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Summary Background Function, aesthetics, and social and psychological well-being are all important aspects for patients undergoing orthognathic surgery. Objective To evaluate the impact of orthognathic surgery on patient perception and quality of life before, during and after treatment. Search methods All relevant systematic reviews published up to 31st July 2020 have been searched via MEDLINE via OVID, Scopus, EMBASE, Web of Science, Cochrane Database of Systematic Reviews, PsycINFO, AMED (Allied and Complementary Medicine Database), and PubMed. Ongoing systematic reviews and grey literature were eliminated. A manual search was also undertaken, and no restrictions were applied to language or publication date. Selection criteria Systematic reviews involving dentofacial deformities related to systemic disorders, cleft lip and palate, facial trauma, and syndromes affecting cranial and dentofacial structures were excluded. Data collection and analysis Identification, screening, eligibility, and quality assessment [using the AMSTAR 2 tool (A Measurement Tool to Assess Systematic Reviews)] were performed by two authors independently. Data were synthesized qualitatively using thematic analysis. Results A total of 662 eligible studies were obtained of which 24 studies were selected for full-text evaluation, resulting in 12 eligible systematic reviews. Limitations Due to heterogeneity of data, quantitative analysis was not possible. Conclusions and implications Aesthetics and function are the main motives for seeking orthognathic surgery. Patient assessment before, during, and after orthognathic surgery is necessary for a thorough evaluation of self-perception and satisfaction throughout treatment. While psychological and social domains improved after orthognathic surgery treatment, the quality of life can deteriorate transiently during the pre-surgical orthodontic phase of treatment. A standardized assessment tool needs to be developed to assess quality-of-life changes consistently and provide comparable results. Registration CRD42020199091.

Summary Background Health economic evaluation is a methodology to maximize health benefits and minimize opportunity costs and is of increasing importance in informing resource allocation decisions in healthcare. Objective This systematic review aims to assess the availability and quality of economic evaluations of any orthodontic interventions and summarize the conclusions of these studies. Search methods A thorough search of the literature was carried out including terms related to orthodontic interventions and economic evaluation between January 2000 and February 2022. MEDLINE, EMBASE, SCOPUS, Web of Science, NHS Economic Evaluation Database, and Cochrane were searched. Grey literature was searched and further hand-searching was performed on the reference lists of relevant systematic reviews. Selection criteria Studies on cleft lip and palate surgery and sleep apnoea were excluded due to the multi-disciplinary nature of these conditions which might alter the applicability of the result to orthodontic interventions. Two independent reviewers selected studies for inclusion. Data collection and analysis Data extraction was carried out through full text analysis of included studies by two authors. The quality of each study was assessed according to the Drummond 10-point Checklist and the National Institute for Health and Care Excellence (NICE) Quality Appraisal Checklist for Economic Evaluations. Characteristics and conclusions of included articles were descriptively summarized. Results Sixteen articles met inclusion criteria. Most of the included articles were trial-based studies, with only one model-based study. Orthodontic interventions assessed included crossbite correction, functional appliance treatment and orthognathic surgery. Most studies were carried out in Europe and specifically in Sweden. The quality of included studies was generally low with 69% of studies reported as having serious limitations according to the NICE Checklist. Conclusion This review highlighted a lack of economic evaluations for orthodontic interventions, and limitations of existing economic evaluations. Recommendations on future research are provided. Registration The protocol for the systematic review was registered on the NIHR Database (www.crd.york.ac.uk/prospero, CRD42021220419).

