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Objective: This study compared the achieved tooth movement to that predicted in the preliminary simulated digital treatment plan between adults and teenagers., Materials and Methods: Records of 60 patients (30 adults; mean age: 36.6 ± 11.36 years, and 30 teenagers; mean age: 16.23 ± 2.25 years) were randomly selected. Initial and predicted models were obtained from the initial simulated treatment plan. The first model of the refinement scan was labeled as achieved. SlicerCMF software (version 3.1; https://www.slicer.org ) was used to superimpose the achieved and predicted digital models over the initial ones with regional superimposition on relatively stable first molars. 600 teeth were measured in each group for horizontal, vertical, angular movements, and transverse dimensions. Accuracy was defined as the achieved amount of movement minus predicted and was calculated for each individual and compared between teens and adults., Results: The mandibular inter-canine width accuracy was statistically significant between groups (p = 0.050). Significant under-correction in horizontal movements was noted for mandibular first premolars in teenagers compared to adults (p = 0.037). There was considerable over-correction in horizontal movements for mandibular central and lateral incisors between groups (p < 0.05). No significant difference was observed between groups in the vertical plane. Rotations were underachieved for maxillary first premolars, more in adults than teenagers (p = 0.017)., Conclusion: The accuracy of achieved versus predicted tooth movement between adults and teenagers was significant for the inter-canine width. Mandibular central and lateral incisors showed significantly greater over-correction in adults in the horizontal plane. The accuracy of rotations and vertical movements was comparable., Competing Interests: Declarations Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Introduction: The objective of this study was to evaluate the short-term and long-term hard-tissue changes with miniscrew-assisted rapid palatal expansion (MARPE) and rapid palatal expansion (RPE) compared with a matched control group with voxel-based superimposition using 3-dimensional cone-beam computed tomography (CBCT) scans., Methods: A total of 180 CBCT scans were analyzed for 60 patients with a mean age of 13.9 years at 3 time points: pretreatment (T1), postexpansion (T2), and posttreatment (T3). Patients were divided into 3 groups: MARPE, RPE, and controls. Voxel-based superimposition was performed for CBCTs from T1 to T2 and T1 to T3 using the anterior cranial base as a reference. The hard-tissue surfaces were extracted after the superimposition procedure. Nine landmarks were analyzed: nasion, A-point, pogonion, left and right alar bases, zygoma, and gonion. Within-group changes were analyzed using linear mixed-effects models, including a random intercept per subject and the mixed effect of time (T1, T2, or T3) with test P values adjusted for multiple testing using Tukey's method. Between-group changes were analyzed using linear mixed-effects models, including a random intercept per subject and the mixed effects of time, group, and group × time interaction with P values adjusted for multiple testing using the Benjamin-Hochberg false discovery rate method., Results: In the short term, both MARPE and RPE led to a significant downward movement of the right gonion and lateral movement of the right alar base compared with controls at T2 (P <0.05). In addition, MARPE led to a significant downward movement of pogonion and left gonion. RPE led to a significant downward movement of the A-point and lateral movement of the left alar base compared with controls at T2 (P <0.05). However, in the long-term, no changes were observed between the groups at T3., Conclusions: There were significant differences in pogonion, alar base, and gonion between MARPE, RPE, and control groups in the short term. However, all the hard-tissue changes were transient, as there were no differences between the 3 groups in the long term., (Copyright © 2024 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: This study aimed to compare the efficiency of temporary anchorage devices (TADs) and fixed functional appliances (FFAs) for mandibular molar protraction., Methods: Orthodontic records of 1050 consecutively treated patients with molar protraction were screened. Thirty-six records (22 females and 14 males; mean age, 17.4 years) were divided into two groups: TAD (21 subjects with 25 edentulous spaces) and FFA (15 subjects with 24 edentulous spaces). The primary outcome measure was the efficiency of protraction [magnitude and time required for protraction (rate) and anchor loss (AL)]. The secondary outcomes involved measuring the type of tooth movement (TOTM), external apical root resorption (EARR), alveolar bone height change (ABHC), alveolar bone width change (ABWC) and appliance failure., Results: The rate of tooth movement was significantly higher for FFAs (0.83 ± 0.35 mm/month) versus TADs (0.49 ± 0.2 mm/month) (P = .005). Total treatment duration was less for FFAs (34.78 ± 8.1 months) versus TADs (47.72 ± 13.94 months) (P = .002). TOTM was similar for both (P = .909). EARR was 1.42 ± 1.38 mm for TAD and 1.25 ± 0.88 mm for FFA (P = .81). ABHC increased in the FFA group (1.01 ± 3.62 mm) and decreased for the TAD group (0.68 ± 1.66 mm). ABWC increased for both TAD (1.81 ± 1.73 mm) and FFA (1.75 ± 1.35 mm). The failure rate was 50% for FFAs and 33% for TADs., Conclusions: Both systems provided translation of lower molars with comparable anchorage control. However, FFAs were more efficient than TADs for lower molar protraction., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Bleeding from gastric varices is life-threatening, with significant rebleeding risk despite standard cyanoacrylate glue injection therapy. Our aim was to evaluate the efficacy and safety of endoscopic ultrasonography (EUS)-guided coil embolization with cyanoacrylate injection (Coil+CYA) compared with EUS-guided cyanoacrylate injection alone (CYA) for the treatment of gastric varices., Methods: The study was conducted at a tertiary referral center in India, using a single-blinded, prospective, and parallel-group randomized design. A total of 50 patients were randomly assigned (1 : 1) to Coil+CYA or CYA. The primary outcome was clinical success (i.e. variceal obliteration). Secondary outcomes involved technical success, gastric variceal recurrence during follow-up, rebleeding episodes, reintervention, and survival., Results: Post-intervention, gastric variceal obliteration assessed by EUS was higher in the Coil+CYA group (100% vs. 92.3%; P = 0.49), with both groups achieving 100% technical success. Rebleeding episodes during 0-12 and 12-24 weeks were comparable in the two groups. At 12 weeks, on EUS, variceal reappearance was less common in the Coil+CYA group (12.5% vs. 19.2%; P = 0.70). Significantly fewer reinterventions were needed in the Coil+CYA group (20.8% vs. 53.8%; P = 0.03). The time to reintervention was significantly longer in the Coil+CYA group ( P = 0.01), and the survival time was also longer ( P = 0.04)., Conclusions: EUS-guided coil embolization with cyanoacrylate injection achieved superior clinical success, reducing the need for reintervention and resulting in improved survival compared with cyanoacrylate injection alone., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Objectives: The objective of this study was to evaluate if there are any morphologic, positional, and volumetric differences in the temporomandibular joint (TMJ) of patients with unilateral posterior crossbite (UPC) compared to controls. Another objective was to analyse the discrepancy in the TMJ between the crossbite versus non-crossbite side in UPC versus right and left sides in controls. Additionally, this study aimed to evaluate the differences in the bone density at the masseteric insertion site at the angle of mandible in the UPC group and control group., Material and Methods: One hundred and thirty-two CBCTs were analysed with 66 patients in UPC group and 66 patients in control group (non-crossbite). Temporomandibular joint spaces - Anterior joint space (AJS), Superior joint space (SJS), Posterior joint space (PJS), Medial joint space (MJS), Middle joint space (MiJS), and Lateral joint space (LJS) were measured. Additionally, bone density at angle of mandible and volume of mandibular condyle were evaluated. The measurements were compared between the groups as well as between the crossbite and non-crossbite sides within the UPC group and between right and left sides within the control group. Furthermore, the associations between UPC and changes in TMJ regarding joint space availability, bone density, condylar head volume, and the effects of sex and age were evaluated using regression analysis., Results: It was observed that UPC group showed a greater condylar volume, than the control group. Additionally, a larger mean discrepancy was observed between the crossbite side and non-crossbite side within the UPC group concerning condylar volume than controls. Concerning age, condylar volume was observed to be larger in adults than children. Adults showed significantly greater bone density and condylar volume than adolescents. Concerning sex, it was observed that males showed a larger SJS (right), MiJS, LJS, and bone density at the mandibular angle than females., Conclusion: There is a difference in the TMJ parameters particularly condylar volume in patients with UPC compared to controls., (Copyright © 2024 CEO. Published by Elsevier Masson SAS. All rights reserved.)

