Dan Boboia 4/2/10 Lit. Review
Title: Upper airway obstruction during midazolam/nitrous oxide sedation in children with enlarged tonsils
Author: Litman et al
Main Purpose: To examine the incidence and severity of upper airway obstruction in children with enlarged tonsils during the inhalation of 50% N2O after premed. with oral versed.
Methods:
25 children presenting for tonsillectomy were used as the study population and 25 children presenting for other types of elective surgery were used as control. Following premed with Versed (0.5mg/kg) measurements were collected during a 3-minute control period followed by 3 min. of breathing 50% N2O with 50% O2. An anesthesiologist held a mask over the child’s mouth and nose without supporting the head and neck or attempting to maintain airway patency. Every 20 seconds the airway patency was graded as none, partial, or complete based on clinical signs and capnography. Clinical signs included chest rise, stridor, and feeling movement of the ventilation bag.
Results:
During 50% N2O inhalation 14 children in the tonsillectomy group and four in the control group demonstrated upper airway obstruction (UAO). One child in the tonsillectomy group developed hypoxemia (SpO2 = 72%). One child in the tonsil group developed complete UAO (50%).
Conclusion:
Children who receive sedation with oral Versed and 50% N2O may exhibit significant UAO, especially in the presence of enlarged tonsils. Presedation physical exams should evaluate the presence of tonsil size during examination of the mouth and airway.
Showing posts with label dan boboia. Show all posts
Showing posts with label dan boboia. Show all posts
Monday, March 29, 2010
Monday, February 22, 2010
Oral Manifestations of Pediatric Human Immunodeficiency Virus Infection: A Review of the Literature
Dan Boboia 2/26/10 Lit. Review
Title: Oral Manifestations of Pediatric Human Immunodeficiency Virus Infection: A Review of the Literature
Author: Kline et al
Type of Article: Review
Purpose: To describe the varied oral manifestations of pediatric HIV infections
Erythematous Candidiasis: inconspicous erythematous changes of the palate and dorsum of the tonugue; buccal mucosa involved occasionally; vesicles seen in severe cases; more common among children with low CD4 lymphocyte counts or symptomatic HIV disease than among those with normal counts or no symptoms.
Hairy Luekoplakia: white or gray lesions along the lateral margins of the tongue; lesions appear hairy when affected mucosa is dried; not specific for HIV infection but common for profound immunosuppresion; related to presence of EBV within the oral mucosal epithelium.
Oral Kaposi’s Sarcoma: blue, purple, or red flat or raised patches / nodules, often involving the palate.
Periodontal Disease: several forms of perio are associated with HIV infection; linear gingival erythema has fiery red band along the margin of the gingival; necritizing ulcerative gingivitis show destruction of one or more of the interdental papillae.
Oral Ulcers: lesions often are severely debilitating because they interfere with chewing, speaking, and swallowing.
Cytomeglovirus: another herpes group virus, cam produce large palatal or pharyngeal ulcers resembling major aphthous ulcers as well as changes resemble HIV-associated periodontal disease
Non-Hodgkins lymphoma: is the other form of malignancy diagnosed commonly in adults with AIDS
Title: Oral Manifestations of Pediatric Human Immunodeficiency Virus Infection: A Review of the Literature
Author: Kline et al
Type of Article: Review
Purpose: To describe the varied oral manifestations of pediatric HIV infections
Erythematous Candidiasis: inconspicous erythematous changes of the palate and dorsum of the tonugue; buccal mucosa involved occasionally; vesicles seen in severe cases; more common among children with low CD4 lymphocyte counts or symptomatic HIV disease than among those with normal counts or no symptoms.
Hairy Luekoplakia: white or gray lesions along the lateral margins of the tongue; lesions appear hairy when affected mucosa is dried; not specific for HIV infection but common for profound immunosuppresion; related to presence of EBV within the oral mucosal epithelium.
Oral Kaposi’s Sarcoma: blue, purple, or red flat or raised patches / nodules, often involving the palate.
Periodontal Disease: several forms of perio are associated with HIV infection; linear gingival erythema has fiery red band along the margin of the gingival; necritizing ulcerative gingivitis show destruction of one or more of the interdental papillae.
Oral Ulcers: lesions often are severely debilitating because they interfere with chewing, speaking, and swallowing.
Cytomeglovirus: another herpes group virus, cam produce large palatal or pharyngeal ulcers resembling major aphthous ulcers as well as changes resemble HIV-associated periodontal disease
Non-Hodgkins lymphoma: is the other form of malignancy diagnosed commonly in adults with AIDS
Tuesday, February 2, 2010
Hereditary Dentin Defects
Dan Boboia 2/5/10 Lit. Review
Title: Hereditary Dentin Defects
Author: Kim et al
Type of Article: Review
Main Purpose:
To discuss the development of the dentin extracellular matrix in the context of it’s evolution, and discuss the phenotypes and clinical classifications of isolated hereditary defects of tooth dentin in the context of recent genetic data respecting their genetic etiologies.