Summary Introduction The purpose of this retrospective study was to evaluate 34 years’ experience of autotransplantation of teeth during orthodontic treatment. Methodology Treatment was completed at Queen Mary’s Hospital, Sidcup, Kent, UK, during the period 1969–2003. A total of 366 teeth were transplanted in 314 patients. Results Canines totalled 78 per cent of all autotransplanted teeth; mean age of patient was 19.4 years. Survival probability for the first 5 years post-autotransplantation was 95 per cent, 94 per cent for the subsequent 5 years, and 88 per cent after 15 years. The maximum observation period was 34 years, the median was 2.0 years, and the mean was 3.51 (standard deviation = 3.68) years. Of the observed teeth, 10 failed and these were lost due to unsuccessful periodontal ligament regeneration and persistent mobility grade III (or greater). Apical pathology was observed in 16 per cent of all autotransplanted teeth. In 79 per cent of this subgroup, apical pathology was evident in the first 3 years post-operatively. Seventy per cent of all external resorption also occurred within the first 3 years. Internal resorption was rare but its occurrence was mostly observed between the second and sixth year post-transplantation. A minority of autotransplanted teeth [14 per cent (n = 51)] needed root canal therapy, and this was completed within the first 6 months post-transplantation. Conclusions Autotransplantation can be a justified procedure with good survival probability. It can be considered an alternative to other treatments, such as prosthodontic replacement of teeth.

Objective To assess if severity of hypodontia is related to a specific skeletal pattern. Study design Lateral cephalometric radiographs and dental panoramic tomographs of 182 hypodontia patients were analysed. The severity of hypodontia was recorded and the sample was divided into groups with mild (n = 71), moderate (n = 56) and severe (n = 55) hypodontia. According to ethnicity, the sample was further subdivided into White Caucasians, African-British, and Arabian/Indian subgroups. Cephalometric measurements were used to quantify the skeletal discrepancy and vertical facial dimensions. Mean and standard deviation for each group were obtained for comparison and an analysis of variance (ANOVA) was carried out to assess the level of significance between the means of the readings in different severity groups. Results In the white Caucasian group, increased severity of hypodontia, was related to a retrusive maxilla with concomitant reduction of A point, Nasion, B point (ANB), reduced mandibular plane angle and anterior lower facial height (P value: 0.0935-0.9371). For the Black-British and Arabian/Indian groups' findings were inconsistent, with no specific pattern as the number of missing teeth increased. Conclusion The white Caucasian group followed a pattern that has previously been reported in other studies. For Black-British and Arabian/Indian groups' findings were inconsistent and no specific pattern emerged for different degrees of hypodontia.

The original histological investigation that forms the basis of our present understanding of tooth movement was carried out on dogs by the Swedish dentist Carl Sandstedt at the Karolinska Institute, Stockholm. His findings were published in 1901 as a monograph in Swedish, and shortly after his death in 1904, as three articles in German entitled 'Einige Beiträge zur Theorie der Zahnregulierung'. Sandstedt observed that the bone was deposited on the alveolar wall of the tension side with both heavy and light forces, new bone spicules following the orientation of the periodontal fibres. On the pressure side, with light forces, osteoclasts resorbed the surface of the alveolar bone, but heavy forces compressed the periodontal ligament resulting in hyalinization--the formation of localized cell-free areas. At these sites, bone removal resulted from undermining resorption by osteoclasts from adjacent marrow spaces. He also observed root resorption and commented on the centre of rotation of the teeth. No English version of Sandstedt's research has ever been published, and in view of its importance, one of us (DB) has translated his three articles from the original German. The aim was to persuade an orthodontic journal to publish the articles in full--however, weighing-in at 21,000 words, the impracticality of this plan soon became clear. We concluded that excerpts from the text plus commentary would be the most practical solution. Where possible and without materially changing the intended meaning, we have translated the German text into something resembling contemporary English, accompanied by the original 16 figures.

