Experiences with Mini Implants Among Paediatric Patients

Experiences with Mini Implants Among Paediatric Patients EXPERIENCE OF PEDIATRIC PATIENTS WITH MINI IMPLANTS UNDER GOING ORTHODONTIC TREATMENT ABSTRACT Objectives: Mini-implants are gaining achievement in orthodontics procedures as they provide maximum anchorage. The study is planned to evaluate different experiences with mini implants among pediatric patients. Methods: This study was done among 86 patients with a mean age of 14Â ±23 years. All the participants were interviewed with the help of a questionnaire containing information as experience during treatment with mini implants, acceptance rate of mini implants, complications faced during procedure and satisfactory results with the treatment. Visual analogue scale (VAS) was used to record pain parameters. The data was analyzed by SPSS 16.0 software. Nonparametric test was applied to obtain the median of VAS scores. Results: Most of the patients face problems with mini implants during mastication of food (28.2%) and speech (23.6%). It also leads to poor oral hygiene in 16.4% of the subjects. The highest VAS scores were traced from the period of one to twenty hour i.e. (33.7 to 40.2). It was observed that most of the subjects get adopted to the mini implants in 5 to 10 days. Conclusions: It is safe and sound to use mini-implants as an orthodontic anchorage device among patients undergoing orthodontic treatment. Mini implants are unquestionably accessory tools for treatment of orthodontists and ought to be utilized in selected cases demanding greatest anchorage. Keywords: Mini-implants, Orthodontics, Pediatric patients. INTRODUCTION Orthodontic procedure is recommended for aesthetics and proper functioning of teeth. Patients look for orthodontic treatment mainly for aesthetic motives but orthodontists normally advise orthodontic treatment to patients for function purposes.1 Orthodontic treatment takes a longer duration in alignment of dentition that leads to dissatisfaction among the patients. So, numbers of techniques have been introduced to assist in the reduction of duration of the treatment.2 Temporary anchorage devices and surgical corticotomies have been discovered for lesser-duration treatment. Reducing the period of treatment with effective techniques, increases the acceptability among patients to accept the orthodontic procedure. 3-4 The usage of temporary anchorage devices (TADs) also recognized as mini-implants can accelerate the treatment in a number of cases.5 Temporary anchorage device or mini implants momentarily fixed to bone for the principle of providing orthodontic anchorage by supporting the teeth, which is subsequently removed after use.6 Mini implants produce skeletal anchorage and have been successfully proven in the treatment of cases with varying degrees of complications, if their placement is correctly positioned. Additional concern is to maintain oral hygiene around the TAD by the patient.7-8 Currently, mini-implants have gained significant status as they provide greatest anchorage in conditions involving orthodontic movements that require maximum control.9 Considering the insertion sites, mini-implants can be fixed in the cortical region of the alveolar bone of mandibular molar; in the median or paramedian sagittal area of the maxillary hard palate; and in the zygomatic bone for orthodontic corrections.10 Height and anatomic structures of the bone determine the length, shape and thickness of mini implants.11 Despite the scientifically advancement in mini-implant use, still there are some limitations of surgical risk with some patients that leads to unwillingness in accepting these devices.12 The present study is done to determine different experiences with mini implants among pediatric patients. METHODOLOGY This epidemiological study was done among patients undergoing orthodontic treatment in the Department of Pedodontics from April to December 2014 in Karad Institute of Dental Sciences. Prior to collection of data, ethical approval was obtained from the Institute and informed consent was taken from all the participants or their guardians. All the willing participants in whom mini implants were fixed were included in the survey and participants with cleft lip and palate and with medical problems were excluded. A pre-tested survey was done among a 10 subjects in order to make sure the level of validity. In this survey, all the participants or their guardians were interviewed with the help of a questionnaire containing information as experience during treatment with mini implants, acceptance rate of mini implants, tolerance, complications faced during procedure and satisfactory results with the treatment. Every subject was asked to complete a questionnaire with eight sections from 1 to 8 according to severity of discomfort