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2.
Dental Press J Orthod ; 25(2): 86-102, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32490929

RESUMEN

INTRODUCTION: A significant increase in the number of adults in search of orthodontic treatment has raised a new challenge for orthodontists: the need to interact with other specialties to achieve excellent results, particularly when dealing with smile aesthetics and facial balance. Several factors should be considered to respond to their demand: adequate tooth leveling and alignment, individual tooth proportions between adjacent teeth and their contralateral teeth, shape and natural appearance of each tooth and gingival architecture, which should all be in agreement with facial harmony. Maxillary or mandibular incisors congenitally missing or lost due to caries or trauma and tooth-size discrepancies (Bolton) are some of the important aesthetic challenges for an integrated orthodontic treatment. OBJECTIVES: This study describes cases that illustrate the clinical challenges of treating the anterior area, as well as the multidisciplinary strategies required for their resolution. CONCLUSION: The increasingly frequent multidisciplinary orthodontic treatments of complex cases seem to effectively maximize aesthetic and functional results using a combination of procedures conducted by specialists in related areas, such as Surgery, Prosthetics, Implantology, Restorative Dentistry and Periodontics.


Asunto(s)
Estética Dental , Incisivo , Adulto , Humanos , Maxilar , Ortodoncistas , Sonrisa
3.
Artículo en Inglés | MEDLINE | ID: mdl-32570842

RESUMEN

COVID-19 has severely impacted dentists, who are at a great risk of infection. This study aimed to investigate if dentists are anxious about returning to their daily activities, and what the perception of the risk is for dentists and orthodontists regarding orthodontic procedures. An online questionnaire, including the Patient Health Questionnaire-4 (PHQ-4), was sent to Italian dentists during the final days of the lockdown with items about anxiety, fear, distress, perceived risk for operators, and concerns about orthodontic patients caused by working during the COVID-19 outbreak. Data were analyzed with a chi-square test and logistic regression analysis. The level of significance was set as p < 0.05. A total of 349 dentists completed the survey, including 183 orthodontists. Returning to their daily work activity was a source of anxiety for 192 participants and this was associated with the level of distress (odds ratio (OR) = 3.7; p < 0.001). Most of the orthodontists (67.6%) thought that they would increase the number of working hours during the week (OR = 1.8; p = 0.007). Italian dentists were mostly scared to return to their daily activities because they considered their jobs a high risk to them and their families. Dentists with an exclusive/prevailing orthodontic activity were forced to increase their working day during the week.


Asunto(s)
Infecciones por Coronavirus/transmisión , Odontólogos/psicología , Exposición Profesional/prevención & control , Salud Laboral , Neumonía Viral/transmisión , Pautas de la Práctica en Odontología/estadística & datos numéricos , Ansiedad/epidemiología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Estudios Transversales , Odontólogos/estadística & datos numéricos , Brotes de Enfermedades , Humanos , Italia/epidemiología , Ortodoncistas/psicología , Ortodoncistas/estadística & datos numéricos , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control
4.
J Contemp Dent Pract ; 21(3): 326-336, 2020 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-32434983

RESUMEN

AIM: This study aimed to overview and collect the current trends and techniques in managing maxillary impacted canines by retrieving recent literature, in a chronological manner from the prevention to the very late stages of treatment in adults. BACKGROUND: We performed a review on the recent literature regarding the current trends on the management of impacted canines. We have researched various types of available articles such as clinical trials and case presentations, meta- and systematic analyses, and literature reviews focusing on clinical management of impacted canines and their outcome evaluations. We adhered to those articles published within the last decade with a focus on treatment planning for impacted and displaced canines. REVIEW RESULTS: Depending on the diagnosis and its timing of it, a maxillary impacted canine can be managed by either prevention or interception, surgical opening followed by autonomous eruption or orthodontically traction, autotransplantation, and at last by removal and space closure. These techniques are elaborated one by one according to the age and severity of the diagnosis. CONCLUSION: Impaction of the canines is a manageable abnormality which is highly dependent on the timing and localization of the displaced tooth. Early detection will give the upper hand to orthodontists to engage by either prevention through extraction of deciduous canines or intercepting via assistant devices to create more space. According to the clinical situation, open or closed surgical uncovering might be required to bond an attachment. However, generally, those techniques did not show any significant clinical distinction in the outcome assessments. CLINICAL SIGNIFICANCE: These approaches are highly technique sensitive and require collaborations with other specialties. Proper diagnosis and prognosis assessment are necessary before making any decision to bring an impacted canine in alignment.


