Medicine and Health Sciences Commons^™

Oropharyngeal Airway Changes Following Orthodontic Treatment Of Anterior Open Bite In Growing Vs Non-Growing Patients, Mona Awadi, Heeyeon Suh, Joorok Park, Heesoo Oh

Orthodontics and Endodontics Theses

Introduction: Orthodontic treatment of anterior open bite can result in a counter-clockwise rotation of the mandible and a more ideal forward position of the tongue. Usually this movement is thought to increase the oropharyngeal airway. The primary aim of the present study was to evaluate changes in vertical dimension and airway in AOB patients following orthodontic treatment. Methods: 52 subjects were included in this retrospective study of anterior open bite malocclusion treated in the graduate orthodontics clinic at the University of the Pacific, Arthur A. Dugoni School of Dentistry between 2006 – 2019. Cephalometric and airway measurements were done by …

Association Of Type And Severity Of Nonsyndromic Orofacial Clefts With Combined Genotypes Of Rfc1 80 Ga, Mthfr 677 Ct, Irf6 (Rs642961) And Irf6 (Rs2235371) Gene Polymorphisms In An Indian Population, Chantal Hakim Dds, Msd, Marie M. Tolarová Md, Phd, Drsc, Miroslav Tolar Md, Phd

Orthodontics and Endodontics Theses

Association of type and severity of nonsyndromic OROFACIAL CLEFTS with combined genotypes of RFC1 80 GA, MTHFR 677 CT, IRF6 rs642961 and rs2235371 gene polymorphisms in an Indian population Abstract By Chantal Hakim University of the Pacific. Arthur Dugoni School of Dentistry 2020 Introduction. Genetic etiology of nonsyndromic orofacial clefts comprises many genes acting together. However, little is known about their interactions. The purpose of our study was to analyze associations of phenotypic subtypes of nonsyndromic orofacial clefts with combinations of four genotypes involving candidate gene polymorphisms. Materials and Methods. We analyzed a large dataset of cases and controls collected …

Comparison Of Skeletal And Dental Differences Between Class I And Class Ii Sides And Their Relationship With Asymmetric Molar Relationships In Class Ii Subdivision Malocclusions – A Cbct Study, Ivan Lo, Heeyeon Suh, Joorok Park, Heesoo Oh

Orthodontics and Endodontics Theses

Introduction: The purpose of this study is to compare dental and skeletal differences between Class I and Class II sides and their contributions to the degree of asymmetric molar relationship in Class II subdivision malocclusions using CBCT.

Methods: One hundred and eight patients presenting with Angle Class II subdivision malocclusions (mean age =21.05 years) were assessed with 3-dimensional cone-beam computed tomography scans. Paired t-tests were used to compare linear skeletal, angular and dental measurement differences between Class I and Class II sides. Correlations of linear skeletal, angular and dental measurement differences between Class I and Class II sides were made …

Invisalign First: A Qualitative Study On The Perceived Benefits And Drawbacks Of Invisalign First As A Treatment Modality For Mixed Dentition Patients, Erin Walker, James Chen

Orthodontics and Endodontics Theses

Given the recent implementation of Invisalign First for early interceptive orthodontic treatment, a limited number of orthodontists have had experience with this treatment modality and there currently are no published studies on the topic. The present study aims to use a qualitative survey to identify common themes in providers’ perceptions of Invisalign First as a new treatment option for early interceptive orthodontics. Twenty-three orthodontists in the private practice sector voluntarily participated in an open-ended survey via email. The results of the survey indicate the following common themes in regards to benefits of Invisalign First: fewer emergencies, patient comfort, patient experience, …

Prediction Of Class Iii Treatment Need And Success, Andrew Levin, James Chen

Orthodontics and Endodontics Theses

Objective: The purpose of the present study is to develop prognostic models for surgical need and treatment success for class III malocclusions. Material and Methods: This is a retrospective cohort study that evaluated treatment outcomes of consecutively treated patients at UCSF from Jan 1st 2007-Jan 1st 2012 and UoP from May 1st, 2014 – May 1st 2019. Receiver operator curves were used to develop prognostic models for surgical need and treatment success for class III malocclusions. Predictor variables were selected a priori (Class III-WITS, U1-PP, IMPA). The prognostic models were validated first using a UCSF validation cohort to show consistency …

