rss_2.0Medicine FeedSciendo RSS Feed for Medicine Feed of intermittent cold-exposure on culprit plaque morphology in ST-segment elevation myocardial infarction patients: a retrospective study based on optical coherence tomography<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Objective</title> <p>Present study aimed to explore the effects of intermittent cold-exposure (ICE) on culprit plaque morphology in patients with ST-segment elevation myocardial infarction (STEMI) in frigid zone.</p> </sec> <sec><title style='display:none'>Methods</title> <p>Totally 848 STEMI patients with plaque rupture (<italic>N</italic> = 637) or plaque erosion (<italic>N</italic> = 211) were enrolled consecutively according to optical coherence tomography imaging. Data on the changes of outdoor air temperature corresponding to 24 solar terms were collected. Patients were divided into different groups according to 24 solar terms and the number of days with indoor central heating. Imaging data were measured and analyzed qualitatively and quantitatively. Statistical analysis was conducted to elucidate the possible association of the STEMI patients of different groups with plaque morphology of culprit vessel with alterations of ambient temperature.</p> </sec> <sec><title style='display:none'>Results</title> <p>The incidence of both plaque rupture and plaque erosion presented trough in summer. The incidence of plaque rupture reached a peak value in early winter when outdoor air temperature dropped below 0 °C and declined with supply of central heating. Persistent cold exposure in early winter was positively and significantly associated with plaque rupture. The incidence of plaque erosion presented a peak in severe winter with outdoor air temperature dropping below −20°C and steady supply of central heating. ICE in severe winter was positively and significantly associated with plaque with intact intima, especially in aged male or current smoking patients. The positive correlation of cold exposure with lipid size in culprit plaque in winter weakened with central heating.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>ICE resulted from switching staying in between outdoor cold environment and indoor warm temperature with central heating in severe winter changed culprit plaque morphology in STEMI. Plaque rupture decreased whereas plaque erosion increased impacted by ICE. The effect of ICE on the transformation of plaque morphology might be explained by reduced lipid deposition.</p> </sec> </abstract>ARTICLE2022-05-20T00:00:00.000+00:00Effect of cold on knee osteoarthritis: Recent research status<abstract> <title style='display:none'>Abstract</title> <p>Osteoarthritis is a common chronic irreversible joint disease characterized by degenerative changes of articular cartilage and secondary hyper osteogeny. Knee osteoarthritis(KOA) affects not only the articular cartilage, but also the entire joint, including subchondral bone, joint capsule, synovial membrane, meniscus, ligaments, periarticular muscles, and tendons. The primary aim of treatment is to relieve symptoms, delay joint degeneration, and maximally maintain patient's quality of life. There are many risk factors contributing to the development of KOA, including climate. This review will discuss the relationship between climate in cold region and KOA and the possibility of modifying risk factors such as the environment for the prevention and treatment of KOA.</p> </abstract>ARTICLE2022-05-20T00:00:00.000+00:00Processes and experiences of satellite haemophilia clinic set-ups in Uganda – a short report<abstract> <title style='display:none'>Abstract</title> <p>Haemophilia knowledge and care are largely missing in much of sub-Saharan Africa and there is a need for concerted efforts to ensure access to care services by affected persons. Haemophilia Foundation Uganda, supported by the global haemophilia community and working with the Uganda Ministry of Health, has set up eight satellite haemophilia treatment centres (HTCs) as part of a wider initiative to raise awareness and improve haemophilia care. Setting up the HTCs has involved a six-step process involving stakeholders in government, healthcare and the community, and ranging from securing initial support to an ongoing follow-up programme of mentorship and training. Over 1,700 healthcare professionals have been trained and 186 patients have been registered at these peripheral facilities over the past five years. This is helping to improve access to care, but there are still shortcomings around diagnostic capacity, available healthcare personnel, and facilities to procure recombinant factor products. We will continue and further our advocacy for budgetary inclusion of haemophilia at political and facility levels. We also propose a continued strengthening of the haemophilia care teams through mentorship, networking, and mobilisation for diagnostic support at large public hospitals.