Asunto(s)
Maxilar , Diente Impactado , Adulto , Diente Canino , Humanos , Ortodoncistas , Erupción Dental
5.
Niger J Clin Pract ; 23(5): 589-595, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32367863

RESUMEN

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.


Asunto(s)
Caries Dental/prevención & control , Higiene Bucal/métodos , Aparatos Ortodóncicos/efectos adversos , Ortodoncia Correctiva/métodos , Ortodoncistas , Pautas de la Práctica en Odontología , Desmineralización Dental/prevención & control , Adulto , Cariostáticos/uso terapéutico , Odontología Basada en la Evidencia/métodos , Femenino , Fluoruros/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Nigeria , Soportes Ortodóncicos/efectos adversos , Encuestas y Cuestionarios , Cepillado Dental
6.
Ned Tijdschr Tandheelkd ; 127(3): 159-168, 2020 Mar.
Artículo en Holandés | MEDLINE | ID: mdl-32343276

RESUMEN

The outflow of orthodontists through retirement is an important factor in the estimation of the required training capacity for this group of professionals. From 2002 through 2018, studies of the professional activity and retirement plans of orthodontists age 55 and older have been conducted fairly frequently, the most recent one dating from 2018. Based on the findings of these surveys, 3 estimations were obtained of the outflow through retirement. These were based on answers in earlier editions, the answers of their contemporaries and on the basis of the legal retirement age in the Netherlands. The number of active orthodontists in 2018 age 55 or older is estimated respectively to be 117, 116 and 102; according to all estimations, they will have retired in 2030. The estimations predict, respectively 56, 57 and 30 orthodontists will retire before 2023. According to 2 of the estimations, the outflow of orthodontists from the field will exceed the inflow from the universities in the coming years. The present training capacity in the Netherlands is not sufficient to compensate for the outflow of the first 2 estimations.


Asunto(s)
Ortodoncistas , Jubilación , Humanos , Países Bajos , Encuestas y Cuestionarios
7.
Stomatologiia (Mosk) ; 99(1): 61-65, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-32125304

RESUMEN

PURPOSE: To examine the main factors affecting the quality of orthodontic treatment. MATERIAL AND METHODS: the survey was conducted over 3 years in 158 orthodontists who participated advanced training in the Departments of Therapeutic Dentistry, Pediatric Dentistry and Orthodontics. A questionnaire was drawn up for the survey including 4 sets of questions: diagnosis, treatment planning, completion and retention, documentation. The results obtained suggest that doctors who were interviewed conducted a complex of diagnostic measures 49.37%, an aesthetic index was never used in the diagnosis in 91.14% of respondents; diagnostic analysis of control and diagnostic models is not carried out by 72.78%, 15.19% use cone-beam computed tomography. In the course of treatment 50.63% conduct individualization of orthodontic equipment, 63.29% perform detailed bends. The rate of orthodontic retreatment in high as 63.92% of orthodontists has the corresponding experience. Completing the treatment process only 13.29% of orthodontist perform a complete analysis of occlusal contacts. Storage of medical records is possible for up to 3 years in 31.01%, up to 5 years in 34.81% of respondents, but 78.48% reported problems with storage space in clinics. CONCLUSION: There are issues that require clarification in the course of continuous education which are: rendering of a computerized X-ray examination; clinical review of cases causing difficulties; identifying and determining the causes of recurrent orthodontic treatment.


