long-term interval. Symptom-focused rumination and distraction were significant predictors of future depressive symptoms across both intervals, with sample-specific effects. In the community sample, symptom-focused rumination predicted more depressive symptoms, whereas in former inpatients, distractive coping predicted fewer depressive symptoms over time. The authors conclude that interventions aimed at reducing rumination should preferably be applied in preventive and early intervention settings, although in individuals with a history of more severe and long-standing depression rumination might gradually lose its capacity to predict the further illness course. In these persons, interventions should particularly strengthen distractive coping. PMID:19899844
Self-Reported Distractions of Middle School Students in Listening to Music and Prose
ERIC Educational Resources Information Center
Flowers, Patricia J.; O'Neill, Alice Ann M.
One hundred eighteen middle school students from three different settings listened individually to a music excerpt and a prose excerpt that were each 3.5 minutes long. As they listened, they clicked a computer touchpad whenever they were distracted either by thoughts or external events, then refocused on the holistic listening task. AfterŌĆ"
The Process of Auditory Distraction: Disrupted Attention and Impaired Recall in a Simulated Lecture Environment
ERIC Educational Resources Information Center
Zeamer, Charlotte; Fox Tree, Jean E.
Literature on auditory distraction has generally focused on the effects of particular kinds of sounds on attention to target stimuli. In support of extensive previous findings that have demonstrated the special role of language as an auditory distractor, we found that a concurrent speech stream impaired recall of a short lecture, especially forŌĆ"
Dial D for Distraction: The Making and Breaking of Cell Phone Policies in the College Classroom
ERIC Educational Resources Information Center
Berry, Michael J.; Westfall, Aubrey
Cell phones are nearly ubiquitous in the college classroom. This study asks two primary questions regarding the making and breaking of in-class cell phone policies. In what manner are students using their phones and how can faculty members minimize the potential for phone-related distractions? To answer these questions we analyze original surveyģ
Amygdala hyperactivation during symptom provocation in obsessiveŌĆōcompulsive disorder and its modulation by distraction
Simon, Daniela; Adler, Nele; Kaufmann, Christian; Kathmann, Norbert
Anxiety disorders have been linked to a hyperactivated cortico-amygdalar circuitry. Recent findings highlight the amygdala's role in mediating elevated anxiety in obsessiveŌĆōcompulsive disorder (OCD). However, modulation of amygdala hyperactivation by attentional distraction ŌĆō an effective emotion regulation strategy in healthy individuals ŌĆō has not yet been examined. While undergoing functional magnetic resonance imaging twenty-one unmedicated OCD patients and 21 controls performed an evaluation and a distraction task during symptom provocation with individually tailored OCD-relevant pictures. To test the specificity of responses, additional aversive and neutral stimuli were included. Significant group-by-picture type interactions were observed within frontoŌĆōstriatoŌĆōlimbic circuits including the amygdala. In these regions patients showed increased BOLD responses during processing of OCD triggers relative to healthy controls. Amygdala hyperactivation was present across OCD symptom dimensions indicating that it represents a common neural correlate. During distraction, we observed dampening of patients' amygdala hyperactivity to OCD-relevant stimuli. Augmented amygdala involvement in patients during symptom provocation, present across OCD symptom dimensions, might constitute a correlate of fear expression in OCD linking it to other anxiety disorders. Attentional distraction seemed to dampen emotional processing of disorder-relevant stimuli via amygdala downregulation. The clinical impact of this strategy to manage anxiety in OCD should be further elucidated. PMID:24818080
Attentional Distraction during Exercise in Overweight and Normal-Weight Boys
Deforche, Benedicte; De Bourdeaudhuij, Ilse
The purpose of this study was to investigate the effect of attentional distraction on field running distance and activity intensity during an exercise session in normal-weight and overweight youngsters and to investigate potential mediators. Fifty-three 12ŌĆō14 yr-old boys participated twice in a 12-min running test and a 20-min exercise session, once with attentional distraction (by listerning to music) and once without distraction (counterbalanced randomised controlled design). At the end of the endurance test running distance was recorded. During the exercise session activity intensity was assessed by accelerometers. After each experiment, rate of perceived exertion (RPE) was estimated and seven questions were asked about how participants experienced the experiment. Both overweight and normal-weight boys ran further during the running test with music (p < 0.05) and this effect was mediated by a decrease in feelings of annoyance. During the exercise session with music, both overweight and normal-weight boys exercised less at low and high intensity and more at moderate and very high intensity (p < 0.01) and this effect was mediated by a decrease in RPE. We can conclude that attentional distraction has a positive effect on running distance on a field endurance test and on activity intensity during an exercise session through different mechanisms in both overweight and normal-weight boys. PMID:25782065
Parenting the Gifted: Balancing a Culture of Distraction with Guided Attention for Gifted Exploration and Reflection
ERIC Educational Resources Information Center
Haensly, Patricia
Looking for relevant material for the Adolescent Psychology course she teaches, the author's attention was drawn to a book by Thomas Cottle, "Mind Fields: Adolescent Consciousness in a Culture of Distraction" (2001). Robert Frost's quotation, "Grant me intention, purpose, and design--That's near enough for me to the Divine," in the frontispieceŌĆ"
Cognitive emotion regulation in patients with schizophrenia: Evidence for effective reappraisal and distraction.
Grezellschak, Sarah; Lincoln, Tania M; Westermann, Stefan
Negative emotions trigger psychotic symptoms, according to a growing body of evidence. Thus, there is a need for effective emotion regulation in schizophrenia. Reappraisal is an effective, cognitive emotion regulation strategy in healthy individuals. However, it is an open research question whether individuals with schizophrenia have difficulties in successfully applying reappraisal. This study experimentally tests the efficacy of reappraisal compared to distraction in patients with schizophrenia and non-clinical controls. An experimental design with group as between-subject factor (non-clinical controls versus patients with schizophrenia) and emotion regulation during anxiety induction as within-subject factor (reappraisal, distraction, no regulation). Seventeen patients with schizophrenia and 27 healthy participants were instructed to respond to anxiety-inducing stimuli by either using reappraisal, distraction or by just watching. Both reappraisal and distraction were effective in down-regulating anxiety, compared to no regulation. The main effect of group and the interaction of emotion regulation condition and group were not significant indicating that the efficacy of both cognitive emotion regulation strategies was independent of group. Patients with schizophrenia are able to apply reappraisal successfully under experimental conditions. Conclusions are limited by the small sample size of this pilot study. Clinical implications for cognitive behavioral therapy for psychosis are discussed. PMID:26231583
Stress Reduction through Audio Distraction in Anxious Pediatric Dental Patients: An Adjunctive Clinical Study
Samadi, Firoza; Jaiswal, JN; Tripathi, Abhay Mani
ABSTRACT Aim: The purpose of the present study was to evaluate the eff-cacy of æaudio distractionÆ in anxious pediatric dental patients. Materials and methods: Sixty children were randomly selected and equally divided into two groups of thirty each. The first group was control group (group A) and the second group was music group (group B). The dental procedure employed was extraction for both the groups. The children included in music group were allowed to hear audio presentation throughout the treatment procedure. Anxiety was measured by using Venham's picture test, pulse rate, blood pressure and oxygen saturation. Results: æAudio distractionÆ was found efficacious in alleviating anxiety of pediatric dental patients. Conclusion: æAudio distractionÆ did decrease the anxiety in pediatric patients to a significant extent. How to cite this article: Singh D, Samadi F, Jaiswal JN, Tripathi AM. Stress Reduction through Audio Distraction in Anxious Pediatric Dental Patients: An Adjunctive Clinical Study. Int J Clin Pediatr Dent 2014;7(3):149-152. PMID:25709291
Integrating Research and Practice: Distractions, Controversies, and Options for Moving Forward
ERIC Educational Resources Information Center
Gambrill, Eileen
Integrating practice and research is vital in all helping professions in order to offer the most ethical, evidence-informed interventions to clients. This article describes some avoidable distractions that hinder integration, discusses controversies related to integration, and describes options for moving forward, including making wasted resourcesŌĆ"
Eye Closure Reduces the Cross-Modal Memory Impairment Caused by Auditory Distraction
ERIC Educational Resources Information Center
Perfect, Timothy J.; Andrade, Jackie; Eagan, Irene
Eyewitnesses instructed to close their eyes during retrieval recall more correct and fewer incorrect visual and auditory details. This study tested whether eye closure causes these effects through a reduction in environmental distraction. Sixty participants watched a staged event before verbally answering questions about it in the presence ofŌĆ"
Correction of Length Discrepancy of Radius and Ulna with Distraction Osteogenesis: Three Cases
Koca, Kenan; Akpancar, Serkan; Y─▒ld─▒z, Cemil
Objectives. The aim of the study was to investigate the results of patients with isolated length discrepancy between ulna and radius who underwent distraction osteogenesis with unilateral external fixator. Material and Methods. A patient with ulna shortening due to multiple enchondromatosis, a patient with ulna shortening due to ulnar club hand, and a patient with radial shortening due to radial club hand were included in the study. The patients underwent ulna and radial distraction osteogenesis with unilateral external fixator. Range of wrist and forearm motion, deformities, and length discrepancy of ulna and radius were compared at preoperative and postoperative. Results. Duration of external fixation and followup were 2.6 and 23.3 months, respectively. Mean distraction osteogenesis was 1.66ŌĆēcm. No patient reached the length of normal side. Range of rotation of forearm was increased by 15┬░. Range of ulnar-radial deviation was increased by 21.6┬░. Deformity of 15┬░ at patient with multiple enchondromatosis was corrected. Conclusion. Isolated ulna or radius shortening may reduce with distraction osteogenesis by unilateral external fixator to prevent serious deformity. PMID:26347840
[Ostegenesis bifocal distraction as an alternative of mandibular reconstruction. A case report].
