Interdisciplinary Role of Orthodontist in Screening and Managing Obstructive Sleep Apnea in Children and Adults.

Obstructive sleep apnea (OSA) can affect children and adults, and, if left untreated, could have a major impact on the general and overall well-being of the patient. Dental health care providers and orthodontists have an interdisciplinary role in screening patients at risk for OSA and make a referral to establish a definitive diagnosis by a sleep physician. The gold standard of diagnostic testing is polysomnography. The adeno-tonsillar hypertrophy is the primary cause of sleep apnea in children; therefore, adeno-tonsillectomy must be the first line of treatment. Post adeno-tonsillectomy, if there is residual OSA due to underlying skeletal discrepancy, the patient may be referred to an orthodontist for appropriate management. Currently the evidence in the literature for prophylactic growth modification in children to prevent OSA is weak. In adults, the gold standard for managing OSA is Positive Airway Pressure (PAP) therapy; however, adherence to this treatment is rather low. The oral appliance (OA) therapy is an alternate for PAP intolerant patients and for mild to moderate OSA patients. The OA therapy has to be administered by a qualified dentist or orthodontist after careful examination of dental and periodontal health as well as any pre-existing joint conditions. The OA therapy could cause OA-associated malocclusion and patients have to be made aware of prior to initiating treatment. In patients with severe OSA, surgical maxilla-mandibular advancement (MMA) is highly effective.

Obstructive sleep apnea: What is an orthodontist's role?

BACKGROUND: The American Association of Orthodontists white paper on obstructive sleep apnea and orthodontics remains the most authoritative statement on the topic. This was produced in 2019 due to increasing orthodontic interest in obstructive sleep apnea (OSA) and the lack of formal guidelines for orthodontists. Since the white paper's release, advocacy for contrarian ideas and practices remain. Orthodontists are sometimes acting as primary care providers for OSA. Procedures appropriate only for screening are sometimes being used for diagnosis. The side effects of effective treatments such as mandibular advancement devices need further consideration. Also, research has clarified the effectiveness and ineffectiveness of treatments such as palatal expansion. RESULTS: Part of an orthodontist's role is screening for OSA. The correct action when this is suspected remains referral to the appropriate physician specialist for diagnosis and treatment or coordination of treatment. Orthodontists may participate in the treatment of patients with OSA as a member of a multi-disciplinary team. Effective orthodontic treatments may include orthognathic surgery with maxillomandibular advancement and mandibular advancement devices. The negative effects of the latter make this a choice of last resort. Current research indicates that OSA alone is not sufficient indication for palatal expansion. CONCLUSIONS: Orthodontists should appropriately screen for obstructive sleep apnea. This may be done as part of our health histories, our clinical examination, and review of radiographs taken for purposes other than the diagnosis and screening for OSA. Orthodontic treatment for OSA can be helpful and effective. However, this may be done only after referral to the appropriate physician specialist, as part of a multi-disciplinary team, with consideration of the likely effectiveness of treatment, and after all likely and potential negative consequences have been considered and thoroughly discussed with the patient.

Un "boxing" the reality: Knowledge, attitude, and perception of orthodontists, dental practitioners, and orthodontic patients toward mouthguards' wear during contact sports-A cross-sectional study.

INTRODUCTION: Mouthguards (MGs) have the potential to prevent contact sport-related dental injuries. However, varying perceptions of their effectiveness persist, influencing recommendations by dental professionals. AIM: To assess the attitudes, knowledge, and perceptions of orthodontists, other dental practitioners (general dentists and other dental specialists), and orthodontic patients involved in contact sports regarding the use of MGs. METHODOLOGY: A cross-sectional survey was designed to collect information from dental clinicians (orthodontists and other dental practitioners) and their orthodontic patients about using MGs during sports participation. A convenience sampling technique was used to recruit the participants for an online survey. A total of 107 (32 males/75 females) dental clinicians and 147 (75 males/72 females) orthodontic patients (mean age 17.5 ± 5.84 years) participated in the study. Pre-validated questionnaires, specifically designed for dental clinicians and orthodontic patients, were used. Data were analyzed using SPSS software (version 28.0; SPSS). RESULTS: Nearly 50% of dental clinicians have recently recommended MGs to their patients in their clinical practice out of which 59% preferred the stock type; 33% of dental clinicians enquired their patients about involvement in contact sports during initial visits. The majority of orthodontic patients acquired knowledge about MGs through the Internet. More than half of orthodontic patients expressed unwillingness to pay for MGs, and 89% of orthodontic patients found using MGs during contact sports uncomfortable. CONCLUSION: The findings provide valuable insights into the practices and attitudes of dental clinicians and orthodontic patients regarding MGs, their recommendations, and the comfort levels associated with using them during contact sports.

