The Orthodontic Tooth Movement Health And Social Care Essay

The Orthodontic Tooth Movement Health And Social Care Essay Orthodontics tooth movement is achieved by delivering a constant controlled force to the teeth. The duration of the force applied is the key factor for successful tooth movement rather than the force magnitude. The aim of the orthodontics treatment is to achieve good occlusion with minimal side effects. Several factors should be considered during the orthodontic treatment such as force type, force magnitude and the duration of treatment to avoid the undesirable effect. Proffit have defined the orthodontic tooth movement as a biological response due to the changes in the physiological equilibrium of the dentofacial complex when an external force is applied. Theories of orthodontic tooth movement Teeth are positioned in harmony with the oral environment to maintain their position. The applied forces will cause histological changes during teeth movement. These forces will cause bone resorption on the pressure side and deposition on the tension side, most importantly that the capillaries remain patent on the compressed side to allow cell proliferation and avoid the formation of hyalinized zone On the other hand bone formation will occur at the tension side due to the increased periodontal ligament width and the proliferating fibroblast and osteoprogenitor cells. Osteoblast will be formed from the proliferated osteoprogenitor and will deposite osteoid and result in bone formation.( systematic review) Several theories have been proposed to explain orthodontics tooth movement. The main theories are : Biomechanical theory The biomechanical theory is mainly based on experiments and cellular response observation explaining the biological events during orthodontic tooth movement. The earliest evidence supporting the role of Prostaglandin in orthodontic tooth movement was provided by Hang (Hang et al 1976). He noticed that mechanical distortion of the cell membrane in a culture dish will increase the synthesis of Prostaglandin. Later Harrel supported these finding in his in vitro. Harrel showed that mechanical distortion will generate Prostaglandin and cyclin adenosine monophosphate (c AMP).HARREL 1977 Other researchers ( rodan et al 1975, davidaritch and shanfield 1975) have found that mechanical distortion will cause changes in the intracellular nucleotides changes. The biomechanical theory was based on these finding and proposed that mechanical strain of the cell membrane will activate the cell signaling cascade. Initially phospholipase A2 will be activated which will initiate the metabolism of arachidonic acid. The leukotrienes and the Prostaglandins will be synthesized in response to the metabolism of Arachidonic acid. The synthesis of Prostaglandin will increase three time after five minutes. The Prostaglandin then activates the G proteins receptors on the cell membrane which will initiate a second messenger signaling cascade causing a cellular response leading to bone remodeling. Yamasaki provided further evidence to support this theory by designing a three phase split mouth study to investigate the effect of administrating Prostaglandin on orthodontic tooth movement. One side was injected with Prostaglandin and the contra lateral served as the control. Phase one involved the movement of the upper first premolar buccaly. The rate of tooth movement was doubled on the injected side when compared to the control side. Phase two involved retraction of the canine into the upper first premolar space using sectional contraction loops. The findings were similar to phase one. The third phase involved the retraction of the canine with the routine mechanics. The rate of movement was 1.6 faster on the injected side than the control side. No adverse effects were recorded in the gingiva or the alveolar bone. Yamasaki et al 1984 piezoelectric theory This theory proposes that the pressure applied to the tooth will be transferred to the adjacent alveolar bone which will respond by bending and causing small electrical current produced by electrons being transferred from deformed crystal structure to another. The electrical current will activate the osteoclast and osteoblast and result in bone remodeling required for tooth movement (mcdonald 1993) This theory was supported by Baumrinds split mouth study on rats. Baumrind showed that the tooth crown will displace ten times more than the reduction of the periodontal ligaments on the pressure side. The difference in the amount of displacement between the crown and periodontal ligament has lead to the assumption that the alveolar bone deflects more readily than the periodontal ligament. Considering the amount of crown deflection and the periodontal ligament changes, it can be concluded that lower forces can be used to produce bone deflection which will create changes in the periodontal ligaments.(baumrind 1969) Several studies on animals and human investigating an endogenous electric signals, bioelectric potential, showed that the application of low voltage direct current will modify the bioelectric potential and cellular activity causing faster tooth movement when compared to a control group.