Does facial growth pattern affect the perception of lower facial asymmetry?

OBJECTIVES: To investigate the influence of vertical facial type on esthetic perception of lower facial asymmetry as evaluated by orthodontists, dentists, and laypeople. MATERIALS AND METHODS: Three adult females were selected with normal growth patterns (NGP), vertical growth patterns (VGP), and horizontal growth patterns (HGP). Frontal photographs were made symmetric and digitally altered, rotating the lower facial third clockwise, ranging from 0° to 6° in 1° increments. A web-based survey was designed with 24 images (eight images for each model) in random order. Each image was rated using a scale ranging from 0 (unattractive) to 10 (the most attractive) by 75 orthodontists, 73 dentists, and 78 laypeople. Kruskal-Wallis test was used to determine whether differences among groups were significant. Pairwise comparisons were made with Mann-Whitney U test. The significance level was set at P = .05. RESULTS: In NGP, orthodontists and dentists could recognize slighter deviations (2°), while deviations in VGP and HGP under 3° were not recognized by all groups. Severe deviations (≥4°) were distinguished better in HGP by orthodontists and laypeople. In VGP and NGP, there was no significant difference over 4°. CONCLUSIONS: Growth pattern has a significant influence on perception of lower facial asymmetry. Less severe asymmetry can be detected better in NGP. In severe degrees, increments of asymmetry can be perceived more in HGP by orthodontists and laypeople.

Evaluating the impact of social media marketing from the perspective of orthodontists.

OBJECTIVE: In developed countries, orthodontists utilize social media platforms as a pivotal component of their marketing strategies. However, there exists a gap in understanding the broader perspective of healthcare professionals on the utilization of social media in healthcare service delivery. Therefore, this study aims to evaluate the perceptions of healthcare professionals in Turkey regarding the integration of social media within healthcare service delivery. MATERIALS & METHODS: This cross-sectional study, conducted between January and February 2023, surveyed 378 members of the Turkish Orthodontic Society. The survey consisted of two parts: a demographic questionnaire with 28 items and a 21-item "Social Media Marketing Activities Scale," developed with input from three experts. Data analysis will include an explanatory factor analysis. This study provides a snapshot of orthodontists' perspectives on social media marketing practices. RESULTS: When participants' views of patient communication through social media were examined, 19.8% said they "thought it was right" and 80.2% said they "thought it was wrong". The treatment and treatment alternatives shared with patients through social media were implemented in 16.5% of cases and not implemented in 83.5% of cases. When examining the social media accounts used by participants to communicate with patients, 56.8% used personal accounts, 43.2% used professional accounts, and when analyzing the social media accounts they used for promotional purposes, 15.8% had personal accounts, 84.2% of them used professional accounts. More than half (59.8%) of orthodontists believed that communicating with patients on social media could cause legal problems. The majority of orthodontists (88.7%) followed their competitors. CONCLUSION: The prevalence of participants' use of social media posts for advertising purposes was low, and it was determined that the main reason for this was the prohibition of advertising in the provision of health services.

Aesthetic assessment of maxillary lateral and canine implant-supported crowns by laypersons and orthodontists.

INTRODUCTION: The objectives of this study were to evaluate how laypersons and orthodontists evaluate and rank aesthetic parameters of an implant-supported crown (ISC) on the canine position (ISC-C) and lateral position (ISC-L). METHODS: A digital survey of 11 cases, 5 ISC-C, 5 ISC-L and 1 control case without ISC, was distributed to 207 laypersons and 296 orthodontists. All cases included one extraoral photograph and three intraoral photographs. The respondents were asked to identify the ISC and to evaluate the aesthetic parameters regarding colour of the implant (CI), shape of the implant (SI) and gingival colour around ISC (GCI). Differences within and between the groups were tested using Chi-2-test and Independent-Samples t-test. RESULTS: All invited laypersons and 184 orthodontists (62% response rate) answered the survey. Orthodontists (89%) more correctly identified the ISC, regardless of its position, than laypersons (50%) (p < 0.001). Both laypersons (54%) and orthodontists (23%) rated higher proportions of acceptance of CI, SI and GCI in favour for the ISC-L than ISC-C (laypersons: 40%, orthodontists: 10%) (p < 0.001). Assessing each parameter separately, orthodontists rated higher for ISC-L, compared to the ISC-C (p < 0.001). In general, laypersons and orthodontist ranked tooth colour (mean, standard deviation [SD]:8.0,1.5 and 9.0, 1.0) and tooth shape (mean, SD: 8.0, 1.7 and 8.8, 1.2) as aesthetically higher than the gingival colour (mean, SD: 7.2, 2.2 and 8.0, 1.7) (p > 0.001).  Conclusion: Laypersons and orthodontists consider the ISC-L as aesthetically more preferable, compared to the ISC-C.

