Tongue Depressor Research Articles

Exploring Trismus Management in Australia: A Mixed Methods Evaluation of Surveys and Interviews With Health Professionals.

This study evaluates how health care professionals manage trismus in Australia and identifies facilitators and barriers experienced by clinicians in routine patient care. A mixed-methods approach was used to evaluate the experience of clinicians. Medical, nursing, and allied health practitioners in Australia were invited to participate if they had treated patients with trismus in the last 5 years. Participants completed an investigator-designed survey and were invited to participate in a semi-structured audio-recorded interview to explore practice in more depth. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed thematically using an inductive, data-driven approach. Fifty-six clinicians (38 speech pathologists, 9 physiotherapists, 7 medical doctors, 1 nurse, and 1 osteopath) completed the survey, 12 of which also participated in an interview. The most common assessment tool was a commercially available measurement tool (Therabite or Orastretch), the most common treatment approach was stacked tongue depressors, and the most common exercise regimen was a 30- s stretch 25 times per day. Common barriers to trismus management included the high cost of devices, lack of clinical experience, and lack of training opportunities outside their institution. Clinician-perceived facilitators were different modes of information provision and time to consider the exercise instructions and rationale. Several clinicians relied on telehealth to reach patients in remote locations and improve efficiency. A range of clinicians treat trismus arising from a variety of conditions. Training opportunities are critical for clinicians to develop and extend their skills in assessing and treating trismus. The morbidity associated with trismus, and the absence of a clinical guideline or consensus document warrants careful consideration as to the translation of evidence into the clinical context.

Differential neuromotor control of the vertical and longitudinal genioglossus muscle fibers: An overlooked tongue retractor

IntroductionThe genioglossus (GG) is known to be the main tongue protrusor, and therefore plays a major role in breathing. However, due to the fan shape of the GG fibers, it could be assumed that contraction of the anterior fibers of the GG do not cause tongue protrusion. In this study, we examined the effect of contraction of the anterior-vertical fibers of the GG (GGV) on the tongue and their EMG activity during wakefulness and sleep. The findings were compared to those of the longitudinal fibers (GGL), which, based on their orientation, are responsible for tongue protrusion. MethodsFine-wire electrode pairs were placed into the GGV and GGL in 11 patients with untreated OSA. Movement of the tongue during electrical stimulation at each site was videoed. The same electrodes were used to record EMG from both sites during respiratory stimulation by inspiratory loading and CO2 rebreathing during wakefulness. During sleep, repetitive flow limitation events were induced with low-level CPAP to augment GG activity. ResultsIn all participants, electrical stimulation of GGL and GGV protruded and retracted the tongue, respectively. Respiratory stimulation increased GG activity, but GGV reached only 39 % and 23 % of peak GGL activity during high resistive loading and PCO2 of 65 mmHg, respectively. Flow limitation during sleep increased GGL to levels that were considerably higher than awake baseline, but GGV activity remained tonic or with minimal phasic activity, reaching on average 15 % of GGL peak activity. ConclusionsOur electrical stimulation findings indicate that GGV is a tongue retractor and depressor. Tongue stimulation for OSA should avoid this area. The EMG results demonstrate that the anterior part of the GG is controlled very differently from the longitudinal protrusive fibers. The GGV responses are similar to those previously found in tongue retractors and peri-pharyngeal muscles other than the GG, in which diminished activation during sleep is likely to be involved in the failure of increasing GGL activity to alleviate flow limitation.

Exploring the integrated potential of pyrolysis and low-temperature wet torrefaction for typical medical waste valorization: A multifaceted approach leveraging online TG-FTIR-MS, 2D-COS, iso-conversional kinetics, and reaction mechanisms

