Self-harm, dentofacial features, and bullying.

INTRODUCTION: Self-harm is a growing public health problem. The study aimed to investigate the prevalence of self-harm among a representative sample of school children and the contribution of dentofacial appearance and being bullied because of dentofacial appearance to self-harm. METHODS: This was a cross-sectional study in which a representative sample of eighth-grade students (aged 13-14 years) from randomly selected schools was asked to complete anonymous questionnaires distributed in the classroom. The final sample size was 699 children (339 girls, 360 boys) with a mean age of 13.3 years, representing 1.26% of the target population. RESULTS: The prevalence of self-harm was 26.9% (n = 188), with no statistically significant gender differences (P >0.05). Among all the subjects who reported self-harm, 47.9% (n = 90) reported self-harm because of dentofacial features. A total of 41 subjects reported self-harm because of bullying targeted at dentofacial features, representing around one fifth of subjects who reported self-harm. The 3 most common dentofacial features contributing to self-harm and self-harm as a result of bullying were tooth color and shape, spacing between the teeth or missing teeth, and prominent maxillary anterior teeth. CONCLUSIONS: This study demonstrated a relatively high experience of self-harm reported by adolescent school children, with many reporting self-harm as a result of their dentofacial appearance and bullying because of dentofacial features. The present study provides baseline data to better understand the relationship between self-harm and dentofacial features.

Comparing patient-centered outcomes and efficiency of space closure between nickel-titanium closed-coil springs and elastomeric power chains during orthodontic treatment.

OBJECTIVES: To compare patient-reported pain, discomfort, and difficulty in maintaining proper brushing between nickel-titanium closed-coil springs (CS) and elastomeric power chains (PC) when used for space closure. The secondary aims were to compare plaque control and efficiency of space closure between these two force delivery systems. MATERIALS AND METHODS: A total of 48 patients who required extractions of upper first premolars and distal movement of upper canines had the CS randomly allocated to either the right or left side. Blinding was applied at data collection and analysis. Primary outcomes were pain intensity measured on visual analog scale, pain onset and duration, discomfort, and difficulty in maintaining proper brushing from the start of canine retraction at baseline and at 6 and 12 weeks thereafter. Secondary outcomes were plaque scores and the rate of space closure. RESULTS: No significant differences in mean pain scores, pain onset, and duration at different time intervals between CS and PC were observed. The CS side was significantly less comfortable than the PC (P < .0001) and more difficult to keep clean (P = .008). No significant differences in plaque scores were observed between CS and PC groups at any time interval. CS produced a faster rate of space closure than did PC (P = .008). CONCLUSIONS: CS were less tolerated than PC by patients but produced an average of 0.5 mm more movement than did the PC during the 12-week study period.

The Online Attention to Cleft Lip and Palate Research: An Altmetric Analysis.

OBJECTIVES: To identify research articles related to cleft lip and/or cleft palate (CL/P) that generated the highest online attention. METHODS: Altmetric Explorer was used to identify the 100 articles with the highest Altmetric Attention Score (AAS). Descriptive and correlation statistics were performed to study the characteristics of these articles in relation to their publication data, research type and domain, number of Mendeley readers, and dimensions citations. Citation counts were extracted from Scopus and Google Scholar. RESULTS: The median AAS for the top 100 outputs was 22 (range from 12 to 458). The outputs were mostly discussed on Twitter (median = 8; range = 0-131). Topics discussing treatment and care for patients with CL/P accounted for 38% of the articles with the highest AAS followed by etiology and risk factors (32%). The majority of articles originated from the USA (46%) followed by Europe (16%) and the United Kingdom (15%). No significant differences were observed in AAS among different study designs, topic domains, journals' ranking and impact factor, and the number of citations in Scopus and Google Scholar. CONCLUSIONS: Researchers should consider use of social platforms to disseminate their work among scholars and nonscholars. Altmetrics can be combined with traditional metrics for a more comprehensive assessment of research impact.

