OBJECTIVE: To evaluate the difference in the oral hygiene status of participants with fixed appliances between a 'weekly WhatsApp application oral hygiene message reminders' trial group and a 'verbal instructions' contro...OBJECTIVE: To evaluate the difference in the oral hygiene status of participants with fixed appliances between a 'weekly WhatsApp application oral hygiene message reminders' trial group and a 'verbal instructions' control group over a follow-up duration of 12 weeks. DESIGN: Prospective, single-blind, randomised controlled trial with an allocation ratio of 1:1 over a 12-week follow-up. SETTING: Government Orthodontic Unit, Raub Dental Clinic, Raub, Pahang, Ministry of Health, Malaysia. PARTICIPANTS: A total of 40 patients aged 13-25 years undergoing orthodontic treatment with fixed appliances. METHODS: The 40 patients were recruited and randomly allocated to a control (n = 20) or trial group (n = 20). Participants in the trial group received weekly oral hygiene reminders via the WhatsApp application for 12 weeks, while the control group did not receive any reminders. The primary outcome was oral hygiene, which was measured by the single-blinded examiner using the Orthodontic Plaque Index (OPI) at three orthodontic check-ups: baseline (T0); 6-week follow-up (T1); and 12-week follow-up (T2). RESULTS: The mean age of participants was 17 years, and 80% were female. At the end of the 12-week follow-up, improvements in OPI scores were observed, regardless of the intervention. At T2, the median OPI score for the trial group (n = 20) was 0 (interquartile range [IQR = 0) while that for the control group (n = 20) was 2 (IQR = 0). A Mann-Whitney test revealed a statistically significant difference ( <0.05), with effect size = 0.87 between the control and trial groups, whereby the latter witnessed marked improvement in OPI throughout the visits. No harms or adverse effects occurred in this trial. CONCLUSION: The short-term findings demonstrated that participants receiving regular reminders of oral hygiene via WhatsApp messaging had a significant improvement in oral hygiene compared to the control group.
OBJECTIVE: To evaluate the prevalence of bullying among schoolchildren and to study the correlation between bullying and a specific type of malocclusion, self-esteem, oral health-related quality of life (OHRQoL), the nee...OBJECTIVE: To evaluate the prevalence of bullying among schoolchildren and to study the correlation between bullying and a specific type of malocclusion, self-esteem, oral health-related quality of life (OHRQoL), the need for orthodontic treatment and socioeconomic status. DESIGN: A cross-sectional study. SETTING: Low, middle and high socioeconomic group schools in the same educational district in Cairo, Egypt. PARTICIPANTS: A total of 324 Egyptian schoolchildren aged 11-14 years. METHODS: Validated questionnaires were used to assess self-reported bullying frequency and intensity, self-esteem and OHRQoL. The Index of Orthodontic Treatment Need (IOTN) was used to assess the orthodontic treatment need and the participants' occlusion was classified according to the British Standard Incisors (BSI) classification. RESULTS: Bullying was found to be prevalent in 61.7% of the sample. Regression analysis revealed that participants with a Class II division 1 incisor relationship had the highest odds ratio (OR) for predicting bullying (OR = 1.86, 95% confidence interval [CI] = 1.38-2.15). Being bullied was significantly associated with lower self-esteem (OR = 0.47, 95% CI = 0.13-0.78), worse OHRQoL (OR = 2.73, 95% CI = 1.95-3.15) and a high need for orthodontic treatment, as determined by the IOTN Dental Health Component score (OR = 1.33, 95% CI = 1.05-1.95) and IOTN Aesthetic Component score (OR = 1.52, 95% CI = 1.12-1.88). Moreover, participants in high and middle socioeconomic groups had a lower OR for predicting bullying than those in the low socioeconomic group (OR = 0.27, 95% CI = 0.13-0.54). CONCLUSION: The bullying prevalence among Egyptian schoolchildren aged 11-14 years was very high. The prevalence of bullying was higher in schoolchildren with higher orthodontic treatment need and Class II division 1 incisor relationship. Bullying was correlated to poor self-esteem as well as poor OHRQoL. In addition, low socioeconomic status was found to be a potential predictor for bullying.