</p> </abstract>ARTICLE2022-05-20T00:00:00.000+00:00Discrete choice experiments: An overview of experience to date in haemophilia<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title><p>The patient voice is an important consideration in the availability and choice of pharmaceuticals – however, how to capture this complex area and apply it formally within regulation, health technology assessment and reimbursement remains subject to ongoing debate. Patient preference studies such as discrete choice experiments (DCEs) are being utilised more frequently in healthcare and it is anticipated that patient preference data will be incorporated more frequently into regulatory submissions moving forward.</p></sec> <sec><title style='display:none'>Aim</title><p>The aim of this review is to provide an overview of DCEs conducted within haemophilia to date and to consider the key issues in response to a rapidly evolving therapeutic pathway.</p></sec> <sec><title style='display:none'>Methods</title><p>A systematic literature search was undertaken via Ovid MEDLINE and EMBASE CLASSIC + EMBASE. Abstracts were uploaded and analysed via Rayyan systematic review software. Results: Of 478 records identified from the database searches, 12 full text journal articles met the inclusion criteria with a date range from 2005–2021. There have been two published studies exploring haemophilia patient preferences in relation to gene therapy: one DCE and one utilising a threshold technique. Surveyed audiences included physicians, patients, pharmacists, healthcare professionals and caregivers. 50% of the included studies (n=6) were exclusively conducted in the US, whilst 3 recruited participants across multiple countries. The sample size varied considerably between studies with the total sample size ranging from 30 participants to 505 participants. For the studies involving patients and their caregivers, the mean patient age range was 8.2–41.4 years. There was diversity in (a) the scale of the qualitative work undertaken to support the DCEs, (b) the undertaking of pilots, and (c) how extensively these elements were reported in the included studies. There is a notable trend towards using an online web-based format, with 3 out of 4 DCEs since 2019 utilising this approach. The number of attributes observed per DCE ranged from 5–12 with a median of 6 attributes from the included studies. The number of levels per attribute was relatively consistent (range 2–5) with 2–3 (n=4) and 2–4 levels (n=4) being utilised most frequently.</p></sec> <sec><title style='display:none'>Conclusion</title><p>Patient preferences and the methods for capturing these are likely to be subject to ongoing debate as the haemophilia care pathway evolves to offer more therapeutic options with a range of risks and benefits. Whilst techniques such as DCE are effective at quantifying patient preferences, they tell us little about the reasons driving these decisions and the likelihood that they will change in response to temporal or external factors. DCEs could be particularly useful for estimating the uptake of new products and assessing potential budget impact. Accelerated and reformed regulatory processes are likely to increase demand for patient preference studies. There is therefore an increased requirement to ensure that patient advocacy groups (PAGs) are resourced and have the expertise to support these studies alongside other research commitments, and that manufacturers consider collaborative approaches when formally capturing patient preferences.</p> <p><fig id="j_jhp-2022-0006_fig_007" position="float" fig-type="figure"><caption><p>As more therapeutic options become available in haemophilia care, discrete choice experiment may be a useful means of gauging patient preference</p><p>© Shutterstock</p></caption><graphic xmlns:xlink="" xlink:href="graphic/j_jhp-2022-0006_fig_007.jpg"/></fig></p></sec> </abstract>ARTICLE2022-05-20T00:00:00.000+00:00Point of care ultrasonography in patients with haemophilia and acute haemarthrosis: a physiotherapist and sonographer inter-professional agreement pilot study<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title><p>Haemophilia treatment centres (HTCs) around the world are increasingly adopting point-of-care ultrasonography (POCUS) for the assessment of acute haemarthrosis and to monitor joint health. POCUS is in large part administered by physiotherapists in most comprehensive care teams. Appropriate implementation of haemophilia-specific POCUS requires an educational foundation and training to ensure competency and optimal outcomes. Inter-professional agreement and evaluation of image quality are important measures of competency and acceptable use of POCUS.</p></sec> <sec><title style='display:none'>Aims</title><p>To determine the level of agreement between physiotherapist and sonographer-performed POCUS scans and to compare the quality of the ultrasound images obtained by physiotherapists to those obtained by the sonographer.