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Abstract Background Randomised controlled trials are often beset by problems with poor recruitment and retention. Information to support decisions on trial participation is usually provided as printed participant information sheets (PIS), which are often long, technical, and unappealing. Multimedia information (MMI), including animations and videos, may be a valuable alternative or complement to a PIS. The Trials Engagement in Children and Adolescents (TRECA) study compared MMI to PIS to investigate the effects on participant recruitment, retention, and quality of decision-making. Methods We undertook six SWATs (Study Within A Trial) within a series of host trials recruiting children and young people. Potential participants in the host trials were randomly allocated to receive MMI-only, PIS-only, or combined MMI + PIS. We recorded the rates of recruitment and retention (varying between 6 and 26 weeks post-randomisation) in each host trial. Potential participants approached about each host trial were asked to complete a nine-item Decision-Making Questionnaire (DMQ) to indicate their evaluation of the information and their reasons for participation/non-participation. Odds ratios were calculated and combined in a meta-analysis. Results Data from 3/6 SWATs for which it was possible were combined in a meta-analysis (n = 1758). Potential participants allocated to MMI-only were more likely to be recruited to the host trial than those allocated to PIS-only (OR 1.54; 95% CI 1.05, 2.28; p = 0.03). Those allocated to combined MMI + PIS compared to PIS-only were no more likely to be recruited to the host trial (OR = 0.89; 95% CI 0.53, 1.50; p = 0.67). Providing MMI rather than PIS did not impact on DMQ scores. Once children and young people had been recruited to host trials, their trial retention rates did not differ according to intervention allocation. Conclusions Providing MMI-only increased the trial recruitment rate compared to PIS-only but did not affect DMQ scores. Combined MMI + PIS instead of PIS had no effect on recruitment or retention. MMIs are a useful tool for trial recruitment in children and young people, and they could reduce trial recruitment periods.

Objective: To evaluate the effectiveness of bone anchored maxillary protraction (BAMP) in the management of class III skeletal malocclusion in children aged 11–14 years compared with an untreated control group in terms of perceived need for orthognathic surgery, skeletal and dental change, and psychological impact. Design: A multicentre two-armed parallel randomised controlled trial. Setting: Six UK hospital orthodontic units. Methods: A total of 57 patients were randomly allocated into either the BAMP group (BAMPG) (n = 28) or a no treatment control group (CG) (n = 29). Outcomes: Data collection occurred at registration (DC1),18 months (DC2) and 3 years (DC3), where skeletal and dental changes were measured from lateral cephalograms and study models. Oral Aesthetic Subjective Impact Score (OASIS) and Oral Quality of Life (OHQOL) questionnaires were used to assess the psychological impact of treatment. Results: The mean age was 12.9 ± 0.7 years and 12.6 ± 0.9 years in the BAMPG and CG, respectively. At DC2, the BAMPG achieved a class III ANB improvement of +0.6° compared with −0.7° in the CG (P = 0.004). The overjet improvement was +1.4 mm for the BAMPG and −0.2 mm for the CG (P = 0.002). There was no evidence of any other group differences for the other skeletal or dental cephalometric outcomes (P > 0.05) or the questionnaire data (OASIS P = 0.10, OHQOL P = 0.75). At DC2, the 18-month follow-up, 22% of the BAMPG achieved a positive overjet. At the 3-year follow-up (DC3), fewer participants in the BAMPG were perceived to need orthognathic surgery (48%) compared with 75% of participants in the CG (P = 0.04), with an odds ratio of 0.31 (95% confidence interval = 0.10–0.95). Conclusion: The BAMP technique did not show any social or psychological benefits; however, the skeletal class III improvement in ANB and the overjet change were sufficient to reduce the perceived need for orthognathic surgery by 27% compared with the CG. [ABSTRACT FROM AUTHOR]

The article is a conference report on LILAC 2024, which focused on the themes of compassion and authenticity in information literacy. The conference explored topics such as artificial intelligence and critical AI literacy, playfulness and creativity in induction, and inclusive design in teaching and libraries. The sessions emphasized the need to recontextualize existing information literacy skills for learners and highlighted the importance of critical thinking and transparency in the context of AI. The conference also discussed the role of compassion and authenticity in pedagogy, particularly in meeting the diverse needs of learners. Practical examples were shared on rearticulating library services for arts students and incorporating visual approaches to teaching. The conference also addressed neurodiversity and the use of memes in information literacy teaching. Overall, the conference promoted compassionate pedagogies and positive pragmatism in navigating the changing landscape of information literacy. [Extracted from the article]

The aim of the present study was to investigate whether the same orthodontic information can be obtained from study models or photographs of study models in order to assess the Index of Orthodontic Treatment Need (IOTN). The study also aimed to assess inter- and intra-examiner reliability in the assessment of orthodontic treatment need.

