Orthodontic Specialists Research Articles

Exploring the Clinical Disconnect in Integrated Treatment Pathways for Craniofacial Structural and Functional Anomalies: Collaboration Challenges between Orthopaedic Surgeons, Paediatricians and General Practitioners Referring to Orthodontists

Abstract Introduction: Orthodontic problems extend beyond mere tooth ailments, affecting overall bodily health. Neglecting them can result in severe illnesses, reducing quality of life and lifespan. Physicians must educate patients about the link between orthodontic health and general well-being, stressing the importance of treating dental issues to restore both oral health and smiles. Materials and Methods: This cross-sectional investigation included orthopaedic surgeons, paediatricians and general practitioners working in the government and private sectors. Knowledge, attitude and practice surveys were used for the study. Our analysis included 25 clinicians (n = 75) from each speciality. Results: Among the 25 paediatricians surveyed, only 52% (13) are referring patients to orthodontists, as indicated in the study. Of the 25 general physicians included in the survey, merely 12% (03) are sending patients to orthodontists, with the remaining 88% not making any referrals. Similarly, among the 25 orthopaedic surgeons surveyed, 52% (13) refer patients to orthodontists, while the rest do not refer to orthodontic specialists. Conclusion: A multidisciplinary approach is crucial in bridging the clinical gap among paediatricians, general physicians, orthopaedic surgeons and orthodontists. Integrated care models, through specialised clinics, provide comprehensive evaluations and patient treatment plans. Care coordination mechanisms such as joint consultations and shared decision-making platforms facilitate seamless communication among healthcare providers and empower patients in their care. Continuing education and technological advancements enhance collaboration, fostering teamwork and improving patient outcomes.

Comparison of two-dimensional Grummons’ analysis and three-dimensional asymmetry index measurement in diagnosis of dentocraniofacial asymmetry

Background Dentocraniofacial asymmetry is a common condition that affects many individuals. Accurate diagnosis of this condition is essential for effective treatment planning. Aim This study aimed to compare the diagnosis of dentocraniofacial asymmetry using two-dimensional and three-dimensional methods. Methods A cross-sectional, observational study was conducted at the Orthodontic Specialist Clinic of the Dental Hospital Faculty of Dentistry, University of Indonesia from March to April 2023. The study included 15 patients who had not undergone orthodontic treatment and were diagnosed with dentocraniofacial asymmetry. The study compared the results of diagnosing asymmetry in 15 different facial features, including the anterior nasal spine, upper and lower first incisors, pterygomaxillary fissure, orbita, menton, porion, upper and lower first molars, coronoid process, gonion, zygoma, latero nasale, and jugulare. Results The study found that there was no significant difference in the diagnosis of dentocraniofacial symmetry between the two- and three-dimensional methods across all 15 parameters measured. The researchers used Fisher's Exact Test to compare the proportion between dependent variables and found that the p-value was greater than 0.05, indicating that there was no significant difference in the diagnosis of dentocraniofacial symmetry between the two methods. The study also used Kappa Cohen analysis to measure the strength of agreement between the diagnosis of dentocraniofacial symmetry of the two-dimensional and three-dimensional methods on each parameter. Conclusion The findings of this study suggest that both two-dimensional and three-dimensional methods are equally effective in diagnosing dentocraniofacial asymmetry. This information may be useful for orthodontists in deciding which method to use when diagnosing dentocraniofacial asymmetry.

Characteristic Features of Bimaxillary Proclination: A 5-Year Review in Najran, a Saudi Arabian Sub-population.

