Análisis de diferentes protocolos cefalométricos laterales. Parte II: consideraciones sobre diferentes aplicaciones / Analysis of different lateral cephalometric protocols. Part II: consideratios on different applications

El objetivo de esta segunda parte es relacionar el protocolo utilizado en el Ateneo Argentino de Odontología (A.A.O.) expuesto en la Parte I, con los cefalogramas laterales diseñados por los Dres. Arne Björk, Joseph Jarabak, James McNamara y Robert Ricketts y proponer las visiones complementarias en la búsqueda de un diagnóstico y un plan de tratamiento de mayor precisión. La aplicación de una secuencia lógica en el diagnóstico de una maloclusión permite establecer una categoría de análisis jerarquizada en función de los condicionantes y de las posibilidades de intervención terapéutica (AU)

The objective of this second part is to relate the protocol used in the Ateneo Argentino de Odontología (A.A.O.) exposed in Part I, with the lateral cephalograms designed by the Drs. Arne Bjork, Joseph Jarabak, James McNamara and Robert Ricketts and propose complementary visions in the search for a more accurate diagnosis and treatment plan. The application of a logical sequence in the diagnosis of malocclusion, allows to establish a category of hierarchical analysis according to the conditions and the possibilities of therapeutic intervention (AU)

Guidelines for development of Implant Dentistry in the next 10 years regarding innovation, education, certification, and associations.

BACKGROUND: During the third Summer Camp of European Association of Osseointegration (EAO), 40 junior representatives from various European societies and associations were brought together to discuss and explore the following topics in Implant Dentistry in the next 10 years: (I) certification, (II) societies and associations, (III) continuing education, and (IV) innovations. AIMS: The aims of all working groups were to identify and outline the present situation in the area of the selected topic and to propose improvements and innovations to be implemented in the following 10 years. MATERIALS AND METHODS: Four different groups were assigned randomly to one of the four working units. The method to discuss the selected topics was World Cafè. The summaries of four topics were then given to all participants for peer review. RESULTS AND CONCLUSIONS: All four groups presented the conclusions and guidelines accordingly: (I) The recognition for Implant Dentistry and accreditation of training programs would lead to an improvement of the quality of care to the benefit of the patients; (II) Dental associations and societies have to continuously improve communication to meet needs of dental students, professionals, and patients (III) European Dental Board should be installed and become responsible for continue dental education; (IV) dental engineering, peri-implant diseases, and digital workflow in dentistry currently have limited tools that do not guarantee predictable results.

British Orthodontic Society's initiative on orthodontic retention, A GDP's perspective.

The British Orthodontic Society (BOS) recently published a number of news articles aimed at drawing attention to its 'Hold that Smile' campaign which promotes lifelong retainer wear. The BOS's stated intention is to 'generate a viral #HoldthatSmile campaign in order to build awareness of its message that retainers are for life'. The campaign also seeks to recruit the support of GDPs and DCPs, including nurses, in motivating patients to wear retainers for life. It suggests that orthodontists and GDPs need to work collaboratively and suggests that dentists would need to check patients are taking care of their retainers over the long term. This article discusses a number of aspects of the BOS's initiative on retention including the public campaign, the evidence base, long-term retention care, retrospective support, the impact on consent, considerations for GDPs and record-keeping with suggestions on improving long-term support for patients.

Global networking: Meeting the challenges, facilitating collaboration.

The constant change of information and technology advancement as well as the impact of social media has radically changed the world and education and, in particular, the needs of students, organisations and disadvantaged communities who share the aim of training and providing quality healthcare services. Dental organisations and education centres around the world have recognised the importance of networking in delivering effective education to students, healthcare professionals and communities. Networking is one way to meet the challenges of delivering healthcare education and services. This can be achieved by sharing of resources, expertise, knowledge and experience to benefit all the stakeholders in healthcare delivery. The joint ADEE/ADEA Meeting in London on 8-9 May 2017 has facilitated discussions amongst dental educators from all over the world during a workshop on "Global Networking: the how and why for dental educators." The aim of this workshop was to determine how can dental educators worldwide network to share ideas, experience, expertise and resources to improve both the curricula and the teaching and learning environment. A pre-conference survey was designed and implemented to identify the domains of interest and needs of participants. A structured questionnaire was administered, and this information was used to guide discussions on three main themes: curricula, faculty development and mobility of faculty and students. Four questions were then defined to help group leaders to frame discussions in the four working groups. The four groups engaged in parallel discussions, with the ideas recorded and collated by group leaders, which later served for the thematic analysis across the groups to draw the key points discussed. Overall, a great desire and potential to create a global networking to share and gain support and expertise at individual and organisational level was apparent and the working group has proposed an action plan, acknowledging that it requires great planning, effort and commitment.

FDI-Unilever Brush Day & Night partnership: 12†years of improving behaviour for better oral health.

Twelve years ago, FDI World Dental Federation and Unilever Oral Care began a partnership to raise awareness of oral health globally. This aim reflects FDI's mission to "lead the world to optimal oral health", and one of the goals set by the Unilever Sustainable Living Plan "to improve health and well-being for more than 1 billion" by 2020. This partnership has developed a series of public health programmes to improve the brushing habits of targeted populations through health promotion and educational campaigns worldwide. Building on the success of the first two phases of the partnership, the third phase (Phase III), named Brush Day & Night, aimed to educate children in brushing twice-daily with fluoride toothpaste via a 21 Day school programme. This article reports the main outcomes of the past 12 years of this partnership, in particular the key outreach and figures of Phase III evaluation. School programmes were implemented in 10 countries, where local teams collected data from children aged between 2 and 12 years to monitor their oral health behaviours using specific indicators. In addition to the school programme, the World Oral Health Day was used as a vehicle to convey oral health awareness to influential governing bodies and the public. As a result, over 4 million people were directly reached by the programme in 2016.

