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Introduction: Thoracolumbar spine injuries can result from various traumatic events such as falls, motor vehicle accidents, and sports injuries. While surgical intervention is often indicated for complex fractures and in case of neurological deficits, non-operative treatment remains a viable option for certain types of injuries. Aims: This manuscript aims to provide a comprehensive overview of the specific indications and treatment options of non-operative thoracolumbar spine injuries. It seeks to provide evidence-based recommendations for selecting patients suitable for conservative management based on fracture type and stability, absence of neurological deficits, spine deformity, integrity of the posterior ligament complex and patient specific factors. [ABSTRACT FROM AUTHOR]

(1) Background and aim: The effects of functional therapies on dentoalveolar and skeletal structures have been investigated in orthodontics for many years. The aim of this retrospective study was to evaluate the changes caused by fixed and removable functional therapy in the mandibular anterior trabecular structures using fractal dimension (FD) analysis. (2) Methods: A total of 60 patients with skeletal and dental class II malocclusion were included in the study and three groups were formed: the untreated control group (CG), the Forsus fatigue-resistant device group (FFRDG), and the Monoblock group (MBG). Bone areas of interest determined in the buccoapical of the mandibular incisors and the symphysis in the lateral cephalometric radiographs taken before (T0) and after (T1) functional therapy were evaluated using FD analysis. The relationship between the FD and IMPA (Incisor Mandibular Plane Angle) angles was evaluated. Parametric and nonparametric tests were used in statistical analysis according to normality distribution. The statistical significance level was determined as p < 0.05. (3) Results: There was no statistically significant difference between the FD values of all groups at T0 (p > 0.05). At T1, buccoapical FD values were significantly lower in FFRDG and MBG compared to the control group (p < 0.05), while symphyseal FD values were not found to be significant (p > 0.05). The IMPA angle was significantly lower in the FFRDG and MBG than in the control group at T0, while it was higher at T1 (p < 0.05). While a significant negative correlation was observed between the IMPA angle and buccoapical FD values in both FFRDG and MBG (p < 0.05), it was not observed with the symphysis FD values (p > 0.05). (4) Conclusions: Trabecular changes caused by functional therapy in the mandibular anterior bone can be evaluated on lateral cephalometric radiographs with FD analysis. It was concluded that orthodontists should ensure controlled changes in the IMPA angle during functional therapy, especially for the decreases in FDs seen in the buccoapical alveolar region due to the forward movement of the mandibular incisors. [ABSTRACT FROM AUTHOR]

Hydrogen sulfide (H2S) is a gasotransmitter with significant physiological effects, including anti-inflammatory properties, regulation of oxidative stress, and vasodilation, thus regulating body functions. Functional therapy involves using treatments that target the underlying cause of a disease, rather than simply treating symptoms. Epigenetics refers to changes in gene expression that occur through modifications to DNA, to the proteins that package DNA, or to noncoding RNA mechanisms. Recent research advances suggest that H2S may play a role in epigenetic regulation by altering DNA methylation patterns and regulating histone deacetylases, enzymes that modify histone proteins, or modulating microRNA mechanisms. These critical findings suggest that H2S may be a promising molecule for functional therapy in various diseases where epigenetic modifications are dysregulated. We reviewed the relevant research progress in this area, hoping to provide new insights into the epigenetic mechanisms of H2S. Despite the challenges of clinical use of H2S, future research may lead to the progress of new therapeutic approaches. Antioxid. Redox Signal. 40, 110–121. [ABSTRACT FROM AUTHOR]

In recent decades, minimally invasive endoscopy has been widely applied in various domains of pediatric surgery. It offers the advantages of minimal trauma, faster recovery and lesser pain. However, minimally invasive surgical incision is not equal to functional minimally invasiveness. This review focused upon the concept of functional minimally invasive surgery and its clinical applications in pediatric surgery. Through a combination of precision medicine, application of new technology and accelerated rehabilitation surgery, treatment outcomes may be optimized with minimal trauma so that quality-of-life is thus improved. [ABSTRACT FROM AUTHOR]

