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.

Evaluation of online game-based and traditional teaching methods in cephalometric landmarks identifications.

INTRODUCTION: Orthodontic students need to accurately identify cephalometric landmarks to perform cephalometric measurements, which is the prerequisite to proper orthodontic diagnosis and treatment. To provide insights into future cephalometric education, we compared the performance of different methods that can be used in tracing practice, including a novel online game-based method, the cephalometric training module of Uceph (version 948; Uceph, Chengdu, China). METHODS: A total of 45 first-year orthodontic graduate students were divided into 3 groups to receive different kinds of cephalometric training (module group, practicing with the cephalometric training module of Uceph; teaching group, practicing under the teacher's guidance; self-training group, practicing with traced cephalogram as reference). After training with 4 cephalograms, students completed 2 test samples in which the tracing accuracy and time were recorded and a questionnaire concerning their feelings. RESULTS: Both the teaching and module group offered performance advantages on increasing the tracing accuracy and speed of students. The module group provided a better performance on improving tracing accuracy than the teaching group. Students in the module group showed improved concentration, interest, satisfaction toward the teaching method and confidence of correctly identifying landmarks than self-training group, and enhanced interest than students in the teaching group. CONCLUSIONS: The shooting game-based cephalometric training module of Uceph has demonstrated better performance than traditional face-to-face teaching and self-learning, proving to be a viable online tool to train cephalometric tracing, especially during the coronavirus disease 2019 pandemic.