Reliability and comparison of two facial measurements to detect changes of occlusal vertical dimension in complete denture wearers

Gerodontology 2010; doi: 10.1111/j.1741‐2358.2009.00353.x
Reliability and comparison of two facial measurements to detect changes of occlusal vertical dimension in complete denture wearers Background: Facial measurements are frequently used to determine OVD. However, the reliability of neither the method nor the chosen landmarks has been cleared yet. Objective: This study compares the reliability of two facial measurements, subnasal (SN) to chin (C) and tip of the nose (TN) to C, for determining occlusal vertical dimension (OVD). Materials and methods: Thirty edentulous subjects with adequate neuromuscular co‐ordination, without signs and symptoms of temporomandibular disorders and who had been wearing complete dentures for at least 5 years were enrolled. A modified central bearing device was used to alter the OVD and facial measurements were made with a digital caliper. Student’s t‐test was used to compare the two measurements. Interobserver and intraobserver reliability were evaluated with Spearman’s rho correlation test. Results: TN–C distance had an improved correlation with the changes in intraoral alterations than SN–C distance. While the means of the changes in facial measurements were in good agreement with the intraoral alterations, the ranges were wide. Both interobserver and intraobserver reliability of the measurements were high. Conclusion: While facial measurement is not a good predictor of OVD, TN–C distance appears to be more reliable than SN–C distance.     

Care of maxillofacial injuries: survey of plastic surgeons.

The purpose of this survey was to evaluate the current trends in the care of facial trauma. Data were obtained through the responses of a survey mailed to all those members and candidates listed in the 1989 American Society of Plastic and Reconstructive Surgeons Directory. A total of 2777 questionnaires were sent, with 1113 (40 percent) returned by means of a self-addressed envelope. Demographic results show that over 70 percent of the treating plastic surgeons fall within the age range 30 to 50 years. Although significant advances have occurred, treatment goals have remained unchanged. These center around the principles of accurate reduction and precise stabilization of fracture segments. The results of this survey reveal that a number of acceptable techniques were employed in the surgical repair of mandibular and zygomatic complex fractures. In the care of Le Fort III fractures, 59 percent of the respondents preferred the use of miniplates and screws for stabilization. Only 26.8 percent believed that facial fracture repair should be performed within the initial 24 hours. With frontal sinus fractures, the vast majority of plastic surgeons (82.1 percent) obtained a neurosurgical consultation. When the posterior wall was involved, 45.6 percent favored removal of the sinus mucosa, 29.7 percent obliterated the frontal sinus with a variety of autogenous materials, while 20.5 percent preferred cranialization. In summary, this survey shows a wide variation in the practice of facial fracture management within the plastic surgical community.     

Dynamics of the gamma-responses in an 8-second interval between facial and trigger stimuli as dependent the success of task performance

A cognitive set to facial expression was used as a model with the loading on working memory being increased by increasing the interval between the facial and triggering stimuli to 8 seconds. The aim was to determine whether the intensity of brain potentials evoked in a range of 41–60 Hz (the range 15–60 Hz was used) by facial stimuli is associated with the “success” of task performance (mistake rate). An index of average amplitudes of EEG oscillations was used to measure the response to facial stimuli, and γ responses proved to be associated with the number of mistakes in performing the task. The results make it possible to consider the γ responses to facial stimuli as an EEG correlate of the internal states that correspond to adequate actions of the subject in the test with a 8-s interval between the facial and trigger stimuli.     

Histological studies of the dorsal nasal,Angularis Oculi,and facial veins of sheep (Ovis aries)