Mini-invasive surgery has been widely applied during pediatric surgery and it has achieved satisfactory outcomes. However, there are still such practical problems as emphasizing incisional appearance and neglecting functional recovery. There is also a lack of evaluation standards for pediatric mini-invasive surgery. Accurate preoperative decision-making, removing target lesions, intraoperative injury control and rational surgical approaches should be strengthened. Measures and concepts of functional mini-invasive surgery, such as accelerated rehabilitation, effective nutrition management and perioperative psychological interventions, require refining. The concept of functional mini-invasive surgery must be integrated into the entire surgical management processes of preoperative diagnoses, evaluations, nutritional managements, surgical procedures and ERAS. Individualized protocols should be developed and the recovery of patient organs and overall functions adopted as the evaluation criteria. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Health Sciences / Sağlık Bilimleri Dergisi is the property of Erciyes Universitesi Saglik Bilimleri Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Estudios Pedagogicos (Valdivia) is the property of Estudios Pedagogicos and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The variety of etiological factors contributing to the development of distal bite various form, as well as the structures that are affected by the disorders determine the deegre of complexity of the malocclusion itself, and thus the choice of therapeutic procedure by which it will be treated. An 11-year-old female patient was diagnosed with this type of malocclusion with a certain degree of presence of other irregularities. After a detailed diagnostic procedure, and determining the type of growth, we approach the therapeutic procedure in two phases. By applying the funcional therapy in the first phase, we correct the vertical growth type, and then in the second phase of therapy using a fixed technique we achieve harmonious intermaxillary relations, an adequate molar and canine Class I relationship as well, thus improving the aesthetics of the patient's face.

Aim of the study. Orthodontic treatment intends to create a harmony between dental, muscular and osseous components. The purpose of this study was to evaluate, using proportional indexes, the effect of functional therapy on facial aesthetics rehabilitation, in class II/1 patients. Material and methods. We selected 60 patients with class II/1 malocclusion, aged between 6 and 12 years, treated with functional appliances. Specific indexes on standard photography at the beginning and the end of the treatment were assessed: F2- Lower face-face height, F3-Mandibulo-face height, F4-Mandibulo-upper face height, F5-Mandibulo-lower face height. Results. Statistically significant differences were noticed for F4 and F5 (p

Copyright of Journal of Craniomandibular Function is the property of Quintessence Publishing Company Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Affecting more than 264 million people, depression is a systemic and multifactorial disorder that represents one of the leading causes of illness and disability worldwide. Several studies showed an inflammatory response in depressed patients, including the involvement of both chronic low-grade inflammatory response and activation of cell-mediated immunity. The present study aimed to verify the efficacy of a structured functional therapy program for patients with depressed mood, and to determine whether this program can significantly reduce levels of C-reactive protein. Method: 28 outpatients with depressed mood received 20 individual sessions of Functional therapy. Data about socio-demographic variables, depression, self-esteem, and quality of life were collected; moreover, blood specimens were collected before and after treatment, and CRP measurement was performed by immunoenzymatic method. All measures were administered at baseline, at the end of treatment (i.e., 3 months after baseline), and at follow-up (i.e., 6 months after baseline). Results: A repeated measures ANOVA showed a significant difference after treatment on depression levels, levels of self-esteem, and all dimensions of quality of life, such as physical, psychological, social relationships, and environment. Furthermore, a statistically significant difference on levels of CRP was found. Moreover, at follow-up, improvements were maintained. Conclusions: The study revealed initial evidence of the efficacy of a functional therapy program on treating depression and its psychological and inflammation-related markers. [ABSTRACT FROM AUTHOR]

