A prospective clinical trial was conducted to determine the cephalometric and occlusal changes following maxillary expansion and protraction. Twenty Southern Chinese patients (eight males and 12 females with a mean age of 8.4 +/- 1.8 years) with skeletal Class III malocclusions were treated consecutively with maxillary expansion and a protraction facemask. Growth adaptation of these patients was followed for 2 years after removal of the appliances and compared with a control group of subjects with no treatment. Lateral cephalometric radiographs were used to quantify the skeletal and dental changes before treatment (T1), immediately after treatment (T2) and 2 years after removal of appliances (T3). With 8 months of treatment (T2-T1), overjet was overcorrected from a -2.0 to 3.5 mm. The maxilla moved forwards by an average of 2.1 mm and the molar relationship was improved to a Class I dental arch relationship. The palatal and occlusal planes were tilted upward 1.0 and 2.0 degrees, respectively. Two years following removal of the appliances (T3-T2), a positive overjet was maintained in 18 out of 20 patients. The maxilla continued to move forwards in the treated subjects similar to the controls. The mandible outgrew the maxilia. In most instances, dental compensation with proclination of the maxillary incisors was observed. The palatal plane returned to pre-treatment value. The occlusal plane continued to tilt upward due to eruption of the molars and proclination of the incisors. Analysis of dental casts showed a significant increase in maxillary intercanine (2.2 mm) and intermolar widths (2.3 mm) with 7 days of rapid palatal expansion followed by maxillary protraction. The percentage relapse in maxillary intermolar widths was 30-45 per cent after 1 year, in most cases with minimal retention. In the mandibular arch, the concurrent increase in intermolar width (2.3 mm) was primarily due to buccal uprighting of the posterior molars when the maxilla was protracted into a Class I skeletal relationship and was stable after 1 year. The results of this study indicate stability of orthopaedic treatment of Class III malocclusions directed at the maxilla. Despite some relapse, a net improvement in maxillomandibular relationship and a positive overjet was maintained in 18 out of 20 patients at the end of the follow-up period.

Objectives: To develop and evaluate two BMI-based instruments to determine perceptions of weight status, particularly perceptions of overweight and obesity, using pictorial images of women and men. Methods: Pictures of adults with known BMI values were used to construct gender-specific body size guides (BSGs) containing 10 bodies that ranged from underweight to class III obesity. Figures were standardized and a composite face was added to each. The BSGs were administered to 400 adults to assess the psychometric properties of the instruments and weight perceptions. Results: High correlations between the BMIs of respondents and the BMIs of the current body selected by respondents provided strong support for the criterion-related validity of the BSGs, and the logical pattern of responses to items assessing perception of weight categories supported construct validity for the scales. Test-retest reliability, assessed by correlations for both current and ideal body, was also high, despite the lengthy 6-month testing interval. Respondents' perceptions of the bodies within specific weight categories indicated that a majority failed to recognize the overweight female as overweight and perceived the overweight male as normal weight. Obese bodies were generally unrecognized as such until the bodies reached the higher levels of obesity (that is, BMI values 439). Perception of weight was influenced by the respondents' weight status and gender. Conclusions: Psychometric analyses indicated the BSGs are valid and reliable instruments. These results, coupled with the face validity of the scales and the relationship between the bodies and BMI values, indicate the BSGs offer advantages over existing instruments for researchers of weight perception and body image. Administration of the scales to an adult sample confirmed that overweight and obesity are under-recognized. Increased efforts to improve public understanding of these terms are needed and the BSGs may provide useful tools for this purpose.

BackgroundProtraction facemask has been advocated for treatment of class III malocclusion with maxillary deficiency. Studies using tooth-borne rapid palatal expansion (RPE) appliance as anchorage have experienced side effects such as forward movement of the maxillary molars, excessive proclination of the maxillary incisors, and an increase in lower face height. A new Hybrid Hyrax bone-anchored RPE appliance claimed to minimize the side effects of maxillary expansion and protraction. A retrospective study was conducted to compare the skeletal and dentoalveolar changes in patients treated with these two protocols.MethodsTwenty class III patients (8 males, 12 females, mean age 9.8 ± 1.6 years) who were treated consecutively with the tooth-borne maxillary RPE and protraction device were compared with 20 class III patients (8 males, 12 females, mean age 9.6 ± 1.2 years) who were treated consecutively with the bone-anchored maxillary RPE and protraction appliances. Lateral cephalograms were taken at the start of treatment and at the end of maxillary protraction. A control group of class III patients with no treatment was included to subtract changes due to growth to obtain the true appliance effect. A custom cephalometric analysis based on measurements described by Bjork and Pancherz, McNamara, Tweed, and Steiner analyses was used to determine skeletal and dental changes. Data were analyzed using a one-way analysis of variance.ResultsSignificant differences between the two groups were found in 8 out of 29 cephalometric variables (p < .05). Subjects in the tooth-borne facemask group had more proclination of maxillary incisors (OLp-Is, Is-SNL), increase in overjet correction, and correction in molar relationship. Subjects in the bone-anchored facemask group had less downward movement of the “A” point, less opening of the mandibular plane (SNL-ML and FH-ML), and more vertical eruption of the maxillary incisors.ConclusionsThe Hybrid Hyrax bone-anchored RPE appliance minimized the side effect encounter by tooth-borne RPE appliance for maxillary expansion and protraction and may serve as an alternative treatment appliance for correcting class III patients with a hyperdivergent growth pattern.

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The LAD is a reliable and valid instrument for measuring literacy in adults with diabetes. It can be administered in 3 minutes or less, and the raw score is scaled to a reading grade level.

To investigate the efficacy of antioxidant therapy on collagen synthesis in corrosive esophageal burns, 110 Sprague-Dawley rats were divided into five groups of 22 animals each. A standard esophageal caustic burn was produced by 1 ml of 10% sodium hydroxide solution for the rats in groups B to E; group A was instilled only with 0.9% saline after preparation of the distal esophageal segment. Group A animals (controls) were uninjured and untreated. Group B had untreated esophageal burns. Esophageal burns were treated in group C with vitamin E (10 mg/kg IM), in group D with vitamin C (10 mg/kg IP), and in group E with methylprednisolone (30 mg/kg IM) on each of 5 days. Eight rats from each group were killed 4 days after initiation of the study and the abdominal esophagus was studied for tissue malondialdehyde (MDA; micromol/g protein) levels. The other rats were killed 28 days after initiation of the study and determination of hydroxyproline (HP) (microg/g tissue) levels in esophageal tissue was performed for 8 rats in each group. Histopathologic evaluation was also performed in the other 6 rats from each group. MDA levels in esophageal tissue were significantly lower in groups C (9.24 +/- 2.62, P < 0.01) and group E (6.26 +/- 2.22, P < 0.001) than in group B (12.35 +/- 1.80). HP levels were significantly lower in groups A (0.75 +/- 0.21, P < 0.001), C (1.11 +/- 0.15, P < 0.01), and E (0.96 +/- 0.15, P < 0.001) than in group B (1.40 +/- 0.20). Histopathologically, collagen deposition in the submucosa and tunica muscularis was lower in groups C and E than in group B (P < 0.05, and 0.01, respectively). Our results demonstrate that treatment with antioxidant drugs such as vitamin E and methylprednisolone decreased tissue HP levels, and thus inhibited new collagen synthesis and stricture formation in rats with alkali-induced caustic esophageal burns.

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