Asunto(s)
Maloclusión , Ortodoncia , Adulto , Niño , Atención Odontológica , Humanos , Ortodoncistas , Encuestas y Cuestionarios
8.
Braz Oral Res ; 34: e003, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32022222

RESUMEN

This retrospective study evaluated facial profile pleasantness determined by two protocols of Class II treatment. The sample comprised facial profile silhouettes obtained retrospectively from the pretreatment (T1) and posttreatment (T2) cephalograms of 60 patients (42 males and 18 females) divided into two groups. One group of 30 patients (mean age of 12.84 years) was treated with the extraction of maxillary first premolars (mean treatment time of 2.7 years), and the other group of 30 patients (mean age of 12.81 years) was treated with a mandibular advancement appliance (Forsus) (mean treatment time of 2.49 years). The facial profile silhouettes (T1 and T2) were randomly distributed in an album containing one patient per sheet. The examiners consisted of 60 orthodontists and 60 lay individuals, who analyzed the profiles in regard to facial pleasantness, using the Likert scale. A comparison between stages T1 and T2 of the two treatment protocols and between the examiners was performed by mixed-design analysis of variance at a significance level of 5%. The results demonstrated a significant difference between T1 and T2 (greater scores for T2 compared to T1), and between lay individuals and orthodontists (orthodontists assigned higher scores), but with no significant difference between the treatment protocols. Both protocols produced positive effects on the facial profile esthetics, from the standpoint of lay individuals and orthodontists.


Asunto(s)
Estética Dental , Cara/patología , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase II/terapia , Extracción Dental/métodos , Adolescente , Análisis de Varianza , Diente Premolar/cirugía , Cefalometría , Niño , Femenino , Humanos , Masculino , Variaciones Dependientes del Observador , Aparatos Ortodóncicos Fijos , Ortodoncia Correctiva/métodos , Ortodoncistas , Percepción , Estudios Retrospectivos , Estadísticas no Paramétricas , Resultado del Tratamiento
9.
Artículo en Inglés | MEDLINE | ID: mdl-32032410

RESUMEN

The objective of this study was to verify differences in eye-tracking metrics and subjective smile esthetic ratings between general practitioners, orthodontists, and laypersons in cases of maxillary lateral incisor gingival margin deviations. Unilateral apical and incisal gingival margin deviations of 1, 2, and 3 mm were digitally produced in pictures of a man and a woman smiling. Specific areas of interest (AOIs) were created in each picture. Eye-tracking metric data included the time to first fixation (TFF) and number of fixations (NF). A specific sensor and software were used to acquire information on the eye movements. Data on the smile esthetic ratings were obtained using a visual analog scale (VAS). Analysis of variance and Pearson correlation were applied. The TFF on the AOIs in the mouth was shorter for general practitioners and orthodontists, signifying that general practitioners and orthodontists rapidly perceived the features in these areas, while for laypersons, the TFF was shorter for the AOIs of the eyes (P < .05). The NF was greater on the AOIs in the mouth for general practitioners and orthodontists, whereas to the laypersons, the NF tended to be greater on the AOIs in the eyes. Mean VAS scores differed between observer groups (P < .05). For the male picture, the 1-mm and 2-mm apical gingival margin deviations received the highest scores from the laypersons, while for both female and male pictures, the 1-mm apical deviation received the highest scores from the general practitioners and orthodontists. Higher VAS scores resulted in longer times that general practitioners and orthodontists spent looking at the gingival margin changes. General practitioners and orthodontists differ from laypersons in their perceptions of smile esthetics. Eye-tracking metrics revealed that the AOIs in the mouth aroused greater interest from the general practitioners and orthodontists, and this interest became greater as the gingival margin deviations increased to 3 mm. Laypersons fixated more on the AOIs of the eyes. The VAS scores indicated that general practitioners and orthodontists were more critical than laypersons, accepting smaller deviations in the gingival margins of the maxillary lateral incisors.


Asunto(s)
Estética Dental , Incisivo , Actitud del Personal de Salud , Femenino , Humanos , Masculino , Ortodoncistas , Sonrisa
10.
J Orthod ; 47(2): 116-128, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32052682

