Survival and failure rate of lower lingual bonded retainers: A retrospective cohort evaluation.

OBJECTIVE: The objectives of the study were to evaluate the survival rates for lower lingual retainers (LLRs) and to establish a correlation between patients' treatment-related factors (age, sex, malocclusion, appliance used for treatment, teeth bonded, retention protocols) to the survival of LLRs. MATERIALS AND METHODS: A total of 765 subjects [474 females and 291 males: mean age = 24.29 ± 10.67 years] between 2013 and 2022 were included. A customized data collection form was utilized to gather the data from the electronic health record (EHR) of subjects. Patient-related factors, crowding or spacing, deep bite or open bite and duration of treatment were extracted from patients' files. Kaplan-Meier estimator was used for the survival function, whereas Cox proportional hazards regression models were used to associate risk factors with retainer survival. RESULTS: 328 (42.9%) subjects had their LLRs failed, and the survival period was on average 17.37 ± 22.85 months. On the other hand, the follow-up period for the retainers that did not fail was on average 47.19 ± 23.66 months. 192 (28.3%) subjects had segment failure (retainer detached from 3 teeth or less), while 51 (7.5%) subjects had failures in more than 3 teeth (complete). None of the evaluated clinical variables were significantly associated with LLRs failure except for the bite category (P = .013) and the appliance used for treatment (P < .001). CONCLUSION: Success rate for LLRs was 57.1% over 47.19 months, failure rate was 42.9% over 17.37 months. The presence of deep bite and treatment with aligners were significantly associated with increased failure rate.

Short-term and long-term effects of miniscrew-assisted and conventional rapid palatal expansion on the cranial and circummaxillary sutures.

INTRODUCTION: The objective of this study was to analyze the short-term and long-term effects of miniscrew-assisted rapid palatal expansion (MARPE) and conventional rapid palatal expansion (RPE) appliances on cranial and circummaxillary sutures as compared with a matched control group. METHODS: One hundred and eighty cone-beam computed tomography scans for 60 subjects were evaluated for the 3 groups: (1) MARPE (n = 20; aged 13.7 ± 1.74 years), (2) RPE (n = 21; age 13.9 ± 1.14 years), and (3) control (n = 19; age 13.3 ± 1.49 years) at pretreatment (T1), postexpansion (T2), and posttreatment (T3) (T1 to T3: MARPE, 2 years 8 months; RPE, 2 years 9 months; control, 2 years 7 months). Frontonasal suture, frontomaxillary suture, zygomaticomaxillary suture, zygomaticofrontal suture, intermaxillary suture, pterygomaxillary suture, nasomaxillary suture, and zygomaticotemporal suture were measured on the right and left sides for all 3 time labels. In addition, midpalatal suture was measured at the incisor, canine, and molar levels. RESULTS: Within-group analysis showed that MARPE and RPE led to a significant increase in the widths of frontonasal, frontomaxillary, intermaxillary, nasomaxillary, and midpalatal suture at incisor, canine, and molar levels at T2 compared with T1. Between-group analysis showed that MARPE and RPE significantly increased the width of the intermaxillary and midpalatal suture at the incisor, canine, and molar compared with controls at T2. In the long term, between-group comparisons showed no significant difference among the 3 groups except that MARPE led to a significant increase in the width of midpalatal suture at incisor, canine, and molar levels compared with RPE and controls at T3. CONCLUSIONS: MARPE led to a significant increase in the width of the midpalatal suture at incisor, canine, and molar levels compared with RPE and controls in the long term. There was no difference in the width of other cranial and circummaxillary sutures among the 3 groups in the long term.

Saturdays Orthodontic Appointments, Demand, and Patients' Commitment.