OBJECTIVE: To evaluate the knowledge and preference of patients treated at a Dental School in Jaraguá do Sul, Brazil, about using aligners and the reasons for choosing this device as a treatment option. DESIGN: A cross-s...OBJECTIVE: To evaluate the knowledge and preference of patients treated at a Dental School in Jaraguá do Sul, Brazil, about using aligners and the reasons for choosing this device as a treatment option. DESIGN: A cross-sectional study. PARTICIPANTS: A total of 82 participants aged 18-45 years recruited at a screening clinic. METHODS: A questionnaire was completed in person using a tablet with digital forms. RESULTS: Almost half of the participants (49%) knew about aligners; 40% were aged 18-24 years, and 77% were female. When observing the images of the types of orthodontic appliances, the aligners had an acceptance rate of 80%. Among the reasons that led to the preference for choosing aligners, 68% cited aesthetics and 42% comfort. CONCLUSION: Recently, clear aligners have become a popular choice for orthodontic treatment, particularly among adults. Despite their popularity and effectiveness, many patients still need more information about aligner treatment. Over half of the respondents did not know what orthodontic aligners were. Younger participants had more knowledge about aligners than older participants. Patients still need more knowledge about the types of appliances available for orthodontic treatment. When presented with images of the kinds of devices available, almost 80% of participants showed greater satisfaction with aligners.
AIMS: To explore any changes in the perceived gender and affiliation of first authors of papers published in the and , over the last 50 years. METHODS: Electronic hand searches of the from 1973 to 2021, were undertaken...AIMS: To explore any changes in the perceived gender and affiliation of first authors of papers published in the and , over the last 50 years. METHODS: Electronic hand searches of the from 1973 to 2021, were undertaken to identify research and clinical papers published the first volume of the BJO (1973-74) and then the first two volumes of each subsequent decade i.e. 1980-81; 1990-91 to 2020-21. Articles such as Editorials, Product Updates and Abstract summaries, were excluded.The perceived gender of the first author was identified from their forename, internet sources and/or personal knowledge, where possible. The country of the first author's affiliation was identified from the author details stated in the papers. The countries were then grouped into geographical areas. RESULTS: A total of 385 papers were identified with a steady increase from 1973 to 2021. There was a statistically significant increase in papers published by authors who were perceived to be female (odds ratio 8.33; 95% CI 4.75, 14.64). The increase in papers published by non-UK affiliated first authors was significant (odds ratio 5.01; 95% CI 2.78, 9.02). CONCLUSIONS: The has seen a significant change, over the last 50 years, in its authorship profile from nearly exclusively male, UK based authors to more than 60% of published papers having a first author who was perceived as being female and 37% originating from outside the UK.
BACKGROUND: It is 50 years since publication of the first volume of the (). Now known as the (), the official journal of the British Orthodontic Society strives to published high quality, evidence-based research. AIM:...BACKGROUND: It is 50 years since publication of the first volume of the (). Now known as the (), the official journal of the British Orthodontic Society strives to published high quality, evidence-based research. AIM: To compare the content of articles published by the in 1973-1974 with those in the in 2022-2023 to identify any changes over 50 years. METHODS: volume 1 issues 1-5 and volume 49 issues 2-4 and volume 50 issues 1-2 were hand-searched and full articles obtained. Some articles were excluded. The included reports were assessed using objective criteria (see Supplemental materials). RESULTS: Similar proportions of articles reporting the results of studies collecting data directly from participants of orthodontic interest were published (: n = 12, 26%; : n = 15, 23%); however, there was an increase in the proportion of articles reporting studies that collected data from a non-orthodontic patient sample (: n = 5, 11%; : n = 15, 23%). There was also an increase in the reporting of prospective data collection (: n = 1; 6%; : n = 23, 79%), but much of this research was cross-sectional (: n = 8, 50%; : n = 20, 69%), using convenience sampling (: n = 13, 81%; : n = 23, 79% of articles reporting the results of data collected from human participants). Most research was non-experimental (: n = 16, 100%; : n = 26, 90%). CONCLUSIONS: Some similarities in the types of reports published were found, as well as some encouraging differences. Decreasing retrospective data reports and increasing prospective data reports is welcome, but many are still non-experimental and cross-sectional. There is a need to publish more longitudinal, experimental clinical data to enhance knowledge and understanding of the effects of orthodontic treatment.
