Abstract
INTRODUCTION
Child Abuse (CA) is complicated to define. In effect, the definition changes in different studies according to the context involved, since there is a lack of agreement in the scientific community that prevents homogenization of the different definitions. Greenbaum et al gave the definition of Child Neglect (CN). as the failure of the primary caregivers to meet the child’s basic intellectual, physical, or emotional needs, though no precise indication is given as to what the parents or caregivers have to do (or not do), or for how long, to cause immediate or potential harm . The Expanded Hierarchical Classification System (EHCS) is the most widely used tool and classifies child abuse into four broad categories: sexual abuse, physical abuse, neglect and emotional abuse There are high comorbidity levels among these four categories .50-80% of all do-cumented cases were found, CA involve the head and neck region (traumatisms of the mouth, head and face), thereby placing dental professionals in a dominant position for detecting and diagnosing the physical and emotional manifestations of CA and reporting it to the competent authorities . according to Kaur et al.55% of the surveyed dentists did not have the capacity to interpret suspect cases and identify signs of abuse, due to a lack of training in the field and of knowledge about how to report such cases to the authorities. Child abuse in this way comprises a great extent unknown and minimal announced social issue that influences all nations and social circles.
The literature shows a discrepancy between suspected cases of CA and actually reported cases thus in-dicating that although dentists are capable of recognizing and suspecting cases of CA, there is a lack of knowledge about how to proceed in such cases. This logical inconsistency between suspicion and reporting shows the sufficient administration of youngsters enduring CA to stay lacking. In order to address this problem, it is necessary to establish whether the theoretical knowledge of dentists is correct and sufficient to diagnose and report CA. Thus, the purpose of this study was to review the current literature in order to assess current perceptions, knowledge and attitudes among dental professionals in relation to CA; the obstructions confronting the detailing of cases; and the key clinical characteristics for the identification of CA.
The PubMed (MEDLINE) database of the United States National Library of Medicine, ScienceDirect, LILACS and Sci-ELO were used to conduct a literature search of articles published up until March 2019. The search terms “dental neglect”, “dentistry”, “maltreatment”, “diagnosis”, “child abuse” and “child neglect” were used in different combi-nations. No restrictions were placed on the year or language of publication. The search was completed with a review of the references of the selected articles to identify additional studies not found in the initial literature search. All articles chose from the electronic and manual searches were separately evaluated by the first and second writers of the current examination, based on the established inclusion criteria.
Chosen full-text articles were required to meet the following criteria: descriptive (cross-sectional) or analytical observational (retrospective and prospective) studies pertinent to the objectives of the present study, and with a clear defini-tion of CA or CN. All examinations including wellbeing or non-wellbeing experts other than dental specialists were prohibited.
3. RESULTS
The main physical injuries and psychological signs found were the presence of caries and increased dental plaque and gingival inflammation scores , reflecting the close relationship between abuse and/or neglect and poor oral hygiene and health. Burns and bone and dental fractures ,as well as bacterial and viral infections , fractures, lacerations, ma-locclusions due to traumatisms, biting or contusions were also reported.Children suffering CA also presented psychological disorders such as anxiety, depression or stress .The most frequent risk factor for abuse was behavioral alterations in the form of depression, personality alterations, anxiety, stress or social isolation .A low socioeconomic level and alcohol and drug abuse were also associated with an increased risk of abuse, in the same way as monoparental families or criminality.
The suspicion and reporting of cases apparently varied among the various investigations. The main barrier faced during the reporting of abuse was an uncertain diagnosis, followed by concern about the con-sequences which reporting may have for the child , and a lack of knowledge of how to proceed in reporting CA.While no international standards or protocols are available, reporting to the authorities or the police was the most commonly used option among the surveyed dental professionals .
Table 1. Strategy inclusion and exclusion criteria.
|
Key words |
Dental neglect, Dentistry, Maltreatment, Diagnosis, Child abuse, Child neglect |
|
Inclusion criteria |
- Pertinent to the objectives |
|
Exclusion criteria |
- Expert opinions |
CONCLUSION
In this experiment dentists productively suspect cases of CA in their clinical practice, but few report such cases. This important discrepancy between the number of suspected cases and the cases actually reported is due to the existence of a series of barriers that complicate the task of the dental professional - thus underscoring the need to improve training in this setting, since cases of CA may persist over time if adequate measures are not taken. The clinical signs of CA or neglect identified in the present study include burns, untreated caries, lacerations, biting, traumatisms, dental avulsions, bruises and psychological and behavioral disorders. Careful compilation of the case history is essential. Likewise, standardized guidelines and strategies are needed to help dentists detect cases of CA, as well as multidisciplinary work with other health professionals in both the public and the private settings. The definition of reporting protocols and improved training in CA are crucial for reducing morbidity-mortality among these children.
Rubina Mumtaz
The objective is based on the study that evaluates the upper lip length and thickness changes in the vertical dimensions of maximum smile in patients with class I and class II div 1,2 of malocclusion According To Angle's Classification.