Flores-Espinosa, Jos├® Arturo; Romero-Flores, Jovita
Mandibular continuity can be lost due to several factors. Whatever the cause, the restitution of the anatomy is important for aesthetic and functional purposes. Nowadays many graft techniques are available. Some of them have been shown to be successful in a lot of cases, nevertheless the osteogenic distraction should be considered as an alternative procedure to mandibular reconstruction. The osteogenic distraction can offer some advantages like a short surgical time, low morbidity, avoidance of the risk of graft rejection and also less vascular problems. Some of the disadvantages associated to this technique are that patients require longer follow-up periods. More patient cooperation is required also and finally, a risk of deviation of the distraction vector is also present, This kind of complication can increase the necessity of placing an external orthopedic device. An adequate management requires knowledge of both the bony biology and the possible biomechanical implications. Suitable planning of the osteogenic distraction procedure in combination with physical and psychological training of the patient can produce good aesthetic and functional results. PMID:22176830
Technology Transfer Automated Retrieval System (TEKTRAN)
These studies were designed to determine the reliability of in vitro tensile testing to measure the temporal development of regenerate bone strength in rats during limb lengthening (distraction osteogenesis, DO). External fixators were placed on the right tibiae of 36 virus-free, 400-450 g male Spr...
77 FR 24764 - Visual-Manual NHTSA Driver Distraction Guidelines for In-Vehicle Electronic Devices
Federal Register 2010, 2011, 2012, 2013, 2014
...On February 24, 2012, NHTSA published proposed voluntary NHTSA Driver Distraction Guidelines for in-vehicle electronic devices. The agency provided a 60-day comment period. We received a petition from the Alliance of Automobile Manufacturers requesting an extension of the comment period. The petitioner argued that additional time was needed to review information that was not placed in the......
77 FR 15452 - Visual-Manual NHTSA Driver Distraction Guidelines for In-Vehicle Electronic Devices
Federal Register 2010, 2011, 2012, 2013, 2014
...On February 24, 2012, NHTSA published proposed Visual-Manual Driver Distraction Guidelines for In-Vehicle Electronic Devices. NHTSA is announcing a public workshop to discuss technical issues relevant to these proposed Guidelines. The workshop will include brief NHTSA presentations outlining the content of and basis for the Guidelines and will provide opportunities for the public to ask......
77 FR 12907 - Visual-Manual NHTSA Driver Distraction Guidelines for In-Vehicle Electronic Devices
Federal Register 2010, 2011, 2012, 2013, 2014
... proposed NHTSA Driver Distraction Guidelines (77 FR 11200). NHTSA is announcing a set of public hearings... must be received by April 24, 2012 (77 FR 11200). ADDRESSES: Hearings. The March 12, 2012 hearing will... visual-manual means (meaning the driver looking at a device, manipulating a device-related control...
'What's in a name?' 'No more than when it's mine own'. Evidence from auditory oddball distraction.
Ljungberg, Jessica K; Parmentier, Fabrice B R; Jones, Dylan M; Marsja, Erik; Neely, Gregory
Research of the distractor value of hearing the own name has shown that this self-referring stimulus captures attention in an involuntary fashion and create distraction. The behavioral studies are few and the outcomes are not always clear cut. In this study the distraction by own name compared to a control name was investigated by using a cross-modal oddball task in two experiments. In the first experiment, thirty-nine participants were conducting a computerized categorization task while exposed to, to-be ignored own and matched control names (controlling for familiarity, gender and number of syllables) as unexpected auditory deviant stimulus (12.5% trials for each name category) and a sine wave tone as a standard stimulus (75% of the trials). In the second experiment, another group of thirty-nine participants completed the same task but with the additional deviant stimulus of an irrelevant word added (10% trials for each deviant type and 70% trials with the standard stimulus). Results showed deviant distraction by exposure to both the irrelevant word, own and the control name compared to the standard tone but no differences were found showing that the own name captured attention and distracted the participants more than an irrelevant word or a control name. The results elucidate the role of the own name as a potent auditory distractor and possible limitations with its theoretical significance for general theories of attention are discussed. PMID:24880979
When compensation fails: attentional deficits in healthy ageing caused by visual distraction.
