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Letizia Perillo,1 Maria Esposito,2 Alberto Caprioglio,3 Stefania Attanasio,1 Annamaria Chiara Santini,2 Marco Carotenuto2 1Department of Orthodontics, Second University of Naples, Naples, Italy; 2Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy; 3Department of Orthodontics, University of Insubria, Varese, Italy Background: Dental malocclusions can be considered not only as an oral health problem, because they are linked to quality of life perception. Many factors related to malocclusion have strong influences on the perception of facial esthetics (eg, anterior tooth alignment, tooth shape and position, lip thickness, symmetric gingival or tooth contour, lip profile, and overjet). Many reports have shown that the perception of facial esthetics can influence psychological development from early childhood to adulthood. The aim of this study is to investigate the effect of dental malocclusion on self-esteem in a sample of adolescents. Materials and methods: The study population was composed of 516 orthodontically untreated subjects (256 males) mean ages 13.75±1.977 years recruited from schools in the Campania region of Italy between January 2011 and July 2011. To evaluate the self-esteem grade in our population, all subjects filled out the Multidimensional Self Concept Scale questionnaire and attended an orthodontic clinical evaluation to estimate dental occlusal aspects. Results: Pearson's analysis shows the relationship in our sample between some occlusal characteristics (crossbite and dental crowding) and aspects of self-concept evaluation (social, competence, academic, physical, and global score) of the Multidimensional Self Concept Scale questionnaire. Moreover, logistic regression analysis shows the potential role of dental crowding (odds ratio 5.359; 95% confidence interval 3.492–8.225) and crossbite (odds ratio 6.153; 95% confidence interval 3.545–10.678) as risk factors for development of global self-concept score abnormalities. Conclusion: Our findings confirm the relationship between psychosocial well-being, self-esteem, and dental malocclusion among adolescents. Keywords: dental malocclusion, self-concept, adolescents, crossbite, dental crowding

Letizia Perillo,1 Maria Esposito,2 Mariarosaria Contiello,1 Alessandra Lucchese,3 Annamaria Chiara Santini,2 Marco Carotenuto2 1Department of Orthodontics, Second University of Naples, Naples, 2Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, 3Department of Orthodontics, University of Ferrara, Ferrara, Italy Aim: The objective of the study reported here was to assess the orthodontic features in children affected by developmental dyslexia (DD). Patients and methods: A total of 28 children affected by DD (22 boys, six girls; mean age: 9.78 ± 1.69 years) were compared with 51 healthy children (38 boys, 13 girls; mean age 9.41 ± 1.48; range 7–10 years). Reading and writing skills were evaluated along with orthodontic features. Results: The DD and control groups were not significantly different in terms of total intelligence quotient (P = 0.441) and writing skills (P = 0.805 and P = 0.240, respectively), whereas significant differences were observed between the DD group and control group in both word reading (2.018 ± 1.714 vs 0.917 ± 0.563; P = 0.000) and non-word reading (2.537 ± 1.543 vs 0.862 ± 0.244; P = 0.000). Moreover, for many orthodontic features, there was no significant difference between the two groups; only in prevalence of diastemas (57.14%, P = 0.006), midline diastemas (46.42%, P = 0.007), overbite >4 mm (71.42%, P = 0.006) and overjet >4 mm (53.57%, P = 0.001), was there a statistically significant difference. According to univariate logistic regression analysis, the presence of diastemas (odds ratio [OR] 4.33; 95% confidence interval [CI] 1.61–11.65), midline diastemas (OR 4.68; 95% CI 1.61–13.43), an overbite >4 mm (OR 1.75; 95% CI 0.64–4.71), or an overjet >4 mm (OR 2.76; 95% CI 1.06–7.20) seems to play a role in the relationship between occlusal abnormalities and DD in children. Conclusion: Children with DD tend to present with altered dental features, particularly in the area of the incisors, suggesting that a persistently different tongue kinematic profile may thus affect both the developmental variability of the tongue and lip and the occlusion. Keywords: malocclusion, orthodontic features, learning disorder, kinematic profile

