Objective: To evaluate the condylar changes through cone-beam computed tomography (CBCT) images in patients treated with Twin-Block functional appliance. Materials and Methods: In this retrospective study, CBCT images of 30 patients who were treated with the Twin-Block appliance were used. Mandible was segmented and pretreatment and posttreatment (T0 and T1) condylar volume was compared. The angle between sella-nasion-Point A (SNA), angle between sella-nasion-Point B (SNB), angle between Point A-nasion-Point B (ANB), midfacial length (Co-A), mandibular length (Co-Gn), and the distances from right condylion to left condylion (Co R -Co L ) were also measured on three-dimensional images. Differences were analyzed with Wilcoxon signed rank tests, and Mann-Whitney U-tests were used to compare the scores of male and female participants. Significance was set at P , .05. Results: In this study, a decrease in SNA and ANB (P , .05 and P , .01, respectively) and an increase in SNB (P , .01) were found. Additionally, Co R -Co L , Co-Gn, and condylar volume increased at both the left and right sides (P , .01). However, increase at Co-A was not statistically significant (P . .05). Comparison of differences by sex was not statistically significant for all measurements (P . .05). Conclusion: Twin-Block appliance increases condylar volume, mandibular length, and intercondylar distance by stimulating growth of condyle in an upward and backward direction.

ObjectiveTo determine the changes in dental anxiety, state anxiety, and trait anxiety levels of patients and their parents after 3 months of active orthodontic treatment.MethodsWe evaluated 120 patients and one parent of each patient. State Anxiety (STAI-S), Trait Anxiety (STAI-T), and Corah's Dental Anxiety Scale (DAS) were administered before orthodontic treatment (T1) and after 3 months of treatment (T2). Differences in scores between T1 and T2 were compared using paired-sample t-tests and the relationship between the scores of the DAS and the STAI were analyzed using a bivariate two-tailed Pearson correlation test.ResultsDental anxiety and state anxiety levels decreased among the patients after adjustment to orthodontic treatment (p < 0.001). However, 3 months of treatment was not sufficient to decrease the anxiety levels of parents (p > 0.05). Patient trait anxiety affected patient state anxiety and dental anxiety (p < 0.01). Additionally, a significant correlation was found between patient dental anxiety and parent dental anxiety (p < 0.05).ConclusionsDental anxiety and state anxiety levels decrease after patients become familiar with their orthodontist and they became accustomed to orthodontic treatment. However, 3 months is not a sufficient length of time to decrease parental anxiety levels.

The aim of this study was to evaluate three-dimensional (3D) effects of Twin-block functional appliance (TB) on the pharyngeal airway by using cone beam computed tomography (CBCT). A total of 30 patients (14 females, 16 males; mean age 12.50 ± 1.23 and 12.83 ± 1.17 years, respectively) with skeletal Class II malocclusion were included in this study and were treated with TB. On the pretreatment (T1) and posttreatment (T2) CBCT scans, volumetric changes in the pharyngeal airway; SNA, SNB, and ANB angles; and bilateral effective mandibular (Co-Gn) and midfacial length (Co-A) were also evaluated. The statistical differences were accessed by Wilcoxon signed-rank tests, and Mann-Whitney U tests were used to analyze the scores of male and female subjects. In this study, an increase was observed in SNB and Co-Gn ( p < 0.01 ) while a decrease in ANB and SNA ( p < 0.01 and p < 0.05 , respectively) was found. However, increase in midfacial length was not statistically significant ( p > 0.05 ). In the evaluation of volumetric pharyngeal airway changes, statistically significant increases ( p < 0.01 ) in the upper and lower division and total airway volume were determined. Gender differences were insignificant for all measurements ( p > 0.05 ). Volumetric changes in the pharyngeal airway after functional therapy can be successfully evaluated by CBCT images. The anterior repositioning of the mandible by TB increases the mandibular length and pharyngeal airway volume in patients with retrognathic mandible.

ObjectiveTo assess the position and movements of the hyoid bone during deglutition in patients with open bite.MethodsThirty-six subjects were divided into 2 groups according to the presence of anterior open bite. The open bite group (OBG) and control group each comprised 18 patients with a mean overbite of -4.9 ± 1.9 mm and 1.9 ± 0.7 mm. The position of the hyoid bone during the 4 stages of deglutition was evaluated by measuring vertical and horizontal movement of the bone.ResultsInteractions of group and stage showed no significant effect on the measurements (p > 0.05). However, when group and stage were evaluated individually, they showed significant effects on the measurements (p < 0.001). In OBG, the hyoid bone was more inferiorly and posteriorly positioned, and this position continued during the deglutition stages.ConclusionsThe hyoid bone reaches the maximum anterior position at the oral stage and maximum superior position at the pharyngeal stage during deglutition. Open bite does not change the displacement pattern of the bone during deglutition. The hyoid bone is positioned more inferiorly and posteriorly in patients with open bite because of released tension on the suprahyoid muscles.

