Labial frenectomy: current clinical practice of orthodontists in the United Kingdom.

OBJECTIVES: To obtain views of orthodontists in the United Kingdom on frenectomy in terms of its indications and timing and a recommended retention regimen after correction of median diastema. MATERIALS AND METHODS: A 14-item online questionnaire was sent to orthodontic specialists for completion. The questionnaire covered demographics and orthodontists' experience and views on frenectomy. RESULTS: Three hundred and fifty-three orthodontists with various background and experience responded to the survey. Three-quarters of respondents routinely performed a blanche test to aid diagnosis of the abnormal frenum; however, only 15% carried out radiographic investigation. Three-quarters of the orthodontists would consider frenectomy as a part of orthodontic treatment, and variation existed among the clinicians in terms of its timing. Frenectomy without orthodontic treatment was not preferred. There was much variation in the retention regimen after diastema closure regardless of frenectomy. CONCLUSIONS: Complete consensus among the orthodontists was not obtained; however, some agreement was found regarding the development of a logical diagnosis and treatment approach. High-quality studies are required to produce national protocols or UK guidelines.

Application of the diode laser for soft-tissue surgery in orthodontics: Case series.

Referral to an oral surgeon for soft-tissue surgery before, during or after orthodontic treatment is not uncommon. This process may delay treatment and could potentially increase the risk of complications. In addition, seeing multiple specialties in different environments may demotivate paediatric or anxious patients from pursuing orthodontic treatment and could also adversely affect patient compliance and satisfaction. The development of laser technology provides a safe and effective alternative, allowing the orthodontic clinician to perform soft-tissue surgery. To date, there are no laser exposure protocols or UK guidelines regarding the use of laser surgery in orthodontics. This case series reports four clinical cases that demonstrate potential advantages of using a diode laser for the management of soft tissue in the field of orthodontics.

Information retention of orthodontic patients and parents: A randomized controlled trial.

INTRODUCTION: A randomized controlled trial was undertaken to compare the efficacy of 3 methods of delivering information on short- and long-term recall of information in orthodontic patients and parents. METHODS: Participants who received an audiovisual presentation on orthodontic treatment were randomly allocated to 1 of 3 written information groups (leaflets, generic mind map, or participant's customized mind map). A questionnaire was used to assess short- and long-term retention of information (maximum score 30). RESULTS: Eighty-eight patients (94.6%) and 77 parents (86.5%) completed the study. The average knowledge scores at baseline for the patient groups were 17.71 95 CI 16.28-19.14), 16.58 (14.67-18.49), and 17.37 (15.92-18.81), respectively. The parents' knowledge scores for the 3 groups were 19.06 (17.51-20.62), 19.39 (17.44-21.35), and 18.76 (17.19-20.33), respectively. The short- and long-term knowledge scores improved over baseline in all 3 groups (P <0.0001). The parents achieved higher scores than the patients (P = 0.002) and their rate of forgetting information was less. The knowledge scores of the mind map groups were higher than that of the leaflet group for all cohorts (P = 0.025). No statistical difference was found between the type of mind map. The correlation between patient and parent knowledge scores was significant (P <0.0001) at all 3 time points. CONCLUSIONS: Provision of an audiovisual presentation supplemented with 1 of 3 written information methods is an effective way of delivering information. There was a significant improvement in the retention of information with the use of mind maps compared with leaflets. The generic mind map is equally as effective, more consistent in information delivered, and less labor intensive than the individual customized mind map and therefore would be our recommendation. Participation of parents is important because they comprehend and retain information better. In this study, 100% of parents shared information with their children, perhaps improving the patients' recall.

Leiomyosarcoma of the tongue with multiple metastases: a case report and review of literature.

Leiomyosarcoma of the tongue is an extremely rare malignant mesenchymal neoplasm and only 25 cases have been described in the English-language literature, 22 of which were primary lesions. A case is presented of a 54-year-old female patient diagnosed with primary leiomyosarcoma of the tongue with lung and multiple soft tissue metastases. This case is especially unusual because widespread soft tissue metastases resulted, involving the lung and skeletal muscle in 3 separate sites. Unfortunately, curative treatment was not possible. Chemotherapy using a combination of ifosfamide and doxorubicin was, therefore, provided as palliation, with a good response after a 3-week cycle of therapy. Currently available literature on primary and secondary leiomyosarcoma of the tongue was reviewed for a better understanding of this rare mesenchymal neoplasm. To the investigators' knowledge, there are no other reported cases in the literature that have previously been managed with chemotherapy alone.

Multiple synchronous cutaneous squamous cell carcinomas of the head and neck: a case report.

Cutaneous squamous cell carcinoma (CSCC) is the second most common skin cancer in whites, with a relatively low metastatic potential and a general amenability to local treatment. However, patients with high-risk CSCC is more likely to develop local and distant metastases that could be fatal. We present a case of an 82-year-old white man who initially presented with a solitary squamous cell carcinoma (SCC) of the scalp and subsequently developed more than 40 primary CSCC lesions and metastases to the right parotid lymph nodes and thoracic vertebrae within 14 months of the primary diagnosis. Our report highlights the challenges that aggressive SCC can bring in the elderly population and describes some of the treatment modalities of CSCC.