OBJECTIVE: Mesenchymal stem cells (MSCs) have been deeply investigated in regenerative medicine because of their crucial role in tissue healing, such as tissue regeneration. Dental-derived stem cells (d-DSCs) are easily available from dental tissues, which can be isolated from all age patients with minimal discomfort. PATIENTS AND METHODS: Normal unerupted third molars tooth buds were collected from adolescents' patients underwent to extractions for orthodontic reasons. The expression of the genes Kruppel-like factor 4 (Klf-4), octamer- binding transcription factor 4 (Oct-4), homeobox transcription factor Nanog (NANOG) was investigated in d-DSCs obtained from dental bud (DBSCs), differentiated toward osteoblastic phenotype and not. RESULTS: Our results showed that DBSCs expressed Oct-4, Nanog, and Klf-4 in undifferentiated conditions and interestingly the expression of such genes increased when the cells were kept in osteogenic medium. CONCLUSIONS: These attractive stemness properties, together with the effortlessly isolation, during common oral and maxillofacial surgical procedures, from undifferentiated tissues such as dental bud, make this kind of d-DSCs a promising tool in regenerative medicine, having the potential for clinical applications, and reinforcing the present challenge to develop new preventive and healing strategies in tissue regeneration. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The clinical use of mesenchymal stem cells (MSCs) in regenerative medicine either in tissue repair or tissue reconstruction has given highly interesting results thanks to their particular nature. Sources that have attracted the attention of medical scientists from where stem cells (SCs) in adults could be obtained are different and, dental tissues have certainly become an optimal source of MSCs. Dental tissue is a main reservoir of two types of MSCs dental bud (DBSCs) that constitute the immature precursor of the tooth and dental pulp (DPSCs) that are derived from dental inner pulp and partly from dental follicle tissue and can differentiate into several cell phenotypes as osteoblast, chondrocyte, hepatocytes, cardiomyocytes, neuron and β cells. PATIENTS AND METHODS: Normal impacted third molars and tooth buds were collected from adults and adolescents underwent to extractions for orthodontic reasons. The expression of the five stemness genes Nanog, OCT4, Sox2, c-Myc and Klf4 were investigated by qRT-PCR in two different dental stem/progenitor cells: dental pulp stem cells (DPSCs) and stem cells from dental bud (DBSCs), differentiated toward osteoblastic phenotype and not. RESULTS: Both DPSCs and DBSCs are easy to access and we found their expression of the typical mesenchymal stemness makers and osteogenic capacity due to the effective presence of embryonic gene regulators like Nanog, OCT4, Sox2, c-Myc and Klf4. Both DBSCs and DPSCs could represent a valid tool in regenerative medicine and translational applications. CONCLUSIONS: The results depicted here provide, for the first time to our knowledge, a comparative outcome about the stemness properties generated from accessible tissues such as DPSCs and DBSCs. These two types of SCs showed few different distinctive genetic traits supposedly in relation to their origin, location and stage of maturation. Certainly these SCs reserve solid potential for human clinical application in autologous procedure for bone, hard tissue and soft tissue regeneration, easy to isolate, ready availability, high-biocompatibility and safety and no ethical restrictions. [ABSTRACT FROM AUTHOR]

Mandibular prognathism (MP) is a recognizable phenotype associated with dentoskeletal class III malocclusion. MP is a complex genetic trait, although familial recurrence also suggests the contribution of single inherited variations. To date, the genetic causes of MP have been investigated using linkage analysis or association studies in pooled families. Here for the first time, next-generation sequencing was used to study a single family with a large number of MP-affected members and to identify MP-related candidate genes. A 6-generation kindred with MP segregating as an autosomal dominant character was recruited. To identify family members affected by MP, a standard cephalometric procedure was used. In 5 MP subjects separated by the largest number of meioses, whole-exome sequencing was performed. Five promising missense gene variants (BMP3, ANXA2, FLNB, HOXA2, and ARHGAP21) associated with MP were selected and genotyped in most other family members. In this family, MP seemed to consist of 2 distinct genetic branches. Interestingly, the Gly1121Ser variant in the ARHGAP21 gene was found to be shared by all MP individuals in the larger branch of the family with nearly complete penetrance. This variant is rare in the Caucasian population (frequency 0.00034) and is predicted as damaging by all bioinformatic algorithms. ARHGAP21 protein strengthens cell-cell adhesions and may be regulated by bone morphogenetic factors, thus influencing mandibular growth. Further studies in both animal models and human patients are required to clarify the significance of this association. [ABSTRACT FROM PUBLISHER]

Periodontal disease is characterized by inflammation and bone loss. The balance between inflammatory mediators and their counter-regulatory molecules may be fundamental for determining the outcome of immune pathology of periodontal disease. Cytokines play crucial roles in the maintenance of tissue homeostasis, a process which requires a delicate balance between anabolic and catabolic activities. In particular, two families of growth factors-such as transforming growth factor-ßl (TGF- ßl) and vascular endothelial growth factor (VEGF) are thought to play important roles in modulating the proliferation and/or migration of structural cells involved in inflammation and regulation of immune responses. The aim of this work was to analyze gingival samples and periodontal tissue specimens collected from thirty-eight patients with chronic periodontal disease and from forty healthy individuals, in order to detect the expression and distribution of TGF-ßl and VEGF between the two groups. TGF-ßl and VEGF expression levels were detected using immunohistochemical analysis and computer-assisted morphometric analysis. The findings presented here suggest that biomarker such as TGF-ßl and VEGF have an important regulating role in the orchestration of the immune response, which in turn influence the outcome of disease establishment and evolution. [ABSTRACT FROM AUTHOR]

