What is the Minimal Perceptible Change for the Dimensional Alteration of Facial Structures in the Frontal View?

BACKGROUND: A better understanding of the perceptibility of dimensional changes in facial structures is of interest to all involved in facial esthetics. PURPOSE: We aimed to determine the minimal perceptible change (MPC) in the dimensional alterations of the facial structures in the frontal view and the influential factors. STUDY DESIGN, SETTING, SAMPLE: This cross-sectional study was conducted on individuals accompanying the patients at the outpatient department of a tertiary-care hospital and students in art and science. Those with impaired cognition, craniofacial anomalies, history of esthetic facial surgeries and health professionals working on facial esthetics were excluded. INDEPENDENT VARIABLE: The observers assessed the frontal photographs of 2 models and their modifications. The independent variables were the anatomic structure modified (mouth, nose, ears, eyes), the percentage change (5, 10, 15%), and the type of modification (magnification or reduction). MAIN OUTCOME VARIABLES: The outcome variables were the MPC (perceived by at least 50% of the observers) and the perceptibility of changes (Yes/No) COVARIATES: The age of the observer, the sex of the observer and the model were the covariates. ANALYSES: The intergroup differences in perceptibility of changes and the influence of independent variables and covariates were analyzed with χ2/Cochran's Q test and generalized estimating equations, respectively, with statistical significance set at P < .05. RESULTS: The sample comprised 110 males and 110 females, aged 23.9 ± 5.8 years. The MPC was 5% for the mouth, nose, and eyes and 15% for the ears. The changes in the nose [OR = 0.68 (0.56 to 0.83), P < .001], ears [OR = 0.29 (0.24 to 0.36), P < .001], and eyes [OR = 0.78 (0.64 to 0.95), P = .015] were less perceptible than the mouth. The perceptibility was higher in female than male observers [OR = 1.37 (1.11 to 1.69), P = .003] and reduction than magnification [OR = 1.11 (1.00 to 1.23) P = .036]. Compared to a 5% change, the perceptibility was higher for 10 and 15% [OR = 2.00 (1.76 to 2.27), 3.33 (2.84 to 3.91), respectively, P < .001]. CONCLUSION AND RELEVANCE: The MPC was 5% for the mouth, nose, and eyes and 15% for the ears. The perceptibility of change was influenced by the structure, the extent and type of modification and the observer's sex. These findings may be of use to all professionals involved in esthetic facial corrections.

A bibliometric analysis of the 100 top-cited systematic review and meta-analysis in Orthodontics.

OBJECTIVE: This bibliometric study aimed to analyze the citation metrics, journal and author characteristics, and subject domains of the 100 top-cited Systematic Reviews (SR) and Meta-Analysis (MA) in orthodontics. MATERIAL AND METHODS: An electronic database search was conducted for SR and MA in the Web of Science on 16th July 2023, without language and time restrictions. Of the 802 hits returned, the 100 top-cited orthodontic articles were shortlisted. They were analyzed for citation metrics, journal characteristics (journal, year of publication, impact factor-IF), author and affiliation characteristics (number, primary and corresponding author's affiliation, and country), study domain, and keywords. RESULTS: These articles were published from 1996 to 2021 in 20 journals, with an impact factor of 1.9 to 10.5, by 351 researchers affiliated with 104 universities. Their citations ranged from 45 to 344, and 34 poised to be classified as classic (≥ 100 citations). The maximum number of articles was published in the American Journal of Orthodontics and Dentofacial Orthopedics (n=38), the European Journal of Orthodontics (n=18), and the Angle Orthodontist (n=8). The authors for individual papers ranged from 1 to 10, with 5 being the most common (n=58). Europe had the highest contribution regarding the number of corresponding authors, institutions, and citations. Bone anchorage and orthodontic tooth movement/Biomechanics were the most frequently researched domains (n=11 each). The most common keyword used was Orthodontics (n=19), followed by Systematic Review (n=16) and Meta-analysis (n=9). CONCLUSION: In general, the top cited SR and MA were published in high-impact orthodontic journals, were multi-authored, and reflected the collaborative work from different universities.

A bibliometric analysis of the 100 top-cited systematic review and meta-analysis in Orthodontics

