Bite Patient Research Articles

A dog bite study in a dog rabies-affected area in South Africa.

BackgroundRabies is an untreatable and highly fatal viral zoonosis. Despite the ability to control and prevent the disease, it is estimated that one person dies of rabies every 10 minutes in developing countries. However, the true burden of the disease remains undefined in most developing countries because of a lack of systematic surveillance. Dog bite data obtained from healthcare facilities where dog bite victims seek medical care may provide an additional source of information that can be used to inform the burden of disease and identify points for interventions for improved delivery of post-exposure prophylaxis (PEP) to prevent the disease.MethodsA descriptive epidemiological study was conducted using data obtained from dog bite registers and patient case files at a healthcare facility for a two year period (2015-2017).ResultsThe study reported frequency, demographics, source, geographic and temporal distribution of bite cases reported to a hospital serving a rabies-affected community. In addition, the post-exposure management of dog bite cases at this facility is described.ConclusionDog bites was not an infrequently reported at the healthcare facility, with up to 29 cases reported in a month during the study period. The affected population was defined and it is motivated that this information is useful for targeted health interventions. Findings related to the delivery of PEP may also be used to direct training and re-training of healthcare workers for improved delivery of PEP.

One Health in Practice: Using Integrated Bite Case Management to Increase Detection of Rabid Animals in Tanzania.

Rabies is a neglected zoonotic disease that causes an estimated 59,000 human deaths worldwide annually, mostly in Africa and Asia. A target of zero human deaths from dog-mediated rabies has been set for 2030, and large-scale control programs are now advocated. However, in most low-income endemic countries surveillance to guide rabies control is weak and few cases of rabies are recorded. There is an urgent need to enhance surveillance to improve timely case detection and inform rabies control and prevention, by operationalizing a “One Health” approach. Here we present data from a study piloting Integrated Bite Case Management (IBCM) to support intersectoral collaboration between health and veterinary workers in Tanzania. We trained government staff to implement IBCM, comprising risk assessments of bite patients by health workers, investigations by livestock field officers to diagnose rabid animals, and use of a mobile phone application to support integration. IBCM was introduced across 20 districts in four regions of Tanzania and results reported after 1 year of implementation. Numbers of bite patient presentations to health facilities varied across regions, but following the introduction of IBCM reporting of bite patients at high-risk for rabies more than doubled in all regions. Over 800 high-risk investigations were carried out, with 49% assessed as probable dog rabies cases on the basis of clinical signs, animal outcome, and rapid diagnostic testing. The status of a further 20% of biting animals could not be determined but rabies could not be ruled out. Livestock field officers reported that use of rapid diagnostic tests (RDTs) were useful for confirming rabies occurrence. Overall, our study provides further evidence that IBCM is a practical approach that can improve rabies detection in endemic countries, and be used to monitor the impact of mass dog vaccinations, including potential to verify rabies freedom. However, the main challenges to implementation are limited training of health workers in rabies, perceived burden of real-time recording and limited resources for livestock field officers to undertake investigations. Nonetheless, IBCM dramatically improved case detection and communication between sectors and we recommend further implementation research to establish best practice and applicability to other settings.

Treatment of a Class II Deep Bite Malocclusion Using Orthodontic Mini-Implants: Case Report

Deep bite is due to various dental and skeletal etiologies. The treatment of deep bite includes growth modification, orthodontic treatment (intrusion of the anterior teeth or extrusion of the posterior teeth or combination of the two) and orthognathic surgery. During treatment planning, the orthodontists should consider patient’s growth potential, skeletal pattern, vertical positions of the maxillary incisors relative to the upper lip, occlusal plane, and gummy smile, etc. In the case of Class II patient with mandible deficiency, counterclockwise rotation of the mandible by intrusion of the posterior teeth could improve the facial profile. However, in a Class II deep bite patient, the counterclockwise rotation of the mandible could worsen the deep bite. This clinical case report presents the vertical control of a Class II deep bite malocclusion by distalization of the whole maxillary dentition and intrusion of the anterior teeth using orthodontic mini-implants (OMIs).

