In a cross-sectional, epidemiological study of phenytoin induced gingival overgrowth in 77 institutionalized persons with epilepsy, the severity of the gum lesions was quantified by means of a precise new technique. Lesion severity was then compared statistically to other clinical and laboratory parameters. Positive correlations were detected between overgrowth severity and gingival inflammation, probing depths, calculus accumulation, plaque score and the measurement gingival margin to mucogingival junction (GM-MGJ). No correlation was observed between lesion severity and patients age, daily drug dosage, plasma or saliva phenytoin level, or salivary concentration of the major phenytoin metabolite.
Oral hygiene has been implicated as a casual factor in the development of dental caries and periodontal disease in mentally retarded individuals. Little attention, however, has been given to the determinants of oral hygiene status. The present paper assesses the oral hygiene status of institutionalized (I) and noninstitutionalized (NI) mentally retarded (MR) individuals aged 4 through 25, in relation to age, degree of mental retardation, and socioeconomic status. Institutional status was found to be a major determinant in oral hygiene conditions of the study group, as IMR individuals had significantly higher OHI scores than NIMR individuals. Associations of age and OHI were significant only for NIMR. Although differences between I and NI groups, with respect to degree of mental retardation, were seen for mildly, moderately, and severely retarded, no significant difference in OHI scores between I and NI profoundly retarded was seen. Socioeconomic status was not found to be a significant factor in the oral hygiene status of MR individuals. This study emphasizes the need to assess age, degree of mental retardation, and institutional status when implicating oral hygiene in caries and periodontal disease prevalence in MR individuals.
Objectives: The objective of this study is to demonstrate that computational finite element models can be used to reliably simulate dynamic interaction between a pacifier, the palate, and the tongue during nonnutritive sucking (NNS). The interactions can be quantified by the results of finite element analyses which include deformation, strain, stress, contact force, and contact area. Materials and Methods: A finite element model was created based upon CAD solid models of an infant pacifier and palate. The silicone pacifier bulb is represented by a hyperelastic constitutive law. Contact surfaces are defined between the pacifier and palate. A time and spatially varying pressure load is applied to the bulb representing peristaltic interaction with the tongue. A second time-varying, periodic pressure representing NNS is applied to the model simultaneously. A large displacement, nonlinear transient dynamic analysis is run over two NNS cycles. Results: Results from the finite element analysis show the deformed shape of the bulb with maximum principal elastic strain of 0.23 and a range of maximum principal stress on the palate from 0.60 MPa (tensile) to −0.27 MPa (compressive) over the NNS cycles. The areas of contact between the pacifier and the palate are shown in surface contour plots.Conclusions: A nonlinear transient dynamic finite element model can simulate the mechanical behavior of a pacifier and its interaction with the tongue and contact with the palate subject to NNS. Quantitative results predicting deformation, strain, stress, contact force, and contact area can be used in comparative studies to provide insight on how pacifiers cause changes in dental, orthognathic, and facial development.
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