Orthodontic Anchorage Unit Research Study

Orthodontic Anchorage Unit Research Study Chapter 3 MATERIALS AND METHODS A three-dimensional bone block model (Figure 2) integrated with a miniscrew was constructed with a computer-aided design program (SolidWorks; Dassault Systemes SolidWorks, Concord, Mass) to simulate a miniscrew implanted in bone as an orthodontic anchorage unit. Figure 2. Three dimensional bone block model with screw embedded. The bone block, consisting of cortical and cancellous bone, was constructed with dimensions of 20 mm. in length and width, and 15 mm. in height for evaluation. [1] The cortical bone thickness, elastic moduli, Poisson’s ratio, shear moduli and density of the edentulous maxillary and mandibular alveolar bone as shown on Table 2 was based on the studies of Dechow et al.[2] and Schwartz-Dabney and Dechow[3], respectively; and the dentate specimen based on the study of Peterson et al. [4] These were taken from specific locations of the edentulous maxillary and mandibular alveolar bone as shown in Figure 3. Since cancellous bone density was found to have little or no consequence to results obtained by previous studies[5], a fixed value will be set with elastic moduli of 1.3 GPa, Poisson’s ratio of 0.3, shear moduli of 2.0 and density 0.5g/cm3. Figure 3. Location from which cortical bone specimens were removed from the edentulous crania by Dechow et al.[6] and the edentulous mandibles by Schwartz-Dabney and Dechow[7] The miniscrew geometry was based on the MONDEAL system (MONDEAL Medical Systems, Muhlheim, Germany): ie, the screw thread profile was an isosceles triangle 0.4 mm in height and 0.16 mm along the base.[8] The thread pitch was 1.0 mm. These thread dimensions were fixed in all screw designs in this study. The miniscrew will be assumed to be homogeneous, isotropic and linearly elastic titanium alloy (Ti-6Al-4V) with elastic modulus of 114 GPa, Poisson’s ratio or 0.34 and Yield strength of 880MPa.[9] Table 2. Material properties of maxillary[10] and mandibular[11] alveloar cortical bone. The model was meshed automatically with 10-node tetrahedral solid elements. The interface between the cortex and the cancellous bone was assumed to be fully bonded; i.e., the elements were continuous, sharing the same nodes along the interface. A node-to-node contact condition was given on the interface between the miniscrew and the bone block to imitate a stage without osseointegration.[13] The static load along the x-axis was applied to the head of the miniscrew and perpendicular to its long axis to simulate the orthodontic force. For the nodes located on the 5 exterior surfaces of the bone block, all but the superior surface where the miniscrew entered was constrained in all degrees of freedom to simulate the boundary condition. The nodal solution of the von Mises stress in the bone and the displacement of the miniscrew were calculated for each model with the finite element analysis program.[14] To determine the loading effect, the maxillary and mandibular bone blocks will be subjected to four force magnitudes (1, 2, 4 and 6 N) and three force directions (60o , 90o and 120o) to mimic various clinical conditions. A force direction of 90o was the force perpendicular to the long axis of the miniscrew and parallel to the bone surface.[15] 2 N is the reported clinically safe limit for immediate loading.[16] The loads will be applied at the level of the eye of the screw meant for tying ligatures in a clinical situation.[17] To determine the screw size effect, three screw (outer) diameters (1.5, 2.0 and 2.3 mm.) and five screw length (7, 9, 11, 13 and 15 mm.). The screw length will be measured including the screw head, which had a 2 mm. height for all screw models. To simulate soft tissue thickness, various screw depths (screw length in the bone block) will be modelled.[18] For each screw length, the exposed screw length of 3, 4, 5 mm. will be measured. The von Mises stress and the displacement was determined for the different screw length, diameter and exposed screw length was subjected to the different force magnitude and direction. For every bone specimen there was 540 different scenarios. The stress distribution was then observed for the screws that exhibited the highest stress for each bone specimen and for each force direction. Chapter 5 SUMMARY OF FINDINGS, CONCLUSION AND RECOMMENDATIONS Summary of Findings There is no direct relationship between stress and displacement established. The pattern of the von Mises stress of miniscrews embedded on different bones are similiar with only minor differences. Whereas the maxillary edentulous specimens showing more displacement compared to its mandibular counterpart. Though the highest stress and highest displacement can be observed in 6 N of force at 90o direction at 5 mm. exposed length and the lowest stress and lowest displacement can be observed in 1 N of force at 1200 direction at 3 mm. exposed length. The stress is concentrated on the cortical bone irrespective of the screw length and the exposed screw length. It is more intensified at 5 mm exposed screw length because the moment of arm becomes longer, and lighter at 3 mm exposed length because the moment arm becomes shorter. The cortical bone acts as the fulcrum of the force. All miniscrews embedded in mandibular edentulous specimens were able to establish primary stability except for 2 scenarios in MDE4. 