Objectives. Orthodontic treatment intends to create a harmony between dental, muscular and osseous components. The purpose of this case presentation was to emphasize consequences of early loss of temporary teeth on dental-maxillary complex development. Material and methods. 10 years old patient with dental movements following the early extraction of temporary teeth. The patient has habitual oral breathing associated with lower lip interposition. Results. The functional treatment with twin-block appliance was chosen, taking into account the age-specific growth potential. Discussions. Premature extraction of temporary teeth engenders lee-way-space loss, significant shortening and transverse constriction of the dental arch, elements aggravated by dysfunctions and parafunctions. Conclusion. The early extractions performed during the growth period, through the associated dental migrations, determine growth changes with consequences on the functionality of the dento-maxillary apparatus. [ABSTRACT FROM AUTHOR]

Background: The aim of the study included interdisciplinary efficiency in treatment children with class II Angle malocclusions in association with osteopathy problems. Material and methods: there were examined 30 patients of the 6- 12 years old with class II Angle malocclusion in association with osteopathy problems. The patients were divided into two groups, the main group consists of children, who have complex treatment, and in the control group they have just orthodontic treatment. Results: The results show that patients with complex treatment have potentially positive contributions in anthropometric changes as well as in facial appearance and postural problems. The orthodontic treatment of patients, from the control group, was 1.5 times longer than in the main group. So complex treatment of patients combined with postural problems is much shorter and have a positive influence on musculoskeletal disorders than in the control group. Conclusions: Efficient complex treatment of children with malocclusion and osteopathic problems influences the duration of orthodontic treatment of class II malocclusion conditioned by distal position of mandible.

Introduction: Myofunctional therapy is becoming an increasingly recommended treatment option. The objective of this case presentation was to highlight the advantages and disadvantages of this therapeutic approach. Discussions: The objectives of myofunctional treatment are the morphological, functional and aesthetic balancing of the skeletal, muscular and dental systems, and the elimination of dysfunctional factors. This therapeutic approach is addressed to patients in the growth period, uses relatively simple means but requires very good compliance from the patient and the family. The patient's motivation and will are individual factors that play an important role in the success of such treatment. Conclusions: Myofunctional therapy requires an individualized approach, according to the psychological characteristics of the child, to achieve the desired results and not just following the treatment objectives derived from the diagnosis of the dento-maxillary anomaly. [ABSTRACT FROM AUTHOR]

Objective: This randomized controlled trial examined the efficacy of adding a fasting‐mimicking diet to a structured psychotherapy protocol for treating depression. Design: Of 20 patients with depression, 10 were randomly assigned to psychotherapy and dieting (i.e., experimental group) and the other 10 to psychotherapy only (i.e., control group). Patients in both groups received 20 individual sessions of functional therapy along with nutrition consultation. Patients in the control group were instructed to maintain their usual daily diets. Results: Both treatments were effective in reducing depression as well as increasing self‐esteem and quality of life. The experimental group showed improved self‐esteem and psychological quality of life as well as a reduction in their mean body mass index, in comparison to the control group. Conclusions: The study revealed initial evidence of the efficacy of combining psychotherapy with a fasting‐mimicking diet to treat depression and its correlates. [ABSTRACT FROM AUTHOR]

Aim: To review definitions and elements of interventions in studies, which used the word "functional" to describe their intervention for children with cerebral palsy (CP), and to determine whether definitions and elements are similar to criteria of functional therapy described in the Dutch Guidelines. Methods: Systematic review of intervention studies, which used the word "functional" to describe interventions for children with CP. We described criteria of functional therapy that were used to describe the intervention, and whether criteria were described similarly to the descriptions used in the Dutch Guidelines. Results: Of the 27 included studies, criteria "based on the activities/participation level of the ICF-CY", "goal-directed" and "context-specific" were referred to the most (40–59.3%). Descriptions of these criteria were less comparable to the suggested definition (43.8–69.2%). The remaining three criteria ("active involvement", "task-specific", and "focused on functionality instead of normality") were referred to less frequently (18.5–33.3%). The descriptions reported for these criteria were, however, the most comparable with the suggested definitions (80–100%). Conclusions: The included studies, in general have not used criteria of functional therapy. Future studies have to describe the elements of interventions in detail. Moreover, it is important to reach consensus on the definition and elements of functional therapy. [ABSTRACT FROM AUTHOR]

