Trends and insights in animal and biomedical research: A 5-year scientometric analysis of orthodontic peer-reviewed journals.

BACKGROUND: Biomedical research plays a critical role in advancing orthodontic innovations by identifying new targets for therapeutic interventions and developing more effective, personalized orthodontic treatment. This study evaluates the major contributors and trends in animal-related orthodontic research over the past 5 years (2017-2023). METHODS: All animal-related studies published in the eight orthodontic journals listed in the 2022 Journal Citation Reports between January 2017 and June 2023 were retrieved from the Web of Science Core Collection. After examination, the following bibliometric data were extracted from each article: title, authors, affiliations, geographic origin, year of publication, journal name, and keywords. Multiple bibliometric software packages including Biblioshiny R-package software, Datawrapper, and Datasmith were used to analyze different bibliometric outcomes. RESULTS: A total of 3669 articles were screened from which 266 were selected and included in the analysis. The annual growth rate of production exhibited a decline of 11.18%. Most of the included studies focused on orthodontic tooth movement (32.3%), mainly utilizing rat models (50%). Although the United States accounted for the highest number of publications (n = 236), the trend in funded research showed a decreasing trajectory over time, with notably limited funding from the National Institutes of Health. CONCLUSION: This study reveals a declining trend in overall animal-related orthodontic research, highlighted by a significant decrease in National Institutes of Health funding over time. To address this gap, academic institutions and professional organizations should support initiatives fostering biomedical orthodontic research.

Sharing endodontic research on social media platforms: Is it effective? A 10-year timeline analysis.

The purpose of this study was to analyse the social media activity related to endodontic research over the last 10-years. All research articles published in endodontic journals listed in Scopus (Sc) published in 2012 and 2018 were included in our study. The Altmetric Attention Score (AAS), Twitter, and Facebook mentions were obtained for each article. Citation counts were extracted using two citation metrics: Google Scholar (GS) and Sc. Correlations between the AAS, the number of social media mentions, and citations were analysed using Spearman's rank order correlation coefficient. A multivariable Poisson log-linear regression analysis shows that papers mentioned on social media gain about 35% more citations in GS and 31% more citations in Sc. The academic citations per article on GS and Sc were positively correlated with the AAS. Our data suggest an increasing positive correlation between social media mentions and article citations over the years.

Spatial histomorphometry reveals that local peripheral nerves modulate but are not required for skeletal adaptation to applied load in mice.

Mechanical loading is required for bone health and results in skeletal adaptation to optimize strength. Local nerve axons, particularly within the periosteum, may respond to load-induced biomechanical and biochemical cues. However, their role in the bone anabolic response remains controversial. We hypothesized that spatial alignment of periosteal nerves with sites of load-induced bone formation would clarify this relationship. To achieve this, we developed RadialQuant, a custom tool for spatial histomorphometry. Tibiae of control and neurectomized (sciatic/femoral nerve cut) pan-neuronal Baf53b-tdTomato reporter mice were loaded for 5-days. Bone formation and periosteal nerve axon density were then quantified simultaneously in non-decalcified sections of the mid-diaphysis using RadialQuant. In control animals, anabolic loading induced maximal periosteal bone formation at the site of peak compression, as has been reported previously. Loading did not significantly change overall periosteal nerve density. However, a trending 28% increase in periosteal axons was noted at the site of peak compression in loaded limbs. Neurectomy depleted 88% of all periosteal axons, with near-total depletion on load-responsive surfaces. Neurectomy alone also caused de novo bone formation on the lateral aspect of the mid-diaphysis. However, neurectomy did not inhibit load-induced increases in periosteal bone area, mineralizing surface, or bone formation rate. Rather, neurectomy spatially redistributed load-induced bone formation towards the lateral tibial surface with a reduction in periosteal bone formation at the posterolateral apex (-63%) and enhancement at the lateral surface (+1360%). Altogether, this contributed to comparable load-induced changes in cortical bone area fraction (+4.4% in controls; +5.4% in neurectomized). Our results show that local skeletal innervation modulates but is not required for skeletal adaptation to applied load. This supports the continued use of loading and weight-bearing exercise as an effective strategy to increase bone mass, even in patients with peripheral nerve damage or dysfunction.

