Search results for: inferior dental nerve

Authors: G. Fitzpatrick, S. O. Chonghaile, D. Harmon

Abstract:

Objective: Chronic pain patients represent a unique challenge in the Emergency Department. Very little literature has been published regarding this group of patients. Our aim was to determine the attitude of patients with chronic pain to the Emergency Department in order to improve and streamline their future visits. Methods: A two-year survey was carried out on Chronic Pain Patients regarding their Emergency Department Attendances. Patients attending the Pain Clinic in Croom Hospital, Co. Limerick were asked to complete a 20-part questionnaire regarding their experiences of visiting the Emergency Department in the preceding year. 46 questionnaires were completed. Results: Unbearable breakthrough pain was the main reason for visiting the Emergency Department. More than half (54%) of those surveyed were not satisfied with the treatment received. Problems indicated included under-treatment of pain (59%), a sense of being under undue suspicion of drug-seeking behaviour (33%) and a perception that the patient themselves understood their condition better than the treating doctor (76%). Paracetamol, NSAIDs, or time off work comprised 72% of the treatments offered – all of which could have been provided by their General Practitioner. Only 4% were offered a nerve block. 67% felt that the creation of personalised Patient Plans, consisting of an agreed plan between the patient, their pain specialist, and the Emergency Department, would expedite their trip through the Emergency Department. Conclusions: Chronic pain patients generally have a negative experience in the ED. Possible future solutions include increasing our empathy and levels of knowledge, provision of nerve blocks in the ED, and use of personalised “Patient Plans” to streamline the treatment pathway for this group of patients.

Keywords: chronic pain, survey, patients, emergency department

Procedia PDF Downloads 368

Authors: Hye-Young Shin, Chan Kee Park

Abstract:

Background: To compare the thinning patterns of the ganglion cell-inner plexiform layer (GCIPL) and peripapillary retinal nerve fiber layer (pRNFL) as measured using Cirrus high-definition optical coherence tomography (HD-OCT) in patients with visual field (VF) defects that respect the vertical meridian. Methods: Twenty eyes of eleven patients with VF defects that respect the vertical meridian were enrolled retrospectively. The thicknesses of the macular GCIPL and pRNFL were measured using Cirrus HD-OCT. The 5% and 1% thinning area index (TAI) was calculated as the proportion of abnormally thin sectors at the 5% and 1% probability level within the area corresponding to the affected VF. The 5% and 1% TAI were compared between the GCIPL and pRNFL measurements. Results: The color-coded GCIPL deviation map showed a characteristic vertical thinning pattern of the GCIPL, which is also seen in the VF of patients with brain lesions. The 5% and 1% TAI were significantly higher in the GCIPL measurements than in the pRNFL measurements (all P < 0.01). Conclusions: Macular GCIPL analysis clearly visualized a characteristic topographic pattern of retinal ganglion cell (RGC) loss in patients with VF defects that respect the vertical meridian, unlike pRNFL measurements. Macular GCIPL measurements provide more valuable information than pRNFL measurements for detecting the loss of RGCs in patients with retrograde degeneration of the optic nerve fibers.

Keywords: brain lesion, macular ganglion cell, inner plexiform layer, spectral-domain optical coherence tomography

Procedia PDF Downloads 335

Authors: R. A. Shahmiri, O. Standard, J. Hart, C. C. Sorrell

Abstract:

Yttrium stabilized tetragonal zirconium polycrystalline (Y-TZP) has been used as a dental biomaterial. The strength and toughness of zirconia can be accounted for by its toughening mechanisms, such as crack deflection, zone shielding, contact shielding, and crack bridging. Prevention of crack propagation is of critical importance in high-fatigue situations, such as those encountered in mastication and para-function. However, the poor translucency of Y-TZP means that it may not meet the aesthetic requirements due to its white/grey appearance in polycrystalline form. To improve optical property of the Zirconia, precise evaluation of its refractive index is of significance. Zirconia`s optical properties need to be studied more in depth. Number of studies assumed, scattered light is isotropically distributed over all angles from biological media when defining optical parameters. Nevertheless, optical behaviour of real biological material depends on angular scattering of light by anisotropy material. Therefore, the average cosine of the scattering angle (which represent recovery phase function in the scattering angular distribution) usually characterized by anisotropy material. It has been identified that yttrium anti-sites present in the space charge layer have no significant role in the absorption of light in the visible range. Addition of cation dopant to polycrystalline zirconia results in segregate to grain boundaries and grain growth. Intrinsic and extrinsic properties of ZrO2 and their effect on optical properties need to be investigated. Intrinsic properties such as chemical composition, defect structure (oxygen vacancy), phase configuration (porosity, second phase) and distribution of phase need to be studied to comprehend their effect on refraction index, absorption/reflection and scattering. Extrinsic properties such as surface structure, thickness, underlying tooth structure, cement layer (type, thickness), and light source (natural, curing, artificial) of ZrO2 need to be studied to understand their effect on colour and translucency of material. This research reviewed effect of stabilization of tetragonal zirconia on optical property of zirconia for dental application.

Keywords: optical properties, zirconia dental biomaterial, chemical composition, phase composition

Procedia PDF Downloads 392

Authors: B. Nair, S. Singh

Abstract:

Oral health behaviors such as dietary preferences and tooth brushing are acquired during a child’s primary socialization period yet many oral health promotion interventions are implemented without taking into account the role and impact of parental influence in supporting healthy oral health behaviors. The aim and objective of this study was to determine the relationship between parental income and level of education with knowledge, attitudes and perceptions of oral health care practices. Methods: The study design was cross-sectional and exploratory, and data collection occurred in two phases. Phase 1 comprised of a self-administered questionnaire. The sample consisted of parents of 313 Grade 1 learners aged between 5-6 years old attending one of twelve selected public primary schools in the Chatsworth Circuit, Durban, South Africa. Phase 2 comprised of focus group discussions held at 5 purposively selected schools. Data collection comprised of a semi-structured face-to-face group interview with the objective of obtaining a deeper understanding of parental knowledge, attitudes and perceptions of dental caries. Results and Discussion: Almost 56% of participants earned a monthly income of less than R6000 (600 US dollars). Nearly three quarters (77.5%) of participants indicated that they did not have medical aid/insurance scheme. More than three-quarters of the participants (76.6%) identified diet as being the primary cause of decayed teeth. More than half of the study sample (56.1%) indicated that milk teeth were important and that rotten teeth (74.6%) could affect the child’s health. Almost half (49.8%) of participants reported that “bad teeth” were inherited. With more than two-thirds of the participants (77.7%), having at most a high school education, there was a correlation between the level of the caregiver’s education and the oral health care of the child. The analysis of the correlation between a child having decayed teeth and income (p=.007); and the manner in which the income is received (p=.003) was statistically significant. The results indicate that more effort needs to be placed in understanding parental knowledge, perceptions and attitudes towards dental caries. Parental level of education, income and oral health literacy is shown to be related to attitudes, and perceptions towards dental caries and its subsequent preventive measures. These findings have important implications for oral health planning at community and facility-based levels.

