Malocclusion or laterorhinia: Which one impacts aesthetic facial perception the most?

INTRODUCTION: This study aimed to evaluate the perception of facial attractiveness when nose and teeth, together or isolated, present different degrees of disharmony. The secondary objective was to compare the perception of laypersons with that of dentists. MATERIALS AND METHODS: This cross-sectional observational study included 112 individuals (58 laypersons and 54 dentists) that evaluated 6 manipulated images of the face of the same model, scoring their attractiveness using 10 cm Visual Analogue Scales (VAS), with least and most attractive at the left and right anchors, respectively. The images contained manipulations performed only on the nose (laterorhinia) and mouth (misaligned teeth), as follows: (1) standard photograph, with symmetrical nose + aligned teeth; (2) 2 mm nasal deviation + aligned teeth; (3) 4 mm nasal deviation + aligned teeth; (4) symmetrical nose + misaligned teeth; (5) 2 mm nasal deviation + misaligned teeth and (6) 4 mm nasal deviation + misaligned teeth. We used the repeated measures ANOVA test and Tukey's post-test for intra-group comparison of the images. The independent t-test was used for inter-group comparison of each image. RESULTS: In the laypersons' group, the highest grades were given to images with aligned teeth and the lowest to misaligned teeth (smallest mean difference = 2.88 cm). For this group, there was no statistically significant difference (P-values ranged from .988 to 1.000) between scores of the three images in which teeth were aligned (range of 7.70-7.78 cm). In the group of dentists, highest grades were given to images with aligned teeth and the lowest to misaligned teeth. Difference between images 3 and 4 was not statistically significant (P = .204). All other differences between any image of straight teeth and any image with misaligned teeth were significant and the smallest mean difference between the two groups of images was 1.87 (P = .039). However, in the images with aligned teeth, there was also a statistically significant difference with higher scores to the images with symmetrical nose in contrast with those with significant laterorhinia (mean difference = 1.03 cm). CONCLUSION: Teeth disharmonies had a more negative impact on the aesthetic perception of the face than did nose deviations, for both dentists and laypersons.

Pain perception and expectation related to interradicular mini-implants insertion: a systematic review and meta-analysis.

OBJECTIVES: The aim of this systematic review was to compare the expectation and perception of pain reported by patients before and after the installation of interradicular mini-implants. MATERIALS AND METHODS: Electronic search was performed in six databases. Inclusion criteria were randomized controlled trials (RCTs) or non-randomized controlled clinical trials (nRCTs); studies using mini-implants in the interradicular region; assessment of pain intensity by visual analogue or numerical scale. The risk of bias assessment was based on the Rob 2 tool and Robins-I. RESULTS: A total of 1566 articles were retrieved, and 21 met the eligibility criteria. Six were classified as high risk, one as critical and the other one as uncertain, according to the Robins-I tool. In articles evaluated by the Rob2 tool, ten were classified as serious risk and three as moderate risk. A meta-analysis was also performed. Weighted means were calculated among the studies using the random-effects model and forest plots were generated. Heterogeneity was assessed through the Q test and I2 statistics. It was observed, with moderate evidence, that on a scale of 0 to 10, the pain expectation (effect size 4.75) is higher than that effectively pain generated by the procedure (effect size 1.94). CONCLUSION: Pain expectation was greater than that actually generated by the procedure, being almost non-existent 7 days postoperatively. CLINICAL RELEVANCE: This study may help the clinician to reassure the patient regarding the sensations that could be experienced during and after the installation.

Patient perception of orthodontists with different stereotypes: development, psychometric properties, and application of an assessment instrument.

