An Evaluation of Knowledge, Attitude, and Practice of Accelerated Orthodontics amongst Orthodontists.

BACKGROUND: Accelerated orthodontic teeth movement are procedures carried out to increase the rate of tooth movement thereby reducing treatment time. There are numerous techniques currently available to accelerate orthodontic treatment time, but evidence is still needed to determine the degree to which orthodontists accept and practice accelerated orthodontics. The present study is aimed at assessing the knowledge of Orthodontists on the practice of accelerated orthodontics; as well as their willingness to adopt it as a treatment option for their patients. METHODOLOGY: Ethical approval was obtained before the commencement of the study. The study population comprised all orthodontists practicing in Nigeria. Questionnaires were administered physically to the orthodontists at their annual general meeting. E-mails were further used to distribute the questionnaire to the orthodontists who were absent from the annual meeting. The questionnaire obtained information on respondents' biodata, knowledge, attitude, and practice of accelerated orthodontic treatment procedures.Statistical analysis was performed using IBM SPSS software version 27. The level of significance was 0.05 for all statistical analysis. RESULTS: The study participants comprised 60 respondents, with a mean age of 34.18 years and a male-to-female ratio of 1.3:1. A Majority of them were satisfied with treatment time/duration (61.7%), they had a good knowledge of accelerated orthodontics (83.3%) with piezocision (75%) and micro-osteoperforation (63.3%) being the most popular. All orthodontists were interested in accelerated orthodontics, if it offered up to 30% reduction in treatment time. Major limitations to the practice included unavailability of technique materials (50%), insufficient knowledge (41.7%) and cost (35%). CONCLUSION: Most orthodontists did not routinely practice accelerated orthodontics despite adequate knowledge. They were willing to offer accelerated orthodontic treatment (AOT) if patients were willing to pay an additional fee. The less invasive methods were more accepted.

CONTEXTE: Les mouvements dentaires orthodontiques accélérés sont des procédures réalisées pour augmenter la vitesse de déplacement des dents, réduisant ainsi le temps de traitement. Il existe de nombreuses techniques actuellement disponibles pour accélérer le temps de traitement orthodontique, mais des preuves sont encore nécessaires pour déterminer dans quelle mesure les orthodontistes acceptent et pratiquent l'orthodontie accélérée. La présente étude vise à évaluer les connaissances des orthodontistes sur la pratique de l'orthodontie accélérée, ainsi que leur volonté de l'adopter comme option de traitement pour leurs patients. MÉTHODOLOGIE: L'approbation éthique a été obtenue avant le début de l'étude. La population étudiée comprenait tous les orthodontistes exerçant au Nigeria. Des questionnaires ont été administrés physiquement aux orthodontistes lors de leur assemblée générale annuelle. Des courriels ont ensuite été utilisés pour distribuer le questionnaire aux orthodontistes absents de l'assemblée annuelle. Le questionnaire a recueilli des informations sur les données biographiques des répondants, ainsi que sur leurs connaissances, attitudes et pratiques en matière de traitement orthodontique accéléré. L'analyse statistique a été réalisée à l'aide du logiciel IBM SPSS version 27. Le niveau de signification était de 0,05 pour toutes les analyses statistiques. RÉSULTATS: Les participants à l'étude étaient au nombre de 60, avec un âge moyen de 34,18 ans et un ratio hommes-femmes de 1,3:1. La majorité d'entre eux étaient satisfaits du temps/durée du traitement (61,7 %), ils avaient de bonnes connaissances en orthodontie accélérée (83,3 %) avec la piezocision (75 %) et la micro-ostéoperforation (63,3 %) étant les plus populaires. Tous les orthodontistes étaient intéressés par l'orthodontie accélérée, si elle offrait une réduction allant jusqu'à 30 % du temps de traitement. Les principales limitations à la pratique comprenaient l'indisponibilité des matériaux de technique (50 %), le manque de connaissances (41,7 %) et le coût (35 %). CONCLUSION: La plupart des orthodontistes ne pratiquaient pas systématiquement l'orthodontie accélérée malgré des connaissances adéquates. Ils étaient prêts à proposer un traitement orthodontique accéléré (TOA) si les patients étaient prêts à payer des frais supplémentaires. Les méthodes moins invasives étaient plus acceptées. MOTS-CLÉS: Orthodontie accélérée, orthodontiste, temps de traitement, piezocision.

An Audit of Orthodontic Retention Protocol in a Tertiary Health Institution: A 3-Year Retrospective Study.

BACKGROUND: The aim of this study was to determine the retention practices following orthodontic treatment in a tertiary health institution in Nigeria. METHODS: A retrospective study conducted in the Orthodontic Clinic of the Lagos University Teaching Hospital over a 3-year-period. Data on the type of retainers used and the retention practices in the upper and lower arches were obtained from case files of patients who had completed orthodontic treatment in the institution. Statistical analysis was performed using IBM SPSS software version 23. RESULTS: The demographic variables comprised of 136 subjects; 93 females (68.4%) and 43 males (31.6%). Their ages ranged from 9-44 years with a mean age of 18.96 ± 6.75. Class I malocclusion was the most common malocclusion pattern (84.6%), followed by Class II (10.3%) and Class III (5.1%). Removable retainers were more commonly used and accounted for retention carried out in 85.3% of the study population. There was a preference for the use of removable retainers in the upper arch; the Hawley retainer being the most used (79.4%). In the lower arch however, no form of retention was carried out for majority of the patients after orthodontic treatment (86.8%). However, when done, the fixed lingual retainer was the most frequently used (13.2%). CONCLUSION: The Hawley retainer was the predominant retainer in this study. The fixed lingual retainer was the most frequently used in the lower arch. Longitudinal studies are required to determine efficacy of different types of retention following orthodontic treatment.