Patient And Parent Perceptions On Outcomes In Early Orthodontic Treatment, Joseph Phillips, James Chen

Orthodontics and Endodontics Theses

Introduction: Orthodontics has clinical benefits, however, the psychosocial outcomes are not well understood. These soft benefits are often classified as aesthetic, functional, and psychosocial, however, there is limited work understanding these outcomes as reported directly from the patient. By better understanding the patient’s perspectives, we can continually refine our clinical model to be patient-centric and more appropriately manage the patient’s expectations and experiences. Materials and Methods: This is a cross-sectional qualitative study of 20 parents of 24 children ages 8-11 years. Participants were remotely interviewed using a semi-structured chronologically based line of questioning to elucidate their perceived outcomes of early …

Prevalence Of Short Root Anomaly In Patients Seeking Orthodontic Treatment, Tim Howarth, James Chen, Heesoo Oh

Orthodontics and Endodontics Theses

Introduction: The purpose of this study was to investigate variance in prevalence and severity of short root anomaly (SRA) in patients seeking orthodontic treatment, stratified by ethnicity and sex. Materials and Methods: In this retrospective cross-sectional study, we evaluated 896 patients who had initial cone-beam computed tomographies (CBCTs) taken from July 1, 2014 to May 30, 2019. Panoramic radiographs and images from the CBCTs of each patient were extracted and placed in a database. The crown-to-root ratio of maxillary central incisors, lateral incisors, canines, and all pre-molars were evaluated to determine the presence, severity and associations of SRA. A Chi-square …

Soft Tissue Effects From Maxillomandibular Advancement With Counterclockwise Rotation, Timothy Yu, Audrey Yoon, Stanley Yung Chuan Liu, Heeyeon Suh, Joorok Park, Heesoo Oh

Orthodontics and Endodontics Theses

Introduction: The purpose of the study was to evaluate the effects of maxillomandibular advancement (MMA) surgery with counterclockwise rotation on soft tissue oral and nasal structures. Materials and Methods: This retrospective study included 34 subjects diagnosed with OSA who underwent MMA at the Stanford Sleep Clinic. Initial (T1) and Final (T2) CBCTs were evaluated and compared for 10 hard tissue and 15 soft tissue measurements. Additionally, the external nasal valve surface area was measured and compared between the two time points. A 3D superimposition was performed and used to evaluate the relative hard and soft tissue movements. Results: There was …

Efficiency And Effectiveness Of Arch Expansion With Corticotomy-Assisted Clear Aligner Therapy, Thomas Roblee, Robert R. Boyd, James Chen, Heesoo Oh

Orthodontics and Endodontics Theses

Introduction: Surgically Facilitated Orthodontic Therapy (SFOT) has been utilized for years to overcome the limitations encountered with traditional orthodontic treatment of dentoalveolar and alveoloskeletal malocclusions. The procedure, which consists of full flap corticotomies and bone grafting, has many proposed benefits including increased speed and range of tooth movement. The purpose of this study is to evaluate arch expansion in patients treated with SFOT and clear aligners. Materials and Methods: A retrospective cohort study design was used to evaluate 51 consecutive adult patients that were treatment planned for significant arch expansion with corticotomies, bone grafting, and clear aligners. 17 of the …

Epidemiology, Outcome, And Prognostic Factors Of Oropharyngeal Lymphoepithelial Carcinoma: A Population-Based Analysis Using The Seer Database, Serena Lee

Orthodontics and Endodontics Theses

Introduction: Lymphoepithelial carcinoma (LEC) in the oropharynx is rare. Current understanding of the disease is derived mainly from case reports and small case series, prompting further elucidation of its epidemiology and prognostic factors that affect outcome. The aim of this retrospective cohort study was to examine demographic characteristics, clinicopathologic features, and prognostic factors in patients with oropharyngeal LEC. Methods: The U.S. National Cancer Institute’s SEER registry was queried to obtain data on patients with primary oropharyngeal LEC from 1975 to 2016. Variables examined include age at diagnosis, sex, race, year of diagnosis, primary site of tumor origin, tumor size, extent, …

Improving Symptomatic Postural Tachycardia With Pharmacotherapy Versus Physical Conditioning, Heather L. Conklin

Physician Assistant Capstones

An estimated one to three million Americans are affected by orthostatic intolerance, with females under age 35 the most common. Postural orthostatic tachycardia syndrome (POTS) is a disorder marked by symptoms of orthostatic intolerance within the first ten minutes of a patient moving from supine to an upright standing position. Patients must experience a sustained heart rate increase of at least 30 bpm (40 for pediatric patients) or greater than 120 bpm in the absence of orthostatic hypotension (OH). A thorough clinical evaluation should be performed prior to head-up tilt (HUT) testing to exclude other causes of tachycardia.