with visual analogue scale (VAS). Discomfort level was noted at different intervals of time. The data was analyzed by SPSS 16.0 software. Nonparametric test was applied to obtain the median of VAS scores. RESULTS The total study sample was 86 whom mini implant was fixed with orthodontic appliances. The participants were categorized as boys (41) girls (45) with a mean age of 14Â ±23 years. After fixing the mini implant, most of the patients showed satisfactory results with time (86.4%). In the present study, the most disagreeable feeling experienced was due to the pressure of mini implants on teeth surface (42.6%) followed by the time of insertion when the implant is placed in the bone (36.5%). Few subjects feel unpleasantness at the time of removal of implant (20.9%) as shown in Graph 1. Graph 2 showed that most of the patients face problems with mini implants during mastication of food (28.2%) and speech (23.6%). It also leads to poor oral hygiene in 16.4% of the subjects. It causes injuries in 10.6% of the participants. Less number of participants showed its relation to poor aesthetics (6.5%). The highest VAS scores were traced from the period of one hour to twenty hour i.e. (33.7 to 40.2). After this time the scores declined as 15.7 after one week, 8.2 after two week and 2.3 after one month (Graph 3). After the placement of mini-implant, the immediate effect noticed by the patients is the pressure on tooth surface (31.3%) followed by pressure on mini implants (26.5%). Some felt discomfort in the jaw bone (18.7%) and hard palate (14.6%) as mentioned in Graph 4. It was observed that most of the subjects get adopted to the mini implants in 5 to 10 days i.e. 37.4%, followed by 29.6% in 10 to 15 days. Less than twenty percent get used to within five days. Few participants showed normal response with implants after 15 days as showd in Graph 5. DISCUSSION Anchorage is the resistance to unwanted movement of tooth. The increased use of temporary anchorage devices (mini implants) has developed to decrease the risks of patient compliance in the wish of providing supplementary outcomes.13 They also provide increased flexibility in supporting the tooth movements with conventional appliance mechanics.14 The level of pain after placement of mini implant was seen maximum from one to twenty hours and the peak declined after one week. The result of the present study was similar with study done by Kuroda et al., 2007. This drop in pain level could be brought by the restraint of supporting soft tissues.15 Regarding the most disagreeable experience with mini implants felt by patients was pressure of implant followed by its placement. However Bustamante et al showed that numbness from the anesthetic was mentioned by 20%, pressure from mini implant fixation by 40% and too lengthy procedure was mentioned by 10% of patients. The fact behind the pressure of mini implant is perfectly understandable as it was a new procedure and unknown for the patients. It had been suggested by the orthodontist with the aim of facilitating the orthodontic treatment. Even after consenting to the procedure, patients felt some psychological discomfort, even though no pain had been said.16 When the experience of mini implants was observed, mastication and speaking problems were commonly seen in the participants. But Bustamante et al showed that oral hygiene difficulties were mentioned by 40%, mastication difficulties by 10%, psychological pain by 10%. In spite of the huge contribution of these mini implants, they pose complexities related to surgical procedures, and discomfort level to the patients. Notwithstanding these barriers, patients should be inform in advance that surgical procedures are simple are performed under local anesthetic. In addition, procedure efficiency is improved and time is shortened.17 The study showed that most of the patients adapted to these mini implants 5 to 15 days, as the pain subsides with time and structures supporting implant get stabilized with implant. The time required to adapting to mini implants, ranged from 5 to 15 days. Bustamante et al in their study mentioned that patients required around ten days to get used to implants. Sixty percent were entirely adapted by third day after surgery, whereas others required a longer duration of time.16 CONCLUSIONS The study showed that most of the participants were satisfied with mini implants as it accelerates the treatment. Mostly discomfort level was noted by the pressure of mini implant. Later on it also leads to chewing, speaking and hygiene problems. The peak level of pain was from one hour to one day and most of the subjects get used to the implants within 20 days. Mini implants are unquestionably accessory tools for treatment of orthodontists and ought to be utilized in selected cases demanding greatest anchorage. 1

