International investigation on temporary anchorage device use: A survey of orthodontists.

BACKGROUND: This study investigates characteristics of temporary anchorage devices (TADs) use by surveying a sample of international orthodontists. Furthermore, the survey investigates the stability, insertion technique, and failure rate of TADs and professionals' experience in residency, and it also attempts to establish guidelines for its use in everyday practice. METHODS: A 19-question survey was sent to orthodontists worldwide asking opinion-based, case-specific, and placement technique questions regarding TADs. Results were collected from 251 survey respondents. The country/regions of practice and length of time practicing orthodontics were the independent variables. RESULTS: Survey respondents indicated that most orthodontists rarely or sporadically use TADs. Significant differences were also found for TAD utilization purposes, sizes, and placement techniques among different countries/regions and for failure rates (1 or more of the last 6 TADs placed failed-61.6%). A significant difference was found in how many TADs orthodontists placed in residency versus private practice (56% vs. 15%) in relation to how long they have been practicing, but it did not greatly affect the frequency of use, mechanics, or placement technique. CONCLUSIONS: The frequency of TAD use is similar in many different countries and among different age groups. Although the collected responses suggested significant differences among respondents from different countries, the variability of results for TAD use worldwide prevent the establishment of clear guidelines.

Generational perspectives of orthodontists in the U.S. and Canada: A survey study.

INTRODUCTION: The objectives of this study were to identify differences between generations of orthodontists in the United States and to evaluate the perspective of each generation on widely debated topics in orthodontics. METHODS: A 22-item Institutional Review Board-approved survey was randomly distributed to orthodontists in the United States and Canada. Participants were asked questions about the use of technology, the future of clear aligner therapy, orthodontic education, student debt, marketing, and corporate orthodontics, among other topics. RESULTS: Significant increase in female orthodontists over generations and a decrease in orthodontic educators were found (P <0.001). Among generations, differences were found regarding the amount of student debt, use of specific diagnostic tools, marketing preferences, and their opinion on the future of clear aligner therapy. Most of the silent generation did not have student debt, whereas millennials reported paying off their debt in 1 year to >20 years and being most heavily burdened by student debt. Younger generations appeared more likely to use cone-beam computed tomography and intraoral imaging, whereas older generations preferred traditional diagnostic tools such as hand-wrist radiographs and alginate impressions. Most of the silent generation indicated not marketing their practices, whereas millennials rely heavily on social media and e-mails for marketing. CONCLUSIONS: Clear distinctions exist between different generations of orthodontists. Issues such as increasing student debt load and a decrease in orthodontic educators over generations should be addressed to preserve the future of the orthodontic specialty.

U.S. and Canadian Orthodontic Faculty Professional Satisfaction: A Survey Study.

The aims of this study were to evaluate U.S. and Canadian orthodontic faculty members' degree of job satisfaction and to assess the relationship between job satisfaction and factors such as full-time/part-time status, tenure status, age, and teaching training. This information is needed to set long-term goals for improving the recruitment and retention of full-time and part-time faculty. In August 2016, all members of the Council on Orthodontic Education Society of Educators and faculty members of the American Association of Orthodontists were invited via email to participate in a 34-question survey, which collected demographic data and asked respondents to report their degree of satisfaction on seven factors. Out of 645 individuals invited to participate, 133 completed all items on the survey (response rate 20.6%). The results showed that faculty time commitment, rank/position in the institution, and tenure status affected respondents' levels of satisfaction regarding quantity of clinical time, value placed on teaching by their institution and students, and leadership of their department chair. In the open-ended responses, increased compensation, more teaching time, and less administrative activity were the most frequent recommendations to improve satisfaction levels. About half (52%) of the respondents reported being satisfied with their financial compensation. Respondents whose institutions gave them training opportunities in teaching skills were 4.78 times more satisfied than those not given those opportunities. The results suggest that reduction of administrative workload, creation of meaningful faculty development programs, more feedback and sharing of information about requirements for promotion, and improvement of financial compensation could improve recruitment and retention of orthodontic educators.

Perceptions of chin asymmetries among dental professionals and laypersons.

INTRODUCTION: Previous studies have looked at a variety of dental and facial asymmetries and compared their detection by dental professionals with those of laypersons. However, few studies have analyzed the diagnosis and perception of chin asymmetries. In this study, we assessed whether dental professionals can recognize and diagnose facial asymmetries of the chin better than laypeople. METHODS: Chin asymmetries were analyzed through a series of edited frontal photographs of 2 subjects (male and female). The transverse position of the chin was digitally altered from 0° (no alteration) to 6° (most severe alteration). Participant responses were collected from laypersons (n = 64), nonorthodontist dentists (n = 58), and orthodontists (n = 145). Participants graded the photographs according to esthetic appeal using a visual analog scale. Statistical analysis produced diagnostic threshold levels for identifying chin asymmetries. RESULTS: Nonorthodontist dentists and orthodontists were better able to diagnose transverse chin asymmetry in the female subject at a lower threshold level of 2° of deviation, compared with laypersons at a 3° deviation. Orthodontists could diagnose transverse chin asymmetry in the male subject at a lower threshold level of 1° of deviation, compared with laypersons and nonorthodontist dentists at a 2° deviation. All 3 groups of raters graded very small or no chin asymmetries (1° and 0°) as more attractive, whereas high degrees of chin asymmetries (5° and 6°) were graded as most unattractive by all 3 groups. CONCLUSIONS: Transverse asymmetries of the chin influence the perception of facial attractiveness by laypersons, nonorthodontist dentists, and orthodontists. Subjects with small asymmetries are graded as most attractive, and subjects with large asymmetries are graded as least attractive. Orthodontists were the harshest graders, followed by the nonorthodontist dentists, whereas laypersons were the most lenient. The accuracy of diagnosing chin asymmetries varied among laypersons, nonorthodontist dentists, and orthodontists. Laypersons were the least accurate in diagnosing transverse chin asymmetries in a female subject, and they were just as accurate as nonorthodontist dentists when diagnosing this asymmetry in a male subject. Nonorthodontist dentists were just as accurate as orthodontists when diagnosing transverse chin asymmetries in a female subject, and orthodontists were the most accurate in diagnosing transverse chin asymmetries in a male subject.