Background Bimaxillary proclination (BP) has been described as a clinical condition depicted by proclined upper and lower incisors with an amplified lip incompetence. The current study aimed to investigate the prevalence and characteristic features of bimaxillary proclination in Najran. Methods This was a retrospective study to appraise bimaxillary proclination in an orthodontic specialist clinic and research complex in Najran, Saudi Arabia from January 2018 to December 2022. Patients requesting orthodontic treatment for malocclusion were evaluated. Data retrieved include: age, gender, presence of bimaxillary proclination, and facial profile of affected patients. IBM SPSS Statistics for IOS Version 25 (Armonk, NY: IBM Corp) was used for analysis. Results were presented as simple frequencies and descriptive statistics. Results Three hundred and twenty-six (326) patients sought treatment for different types of malocclusion out of which 277 (84.9%) had bimaxillary proclination. There were 123 (44.4%) males and 154 (55.6%) females with an M:F ratio of 1:1.3. Age ranged from 6 to 55 years with a mean SD of 22.6 ± 8.98. More females had bimaxillary proclination. The majority of the patients with bimaxillary proclination had convex facial profiles and a Class I relationship(241 (73.9%) and (135 (48.7%)), respectively. Conclusion Bimaxillary proclination is a common orthodontic health issue with high prevalence in the Najran region. Female preponderance was observed. Most of the patients have a Class I Angle's relationship.

Knowledge and Awareness on Aligner Treatment Protocol Among General Dentists, and Non Orthodontic Specialists: A Questionnaire study

The general dental practitioners and other non-orthodontic specialists can play the role of orthodontic health educators. Dentists have the responsibility to recognize, diagnose, and manage or refer abnormalities in the developing dentition. Hence for proper counseling and referral, general dentists and non-orthodontic specialists must have adequate level of orthodontic knowledge. Aim and objective: This study aims to determine and evaluate the knowledge and attitude of general dentists and non-orthodontic specialists towards early orthodontic treatment. The objective of the study was to assess the knowledge of orthodontic treatment among general dentists and non-orthodontic specialists and to compare the knowledge of orthodontic treatment between the two groups. Material and methods: 308 dental professionals were included in the study. The participants were divided into three groups; Group I included general practitioners, Group II had non-orthodontic postgraduate students, and Group III had non- orthodontic specialists. The questionnaire included 20 closed-ended, multiple choice questions. The first five questions include; general information such as gender, age, educational qualification, years of clinical experience and attachment to educational institutions. The next fifteen questions depict the attitude and awareness of principles and practices in orthodontics. Results: The study highlights the need for better education for treatment concepts in aligner therapy to the general dentist and non-orthodontic specialist. Conclusion: Conduction of Continuing Education programs to update them regularly in newer treatment protocols might be of great help to the practitioners in providing meticulous care to their patients. Overall, clear aligners have revolutionized orthodontic treatment by offering improved aesthetics, patient acceptance, and quality of life.

Knowledge and Awareness of the orthodontic triage and its uses among dental healthcare professionals – a cross-sectional study

IntroductionIn orthodontics, the triage system is used to assess the preadolescents to rule out interventions needed earlier and to assess the nature of orthodontic problems as complex or moderate. The objective of this study was to determine the knowledge and awareness of orthodontic triage and its uses among dental healthcare professionals (DHCP).Materials and methodsA triage awareness questionnaire (TAQ) was formulated and validated as reliable by a panel of five orthodontic specialists which was then circulated online among 400 DHCP. The questionnaire consisted of nine sections that assessed the current knowledge and usage of orthodontic triage among the dental community. Frequencies and percentages were reported for all categorical variables. Chi-square was used to assess the association among the variables.ResultsThe response rate was 28.2% with the majority of participants being general dentists. Regarding the knowledge and use of triage, 40% of DHCP were only familiar with the word “orthodontic triage” while being unaware of how it works and 79% denied using orthodontic triage. Regarding the management of anomalies, 42% of DHCP preferred extraction as the management of supernumerary teeth (p = 0.013). Practitioners belonging to private setups performed visual inspection in growing patients for assessment of their facial features (p = 0.012). Clinicians with more than one year of experience referred young patients to orthodontic specialists for the management of crossbite (p = 0.024). Younger clinicians (25–35 years) with more than one year of experience referred adult patients to orthodontists for correction of their unesthetic smile (p = 0.013).ConclusionsThis paper provides foundational data for the development of future policies and protocols supporting structured, evidence-based approaches to patient management via use of orthodontic triage. This study underscores the importance of targeted educational interventions to enhance understanding and implementation of orthodontic triage principles in clinical practice. Further probing is necessary to discern the disparity between understanding the orthodontic triage and effective employment of its components among practicing dental healthcare professionals.