Un "boxing" the reality: Knowledge, attitude, and perception of orthodontists, dental practitioners, and orthodontic patients toward mouthguards' wear during contact sports-A cross-sectional study.

INTRODUCTION: Mouthguards (MGs) have the potential to prevent contact sport-related dental injuries. However, varying perceptions of their effectiveness persist, influencing recommendations by dental professionals. AIM: To assess the attitudes, knowledge, and perceptions of orthodontists, other dental practitioners (general dentists and other dental specialists), and orthodontic patients involved in contact sports regarding the use of MGs. METHODOLOGY: A cross-sectional survey was designed to collect information from dental clinicians (orthodontists and other dental practitioners) and their orthodontic patients about using MGs during sports participation. A convenience sampling technique was used to recruit the participants for an online survey. A total of 107 (32 males/75 females) dental clinicians and 147 (75 males/72 females) orthodontic patients (mean age 17.5 ± 5.84 years) participated in the study. Pre-validated questionnaires, specifically designed for dental clinicians and orthodontic patients, were used. Data were analyzed using SPSS software (version 28.0; SPSS). RESULTS: Nearly 50% of dental clinicians have recently recommended MGs to their patients in their clinical practice out of which 59% preferred the stock type; 33% of dental clinicians enquired their patients about involvement in contact sports during initial visits. The majority of orthodontic patients acquired knowledge about MGs through the Internet. More than half of orthodontic patients expressed unwillingness to pay for MGs, and 89% of orthodontic patients found using MGs during contact sports uncomfortable. CONCLUSION: The findings provide valuable insights into the practices and attitudes of dental clinicians and orthodontic patients regarding MGs, their recommendations, and the comfort levels associated with using them during contact sports.

Perceptions and utilization of tele-orthodontics: a survey of the members of the American Association of Orthodontists.

OBJECTIVE: This study aimed to investigate orthodontists' utilization and perceptions of tele-orthodontics. MATERIALS AND METHODS: A 30-item online survey was distributed to members of the American Association of Orthodontists (AAO). The questionnaire encompassed topics concerning the orthodontists' utilization, perceptions, clinical applications, limitations, and concerns regarding tele-orthodontics. Descriptive statistics were employed, and comparisons between responses from users and non-users were conducted  using Wilcoxon rank-sum tests and Fisher's exact tests. RESULTS: 152 members completed the survey, (response rate: 2.4%). More than two third of respondents (69.74%) were users of tele-orthodontics. Users were more aligned with the belief that tele-orthodontics facilitates effective communication (mean ± standard deviation (SD) 4.06 ± 0.83 vs. 3.33 ± 0.94, p < 0.001). Both groups agreed on the requirement of patient fees for tele-orthodontic visits (mean ± SD: 3.62 ± 1.11 users vs. 3.74 ± 1.02 non-users, p = 0.659), and on the capability  of the system to reduce unwarranted referrals (p = 0.20). The majority of participants acknowledged  the utility of the system in monitoring aligners' patients (89% in users vs. 61% in non-users, p < 0.001). Non-users expressed greater concerns regarding privacy risks (mean ± SD: 3.06 ± 0.97 users vs. 3.57 ± 0.86 non-users, p = 0.002). Both groups stressed the significance of obtaining informed consent before utilizing tele-orthodontics. CONCLUSIONS: The widespread acceptance of tele-orthodontics among AAO members was apparent, as demonstrated by their recognition of its effectiveness. There was notable variation in how users and non-users perceived tele-orthodontics. The study's results offer valuable insights into both the potential benefits and drawbacks of incorporating this technology into clinical practice from the clincians' perspective.

