Patient reported experiences and treatment outcomes of orthodontic patients treated within secondary care settings in the South West of England during the COVID-19 pandemic.

OBJECTIVE: To assess the impact of the temporary cessation of orthodontic services on patients undergoing treatment during the COVID-19 pandemic. DESIGN: Two-phase multicentre service evaluation. SETTING: Secondary care orthodontic departments in the South West of England. MATERIALS AND METHODS: Phase 1 - Patient-Reported Experience Measure questionnaire (PREM). The questionnaire was distributed to patients who had undergone orthodontic treatment during the COVID-19 pandemic once services had resumed. Phase 2 - assessment of treatment outcomes, specifically with the Peer Assessment Rating (PAR) Index. A total of 280 PAR scores were obtained from a cohort of patients treated before and during the pandemic. RESULTS: A total of 711 PREM questionnaires were completed. Participants generally felt relaxed when visiting secondary care settings, orthodontic departments and whilst wearing orthodontic appliances during the pandemic. Nearly 40% of participants were concerned that the pandemic would impact on their treatment, particularly treatment length. Treatment outcomes revealed that patients treated before and during the pandemic experienced percentage PAR score reductions of 83.9% and 80.6%, respectively. Patients receiving treatment during the pandemic experienced longer treatment durations of 126 days. CONCLUSION: During the pandemic, low levels of anxiety were reported with respect to receiving orthodontic treatment in secondary care settings. Irrespective of the pandemic, a high standard of orthodontic treatment was provided. However, patient concerns regarding treatment length were justified.

A prospective evaluation of factors affecting occlusal stability of Class II correction with Twin-block followed by fixed appliances.

INTRODUCTION: Modified Twin-block therapy followed by fixed appliances (TBFA) is a standard treatment modality in Class II malocclusion; however, there is little information regarding the stability of this approach. We aimed to assess the stability of Class II correction with TBFA and to evaluate factors that may affect stability. METHODS: A prospective evaluation involving convenience sampling of 64 participants treated with TBFA was undertaken over 12 months. Study models and lateral cephalometric radiographs were obtained to record overjet and molar relationship, Peer Assessment Rating score, and skeletal parameters, and a new objective buccal segment interdigitation scoring system was developed. Multivariate logistic regression analysis was used to assess the stability of anteroposterior occlusal correction and the degree of buccal interdigitation, pretreatment skeletal discrepancy, and change in overjet during treatment. RESULTS: Mean overjet reduction of 6.22 mm arose during treatment, with the canine and molar relationships improving by 3.34 mm and 2.67 mm, respectively. In the 12 months posttreatment, a relapse of 0.67 mm and 0.06 mm in overjet and molar relationship, respectively, was observed, with 25% of subjects having overjet relapse of >1 mm. There is weak evidence that the treatment-induced change in overjet is linked with overjet relapse (P = 0.05; odds ratio, 0.67; 95% confidence interval, 0.44, 1.01). No significant relationship was observed, however, between anteroposterior stability and buccal segment interdigitation (P = 0.99), pretreatment skeletal discrepancy (P = 0.10) or prescribed retention regime (P = 0.63). CONCLUSIONS: Overall, acceptable levels of stability were observed, although appreciable relapse was noted in 25% of participants. Neither the degree of buccal segment interdigitation nor pretreatment skeletal discrepancy was predictive of anteroposterior occlusal stability.

What I wish I'd learned as an orthodontic trainee: an online survey of British Orthodontic Society members concerning postgraduate training experiences.

OBJECTIVE: To survey the opinion of recently qualified and established orthodontists on the perceived value of their training and to identify specific areas which which were considered to be deficient, adequately covered or focussed on excessively. DESIGN: Descriptive cross-sectional survey. SETTING: Online electronic questionnaire. PARTICIPANTS: Members of the British Orthodontic Society (BOS). METHODS: An electronic questionnaire was circulated to members of the BOS focusing on dental education history, and opinions concerning orthodontic teaching generally and specific clinical and non-clinical subjects. Information was also obtained in terms of possible need for improvement, modification or removal of teaching on focused academic and clinical aspects. RESULTS: A total of 217 responses were received from 1080 emailed invitations resulting in a response rate of 20.1%. Respondents were generally satisfied with their training both in relation to theoretical, academic and practical aspects. However, training was regarded as deficient by some respondents in respect of temporary anchorage devices (38%), bonded retainers (6%), experience with lingual appliances (47%), removable aligners (44%), inter-proximal reduction (24%) and adult orthodontics (16%), working with therapists (32%), and NHS contracts (47%) and commissioning (47%). CONCLUSION: The overall satisfaction of BOS members with postgraduate orthodontic training is generally high, although both recently qualified and established practitioners emphasised the need for better exposure to training in specific practical aspects and practice management within the NHS.

Isomeric ionic lithium isonicotinate three-dimensional networks and single-crystal-to-single-crystal rearrangements generating microporous materials.

Reaction between LiOH and isonicotinic acid (inicH) in the appropriate solvent or mixture of solvents affords a family of variously solvated forms of a simple ionic lithium salt, viz., Li(+)inic(-)·S (where S = 0.5 morpholine, 0.5 dioxane, 0.25 n-hexanol, 0.5 N-methylpyrrolidinone, 0.5 N,N-dimethylformamide, 0.5 n-propanol, 0.5 cyclohexanol, 0.5 pyridine, 0.5 t-butanol, 0.5 ethanol, and 0.5 methanol). Three-dimensional Li(+)inic(-) frameworks containing solvent-filled channels are present in all of these except for the MeOH and EtOH solvates. The nondirectional character of the electrostatic interactions between the Li(+) and inic(-) ions bestows an element of "plasticity" upon the framework, manifested in the observation of no less than five different framework structures within the family. Unusual single-crystal-to-single-crystal transformations accompany desolvation of Li(+)inic(-)·S in which the Li(+)inic(-) framework undergoes a major rearrangement (from a structure containing "8484 chains" to one with "6666 chains"). The "before and after" structures are strongly suggestive of the mechanism and the driving force for these solid state framework rearrangements: processes which further demonstrate the "plasticity" of the ionic Li(inic) framework. A solid-state mechanism for these desolvation processes that accounts very satisfactorily for the formation of the channels and for the diverse geometrical/topological aspects of the transformation is proposed. The reverse process allows the regeneration of the solvated 8484 form. When the 6666 Li(+)inic(-) form is immersed in carbon disulfide, a single-crystal-to-single-crystal transformation occurs to generate Li(+)inic(-)·0.25CS2. The hydrate, Li(+)inic(-)·2H2O which consists of discrete Li(inic)·H2O chains obtained by recrystallizing the salt from water, can also be obtained by hydration of the 6666 form. A dense 3D network with the formula, Li(inic) can be obtained in a reversible process by the removal of the water from the hydrated form and also by crystallization from a t-amyl alcohol solution.