Aim: The aim of this retrospective investigation was to measure vertical bone thickness on the hard palate, determine areas with adequate bone for the insertion of orthodontic mini-implants (MIs), and provide clinical guidelines for identification of those areas. Materials and methods: Pre-treatment records of 1007 patients were reviewed by a single examiner. A total of 125 records fulfilled the inclusion criteria and were further investigated. Bone measurements were performed on cone-beam computed tomography scans, at a 90° angle to the bone surface, on 28 predetermined and standardized points on the hard palate. Bone thickness at various areas was associated to clinically identifiable areas on the hard palate by means of pre-treatment plaster models. Results: Bone thickness ranged between 1.51 and 13.86mm (total thickness) and 0.33 and 1.65mm (cortical bone thickness), respectively. Bone thickness was highest in the anterior palate and decreased significantly towards more posterior areas. Plaster model analysis revealed that bone thickness was highest at the level of the third palatal ruga. Conclusions: The areas on the anterior palate with adequate bone thickness for successful insertion of orthodontic MI correspond to the region of the third palatal ruga. These results provide stable and clinically identifiable landmarks for the insertion of palatal MIs.

OBJECTIVE: This prospective randomized clinical trial investigated the impact of different tooth brushing strategies and sealant application on patients with fixed appliances: plaque, gingival, caries index scores, periodontal parameters, microbial, and molecular biological parameters were assessed. MATERIALS AND METHODS: Fifty-five male and 63 female patients aged 11–15 years were enrolled in this 12-week, four-arm parallel-group trial. Patients of group 1 used a Sonicare® FlexCare electric brush, patients of group 2 used a manual (elmex® interX short head) plus interdental (Curaprox® CPS 15) brush, and patients of group 3 and 4 used a manual brush only. The teeth of patients in groups 1, 2, and 3 were sealed with a filled resin (ProSeal®). Patients were advised to brush twice daily and measured time spent brushing mornings and evenings [tooth brushing duration (TBD)]. Plaque (PIB, TQHI, MAPI) and gingival index (PBI) as well as caries index (DMFT/DMFS) scores were assessed at baseline and after 4, 8, and 12 weeks. RESULTS AND CONCLUSIONS: TBD did not differ significantly between patients using the electric or manual brush only (between 197 and 209 seconds) but was longer when using the combination of two manual brushes. TBD was slightly longer in the evenings. There was no gender difference. Although TBD was longer for the combination group, we failed to demonstrate any beneficial effect on outcome parameters for this group. No differences between sealed or unsealed tooth surfaces or for use of a manual or electric brush were observed.

The aim of this study was to determine the incidence of facial clefting in Cambridge, UK, using multiple resources of ascertainment and to relate the findings to antenatal ultrasound screening (AUS) detection rates. AUS records from an obstetric ultrasound department, post-natal records from the regional craniofacial unit, and autopsy reports of foetuses over 16 weeks' gestational age from a regional pathology department from 1993 to 1997 were retrospectively reviewed. Cross-referencing between the three data sets identified all cases of facial clefts. Of 23,577 live and stillbirths, 30 had facial clefts. AUS detected 17 of these. Sixteen of the 30 had isolated facial clefts. Others had associated anomalies, chromosomal defects, or syndromes. Percentages and confidence intervals were calculated from the above data. Twenty-one resulted in live births, seven terminations, and two foetal deaths. Overall, detection rate by AUS was 65 percent [67 percent isolated cleft lip, 93 per cent cleft lip and palate (CLP), and 22 percent isolated cleft palate], with no false positives. The incidence of facial clefts was 0.127 percent (95 percent confidence interval 0.089-0.182 percent); the incidence for isolated CLP was lower than previously reported: 0.067 percent (0.042-0.110 percent). With one exception, all terminations were in foetuses with multiple anomalies. The figures presented will enable joint CLP clinics to give parents information of termination rates. The study allows pre-pregnancy counselling of families previously affected by clefting about the reliability of AUS detection rates.

This fourth edition is the long-awaited sequel of its predecessor. The book, which consists of two parts encompassing 28 chapters altogether, has increased by 200 pages and is now in colour. All the chapters have been written by eminent researchers in orthodontics. The book is extensively illustrated with outstanding treatment results and easy to understand tables, diagrams, and clinical images, which clarify the text. Part 1, which consists of 11 chapters, details diagnosis and treatment planning and occupies just under half of the volume. As with most orthodontic texts it starts with clinical orthodontic diagnosis and includes a number of references. The second chapter describes modern aspects of craniofacial …