White spot lesion-related perception of aesthetics and treatment satisfaction among orthodontic patients, orthodontists and other dental specialists.

OBJECTIVE: To investigate the impact of various degrees of white spot lesions (WSLs) of maxillary anterior teeth on the aesthetic perception and treatment satisfaction among orthodontic patients, orthodontists and other dental specialists and to evaluate the differences among the three groups. METHODS: A total of 45 orthodontic patients (OP), 45 orthodontists (OR) and 45 other dental specialists (OS) were recruited. Subjective evaluations of perceived aesthetics and treatment satisfaction were performed towards eight digitally generated photographs of maxillary anterior teeth with incremental degrees of WSLs using a numerical visual analogue scale (VAS) from 0 to 100. Data were collected and analysed with descriptive statistics, repeated one-way analysis of variance and multivariable generalized estimating equations. RESULTS: A total of 135 valid questionnaires were collected. Regarding aesthetic scores for WSLs, OP gave more positive scores than OR and OS (p < .05) towards excessive white spot formation without colouration and were more tolerant than OR (p < .05) towards excessive white spot formation with slight colouration. The level of treatment satisfaction for slight to severe WSLs without cavitation was higher in OP than OR. Patients with higher education levels had more negative scores for aesthetic perception and treatment satisfaction (p < .05). Patients who brushed teeth more frequently scored lower in treatment satisfaction (p < .05). CONCLUSIONS: Orthodontists were the most critical when evaluating aesthetics and treatment satisfaction for slight to severe WSLs without cavitation. For orthodontic patients, better oral hygiene habits and higher education levels were associated with more critical attitudes towards WSLs.

Perception of Dental and Smile Esthetics by Orthodontists and Prosthodontists: A Pilot Study.

PURPOSE: To examine if there are differences in smile esthetic evaluation scores by orthodontists and prosthodontists and if there are changes in those scores when two evaluations are performed, when the time of observation is increased, and when the lips are present or absent from the images. MATERIALS AND METHODS: In total, 12 individuals participated in this pilot study. Two digital images were taken from each individual. The first digital image was a smile view, and the second image was an intraoral view. Two presentation files were prepared, with two images for each individual. The smile and dental attractiveness ratings were obtained from 10 specialists. RESULTS: Repeated measures ANOVA was applied including all four within-subject factors, the evaluator (E), the repetition (R), the time of observation (T), and the presence or not of lips (L). Factors E, T, and L each had a statistically significant main effect. E and R had a statistically significant combined effect. In particular, the esthetic score for the view with smile was overall higher than for the intraoral view. The same results were obtained when the analysis was repeated with the 10 evaluators grouped to prosthodontists and orthodontists, and the prosthodontists tended to score higher than the orthodontists. CONCLUSIONS: The evaluator and the presence of lips have a statistically significant effect. The present pilot study has found that three (E, L, R) out of four factors (T) are important for the evaluation of dental esthetics.

What do black patients expect from orthodontic treatment? The aesthetic perception of facial profile between orthodontists and black laypersons.

OBJECTIVE: To evaluate the influence of anteroposterior position of the soft tissue on facial attractiveness in black people, and compare the perception of aesthetics and satisfaction between orthodontists and black laypersons. METHODS: The sample was composed of 69 orthodontists and 69 laypersons of black ethnicity (n=138). Facial profile photographs of two black volunteers, a man and a woman, were digitally manipulated to change the position of the lips and chin, by making gradual changes of 4mm in relation to the true vertical line, simulating advance or retrusion of the soft tissues by -2, -6, -10, +2, +6, +10mm, totalling six images per sex. The photographs were classified by the research participants using a visual analogue scale (VAS), from 0 (unpleasant) to 100 (pleasant). The results were analyzed by generalized linear model and by the Fisher's exact test, considering the level of significance of 5%. RESULTS: The orthodontists and black laypersons considered straight profiles the most pleasant. The two groups classified the male profile as being more unpleasant in comparison with the female facial profile, which was concave. When evaluating all the images together, the image most indicated as being the most pleasant, once again, was the one with the straight profile, for both sexes. CONCLUSION: The influence of orthodontists' and laypersons' aesthetic perception on evaluating the facial profile of blacks was similar. The straight profile was classified as the most pleasant and the concave, as the most unpleasant.

