Enniswilliford8842
Replacement resorption is a common complicating factor in teeth that have been avulsed or intruded. Poor short- and long-term management of dental injuries in children can have a significant impact on a child's dental function, aesthetics and ultimately their quality of life. This article aims to provide clarity on the physiological process of replacement resorption, the clinical presentation and an overview of interceptive treatment that is available.Evidence supports minimally invasive dentistry, and we have a better understanding of dental caries as a biofilm-mediated disease. These factors, together with the current need to reduce aerosol generation, make treatment approaches such as the Hall Technique and the use of silver diamine fluoride (SDF) more relevant than ever.Successful treatment planning depends on carious lesions being detected, their status accurately assessed, and a correct diagnosis made. Choosing the most appropriate treatment options for the tooth and child relies on marrying this with a precise history and an understanding of indications and contraindications for treatments.This article outlines the optimal use of the Hall Technique and SDF, allowing dental practitioners and therapists to use these modalities as less invasive approaches to provide the highest quality treatment for children with dental caries; less is more.Children with haemophilia present a bleeding risk and a challenge for dentists. Guidelines on the dental management of haemophilia patients are largely based on expert consensus. Many existing guidelines also provide generic guidance mainly for adult patients, which have been adapted for children. However, children have unique needs that require additional considerations. With limited evidence available, it is important that dentists have an understanding of the principles of both medical and dental management and have a close collaboration with the haematologist at all times. Therefore, this paper provides some key principles related to various aspects of dental management of children with haemophilia. Furthermore, there has been a recent update to the World Federation of Haemophilia (WFH) Guidelines for the Management of Haemophilia,1 with references to novel medical therapies for haemophilia. Hence, this paper also aims to inform dentists with the standard and newer medical therapies for haemophilia, including a specific focus on the novel agent Emicizumab and the associated dental considerations.
The current standard of care for first permanent molars (FPMs) requiring extraction is removal of these teeth between the chronological ages of eight to ten years, as per UK guidelines.
This often involves a general anaesthetic (GA) with surgical admission to hospital. This study explores parental views on minimally invasive (MI) techniques as an alternative to the UK current standard of care for extractions of FPMs deemed to require removal between the chronological ages of eight to ten years.
A qualitative investigation, using semi-structured interviews was conducted with parents/carers of children attending a teaching hospital for extraction of compromised FPMs under GA. Thematic framework analysis was used to present the findings. The consolidated criteria for reporting qualitative research (COREQ) were used as a guide to ensure quality.
The main themes emerging were participants' surprise at how poor the prognosis was for their child's FPMs; acceptance that care was beyond the scope of primary care; willingness by some to undergo GA again; requests for information about the guarantee of success of MI treatment; concerns about the residual black staining from silver diamine fluoride (SDF); and acceptance of extraction spaces because of potential future failure of MI.
This exploratory qualitative study has shown that, while extraction of compromised FPMs under GA is accepted by most parents/carers, there appears to be a growing acceptance of MI approaches to restore FPMs instead of extraction of these teeth.
This exploratory qualitative study has shown that, while extraction of compromised FPMs under GA is accepted by most parents/carers, there appears to be a growing acceptance of MI approaches to restore FPMs instead of extraction of these teeth.Children are not miniature adults, yet when a child celebrates their sixth birthday, little do they know that, with the arrival of their first 'adult' tooth, they are about to gain their first real experience of being a 'grown-up'. The age of six is a key milestone in the mental, physical and emotional wellbeing of children, with most children in the UK having commenced primary school education by their fifth birthday. Six-year-olds are about to enter the most critical period in their dental development, the mixed-dentition phase, where their mouths are in a near continuous state of flux. This pivotal age in their dental development should not be undervalued; the dental decisions we make at this age means childhood lasts a lifetime. Caries is the most prevalent, preventable global disease, and with one in four children suffering from dental caries in the primary dentition by the time they start school, the foundations we lay down at the age of six translate into lifelong benefits for the permanent dentition. In this paper, the aim is to demonstrate that at the age of six we get a second chance to get things right. From caries risk factors and tailoring the five pillars of prevention by educating parents on the developing dentition, to reinforcing the importance of habit-breaking, developmental anomalies of enamel and early orthodontic intervention, this paper describes