Search Results (12)

The prevalence of temporomandibular disorders during childhood and adolescence reported until 2019 was between 7 and 68%. The aim of the present study is to determine the prevalence of temporomandibular disorders in children. This study, registered in The International Prospective Register of Systematic Reviews (CRD42022378908), assessed the prevalence of temporomandibular disorders in children and adolescents through the Research Diagnostic Criteria for Temporomandibular Disorders. Information was restricted based on the age and language of publication. In total, 985 records were identified through databases (EBSCO, PubMed, Web of Science, Scopus, and Cochrane Library) and 45 through grey literature sources (SciELO, Google Scholar, and Latindex). After removing duplicates and irrelevant records, 285 studies were screened, of which 32 had their full text assessed. Eight were included for qualitative and quantitative synthesis. The prevalence of muscle pain ranged from 0% to 31%; arthralgia ranged from 0.8% to 3.5%; disc displacement with reduction ranged from 0.4% to 14.4%; disc displacement without reduction ranged from 0% to 0.3%; osteoarthritis ranged from 0% to 0.6%; and osteoarthritis (in another context) ranged from 0% to 2.2%. This review highlights the varying prevalence of temporomandibular disorders (TMDs) in children and adolescents, with muscle pain as the most common symptom. Despite advancements in diagnostic criteria, gaps in imaging and psychological evaluation persist. Full article

Background: Mandibular condyle fractures in pediatric patients can lead to crippling sequelae such as ankylosis, pain and facial deformity if not managed properly. However, there is no consensus on the best approach for treating these fractures in children. Objective: This study aimed to describe the management of mandibular condyle fractures in growing patients across 14 maxillofacial departments worldwide. Methods: A retrospective multicenter study was conducted on children and adolescents aged 0 to 16 who had at least one mandibular condyle fracture. This study included patients who underwent expectant, closed, or open management and were treated over an 11-year period. Results: 180 patients had at least one mandibular condyle fracture, and 37 had a second condylar fracture. One hundred sixteen patients (65%) were males, and 64 (35%) were females (ratio 1.8:1). An expectant strategy was chosen in 51 (28%) patients, a closed treatment—stand-alone maxillomandibular fixation (MMF)—in 47 (26%), and open reduction and internal fixation (ORIF) was performed in 82 (46%) patients. The management varied significantly between the different departments (p < 0.0001). Significant differences were also identified between the fracture type (non-displaced, displaced or comminuted) and the management of the 180 patients with a single condylar fracture. Out of 50 non-displaced fractures, only 3 (6%) had ORIF, 25 (50%) had expectant management, and 22 (44%) had MMF. Out of 129 displaced fractures, 79 (62%) had ORIF, 25 (19%) had a soft diet, and 25 (19%) had MMF. Conclusions: Expectative management, MMF, and ORIF were all effective in treating pediatric mandibular condyle fractures, with a low incidence of complications and asymmetry. Full article

Patellar sleeve fractures, though relatively rare, present unique challenges in diagnosis and management. This review aims to provide a comprehensive overview of the current understanding of patellar sleeve fractures, focusing on their epidemiology, clinical presentation, imaging, and management strategies. Epidemiologically, these fractures are uncommon, representing approximately 1% of all fractures in pediatric patients, yet they account for 50% of all patella fractures in this population. They predominantly affect adolescents, with a peak incidence around 12.7 years of age, and are more common in boys, occurring at a ratio of 3 to 5:1. Understanding these demographic patterns is crucial for early recognition and appropriate management. Clinically, patellar sleeve fractures typically present with the sudden onset of severe pain, often associated with explosive activities such as jumping. However, diagnosis can be challenging, particularly in cases with minimal displacement or where alternative muscle groups compensate for the injury. Differential diagnosis is essential, and clinicians should be vigilant for signs such as palpable gaps at the lower pole of the patella and patella alta. Imaging modalities play a vital role in diagnosis, with plain X-rays often revealing no bony damage. Ultrasonography may offer a cost-effective alternative, especially in cases where radiographic findings are inconclusive. Advanced imaging techniques such as MRI can assist in characterizing the extent of the injury and assessing for associated complications. Management strategies encompass a spectrum of approaches, ranging from conservative measures such as immobilization and physical therapy to surgical interventions, including open reduction and internal fixation or arthroscopic surgery. The choice of treatment depends on various factors, including the fracture pattern, displacement, patient age, activity level, and associated injuries. Despite advancements in diagnosis and treatment, the optimal management of patellar sleeve fractures remains a clinical challenge. Further research is warranted to elucidate optimal algorithms for diagnosis and treatment, with the ultimate goal of improving outcomes and reducing the risk of long-term complications associated with this rare but clinically significant knee injury. Full article