Flipped classroom orthodontic education for undergraduate dental students: A factor analysis study.

Dental schools have a primary responsibility to devise a curriculum that enhances students' confidence and knowledge in orthodontic case analysis. This study aims to compare the confidence levels and performance of undergraduate students in orthodontic case screening, moderated by faculty in a lecture-based format against their self-analysis of the same cases 1 year later, using a case-based and flipped learning approach. This study involved 100 fifth-year students. The same group received predoctoral orthodontics training through an instructor-centered, didactic approach in their fifth year and a case-based, student-centered, flipped classroom approach in their sixth year. At the end of each semester, the students completed an orthodontic case analysis and a self-reflection survey. This study found no significant differences in diagnostic capabilities for orthodontic findings between the two methods studied. However, the self-evaluation survey data revealed an increase in students' confidence levels. This was specifically in terms of carrying out independent orthodontic case diagnosis, effectively communicating with orthodontic specialists, and their comfort in approaching orthodontic cases following the flipped classroom approach. Despite increased confidence in case diagnosis, the results showed that final-year students are uncertain about creating initial treatment plans and referring cases at an early stage. Despite no observed improvement in students' orthodontic diagnostic abilities after another semester of student-centered learning, their confidence in diagnosing orthodontic cases was notably enhanced.

Clinical Management of Facemasks for Early Treatment of Class III Malocclusion: A Survey among SIDO Members.

To evaluate whether there are differences among orthodontists in the clinical management of facemask treatment for early treatment of Class III malocclusion, a survey consisting of 16 questions was conducted among members of the Italian Society of Orthodontics (SIDO). Sixty percent of the respondents were Specialists in Orthodontics (S) whereas 40% were General Dentists practicing Orthodontics (GD). Descriptive statistics were calculated to summarize the collected data. Differences in answers between S and GD were assessed with the Fisher's exact test for dichotomous variables, chi-square test for qualitative variables, and Mann-Whitney test for ordinal variables. A total of 151 clinicians participated in this survey. As for treatment timing, about 80% of the participants reported treating Class III patients with RPE and facemask between 5 and 8 years of age. Most of the participants requested the patients to wear the facemask in the afternoon and at night for a period of 9 or 12 months with recommended forces of 500 g per side. Comparisons between S and GD showed that S preferred the Petit facemask whereas GD favored the Delaire's type facemask (Fisher's Exact test, p = 0.0005). S and GD also differed significantly in their judgment of the most critical time of treatment, which for the majority of GD was the initial period but for the S was the final period (Chi-square test p = 0.0188). This survey showed that the facemask is not well received by the patients who, along with their parents, express concerns regarding its tolerability.

Comparison of two-dimensional Grummons’ analysis and three-dimensional asymmetry index measurement in diagnosis of dentocraniofacial asymmetry

Background Dentocraniofacial asymmetry is a common condition that affects many individuals. Accurate diagnosis of this condition is essential for effective treatment planning. Aim This study aimed to compare the diagnosis of dentocraniofacial asymmetry using two-dimensional and three-dimensional methods. Methods A cross-sectional, observational study was conducted at the Orthodontic Specialist Clinic of the Dental Hospital Faculty of Dentistry, University of Indonesia from March to April 2023. The study included 15 patients who had not undergone orthodontic treatment and were diagnosed with dentocraniofacial asymmetry. The study compared the results of diagnosing asymmetry in 15 different facial features, including the anterior nasal spine, upper and lower first incisors, pterygomaxillary fissure, orbita, menton, porion, upper and lower first molars, coronoid process, gonion, zygoma, latero nasale, and jugulare. Results The study found that there was no significant difference in the diagnosis of dentocraniofacial symmetry between the two- and three-dimensional methods across all 15 parameters measured. The researchers used Fisher's Exact Test to compare the proportion between dependent variables and found that the p-value was greater than 0.05, indicating that there was no significant difference in the diagnosis of dentocraniofacial symmetry between the two methods. The study also used Kappa Cohen analysis to measure the strength of agreement between the diagnosis of dentocraniofacial symmetry of the two-dimensional and three-dimensional methods on each parameter. Conclusion The findings of this study suggest that both two-dimensional and three-dimensional methods are equally effective in diagnosing dentocraniofacial asymmetry. This information may be useful for orthodontists in deciding which method to use when diagnosing dentocraniofacial asymmetry.