Global scholarly output on orthodontic temporary anchorage devices (TADs): A silver jublee scientometric analysis.

OBJECTIVES: This study aimed to analyze the global scholarly production of articles related to temporary anchorage devices (TADs) from 1998-2023 in peer-reviewed dental journals indexed in the Web of Science. MATERIALS AND METHODS: A database of TADs-related articles was created via a Web of Sciences structured search. The bibliometric characteristics of the studies, including the number of citations, publication year, journal title, journal impact factor (IF), authorship, contributing institutions and countries, thematic field, and study design, were extracted. Keyword co-occurrence network analyses and the correlation between the number of citations and the article age, journal IF, and journal quartile of each article were performed. RESULTS: The top 50 cited articles were published from 1999-2016, and the total number of citations ranged from 82-602, with 160.36 citations/paper on average. Most of the articles originated from Japan (n = 12), with the most remarkable contributions from Nihon and Okayama Universities, Japan (n = 5, each). The American Journal of Orthodontics and Dentofacial Orthopedics had the most cited articles, with 196.57 citations/paper on average. A significant positive correlation occurred between the number of citations and publication age (rho = 0.392, P = 0.005). CONCLUSION: Our scientometric analysis reported the characteristics of TADs-related articles published over 25 years. Most highly-cited articles were published between 2005 and 2008. The positive correlation between articles' publication date and the number of citations might impact the top 50 within the next 5-10 years.

Evaluating free segmentation tools for CBCT-derived models: Cost-effective solutions.

OBJECTIVES: This study evaluated the segmentation accuracy and reliability of free software packages and compared them with commercial alternatives. MATERIAL AND METHODS: A total of 36 stone models were scanned using a desktop scanner and then imaged by cone beam computed tomography (CBCT). The CBCT volumes were segmented using 2 free software packages (3D Slicer and Blue Sky Plan) and 2 commercial software packages (Mimics and OnDemand3D). Stereolithography (STL) files generated by the desktop scanner were used as the control group (reference models). The accuracy of segmentation was evaluated by (1) comparing 6 linear measurements taken from each STL model generated by the 4 software packages with that obtained by the scanner, and (2) deviation analysis of each STL model generated by the 4 software packages with that obtained by the scanner. Absolute error and percentage error, repeated measures anova and Friedman test followed by post hoc analysis, intraclass correlation coefficient (ICC), and Pearson's r were used to evaluate the accuracy of the tested software packages. RESULTS: There was no statistically significant difference in all intra-arch measurements obtained using the four software packages. Measurements obtained using the free software packages and the scanner showed excellent positive correlation, ranging from 0.825 to 0.988, confirming equivalence with commercial software packages. CONCLUSION: Within the settings of the current study, accurate and time-saving segmentations with high positive correlation could be performed using the tested free segmentation software packages (3D Slicer and Blue Sky Plan). Nevertheless, further evaluation is necessary to gage their accuracy using different CBCT modalities.

#clearaligners and social media: An in-depth analysis of clear aligners' content on Instagram.

