Commentary

ObjectiveEarly orthodontic treatment with cost reimbursement within the framework of the German statutory health insurance (GKV) is only possible for a strictly defined malocclusion group as defined by the orthodontic indication groups (KIG). It is not yet clear whether the application of the KIG criteria and corresponding successful early orthodontic interventions result in no or significantly less need for treatment in the late mixed dentition or in the permanent dentition. This study therefore investigated short-term intervention stability from a 10-year-period.Materials and methodsBetween 2009 and 2019, n = 661 patients were diagnosed with indication groups D (increased overjet), M (reversed overjet), B (scissors bite), K (crossbite), or P (lack of space) including orthodontic treatment need. N = 70 patients (35 female, 35 male) met the inclusion criteria of the study and had received early orthodontic treatment with a mean duration of 15.44 ± 2.20 months. Orthodontic indication groups (KIG) were evaluated at the beginning (aged 7.99 ± 1.44 years) and the end of early orthodontic treatment (aged 9.63 ± 1.49 years) and at a voluntary control or the beginning of additional orthodontic treatment (aged 11.85 ± 1.72 years). The evaluation included established procedures for categorization of orthodontic indication groups and their respective classification. Statistics included Chi-square test and Kendall´s tau-b. The level of significance was set at p < 0.05.ResultsThe results showed reversed overjet in 44.3% and crossbites in 41.4% of the patients as most common indication for early orthodontic treatment. At the end of early orthodontic treatment, no orthodontic treatment need was present in 87.1%. At the late mixed dentition, the treatment result of early orthodontic treatment was stable in N = 61 out of N = 70 patients.ConclusionsThe results of our study confirm preventive benefits of early orthodontic treatment, especially in patients with transverse anomalies or reversed overjet.Clinical relevanceA short-term orthodontic intervention with correct indication during primary or early mixed dentition can prevent or reduce further treatment need during late mixed or permanent dentition, and should therefore not be postponed.

Incisor trauma in an adolescent Arab population: Prevalence, severity, and occlusal risk factors

To test whether early headgear (HG) treatment and space conditions in the dental arch affect the eruption pathway of the maxillary canines in young children with mixed dentition. Data from two randomized controlled trials studying the effects of early HG treatment were pooled, yielding a study sample comprising 99 children (38 girls and 61 boys, mean age 7.6 years) with Angle Class II occlusion. Fifty-one children were treated with HG and 48 children served as an untreated control group (CG). Digital 3D models and panoramic radiographs were taken before (T0) and after (T1) treatment, and changes in the maxillary canine eruption angle and interdental spaces were measured at T0 and T1. A paired samples t-test was used to assess changes in maxillary canine angulation, and an independent samples t-test was used to evaluate the effect of HG treatment on spacing in the dental arch. Associations between intra-arch space conditions and changes in maxillary canine angulation were estimated with linear regression models. The eruption pattern of the permanent canine was significantly more vertical in the HG group than in the CG. The linear regression models showed a statistically significant association among the intercanine distance, crowding in the anterior part of the maxilla, and changes in the maxillary canine eruption angle. The maxillary canine eruption pattern changed significantly more to a vertical direction in spaced dental arches than in crowded dental arches in the HG group. This study shows that early HG treatment in children with Angle Class II occlusion may change the eruption pattern of permanent maxillary canines to a more vertical direction. This change appears to be related to space conditions in the maxillary arch, especially in the intercanine region, with more effect in children with spaced dental arches than in children with crowded dental arches.

Concerted effort needed to clarify complex issues for general public

Benefit of early Class II treatment: Progress report of a two-phase randomized clinical trial

The aim of this study was to assess the mean overjet in school-going Libyan children and to examine the relationship between increased overjet and permanent incisor's trauma. This study is a part of a cross-sectional investigation of aspects of dental health of 2015 school going Libyan children aged between 6 and 16 years old of both genders from both rural and urban areas. Overjet was measured as the horizontal distance in millimetres between the upper and lower incisors. Trauma to permanent incisors was assessed according to Elli's Classification. SPSS version 20.0 for percentages was used for statistical analysis. The relationship between increased overjet and incisor trauma was tested using the Chi-square test at 0.05 significance level. The overjet measurement ranged from -2 mm to 8 mm with the mean overjet of 3.062 (1.23, SD). The prevalence of incisor trauma was statistically significantly higher in children with increased overjet (P < 0.0001). The average mean overjet value in Libyan children is between 2 mm and 3 mm and below or above these values, considered decreased or increased, respectively. Traumatic injuries to permanent incisors significantly increased with increased overjet.