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Copyright of Mondo Ortodontico is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Orthodontics is a branch of dentistry that aims at the resolution of dental malocclusions. The specialist carries out the treatment using intraoral or extraoral orthodontic appliances that require forces of a given load level to obtain a tooth movement in a certain direction in dental arches. Orthodontic toothmovement is dependent on efficient remodeling of periodontal ligament and alveolar bone, correlated with several biological and mechanical responses of the tissues surrounding the teeth. A periodontal ligament placed under pressure will result in bone resorption whereas a periodontal ligament under tension results in bone formation. In the primary stage of the application of orthodontic forces, an acute inflammation occurs in periodontium. Several proinflammatory cytokines are produced by immune-competent cells migrating by means of dilated capillaries. In this paper we summarize, also through the utilization of animal models, the role of some of these molecules, namely, interleukin-1β and vascular endothelial growth factor, that are some proliferation markers of osteoclasts and osteoblasts, and the macrophage colony stimulating factor. [ABSTRACT FROM AUTHOR]

Evidence on facial rehabilitation therapy (FRT) for acute facial paralysis (FP) remains limited. We present a retrospective review of patients with acute FP who have received FRT with physical therapists within 1 year of FP onset as determined by Sunnybrook Facial Grading Scale (SFGS) composite scores. A total of 702 patients with a clinical diagnosis of FP were referred to a university rehabilitation program between January 1, 2015 and January 1, 2022. Seventy-six patients met the criteria, defined as FP diagnosis <12 months before FRT initiation, ≥3 therapy sessions, and sufficient follow-up data. Average number of treatment sessions between SFGS scores was 7.7. History of cancer, sex, number of treatment sessions, and initial SFGS score were correlated with change in SFGS. Time to treatment was not correlated with change in SFGS score. SFGS improved with each additional treatment session ( p  < 0.01). Each additional point in the initial SFGS was correlated with less change in the final SFGS score ( p  < 0.01). FRT can provide meaningful improvement in functionality for patients with acute FP, regardless of time to treatment. Furthermore, patients who present with poorer functionality at baseline and those who undergo more treatment are most likely to see SFGS improvement. Research comparing the effect of facial rehabilitation with other treatment modalities and to a control cohort is warranted., Competing Interests: None declared., (Thieme. All rights reserved.)

Background: An update on the knowledge regarding the orthopedic/orthodontic role in treating JIA-related dentofacial deformities is relevant., Objectives: This systematic review aimed to assess the level of evidence regarding the management of dentofacial deformity from juvenile idiopathic arthritis (JIA) with orthodontics and/or dentofacial orthopedics., Search Methods: The following databases were searched without time or language restrictions up to 31 January 2024 (Medline, Embase, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and Latin American and Caribbean Health Sciences Literature)., Selection Criteria: Inclusion criteria were studies dealing with JIA subjects receiving treatment with orthodontic and/or dentofacial orthopedic functional appliances., Data Collection and Analysis: After the removal of duplicate studies, data extraction, and risk of bias assessment according to ROBINS-I guidelines were conducted. Data extraction was conducted by two independent authors., Results: The electronic database search identified 397 eligible articles after the removal of duplicates. Following the application of the pre-defined inclusion and exclusion criteria, 11 articles were left for inclusion. Two trials were associated with a severe risk of bias, four trials were at moderate risk of bias, and the other five presented a low risk of bias. Various research groups employed and documented the effects of different types of appliances and methodologies. The study heterogeneity did not allow for meta-analyses. In addition, a lack of uniformity in treatment objectives was observed across the included studies. After treatment with dentofacial orthopedics skeletal improvement was demonstrated in 10 studies, and a decrease in orofacial signs and symptoms was reported in 7 studies., Conclusions: Across the available literature, there is minor evidence to suggest that dentofacial orthopedics may be beneficial in the management of dentofacial deformities from JIA. There is little evidence to suggest that it can reduce orofacial signs and symptoms in patients with JIA. Based on current evidence, it is not possible to outline clinical recommendations for specific aspects of orthopedic management in growing subjects with JIA-related dentofacial deformity., Registration: PROSPERO (CRD42023390746)., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Animal welfare has become an increasingly important concern regarding equids working as carriage animals. In the present study, the changes in the markers of stress and inflammatory responses as a result of the work performed by tourism carriage horses under real working conditions in Sicily (Italy) were investigated. Twenty-two Standardbreds performed a normal working day in the carriage tourism business during the months of May, June and July 2022, consisting of one day of work for each month. Blood samples were collected in the stables at rest before the tour route (Pre; 07.00 AM) and within 10 min after the end of the workday (Post; 05.00 PM). Haematological parameters, serum concentration of cortisol, total proteins together with the globulin fractions were investigated before and after the carriage work. Environmental temperature, relative humidity and temperature humidity index (THI) were also assessed. The direct erythrocyte indices increased after work compared to rest condition (P < 0.05). The values of cortisol, total proteins and globulins were not affected by carriage work (P > 0.05), while, higher cortisol, total proteins, α1- and α2-globulins values were observed in July compared to May and June (P < 0.05). These changes are probably due to the increase in THI values which showed mild stress in June and high stress in July. This study suggests that the tourism carriage horses herein investigated have adapted to their work activity, however, avoiding working horses during the hottest hours of the day in the summer months is advocated., Competing Interests: Declaration of competing interest The authors declare no competing interests. None of the authors has any financial or personal relationships that could inappropriately influence or bias the content of the paper., (Copyright © 2024. Published by Elsevier Inc.)