Background: Incisor retraction is often a crucial phase in ongoing orthodontic treatment, with significant implications for alveolar remodeling mechanisms. There are two prevailing theories which seek to explain this. According to the first, teeth move with the bone, while according to the second, teeth move within the bone. This systematic review seeks to assess morphometric changes in the maxillary alveolar process resulting from incisor retraction following premolar extraction and to evaluate the potential for bone remodeling associated with orthodontic movement. Methods: The study was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The following electronic databases were searched: PubMed, Google Scholar, Web of Science EMBASE and the Cochrane Central Register of Controlled Trials. The databases were searched using the following keywords: “Bone remodeling and retraction of incisors”, “Alveolar bone and incisor retraction”, “Bone thickness and incisor retraction”, and “Bone changes and orthodontic treatment”. Search filters were utilized to identify relevant papers and articles written in English and published during the last 10 years. Based on the information provided in their abstracts, papers and articles were selected according to the following criteria: randomized clinical trials (RCTs), controlled clinical prospective trials (CCTs), and retrospective studies. Articles unrelated to the study’s scope or failing to meet inclusion criteria were excluded. These generally comprised individual case reports, case series reports, literature reviews, experimental studies, studies with limited data (including conference abstracts and journal writings), studies involving an unrepresentative group of patients (less than 10 patients), studies concerning patients with syndromes, and animal experiments. The remaining articles which were deemed relevant underwent comprehensive reference review and such journals as the American Journal of Orthodontics, Dentofacial Orthopedics, International Orthodontics, Journal of Clinical Orthodontics, and Angle Orthodontist were manually searched. Results: Seven articles meeting the inclusion criteria articles were selected for final evaluation, with a total of 284 participants, including 233 women and 51 men. During the analysis of the results included in the publications, a lack of homogeneity was observed, rendering a reliable statistical analysis and heterogeneity assessment unobtainable. Noteworthy disparities in methodologies and measurements posed a risk of drawing inappropriate conclusions. Consequently, emphasis was placed on qualitative analysis, emphasizing the need for standardization in future studies of a similar nature, to enable valid and comparable analyses. Conclusions: The research findings incorporated in this review demonstrate that significant bone loss occurs because of incisor retraction, which diminishes distance between the bone surface and the root surface on the palatal aspect. The magnitude of this change may vary, contingent upon both the extent of incisor displacement and alterations in their inclination, thereby affecting the positioning of the root tips. This change is significantly higher in adults than in growing adolescents. The rationale behind this assertion lies in the widely recognized phenomenon of declining cellular activity with advancing age. The decrease in the speed and intensity of cellular changes may explain the diminished capacity for remodeling as patient age increases. There is ongoing discourse regarding alterations in the volume of bone on the labial aspect of the alveolar process. Further research is necessary to measure whether bone remodeling during orthodontic movement is contingent upon other factors, such as the speed and biomechanics of retraction, the level of applied orthodontic force, and the patient age. Full article

Many recent legislative reforms concerning children have emphasized the importance of involving children and adolescents in accordance with the principles of Article 12 in the UN Convention on the Rights of the Child. This article deals with the rights of youths to express their opinions, feelings, and views in parent-teacher conferences in lower secondary education in Denmark. Both international and Danish research on parent-teacher conferences has shown that students are often objectified and are not provided with real opportunities to participate with their own voices and perspectives. Based on the sociology of Hartmut Rosa, the article explores students’ experiences of parent-teacher conferences as zones of alienation or spaces of resonance. In addition, we draw on Gert Biesta’s concept of subjectification to analyze how the current organization of the conferences largely displaces students’ opportunities to bring themselves into play as subjects of their own lives. The analysis is based on observations and interviews carried out in 2021 and 2022. Full article