</p></sec> <sec><title style='display:none'>Methods</title><p>This single blind, prospective, pilot study recruited patients with haemophilia A and B who presented to clinic with a suspected acute haemarthrosis of the elbow, knee, or ankle and consented to participate. POCUS scans were performed by one trained physiotherapist and one sonographer in the haemophilia ambulatory clinic at patient presentation, one-week follow-up, and two-week follow-up. The physiotherapist participated in formal training consisting of 12 hours of online didactic modules and a two-day, 12-hour practical module with instructor-led hands-on training. For the primary objective, the outcome of interest was the binary decision on the presence or absence of blood within the joint. For the secondary objective, image quality was evaluated by the radiologist post hoc and rated as optimal, acceptable, or sub-optimal.</p></sec> <sec><title style='display:none'>Results</title><p>Thirteen participants with haemophilia consented to the study. The results indicated an excellent level of agreement (k=0.80) with an observed agreement of 91.7%, a specific positive agreement of 94.1%, and a specific negative agreement of 85.7% for the detection of blood within the joint space. The quality of the ultrasound images obtained by the physiotherapist were rated by the radiologist as optimal (84.6%) and acceptable (15.4%). None of the images were rated as sub-optimal.</p></sec> <sec><title style='display:none'>Conclusion</title><p>Optimal image quality and a high level of agreement between the physiotherapist and sonographer-performed POCUS for the assessment of acute hemarthrosis in people with haemophilia A and B was observed. These results suggest that, with a short formal training programme, physiotherapists can be proficient in the performance, acquisition, and interpretation of POCUS scans in patients with haemophilia.</p></sec> </abstract>ARTICLE2022-05-20T00:00:00.000+00:00Treatment of a patient with severe haemophilia A presenting with left extra pleural haematoma and diagnosed with inhibitors – case report<abstract> <title style='display:none'>Abstract</title> <p>Haemophilia is an inherited X-linked bleeding disorder characterised by a deficiency or absence of clotting factor VIII (haemophilia A) or IX (haemophilia B), which can cause musculoskeletal bleeding. The standard treatment for haemophilia is with factor concentrates to replace the missing or deficient clotting factor. However, there is a risk that the immune system develops antibodies against the exogenous factor, known as inhibitors. Managing patients with haemophilia and inhibitors who develop bleeding in unusual sites can be challenging for the treating physician. Here, we present a rare case of patient with severe haemophilia A who was diagnosed with inhibitors after developing bleeding in the left posterior chest wall (extra pleural haematoma). The patient was successfully managed with activated prothrombin complex concentrate (aPCC) (FEIBA: FVIII inhibitor bypassing activity; Baxter AG), and the pain and swelling gradually resolved over three weeks. This case emphasises the importance of clinical suspicion of inhibitor formation in a patient already diagnosed with haemophilia A presenting with unusual bleeding that does not respond to standard treatment.</p> </abstract>ARTICLE2022-05-20T00:00:00.000+00:00Cryptotanshinone increases the sensitivity of liver cancer to sorafenib by inhibiting the STAT3/Snail/epithelial mesenchymal transition pathway<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Objective</title> <p>Sorafenib resistance has been a major factor limiting its clinical use as a targeted drug in liver cancer. The present study aimed to investigate whether cryptotanshinone can enhance the sensitivity of liver cancer and reduce the resistance to sorafenib.</p> </sec> <sec><title style='display:none'>Methods</title> <p>Sorafenib-resistant cells were established based on HepG2 and Huh7 cell lines. And the anti-tumor effect of sorafenib combined with cryptotanshinone on the sorafenib-resistant cells was verified by MTT, colony formation, transwell assays and tumor growth xenograft model. Moreover, the effects of the combined treatment on the expression of phosphorylated (p)-STAT3, as well as epithelial mesenchymal transition (EMT) and apoptosis related proteins of cells were evaluated by western blot analysis.</p> </sec> <sec><title style='display:none'>Results</title> <p>It was identified that cryptotanshinone inhibited the viability of both HepG2 and Huh7 cells in a dose- and time-dependent manner, and decreased p-STAT3 expression rather than total STAT3 expression at a concentration of 40 μmol/L. In the sorafenib-resistant cells, sorafenib in combination with cryptotanshinone markedly inhibited cell viability, invasion and migration compared with sorafenib alone. In contrast, increased p-STAT3 level by colivelin led to the inhibition of the synergistic effect of cryptotanshinone and sorafenib not only on cell viability, but also on EMT and apoptosis, suggesting that cryptotanshinone and sorafenib may act by downregulating STAT3 signaling. Further, the inhibition of carcinogenicity effect was also verified in xenografted tumor models.