Keywords: oral health prevention, parental education, dental caries, attitudes and perceptions

Procedia PDF Downloads 381

Authors: Mihai-Ionut Firescu, Mark A. P. Carson

Abstract:

We present a case of inferior vena cava agenesis (IVCA) associated with bilateral deep venous thrombosis (DVT) in a patient with Beckwith-Wiedemann syndrome (BWS). In adult patients with BWS presenting with bilateral lower limb oedema, specific aetiological factors should be considered. These include cardiomyopathy and intraabdominal tumours. Congenital malformations of the IVC, through causing relative venous stasis, can lead to lower limb oedema either directly or indirectly by favouring lower limb venous thromboembolism; however, they are yet to be reported as an associated feature of BWS. Given its life-threatening potential, the prompt initiation of treatment for bilateral DVT is paramount. In BWS patients, however, this can prove more complicated. Due to overgrowth, the above-average birth weight can continue throughout childhood. In this case, the patient’s weight reached 170 kg, impacting on anticoagulation choice, as direct oral anticoagulants have a limited evidence base in patients with a body mass above 120 kg. Furthermore, the presence of IVCA leads to a long-term increased venous thrombosis risk. Therefore, patients with IVCA and bilateral DVT warrant specialist consideration and may benefit from multidisciplinary team management, with hematology and vascular surgery input. Conclusion: Here, we showcased a rare cause for bilateral lower limb oedema, respectively bilateral deep venous thrombosis complicating IVCA in a patient with Beckwith-Wiedemann syndrome. The importance of this case lies in its novelty, as the association between IVC agenesis and BWS has not yet been described. Furthermore, the treatment of DVT in such situations requires special consideration, taking into account the patient’s weight and the presence of a significant, predisposing vascular abnormality.

Keywords: Beckwith-Wiedemann syndrome, bilateral deep venous thrombosis, inferior vena cava agenesis, venous thromboembolism

Procedia PDF Downloads 231

Authors: Trevor E. Davis, Isaac Cassar, Yi-Kai Lo, Wentai Liu

Abstract:

This study models the use of transcutaneous electrical nerve stimulation on skin with a disk electrode in order to simulate tissue damage. The current density distribution above a disk electrode is known to be a dynamic and non-uniform quantity that is intensified at the edges of the disk. The non-uniformity is subject to change through using various electrode geometries or stimulation methods. One of these methods known as edge-retarded stimulation has shown to reduce this edge enhancement. Though progress has been made in modeling the behavior of a disk electrode, little has been done to test the validity of these models in simulating the actual heat transfer from the electrode. This simulation uses finite element software to couple the injection of current from a disk electrode to heat transfer described by the Pennesbioheat transfer equation. An example application of this model is studying an experimental form of stimulation, known as edge-retarded stimulation. The edge-retarded stimulation method will reduce the current density at the edges of the electrode. It is hypothesized that reducing the current density edge enhancement effect will, in turn, reduce temperature change and tissue damage at the edges of these electrodes. This study tests this hypothesis as a demonstration of the capabilities of this model. The edge-retarded stimulation proved to be safer after this simulation. It is shown that temperature change and the fraction of tissue necrosis is much greater in the square wave stimulation. These results bring implications for changes of procedures in transcutaneous electrical nerve stimulation and transcutaneous spinal cord stimulation as well.

Keywords: bioheat transfer, electrode, neuroprosthetics, TENS, transcutaneous stimulation

Procedia PDF Downloads 237

Authors: Mayur Chaudhari, Ashutosh Gaikwad, Shubham Kavathale, Aditya Mule, Dilip Panchal, Puja Verma

Abstract:

The purpose of this investigation was to locate restorative bio-materials for the manufacture of implants and crowns. A three-dimensional (3D) finite element analysis (FEA) was carried out to evaluate the stress distribution in the implant and abutment with several types of bio-materials and various prosthetic crowns. While the dental implant, abutment, and screw were subjected to a vertical impact force, the effects of mechanical characteristics such as Young's modulus and Poisson's ratio were evaluated and contrasted. Crowns are made from zirconia, cobalt, ceramic, acrylic resin, and porcelain materials. Implants are made from materials such as titanium, zirconia, PEEK, and CFR-PEEK. SolidWorks was used to create the 3D geometry, and Ansys Software was used to analyze it. The results show that using CFR-PEEK implants and an acrylic resin crown resulted in less bone stress than using alternative materials. In order to reduce the amount of stress on the bone and possibly prevent implant failure, the study's findings support the use of a CFR PEEK implant, abutment, and crown in bruxism patients.

Keywords: biomaterials, implant, crown, abutment

Procedia PDF Downloads 57

Authors: Christina Tran, Lu Khoo, Andrea Waylen

Abstract:

Introduction: The evolution of the dental consultation from paternalism to partnership has been well documented in developed Western countries. Great emphasis is now placed on the importance of empowering patients to make decisions regarding their care, obtaining informed consent, and maintaining patient privacy and confidentiality. With the majority of communication occurring non-verbally, clinicians often adopt behaviours which suggest an approachable and positive attitude. However, evidence indicates that in Asia, a paternalistic model may be favored in medicine. The power imbalance occurring in doctor-patient relationships worldwide may be exacerbated by various factors in Southeast Asia: the strong hierarchical culture, and the large education gap between doctor and patient. Further insight into this matter can be gained by observing patient-dentist communication in Cambodia. The dentist:population ratio in Cambodia is approximately 1:33,000, with rural areas remaining extremely underserviced. We have carried out an observational study of communication in a voluntary dental clinic in Cambodia with the aim of describing whether the patient-dentist relationship follows a paternalistic or patient-centred model. Method: Over a period of two weeks, two clinicians provided dental care as part of a voluntary program in two Cambodian settings: a temporary, rural clinic and a permanent clinic in Phnom Penh. The clinicians independently recorded their experiences in diaries, making observations on the verbal and non-verbal communication between patients and staff. General observations such as the clinic environment were also made. The diaries were then compared and analyzed using a thematic approach. Results: The overall themes that emerged were regarding the clinic environment, verbal communication, and non-verbal communication. Regarding the clinic environment, the rural clinic was arranged in order to easily direct patients from one dentist to another, with little emphasis on continuous patient care. There was also little consideration for patient privacy: patients were often treated in the presence of many observers, including other waiting patients. However, the permanent clinic was structured to allow greater patient privacy, with continuous patient care occurring throughout the appointment. Regarding verbal communication, there was a strongly paternalistic approach to gaining consent and giving instruction. Patients rarely asked questions regarding their treatment, with dentists doing little to encourage patient involvement. Non-verbal communication between patients and dentists was generally paternalistic, with the dentist often addressing the supine patient from above. Patients often avoided making eye-contact, which may have indicated discomfort or lack of engagement. Both adult and paediatric patients rarely raised verbal concerns regarding pain during treatment, despite displaying non-verbal signs of experiencing pain. Anxious paediatric patients were sometimes managed with physical restraint by their mothers to facilitate treatment. Conclusion: Patient-professional communication in the Cambodian dental setting was observed to be generally paternalistic in nature, although more patient-centred aspects were observed in the established, urban setting. However, it should be noted that these observations are subjective in nature, and that the patients’ actual perceptions of their communication experience were unexplored. Further observations in variety of dental settings in Cambodia are needed before any definitive conclusions can be made.