CONTEXT: Immersing students studying health promotion and disease prevention into community settings facing health disparities is an essential supplement to their academic experience. As part of many public health professions, these students will likely need to understand the values and beliefs of different cultures so that decisions of appropriate health promotion and treatment can be made equitably. This paper evaluates an education immersion program that was part of a National Cancer Institute funded collaboration supporting the recruitment and training of university students in cancer research. The primary aim of the Health Disparities Field Experience (HDFE) was to facilitate an experience for students pursuing a health-related degree to understand the conceptual issues in border/rural health and the cultural contexts related to health disparities among medically and financially indigent populations in the region. SUBJECTS AND METHODS: This study was conducted using qualitative research methods using a variation of the content analysis approach using open codes to categorize the data. Six students were selected to participate in the HDFE (five graduate students and one undergraduate) and all six of the participants completed pre- and post-test surveys. RESULTS: From the analysis of the data, posttest qualitative responses indicated that three participants saw racism as a primary cause of cancer-related disparities, a change from their pretest responses. When asked about the personal impact of the HDFE, respondents mentioned the importance of the experiential component. CONCLUSIONS: Participants learned about health disparities from the HDFE and expressed high satisfaction with this approach to education.

To evaluate whether delaying treatment with a twin block appliance affects treatment outcomes, in terms of skeletal and dental change and psychological disadvantage. Multicentre, two-arm parallel randomised controlled trial. Three UK hospital orthodontic units. A total of 75 participants were randomly allocated into an Immediate Treatment Group (ITG) (n= 41) and an 18-month delayed Later Treatment Group (LTG) (n=34). Dentofacial changes were recorded from lateral cephalograms and study models, psychological impact was measured using a child perception questionnaire (CPQ11–14) and an Oral Aesthetic Subjective Impact Score (OASIS) at registration (DC1), 18 months (DC2) and 3 years (DC3). The ITG initial effect was a mean ANB reduction was 1.6° (P<0.001) (95% confidence interval [CI] = 0.89–2.29), and an overjet reduction of 5.06 mm (P<0.001) (95% CI = 3.96–6.16) (boys: aged 12 years 8 months; girls: aged 11 years 8 months). There were no statistically significant differences between the ITG and LTG for twin block treatment outcomes, but the ITG active treatment time was longer (P=0.004) (ITG: 13.1 months; LTG: 9.8 months). There was insufficient evidence to state that patients were psychologically disadvantaged by waiting 18 months for active twin block treatment (P>0.05). Participants achieved similar clinical and psychological outcomes irrespective of whether they started their twin block at the age of referral (ITG) or 18 months later (LTG). This suggests that boys aged 12 years 8 months and girls aged 11 years 8 months, on average, are not disadvantaged by waiting 18 months for active twin block treatment. [ABSTRACT FROM AUTHOR]

This article is an interview with an author who is a consultant orthodontist. The author discusses their background and training, as well as their motivation for becoming an orthodontist. They also explain the reasons behind their decision to undertake a specific study on a treatment technique called BAMP for skeletal class III malocclusion in teenage children. The author mentions the difficulties they encountered during the project and how they overcame them. They also discuss the results of the study and their plans for the future, including extending knowledge and training of BAMP to other orthodontic and surgical colleagues. The author concludes by offering advice to young orthodontic researchers. [Extracted from the article]

To compare two methods of providing information about the Bone Anchored Maxillary Protraction (BAMP) trial: standard printed information and multimedia websites, for their quality and ease of understanding, and impact on decision-making. Randomised controlled trial. Orthodontic outpatient clinic in the UK. Participants were 109 adolescents (aged 11–14 years) attending for orthodontic treatment. While awaiting treatment they were asked to imagine being recruited to the BAMP clinical trial. They were individually randomised to receive the printed or the multimedia website information (comprising text, animations and 'talking head' videos). After reading or viewing the information, they completed a 9-item Likert scale Decision-Making Questionnaire (DMQ) (score range 0–36) plus three free-text questions on their evaluation of the information. A total of 104 participants completed the questionnaire. Mean total DMQ scores were higher (more positive) in the website group (28.1 vs. 27.0), although the difference was small and not statistically significant (P = 0.20). Analysis of individual questionnaire items showed two statistically significant differences: the website information had higher ratings on 'easy to understand' (Z = 3.03; P = 0.003) and 'confidence in decision-making' (Z = 2.00; P = 0.044). On the three free-text questions, more positive and fewer negative comments were made about the websites than the printed information. In this hypothetical trial setting, adolescent patients found that trial information conveyed on a multimedia website was easier to understand and made them more confident in their decision about trial participation. Their subjective evaluations of the website were also more positive and less negative than about the printed information. Multimedia information has the potential to increase the quality of engagement and information exchange when seeking consent for research. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to validate the child perception questionnaire (CPQ(11-14)) with a sample of schoolchildren in Greater Manchester, United Kingdom. Methods: We made a longitudinal survey of children from 1999 to 2002, using the index of orthodontic treatment need (IOTN) at baseline when the children were 11 to 12 years old, the CPQ(11-14), and their uptake of orthodontic treatment 3 years later. Results: CPQ(11-14) scores corresponded to differences in IOTN scores. These were related to the child's emotional and social well-being. Regression analysis showed that CPQ(11-14) scores were higher for girls, for higher grades of the dental health component of the IOTN, and for children who thought that their teeth needed straightening. Conclusions: CPQ(11-14) has acceptable reliability and validity, and is likely to be a useful measure for orthodontic trials. The impact of malocclusion on a child's quality of life might be substantial. [ABSTRACT FROM AUTHOR]

