Thesis (M.S.)--University of Michigan, 1998. / Includes bibliographical references.

Aim This thesis has several aims;• to explore the available evidence surrounding interceptive orthodontics (IO), • to explore current general dental practice with regard to the provision of interceptive orthodontic care, and• to consider the way forward in the UK for providing simple interceptive orthodontic care for children in primary care. Methods Systematic reviews were conducted in areas where there had previously been no high quality reviews; interventions for the cessation of non-nutritive sucking habits (NNSH) in children, and correction of anterior crossbites in children. Semi-structured interviews were performed, transcribed, and thematic analysis performed, helping to develop a questionnaire. Following development, the questionnaire was posted to 400 General Dental Practitioners (GDPs) across Scotland. The results were analysed, and potential barriers to providing care were identified. A cost analysis was performed, using some of the data from the questionnaire to calculate the current cost to the NHS of managing children with persistent digit sucking habits. A sensitivity analysis was constructed to predict if a saving could be made to the NHS, if there was a change in clinical practice in primary care. Finally, a protocol for an interventional study was developed using the results from some of this work, to increase the provision of IO in primary care. Results The systematic review of interventions for NNSH identified 183 initial papers, which after checking for relevance and quality, were reduced to a final six RCTs which were included in the final review. The results suggested that a fixed habit breaker was the most effective intervention for digit suckers. The systematic review of correction of anterior crossbites in children identified 499 papers, which after checking for relevance and quality, were reduced to a final 46 studies which were included in the final review. The results suggested that anterior crossbites were best managed with a fixed “2 x 4” appliance. The interviews suggested confidence, and previous experience may play a role in determining whether a GDP will provide IO. The questionnaire highlighted that confidence, knowledge, and age could all be barriers to providing care, and these were the focus for the design of the intervention study. The cost analysis demonstrated that a potential saving of approximately £20,000 to NHS Tayside could be made by changing current practice from provision of a URA to a fixed habit breaker. If this change was implemented across Scotland this saving could increase to over £1,000,000. Larger savings could be made if less monitoring of the habit and more provision of fixed habit breakers was implemented (over £60,000 in NHS Tayside). Conclusions The systematic reviews highlighted the need for high quality studies in their subject areas. The cost analysis demonstrates the range in savings that could be made to the NHS depending on the changes made to current GDP practice. The interviews and questionnaire demonstrated there is scope to improve the provision of IO in primary care. The biggest barrier to providing IO appears to be confidence, specific to designing treatment plans, and how effectively the plan can be carried out for the patient. It is intended that the proposed investigation, outlined at the end of this thesis, to increase GDPs provision of IO, will be conducted. If the intervention proves successful, it could be rolled out across the UK, changing current clinical practice.

Thesis (M.S.)--University of Michigan, 2001. / Includes bibliographical references.

Thesis (MChD(Orthodontics))--Universiteit van Pretoria, 1999. / Also available online.

Thesis (M.S.)--University of Michigan, 2001. / Includes bibliographical references.

