Does the quality of orthodontic studies influence their Altmetric Attention Score?

OBJECTIVE The aim of this study was to determine whether an association between study quality, other study characteristics, and Altmetric Attention Scores (AASs) existed in orthodontic studies. METHODS The Scopus database was searched to identify orthodontic studies published between January 1, 2017, and December 31, 2019. Articles that satisfied the eligibility criteria were included in this study. Study characteristics, including study quality were extracted and entered into a pre-pilot data collection sheet. Descriptive statistics were calculated. On an exploratory basis, random forest and gradient boosting machine learning algorithms were used to examine the influence of article characteristics on AAS. RESULTS In total, 586 studies with an AAS were analyzed. Overall, the mean AAS of the samples was 5. Twitter was the most popular social media platform for publicizing studies, accounting for 53.7%. In terms of study quality, only 19.1% of the studies were rated as having a high level of quality, with 41.8% of the studies deemed moderate quality. The type of social media platform, number of citations, impact factor, and study type were among the most influential characteristics of AAS in both models. In contrast, study quality was one of the least influential characteristics on the AAS. CONCLUSIONS Social media platforms contributed the most to the AAS for orthodontic studies, whereas study quality had little impact on the AAS

Clinical evaluation of marketed and non-marketed orthodontic products: are researchers now ahead of the times? A meta-epidemiological study.

BACKGROUND The advertisement and adoption of untested orthodontic products is common. This study aimed to provide an update regarding the prevalence of clinical trials in orthodontics evaluating commercially marketed products. Associations between marketed/non-marketed products and study characteristics such as direction of effect, declaration of conflict of interest and industry sponsorship were evaluated. In addition, within the marketed products associations between direction of effect and study characteristics were explored. MATERIAL AND METHODS Electronic searching of a single database (Medline via PubMed) was undertaken to identify Randomized controlled trials (RCTs) published over a 5-year period (1st January 2017 to 31st December 2021). Descriptive statistics and associations between trial characteristics were explored. RESULTS 196 RCTs were analysed. RCTs were frequently published in Angle Orthodontist (18.4%), American Journal of Orthodontics and Dentofacial Orthopedics (14.8%) and European Journal of Orthodontics (13.3%). 65.3% (128/196) of trials assessed marketed products after their introduction. The majority of trials assessed interventions to improve treatment efficiency (33.7%). Growth modification appliances were typically analysed in non-marketed compared to marketed products. An association between the type of product (marketed vs non-marketed) and both the declaration of conflict of interest and industry sponsorship was detected. For individual RCTs assessing marketed products either a positive effect (45.3%) or equivalence between interventions or between intervention and untreated control (47.7%) was evident. In 27% of these trials either no conflict of interest or industry funding was not clearly declared. Within the marketed products, no association between the direction of the effect and conflict of interest or funding was detected. CONCLUSIONS The analysis of marketed orthodontic products after their introduction is still common practice. To reduce research waste, collaboration prior to the licensing and marketing of orthodontic products between researchers, industry and manufacturers is recommended

Do we get better outcomes from early treatment of Class III discrepancies

Early orthodontic treatment in the mixed dentition aims to simplify definitive treatment in the permanent dentition. In Class III cases, this can be an effective strategy for the management of a local anterior crossbite, using either a removable or simple fixed appliance. For more significant Class III malocclusions, the decision to intervene early is a more difficult one. Traditionally, orthodontists in the UK have been reluctant to embark on early treatment in the presence of a skeletal Class III relationship but there is now some evidence that in selected cases, the use of protraction headgear can be a successful method of avoiding the need for later surgery. Although growth prediction in Class III cases is notoriously difficult, in the presence of maxillary retrognathia, the general dental practitioner should consider early referral of Class III cases to a specialist orthodontist

Should we recommend early overjet reduction to prevent dental trauma

There is an association between increased overjet and risk of trauma to the maxillary incisor teeth in children and adolescents. It would therefore seem sensible to recommend overjet reduction as early as possible to help reduce this risk. However, orthodontic outcomes are essentially the same whether you start treatment in the early or late mixed dentition, while early treatment carries a heavier burden on compliance - taking longer and involving more appointments. This article explores the complex association between early overjet reduction and dental trauma in the context of current best evidence. Careful case selection is advised when justifying early intervention for increased overjet based on reducing trauma risk