Objective: To assess if the dental follicle volume of palatally impacted canines (PICs) affects the relative root position of the adjacent lateral incisors (LIs) and first premolars (FPs)., Materials and Methods: A retrospective cross-sectional study of 49 patients with unilaterally PICs with dental follicles who had CBCT imaging previously taken. Four orthodontic centers in different countries provided the sample. A mean difference of 5° between the angular measurements (mesiodistal tip, buccolingual inclination, or mesiodistal rotation) of the LI and FP adjacent to the PIC and the controls was considered clinically relevant. A value of 0.05 was set for significance level and a power of 80%. The minimum sample size was determined to be 26 patients. These patients were further assigned to an LI sample (n = 49) and an FP sample (n = 23), dependent on the direct contact of the dental follicle to that adjacent tooth. A manual segmentation technique was used to obtain the volumetric measurements of the dental follicle. Angular measurements of adjacent teeth were then compared to the contralateral nonimpacted side, which acted as the control. A multivariant regression analysis was performed using IBM SPSS software, and statistical significance was set at α = 0.05., Results: Adequate intra-rater reliability was accomplished. The multivariant regression analysis implied that there is no difference in the mean change in the tip, torque, and rotation of the LI and FP between the impacted and control sides when dental follicle volumes are considered (P = .509 for the LI sample and P = .804 for the FP sample)., Limitations: CBCT imaging of dental follicle border delimitations, partial volume effect, and scattering are limitations. This is a convenience sample where the FP subsample is small., Conclusion: The dental follicle volume of the PICs does not seem to influence the relative position of the adjacent LI and FP mesiodistal tip, buccolingual inclination, and mesiodistal rotation. Early intervention could have been suggested to avoid certain malocclusion traits if significant displacements were demonstrated., (© 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.)

Background: The occurrence of mandibular canine impaction and/ or transmigration is a rare clinical entity but diagnosis and treatment planning is of clinical significance. The associated etiological factors and the clinical guidelines for the management are still not clear. The aim of this systematic review was to summarize the available data to report the prevalence and identify the etiological factors, clinical features, and various treatment outcomes in patients with mandibular canine impaction and/or transmigration., Methods: The review protocol was registered in PROSPERO (CRD42021222566) and was conducted and reported according to the PRISMA and Cochrane Handbook / Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. A computerized search of studies published up to April 30, 2023, was conducted using the following databases: Medline, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and Latin American and Caribbean Health Sciences Literature. A manual search of the reference and citation lists of eligible articles and existing systematic reviews for any additions were also conducted. The Newcastle-Ottawa Scale quality assessment tool was used to assess the studies' quality., Results: After removing 6 duplicates, 3700 articles were identified. For the final analysis, 19 studies published between 1985 and 2023 met all the eligibility criteria and were included. A total of 7 studies presented as good and 12 studies presented as satisfactory. Patients were screened in ten studies and diagnostic records from archives were retrieved in nine studies. The total number of diagnostic records screened was 138.394, and the total number of patients from the included studies was 43.127., Conclusions: Based on the findings from this systematic review, the prevalence of mandibular canine impaction ranged from 0.008% to 1.29% while canine transmigration from 0.12% to 0.98%. Crowding of the mandibular arch, the presence of a retained deciduous canine, and odontoma or cyst are the etiological factors more commonly associated with mandibular canine impaction and or transmigration. Surgical extraction and surgical exposure followed by orthodontic traction are the two most frequently carried out treatment modalities in the management of mandibular canine impaction and or transmigration., (© 2023. The Author(s).)