(giovanelli s à ¢Ã¢â€š ¬Ã‚ ¦.ref 9 p324) Davidovich showed that by applying electrical current ( 15  µ amps) combined with force of 80 g will enhance bone resoprtion near the anode and bone deposition near the cathode when compared to the control.( Davidovich et al 1980) Heller and Nanda demonstrated that periodontal ligaments are less likely to undergo tensile strain or transfer the force directly to the alveolar bone.( Heller and Nanda 1979) Piezoelectric signals characterize by a fast decay rate even if the force is maintained as the crystals will remain stable. If the force was removed the crystal will return to the original shape and an equivalent signal and opposite in direction will be created. The role of stress generated signals during normal mastication is well documented in the literature in maintaining the alveolar bone. On the other hand, the constant orthodontic forces will create a brief signal which will not create a prominent stress generated signals. These signals have little if anything to do with tooth movment.Profit text book Pressure tension hypothesis Classic hypothesis proposed by Oppenheim, Sandstedt and Schwarz based on histological research. This theory proposes that tooth movement will occur in the periodontal ligaments and the collagen fibers will create a pressure and tension sides transferring the applied forces to the adjacent alveolar bone. The forces should be less than the capillary blood pressure to maintain the blood flow and avoid bone necrosis. On the pressure side, the periodontal ligament will display disorganization and the cell replication will decrease in response to the vascular constriction. On the tension side the periodontal ligament will be stretched and increase the cell replication. Baurmrind 1969 report showed statistically significant increase in cell replication during tooth movement and there was a reduction in collagen formation rate on the tension and pressure side. Heller and Nanda (1979) interfered with the collagen function and metabolism by administrating lathyritic agent beta aminoproprionitrile and showed that normal tooth movement will occur in periodontal ligaments with disrupted collagen fibers. Their findings demonstrated that periodontal ligaments are less likely to undergo tensile strain or transfer the force directly to the alveolar bone. Bone bending Orthodontic tooth movement phases Once the orthodontic force is applies to the tooth the bone remodeling process will begin. During the first six to eight days there will be an initial period of rapid movement due to the periodontal ligaments compression and tooth displacement within the periodontal ligament. The blood supply will be reduced or cut off producing hyalinized zone; a vascular cell free zone. In the second phase; the lag phase; tooth movement will be minimal or will stop completely due to the hyalinized zone. On the histological level Retain ( 1957, 1960) have reported that the a vascular cell free zone will be formed even with minimal force and the a vascular cell free zone will occur more with short roots. The lag in tooth movement varies between four to twenty days according to the applied force; with light forces the lag phase will be relatively short and it will increase with heavier forces. The periodontal ligaments will reorganize to remove the hyalinized zone by phagocytosis; foreign body gaint cells, macrophages, fibroblast and pre-osteoclasts will be recruited from the neighboring undamaged alveolar bone marrow cavities and the periodontal ligaments. Once the avascular cell free zone is removed tooth movement will commence again; the last phase. Tooth movement usually begins forty days after the initial force application. Recent study by Von Bohl demonstrated that the hyalinized zone will be formed during the last phase and it is more frequent with high forces and have no effect on orthodontic tooth movement at this stage as the bone remodeling process will continue at a certain rate independently from the force magnitude. Von Bohl concluded that the formation of a vascular cell free zone is apart of the orthodontic tooth movement process. His report supported the pervious finding of Owman moll et al 1996 and Vas leeuwen 1999 Orthodontic force magnitude Orthodontic forces can delivered through the use of fixed appliances, removable appliances , TAD, extra orally such as head gear à ¢Ã¢â€š ¬Ã‚ ¦etc.to achieve the desired tooth movement different force magnitude will be required. The recommended forces are: bodily movement tipping intrusion extrusion

Patient’s history Essay