RESUMEN

OBJECTIVE: To survey the opinion of recently qualified and established orthodontists on the perceived value of their training and to identify specific areas which which were considered to be deficient, adequately covered or focussed on excessively. DESIGN: Descriptive cross-sectional survey. SETTING: Online electronic questionnaire. PARTICIPANTS: Members of the British Orthodontic Society (BOS). METHODS: An electronic questionnaire was circulated to members of the BOS focusing on dental education history, and opinions concerning orthodontic teaching generally and specific clinical and non-clinical subjects. Information was also obtained in terms of possible need for improvement, modification or removal of teaching on focused academic and clinical aspects. RESULTS: A total of 217 responses were received from 1080 emailed invitations resulting in a response rate of 20.1%. Respondents were generally satisfied with their training both in relation to theoretical, academic and practical aspects. However, training was regarded as deficient by some respondents in respect of temporary anchorage devices (38%), bonded retainers (6%), experience with lingual appliances (47%), removable aligners (44%), inter-proximal reduction (24%) and adult orthodontics (16%), working with therapists (32%), and NHS contracts (47%) and commissioning (47%). CONCLUSION: The overall satisfaction of BOS members with postgraduate orthodontic training is generally high, although both recently qualified and established practitioners emphasised the need for better exposure to training in specific practical aspects and practice management within the NHS.


Asunto(s)
Ortodoncia , Sociedades Odontológicas , Estudios Transversales , Humanos , Ortodoncistas , Encuestas y Cuestionarios
11.
J Clin Pediatr Dent ; 44(1): 20-27, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31995422

RESUMEN

Purpose: Molar Incisor Hypomineralization (MIH) is a developmental enamel anomaly of systemic origin affecting the first permanent molars and often the permanent incisors. Despite MIH being a prevalent anomaly, its diagnosis and management are challenging for practitioners; including poor anesthesia, failure of restorations, rapid enamel breakdown, poor resin adhesion, and related child anxiety. This study aimed to evaluate knowledge regarding and management of MIH amongst orthodontists and dentists. Study design: The study was performed from March to September 2017 and included 336 dentists and 32 orthodontists. Questionnaires comprised questions on MIH diagnosis, socio-demographic characteristics of the subjects, and photographs of a case of MIH with related questions regarding management. Results: Our results showed that 48% of dentists and 25% of orthodontists misdiagnosed MIH; with misdiagnosis associated with graduation prior to 1986 (p < 0.001). Amongst dentists, 59% applied a fluoridated product and 34% applied fissure sealants in the case of moderate MIH. The application of fluoride was associated with graduation after 1986 (p < 0.0001).Conclusion: Large disparities about knowledge and management of MIH exist between dental practitioners in France. Education regarding diagnosis and management of MIH is necessary.


Asunto(s)
Hipoplasia del Esmalte Dental , Ortodoncistas , Niño , Esmalte Dental , Odontólogos , Humanos , Diente Molar , Prevalencia
13.
J Prosthet Dent ; 123(2): 314-321, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31153615

RESUMEN

STATEMENT OF PROBLEM: Multidisciplinary treatment needs a common goal, and dentists should understand the esthetic perception of laypeople and the other specialists involved. Such information is sparse. PURPOSE: The purpose of this cross-sectional study was to compare the influence of gingival display on perceived smile esthetics among restorative dentists, orthodontists, prosthodontists, periodontists, and laypeople. MATERIAL AND METHODS: Photographs of the smiles of 2 volunteers (1 female and 1 male) were manipulated on a computer to produce gingival exposure of 1, 3, and 5 mm and central incisor coverage of 3 and 5 mm. The images were evaluated by using a 100-mm visual analog scale by 155 raters divided into 5 groups (restorative dentists, orthodontists, prosthodontists, periodontists, and laypeople). RESULTS: The dental specialists, mainly orthodontists and periodontists, were more sensitive about alterations in gingival display than the laypeople. For the female smile, higher mean scores were attributed to 1 mm of gingival exposure by all groups of raters. For the male smile, 3 mm of central incisor coverage received higher mean scores, except for the laypeople, who considered gingival display of 1 mm to be more attractive. For both smiles, 5 mm of gingival display was judged to be the least attractive. CONCLUSIONS: Considering the differences in opinion between dental specialists and laypeople and the acceptable variations in gingival display, the preferences of patients should be considered in the diagnosis and treatment decision-making process.