Aesthetic assessment of maxillary lateral and canine implant-supported crowns by laypersons and orthodontists.

INTRODUCTION: The objectives of this study were to evaluate how laypersons and orthodontists evaluate and rank aesthetic parameters of an implant-supported crown (ISC) on the canine position (ISC-C) and lateral position (ISC-L). METHODS: A digital survey of 11 cases, 5 ISC-C, 5 ISC-L and 1 control case without ISC, was distributed to 207 laypersons and 296 orthodontists. All cases included one extraoral photograph and three intraoral photographs. The respondents were asked to identify the ISC and to evaluate the aesthetic parameters regarding colour of the implant (CI), shape of the implant (SI) and gingival colour around ISC (GCI). Differences within and between the groups were tested using Chi-2-test and Independent-Samples t-test. RESULTS: All invited laypersons and 184 orthodontists (62% response rate) answered the survey. Orthodontists (89%) more correctly identified the ISC, regardless of its position, than laypersons (50%) (p < 0.001). Both laypersons (54%) and orthodontists (23%) rated higher proportions of acceptance of CI, SI and GCI in favour for the ISC-L than ISC-C (laypersons: 40%, orthodontists: 10%) (p < 0.001). Assessing each parameter separately, orthodontists rated higher for ISC-L, compared to the ISC-C (p < 0.001). In general, laypersons and orthodontist ranked tooth colour (mean, standard deviation [SD]:8.0,1.5 and 9.0, 1.0) and tooth shape (mean, SD: 8.0, 1.7 and 8.8, 1.2) as aesthetically higher than the gingival colour (mean, SD: 7.2, 2.2 and 8.0, 1.7) (p > 0.001).  Conclusion: Laypersons and orthodontists consider the ISC-L as aesthetically more preferable, compared to the ISC-C.

Soft skills in Orthodontics: an analysis in residents and experienced professionals.

INTRODUCTION: Soft skills represent a range of personal skills, attitudes and characteristics relevant to success and adequate work performance. OBJECTIVE: This study aimed to evaluate the knowledge and usage of soft skills in Orthodontics. METHODS: The participants answered a questionnaire containing 27 objective questions on awareness and frequency of soft skills in their professional activities. Participants were also asked to rank the soft skills in a crescent order of importance. The sample was divided into subgroups: A) residents in Orthodontics; B) orthodontists with less than 5 years of experience and C) orthodontists with more than 5 years of experience. Intergroup comparisons were performed using the Kruskal-Wallis test. Sexual differences were compared using Mann-Whitney test (p< 0.05). RESULTS: The sample of this observational study comprised 129 experienced orthodontists and residents in Orthodontics (92 women, 37 men) with mean age of 35.3 years. From the total sample, 54,6% of respondents reported no previous instructions on soft skills. All respondents reported using the analyzed soft skills with a similar frequency (median 4-5). Residents reported accessing reliable sources in bibliographic research less frequently (46%). Female orthodontists reported to seek help from teachers and other professionals more often than males. Ethics and communication were frequently ranked as the most important soft skills. Information management and leadership were frequently less ranked as important soft skills. CONCLUSION: Poor knowledge of soft skills was demonstrated by residents and orthodontists. Communication skill was highly used and frequently ranked as the most important soft skill.

Perceptions and utilization of tele-orthodontics: a survey of the members of the American Association of Orthodontists.