A key challenge in aging research is extending lifespan in tandem with slowing down functional decline so that life with good health (healthspan) can be extended. Here, we show that monthly clearance, starting from 20 months, of a small number of cells that highly express p21 Cip1 (p21 high ) improves cardiac and metabolic function and extends both median and maximum lifespans in mice. Importantly, by assessing the health and physical function of these mice monthly until death, we show that clearance of p21 high cells improves physical function at all remaining stages of life, suggesting healthspan extension. Mechanistically, p21 high cells encompass several cell types with a relatively conserved proinflammatory signature. Clearance of p21 high cells reduces inflammation and alleviates age-related transcriptomic signatures of various tissues. These findings demonstrate the feasibility of healthspan extension in mice and indicate p21 high cells as a therapeutic target for healthy aging., Competing Interests: Declaration of interests M.X., T.T., and J.L.K. have a financial conflict of interest with a Mayo Clinic pending patent for p21-Cre mouse model., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Aim This study aimed to assess the impact of positive pressure, negative pressure (EndoVac), and sonic-activated irrigation (EndoActivator) on postoperative pain with symptomatic irreversible pulpitis and symptomatic apical periodontitis. The hypothesis tested the superiority of negative pressure irrigation in reducing pain and analgesic requirements. Methodology Forty-eight eligible patients meeting inclusion criteria were enrolled, ensuring comprehension through verbal and written patient information sheets. The sample size calculation, based on prior data, determined 14 teeth per group with consideration for potential dropouts, resulting in 16 teeth per group. Inclusion criteria included healthy individuals aged 16-65 years with single-rooted teeth diagnosed with symptomatic irreversible pulpitis and symptomatic apical periodontitis, while exclusion criteria comprised recent analgesic intake, pregnancy, lactation, and specific dental conditions. Participants were allocated to three groups using computer-generated block randomization with allocation concealment via sequentially numbered opaque sealed envelopes. While blinding of the operator was not feasible, patient and assessor blinding was ensured. Preoperative data collection included patient demographics, tooth details, and pain intensity assessed on a Visual Analogue Scale (VAS). Root canal therapy procedures, conducted in two visits, included instrumentation and irrigation using 3% NaOCl across three groups: positive pressure irrigation, negative pressure irrigation, and sonic activation. Postoperative pain and analgesic intake were evaluated using VAS at specific intervals. One assessor tabulated and analyzed all the information. Results Postoperative pain assessments revealed that the EV group experienced the lowest pain levels, followed by the EA and SVN groups, with significant differences observed at six and 24 hours postoperatively (p < 0.05). Analgesic requirements correlated with pain levels, with the SVN group requiring the most analgesics and the EV group the least, highlighting the efficacy of the interventions. Conclusions Negative pressure irrigation (EndoVac) significantly reduced postoperative pain compared to conventional side-vented needle irrigation. These findings enhance understanding and guide evidence-based recommendations for optimizing endodontic procedures and prioritizing patient comfort and outcomes., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethics Committee, All India Institute of Medical Sciences, Jodhpur issued approval AIIMS/IEC/2022/3967. The project has been approved with effect from March 21, 2022, subject to the following conditions: The approval is valid for the period of the study according to this protocol under the responsibility of Guide: Dr Pravin Kumar, Co-Guide: Dr. Vinay Chugh. No significant changes to the research protocol could be made and implemented without the prior consent of the IEC, and any changes or deviations from the protocol that increase the risk for the subjects should be submitted to the IEC and approved by it prior to implementation. It has been confirmed by the Ethics Committee of AIIMS. Jodhpur is composed of and functions as per the ICH GCP and other application regulatory guidelines. It is hereby confirmed that neither you nor any of the study team members have participated in the voting or decision-making procedures of the committee. The study progress report should be made available to the IEC for review annually. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Kumar et al.)

Background: Osteogenesis imperfecta (OI) is a genetic disorder of connective tissue caused by mutations associated with type I collagen, which results in defective extracellular matrix in temporomandibular joint (TMJ) cartilage and subchondral bone. TMJ is a fibrocartilaginous joint expressing type I collagen both in the cartilage and the subchondral bone. In the present study the effects of alendronate and altered loading of the TMJ was analyzed both in male and female OI mice., Materials and Methods: Forty-eight, 10-weeks-old male and female OI mice were divided into 3 groups: (1) Control group: unloaded group, (2) Saline + Loaded: Saline was injected for 2 weeks and then TMJ of mice was loaded for 5 days, (3) alendronate + loaded: alendronate was injected for 2 weeks and then TMJ of mice was loaded for 5 days. Mice in all the groups were euthanized 24-h after the final loading., Results: Alendronate pretreatment led to significant increase in bone volume and tissue density. Histomorphometrically, alendronate treatment led to increase in mineralization, cartilage thickness and proteoglycan distribution. Increased mineralization paralleled decreased osteoclastic activity. Our immunohistochemistry revealed decreased expression of matrix metallopeptidase 13 and ADAM metallopeptidase with thrombospondin type 1 motif 5., Conclusion: The findings of this research support that alendronate prevented the detrimental effects of loading on the extracellular matrix of the TMJ cartilage and subchondral bone., (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Background: External apical root resorption (EARR) is an unfavorable side effect of orthodontic treatment. Orthodontic treatment of patients with increased crowding could lead to the proclination of incisors and proximity of roots to the cortical plates., Aims: The aim of this study was to evaluate the effects of the proximity of the labial and lingual cortical plates and the inclination of incisors on EARR., Settings and Design: Twenty-six patients (age: 13.39 years) with nonextraction fixed orthodontic treatment were evaluated at pretreatment and posttreatment (52 cone-beam computed tomographies)., Materials and Methods: The maxillary and mandibular incisors (416 teeth) were evaluated for the pretreatment predictors such as the labial and palatal (lingual) cortical plate thickness, width of the mandibular symphysis/maxillary alveolus and cancellous bone, position of the root apex in cancellous/cortical bone, and treatment factors such as distance of root to the labial and palatal (lingual) outer and inner cortical plate and incisor inclination., Statistical Analysis Used: Statistical analyses were performed with R software at a 0.05 significance level. Each parameter was compared between pretreatment and posttreatment by a paired t -test, and the association to root resorption was performed using a regression model., Results: Clinically significant (>1 mm) root resorption was observed in 35% of all mandibular incisors and 52% of all maxillary incisors. Width of cancellous bone, position of the root apex in cortical bone, proximity of the root apex to the labial and palatal (lingual) outer cortical plate, lingual inner cortical plate, and proclination of incisors were significant factors associated with EARR., Conclusions: Proximity to the cortical plates and proclination of incisors are associated with increased EARR., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Contemporary Clinical Dentistry.)

