Treatment of iron deficiency anemia induces weight loss and improves metabolic parameters

BACKGROUND

The treatment of iron deficiency anemia is oral iron replacement which has side effects mostly related with gastrointestinal system. A significant rate of the patients that discontinuing the treatment complained of weight gain during treatment in our clinical practise, despite, oral iron preparations are not known to have such a side effect in adults. Therefore, we planned to investigate this myth whether iron preparations cause an increase in weight, waist circumference, body mass index and laboratory metabolic parameters that may accompany to weight gain.

MATERIALS AND METHODS

Twenty-one women admitted to our out-patient clinics with iron deficiency anemia were enrolled to the study. Waist circumference, body weight, body mass index, systolic and diastolic blood pressures, hemogram and other laboratory parameters assessed and recorded at the first visit and repeated 4 to 6 moths after initiation of treatment.

RESULTS

Waist circumference, body weight and BMI significantly reduced in patients after treatment compared to pre-treatment period. Moreover, HDL was increased and triglyceride was decreased significantly in after treatment compared to pre-treatment period.

CONCLUSIONS

We suggest that treatment of iron deficiency may improve not only haematological but also metabolic and anthropometric parameters. Due to the small study population of our cohort, larger prospective studies are needed to confirm our results.

Condylar response to functional therapy with Twin-Block as shown by cone-beam computed tomography

OBJECTIVE

To evaluate the condylar changes through cone-beam computed tomography (CBCT) images in patients treated with Twin-Block functional appliance.

MATERIALS AND METHODS

In this retrospective study, CBCT images of 30 patients who were treated with the Twin-Block appliance were used. Mandible was segmented and pretreatment and posttreatment (T0 and T1) condylar volume was compared. The angle between sella-nasion-Point A (SNA), angle between sella-nasion-Point B (SNB), angle between Point A-nasion-Point B (ANB), midfacial length (Co-A), mandibular length (Co-Gn), and the distances from right condylion to left condylion (CoR-CoL) were also measured on three-dimensional images. Differences were analyzed with Wilcoxon signed rank tests, and Mann-Whitney U-tests were used to compare the scores of male and female participants. Significance was set at P < .05.

RESULTS

In this study, a decrease in SNA and ANB (P < .05 and P < .01, respectively) and an increase in SNB (P < .01) were found. Additionally, CoR-CoL, Co-Gn, and condylar volume increased at both the left and right sides (P < .01). However, increase at Co-A was not statistically significant (P > .05). Comparison of differences by sex was not statistically significant for all measurements (P > .05).

CONCLUSION

Twin-Block appliance increases condylar volume, mandibular length, and intercondylar distance by stimulating growth of condyle in an upward and backward direction.

Evaluation of hyoid bone movements in subjects with open bite: a study with real-time balanced turbo field echo cine-magnetic resonance imaging

Objective

To assess the position and movements of the hyoid bone during deglutition in patients with open bite.

Methods

Thirty-six subjects were divided into 2 groups according to the presence of anterior open bite. The open bite group (OBG) and control group each comprised 18 patients with a mean overbite of -4.9 ± 1.9 mm and 1.9 ± 0.7 mm. The position of the hyoid bone during the 4 stages of deglutition was evaluated by measuring vertical and horizontal movement of the bone.

Results

Interactions of group and stage showed no significant effect on the measurements (p > 0.05). However, when group and stage were evaluated individually, they showed significant effects on the measurements (p < 0.001). In OBG, the hyoid bone was more inferiorly and posteriorly positioned, and this position continued during the deglutition stages.

Conclusions

The hyoid bone reaches the maximum anterior position at the oral stage and maximum superior position at the pharyngeal stage during deglutition. Open bite does not change the displacement pattern of the bone during deglutition. The hyoid bone is positioned more inferiorly and posteriorly in patients with open bite because of released tension on the suprahyoid muscles.

Relationship between Class III malocclusion and hyoid bone displacement during swallowing: a cine-magnetic resonance imaging study

Objective

The displacement of the hyoid bone (HB) is a critical biomechanical component of the swallowing function. The aim of this study was to evaluate the swallowing-induced vertical and horizontal displacements of the HB in subjects with 2 different magnitudes of skeletal Class III malocclusion, by means of real-time, balanced turbo-field-echo (B-TFE) cine-magnetic resonance imaging.

Methods

The study population comprised 19 patients with mild skeletal Class III malocclusion, 16 with severe skeletal Class III malocclusion, and 20 with a skeletal Class I relationship. Before the commencement of the study, all subjects underwent cephalometric analysis to identify the nature of skeletal malformations. B-TFE images were obtained for the 4 consecutive stages of deglutition as each patient swallowed 10 mL of water, and the vertical and horizontal displacements of the HB were measured at each stage.