Orientador: Vania Celia Vieira de Siqueira / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-15T06:03:17Z (GMT). No. of bitstreams: 1 Sousa_MeireAlvesde_D.pdf: 1934280 bytes, checksum: 6ccaf4ca61a91707535d7c63a1d6cd46 (MD5) Previous issue date: 2010 / Resumo: A eletromiografia de superfície representa um importante instrumento de avaliação da função muscular. No entanto, apresenta limitações, devido à grande variabilidade que ocorre na amplitude do sinal eletromiográfico obtido. Com o intuito de diminuir essa variabilidade, sugere-se a normalização dos dados coletados, que consiste na divisão do sinal eletromiográfico bruto registrado por um valor de referência, expresso em porcentagem, derivado da própria medida do sinal eletromiográfico. Objetivou-se neste estudo avaliar, por meio da eletromiografia, a ocorrência de alterações na atividade eletromiográfica da porção superficial do músculo masséter, da porção anterior do músculo temporal e dos segmentos superior e inferior do músculo orbicular da boca, bilateralmente, em 25 jovens, entre 8 e 10 anos de idade, com maloclusão Classe II, 1ª divisão dentária, após se submeterem ao tratamento ortodôntico com o aparelho extrabucal, comparando-os com um grupo de 25 jovens com oclusão normal, com idade similar. Além de avaliar se o procedimento de normalização dos dados obtidos influencia no resultado final. Para a captação dos sinais eletromiográficos dos músculos masséter e temporal utilizou-se eletrodos de superfície ativos diferenciais simples, e para o músculo orbicular da boca, eletrodos de superfície passivos de Ag/AgCl. Realizou-se a coleta do sinal na situação de repouso, na contração isométrica e na contração isotônica, antes e após o tratamento ortodôntico no grupo com maloclusão e em períodos similares no grupo com oclusão normal. Por meio de software específico, determinou-se o valor da Root Mean Square (RMS) de cada movimento realizado. Submeteu-se os dados iniciais coletados à normalização, comparando-os com os dados iniciais originais, por meio da análise de variância (ANOVA) para parcelas subdivididas Os resultados demonstraram que o procedimento de normalização influenciou a interpretação dos dados ao suprimir as diferenças existentes entre os grupos, reforçando a idéia de que os resultados originais permitiram conclusões mais adequadas do que os dados normalizados. Com base nesses resultados, optou-se pela utilização dos dados originais para avaliar o efeito do tratamento ortodôntico no grupo com maloclusão. Nesta etapa utilizou-se a ANOVA para medidas repetidas com modelos mistos e o teste de Tukey (a=0,05). Observou-se que ocorreu uma diminuição na atividade eletromiográfica de todos os músculos do grupo com maloclusão e com oclusão normal, entretanto esta diferença não apresentou-se estatisticamente significante para o músculo temporal direito e orbicular da boca, segmento superior. Na fase inicial do estudo o grupo com maloclusão apresentou maior atividade elétrica em todos os músculos do que o com oclusão normal, no entanto, essa diferença não apresentou-se significante para o músculo masséter. Não ocorreram diferenças significativas entre os grupos na fase final do experimento. Concluiu-se que o tratamento com o aparelho extrabucal possibilitou a melhora do padrão muscular das jovens com maloclusão Classe II, 1ª divisão dentária. / Abstract: The surface electromyography is an excellent way to evaluate the muscle function. However, it presents limitations, because the great variability in the amplitude of the electromyographic signal obtained. To reduce this variability, has been proposed the normalization of the electromyographic signal. The process consist of dividing the raw electromyographic recorder signal by a reference value expressed as a percentage, derived from measure of the electromyographic signal itself. The purpose of this study was to evaluate electromyographically the action potential of the superficial masseter muscle, the anterior temporal muscle, the orbicularis oris muscle, upper and lower segment, bilaterally, in 25 young females, aged ranging from 8 to 10 years old, with Class II division 1 malocclusion after the treatment with extraoral appliances and to compare them with 25 young females with normal occlusion, with similar aged. And to evaluate if the experiment final results can be influenced by the normalization of electromyographic data. The electromyographic signals of the masseter and temporal muscles were adquired by active single differential surface electrodes, and of the orbicularis oris muscle by passive surface electrodes of the Ag/AgCl. Muscle activity was recorded in resting position, in isometric contraction and in isotonic contraction, before and after orthodontic treatment in the malocclusion group and similar periods in the normal occlusion group. Through of specific software was determined the Root Mean Square (RMS) values of each movement. The initial data collected were submitted to the normalization procedure and were compared with the initial raw data, through of statistical analyses of variance. The results showed that the normalization procedure was able to affect the electromyographic data, suppressing the difference between the groups. This support the idea that the raw data were able to produce better conclusions than normalized data. Thus, the orthodontic treatment of the malocclusion group was evaluated using the raw data, through of statistical analyses of variance and Tukey test (a=0,05). The results showed that there was decrease of the electromyographic activity in all the muscles, in both groups difference between the groups, but that difference was not statistically significant for the right temporal muscle and the orbicularis oris muscle upper segment The muscle activity was higher in the malocclusion group than normal occlusion group in the initial phase, but that difference was not statistically significant for the masseter muscle. In the final phase there was not significant difference between the groups. It was concluding that the treatment with extraoral appliances was able to improve the muscular pattern of the young females with Class II division 1 malocclusion. / Doutorado / Ortodontia / Doutor em Radiologia Odontológica

Thesis--University of Oklahoma. / Includes bibliographical references (leaves 99-101).