OBJECTIVE: To ascertain the working patterns of the NHS orthodontic workforce in Wales and any possible future changes. DESIGN: Descriptive cross-sectional survey. PARTICIPANTS: NHS orthodontic practitioners in Wales. ME...OBJECTIVE: To ascertain the working patterns of the NHS orthodontic workforce in Wales and any possible future changes. DESIGN: Descriptive cross-sectional survey. PARTICIPANTS: NHS orthodontic practitioners in Wales. METHODS: An anonymised email distributed an electronic two-part survey of the Welsh NHS orthodontic workforce. The survey consisted of three sections: (1) demographic information; (2) respondents' working pattern (part 1); and (3) perceptions of professional satisfaction (part 2). RESULTS: Part 1 of the survey yielded a 70.5% response rate (n = 79); 65.8% of the respondents were women. Of the respondents, 45.6% (n = 36) worked full time (F/T), 39.2% (n = 31) worked less than F/T and 15.2% (n = 12) worked more than F/T. Of the male respondents, 81.5% (n = 22) worked 10 sessions or more compared to 50% (n = 26) of women. The respondents undertook 508.5 orthodontic clinical sessions per week within Wales; of these sessions, 87.6% (n = 445.5) delivered NHS orthodontic care. Of the respondents, 8.4% (n = 7) were planning to increase their orthodontic clinical time within the next 2 years, 24.1% (n = 19) were planning to decrease it and 20.3% (n = 16) were unsure. One-quarter of respondents indicated that they were planning to stop clinical orthodontic activity within the next 5 years, including 53.3% (n = 8) of DwSIs, 37% (n = 10) of primary care specialists and 13.3% (n = 2) of consultants. The pandemic was an influencing factor for 80% of these clinicians. CONCLUSIONS: Part 1 of the survey suggested that the majority of the orthodontic workforce was female, were working full time or more, and spent most sessions delivering NHS care. One-quarter of respondents were planning to cease undertaking orthodontic activity within the next 5 years.
OBJECTIVE: To ascertain the perceptions of the Welsh NHS orthodontic workforce regarding their job satisfaction and work life balance. DESIGN: Descriptive cross-sectional survey. PARTICIPANTS AND SETTING: Clinicians prov...OBJECTIVE: To ascertain the perceptions of the Welsh NHS orthodontic workforce regarding their job satisfaction and work life balance. DESIGN: Descriptive cross-sectional survey. PARTICIPANTS AND SETTING: Clinicians providing NHS orthodontic treatment in Wales. METHODS: An anonymised, email-distributed, electronic, two-part survey (onlinesurveys.ac.uk) of the Welsh NHS orthodontic workforce working within Wales was undertaken. The survey consisted of three sections: (1) demographic information (part 1); (2) respondents' working pattern (part 1); and (3) perceptions of professional job satisfaction and work/life balance (part 2). The responses received were exported into an Excel spreadsheet for descriptive analysis. The free-text comments were collated for each question and subsequently underwent a content analysis to identify any common themes. RESULTS: Part 2 of the survey yielded an overall response rate of 69.6% (n = 78). Over 96% (n = 75) of respondents felt that they had 'made the right career choice, including 100% of orthodontic trainees, orthodontic specialists and orthodontic consultants. Of the respondents, 88.5% (n = 69) said they 'enjoyed going to work', with the remaining being mostly neutral in their opinion. Of the respondents, 79.5% (n = 62) felt they were able to 'provide their patients the optimum care' and 64.1% (n = 50) felt that more demands were being placed upon them by patients and parents. Overall, 52.6% (n = 41) of survey respondents believed it was becoming increasingly difficult to achieve an effective work/life balance, and this was more prevalent among male respondents (61.5%, n = 16) than female respondents (48.1%, n = 25), although this difference was not statistically significant ( >0.05). CONCLUSIONS: Over 96% of respondents felt they have chosen the right career and that flexibility and a good working environment are important to job satisfaction. Respondents felt that there are increasing demands being placed upon them by patients/parents, employers, the Regulators, the Government and Health Boards. This is leading to increased difficulty in achieving a satisfactory work/life balance, especially among male respondents.
