Undesirable work factors, such as awkward upper body postures and repetitive arm motion, in the workplace can lead to upper extremity pain. Research suggests that these work-related factors, and subsequent rotator cuff fatigue, may cause the subacromial space (the space between the inferior acromion surface and superior humerus) of the shoulder to decrease. Reducing this space can create impingement of the interposed tissues, which causes shoulder pain. The aim of this study was to examine superior humeral head excursion and changes in the width of the subacromial space (acromio-humeral interval) after fatiguing the rotator cuff musculature. Four anterior-posterior radiographs of the glenohumeral joint at arm abduction angles of 0˚, 45˚, 90˚ and 135˚ were taken before and after a fatiguing task. The fatiguing task was a simulated job task requiring shoulder flexion/abduction and internal/external rotation, with the intention of exhausting the entire rotator cuff. The position of the humeral head with respect to the glenoid cavity was significantly affected both by arm angle and fatigue state; the mean humeral superior excursion following fatigue was 0.63±1.76mm. In the pre-fatigued state, increasing arm angle was related to superior translation until 90˚, after which the humeral head moved inferiorly to a more central position. In the post-fatigued state, the inability of the rotator cuff to centralize the humeral head led to increasing translations with higher elevations. Although the magnitude of translation in this study was smaller than seen in patients with rotator cuff tears, continuous overhead work demonstrably created rotator cuff fatigue, which apparently inhibited the ability of the shoulder musculature to resist upward translation of the humerus. Therefore, jobs that require overhead and repetitive work arguably put the worker at greater risk for superior translation of the humerus and subsequent related tissue damage.

The aim of this study was to test the accuracy of two methods for age estimation in non-adults, Cameriere’s European formula and AlQahtani’s London Atlas, on a multi-ethnic American sample. Radiographs of European, Hispanic and American Indian children (166 girls and 194 boys) aged between 6 and 17 years were analyzed following both methods. The accuracy of each method was assessed using the mean difference and the mean of the absolute values of the residuals (mean prediction error). Categories relating to ethnicity, sex and age were applied to the assessment of accuracy in order to compare these two approaches. Results indicate that Cameriere’s European formula significantly underestimated age for both sexes (p < 0.001), with a mean difference of -1.19 years for girls and -1.32 years for boys, prompting the first author to create an American specific formula. The American formula slightly overestimated age but this difference was not significant (p>0.05). Using Cameriere’s European formula the mean prediction error (ME) was 1.51 years for girls and 1.58 years for boys while the ME was 1.24 years for girls and 1.13 years for boys, using the American formula. The London Atlas underestimated age with a mean difference of -0.18 for girls and -0.16 for boys. The absolute mean difference was 1.04 years for girls and 1 year for boys. For both methods, differences in accuracy based on sex or ethnic group were not significant (P>0.05). The results indicate that both methods may be useful for estimating age in a forensic context.

Orientador: Eduardo Hebling / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-18T21:15:42Z (GMT). No. of bitstreams: 1 Souza_SilviaFerreirade_M.pdf: 622832 bytes, checksum: e711ade5c26d35edfa9b7f9cb5a5d983 (MD5) Previous issue date: 2011 / Resumo: O aumento da longevidade da população mundial faz com que a expectativa de manutenção da dentição possa ser observada em idosos. Esse fato pode acarretar em aumento da prevalência das doenças periodontais nessa população. O objetivo desse estudo foi avaliar a condição periodontal de idosos institucionalizados. Foram utilizados dados secundários provenientes de estudo anterior. Foram avaliados os exames radiográficos periapicais padronizados obtidos de uma amostra de 70 pessoas, de ambos os gêneros, com idade acima de 65 anos, funcionalmente independentes ou parcialmente independentes, com o mínimo de 6 dentes em ambas as arcadas, residentes em duas instituições da cidade de Piracicaba-SP, Brasil. As radiografias foram avaliadas por um examinador calibrado (Kappa > 85%), em ambiente escuro, com uso de lupa, negatoscópio e paquímetro digital. O Nível Ósseo Marginal (NOM) interproximal foi utilizado como parâmetro de avaliação. Os dados foram avaliados pelos testes de Wilcoxon e Kruskal-wallis. A prevalência de reduzido NOM foi alta, influenciando a expressiva perda dentária observada entre os idosos. Nenhuma diferença na distribuição do NOM entre os grupos de dentes foi observada. Futuras ações e políticas de saúde devem ser desenvolvidas para melhorar a condição periodontal para essa população / Abstract: The increase in longevity of the world population makes the expectation of maintenance of dentition can be observed in the elderly. This fact may result in increased prevalence of periodontal diseases in this population. The aim of this study was to evaluate the periodontal condition of institutionalized elderly. Secondary data from a previous study were used. Standardized periapical radiographic exams obtained from a sample of 70 subjects, both genders, aged above 65 years, functionally independent or partially independent, with a minimum of 6 teeth in both the arcades, residing in two institutions of the city of Piracicaba-SP, Brazil, were assessed. The radiographs were evaluated by a calibrated examiner (Kappa > 85%), in environment dark, using loupe, negatoscópio and digital caliper. Interdental Marginal Bone Level (MBL) was used as assessed parameter. The data were assessed by means of Wilcoxon and Kruskal-wallis tests. The prevalence of reduced MBL was high, influencing the expressive tooth loss among the elderly. No difference in a distribution of the MBL between the teeth groups was founded. Further preventive actions and health politics have been developed for improve the periodontal status for this population / Mestrado / Odontologia em Saude Coletiva / Mestre em Odontologia em Saúde Coletiva