Management of orthodontically induced white spot lesions: A survey of the orthodontic practitioners of Pakistan.

To assess the level of awareness among orthodontic practitioners about the diagnosis and management of orthodontically induced white spot lesions. The cross-sectional study was conducted from August 28, 2022, to March 3, 2023, at Bakhtawar Amin Medical and Dental College, Multan, and comprised orthodontic specialists and postgraduate residents. Data was collected using a 14-item questionnaire regarding diagnosis and management of orthodontically induced white spot lesions. The questionnaire was disseminated online, and the responses were compared between the groups. Data was analysed using SPSS 24. Of the 278 subjects, 205(73.7%) were residents; 156(75%) females and 49(24%) males with mean professional experience of 4.24±4.08 years. There were 73(26.3%) specialists; 44(60.3%) females and 29(39.7%) males with mean professional experience 9.07±4.85 years. There were 48(66%) specialists and 131(64%) residents who thought the most commonly affected teeth with WSL were maxillary central incisors, while 30(41%) specialists and 38(33%) residents said the least commonly affected tooth was maxillary canine. Among the specialists, 29(38%) considered halting treatment and regular follow-up as the best approach for managing white spot lesions detected during orthodontic treatment, while 76(37%) residents preferred to use fluorides and casein phosphopeptide-amorphous calcium phosphate. There were significant differences between the specialists and residents for the items related to the incidence of white spot lesions, timing for additional precautions and measures for detection, management during active treatment and modalities of prevention (p<0.05). Despite being fairly common in orthodontic patients, the awareness regarding white spot lesions and related management protocols was found to be dubious in orthodontic practitioners, depicting lack of a standardised protocol.

The performance of artificial intelligence models in generating responses to general orthodontic questions: ChatGPT vs Google Bard

This study aimed to evaluate and compare the performance of 2 artificial intelligence (AI) models, Chat Generative Pretrained Transformer-3.5 (ChatGPT-3.5; OpenAI, San Francisco, Calif) and Google Bidirectional Encoder Representations from Transformers (Google Bard; Bard Experiment, Google, Mountain View, Calif), in terms of response accuracy, completeness, generation time, and response length when answering general orthodontic questions. A team of orthodontic specialists developed a set of 100 questions in 10 orthodontic domains. One author submitted the questions to both ChatGPT and Google Bard. The AI-generated responses from both models were randomly assigned into 2 forms and sent to 5 blinded and independent assessors. The quality of AI-generated responses was evaluated using a newly developed tool for accuracy of information and completeness. In addition, response generation time and length were recorded. The accuracy and completeness of responses were high in both AI models. The median accuracy score was 9 (interquartile range [IQR]: 8-9) for ChatGPT and 8 (IQR: 8-9) for Google Bard (Median difference: 1; P<0.001). The median completeness score was similar in both models, with 8 (IQR: 8-9) for ChatGPT and 8 (IQR: 7-9) for Google Bard. The odds of accuracy and completeness were higher by 31% and 23% in ChatGPT than in Google Bard. Google Bard's response generation time was significantly shorter than that of ChatGPT by 10.4 second/question. However, both models were similar in terms of response length generation. Both ChatGPT and Google Bard generated responses were rated with a high level of accuracy and completeness to the posed general orthodontic questions. However, acquiring answers was generally faster using the Google Bard model.

Orthodontists on Social Media: Instagram's Influence.

