Parents' Awareness of Malocclusion and Orthodontic Consultation for Their Children: A Cross-Sectional Study.

Parents' awareness of malocclusion and the appropriate timing to seek orthodontic consultation for their children has a substantial impact on children's orthodontic treatment. This cross-sectional study aims to investigate parents' awareness of malocclusion and orthodontic consultation of their children and the influence of parents' demographics on their awareness level. An electronic survey collected information about participants' demographics and awareness about malocclusion and orthodontic consultation of children. A total of 473 parents living in Jeddah, Saudi Arabia, participated in the study. The average awareness level among parents was moderate (3.09 ± 1.4). Male gender and unemployment were associated with low orthodontic awareness levels relative to moderate awareness (OR = 3.3, 95% CI = 1.8-5.8 and OR = 2.1, 95% CI = 1.1-3.8, respectively). Former or current orthodontic treatment was associated with high awareness levels (OR = 3.9, 95% CI = 2.4-6.5). There is still a need to raise the awareness of Saudi parents about malocclusion and orthodontic consultations for their children. Orthodontic awareness-raising campaigns should be designed to include fathers and parents with low socioeconomic status. The findings of this study also suggest that orthodontists can enhance their patient's awareness of malocclusion and orthodontic consultation for their children.

The role of orthodontics in management of obstructive sleep apnea.

Dental sleep medicine is the field of dental practice that deals with the management of sleep-related breathing disorders, which includes obstructive sleep apnea (OSA) in adults and children. Depending on the developmental age of the patient and the cause of the apnea dental treatment options may vary. For adult patients, treatment modalities may include oral appliance therapy (OAT), orthognathic surgery and surgical or miniscrew supported palatal expansion. While for children, treatment may include non-surgical maxillary expansion and orthodontic functional appliances. Many physicians and dentists are unaware of the role dentistry, particularly orthodontics, may play in the interdisciplinary management of these disorders. This review article is an attempt to compile evidence-based relevant information on the role of orthodontists/sleep dentists in the screening, diagnosis, and management of sleep apnea. Oral sleep appliance mechanisms of action, selective efficacy, and the medical physiological outcomes are discussed. The purpose of this review is to provide a comprehensive understanding of how orthodontists and sleep physicians can work in tandem to maximize the benefits and minimize the side effects while treating patients with OSA.

Pulp volume changes after piezocision-assisted tooth movement: a randomized clinical trial.

BACKGROUND: Orthodontic treatment may result in undesirable side effects, such as root resorption and a decrease in the size of the pulp tissue which could be associated with the duration of the orthodontic treatment. Piezocision-assisted tooth movement was introduced as a minimally invasive surgical procedure to shorten orthodontic treatment time. This prospective randomized clinical trial was aimed to compare the pulp volume changes of maxillary anterior teeth after en-masse retraction with or without piezocision-assisted orthodontics. METHODS: Patients who required orthodontic treatment with bilateral maxillary first premolar extractions and en-masse retraction were recruited. Patients were randomly divided into extraction with piezocision, or only extraction, serving as controls. Pulp volume and root length changes of the maxillary six anterior teeth were measured and compared between the two groups using a 3-Dimensional analytical software. Paired and independent sample t-tests were used to compare within and between groups. Bivariate correlation was done between the mean change in pulp volume and its corresponding root length. The significance level was set at α = 0.05. RESULTS: A total of 23 patients were included, 12 in the piezocision, and 11 in the control group. At the end of the en-masse retraction phase, (mean = 122.74 ± 3.06 days) pulp volume was significantly decreased in all six anterior teeth in both groups (P < 0.01). The decrease in pulp volume was not statistically different between both groups, (P > 0.05). There was a statistically significant but moderate correlation only between the pulp volume change of the right canine and its root length, r = 0.44, P = 0.034. CONCLUSIONS: The effect of piezocision-assisted orthodontic tooth movement on the pulp volume was comparable to the conventional orthodontic treatment. The degree of change in pulp volume does not appear to be related to the amount of root resorption. Trial registration NCT03180151. Registered December 25, 2016, retrospectively registered, https://clinicaltrials.gov/ct2/show/record/NCT03180151 .

Youth Perception of Different Orthodontic Appliances.

PURPOSE: To explore youth perception of the esthetics of different orthodontic appliances measured using different concepts of esthetics. PATIENTS AND METHODS: A questionnaire was answered by 194 youth participants (35.5% were 9-11 years old; 32.5% were 12-14 years old; and 32% were 15-17 years old). Participants evaluated and compared the attractiveness of images of different orthodontic appliances using a Likert scale. They indicated the acceptability of the appliances with a yes/no answer. They then chose which appliance to rank as their most preferred. RESULTS: The highest median attractiveness rating was for clear aligners (Mdn= 8, IQR= 4.25), followed by lingual and standard ceramic brackets (Mdn= 7, IQR= 6). The lowest median attractiveness rating was for hybrid brackets (Mdn= 4, IQR= 4). Clear aligners were significantly more attractive than all other orthodontic appliances (P<0.0001). Clear aligners also had the highest percentage of acceptability (80%), while hybrid brackets scored the lowest (42%). Ceramic and metal brackets fell in the middle range of attractiveness and acceptability but were chosen by male middle schoolers as their preferred appliances. Clear aligners were ranked the highest by this cohort. CONCLUSION: This study demonstrates the widespread preference and acceptability of clear aligners among the youth. Other orthodontic appliances were acceptable but to a lesser extent than clear aligners. This study informs orthodontists about their youth consumers' behavior and may help inform treatment discussions in the orthodontic clinic.