Results

At all stages of swallowing, the vertical position of the HB in the severe Class III malocclusion group was significantly lower than those in the mild Class III and Class I malocclusion groups. Similarly, the horizontal displacement of the HB was found to be significantly associated with the severity of malocclusion, i.e., the degree of Class III malocclusion, while the amount of anterior displacement of the HB decreased with an increase in the severity of the Class III deformity.

Conclusions

Our findings indicate the existence of a relationship between the magnitude of Class III malocclusion and HB displacement during swallowing.

Evaluation of anxiety level changes during the first three months of orthodontic treatment

Objective

To determine the changes in dental anxiety, state anxiety, and trait anxiety levels of patients and their parents after 3 months of active orthodontic treatment.

Methods

We evaluated 120 patients and one parent of each patient. State Anxiety (STAI-S), Trait Anxiety (STAI-T), and Corah's Dental Anxiety Scale (DAS) were administered before orthodontic treatment (T1) and after 3 months of treatment (T2). Differences in scores between T1 and T2 were compared using paired-sample t-tests and the relationship between the scores of the DAS and the STAI were analyzed using a bivariate two-tailed Pearson correlation test.

Results

Dental anxiety and state anxiety levels decreased among the patients after adjustment to orthodontic treatment (p < 0.001). However, 3 months of treatment was not sufficient to decrease the anxiety levels of parents (p > 0.05). Patient trait anxiety affected patient state anxiety and dental anxiety (p < 0.01). Additionally, a significant correlation was found between patient dental anxiety and parent dental anxiety (p < 0.05).

Conclusions

Dental anxiety and state anxiety levels decrease after patients become familiar with their orthodontist and they became accustomed to orthodontic treatment. However, 3 months is not a sufficient length of time to decrease parental anxiety levels.

Orthodontic treatment of transposition of permanent mandibular lateral incisor and left canine in mixed dentition: a case report

The purpose of this study was to present the orthodontic treatment of a unilateral transposition of a permanent mandibular left canine and permanent mandibular lateral incisor during middle transitional dentition in a 10-year-old female. A panoramic radiograph showed the apex of the permanent mandibular left lateral incisor to be resting on the mesial corner of the permanent mandibular left canine crown, which was ectopically erupted in the proximity of the primary mandibular left second molar. A removable appliance was used to upright the permanent mandibular left lateral incisor, after which a utility arch was used until full eruption of the permanent dentition. Treatment continued with a fixed appliance system that included all teeth until the transposition of the canine and lateral incisor was corrected and a class I occlusion with a favorable smile was obtained (at 36 months).

Effects of Hyperbaric Oxygen during Experimental Tooth Movement

Objective: To determine the effects of hyperbaric oxygen (HBO) on bone remodeling during orthodontic tooth movement.

Materials and Methods: Twenty-four male, adult Sprague Dawley rats were randomly divided into two groups. HBO was administered in the first group, and the second group served as a control. The mandibular first molars were moved mesially by means of Ni-Ti closed coil springs in all groups.

Results: Results were evaluated histomorphometrically and the parameters of trabecular bone volume (BV/TV), trabecular bone number (Tr.N), and trabecular separation (Tr.Sep) were evaluated at the interradicular bone area of the mandibular first molars. Increases in BV/TV and Tr.N and decreases in Tr.Sep revealed the osteoblastic activity of HBO. HBO application caused an increase in bone apposition and osteoblastic activity or a decrease in osteoclastic activity.

Conclusions: HBO enhanced the bone formation during experimental tooth movement. Therefore, the findings of this study support our hypothesis that osteoblastic activity might be modulated by changes in the environmental oxygen tension.

Effects of laser irradiation on the release of basic fibroblast growth factor (bFGF), insulin like growth factor-1 (IGF-1), and receptor of IGF-1 (IGFBP3) from gingival fibroblasts