The demographics of dog bites due to K-9 (legal intervention) in the United States

BackgroundThere is sparse literature regarding K-9 (legal intervention) dog bites. It was the purpose of this study to analyze the demographics of K-9 dog bites using a national data base. MethodsThis was a retrospective study of prospectively collected data from National Electronic Injury Surveillance System - All Injury Program for years 2005–2013. Patients with dog bites were identified and those due to legal intervention were analyzed. Statistical analyses were performed with SUDAAN 11.0.01™ software. A p < 0.05 was considered statistically significant. ResultsThere were an estimated 32, 951 K-9 dog bite ED visits, accounting for 1.1% of all ED dog bite visits. The K-9 group was nearly all male (95.0 vs 52.1%) and more commonly Black (42.0 vs 13.0%) compared to the non K-9 group. Bites to the head/neck and upper extremity were less frequent and lower extremity bites more frequent in the K-9 group; K-9 bites more commonly occurred outside the home. Within the K-9 group, the proportion of White patients increased with increasing age and smaller hospital size. Patients seen in small and medium size hospitals were in the middle age ranges, while those in the very young and >64 years of age were only seen at large hospitals. The average annual incidence of K-9 dog bites seen in the ED for US was 2.43 per 100,000 males with no changes over time. ConclusionsIn the US, 1.1% of all ED visits for dog bites are due to K-9 intervention with no change in incidence, even though this study spanned the time when it was encouraged to change K-9 intervention; from “find and bite” to “find and bark”. The K-9 dog bite patient is nearly always male, more commonly Black, occurred away from home, and has a 3.7% hospital admission rate. Bites to the head/neck are less common compared to the non K-9 dog bite group.

Clinical and Radiographic Evaluation of Reconstruction and Prosthetic Rehabilitation of mandibular resection defects using iliac grafts combined with implant placement

The aim of the current study was to evaluate efficacy of using iliac grafts combined with implants and retaining a provisional fixed-detachable (hybrid) prosthesis in the reconstruction of mandibular defects regarding average bone loss in graft height, peri-implant marginal bone loss, maximum bite force, facial asymmetry ,patient satisfaction and oral health quality of life (OHRQoL).Patients and methods: 11 patients were subjected to mandibular marginal resection with immediate reconstruction by autogenous iliac crest graft with implant placement. After 6 months they were rehabilitated with provisional screw-retained prosthesis. Radiographic assessment of average bone loss in graft height and marginal bone loss around dental implants was performed. Facial asymmetry, Maximum bite force, Patient satisfaction and oral health quality of life (OHRQoL) were assessed after the first surgery, at loading, 6 and 12 months later.Results: Average bone loss of graft height (mean 2.14±1.03). Average peri-implant Marginal bone loss after 1 year 1.42±0.38. The increase in marginal bone loss along the study period was significant (P<0.001). Maximum bite force of the rehabilitated side increased significantly along the study period. There was a statistically high significant difference between the scores of all OHIP-5 items scores except in the scores of the difficulty doing usual jobs item.Conclusion: Within the limitations of this study, it was concluded that construction of mandibular defect using iliac crest graft combined with dental implants and retaining a provisional fixed- detachable prothesis can be an effective procedure to restore bony defect, facial asymmetry, maximum bite force, patient satisfaction and oral health quality of life.

Microimplant Supported Vertical Control Treatment for Skeletal Class I Dolichofacial Patient with Transverse Discrepancy and Anterior Open Bite

Some open bite can be relieved by intrusion of molars in non-extraction approaches, which is usually suggested for patients with acceptable facial profiles or non-hyperdivergent skeletal patterns. In cephalometric analyses, mesial angulation of molars’ axes is frequently observed in patients with open bite. Therefore, a treatment strategy is to correct anterior open bite by both clockwise rotation of maxillary molars and counter-clockwise rotation of mandibular molars, resulting in uprighting and intruding force of molars. Using this manner, clinicians are recommended to reinforce skeletal anchorage by placing microimplants into alveolar bone between the first and second molars. In this case report, we have successfully treated an anterior open bite patient with transverse disharmony by managing vertical dimension using microimplant. (Clin J Korean Assoc Orthod 2019;9(1):34-44)

Clinicoepidemiology, clinical profile and outcome of venomous snake bite in children in Konaseema region of Andhra Pradesh, India