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>The present results indicated that cryptotanshinone could synergize with sorafenib to inhibit the proliferative, invasive, and migratory abilities of sorafenib-resistant cells by downregulating STAT3 signaling.</p> </sec> </abstract>ARTICLE2022-05-20T00:00:00.000+00:00Challenges and improvement in management of neonates born to mothers with COVID-19 in China<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Objective</title> <p>China was the first country suffering from the SARS-CoV-2 pandemic and one of the countries with stringent mother-neonate isolation measure implemented. Now increasing evidence suggests that coronavirus disease 2019 (COVID-19) should not be taken as an indication for formula feeding or isolation of the infant from the mother.</p> </sec> <sec><title style='display:none'>Methods</title> <p>We conducted a retrospective cohort study in 44 hospitals from 14 provinces in China to investigate the management of neonates whose mothers have confirmed or suspected COVID-19. In addition, 65 members of Chinese Neonatologist Association (CNA) were invited to give their comments and suggestions on the clinical management guidelines for high-risk neonates.</p> </sec> <sec><title style='display:none'>Results</title> <p>There were 121 neonates born to 118 mothers suspected with COVID-19 including 42 mothers with SARS-CoV-2 positive results and 76 mothers with SARS-CoV-2 negative results. All neonates were born by caesarean section, isolated from their mothers immediately after birth and were formula-fed. Five neonates were positive for SARS-CoV-2 at initial testing between 36 and 46 h after birth. Regarding the confusion on the clinical management guidelines, 58.78% of the newborns were put into isolation, 32.22% were subject to PCR tests, and 5.16% and 2.75% received breastfeeding and vaccination, respectively.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>The clinical symptoms of neonates born to mothers with confirmed SARS-CoV-2 were mild, though five neonates might have been infected in utero or during delivery. Given the favorable outcomes of neonates born to COVID-confirmed mothers, full isolation may not be warranted. Rather, separation of the mother and her newborn should be assessed on a case-by-case basis, considering local facilities and risk factors for adverse outcomes, such as prematurity and fetal distress.</p> </sec> </abstract>ARTICLE2022-05-20T00:00:00.000+00:00A randomized retrospective clinical study on the choice between endodontic surgery and immediate implantation<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Periapical endodontic surgery (PES) for root amputation and tooth replacement by immediate implant placement are two possible treatment options for bone lesions in the root apex of a tooth that has previously undergone endodontic treatment. Treatment methods are performed when the effectiveness of orthograde canal revision is questionable or when such treatment cannot be performed. The effectiveness of these methods varies from study to study.</p> </sec> <sec><title style='display:none'>Objective</title> <p>clinical evaluation of the efficacy of periapical endodontic surgery for root amputation and immediate implant placement with simultaneous tooth extraction in the proximate and long-term treatment.</p> </sec> <sec><title style='display:none'>Materials and methods</title> <p>The study included 183 patients between the ages of 24 and 63. Patients were divided into 2 groups; group I - endodontic surgery was performed to resect the apex of the tooth root (108 patients) and group II - an operation to install an implant with simultaneous tooth extraction (75 patients). In group I, in 36 cases, PES was performed in the area of the first molars and premolars, and 72 cases in the area of incisors and canines. In group II, 75 patients received 231 implants.</p> </sec> <sec><title style='display:none'>Results</title> <p>In all 108 patients of group I in the postoperative period and within 1 month, the wounds healed without complications. In none of the 36 operated premolars and molars, there was no definitive elimination of the radiographic bone loss (Rude grade 2 and 3) after 12 months. In the area of incisors and canines, complete healing was observed only in 37.5% of cases (I class according to Rud). In group II, out of 184 implants installed immediately after tooth extraction, one was removed one month after implantation. In other cases, all implants were successfully integrated with the subsequent fabrication of prosthetic construction.