World Association for the Advancement of Veterinary Parasitology (W.A.A.V.P.): Third edition of the guideline for evaluating efficacy of anthelmintics in ruminants (bovine, ovine, caprine).

This guideline is aimed at those who are involved in the assessment of anthelmintic efficacy in ruminant livestock species (bovine, ovine and caprine). The intent is to provide a framework that can be adopted worldwide for the testing of anthelmintics in ruminants, such that studies carried out in different countries can be compared and thereby unnecessary duplication can be reduced. Recommendations are made for the selection, housing and feeding of study animals, the type of studies required, the method used to conduct those studies, the assessment of results and the standards for defining anthelmintic efficacy.

The orthodontic condition of children in England, Wales and Northern Ireland 2013.

Background The 2013 Children's Dental Health Survey is the fifth in a series of national surveys.Aims This paper reports the orthodontic condition of 12- and 15-year-olds and how they and their parents feel about the appearance of their teeth.Methodology A representative sample of children (5y, 8y, 12y, 15y) in England, Wales and Northern Ireland were invited to participate in dental examinations. A modified Index of Orthodontic Treatment Need (IOTN) was used as a measure of orthodontic treatment need for 12- and 15-year-olds. Children and parents were invited to complete a questionnaire about oral health behaviour and attitudes.Results Nine percent of 12-year-olds and 18% of 15-year-olds were undergoing orthodontic treatment at the time of the survey. Forty-four percent of 12-year-olds and 29% of 15-year-olds expressed a desire for straighter teeth, however over half of this group would not qualify for NHS treatment. Unmet treatment need was higher in children eligible for free school meals (P <0.05 at 15y).Conclusions Provision of and demand for orthodontic treatment is increasing, with a significant proportion of children who desire orthodontic care not eligible to receive it. Children from deprived backgrounds have greater unmet orthodontic treatment need.

The orthodontic condition of children in the United Kingdom, 2003.

BACKGROUND: The 2003 Children's Dental Health Survey is the fourth in a series of decennial national children's dental health surveys in the United Kingdom. AIMS: This paper reports on the orthodontic condition of children aged 12 and 15 years. METHODOLOGY: A representative sample of children across the UK were invited to participate in a clinical dental examination in school. Two thousand, five hundred and ninety-five 12-year-olds and 2,142 15-year-olds were examined. Current and past orthodontic treatment and type of appliance worn were recorded. Orthodontic treatment need was assessed by the Modified IOTN in those not undergoing treatment. A postal questionnaire sought parents' views on the orthodontic condition of their children and perceived need for treatment. RESULTS: At age 12, 35% were judged to have an orthodontic treatment need, 57% had no need and 8% were wearing an appliance. The corresponding figures at age 15 were, 21% (need), 65% (no need) and 14% (wearing appliance). A higher proportion of girls (p < 0.05) were wearing an appliance than boys. A greater proportion of 15-year-olds were undergoing treatment than in the 1993 and 1983 surveys and the use of fixed appliances had increased. CONCLUSIONS: In this representative sample of UK children, one in five were still judged as having an orthodontic treatment need at age 15 years, as determined by the modified index of orthodontic treatment need. However, considerable variation was observed between professional and lay perceptions of need.

The influence of lower face vertical proportion on facial attractiveness.

This study investigated the influence of changing lower face vertical proportion on the attractiveness ratings scored by lay people.Ninety-two social science students rated the attractiveness of a series of silhouettes with normal, reduced or increased lower face proportions. The random sequences of 10 images included an image with the Eastman normal lower face height relative to total face height [lower anterior face height/total anterior face height (LAFH/TAFH) of 55 per cent], and images with LAFH/TAFH increased or decreased by up to four standard deviations (SD) from the Eastman norm. All the images had a skeletal Class I antero-posterior (AP) relationship. A duplicate image in each sequence assessed repeatability. The participants scored each image using a 10 point numerical scale and also indicated whether they would seek treatment if the image was their own profile. The profile image with normal vertical facial proportions was rated by the lay people as the most attractive. Attractiveness scores reduced as the vertical facial proportions diverged from the normal value. Images with a reduced lower face proportion were rated as significantly more attractive than the corresponding images with an increased lower face proportion. Images with a reduced lower face proportion were also significantly less likely to be judged as needing treatment than the corresponding images with an increased lower face proportion.

The psychosocial impact of orthognathic surgery: a systematic review.