12-13% of miniscrews embedded on maxillary edentulous specimen were not able to establish primary stability. Majority of these occurred with screw diameter of 1.5 mm. (78 85%), exposed screw length of 5 mm. (61 72%), force magnitude of 6 N. (62 – 68 %), and force angle of 900 (40 45%). Conclusion Based on the data gathered, it is found that placement of orthodontic miniscrew on edentulous alveolar bone on both the maxilla and mandible is possible. The use of miniscrew with diameter of 2mm or wider embedding it on attached gingiva of 2mm or thinner, loading it with force 2 N or lower at an angle 60 or 1200 could increase chances of establishing primary stability. Recommendations The proponent of this research would like to recommend the implementation of a Randomized Controlled Trial based on the results of this study. This would ensure the evidence-based practice of the miniscrew anchorage. References [1] T. C. Liu and others, Finite Element Analysis of Miniscrew Implants Used for Orthodontic Anchorage, Am J Orthod Dentofacial Orthop, 141 (2012). [2] P. C. Dechow, Q. Wang, and J. Peterson, Edentulation Alters Material Properties of Cortical Bone in the Human Craniofacial Skeleton: Functional Implications for Craniofacial Structure in Primate Evolution, The Anatomical Records: Advances in Integrative Anatomy and Evolutionary Biology, 293 (2010). [3] C. L. Schwartz-Dabney and P. C. Dechow, Edentulation Alters Material Properties of Cortical Bone in the Human Mandible, J Dent Res, 81 (2002). [4] J. Peterson, Q. Wang, and P. C. Dechow, Material Properties of the Dentate Maxilla, Anat Rec A Discov Mol Cell Evol Biol, 288 (2006). [5] A. Gracco and others, Numerical/Experimental Analysis of the Stress Field around Miniscrews for Orthodontic Anchorage, Eur J Orthod, 31 (2009). [6] Dechow, Wang, and Peterson. [7] Schwartz-Dabney and Dechow. [8] Liu and others [9] Gerhard Welsch, R. Boyer, and E.W. Collings, Materials Properties Handbook: Titanium Alloys, (Asm International, 1994). [10] Dechow, Wang, and Peterson. [11] Schwartz-Dabney and Dechow. [12] Peterson, Wang, and Dechow. [13] Liu and others [14] Ibid. [15] Ibid. [16] A. G. Crismani and others, Miniscrews in Orthodontic Treatment: Review and Analysis of Published Clinical Trials, Am J Orthod Dentofacial Orthop, 137 (2010). [17] S. Singh and others, Three-Dimensional Finite Element Analysis of Strength, Stability, and Stress Distribution in Orthodontic Anchorage: A Conical, Self-Drilling Miniscrew Implant System, Am J Orthod Dentofacial Orthop, 141 (2012). [18] Liu and others

Int Marketing

Synopsis Throughout the article we know that Pegasus Airlines is one of the best airlines in Turkey. The secret behind the success of the airlines was continuity of developing to meet passenger expectations and priorities. For example, Pegasus has put in place a yield management strategy for ticket pricing, using the strategy of Southwest Airlines of North America as an example. Pegasus has also developed a credit/loyalty card which offers customers a range of benefits including insurance rate reductions and also developed a specific customer satisfaction guarantee policy to the customers.Pegasus also offers customer service experience at the airport such as providing exclusive allotments for the first 72 hours of parking with a valet parking option. As a result, Pegasus innovative customer service won the company an award for â€Å"Best Airline Business Price† in 2006. The marketing strategy applied by Pegasus Airlines has succeeded Pegasus as one of the most searched airline in Turkey on Google. Pegasus’ employees also work as a team to provide a democratic environment in which everyone shares their ideas freely.Continuous training also ensured regular career progression and high levels of motivation through a solid performance system and regular personal feedback. Pegasus’ strong word of mouth has also been important in the airline’s success and is reflected in the words of customers on a special Web site titled â€Å"Pegasus Listens to You. † This encourage customers to generate ideas for service improvement, to debate generic questions and topics relating to the airline’s management and services, and also to encourage customers to report problems they have encountered.As a conclusion, efficient management techniques and great marketing skills has ensured Pegasus as one of the successful airlines in Turkey. 