1,720,962 research outputs found
Direct TMJ injuries
No full textNormal anatomy and function of temporomandibular joint (TMJ) may be altered by direct traumatic injuries of joint tissues or of adjacent bones such as the lower jaw. Both cases are known as "direct trauma" to differentiate them from "indirect trauma" acting on the TMJ without contact, such as the TMJ whiplash. Nature and direction of traumatic forces, type of acute lesions (i.e. fractures and/or contusions), accuracy of diagnosis and correctness of therapeutic approach will influence the onset of different temporomandibular disorders (TMD), ranging from muscle disorders or disc displacement with reduction to severe ankylosis. The dentist acting as expert witness has to assess trauma-related TMD symptoms: a correct evaluation must be based on a complete articular and muscular assessment, must take into account for the existing literature, and must follow a correct step-by-step sequence. This approach allows to discriminate between trauma-related and non-related lesions, through the identification of pre-existing pathologies or risk factors. The final report will provide the medical legal basis of a complete evaluation
Temporomandibular joint bilateral post-traumatic ankylosis: a report of a case treated with interpositional arthroplasty
No full textAnkylosis of the temporomandibular joint (TMJ) is a severe disorder which leads to jaw function impairment and restricted mouth opening. The surgical approach to TMJ ankylosis can be performed according to different techniques. The present paper is a report of a bilateral post-traumatic case of TMJ ankylosis. The patient suffered bilateral condylar fractures as a consequence of a road accident and showed a limited mouth opening (22 mm) along with dental occlusion abnormalities. Conservative treatments were uneffective to improve jaw impairment, so a computerized tomography was requested for surgical treatment planning. Both temporomandibular joints showed severe ankylosis with a bone fragment located medially to the condyle. An arthroplasty with the interposition of a combined flap (temporalis muscle, fascia, periosteum) was performed. The post-treatment course was uneventful, and the patient has undergone physiatric rehabilitation immediately after the intervention. At the 5-years follow-up mouth opening was 46 mm. TMJ arthroplasty with the interposition of autogenous material is an effective technique to restore jaw function and to prevent recurrencies in cases of ankylosis
Occlusion and temporomandibular disorders: a malpractice case with medical legal considerations
No full textOcclusion and temporomandibular The issue of temporomandibular disorders (TMD) diagnosis and treatment has become a matter of increasing interest in the medical legal field in recent years. The old-fashioned theories based on the occlusal paradigm was proven to be erroneous, and clinicians who still provide irreversible treatments to TMD patients have to be conscious of the potential legal consequences of their behavior. The present paper described an illustrative case report of a patient to whom extensive and irreversible occlusal therapies were performed with the unique aim to provide relief from TMD symptoms. The treatment was unsuccessful and the dental practitioner was called into cause for a professional liability claim. The clinician was judged guilty of malpractice on the basis of the lack of scientific evidence of the irreversible occlusal approaches to TMD, which were erroneously used and did not give the patient any benefit, thus forcing him to a non necessary financial and biological cost. The failure to satisfy the contract with the patient, which is usually not covered by any insurance company, forced the practitioner to give the money back to the patient. The ethical and legal implications of such case were discussed, with particular focus on the concept that medical legal advices need to satisfy the highest standards of evidence and have to be strictly based on scientific knowledge
Whiplash and temporomandibular disorders: Forensic medical implications
No full textClaims for compensation for temporomandibular joint (TMJ) injuries after a rear-end traffic collision are increasing so much that the occurrence of a TMJ whiplash at the same time of a cervical whiplash might be supposed. As the dentist collaborating with the medical examiner is more and more frequently requested to evaluate symptoms similar to those characterizing temporomandibular disorders (TMD), whose onset is related to a vehicle accident (usually a rear-end), the need to evaluate the plausibility of proposed cause-and-effect relations is evident. A literature review following the criteria of Evidence Based Medicine (EBM) seems to suggest the difficulty to analyze this topic according to criteria traditionally used in forensic medicine, even if they are unquestionably important for a correct assessment. In spite of these problems, it is possible to emphasize the importance of some parameters like TMD onset time after whiplash trauma and the timing of acquisition and completeness of the case, especially health status before trauma, as it does not seem biologically plausible that a whiplash trauma may damage an otherwise healthy TMJ. By contrast, if a cause-and-effect relation is lacking, the trauma may be considered, an aggravating or a worsening factor in presence of other risk and/or predisposing factors or in presence of a previously compromised TMJ
Temporomandibular disorders assessment: medicolegal considerations in the evidence-based era
No full textP>Temporomandibular disorders (TMD) are a frequent finding in cases of facial trauma or dental malpractice, and legal claims for TMD damage have been increased over the years. Temporomandibular disorders assessment in the medical legal setting is complicated by the peculiarities of these disorders, whose symptoms are heterogeneous, fluctuant, and recognise a multifactorial origin. A systematic Medline search in the National Library of Medicine's PubMed database pointed out that, despite the medical legal aspects of the dental profession are gaining a growing attention, there is a paucity of literature dealing with patients with TMD assessment. For these reasons, evidence-based knowledge in the field of TMD diagnosis and treatment was summarised in this article with the aim of providing useful suggestions for a medical legal approach to TMD
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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