The validity and reliability of an automated method of scoring dental arch relationships in unilateral cleft lip and palate using the modified Huddart-Bodenham scoring system

Objective: To evaluate an automated software tool for the assessment of dental arch relationships using the modified Huddart and Bodenham index. Design: Cohort of 43 models of subjects aged 9-21 with UCLP and the ten GOSLON reference models sets. Method: The 53 sets of plaster models were scored using the MHB index and scanned (R700, 3Shape, Copenhagen, Denmark). The digital models were MHB scored visually (Orthoanalyzer, 3Shape, Copenhagen, Denmark) and landmarked for automatic scoring using a Rhino software plug-in (Rhinoceros, version 5, www.rhino3d.co.uk). Scoring/landmarking was undertaken by three observers and repeated after one month. Intra- and inter-observer reproducibility were tested using Cronbach’s Alpha and intraclass correlation coefficients (ICC) (threshold > 0.9). Bland-Altman plots demonstrated inter-observer agreement for each model format. Random and systematic error with digital landmark identification error were determined using the x, y and z co-ordinates for 28 models digitized twice one month apart using Cronbach’s alpha and a t-test, respectively. Results: Intra-operator landmark identification was excellent (Cronbach’s alpha = 0.933) with no differences between sessions (P>0.05). Intra-observer reproducibility was excellent for all examiners (Cronbach’s alpha and ICC 0.986-0.988). Inter-observer reproducibility was highest for the software plug-in (0.991), followed by plaster (0.989) and Orthoanalyzer (0.979) and Bland-Altman plots confirmed no systematic bias and greater consistency of scores with the automated software. Conclusion: The automated MHB software tool is valid, reproducible and the most objective method of assessing maxillary arch constriction for patients with UCLP

Finding H.O.P.E. in Orthodontic simulated training

The global pandemic significantly impacted most areas of the dental profession. Limitations on treatment, footfall in clinical and university centres and social distancing affected our ability to provide patient care and clinical training. This article details how custom 3D-printed training tools were used to mitigate some of the constraints affecting our established simulated orthodontic clinical skills course. The development of the training tools, structure of the course and potential future implications are discussed

Cleft lip and palate in Scotland : a survey

The aim of the survey was to assess midwives' experiences and knowledge of cleft lip and/or palate (CL+/-P), confidence in supporting the families and giving feeding advice, and to identify areas for input from the cleft team. In order to do so, questionnaires were sent to maternity units across Scotland. The results were as follows: 206 questionnaires were returned (42 per cent response rate). Forty one per cent of the midwives had helped a baby with CL+/-P to be born; 23 per cent knew the incidence of CL+/-P; 33 per cent were aware of the stages in treating CL+/- P; 99 per cent were aware that feeding difficulties are a potential complication. When asked about offering support to the families, 70 per cent were not confident and 60 per cent were not confident at giving feeding advice. Regarding cleft team input, 65 per cent would like a training day, 45 per cent requested small group teaching, 50 per cent would like a website and 57 per cent would like printed literature. Our recommendations are to implement training, for midwives, along with supporting websites and literature

War Narratives: Framing Our Understanding of the War on Terror

Unlike past American wars, the current war on terror has not been associated with a centrally proffered narrative providing some guidance and orientation for those administering government services under state-of-war conditions. War is as much a cultural endeavor as it is a military undertaking, and the absence of a clear sensemaking narrative was detected in this study of public administrators from three agencies with varying proximity to the conflict. Q-methodology was used to explore the way individuals processed the war narratives put forth by the Bush administration and reported in the media immediately following the September 11 attacks. Though no distinct state-of-war narratives were found among the public administrators in this study, there are clear indications that latent narratives reflecting local political and organizational task environments have emerged