Asunto(s)
Estética Dental , Ortodoncistas , Actitud del Personal de Salud , Actitud Frente a la Salud , Estudios Transversales , Odontólogos , Femenino , Humanos , Incisivo , Masculino , Sonrisa
14.
Eur J Orthod ; 42(1): 86-92, 2020 Jan 27.
Artículo en Inglés | MEDLINE | ID: mdl-31323673

RESUMEN

OBJECTIVE: This cross-sectional study aimed to explore the level of knowledge and expectations people deciding on a future orthodontic treatment have about post-orthodontic retention and to investigate the influence of sociocultural characteristics. MATERIAL AND METHODS: A total of 227 consecutive people involved as legal decision maker (as patient, parent, or legal guardian) for a prospective orthodontic treatment (mean age 37.1 years; 37.3 per cent male) received before their first appointment a questionnaire to assess their knowledge and expectations about post-orthodontic retention. Data were analysed descriptively, whereas predictors were identified with logistic regressions at P value of less than or equal to 0.05. RESULTS: Among the 220 responders, 46.3 per cent (n = 99) knew that retention appliances are used after orthodontic treatment and 52.8 per cent (n = 113) believed perfect results can guarantee stability, whereas at the same time, 77.8 per cent (n = 168) knew that teeth can move on their own without any orthodontic appliances. The majority considered stability of the orthodontic result important or extremely important (94.5 per cent; n = 206), preferred bonded over removable retainers (67.2 per cent; n = 133), believed the orthodontist to be primarily responsible for a stable result (73.2 per cent; n = 158), and found it appropriate to charge for recall visits (72.9 per cent; n = 153). Participants' gender, age, education, nationality, and past orthodontic experiences within the close family significantly influenced answers. LIMITATIONS: The setting of a single-centred survey conducted in one university moderates the generalizability of the portrayed results. CONCLUSIONS: Although stability of orthodontic treatment results is very important to people deciding about a prospective orthodontic treatment, knowledge regarding the need for post-orthodontic retention varies and may at times be contradictious. Sociocultural factors seem to influence the level of knowledge and the expectations on post-orthodontic retention.


Asunto(s)
Toma de Decisiones , Retenedores Ortodóncicos , Ortodoncistas , Educación del Paciente como Asunto , Adulto , Estudios Transversales , Femenino , Humanos , Consentimiento Informado , Masculino , Estudios Prospectivos , Encuestas y Cuestionarios
15.
Am J Orthod Dentofacial Orthop ; 156(5): 663-674.e1, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31677675

RESUMEN

INTRODUCTION: The aim of this study is to analyze articles published in orthodontic journals included in Journal Citation Reports (JCR) to determine current trends in orthodontic publishing. METHODS: Articles included in orthodontic journals in 2016 JCR and published during 2007-2017 were selected. After applying inclusion criteria, author-based parameters (article title, first author's name, institution and sex, number of authors, number of affiliations, first author's origin, and geographic origin), article-based parameters (article type, main topic, and research design), and the number of cites and self-cites were registered for each article. RESULTS: A total of 7119 articles were analyzed, and 842 different centers and 4483 different authors were identified. The percentage of female authors showed a tendency to increase over the decade; the most productive country was the United States (17.4%). Bone anchorage was the most recurrent topic (7.2%). More than three-fourths of articles (80.8%) proceeded from orthodontic departments belonging to public institutions, with a decreasing trend in nonacademic or private affiliations. Positive and negative correlations were found to exist between citation counts and other variables. CONCLUSIONS: American Journal of Orthodontics and Dentofacial Orthopedics, Angle Orthodontist, and European Journal of Orthodontics were the 3 main journals with regard to production volume, with the United States being the most productive country. The most recurrent topic was bone anchorage, and most of the studies were research articles with observational cross-sectional design. Study design, geographic origin of the articles, article type, and the main subject of the article may be predictive of citation numbers.