BACKGROUND AND OBJECTIVES: Clear aligners-related posts are popularized on social media platforms to educate patients and peers and to market aligners in dental practices. This study aimed to characterize the account credentials and content of the top-performing posts to understand the spread of clear aligners-related information on Instagram. MATERIALS AND METHODS: This cross-sectional web-based study analysed 13 Instagram clear aligners-related hashtags. Content analysis was performed for the "Top 10 posts" listed under the "Top" section for each hashtag within Instagram, as sorted by Instagram's algorithm. Data were analysed for the poster's background, credentials, role, post format, content, and engagement level ratio. Duplicate posts and those not relevant to clear aligners were excluded. Quantitative and qualitative analyses of the collected data were conducted. RESULTS: A total of 29 192 596 posts mentioned the selected hashtags, of which 130 posts were screened in this study. Most posts were authored by dentists (n = 84), 79.8% of them were orthodontic specialists. Self-promotional posts comprised 90.2%, while educational posts accounted for only 8.9%. Interestingly, the number of likes and comments received on posts by patients (n = 19, median = 112, IQR = 340) was significantly higher than those posted by dentists (n = 84, median = 93, IQR = 81.75) (P = .004). CONCLUSION: More than 29 million posts about clear aligners were identified on Instagram. Orthodontists are the leading authors of aligners hashtags. However, the majority of the posts are self-promotional and have nonfactual information. Social media awareness among orthodontic specialists may help provide more evidence-based content about clear aligners and can act as an interactive networking and health communication platform.

Altering maternal calcium and phosphorus dietary intake induces persistent sex-specific changes in the dentition of the offspring.

BACKGROUND: The maternal diet is essential to offspring development, but the specific effects on tooth morphology are still unknown. The aim of this study was to evaluate the effects of altering maternal calcium (Ca) and phosphorus (P) supplementation during gestation and lactation on offspring dentition. METHODS: Pregnant mice were fed an experimental diet containing a threefold increase in Ca and a threefold decrease in P compared to the standard mouse chow diet at embryonic Day 0.5 (E0.5). Offspring mice were maintained on standard or experimental diets from post-natal Day 0 to weaning, then fed control diets until 6 weeks of age. Six-week-old offspring heads were collected and scanned using micro-computed tomography. Dental morphometrics of offspring maxillary and mandibular first and third molars (n = 5-6 per diet/per sex) were determined. A two-way ANOVA test was employed to verify the existence of any significant differences between groups. The significance level was set at P < .05. RESULTS: A two-way ANOVA revealed a statistically significant interaction between the effects of diet and sex on the upper and lower dentition. Moreover, experimental diet-fed female offspring exhibited smaller molars with shorter mesiodistal width and larger pulp chambers relative to controls, while experimental diet-fed male offspring possessed larger molars with wider mesiodistal width and smaller pulp chambers. CONCLUSION: Our findings reveal that altering the maternal and offspring dietary Ca:P ratio during gestation, lactation and weaning led to significant, sex-specific changes in the offspring dentition. The differences in dentition appeared to be correlated with the sex-specific changes in the craniofacial skeleton.

Erosive tooth wear and salivary parameters among competitive swimmers and non-swimmers in Egypt: a cross-sectional study.

INTRODUCTION: Competitive swimmers spend considerable time practicing their sport. Prolonged exposure to chlorinated water can alter salivary parameters and might compromise oral health. This study aimed to determine erosive tooth wear status and its related risk factors among competitive swimmers as compared to non-swimmers. MATERIALS AND METHODS: A cross-sectional study consisting of 180 athletes (90 competitive swimmers versus 90 competitive rowers "non-swimmers") was conducted. Participants were interviewed on the common erosion risk factors. The Basic Erosive Wear Examination system was used to assess the status of erosive tooth wear. Stimulated saliva sample was collected before and after a training session and pool pH was evaluated using pH strips for 7 days. Data were analyzed using descriptive statistics and multivariable analysis. RESULTS: The prevalence of dental erosion was significantly higher among competitive swimmers (60%) with higher BEWE scores compared to non-swimmers (25.6%). The salivary flow rate was reduced significantly after training sessions in both groups while salivary pH increased among swimmers. Evaluation of pool water revealed a continuous reduction in the pH level, reaching a very acidic pH level of 3.24. CONCLUSION: Erosive tooth wear is more prevalent among competitive swimmers. Years of practice and regular consumption of acidic drinks increase the odds of developing erosive lesions. A high incidence of erosive lesions may be attributed to a reduction in swimming pool pH level. Salivary parameters showed variations between groups after training sessions.

