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Vassis S, Sabljic S, Noeldeke B, Sefidroodi M, Küseler A, Klit Pedersen T, Stoustrup P. Effects of orthopedic treatment (distraction splint) on dentofacial deformities in patients with juvenile idiopathic arthritis. Eur J Orthod 2024; 46:cjae005. [PMID: 38376495 DOI: 10.1093/ejo/cjae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
BACKGROUND Juvenile idiopathic arthritis (JIA) frequently affects the temporomandibular joint (TMJ), which can alter mandibular growth and development and result in dentofacial deformities. OBJECTIVE To assess the outcomes of orthopedic treatment with distraction splint (DS) in patients with JIA-related dentofacial deformity. METHODS The retrospective study involved 30 patients with JIA and unilateral TMJ involvement, another study group of 20 patients with JIA and bilateral TMJ involvement, and a control group of 18 non-JIA orthodontic patients with Class II and III malocclusions. The inclusion criteria were DS treatment and cone-beam computed tomography (CBCT) scans before (T0) and 2 years after treatment (T1). Dentofacial morphology and deformity were evaluated based on a validated three-dimensional CBCT-based morphometric analysis. Intergroup differences in outcome measures were compared at T0 and T1, and intragroup changes between T0 and T1 were assessed using the Kruskal-Wallis test. RESULTS Initial evaluations at T0 revealed significant differences between the unilateral and bilateral JIA groups and the control group for three out of eight dentofacial deformity variables: inter-side difference in total posterior mandibular height, mandibular axial angle, and posterior/anterior face height (ratio). At follow-up (T1), significant inter-group differences were only observed in total posterior mandibular height indicating that intergroup differences were less pronounced after splint treatment. Assessing inter-group changes between T0 and T1 showed that all parameters remained constant except posterior/anterior face height ratio, which significantly decreased between T0 and T1. CONCLUSIONS The findings demonstrate the potential of DS treatment for patients with JIA and unilateral or bilateral TMJ involvement to generally support normal dentofacial growth or at least limit further deterioration of dentofacial deformities.
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Affiliation(s)
- Stratos Vassis
- Section of Orthodontics, Aarhus University, Vennelyst Blvd 9, 8000 Aarhus, Denmark
| | - Sanja Sabljic
- Section of Orthodontics, Aarhus University, Vennelyst Blvd 9, 8000 Aarhus, Denmark
| | - Beatrice Noeldeke
- Department of Economics, Leibniz University Hannover, Am Königsworther Platz 1, 30167 Hannover, Germany
| | | | - Annelise Küseler
- Section of Orthodontics, Aarhus University, Vennelyst Blvd 9, 8000 Aarhus, Denmark
| | - Thomas Klit Pedersen
- Section of Orthodontics, Aarhus University, Vennelyst Blvd 9, 8000 Aarhus, Denmark
| | - Peter Stoustrup
- Section of Orthodontics, Aarhus University, Vennelyst Blvd 9, 8000 Aarhus, Denmark
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Vassis S, Resnick CM, Nørgaard M, Strawn KM, Grove H, Noeldeke B, Herlin T, Pedersen TK, Stoustrup PB. Impact of physiotherapy on orofacial manifestations of juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2023; 21:116. [PMID: 37828517 PMCID: PMC10571390 DOI: 10.1186/s12969-023-00900-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/27/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Physiotherapy appears as a promising therapy option for patients with Juvenile Idiopathic Arthritis (JIA) [1, 2], but the effects of physiotherapy and jaw exercises on JIA-related orofacial symptoms remain unknown [3]. The aim of this proof-of-concept study was to assess the impact of orofacial physiotherapy and home-exercise programs in patients with JIA and temporomandibular joint (TMJ) involvement. METHODS Twelve patients with JIA and TMJ involvement received a treatment of physiotherapy, complemented by prescribed home exercises spanning over eight weeks. Orofacial symptoms and dysfunction were monitored pre-treatment, during treatment, after treatment, and at a three-months follow-up. RESULTS Orofacial pain frequency and intensity significantly decreased during the course of the treatment (p = 0.009 and p = 0.006), with further reductions observed at the three-month follow-up (p = 0.007 and p = 0.002). During treatment, the mandibular function improved significantly in terms of maximal mouth opening capacity, laterotrusion, and protrusion. CONCLUSIONS This proof-of-concept study shows favourable effects of physiotherapy and home excercises in the management of JIA-related orofacial symptoms and dysfunctions.