OBJECTIVE: This study aimed to investigate orthodontists' utilization and perceptions of tele-orthodontics. MATERIALS AND METHODS: A 30-item online survey was distributed to members of the American Association of Orthodontists (AAO). The questionnaire encompassed topics concerning the orthodontists' utilization, perceptions, clinical applications, limitations, and concerns regarding tele-orthodontics. Descriptive statistics were employed, and comparisons between responses from users and non-users were conducted  using Wilcoxon rank-sum tests and Fisher's exact tests. RESULTS: 152 members completed the survey, (response rate: 2.4%). More than two third of respondents (69.74%) were users of tele-orthodontics. Users were more aligned with the belief that tele-orthodontics facilitates effective communication (mean ± standard deviation (SD) 4.06 ± 0.83 vs. 3.33 ± 0.94, p < 0.001). Both groups agreed on the requirement of patient fees for tele-orthodontic visits (mean ± SD: 3.62 ± 1.11 users vs. 3.74 ± 1.02 non-users, p = 0.659), and on the capability  of the system to reduce unwarranted referrals (p = 0.20). The majority of participants acknowledged  the utility of the system in monitoring aligners' patients (89% in users vs. 61% in non-users, p < 0.001). Non-users expressed greater concerns regarding privacy risks (mean ± SD: 3.06 ± 0.97 users vs. 3.57 ± 0.86 non-users, p = 0.002). Both groups stressed the significance of obtaining informed consent before utilizing tele-orthodontics. CONCLUSIONS: The widespread acceptance of tele-orthodontics among AAO members was apparent, as demonstrated by their recognition of its effectiveness. There was notable variation in how users and non-users perceived tele-orthodontics. The study's results offer valuable insights into both the potential benefits and drawbacks of incorporating this technology into clinical practice from the clincians' perspective.

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.

Orthodontists' use of remote monitoring platforms pre-, amid, and post-COVID-19: a survey study.

BACKGROUND: Did the COVID-19 pandemic affect orthodontists' use of remote monitoring platforms? The goal of this research was to examine orthodontists' experiences implementing remote monitoring platforms before, during, and after the initial COVID-19 lockdown. METHODS: In this descriptive cross-sectional survey study, an electronic, anonymous questionnaire consisting of a series of 31 short-answer and multiple-choice questions was administered to an international sampling of practicing orthodontists. The target population in the study included currently practicing orthodontists who were graduates of an accredited orthodontic residency program. Participants were recruited in 2021 through collaboration with the American Association of Orthodontists (AAO) Partners in Research Program and the Harvard School of Dental Medicine Orthodontic Alumni Association. Descriptive analysis was conducted, reporting frequency (N and %) distributions for each question. The questionnaire aimed to describe whether orthodontists incorporated remote monitoring platforms into their practices, their experiences doing so, and if the COVID-19 pandemic influenced their use of these resources. RESULTS: Orthodontists' use of remote monitoring platforms was negligible prior to the pandemic; however, a quarter of surveyed orthodontists began using a remote monitoring platform during COVID-19 and nearly all respondents plan to continue using remote monitoring for the foreseeable future. Approximately half of orthodontists believe most patients' treatment progress can be monitored to the standard of care between in-person orthodontic appointments using remote monitoring platforms. Half of the orthodontists who do not currently use a remote monitoring platform in their practice are interested in learning more about how to implement one. CONCLUSIONS: The COVID-19 pandemic led to an increase in the interest and adoption of remote monitoring platforms in orthodontic practices. Most orthodontists had not incorporated remote monitoring platforms into their practices prior to the COVID-19 pandemic. However, this study revealed that a subset of orthodontists utilized the pandemic as motivation to incorporate remote monitoring into their practices and an additional group of orthodontists were interested in incorporating one in the future. Remote monitoring platforms garnered interest and importance with the arrival of the COVID-19 pandemic and may only have an increasing role in the field in years to come.

Evaluation of the use of a clinical practice guideline for external apical root resorption among orthodontists.

BACKGROUND: External apical root resorption (EARR) is a frequently observed adverse event in patients undergoing fixed appliance therapy. Assessing the patients' risk during treatment is important, as certain factors are assumed to be associated with an increased likelihood of occurrence. However, their predictive value remains limited, making evidence-based clinical decision-making challenging for orthodontists. To address this issue, the Dutch Association of Orthodontists (NvVO) developed a clinical practice guideline (CPG) for EARR in accordance with the AGREE II instrument (Appraisal of Guidelines for Research and Evaluation II) in 2018. The aim of this study is to get insight into the actual utilization and the practical implementation of the guideline among orthodontists. The hypothesis to be tested was that after its introduction, clinical practice for EARR has changed towards the recommendations in the CPG. OBJECTIVE: To investigate the use of the 2018 clinical practice guidelines for EARR among orthodontists 3 years after its introduction. METHODS: A questionnaire using a 7-point Likert scale was developed concerning four domains of EARR described in the guideline. The questionnaire was piloted, finalised, and then distributed digitally among Dutch orthodontists. REDCap was used for data collection, starting with an invitation email in June 2021, followed by two reminders. Effect was tested by the Mann-Whitney U test, and the influence of demographic variables was analysed. RESULTS: Questionnaires were sent out to all 275 and completed by 133 (response rate 48%); N = 59 females and N = 73 males were included; 81% had their training in the Netherlands, 89% had ≥ 6 years of work experience, and 89% worked in private orthodontic practice. One hundred thirty orthodontists (98.5%) reported changes in clinical practice. The biggest positive change in clinical behaviour regarding EARR occurred if EARR was diagnosed during treatment. Sex, clinical experience, country of specialist training, and working environment of the respondents did not affect clinical practices regarding EARR. CONCLUSIONS: This questionnaire demonstrated that, 3 years after introduction of the guideline, orthodontists improved their self-reported clinical practices to a more standardised management of root resorption. None of the demographic predictors had a significant effect on the results.