Orientador: Vania Celia Vieira de Siqueira / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-09T18:34:07Z (GMT). No. of bitstreams: 1 Carvalho_AnaZildaNazarBergamode_M.pdf: 2690081 bytes, checksum: 6c44469b6eaa2fbdcab6f44ba2a636d0 (MD5) Previous issue date: 2007 / Resumo: O presente estudo objetivou analisar a efetividade do aparelho extrabucal (AEB), por meio de avaliação cefalométrica, em 40 telerradiografias, obtidas em norma lateral, de jovens do sexo feminino, com média de idade 9,15 anos, em fase de dentição mista, com maloclusão de Classe II, 1ª divisão dentária, subdivididas em 20 ao início do tratamento e 20 ao final. Anteriormente ao tratamento, as jovens apresentaram um padrão dolicofacial de crescimento, equilíbrio entre a altura facial superior e inferior, com índice de altura facial suavemente aumentado. A maxila mostrava-se bem posicionada em relação à porção média da base do crânio, com sua dimensão ântero-posterior próximo à normalidade, apenas com leve desarmonia entre as bases apicais. O tratamento ortodôntico envolveu a utilização do AEB, tração alta, com 350g de força, de cada lado, de 14-18 horas diárias, durante 22,35 meses. Avaliaram-se os valores de: SN.GoGn, FMA, N-ENA, ENAMe, IAF, Fg-S, S-Fpm,, Fpm-ENA, SNA, SNB, ANB, Fpm-6, 1.NA, 1-NA, 1.PP. As radiografias, em sua totalidade, foram traçadas duas vezes pelo mesmo pesquisador, e empregou-se a fórmula de Dalhberg para verificar a ocorrência ou não de erro do método. Os resultados revelaram um erro casual menor que 1,5º e 1,0mm, indicando confiabilidade dos dados obtidos. Os valores médios de cada grandeza cefalométrica submeteram-se ao teste paramétrico ¿t¿ de Student, que revelou que o padrão de crescimento não se modificou com o tratamento. O equilíbrio entre altura facial superior e inferior manteve-se. A relação das bases apicais se alterou favoravelmente, reduzindo o valor de ANB. Ocorreu restrição do deslocamento anterior da maxila, e sua dimensão ântero-posterior aumentou suavemente. O molar superior permanente distalizou efetivamente e os incisivos se retroposicionaram em suas bases apicais. O presente estudo sugeriu que o tratamento precoce da maloclusão de Classe II, 1ª divisão dentária utilizando AEB, tração alta, atingiu seus objetivos corrigindo o posicionamento dos molares e incisivos, além de melhorar a relação entre as bases apicais, favorecendo então uma segunda fase de tratamento ortodôntico quando necessário / Abstract: The present study aimed to analyze the effectiveness of the extraoral force (AEB), through an cephalometric evaluation, in 40 lateral cephalograms, 20 pre and 20 post treatment, of girls, with age¿s ranged from 9.15 years, in the mixed dentition, with Classe II, division 1 malocclusion. Initially, the girls presented a dolicofacial skeletal growth pattern, equilibrium among the superior and inferior facial height, facial height index increased. The maxilla was well positioned in relation to the medium portion of the base of the cranium, the anteroposterior dimension is normal; the jaw relationship (ANB) was deficient. The headgear appliance, with traction occiptal, with 350g of force, bilaterally, for 14 hours daily rates, was used for 22.35 months. It was evaluated the values of: SN.GoGn, FMA, N-ENA, ENA-me, IAF, Fg-S, S-Fpm, Fpm-ENA, SNA, SNB, ANB, Fpm-6, 1.NA, 1-NA, 1.PP. The lateral cephalograms, in your totality, were traced twice by the same researcher, and the Dalhberg index was used to verify the occurrence or not the mistake occurrence. The results revealed a smaller casual mistake than 1.5° and 1.0mm, indicating reliability of the obtained data. The medium values of each greatness cefalometric underwent the parametric test ¿t¿ of Student. The data base revealed that the growth pattern didn't modify with the treatment. The balance between superior facial height and inferior stayed. The jaw relationship changes positively, reducing the value of ANB. It occurred a restriction of anterior displacement maxillary, and your anteroposterior dimension increased smoothly. The headgear has a distal effect on the first molar permanent superior, and a retroclination of the maxillary incisors. The present study suggested that the Classe II, division 1 malocclusion headgear treatment, with traction occiptal, it reached your objectives correcting the positioning of the molars, and incisive, improving the jaw relationship, favoring the second phase of orthodontic treatment then when necessary / Mestrado / Ortodontia / Mestre em Radiologia Odontológica