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

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

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

Prevalence and nature of bullying in schoolchildren aged 10–14 years and its association with malocclusion: A cross-sectional study in the South East of the UK

Objective: To investigate the prevalence of, and relationship between, bullying and malocclusion in schoolchildren aged 10–14 years in the South East of the UK. Design: Cross-sectional cohort study. Setting: Sixteen primary and secondary schools in South East of the UK. Participants: Schoolchildren aged 10–14 years who were consented to participate. Methods: The prevalence and nature of bullying were measured using a questionnaire. Traits of malocclusion and the need for orthodontic treatment was assessed by clinical examination and determined by the Index of Orthodontic Treatment Need (IOTN) Dental Health (DHC) and Aesthetic components (AC). Results: Complete data were collected for 698 participants. The number defined as being bullied was 68 (9.7%). There was no difference in the prevalence of bullying between gender, ethnicity or age. Higher rates of bullying were reported in mixed sex schools ( P = 0.03). Participants with an increased overjet ( P = 0.02) and/or a greater need for treatment, as measured by IOTN DHC ( P = 0.01) and AC ( P = 0.01), reported higher rates of bullying. While there was no difference in the overall prevalence of bullying between genders, boys were more likely than girls to experience physical bullying ( P <0.001) and being called names ( P = 0.03) Conclusion: A significant relationship was evident between being bullied and certain traits of malocclusion

Designing a suite of measurements to understand the critical zone

Many scientists have begun to refer to the earth surface environment from the upper canopy to the depths of bedrock as the critical zone (CZ). Identification of the CZ as an integral object worthy of study implicitly posits that the study of the whole earth surface will provide benefits that do not arise when studying the individual parts. To study the CZ, however, requires prioritizing among the measurements that can be made – and we do not generally agree on the priorities. Currently, the Susquehanna Shale Hills Critical Zone Observatory (SSHCZO) is expanding from a small original focus area (0.08 km2 , Shale Hills catchment), to a larger watershed (164 km2 , Shavers Creek watershed) and is grappling with the prioritization. This effort is an expansion from a monolithologic first-order forested catchment to a watershed that encompasses several lithologies (shale, sandstone, limestone) and land use types (forest, agriculture). The goal of the project remains the same: to understand water, energy, gas, solute, and sediment (WEGSS) fluxes that are occurring today in the context of the record of those fluxes over geologic time as recorded in soil profiles, the sedimentary record, and landscape morphology. Given the small size of the Shale Hills catchment, the original design incorporated measurement of as many parameters as possible at high temporal and spatial density. In the larger Shavers Creek watershed, however, we must focus the measurements. We describe a strategy of data collection and modeling based on a geomorphological and land use framework that builds on the hillslope as the basic unit. Interpolation and extrapolation beyond specific sites relies on geophysical surveying, remote sensing, geomorphic analysis, the study of natural integrators such as streams, groundwaters or air, and application of a suite of CZ models. We hypothesize that measurements of a few important variables at strategic locations within a geomorphological framework will allow development of predictive models of CZ behavior. In turn, the measurements and models will reveal how the larger watershed will respond to perturbations both now and into the future

Study protocol for the management of impacted maxillary central incisors: a multicentre randomised clinical trial: the iMAC Trial

BACKGROUND Failure of eruption of the maxillary permanent incisor teeth usually presents in the mixed dentition between the ages of 7 and 9 years. Missing and unerupted maxillary incisors can be regarded as unattractive and have a potentially negative impact on facial and dental aesthetics. The presence of a supernumerary tooth (or odontoma) is commonly responsible for failed eruption or impaction of the permanent maxillary incisors. The primary objective of this trial is to investigate the success of eruption associated with maxillary incisor teeth that have failed to erupt because of a supernumerary tooth in the anterior maxilla. METHODS This protocol describes an interventional multicentre two-arm randomised clinical trial. Participants meeting the eligibility criteria will be randomised (unrestricted equal participant allocation [1:1]) to either space creation with an orthodontic appliance, removal of the supernumerary tooth and application of direct orthodontic traction or space creation with an orthodontic appliance, removal of the supernumerary tooth and monitoring. The primary outcome of this trial is to determine the prevalence of successfully erupted maxillary central permanent incisors at 6 months following removal of the supernumerary tooth. Secondary outcome measures include (1) the effect of initial tooth position (assessed radiographically) on time taken for the tooth to erupt, (2) time taken to align the unerupted tooth to the correct occlusal position, (3) gingival aesthetics and (4) changes in the self-reported Oral Health Related-Quality of Life (OHRQoL) (pre-and post-treatment). DISCUSSION There is a lack of high-quality robust prospective studies comparing the effectiveness of interventions to manage this condition. Furthermore, the UK national clinical guidelines have highlighted a lack of definitive treatment protocols for the management of children who present with an unerupted maxillary incisor due to the presence of a supernumerary tooth. The results of this trial will inform future treatment guidelines for the management of this condition in young children. TRIAL REGISTRATION ISRCTN Registry ISRCTN12709966 . Registered on 16 June 2022

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts

Handbook of orthodontics / by Martyn T. Cobourne, Andrew T. DiBiase.

Includes bibliographical references and index.427 p.

Orthodontic clinicians' attitudes and knowledge of dentogingival aesthetics: A cross-sectional survey of BOS members.

OBJECTIVE To assess orthodontic clinicians' knowledge and attitudes towards dentogingival aesthetics and to explore characteristics that predict the knowledge of dentogingival aesthetics. DESIGN Cross-sectional questionnaire. SETTING On-line survey of members of the British Orthdontic Society. MATERIALS AND METHODS An 11-item online questionnaire was sent to orthodontic practitioners for completion. The questionnaire covered respondent demographics and questions relating to both knowledge and attitudes towards dentogingival aesthetics (six parameters). Descriptive statistics were calculated for study characteristics and summary values for the survey items. Responses to the eight knowledge-based questions were converted to a binary outcome (correct and incorrect answer). The maximum score that could be achieved was eight. Multivariable modelling was used in order to examine associations between the study characteristics and the aggregate score. RESULTS A total of 252 responses were obtained resulting in a response rate of 17%. Within this cohort, the respondents were primarily women (52.8%) and aged 30-40 years (35.7%). The mean score for the eight knowledge-based questions was 3.8 ± 1.8 (range = 0-8). Knowledge of the ideal gingival margin position of the anterior teeth was high (92.4%). Knowledge of the other five dentogingival aesthetic parameters was variable. In the multivariable analysis, lower knowledge scores were predicated by respondents who did not have a special interest in dental aesthetics (-0.54; 95% confidence interval [CI] = -1.01 to -0.07; P = 0.02), who could not recall attending courses, lectures or seminars on dental aesthetics in the past five years (-0.80; 95% CI = -1.43 to -0.17; P = 0.01) and with increasing age (-0.43; 95% CI = -0.62 to -0.23; P < 0.001). CONCLUSION Knowledge of ideal dentogingival parameters is generally suboptimal among orthodontists in the UK. The reported lack of knowledge of the ideal dentogingival parameters may also influence respondents' attitudes towards the importance of dentogingival aesthetics. Further teaching or courses related to dentogingival aesthetics is desired by orthodontic clinicians

Hanbook of Orthodontics

viii, 571 Halaman.; 21 c