OBJECTIVE: To assess the impact of gender and orthodontic qualification length on the awareness, knowledge and usage of orthodontic diagnostic mobile applications, non-diagnostic mobile applications and social media plat...OBJECTIVE: To assess the impact of gender and orthodontic qualification length on the awareness, knowledge and usage of orthodontic diagnostic mobile applications, non-diagnostic mobile applications and social media platforms among orthodontic clinicians. DESIGN: Cross-sectional questionnaire-based study. SETTING: The Republic of Croatia. PARTICIPANTS: A total of 92 orthodontic specialists, members of the Croatian Dental Chamber. METHODS: This study was conducted using a questionnaire distributed via email to orthodontic clinicians between May and July 2022. RESULTS: In total, 92 respondents were divided into groups according to sex and median orthodontic qualification length: more recently qualified (MRQ) with ⩽12 years; and longer qualified (LQ) with >12 years. Nearly one-third of respondents did not have any prior knowledge of mobile applications used as an orthodontic diagnostic tool. MRQ respondents were more interested in using mobile apps as opposed to computer software for digital analysis ( < 0.05). This interest was in a negative correlation with orthodontic qualification length ( < 0.01) and was more prevalent among female respondents ( < 0.001). About one-third (32.6%) of respondents did not use non-diagnostic mobile applications and 44.6% did not use social media platforms. Nearly two-thirds (62%) of the respondents did not promote their work through social media. Male respondents and LQ promoted their work more frequently than others ( < 0.05). The usage of other mobile applications was in a positive correlation with the knowledge and awareness of orthodontic mobile applications ( < 0.05). CONCLUSION: Orthodontic clinicians lacked knowledge, awareness and the usage of orthodontic diagnostic mobile applications according to sex and orthodontic qualification length. One-third used non-diagnostic mobile applications and less than half used social platforms in daily clinical work.
OBJECTIVE: To assess changes in clinical crown height (CCH) in adult orthodontic patients treated by fixed appliances to distalise the molars. DESIGN: Retrospective case series study. SETTING AND PATIENTS: A total of 30...OBJECTIVE: To assess changes in clinical crown height (CCH) in adult orthodontic patients treated by fixed appliances to distalise the molars. DESIGN: Retrospective case series study. SETTING AND PATIENTS: A total of 30 adults with healthy periodontal tissues who received orthodontic treatment at the Department of Orthodontics, Yokohama, Japan and its related orthodontic clinic were assessed. METHODS: CCH was measured as the distance from the gingival margin to the crown plane perpendicular to the tooth axis. Treatment changes of CCH of each tooth were examined on the labial/buccal and lingual/palatal side. RESULTS: In the upper dentition, on the labial/buccal side, the CCH of the lateral incisors, canines, first premolars, first molars and second molars were increased significantly ( < 0.01), with a median value of 0.41 mm, 0.43 mm, 0.28 mm, 0.43 mm and 0.55 mm, respectively. In contrast on the palatal side, the CCH of the central incisors, first molars, and second molars decreased significantly ( < 0.01), with a median value of -0.41 mm, -0.30 mm and -0.20 mm, respectively. In the lower dentition on the labial/buccal side, the CCH of the first premolars, second premolars and first molars were increased significantly, with a median value of 0.39 mm ( < 0.01), 0.43 mm ( < 0.01) and 0.19 mm ( < 0.05), respectively. The second molars exhibited a significant decrease in CCH with a median value of -0.26 mm ( < 0.05). On the lingual side, the CCH of the central incisors, lateral incisors, canines, first premolars, second premolars and first molars were increased significantly ( < 0.01), with a median value of 0.28 mm, 0.22 mm, 0.31 mm, 0.37 mm, 0.26 mm and 0.28 mm, respectively. CONCLUSION: Significant differences were observed in CCH before and after treatment for many teeth, the average change was less than 0.5 mm. The impact on the long-term health of the periodontal tissue is unknown.