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Affiliation(s)
- Stratos Vassis
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Blvd. 9, Aarhus C, DK-8000, Denmark.
| | - Cory M Resnick
- Department of Oral and Maxillofacial Surgery, Harvard Medical School, 188 Longwood Avenue, Boston, MA, 02115, United States of America
| | - Mette Nørgaard
- Department of Physiotherapy, Aarhus University Hospital, Skejby, Denmark, Palle Juul- Jensens Boulevard 103, Aarhus N, 8200, Denmark
| | - Kathleen M Strawn
- Department of Physical and Occupational Therapy, Boston Children's Hospital, 300 Longwood Ave., Boston, MA, 02115, United States of America
| | - Helle Grove
- Mårslet Fysioterapi & Traeningscenter, Hørretvej 16 C, Mårslet, 8320, Denmark
| | - Beatrice Noeldeke
- Leibniz University Hannover, Welfengarten 1, 30167, Hannover, Germany
| | - Troels Herlin
- Department of Clinical Medicine, Department of Paediatrics, Aarhus University, Palle Juul- Jensens Boulevard 103, Aarhus N, 8200, Denmark
| | - Thomas Klit Pedersen
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Blvd. 9, Aarhus C, DK-8000, Denmark
| | - Peter Bangsgaard Stoustrup
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Blvd. 9, Aarhus C, DK-8000, Denmark
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Vassis S, Bauss O, Noeldeke B, Sefidroodi M, Stoustrup P. A novel method for assessment of human midpalatal sutures using CBCT-based geometric morphometrics and complexity scores. Clin Oral Investig 2023; 27:4361-4368. [PMID: 37178173 PMCID: PMC10415503 DOI: 10.1007/s00784-023-05055-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/30/2023] [Indexed: 05/15/2023]
Abstract
INTRODUCTION Management of dentofacial deficiencies requires knowledge about sutural morphology and complexity. The present study assesses midpalatal sutural morphology based on human cone-beam computed tomography (CBCT) using geometric morphometrics (GMM) and complexity scores. The study is the first to apply a sutural complexity score to human CBCT datasets and demonstrates the potential such a score has to improve objectiveness and comparability when analysing the midpalatal suture. MATERIALS AND METHODS CBCTs of various age and sex groups were analysed retrospectively (n = 48). For the geometric morphometric analysis, landmark acquisition and generalised Procrustes superimposition were combined with principal component analysis to detect variability in sutural shape patterns. For complexity analysis, a windowed short-time Fourier transform with a power spectrum density (PSD) calculation was applied to resampled superimposed semi-landmarks. RESULTS According to the GMM, younger patients exhibited comparable sutural patterns. With increasing age, the shape variation increased among the samples. The principal components did not sufficiently capture complexity patterns, so an additional methodology was applied to assess characteristics such as sutural interdigitation. According to the complexity analysis, the average PSD complexity score was 1.465 (standard deviation = 0.010). Suture complexity increased with patient age (p < 0.0001), but was not influenced by sex (p = 0.588). The intra-class correlation coefficient exceeded 0.9, indicating intra-rater reliability. CONCLUSION Our study demonstrated that GMM applied to human CBCTs can reveal shape variations and allow the comparison of sutural morphologies across samples. We demonstrate that complexity scores can be applied to study human sutures captured in CBCTs and complement GMM for a comprehensive sutural analysis.
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Affiliation(s)
- Stratos Vassis
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Blvd. 9, 8000, Aarhus, Denmark.
| | - Oskar Bauss
- Orthodontic Practice, Luisenstrasse 10/11, 30159, Hannover, Germany
| | | | - Mohammedreza Sefidroodi
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Blvd. 9, 8000, Aarhus, Denmark
| | - Peter Stoustrup
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Blvd. 9, 8000, Aarhus, Denmark
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Nassif S, Wichmann J, Strube D, Vassis S, Christiansen H, Steinmann D. Cisplatin Versus Carboplatin and Paclitaxel in Radiochemotherapy for Patients With Locally Advanced Head and Neck Squamous Cell Carcinoma. In Vivo 2022; 36:821-832. [PMID: 35241538 DOI: 10.21873/invivo.12769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The implementation of a platinum-containing regimen is recommended for definitive and adjuvant therapy of patients with locally advanced head and neck tumour. We compared the conditions for the use of cisplatin or carboplatin/paclitaxel or for changing between these two regimens on a clinic-specific basis. PATIENTS AND METHODS We evaluated 150 patients with advanced head and neck squamous cell carcinoma who received simultaneous radiochemotherapy at our institution between 2012 and 2017. Chemotherapy with weekly doses of cisplatin (40 mg/m2, group 1) or, in cases of impaired renal and/or cardiac function, with weekly doses of carboplatin AUC2 and paclitaxel (45 mg/m2, group 2), was performed as a first-choice therapy. If toxicities occurred in group 1, treatment was switched to the carboplatin/paclitaxel regimen (group 3). Patient- and therapy-related parameters, toxicity and survival data were compared across groups. RESULTS We examined 99, 30, and 21 patients in each group who received at least 1 course of chemotherapy. Group 3 patients switched from cisplatin to carboplatin/paclitaxel after a median of 3 courses due to nephrotoxicity (95.2%). The target of at least 5 chemotherapy courses was most frequently achieved by patients in group 1 (69.7%), followed by group 3 (61.9%) and then group 2 (40.0%). Multivariate analysis revealed that patients who switched groups were more likely to be over 60 years old (p=0.021), undergo definitive radiochemotherapy (p=0.049) and develop higher nephrotoxicity (p=0.036) than group 1 patients. Outcomes did not differ between groups. CONCLUSION When cisplatin application is contraindicated due to renal- or cardiotoxicity, carboplatin/paclitaxel is an appropriate option.
