Search

Background: Early orthopaedic treatment with rapid maxillary expansion (RME) associated with facemask (FM) has been shown to be effective in correcting Class III malocclusions in children. Treatment with pushing splints 3 (PS3) has shown to correct skeletal discrepancies in Class III growing patients. However, the effects of orthopaedic treatment on the upper airways in children with Class III malocclusion is controversial. Objectives: The aim of this study was to evaluate the cephalometric changes in the airways of PS3 compared to the RME/FM protocol. Materials and Methods: In this study, 48 patients with Class III malocclusion (age range 5.5–8.5 years old) were selected for this study, and 24 were treated with PS3 appliance and 24 with RME/FM therapy. Lateral cephalograms before (T0) and at the end of the treatment (T1) were analysed to compare pharyngeal spaces. Paired and unpaired t tests were used for data analysis (P <.05). Results: A total of 41 patients (21 patients for the PS3 group, 11 males and 10 females, mean age 7.0 ± 1.2 years; 20 patients for the RME/FM group, 10 males and 10 females, mean age 7.2 ± 1.3 years) were included. The results showed a statistically significant (P <.05) increase in the nasopharyngeal space after both therapies. However, the effects were similar considering that there were no differences between groups for the assessed variables at T0–T1. Conclusions: Early treatment of Class III malocclusion with PS3 does not induce a statistically significant increase in the sagittal airway space compared to RME/FM. The absence of untreated group could not define the role of growth in the increase of space. [ABSTRACT FROM AUTHOR]

To evaluate whether there are differences among orthodontists in the clinical management of facemask treatment for early treatment of Class III malocclusion, a survey consisting of 16 questions was conducted among members of the Italian Society of Orthodontics (SIDO). Sixty percent of the respondents were Specialists in Orthodontics (S) whereas 40% were General Dentists practicing Orthodontics (GD). Descriptive statistics were calculated to summarize the collected data. Differences in answers between S and GD were assessed with the Fisher's exact test for dichotomous variables, chi-square test for qualitative variables, and Mann–Whitney test for ordinal variables. A total of 151 clinicians participated in this survey. As for treatment timing, about 80% of the participants reported treating Class III patients with RPE and facemask between 5 and 8 years of age. Most of the participants requested the patients to wear the facemask in the afternoon and at night for a period of 9 or 12 months with recommended forces of 500 g per side. Comparisons between S and GD showed that S preferred the Petit facemask whereas GD favored the Delaire's type facemask (Fisher's Exact test, p = 0.0005). S and GD also differed significantly in their judgment of the most critical time of treatment, which for the majority of GD was the initial period but for the S was the final period (Chi-square test p = 0.0188). This survey showed that the facemask is not well received by the patients who, along with their parents, express concerns regarding its tolerability. [ABSTRACT FROM AUTHOR]

Prior research on racial/ethnic disparities in COVID-19 mortality has often not considered to what extent they reflect COVID-19–specific factors, versus preexisting health differences. This study examines how racial/ethnic disparities in COVID-19 mortality vary with age, sex, and time period over April-December 2020 in the United States, using mortality from other natural causes as a proxy for underlying health. We study a novel measure, the COVID excess mortality percentage (CEMP), defined as the COVID-19 mortality rate divided by the non-COVID natural mortality rate, converted to a percentage, where the CEMP denominator controls (albeit imperfectly) for differences in population health. Disparities measured using CEMP deviate substantially from those in prior research. In particular, we find very high disparities (up to 12:1) in CEMP rates for Hispanics versus Whites, particularly for nonelderly men. Asians also have elevated CEMP rates versus Whites, which were obscured in prior work by lower overall Asian mortality. Native Americans and Blacks have significant disparities compared with White populations, but CEMP ratios to Whites are lower than ratios reported in other work. This is because the higher COVID-19 mortality for Blacks and Native Americans comes partly from higher general mortality risk and partly from COVID-specific risk. [ABSTRACT FROM AUTHOR]

Objective: To assess the short‐ and long‐term dentoskeletal effects of early Class III treatment with rapid maxillary expansion and facemask (RME/FM) followed by fixed appliances. Materials and Methods: A total of 44 patients (27 females, 17 males) treated consecutively with RME/FM were included from the archives of 3 centres. Three lateral cephalograms were available: T0 (before the start of RME/FM therapy, mean age 8.1 ± 1.8 years), T1 (immediately after RME/FM, mean age 9.8 ± 1.6 years), and T2 (long‐term observation, mean age 19.5 ± 1.6 years). A control group of 17 untreated Class III subjects (12 females and 5 males) also was selected. Between‐group statistical comparisons were performed with ANCOVA. Results: No statistically significant differences for any of the cephalometric variables were found at T0. In the short term, the treated group showed significant improvements in ANB (+2.9°), Wits appraisal (+2.7 mm), SNA (+1.8°) and SNB (−1.1°). A significant closure of CoGoMe angle (−1.3°) associated with smaller increments along Co‐Gn (−2.4 mm) also was found together with a significant increase in intermaxillary divergence (+1.3°). In the long‐term, significant improvements in ANB (+2.6°), Wits appraisal (+2.7 mm) and SNB (−1.7°) were recorded together with a significant closure of the CoGoMe angle (−2.9°). No significant long‐term changes in vertical skeletal relationships were found. Conclusions: RME/FM therapy was effective in improving Class III dentoskeletal relationships in the short term. These changes remained stable in the long‐term due mainly to favourable mandibular changes. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical management of stage IV periodontitis patients among clinicians within the Italian Society of Periodontology and Implantology. Methods: A cross‐sectional study was designed on a web‐based anonymous survey. Comparison between ordinary members (OMs) versus active and certified members (ACMs) and comparison between members with at least 10 years of experience in periodontology (Ov10) and members with less than 10 years of experience in periodontology (Un10) were performed. Results: A total of 324 out of 1362 members (response rate of 24%) responded to the questionnaire. ACMs and Ov10 more often reported their teams hold adequate skills to manage cases. Step I and II periodontal therapy took more time in the ACMs and Ov10 groups. ACMs used different strategies to perform step I‐II therapy, and antibiotics were used less frequently than OMs. Unresponsive sites were treated more often with surgery by ACMs compared to OMs. ACMs adopted different treatment sequences compared to OMs. Ov10 group used more often CBCT, lateral cephalogram, and wax‐up while Un10 group tend to avoid orthodontic therapy. Conclusions: More experienced members spent more time in step I and II of periodontal therapy, used more diagnostic tools, and performed more often surgery and orthodontics in the treatment of stage IV periodontitis patients. [ABSTRACT FROM AUTHOR]