Background: Venomous snake bite is an acute medical emergency, and children are more quickly and severely affected than adult. Venomous snake bite is responsible for 28.5 deaths per 1000 snake bite death among 5-15years old children. Most of them used to be from rural India and is more common in school going children. But there is no study regarding clinic epidemiology and treatment outcome among pediatric age group in this part of Andhra Pradesh. This retrospective descriptive has been conducted to evaluate the clinic epidemiology, clinical presentation, complication and treatment outcome in snake bite in pediatric patients in our set up.Methods: Present study is a retrospective, descriptive study conducted in the department of paediatrics Konaseema institute of medical science Amalapuram Andhra Pradesh, between 2006 to September 2018. This study protocol is approved by the institutional ethics committee. All the clinical parameters like, age, sex, season of bite, time of bite, socio economic statue, region, site, common clinical presentation, complications, reaction to ASV outcome of treatment were obtained from patient’s case record and was analysed.Results: In present study total 166 snake bite patient case records were evaluated, out of this 166 snake bite cases, 28 bites were by unknown snakes. Demographic profile of patient shows that out of 70 cases, 49 cases were in male child and 21 cases were in female child. Regarding clinical profile of the children with snake bite as mentioned in Table 3, local pain was present in (n=70) 100 % patients. Local blending was presenting symptom in 64.28 %(n=45) patients.Conclusions: From present study authors conclude that snake bite in children is more common among school going children, during monsoon and post monsoon, and in rural area. In our region vasculotoxic snake envanomation is more common and presented with cellulitis which required surgical intervention in most of circumstances. In neurotoxic envenomation some patient developed respiratory paralysis which required ventilatory support.

Clinical profile of acute kidney injury in snake bite patient at tertiary care center

Clinical profile of acute kidney injury in snake bite patient at tertiary care center

On the path to rabies elimination: The need for risk assessments to improve administration of post-exposure prophylaxis

BackgroundCosts of rabies post-exposure prophylaxis (PEP) often remain high in regions where rabies has been controlled in dogs, presenting a challenge for sustaining rabies elimination programmes. We investigated the potential for bite patient risk assessments to improve PEP provision and surveillance in settings approaching elimination of dog-mediated rabies. MethodsWe conducted a longitudinal study of patients presenting to animal bite treatment centres (ABTCs) on the island province of Bohol in the Philippines to investigate the health status of biting dogs and to quantify current expenditure on PEP. ResultsIncidence of bite patients presenting to ABTCs was high (>300/100,000 persons/year) and increasing, resulting in substantial health provider costs. Over $142,000 was spent on PEP in 2013 for a population of 1.3 million. From follow up of 3820 bite patients we found that >92% were bitten by healthy dogs (alive 14 days after the bite) and just 1.4% were bitten by probable or confirmed rabid dogs. The status of dogs that bit 6% of patients could not be determined. During the course of investigations of bites by suspect dogs, we were able to obtain samples for case confirmation, identify exposed persons who had not sought PEP as well as in-contact dogs at risk of developing rabies. We calculate that expenditure on PEP could at least be halved through more judicious approaches to provision of PEP, based on the histories of biting animals determined through risk assessments with bite patients. ConclusionsWe conclude that a One Health approach to surveillance based on Integrated Bite Case Management could improve the sustainability and effectiveness of rabies elimination programmes while also improving patient care by identifying those genuinely in need of lifesaving PEP.

Full-mouth rehabilitation of partial edentulism in a deep bite patient

과도한 수직피개를 가진 과개교합 환자에서 안정적인 유지접촉이 없는 경우 연조직 외상, 치질 파괴, 대합치 정출의 문제가 일어날 수 있고 이는 결과적으로 교합평면의 붕괴와 기능적, 심미적 문제로 이어진다. 치아의 상실과 마모가 발생된 환자에 대한 치료계획 수립 시 올바른 교합수직고경 설정을 통해 환자의 안정적...

Complete oral rehabilitation of a deep bite patient with Ewing’s sarcoma; surgical and prosthetic phases: A clinical report

Introduction: Ewings sarcoma (ES) is an unusual, aggressive malignant neoplasm occurring primarily in the long bones of the lower and upper extremities followed by pelvis, ribs, vertebrae, skull, and jaws-bones. Patients with ES tumor need long-term complete oral reconstruction. The location of the primary tumor in the face is predominantly in the mandible, and usually in the posterior mandible. Case Report: Here, both surgical procedures and prosthetic reconstruction in three stages of a 10-year-old childs life presented. Definitive prosthetic reconstruction is extremely challenging in such patients after previous excessive surgical resection, especially when the patient has complex dental abnormality. Fixed dental prostheses and implant-supported fixed restorations have been selected as the preferred treatment option in this case after increasing occlusal vertical dimension (OVD) to create sufficient interocclusal space (IOS). Discussion: In this case, ES patient treated in three phases. In the first-stage, only surgical resection of tumor and bone graft reconstruction with titanium plate fixation was performed. In the second-stage, Lefort I surgery for maxilla with dental implants insertion in mandible was done simultaneously. For definitive restorations fabrication, it was mandatory to increase occlusal vertical dimension (OVD) to create sufficient inter-occlusal space (IOS) for the restorations. OVD has been altered to achieve more stable relationship of mandibular teeth with maxillary teeth, and to obtain an optimum esthetic and functional result. Several factors should be considered as determinants for increasing the OVD such as remaining tooth structure, the space available for the restorations such as the current situation, occlusal variables, and esthetics.