Selective brain cooling (SBC) requires vasoactivity in the superficial veins of the face of the animal. This vasoactivity is possible because of an adequate amount of smooth muscle in the tunica media of each of these superficial vessels, enabling it to act as a “muscle sphincter.” In this study, the angularis oculi, dorsal nasal, distal, and proximal parts of the facial veins in sheep were examined histologically to describe an anatomical basis for SBC. Measurements of the tunica media thickness, the lumen diameter, and the ratio of these measurements showed that the relative tunica media thicknesses in the angularis oculi vein and the dorsal nasal vein are statistically smaller (P < 0.001) than in the distal or the proximal parts of the facial vein. In the angularis oculi, dorsal nasal, and distal part of the facial vein, the tunicae mediae were composed of five to seven circularly arranged smooth muscle layers, suggesting their ability to vasoconstrict. The proximal part of the facial vein possesses both circularly and longitudinally arranged smooth muscle layers. The circular smooth muscle layers suggest a vasoconstrictory function, whereas the longitudinal smooth muscle layers imply a vasodilatory function in this part of the facial vein. Both the dorsal nasal and the proximal part of the facial vein, but not the angularis oculi or the distal part of the facial vein, possess endothelial valves near their confluences with other veins. It was concluded from this study that the angularis oculi and the distal part of the facial vein vasoconstrict, whereas the proximal part of the facial vein vasodilates, enabling the necessary changes in blood flow in SBC. J. Morphol. 237:275–281, 1998. © 1998 Wiley-Liss, Inc.     

Excision of the submandibular gland by an intraoral approach

To improve the outcome in patients with benign diseases of the submandibular gland, we have developed an entirely intraoral technique for excision of the submandibular gland. This procedure is anatomically safe and can be performed with minimal morbidity. We believe the essential surgical steps are as follows: (1) infiltration with Xylocaine plus epinephrine with an adequate waiting period for hemostasis; (2) careful identification of the submandibular duct/lingual nerve relationship; (3) anterior retraction of the mylohyoid muscle to expose the superficial lobe; (4) superiorly directed, extraoral, manipulation of the submandibular gland; and (5) close and blunt dissection to the gland laterally to avoid injury to the facial artery and vein.     

Potentialities of magnetic resonance imaging in the complex of prenatal radiation diagnosis of fetal malformations

The purpose of the study was to investigate the potentialities of magnetic resonance imaging (MRI) in the complex of prenatal radiation diagnosis of fetal malformations. Twenty-eight female patients with suspected fetal malformations were examined. Ultrasound study was supplemented by MRI according to a specially developed protocol. Various fetal CNS malformations were diagnosed. These included the Arnold-Chiari syndrome, the Dandy-Walker syndrome, occlusive hydrocephaly, lobular holoprosencephaly, porencephaly, diaphragmatic hernias, anomalies of the abdomen and retroperitoneal space, as well as anomalies of facial structures, including median clefts, and dacryocystocele. The use of MRI in the complex prenatal radiation diagnosis makes it possible to visualize fetal malformation more clearly, contributes to the more adequate prediction of the outcome of pregnancy and to the choice of a management policy for a female patient.     

Organization of cortical processing for facial movements during licking in cats

We proposed that cortical organization for the execution of adequate licking in cats was processed under the control of two kinds of affiliated groups for face and jaw & tongue movements (Hiraba H, Sato T. 2005A. Cerebral control of face, jaw, and tongue movements in awake cats: Changes in regional cerebral blood flow during lateral feeding Somatosens Mot Res 22:307–317). We assumed the cortical organization for face movements from changes in MRN (mastication-related neuron) activities recorded at area M (motor cortex) and orofacial behaviors after the lesion in the facial SI (facial region in the primary somatosensory cortex). Although we showed the relationship between facial SI (area 3b) and area M (area 4δ), the property of area C (area 3a) was not fully described. The aim of this present study is to investigate the functional role of area C (the anterior part of the coronal sulcus) that transfers somatosensory information in facial SI to area M, as shown in a previous paper (Hiraba H. 2004. The function of sensory information from the first somatosensory cortex for facial movements during ingestion in cats Somatosens Mot Res 21:87--97). We examined the properties of MRNs in area C and changes in orofacial behaviors after the area C or area M lesion. MRNs in area C had in common RFs in the lingual, perioral, and mandibular parts, and activity patterns of MRNs showed both post- and pre-movement types. Furthermore, cats with the area C lesion showed similar disorders to cats with the area M lesion, such as the dropping of food from the contralateral mouth, prolongation of the period of ingestion and mastication, and so on. From these results, we believe firmly the organization of unilateral cortical processing in facial SI, area C, and area M for face movements during licking.     