Identifying Patients With Major Depression Who Benefit From Ketamine Therapy, Jessi Riel

Physician Assistant Capstones

Over the last few years, ketamine has been studied as a possible treatment option for Major Depressive Disorder (MDD) and TRD. Ketamine is an NMDA receptor antagonist that targets the glutaminergic system and produces rapid antidepressant effects from mechanisms that are still incompletely defined.5 In March 2019, the FDA approved intranasal esketamine, an enantiomer of ketamine, as a treatment for those who have failed at least two antidepressant medications.6The approval of esketamine as a treatment option for major depressive disorder is considered a significant breakthrough in psychiatric medicine and provides promise for the future of depression management. Nonetheless, the effects …

Military Veteran Ptsd Treament: How Does Eye Movement Desensitization And Reprocessing Therapy Compare To Prolonged Exposure Therapy?, Jamie Romero

Physician Assistant Capstones

Therefore, the question to be answered is, in military veterans with PTSD, how does prolonged exposure therapy compare to eye movement desensitization and reprocessing therapy (EMDR) in regard to treatment success rates during treatment course? Our Veterans serve our country, protect us and some pay the ultimate sacrifice with their lives. We owe those who remain behind with invisible scars the effort and desire to find the best treatment.

Exercise Regimen Recommendations In Type Ii Diabetics And Their Effects On Glucose Control, Emily Schroeder Smith

Physician Assistant Capstones

The most effective non-pharmacologic method of reducing the hemoglobin A1c (HgbA1c) levels in type II diabetic patients is still debated. Clinicians evaluating and treating Type II Diabetics (T2DM) generally recommend diet and lifestyle modifications as initial therapy. The medical literature comparing different types of exercise and their effects on glucose control was reviewed with the goal of determining whether aerobic or resistance exercise was more effective for reducing HgbA1c levels in type II diabetics. The more effective form of exercise, if any, could then be recommended in addition to diet and other lifestyle changes. Although the studies were heterogeneous in …

Effects Of Exercise On The Progression Of Multiple Sclerosis, Nicole Briggs

Physician Assistant Capstones

Multiple sclerosis (MS) has a vast array of clinical presentations, yet the science of its pathophysiology has not evolved adequately to target or prevent the sequelae of the disease. What is known, however, is that MS is a chronic inflammatory and neurodegenerative disease of the central nervous system due to demyelination of the axons of white matter resulting from infiltration of lymphocytes and astrocytes. 1 This axonal loss leads to the neurologic and constitutional (or systemic) deficits: visual disturbances, tremors, weakness, fatigue, cognitive impairment, depression/anxiety, poor motor control, and overall very poor quality of life from reduced mobility. 2 The …

Platelet-Rich Plasma Intra-Articular Injections In Reducing Pain And Improving Function In Patients With Osteoarthritis, Chelsea M. Brekke

Physician Assistant Capstones

Whether the complex and time-intensive requirements for administering PRP warrants its use for intra-articular (IA) therapy in OA is in question and should be examined. If PRP is at least or even more effective than corticosteroids or hyaluronic acid (HA) for relieving pain and restoring function, then it can be recommended with confidence to OA patients who are appropriate candidates for intra-articular injections. In addition, if its beneficial effects are more durable than other IA agents, it may become the preferred treatment of choice.

Human Trafficking In Healthcare And The Efforts To Identify And Rescue, Josephine Appeng

Physician Assistant Capstones

Given the covert nature of HT, there exists little compelling evidence of its full extent in healthcare. Nonetheless, there is growing development in research, training, and interventions to improve the knowledge and skills of healthcare providers. To apply this in the clinical setting, researchers must demonstrate, for clinicians likely to encounter HT victims, how the knowledge and confidence levels to identify and respond to HT victims compare before and after a training session.