AIM: The purpose of this study was to determine the demand for orthodontic appointments on weekends and the level of commitment the patients have for those appointments. MATERIALS AND METHODS: A survey of 17 questions was created and given to 199 adult patients. The first six questions addressed demographic information, followed by three questions addressing whether coming to their orthodontic appointments required taking time off of work. The remaining questions asked if they would prefer to attend orthodontic appointments on Saturday if they would take advantage of a Saturday appointment, and what their preferred time and level of commitment would be for this appointment. The data were analyzed using the logistic-regression Chi-square test. RESULTS: About 77.4% of the participants indicated that they would take advantage of appointments on Saturdays if available. The most preferred time for Saturday appointments was 7:00 am-10:00 am, followed by 10:00 am-12:00 pm. About 60.6% of the participants reported that they would be willing to sign up for AutoPay in order to be seen on Saturday. Among those who would take advantage of weekend appointments, 82.6% reported that they would likely never miss or reschedule a Saturday appointment, and 75.3% would choose an orthodontist who is open on Saturday over another orthodontist who is not. Among participants who work more than 40 hours per week, 86.1% (106) wanted to take advantage of Saturday appointments. Participants with a high household income are less inclined to take advantage of Saturday appointments compared with those with a low household income. Participants who need to take time off of work are more inclined to take advantage of Saturday appointments [93% (106) favorable vs 7% (8) unfavorable]. Participants who need to take their child out of school early for their orthodontic appointments during the week are more inclined to take advantage of Saturday appointments [87% (97) favorable vs 13% (15) unfavorable] than those who do not need to. CONCLUSION: There is a demand for Saturday orthodontic appointments with a very high commitment level among the majority of those patients. The Saturday demographic tends to be participants with a low household income who work 40 or more hours per week. CLINICAL SIGNIFICANCE: Orthodontic offices may consider working at least one Saturday per month to satisfy patient needs. They can use this survey to explore their own market for Saturday clinical practice.

Coronavirus disease 2019 (COVID-19) and QTc prolongation.

INTRODUCTION: The cause-and-effect relationship of QTc prolongation in Coronavirus disease 2019 (COVID-19) patients has not been studied well. OBJECTIVE: We attempt to better understand the relationship of QTc prolongation in COVID-19 patients in this study. METHODS: This is a retrospective, hospital-based, observational study. All patients with normal baseline QTc interval who were hospitalized with the diagnosis of COVID-19 infection at two hospitals in Ohio, USA were included in this study. RESULTS: Sixty-nine patients had QTc prolongation, and 210 patients continued to have normal QTc during hospitalization. The baseline QTc intervals were comparable in the two groups. Patients with QTc prolongation were older (mean age 67 vs. 60, P 0.003), more likely to have underlying cardiovascular disease (48% versus 26%, P 0.001), ischemic heart disease (29% versus 17%, P 0.026), congestive heart failure with preserved ejection fraction (16% versus 8%, P 0.042), chronic kidney disease (23% versus 10%, P 0.005), and end-stage renal disease (12% versus 1%, P < 0.001). Patients with QTc prolongation were more likely to have received hydroxychloroquine (75% versus 59%, P 0.018), azithromycin (18% vs. 14%, P 0.034), a combination of hydroxychloroquine and azithromycin (29% vs 7%, P < 0.001), more than 1 QT prolonging agents (59% vs. 32%, P < 0.001). Patients who were on angiotensin-converting enzyme inhibitors (ACEi) were less likely to develop QTc prolongation (11% versus 26%, P 0.014). QTc prolongation was not associated with increased ventricular arrhythmias or mortality. CONCLUSION: Older age, ESRD, underlying cardiovascular disease, potential virus mediated cardiac injury, and drugs like hydroxychloroquine/azithromycin, contribute to QTc prolongation in COVID-19 patients. The role of ACEi in preventing QTc prolongation in COVID-19 patients needs to be studied further.

Correlation between adolescent orthodontic quality of life and ABO Discrepancy Index in an orthodontic treatment-seeking population: A cross-sectional study.