Objective: To evaluate whether patients who had received early class III protraction facemask treatment were less likely to need orthognathic surgery compared with untreated controls. This paper is a 6-year follow-up of a previous clinical trial.Design: Multi-centre 2-arm parallel randomized controlled trial.Setting: Eight United Kingdom hospital orthodontic departments.Participants: Seventy three 7- to 9–year-old children.Method: Patients were randomly allocated, stratified for gender, into an early class III protraction facemask group (PFG) (n = 35) and a control/no treatment group (CG) (n = 38). The primary outcome, need for orthognathic surgery was assessed by panel consensus. Secondary outcomes were changed in skeletal pattern, overjet, Peer Assessment Rating (PAR), self-esteem and the oral aesthetic impact of malocclusion. The data were compared between baseline (DC1) and 6-year follow-up (DC4). A per-protocol analysis was carried out withn = 32 in the CG andn = 33 in the PFG.Results: Thirty six percent of the PFG needed orthognathic surgery, compared with 66% of the CG (P = 0.027). The odds of needing surgery was 3.5 times more likely when protraction facemask treatment was not used (odds ratio = 3.34 95% CI 1.21–9.24). The PFG exhibited a clockwise rotation and the CG an anti-clockwise rotation in the maxilla (regression coefficient 8.24 (SE 0.75); 95% CI 6.73–9.75;P < 0.001) and the mandible (regression coefficient 6.72 (SE 0.73); 95% CI 5.27–8.18;P < 0.001). Sixty eight per cent of the PFG maintained a positive overjet at 6-year follow-up. There were no statistically significant differences between the PFG and CG for skeletal/occlusal improvement, self-esteem or oral aesthetic impact.Conclusions: Early class III protraction facemask treatment reduces the need for orthognathic surgery. However, this effect cannot be explained by the maintenance of skeletal cephalometric change. [ABSTRACT FROM PUBLISHER]

Objective: To investigate the effectiveness of early class III protraction facemask treatment in children under 10 years of age at 3-year follow-up. Design: Multicentre randomized controlled trial. Subjects and Methods: Seventy-three patients were randomly allocated, stratified for gender, into early class III protraction facemask group (PFG) (n=35) and a control/no treatment group (CG) (n=38). Outcomes: Dentofacial changes were assessed from lateral cephalograms and occlusal changes using the peer assessment rating (PAR). Self-esteem was assessed using the Piers-Harris children's self-concept scale, and the psychosocial impact of malocclusion with oral aesthetic subjective impact score (OASIS) questionnaire. Temporomandibular joint (TMJ) signs and symptoms were also recorded. The time points for data collection were at registration (DC1), 15 months later (DC2) and 3 years post-registration (DC3). Results: The following mean skeletal and occlusal changes occurred from the class III starting point to DC3 (3-year follow-up): SNA. PFG moved forwards +2.3° (CG forward +1.6°; P=0.14); SNB, PFG moved forwards +0.8° (CG forward +1.5°, P=0.26); ANB, PFG class III base improved +1.5° (CG stayed about the same at +0.1°; P=0.001). This contributed to an overall difference in ANB between PFG and CG of + 1.4° in favour of early protraction facemask treatment. The overjet was still improved by +3.6 mm in the PFG and changed a small amount +1.1 mm in the CG (P=0.001). A 21% improvement in PAR was shown in the PFG and the CG worsened by 8.4% (P=0.02). There was no increase in self-esteem (Piers-Harris score) for PFG compared with the CG (p>=0.56) and no statistically significant difference in the impact of malocclusion (OASIS) between groups in terms of the changes from DC1 to DC3 (P=0.18). TMJ signs and symptoms were very low at DC1 and DC3. Conclusions: The favourable effect of early class III protraction facemask treatment undertaken in patients under 10 years of age, is maintained at 3-year follow-up in terms of ANB, overjet and % PAR improvement. The direct protraction treatment effect at SNA is still favourable although not statistically significantly better than the CG. Seventy per cent of patients in PFG had maintained a positive overjet which we have defined as ongoing treatment success. Early protraction facemask treatment does not seem to influence self-esteem or reduce the patient's personal impact of their malocclusion at 3-year follow-up. [ABSTRACT FROM AUTHOR]