Magister Scientiae Dentium - MSc(Dent) / Background: Dental age is an indicator of the physiological maturity of growing children. Different methods for estimating the dental age in comparison to the chronological age were proposed in the literature. Objective: The aim of this study was to compare the accuracy of two methods i.e. the Phillips and Proffit methods in estimating the dental age in a sample of South African children at the Tygerberg dental faculty. Methods: A retrospective study was conducted by randomly selecting 100 panoramic radiographs with known chronological age. The sample contained an equal number of girls and boys (50 in each group) and the chronological age ranged between 6 and 11 years. Dental age for each radiograph was estimated using the Phillips and the Proffit methods respectively. The mean difference between dental and chronological age was calculated. Dental and chronological ages were compared using overall bias and random errors. Results: The results showed that for the girls’ sample, the Phillips method underestimated the age by 4 months which is statistically significant (p-value =0.03). The Proffit method underestimated the age by 2 days which is not statistically significant (p-value =0.97). Both methods however have the same frequency of random errors. For the boys’ sample, Phillips’ method underestimated the age by 6 months which is statistically significant (p-value <0.0001). Proffit’s method underestimated the age by 2 months which is not statistically significant (p-value= 0.15). The Phillips method was shown to have fewer random errors in boys. Discussion: The above mentioned results showed that for dental age estimation for girls, Proffit’s method would be more appropriate. This rationale is explained by the conclusion that it only underestimates the age by 2 days and has the same frequency of random errors as Phillips’ method. However, if one had to choose between the two methods for boys, the situation should be evaluated carefully. For boys, the Phillips method has fewer random errors but a larger overall bias (6 months) whereas Proffit’s method has more random errors but less overall bias (2 months). The choice between the two methods should therefore depend on the purpose of the estimation. If the method is used for estimating the age in a single individual with an unknown chronological age, Phillips’ method would be more preferable. However, if the method is used for age estimation in populations with a known mean chronological age, Proffit is preferred. Conclusion: Proffit’s description for dental development has been shown to be accurate in estimating the DA. It may therefore be considered to be a legitimate DA estimation method and not just a developmental description for the dentition.

Introduction: Metaphyseal inwaisting is a process that occurs during long bone growth and remodelling of epiphyses and results in a proportional increase in growth plate width (GPW) and a decrease in metaphyseal width (MW). The Metaphyseal Index (MI) compares GPW to MW, usually in the distal femur. However, due to bone-age assessments, the most commonly performed radiograph in children is that of the hand/forearm. Previous work showed that gymnasts have a more widened growth plate at the distal radius than normal children, but these studies did not quantify the morphological changes using the MI and pQCT measures. Previous studies have shown that the use of DXA hand/forearm images for the purposes of bone-age assessment were unreliable for children aged 11 and under. Aims: Examine distal radius morphology of 378 Normal subjects (155 male), 36 Gymnast subjects (15 male), 17 NF1 subjects (7 male) and 108 CDGP subjects (83male) to calculate the precision of MI, MW and GPW measurements, to determine a normal reference range for the MI in Normal subjects and use this to compare to the other 3 groups, and to compare longitudinal measurements. Also, to investigate whether DXA software upgrades have improved the ability to make TW3 bone-age assessments, to investigate how closely DXA compares with standard radiographs using 98 (38 male) DXA hand images and radiographs, and calculate the precision (CV%) of the GP and TW3 bone-age assessment methods. Methods: Anthropometric data, Tanner stage, posterior-anterior hand radiographs and pQCT scans of the non-dominant hand/forearm were obtained. MI was measured using a semi-automated computer-assisted method. Statistical analyses were used to compare males and females, and compare the Normal group to other groups. Also, DXA images and radiographs were assessed by the same assessor and the TW3 and GP bone-ageing methods were compared. A CV% was calculated for both comparisons. Results: The CV% of MI, MW and GPW = 1.05%, 0.92% and 1.28% respectively. MI of males and females was not statistically different in any group. The MI of Gymnasts was significantly lower than the Normal group (p = 0.008). The NF1 and CDGP groups were not significantly different from the Normal group. Longitudinal measurements indicated those with a low/high MI at the first visit were likely to have a low/high MI at the second visit, though occasionally the MI would decrease between visits. DXA bone age assessments proved to be reliable in subjects of all ages assessed in this study and showed a CV% only slightly higher than standard radiographs (CV = 2.95% DXA vs2.68% radiograph). The CV% of GP and TW3 methods = 2.68% & 1.61% respectively. Discussion: The CV% of MI, MW and GPW shows these methods to be very precise. The mean MI of gymnasts is significantly lower than in normal children due to a widening of the growth plate and not due to a reduction in metaphyseal width. Insufficient subject numbers and smaller age ranges, particularly in the Gymnast and NF1 groups may play a part in the non-significant differences between them and the Normal group. DXA CV% shows that DXA is almost interchangeable with standard radiographs. The TW3 and GP CVs% show that TW3 bone-age assessment is more precise than the GP method. This confirms the tight control that the MW and GPW have in proportion to each other. This is the first study to quantify changes in distal radius morphology in normal, athlete and disease groups, and create a range of normal reference values, which could be useful for future work in this area.