Studies of therapist adherence in relation to treatment outcome have produced mixed results. The aim of the present study was to investigate change in therapist adherence to cognitive-behavioral therapy (CBT) for bulimia nervosa over time, and to investigate the relationship between adherence and client outcome in early, middle, and late phases of treatment. Thirty-six clients received the focused form of "enhanced" CBT (CBT-E) for bulimia nervosa. Trained observers rated audiotapes of 92 full-length therapy sessions from early (Session 3), middle (Session 11), and late phases (Session 20) of treatment using the Cognitive-Behavioral Therapy Treatment Protocol Adherence Scale. Change in adherence across the 3 treatment phases was examined using multilevel analysis. The relationship between early, middle, and late adherence levels and end-of-treatment binging frequency was examined using multilevel Poisson regression analysis. Adherence decreased significantly over the course of treatment. Higher levels of therapist adherence in early and middle phases of treatment were associated with reduced binging frequency, whereas higher levels of adherence measured late in treatment was not. Results indicate that therapists' adherence to the CBT-E treatment protocol decreases over time and that high levels of protocol adherence in early and middle phases of treatment are more important for positive client outcomes than high levels of adherence in the end of treatment. (PsycINFO Database Record

Knowledge about typical change patterns of psychotherapy patients can help to improve treatment guidelines for psychological disorders. Recent studies showed that it is possible to identify several patient subgroups with regard to their early change pattern. However, although focusing on the early phase of treatment, change patterns in later stages have hardly been investigated yet. In this study, Growth Mixture Modelling was used to identify latent change classes in different phases of therapy in a naturalistic sample of 1229 psychotherapy outpatients. Furthermore, this paper inquired into the relation between the change patterns in different phases as well as their predictive power for therapy length and outcome. Results revealed different change patterns for the three investigated phases. While in an early treatment phase, (sessions one-six) five different change patterns could be identified: the number of change classes decreased considerably over time, resulting in three patterns in the second (sessions 7-12) and two in the third phase (sessions 13-18). In each phase, by far, the biggest class showed a pattern of good progress with small/no further improvements. Most change in patients' progress estimates took place in an early phase of the treatment and levelled out on a relatively high level in later phases of the treatment. Substantial improvements were still present in later phases of the treatment but occurred less frequent than in early stages. Continuous outcome monitoring and feedback systems should integrate progress measures to monitor patients progress especially in the early phase of the treatment and feed the so gained information back to therapists.

This study aimed to assess the different needs of patients with breast cancer and their families in online health communities at different treatment phases using a Latent Dirichlet Allocation (LDA) model. Using Python, breast cancer-related posts were collected from two online health communities: patient-to-patient and patient-to-doctor. After data cleaning, eligible posts were categorized based on the treatment phase. Subsequently, an LDA model identifying the distinct need-related topics for each phase of treatment, including data preprocessing and LDA topic modeling, was established. Additionally, the demographic and interactive features of the posts were manually analyzed. We collected 84,043 posts, of which 9504 posts were included after data cleaning. Early diagnosis and rehabilitation treatment phases had the highest and lowest number of posts, respectively. LDA identified 11 topics: three in the initial diagnosis phase and two in each of the remaining treatment phases. The topics included disease outcomes, diagnosis analysis, treatment information, and emotional support in the initial diagnosis phase; surgical options and outcomes, postoperative care, and treatment planning in the perioperative treatment phase; treatment options and costs, side effects management, and disease prognosis assessment in the non-operative treatment phase; diagnosis and treatment options, disease prognosis, and emotional support in the relapse and metastasis treatment phase; and follow-up and recurrence concerns, physical symptoms, and lifestyle adjustments in the rehabilitation treatment phase. The needs of patients with breast cancer and their families differ across various phases of cancer therapy. Therefore, specific information or emotional assistance should be tailored to each phase of treatment based on the unique needs of patients and their families.