Objective: To assess the effectiveness of banding versus bonding of first permanent molars during fixed appliance treatment; in terms of attachment failure, patient discomfort and post-treatment enamel demineralization. Design: Multi-centre randomized clinical trial. Setting: One District General Hospital Orthodontic Department and two Specialist Orthodontic Practices. Participants: Orthodontic patients aged between 10 and 18 years old, randomly allocated to either receive molar bands (n=40) or molar bonds (n=40). Method: Bands were cemented with a conventional glass ionomer cement and tubes were bonded with light-cured composite to all four first permanent molar teeth for each subject. Attachments were reviewed at each recall appointment to assess loosening or loss. The clinical end point of the trial was the day of appliance debond. Enamel demineralization at debond was assessed using the modified International Caries Assessment and Detection System (ICDAS). Results: The first time failure rate for molar bonds was 18.4% and 2.6% for molar bands (P=0.0002). Survival analysis demonstrated molar bonds were more likely to fail compared with molar bands. First permanent molars with bonded tubes experienced more demineralization than those with cemented bands (P=0.027). There was no statistically significant difference in discomfort experienced by patients after banding or bonding first permanent molars (P>0.05). Conclusion: This study shows that as part of fixed appliance therapy, American Orthodontics photoetched first permanent molar bands cemented with 3M ESPE Ketac-Cem perform better than American Orthodontics low profile photo-etched and mesh-based first permanent molar tubes bonded with 3M Unitek Transbond XT in terms of failure behaviour and molar enamel demineralization. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effectiveness of early class III protraction facemask treatment in children under 10 years of age. Design: Multicentre, randomized controlled trial. Setting: Eight UK hospital orthodontic units. Subjects and methods: Seventy-three patients were randomly allocated, stratified for gender, into an early class III protraction facemask group (PFG) (n= 35) and a control/no treatment group (CG) (n = 38). Outcomes: Dentofacial changes from lateral cephalograms and occiusal changes using the peer assessment rating (PAR). Self- esteem was assessed using the Piers-Harris children's self-concept scale, and the psychosocial impact of malocclusion with an oral aesthetic subjective impact scores (OASIS) questionnaire. Temporomandibular joint (TMJ) signs and symptoms were also recorded. The time points for data collection were at registration (DC1) and 15 months later (DC2). Results: The following mean skeletal and occlusal changes occurred from the class III starting point: SNA, PFG moved forwards 1.4° (CG forward 0.3°; P=0.018); SNB, PFG moved backwards -0.7° (CG forward 0.8°; P<0.001); ANB, PFG class III base improved + 2.1° (CG worsened by -0.5°; P<0.001). This contributed to an overall difference in ANB between PFG and CG of 2.6° in favour of early protraction facemask treatment. The overjet improved +4.4 mm in the PFG and marginally changed +0.3 mm in the CG (P<0.001). A 32.2% improvement in PAR was shown in the PFG and the CG worsened by 8.6%. There was no increased self-esteem (Piers-Harris score) for treated children compared with controls (P=0.22). However, there was a reduced impact of malocclusion (OASIS score) for the PFG compared with the CG (P=0.003), suggesting treatment resulted in slightly less concern about the tooth appearance. TMJ signs and symptoms were very low at DC1 and DC2 and none were reported during active facemask treatment. Conclusions: Early class III orthopaedic treatment, with protraction facemask, in patients under 10 years of age, is skeletally and dentally effective in the short term and does not result in TMJ dysfunction. Seventy per cent of patients had successful treatment, defined as achieving a positive overjet. However, early treatment does not seem to confer a clinically significant psychosocial benefit. [ABSTRACT FROM AUTHOR]

Objective: To screen patients with oligoarticular and polyarticular forms of Juvenile Idiopathic Arthritis (JIA) to determine (i) the severity of their class II skeletal pattern; (ii) temporomandibular joint signs and symptoms and (iii) use of systemic corticosteroids. Design: Cross-sectional screening. Subjects and setting: Sixty-eight children with JIA aged between 9 and 16 years old who were screened at four regional treatment centres in the UK. Method: Patients were screened clinically and radiographically for the presence of class 11 skeletal pattern and temporomandibular (TMJ) pain dysfunction syndrome. In addition, the JIA sub-type and history of disease activity and medication were recorded. Main outcome measures: Class II skeletal pattern, TMJ signs and symptoms, use of systemic corticosteroids. Results: The mean ANB values were 4.2 degrees (SD=2.9 degrees) in the oligoarticular group and 5.1 degrees (SD=3.8 degrees) in the polyarticular group. Just under one-third of children had a moderate or severe class II skeletal pattern and a further quarter of children had a mild class II skeletal pattern. Clinical signs and symptoms of temporomandibular joint pain dysfunction syndrome were low (<20%), except for crepitus and click which affected between 24 and 40% of JIA children. Radiographically, 57% of oligoarticular and 77% of polyarticular cases exhibited condylar erosion. Use of systemic corticosteroids varied between centres, but overall, was prescribed more in polyarticular cases (P=0.00l). Conclusions: Just under one-third of oligoarticular and polyarticular JIA patients exhibited a moderate or severe class II skeletal pattern. It is, therefore, likely that any future clinical trial to investigate the effect of functional appliance treatment in JIA patients,will need multicentre co-operation to fulfil potential sample size requirements. Clinical signs and symptoms of temporomandibular joint pain dysfunction syndrome were low except for crepitus and click. However radiographic evidence of condylar erosion was high particularly in the polyarticular group. Use of systemic corticosteroids was prescr bed more in polyarticular cases and this is likely to reflect the severity of the disease. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to evaluate the effectiveness of orthodontic/orthognathic surgical care provided in the North West region of England. It was an observational, prospective cohort study at 13 maxillofacial clinics in the United Kingdom. Methods: The 131 patients comprised 47 males (35.9%) and 84 females (64.1%), with an average age of 22.6 years. They received orthodontic/orthognathic treatment according to the normal protocols of the operators. They were then followed until all orthodontic treatment was completed. Final skeletal pattern, final peer assessment rating score, number of attendances, and duration of treatment were recorded. Results: At the end of the 5-year study, 94 patients had completed treatment, and 71 had complete data. Data analysis showed that, overall, the treatments provided were effective in terms of skeletal and dental occlusal outcomes; the final mean peer assessment rating score was 10.58. However, treatment duration was longer than commonly expected, with a mean length of 32.8 months (SD,11.3). The outcome of treatment was influenced by only pretreatment skeletal discrepancy. Conclusions: This prospective investigation showed that orthodontic/orthognathic surgical care was effective. The outcome of treatment was influenced only by the severity of the pretreatment skeletal discrepancy. [Copyright &y& Elsevier]