Summary:
Inherited defects are divided into 5 types: 3 types of DGI (DGY types 1, 2, and 3), and 2 types of dentinal dysplasia (DD-1 and DD-2). DGI type 1 is OI with DGI. This is caused by mutations in the two genes encoding type I collagen. DD-II, DGI-II, DGI-III all have their own pattern of inherited defects limited to the dentition. DD-I has an etiology which is still a mystery. It features short, blunt roots with obliterated pulp chambers and abnormal crowns (color, shape, and form). A major surprise in the characterization of genes underlying inherited dentin defects is the lack of roles played by genes encoding less-abundant non-collagenous proteins in dentin, such as DMP1, IBSP, MEPE, SPP1, and OPN.
Evaluation:
A very dense article which requires multiple readings in order to “digest” all of the genetic material presented. Can anyone say Braz Macedo.
Title: Hereditary Dentin Defects
Author: Kim et al
Type of Article: Review
Main Purpose:
To discuss the development of the dentin extracellular matrix in the context of it’s evolution, and discuss the phenotypes and clinical classifications of isolated hereditary defects of tooth dentin in the context of recent genetic data respecting their genetic etiologies.
Summary:
Inherited defects are divided into 5 types: 3 types of DGI (DGY types 1, 2, and 3), and 2 types of dentinal dysplasia (DD-1 and DD-2). DGI type 1 is OI with DGI. This is caused by mutations in the two genes encoding type I collagen. DD-II, DGI-II, DGI-III all have their own pattern of inherited defects limited to the dentition. DD-I has an etiology which is still a mystery. It features short, blunt roots with obliterated pulp chambers and abnormal crowns (color, shape, and form). A major surprise in the characterization of genes underlying inherited dentin defects is the lack of roles played by genes encoding less-abundant non-collagenous proteins in dentin, such as DMP1, IBSP, MEPE, SPP1, and OPN.
Evaluation:
A very dense article which requires multiple readings in order to “digest” all of the genetic material presented. Can anyone say Braz Macedo.
Tuesday, November 10, 2009
A Modified Method of Mouthguard Fabrication for Orthodontic Patients
LUTHERAN MEDICAL CENTER
Dental Residency Program
Literature Review Form
Resident: Boboia Date: 11/9/09
Article title: A Modified Method of Mouthguard Fabrication for Orthodontic Patients
Author(s): Maeda et al.
Journal: Dental Traumatology
Volume #; Number; Page #s): 24, 475-442
Year: 2008
Purpose: Describe a method for custom-made MG fabrication using sheet and tube materials
Orthodontic appliances are a major risk factor for traumatic injuries during sport events. Taking precise impressions is difficult resulting in poorly fitting mouthguards.
Summary Fabrication Procedure:
1) Take alginate impressions and pour
2) Apply a catheter tube material to the surface of the brackets by making a cut and fixing it with cyano-acrylate adhesive
3) Use a 3mm thick sheet and vacuum former and to make mouth guard
4) Make necessary adjustments after trimming and polishing
Discussion:
In fabricating mouthguard one must minimize bulk, maximize retention, leave space available for tooth movement, achieve retention to the anchor tooth positions.
Assesment: Good article for those people who have never made a athletic mouthguard. The only item worth noting is the use of a tube as a block out material for orthodontic brackets and arch wire.
Dental Residency Program
Literature Review Form
Resident: Boboia Date: 11/9/09
Article title: A Modified Method of Mouthguard Fabrication for Orthodontic Patients
Author(s): Maeda et al.
Journal: Dental Traumatology
Volume #; Number; Page #s): 24, 475-442
Year: 2008
Purpose: Describe a method for custom-made MG fabrication using sheet and tube materials
Orthodontic appliances are a major risk factor for traumatic injuries during sport events. Taking precise impressions is difficult resulting in poorly fitting mouthguards.
Summary Fabrication Procedure:
1) Take alginate impressions and pour
2) Apply a catheter tube material to the surface of the brackets by making a cut and fixing it with cyano-acrylate adhesive
3) Use a 3mm thick sheet and vacuum former and to make mouth guard
4) Make necessary adjustments after trimming and polishing
Discussion:
In fabricating mouthguard one must minimize bulk, maximize retention, leave space available for tooth movement, achieve retention to the anchor tooth positions.
Assesment: Good article for those people who have never made a athletic mouthguard. The only item worth noting is the use of a tube as a block out material for orthodontic brackets and arch wire.