Keywords: patient-dentist communication, paternalism, patient-centered, non-verbal communication

Procedia PDF Downloads 115

Authors: Yuko Ishiwaka, Tomohiro Yoshida, Tadateru Itoh

Abstract:

Human makes preparation called readiness potential unconsciously (RP) before awareness of their own decision. For example, when recognizing a button and pressing the button, the RP peaks are observed 200 ms before the initiation of the movement. It has been known that the preparatory movements are acquired before actual movements, but it has not been still well understood how humans can obtain the RP during their growth. On the proposition of why the brain must respond earlier, we assume that humans have to adopt the dangerous environment to survive and then obtain the behavior to cover the various time lags distributed in the body. Without RP, humans cannot take action quickly to avoid dangerous situations. In taking action, the brain makes decisions, and signals are transmitted through the Spinal Cord to the muscles to the body moves according to the laws of physics. Our research focuses on the time lag of the neuron signal transmitting from a brain to muscle via a spinal cord. This time lag is one of the essential factors for readiness potential. We propose a firing pattern controller model of a motor nerve system considered innervation and jitter, which produces time lag. In our simulation, we adopt innervation and jitter in our proposed muscle-skeleton model, because these two factors can create infinitesimal time lag. Q10 Hodgkin Huxley model to calculate action potentials is also adopted because the refractory period produces a more significant time lag for continuous firing. Keeping constant power of muscle requires cooperation firing of motor neurons because a refractory period stifles the continuous firing of a neuron. One more factor in producing time lag is slow or fast-twitch. The Expanded Hill Type model is adopted to calculate power and time lag. We will simulate our model of muscle skeleton model by controlling the firing pattern and discuss the relationship between the time lag of physics and neurons. For our discussion, we analyze the time lag with our simulation for knee bending. The law of inertia caused the most influential time lag. The next most crucial time lag was the time to generate the action potential induced by innervation and jitter. In our simulation, the time lag at the beginning of the knee movement is 202ms to 203.5ms. It means that readiness potential should be prepared more than 200ms before decision making.

Keywords: firing patterns, innervation, jitter, motor nerve system, readiness potential

Procedia PDF Downloads 825

Authors: Ana Ferreira, Ines Costa, Patricia Polónia, Josué Pereira, Olinda Faria, Pedro Alberto Silva

Abstract:

Introduction: Optical coherence tomography (OCT) and visual field tools are pivotal in evaluating neurological deficits and predicting potential visual improvement following surgical decompression in neurosurgical patients. Despite their clinical significance, a comprehensive understanding of their utility in this context is lacking in the literature. This study aims to elucidate the applications of OCT and visual field assessment, delineating distinct patterns of visual deficit presentations within the studied cohort. Methods: This retrospective analysis considered all adult patients who underwent a single surgery for pituitary adenoma or anterior skull base meningioma with optic nerve involvement, coupled with neuro-ophthalmology evaluation, between July 2020 and January 2023. A minimum follow-up period of 6 months was deemed essential. Results: A total of 24 patients, with a median age of 61, were included in the analysis. Three primary patterns emerged: 1) Low visual field involvement with compromised OCT, 2) High visual field involvement with relatively unaffected OCT, and 3) Significant compromise observed in both OCT and visual fields. Conclusion: This study delineates various findings in OCT and visual field assessments with illustrative examples. Based on the current findings, a prospective cohort will be systematically collected to further investigate and validate these patterns and their prognostic significance, enhancing our understanding of the utility of OCT and visual fields in neurosurgical patients.

Keywords: OCT, neurosurgery, visual field, optic nerve

Procedia PDF Downloads 69

Authors: Thi. A. D. Tran, Matthieu Arnold, Dominique Adolphe, Laurence Schcher, Guillaume Reys

Abstract:

During daily oral health cares, dental surgeons are in contact with numerous potentially infectious germs from patients' saliva and blood. In order to take into account these risks, a product development process has been unrolled to propose to the dental surgeon a personal protection equipment that is suitable with their expectations in terms of images, protection and comfort. After a consumer study, to evaluate how the users wear the garment and their expectations, specifications have been carried out and technical solutions have been developed in order to answer to the maximum of the desiderata. Thermal studies and comfort studies have been performed. The obtained results lead to define the technical solutions concerning the design of the new scrub. Three main functions have been investigated, the ergonomic aspect, the protection and the thermal comfort. In terms of ergonomic aspect, instrumented garments have been worn and pressure measurements have been done. The results highlight that a raglan shape for the sleeves has to be selected for a better dynamic comfort. Moreover, spray tests helped us to localize the potential contamination area and therefore protection devices have been placed on the garment. Concerning the thermal comfort, an I-R study was conducted in consulting room under the real working conditions; the heating zones have been detected. Based on these results, solutions have been proposed and implemented in a new gown. This new gown is currently composed of three different parts; a protective layer placed in the chest area to avoid contamination; a breathable layer placed in the back and in the armpits and a normal PET/Cotton fabric for the rest of the gown. Through the fitting tests conducted in hospital, it was obtained that the new design was highly appreciated. Some points can nevertheless be further improved. A final product will be produced based on necessary improvements.