The aim of this study was to review the reported psychosocial benefits of orthognathic surgery. A systematic review of the literature was conducted using MEDLINE (1966 to December 2000), Web of Science (1981 to December 2000), and reference sections of identified articles. We also hand searched key orthodontic, oral surgery, and psychology journals. No language limitations were imposed. Randomized controlled trials, other controlled clinical trials, prospective studies (with or without controls), and retrospective studies (with or without controls) were considered for inclusion. Two reviewers extracted the data and independently assessed the quality of the studies. In all, 29 studies, including a number of prospective and retrospective studies, were identified as relevant. The results of the review indicated that orthognathic patients experience psychosocial benefits as a result of orthognathic surgery, including improved self-confidence, body and facial image, and social adjustment. However, there were wide variations in the study designs and a lack of uniformity in measuring the psychosocial constructs. This made it difficult to quantify the extent and the duration of the psychosocial benefits.

Modified IOTN: an orthodontic treatment need index for use in oral health surveys.

This paper reports the results of a study of the reliability of a modified version of the Index of Orthodontic Treatment Need (IOTN) for use in oral health surveys. Twelve non-specialist dental examiners were trained in the use of the Modified IOTN using a standardised teaching protocol lasting approximately 1.5 hours. Following a school-based calibration exercise it was found that nearly all the examiners achieved either good or excellent agreement (mean Kappa=0.74). The average sensitivity and specificity scores were 0.90 and 0.84, respectively. The Modified IOTN appears to overcome the training and reliability problems that often accompany the use of orthodontic indices by non-specialists in oral health surveys.

Changes in substance P and neurokinin A in gingival crevicular fluid in response to periodontal treatment.

BACKGROUND: The study of periodontitis provides a unique model for assessing the involvement of neuropeptides in inflammatory disease. AIM: To investigate the effects of periodontal treatment, resulting in a return to periodontal health, on the levels of substance P (SP) and neurokinin A (NKA) in gingival crevicular fluid (GCF). METHOD: We completed a cause of non-surgical treatment for 8 subjects with periodontitis (6 females 2 males, mean age 45.1, range 38-67 years) started a course of non-surgical periodontal treatment. Clinical indices were measured at 2 periodontitis sites at the initial visit and at 8 weeks after the completion of treatment in each subject. A 30-s sample of GCF was collected from each test site using perio paper strips. Each strip was placed into 500 microl of ice cold 0.1 M PBS, pH 7.4, vortex mixed for 30 s, and then stored at -70 degrees C until analysed by radioimmunoassay. RESULTS: The clinical condition of all test sites improved as a result of the periodontal treatment. The levels (pg/30 s sample) of SP fell from 56.3 (SD 66.0) at the initial visit to 4.2 (3.1) after treatment, p=0.017. The concentration (pg/microl) of SP in GCF fell from 140.6 (175.6) to 24.2 (11.1), p=0.036. The levels of NKA fell from 30.5 (17.1) to 10.6 (4.9), p=0.012 whereas the concentration changed little from 85.4 (43.5) to 61.6 (15.1), p=0.41. CONCLUSION: The reduction in inflammation resulting from effective periodontal treatment is associated with a reduction in the levels of tachykinins in gingival crevicular fluid.

The influence of dental to facial midline discrepancies on dental attractiveness ratings.

This study investigated the perception of discrepancies between the dental and facial midlines by orthodontists and young laypeople. A smiling photograph of a young adult female was modified by moving the dental midline relative to the facial midline. Twenty orthodontists (10 males and 10 females) and 20 young adult laypeople (10 males and 10 females) scored the attractiveness of the smile on the original image and each of the modified images using a 10-point scale. The results showed that the images were scored as less attractive both by the orthodontists and laypeople as the size of the dental to facial midline discrepancy increased. The scores were unrelated to the direction of the midline discrepancy (left or right) or to the gender of the judge. Further analysis revealed that the orthodontists were more sensitive than laypeople to small discrepancies between the dental and facial midline. It was estimated that the probability of a layperson recording a less favourable attractiveness score when there was a 2-mm discrepancy between the dental and facial midlines was 56 per cent.

Predictors of outcome among patients with class II division 1 malocclusion treated with fixed appliances in the permanent dentition.

This retrospective study investigated the outcomes achieved in 212 consecutively completed patients with Class II Division 1 malocclusion (overjet > 6 mm). All patients were treated in the permanent dentition with upper and lower fixed appliances. A composite outcome measure was used to identify those cases with an excellent outcome (posttreatment PAR

The effects of increasing the reverse curve of Spee in a lower archwire examined using a dynamic photo-elastic gelatine model.