Wascher, Edmund; Schneider, Daniel; Hoffmann, Sven; Beste, Christian; Sõnger, Jessica
Age related changes in frontal lobe functions are often related to attentional deficits that lead to increased distractibility by irrelevant stimuli. However, attentional functions have been reported not to decline in general with increasing age but simply be too slow to deal properly with distraction in time. Therefore older people might be able to compensate for distraction quite efficiently with sufficient processing time. Compensation, however, might fail when early perceptual processing is affected by distraction already. In the present study, a change in luminance or in orientation had to be detected in a sequence of two visual frames. Older participants showed reduced performance only when luminance and orientation changes were presented simultaneously at separate locations (perceptual conflict condition). Sensory ERP components were not overall altered with increasing age. Only in conflicting trials, a strong bias towards physically more salient information was observed. Additionally, older adults showed markedly delayed ERP-correlates of fronto-central control mechanisms in the conflict condition. The data indicate that processing deceleration cannot compensate for perceptual conflicts induced by mis-weighting of incoming information. PMID:23044276
Aligolbandi, Kobra; Siamian, Hasan; Balaghafari, Azita; Vahedi, Mohammad; Naeimi, Omolbanin
Background: Distraction is nothing but internal intension of the mind towards involvement of the person. This research studied classroom distractions factors among students of Faculty of Allied medical Sciences in year 2014-2015, so that with the findings of the research about classroom distractorsŌĆÖ factors and to present proposed suggestions for decreasing and removing of distractions. Methods: This is an exploratory study. Data collection in this study was the researcher made questionnaire based on Likert-type scales. SPSS software was used for analyzing the data statistics such as mean, standard deviation and frequency ratings, each subset of the elements associated with distraction Friedman test has been used to determine the ranking of each of the components. Results: 139 people participated in the six majors in this study which 91 people (65.5%) was female, and 48 people (34.5%) was male. Maximum number of 31 people (22.3) was in laboratory science, Lowest number of 15 (10.08 percent) in medical records, 25 (18%) people in Radiology, health information technology and medical emergencies which each of above course studies with 23 people (16.5 %), Anesthesiology 22 (15.8 percent) participated in this study. Among the internal factors of distraction between male and female students, the sleeping factor was in first priority and ŌĆ£My phone / pager ringing or answering the mobileŌĆØ was in last priority. Among distraction external factors in male students, the factor ŌĆ£Adornment of professorsŌĆØ with mean 3.27 and SD=1.30 and Mean Rank=23.06 was in first priority, and among external distraction factors in girl students, the factor, ŌĆ£Used clothing and exotic costumes of ClassmatesŌĆØ with mean=3.21, SD=1.30 and mean rank=22.66 was in first priority and factor of ŌĆ£Surroundings Noise (mowing, drilling, construction, and ŌĆ")ŌĆØ for male and female students was in last priority. Conclusions: Attention and concentration are crucial to effective accomplishment. If a teacher is not proficient in controlling attention, focusing and refocusing when things go awry, this can cause loss of focus and in turn create a variety of problems. PMID:26889100
Endodontic Treatment of Bilateral Maxillary First Premolars with Three Roots Using CBCT: A Case Report
Gopal, Sujatha; John, Gijo; Pavan Kumar, K.; Latha, Swarna; Latha, Suma; Kallepalli, Sowmya
One of the determining factors for the success of endodontic therapy is understanding the morphological anatomy of the tooth structure and its variants in relation to its template anatomy. The internal anatomy of maxillary first premolars is particularly complex due to their variation in number of roots and canal configuration. However, the bilateral presence of three roots in a maxillary first premolar is of rare occurrence. This case report describes the unusual anatomy bilaterally detected in maxillary first premolars using Cone-Beam Computed Tomography. PMID:24715995
Endodontic Management of Maxillary First Molar with Type I Canal Configuration¢ A Rare Case Report
Desai, Niranjan; Raghavendra, Srinidhi Surya; Mittal, Priya; Patil, Gururaj
Thorough knowledge about the root canal variations is essential for the predictable endodontic treatment outcome. The root and root canal anatomy of maxillary first molar varies greatly. A Pub-med literature search about single rooted single canalled maxillary first molar was done to know its details such as incidence, diagnostic method used, age, sex and ethnic background of patient. This article presented report of a single rooted single canalled maxillary first molar in a 27-year-old healthy Asian female. PMID:26023655
Animals have been described as segmented for more than 2,000┬Āyears, yet a precise definition of segmentation remains elusive. Here we give the history of the definition of segmentation, followed by a discussion on current controversies in defining a segment. While there is a general consensus that segmentation involves the repetition of units along the anterior-posterior (a-p) axis, long-running debates exist over whether a segment can be composed of only one tissue layer, whether the most anterior region of the arthropod head is considered segmented, and whether and how the vertebrate head is segmented. Additionally, we discuss whether a segment can be composed of a single cell in a column of cells, or a single row of cells within a grid of cells. We suggest that ŌĆśsegmentationŌĆÖ be used in its more general sense, the repetition of units with a-p polarity along the a-p axis, to prevent artificial classification of animals. We further suggest that this general definition be combined with an exact description of what is being studied, as well as a clearly stated hypothesis concerning the specific nature of the potential homology of structures. These suggestions should facilitate dialogue among scientists who study vastly differing segmental structures. PMID:24345042
Validation of in vivo assessment of facial soft-tissue volume changes and clinical application in midfacial distraction: a technical report.
Nkenke, Emeka; Langer, Astrid; Laboureux, Xavier; Benz, Michaela; Maier, Tobias; Kramer, Manuel; H├żusler, Gerd; Kessler, Peter; Wiltfang, J├Črg; Neukam, Friedrich Wilhelm
The purpose of this study was to validate the assessment of visible volume changes of the facial soft tissue with an optical three-dimensional sensor and to introduce new parameters for the evaluation of the soft-tissue shape achieved from three-dimensional data of selected cases of midfacial distraction. Images of a truncated cone of known volume were assessed repeatedly with an optical three-dimensional sensor based on phase-measuring triangulation to calculate the volume. Two cubic centimeters of anesthetic solution was injected into the right malar region of 10 volunteers who gave their informed consent. Three-dimensional images were assessed before and immediately after the injections for the assessment of the visible volume change. In five patients who underwent midfacial distraction after a high quadrangular Le Fort I osteotomy, three-dimensional scans were acquired before and 6 and 24 months after the operation. The visible soft-tissue volume change in the malar-midfacial area and the mean distance of the accommodation vector that transformed the preoperative into the postoperative surface were calculated. The volume of the truncated cone was 235.26 +/- 1.01 cc, revealing a measurement uncertainty of 0.4 percent. The injections of anesthetic solution into the malar area resulted in an average visible volume change of 2.06 +/- 0.06 cc. The measurement uncertainty was 3 percent. In the five patients, the average distance of maxillary advancement was 6.7 +/- 2.3 mm after 6 months and 5.4 +/- 3.0 mm after 2 years. It was accompanied by a mean visible volume increase of 8.92 +/- 5.95 cc on the right side and 9.54 +/- 4.39 cc on the left side after 6 months and 3.54 +/- 3.70 cc and 4.80 +/- 3.47 cc, respectively, after 2 years. The mean distance of the accommodation vector was 4.41 +/- 1.94 mm on the right side and 4.74 +/- 1.32 mm on the left side after 6 months and 1.62 +/- 1.96 mm and 2.16 +/- 1.52 mm, respectively, after 2 years. The assessment of visible volume changes by optical three-dimensional images can be carried out with considerable accuracy. The determination of volume changes and accompanying accommodation vectors completes the cephalometric analysis during the follow-up of patients undergoing midfacial distraction. The new parameters will help to assess normative soft-tissue data on the basis of three-dimensional imaging with a view to an improved three-dimensional prediction of the operative outcome of orthognathic surgery. PMID:12900593
Severe maxillary osteomyelitis in a Gray Wolf (Canis lupus)
Barber-Meyer, Shannon
Dental injuries to or abnormalities in functionally important teeth and associated bones in predators may significantly reduce the ability to kill and consume prey (Lazar et al. 2009). This impairment is likely exacerbated in coursing predators, such as Gray Wolves, that bite and hold onto fleeing and kicking prey with their teeth. Damage to carnassials (upper fourth premolar, P4, and lower first molar, M1) and associated bones in Gray Wolves may especially inhibit the consumption of prey because these teeth slice meat and crush bone. Here I report maxillary osteomyelitis involving the carnassials in a wild Gray Wolf from northeastern Minnesota of such severity that I hypothesize it ultimately caused the Gray Wolf to starve to death.
Apicotomy: surgical management of maxillary dilacerated or ankylosed canines.
Ara├║jo, Eust├Īquio A; Ara├║jo, Cristiana V; Tanaka, Orlando M
This clinical article reports a technique, apicotomy, for managing dilacerated or ankylosed canines. The records of 3 patients successfully treated with apicotomy are presented. Orthodontists observe clinically significant incidences of impacted maxillary canines in their daily practices. Several procedures have been described to bring an ankylosed, impacted tooth into occlusion. Luxation is the most widely used solution, but there are risks involved with that approach, and the success rate is low. Surgical repositioning has also been used, but morbidity is high, and the aggressiveness of the procedure might also contraindicate it. Ankylosis might be related to the anatomic position of the canine's root apex and its adjacent anatomic structures. Apicotomy is a guided fracture of a canine root apex, followed by its orthodontic traction. It is a conservative surgical alternative for treating impacted canines with dilacerations or apical root ankylosis. PMID:24286914
[Agenesis of the maxillary lateral incisors: orthodontic and implant approach].
