Strategic use of obturator prostheses for the rehabilitation of oral cancer patients during the COVID-19 pandemic.

During the current pandemic scenario, maxillofacial rehabilitation specialists involved with supportive care in cancer must transform its practice to cope with COVID-19 and improve protocols that could quickly return the oral function of complex cancer patients who cannot wait for surgical complex rehabilitation. This includes the role of the maxillofacial prosthodontist for the rehabilitation of surgically treated patients with maxillary cancers by the means of filling obturator prostheses that are considered an optimal scientific-based strategy to reduce hospital stay with excellent pain control, oral function (speech, swallowing, mastication, and facial esthetics), psychologic and quality of life outcomes for the patients following intraoral cancer resection. Therefore, the aim of this commentary was to bring new lights to the strategic use of obturator prostheses for the rehabilitation of oral cancer patients during the COVID-19 pandemic as well as to present a protocol for managing such cases.

Accuracy of 3-dimensional printed dental models reconstructed from digital intraoral impressions.

INTRODUCTION: A rapidly advancing digital technology in orthodontics is 3-dimensional (3D) modeling and printing, prompting a transition from a more traditional clinical workflow toward an almost exclusively digital format. There is limited literature on the accuracy of the 3D printed dental models. The aim of this study was to assess the accuracy of 2 types of 3D printing techniques. METHODS: Digital and alginate impressions of the oral environment were collected from 30 patients. Subsequently, digital impressions were used to print 3D models using digital light processing (DLP) and polyjet printing techniques, and alginate impressions were poured up in stone. Measurements for the 3 model types (digital, DLP, and polyjet) were compared with the stone models. Tooth measurements (first molar to first molar) included mesiodistal (crown width) and incisal/occlusal-gingival (crown height). Arch measurements included arch depth and intercanine and intermolar widths. Intraobserver reliability of the repeated measurement error was assessed using intraclass correlation coefficients. RESULTS: The intraclass correlation coefficients were high for all recorded measurements, indicating that all measurements on all model types were highly reproducible. There were high degrees of agreement between all sets of models and all measurements, with the exception of the crown height measurements between the stone and DLP models, where the mean difference was statistically significant. CONCLUSIONS: Both the DLP and polyjet printers produced clinically acceptable models and should be considered viable options for clinical application.

The possibility of modification and improvement of dental services in Poland for children and adolescents with special emphasis on orthodontic service.

AIM: World Dental Federation reveals that dental caries is one of the most common diseases in the world, and as much as 90% of the population is facing oral cavity problems. About 28% of teenagers aged 10 and 15 absolutely needs orthodontic treatment and about another third of this age group represents very serious cases. The aim of this study is to verify the authorial model which modifies and facilitates the system of dental services in Poland with a special emphasis on orthodontic service. MATERIAL AND METHODS: The research was carried out with the method of diagnostic survey through a survey questionnaire. For this study, 1159 people were questioned for the research. In order to check the reliance between the variables Pearson chi-square test and the test of the Highest Reliability were used. Average market prices and the "prices expected" by the Greater Poland Voivodship Department of National Healthcare System were used to price dental services. RESULTS: The research revealed that the highest percentage of people who used only private dental services is between 19 and 64 years of age and the lowest percentage is represented by the elderly, i.e. subjects over 65 years of age. As for the dental services offered by the National Health Fund, the highest percentage of patients are children and adolescents under 18 and the lowest percentage of patients is represented by people in the working age. The tendency towards private healthcare is in direct proportion to parents' increase in the level of education. The main reason why parents take their children to a private dentist is the long waiting time for the visit offered by the National Health Fund as well as better materials and equipment offered by private dentists. The costs connected with extending the basket of guaranteed services for children and youngsters are combined with the increase in National Health Fund expenditure reaching EUR 7,014,151. The lack of refunding dental services for patients aged 19-64 will generate savings reaching about EUR 34,756,765. CONCLUSION: The reduction of public funds allocated for dental treatment of patients aged 19-64 will generate savings which will satisfy the needs connected with the increase in the range of refunded orthodontic treatment with the use of orthodontic permanent braces for patients under 18 years of age. The solution suggested will only slightly affect people in the working age as they reveal a strong tendency for treatment financed with their private funds.

Socioeconomic disparities in orthodontic treatment outcomes and expenditure on orthodontics in England's state-funded National Health Service: a retrospective observational study.