Free proximal gracilis muscle and its skin paddle compound flap transplantation for complex facial paralysis

Gracilis functioning free-muscle transplantation for the correction of pure facial paralysis has been a preferred method used by many reconstructive microsurgeons. However, for complex facial paralysis, the deficits include facial paralysis along with soft-tissue, mucosa, and/or skin defects. No adequate solution has been proposed. Treatment requests in those patients are not only for facial reanimation but also for correction of the defects. Of 161 patients with facial paralysis treated with gracilis functioning free-muscle transplantation from 1986 to 2002, eight patients (5 percent) presented with complex deficits requiring not only facial reanimation but also aesthetic correction of tissue defects. The tissue defects included an intraoral defect created following contracture release (one patient), infra-auricular radiation dermatitis with contour depression (one patient), temporal depression following a temporalis muscle-fascia transfer (one patient), ear deformity (two patients), and infra-auricular atrophic tissue with contour depression (three patients). A compound flap, consisting of a gracilis muscle with its overlying skin paddle separated into two components, was transferred for simultaneous correction of both problems. The blood supply to the gracilis and to the skin paddle originated from the same source vessel and therefore required the anastomosis of only one set of vessels. The versatility of this compound flap allows for a wide arc of rotation of the skin paddle around the muscle. All flaps were transferred successfully without complications. Satisfactory results of facial reanimation were recorded in five patients after all stages were completed. The remaining three patients are undergoing physical therapy and waiting for revision of the skin paddle.     

A novel method for prediction of dynamic smiling expressions after orthodontic treatment: a case report

Smile esthetics has become increasingly important for orthodontic patients, thus prediction of post-treatment smile is necessary for a perfect treatment plan. In this study, with a combination of three-dimensional craniofacial data from the cone beam computed tomography and color-encoded structured light system, a novel method for smile prediction was proposed based on facial expression transfer, in which dynamic facial expression was interpreted as a matrix of facial depth changes. Data extracted from the pre-treatment smile expression record were applied to the post-treatment static model to realize expression transfer. Therefore smile esthetics of the patient after treatment could be evaluated in pre-treatment planning procedure. The positive and negative mean values of error for prediction accuracy were 0.9 and ? 1.1 mm respectively, with the standard deviation of ± 1.5 mm, which is clinically acceptable. Further studies would be conducted to reduce the prediction error from both the static and dynamic sides as well as to explore automatically combined prediction from the two sides.     

Preferences for wildlife management methods among the peri-urban public in Scotland

Wildlife management remains a matter of considerable controversy amongst many stakeholders, particularly where lethal control (culling) is used. Wild deer provide perhaps one of the best examples of such a management ‘problem’, especially where they are encountered in peri-urban environments. Faced with potential controversy, decision-makers in public land management organisations need information which clearly differentiates between generally acceptable management objectives and methods, and less mainstream preferences. We conducted a questionnaire survey aimed at assessing the preferences of community members in peri-urban Scotland for management methods in response to specific problems and analysed the results in relation to three social categories—age, gender and familiarity with wildlife. Active management was broadly accepted. Fencing dominated as the preferred first management response with little variation across social category, or between management problems. Changing human behaviour (e.g. introducing speed limits) was also a highly preferred response by the respondents in this study. In general, the order of preferred management responses stayed the same in relation to different management impacts. Culling (lethal control) had almost no support as a first management response to any problem, although considerably more respondents support it as a third preference. Our results suggest that culling is acceptable as a subsidiary management response in peri-urban areas, but only where other preferred management methods have been tried and failed.     

Benorylate in Management of Still's Disease

The present recommended dose of benorylate is not satisfactory for the management of children suffering from inflammatory polyarthritis. A starting dose of 200 mg/kg/day should be used, and the salicylate level checked at seven days and the dosage adjusted to give an anti-inflammatory effect—that is, a blood salicylate level of between 25 and 30 mg/100 ml. Once a satisfactory level has been achieved, this dosage should be maintained with occasional monitoring of the salicylate level. The paracetamol level does not need to be estimated as it tends to follow the salicylate level, provided that liver function is normal; thus it is quite safe to monitor only the salicylate level. Given in an adequate dosage, benorylate seems to be an acceptable salicylate preparation for use in juveniles suffering from chronic polyarthritis.     