The aim of the study was to investigate how obesity can influence sleep respiratory parameters in obstructive sleep apnea syndrome (OSAS) in children., Methods: The study analyzes 56 Caucasian children and adolescents aged 11 ± 2.79 years with a BMI > 5th percentiles and a PSQ value ≥ 0.33. Children were divided into Obesity Group (OG) with BMI ≥ 95th and Control Group (CG) with 5th < BMI > 95th percentile. All selected children underwent PG. Respiratory parameters AHI (Apnea-Hypopnea Index), SaO 2 (Saturation of Oxygen), ODI (Oxygen Desaturation Index), and Nadir (the lowest value of SaO 2 registered during PG) were extracted from the PG. AHI was used to divide the severity of OSAS into four levels: snoring (AHI ≤ 1), mild (AHI > 1 and ≤5), moderate (AHI > 5 and <10), and severe (AHI ≥ 10)., Results: The comparison analysis between the OG and CG showed a statistical significance only for ODI ( p = 0.02). A statistically significant correlation between BMI and AHI (r = 0.02), SaO 2 (r = 0.01), and Nadir O 2 (r = 0.02) was found., Conclusions: There was no strong correlation between obesity and OSAS, but a positive association was found between BMI and AHI severity.

Objectives: To identify and analyze the 50 most cited articles on temporary anchorage devices (TADs) and investigate the achievement and development of scientific research about the topic through a bibliometric analysis., Materials and Methods: On August 22, 2022, a computerized database search was performed to detect papers published in the scientific literature about TADs from 2012 to 2022. Metrics data were identified using the Incites Journal Citation Reports (Clarivate Analytics) data set. The Scopus database was used to obtain information on the authors' affiliations, country of origin, and h-index. Key words were automatically harvested from the selected articles to implement the visualized analysis., Results: From a total of 1858 papers screened by searching the database, a list of the top 50 most cited articles was created. The total number of citations collected by the 50 most cited articles in TADs was 2380. Among the 50 most cited articles on TADs, 38 were original research papers (76.0%) and 12 were reviews (24.0%). As shown by the key word-network analysis, Orthodontic anchorage procedure was identified as the larger node., Conclusions: Findings of this bibliometric study showed an increasing number of citations for papers on TADs, accompanied by a simultaneous rise in scientific interest in this topic in the past decade. The present work identifies the most influential articles, emphasizing the journals, the authors, and the topics addressed., (© 2023 by The EH Angle Education and Research Foundation, Inc.)

Objective: Compliance is critical for successful outcomes in orthodontics, and personality traits may play a role in determining patient adherence. This study aimed to monitor compliance during treatment with removable clear aligners (CA) [Align Technology Inc, San José, Calif ], and evaluate the influence of motivational techniques and the patient's profiles assessed through the psychological well-being (PWB) questionnaire on clinical outcomes., Methods: Thirty-nine consecutive patients in permanent dentition seeking treatment with CA were recruited from two universities. Casts were obtained before treatment and after 3, 6, and 12 months and the corresponding digital Clincheck©.STL files were used to calculate the discrepancy index to check for differences between virtual and real treatment stages. Patients were divided into two groups: the Case group, which received motivational techniques at each appointment, and the control group which received instructions only at the beginning. Psychological profiles were evaluated before treatment (T0) and after 3 (T1), 6 (T2), and 12 (T3) months., Results: There were no differences between the Case and Control groups regarding the use of motivational reminders. The analysis of the PWB showed that almost all values increased, and there was a strong correlation between dental casts and correspondent. STL files at every time point. The PWB showed increased values from T0 to T3 in the sample., Conclusion: Motivational techniques did not affect patient compliance, and treatment outcomes were achieved as planned. The PWB of all patients improved throughout the treatment with CA.

Objective: The aim of this prospective cross sectional study was to evaluate the cranial structure and condylar asymmetry of adult patients with rheumatoid arthritis (RA) diagnosed after 25 years of age compared to a healthy adult control group., Methods: Eighteen adult patients (57.4 ± 11.4 years) with RA were compared with a control group. Cephalometric analysis and the Habets method for the calculation of the condylar asymmetry were used. The main cephalometric data investigated were focused on the diagnosis of hyperdivergent cranial structure (NSL/ML, NL/ML), backwards rotation of the mandible (Fh/ML), short vertical ramus (Ar:Go), steep mandibular plane (ML/Oc)., Results: The cephalometric data considered were not significantly different in the RA vs controls except for the steepness of the occlusal plane (NL/Oc), which was steeper in the patients group (P < 0.02) and the ramus of the mandible which was greater in patients. The asymmetry of the condyles was significant (P < 0.003) and different from the control group, but that of the ramus was not., Conclusions: In this study, RA patients diagnosed after 25 years of age did not show a different pattern of growth with respect to the control group. As expected, the condyles showed a difference being asymmetrical in RA patients due to the high turnover of this joint reacting to severe systemic inflammation in conditions of continuous functional work, load and forces. This study follows a previous study with the same research plan conducted on young JIA patients who showed a different pattern of growth of the skull leading to a severe hyperdivergent cranial structure with backward rotation of the mandible; this is mainly due to the insufficient growth of the condylar site exposed to the inflammatory process during development. Unlike JIA patients, this study showed that RA patients follow an individual growth pattern not affected by inflammation, even if they show joint asymmetry., (© 2023. The Author(s).)