The Main Characters In The Brother K English Literature Essay

The â€Å" secret plan † of the narrative is alone from many other books, in that it feels like 5 different secret plans all ramifying off from the same starting point, and all stoping up at the same topographic point. Each of the major characters has their ain â€Å" secret plan † : Papa, Peter, Everett, Irwin, and the remainder of the household at the house. Papa is, merely that, the male parent of the family. Once a professional hurler, he subsequently retired to work in a factory. Several old ages subsequently, his pollex was crushed by some machinery in the factory ‘s paper imperativeness, intending that he could ne'er flip once more without a particular surgery, one they could n't afford. This sent him into a spiral of depression that lasted many old ages, until Kincaid snapped him out of it. He began developing once more, despite his pollex, and after a batch of preparation, he was fliping once more, but nowhere near his â€Å" glory yearss † . Final ly, due to some tampering by Everett, he is able to acquire his surgery, and replaces his bad pollex with his toe, and gets a prosthetic toe to replace that. He finally works his manner back up the baseball ladder until he is the alleviation hurler for the Tugs. He merely quits when he realizes he has to take between baseball and his household. He dies a few months afterwards, due to several types of malignant neoplastic disease. Peter is a genius degree mind who believes really strongly in Zen Buddhist doctrines, and ends up at Harvard for all of his work, avoiding the bill of exchange by manner of scholarship. Finally going to India, he returns place after being robbed of all of his ownerships, although deriving a great trade of cognition about the doctrines he believes in. Everett, on the other manus, is about an antonym of Peter. His beliefs are anarchistic and agnostic in nature, and he is much more extremist in his actions. From beginnings hassling his ain female parent about her spiritual beliefs, he finally ruins his household ‘s relationship with their curate. After he graduates High school, he uses his natural endowment of address to progress in life, going a â€Å" hippy † . Droping out of school in order to dodge the bill of exchange, he finally ends up in Canada, love struck by the one miss who his powers of address could n't enchant, named Natasha. After an on/off relationship affecting many letters, he finally comes back to the US to assist his brother, despite the effects of bill of exchange evasion. The 3rd oldest, Irwin, has no mental art, but is alternatively, an about everlastingly happy, soft giant. By book ‘s terminal, he is one of merely 3 characters left in the household whose beliefs are strictly Christian. Due to dropping out of school and non wishing to run off, he is drafted into the Vietnam War, where his apparently eternal benevolence runs dry. He snaps after his squad is forced to kill a little kid, utilizing n il but a tubing of toothpaste and his fists to assail his bid officer. These actions landed him in a mental establishment back in the United States, where he was subjected to an copiousness of narcotics and repeated electroconvulsive therapy therapy when he would n't halt singing the church anthem he grew up with. Upon larning of this, his household puts aside their differences and calls upon many of their churchgoing friends to come and assist acquire him out of the establishment. They win, and he recovers finally, through tackling the originative mercantile establishment of wood ranges. The remainder of the characters are much more minor. Mama is an highly spiritual lady who keeps the whole household together, even when 2/3 of her kids reject her instructions. Beatrice/Bet and Winifred/Fred are twins born after Kincaid, both really scientifically minded, but ramifying off sacredly, as Bet ‘s uninterrupted dark panics have lead her to an agnostic/atheist point of view, and Fr ed ‘s beliefs remaining Christian. All of these characters and events come together as the kids and parents try to populate their lives. In my sentiment, the most memorable scene from this book was the minute that they allow Irwin out of the mental establishment. The concluding behind this being that, up until this scene, the book had been reasonably realistic. The war was portrayed as dark, farinaceous and meaningless, the characters three dimensional and complex. But this minute merely shattered that for me. No authorities establishment would be that easy overthrown by a few household members and some spiritual leaders. Irwin was, from a 3rd individual ‘s point of view, still lawfully insane. They had every ground to maintain him at that place. This scene was such a displacement in the secret plan that I suppose it stuck with me. My favourite quotation mark from this book is: â€Å" aˆÂ ¦ † Want to hear why? Do you desire to cognize why Linda could ne'er kip? † I forced myself to nod. Good. It ‘s good to shareaˆÂ ¦ † ( Page 390 ) This is from the scene where Bet is depicting her dark panics to Kincaid. My ground behind picking this quotation mark is that, for one, it was a immense turning point in the narrative for Kincaid. Prior to this point, he himself was a minor character, more frequently than non leting his wiser older sibling to make everything. This is one of the few points in the narrative where he takes the brunt of the blow and shows some development as a character. For two, and for the same grounds mentioned, this shows off one of the major subjects in The Brothers K that is salvation. Every character in this book redeems themselves at one point or another, with the possible exclusion of T Bar, one of the people Peter met in India who helped him along his journey . Personally, I did non like this book. Many parts I had to maintain forcing myself frontward, with the promise that it may acquire more interesting subsequently on. And it did, for the most portion. But any clip the secret plan of one character would get down to acquire interesting, it would trade off to another character, and so another, until I had long forgotten why I was interested in the first character in the first topographic point. I did, nevertheless like how every character was given a sufficient wrap up, but at the same clip, the stoping felt really rushed. Where as in most of the book, at most merely a few months would travel by without notice ; the stoping skipped full old ages in between paragraphs. A more minor complain is about the names. It took me half the book to recognize that Winnie and Fred is the same individual, and that it is a miss. But about three quarters of the manner through the book, Irwin adopts the nickname Winnie, with no account behind it. This book besides has a batch of reasonably unneeded spots to it, apparently in order to give the characters more credibility. A multi portion â€Å" History of My Dad † written by Irwin serves to give the Papa character a back narrative that is n't truly needed. There are besides several interviews with celebrated baseball participants. All in all, this book may be a good read for the history partisans, but I do n't believe that the mean Joe would happen it really appealing.