Introduction: The aim of this study was to evaluate the effectiveness of early orthodontic treatment with the Twin-block appliance for the treatment of Class II Division 1 malocclusion. This was a multi-center, randomized, controlled trial with subjects from 14 orthodontic clinics in the United Kingdom. Methods: The study included 174 children aged 8 to 10 years with Class II Division 1 malocclusion; they were randomly allocated to receive treatment with a Twin-block appliance or to an initially untreated control group. The subjects were then followed until all orthodontic treatment was completed. Final skeletal pattern, number of attendances, duration of orthodontic treatment, extraction rate, cost of treatment, and the child''s self-concept were considered. Results: At the end of the 10-year study, 141 patients either completed treatment or accepted their occlusion. Data analysis showed that there was no differences between those who received early Twin-block treatment and those who had 1 course of treatment in adolescence with respect to skeletal pattern, extraction rate, and self-esteem. Those who had early treatment had more attendances, received treatment for longer times, and incurred more costs than the adolescent treatment group. They also had significantly poorer final dental occlusion. Conclusions: Twin-block treatment when a child is 8 to 9 years old has no advantages over treatment started at an average age of 12.4 years. However, the cost of early treatment to the patient in terms of attendances and length of appliance wear is increased. [Copyright &y& Elsevier]

AIMS: To report the results of I(125) prostate brachytherapy from a central, prospectively collected database of three UK institutions. MATERIALS AND METHODS: All patients treated with I(125) permanent prostate brachytherapy at the Christie Hospital, Manchester (CHM), Cookridge Hospital, Leeds (CKL) and Mount Vernon Hospital, Northwood, London (MVL) since 2003 have been prospectively registered on a detailed central database. Patient, tumour, pre- and post-implant dosimetry data have been recorded. Urinary toxicity as assessed by the International Prostate Symptom Score, catheterisation and urinary stricture rates after implant have been documented and biochemical failure determined, using both the American Society for Therapeutic Radiology and Oncology (ASTRO) consensus and the Phoenix (nadir+2ng/ml) definition. RESULTS: In total, 1535 patients were registered on the database between January 2003 and October 2006, including 432 from CHM, 926 from CKL and 177 from MVL, with a median follow-up of 21 months (range 1-56). Patient and tumour characteristics were similar at all centres. Pre-implant dose indices were comparable between centres, except for the V150, with median values of 51.9, 64.3 and 69.8% at CHM, CKL and MVL, respectively. Median post-implant dose parameters were lower than pre-planned constraints by up to 33.0% at each centre for all values, except at CKL where the V200 was 23.9% higher. The International Prostate Symptom Score increased from a median of 5 at baseline to 18, 6 weeks after implant, but was not significantly different to baseline values by 12 months. Nine per cent of men required catheterisation after implant for a median duration of 53 days, but urinary stricture rates remained low at 1%. Neoadjuvant hormonal manipulation was used in 228 men (15%) for downsizing and 159 (10%) for intermediate/high-risk disease. Collated biochemical failure rates were low at this point of follow-up, with actuarial 2-year ASTRO and Phoenix biochemical failure-free survival rates of 94.4 and 94.5%, respectively, consistent with other large single centre reports. When post-implant dosimetric factors were assessed for a relationship to biochemical failure, no indices consistently predicted for improved ASTRO and Phoenix biochemical failure-free survival rates. CONCLUSIONS: This ongoing collaboration shows that with limited infrastructure (a single industry-sponsored data manager), a large multi-institutional database estimated to represent one-third of implants carried out in the UK during this time can be developed. Patient selection was similar across all centres and adhered to published guidelines. Early biochemical and toxicity outcomes confirm the efficacy and tolerability of I(125) prostate brachytherapy in a large cohort of patients. A further analysis is planned. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To report the results of I125 prostate brachytherapy from a central, prospectively collected database of three UK institutions. Materials and methods: All patients treated with I125 permanent prostate brachytherapy at the Christie Hospital, Manchester (CHM), Cookridge Hospital, Leeds (CKL) and Mount Vernon Hospital, Northwood, London (MVL) since 2003 have been prospectively registered on a detailed central database. Patient, tumour, pre- and post-implant dosimetry data have been recorded. Urinary toxicity as assessed by the International Prostate Symptom Score, catheterisation and urinary stricture rates after implant have been documented and biochemical failure determined, using both the American Society for Therapeutic Radiology and Oncology (ASTRO) consensus and the Phoenix (nadir+2ng/ml) definition. Results: In total, 1535 patients were registered on the database between January 2003 and October 2006, including 432 from CHM, 926 from CKL and 177 from MVL, with a median follow-up of 21 months (range 1–56). Patient and tumour characteristics were similar at all centres. Pre-implant dose indices were comparable between centres, except for the V150, with median values of 51.9, 64.3 and 69.8% at CHM, CKL and MVL, respectively. Median post-implant dose parameters were lower than pre-planned constraints by up to 33.0% at each centre for all values, except at CKL where the V200 was 23.9% higher. The International Prostate Symptom Score increased from a median of 5 at baseline to 18, 6 weeks after implant, but was not significantly different to baseline values by 12 months. Nine per cent of men required catheterisation after implant for a median duration of 53 days, but urinary stricture rates remained low at 1%. Neoadjuvant hormonal manipulation was used in 228 men (15%) for downsizing and 159 (10%) for intermediate/high-risk disease. Collated biochemical failure rates were low at this point of follow-up, with actuarial 2-year ASTRO and Phoenix biochemical failure-free survival rates of 94.4 and 94.5%, respectively, consistent with other large single centre reports. When post-implant dosimetric factors were assessed for a relationship to biochemical failure, no indices consistently predicted for improved ASTRO and Phoenix biochemical failure-free survival rates. Conclusions: This ongoing collaboration shows that with limited infrastructure (a single industry-sponsored data manager), a large multi-institutional database estimated to represent one-third of implants carried out in the UK during this time can be developed. Patient selection was similar across all centres and adhered to published guidelines. Early biochemical and toxicity outcomes confirm the efficacy and tolerability of I125 prostate brachytherapy in a large cohort of patients. A further analysis is planned. [Copyright &y& Elsevier]

