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Mini-dental implants (MDIs) are defined as dental implants with a diameter of less than 3 mm, made of the same biocompatible material as conventional dental implants. Their use to replace missing teeth as well as to support complete overdentures is very well documented in the literature. Additional indications for their use include placement in interdental spaces with insufficient space to warrant placement of conventional dental implants and in cases where surgical bone augmentation procedures are contraindicated. In general, MDIs are less invasive, require less time, result in less post-operative morbidity and are more cost effective in comparison to conventional dental implants. CPD/Clinical Relevance: Dental implants are the fastest growing area in dentistry and MDIs have been exhibiting an increase in popularity. They are considered a viable treatment option due to their associated decreased surgical morbidity, their clinical efficiency with immediate-loading being the norm and above all cost-effectiveness.

Aims and Objectives: To review and report on the literature covering the cumulative survival and success of Mini Dental Implants (MDIs) supporting complete removable over-dentures. Materials and Methods: An electronic keyword search was carried out using PubMed for Medline (National Library of Medicine, Washington, DC), Google-Scholar, and the Web of Science® interface by M.C. and S.R. The standard and network approaches were utilised according to O’Connor (1992). The initial search was carried out from the 1st of December 2015 to the 31st of March 2016, followed by a second and final search finalised in November 2020. The above -mentioned data bases were searched using combinations of the following key words: Mini dental implant*, Mini-dental implant*, “Narrow diameter dental implant*”, “small diameter dental implant*”. Boolean operators (‘Or’ and ‘AND’) were used to expand, exclude and join keywords. Results: 20 full text articles were analysed. The cumulative MDI survival rate ranged from 66-100% at 1-8.7 years. Success rates ranged from 78-100% Conclusions: MDI survival rates were found to be lower than those of regular sized implants supporting removable complete over-dentures however success rates of MDIs are high in the short term and offer a very good alternative to regular sized implants. Failures and complications were more prevalent in the maxilla than in the mandible.

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.

Introduction The present ex-vivo study was designed to evaluate the surface roughness and analyse potential adhesive remnants on the enamel surface after composite removal using either an Er:YSGG WaterLase (WL) (Biolase®, Irvine, CA, USA) or a tungsten carbide (TC) bur (Alston, England, UK). Methods An in vitro study was designed using 21 extracted lower premolars. Pre-coated stainless steel brackets (3M Unitek, Monrovia, CA, USA) were bonded on all of the teeth except one, which served as a control. The teeth were allocated into two groups: Group 1 (n = 5), removal of composite with a TC bur. Group 2 (n = 15), removal of composite using the WL. Scanning electron microscope (SEM) imaging and Energy Dispersive X-ray Spectroscopy (EDS) were used to determine the surface roughness and atomic composition of the surfaces. Results Group 1 had a median damage depth of 17.6 µm with a range between 11.5 µ m and 28.7 µ m. Group 2 had a median damage depth of 166.3 µ m, with a range between 86.6 to 263.1 µ m. The depth differences between the two groups were statistically significant (p < 0.001, Mann–Whitney test). The atomic composition of the WL group was similar to sound enamel. The TC group showed a quantitative increase in carbon and silicone by 38.2% and 11.5%, respectively, a decrease in oxygen by 44.1% and an absence of phosphorous and calcium. Conclusion WL is efficient at removing composite from the enamel surface but could result in increased enamel surface roughness in comparison with conventional TC burs.

Objective: The use of media campaigns in health promotion has become more common in recent years. #HoldthatSmile is a British Orthodontic Society life-long retention awareness campaign aimed at the general public and dental profession launched in 2017. This study investigated #HoldthatSmile exposure on social media platforms over a 12-month period following campaign launch. Design: A cross-sectional content analysis. Setting: Public-facing, English-language posts tagged #HoldthatSmile on the Facebook, Instagram and Twitter social media platforms. Methods: Data were collected relating to a 12-month period, from September 2017 immediately following campaign launch, to the end of September 2018. The primary outcome was exposure to the #HoldthatSmile campaign on the different platforms through analysis of posts, measurement of audience reached and engagement. Secondary outcomes included demographics of user-types and content analysis of reactive comments on posts. Results: A total of 205 relevant posts with #HoldthatSmile were identified on Twitter (n=90, 43.9%), Facebook (n=64, 31.2%) and Instagram (n=51, 24.9%) with an overall calculated audience reach of 108,807 individuals. There were 1849 reactions across the three platforms. The percentage of reactions that generated comments was low at 3%, 6.1% and 5.7% for Twitter, Facebook and Instagram, respectively. Just over three-quarters of users were either Dental Surgeries (53%) or Professional Dental Bodies (28%) and the vast majority were from the United Kingdom. Overall, most comments were positive (46%, n=36) or neutral (44%, n=35) with only 10% (n=8) negative. The overriding theme was a person’s name, with the user commonly typing a friend’s name in order to bring their attention to the post. Conclusion: There were a relatively low number of posts relevant to #HoldthatSmile on Twitter, Facebook and Instagram over the campaign’s first 12 months. However, the majority of these did convey positive or neutral messages.

