Occlusal outcomes in combined orthodontic and orthognathic treatment

OBJECTIVE: To investigate the treatment outcome in terms of the malocclusion features and the changes in the occlusion of patients undergoing orthodontic/orthognathic treatment using the Peer Assessment Rating (PAR) and the Index of Complexity, Outcome and Need (ICON) and to test the application of the Index of Orthognathic Functional Treatment Need (IOFTN) on this sample as a measure of orthognathic pre-treatment need. DESIGN: Retrospective longitudinal cohort study. SETTING: The orthodontic department at the Eastman Dental Hospital. MATERIAL AND METHODS: The study models of a sample of 100 orthodontic/orthognathic patients who were treated at the Eastman Dental Hospital were measured using the PAR index and ICON at three stages: pre-treatment, pre-surgery and at debond. Treatment need was assessed by measuring IOTN and IOFTN using start study models. RESULTS: 99% of the sample showed an improvement in PAR score, with 82% of the sample being greatly improved. ICON showed that 95% of the sample had an improvement of different degrees with 5% being not improved or worse. The IOFTN qualified 97% of the patients for orthognathic treatment when used retrospectively on the sample while the DHC of IOTN qualified the whole sample for orthodontic treatment. CONCLUSIONS: Orthodontic/orthognathic treatment showed improved and acceptable overall results. The PAR index and ICON were valid measures to investigate the outcome of orthognathic treatment. IOFTN proved to be a useful tool in determining and prioritizing orthognathic treatment based purely on functional need

Novel scaffolds for tissue engineering of human skeletal muscles

Tissue engineering is a multidisciplinary approach aimed at producing new organs and tissues for implantation in order to circumvent the limitations imposed by current techniques such as surgical tissue transfer. Structure begets function and highly ordered skeletal muscle (SkM) consists of elongated, multinucleate muscle cells (fibres) that are arranged in bundles surrounded by connective tissue sheaths. It is therefore of no surprise that tissue engineered SkM complexes are often designed around fibre containing scaffolds. This work is the natural continuation of strategies introduced at TCES 200

National British Orthodontic Society (BOS) Orthognathic Audit 2017-2018

OBJECTIVE: To carry out a UK national clinical audit of orthognathic acceptance criteria and information provided to orthognathic patients before treatment. DESIGN: National clinical audit. SETTING: Data collected using Bristol Online Surveys. PARTICIPANTS: Sixty-nine UK hospital orthodontic departments submitted data. METHODS: Data were collected at two time points using Bristol Online Surveys over a period of 12 months. These were before treatment at the first multidisciplinary clinic (MDT) and immediately after surgery. The data collected included: Index of Orthognathic Functional Treatment Need (IOFTN); Index of Orthodontic Treatment Need (IOTN); age; previous orthodontic treatment; attendance at an MDT; treatment times; and information provision. RESULTS: Eighty-five units agreed to take part in the audit with 69 submitting data, giving a response rate of 81%. The data from 3404 patients were uploaded, 2263 before treatment and 1141 immediately after surgery. Of patients, 91.07% had an IOFTN score of 4 or 5 and 88.73% had an IOTN score of 4 or 5. The mean age at the first MDT was 22 years in the first cohort and 21 years and 4 months in the second immediate post-surgery cohort. Of patients, 37.93% had undergone some form of previous orthodontic treatment, but only 0.28% had undergone previous orthognathic treatment; 96.93% had an MDT confirm that orthodontic treatment by itself was insufficient to adequately correct their functional symptoms. The average treatment time from bond up to surgery was 2 years and 6 months. With respect to information provision, patients received information from a number of sources, principally the British Orthodontic Society (BOS) patient information leaflets and the BOS website Your Jaw Surgery. CONCLUSIONS: In the UK, the majority of orthognathic cases fulfil the criteria for acceptance for NHS-funded orthognathic treatment, as outlined by the Chief Dental Officer's interim guidance on orthognathic treatment. This suggests any prior approval process would not be a good use of NHS resources in the commissioning of orthognathic treatment

