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Air pollution is a major cardiovascular risk factor leading to higher rates of heart failure and myocardial infarction (MI), but its effects on functional recovery after an MI remain unknown. Cardiac rehabilitation is a cornerstone of post-MI care and leads to better performance and quality of life, but its benefits may be hampered in heavily polluted environments. To assess the effect of different pollutants on post-MI rehabilitation, we included 137 post-MI patients from 7 Spanish hospitals that were enrolled in a cardiac rehabilitation program who underwent two cardiopulmonary exercise tests (CPET) within a 12-week period. Air pollution data were obtained from preexistent databases and matched with the patient's zip code. Patients exposed to higher NO2 levels (>22.5 ppb, above the median exposure of the cohort) had less improvement in peak oxygen consumption (0.9 % vs 9.5 %, p = 0.014), in oxygen pulse (0.0 % vs 6.9 %, p = 0.034) and tidal volume (−3.7 % vs 4.0 %). PM2.5 and PM10 did not have an impact on CPET parameters. After adjusting by age, sex, active smoking, hypertension, diabetes, hemoglobin, beta-blockers and left ventricular ejection fraction at discharge, the association between high NO2 levels and the change in peak VO2 remained significant (p = 0.029). This study highlights the importance of air pollution during cardiac rehabilitation and suggests that NO2 negatively impact on post-MI functional recovery.

ABSTRACT: Background: The European Economic Area (EEA) is composed of member states with a multitude of different regions. This study aimed to analyse the ratios of general dentists and dental specialists to the total population and the proportion of dental specialists to general dentists in 24 European countries and to explore specific intranational differences within 2 countries: France and Germany. Methods: Available official documents and webpages from the United Kingdom and 23 of the 30 countries comprising the EEA were analysed. Data were expressed as absolute values, ratios of general dentists and dental specialists in the total of population, and percentages of dental specialists/dentists. The Mann–Whitney U test was used to clarify the main ratios that distinguish France from Germany, and cluster analysis was employed to determine similar areas. Results: Significant differences were found between countries, with Ireland and Austria having the lowest ratio of dentists and Romania and Greece having the highest. The Czech Republic, the Netherlands, France, and Denmark had the lowest ratios of dental specialists to the total population. Lithuania, Sweden, and Germany had the highest number of dental specialists. Orthodontists were the most numerous specialists (5.0% of dentists), followed by oral surgeons (2.7%). In France, differences between departments were pronounced and associated with the presence of dental schools and per capita income. In Germany, only the correlation between per capita income and the density of oral surgeons was significant. Conclusions: Diverse ratios of general dentists and dental specialists to the total population and the proportion of dental specialists to general dentists were discovered within the examined countries, and their maximum values were 2.5, 5.7, and 4.1 times the minimum values, respectively. Differences were even found within the same country, as was the case in France and, to a lesser extent, in Germany.

Abstract Background The purposes of the present study were to evaluate the changes produced by the Austro Repositioner, and to assess the stability of Class II malocclusion treatment with the Austro Repositioner associated with fixed appliances and its capacity to control the vertical dimension in dolichofacial patients. Methods A group of patients with Class II malocclusion due to mandibular retrognathism and a dolichofacial growth pattern treated with the Austro Repositioner combined with fixed appliances were compared to a matched untreated control group of subjects with Class II malocclusion. Evaluations were made on the basis of lateral cephalograms taken at T1 (initial records), T2 (end of treatment), and T3 (1 year after treatment). Statistical comparisons were performed with paired- and two-sample t tests. Results The experimental (treated) group comprised 30 patients, 14 boys and 16 girls, and the control group comprised 30 subjects (15 boys and 15 girls) with similar ages at T1, T2 and T3. In the treated group, a significant decrease in the ANB angle was found (− 3.79 ± 1.46; p

Abstract Background There is a lack of studies comparing the status of dental specialties worldwide. Therefore, this study aimed to analyze the differences and similarities between the number and types of dental specialties in 31 countries, including every continent, in the world. Materials and methods Available official documents and webpages from regulatory bodies, official colleges and councils, and dental institutions were collected from 31 countries and analyzed to obtain reliable data on dental specialties. Differences were analyzed using the Lorentz curve and Gini test. Additionally, a cluster analysis was performed to obtain groups of countries with similar patterns in the number and types of dental specialties. Results A total of 32 different specialties were officially recognized among all the analyzed countries. Orthodontics and oral surgery (100% and 93.1%, respectively) were the two most frequently officially recognized dental specialties worldwide. The total global degree of inequality in the 31 analyzed countries was 42.4%. The Anglo-Saxon countries showed the greatest similarity, approximately 15-fold higher than the European countries. Cluster analysis differentiated six main groups of countries according to the number and types of dental specialties. European countries formed one of the two largest clusters, and the other cluster was of Anglo-Saxon, Asian, African, and several Eastern European countries with a high number of specialties. Conclusions Officially recognized dental specialties in the different continents and countries show an asymmetric organization. The number, names, and skills of officially recognized dental specialties exhibited significant differences, showing inequalities in their organization. The Anglo-Saxon pattern of dental specialties showed greater equality than the European pattern. Orthodontics was the only constant element among the different patterns.