In this case report multidisciplinary treatment of a 16 years old male patient was presented. In the radiographic evaluation, it was determined that maxillary right lateral incisor was congenital missing, canine was impacted at the same side, and left central incisor was dilacerated and impacted. In the intraoral examination, it was observed that space of the left central incisor was closed mildly by the migration of the neighbor teeth, there was a midline deviation, and left lateral incisor had a narrow mesio-distal width. Dilacerated central incisor was extracted and a button was attached on the impacted canine by a surgical approach. Impacted canine was erupted, midline was corrected, and left lateral incisor was moved to the place of the extracted central incisor with orthodontic treatment. After orthodontic treatment, central incisor form was given to the left lateral incisor by applying a porcelain crown and lateral incisor form was given to the canines by drilling the cusp tips with diamond bur. At the end of treatment, the patient attained a functional occlusion and esthetic appearance.

This study was aimed at proposing a three-dimensional (3D) evaluation method for the soft tissue effects of Twin Block (TB) functional appliance therapy by using cone beam computed tomography (CBCT) images. In this retrospective study, a total of 60 pre- and posttreatment (T0 and T1) CBCT images of Class II patients with mandibular retrognathia treated with a TB appliance were used. Volumetric and linear soft tissue changes were evaluated quantitatively with 3D measurements and qualitatively with color mapping visual. Linear (NV-A and NV-Pog) and angular (SNA, SNB, and ANB) skeletal changes were also measured on 3D images. The Wilcoxon signed-rank test was used to compare statistical differences, and the scores of male and female participant differences were observed with the Mann–Whitney U test. In this study, a decrease was observed in SNA ( p < 0.05 ), ANB ( p < 0.01 ), and NV-Pog ( p < 0.05 ) while an increase in SNB ( p < 0.01 ) was found. However, decrease in NV-A distance was not statistically significant ( p > 0.05 ). As a result of the evaluation of soft tissue changes, while the anterior reposition of the lower lip, soft tissue pogonion, and soft tissue gnathion was found to be significant ( p < 0.01 , p < 0.01 , and p < 0.05 , respectively), the upper lip and subnasale repositions were not statistically significant ( p > 0.05 ). 3D soft tissue changes after TB therapy can be evaluated quantitatively and qualitatively by using CBCT images. Anterior repositioning of the mandible with functional therapy also provides improvement in soft tissue profile, especially in the lower facial region.

Aim: This study aims to determine the anxiety levels of orthodontic patients related to the coronavirus pandemic and to evaluate the effects of quarantine on orthodontic appointments and orthodontic treatment. Methodology: This cross-sectional study was conducted as an online survey with the participation of patients who were actively receiving orthodontic treatment. A total of 281 orthodontic patients (191 [67.97%] females and 90 [32.03%] males) participated in the survey. The questionnaire consisted of five sections that included questions about demographics, the COVID-19 pandemic, and the patients’ orthodontic status. Anxiety levels were measured using Turkish versions of the Beck Anxiety Inventory and the Corah’s Dental Anxiety Scale. Descriptive statistics, the Kolmogorov-Smirnov and Shapiro-Wilk normality tests, the Pearson correlation test, and the Mann Whitney U test were used for statistical analysis. Results: Regarding patients’ perceptions of the pandemic, 251 patients (89.32%) reported that they were sufficiently informed about COVID-19. The main concern about the effects of quarantine on orthodontic treatment was the delay of orthodontic treatment at a rate of 58.36% (164/281). This study found that 36% (103/281) of the participants exhibited anxiety symptoms. The prevalence of dental anxiety specifically was 33% (95/281). Our study results reveal a significant relationship between dental anxiety and general anxiety, which indicates that dentally anxious people tend to also be generally anxious. Females had significantly higher anxiety levels than males (p <0.001). Conclusion: The coronavirus pandemic and quarantine seem to impact orthodontic patients’ anxiety. Delay of treatment was the primary concern of patients during the COVID-19 pandemic. Female patients were more anxious than males.   How to cite this article: Yıldırım E, Adıgüzel A, Karaçay Ş. Assessment of the anxiety levels of orthodontic patients during the COVID-19 pandemic. Int Dent Res 2021;11(Suppl.1):73-9. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.12   Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

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