Invisalign Lite: a cross-sectional investigation of orthodontist treatment-planning practices.

OBJECTIVES: To survey treatment-planning practices of orthodontists related to the Invisalign Lite clear aligner appliance (Align Technology, San Jose, Calif). MATERIALS AND METHODS: Patients satisfying inclusion and exclusion criteria and treated with Invisalign Lite were selected from a database containing more than 17,000 patients. Relevant data regarding treatment-planning practices were obtained from Align Technology's treatment-planning facility, ClinCheck, and evaluated. RESULTS: Most (n = 135; 79.9%) patients were female and had a median (interquartile range [IQR]) age of 30.5 (23.8, 43.1) years. The median (IQR) number of aligners for the sample was 23.0 (14, 28) for the maxilla and 24 (14, 28) for the mandible. Most (n = 122; 72.2%) patients required at least one additional series of aligners. More locations for interproximal reduction (IPR) were prescribed in the mandible (mean 1.91 [1.78]) than in the maxilla (1.03 [1.78]; P < .024) in the initial accepted plan of all patients. More teeth were prescribed composite resin (CR) attachments in the maxilla (P < .0001) in the initial accepted plan of all patients. Issues regarding tooth position protocols (n = 50; 53.3%) and requirement for additional IPR (n = 68; 45.3%) were reasons for treatment plan changes before acceptance of the initial treatment plan by orthodontists. CONCLUSIONS: More than 7 of 10 patients required at least one additional series of aligners after the initial series of Invisalign Lite aligners was completed. Prescription of IPR was more common in the mandible, and prescription of CR attachments was more common in the maxilla.

Oral maxillofacial surgeons and Orthodontists’ perceptions about anterior inferior crowding and indications of mandibular third molar extraction / Percepciones de los cirujanos maxilofaciales y ortodoncistas sobre el apiñamiento anteroinferior y las indicaciones de la extracción del tercer molar mandibular

Background: There are still many doubts about anterior inferior crowding and indications of mandibular third molar extraction, although it is very studied subject in the literature. The aim of this study was to evaluate the perceptions of oral maxillofacial surgeons (OMFSs) and orthodontists about anterior inferior crowding and indications of mandibular third molar extraction. Material and Methods: A web-based survey was developed and sent to professionals in order to collect their opinion about the fact that third lower molars cause crowding and questions about the indication of third molars for orthodontic treatment. Descriptive analysis was performed and Chi-square or G tests were applied with a 95% confidence interval. Results: The study included a total of 218 participants, of whom 115 were OMFSs and 103 were orthodontists. The results showed that 56.5% of OMFSs and 35.0% of orthodontists believe that the lower third molars cause anterior inferior crowding (p<0.001). A total of 91.3% of OMFSs and 70.9% of orthodontists indicate the extraction of lower third molars to aid orthodontic treatment (p<0.001). Conclusions: It can be concluded that in being an oral maxillofacial surgeon, a higher odds ratio is observed to consider that lower third molars cause dental crowding compared to those who are orthodontist. The indication of exodontia of lower third molars for orthodontic treatment was more frequent among OMFSs when compared to orthodontists.(AU)

Performance of dental students, orthodontic residents, and orthodontists for classification of midpalatal suture maturation stages on cone-beam computed tomography scans - a preliminary study.

