Knowledge, attitudes and professional practices of ortho-periodontal care of adults: a cross-sectional survey in France.

BACKGROUND: Due to increasing numbers of adult patients, orthodontists are being confronted more and more with periodontal problems. Coordination amongst orthodontists, periodontists and general dentists is useful in preventing and stopping periodontal disease. The main objectives of this survey were to evaluate the technical knowledge, techniques and attitudes employed by French orthodontists, periodontists and general dentists in adult dental care. METHODS: A cross-sectional online survey was distributed to French dentists. The questionnaire, consisting of 30 questions, was divided into six sections covering treatment programs and the forensic environment. RESULTS: One thousand one hundred twenty-two complete answers were recorded. Adults undergoing orthodontic treatment represented 19.9% of the orthodontists' patients, but only 2.67% of the general dentists' patients. Communication between clinicians was rated as good, greater than 3 out of 5. Before treatment, orthodontists were less alarmed than generalists regarding bleeding, recessions, increased probing depths, halitosis and hyperplasia. During treatment, orthodontists never or only occasionally performed palpation or probing in 54.2% and 84.6% of cases. Gingivitis and recessions were the main reasons for consultations for 22.0% and 20.1% of general dentists and periodontists after orthodontic treatment. Of the practitioners surveyed, 43% felt that they experienced a setback in the ortho-periodontal treatment. CONCLUSIONS: This study revealed discrepancies in the knowledge and attitudes of practitioners. Therapeutic management remains one of the major challenges of multidisciplinary treatments. Continuing education needs to be further developed in this field.

Accuracy evaluation of bracket repositioning by indirect bonding: hard acrylic CAD/CAM versus soft one-layer silicone trays, an in vitro study.

OBJECTIVES: Rapid development of digital technologies and 3D printing provide new tools for orthodontic indirect bonding. The purpose of this in vitro study is to evaluate the clinical acceptability of hard CAD/CAM indirect bonding tray. MATERIAL AND METHODS: Ten soft silicone transfer trays and ten hard CAD/CAM trays were produced, and 200 brackets were placed on them. The brackets were then transferred to twenty stereolithography -printed models by indirect bonding. These models were scanned and digitally compared with the reference model by three-dimensional superimpositions (GOM software). The linear and angular measurements were collected and analyzed. RESULTS: For the CAD/CAM trays, 100% of the mesiodistal, vertical, and transverse measurements of incisors were within the clinically acceptable range of the American Board of Orthodontists (ABO) standards. More specifically, the clinically acceptable linear measurements were between 97 and 100% for silicone trays while they were between 89 and 100% for CAD/CAM trays. The clinically acceptable angular measurements varied between 87 and 100% for the silicone trays and between 79 and 100% for the CAD/CAM trays. Silicone trays were more precise than CAD/CAM trays. The difference was significant for all linear and angular measurements. CONCLUSIONS: While the CAD/CAM group shows clinically acceptable results according to the ABO, silicone remains to be more precise than CAD/CAM for transfer trays and is therefore still the reference. CLINICAL RELEVANCE: We demonstrate here that the orthodontic indirect bondings, whether they are realized using silicone transfer trays or CAD/CAM trays, are clinically acceptable in terms of the repositioning accuracy of brackets.