The rapid growth of medical waste, exacerbated by the COVID-19 pandemic and advancements in healthcare, has drawn increased public scrutiny regarding its proper disposal and treatment. This research aimed to characterize the wet torrefaction of a typical medical waste biomass (MWB) composition, comprising bamboo swabs, skewers, splints, cotton balls, tongue depressors, toothpicks, and chopsticks, followed by its co-pyrolysis with medical waste plastic (MWP) including catheter bags, drapes, IV tubing, IV bags, oxygen masks, syringes, and test tubes. The study employed thermogravimetric analysis, TG-FTIR, 2D correlation spectroscopy, iso-conversional kinetics, and mass spectrometry techniques elucidated the driving factors, behaviors, products, mechanisms, and pathways involved. The pyrolysis temperature ranges were 180.15 to 400 °C for TMWB and 380.04 to 550 °C for MWP, with average activation energies of 150.22 and 221.59 kJ/mol for their respective devolatilization processes. Incorporating 20 % and 40 % MWP into the co-pyrolysis process yielded the best performance, characterized by the lowest activation energy. The co-pyrolysis process promoted the release of cyclic hydrocarbons and chain hydrocarbons, but decreased the yields of alcohols, esters, ethers, phenols, and acids, through synergistic mechanisms. Unraveling the pyrolysis pathways and dynamics of these representative medical waste streams offers valuable insights into improving energy recovery, mitigating pollution, diminishing waste volumes, and optimizing industrial thermochemical conversion processes for safely treating these hazardous materials.

Tongue depressor (bio)sensors: A fast decentralized self-testing of salivary biomarkers for personalized medicine

The clinical tests usually make use of blood samples, requiring invasive sample collection protocols, which are not appropriate for decentralized, frequent, and point-of-care (POC) applications. Here, we report disposable (bio)sensors combining electrochemical and colorimetric technologies on an accessible and lightweight wooden tongue depressor platform. The array of (bio)sensors on this commonly used medical tool enables rapid, and safe saliva sampling and showed promise to be used for frequent self-testing of four clinically relevant biomarkers (glucose, uric acid, nitrite, and thiocyanate) in saliva. The electrochemical system was designed to detect uric acid and glucose by chronoamperometric measurements in clinically relevant concentrations ranging from 50 to 500 µmol L−1 and from 10 to 5000 µmol L−1, respectively. Meanwhile, the colorimetric paper-based spot tests were optimized to detect nitrite and thiocyanate in concentrations ranging from 5 to 200 µmol L−1 and 0.5 to 2.1 mmol L−1, respectively, using digital image colorimetry. Our affordable tongue depressor (bio)sensors provide results within 5 min and achieve limits of detection in the µmol L−1 range. Importantly, the results provided by our tests when applied to human saliva samples presented excellent concordance with the traditional spectrophotometric method (at a 95 % confidence level), demonstrating the reliability and robustness of our method. In addition, the toxicity and biocompatibility studies of the tongue depressor (bio)sensors were evaluated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), Calcein acetoxymethyl ester (Calcein AM), and Calcein Propidium Iodide Hoechst (Calcein PI) Analysis, confirming the safety use of the test. Therefore, our tongue depressor (bio)sensor facilitates frequent testing of several biomarkers and can contribute to personalized medicine.

Effects of canopy gaps on microclimate, soil biological activity and their relationship in a European mixed floodplain forest

Forest canopy gaps can influence understorey microclimate and ecosystem functions such as decomposition. Gaps can arise from silviculture or tree mortality, increasingly influenced by climate change. However, to what degree canopy gaps affect the buffered microclimate in the understorey under macroclimatic changes is unclear. We, therefore, investigated the effect of forest gaps differing in structure and size (25 gaps: single tree gaps up to 0.67 ha cuttings) on microclimate and soil biological activity compared to closed forest in a European mixed floodplain forest. During the investigation period in the drought year 2022 between May and October, mean soil moisture and temperature as well as soil and air temperature fluctuations increased with increasing openness. In summer, the highest difference of monthly means between cuttings and closed forest in the topsoil was 3.98 ± 9.43 % volumetric moisture and 2.05 ± 0.89 °C temperature, and in the air at 30 cm height 0.61 ± 0.35 °C temperature. For buffering, both the over- and understorey tree layers appeared as relevant with a particularly strong influence of understorey density on soil temperature. Three experiments, investigating soil biological activity by quantifying decomposition rates of tea and wooden spatulas as well as mesofauna feeding activity with bait-lamina stripes, revealed no significant differences between gaps and closed forest. However, we found a positive significant effect of mean soil temperature on feeding activity throughout the season. Although soil moisture decreased during this period, it showed no counteracting effect on feeding activity. Generally, very few significant relationships were observed between microclimate and soil biological activity in single experiments. Despite the dry growing season, decomposition rates remained high, suggesting temperature had a stronger influence than soil moisture. We conclude that the microclimatic differences within the gap gradient of our experiment were not strong enough to affect soil biological activity considerably.