EFFECT OF ONE VERSUS TWO IMPLANT RETAINED OVERDENTURES ON BITING FORCE, MASTICATORY EFFICIENCY AND PATIENT SATISFACTION

Background: Single symphyseal implant-retained overdentures have been suggested as an alternative to the standard two implant treatment. There is, however, a need for more studies to compare the functional and patient outcome aspects of both treatment modalities. Objective: The aim of this prospective study is to compare the effect of single symphyseal versus two implant mandibular overdentures on the objective variables: maximum bite force (MBF) and masticatory efficiency (ME), in addition to patient satisfaction (PS) as a patient based outcome. Materials and methods: A total of 60 completely edentulous male patients were initially included in this investigation: 50 from three previously published studies and simultaneously participating in this study in addition to 10 new subjects. 53 participants concluded the study. All subjects received new conventional complete dentures. After 2 months adaptation period, patients allocation was carried out into 3 groups based on the type of implant retained mandibular overdenture that will be constructed: Group (1) single symphyseal implants with locator attachments; Group (2) two interforaminal freestanding implants with locator attachments; Group (3) two splinted interforaminal implants with bar-clip attachments. A capacitive sensor was used to evaluate unilateral MBF. Sieve method was implemented for ME assessment. PS was evaluated in 7 functions using visual analogue scale. MBF and ME were assessed 2 months after conventional complete dentures insertion (baseline); and then at 6months, 1year and 2 years after implant functional loading. PS was monitored at baseline and 24 months after implant loading. Level of statistical significance was set at p < 0.05. Results: All subjects reported a significant improvement in MBF, ME and most of PS variables when implants were used in comparison to the baseline status with conventional dentures. No significant differences were observed between MBF and ME findings among the three groups after implant placement. PS function of maintaining hygiene showed less favourable outcomes in group 3. Conclusions: Mandibular implant retained overdentures in contrast to complete dentures improved maximum bite force, masticatory efficiency and patient satisfaction. Outcomes with one and two splinted and unsplinted implants were comparable. Bars, however, complicated hygiene.

Comparison of masticatory efficiency, patient satisfaction for single, two, and three implants supported overdenture in the same patient: A pilot study.

Statement of Problem:Over 30% of the world population suffers from edentulism. Implant supported overdenture have been a relatively successful treatment option for edentulism and have shown to slowed the rate of residual resorption and maintain the vertical height of the residual.Purpose:The purpose of this study was to measure patient masticatary efficiency and satisfaction with the mandibular one-, two-, and three-implant-retained overdenture therapy when compared with conventional denture in a the same patients.Materials and Methods:Ten complete edentulous patients, who were wearing conventional complete dentures, were involved in this study. Three single piece endosseous implant of 3.0 mm in diameter and 13 mm in length were surgically placed in the mandible in the region of B, C, and D. Mandibular denture was connected for single, two, and three implant supported overdenture periodically and checked for masticatory efficiency using a bite gauge and patient satisfaction using a questionnaire.Results:Statistical analysis was done using Wilcoxon signed rank test. Four groups of bite forces when compared to each other. Group 1 was compared with Group 2, with the statistical value showing significance. Signed rank test showed no significance (0.268) when Group 2 was compared with Group 3. When Group 3 was compared with Group 4, and Group 1 compared with Group 4, rank test showed significant values. Four groups were compared with each other for patient satisfaction, Group 1 was compared with Group 2, with the statistical value showing no significance.Conclusions:A single midline implant supported overdenture can be considered as a suitable and cost-effective treatment option over conventional denture. The study concludes that masticatory efficiency of this single midline implant supported overdenture is better than the conventional complete denture.