Nursing Diagnosis 1: Inadequate nutrition Debbie’s nutrition is not adequate for her age, as well as her weight. Due to frequent nausea/vomiting, emotional distress she lost weight. Her weight is less ( 89 pounds) compared to her usual weight ( 110 pounds). The assessment and management of weight is a major preoccupation in contemporary healthcare. Clinical interventions focus on achieving energy balance deficit and are premised on claims that excess weight/fatness (body mass index (BMI) > 25) is a significant direct cause of morbidity and mortality and, correspondingly, that weight loss in fat (‘overweight’ or ‘obese’) people will reduce risk and/or improve health outcomes. (Aphramor, 2010). Desired Outcome 1 Desired Outcome 2 Nursing Intervention 1 Refer Debbie to nutritionist. Debbie will have more information regarding healthy eating within 2 weeks. She will realize the importance of her diet and metabolism. Debbie realized the importance of healthy nutrition and regimen. She gained weight in 2 months more than 10 pounds. She feels comfortable and happy. Nursing Intervention 2 Pharmacological intervention, education regarding medications. Debbie will control her weight also by controlling her nausea using the prescribed medication for nausea. She will receive information on how to use the medication, frequency, dosage, side effects in 2 days. After one week Debbie has more information regarding her medications, realized that medication helps her to control nausea and takes as ordered. Evaluation method Follow up visit in doctor’s office after discharge within 2 weeks, daily weights. Follow visit- patient weighs 12 pounds more, less nauseous, feels comfortable in her weight. Rationale Patient education, more information regarding nutrition, talking, relaxation techniques, pharmacological. Given instructions regarding future appointments and plans on her treatment, daily weights, weight control. Nursing Diagnosis 2: Educational deficit Debbie needs more information regarding her care. She needs education related to medications, self-catheterization, breast self-examination. Patient education is a central the practice of nursing and should be in part of their domain. The most important part of patient education is to prepare Debbie for independence in her care, increase the confidence and competence for self-management. (Bastable, 2006). Desired Outcome 1 Desired Outcome 2 Nursing Intervention 1 Instructions on how do self breast- examinations and self- catheterization, warning signs/symptoms. Debbie will be able to do breast self-examination herself in one week, will be able to perform intermittent self-catheterization. Two weeks passed. Debbie states how she performs breast self-examination, what she needs to look out for. She states how often she does the examination and demonstrates what positional changes she needs to do. Nursing Intervention 2 Patient education Debbie will know information about her medications, route, dosage, side effects in 2 days. Teach back achieved regarding medications. Debbie states that she was anxious previously as she thought the will not remember all the information given. She is happy as she did everything correct. Evaluation method Asked multiple cross questions, Debbie answers as educated, seems more interested in future education. Debbie made an organizer for her. The organizer contains medication regimen, few special considerations, reminders. Rationale Demonstrated Debbie how to do breast examination, catheterization. Used a kit and plastic body to demonstrate. Used the board to give important information regarding medication. Debbie demonstrates what she does at home to do the catheterization, breast self-examination, questions given, answered properly as was educated. Nursing Diagnosis 3: Emotional distress. Debbie is experiencing emotional distress, anxiety. As stated in case study she is tearful, has great concern regarding her future. Effective  communication among nurse and patient/family can improve care and relieve suffering. The diagnosis and treatment for cancer is a major challenge and it affects all aspects of life. By therapeutic communication, providing information, encouraging optimistic outlook, teaching how to reduce stress patient care will have better outcomes. (Yarbro, Wujchik, & Gobel, 2010). Desired Outcome 1 Desired Outcome 2 Nursing Intervention 1 Debbie will get used to controlling her stress by daily walks, relaxation techniques, music, spending time with family in 2 weeks. Debbie states she feels better spending time with family, resting, being in the park, meeting friends when feeling lonely and anxious. Nursing Intervention 2 Debbie will be seen by spiritual care in 2 days. Debbie states that her conversations with spiritual care makes her feel more relaxed, she reads books, has prayers at her bedside. Evaluation method Given instructions on how to manage time and stress with different activities, planning activity and periods of rest. Asked questions regarding Debbie’s days, stress management. Rationale Educational packets, brochures, referrals provided. Multiple written stress tests used to find our patient’s emotional condition. Seems more relaxed and less anxious. References Aphramor, L. (2010, July). Validity of claims made in weight management research: a narrative review of dietetic articles. Nutrition Journal, 9(). Bastable, S. B. (2006). Essentials of Patient Education. : Jones & Bartlett Learning. Yarbro, C., Wujchik, D., & Gobel, B. (2010). Cancer Nursing: Principles and Practice (7th ed.). : Jones & Bartlett Learning.