Obstructive sleep apnea (OSA) can affect children and adults, and, if left untreated, could have a major impact on the general and overall well-being of the patient. Dental health care providers and orthodontists have an interdisciplinary role in screening patients at risk for OSA and make a referral to establish a definitive diagnosis by a sleep physician. The gold standard of diagnostic testing is polysomnography. The adeno-tonsillar hypertrophy is the primary cause of sleep apnea in children; therefore, adeno-tonsillectomy must be the first line of treatment. Post adeno-tonsillectomy, if there is residual OSA due to underlying skeletal discrepancy, the patient may be referred to an orthodontist for appropriate management. Currently the evidence in the literature for prophylactic growth modification in children to prevent OSA is weak. In adults, the gold standard for managing OSA is Positive Airway Pressure (PAP) therapy; however, adherence to this treatment is rather low. The oral appliance (OA) therapy is an alternate for PAP intolerant patients and for mild to moderate OSA patients. The OA therapy has to be administered by a qualified dentist or orthodontist after careful examination of dental and periodontal health as well as any pre-existing joint conditions. The OA therapy could cause OA-associated malocclusion and patients have to be made aware of prior to initiating treatment. In patients with severe OSA, surgical maxilla-mandibular advancement (MMA) is highly effective., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Binuclear vanadyl(IV) porphyrin ( V 2 BP ), where two vanadium(IV) porphyrin macrocycles are linked through benzimidazole units at the β-positions, has been prepared and characterized with various techniques, such as UV-vis, Fourier transform-infrared, electron paramagnetic resonance, cyclic voltammetry, density functional transform calculations, and mass spectrometry. V 2 BP exhibits a red shift (Δλ max = 10 nm) in the Soret band as compared with unsubstituted parent vanadyl(IV) meso -tetraphenylporphyrin ( VP ). The synthesized binuclear vanadyl(IV) porphyrin ( V 2 BP ) has further been studied as a catalyst to explore a single-pot multicomponent Biginelli reaction producing biologically active 3,4-dihydropyrimidin-2-(1 H )-one (DHPM)-based biomolecules and the corresponding thiones under solvent-free conditions and its catalytic activity has been compared with vanadyl(IV) meso -tetraphenylporphyrin ( VP ). Several reaction conditions, such as the amount of catalyst, time, solvent, and temperature, have been optimized to obtain the maximum yield of DHPMs or thiones. The synthesized β-functionalized V 2 BP porphyrin dimer manifests much higher conversion (84-95% yield) of DHPMs or the corresponding thiones under the optimized reaction conditions with high TON (4454-5037) and TOF (1113-1259 h -1 ) values for the one-pot multicomponent Biginelli reaction as compared to the literature. The catalyst exhibited excellent recyclability up to 10 cycles.

The objective of this paper was to assess the outcome of bone graft material at alveolar bone augmentation sites combined with dental implants in postmenopausal women with compromised bone health by evaluating cone beam computerized tomography (CBCT) scans at multiple time points.CBCT scans were analyzed on 55 postmenopausal women with compromised bone health status to determine the fate of alveolar bone augmentation. CBCT scans were taken immediately after surgery and 9 and 24 months postoperatively. The patient's medication regimens and durations were recorded, and the pixel intensity value (PIV) was measured and standardized using scoring criteria and visual assessment. Statistical analyses included 2-sample t tests for continuous variables and Fisher's exact tests for categorical variables.Among the normal patients, 73% received a grade 2 visual score, and 27% received a grade 1 visual score. After 24 months, 45% of patients received a grade 2 score, and 27% received a grade 3 score. In the osteoporotic group receiving medication, 77% of participants received a grade 1 visual score at the 9-month postoperative evaluation, while 23% received a grade 2 score. At the 24-month assessment, 55% of patients received a grade 1 score, 41% received a grade 2 score, and only 5% received a grade 3 score. Notably, although the graft material did not remodel into native bone, it was a scaffold for implants in controlled osteoporotic patients. The study's results show that the pixel intensity values of particulate graft materials are similar across the three different time points, suggesting that the graft material's pixel intensity value remains constant in postmenopausal women with osteoporosis. The study's limitations include a small sample size and a restricted 24-month follow-up period. This limited time frame may need to capture long-term changes or variations in graft materials adequately. Future research should include a larger sample size and have a longer follow-up duration to provide a more comprehensive understanding of the change in graft materials between patients with normal and compromised bone health.

Posterior Crossbite is a common condition resulting because of transverse maxillary deficiency. The growth of the craniofacial complex finishes first in the transverse dimension, followed by sagittal and vertical dimensions. Conventional rapid palatal expansion (RPE) appliances are commonly used to correct transverse maxillary deficiency. Although RPE is efficient in correcting posterior crossbite, it results in dental side effects such as buccal tipping of maxillary molars, root resorption, bone dehiscence, and relapse. Mini-implant-assisted RPE has been introduced to increase the skeletal effects of expansion especially in patients with increased maturation and greater interdigitation of midpalatal suture. This article will review the biomechanics of RPE and mini-implant-assisted RPE. Additionally, the different designs of MARPE and the long-term clinical effects of expansion appliances will also be discussed in detail., (Copyright © 2024 World Federation of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Objective: Fibroblast growth factors (FGFs) are a family of 22 proteins and 4 FGF receptors (FGFRs) that are crucial elements for normal development. The contribution of different FGFs and FGFRs for the homeostasis or disease of the cartilage from the mandibular condyle is unknown. Therefore, our goal was to characterize age-related alterations in the protein expression of FGF ligands and FGFRs in the mandibular condyle of mice., Method: Mandibular condyles of 1-, 6-, 12-, 18-, and 24-month-old C57BL/6J male mice (5 per group) were collected and histologically sectioned. Immunofluorescence for FGFs that have been reported to be relevant for chondrogenesis (FGF2, FGF8, FGF9, FGF18) as well as the activated/phosphorylated FGFRs (pFGFR1, pFGFR3) was carried out., Results: FGF2 and FGF8 were strongly expressed in the cartilage and subchondral bone of 1-month-old mice, but the expression shifted mainly to the subchondral bone as mice aged. FGF18 and pFGFR3 expression was limited to the cartilage of 1-month-old mice only. Meanwhile, pFGFR1 and FGF9 were mostly limited to the cartilage with a significant increase in expression as mice aged., Conclusions: Our results indicate FGF2 and FGF8 are important growth factors for mandibular condylar cartilage growth in young mice but with limited role in the cartilage of older mice. In addition, the increased expression of pFGFR1 and FGF9 and the decreased expression of pFGFR3 and FGF18 as mice aged suggest the association of these factors with aging and osteoarthritis of the cartilage of the mandibular condyle., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: To assess the accuracy of ChatGPT answers concerning orthodontic clear aligners., Materials and Methods: A cross-sectional content analysis of ChatGPT generated responses to queries related to clear aligner treatment (CAT) was undertaken. A total of 111 questions were generated by three orthodontists based on a set of predefined domains and subdomains. The artificial intelligence (AI)-generated (ChatGPT) answers were extracted and their accuracy was determined independently by five orthodontists. The accuracy of answers was assessed using a prepiloted four-point scale scoring rubric. Descriptive statistics were performed., Results: The total mean accuracy score for the entire set was 2.6 ± 1.1. It was noted that 58% of the AI-generated answers were scored as objectively true, 18% were selected facts, 9% were minimal facts, and 15% were false. False claims included the ability of CAT to reduce the need for orthognathic surgery (4.0 ± 0.0), improve airway function (3.8 ± 0.5), achieve root parallelism (3.6 ± 0.5), alleviate sleep apnea (3.8 ± 0.5), and produce more stable results compared to fixed appliances (3.8 ± 0.5)., Conclusions: The overall level of accuracy of ChatGPT responses to questions concerning CAT was suboptimal and lacked citations to relevant literature. Ability of the software to offer current and precise information was limited. Therefore, clinicians and patients must be mindful of false claims and relevant facts omitted in the answers generated by ChatGPT., (© 2024 by The EH Angle Education and Research Foundation, Inc.)