Aim: This current study evaluated and compared the skeletal changes in the head of the condyle, glenoid fossa, and articular space between the twin block appliance and PowerScope™ a fixed functional appliance., Materials and Methods: This study was a pilot, randomized, single-blinded, assessing the skeletal changes in the components of the temporomandibular joint (TMJ) using cone-beam computed tomography (CBCT). The study was conducted in 20 subjects in the age range of 11-14 years with class II division 1 malocclusion. These subjects were distributed randomly between two groups with an allocation ratio of 1:1 (group I-twin block and group I-PowerScope™). Follow-ups of both groups were done till desirable skeletal correction was attained (clinical edge-to-edge incisor relation)., Results: Condylar parameters such as position, height, and length were evaluated bilaterally in the CBCT scans. After using both devices, there was an increase in all condylar qualities; however, the twin block appliance showed a more noticeable difference, which has been determined to be statistically significant. In the twin block group, there was an average decrease of 0.56 mm in the anterior articular space and an increase of 1.2 and 2.64 mm in the middle and posterior articular spaces, respectively. In the PowerScope™ group, there was an average decrease of 0.23 mm in the anterior articular space and an increase of 2.55 and 1.85 mm in the middle and posterior articular spaces, respectively. In the case of the twin block device, the change in glenoid fossa angle was observed to be 6.1 mm on both sides and a mean difference of 1.25 mm on the right-side and 1.75 mm on the left-side was observed in the case of PowerScope™. The difference was established to be significant with a p < 0.05 in all cases., Conclusion: Condylar attributes increased after the application of both devices but the difference was more pronounced in the case of twin block appliances. The difference in articular space (middle and posterior) between the twin block group and PowerScope™ group, was not significant statistically. In the present study, the remodeling in the glenoid fossa was greater in the twin block group compared to the PowerScope™ group., How to Cite This Article: Halapanavar B, MN P, Deshmukh S, et al. Comparison of Skeletal Changes in the Temporomandibular Joint between the Twin Block Appliance and Fixed Functional Appliance: A Longitudinal Follow-up Study. Int J Clin Pediatr Dent 2024;17(1):7-14., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2024; The Author(s).)

Copyright of Journal of Craniomandibular Function is the property of Quintessence Publishing Company Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

For understanding of reasons of bone nonunion after fractures we have to study the mechanisms which are on the base of cells differentiation. Objective: on the base of clinical and morphologic examination we studied the mechanisms of cells differentiation at regeneration process after shaft fractures. Methods: for histological study we took fibrin-blood clots from perifracture area and adjacent soft tissues in 25 patients after closed shaft fractures at open reduction. Biopsy samples of 9 patients were studied additionally with imunohistochemistry methods for the analysis of vessels endothelial growth factor and transforming growth factor-β (TGF-β). For assessment of fracture union we used x-rays. Results: in 1-5 days after trauma we have found fibrin-blood clots, where thickened fibrin partitions were located parallel to each other. Cells were formed by fibrin partitions, they had oval shape, it depicted the presence of fluid pressure inside of them. Expressed reaction on the vessels endothelial growth factorwas found in fibrin. During 7-18 days after fracture the fibrin-blood clot was reorganizes with formation of granular, soft tissue and osteogenic tissues. Expression of vessels endothelial growth factorand TGF-β was registered in cells. Conclusions: osteogenic differentiation of mesenchimal cells in bone callous after the fracture can appear in case of coincide in time and space key factors -- presence of fibrin matrix saturated vessels endothelial growth factor. It initiates vessels formation. Also there is need of close contact with alive mature tissues (bone, periosteum, muscles) which are the sources of slightly differentiated cells; tensions in fibrin-collagen blastema. [ABSTRACT FROM AUTHOR]