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>The complex “implant (installed in the socket of the tooth immediately after its removal) - bone - soft tissues - prosthetic construction” is stable over time in terms of functional and aesthetic parameters, preservation of bone tissue, and mucous membrane.</p> </sec> </abstract>ARTICLE2022-05-20T00:00:00.000+00:00Altered expression profile of long non-coding RNAs during heart aging in mice<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Objective</title> <p>Long noncoding RNAs (lncRNAs) play an important role in regulating the occurrence and development of cardiovascular diseases. However, the role of lncRNAs in heart aging remains poorly understood. The objective of this study was to identify differentially expressed lncRNAs in the heart of aging mice and elucidate the relevant regulatory pathways of cardiac aging.</p> </sec> <sec><title style='display:none'>Materials and methods</title> <p>Echocardiography was used to detect the cardiac function of 18-months (aged) and 3-months (young) old C57BL/6 mice. Microarray analysis was performed to unravel the expression profiles of lncRNAs and mRNAs, and qRT-PCR to verify the highly dysregulated lncRNAs.</p> </sec> <sec><title style='display:none'>Results</title> <p>Our results demonstrated that the heart function in aged mice was impaired relative to young ones. Microarray results showed that 155 lncRNAs were upregulated and 37 were downregulated, and 170 mRNAs were significantly upregulated and 44 were remarkably downregulated in aging hearts. Gene ontology analysis indicated that differentially expressed genes are mainly related to immune function, cell proliferation, copper ion response, and cellular cation homeostasis. KEGG pathway analysis showed that the differentially expressed mRNAs are related to cytokine-cytokine receptor interaction, inflammatory mediator regulation of TRP channels, and the NF-kappa B signaling pathway.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>These results imply that the differentially expressed lncRNAs may regulate the development of heart aging. This study provides a new perspective on the potential effects and mechanisms of lncRNAs in heart aging.</p> </sec> </abstract>ARTICLE2022-05-20T00:00:00.000+00:00Nortriterpenoids from the fruit stalk of (Turcz.) Baill.<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Objective</title> <p>The fruit stalk of <italic>Schisandra chinensis</italic> (Turcz.) Baill. (<italic>S. chinensis</italic>) has been found to contain bioactive components similar to the fruit of <italic>S. chinensis</italic>. Here, we report a recent discovery about new nortriterpenoids with a novel skeleton and anti-gastric cancer activity, which were isolated from the fruit stalk of <italic>S. chinensis</italic>.</p> </sec> <sec><title style='display:none'>Methods</title> <p>The chemical components of ethyl acetate extract from 70% ethanol extract from <italic>S. chinensis</italic> fruit stalk were separated, purified, and identified by liquid chromatography methods (silica gel, ODS, HPLC) and extensive spectroscopic analyses (NMR, IR, UV, MS, CD).</p> </sec> <sec><title style='display:none'>Results</title> <p>Two new nortriterpenoids, schilancitrilactone M and 25-hydroxyl schindilactone D (1 and 2), along with ten known nortriterpenoids (3–12) were isolated from the fruit stalk of <italic>S. chinensis</italic>. The isolated compounds were tested for their cytotoxic activities against MGC-803 cells, and the results showed that compounds 6–8 possessed significant activities with IC<sub>50</sub> of 9.01, 11.77, and 2.74 μmol/L, respectively.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>Twelve nortriterpenoids including two new compounds were isolated from the fruit stalk of <italic>S. chinensis</italic> for the first time. Among them, compounds 6–8 showed significant anti-gastric cancer activities. We postulated that the fruit stalk of <italic>S. chinensis</italic> could be used as an anti-gastric cancer drug.</p> </sec> </abstract>ARTICLE2022-05-20T00:00:00.000+00:00Dissecting pathophysiology of a human dominantly inherited disease, familial amyloidotic polyneuropathy, by using genetically engineered mice<abstract> <title style='display:none'>Abstract</title> <p>Familial amyloidotic polyneuropathy (FAP) is a type of systemic amyloidosis characterized by peripheral and autonomic neuropathy. Although FAP is a typical autosomal dominant disorder caused by a point mutation in the TTR gene, the average age at onset varies significantly among different countries. This discrepancy clearly suggests that a combination of intrinsic factors as well as extrinsic (environmental) factors shapes the development of FAP. However, these factors are difficult to analyze in humans, because detailed pathologic tissue analysis is only possible at autopsy. Thus, mouse models have been produced and used to disentangle these factors. This review covers the mouse models produced thus far and how these models are applied to analyze intrinsic and extrinsic factors involved in disease development and to test drug efficacy.