Abstract Background Although the European Economic Space usually acts in a united and organized way, several main differences are found regarding the type and number of dental specialties all around this group of member states. The aim of the study is to analyse the inequalities and similarities existing between 21 European countries, highlighting the number and types of recognized dental specialties. Methods Available official documents and webpages from 20 out of the 30 countries of which the European Economic Space is comprised plus the United Kingdom (UK), were analysed to obtain reliable data referred to dental specialties. Differences were tested with the Lorentz curve and Gini test. Additionally, a Cluster analysis was performed to obtain groups of countries with a similar pattern in the number and type of dental specialties. Results Up to a total of 15 different specialties are officially recognized in all the analysed countries. Orthodontics (90%) and Oral Surgery (81%) are the two most frequently recognized specialties. The total global degree of inequality of the analysed countries was 40.2%. Cluster analysis differentiated three different main groups of countries according to the number and type of dental specialties. Conclusions The situation of dental specialties in the area of the EES plus the UK exhibits an unequal organization. Cluster analysis showed 3 main clusters of countries with a similar pattern of dental specialties.

Abstract Background Class III malocclusion is associated with high sexual dimorphism, especially in individuals older than 13 years of age, with significant differences in growth between males and females during the pubertal and postpubertal stages, and in adulthood. The aim of this research was to examine differences between males and females in long-term stability (10 years) of treatment for skeletal Class III malocclusion. Methods Thirty patients (15 males and 15 females) with skeletal Class III malocclusion, who had been treated with rapid maxillary expansion (RME) combined with face mask protraction followed by fixed appliances, were selected sequentially. Thirty patients (15 males and 15 females) with skeletal Class I and mesofacial patterns treated only with fixed appliances for dental problems served as the control group. Differences between groups and sexes were evaluated using lateral cephalograms taken at the start of treatment (T0), immediately after the end of treatment (T1), and after 10 years (T2). The long-term treatment success rate was calculated. Results Ten years after Class III treatment, overjet and overbite relapse occurred similarly in females (− 0.68 ± 0.7 mm; − 0.38 ± 0.75 mm, respectively) and males (− 1.09 ± 1.47 mm; − 0.64 ± 0.9 mm, respectively); the ANB angle and Wits appraisal became significantly more negative in males (− 1.37 ± 1.06°; − 2.7 ± 2.53 mm) than in females (− 0.18 ± 1.26°; − 0.46 ± 1.94 mm). The success rate was 73.3% in males and 80% in females. Conclusions Significant differences in the long-term stability of Class III treatment outcomes have been found between males and females, with a larger skeletal Class III relapse and lower long-term success rates in males.

Background: We conducted research to investigate the effects of the eruption sequence of posterior teeth, arch dimensions, and incisor inclination on dental crowding. Material and Methods: A cross-sectional analytic study was performed on 100 patients (54 boys and 46 girls; mean ages: 11.69 and 11.16 years, respectively). Seq1 (canine-3-/second premolar-5-) or Seq2 (5/3) eruption sequences were recorded in maxilla, and Seq3 (canine-3-/first premolar-4-) or Seq4 (4/3) eruption sequences in mandible; tooth size, available space, tooth size-arch length discrepancy (TS-ALD), arch lengths, incisor inclination and distance, and skeletal relationship were noted. Results: The most common eruption sequences in the maxilla and mandible were Seq1 (50.6%), and Seq3 (52.1%), respectively. In the maxilla, posterior tooth sizes were larger in crowded cases. In the mandible, anterior and posterior tooth sizes were larger in crowded patients. No relationship between incisor variables and the maxillo-mandibular relationship and dental crowding was found. A negative correlation between inferior TS-ALD and the mandibular plane was found. Conclusions: Seq1 and Seq 2 in the maxilla and Seq 3 and Seq 4 in the mandible were equally prevalent. An eruption sequence of 3–5 in the maxilla and 3–4 in the mandible is more likely to cause crowding.

The aim of this study was to determine the relationship between the closure stage of the spheno-occipital synchondrosis and the maturational stage of the cervical vertebrae (CVM) in growing and young adult subjects using cone beam computed tomography (CBCT). CBCT images with an extended field of view obtained from 315 participants (148 females and 167 males; mean age 15.6 ±7.3 years; range 6 to 23 years) were analyzed. The fusion status of the synchondrosis was determined using a five-stage scoring system; the vertebral maturational status was evaluated using a six-stage stratification (CVM method). Ordinal regression was used to study the ability of the synchondrosis stage to predict the vertebral maturation stage. Vertebrae and synchondrosis had a strong significant correlation (r = 0.89) that essential was similar for females (r = 0.88) and males (r = 0.89). CVM stage could be accurately predicted from synchondrosis stage by ordinal regression models. Prediction equations of the vertebral stage using synchondrosis stage, sex and biological age as predictors were developed. Thus this investigation demonstrated that the stage of spheno-occipital synchondrosis, as determined in CBCT images, is a reasonable indicator of growth maturation.

Objectives: This study aimed to evaluate the effectiveness of a novel hybrid aligner system, Geniova Technologies™ (GT), for arch expansion and to compare the predictability of its virtual setup with a conventional clear aligner system (CA) after the first treatment phase. Materials and Methods: Forty (mean age: 31.3 years for GT, 38.4 years for CA) adult patients with maxillary dentoalveolar compression and anterior crowding >3 mm were enrolled and assigned to GT and CA groups. Transverse changes for canines and premolars were measured at the cusp and cervical levels. Results: No significant baseline differences in transverse dimensions were found between groups. Treatment duration (4.25 months for GT vs. 9.75 months for CA) and the number of aligners (4.25 in GT vs. 28.25 in CA) significantly differed (p < 0.001). At the cusp level, mean transverse expansions for the maxillary first premolars were 2.78 mm (GT) and 2.44 mm (CA). However, effectiveness comparisons revealed no significant differences in expansion outcomes, with both groups showing similar accuracy. Conclusions: The GT group achieved comparable dentoalveolar expansion of canines and premolars in significantly less time and with fewer aligners than the CA group. The predictability of virtual setup measurements was similar for both systems, confirming their comparable performance in achieving planned expansion.