Asunto(s)
Ortodoncia , Publicaciones Periódicas como Asunto , Bibliometría , Estudios Transversales , Humanos , Ortodoncia/tendencias , Ortodoncistas
16.
Prog Orthod ; 20(1): 42, 2019 Nov 25.
Artículo en Inglés | MEDLINE | ID: mdl-31761963

RESUMEN

OBJECTIVES: To assess the perceived facial changes in class II division 1, convex profile patients treated with functional followed by fixed orthodontic appliances. SUBJECTS AND METHODS: The study sample consisted of 36 pairs of pre- and post-treatment photographs (frontal and profile, at rest) of 12 patients treated with activator, 12 with twin-block, and 12 controls with normal profiles, treated without functional appliances. All photographs were presented in pairs to 10 orthodontists, 10 patients, 10 parents, and 10 laypersons. Visual analog scale (VAS) ratings of changes in facial appearance were assessed. RESULTS: The patient groups were similar in sex distributions, age, and treatment duration. The different rater groups showed strong to excellent agreement. There were no significant differences among treatment groups (F = 0.91; P = 0.526; Wilks lambda = 0.93), raters (F = 1.68; P = 0.054; Wilks lambda = 0.83), and when testing the combined effect of treatment and rater on the results (F = 0.72; P = 0.866; Wilks lambda = 0.85). The raters detected slightly more positive changes in the activator and twin-block groups, compared to the control group, regarding the lower face and the lips, but these findings did not reach significance. Furthermore, their magnitude hardly exceeded 1/20th of the total VAS length. LIMITATIONS: Retrospective study design. CONCLUSIONS: The perceived facial changes of convex profile patients treated with functional, followed by fixed orthodontic appliances, did not differ from those observed in normal profile patients, when full-face frontal and profile photos were simultaneously assessed. Consequently, professionals should be skeptical regarding the improvement of a patient's facial appearance when this treatment option is used.


Asunto(s)
Maloclusión de Angle Clase II , Aparatos Ortodóncicos Funcionales , Cefalometría , Estética , Cara , Humanos , Labio , Ortodoncistas , Estudios Retrospectivos , Resultado del Tratamiento
17.
Adv Clin Exp Med ; 28(12): 1633-1638, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31778599

RESUMEN

BACKGROUND: Predicting the cooperation of orthodontic patients seems to be of the utmost importance for successful results in treatment with removable appliances, especially if their cost is to be covered from public funding. Therefore, the issue of unbiased pre-treatment assessment of cooperation still calls for an investigation. OBJECTIVES: The objective of this study was to check whether smile attractiveness and its importance, subjectively evaluated by the patients/their caregivers, are reliable predictors of a patient's compliance during treatment with removable appliances. MATERIAL AND METHODS: The study group comprised 97 patients aged 9-12 years, treated with active plates or twin-blocks, equipped with the TheraMon® system. Before treatment, the caregivers and the patients filled out the questionnaires ranking both of the investigated variables. After 9 months of treatment, we analyzed the correlations of the daily wear time (DWT) and other variables. RESULTS: The analysis revealed the following: no relevance of the DWT to the type of removable appliances; negative correlation between the DWT and smile attractiveness assessed by the children and their caregivers; evidently elongated DWT (up to 9.68 h in children), who, together with the caregivers, evaluated their smile attractiveness as poor; coherence of children's and their caregivers' responses evaluating smile attractiveness and its importance, as well as the lack of consistency when comparing responses provided separately by the children and their caregivers. CONCLUSIONS: Application of the TheraMon® sensors objectively proved that the patient's smile attractiveness ranked subjectively as low predicts the orthodontic patient's irreproachable cooperation. Therefore, our easy-to-use questionnaire calls for changing the protocol regarding the wearing time of removable appliances during treatment and introducing an evidence-based policy of reimbursement for such therapy from public funds. Further investigation of the effectiveness of removable appliances worn shorter than previously presumed and of the motivation to continue treatment, once smile attractiveness has been improved, is necessary.


Asunto(s)
Aparatos Ortodóncicos Removibles , Cooperación del Paciente , Autoimagen , Niño , Femenino , Humanos , Masculino , Ortodoncistas , Encuestas y Cuestionarios
18.
Br Dent J ; 227(8): 741-746, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31654014

RESUMEN

Orthodontics, like all areas of dentistry, offers the option to pursue a career in academia. In addition to providing clinical care for patients, academic orthodontists have a role in educating dental students and the wider dental community. There is also the option to engage with and undertake research, which may advance treatment and improve patient care. There is currently a shortage of academic orthodontists in the UK, with institutions reporting difficulties in the recruitment to academic posts. This problem is not only confined to orthodontics but widespread among dentistry. As a result, there is concern regarding the long-term future of dental academia. This paper considers why this might be the case and aims to raise awareness of the shortage in dental academic staff. It will discuss some of the main reasons put forward to explain this shortage and offer information and guidance to those interested in pursuing a career as an orthodontic academic.