#implantology: A content analysis of the implant-related hashtags on Instagram.

STATEMENT OF PROBLEM: Social media platforms such as Instagram have recently become popular among dentists, dental interest groups, and patients for sharing dental-related information. However, a study that dissects and analyzes implant-related posts on Instagram is lacking. PURPOSE: The purpose of this study was to analyze the type of implant-related information on Instagram by highlighting the characteristics of the top-performing posts and assessing their usefulness as educational content. MATERIAL AND METHODS: A list of 12 implantology-related hashtags on Instagram was searched, and, for each hashtag, data were acquired for the "Top 12 posts" listed by the Instagram search algorithm. The contents of each post, including the number of likes and followers, content type, poster role, post content, theme and type, account type, and accuracy of claims, were collected. Descriptive statistics were calculated, and comparisons were performed by using the Mann-Whitney U and Kruskal Wallis tests (α=.05). RESULTS: The search identified 4 541 867 implant-related posts. The 2 most used hashtags were #dentalimplants (n=1 478 770) and #implant (n=1 303 575). Authorship and content analysis showed that dentists, including specialists, posted about 42% of the posts. More than half of the posts were in the form of pictures (62.5%), self-promotional (77.8%), and used for marketing purposes (61.8%). Most posts were not supported by evidence, and only 27.8% shared clinical facts. However, compared with self-promotional posts, most educational posts shared clinical facts with more likes, views, and followers (P<.001). CONCLUSIONS: More than 4 million posts related to implant dentistry were identified on Instagram. Dental interest groups and patients authored most posts, with less contribution from dentists and specialists. Social media awareness among dentists may enhance the number of educational posts and provide a novel platform for networking and communication.

Role of the Peripheral Nervous System in Skeletal Development and Regeneration: Controversies and Clinical Implications.

PURPOSE OF REVIEW: This review examines the diverse functional relationships that exist between the peripheral nervous system (PNS) and bone, including key advances over the past century that inform our efforts to translate these discoveries for skeletal repair. RECENT FINDINGS: The innervation of the bone during development, homeostasis, and regeneration is highly patterned. Consistent with this, there have been nearly 100 studies over the past century that have used denervation approaches to isolate the effects of the different branches of the PNS on the bone. Overall, a common theme of balance emerges whereby an orchestration of both local and systemic neural functions must align to promote optimal skeletal repair while limiting negative consequences such as pain. An improved understanding of the functional bidirectional pathways linking the PNS and bone has important implications for skeletal development and regeneration. Clinical advances over the next century will necessitate a rigorous identification of the mechanisms underlying these effects that is cautious not to oversimplify the in vivo condition in diverse states of health and disease.

The relation between social media mentions and academic citations in orthodontic journals: A preliminary study.

BACKGROUND: To study the relation between social media mentions and academic citations for articles published in peer-reviewed orthodontic journals. METHODS: Articles published in early 2018 in seven peer-reviewed orthodontic journals were retrospectively analyzed in September 2022. Citation counts of the articles were evaluated using two databases: Google Scholar (GS) and Web of Science (WoS). The Altmetric Attention Score, Twitter, Facebook mentions, and Mendeley reads were tracked using the Altmetric Bookmarklet. The citation counts and social media mentions were correlated using Spearman rho. RESULTS: A total of 84 articles were identified during the initial search; 64 (76%) were original studies and systematic review articles and included in the analysis. A total of 38% of the articles had at least one mention on social media. Over the study period, the average number of citations of the articles mentioned on social media was higher than the non-mentioned articles for GS and WoS, respectively. Moreover, significant positive correlations existed between the Altmetric Attention Score and the number of citations in GS and WoS (rs = 0.31, P = 0.001 and rs = 0.26, P = 0.04). CONCLUSIONS: Social media mentions and citations of articles published in peer-reviewed orthodontic journals are correlated, with a clear difference in the number of citations in articles mentioned on social media versus those not mentioned, indicating possible increased reach of articles disseminated on social media.