In this two-part article a novel case study is presented of how peer group collaboration, facilitated through digital technology, can be used to aid and facilitate the development of strategies for overcoming work-based challenges. Part 1 illustrates the importance of peer review in dentistry, introduces the inception of the South Wales Peer Review Group and explores the process of assembling the team of collaborators. Part 2 explains how the various considerations were assessed, how the collaborative ideas evolved and what outcomes were agreed. CPD/Clinical Relevance: During the COVID-19 pandemic, new strategies and protocols need to be developed to adhere to emerging and changing guidelines. The process of peer group collaboration is important for shaping the new service beyond the pandemic.

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.

Aims To determine the current processes used to assess dental school admissions in the UK as well as compare the applicants' demography.Methods All 16 dental schools in the UK were invited to complete a questionnaire analysing the admissions protocols between 2018-2019 and 2019-2020. These data were combined with the admission process information available online. Retrospective data from the University Clinical Aptitude Test including the sociodemographic status of dental applicants were collected. For the six dental schools that did not reply, data presented were collected from information available to the public.Results The majority of applicants were women (63.2% in 2019-2020), white (27.9%) and are sixth form attendees or attend a further education college (40.6%). Of those who apply to study dentistry, 15.5% are graduates who hold a first degree. For each undergraduate dental place available, there were 12.6 applicants and 9.4 applicants to each post-qualified dental undergraduate place.Conclusion Further advancements are required to widen participation and broaden the sociodemographic status of dental applicants. This area would benefit from a long-term prospective study about recruitment methods and its correlation with performance at dental school. COVID-19 is impacting the application process, the full extent of which is yet to be determined.

Minimum intervention is defined as the smallest value or number of interruptions. Intervention is defined as an action intended for a challenging situation to improve it or to prevent it from getting worse. This article defines what constitutes 'minimum intervention' in dentistry and specifically in orthodontics. It presents the clinical techniques that constitute the specialty of orthodontics and identifies the ones that are deemed as minimum interventions. This article also presents the scientific evidence backing several orthodontic techniques, rendering them acceptable by the profession over others with no or very poor scientific evidence, thus increasing the chances of suboptimal outcomes.

The aim of the present study was to describe a case with juvenile idiopathic arthritis (JIA) with bilateral temporomandibular joint (TMJ) involvement and long-term facial growth implications, requiring complex surgical treatment and multidisciplinary teams. CPD/Clinical Relevance: Consideration was given to TMJ replacement with alloplastic graft, however, the final management strategy involved bimaxillary surgery.

Introduction The validity, reliability and inter-method agreement of Peer Assessment Scores (PAR) from acrylic models and their digital analogues were assessed. Method Ten models of different occlusions were digitised, using a 3 Shape R700 laser scanner (Copenhagen, Denmark). Each set of models was conventionally and digitally PAR-scored twice in random order by 10 examiners. The minimum time between repeat measurements was two weeks. The repeatability was assessed by applying Carstensen’s analysis. Inter-method agreement (IEMA) was assessed by Carstensen’s limit of agreement (LOA). Results Intra-examiner repeatability (IER) for the unweighted and weighted data was slightly better for the conventional rather than the digital models. There was a slightly higher negative bias of -1.62 for the weighted PAR data for the digital models. IEMA for the overall weighted data ranged from −8.70 – 5.45 (95% Confidence Interval, CI). Intra-class Correlation Coefficients (ICC) for the weighted data for conventional, individual and average scenarios were 0.955 (0.906 – 0.986 CI), 0.998 (0.995 – 0.999 CI). ICC for the weighted digital data, individual and average scenarios were 0.99 (0.97 – 1.00) and 1.00. The percentage reduction required to achieve an optimal occlusion increased by 0.4% for the digital scoring of the weighted data. Conclusion Digital PAR scores obtained from scanned plastic models were valid and reliable and, in this context, the digital semi-automated method can be used interchangeably with the conventional method of PAR scoring.

Background Nicolaides–Baraitser Syndrome(NCBRS) is an extremely rare condition which has been reported in only a few cases. NCBRS is a distinct clinical condition with typical clinical features of pre- and post-natal global developmental delay, impaired speech, and seizures. Microcephaly, sparse hair, anteverted alae nasi, undefined philtrum, prominence of distal phalanges and interphalangeal joints, and short metacarpals are also typical of NCBRS. Case Report There are no reported cases in the literature of patients with NCBRS presenting with multiple dental impactions, and to the authors’ knowledge, this is the 28th fully documented case of NCBRS and only 75 cases identified as potentially having NCBRS. The clinical features, diagnosis, and course of management are also described. Conclusion Although NCBRS is very rare, it is important to assess dental development in view of the possibility of multiple supernumerary teeth which can have detrimental effects on the occlusion.