Tuberculosis is an infectious disease caused by the bacteria Mycobacterium tuberculosis. Tuberculosis can be treated by taking Anti-Tuberculosis Drugs (OAT). Tuberculosis treatment is divided into two phases, namely the initial phase and the advanced phase. Side effects of OAT use can cause hematological abnormalities in the blood such as anemia. The purpose of this study was to determine the comparison of erythrocytes in tuberculosis patients undergoing initial and advanced phase treatment as monitoring of anemia risk. This type of research was a comparative study. The research subjects were 30 subjects undergoing initial phase treatment and 30 subjects in advanced phase treatment obtained using the total sampling method. The results of this study obtained a normal erythrocyte index in the early phase of 21 (70%) subjects, normocytic hypochromic 6 (20%) subjects, and microcytic hypochromic 3 (10%) subjects. In comparison, the normal erythrocyte index in the advanced phase was 26 (87%) subjects and microcytic hypochromic 4 (13%) subjects. From the results of the statistical test study using the Mann-Whitney test, the Asymp. Sig. (2 tailed) value was obtained 0.000 (&lt;0.05), which indicates that there is a comparison between the results of the erythrocyte index examination in TB patients undergoing early and advanced phase treatment so that in this study, the hypothesis H is accepted and Ho is rejected. This study concludes that more people experience anemia in the early phase of treatment than in the advanced phase of treatment.

Activator versus cervical headgear: Superimpositional cephalometric comparison

Space supervision and guidance of eruption in management of lower transitional crowding: A non-extraction approach

Purpose: The purpose of this study was to investigate the precise effects of a headgear (HG) on the maxillary first premolar (U4), maxillary second premolar (U5), and maxillary first molar (U6). Materials and methods: The participants were divided into two groups: HG group and control group. The HG group consisted of 25 patients who were treated with an HG and maxillary lateral expansion. The control group consisted of 21 patients who received maxillary lateral expansion treatment. Movements of U4, U5, and U6 were measured using cone-beam computed tomography (CBCT). The mesiodistal positions of U4, U5, and U6 were assessed based on the vertical reference plane (VRP) defined by the landmarks of the maxilla. Results: Distal movement of U4, U5, and U6 was observed in the HG group, while mesial movement of U4, U5, and U6 was observed in the control group. Moreover, the positions of U4 and U5 were more distal than that of U6 in the HG group, while the positions of U4 and U5 were less mesial than that of U6 in the control group. The amount of distal movement of U4 and U5 was strongly correlated with that of U6 in the HG group. Conclusions: Simultaneous distal movement of U4 and U5 can be achieved with U6 distal movement using an HG in the early mixed dentition period. Moreover, the amount of distal movement of U4 and U5 was larger than that of U6. Hence, early orthodontic treatment using HG appears to be effective for correcting Class II malocclusion.

BackgroundOne of the main limitations of radiation therapy is the resistance of tumor cells. This study aimed at evaluating the relationship between the expression of epidermal growth factor receptor (EGFR) and echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) and tumor radiosensitivity in patients with non-small cell lung cancer.MethodsMedical case files, pathological results for EGFR and EML4-ALK, and computerized tomography scans of patients with NSCLC treated with thoracic radiation therapy were analyzed.ResultsThe sample size was 101 patients with mean age 58.43 ± 9.89 years. Statistically significant differences were observed in the mean reduction of long tumor diameter during the early treatment phase in EGFR-positive versus EGFR-negative patients (p value = 0.04) and in short tumor diameter during the late treatment phase in EGFR-positive versus EGFR-negative patients (p value = 0.04).ConclusionPatients with overexpression of EGFR mutations are more radiosensitive during the early treatment phase, and EML4-ALK mutations were less radiosensitive regardless of phases.

The aim of this study was to examine the prevalence of comorbid mental disorders as well as the extent of psychosocial distress in patients with intracranial tumours and their partners during the early treatment phase. Moreover, we aimed to identify which events are experienced as most distressing in the context of the early diagnosis of brain cancer by patients and spouses. Structured clinical interviews for DSM-IV (SCID-IV) were conducted with 26 patients and their partners after the first neurosurgical treatment within the first 3 months after the detection of a brain tumour. Screening measures (NCCN distress thermometer, HADS, IES-R) were used to assess the extent of psychosocial distress as well as anxiety, depression and traumatic stress responses. Distressing experiences were assessed via a structured questionnaire and interview. Thirty-eight per cent of the patients and 47% of the partners suffered from a psychiatric disorder. Most frequent diagnoses were adjustment disorder and acute stress disorder. The majority of the participants suffered from elevated psychosocial distress. Partners were equally or even more affected than the patients. For the patients, the experience most frequently described as distressing was the first detection of the tumour. The majority of the partners reported to be distressed by the fear of surgery outcomes. This study revealed that during this very first treatment phase, both brain tumour patients and their spouses show a high prevalence of comorbid mental disorders and psychosocial distress. The findings suggest that research and clinical efforts are needed to address the psychosocial concerns of these populations.