The aim of this study was to determine how orthodontists utilize the social media application Instagram for health communication. Four Turkish keywords were manually searched on the Instagram platform on February 12, 2022: "orthodontist" (ortodontist), "orthodontics" (ortodonti), "orthodontic specialist" (ortodonti uzmanı), and "doctor of orthodontist" (ortodonti doktoru). A total of 195 orthodontist accounts matching the inclusion criteria were divided into two groups: public and private. Profile information analyses were performed, and the results for public and private accounts were compared. Public accounts were further divided by gender and whether they shared a company name in their profiles. Groups were compared according to post content and type of patient photo. Statistical analysis involved the Shapiro-Wilk test, an Independent Samples t-test, the Mann-Whitney U test, and chi-square and Kappa tests. The number of posts (96.06±149.30 vs. 195.36±248.51) and followers (1,250.56±2,347.47 vs. 4,071.43±6,557.63) were higher for public accounts. The number of followers (3,171.62±4,645.08 vs. 5,472.57±8,595.99) and daily posts (0.17±0.37 vs. 0.23±0.43) were higher for accounts with a company name. In the content analysis, posts on clear aligners (1.51±4.74 vs. 6.60±18.60, p<0.05) and patient and company advertisements were more common (0.49±1.85 vs. 3.70±10.70, p<0.05) for accounts with a company name. While public orthodontist accounts commonly promote fixed mechanics as a treatment option, accounts with a company name adopt a different approach, emphasizing the sharing of information about clear aligners.

Investigating the Effective Factors on the Acceptance of Teleorthodontic Technology Based on the Technology Acceptance Model 3 (TAM3).

Health information technology is used in dentistry worldwide. Despite the limited specialized resources for providing orthodontic treatment in Iran, the need to examine the technology acceptance model (TAM) seems necessary and is a significant step in the successful acceptance of teleorthodontic technology. The present study has identified and investigated the factors affecting the acceptance of teleorthodontic technology among orthodontists based on the TAM3 with the aim of successful implementation and deployment of this technology. In this descriptive-analytical research, 300 Iranian orthodontists who were members of the Iranian Orthodontic Association were selected by census sampling. The data was gathered through a modified and accommodated questionnaire called the acceptance model 3. The validity was confirmed. Moreover, the reliability was calculated based on Cronbach's alpha, which was equal to 0.870. Multiple linear regression analysis was also utilized to investigate the relationships between dependent, independent, and mediator variables. Besides, the final model was designed by the Amos software. The results of 251 orthodontic specialists proved that subjective norm, job relevance, output quality, results in demonstrability, and job relevance on output quality could significantly affect perceived usefulness. Similarly, the perception of external control was identified to have a significant influence on perceived ease of use. On the other hand, the perceived usefulness does not play a mediating role between perception and subjective norm. Furthermore, perceived usefulness was confirmed as a mediating factor in relationship to both perceived ease of use and behavioral intention. The findings of the present study revealed valuable scientific evidence to identify and apply the key factors affecting the acceptance and use of modern teleorthodontic technology in Iran. Besides, the structure of the TAM3 was recognized as fruitful and worthwhile for predicting the acceptance of this new technology and also in identifying key effective factors.

The concept of AI-assisted self-monitoring for skeletal malocclusion.

Background: Skeletal malocclusion is common among populations. Its severity often increases during adolescence, yet it is frequently overlooked. The introduction of deep learning in stomatology has opened a new avenue for self-health management. Methods: In this study, networks were trained using lateral photographs of 2109 newly diagnosed patients. The performance of the models was thoroughly evaluated using various metrics, such as sensitivity, specificity, accuracy, confusion matrix analysis, the receiver operating characteristic curve, and the area under the curve value. Heat maps were generated to further interpret the models' decisions. A comparative analysis was performed to assess the proposed models against the expert judgment of orthodontic specialists. Results: The modified models reached an impressive average accuracy of 84.50% (78.73%-88.87%), with both sex and developmental stage information contributing to the AI system's enhanced performance. The heat maps effectively highlighted the distinct characteristics of skeletal class II and III malocclusion in specific regions. In contrast, the specialist achieved a mean accuracy of 71.89% (65.25%-77.64%). Conclusions: Deep learning appears to be a promising tool for assisting in the screening of skeletal malocclusion. It provides valuable insights for expanding the use of AI in self-monitoring and early detection within a family environment.