Global survey to assess preferences when attending virtual orthodontic learning sessions: optimising uptake from virtual lectures.

OBJECTIVES: Understanding the issues concerning the conducting of virtual orthodontic learning sessions (VOLSs) is essential. This study aims to identify attendees- and host-related aspects that could optimise learning and uptake from the VOLSs. METHODOLOGY: Fourteen pre-validated questions were anonymously and electronically sent to 3000 orthodontic residents and specialists globally. The survey included demographic questions and questions to gauge attendees' engagement, memorising, and motivation-related factors. Reminders were sent at two-week intervals to non-respondents. The survey was closed when the sample size was met. Descriptive and inferential statistics were performed. RESULTS: 593 orthodontic residents and specialists (294 males and 299 females), primarily junior orthodontists and residents aged between 25 and 35 years of age, completed the survey. Post-VOLS recording was highly requested by the participants (8.84/10, 95% CI 8.67-9.00) with no significant influence of demographics on this trend (p > 0.05). Most of the participants were in favour of short post-VOLSs feedback (6.79/10 95% CI 6.58-6.99) with significant differences (p = 0.048) between participants from different regions of the world. The average number of screenshots taken was 6.1 per lecture. The learners' interests in attending on-line lectures were mainly to learn new clinical orthodontic tips (96.8%). CONCLUSION: Implementing a short feedback survey after VOLSs, the provision of recording, and the provision of certificates of attendance need to be considered.

Impact of assessing smile parameters as part of orthodontic treatment planning - a survey based analysis.

BACKGROUND: Smile forms an imporatnt aspect of facial analysis, as it contributes to overall facial esthetics. Many orthodontists pay more attention to cephalometric radiograph; and profile assessment to improve their patients' esthetics; however, the facial attractiveness of the individuals is obviously improved through enhancing their smiles. This study was aimed at evaluating the impact of analyzing certain smile esthetic parameters on diagnosis and treatment plan for individuals seeking orthodontic treatment. MATERIALS AND METHODS: An electronic questionnaire with 24 questions arranged on five main axes was designed. These axes included smile arc, smile line, buccal corridors, smile symmetry, and photographic analysis of the smile, with several questions in each axis. The electronic link of the questionnaire was sent to all members of the Iraqi Orthodontic Society in April 2019. The answers were collected after 4 weeks of questionnaire link distribution date. RESULTS: Among the surveyed orthodontists, there was a consistent agreement to assess the smile arc, smile line, buccal corridors, and smile symmetry, with main axes scores (4.14 ± 0.81, 4.1 ± 0.79, 3.86 ± 0.82, and 4.16 ± 0.86 respectively). Moreover, the participants prefer, with 3.89 ± 0.86 main axis score, to use the facial photograph for a less time-consuming and detailed evaluation of smile features. CONCLUSIONS: Smile parameters, for example, smile arc, smile line, buccal corridors, and smile symmetry are better to be analyzed using photographs during orthodontic diagnosis and treatment planning.

The Perception of COVID-19 among Italian Dentists: An Orthodontic Point of View.