Cone beam computed tomography (CBCT) technology is increasingly utilized in the head and neck region and is valuable in treatment planning for cleft palate patients, potentially enabling the creation of 3D-printed obturators to assist with feeding and speech. This technical report investigates the feasibility of using data from a 360-degree CBCT scan to accurately produce a cleft palate obturator and assesses whether a lower-dose 180-degree CBCT scan can achieve a comparable result. A simulated cleft palate was crafted on a dehydrated human skull, which was then scanned using both 360-degree and 180-degree CBCT scanning protocols. Two obturators were digitally designed based on the segmented images from each scan and subsequently 3D printed. Evaluation of the segmented images and 3D-printed obturators from both protocols demonstrated clear visualization of anatomical landmarks and identical scores across all parameters, suggesting that the 180-degree CBCT scan can produce an obturator of comparable quality to that of the 360-degree scan, with the added benefit of reduced radiation exposure., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Nelson et al.)

Introduction: This study aimed to evaluate the soft-tissue changes in the long-term after miniscrew-assisted rapid palatal expansion (MARPE) and conventional rapid palatal expansion (RPE) appliances compared with a matched control group using voxel-based superimposition of cone-beam computed tomography (CBCT) scans., Methods: A total of 180 CBCTs for 60 patients at 3-time points were evaluated: pretreatment (T1), postexpansion (T2), and posttreatment (T3) for 3 groups: (1) MARPE, (2) RPE, and (3) controls (time-period T1 to T3: MARPE, 2 years 8 months; RPE, 2 years 9 months; control, 2 years 7 months). The voxel-based superimposition technique was used to superimpose the CBCT scans, after which the soft-tissue surfaces were extracted from the superimposed T1-CBCT, T2-CBCT, and T3-CBCT scans. Nine landmarks were identified on the CBCT scans: nasion, A-point, pogonion, right and left alar base, right and left zygoma, and right and left gonion. The coordinates of the 9 parameters were obtained in the x-axis, y-axis, and z-axis for the CBCT scans and subjected to statistical analyses. The changes in the soft-tissue surfaces were also evaluated by color-coded maps for short-term (T2) and long-term (T3) changes. The mean changes from T1 to T2 and T1 to T3 were tested against no change within the groups by paired t test, and the mean changes among the 3 groups were compared with analysis of variance F test with Tukey's Honest significant difference used for adjusting P values for multiple testing., Results: In the short term, both MARPE and RPE led to a significant downward movement of pogonion, left gonion, and lateral movement of the right and left alar base compared with controls at T2 (P <0.05). In addition, MARPE led to a significant downward movement of right gonion than controls at T2 (P <0.05). Moreover, RPE led to a significant downward and forward movement of A-point and downward movement of the right and left alar base than controls at T2 (P <0.05). However, in the long-term, there were no significant differences in the soft-tissue changes among the MARPE, RPE, and control groups., Conclusions: MARPE and RPE do not lead to significant soft-tissue changes in the long term when compared with controls., (Copyright © 2023 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Background: The standard screening protocol for radiographic examination in dentistry as per the American Dental Association recommendations is a panoramic radiograph (PAN) and four horizontal bitewings. PAN inherently suffers from several shortcomings like the superimposition of anatomic structures, especially of the cervical spine that obscures a significant portion of the anterior maxilla and mandible. This region has a significant amount of pathology that is not adequately imaged. Three-dimensional (3D) imaging provides circumferential information on the area of interest and adds value to the diagnosis and treatment planning of pathology, especially in the anterior maxilla and mandible. However, there is not an adequate number of well-designed studies that articulate the true value addition of 3D imaging for the evaluation of this region., Objectives: The objective of this study is to evaluate the value addition of 3D imaging in diagnosing pathologies in the anterior maxilla and mandible when compared to two-dimensional PAN., Materials and Methods: A total of 25 cases that had a diagnosis of anterior pathology and had both a PAN and a cone beam computed tomography (CBCT) scan were collected for this study. An institutional review board approval to retrospectively evaluate these data was obtained. The PAN and CBCT scans were randomly evaluated by a second-year dental student, an oral and maxillofacial radiology resident in training, and a board-certified oral radiologist. The scans were evaluated using a three-point modified Likert scale, where 1 represents "not visible or clear," 2 represents "visible but not clear," and 3 represents "visible and clear." The lesions were evaluated for characteristics like lesion location, size & shape, internal contents, borders of the lesion, cortical integrity, locularity, and effect on adjacent structures like root resorption. After the evaluation was completed, a comparison of the lesion diagnosis was done with histopathology to confirm the diagnosis. The evaluators were also asked to comment on the specific feature that 3D imaging provided that added value to the case. Kappa analysis was done to evaluate inter-operator reliability., Results: PAN demonstrated significantly lower efficacy in identifying and diagnosing lesions. Only 56% of cases were analyzed using PAN, with 44% deemed undetectable or poorly visualized. These challenging cases necessitated CBCT scans for accurate diagnosis, which successfully diagnosed all 25 cases. The p-value of 0.0002 for PAN implies a highly significant difference from histopathology, suggesting the distinctions are not due to chance. Conversely, the p-value of 0.3273 for CBCT implies that observed differences may be random, lacking sufficient evidence to reject the null hypothesis. CBCT scans consistently outperformed PAN in visualizing various lesion characteristics, underscoring their superior diagnostic capabilities., Conclusions: In this study, with a small sample size, 3D imaging provided a significant value addition to the diagnosis and treatment planning by providing additional information regarding the location, extent, internal content, and effect on adjacent structures. The practical implications for clinical settings, along with comparisons to current literature, underscore the study's distinctiveness., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Muttanahally et al.)

Background: Stature or body height is one of the most important and useful anthropometric parameters which determines the physical identity of an individual. Cranium encompasses hard tissue components with approximately immortal behavior, reason being cranial measurements were selected for the present study for estimation of stature., Objective: This investigation aimed to assess the stature of unknown using cephalometric parameters by creating equations through regression analysis., Materials and Methods: We selected 361 dental students for the present research; among them, 210 were females and 151 were males in the age range of 21-32 years. Stature and cephalic parameters, i.e., fronto-occipital circumference, head length, and head breadth were measured for each contributor following standard methods and techniques. Cephalic Index was calculated by using the formula: Cephalic Index (CI) = (Head width/Head length) ×100. Karl Pearson's correlation coefficient of stature with cephalic parameters was calculated, and regression analysis was done to generate the formulae for stature estimation., Results: Results indicated that all cephalic measurements have strong correlation with stature, and among them, circumference of head was found to be the most reliable predictor., Conclusion: Stature of unknown or deceased can be identified using cephalic parameters as an auxiliary practice., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 National Journal of Maxillofacial Surgery.)