Sabri, Roy; Aboujaoude, Nadim
Missing maxillary lateral incisors create a major esthetic problem due to their strategic position in the smile. The two treatment approaches commonly taken are creating adequate space to prosthetically replace the missing lateral incisors or closing the spaces and replacing the missing lateral incisors by the canines. This article will discuss indications, advantages, disadvantages and problems encountered in cases of space opening and space closure for missing laterals. The amount of space to be created, the preparation and the timing for implant placement, the bone volume, the implant size and prosthetic considerations will also be discussed. The methods for reshaping canines and building them up to simulate lateral incisors in orthodontic space closure, and positioning the canines and first premolars - so that they resemble to the teeth they are replacing - will be described. PMID:19061632
Non-Hodgkin's lymphoma of maxillary sinus: An unusual presentation
Adwani, Dwarkadas Gokuldas; Arora, Rajender Singh; Bhattacharya, Anirudh; Bhagat, Bhushan
Non-Hodgkin's Lymphoma (NHL) are a group of neoplasms that originate from the cells of the lymphoreticular system. Forty percent of Non-Hodgkin's lymphoma arises from extranodal sites. The nasal cavities and paranasal sinuses are rarely affected by primary NHL. Common primary extranodal sites of lymphomas include stomach, liver, soft tissue, dura, bone, intestine and bone marrow. Most patients present with rapidly enlarging masses, often with symptoms both locally and systemically (fever, recurrent night sweats, or weight loss). The vast majority of patients with localized disease are curable with combined modality therapy or combination chemotherapy alone. About 50% patients are cured with doxorubicin based combination chemotherapy and rituximab. An atypical case of extranodal Non-Hodgkin's lymphoma of maxillary sinus is discussed. PMID:23662270
A Rare Occurrence of Geminated-Taloned Maxillary Lateral Incisor
Kayal, Vizhi G
ABSTRACT The talon cusp is a developmental anomaly characterized by the presence of an accessory cusp like structure projecting from the cingulum area of the anterior teeth. Gemination is an anomaly caused by a single tooth germ that attempted to divide during its development. These developmental anomalies may cause clinical problems including esthetic impairment, pain, caries and tooth crowding. Co-occurrence of two anomalies in a teeth is rare. This paper presents an unusual case of talon cusp on geminated permanent lateral incisor. How to cite this article: Neeraja R, Kayal VG. A Rare Occurrence of Geminated-Taloned Maxillary Lateral Incisor. Int J Clin Pediatr Dent 2012;5(2):136-138. PMID:25206153
A rare occurrence of geminated-taloned maxillary lateral incisor.
Neeraja, R; Kayal, Vizhi G
The talon cusp is a developmental anomaly characterized by the presence of an accessory cusp like structure projecting from the cingulum area of the anterior teeth. Gemination is an anomaly caused by a single tooth germ that attempted to divide during its development. These developmental anomalies may cause clinical problems including esthetic impairment, pain, caries and tooth crowding. Co-occurrence of two anomalies in a teeth is rare. This paper presents an unusual case of talon cusp on geminated permanent lateral incisor. How to cite this article: Neeraja R, Kayal VG. A Rare Occurrence of Geminated-Taloned Maxillary Lateral Incisor. Int J Clin Pediatr Dent 2012;5(2):136-138. PMID:25206153
Management of Class II malocclusion with ectopic maxillary canines
Mascarenhas, Rohan; Parveen, Shahista; Ansari, Tariq Aziz
Correction of Class II relationship, deep bite and ectopically erupting canines is an orthodontic challenge for the clinician. A 13-year-old male patient presented with Class II malocclusion, ectopically erupting canines, and cross bite with maxillary left lateral incisor. He was treated with a combination of Headgear, ForsusŌäó fatigue resistant device [FFRD] with fixed mechanotherapy for the management of space deficiency and correction of Class II malocclusions. Headgear was used to distalize upper first molars and also to prevent further downward and forward growth of the maxilla. Then ForsusŌäó FFRD was used for the advancement of the mandible. The molar and canine relationship were corrected from a Class II to a Class I. The objectives were to establish good occlusion and enable eruption of unerupted canines. All these objectives were achieved and remained stable. PMID:26097371
Management of Class II malocclusion with ectopic maxillary canines.
Mascarenhas, Rohan; Parveen, Shahista; Ansari, Tariq Aziz
Correction of Class II relationship, deep bite and ectopically erupting canines is an orthodontic challenge for the clinician. A 13-year-old male patient presented with Class II malocclusion, ectopically erupting canines, and cross bite with maxillary left lateral incisor. He was treated with a combination of Headgear, ForsusŌäó fatigue resistant device [FFRD] with fixed mechanotherapy for the management of space deficiency and correction of Class II malocclusions. Headgear was used to distalize upper first molars and also to prevent further downward and forward growth of the maxilla. Then ForsusŌäó FFRD was used for the advancement of the mandible. The molar and canine relationship were corrected from a Class II to a Class I. The objectives were to establish good occlusion and enable eruption of unerupted canines. All these objectives were achieved and remained stable. PMID:26097371
Periodontal bacteria in rabbit mandibular and maxillary abscesses.
Tyrrell, Kerin L; Citron, Diane M; Jenkins, Jeffrey R; Goldstein, Ellie J C
Despite the high incidence of odontogenic abscesses in pet rabbits, published data on the bacteriology of these infections are lacking, and clinical cultures are often ambiguous, making antibiotic choices difficult. In order to define the bacteriology of these infections, 12 rabbit mandibular and maxillary abscesses were cultured aerobically and anaerobically. All specimens yielded pathogenic bacteria, including Fusobacterium nucleatum, Prevotella heparinolytica, Prevotella spp., Peptostreptococcus micros, Streptococcus milleri group, Actinomyces israelii, and Arcanobacterium haemolyticum. These organisms are consistent with the characterized bacteriology of periodontal disease in human and other mammalian studies. The isolates were tested against 10 antimicrobial agents commonly used to treat rabbits; 100% of the strains tested were susceptible to clindamycin, 96% were susceptible to penicillin and ceftriaxone, 54% were susceptible to ciprofloxacin, and only 7% were susceptible to trimethoprim-sulfamethoxazole. PMID:11880435
Periodontal Bacteria in Rabbit Mandibular and Maxillary Abscesses
Tyrrell, Kerin L.; Citron, Diane M.; Jenkins, Jeffrey R.; Goldstein, Ellie J. C.
Despite the high incidence of odontogenic abscesses in pet rabbits, published data on the bacteriology of these infections are lacking, and clinical cultures are often ambiguous, making antibiotic choices difficult. In order to define the bacteriology of these infections, 12 rabbit mandibular and maxillary abscesses were cultured aerobically and anaerobically. All specimens yielded pathogenic bacteria, including Fusobacterium nucleatum, Prevotella heparinolytica, Prevotella spp., Peptostreptococcus micros, Streptococcus milleri group, Actinomyces israelii, and Arcanobacterium haemolyticum. These organisms are consistent with the characterized bacteriology of periodontal disease in human and other mammalian studies. The isolates were tested against 10 antimicrobial agents commonly used to treat rabbits; 100% of the strains tested were susceptible to clindamycin, 96% were susceptible to penicillin and ceftriaxone, 54% were susceptible to ciprofloxacin, and only 7% were susceptible to trimethoprim-sulfamethoxazole. PMID:11880435
Dens invaginatus in a geminated maxillary lateral incisor.