What do dental codes of ethics and conduct suggest about attitudes to raising concerns and self-regulation?

Background The ability of the dental profession to self-regulate and address poor performance or impairment is crucial if practitioners are to demonstrate a public commitment to patient safety. Failure of the profession to actively engage in this activity is likely to call into question trustworthiness and ability to place the interests of patients and the public first.Aim To investigate attitudes towards self-regulation and the raising of concerns as expressed through the ethical codes of different dental professional and regulatory organisations.Method A qualitative review of professional codes of ethics written and published by dental associations and regulatory bodies using thematic analysis to discern common attitudes and perspectives on self-regulation.Results Four main themes were identified; (1) explicit expression of the need to report; (2) warning against frivolous reporting; (3) acceptance of reporting being difficult and; (4) threshold requiring a professional to report. From these themes, common and differing attitudes were then explored.Conclusions This review shows that often codes of ethics and practice do discuss an obligation to self-regulate and raise concerns but that this is accompanied by an anxiety surrounding unsubstantiated or malicious reporting. This gives the collective guidance a defensive tone and message that may be unhelpful in promoting a culture of openness and candour.

A multi-centered epidemiological study evaluating the validity of the treatment difficulty indices developed by the Japan Prosthodontic Society.

PURPOSE: The Japan Prosthodontic Society developed a multi-axis assessment protocol to evaluate the complex variations in patients who need prosthodontic care, and to classify the level of treatment difficulty. A previous report found the protocol to be sufficiently reliable. The purpose of this multi-center cohort study was to evaluate the validity of this multi-axis assessment protocol. METHODS: The treatment difficulty was evaluated using the multi-axis assessment protocol before starting prosthodontic treatment. The time required for active prosthodontic treatment, medical resources such as treatment cost, and changes in the oral health-related QOL before and after treatment, were evaluated after treatment completion. The construct validity of this protocol was assessed by the correlation between the dentist's pre-operative subjective assessment of the treatment difficulty, and the level of difficulty determined by this protocol. The predictive validity was assessed estimating the correlations between a "comprehensive level of treatment difficulty" based on the four axes of this protocol and total treatment cost, total treatment time, and changes in the oral health-related QOL before and after treatment. RESULTS: The construct validity of this protocol was well documented except for psychological assessment. Regarding the predictive validity, the comprehensive level of treatment difficulty assessed before treatment was significantly correlated with the three surrogate endpoints known to be related to the treatment difficulty (total treatment cost, treatment time, and improvement in the oral health-related QOL). To further clarify the validity of the protocol according to patients' oral condition, a subgroup analysis by defects was performed. Analyses revealed that treatment difficulty assessment before treatment was significantly related to one or two surrogate endpoints in the fully edentulous patients and the partially edentulous patients. No significant relationship was observed in the patients with mixture of full/partial edentulism and the patients with teeth problems, possibly due to the small sample size in these groups. CONCLUSION: This study revealed that the multi-axis assessment protocol was sufficiently valid to predict the level of treatment difficulty in prosthodontic care in patients with fully edentulous defects and with partially edentulous defects.

Massachusetts Dental Schools Respond to the Prescription Opioid Crisis: A Statewide Collaboration.

The prescription opioid crisis has involved all sectors of U.S. society, affecting every community, socioeconomic group, and age group. While federal and state agencies are actively working to deal with the epidemic, medical and dental providers have been tasked to increase their awareness of the issues and consider ways to safely prescribe opioids and, at the same time, effectively treat their patients' pain. The Commonwealth of Massachusetts, under the leadership of Governor Charles D. Baker and his administration, challenged the state's four medical schools and three dental schools to improve their curricula to prepare the next generation of clinicians to deal with this crisis in an evidence-based, effective, and sympathetic way. This Perspectives article outlines the national prescription opioid crisis, details its effects in Massachusetts, and describes the interdisciplinary collaboration among the Commonwealth, the three dental schools, the Massachusetts Dental Society, and a concerned student group. The article also describes the efforts each dental school is undertaking as well as an assessment of the challenges and limitations in implementing the initiative. The authors hope that the Massachusetts model will be a useful resource for dental schools in other states.

Strengthening the American Academy of Pediatric Dentistry's Public Policy Advocate Network: Identifying Advocacy Efforts and Recommendations.

PURPOSE: The purposes of this study were to collect information on involvement, training, and barriers to participation in advocacy efforts for Public Policy Advocates (PPAs) of the American Academy of Pediatric Dentistry (AAPD) and make recommendations to the AAPD. METHODS: Preliminary data were collected from the PPAs during structured AAPD program meetings, conference calls, and individual interviews. Based on these data, a survey was created, piloted, and sent electronically to all PPAs. Data were analyzed and collated by frequencies. RESULTS: Responses from 38 PPAs (100 percent) revealed they were involved with state legislatures and state chapters of the AAPD and American Dental Association. Eighty-two percent of the PPAs requested additional public policy training and clearer communication channels within the network. PPAs are funding their own advocacy efforts, and the time and resources spent away from patient care is a financial barrier. CONCLUSIONS: The Public Policy Advocate network holds a broad policy skill set and voluntarily commits time and resource to advocate for the support of the pediatric dental patient at state and federal government levels. The American Academy of Pediatric Dentistry can strengthen the PPA's self-directed leadership role at state and federal levels through formalized training, restructuring of the network, and increased resources.