COVID-19 has severely impacted dentists, who are at a great risk of infection. This study aimed to investigate if dentists are anxious about returning to their daily activities, and what the perception of the risk is for dentists and orthodontists regarding orthodontic procedures. An online questionnaire, including the Patient Health Questionnaire-4 (PHQ-4), was sent to Italian dentists during the final days of the lockdown with items about anxiety, fear, distress, perceived risk for operators, and concerns about orthodontic patients caused by working during the COVID-19 outbreak. Data were analyzed with a chi-square test and logistic regression analysis. The level of significance was set as p < 0.05. A total of 349 dentists completed the survey, including 183 orthodontists. Returning to their daily work activity was a source of anxiety for 192 participants and this was associated with the level of distress (odds ratio (OR) = 3.7; p < 0.001). Most of the orthodontists (67.6%) thought that they would increase the number of working hours during the week (OR = 1.8; p = 0.007). Italian dentists were mostly scared to return to their daily activities because they considered their jobs a high risk to them and their families. Dentists with an exclusive/prevailing orthodontic activity were forced to increase their working day during the week.

Does the vertical position of maxillary central incisors in men influence smile esthetics perception?

INTRODUCTION: The aim of this study was to investigate whether there is any influence on the perception of smile esthetics among orthodontists and laypersons, with regard to different vertical positions of the maxillary central incisors. METHODS: Frontal smile photographs digitally altered at full-face view and close-up view of 2 adult men aged between 20 and 30 years were used. Six vertical positions of the central incisors were created, with changes of 0.5 mm. The images were randomly assembled in an album that was presented to 53 orthodontists and 53 laypersons, who evaluated the attractiveness of the images by using visual analog scales. Comparison among the images was performed using 1-way analysis of variance, with Tukey post-hoc test. To compare the distribution of the mean scores between the full-face and close-up smile views, and between orthodontists and laypersons, the Student t test was used. The level of significance was established at 5%. RESULTS: The best evaluations presented the following: (a) the gingival margins of the central incisors corresponded to, or were up to, 1 mm below the line of the canine gingival margins, and (b) the incisal step between the central and lateral incisors was from 1.0 to 2.0 mm. The smiles considered least attractive showed (a) the central incisor gingival margins were 1.0 mm above or 1.5 mm below the canine gingival margins, and (b) no step, or a step of 2.5 mm, between the central and lateral incisors. CONCLUSIONS: The results of this study suggested that, in men, slightly extruded central incisors were esthetically more attractive than intruded incisors.

Knowledge and beliefs regarding temporomandibular disorders among orthodontists.

INTRODUCTION: This project was undertaken to accomplish 2 objectives: (1) to identify whether there is a discrepancy between orthodontists and experts in temporomandibular disorders (TMD) related to diagnosis and treatment of TMD patients, and (2) to influence the manner in which TMD curricula are taught in orthodontic residency programs, better preparing future orthodontic specialists to diagnose and treat (and refer) patients with TMD. METHODS: A survey invitation was e-mailed to 8870 members of the American Association of Orthodontists. Items were answered on a 6-point scale (0 = I don't know; 1 = strongly disagree; 2 = disagree; 3 = neutral; 4 = agree; 5 = strongly agree). A group consensus was attributed when more than 50% of the orthodontists supported a response. Previously published responses of TMD experts were used as a reference to evaluate the orthodontists' responses. Comparisons between the responses from the 2 groups were assessed using a z-test. RESULTS: Among the participants who responded to the questionnaire, 148 were residents, 1132 were private practitioners, and 61 were full-time faculty. Sixty-two percent of the participants did not think they received enough training in TMD during their orthodontic residency. Although 62% of participants indicated that they feel comfortable diagnosing TMD patients, 50.2% do not feel comfortable treating TMD patients. There was no significant difference between the 2 groups' responses under one-third of the questions. CONCLUSIONS: It is clear that orthodontic residencies in the U.S. need to improve methods of teaching TMD concepts. Although most orthodontists feel comfortable diagnosing TMD patients, less than half feel comfortable treating those patients, and the difference in responses with the TMD expert group was significant in 71% of the questions.

Variation in bracket slot sizes, ligation methods and prescriptions: UK national survey.