Additional considerations for gray wolf management after their removal from Endangered Species Act protections

Mech (2010) provided a review of options involving regulated, public hunting of gray wolves (Canis lupus) when states regain control of wolf management. We agree with his general conclusion that the use of lethal management should focus more in areas of conflict and less in wilderness areas, especially near protected places like national parks. Here, we expand on Mech's work and provide additional considerations that could be incorporated into state management plans to make them more acceptable to an increasingly diverse group of interested stakeholders, including: 1) the use of human dimensions research to understand the conditions under which stakeholders find lethal management acceptable, and to evaluate the acceptability of agency efforts to increase tolerance for wolves; 2) employing preventative measures to protect livestock and pets, especially in cases where wolf packs are highly visible to the public; and 3) selective use of sport hunting in areas where wolf impacts are deemed unacceptable. © 2011 The Wildlife Society.     

Organization of cortical processing for facial movements during licking in cats

We proposed that cortical organization for the execution of adequate licking in cats was processed under the control of two kinds of affiliated groups for face and jaw & tongue movements (Hiraba H, Sato T. 2005A. Cerebral control of face, jaw, and tongue movements in awake cats: Changes in regional cerebral blood flow during lateral feeding Somatosens Mot Res 22:307-317). We assumed the cortical organization for face movements from changes in MRN (mastication-related neuron) activities recorded at area M (motor cortex) and orofacial behaviors after the lesion in the facial SI (facial region in the primary somatosensory cortex). Although we showed the relationship between facial SI (area 3b) and area M (area 4delta), the property of area C (area 3a) was not fully described. The aim of this present study is to investigate the functional role of area C (the anterior part of the coronal sulcus) that transfers somatosensory information in facial SI to area M, as shown in a previous paper (Hiraba H. 2004. The function of sensory information from the first somatosensory cortex for facial movements during ingestion in cats Somatosens Mot Res 21:87-97). We examined the properties of MRNs in area C and changes in orofacial behaviors after the area C or area M lesion. MRNs in area C had in common RFs in the lingual, perioral, and mandibular parts, and activity patterns of MRNs showed both post- and pre-movement types. Furthermore, cats with the area C lesion showed similar disorders to cats with the area M lesion, such as the dropping of food from the contralateral mouth, prolongation of the period of ingestion and mastication, and so on. From these results, we believe firmly the organization of unilateral cortical processing in facial SI, area C, and area M for face movements during licking.     

Technical Critique of the Multimedia,Multipathway, Multireceptor Risk Assessment Model

The U.S. Environmental Protection Agency (USEPA) is developing the Multimedia, Multipathway, Multireceptor Risk Assessment (3MRA) model to evaluate potential human and ecological risks associated with the disposal of solid wastes designated as hazardous wastes in nonhazardous waste management units. USEPA intends to use the 3MRA model to determine national exit levels that will allow solid wastes that theoretically pose acceptable human and ecological risks to be safely managed in Subtitle D nonhazardous waste management units. We critically evaluated the 3MRA model to determine whether the methodology, interim modules, and input parameters are appropriate and scientifically defensible. Overall, our review of the 3MRA model indicates that it contains many conservative assumptions that may limit the validity of the model results and its use as a national model adequate for making regulatory decisions. Many of the assumptions and data inputs used to model the pathways involved in the transport of chemicals from a waste management unit are flawed. Other specific concerns include the lack of model validation, incompatibility of data between modules, and overestimation of potential human and ecological exposures. Before using the 3MRA model, we recommend that USEPA consider whether the 3MRA model is either an appropriate or accurate tool for evaluating the disposal of hazardous wastes nationwide.     

Is hunting large carnivores different from hunting ungulates? Some judgments made by Norwegian hunters

The increase in large carnivore populations in a number of European countries causes numerous social conflicts and populations need to be kept at levels that are acceptable to the public. This may eventually require opening up or increasing public hunting of species like bear, wolf, wolverines and lynx as a management strategy. We surveyed a sample of 672 Norwegian hunters to examine how they judged a set of dilemmas associated with hunting carnivores versus ungulates. More than one-half of the sample would like to maintain or increase the current population sizes of the large carnivores (for wolverines: 57.5%; bears: 65.6%; wolves: 66.1%; lynx: 59.6%). A large majority of hunters (85.5%) emphasise not stressing the game over securing success in killing game, require adequate shooting skills (87.7%), linking harvest strategies to ecological principles (79.5%) rather than the level of conflict, and sustainable wildlife populations (95.1%) over optimum economic yield. Carnivore hunting is associated with a stronger preference for quotas based on science rather than local knowledge as well as paying more attention to the conflict level, compared to the judgments made for ungulate hunting. Positive attitudes toward maintaining or increasing carnivore populations are associated with a concern for animal welfare, and faith in scientific information, ecological values and sustainable wildlife populations.     