Adoption vs. Foster Parenting - 2218 Words

Adoption vs. Foster Parenting When I had cable TV, I used to watch a show on the Learning Channel, called An Adoption Story. The show followed the story of a different couple each time, as they adopted a child. It was beautiful to see a childless couple be able to adopt a child of their own. The love and joy was the same as if they had given birth to the child. Adoption is truly a blessing, both for the childless couples, and for the birth mother searching for a loving home for her baby. I always wondered what it would be like to adopt a child or provide a foster home for a few underprivileged children. I have always had a soft spot for children and I thought that by doing something so small for someone else could be so rewarding in†¦show more content†¦Don t get me wrong, not all foster parents are dishonest and abusive, but you think with all the background checks and prescreenings that the government would do a little better at choosing foster parents. I know one or two are bound to slip through the crack but there are more and more horror stories about foster parents being arrested or under investigation for the death, abuse, or neglect of a child that was placed in their care by the state. It s no wonder that the decision to put your child up for adoption is even harder today than it was 30 years ago. Thirty or forty years ago, before readily available contraception, many unmarried, pregnant girls were forced into hiding. They spent months in wage homes as unpaid servants, unwed maternity institutions or both (Wilson-Buterbaugh 12). Adoption is a legal process that creates a new, permanent parent-child relationship where one didn t exist before. The adoption proceedings take place in court before a Judge. Adoption bestows on the adoptive parent(s) all the rights and responsibilities of a legal parent, and gives the child being adopted all the social, emotional, and legal rights and responsibilities of a family member. 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My father supported her both financially and emotionally throughout the pregnancy, the process of deciding on the best option for the child, the appointments with the local social workers and finally meeting with potential parents looking to adoptRead MoreThe Law Can Affect Family Life Essay1991 Words   |  8 Pages The law can affects family life in many ways. Laws will in dicate whom and when we can marry, under what circumstances we can file for a divorce, who can adopt children, what responsibilities should come with parenting, and what happens when we do not uphold our parental responsibilities. In recent years, our lawmakers here in the United States have made important decisions affecting families consisting of gay parents. Gay couples can face a legal minefield when trying to ensure parental rights.Read MoreNot Protecting the Right of Homosexual Marriage Endangers the Rights of Others1173 Words   |  5 Pagesbisexual couple get married they only receive 300 state rights. When a strait couple get married they receive those 300 state rights as well as 1,049 federal rights. Among the federal rights same-sex marriages do not receive are: joint parenting, adoption, foster care, custody, visitation, insurance, family health care, tax returns, making medical decisions on a partners behalf, visiting a deceased partners grave, immigration and receivi ng government profits such as social security and MedicareRead MoreShould Same Sex Marriage Be Legalized?1677 Words   |  7 Pagestax perspective of gay marriage.† In section 3 of the Defense of Marriage Act (DOMA) it says that by federal law â€Å"a legal union is between one man and one woman as husband and wife† thereby contradictory to gay marriage. In a Supreme Court case States vs. Windsor, the surviving spouse of a same sex couple sued for a refund of federal estate taxes paid by deceased spouse’s estate. They were married in Toronto, Canada but resigned in New York which made the marriage valid. 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Having grown up in an institution with multiple caregivers and less than normal caregiver interaction, Joey has not developed a trust of others, and has not responded well to encouragement by his parents

The Yellow Wallpaper - 1156 Words

The Yellow Wallpaper: In the 19th century, mental illness was an uncommon issue to be discussed. The public would treat the illness only by avoiding the matter and forcing the sick to feel helpless. At that time, the medical profession had not yet distinguished between diseases of the mind and diseases of the brain. Neurologists such as Dr. Silas Mitchell treated the problems that would now be treated by psychiatrists, such as depression. The most accepted cure was Mitchells â€Å"Rest Cure,† which required complete isolation from family and friends. It forbid any type of mental or physical energy, and required total bed rest. The harsh results of the â€Å"Rest Cure† are easily seen in the story titled â€Å"The Yellow Wallpaper† written by†¦show more content†¦C. Skey, a Victorian Age physician. (Showalter, p. 130) In fact, as shown in â€Å"The Yellow Wallpaper†, strong and creative women were forbidden from exercising their minds and bodies. They often struck out with fits of hysteria, or became extremely depressed because they could not find useful outlets for their energy. The narrator was unable to express her thoughts through writing, because her health depended upon her remaining relaxed and peaceful. In addition, postpartum depression was not diagnosed as a reasonable condition during Gilmans time. Motherhood brings significant hormonal and other changes that require psychological adjustment. After giving birth, some women become extremely depressed. Postpartum depression, coupled with the unfair social constraints of the Victorian Era, drove