BACKGROUND: This study aimed to assess whether there are potential areas for efficiency improvements in the National Health Service (NHS) orthodontic service in North West England and to assess the socioeconomic status (SES)-related equity of the outcomes achieved by the NHS. METHODS: The study involved a retrospective analysis of 2008-2012 administrative data, and the study population comprised patients aged ≥10 who started NHS primary care orthodontic treatment in North West England in 2008. The proportions of treatments that were discontinued early and ended with residual need (based on post-treatment Index of Orthodontic Treatment Need [IOTN] scores that met or exceeded the NHS eligibility threshold of 3.6) and the associated NHS expenditure were calculated. In addition, the associations with SES were investigated using linear probability models. RESULTS: We found that 7.6% of treatments resulted in discontinuation (which was associated with an NHS annual expenditure of £2.3 m), and a further 19.4% (£5.9 m) had a missing outcome record. Furthermore, 5.2% of treatments resulted in residual need (£1.6 m), and a further 38.3% (£11.6 m) had missing IOTN data (due to either a missing outcome record or an incomplete IOTN outcome field in the record), which led to an annual NHS expenditure of £13.2 m (44% of the total expenditure) on treatments that are a potential source of inefficiency. Compared to the patients in the highest SES group, those in the lower SES groups were more likely both to discontinue treatment and to have residual need on treatment completion. CONCLUSIONS: Substantial inefficiencies were evident in the NHS orthodontic service, with 7.6% of treatments ending in discontinuation (£2.3 m) and 5.2% ending with residual need (£1.6 m). Over a third of cases had unreported IOTN outcome scores, which highlights the need to improve the outcome monitoring systems. In addition, the SES gradients indicate inequity in the orthodontic outcomes, with children from disadvantaged communities having poorer outcomes compared to their more affluent peers.

Attracting orthodontic patients via the Internet: A 20-year evolution.

A generation ago, attracting new patients to an orthodontic practice was often done simply by cultivating a few good referral sources. General dentists, including some who might have provided orthodontic treatment out of necessity, were generally glad to have a trusted specialist they could recommend to their patients. Although general dentists remain an important source of new patients today, many consumers now turn to the Internet for help selecting their own specialists. As orthodontists face more competition from various sources, successful clinicians will make it easy for search engines--and patients--to find their Web sites on the Internet.

[THE ORGANIZATION OF CONTROLLING QUALITY OF ORTHODONTIC CARE OF POPULATION].

The article presents originally developed model of quality of orthodontic care of population on the level of subject of the Russian Federation. The model includes the following elements: demand of population in orthodontic care, mission of orthodontic service, regulations of orthodontic service, table of facilities, staff list, standards of evaluation of effectiveness and audit of effectiveness of orthodontic care of population, and standards of quality control. The developed standards of quality control exemplified by typical stomatological polyclinic, demonstrated reserves of further development of quality and accessibility of orthodontic service to population in functioning of medical organization.

[Diagnosis and treatment of supernumerary teeth in the premaxillary region: a literature review].

Supernumerary teeth are more frequently located in the premaxillary region. Mesiodentes are the most common supernumerary teeth, occurring in 0.15% to 1.9% of the population. Supernumerary teeth are frequently diagnosed in a random radiograph, or after clinical symptoms appear. The majority of the complications consist of delayed or ectopic eruption of the permanent incisors. It is important for the clinician to be aware of the phenomenon and its implications, in order to diagnose it as early as possible. Extraction of the supernumerary teeth in the late mixed dentition, will minimize the chances of damaging the adjacent permanent teeth, but will reduce the possibility of spontaneous eruption of an impacted permanent incisor. Extraction in the early mixed dentition can expedite the eruption of the permanent incisor, although it may involve sedation or general anesthesia, due to lack of cooperation in the young patient. Because to the risk of uneruption of the permanent impacted incisor, exposure of the teeth and bonding a ligature or bracket at the same procedure, and providing a possibility for the dentist to make the incisor erupt after the first operation, should the incisor not erupt spontaneously. Treating these cases require the cooperation of pediatric dentist, orthodontic and dental surgeon, and sometimes the involvement of an anesthesiologist.

Social media basics for orthodontists.

One of the most common buzz words in today's online world is "social media." This article defines social media, explains why it is important to practicing orthodontists, and provides information about how doctors can incorporate it into their practices. Five of the most useful social media tools are described in detail, outlining the strengths, weaknesses, opportunities, and risks inherent in each.

The human capital crisis in orthodontics.

The economics of dental practice are changing. The author reflects on the loss of a long-term, highly effective, and dedicated assistant in an orthodontic practice. Changes in technology, numbers of dentists, expected benefit levels, and a competitive workplace environment are combining to put pressures on the traditional model of oral health care. Whatever the solution turns out to be, the profession should take the lead in actively developing alternatives, and these will necessarily involve development of human capital in the dental practice.

Because nice matters--surviving in a down economy.

Too many times, in our busy lives, we lose track of what really matters and neglect our practices to the point of not attracting new patients or even losing some of our current patients. Being nice to our patients, providing extraordinary service and spending a little extra time in our treatment rooms will pay huge dividends in terms of full schedules. This article will outline some simple techniques you can use immediately in your office to increase referrals and have your current patients "begging for more".

Orthodontic therapists--a challenge for the 21st century.

The introduction of orthodontic therapists in 2007 has led to significant changes to the delivery of orthodontic treatment in the UK. This article outlines the author's experience of training therapists on the Yorkshire Orthodontic Therapy Course and discusses challenges faced by this new way of providing orthodontics in the UK.