Knee Osteoarthritis And The Efficacy Of Different Forms Of Exercise: Is One Form Better Than Another?, Cayla Clark

Physician Assistant Capstones

Osteoarthritis affects 20% of the global population, making it the most common musculoskeletal problem in the world. Knee osteoarthritis (OA) increases in prevalence with age and affects women more than men, although both are affected. Eighty percent of persons with knee OA experience pain and 25% struggle to perform activities of daily living. These decreases in function and mobility can affect the overall quality of life for these individuals. Several studies have examined different forms of exercise in knee OA patients (resistance training, aerobic exercise, dynamic training, mind-body exercise, and retro and forward walking) as a means of improving pain, …

Which Diet Should Providers Recommend To Patients To Help Reduce Their Risk Of Cognitive Decline And Alzheimer’S Disease?, Becca E. Escoto

Physician Assistant Capstones

Recent studies indicate that in the United States 6.1 million people had clinical Alzheimer’s Disease (AD) or mild cognitive impairment in 2017. This number is expected to grow to 15 million by 2060.1 The World Alzheimer Report of 2015 estimated the global cost of AD to be one trillion US dollars in 2018, and AD is currently ranked as the sixth leading cause of death in the United States.2 As life expectancy throughout the world increases, these numbers will continue to grow. Interventions and preventative measures are important to implement in all patient populations as they could delay disease onset …

Supervised Injection Facilities And Harm Prevention In Recreational Drug Users, Kirsten Dorsey

Physician Assistant Capstones

Supervised Injection Facilities (SIF) are a proposed public health intervention for improving access to medical care, decreasing comorbidities related to drug use and overdose related deaths, as well as changing drug use patterns. SIF are medically staffed clinics where drug users may bring and consume their own illicit drugs. Medical staff are available to intervene and stabilize patients in cases of overdose, but can also instruct patients on safe venous access, provide access to clean needles, give prescriptions for narcan, and provide symptomatic treatment for withdrawal symptoms. Some clinics are also beginning to offer counseling and psychiatric services as well …

Utilization Of Ultrasound-Guided Peripheral Intravenous Access In The Reduction Of Central Venous Catheter Insertion, Megan Culberson

Physician Assistant Capstones

Intravenous (IV) catheter placement is the most frequently performed hospital procedure. IV catheters are essential for administering medications, fluids, radiographic contrast media, and collecting blood specimens. , However, IV catheter placement can be problematic in patients with veins that are not palpable or visible as this may delay the course of treatment. Most studies define difficult venous access as undergoing at least two IV attempts without success or use of other methods of IV placement. Alternative means of IV access include the use of an atypical vein (i.e., external jugular vein), ultrasound-guided peripheral intravenous catheter (USGPIV) placement, intraosseous (IO) device …

The Provider’S Approach To Addressing Vaccine Hesitancy, Leslie Hohenbrink

Physician Assistant Capstones

Heralded as one of the greatest innovations in medical science was the discovery and implementation of vaccines to prevent illness. It is why our society is no longer plagued with diseases such as smallpox and polio on a large scale. In recent years though, society has faced a new emerging threat in the form of vaccine skepticism and avoidance. Different terms have been used to describe this distrust in vaccines. The current preferred term of vaccine hesitancy is associated with refusal or postponement of vaccination despite vaccine accessibility and availability. This term is preferred over previous labels such as anti-vaxers, …

Atherosclerotic Cardiovascular Disease –The Gut Microbiome As A Risk Factor, Kristin J. Gedda

Physician Assistant Capstones

As it remains, cardiovascular disease (CVD) has been the leading cause of mortality across the globe accounting for as many as 17.9 million deaths per year and projected to increase to more than 23.6 million deaths by 2030.1 Of the CVD related deaths, the majority are due to acute myocardial infarctions (AMI) and cerebral vascular accidents (CVA) and are associated with modifiable risk factors such as obesity, dyslipidemia, hypertension, and diabetes.2 Lifestyle modifications for decreasing these risk factors have been actively emphasized in healthcare, but do not eliminate the risks entirely. In addition to diet, exercise, and smoking cessation, other …

Observation Versus Surgery?: A Treatment Paradigm Shift For The Fastest Rising Cancer Diagnosis In The World: Papillary Thyroid Cancer, Emily Clyma