Introduction: The aim of this study was to evaluate whether the index of orthodontic treatment need (IOTN) could be weighted by using consumer-based sociodental measures to predict the uptake of orthodontic services. Methods: The sample consisted of 525 schoolchildren, 11 to 12 years old, from Greater Manchester, United Kingdom. Child-perceived IOTN aesthetic component (AC), examiner IOTN AC and dental health component, and child socioeconomic status (Townsend score) were recorded. Two consumer sociodental measures (utility and oral aesthetic subjective impact scale values) were recorded. Three years later, the proportion of the subjects who had received orthodontic treatment or were on a waiting list for orthodontic treatment was recorded, and the rate of service uptake was determined. Results: Sociodental indicators did not predict uptake of orthodontic services. A child with higher normative clinical treatment need was 3 times more likely to receive orthodontic treatment than a child with low clinical need (P < .05). Conclusions: Consumer-based sociodental information does not predict future use of orthodontic services. Factors such as clinical IOTN and child-perceived IOTN AC will adequately predict use of orthodontic services. [Copyright &y& Elsevier]

Presents guidelines on how to perform a randomized controlled trial in orthodontics. Establishment of objectives; Patient registration; Randomization; Data analysis.

Objectives To evaluate which orthodontic adhesives (a) bond orthodontic brackets to teeth more reliably and (b) are more effective at preventing decalcification. Data sources The search strategy for the literature review was carried out according to the standard Cochrane systematic review methodology. The Cochrane Clinical Trials Register and the Cochrane Oral Health Group Specialized Register were searched for randomized clinical trials and controlled clinical trials. All volumes that had not already been assessed by the Oral Health Group in the European Journal of Orthodontics, American Journal of Orthodontics, Journals of Orthodontics, and Angle Orthodontist were hand-searched. Inclusion and exclusion criteria were applied when considering the studies to be included in this review. Data selection The primary outcome measure was the failure of the orthodontic adhesive. A secondary outcome of decalcification occurring around the orthodontic bracket was also recorded, if data were available. Data extraction Two randomized clinical trials and one controlled clinical trial were identified that fulfilled all the inclusion and exclusion criteria. The trials compared: (a) light- and chemically-cured composite; (b) chemically-cured composite and conventional glass ionomer cement; and (c) chemically-cured composite and light-cured compomer. Data synthesis Each paper was quality assessed by two people independently. A qualitative analysis of the trials in the review is presented. The data presentation, for the majority of the trials, precluded the use of suggested Cochrane Health Group statistical analysis. Conclusions It is difficult to draw any conclusions from this review; however, suggestions are made for methods of improving future research involving orthodontic adhesives. [ABSTRACT FROM AUTHOR]