This paper describes the development and testing of a dynamic in vitro photo-elastic model for evaluating the effects of orthodontic mechanics on an entire arch of teeth. A model of a mandibular arch was made and the teeth were embedded in a gelatine material with a high level of mechanical creep which permitted tooth movement in response to orthodontic forces. The excellent photo-elastic properties of this material also facilitated the analysis of the stress distribution around the roots of the teeth. The model of a mandibular arch was used to investigate the tooth movements and stress distributions produced by increasing the reverse curve of Spee in a 0.018 x 0.025-inch stainless steel archwire. The results revealed that a 1-mm reverse curve of Spee increased the arch length by 1.6 mm, but increasing the reverse curve of Spee to 5 mm did not increase arch length further. Photo-elastic analysis showed an increased stress distribution around the roots of the incisors and molars as the reverse curve of Spee was increased in the archwire.

Palatally ectopic canines: closed eruption versus open eruption.

This paper reviews the available evidence supporting 2 commonly used methods of surgically exposing palatally ectopic canines. The closed eruption method (a bonded attachment is placed at operation and the palatal flap is sutured back intact) is compared with the open eruption method (a window of palatal mucosa is excised and the canine allowed to erupt naturally). The choice of surgical technique is reviewed in terms of the long-term periodontal implications, the rate of repeat surgery, and treatment time.

Thermal image analysis of electrothermal debonding of ceramic brackets: an in vitro study.

This study used modern thermal imaging techniques to investigate the temperature rise induced at the pulpal well during thermal debonding of ceramic brackets. Ceramic brackets were debonded from vertically sectioned premolar teeth using an electrothermal debonding unit. Ten teeth were debonded at the end of a single 3-second heating cycle. For a further group of 10 teeth, the bracket and heating element were left in contact with the tooth during the 3-second heating cycle and the 6-second cooling cycle. The average pulpal wall temperature increase for the teeth debonded at the end of the 3-second heating cycle was 16.8 degrees C. When the heating element and bracket remained in contact with the tooth during the 6-second cooling cycle an average temperature increase of 45.6 degrees C was recorded.

Treatment outcome for a sample of patients with Class II division 1 malocclusion treated at a regional hospital orthodontic department.

This retrospective study assessed the outcome of orthodontic treatment of 264 patients with Class II division 1 malocclusion (overjet greater than 6 mm). The sample comprised patients who had completed their fixed appliance orthodontic treatment at a regional hospital orthodontic unit in the Republic of Ireland. The PAR Index (Peer Assessment Rating) was used to evaluate treatment outcome using before and after treatment study casts. The results revealed that treatment for this particular type of malocclusion was highly effective with a very few patients failing to benefit from their orthodontic treatment.

A retrospective comparison of craniofacial form in Northern Irish children with unilateral cleft lip and palate.

OBJECTIVE: This study evaluated the craniofacial form of a sample of Northern Irish children with unilateral cleft lip and palate (UCLP). The quality of the outcomes achieved was compared with the outcomes reported for the six centers involved in the European multicenter study (Mars et al., 1992; Mølsted et al, 1992). DESIGN: Retrospective analysis. PATIENTS: All children born with complete skeletal UCLP in Northern Ireland during the years 1983 to 1987. MAIN OUTCOME MEASURES: Cephalometric analysis was used to determine the craniofacial form and soft tissue profile. The quality of the dental arch relationships was independently assessed using the Goslon ranking system. RESULTS: The sample comprised 25 children with complete skeletal UCLP who had cephalometric radiographs and study casts recorded at a mean age of 9.4 years (range, 8 to 11 years). Cephalometric analysis revealed no important skeletal differences between the Northern Irish UCLP children and the published results from the six Eurocleft centers. The soft tissue profile of the Northern Irish UCLP children was significantly more convex than the soft tissue profile recorded for center D in the Eurocleft study. The Goslon ranking system revealed that 18 (72%) of the Northern Irish UCLP children had good or satisfactory dental arch relationships. CONCLUSIONS: No clinically important differences were detected between the mean cephalometric skeletal parameters of the Northern Irish UCLP children and those published for the six cleft centers involved in the Eurocleft study. On average, the Northern Irish UCLP children were found to differ significantly from Eurocleft's center D in their soft tissue facial contour and sagittal lip profile. The quality of the dental arch relationships of the Northern Irish sample was between the best and the less good Eurocleft centers.

Clinical assistant training in orthodontics--how effective is it?

