Adult orthodontics in the absence of orthognathic treatment: a hospital perspective.

OBJECTIVE: To examine adult orthodontic treatment within two hospital settings and ascertain whether any factors have a statistically significant effect on treatment outcomes. DESIGN: A retrospective observational study. MATERIALS AND METHODS: Through the analysis of hospital case notes, variables relating to adult patients undergoing orthodontic treatment that did not involve orthognathic surgery between 1991 and 2008 at the Eastman Dental and Croydon University Hospitals, were studied. In addition, a proportion of study models were Peer Assessment Rating (PAR) scored to determine treatment outcome. RESULTS: Females accounted for 76·2% of the adults studied, with a mean age of 31·24 years. The most commonly presenting malocclusion was a class II division 1 incisor relationship on a class II skeletal base, with over half of all patients studied having missing teeth upon presentation. The mean treatment length was 2·29 years. Only the type of orthodontic treatment (orthodontic-only or multidisciplinary) and/or the presence of a crowded upper labial segment had a statistically significant effect on treatment outcomes, as measured by PAR scores. CONCLUSION: This study has highlighted demographical and treatment trends from a cohort of adult patients studied within two hospital orthodontic departments. It also illustrates that a crowded upper labial segment and the type of treatment provided has a statistically significant effect on post-treatment PAR scores.

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. They particularly found it useful to meet a patient who had completed treatment. All of those who attended said that they understood the information given to them and would recommend the clinic to those considering orthognathic treatment. They also liked having other patients there with them on the clinic.

Adult orthodontics--who's doing what?

OBJECTIVES: To estimate the number of adults currently being treated by specialist orthodontists in the UK, both within the National Health Service (NHS) and privately, together with the factors relating to adults undergoing orthodontic treatment, their malocclusions and details of treatment undertaken. DESIGN: Self-administered postal questionnaire. PARTICIPANTS AND SETTING: All individuals entered on the General Dental Council's Specialist List in Orthodontics, registered within the UK. METHODS: A questionnaire was sent to all those on the General Dental Council's Specialist List in Orthodontics to ascertain the numbers of adult patients being treated by specialist orthodontists and factors relating to their treatment. This included age and gender of adults being treated, sources of referral, type of orthodontic treatment carried out, disciplines involved in multidisciplinary treatment, appliance types used and issues which practitioners felt affected adult treatment. Adults undergoing orthognathic treatment were excluded from this study. RESULTS: The questionnaire yielded a response rate of 70%. Those respondents working in combined hospital/university posts treated the largest proportion of adults within the NHS and those working in specialist orthodontic practice treated the largest number privately. Within 1 year, the estimated mean number of adult cases started by specialist orthodontists within the NHS was 20.9 and privately was 28.2. The majority of adults treated were reported to be within the 26-35 year age group. Most adult patients were referred for orthodontic treatment by their general dental practitioners and over 70% of treatment provided was orthodontic-only. Adults' concerns regarding the appearance of orthodontic appliances was quoted by orthodontists as being the most commonly occurring potentially complicating factor with regards to both NHS and private treatment. CONCLUSIONS: Although there are reports in the literature that the number of adult orthodontic patients is increasing, there are no comprehensive figures regarding the number of adults previously treated within the NHS and privately in the UK to compare our data with. This paper presents initial data relating to practitioners' estimates of the numbers of adults being treated in the UK.

Darier disease affecting the gingival and oral mucosal surfaces.

Darier disease is an uncommon genodermatosis reflecting defective desmosomal structure and function. The present report details the oral features of a patient with well-characterized Darier disease and reviews current knowledge of the genetic basis of this genodermatosis that can often affect the craniofacial tissues.

Aspects of HIV disease relevant to dentistry in the 21st century.

UNLABELLED: HIV disease remains a significant health concern in Europe and the rest of the world. The present article details the epidemiological shifts, changes in therapy and oral manifestations of HIV disease of relevance to all oral healthcare professionals. CLINICAL RELEVANCE: Knowledge regarding the oral and dental aspects of HIV infection remain of importance to all dental healthcare professionals.