Introduction: Labiopalatal impacted canines (L-PICs) occur when the canines lie between central and lateral incisors, with their tip palatal to the central incisor and part of their crown labial to the lateral incisor. Because of their unusual position, they are often misdiagnosed, and their orthodontic resolution fails. This study aims to provide clinicians with pathognomonic features for early and accurate positional diagnosis of L-PICs., Methods: The L-PIC sample included 21 subjects with full diagnostic records. The control group of normally erupted canines was taken from a previous study. Clinical photographs, 2-dimensional radiographs, and cone-beam computed tomography were used to evaluate the positions of the adjacent incisors and first premolars, the canine incisor index, and the mesiodistal width of the lateral vs central incisors., Results: Central incisors adjacent to L-PICs showed significant mesial root angulation, labial root inclination, and mesiolabial crown rotation, whereas lateral incisors presented significant distal root angulation, palatal root inclination, and mesiolabial crown rotation, in comparison to controls. The roots of the central and lateral incisors were divergent, in contrast to the controls, in which they were slightly convergent. The first premolar positions were not affected. The mean canine incisor index was significantly bigger in L-PICs vs the controls, suggesting a palatal canine. The lateral incisor widths were similar between the groups., Conclusions: This study provides the orthodontist with evidence-based clinical and radiographic red flags for diagnosing L-PIC, which may allow timely initiation of orthodontic treatment and correct planning of mechanotherapy., (Copyright © 2022 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Advanced dental education programs in orthodontics and dentofacial orthopedics require an extensive and comprehensive evidence-based experience, which must be representative of the current didactic and technical advancements. Over the past 25 years, the World Federation of Orthodontists (WFO) has placed emphasis in the support for the recognized orthodontic specialty training programs in every region of the world. In its early years, the WFO developed general principles for specialty education that culminated in the first comprehensive curriculum recommendations, i.e., the WFO Guidelines for Postgraduate Orthodontic Education, which was published in February 2009. In view of the significant changes in the specialty of orthodontics, the WFO has revised and updated its previous document to reflect the expanded scope and demands of current orthodontic education and practice. The members of the task force participated in a thorough revision of the guidelines and created a new document that takes into consideration the didactic, clinical, and the appropriate physical facilities to provide clinical care, study, and research areas. Although it is recognized that there will be variations in teaching and faculty assets, as well as facilities, access to materials, and equipment, the aim of the WFO Educational Guidelines is to provide the minimum program requirements necessary to provide orthodontic specialty residents the educational experience that prepares them to deliver the best level of orthodontic treatment for their patients. It is recommended that these guidelines be used universally by orthodontic specialty program educators and related educational, scientific, and administrative institutions to evaluate and compare their curriculum to a world standard., (Copyright © 2023 World Federation of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Objectives: To compare the changes of palatal volume and area in patients treated with tooth-tissue-borne palatal expanders (conventional Haas) and miniscrew-supported palatal expanders (modified Haas)., Materials and Methods: The sample included casts of 22 patients treated as part of a clinical study at the Department of Orthodontics, Al-Azhar University, to correct their crossbite malocclusion. Patients were divided equally into two groups upon arrival. The first group, with a mean age of 12 years and 6 months, received the miniscrew-supported palatal expander. The second group, with a mean age of 12 years and 2 months, received the Haas design-palatal expansion appliance. Pre- and post-expansion dental casts were cone beam computed tomography scanned and the slices were constructed into 3D volumes. Fully automated superimposition was done for pre- and post-expansion 3D models. Palatal volume and area were determined, and all measurements were carried out blindly. Paired t-test was used to assess the mean differences within each group and Welch's t-test was applied to assess the mean changes between the two groups. Shapiro-Wilk test was used to test for the normality of the data., Results: There were no statistical differences in volume changes either within each group or between the groups. Although area changes were statistically significant within each group, the difference between the groups was not significant., Conclusions: Changes that result from the use of either method to expand the upper arch occur primarily in the shape of the palate, but not in its size., (© 0000 by The EH Angle Education and Research Foundation, Inc.)

