The role of orthodontics in the management of tooth wear.

Pathological tooth wear is a dental problem that affects all age groups and appears to be increasing in prevalence. A subset of these patients may benefit from a combination of orthodontic and restorative care which will be discussed in this article. Orthodontics can help to create the necessary vertical, anterior-posterior and mesio-distal space for restorative work, reducing the need for tooth reduction and lessening the biological costs of restorative care, helping to reposition the gingival margins where this impacts upon aesthetics, as well as correcting co-existing malocclusion.

Maxillary Changes Following Facial Bipartition - A Three-Dimensional Quantification.

Introduction: Children with Apert syndrome have hypertelorism and midfacial hypoplasia, which can be treated with facial bipartition (FB), often aided by rigid external distraction. The technique involves a midline osteotomy that lateralizes the maxillary segments, resulting in posterior cross-bites and midline diastema. Varying degrees of spontaneous realignment of the dental arches occurs postoperatively.

The maxillary incisor labial face tangent: clinical evaluation of maxillary incisor inclination in profile smiling view and idealized aesthetics.

Background: To test the hypothesis that in profile smiling view, for ideal aesthetics, a tangent to the labial face of the maxillary central incisor crowns should be approximately parallel to the true vertical line and thereby perpendicular to the true horizontal line.

Methods: An idealized female image was created with computer software and manipulated using the same software to construct an "ideal" female profile image with proportions, and linear and angular soft tissue measurements, based on currently accepted criteria for idealized Caucasian profiles. The maxillary incisor labial face tangent was altered in 5° increments from 70 to 120°, creating a range of images, shown in random order to 70 observers (56 lay people and 14 clinicians), who ranked the images from the most to the least attractive.

Chair side measuring instrument for quantification of the extent of a transverse maxillary occlusal plane cant.

Background: Treatment planning the correction of a transverse maxillary occlusal plane cant often involves a degree of qualitative "eyeballing", with the attendant possibility of error in the estimated judgement. A simple chair side technique permits quantification of the extent of asymmetry and thereby quantitative measurements for the correction of the occlusal plane cant.

Methods: A measuring instrument may be constructed by soldering the edge of a stainless steel dental ruler at 90° to the flat surface of a similar ruler.

Mind the gap: A novel technique for space closure - a case report.

Patients presenting with severe hypodontia can be challenging to manage. They often present with significant spaces within the dental arches and the lack of permanent teeth can make anchorage control difficult. This case report demonstrates a novel technique for diastema closure in a 14-year-old with severe hypodontia.

Facial feminisation: an overview of the role of the surgeon and orthodontist.

Facial feminisation surgery (FFS) aims to feminise the face by changing masculine facial features to feminine ones. It is commonly undertaken for transsexual individuals who are transitioning from male to female or for women who wish to further feminise their facial appearance. Assessment and treatment planning by a multidisciplinary team is essential for any patient considering FFS.

Challenges and opportunities facing contemporary orthognathic surgery.

Here, we provide a brief overview of the challenges, innovations and potential opportunities facing contemporary management of individuals requiring orthognathic care.

Treatment Outcomes and Assessment of Oral Health Related Quality of Life in Treated Hypodontia Patients.

Objectives: 1. Assess treatment outcomes and oral health related quality of lifeM (OHRQoL) of hypodontia patients after completing dental treatment at the Eastman Dental Hospital and compare it with British public norms. 2.

Effect of social media in improving knowledge among patients having fixed appliance orthodontic treatment: A single-center randomized controlled trial.

Introduction: Research has shown that orthodontic patients are more likely to retain information presented in an audiovisual format. However, there has been little research on the effectiveness of audiovisual information provided through different routes such as the Internet. This parallel-group randomized controlled trial assessed whether provision of audiovisual information on the YouTube (Google, San Bruno, Calif) Web site to orthodontic patients undergoing fixed appliance treatment results in improved patient knowledge when compared with conventional methods of information provision.

A study to investigate the bond strengths of orthodontic brackets bonded to prosthetic acrylic teeth.

Introduction: In this study, we compared the shear bond strengths of five different adhesive techniques for attaching metal orthodontic brackets onto acrylic pontics.

Materials And Methods: Two hundred upper left lateral incisor acrylic teeth with bonded brackets were divided into five groups - composite alone (control), composite following sandblasting, composite held with a mechanical undercut, cyanoacrylate adhesive and Panavia(®). The initial bond strength was tested using the Instron Universal Testing Machine.

Smile analysis: what to measure.

Unlabelled: Patients seek dental treatment to improve oral function as well as their attractiveness. In order to improve smile attractiveness, clinicians need to carry out a comprehensive smile assessment. The aim of this paper is to help clinicians to adopt a systematic approach toward smile assessment by introducing a smile assessment form.

The dental development in patients with Aperts syndrome.

Objectives: The aim of this retrospective study was to quantify the level of dental developmental delay in a group of patients with Aperts syndrome when compared to matched controls.

Methods: Twenty-six Dental Panoramic Tomographic (DPT) radiographs of patients with Apert syndrome attending Great Ormond Street Hospital were compared to controls (n = 29) from the Eastman Dental Hospital, UK. Dental development was assessed using the staging systems of Demirjian and Haavikko, and dental age (DA) was estimated using the weighted averages method.