1. Give examples of needs, wants and demands that Pegasus customers demonstrate, differentiating these three c oncepts. What are the implications of each for Pegasus’ practices? Needs: In conjunction with the needs of people to take airplane, Turkish Airlines had been established in order to let passengers travel from one place to another. Wants: Wants are the form human needs take as they are shaped by culture and individual personality.Customers will prefer to choose Pegasus instead of Onur Air, Fly Air, Sun Express, and Atlasjet because Pegasus delivering low prices with a high-quality service experience to them. Demands: Demands is mean by humans wants that are backed by buying power. Given their wants and resources, people demand products with benefits that add up to the most value and satisfaction. For example, Pegasus provided customer service at the airport such as exclusive allotments for the first 72 hours of parking with a valet parking option.The implications of each for Pegasus’ practices are provide convenient for the customers because they are able to do online b ooking through the internet. The passengers are also able to find hotel easily through customer service and they can get some discount as well. Other than that, these practices can also bring profits and income to the company. These practices are able to attract more customers to select Pegasus Airlines. 2. Describe in detail all the facets of Pegasus’ product. What is being exchanged in a Pegasus transaction? )An in-plane-bulletin is avalaible for customer, with a mix of offers amd features on certains destination. Althouoght the bulletin is free for customers, but this generates incomes via advertisement. ii)Pegasus has a Facebook page complete with a game entitling customer to win free tckets. Pegasus too have a Twitter page that offers special compettion. A special campaign associated with Vodafone, called the ‘Mobile Phone Fly’ whereby customer collect sms-es to gain discounts, emulating the traditional strategy of other airlines, ie, ‘Shops and milesà ¢â‚¬â„¢.This is to create a sustainable relationship with it’s customer while leveraging the possibilities of social networks and other digital technologies. iii) A special web site tittled â€Å"Pegasus Listens To You†, where it encourage customers to generate ideas for services, improvement, debate generic questions and topics, relating to the airline’s management and services, also to encourage customers to report problems they have encoutered. This helps Pegasus to consistantly obtain feedback and maintain profitable relationship. 3. Which of the five marketing management concepts best applies to Pegasus?Among the five marketing management concepts, we came out with a conclusion that the Marketing Concept best applies to Pegasus. The Marketing Concept is defined as the philosophy that holds the achieving organizational goals depends on knowing the needs and wants of target marketing and delivering the desired satisfactions better than competitors do. Based o n the article, Pegasus Airlines had satisfied the needs of customers by providing airplanes that bring passengers from place to another. Pegasus had also satisfied the wants of target marketing by offer affordable flight tickets, so that everyone will be able to take a flight.Under the marketing concept, the Pegasus Airlines integrates all the marketing activities that affect customers. In turn, it yields profits by creating lasting relationships with the right customers based on customer value and satisfaction. For example, the Pegasus had carried out ticket pricing strategy and the system was complemented by an electronic ticket policy whereby passengers receive their information via SMS and e-mail. This had provided convenient to the passengers because it had save a lot of their time and they can book air ticket at home by using the Internet.Besides that, Pegasus had also developed a specific customer satisfaction guarantee policy that provides customers. For example, in the case of a delay greater than 3 hours, a refund of the ticket will be given out, and if delay greater than 5 hours, a refund and a free ticket will be given out. Pegasus also offers a customer service experience at the airport by providing exclusive allotments for the first 72 hours of parking with a valet parking option, VIP and Business Class lounges, car rental and many hotel partners where customers can get some discount. . What value does Pegasus create for its customers? Pegasus create customer perceived value by keeping up with its customers even when they are not flying. Pegasus had created a Facebook page complete with a game entitling customers to win free tickets. The company also has a Twitter account which offers customers special competitions. Other than that, Pegasus had also carried out a special campaign in association with Vodafone called â€Å"mobile phone fly†, whereby consumers accumulated for each SMS an award of 5 percent toward a Pegasus ticket discount.Bes ides that, Pegasus had also created a website called â€Å"Pegasus Listens to You. † This is to encourage customers to generate ideas for service improvement, to debate generic questions and topics relating to the airline’s management and services, and to encourage customers to report problems they have encountered. In short, Pegasus hopes to create a sustainable relationship with its customers while leveraging the possibilities of social networks and other digital technologies. In general, the customers are getting more benefits than the costs that they have to pay to get the service given by pegasus.