Wednesday, October 7, 2009
A longitudinal study of dental arch width at the deciduous second molars on children 4 to 8 years of age
Dan Boboia
Article Review 10/9/09
Title: A longitudinal study of dental arch width at the deciduous second molars on children 4 to 8 years of age.
Author: Howard Meredith and Wayne Hopp
The Journal of Dental Research: December 1956, Vol. 35, #6
Major Topic:
1) To present findings on the reliability of records for maximum rectilinear distance between the buccal surfaces of the deciduous second molars at three different ages.
2) Statistically describe interbuccal width at deciduous second molars on 12 age-arch-sex subgroups of North American white children.
3) To analyze longitudinal data pertaining to growth in dental arch width between 4 and 8 years of age.
4) To investigate a number of dental arch relationships
Methods:
40 boys and 37 girls enrolled in a long-term research program at the University of Iowa Dept. of Orthodontics. There were 4 criteria for acceptance: age (<4), race (white), geographic location (vicinity to Iowa City), and availability for longitudinal study (willingness to participate and likelihood of continuing residence in the region).
Additional Criteria:
1) Max. and mnd. Casts were required to be on file at 4, 6, 8 years of age
2) 4 erupted deciduous second molars present at each age
3) 4 erupted deciduous first molars present at each age
4) All buccal surfaces of the deciduous second molars free of restorative dental work
5) A developmental record showing no orthodontic treatment
Dental stone casts made from alginate impressions were obtained within 2 weeks of pts. 4, 6, and 8 birthday; Maximum rectilinear distance determined by measuring between the buccal surfaces of the right and left deciduous molars with calipers
Summary of Findings:
1) Maximum transverse diameter of dental arches at the deciduous second molars can be determined with high dependability
2) Interbuccal width at the deciduous second molars differs with arch, sex, and age. Maxillary arch is 3.1 mm wider then mandibular arch, the male arches are 1.9 mm wider then female arches, and the dental arches at age 4 are 1.7 mm narrower then at age 8 years.
3) The maxillary arch is slightly more variable then the mandibular arch
4) Changes in arch width differ widely from child to child between the ages of 4 to 8 years some arches remain close to the same while others increase as much as 3.5 mm
5) The two dental arches are positively related with regard to both size at a given age and, and change in size with advanced age.
6) There is a moderately high relationship between width of a given arch at 4 years and width of the same arch at 8 years, but there is no relationship between width of a given arch at 4 years and change in the width between 4 and 8 years.
7) Correlations between dental arch widths and widths of the face are positive but fairly low.
Article Review 10/9/09
Title: A longitudinal study of dental arch width at the deciduous second molars on children 4 to 8 years of age.
Author: Howard Meredith and Wayne Hopp
The Journal of Dental Research: December 1956, Vol. 35, #6
Major Topic:
1) To present findings on the reliability of records for maximum rectilinear distance between the buccal surfaces of the deciduous second molars at three different ages.
2) Statistically describe interbuccal width at deciduous second molars on 12 age-arch-sex subgroups of North American white children.
3) To analyze longitudinal data pertaining to growth in dental arch width between 4 and 8 years of age.
4) To investigate a number of dental arch relationships
Methods:
40 boys and 37 girls enrolled in a long-term research program at the University of Iowa Dept. of Orthodontics. There were 4 criteria for acceptance: age (<4), race (white), geographic location (vicinity to Iowa City), and availability for longitudinal study (willingness to participate and likelihood of continuing residence in the region).
Additional Criteria:
1) Max. and mnd. Casts were required to be on file at 4, 6, 8 years of age
2) 4 erupted deciduous second molars present at each age
3) 4 erupted deciduous first molars present at each age
4) All buccal surfaces of the deciduous second molars free of restorative dental work
5) A developmental record showing no orthodontic treatment
Dental stone casts made from alginate impressions were obtained within 2 weeks of pts. 4, 6, and 8 birthday; Maximum rectilinear distance determined by measuring between the buccal surfaces of the right and left deciduous molars with calipers
Summary of Findings:
1) Maximum transverse diameter of dental arches at the deciduous second molars can be determined with high dependability
2) Interbuccal width at the deciduous second molars differs with arch, sex, and age. Maxillary arch is 3.1 mm wider then mandibular arch, the male arches are 1.9 mm wider then female arches, and the dental arches at age 4 are 1.7 mm narrower then at age 8 years.
3) The maxillary arch is slightly more variable then the mandibular arch
4) Changes in arch width differ widely from child to child between the ages of 4 to 8 years some arches remain close to the same while others increase as much as 3.5 mm
5) The two dental arches are positively related with regard to both size at a given age and, and change in size with advanced age.
6) There is a moderately high relationship between width of a given arch at 4 years and width of the same arch at 8 years, but there is no relationship between width of a given arch at 4 years and change in the width between 4 and 8 years.
7) Correlations between dental arch widths and widths of the face are positive but fairly low.
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