[Factors playing a part in the failure of retention wires]. / Factoren die een rol spelen bij het falen van retentiespalken.

Retention plays an important part during orthodontic treatment. Orthodontic treatment can be divided into 2 phases: an active phase in which treatment is carried out with orthodontic appliances and a second, passive phase with retention, with which an attempt is made to prevent a return to the original or another position. In practice, fixed retainers with a retention wire are usually chosen because of the many advantages of such wires. Even though fixed retention is now the gold standard in orthodontic follow-up, it does fail fairly often. In particular, because the procedures for manufacturing and placing are technically sensitive. A number of studies report that on average 34.9% (range of 10.3-47%) of the bonded retention wires come loose after an average of 2 years. A number of factors play a part in this. Based on the literature, it is possible to make some practical recommendations on the lifespan of a retainer.

[Orthodontic treatment of a malocclusion with a compromised central upper incisor]. / Orthodontische behandeling van een malocclusie met een gecompromitteerde centrale bovenincisief.

An 11-year-old girl presented at an orthodontist asking for the correction of the crooked position of her upper and lower front teeth. In addition, the patient was concerned about the abnormal shape and size of tooth 21. There was a disto-occlusion, crowding and tooth gemination of tooth 21 with the shape of a dens invaginatus. The tooth, moreover, was infected. Teeth 21 and 14 were extracted as part of the treatment. By means of a guided transposition, tooth 23 was brought to the extraction site of tooth 21. Treatment was performed with hybrid fixed appliance techniques.

[Medication review in the mental health care service: experiences on long-stay units]. / Medicatiebeoordeling in de ggz: praktijkervaring op afdelingen voor langdurig verblijf.

BACKGROUND: Medication review is a recurrent, structured and critical evaluation of pharmacotherapy by patient, physician and pharmacist. The Dutch Health Care Inspectorate considers medication review to be a way of improving the quality and safety of drug treatment. However, little is known about the costs, effectiveness and feasibility of medication review in the practice of mental health care. AIM: To obtain an impression of the costs and benefits of a first medication review in a clinical mental health care setting with chronic patients. METHOD: In 2013, the mental health organisation Yulius enrolled 70 hospitalised chronic patients for a first medication review. A detailed record was kept of the prescribed medication, medication changes, and the time invested. RESULTS: More than half of the proposed changes in medication were eventually implemented; 20% of these changes were made during a planned evaluation after three months. The number of drugs prescribed decreased after medication review; the reduction applied more often to somatic medication than to psychotropic medication. Costs relating to medication reviews seemed to be at least in balance with the benefits. CONCLUSION: In the group of patients with severe mental disorder, medication review seems to provide a good opportunity to assess the rationality of pharmacotherapy in a multidisciplinary approach. The time invested appears to be offset by the benefits of medication review.