Objective To evaluate the craniofacial changes induced by functional appliances with special regard to the oro and nasopharyngeal sagittal airway dimensions in subjects with dentoskeletal Class II malocclusions when compared with an untreated Class II control group immediately after therapy and at long-term observation. Methods A group of 40 patients (21 females and 19 males) with Class II malocclusion treated consecutively either with a Bionator or an Activator followed by fixed appliances was compared with a matched control group of 31 subjects (16 females and 15 males) with untreated Class II malocclusion. The treated sample was evaluated at T1, start of treatment (mean age: 9.9 ± 1.4 years); T2, end of functional treatment and prior to fixed appliances (mean age: 11.9 ± 1.3 years); and T3, long-term observation at the end of growth (mean age: 18.2 ± 2.1 years). Statistical comparisons were performed with independent sample t tests at T1 (baseline characteristics) and for the T1−T2, T2-T3, and T1-T3 changes. Results During active treatment the treated group showed a significant increment in lower airway dimension (PNS-AD1), as well as a significant improvement in the upper airway dimension (PNS-AD2). A significant decrease in the upper adenoid size (AD2-H) was also found. In the longterm evaluation, a significant increase in both lower and upper airway thickness (PNS-AD1; PNS-AD2) and a significant decrease in the upper adenoid thickness were still present in the treated group. Conclusion The treatment with functional appliances produced significant favorable changes during active treatment in the oro- and nasopharyngeal sagittal airway dimensions in dentoskeletal Class II subjects when compared with untreated controls, and these changes were stable in the long-term. [ABSTRACT FROM AUTHOR]

Objective The study was focused on evaluating the change in mandibular morphology following the Twin Block appliance therapy and recording its effect on the maxilla and maxillary dentoalveolar complex. Also, the results of the Twin Block appliance between males and females were compared.  Material and methods In this two-armed retrospective cephalometric study, 30 patients (mean age 12 years) treated with Twin Block appliance for the period of 8-12 months were chosen, and their records were obtained to analyze. These results were compared with 15 control subjects of the same age group chosen from the American Association of Orthodontics Foundation (AAOF) growth legacy collection: Michigan Growth Study Class II subjects. Cephalometric tracing was done, and data was processed for descriptive statistical analysis. Results Paired sample t-test and ANOVA test were performed to evaluate the differences in the pre-treatment (T1) and post-functional (T2) values. ∠ANB showed a mean difference of -4.71°±1.55° for males and 6.22°±6.78° for females, which is significant. The mandibular length (Co-Gn), for male subjects, the mean difference was 5.14±1.74 mm, and for female subjects, it was 6±2mm, which is highly significant; 49.88% of skeletal changes and 50.12% of dentoalveolar changes were reported to bring about Class II correction with Twin Block. Conclusion A successful increase in mandibular length was achieved using a Twin Block as a functional appliance. Also, the significant maxillary restraining effect was recorded. More skeletal changes were observed in males than females., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Gandhi et al.)

Introduction: Dentofacial functional appliances used for the treatment of skeletal Class II malocclusion are divided into two groups: Removable appliances and fixed (bonded) appliances, each with certain advantages and disadvantages. Considering the problems related to functional appliances such as high volume in the oral cavity, patient noncompliance, esthetics, tissue irritation or ulceration, speech or breathing difficulties, etc., there is considerable demand to develop a new appliance that can overcome these issues. Thus, the aim of the current study is to present a hypothesis regarding a new functional treatment technique. The hypothesis: We hypothesize that by fixing mini-plates or -implants in the posterior region of the mandible and the anterior part of the infrazygomatic crest region of the maxilla using intermaxillary elastics, we can expect a forward growth of the mandible in a growing child. Using this technique, the force vector will be in the oblique (forward-upward) direction. By installing mini-plates with a long connecting bar in the infrazygomatic crest region (with the orthodontic attachment head approximating the level of the occlusal plane), and mini-plates or -implants in the most posterior and superior regions of the mandible, such as the retromolar region, the force vector can be placed in the most horizontal direction possible. Evaluation of the hypothesis: In the literature, significant growth modification results were reported in skeletal Class III patients using intermaxillary elastics and bone-anchored devices fixed in both jaws, when compared with those in the nontreatment group. Therefore, in practice, intermaxillary elastics can produce enough traction to stimulate the bone to change and grow. Thus, we presume that inverting the direction of the force vector (i.e., posterior-anterior force) may have similar growth effects on the mandibles of growing children.