OBJECTIVE: This study designed to investigate the use of fixed bracket slot sizes, ligation method and prescriptions in the UK using an online survey/questionnaire comprised of seven questions. MATERIAL AND METHODS: The questionnaire link along with an explanation of its nature was circulated via the British Orthodontic Society (BOS) to all 978-email addresses of the Consultant Orthodontists Group (COG) and Orthodontic Specialists Group (OSG) (registered on the UK Specialist List for Orthodontics) members inviting them to participate. Two email reminders were sent to increase the response rate. Chi2 analyses determined the statistical differences in the use of bracket slots and prescriptions according to the regions and years of experience. RESULTS: The respondents represented 31.2% of the BOS specialist orthodontic members. Most of the respondents practised in the South of England with experience between 11-30years. The vast majority of the respondents routinely used brackets with the multibracket appliance treatment (MBT) prescription (81.6%) and 0.022-inch slot size (98.7%), which was statistically significantly higher in all geographical regions and experience levels (P<0.001). The majority of the respondents reported either 100% or 90% use of conventional brackets when compared to self-ligating brackets. CONCLUSION: The vast majority of UK specialist orthodontists use conventional ligating MBT prescription brackets with the 0.022-inch slot size. This was mainly because they perceive that this combination provides better treatment outcomes, whilst many respondents also indicated that they were taught and trained using this combination and that there was not enough evidence to support a change in their clinical practice.

Comparative study between different groups of esthetic component of the Index of Orthodontic Treatment Need and eye tracking.

INTRODUCTION: The objective of this study was to determine how different people perceive distinct malocclusions with the use of eye tracking and to compare the results with scores from the subjective visual attractiveness scale (VAS) following 3 grades obtained from the Aesthetic Component of the Index of Orthodontic Treatment Need (AC-IOTN) scale. METHODS: Ninety participants were equally distributed into 3 groups-dentists, orthodontists, and laypeople-and underwent 1 eye-tracking session. After being positioned and calibrated, they were shown 3 dental images. The images reflected the AC-IOTN grades of 1 (close to ideal), 5 (borderline need for treatment), and 8 (definite need for treatment). During the viewing, eye-tracker data were collected for fixation points, duration, and attractiveness (according to the VAS) for each image. The variables were statistically tested with the use of 2-way analysis of variance and complete factorial model (between groups, grades, and for the interactions between them). RESULTS: Grade 1 received the highest subjective score independently from the participant group. This was in contrast to grades 5 and 8, which received similar scores, although the means of fixation points and duration were not significantly different among the grades (P > 0.05). The scores obtained from the dentist group were significantly higher than those from the other groups when the comparison was independent from the grade. In terms of fixation points, there were differences between dentists and orthodontists and between orthodontists and laypeople. The fixation point mean was higher for orthodontists than for dentists and was similar to that for laypeople. CONCLUSIONS: Orthodontists were able to closely analyze the occlusal problems presenting with more severe malocclusions, and the specialists noticed more fixation points. Duration times, however, were not significantly different, because the orthodontists had greater interest, even in situations of unfavorable esthetics.

Knowledge of orthodontic treatment approach of traumatized teeth by a group of Belgian general dentists, pediatric dentists, and orthodontists.

BACKGROUND/AIM: Traumatized teeth are more susceptible to complications during orthodontic tooth movement. The aim of this study was to explore current practices among Belgian dental practitioners regarding orthodontic treatment of children with a history of dental trauma. MATERIAL AND METHODS: A questionnaire survey was organized among general dentists, pediatric dentists, and orthodontists in Flanders (Belgium). Questionnaires were distributed at the occasions of annual meetings or symposia. They consisted of questions regarding exposure to dental trauma and orthodontic treatment approach for patients with a dental trauma history. RESULTS: The questionnaire was completed by 121 general dentists, 47 pediatric dentists, and 99 orthodontists. A history of dental trauma influenced referral for orthodontic treatment by general dentists and pediatric dentists moderately (median VAS scores of 5 and 6, respectively, on a scale of 0 (not at all) to 10 (utmost)), indicating uncertainty and doubt. Additional checkups during tooth movement were usually not organized by general dentists in 33.6% and by pediatric dentists in 19.1% of cases (P = 0.006). One-third of the orthodontists (33.3%) experienced tooth loss linked to orthodontic movement of a tooth with dental trauma history in at least one patient. Only a minority of the practitioners knew of the existence of specific guidelines (7.6%, 15.6% and 22.7%, respectively, of general dentists, pediatric dentists, and orthodontists) (P = 0.007). The Dental Trauma Guide was the guideline mentioned most frequently, although this tool does not contain recommendations regarding orthodontic treatment after trauma. CONCLUSION: In the group of Belgian general dental, pediatric and orthodontists surveyed, there was uncertainty regarding the orthodontic management of patients with a history of dental trauma especially among general practitioners. Further educational training is recommended.