What are the differences in protective characteristics of orthodontic mouthguards? An in vitro study

BACKGROUND Orthodontic patients wearing fixed appliances are susceptible to traumatic dental injuries during contact-sport. This laboratory study investigated the protective qualities of orthodontic mouthguards using impact-testing to a typodont fitted with a fixed appliance through peak load transfer and retention of the mouthguard. METHODS Seven orthodontic mouthguards [three custom-made (Medium-CM, Heavy-CM, Heavy-pro-CM); three commercially-available mouth-formed (Shock-Doctor® Ultra Braces, Opro® Ortho-Gold Braces, Opro® Ortho-Bronze Braces) and a Shock-Doctor® Instant-Fit] were fitted to a maxillary arch typodont bonded with a fixed appliance and impact-tested using 0.5 or 1 Joule (J) energy via hockey-ball, cricket-ball or steel-ball projectile. A load-cell recorded peak load transfer through mouthguard to typodont with retention scored in a binary manner dependent upon any displacement following impact. Differences across mouthguards were calculated with ANOVA or Kruskal-Wallis test for normal and non-normal data, respectively. Post hoc comparisons across mouthguards were conducted via Dunnett's test with Sidak correction. RESULTS Only the three custom-made and Opro® Ortho-Gold Braces were not displaced by impact-testing. For these, Opro® Ortho-Gold Braces transferred the smallest load for 3/6 impact-tests, followed by Medium-CM. Heavy-pro-CM performed poorly, ranking penultimate or worst for all impact-tests. Significant differences were found between mouthguards for cricket-ball and steel-ball set-ups. The Opro® Ortho-Gold Braces performed better than the Heavy and Heavy-pro-CM for 0.5 J cricket-ball impact-test (P < 0.05), whilst Medium-CM performed better than Heavy-pro-CM. For 1 J cricket-ball, there were significant differences between Medium-CM and Heavy-pro-CM (P < 0.05). For 0.5 J steel-ball, the Medium-CM performed significantly better than both Heavy-pro-CM and Opro® Ortho-Gold Braces (P < 0.05), whilst Heavy-CM performed better than the Heavy-pro-CM (P < 0.05). For the 1 J steel-ball, Medium and Heavy-CM performed better than Opro® Ortho-Gold Braces (P < 0.05). CONCLUSIONS Opro® Ortho-Gold and Medium-CM mouthguards offer the best protection for low-impact sports, whilst Medium or Heavy-CM mouthguards are recommended for high-impact sport

Do we get better outcomes from early treatment of Class III discrepancies?

Early orthodontic treatment in the mixed dentition aims to simplify definitive treatment in the permanent dentition. In Class III cases, this can be an effective strategy for the management of a local anterior crossbite, using either a removable or simple fixed appliance. For more significant Class III malocclusions, the decision to intervene early is a more difficult one. Traditionally, orthodontists in the UK have been reluctant to embark on early treatment in the presence of a skeletal Class III relationship but there is now some evidence that in selected cases, the use of protraction headgear can be a successful method of avoiding the need for later surgery. Although growth prediction in Class III cases is notoriously difficult, in the presence of maxillary retrognathia, the general dental practitioner should consider early referral of Class III cases to a specialist orthodontist

The quality and content of websites in the UK advertising aligner therapy: are standards being met?

Aims To evaluate the quality of information and compliance with General Dental Council (GDC) ethical advertising guidelines for English-language orthodontic websites providing orthodontic treatment with aligners in the United Kingdom (UK).Materials and methods The term 'orthodontic aligners or braces' was entered into the Google online search engine. The first 100 English language orthodontic websites (practice or company) were pooled. Both the quality (DISCERN instrument) and compliance with GDC ethical advertising guidelines were assessed. Frequency distributions and the overall summative DISCERN score for each website were calculated.Results The overall mean DISCERN score was 42.9 (SD = 9.4). The quality of information was only rated as good-excellent for 16% of websites and only 11% of websites showed full compliance with GDC guidelines on ethical advertising. A link to the GDC/authority website (75%), the date when the website was last updated (72%), and the practice complaints policy (66%) were not commonly provided. The country of qualification, a statement of whether practices provide NHS or private treatment or a combination of both, and the date when the website was last updated, were significant predictors for the overall quality based on DISCERN score.Conclusions The quality of information provided on websites providing aligner therapy and their compliance with GDC guidelines on ethical advertising was suboptimal. An improvement in both areas is required