Aim To compare the rates of orthodontic space closure for: Active ligatures, polyurethane powerchain (Rocky Mountain Orthodontics, RMO Europe, Parc d'Innovation, Rue Geiler de Kaysersberg, 67400 Illkirch-Graffenstaden, Strasbourg, France) and nickel titanium springs. Sample Patients entering the space closure phase of fixed orthodontic treatment attending six orthodontic providers. Twelve patients received active ligatures (48 quadrants), 10 patients received powerchain (40 quadrants) and 11 patients, nickel-titanium springs (44 quadrants). Method Patients were randomly allocated for treatment with active ligatures, powerchain or nickel titanium springs. Upper and lower study models were collected at the start of space closure (To) and 4 months later (T1). We recorded whether the patient wore Class II or Class III elastics. Space present in all four quadrants was measured, by a calibrated examiner, using Vernier callipers at To and T1. The rate of space closure, in millimetres per month (4 weeks) and a 4-monthly rate, was then calculated. Examiner reliability was assessed at least 2 weeks later. Results Mean rates of space closure were 0.35 mm/month for active ligatures, 0.58 mm/month for powerchain, and 0.81 mm/month for NiTi springs. No statistically significant differences were found between any methods with the exception of NiTi springs showing more rapid space closure than active ligatures (P < 0.05). There was no effect of inter-arch elastics on rate of space closure. Conclusions NiTi springs gave the most rapid rate of space closure and may be considered the treatment of choice. However, powerchain provides a cheaper treatment option that is as effective. The use of inter-arch elastics does not appear to influence rate of space closure. [ABSTRACT FROM AUTHOR]

The aim of the investigation was to evaluate which radiographic factors influenced the orthodontists' decision whether to expose or remove an impacted upper permanent canine and was a retrospective, cross-sectional design. The sample consisted of all radiographic records of patients referred to the Orthodontic Department at Manchester University Dental Hospital with impacted upper permanent canines between 1994-1998 (n = 44). The following canine position measurements were made from the OPG: angulation to the midline, vertical height, antero-posterior position of the root, overlap of the adjacent incisor, and presence of root resorption of adjacent incisor(s). The labio-palatal position of the impacted canine was assessed from the lateral skull radiograph. Whether the impacted canine had been exposed and orthodontically aligned or removed was also recorded. Stepwise logistic regression analysis showed that the labio-palatal position of the crown influenced the treatment decision, with palatally positioned impacted canines more likely to be surgically exposed and those in the line of the arch, or labially situated, removed (P < 0·05). Additionally, as the canine angulation to the midline increased, the canine was more likely to be removed (P < 0·05). The orthodontists' decision to expose or remove an impacted upper permanent canine, based on radiographic information, seems to be primarily guided by two factors: labio-palatal crown position and angulation to the midline. [ABSTRACT FROM AUTHOR]

The aim of this investigation was to establish whether the Index of Orthodontic Treatment Need is reliable over time between the ages of 11 and 19 years. It consisted of a longitudinal sample of 314 11- and 15-year-old and 142 19-year-old subjects who had not received orthodontic treatment or extractions. The changes in the aesthetic component (AC) and the dental health component (DHC) of the Index of Orthodontic Treatment Need (IOTN) were measured between the ages of 11 and 19 years. The results suggested that the dental health component of IOTN was reliable over time between the ages of 11-19 years despite temporal changes in the separate occlusal traits that comprise the index. The aesthetic component of IOTN tended to show an improvement over time. The Index of Orthodontic Treatment Need is a reliable index over time when taking into account occlusal changes that are occurring during the 11-19-year age range. The study provides some reassurance to clinicians that an IOTN grading at age 11 years is unlikely to change by the time the patient is 19 years. [ABSTRACT FROM AUTHOR]

The article presents information on a study conducted to assess the ability of dental hygeinists in carrying out orthodontic auxiliary procedures. Five orthodontists were selected who had completed their 3-year specialist training. They were made to work on typodonts, which consist of teeth set up in wax in the form of a Class II division 1 malocclusion. The study found out that orthodontists were nearly 2-4 times more efficient than a newly trained orthodontic auxiliary.

Aim: The aim of the study was to evaluate the reliability of a panel of orthodontists for accepting new patient referrals based on clinical photographs. Sample: Eight orthodontists from Greater Manchester, Lancashire, Chester, and Derbyshire observed clinical photographs of 40 consecutive new patients attending the orthodontic department, Hope Hospital, Salford. Method: They recorded whether or not they would accept the patient, as a new patient referral, in their department. Each consultant was asked to take into account factors, such as oral hygiene, dental development, and severity of the malocclusion. Statistics: Kappa statistic for multiple-rater agreement and kappa statistic for intra-observer reliability were calculated. Results: Inter-observer panel agreement for accepting new patient referrals based on photographic information was low (multiple rater kappa score 0.37). Intra-examiner agreement was better (kappa range 0.34-0.90). Conclusion: Clinician agreement for screening and accepting orthodontic referrals based on clinical photographs is comparable to that previously reported for other clinical decision making. [ABSTRACT FROM AUTHOR]

In this article, the author reflects on a research based on effects of facemask and reverse chin cup on maxillary deficient patients.