Asunto(s)
Odontólogos , Ortodoncia , Selección de Profesión , Atención Odontológica , Humanos , Ortodoncistas , Estudiantes de Odontología
19.
Am J Orthod Dentofacial Orthop ; 156(4): 475-484, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31582119

RESUMEN

INTRODUCTION: This project was undertaken to accomplish 2 objectives: (1) to identify whether there is a discrepancy between orthodontists and experts in temporomandibular disorders (TMD) related to diagnosis and treatment of TMD patients, and (2) to influence the manner in which TMD curricula are taught in orthodontic residency programs, better preparing future orthodontic specialists to diagnose and treat (and refer) patients with TMD. METHODS: A survey invitation was e-mailed to 8870 members of the American Association of Orthodontists. Items were answered on a 6-point scale (0 = I don't know; 1 = strongly disagree; 2 = disagree; 3 = neutral; 4 = agree; 5 = strongly agree). A group consensus was attributed when more than 50% of the orthodontists supported a response. Previously published responses of TMD experts were used as a reference to evaluate the orthodontists' responses. Comparisons between the responses from the 2 groups were assessed using a z-test. RESULTS: Among the participants who responded to the questionnaire, 148 were residents, 1132 were private practitioners, and 61 were full-time faculty. Sixty-two percent of the participants did not think they received enough training in TMD during their orthodontic residency. Although 62% of participants indicated that they feel comfortable diagnosing TMD patients, 50.2% do not feel comfortable treating TMD patients. There was no significant difference between the 2 groups' responses under one-third of the questions. CONCLUSIONS: It is clear that orthodontic residencies in the U.S. need to improve methods of teaching TMD concepts. Although most orthodontists feel comfortable diagnosing TMD patients, less than half feel comfortable treating those patients, and the difference in responses with the TMD expert group was significant in 71% of the questions.


Asunto(s)
Educación de Posgrado en Odontología/normas , Ortodoncistas/educación , Ortodoncistas/psicología , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/terapia , Adulto , Actitud del Personal de Salud , Femenino , Humanos , Masculino , Encuestas y Cuestionarios , Estados Unidos
20.
Am J Orthod Dentofacial Orthop ; 156(4): 485-492, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31582120

RESUMEN

INTRODUCTION: The aim of this study was to investigate whether there is any influence on the perception of smile esthetics among orthodontists and laypersons, with regard to different vertical positions of the maxillary central incisors. METHODS: Frontal smile photographs digitally altered at full-face view and close-up view of 2 adult men aged between 20 and 30 years were used. Six vertical positions of the central incisors were created, with changes of 0.5 mm. The images were randomly assembled in an album that was presented to 53 orthodontists and 53 laypersons, who evaluated the attractiveness of the images by using visual analog scales. Comparison among the images was performed using 1-way analysis of variance, with Tukey post-hoc test. To compare the distribution of the mean scores between the full-face and close-up smile views, and between orthodontists and laypersons, the Student t test was used. The level of significance was established at 5%. RESULTS: The best evaluations presented the following: (a) the gingival margins of the central incisors corresponded to, or were up to, 1 mm below the line of the canine gingival margins, and (b) the incisal step between the central and lateral incisors was from 1.0 to 2.0 mm. The smiles considered least attractive showed (a) the central incisor gingival margins were 1.0 mm above or 1.5 mm below the canine gingival margins, and (b) no step, or a step of 2.5 mm, between the central and lateral incisors. CONCLUSIONS: The results of this study suggested that, in men, slightly extruded central incisors were esthetically more attractive than intruded incisors.


Asunto(s)
Estética Dental/psicología , Encía/anatomía & histología , Incisivo/anatomía & histología , Maxilar/anatomía & histología , Ortodoncistas/psicología , Sonrisa/psicología , Adulto , Actitud del Personal de Salud , Actitud Frente a la Salud , Humanos , Masculino , Percepción , Fotograbar , Escala Visual Analógica
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