Knowledge of Signs, Symptoms, Risk Factors, and Complications of Obstructive Sleep Apnea among Dental Interns.

Dentists are uniquely positioned to identify patients at risk of obstructive sleep apnea (OSA) and its complications. However, previous reports have shown that the average general dentist possesses insufficient knowledge about the clinical manifestations and complications of OSA. AIM: The purpose of this study was to examine Saudi dental interns' knowledge related to the clinical manifestations and impact of OSA. MATERIALS AND METHODS: This was a cross-sectional study using a self-administered questionnaire to assess the interns' knowledge related to the symptoms, signs, diagnosis, risk factors, and complications of OSA in adults and children. RESULTS: The average of the proportions of factually correct participant responses of the questionnaire categories was 47%. Participants did best in the category of questions related to predisposing factors (50% of questions were answered correctly), but less than 50% of questions were answered correctly in other OSA-related areas. Most participants scored 49% or lower in this questionnaire. CONCLUSION: Saudi dental interns had poor knowledge related to OSA. This may relate to the insufficiency of teaching sleep-related topics in dental curricula, among other reasons. CLINICAL SIGNIFICANCE: Given the potential impact of OSA on cardiovascular health, metabolic syndrome, and other public health problems, it is important to remedy this knowledge gap and empower future physicians with the knowledge required to participate in detecting OSA patients and referring them for evaluation.

Adult Perceptions of Different Orthodontic Appliances.

Introduction: Pursuing an esthetically-pleasing orthodontic outcome, orthodontic patients must consider and choose from the different available options of orthodontic appliance. Practitioners need to be better informed of their customers' preferences to make better practice management decisions and satisfy their patients' needs. PURPOSE: To explore adult laypeople's perceptions of the attractiveness, acceptability, preference and economic value of different orthodontic appliances when they consider these appliances for themselves and for their children. PATIENTS AND METHODS: This cross-sectional survey included 199 adults (110 females). The average age of participants was 27.7 years. Participants answered a questionnaire evaluating and comparing multiple smiling images of an adult wearing different orthodontic appliances. Participants rated each appliance for: (1) attractiveness on a Likert scale; (2) acceptability of having the appliance placed for themselves and their children (with a yes/no response); (3) preference (by ranking all appliances in order); and (4) economic value (by providing the additional amount they are willing to pay for each appliance for themselves and their children). RESULTS: We found a statistically significant difference in the attractiveness scores between the different orthodontic appliances (p< 0.0001). The most attractive appliances were clear aligners and lingual brackets. The least attractive appliances were colored o-tied-brackets followed by shaped-brackets. Clear aligners were the most acceptable appliances among our participants to have placed on themselves (86.9%) and their children (84.9%). Shaped brackets were the least acceptable appliances among our participants to have placed on themselves (24.1%) and their children (36.2%). The most preferred appliances were lingual brackets (39.2%), followed by clear aligners (34.17%). The least preferred appliances were colored o-tied-brackets (4%). Participants varied with regards to how much more they were willing to pay for each of the different orthodontic appliances. The majority were willing to pay more for clear aligners and lingual brackets to have them placed on themselves but not to have them placed on their children. CONCLUSION: Adults preferred more innovative esthetic appliances over traditional ones and were willing to pay more to have them placed on themselves but not on their children.

Diagnostic performance of eruption stages for identification of skeletal maturity.

OBJECTIVES: To investigated the diagnostic performance of circumpubertal eruption stages which identify skeletal maturity stages using the cervical vertebral maturation (CVM) method in a Saudi population. METHODS: This is a retrospective cross-sectional study. Lateral cephalograms, panoramic radiographs, and intraoral pictures of 600 orthodontic patients (284 boys, 316 girls) who met inclusion criteria were assessed. Records were retrieved between January 2016 and April 2018. The diagnostic performance of eruption stages for identifying skeletal maturity was tested with positive likelihood ratios (LHR+). RESULTS: Prevalence of each CVM stage in the eruption stages was reported. For every eruption stage, LHR+ was reported in order to identify every CVM stage. The majority of the LHR+ values were ≤3.5, with a significant value of ≥10 for the identification of the post-pubertal growth stage. The other eruptions stages did not strongly predict skeletal maturity. CONCLUSION: In treatment planning for cases that require identifying the growth peak, the use of eruption stages is not recommended as an indicator of skeletal maturity except for the early permanent dentition stage where strong diagnostic performance for identifying post-pubertal skeletal growth stage has been shown.