OBJECTIVE: To investigate the quantity and the quality of orthodontic treatment carried out by dentists who have completed a 2-year orthodontic clinical assistant training programme. DESIGN: Retrospective analysis. SUBJECTS AND METHODS: During a 12-month period the volume of orthodontic treatments completed by 18 dentists who had participated in a clinical assistant training scheme was analysed. Using study models the initial need for treatment and the outcome of treatment of a consecutive sample of each dentist's completed cases were assessed. MAIN OUTCOME MEASURES: IOTN and PAR indices used by expert examiners. RESULTS: The median number of cases treated by the dentists was 37 with a range of 2 to 488. No significant predictive variables were associated with the higher volume operators. Of the 166 orthodontic cases evaluated 72.9% had a definite dental health need for orthodontic treatment. Following treatment the mean post-treatment PAR score for the whole sample was 9.2 (median = 8.0). Thirteen (72%) of the dentists had an average post-treatment PAR score of 10 or less. CONCLUSIONS: The outcomes achieved by the Northern Irish clinical assistants were similar to those reported for other clinical assistant schemes. A significant proportion of the dentists treated a relatively low volume of patients and two of the dentists treated a very high volume of cases.

Bonding to molars--the effect of etch time (an in vitro study).

This study evaluated the effect of etch time on the shear bond strength obtained when bonding to the buccal enamel of first molar teeth. Recently extracted first molar teeth were etched with 37 per cent phosphoric acid gel for 15, 30 and 60 seconds. Preformed cylinders of Concise composite resin were then bonded to the buccal surfaces of the molar teeth. After storage in water for 24 hours at 37 degrees C, the specimens were debonded in a direction parallel to the buccal surface. Examination of the shear bond strengths showed significant differences in shear bond strength between 15 and 30 seconds (P < 0.01) and between 15 and 60 seconds (P < 0.001). Weibull analysis revealed that the probability of bond survival increased as etch time increased, however, the difference between 30 and 60 seconds was not statistically significant. The results indicate that, despite current recommendations of a 15-second etch for premolars, canines and anterior teeth, an etching time of at least 30 seconds should be used when bonding to the buccal surfaces of first molars. A further increase in etching time to 60 seconds produces no significant increase in bond strength.

Equity and orthodontic treatment: a study among adolescents in Northern Ireland.

This epidemiological study investigated the reasons why children in Northern Ireland who need orthodontic treatment do not receive treatment even when it is provided free by the state. A total of 1584 15- and 16-year-olds were examined in 23 high schools with the Index of Orthodontic Treatment Need. The characteristics of the adolescents who had received orthodontic treatment were compared with those who had a definite need for treatment and yet did not receive treatment or advice. One in 10 of the adolescents examined had an unmet need for orthodontic treatment. Logistic regression analysis was used to assess the influence of 11 variables including socioeconomic status, religion, and standard of dental health on the uptake of orthodontic care. This analysis revealed that the only significant predictors of whether an adolescent received orthodontic treatment was the dental attendance pattern of the adolescent, the adolescent's dental health, and the dental attendance pattern of the adolescent's mother. Those adolescents who had good dental health, who regularly attended a dentist, and whose mother regularly attended a dentist were more likely to receive orthodontic treatment.

A field trial of an orthodontic treatment need learning package for general dental practitioners.

OBJECTIVE: To evaluate whether GDPs using an index of Orthodontic Treatment Need (IOTN) learning package in a practice setting referred (or treated) more patients with a definite need for orthodontic treatment. DESIGN: A randomised controlled trial. SUBJECTS AND METHODS: 20 GDPs (test group) used the package when selecting patients for orthodontic care during normal dental practice. A control group of 20 GDPs did not use the package. Over a 12-month period impressions were taken by the participating GDPs of all patients selected for orthodontic treatment, either referred to another practitioner or to be treated by the GDP. MAIN OUTCOME MEASURE: IOTN used by two expert examiners. RESULTS: Among the patients selected for orthodontic treatment by the test group there were more patients with a definite objective need for orthodontic treatment (78.1% versus 62.5% in the control group). After adjustment for potential confounding variables, the odds on a patient selected by a test group dentist being in definite need were 2.24 (95% CI 1.25, 4.01) more than the odds on a patient selected by a control group dentist (P = 0.007). CONCLUSIONS: Use of the IOTN learning package by GDPs would reduce the proportion of patients selected for orthodontic treatment with low or moderate objective need.

An investigation of tooth size in Northern Irish people with bimaxillary dental protrusion.

This study examined tooth size in a sample of thirty Northern Irish people with bimaxillary dental protrusion. The mesiodistal diameters of all permanent teeth (excluding second and third molars) were measured. The tooth sizes were compared with a control group who did not have bimaxillary dental protrusion. The results revealed that, on average, tooth size for the overall maxillary and mandibular dentition was 5.7 per cent larger in the bimaxillary sample than in the control sample.