There is a paucity of largescale collaborative initiatives in orthodontics and craniofacial health. Such nationally representative projects would yield findings that are generalizable. The lack of large-scale collaborative initiatives in the field of orthodontics creates a deficiency in study outcomes that can be applied to the population at large. The objective of this study is to provide a narrative review of potential applications of blockchain technology and federated machine learning to improve collaborative care. We conducted a narrative review of articles published from 2018 to 2023 to provide a high level overview of blockchain technology, federated machine learning, remote monitoring, and genomics and how they can be leveraged together to establish a patient centered model of care. To strengthen the empirical framework for clinical decision making in healthcare, we suggest use of blockchain technology and integrating it with federated machine learning. There are several challenges to adoption of these technologies in the current healthcare ecosystem. Nevertheless, this may be an ideal time to explore how best we can integrate these technologies to deliver high quality personalized care. This article provides an overview of blockchain technology and federated machine learning and how they can be leveraged to initiate collaborative projects that will have the patient at the center of care., (© 2023 The Authors. Orthodontics & Craniofacial Research published by John Wiley & Sons Ltd.)

Machine Learning (ML), a subfield of Artificial Intelligence (AI), is being increasingly used in Orthodontics and craniofacial health for predicting clinical outcomes. Current ML/AI models are prone to accentuate racial disparities. The objective of this narrative review is to provide an overview of how AI/ML models perpetuate racial biases and how we can mitigate this situation. A narrative review of articles published in the medical literature on racial biases and the use of AI/ML models was undertaken. Current AI/ML models are built on homogenous clinical datasets that have a gross underrepresentation of historically disadvantages demographic groups, especially the ethno-racial minorities. The consequence of such AI/ML models is that they perform poorly when deployed on ethno-racial minorities thus further amplifying racial biases. Healthcare providers, policymakers, AI developers and all stakeholders should pay close attention to various steps in the pipeline of building AI/ML models and every effort must be made to establish algorithmic fairness to redress inequities., (© 2023 The Authors. Orthodontics & Craniofacial Research published by John Wiley & Sons Ltd.)

Objectives: The objective of this study was to determine global changes in gene expression with next generation sequencing (NGS) in order to assess the biological effects of orthodontic tooth movement (OTM) on alveolar bone in a rat model., Materials and Methods: Thirty-five Wistar rats (age 14 weeks) were used in the study. The OTM was performed using closed coil Nickel-Titanium spring to apply a mesial force on maxillary first molars of 8-10 g. Three hours, 1, 3, 7 and 14 days after the placement of the appliance, rats were killed at each time point respectively. The alveolar bone, around left maxillary first molar, were excised on compression side. The samples were immediately frozen in liquid nitrogen for subsequent RNA extraction. Total RNA samples were prepared for mRNA sequencing using the Illumina kit. RNA-Seq reads were aligned to the rat genomes using the STAR Aligner and bioinformatic analysis was performed., Results: A total of 18 192 genes were determined. Day 1 has the highest number of differentially expressed genes (DEGs) observed with more upregulated than downregulated genes. A total of 2719 DEGs were identified to use as input for the algorithm. Six distinct clusters of temporal patterns were observed representing proteins that were differentially regulated indicating different expression kinetics. Principal component analysis (PCA) showed distinct clustering by time points and days 3, 7 and 14 share similar gene expression pattern., Conclusions: Distinct gene expression pattern was observed at different time points studied. Hypoxia, inflammation and bone remodelling pathways are major mechanisms behind OTM., (© 2023 The Authors. Orthodontics & Craniofacial Research published by John Wiley & Sons Ltd.)

Introduction: This study compared treatment efficacy for specific tooth movements between 2 clear aligner systems (Clarity [3M Oral Care Solutions, St Paul, Minn] and Invisalign [Align Technology, San Jose, Calif])., Methods: The study sample included 47 patients (7 males, 40 females; mean age, 36.57 ± 15.97 years) treated with Invisalign and 37 (4 males, 33 females; mean age, 34.30 ± 16.35 years) treated with Clarity aligners who completed their first set of aligners and had an initial refinement scan. Initial and predicted models were obtained from the initial simulated treatment plan. The first model of the refinement scan was labeled as achieved. SlicerCMF software (version 3.1; http://www.slicer.org) was used to superimpose the achieved and predicted digital models over the initial ones with regional superimposition on the relatively stable first molars. Nine hundred forty teeth in the Invisalign system were measured for horizontal, vertical, and angular movements and transverse width and compared with similar measurements of 740 teeth for the Clarity aligners. The deviation from the predicted was calculated and compared between both systems., Results: The deviation achieved from the predicted was significant between the groups for the mandibular interpremolar and intercanine widths (P <0.05). Clarity aligners significantly undercorrected rotations compared with Invisalign for the mandibular first premolars, mandibular canines, maxillary canines, and maxillary central incisors. There was no statistically significant difference between the groups for the achieved vs predicted movements in the horizontal and vertical planes (P >0.05)., Conclusions: The efficacy of clear aligner therapy systems (Clarity and Invisalign) in treating mild and moderate malocclusions was comparable. Deviation of the achieved movements from the predicted was greatest for rotational and vertical movements., (Copyright © 2023 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Objective The study was focused on evaluating the change in mandibular morphology following the Twin Block appliance therapy and recording its effect on the maxilla and maxillary dentoalveolar complex. Also, the results of the Twin Block appliance between males and females were compared.  Material and methods In this two-armed retrospective cephalometric study, 30 patients (mean age 12 years) treated with Twin Block appliance for the period of 8-12 months were chosen, and their records were obtained to analyze. These results were compared with 15 control subjects of the same age group chosen from the American Association of Orthodontics Foundation (AAOF) growth legacy collection: Michigan Growth Study Class II subjects. Cephalometric tracing was done, and data was processed for descriptive statistical analysis. Results Paired sample t-test and ANOVA test were performed to evaluate the differences in the pre-treatment (T1) and post-functional (T2) values. ∠ANB showed a mean difference of -4.71°±1.55° for males and 6.22°±6.78° for females, which is significant. The mandibular length (Co-Gn), for male subjects, the mean difference was 5.14±1.74 mm, and for female subjects, it was 6±2mm, which is highly significant; 49.88% of skeletal changes and 50.12% of dentoalveolar changes were reported to bring about Class II correction with Twin Block. Conclusion A successful increase in mandibular length was achieved using a Twin Block as a functional appliance. Also, the significant maxillary restraining effect was recorded. More skeletal changes were observed in males than females., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Gandhi et al.)

Introduction The primary objective of this study was to quantitatively analyze the skeletal and dentoalveolar parameters following the mandibular expansion with a banded appliance. It was also part of the study to evaluate the amount of dental expansion and assess the change in the intermolar and individual first molar angulation. The basal bone parameters were compared to assess the skeletal effect of removable mandibular expansion appliance therapy. Methods In this retrospective cone beam computed tomography (CBCT) study, a total of 80 subjects with mandibular expansion therapy were screened. After imposing inclusion/exclusion criteria, 70 patients (40 females and 30 males) with a mean age of 8.8±1.24 years and 4.79±3.59 months were included. The mean expansion period was 3.04±1.61 months. Skeletal parameters such as buccal cortical thickness, buccal bone width, and cortical density were measured at 2mm from the alveolar crest, mid-root, and apex region in the coronal slice at the level of the mesiobuccal root of the first molar. Expansion parameters such as intermolar width, intermolar angulation, and individual molar angulation were also measured in the same slice. Finally, basal bone parameters such as inter-mental foramina distance and anterior arch perimeter were recorded. Results No significant difference (p>0.05) was found for most skeletal parameters following the expansion, except for the mid-root buccal bone width (p<0.05). On average, 4.54±2.53 mm of dental expansion (p<0.05) was achieved at the first molar region. Individual molar angulation showed a statistically significant difference (right = 7.46±7.91°, left = 7.53±7.18°, p=<0.05). The basal bone parameters showed no significant difference (p>0.05). Conclusions The mandibular expansion device leads to an increase in intermolar distance. The amount of expansion achieved with such devices is due to the buccal tipping of the molars. Skeletal effects such as cortical thickness, buccal bone width, or changes in the basal bone dimensions should not be expected with mandibular expansion therapy., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Gandhi et al.)