The surgical management of Treacher Collins syndrome.

Treacher Collins syndrome (TCS), mandibulofacial dysostosis, or Franceschetti-Zwahlen-Klein syndrome, is a rare genetic disorder characterised by dysgenesis of the hard and soft tissues of the first and second branchial arches. Early operations focus on maintaining the airway, protecting the eyes, and supporting auditory neurological development. Later operations include staged reconstruction of the mouth, face, and external ear.

A comparison of skeletal maturation in patients with tooth agenesis and unaffected controls assessed by the cervical vertebral maturation (CVM) index.

Objective: The aims of this study were to (1) investigate if there is a difference in skeletal maturation between tooth agenesis and control patients and (2) whether skeletal maturation is affected by the severity of tooth agenesis. The cervical vertebral maturation (CVM) index can be used to assess skeletal maturation.

Design: A retrospective cross-sectional study.

Multiple endocrine neoplasia in an orthodontic patient: Interprofessional diagnostic and treatment implications.

Background: Multiple endocrine neoplasia, type 2B (MEN 2B), is an autosomal-dominant condition characterized by the development of multiple endocrine tumors. All affected people develop an aggressive form of medullary thyroid cancer (MTC). Without early prophylactic thyroidectomy, the prognosis for patients with MEN 2B is poor; the average age at death is 21 years.

Radiographic study of delayed tooth development in patients with dental agenesis.

Introduction: The aims of this study were to compare the radiographic development of permanent teeth in a group of children affected by dental agenesis with an unaffected control group and to determine the effects of confounding factors including the severity of the dental agenesis, age, sex, ethnicity, and the number of stages used to estimate dental age.

Methods: A single-center retrospective cross-sectional study of dental panoramic tomographs was undertaken between July 2007 and April 2008 in a postgraduate teaching school. A total of 139 patients (aged 9-18 years) were recruited from the orthodontic clinic on the basis of predetermined inclusion and exclusion criteria to either a dental agenesis group or a control group.

Smile esthetics: the influence of posterior maxillary gingival margin position.

Purpose: Successful replacement of posterior teeth using contemporary prosthodontic techniques in esthetically demanding cases relies upon visual replication of the natural posterior dentition and surrounding gingival architecture. There is currently little in the way of guidance for creating ideal or acceptable gingival relationships for posterior teeth.

Materials And Methods: A cross-sectional study was conducted comparing perceptions of four groups of individuals to six digitally manipulated images with various posterior teeth gingival margin position configurations.

Pyogenic granuloma: a rare side complication from an orthodontic appliance.

This case report discusses a rare side effect associated with the use ofa fixed quad helix orthodontic appliance. A 14-year-old healthy girl presented with a painful enlarging mass on her tongue, which was causing distress to both her and her parents. Investigations confirmed that the mass was a pyogenic granuloma and management involved surgical excision of the mass and removal of the quad helix appliance.

Effect of occlusal plane on smile attractiveness.

Objective: To determine the influence of the occlusal plane angle on smile attractiveness as perceived by a group of adult orthodontic patients and dentists.

Materials And Methods: The first stage utilized a laboratory approach to record changes in vertical tooth position at different occlusal plane angles using a maxillary model mounted on an articulator. In the second stage, photographic manipulation was undertaken, using data from stage 1, to produce a computerized prediction of the appearance of the smile at differing occlusal plane angles (0, 5, 10, 15, and 20 degrees).

A new style of orthognathic clinic.

The Orthognathic Team at the Eastman Dental Hospital has developed a new style of multidisciplinary clinic to supplement the traditional orthognathic consultation. The aim of the new clinic is to increase patient satisfaction and involvement in the consent and decision making process, as well as optimizing the information given to prospective patients regarding all aspects of this complex elective treatment. Results of a survey of patients attending the clinic found that 80% thought that the information given was 'just the right amount' and 96% were satisfied with the new structure.

Retrospective study to determine the change in referral pattern to St George's Hospital Orthodontic Department before and after the 2006 NHS Dental Contract changes.

Aim: The aim of this study was to determine the possible effects of the 2006 National Health Service General Dental Services contract changes on the referral pattern to the orthodontic department at St George's Hospital, South West London.

Method: This study was carried out on a retrospective basis. The notes of consecutive patients referred between 1st May and 30th September in 2005 and 2008 were assessed, and the patient's Index of Orthodontic Treatment Need (IOTN) and the source of referral noted.

A cephalometric study to investigate the skeletal relationships in patients with increasing severity of hypodontia.

Objectives: To determine the skeletal relationships in patients with hypodontia and analyze the effects of severity and pattern.

Materials And Methods: Pretreatment lateral cephalograms from 277 patients with hypodontia, categorized by the number of missing teeth as mild (1-2), moderate (3-5), or severe (> or =6), were digitized recording angular measurements and ratios and compared with published norms matched for age and gender. Pattern was determined as mandibular, maxillary, bimaxillary, bilateral, anterior, posterior, and anteroposterior.