Comments on the study "Self-perceived orthodontic treatment need evaluated through 3 scales in a university population," by C. Flores-Mir et al. Evaluation of patient/self-perceived need which could influence demand for orthodontic treatment; Measurement of correlations between IOTN AC, OASIS and visual analogue scale approaches for assessing consumer perceptions.

Objective: To report the outcomes of >1000 men with low-risk prostate cancer treated with low-dose-rate (LDR) brachytherapy at three large UK cancer centres., Patients and Methods: A total of 1038 patients with low-risk prostate cancer (prostate-specific antigen [PSA] ≤10 ng/mL, Gleason score 6, ≤T2b disease) were treated with LDR iodine 125 (I-125) brachytherapy between 2002 and 2007. Patients were treated at three UK centres. PSA and clinical follow-up was performed at each centre. Biochemical recurrence-free survival was reported for the cohort., Results: The median (range) PSA follow-up for the whole group was 5 years (4 months to 9 years). A total of 79 patients had biochemical failure, defined by a rise in PSA level: 16 patients fulfilled the ASTRO definition of biochemical failure, 25 patients fulfilled the Phoenix definition and 38 patients fulfilled both definitions. The 5-year biochemical relapse-free survival (bRFS) rate was 94.1% by the ASTRO definition and 94.2% by the Phoenix definition. The absence of neoadjuvant hormone therapy was predictive of inferior biochemical control as defined by the Phoenix definition (P = 0.033)., Conclusions: Our prospective multicentre series showed excellent bRFS with LDR I-125 brachytherapy for patients with low-risk prostate cancer. Further work is necessary to define the role of neoadjuvant androgen deprivation therapy in combination with brachytherapy., (© 2013 The Authors. BJU International © 2013 BJU International.)

Background and Purpose: Routine use of I-125 interstitial brachytherapy (BT) alone in intermediate risk (IR) prostate cancer is controversial. It is often combined with external beam radiotherapy (EBRT). The biochemical outcome of a large cohort of only IR disease treated with BT monotherapy is reported., Materials and Methods: Between 2003 and 2007, 615 patients with Memorial Sloan-Kettering Cancer Centre (MSKCC) defined IR disease (one risk factor only-T2b, or Gleason score (GS) 7, or raised initial PSA (iPSA) 10.1-20ng/ml) were treated with BT monotherapy. ASTRO (3 consecutive rises) and Phoenix (nadir plus 2) criteria defined biochemical failure. Potential prognostic factors (pre- and post-implant dosimetric indices, GS 3+4 versus 4+3, androgen deprivation therapy (ADT)) were analysed., Results: Median follow-up was 5.0years. Forty-three patients had stage T2b, 180 had raised iPSA, 392 had GS 7 disease. ADT was received by 108 patients. The 5-year biochemical no evidence of disease (bNED) rates are 87.3% (by ASTRO), 88.6% (by Phoenix). Stratification by risk factor (T2b, GS7, raised iPSA) demonstrated raised iPSA to have poorer outcome only by Phoenix criteria (p=0.0002). Other potential prognostic variables were non-significant., Conclusion: Good rates of biochemical control can be achieved in the medium term with BT monotherapy in IR disease. Raised iPSA correlated with a poorer outcome., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Purpose: To improve a questionnaire used to collect patient-reported outcomes from patients with early stage prostate cancer treated with brachytherapy. A secondary aim was to adapt the Late Effects of Normal Tissue (LENT) subjective toxicity questionnaire for use to collect Common Terminology Criteria for Adverse Events (CTCAE) data, the current preferred platform for assessing radiation toxicity., Materials and Methods: Three hundred and seventy-seven patients were treated with permanent iodine-125 seed implant brachytherapy for early prostate cancer. Toxicity data were collected before and at nine time points post-treatment (0-36 months). Compliance rates for patients completing individual items and item-subsection correlation coefficients were calculated. A factor analysis was carried out to analyse responses to the questionnaire and identify less informative questions, which could be removed. Cronbach's α coefficient was used to measure reliability., Results: Two thousand one hundred and eighty-eight questionnaires were analysed. There was poor compliance for questions specifically relating to operations and bowel medication. We found that the division of the questionnaire into subsections based on anatomical site was reasonable and that certain items could be safely removed. The high mean value for Cronbach's α across all questionnaires (0.752; 95% CI: 0.726-0.779) indicated that the questionnaire was reliable. Fifteen of the 44 questions were removed from the original questionnaires. Questions on urinary incontinence severity, management of urinary and bowel incontinence, effects of reduced flow of urine and the effects of symptoms on activity of daily living and change in sexual function were required to adapt the LENT subjective questionnaire for use to collect CTCAE data., Conclusions: A questionnaire, validated over 6 years to collect LENT subjective data were adapted and is a reliable approach for collecting CTCAE data after prostate brachytherapy., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)