Keywords: comfort, dentists, garment, thermal

Procedia PDF Downloads 307

Authors: Rana Mohamed, Ahmed E. Gomaa, Gehan Safwat, Ayman Diab

Abstract:

Background: Bio-fabrication is a multidisciplinary research field that combines several principles, fabrication techniques, and protocols from different fields. The open-source-software movement is a movement that supports the use of open-source licenses for some or all software as part of the broader notion of open collaboration. Additive manufacturing is the concept of 3D printing, where it is a manufacturing method through adding layer-by-layer using computer-aided designs (CAD). There are several types of AM system used, and they can be categorized by the type of process used. One of these AM technologies is Digital light processing (DLP) which is a 3D printing technology used to rapidly cure a photopolymer resin to create hard scaffolds. DLP uses a projected light source to cure (Harden or crosslinking) the entire layer at once. Current applications of DLP are focused on dental and medical applications. Other developments have been made in this field, leading to the revolutionary field 3D bioprinting. The open-source movement was started to spread the concept of open-source software to provide software or hardware that is cheaper, reliable, and has better quality. Objective: Modification of desktop 3D printer into 3D bio-printer and the integration of DLP technology and bio-fabrication to produce an antibacterial dental model. Method: Modification of a desktop 3D printer into a 3D bioprinter. Gelatin hydrogel and sodium alginate hydrogel were prepared with different concentrations. Rhizome of Zingiber officinale, Flower buds of Syzygium aromaticum, and Bulbs of Allium sativum were extracted, and extractions were selected on different levels (Powder, aqueous extracts, total oils, and Essential oils) prepared for antibacterial bioactivity. Agar well diffusion method along with the E. coli have been used to perform the sensitivity test for the antibacterial activity of the extracts acquired by Zingiber officinale, Syzygium aromaticum, and Allium sativum. Lastly, DLP printing was performed to produce several dental models with the natural extracted combined with hydrogel to represent and simulate the Hard and Soft tissues. Result: The desktop 3D printer was modified into 3D bioprinter using open-source software Marline and modified custom-made 3D printed parts. Sodium alginate hydrogel and gelatin hydrogel were prepared at 5% (w/v), 10% (w/v), and 15%(w/v). Resin integration with the natural extracts of Rhizome of Zingiber officinale, Flower buds of Syzygium aromaticum, and Bulbs of Allium sativum was done following the percentage 1- 3% for each extract. Finally, the Antimicrobial dental model was printed; exhibits the antimicrobial activity, followed by merging with sodium alginate hydrogel. Conclusion: The open-source movement was successful in modifying and producing a low-cost Desktop 3D Bioprinter showing the potential of further enhancement in such scope. Additionally, the potential of integrating the DLP technology with bioprinting is a promising step toward the usage of the antimicrobial activity using natural products.

Keywords: 3D printing, 3D bio-printing, DLP, hydrogel, antibacterial activity, zingiber officinale, syzygium aromaticum, allium sativum, panax ginseng, dental applications

Procedia PDF Downloads 92

Authors: Nélio Veiga, Paula Ferreira, Tiago Correia, Maria J. Correia, Carlos Pereira, Odete Amaral, Ilídio J. Correia

Abstract:

Introduction: The application of fissure sealants is considered to be an important primary prevention method used in dental medicine. However, the formation of microleakage gaps between tooth enamel and the fissure sealant applied is one of the most common reasons of dental caries development in teeth with fissure sealants. The association between various dental biomaterials may limit the major disadvantages and limitations of biomaterials functioning in a complementary manner. The present study consists in the incorporation of a cariostatic agent – silver diamine fluoride (SDF) – in a resin-based fissure sealant followed by the study of release kinetics by spectrophotometry analysis of the association between both biomaterials and assessment of the inhibitory effect on the growth of the reference bacterial strain Streptococcus mutans (S. mutans) in an in vitro study. Materials and Methods: An experimental in vitro study was designed consisting in the entrapment of SDF (Cariestop^® 12% and 30%) into a commercially available fissure sealant (Fissurit^®), by photopolymerization and photocrosslinking. The same sealant, without SDF was used as a negative control. The effect of the sealants on the growth of S. mutans was determined by the presence of bacterial inhibitory halos in the cultures at the end of the incubation period. In order to confirm the absence of bacteria in the surface of the materials, Scanning Electron Microscopy (SEM) characterization was performed. Also, to analyze the release profile of SDF along time, spectrophotometry technique was applied. Results: The obtained results indicate that the association of SDF to a resin-based fissure sealant may be able to increase the inhibition of S. mutans growth. However, no SDF release was noticed during the in vitro release studies and no statistical significant difference was verified when comparing the inhibitory halo sizes obtained for test and control group.  Conclusions: In this study, the entrapment of SDF in the resin-based fissure sealant did not potentiate the antibacterial effect of the fissure sealant or avoid the immediate development of dental caries. The development of more laboratorial research and, afterwards, long-term clinical data are necessary in order to verify if this association between these biomaterials is effective and can be considered for being used in oral health management. Also, other methodologies for associating cariostatic agents and sealant should be addressed.

Keywords: biomaterial, fissure sealant, primary prevention, silver diamine fluoride

Procedia PDF Downloads 255

Authors: Jayshree Patnaik, Bhaskar Bhowmick

Abstract:

The economic growth of any nation is steered and dependent on innovation in technology. It can be preferably argued that technology has enhanced the quality of life. Technology is linked both with an economic and a social structure. But there are some parts of the world or communities which are yet to reap the benefits of technological innovation. Business and organizations are now well equipped with cutting-edge innovations that improve the firm performance and provide them with a competitive edge, but rarely does it have a positive impact on any community which is weak and marginalized. In recent times, it is observed that communities are actively handling social or ecological issues with the help of indigenous technologies. Thus, "Appropriate Technology" comes into the discussion, which is quite prevalent in the rural third world. Appropriate technology grew as a movement in the mid-1970s during the energy crisis, but it lost its stance in the following years when people started it to describe it as an inferior technology or dead technology. Basically, there is no such technology which is inferior or sophisticated for a particular region. The relevance of appropriate technology lies in penetrating technology into a larger and weaker section of community where the “Bottom of the pyramid” can pay for technology if they find the price is affordable. This is a theoretical paper which primarily revolves around how appropriate technology has faded and again evolved in both developed and developing countries. The paper will try to focus on the various concepts, history and challenges faced by the appropriate technology over the years. Appropriate technology follows a documented approach but lags in overall design and diffusion. Diffusion of technology into the poorer sections of community remains unanswered until the present time. Appropriate technology is multi-disciplinary in nature; therefore, this openness allows having a varied working model for different problems. Appropriate technology is a friendly technology that seeks to improve the lives of people in a constraint environment by providing an affordable and sustainable solution. Appropriate technology needs to be defined in the era of modern technological advancement for sustainability.