Background: The condylar and glenoid fossa morphology can alter in patients with temporomandibular disorders (TMD), which can lead to changes in the temporomandibular joint (TMJ) space volume. Volumetric evaluation of TMJ can represent the entire three-dimensional (3D)-joint space between the condyle and glenoid fossa., Aims: To perform 3D assessment of TMJ volume, condylar, and glenoid-fossa morphology using cone-beam computed tomography and evaluate the correlation between these parameters., Settings and Design: Thirty-four patients (age: 13.50 years) who had no previous history of TMD were included., Materials and Methods: The volume of TMJ space was measured and divided into anterior, posterior, medial, and lateral TMJ volume. The antero-posterior (AP) and medio-lateral (ML) condylar width, AP and ML glenoid-fossa width, and glenoid-fossa depth were evaluated., Statistical Analysis Used: Statistical analyses were performed with R software at a 0.05 significance level. Each parameter was compared between the left and right sides using a paired-t test. The correlations between the parameters were obtained by the Pearson correlation coefficient., Results: There was no significant difference between lateral and medial TMJ volume; however, posterior TMJ volume was significantly greater than anterior TMJ volume. A significant correlation was observed between AP glenoid-fossa width and TMJ volume, glenoid-fossa depth and TMJ volume, AP position of the condyle and anterior TMJ volume, ML position of the condyle and medial TMJ volume, glenoid-fossa width and condyle width in AP and ML dimension, glenoid-fossa depth and AP glenoid-fossa width., Conclusions: In addition to the evaluation of condylar and glenoid-fossa morphology, assessment of TMJ space volume is important for comprehensive evaluation of the joint., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Contemporary Clinical Dentistry.)

This study aimed to systematically gather and analyze the current level of evidence for the effectiveness of the vibrational force in accelerating orthodontic tooth movement (OTM). This systematic review was conducted using three electronic databases: Scopus, PubMed, and Google Scholar until March 2022. The search was done through the following journals: European Journal of Orthodontics , American Journal of Orthodontics and Dentofacial Orthopedics , The Angle Orthodontist , Progress in Orthodontics , and Seminars in Orthodontics . Human or animal studies that have evaluated the effect of vibrational force on the rate of OTM were selected. A meta-analysis was performed for the rate of canine movement per month. Database research, elimination of duplicate studies, data extraction, and risk of bias assessment were performed by authors independently and in duplication. A fixed and random-effect meta-analysis was performed to evaluate the effect of vibrational forces. A total of 19 studies (6 animal and 13 human studies) that met the inclusion criteria were included. Meta-analysis was performed based on four human clinical trials. Three out of four studies showed no significant difference in the rate of canine movement between vibrational force and control groups. The limitation of this study was the small sample size and significant heterogeneity among the studies. Although vibrational forces have been shown to accelerate OTM in experimental studies, the results are inconsistent in clinical studies. The inability to apply desired peak load to the targeted teeth may be the main factor in inconsistent clinical outcomes., Competing Interests: None declared., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).)

The pandemic of COVID-19 and its widespread transmission have made us realize the importance of early, quick diagnostic tests for facilitating effective cure and management. The primary obstacles encountered were accurately distinguishing COVID-19 from other illnesses including the flu, common cold, etc. While the polymerase chain reaction technique is a robust technique for the determination of SARS-CoV-2 in patients of COVID-19, there arises a high demand for affordable, quick, user-friendly, and precise point-of-care (POC) diagnostic in therapeutic settings. The necessity for available tests with rapid outcomes spurred the advancement of POC tests that are characterized by speed, automation, and high precision and accuracy. Paper-based POC devices have gained increasing interest in recent years because of rapid, low-cost detection without requiring external instruments. At present, microfluidic paper-based analysis devices have garnered public attention and accelerated the development of such POCT for efficient multistep assays. In the current review, our focus will be on the fabrication of detection modules for SARS-CoV-2. Here, we have included a discussion on various strategies for the detection of viral moieties. The compilation of these strategies would offer comprehensive insight into the detection of the causative agent preparedness for future pandemics. We also provide a descriptive outline for paper-based diagnostic platforms, involving the determination mechanisms, as well as a commercial kit for COVID-19 as well as their outlook.

Introduction: Indigenous Australians (Aboriginal and Torres Strait Islander) have lower overall survival from lung cancer compared with nonindigenous Australians. Indigenous Australians receive higher rates of chemotherapy and/or radiotherapy. The equity of peri-operative care and thoracic surgical outcomes in Australian indigenous populations have not been contemporarily evaluated., Methods: We performed a retrospective registry analysis of the Queensland Cardiac Outcomes Registry Thoracic Database evaluating all adult lung cancer resections across Queensland from January 1, 2016 to April 20, 2022. Evaluating the time from diagnosis to surgery, operative data, and postoperative morbidity and mortality comparing Aboriginal and/or Torres Strait Islander people with nonindigenous Australians., Results: There were 31 patients (2.56%) of 1208 who identified as indigenous. The mean age at surgery was 68.2 years versus 66 years in the indigenous and nonindigenous, respectively ( p  = 0.23). There was female predominance among indigenous patients (n = 28, 90.32%, p < 0.01) and the average body mass index was lower (22.52 versus 27.09, p < 0.01). There was no variation in the surgical parameters or histopathologic distribution of cancer type between groups. Multivariable logistic regression analysis suggested that indigenous patients were at elevated risk of blood transfusion (relative risk 3.9, p  = 0.014, OR = 9.01, 95% confidence interval [CI]: 2.25-36.33, p < 0.01) and had greater transfusion requirements (risk ratio 4.08, p  = 0.0116 and OR = 12.67, 95% CI: 2.25-71.49, p < 0.01); however, the influence of low absolute number of transfusions must be acknowledged here. Indigenous status was not associated with increased intensive care unit admission (OR = 1.79, 95% CI: 0.17-18.80, p  = 0.62), return to operating theater (OR = 2.1, 95% CI: 0.24-18.15, p  = 0.50), new atrial fibrillation (OR = 0.52, 95% CI: 0.07-4.01, p  = 0.55), prolonged air leak (OR = 0.29, 95% CI: 0.04- 2.16, p  = 0.228), or pneumonia postoperatively (OR = 4.77, 95% CI: 0.55-41.71, p  = 0.16). With only three deaths, no meaningful trends were observed. Time from diagnosis to surgery was comparable in the indigenous and nonindigenous groups (88.6 d, 95% CI: 54.26-123.24 versus 86.2 d, 81.40-91.02, p  = 0.87). Postoperative length of stay was not numerically or statistically different between groups. (indigenous 7.54 d versus nonindigenous 7.13 d, p  = 0.90)., Conclusions: Indigenous patients are more likely to receive a blood transfusion than nonindigenous patients during lung resection. Reassuringly, the perioperative care provided to indigenous Australians undergoing lung resection in Queensland seems to be comparable to that of the nonindigenous population., (© 2023 The Authors.)

