Introduction: Coronavirus disease 2019 (COVID-19) is a contagious disease caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2). It emerged as a global pandemic in early 2020, affecting more than 200 countries and territories. The infection is highly contagious, with disease transmission reported from asymptomatic carriers, including children. It spreads through person-to-person contact via aerosol and droplets. The practice of social distancing-maintaining a distance of 1-2 m or 6 ft-between people has been recommended widely to slow or halt the spread. In orthodontics, this distance is difficult to maintain, which places orthodontists at a high risk of acquiring and transmitting the infection. The objective of this review is to report to orthodontists on the emergence, epidemiology, risks, and precautions during the disease crisis. This review should help increase awareness, reinforce infection control, and prevent cross-transmission within the orthodontic facility. Methods: A comprehensive literature review of English and non-English articles was performed in March 2020 using COVID-19 Open Research Dataset (CORD-19 2020), PubMed, MEDLINE, Scopus, and Google Scholar to search for infection control and disease transmission in orthodontics. Results: This review emphasizes minimizing aerosol production and reinforcing strict infection control measures. Compliance with the highest level of personal protection and restriction of treatment to emergency cases is recommended during the outbreak. Surface disinfection, adequate ventilation, and decontamination of instruments and supplies following the guidelines are required. Conclusions: Reinforcing strict infection control measures and minimizing personal contact and aerosol production are keys to prevent contamination within orthodontic settings. Although no cases of COVID-19 cross-transmission within a dental facility have been reported, the risk exists, and the disease is still emerging. Further studies are required.

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Background The aim of this study was to evaluate the impact of clinical closure and delayed orthodontic care delivery in terms of types of emergencies, pain intensity, and disability experienced by orthodontic patients during the COVID-19 pandemic. Methods This was a descriptive cross-sectional study using an electronic survey that was distributed to orthodontic patients who were not seen in clinic for 2 to 3 months due to clinic closure. The survey included demographics, types of orthodontic emergencies, Numerical Rating Scale, and Manchester Orofacial Pain Disability Scale. Results There were a total of 150 respondents with mean age of 20 years; 57.33% were female patients. The most common reported orthodontic emergencies were poking wire 30%, debonded brackets 27.3%, bad odor 24%, sharp ligature tie 20%, inflammation and bleeding 9.3%, ulcer 8.7%, and problematic palatal device 8%. Pain was significantly associated with poking wire ( P < 0.001), sharp ligature tie ( P < 0.01), ulcer ( P < 0.05), and problematic palatal device ( P < 0.01). Poking wire, sharp ligature tie, and problematic palatal device were found to be significant predictors of pain intensity. Median pain intensity was 3, similar to the median disability score. There was a significant association between pain intensity and disability score ( P < 0.01). With each unit increase in pain intensity, the disability score increased by 1.18. Conclusions Delay in receiving orthodontic care could result in an orthodontic emergency, yet pain and disability resulting from these events are minimal. The decision to resume clinical service should be evaluated considering risks and benefits in case of the pandemic. Further studies are required.

Different occlusal features can affect the number, the position and the magnitude of teeth contacts. 1,2 In turn, the contacts between the teeth can influence different aspects of both static and dynamic dental occlusion. 3 Measurement of occlusal balance and tooth contact is often unreliable. Qualitative occlusal measures are habitually used because they are inexpensive and feasible. They encompass articulating paper, articulating silk, articulating film, metallic shim stock film and high spot indicators. 4,5 The main limitations of the use

Heat shock protein 47 (HSP47) is a collagen-specific molecular chaperone that helps the molecular maturation of various types of collagens. A close association between increased expression of HSP47 and the excessive accumulation of collagens is found in various human and experimental fibrotic diseases. Increased levels of HSP47 in fibrotic diseases are thought to assist in the increased assembly of procollagen, and thereby contribute to the excessive deposition of collagens in fibrotic areas. Currently, there is not a good universal histological marker to identify collagen-producing cells. Identifying phenotypically altered collagen-producing cells is essential for the development of cell-based therapies to reduce the progression of fibrotic diseases. Since HSP47 has a single substrate, which is collagen, the HSP47 cellular expression provides a novel universal biomarker to identify phenotypically altered collagen-producing cells during wound healing and fibrosis. In this brief article, we explained why HSP47 could be used as a universal marker for identifying phenotypically altered collagen-producing cells.

A BSTRACT Objective: To provide dentists and dental team with insights concerning risk and precautions during COVID-19 outbreak crisis as it would help in decision making among dental community. Materials and Methods: A comprehensive review of all English and non-English articles was carried out using the available CORD-19 dataset with MEDLINE via PubMed, Cochrane library, Google Scholar and ScienceDirect databases. The study included all articles that matched the search terms. Results: A total of 353 were retrieved, of which 13 articles were reviewed comprehensively. Studies included in this systematic review emphasized on reinforcing strict infection control measures and minimizing human-to-human contact during COVID-19 outbreak. All surfaces in operatory room including waiting area need adequate ventilation and disinfection. Dental patients need to be screened using COVID-19 targeted questions as well as measuring their body temperature. Restricting dental treatments to only emergency cases and rescheduling all routine visits is advised with careful attention to minimize aerosol generation and following highest level of personal protection when treating COVID-19 confirmed cases. Dental offices need to establish a standard protocol of case reporting and referral to other well-prepared facilities. Lastly, online platforms are beneficial tools in providing psychological support to distressed dentists, dental team and dental patients and educating public during COVID-19 crisis. Conclusion: Dental team need to follow strict infection control measures and minimize aerosol generation during COVID-19 outbreak. It is the responsibility of dental care workers to keep themselves informed and ensure safety and control transmission within dental facilities. Further research is required.

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