ABSTRACT Objective: This bibliometric study aimed to analyze the citation metrics, journal and author characteristics, and subject domains of the 100 top-cited Systematic Reviews (SR) and Meta-Analysis (MA) in orthodontics. Material and Methods: An electronic database search was conducted for SR and MA in the Web of Science on 16th July 2023, without language and time restrictions. Of the 802 hits returned, the 100 top-cited orthodontic articles were shortlisted. They were analyzed for citation metrics, journal characteristics (journal, year of publication, impact factor-IF), author and affiliation characteristics (number, primary and corresponding author's affiliation, and country), study domain, and keywords. Results: These articles were published from 1996 to 2021 in 20 journals, with an impact factor of 1.9 to 10.5, by 351 researchers affiliated with 104 universities. Their citations ranged from 45 to 344, and 34 poised to be classified as classic (≥ 100 citations). The maximum number of articles was published in the American Journal of Orthodontics and Dentofacial Orthopedics (n=38), the European Journal of Orthodontics (n=18), and the Angle Orthodontist (n=8). The authors for individual papers ranged from 1 to 10, with 5 being the most common (n=58). Europe had the highest contribution regarding the number of corresponding authors, institutions, and citations. Bone anchorage and orthodontic tooth movement/Biomechanics were the most frequently researched domains (n=11 each). The most common keyword used was Orthodontics (n=19), followed by Systematic Review (n=16) and Meta-analysis (n=9). Conclusion: In general, the top cited SR and MA were published in high-impact orthodontic journals, were multi-authored, and reflected the collaborative work from different universities.

RESUMO Objetivo: Este estudo bibliométrico teve como objetivo analisar as métricas de citação, as características dos periódicos e dos autores, e os domínios temáticos das 100 Revisões Sistemáticas (RS) e Meta-Análises (MA) mais citadas em Ortodontia. Material e Métodos: Uma pesquisa em banco de dados eletrônico foi realizada para RS e MA na Web of Science no dia 16 de julho de 2023, sem restrições de idioma e data de publicação. Dos 802 resultados encontrados, foram selecionados os 100 artigos ortodônticos mais citados. Eles foram analisados quanto a métricas de citação, características do periódico (revista, ano de publicação e fator de impacto [FI]), características dos autores e afiliação (quantidade, afiliação dos autores principal e correspondente, e país), domínio do estudo e palavras-chave. Resultados: Esses artigos foram publicados entre 1996 e 2021 em 20 periódicos com fator de impacto de 1,9 a 10,5, por 351 pesquisadores afiliados a 104 universidades. Suas citações variaram de 45 a 344, com 34 prestes a serem classificados como clássicos (≥ 100 citações). A maior quantidade de artigos foi publicada na American Journal of Orthodontics and Dentofacial Orthopedics (n=38), na European Journal of Orthodontics (n=18), e no The Angle Orthodontist (n=8). A quantidade de autores por artigo variou de 1 a 10, sendo 5 o mais frequente (n=58). A Europa teve a maior contribuição em relação ao número de autores correspondentes, instituições e citações. Ancoragem óssea e movimentação dentária ortodôntica/Biomecânica foram os domínios mais abordados (n=11 cada). A palavra-chave mais utilizada foi Ortodontia (n=19), seguida de Revisão Sistemática (n=16) e Meta-análise (n=9). Conclusão: No geral, as RS e MA mais citadas foram publicadas em revistas ortodônticas de alto impacto, eram de autoria múltipla e refletiam o trabalho colaborativo de diferentes universidades.

Steroid supplementation before minor oral surgical procedures in patients taking long-term glucocorticoids: A triple-blinded, randomized, placebo-controlled trial.

BACKGROUND: Patients undergoing long-term glucocorticoid therapy are administered additional glucocorticoids before minor dental procedures, although this is not supported by evidence. The authors designed this study to validate the hypothesis that routine blanket glucocorticoid supplementation is unnecessary during minor oral surgical procedures under local anesthesia. METHODS: The authors recruited 270 patients into 3 groups (1:1:1 allocation) from the dental outpatient department. Primary outcomes were changes in hemodynamic parameters and frequency of adverse events among the 3 groups. The secondary outcome was the association of preprocedural stress and procedural pain with periprocedural adverse events in the long-term glucocorticoid therapy group (groups I and II). RESULTS: No clinically relevant changes in hemodynamic parameters among the 3 groups were found. The authors also found low periprocedural adverse events in all 3 groups combined (n = 1), so they did not explore the secondary outcomes further. CONCLUSIONS: Among patients undergoing long-term glucocorticoid therapy for indications other than primary adrenal insufficiency, elective minor oral surgical procedures can be performed safely with only their daily dose of glucocorticoid when their medical conditions are optimized. Routine additional glucocorticoid supplementation appears unnecessary. The results of the study also revealed opportunities for value addition by means of integrating oral health care with medical follow-up for patients with multiple co-occurring medical conditions. PRACTICAL IMPLICATIONS: Routine blanket glucocorticoid supplementation among patients taking a long-term glucocorticoid for indications other than primary adrenal insufficiency appears unnecessary before minor oral surgical procedures under local anesthesia. This clinical trial was registered at Clinical Trial Registry-India. The registration number is CTRI/2017/02/007779.

Apriori sample size estimation and reporting in original articles published from 2012 to 2020 in two Asian orthodontic journals.