Prevalence of Dental Anomalies Among the Pediatric Population at Abbasi Shaheed Hospital, Karachi, Pakistan: A Cross-Sectional Survey

Background: Pediatric dental anomalies refer to irregularities or abnormalities in the development, structure, or positioning of the teeth in the oral cavity of children. These anomalies can encompass a wide range of conditions that affect the number, size, shape, and structure of teeth. In Karachi, there is limited evidence regarding the prevalence of dental anomalies in children. Objective: This study investigated the prevalence of dental anomalies in the pediatric population of the Abbasi Shaheed Hospital, Karachi, Pakistan. Material and Methods: A cross-sectional study was conducted among 278 children aged between 3 and 12 years. The socio-demographic and thorough medical history were recorded on a predesigned performa. The diagnosis of all dental anomalies was based on clinical interpretation using sterilized mouth mirrors, probes, or tongue depressors. Difficult cases were addressed by senior faculty members. Data analysis was conducted using SPSS version 19. Descriptive statistics were used to present the frequency and Mean ± SD. Result: The prevalence of dental anomalies was 7.4%. in the study area. Male-to-female ratio was 2.2:1. Boys exhibited a higher prevalence of 10.05% compared to girls (4.3%). Peg Lateral Incisors and Fusion/Gemination were the most common anomalies among both genders. Dilaceration, Dentinogenesis Imperfecta, Amelogenesis Imperfecta, Talon Cusp, Anodontia, and supernumerary Tooth (disto-molar) were not identified in either boys or girls. The highest number of dental anomalies was recorded at ages 11 and 12 years. Conclusion: The prevalence of dental anomalies was high in the study area, underscoring the significance of early diagnosis and careful management to prevent complications.

Wooden tongue depressors as oviposition substrate for the detection of container-breeding Aedes species in ovitraps – Do we miss something?

Wooden tongue depressors as oviposition substrate for the detection of container-breeding Aedes species in ovitraps – Do we miss something?

Assessment of the Oral Health Status of Patients Admitted to Pediatric Intensive Care Units: A Cross-Sectional Study.

It is important to detect oral health problems early among patients admitted to pediatric intensive care units to establish the diagnosis and consequently allow nurses to plan appropriate oral care practices. The study aimed to assess the oral health status of patients admitted to pediatric intensive care units. This descriptive cross-sectional study was conducted from June to September 2021 in the pediatric intensive care units of 3 hospitals. A total of 88 children were included in the study. An intraoral assessment was performed using a tongue depressor and a flashlight, and data were collected using a patient information form and the Oral Assessment Guide (OAG). The mean OAG score was 8.45 ± 2.876 points. A significant difference was found in the OAG score between the patients 60 months or younger and those 61 months or older (P < .05). The OAG score was significantly associated with the use of diuretics (P < .05) and the frequency of oral care (P < .05). A negative relationship was found between the OAG score and the Glasgow Coma Scale score (P < .05). The oral health status of the patients worsened as their age increased, and their state of consciousness decreased. Oral care was more frequently applied to the patients who received artificial respiration. The study provides evidence-based data regarding the early detection of the factors threatening oral health and the necessary precautions.

Micronuclei as an indicator of genotoxic change in epithelial cells of buccal mucosa after panoramic radiographs.