BACKGROUND: Assessment of midpalatal suture maturation on cone-beam computed tomography (CBCT) scans is performed by visual inspection and is therefore subjective. The extent to which the assessment of midpalatal suture maturation is affected by rater experience has not been adequately explored in the existing literature, thus limiting the availability of evidence-based findings. This study compared the outcomes of classification by dental students, orthodontic residents, and orthodontists. METHODS: Three different groups of students, orthodontic residents, and orthodontists evaluated 10 randomly chosen CBCT scans regarding midpalatal suture maturation from a pool of 179 patients (98 female and 81 male patients) aged 8 - 40 years which were previously classified by evaluating CBCT scans. The pool was set as benchmark utilizing midpalatal suture maturation classification by one examiner (OsiriX Lite version 11.0; Pixmeo SARL, Bernex, Switzerland). For assessment of intra-rater reliability of the examiners of each group the randomly chosen subjects were reclassified for midpalatal suture maturation after a wash-out period of two weeks by using the same software. Statistical analysis was performed to evaluate intra- and interrater reliability of the three groups with differing experience level. RESULTS: Groupwise intra-rater reliability assessment between the classification and reclassification was weak for examiners with a low level of experience (k = 0.59). Orthodontists had highest degree of agreement with regard to benchmark classification with an inter-rater reliability to be considered as moderate (k = 0.68). CONCLUSIONS: Assessment of midpalatal suture maturation on CBCT scans appears to be a subjective process and is considerably related to the experience level of the examiner. A high level of clinical experience seems to be favorable but does not necessarily ensure accurate results.

Quality assessment of available Internet information on early orthodontic treatment.

BACKGROUND: This study aimed to evaluate the content, reliability, quality and readability of information on Internet websites about early orthodontic treatment. METHODS: The "early orthodontic treatment" search term was individually entered into four web search engines. The content quality and reliability were reviewed with DISCERN, Journal of American Medical Association (JAMA), and Health on the Net code (HONcode) tools using the contents of websites meeting predetermined criteria. The readability of websites was evaluated with Flesch Reading Facilitate Score (FRES) and Flesch-Kincaid Grade Level (FKGL). RESULTS: Eighty-six websites were suitable for inclusion and scoring of the 200 websites. 80.2% of websites belonged to orthodontists, 15.1% to multidisciplinary dental clinics and 4.7% to professional organizations. The mean DISCERN score of all websites (parts 1 and 2) was 27.98/75, ranging between 19 and 67. Professional organization websites had the highest scores for DISCERN criteria. Moreover, 45.3% of websites were compatible with JAMA's disclosure criterion, 7% with the currency criterion, 5.8% with the authorship criterion and 5.8% with the attribution criterion. Only three websites met all JAMA criteria, and these websites belonged to professional organizations. None of the websites had the HONcode logo. Mean FRES and FKGL were 47.6 and 11.6, respectively. CONCLUSIONS: The quality of web-based information about early orthodontic treatment is poor, and readability is insufficient. More accurate and higher quality Internet sources are required on the web.

Difficulties experienced by dentists and orthodontists regarding ethical issues when announcing the diagnosis of a rare oral disease: a qualitative study in Marseille, France.

PURPOSE: It is traditionally considered that breaking bad news to patients does not represent a cause for concern for dental professionals. However, there are situations where they will be confronted with this task, as in the case of rare dental diseases. Little information is available regarding the feelings of healthcare professionals on this subject. There are no qualitative studies that explore how a diagnosis of oligodontia is announced to patients by dentists and orthodontists. The aim of our study is to explore the difficulties and ethical issues experienced by dental health professionals when they have to announce a diagnosis of oligodontia to a patient and their family. METHODS: This study relied on a qualitative research method using focus groups of dentists and orthodontists and a thematic analysis procedure. RESULTS: The difficulties experienced could be summarised within five topics: organisational difficulties, difficulties with the management of dental treatment and with the administrative management associated with this anomaly, difficulties with the content of the announcement, and relational difficulties. These could be grouped in two categories: practical difficulties and ethical difficulties. CONCLUSION: This survey allowed us to understand the difficulties encountered by dentists and orthodontists when announcing oligodontia. The participants felt uncomfortable with this task and were under stress. They reported difficulties in delivering the medical information and in adapting to the message. It is essential that dental professionals develop skills in medical communication.

Attractive combinations of female gingival displays, buccal corridor sizes, and facial heights according to orthodontists, dentists, and laypeople of different ages and sexes: a psychometric study.