INTRODUCTION: This research aimed to develop and validate a questionnaire that considers social judgments and, through its application, assesses whether the presence of piercings, tattoos, beards, and loose hair visible in the face and neck region reflect on the patient perception regarding characteristics of the orthodontist's professional scope. METHODS: The developed questionnaire had its psychometric properties evaluated and was applied to 220 young people and adults, aged 18-70 years, who responded according to their perception of 12 manipulated images of orthodontists with different stereotypes, considering the following items: hygiene, care, punctuality, experience and knowledge in orthodontics. RESULTS: The developed questionnaire showed high acceptability, confirmed reliability and validity of the construct, and satisfactory internal consistency. The stereotype interfered with the perception of professionalism (P <0.01), in which the orthodontist with combined characteristics (beard/loose hair, piercing, earrings, and tattoo) obtained the lowest mean scores, both for each item of the questionnaire individually (P <0.01) and in total (P <0.01). Health professional (P = 0.427) and educational level (P = 0.285) status did not influence the perception; however, there was a significant difference for the age groups (P = 0.041). CONCLUSIONS: The developed questionnaire proved to be valid and reliable for application. Orthodontists with piercings and tattoos on the face and neck were considered less professional. Being a health professional and educational level status did not influence the perception. However, older subjects (aged 51-70 years) were more critical in judging stereotypes than younger subjects (aged 18-30 years).

Percepção do paciente frente a ortodontistas com diferentes estereótipos: desenvolvimento, propriedades psicométricas e aplicação de um instrumento de avaliação / Patient's perception of orthodontists with different stereotypes: development, psychometric properties and application of an evaluation instrument

Esta pesquisa objetivou desenvolver e validar um questionário que considere julgamentos sociais e, através de sua aplicação, avaliar se a presença de piercings, tatuagens, barba e cabelo solto visíveis na região de face e pescoço refletem na percepção do paciente frente a características do escopo profissional do Ortodontista. Para isso, o questionário desenvolvido teve suas propriedades psicométricas avaliadas e foi aplicado em 220 jovens e adultos, com idade entre 18 e 70 anos, que responderam sobre sua percepção frente a 12 imagens manipuladas de Ortodontistas com diferentes estereótipos, levando em considerações os seguintes itens: higiene, cuidado, pontualidade, experiência e conhecimento em Ortodontia. Como resultado, o questionário desenvolvido apresentou alta aceitabilidade, confiabilidade e validade do constructo confirmadas e consistência interna satisfatória. O estereótipo interferiu na percepção de profissionalismo (p<0.01), onde o Ortodontista com características combinadas (barba/cabelo solto, piercing, brinco e tatuagem) obteve os menores escores médios, tanto para cada item do questionário individualmente (p<0.01) quanto no total (p<0.01). Ser ou não profissional da área da saúde (p=0.427) e nível educacional (p=0.285) não influenciaram na percepção, porém, houve diferença significativa para as faixas etárias (p=0.041). Assim, concluiu-se que o questionário desenvolvido se provou válido e confiável para aplicação. Ortodontistas com piercings e tatuagens na região da face e pescoço foram considerados menos profissionais. Ser ou não profissional da saúde e nível educacional não influenciaram na percepção, porém, indivíduos mais velhos (51 a 70 anos) foram mais críticos no julgamento dos estereótipos do que indivíduos jovens (18 a 30 anos). (AU)

This research aimed to develop and validate a questionnaire that considers social judgments and, through its application, to assess whether the presence of piercings, tattoos, beard and loose hair visible in the face and neck region reflect on the patient perception regarding characteristics of the orthodontist's professional scope. For this, the questionnaire developed had its psychometric properties evaluated and was applied to 220 young people and adults, aged between 18 and 70 years, who responded according to their perception of 12 manipulated images of orthodontists with different stereotypes, taking into account the following items: hygiene, care, punctuality, experience and knowledge in Orthodontics. As results, the questionnaire developed showed high acceptability, confirmed reliability and validity of the construct and satisfactory internal consistency. The stereotype interfered with the perception of professionalism (p<0.01), where the orthodontist with combined characteristics (beard/loose hair, piercing, earrings and tattoo) obtained the lowest mean scores, both for each item of the questionnaire individually (p<0.01) and in total (p<0.01). Being a health professional (p=0.427) and educational level (p=0.285) did not influence the perception, however, there was a significant difference for the age groups (p=0.041). Thus, it was concluded that the developed questionnaire proved to be valid and reliable for application. Orthodontists with piercings and tattoos on the face and neck were considered less professional. Being a health professional and educational level did not influence the perception, however, older individuals (51 to 70 years) were more critical in judging stereotypes than younger individuals (18 to 30 years). (AU)