The purpose of this study was to evaluate the accuracy of Le Fort I surgery by comparing planned surgical movements with actual outcomes.A minimum number of seven consecutive cases that had undergone a Le Fort I osteotomy procedure alone or in combination with a mandibular osteotomy from six different hospital units in the East of England between 2009 and 2010 were identified. A total of 56 cases met the inclusion criteria where surgical splints were used and model surgery had been performed. Pre- and post-operative lateral cephalograms were digitised using DolphinIn 71% of cases surgical movements were within 2 mm and 20% of this group were within 1 mm of the predicted position. The mean accuracy was 1.39 mm (SD 0.92 mm) for the former and 0.78 mm (SD 0.58 mm) for the latter. Accuracy correlated negatively with increased surgical complexity, particularly posterior differential impactions of the maxilla. There was no statistically significant difference between centres.Pre-operative surgical planning of Le Fort I osteotomies was generally accurate. This study demonstrates that different operators across six centres produced consistent surgical outcomes and this confirms previously reported data.

This paper describes applications of electropalatography (EPG) and the stages of laboratory construction. EPG is thought to be useful for improving speech of cleft lip and palate patients because it gives a direct visual feedback of tongue-to-palate contact allowing patients to alter tongue position, ideally leading to an improvement of their speech. Clinical Relevance: Electropalatography is a clinical technique utilized to improve speech in cleft lip and palate patients. It allows patients and speech and language therapists to visualize the placement of the tongue within the oral cavity. This technique helps to correct abnormal articulations by adopting normal patterns for consonants or vowels that patients find difficult to pronounce.

Cherubism is a rare hereditary disease that frequently manifests as a painless enlargement of the mandible and/or maxilla. The disease usually progresses rapidly during the first and second decades of life but it is self-limiting and often regresses. Although few orthodontic case reports describing cherubic patients exist, the timing and extent of surgical intervention is controversial.This present paper aims to review the treatment literature and provide a case report of a patient who underwent orthodontic/surgical management.The patient presented with severe cherubism in her late teenage years; her main complaint was poor facial and dental appearance. Multiple teeth were missing and those present demonstrated significant preoperative root resorption. Treatment consisted of orthodontic alignment of the upper anterior teeth and a recontouring osteotomy.Confirmed by the patient, the combination approach led to a significant improvement in facial aesthetics and better self-esteem. Tooth movement through the osseous lesions was uneventful and no further root resoption was observed.Orthodontic treatment may be undertaken in those affected by Cherubism even with pre-existing idiopathic root resorption, but patients need to be appropriately informed and consented.

Interceptive Orthodontics: A Practical Guide to Occlusal Management (2014) Author: Joseph Noar Publisher: Wiley Blackwell, Chichester, Sussex, UK Price: $72.99 ISBN: 978-0-470-65621-1 Pages: 80 This is an exceptionally good book written by a leading clinician and published by Wiley Blackwell. It is well illustrated, very portable, and the content is very concise. ‘Interceptive Orthodontics’ is a book of 80 pages including the index and that makes it one of the shortest textbooks in the market. It comprises four chapters and excluding …

To evaluate the process of combined orthognathic and orthodontic care. To identify factors that affect treatment time and percentage Peer Assessment Rating (PAR) reduction, and the PAR efficiency factor for such cases.Retrospective multi centre study of patients who underwent orthognathic treatment in the East of England region.Analysis of consecutive cases that underwent orthognathic surgery in 2008. Inclusion criteria included pre- and post-surgery orthodontic treatment.Ten orthodontic units submitted data for a total of 118 patients. Within the sample, 64% were class III, 35% class II/1 and 1% class II/2. Overall extraction rate, excluding third molars, was 58%. Median age at bond up was 17 years. Mean total number of orthodontic attendances was 23. Median length of pre-surgical orthodontics was 23 months and post-surgical orthodontics was 7 months. Median length of total treatment was 29 months. Mean wait for surgery was 3·6 months. Diagnosis of incisor relationship and skeletal base, transfer of operator, total number of visits, tooth extraction and treatment unit affected treatment duration. Median pre- and post-treatment PAR scores were 43 and 4, respectively. Median change in PAR score was 38·5. Median per cent reduction in PAR was 90·6%. The median PAR efficiency factor (reduction in PAR score divided by treatment time in months) was 1·24. Diagnosis of incisor relationship and skeletal base correlated with percentage reduction in PAR score.Combined orthognathic treatment was effective. Factors affecting treatment duration and percentage reduction in PAR have been established.

The orthodontic treatment of patients on bisphosphonates is becoming an increasing aspect of contemporary practice. This article will draw attention to the chemical structure and effects of these drugs on bone and will provide the latest recommendations to avoid potential sequelae.