Objective: This scoping review aims to describe dental treatment-related patient-reported outcomes (dPROs) while using oral appliances (OAs) to manage obstructive sleep apnea (OSA) in children and adults., Methods: Available literature that assessed dPROs in children and adults with OSA managed through OAs. Any clinical studies were included without restrictions of year or country. The results were analyzed and reported using narrative text and tables accompanying a descriptive summary., Results: The searches identified 1718 citations, and of these, forty-five studies were finally included. A total of 3498 adults were included in all 42 primary studies included in this review, in which all the studies presented adults as participants. The dPROs assessed were quality of life (QoL), reported side effects after OA usage, patient satisfaction, and experience with treatment, and subjective perception of occlusal changes after treatment., Conclusion: This scoping review suggests that dPROs are mostly investigated as a secondary outcome from major studies exploring the effects of OAs on OSA severity, and often, dPROs are not well discussed or displayed on their report. As no risk of bias or certainty level assessment was completed, findings need to be carefully considered. Although in general terms management with OAs among adults with OSA does not seem to be uncomfortable or causing major problems to their lives, some mild discomfort and endured occlusal disturbances was reported in some studies. QoL seems to improve but consistent agreement was elusive. Data does not include experiences among those that dropped OA use. No data seems to exist about dPROs in children., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background: To assess the predictability of crowding resolution and the efficacy of different strategies to gain space during clear aligners treatment., Methods: A total of 10 clinicians were randomly recruited using the Doctor Locator by Align Technology (California). For each clinician, four consecutive patients treated with aligners and manual stripping were selected for a total of 40 subjects. Thus, 80 arches were collected and uploaded on the Orthoanalyzer software for arch measurements. The data were gained on the starting arch form (T0), on the virtual arch developed with digital planning (vT1), and on the arch form achieved at the end of the aligner sequences (T1). The following parameters were scored: Little's Irregularity Index, transversal arch diameters, (intercuspid, interpremolar, and intermolar width), incisor position/arch length, and enamel interproximal reduction (IPR)., Results: For all the measurements, statistically significant differences were found at different stages. The predictability of crowding resolution was very high, ranging from 87% in the upper arch and 81% in the lower one. Among the different strategies to gain space, variations in sagittal incisor position were predictable, with a value of 70% both in the upper and lower arch. Conversely, changes in arch diameters were less reliable varying between 49 and 67% in the lower arch and 59-83% in the upper one. Moreover, IPR was the least accurate procedure, wavering at 49% in the upper arch and 42% in the lower arch., Conclusions: The predictability of crowding resolution during treatment with aligners was high. However, the virtual arch forms obtained at the end of digital planning (vT1) did not correspond with the arch forms at the end of the aligner sequences (T1). The IPR was the least predictable strategy to gain space, being, perhaps, an operator-dependent procedure., (© 2022. The Author(s).)

Gingival crevicular fluid (GCF) is a site-specific exudate deriving from the epithelium lining of the gingival sulcus. GCF analysis provides a simple and noninvasive diagnostic procedure to follow-up periodontal and bone remodeling in response to diseases or mechanical stimuli such as orthodontic tooth movement (OTM). In recent years, the use of vibrational spectroscopies such as Fourier Transform Infrared and Raman microspectroscopy and Surface-Enhanced Raman spectroscopy contributed to characterizing changes in GCF during fixed orthodontic treatment. Amide I band plays a relevant role in the analysis of these changes. The aim of this study was to investigate the spectroscopy response of Amide I depending on the OTM process duration. A model based on Gaussian-Lorentzian curves was used to analyze the infrared spectra, while only Lorentzian functions were used for Raman and SERS spectra. Changes induced by the OTM process in subcomponents of the Amide I band were determined and ascribed to secondary structure modification occurring in proteins. The vibrational spectroscopies allow us to efficiently monitor the effects of the orthodontic force application, thus gaining increasing attention as tools for individual patient personalization in clinical practice.

Background : Heavy metals are toxic, non-biodegradable substances able to enter the food chain of cows and then transfer to their milk. This study investigated the relationship between the heavy metal concentrations in serum and milk and the environmental pollutants exposure at two different farms in Ragusa, Italy. Methods : To evaluate the concentrations of aluminum (Al), chromium (Cr), iron (Fe), copper (Cu), zinc (Zn), arsenic (As), cadmium (Cd), and lead (Pb), milk and serum samples were collected from 40 Friesian dairy cows from farm 1 at about 3.7 km from an industrial area (group 1) and 40 Friesian dairy cows from farm 2 at about 400 mt from a greenhouse and 6.0 km from a chemical fertilizer factory (group 2). Results : The concentrations of heavy metals measured in serum and milk showed no statistically significant differences between group 1 and group 2. No significant correlation between heavy metals in serum and milk in group 1 was observed. A positive correlation between Zn concentrations measured in milk and serum samples was observed in group 2 (r = 0.35, p = 0.03). Conclusions : The determination of heavy metals in serum and milk can be an important tool to detect the exposure to environmental pollutants and in monitoring the hygienic state of the environment in which milk is produced.

