Still Scholarworks (A.T. Still University)
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A Multisegmental Approach to Dry Needling Plantar Fasciitis: A Case Study
No full textContext: Plantar heel pain is a common problem affecting foot function, causing pain in the foot under the heel. Plantar fasciitis is commonly treated with conservative treatment, such as joint and soft tissue mobilization, self-stretching home programs, foot orthoses, and night splinting or booting. Dry needling (DN) has shown to be an effective method of treating plantar fasciitis (PF) in multiple randomized control trials. Dry needling is a technique that has been reported to be beneficial in managing pain and dysfunction after PF. Still, there is limited published literature on DN, a myofascial sequence as part of the treatment of PF. Case Presentation: The patient was a 38-year-old female runner referred by a podiatrist for evaluation and treatment to include DN and therapy for persistent PF in the right foot. She was treated 4 times over 3 weeks with a home exercise program. Management and Outcomes: The DN intervention was beyond the local plantar fascia and incorporated 11 locations from the foot up the posterior chain and 2 electric stim channels. The patient had reduced pain as measured by a visual analog scale, increased function as measured by the functional ankle disability index, and range of motion increases. Conclusions: This case illustrates the use of DN and a home exercise program to provide a favorable outcome in a patient with PF
Do Cognitive Behavioral Therapy Techniques Reduce Symptom Duration in Children and Adolescents Who Have Sustained a Mild Traumatic Brain Injury?
No full textFocused Clinical Question: Does cognitive behavioral therapy (CBT) reduce concussion symptoms among children and adolescents following mild traumatic brain injury? Clinical Bottom Line: Based on the results of this critically appraised topic, there is moderate evidence to support the use of CBT as a treatment intervention to reduce complaints of persistent concussion symptoms in children and adolescents
Sclerosing odontogenic carcinoma: report of a case and review of the literature
No full textBackground
Sclerosing odontogenic carcinoma is an exceedingly rare gnathic malignancy first described by Koutlas et al. in 2008, and was only recently designated as a distinct pathologic entity by World Health Organization in the 2017 Classification of Head and Neck Tumors. To date, fewer than fifteen cases of this neoplasm have been reported in the English language literature. This tumor is characterized by thin cords, strands, and small nests of epithelium in a densely sclerotic stroma. In some tumor foci, the density of the stroma may be sufficient to compress the epithelial component beyond detection in the absence of immunohistochemistry, thus rendering this entity a particularly challenging diagnosis in small sample sizes. Methods
A 55-year-old male presented with an asymptomatic lesion of posterior left maxilla. Cone beam computed tomography (CBCT) demonstrated a large, well-defined bony lesion with scalloped border, spanning from canine to first molar. External root resorption of the adjacent teeth was also noted. Microscopic examination of the biopsy specimen revealed an odontogenic tumor with features consistent with sclerosing odontogenic carcinoma. Immunohistochemical staining was performed to confirm the diagnosis. Results
The tumor was positive for CK5/6, CK19, E-cadherin, p63 and negative for CK20 and CK7. Conclusion
Sclerosing odontogenic carcinoma is a rare, low-grade malignancy of odontogenic origin, which represents a diagnosis of exclusion in many cases. An immunohistochemical profile demonstrating positivity for markers including CK5/6, CK19, p63, and E-cadherin, in addition to a set of pertinent negative findings, can aid in the diagnosis of this tumor. This entity appears to lack metastatic potential despite its locally destructive behavior and a common histologic finding of perineural invasion
CAD/CAM lithium disilicate ceramic crowns: Effect of occlusal thickness on fracture resistance and fractographic analysis
No full textThis study uses fracture tests and fractographical analysis to compare computer-aided design and computer-aided manufacturing (CAD/CAM) lithium disilicate molar crowns with the previous occlusal thickness recommendation of 1.5-mm, the new recommendation of 1.0-mm, and a less invasive thickness of 0.8-mm. After fatigue application, fracture tests and fractographic analysis were conducted. The fracture resistance of CAD/CAM lithium disilicate molar crowns was different depending on the occlusal thickness of the restoration, and decreased with lower the thickness. However, the fracture resistance of crowns of all three thicknesses exceeded the reported maximum bite force in the first molar region after the fatigue process, and can be considered acceptable for use in the clinic
How does the novel piezoelectric 11 Gracey Curette compare to Gracey Curette or piezoelectric scaler?