The radiation released at the time of dental panoramic radiographs causes genotoxic and cytotoxic effects on epithelial cells. This research aimed to evaluate the changes in the frequencies of micronucleated cells in patients' buccal epithelial cells following dental panoramic radiography. 74 patients were recruited for the study who were advised for panoramic radiographs. Using a wooden spatula, the buccal epithelial cells were scraped from both cheeks before to panoramic radiation exposure and ten days after the panoramic radiation exposure. Giemsa stain was used to stain the cells, and 500 cells were scored on a slide to determine the frequency of micronuclei. To determine the difference between the frequency of micronuclei before and after radiation exposure, a paired t-test was used in the statistical analysis. The proportion of micronuclei cells was 0.11% before radiation exposure and 0.57% following radiation exposure after 10 days. A statistically significant increase in the frequencies of micronuclei was noted after radiation exposure values. This study revealed the genotoxicity of epithelial cells with dental panoramic radiation exposure. It is advised to reduce the use of such radiographs and to use only when there is no other diagnostic tool that is helpful or when absolutely essential.

Cytomorphometric analysis: A possible adjunct for age estimation

Abstract Background: Age estimation plays a crucial role in identifying an unknown individual in the event of any mass disaster or crime. One of the important noninvasive procedures that may have an impact on determining an individual’s age is exfoliative cytology. Aim and Objective: Exfoliated buccal mucosa cells were used in the study to determine the participant’s age by assessing the changes in nuclear diameter (ND), nuclear–cytoplasmic (N: C) ratio, and cell diameter (CD). Materials and Methods: With the help of a moistened wooden spatula and a light scraping motion, buccal smears were taken from 100 healthy and normal individuals across various age groups. The samples were then preserved with 95% ethanol and stained using ultrafast Papanicolaou stain. Cell and nuclear diameter were measured for each of these cells using the ImageJ software, and N: C was calculated from the two parameters. The N: C was calculated from CD and ND for each subject. One-way ANOVA tests were used for statistical analysis. Results: A significant difference in the diameter of cell and nucleus with the individual’s age (P &lt; 0.05) was noticed. The N: C ratio reduces with increasing age but is not consistent. Conclusion: Buccal smears show age-related alterations that could be utilized as an effective tool for age estimation.

Development of Human-Size Swallowing Robot

The number of patients with swallowing disorders is increasing according to the aging of society, although swallowing plays a significant role in the dietary process. The process of swallowing includes a very fast reflexive motion; there are difficulties in analyzing its mechanism even with the latest medical imaging technologies. In recent years, a simulator, named “Swallow Vision®,” has been developed from medical images such as MRI and CT to clearly visualize swallowing motion. It enables us to understand the kinesiology and analyze the motion of organs in swallowing. By using kinematic data obtained from this simulator and referring to medical knowledge, we develop a robotic simulator that has the potential to mimic human swallowing motion. The robot is able to perform tongue depressor and pharynx contraction to swallow food bolus. A performance evaluation is conducted to determine whether it is possible to swallow food bolus properly or where the bolus remains when failing.

An Examination of Improvement in Swallowing and Speech Production on the Quality of Life Among Children with Cerebral Palsy in Mombasa County, Kenya

The purpose of this research was to examine if an improvement in swallowing and speech production can increase the quality of life among children with Cerebral Palsy (CP). Dynamic Systems Theory by Smith and Thelen (1995) was adopted. Case study design was adopted for the study which allowed a researcher to look into a single subject in depth. Piloting was done at the Association for the Physically Disabled of Kenya (APDK), Mombasa County. Purposive sampling was employed to sample children between 3-8 years of age with Cerebral Palsy. Modified speech assessment tools and a list of the evidence-based swallowing exercises were used to collect data. Data analysis was carried out using both qualitative and quantitative methods. Data was analyzed using Statistical Package for Social Sciences (SPSS, version 24.0) and descriptive statistics of frequencies and percentages were used to summarize the demographic information. Analysis of Covariance (ANCOVA) for the pre-treatment and post treatment engaging swallowing exercises was computed at .05 alpha level. Tables and graphs were used to present the data. A p-value &lt; 0.05 was considered statistically significant if there were differences in the mean ranks of the responses. Findings revealed that before treatment through swallowing exercises, an average of one child with CP could communicate through speech and was able to feed variety of food without problems. However, after the administration of swallowing exercise during the eighth week, an average of children with CP across all the groups were able to communicate through speech and feed a variety of food without help The use of tongue extension, tongue retraction , tongue tip up, elevating tongue towards palate, opening of the jaw, circular movement of the jaw and lip press on tongue depressor had the highest mean rank implying that they had better effects on speech and vocal quality among children with CP under the study. The study concludes that apart from enhancing speech production, swallowing exercises positively impacted on quality of life among children with CP. The study recommends the government should create awareness regarding the need to promote speech therapy courses and medical education to increase the number of available speech therapists. Keywords: improvement in swallowing exercise; speech production; quality of life; children with Cerebral Palsy