Various studies have shown biostimulation effects of laser irradiation by producing metabolic changes within the cells. Little is known about the biological effect of laser irradiation on the oral tissues. Among the many physiological effects, it is important to recognize that low-level laser therapy (LLLT) may affect release of growth factors from fibroblasts. Therefore, the aim of the present study was to determine whether the laser irradiation can enhance the release of basic fibroblast growth factor (bFGF), insulin-like growth factor-1 (IGF-1), and receptor of IGF-1 (IGFBP3) from human gingival fibroblasts (HGF). The number of all samples in the study were 30, and the samples were randomly divided into three equal groups; In the first group (single dose group), HGF were irradiated with laser energy of 685 nm, for 140 s, 2 J/cm(2) for one time, and in the second group, energy at the same dose was applied for two consecutive days (double dose group). The third group served as nonirradiated control group. Proliferation, viability, and bFGF, IGF-1, IGFBP3 analysis of control and irradiated cultures were compared with each other. Both of the irradiated groups revealed higher proliferation and viability in comparison to the control group. Comparison of the single-dose group with the control group revealed statistically significant increases in bFGF (p < 0.01) and IGF-1 (p < 0.01), but IGFBP3 increased insignificantly (p > 0.05). When the double dose group was compared with the control group, significant increases were determined in all of the parameters (p < 0.01). In the comparison of the differences between the two irradiated groups (one dose and two doses), none of the parameters displayed any statistically significant difference (p > 0.05). In both of the laser groups, LLLT increased the cell proliferation and cell viability. The results of this study showed that LLLT increased the proliferation of HGF cells and release of bFGF, IGF-1, and IGFBP3 from these cells. LLLT may play an important role in periodontal wound healing and regeneration by enhancing the production of the growth factors.

Clinical and intraoral findings of a patient with tricho-rhino-phalangeal syndrome type I

Tricho-rhino-phalangeal syndrome (TRPS) is a rare and an autosomal dominant disorder having the following characteristics: slowly growing sparse hair, medially thick and laterally thin eyebrows, bulbous tip of the nose, long flat philtrum and thin upper lip with vermilion border, protruding ears, cone-shaped epiphyses and swelling. Our report intends to introduce TRPS to the dental literature and to present oral, clinical and radiological data of a patient with TRPS. A rare association of supernumerary teeth was also diagnosed and one of them was extracted as it impeded on the eruption path of left premolar tooth.

Treatment of space loss caused by submerged maxillary second primary molar

Submersion is a clinical term describing a tooth depressed below the occlusal plane. In this case report, we present the treatment of a patient who had totally submerged primary maxillary second molar, which caused impaction of the second premolar and space loss in the maxillary arch due to tipping of adjacent teeth. A 12-year-old girl was referred to the pediatric dentistry clinic. The intra-oral examination revealed that right maxillary second primary molar was localized buccal side of posterior maxillary alveolar process, being almost completely covered by gingiva and adjacent teeth inclined closing the space of the related teeth completely. Periapical radiograph demonstrated that maxillary second premolar was impacted. Based on clinical and radiographic findings, maxillary primary second molar was extracted. Headgear was used for the distalization of maxillary right first molar in order to create space for the impacted second premolar. Eruption begun spontaneously 6 months later.

A unique treatment of finger-sucking habit in children with mental retardation: report of 2 cases

Finger-sucking habit, or nonnutritive sucking, usually ceases spontaneously in childhood. If the habit is not broken, however, not only will dental occlusion be affected, but the shape of the finger may be altered as well. When the habit is broken, the threatening disturbances of digital growth and dental occlusion will resolve spontaneously. This article describes a unique type of habit-breaking appliance applied on the sucked fingers of 2 children with mental retardation. The advantages of this type of extraoral appliance are discussed.

Distraction osteogenesis in a severe mandibular deficiency

OBJECTIVE

Distraction osteogenesis is an alternative treatment method for the correction of mandibular hypoplasia. In this case report, distraction with a multidirectional extraoral device was performed to gradually lengthen the corpus and ramus of a patient who had a severe hypoplastic mandible.

MATERIALS AND METHODS

The patient underwent bilateral extraoral ramus and corpus distraction osteogenesis. After seven days of latency period, distraction was performed 0.5 mm twice a day. Subsequent consolidation period was 12 weeks.

RESULTS

The patient's mandible was elongated successfully. Cephalometric analysis revealed that ANB angle decreased from 13 degrees to 6 degrees , overjet of 15 mm decreased to 4 mm, corpus length increased from 49 mm to 67 mm, and ramus length increased from 41 mm to 43 mm. Posterior airway space (PAS) also increased due to advancement of the mandible. In stereolithographic model evaluation it was determined that the distances from condylion to gonion and from gonion to pogonion increased.

CONCLUSION

Satisfactory results from both aesthetic and functional standpoints were obtained by distraction osteogenesis of the ramus and corpus.

Tumor Necrosis Factor–α Levels during Two Different Canine Distalization Techniques

Objectives: To compare levels of tumor necrosis factor (TNF)-α while applying continuous and heavy interrupted forces.