Keywords: appropriate technology, community, developing country, sustainability

Procedia PDF Downloads 260

Authors: Thomas Turner

Abstract:

Due to the Covid-19 pandemic alternative ways of delivering dental education were required. As a result, many institutions moved teaching online. The impact of this is poorly understood. Is online problem-based learning (PBL) and case-based learning (CBL) effective and is it suitable in the post-pandemic era? PBL and CBL are both types of interactive, group-based learning which are growing in popularity within many dental schools. PBL was first introduced in the 1960’s and can be defined as learning which occurs from collaborative work to resolve a problem. Whereas CBL encourages learning from clinical cases, encourages application of knowledge and helps prepare learners for clinical practice. To evaluate the use of online PBL and CBL. A literature search was conducted using the CINAHL, Embase, PubMed and Web of Science databases. Literature was also identified from reference lists. Studies were only included from dental education. Seven suitable studies were identified. One of the studies found a high learner and facilitator satisfaction rate with online CBL. Interestingly one study found learners preferred CBL over PBL within an online format. A study also found, that within the context of distance learning, learners preferred a hybrid curriculum including PBL over a traditional approach. A further study pointed to the limitations of PBL within an online format, such as reduced interaction, potentially hindering the development of communication skills and the increased time and technology support required. An audience response system was also developed for use within CBL and had a high satisfaction rate. Interestingly one study found achievement of learning outcomes was correlated with the number of student and staff inputs within an online format. Whereas another study found the quantity of learner interactions were important to group performance, however the quantity of facilitator interactions was not. This review identified generally favourable evidence for the benefits of online PBL and CBL. However, there is limited high quality evidence evaluating these teaching methods within dental education and there appears to be limited evidence comparing online and faceto-face versions of these sessions. The importance of the quantity of learner interactions is evident, however the importance of the quantity of facilitator interactions appears to be questionable. An element to this may be down to the quality of interactions, rather than just quantity. Limitations of online learning regarding technological issues and time required for a session are also highlighted, however as learners and facilitators get familiar with online formats, these may become less of an issue. It is also important learners are encouraged to interact and communicate during these sessions, to allow for the development of communication skills. Interestingly CBL appeared to be preferred to PBL in an online format. This may reflect the simpler nature of CBL, however further research is required to explore this finding. Online CBL and PBL appear promising, however further research is required before online formats of these sessions are widely adopted in the post-pandemic era.

Keywords: case-based learning, online, problem-based learning, remote, virtual

Procedia PDF Downloads 75

Authors: Yasuyuki Takahashi, Hayato Ishimura, Masao Miyagawa, Teruhito Mochizuki

Abstract:

Quantitative measurement of myocardium perfusion is possible with single photon emission computed tomography (SPECT) using a semiconductor detector. However, accumulation of ^99mTc-tetrofosmin in the liver may make it difficult to assess that accurately in the inferior myocardium. Our idea is to reduce the high accumulation in the liver by using dynamic SPECT imaging and a technique called time subtraction. We evaluated the performance of a new SPECT system with a cadmium-zinc-telluride solid-state semi- conductor detector (Discovery NM 530c; GE Healthcare). Our system acquired list-mode raw data over 10 minutes for a typical patient. From the data, ten SPECT images were reconstructed, one for every minute of acquired data. Reconstruction with the semiconductor detector was based on an implementation of a 3-D iterative Bayesian reconstruction algorithm. We studied 20 patients with coronary artery disease (mean age 75.4 ± 12.1 years; range 42-86; 16 males and 4 females). In each subject, 259 MBq of ^99mTc-tetrofosmin was injected intravenously. We performed both a phantom and a clinical study using dynamic SPECT. An approximation to a liver-only image is obtained by reconstructing an image from the early projections during which time the liver accumulation dominates (0.5~2.5 minutes SPECT image-5~10 minutes SPECT image). The extracted liver-only image is then subtracted from a later SPECT image that shows both the liver and the myocardial uptake (5~10 minutes SPECT image-liver-only image). The time subtraction of liver was possible in both a phantom and the clinical study. The visualization of the inferior myocardium was improved. In past reports, higher accumulation in the myocardium due to the overlap of the liver is un-diagnosable. Using our time subtraction method, the image quality of the ^99mTc-tetorofosmin myocardial SPECT image is considerably improved.

Keywords: 99mTc-tetrofosmin, dynamic SPECT, time subtraction, semiconductor detector

Procedia PDF Downloads 330

Authors: Andreas Aceranti, Sergio Romanò, Simonetta Vernocchi, Silvia Arnaboldi, Emilio Mazza

Abstract:

As a result of the Sars-Cov2 pandemic, the incidence of thymism disorders has significantly increased and, often, patients are reluctant to want to take drugs aimed at stabilizing mood. In order to provide an alternative approach to drug therapies, we have prepared a study in order to evaluate the possibility of improving the quality of life of these subjects through osteopathic treatment. Patients were divided into visceral and fascial manual treatment with the aim of increasing serotonin levels and stimulating the vagus nerve through validated techniques. The results were evaluated through the administration of targeted questionnaires in order to assess quality of life, mood, sleep and intestinal functioning. At a first endpoint we found, in patients undergoing fascial treatment, an increase in quality of life and sleep: in fact, they report a decrease in the number of nocturnal awakenings; a reduction in falling asleep times and greater rest upon waking. In contrast, patients undergoing visceral treatment, as well as those included in the control group, did not show significant improvements. Patients in the fascial group have, in fact, reported an improvement in thymism and subjective quality of life with a generalized improvement in function. Although the study is still ongoing, based on the results of the first endpoint we can hypothesize that fascial stimulation of the vagus nerve with manual and osteopathic techniques may be a valid alternative to pharmacological treatments in mood and sleep disorders.

Keywords: ostheopathy, insomnia, noctural awakening, thymism

Procedia PDF Downloads 87

Authors: P. Siriarchawatana, K. Leungchavaphongse, N. Covavisaruch, K. Rojananuangnit, P. Boondaeng, N. Panyayingyong

Abstract:

Glaucoma is a disease that causes visual loss in adults. Glaucoma causes damage to the optic nerve and its overall pathophysiology is still not fully understood. Vasculopathy may be one of the possible causes of nerve damage. Photographic imaging of retinal vessels by fundus camera during eye examination may complement clinical management. This paper presents an innovation for measuring central light reflex width-to-retinal vessel diameter ratio (CRR) from digital retinal photographs. Using our edge detection technique, CRRs from glaucoma and normal eyes were compared to examine differences and associations. CRRs were evaluated on fundus photographs of participants from Mettapracharak (Wat Raikhing) Hospital in Nakhon Pathom, Thailand. Fifty-five photographs from normal eyes and twenty-one photographs from glaucoma eyes were included. Participants with hypertension were excluded. In each photograph, CRRs from four retinal vessels, including arteries and veins in the inferotemporal and superotemporal regions, were quantified using edge detection technique. From our finding, mean CRRs of all four retinal arteries and veins were significantly higher in persons with glaucoma than in those without glaucoma (0.34 vs. 0.32, p < 0.05 for inferotemporal vein, 0.33 vs. 0.30, p < 0.01 for inferotemporal artery, 0.34 vs. 0.31, p < 0.01 for superotemporal vein, and 0.33 vs. 0.30, p < 0.05 for superotemporal artery). From these results, an increase in CRRs of retinal vessels, as quantitatively measured from fundus photographs, could be associated with glaucoma.