Pallivathukal, Renjith George; Misra, Alok; Nagraj, Sumanth Kumbargere; Donald, Preethy Mary
Dens invaginatus (DI) and gemination are two developmental abnormalities that are well reported in the dental literature, but their coexistence in a single tooth is rare. Such situations worsen the risk factors associated with these anomalies, and the treatment plan should be customised as they possess altered morphology and anatomy. A 19-year-old girl came for evaluation of a cracked tooth in the front region of the upper jaw. The tooth showed clinical features of gemination and radiographic features of DI, and was diagnosed as DI in geminated maxillary lateral incisor. The differential diagnoses based on clinical appearance without radiographic investigation may warrant the treatment approach if these two abnormalities coexist in a single tooth. The report also highlights the importance of three-dimensional imaging in diagnosis and treatment planning of teeth with altered pulp canal anatomy. There are few reported cases in the literature detailing the treatment options for these two anomalies occurring in the same tooth. PMID:26002668
Distraction and Pedestrian Safety: How Talking on the Phone, Texting, and Listening to Music Impact Crossing the Street
Schwebel, David C.; Stavrinos, Despina; Byington, Katherine W.; Davis, Tiffany; OŌĆÖNeal, Elizabeth E.; de Jong, Desiree
As use of handheld multimedia devices has exploded globally, safety experts have begun to consider the impact of distraction while talking, text-messaging, or listening to music on traffic safety. This study was designed to test how talking on the phone, texting, and listening to music may influence pedestrian safety. 138 college students crossed an interactive, semi-immersive virtual pedestrian street. They were randomly assigned to one of four groups: crossing while talking on the phone, crossing while texting, crossing while listening to a personal music device, or crossing while undistracted. Participants distracted by music or texting were more likely to be hit by a vehicle in the virtual pedestrian environment than were undistracted participants. Participants in all three distracted groups were more likely to look away from the street environment (and look toward other places, such as their telephone or music device) than were undistracted participants. Findings were maintained after controlling for demographics, walking frequency, and media use frequency. Distraction from multimedia devices has a small but meaningful impact on college studentsŌĆÖ pedestrian safety. Future research should consider the cognitive demands of pedestrian safety, and how those processes may be impacted by distraction. Policymakers might consider ways to protect distracted pedestrians from harm and to reduce the number of individuals crossing streets while distracted. PMID:22269509
Driver inattention and driver distraction in serious casualty crashes: data from the Australian National Crash In-depth Study.
Beanland, Vanessa; Fitzharris, Michael; Young, Kristie L; Lenn├®, Michael G
Driver inattention and driver distraction represent a major problem in road safety. Although both are believed to contribute to increased crash risk, there is currently limited reliable information on their role in crashes. The current study used in-depth data from the Australian National Crash In-depth Study to investigate the role of driver distraction and inattention in serious casualty crashes. The sample included 856 crashes from 2000 to 2011, in which at least one party was admitted to hospital due to crash-related injuries. Crashes were coded using a taxonomy of driver inattention that delineates five inattention subtypes: restricted attention, misprioritised attention, neglected attention, cursory attention, and diverted attention (distraction). Approximately 45% of crashes could not be coded due to insufficient information while in an additional 15% the participant indicated the "other driver was at fault" without specifying whether inattention was involved. Of the 340 remaining cases, most showed evidence of driver inattention (57.6%) or possible inattention (5.9%). The most common subtypes of inattention were restricted attention, primarily due to intoxication and/or fatigue, and diverted attention or distraction. The most common types of distraction involved voluntary, non-driving related distractions originating within the vehicle, such as passenger interactions. The current study indicates that a majority of serious injury crashes involve driver inattention. Most forms of inattention and distraction observed are preventable. This study demonstrates the feasibility of using in-depth crash data to investigate driver inattention in casualty crashes. PMID:23499981
Transplantation of Autologous Bone Marrow Mesenchymal Stem Cells with Platelet-Rich Plasma Accelerate Distraction Osteogenesis in A Canine Model
Dehghan, Mohammad Mehdi; Baghaban Eslaminejad, Mohamadreza; Motallebizadeh, Nader; Ashrafi Halan, Javad; Tagiyar, Leila; Soroori, Sarang; Nikmahzar, Agbibi; Pedram, Mirsepehr; Shahverdi, Abdolhossein; Kazemi Mehrjerdi, Hossein; Izadi, Sadra
Objective Distraction osteogenesis (DO) is a surgical procedure used to generate large volumes of new bone for limb lengthening. Materials and Methods In this animal experimental study, a 30% lengthening of the left tibia (mean distraction distance: 60.8 mm) was performed in ten adult male dogs by callus distraction after osteotomy and application of an Ilizarov fixator. Distraction was started on postoperative day seven with a distraction rate of 0.5 mm twice per day and carried out at a rate of 1.5 mm per day until the end of the study. Autologous bone marrow mesenchymal stem cells (BM-MSCs) and platelet-rich plasma (PRP) as the treatment group (n=5) or PRP alone (control group, n=5) were injected into the distracted callus at the middle and end of the distraction period. At the end of the consolidation period, the dogs were sacrificed after which computerized tomography (CT) and histomorphometric evaluations were performed. Results Radiographic evaluationsrevealed that the amount and quality of callus formations were significantly higher in the treatment group (P<0.05). As measured by CT scan, the healing parametersin dogs of the treatment group were significantly greater (P<0.05). New bone formation in the treatment group was significantly higher (P<0.05). Conclusion The present study showed that the transplantation of BM-MSCs positively affects early bony consolidation in DO. The use of MSCs might allow a shortened period of consolidation and therefore permit earlier device removal. PMID:26199903
Adipose-derived stem cells transfected with pEGFP-OSX enhance bone formation during distraction osteogenesis*
Lai, Qing-guo; Sun, Shao-long; Zhou, Xiao-hong; Zhang, Chen-ping; Yuan, Kui-feng; Yang, Zhong-jun; Luo, Sheng-lei; Tang, Xiao-peng; Ci, Jiang-bo
This study was designed to investigate the effects of local delivery of adipose-derived stem cells (ADSCs) transfected with transcription factor osterix (OSX) on bone formation during distraction osteogenesis. New Zealand white rabbits (n=54) were randomly divided into three groups (18 rabbits per group). A directed cloning technique was used for the construction of recombinant plasmid pEGFP-OSX, where EGFP is the enhanced green fluorescence protein. After osteodistraction of the right mandible of all experimental rabbits, rabbits in group A were treated with ADSCs transfected with pEGFP-OSX, group B with ADSCs transfected with pEGFP-N1, and group C with physiological saline. Radiographic and histological examinations were processed after half of the animals within each group were humanely killed by injection of sodium pentothal at Week 2 or 6 after surgery. The distraction bone density was measured as its projectional bone mineral density (BMD). Three parameters were measured, namely, the thickness of new trabeculae (TNT), and the volumes of the newly generated cortical bone (NBV1) and the cancellous bone (NBV2) of the distracted regions. Good bone generation in the distraction areas was found in group A, which had the highest BMD, TNT, and NBV in the distraction zones among the groups. There was no significant difference in bone generation in the distraction areas between groups B and C. The results indicate that the transplantation of ADSCs transfected with pEGFP-OSX can effectively promote bone generation during distraction in vivo. PMID:24793766
Effects of flexion-distraction manipulation therapy on pain and disability in patients with lumbar spinal stenosis
Choi, Jioun; Lee, Sangyong; Jeon, Chunbae
[Purpose] This study examined the effects of flexion-distraction manipulation therapy on pain and disability in patients with lumbar spinal stenosis. [Subjects] Thirty patients with lumbar spinal stenosis were divided into two groups: a conservative treatment group (n=15) and a flexion-distraction manipulation group (n=15). [Methods] The conservative treatment group received conservative physical therapy, and the flexion-distraction group received both conservative physical therapy and flexion-distraction manipulation therapy. Both groups received treatment 3 times a week for 6 weeks. The Visual Analog Scale was used to measure pain intensity, and the Oswestry Disability Index was used to evaluate the level of disability caused by the pain. [Results] The Visual Analog Scale scores for pain were significantly decreased in both groups. In the between-group comparison, the decrease in pain was more significant in the flexion-distraction group. According to the Oswestry Disability Index, the level of disability was significantly decreased in both groups, but the decrease was more significant in the flexion-distraction group. [Conclusion] Flexion-distraction manipulation appears to be an effective intervention for pain and disability among patients with lumbar spinal stenosis. PMID:26180352
Decomposing Self-Control: Individual Differences in Goal Pursuit Despite Interfering Aversion, Temptation, and Distraction.
