Upper airway dimensions and the skeletal parameters in orthodontic patients who developed moderate-severe COVID-19 symptoms during the pandemic

BACKGROUND

Large airway dimensions are associated with a rapid decline in the lung function and a higher risk of hospitalization. Therefore, the airway dimensions of healthy subjects who tested positive for coronavirus disease 2019 (COVID-19) may be associated with the severity of COVID-19 symptoms.

OBJECTIVES

The objectives of this study were to measure the upper airway dimensions and the craniofacial skeletal parameters in patients who tested positive for COVID-19, to compare the upper airway dimensions and the craniofacial skeletal parameters between patients who developed no/mild symptoms and those with moderate-severe COVID-19 symptoms, and to assess any association of the skeletal relationships (anteroposterior (AP) and vertical) and the upper airway dimensions with the severity of COVID-19 symptoms in adult subjects.

MATERIAL AND METHODS

A total of 204 orthodontic patients who tested positive for COVID-19 were evaluated. Of these, only 137 met the inclusion criteria. The sample was further subdivided into 2 groups based on the severity of symptoms: cases (moderate-severe symptoms; n = 56); and controls (asymptomatic/ mild symptoms; n = 81). The upper airway dimensions and the skeletal parameters were measured on lateral cephalograms. The nonparametric Mann-Whitney U test was used to detect differences between the cases and the controls. Binary logistic regression analysis was used to evaluate the association between the studied variables and the severity of symptoms.

RESULTS

The cases had a reduced lower face height (LFH) and a reduced perpendicular distance from the hyoid bone to the line connecting the anteroinferior limit of the 3rd cervical vertebra (C3) and the retrognathion point (RGN) (HH1) as compared to the controls. Regression analysis revealed a significant association of LFH (p = 0.013), the vertical airway length (VAL) (p = 0.002) and HH1 (p = 0.021) with the severity of COVID-19 symptoms.

CONCLUSIONS

The types of malocclusion were similar in the cases and the controls. Patients with reduced LFH and VAL, and a superiorly positioned hyoid bone in relation to the mandible developed more severe COVID-19 symptoms.

The relationship between personality traits, pain perception and attitude toward orthodontic treatment

OBJECTIVE

To investigate the relationship between personality traits and a person's attitude toward orthodontic treatment and perception of pain during orthodontic treatment.

MATERIALS AND METHODS

The sample consisted of two groups: group 1 consisted of 200 untreated subjects (100 males, 100 females; average age, 21.50 +/- 3.35 years), and group 2 consisted of 200 treated subjects (100 males, 100 females; average age, 20.92 +/- 2.48 years). The instrument for data collection was a questionnaire that included assessment of patients' personality profiles, pain expectation for untreated subjects, pain experience for treated subjects, and attitudes toward orthodontic treatment.

RESULTS

Gender, treatment status, and personality traits did not affect subjects' average attitude toward orthodontic treatment, whereas gender was the only variable that affected subjects' average pain perception (P < .01). The average attitude score in subjects who experienced pain during orthodontic treatment was 5.06 +/- 1.43, compared to 4.32 +/- 1.35 for subjects who did not experience pain (P < .001). The average pain perception scores in treated subjects with previous knowledge of orthodontic treatment was 5.29 +/- 1.94, compared to 6.07 +/- 1.95 in subjects who did not have previous knowledge of orthodontic treatment (P < .01).

CONCLUSIONS

Personality traits did not affect attitude toward orthodontic treatment and pain perception/experience during orthodontic treatment. A more positive attitude was found in patients who experienced less pain during orthodontic treatment.

Factors affecting patient satisfaction after orthodontic treatment

The objective of this study was to identify factors that may affect patients' satisfaction with their dentition after orthodontic treatment. Fifty patients (20 males and 30 females; mean age 20.7 +/- 4.2 years) who successfully had finished fixed orthodontic treatment were included in the study. All subjects were treated with upper and lower fixed orthodontic appliances for an average duration of 19 +/- 4 months and were in retention stage (6-12 months) with upper Hawley and lower fixed bonded retainers. Dental Impact on Daily Living questionnaire was used to assess the effect of orthodontic treatment on daily living and satisfaction with the dentition in the study sample. The NEO Five Factor inventory was used to assess personality profiles in the study sample. Comparisons between groups were made using chi-square test. Personality traits were found to be correlated with patients' satisfaction with their dentition after orthodontic treatment. Higher neuroticism scores had a significant negative relationship with total satisfaction with the dentition (P < .05). Age, sex, and pretreatment orthodontic treatment need had no relationship with the patient's satisfaction. Patients treated nonextraction showed more dissatisfaction with their dentition (P < .05). In orthodontically treated patients, higher neuroticism scores were associated with lower levels of satisfaction with the dentition.