Adult orthodontic patients: What is important to them?

OBJECTIVE: To understand patients' motivations for pursuing treatment, to appreciate what information patients seek and to explore potential factors affecting decision making in adults considering, undergoing or who have had orthodontic treatment in the private sector. DESIGN: Cross-sectional questionnaire study. SETTING: Online questionnaire. PARTICIPANTS: A total of 209 (83% women, 16% men, 1% preferred not to say) completed responses were received. METHODS: Once piloted, the final survey was made available online to adults in the United Kingdom (UK) and Republic of Ireland (RoI) who were either considering having orthodontic treatment, currently undergoing treatment or had recently completed treatment in the private sector. RESULTS: The most commonly selected motivating factor was to 'improve the appearance of my teeth' (82%). The information sought related predominantly to treatment duration (64%), potential end results (56%), types of appliances that were available (55%) and cost (52%). The two most commonly reported social factors that had influenced participants to consider treatment were 'seeing myself on social media' (31%) and 'it is more socially acceptable to have braces' (31%). CONCLUSION: While this area remains relatively underexplored in the literature, it is crucial to develop a comprehensive understanding due to the increasing number of adults seeking orthodontic treatment. This study not only reinforces the existing knowledge regarding adults seeking orthodontic treatment, such as the predominant role of aesthetics as a motivating factor, but also introduces some novel insights. Specifically, we highlight the influence of social factors on decision-making processes and the importance of effectively communicating the duration of treatment to patients.

Late-forming supernumerary teeth: A case series.

The aim of this case series was to illustrate the development of late-forming supernumerary teeth (LFST) and highlight the implications for orthodontic treatment. There are limited studies relating to the aetiology, prevalence and treatment of LFST and the cases presented here demonstrate the management of LFST within a tertiary care centre. Five cases are presented, which show various presentations and chronological ages in the development of LFST. This case series emphasises the significance of maintaining a low threshold for suspecting LFST in patients where supernumerary teeth have previously been identified. It also highlights the importance of regular clinical and radiographic reviews. Timely identification can help prevent complications and optimise treatment outcomes.

Orthodontic therapy teaching review at Trinity College Dublin.

INTRODUCTION: The aim of this teaching review was to obtain feedback from graduates of the Orthodontic Therapy course from the School of Dental Science, Trinity College Dublin, which was established in 2014. MATERIALS AND METHODS: A focus group, comprising of one to two graduates from each of the five years of the orthodontic therapy course, convened to obtain feedback. Thematic analysis was used to analyse the feedback transcribed from the focus group. RESULTS: Multiple themes emerged including enthusiasm, commitment, educational support, peer support and satisfaction. The graduates found the course challenging but very rewarding, helped by support from the university, mentors and peers. Satisfaction was very high from all participants with 100% reporting they would recommend the course. Suggestions emerged regarding the delivery of specific didactic components of the course and increased engagement with the specialist orthodontic mentors to ensure teaching is standardised for all trainees. CONCLUSION: The course is rated very highly by the graduates and completion of this training has had a positive impact on their job satisfaction. Members of the focus group provided constructive feedback on the delivery of the course, which will contribute to its refinement for future trainees.

Do malocclusions affect oral health related quality of life?

Design A prospective interdisciplinary, multi-centre, cohort study.Cohort selection A total of 250 patients were recruited from three university departments of orthodontics and one orthodontic dental practice. The cohort size was decided by a sample size calculation performed and the participants were selected over 14 months. Four psychological questionnaires were used, each targeting specific psychological characteristics, combined with orthodontic assessments. Only questionnaires in English, with German translations, were chosen for international comparability. The COHIP-19 was used to assess Oral Health Related Quality of Life (OHRQoL), the KIDSCREEN-10 index was used to assess HRQoL, the RSES was used to assess self-esteem and the SDQ was used for behavioral problems. To record the orthodontic parameters, standardised orthodontic diagnosis consisted of detailed anamnesis, functional diagnosis, extra-oral photos, an orthopantomogram, lateral cephalomentrics and plaster impressions. The same assessor examined the questionnaires and the orthodontic measurements.Data analysis Statistical programme (SPSS) was used to assess the data. Simple linear regression models were tested to assess the predictive values of all the specific orthodontic parameters individually (= predictors) on the COHIP-G19 (= criterion). Further to this, multiple linear regression analysis was used to assess which of the independent predictors can be assessed in combination to relate to OHRQoL.Results The questionnaire was completed by 248 participants. From the simple linear regression, there was a statistically significantly impact on COHIP-G19 score in patients with competent lip closure, straight chin position, little-index-upper, overjet, overbite and ANB.For the multiple linear regression analysis, age, KIDSCREEN-10 index, RSES, SDQ and all six orthodontic parameters that had a statistically significant impact on COHIP-G19 (P <0.05) in the simple linear regression were assessed. Of these five (SDQ, KIDSCREEN-10, overjet, little-index-upper and overbite) parameters resulted in a multi-linear regression model that was statistically significant and explained 32.3% of the total variance in OHRQoL. Adding additional parameters did not significantly improve the R2-change.Conclusions Further longitudinal studies are required to investigate if the treatment of these malocclusions also improves the OHRQoL of children and adolescents.

The value of cone beam CT in assessing and managing a dilated odontome of a maxillary canine.

A case of an unusual anomaly in a maxillary canine is described. A deep enamel invagination resulted in pulpal necrosis, longstanding infection and development of an associated radicular cyst. Diagnostic X-ray imaging was invaluable in demonstrating the complex root anatomy of the dilated odontome. In particular, a cone beam CT scan helped in the formulation of an appropriate treatment plan. Clinical Relevance: Three-dimensional imaging using cone beam CT was valuable in this case to demonstrate the complicated anatomy of a rare dental anomaly, and to help plan treatment.