</p> </abstract>ARTICLE2022-05-20T00:00:00.000+00:00Prevalence of interproximal tooth reduction prescribed as part of initial Invisalign treatment in 10 orthodontic practices<abstract> <title style='display:none'>Abstract</title> <p>Interproximal reduction (IPR) is a therapeutic procedure used during orthodontic treatment and is apparently a commonly incorporated feature in the treatment planning of aligner cases.</p> <p>The present study investigated the prescription of IPR in the 50 most recently accepted initial aligner treatment plans for each of 10 orthodontic practices. The number of plans incorporating IPR, as well as the magnitude and location of the prescribed IPR, were assessed.</p> <p>The results showed that IPR was heavily prescribed, with an average of 71% of the 500 reviewed plans receiving IPR as part of that plan. When IPR was prescribed, the amount averaged 2.16 mm per case over 6.92 contact points. The lower anterior teeth had the most heavily prescribed IPR associated with the number of interproximal contacts and the respective amount, while the upper anterior teeth had the least heavily prescribed IPR.</p> </abstract>ARTICLE2022-02-14T00:00:00.000+00:00Correction of Class II division 2 with crowding and bilateral fully transposed impacted mandibular canines<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Maxillary canine impaction has been extensively reported, but studies of mandibular canine impaction are relatively few. Clinical studies and reports of experience treating mandibular canine impaction are of clinical benefit to both orthodontists and dentists.</p> </sec> <sec><title style='display:none'>Aims</title> <p>This report introduces a Class II division 2 crowded case with severely impacted, fully transposed, mandibular canines treated by a non-extraction approach and mandibular arch expansion.</p> </sec> <sec><title style='display:none'>Methods</title> <p>The completely transposed, impacted, mandibular canines were successfully aligned. The crowding was relieved by arch expansion and incisor proclination without obvious radiographic alveolar bone loss. The two severely labially displaced mandibular canines assisted in the expansion of the narrow mandibular arch.</p> </sec> <sec><title style='display:none'>Results</title> <p>The maxillary and mandibular arches were expanded and well aligned, and Class II molar and canine relationships and a normal overjet and overbite were established. The mandibular canines were aligned in advantageous positions. There was no regional alveolar bone resorption around the mandibular canines.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>The treatment approach provided an example of significant bone remodelling. Using the impacted mandibular canines for anchorage, the age of the patient provided an opportunity to adopt a relatively conservative and unique treatment approach which may be applied to relieve crowding.</p> </sec> </abstract>ARTICLE2022-01-17T00:00:00.000+00:00Comparison of mini-screw-assisted rapid maxillary expansion in adolescents with different body mass indices: a prospective clinical study<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Objectives</title> <p>The objective of the present study was to compare the dentoskeletal effects of mini-screw-assisted rapid maxillary expansion (RME) in children with different body mass index (BMI) percentiles.</p> </sec> <sec><title style='display:none'>Study design</title> <p>The study was performed on 20 patients who were divided into two groups based on their BMI percentiles as normal-weight (<italic>n</italic> = 10) and overweight-obese (<italic>n</italic> = 10). The linear, angular and area analyses were performed on lateral and postero-anterior cephalometric radiographs and three-dimensional dental models before and after RME therapy.</p> </sec> <sec><title style='display:none'>Results</title> <p>A statistically significant increase was observed in maxillary intermolar and intercanine distances and palatal area measurements in both groups (<italic>P</italic> &lt; 0.05). There was no significant difference between the two groups when dental RME changes were measured on 3D models. A significant difference was observed in latero-nasal and maxillo-mandibular width as well as postero-anterior cephalometric parameters between the groups (<italic>P</italic> &lt; 0.05). While a significant change was observed in the SN-GoMe, FMA, Z angle, Wits appraisal, total anterior facial height and lower anterior facial height parameters in the normal-weight group (<italic>P</italic> &lt; 0.05), a statistically significant change was observed in the gonial and nasolabial angles in the overweight-obese group.