Pulpal blood flow changes and pain scores related to using Superelastic 0.018-inch Nickel Titanium as the first orthodontic alignment archwire: a prospective clinical trial.

BACKGROUND: Optimal orthodontic force results in maximum rate of tooth movement without tissue damage. Even though starting orthodontic treatment with a thicker archwire may shorten treatment duration, the evidence on the effect of using 0.018-inch NiTi as the first alignment archwire on pulpal blood flow (PBF) status is still scarce. OBJECTIVES: to record PBF changes and pain scores associated with using 0.018-inch NiTi as the first alignment archwire during fixed orthodontic treatment. METHODOLOGY: Patients were selected from subjects attending postgraduate orthodontic teaching clinics at Jordan University of Science and Technology. In total, forty healthy patients who exhibited mild lower arch crowding were included. A split-mouth trial design was used. Each patient received two archwire sizes at one time joined in the midline by crimpable hook and applied in the lower arch. Patients were assigned into one of two groups based on archwire sizes used. Group 1: 0.014-inch and 0.018-inch NiTi (Six males, 14 females aged 19.4±1.33 years) and Group 2: 0.016-inch and 0.018-inch NiTi (Seven males, 13 females aged 19.6±1.45 years). The archwire size group was randomly allocated with a 1:1 allocation ratio. A Laser Doppler Flowmeter was used to measure PBF at different time intervals (T0-T5). Pain scores were recorded using a visual analogue scale (VAS). A repeated measures ANOVA and a post-hoc Bonferroni comparison tests were conducted to examine differences at the different time points before and during orthodontic alignment. RESULTS: For all studied archwire sizes, PBF decreased 20 minutes after their placement. Most PBF changes occurred within 24hours and continued to decrease until 72 hours after archwire placement where the maximum reduction was reached. Eventually, normal values were reverted within 1 month. PBF changes were similar between all alignment - groups. CONCLUSIONS: Initial orthodontic alignment with 0.018-inch NiTi does not cause irreversible changes to pulpal vasculature or produces higher pain scores.

Academic performance of dental students: A randomised trial comparing live, audio recorded and video recorded lectures.

OBJECTIVES: To compare the academic performance of 4th-year dental students randomly divided into three learning groups: live lecture, video recorded lecture and audio recorded lecture. To assess students' attitudes towards the three learning methods. MATERIALS AND METHODS: 4th-year undergraduate students, enrolled in the Orthodontics Theory-1 course, were randomised into three groups receiving different teaching methods; video recorded lecture, audio recorded lecture and live lecture. Subjects were asked to answer two open-ended questions. The first was a simple basic knowledge question in which the answer involved transcribing information from the question, while the second required analytical thinking. Students were also asked to complete a questionnaire assessing their attitudes towards the three learning methods. RESULTS: 94 students participated in the study and were randomly allocated to each learning method. There were no significant differences in scores between the 3 study groups when answering the basic knowledge question (P > .05). The mean score for the analytic question was significantly higher for the live lecture and video recorded lecture groups compared to the audio recorded lecture group (P < .05). The majority of students agreed that lectures were an essential part of their learning experience and that lectures allowed interaction between students and lecturer. Two-thirds of students reported that watching a video recorded lecture provided a similar learning experience to attending a live lecture. CONCLUSION: Video recorded, audio recorded and live lectures were found to be equally effective for providing basic knowledge. Video recorded and live lectures were more effective than audio recorded lecture at assessing higher levels of analytical thinking. Students attending video recorded lecture performed as well as those attending the live lecture.