The precision of two alternative indirect workflows for digital model production: an illusion or a possibility?

OBJECTIVE: Despite the clear drive from both research and clinical dentistry toward digital transformation, there are limitations to implementing intra-oral scanning (IOS) into daily dental practice. This study aimed to compare the precision of digital models obtained from two alternative indirect workflows to direct IOS. MATERIAL AND METHODS: Two indirect digital workflows were evaluated in this study. In the IOS group (direct), IOS directly obtained digital impressions of participants' upper and lower dental arches, while in the Scan Impression (Scan Imp) group (indirect), a desktop scanner scanned silicone-based impressions of upper and lower whole arches that were taken with plastic trays. In the cone-beam computed tomography impression (CBCT Imp) group (indirect), a CBCT machine scanned the silicone-based impressions. Then, the precision of the entire arch and individual teeth for all digital impressions was virtually quantified. Following superimposition, differences between standard tessellation language (STL) files obtained from both-direct and indirect-methods were evaluated by color-mapping and measuring the surface distance between superimposed STL files. Furthermore, 18 linear measurements were taken from each digital model. ANOVA with repeated measures, Pearson coefficient, and intraclass correlation coefficient were used for intergroup comparisons. RESULTS: The digital models obtained from the two indirect workflows differed from the IOS in some dental and intra-arch measurements but were considered clinically acceptable. Ranked against IOS, CBCT Imp models had greater precision, followed by Scan Imp. CONCLUSION: Digital models obtained from two indirect, alternative workflows, desktop, and CBCT scanning of impression, have clinically acceptable accuracy and reliability of tooth size and intra-arch measurements, providing the use of proper methodologies. CLINICAL RELEVANCE: There are some limitations to implementing IOS in daily clinical practice. However, several alternative digital model production techniques might provide an affordable solution. Although they may insignificantly differ in accuracy, all can be applied clinically.

Altering osteoclast numbers using CTSK models in utero affects mice offspring craniofacial morphology.

BACKGROUND: Bone remodelling during development and growth is important for craniofacial integrity of offspring. The aim of this study was to investigate the changes in offspring adult skull morphology when the osteoclasts number was altered in utero, using three-dimensional (3D) geometric morphometric analysis (GMA). MATERIALS AND METHODS: We altered osteoclasts number in utero via two approaches. First, we generated heterozygous CtskCre ;DTAfl/+ (diphtheria toxin A) mice. Second, we altered Ctsk expression in vivo by injecting pregnant wild-type dams at embryonic day (E) 12.5 with in vivo siRNA specific for Ctsk. Mice were collected at 6 weeks and analysed using geometric morphometric analysis via computed tomography, histomorphometry and gene expression analysis. RESULTS: Altering osteoclasts number in utero affected the offspring adult skull morphology. Decreased Ctsk and osteoclast numbers were associated with a decrease in cranial vault height and an increase in mandibular body length. Changes in size and shape were observed with an increased number of osteoclasts in CtskCre ;DTAfl/+ mice, including an increase in cranial vault height, as well as a shortening of mandibular body length and ramus height. CONCLUSION: The findings of this study suggest that modulation of osteoclast numbers during pre- and post-natal development may be a previously unknown factor in the aetiology of skeletal malocclusions. An improved understanding of the factors affecting bone homeostasis during development and growth may help in the development of future therapies that would target the early intervention of skeletal malocclusion.

Sex differences and risk factors for bleeding in Alagille syndrome.

