Patient adherence during removable functional appliance therapy
Schafer K, Ludwig B, Meyer-Gutknecht H, Schott TC. Quantifying patient adherence during active orthodontic treatment with removable appliances using microelectronic wear-time documentation. Eur J Orthod 2015;37:73-80
Removable appliances are a common treatment modality used in both active and retentive phases of orthodontic treatment. It is well known that patient adherence is imperative for optimal therapeutic success. Until recently, it has been almost impossible for orthodontists to objectively evaluate how consistently patients were adhering to their prescribed wear times. The aim of this study was to quantify the adherence of active removable appliances during the first 3 months of treatment. This was a multicenter, prospective cohort study that evaluated how wear time was influenced by age, sex, device type, location of treatment, and health insurance status. One hundred forty-one patients were divided into 3 age groups: 7-9, 10-12, and 13-15 years. Each patient was treated either in one of 3 private practices in Germany or at the University Hospital of Tubingen, Germany. A temperature-sensitive microsensor, TheraMon Sensor, was placed in a standard activator, a Class III activator, or a maxillary expander, and the stored data were transferred at routine visits. The overall median wear time was 9.7 hours per day compared with the prescribed wear time of 15 hours per day; only 7.8% of the patients reached the prescribed 15 hours. Statistically significant differences were seen based on sex, age, location, and health insurance. Wear time decreased as age increased, with the youngest patients wearing their appliances for a median of 12.1 hours per day, and the oldest wearing them for 8.5 hours a day. Girls wore their devices longer in each age group by 1.3 hours. Wear times were significantly higher in patients with private health insurance during the first 3 months and in each month separately. There was no significant difference between device types.
Reviewed by Nicolas Freda
The sella turcica in subjects with Down syndrome
Korayem M, AlKofide E. Size and shape of the sella turcica in subjects with Down syndrome. Orthod Craniofac Res 2015;18:43-50
Down syndrome (DS) is a congenital anomaly caused by a third copy of chromosome 21. DS is associated with, but not limited to, growth delay, varying degrees of mental retardation, and thyroid disorders, which are mainly regulated by the pituitary gland. The development of the pituitary gland is coordinated with the sella turcica. The objective of this study was to study the size and shape of the sella turcica in persons with DS and compare them with matched controls without the syndrome. Sixty patients affected with DS of both sexes with an age range of 12 to 22 years were matched with 60 subjects without DS. Dental examinations and cephalometric radiographs were obtained and compared between the groups. All cephalometric radiographs were digitized and traced by 1 examiner using Dolphin software. The linear dimensions of the sella turcica were measured and compared in both groups. The results showed that sella turcica diameter and depth were significantly greater in the subjects with DS than in the controls. Likewise, a “normal” shape of sella turcica was significantly less frequent in the DS group. Also, the anterior wall was most likely to be oblique, in addition to the simultaneous presence of more than one other “abnormal” shape in the same patient. The size, shape, and morphology of sella turcica differ in subjects with DS when compared with the controls. Larger diameter and depth of the sella turcica were more commonly found in the DS group. Although the etiology of such variations still needs to be elucidated, this research will familiarize clinicians with the morphologic difference of the sella turcica in patients with DS.
Reviewed by Mohammed Al Jearah