Restoration of edentulous sites with dental implants is increasingly becoming a popular choice. Cross-sectional 3-dimensional imaging using cone-beam computed tomography (CBCT) provides a better depiction of the implant site to help the clinician plan the procedure better. In spite of the advantages, radiation dose will always remain a concern. The evolution of lower-dose protocols is ongoing, but whether those acquisition protocols yield comparable diagnostic information is still not well established. The objective of this study was to evaluate the diagnostic efficacy of a low-dose, 180° rotational CBCT acquisition protocol for evaluating a potential implant site in comparison with a conventional 360° rotational acquisition. Ten dentate and partially edentulous dry human skulls providing 82 randomized implant sites-40 in the maxilla and 42 in the mandible-were chosen for this study. Each skull was imaged using a 360° and a 180° rotational acquisition on a J. Morita Accuitomo CBCT scanner. Evaluation of cortical and trabecular bone, height, width, and proximity to critical structures, such as the inferior alveolar nerve canal and the maxillary sinus, were measured. An oral surgeon and an oral radiologist rated the diagnostic efficacy of the scans by evaluating the above characteristics. Statistical evaluation of the data with linear regression showed significant agreement between both protocol measurements. Kappa analyses yielded a good interobserver agreement. In this proof-of-concept study, CBCT imaging using the lower-dose, modified arc, and 180° acquisition protocol shows comparable results to the conventional 360° protocol for preoperative implant assessment.

Objectives: To investigate aligner treatment protocols among orthodontists in the United States and Canada and assess the factors influencing clinician choices in aligner systems, treatment protocols, and targeted malocclusions for aligners., Materials and Methods: A validated online questionnaire was developed specifically for this research and consisted of three sections. Section 1 evaluated demographics and experience with aligners. Section 2 assessed patient selection and demands and clinician confidence in treating various malocclusions with aligners. Section 3 evaluated treatment protocols used by clinicians. The American Association of Orthodontists Partners in Research Program distributed the survey via e-mail to active members in the United States and Canada., Results: A total of 160 providers completed the survey. Aligners were used by 65.00% of respondents, with the Invisalign system the most popular (81.25%). Aligners were mostly used for adults (97.50%). Tipping was ranked as the easiest movement (1.79 ± 1.35). Extrusion (4.34 ± 1.53) and root movement (4.31 ± 1.27) were ranked as the most difficult. Most were confident treating mild (98.8%) and moderate (82.5%) crowded cases, spacing (96.9%), and anterior crossbite (85%). Of the providers, 58.12% recommended aligners to be changed weekly. Respondents who were confident addressing some of the severe malocclusions were more likely to use Invisalign., Conclusions: Invisalign is the most popular aligner system, and clinicians seem to be confident using it. Providers are aware of the pitfalls of aligners; they find it challenging to perform root movement and extrusion, and they seem confident treating mild to moderate malocclusions. They avoid complex cases with impactions and severe skeletal problems., (© 2023 by The EH Angle Education and Research Foundation, Inc.)

Objectives: To evaluate the utility and efficiency of four voice-activated, artificial intelligence-based virtual assistants (Alexa, Google Assistant, Siri, and Cortana) in addressing commonly asked patient questions in orthodontic offices., Materials and Methods: Two orthodontists, an orthodontic resident, an oral and maxillofacial radiologist, and a dental student used a standardized list of 12 questions to query and evaluate the four most common commercial virtual assistant devices. A modified Likert scale was used to evaluate their performance., Results: Google Assistant had the lowest (best) mean score, followed by Siri, Alexa, and Cortana. The score of Google Assistant was significantly lower than Alexa and Cortana. There was significant variablity in virtual assistant response scores among the evaluators, with the exception of Amazon Alexa. Lower scores indicated superior efficiency and utility., Conclusions: The common commercially available virtual assistants tested in this study showed significant differences in how they responded to users. There were also significant differences in their performance when responding to common orthodontic queries. An intelligent virtual assistant with evidence-based responses specifically curated for orthodontics may be a good solution to address this issue. The investigators in this study agreed that such a device would provide value to patients and clinicians., (© 2023 by The EH Angle Education and Research Foundation, Inc.)

Background: Atrial fibrillation (AF) following coronary artery bypass graft surgery (CABG) is common and results in significant increases in hospital stay and financial encumbrance., Objective: Determine and use the predictors of postoperative AF (POAF) following CABG to develop a new predictive screening tool., Method: A retrospective case-control study evaluated 388 patients (98 developed POAF and 290 remained in sinus rhythm) who undertook CABG surgery at Townsville University Hospital between 2016 and 2017. The demographic profile, risk factors for AF including hypertension, age≥75 years, transient ischaemic attack or stroke, chronic obstructive pulmonary disease (HATCH) score, electrocardiography features and perioperative factors were determined., Results: Patients who developed POAF were significantly older. On univariate analysis HATCH score, aortic regurgitation, increased p-wave duration and amplitude in lead II and terminal p-wave amplitude in lead V1 were associated with POAF; as were increased cardiopulmonary bypass time (103.5±33.9 vs 90.6±26.4 min, p=0.001) and increased cross clamp time. On multivariate analysis age (p=0.038), p-wave duration ≥100 ms (p=0.005), HATCH score (p=0.049) and CBP Time ≥100 min (p=0.001) were associated with POAF. Receiver operating characteristic curve demonstrated that with a cut-off of ≥2 for HATCH score, POAF could be predicted with a sensitivity of 72.8% and a specificity of 34.7%. Adding p-wave duration in lead II >100 ms and cardiopulmonary bypass time >100 min to the HATCH score increased the sensitivity to 83.7% with a specificity of 33.1%. This was termed the HATCH-PC score., Conclusion: Patients with HATCH scores ≥2, and those with p-wave duration >100 ms, or cardiopulmonary bypass time >100 min were at greater risk of developing POAF following CABG., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: Non-small cell lung cancer is the most common malignancy of the elderly, with 5-year survival estimates of 16.8%. The prognostic benefit of surgical resection for early lung cancer is irrefutable and maintained irrespective of age, even in patients over 75 years. Concerningly, despite the prognostic benefit of surgery there are deviations from standard treatment protocols with increasing age due to concerns of increased morbidity and mortality with surgery, without evidence to support this., Method: A state-wide retrospective registry study of Queensland's Cardiac Outcomes Registry's (QCOR) Thoracic Database examining the influence of age on the safety of Lung Resection (1 January 2016-20 April 2022)., Results: This included 1,232 patients, mean age at surgery was 66 years (range 14-91 years), with 918 thoracotomies performed. Three deaths occurred within 30-days (0.24%). Octogenarians (n=60) had lower rates of smoking (26% vs 6%), respiratory, cardiovascular, and cerebrovascular disease suggesting this subset of patients is carefully selected. Octogenarian status was not associated with an increased all-cause morbidity (p=0.09) or 30-day mortality (p=0.06). Further to this it was not associated with re-operation (4.4% vs 8.3%, p=0.1), increased postoperative stay (6.66 vs 6.65 days, p=0.99) or myocardial infarction. An independent predictor of morbidity was male sex (OR 1.58, CI 1.2-2.1 p=0.001)., Conclusion: Age ≥80 years did not increase surgical morbidity or mortality in the appropriately selected patient and should not be a barrier to referral for consideration of surgical resection., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: The coronavirus disease-19 (COVID-19) pandemic poses unprecedented challenges to global healthcare. The contemporary influence of COVID-19 on the delivery of lung cancer surgery has not been examined in Queensland., Methods: We performed a retrospective registry analysis of the Queensland Cardiac Outcomes Registry (QCOR), thoracic database examining all adult lung cancer resections across Queensland from 1/1/2016 to 30/4/2022. We compared the data prior to, and after, the introduction of COVID-restrictions., Results: There were 1207 patients. Mean age at surgery was 66 years and 1115 (92%) lobectomies were performed. We demonstrated a significant delay from time of diagnosis to surgery from 80 to 96 days (P < 0.0005), after introducing COVID-restrictions. The number of surgeries performed per month decreased after the pandemic and has not recovered (P = 0.012). 2022 saw a sharp reduction in cases with 49 surgeries, compared to 71 in 2019 for the same period., Conclusion: Restrictions were associated with a significant increase in pathological upstaging, greatest immediately after the introduction of COVID-restrictions (IRR 1.71, CI 0.93-2.94, P = 0.05). COVID-19 delayed the access to surgery, reduced surgical capacity and consequently resulted in pathological upstaging throughout Queensland., (© 2023 Commonwealth of Australia. ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons.)