Pulpal blood flow changes and pain scores related to using Superelastic 0. 018-inch Nickel Titanium as the first orthodontic alignment archwire: a prospective clinical trial

Abstract Background Optimal orthodontic force results in maximum rate of tooth movement without tissue damage. Even though starting orthodontic treatment with a thicker archwire may shorten treatment duration, the evidence on the effect of using 0.018-inch NiTi as the first alignment archwire on pulpal blood flow (PBF) status is still scarce. Objectives to record PBF changes and pain scores associated with using 0.018-inch NiTi as the first alignment archwire during fixed orthodontic treatment. Methodology Patients were selected from subjects attending postgraduate orthodontic teaching clinics at Jordan University of Science and Technology. In total, forty healthy patients who exhibited mild lower arch crowding were included. A split-mouth trial design was used. Each patient received two archwire sizes at one time joined in the midline by crimpable hook and applied in the lower arch. Patients were assigned into one of two groups based on archwire sizes used. Group 1: 0.014-inch and 0.018-inch NiTi (Six males, 14 females aged 19.4±1.33 years) and Group 2: 0.016-inch and 0.018-inch NiTi (Seven males, 13 females aged 19.6±1.45 years). The archwire size group was randomly allocated with a 1:1 allocation ratio. A Laser Doppler Flowmeter was used to measure PBF at different time intervals (T0-T5). Pain scores were recorded using a visual analogue scale (VAS). A repeated measures ANOVA and a post-hoc Bonferroni comparison tests were conducted to examine differences at the different time points before and during orthodontic alignment. Results For all studied archwire sizes, PBF decreased 20 minutes after their placement. Most PBF changes occurred within 24hours and continued to decrease until 72 hours after archwire placement where the maximum reduction was reached. Eventually, normal values were reverted within 1 month. PBF changes were similar between all alignment - groups. Conclusions Initial orthodontic alignment with 0.018-inch NiTi does not cause irreversible changes to pulpal vasculature or produces higher pain scores.

Relationship between oral health impacts and personality profiles among orthodontic patients treated with Invisalign clear aligners.

This within subject clinical experiment assessed oral health impacts before and after Invisalign orthodontic treatment and their relationships with personality characteristics. 50 patients (26 females and 24 males; mean age = 27.62 ± 8.25 years, SE = 1.17, 95% CI = 24.71-29.89 years) were assessed before and after treatment with Invisalign orthodontic treatment. Treatment clinical success was evaluated according defined clinical guidelines. Oral health impacts before and after Invisalign orthodontic treatment were measured via the Oral Health Impact Profile (OHIP). Personality features were measured via the NEO Five-Factor Inventory (NEO-FFI). Probability of α = .05 was utilized to identify significant findings. Females scored less OHIP scores after treatment (had less negative impacts) in comparison to baseline OHIP scores (t = 3.782, df = 25, P = .001, 95% CI of mean difference = 2.750-9.327). Among males, openness scores (R2 = .911, B = 5.235, 95% CI for B = 0.062-10.407, t = 2.601, P = .048) were able to predict OHIP scores before treatment; meanwhile, extraversion (R2 = .959, B = - 8.224, 95% CI for B = - 14.605-1.843, t = - 3.313, P = .021), openness (R2 = .959, B = 21.795, 95% CI for B = 10.737-32.853, t = 5.067, P = .004), and conscientiousness (R2 = .959, B = 10.293, 95% CI for B = 4.796-15.790, t = 4.813, P = .005) scores were useful to predict OHIP scores after treatment (R2 = .959, P < .05). NEO-FFI scores were not useful to predict OHIP scores before or after treatment among females (P > .05). These findings demonstrate that oral health impacts of Invisalign orthodontic treatment and personality profiles contribution to oral health impacts were different between genders.

Megestrol acetate induced proliferation and differentiation of osteoblastic MC3T3-E1 cells: A drug repurposing approach.