Developmental Theories Essay - 816 Words

Reaction Paper Number One Theories of Development There are many types of developmental theories. First being the Psychoanalytic Theory, and the Cognitive Theory. Within these two types of theories there are several psychologists that have their own theory of development. After exploring these different theories I will then share my opinion on which theory I believe to be more accurate. By definition the Psychoanalytic Theory describes development as a primarily unconscious and heavily colored by emotion. Behavior is merely a surface characteristic, and the symbolic workings of the mind have to be analyzed to understand behavior (Santrock). Sigmund Freud took the psychoanalytic approach with his Psychosexual Theory, Freud†¦show more content†¦For example during the anal stage the primary focus is learning to control the bladder and bowel movements, thus giving a child a since of independence. Although if a child is not rewarded properly or ridiculed for having accidents a child may have a negative out come later in life as a result (Cherry). Erikson also took the psychoanalytic approach with his Psychosocial Theory. Erikson believed that people developed socially and where motivated by the desire to affiliate with other people. He also believed that people continued to develop through their entire life span with equal importance. There are eight stages in Erikson’s theory starting from the Oral Stage, where a person develops trust versus mistrust, and continues to the Integrity versus Despair Stage accruing into the late 60’s and onward. Like Freud, Erikson believed that if any one stage is not successfully accomplished negative effects could result later in life. Although because Erikson believed that people continue to develop throughout life if any one stage is not successfully achieved at the recommended time, a person could still accomplish the level thus resulting in a positive outcome. Cognitive Theories focus on conscious thoughts, remembering, problem solving and decision making. Cognitive development refers to how a person understands the world through interaction. Piaget, and Vygotsky both took the Cognitive approach to development. Vygotsky claimed that social development was far moreShow MoreRelatedDevelopmental Stages And Developmental Theories1004 Words   |  5 PagesDevelopmental Stages and Developmental Theories There have been numerous studies on human development to explain how we function at different stages in our lives. These studies have looked at development from birth to adulthood. 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Initially she spends most of her time living alone as she does not have any friends and her father is busy in his work. It’s seems that both are not attached emotionally with each other which results in the manifestation of her affectionlessRead MoreTheories Of Developmental Psychology : Attachment Theory1178 Words   |  5 PagesDescribe and evaluate two theories in developmental psychology Attachment theory, it refers to an affectionate bond. â€Å"A relatively extended and enduring connection with the partner is important as a unique individual is interchangeable with no other† Ainsworth (1989) cited in Gross (2003) hand out in class (03/06/2013).The aim of this attachment is for the infant to remain in close proximity to the attachment figure as she is considered the secure base and the infant would become distressed on separation

Reality TV and Love Essays - 2897 Words

Reality TV and Love It seems that you can’t turn on a television set anymore without a reality show being on. All networks have recently started to pump out reality shows left and right. And why wouldn’t they? Reality shows are highly rated, with three of them being in the top ten on the Nielsen ratings chart. In fact, these shows are becoming more popular than the sitcoms and dramas aired. New sitcoms and dramas struggle to get attention of the public when going against a reality show. Programs such as The Beast and Go Fish, which critics loved and raved about, are victims of the wrath of reality shows. These shows are now cancelled. What makes these shows so popular? They bring out a certain attribute of a†¦show more content†¦Different shows use different techniques such as using factors like money or material wealth; all which have proved to be successes for them in the ratings. Love is used in many different ways to please the people and to get ratings. False Image of Love Reality shows strive to create relationships and keep viewers attention by interesting or shocking them. The relationships are not however, natural relationships. One example of an unnatural relationship development in reality TV would be Fox’s â€Å"Married by America†. In this show, people who have just met get engaged in hopes that in just a few weeks, the couple will marry. In most cases, people date for a period of time before being engaged and people usually do not marry as quickly as the couples do in the show. There is also more relationship development. Other examples would be marrying someone for their money, such as CBS’s â€Å"Cupid† or NBC’s â€Å"For Love or Money†. The shows both deal with someone marrying someone for money rather than for Love. Marrying someone just for money is unnatural; people usually marry someone for love and not just for their money. Reality shows say they are promoting healthy and normal relationships. The shows say they are not trying to sensationalize relationships or twist the story. The shows claim they do not edit the show, and that it’s all real and it’s showing exactly what the couples do. ItShow MoreRelatedReality Tv - the Real Issues Essay1246 Words   |  5 Pagesfavorite movie star dresses, or listening to the newest bands, media makes a difference in everyone’s life. Recently reality television has become a bigger, more popular pastime that many American people enjoy. With so many different reality shows coming out one of the biggest problems that America faces is what kind of message these shows are projecting to their viewers. Almost every reality show that’s out there right now is in some way almost degrading to regular human beings. Shows that get some ofRead MoreNegative Stereotypes in Reality Television1639 Words   |  7 PagesAs Reality TV becomes more prominent it seems as though negative stereotypes overtly saturate this genre of entertainment. 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They are not like movies or series that are being acted or are done based on actual stories. The characters shown in these shows are the real people who act. Keeping up with Kardashians, Love and hip-hop, and the Police women of Cincinnati are some of the recent rea lity TV shows that are aired on American TV channels. Keeping up with the Kardashians is about