Mental wellbeing and Mental Health Essay

1. Understand the different views on the nature of mental  well-being and Mental health and the factors that may influence both across lifespan: It is a well known fact, that everyone is one of kind unique if you like. There for there will be always different views on this as well as other matters. ( diet, fitness ect)  while † this and that † is working for some, it may not work for the other. However there is a basic so called skeleton form which we can build up what is the best for the individual. Mental well-being can be very unstable thing and it can be tipped either way at any time by trauma or excitement. Influencing factors: – childhood – own believes – education – lifestyle – status of body and mind – reasons for mental well-being/ or illness ( stress, death of loved one ect) – other known/ unknown influencing factors 1.1 Evaluate two different views on the nature of  mental well-being and mental health As already stated every individual is unique and we cannot assume of otherwise. There for every individual. However there is a basic skeletons from which we can build on ( assessment, diagnosis and therapy) If we would go to total basics then we would find two directions from which to start. Positive- People in that state of mind having † can do attitude†, find easy problem s solving, their physical health is usually very good or healing of injury or other goes much faster then at negative thinking individual. – In case of diagnosis and care positive verbalisation helps to encourage a positive process and to keep on track in order to get well HOWEVER: every individual is unique and there for the carer/ doctor or other must must always let client find best path which is best for the client. ( his own way at his own time) Negative- individual sees all as † all hope lost/ no other way† , due lack of hope   and motivation lets thing spin out of hand to make things worse.  Problem to acknowledge a problem or willingness to accept helping  hand is a big issue. ( various reasons like shameless, loss of hope,other). – with the negative mental state you may find that physical signs are at  present ( lack of sleep, aggression, nervosas, other) Mental health – linked to medical model which focuses on treating illnesses establishing diagnosis and treatment as well as prevention, providing medical and other support ( various groups sessions ect) mental well-being- take holistic view of the individual experience. eg. How clients friends and family react to him and his illness, providing moral and social support. – Also nutrition and area client lives plays great role – various activities with the friends and family – Rather than providing medical treatment it is more about helping getting better and supported or not sick at all 1.2 explain range of factors which may influence mental well-being and mental health across the life span including ( 3 factors): – individuals past history- childhood and teenage hood are the vital parts of our lifes. They makes us who we are, makes our believes or other. ( hobbies, mind set, likes not likes other) whether we like it or not nearly whole life we will compare new outcomes or solving new problems base on our past. – biological factors- heath problems run in family at the present or in past. ( usually heritage illness) – male or female – brain or other injury not related to family ( accident or other) – poor nutrition or drug abuse – intake of toxins in body Social factors- family ground indiv. grown up – various social believes ( religion or other) – group of people who socialise with, how they observe you (example heath or drug oriented groups) – state or community you life in and how they accept you psychological factors- already ongoing psych. Illness – stress or shock – loss of loved one – lack of self esteem 1.3 Explain how following types of risk factors and protective factors influence level of resilience in individuals and groups in relation  to mental health and well being: In quantum physics as well as in various ancient civilisation there was/ is believe that all is corrected including people. It my my believe, that it is really so. We all creating each other reality as well as improving/ destroying one to another ( helping or acting badly in order to make a harm) Small thing, action or word can have huge positive or negative impact on us. There for it is important to identify that it is mostly actions of other which may resolve in to improving/ sustaining our mental health or the opposite( too much letting down may resolve in not trusting people or lack of self-esteem) – Risk factors including inequalities, poor quality social relationships: constant discrimination, putting down, rejection or not acceptance are examples of high risk factors. These behaviours of other towards us have not just negative impact on us, but may have potentially deadly consequences for others as well( recent shooting in schools, which were flamed my humiliation or bad rejection of killers ) – protective factors including socially valued roles, social support and contact: Inclusion, full or part acceptance as well as learning about individuals, their habits, believes and other has