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., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

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., (Copyright © 2023 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Objectives: The purpose of this study was to evaluate the effects of alendronate on orthodontic tooth movement (OTM) and bone modelling/remodelling in an osteogenesis imperfecta (OI) mice model., Materials and Methods: Ten-week-old male and female OI mice (Col1a2oim, n = 32) were divided into four groups: 1. Alendronate male (AM, n = 8), 2. Alendronate female (AF, n = 8), 3. saline male (SM, n = 8), and 4. saline female (SF, n = 8). The mice in all four groups received either Alendronate (0.05 mg/kg) or vehicle (saline 0.05 mg/kg) subcutaneously for 2 weeks prior to the placement of orthodontic spring. A nickel-titanium spring applying 3-5 cN of force was used to perform the OTM for 1 week. After 7 days of OTM, the OI mice were euthanized with CO2 inhalation and microfocus computed tomography and histological analyses were performed., Results: AM and AF mice showed a significant decrease (P < 0.05) in the rate of OTM compared with SM and SF mice, respectively. In addition, AM and AF mice showed a significant increase (P < 0.05) in the bone volume fraction (BVF) and tissue density (TD) compared with SM and SF mice. Histological analysis of haematoxylin-eosin staining revealed a hyalinization zone in AM and AF mice compared with SM and SF mice. Furthermore, tartrate-resistant acid phosphatase staining indicated decreased number of osteoclasts in AM and AF mice compared with SM and SF mice. Picrosirius red staining showed, Alendronate treatment led to thick uniform and smooth morphology of collagen fibres as compared with saline group. Similarly, second harmony generation images also revealed thicker collagen fibres at the periodontal ligament (PDL)-cementum entheses and PDL-alveolar bone entheses in AM and AF mice compared with SM and SF mice., Conclusions: Alendronate led to a decrease in the rate of OTM, increase in BVF and TD, decrease in the number of osteoclasts, and smooth and thick collagen fibres compared with saline in both male and female OI mice., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

The uncertainties of the environment and the emission levels of nonrenewable resources have compelled humanity to develop sustainable energy savers and sustainable materials. One of the most abundant and versatile bio-based structural materials is wood. Wood has several promising advantages, including high toughness, low thermal conductivity, low density, high Young's modulus, biodegradability, and non-toxicity. Furthermore, while wood has many ecological and structural advantages, it does not meet optical transparency requirements. Transparent wood is ideal for use in various industries, including electronics, packaging, automotive, and construction, due to its high transparency, haze, and environmental friendliness. As a necessary consequence, current research on developing fine wood is summarized in this review. This review begins with an explanation of the history of fine wood. The concept and various synthesis strategies, such as delignification, refractive index measurement methods, and transparent lumber polymerization, are discussed. Approaches and techniques for the characterization of transparent wood are outlined, including microscopic, Fourier transform infrared (FTIR), and X-ray diffraction (XRD) analysis. Furthermore, the characterization, physical properties, mechanical properties, optical properties, and thermal conductivity of transparent wood are emphasized. Eventually, a brief overview of the various applications of fine wood is presented. The present review summarized the first necessary actions toward future transparent wood applications., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022. Published by Elsevier B.V.)

Objectives: The objective of the study was to quantify the 3-D location of impacted canines by measuring their linear and angular deviations in relation to adjacent structures and further evaluate impaction severity., Methods: CBCT images of 314 impacted canines were analysed in the sagittal, coronal and axial planes. Linear and angular measurements were recorded. Canine inclination was identified in coronal and sagittal planes. An evaluation system was constructed for analysis. Upright canine was considered as the appropriate position for fully erupted maxillary canine. Outcomes were compared between right and left sides and by gender. For categorical variables, chi-square tests were used while Mann-Whitney U test was used for continuous variables. Regression models were used to measure severity., Results: Impactions were greater in females (119/207; 57.5%). No significant differences between unilateral (100/207; 49.3%) and bilateral (107/207; 51.7%) (P > 0.05). Out of 314 impactions, 105 (33.4%) were mild, 118 (37.58%) moderate and 91 (28.98%) severe. Severe impactions were primarily buccal (44/ 91; 48.3%), in the occlusal ½ of the adjacent incisor root (38/ 91, 41.7%), mesial to the distal border of central incisor (47/91, 51.6%), with sagittal angle value + >45 ̊ (46/ 91, 50.5%) and mesial tip + >30 ̊ (86/ 91, 94.5%)., Conclusions: Severely impacted canines had their crowns buccal, closer to occlusal plane and mesial to the distal border of the central incisor with greater than 45-degree buccal inclination and greater than 30-degree mesial tip. The sagittal angle can have a significant impact on the severity of impaction. A new classification system was proposed to quantify severity., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Introduction: A close relationship occurs between the type of bone density and the success of orthodontic mini-implant. The aim of this study was to find out the mean bone density in interradicular areas of the maxilla among patients visiting dental unit of a tertiary care centre., Methods: A descriptive cross-sectional study was performed at the Department of Orthodontics and Dentofacial Orthopedics at a tertiary care centre from 15 January 2022 to 28 June 2022 after taking ethical approval from the Institutional Review Committee (Reference number: UCMS/IRC/175/21). Data was collected from scan reports obtained with a computed tomography scanner. Bone density was measured at 6 mm height from the alveolar crest. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated., Results: Out of 70 patients, mean bone density at interradicular areas of maxilla was 992.31±204.20 HU (944.46-1040.13, 95% Confidence Interval). Between central and lateral incisor 50 (71.44%) had D2 type of bone density., Conclusions: The mean bone density in inter radicular areas of the maxilla among patients visiting the dental outpatient department was similar to other studies done in similar settings., Keywords: bone density; prevalence; prostheses and implants.

Using wide-field and point detection modalities, we show how optical trapping dynamics under femtosecond pulsed excitation can be explored by complementing detection of two-photon fluorescence with backscatter. Radial trajectories of trapped particles are mapped from correlated/anti-correlated fluctuations in backscatter pattern whereas temporal evolution of two-photon fluorescence is used to mark the onset of trapping involving multiple particles. Simultaneous confocal detection of backscatter and two-photon fluorescence estimates axial trap stiffness, delineating short-time trapping dynamics. When a second particle is being trapped an oscillatory signal is observed which is due to interference of backscatter amplitudes, revealing inter-particle interactions within the trap. These findings are crucial steps forward to achieve controlled manipulation by harnessing optical nonlinearity under femtosecond pulsed excitation., (© 2023. The Author(s).)