American Journal of Orthodontics and Dentofacial Orthopedics最新文献

Introduction: Patients in the orthognathic surgery process frequently turn to social media to obtain information and share their experiences. Accordingly, the present study analyzed YouTube comments to evaluate patient satisfaction, emotional tendencies, and social interactions, aiming to draw implications for improving communication and psychological support strategies.

Methods: A total of 250,582 comments from 8044 YouTube videos on orthognathic surgery were collected using Mozdeh (University of Wolverhampton, Wolverhampton, UK) and R software (version 4.2.2, Posit, PBC, Boston, Mass). After preprocessing, 111,953 comments remained. Sentiment analysis (AFFIN/NRC lexicons), structural topic modeling, and manual thematic analysis (10% sample) were performed. Gender-based discourse differences were examined using Chi-square tests with Benjamini-Hochberg correction.

Results: Ten main themes were identified through structural topic modeling and thematic analyses. Positive emotions were mostly expressed, though fear and negativity were also observed. Esthetic and emotional expressions were used more often by women, whereas cost-related terms were used more often by men. Thematic qualitative analyses revealed that YouTube videos and comments were perceived by patients as a source of psychological support, whereas certain misleading content was also found to have the potential to misguide patients during the treatment process.

Conclusions: This study has transcended the limited scope of traditional surveys, which are confined to specific time periods and small sample sizes, by making it possible to access patient experiences shared on the YouTube platform without temporal or spatial constraints. The analyses revealed prevalent misconceptions on social media and assessed patients' expectations, concerns, and psychological states. The findings serve as a practical guide for healthcare professionals in developing patient-centered communication and care strategies.

Introduction: Mental health is a key component of overall well-being. Adolescents often experience gradual changes in their mental health, which can go unnoticed and undiagnosed. The aims of this study were as follows: (1) to assess the feasibility of implementing mental health screening for adolescent patients in the orthodontic setting and (2) to examine the difference between guardian and patient responses.

Methods: The Pediatric Symptom Checklist (PSC), a questionnaire used to identify emotional and behavioral issues, was employed as a screening tool in the orthodontic setting. Participants included children aged 12-17 years and their legal guardians. Measures of feasibility included the following: survey acceptance rate, survey completion rate and duration, and patient and guardian responses to questions related to the importance of screening and willingness to participate again. Analysis of overall and subscale checklist scores, as well as concordance between patient and guardian responses, was used to assess the difference in checklist responses.

Results: A total of 100 orthodontic patients and their legal guardians completed a modified version of the PSC in an average of 3-4 minutes. Overall, 14% patients had scores ≥15, indicating significant problems with emotion and behavior, compared with just 2% guardians. There was a significant difference between the mean PSC score for participants (8.22) and guardians (5.45) (P <0.01). Concordance of responses between participant and guardian was low to moderate for many factors on the PSC.

Conclusions: Screening for mental health in the orthodontic setting is easily implemented and can help identify patients who require additional support and intervention.

Introduction: This study aimed to analyze 3-dimensional (3D) tooth movement patterns during mandibular molar intrusion using finite element analysis, with a particular focus on the effects of temporary skeletal anchorage devices positioning and archwire constriction bend (ACB).

Methods: A 3D finite element model of the mandibular dentition was constructed. Intrusive forces of 2.0 N were applied to the archwire either mesial (M6 model) or distal (D6 model) to the first molar, whereas bilateral forces of 1.0 N were applied in the MD6 model. An ACB force of 1.0 N was applied lingually to both ends of the archwire. Tooth displacement, angulation change, and occlusal plane rotation were evaluated in 3 dimensions after 100 cycles of bone remodeling simulation, both with and without ACB during molar intrusion.

Results: Mandibular molars exhibited intrusion accompanied by mesial tipping in the M6 model, distal tipping in the D6 model, and minimal tipping in the MD6 model, regardless of the presence or absence of ACB. The mandibular central incisor (Mn1) demonstrated labioversion in the M6 model and linguoversion in both the D6 and MD6 models without ACB. With ACB applied, Mn1 consistently showed labioversion across all models, with the greatest intrusion and labioversion observed in the M6 model. The occlusal plane angle (OPA) rotated counterclockwise in all models except the M6 model with ACB, which exhibited a slight clockwise rotation. Mandibular posterior teeth showed buccal tipping in all models except the M6 model with ACB, where molars tipped lingually. ACB application reduced buccal tipping of the mandibular posterior teeth and mitigated counterclockwise rotation of the OPA, while promoting intrusion and labioversion of Mn1. Notably, OPA remained nearly stable during molar intrusion in the M6 model with ACB.

Conclusions: The appropriate force direction for mandibular molar intrusion, combined with ACB, facilitates controlled 3D tooth movement patterns.

Introduction: The clinical effectiveness of aligners is impacted by wear time (WT). This study aimed to objectively assess WT using microsensors and to evaluate whether patient awareness of monitoring affects WT.

Methods: This study was designed as a single-center, 2-arm, parallel-group randomized controlled trial in 43 adult patients. Orthodontic aligner treatment with an integrated microsensor was used to assess WT across 6 consecutive appointments, scheduled biweekly. Patients were randomly assigned to group 1 or 2 in a 1:1 ratio using an online randomization tool. Allocation was concealed using sequentially numbered opaque, sealed envelopes. Patients were either informed about the use of microsensors to register intraoral temperature (group 1, "unaware") or to assess patient compliance based on the temperature data (group 2, "aware"). Operators and patients could not be blinded to the treatment allocation. However, outcome assessment was blinded. A linear mixed model was used to estimate the effect of study arm on WT per wave, with age and sex included as explanatory variables.

Results: At follow-up, 3 patients discontinued intervention. Forty patients were included in the final analysis (male, 12; female, 28; mean age, 36.2 ± 14.2 years). The linear mixed model showed that awareness of monitoring (group 2) resulted in significantly higher WT, with an increase of 4.41 h/d (95% confidence interval, 1.88-6.93, P = 0.0011). WT declined significantly at later visits. No harms or adverse effects were reported or observed.

Conclusions: Awareness of being monitored improved patient compliance and can be used as an effective strategy to enhance WT during aligner therapy in adults.

Trial registration: German Clinical Trials Register (DRKS00029027).