great positive impact and well as it is great prevention of above stated risks. It was this strategy ( were all nation united against nazi example) managed to achieve great goal to win both world wars as well as in today’s climate to prevent or quickly end another. The same result is achieved when dealing with individuals. Example of risk factors- understaffed care home may have a problem with staff having enough time to spend  with client to ensure proper job done and to avoid any distress on clients as well as carer’s side. Carer feeling under pressure to do it all in hurry may send signals to client( by actions, voice tone or body language) â€Å" u again/ I want you off my back† despite it may not be so. Example of protective action- providing enough staff in to care home as well as management taking time to re ensure staff that they value staff opposition, time and afford can provide furtherer creative thinking on staff side. ( suggest improvements, proper problems records and correction ect) This can resolve in calm and happy staff and their happy feeling can transfer on client ( client being more positive, calm more co-operative, health problems stabilized) Also, the more respect and interest in client carer shown ( within the reasons) the more open, happier and co-operative client is. 2. know how to implement an effective strategy for promoting mental well-being and mental health with individuals and groups: 2.1 Explain steps that an individual may take to promote their mental well-being and mental health- -take himself/ others with reserve ( not too seriously, not  everything is as bad as it seems) – if problem which cannot be solved by your own doing  seek advice ( also helps to stop problem from getting worse) – socialise with people you feel good with and minimize contact with those one who may cause stress or worse. ( no worth of your anger, or damaged health) – regular sport, indoors/ outdoors activities, meditation, relaxation, find a hobby ( doing things you love have great healing properties) – sometimes animals can provide great comfort and relaxation ( so called animal therapy is used on daily bases. Given love= received love) – Find goal who want to achieve as a reason to be.  ( having a goal can be great engine to keep you going on the road you want to be) – Volunteering can provide great satisfaction, boost up self believe and self-worth ( by doing something good and make a difference, makes you feel better about yourself.) – Love frequency- every emotion has a frequency which resonates. Frequency of love is 528 MHz. In Switzerland used to heal damaged tissue. Can be also used for emotion balance restoration 2.2 Explain how to support an individual in promoting their mental well-being and mental health- – showing by practical example, that anything can be done.  ( someone just got new will never use leg again and there for run, visit with him army heroes centre to visit people with similar injury, but still doing what they love) – re-ensure client you and everyone else involved will be always there for him and there is nothing he cannot ask or do. -listen the problem and act as a middle man to find the right solution, comfort or just show that † not all is lost† – make people aware/ organise various events meetings or programs where everyone is welcomed. ( cancer UK research run, Macmillan coffee  morning. You never know what it can give to the individual) – together visit or to do all kind of sport/ other indoors/ outdoors activities – introduce all options how to stay happy and healthy ( books, youtube videos, talks) – Radiate happiness and positivity- in order to help other you must be ok. If people sense from you negativity, may not accept your help and support. 2.3 evaluate a strategy for supporting and individual in promoting their mental well-being and mental health- – Assessment- gather all info available about client ( friends, family, medic. Professionals, other) – make- up your own pre- picture of client, but use it ONLY as a guideline ( so you know what you stepping in to ) – meet up with client and talk ( than you can make final picture, which will need gradual and frequent adjustments- every day is different) – support- finding the best optional choices for client based on your assessment and introducing them to client. ( make sure he knows there are just options he makes final call) – Let client choose the best one for him with explanation it may be changed at any time if needed. – proceed to chosen program providing constant support, re-ensuring, assistance, example and guidance – revaluation- this part should be done on regular bases to see how client view all what is happening also to see his state of well- being and mental health In past have worked with client who was very linked to his wife. She regularly visited him on Monday, Wednesday and Friday. However, between these days he was angry and wanted to see her or leave the care home. In order to ensure his calamines and better management of his behaviour, lady wrote by herself days and times on small peace of paper when she is due to come. So when she was due on Wednesday and on Tuesday he was angry, I just shown the ticked for Wednesday to him. He recognised the writing of his wife and under written promise on Wednesday visit he calmed down. To make it feel like â€Å" it’s just in few moments†, I have converted ? day in to hours minus sleep( giving feeling it will be here soon) and than doing various activities in order time to pass more quickly and waiting to feel much bearable. 