Steimke, Rosa; Stelzel, Christine; Gaschler, Robert; Rothkirch, Marcus; Ludwig, Vera U; Paschke, Lena M; Trempler, Ima; Kathmann, Norbert; Goschke, Thomas; Walter, Henrik
Self-control can be defined as the ability to exert control over ones impulses. Currently, most research in the area relies on self-report. Focusing on attentional control processes involved in self-control, we modified a spatial selective attentional cueing task to test three domains of self-control experimentally in one task using aversive, tempting, and neutral picture-distractors. The aims of the study were (1) to investigate individual differences in the susceptibility to aversive, tempting, and neutral distraction within one paradigm and (2) to test the association of these three self-control domains to conventional measures of self-control including self-report. The final sample consisted of 116 participants. The task required participants to identify target letters "E" or "F" presented at a cued target location while the distractors were presented. Behavioral and eyetracking data were obtained during the performance of the task. High task performance was encouraged via monetary incentives. In addition to the attentional self-control task, self-reported self-control was assessed and participants performed a color Stroop task, an unsolvable anagram task and a delay of gratification task using chocolate sweets. We found that aversion, temptation, and neutral distraction were associated with significantly increased error rates, reaction times and gaze pattern deviations. Overall task performance on our task correlated with self-reported self-control ability. Measures of aversion, temptation, and distraction showed moderate split-half reliability, but did not correlate with each other across participants. Additionally, participants who made a self-controlled decision in the delay of gratification task were less distracted by temptations in our task than participants who made an impulsive choice. Our individual differences analyses suggest that (1) the ability to endure aversion, resist temptations and ignore neutral distractions are independent of each other and (2) these three domains are related to other measures of self-control. PMID:27148101
Decomposing Self-Control: Individual Differences in Goal Pursuit Despite Interfering Aversion, Temptation, and Distraction
Steimke, Rosa; Stelzel, Christine; Gaschler, Robert; Rothkirch, Marcus; Ludwig, Vera U.; Paschke, Lena M.; Trempler, Ima; Kathmann, Norbert; Goschke, Thomas; Walter, Henrik
Self-control can be defined as the ability to exert control over ones impulses. Currently, most research in the area relies on self-report. Focusing on attentional control processes involved in self-control, we modified a spatial selective attentional cueing task to test three domains of self-control experimentally in one task using aversive, tempting, and neutral picture-distractors. The aims of the study were (1) to investigate individual differences in the susceptibility to aversive, tempting, and neutral distraction within one paradigm and (2) to test the association of these three self-control domains to conventional measures of self-control including self-report. The final sample consisted of 116 participants. The task required participants to identify target letters ŌĆ£EŌĆØ or ŌĆ£FŌĆØ presented at a cued target location while the distractors were presented. Behavioral and eyetracking data were obtained during the performance of the task. High task performance was encouraged via monetary incentives. In addition to the attentional self-control task, self-reported self-control was assessed and participants performed a color Stroop task, an unsolvable anagram task and a delay of gratification task using chocolate sweets. We found that aversion, temptation, and neutral distraction were associated with significantly increased error rates, reaction times and gaze pattern deviations. Overall task performance on our task correlated with self-reported self-control ability. Measures of aversion, temptation, and distraction showed moderate split-half reliability, but did not correlate with each other across participants. Additionally, participants who made a self-controlled decision in the delay of gratification task were less distracted by temptations in our task than participants who made an impulsive choice. Our individual differences analyses suggest that (1) the ability to endure aversion, resist temptations and ignore neutral distractions are independent of each other and (2) these three domains are related to other measures of self-control. PMID:27148101
Intermediate-Term Follow-up After Ankle Distraction for Treatment of End-Stage Osteoarthritis
Nguyen, Mai P.; Pedersen, Douglas R.; Gao, Yubo; Saltzman, Charles L.; Amendola, Annunziato
Background: Treatment of end-stage ankle osteoarthritis remains challenging, especially in young patients. Initial reports have shown early benefits of joint distraction for the treatment of ankle osteoarthritis. We report the five to ten-year results of a previously described patient cohort following ankle distraction surgery. Methods: All thirty-six patients who had undergone ankle distraction surgery between December 2002 and October 2006 were contacted. Patients were evaluated by a clinical investigator and completed the Ankle Osteoarthritis Scale (AOS) and Short Form-36 (SF-36) surveys. Radiographs as well as computed tomography and magnetic resonance imaging scans of the ankles were obtained at the follow-up visits. Results: Twenty-nine patients (81%) were followed for a minimum of five years (mean and standard deviation, 8.3 ┬▒ 2.2 years). Sixteen (55%) of the twenty-nine patients still had the native ankle joint whereas thirteen patients (45%) had undergone either ankle arthrodesis or total ankle arthroplasty. Positive predictors of ankle survival included a better AOS score at two years (hazard ratio [HR] = 0.048, 95% confidence interval [CI] = 0.0028 to 0.84, p = 0.04), older age at surgery (HR = 0.91, 95% CI = 0.83 to 0.99, p = 0.04), and fixed distraction (HR = 0.094, 95% CI = 0.017 to 0.525, p < 0.01). Radiographs and advanced imaging revealed progression of ankle osteoarthritis at the time of final follow-up. Conclusions: Ankle function following joint distraction declines over time. Patients should be well informed of the commitment that they must make during the treatment period as well as the long-term results after surgery. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. PMID:25834084
Resorption of labial bone in maxillary anterior implant
Cho, Young-Bum; Moon, Seung-Jin; Chung, Chae-Heon
PURPOSE The purpose of this study was to evaluate the amount of resorption and thickness of labial bone in anterior maxillary implant using cone beam computed tomography with Hitachi CB Mercuray (Hitachi, Medico, Tokyo, Japan). MATERIALS AND METHODS Twenty-one patients with 26 implants were followed-up and checked with CBCT. 21 OSSEOTITE NT® (3i/implant Innovations, Florida, USA) and 5 OSSEOTITE® implants (3i/implant Innovations, Florida, USA) were placed at anterior region and they were positioned vertically at the same level of bony scallop of adjacent teeth. Whenever there was no lesion or labial bone was intact, immediate placement was tried as possible as it could be. Generated bone regeneration was done in the patients with the deficiency of hard tissue using Bio-Oss® (Geistlich, Wolhusen, Switzerland) and Bio-Gide® (Geistlich, Wolhusen, Switzerland). Second surgery was done in 6 months after implant placement and provisionalization was done for 3 months. Definite abutment was made of titanium abutment with porcelain, gold and zirconia, and was attached after provisionalization. Two-dimensional slices were created to produce sagittal, coronal, axial and 3D by using OnDemand3D (Cybermed, Seoul, Korea). RESULTS The mean value of bone resorption (distance from top of implant to labial bone) was 1.32 ± 0.86 mm and the mean thickness of labial bone was 1.91 ± 0.45 mm. CONCLUSION It is suggested that the thickness more than 1.91 mm could reduce the amount and incidence of resorption of labial bone in maxillary anterior implant. PMID:21814617
An Alternative Maxillary Sinus Lift Technique ŌĆō Sinu Lift System
T, Parthasaradhi; B, Shivakumar; Kumar, T.S.S.; P, Suganya
Objectives: Maxillary sinus augmentation surgical techniques have evolved greatly allowing successful placement of dental implants in the atrophic posterior maxillary region. The purpose of the present study is to evaluate the clinical and radiological outcomes and postoperative morbidity of sinus floor elevation procedures performed using the minimally invasive surgical technique the Sinu lift system. Materials and Methods: Sinus lift procedure was done using the sinu lift system by a transcrestal approach and bone augmentation was done on ten systemically healthy patients using ╬▓- tricalcium phosphate and platelet rich plasma mix. The study was evaluated upto six months period with bone related parameters being assessed at base line using CT scan, OPG and after six months the results were analysed using SPSS Version 18.0 software (p < 0.01 (0.005). Wilcoxson signed rank sum test was used to correlate between preoperative and postoperative measurements. Implant placements were done at the desired area of sinus augmentation with a two year follow up. (Nobel Biocare, Nobel Biocare Holding AG, Z├╝rich-Flughafen, Switzerland) Results: The augmented sites had a significant increase in the bone parameters at the desired grafted region. The mean gain in bone height as observed in CT Scan had revealed increased measurements from 5.80mm┬▒0.98 to 10.20mm┬▒1.68 at the sixth month evaluation. This was statistically significant (0.005). Clinically, no complications were observed during or after the surgical procedure. Conclusion: Within the limitations of this study, the Sinu lift system with a controlled working action resulted in high procedural success and this procedure may be an alternative to the currently used surgical methods. PMID:25954702
Impact assisted segmented cutterhead
Morrell, Roger J.; Larson, David A.; Ruzzi, Peter L.