Magister Chirurgiae Dentium (MChD) / Skeletal age assessment is not only an important aspect in orthodontic treatment planning, but is also widely used in forensic medicine and physi cal anthropology. Vari aus studi es have shown that chronological age may be at variance with an individual's biologic age. Current research would seem to indicate that the hand-wrist radiograph provides the most accurate method of assessing skeletal age for diagnostic purposes. In recent years the number of patients presenting with malocclusions of a skeletal nature at the University of the Western Cape has increased si gnifi cantly. If it i s accepted that treatment of jaw di screpancies associated with malocclusion is dependent on a large component of dentofacial orthopedics, then by implication it is necessary that a substanti al amount of faci al growth remai ns. The need has therefore arisen for the establishment of skeletal maturation trends in the Western Cape. Skeletal maturity was assessed from hand-wrist radiographs in a sample of 318 Western Cape children aged 6 to 16 years for both sexes, utilising the bone specific Tanner-Whitehouse TW-2 scoring system. Data obtai ned from the present study showed a marked difference in skel etal maturati on trends between femal es of the Western Cape to that of the British norm, while the males showed less divergence. Further, these findings show that in both sexes the epiphyseal bones matured in advance of the TW-standard. Carpal maturation, however, was delayed in the male when compared to the British standard, while that of the female conformed to that of the British standard.

Magister Chirurgiae Dentium (MChD) / There is no data specific to the Qatari population on the incidence of dental anomalies. The aim of this study was to investigate the incidence of dental anomalies in a Qatari population sample of patients between 6 and 65 years of age and to use the record as a key for human identification in forensic odontology.Records of panoramic radiographs of a Qatari population sample of 457 patients, comprised of (227 females; mean age 16.84 and 230 males; mean age 18.55) were examined to identify all dental anomalies. Dental anomalies were investigated in 4 groups, each group including subdivisions with a total of 15 subdivisions.

No description available.

The aim is to determine the effect of reference standard related bias on estimates of plain radiograph reading performance using studies conducted in clinical practice. Data were extracted on study eligibility, clinical and reference standard characteristics and reading performance. The choice of reference standards and the prevalence of bias are presented descriptively. Associations between bias and reading performance are estimated using a regression model that produces relative diagnostic odds ratios (RDOR) with 95% confidence intervals (CIs). Three of the 20 eligible studies addressed all five reference standard related biases; 15 studies addressed three or more. When the reference standard report is influenced by knowledge of an observer's opinion this is associated with a significant overestimation in reading performance (RDOR, 3.7; 95% CI, 1.6 to 8.3; p¿=¿0.01). There is limited evidence that reading performance is inflated when the observer is aware of the reference standard report before commenting on the radiograph (RDOR, 1.7; 95% CI, 0.6 to 5.1) and deflated when a less valid reference standard is used (RDOR, 0.5; 95% CI, 0.1 to 2.5). There is no evidence that reading performance is affected by application of the reference standard depending on an observer's opinion and using different reference standards in the same study. In conclusion we found variation in the choice and application of reference standards in studies of plain radiograph reading performance, but only when reference standards report in the knowledge of an observer's opinion does this contribute to a significant overestimation in reading performance.

To determine the accuracy of radiographer plain radiograph reporting in clinical practice. MATERIALS AND METHODS Studies were identified from electronic sources and by hand searching journals, personal communication and checking reference lists. Eligible studies assessed radiographers' plain radiograph reporting in clinical practice compared with a reference standard, and provided accuracy data to construct 2×2 contingency tables. Data were extracted on study eligibility and characteristics, quality and accuracy. Summary estimates of sensitivity and specificity and receiver operating characteristic curves were used to pool the accuracy data. RESULTS Radiographers compared with a reference standard, report plain radiographs in clinical practice at 92.6% (95% CI: 92.0¿93.2) and 97.7% (95% CI: 97.5¿97.9) sensitivity and specificity, respectively. Studies that compared selectively trained radiographers and radiologists of varying seniority against a reference standard showed no evidence of a difference between radiographer and radiologist reporting accuracy of accident and emergency plain radiographs. Selectively trained radiographers were also found to report such radiographs as accurately as those not solely from accident and emergency, although some variation in reporting accuracy was found for different body areas. Training radiographers improved their accuracy when reporting normal radiographs. CONCLUSION This study systematically synthesizes the literature to provide an evidence-base showing that radiographers can accurately report plain radiographs in clinical practice.