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Affiliation(s)
- Sandy Nassif
- Clinic for Radiotherapy and Special Oncology of the Hannover Medical School, Hannover, Germany;
| | - Jorn Wichmann
- Clinic for Radiotherapy and Special Oncology of the Hannover Medical School, Hannover, Germany
| | - Dominic Strube
- University of Applied Sciences, Technology, Business and Design Wismar, Wismar, Germany
| | - Stratos Vassis
- Clinic for Radiotherapy and Special Oncology of the Hannover Medical School, Hannover, Germany
| | - Hans Christiansen
- Clinic for Radiotherapy and Special Oncology of the Hannover Medical School, Hannover, Germany
| | - Diana Steinmann
- Clinic for Radiotherapy and Special Oncology of the Hannover Medical School, Hannover, Germany
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Bauss O, Vassis S. Unilateral palatally impacted canines: Evaluation of pulpal condition after surgical exposure and orthodontic alignment. Advances in Oral and Maxillofacial Surgery 2022. [DOI: 10.1016/j.adoms.2021.100214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Vassis S, Nöldeke B, Christiansen H, von Klot CA, Merten R. Moderately HRT vs. CRT for localized prostate cancer using image-guided VMAT with SIB: evaluation of acute and late toxicities. Strahlenther Onkol 2020; 196:598-607. [PMID: 32040691 PMCID: PMC7305256 DOI: 10.1007/s00066-020-01589-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 01/23/2020] [Indexed: 12/31/2022]
Abstract
Purpose This retrospective study aims at investigating the effects of moderately hypofractionated radiation therapy (HRT) on acute and late toxicities as well as on early biochemical control and therapeutic efficiency compared to conventional radiation therapy (CRT) in prostate cancer. Patients and methods We analyzed 55 HRT patients irradiated with the total dose of 60 Gy in 20 fractions delivered over 4 weeks. These patients were compared to a control group of 55 patients who received CRT with a total of <78 Gy in 37–39 fractions delivered over circa 8 weeks. External beam radiation therapy (EBRT) was conducted using daily image-guided (cone beam CT) volumetric modulated arc therapy (VMAT) and a simultaneously integrated boost (SIB) for both groups to protect the rectum. Acute toxicities were evaluated according to Common Terminology Criteria for Adverse Events (CTCAE) v5, whereas chronic toxicities were assessed in accordance with LENT-SOMA. Patient traits were compared by implementing t‑tests and Wilcoxon–Whitney tests for continuous variables, whereas discrete characteristics were evaluated by applying two-tailed Fisher’s exact tests. In addition, we calculated average treatment effects (ATE). Thereby, propensity score matching (PSM) based on nearest-neighbor matching considering age, comorbidities, and risk stratification as covariates was applied. The statistical analysis was conducted using Stata 14.2 (StataCorp LLC, TX, USA). Results As confirmed by the descriptive tests, the ATE revealed that the intensity and occurrence of urinary frequency (p = 0.034) and proctitis (p = 0.027) significantly decreased for the HRT group, whereas all other acute toxicities did not differ significantly between the HRT and CRT groups. For late toxicities, neither statistical tests nor ATE estimation showed significant differences. Also, no significant difference was found regarding the decrease in prostate specific antigen (PSA) after a median follow-up of 13 months (range 2–28 months), which indicates biochemical freedom from progression. Conclusion HRT offers several medical and economic advantages and should therefore be considered as a useful alternative to CRT.
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Affiliation(s)
- Stratos Vassis
- Department of Radiation Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hanover, Germany.
| | - Beatrice Nöldeke
- Institute for Environmental Economics and World Trade, Leibniz University, Königsworther Platz 1, 30167, Hanover, Germany
| | - Hans Christiansen
- Department of Radiation Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hanover, Germany
| | - Christoph A von Klot
- Department of Urology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hanover, Germany
| | - Roland Merten
- Department of Radiation Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hanover, Germany
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Vassis S, Karigiannis G, Balayiannis G, Militsopoulou M, Mamos P, Francis GW, Papaioannou D. Simple syntheses of N-alkylated spermidine fragments and analogues of the spermine alkaloid kukoamine A. Tetrahedron Lett 2001. [DOI: 10.1016/s0040-4039(00)02308-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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