Skeletal Class III malocclusion with a prognathic mandible is one of the most severe maxillofacial deformities. Esthetics and functions are strongly effected and the treatments are long and hard in these malocclusions. Mandibular prognathism or maxillary retrusion or both might cause this type of malocclusions. Treatment approaches depend on the etiology, the severity of the malocclusion and the developmental stage of the subject. In growing children facial growth modification can be an effective method. Orthopedic appliances such as chincup, face mask, maxillary protraction and the functional appliances are mainly used for the correction of Class III malocclusions. In adults fixed orthodontic treatment and orthognathic surgery is required. Within recent years, the number of studies have increased presenting the use of distraction osteogenesis. This review summarizes the etiology, treatment strategies and effects of the different treatment approaches in Class III malocclusions. ÖZET Sınıf III malokluzyonlar, maksillofasiyal deformiteler içinde en ciddi anomalilerden biridir. Bireylerde estetik ve fonksiyon açısından yetersizliğe yol açan ve tedavileri oldukça uzun ve zor anomalilerdir. Bu malokluzyonlara alt çene prognatisi, üst çene retruzyonu veya her ikisi birden sebep olabilir. Tedavi yaklaşımları malokluzyonun kaynaklandığı çeneye, etiyolojisine, malokluzyonun şiddetine ve bireyin içinde bulunduğu büyüme gelişim dönemine bağlı olarak değişir. Büyüme dönemindeki çocuklarda yüz büyümesinin yönlendirilmesi etkili bir tedavi yaklaşımıdır. Bu amaçla; çenelik, yüz maskesi veya bazı fonksiyonel apareyler kullanılmaktadır. Erişkin dönemdeki bireylerde ise sabit ortodontik tedaviler ve ortognatik cerrahi yaklaşımları uygulanmaktadır. Son yıllarda distraksiyon osteogenezis yöntemi ile yapılan çalışmalara rastlanmaktadır. Bu derlemede, sınıf III malokluzyonların etiyolojileri, tedavi stratejileri ve farklı tedavi etkileri özetlenmiştir. Anahtar kelimeler: Sınıf III malokluzyon, çenelik, yüz maskesi, fonksiyonel tedavi, distraksiyon osteogenezis

Class II malocclusions are seen due to the underdevelopment of the mandible in most of the cases. To compensate for the mandible retrusive position, there is flaring of the lower anterior teeth or retroclination of the central incisors as a compensatory mechanism seen in Class II division 2 type of malocclusion. This case report evaluates the skeletal and dental changes when a 12-year-old female patient with Class II div 2 malocclusion was treated with a modified anterior inclined plane. The postreatment data suggested that there were no significant changes in the vertical skeletal parameters. The upper central incisors were significantly realigned by proclination along with retroclination of the lateral incisors. There was significant increase in the mandibular length. The results revealed that the modified anterior inclined plane showed good results in the treatment of a case of Class II div 2 malocclusion.

Copyright of Journal of Craniomandibular Function is the property of Quintessence Publishing Company Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The effects of the application of CO2-baths for the purposes of the specific early functional combined therapy in cases of reflexsympathetic dystrophy should be differentiated.Subjects: Forty patients suffering from acute post-traumatic reflex sympathetic dystrophy in the hand.Design: A four weeks’ omission test was carried out in group B. The resultswere contrasted to group A. The relevant parameters in the process of regeneration were statistically calculated as a chronological serial analysis.Results: In regard of the multi-variable design the results demonstrated highly significant group differences in the case of the progression of regeneration, at which group A was definitely superior to group B. Group B displayed an additional effect of delay. Conclusion: The potential influences with regard to the effects of the CO2-bath are: better organisation of the exercises and superior progression of regeneration. Obviously there are beneficial effects of the combination therapy.