An impact assisted segmented cutterhead device is provided for cutting various surfaces from coal to granite. The device comprises a plurality of cutting bit segments deployed in side by side relationship to form a continuous cutting face and a plurality of impactors individually associated with respective cutting bit segments. An impactor rod of each impactor connects that impactor to the corresponding cutting bit segment. A plurality of shock mounts dampening the vibration from the associated impactor. Mounting brackets are used in mounting the cutterhead to a base machine.
Disappearance of a dental implant after migration into the maxillary sinus: an unusual case.
Damlar, ─░brahim
Migration of dental implants into the maxillary sinus is uncommon. However, poor bone quality and quantity in the posterior maxilla can increase the potential for this complication to arise during implant placement procedures. The aim of this report is to present a dental implant that migrated into the maxillary sinus and disappeared. A 53-year-old male patient was referred to us by his dentist after a dental implant migrated into his maxillary sinus. The displaced implant was discovered on a panoramic radiograph taken five days before his referral. Using computed tomography, we determined that the displaced dental implant was not in the antrum. There was also no sign of oroantral fistula. Because of the small size of the displaced implant, we think that the implant may have left the maxillary sinus via the ostium. PMID:26568932
Sporotrichosis of Maxillary Sinuses in a Middle Aged Female Patient from Rural Area of Eastern India
Das, Saumik; Sinha, Ramanuj; Aggarwal, Neeraj; Chakravorty, Sriparna
Sporotrichosis is commonly a chronic infection caused by Sporothrix schenckii, a saprophytic fungus and is usually limited to cutaneous and subcutaneous tissues. Disseminated systemic, osteoarticular or pulmonary sporotrichosis have been reported but nasal sinusitis by this fungus is extremely infrequent. Earlier report from southern India documented a case of maxillary sinusitis by Sporothrix schenckii. Here we report a similar case of bilateral maxillary sinusitis in a middle aged female from a village of Bihar, a state in eastern India. She underwent endoscopic maxillary sinus surgery for nasal symptoms and diagnosed to have sporotrichotic infection of maxillary sinuses. The diagnosis was done by mycological and histopathological examination and patient improved under antifungal chemotherapy. PMID:27134873
[Orthodontic tooth movement through the maxillary sinus in an adult with multiple missing teeth].
Oh, Heesoo; Herchold, Kiri; Hannon, Stephanie; Heetland, Kelly; Ashraf, Golnaz; Nguyen, Vince; Cho, Heon Jae
This case report describes the successful orthodontic tooth movement through the maxillary sinus in an adult patient. A 41-year-old Asian woman had severe lip protrusion and multiple missing posterior teeth. Her orthodontic treatment included the extraction of two teeth, maximum retraction of the incisors using the extraction spaces and the existing spaces from the missing molars, and closure of all remaining spaces. Even though the treatment time was extended because of the anatomic and biologic challenges associated with moving posterior teeth over a long distance through the maxillary sinus, a successful outcome was obtained, with significant bone modeling of the maxillary sinus. The results demonstrate that a carefully selected force system can overcome the anatomic limitations of moving tooth against the cortical bone of the maxillary sinus wall in adult patients. PMID:26655418
Triple-X syndrome accompanied by single maxillary central incisor: case report.
Miura, M; Kato, N; Kojima, H; Oguchi, H
Facial, oral, and dental findings of an 11-year-old girl with XXX syndrome are reported. Clinical examination reveals midfacial hypoplasia, congenital absence of teeth, and solitary maxillary central incisors both in primary and permanent dentitions. PMID:8378162
Disappearance of a dental implant after migration into the maxillary sinus: an unusual case
Migration of dental implants into the maxillary sinus is uncommon. However, poor bone quality and quantity in the posterior maxilla can increase the potential for this complication to arise during implant placement procedures. The aim of this report is to present a dental implant that migrated into the maxillary sinus and disappeared. A 53-year-old male patient was referred to us by his dentist after a dental implant migrated into his maxillary sinus. The displaced implant was discovered on a panoramic radiograph taken five days before his referral. Using computed tomography, we determined that the displaced dental implant was not in the antrum. There was also no sign of oroantral fistula. Because of the small size of the displaced implant, we think that the implant may have left the maxillary sinus via the ostium. PMID:26568932
Stress Distribution on Short Implants at Maxillary Posterior Alveolar Bone Model With Different Bone-to-Implant Contact Ratio: Finite Element Analysis.