Open time studies of cold curing polyurethane adhesives using a standardized spatula test setup suitable for near-production conditions

The presented studies introduce a new set-up and method to analyse the maximum open time of cold curing adhesives in a production environment. By using this new set-up, a manual spatula test, Attenuated Total Reflection Fourier Transform Infrared Spectroscopy (ATR-FTIR) and a rheological method, the curing reaction of two cold curing two component polyurethane adhesives, were investigated. Furthermore, the effect of different joining times on the bonding behaviour were investigated using single lap shear samples.The lap shear tests showed that the prior problem for industrial applications is the dimensional accuracy rather than the adhesion to the substrates as all samples showed cohesive or substrate near cohesive failure even when joined after the maximum open time. All used methods showed a coherent curing behaviour for both adhesives. However, the derived times as well as their accuracies vary depending on the used method. Using the easy manual spatula test, the open time is determined by the sensory feelings of the testing person while pressing a wooden spatula into the adhesive bead and is often used in industrial applications. However, the accuracy lies only within 10–20 s especially for slow curing adhesives. In comparison, the ATR-FTIR method, which is based on the decrease of the isocyanate group during the reaction, showed shorter times, whereas longer times were determined by observing the complex viscosity increase of the rheological measurements. Even though the ATR-FTIR and rheological measurements showed reproducible times due to the required laboratory environment and testing procedure, they are therefore not suitable for production conditions. As the introduced new method is based on the manual spatula test, it is suitable for the production environment with the advantage of a good reproducibility. Furthermore, with this method decreasing maximum open times were observed for increasing bead cross sections.

Preoperative, Intraoperative and Postoperative Assessment of Pelvic Organ Prolapse by Pelvic Organ Prolapse Quantification System and Surgical Outcome

Background: Pelvic organ prolapse (POP) is a common disease of middle aged and elderly women with an incidence of 7-10% and life time risk for surgery 11 to 20%. Assessing pelvic organ prolapsed in an objective, reproducible and applicable method is essential to have successful surgical outcome. Aim of the study was preoperative, intraoperative pre and postsurgical as well as postoperative assessment of pelvic organ prolapse by POP- Q system in patients undergoing reconstructive surgery and measure optimum surgical outcome stage 0 (Q&lt;-1), Tvl &gt; 4 cm and Genital hiatus (3 to 3.4cm) to prevent recurrence (POP-Q stage &gt; -1) and dyspareunia (Pb d”3 cm). Methods : This was hospital based Prospective study done with 250 patient diagnosed as pelvic organ prolapse at OPD. Excluding 14 patients 236 had surgery in Chattagram Metropolitan Hospital during January 2010 to December 2019. POP-Q measurement was done with Valsalva before anesthesia, intraoperative after anesthesia pre and postsurgical and postoperatively in follow up visit within three months of surgery by same surgeon. All POPQ measurement were done by same surgeon using a wooden Spatula marked in cm (POP-Q popsicle stick). All measurement were recorded in grid form and preoperative &amp; presurgical POP-Q staging was done. The result was then summarized as mean and SD for numerical variable and percentage for categorical variable. Result : A total 236 patient had surgery, 233 had vaginal hysterectomy with Apical vaginal suspension with uterosacral ligament and sacrospinous fixation was done in 3 patients with vault prolapse. Mean age was 51 ± 5SD years (51 to 60 years 51%), 84% sexually active, low socioeconomic group (68%), multiparous 100% mean parity 4 ± 2SD (e” 6 62%), 95% had vaginal delivery with history of home delivery 89%, resuming house hold work within two weeks of delivery in 97% cases. Most were postmenopausal 96%. All intraoperative presurgical measurement except Pb and Tvl showed significant higher descent as compared to preoperative finding before anesthesia, mean difference were Aa 0.7, Ba1.6, C 1.6, Ap 0.25 Bp 1.6 D1.6 Gh. 8cm with highest descent in Ba C, D Bp. Immediate postsurgical measurement all patient showed optimum anatomical outcome (stage 0). But follow up within 3 month (10 to 90 days) 13 patient showed satisfactory anatomical outcome (stage 1 Q&lt;-1)) with no recurrence (Q&gt;-1) nor dyspareunia. Total vaginal length and Pb no change in measurement before and after anesthesia but Tvl reduced by 2.3 cm and Pb increased by .3cm postsurgical. Presurgical measurementof Gh increased by. 8cm but reduced to 3.5 cm postsurgical. No significant difference in postsurgical intraoperative measurements during follow up within 3 months except Gh (3.2 cm) which is narrower even with valsalva menovure. Conclusion : POP-Q technique in assessment of Pelvic organ prolapse was anatomically site specific and is with good reproducibility and less intra and inter observer variation. Significant difference in descent alert surgeon to plan surgical technique to have optimum anatomical outcome and prevent recurrence and dysparunea. Bangladesh J Obstet Gynaecol, 2022; Vol. 37(2): 109-118