Some orthodontists' experiences of volunteering for a community orthodontic initiative.

INTRODUCTION: In society, dental professionals, including orthodontists, are often viewed as being solely motivated by money. Nevertheless, numerous orthodontists volunteer for community initiatives where they provide free or heavily subsidized treatment for underserved populations. This study explores the motivations of a group of New Zealand orthodontists who volunteered for one of these initiatives, Wish For A Smile (WFAS), as well as the high and low points of this work. METHODS: Qualitative telephone interviews were conducted with 11 orthodontists who volunteer for WFAS. An inductive data analysis of the data was undertaken and a descriptive qualitative method was chosen. RESULTS: Most participants volunteered for WFAS because they desired to give back to the community. High points of their voluntary work were seeing patients' self-esteem, happiness, and future life chances increase as a result of treatment. Low points included seeing the challenging life circumstances of some WFAS patients and treating some adolescents who appeared not to qualify. A number of participants said WFAS patients were more grateful and cooperative than fee-paying patients, whereas others reported the opposite. CONCLUSIONS: There are many reasons why orthodontists volunteer for orthodontic community initiatives, although many may be motivated by a sense of social responsibility to give back to the community.

Understanding technology adoption by orthodontists: A qualitative study.

INTRODUCTION: Orthodontics is evolving with advances in 3D imaging, additive fabrication, digital scanning, and treatment planning. With digital tools, orthodontic treatment may become more predictable, efficient, and effective while reducing side-effects. These technologies are affecting patient care, but knowledge of their adoption patterns and influence is incomplete. We aimed to identify adoption decision makers, information sources, perspectives, incentives, and barriers. METHODS: Twenty-four privately practicing orthodontists were interviewed in a semistructured format following a topic guide. Interview transcripts were analyzed to identify factors in technology adoption and its perceived influence on practice. Thematic patterns were established through iterative systematic analysis, and qualitative validity was ensured with researcher triangulation. RESULTS: Qualitative interviews revealed that orthodontists make purchasing decisions independently from staff, after consulting other dentists and company representatives. Meetings, residency training, and continuing education courses are influential information sources, whereas research literature is not. Early and middle adopters are integrating digital imaging, planning, and fabrication technologies into practice and view enhanced ease of use, capabilities, performance, and procedural efficiency as primary incentives to adoption. Improving outcomes and patient comfort are not frequently cited as incentives, and all interviewees view cost as the largest barrier. Orthodontists positively perceive the influence of technology on their practices, but are concerned that further innovation and direct-to-consumer products will cause loss of market share. CONCLUSIONS: CAD/CAM appliances, 3D imaging, and digital treatment planning are viewed as future standards of care and are increasingly being incorporated into the orthodontic office. Understanding the technology adoption process can guide innovation to improve treatment and ease the transition into a digital workflow.

[Recognising and reporting child abuse by orthodontists]. / Herkenning en melding van kindermishandeling door orthodontisten.

In 2013, the child abuse and domestic violence reporting code was introduced in the Netherlands, which obliged caregivers to report suspicions of child abuse or domestic violence. In 2014, a survey was conducted among dentists on this subject. However, nothing was known about the use of the reporting code among orthodontists. In December 2015, a survey was sent to members of the Dutch Orthodontic Society (NVvO). The survey consisted of 20 items about applying the reporting code and experiences with patients. Most orthodontists were aware of the reporting code (83%) and had implemented this in their practice (64%). Nevertheless, orthodontists found it difficult to recognise signs of child abuse, mostly because of a lack of experience in this area. Most orthodontists who suspected child abuse took action, mainly by seeking advice from the foundation 'Veilig Thuis' ('Safe at Home').