Materials and Methods: A hybrid retractor was used in the first group. In the second group, rapid canine distalization through periodontal distraction was performed. Gingival crevicular fluid samples were collected from the distal sides of the canine teeth before attaching the appliances and at 1 hour, 24 hours, and 1 week after the force was applied.

Results: In the hybrid reactor group, concentration of TNF-α decreased at 1 week according to 24-hour measurements. In the rapid canine distalization group, it severely increased at 1 hour. In the evaluation of between-group differences, significantly higher values were determined in the rapid canine distalization group at 1 hour and 1 week.

Conclusions: Heavy interrupted force induces a rapid release of TNF-α, and the tissue response continues for a longer time period. To avoid the harmful effects of heavy interrupted force, there might be feedback mechanisms that prevent the mediators from increasing excessively.

Dynamic MRI Evaluation of Tongue Posture and Deglutitive Movements in a Surgically Corrected Open Bite

Tongue thrust usually develops in the presence of anterior open bite in order to achieve anterior valve function. In the literature, tongue thrust is described both as the result and the cause of open bite. If it is an adaptation to malocclusion, then tongue posture and deglutitive tongue movements should change after treatment. In this case report, an adult who had skeletal open bite and Class II malocclusion caused by mandibular retrusion was treated surgically. The mandible was advanced in a forward and upward direction with a sagittal split osteotomy. The open bite and Class II malocclusion were corrected and an increase in the posterior airway space (PAS) was observed. Pretreatment and posttreatment dynamic magnetic resonance imaging (MRI) revealed that tongue tip was retruded behind the incisors and contact of the tongue with the palate increased. It was also determined that the anterior and middle portions descended, whereas the posterior portion was elevated at all stages. Advancement of the mandible, correction of open bite, and an increase in PAS affected not only the tongue posture and deglutitive movements, but also the breathing pattern of the patient.

Forsus Nitinol Flat Spring and Jasper Jumper corrections of Class II division 1 malocclusions

OBJECTIVE

To compare the effects of Forsus Nitinol Flat Spring (FNFS) and Jasper Jumper (JJ) in the correction of Class II division I malocclusions.

MATERIALS AND METHODS

Our research was conducted on 48 adolescents, who had a normal or horizontal growth pattern and retrognathic mandible. The patients were divided into three equal groups randomly. First group was treated with FNFS, and the second group was treated with JJ appliances, whereas the third group was the control group. Lateral cephalograms and study models were obtained after the leveling phase and at time of the removal of the appliances.

RESULTS

Cephalometric analysis revealed that both the appliances stimulated mandibular growth, increased the anterior face height because of the lower face, and elongated the posterior face height because of the growth of temporomandibular joint. Maxillary central incisors were extruded, retruded, and distally tipped. Contrarily, intrusion, protrusion, and labial tipping were observed in the mandibular central incisors. Distal movement and intrusion of the maxillary first molars and mesial movement and extrusion of the mandibular first molars were the other dental alterations. Overjet and overbite were decreased, and a Class I molar relationship and improvement in the profile were attained in both treatment groups. Cast model analysis showed expansion in the maxillary and mandibular dental arches.

CONCLUSIONS

Both the appliances were effective in the treatment of Class II malocclusion and revealed nearly same alterations in the skeletal, dental, and soft tissue parameters.

Management of a fused central incisor in association with a macrodont lateral incisor: a case report

Fusion is developmental anomaly of the dental hard tissue and is defined as the joining of 2 developing tooth germs resulting in a single large tooth structure. Different treatment methods can be used according to the requirements of the situation. The purpose of this case report was to present the multidisciplinary treatment of a patient who had a permanent maxillary left central tooth fused with a supernumerary incisor and a macrodont permanent maxillary right lateral incisor. In the radiographic evaluation, it was determined that the fused tooth had 2 separate roots. The supernumerary tooth was extracted after hemisection, and endodontic treatment was performed on the remaining portion. The distal side of the macrodont lateral incisor was recontoured, and the right central incisor was reshaped with a strip crown to provide aesthetic appearance and to gain space for the alignment of teeth. Following the restoration of the incisors, orthodontic treatment was provided.

Use of zygomatic anchors during rapid canine distalization: a preliminary case report

Rapid canine distalization is a technique involving periodontal ligament distraction. The primary aim of this technique is to distalize the canines without anchorage loss and to shorten the duration of orthodontic treatment. After the rapid canine distalization, the healing process of the periodontal ligament is similar to rapid palatal expansion and requires a consolidation period. The long consolidation period of the technique conflicts with the second aim. Skeletal anchorage systems seem to compensate for this conflict because they can be also used for retraction of incisors during consolidation period. This case report presents the orthodontic treatment of a 16-year-old female, who had a bimaxillary retrusion and a dental Class II division I malocclusion. Upper first premolars were extracted and, while the canines were being distalized rapidly by periodontal ligament distraction, the incisors were retracted using a zygomatic anchorage system. The treatment of the patient was completed in five months without any anchorage loss.