the importance of the age of six, never before so exclusively expressed in a dental sense.Managing paediatric patients in primary dental care while awaiting treatment by the specialist paediatric dental services can be tricky. COVID-19 has had a significant impact on dental services meaning wait times to be seen by a paediatric dental service may have been delayed. This article will discuss the management of paediatric patients in primary dental care and provide an update on some of the latest techniques in paediatric dentistry. It also covers tips that can be employed in the primary dental care setting such as the use of tooth mousse and silver diamine fluoride.Traumatic dental injuries are a common occurrence among children. Effective acute and long-term management of traumatic dental injuries can improve patient outcomes, especially in the paediatric patient. It is important that all dental professionals follow up-to-date, evidence-based guidance when treating patients. This article aims to highlight the main changes in the 2020 International Association of Dental Traumatology (IADT) Guidelines for Evaluation and Management of Traumatic Dental Injuries, to ensure that all dental professionals are fully aware of current guidelines and are managing patients appropriately.Children presenting with discoloured teeth commonly suffer from low self-esteem. This paper reports the findings from a questionnaire evaluating changes brought about by dental bleaching and the psychosocial effects of bleaching on 22 patients. All patients reported to like the overall appearance of their teeth following bleaching and reported a significant improvement in mental wellbeing. In the current climate where positive mental health is at the forefront of the minds of commissioners, health care providers, and the general public alike, this service evaluation demonstrates the positive effect that carefully planned dental bleaching can have on the mental wellbeing of under 18-year-olds with discoloured teeth.Thumb sucking and tongue thrusting habits are mostly counteracted and rehabilitated using a tongue crib. Most patients find the conventional crib difficult (due to its position and length) in the initial days of treatment and become uncooperative. Hence, few modifications are made to the traditional design of the tongue crib for easy adjustment of the crib height and angulation, which provides comfort to the patient.
Cardiotoxicity is the most important side effect of Trastuzumab treatment. The purpose of this study is to evaluate the prevalence of Trastuzumab induced cardiotoxicity and to analyze risk factors associated with this side effect.
A retrospective institutional study was carried out from June 2018 to December 2018 at the department of Medical Oncology of Salah Azaiz institute, Tunis, Tunisia. Demographic, clinical characteristics (menopausal status, breast cancer stage, anthracyclines exposure, comorbidities presence…) and left ventricular ejection function (LVEF) measurements, were collected from patient records.
Twenty-three women (20%) had Trastuzumab induced cardiotoxicity.65.2% (N = 15) experienced a decrease in LVEF more than 10% with a decrease below normal value and 34.8% (N = 8) experienced a decrease in LVEF more than 20%. Obesity is a risk factor for the occurrence of Trastuzumab induced cardiotoxicity (adjusted odds ratio (OR) = 2.919 (95% confidence interval (CI) [1.0411-8.186];
= 0.042).
Our study highlighted that obesity is associated with a high risk of cardiotoxicity in women treated with Trastuzumab. Therefore, close monitoring of cardiac function is recommended especially for obese women during Trastuzumab administering.
Our study highlighted that obesity is associated with a high risk of cardiotoxicity in women treated with Trastuzumab. Therefore, close monitoring of cardiac function is recommended especially for obese women during Trastuzumab administering.Thermal nociception involves the transmission of temperature-related noxious information from the periphery to the CNS and is a heritable trait that could predict transition to persistent pain. Rodent forward genetics complement human studies by controlling genetic complexity and environmental factors, analysis of end point tissue, and validation of variants on appropriate genetic backgrounds. Reduced complexity crosses between nearly identical inbred substrains with robust trait differences can greatly facilitate unbiased discovery of novel genes and variants. ITF3756 We found BALB/cByJ mice showed enhanced sensitivity on the 53.5°C hot plate and mechanical stimulation in the von Frey test compared to BALB/cJ mice and replicated decreased gross brain weight in BALB/cByJ versus BALB/cJ. We then identified a quantitative trait locus (QTL) on chromosome 13 for hot plate sensitivity (LOD = 10.7; p less then 0.001; peak = 56 Mb) and a QTL for brain weight on chromosome 5 (LOD = 8.7; p less then 0.001). Expression QTL mapping of brain tissues identified H2afy (56.07 Mb) as the top transcript with the strongest association at the hot plate locus (FDR = 0.0002) and spliceome analysis identified differential exon usage within H2afy associated with the same locus. Whole brain proteomics further supported decreased H2AFY expression could underlie enhanced hot plate sensitivity, and identified ACADS as a candidate for reduced brain weight. To summarize, a BALB/c reduced complexity cross combined with multiple-omics approaches facilitated identification of candidate genes underlying thermal nociception and brain weight. These substrains provide a powerful, reciprocal platform for future validation of candidate variants.