The impact of tooth agenesis on oral health-related quality of life in children.

OBJECTIVE: The purpose of this cross-sectional survey was to evaluate the psychosocial impact of tooth agenesis in children and to investigate the potential influence of gender, socioeconomic status, severity of tooth absence, and the number of retained primary teeth on their quality of life. MATERIALS AND METHODS: A total of 86 children (36 male, 50 female) with tooth agenesis, aged 11-14 years were recruited from the Birmingham Dental Hospital, United Kingdom. Thirty subjects with a complete dentition and having a low treatment need acted as controls. Children completed the validated Child Perceptions Questionnaire (CPQ) and their parents completed the Parental-Caregiver Perceptions Questionnaire (P-CPQ). RESULTS: The median number of missing teeth in the sample population was 6. There were significant differences in the oral symptoms, functional limitations and the social and emotional well-being reported between the agenesis and control groups. The overall CPQ scores were significantly higher in children with tooth agenesis (P<0·001). No significant correlation was detected between the number of missing teeth and the quality of life score. There was no influence found on the CPQ score from gender, socioeconomic status, the site of agenesis or the presence of retained primary teeth. There was moderate correlation between parental and child reported quality of life. CONCLUSIONS: Tooth agenesis can have a significant impact on the quality of life of children, resulting in oral symptoms, functional limitation and also affecting emotional and social well-being. This does not appear to be related to the number of missing teeth. This study has implications for our understanding of the effect of tooth absence on the quality of life of children and their parents and addressing these reported impacts may help to improve patient satisfaction.

Effects of playing a wind instrument on the occlusion.

INTRODUCTION: There is a popular belief among some musicians that playing a wind instrument regularly can affect the position of the teeth. The aim of this study was to investigate this hypothesis. METHODS: A cross-sectional observational study was carried out, comparing the occlusions of 170 professional musicians selected from 21 orchestras and organizations in the United Kingdom. The subjects were subdivided according to type of instrument mouthpiece and included 32 brass players with large cup-shaped mouthpieces, 42 brass players with small cup-shaped mouthpieces, and 37 woodwind players with single-reed mouthpieces. Fifty-nine string and percussion players formed the control group. Impressions were taken of the teeth of each subject, and occlusal parameters were assessed from the study casts. The results were analyzed by using analysis of variance (ANOVA) and chi-square tests. RESULTS: No statistically significant differences were found in overjet (P = 0.75), overbite (P = 0.55), crowding (maxillary arch, P = 0.31; mandibular arch, P = 0.10), irregularity index (maxillary arch, P = 0.99; mandibular arch, P = 0.16), and the prevalence of incisor classification (P = 0.15) between the wind instrument players and the control group. However, the large-mouthpiece brass group had a significantly higher prevalence of lingual crossbites in comparison with all other groups. CONCLUSIONS: Playing a wind instrument does not significantly influence the position of the anterior teeth and is not a major etiologic factor in the development of a malocclusion. However, playing a brass instrument with a large cup-shaped mouthpiece might predispose a musician to develop lingual crossbites or lingual crossbite tendencies.

A comparison of different ligation methods on friction.

INTRODUCTION: An elastomeric module with a polymeric coating has been developed to reduce the friction of sliding mechanics. This in-vitro study examined the stability of the coating and compared the frictional properties of coated modules with those of other common ligation methods. METHODS: Six ligation methods (regular uncoated, slick [coated], conventional silver, easy-to-tie, silicone-impregnated, and standard silver modules) were used with standard stainless steel brackets and 0.019 x 0.025-in archwires, and resistance to movement was measured. Two self-ligating (Speed [Strite Industries, Cambridge, Ontario, Canada] and Damon 2 [Sybron Dental Specialities Ormco, Orange, Calif]) brackets were also tested. RESULTS: The Damon 2 self-ligating brackets produced less friction than the other ligation methods, followed by the coated modules. There was no significant difference between the frictional resistance of brackets ligated with regular uncoated, silicone-impregnated, and easy-to-tie modules. Speed self-ligating brackets produced less friction than regular uncoated, conventional silver, and standard silver modules. The frictional properties of coated modules were not significantly affected by repeating the test 5 times or by storage in saliva for a week. CONCLUSIONS: Damon 2 brackets produced no recordable friction of ligation. Coated modules produced 50% less friction than all other ligation methods except Damon 2. The coating was resistant to the simulated effects of the oral environment. Different methods of human saliva application were found to affect the frictional properties of the coating.

Clinical outcome monitoring program (COMP): a new application for use in orthodontic audits and research.

Awareness has been growing in recent years about the importance of clinical auditing to provide better orthodontic care to patients. A new, flexible software package, Clinical outcomes monitoring program (COMP), designed to facilitate clinical audits and research, is described. COMP is simple and easy to use and allows clinicians to gather a full data set with the PAR, ICON, or IOTN indexes and to accurately describe clinical outcome and activity. An audit was carried out to demonstrate the use of the software. A total of 205 consecutively finished patients from Good Hope Hospital, Sutton Coldfield, United Kingdom, were analyzed with the software. General and personal trends for 2 clinicians working in a multioperator unit were examined. Results for the unit showed an average PAR improvement of 77.5%, with clinician A performing marginally better overall than clinician B. A general tendency to be less efficient at improving the right, rather than the left, molar relationship was identified. This problem was particularly evident for clinician B, who achieved on average only a 10% improvement in this area. We conclude that COMP is potentially a useful and powerful tool to facilitate orthodontic audits and research.

The effect of ligation method on friction in sliding mechanics.

During orthodontic tooth movement with the preadjusted edgewise system, friction generated at the bracket/archwire interface tends to impede the desired movement. The method of ligation is an important contributor to this frictional force. This in vitro study investigated the effect of ligation method on friction and evaluated the efficacy of the new slick elastomeric modules from TP Orthodontics (La Porte, Ind), which are claimed to reduce friction at the module/wire interface. Slick modules were compared with regular nonslick modules, stainless steel ligatures, and the SPEED self-ligating bracket system (Strite Industries, Cambridge, Ontario, Canada). The effect of using slick modules with metal-reinforced ceramic (Clarity, 3M Unitek, Monrovia, Calif) and miniature brackets (Minitwin, 3M Unitek) was also examined. Results showed that, when considering tooth movement along a 0.019 x 0.025-in stainless steel archwire, saliva-lubricated slick modules can reduce static friction at the module/archwire interface by up to 60%, regardless of the bracket system. The SPEED brackets produced the lowest friction compared with the 3 other tested bracket systems when regular modules were used. The use of slick modules, however, with all of the ligated bracket types tested significantly reduced friction to below the values recorded in the SPEED groups. Loosely tied stainless steel ligatures were found to generate the least friction.

An investigation into the relationship between the cranial base angle and malocclusion.

A number of authors have suggested that there is a relationship between the degree of cranial base flexion and type of malocclusion, with the angle becoming increasingly obtuse from class III through class I to class II subjects. A retrospective cephalometric study was carried out to examine the contribution of cranial base angle in the four groups of malocclusion as classified by the British Standards Institution. Results showed that the cranial base flexure does not play a pivotal role in determining malocclusion. Jaw size, however, was significantly different between the main classes of malocclusion. The maxilla was found to be longer in class II subjects and the mandible longer in class III subjects.