No full textDesign In vitro study. Case selection A piezoelectric 11 Gracey Curette tip that combines a piezoelectric device and manual curette was tested for root surface roughness and bacterial adhesion after instrumentation. This novel device was compared against Gracey Curette, piezoelectric scaler and untreated control. Data analysis Extracted human teeth roots (n = 36) were randomly assigned to each of the four groups, of which three groups underwent instrumentation as assigned and one served as untreated control. Profilometer was used to measure the surface roughness after instrumentation. In addition, S. mutans was inoculated to evaluate adhesion on the instrumented root surface. Results The piezoelectric 11 Gracey Curette tip demonstrated significantly lower surface roughness compared to Gracey Curette, piezoelectric scaler and untreated control groups. With regards to bacterial adhesion, there was no significant differences in CFU values between novel device tips, Gracey Curette and piezoelectric scaler. Conclusions Instrumentation with a piezoelectric 11 Gracey Curette tip resulted in a significantly smoother surface compared to instrumentation with Gracey Curette or piezoelectric scaler. As far as bacterial adherence, piezoelectric 11 Gracey Curette tip was not significantly different compared to the traditional methods. Given the limitations of in vitro research, further clinical studies need to be conducted to evaluate clinical outcomes and patient-centred outcomes
Maxillary incisor position-based orthodontic treatment with miniscrews
No full textTraditionally, orthodontic diagnosis and treatment have primarily involved the assessment of skeletodental relationships, with a particular focus on the mandibular dentition. Recently the focus has shifted towards the maxillary incisors as a starting point for facial esthetics with growing demands for facial esthetics. Three-dimensional maxillary incisor position (MIP) plays a pivotal role in improving facial esthetics in smiling and resting positions. With the advent of miniscrews, biomechanical force application in orthodontic treatment has become simpler due to absolute anchorage. Miniscrews allow clinicians to move teeth more precisely and easily in three dimensions according to the treatment plan, which was challenging or impossible with conventional biomechanics. Therefore, MIP using miniscrews should be a starting point for esthetic treatment planning
Cervical artery dissection: A common cause of stroke in young adults
No full textAbstract
Cervical artery dissection is a common cause of stroke in young adults and can lead to significant disability. Clinicians should be able to recognize the clinical presentation and diagnose this condition to prevent cerebral ischemia and its complications. Consider cervical artery dissection in a young adult with new-onset, unilateral head pain with or without neck pain with antecedent neck trauma, with or without neurologic deficits or risk factors for dissection. Early diagnosis can lead to better outcomes but the overall prognosis is good for young adults with cervical artery dissection
Implementation of a Protocol for Conservative Treatment of Thumb Carpometacarpal Osteoarthritis
Get PDFBackground and Purpose. Pain and stiffness in the hands often occurs in older age because of osteoarthritis. The thumb carpometacarpal joint is the most affected site, producing more pain and disability than any other joint in the hand. Conservative treatment to stabilize the joint, including manual therapy, joint mobilization, splinting, education, activity modification, stretches, and exercises, has proven effective to slow disease progression. Inclusion of functional activity is not studied yet is warranted. Methods. Five participants were included. All participants were between 53 and 82 years old. Participants completed several weeks of hand therapy depending on their presentation. Measures included goniometry, the Kapandji index, grip and pinch strength, the visual analog scale for pain, and the quick disability of the arm, shoulder, and hand questionnaire. Patient perspectives were obtained via subjective reporting and a discharge survey. Results and Discussion. All patients demonstrated various clinically important improvements in active range of motion, thumb opposition, and pain. Two patients demonstrated clinically important improvements in strength. None of the participants demonstrated clinically important change in patient-reported function via the quick disability of the arm, shoulder, and hand questionnaire. Results are relatively consistent with previous research. Subjective reporting indicated improved pain and function, and important themes regarding protocol components. Conclusion. In addition to the current experience, more research is warranted. Combining patient perspectives and outcome measures enables patient-centered care for best practice
Impact of the Level of Parental Involvement in Occupational Therapy Services on Patient Outcomes for Children Ages 0-3 in the Outpatient Setting
Get PDFThis project aims to analyze the relationship between parent involvement in OT services and patient outcomes for children ages 0-3 in the outpatient setting. This project involves both therapist and parent interactions with the administration of surveys over the span of a 14-week period to measure parental involvement. Standardized assessment scores were used throughout the project to measure patient outcomes. The implementation of this project can help parents understand the importance of their involvement in occupational therapy services both inside the clinic and at home and how it can increase patient outcomes and child development