Engineered craniofacial muscle constructs express markers of muscle differentiation

Tissue engineering has the potential to serve as an alternative to surgical tissue transfer for the management of soft tissue defects. The perceived advantages include reduced donor site morbidity and restoration of function and aesthetics to ideal. Degradable scaffolds are utilised in the early stages of cell growth and development with the advantage of eventual elimination to leave space for the engineered tissue and a reduced chance of rejection

National BOS Orthognathic Audit 2017-2018

Objective; To carry out a UK national clinical audit of orthognathic acceptance criteria and information provided to orthognathic patients prior to treatment. / Design; National clinical audit. / Setting; Data collected using Bristol Online Surveys (BOS). / Participants; 69 UK hospital orthodontic departments submitted data. / Methods; Data was collected at two time points using BOS over a period of 12 months. These were prior to treatment at the first multidisciplinary clinic (MDT), and immediately post-surgery. The data collected included: IOFTN, IOTN, age, previous orthodontic treatment, attendance at an MDT, treatment times and information provision. / Results; 85 units agreed to take part in the audit with 69 submitting data, giving a response rate of 81%. The data from 3404 patients were uploaded, 2263 prior to treatment and 1141 immediately post-surgery. 91.07% of patients had an IOFTN score of 4 or 5 and 88.73% had an IOTN score of 4 or 5. The mean age at the first MDT was 22yr in the first cohort, and 21yr and 4mo in the second immediate post-surgery cohort. 37.93% of patients had undergone some form of previous orthodontic treatment, but only 0.28% had undergone previous orthognathic treatment. 96.93% had a multidisciplinary team confirm that orthodontic treatment by itself was insufficient to adequately correct their functional symptoms. The average treatment time from bond up to surgery was 2yr and 6mo. With respect to information provision, patients received information from a number of sources, principally the BOS patient information leaflets and the BOS website Your Jaw Surgery. / Conclusions; In the UK, the majority of orthognathic cases fulfil the criteria for acceptance for NHS funded orthognathic treatment, as outlined by the Chief Dental Officer’s interim guidance on orthognathic treatment. This suggests any prior approval process would not be a good use of NHS resources in the commissioning of orthognathic treatment

Defining the Properties of an Array of -NH2-Modified Substrates for the Induction of a Mature Osteoblast/Osteocyte Phenotype from a Primary Human Osteoblast Population Using Controlled Nanotopography and Surface Chemistry

Accelerating the integration of a joint replacement or the healing of a bone fracture, particularly a complicated non-union fracture, would improve patient welfare and decrease healthcare costs. Currently, an autologous bone graft is the gold standard method for the treatment of complicated non-union fractures, but it is not always possible to harvest such a graft. A proactive highly inductive so-called smart material approach is pertinent in these cases. In this study, the surface chemistry of a previously approved material with desirable bulk material properties was modified to investigate its potential as an economical and effective alternative. The objective was to create stable synthetic chemical coatings that could guide cells along the osteogenic lineage required to generate mineralised tissue that would induce and accelerate bone healing. Primary human osteoblast-like cells were cultured in vitro for 7, 14 and 28 days on amine-terminated (chain length in the range 3–11) silane-modified glass surfaces with controlled nanotopography, to determine how surface chemistry and nanotopography change osteoblast function. The materials were characterised using atomic force microscopy (AFM), scanning electron microscopy (SEM), water contact angle (WCA) and a novel ninhydrin assay. The cells were analysed using qRT-PCR, von Kossa tinctural staining for mineralisation, and visualised using both transmitted white light and electron microscopy. Bone-like nodules, quantified using microscopy, only formed on the short-chain (chain length 3 and 4) amines after 7 days, as did the up-regulation of sclerostin, suggestive of a more mature osteoblast phenotype. In this paper, we report more rapid nodule formation than has previously been observed, without the addition of exogenous factors in the culture medium. This suggests that the coating would improve the integration of implants with bone or be the basis of a smart biomaterial that would accelerate the bone regeneration process