CONTEXTE: Le but de cette étude était de déterminer les pratiques de rétention suite à un traitement orthodontique dans un établissement de santé tertiaire au Nigeria. MÉTHODES: Une étude rétrospective execute à la clinique d'orthodontie de l'hôpital universitaire de Lagos sur une période de 3 ans. Données sur le type de rétention utilisé et le les pratiques de rétention dans les arcades supérieures et inférieures ont été obtenues à partir des dossiers de patients ayant terminé un traitement orthodontique dans l'établissement. analyses statistiques a été réalisée à l'aide du logiciel IBM SPSS version 23. RÉSULTATS: Les variables démographiques comprenaient 136 sujets; 93 femmes (68,4%) et 43 hommes (31,6%). Leur âge variait de 9 à 44 ans avec un âge moyen de 18,96 ± 6,75 ans. La malocclusion de classe I était le modèle de malocclusion le plus courant (84,6%), suivie de la classe II (10,3%) et de la classe III (5,1%). Les dispositifs de retenue amovibles étaient plus couramment utilisés et représentaient la rétention effectuée dans 85,3% de la population étudiée. Il y avait une préférence pour l'utilisation de dispositifs de retenue amovibles dans l'arcade supérieure; le dispositif de retenue Hawley étant le plus utilisé (79,4%). Dans l'arcade inférieure cependant, aucune forme de rétention n'a été réalisée pour la majorité des patients après un traitement orthodontique (86,8%). Cependant, une fois terminé, le dispositif de retenue lingual fixe était le plus fréquemment utilisé (13,2%). CONCLUSION: Le dispositif de retenue Hawley était le dispositif de retenue prédominant dans cette étude. Le dispositif de retenue lingual fixe était le plus fréquemment utilisé dans l'arcade inférieure. Des études longitudinales sont nécessaires pour déterminer l'efficacité des différents types de rétention après un traitement orthodontique.

Demineralization preventive practices among Nigerian orthodontists-An evidence-based approach?

BACKGROUND: The prevalence of white spot lesions/tooth demineralization during orthodontic fixed appliance therapy ranges widely from 2 to 96% of patients. The purpose of this study was to evaluate measures used by orthodontists practicing in Nigeria to manage demineralization during and after fixed orthodontic treatment and how it compares with the available evidence-based information. METHOD: Study group comprised of 60 practitioners (21 orthodontists and 39 orthodontic residents) in Nigeria. Self-administered questionnaires were used to obtain information on the measures they use to prevent the occurrence of demineralization at the onset and during orthodontic treatment, as well as the management of its occurrence at treatment completion. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 17.0. Descriptive statistics were used. Level of significance was set at P < 0.05. RESULTS: Responses obtained showed that 96.7% of orthodontic practitioners routinely advised their patients on tooth cleaning methods; the use of manual orthodontic toothbrush (78.3%) and dental floss (51.7%) being popularly recommended methods. However, 51.7% used a specific demineralization preventive protocol at the start of treatment. Oral hygiene instruction was observed to be the most commonly adopted protocol (51.7%), followed by fluoride rinses (41.7%) (considered relatively ineffective). Extraoral hygiene instruction was the most common treatment protocol used when tooth demineralization occurred during and after treatment (56.7% and 73.3% respectively). Approximately 92% of the orthodontists agreed on the need for the development of a basic protocol to prevent demineralization. CONCLUSION: The demineralization preventive measures used by Nigerian orthodontists and orthodontic residents are inconsistent and not based on evidence-based information. The development of standardized demineralization prevention protocol was therefore recommended.

FACTORS ASSOCIATED WITH ODONTOGENIC BACTERAEMIA IN ORTHODONTIC PATIENTS.

BACKGROUND: Various researches have investigated factors associated with the prevalence and intensity of bacteraemia following oral procedures including orthodontic procedures. AIM: The aim of this study was to determine the effect of age, gender, plaque and gingival indices on the occurrence of odontogenic bacteraemia following orthodontic treatment procedures. SETTING: Orthodontic Clinic, Lagos University Teaching Hospital (LUTH), Lagos, Nigeria. METHODOLOGY: Using the consecutive, convenience sampling method, a total of 100 subjects who met the inclusion criteria were recruited for the study and peripheral blood was collected before and again within 2 minutes of completion of orthodontic procedures for microbiologic analysis using the BACTEC automated blood culture system and the lysis filtration methods of blood culturing. The subjects were randomly placed in one of four orthodontic procedures investigated: alginate impression making (Group I), separator placement (Group II), band cementation (Group III) and arch wire change (Group IV). Plaque and gingival indices were assessed using the plaque component of the Simplified Oral Hygiene Index (OHI-S) (Greene & Vermillion) and Modified gingival index (Lobene) respectively before blood collection. Spearman Point bi-serial correlations and logistic regression statistics were used for statistical evaluations at p < 0.05 level. RESULTS: An overall baseline prevalence of bacteraemia of 3% and 17% were observed using the BACCTEC and lysis filtration methods respectively. Similarly, overall prevalence of bacteraemia following orthodontic treatment procedures of 16% and 28% were observed respectively using the BACTEC and lysis filtration methods. A statistically significant increase in the prevalence of bateraemia was observed following separator placement (p=0.016). An increase in age, plaque index scores and modified gingival index scores of the subjects were found to be associated with an increase in the prevalence of bacteraemia following orthodontic treatment procedures, with plaque index score showing the strongest correlation. CONCLUSION: Separator placement was found to induce significantly highest level of bacteraemia. Meticulous oral hygiene practice and the use of 0.2% chlorhexidine mouth rinse prior to separator placement may be considered an effective measure in reducing oral bacteria load and consequent reduction of the occurrence of bacteraemia following orthodontic treatment procedures.