{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T15:00:35Z","timestamp":1767193235924,"version":"3.48.0"},"reference-count":44,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T00:00:00Z","timestamp":1755820800000},"content-version":"unspecified","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"the Shanghai Municipal Health Commission","award":["20214Y0123"],"award-info":[{"award-number":["20214Y0123"]}]},{"name":"the Construction Project of the \"Discipline Peak-Climbing Plan\u201d of Xinhua Hospital Affliated with Shanghai Jiao Tong UniversitySchool of Medicine","award":["XKPF2024B5002"],"award-info":[{"award-number":["XKPF2024B5002"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,7,18]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The primary objective was to determine peritraumatic distress among orthodontic patients during the COVID-19 lockdown. And the secondary objective was to determine the relationship between peritraumatic distress in relation to different appliance types.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Primary hospital between May and June 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Patients in the process of orthodontic treatment, able to read Mandarin online, provided informed consent for the use of the data recorded and completed the questionnaire within a reasonable time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>None.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The demographic information and orthodontic urgencies were collected using online questionnaires. The peritraumatic distress symptoms were assessed by the COVID-19 Peritraumatic Distress Index (CPDI). The temporomandibular joint (TMJ) pain was evaluated using a Visual Analogue Scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 480 participants were enrolled, including 331 with fixed appliances, 131 with clear aligners and 18 with removable appliances. For all participants, the median CPDI score was 12 (4, 19). Higher CPDI scores were observed in participants with urgency (14 (6, 21) vs 8 (2, 15), p&lt;0.001), participants aged \u226518 years (15 (6, 23) vs 8 (2, 15), p&lt;0.001) and participants with TMJ pain (15 (8, 24) vs 11 (3, 18), p&lt;0.001). Linear regression showed that age &gt;18 years (\u03b2=0.271, p&lt;0.001), TMJ pain (\u03b2=0.169, p&lt;0.001) and urgency (\u03b2=0.144, p=0.001) were independently associated with the mean CPDI score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The study suggested that during catastrophic events such as the COVID-19 lockdown, orthodontic urgencies may exacerbate patients\u2019 peritraumatic distress, especially among adult patients and those who suffer from TMJ pain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-095959","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T10:50:33Z","timestamp":1755859833000},"page":"e095959","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Peritraumatic distress and its relationship to appliance-related orthodontic emergencies in orthodontic patients during the COVID-19 lockdown in Shanghai, China: a cross-sectional study"],"prefix":"10.1136","volume":"15","author":[{"given":"Li\u2019an","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Stomatology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuhsin","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuting","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wa","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianyong","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8120-9882","authenticated-orcid":false,"given":"Xin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,8,22]]},"reference":[{"key":"2025123106472999000_15.8.e095959.1","doi-asserted-by":"crossref","first-page":"45","DOI":"10.14219\/jada.archive.2011.0027","article-title":"Medical emergencies in a dental office: inhalation and ingestion of orthodontic objects","volume":"142","author":"Bilder","year":"2011","journal-title":"J Am Dent Assoc"},{"key":"2025123106472999000_15.8.e095959.2","doi-asserted-by":"crossref","DOI":"10.1186\/s40510-020-00310-y","article-title":"Management of orthodontic emergencies during 2019-NCOV","volume":"21","author":"Caprioglio","year":"2020","journal-title":"Prog Orthod"},{"key":"2025123106472999000_15.8.e095959.3","doi-asserted-by":"crossref","first-page":"131","DOI":"10.12968\/denu.2015.42.2.131","article-title":"Emergencies in orthodontics. 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