OBJECTIVE: To compare the sagittal and vertical cephalometric effects in participants treated with an expander with differential opening (EDO) versus the fan-type expander (FE). DESIGN: Two-arm parallel randomised clinic...OBJECTIVE: To compare the sagittal and vertical cephalometric effects in participants treated with an expander with differential opening (EDO) versus the fan-type expander (FE). DESIGN: Two-arm parallel randomised clinical trial (RCT). METHODS: This study comprised cone-beam computed tomography-derived cephalometric images from 48 participants from a RCT. The sample was randomly allocated into two groups. The study was single-blinded. In total, 24 participants were treated with rapid maxillary expansion (RME) using EDO and 24 participants underwent RME using FE. The primary outcomes were the dentoskeletal vertical changes produced by RME. The secondary outcomes were the dentoskeletal sagittal changes. A cephalometric analysis was performed before treatment and 1 or 6 months after the active phase of RME using Dolphin Imaging Software. Intergroup comparisons of interphase changes were performed using the -test and Mann-Whitney U test ( < 0.05). RESULTS: The final sample comprised 24 patients (11 men, 13 women; mean age = 7.6 ± 0.9 years) in the EDO group and 24 patients (10 boys, 14 girls; mean age = 7.8 ± 0.9 years) in the FE group. Both expanders produced a similar clockwise rotation of the mandible (FMA; mean difference [MD] = 0.09°, 95% confidence interval [CI] = -1.01 to 0.84). In the FE group, a greater increase of the SNA angle was observed after expansion compared to the EDO group (MD = 1.04°, 95% CI = -1.90 to -1.58). More palatal torque of maxillary incisors was observed in the FE group (MD = 1.32°, 95% CI = 0.05-2.56). Of the participants, 54% reported a little discomfort during the active phase of treatment and 46% of the participants did not report any discomfort. CONCLUSION: Both expanders produced similar vertical cephalometric changes. FEs caused slightly more maxillary anterior displacement after expansion with a compensatory palatal torque of the maxillary incisors, compared to the EDOs. However, the amount of sagittal difference was not clinically relevant. TRIAL REGISTRATION: The trial was registered at ClinicalTrials.gov, under the identifier NCT03705871.
OBJECTIVE: To investigate clear aligner therapy (CAT) practice among orthodontists in the British Orthodontic Society (BOS). DESIGN: A cross-sectional online survey. METHODS: An electronic survey was distributed to membe...OBJECTIVE: To investigate clear aligner therapy (CAT) practice among orthodontists in the British Orthodontic Society (BOS). DESIGN: A cross-sectional online survey. METHODS: An electronic survey was distributed to members of the BOS in 2022. The survey comprised questions regarding respondent demographics, general use of CAT, the choice of proprietary CAT appliances, CAT planning, case selection, treatment protocols and orthodontist-reported CAT problems. RESULTS: Overall, there were 233 (19.5%) respondants with the majority (n = 121, 53.1%) being female. Most respondents reported practising in England (n = 171, 74.7%). The majority (n = 177, 77.3%) indicated that they used CAT in their practice, with 48.1% (n = 81) treating 1-20 patients with CAT annually. The most frequently prescribed CAT system was Invisalign (n = 138, 81.2%). One to three changes to the initial digital treatment plan were made by 72.9% (n = 121) with final tooth positions being the most common reason for adjustment (64.4%). Most (n = 97, 60.3%) rarely or never performed premolar extractions with CAT. Of the respondents, 23 12.7%) reported that they always or mostly used a remote monitoring system in conjunction with CAT, with a wide range of aligner change protocols reported. The median number of months required to complete non-extraction CAT reported by the respondents was 12. Most respondents (n = 77, 51.7%) did not feel that CAT provides superior outcomes compared with fixed appliance therapy. CONCLUSION: CAT practice varied widely among the surveyed orthodontists. A predilection for the use of Invisalign and utility in less severe cases was noted.
