Transverse analysis of cone-beam computed tomography (CBCT) at the canine level

OBJECTIVE: To determine the range of positions and relationships between the maxillary and mandibular canines and the related skeleton, and to evaluate using CBCT imaging whether dental and skeletal transverse discrepancies identified in the molar area also exist in the canine area. METHODS: CBCT scans of 148 patients, with and without crossbite were analyzed to assess the width of the jaws and the inclination of the canines relative to the occlusal plane. The dental and skeletal measurements were compared between the non-crossbite and the crossbite groups. RESULTS: At the canine area, we found no statistically significant differences between the non-crossbite group and the crossbite group in canine transverse angulations and maxillary and mandibular width. There is a weak statistically significant correlation between canine lingual width and both maxillary and mandibular canine axial angles that is not observed between canine palatal width and both maxillary and mandibular canine axial angles. We found a weak statistically significant correlation between maxillary canine and molar angulations as well as palatal and lingual width, but not between mandibular canine and molar angulations. CONCLUSION: We have developed a reliable method to measure transverse tooth angulation and skeletal width using CBCT at the canine level. Changes in transverse angulation and compensation observed in the molar area do not carry on at the canine area. Expansion of crossbite cases are most likely needed at the molar area, as our findings suggest that crossbites are more confined to the molar area and less expressed at the canine level

Diseases of the prostate gland, prostate specific antigen and periodontal disease

OBJECTIVE: The overall objective of this study was to evaluate the relationship between different diseases of the prostate gland (Benign Prostate Hyperplasia (BPH), Prostatitis, and Prostate Cancer) as well as levels of Prostate specific Antigen (PSA) with periodontal disease. METHODS: A subset of data from the VA Dental Longitudinal Study was used for this study. The total sample size was 352 subjects with at least one PSA reading. Diagnoses of diseases of the prostate gland (BPH, Prostatitis, and Prostate Cancer) and PSA were used as the main outcome variables. Measurements of periodontal disease [average clinical attachment loss (CAL), average probing pocket depth (APD), and number of teeth with severe bone loss (NTBL)] were used as the main predictors. Statistical analysis included descriptive, bivariate, and multivariate testing. For the final multivariate analysis, Generalize Estimating Equations (GEE) controlling for potential confounders was used. RESULTS: The study subjects were predominantly Caucasian males. At baseline the mean age was 71 years, and the mean PSA level was 2.5 ng/ml. The proportion of subjects with prostate diseases at baseline was 79.6% for BPH, 7.4% for prostatitis, and 8.8% for prostate cancer. Using GEE models and after controlling for potential confounders we found an association between CAL and BPH, as for every millimeter increase in CAL the odds of having BPH increased by 41%. We have also found that those with BPH and CAL above 2.7mm have higher PSA levels than those with either condition alone. We have not found any relationship between BPH and APD or NTBL. We have also not found any relationship between PSA, Prostatitis, and prostate cancer with any of the measurements of periodontal disease used in this study. CONCLUSION: This study showed an association between an increase in CAL and BPH. As well as showing that those with BPH and CAL above 2.7mm have higher PSA levels than those with either condition alone. These findings support that periodontal disease could affect the health of the prostate gland in an aging population, as well as the importance of oral health as an important and integral part of general health and well-being

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

The Reliability of ClinCheck^® Accuracy before and after Invisalign^® Treatment—A Multicenter Retrospective Study

The objective was to evaluate the accuracy of ClinCheck® reliability in the sagittal, vertical, transverse, and arch length dimensions before and after Invisalign® (Align Technology, Santa Clara, CA, USA) treatment. This retrospective study was conducted on 206 patients who underwent dual-arch clear aligner therapy exclusively with Invisalign®. Digital models were obtained from iTero® scanners from three different private practices where the treatment plans were performed and executed by multiple orthodontists with varying degrees of experience. The ClinCheck® models of the initial, achieved, and predicted outcome were obtained from Align Technology® and the values were compared using Pearson correlation (p p p = 0.03, p ® was 76.85% overall; however, Invisalign® providers may need to exaggerate the digital tooth movements to achieve the desired outcome

The relationship between maxillary sinus volume and different cephalometric characteristics in orthodontics

Introduction: This study aimed to evaluate the maxillary sinus volume (MSV) in both genders in a Saudi sample and among different skeletal patterns. Materials and Methods: This retrospective cross-sectional study included 52 cone-beam computed tomography (CBCT) scans of 18 years or older individuals with complete dentition and healthy medical history. MSV was measured as the mean value of both sides in cubic millimeters (mm3) using OnDemand three-dimensional™ Dental. Cephalometric tracings were conducted on cephalograms obtained from CBCT scans. The beta, A × B, and Frankfort-mandibular plane angles were selected to determine the sagittal and vertical skeletal patterns of the study subjects. Descriptive statistics and other tests were conducted. The significance level was set at P 0.05). Conclusions: The MSV in the studied Saudi sample was larger among males. However, different skeletal patterns have no statistically significant differences in MSV

Multinational study on profile preference of laypersons

BACKGROUND: This study aimed to assess the facial profile preferences of lay people in seven locations from different countries and whether their place of residence, sex, age, race, education, or income influenced the decision. METHODS: After altering the lip and nose in 1 mm increments in the sagittal and sagittal/vertical directions, 50 profile silhouettes with white-like facial features were rated by evaluators. The soft tissue values were integrated into the profiles, and profile preferences were identified for each location. An ANOVA with post hoc Tukey test was used to compare the differences in mean preference in each location. A multivariable regression model was used to assess the effect of the demographics of the evaluator on preference. RESULTS: Thirteen profiles were ultimately analyzed. The mean for profile preference was significantly different across locations (P < 0.0001). For evaluators in the United States and Lebanon, the most preferred profile had the original lip and original nose. In Switzerland and South Africa, retrusive lips, and a small and less upturned nose was most preferred. In Japan and Saudi Arabia, the most preferred profile had the original lip and a protrusive nose that was less upturned. A protrusive lip with a small, upturned nose was preferred in Turkey. Profile change (P < 0.0001), location (P < 0.0001), sex (P < 0.0001), and race (P = 0.02) were significant confounders; in contrast, age, education, and income were not significant. CONCLUSIONS: Profile preference is different among the seven locations. For the most part, lay people prefer profiles within one SD from white norms. Also, an upturned nose is the least favored in most of the locations. Sex and race are also significant confounders. CLINICAL RELEVANCE: An orthodontic treatment plan decision is affected by an individual's preference for their facial appearance. This study helps clinicians understand how racial and regional differences may affect patients' preferences and, therefore, their expectations for orthodontic treatment results

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care