AIMS: To evaluate the proportion and completeness of reporting apriori sample size estimation (SSE) in research articles published in the Journal of Orthodontic Science (JOS) and the Journal of Indian Orthodontic Society (JIOS). MATERIALS AND METHODS: All online research articles published in both journals from 2012 to 2020 were screened. Those reporting apriori SSE were analyzed for the study design and completeness of SSE reporting (outcome parameter and assumptions, Type I error, Power/type II error, one or two-tailed test, the method used, justifications for assumptions, adjustments in sample size, and the target sample size). Chi-square or Fisher exact test was used to analyze the differences between the journals in the proportions of articles reporting these characteristics. RESULTS: Twenty articles (13.2%) in JOS and 24 (8.3%) in JIOS, have reported apriori SSE [χ2 (1, N = 440) = 2.573, P=0.10]. Non-clinical and quasi-experimental studies formed nearly two-thirds of articles reporting SSE in JOS. Quasi-experimental (34%), randomized controlled trials (28%), and cross-sectional studies (24%) formed the bulk of articles reporting SSE in JIOS. Type II error/power was the most frequently reported characteristic in both (75% and 95.8% in JOS and JIOS, respectively), and the number of tails was the least (5% and 0%, respectively). More articles in JOS than JIOS reported the outcome variable used [65% vs. 12.5%, χ2 (1, N = 44) = 12.99, P <.001] and provided justifications for the assumptions [70% vs 33.3%, χ2 (1, N = 44) = 5.86, P = 0.01]. CONCLUSION: The extent and completeness of reporting apriori SSE are suboptimal in these journals and require prompt and stringent curative measures.

Unexpected Blooming Artifact in Brain Magnetic Resonance Imaging.

Unexpected foreign bodies are occasionally discovered during magnetic resonance imaging (MRI). These are often present unknown to the patient, missed during routine pre-MRI screening and result in unnecessary delay during MRI. The authors present a patient with traumatically embedded foreign body in the scalp that escaped pre-MRI screening and caused susceptibility artifacts during brain MRI. The object was surgically removed to allow the imaging to be completed. Patients with suspicion or history of facial trauma or with dental restorations are referred to concerned specialists for compatibility of hardware, restorations and for assessing risks during MRI due to these. This patient is presented as a reminder for clinicians to probe further during anamnesis and have a high index of suspicion for foreign bodies that may be present even after trivial injuries.

Desquamative gingivitis as only presenting sign of mucous membrane pemphigoid.

Desquamative gingivitis (DG) is a clinical condition in which the gingiva appears reddish, glazed, and friable with loss of superficial epithelium. DG is considered a clinical manifestation of many gingival diseases and hence not identified as a diagnosis itself. Mucous membrane pemphigoid (MMP) is an autoimmune vesiculobullous disorder of mucous membrane characterized by subepithelial bullae formation. MMP can affect the mucous membranes of oral cavity, conjunctiva, nasopharynx, larynx, esophagus, genitourinary tract, and anus and vary in its severity. The most commonly affected sites are oral cavity and conjunctiva. Since DG may be the early sign or only presenting sign of these conditions, most of the times, dental surgeon plays a key role in the diagnosis and prevention of the systemic complications of these diseases. We report a case of a 41-year-old male patient presented with DG. Histopathological examination revealed subepithelial clefting suggestive of MMP. The patient was treated with topical application of triamcinolone acetonide 0.1% 3-4 times a day for 1 month.

Orientation of Dental Professionals in India towards Integrative Medicine: A Cross-Sectional Survey.

INTRODUCTION: There is a growing demand on our health care system, including Dentistry, to shift from a bio-medical approach to Integrative model of care. The attitudes of health professionals towards Integrative Medicine (IM) are an important factor that influences this transition. AIM: The aim of this study was to evaluate and compare the orientation of the dental professionals in India towards the principles and practice of Integrative Medicine. MATERIALS AND METHODS: A cross-sectional survey was conducted on 286 dental faculty and postgraduate students from three dental schools in India. The participants voluntarily and anonymously completed the "Integrative Medicine-30' questionnaire, a 30 item self-report instrument that measures the health care provider's orientation towards Integrative Medicine in five subscales. Data analysis included summary statistics and intergroup comparisons by gender and professional status with independent samples Mann-Whitney U test. RESULTS: The overall orientation of the dental professionals towards IM was almost neutral. While the use of learning resources on Complementary and Alternative Medicine was lower, they showed a more positive orientation towards patient-centred care. Compared to postgraduate students of Dentistry, the dental faculty were more oriented towards IM (median score of 82 vs. 79.5, p<0.01), especially in terms of learning from alternate paradigms (14 vs. 12, p<0.01) and safety of Complementary and Alternative Medicine (13 vs. 12, p<0.01). Females scored better than males both in terms of overall orientation (82 vs. 78, p<0.01) and towards patient-centred care (12 vs. 11, p<0.001). CONCLUSION: The results highlight the impending need to improve the orientation of dental professionals in India towards the principles and practice of IM.