Perception of treatments with self-ligating and conventional brackets in peruvian orthodontists.

Orthodontists' perception of bracket techniques plays a significant role in planning, allowing critical evaluation of the patient's facial aesthetics. To compare the perception of Peruvian orthodontists regarding treatments with self-ligating and conventional brackets. A questionnaire was applied to 168 orthodontic specialists (53% men, average professional experience 9 years) to evaluate preferences for treatment phases, benefits of patient consultation according to the type of bracket, experience with self-ligating brackets, and demographic and clinical characteristics (sex, years of experience, volume of care and length of experience). The Kruskal-Wallis Test and Chi-square test were used with P < 0.05. The total preference for self-ligating brackets (48.9%) was higher than conventional brackets (18.8%). Self-ligating brackets were preferred in most treatment phases (46.4%-63.7%) but not in completion and finishing, in which conventional brackets were preferred. Most orthodontists preferred self-ligating brackets (40.5%-60.7%) over conventional brackets (4.2%-14.3%) due to patient comfort, oral hygiene, and total treatment and appointment time control, but not the cost. The orthodontists reported SLB having mastered their technique in <10 cases (59.5%), the experience of <2 years (45.2%), applying control times of 4-9 weeks (78.6%), and feeling comfortable with their use (89.3%). Preferences were not associated with sex (P > 0.05) but rather with years of professional experience (P < 0.05). Peruvian orthodontists preferred self-ligating brackets over conventional brackets in most treatment phases associated with user comfort and oral hygiene management and treatment/control time, and professional experience. However, some factors, such as cost-effectiveness, counteracted this preference.

Survey of National Health Service (NHS) orthodontic practitioners in Wales, UK. Part 2: job satisfaction perceptions of the workforce 2021-2022.

To ascertain the perceptions of the Welsh NHS orthodontic workforce regarding their job satisfaction and work life balance. Descriptive cross-sectional survey. Clinicians providing NHS orthodontic treatment in Wales. An anonymised, email-distributed, electronic, two-part survey (onlinesurveys.ac.uk) of the Welsh NHS orthodontic workforce working within Wales was undertaken. The survey consisted of three sections: (1) demographic information (part 1); (2) respondents' working pattern (part 1); and (3) perceptions of professional job satisfaction and work/life balance (part 2). The responses received were exported into an Excel spreadsheet for descriptive analysis. The free-text comments were collated for each question and subsequently underwent a content analysis to identify any common themes. Part 2 of the survey yielded an overall response rate of 69.6% (n = 78). Over 96% (n = 75) of respondents felt that they had 'made the right career choice, including 100% of orthodontic trainees, orthodontic specialists and orthodontic consultants. Of the respondents, 88.5% (n = 69) said they 'enjoyed going to work', with the remaining being mostly neutral in their opinion. Of the respondents, 79.5% (n = 62) felt they were able to 'provide their patients the optimum care' and 64.1% (n = 50) felt that more demands were being placed upon them by patients and parents. Overall, 52.6% (n = 41) of survey respondents believed it was becoming increasingly difficult to achieve an effective work/life balance, and this was more prevalent among male respondents (61.5%, n = 16) than female respondents (48.1%, n = 25), although this difference was not statistically significant (P >0.05). Over 96% of respondents felt they have chosen the right career and that flexibility and a good working environment are important to job satisfaction. Respondents felt that there are increasing demands being placed upon them by patients/parents, employers, the Regulators, the Government and Health Boards. This is leading to increased difficulty in achieving a satisfactory work/life balance, especially among male respondents.