Introduction: Tibial spine avulsion injury, tibial eminence injury, tibial spine fracture, and anterior cruciate ligament (ACL) avulsion are multiple terms that express the same pathological condition. It can be encountered both in the pediatric and adult population. A wide array of surgical techniques have been proposed to manage displaced tibial spine avulsions. Anyway, insufficient evidence is currently available to prefer one fixation technique over another, and a gold-standard arthroscopy-based technique is still missing. In this article, we describe a mini-invasive, safe and user-friendly technique for arthroscopic reduction and internal fixation of displaced tibial eminence fractures. Materials and methods: Standard and patient-specific accessory arthroscopic portals allow for full access to knee visualization and management of concomitant intraarticular lesions. After performing the debridement of the inflammatory tissue and the release of eventual interposed tissues in the fracture site, the tibial eminence avulsion can be reduced by using a less-invasive bone impactor. With the knee flexed to 90°, the fracture fragments are then synthesized (under fluoroscopic control) with three thin Kirschner wires inserted in a proximal–distal direction in a cross-shaped geometry. Results: This technique allows a fast surgical and hospitalization time, a punctiform arthrotomy, proximal tibial physis preservation, and an early rehabilitation program. Conclusions: This novel technique seems attractive and very promising since it is respectful of the epiphyseal growth plates and is thus suitable for children and adolescents. Full article

Background and Objectives: Type V tibial tubercle avulsion fractures are extremely rare; therefore, information on them remains limited. Furthermore, although these fractures are intra-articular, to the best of our knowledge, there are no reports on their assessment via magnetic resonance imaging (MRI) or arthroscopy. Accordingly, this is the first report to describe the case of a patient undergoing detailed evaluation via MRI and arthroscopy. Case Presentation: A 13-year-old male adolescent athlete jumped while playing basketball, experienced discomfort and pain at the front of his knee, and fell down. He was transported to the emergency room by ambulance after he was unable to walk. The radiographic examination revealed a Type Ⅴ tibial tubercle avulsion fracture that was displaced. In addition, an MRI scan revealed a fracture line extending to the attachment of the anterior cruciate ligament (ACL); moreover, high MRI intensity and swelling due to ACL were observed, suggesting an ACL injury. On day 4 of the injury, open reduction and internal fixation were performed. Furthermore, 4 months after surgery, bone fusion was confirmed, and metal removal was performed. Simultaneously, an MRI scan obtained at the time of injury revealed findings suggestive of ACL injury; therefore, an arthroscopy was performed. Notably, no parenchymal ACL injury was observed, and the meniscus was intact. The patient returned to sports 6 months postoperatively. Conclusion: Type V tibial tubercle avulsion fractures are known to be extremely rare. Based on our report, we suggest that MRI should be performed without hesitation if intra-articular injury is suspected. Full article

Aims: Armed conflicts produce a wide series of distressing consequences, including death, all of which impact negatively on the lives of survivors. This paper focuses specifically on the mental health consequences of war on adults and child/adolescent refugees or those living in war zones through a review of all systematic reviews and/or meta-analyses published from 2005 up until the current time. Results: Fifteen systematic reviews and/or meta-analyses conducted in adult populations, and seven relating to children and adolescents, were selected for the purpose of this review. Prevalence rates of anxiety, depression and post-traumatic stress disorder (PTSD) were two- to three-fold higher amongst people exposed to armed conflict compared to those who had not been exposed, with women and children being the most vulnerable to the outcome of armed conflicts. A series of war-related, migratory and post-migratory stressors contribute to short- and long-term mental health issues in the internally displaced, asylum seekers and refugees. Conclusion: It should be a required social responsibility for all psychiatrists and psychiatric associations to commit to raising awareness amongst political decision-makers as to the mental health consequences caused by armed conflicts, as part of their duty of care for people experiencing the consequences of war. Full article

Background and Objectives: The femoral neck system (FNS) is a new minimally invasive internal fixation system for femoral neck fractures (FNFs), but its use has not been reported in adolescents. The aim of this study was to compare the clinical and radiographic outcomes of displaced FNF in adolescents treated with FNS or a cannulated compression screw (CCS). Materials and Methods: A retrospective study of 58 consecutive patients with displaced FNF treated surgically was performed; overall, 28 patients underwent FNS and 30 CCS fixation. Sex, age at injury, type of fracture, associated lesions, duration of surgery, radiation exposure, and blood loss were collected from the hospital database. The clinical and radiographic results, as well as complications, were recorded and compared. Results: The patients were followed up for 16.4 ± 3.1 months on average after index surgery (range, 12 to 24). Consolidation time among patients treated with FNS was significantly lower than those managed by CCS (p = 0.000). The functional scores of patients treated with FNS were significantly higher than those managed by CCS (p = 0.030). Unplanned hardware removal in patients treated with FNS was significantly lower than in those managed by CCS (p = 0.024). Conclusions: FNS has a lower complication rate and better functional outcome than CCS. It may be a good alternative to treat femoral neck fractures in adolescents. Full article