AIMS: Drug repurposing or repositioning i.e.; identifying new indications for existing drugs have recently accelerated the process of drug discovery and development. Megestrol acetate (1) is a well-known progestin. It is commonly used as an appetite stimulant, and also in the treatment of breast, and endometrial cancers. The aim of this study is to investigate the effect of megestrol acetate (1) in osteoblast differentiation, and to determine the possible mechanism involved in megestrol acetate (1) induced osteoblast differentiation. MAIN METHODS: Cytotoxicity of different steroidal drugs was evaluated using MTT assay. Alkaline phosphatase (ALP) activity was also determined, and alizarin red S (ARS) staining was performed to measure extracellular mineralization. Osteogenic protein levels were determined using Western blot analysis. KEY FINDINGS: Results of the current study indicated that the megestrol acetate (1) enhanced the proliferation and differentiation of osteoblast cells at 1, 0.2, and 0.04 µM. This stimulatory effect of the megestrol acetate (1) was more prominent at 0.2 µM for cell proliferation, while the maximum cell differentiation (ALPase activity, and calcification) was observed at 0.04 µM. Western blot analysis also showed that megestrol acetate (1) altered the expression of bone morphogenic protein-2 (BMP2), p38, and pJNK proteins. Hence, only moderate doses of MGA (1) can enhance osteoblast proliferation and differentiation. SIGNIFICANCE: Our results identified that megestrol acetate (1) could be a potential lead for further research towards bone fragility related disorders.

Effect of socioeconomic status on normative and perceived orthodontic treatment need.

OBJECTIVE: To determine the influence of socioeconomic status (SES) on normative and perceived orthodontic treatment need, satisfaction with dental appearance, and regularity of dental attendance. MATERIALS AND METHODS: The sample consisted of 550 adolescents (232 boys, 318 girls) aged 13 to 17 years who were categorized according to SES into three groups: low, middle, and high SES. Normative treatment need was assessed by using the Index of Orthodontic Treatment Need. Data were collected by clinical examination and face-to-face interview. The χ(2) test and logistic regression analysis were used for statistical analyses. RESULTS: Approximately 34.0% of the untreated subjects had a definite dental need for treatment and 24.5% had a moderate need; among those, 53.5% were of low SES (P  =  .017). One-third of the sample had a moderate to definite esthetic need, most of whom had a low SES (P  =  .009). Of the subjects who were dissatisfied with their dental appearance and reported a self-perceived need for treatment, around one-third had a low SES. Most subjects with low SES were irregular dental attenders (P < .001). Subjects of low SES, those who had a self-perceived need for treatment, and those who were dissatisfied with their dental appearance were more likely to have a definite normative esthetic need. CONCLUSIONS: Subjects of low SES exhibited greater normative and perceived treatment needs than subjects of higher SES. They were less satisfied with their dental appearance and visited a dentist less frequently.

Mandibular symphysis morphology and dimensions in different anteroposterior jaw relationships.

OBJECTIVE: To assess the morphology and dimensions of mandibular symphysis (MS) in different anteroposterior jaw relationships and to investigate whether craniofacial parameters have any correlation with its shape and/or dimensions. MATERIALS AND METHODS: Lateral cephalograms of subjects with Class I, Class II, and Class III skeletal relationships were traced. Several craniofacial and MS parameters were measured. MS parameters were compared between the three groups using analysis of variance and were correlated with the craniofacial parameters using the Pearson correlation coefficient. RESULTS: Larger angle of concavity of the chin, more inclination of the alveolar bone toward the mandibular plane, and larger MS dimensions and area (P < .001) were found with a Class III skeletal relationship compared to Class I and Class II relationships. The Pearson correlation coefficient between Id-Me and AFH was r  =  0.83 and between Id-Me and LAFH it was r  =  0.81. CONCLUSIONS: The dimensions and configuration of MS in the Class III relationship were different than those in Class I and Class II relationships; the alveolar part of MS compensated for the skeletal relationship in the Class III pattern. MS dimensions were strongly correlated to anterior facial dimensions.

Factors influencing the uptake of orthodontic treatment.