Orthodontic patient’s perspectives, attitudes, and readiness toward teleorthodontics

Abstract Aim: To evaluate the perspective, attitude, and readiness of orthodontic patients toward teleorthodontics. Materials and Methods: This prospective study was conducted at an orthodontic specialist clinic, Kulliyyah of Dentistry, Kuantan Pahang, Malaysia, involving all 46 orthodontic patients requiring active orthodontic treatment from February to July 2021. Patients were offered four options of online consultation: telephone call, virtual meeting, WhatsApp messaging, and a combination of all three methods. An online survey was distributed after the online consultations to assess patients’ perspectives, attitudes, and readiness toward teleorthodontics. Descriptive statistics were used to summarize the demographic data. Mann–Whitney U test and Kruskal–Wallis test were used to compare the patient’s perspectives, attitudes, and readiness toward teleorthodontics based on their demographic background. A Spearman’s correlation coefficient looked at the linear relationship between the perspective, attitude, and readiness toward teleorthodontics practice. Results: About 82.4% agreed that teleorthodontics was convenient. About 82% agreed that teleorthodontics should be practiced during the pandemic and 72% agreed that it should be practiced after the pandemic. About 89.1% agreed that teleorthodontics bring benefits during the pandemic, and 74% agreed that teleorthodontics might bring benefits after the pandemic. No significant difference was found between sociodemographic background with the total scores of patients’ perspectives, readiness, and attitude toward teleorthodontics. Conclusions: The majority of the patients showed good perspective, attitude, and readiness toward teleorthodontics. Teleorthodontics on certain clinical procedures can be implemented postpandemic to reduce in-office orthodontic visits.

Initial development of an 'Orthodontic Care Index' involving treatment need,-complexity and-priority.

The aim of this study was to develop an evidence-based scoring system for prioritizing limited orthodontic resources based on orthodontic treatment need (OTN), orthodontic treatment complexity (OTC), and orthodontic treatment priority (OTP), which is not merely a scoring system for malocclusion but also a comprehensive classification of orthodontic issues incorporating patient- and treatment-related factors, called Orthodontic Care Index (OCI). The development of the OCI involved eight phases, starting with a systematic literature review to identify all possible parameters involved in determining OTN, OTC, and OTP. An eight-member orthodontic specialist panel then evaluated and scored the significance of each parameter, resulting in a parameter-score list. Subsequently, a retrospective convenience sample of 61 patients was scored with the parameter-score list, and using the same convenience sample a gold standard was established through the expert opinion of a third orthodontic panel. Linear regression analysis was used to estimate weights of importance and construct a formula to calculate index scores. Lastly, the expert opinion was compared to the index scores, to determine the index performance. The preliminary index separately calculates OTN, OTC, and OTP for a patient as the weighted sum of his/her domain scores. The sensitivity of the index for predicting OTN, OTC, and OTP was high (98.1%, 82.9%, and 92.7% respectively), while the variability of each was relatively low (52.1%, 31.2%, and 52.6% respectively). The OCI shows promise as a guideline for prioritizing orthodontic care. It will be further refined and validated to enhance its performance and usefulness.

Concordancia del espesor óseo vestibular a nivel del Punto A entre Telerradiografía y Tomografía computarizada de haz cónico

Objective: The aim of this study was to determine the concordance of the vestibular bone thickness measured at the level of point A between Teleradiography and Cone Beam Computed Tomography (CBCT). Materials and Methods: This study consisted of a cross-sectional analytical design of concordance that evaluated the teleradiographies and CBCTs of 32 patients. The measurements were performed by three evaluators, specialists in orthodontics. Two of them measured the CBCTs and one evaluated the teleradiographs. The concordance of both tests was determined using the Concordance Correlation Coefficient. Results: When evaluating the value of the vestibular bone thickness at the level of point A between the CBCT and the teleradiography, it was observed that the mean value of the absolute difference between the two was 0.95±0.74, 95%CI [0.68–1.22], being statistically significant (p=0.0027). When the concordance between both tests was analyzed, it was observed that it was poor (CCC=0.204 95%CI [0.014–0.394]), although statistically significant (p&lt;0.00001). Conclusions: It was possible to conclude that there is no concordance in the measurement of the vestibular bone thickness at the level of Point A between the Teleradiography and the CBCT. Keywords: Cone-beam computed tomography; Orthodontics; Cephalometry; Incisor; Patients; Cross-sectional studies

Awareness and usage of mobile applications as an orthodontic diagnostic tool among Croatian orthodontic clinicians.