Comparison of the effectiveness of various valsalva maneuvers in the management of stable narrow and wide QRS complex tachycardia in the emergency department

Purpose: Narrow and wide QRS complex tachycardias are among the causes of arrhythmia in patients frequently admitted to the emergency department (ED). The first recommended step in the management of patients with a stable narrow and wide QRS tachycardia is a vagal maneuver. Althougah there are many maneuvers that can provide vagal stimulation, the most effective vagal maneuver is still unknown. This study aims at determining the most effective vagal maneuver by comparing the four most commonly used maneuvers.&#x0D; Materials and methods: One hundred and thirty-two patients were included in this study; they were randomly and equally distributed into four groups. Carotid sinus massage (CSM) was applied to the first group, the REVERT method was applied to the second group (a 10-cc injector was used), a modified REVERT method was applied to the third group (a 60-cc injector was used), and the abeslang (wooden tongue depressor) method was applied to the fourth group. During these four applications, the patients’ vital signs were monitored, and preparations were made for any emergency.&#x0D; Results: Of the 132 patients included in the study, 61 (46.2%) were males, and 71 (53.8%) were females. The average age of the patients was 56.3 years. One hundred and twenty-six had narrow QRS tachycardias, and 6 had stable wide QRS tachycardias. The patients were randomly distributed into 4 groups. In the 1st group, 1 patient (3%) returned to a normal rhythm with the CSM method. In the 2nd group, 3 patients (9.1%) returned to a normal rhythm with the REVERT method. Nine patients (27.3%) in the 3rd group returned to a normal rhythm with the modified REVERT method. 6 patients (18.2%) in the 4th group returned to normal rhythm with the abeslang method. None of the stable wide QRS tachycardias responded to vagal stimulation methods.&#x0D; Conclusion: The modified REVERT and abeslang methods are preferred primarily in patients entering the ED with the complaint of a stable narrow or wide QRS tachycardia in the case that a vagal maneuver is to be applied. On the other hand, a vagal maneuver is not effective in the management of a stable wide QRS tachycardia.