Mandibular distraction with MD-DOS device

Distraction osteogenesis is an alternative treatment method for the correction of mandibular hypoplasia. In this case report, mandibular distraction with a dynamic osteosynthesis system (MD-DOS) was performed to gradually lengthen the mandible of a patient who had a severe hypoplastic mandible. The patient underwent intraoral bilateral mandibular distraction osteogenesis. The latency period after the operation was seven days. The distraction was performed three times daily for 14 days at the rate of 0.33 mm each time. Subsequent retention was nine weeks. The patient's mandible was elongated successfully and a satisfactory profile and occlusion was achieved.

Dentofacial effects of asymmetric headgear and cervical headgear with removable plate on unilateral molar distalization

Cervical headgear (CHG) is used widely in the treatment of Class II anomalies. Asymmetric headgear (AHG) is an alternative treatment for the correction of unilateral Class II dental relationships. The purpose of this investigation was to compare the effects of AHG with those of a CHG combined with a removable plate in unilateral first molar distalization. The study consisted of 20 patients with unilateral Class II molar relationship (12 girls and eight boys). One group of 10 patients was treated with an AHG, and a second group of 10 patients was treated with a CHG and a removable plate. Lateral cephalograms and basilar radiographs were taken before and after molar distalization. It was found that distalization and distal tipping of molar on the passive side was less in the CHG and removable plate (CHG-RP) group. Distalization and distal tipping of the second premolar on the distalization side was also reduced in this group. Incisors were retruded in both groups but were retruded more in the CHG-RP group.

Initial intrusion of the molars in the treatment of anterior open bite malocclusions in growing patients

The treatment of the hyperdivergent phenotype and/or anterior openbite is one of the common problems facing orthodontists. The purpose of this study is to present a new appliance (Molar Intruder) for molar intrusion and to determine its effects in the treatment of anterior openbite. The study group comprised 14 patients (eight girls and six boys), with a mean age of 10 years and 7 months. All presented anterior open bite malocclusions between the second premolars. The study was carried out on lateral head films taken before (T1) and after (T2) molar intrusion. Periapical radiographs, study models, and standard photographs of all the patients were also obtained before and after molar intrusion. The paired sample t-test was used to determine the differences between the parameters. The average treatment time with the Molar Intruder was five months. The mean intrusion of maxillary and mandibular molars was 1.86 mm and 1.04 mm, respectively. Maxillary incisors extruded 0.54 mm with a labial tipping of 1.46 degrees and overbite increased by 4.00 mm. The mandibular plane angle was decreased by 1.57 degrees, and the anterior face height was decreased by 1.86 mm on average. The mandible showed a counterclockwise rotation, the chin moved forward, and the posterior facial height/anterior facial height ratio was increased. Anterior openbites of the patients were significantly rehabilitated at the end of the intrusion period, simplifying further orthodontic treatment.

Efficacy of treatment to relieve mucositis-induced discomfort

To determine the efficacy of a mouthwash in relieving mucositis-induced discomfort in patients receiving chemotherapy, 31 (16 male, 15 female) with a mean age of 45 (range 16-80) were given an in-house three-drug (lidocaine, diphenhydramine and sodium bicarbonate in normal saline) mouthwash when they developed mucositis of any severity. The complications were assessed on the CALGB (Cancer and Leukemia Group B) scale. The response to the mouthwash was reported on a self-assessment scale. Patients' response data were analyzed with reference to: (1) relief throughout the duration of mucositis and (2) relief during the worst stage (for each episode) of mucositis. Five patients with fungal, viral or bacterial oral infection were excluded from study. Overall, 4 patients had grade I, 16 patients had grade II, 10 patients had grade III and 1 patient had grade IV mucositis. The average duration of mucositis was 7.9 days (range 3-23 days), and the mean duration of the worst stage of mucositis was 4.81 days (range 2-13 days). The mean mucositis severity score was 1.9 (range 1-4), and the average self-assessment (response) score was 0.81 (range 0-2). The mean mucositis score during the worst stage of mucositis was 2.25 (range 1-4), and the average self-assessment (response) score during the worst stage of mucositis was 0.91 (range 0-2.7). These results suggests that this three-drug mouthwash provides effective symptomatic relief in patients with chemotherapy-induced mucositis.