Keywords: glaucoma, retinal vessel, central light reflex, image processing, fundus photograph, edge detection

Procedia PDF Downloads 321

Authors: Belly Yordan

Abstract:

Orthodontic treatment can be done by using the fix and removable orthodontic appliance. The success of treatment depends on the patient’s age, the type of malocclusion, treatment of space discrepancy, patient’s oral hygiene, operator skills, and patient cooperation. This case report was aimed to show the success of orthodontic treatment in patients with skeletal class I relationship, class I angle dental malocclusion with anterior crowding and rotation by using a removable appliance with modification. The removable appliance used is standard with removable plate components such as passive clasp (Adam’s hook clasp) accompanied with some active clasps (labial bow, some springs, etc.). A button is used as an additional tool or combined with other tools to correct tooth in rotated position. The results obtained by the success of treatments which is shown in pre and post-treatment photos, the overjet was reduced, the arch form became normal, the tooth malposition became normal, and rotation was corrected. Facial profile appearance of the patient is getting better, and the dental coordination also became better. This case report is to prove that treatment with the removable appliance is quite successful with the robust wearing of appropriate retainers.

Keywords: success rate, anterior crowding, orthodontic treatment, removable appliances

Procedia PDF Downloads 165

Authors: Matthew Sedgwick

Abstract:

Introduction: Social media continues to grow in popularity and Instagram is one of the largest platforms available. It provides an invaluable method of communication between health care professionals and patients. Both patients and dentists can benefit from seeing clinical cases posted by other members of the profession. It can prompt discussion about how the outcome was achieved and showcases what is possible with the right techniques and planning. This study aimed to identify what people were posting about the topic ‘veneers’ and inform health care professionals as to what content had the most engagement and make recommendations as to how to improve the quality of social media posts. Design: 150 consecutive posts for the search term ‘veneers’ were analyzed retrospectively between 21st October 2021 to 31st October 2021. Non-English language posts duplicated posts, and posts not about dental veneers were excluded. After exclusions were applied, 80 posts were included in the study for analysis. The content of the posts was analyzed and coded and the main themes were identified. The number of comments, likes and views were also recorded for each post. Results: The themes were: before and after treatment, cost, dental training courses, treatment process and trial smiles. Dentists were the most common posters of content (82.5%) and it was interesting to note that there were no patients who posted about treatment in this sample. The main type of media was photographs (93.75%) compared to video (6.25%). Videos had an average of 45,541 views and more comments and likes than the average for photographs. The average number of comments and likes per post were 20.88 and 761.58, respectively. Conclusion: Before and after photographs were the most common finding as this is how dentists showcase their work. The study showed that videos showing the treatment process had more engagement than photographs. Dentists should consider making video posts showing the patient journey, including before and after veneer treatment, as this can result in more potential patients and colleagues viewing the content. Video content could help dentists distinguish their posts from others as it can also be used across other platforms such as TikTok or Facebook reaching a wider audience. More informative posts about how the result has shown are achieved required, including potential costs. This will help increase transparency regarding this treatment method, including the financial and potential biological cost to teeth. As a result, this will improve patient understanding and become an invaluable adjunct in informed consent.

Keywords: content analysis, dental veneers, Instagram, social media

Procedia PDF Downloads 134

Authors: S. Curtin, A. Trace

Abstract:

Introduction: As patients can often be ambivalent about or resistant to any change in their smoking behavior the traditional ‘5 A’ model may be limited as it assumes that patients are ready and motivated to change. However, there is a stage model that is helpful to give guidance for dental students: the Transtheoretical Model (TTM). This model allows students to understand the tasks and goals for the pre-contemplation stage. The TTM was introduced in early stages as a core component of a smoking cessation programme that was integrated into a Behavioral Science programme as applied to dentistry. The aim of the present study is to evaluate and illustrate the students’ current level of knowledge from the questions the students generated in order to engage patients in the tasks and goals of the pre-contemplation stage. Method: N=47 responses of fifth-year undergraduate dental students. These responses were the data set for this study and related to their knowledge base of appropriate questions for a dentist to ask at the pre-contemplation stage of change. A deductive -descriptive analysis was conducted on the data. The goals and tasks of the pre-contemplation stage of the TTM provided a template for this deductive analysis. Results: 51% of students generated relevant, open, exploratory questions for the pre-contemplation stage, whilst 100% of students generated closed questions. With regard to those questions appropriate for the pre-contemplation stage, 19% were open and exploratory, while 66% were closed questions. A deductive analysis of the open exploratory questions revealed that 53% of the questions addressed increased concern about the current pattern of behavior, 38% of the questions concerned increased awareness of a need for change and only 8% of the questions dealt with the envisioning of the possibility of change. Conclusion: All students formulated relevant questions for the pre-contemplation stage, and half of the students generated the open, exploratory questions that increased patients’ awareness of the need to change. More training is required to facilitate a shift in the formulation from closed to open questioning, especially given that, traditionally, smoking cessation was modeled on the ‘5 As’, and that the general training for dentists supports an advisory and directive approach.

Keywords: behaviour change, pre-contemplation stage, trans-theoretical model, undergraduate dentistry students

Procedia PDF Downloads 409

Authors: Seung Ju Yeon, Seul Ki Min, Jun Sang Park, Yeo Seon Kwon, Hoo Cheol Lee, Hyun Jung Shim, Il-Doo Kim, Ja Kyeong Lee, Hwa Sung Shin

Abstract:

In brain injury, depleting oxidative stress is the most effective way to reduce the brain infarct size. C-phycocyanin (C-Pc) is a well-known antioxidant protein that has neuroprotective effects obtained from green microalgae. Astrocyte is glial cell that supports the nerve cell such as neuron, which account for a large portion of the brain. In brain injury, such as ischemia and reperfusion, astrocyte has an important rule that overcomes the oxidative stress and protect from brain reactive oxygen species (ROS) injury. However little is known about how C-Pc regulates the anti-oxidants effects of astrocyte. In this study, when the C-Pc was treated in oxidized astrocyte, we confirmed that inflammatory factors Interleukin-6 and Interleukin-3 were increased and antioxidants enzyme, Superoxide dismutase (SOD) and catalase was upregulated, and neurotrophic factors, brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) was alleviated. Also, it was confirmed to reduce infarct size of the brain in ischemia and reperfusion because C-Pc has anti-oxidant effects in middle cerebral artery occlusion (MCAO) animal model. These results show that C-Pc can help astrocytes lead neuroprotective activities in the oxidative stressed environment of the brain. In summary, the C-PC protects astrocytes from oxidative stress and has anti-oxidative, anti-inflammatory, neurotrophic effects under ischemic situations.