To assess the impact of gender and orthodontic qualification length on the awareness, knowledge and usage of orthodontic diagnostic mobile applications, non-diagnostic mobile applications and social media platforms among orthodontic clinicians. Cross-sectional questionnaire-based study. The Republic of Croatia. A total of 92 orthodontic specialists, members of the Croatian Dental Chamber. This study was conducted using a questionnaire distributed via email to orthodontic clinicians between May and July 2022. In total, 92 respondents were divided into groups according to sex and median orthodontic qualification length: more recently qualified (MRQ) with ⩽12 years; and longer qualified (LQ) with >12 years. Nearly one-third of respondents did not have any prior knowledge of mobile applications used as an orthodontic diagnostic tool. MRQ respondents were more interested in using mobile apps as opposed to computer software for digital analysis (P < 0.05). This interest was in a negative correlation with orthodontic qualification length (P < 0.01) and was more prevalent among female respondents (P < 0.001). About one-third (32.6%) of respondents did not use non-diagnostic mobile applications and 44.6% did not use social media platforms. Nearly two-thirds (62%) of the respondents did not promote their work through social media. Male respondents and LQ promoted their work more frequently than others (P < 0.05). The usage of other mobile applications was in a positive correlation with the knowledge and awareness of orthodontic mobile applications (P < 0.05). Orthodontic clinicians lacked knowledge, awareness and the usage of orthodontic diagnostic mobile applications according to sex and orthodontic qualification length. One-third used non-diagnostic mobile applications and less than half used social platforms in daily clinical work.

Assessing dentists’ awareness of the orthodontic–restorative interface

ObjectivesAwareness of the interface between restorative and orthodontic treatments is essential for dentists to facilitate a meaningful interdisciplinary approach by integrating the knowledge and skills of different dental disciplines into patients’ treatment to enhance outcomes. The aim of this study was to investigate General Dental Practitioners’ (GDPs) awareness of the orthodontic–restorative interface. MethodsThis was a mixed-method study involving the collection of a) quantitative data via a bespoke online questionnaire and b) qualitative data through open questions. A weblink was created to the questionnaire using Opinio®. The questionnaire was distributed to GDPs practising in the UK. Clinical vignette-based questions assessed GDPs awareness and the results were categorised into two groups: aware and unaware. Two months after the primary survey, respondents were sent an email with follow-up (reliability) survey. Reliability responses were compared against the primary responses to assess the repeatability using intraclass correlation coefficient. Data were analysed using independent t-test and X2 test. Results118 complete responses were received. 63 GDPs (53.4 % [95 % CI 44 %–63 %]) demonstrated a good understanding of the orthodontic–restorative interface. These GDPs were characterised by greater age (t = 2.75, p = 0.007) and experience (t = 3.54, p < 0.001). Qualitative data showed that respondents perceived orthodontic-restorative treatments as minimally invasive and aesthetics enhancing. ConclusionsOrthodontic-restorative treatment aids in minimal invasive dentistry. GDPs lack adequate awareness of the orthodontic–restorative interface in relation to patient care and communication with patients. More quality and structured undergraduate and postgraduate training are imperative to facilitate GDPs to understand and utilise aspects of orthodontic-restorative treatments to raise the standard of patient care. Additionally, to support these patients, the educational pathway between GDPs and specialist orthodontists is crucial. Clinical SignificanceGDPs ability to assess and carry out orthodontic-restorative treatments would conserve natural teeth. Dependable access to orthodontic services would encourage GDPs to refer challenging cases to specialists or dentists with enhanced skills. When the circumstances call for it, patients should be given orthodontic-restorative alternatives, regardless of the potential consequences of their acceptance of the procedures.