Mapping cellular processes in the mesenchyme during palatal development in the absence of Tbx1 reveals complex proliferation changes and perturbed cell packing and polarity

The 22q11 deletion syndromes represent a spectrum of overlapping conditions including cardiac defects and craniofacial malformations. Amongst the craniofacial anomalies that are seen, cleft of the secondary palate is a common feature. Haploinsufficiency of TBX1 is believed to be a major contributor toward many of the developmental structural anomalies that occur in these syndromes, and targeted deletion of Tbx1 in the mouse reproduces many of these malformations, including cleft palate. However, the cellular basis of this defect is only poorly understood. Here, palatal development in the absence of Tbx1 has been analysed, focusing on cellular properties within the whole mesenchymal volume of the palatal shelves. Novel image analyses and data presentation tools were applied to quantify cell proliferation rates, including regions of elevated as well as reduced proliferation, and cell packing in the mesenchyme. Also, cell orientations (nucleus–Golgi axis) were mapped as a potential marker of directional cell movement. Proliferation differed only subtly between wild‐type and mutant until embryonic day (E)15.5 when proliferation in the mutant was significantly lower. Tbx1 (−/−) palatal shelves had slightly different cell packing than wild‐type, somewhat lower before elevation and higher at E15.5 when the wild‐type palate has elevated and fused. Cell orientation is biased towards the shelf distal edge in the mid‐palate of wild‐type embryos but is essentially random in the Tbx1 (−/−) mutant shelves, suggesting that polarised processes such as directed cell rearrangement might be causal for the cleft phenotype. The implications of these findings in the context of further understanding Tbx1 function during palatogenesis and of these methods for the more general analysis of genotype–phenotype functional relationships are discussed

An investigation into the reliability of a mobile app designed to assess orthodontic treatment need and severity.

Aim To investigate reliability of the Easy IOTN app between clinicians with different levels of experience in determining Index of Orthodontic Treatment Need (IOTN) Dental Health Component (DHC) and Aesthetic Component (AC) scores from study models. The accuracy of each clinician in discriminating treatment need using the app against the 'gold standard' conventional assessment at the threshold of treatment acceptance criteria was also explored.Materials and methods In total, 150 sets of pre-treatment study models were assessed by six clinicians using the app on two separate occasions (T1 and T2). A single IOTN-calibrated clinician also scored the models using the conventional technique. Clinician scores for both intra- and inter-rater reliability were assessed using Cohen's Kappa. The performance of each clinician in discriminating treatment need using the app against the conventional assessment method at the threshold of treatment acceptance criteria was also assessed using the area under the curve-receiver operating characteristic.Results The intra-rater agreement for the clinician undertaking the conventional assessment of the models was 1.0. Intra-rater agreement scores for clinicians using the Easy IOTN app ranged between 0.37-0.87 (DHC) and 0.22-0.44 (AC). Inter-rater agreement scores at T2 were 0.59 (DHC) and 0.23 (AC). Based on the IOTN DHC, all clinicians displayed an excellent level of accuracy in determining malocclusions qualifying for treatment (range 81.7-90.0%). Based on the IOTN AC, all clinicians showed an acceptable level of accuracy in determining malocclusions qualifying for treatment (range 71.9-79.2%).Conclusions The Easy IOTN app was shown to have moderate inter-rater reliability. Variation in the intra-rater reliability was evident between clinicians of different grades/level of experience. Importantly, the diagnostic accuracy of the app to discriminate between malocclusions that qualify for NHS treatment was rated as excellent (IOTN DHC) and acceptable (IOTN AC) and independent of clinician grade or level of experience