Keywords: c-phycocyanin, astrocyte, reactive oxygen species, ischemia and reperfusion, neuroprotective effect

Procedia PDF Downloads 314

Authors: Xing Wang, Lin Feng, Lingling E., Hongchen Liu

Abstract:

In patients with type 2 diabetes mellitus (DM) there is poorer quality osseointegration than in non-diabetic (n-DM) patients, and the success of dental implants is less. Recent studies have demonstrated that insulin could stimulate bone cells to produce and accelerate implant osseointegration in DM patients.This raised the question whether insulin could provide local bone anabolic effects in non-diabetic patients. In this study,48 SD rats were divided into four groups randomly: DM group, DM+insulin group, n-DM group, n-DM + insulin group. All rats were implanted the titanium implant near the epiphyseal end of tibia, then the DM + insulin and n-DM + insulin group received twice-daily subcutaneous injections of insulin (10U/day).Two,four and eight weeks after implantation, rats were killed in batches. Histomorphometry and immunohistochemistry were used to evaluate bone formation and osseointegration. The amount of newly formed bone, Implant–bone contact and the expression of OCN,RUNX2 in the DM+insulin, n-DM and n-DM+insulin group were significantly more than in the DM group (p<0.05). Compared with the n-DM group,the Implant–bone contact and expression of OCN,RUNX2 were significantly increased in n-DM+insulin group (p< 0.05). Taken together,these observations provide evidence that insulin has the potential to increase bone formation and osseointegration around implant not only in diabetic subjects but also in non-diabetic subject.

Keywords: insulin, diabetes mellitus, osseointegration, dental implants

Procedia PDF Downloads 461

Authors: Yusser Olguín, Diego Benavente, Fernando Dorta, Nicole Orellana, Cristian Acevedo

Abstract:

One of the greatest challenges of tissue engineering is the generation of materials in which the highest possible number of conditions can be incorporated to stimulate the proliferation and differentiation of cells, which will be transformed together with the material into new functional tissue. In this sense, considering the properties of microfluidics and its relationship with cellular micro-environments, the possibility of controlling flow patterns and the ability to design diverse patterns in the chips, a microfluidic cell culture system can be established as a means for the evaluation of the effect of different parameters in a controlled and precise manner. Specifically in relation to the study and development of alternatives in peripheral nervous tissue engineering, it is necessary to consider different physical and chemical neurotrophic stimuli that promote cell growth and differentiation. Chemical stimuli include certain vitamins, glucocorticoids, gangliosides, and growth factors, while physical stimuli include topological stimuli, mechanical forces of the cellular environment and electrical stimulation. In this context, the present investigation shows the results of cell stimulation in a microbioreactor using electrical and chemical stimuli, where the differentiation of PC12 cells as a neuronal model is evidenced by neurite expression, dependent on the stimuli and their combination. The results were analysed with a multi-factor statistical approach, showing several relationships and dependencies between different parameters. Chip design, operating parameters and concentrations of neurotrophic chemical factors were found to be preponderant, based on the characteristics of the electrical stimuli.

Keywords: microfluidics, nerve tissue engineering, microbioreactor, electrical stimuli

Procedia PDF Downloads 79

Authors: Gadia Duhita, Noorhana, Tjhin Wiguna

Abstract:

Background: ADHD is the most common behavioural disorder in Indonesia. A stimulant, specifically methylphenidate, has been the first drug of choice for an ADHD treatment more than half a century. During the last decade, non-stimulant therapy (atomoxetine) for ADHD treatment has been developing. Growing evidence of its efficacy and the difference in its side effects profile to stimulant therapy have made methylphenidate’s position as a first line therapy for ADHD in need of re-evaluation. Both methylphenidate and atomoxetine have proven themselves against placebos in reducing core symptoms of ADHD. More recent studies directly compare the efficacy of methylphenidate and atomoxetine. Objective: The objective of this paper is to find out if either methylphenidate or atomoxetine is superior to another. This paper will assess the validity, importance, and applicability of current available evidence which compare the effectivity, efficacy, and safety of methylphenidate to atomoxetine for treatment in children and adolescents with ADHD. Method: The articles were searched for through the PubMed and Cochrane databases with “attention deficit/hyperactivity disorder OR adhd”, “methylphenidate”, and “atomoxetine” as the search keywords. Two articles which were relevant and eligible were chosen by using inclusion and exclusion criterias to be critically appraised. Result: The study by Hazel et al. showed that the efficacy of methylphenidate and atomoxetine are comparable for treatment in child and adolescent ADHD. The result shows 53.6% (95% CI 48.5%-58.4%) of the patient responded to the treatment by atomoxetine and 54.4% (95% CI 47.6%-61.1%) patients responded to methylphenidate, with the difference in proportion of–0.9% (95% CI –9.2%-7.5%). The other study by Hanwella et al. also showed that the efficacy of atomoxetine was not inferior to metilphenidate (SMD = 0.09, 95% CI –0.08-0.26) (Z = 1.06, p = 0.29). However, the sub-group analysis showed that OROS methylphenidate is more effective compared to atomoxetine (SMD = 0.32, 95% CI 0.12-0.53) (Z = 3.05, p < 0.02). Conclusion: The efficacy of methylphenidate and atomoxetine in reducing symptoms of ADHD is comparable. None is proven inferior to another. The choice of pharmacological tratment children and adolescents with ADHD should be made based on contraindication and the side effects profile of each drug.