The purpose o1 this study is to evaluate the dental and soft tissue changes in patients treated with the Jasper Jumper appliance which was filled with sectional arches. The study sample consisted of 30 subjects (15 treated, 15 untreated) with skeletal and dental Class II malocclusion. Our study was carried out on 60 lateral cephalometric films which were taken before placement and after removal of the Jasper Jumper appliance in the treatment group, and at inital and six months follow-up in the control group. The patient selection criteria were as follows skeletal and dental Class II malocclusion characterized by retrognathic mandible, normal or low angle vertical growth pattern, and post-peak growth period. The statistical assessment of the data suggested the following conclusions. The mandibular incisors were protructed and intructed while the maxillary incisors were retructed and extructed. The occlusal plane was rotated in clockwise direction as a result of dentoalveoler changes. Overbite and overjet were reduced in all patients. Soft tissue profiile improved significantly. As a result of the overjet reductiuon due to the retrusion of the upper incisors, the upper lip moved back and the lower lip no longer captured at the back of the upper incisors. Moreover, the lower incisors which are proclined supported the lower lip. Lip strength decreased favorably as a result of the upper incisors retrusion. The results of this study revealed that in late-adolescent patients Jasper Jumper appliance corrected Class II discrepancies mosbly through dentoalveolar changes. It is suggested that this treatment method could be an alternative to orthognathic surgery in borderline Class II cases.

• Many beneficial rehabilitation therapies exist for patients with multiple sclerosis. • Patient-centred plans that include goal setting are crucial aspects of therapy. • Exercise therapy offers physical, cognitive and psychological benefits for patients. • Both in- and out-patient settings can provide patient condition-dependant benefits. • Measurable improvements should be seen in impairment, activity and participation. Multiple sclerosis (MS) is a chronic, debilitating disease characterised by demyelination of the nerves of the central nervous system that results in patients progressively losing the ability to perform daily tasks. As there is no cure for this disease, rehabilitation therapy is an important aspect of care; assisting patients to regain or retain function and improve their physical, mental and social wellbeing. At present there is no current consistent model of care for MS, likely due to the variable symptom presentation. Various forms of rehabilitation therapy are available, and these include physical rehabilitation methods, such as balance and gait therapy, speech and respiration rehabilitation, and occupational therapy. Contrary to previous understanding, exercise-based therapies have shown various benefits for patients with MS, and in addition to improving MS-related physical symptoms, have been shown to reduce the risk of developing cardiovascular disease and can improve cognitive function. Cognition rehabilitation therapy specifically focuses on behavioural tasks and is divided into two main forms: compensatory rehabilitation, which offers cognitive functioning benefits, and restorative rehabilitation, which offers memory benefits. Excitation therapies include cranial stimulation and other stimulation rehabilitation methods such as focal muscle vibration therapy and these non-invasive techniques may improve patient's physical ability. Additionally, more novel rehabilitation methods include robot-assisted gait therapy and telerehabilitation, both of which are expected to play progressively more prominent roles in the future of rehabilitation therapy. The structure of the care team has been found to impact patient outcomes, and both in- and out-patient care settings have been found to be beneficial, dependant on the patient's circumstances, with certain patients better suited to a particular setting. While a single point of care is recommended for patients, a multidisciplinary care team and regular reassessment is recommended to manage changing symptoms and ensure continuity of care. The importance of the critical components of rehabilitation have been identified, and these are of vital importance in achieving beneficial outcomes. These components include the patients' participation in the treatment, goal setting with a multidisciplinary care team, a guiding-light purpose for the patient, which focusses on recognizing their personal potential and obtaining improvements through a tailored plan. The final critical component of rehabilitation is the results measurement, which highlights the need for a quantifiable reduction in impairment and improvement in activity and participation. Overall, a lack of standardisation in outcome measurements makes comparison challenging. This is particularly important when comparing standard methods of care with more novel rehabilitation techniques. However, within the broad area of rehabilitation therapies, it is clear that patients with MS can benefit from rehabilitation practices; physically, mentally and socially. [ABSTRACT FROM AUTHOR]