Facial nerve palsy in the newborn: incidence and outcome

This study retrospectively identifies and characterizes patients with facial palsy related to birth trauma and describes the natural history of this disorder. The records of infants born with facial weakness or paralysis over a 5-year period at Brigham and Women's Hospital were reviewed, and criteria were defined to assign a diagnosis of acquired facial palsy based on birth history and documented physical examinations. The majority of patients were followed up by interview with a family member. Among 44,292 infants born between October 1, 1982 and July 31, 1987, there were 92 recorded cases of congenital seventh nerve palsy. Of these, 81 were acquired, for an incidence of 1.8 per 1000. Seventy-four of the 81 (91 percent) were associated with forceps delivery. By contrast, obstetric forceps were used in 19 percent of all deliveries during the period of the study. The average weight of subjects was 3.55 kg, versus a mean overall birth weight of 3.23 kg. Fifty-nine percent of mothers of affected children and 37 percent of controls were prima gravidas. Forceps delivery, birth weight of 3500 gm or more, and primiparity were all significant risk factors for acquired facial palsy. The incidence of additional birth injuries also was substantially higher among affected subjects than among the general population of newborns. Sixty-six of 81 patients had adequate follow-up. Recovery has been complete for 59 patients (89 percent) and incomplete for the remaining 7 (mean follow-up 34 months). In summary, congenital traumatic facial palsy has definable risk factors and a predictably favorable outcome.     

Improved STD Syndrome Management by a Network of Clinicians and Pharmacy Workers in Peru: The PREVEN Network

Background

Sexually Transmitted diseases (STD) syndrome management has been one cornerstone of STD treatment. Persons with STD symptoms in many countries, especially those with limited resources, often initially seek care in pharmacies. The objective of the study was to develop and evaluate an integrated network of physicians, midwives and pharmacy workers trained in STD syndromic management (The PREVEN Network) as part of a national urban community-randomized trial of sexually transmitted infection prevention in Peru.

Methods and Findings

After a comprehensive census of physicians, midwives, and pharmacies in ten intervention and ten control cities, we introduced seminars and workshops for pharmacy workers, and continuing education for physicians and midwives in intervention cities and invited graduates to join the PREVEN Network. “Prevention Salespersons” visited pharmacies, boticas and clinicians regularly for educational support and collection of information on numbers of cases of STD syndromes seen at pharmacies and by clinicians in intervention cities. Simulated patients evaluated outcomes of training of pharmacy workers with respect to adequate STD syndrome management, recommendations for condom use and for treatment of partners. In intervention cities we trained, certified, and incorporated into the PREVEN Network the workers at 623 (80.6%) of 773 pharmacies and 701 (69.6%) of 1007 physicians and midwives in private practice. Extremely high clinician and pharmacy worker turnover, 13.4% and 44% respectively in the first year, dictated continued training of new pharmacy workers and clinicians. By the end of the intervention the Network included 792 pharmacies and 597 clinicians. Pharmacies reported more cases of STDs than did clinicians. Evaluations by simulated patients showed significant and substantial improvements in the management of STD syndromes at pharmacies in intervention cities but not in control cities.

Conclusions

Training pharmacy workers linked to a referral network of clinicians proved feasible and acceptable. High turn-over was challenging but over come.     