Keywords: attention deficit/hyperactivity disorder, ADHD, atomoxetine, methylphenidate

Procedia PDF Downloads 473

Authors: Areej Al-Khabbaz, Swapna Goerge, Majedah Abdul-Rasoul

Abstract:

Introduction: The most prevalent periodontal disease among children is gingivitis, and it usually becomes more severe in adolescence. A number of intervention studies suggested that resolution of periodontal inflammation can improve metabolic control in patients diagnosed with diabetes mellitus. Aim: to assess the effect of non-surgical periodontal therapy on glycemic control of children diagnosed with diabetes mellitus. Method: Twenty-eight children diagnosed with diabetes mellitus were recruited with established diagnosis diabetes for at least 1 year. Informed consent and child assent form were obtained from children and parents prior to enrolment. The dental examination for the participants was performed on the same week directly following their annual medical assessment. All patients had their glycosylated hemoglobin (HbA1c%) test one week prior to their annual medical and dental visit and 3 months following non-surgical periodontal therapy. All patients received a comprehensive periodontal examination The periodontal assessment included clinical attachment loss, bleeding on probing, plaque score, plaque index and gingival index. All patients were referred for non-surgical periodontal therapy, which included oral hygiene instruction and motivation followed by supra-gingival and subg-ingival scaling using ultrasonic and hand instruments. Statistical Analysis: Data were entered and analyzed using the Statistical Package for Social Science software (SPSS, Chicago, USA), version 18. Statistical analysis of clinical findings was performed to detect differences between the two groups in term of periodontal findings and HbA1c%. Binary logistic regression analysis was performed in order to examine which factors were significant in multivariate analysis after adjusting for confounding between effects. The regression model used the dependent variable ‘Improved glycemic control’, and the independent variables entered in the model were plaque index, gingival index, bleeding %, plaque Statistical significance was set at p < 0.05. Result: A total of 28 children. The mean age of the participants was 13.3±1.92 years. The study participants were divided into two groups; Compliant group (received dental scaling) and non-complaints group (received oral hygiene instructions only). No statistical difference was found between compliant and non-compliant group in age, gender distribution, oral hygiene practice and the level of diabetes control. There was a significant difference between compliant and non-compliant group in term of improvement of HBa1c before and after periodontal therapy. Mean gingival index was the only significant variable associated with improved glycemic control level. In conclusion, this study has demonstrated that non-surgical mechanical periodontal therapy can improve HbA1c% control. The result of this study confirmed that children with diabetes mellitus who are compliant to dental care and have routine professional scaling may have better metabolic control compared to diabetic children who are erratic with dental care.

Keywords: children, diabetes, metabolic control, periodontal therapy

Procedia PDF Downloads 157

Authors: Yogesh Bacchaw, Ashish Dabade

Abstract:

Nowadays oral health is raising concern in society. Acid producing microorganisms changes the oral pH and creates a favorable environment for microbial growth. This growth not only promotes dental decay but also bad breath. Generally Recognized As Safe (GRAS) listed component was incorporated in chewing gum as an antimicrobial agent. The chewing gum produced exhibited up to 9 hours of antimicrobial activity against oral microflora. The toxicity of GRAS component per RACC value of chewing gum was negligible as compared to actual toxicity level of GRAS component. The antibacterial efficiency of chewing gum was tested by using total plate count (TPC) and colony forming unit (CFU). Nine hours were required to microflora to reach TPC/CFU of before chewing gum consumption. This chewing gum not only provides mouth freshening activity but also helps in lowering dental decay, bad breath, and enamel whitening.

Keywords: colony forming unit (CFU), chewing gum, generally recognized as safe (GRAS), microbial growth, microorganisms, oral health, RACC, total plate count (TPC), antimicrobial agent, enamel whitening, oral pH

Procedia PDF Downloads 309

Authors: Osama Safwat Mohamed

Abstract:

Pits and fissures dental caries can be prevented using sealant material. This study aimed to compare the microleakage and interfacial morphology of flowable nanocomposites and conventional pit and fissure sealants. 60 extracted intact and caries-free permanent mandibular third molars. The teeth were randomly divided into three groups (n = 20) according to the material used for pit and fissure sealant. Group I: Unfilled resin-based pits and fissure sealant, Group II: Unfilled resin-based pits and fissure sealant with bond and Group III: Nano flowable composite resin with bond. The results showed that nano-flowable composite was significantly better than the conventional sealants groups p = 0.000. As well there was better as well, there were gaps between sealants and the tooth surfaces in groups I and II, but for group III, there was close contact between the nano-flowable composite and tooth surfaces. It was concluded that nano-flowable composite showed better microleakage and interfacial morphology results than conventional pits and fissure sealant and offered promising results at the fissure sealing.

Keywords: pits and fissures, Sealant, nanocomposite, dental caries

Procedia PDF Downloads 124

Authors: Emmanuel Kamal Aziz Saba, Hussein Al-Moghazy Sultan

Abstract:

The aim of this study was to evaluate clinically and electro physiologically the autonomic nervous system changes associated with rheumatoid arthritis (RA). The present study included 25 patients with RA [22 women (88%)] and 30 apparently healthy control subjects [27 women (90%)]. A thorough clinical examination was carried out. Disease activity and functional disability were assessed. Tests for assessment of autonomic functions include active and passive orthostatic stress tests, and sympathetic skin response (SSR). The presence of abnormality in 2 tests or more was a clue for the presence of autonomic neuropathy (AN). Sural sensory nerve conduction study and posterior tibial motor nerve conduction study were done. There was a statistically significant decrease in standing systolic and diastolic blood pressure (BP) components of the active orthostatic stress test and SSR amplitude as well as statistically significant prolongation of SSR latency of RA patients when compared to control. Three patients (12%) had clinical symptoms suggestive of AN; increased to 14 patients (56 %) when orthostatic stress tests and SSR were utilized. There were no statistically significant differences between patients with different disease activity score 28 with 4 variables grades of RA activity and SSR latency and amplitude. There were no statistically significant differences between patients with different Stanford Health Assessment Questionnaire Disability Index grades of RA functional disability and SSR latency and amplitude. In conclusion, autonomic neuropathy is a common extra-articular manifestation of RA affecting sympathetic and parasympathetic fibers.

Keywords: autonomic neuropathy, orthostatic stress test, rheumatoid arthritis, sympathetic skin response

Procedia PDF Downloads 352

Authors: Sheng-Che Chen, Keng-Ren Lin, Che-Hsin Lin, Hao-Yuan Tseng, Chih-Han Chang

Abstract:

Teeth play an important role in providing the essential nutrients. The force loading of chewing on the crow is important condition to evaluate long-term success of many dental treatments. However, the quantification of the force regarding forces are distributed over the dental crow is still not well recognized. This study presents an industrial-grade piezoelectric-based multilayer ceramic capacitors (MLCCs) force sensor for measuring the distribution of the force distribute over the first molar. The developed sensor array is based on a flexible polyimide electrode and barium titanate-based MLCCs. MLCCs are commonly used in the electronic industry and it is a typical electric component composed of BaTiO₃, which is used as a capacitive material. The most important is that it also can be used as a force-sensing component by its piezoelectric property. In this study, to increase the sensitivity as well as to reduce the variation of different MLCCs, a treatment process is utilized. The MLCC force sensors are able to measure large forces (above 500 N), making them suitable for measuring the bite forces on the tooth crown. Moreover, the sensors also show good force response and good repeatability.

Keywords: force sensor array, multilayer ceramic capacitors, occlusal force, piezoelectric

Procedia PDF Downloads 409