Periodontal disease, tooth loss and dementia: Is there a link? A systematic review.

BACKGROUND: It has been suggested that dementia is caused by neuronal damage due to chronic inflammation from peripheral sources such as the oral cavity in periodontal disease. OBJECTIVE: The aim of our review was to assess the risk of dementia or cognitive impairment associated with chronic periodontitis and multiple tooth loss. MATERIALS AND METHODS: An extensive search of electronic databases of articles on the relation between periodontitis, tooth loss and dementia published on or before April 2016 was conducted. Experimental and human studies that provided a description consistent with multiple tooth loss, chronic periodontal disease and cognitive impairment obtained by validated methods were selected. The data extracted from the articles included study design, country of origin, sample size, methods used to assess periodontitis and cognition, average age at the baseline and number of years of follow-up. The Newcastle-Ottawa scale was used to assess the quality of human studies. RESULTS: The literature search yielded 756 articles which were independently screened, and 16 articles were included in the review. Four human studies reported an association of subsequent dementia with multiple tooth loss. One human study reported that chronic periodontal disease was associated with dementia. Eight experimental studies demonstrated an association between cognitive impairment and tooth loss. CONCLUSION: The literature on chronic periodontitis and multiple tooth loss as risk factors to dementia remains inconclusive. More randomised clinical trials on the association between periodontitis and dementia with uniform criteria for evaluation and diagnosis of periodontitis are warranted.

Maxillary lateral incisor agenesis and its relationship to overall tooth size.

STATEMENT OF PROBLEM: Agenesis of the maxillary lateral incisor has been linked to differences in the size of the remaining teeth. Thus, the mesiodistal space required for definitive esthetic restoration in patients with missing maxillary lateral incisors may be reduced. PURPOSE: The purpose of this study was to determine whether a tooth size discrepancy exists in orthodontic patients with agenesis of one or both maxillary lateral incisors. MATERIAL AND METHODS: Forty sets of dental casts from orthodontic patients (19 men and 21 women; mean 15.9 years of age; all of European origin) were collected. All casts had agenesis of one or both maxillary lateral incisors. Teeth were measured with a digital caliper at their greatest mesiodistal width and then compared with those of a control group matched for ethnicity, age, and sex. Four-factor ANOVA with repeated measures of 2 factors was used for statistical analysis (α=.05). RESULTS: Orthodontic patients with agenesis of one or both maxillary lateral incisors exhibited smaller than normal tooth size compared with the control group. The maxillary arch had a larger tooth size difference between the control and test groups than the mandibular arch (there was a significant Jaw × Group interaction [F=4.78, P=.032]). CONCLUSIONS: Agenesis of one or both maxillary lateral incisors is significantly associated with tooth size discrepancy, which may affect the space remaining for restoration of the remaining teeth.

Patients' attitudes toward screening for medical conditions in a dental setting.

OBJECTIVES: Previous studies demonstrated the efficacy of chairside medical screening by dentists to identify patients who are at increased risk for developing cardiovascular-associated events and the favorable attitude of dentists toward chairside medical screening. This study assessed patient attitudes toward chairside medical screening in a dental setting. METHODS: A self-administered questionnaire of eight five-point response scale questions was given to a convenience sample of adult patients attending an inner-city dental school clinic and two private practice settings. Wilcoxon-Mann-Whitney tests and t-tests were used to compare responses between study groups. Friedman nonparametric analysis of variance was used to compare response items within each question. RESULTS: Regardless of setting, the majority of respondents was willing to have a dentist conduct screening for heart disease, high blood pressure, diabetes, human immunodeficiency virus infection, and hepatitis infection (55-90 percent); discuss results immediately (79 percent and 89 percent); provide oral fluids, finger-stick blood, blood pressure measurements, and height and weight (60-94 percent); and pay up to $20 (50-67 percent). Respondents reported that their opinion of the dentist would improve regarding the dentist's professionalism, knowledge, competence, and compassion (48-77 percent). The fact that the test was not done by a physician was ranked as the least important potential barrier. While all respondents expressed a favorable attitude toward chairside screening, the mean score was significantly lower among clinic patients across most questions/items. The priority rankings within an item were similar for both groups. CONCLUSIONS: Acceptance by patients of chairside medical screening in a dental setting is a critical element for successful implementation of this strategy.