Social compatibility in a newly formed all‐male group of white crowned mangabeys (Cercocebus atys lunulatus)

Surplus males in primate captive populations are a common problem for zoos. Some captive breeding programs promote all‐male groups as an adequate option to house surplus males, but there have been few attempts to assess the feasibility of this management technique across primate species. The present study provides preliminary data regarding social compatibility within a newly formed all‐male group of four white crowned mangabeys (Cercocebus atys lunulatus). The study was conducted at the Valencia Zoo (Spain), where data on social behavior were collected over 6 months using continuous focal animal sampling for a total of 87 hr of observation. Results show that low intensity aggressive behaviors (facial threats) were expressed at high rates, whereas physical aggression (fights) rarely occurred. Aggression was more frequent among individuals belonging to the same age–gender class. Regarding affiliative behaviors, every individual actively sought proximity to all other group members through positive approaches, and although not all males carried out social grooming, every male was groomed by at least one group member. Our results suggest that the group was compatible socially because social relationships among the individuals were not neutral, and physical aggression occurred at low rates. The present study provides preliminary data supporting the feasibility of all‐male groups as a management option for surplus males in captive populations of white crowned mangabeys. Nevertheless, further studies are needed to be able to generalize both within and across species. Zoo Biol 0:1–7, 2007. © 2006 Wiley‐Liss, Inc.     

Recovery of fish and crustacean communities during remediation of tidal wetlands affected by leachate from acid sulfate soils in north-eastern Australia

In the 1970s, acid sulfate soils (ASS) distributed within about 720 ha of predominantly mangrove and salt pan wetlands at East Trinity in north Queensland were developed after the area was isolated from tidal flooding by a surrounding seawall and the installation of tidal gates on major drainage creeks. Following drainage and oxidation of these estuarine acidic sediments, resultant acid leachate caused considerable, ongoing environmental problems including regular fish kills. A rehabilitation program covering much of these former tidal wetlands commenced in 2000 using a lime-assisted tidal exchange management regime. Changes in the established populations of estuarine fish and crustaceans were monitored in the two creeks (Firewood and Hills Creeks) where tidal flows were reinstated. In Firewood Creek between 2001 and 2005, there was a progressive increase in fish species richness, diversity and abundance. The penaeid prawn Fenneropenaeus merguiensis was a major component of the cast net catches in the lower sections of both Firewood and Hills Creeks but its relative abundance decreased upstream of the tidal gates on the seawall. Well established stocks of predominantly juvenile, male Scylla serrata resident upstream of the tidal gates indicated suitable habitats with acceptable water and sediment quality and adequate availability of food. The regular fish kills that occurred prior to the management regime abated and, overall, the implementation of the rehabilitation program is yielding positive benefits for the local fisheries.     

Multiracial Facial Golden Ratio and Evaluation of Facial Appearance

This study aimed to investigate the association of facial proportion and its relation to the golden ratio with the evaluation of facial appearance among Malaysian population. This was a cross-sectional study with 286 randomly selected from Universiti Sains Malaysia (USM) Health Campus students (150 females and 136 males; 100 Malaysian Chinese, 100 Malaysian Malay and 86 Malaysian Indian), with the mean age of 21.54 ± 1.56 (Age range, 18–25). Facial indices obtained from direct facial measurements were used for the classification of facial shape into short, ideal and long. A validated structured questionnaire was used to assess subjects’ evaluation of their own facial appearance. The mean facial indices of Malaysian Indian (MI), Malaysian Chinese (MC) and Malaysian Malay (MM) were 1.59 ± 0.19, 1.57 ± 0.25 and 1.54 ± 0.23 respectively. Only MC showed significant sexual dimorphism in facial index (P = 0.047; P<0.05) but no significant difference was found between races. Out of the 286 subjects, 49 (17.1%) were of ideal facial shape, 156 (54.5%) short and 81 (28.3%) long. The facial evaluation questionnaire showed that MC had the lowest satisfaction with mean score of 2.18 ± 0.97 for overall impression and 2.15 ± 1.04 for facial parts, compared to MM and MI, with mean score of 1.80 ± 0.97 and 1.64 ± 0.74 respectively for overall impression; 1.75 ± 0.95 and 1.70 ± 0.83 respectively for facial parts. In conclusion: 1) Only 17.1% of Malaysian facial proportion conformed to the golden ratio, with majority of the population having short face (54.5%); 2) Facial index did not depend significantly on races; 3) Significant sexual dimorphism was shown among Malaysian Chinese; 4) All three races are generally satisfied with their own facial appearance; 5) No significant association was found between golden ratio and facial evaluation score among Malaysian population.