INTRODUCTION: Esthetics plays a crucial role in orthodontics and many other dental and medical fields. To date, no study has assessed the combined effects of the 3 facial features 'facial height, gingival display (GD), and buccal corridor size (BC)' on facial/smile beauty. Therefore, this study was conducted for the first time. METHODS: In this psychometric diagnostic study, beauty of 27 randomized perceptometric images of a female model with variations in facial heights (short, normal, long), gingival displays (0, 2, 4, 6 mm), and buccal corridor sizes (2%, 10%, 15%, 20%, 25%) were evaluated by 108 judges (36 orthodontists, 36 dentists, 36 laypeople) using a 5-scale Likert scale (1 to 5). Combined effects of facial heights, GDs, BCs, judges' sexes, ages, and jobs, and their 2-way interactions were tested using a mixed-model multiple linear regression and a Bonferroni test. Zones of ideal features were determined for all judges and also for each group using repeated-measures ANOVAs and the Bonferroni test (α=0.05). RESULTS: Judges' sex but not their age or expertise might affect their perception of female beauty: men gave higher scores. The normal face was perceived as more beautiful than the long face (the short face being the least attractive). Zero GD was the most attractive followed by 4 mm; 6 mm was the least appealing. BCs of 15% followed by 10% were the most attractive ones, while 25% BC was the worst. The zone of ideal anatomy was: long face + 0mm GD + 15% BC; normal face + 2mm GD + 15% BC; long face + 2mm GD + 15% BC; normal face + 0mm GD + 15% BC. CONCLUSIONS: Normal faces, zero GDs, and 15% BCs may be the most appealing. Facial heights affect the perception of beauty towards GDs but not BCs.

White spot lesion-related perception of aesthetics and treatment satisfaction among orthodontic patients, orthodontists and other dental specialists.

OBJECTIVE: To investigate the impact of various degrees of white spot lesions (WSLs) of maxillary anterior teeth on the aesthetic perception and treatment satisfaction among orthodontic patients, orthodontists and other dental specialists and to evaluate the differences among the three groups. METHODS: A total of 45 orthodontic patients (OP), 45 orthodontists (OR) and 45 other dental specialists (OS) were recruited. Subjective evaluations of perceived aesthetics and treatment satisfaction were performed towards eight digitally generated photographs of maxillary anterior teeth with incremental degrees of WSLs using a numerical visual analogue scale (VAS) from 0 to 100. Data were collected and analysed with descriptive statistics, repeated one-way analysis of variance and multivariable generalized estimating equations. RESULTS: A total of 135 valid questionnaires were collected. Regarding aesthetic scores for WSLs, OP gave more positive scores than OR and OS (p < .05) towards excessive white spot formation without colouration and were more tolerant than OR (p < .05) towards excessive white spot formation with slight colouration. The level of treatment satisfaction for slight to severe WSLs without cavitation was higher in OP than OR. Patients with higher education levels had more negative scores for aesthetic perception and treatment satisfaction (p < .05). Patients who brushed teeth more frequently scored lower in treatment satisfaction (p < .05). CONCLUSIONS: Orthodontists were the most critical when evaluating aesthetics and treatment satisfaction for slight to severe WSLs without cavitation. For orthodontic patients, better oral hygiene habits and higher education levels were associated with more critical attitudes towards WSLs.

Awareness about the orthodontic specialty: A survey study.

BACKGROUND: This study aimed to examine how well patients can differentiate between orthodontists and dentists. METHODS: Four hundred patients who applied to the Ondokuz Mayis University Faculty of Dentistry, Department of Oral and Maxillofacial Radiology between March and November of 2022 were queried regarding the difference between an orthodontist and a dentist via a face-to-face survey. The respondents were separated into the following two study groups: patients who had previously undergone orthodontic treatment and those who had not. Demographic data of the patients, such as age, sex, educational status, and monthly income, were also collected, and the effects of these factors on their doctor preferences were analyzed. RESULTS: The vast majority of respondents (>85%) thought that a dentist should be an orthodontic specialist to provide orthodontic treatment. Seven percent of patients chose to receive orthodontic treatment from a dentist. Patients who chose an orthodontist for their treatment were predominantly female and had a high income and a higher level of education. Patients who had a history of orthodontic treatment were better aware of the profession of orthodontics than those who did not. CONCLUSIONS: The results indicated that the respondents did not fully understand the clear distinction between an orthodontist and a dentist. This outcome suggests that education concerning this issue is required.