Management of patients with non-syndromic clefts of the lip and/or palate Part 2:from primary surgery to alveolar bone grafting

Part 1 of this series of articles addressed the care of the child with a cleft of the lip and/or palate from antenatal diagnosis until primary surgery. The second part of this article discusses their care from primary surgery until alveolar bone grafting. Clinical Relevance: Dentists should be aware of the different types of cleft lip and/or palate that occur and the role of the dentist in the overall management of patients who have clefts. </jats:p

Management of patients with non-syndromic clefts of the lip and/or palate Part 1:from antenatal diagnosis to primary surgery

Patients with clefts of the lip and/or palate require input from a diverse group of medical, surgical, dental and parasurgical specialties working as part of a multidisciplinary team in the UK. Co-ordinated care ensures that the patient receives optimal treatment whilst minimizing the burden of care for the NHS and family. The primary care dentist has an important role in the overall management of patients with clefts. Because the dentist-patient/parent relationship is of a long-term nature, the primary care dentist can also provide useful support and advice for families as they progress through the care pathway. This three-part article will illustrate the integration of dentistry with the other aspects of care. Clinical Relevance: Dentists should be aware of the different types of cleft lip and/or palate that occur and the role of the dentist in the overall management of patients who have clefts. </jats:p

How much incisor decompensation is achieved prior to orthognathic surgery?

Objectives: To quantify incisor decompensation in preparation for orthognathic surgery. Study design: Pre-treatment and pre-surgery lateral cephalograms for 86 patients who had combined orthodontic and orthognathic treatment were digitised using OPAL 2.1 [http://www.opalimage.co.uk]. To assess intra-observer reproducibility, 25 images were re-digitised one month later. Random and systematic error were assessed using the Dahlberg formula and a two-sample t-test, respectively. Differences in the proportions of cases where the maxillary (110 0 +/- 6 0 ) or mandibular (90 0 +/- 6 0 ) incisors were fully decomensated were assessed using a Chi-square test (p<0.05). Mann-Whitney U tests were used to identify if there were any differences in the amount of net decompen - sation for maxillary and mandibular incisors between the Class II combined and Class III groups (p<0.05). Results: Random and systematic error were less than 0.5 degrees and p<0.05, respectively. A greater proportion of cases had decompensated mandibular incisors (80%) than maxillary incisors (62%) and this difference was statis - tically significant (p=0.029). The amount of maxillary incisor decompensation in the Class II and Class III groups did not statistically differ (p=0.45) whereas the mandibular incisors in the Class III group underwent statistically significantly greater decompensation (p=0.02). Conclusions: Mandibular incisors were decompensated for a greater proportion of cases than maxillary incisors in preparation for orthognathic surgery. There was no difference in the amount of maxillary incisor decompensation between Class II and Class III cases. There was a greater net decompensation for mandibular incisors in Class III cases when compared to Class II cases

Different methods of canine retraction-Part 2

Background: This review aims to discuss various canine retraction techniques using frictionless mechanics. Methods: Between 1930 and February 2022, searches were conducted about various canine retraction techniques using fixed orthodontic appliances in various databases, including PubMed Central, Science Direct, Wiley Online Library, the Cochrane Library, Textbooks, Google Scholar, Research Gate, and manual searching. Results: After removing the duplicate articles, publications that described how to use archwires to perform canine retraction with the archwires were included. Conclusions: The pros and cons of various canine retraction techniques using archwires were thoroughly discussed. T-loop is the preferred spring of all because of its characteristics.</p

Different methods of canine retraction-Part 2

Background: This review aims to discuss various canine retraction techniques using frictionless mechanics. Methods: Between 1930 and February 2022, searches were conducted about various canine retraction techniques using fixed orthodontic appliances in various databases, including PubMed Central, Science Direct, Wiley Online Library, the Cochrane Library, Textbooks, Google Scholar, Research Gate, and manual searching. Results: After removing the duplicate articles, publications that described how to use archwires to perform canine retraction with the archwires were included. Conclusions: The pros and cons of various canine retraction techniques using archwires were thoroughly discussed. T-loop is the preferred spring of all because of its characteristics.</p