Spontaneous bleeds are a leading cause of death in the pediatric JAG1-related liver disease Alagille syndrome (ALGS). We asked whether there are sex differences in bleeding events in patients, whether Jag1Ndr/Ndr mice display bleeds or vascular defects, and whether discovered vascular pathology can be confirmed in patients non-invasively. We performed a systematic review of patients with ALGS and vascular events following PRISMA guidelines, in the context of patient sex, and found significantly more girls than boys reported with spontaneous intracranial hemorrhage. We investigated vascular development, homeostasis, and bleeding in Jag1Ndr/Ndr mice, using retina as a model. Jag1Ndr/Ndr mice displayed sporadic brain bleeds, a thin skull, tortuous blood vessels, sparse arterial smooth muscle cell coverage in multiple organs, which could be aggravated by hypertension, and sex-specific venous defects. Importantly, we demonstrated that retinographs from patients display similar characteristics with significantly increased vascular tortuosity. In conclusion, there are clinically important sex differences in vascular disease in ALGS, and retinography allows non-invasive vascular analysis in patients. Finally, Jag1Ndr/Ndr mice represent a new model for vascular compromise in ALGS.

Studying Different Operating Conditions on Reverse Osmosis Performance in the Treatment of Wastewater Containing Nickel (II) Ions.

The reverse osmosis performance in removing nickel ions from artificial wastewater was experimentally and mathematically assessed. The impact of temperature, pressure, feed concentration, and feed flow rate on the permeate flux and Ni (II) rejection % were studied. Experiments were conducted using a SEPA CF042 Membrane Test Skid-TFC BW30XFR with applied pressures of 10, 20, 30, and 40 bar and feed concentrations of 25, 50, 100, and 150 ppm with varying operating temperatures of 25, 35, and 45 °C, while the feed flow rate was changed between 2, 3.2, and 4.4 L/min. The permeate flux and the Ni (II) removal % were directly proportional to the feed temperature and operating pressure, but inversely proportional to the feed concentration, where the permeate flux increased by 49% when the temperature was raised from 25 to 45 °C, while the Ni (II) removal % slightly increased by 4%. In addition, the permeate flux increased by 188% and the Ni (II) removal % increased to 95.19% when the pressure was raised from 10 to 40 bar. The feed flow rate, on the other hand, had a negligible influence on the permeate flux and Ni (II) removal %. The temperature correction factor (TCF) was determined to be directly proportional to the feed temperature, but inversely proportional to the operating pressure; nevertheless, the TCF was unaffected either by the feed flow rate or the feed concentration. Based on the experimental data, mathematical models were generated for both the permeate flux and nickel removal %. The results showed that both models matched the experimental data well.

Unilateral Loss of Maxillary Molars in Young Mice Leads to Bilateral Condylar Adaptation and Degenerative Disease.

The adaptive response of the mandible and temporomandibular joint (TMJ) to altered occlusion in juvenile patients is presently unclear. To address this question, we established a mouse model in which all molars were extracted from the maxillary right quadrant in prepubertal, 3-week-old mice and analyzed morphological, tissue, cellular, and molecular changes in the mandible and condyle 3 weeks later. Unilateral loss of maxillary molars led to significant, robust, bilateral changes, primarily in condylar morphology, including anteroposterior narrowing of the condylar head and neck and increased convexity at the condylar surface, as determined by geometric morphometric analysis. Furthermore, both condyles in experimental mice exhibited a degenerative phenotype, which included decreased bone volume and increased mineral density near the condylar head surface compared to control mice. Changes in condylar morphology and mineralized tissue composition were associated with alterations in the cellular architecture of the mandibular condylar cartilage, including increased expression of markers for mature (Col2a1) and hypertrophic (Col10a1) chondrocytes, suggesting a shift toward differentiating chondrocytes. Our results show significant bilateral condylar morphological changes, alterations in tissue composition, cellular organization, and molecular expression, as well as degenerative disease, in response to the unilateral loss of teeth. Our study provides a relatively simple, tractable mouse tooth extraction system that will be of utility in uncovering the cellular and molecular mechanisms of condylar and mandibular adaptation in response to altered occlusion. © 2022 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Altering calcium and phosphorus supplementation in pregnancy and lactation affects offspring craniofacial morphology in a sex-specific pattern.

