LONGITUDINAL CHANGES IN DENTAL ARCH CIRCUMFERENCE IN SULAIMANI CITY

Background: Evaluation of dental arches is of great importance for definitive diagnosis and optimal craniofacial treatment. The circumference or perimeter is the most important dimension of the dental arch and it changes according to age and gender. This issue hasn't been conducted yet in sulaimani city;Aims: aim of the present study was to assess the dimensional changes in the dental arches occurring during the transitional period from mixed to permanent dentition in individuals with normal dentition.Methods: A group of fifty children with normal dentition aged 8-9 years were selected according to specific criteria in sulaimani city in kurdistan of iraq, dental arch dimensions were measured. Five years later, a second examination and measurement was performed to record the changes in dental arches. The data was analyzed by using statistical package for social sciences (SPSS, version 15) program for obtaining the descriptive statistics including the mean, and standard deviation, also the inferential statistics (t-test) was applied to test the significance difference between the dimensions.Results: The study showed an increase in the arch perimeter of the maxilla in the transition from mixed to permanent dentition for both males and females whereas in the lower arch it was the reverse. The arch perimeter differences between maxillary and mandibular arches show high significancy in both mixed and permanent dentitions P(0.00), P(0.00). There was asymmetry in the ach length between right and left side for both mixed and permanent dentition and most of the measurements of the permanent dentition showed high significant differences between right and left sides. There was a significant difference P(0.00) in maxillary and mandibular left and right incisor- canine distance (I-C) between males and females.Conclusion: Controlling the reduction of total arch length in the transition period from mixed dentition to permanent dentition may help in the early treatment of crowding of the teeth

Prediction of the Dental Arch Perimeter in a Kurdish Sample in Sulaimani City Based on Other Linear Dental Arch Measurements as a Malocclusion Preventive Measure

The current study aimed to find a prediction equation to estimate the arch perimeter (AP) depending on various arch dimensions including intercanine width (ICW), intermolar width (IMW), interpremolar width (IPMW), and arch length (AL) in a sample of the Kurdish population in Sulaimani City. The study sample was 100 pairs of preorthodontic dental casts. Calculations of dental arch dimensions and perimeter were performed by a digital vernier. Statistical analysis was performed via using the SPSS version 25 software. The developed prediction equation for the upper arch was Y=+1.3×arch length+1×intermolar width, whereas the equation for the lower arch was Y=+0.9×intermolar width+0.92×intercanine width. Paired t-test revealed no statistical difference between predicted and real arch perimeters. Two separate prediction equations for upper and lower arches were developed based on the arch length (AL) and intermolar width (IMW) for the maxillary arch, intermolar (IMW), and inter canine widths (ICW) for the lower arch. The developed equations could have further beneficial impacts on orthodontic diagnosis and treatment planning

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)