OBJECTIVE: To evaluate the association between adolescents' orthodontic quality of life before initiating orthodontic treatment and their objective case complexity as measured by the American Board of Orthodontics' Discrepancy Index (DI). DESIGN AND SETTING: A single-centre, cross-sectional survey study. METHODS: The Orthodontic Quality of Life Assessment Survey (OQoLAS) was administered to 240 adolescents (aged 11-14 years) during their record-gathering appointment. After completion of the survey, a DI score was calculated for each patient based on pretreatment measurements. Pearson correlation coefficients, r, were used to assess the association of DI scores with OQoLAS total and subdomain scores. A multiple linear regression of OQoLAS total scores adjusting for age, gender and DI scores was conducted. RESULTS: The study did not find a strong correlation between OQoLAS and DI scores (r = 0.10; P = 0.6497). On average, the OQoLAS scores (functional, emotional and social subdomains of OQoLAS) were slightly higher among girls than among boys but there was no statistical difference for total OQoLAS score between boys and girls (42.4 vs. 45.4, P = 0.2005). However, there was a significant difference in oral health perception rating between boys and girls, with girls being more likely to rate their oral health positively (adjusted P = 0.0226). The total DI scores of boys with respect to girls were not statistically different (P = 0.4256). The components of the DI that showed highest score were for cephalometric measures, followed by overjet; and the lowest scores were for lateral open bite and buccal posterior crossbite. The measure of association analysis did not show any strong correlation between the OQoLAS (total score and subdomain scores), and DI score or any of its components. CONCLUSION: Malocclusion severity was not found to be correlated with orthodontic quality of life in adolescents aged 11-14 years seeking orthodontic treatment.

Differentiating secondary from primary dengue using IgG to IgM ratio in early dengue: an observational hospital based clinico-serological study from North India.

BACKGROUND: Secondary dengue causes more severe disease than the primary. Early on, it is important to differentiate the two. We tried to find important clinical and laboratory differences between the two for the purpose of early differentiation. METHODS: One hundred fourteen patients confirmed on reverse transcriptase-polymerase chain reaction (RT PCR) were studied. On day 2 of illness IgM and IgG indices were studied for calculation of IgG/IgM ratio. A one-step immunochromatographic assay was used for classification of patients into primary and secondary dengue. Patient characteristics were also studied. RESULTS: Dengue serotype 1 was the most common found in 60.5% patients. 66.7% (76 patients) had secondary dengue. Secondary dengue cases had a higher mean temperature (101.56 ± 1.55 vs. 100.79 ± 1.25,°F, p 0.015), lower platelet counts (50.51 ± 38.91 vs. 100.45 ± 38.66, x 103/micl, p <0.0001) and a significantly higher percentage of Dengue hemorrhagic fever/Dengue shock syndrome (38.2% vs. 2.6%, p <0.0001). In early phase of dengue NS1 and PCR were found to be better tests for diagnosis and later IgM is better. The IgG/IgM ratio of ≥ 1.10 had a sensitivity of 100%, specificity of 97.4% and accuracy of 67.5% in differentiating secondary from primary dengue. CONCLUSION: Early on in the clinical course, IgG/ IgM ratio can play an important role to differentiate the two. We found the ratio of ≥ 1.10 to be the best cut off for the same.

In-hospital outcomes of COVID-19 infection in patients with underlying cardiovascular disease.