INTRODUCTION: The effects on offspring craniofacial bone morphology and accretion because of altered maternal exposure to dietary components such as calcium (Ca) and phosphorus (P) are unclear. The objective of this study was to investigate the changes in offspring skull morphology and tissue mineral density (TMD), including sex-specific changes, with exposure to a maternal diet high in Ca-to-P levels during gestation and lactation in mice. METHODS: Time-mated FVB wild-type mice were fed a normal or experimental diet during gestation until weaning. The experimental diet contained a 3-fold increase in Ca and a 3-fold decrease in P (Ca:P molar ratio, 10.5) compared with normal mouse chow (Ca:P molar ratio, 1.5). The heads of 6-week-old control and experimental offspring mice were collected and scanned using microcomputed tomography. Three-dimensional geometric morphometric analysis was performed to analyze changes in craniofacial morphology. TMD measurements were also analyzed. RESULTS: We observed subtle changes and no significant differences between offspring control and experimental skulls when we compared all samples. However, when we separated skulls by sex, we discovered significant differences in craniofacial morphology and TMD. Experimental female offspring possessed skulls that were smaller, narrower transversely, taller vertically, and decreased in TMD. Experimental male offspring possessed skulls that were larger, wider transversely, shorter vertically, and increased in TMD. CONCLUSIONS: Maternal exposure to diet and increased Ca:P molar ratio during gestation and lactation led to significant, sex-specific morphologic and TMD changes in 6-week-old mouse skulls.

Using Twitter to promote #orthodontic research and clinical innovations: Practice and challenges.

While Twitter has substantial benefits in real-time sharing and dissemination of information and facilitating discussions, currently there is a noticeable absence of its use in the orthodontic profession and peer-reviewed journals. This review aims to introduce the basics of using social media; provide a perspective and prospective vision on effective practices on the use of Twitter in sharing orthodontic discoveries and clinical innovations; and discuss the limitations and caveats of using such approaches in sharing and assimilating information. There has been increasing debate on the potential role of social media, specifically Twitter, in shaping the way scholars and clinicians access, discuss, and disseminate research and clinical innovations. Despite various caveats, such as misinformation, privacy concerns, and unprofessionalism, Twitter can be used to efficiently share discoveries and innovations and facilitate networking. Thus, the use of Twitter during professional orthodontic meetings can enhance their impact by enabling nonattendees to participate in the meeting virtually and in real time. Moreover, utilization of Twitter by peer-reviewed journals can aid in enhancing the dissemination of information. That, with the optimization of algorithms and strategies, can also maximize reach and impact. Future efforts are essential to develop standardized guidelines for the use of Twitter among orthodontic healthcare professionals and scholars to better manage scientific integrity, privacy, and ethical concerns. Professional orthodontic organizations, journals, and researchers should be aware of the potential benefits of Twitter strategies that could be applied to maximize the impact and dissemination of orthodontic discoveries to reach the largest possible audience that will facilitate collaboration and discussion, and advance the delivery of cutting-edge treatments.

Dental Education in the Time of COVID-19 Pandemic: Challenges and Recommendations.

Moving within the second wave of the coronavirus (COVID-19) pandemic, dental education delivery has been profoundly affected by this crisis, so has the structure, evaluation, and future of dental education. Both pre-clinical and clinical dental education have experienced challenges ranging from fully online educational content to limited dental training for senior dental students. This crisis appears to be a tipping point that produced confusion in dental teaching especially clinical sciences. Although medical institutions immediately started to adapt to the unexpected COVID-19 crisis, dental and oral health educational services are profoundly impaired due to the dental team's propinquity to the patient and the aerosols generated during routine dental therapeutic procedures. Dental students unlike other medical students are considered to be at the highest risk due to the nature of their clinical training that includes working in the oral cavity of patients using aerosol-generating equipment. Some dental schools have taken the leadership and documented their modifications during this pandemic; however, there is a serious need for further investigation and wide range screening of the situation in the dental schools during the COVID-19 crisis. The aim of this mini-review is to present these challenges and how academic dental institutions have implemented strategies to overcome them.