OBJECTIVES: The aim of this study was to investigate the factors that may influence orthodontic treatment uptake such as socioeconomic class (SEC), type of funding, and gender. METHODS: The sample comprised 550 adolescents (232 men, 318 women) aged 13-17 years. Demographic data and questions concerning treatment experience, satisfaction with dental appearance, self-perceived need, dental attendance pattern, and presence of a health insurance were collected by means of a questionnaire. SEC was established by using an index developed for Jordanians. Normative treatment need was assessed by using the Index of Orthodontic Treatment Need. Chi-squared test and logistic regression analysis were used for the statistical analyses. RESULTS: Treatment uptake was significantly less in the low SEC group (5.2 percent) than the other SEC groups. Women were more frequently treated than men as were those subjects who possessed a health insurance and who regularly attended a dentist. The odds of not receiving orthodontic treatment were significantly higher in the lowest SEC group (odds ratio = 26, P < 0.001). Gender, health insurance, and dental attendance pattern were significant variables in predicting treatment uptake but to a lesser extent than SEC. CONCLUSIONS: Low SEC had a strong predictive effect on treatment uptake; socioeconomically deprived individuals were less likely to undergo orthodontic treatment.

The effect of malocclusion and self-perceived aesthetics on the self-esteem of a sample of Jordanian adolescents.

The aims of this study were to evaluate the effect of normative treatment need, perceived social impact of malocclusion and satisfaction with dental appearance on self-perceived treatment need, self-perceived aesthetics, and self-esteem; the influence of self-perceived need and aesthetics on self-esteem; and whether receipt of orthodontic treatment influences self-esteem. A questionnaire was administered to a random sample of 410 students (195 males and 215 females) aged 14-16 years. Self-esteem was measured using the Global Negative Self-Evaluation (GSE) scale. The Aesthetic and Dental Health Components (AC and DHC) of the Index of Orthodontic Treatment Need (IOTN) were used to assess orthodontic treatment need. Students' AC scores determined their self-perceived dental aesthetics. Spearman correlation coefficient was used to analyse the association between all variables, and multiple stepwise regression analysis to study the effect of independent variables on self-perceived need for treatment, self-perceived aesthetics, and self-esteem. A correlation existed between the students' and examiner's AC scores (P < 0.01); however, students were less critical in evaluating their aesthetic appearance. Students who perceived themselves in need of treatment had a great need for treatment, as assessed by the DHC and the AC of the IOTN (r = 0.421 and 0.489, respectively), were dissatisfied with their dental appearance (r = 0.542) and avoided smiling to hide their teeth (r = 0.457). Students who scored high on the GSE scale perceived a need for orthodontic treatment, evaluated their dental aesthetics poorly, perceived an impact of malocclusion on social acceptance, and had a great normative orthodontic treatment need; the correlation, however, was weak with r values ranging from 0.134 to 0.317. Students who had received orthodontic treatment showed greater self-esteem than those who had not, although the correlation was weak. Dissatisfaction with dental appearance had a strong predictive effect on self-esteem.

Photo-elastic stress analysis of initial alignment archwires.

Photo-elastic models replicating a lower arch with a moderate degree of lower incisor crowding and a palatally displaced maxillary canine were used to evaluate the stresses transmitted to the roots of the teeth by initial alignment archwires. Six initial alignment archwires were compared, two multi-strand stainless steel wires, two non-super-elastic (stabilized martensitic form) nickel titanium wires, and two stress-induced super-elastic (austenitic active) nickel titanium wires. Three specimens of each archwire type were tested. Analysis of the photo-elastic fringe patterns, in the medium supporting the teeth, revealed that the non-super-elastic nickel titanium archwires produced the highest shear stresses (P = 0.001). However, the shear stresses generated by the super-elastic alignment archwires and the multi-strand stainless steel archwires were very similar (P = 1.00). These results show that even in situations where large deflections of initial alignment archwires are required, super-elastic archwires do not appear to have any marked advantage over multi-strand stainless steel alignment archwires in terms of the stresses transferred to the roots of the teeth.