BACKGROUND: The effects of cardiovascular comorbidities on outcomes in COVID-19 hospitalized patients has not been well studied. METHODS: This is a hospital-based study evaluating the effects of CVD on the outcomes in patients admitted with COVID-19. Clinical outcomes were studied in patients with and without CVD. RESULTS: Eighty-seven patients had CVD, and 193 patients had no history of CVD. Ischemic heart disease was the most common CVD (63%). When compared with patients with no CVD, those with CVD had higher mortality (29% vs 9%, p < 0.001), discharge to a skilled nursing facility (SNF) (36% vs 15%, p < 0.001), and change of code status to 'do not resuscitate' (41% vs 14%, p < 0.001). The odds for mortality were high with ischemic heart disease (OR 3.6, 95% CI 1.8-7.3, p < 0.001), and systolic heart failure (OR 3.8,95% CI 1.2-12.3, p = 0.02). Patients in the CVD group were more likely to have incident atrial fibrillation (22% vs 3%, p < 0.001), type 2 Mi (17% vs 6%, p = 0.002), high BNP (57% vs 14%, p < 0.001), acute kidney injury (64% vs 29%, p < 0.001), and any type of circulatory shock (27% vs 12%, p = 0.001). CONCLUSION: CVD is associated with increased mortality, myocardial injury, arrhythmias, and discharges to an SNF.

Curcumin Preparations Can Improve Flow-Mediated Dilation and Endothelial Function: A Meta-Analysis.

INTRODUCTION: Endothelial dysfunction is an early marker of atherosclerosis. Flow-mediated dilation (FMD), measured by ultrasonography, is used to noninvasively assess endothelial dysfunction. Preparations of curcumin, a naturally occurring pigment found in turmeric, may improve FMD and thus endothelial dysfunction. We did a systematic review and meta-analysis to analyze the effect of curcumin preparations on endothelial dysfunction. METHODS: Five randomized clinical trials met the inclusion criteria for meta-analysis. The primary outcome was an improvement in FMD, as measured at brachial artery, after supplementations with curcumin preparations compared to the control group. Standardized mean difference and Hedges' g were used for effect size (ES) measurement. An ES of 0.2-0.5 is considered small, 0.5-0.8 is medium, and more than 0.8 is large. Publication bias was studied too. RESULTS: We found supplementation with curcumin preparations had an overall ES (standard difference in means) of 1.379 (95% CI 0.485-2.274, p = 0.003) on FMD. The overall Hedges' g was 1.353 (95% CI 0.47-2.235, p = 0.03). This analysis suggests a positive and large ES of curcumin preparations on FMD using a random effect model. Smokers had a smaller increase in FMD compared to nonsmokers (ES 0.379 vs. 1.639, p = 0.034). CONCLUSION: This meta-analysis of 5 randomized clinical trials indicates a significant effect of curcumin preparations to increase the FMD compared to placebo and thus endothelial function. This effect is not strongly noticed in smokers.

Comparison of transverse maxillary dental arch width changes with self-ligating and conventional brackets in patients requiring premolar extraction - A randomised clinical trial.

OBJECTIVE: The purpose of this study was to evaluate, the change in the transverse maxillary arch dimensions, in patients requiring all first premolar extractions when using Active and Passive Self-ligating brackets, and comparing them with Conventional brackets. MATERIALS AND METHODS: This study was a non-blinded randomised clinical trial, which consisted of 42 patients (21 males and 21 females) within the age group of 16-25 years, having bimaxillary protrusion. They were divided into three groups with 14 patients each. In Group 1 - Conventional brackets (3M Unitek), in Group 2 - Passive Self-ligation brackets: Smart Clip (3M Unitek), and in Group 3 - Active Self-ligation brackets: Empower AO (American Orthodontics) were bonded. All brackets had MBT prescription and 0.02" slot size. Dental study models were taken before the start of treatment and after six months of retraction. Inter-canine and intermolar widths were measured in all the three groups in the above mentioned stages. RESULTS: As compared to Conventional brackets, Self-ligating brackets (Passive and Active) showed greater increase in the transverse arch widths. Furthermore, between Passive and Active Self-ligating brackets, Passive Self-ligating brackets - Smart Clip (Group 2) showed a greater increment in the transverse arch dimensions, with an increase of 4.89mm in the inter-canine width and 3.4mm in intermolar width. CONCLUSION: Significant difference was found between Self-ligating brackets and the Conventional bracket system regarding maxillary arch width dimensional changes. Passive Self-ligating brackets - Smart Clip (Group 2) showed the highest and inter-molar width increase.