PREVALENCE OF STOMATOLOGICAL ALTERATIONS IN PREGNANT WOMEN FROM THE CITY OF CURITIBA, BRAZIL

Objective Determine the prevalence of diseases or alterations in oral soft tissues of pregnant women attended to care at the "Unidade de Saúde Mãe Curitibana", Curitiba, Brazil. Study Design A cross-sectional and observational study, linked to the "Coorte de Saúde Materno-Infantil de Curitiba (COOSMIC)", whose sample consisted of 187 pregnant women, mean age 25.28 years (± 6.63). All pregnant women were interviewed with a questionnaire, regardless of any prenatal period, followed by extraoral and intraoral examinations, using ambient light, mouth mirrors, periodontal probes, and wooden spatulas. Results The results were analyzed descriptively. From the 187 pregnant women, 152 (81.28%) presented no stomatological alterations. Thirty-five (8.71%) pregnant women presented the following isolated oral alterations: fissured tongue (31.42%), benign migratory glossitis (22.85%), depapillated tongue (2.85%), herpes simplex (2.85%), and pyogenic granuloma (2.85%). Three pregnant women had more than one alteration: benign migratory glossitis and fissured tongue (2.85%), ankyloglossia and depapillated tongue (2.85%), and ankyloglossia and fissured tongue (2.85%). Other different conditions from those above mentioned were present in 10 (28.57%) cases. Conclusion The most prevalent conditions in pregnant women was fissured tongue (N=11; 31.42%), and benign migratory glossitis (N=8; 22.85%). Dental care of pregnant women is essential for their oral health maintenance. Determine the prevalence of diseases or alterations in oral soft tissues of pregnant women attended to care at the "Unidade de Saúde Mãe Curitibana", Curitiba, Brazil. A cross-sectional and observational study, linked to the "Coorte de Saúde Materno-Infantil de Curitiba (COOSMIC)", whose sample consisted of 187 pregnant women, mean age 25.28 years (± 6.63). All pregnant women were interviewed with a questionnaire, regardless of any prenatal period, followed by extraoral and intraoral examinations, using ambient light, mouth mirrors, periodontal probes, and wooden spatulas. The results were analyzed descriptively. From the 187 pregnant women, 152 (81.28%) presented no stomatological alterations. Thirty-five (8.71%) pregnant women presented the following isolated oral alterations: fissured tongue (31.42%), benign migratory glossitis (22.85%), depapillated tongue (2.85%), herpes simplex (2.85%), and pyogenic granuloma (2.85%). Three pregnant women had more than one alteration: benign migratory glossitis and fissured tongue (2.85%), ankyloglossia and depapillated tongue (2.85%), and ankyloglossia and fissured tongue (2.85%). Other different conditions from those above mentioned were present in 10 (28.57%) cases. The most prevalent conditions in pregnant women was fissured tongue (N=11; 31.42%), and benign migratory glossitis (N=8; 22.85%). Dental care of pregnant women is essential for their oral health maintenance.

The evaluation of TheraBite and wooden tongue depressor in the treatment of trismus and health-related quality of life.

This study aimed to compare the efficacy of TheraBite system and a wooden tongue depressor in head and neck cancer (HNC) patients and assess their quality of life (QoL) using modified questionnaires. The effects of exercise using TheraBite and a wooden tongue depressor on trismus were evaluated in 40 HNC and 10 healthy individuals. All patients performed the exercise program for 3 weeks, with a follow-up session. The patients' pre-treatment and post-treatment mouth opening (MO) values were recorded. The HNC patients completed the QoL questionnaire after the treatment. The highest mean value of MO pre-treatment scores was recorded in the control group (p < 0.05). The differences among all the scores for QoL questionnaires were insignificant (p > 0.05). TheraBite system increased MO compared to a wooden tongue depressor. The questionnaire revealed that radiotherapy had side effects on patients.

755 3D Printed Mouth Stretcher

Abstract Introduction Microstomia can impede eating, speech, dental care, and surgical procedures (intubation). MPAs (microstomia preventative appliance/apparatus) are often used to manage burns around the mouth where there can be tightness in the oral commissures (microstomia). MPAs, however, are becoming more difficult to attain. Burn center therapy departments have been trying to find, or develop, a comparable replacement. Having been able to procure a 3D printer, our department is now able to print this new design. It has been trialed with a patient who reports the device is comfortable to wear and easy to use. Methods In developing a device to incrementally spread the oral commissures, different “garage tools” (C-clamp, caliper, wrench, etc) were trialed. From these ideas, this ratcheting slide version was determined to be the most durable and simple to use. The “clamp” ends were replaced with interchangeable “spools”. It is printed with a plastic filament called PLA (polylactic acid) and took between 100 minutes to 200 minutes to print all pieces of the mouth stretcher depended on the size of the device. The total cost to print ranges from $1.00 to $2.00 per device depending on the size. The main support, the slider, and the spools each need their own STL file, but were designed synchronously so that the parts all fit together properly. This mouth stretcher can be resized via different sized spools or made on a smaller scale for a pediatric version. It can also be used as a horizontal mouth stretcher (instead of using layers of tongue depressors). Results Our adult patient was able to improve his oral commissure measurements and he reports the device was comfortable and he was even able to sleep with it. The patient was able to increase the horizontal opening of his mouth 1 cm and vertical opening of his mouth 1.25 cm with inconsistent use over 9 months as he needed to take breaks due to another eye surgery during this time. Conclusions Stretching the oral commissures can be done cost-effectively (once a 3D printer is available) and easily used with minimal instruction for the patient. It could be trialed with varying sizes and shapes of “spools” for improving patient comfort and to minimize any areas of tissue breakdown (pressure sores) in the mouth. Past use of microsomia splints have been very beneficial, increasing mouth ROM which can diminish likelihood of surgical reconstruction and decrease the possibility of eversion of lower lip. Applicability of Research to Practice It may be difficult to provide for patients due to the expense of procuring a 3D printer and requires knowledge of 3D printing. However, as 3D printing becomes more commonplace in schools, hospitals, and homes, there will be increasing opportunity for further creativity, innovation, and use in the burn world.