INTRODUCTION: The management of eruption disturbances in orthodontics may be challenging and requires a careful diagnosis and treatment planning. This case report discusses the challenges of a two-phase orthodontic treat...INTRODUCTION: The management of eruption disturbances in orthodontics may be challenging and requires a careful diagnosis and treatment planning. This case report discusses the challenges of a two-phase orthodontic treatment of a patient presenting with a dental eruption pattern anomaly. PATIENT CONCERNS: A 10-year-old boy presented with no complaints for a routine orthodontic evaluation during the mixed dentition. PRIMARY DIAGNOSES: The patient was diagnosed with a skeletal Class I malocclusion with unilateral posterior crossbite, incomplete mandibular lateral incisor-canine transposition and a unilateral maxillary ectopic canine. INTERVENTIONS: Phase 1 started with rapid maxillary expansion to correct the maxillary constriction and the ectopic eruption of the right maxillary canine. In the mandibular arch, phase 1 included the extraction of the left primary lateral incisor and canine, alignment of the left permanent lateral incisor and orthodontic traction of the left permanent canine. The duration of phase 1 was 14 months. Phase 2 involved a comprehensive course of orthodontic treatment and started when the patient was aged 13 years. This phase lasted 18 months. RESULTS: An adequate dental occlusion was obtained, and the treatment results were stable after an 18-month follow-up. CONCLUSION: In this case, the early diagnosis of the dental anomalies was valuable as it allowed an early intervention to be undertaken, which resulted in overall treatment simplification and potentially minimised the adverse effects. This case report reinforces the importance of a careful follow-up during mixed dentition.
BACKGROUND: The accuracy of artificial intelligence (AI) in treatment planning and outcome prediction in orthognathic treatment (OGT) has not been systematically reviewed. OBJECTIVES: To determine the accuracy of AI in t...BACKGROUND: The accuracy of artificial intelligence (AI) in treatment planning and outcome prediction in orthognathic treatment (OGT) has not been systematically reviewed. OBJECTIVES: To determine the accuracy of AI in treatment planning and soft tissue outcome prediction in OGT. DESIGN: Systematic review. DATA SOURCES: Unrestricted search of indexed databases and reference lists of included studies. DATA SELECTION: Clinical studies that addressed the focused question 'Is AI useful for treatment planning and soft tissue outcome prediction in OGT?' were included. DATA EXTRACTION: Study screening, selection and data extraction were performed independently by two authors. The risk of bias (RoB) was assessed using the Cochrane Collaboration's RoB and ROBINS-I tools for randomised and non-randomised clinical studies, respectively. DATA SYNTHESIS: Eight clinical studies (seven retrospective cohort studies and one randomised controlled study) were included. Four studies assessed the role of AI for treatment decision making; and four studies assessed the accuracy of AI in soft tissue outcome prediction after OGT. In four studies, the level of agreement between AI and non-AI decision making was found to be clinically acceptable (at least 90%). In four studies, it was shown that AI can be used for soft tissue outcome prediction after OGT; however, predictions were not clinically acceptable for the lip and chin areas. All studies had a low to moderate RoB. LIMITATIONS: Due to high methodological inconsistencies among the included studies, it was not possible to conduct a meta-analysis and reporting biases assessment. CONCLUSION: AI can be a useful aid to traditional treatment planning by facilitating clinical treatment decision making and providing a visualisation tool for soft tissue outcome prediction in OGT. REGISTRATION: PROSPERO CRD42022366864.