Russia’s military incursion into Ukraine triggered the mass displacement of two-thirds of Ukrainian children and adolescents, creating a cascade of population health consequences and producing extraordinary challenges for monitoring and controlling preventable pediatric infectious diseases. From the onset of the war, infectious disease surveillance and healthcare systems were severely disrupted. Prior to the reestablishment of dependable infectious disease surveillance systems, and during the early months of the conflict, our international team of pediatricians, infectious disease specialists, and population health scientists assessed the health implications for child and adolescent populations. The invasion occurred just as the COVID-19 Omicron surge was peaking throughout Europe and Ukrainian children had not received COVID-19 vaccines. In addition, vaccine coverage for multiple vaccine-preventable diseases, most notably measles, was alarmingly low as Ukrainian children and adolescents were forced to migrate from their home communities, living precariously as internally displaced persons inside Ukraine or streaming into European border nations as refugees. The incursion created immediate impediments in accessing HIV treatment services, aimed at preventing serial transmission from HIV-positive persons to adolescent sexual or drug-injection partners and to prevent vertical transmission from HIV-positive pregnant women to their newborns. The war also led to new-onset, conflict-associated, preventable infectious diseases in children and adolescents. First, children and adolescents were at risk of wound infections from medical trauma sustained during bombardment and other acts of war. Second, young people were at risk of sexually transmitted infections resulting from sexual assault perpetrated by invading Russian military personnel on youth trapped in occupied territories or from sexual assault perpetrated on vulnerable youth attempting to migrate to safety. Given the cascading risks that Ukrainian children and adolescents faced in the early months of the war—and will likely continue to face—infectious disease specialists and pediatricians are using their international networks to assist refugee-receiving host nations to improve infectious disease screening and interventions. Full article

Previous research has shown that gender affects social support and post-traumatic stress disorders (PTSD). The present study explores the main and interaction effects of gender and place of settlement on social support, PTSD symptoms, and insomnia in internally displaced adolescents (IDAs) in North-east of Nigeria. A stratified sampling method was used to select 109 participants from IDAs living in the camp, while 27 additional IDAs were purposively recruited from those living in the host community. Participants completed measures of Harvard Trauma Questionnaire Part-II, Insomnia Severity Index, and Crisis Support. No significant effects of gender on perceived social support, PTSDs, and insomnia were observed. Place of settlement had a significant effect on social support, with IDAs living in the camp having a higher mean score, while place of settlement had no significant effects on PTSD and insomnia. A significant interaction effect of gender and place of settlements on insomnia was found, with males living in the community having a higher mean score than their female counterparts, as well as both males and females in the camp. In conclusion, there is a need to understand male IDAs who reside in non-camp settings better, including the nature of their challenges, the outcomes they desire, and the limitations they experienced. Full article

Purpose: To analyze the relationships between body mass index (BMI), ideal body, current declared body shape, and gap between ideal and declared body shape, and the associations that these have with social and cultural factors among 329 adolescents (11 to 15 years i.e., at two stages of adolescence, the early and late adolescence), attending an international school in Luxembourg, and 281 from Paris. Methods: A cross-sectional survey was conducted using an online questionnaire. Missing data were addressed using the data augmentation method in a Bayesian framework. Results: For both sets, higher the BMI and bigger their current body shape (CBS), the slimmer their ideal body shape, especially for those who perceive a link between body shape and beauty. For girls, slimness is a shared ideal; for boys, older they are, more they want a muscular body shape. Most students want slimmer bodies, but in affluent or intermediate social milieu students in relations to identification to personalities such as celebrities, while students from modest milieus, this is expressed in relation to success in love. In addition, they declared that their “talk diet with friends” were associated with large gap between ideal and declared body shape. Conclusions: A social control norm was revealed involving a displacement of values affecting body weight and health in the late stage of adolescence to early adolescence, especially for boys. Full article