Francesca Pazzaglia

Introduction: Although the superiority of clear aligners over multi-bracket appliances in keeping gingiva healthy has been suggested, the possible benefits of one aligner design over another have not yet been investigated, especially with regard to the vestibular edge. Objective: The aim of this study was to measure several periodontal indexes in adolescents undergoing orthodontic treatment with aligners, comparing two different types of rim. Methods: The study involved 43 patients aged between 14 and 18 years. The periodontal health was assessed using plaque index (PI), gingival index (GI), and gingival bleeding index (GBI), at the start of the treatment with aligners (T0), with a vestibular rim (VR) reaching up to 3 mm beyond the gingival margin. Three months later (T1), aligners were set to obtain a juxtagingival rim (JR) on the second quadrant and VR on the first quadrant. The periodontal indexes were measured again, both at T1 and then three months later (T2). Results: Intra-quadrant comparisons revealed a statistically significant worsening of the periodontal indexes only for the second quadrant (p<0.05), at T1 (GI), and especially at T2 (PI, GI, GBI), while no statistically significant changes were found for the first quadrant. Conclusions: More severe mechanical irritation, especially during insertion and removal of the aligner, can explain the worsening inflammatory indexes with the JR. In addition, the pressure exerted by the JR on the gingival sulcus seemed to facilitate plaque deposition, whereas the VR had a protective effect, reducing the risk of mechanical trauma.

Background and Objectives Navigational skills display clear signs of decline with increasing age, especially in pathological aging. Therefore, navigability—the extent to which destinations can be reached with reasonable effort and time—should be considered in residential care home design. We aimed to develop a scale assessing environmental features (i.e., indoor visual differentiation, signage, and layout) for navigability in residential care homes: the Residential Care Home Navigability (RCHN) scale. To this end, we examined whether navigability and its factors were associated with a sense of direction within the residential care homes to different degrees for older adult residents, caregivers, and staff. The relationship between navigability and residential satisfaction was also considered. Research Design and Methods A sample of 523 participants (230 residents, 126 family caregivers, and 167 staff members) responded to the RCHN, assessed their sense of orientation and general satisfaction, and performed a pointing task. Results Results confirmed the RCHN scale’s 3-level factor structure, good reliability, and validity. A subjective sense of direction, but not pointing task performance, was associated with navigability and its factors. In particular, visual differentiation is positively associated with a sense of direction regardless of group, whereas signage and layout contributed to a better experience of a sense of direction, especially among older residents. Navigability was not related to residents’ satisfaction. Discussion and Implications Navigability supports perceived orientation in residential care homes, especially for older residents. Moreover, the RCHN is a reliable tool for the assessment of RCHN, with important implications for minimizing spatial disorientation through environmental interventions.