</p> </sec> <sec><title style='display:none'>Conclusions</title> <p>Mini-screw-assisted RME treatment significantly increased maxillary intermolar and intercanine width, and the palatal area in both groups; however, there was no significant difference between the BMI groups.</p> </sec> </abstract>ARTICLE2022-01-17T00:00:00.000+00:00Aligner treatment: patient experience and influencing factors<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Objectives</title> <p>To investigate patient experience of aligner treatment and associated influencing factors.</p> </sec> <sec><title style='display:none'>Methods</title> <p>A total of 102 patients wearing Invisalign clear aligners (Align Technology, California, USA) were recruited in an initial treatment group (<italic>N</italic> = 62) and a refinement group (<italic>N</italic> = 40). Clinical diagnoses and treatment designs were collected. Data from a Visual Analogue Scale (VAS), a Self-Rating Anxiety Scale (SAS), and an Oral Health Impact Profile-14 (OHIP-14) were recorded at the commencement (Day 0, before wearing the first set of aligners) and during the first 7 days (Days 1–7) after wearing the first set of aligners.</p> </sec> <sec><title style='display:none'>Results</title> <p>The patient experience of aligner treatment (i.e., pain, anxiety and quality of life) was poorest during the first two days (<italic>P</italic> &lt; 0.05), and returned to a normal level within a week. The level of patient experience during the initial phase was greater than that during the later refinement phase (<italic>P</italic> &lt; 0.01). During the initial treatment, the studied factors did not significantly influence the level of pain (VAS) (<italic>P</italic> &gt; 0.05 for all) nor anxiety (SAS) (<italic>P</italic> &gt; 0.10 for all); the number of teeth with optimised attachments significantly (<italic>R</italic> = 0.28, <italic>P</italic> = 0.03) influenced the quality of life (OHIP-14). During the refinement phase, the studied factors did not significantly influence the level of pain (VAS) (<italic>P</italic> &gt; 0.09 for all); the number of aligner sets significantly influenced the level of anxiety (SAS) (<italic>R</italic> = 0.41, <italic>P</italic> &lt; 0.01); the Index of Treatment Complexity Outcome and Need (ICON) (<italic>R</italic> = 0.44, <italic>P</italic> &lt; 0.01) and whether elastics were required significantly influenced the quality of life (OHIP-14) (<italic>R</italic> = 0.349, <italic>P</italic> = 0.03).</p> </sec> <sec><title style='display:none'>Conclusions</title> <p>Patient experience of aligner treatment was poorest during the first two days and improved over a week. Patient experience during the initial phase was generally worse than that during refinement. Four clinical factors were found to have an influence, including the number of teeth with optimised attachments, the number of aligner sets, the ICON, and the need for elastics.</p> </sec> </abstract>ARTICLE2022-02-17T00:00:00.000+00:00Edentulous ridge space closure after bone augmentation using different graft materials: A report of two cases<abstract> <title style='display:none'>Abstract</title> <p>Post-extraction alveolar ridge resorption is a common sequela when missing mandibular molar spaces are not managed in a timely fashion. The situation becomes more complicated in patients who seek orthodontic treatment if closure of the edentulous space is the major objective in order to avoid prosthetic rehabilitation. In the present article, two cases are reported, in which different bone augmentation graft materials were used and treatment duration and post-orthodontic alveolar ridge characteristics were compared. A regional acceleratory phenomenon after the grafting procedure facilitated uneventful orthodontic space closure. The status of the investing alveolar bone was compared using post-treatment cone-beam computed tomography. Both autogenous bone graft and allograft ridge augmentation procedures aided in successful molar protraction through the resorbed mandibular alveolar ridge, as well as preventing periodontal attachment loss.</p> </abstract>ARTICLE2022-01-17T00:00:00.000+00:00Orthodontics on sale: fixed appliances on E-commerce platforms<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title> <p>The sale of orthodontic materials, considered as medical devices, is regulated in order to protect patients. The availability of orthodontic products on e-commerce platforms, however, may go unregulated and compromise patient safety.</p> </sec> <sec><title style='display:none'>Objective</title> <p>The present study aimed to investigate the sale of fixed orthodontic appliances on a local and global e-commerce platform.