some women mad, causing serious mental illness and even suicide. (Showalter, p. 130) The main character in â€Å"The Yellow Wallpaper† encounters many signs of entrapment. Her mind and body are unable to escape the toucher of the â€Å"Rest Cure† given to her by her husband. It is apparent from the beginning of the story that her husbandShow MoreRelatedThe Yellow Wallpaper829 Words   |  4 Pages The Yellow Wallpaper Charlotte Perkins Gilmans The Yellow Wallpaper first appeared in 1892 and became a notary piece of literature for it s historical and influential context. Gilmans The Yellow Wallpaper was a first hand account of the oppression faced toward females and the mentally ill,whom were both shunned in society in the late 1890s. It is the story of an unnamed woman confined by her doctor-husband to an attic nursery with barred windows and a bolted down bed. Forbidden to writeRead More The yellow wallpaper619 Words   |  3 Pages nbsp;nbsp;nbsp;nbsp;nbsp;The plot of â€Å"The Yellow Wallpaper† comes from a moderation of Charlotte Perkins Gilman’s personal experience. In 1887, just two years after the birth of her first child, Dr. Silas Weir Mitchell diagnosed Gilman with neurasthenia, an emotional disorder characterized by fatigue and depression. Mitchell decided that the best prescription would be a â€Å"rest cure†. Mitchell encouraged Gilman to â€Å"Live a domestic l ife as far as possible,† to â€Å"have two hours’ intellectual lifeRead MoreYellow Wallpaper1095 Words   |  5 Pagesand treatments played in reinforcing the prevailing, male-dominant gender roles through the subversion, manipulation and degrading of female experience through the use of medical treatments and power structures. Charlotte Perkins Gilman’s â€Å" The Yellow Wallpaper† is a perfect example of these themes. In writing this story, Charlotte Perkins Gilman drew upon her own personal experiences with hysteria. The adoption of the sick-role was a product of-and a reaction against gender norms and all of the pressuresRead MoreYellow Wallpaper1673 Words   |  7 PagesSvetlana Kryzhanovskaya Prof. Grajeda ENC 3014-MidTerm Paper March 12, 2012 Structuralism amp; Feminist Theory ‘The Yellow Wallpaper’ written by Charlotte Gilman can be affectively analyzed from two schools of thought structuralism and feminist theory. Though structuralists’ deny the work of literature any connection to its author (it must be what it is, no underlying meaning) feminist theory must first and foremost be understood in its historical framework. By the turn of the century,Read MoreThe Yellow Wallpaper3202 Words   |  13 PagesEnglish 1302 22 November 2011 Main Character’s Outsider Theme In Charlotte Perkins Gilman’s â€Å"The Yellow Wallpaper†, the narrator, Jane, is struggling to deal with her depression that she is suffering in a confined room that her husband, John put her in. John believes that this will cure Jane and make her better from her depression. Instead, Jane is slowly losing herself within the yellow wallpaper in the room causing her to become insane. Jane is not able to express her feelings with her husbandRead MoreThe Yellow Wallpaper1362 Words   |  6 Pages â€Å"The Yellow Wallpaper† Charlotte Perkins Gilman â€Å"The Yellow Wallpaper† written by Charlotte Perkins Gilman is gothic psychological short story written in journal-style with first-person narrative. Other elements used in the story are symbols, irony, foreshadowing, and imagery. â€Å"The Yellow Wallpaper is about a woman who suffers from postpartum depression. Her husband, a physician, puts her on â€Å"rest cure of quiet and solitude.† (Wilson 278). This cure consisted of the narrator being confinedRead More The Yellow Wallpaper1466 Words   |  6 Pagesfeminist socialist and a realist novelist capture moments that make their readers rethink life and the world surrounding. Gilman’s â€Å"The Yellow Wallpaper† was first published in 1892, about a white middle-class woman who was confined to an upstairs room by her husband and doctor, the room’s wallpaper imprisons her and as well as liberates herself when she tears the wallpaper off at the end of the story. On the other hand, Craneâ₠¬â„¢s 1893 Maggie: A Girl of the Streets is the realist account of a New York girlRead MoreThe Yellow Wallpaper961 Words   |  4 Pages The Yellow Paper is a symbolic story written by Charlotte Perkins Gilman. It is a disheartening tale of a woman struggling to free herself from postpartum depression. This story gives an account of an emotionally and intellectual deteriorated woman who is a wife and a mother who is struggling to break free from her metal prison and find peace. The post-partum depression forced her to look for a neurologist doctor who gives a rest cure. She was supposed to have a strict bed rest. The woman livedRead MoreThe Yellow Wallpaper1844 Words   |  8 PagesSarah Kreeger EngWr 301 Professor Bradford 21 July 2013 Short Story Analysis The Yellow Wallpaper: The Power of Society’s Views On the Care of Mental Patients â€Å"The Yellow Wallpaper† by Charlotte Perkins Gilman takes the form of journal entries of a woman undergoing treatment for postpartum depression. Her form of treatment is the â€Å"resting cure,† in which a person is isolated and put on bed rest. Her only social interaction is with her sister-in-law Jennie and her husband, John, who is alsoRead Moreyellow wallpaper1165 Words   |  5 PagesIn the short story â€Å"The Yellow Wallpaper†, Charlotte Perkins Gilman, talks about a woman who is newly married and is a mother who is in depression. â€Å"The Yellow Wall-Paper† is written as the secret journal of a woman who, failing to relish the joys of marriage and motherhood, is sentenced to a country rest cure. Though she longs to write, her husband - doctor forbid it. The narrator feels trapped by both her husband and surroundings. The woman she sees behind the wallpaper is a symbol of herself and