2.4 Describe key aspects of a local, national or international strategy to promote mental well-being and mental health within a group or community- -Raising awareness about the problem and identification of consequences ( supporting various groups, meetings, internet media other media, explaining consequences of mental illness and importance of mental health) – Education and physical education- providing knowledge to people and promoting various activities -Promoting inclusion and fighting discrimination and various stigmas – improving mental health of- infants and very young children – children and young people – well- being in working life – well-being in later life – in communities – improving mental health promotion and prevention in local services – promoting research and education as well as international/ national co-operation – regular evaluations of status of national/ international Mental health and well being – Promoting inclusion and comunity spirit ( mix meetings of various religious or other groups) 2.5 Evaluate a local, national or international stratedy to promote mental well-being and mental health within a group or comunity: In last decade have been finaly recognised how important well-being and mental health is. So much so, that comunal, local, national and international tratedies have been developed and implicated to fight growing problem of mental health. ( more and more people have well- being or mental health issues or physical illneses directly linked to mental health) Most of the strategies are directed on young people where problem is the worst. Promoting equality and conclusion is one of the important part of promoting mental health as well as preventing mental health related illneses. Regular meeting on local, national or international level have been held in order to tackle problem more effectively. There are lot of support groups/ organisation supported by goverments or just run as charities. Also great finances have been put in to education and prevention programs in order to esure healty future and current generation.

Business Benefits Swot Analysis And Pestle Analysis

1. Valentinos, Mission Statement, Three Business Benefits, SWOT Analysis and PESTLE Analysis. - Mission Statement To guide persons to the right path in their relations with a high level of privacy and confidentiality. - Three Business Benefits - SWOT Analysis Strengths: 1. The long established brand name and the stability performance as a result of the experience gained during the years of work. 2. The use of high technology and experienced staff who are ready to meet the members needs. 3. Diversification of provided services (friendship, love, marriage and meeting new people). 4. Huge database for all members of society. 5. The efficiency in matchmaking services, giving advices, answering clients enquiries. Weaknesses: 1. The use†¦show more content†¦The users can provide a brief profile and search for their partners in the website which is secure and can be trusted. Unlike the current offline system, the new online dating system will serve millions of singles looking for relationships, romance, love and marriage to find their desirable partners and interact with them easily. - Context diagram - Potential benefits and costs Benefits: 1. Provide faster service – the processes on the internet needs seconds to be completed. 2. Attracting larger number of customers – as a result of the services, the number of customer will be increased. 3. Increase profits and revenues – as a result of the large numbers of customers. 4. Reduce the needed time – by using the internet unlike the offline services which may take long time. 5. Further reputation – quality of performance and customers satisfaction help to spread its reputation. 6. Providing new services and developing the systems by using the customer fees in order to grow its client base. Costs: 1. The new system installation cost. 2. Costs of periodic update of the system. 3. Costs of repairing the malfunctions that can occur. 4. Software and hardware maintenance cost. 5. Staff training cost. - Smart Objectives: 1. To record all customer data with 99% accuracy. 2. To accurately display the matching files to the customers. 3. To supply the new customers with 100% instructions about how to use the system. 4. To increase the quality of performance by 80%. 5.Show MoreRelatedInternal And Internal Analysis Of Tesco1721 Words   |  7 Pagesin their business. As the external and internal analysis are very useful for marketing a large enterprise, this essay will explore both external and internal analysis that Tesco has been performed. First, it will define and outline the importance of SWOT and PESTLE. Then, it will examine the Strengths and Weaknesses of Tesco. Next, it will use the PESTLE to carry out Opportunities and Threats. 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