</p> </sec> <sec><title style='display:none'>Materials and Methods</title> <p>A cross-sectional analysis of orthodontic materials sold on Shopee and Amazon was conducted using a specific keyword search for brackets, arch wires and ligatures. After deleting duplicates and irrelevant search results, the top 50 products for each keyword search were analysed. Product name, the type of product, seller, cost, star rating, the number of reviews, the number of sales, shipping location and brand identification were recorded. Brand registration with a medical device regulatory authority was checked. Collected data were tabulated in Google (spread)sheet to derive descriptive statistics and frequency tables.</p> </sec> <sec><title style='display:none'>Results</title> <p>A total of 800 search results were screened. Three hundred and forty-eight relevant results were identified, approximately two-thirds of which originated from Shopee. Ligatures generated the highest search outcome in both Shopee (39%) and Amazon (80%). Fixed orthodontic materials sold on Shopee resulted in a larger number of reviews, higher star ratings and a lower cost per item compared to those supplied by Amazon. Products on Amazon were more likely to have brand identification (97%) compared to Shopee (5%). None of the identifiable brands on Shopee were registered with regulatory bodies, whereas eight products listed on Amazon were registered. A large portion of shipping locations originated from China for both e-commerce platforms.</p> </sec> <sec><title style='display:none'>Conclusions</title> <p>Orthodontic brackets, arch wires and ligatures are more readily available on Shopee compared to Amazon. The quality and safety of these products cannot be assured as the majority of the products were either not clearly labelled or their registration was not identified under the regulation of medical devices.</p> </sec> </abstract>ARTICLE2022-01-04T00:00:00.000+00:00Non-extraction camouflage treatment using extra-alveolar skeletal anchorage<abstract> <title style='display:none'>Abstract</title> <p>A 23-year-old female patient with moderate crowding and a bilateral molar scissor-bite was successfully treated without tooth extraction. Extra-alveolar skeletal anchorage, involving a three-dimensional key plate in the maxilla and two miniscrews in the buccal shelf of the mandible, were used for distalisation, buccolingual uprighting, and the intrusion of molars by fixed orthodontic appliances. Cone-beam computed tomography was used to identify available posterior space for the distalisation and buccolingual correction of the molars in scissor-bite. The total treatment time was 24 months. Post-treatment results showed good occlusal relationships and smile aesthetics. Twelve-month post-treatment records demonstrated no significant relapse and a favourable facial balance.</p> </abstract>ARTICLE2022-01-27T00:00:00.000+00:00Comparative assessment of the survival, stability and occlusal settling between two types of thermoplastic retainers: a prospective clinical trial<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title> <p>A controlled clinical trial was undertaken to compare the effectiveness of Vivera<sup>®</sup> and Duran<sup>®</sup> retainers with regard to the survival, stability and occlusal settling over the first 6 months of retention following the completion of clear aligner treatment.</p> </sec> <sec><title style='display:none'>Methods</title> <p>Consenting participants who met the inclusion criteria were recruited from a single, metropolitan Melbourne orthodontic practice. The participants were divided according to their retainer type, Vivera<sup>®</sup> (<italic>n</italic> = 10) or Duran<sup>®</sup> (<italic>n</italic> = 14). Each retainer type was fabricated to a standardised design. Intra-oral scans were taken at the time of debond (T<sub>0</sub>), at 3 months (T<sub>2</sub>) and at 6 months (T<sub>3</sub>). The participants wore their retainers full-time for the first 3 months and part-time for the remaining 3 months. The retainers were inspected at each review for damage that required replacement and failures were recorded in ‘days from insert’. Patient reported failures were also recorded. Intra-oral scans were assessed for changes in incisor irregularity and the number of occlusal contacts and comparisons between the two retainer groups were investigated. The impact of full-time and part-time wear on occlusal settling was also assessed for each retainer type.</p> </sec> <sec><title style='display:none'>Results</title> <p>Vivera<sup>®</sup> retainers showed a greater survival time in comparison to Duran<sup>®</sup> retainers, as no Vivera<sup>®</sup> failures were observed over the initial 6 months of retention. Both retainer groups showed similar results related to incisor stability and occlusal settling. Part-time wear resulted in increased posterior settling for both retainer types.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>Vivera<sup>®</sup> retainers were as clinically effective as the Duran<sup>®</sup> retainer but exhibit a significantly higher survival rate. Part-time wear of full-coverage thermoplastic retainers appears to increase posterior settling.</p> </sec> </abstract>ARTICLE2022-02-17T00:00:00.000+00:00en-us-1