Hallux Valgus Bunion Splint: Surgical Dressing Technique.

Hallux valgus is a common condition with a complex etiology resulting in numerous treatment options. Recurrence of the deformity can occur following correction. Surgical technique and possibly also postoperative care play a role in reducing recurrence rates. This article highlights a postoperative surgical dressing technique which allows for semirigid support during the immediate postoperative period. A wooden tongue depressor placed along the medial border of the hallux comprises the primary support for the dressing. The rigidity of the tongue depressor allows for the hallux to be drawn toward the depressor, encouraging neutral alignment of the hallux. Dressings are removed 2 weeks postoperatively, with new dressings applied in similar fashion and maintained in place until 6 weeks postoperatively. Based upon our observations, our surgical dressing technique provides sufficient support following hallux valgus correction surgery while being straightforward to replicate without the need for frequent dressing changes. The dressing materials are of negligible cost and are typically readily available. No associated wound complications have been observed. We present an easily replicable and affordable option for postoperative hallux valgus correction surgical dressings. Level V: Expert Opinion.

Sister Marie Joseph Nodule in a Polypathological Patient: Study of an Observation at the Dermatology Hospital of Bamako (Mali)

Summary: Sister Mary Joseph nodule is a metastatic localization with a generally abdominal-pelvic origin and secondary to a primary adenocarcinoma in 90% of cases. We report an observation of Sister Mary Joseph nodule revealing a primary adenocarcinoma of the colon in a young adult with multiple pathologies. Observation: A 57-year-old patient, followed for hepatitis B, HIV1+, and benefiting from a therapeutic regimen (Tenofovir+Lamivudine+Dolutegravir) since 2019 and later a hyperthyroidism of incidental discovery. For one year he has had a firm nodular ulceration measuring 07 cm in its longest axis, with a reddish-pink appearance and whitish deposits, a haemorrhagic ooze on contact, and located at the umbilicus. Also, a tongue laden with whitish coatings that are easily removed with a tongue depressor and the inner surface of the cheeks and palate are erythematous. Bilateral exophthalmos abolished vocal vibrations in both lung bases; two hard left inguinal adenopathies adhering to the deep plane, painless, 3 cm in diameter each. He also described episodes of alternating constipation and diarrhoea accompanied by abdominal pain, coughing, physical asthenia and weight loss (40% loss in 2 years). Anatomopathology of a fragment of the nodule revealed a well-differentiated adenocarcinoma whose tumour cells were of colorectal origin and expressed CK20 and CK8/18. Colonoscopy revealed a multilobed polyploid tumour of the ascending colon and histology concluded that it was a liberkuhnian adenocarcinoma. A chest CT scan revealed pulmonary and abdominal-pelvic metastases and the diagnosis of a Sister Mary Joseph nodule revealing a colonic and metastatic adenocarcinoma was made. The patient was referred to the oncology department for palliative care after the surgical opinion. Conclusion: The nodule of Sister Marie Joseph is a cutaneous metastasis revealing a cancer of the abdominopelvic sphere. This rare and characteristic tumour deserves to be known by practitioners .......