Full mouth rehabilitation of deep bite patient with segmental osteotomy and orthodontic treatment

Full mouth rehabilitation of deep bite patient with segmental osteotomy and orthodontic treatment

A digital process for additive manufacturing of occlusal splints: a clinical pilot study

The aim of this study was to develop and evaluate a digital process for manufacturing of occlusal splints. An alginate impression was taken from the upper and lower jaws of a patient with temporomandibular disorder owing to cross bite and wear of the teeth, and then digitized using a table laser scanner. The scanned model was repaired using the 3Data Expert software, and a splint was designed with the Viscam RP software. A splint was manufactured from a biocompatible liquid photopolymer by stereolithography. The system employed in the process was SLA 350. The splint was worn nightly for six months. The patient adapted to the splint well and found it comfortable to use. The splint relieved tension in the patient's bite muscles. No sign of tooth wear or significant splint wear was detected after six months of testing. Modern digital technology enables us to manufacture clinically functional occlusal splints, which might reduce costs, dental technician working time and chair-side time. Maximum-dimensional errors of approximately 1 mm were found at thin walls and sharp corners of the splint when compared with the digital model.

Pilot Balloon Malfunction Caused by Endotracheal Tube Bite Blocker

A patient's bite is a frequent cause of endotracheal tube (ETT) obstruction, which affects the volume and pressure delivered by the ventilator. Bite-related ETT obstruction is a frequent cause of ventilator alarm activation, and can cause respiratory failure, negative-pressure pulmonary edema, and

Comparison of patient satisfaction, quality of life, and bite force between elderly edentulous patients wearing mandibular two implant‐supported overdentures and conventional complete dentures after 4 years

This study compared two groups of patients who were elderly and edentulous, one group included subjects who had mandibular overdentures supported by two implants (Group I); the other groups wore conventional complete dentures (Group II). This retrospective study included 100 edentulous patients (50 from each group) with an average age of 67.86 years, who had been followed for 4 years. The groups were compared in terms of patient satisfaction, quality of life (QOL), and bite force. The bite force and patient satisfaction scores of Group I were found to be statistically significantly higher than Group II (p < .05). However, no statistically significant difference was found between the two groups' QOL scores (p > .05) except on the physical pain subscale (p = .013). Based on these results, it can be concluded that after 4 years of function, subjects wearing mandibular overdentures supported by two implants had higher values for bite force and patient satisfaction scores, but similar QOL scores when compared to conventional complete denture-wearers.

Using Emergency Department Data to Conduct Dog and Animal Bite Surveillance in New York City, 2003–2006

Most animal bites in the United States are due to dogs, with approximately 4.7 million reports per year. Surveillance for dog and other animal bites requires a substantial investment of time and resources, and underreporting is common. We described the use and findings of electronic hospital emergency department (ED) chief complaint data to characterize patients and summarize trends in people treated for dog and other animal bites in New York City (NYC) EDs between 2003 and 2006. Retrospective data were obtained from the syndromic surveillance system at the NYC Department of Health and Mental Hygiene. We used a statistical program to identify chief complaint free-text fields as one of four categories of animal bites. We evaluated descriptive statistics and univariate associations on the available demographic data. The findings were also compared with data collected through the existing passive reporting animal bite surveillance system. During the study period, more than 6,000 animal bite patient visits were recorded per year. The proportion of visits for animal bites did not appear to change over time. Dog bites accounted for more than 70% and cat bites accounted for 13% of animal bite patient visits. Demographic characteristics of patients were similar to those identified in NYC's passive surveillance system. Our findings suggest that the use of ED data offers a simple, less resource-intensive, and sustainable way of conducting animal bite surveillance and a novel use of syndromic surveillance data. However, it cannot replace traditional surveillance used to manage individual patients for potential rabies exposures.

Functional cephalometry analysis and computerized axiography before and after therapy with “Function Generating Bite” in a deep bite patient

Background The interest of this case report is the evaluation of the correlation between the condylar pathways and incisor guidance recorded by computerized axiography and functional cephalometry analysis before and after therapy with the “Function Generating Bite” (FGB-D) appliance for deep bite correction.

The influence of implant number and attachment type on maximum bite force of mandibular overdentures: a retrospective study

Assessment of the influence of such factors as attachment type, number of implants, gender and age of patients on maximum bite force (MBF). Sixty-two edentulous patients (32 females, 30 males; aged 64.03 ± 10.07 years, range 42-90 years) with mandibular implant overdentures with various attachment types were included in the study and their MBFs were recorded. The results were evaluated statistically at a significance level of p < 0.05. The MBF in male patients was found to be statistically significantly (p < 0.05) higher than in female patients. No statistically significant differences (p > 0.05) were found with respect to age groups, attachment types and number of implants supporting the mandibular overdentures. Within the limitations of this study, it is concluded that independent of the number applied, dental implants increase MBF in edentulous patients. While males show higher bite force, patient age and attachment type seem not to play an important role.