Agneta Lith

Perceptual analysis of speech and the activity in the lateral pharyngeal walls before and after velopharyngeal flap surgery

The purpose of this study was to investigate the effects of velopharyngeal flap surgery on speech and its relation with the activity in the lateral pharyngeal wall. Videofluoroscopic recordings made before and after operation were used in this retrospective study, which comprised 28 patients who had pharyngeal flap surgery between 5:5 and 14:3 (mean 8:6) years:months of age at the Sahlgrenska University Hospital, Göteborg, Sweden. Twenty-four patients had different types of clefts and four had velopharyngeal impairment (VPI) without a cleft palate. Eleven had additional malformations. Speech and activity in the lateral pharyngeal walls were rated perceptually preoperatively and postoperatively. The study confirmed that patients with VPI can be helped by a velopharyngeal flap operation. There seemed to be a relation with the activity in the lateral pharyngeal wall and speech. The later the postoperative assessment, the better the speech, but the age at operation did not affect the result. The impact of additional anomalies and syndromes should be investigated further.

Frequency of errors and pathology in panoramic images of young orthodontic patients

The aims of this study were to evaluate the frequency of errors in panoramic radiographs in young orthodontic patients, to register pathologic and abnormal conditions, and to compare these findings with the patients record. A total of 1287 panoramic radiographs of children and adolescents (530 boys and 757 girls; mean age 14.2 years) were analyzed. The radiographs were obtained of patients referred for orthodontic treatment during a 1 year period. Four observers evaluated the radiographs for 10 common errors, pathologies, and/or anomalies. Cohens kappa was used for the calculations of inter- and intraobserver variability. Five of the errors were divided into clinically relevant or not clinically relevant errors, i.e. errors influencing diagnosis. Only those pathological findings with a possible influence on orthodontic treatment were compared with the patients record. Of the 1287 radiographs, 96 per cent had errors. The number of errors in each image varied between 1 and 5, and in 24 per cent of these images, the errors could be of importance for clinical decision making. The most common error was that the tongue was not in contact with the hard palate. Pathologies or anomalies were found in 558 patients and a total of 1221 findings were recorded. Findings of possible relevance for orthodontic treatment were 63, and 12 of those were registered in the patient records. Pathological findings outside the dental arches were low and could be an argument for minimizing the radiation field.

Carious lesions : diagnostic accuracy using pre-calibrated monitor in various ambient light levels : an in vitro study

OBJECTIVES This study investigated the effect of different monitor calibration modes under various ambient lighting conditions on the ability of observers to recognize proximal carious lesions of varying depths. METHODS 7 observers evaluated 100 teeth for proximal carious lesions on standardized digital radiographs using 3 set-ups: (1) pre-calibrated monitor for high ambient light (higher than 1000 lux), (2) pre-calibrated monitor for low ambient light (less than 50 lux) and (3) Barten calibration (Digital Imaging and Communication in Medicine) on the monitor in dimmed ambient light (less than 50 lux). Receiver operating characteristic curves were plotted for all observations. The criterion standard was histological examination of the teeth. The effects of three conditions were compared using a paired t-test. The level of significance was set to p < 0.05. RESULTS No significant difference was found in diagnostic accuracy for the detection of any type of proximal carious lesions between the different calibration modes of the monitor according to different ambient light levels. CONCLUSIONS There is no evidence that any difference between ambient light levels affects the ability to detect carious lesions in digital radiographs as long as the monitor was calibrated in accordance with the surrounding light level.

Evaluation of bone tissue formation in a flat surface attachment of a Bone Conduction Implant - A pilot study in a sheep model

The bone conduction implant (BCI) is a new bone conduction hearing device implanted under intact skin. The transducer has a flat direct contact with the mastoid part of the temporal bone, and no screws are used. The sound signal is transmitted from the external audio processor to the implant by means of magnetic induction. In this study, osseointegration of a flat passive BCI transducer dummy in sheep skulls was assessed using quantitative and qualitative histology as well as cone beam computed tomography (CBCT) and computed tomography (CT). The histology results were also related to the mechanical properties of the bone-to-implant interface. Eight months after the surgical implantation, histology sections of the bone close to the implant showed bone remodeling, compact bone and osseointegration. The histological findings corresponded well to the mechanical measurements indicating stiffer bone close to the implant and unaffected skull vibration transmission. Neither CBCT nor CT had enough resolution to visualize the bone-to-implant interface in detail. In this study, using an animal model, it is shown that a flat implant in contact with bone can be a feasible method for efficient vibration transmission to the skull bone.

Approximal caries increment in adolescents after a visual aid in combination with a comprehensive open discussion

Abstract Objective. To achieve greater motivation for behavioural changes; educating, motivating and supporting the patients ability to change lifestyle factors related to the caries disease are important tasks in the prevention of the disease. The aim of this study was to evaluate whether a visual aid (Visual Caries Dialogue, VCD) in combination with a comprehensive open discussion has a beneficial effect on approximal caries development among a population of young adolescents. Materials and methods. The study subjects were randomized to either an intervention group (n = 118), where VCD was conducted, or a control group (n = 112) receiving traditional oral healthcare information, at the annual dental health examination. The number of caries lesions reaching through the entire enamel (D2) and dentin caries reaching through the enamel into the dentin (D3) were recorded from bitewing radiographs each year, from 2001–2004. Differences between the study groups regarding at least two new approximal surfaces with caries (D2–D3) were tested using logistic regression. Results. The caries increment was lower in the intervention group compared to the control group. During the 3-year follow-up, 18 (15.3%) patients in the intervention group and 40 (35.7%) patients in the control group demonstrated a DS-approximal increment of at least two surfaces with a risk ratio of 2.34 (95% CI = 1.43–3.83). Conclusion. Visual Caries Dialogue in combination with a comprehensive open discussion reduced approximal caries increment among young individuals. The method provides an innovative simple and low-cost way of delivering information to patients and guides busy dental healthcare personnel in the approach.