Participants the present study was conducted on 120 subjects randomly which are selected from the students and staff of faculty of dentistry in Hama University. It was explained that this was a study on lip movements involving a short question naire followed by a (5- 10 second) video clip capturing only a small part of the face (chin to nose). Video graphic records on these 120 subjects, who are consented to participate in the study, were taken to the study on perioral zone at rest and on smiling. The subjects were mainly divided into three groups, namely, group 1 (class I), group 2 (class II div1), group 3 (class II div2), containing 20 males and 20 females. Inclusion criteria:
Selection Criteria for the Class-II Sample Class II div 1:
Class II div 2:
Smile Recording and Measurements The subjects are explained on the study of smile involving between 5- 10-second video clip on the small part of the face. An informed consent was obtained from each subject who are agreed to participate in the study voluntarily. A video camera (SONY DSC-H200) was set on the tripod 4 feet from the subject. The subjects are mainly based on the adjustable stool and instructed to hold the head in a natural head position by looking straight towards an imaginary mirror. If head position is in the required position, then the research will carry out in natural head orientation. The camera lens was adjusted to be parallel across the apparent plane and the camera is focused only on the mouth (from nose to chin), So that the person could not be identified which are included in the capture area (frame) with 2 rulers and millimeter markings. The rulers are screwed in the cross configuration so that if the subject accidentally rotates the 1 ruler, and the other ruler could be used to analyze the frame. The lip position is achieved based on the subject of lick the lips and then swallow. Then, the subjects are instructed to say
‘‘Subject number __’’. Recording began 1 second before the subject started and ended with the smile. The video clip was downloaded to a computer (LG RD590) and then uploaded to Screen analyzer Live (version 4.0, Andreas Winter, Vienna, Austria),which is a video-editing software program. Each frame was analyzed, and 2 frames were captured for the study. Each frame was then finally analyzed and two
The objective is based on the study that evaluates the upper lip length and thickness changes in the vertical dimensions of maximum smile in patients with class I and class II div 1,2 of malocclusion According To Angle's Classification.
Participants the present study was conducted on 120 subjects randomly which are selected from the students and staff of faculty of dentistry in Hama University. It was explained that this was a study on lip movements involving a short question naire followed by a (5- 10 second) video clip capturing only a small part of the face (chin to nose). Video graphic records on these 120 subjects, who are consented to participate in the study, were taken to the study on perioral zone at rest and on smiling. The subjects were mainly divided into three groups, namely, group 1 (class I), group 2 (class II div1), group 3 (class II div2), containing 20 males and 20 females. Inclusion criteria:
Selection Criteria for the Class-II Sample Class II div 1:
Class II div 2:
Smile Recording and Measurements The subjects are explained on the study of smile involving between 5- 10-second video clip on the small part of the face. An informed consent was obtained from each subject who are agreed to participate in the study voluntarily. A video camera (SONY DSC-H200) was set on the tripod 4 feet from the subject. The subjects are mainly based on the adjustable stool and instructed to hold the head in a natural head position by looking straight towards an imaginary mirror. If head position is in the required position, then the research will carry out in natural head orientation. The camera lens was adjusted to be parallel across the apparent plane and the camera is focused only on the mouth (from nose to chin), So that the person could not be identified which are included in the capture area (frame) with 2 rulers and millimeter markings. The rulers are screwed in the cross configuration so that if the subject accidentally rotates the 1 ruler, and the other ruler could be used to analyze the frame. The lip position is achieved based on the subject of lick the lips and then swallow. Then, the subjects are instructed to say
‘‘Subject number __’’. Recording began 1 second before the subject started and ended with the smile. The video clip was downloaded to a computer (LG RD590) and then uploaded to Screen analyzer Live (version 4.0, Andreas Winter, Vienna, Austria),which is a video-editing software program. Each frame was analyzed, and 2 frames were captured for the study. Each frame was then finally analyzed and two
frames were selected for the study. The first frame represents the subject on lips at relaxed lip position, and the second frame represented the subject on natural unstrained posed smile. The widest range of the subject was posed on smile frame and was selected as one of 10 or more frames the identical smile. Thus, the selected smile image represents a sustainable and repeatable smile position. Each frame was opened in Adobe Photoshop 6.0 (Adobe Systems, San Jose, Calif) and is adjusted by using the millimeter ruler in the frame. Calibration of the software is done based on the previous study of Desai Dental.
Measurements on Rest Frame (Figure 1) 1. Upper lip length- from subscale to station superiors 2. Upper lip thickness-The vertical distance from the most superior point of cupid’s bow to the most inferior portion of the tubercle of the upper lip.
Measurements on Smile Frame (Figure 2) 1. Upper lip length-The distance from sub scale to stomion superiors 2. Upper lip thickness-The vertical distance from the most superior point of cupid’s bow to the most inferior portion of the tubercle of the upper lip The measurements were made based on the posed smile photograph as shown in Figures 1 and 2
Statistical Analysis
Minitab 15 (Minitab Inc, State College, PA, USA) is used to perform the statistical analysis. With the alpha set at 5%, Data which is summarized as mean 6 SD. Groups are compared by two-factor (class of malocclusion and sex) analysis of variance (ANOVA) using general linear models. If the ANOVA shows the statistical significance, the Bonferroni post hoc test was done to determine which groups were significant from the others.
Results: Statistically significant differences are made which were apparent in most of the measured variables. Changes in upper lip length and upper lip thickness were higher in class I followed by class II div2 then via class
Conclusions: The data from this study clearly states that malocclusion effects on the changes in upper lip length and thickness, besides the changes differ between males and females.
Keywords: Smile, Digital video, Malocclusion, Lip length, Lip thickness.
Note: This work is partly presented at 24th International Conference on Dental Education During March 18-19, 2019 held at Paris,France
Journal of Health & Medical Informatics received 2700 citations as per Google Scholar report
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