Objective: The aim of this systematic review with meta-analysis was to evaluate the efficacy of conservative interventions in pain relief in patients with intracapsular temporomandibular disorders (TMD)., Methods: PubMed, Scopus, and Web of Science were systematically searched until January 1 st , 2022 to identify randomized controlled trials (RCTs) presenting patients with diagnosis of intracapsular TMD according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), conservative approaches as interventions, and pain intensity as outcome., Results: Out of 3372 papers, 13 RCTs were included, with 844 study participants. Most of them (n = 7) investigated the efficacy of splint appliance. Meta-analysis revealed that rehabilitative interventions had a significant overall effect size of 0.75 [0.17, 1.34], reporting splint appliance and laser therapy as significantly effective treatments., Conclusion: Findings of this systematic review with network meta-analysis suggested that conservative approaches might be effective in pain relief of intracapsular TMD patients.

Introduction: Obstructive sleep apnea is characterized by a reduced airflow through the upper airways during sleep. Two forms of obstructive sleep apnea are described: the central form and the obstructive form. The obstructive form is related to many factors, such as the craniofacial morphology., Objective: To evaluate the correlation between the morphology of the cranial base, of the mandible and the maxilla, and obstructive sleep apnea severity., Methods: Eighty-four patients, mean age of 50.4 years old; 73 males and 11 females with obstructive sleep apnea were enrolled in the present study. Patients with high body mass index and comorbidities were excluded. Lateral cephalograms and polysomnography were collected for each patient to evaluate the correlation between craniofacial morphology and obstructive sleep apnea severity. A Spearman's rho correlation test between cephalometric measurements and obstructive sleep apnea indexes was computed. Statistical significance was set at p < 0.05., Results: Patients with a severe obstructive sleep apnea presented a reduction of sagittal growth of both effective mandibular length and cranio-basal length. The mandibular length was the only variable with a statistical correlation with apnea-hypopnea index. Vertical dimension showed a weak correlation with the severity of obstructive sleep apnea. No correlation with maxillary sagittal dimension was shown., Conclusion: Obstructive sleep apnea severity may be correlated to mandibular and cranial base growth. Facial vertical dimension had no correlation with obstructive sleep apnea severity., (Copyright © 2020 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.)

Introduction: The aim of the study was to investigate the relationship between biosecurity as scored on the Italian National Animal Welfare Reference Centre (Centro di Referenza Nazionale per il Benessere Animale - CReNBA) checklist and the prevalence of Mycobacterium avium subsp. paratuberculosis , Chlamydophila abortus and Neospora caninum on dairy farms located in Ragusa, Italy., Material and Methods: The checklist was used to assign an animal welfare score to 31 dairy farms. Twenty-one farms with a moderate score (>33%, <66%) formed group 1, and 10 farms with a high score (>66%) were group 2. Blood samples were collected from all cows on each farm to investigate the titres of antibodies against the relevant pathogens. Two-way analysis of variance was applied to assess differences between the two experimental groups and the Mann-Whitney test was applied to evaluate prevalence differences in the tested parasites between the groups., Results: All tested farms had a score that classified them as either good or excellent. A higher incidence of Neospora caninum was observed in group 1. The incidences of the other two parasites were no different between the two groups., Conclusion: The CReNBA checklist represents an impartial, reproducible, functional and smart instrument based on risk analysis and assigns a farm a mathematical animal welfare score. Among the parasites tested for, only Neospora caninum had prevalence influenced by biosecurity. Our preliminary results highlighted the positive associations between good animal welfare, high levels of biosecurity, and the prevention of the infectious diseases caused by the parasites in our focus, which are common on dairy farms., Competing Interests: Conflict of Interest Conflict of Interest Statement: The authors declare that there is no conflict of interest regarding the publication of this article., (© 2022 L. Perillo et al. published by Sciendo.)

Objective: To evaluate pain control in patients with joint and muscle pain in temporomandibular disorder (TMD) diagnosis treated with oral non-steroidal anti-inflammatory drugs (NSAIDs)., Methods: The systematic research was conducted via Pubmed, Scopus, Web of Science, Google Scholar, and Cochrane databases., Results: Four full-text randomized-controlled trials (RCTs) were considered eligible. This systematic review included 164 patients whose VAS scores were assessed before and after therapy. In the selected studies, a strong heterogeneity in the diagnosis and in the use of different types and prescriptions of NSAIDs was highlighted. These limitations had to be considered to understand whether a clinical recommendation could be made. Eventually, all patients treated with NSAIDs showed an improvement in pain., Conclusion: The use of oral NSAIDs as the first approach to control joint and muscle pain is sustained by the current scientific literature, but further investigations on this topic are still needed.