Physician Assistant Capstones

Papillary thyroid cancer has increased in incidence dramatically over the past three decades making it the fastest rising cancer diagnosis in the world. The prognosis of this disease remains excellent despite this dramatic rise which has called into question the risk of overdiagnosis and overtreatment of this disease. The American Thyroid Associated (ATA) currently recommends surgical treatment for all confirmed malignant thyroid nodules over 1 cm in diameter. However, some research suggests that tumors under 1 cm have a greater prevalence of lymph node metastases while other research suggests that observation is an appropriate option for tumors greater than 1 …

Short Sleep Duration And The Risk Of Hypertension And Diabetes, Jacob Novick

Physician Assistant Capstones

Per the CDC, in the year 2016, essential hypertension as a primary diagnosis lead to 1 million emergency department visits. Outpatient visits with that same diagnosis and year were staggering as well, at 32.8 million visits.5 Mortality in 2016 exceeded 35,000 deaths due to primary hypertension.5 The numbers are just as concerning for diabetes, per the CDC’s report that 11.4% and 11.5% of emergency department visits and physician office visits, respectfully, involved diabetes in 2016. In addition, diabetes was responsible for more than 83,000 deaths in 2016.6

These statistics highlight the importance of determining the relationship of short sleep durations …

In Healthcare Providers, What Is The Effect Of Mindfulness-Based Interventions Compared With No Mindfulness-Based Interventions On Stress And Burnout In 4 Weeks Or More?, Anne Chan

Physician Assistant Capstones

High suicide rates and job burnout are associated with the healthcare profession, especially among physicians. The healthcare work environment is characterized by stress, demanding workloads, long shifts, and strong emotions that impact the well-being of healthcare providers (HCPs).1-3 HCPs may experience symptoms of anxiety, stress, depression, and insomnia. The well-being of healthcare providers ultimately affects medical-decision making and quality of patient care.1,4-6 Mindfulness practice has been proposed to reduce workplace stress experienced by HCPs.1,6 Mindfulness is a form of training in which an individual maintains attention on the unfolding present experience in a non-judgmental way.1 Practicing mindfulness is believed to …

Effectiveness Of Mannitol Vs Hypertonic Saline For Intracranial Hypertension From Traumatic Brain Injury, Jennifer Saephanh

Physician Assistant Capstones

Since elevated ICP is complicated by higher mortality and serious neurologic deficits, its prevention and treatment are key. Osmotic agents can decrease cerebral edema and thus, ICP. This therapy is used in TBI patients who have clinical manifestations of cerebral edema and ICH or have a documented elevated ICP.3 Specifically, two osmotic agents, hypertonic saline (HTS) and mannitol (MNT), have been shown to be effective for ICP.3 Nonetheless, whether one agent is superior to the other has yet to be determined. Each osmotic agent has theoretical advantages. HTS has several theoretical advantages over MNT including intravascular volume replenishment and prevention …

The Effects Of Exercise On Quality Of Life In People With Rheumatoid Arthritis, Brooke Fletcher

Physician Assistant Capstones

Rheumatoid arthritis (RA) is a chronic, systemic disease that results in bone and joint destruction, commonly effecting joints of the hands and feet, leading to pain and physical limitations. Because of these limitations, quality of life in patients with RA can be heavily impacted.1 Quality of life (QOL) is described as the standard in which a person or group experiences happiness, solace, and a sense of well-being.2 QOL may be affected by various factors in a person’s life and can range widely from individual to individual. For people with RA, quality of life is considered as a combination of several …

The Effects Of Coping Mechanisms On Success And Overall Health Of Medical Students, Ariella Mahgerefteh

Physician Assistant Capstones

The purpose of this paper is to analyze the current published literature in determining the following question. In students studying medicine, how does seeking professional mental health assistance for anxiety and depression compared to trying self-remedies effect overall health and academic performance throughout their medical training education?

Culturally Competent Diabetes Self-Management Education Improves Hba1c Levels In Hispanic Patients With Type 2 Diabetes, Sirena Sechslingloff

Physician Assistant Capstones

There are several techniques that have been employed to make diabetes self-management programs culturally tailored to Hispanic communities. Among these include leading the self-management courses in Spanish and even more so with an instructor of the same cultural background. Another widely used approach is encouraging participants to bring a family member to the classes. In addition, many culturally tailored DSME programs hold classes in a community setting instead of health care centers to increase attendance rates. Lastly, incorporating cooking classes or educating patients on healthier eating based on culturally traditional foods has been utilized in culturally tailored DSME courses.