Yazicioglu, Duygu; Bayram, Burak; Oguz, Yener; Cinar, Duygu; Uckan, Sina
The aim of this study was to evaluate the stress distribution of the short dental implants and bone-to-implant contact ratios in the posterior maxilla using 3-dimensional (3D) finite element models. Two different 3D maxillary posterior bone segments were modeled. Group 1 was composed of a bone segment consisting of cortical bone and type IV cancellous bone with 100% bone-to-implant contact. Group 2 was composed of a bone segment consisting of cortical bone and type IV cancellous bone including spherical bone design and homogenous tubular hollow spaced structures with 30% spherical porosities and 70% bone-to-implant contact ratio. Four-millimeter-diameter and 5-mm-height dental implants were assumed to be osseointegrated and placed at the center of the segments. Lateral occlusal bite force (300 N) was applied at a 25░ inclination to the implants long axis. The maximum von Mises stresses in cortical and cancellous bones and implant-abutment complex were calculated. The von Mises stress values on the implants and the cancellous bone around the implants of the 70% bone-to-implant contact group were almost 3 times higher compared with the values of the 100% bone-to-implant contact group. For clinical reality, use of the 70% model for finite element analysis simulation of the posterior maxilla region better represents real alveolar bone and the increased stress and strain distributions evaluated on the cortical and cancellous bone around the dental implants. PMID:26867093
Dot├║, Ivan; Lorenz, William A; VAN Hentenryck, Pascal; Clote, Peter
We describe several dynamic programming segmentation algorithms to segment RNA secondary and tertiary structures into distinct domains. For this purpose, we consider fitness functions that variously depend on (i) base pairing probabilities in the Boltzmann low energy ensemble of structures, (ii) contact maps inferred from 3-dimensional structures, and (iii) Voronoi tessellation computed from 3-dimensional structures. Segmentation algorithms include a direct dynamic programming method, previously discovered by Bellman and by Finkelstein and Roytberg, as well as two novel algorithms - a parametric algorithm to compute the optimal segmentation into k classes, for each value k, and an algorithm that simultaneously computes the optimal segmentation of all subsegments. Since many non-coding RNA gene finders scan the genome by a moving window method, reporting high-scoring windows, we apply structural segmentation to determine the most likely 5' and 3' boundaries of precursor microRNAs. When tested on all precursor microRNAs of length at most 100 nt from the Rfam database, benchmarking studies indicate that segmentation determines the 5' boundary with discrepancy (absolute value of difference between predicted and real boundaries) having mean -0.640 (stdev 15.196) and the 3' boundary with discrepancy having mean -0.266 (stdev. 17.415). This yields a sensitivity of 0.911 and positive predictive value of 0.906 for determination of exact boundaries of precursor microRNAs within a window of approximately 900 nt. Additionally, by comparing the manual segmentation of Jaeger et al. with our optimal structural segmentation of 16S and 16S-like rRNA of E. coli, rat mitochondria, Halobacterium volcanii, and Chlamydomonas reinhardii chloroplast into 4 segments, we establish the usefulness of (automated) structural segmentation in decomposing large RNA structures into distinct domains. PMID:19908358
Root Canal Treatment of a Maxillary Second Molar with Two Palatal Canals: a Case Report
Nabavizadeh, MohammadReza; Abbaszadegan, Abbas; Mirhadi, Hosein; Ghahramani, Yasmin
Careful understanding of internal anatomy of root canal system is crucial for successful endodontic treatment. The presence of two palatal canals in maxillary second molar is unusual but noteworthy as an aid to appropriate diagnosis and treatment. This paper reported a case of a maxillary right second molar with two root canals in the palatal root. The root canal treatment and case management were also explained. PMID:26636127
Class II, Division 1 Angle malocclusion with severe proclination of maxillary incisors
Montanha, K├Ītia
Protrusion of maxillary incisors is a common complaint among patients seeking orthodontic treatment. This report addresses the correction of Class II Angle malocclusion with excessively bucally proclined maxillary incisors, in an adolescent female patient, through the use of extraoral and fixed appliances. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) as part of the requirements for obtaining the title of certified by the BBO. PMID:27007768
Maxillary esthetics, mandibular function: a rationale for predictable treatment of the moderately worn dentition.
Hermanides, Leon; Larson, Kim
An older patient presented with concerns about tooth wear. A treatment plan driven by the dominant risk factors of esthetics and function was preceded by a comprehensive evaluation to determine the etiology of the moderately worn dentition. Treatment goals included lengthening maxillary teeth, leveling the posterior occlusal planes, opening the vertical dimension of occlusion, and establishing bilateral simultaneous posterior occlusion. Esthetic parameters were established with the maxillary arch, enabling the functional goals to be addressed with treatment in the mandibular arch. PMID:25199031
Derevator: a soft tissue elevator for maxillary sinus in endoscopic sinus surgery.
Dere, H; Ozcan, K M; Ozcan, I
Removal of the soft tissue lesions from the maxillary sinus is sometimes difficult and time consuming in endoscopic sinus surgery. Failure of endoscopic removal may necessitate combination of canine fossa approach and endoscopic approach. Our new instrument, 'Derevator', is designed for easy removal of the pathological soft tissue lesions from the maxillary sinus through middle meatal antrostomy. Derevators are available for both adults and children. Suction-tipped ones are also available. PMID:17550513
The impact of frenulum height on strains in maxillary denture bases
Bilhan, Hakan; Baysal, Gokhan; Sunbuloglu, Emin; Bozdag, Ergun
PURPOSE The midline fracture of maxillary complete dentures is a frequently encountered complication. The purpose of this study was to assess the effect of frenulum height on midline strains of maxillary complete dentures. MATERIALS AND METHODS A removable maxillary complete denture was fabricated and duplicated seven times. Four different labial frenulum heights were tested for stresses occurring on the palatal cameo surface. The strains were measured with strain gauges placed on 5 different locations and the stresses were calculated. To mimic occlusal forces bilaterally 100 N of load was applied from the premolar and molar region. RESULTS A statistically significant association between the height of the labial frenulum and the calculated stresses and strains was shown (P<.05) predominantly on the midline and especially on the incisive papilla. The results showed that stress on the anterior midline of the maxillary complete denture increases with a higher labial frenulum. CONCLUSION Within the limitations of this in vitro study, it can be concluded that the stress on the anterior midline of the maxillary complete denture increases with a higher labial frenulum. Surgical or mechanical precautions should be taken to prevent short-term failure of maxillary complete dentures due to stress concentration and low cycle fatigue tendency at the labial frenulum region. PMID:24353878
Variation in Size and Form between Left and Right Maxillary Central Incisor Teeth
Vadavadagi, Suneel V; Hombesh, M N; Choudhury, Gopal Krishna; Deshpande, Sumith; Anusha, C V; Murthy, D Kiran
Background: To compare the variation in size of left and right maxillary central incisors for male patients (using digital calipers of 0.01 mm accuracy). To compare the variation in size of left and right maxillary central incisors for female patients (using digital calipers of 0.01 mm accuracy). To find out the difference between the maxillary central incisors of men and women. Its clinical applicability if difference exists. Materials and Methods: A total of 70 dental students of PMNM Dental College and Hospital were selected. Of 70 dental students, 40 male and 30 female were selected. Impressions were made for all subjects, using irreversible hydrocolloid (Algitex, manufacturer DPI, Batch-T-8804) using perforated stock metal trays. The mesiodistal crown width and cervical width were measured for each incisor and recorded separately for left and right teeth. The length was measured for each incisor and recorded separately for left and right maxillary central incisor using digitec height caliper. Results: The mean value of maximum crown length of maxillary left central incisor of male was greater in length compared with maxillary right central incisor. Mean value of maximum crown length for male patient right and left side was greater compared with maximum crown length of female patient. Conclusion: When compared the dimensions of teeth between two sex, male group shows larger values to female group. PMID:25859104
One of six experimental stream segments used to study the dispersal of free embryo sturgeon at the Columbia Environmental Research Center.┬Ā The stream segment is 5 meters long and 0.5 meters wide, and is filled with cobble-sized rock to a depth of 12 centimeters.┬Ā Streams are covered durin...
Use of instant messaging predicts self-report but not performance measures of inattention, impulsiveness, and distractibility.
Levine, Laura E; Waite, Bradley M; Bowman, Laura L
We examined how young adults' use of instant messaging, text messaging, and traditional reading related to their self-reported experience of distractibility and impulsiveness and to their performance on computerized tasks designed to assess inattention and impulsive responses to visual stimuli. Participants reported their media use and completed self-report measures of impulsiveness (i.e., the Barratt Impulsiveness Scale) and distractibility for academic reading. They also completed performance based measures of inattention and impulsiveness using the Tests of Variables of Attention (T.O.V.A.(®)). Results demonstrated that instant message use was significantly related to higher levels of attentional impulsiveness and distractibility on the self-report measures, while traditional reading consistently predicted lower levels of impulsiveness and distractibility. However, media use was not significantly related to the performance measures of inattention and behavioral impulsiveness. PMID:23952624
A new 2-dimensional method for constructing visualized treatment objectives for distraction osteogenesis of the short mandible.
van Beek, H
Open bite development during distraction of the mandible is common and partly due to inaccurate planning of the treatment. Conflicting guidelines exist in the literature. A method for Visualized Treatment Objective (VTO) construction is presented as an aid for determining the correct orientation of monodirectional and multidirectional distractors. Distraction on the left and on the right side of the mandible takes place in a parallel manner in order to maintain intercondylar width. It follows that in the absence of marked asymmetry, the amount of mandibular body distraction, the amount of ramus distraction and (should it apply), the amount of closure of the gonial angle, can be derived from a simple 2-dimensional plan. After presurgical orthodontic treatment, a cephalogram is taken and a VTO is constructed, that aims at a good occlusion with the enhanced mandible in centric relation, with little or no change of the original position of the rami. PMID:19837600